Understanding Risk Tolerance and Building an Effective Safety Culture

NASA Technical Reports Server (NTRS)

Loyd, David

2018-01-01

Estimates range from 65-90 percent of catastrophic mishaps are due to human error. NASA's human factors-related mishaps causes are estimated at approximately 75 percent. As much as we'd like to error-proof our work environment, even the most automated and complex technical endeavors require human interaction... and are vulnerable to human frailty. Industry and government are focusing not only on human factors integration into hazardous work environments, but also looking for practical approaches to cultivating a strong Safety Culture that diminishes risk. Industry and government organizations have recognized the value of monitoring leading indicators to identify potential risk vulnerabilities. NASA has adapted this approach to assess risk controls associated with hazardous, critical, and complex facilities. NASA's facility risk assessments integrate commercial loss control, OSHA (Occupational Safety and Health Administration) Process Safety, API (American Petroleum Institute) Performance Indicator Standard, and NASA Operational Readiness Inspection concepts to identify risk control vulnerabilities.

Human factors in airway facilities maintenance : development of a prototype outage assessment inventory.

DOT National Transportation Integrated Search

1994-02-01

The airway facilities (AF) maintenance community is concerned with identifying ways of reducing both the incidence of equipment failure and the amount of time required to restore equipment to operational status following a failure. It is vitally impo...

Human factors in waste management - potential and reality

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

Thompson, J.S.

There is enormous potential for human factors contributions in the realm of waste management. The reality, however, is very different from the potential. This is particularly true for low-level and low-level mixed-waste management. The hazards are less severe; therefore, health and safety requirements (including human factors) are not as rigorous as for high-level waste. High-level waste management presents its own unique challenges and opportunities. Waste management is strongly driven by regulatory compliance. When regulations are flexible and open to interpretation and the environment is driven so strongly by regulatory compliance, standard practice is to drop {open_quotes}nice to have{close_quotes} features, likemore » a human factors program, to save money for complying with other requirements. The challenge is to convince decision makers that human factors can help make operations efficient and cost-effective, as well as improving safety and complying with regulations. A human factors program should not be viewed as competing with compliance efforts; in fact, it should complement them and provide additional cost-effective means of achieving compliance with other regulations. Achieving this synergy of human factors with ongoing waste management operations requires educating program and facility managers and other technical specialists about human factors and demonstrating its value {open_quotes}through the back door{close_quotes} on existing efforts. This paper describes ongoing projects at Los Alamos National Laboratory (LANL) in support of their waste management groups. It includes lessons learned from hazard and risk analyses, safety analysis reports, job and task analyses, operating procedure development, personnel qualification/certification program development, and facility- and job-specific training program and course development.« less

Human Factors Research Under Ground-Based and Space Conditions. Part 1

NASA Technical Reports Server (NTRS)

1997-01-01

Session TP2 includes short reports concerning: (1) Human Factors Engineering of the International space Station Human Research Facility; (2) Structured Methods for Identifying and Correcting Potential Human Errors in Space operation; (3) An Improved Procedure for Selecting Astronauts for Extended Space Missions; (4) The NASA Performance Assessment Workstation: Cognitive Performance During Head-Down Bedrest; (5) Cognitive Performance Aboard the Life and Microgravity Spacelab; and (6) Psychophysiological Reactivity Under MIR-Simulation and Real Micro-G.

NASA and Me

NASA Technical Reports Server (NTRS)

Wong, Douglas T.

2010-01-01

Topics in this student project report include: biography, NASA history and structure, overview of Johnson Space Center facilities and major projects, and an overview of the Usability Testing and Analysis Facility (UTAF). The UTAF section slides include space habitat evaluations with mockups, crew space vehicle evaluations, and human factors research.

Human performance models for computer-aided engineering

NASA Technical Reports Server (NTRS)

Elkind, Jerome I. (Editor); Card, Stuart K. (Editor); Hochberg, Julian (Editor); Huey, Beverly Messick (Editor)

1989-01-01

This report discusses a topic important to the field of computational human factors: models of human performance and their use in computer-based engineering facilities for the design of complex systems. It focuses on a particular human factors design problem -- the design of cockpit systems for advanced helicopters -- and on a particular aspect of human performance -- vision and related cognitive functions. By focusing in this way, the authors were able to address the selected topics in some depth and develop findings and recommendations that they believe have application to many other aspects of human performance and to other design domains.

Natural and anthropogenic factors affecting the shallow groundwater quality in a typical irrigation area with reclaimed water, North China Plain.

PubMed

Gu, Xiaomin; Xiao, Yong; Yin, Shiyang; Pan, Xingyao; Niu, Yong; Shao, Jingli; Cui, Yali; Zhang, Qiulan; Hao, Qichen

2017-09-22

In this study, the hydrochemical characteristics of shallow groundwater were analyzed to get insight into the factors affecting groundwater quality in a typical agricultural dominated area of the North China Plain. Forty-four shallow groundwater samples were collected for chemical analysis. The water type changes from Ca·Na-HCO 3 type in grass land to Ca·Na-Cl (+NO 3 ) type and Na (Ca)-Cl (+NO 3 +SO 4 ) type in construction and facility agricultural land, indicating the influence of human activities. The factor analysis and geostatistical analysis revealed that the two major factors contributing to the groundwater hydrochemical compositions were the water-rock interaction and contamination from sewage discharge and agricultural fertilizers. The major ions (F, HCO 3 ) and trace element (As) in the shallow groundwater represented the natural origin, while the nitrate and sulfate concentrations were related to the application of fertilizer and sewage discharge in the facility agricultural area, which was mainly affected by the human activities. The values of pH, total dissolved solids, electric conductivity, and conventional component (K, Ca, Na, Mg, Cl) in shallow groundwater increased from grass land and cultivated land, to construction land and to facility agriculture which were originated from the combination sources of natural processes (e.g., water-rock interaction) and human activities (e.g., domestic effluents). The study indicated that both natural processes and human activities had influences on the groundwater hydrochemical compositions in shallow groundwater, while anthropogenic processes had more contribution, especially in the reclaimed water irrigation area.

Human factors engineering in oil and gas--a review of industry guidance.

PubMed

Robb, Martin; Miller, Gerald

2012-01-01

Oil and gas exploration and production activities are carried out in hazardous environments in many parts of the world. Recent events in the Gulf of Mexico highlight those risks and underline the importance of considering human factors during facility design. Ergonomic factors such as machinery design, facility and accommodation layout and the organization of work activities have been systematically considered over the past twenty years on a limited number of offshore facility design projects to a) minimize the occupational risks to personnel, b) support operations and maintenance tasks and c) improve personnel wellbeing. During this period, several regulators and industry bodies such as the American Bureau of Shipping (ABS), the American Society of Testing and Materials (ASTM), the UK's Health and Safety Executive (HSE), Oil and Gas Producers (OGP), and Norway's Petroleum Safety Authority (PSA) have developed specific HFE design standards and guidance documents for the application of Human Factors Engineering (HFE) to the design and operation of Oil and Gas projects. However, despite the existence of these guidance and recommended design practise documents, and documented proof of their value in enhancing crew safety and efficiency, HFE is still not well understood across the industry and application across projects is inconsistent. This paper summarizes the key Oil and Gas industry bodies' HFE guidance documents, identifies recurring themes and current trends in the use of these standards, provides examples of where and how these HFE standards have been used on past major offshore facility design projects, and suggests criteria for selecting the appropriate HFE strategy and tasks for future major oil and gas projects. It also provides a short history of the application of HFE to the offshore industry, beginning with the use of ASTM F 1166 to a major operator's Deepwater Gulf of Mexico facility in 1990 and the application of HFE to diverse world regions. This latter point highlights the need to consider user populations when selecting HFE design criteria, an aspect strongly emphasized in current industry guidance.

Tents and Shelters

DTIC Science & Technology

2010-07-15

Electromagnetic Interference ( EMI ), Transportability, Environmental, Human Factors Engineering (HFE), Reliability, Availability and Maintainability (RAM), and...vehicles and trailers to store, protect, and secure equipment, tools, and other theft-prone items. CBCs are designed not to interfere with the carrier’s...Transportability Test Facility. d. Electromagnetic Interference ( EMI ) Test Facility. e. Areas capable of conducting Blackout, Sound, Sand and Dust tests

Evaluation of vision training using 3D play game

NASA Astrophysics Data System (ADS)

Kim, Jung-Ho; Kwon, Soon-Chul; Son, Kwang-Chul; Lee, Seung-Hyun

2015-03-01

The present study aimed to examine the effect of the vision training, which is a benefit of watching 3D video images (3D video shooting game in this study), focusing on its accommodative facility and vergence facility. Both facilities, which are the scales used to measure human visual performance, are very important factors for man in leading comfortable and easy life. This study was conducted on 30 participants in their 20s through 30s (19 males and 11 females at 24.53 ± 2.94 years), who can watch 3D video images and play 3D game. Their accommodative and vergence facility were measured before and after they watched 2D and 3D game. It turned out that their accommodative facility improved after they played both 2D and 3D games and more improved right after they played 3D game than 2D game. Likewise, their vergence facility was proved to improve after they played both 2D and 3D games and more improved soon after they played 3D game than 2D game. In addition, it was demonstrated that their accommodative facility improved to greater extent than their vergence facility. While studies have been so far conducted on the adverse effects of 3D contents, from the perspective of human factor, on the imbalance of visual accommodation and convergence, the present study is expected to broaden the applicable scope of 3D contents by utilizing the visual benefit of 3D contents for vision training.

42 CFR 59a.12 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS NATIONAL LIBRARY OF MEDICINE GRANTS... professionally integrated region. Factors considered are location and extent of communication facilities and...). Secretary means the Secretary of Health and Human Services and any other official of the Department of...

Human factors dimensions in the evolution of increasingly automated control rooms for near-earth satellites

NASA Technical Reports Server (NTRS)

Mitchell, C. M.

1982-01-01

The NASA-Goddard Space Flight Center is responsible for the control and ground support for all of NASA's unmanned near-earth satellites. Traditionally, each satellite had its own dedicated mission operations room. In the mid-seventies, an integration of some of these dedicated facilities was begun with the primary objective to reduce costs. In this connection, the Multi-Satellite Operations Control Center (MSOCC) was designed. MSOCC represents currently a labor intensive operation. Recently, Goddard has become increasingly aware of human factors and human-machine interface issues. A summary is provided of some of the attempts to apply human factors considerations in the design of command and control environments. Current and future activities with respect to human factors and systems design are discussed, giving attention to the allocation of tasks between human and computer, and the interface for the human-computer dialogue.

An Illumination Modeling System for Human Factors Analyses

NASA Technical Reports Server (NTRS)

Huynh, Thong; Maida, James C.; Bond, Robert L. (Technical Monitor)

2002-01-01

Seeing is critical to human performance. Lighting is critical for seeing. Therefore, lighting is critical to human performance. This is common sense, and here on earth, it is easily taken for granted. However, on orbit, because the sun will rise or set every 45 minutes on average, humans working in space must cope with extremely dynamic lighting conditions. Contrast conditions of harsh shadowing and glare is also severe. The prediction of lighting conditions for critical operations is essential. Crew training can factor lighting into the lesson plans when necessary. Mission planners can determine whether low-light video cameras are required or whether additional luminaires need to be flown. The optimization of the quantity and quality of light is needed because of the effects on crew safety, on electrical power and on equipment maintainability. To address all of these issues, an illumination modeling system has been developed by the Graphics Research and Analyses Facility (GRAF) and Lighting Environment Test Facility (LETF) in the Space Human Factors Laboratory at NASA Johnson Space Center. The system uses physically based ray tracing software (Radiance) developed at Lawrence Berkeley Laboratories, a human factors oriented geometric modeling system (PLAID) and an extensive database of humans and environments. Material reflectivity properties of major surfaces and critical surfaces are measured using a gonio-reflectometer. Luminaires (lights) are measured for beam spread distribution, color and intensity. Video camera performances are measured for color and light sensitivity. 3D geometric models of humans and the environment are combined with the material and light models to form a system capable of predicting lighting conditions and visibility conditions in space.

Contextual factors as a key to understanding the heterogeneity of effects of a maternal health policy in Burkina Faso?

PubMed Central

Belaid, Loubna; Ridde, Valéry

2015-01-01

Burkina Faso implemented a national subsidy for emergency obstetric and neonatal care (EmONC) covering 80% of the cost of normal childbirth in public health facilities. The objective was to increase coverage of facility-based deliveries. After implementation of the EmONC policy, coverage increased across the country, but disparities were observed between districts and between primary healthcare centres (PHC). To understand the variation in coverage, we assessed the contextual factors and the implementation of EmONC in six PHCs in a district. We conducted a contrasted multiple case study. We interviewed women (n = 71), traditional birth attendants (n = 7), clinic management committees (n = 11), and health workers and district health managers (n = 26). Focus groups (n = 62) were conducted within communities. Observations were carried out in the six PHCs. Implementation was nearly homogeneous in the six PHCs but the contexts and human factors appeared to explain the variations observed on the coverage of facility-based deliveries. In the PHCs of Nogo and Tara, the immediate increase in coverage was attributed to health workers’ leadership in creatively promoting facility-based deliveries and strengthening relationships of trust with communities, users’ positive perceptions of quality of care and the arrival of female professional staff. The change of healthcare team at Iata’s PHC and a penalty fee imposed for home births in Belem may have caused the delayed effects there. Finally, the unchanged coverage in the PHCs of Fati and Mata was likely due to lack of promotion of facility-based deliveries, users’ negative perceptions of quality of care, and conflicts between health workers and users. Before implementation, decision-makers should perform pilot studies to adapt policies according to contexts and human factors. PMID:24633914

Human factors in spacecraft design

NASA Technical Reports Server (NTRS)

Harrison, Albert A.; Connors, Mary M.

1990-01-01

This paper describes some of the salient implications of evolving mission parameters for spacecraft design. Among the requirements for future spacecraft are new, higher standards of living, increased support of human productivity, and greater accommodation of physical and cultural variability. Design issues include volumetric allowances, architecture and layouts, closed life support systems, health maintenance systems, recreational facilities, automation, privacy, and decor. An understanding of behavioral responses to design elements is a precondition for critical design decisions. Human factors research results must be taken into account early in the course of the design process.

42 CFR 488.404 - Factors to be considered in selecting remedies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES... the one deficiency to other deficiencies resulting in noncompliance. (2) The facility's prior history...

Independent Verification and Validation of Complex User Interfaces: A Human Factors Approach

NASA Technical Reports Server (NTRS)

Whitmore, Mihriban; Berman, Andrea; Chmielewski, Cynthia

1996-01-01

The Usability Testing and Analysis Facility (UTAF) at the NASA Johnson Space Center has identified and evaluated a potential automated software interface inspection tool capable of assessing the degree to which space-related critical and high-risk software system user interfaces meet objective human factors standards across each NASA program and project. Testing consisted of two distinct phases. Phase 1 compared analysis times and similarity of results for the automated tool and for human-computer interface (HCI) experts. In Phase 2, HCI experts critiqued the prototype tool's user interface. Based on this evaluation, it appears that a more fully developed version of the tool will be a promising complement to a human factors-oriented independent verification and validation (IV&V) process.

42 CFR 93.408 - Mitigating and aggravating factors in HHS administrative actions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Mitigating and aggravating factors in HHS administrative actions. 93.408 Section 93.408 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES...

42 CFR 93.408 - Mitigating and aggravating factors in HHS administrative actions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Mitigating and aggravating factors in HHS administrative actions. 93.408 Section 93.408 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES...

42 CFR 93.408 - Mitigating and aggravating factors in HHS administrative actions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Mitigating and aggravating factors in HHS administrative actions. 93.408 Section 93.408 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES...

42 CFR 93.408 - Mitigating and aggravating factors in HHS administrative actions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Mitigating and aggravating factors in HHS administrative actions. 93.408 Section 93.408 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES...

Proposal for a new categorization of aseptic processing facilities based on risk assessment scores.

PubMed

Katayama, Hirohito; Toda, Atsushi; Tokunaga, Yuji; Katoh, Shigeo

2008-01-01

Risk assessment of aseptic processing facilities was performed using two published risk assessment tools. Calculated risk scores were compared with experimental test results, including environmental monitoring and media fill run results, in three different types of facilities. The two risk assessment tools used gave a generally similar outcome. However, depending on the tool used, variations were observed in the relative scores between the facilities. For the facility yielding the lowest risk scores, the corresponding experimental test results showed no contamination, indicating that these ordinal testing methods are insufficient to evaluate this kind of facility. A conventional facility having acceptable aseptic processing lines gave relatively high risk scores. The facility showing a rather high risk score demonstrated the usefulness of conventional microbiological test methods. Considering the significant gaps observed in calculated risk scores and in the ordinal microbiological test results between advanced and conventional facilities, we propose a facility categorization based on risk assessment. The most important risk factor in aseptic processing is human intervention. When human intervention is eliminated from the process by advanced hardware design, the aseptic processing facility can be classified into a new risk category that is better suited for assuring sterility based on a new set of criteria rather than on currently used microbiological analysis. To fully benefit from advanced technologies, we propose three risk categories for these aseptic facilities.

Disease induction by human microbial pathogens in plant-model systems: potential, problems and prospects.

PubMed

van Baarlen, Peter; van Belkum, Alex; Thomma, Bart P H J

2007-02-01

Relatively simple eukaryotic model organisms such as the genetic model weed plant Arabidopsis thaliana possess an innate immune system that shares important similarities with its mammalian counterpart. In fact, some human pathogens infect Arabidopsis and cause overt disease with human symptomology. In such cases, decisive elements of the plant's immune system are likely to be targeted by the same microbial factors that are necessary for causing disease in humans. These similarities can be exploited to identify elementary microbial pathogenicity factors and their corresponding targets in a green host. This circumvents important cost aspects that often frustrate studies in humans or animal models and, in addition, results in facile ethical clearance.

Assessment of Human Factors

NASA Technical Reports Server (NTRS)

Mount, Frances; Foley, Tico

1999-01-01

Human Factors Engineering, often referred to as Ergonomics, is a science that applies a detailed understanding of human characteristics, capabilities, and limitations to the design, evaluation, and operation of environments, tools, and systems for work and daily living. Human Factors is the investigation, design, and evaluation of equipment, techniques, procedures, facilities, and human interfaces, and encompasses all aspects of human activity from manual labor to mental processing and leisure time enjoyments. In spaceflight applications, human factors engineering seeks to: (1) ensure that a task can be accomplished, (2) maintain productivity during spaceflight, and (3) ensure the habitability of the pressurized living areas. DSO 904 served as a vehicle for the verification and elucidation of human factors principles and tools in the microgravity environment. Over six flights, twelve topics were investigated. This study documented the strengths and limitations of human operators in a complex, multifaceted, and unique environment. By focusing on the man-machine interface in space flight activities, it was determined which designs allow astronauts to be optimally productive during valuable and costly space flights. Among the most promising areas of inquiry were procedures, tools, habitat, environmental conditions, tasking, work load, flexibility, and individual control over work.

A Human Factor Analysis to Mitigate Fall Risk Factors in an Aerospace Environment

NASA Technical Reports Server (NTRS)

Ware, Joylene H.

2010-01-01

This slide presentation reviews the study done to quanitfy the risks from falls from three locations (i.e., Shuttle Landing Facility Launch Complex Payloads and Vehicle Assembly Building) at the Kennedy Space Center. The Analytical Hierarchy Process (AHP) is reviewed and the mathematical model developed is detailed.

Leveraging Health Care Simulation Technology for Human Factors Research: Closing the Gap Between Lab and Bedside.

PubMed

Deutsch, Ellen S; Dong, Yue; Halamek, Louis P; Rosen, Michael A; Taekman, Jeffrey M; Rice, John

2016-11-01

We describe health care simulation, designed primarily for training, and provide examples of how human factors experts can collaborate with health care professionals and simulationists-experts in the design and implementation of simulation-to use contemporary simulation to improve health care delivery. The need-and the opportunity-to apply human factors expertise in efforts to achieve improved health outcomes has never been greater. Health care is a complex adaptive system, and simulation is an effective and flexible tool that can be used by human factors experts to better understand and improve individual, team, and system performance within health care. Expert opinion is presented, based on a panel delivered during the 2014 Human Factors and Ergonomics Society Health Care Symposium. Diverse simulators, physically or virtually representing humans or human organs, and simulation applications in education, research, and systems analysis that may be of use to human factors experts are presented. Examples of simulation designed to improve individual, team, and system performance are provided, as are applications in computational modeling, research, and lifelong learning. The adoption or adaptation of current and future training and assessment simulation technologies and facilities provides opportunities for human factors research and engineering, with benefits for health care safety, quality, resilience, and efficiency. Human factors experts, health care providers, and simulationists can use contemporary simulation equipment and techniques to study and improve health care delivery. © 2016, Human Factors and Ergonomics Society.

Overview of the Human Exploration Research Analog (HERA)

NASA Technical Reports Server (NTRS)

Neigut, J.

2015-01-01

In 2013, the Human Research Program at NASA began developing a new confinement analog specifically for conducting research to investigate the effects of confinement on the human system. The HERA (Human Exploration Research Analog) habitat has been used for both 7 and 14 day missions to date to examine and mitigate exploration risks to enable safe, reliable and productive human space exploration. This presentation will describe how the Flight Analogs Project developed the HERA facility and the infrastructure to suit investigator requirements for confinement research and in the process developed a new approach to analog utilization and a new state of the art analog facility. Details regarding HERA operations will be discussed including specifics on the mission simulation utilized for the current 14-day campaign, the specifics of the facility (total volume, overall size, hardware), and the capabilities available to researchers. The overall operational philosophy, mission fidelity including timeline, schedule pressures and cadence, and development and implementation of mission stressors will be presented. Research conducted to date in the HERA has addressed risks associated with behavioral health and performance, human physiology, as well as human factors. This presentation will conclude with a discussion of future research plans for the HERA, including infrastructure improvements and additional research capabilities planned for the upcoming 30-day missions in 2016.

The development of seasonal emission factors from a Canadian commercial laying hen facility

NASA Astrophysics Data System (ADS)

Morgan, Robert J.; Wood, David J.; Van Heyst, Bill J.

2014-04-01

Pollutants emitted from poultry housing facilities are a concern from a human health, bird welfare, and environmental perspective. Development of emission factors for these aerial pollutants is difficult due to variable climatic conditions, the number and type of poultry, and the wide range of management practices used. To address these concerns, a study was conducted to develop emission factors for ammonia and particulate matter over a period of one year from a commercial poultry laying hen facility in Wellington County, Ontario, Canada. Instruments housed inside an on-site mobile trailer were used to monitor in-house concentrations of ammonia and size fractionated particulate matter via a heated sample line. Along with a ventilation profile, emission factors were developed for the facility. Average emissions of 19.53 ± 19.97, 2.55 ± 2.10, and 1.10 ± 1.52 g day-1 AU-1 (where AU is defined as an animal unit equivalent to 500 kg live mass) for ammonia, PM10, PM2.5, respectively, were observed. All emissions peaked during the winter months, with the exception of PM2.5 which increased in the summer.

NASA's Man-Systems Integration Standards: A Human Factors Engineering Standard for Everyone in the Nineties

NASA Technical Reports Server (NTRS)

Booher, Cletis R.; Goldsberry, Betty S.

1994-01-01

During the second half of the 1980s, a document was created by the National Aeronautics and Space Administration (NASA) to aid in the application of good human factors engineering and human interface practices to the design and development of hardware and systems for use in all United States manned space flight programs. This comprehensive document, known as NASA-STD-3000, the Man-Systems Integration Standards (MSIS), attempts to address, from a human factors engineering/human interface standpoint, all of the various types of equipment with which manned space flight crew members must deal. Basically, all of the human interface situations addressed in the MSIS are present in terrestrially based systems also. The premise of this paper is that, starting with this already created standard, comprehensive documents addressing human factors engineering and human interface concerns could be developed to aid in the design of almost any type of equipment or system which humans interface with in any terrestrial environment. Utilizing the systems and processes currently in place in the MSIS Development Facility at the Johnson Space Center in Houston, TX, any number of MSIS volumes addressing the human factors / human interface needs of any terrestrially based (or, for that matter, airborne) system could be created.

A macro environmental risk assessment methodology for establishing priorities among risks to human health and the environment in the Philippines

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

Gernhofer, S.; Oliver, T.J.; Vasquez, R.

1994-12-31

A macro environmental risk assessment (ERA) methodology was developed for the Philippine Department of Environment and Natural Resources (DENR) as part of the US Agency for International Development Industrial Environmental Management Project. The DENR allocates its limited resources to mitigate those environmental problems that pose the greatest threat to human health and the environment. The National Regional Industry Prioritization Strategy (NRIPS) methodology was developed as a risk assessment tool to establish a national ranking of industrial facilities. The ranking establishes regional and national priorities, based on risk factors, that DENR can use to determine the most effective allocation of itsmore » limited resources. NRIPS is a systematic framework that examines the potential risk to human health and the environment from hazardous substances released from a facility, and, in doing so, generates a relative numerical score that represents that risk. More than 3,300 facilities throughout the Philippines were evaluated successfully with the NRIPS.« less

Fusion interfaces for tactical environments: An application of virtual reality technology

NASA Technical Reports Server (NTRS)

Haas, Michael W.

1994-01-01

The term Fusion Interface is defined as a class of interface which integrally incorporates both virtual and nonvirtual concepts and devices across the visual, auditory, and haptic sensory modalities. A fusion interface is a multisensory virtually-augmented synthetic environment. A new facility has been developed within the Human Engineering Division of the Armstrong Laboratory dedicated to exploratory development of fusion interface concepts. This new facility, the Fusion Interfaces for Tactical Environments (FITE) Facility is a specialized flight simulator enabling efficient concept development through rapid prototyping and direct experience of new fusion concepts. The FITE Facility also supports evaluation of fusion concepts by operation fighter pilots in an air combat environment. The facility is utilized by a multidisciplinary design team composed of human factors engineers, electronics engineers, computer scientists, experimental psychologists, and oeprational pilots. The FITE computational architecture is composed of twenty-five 80486-based microcomputers operating in real-time. The microcomputers generate out-the-window visuals, in-cockpit and head-mounted visuals, localized auditory presentations, haptic displays on the stick and rudder pedals, as well as executing weapons models, aerodynamic models, and threat models.

Factors influencing experience in crowds - The participant perspective.

PubMed

Filingeri, Victoria; Eason, Ken; Waterson, Patrick; Haslam, Roger

2017-03-01

Humans encounter crowd situations on a daily basis, resulting in both negative and positive experiences. Understanding how to optimise the participant experience of crowds is important. In the study presented in this paper, 5 focus groups were conducted (35 participants, age range: 21-71 years) and 55 crowd situations observed (e.g. transport hubs, sport events, retail situations). Influences on participant experience in crowds identified by the focus groups and observations included: physical design of crowd space and facilities (layout, queuing strategies), crowd movement (monitoring capacity, pedestrian flow), communication and information (signage, wayfinding), comfort and welfare (provision of facilities, environmental comfort), and public order. It was found that important aspects affecting participant experience are often not considered systematically in the planning of events or crowd situations. The findings point to human factors aspects of crowds being overlooked, with the experiences of participants often poor. Copyright © 2016. Published by Elsevier Ltd.

Socio-cultural and service delivery dimensions of maternal mortality in rural central India: a qualitative exploration using a human rights lens

PubMed Central

Jat, Tej Ram; Deo, Prakash R.; Goicolea, Isabel; Hurtig, Anna-Karin; San Sebastian, Miguel

2015-01-01

Background Despite the avoidable nature of maternal mortality, unacceptably high numbers of maternal deaths occur in developing countries. Considering its preventability, maternal mortality is being increasingly recognised as a human rights issue. Integration of a human rights perspective in maternal health programmes could contribute positively in eliminating avertable maternal deaths. This study was conducted to explore socio-cultural and service delivery–related dimensions of maternal deaths in rural central India using a human rights lens. Design Social autopsies were conducted for 22 maternal deaths during 2011 in Khargone district in central India. The data were analysed using thematic analysis. The factors associated with maternal deaths were classified by using the ‘three delays’ framework and were examined by using a human rights lens. Results All 22 women tried to access medical assistance, but various factors delayed their access to appropriate care. The underestimation of the severity of complications by family members, gender inequity, and perceptions of low-quality delivery services delayed decisions to seek care. Transportation problems and care seeking at multiple facilities delayed reaching appropriate health facilities. Negligence by health staff and unavailability of blood and emergency obstetric care services delayed receiving adequate care after reaching a health facility. Conclusions The study highlighted various socio-cultural and service delivery–related factors which are violating women's human rights and resulting in maternal deaths in rural central India. This study highlights that, despite the health system's conscious effort to improve maternal health, normative elements of a human rights approach to maternal health (i.e. availability, accessibility, acceptability, and quality of maternal health services) were not upheld. The data and analysis suggest that the deceased women and their relatives were unable to claim their entitlements and that the duty bearers were not successful in meeting their obligations. Based on the findings of our study, we conclude that to prevent maternal deaths, further concentrated efforts are required for better community education, women's empowerment, and health systems strengthening to provide appropriate and timely services, including emergency obstetric care, with good quality. PMID:25840595

Socio-cultural and service delivery dimensions of maternal mortality in rural central India: a qualitative exploration using a human rights lens.

PubMed

Jat, Tej Ram; Deo, Prakash R; Goicolea, Isabel; Hurtig, Anna-Karin; San Sebastian, Miguel

2015-01-01

Despite the avoidable nature of maternal mortality, unacceptably high numbers of maternal deaths occur in developing countries. Considering its preventability, maternal mortality is being increasingly recognised as a human rights issue. Integration of a human rights perspective in maternal health programmes could contribute positively in eliminating avertable maternal deaths. This study was conducted to explore socio-cultural and service delivery-related dimensions of maternal deaths in rural central India using a human rights lens. Social autopsies were conducted for 22 maternal deaths during 2011 in Khargone district in central India. The data were analysed using thematic analysis. The factors associated with maternal deaths were classified by using the 'three delays' framework and were examined by using a human rights lens. All 22 women tried to access medical assistance, but various factors delayed their access to appropriate care. The underestimation of the severity of complications by family members, gender inequity, and perceptions of low-quality delivery services delayed decisions to seek care. Transportation problems and care seeking at multiple facilities delayed reaching appropriate health facilities. Negligence by health staff and unavailability of blood and emergency obstetric care services delayed receiving adequate care after reaching a health facility. The study highlighted various socio-cultural and service delivery-related factors which are violating women's human rights and resulting in maternal deaths in rural central India. This study highlights that, despite the health system's conscious effort to improve maternal health, normative elements of a human rights approach to maternal health (i.e. availability, accessibility, acceptability, and quality of maternal health services) were not upheld. The data and analysis suggest that the deceased women and their relatives were unable to claim their entitlements and that the duty bearers were not successful in meeting their obligations. Based on the findings of our study, we conclude that to prevent maternal deaths, further concentrated efforts are required for better community education, women's empowerment, and health systems strengthening to provide appropriate and timely services, including emergency obstetric care, with good quality.

Resources for Improving Computerized Learning Environments.

ERIC Educational Resources Information Center

Yeaman, Andrew R. J.

1989-01-01

Presents an annotated review of human factors literature that discusses computerized environments. Topics discussed include the application of office automation practices to educational environments; video display terminal (VDT) workstations; health and safety hazards; planning educational facilities; ergonomics in computerized offices; and…

Environmental Factors Associated with Norovirus Transmission in Long-Term Care Facilities in South Carolina.

PubMed

Jayasekara, Lalani; Leone, Cortney M; Sharp, Julia; Getty, Morgan

2016-09-01

In the U.S., 60% of norovirus outbreaks are attributed to long-term care facilities (LTCFs). A descriptive study of 26 LTCFs in South Carolina was conducted to determine the presence of environmental factors associated with transmission of human noroviruses. Sanitary conditions in one common area, one staff/visitor bathroom, and the main kitchen were assessed using two audit forms. While surfaces in all kitchens were in good sanitary condition, 23 LTCFs used quaternary ammonium-based sanitizers and three LTCFs used chlorine bleach for kitchen sanitization. All common areas were also clean and in good condition; however, 20 LTCFs had upholstered chairs, and five LTCFs had carpeted floors. Seven facilities used quaternary ammonium-based disinfectants exclusively, whereas six LTCFs used chlorine bleach exclusively, and eight LTCFs used both to disinfect common areas. Seven staff/visitor bathrooms were accessible to residents, and hand washing signage was missing from 10. These results reveal the presence of environmental factors that might facilitate norovirus transmission within LTCFs.

Human Factors Engineering Requirements for the International Space Station - Successes and Challenges

NASA Technical Reports Server (NTRS)

Whitmore, M.; Blume, J.

2003-01-01

Advanced technology coupled with the desire to explore space has resulted in increasingly longer human space missions. Indeed, any exploration mission outside of Earth's neighborhood, in other words, beyond the moon, will necessarily be several months or even years. The International Space Station (ISS) serves as an important advancement toward executing a successful human space mission that is longer than a standard trip around the world or to the moon. The ISS, which is a permanently occupied microgravity research facility orbiting the earth, will support missions four to six months in duration. In planning for the ISS, the NASA developed an agency-wide set of human factors standards for the first time in a space exploration program. The Man-Systems Integration Standard (MSIS), NASA-STD-3000, a multi-volume set of guidelines for human-centered design in microgravity, was developed with the cooperation of human factors experts from various NASA centers, industry, academia, and other government agencies. The ISS program formed a human factors team analogous to any major engineering subsystem. This team develops and maintains the human factors requirements regarding end-to-end architecture design and performance, hardware and software design requirements, and test and verification requirements. It is also responsible for providing program integration across all of the larger scale elements, smaller scale hardware, and international partners.

Safety and the Human Factor.

ERIC Educational Resources Information Center

Smith, Ann

1982-01-01

Discusses four elements of safety programs: (1) safety training; (2) safety inspections; (3) accident investigations; and (4) protective safety equipment. Also discusses safety considerations in water/wastewater treatment facilities focusing on falls, drowning hazards, trickling filters, confined space entry, collection/distribution system safety,…

Integrated capabilities in heavy vehicles : human factors research needs

DOT National Transportation Integrated Search

2003-10-09

The Full Road Closure method uses facility closure and total traffic diversion, which may be for one direction or bi-directional traffic flow, to accelerate construction and reduce the negative impacts of work zones. With good planning, interagency c...

Outbreak of Drug-Resistant Mycobacterium tuberculosis Among Homeless People in Atlanta, Georgia, 2008-2015

PubMed Central

VanderEnde, Daniel S.; Holland, David P.; Haddad, Maryam B.; Yarn, Benjamin; Yamin, Aliya S.; Mohamed, Omar; Sales, Rose-Marie F.; DiMiceli, Lauren E.; Burns-Grant, Gail; Reaves, Erik J.; Gardner, Tracie J.; Ray, Susan M.

2017-01-01

Objectives: Our objective was to describe and determine the factors contributing to a recent drug-resistant tuberculosis (TB) outbreak in Georgia. Methods: We defined an outbreak case as TB diagnosed from March 2008 through December 2015 in a person residing in Georgia at the time of diagnosis and for whom (1) the genotype of the Mycobacterium tuberculosis isolate was consistent with the outbreak strain or (2) TB was diagnosed clinically without a genotyped isolate available and connections were established to another outbreak-associated patient. To determine factors contributing to transmission, we interviewed patients and reviewed health records, homeless facility overnight rosters, and local jail booking records. We also assessed infection control measures in the 6 homeless facilities involved in the outbreak. Results: Of 110 outbreak cases in Georgia, 86 (78%) were culture confirmed and isoniazid resistant, 41 (37%) occurred in people with human immunodeficiency virus coinfection (8 of whom were receiving antiretroviral treatment at the time of TB diagnosis), and 10 (9%) resulted in TB-related deaths. All but 8 outbreak-associated patients had stayed overnight or volunteered extensively in a homeless facility; all these facilities lacked infection control measures. At least 9 and up to 36 TB cases outside Georgia could be linked to this outbreak. Conclusions: This article highlights the ongoing potential for long-lasting and far-reaching TB outbreaks, particularly among populations with untreated human immunodeficiency virus infection, mental illness, substance abuse, and homelessness. To prevent and control TB outbreaks, health departments should work with overnight homeless facilities to implement infection control measures and maintain searchable overnight rosters. PMID:28257261

Facilities, breed and experience affect ease of sheep handling: the livestock transporter's perspective.

PubMed

Burnard, C L; Pitchford, W S; Hocking Edwards, J E; Hazel, S J

2015-08-01

An understanding of the perceived importance of a variety of factors affecting the ease of handling of sheep and the interactions between these factors is valuable in improving profitability and welfare of the livestock. Many factors may contribute to animal behaviour during handling, and traditionally these factors have been assessed in isolation under experimental conditions. A human social component to this phenomenon also exists. The aim of this study was to gain a deeper understanding of the importance of a variety of factors affecting ease of handling, and the interactions between these from the perspective of the livestock transporter. Qualitative interviews were used to investigate the factors affecting sheep behaviour during handling. Interview transcripts underwent thematic analysis. Livestock transporters discussed the effects of attitudes and behaviours towards sheep, helpers, facilities, distractions, environment, dogs and a variety of sheep factors including breed, preparation, experience and sex on sheep behaviour during handling. Transporters demonstrated care and empathy and stated that patience and experience were key factors determining how a person might deal with difficult sheep. Livestock transporters strongly believed facilities (ramps and yards) had the greatest impact, followed by sheep experience (naivety of the sheep to handling and transport) and breed. Transporters also discussed the effects of distractions, time of day, weather, dogs, other people, sheep preparation, body condition and sheep sex on ease of handling. The concept of individual sheep temperament was indirectly expressed.

Aviation human factors research in U.S. universities: Potential contributions to national needs

NASA Technical Reports Server (NTRS)

Key Dismukes, R.

1994-01-01

Univesity research can make vital contributions to national needs in aviation human factors (AHF). This article examines the types of expertise and facilities available in universities and explores how university capabilities complement the work of government laboratories. The AHF infrastructure is discussed and compared to other fields of applied research. Policy and funding issues are also examined. This study is based on a survey conducted by the author, which included site visits to several universities, telephone interviews with faculty members at other universities, and a search of the AHF research literature.

Using of New Management Approaches in the Field of Personal Marketing in the Transport Company

NASA Astrophysics Data System (ADS)

Matusova, Dominika; Gogolova, Martina

2017-10-01

Personal marketing is a relatively new field in the theory and practice of human resources (HR) activities in the corporate and business sector. As a separate area of HR management was established of the earmarking of personnel management. In the article is mentioned about the facility manager. This position introduces a specific category - behaviour of manager. The facility manager has to dispose the skills from the areas: operation and maintenance, property, facility management processes, human factors of environment, planning, function devices, finance and quality management and innovation and communication. In the article is described the situation in transport company, specifically - Railway Company Slovakia, Inc. (ZSSK). Employees of the company works in departments as: managers, sellers, operators for services and maintenance, economists and controllers. The transport company had 5949 employees in 2015. That was about 108 employees more than the previous year. Facility manager and the company, set the targets which want to achieve within the planned time. Beyond the objectives are fundamental the values of company, business vision and mission.

Human factor design of habitable space facilities

NASA Technical Reports Server (NTRS)

Clearwater, Yvonne A.

1987-01-01

Current fundamental and applied habitability research conducted as part of the U.S. space program is reviewed with emphasis on methods, findings, and applications of the results to the planning and design of the International Space Station. The discussion covers the following six concurrent directions of habitability research: operational simulation, functional interior decor research, space crew privacy requirements, interior layout and configuration analysis, human spatial habitability model, and analogous environments research.

D-Side: A Facility and Workforce Planning Group Multi-criteria Decision Support System for Johnson Space Center

NASA Technical Reports Server (NTRS)

Tavana, Madjid

2005-01-01

"To understand and protect our home planet, to explore the universe and search for life, and to inspire the next generation of explorers" is NASA's mission. The Systems Management Office at Johnson Space Center (JSC) is searching for methods to effectively manage the Center's resources to meet NASA's mission. D-Side is a group multi-criteria decision support system (GMDSS) developed to support facility decisions at JSC. D-Side uses a series of sequential and structured processes to plot facilities in a three-dimensional (3-D) graph on the basis of each facility alignment with NASA's mission and goals, the extent to which other facilities are dependent on the facility, and the dollar value of capital investments that have been postponed at the facility relative to the facility replacement value. A similarity factor rank orders facilities based on their Euclidean distance from Ideal and Nadir points. These similarity factors are then used to allocate capital improvement resources across facilities. We also present a parallel model that can be used to support decisions concerning allocation of human resources investments across workforce units. Finally, we present results from a pilot study where 12 experienced facility managers from NASA used D-Side and the organization's current approach to rank order and allocate funds for capital improvement across 20 facilities. Users evaluated D-Side favorably in terms of ease of use, the quality of the decision-making process, decision quality, and overall value-added. Their evaluations of D-Side were significantly more favorable than their evaluations of the current approach. Keywords: NASA, Multi-Criteria Decision Making, Decision Support System, AHP, Euclidean Distance, 3-D Modeling, Facility Planning, Workforce Planning.

The Educator's "Action" Office.

ERIC Educational Resources Information Center

Martin, Dikran J.

Design criteria, standards, and human factors related to designing and planning flexible and efficient work environments for college faculty members are overviewed with six model (example) office plans included. The physical and psychological design needs in such an office facility are given, with task performance data on student faculty…

Wayfinding: a quality factor in human design approach to healthcare facilities.

PubMed

Del Nord, R

1999-01-01

The specific aim of this paper is the systematic analysis of interactions and reciprocal conditions existing between the physical space of hospital buildings and the different categories of individuals that come in contact with them. The physical and environmental facilities of hospital architecture often influence the therapeutic character of space and the employees. If the values of the individual are to be safeguarded in this context, priority needs to be given to such factors as communication, privacy, etc. This would mean the involvement of other professional groups such as psychologists, sociologists, ergonomists, etc. at the hospital building planning stage. This paper will outline the result of some research conducted at the University Research Center "TESIS" of Florence to provide better understanding of design strategies applied to reduce the pathology of spaces within the healthcare environment. The case studies will highlight the parameters and the possible architectural solutions to wayfinding and the humanization of spaces, with particular emphasis on lay-outs, technologies, furniture and finishing design.

Aviation human factors research in US universities: Potential contributions to national needs

NASA Technical Reports Server (NTRS)

Dismukes, R. Key

1994-01-01

Universities can and should make vital contributions to national needs in aviation human factors. However, to guide and utilize university research effectively we must understand what types of expertise and facilities universities can bring to bear on aviation problems. We should be aware of where relevant research is already underway and where untapped potential exists. How does the character of research in universities differ from and complement research in government and industry laboratories? What conditions would encourage universities to focus on national priorities and would promote high quality, relevant research? This paper attempts to address these issues. It is based on a survey conducted by the author, which included site visits to several universities, telephone interviews with faculty members at other universities, and a search of the aviation human factors research literature.

Nosocomial infections in geriatric long-term-care and rehabilitation facilities: exploration in the development of a risk index for epidemiological surveillance.

PubMed

Golliot, F; Astagneau, P; Cassou, B; Okra, N; Rothan-Tondeur, M; Brücker, G

2001-12-01

To compute a risk index for nosocomial infection (NI) surveillance in geriatric long-term-care facilities (LTCFs) and rehabilitation facilities. Analysis of data collected during the French national prevalence survey on NIs conducted in 1996. Risk indices were constructed based on the patient case-mix defined according to risk factors for NIs identified in the elderly. 248 geriatric units in 77 hospitals located in northern France. All hospital inpatients on the day of the survey were included. Data from 11,254 patients were recorded. The overall rate of infected patients was 9.9%. Urinary tract, respiratory tract, and skin were the most common infection sites in both rehabilitation facilities and LTCFs. Eleven risk indices, categorizing patients in 3 to 7 levels of increasing NI risk, ranging from 2.7% to 36.2%, were obtained. Indices offered risk adjustment according to NI rate stratification and clinical relevance of risk factors such as indwelling devices, open bedsores, swallowing disorders, sphincter incontinence, lack of mobility, immunodeficiency, or rehabilitation activity. The optimal index should be tailored to the strategy selected for NI surveillance in geriatric facilities in view of available financial and human resources.

Characterization of the radiation environment at the UNLV accelerator facility during operation of the Varian M6 linac

NASA Astrophysics Data System (ADS)

Hodges, M.; Barzilov, A.; Chen, Y.; Lowe, D.

2016-10-01

The bremsstrahlung photon flux from the UNLV particle accelerator (Varian M6 model) was determined using MCNP5 code for 3 MeV and 6 MeV incident electrons. Human biological equivalent dose rates due to accelerator operation were evaluated using the photon flux with the flux-to-dose conversion factors. Dose rates were computed for the accelerator facility for M6 linac use under different operating conditions. The results showed that the use of collimators and linac internal shielding significantly reduced the dose rates throughout the facility. It was shown that the walls of the facility, in addition to the earthen berm enveloping the building, provide equivalent shielding to reduce dose rates outside to below the 2 mrem/h limit.

Virtually-augmented interfaces for tactical aircraft.

PubMed

Haas, M W

1995-05-01

The term Fusion Interface is defined as a class of interface which integrally incorporates both virtual and non-virtual concepts and devices across the visual, auditory and haptic sensory modalities. A fusion interface is a multi-sensory virtually-augmented synthetic environment. A new facility has been developed within the Human Engineering Division of the Armstrong Laboratory dedicated to exploratory development of fusion-interface concepts. One of the virtual concepts to be investigated in the Fusion Interfaces for Tactical Environments facility (FITE) is the application of EEG and other physiological measures for virtual control of functions within the flight environment. FITE is a specialized flight simulator which allows efficient concept development through the use of rapid prototyping followed by direct experience of new fusion concepts. The FITE facility also supports evaluation of fusion concepts by operational fighter pilots in a high fidelity simulated air combat environment. The facility was utilized by a multi-disciplinary team composed of operational pilots, human-factors engineers, electronics engineers, computer scientists, and experimental psychologists to prototype and evaluate the first multi-sensory, virtually-augmented cockpit. The cockpit employed LCD-based head-down displays, a helmet-mounted display, three-dimensionally localized audio displays, and a haptic display. This paper will endeavor to describe the FITE facility architecture, some of the characteristics of the FITE virtual display and control devices, and the potential application of EEG and other physiological measures within the FITE facility.

Parents' Perception on De La Salle University-Dasmarinas Services

ERIC Educational Resources Information Center

Cortez-Antig, Carmelyn

2011-01-01

The study was conducted to find out the parents' perception on the De La Salle University-Dasmarinas services which are grouped as follows: (1) Academic instruction factor; (2) Quality of human ware (includes faculty, administration, staff support through medical services, guidance and discipline); (3) Quality of hardware (dorm facilities,…

Utilizing a Human Factors Nursing Worksystem Improvement Framework to Increase Nurses' Time at the Bedside and Enhance Safety.

PubMed

Probst, C Adam; Carter, Megan; Cadigan, Caton; Dalcour, Cortney; Cassity, Cindy; Quinn, Penny; Williams, Tiana; Montgomery, Donna Cook; Wilder, Claudia; Xiao, Yan

2017-02-01

The aim of this study is to increase nurses' time for direct patient care and improve safety via a novel human factors framework for nursing worksystem improvement. Time available for direct patient care influences outcomes, yet worksystem barriers prevent nurses adequate time at the bedside. A novel human factors framework was developed for worksystem improvement in 3 units at 2 facilities. Objectives included improving nurse efficiency as measured by time-and-motion studies, reducing missing medications and subsequent trips to medication rooms and improving medication safety. Worksystem improvement resulted in time savings of 16% to 32% per nurse per 12-hour shift. Requests for missing medications dropped from 3.2 to 1.3 per day. Nurse medication room trips were reduced by 30% and nurse-reported medication errors fell from a range of 1.2 to 0.8 and 6.3 to 4.0 per month. An innovative human factors framework for nursing worksystem improvement provided practical and high priority targets for interventions that significantly improved the nursing worksystem.

New recreational facilities for the young and the old in Los Angeles: policy and programming implications.

PubMed

Cohen, Deborah A; Sehgal, Amber; Williamson, Stephanie; Marsh, Terry; Golinelli, Daniela; McKenzie, Thomas L

2009-01-01

It is assumed that higher quality recreation facilities promote physical activity and serve communities better. We tested this assumption by comparing changes in the use of an expanded and renovated skate park (a facility for skateboarding) and a modernized senior citizen's center to two similar facilities that were not refurbished. The skate park was nearly tripled in size, and the senior center was remodeled and received new exercise equipment, a courtyard garden, and modern architectural features. We assessed use of these facilities through direct observation and surveyed both facility users and residents living within 2 miles of each facility. We found that making improvements to facilities alone will not always guarantee increased use. Although there was a 510% increase in use of the expanded skate park compared to a 77% increase in the comparison skate park, the senior center had substantially fewer users and provided fewer hours of exercise classes and other programmed activities after the facility was renovated. The implication of our study is that use results from a complex equation that includes not only higher quality recreation facilities but also progamming, staffing, fees, hours of operation, marketing, outreach, and perhaps a host of other human factors.

Human Factors and Safety Evaluation of the Automatic Test and Repair System (AN/MSM-105(V)1)

DTIC Science & Technology

1984-07-01

box and the main breaker box In both the ETF and ERF did not conform to military standards In that they consisted of black letters on a gold ...transportable test and repair system for electronic equipment that consists of an electronic test facility ( ETF ) and an electronic repair facility (ERF...personal gear in both the ETF and the ERF, and in the ETF there was not nearly enough room for the storage of the interconnect devices, tapes and manuals

Human Factors Checklist: Think Human Factors - Focus on the People

NASA Technical Reports Server (NTRS)

Miller, Darcy; Stelges, Katrine; Barth, Timothy; Stambolian, Damon; Henderson, Gena; Dischinger, Charles; Kanki, Barbara; Kramer, Ian

2016-01-01

A quick-look Human Factors (HF) Checklist condenses industry and NASA Agency standards consisting of thousands of requirements into 14 main categories. With support from contractor HF and Safety Practitioners, NASA developed a means to share key HF messages with Design, Engineering, Safety, Project Management, and others. It is often difficult to complete timely assessments due to the large volume of HF information. The HF Checklist evolved over time into a simple way to consider the most important concepts. A wide audience can apply the checklist early in design or through planning phases, even before hardware or processes are finalized or implemented. The checklist is a good place to start to supplement formal HF evaluation. The HF Checklist was based on many Space Shuttle processing experiences and lessons learned. It is now being applied to ground processing of new space vehicles and adjusted for new facilities and systems.

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.

Human Factors Evaluation of the Hidalgo Equivital EQ-02 Physiological Status Monitoring System

DTIC Science & Technology

2013-10-11

Destruction – Civil Support Team (WMD-CST) responding (11), and ricin letters that were intercepted en route to a member of Congress and the President...positive for ricin at Washington mail facility. CNN U.S., April 17, 2013. (http://www.cnn.com/2013/04/16/us/tainted-letter- intercepted accessed

Characterization of infectious aerosols in health care facilities: an aid to effective engineering controls and preventive strategies.

PubMed

Cole, E C; Cook, C E

1998-08-01

Assessment of strategies for engineering controls for the prevention of airborne infectious disease transmission to patients and to health care and related workers requires consideration of the factors relevant to aerosol characterization. These factors include aerosol generation, particle size and concentrations, organism viability, infectivity and virulence, airflow and climate, and environmental sampling and analysis. The major focus on attention to engineering controls comes from recent increases in tuberculosis, particularly the multidrug-resistant varieties in the general hospital population, the severely immunocompromised, and those in at-risk and confined environments such as prisons, long-term care facilities, and shelters for the homeless. Many workers are in close contact with persons who have active, undiagnosed, or insufficiently treated tuberculosis. Additionally, patients and health care workers may be exposed to a variety of pathogenic human viruses, opportunistic fungi, and bacteria. This report therefore focuses on the nature of infectious aerosol transmission in an attempt to determine which factors can be systematically addressed to result in proven, applied engineering approaches to the control of infectious aerosols in hospital and health care facility environments. The infectious aerosols of consideration are those that are generated as particles of respirable size by both human and environmental sources and that have the capability of remaining viable and airborne for extended periods in the indoor environment. This definition precludes skin and mucous membrane exposures occurring from splashes (rather than true aerosols) of blood or body fluids containing infectious disease agents. There are no epidemiologic or laboratory studies documenting the transmission of bloodborne virus by way of aerosols.

Man-vehicle systems research facility: Design and operating characteristics

NASA Technical Reports Server (NTRS)

1983-01-01

The Man-Vehicle Systems Research Facility (MVSRF) provides the capability of simulating aircraft (two with full crews), en route and terminal air traffic control and aircrew interactions, and advanced cockpit (1995) display representative of future generations of aircraft, all within the full mission context. The characteristics of this facility derive from research, addressing critical human factors issues that pertain to: (1) information requirements for the utilization and integration of advanced electronic display systems, (2) the interaction and distribution of responsibilities between aircrews and ground controllers, and (3) the automation of aircrew functions. This research has emphasized the need for high fidelity in simulations and for the capability to conduct full mission simulations of relevant aircraft operations. This report briefly describes the MVSRF design and operating characteristics.

Design for an integrated discipline operations control center for Space Station Freedom

NASA Technical Reports Server (NTRS)

Haines, Richard F.

1993-01-01

This paper presents selected features of a human factors oriented plan for a Space Station Freedom (SSF) ground Discipline Operations Center (DOC) that is integrated with other work areas used by multidisciplinary life scientists. This combined facility is referred to as an integrated DOC or IDOC. This plan is based upon the assumption that there will be a constantly changing array of specialized equipment and procedures used by life sciences principal investigators (PI) on the ground which must be linked to SSF through various DOC systems. Other sites will also be able to communicate with SSF (Anon., 1992). It is also assumed that cost reduction will be a major design consideration and that one integrated structure will be less expensive to build and operate than two separate ones. Since both the DOC personnel and PIs will need to communicate with the flight crew aboard SSF, the general interconnect architecture of the PIs' communication linkage is considered here. Key human factor design elements of this plan include: a candidate facility layout which accommodates three (3), multipurpose, rapidly reconfigurable work areas (suites) and consequent user traffic flow considerations, a multimedia telecommunications support capability, functional (human) traffic flow, optimized internal illumination and acoustics requirements, selected volumetric and safety requirements, and other architectural design parameters.

Stock-outs of essential health products in Mozambique - longitudinal analyses from 2011 to 2013.

PubMed

Wagenaar, Bradley H; Gimbel, Sarah; Hoek, Roxanne; Pfeiffer, James; Michel, Cathy; Manuel, João Luis; Cuembelo, Fatima; Quembo, Titos; Afonso, Pires; Gloyd, Stephen; Sherr, Kenneth

2014-07-01

To assess the relationship between health system factors and facility-level EHP stock-outs in Mozambique. Service provisions were assessed in 26 health facilities and 13 district warehouses in Sofala Province, Mozambique, from July to August in 2011-2013. Generalised estimating equations were used to model factors associated with facility-level availability of essential drugs, supplies and equipment. Stock-out rates for drugs ranged from 1.3% for oral rehydration solution to 20.5% for Depo-Provera and condoms, with a mean stock-out rate of 9.1%; mean stock-out rates were 15.4% for supplies and 4.1% for equipment. Stock-outs at the district level accounted for 27.1% (29/107) of facility-level drug stock-outs and 44.0% (37/84) of supply stock-outs. Each 10-km increase in the distance from district distribution warehouses was associated with a 31% (CI: 22-42%), 28% (CI: 17-40%) or 27% (CI: 7-50%) increase in rates of drug, supply or equipment stock-outs, respectively. The number of heath facility staff was consistently negatively associated with the occurrence of stock-outs. Facility-level stock-outs of EHPs in Mozambique are common and appear to disproportionately affect those living far from district capitals and near facilities with few health staff. The majority of facility-level EHP stock-outs in Mozambique occur when stock exists at the district distribution centre. Innovative methods are urgently needed to improve EHP supply chains, requesting and ordering of drugs, facility and district communication, and forecasting of future EHP needs in Mozambique. Increased investments in public-sector human resources for health could potentially decrease the occurrence of EHP stock-outs. © 2014 John Wiley & Sons Ltd.

Stock-outs of essential health products in Mozambique-longitudinal analyses from 2011 to 2013

PubMed Central

Wagenaar, Bradley H.; Gimbel, Sarah; Hoek, Roxanne; Pfeiffer, James; Michel, Cathy; Manuel, João Luis; Cuembelo, Fatima; Quembo, Titos; Afonso, Pires; Gloyd, Stephen; Sherr, Kenneth

2015-01-01

objectives To assess the relationship between health system factors and facility-level EHP stock-outs in Mozambique. methods Service provisions were assessed in 26 health facilities and 13 district warehouses in Sofala Province, Mozambique, from July to August in 2011–2013. Generalised estimating equations were used to model factors associated with facility-level availability of essential drugs, supplies and equipment. results Stock-out rates for drugs ranged from 1.3% for oral rehydration solution to 20.5% for Depo-Provera and condoms, with a mean stock-out rate of 9.1%; mean stock-out rates were 15.4% for supplies and 4.1% for equipment. Stock-outs at the district level accounted for 27.1% (29/107) of facility-level drug stock-outs and 44.0% (37/84) of supply stock-outs. Each 10-km increase in the distance from district distribution warehouses was associated with a 31% (CI: 22–42%), 28% (CI: 17–40%) or 27% (CI: 7–50%) increase in rates of drug, supply or equipment stock-outs, respectively. The number of heath facility staff was consistently negatively associated with the occurrence of stock-outs. conclusions Facility-level stock-outs of EHPs in Mozambique are common and appear to disproportionately affect those living far from district capitals and near facilities with few health staff. The majority of facility-level EHP stock-outs in Mozambique occur when stock exists at the district distribution centre. Innovative methods are urgently needed to improve EHP supply chains, requesting and ordering of drugs, facility and district communication, and forecasting of future EHP needs in Mozambique. Increased investments in public-sector human resources for health could potentially decrease the occurrence of EHP stock-outs. PMID:24724617

Facility Design and Health Management Program at the Sinnhuber Aquatic Research Laboratory

PubMed Central

Barton, Carrie L.; Johnson, Eric W.

2016-01-01

Abstract The number of researchers and institutions moving to the utilization of zebrafish for biomedical research continues to increase because of the recognized advantages of this model. Numerous factors should be considered before building a new or retooling an existing facility. Design decisions will directly impact the management and maintenance costs. We and others have advocated for more rigorous approaches to zebrafish health management to support and protect an increasingly diverse portfolio of important research. The Sinnhuber Aquatic Research Laboratory (SARL) is located ∼3 miles from the main Oregon State University campus in Corvallis, Oregon. This facility supports several research programs that depend heavily on the use of adult, larval, and embryonic zebrafish. The new zebrafish facility of the SARL began operation in 2007 with a commitment to build and manage an efficient facility that diligently protects human and fish health. An important goal was to ensure that the facility was free of Pseudoloma neurophilia (Microsporidia), which is very common in zebrafish research facilities. We recognize that there are certain limitations in space, resources, and financial support that are institution dependent, but in this article, we describe the steps taken to build and manage an efficient specific pathogen-free facility. PMID:26981844

Facility Design and Health Management Program at the Sinnhuber Aquatic Research Laboratory.

PubMed

Barton, Carrie L; Johnson, Eric W; Tanguay, Robert L

2016-07-01

The number of researchers and institutions moving to the utilization of zebrafish for biomedical research continues to increase because of the recognized advantages of this model. Numerous factors should be considered before building a new or retooling an existing facility. Design decisions will directly impact the management and maintenance costs. We and others have advocated for more rigorous approaches to zebrafish health management to support and protect an increasingly diverse portfolio of important research. The Sinnhuber Aquatic Research Laboratory (SARL) is located ∼3 miles from the main Oregon State University campus in Corvallis, Oregon. This facility supports several research programs that depend heavily on the use of adult, larval, and embryonic zebrafish. The new zebrafish facility of the SARL began operation in 2007 with a commitment to build and manage an efficient facility that diligently protects human and fish health. An important goal was to ensure that the facility was free of Pseudoloma neurophilia (Microsporidia), which is very common in zebrafish research facilities. We recognize that there are certain limitations in space, resources, and financial support that are institution dependent, but in this article, we describe the steps taken to build and manage an efficient specific pathogen-free facility.

The integration of Human Factors (HF) in the SAR process training course text

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

Ryan, T.G.

1995-03-01

This text provides the technical basis for a two-day course on human factors (HF), as applied to the Safety Analysis Report (SAR) process. The overall objective of this text and course is to: provide the participant with a working knowledge of human factors-related requirements, suggestions for doing a human safety analysis applying a graded approach, and an ability to demonstrate using the results of the human safety analysis, that human factors elements as defined by DOE (human factors engineering, procedures, training, oversight, staffing, qualifications), can support wherever necessary, nuclear safety commitments in the SAR. More specifically, the objectives of themore » text and course are: (1) To provide the SAR preparer with general guidelines for doing HE within the context of a graded approach for the SAR; (2) To sensitize DOE facility managers and staff, safety analysts and SAR preparers, independent reviewers, and DOE reviewers and regulators, to DOE Order 5480.23 requirements for HE in the SAR; (3) To provide managers, analysts, reviewers and regulators with a working knowledge of HE concepts and techniques within the context of a graded approach for the SAR, and (4) To provide SAR managers and DOE reviewers and regulators with general guidelines for monitoring and coordinating the work of preparers of HE inputs throughout the SAR process, and for making decisions regarding the safety relevance of HE inputs to the SAR. As a ready reference for implementing the human factors requirements of DOE Order 5480.22 and DOE Standard 3009-94, this course text and accompanying two-day course are intended for all persons who are involved in the SAR.« less

Dialysis Facility Safety: Processes and Opportunities.

PubMed

Garrick, Renee; Morey, Rishikesh

2015-01-01

Unintentional human errors are the source of most safety breaches in complex, high-risk environments. The environment of dialysis care is extremely complex. Dialysis patients have unique and changing physiology, and the processes required for their routine care involve numerous open-ended interfaces between providers and an assortment of technologically advanced equipment. Communication errors, both within the dialysis facility and during care transitions, and lapses in compliance with policies and procedures are frequent areas of safety risk. Some events, such as air emboli and needle dislodgments occur infrequently, but are serious risks. Other adverse events include medication errors, patient falls, catheter and access-related infections, access infiltrations and prolonged bleeding. A robust safety system should evaluate how multiple, sequential errors might align to cause harm. Systems of care can be improved by sharing the results of root cause analyses, and "good catches." Failure mode effects and analyses can be used to proactively identify and mitigate areas of highest risk, and methods drawn from cognitive psychology, simulation training, and human factor engineering can be used to advance facility safety. © 2015 Wiley Periodicals, Inc.

Space Station in the 21st century - A social perspective

NASA Technical Reports Server (NTRS)

Bluth, B. J.

1986-01-01

A human factors and sociological consideration of Space Station crew facilities and interactions is presented which attempts to place the experiences of astronaut communities in the larger context of late 20th century industrial, economic, and cultural trends. Attention is given to the relationship of Space Station communities to 'Information Society' - related historical developments.

NASA aeronautics research and technology

NASA Technical Reports Server (NTRS)

1986-01-01

The technical accomplishments and research highlights of 1986 are featured, along with information on possible areas of future research. These include hypersonic, supersonic, high performance, subsonic, and rotorcraft vehicle technology. Fundamental disciplinary research areas discussed include aerodynamics, propulsion, materials and structures, information sciences and human factors, and flight systems/safety. A description of the NASA organization and facilities is given.

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

PubMed

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

2016-01-01

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

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

PubMed Central

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

2016-01-01

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

An Antarctic research outpost as a model for planetary exploration.

PubMed

Andersen, D T; McKay, C P; Wharton, R A; Rummel, J D

1990-01-01

During the next 50 years, human civilization may well begin expanding into the solar system. This colonization of extraterrestrial bodies will most likely begin with the establishment of small research outposts on the Moon and/or Mars. In all probability these facilities, designed primarily for conducting exploration and basic science, will have international participation in their crews, logistical support and funding. High fidelity Earth-based simulations of planetary exploration could help prepare for these expensive and complex operations. Antarctica provides one possible venue for such a simulation. The hostile and remote dry valleys of southern Victoria Land offer a valid analog to the Martian environment but are sufficiently accessible to allow routine logistical support and to assure the relative safety of their inhabitants. An Antarctic research outpost designed as a planetary exploration simulation facility would have great potential as a testbed and training site for the operation of future Mars bases and represents a near-term, relatively low-cost alternative to other precursor activities. Antarctica already enjoys an international dimension, an aspect that is more than symbolically appropriate to an international endeavor of unprecedented scientific and social significance--planetary exploration by humans. Potential uses of such a facility include: 1) studying human factors in an isolated environment (including long-term interactions among an international crew); 2) testing emerging technologies (e.g., advanced life support facilities such as a partial bioregenerative life support system, advanced analytical and sample acquisition instrumentation and equipment, etc.); and 3) conducting basic scientific research similar to the research that will be conducted on Mars, while contributing to the planning for human exploration. (Research of this type is already ongoing in Antarctica).

Motivation and Retention of Physicians in Primary Healthcare Facilities: A Qualitative Study From Abbottabad, Pakistan

PubMed Central

Shah, Sayed Masoom; Zaidi, Shehla; Ahmed, Jamil; Rehman, Shafiq Ur

2016-01-01

Background: Workforce motivation and retention is important for the functionality and quality of service delivery in health systems of developing countries. Despite huge primary healthcare (PHC) infrastructure, Pakistan’s health indicators are not impressive; mainly because of under-utilization of facilities and low patient satisfaction. One of the major underlying issues is staff absenteeism. The study aimed to identify factors affecting retention and motivation of doctors working in PHC facilities of Pakistan. Methods: An exploratory study was conducted in a rural district in Khyber Puktunkhwa (KP) province, in Pakistan. A conceptual framework was developed comprising of three organizational, individual, and external environmental factors. Qualitative research methods comprising of semi-structured interviews with doctors working in basic health units (BHUs) and in-depth interviews with district and provincial government health managers were used. Document review of postings, rules of business and policy actions was also conducted. Triangulation of findings was carried out to arrive at the final synthesis. Results: Inadequate remuneration, unreasonable facilities at residence, poor work environment, political interference, inadequate supplies and medical facilities contributed to lack of motivation among both male and female doctors. The physicians accepted government jobs in BHUs with a belief that these jobs were more secure, with convenient working hours. Male physicians seemed to be more motivated because they faced less challenges than their female counterparts in BHUs especially during relocations. Overall, the organizational factors emerged as the most significant whereby human resource policy, career growth structure, performance appraisal and monetary benefits played an important role. Gender and marital status of female doctors was regarded as most important individual factor affecting retention and motivation of female doctors in BHUs. Conclusion: Inadequate remuneration, unreasonable facilities at residence, poor work environment, political interference, inadequate supplies, and medical facilities contributed to lack of motivation in physicians in our study. Our study advocates that by addressing the retention and motivation challenges, service delivery can be made more responsive to the patients and communities in Pakistan and other similar settings. PMID:27694660

Motivation and Retention of Physicians in Primary Healthcare Facilities: A Qualitative Study From Abbottabad, Pakistan.

PubMed

Shah, Sayed Masoom; Zaidi, Shehla; Ahmed, Jamil; Rehman, Shafiq Ur

2016-04-09

Workforce motivation and retention is important for the functionality and quality of service delivery in health systems of developing countries. Despite huge primary healthcare (PHC) infrastructure, Pakistan's health indicators are not impressive; mainly because of under-utilization of facilities and low patient satisfaction. One of the major underlying issues is staff absenteeism. The study aimed to identify factors affecting retention and motivation of doctors working in PHC facilities of Pakistan. An exploratory study was conducted in a rural district in Khyber Puktunkhwa (KP) province, in Pakistan. A conceptual framework was developed comprising of three organizational, individual, and external environmental factors. Qualitative research methods comprising of semi-structured interviews with doctors working in basic health units (BHUs) and in-depth interviews with district and provincial government health managers were used. Document review of postings, rules of business and policy actions was also conducted. Triangulation of findings was carried out to arrive at the final synthesis. Inadequate remuneration, unreasonable facilities at residence, poor work environment, political interference, inadequate supplies and medical facilities contributed to lack of motivation among both male and female doctors. The physicians accepted government jobs in BHUs with a belief that these jobs were more secure, with convenient working hours. Male physicians seemed to be more motivated because they faced less challenges than their female counterparts in BHUs especially during relocations. Overall, the organizational factors emerged as the most significant whereby human resource policy, career growth structure, performance appraisal and monetary benefits played an important role. Gender and marital status of female doctors was regarded as most important individual factor affecting retention and motivation of female doctors in BHUs. Inadequate remuneration, unreasonable facilities at residence, poor work environment, political interference, inadequate supplies, and medical facilities contributed to lack of motivation in physicians in our study. Our study advocates that by addressing the retention and motivation challenges, service delivery can be made more responsive to the patients and communities in Pakistan and other similar settings. © 2016 by Kerman University of Medical Sciences

78 FR 72899 - Draft Guidance for Industry on Registration for Human Drug Compounding Outsourcing Facilities...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-04

... facilities. The draft guidance discusses the process for registration of outsourcing facilities. The draft... outsourcing facilities that will participate in the process. Estimated reporting burden until September 30...] Draft Guidance for Industry on Registration for Human Drug Compounding Outsourcing Facilities Under...

Legal requirements for human-health based appeals of wind energy projects in ontario.

PubMed

Engel, Albert M

2014-01-01

In 2009, the government of the province of Ontario, Canada passed new legislation to promote the development of renewable energy facilities, including wind energy facilities in the province. Throughout the legislative process, concerns were raised with respect to the effect of wind energy facilities on human health. Ultimately, the government established setbacks and sound level limits for wind energy facilities and provided Ontario residents with the right to appeal the approval of a wind energy facility on the ground that engaging in the facility in accordance with its approval will cause serious harm to human health. The first approval of a wind facility under the new legislation was issued in 2010 and since then, Ontario's Environmental Review Tribunal as well as Ontario's courts has been considering evidence proffered by appellants seeking revocation of approvals on the basis of serious harm to human health. To date, the evidence has been insufficient to support the revocation of a wind facility approval. This article reviews the legal basis for the dismissal of human-health based appeals.

Space architecture monograph series. Volume 4: Genesis 2: Advanced lunar outpost

NASA Technical Reports Server (NTRS)

Fieber, Joseph P.; Huebner-Moths, Janis; Paruleski, Kerry L.; Moore, Gary T. (Editor)

1991-01-01

This research and design study investigated advanced lunar habitats for astronauts and mission specialists on the Earth's moon. Design recommendations are based on environmental response to the lunar environment, human habitability (human factors and environmental behavior research), transportability (structural and materials system with least mass), constructability (minimizing extravehicular time), construction dependability and resilience, and suitability for NASA launch research missions in the 21st century. The recommended design uses lunar lava tubes, with construction being a combination of Space Station Freedom derived hard modules and light weight Kevlar laminate inflatable structures. The proposed habitat includes research labs and a biotron, crew quarters and crew support facility, mission control, health maintenance facility, maintenance work areas for psychological retreat, privacy, and comtemplation. Furniture, specialized equipment, and lighting are included in the analysis and design. Drawings include base master plans, construction sequencing, overall architectural configuration, detailed floor plans, sections and axonometrics, with interior perspectives.

Gut Microbiome Standardization in Control and Experimental Mice.

PubMed

McCoy, Kathy D; Geuking, Markus B; Ronchi, Francesca

2017-04-03

Mouse models are used extensively to study human health and to investigate the mechanisms underlying human disease. In the past, most animal studies were performed without taking into consideration the impact of the microbiota. However, the microbiota that colonizes all body surfaces, including the gastrointestinal tract, respiratory tract, genitourinary tract, and skin, heavily impacts nearly every aspect of host physiology. When performing studies utilizing mouse models it is critical to understand that the microbiome is heavily impacted by environmental factors, including (but not limited to) food, bedding, caging, and temperature. In addition, stochastic changes in the microbiota can occur over time that also play a role in shaping microbial composition. These factors lead to massive variability in the composition of the microbiota between animal facilities and research institutions, and even within a single facility. Lack of experimental reproducibility between research groups has highlighted the necessity for rigorously controlled experimental designs in order to standardize the microbiota between control and experimental animals. Well controlled experiments are mandatory in order to reduce variability and allow correct interpretation of experimental results, not just of host-microbiome studies but of all mouse models of human disease. The protocols presented are aimed to design experiments that control the microbiota composition between different genetic strains of experimental mice within an animal unit. © 2017 by John Wiley & Sons, Inc. Copyright © 2017 John Wiley & Sons, Inc.

78 FR 72897 - Draft Guidance for Industry on Interim Product Reporting for Human Drug Compounding Outsourcing...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-04

...] Draft Guidance for Industry on Interim Product Reporting for Human Drug Compounding Outsourcing... Compounding Outsourcing Facilities Under Section 503B of the Federal Food, Drug, and Cosmetic Act.'' The draft... human drug compounders that choose to register as outsourcing facilities (outsourcing facilities). DATES...

Risk management study for the retired Hanford Site facilities: Qualitative risk evaluation for the retired Hanford Site facilities. Volume 3

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

Coles, G.A.; Shultz, M.V.; Taylor, W.E.

1993-09-01

This document provides a risk evaluation of the 100 and 200 Area retired, surplus facilities on the Hanford Site. Also included are the related data that were compiled by the risk evaluation team during investigations performed on the facilities. Results are the product of a major effort performed in fiscal year 1993 to produce qualitative information that characterizes certain risks associated with these facilities. The retired facilities investigated for this evaluation are located in the 100 and 200 Areas of the 1,450-km{sup 2} (570-mi{sup 2}) Hanford Site. The Hanford Site is a semiarid tract of land in southeastern Washington State.more » The nearest population center is Richland, Washington, (population 32,000) 30-km (20 mi) southeast of the 200 Area. During walkdown investigations of these facilities, data on real and potential hazards that threatened human health or safety or created potential environmental release issues were identified by the risk evaluation team. Using these findings, the team categorized the identified hazards by facility and evaluated the risk associated with each hazard. The factors contributing to each risk, and the consequence and likelihood of harm associated with each hazard also are included in this evaluation.« less

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

PubMed

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

2017-04-05

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

Factors promoting resident deaths at aged care facilities in Japan: a review.

PubMed

Sugimoto, Kentaro; Ogata, Yasuko; Kashiwagi, Masayo

2018-03-01

Due to an increasingly ageing population, the Japanese government has promoted elderly deaths in aged care facilities. However, existing facilities were not designed to provide resident end-of-life care and the proportion of aged care facility deaths is currently less than 10%. Consequently, the present review evaluated the factors that promote aged care facility resident deaths in Japan from individual- and facility-level perspectives to exploring factors associated with increased resident deaths. To achieve this, MEDLINE, CINAHL, Web of Science and Ichushi databases were searched on 23 January 2016. Influential factors were reviewed for two healthcare services (insourcing and outsourcing facilities) as well as external healthcare agencies operating outside facilities. Of the original 2324 studies retrieved, 42 were included in analysis. Of these studies, five focused on insourcing, two on outsourcing, seven on external agencies and observed facility/agency-level factors. The other 28 studies identified individual-level factors related to death in aged care facilities. The present review found that at both facility and individual levels, in-facility resident deaths were associated with healthcare service provision, confirmation of resident/family end-of-life care preference and staff education. Additionally, while outsourcing facilities did not require employment of physicians/nursing staff to accommodate resident death, these facilities required visits by physicians and nursing staff from external healthcare agencies as well as residents' healthcare input. This review also found few studies examining outsourcing facilities. The number of healthcare outsourcing facilities is rapidly increasing as a result of the Japanese government's new tax incentives. Consequently, there may be an increase in elderly deaths in outsourcing healthcare facilities. Accordingly, it is necessary to identify the factors associated with residents' deaths at outsourcing facilities. © 2016 The Authors. Health and Social Care in the Community Published by John Wiley & Sons Ltd.

Spaceflight Human System Standards

NASA Technical Reports Server (NTRS)

Holubec, Keith; Tillman, Barry; Connolly, Jan

2009-01-01

NASA created a new approach for human system integration and human performance standards. NASA created two documents a standard and a reference handbook. The standard is titled NASA Space Flight Human-System Standard (SFHSS) and consists of two-volumes: Volume 1- Crew Health This volume covers standards needed to support astronaut health (medical care, nutrition, sleep, exercise, etc.) Volume 2 Human Factors, Habitability and Environmental Health This volume covers the standards for system design that will maintain astronaut performance (ie., environmental factors, design of facilities, layout of workstations, and lighting requirements). It includes classic human factors requirements. The new standards document is written in terms so that it is applicable to a broad range of present and future NASA systems. The document states that all new programs prepare system-specific requirements that will meet the general standards. For example, the new standard does not specify a design should accommodate specific percentiles of a defined population. Rather, NASA-STD-3001, Volume 2 states that all programs shall prepare program-specific requirements that define the user population and their size ranges. The design shall then accommodate the full size range of those users. The companion reference handbook, Human Integration Design Handbook (HIDH), was developed to capture the design consideration information from NASA-STD-3000, and adds spaceflight lessons learned, gaps in knowledge, example solutions, and suggests research to further mature specific disciplines. The HIDH serves two major purposes: HIDH is the reference document for writing human factors requirements for specific systems. HIDH contains design guidance information that helps insure that designers create systems which safely and effectively accommodate the capabilities and limitations of space flight crews.

Personnel reliability impact on petrochemical facilities monitoring system's failure skipping probability

NASA Astrophysics Data System (ADS)

Kostyukov, V. N.; Naumenko, A. P.

2017-08-01

The paper dwells upon urgent issues of evaluating impact of actions conducted by complex technological systems operators on their safe operation considering application of condition monitoring systems for elements and sub-systems of petrochemical production facilities. The main task for the research is to distinguish factors and criteria of monitoring system properties description, which would allow to evaluate impact of errors made by personnel on operation of real-time condition monitoring and diagnostic systems for machinery of petrochemical facilities, and find and objective criteria for monitoring system class, considering a human factor. On the basis of real-time condition monitoring concepts of sudden failure skipping risk, static and dynamic error, monitoring systems, one may solve a task of evaluation of impact that personnel's qualification has on monitoring system operation in terms of error in personnel or operators' actions while receiving information from monitoring systems and operating a technological system. Operator is considered as a part of the technological system. Although, personnel's behavior is usually a combination of the following parameters: input signal - information perceiving, reaction - decision making, response - decision implementing. Based on several researches on behavior of nuclear powers station operators in USA, Italy and other countries, as well as on researches conducted by Russian scientists, required data on operator's reliability were selected for analysis of operator's behavior at technological facilities diagnostics and monitoring systems. The calculations revealed that for the monitoring system selected as an example, the failure skipping risk for the set values of static (less than 0.01) and dynamic (less than 0.001) errors considering all related factors of data on reliability of information perception, decision-making, and reaction fulfilled is 0.037, in case when all the facilities and error probability are under control - not more than 0.027. In case when only pump and compressor units are under control, the failure skipping risk is not more than 0.022, when the probability of error in operator's action is not more than 0.011. The work output shows that on the basis of the researches results an assessment of operators' reliability can be made in terms of almost any kind of production, but considering only technological capabilities, since operators' psychological and general training considerable vary in different production industries. Using latest technologies of engineering psychology and design of data support systems, situation assessment systems, decision-making and responding system, as well as achievement in condition monitoring in various production industries one can evaluate hazardous condition skipping risk probability considering static, dynamic errors and human factor.

BRUCELLOSIS IN TEREKEKA COUNTY, CENTRAL EQUATORIA STATE, SOUTHERN SUDAN.

PubMed

Lado, D; Maina, N; Lado, M; Abade, A; Amwayi, S; Omolo, J; Oundo, J

2012-01-01

To identify factors associated with Brucellosis in patients attending Terekeka Health Facility, Terekeka County, Central Equatoria State, Southern Sudan and to evaluate the utility of the rapid test kit Euracil®. A facility based case-control study. Terekeka Health Facility, Terekeka County, Central Equatoria State, Southern Sudan. Cases were patients presenting at the Terekeka Health Facility with clinical symptoms suggestive of Brucellosis and tested positive for Brucellosis by rapid antigen test while controls were selected from individuals attending Terekeka Health facility with health problems unrelated to brucellosis or febrile illness. A total of fifty eight cases with clinical symptoms suggestive of and tested positive for Brucellosis by rapid antigen test presented. A total of 116 consented controls were recruited into the study. Males accounted for 52% of the cases and 53% of the controls. The mean age was 31 years for both groups. Cases without formal education were 84% while 40% had no source of income, 20% of the cases and 14% of the controls were cattle keepers while 5% of the cases and 13% of the controls were students. In multivariate analysis there were many factors associated with Brucellosis like consumption of raw meat, living with animals at the same place, raising of goats, farm cleaning contact, eating of aborted and wild animals. Logistic regression revealed two factors associated with the disease; consumption of raw milk (OR=3.9, P-value 0.001, 95% CI 1.6666-9.0700) was a risk factor while drinking boiled milk was protective (OR = 0.09, p-value 0.000, 95% CI, 0.1-0.2). The main age-groups affected were 20-30 years with males being affected more than females. Drinking of raw milk was significantly associated with Brucellosis while drinking boiled milk was protective. There should be active public health education on the benefits of boiling milk before consumption. Further studies to elucidate the extent and epidemiology of brucellosis in humans and animals in Southern Sudan are recommended.

Influence of weather factors on moisture content of light fuels in forests of the northern Rocky Mountains

Treesearch

George M. Jemison

1935-01-01

The necessity of forest-fire protection is generally recognized in the United Slates. The tremendous damage done by forest fires each year to valuable timber, watershed cover, forest range, wildlife, recreational facilities, and personal property has impressed upon the people the need for preventing and controlling forest fires so far as this is humanly possible.

Auditory and Acoustic Research & Development at Air Force Research Laboratory (AFRL)

DTIC Science & Technology

2010-09-01

aircraft noise measurement and modeling, speech communication in noise, and national and international standards for over 60 years. This article ...substantial technical document and a complete review is beyond the scope of this article . The purpose of this section is to give some examples of...acoustics facilities and instrumentation. The multi-disciplinary researchers included experts in audiology , biomedical engineering, human factors

Estimating Human Trabecular Meshwork Stiffness by Numerical Modeling and Advanced OCT Imaging.

PubMed

Wang, Ke; Johnstone, Murray A; Xin, Chen; Song, Shaozhen; Padilla, Steven; Vranka, Janice A; Acott, Ted S; Zhou, Kai; Schwaner, Stephen A; Wang, Ruikang K; Sulchek, Todd; Ethier, C Ross

2017-09-01

The purpose of this study was to estimate human trabecular meshwork (hTM) stiffness, thought to be elevated in glaucoma, using a novel indirect approach, and to compare results with direct en face atomic force microscopy (AFM) measurements. Postmortem human eyes were perfused to measure outflow facility and identify high- and low-flow regions (HF, LF) by tracer. Optical coherence tomography (OCT) images were obtained as Schlemm's canal luminal pressure was directly manipulated. TM stiffness was deduced by an inverse finite element modeling (FEM) approach. A series of AFM forcemaps was acquired along a line traversing the anterior angle on a radially cut flat-mount corneoscleral wedge with TM facing upward. The elastic modulus of normal hTM estimated by inverse FEM was 70 ± 20 kPa (mean ± SD), whereas glaucomatous hTM was slightly stiffer (98 ± 19 kPa). This trend was consistent with TM stiffnesses measured by AFM: normal hTM stiffness = 1.37 ± 0.56 kPa, which was lower than glaucomatous hTM stiffness (2.75 ± 1.19 kPa). None of these differences were statistically significant. TM in HF wedges was softer than that in LF wedges for both normal and glaucomatous eyes based on the inverse FEM approach but not by AFM. Outflow facility was significantly correlated with TM stiffness estimated by FEM in six human eyes (P = 0.018). TM stiffness is higher, but only modestly so, in glaucomatous patients. Outflow facility in both normal and glaucomatous human eyes appears to associate with TM stiffness. This evidence motivates further studies to investigate factors underlying TM biomechanical property regulation.

Multiple ART Programs Create a Dilemma for Providers to Monitor ARV Adherence in Uganda.

PubMed

Obua, Celestino; Gusdal, Annelie; Waako, Paul; Chalker, John C; Tomson, Goran; Wahlström, Rolf; Team, The Inrud-Iaa

2011-01-01

Increased availability and accessibility of antiretroviral therapy (ART) has improved the length and quality of life amongst people living with HIV/AIDS. This has changed the landscape for care from episodic to long-term care that requires more monitoring of adherence. This has led to increased demand on human resources, a major problem for most ART programs. This paper presents experiences and perspectives of providers in ART facilities, exploring the organizational factors affecting their capacity to monitor adherence to ARVs. From an earlier survey to test adherence indicators and rank facilities as good, medium or poor adherence performances, six facilities were randomly selected, two from each rank. Observations on facility set-up, provider-patient interactions and key informant interviews were carried out. The strengths, weaknesses, opportunities and threats identified by health workers as facilitators or barriers to their capacity to monitor adherence to ARVs were explored during group discussions. Findings show that the performance levels of the facilities were characterized by four different organizational ART programs operating in Uganda, with apparent lack of integration and coordination at the facilities. Of the six facilities studied, the two high adherence performing facilities were Non-Governmental Organization (NGO) programs, while facilities with dual organizational programs (Governmental/NGO) performed poorly. Working conditions, record keeping and the duality of programs underscored the providers' capacity to monitor adherence. Overall 70% of the observed provider-patient interactions were conducted in environments that ensured privacy of the patient. The mean performance for record keeping was 79% and 50% in the high and low performing facilities respectively. Providers often found it difficult to monitor adherence due to the conflicting demands from the different organizational ART programs. Organizational duality at facilities is a major factor in poor adherence monitoring. The different ART programs in Uganda need to be coordinated and integrated into a single well resourced program to improve ART services and adherence monitoring. The focus on long-term care of patients on ART requires that the limitations to providers' capacity for monitoring adherence become central during the planning and implementation of ART programs.

The Application of the Human Engineering Modeling and Performance Laboratory for Space Vehicle Ground Processing Tasks at Kennedy Space Center

NASA Technical Reports Server (NTRS)

Woodbury, Sarah K.

2008-01-01

The introduction of United Space Alliance's Human Engineering Modeling and Performance Laboratory began in early 2007 in an attempt to address the problematic workspace design issues that the Space Shuttle has imposed on technicians performing maintenance and inspection operations. The Space Shuttle was not expected to require the extensive maintenance it undergoes between flights. As a result, extensive, costly resources have been expended on workarounds and modifications to accommodate ground processing personnel. Consideration of basic human factors principles for design of maintenance is essential during the design phase of future space vehicles, facilities, and equipment. Simulation will be needed to test and validate designs before implementation.

Aeronautics Technology Possibilities for 2000: Report of a workshop

NASA Technical Reports Server (NTRS)

1984-01-01

The potential of aeronautical research and technology (R&T) development, which could provide the basis for facility planning and long range guidance of R&T programs and could establish justification for support of aeronautical research and technology was studied. The projections served specific purposes: (1) to provide a base for research and future facilities needed to support the projected technologies, and development advanced vehicles; (2) to provide insight on the possible state of the art in aeronautical technology by the year 2000 for civil and military planners of air vehicles and systems. Topics discussed include: aerodynamics; propulsion; structures; materials; guidance, navigation and control; computer and information technology; human factors; and systems integration.

Research and technology, 1990

NASA Technical Reports Server (NTRS)

1990-01-01

Selected research and technology activities at Ames Research Center, including the Moffett Field site and the Dryden Flight Research Facility, are summarized. These accomplishments exemplify the Center's varied and highly productive research efforts for 1990. The activities addressed are under the directories of: (1) aerospace systems which contains aircraft technology, full-scale aerodynamics research, information sciences, aerospace human factors research, and flight systems and simulation research divisions; (2) Dryden flight research facility which contains research engineering division; (3) aerophysics which contains aerodynamics, fluid dynamics, and thermosciences divisions; and (4) space research which contains advanced life support, space projects, earth system science, life science, and space science divisions, and search for extraterrestrial intelligence and space life sciences payloads offices.

A comparative study on the level of satisfaction among regular and contractual health-care workers in a Northern city of India

PubMed Central

Dixit, Jyoti; Goel, Sonu; Sharma, Vijaylakshmi

2017-01-01

Introduction: Job satisfaction greatly determines the productivity and efficiency of human resources for health. The current study aims to assess the level of satisfaction and factors influencing the job satisfaction among regular and contractual health-care workers. Materials and Methods: A cross-sectional quantitative study was conducted from January to June 2015 among health care workers (n = 354) at all levels of public health-care facilities of Chandigarh. The correlation between variables with overall level of satisfaction was computed for regular and contractual health-care workers. Stepwise multiple linear regression was done to elucidate the major factors influencing job satisfaction. Results: Majority of the regular health-care staff was highly satisfied (86.9%) as compared to contractual staff (10.5%), which however was moderately satisfied (55.9%). Stepwise regression model showed that work-related matters (β = 1.370, P < 0.01), organizational facilities (β = 1.586, P < 0.01), privileges attached to the job (β = 0.530, P < 0.01), attention to the suggestions (β = 0.515, P < 0.01), chance of promotion (β = 0.703, P < 0.01), and human resource issues (β = 1.0721, P < 0.01) are strong predictors of overall satisfaction level. Conclusion: Under the National Rural Health Mission, contract appointments have improved the overall availability of health-care staff at all levels of public health facilities. However, there are concerns regarding their level of motivation with various aspects related to the job, which need to be urgently addressed so as to improve the effectiveness and efficiency of health services. PMID:29302557

A comparative study on the level of satisfaction among regular and contractual health-care workers in a Northern city of India.

PubMed

Dixit, Jyoti; Goel, Sonu; Sharma, Vijaylakshmi

2017-01-01

Job satisfaction greatly determines the productivity and efficiency of human resources for health. The current study aims to assess the level of satisfaction and factors influencing the job satisfaction among regular and contractual health-care workers. A cross-sectional quantitative study was conducted from January to June 2015 among health care workers ( n = 354) at all levels of public health-care facilities of Chandigarh. The correlation between variables with overall level of satisfaction was computed for regular and contractual health-care workers. Stepwise multiple linear regression was done to elucidate the major factors influencing job satisfaction. Majority of the regular health-care staff was highly satisfied (86.9%) as compared to contractual staff (10.5%), which however was moderately satisfied (55.9%). Stepwise regression model showed that work-related matters (β = 1.370, P < 0.01), organizational facilities (β = 1.586, P < 0.01), privileges attached to the job (β = 0.530, P < 0.01), attention to the suggestions (β = 0.515, P < 0.01), chance of promotion (β = 0.703, P < 0.01), and human resource issues (β = 1.0721, P < 0.01) are strong predictors of overall satisfaction level. Under the National Rural Health Mission, contract appointments have improved the overall availability of health-care staff at all levels of public health facilities. However, there are concerns regarding their level of motivation with various aspects related to the job, which need to be urgently addressed so as to improve the effectiveness and efficiency of health services.

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

NASA Technical Reports Server (NTRS)

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

1996-01-01

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

76 FR 24213 - Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-29

...This proposed rule would implement section 3004 of the Affordable Care Act, which establishes a new quality reporting program that provides for a 2 percent reduction in the annual increase factor beginning in 2014 for failure to report quality data to the Secretary of Health and Human Services. This proposed rule would also update the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year 2012 (for discharges occurring on or after October 1, 2011 and on or before September 30, 2012) as required by the Social Security Act (the Act). The Act requires the Secretary to publish in the Federal Register on or before the August 1 that precedes the start of each FY the classification and weighting factors for the IRF prospective payment system (PPS) case-mix groups and a description of the methodology and data used in computing the prospective payment rates for that fiscal year. We are also proposing to consolidate, clarify, and revise existing policies regarding IRF hospitals and IRF units of hospitals to eliminate unnecessary confusion and enhance consistency. Furthermore, in accordance with the general principles of the President's January 18, 2011 Executive Order entitled ``Improving Regulation and Regulatory Review,'' we are proposing to amend existing regulatory provisions regarding ``new'' facilities and changes in the bed size and square footage of IRFs and inpatient psychiatric facilities (IPFs) to improve clarity and remove obsolete material.

Nondestructive testing techniques

NASA Astrophysics Data System (ADS)

Bray, Don E.; McBride, Don

A comprehensive reference covering a broad range of techniques in nondestructive testing is presented. Based on years of extensive research and application at NASA and other government research facilities, the book provides practical guidelines for selecting the appropriate testing methods and equipment. Topics discussed include visual inspection, penetrant and chemical testing, nuclear radiation, sonic and ultrasonic, thermal and microwave, magnetic and electromagnetic techniques, and training and human factors. (No individual items are abstracted in this volume)

Research and Development, Technology Requirements, and Use of Existing Space Assets

NASA Technical Reports Server (NTRS)

Grey, Jerry; Rowell, Larry

1999-01-01

Technology requirements are addressed in three categories: (1) Passenger-carrying STS(s); (2) orbital facilities (including on-orbit operations such as servicing) and human factors (crew and passenger training and recreation, on-orbit environmental control, etc.); and (3) ground infrastructure. An example tourism trip scenario is used in discussing possible targets for technology development activities. Some general comments are made as are considerations for other working groups.

EPM - The European Facility for human physiology research on ISS.

PubMed

Rieschel, Mats; Nasca, Rosario; Junk, Peter; Gerhard, Ingo

2002-07-01

The European Physiology Modules (EPM) Facility is one of the four major Space Station facilities being developed within the framework of ESA's Microgravity Facilities for Columbus (MFC) programme. In order to allow a wide spectrum of physiological studies in weightlessness conditions, the facility provides the infrastructure to accommodate a variable set of scientific equipment. The initial EPM configuration supports experiments in the fields of neuroscience, bone & muscle research, cardiovascular research and metabolism. The International Space Life Science Working Group (ISLSWG) has recommended co-locating EPM with the 2 NASA Human Research Facility racks.

Identifying Factors for Worker Motivation in Zambia's Rural Health Facilities.

PubMed

Cross, Samuel S; Baernholdt, Dr Marianne

2017-01-01

Within Zambia there is a shortage of health workers in rural areas. This study aims to identify motivating factors for retaining rural health workers. Sixty rural health workers completed surveys and 46 were interviewed. They rated the importance of six motivating factors and discussed these and other factors in interviews. An interview was conducted with a Government Human Resources Manager (HR Manager) to elicit contextual information. All six factors were identified as being very important motivators, as were two additional factors. Additional career training was identified by many as the most important factor. Comparison of results and the HR Manager interview revealed that workers lacked knowledge about opportunities and that the HR manager was aware of barriers to career development. The Zambian government might better motivate and retain rural health workers by offering them any combination of identified factors, and by addressing the barriers to career development.

Berkeley Lab - Materials Sciences Division

Science.gov Websites

MSD Support Human Resources Facilities & Space Planning Procurement and Property Proposals & ; Finance Templates Travel One-Stop Acknowledging MSD Support Human Resources Facilities & Space Operations For information regarding Human Resources, procedures for acknowledging MSD support, division

Berkeley Lab - Materials Sciences Division

Science.gov Websites

MSD Support Human Resources Facilities & Space Planning Procurement and Property Proposals & ; Finance Templates Travel One-Stop Acknowledging MSD Support Human Resources Facilities & Space Planning Procurement and Property Proposals & Finance Templates Travel Human Resources General

A fall prevention guideline for older adults living in long-term care facilities.

PubMed

Jung, D; Shin, S; Kim, H

2014-12-01

Falls are among the most frequent critical health problems for older adults over 65 years of age and often result in consequential injuries. This study developed a guideline covering risk factors and interventions for falls in order to prevent them from occurring in long-term care facilities. This study was grounded in the methodological approach of the Scottish Intercollegiate Guideline Network for establishing evidence-based guidelines: (1) establishment of the target population and scope of the guideline, (2) systematic literature review and critical analysis, (3) determination of the recommendation grade, (4) development of a draft nursing intervention guideline and algorithm, (5) expert evaluation of the draft nursing intervention guideline, and (6) confirmation of the final intervention guideline and completion of the algorithm. The resulting evidence-based fall prevention guideline consists of a three-step factor assessment and a three-step intervention approach. The resulting guideline was based on the literature and clinical experts. Further research is required to test the guideline's feasibility in across long term care facilities. This guideline can be used by nurses to screen patients who are at a high risk of falling to provide patient interventions to help prevent falls. Considering the high rate of falls at long-term care facilities and the absence of evidence-based guidelines to prevent them, additional studies on falls at long-term care facilities are necessary. Meanwhile, given prior research that indicates the importance of human resources in the application of such guidelines, continuous investigations are needed as to whether the research outcomes are actually conveyed to nurses. © 2014 International Council of Nurses.

Simian hemorrhagic fever virus infection of rhesus macaques as a model of viral hemorrhagic fever: Clinical characterization and risk factors for severe disease

PubMed Central

Johnson, Reed F.; Dodd, Lori; Yellayi, Srikanth; Gu, Wenjuan; Cann, Jennifer A.; Jett, Catherine; Bernbaum, John G.; Ragland, Dan R.; Claire, Marisa St.; Byrum, Russell; Paragas, Jason; Blaney, Joseph E.; Jahrling, Peter B.

2011-01-01

Simian Hemorrhagic Fever Virus (SHFV) has caused sporadic outbreaks of hemorrhagic fevers in macaques at primate research facilities. SHFV is a BSL-2 pathogen that has not been linked to human disease; as such, investigation of SHFV pathogenesis in non-human primates (NHPs) could serve as a model for hemorrhagic fever viruses such as Ebola, Marburg, and Lassa viruses. Here we describe the pathogenesis of SHFV in rhesus macaques inoculated with doses ranging from 50 PFU to 500,000 PFU. Disease severity was independent of dose with an overall mortality rate of 64% with signs of hemorrhagic fever and multiple organ system involvement. Analyses comparing survivors and non-survivors were performed to identify factors associated with survival revealing differences in the kinetics of viremia, immunosuppression, and regulation of hemostasis. Notable similarities between the pathogenesis of SHFV in NHPs and hemorrhagic fever viruses in humans suggest that SHFV may serve as a suitable model of BSL-4 pathogens. PMID:22014505

Human Factors Report: TMA Operational Evaluations 1996 and 1998

NASA Technical Reports Server (NTRS)

Lee, Katharine K.; Quinn, Cheryl M.; Hoang, Ty; Sanford, Beverly D.

2000-01-01

The Traffic Management Advisor (TMA) is a component of the Center-TRACON Automation System (CTAS), a suite of decision-support tools for the air traffic control (ATC) environment which is being developed at NASA Ames Research Center. TMA has been operational at the ATC facilities in Dallas/Fort Worth, Texas, since an operational field evaluation in 1996. The Operational Evaluation demonstrated significant benefits, including an approximately 5 percent increase in airport capacity. This report describes the human factors results from the 1996 Operational Evaluation and an investigation of TMA usage performed two years later, during the 1998 TMA Daily Use Field Survey. The results described are instructive for CTAS focused development, and provide valuable lessons for future research in ATC decision-support tools where it is critical to merge a well-defined, complex work environment with advanced automation.

How do supply-side factors influence informal payments for healthcare? The case of HIV patients in Cameroon.

PubMed

Kankeu, Hyacinthe Tchewonpi; Boyer, Sylvie; Fodjo Toukam, Raoul; Abu-Zaineh, Mohammad

2016-01-01

Direct out-of-pocket payments for healthcare continue to be a major source of health financing in low-income and middle-income countries. Some of these direct payments take the form of informal charges paid by patients to access the needed healthcare services. Remarkably, however, little is known about the extent to which these payments are exercised and their determinants in the context of Sub-Saharan Africa. This study attempts therefore to shed light on the role of supply-side factors in the occurrence of informal payments while accounting for the demand-side factors. The study relies on data taken from a nationally representative survey conducted among people living with HIV/AIDS in Cameroon. A multilevel mixed-effect logistic model is employed to identify the factors associated with the incidence of informal payments. Results reveal that circa 3.05% of the surveyed patients incurred informal payments for the consultations made on the day of the survey. The amount paid informally represents up to four times the official tariff. Factors related to the following: (i) human resource management of the health facilities (e.g., task shifting); (ii) health professionals' perceptions vis-à-vis the remunerations of HIV care provision; and (iii) reception of patients (e.g., waiting time) significantly influence the probability of incurring informal payments. Also of note, the type of healthcare facilities is found to play a role: informal payments appear to be significantly lower in private non-profit facilities compared with those belonging to public sector. Our findings allude to some policy recommendations that can help reduce the incidence of informal payments. Copyright © 2014 John Wiley & Sons, Ltd.

Human Factors Engineering Program for Intercontinental Ballistic Missile Systems, (MIL-STD-1794(USAF))

DTIC Science & Technology

1986-10-01

opeational test and evaluation (OT&R). The OT&B Is comprised of Initial operational test and evaluation ( IOT &R) and follow-on test and evaluation (FOT&R). OT&I...BP HYL FVAC beating, ventilation and air conditioning am. ICBM Intercntinental ballistic missile an. IOT &R Initial operational test and *valuation so...and maintenance vehicles (stop- B pod, engine idle-exterior), facility equipment utility rooms, heating, ventilation and air conditioning ( HVAC

Results and Lessons Learned from Performance Testing of Humans in Spacesuits in Simulated Reduced Gravity

NASA Technical Reports Server (NTRS)

Chappell, Steven P.; Norcross, Jason R.; Gernhardt, Michael L.

2010-01-01

The Apollo lunar EVA experience revealed challenges with suit stability and control-likely a combination of mass, mobility, and center of gravity (CG) factors. The EVA Physiology, Systems and Performence (EPSP) Project is systematically working with other NASA projects, labs, and facilities to lead a series of studies to understand the role of suit mass, weight, CG, and other parameters on astronaut performance in partial gravity environments.

Determinants of health system delay at public and private directly observed treatment, short course facilities in Lagos State, Nigeria: A cross-sectional study.

PubMed

Adejumo, Olusola Adedeji; Daniel, Olusoji James; Otesanya, Andrew Folarin; Adejumo, Esther Ngozi

2016-09-01

Despite several studies on health system delay (HSD) among tuberculosis (TB) patients in Nigeria, no study has compared HSD in private and public health facilities. This study assessed the determinants of HSD in public and private health facilities offering the directly observed treatment, short course (DOTS). A descriptive cross-sectional study was conducted. A total of 470 new smear-positive TB patients aged 14years and older were consecutively recruited between October 1, 2012, and December 31, 2012, from 34 (23 public and 11 private) DOTS facilities that offered treatment and microscopy services. Mann-Whitney U test and logistic regression were used to assess the determinants of HSD. The median HSD was longer at public DOTS facilities (14days; interquartile range [IQR] 10-21days) than private DOTS facilities (12.5days; IQR 10.0-14.0days, p=.002). Age and human immunodeficiency virus status were determinants of HSD at the public DOTS facilities, whereas sex and income were determinants of HSD at the private DOTS facilities. TB patients who first visited a nonhospital facility were over four times more likely (odds ratio 4.12; 95% confidence interval 2.25-7.54) to have prolonged HSD than those who first visited the government hospital when they first developed the symptoms of TB after controlling for other factors in the model. Determinants of HSD at the public and private DOTS facilities vary. Strategies to reduce HSD at both public and private DOTS facilities in Lagos State, Nigeria, are urgently needed. Copyright © 2016 Asian-African Society for Mycobacteriology. Published by Elsevier Ltd. All rights reserved.

Human Factors Assessment: The Passive Final Approach Spacing Tool (pFAST) Operational Evaluation

NASA Technical Reports Server (NTRS)

Lee, Katharine K.; Sanford, Beverly D.

1998-01-01

Automation to assist air traffic controllers in the current terminal and en route air traff ic environments is being developed at Ames Research Center in conjunction with the Federal Aviation Administration. This automation, known collectively as the Center-TRACON Automation System (CTAS), provides decision- making assistance to air traffic controllers through computer-generated advisories. One of the CTAS tools developed specifically to assist terminal area air traffic controllers is the Passive Final Approach Spacing Tool (pFAST). An operational evaluation of PFAST was conducted at the Dallas/Ft. Worth, Texas, Terminal Radar Approach Control (TRACON) facility. Human factors data collected during the test describe the impact of the automation upon the air traffic controller in terms of perceived workload and acceptance. Results showed that controller self-reported workload was not significantly increased or reduced by the PFAST automation; rather, controllers reported that the levels of workload remained primarily the same. Controller coordination and communication data were analyzed, and significant differences in the nature of controller coordination were found. Controller acceptance ratings indicated that PFAST was acceptable. This report describes the human factors data and results from the 1996 Operational Field Evaluation of Passive FAST.

Job satisfaction and motivation among public sector health workers: evidence from Ethiopia.

PubMed

Hotchkiss, David R; Banteyerga, Hailom; Tharaney, Manisha

2015-10-29

Although human resources for health have received increased attention by health systems decision-makers and researchers in recent years, insufficient attention has been paid to understanding the factors that influence the performance of health workers. This empirical study investigates the factors that are associated with health worker motivation over time among public sector primary health care workers in Ethiopia. The study is based on data from public sector health worker surveys collected through a convenience sample of 43 primary health care facilities in four regions (Addis Ababa, Oromia, Amhara, and Somali) at three points in time: 2003/04, 2006, and 2009. Using a Likert scale, respondents were asked to respond to statements regarding job satisfaction, pride in work, satisfaction with financial rewards, self-efficacy, satisfaction with facility resources, and self-perceived conscientiousness. Inter-reliability of each construct was assessed using Cronbach's alpha, and indices of motivational determinants and outcomes were calculated for each survey round. To explore the associations between motivational determinants and outcomes, bivariate and multivariate regression analyses were carried out based on a pooled dataset. Among the sample public sector health workers, several dimensions of health worker motivation significantly increased over the study period, including two indicators of motivational outcomes-overall job satisfaction and self-perceived conscientiousness-and two indicators of motivational determinants-pride and self-efficacy. However, two other dimensions of motivation-satisfaction with financial rewards and satisfaction with facility resources-significantly decreased. The multivariate analyses found that the constructs of pride, self-efficacy, satisfaction with financial rewards, and satisfaction with facility resources were significantly associated with the motivational outcomes, after controlling for other factors. Overall, the findings support the premise that both financial and non-financial factors are important determinants of health worker motivation in the Ethiopian context. Although the findings do not point to specific interventions that should be introduced, they do suggest possible areas that interventions should target to help improve health worker motivation.

The gap in human resources to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico.

PubMed

Alcalde-Rabanal, Jacqueline Elizabeth; Nigenda, Gustavo; Bärnighausen, Till; Velasco-Mondragón, Héctor Eduardo; Darney, Blair Grant

2017-08-03

The purpose of this study was to estimate the gap between the available and the ideal supply of human resources (physicians, nurses, and health promoters) to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico. We conducted a cross-sectional observational study using a convenience sample. We selected 20 primary health facilities in urban and rural areas in 10 states of Mexico. We calculated the available and the ideal supply of human resources in these facilities using estimates of time available, used, and required to deliver health prevention and promotion services. We performed descriptive statistics and bivariate hypothesis testing using Wilcoxon and Friedman tests. Finally, we conducted a sensitivity analysis to test whether the non-normal distribution of our time variables biased estimation of available and ideal supply of human resources. The comparison between available and ideal supply for urban and rural primary health care facilities reveals a low supply of physicians. On average, primary health care facilities are lacking five physicians when they were estimated with time used and nine if they were estimated with time required (P < 0.05). No difference was observed between available and ideal supply of nurses in either urban or rural primary health care facilities. There is a shortage of health promoters in urban primary health facilities (P < 0.05). The available supply of physicians and health promoters is lower than the ideal supply to deliver the guaranteed package of prevention and health promotion services. Policies must address the level and distribution of human resources in primary health facilities.

76 FR 47835 - Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-05

...This final rule will implement section 3004 of the Affordable Care Act, which establishes a new quality reporting program that provides for a 2 percent reduction in the annual increase factor beginning in 2014 for failure to report quality data to the Secretary of Health and Human Services. This final rule will also update the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2012 (for discharges occurring on or after October 1, 2011 and on or before September 30, 2012) as required under section 1886(j)(3)(C) of the Social Security Act (the Act). Section 1886(j)(5) of the Act requires the Secretary to publish in the Federal Register on or before the August 1 that precedes the start of each FY the classification and weighting factors for the IRF prospective payment system (PPS) case-mix groups and a description of the methodology and data used in computing the prospective payment rates for that fiscal year. We are also consolidating, clarifying, and revising existing policies regarding IRF hospitals and IRF units of hospitals to eliminate unnecessary confusion and enhance consistency. Furthermore, in accordance with the general principles of the President's January 18, 2011 Executive Order entitled ``Improving Regulation and Regulatory Review,'' we are amending existing regulatory provisions regarding ''new'' facilities and changes in the bed size and square footage of IRFs and inpatient psychiatric facilities (IPFs) to improve clarity and remove obsolete material.

Work stress among nursing home care attendants in Taiwan: a questionnaire survey.

PubMed

Hsu, Hui-Chuan; Kung, Yuan-Wei; Huang, Hsiao-Chien; Ho, Pei-Yu; Lin, Ya-Ying; Chen, Wen-Shin

2007-07-01

Care attendants constitute the main workforce in nursing homes, but their heavy workload, low autonomy, and indefinite responsibility result in high levels of stress and may affect quality of care. However, few studies have focused of this problem. The aim of this study was to examine work-related stress and associated factors that affect care attendants in nursing homes and to offer suggestions for how management can alleviate these problems in care facilities. We recruited participants from nine nursing homes with 50 or more beds located in middle Taiwan; 110 care attendants completed the questionnaire. The work stress scale for the care attendants was validated and achieved good reliability (Cronbach's alpha=0.93). We also conducted exploratory factor analysis. Six factors were extracted from the work stress scale: insufficient ability, stressful reactions, heavy workload, trouble in care work, poor management, and working time problems. The explained variance achieved 64.96%. Factors related to higher work stress included working in a hospital-based nursing home, having a fixed schedule, night work, feeling burden, inconvenient facility, less enthusiasm, and self-rated higher stress. Work stress for care attendants in nursing homes is related to human resource management and quality of care. We suggest potential management strategies to alleviate work stress for these workers.

Biomedical user facility at the 400-MeV Linac at Fermilab

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

Chu, W.T.

1993-12-01

In this paper, general requirements are discussed on a biomedical user facility at the Fermilab`s 400-MeV Linac, which meets the needs of biology and biophysics experiments, and a conceptual design and typical operations requirements of the facility is presented. It is assumed that no human patient treatment will take place in this facility. If human patients were treated, much greater attention would have to be paid to safeguarding the patients.

Determining the Prevalence of Human Immunodeficiency Virus (HIV) within a Residential Facility for Persons with Mental Retardation.

ERIC Educational Resources Information Center

Pledgie, Thomas K.; Schumacher, Steven H.

1993-01-01

Administrators of residential facilities for persons with mental retardation are urged to take a proactive stance in determining the prevalence of Human Immunodeficiency Virus (HIV). Administrators of one 345-bed intermediate care facility used a double blind seroprevalence study. No HIV infection was found in this group. (DB)

A Study on Governance and Human Resources for Cooperative Road Facilities Management

NASA Astrophysics Data System (ADS)

Ohno, Sachiko; Takagi, Akiyoshi; Kurauchi, Fumitaka; Demura, Yoshifumi

Within today's infrastructure management, Asset Management systems are becoming a mainstream feature. For region where the risk is low, it is necessary to create a "cooperative road facilities management system". This research both examined and suggested what kind of cooperative road facilities management system should be promoted by the regional society. Concretely, this study defines the operational realities of a previous case. It discusses the problem of the road facilities management as a governance. Furthermore, its realization depends on "the cooperation between municipalities", "the private-sector initiative", and "residents participation" .Also, it discusses the problem of human resources for governance. Its realization depends on "the engineers' promotion", and "creation of a voluntary activity of the resident" as a human resources. Moreover, it defines that the intermediary is important because the human resources tied to the governance. As a result, the prospect of the road facilities management is shown by the role of the player and the relation among player.

Lockheed Martin T-Rex: Preliminary report

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

NONE

1997-07-31

T-Rex is a robot which may be used in toxic or flammable environments. The assessment of the T-Rex conducted at the Lockheed Martin facility was limited in its scope. The scope of the assessment was directed by the type of equipment being used and the amount of accessibility to the equipment. Due to severe time constraints--the assessment was conducted in one day--human factors interface activities were limited. This should be considered a preliminary assessment. This report covers aspects of the technology that were available to the assessment team. Recommendations for future evaluation of this technology are also included. The contentsmore » are as follows: Electrical Considerations; General Electrical Consideration; Trailing Cables; Grounding; Surface High Voltage Distribution; Low and Medium Voltage Alternating Current Circuits; Potential for Harmful Human Factor Incidents and Enterprise Disablement; Exclusion Zone Emergency Maintenance; and Recommendations.« less

Factors associated with job satisfaction among commune health workers: implications for human resource policies.

PubMed

Tran, Bach Xuan; Van Hoang, Minh; Nguyen, Hinh Duc

2013-01-30

Job satisfaction among health workers is an important indicator in assessing the performance and efficiency of health services. This study measured job satisfaction and determined associated factors among health workers in 38 commune health stations in an urban district and a rural district of Hanoi, Vietnam. A total of 252 health workers (36 medical doctors and 216 nurses and technicians; 74% female) were interviewed. A job satisfaction measure was developed using factor analysis, from which four dimensions emerged, namely 'benefits and prospects,' 'facility and equipment,' 'performance,' and 'professionals.' The results demonstrate that respondents were least satisfied with the following categories: salary and incentives (24.0%), benefit packages (25.1%), equipment (35.7%), and environment (41.8%). The average satisfaction score was moderate across four domains; it was the highest for 'performance' (66.6/100) and lowest for 'facility and equipment' (50.4/100). Tobit-censored regression models, constructed using stepwise selection, determined significant predictors of job satisfaction including age, areas of work and expertise, professional education, urban versus rural setting, and sufficient number of staff. The findings highlight the need to implement health policies that focus on incentives, working conditions, workloads, and personnel management at grassroots level.

Extravehicular Activity training and hardware design considerations

NASA Technical Reports Server (NTRS)

Thuot, Pierre J.; Harbaugh, Gregory J.

1993-01-01

Designing hardware that can be successfully operated by EVA astronauts for EVA tasks required to assemble and maintain Space Station Freedom requires a thorough understanding of human factors and of the capabilities and limitations of the space-suited astronaut, as well as of the effect of microgravity environment on the crew member's capabilities and on the overhead associated with EVA. This paper describes various training methods and facilities that are being designed for training EVA astronauts for Space Station assembly and maintenance, taking into account the above discussed factors. Particular attention is given to the user-friendly hardware design for EVA and to recent EVA flight experience.

Human Factors Workshop on Aviation (4th) Transcript Held at Atlantic City, New Jersey on 13-15 May 1981.

DTIC Science & Technology

1982-05-01

and some specific examples of problems and recom- mended solutions . At the third workshop, we continued the process of defining and discussing the... procurement . The replacement of computer and display equipment in a system that must * support continuous operation without degradation in service...all facilities are equally busy . We have also been running, with the assistance of our Transportation Systems Center and the MITRE Corporation, a

Passengers, Crew, Life Support, and Insurance Considerations

NASA Technical Reports Server (NTRS)

ONeil, Daniel A.; Young, Lawrence R.

1999-01-01

This section describes the key issues, barriers, opportunities, and potential trip packages related to the needs and expectations of initial space adventure travelers. A variety of ideas to overcome barriers is presented that address financial, psychological, and sociological problems expected to be encountered in establishing a general PST and tourism business. Tour package descriptions range from near-term surface training facilities to far-term lunar ones. Recommendations include requirements pertaining to human factors in design and needed technology.

User-Computer Interactions: Some Problems for Human Factors Research

DTIC Science & Technology

1981-09-01

accessibility from the work place or home of R. information stored in major repositories. o Two-way real-time communication between broadcasting - facilities...Miller, and R.W. Pew (BBN Inc.) MDA 903-80-C-0551 9. PERFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT. PROJECT, TASK AREA & WORK UNIT NUMBERS...average U.S. home has gone from about 10 in 1940 to about 100 in 1960 to a few thousand in 1930. Collectively, these trends represent an enormous

Functional Metagenomics of Spacecraft Assembly Cleanrooms: Presence of Virulence Factors Associated with Human Pathogens

PubMed Central

Bashir, Mina; Ahmed, Mahjabeen; Weinmaier, Thomas; Ciobanu, Doina; Ivanova, Natalia; Pieber, Thomas R.; Vaishampayan, Parag A.

2016-01-01

Strict planetary protection practices are implemented during spacecraft assembly to prevent inadvertent transfer of earth microorganisms to other planetary bodies. Therefore, spacecraft are assembled in cleanrooms, which undergo strict cleaning and decontamination procedures to reduce total microbial bioburden. We wanted to evaluate if these practices selectively favor survival and growth of hardy microorganisms, such as pathogens. Three geographically distinct cleanrooms were sampled during the assembly of three NASA spacecraft: The Lockheed Martin Aeronautics' Multiple Testing Facility during DAWN, the Kennedy Space Center's Payload Hazardous Servicing Facility (KSC-PHSF) during Phoenix, and the Jet Propulsion Laboratory's Spacecraft Assembly Facility during Mars Science Laboratory. Sample sets were collected from the KSC-PHSF cleanroom at three time points: before arrival of the Phoenix spacecraft, during the assembly and testing of the Phoenix spacecraft, and after removal of the spacecraft from the KSC-PHSF facility. All samples were subjected to metagenomic shotgun sequencing on an Illumina HiSeq 2500 platform. Strict decontamination procedures had a greater impact on microbial communities than sampling location Samples collected during spacecraft assembly were dominated by Acinetobacter spp. We found pathogens and potential virulence factors, which determine pathogenicity in all the samples tested during this study. Though the relative abundance of pathogens was lowest during the Phoenix assembly, potential virulence factors were higher during assembly compared to before and after assembly, indicating a survival advantage. Decreased phylogenetic and pathogenic diversity indicates that decontamination and preventative measures were effective against the majority of microorganisms and well implemented, however, pathogen abundance still increased over time. Four potential pathogens, Acinetobacter baumannii, Acinetobacter lwoffii, Escherichia coli and Legionella pneumophila, and their corresponding virulence factors were present in all cleanroom samples. This is the first functional metagenomics study describing presence of pathogens and their corresponding virulence factors in cleanroom environments. The results of this study should be considered for microbial monitoring of enclosed environments such as schools, homes, hospitals and more isolated habitation such the International Space Station and future manned missions to Mars. PMID:27667984

Lapse in Institutional Animal Care and Use Committee Continuing Reviews.

PubMed

Tsan, Min-Fu; Grabenbauer, Michael; Nguyen, Yen

2016-01-01

The United States federal animal welfare regulations and the Public Health Service Policy on Humane Care and Use of Laboratory Animals require that institutional animal care and use committees (IACUCs) conduct continuing reviews of all animal research activities. However, little is known about the lapse rate of IACUC continuing reviews, and how frequently investigators continue research activities during the lapse. It is also not clear what factors may contribute to an institution's lapse in IACUC continuing reviews. As part of the quality assurance program, the Department of Veterans Affairs (VA) has collected performance metric data for animal care and use programs since 2011. We analyzed IACUC continuing review performance data at 74-75 VA research facilities from 2011 through 2015. The IACUC continuing review lapse rates improved from 5.6% in 2011 to 2.7% in 2015. The rate of investigators continuing research activities during the lapse also decreased from 47.2% in 2012 to 7.4% in 2015. The type of IACUCs used and the size of animal research programs appeared to have no effect in facility's rates of lapse in IACUC continuing reviews. While approximately 80% of facilities reported no lapse in IACUC continuing reviews, approximately 14% of facilities had lapse rates of >10% each year. Some facilities appeared to be repeat offenders. Four facilities had IACUC lapse rates of >10% in at least 3 out of 5 years, suggesting a system problem in these facilities requiring remedial actions to improve their IACUC continuing review processes.

Revealed access to haemodialysis facilities in northeastern Iran: Factors that matter in rural and urban areas.

PubMed

Kiani, Behzad; Bagheri, Nasser; Tara, Ahmad; Hoseini, Benyamin; Tabesh, Hamed; Tara, Mahmood

2017-11-07

Poor access to haemodialysis facilities is associated with high mortality and morbidity rates. This study investigated factors affecting revealed access to the haemodialysis facilities considering patients living in rural and urban areas without any haemodialysis facility (Group A) and those living urban areas with haemodialysis facilities (Group B). This study is based on selfreported Actual Access Time (AAT) to referred haemodialysis facilities and other information regarding travel to haemodialysis facilities from patients. All significant variables on univariate analysis were entered into a univariate general linear model in order to identify factors associated with AAT. Both spatial (driving time and distance) and non-spatial factors (sex, income level, caregivers, transportation mode, education level, ethnicity and personal vehicle ownership) influenced the revealed access identified in Group A. The non-spatial factors for Group B patients were the same as for Group A, but no spatial factor was identified in Group B. It was found that accessibility is strongly underestimated when driving time is chosen as accessibility measure to haemodialysis facilities. Analysis of revealed access determinants provides policymakers with an appropriate decision base for making appropriate decisions and finding solutions to decrease the access time for patients under haemodialysis therapy. Driving time alone is not a good proxy for measuring access to haemodialysis facilities as there are many other potential obstacles, such as women's special travel problems, poor other transportation possibilities, ethnicity disparities, low education levels, low caregiver status and low-income.

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.

9 CFR 3.27 - Facilities, outdoor.

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 § 3.27 Facilities, outdoor. (a) Hamsters shall not be housed in outdoor facilities. (b) Guinea pigs shall not be housed in outdoor facilities unless...

78 FR 20326 - Draft Compliance Policy Guide Sec. 100.250 Food Facility Registration-Human and Animal Food...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-04

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-D-0126] Draft Compliance Policy Guide Sec. 100.250 Food Facility Registration--Human and Animal Food; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug...

76 FR 67465 - Preventive Controls for Registered Human Food and Animal Food/Feed Facilities; Reopening of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0238] Preventive Controls for Registered Human Food and Animal Food/ Feed Facilities; Reopening of the Comment Period AGENCY: Food and Drug Administration, HHS. ACTION: Notice; reopening of the comment period...

Clinical-grade production of human mesenchymal stromal cells: occurrence of aneuploidy without transformation.

PubMed

Tarte, Karin; Gaillard, Julien; Lataillade, Jean-Jacques; Fouillard, Loic; Becker, Martine; Mossafa, Hossein; Tchirkov, Andrei; Rouard, Hélène; Henry, Catherine; Splingard, Marie; Dulong, Joelle; Monnier, Delphine; Gourmelon, Patrick; Gorin, Norbert-Claude; Sensebé, Luc

2010-02-25

Clinical-grade human mesenchymal stromal cells (MSCs) have been expanded in vitro for tissue engineering or immunoregulatory purposes without standardized culture conditions or release criteria. Although human MSCs show poor susceptibility for oncogenic transformation, 2 recent studies described their capacity to accumulate chromosomal instability and to give rise to carcinoma in immunocompromised mice after long-term culture. We thus investigated the immunologic and genetic features of MSCs expanded with fetal calf serum and fibroblast growth factor or with platelet lysate in 4 cell-therapy facilities during 2 multicenter clinical trials. Cultured MSCs showed a moderate expression of human leukocyte antigen-DR without alteration of their low immunogenicity or their immunomodulatory capacity. Moreover, some transient and donor-dependent recurring aneuploidy was detected in vitro, independently of the culture process. However, MSCs with or without chromosomal alterations showed progressive growth arrest and entered senescence without evidence of transformation either in vitro or in vivo.

New perspective on functional capabilities of microbiome associated with spacecraft assembly facilities

NASA Astrophysics Data System (ADS)

Vaishampayan, Parag

2016-07-01

In compliance with Planetary Protection policy, NASA monitors the total microbial burden of spacecraft and associated environments as a means for minimizing forward contamination. Despite numerous characterizations of microbial populations in spacecraft assembly cleanrooms, understanding the metabolic traits responsible for their persistence and survival remains a significant challenge. The principal objective of this study is to establish functional traits by exploring the entire gene content (metagenome) of the cleanroom microbial community. DNA-based techniques are incapable of distinguishing viable microorganisms from dead microbial cells in samples. Consequently, metagenomic analyses based on total environmental DNA extracts do not render a meaningful understanding of the metabolic and/or functional characteristics of living microorganisms in cleanrooms. A molecular viability marker was applied to samples collected from a cleanroom facility, and subsequent metagenomic sequencing experiments showed considerable differences between the resulting viable-only and total microbiomes. Nevertheless, analyses of sequence abundance suggested that the viable microbiome was influenced by both the human microbiome and the ambient ecosystem external to the facility, which resulted in a complex community profile. Also detected were the first viral signatures ever retrieved from a cleanroom facility: the genomes of human cyclovirus 7078A and Propionibacterium phage P14.4. We also wanted to evaluate if the strict cleaning and decontamination procedures selectively favor survival and growth of hardy microrganisms, such as pathogens. Three geographically distinct cleanrooms were sampled during the assembly of three NASA spacecraft: Dawn, Phoenix, and Mars Science Laboratory. Potential pathogens and their corresponding virulence factors were present in all the samples. Decreased microbial and pathogenic diversity during spacecraft assembly, compared to before and after, indicates that decontamination and preventative measures were effective and well implemented. The findings presented here, as well as the innovative methods that enabled their discovery, promise to have profound implications for the design and interpretation of ongoing and future studies in cleanrooms, indoor environments, and potential future human missions to Mars.

Motivation of human resources for health: a case study at rural district level in Tanzania.

PubMed

Zinnen, Véronique; Paul, Elisabeth; Mwisongo, Aziza; Nyato, Daniel; Robert, Annie

2012-01-01

An increasing number of studies explore the association between financial and non-financial incentives and the retention of health workers in developing countries. This study aims to contribute to empirical evidence on human resource for health motivation factors to assist policy makers in promoting effective and realistic interventions. A cross-sectional survey was conducted in four rural Tanzanian districts to explore staff stability and health workers' motivation. Data were collected using qualitative and quantitative techniques, covering all levels and types of health facilities. Stability of staff was found to be quite high. Public institutions remained very attractive with better job security, salary and retirement benefits. Satisfaction over working conditions was very low owing to inadequate working equipment, work overload, lack of services, difficult environment, favouritism and 'empty promotions'. Positive incentives mentioned were support for career development and supportive supervision. Attracting new staff in rural areas appeared to be more difficult than retaining staff in place. The study concluded that strategies to better motivate health personnel should focus on adequate remuneration, positive working and living environment and supportive management. However, by multiplying health facilities, the latest Tanzanian human resource for health plan could jeopardize current positive results. Copyright © 2012 John Wiley & Sons, Ltd.

The effect of a multi-component intervention on disrespect and abuse during childbirth in Kenya.

PubMed

Abuya, Timothy; Ndwiga, Charity; Ritter, Julie; Kanya, Lucy; Bellows, Ben; Binkin, Nancy; Warren, Charlotte E

2015-09-22

Disrespect and abuse (D & A) during labor and delivery are important issues correlated with human rights, equity, and public health that also affect women's decisions to deliver in facilities, which provide appropriate management of maternal and neonatal complications. Little is known about interventions aimed at lowering the frequency of disrespectful and abusive behaviors. Between 2011 and 2014, a pre-and-post study measured D & A levels in a three-tiered intervention at 13 facilities in Kenya under the Heshima project. The intervention involved working with policymakers to encourage greater focus on D & A, training providers on respectful maternity care, and strengthening linkages between the facility and community for accountability and governance. At participating facilities, postpartum women were approached at discharge and asked to participate in the study; those who consented were administered a questionnaire on D & A in general as well as six typologies, including physical and verbal abuse, violations of confidentiality and privacy, detainment for non-payment, and abandonment. Observation of provider-patient interaction during labor was also conducted in the same facilities. In both exit interview and observational studies, multivariate analyses of risk factors for D & A controlled for differences in socio-demographic and facility characteristics between baseline and endline surveys. Overall D & A decreased from 20-13% (p < 0.004) and among four of the six typologies D & A decreased from 40-50%. Night shift deliveries were associated with greater verbal and physical abuse. Patient and infant detainment declined dramatically from 8.0-0.8%, though this was partially attributable to the 2013 national free delivery care policy. Although a number of contextual factors may have influenced these findings, the magnitude and consistency of the observed decreases suggest that the multi-component intervention may have the potential to reduce the frequency of D & A. Greater efforts are needed to develop stronger evaluation methods for assessing D & A in other settings.

Organizational factors influencing health information technology adoption in long-term-care facilities.

PubMed

Wang, Tiankai; Wang, Yangmei; Moczygemba, Jackie

2014-01-01

Long-term care (LTC) is an important sector of the health care industry. However, the adoption of health information technology (HIT) systems in LTC facilities lags behind that in other sectors of health care. Previous literature has focused on the financial and technical barriers. This study examined the organizational factors associated with HIT adoption in LTC facilities. A survey of 500 LTC facilities in Texas enabled researchers to compile HIT indexes for further statistical analyses. A general linear model was used to study the associations between the clinical/administrative HIT indexes and organizational factors. The empirical outcomes show that the size of an LTC facility has a significant association with HIT adoption. Rural LTC facilities, especially freestanding ones, adopt less HIT than their urban counterparts, whereas freestanding LTC facilities have the lowest HIT adoption overall. There is not enough evidence to support ownership status as a significant factor in HIT adoption. Some implications are proposed, but further research is necessary.

Simian hemorrhagic fever virus infection of rhesus macaques as a model of viral hemorrhagic fever: clinical characterization and risk factors for severe disease.

PubMed

Johnson, Reed F; Dodd, Lori E; Yellayi, Srikanth; Gu, Wenjuan; Cann, Jennifer A; Jett, Catherine; Bernbaum, John G; Ragland, Dan R; St Claire, Marisa; Byrum, Russell; Paragas, Jason; Blaney, Joseph E; Jahrling, Peter B

2011-12-20

Simian Hemorrhagic Fever Virus (SHFV) has caused sporadic outbreaks of hemorrhagic fevers in macaques at primate research facilities. SHFV is a BSL-2 pathogen that has not been linked to human disease; as such, investigation of SHFV pathogenesis in non-human primates (NHPs) could serve as a model for hemorrhagic fever viruses such as Ebola, Marburg, and Lassa viruses. Here we describe the pathogenesis of SHFV in rhesus macaques inoculated with doses ranging from 50 PFU to 500,000 PFU. Disease severity was independent of dose with an overall mortality rate of 64% with signs of hemorrhagic fever and multiple organ system involvement. Analyses comparing survivors and non-survivors were performed to identify factors associated with survival revealing differences in the kinetics of viremia, immunosuppression, and regulation of hemostasis. Notable similarities between the pathogenesis of SHFV in NHPs and hemorrhagic fever viruses in humans suggest that SHFV may serve as a suitable model of BSL-4 pathogens. Published by Elsevier Inc.

System Analysis and Evaluation of Greenhouse Modules within Moon/Mars Habitats

NASA Astrophysics Data System (ADS)

Prasad Nagendra, Narayan; Schubert, Daniel; Zabel, Paul

2012-07-01

Long term settlement on different planets of the solar system is a fascination for mankind. Some researchers contemplate that planetary settlement is a necessity for the survival of the human race over millions of years. The generation of food for self sufficiency in space or on planetary bases is a vital part of this vision of space habitation. The amount of mass that can be transported in deep space missions is constrained by the launcher capability and its costs. The space community has proposed and designed various greenhouse modules to cater to human culinary requirements and act as part of life support systems. A survey of the different greenhouse space concepts and terrestrial test facilities is presented, drawing a list of measurable factors (e.g. growth area, power consumption, human activity index, etc.) for the evaluation of greenhouse modules. These factors include tangible and intangible parameters that have been used in the development of an evaluation method on greenhouse concepts as a subsystem of planetary habitats at the DLR Institute of Space Systems, Bremen.

Modular Extended-Stay HyperGravity Facility Design Concept: An Artificial-Gravity Space-Settlement Ground Analogue

NASA Technical Reports Server (NTRS)

Dorais, Gregory A.

2015-01-01

This document defines the design concept for a ground-based, extended-stay hypergravity facility as a precursor for space-based artificial-gravity facilities that extend the permanent presence of both human and non-human life beyond Earth in artificial-gravity settlements. Since the Earth's current human population is stressing the environment and the resources off-Earth are relatively unlimited, by as soon as 2040 more than one thousand people could be living in Earthorbiting artificial-gravity habitats. Eventually, the majority of humanity may live in artificialgravity habitats throughout this solar system as well as others, but little is known about the longterm (multi-generational) effects of artificial-gravity habitats on people, animals, and plants. In order to extend life permanently beyond Earth, it would be useful to create an orbiting space facility that generates 1g as well as other gravity levels to rigorously address the numerous challenges of such an endeavor. Before doing so, developing a ground-based artificial-gravity facility is a reasonable next step. Just as the International Space Station is a microgravity research facility, at a small fraction of the cost and risk a ground-based artificial-gravity facility can begin to address a wide-variety of the artificial-gravity life-science questions and engineering challenges requiring long-term research to enable people, animals, and plants to live off-Earth indefinitely.

Health Facility Graduation from Donor-Supported Intensive Technical Assistance and Associated Factors in Zambia.

PubMed

Koni, Phillip; Chishinga, Nathaniel; Nyirenda, Lameck; Kasonde, Prisca; Nsakanya, Richard; Welsh, Michael

2015-01-01

The FHI360-led Zambia Prevention Care and Treatment partnership II (ZPCT II) with funding from United States Agency for International Development, supports the Zambian Ministry of Health in scaling up HIV/AIDS services. To improve the quality of HIV/AIDS services, ZPCT II provides technical assistance until desired standards are met and districts are weaned-off intensive technical support, a process referred to as district graduation. This study describes the graduation process and determines performance domains associated with district graduation. Data were collected from 275 health facilities in 39 districts in 5 provinces of Zambia between 2008 and 2012. Performance in technical capacity, commodity management, data management and human resources domains were assessed in the following services areas: HIV counselling and testing and prevention of mother to child transmission, antiretroviral therapy/clinical care, pharmacy and laboratory. The overall mean percentage score was calculated by obtaining the mean of mean percentage scores for the four domains. Logistic regression models were used to obtain odds ratios (OR) and 95% confidence intervals (CI) for the domain mean percentage scores in graduated versus non-graduated districts; according to rural-urban, and province strata. 24 districts out of 39 graduated from intensive donor supported technical assistance while 15 districts did not graduate. The overall mean percentage score for all four domains was statistically significantly higher in graduated than non-graduated districts (93.2% versus 91.2%, OR = 1.34, 95%CI:1.20-1.49); including rural settings (92.4% versus 89.4%, OR = 1.43,95%CI:1.24-1.65). The mean percentage score in human resource domain was statistically significantly higher in graduated than non-graduated districts (93.6% versus 71.6%, OR = 5.81, 95%CI: 4.29-7.86) and in both rural and urban settings. QA/QI tools can be used to assess performance at health facilities and determine readiness for district graduation. Human resources management domain was found to be an important factor associated with district graduation.

Health Facility Graduation from Donor-Supported Intensive Technical Assistance and Associated Factors in Zambia

PubMed Central

Koni, Phillip; Chishinga, Nathaniel; Nyirenda, Lameck; Kasonde, Prisca; Nsakanya, Richard; Welsh, Michael

2015-01-01

Introduction The FHI360-led Zambia Prevention Care and Treatment partnership II (ZPCT II) with funding from United States Agency for International Development, supports the Zambian Ministry of Health in scaling up HIV/AIDS services. To improve the quality of HIV/AIDS services, ZPCT II provides technical assistance until desired standards are met and districts are weaned-off intensive technical support, a process referred to as district graduation. This study describes the graduation process and determines performance domains associated with district graduation. Methods Data were collected from 275 health facilities in 39 districts in 5 provinces of Zambia between 2008 and 2012. Performance in technical capacity, commodity management, data management and human resources domains were assessed in the following services areas: HIV counselling and testing and prevention of mother to child transmission, antiretroviral therapy/clinical care, pharmacy and laboratory. The overall mean percentage score was calculated by obtaining the mean of mean percentage scores for the four domains. Logistic regression models were used to obtain odds ratios (OR) and 95% confidence intervals (CI) for the domain mean percentage scores in graduated versus non-graduated districts; according to rural-urban, and province strata. Results 24 districts out of 39 graduated from intensive donor supported technical assistance while 15 districts did not graduate. The overall mean percentage score for all four domains was statistically significantly higher in graduated than non-graduated districts (93.2% versus 91.2%, OR = 1.34, 95%CI:1.20–1.49); including rural settings (92.4% versus 89.4%, OR = 1.43,95%CI:1.24–1.65). The mean percentage score in human resource domain was statistically significantly higher in graduated than non-graduated districts (93.6% versus 71.6%, OR = 5.81, 95%CI: 4.29–7.86) and in both rural and urban settings. Conclusions QA/QI tools can be used to assess performance at health facilities and determine readiness for district graduation. Human resources management domain was found to be an important factor associated with district graduation. PMID:26098555

Sit Up Straight

NASA Technical Reports Server (NTRS)

1998-01-01

BioMetric Systems has an exclusive license to the Posture Video Analysis Tool (PVAT) developed at Johnson Space Center. PVAT uses videos from Space Shuttle flights to identify limiting posture and other human factors in the workplace that could be limiting. The software also provides data that recommends appropriate postures for certain tasks and safe duration for potentially harmful positions. BioMetric Systems has further developed PVAT for use by hospitals, physical rehabilitation facilities, insurance companies, sports medicine clinics, oil companies, manufacturers, and the military.

Human Factors Principles in Information Dashboard Design

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

Hugo, Jacques V.; St. Germain, Shawn

When planning for control room upgrades, nuclear power plants have to deal with a multitude of engineering and operational impacts. This will inevitably include several human factors considerations, including physical ergonomics of workstations, viewing angles, lighting, seating, new communication requirements, and new concepts of operation. In helping nuclear power utilities to deal with these challenges, the Idaho National Laboratory (INL) has developed effective methods to manage the various phases of the upgrade life cycle. These methods focus on integrating human factors engineering processes with the plant’s systems engineering process, a large part of which is the development of end-state conceptsmore » for control room modernization. Such an end-state concept is a description of a set of required conditions that define the achievement of the plant’s objectives for the upgrade. Typically, the end-state concept describes the transition of a conventional control room, over time, to a facility that employs advanced digital automation technologies in a way that significantly improves system reliability, reduces human and control room-related hazards, reduces system and component obsolescence, and significantly improves operator performance. To make the various upgrade phases as concrete and as visible as possible, an end-state concept would include a set of visual representations of the control room before and after various upgrade phases to provide the context and a framework within which to consider the various options in the upgrade. This includes the various control systems, human-system interfaces to be replaced, and possible changes to operator workstations. This paper describes how this framework helps to ensure an integrated and cohesive outcome that is consistent with human factors engineering principles and also provide substantial improvement in operator performance. The paper further describes the application of this integrated approach in the strategic modernization program at a nuclear power plant where legacy systems are upgraded to advanced digital technologies through a systematic process that links human factors principles to the systems engineering process. This approach will help to create an integrated control room architecture beyond what is possible for individual subsystem upgrades alone. In addition, several human factors design and evaluation methods were used to develop the end-state concept, including interactive sessions with operators in INL’s Human System Simulation Laboratory, three-dimensional modeling to visualize control board changes.« less

Method and computer program product for maintenance and modernization backlogging

DOEpatents

Mattimore, Bernard G; Reynolds, Paul E; Farrell, Jill M

2013-02-19

According to one embodiment, a computer program product for determining future facility conditions includes a computer readable medium having computer readable program code stored therein. The computer readable program code includes computer readable program code for calculating a time period specific maintenance cost, for calculating a time period specific modernization factor, and for calculating a time period specific backlog factor. Future facility conditions equal the time period specific maintenance cost plus the time period specific modernization factor plus the time period specific backlog factor. In another embodiment, a computer-implemented method for calculating future facility conditions includes calculating a time period specific maintenance cost, calculating a time period specific modernization factor, and calculating a time period specific backlog factor. Future facility conditions equal the time period specific maintenance cost plus the time period specific modernization factor plus the time period specific backlog factor. Other embodiments are also presented.

Factors affecting minority population proximity to hazardous facilities

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

Nieves, L.A.; Nieves, A.L.

1995-04-01

Disproportionate exposure of minority groups to environmental hazards has been attributed to ``environmental racism`` by some authors, without systematic investigation of the factors underlying this exposure pattern. This study examines regional differences in the proximity of African-Americans, Hispanics, Asians, and non-Hispanic Whites to a broad range of facility types and explores the effects of urban and income factors. A statistically significant inverse relationship is found between the percentage of non-Hispanic Whites and virtually all facility categories in all regions. Except for Hispanics in the South, all such associations for minority groups show a direct relationship, though some are nonsignificant. Themore » geographic concentration of facilities is more closely tied to urbanization than to economic factors. Controlling for both urban and economic factors, minority population concentration is still a significant explanatory variable for some facility types in some regions. This finding is most consistent for African-Americans.« less

Variation in fistula use across dialysis facilities: is it explained by case-mix?

PubMed

Tangri, Navdeep; Moorthi, Ranjani; Tighiouhart, Hocine; Meyer, Klemens B; Miskulin, Dana C

2010-02-01

Arteriovenous fistulas (AVFs) remain the preferred vascular access for hemodialysis patients. Dialysis facilities that fail to meet Centers for Medicare & Medicaid Services goals cite patient case-mix as a reason for low AVF prevalence. This study aimed to determine the magnitude of the variability in AVF usage across dialysis facilities and the extent to which patient case-mix explains it. The vascular access used in 10,112 patients dialyzed at 173 Dialysis Clinic Inc. facilities from October 1 to December 31, 2004, was evaluated. The access in use was considered to be an AVF if it was used for >70% of hemodialysis treatments. Mixed-effects models with a random intercept for dialysis facilities evaluated the effect of facilities on AVF usage. Sequentially adjusted multivariate models measured the extent to which patient factors (case-mix) explain variation across facilities in AVF rates. 3787 patients (38%) were dialyzed using AVFs. There was a significant facility effect: 7.6% of variation in AVF use was attributable to facility. This was reduced to 7.1% after case-mix adjustment. There were no identified specific facility-level factors that explained the interfacility variation. AVF usage varies across dialysis facilities, and patient case-mix did not reduce this variation. In this study, 92% of the total variation in AVF usage was due to patient factors, but most were not measurable. A combination of patient factors and process indicators should be considered in adjudicating facility performance for this quality indicator.

Unique life sciences research facilities at NASA Ames Research Center

NASA Technical Reports Server (NTRS)

Mulenburg, G. M.; Vasques, M.; Caldwell, W. F.; Tucker, J.

1994-01-01

The Life Science Division at NASA's Ames Research Center has a suite of specialized facilities that enable scientists to study the effects of gravity on living systems. This paper describes some of these facilities and their use in research. Seven centrifuges, each with its own unique abilities, allow testing of a variety of parameters on test subjects ranging from single cells through hardware to humans. The Vestibular Research Facility allows the study of both centrifugation and linear acceleration on animals and humans. The Biocomputation Center uses computers for 3D reconstruction of physiological systems, and interactive research tools for virtual reality modeling. Psycophysiological, cardiovascular, exercise physiology, and biomechanical studies are conducted in the 12 bed Human Research Facility and samples are analyzed in the certified Central Clinical Laboratory and other laboratories at Ames. Human bedrest, water immersion and lower body negative pressure equipment are also available to study physiological changes associated with weightlessness. These and other weightlessness models are used in specialized laboratories for the study of basic physiological mechanisms, metabolism and cell biology. Visual-motor performance, perception, and adaptation are studied using ground-based models as well as short term weightlessness experiments (parabolic flights). The unique combination of Life Science research facilities, laboratories, and equipment at Ames Research Center are described in detail in relation to their research contributions.

Effects of Y27632 on aqueous humor outflow facility with changes in hydrodynamic pattern and morphology in human eyes.

PubMed

Yang, Chen-Yuan Charlie; Liu, Ye; Lu, Zhaozeng; Ren, Ruiyi; Gong, Haiyan

2013-08-28

To determine the effect of Y27632, a Rho-kinase inhibitor on aqueous outflow facility, flow pattern, and juxtacanalicular tissue (JCT)/trabecular meshwork (TM) morphology in human eyes. Sixteen enucleated human eyes were perfused with PBS plus glucose (GPBS) at 15 mm Hg to establish the baseline outflow facility. Six eyes were perfused for short-duration (30 minute) with either 50 μM Y27632 or GPBS (n = 3 per group). Ten eyes were perfused for long duration (3 hours) with either 50 μM Y27632 or GPBS (n = 5 per group). Outflow pattern was labeled using fluorescent microspheres, and effective filtration length (EFL) was measured. Morphologic changes and their relationship to EFL and facility were analyzed. Outflow facility significantly increased after short-duration perfusion with Y27632 compared with its own baseline (P = 0.03), but did not reach statistical significance compared with its controls (P = 0.07). Outflow facility (P = 0.01) and EFL (P < 0.05) were significantly increased after long-duration perfusion with Y27632 compared with its controls. Increases in outflow facility and EFL demonstrated a positive correlation. Morphologically, the TM and JCT of high-tracer regions were more expanded compared with low-tracer regions. A significant increase in JCT thickness was found in the long-duration Y27632 group compared with its control group (10.0 vs. 8.0 μm, P < 0.01). Y27632 increases outflow facility in human eyes. This increase correlates positively with an increase in EFL, which is associated with an increased expansion in the JCT. Our data suggest that EFL could serve as a novel parameter to correlate with outflow facility.

Firefighting to Innovation: Using Human Factors and Ergonomics to Tackle Slip, Trip, and Fall Risks in Hospitals.

PubMed

Hignett, Sue; Wolf, Laurie; Taylor, Ellen; Griffiths, Paula

2015-11-01

The aim of this study was to use a theoretical model (bench) for human factors and ergonomics (HFE) and a comparison with occupational slips, trips, and falls (STFs) risk management to discuss patient STF interventions (bedside). Risk factors for patient STFs have been identified and reported since the 1950s and are mostly unchanged in the 2010s. The prevailing clinical view has been that STF events indicate underlying frailty or illness, and so many of the interventions over the past 60 years have focused on assessing and treating physiological factors (dizziness, illness, vision/hearing, medicines) rather than designing interventions to reduce risk factors at the time of the STF. Three case studies are used to discuss how HFE has been, or could be, applied to STF risk management as (a) a design-based (building) approach to embed safety into the built environment, (b) a staff- (and organization-) based approach, and (c) a patient behavior-based approach to explore and understand patient perspectives of STF events. The results from the case studies suggest taking a similar HFE integration approach to other industries, that is, a sustainable design intervention for the person who experiences the STF event-the patient. This paper offers a proactive problem-solving approach to reduce STFs by patients in acute hospitals. Authors of the three case studies use HFE principles (bench/book) to understand the complex systems for facility and equipment design and include the perspective of all stakeholders (bedside). © 2015, Human Factors and Ergonomics Society.

Strategy to increase Barangan Banana production in Kabupaten Deli Serdang

NASA Astrophysics Data System (ADS)

Adhany, I.; Chalil, D.; Ginting, R.

2018-02-01

This study was conducted to analyze internal and external factors in increasing Barangan Banana production in Kabupaten Deli Serdang. Samples were determined by snowball sampling technique and purposive sampling method. Using SWOT analysis method, this study found that there were 6 internal strategic factors and 9 external strategic factors. Among that strategic factors, support for production facilities appears as the most important internal strategic factor, while the demand for Barangan Banana. as the most important external strategic factor. Based on the importance and existing condition of these strategic factors, using support for production facilities and realization of supporting facilities with farming experience are the strategies covering strength-opportunity (SO), organizing mentoring to meet the demand for Barangan Banana are the strategies covering weakness-opportunity (WO), making use of funding support and subsidies to widen the land, using tissue culture seeds and facilities and infrastructures are the strategies covering strength-threat (ST), increas the funding support to widen the land, the use of tissue culture seeds and facilities and infrastructures are the strategies covering weakness-threat (WT) are discussed and proposed to increase Barangan Banana productivity in Kabupaten Deli Serdang.

Animal-assisted interventions: A national survey of health and safety policies in hospitals, eldercare facilities, and therapy animal organizations.

PubMed

Linder, Deborah E; Siebens, Hannah C; Mueller, Megan K; Gibbs, Debra M; Freeman, Lisa M

2017-08-01

Animal-assisted intervention (AAI) programs are increasing in popularity, but it is unknown to what extent therapy animal organizations that provide AAI and the hospitals and eldercare facilities they work with implement effective animal health and safety policies to ensure safety of both animals and humans. Our study objective was to survey hospitals, eldercare facilities, and therapy animal organizations on their AAI policies and procedures. A survey of United States hospitals, eldercare facilities, and therapy animal organizations was administered to assess existing health and safety policies related to AAI programs. Forty-five eldercare facilities, 45 hospitals, and 27 therapy animal organizations were surveyed. Health and safety policies varied widely and potentially compromised human and animal safety. For example, 70% of therapy animal organizations potentially put patients at risk by allowing therapy animals eating raw meat diets to visit facilities. In general, hospitals had stricter requirements than eldercare facilities. This information suggests that there are gaps between the policies of facilities and therapy animal organizations compared with recent guidelines for animal visitation in hospitals. Facilities with AAI programs need to review their policies to address recent AAI guidelines to ensure the safety of animals and humans involved. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Reducing health risk assigned to organic emissions from a chemical weapons incinerator.

PubMed

Laman, David M; Weiler, B Douglas; Skeen, Rodney S

2013-03-01

Organic emissions from a chemical weapons incinerator have been characterized with an improved set of analytical methods to reduce the human health risk assigned to operations of the facility. A gas chromatography/mass selective detection method with substantially reduced detection limits has been used in conjunction with scanning electron microscopy/energy dispersive X-ray spectrometry and Fourier transform infrared microscopy to improve the speciation of semi-volatile and non-volatile organics emitted from the incinerator. The reduced detection limits have allowed a significant reduction in the assumed polycyclic aromatic hydrocarbon (PAH) and aminobiphenyl (ABP) emission rates used as inputs to the human health risk assessment for the incinerator. A mean factor of 17 decrease in assigned human health risk is realized for six common local exposure scenarios as a result of the reduced PAH and ABP detection limits.

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...

Hypergravity Facilities: Extending Knowledge Over the Continuum of Gravity

NASA Technical Reports Server (NTRS)

Souza, Kenneth A.

1999-01-01

Historical perspectives, reasons for gravitational research, key questions regarding centrifuges, particular centrifuge discussions, vestibular research facilities, the hypergravity facility for cell culture, the human research facility, as well as the center for bioinformatics are all topics discussed in viewgraph form.

Factors influencing resource allocation decisions and equity in the health system of Ghana.

PubMed

Asante, A D; Zwi, A B

2009-05-01

Allocation of financial resources in the health sector is often seen as a formula-driven activity. However, the decision to allocate a certain amount of resources to a particular health jurisdiction or facility may be based on a broader range of factors, sometimes not reflected in the existing resource allocation formula. This study explores the 'other' factors that influence the equity of resource allocation in the health system of Ghana. The extent to which these factors are, or can be, accounted for in the resource allocation process is analysed. An exploratory design focusing on different levels of the health system and diverse stakeholders. Data were gathered through semi-structured qualitative interviews with health authorities at national, regional and district levels, and with donor representatives and local government officials in 2003 and 2004. The availability of human resources for health, local capacity to utilize funds, donor involvement in the health sector, and commitment to promote equity have considerable influence on resource allocation decisions and affect the equity of funding allocations. However, these factors are not accounted for adequately in the resource allocation process. This study highlights the need for a more transparent resource allocation system in Ghana based on needs, and takes into account key issues such as capacity constraints, the inequitable human resource distribution and donor-earmarked funding.

Measuring clinical outcomes of animal-assisted therapy: impact on resident medication usage.

PubMed

Lust, Elaine; Ryan-Haddad, Ann; Coover, Kelli; Snell, Jeff

2007-07-01

To measure changes in medication usage of as-needed, psychoactive medications and other select as-needed medication usage as a result of a therapy dog residing in the rehabilitation facility. Additional measures are participants' thoughts and feelings on quality-of-life factors. One group, pretest, post-test. Residential rehabilitation facility. Convenience sample, N = 58 residents living at the facility. A certified, trained therapy dog. Changes in as-needed medication usage for the following categories: analgesics, psychoactive medications, and laxatives, as well as changes in vital sign measurements of blood pressure, pulse, respiration rate, and body weight. Additionally, changes in the residents' perception of quality-of-life factors. One of the three monitored drug classes, analgesia, revealed a decrease in medication usage (mean = 2.6, standard deviation [SD] +/- 6.90, P = 0.017), and one of four monitored vital signs, pulse, showed a decrease (mean = 5.8, SD +/-7.39, P = 0.000) in study participants exposed to the therapy dog. Positive changes were reported in study participants' quality of life. The benefits to human welfare as a result of the presence of a therapy dog have the potential to decrease medication usage for certain conditions in long-term care patients as well as decrease costs. Pharmacist involvement in animal-assisted therapy has the potential to make unique and measurable improvements to best patient care.

The joint relationship between organizational design factors and HR practice factors on direct care workers' job satisfaction and turnover intent.

PubMed

Kim, Jungyoon; Wehbi, Nizar; Dellifraine, Jami L; Brannon, Diane

2014-01-01

Human resource (HR) practices, such as training and communication, have been linked to positive employee job commitment and lower turnover intent for direct care workers (DCWs). Not many studies have looked at the combined interaction of HR practices and organizational structure. The aim of this study is to examine the relationship between organizational structure (centralization, formalization, and span of control) and HR practices (training, horizontal communication, and vertical communication) on DCW's job satisfaction and turnover intent. Data were collected from 58 long-term care facilities in five states. We used latent class analysis to group facility characteristics into three sets of combinations: "organic," "mechanistic," and "minimalist." We used multivariate regression to test the relationship of each of these groups on DCW's job satisfaction and turnover intent. After controlling for state, organizational, and individual covariates, the organic group, which represents decentralized and less formalized structures and high levels of job training and communication, was positively related to job satisfaction and negatively related to intent to leave. On the other hand, the minimalist group, which is characterized by low levels of job-related training and communication, showed no significant differences from the mechanistic group (referent) on job satisfaction and intent to leave. These findings imply that managers in long-term care facilities may want to consider adopting organic, decentralized structures and HR practices to retain DCWs.

Pathways for Disposal of Commercially-Generated Tritiated Waste

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

Halverson, Nancy V.

From a waste disposal standpoint, tritium is a major challenge. Because it behaves like hydrogen, tritium exchanges readily with hydrogen in the ground water and moves easily through the ground. Land disposal sites must control the tritium activity and mobility of incoming wastes to protect human health and the environment. Consequently, disposal of tritiated low-level wastes is highly regulated and disposal options are limited. The United States has had eight operating commercial facilities licensed for low-level radioactive waste disposal, only four of which are currently receiving waste. Each of these is licensed and regulated by its state. Only two ofmore » these sites accept waste from states outside of their specified regional compact. For waste streams that cannot be disposed directly at one of the four active commercial low-level waste disposal facilities, processing facilities offer various forms of tritiated low-level waste processing and treatment, and then transport and dispose of the residuals at a disposal facility. These processing facilities may remove and recycle tritium, reduce waste volume, solidify liquid waste, remove hazardous constituents, or perform a number of additional treatments. Waste brokers also offer many low-level and mixed waste management and transportation services. These services can be especially helpful for small-quantity tritiated-waste generators, such as universities, research institutions, medical facilities, and some industries. The information contained in this report covers general capabilities and requirements for the various disposal/processing facilities and brokerage companies, but is not considered exhaustive. Typically, each facility has extensive waste acceptance criteria and will require a generator to thoroughly characterize their wastes. Then a contractual agreement between the waste generator and the disposal/processing/broker entity must be in place before waste is accepted. Costs for tritiated waste transportation, processing and disposal vary based a number of factors. In many cases, wastes with very low radioactivity are priced primarily based on weight or volume. For higher activities, costs are based on both volume and activity, with the activity-based charges usually being much larger than volume-based charges. Other factors affecting cost include location, waste classification and form, other hazards in the waste, etc. Costs may be based on general guidelines used by an individual disposal or processing site, but final costs are established by specific contract with each generator. For this report, seven hypothetical waste streams intended to represent commercially-generated tritiated waste were defined in order to calculate comparative costs. Ballpark costs for disposition of these hypothetical waste streams were calculated. These costs ranged from thousands to millions of dollars. Due to the complexity of the cost-determining factors mentioned above, the costs calculated in this report should be understood to represent very rough cost estimates for the various hypothetical wastes. Actual costs could be higher or could be lower due to quantity discounts or other factors.« less

Facile Fabrication of a Silver Nanoparticle Immersed, Surface-Enhanced Raman Scattering Imposed Paper Platform through Successive Ionic Layer Absorption and Reaction for On-Site Bioassays.

PubMed

Kim, Wansun; Kim, Yeon-Hee; Park, Hun-Kuk; Choi, Samjin

2015-12-23

We introduce a novel, facile, rapid, low-cost, highly reproducible, and power-free synthesizable fabrication method of paper-based silver nanoparticle (AgNP) immersed surface-enhanced Raman scattering (SERS) platform, known as the successive ionic layer absorption and reaction (SILAR) method. The rough and porous properties of the paper led to direct synthesis of AgNPs on the surface as well as in the paper due to capillary effects, resulting in improved plasmon coupling with interparticles and interlayers. The proposed SERS platform showed an enhancement factor of 1.1 × 10(9), high reproducibility (relative standard deviation of 4.2%), and 10(-12) M rhodamine B highly sensitive detection limit by optimizing the SILAR conditions including the concentration of the reactive solution (20/20 mM/mM AgNO3/NaBH4) and the number of SILAR cycles (six). The applicability of the SERS platform was evaluated using two samples including human cervical fluid for clinical diagnosis of human papillomavirus (HPV) infection, associated with cervical cancer, and a malachite green (MG) solution for fungicide and parasiticide in aquaculture, associated with human carcinogenesis. The AgNP-immersed SERS-functionalized platform using the SILAR technique allowed for high chemical structure sensitivity without additional tagging or chemical modification, making it a good alternative for early clinical diagnosis of HPV infection and detection of MG-activated human carcinogenesis.

Early Impacts of a Human-in-the-Loop Evaluation in a Space Vehicle Mock-up Facility

NASA Technical Reports Server (NTRS)

Byrne, Vicky; Vos, Gordon; Whitmore, Mihriban

2008-01-01

The development of a new space vehicle, the Orion Crew Exploration Vehicle (CEV), provides Human Factors engineers an excellent opportunity to have an impact early in the design process. This case study highlights a Human-in-the-Loop (HITL) evaluation conducted in a Space Vehicle Mock-Up Facility and will describe the human-centered approach and how the findings are impacting design and operational concepts early in space vehicle design. The focus of this HITL evaluation centered on the activities that astronaut crewmembers would be expected to perform within the functional internal volume of the Crew Module (CM) of the space vehicle. The primary objective was to determine if there are aspects of a baseline vehicle configuration that would limit or prevent the performance of dynamically volume-driving activities (e.g. six crewmembers donning their suits in an evacuation scenario). A second objective was to step through concepts of operations for known systems and evaluate them in integrated scenarios. The functional volume for crewmember activities is closely tied to every aspect of system design (e.g. avionics, safety, stowage, seats, suits, and structural support placement). As this evaluation took place before the Preliminary Design Review of the space vehicle with some designs very early in the development, it was not meant to determine definitely that the crewmembers could complete every activity, but rather to provide inputs that could improve developing designs and concepts of operations definition refinement.

Facility-Level Factors Influencing Retention of Patients in HIV Care in East Africa.

PubMed

Rachlis, Beth; Bakoyannis, Giorgos; Easterbrook, Philippa; Genberg, Becky; Braithwaite, Ronald Scott; Cohen, Craig R; Bukusi, Elizabeth A; Kambugu, Andrew; Bwana, Mwebesa Bosco; Somi, Geoffrey R; Geng, Elvin H; Musick, Beverly; Yiannoutsos, Constantin T; Wools-Kaloustian, Kara; Braitstein, Paula

2016-01-01

Losses to follow-up (LTFU) remain an important programmatic challenge. While numerous patient-level factors have been associated with LTFU, less is known about facility-level factors. Data from the East African International epidemiologic Databases to Evaluate AIDS (EA-IeDEA) Consortium was used to identify facility-level factors associated with LTFU in Kenya, Tanzania and Uganda. Patients were defined as LTFU if they had no visit within 12 months of the study endpoint for pre-ART patients or 6 months for patients on ART. Adjusting for patient factors, shared frailty proportional hazard models were used to identify the facility-level factors associated with LTFU for the pre- and post-ART periods. Data from 77,362 patients and 29 facilities were analyzed. Median age at enrolment was 36.0 years (Interquartile Range: 30.1, 43.1), 63.9% were women and 58.3% initiated ART. Rates (95% Confidence Interval) of LTFU were 25.1 (24.7-25.6) and 16.7 (16.3-17.2) per 100 person-years in the pre-ART and post-ART periods, respectively. Facility-level factors associated with increased LTFU included secondary-level care, HIV RNA PCR turnaround time >14 days, and no onsite availability of CD4 testing. Increased LTFU was also observed when no nutritional supplements were provided (pre-ART only), when TB patients were treated within the HIV program (pre-ART only), and when the facility was open ≤4 mornings per week (ART only). Our findings suggest that facility-based strategies such as point of care laboratory testing and separate clinic spaces for TB patients may improve retention.

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 after controlling for socio-demographic factors. Improving uptake of delivery care would require greater attention to rural-urban inequities and health facility management practices, and to increasing the number of health facilities with fundamental elements for delivery of basic emergency obstetric and neonatal care.

Association between health worker motivation and healthcare quality efforts in Ghana.

PubMed

Alhassan, Robert Kaba; Spieker, Nicole; van Ostenberg, Paul; Ogink, Alice; Nketiah-Amponsah, Edward; de Wit, Tobias F Rinke

2013-08-14

Ghana is one of the sub-Saharan African countries making significant progress towards universal access to quality healthcare. However, it remains a challenge to attain the 2015 targets for the health related Millennium Development Goals (MDGs) partly due to health sector human resource challenges including low staff motivation. This paper addresses indicators of health worker motivation and assesses associations with quality care and patient safety in Ghana. The aim is to identify interventions at the health worker level that contribute to quality improvement in healthcare facilities. The study is a baseline survey of health workers (n = 324) in 64 primary healthcare facilities in two regions in Ghana. Data collection involved quality care assessment using the SafeCare Essentials tool, the National Health Insurance Authority (NHIA) accreditation data and structured staff interviews on workplace motivating factors. The Spearman correlation test was conducted to test the hypothesis that the level of health worker motivation is associated with level of effort by primary healthcare facilities to improve quality care and patient safety. The quality care situation in health facilities was generally low, as determined by the SafeCare Essentials tool and NHIA data. The majority of facilities assessed did not have documented evidence of processes for continuous quality improvement and patient safety. Overall, staff motivation appeared low although workers in private facilities perceived better working conditions than workers in public facilities (P <0.05). Significant positive associations were found between staff satisfaction levels with working conditions and the clinic's effort towards quality improvement and patient safety (P <0.05). As part of efforts towards attainment of the health related MDGs in Ghana, more comprehensive staff motivation interventions should be integrated into quality improvement strategies especially in government-owned healthcare facilities where working conditions are perceived to be the worst.

Conducting Closed Habitation Experiments: Experience from the Lunar Mars Life Support Test Project

NASA Technical Reports Server (NTRS)

Barta, Daniel J.; Edeen, Marybeth A.; Henninger, Donald L.

2004-01-01

The Lunar-Mars Life Support Test Project (LMLSTP) was conducted from 1995 through 1997 at the National Aeronautics and Space Administration s (NASA) Johnson Space Center (JSC) to demonstrate increasingly longer duration operation of integrated, closed-loop life support systems that employed biological and physicochemical techniques for water recycling, waste processing, air revitalization, thermal control, and food production. An analog environment for long-duration human space travel, the conditions of isolation and confinement also enabled studies of human factors, medical sciences (both physiology and psychology) and crew training. Four tests were conducted, Phases I, II, IIa and III, with durations of 15, 30,60 and 91 days, respectively. The first phase focused on biological air regeneration, using wheat to generate enough oxygen for one experimental subject. The systems demonstrated in the later phases were increasingly complex and interdependent, and provided life support for four crew members. The tests were conducted using two human-rated, atmospherically-closed test chambers, the Variable Pressure Growth Chamber (VPGC) and the Integrated Life Support Systems Test Facility (ILSSTF). Systems included test articles (the life support hardware under evaluation), human accommodations (living quarters, kitchen, exercise equipment, etc.) and facility systems (emergency matrix system, power, cooling, etc.). The test team was managed by a lead engineer and a test director, and included test article engineers responsible for specific systems, subsystems or test articles, test conductors, facility engineers, chamber operators and engineering technicians, medical and safety officers, and science experimenters. A crew selection committee, comprised of psychologists, engineers and managers involved in the test, evaluated male and female volunteers who applied to be test subjects. Selection was based on the skills mix anticipated for each particular test, and utilized information from psychological and medical testing, data on the knowledge, experience and skills of the applicants, and team building exercises. The design, development, buildup and operation of test hardware and documentation followed the established NASA processes and requirements for test buildup and operation.

Conducting Closed Habitation Experiments: Experience from the Lunar Mars Life Support Test Project

NASA Technical Reports Server (NTRS)

Barta, Daniel J.; Edeen, Marybeth A.; Henninger, Donald L.

2006-01-01

The Lunar-Mars Life Support Test Project (LMLSTP) was conducted from 1995 through 1997 at the National Aeronautics and Space Administration s (NASA) Johnson Space Center (JSC) to demonstrate increasingly longer duration operation of integrated, closed-loop life support systems that employed biological and physicochemical techniques for water recycling, waste processing, air revitalization, thermal control, and food production. An analog environment for long-duration human space travel, the conditions of isolation and confinement also enabled studies of human factors, medical sciences (both physiology and psychology) and crew training. Four tests were conducted, Phases I, II, IIa and III, with durations of 15, 30, 60 and 91 days, respectively. The first phase focused on biological air regeneration, using wheat to generate enough oxygen for one experimental subject. The systems demonstrated in the later phases were increasingly complex and interdependent, and provided life support for four crew members. The tests were conducted using two human-rated, atmospherically-closed test chambers, the Variable Pressure Growth Chamber (VPGC) and the Integrated Life Support Systems Test Facility (ILSSTF). Systems included test articles (the life support hardware under evaluation), human accommodations (living quarters, kitchen, exercise equipment, etc.) and facility systems (emergency matrix system, power, cooling, etc.). The test team was managed by a lead engineer and a test director, and included test article engineers responsible for specific systems, subsystems or test articles, test conductors, facility engineers, chamber operators and engineering technicians, medical and safety officers, and science experimenters. A crew selection committee, comprised of psychologists, engineers and managers involved in the test, evaluated male and female volunteers who applied to be test subjects. Selection was based on the skills mix anticipated for each particular test, and utilized information from psychological and medical testing, data on the knowledge, experience and skills of the applicants, and team building exercises. The design, development, buildup and operation of test hardware and documentation followed the established NASA processes and requirements for test buildup and operation.

Factors associated with adequate weekly reporting for disease surveillance data among health facilities in Nairobi County, Kenya, 2013.

PubMed

Mwatondo, Athman Juma; Ng'ang'a, Zipporah; Maina, Caroline; Makayotto, Lyndah; Mwangi, Moses; Njeru, Ian; Arvelo, Wences

2016-01-01

Kenya adopted the Integrated Disease Surveillance and Response (IDSR) strategy in 1998 to strengthen disease surveillance and epidemic response. However, the goal of weekly surveillance reporting among health facilities has not been achieved. We conducted a cross-sectional study to determine the prevalence of adequate reporting and factors associated with IDSR reporting among health facilities in one Kenyan County. Health facilities (public and private) were enrolled using stratified random sampling from 348 facilities prioritized for routine surveillance reporting. Adequately-reporting facilities were defined as those which submitted >10 weekly reports during a twelve-week period and a poor reporting facilities were those which submitted <10 weekly reports. Multivariate logistic regression with backward selection was used to identify risk factors associated with adequate reporting. From September 2 through November 30, 2013, we enrolled 175 health facilities; 130(74%) were private and 45(26%) were public. Of the 175 health facilities, 77 (44%) facilities classified as adequate reporting and 98 (56%) were reporting poorly. Multivariate analysis identified three factors to be independently associated with weekly adequate reporting: having weekly reporting forms at visit (AOR19, 95% CI: 6-65], having posters showing IDSR functions (AOR8, 95% CI: 2-12) and having a designated surveillance focal person (AOR7, 95% CI: 2-20). The majority of health facilities in Nairobi County were reporting poorly to IDSR and we recommend that the Ministry of Health provide all health facilities in Nairobi County with weekly reporting tools and offer specific trainings on IDSR which will help designate a focal surveillance person.

The facilitating factors and barriers encountered in the adoption of a humanized birth care approach in a highly specialized university affiliated hospital

PubMed Central

2011-01-01

Background Considering the fact that a significant proportion of high-risk pregnancies are currently referred to tertiary level hospitals; and that a large proportion of low obstetric risk women still seek care in these hospitals, it is important to explore the factors that influence the childbirth experience in these hospitals, particularly, the concept of humanized birth care. The aim of this study was to explore the organizational and cultural factors, which act as barriers or facilitators in the provision of humanized obstetrical care in a highly specialized, university-affiliated hospital in Quebec province, in Canada. Methods A single case study design was chosen. The study sample included 17 professionals and administrators from different disciplines, and 157 women who gave birth in the hospital during the study. The data was collected through semi-structured interviews, field notes, participant observations, a self-administered questionnaire, documents, and archives. Both descriptive and qualitative deductive content analyses were performed and ethical considerations were respected. Results Both external and internal dimensions of a highly specialized hospital can facilitate or be a barrier to the humanization of birth care practices in such institutions, whether independently, or altogether. The greatest facilitating factors found were: caring and family- centered model of care, professionals' and administrators' ambient for the provision of humanized birth care besides the medical interventional care which is tailored to improve safety, assurance, and comfort for women and their children, facilities to provide a pain-free birth, companionship and visiting rules, dealing with the patients' spiritual and religious beliefs. The most cited barriers were: the shortage of health care professionals, the lack of sufficient communication among the professionals, the stakeholders' desire for specialization rather than humanization, over estimation of medical performance, finally the training environment of the hospital leading to the presence of too many health care professionals, and consequently, a lack of privacy and continuity of care. Conclusion The argument of medical intervention and technology at birth being an opposing factor to the humanization of birth was not seen to be an issue in the studied highly specialized university affiliated hospital. PMID:22114870

21 CFR 1271.190 - Facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Facilities. 1271.190 Section 1271.190 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) REGULATIONS UNDER CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION HUMAN CELLS, TISSUES, AND...

45 CFR 1170.32 - Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 3 2011-10-01 2011-10-01 false Existing facilities. 1170.32 Section 1170.32 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE HUMANITIES NONDISCRIMINATION ON THE BASIS OF HANDICAP IN FEDERALLY...

45 CFR 1170.32 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Existing facilities. 1170.32 Section 1170.32 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE HUMANITIES NONDISCRIMINATION ON THE BASIS OF HANDICAP IN FEDERALLY...

21 CFR 1271.190 - Facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Facilities. 1271.190 Section 1271.190 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) REGULATIONS UNDER CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION HUMAN CELLS, TISSUES, AND...

Evaluation of an Indoor Sonic Boom Subjective Test Facility at NASA Langley Research Center

NASA Technical Reports Server (NTRS)

Loubeau, Alexandra; Rathsam, Jonathan; Klos, Jacob

2011-01-01

A sonic boom simulator at NASA Langley Research Center has been constructed for research on human response to low-amplitude sonic booms heard indoors. Research in this facility will ultimately lead to development of a psychoacoustic model for single indoor booms. The first subjective test was designed to explore indoor human response to variations in sonic boom rise time and amplitude. Another goal was to identify loudness level variability across listener locations within the facility. Finally, the test also served to evaluate the facility as a laboratory research tool for studying indoor human response to sonic booms. Subjects listened to test sounds and were asked to rate their annoyance relative to a reference boom. Measurements of test signals were conducted for objective analysis and correlation with subjective responses. Results confirm the functionality of the facility and effectiveness of the test methods and indicate that loudness level does not fully describe indoor annoyance to the selected sonic boom signals.

Fuzzy risk analysis of a modern γ-ray industrial irradiator.

PubMed

Castiglia, F; Giardina, M

2011-06-01

Fuzzy fault tree analyses were used to investigate accident scenarios that involve radiological exposure to operators working in industrial γ-ray irradiation facilities. The HEART method, a first generation human reliability analysis method, was used to evaluate the probability of adverse human error in these analyses. This technique was modified on the basis of fuzzy set theory to more directly take into account the uncertainties in the error-promoting factors on which the methodology is based. Moreover, with regard to some identified accident scenarios, fuzzy radiological exposure risk, expressed in terms of potential annual death, was evaluated. The calculated fuzzy risks for the examined plant were determined to be well below the reference risk suggested by International Commission on Radiological Protection.

42 CFR 124.514 - Compliance alternative for facilities with small annual obligations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT MEDICAL FACILITY CONSTRUCTION AND MODERNIZATION Reasonable... recent year for which a published index is available. (ii) Title XVI-assisted facilities. (A) For the...

42 CFR 124.514 - Compliance alternative for facilities with small annual obligations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT MEDICAL FACILITY CONSTRUCTION AND MODERNIZATION Reasonable... recent year for which a published index is available. (ii) Title XVI-assisted facilities. (A) For the...

48 CFR 352.242-71 - Tobacco-free facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (e.g., cigarettes, cigars, pipes, and smokeless tobacco) while on any HHS property, including use in.... 352.242-71 Section 352.242-71 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES CLAUSES... following clause: Tobacco-free Facilities (January 2006) In accordance with Department of Health and Human...

Design and development of a Space Station proximity operations research and development mockup

NASA Technical Reports Server (NTRS)

Haines, Richard F.

1986-01-01

Proximity operations (Prox-Ops) on-orbit refers to all activities taking place within one km of the Space Station. Designing a Prox-Ops control station calls for a comprehensive systems approach which takes into account structural constraints, orbital dynamics including approach/departure flight paths, myriad human factors and other topics. This paper describes a reconfigurable full-scale mock-up of a Prox-Ops station constructed at Ames incorporating an array of windows (with dynamic star field, target vehicle(s), and head-up symbology), head-down perspective display of manned and unmanned vehicles, voice- actuated 'electronic checklist', computer-generated voice system, expert system (to help diagnose subsystem malfunctions), and other displays and controls. The facility is used for demonstrations of selected Prox-Ops approach scenarios, human factors research (work-load assessment, determining external vision envelope requirements, head-down and head-up symbology design, voice synthesis and recognition research, etc.) and development of engineering design guidelines for future module interiors.

Extravehicular activity training and hardware design consideration

NASA Technical Reports Server (NTRS)

Thuot, P. J.; Harbaugh, G. J.

1995-01-01

Preparing astronauts to perform the many complex extravehicular activity (EVA) tasks required to assemble and maintain Space Station will be accomplished through training simulations in a variety of facilities. The adequacy of this training is dependent on a thorough understanding of the task to be performed, the environment in which the task will be performed, high-fidelity training hardware and an awareness of the limitations of each particular training facility. Designing hardware that can be successfully operated, or assembled, by EVA astronauts in an efficient manner, requires an acute understanding of human factors and the capabilities and limitations of the space-suited astronaut. Additionally, the significant effect the microgravity environment has on the crew members' capabilities has to be carefully considered not only for each particular task, but also for all the overhead related to the task and the general overhead associated with EVA. This paper will describe various training methods and facilities that will be used to train EVA astronauts for Space Station assembly and maintenance. User-friendly EVA hardware design considerations and recent EVA flight experience will also be presented.

Extravehicular activity training and hardware design consideration.

PubMed

Thuot, P J; Harbaugh, G J

1995-07-01

Preparing astronauts to perform the many complex extravehicular activity (EVA) tasks required to assemble and maintain Space Station will be accomplished through training simulations in a variety of facilities. The adequacy of this training is dependent on a thorough understanding of the task to be performed, the environment in which the task will be performed, high-fidelity training hardware and an awareness of the limitations of each particular training facility. Designing hardware that can be successfully operated, or assembled, by EVA astronauts in an efficient manner, requires an acute understanding of human factors and the capabilities and limitations of the space-suited astronaut. Additionally, the significant effect the microgravity environment has on the crew members' capabilities has to be carefully considered not only for each particular task, but also for all the overhead related to the task and the general overhead associated with EVA. This paper will describe various training methods and facilities that will be used to train EVA astronauts for Space Station assembly and maintenance. User-friendly EVA hardware design considerations and recent EVA flight experience will also be presented.

21 CFR 606.40 - Facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Facilities. 606.40 Section 606.40 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS CURRENT GOOD MANUFACTURING PRACTICE FOR BLOOD AND BLOOD COMPONENTS Plant and Facilities § 606.40 Facilities...

42 CFR 124.517 - Unrestricted availability compliance alternative for Title VI-assisted facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... for Title VI-assisted facilities. 124.517 Section 124.517 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT MEDICAL FACILITY CONSTRUCTION AND... availability compliance alternative for Title VI-assisted facilities. (a) Effect of certification. The...

21 CFR 606.40 - Facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Facilities. 606.40 Section 606.40 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS CURRENT GOOD MANUFACTURING PRACTICE FOR BLOOD AND BLOOD COMPONENTS Plant and Facilities § 606.40 Facilities...

Indicators of Dysphagia in Aged Care Facilities

ERIC Educational Resources Information Center

Pu, Dai; Murry, Thomas; Wong, May C. M.; Yiu, Edwin M. L.; Chan, Karen M. K.

2017-01-01

Purpose: The current cross-sectional study aimed to investigate risk factors for dysphagia in elderly individuals in aged care facilities. Method: A total of 878 individuals from 42 aged care facilities were recruited for this study. The dependent outcome was speech therapist-determined swallowing function. Independent factors were Eating…

Human Engineering Operations and Habitability Assessment: A Process for Advanced Life Support Ground Facility Testbeds

NASA Technical Reports Server (NTRS)

Connolly, Janis H.; Arch, M.; Elfezouaty, Eileen Schultz; Novak, Jennifer Blume; Bond, Robert L. (Technical Monitor)

1999-01-01

Design and Human Engineering (HE) processes strive to ensure that the human-machine interface is designed for optimal performance throughout the system life cycle. Each component can be tested and assessed independently to assure optimal performance, but it is not until full integration that the system and the inherent interactions between the system components can be assessed as a whole. HE processes (which are defining/app lying requirements for human interaction with missions/systems) are included in space flight activities, but also need to be included in ground activities and specifically, ground facility testbeds such as Bio-Plex. A unique aspect of the Bio-Plex Facility is the integral issue of Habitability which includes qualities of the environment that allow humans to work and live. HE is a process by which Habitability and system performance can be assessed.

Corrosion Protection for Space and Beyond

NASA Technical Reports Server (NTRS)

Calle, Luz Marina

2007-01-01

Florida is home to NASA's Launch Operations Center. Since its establishment in July 1962, the spaceport has served as the departure gate for every American manned mission and hundreds of advanced scientific spacecraft under the Launch Services Program. The center was renamed the John F. Kennedy Space Center in late 1963 to honor the president who put America on the path to the moon. Today, NASA is on the edge of a bold new chaIlenge: the ConsteIlation Program. ConsteIlation is a NASA program to create a new generation of spacecraft for human spaceflight, consisting primarily of the Ares I and Ares V launch vehicles, the Orion crew capsule, the Earth Departure stage and the Lunar access module. These spacecraft will be capable of performing a variety of missions, from Space Station resupply to lunar landings. The ambitious new endeavor caIls for NASA to return human explorers to the moon and then venture even farther, to Mars and beyond. As the nation's premier spaceport, Kennedy Space Center (KSC) will playa critical role in this new chapter in exploration, particularly in the conversion of the launch facilities to accommodate the new launch vehicles. To prepare for this endeavor, the launch site and facilities for the next generation of crew and cargo vehicles must be redesigned, assembled and tested. One critical factor that is being carefuIly considered during the renovation is protecting the new facilities and structures from corrosion and deterioration.

Designing for Our Future in Space

NASA Technical Reports Server (NTRS)

Connolly, Janis

2007-01-01

Over the past several years, the disciplines of architecture and human factors have been increasingly recognized as specialties that have focused upon "human-centered design" in the development of spacecraft and surface habitats. These specialties have been instrumental in the conceptual design of overall spacecraft configurations and layouts, as well as habitability outfitting hardware, such as the galley, hygiene facility, sleep quarters, or the layout of displays and controls. From the human-centered perspective, this approach to design assists in the mitigation of risk when designing for an extreme environment such as space. It takes into account the human s physical and cognitive capabilities and limitations, the human s performance in the context of human space flight, the human s interaction with machines that are both physically and cognitively complex, the activities required of the human to accomplish the goals of missions, and the use of design practices that promote products to enable human activity. It is this latter aspect - the use of design practices that promote products to enable human activity - that is the focus of the approach used by the Rhode Island School of Design (RISD) in collaboration with the Habitability and Human Factors Branch (HHFB) at the NASA Johnson Space Center (JSC). During the past few years, there has been a growing recognition of the value added by utilizing industrial designers to further the conceptual development of space hardware, that when used in conjunction with architecture and human factors, provides a robust solution to the design challenge. The "Design for Extreme Environments" Studio at RISD has taken suggested design topics from the NASA JSC HHFB and asked the students to investigate solutions to these challenges. The topics have demanded that the student pay particular attention to a variety of aspects of the space environment and understand how the human responds to each. The student must then adapt the design to these responses. The studio environment has been one way to introduce these challenges, but providing for an "in-residence" opportunity at JSC has given the students a broader vision and set of experiences. The accompanying presentation highlights the studio as well as in-residence work that has been accomplished.

Factors associated with adequate weekly reporting for disease surveillance data among health facilities in Nairobi County, Kenya, 2013

PubMed Central

Mwatondo, Athman Juma; Ng'ang'a, Zipporah; Maina, Caroline; Makayotto, Lyndah; Mwangi, Moses; Njeru, Ian; Arvelo, Wences

2016-01-01

Introduction Kenya adopted the Integrated Disease Surveillance and Response (IDSR) strategy in 1998 to strengthen disease surveillance and epidemic response. However, the goal of weekly surveillance reporting among health facilities has not been achieved. We conducted a cross-sectional study to determine the prevalence of adequate reporting and factors associated with IDSR reporting among health facilities in one Kenyan County. Methods Health facilities (public and private) were enrolled using stratified random sampling from 348 facilities prioritized for routine surveillance reporting. Adequately-reporting facilities were defined as those which submitted >10 weekly reports during a twelve-week period and a poor reporting facilities were those which submitted <10 weekly reports. Multivariate logistic regression with backward selection was used to identify risk factors associated with adequate reporting. Results From September 2 through November 30, 2013, we enrolled 175 health facilities; 130(74%) were private and 45(26%) were public. Of the 175 health facilities, 77 (44%) facilities classified as adequate reporting and 98 (56%) were reporting poorly. Multivariate analysis identified three factors to be independently associated with weekly adequate reporting: having weekly reporting forms at visit (AOR19, 95% CI: 6-65], having posters showing IDSR functions (AOR8, 95% CI: 2-12) and having a designated surveillance focal person (AOR7, 95% CI: 2-20). Conclusion The majority of health facilities in Nairobi County were reporting poorly to IDSR and we recommend that the Ministry of Health provide all health facilities in Nairobi County with weekly reporting tools and offer specific trainings on IDSR which will help designate a focal surveillance person. PMID:27303581

Human adaptation to isolated and confined environments: Preliminary findings of a seven month Antarctic winter-over human factors study

NASA Technical Reports Server (NTRS)

Evans, Gary W.; Stokols, Daniel; Carrere, Sybil

1988-01-01

This field study was conducted during the last decade of an austral winter-over at Palmer Station in the Antarctic. The purpose of the study was to understand temporal patterns in physiological arousal and psychological mood over the course of the mission. The investigators were principally interested in how people adapted over time to chronic and acute stressors, and how people use and modify their built environment. Physiological and psychological data were collected several times a week, and information on behavior and the use of physical facilities was collected monthly. Physiological and psychological data were compared with social changes in the setting toward the development of a sequential model of human-environment transactional relationships. Based on the study results, guidelines for design of future isolated and confined environments (ICEs) included: plan space for items which make people feel at home, provide materials to allow people to personalize their environment, allow for flexible environments, provide areas for visual and auditory privacy, equip areas for socializing and remove them from private areas, and provide facilities for exercise and for projects involving physical activity. The study offers guidelines about patterns of adaption that could be expected in an ICE, discusses how these settings can be programmed to facilitate successful adjustment, and provides information about how to design future ICE habitats to maximize a healthy living environment.

Micronuclei Induction in Human Fibroblasts Exposed In Vitro to Los Alamos High-Energy Neutrons

NASA Technical Reports Server (NTRS)

Gersey, Brad; Sodolak, John; Hada, Megumi; Saganti, Prem; Wilkins, Richard; Cucinotta, Francis; Wu, Honglu

2006-01-01

High-energy secondary neutrons, produced by the interaction of galactic cosmic rays with the atmosphere, spacecraft structure and planetary surfaces, contribute to a significant fraction to the dose equivalent in crew members and passengers during commercial aviation travel, and astronauts in space missions. The Los Alamos Nuclear Science Center (LANSCE) neutron facility#s ICE House 30L beamline is known to generate neutrons that simulate the secondary neutron spectra of earth#s atmosphere. The neutron spectrum is also similar to that measured onboard spacecraft like the MIR and International Space Station (ISS). To evaluate the biological damage, we exposed human fibroblasts in vitro to the LANSCE neutron beams without degrader at an entrance dose rate of 25 mGy/hr and analyzed the micronuclei (MN) induction. The cells were also placed behind a 9.9 cm water column to study effect of shielding in the protection of neutron induced damages. It was found that the dose response in the MN frequency was linear for the samples with and without shielding and the slope of the MN yield behind the shielding was reduced by a factor of 3.5. Compared to the MN induction in human fibroblasts exposed to a gamma source at a low dose rate, the RBE was found to be 16.7 and 10.0 for the neutrons without and with 9.9 cm water shielding, respectively.

30 CFR 285.1014 - When will MMS suspend an Alternate Use RUE?

Code of Federal Regulations, 2010 CFR

2010-07-01

... OFFSHORE RENEWABLE ENERGY ALTERNATE USES OF EXISTING FACILITIES ON THE OUTER CONTINENTAL SHELF Rights of Use and Easement for Energy- and Marine-Related Activities Using Existing OCS Facilities Alternate Use... resources; life (including human and wildlife); property; the marine, coastal, or human environment; or...

42 CFR 37.43 - Protection against radiation emitted by roentgenographic equipment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... specified in § 37.41, roentgenographic equipment, its use and the facilities (including mobile facilities... facilities (including mobile facilities) in which such equipment is used shall conform to the recommendations... roentgenographic equipment. 37.43 Section 37.43 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN...

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...

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...

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...

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...

RNA-programmed genome editing in human cells

PubMed Central

Jinek, Martin; East, Alexandra; Cheng, Aaron; Lin, Steven; Ma, Enbo; Doudna, Jennifer

2013-01-01

Type II CRISPR immune systems in bacteria use a dual RNA-guided DNA endonuclease, Cas9, to cleave foreign DNA at specific sites. We show here that Cas9 assembles with hybrid guide RNAs in human cells and can induce the formation of double-strand DNA breaks (DSBs) at a site complementary to the guide RNA sequence in genomic DNA. This cleavage activity requires both Cas9 and the complementary binding of the guide RNA. Experiments using extracts from transfected cells show that RNA expression and/or assembly into Cas9 is the limiting factor for Cas9-mediated DNA cleavage. In addition, we find that extension of the RNA sequence at the 3′ end enhances DNA targeting activity in vivo. These results show that RNA-programmed genome editing is a facile strategy for introducing site-specific genetic changes in human cells. DOI: http://dx.doi.org/10.7554/eLife.00471.001 PMID:23386978

International Human Rights and the Mistreatment of Women During Childbirth

PubMed Central

Zampas, Christina; Vogel, Joshua P.; Bohren, Meghan A.; Roseman, Mindy; Erdman, Joanna N.

2016-01-01

Abstract International human rights bodies have played a critical role in codifying, setting standards, and monitoring human rights violations in the context of sexual and reproductive health and rights. In recent years, these institutions have developed and applied human rights standards in the more particular context of maternal mortality and morbidity, and have increasingly recognized a critical human rights issue in the provision and experience of care during and after pregnancy, including during childbirth. However, the international human rights standards on mistreatment during facility-based childbirth remain, in an early stage of development, focused largely on a discrete subset of experiences, such as forced sterilization and lack of access to emergency obstetric care. As a consequence, the range of mistreatment that women may experience has not been adequately addressed or analyzed under international human rights law. Identifying human rights norms and standards related to the full range of documented mistreatment is thus a first step towards addressing violations of human rights during facility-based childbirth, ensuring respectful and humane treatment, and developing a program of work to improve the overall quality of maternal care. This article reviews international human rights standards related to the mistreatment of women during childbirth in facility settings under regional and international human rights law and lays out an agenda for further research and action. PMID:28559681

International Human Rights and the Mistreatment of Women During Childbirth.

PubMed

Khosla, Rajat; Zampas, Christina; Vogel, Joshua P; Bohren, Meghan A; Roseman, Mindy; Erdman, Joanna N

2016-12-01

International human rights bodies have played a critical role in codifying, setting standards, and monitoring human rights violations in the context of sexual and reproductive health and rights. In recent years, these institutions have developed and applied human rights standards in the more particular context of maternal mortality and morbidity, and have increasingly recognized a critical human rights issue in the provision and experience of care during and after pregnancy, including during childbirth. However, the international human rights standards on mistreatment during facility-based childbirth remain, in an early stage of development, focused largely on a discrete subset of experiences, such as forced sterilization and lack of access to emergency obstetric care. As a consequence, the range of mistreatment that women may experience has not been adequately addressed or analyzed under international human rights law. Identifying human rights norms and standards related to the full range of documented mistreatment is thus a first step towards addressing violations of human rights during facility-based childbirth, ensuring respectful and humane treatment, and developing a program of work to improve the overall quality of maternal care. This article reviews international human rights standards related to the mistreatment of women during childbirth in facility settings under regional and international human rights law and lays out an agenda for further research and action.

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

M. L. Abbott; K. N. Keck; R. E. Schindler

This screening level risk assessment evaluates potential adverse human health and ecological impacts resulting from continued operations of the calciner at the New Waste Calcining Facility (NWCF) at the Idaho Nuclear Technology and Engineering Center (INTEC), Idaho National Engineering and Environmental Laboratory (INEEL). The assessment was conducted in accordance with the Environmental Protection Agency (EPA) report, Guidance for Performing Screening Level Risk Analyses at Combustion Facilities Burning Hazardous Waste. This screening guidance is intended to give a conservative estimate of the potential risks to determine whether a more refined assessment is warranted. The NWCF uses a fluidized-bed combustor to solidifymore » (calcine) liquid radioactive mixed waste from the INTEC Tank Farm facility. Calciner off volatilized metal species, trace organic compounds, and low-levels of radionuclides. Conservative stack emission rates were calculated based on maximum waste solution feed samples, conservative assumptions for off gas partitioning of metals and organics, stack gas sampling for mercury, and conservative measurements of contaminant removal (decontamination factors) in the off gas treatment system. Stack emissions were modeled using the ISC3 air dispersion model to predict maximum particulate and vapor air concentrations and ground deposition rates. Results demonstrate that NWCF emissions calculated from best-available process knowledge would result in maximum onsite and offsite health and ecological impacts that are less then EPA-established criteria for operation of a combustion facility.« less

Measuring Land Uses Accessibility by Using Fuzzy Majority Gis-Based Multicriteria Decision Analysis Case Study: Malayer City

NASA Astrophysics Data System (ADS)

Taravat, A.; Yari, A.; Rajaei, M.; Mousavian, R.

2014-10-01

Public spaces accessibility has become one of the important factors in urban planning. Therefore, considerable attention has been given to measure accessibility to public spaces on the UK, US and Canada, but there are few studies outside the anglophone world especially in developing countries such as Iran. In this study an attempt has been made to measure objective accessibility to public spaces (parks, school, library and administrative) using fuzzy majority GIS-based multicriteria decision analysis. This method is for defining the priority for distribution of urban facilities and utilities as the first step towards elimination of social justice. In order to test and demonstrate the presented model, the comprehensive plan of Malayer city has been considered for ranking in three objectives and properties in view of index per capital (Green space, sport facilities and major cultural centers like library and access index). The results can be used to inform the local planning process and the GIS approach can be expanded into other local authority domains. The results shows that the distribution of facilities in Malayer city has followed on the base of cost benefit law and the human aspect of resource allocation programming of facilities (from centre to suburbs of the city).

Finding the team for Mars: a psychological and human factors analysis of a Mars Desert Research Station crew.

PubMed

Sawyer, Benjamin D; Hancock, P A; Deaton, John; Suedfeld, Peter

2012-01-01

A two-week mission in March and April of 2011 sent six team members to the Mars Desert Research Station (MDRS). MDRS, a research facility in the high Utah desert, provides an analogue for the harsh and unusual working conditions that will be faced by men and women who one day explore Mars. During the mission a selection of quantitative and qualitative psychological tests were administered to the international, multidisciplinary team. A selection of the results are presented along with discussion.

The relationship between the availability of the supporting elements of pedestrian with pedestrian crossing facility usage based on user preferences (Case Study corridor of Sumbersari Street, Gajayana Street, MT. Haryono Street, Malang City)

NASA Astrophysics Data System (ADS)

Soetrisno, D. P.

2017-06-01

Pedestrian crossing facilities are effective enough to avoid pedestrians with vehicles, but its utilization is still quite low. It indicated that safety is not the only factor that influences a person to utilize the pedestrian crossing facilities. In addition, the availability of supporting elements of the pedestrian is still not quite attention, which is also became a factor that causes the pedestrians doesn’t utilize the pedestrian crossing facilities. Therefore, this research was structured to examine the relationship between the availability of the supporting elements of the pedestrian with pedestrian crossing facility usage based on user preferences. Data collection method used is primary survey consist of observation and the questionnaire. Sampling techniques used is purposive sampling with the number of respondents as many as 211 respondents by using questionnaire with ordinal scales to identify respondents’ consideration level of supporting elements pedestrian and crossing facility utilization factors. The survey is done on 15 crossing facilities area in 3 different locations with the same characteristics of land use in the form of higher education area (university area) and trades and services activities area. The analysis technique used is frequency distribution analysis in order to identify preference pedestrian on the availability of supporting elements of pedestrian and pedestrian crossing facility utilization factors, and chi square analysis is used to analyze the relationship between the availability of the supporting elements of the pedestrian with pedestrian crossing facility utilization. Based on the chi square analysis results with significance 5 % obtained the result that there are six supporting elements of pedestrian having correlation to the factors of pedestrian crossing facility utilization consist of the availability of sidewalk, pedestrian lights, Street Lighting Lamps, Pedestrian Crossing Markings Facilities, Sign Crossings Facilities, vegetation, and dustbin. So the result of this research can be considered for the government as main stakehoder especially the local government in preparing policy to provide supporting elements of pedestrian that should be on the area of pedestrian crossing facilities.

Factors influencing women's utilization of public health care services during childbirth in Malawi Public health facility utilization.

PubMed

Machira, Kennedy; Palamuleni, Martin

2017-06-01

Maternal mortality remains a public health challenge claiming many lives at the time of giving birth lives. However, there have been scanty studies investigating factors influencing women's use of public health facilities during childbirth. The aim of the study was to explore the factors associated with women choice of public health facility during childbirth. The study used 2010 Malawi Demographic Health Survey dataset and a binary logistics regression analysis to estimate the determinants influencing women's use of public health facilities at the time they give birth. Of 23020 women respondents, 8454(36.7%) chose to give birth in public health facilities. Multivariate analysis reported that frequency of antenatal care (ANC), birth order, women's education, wealth status and quality of care were the major predictors increasing women's choice to use public health facilities at childbirth. There is need to use multimedia approach to engage women on significance of utilizing public health facilities during childbirth and promote quality of care in facilities if their health outcome is to improve in Malawi.

Settlement preferences in the disaster-prone areas of Brantas River

NASA Astrophysics Data System (ADS)

Hariyani, S.

2018-01-01

Kota Lama is one of the urban villages in Malang city that has settlements along the Brantas River. Kota Lama experienced three landslides and flooding in 2015 and one in 2016. Those disasters caused the community to take action of post-disaster recovery, yet the people still choose to remain living in Kota Lama. Therefore, the study aims at determining the preferences of the citizens living in disaster-prone areas in Brantas River. The research used a factor analysis of 12 variables: 1) neighbourhood situation, 2) air condition, 3) relations between neighbours, 4) security, 5) location, 6) customs, 7) ethnic diversity, 8) the presence of social groups, 9) the community’s customs and habits, 10) proximity to the economic facilities, 11) adequate educational facilities, and 12) adequate medical/health facilities. The results show that two factors have been formed, namely Factor 1 (access) comprising variables of neighbourhood situation, air condition, relations between neighbours, location, ethnic diversity, the presence of a social group, supporting positive habits at home, close to the economic facilities, educational facilities, as well as medical facilities, and Factor 2 (assurance) consisting of customs and security.

Human use regulatory affairs advisor (HURAA): learning about research ethics with intelligent learning modules.

PubMed

Hu, Xiangen; Graesser, Arthur C

2004-05-01

The Human Use Regulatory Affairs Advisor (HURAA) is a Web-based facility that provides help and training on the ethical use of human subjects in research, based on documents and regulations in United States federal agencies. HURAA has a number of standard features of conventional Web facilities and computer-based training, such as hypertext, multimedia, help modules, glossaries, archives, links to other sites, and page-turning didactic instruction. HURAA also has these intelligent features: (1) an animated conversational agent that serves as a navigational guide for the Web facility, (2) lessons with case-based and explanation-based reasoning, (3) document retrieval through natural language queries, and (4) a context-sensitive Frequently Asked Questions segment, called Point & Query. This article describes the functional learning components of HURAA, specifies its computational architecture, and summarizes empirical tests of the facility on learners.

Education and Racial-Ethnic Differences in Types of Exercise in the United States

PubMed Central

Onge, Jarron M. Saint; Krueger, Patrick M.

2013-01-01

Epidemiological research typically focuses on the intensity, frequency, or duration of physical activity, without consideration of the socially meaningful dimensions of exercise. The authors use data from the 1998 National Health Interview Survey (N = 17,455) and information on participation in 15 exercise behaviors to examine educational differences in exercise among non-Hispanic whites, non-Hispanic blacks, and Mexican Americans. Factor analysis identifies three types of exercise: team sports (e.g., basketball, football), fitness activities (e.g., running, weight lifting), and activities that require the use of specialized facilities (e.g., golf, tennis). Cultural capital and human capital perspectives offer insight into different dimensions of the relationship between education and exercise. Whites disproportionately undertake facility-based exercise, blacks tend toward team and fitness activities, and Mexican Americans gravitate toward team sports. Our findings offer insight into the social stratification of health and can aid the design of public health interventions. PMID:21673147

The Challenges of Field Testing the Traffic Management Advisor (TMA) in an Operational Air Traffic Control Facility

NASA Technical Reports Server (NTRS)

Hoang, Ty; Swenson, Harry N.

1997-01-01

The Traffic Management Advisor (TMA), the sequence and schedule tool of the Center/TRACON Automation System (CTAS), was evaluated at the Fort Worth Center (ZFW) in the summer of 1996. This paper describes the challenges encountered during the various phases of the TMA field evaluation, which included system (hardware and software) installation, personnel training, and data collection. Operational procedures were developed and applied to the evaluation process that would ensure air safety. The five weeks of field evaluation imposed minimal impact on the hosting facility and provided valuable engineering and human factors data. The collection of data was very much an opportunistic affair, due to dynamic traffic conditions. One measure of the success of the TMA evaluation is that, rather than remove TMA after the evaluation until it could be fully implemented, the prototype TMA is in continual use at ZFW as the fully operational version is readied for implementation.

Functional requirements for the man-vehicle systems research facility. [identifying and correcting human errors during flight simulation

NASA Technical Reports Server (NTRS)

Clement, W. F.; Allen, R. W.; Heffley, R. K.; Jewell, W. F.; Jex, H. R.; Mcruer, D. T.; Schulman, T. M.; Stapleford, R. L.

1980-01-01

The NASA Ames Research Center proposed a man-vehicle systems research facility to support flight simulation studies which are needed for identifying and correcting the sources of human error associated with current and future air carrier operations. The organization of research facility is reviewed and functional requirements and related priorities for the facility are recommended based on a review of potentially critical operational scenarios. Requirements are included for the experimenter's simulation control and data acquisition functions, as well as for the visual field, motion, sound, computation, crew station, and intercommunications subsystems. The related issues of functional fidelity and level of simulation are addressed, and specific criteria for quantitative assessment of various aspects of fidelity are offered. Recommendations for facility integration, checkout, and staffing are included.

Emergency, anaesthetic and essential surgical capacity in the Gambia

PubMed Central

Shivute, Nestor; Bickler, Stephen; Cole-Ceesay, Ramou; Jargo, Bakary; Abdullah, Fizan; Cherian, Meena

2011-01-01

Abstract Objective To assess the resources for essential and emergency surgical care in the Gambia. Methods The World Health Organization’s Tool for Situation Analysis to Assess Emergency and Essential Surgical Care was distributed to health-care managers in facilities throughout the country. The survey was completed by 65 health facilities – one tertiary referral hospital, 7 district/general hospitals, 46 health centres and 11 private health facilities – and included 110 questions divided into four sections: (i) infrastructure, type of facility, population served and material resources; (ii) human resources; (iii) management of emergency and other surgical interventions; (iv) emergency equipment and supplies for resuscitation. Questionnaire data were complemented by interviews with health facility staff, Ministry of Health officials and representatives of nongovernmental organizations. Findings Important deficits were identified in infrastructure, human resources, availability of essential supplies and ability to perform trauma, obstetric and general surgical procedures. Of the 18 facilities expected to perform surgical procedures, 50.0% had interruptions in water supply and 55.6% in electricity. Only 38.9% of facilities had a surgeon and only 16.7% had a physician anaesthetist. All facilities had limited ability to perform basic trauma and general surgical procedures. Of public facilities, 54.5% could not perform laparotomy and 58.3% could not repair a hernia. Only 25.0% of them could manage an open fracture and 41.7% could perform an emergency procedure for an obstructed airway. Conclusion The present survey of health-care facilities in the Gambia suggests that major gaps exist in the physical and human resources needed to carry out basic life-saving surgical interventions. PMID:21836755

42 CFR 124.708 - Waiver of recovery-good cause for other use of facility.

Code of Federal Regulations, 2010 CFR

2010-10-01

... facility. 124.708 Section 124.708 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT MEDICAL FACILITY CONSTRUCTION AND MODERNIZATION Recovery of Grant Funds § 124.708 Waiver of recovery—good cause for other use of facility. The Secretary may for good...

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...

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...

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...

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...

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...

10 CFR 26.715 - Recordkeeping requirements for collection sites, licensee testing facilities, and laboratories...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Recordkeeping requirements for collection sites, licensee testing facilities, and laboratories certified by the Department of Health and Human Services. 26.715... laboratories certified by the Department of Health and Human Services. (a) Collection sites providing services...

Evaluating Potential Human Health Risks Associated with the Development of Utility-Scale Solar Energy Facilities on Contaminated Sites

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

Cheng, J. -J.; Chang, Y. -S.; Hartmann, H.

2013-09-01

This report presents a general methodology for obtaining preliminary estimates of the potential human health risks associated with developing a utility-scale solar energy facility on a contaminated site, based on potential exposures to contaminants in soils (including transport of those contaminants into the air).

77 FR 43086 - Solicitation of Written Comments on Draft Phase 3 Long-Term Care Facilities Strategy/Module for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Solicitation of Written Comments on Draft Phase 3 Long-Term Care Facilities Strategy/Module for Inclusion in the National Action Plan To Prevent Healthcare-Associated Infections: Roadmap to Elimination AGENCY: Department of Health and Human Services, Office of the...

An integrated approach for facilities planning by ELECTRE method

NASA Astrophysics Data System (ADS)

Elbishari, E. M. Y.; Hazza, M. H. F. Al; Adesta, E. Y. T.; Rahman, Nur Salihah Binti Abdul

2018-01-01

Facility planning is concerned with the design, layout, and accommodation of people, machines and activities of a system. Most of the researchers try to investigate the production area layout and the related facilities. However, few of them try to investigate the relationship between the production space and its relationship with service departments. The aim of this research to is to integrate different approaches in order to evaluate, analyse and select the best facilities planning method that able to explain the relationship between the production area and other supporting departments and its effect on human efforts. To achieve the objective of this research two different approaches have been integrated: Apple’s layout procedure as one of the effective tools in planning factories, ELECTRE method as one of the Multi Criteria Decision Making methods (MCDM) to minimize the risk of getting poor facilities planning. Dalia industries have been selected as a case study to implement our integration the factory have been divided two main different area: the whole facility (layout A), and the manufacturing area (layout B). This article will be concerned with the manufacturing area layout (Layout B). After analysing the data gathered, the manufacturing area was divided into 10 activities. There are five factors that the alternative were compared upon which are: Inter department satisfactory level, total distance travelled for workers, total distance travelled for the product, total time travelled for the workers, and total time travelled for the product. Three different layout alternatives have been developed in addition to the original layouts. Apple’s layout procedure was used to study and evaluate the different alternatives layouts, the study and evaluation of the layouts was done by calculating scores for each of the factors. After obtaining the scores from evaluating the layouts, ELECTRE method was used to compare the proposed alternatives with each other and with the existing layout; ELECTRE compares the alternatives based on their concordance and discordance indices. The alternatives were ranked from best to worst where regarding to the layouts concerned with the manufacturing area B.4 is the best alternative.

Human resources for refraction services in Central Nepal.

PubMed

Kandel, Himal; Murthy, G V S; Bascaran, Covadonga

2015-07-01

Uncorrected refractive error is a public health problem globally and in Nepal. Planning of refraction services is hampered by a paucity of data. This study was conducted to determine availability and distribution of human resources for refraction, their efficiency, the type and extent of their training; the current service provision of refraction services and the unmet need in human resources for refraction in Central Nepal. This was a descriptive cross-sectional study. All refraction facilities in the Central Region were identified through an Internet search and interviews of key informants from the professional bodies and parent organisations of primary eye centres. A stratified simple random sampling technique was used to select 50 per cent of refraction facilities. The selected facilities were visited for primary data collection. Face-to-face interviews were conducted with the managers and the refractionists available in the facilities using a semi-structured questionnaire. Data was collected in 29 centres. All the managers (n=29; response rate 100 per cent) and 50 refractionists (Response rate 65.8 per cent) were interviewed. Optometrists and ophthalmic assistants were the main providers of refraction services (n=70, 92.11 per cent). They were unevenly distributed across the region, highly concentrated around urban areas. The median number of refractions per refractionist per year was 3,600 (IQR: 2,400 - 6,000). Interviewed refractionists stated that clients' knowledge, attitude and practice related factors such as lack of awareness of the need for refraction services and/or availability of existing services were the major barriers to the output of refraction services. The total number of refractions carried out in the Central Region per year was 653,176. An additional 170 refractionists would be needed to meet the unmet need of 1,323,234 refractions. The study findings demand a major effort to develop appropriately trained personnel when planning refraction services in the Central Region and in Nepal as a whole. The equitable distribution of the refractionists, their community-outreach services and awareness raising activities should be emphasised. © 2015 The Authors. Clinical and Experimental Optometry © 2015 Optometry Australia.

Specific factors influencing information system/information and communication technology sourcing strategies in healthcare facilities.

PubMed

Potančok, Martin; Voříšek, Jiří

2016-09-01

Healthcare facilities use a number of information system/information and communication technologies. Each healthcare facility faces a need to choose sourcing strategies most suitable to ensure provision of information system/information and communication technology services, processes and resources. Currently, it is possible to observe an expansion of sourcing possibilities in healthcare informatics, which creates new requirements for sourcing strategies. Thus, the aim of this article is to identify factors influencing information system/information and communication technology sourcing strategies in healthcare facilities. The identification was based on qualitative research, namely, a case study. This study provides a set of internal and external factors with their impact levels. The findings also show that not enough attention is paid to these factors during decision-making. © The Author(s) 2015.

Job satisfaction: rural versus urban primary health care workers' perception in Ogun State of Nigeria.

PubMed

Campbell, P C; Ebuehi, O M

2011-01-01

Job satisfaction implies doing a job one enjoys, doing it well, and being suitably rewarded for one' efforts. Several factors affect job satisfaction. To compare factors influencing job satisfaction amongst rural and urban primary health care workers in southwestern Nigeria. A cross sectional comparative study recruited qualified health workers selected by multi stage sampling technique from rural and urban health facilities in four local government areas (LGAs) of Ogun State in Southwestern Nigeria. Data were collected and analysed using Epi info V 3.5.1 RESULTS: The response rates were 88(88%) and 91(91%) respectively in the rural and urban areas. While urban workers derived satisfaction from availability of career development opportunities, materials and equipment, in their current job, rural workers derived satisfaction from community recognition of their work and improved staff relationship. Major de-motivating factors common to both groups were lack of supportive supervision, client-provider relationship and lack of in-service training. However more rural 74(84.1%) than urban 62(68.1%) health workers would prefer to continue working in their present health facilities (p=0.04). There was a statistically significant difference between the two groups in job satisfaction with respect to tools availability and career development opportunities (p<0.05). There is dissimilarity in factors influencing job satisfaction between rural and urban healthcare workers. There is need for human resource policy to be responsive to the diverse needs of health workers particularly at the primary level.

Factors associated with bat mortality at wind energy facilities in the United States

USGS Publications Warehouse

Thompson, Maureen; Beston, Julie A.; Etterson, Matthew A.; Diffendorfer, James E.; Loss, Scott R.

2017-01-01

Hundreds of thousands of bats are killed annually by colliding with wind turbines in the U.S., yet little is known about factors causing variation in mortality across wind energy facilities. We conducted a quantitative synthesis of bat collision mortality with wind turbines by reviewing 218 North American studies representing 100 wind energy facilities. This data set, the largest compiled for bats to date, provides further evidence that collision mortality is greatest for migratory tree-roosting species (Hoary Bat [Lasiurus cinereus], Eastern Red Bat [Lasiurus borealis], Silver-haired Bat [Lasionycteris noctivagans]) and from July to October. Based on 40 U.S. studies meeting inclusion criteria and analyzed under a common statistical framework to account for methodological variation, we found support for an inverse relationship between bat mortality and percent grassland cover surrounding wind energy facilities. At a national scale, grassland cover may best reflect openness of the landscape, a factor generally associated with reduced activity and abundance of tree-roosting species that may also reduce turbine collisions. Further representative sampling of wind energy facilities is required to validate this pattern. Ecologically informed placement of wind energy facilities involves multiple considerations, including not only factors associated with bat mortality, but also factors associated with bird collision mortality, indirect habitat-related impacts to all species, and overall ecosystem impacts.

Electronic alerts and clinician turnover: the influence of user acceptance.

PubMed

Hysong, Sylvia J; Spitzmuller, Christiane; Espadas, Donna; Sittig, Dean F; Singh, Hardeep

2014-11-01

Use of certain components of electronic health records (EHRs), such as EHR-based alerting systems (EASs), might reduce provider satisfaction, a strong precursor to turnover. We examined the impact of factors likely to influence providers' acceptance of an alerting system, designed to facilitate electronic communication in outpatient settings, on provider satisfaction, intentions to quit, and turnover. We conducted a cross-sectional Web-based survey of EAS-related practices from a nationwide sample of primary care providers (PCPs) practicing at Department of Veterans Affairs (VA) medical facilities. Of 5001 invited VA PCPs, 2590 completed the survey. We relied on Venkatesh's Unified Theory of Acceptance and Use of Technology to create survey measures of 4 factors likely to impact user acceptance of EAS: supportive norms, monitoring/ feedback, training, and providers' perceptions of the value (PPOV) of EASs to provider effectiveness. Facility-level PCP turnover was measured via the VA's Service Support Center Human Resources Cube. Hypotheses were tested using structural equation modeling. After accounting for intercorrelations among predictors, monitoring/feedback regarding EASs significantly predicted intention to quit (b = 0.30, P < .01), and PPOV of EASs predicted both overall provider satisfaction (b = 0.58, P < .01) and facility-level provider turnover levels (b = -0.19, P < .05), all without relying on any intervening mechanisms. Design, implementation, and use of EASs might impact provider satisfaction and retention. Institutions should consider strategies to help providers perceive greater value in these clinical tools.

The Impact of Athletic Facilities on the Recruitment of Potential Student-Athletes

ERIC Educational Resources Information Center

Schneider, Ray; Messenger, Steve

2012-01-01

Purpose: This study examined the impact that athletic facilities and other college choice factors have on the recruitment of student-athletes to play Division I college hockey compared to the influence of other college choice factors. Although athletic facilities and their seeming importance in the recruitment of top level student-athletes are…

Morphological and Hydrodynamic Correlations with Increasing Outflow Facility by Rho-Kinase Inhibitor Y-27632

PubMed Central

Yang, Chen-Yuan Charlie

2014-01-01

Abstract Rho-kinase inhibitors affect actomyosin cytoskeletal networks and have been shown to significantly increase outflow facility and lower intraocular pressure in various animal models and human eyes. This article summarizes common morphological changes in the trabecular meshwork induced by Rho-kinase inhibitors and specifically compares the morphological and hydrodynamic correlations with increased outflow facility by Rho-kinase inhibitor, Y-27632, in bovine, monkey, and human eyes under similar experimental conditions. Interspecies comparison has shown that morphological changes in the juxtacanalicular connective tissue (JCT) of these 3 species were different. However, these different morphological changes in the JCT, no matter if it's separation between the JCT and inner wall in bovine eyes, or separation between the JCT cells or between the JCT cells and their matrix in monkey eyes, or even no separation between the inner wall and the JCT but a more subtle expansion of the JCT in human eyes, appear to correlate with the increased percent change of outflow facility. More importantly, these different morphological changes all resulted in an increase in effective filtration area, which was positively correlated with increased outflow facility in all 3 species. These results suggest a link among changes in outflow facility, tissue architecture, and aqueous outflow pattern. Y-27632 increases outflow facility by redistributing aqueous outflow through a looser and larger area in the JCT. PMID:24460021

Human Modeling Evaluations in Microgravity Workstation and Restraint Development

NASA Technical Reports Server (NTRS)

Whitmore, Mihriban; Chmielewski, Cynthia; Wheaton, Aneice; Hancock, Lorraine; Beierle, Jason; Bond, Robert L. (Technical Monitor)

1999-01-01

The International Space Station (ISS) will provide long-term missions which will enable the astronauts to live and work, as well as, conduct research in a microgravity environment. The dominant factor in space affecting the crew is "weightlessness" which creates a challenge for establishing workstation microgravity design requirements. The crewmembers will work at various workstations such as Human Research Facility (HRF), Microgravity Sciences Glovebox (MSG) and Life Sciences Glovebox (LSG). Since the crew will spend considerable amount of time at these workstations, it is critical that ergonomic design requirements are integral part of design and development effort. In order to achieve this goal, the Space Human Factors Laboratory in the Johnson Space Center Flight Crew Support Division has been tasked to conduct integrated evaluations of workstations and associated crew restraints. Thus, a two-phase approach was used: 1) ground and microgravity evaluations of the physical dimensions and layout of the workstation components, and 2) human modeling analyses of the user interface. Computer-based human modeling evaluations were an important part of the approach throughout the design and development process. Human modeling during the conceptual design phase included crew reach and accessibility of individual equipment, as well as, crew restraint needs. During later design phases, human modeling has been used in conjunction with ground reviews and microgravity evaluations of the mock-ups in order to verify the human factors requirements. (Specific examples will be discussed.) This two-phase approach was the most efficient method to determine ergonomic design characteristics for workstations and restraints. The real-time evaluations provided a hands-on implementation in a microgravity environment. On the other hand, only a limited number of participants could be tested. The human modeling evaluations provided a more detailed analysis of the setup. The issues identified during the real-time testing were investigated in the human modeling analyses. In some cases, the opposite was true where preliminary human modeling analyses provided the design engineers with critical issues that needed to be addressed further. This extensive approach provided an effective means to fully address ergonomic design considerations and accurately identify critical issues.

Helminth infections among people using wastewater and human excreta in peri-urban agriculture and aquaculture in Hanoi, Vietnam.

PubMed

Do, Thuy Trang; Mølbak, Kåre; Phung, Dac Cam; Dalsgaard, Anders

2007-12-01

To assess the prevalence of helminth infections and their associated risks in a community using both wastewater and human excreta in agriculture and aquaculture. A cross-sectional study was conducted in a peri-urban area in Hanoi, Vietnam. Data on the demography, socioeconomics and sanitation were collected from a survey of 400 agricultural households. Parasitological examination for the eggs of Ascaris sp., Trichuris sp. and hookworm was performed on single stool specimens obtained from study household members' 15-70 years and 0-72 months of age. Of 807 stool samples collected from 620 adults and 187 children, 39% were infected with helminths. The prevalence of infections with Ascaris sp., Trichuris sp. and hookworm was 21.6%, 9.8% and 21.8%, respectively. Univariate and multivariate analyses showed that being an adult, female gender, living in a household without a latrine, excreta composted for less than 1 month and use of fresh human excreta were significantly associated with co-infection with all three helminths. Being an adult was an independent determinant for infections with individual helminths. The absence of a latrine and use of stored urine for irrigation were associated with an increased risk of Ascaris infection. Risk factors for Trichuris infection were inadequately composted excreta and year-round wastewater contact; risk factors for hookworm infection were female gender, household without a latrine and use of fresh human excreta. Wastewater exposure did not pose a major risk for helminth infection in this community. Instead, lack of sanitation facilities and use of fresh or inadequately composted human excreta in agriculture were important risk factors.

Spacecraft crew procedures from paper to computers

NASA Technical Reports Server (NTRS)

Oneal, Michael; Manahan, Meera

1991-01-01

Described here is a research project that uses human factors and computer systems knowledge to explore and help guide the design and creation of an effective Human-Computer Interface (HCI) for spacecraft crew procedures. By having a computer system behind the user interface, it is possible to have increased procedure automation, related system monitoring, and personalized annotation and help facilities. The research project includes the development of computer-based procedure system HCI prototypes and a testbed for experiments that measure the effectiveness of HCI alternatives in order to make design recommendations. The testbed will include a system for procedure authoring, editing, training, and execution. Progress on developing HCI prototypes for a middeck experiment performed on Space Shuttle Mission STS-34 and for upcoming medical experiments are discussed. The status of the experimental testbed is also discussed.

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...

45 CFR 1309.2 - Approval of the use of Head Start funds to continue purchase of facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Approval of the use of Head Start funds to continue purchase of facilities. 1309.2 Section 1309.2 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE...

45 CFR 1309.2 - Approval of the use of Head Start funds to continue purchase of facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Approval of the use of Head Start funds to continue purchase of facilities. 1309.2 Section 1309.2 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE...

45 CFR 1309.2 - Approval of the use of Head Start funds to continue purchase of facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Approval of the use of Head Start funds to continue purchase of facilities. 1309.2 Section 1309.2 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE...

21 CFR 111.310 - What are the requirements for the laboratory facilities that you use?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 2 2012-04-01 2012-04-01 false What are the requirements for the laboratory facilities that you use? 111.310 Section 111.310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN...

21 CFR 111.310 - What are the requirements for the laboratory facilities that you use?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 2 2011-04-01 2011-04-01 false What are the requirements for the laboratory facilities that you use? 111.310 Section 111.310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN...

21 CFR 111.310 - What are the requirements for the laboratory facilities that you use?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 2 2014-04-01 2014-04-01 false What are the requirements for the laboratory facilities that you use? 111.310 Section 111.310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN...

21 CFR 111.310 - What are the requirements for the laboratory facilities that you use?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false What are the requirements for the laboratory facilities that you use? 111.310 Section 111.310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN...

21 CFR 111.310 - What are the requirements for the laboratory facilities that you use?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 2 2013-04-01 2013-04-01 false What are the requirements for the laboratory facilities that you use? 111.310 Section 111.310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN...

45 CFR 1309.2 - Approval of the use of Head Start funds to continue purchase of facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Approval of the use of Head Start funds to continue purchase of facilities. 1309.2 Section 1309.2 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE...

45 CFR 1309.2 - Approval of the use of Head Start funds to continue purchase of facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Approval of the use of Head Start funds to continue purchase of facilities. 1309.2 Section 1309.2 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE...

Insect pest management decisions in food processing facilities

USDA-ARS?s Scientific Manuscript database

Pest management decision making in food processing facilities such as flour mills, rice mills, human and pet food manufacturing facilities, distribution centers and warehouses, and retail stores is a challenging undertaking. Insect pest management programs require an understanding of the food facili...

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...

Scale Development: Perceived Barriers to Public Use of School Recreational Facilities

ERIC Educational Resources Information Center

Spengler, John O.; Ko, Yong Jae; Connaughton, Daniel P.

2012-01-01

Objectives: To test an original scale assessing perceived barriers among school administrators to allowing community use of school recreational facilities outside of regular school hours. Methods: Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Results: Using EFA and CFA, we found that a model including factors of…

How to do human-subjects research if you do not have an institutional review board.

PubMed

Rice, Todd W

2008-10-01

Biomedical research with human subjects has expanded outside of traditional medical centers and hospitals into other health care entities, such as rehabilitation facilities, free-standing out-patient treatment centers, and even home-health agencies. Regardless of the location, federal regulations mandate that all human-subjects research must be overseen by an institutional review board (IRB) or ethics committee to ensure the research abide by the Code of Federal Regulations. Consequently, all human-subjects research must be reviewed and approved by an IRB prior to initiation of any research procedures. Unfortunately, many of these nontraditional research facilities do not have easy access to an IRB. This does not render such research exempt from federal oversight. Clinicians at these facilities have viable options for obtaining IRB approval and legally conducting such research. This paper outlines the available options and their pros and cons.

Patient and Facility Variation in Costs of VHA Heart Failure Patients

PubMed Central

Yoon, Jean; Fonarow, Gregg C.; Groeneveld, Peter W.; Teerlink, John; Whooley, Mary A.; Sahay, Anju; Heidenreich, Paul

2017-01-01

Objectives To determine the variation in annual health care costs among heart failure patients in the VA system. Background Heart failure is associated with considerable use of health care resources, but little is known about patterns in patient characteristics related to higher costs. Methods We obtained VA utilization and cost records for all patients with a diagnosis of heart failure in fiscal year 2010. We compared total VA costs by patient demographic factors, comorbid conditions, and facility where they were treated in bivariate analyses. We regressed total costs on patient factors alone; VA facility alone; and all factors combined to determine the relative contribution of patient factors and facility to explaining cost differences. Results There were 117,870 patients with heart failure, and their mean annual VA costs were $30,719 (SD=49,180) with more than half of their costs due to inpatient care. Patients at younger ages, of Hispanic or black race/ethnicity, diagnosed with comorbid drug use disorders, or who died during the year had the highest costs (all P<0.01). There was variation in costs by facility as mean adjusted costs ranged from approximately $15,000 to $48,000. In adjusted analyses patient factors alone explained more of the variation in health care costs (R2=0.116) compared to the facility where the patient was treated (R2=0.018). Conclusion A large variation in costs of heart failure patients was observed across facilities although this was explained largely by patient factors. Improving the efficiency of VA resource utilization may require increased scrutiny of high-cost patients to determine if adequate value is being delivered to those patients. PMID:26970829

Does size matter in aged care facilities? A literature review of the relationship between the number of facility beds and quality.

PubMed

Baldwin, Richard; Chenoweth, Lynnette; Dela Rama, Marie; Wang, Alex Y

Theory suggests that structural factors such as aged care facility size (bed numbers) will influence service quality. There have been no recent published studies in support of this theory, and consequently, the available literature has not been useful in assisting decision makers with investment decisions on facility size. The study aimed to address that deficit by reviewing the international literature on the relationships between the size of residential aged care facilities, measured by number of beds, and service quality. A systematic review identified 30 studies that reported a relationship between facility size and quality and provided sufficient details to enable comparison. There are three groups of studies based on measurement of quality-those measuring only resident outcomes, those measuring care and resident outcomes using composite tools, and those focused on regulatory compliance. The overall findings support the posited theory to a large extent, that size is a factor in quality and smaller facilities yield the most favorable results. Studies using multiple indicators of service quality produced more consistent results in favor of smaller facilities, as did most studies of regulatory compliance. The theory that aged care facility size (bed numbers) will influence service quality was supported by 26 of the 30 studies reviewed. The review findings indicate that aged care facility size (number of beds) may be one important factor related to service quality. Smaller facilities are more likely to result in higher quality and better outcomes for residents than larger facilities. This has implications for those who make investment decisions concerning aged care facilities. The findings also raise implications for funders and policy makers to ensure that regulations and policies do not encourage the building of facilities inconsistent with these findings.

Analysis of Factors Affecting Women of Childbearing Age to Screen Using Visual Inspection with Acetic Acid.

PubMed

Sidabutar, Sondang; Martini, Santi; Wahyuni, Chatarina Umbul

2017-02-01

The purpose of this study was to evaluate patient factors such as knowledge, attitude, motivation, perception, socio-economic status and travel time to health facilities and assess how these factors affected patients' decision to pursue cervical cancer screening with visual inspection with acetic acid (VIA). A total of 80 women of childbearing age who visited Kenjeran and Balongsari Public Health Centers for health assessments were involved in this study. Patients who agreed to participate in the study underwent a verbal questionnaire to evaluate various factors. Bivariate analysis concluded that knowledge, attitude, motivation, perception, socioeconomic status, and travel time to health facilities were significantly different between women who received VIA screening and women who did not receive VIA screening ( p < 0.05). The factors of knowledge, attitudes, motivation, perception, socio-economic status, and the travel time to health facilities accounted for 2.920-fold, 2.043-fold, 3.704-fold, 2.965-fold, 3.198-fold and 2.386-fold possibility, respectively, of patients to pursue cervical cancer screening with VIA. Multivariate analysis showed that perception, socio-economic status, and travel time to health facilities were the most important factors influencing whether or not women pursued VIA screening. Knowledge, attitude, motivation, perception, socio-economic status, and travel time to health facilities appears to affect women's' decision to pursue cervical cancer screening with VIA, with the largest intake being the motivational factor.

The drivers of facility-based immunization performance and costs. An application to Moldova.

PubMed

Maceira, Daniel; Goguadze, Ketevan; Gotsadze, George

2015-05-07

This paper identifies factors that affect the cost and performance of the routine immunization program in Moldova through an analysis of facility-based data collected as part of a multi-country costing and financing study of routine immunization (EPIC). A nationally representative sample of health care facilities (50) was selected through multi-stage, stratified random sampling. Data on inputs, unit prices and facility outputs were collected during October 3rd 2012-January 14th 2013 using a pre-tested structured questionnaire. Ordinary least square (OLS) regression analysis was performed to determine factors affecting facility outputs (number of doses administered and fully immunized children) and explaining variation in total facility costs. The study found that the number of working hours, vaccine wastage rates, and whether or not a doctor worked at a facility (among other factors) were positively and significantly associated with output levels. In addition, the level of output, price of inputs and share of the population with university education were significantly associated with higher facility costs. A 1% increase in fully immunized child would increase total cost by 0.7%. Few costing studies of primary health care services in developing countries evaluate the drivers of performance and cost. This exercise attempted to fill this knowledge gap and helped to identify organizational and managerial factors at a primary care district and national level that could be addressed by improved program management aimed at improved performance. Copyright © 2015 Elsevier Ltd. All rights reserved.

Addressing Challenges to the Design & Test of Operational Lighting Environments for the International Space Station

NASA Technical Reports Server (NTRS)

Clark, Toni A.

2014-01-01

In our day to day lives, the availability of light, with which to see our environment, is often taken for granted. The designers of land based lighting systems use sunlight and artificial light as their toolset. The availability of power, quantity of light sources, and variety of design options are often unlimited. The accessibility of most land based lighting systems makes it easy for the architect and engineer to verify and validate their design ideas. Failures with an implementation, while sometimes costly, can easily be addressed by renovation. Consider now, an architectural facility orbiting in space, 260 miles above the surface of the earth. This human rated architectural facility, the International Space Station (ISS) must maintain operations every day, including life support and appropriate human comforts without fail. The facility must also handle logistics of regular shipments of cargo, including new passengers. The ISS requires accommodations necessary for human control of machine systems. Additionally, the ISS is a research facility and supports investigations performed inside and outside its livable volume. Finally, the facility must support remote operations and observations by ground controllers. All of these architectural needs require a functional, safe, and even an aesthetic lighting environment. At Johnson Space Center, our Habitability and Human Factors team assists our diverse customers with their lighting environment challenges, via physical test and computer based analysis. Because of the complexity of ISS operational environment, our team has learned and developed processes that help ISS operate safely. Because of the dynamic exterior lighting environment, uses computational modeling to predict the lighting environment. The ISS' orbit exposes it to a sunrise every 90 minutes, causing work surfaces to quickly change from direct sunlight to earthshine to total darkness. Proper planning of vehicle approaches, robotics operations, and crewed Extra Vehicular Activities are mandatory to ensure safety to the crew and all others involved. Innovation in testing techniques is important as well. The advent of Solid State Lighting technology and the lack of stable national and international standards for its implementation pose new challenges on how to design, test and verify individual light fixtures and the environment that uses them. The ISS will soon be replacing its internal fluorescent lighting system to a solid state LED system. The Solid State Lighting Assembly will be used not only for general lighting, but also as a medical countermeasure to control the circadian rhythm of the crew. The new light source has performance criteria very specific to its spectral fingerprint, creating new challenges that were originally not as significant during the original design of the ISS. This presentation will showcase findings and toolsets our team is using to assist in the planning of tasks, and design of operational lighting environments on the International Space Station.

Cardiovascular research in space - Considerations for the design of the human research facility of the United States Space Station

NASA Technical Reports Server (NTRS)

Charles, J. B.; Bungo, M. W.

1986-01-01

The design of the Space Station's Human Research Facility for the collection of information on the long-time physiological adjustments of humans to space is described. The Space Life Sciences-1 mission will carry a rack-mounted echocardiograph for cardiac imaging, a mass spectrometer for cardiac output and respiratory function assessments at rest and during exercise, and a device to stimulate the carotid sinus baroreceptors and measure the resulting changes in heart rate.

Reconstitution of the human biome as the most reasonable solution for epidemics of allergic and autoimmune diseases.

PubMed

Bilbo, Staci D; Wray, Gregory A; Perkins, Sarah E; Parker, William

2011-10-01

A wide range of hyperimmune-associated diseases plague post-industrial society, with a prevalence and impact that is staggering. Strong evidence points towards a loss of helminths from the ecosystem of the human body (the human biome) as the most important factor in this epidemic. Helminths, intestinal worms which are largely eradicated by elements of post-industrial culture including toilets and water treatment facilities, have an otherwise ubiquitous presence in vertebrates, and have co-evolved with the immune system. Not only do helminths discourage allergic and autoimmune reactions by diverting the immune system away from these pathologic processes and stimulating host regulatory networks, helminths release a variety of factors which down-modulate the immune system. A comprehensive view of hyperimmune-related disease based on studies in immunology, parasitology, evolutionary biology, epidemiology, and neurobiology indicates that the effects of biome depletion may not yet be fully realized, and may have an unexpectedly broad impact on many areas of human biology, including cognition. Fortunately, colonization with helminths results in a cure of numerous autoimmune and allergic diseases in laboratory rodents, and clinical studies in humans have indicated their utility for treatment of both multiple sclerosis and inflammatory bowel disease. Based on these considerations, commitment of considerable resources toward understanding the effects of "biome depletion" and systematically evaluating the most effective approach toward biome reconstitution is strongly encouraged. Copyright © 2011 Elsevier Ltd. All rights reserved.

Development of a Rotating Human Research Facility

NASA Technical Reports Server (NTRS)

Mulenburg, Gerald M.; Caldwell, William F.; Tucker, John; Wade, Charles E. (Technical Monitor)

1994-01-01

A unique facility has been developed at the NASA Ames Research Center to provide scientists with unusual research opportunities at greater than Earth's gravity. In addition to its use for basic research, this facility will help provide answers to many of the questions posed by proponents of rotating human space vehicles. This paper describes the design and planned use of this facility, the Spaceflight Environmental Simulator. Using an existing 52-foot diameter cylindrical rotating platform design centrifuge, the revised facility design includes the provision of two human habitats for long duration studies of the effects of hypergravity. Up to four humans (per habitat) will be able to live at up to 2 G for as long as one month without stopping the centrifuge. Each habitat, constructed of lightweight honeycomb sandwich panels, is nominally 9 ft high x 11 ft wide x 25 1/2 ft long. A radial positioning system provides for positioning each habitat at a distance of 15 to 21 feet from the centrifuge's axis of rotation to the midpoint of the habitat's interior floor. As centrifugal acceleration changes with rotation rate, a habitat floor-mounted accelerometer signal provides automatic servo controlled adjustment of each habitat's angle of inclination to provide an environment for the habitat's crew and cargo in which the resultant gravity vector is normal to the habitat floor at all times. Design of the habitats and modifications to the centrifuge are complete, and are currently under construction. Design philosophy and operational rationale are presented along with complete descriptions of the facility and its systems.

77 FR 60125 - Generic Drug Facilities, Sites and Organizations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-02

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-1006] Generic Drug Facilities, Sites and Organizations AGENCY: Food and Drug Administration, HHS. ACTION: Notice of Requirement. SUMMARY: The Food and Drug Administration (FDA) is notifying generic drug facilities...

Removal site evaluation report for the Isotope Facilities at Oak Ridge National Laboratory, Oak Ridge, Tennessee

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

NONE

This removal site evaluation (RmSE) report of the Isotope Facilities at Oak Ridge National Laboratory (ORNL) was prepared to provide the Environmental Restoration Program with information necessary to evaluate whether hazardous and/or radiological contaminants in and around the Isotopes Facility pose a substantial risk to human health or the environment and if remedial site evaluations (RSEs) or removal actions are required. The scope of the project included: (1) a review of historical evidence regarding operations and use of the facility; (2) interviews with facility personnel concerning current and past operating practices; (3) a site inspection; and (4) identification of hazardmore » areas requiring maintenance, removal, or remedial actions. The results of RmSE indicate that no substantial risks exist from contaminants present in the Isotope Facilities because adequate controls and practices exist to protect human health and the environment. The recommended correction from the RmSE are being conducted as maintenance actions; accordingly, this RmSE is considered complete and terminated.« less

Factors Associated With Care Workers' Intention to Leave Employment in Nursing Homes: A Secondary Data Analysis of the Swiss Nursing Homes Human Resources Project.

PubMed

Gaudenz, Clergia; De Geest, Sabina; Schwendimann, René; Zúñiga, Franziska

2017-07-01

The emerging care personnel shortage in Swiss nursing homes is aggravated by high turnover rates. As intention to leave is a predictor of turnover, awareness of its associated factors is essential. This study applied a secondary data analysis to evaluate the prevalence and variability of 3,984 nursing home care workers' intention to leave. Work environment factors and care worker outcomes were tested via multiple regression analysis. Although 56% of care workers reported intention to leave, prevalences varied widely between facilities. Overall, intention to leave showed strong inverse relationships with supportive leadership and affective organizational commitment and weaker positive relationships with stress due to workload, emotional exhaustion, and care worker health problems. The strong direct relationship of nursing home care workers' intention to leave with affective organizational commitment and perceptions of leadership quality suggest that multilevel interventions to improve these factors might reduce intention to leave.

Berkeley Lab - Materials Sciences Division

Science.gov Websites

; Finance Templates Travel One-Stop Acknowledging MSD Support Human Resources Facilities & Space Planning Procurement and Property Proposals & Finance Templates Travel Facilities & Space Planning

Tailoring a Human Reliability Analysis to Your Industry Needs

NASA Technical Reports Server (NTRS)

DeMott, D. L.

2016-01-01

Companies at risk of accidents caused by human error that result in catastrophic consequences include: airline industry mishaps, medical malpractice, medication mistakes, aerospace failures, major oil spills, transportation mishaps, power production failures and manufacturing facility incidents. Human Reliability Assessment (HRA) is used to analyze the inherent risk of human behavior or actions introducing errors into the operation of a system or process. These assessments can be used to identify where errors are most likely to arise and the potential risks involved if they do occur. Using the basic concepts of HRA, an evolving group of methodologies are used to meet various industry needs. Determining which methodology or combination of techniques will provide a quality human reliability assessment is a key element to developing effective strategies for understanding and dealing with risks caused by human errors. There are a number of concerns and difficulties in "tailoring" a Human Reliability Assessment (HRA) for different industries. Although a variety of HRA methodologies are available to analyze human error events, determining the most appropriate tools to provide the most useful results can depend on industry specific cultures and requirements. Methodology selection may be based on a variety of factors that include: 1) how people act and react in different industries, 2) expectations based on industry standards, 3) factors that influence how the human errors could occur such as tasks, tools, environment, workplace, support, training and procedure, 4) type and availability of data, 5) how the industry views risk & reliability, and 6) types of emergencies, contingencies and routine tasks. Other considerations for methodology selection should be based on what information is needed from the assessment. If the principal concern is determination of the primary risk factors contributing to the potential human error, a more detailed analysis method may be employed versus a requirement to provide a numerical value as part of a probabilistic risk assessment. Industries involved with humans operating large equipment or transport systems (ex. railroads or airlines) would have more need to address the man machine interface than medical workers administering medications. Human error occurs in every industry; in most cases the consequences are relatively benign and occasionally beneficial. In cases where the results can have disastrous consequences, the use of Human Reliability techniques to identify and classify the risk of human errors allows a company more opportunities to mitigate or eliminate these types of risks and prevent costly tragedies.

Association between health worker motivation and healthcare quality efforts in Ghana

PubMed Central

2013-01-01

Background Ghana is one of the sub-Saharan African countries making significant progress towards universal access to quality healthcare. However, it remains a challenge to attain the 2015 targets for the health related Millennium Development Goals (MDGs) partly due to health sector human resource challenges including low staff motivation. Purpose This paper addresses indicators of health worker motivation and assesses associations with quality care and patient safety in Ghana. The aim is to identify interventions at the health worker level that contribute to quality improvement in healthcare facilities. Methods The study is a baseline survey of health workers (n = 324) in 64 primary healthcare facilities in two regions in Ghana. Data collection involved quality care assessment using the SafeCare Essentials tool, the National Health Insurance Authority (NHIA) accreditation data and structured staff interviews on workplace motivating factors. The Spearman correlation test was conducted to test the hypothesis that the level of health worker motivation is associated with level of effort by primary healthcare facilities to improve quality care and patient safety. Results The quality care situation in health facilities was generally low, as determined by the SafeCare Essentials tool and NHIA data. The majority of facilities assessed did not have documented evidence of processes for continuous quality improvement and patient safety. Overall, staff motivation appeared low although workers in private facilities perceived better working conditions than workers in public facilities (P <0.05). Significant positive associations were found between staff satisfaction levels with working conditions and the clinic’s effort towards quality improvement and patient safety (P <0.05). Conclusion As part of efforts towards attainment of the health related MDGs in Ghana, more comprehensive staff motivation interventions should be integrated into quality improvement strategies especially in government-owned healthcare facilities where working conditions are perceived to be the worst. PMID:23945073

Executive Order 12898 and Social, Economic, and Sociopolitical Factors Influencing Toxic Release Inventory Facility Location in EPA Region 6: A Multi-Scale Spatial Assessment of Environmental Justice

ERIC Educational Resources Information Center

Moore, Andrea Lisa

2013-01-01

Toxic Release Inventory facilities are among the many environmental hazards shown to create environmental inequities in the United States. This project examined four factors associated with Toxic Release Inventory, specifically, manufacturing facility location at multiple spatial scales using spatial analysis techniques (i.e., O-ring statistic and…

Information Technology and the Human Research Facility

NASA Technical Reports Server (NTRS)

Klee, Margaret

2002-01-01

This slide presentation reviews how information technology supports the Human Research Facility (HRF) and specifically the uses that contractor has for the information. There is information about the contractor, the HRF, some of the experiments that were performed using the HRF on board the Shuttle, overviews of the data architecture, and software both commercial and specially developed software for the specific experiments.

Antarctica as a testing ground for manned missions to the Moon and Mars

NASA Astrophysics Data System (ADS)

Demidov, N. E.; Lukin, V. V.

2017-03-01

This paper is concerned with the study of expedition activity in Antarctica as a part of the search for useful analogies and solutions which can be taken into account in planning manned missions to the Moon and Mars. The following is considered: natural analogies, human factors, station facilities, means of transportation, scientific programs, safety issues, and historical and political analogies. A rationalization is given for the idea of creating a testing ground in Antarctica (stations Vostok, Novolazarevskaya, Jetty Oasis) for ground-based simulation of functioning of a lunar and Martian base.

78 FR 22553 - Generic Drug Facilities, Sites, and Organizations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0391] Generic Drug Facilities, Sites, and Organizations AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing that the generic drug facility self...

16 CFR 453.2 - Price disclosures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... specific funeral goods and funeral services used in connection with the disposition of deceased human bodies, including at least the price of embalming, transportation of remains, use of facilities, caskets... the body; (H) Use of facilities and staff for viewing; (I) Use of facilities and staff for funeral...

16 CFR 453.2 - Price disclosures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... specific funeral goods and funeral services used in connection with the disposition of deceased human bodies, including at least the price of embalming, transportation of remains, use of facilities, caskets... the body; (H) Use of facilities and staff for viewing; (I) Use of facilities and staff for funeral...

16 CFR 453.2 - Price disclosures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... specific funeral goods and funeral services used in connection with the disposition of deceased human bodies, including at least the price of embalming, transportation of remains, use of facilities, caskets... the body; (H) Use of facilities and staff for viewing; (I) Use of facilities and staff for funeral...

24 CFR 232.615 - Eligible borrowers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... intermediate care facility for which the Secretary of Health and Human Services has determined that the... intermediate care facility will meet not only the applicable fire safety requirements of HHS but will meet... application, a nursing home or intermediate care facility need not be providing such services if upon...

16 CFR 453.2 - Price disclosures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... specific funeral goods and funeral services used in connection with the disposition of deceased human bodies, including at least the price of embalming, transportation of remains, use of facilities, caskets... the body; (H) Use of facilities and staff for viewing; (I) Use of facilities and staff for funeral...

16 CFR 453.2 - Price disclosures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... specific funeral goods and funeral services used in connection with the disposition of deceased human bodies, including at least the price of embalming, transportation of remains, use of facilities, caskets... the body; (H) Use of facilities and staff for viewing; (I) Use of facilities and staff for funeral...

21 CFR 110.37 - Sanitary facilities and controls.

Code of Federal Regulations, 2013 CFR

2013-04-01

... HUMAN FOOD Buildings and Facilities § 110.37 Sanitary facilities and controls. Each plant shall be... water to required locations throughout the plant. (2) Properly convey sewage and liquid disposable waste from the plant. (3) Avoid constituting a source of contamination to food, water supplies, equipment, or...

21 CFR 110.37 - Sanitary facilities and controls.

Code of Federal Regulations, 2014 CFR

2014-04-01

... HUMAN FOOD Buildings and Facilities § 110.37 Sanitary facilities and controls. Each plant shall be... water to required locations throughout the plant. (2) Properly convey sewage and liquid disposable waste from the plant. (3) Avoid constituting a source of contamination to food, water supplies, equipment, or...

21 CFR 110.37 - Sanitary facilities and controls.

Code of Federal Regulations, 2012 CFR

2012-04-01

... HUMAN FOOD Buildings and Facilities § 110.37 Sanitary facilities and controls. Each plant shall be... water to required locations throughout the plant. (2) Properly convey sewage and liquid disposable waste from the plant. (3) Avoid constituting a source of contamination to food, water supplies, equipment, or...

Perceptions of newly admitted undergraduate medical students on experiential training on community placements and working in rural areas of Uganda.

PubMed

Kaye, Dan K; Mwanika, Andrew; Sekimpi, Patrick; Tugumisirize, Joshua; Sewankambo, Nelson

2010-06-23

Uganda has an acute problem of inadequate human resources partly due to health professionals' unwillingness to work in a rural environment. One strategy to address this problem is to arrange health professional training in rural environments through community placements. Makerere University College of Health Sciences changed training of medical students from the traditional curriculum to a problem-based learning (PBL) curriculum in 2003. This curriculum is based on the SPICES model (student-centered, problem-based, integrated, community-based and services oriented). During their first academic year, students undergo orientation on key areas of community-based education, after which they are sent in interdisciplinary teams for community placements. The objective was to assess first year students' perceptions on experiential training through community placements and factors that might influence their willingness to work in rural health facilities after completion of their training. The survey was conducted among 107 newly admitted first year students on the medical, nursing, pharmacy and medical radiography program students, using in-depth interview and open-ended self-administered questionnaires on their first day at the college, from October 28-30, 2008. Data was collected on socio-demographic characteristics, motivation for choosing a medical career, prior exposure to rural health facilities, willingness to have part of their training in rural areas and factors that would influence the decision to work in rural areas. Over 75% completed their high school from urban areas. The majority had minimal exposure to rural health facilities, yet this is where most of them will eventually have to work. Over 75% of the newly admitted students were willing to have their training from a rural area. Perceived factors that might influence retention in rural areas include the local context of work environment, support from family and friends, availability of continuing professional training for career development and support of co-workers and the community. Many first year students at Makerere University have limited exposure to health facilities in rural areas and have concerns about eventually working there.

Space technology test facilities at the NASA Ames Research Center

NASA Technical Reports Server (NTRS)

Gross, Anthony R.; Rodrigues, Annette T.

1990-01-01

The major space research and technology test facilities at the NASA Ames Research Center are divided into five categories: General Purpose, Life Support, Computer-Based Simulation, High Energy, and the Space Exploraton Test Facilities. The paper discusses selected facilities within each of the five categories and discusses some of the major programs in which these facilities have been involved. Special attention is given to the 20-G Man-Rated Centrifuge, the Human Research Facility, the Plant Crop Growth Facility, the Numerical Aerodynamic Simulation Facility, the Arc-Jet Complex and Hypersonic Test Facility, the Infrared Detector and Cryogenic Test Facility, and the Mars Wind Tunnel. Each facility is described along with its objectives, test parameter ranges, and major current programs and applications.

The UK Human Genome Mapping Project online computing service.

PubMed

Rysavy, F R; Bishop, M J; Gibbs, G P; Williams, G W

1992-04-01

This paper presents an overview of computing and networking facilities developed by the Medical Research Council to provide online computing support to the Human Genome Mapping Project (HGMP) in the UK. The facility is connected to a number of other computing facilities in various centres of genetics and molecular biology research excellence, either directly via high-speed links or through national and international wide-area networks. The paper describes the design and implementation of the current system, a 'client/server' network of Sun, IBM, DEC and Apple servers, gateways and workstations. A short outline of online computing services currently delivered by this system to the UK human genetics research community is also provided. More information about the services and their availability could be obtained by a direct approach to the UK HGMP-RC.

Habitability as a Tier One Criterion in Exploration Mission and Vehicle Design. Part 1; Habitability

NASA Technical Reports Server (NTRS)

Adams, Constance M.; McCurdy, Matthew Riegel

1999-01-01

Habitability and human factors are necessary criteria to include in the iterative process of Tier I mission design. Bringing these criteria in at the first, conceptual stage of design for exploration and other human-rated missions can greatly reduce mission development costs, raise the level of efficiency and viability, and improve the chances of success. In offering a rationale for this argument, the authors give an example of how the habitability expert can contribute to early mission and vehicle architecture by defining the formal implications of a habitable vehicle, assessing the viability of units already proposed for exploration missions on the basis of these criteria, and finally, by offering an optimal set of solutions for an example mission. In this, the first of three papers, we summarize the basic factors associated with habitability, delineate their formal implications for crew accommodations in a long-duration environment, and show examples of how these principles have been applied in two projects at NASA's Johnson Space Center: the BIO-Plex test facility, and TransHab.

Factors Affecting Discharge to Home of Geriatric Intermediate Care Facility Residents in Japan.

PubMed

Morita, Kojiro; Ono, Sachiko; Ishimaru, Miho; Matsui, Hiroki; Naruse, Takashi; Yasunaga, Hideo

2018-04-01

To investigate factors associated with lower likelihood of discharge to home from geriatric intermediate care facilities in Japan. Retrospective cohort study. We used data from the nationwide long-term care (LTC) insurance claims database (April 2012-March 2014). Study participants were 342,758 individuals newly admitted to 3,459 geriatric intermediate care facilities during the study period. The primary outcome was discharge to home. We performed a multivariable competing-risk Cox regression with adjustment for resident-, facility-, and region-level characteristics. Resident level of care needs and several medical conditions were included as time-varying covariates. Death, admission to a hospital, and admission to another LTC facility were treated as competing risks. During the 2-year follow-up period, 19% of participants were discharged to home. In the multivariable competing-risk Cox regression, the following factors were significantly associated with lower likelihood of discharge to home: older age, higher level of care need, having several medical conditions, private ownership of the facility, more beds in the facility, and more LTC facility beds per 1,000 adults aged 65 and older in the region. Only 19% of residents were discharged to home. Our results are useful for policy-makers to promote discharge to home of older adults in geriatric intermediate care facilities. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

The search and selection of assisted living facilities by elders and family.

PubMed

Castle, Nicholas G; Sonon, Kristen E

2007-08-01

In this study, we examine factors associated with the search, selection, and satisfaction of residents and family members in assisted living. Data were collected from 375 residents of 25 assisted living facilities matched with 375 family members. We conducted face-to-face interviews with the residents to determine: (1) the principal decision maker; (2) the process of searching for a facility; (3) the factors crucial to facility selection; (4) the time frame from the relocation decision to relocation; and (5) satisfaction with selection. Similar questions were asked of family members, using a mail survey. Residents described themselves as extremely influential in 39% of cases when searching for a facility, and in 27% of cases when selecting a facility. Quality, cost, and location were the most influential factors for both residents and family members in selecting a facility. Almost all residents and family would use different search and selection processes if they had to select a facility again, and almost all were dissatisfied with the sources of information available. Consumers and policy makers both favor the use of assisted living settings; but, the information available to choose a setting is far from ideal, and may represent a barrier to both consumer and policy makers' agendas.

Dialysis facility and patient characteristics associated with utilization of home dialysis.

PubMed

Walker, David R; Inglese, Gary W; Sloand, James A; Just, Paul M

2010-09-01

Nonmedical factors influencing utilization of home dialysis at the facility level are poorly quantified. Home dialysis is comparably effective and safe but less expensive to society and Medicare than in-center hemodialysis. Elimination of modifiable practice variation unrelated to medical factors could contribute to improvements in patient outcomes and use of scarce resources. Prevalent dialysis patient data by facility were collected from the 2007 ESRD Network's annual reports. Facility characteristic data were collected from Medicare's Dialysis Facility Compare file. A multivariate regression model was used to evaluate associations between the use of home dialysis and facility characteristics. The utilization of home dialysis was positively associated with facility size, percent patients employed full- or part-time, younger population, and years a facility was Medicare certified. Variables negatively associated include an increased number of hemodialysis patients per hemodialysis station, chain association, rural location, more densely populated zip code, a late dialysis work shift, and greater percent of black patients within a zip code. Improved understanding of factors affecting the frequency of use of home dialysis may help explain practice variations across the United States that result in an imbalanced use of medical resources within the ESRD population. In turn, this may improve the delivery of healthcare and extend the ability of an increasingly overburdened medical financing system to survive.

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.

Household trends in access to improved water sources and sanitation facilities in Vietnam and associated factors: findings from the Multiple Indicator Cluster Surveys, 2000-2011.

PubMed

Tuyet-Hanh, Tran Thi; Lee, Jong-Koo; Oh, Juhwan; Van Minh, Hoang; Ou Lee, Chul; Hoan, Le Thi; Nam, You-Seon; Long, Tran Khanh

2016-01-01

Despite progress made by the Millennium Development Goal (MDG) number 7.C, Vietnam still faces challenges with regard to the provision of access to safe drinking water and basic sanitation. This paper describes household trends in access to improved water sources and sanitation facilities separately, and analyses factors associated with access to improved water sources and sanitation facilities in combination. Secondary data from the Vietnam Multiple Indicator Cluster Survey in 2000, 2006, and 2011 were analyzed. Descriptive statistics and tests of significance describe trends over time in access to water and sanitation by location, demographic and socio-economic factors. Binary logistic regressions (2000, 2006, and 2011) describe associations between access to water and sanitation, and geographic, demographic, and socio-economic factors. There have been some outstanding developments in access to improved water sources and sanitation facilities from 2000 to 2011. In 2011, the proportion of households with access to improved water sources and sanitation facilities reached 90% and 77%, respectively, meeting the 2015 MDG targets for safe drinking water and basic sanitation set at 88% and 75%, respectively. However, despite these achievements, in 2011, only 74% of households overall had access to combined improved drinking water and sanitation facilities. There were also stark differences between regions. In 2011, only 47% of households had access to both improved water and sanitation facilities in the Mekong River Delta compared with 94% in the Red River Delta. In 2011, households in urban compared to rural areas were more than twice as likely (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.9-2.5) to have access to improved water and sanitation facilities in combination, and households in the highest compared with the lowest wealth quintile were over 40 times more likely (OR: 42.3; 95% CI: 29.8-60.0). More efforts are required to increase household access to both improved water and sanitation facilities in the Mekong River Delta, South East and Central Highlands regions of Vietnam. There is also a need to address socio-economic factors associated with inadequate access to improved sanitation facilities.

Design philosophy of the Jet Propulsion Laboratory infrared detector test facility

NASA Technical Reports Server (NTRS)

Burns, R.; Blessinger, M. A.

1983-01-01

To support the development of advanced infrared remote sensing instrumentation using line and area arrays, a test facility has been developed to characterize the detectors. The necessary performance characteristics of the facility were defined by considering current and projected requirements for detector testing. The completed facility provides the desired level of detector testing capability as well as providing ease of human interaction.

Facility and market factors affecting transitions from nursing home to community.

PubMed

Arling, Greg; Abrahamson, Kathleen A; Cooke, Valerie; Kane, Robert L; Lewis, Teresa

2011-09-01

Research into nursing home transitions has given limited attention to the facility or community contexts. To identify facility and market factors affecting transitions of nursing home residents back to the community. Multilevel models were used to estimate effects of facility and market factors on facility-level community discharge rates after controlling for resident demographic, health, and functional conditions. Facility discharge rates were adjusted using Empirical Bayes estimation. Annual cohort of first-time admissions (N=24,648) to 378 Minnesota nursing facilities in 75 nursing home markets from July 2005 to June 2006. Community discharge within 90 days of admission; facility occupancy, payer mix, ownership, case-mix acuity, size, admissions from hospitals, nurse staffing level, and proportion of admissions preferring or having support to return to the community; and nursing market population size, average occupancy, market concentration, and availability of home and community-based services. Rates of community discharge (Empirical Bayes residual) were highest in facilities with more residents preferring community discharge, more Medicare days, higher nurse staffing levels, and higher occupancy. In addition, facilities had higher community discharge rates if they were located in markets with a greater ratio of home and community-based services recipients to nursing home residents and with larger populations. State Medicaid programs should undertake system-level interventions that encourage nursing facilities to reduce unused bed capacity, balance the mix of payers, invest in nurse staffing, and take other steps to promote community discharges. In addition, states should increase home and community-based services, particularly in markets with low community discharge rates.

21 CFR 1250.45 - Food handling facilities on railroad conveyances.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Food handling facilities on railroad conveyances. 1250.45 Section 1250.45 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... facilities on railroad conveyances. (a) Both kitchens and pantries of cars hereafter constructed or...

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...

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...

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...

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...

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...

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...

42 CFR 476.76 - Cooperation with health care facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

77 FR 57094 - Draft Guidance for Industry on Self-Identification of Generic Drug Facilities, Sites, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-D-0881] Draft Guidance for Industry on Self-Identification of Generic Drug Facilities, Sites, and Organizations... ``Self-Identification of Generic Drug Facilities, Sites, and Organizations.'' The document was published...

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...

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

Memo to: Ambulatory Health Care Planners.

ERIC Educational Resources Information Center

Educational Facilities Labs., Inc., New York, NY.

Planning for changing types of health professions and a changing clientele necessitates designing flexible facilities. Findings from a recently completed analysis of ambulatory care facilities are directed to planners in the form of 16 memos. Approaches to planning and design considerations are made that attempt to humanize these facilities.…

Effects of a Facility Dog on Student Learning and Learning Environment

ERIC Educational Resources Information Center

Bradley, Jordana; Maldonado, Nancy

2013-01-01

Educators must consider alternative teaching strategies. Facility dogs as an instructional enhancement are an innovative teaching approach. This case study, guided by human-animal bond theory, investigated how the presence of a trained facility dog, Smooch, affected the school environment. Interviews, field notes and observations were used to…

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

NASA Technical Reports Server (NTRS)

Synnestvedt, Robert (Editor)

1990-01-01

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

9 CFR 3.50 - Facilities, general.

Code of Federal Regulations, 2011 CFR

2011-01-01

... WELFARE STANDARDS Specifications for the Humane Handling, Care, Treatment and Transportation of Rabbits... housing facilities for rabbits shall be structurally sound and shall be maintained in good repair, to...

Development and implementation of a human accuracy program in patient foodservice.

PubMed

Eden, S H; Wood, S M; Ptak, K M

1987-04-01

For many years, industry has utilized the concept of human error rates to monitor and minimize human errors in the production process. A consistent quality-controlled product increases consumer satisfaction and repeat purchase of product. Administrative dietitians have applied the concepts of using human error rates (the number of errors divided by the number of opportunities for error) at four hospitals, with a total bed capacity of 788, within a tertiary-care medical center. Human error rate was used to monitor and evaluate trayline employee performance and to evaluate layout and tasks of trayline stations, in addition to evaluating employees in patient service areas. Long-term employees initially opposed the error rate system with some hostility and resentment, while newer employees accepted the system. All employees now believe that the constant feedback given by supervisors enhances their self-esteem and productivity. Employee error rates are monitored daily and are used to counsel employees when necessary; they are also utilized during annual performance evaluation. Average daily error rates for a facility staffed by new employees decreased from 7% to an acceptable 3%. In a facility staffed by long-term employees, the error rate increased, reflecting improper error documentation. Patient satisfaction surveys reveal satisfaction, for tray accuracy increased from 88% to 92% in the facility staffed by long-term employees and has remained above the 90% standard in the facility staffed by new employees.

Elective surgical case cancellation in the Veterans Health Administration system: identifying areas for improvement.

PubMed

Argo, Joshua L; Vick, Catherine C; Graham, Laura A; Itani, Kamal M F; Bishop, Michael J; Hawn, Mary T

2009-11-01

This study evaluated elective surgical case cancellation (CC) rates, reasons for these cancellations, and identified areas for improvement within the Veterans Health Administration (VA) system. CC data for 2006 were collected from the scheduling software for 123 VA facilities. Surveys were distributed to 40 facilities (10 highest and 10 lowest CC rates for high- and low-volume facilities). CC reasons were standardized and piloted at 5 facilities. Of 329,784 cases scheduled by 9 surgical specialties, 40,988 (12.4%) were cancelled. CC reasons (9,528) were placed into 6 broad categories: patient (35%), work-up/medical condition change (28%), facility (20%), surgeon (8%), anesthesia (1%), and miscellaneous (8%). Survey results show areas for improvement at the facility level and a standardized list of 28 CC reasons was comprehensive. Interventions that decrease cancellations caused by patient factors, inadequate work-up, and facility factors are needed to reduce overall elective surgical case cancellations.

From Hospital to Nursing Facility: Factors Influencing Decisions

ERIC Educational Resources Information Center

Mason, Susan E.; Auerbach, Charles; LaPorte, Heidi Heft

2009-01-01

This study addresses the factors influencing decisions to send medicine-surgical (med-surg) patients home or to nursing facilities (NFs). The sample (n = 7,852) was taken from a large, urban, teaching, med-surg unit where discharges were documented and data collected over a two-and-a-half-year period. Using logistical regression, the factors found…

The National Shipbuilding Research Program. National Workshop (4th) on Human Resource Innovation in Shipbuilding and Ship Repair

DTIC Science & Technology

1995-11-01

SHIP PRODUCTION COMMITTEE FACILITIES AND ENVIRONMENTAL EFFECTS SURFACE PREPARATION AND COATINGS DESIGN/PRODUCTION INTEGRATION HUMAN RESOURCE...we’re all about. 2 Exhibit 1 NATIONAL SHIPBUILDING RESEARCH PROGRAM RESEARCH PANELS SP-1 Facilities and Environmental Effects SP-3 Surface... effectively compete in the international commercial shipbuilding market. On November 30,1993, President Clinton signed into law the National

Using human rights in maternal mortality programs: from analysis to strategy.

PubMed

Freedman, L P

2001-10-01

This article describes an approach to maternal mortality reduction that uses human rights not simply to denounce the injustice of death in pregnancy and childbirth, but also to guide the design and implementation of maternal mortality policies and programs. As a first principle, programs and policies need to prioritize measures that promote universal access to high quality emergency obstetric care services, which we know from health research are essential to saving women's lives. With that priority, human rights principles can be integrated into programs at the clinical, facility management, and national policy levels. For example, a human rights 'audit' can help identify ways to encourage respectful, non-discriminatory treatment of patients, providers and staff in the clinical setting. Human rights principles of entitlement and accountability can inform mechanisms of community participation designed to improve responsiveness and functioning of health facilities. Human rights principles can inform analysis of health sector reform and its impact on access to emergency obstetric care. Whether applied to the intricacies of human relationships within a facility or to the impact of international financial institutions on health systems, the ultimate role of human rights is to identify the workings of power that keep unacceptable levels of maternal morality as they are and to use the human rights vision of dignity and social justice to work for the re-arrangements of power necessary for change.

Automating CapCom: Pragmatic Operations and Technology Research for Human Exploration of Mars

NASA Technical Reports Server (NTRS)

Clancey, William J.

2003-01-01

During the Apollo program, NASA and the scientific community used terrestrial analog sites for understanding planetary features and for training astronauts to be scientists. More recently, computer scientists and human factors specialists have followed geologists and biologists into the field, learning how science is actually done on expeditions in extreme environments. Research stations have been constructed by the Mars Society in the Arctic and American southwest, providing facilities for hundreds of researchers to investigate how small crews might live and work on Mars. Combining these interests-science, operations, and technology-in Mars analog field expeditions provides tremendous synergy and authenticity to speculations about Mars missions. By relating historical analyses of Apollo and field science, engineers are creating experimental prototypes that provide significant new capabilities, such as a computer system that automates some of the functions of Apollo s CapCom. Thus, analog studies have created a community of practice-a new collaboration between scientists and engineers-so that technology begins with real human needs and works incrementally towards the challenges of the human exploration of Mars.

Evolution of community- and healthcare-associated methicillin-resistant Staphylococcus aureus☆

PubMed Central

Uhlemann, Anne-Catrin; Otto, Michael; Lowy, Franklin D.; DeLeo, Frank R.

2013-01-01

Staphylococcus aureus is a prominent cause of human infections globally. The high prevalence of infections is compounded by antibiotic resistance—a significant problem for treatment. Methicillin-resistant S. aureus (MRSA) is endemic in hospitals and healthcare facilities worldwide, and is an increasingly common cause of community-associated bacterial infections in industrialized countries. Although much focus is placed on the role of S. aureus as a human pathogen, it is in fact a human commensal organism that has had a relatively long coexistence with the human host. Many S. aureus infections can be explained by host susceptibility or other predisposing risk factors. On the other hand, the emergence/re-emergence of successful S. aureus clones (referred to as epidemic waves) suggests a rapid bacterial adaption and evolution, which includes the emergence of antibiotic resistance and increased virulence and/or transmissibility. It is within this context that we review our understanding of selected S. aureus epidemic waves, and highlight the use of genome sequencing as a means to better understand the evolution of each lineage. PMID:23648426

Plutonium

NASA Astrophysics Data System (ADS)

Clark, David L.; Hecker, Siegfried S.; Jarvinen, Gordon D.; Neu, Mary P.

The element plutonium occupies a unique place in the history of chemistry, physics, technology, and international relations. After the initial discovery based on submicrogram amounts, it is now generated by transmutation of uranium in nuclear reactors on a large scale, and has been separated in ton quantities in large industrial facilities. The intense interest in plutonium resulted fromthe dual-use scenario of domestic power production and nuclear weapons - drawing energy from an atomic nucleus that can produce a factor of millions in energy output relative to chemical energy sources. Indeed, within 5 years of its original synthesis, the primary use of plutonium was for the release of nuclear energy in weapons of unprecedented power, and it seemed that the new element might lead the human race to the brink of self-annihilation. Instead, it has forced the human race to govern itself without resorting to nuclear war over the past 60 years. Plutonium evokes the entire gamut of human emotions, from good to evil, from hope to despair, from the salvation of humanity to its utter destruction. There is no other element in the periodic table that has had such a profound impact on the consciousness of mankind.

Indoor exposure to toluene from printed matter matters: complementary views from life cycle assessment and risk assessment.

PubMed

Walser, Tobias; Juraske, Ronnie; Demou, Evangelia; Hellweg, Stefanie

2014-01-01

A pronounced presence of toluene from rotogravure printed matter has been frequently observed indoors. However, its consequences to human health in the life cycle of magazines are poorly known. Therefore, we quantified human-health risks in indoor environments with Risk Assessment (RA) and impacts relative to the total impact of toxic releases occurring in the life cycle of a magazine with Life Cycle Assessment (LCA). We used a one-box indoor model to estimate toluene concentrations in printing facilities, newsstands, and residences in a best, average, and worst-case scenario. The modeled concentrations are in the range of the values measured in on-site campaigns. Toluene concentrations can be close or even surpass the occupational legal thresholds in printing facilities in realistic worst-case scenarios. The concentrations in homes can surpass the US EPA reference dose (69 μg/kg/day) in worst-case scenarios, but are still at least 1 order of magnitude lower than in press rooms or newsstands. However, toluene inhaled at home becomes the dominant contribution to the total potential human toxicity impacts of toluene from printed matter when assessed with LCA, using the USEtox method complemented with indoor characterization factors for toluene. The significant contribution (44%) of toluene exposure in production, retail, and use in households, to the total life cycle impact of a magazine in the category of human toxicity, demonstrates that the indoor compartment requires particular attention in LCA. While RA works with threshold levels, LCA assumes that every toxic emission causes an incremental change to the total impact. Here, the combination of the two paradigms provides valuable information on the life cycle stages of printed matter.

Killing of Campylobacter on contaminated plastic and wooden cutting boards by glycerol monocaprate (monocaprin).

PubMed

Thormar, H; Hilmarsson, H

2010-09-01

Contamination in the kitchen with foodborne bacteria is a risk factor in human exposure to these pathogens, an important route being transfer of bacteria from contaminated cutting boards and other surfaces to humans. The aim of this study was to test microbicidal emulsions of glycerol monocaprate (monocaprin) against Campylobacter on contaminated cutting boards. Plastic and wooden cutting boards, soiled with meat juice heavily contaminated with Campylobacter, were treated for 2 min with emulsions of monocaprin (MC) made in water or in buffer at low pH. Viable Campylobacter counts were reduced below the detectable level on plastic board surfaces after treatment with MC emulsions with or without 1.25% washing-up liquids (WUL). The counts were also greatly reduced on wooden boards (P < 0.05). Monocaprin emulsions and mixtures of MC emulsions and WUL may be useful as sanitizers/disinfectants in kitchens and in other food preparing and processing facilities. Cleaning with MC emulsions with or without WUL may reduce the risk of human exposure to Campylobacter.

Burn-center quality improvement: are burn outcomes dependent on admitting facilities and is there a volume-outcome "sweet-spot"?

PubMed

Hranjec, Tjasa; Turrentine, Florence E; Stukenborg, George; Young, Jeffrey S; Sawyer, Robert G; Calland, James F

2012-05-01

Risk factors of mortality in burn patients such as inhalation injury, patient age, and percent of total body surface area (%TBSA) burned have been identified in previous publications. However, little is known about the variability of mortality outcomes between burn centers and whether the admitting facilities or facility volumes can be recognized as predictors of mortality. De-identified data from 87,665 acute burn observations obtained from the National Burn Repository between 2003 and 2007 were used to estimate a multivariable logistic regression model that could predict patient mortality with reference to the admitting burn facility/facility volume, adjusted for differences in age, inhalation injury, %TBSA burned, and an additional factor, percent full thickness burn (%FTB). As previously reported, all three covariates (%TBSA burned, inhalation injury, and age) were found to be highly statistically significant risk factors of mortality in burn patients (P value < 0.0001). The additional variable, %FTB, was also found to be a statistically significant determinant, although it did not greatly improve the multivariable model. The treatment/admitting facility was found to be an independent mortality predictor, with certain hospitals having increased odds of death and others showing a protective effect (decreased odds ratio). Hospitals with high burn volumes had the highest risk of mortality. Mortality outcomes of patients with similar risk factors (%TBSA burned, inhalation injury, age, and %FTB) are significantly affected by the treating facility and their admission volumes.

Factors influencing deliveries at health facilities in a rural Maasai Community in Magadi sub-County, Kenya.

PubMed

Karanja, Sarah; Gichuki, Richard; Igunza, Patrick; Muhula, Samuel; Ofware, Peter; Lesiamon, Josephine; Leshore, Lepantas; Kyomuhangi-Igbodipe, Lenny Bazira; Nyagero, Josephat; Binkin, Nancy; Ojakaa, David

2018-01-03

In response to poor maternal, newborn, and child health indicators in Magadi sub-county, the "Boma" model was launched to promote health facility delivery by establishing community health units and training community health volunteers (CHVs) and traditional birth attendants (TBAs) as safe motherhood promoters. As a result, health facility delivery increased from 14% to 24%, still considerably below the national average (61%). We therefore conducted this study to determine factors influencing health facility delivery and describe barriers and motivators to the same. A mixed methods cross-sectional study involving a survey with 200 women who had delivered in the last 24 months, 3 focus group discussions with health providers, chiefs and CHVs and 26 in-depth interviews with mothers, key decision influencers and TBAs. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) using logistic regression were calculated to identify predictive factors for health facility delivery. Thematic analysis was done to describe barriers and motivators to the same. Of the women interviewed, 39% delivered at the health facility. Factors positively associated with health facility deliveries included belonging to the highest wealth quintiles [aOR 4.9 (95%CI 1.5-16.5)], currently not married [aOR 2.4 (95%CI 1.1-5.4)] and living near the health facility [aOR 2.2 (95%CI 1.1 = 4.4)]. High parity [aOR 0.7 (95%CI 0.5-0.9)] was negatively associated with health facility delivery. Barriers to health facility delivery included women not being final decision makers on place of birth, lack of a birth plan, gender of health provider, unfamiliar birthing position, disrespect and/or abuse, distance, attitude of health providers and lack of essential drugs and supplies. Motivators included proximity to health facility, mother's health condition, integration of TBAs into the health system, and health education/advice received. Belonging to the highest wealth quintile, currently not married and living near a health facility were positively associated with health facility delivery. Gender inequity and cultural practices such as lack of birth preparedness should be addressed. Transport mechanisms need to be established to avoid delay in reaching a health facility. The health systems also need to be functional with adequate supplies and motivated staff.

Seasonal variations and shared latrine cleaning practices in the slums of Kampala city, Uganda.

PubMed

Kwiringira, Japheth; Atekyereza, Peter; Niwagaba, Charles; Kabumbuli, Robert; Rwabukwali, Charles; Kulabako, Robinah; Günther, Isabel

2016-04-27

The effect of seasons on health outcomes is a reflection on the status of public health and the state of development in a given society. Evidence shows that in Sub-Saharan Africa, most infectious diseases flourish during the wet months of the year; while human activities in a context of constrained choices in life exacerbate the effects of seasons on human health. The paper argues that, the wet season and when human activities are at their peak, sanitation is most dire poor slum populations. A shared latrine cleaning observation was undertaken over a period of 6 months in the slums of Kampala city. Data was collected through facility observations, user group meetings, Focus group discussions and, key informant interviews. The photos of the observed sanitation facilities were taken and assessed for facility cleanliness or dirt. Shared latrine pictures, observations, Focus Group Discussion, community meetings and key informant interviews were analysed and subjected to an analysis over the wet, dry and human activity cycles before a facility was categorised as either 'dirty' or 'clean'. Human activity cycles also referred to as socio-economic seasons were, school days, holidays, weekends and market days. These have been called 'impure' seasons, while the 'pure' seasons were the wet and dry months: improved and unimproved facilities were negatively affected by the wet seasons and the peak seasons of human activity. Wet seasons were associated with, mud and stagnant water, flooding pits and a repugnant smell from the latrine cubicle which made cleaning difficult. During the dry season, latrines became relatively cleaner than during the wet season. The presence of many child(ren) users during school days as well as the influx of market goers for the roadside weekly markets compromised the cleaning outcomes for these shared sanitation facilities. Shared latrine cleaning in slums is impacted by seasonal variations related to weather conditions and human activity. The wet seasons made the already bad sanitation situation worse. The seasonal fluctuations in the state of shared slum sanitation relate to a wider malaise in the population and an implied capacity deficit among urban authorities. Poor sanitation in slums is part of a broader urban mismanagement conundrum pointing towards the urgent need for multiple interventions aimed at improving the general urban living conditions well beyond sanitation.

Predictors of Use of Monitored Anesthesia Care for Outpatient Gastrointestinal Endoscopy in a Capitated Payment System.

PubMed

Adams, Megan A; Prenovost, Katherine M; Dominitz, Jason A; Holleman, Robert G; Kerr, Eve A; Krein, Sarah L; Saini, Sameer D; Rubenstein, Joel H

2017-12-01

Use of monitored anesthesia care (MAC) for gastrointestinal endoscopy has increased in the Veterans Health Administration (VHA) as in fee-for-service environments, despite the absence of financial incentives. We investigated factors associated with use of MAC in an integrated health care delivery system with a capitated payment model. We performed a retrospective cohort study using multilevel logistic regression, with MAC use modeled as a function of procedure year, patient- and provider-level factors, and facility effects. We collected data from 2,091,590 veterans who underwent outpatient esophagogastroduodenoscopy and/or colonoscopy during fiscal years 2000-2013 at 133 facilities. The adjusted rate of MAC use in the VHA increased 17% per year (odds ratio for increase, 1.17; 95% confidence interval, 1.09-1.27) from fiscal year 2000 through 2013. The most rapid increase occurred starting in 2011. VHA use of MAC was associated with patient-level factors that included obesity, obstructive sleep apnea, higher comorbidity, and use of prescription opioids and/or benzodiazepines, although the magnitude of these effects was small. Provider-level and facility factors were also associated with use of MAC, although again the magnitude of these associations was small. Unmeasured facility-level effects had the greatest effect on the trend of MAC use. In a retrospective study of veterans who underwent outpatient esophagogastroduodenoscopy and/or colonoscopy from fiscal year 2000 through 2013, we found that even in a capitated system, patient factors are only weakly associated with use of MAC. Facility-level effects are the most prominent factor influencing increasing use of MAC. Future studies should focus on better defining the role of MAC and facility and organizational factors that affect choice of endoscopic sedation. It will also be important to align resources and incentives to promote appropriate allocation of MAC based on clinically meaningful patient factors. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Factors affecting the availability and use of hemodialysis facilities.

PubMed

Cleary, P D; Schlesinger, M; Blumenthal, D

1991-01-01

This article describes factors related to the geographic distribution of hemodialysis facilities and the relationship between availability and use. Such facilities tend to be concentrated in the same types of areas as other medical resources, and the number of medical specialists in an area is related to the rate of treatment for renal diseases. The proportion of treatment stations in an area owned by for-profit organizations is not related to the total treatment rate, but the market share of for-profit facilities is positively related to in-center treatment and negatively related to home treatment.

Illustrative assessment of human health issues arising from the potential release of chemotoxic substances from a generic geological disposal facility for radioactive waste.

PubMed

Wilson, James C; Thorne, Michael C; Towler, George; Norris, Simon

2011-12-01

Many countries have a programme for developing an underground geological disposal facility for radioactive waste. A case study is provided herein on the illustrative assessment of human health issues arising from the potential release of chemotoxic and radioactive substances from a generic geological disposal facility (GDF) for radioactive waste. The illustrative assessment uses a source-pathway-receptor methodology and considers a number of human exposure pathways. Estimated exposures are compared with authoritative toxicological assessment criteria. The possibility of additive and synergistic effects resulting from exposures to mixtures of chemical contaminants or a combination of radiotoxic and chemotoxic substances is considered. The case study provides an illustration of how to assess human health issues arising from chemotoxic species released from a GDF for radioactive waste and highlights potential difficulties associated with a lack of data being available with which to assess synergistic effects. It also highlights how such difficulties can be addressed.

Rural health workers and their work environment: the role of inter-personal factors on job satisfaction of nurses in rural Papua New Guinea

PubMed Central

2012-01-01

Background Job satisfaction is an important focal attitude towards work. Understanding factors that relate to job satisfaction allows interventions to be developed to enhance work performance. Most research on job satisfaction among nurses has been conducted in acute care settings in industrialized countries. Factors that relate to rural nurses are different. This study examined inter-personal, intra-personal and extra-personal factors that influence job satisfaction among rural primary care nurses in a Low and Middle Income country (LMIC), Papua New Guinea. Methods Data was collected using self administered questionnaire from rural nurses attending a training program from 15 of the 20 provinces. Results of a total of 344 nurses were available for analysis. A measure of overall job satisfaction and measures for facets of job satisfaction was developed in the study based on literature and a qualitative study. Multi-variate analysis was used to test prediction models. Results There was significant difference in the level of job satisfaction by age and years in the profession. Higher levels of overall job satisfaction and intrinsic satisfaction were seen in nurses employed by Church facilities compared to government facilities (P <0.01). Ownership of facility, work climate, supervisory support and community support predicted 35% (R2 =0.35) of the variation in job satisfaction. The factors contributing most were work climate (17%) and supervisory support (10%). None of these factors were predictive of an intention to leave. Conclusions This study provides empirical evidence that inter-personal relationships: work climate and supportive supervision are the most important influences of job satisfaction for rural nurses in a LMIC. These findings highlight that the provision of a conducive environment requires attention to human relations aspects. For PNG this is very important as this critical cadre provide the frontline of primary health care for more than 70% of the population of the country. Many LMIC are focusing on rural health, with most of the attention given to aspects of workforce numbers and distribution. Much less attention is given to improving the aspects of the working environment that enhances intrinsic satisfaction and work climate for rural health workers who are currently in place if they are to be satisfied in their job and productive. PMID:22691270

Rural health workers and their work environment: the role of inter-personal factors on job satisfaction of nurses in rural Papua New Guinea.

PubMed

Jayasuriya, Rohan; Whittaker, Maxine; Halim, Grace; Matineau, Tim

2012-06-12

Job satisfaction is an important focal attitude towards work. Understanding factors that relate to job satisfaction allows interventions to be developed to enhance work performance. Most research on job satisfaction among nurses has been conducted in acute care settings in industrialized countries. Factors that relate to rural nurses are different. This study examined inter-personal, intra-personal and extra-personal factors that influence job satisfaction among rural primary care nurses in a Low and Middle Income country (LMIC), Papua New Guinea. Data was collected using self administered questionnaire from rural nurses attending a training program from 15 of the 20 provinces. Results of a total of 344 nurses were available for analysis. A measure of overall job satisfaction and measures for facets of job satisfaction was developed in the study based on literature and a qualitative study. Multi-variate analysis was used to test prediction models. There was significant difference in the level of job satisfaction by age and years in the profession. Higher levels of overall job satisfaction and intrinsic satisfaction were seen in nurses employed by Church facilities compared to government facilities (P <0.01). Ownership of facility, work climate, supervisory support and community support predicted 35% (R2 =0.35) of the variation in job satisfaction. The factors contributing most were work climate (17%) and supervisory support (10%). None of these factors were predictive of an intention to leave. This study provides empirical evidence that inter-personal relationships: work climate and supportive supervision are the most important influences of job satisfaction for rural nurses in a LMIC. These findings highlight that the provision of a conducive environment requires attention to human relations aspects. For PNG this is very important as this critical cadre provide the frontline of primary health care for more than 70% of the population of the country. Many LMIC are focusing on rural health, with most of the attention given to aspects of workforce numbers and distribution. Much less attention is given to improving the aspects of the working environment that enhances intrinsic satisfaction and work climate for rural health workers who are currently in place if they are to be satisfied in their job and productive.

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...

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)...

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...

Good Impressions

ERIC Educational Resources Information Center

Renner, Jason

2010-01-01

It's a fact that most students, faculty and visitors who enter a school or college building eventually will use that facility's restrooms. Whether the destination is a lecture hall or classroom, the gym or other sports facility, the cafeteria or the student union, the human flow of restroom traffic is steady--year-round for some facilities and 24…

Factors Associated With Missed and Cancelled Colonoscopy Appointments at Veterans Health Administration Facilities.

PubMed

Partin, Melissa R; Gravely, Amy; Gellad, Ziad F; Nugent, Sean; Burgess, James F; Shaukat, Aasma; Nelson, David B

2016-02-01

Cancelled and missed colonoscopy appointments waste resources, increase colonoscopy delays, and can adversely affect patient outcomes. We examined individual and organizational factors associated with missed and cancelled colonoscopy appointments in Veteran Health Administration facilities. From 69 facilities meeting inclusion criteria, we identified 27,994 patients with colonoscopy appointments scheduled for follow-up, on the basis of positive fecal occult blood test results, between August 16, 2009 and September 30, 2011. We identified factors associated with colonoscopy appointment status (completed, cancelled, or missed) by using hierarchical multinomial regression. Individual factors examined included age, race, sex, marital status, residence, drive time to nearest specialty care facility, limited life expectancy, comorbidities, colonoscopy in the past decade, referring facility type, referral month, and appointment lead time. Organizational factors included facility region, complexity, appointment reminders, scheduling, and prep education practices. Missed appointments were associated with limited life expectancy (odds ratio [OR], 2.74; P = .0004), no personal history of polyps (OR, 2.74; P < .0001), high facility complexity (OR, 2.69; P = .007), dual diagnosis of psychiatric disorders and substance abuse (OR, 1.82; P < .0001), and opt-out scheduling (OR, 1.57; P = .02). Cancelled appointments were associated with age (OR, 1.61; P = .0005 for 85 years or older and OR, 1.44; P < .0001 for 65-84 years old), no history of polyps (OR, 1.51; P < .0001), and opt-out scheduling (OR, 1.26; P = .04). Additional predictors of both outcomes included race, marital status, and lead time. Several factors within Veterans Health Administration clinic control can be targeted to reduce missed and cancelled colonoscopy appointments. Specifically, developing systems to minimize referrals for patients with limited life expectancy could reduce missed appointments, and use of opt-in scheduling and reductions in appointment lead time could improve both outcomes. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

Factors Influencing Health Facility Delivery in Predominantly Rural Communities across the Three Ecological Zones in Ghana: A Cross-Sectional Study

PubMed Central

Enuameh, Yeetey Akpe Kwesi; Okawa, Sumiyo; Asante, Kwaku Poku; Kikuchi, Kimiyo; Mahama, Emmanuel; Ansah, Evelyn; Tawiah, Charlotte; Adjei, Kwame; Shibanuma, Akira; Nanishi, Keiko; Yeji, Francis; Agyekum, Enoch Oti; Yasuoka, Junko; Gyapong, Margaret; Oduro, Abraham Rexford; Quansah Asare, Gloria; Hodgson, Abraham; Jimba, Masamine; Owusu-Agyei, Seth

2016-01-01

Background Maternal and neonatal mortality indicators remain high in Ghana and other sub-Saharan African countries. Both maternal and neonatal health outcomes improve when skilled personnel provide delivery services within health facilities. Determinants of delivery location are crucial to promoting health facility deliveries, but little research has been done on this issue in Ghana. This study explored factors influencing delivery location in predominantly rural communities in Ghana. Methods Data were collected from 1,500 women aged 15–49 years with live or stillbirths that occurred between January 2011 and April 2013. This was done within the three sites operating Health and Demographic Surveillance Systems, i.e., the Dodowa (Greater Accra Region), Kintampo (Brong Ahafo Region), and Navrongo (Upper-East Region) Health Research Centers in Ghana. Multivariable logistic regression was used to identify the determinants of delivery location, controlling for covariates that were statistically significant in univariable regression models. Results Of 1,497 women included in the analysis, 75.6% of them selected health facilities as their delivery location. After adjusting for confounders, the following factors were associated with health facility delivery across all three sites: healthcare provider’s influence on deciding health facility delivery, (AOR = 13.47; 95% CI 5.96–30.48), place of residence (AOR = 4.49; 95% CI 1.14–17.68), possession of a valid health insurance card (AOR = 1.90; 95% CI 1.29–2.81), and socio-economic status measured by wealth quintiles (AOR = 2.83; 95% CI 1.43–5.60). Conclusion In addition to known factors such as place of residence, socio-economic status, and possession of valid health insurance, this study identified one more factor associated with health facility delivery: healthcare provider’s influence. Ensuring care provider’s counseling of clients could improve the uptake of health facility delivery in rural communities in Ghana. PMID:27031301

Tuberculosis serosurveillance and management practices of captive African elephants (Loxodonta africana) in the Kavango-Zambezi Transfrontier Conservation Area.

PubMed

Rosen, L E; Hanyire, T G; Dawson, J; Foggin, C M; Michel, A L; Huyvaert, K P; Miller, M A; Olea-Popelka, F J

2018-04-01

Transfrontier conservation areas represent an international effort to encourage conservation and sustainable development. Their success faces a number of challenges, including disease management in wildlife, livestock and humans. Tuberculosis (TB) affects humans and a multitude of non-human animal species and is of particular concern in sub-Saharan Africa. The Kavango-Zambezi Transfrontier Conservation Area encompasses five countries, including Zimbabwe, and is home to the largest contiguous population of free-ranging elephants in Africa. Elephants are known to be susceptible to TB; thus, understanding TB status, exposure and transmission risks to and from elephants in this area is of interest for both conservation and human health. To assess risk factors for TB seroprevalence, a questionnaire was used to collect data regarding elephant management at four ecotourism facilities offering elephant-back tourist rides in the Victoria Falls area of Zimbabwe. Thirty-five working African elephants were screened for Mycobacterium tuberculosis complex antibodies using the ElephantTB Stat-Pak and the DPP VetTB Assay for elephants. Six of 35 elephants (17.1%) were seropositive. The risk factor most important for seropositive status was time in captivity. This is the first study to assess TB seroprevalence and risk factors in working African elephants in their home range. Our findings will provide a foundation to develop guidelines to protect the health of captive and free-ranging elephants in the southern African context, as well as elephant handlers through simple interventions. Minimizing exposure through shared feed with other wildlife, routine TB testing of elephant handlers and regular serological screening of elephants are recommended as preventive measures. © 2017 Blackwell Verlag GmbH.

Evaluation of Facility Management by Multivariate Statistics - Factor Analysis

NASA Astrophysics Data System (ADS)

Singovszki, Miloš; Vranayová, Zuzana

2013-06-01

Facility management is evolving, there is no exact than other sciences, although its development is fast forward. The knowledge and practical skills in facility management is not replaced, on the contrary, they complement each other. The existing low utilization of science in the field of facility management is mainly caused by the management of support activities are many variables and prevailing immediate reaction to the extraordinary situation arising from motives of those who have substantial experience and years of proven experience. Facility management is looking for a system that uses organized knowledge and will form the basis, which grows from a wide range of disciplines. Significant influence on its formation as a scientific discipline is the "structure, which follows strategy". The paper deals evaluate technology building as part of an facility management by multivariate statistic - factor analysis.

40 CFR 63.5796 - What are the organic HAP emissions factor equations in Table 1 to this subpart, and how are they...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Emissions Factors for Open Molding and Centrifugal Casting § 63.5796 What are the organic HAP emissions... factors. Equations are available for each open molding operation and centrifugal casting operation and... incorporated in the facility's air emissions permit and are based on actual facility HAP emissions test data...

40 CFR 63.5796 - What are the organic HAP emissions factor equations in Table 1 to this subpart, and how are they...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Emissions Factors for Open Molding and Centrifugal Casting § 63.5796 What are the organic HAP emissions... factors. Equations are available for each open molding operation and centrifugal casting operation and... incorporated in the facility's air emissions permit and are based on actual facility HAP emissions test data...

40 CFR 63.5796 - What are the organic HAP emissions factor equations in Table 1 to this subpart, and how are they...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Organic Hap Emissions Factors for Open Molding and Centrifugal Casting § 63.5796 What are the organic HAP... emissions factors. Equations are available for each open molding operation and centrifugal casting operation... incorporated in the facility's air emissions permit and are based on actual facility HAP emissions test data...

40 CFR 63.5796 - What are the organic HAP emissions factor equations in Table 1 to this subpart, and how are they...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Organic Hap Emissions Factors for Open Molding and Centrifugal Casting § 63.5796 What are the organic HAP... emissions factors. Equations are available for each open molding operation and centrifugal casting operation... incorporated in the facility's air emissions permit and are based on actual facility HAP emissions test data...

40 CFR 63.5796 - What are the organic HAP emissions factor equations in Table 1 to this subpart, and how are they...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Organic Hap Emissions Factors for Open Molding and Centrifugal Casting § 63.5796 What are the organic HAP... emissions factors. Equations are available for each open molding operation and centrifugal casting operation... incorporated in the facility's air emissions permit and are based on actual facility HAP emissions test data...

Proof of concept for a banding scheme to support risk assessments related to multi-product biologics manufacturing.

PubMed

Card, Jeffrey W; Fikree, Hana; Haighton, Lois A; Blackwell, James; Felice, Brian; Wright, Teresa L

2015-11-01

A banding scheme theory has been proposed to assess the potency/toxicity of biologics and assist with decisions regarding the introduction of new biologic products into existing manufacturing facilities. The current work was conducted to provide a practical example of how this scheme could be applied. Information was identified for representatives from the following four proposed bands: Band A (lethal toxins); Band B (toxins and apoptosis signals); Band C (cytokines and growth factors); and Band D (antibodies, antibody fragments, scaffold molecules, and insulins). The potency/toxicity of the representative substances was confirmed as follows: Band A, low nanogram quantities exert lethal effects; Band B, repeated administration of microgram quantities is tolerated in humans; Band C, endogenous substances and recombinant versions administered to patients in low (interferons), intermediate (growth factors), and high (interleukins) microgram doses, often on a chronic basis; and Band D, endogenous substances present or produced in the body in milligram quantities per day (insulin, collagen) or protein therapeutics administered in milligram quantities per dose (mAbs). This work confirms that substances in Bands A, B, C, and D represent very high, high, medium, and low concern with regard to risk of cross-contamination in manufacturing facilities, thus supporting the proposed banding scheme. Copyright © 2015 Elsevier Inc. All rights reserved.

Dialysis Facility and Patient Characteristics Associated with Utilization of Home Dialysis

PubMed Central

Walker, David R.; Inglese, Gary W.; Sloand, James A.

2010-01-01

Background and objectives: Nonmedical factors influencing utilization of home dialysis at the facility level are poorly quantified. Home dialysis is comparably effective and safe but less expensive to society and Medicare than in-center hemodialysis. Elimination of modifiable practice variation unrelated to medical factors could contribute to improvements in patient outcomes and use of scarce resources. Design, setting, participants, & measurements: Prevalent dialysis patient data by facility were collected from the 2007 ESRD Network’s annual reports. Facility characteristic data were collected from Medicare’s Dialysis Facility Compare file. A multivariate regression model was used to evaluate associations between the use of home dialysis and facility characteristics. Results: The utilization of home dialysis was positively associated with facility size, percent patients employed full- or part-time, younger population, and years a facility was Medicare certified. Variables negatively associated include an increased number of hemodialysis patients per hemodialysis station, chain association, rural location, more densely populated zip code, a late dialysis work shift, and greater percent of black patients within a zip code. Conclusions: Improved understanding of factors affecting the frequency of use of home dialysis may help explain practice variations across the United States that result in an imbalanced use of medical resources within the ESRD population. In turn, this may improve the delivery of healthcare and extend the ability of an increasingly overburdened medical financing system to survive. PMID:20634324

Teachers' Utilization of School Facilities and Academic Achievement of Student Nurses in Human Biology in Schools of Nursing in Akwa Ibom State, Nigeria

ERIC Educational Resources Information Center

Usen, Onodiong Mfreke

2016-01-01

The study examined the relationship between teachers' utilization of school facilities and academic achievement of student nurses in Human Biology in schools of Nursing in Akwa Ibom State. Four (4) specific objectives, four (4) research questions and four (4) null hypotheses were formulated to guide the study. Ex-post facto survey design was…

The utilization characteristics of social facilities in the border area of Semarang city

NASA Astrophysics Data System (ADS)

Setioko, Bambang; Olivia, Deasy; Pandelaki, Edward E.; Murtini, Titien Woro

2017-06-01

The rapid growth of settlement in border areas is often considered as a problem of big cities in Indonesia, where people from rural areas prefer to move out and settle in the border areas of big cities due to the provision of better social facilities. Border areas generally do not receive adequate attention and are often overlooked by the local government. It is a common phenomenon in Indonesian cities, including in Semarang City. Increased number of settlements in the border areas in Semarang City is in linear with spontaneous urbanization processes which indicate the heterogeneity emerging of settlement areas. In the early stages of Semarang City spatial planning, the need for social facilities in border areas is included based on the regular standard which is commonly applied to the urban core. In a very short period, the numbers and types of existing social facilities are insufficient to fulfill the needs of the community. Nowadays, in the context of rapid urbanization, the growth of social facilities in border areas is very high. The intense growth of settlements in border areas is very high due to the low price of land in Demak Regency in compared to those of other areas in Semarang City. However, only a few developers involved social facilities as a part of housing estate construction. Consequently, most of the occupants utilize a limited number of social facilities provided by the municipal government, which are actually intended to serve the citizens of Semarang City. This research was conducted at Sendang Mulyo Village which is located in the border of Semarang municipal administrative area and included in Demak Regency. This paper discusses the utilization characteristics of social facilities in the border area of Semarang City, with the aim to get the trigger factors. The method analysis consisted of a statistical test and descriptive analysis. The utilization characteristics were formulated based on the relationship between neighborhood and human behavior. The settlements in the border area of Semarang City have different characteristics. The differences led to a gap of the utilization of facilities between people who live in the planned and unplanned settlement. Therefore, the social spatial concept is required to address the issue.

Effects of a health information system data quality intervention on concordance in Mozambique: time-series analyses from 2009-2012.

PubMed

Wagenaar, Bradley H; Gimbel, Sarah; Hoek, Roxanne; Pfeiffer, James; Michel, Cathy; Manuel, João Luis; Cuembelo, Fatima; Quembo, Titos; Afonso, Pires; Porthé, Victoria; Gloyd, Stephen; Sherr, Kenneth

2015-01-01

We assessed the effects of a three-year national-level, ministry-led health information system (HIS) data quality intervention and identified associated health facility factors. Monthly summary HIS data concordance between a gold standard data quality audit and routine HIS data was assessed in 26 health facilities in Sofala Province, Mozambique across four indicators (outpatient consults, institutional births, first antenatal care visits, and third dose of diphtheria, pertussis, and tetanus vaccination) and five levels of health system data aggregation (daily facility paper registers, monthly paper facility reports, monthly paper district reports, monthly electronic district reports, and monthly electronic provincial reports) through retrospective yearly audits conducted July-August 2010-2013. We used mixed-effects linear models to quantify changes in data quality over time and associated health system determinants. Median concordance increased from 56.3% during the baseline period (2009-2010) to 87.5% during 2012-2013. Concordance improved by 1.0% (confidence interval [CI]: 0.60, 1.5) per month during the intervention period of 2010-2011 and 1.6% (CI: 0.89, 2.2) per month from 2011-2012. No significant improvements were observed from 2009-2010 (during baseline period) or 2012-2013. Facilities with more technical staff (aβ: 0.71; CI: 0.14, 1.3), more first antenatal care visits (aβ: 3.3; CI: 0.43, 6.2), and fewer clinic beds (aβ: -0.94; CI: -1.7, -0.20) showed more improvements. Compared to facilities with no stock-outs, facilities with five essential drugs stocked out had 51.7% (CI: -64.8 -38.6) lower data concordance. A data quality intervention was associated with significant improvements in health information system data concordance across public-sector health facilities in rural and urban Mozambique. Concordance was higher at those facilities with more human resources for health and was associated with fewer clinic-level stock-outs of essential medicines. Increased investments should be made in data audit and feedback activities alongside targeted efforts to improve HIS data in low- and middle-income countries.

Human Exploration System Test-Bed for Integration and Advancement (HESTIA) Support of Future NASA Deep-Space Missions

NASA Technical Reports Server (NTRS)

Marmolejo, Jose; Ewert, Michael

2016-01-01

The Engineering Directorate at the NASA - Johnson Space Center is outfitting a 20-Foot diameter hypobaric chamber in Building 7 to support future deep-space Environmental Control & Life Support System (ECLSS) research as part of the Human Exploration System Test-bed for Integration and Advancement (HESTIA) Project. This human-rated chamber is the only NASA facility that has the unique experience, chamber geometry, infrastructure, and support systems capable of conducting this research. The chamber was used to support Gemini, Apollo, and SkyLab Missions. More recently, it was used to conduct 30-, 60-, and 90-day human ECLSS closed-loop testing in the 1990s to support the International Space Station and life support technology development. NASA studies show that both planetary surface and deep-space transit crew habitats will be 3-4 story cylindrical structures driven by human occupancy volumetric needs and launch vehicle constraints. The HESTIA facility offers a 3-story, 20-foot diameter habitat consistent with the studies' recommendations. HESTIA operations follow stringent processes by a certified test team that including human testing. Project management, analysis, design, acquisition, fabrication, assembly and certification of facility build-ups are available to support this research. HESTIA offers close proximity to key stakeholders including astronauts, Human Research Program (who direct space human research for the agency), Mission Operations, Safety & Mission Assurance, and Engineering Directorate. The HESTIA chamber can operate at reduced pressure and elevated oxygen environments including those proposed for deep-space exploration. Data acquisition, power, fluids and other facility resources are available to support a wide range of research. Recently completed HESTIA research consisted of unmanned testing of ECLSS technologies. Eventually, the HESTIA research will include humans for extended durations at reduced pressure and elevated oxygen to demonstrate very high reliability of critical ECLSS and other technologies.

Accident epidemiology and the U.S. chemical industry: accident history and worst-case data from RMP*Info.

PubMed

Kleindorfer, Paul R; Belke, James C; Elliott, Michael R; Lee, Kiwan; Lowe, Robert A; Feldman, Harold I

2003-10-01

This article reports on the data collected on one of the most ambitious government-sponsored environmental data acquisition projects of all time, the Risk Management Plan (RMP) data collected under section 112(r) of the Clean Air Act Amendments of 1990. This RMP Rule 112(r) was triggered by the Bhopal accident in 1984 and led to the requirement that each qualifying facility develop and file with the U.S. Environmental Protection Agency a Risk Management Plan (RMP) as well as accident history data for the five-year period preceding the filing of the RMP. These data were collected in 1999-2001 on more than 15,000 facilities in the United States that store or use listed toxic or flammable chemicals believed to be a hazard to the environment or to human health of facility employees or off-site residents of host communities. The resulting database, RMP*Info, has become a key resource for regulators and researchers concerned with the frequency and severity of accidents, and the underlying facility-specific factors that are statistically associated with accident and injury rates. This article analyzes which facilities actually filed under the Rule and presents results on accident frequencies and severities available from the RMP*Info database. This article also presents summaries of related results from RMP*Info on Offsite Consequence Analysis (OCA), an analytical estimate of the potential consequences of hypothetical worst-case and alternative accidental releases on the public and environment around the facility. The OCA data have become a key input in the evaluation of site security assessment and mitigation policies for both government planners as well as facility managers and their insurers. Following the survey of the RMP*Info data, we discuss the rich set of policy decisions that may be informed by research based on these data.

Risk-based maintenance of ethylene oxide production facilities.

PubMed

Khan, Faisal I; Haddara, Mahmoud R

2004-05-20

This paper discusses a methodology for the design of an optimum inspection and maintenance program. The methodology, called risk-based maintenance (RBM) is based on integrating a reliability approach and a risk assessment strategy to obtain an optimum maintenance schedule. First, the likely equipment failure scenarios are formulated. Out of many likely failure scenarios, the ones, which are most probable, are subjected to a detailed study. Detailed consequence analysis is done for the selected scenarios. Subsequently, these failure scenarios are subjected to a fault tree analysis to determine their probabilities. Finally, risk is computed by combining the results of the consequence and the probability analyses. The calculated risk is compared against known acceptable criteria. The frequencies of the maintenance tasks are obtained by minimizing the estimated risk. A case study involving an ethylene oxide production facility is presented. Out of the five most hazardous units considered, the pipeline used for the transportation of the ethylene is found to have the highest risk. Using available failure data and a lognormal reliability distribution function human health risk factors are calculated. Both societal risk factors and individual risk factors exceeded the acceptable risk criteria. To determine an optimal maintenance interval, a reverse fault tree analysis was used. The maintenance interval was determined such that the original high risk is brought down to an acceptable level. A sensitivity analysis is also undertaken to study the impact of changing the distribution of the reliability model as well as the error in the distribution parameters on the maintenance interval.

New Ideas on Facilities Management.

ERIC Educational Resources Information Center

Grimm, James C.

1986-01-01

Examines trends in facilities management relating to products and people. Reviews new trends in products, including processes, techniques, and programs that are being expounded by business and industry. Discusses the "people factors" involved in facilities management. (ABB)

Capacity analysis of pedestrian facilities involving individuals with disabilities.

DOT National Transportation Integrated Search

2015-08-31

Walking facilities are important infrastructures that must be designed to accommodate the behavior of pedestrians in order to be effective. Heterogeneity in pedestrian composition is one important factor generally overlooked in walking facility desig...

A hydrologic retention system and water quality monitoring program for a human decomposition research facility: concept and design.

PubMed

Wozniak, Jeffrey R; Thies, Monte L; Bytheway, Joan A; Lutterschmidt, William I

2015-01-01

Forensic taphonomy is an essential research field; however, the decomposition of human cadavers at forensic science facilities may lead to nutrient loading and the introduction of unique biological compounds to adjacent areas. The infrastructure of a water retention system may provide a mechanism for the biogeochemical processing and retention of nutrients and compounds, ensuring the control of runoff from forensic facilities. This work provides a proof of concept for a hydrologic retention system and an autonomous water quality monitoring program designed to mitigate runoff from The Southeast Texas Applied Forensic Science (STAFS) Facility. Water samples collected along a sample transect were analyzed for total phosphorous, total nitrogen, NO3-, NO2-, NH4, F(-), and Cl(-). Preliminary water quality analyses confirm the overall effectiveness of the water retention system. These results are discussed with relation to how this infrastructure can be expanded upon to monitor additional, more novel, byproducts of forensic science research facilities. © 2014 American Academy of Forensic Sciences.

42 CFR 71.47 - Special provisions relating to airports: Office and isolation facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Requirements Upon Arrival at U.S... facilities. Each U.S. airport which receives international traffic shall provide without cost to the...

42 CFR 71.47 - Special provisions relating to airports: Office and isolation facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Requirements Upon Arrival at U.S... facilities. Each U.S. airport which receives international traffic shall provide without cost to the...

42 CFR 71.47 - Special provisions relating to airports: Office and isolation facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Requirements Upon Arrival at U.S... facilities. Each U.S. airport which receives international traffic shall provide without cost to the...

42 CFR 71.47 - Special provisions relating to airports: Office and isolation facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Requirements Upon Arrival at U.S... facilities. Each U.S. airport which receives international traffic shall provide without cost to the...

Life sciences research on the space station: An introduction

NASA Technical Reports Server (NTRS)

1985-01-01

The Space Station will provide an orbiting, low gravity, permanently manned facility for scientific research, starting in the 1990s. The facilities for life sciences research are being designed to allow scientific investigators to perform research in Space Medicine and Space Biology, to study the consequences of long-term exposure to space conditions, and to allow for the permanent presence of humans in space. This research, using humans, animals, and plants, will provide an understanding of the effects of the space environment on the basic processes of life. In addition, facilities are being planned for remote observations to study biologically important elements and compounds in space and on other planets (exobiology), and Earth observations to study global ecology. The life sciences community is encouraged to plan for participation in scientific research that will be made possible by the Space Station research facility.

Analysis of factors of treatment completion in dots health facilities in metro Manila, Philippines: a case-control study.

PubMed

Lagrada, Leizel P; Uehara, Naruo; Kawahara, Kazuo

2008-12-01

STUDY BACKGROUND AND OBJECTIVES: The Philippines is one of the 22 countries with high TB burden. DOTS was adopted not only by purely public providers (PP) but also by public-private mix (PPM) facilities. This study aims to identify the patient and facility factors that promote completion of TB treatment in DOTS facilities in an urban setting. The study also explores the difference between the PP and PPM DOTS facilities in terms of case management and treatment outcomes. [Methods] A case control study was done by interviewing 394 patients sampled from TB cohort report between 2003 and 2005 of 14 DOTS facilities in Metro Manila. Statistical analyses used include chi-square test and logistic regression analysis. Being female and aged 30-44 (OR = 7.04; 95% CI 1.12-44.35), unemployed (OR = 2.73; 95% CI 1.18-6.33), being above per capita poverty threshold (OR = 2.03; 95% CI 1.03-3.99), having experienced at least one of the signs and symptoms of TB (OR = 4.64; 95% CI 1.29-16.67), taking the medication at health facility (OR = 3.87; 95% CI 1.48-10.16) and patient's understanding of DOT (OR = 2.67; 95% CI 1.37-5.23) predict TB treatment completion. Public-private mix type of DOTS facility was also significantly associated with completing treatment (chi 2 (1) = 54.76, p = 0.000). Patient factors like middle-aged female compared to female aged more than 60, being above per capita poverty threshold, unemployment and having experienced at least one signs and symptoms of TB and facility factors like providing treatment at the facility and explaining the DOT to patient increase the likelihood of completing treatment. Thus, encouraging patients to take their medication at the facility and helping the patients understand the importance of DOT can increase TB treatment completion. The seemingly better DOTS implementation and treatment outcomes by the PPM must be evaluated further through cost effectiveness and efficiency studies.

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...

Factors associated with increasing nursing home closures.

PubMed

Castle, Nicholas G; Engberg, John; Lave, Judith; Fisher, Andrew

2009-06-01

We determine the rate of nursing home closures for 7 years (1999-2005) and examine internal (e.g., quality), organizational (e.g., chain membership), and external (e.g., competition) factors associated with these closures. The names of the closed facilities and dates of closure from state regulators in all 50 states were obtained. This information was linked to the Online Survey, Certification, and Reporting data, which contains information on internal, organizational, and market factors for almost all nursing homes in the United States. One thousand seven hundred and eighty-nine facilities closed over this time period (1999-2005). The average annual rate of closure was about 2 percent of facilities, but the rate of closure was found to be increasing. Nursing homes with higher rates of deficiency citations, hospital-based facilities, chain members, small bed size, and facilities located in markets with high levels of competition were more likely to close. High Medicaid occupancy rates were associated with a high likelihood of closure, especially for facilities with low Medicaid reimbursement rates. As states actively debate about how to redistribute long-term care services/dollars, our findings show that they should be cognizant of the potential these decisions have for facilitating nursing home closures.

Household trends in access to improved water sources and sanitation facilities in Vietnam and associated factors: findings from the Multiple Indicator Cluster Surveys, 2000–2011

PubMed Central

Tuyet-Hanh, Tran Thi; Lee, Jong-Koo; Oh, Juhwan; Van Minh, Hoang; Ou Lee, Chul; Hoan, Le Thi; Nam, You-Seon; Long, Tran Khanh

2016-01-01

Background Despite progress made by the Millennium Development Goal (MDG) number 7.C, Vietnam still faces challenges with regard to the provision of access to safe drinking water and basic sanitation. Objective This paper describes household trends in access to improved water sources and sanitation facilities separately, and analyses factors associated with access to improved water sources and sanitation facilities in combination. Design Secondary data from the Vietnam Multiple Indicator Cluster Survey in 2000, 2006, and 2011 were analyzed. Descriptive statistics and tests of significance describe trends over time in access to water and sanitation by location, demographic and socio-economic factors. Binary logistic regressions (2000, 2006, and 2011) describe associations between access to water and sanitation, and geographic, demographic, and socio-economic factors. Results There have been some outstanding developments in access to improved water sources and sanitation facilities from 2000 to 2011. In 2011, the proportion of households with access to improved water sources and sanitation facilities reached 90% and 77%, respectively, meeting the 2015 MDG targets for safe drinking water and basic sanitation set at 88% and 75%, respectively. However, despite these achievements, in 2011, only 74% of households overall had access to combined improved drinking water and sanitation facilities. There were also stark differences between regions. In 2011, only 47% of households had access to both improved water and sanitation facilities in the Mekong River Delta compared with 94% in the Red River Delta. In 2011, households in urban compared to rural areas were more than twice as likely (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.9–2.5) to have access to improved water and sanitation facilities in combination, and households in the highest compared with the lowest wealth quintile were over 40 times more likely (OR: 42.3; 95% CI: 29.8–60.0). Conclusions More efforts are required to increase household access to both improved water and sanitation facilities in the Mekong River Delta, South East and Central Highlands regions of Vietnam. There is also a need to address socio-economic factors associated with inadequate access to improved sanitation facilities. PMID:26950563

The First Development of Human Factors Engineering Requirements for Application to Ground Task Design for a NASA Flight Program

NASA Technical Reports Server (NTRS)

Dischinger, H. Charles, Jr.; Stambolian, Damon B.; Miller, Darcy H.

2008-01-01

The National Aeronautics and Space Administration has long applied standards-derived human engineering requirements to the development of hardware and software for use by astronauts while in flight. The most important source of these requirements has been NASA-STD-3000. While there have been several ground systems human engineering requirements documents, none has been applicable to the flight system as handled at NASA's launch facility at Kennedy Space Center. At the time of the development of previous human launch systems, there were other considerations that were deemed more important than developing worksites for ground crews; e.g., hardware development schedule and vehicle performance. However, experience with these systems has shown that failure to design for ground tasks has resulted in launch schedule delays, ground operations that are more costly than they might be, and threats to flight safety. As the Agency begins the development of new systems to return humans to the moon, the new Constellation Program is addressing this issue with a new set of human engineering requirements. Among these requirements is a subset that will apply to the design of the flight components and that is intended to assure ground crew success in vehicle assembly and maintenance tasks. These requirements address worksite design for usability and for ground crew safety.

Using classification tree modelling to investigate drug prescription practices at health facilities in rural Tanzania.

PubMed

Kajungu, Dan K; Selemani, Majige; Masanja, Irene; Baraka, Amuri; Njozi, Mustafa; Khatib, Rashid; Dodoo, Alexander N; Binka, Fred; Macq, Jean; D'Alessandro, Umberto; Speybroeck, Niko

2012-09-05

Drug prescription practices depend on several factors related to the patient, health worker and health facilities. A better understanding of the factors influencing prescription patterns is essential to develop strategies to mitigate the negative consequences associated with poor practices in both the public and private sectors. A cross-sectional study was conducted in rural Tanzania among patients attending health facilities, and health workers. Patients, health workers and health facilities-related factors with the potential to influence drug prescription patterns were used to build a model of key predictors. Standard data mining methodology of classification tree analysis was used to define the importance of the different factors on prescription patterns. This analysis included 1,470 patients and 71 health workers practicing in 30 health facilities. Patients were mostly treated in dispensaries. Twenty two variables were used to construct two classification tree models: one for polypharmacy (prescription of ≥3 drugs) on a single clinic visit and one for co-prescription of artemether-lumefantrine (AL) with antibiotics. The most important predictor of polypharmacy was the diagnosis of several illnesses. Polypharmacy was also associated with little or no supervision of the health workers, administration of AL and private facilities. Co-prescription of AL with antibiotics was more frequent in children under five years of age and the other important predictors were transmission season, mode of diagnosis and the location of the health facility. Standard data mining methodology is an easy-to-implement analytical approach that can be useful for decision-making. Polypharmacy is mainly due to the diagnosis of multiple illnesses.

Identifying Consistent and Coherent Dimensions of Nursing Home Quality: Exploratory Factor Analysis of Quality Indicators.

PubMed

Xu, Dongjuan; Kane, Robert L; Shippee, Tetyana; Lewis, Teresa M

2016-12-01

There is a general belief that the markers of nursing home quality do not aggregate easily. Identifying consistent and coherent dimensions of quality that usefully summarize the multiplicity of nursing home quality measures is an important goal. It would simplify interpretation and help consumers, their families and advocates to choose nursing facilities. This study uses quality indicators (QIs) from a state nursing home report card to explore the dimensionality of quality in nursing homes and to determine whether aggregation at the resident versus facility level yields the same underlying dimensions. Cross-sectional study. 382 Medicare- and/or Medicaid-certified nursing homes in Minnesota. Residents admitted to the nursing homes during 2011-2012. 16 QIs obtained from the Minimum Data Set 3.0 assessment instrument between 2011 and 2012 were used in the exploratory factor analysis. Factor analysis results suggest four main factors or dimensions to characterize facility performance: continence care (including 4 QIs), restraints and behavioral symptoms (including 3 QIs), care for specific conditions (including 6 QIs), and physical functioning (including 3 QIs). The resident-level and facility-level results generally agreed for 11 QIs. Nursing home quality of care can be captured in summary measures, which can be used by consumers, providers and researchers. Reporting at the resident or facility level will depend on the purpose. These summary measures can be used by policy-makers to identify and reward high-performing facilities and by families to choose nursing facilities for care. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Environmental Management of Human Waste Disposal for Recreational Boating Activities

PubMed

Shafer; Yoon

1998-01-01

/ A methodology to estimate the number of pump-out facilities and dump stations required to service human waste disposal for recreational power boating activities in Pennsylvania during the 1994 boating season is described. Study results suggest that a total of 39 additional pump-out stations and 13 dump stations may be required on seven major waterbodies: The Three Rivers Area, Lake Erie/Presque Isle Bay, Raystown Lake, the Susquehanna River, the Delaware River, Lake Wallenpaupack, and the Kinzua Reservoir. Suggestions for improving the methodology are provided. KEY WORDS: Human waste; Recreation; Power boating; Waste facilities; Waste disposal; Pennsylvania

Hardware development process for Human Research facility applications

NASA Astrophysics Data System (ADS)

Bauer, Liz

2000-01-01

The simple goal of the Human Research Facility (HRF) is to conduct human research experiments on the International Space Station (ISS) astronauts during long-duration missions. This is accomplished by providing integration and operation of the necessary hardware and software capabilities. A typical hardware development flow consists of five stages: functional inputs and requirements definition, market research, design life cycle through hardware delivery, crew training, and mission support. The purpose of this presentation is to guide the audience through the early hardware development process: requirement definition through selecting a development path. Specific HRF equipment is used to illustrate the hardware development paths. .

Family Satisfaction With Nursing Home Care.

PubMed

Shippee, Tetyana P; Henning-Smith, Carrie; Gaugler, Joseph E; Held, Robert; Kane, Robert L

2017-03-01

This article explores the factor structure of a new family satisfaction with nursing home care instrument and determines the relationship of resident quality of life (QOL) and facility characteristics with family satisfaction. Data sources include (1) family satisfaction interviews ( n = 16,790 family members), (2) multidimensional survey of resident QOL ( n = 13,433 residents), and (3) facility characteristics ( n = 376 facilities). We used factor analysis to identify domains of family satisfaction and multivariate analyses to identify the role of facility-level characteristics and resident QOL on facility-mean values of family satisfaction. Four distinct domains were identified for family satisfaction: "care," "staff," "environment," and "food." Chain affiliation, higher resident acuity, more deficiencies, and large size were all associated with less family satisfaction, and resident QOL was a significant (albeit weak) predictor of family satisfaction. Results suggest that family member satisfaction is distinct from resident QOL but is associated with resident QOL and facility characteristics.

Family Satisfaction With Nursing Home Care: The Role of Facility Characteristics and Resident Quality-of-Life Scores

PubMed Central

Shippee, Tetyana P.; Henning-Smith, Carrie; Gaugler, Joseph E.; Held, Robert; Kane, Robert L.

2018-01-01

This article explores the factor structure of a new family satisfaction with nursing home care instrument and determines the relationship of resident quality of life (QOL) and facility characteristics with family satisfaction. Data sources include (1) family satisfaction interviews (n = 16,790 family members), (2) multidimensional survey of resident QOL (n = 13,433 residents), and (3) facility characteristics (n = 376 facilities). We used factor analysis to identify domains of family satisfaction and multivariate analyses to identify the role of facility-level characteristics and resident QOL on facility-mean values of family satisfaction. Four distinct domains were identified for family satisfaction: “care,” “staff,” “environment,” and “food.” Chain affiliation, higher resident acuity, more deficiencies, and large size were all associated with less family satisfaction, and resident QOL was a significant (albeit weak) predictor of family satisfaction. Results suggest that family member satisfaction is distinct from resident QOL but is associated with resident QOL and facility characteristics. PMID:26534835

Stakeholders’ perceptions on factors influencing male involvement in prevention of mother to child transmission of HIV services in Blantyre, Malawi

PubMed Central

2014-01-01

Background Male Involvement (MI) in the Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) services is essential in a patriarchal society where men are decision makers of the household. Male partners have a role in the woman’s risk of acquiring HIV, uptake of HIV testing and participation in Mother to Child Transmission (MTCT) prevention programmes. Although MI is important for uptake of PMTCT interventions, it remains low in Africa. The purpose of this study was to identify factors that promote and hinder MI in PMTCT services in antenatal care (ANC) services in Blantyre, Malawi. Understanding of the factors that influence MI will assist in developing strategies that will involve men more in the programme thereby improving the uptake of PMTCT and HIV testing and counselling services by women and men respectively. Methods An exploratory qualitative study was conducted from December 2012 to January 2013 at South Lunzu Health Centre (SLHC) in Blantyre, Malawi. It consisted of six face to face Key Informant Interviews (KIIs) with health care workers and four Focus Group discussions (FGDs) with 18 men and 17 pregnant women attending antenatal care at the clinic. The FGDs were divided according to sex and age. All FGDs and KIIs were digitally recorded and simultaneously transcribed and translated verbatim into English. Data were analysed using thematic content analysis. Results Participants in both FGDs and KIIs identified the following barriers: lack of knowledge of MI in PMTCT, socioeconomic factors, relationship issues, timidity to be seen in a woman’s domain, unplanned and or extramarital pregnancies, fear of knowing one's HIV status, unwillingness to be associated with the service, health facility based factors, peer influence and cultural factors. The factors that would potentially promote male involvement were categorized into community, health facility and personal or family level factors. Conclusions The factors that may hinder or promote MI arise from different sources. The success of MI lies on recognizing sources of barriers and averting them. Factors that promote MI need to be implemented at different levels of health care. PMID:24998152

Development of facile drug delivery platform of ranibizumab fabricated PLGA-PEGylated magnetic nanoparticles for age-related macular degeneration therapy.

PubMed

Yan, Jian; Peng, Xifeng; Cai, Yulian; Cong, Wendong

2018-06-01

The present anti-angiogenic therapies for neovascular age-related macular degeneration require effective drug delivery systems for transfer drug molecules. Ranibizumab is an active humanized monoclonal antibody that counteracts active forms of vascular endothelial growth factor A in the neovascular age-related macular degeneration therapy. The development of ranibizumab-related therapies, we have designed the effective drug career with engineered magnetic nanoparticles (Fe 3 O 4 ) as a facile platform of ranibizumab delivery for the treatment of neovascular age-related macular degeneration. Ranibizumab conjugated iron oxide (Fe 3 O 4 )/PEGylated poly lactide-co-glycolide (PEG-PLGA) was successfully designed and the synthesized materials are analyzed different analytical techniques. The microscopic techniques (Scanning Electron Microscopy (SEM) & Transmission Electron Microscopy (TEM)) are clearly displayed that spherical nanoparticles into the PEG-PLGA matrix and presence of elements and chemical interactions confirmed by the results of energy dispersive X-ray analysis (EDX) and Fourier trans-form infrared (FTIR) spectroscopic methods. The in vitro anti-angiogenic evaluation of Fe 3 O 4 /PEG-PLGA polymer nanomaterial efficiently inhibits the tube formation in the Matrigel-based assay method by using human umbilical vein endothelial cells. Ranibizumab treated Fe 3 O 4 /PEG-PLGA polymer nanomaterials not disturbed cell proliferation and the results could not display the any significant differences in human endothelial cells. The present investigated results describe that Fe 3 O 4 /PEG-PLGA polymer nanomaterials can be highly favorable and novel formulation for the treatment of neovascular age-related macular degeneration. Copyright © 2018 Elsevier B.V. All rights reserved.

Awards to academic institutions by the Department of Transportation in FY 1975

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

Megerian, G.K.; Whitfield, H.L.

1976-02-20

A comprehensive listing is given of contracts and grants awarded by the Department of Transportation to colleges and universities during fiscal year 1975. The awards are categorized into seven different schemes. Subject areas include (1) carpooling; (2) problems of the elderly and the handicapped; (3) energy; (4) environment; (5) facilities and services; (6) Federal Government role; (7) freight movement; (8) human factors; (9) land use planning; (10) management; (11) materials; (12) motorcycles; (13) noise; (14) personal rapid transit; (15) rural planning; (16) safety; (17) systems development; (18) taxicabs; (19) technology; (20) traffic control; (21) training; (22) tunneling; and (23) urbanmore » planning. (PMA)« less

A flight research program to develop airborne systems for improved terminal area operations

NASA Technical Reports Server (NTRS)

Reeder, J. P.

1974-01-01

The research program considered is concerned with the solution of operational problems for the approximate time period from 1980 to 2000. The problems are related to safety, weather effects, congestion, energy conservation, noise, atmospheric pollution, and the loss in productivity caused by delays, diversions, and schedule stretchouts. The terminal configured vehicle (TCV) program is to develop advanced flight-control capability. The various aspects of the TCV program are discussed, giving attention to avionics equipment, the piloted simulator, terminal-area environment simulation, the Wallops research facility, flight procedures, displays and human factors, flight activities, and questions of vortex-wake reduction and tracking.

Complementary Microorganisms in Highly Corrosive Biofilms from an Offshore Oil Production Facility.

PubMed

Vigneron, Adrien; Alsop, Eric B; Chambers, Brian; Lomans, Bartholomeus P; Head, Ian M; Tsesmetzis, Nicolas

2016-04-01

Offshore oil production facilities are frequently victims of internal piping corrosion, potentially leading to human and environmental risks and significant economic losses. Microbially influenced corrosion (MIC) is believed to be an important factor in this major problem for the petroleum industry. However, knowledge of the microbial communities and metabolic processes leading to corrosion is still limited. Therefore, the microbial communities from three anaerobic biofilms recovered from the inside of a steel pipe exhibiting high corrosion rates, iron oxide deposits, and substantial amounts of sulfur, which are characteristic of MIC, were analyzed in detail. Bacterial and archaeal community structures were investigated by automated ribosomal intergenic spacer analysis, multigenic (16S rRNA and functional genes) high-throughput Illumina MiSeq sequencing, and quantitative PCR analysis. The microbial community analysis indicated that bacteria, particularly Desulfovibrio species, dominated the biofilm microbial communities. However, other bacteria, such as Pelobacter, Pseudomonas, and Geotoga, as well as various methanogenic archaea, previously detected in oil facilities were also detected. The microbial taxa and functional genes identified suggested that the biofilm communities harbored the potential for a number of different but complementary metabolic processes and that MIC in oil facilities likely involves a range of microbial metabolisms such as sulfate, iron, and elemental sulfur reduction. Furthermore, extreme corrosion leading to leakage and exposure of the biofilms to the external environment modify the microbial community structure by promoting the growth of aerobic hydrocarbon-degrading organisms. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Routine habitat change: a source of unrecognized transient alteration of intestinal microbiota in laboratory mice.

PubMed

Ma, Betty W; Bokulich, Nicholas A; Castillo, Patricia A; Kananurak, Anchasa; Underwood, Mark A; Mills, David A; Bevins, Charles L

2012-01-01

The mammalian intestine harbors a vast, complex and dynamic microbial population, which has profound effects on host nutrition, intestinal function and immune response, as well as influence on physiology outside of the alimentary tract. Imbalance in the composition of the dense colonizing bacterial population can increase susceptibility to various acute and chronic diseases. Valuable insights on the association of the microbiota with disease critically depend on investigation of mouse models. Like in humans, the microbial community in the mouse intestine is relatively stable and resilient, yet can be influenced by environmental factors. An often-overlooked variable in research is basic animal husbandry, which can potentially alter mouse physiology and experimental outcomes. This study examined the effects of common husbandry practices, including food and bedding alterations, as well as facility and cage changes, on the gut microbiota over a short time course of five days using three culture-independent techniques, quantitative PCR, terminal restriction fragment length polymorphism (TRFLP) and next generation sequencing (NGS). This study detected a substantial transient alteration in microbiota after the common practice of a short cross-campus facility transfer, but found no comparable alterations in microbiota within 5 days of switches in common laboratory food or bedding, or following an isolated cage change in mice acclimated to their housing facility. Our results highlight the importance of an acclimation period following even simple transfer of mice between campus facilities, and highlights that occult changes in microbiota should be considered when imposing husbandry variables on laboratory animals.

Complementary Microorganisms in Highly Corrosive Biofilms from an Offshore Oil Production Facility

PubMed Central

Alsop, Eric B.; Chambers, Brian; Lomans, Bartholomeus P.; Head, Ian M.; Tsesmetzis, Nicolas

2016-01-01

Offshore oil production facilities are frequently victims of internal piping corrosion, potentially leading to human and environmental risks and significant economic losses. Microbially influenced corrosion (MIC) is believed to be an important factor in this major problem for the petroleum industry. However, knowledge of the microbial communities and metabolic processes leading to corrosion is still limited. Therefore, the microbial communities from three anaerobic biofilms recovered from the inside of a steel pipe exhibiting high corrosion rates, iron oxide deposits, and substantial amounts of sulfur, which are characteristic of MIC, were analyzed in detail. Bacterial and archaeal community structures were investigated by automated ribosomal intergenic spacer analysis, multigenic (16S rRNA and functional genes) high-throughput Illumina MiSeq sequencing, and quantitative PCR analysis. The microbial community analysis indicated that bacteria, particularly Desulfovibrio species, dominated the biofilm microbial communities. However, other bacteria, such as Pelobacter, Pseudomonas, and Geotoga, as well as various methanogenic archaea, previously detected in oil facilities were also detected. The microbial taxa and functional genes identified suggested that the biofilm communities harbored the potential for a number of different but complementary metabolic processes and that MIC in oil facilities likely involves a range of microbial metabolisms such as sulfate, iron, and elemental sulfur reduction. Furthermore, extreme corrosion leading to leakage and exposure of the biofilms to the external environment modify the microbial community structure by promoting the growth of aerobic hydrocarbon-degrading organisms. PMID:26896143

Does decentralisation of tuberculosis care influence treatment outcomes? The case of Oromia Region, Ethiopia

PubMed Central

Raya, J.; Workineh, T.; Klinkenberg, E.; Enquselassie, F.

2014-01-01

Setting: Oromia Region, Ethiopia. Objective: To investigate the effect of decentralised care on anti-tuberculosis treatment outcomes and identify factors affecting outcome among new smear-positive tuberculosis (TB) patients. Design: This was a retrospective cohort study comparing patients treated in the community during the continuation phase with those managed throughout treatment in health facilities. Data were collected from TB registers and patient cards using a pre-tested data capture form. Results: Of the 2226 new smear-positive TB patients registered from July 2010 to June 2012 who were included in the study, 1599 (72.6%) received treatment in health facilities, and the rest in the community. Overall treatment success was 94.7%. Patients treated in the community had comparable treatment success with those managed in health facilities (aOR 1.7, 95%CI 0.80–3.57). Missing doses (OR 0.22, 95%CI 0.08–0.55), supervision during the continuation phase (OR 2.6, 95%CI 1.34–5.05), positive sputum at month 2 (OR 0.07, 95%CI 0.04–0.13) and human immunodeficiency virus infection (OR 0.25, 95%CI 0.13–0.46) were independent predictors of treatment success. Conclusion: Overall treatment success is high in new smear-positive TB patients in Oromia. Patients receiving treatment in the community during the continuation phase have treatment success comparable with that of patients managed in health facilities. PMID:26478507

Factors associated with place of death in Addis Ababa, Ethiopia.

PubMed

Anteneh, Aderaw; Araya, Tekebash; Misganaw, Awoke

2013-03-26

Dying at home is highly prevalent in Africa partly due to lack of accessibility of modern health services. In turn, limited infrastructure and health care deliveries in Africa complicate access to health services. A weak infrastructure and limited health facilities with lower quality in Ethiopia resulted poor health service utilization and coverage, high morbidity and mortality rates. We examined whether people in Addis Ababa died in health facilities and investigated the basic factors associated with place of death. We used verbal autopsy data of 4,776 adults (age>14 years) for the years 2006-2010 from the Addis Ababa Mortality Surveillance Program (AAMSP). The main data source of AAMSP is the burial surveillance from all cemeteries in Addis Ababa. We provide descriptive statistics of place of adult deaths and discussed their covariates using multivariate analyses. Only 28.7% died at health facilities, while the remaining died out of health facilities. There was an increase trend in the proportion of health facility deaths from 25.3% in 2006 to 32.5% in 2010. The risk of health facility death versus out of health facility deaths decreased with age. Compared with those who had no education educated people were more likely to die at health facilities. The chance of in health facility death was a little higher for females than males while religion, occupational status and ethnicity of the deceased had no any significance difference in place of death. Both demographic and social factors determine where adults will die in Addis Ababa, Ethiopia. The majority of people in Addis Ababa died out of health facilities. The health system should also give special attention to the emerging non communicable diseases like cancer for effective treatment of patients.

Factors associated with place of death in Addis Ababa, Ethiopia

PubMed Central

2013-01-01

Background Dying at home is highly prevalent in Africa partly due to lack of accessibility of modern health services. In turn, limited infrastructure and health care deliveries in Africa complicate access to health services. A weak infrastructure and limited health facilities with lower quality in Ethiopia resulted poor health service utilization and coverage, high morbidity and mortality rates. We examined whether people in Addis Ababa died in health facilities and investigated the basic factors associated with place of death. Methods We used verbal autopsy data of 4,776 adults (age>14 years) for the years 2006–2010 from the Addis Ababa Mortality Surveillance Program (AAMSP). The main data source of AAMSP is the burial surveillance from all cemeteries in Addis Ababa. We provide descriptive statistics of place of adult deaths and discussed their covariates using multivariate analyses. Results Only 28.7% died at health facilities, while the remaining died out of health facilities. There was an increase trend in the proportion of health facility deaths from 25.3% in 2006 to 32.5% in 2010. The risk of health facility death versus out of health facility deaths decreased with age. Compared with those who had no education educated people were more likely to die at health facilities. The chance of in health facility death was a little higher for females than males while religion, occupational status and ethnicity of the deceased had no any significance difference in place of death. Conclusion Both demographic and social factors determine where adults will die in Addis Ababa, Ethiopia. The majority of people in Addis Ababa died out of health facilities. The health system should also give special attention to the emerging non communicable diseases like cancer for effective treatment of patients. PMID:23530478

A guideline for interpersonal capabilities enhancement to support sustainable facility management practice

NASA Astrophysics Data System (ADS)

Sarpin, Norliana; Kasim, Narimah; Zainal, Rozlin; Noh, Hamidun Mohd

2018-04-01

Facility management is the key phase in the development cycle of an assets and spans over a considerable length of time. Therefore, facility managers are in a commanding position to maximise the potential of sustainability through the development phases from construction, operation, maintenance and upgrade leading to decommission and deconstruction. Sustainability endeavours in facility management practices will contribute to reducing energy consumption, waste and running costs. Furthermore, it can also help in improving organisational productivity, financial return and community standing of the organisation. Facility manager should be empowered with the necessary knowledge and capabilities at the forefront facing sustainability challenge. However, literature studies show a gap between the level of awareness, specific knowledge and the necessary skills required to pursue sustainability in the facility management professional. People capability is considered as the key enabler in managing the sustainability agenda as well as being central to the improvement of competency and innovation in an organisation. This paper aims to develop a guidelines for interpersonal capabilities to support sustainability in facility management practice. Starting with a total of 7 critical interpersonal capabilities factors identified from previous questionnaire survey, the authors conducted an interview with 3 experts in facility management to assess the perceived importance of these factors. The findings reveal a set of guidelines for the enhancement of interpersonal capabilities among facility managers by providing what can be done to acquire these factors and how it can support the application of sustainability in their practice. The findings of this paper are expected to form the basis of a mechanism framework developed to equip facility managers with the right knowledge, to continue education and training and to develop new mind-sets to enhance the implementation of sustainability measures in FM practices.

A Multidisciplinary Paradigm and Approach to Protecting Human Health and the Environment, Society, and Stakeholders at Nuclear Facilities - 12244

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

Burger, Joanna; Environmental and Occupational Health Sciences Institute, Piscataway, NJ; Gochfeld, Michael

2012-07-01

As the Department of Energy (DOE) continues to remediate its lands, and to consider moving toward long-term stewardship and the development of energy parks on its industrial, remediated land, it is essential to adequately characterize the environment around such facilities to protect society, human health, and the environment. While DOE sites re considering several different land-use scenarios, all of them require adequate protection of the environment. Even if DOE lands are developed for energy parks that are mainly for industrializes sections of DOE lands that will not be remediated to residential standards, there is still the need to consider themore » protection of human health and the environment. We present an approach to characterization and establishment of teams that will gather the information, and integrate that information for a full range of stakeholders from technical personnel, to public policy makers, and that public. Such information is needed to establish baselines, site new energy facilities in energy parks, protect existing nuclear facilities and nuclear wastes, improve the basis for emergency planning, devise suitable monitoring schemes to ensure continued protection, provide data to track local and regional response changes, and for mitigation, remediation and decommissioning planning. We suggest that there are five categories of information or data needs, including 1) geophysical, sources, fate and transport, 2) biological systems, 3) human health, 4) stakeholder and environmental justice, and 5) societal, economic, and political. These informational needs are more expansive than the traditional site characterization, but encompass a suite of physical, biological, and societal needs to protect all aspects of human health and the environment, not just physical health. We suggest a Site Committee be established that oversees technical teams for each of the major informational categories, with appropriate representation among teams and with a broad involvement of a range of governmental personnel, natural and social scientists, Native Americans, environmental justice communities, and other stakeholders. Such informational teams (and Oversight Committee) would report to a DOE-designated authority or Citizen's Advisory Board. Although designed for nuclear facilities and energy parks on DOE lands, the templates and information teams can be adapted for other hazardous facilities, such as a mercury storage facility at Oak Ridge. (authors)« less

Factors associated with bat mortality at wind energy facilities in the United States

EPA Science Inventory

Hundreds of thousands of bats are killed annually by colliding with wind turbines in the U.S., yet little is known about factors causing variation in mortality across wind energy facilities. We conducted a quantitative synthesis of bat collision mortality with wind turbines by re...

State Medicaid Reimbursement for ICF-MR Facilities in the 1978-86 Period.

ERIC Educational Resources Information Center

Swan, James H.; And Others

1989-01-01

The survey of state Medicaid programs concerning reimbursement policies and per diem rates for private Intermediate Care Facilities for the Mentally Retarded for 1978-86 focused on: reimbursement methods; trends in reimbursement rates; and factors affecting reimbursement, including economic factors, reimbursement policies, eligibility policy, bed…

Mistreatment in Assisted Living Facilities: Complaints, Substantiations, and Risk Factors

ERIC Educational Resources Information Center

Phillips, Linda R.; Guo, Guifang

2011-01-01

Purpose of the Study: Use archived public data from Arizona to explore relationships among selected institutional and resident risk and situation-specific factors and complaints and substantiated allegations of various types of mistreatment in assisted living facilities (ALFs). Design and Methods: An exploratory/descriptive 2-group design was…

Health worker perspectives on the possible use of intramuscular artesunate for the treatment of severe malaria at lower-level health facilities in settings with poor access to referral facilities in Nigeria: a qualitative study.

PubMed

Adesoro, Olatunde; Shumba, Constance; Kpamor, John; Achan, Jane; Kivumbi, Harriet; Dada, John; Maxwell, Kolawole; Tibenderana, James; Marasciulo, Madeline; Hamade, Prudence; Oresanya, Olusola; Nankabirwa, Joanita; Baba, Ebenezer

2016-10-12

Innovative strategies are needed to reduce malaria mortality in high burden countries like Nigeria. Given that one of the important reasons for this high malaria mortality is delay in receiving effective treatment, improved access to such treatment is critical. Intramuscular artesunate could be used at lower-level facilities given its proven efficacy, ease of use and excellent safety profile. The objective of this study was therefore to explore health workers' perspectives on the possible use of intramuscular artesunate as definitive treatment for severe malaria at lower-level facilities, especially when access to referral facilities is challenging. The study was to provide insight as a formative step into the conduct of future experimental studies to ascertain the feasibility of the use of intramuscular artesunate for definitive treatment of severe malaria in lower level facilities where access to referral care is limited. This qualitative study was done across three southern States in Nigeria (Oyo, Cross River and Enugu). Key informant interviews were conducted over a period of three months between October and December 2014 among 90 purposively selected health workers with different roles in malaria case management from primary care to policy level. A thematic content analysis was used to analyse data. Overall, most of health workers and other key informant groups thought that the use of intramuscular artesunate for definitive treatment of severe malaria at lower-level facilities was possible. They however reported human resource and infrastructure constraints as factors affecting the feasibility of intramuscular artesunate use as definitive treatment for severe malaria in lower-level facilities.. Specifically identified barriers included limited numbers of skilled health workers available to manage potential complications of severe malaria and poorly equipped facilities for supportive treatment. Intramuscular artesunate was considered easy to administer and the proximity of lower-level facilities to communities was deemed important in considering the possibility of its use at lower-level facilities. Health workers also emphasised the important role of operational research to provide additional evidence to guide the implementation of existing policy recommendations and inform future policy revisions. From the perspective of health workers, use of intramuscular artesunate for definitive treatment of severe malaria at lower-level health facilities in Nigeria is possible but dependent on availability of skilled workers, well-equipped lower-level facilities to provide supportive treatment There is need for further operational research to establish feasibility and guide the implementation of such an intervention.

Adaptive design lessons from professional architects

NASA Astrophysics Data System (ADS)

Geiger, Ray W.; Snell, J. T.

1993-09-01

Psychocybernetic systems engineering design conceptualization is mimicking the evolutionary path of habitable environmental design and the professional practice of building architecture, construction, and facilities management. In pursuing better ways to design cellular automata and qualification classifiers in a design process, we have found surprising success in exploring certain more esoteric approaches, e.g., the vision of interdisciplinary artistic discovery in and around creative problem solving. Our evaluation in research into vision and hybrid sensory systems associated with environmental design and human factors has led us to discover very specific connections between the human spirit and quality design. We would like to share those very qualitative and quantitative parameters of engineering design, particularly as it relates to multi-faceted and future oriented design practice. Discussion covers areas of case- based techniques of cognitive ergonomics, natural modeling sources, and an open architectural process of means/goal satisfaction, qualified by natural repetition, gradation, rhythm, contrast, balance, and integrity of process.

NASA HRP Plans for Collaboration at the IBMP Ground-Based Experimental Facility (NEK)

NASA Technical Reports Server (NTRS)

Cromwell, Ronita L.

2016-01-01

NASA and IBMP are planning research collaborations using the IBMP Ground-based Experimental Facility (NEK). The NEK offers unique capabilities to study the effects of isolation on behavioral health and performance as it relates to spaceflight. The NEK is comprised of multiple interconnected modules that range in size from 50-250m(sup3). Modules can be included or excluded in a given mission allowing for flexibility of platform design. The NEK complex includes a Mission Control Center for communications and monitoring of crew members. In an effort to begin these collaborations, a 2-week mission is planned for 2017. In this mission, scientific studies will be conducted to assess facility capabilities in preparation for longer duration missions. A second follow-on 2-week mission may be planned for early in 2018. In future years, long duration missions of 4, 8 and 12 months are being considered. Missions will include scenarios that simulate for example, transit to and from asteroids, the moon, or other interplanetary travel. Mission operations will be structured to include stressors such as, high workloads, communication delays, and sleep deprivation. Studies completed at the NEK will support International Space Station expeditions, and future exploration missions. Topics studied will include communication, crew autonomy, cultural diversity, human factors, and medical capabilities.

Ultra violet disinfection: A 3-year history

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

Tubesing, R.R.; Lindeke, D.R.

1998-07-01

The Stillwater Wastewater Treatment Facility is one of nine wastewater treatment facilities operated by the Metropolitan Council Environmental Services in the Minneapolis-St. Paul Metropolitan Area. The facility services the cities of Stillwater, Oak Park Heights, and Bayport. In 1993, an ultra violet disinfection facility began operation to provide the disinfection for the Facility. This presentation discusses the reasons for using ultra violet disinfection in lieu of chlorination/dechlorination facilities, the operating performance, and operating cost factors.

Factors Associated With Pupil Toilet Use in Kenyan Primary Schools

PubMed Central

Garn, Joshua V.; Caruso, Bethany A.; Drews-Botsch, Carolyn D.; Kramer, Michael R.; Brumback, Babette A.; Rheingans, Richard D.; Freeman, Matthew C.

2014-01-01

The purpose of this study was to quantify how school sanitation conditions are associated with pupils’ use of sanitation facilities. We conducted a longitudinal assessment in 60 primary schools in Nyanza Province, Kenya, using structured observations to measure facility conditions and pupils’ use at specific facilities. We used multivariable mixed regression models to characterize how pupil to toilet ratio was associated with toilet use at the school-level and also how facility conditions were associated with pupils’ use at specific facilities. We found a piecewise linear relationship between decreasing pupil to toilet ratio and increasing pupil toilet use (p < 0.01). Our data also revealed significant associations between toilet use and newer facility age (p < 0.01), facility type (p < 0.01), and the number of toilets in a facility (p < 0.01). We found some evidence suggesting facility dirtiness may deter girls from use (p = 0.06), but not boys (p = 0.98). Our study is the first to rigorously quantify many of these relationships, and provides insight into the complexity of factors affecting pupil toilet use patterns, potentially leading to a better allocation of resources for school sanitation, and to improved health and educational outcomes for children. PMID:25233014

Factors associated with pupil toilet use in kenyan primary schools.

PubMed

Garn, Joshua V; Caruso, Bethany A; Drews-Botsch, Carolyn D; Kramer, Michael R; Brumback, Babette A; Rheingans, Richard D; Freeman, Matthew C

2014-09-17

The purpose of this study was to quantify how school sanitation conditions are associated with pupils' use of sanitation facilities. We conducted a longitudinal assessment in 60 primary schools in Nyanza Province, Kenya, using structured observations to measure facility conditions and pupils' use at specific facilities. We used multivariable mixed regression models to characterize how pupil to toilet ratio was associated with toilet use at the school-level and also how facility conditions were associated with pupils' use at specific facilities. We found a piecewise linear relationship between decreasing pupil to toilet ratio and increasing pupil toilet use (p < 0.01). Our data also revealed significant associations between toilet use and newer facility age (p < 0.01), facility type (p < 0.01), and the number of toilets in a facility (p < 0.01). We found some evidence suggesting facility dirtiness may deter girls from use (p = 0.06), but not boys (p = 0.98). Our study is the first to rigorously quantify many of these relationships, and provides insight into the complexity of factors affecting pupil toilet use patterns, potentially leading to a better allocation of resources for school sanitation, and to improved health and educational outcomes for children.

Innovation characteristics and intention to adopt sustainable facilities management practices.

PubMed

Lee, So Young; Kang, Mihyun

2013-01-01

Sustainable facilities management (SFM) is important because typical buildings consume more resources and energy than necessary, negatively impact the environment and generate lots of waste (US Department of Energy, 2003, Green Buildings). This study examined innovation characteristics that relate to facility managers' intention to adopt SFM practices. Based on the diffusion of innovations theory (Rogers 1962, 1995, Diffusion of Innovations. 4th ed. New York: The Free Press), an SFM innovation and adoption model was proposed. A survey was conducted with a convenience sample of 240 public facilities managers in 25 facilities management divisions in Seoul, Korea, and its metropolitan areas. Structural equation modelling was employed to analyse the data. The results showed that economic advantage and human comfort aspects are predictors for the intention of SFM adoption. Observability is positively relevant to the intention of SFM adoption. Complexity, however, is not a significant predictor for the intention of SFM adoption. Practical implications for sustainable products and systems and the built environment are suggested. To incorporate an innovation like sustainable practices, it is required to meet the needs of potential adopters. Innovation characteristics that influence facility managers' intention to adopt sustainable facilities management were examined. A survey was conducted. Economic advantage, human comfort and observability are predictors for the intention of adoption of sustainable practice.

The influence of facility design and human resource management on health care professionals.

PubMed

Sadatsafavi, Hessam; Walewski, John; Shepley, Mardelle M

2015-01-01

Cost control of health care services is a strategic concern for organizations. To lower costs, some organizations reduce staffing levels. However, this may not be worth the trade-off, as the quality of services will likely be reduced, morale among health care providers tends to suffer, and patient satisfaction is likely to decline. The potential synergy between human resource management and facility design and operation was investigated to achieve the goal of providing cost containment strategies without sacrificing the quality of services and the commitment of employees. About 700 health care professionals from 10 acute-care hospitals participated in this cross-sectional study. The authors used structural equation modeling to test whether employees' evaluations of their physical work environment and human resource practices were significantly associated with lower job-related anxiety, higher job satisfaction, and higher organizational commitment. The analysis found that employees' evaluations of their physical work environment and human resource practices influenced their job-related feelings and attitudes. Perceived organizational support mediated this relationship. The study also found a small but positive interaction effect between the physical work environment and human resource practices. The influence of physical work environment was small, mainly because of the high predictive value of human resource practices and strong confounding variables included in the analysis. This study specifically showed the role of facility design in reducing job-related anxiety among caregivers. Preliminary evidence is provided that facility design can be used as a managerial tool for improving job-related attitudes and feelings of employees and earning their commitment. Providing a healthy and safe work environment can be perceived by employees as an indication that the organization respects them and cares about their well-being, which might be reciprocated with higher levels of motivation and commitment toward the organization.

Multilateral Research Opportunities in Ground Analogs

NASA Technical Reports Server (NTRS)

Corbin, Barbara J.

2015-01-01

The global economy forces many nations to consider their national investments and make difficult decisions regarding their investment in future exploration. International collaboration provides an opportunity to leverage other nations' investments to meet common goals. The Humans In Space Community shares a common goal to enable safe, reliable, and productive human space exploration within and beyond Low Earth Orbit. Meeting this goal requires efficient use of limited resources and International capabilities. The International Space Station (ISS) is our primary platform to conduct microgravity research targeted at reducing human health and performance risks for exploration missions. Access to ISS resources, however, is becoming more and more constrained and will only be available through 2020 or 2024. NASA's Human Research Program (HRP) is actively pursuing methods to effectively utilize the ISS and appropriate ground analogs to understand and mitigate human health and performance risks prior to embarking on human exploration of deep space destinations. HRP developed a plan to use ground analogs of increasing fidelity to address questions related to exploration missions and is inviting International participation in these planned campaigns. Using established working groups and multilateral panels, the HRP is working with multiple Space Agencies to invite International participation in a series of 30- day missions that HRP will conduct in the US owned and operated Human Exploration Research Analog (HERA) during 2016. In addition, the HRP is negotiating access to Antarctic stations (both US and non-US), the German :envihab and Russian NEK facilities. These facilities provide unique capabilities to address critical research questions requiring longer duration simulation or isolation. We are negotiating release of international research opportunities to ensure a multilateral approach to future analog research campaigns, hoping to begin multilateral campaigns in the latter facilities by 2017. Collaborative use of analog facilities and shared investment in the development of spaceflight countermeasures through multilateral campaigns or missions that leverage the global scientific community will focus high quality research and provide sufficient power to accelerate the development of countermeasures and drive sound recommendations for exploration missions. This panel will provide an overview of efforts to encourage and facilitate multilateral collaboration in analog missions or campaigns and describe the facilities currently under consideration to reach the common goal of enabling safe, reliable, and productive human space exploration.

APPA: Association of Higher Education Facilities Officers Educational Conference and Annual Meeting Proceedings (82nd, Philadelphia, Pennsylvania, July 16-18, 1995).

ERIC Educational Resources Information Center

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

The 23 papers presented in this Proceedings are grouped into four categories: business management; facilities planning, design, and construction; human resource management; and energy and environment. Papers are: (1) "A Business Approach to the Facility Function" (Alan B. Abramson); (2) "Management by Strategic Planning" (Jerry C. Black); (3)…

Why Are Women Dying When They Reach Hospital on Time? A Systematic Review of the ‘Third Delay’

PubMed Central

Knight, Hannah E.; Self, Alice; Kennedy, Stephen H.

2013-01-01

Background The ‘three delays model’ attempts to explain delays in women accessing emergency obstetric care as the result of: 1) decision-making, 2) accessing services and 3) receipt of appropriate care once a health facility is reached. The third delay, although under-researched, is likely to be a source of considerable inequity in access to emergency obstetric care in developing countries. The aim of this systematic review was to identify and categorise specific facility-level barriers to the provision of evidence-based maternal health care in developing countries. Methods and Findings Five electronic databases were systematically searched using a 4-way strategy that combined search terms related to: 1) maternal health care; 2) maternity units; 3) barriers, and 4) developing countries. Forty-three original research articles were eligible to be included in the review. Thirty-two barriers to the receipt of timely and appropriate obstetric care at the facility level were identified and categorised into six emerging themes (Drugs and equipment; Policy and guidelines; Human resources; Facility infrastructure; Patient-related and Referral-related). Two investigators independently recorded the frequency with which barriers relating to the third delay were reported in the literature. The most commonly cited barriers were inadequate training/skills mix (86%); drug procurement/logistics problems (65%); staff shortages (60%); lack of equipment (51%) and low staff motivation (44%). Conclusions This review highlights how a focus on patient-side delays in the decision to seek care can conceal the fact that many health facilities in the developing world are still chronically under-resourced and unable to cope effectively with serious obstetric complications. We stress the importance of addressing supply-side barriers alongside demand-side factors if further reductions in maternal mortality are to be achieved. PMID:23704943

Association of Antibiotic Resistance in Agricultural Escherichia coli Isolates with Attachment to Quartz▿

PubMed Central

Liu, Ping; Soupir, Michelle L.; Zwonitzer, Martha; Huss, Bridgette; Jarboe, Laura R.

2011-01-01

Surface water can be contaminated by bacteria from various sources, including manure from agricultural facilities. Attachment of these bacteria to soil and organic particles contributes to their transport through the environment, though the mechanism of attachment is unknown. As bacterial attachment to human tissues is known to be correlated with antibiotic resistance, we have investigated here the relationship between bacterial attachment to environmental particles and antibiotic resistance in agricultural isolates. We evaluated 203 Escherichia coli isolates collected from swine facilities for attachment to quartz, resistance to 13 antibiotics, and the presence of genes encoding 13 attachment factors. The genes encoding type I, EcpA, P pili, and Ag43 were detected, though none was significantly related to attachment. Quartz attachment was positively and significantly (P < 0.0038) related to combined resistance to amoxicillin/streptomycin/tetracycline/sulfamethazine/tylosin/chlortetracycline and negatively and significantly (P < 0.0038) related to combined resistance to nalidixic acid/kanamycin/neomycin. These results provide clear evidence for a link between antibiotic resistance and attachment to quartz in agricultural isolates. We propose that this may be due to encoding by the responsible genes on a mobile genetic element. Further exploration of the relationship between antibiotic resistance and attachment to environmental particles will improve the understanding and modeling of environmental transport processes, with the goal of preventing human exposure to antibiotic-resistant or virulent microorganisms. PMID:21821756

Association of antibiotic resistance in agricultural Escherichia coli isolates with attachment to quartz.

PubMed

Liu, Ping; Soupir, Michelle L; Zwonitzer, Martha; Huss, Bridgette; Jarboe, Laura R

2011-10-01

Surface water can be contaminated by bacteria from various sources, including manure from agricultural facilities. Attachment of these bacteria to soil and organic particles contributes to their transport through the environment, though the mechanism of attachment is unknown. As bacterial attachment to human tissues is known to be correlated with antibiotic resistance, we have investigated here the relationship between bacterial attachment to environmental particles and antibiotic resistance in agricultural isolates. We evaluated 203 Escherichia coli isolates collected from swine facilities for attachment to quartz, resistance to 13 antibiotics, and the presence of genes encoding 13 attachment factors. The genes encoding type I, EcpA, P pili, and Ag43 were detected, though none was significantly related to attachment. Quartz attachment was positively and significantly (P < 0.0038) related to combined resistance to amoxicillin/streptomycin/tetracycline/sulfamethazine/tylosin/chlortetracycline and negatively and significantly (P < 0.0038) related to combined resistance to nalidixic acid/kanamycin/neomycin. These results provide clear evidence for a link between antibiotic resistance and attachment to quartz in agricultural isolates. We propose that this may be due to encoding by the responsible genes on a mobile genetic element. Further exploration of the relationship between antibiotic resistance and attachment to environmental particles will improve the understanding and modeling of environmental transport processes, with the goal of preventing human exposure to antibiotic-resistant or virulent microorganisms.

Factors influencing antibiotic prescribing in long-term care facilities: a qualitative in-depth study.

PubMed

van Buul, Laura W; van der Steen, Jenny T; Doncker, Sarah M M M; Achterberg, Wilco P; Schellevis, François G; Veenhuizen, Ruth B; Hertogh, Cees M P M

2014-12-16

Insight into factors that influence antibiotic prescribing is crucial when developing interventions aimed at a more rational use of antibiotics. We examined factors that influence antibiotic prescribing in long-term care facilities, and present a conceptual model that integrates these factors. Semi-structured qualitative interviews were conducted with physicians (n = 13) and nursing staff (n = 13) in five nursing homes and two residential care homes in the central-west region of the Netherlands. An iterative analysis was applied to interviews with physicians to identify and categorize factors that influence antibiotic prescribing, and to integrate these into a conceptual model. This conceptual model was triangulated with the perspectives of nursing staff. The analysis resulted in the identification of six categories of factors that can influence the antibiotic prescribing decision: the clinical situation, advance care plans, utilization of diagnostic resources, physicians' perceived risks, influence of others, and influence of the environment. Each category comprises several factors that may influence the decision to prescribe or not prescribe antibiotics directly (e.g. pressure of patients' family leading to antibiotic prescribing) or indirectly via influence on other factors (e.g. unfamiliarity with patients resulting in a higher physician perceived risk of non-treatment, in turn resulting in a higher tendency to prescribe antibiotics). Our interview study shows that several non-rational factors may affect antibiotic prescribing decision making in long-term care facilities, suggesting opportunities to reduce inappropriate antibiotic use. We developed a conceptual model that integrates the identified categories of influencing factors and shows the relationships between those categories. This model may be used as a practical tool in long-term care facilities to identify local factors potentially leading to inappropriate prescribing, and to subsequently intervene at the level of those factors to promote appropriate antibiotic prescribing.

Profile of hepatitis B and C virus infection in prisoners in Lubuk Pakam correctional facilities

NASA Astrophysics Data System (ADS)

Rey, I.; Saragih, R. H.; Effendi-YS, R.; Sembiring, J.; Siregar, G. A.; Zain, L. H.

2018-03-01

Prisoners in correctional facilities are predisposed to chronic viral infections because of their high-risk behaviors or unsafe lifestyle. The economic and public health burden of chronic hepatitis B and C and its sequelae need to be addressed, such as by finding the risk factors and therefore reducing the spread of HCV and HBV infection in prisons. This study aimed to see the profile of Hepatitis B and C Virus Infection in prisoners in Lubuk Pakam Correctional Facilities. This cross-sectional study was in Lubuk Pakam Correctional Facilities in 2016. From 1114 prisoners in Lubuk Pakam correctional facility, we randomly examined 120 prisoners for HBV and HCV serology markers. From 120 prisoners, six prisoners were HBV positive, 21 prisoners were HCV positive and one prisoner positive for both HCV and HBV infection. The most common risk factors for prisoners getting HBV infection are tattoos and free sex (36.4% and 36.4%, respectively). The most common risk factors for HCV infection in prisoners are tattoos and free sex (40% and 35%, respectively).

Numerical Facilities: A Review of the Literature. Technical Report 1985-3.

ERIC Educational Resources Information Center

Tal, Joseph S.

This review of the relevant literature in the area of numerical facility attempts to clarify the construct of numerical facility and provide guidance for items tapping this ability. The review is presented in five parts. The first section introduces two approaches that can be used to investigate numerical facility, including factor analysis.…

Self-adapted and tunable graphene strain sensors for detecting both subtle and large human motions.

PubMed

Tao, Lu-Qi; Wang, Dan-Yang; Tian, He; Ju, Zhen-Yi; Liu, Ying; Pang, Yu; Chen, Yuan-Quan; Yang, Yi; Ren, Tian-Ling

2017-06-22

Conventional strain sensors rarely have both a high gauge factor and a large strain range simultaneously, so they can only be used in specific situations where only a high sensitivity or a large strain range is required. However, for detecting human motions that include both subtle and large motions, these strain sensors can't meet the diverse demands simultaneously. Here, we come up with laser patterned graphene strain sensors with self-adapted and tunable performance for the first time. A series of strain sensors with either an ultrahigh gauge factor or a preferable strain range can be fabricated simultaneously via one-step laser patterning, and are suitable for detecting all human motions. The strain sensors have a GF of up to 457 with a strain range of 35%, or have a strain range of up to 100% with a GF of 268. Most importantly, the performance of the strain sensors can be easily tuned by adjusting the patterns of the graphene, so that the sensors can meet diverse demands in both subtle and large motion situations. The graphene strain sensors show significant potential in applications such as wearable electronics, health monitoring and intelligent robots. Furthermore, the facile, fast and low-cost fabrication method will make them possible and practical to be used for commercial applications in the future.

WTEC monograph on instrumentation, control and safety systems of Canadian nuclear facilities

NASA Technical Reports Server (NTRS)

Uhrig, Robert E.; Carter, Richard J.

1993-01-01

This report updates a 1989-90 survey of advanced instrumentation and controls (I&C) technologies and associated human factors issues in the U.S. and Canadian nuclear industries carried out by a team from Oak Ridge National Laboratory (Carter and Uhrig 1990). The authors found that the most advanced I&C systems are in the Canadian CANDU plants, where the newest plant (Darlington) has digital systems in almost 100 percent of its control systems and in over 70 percent of its plant protection system. Increased emphasis on human factors and cognitive science in modern control rooms has resulted in a reduced workload for the operators and the elimination of many human errors. Automation implemented through digital instrumentation and control is effectively changing the role of the operator to that of a systems manager. The hypothesis that properly introducing digital systems increases safety is supported by the Canadian experience. The performance of these digital systems has been achieved using appropriate quality assurance programs for both hardware and software development. Recent regulatory authority review of the development of safety-critical software has resulted in the creation of isolated software modules with well defined interfaces and more formal structure in the software generation. The ability of digital systems to detect impending failures and initiate a fail-safe action is a significant safety issue that should be of special interest to nuclear utilities and regulatory authorities around the world.

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

PubMed

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

2018-01-01

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

Crew Factors in Flight Operations XII: A Survey of Sleep Quantity and Quality in On-Board Crew Rest Facilities

NASA Technical Reports Server (NTRS)

Rosekind, Mark R.; Gregory, Kevin B.; Co, Elizabeth L.; Miller, Donna L.; Dinges, David F.

2000-01-01

Many aircraft operated on long-haul commercial airline flights are equipped with on-board crew rest facilities, or bunks, to allow crewmembers to rest during the flight. The primary objectives of this study were to gather data on how the bunks were used, the quantity and quality of sleep obtained by flight crewmembers in the facilities, and the factors that affected their sleep. A retrospective survey comprising 54 questions of varied format addressed demographics, home sleep habits, and bunk sleep habits. Crewmembers from three airlines with long-haul fleets carrying augmented crews consisting of B747-100/200, B747-400, and MD-11 aircraft equipped with bunks returned a total of 1404 completed surveys (a 37% response rate). Crewmembers from the three carriers were comparable demographically, although one carrier had older, more experienced flight crewmembers. Each group, on average, rated themselves as "good" or "very good" sleepers at home, and all groups obtained about the same average amount of sleep each night. Most were able to sleep in the bunks, and about two thirds indicated that these rest opportunities benefited their subsequent flight deck alertness and performance. Comfort, environment, and physiology (e.g., being ready for sleep) were identified as factors that most promoted sleep. Factors cited as interfering with sleep included random noise, thoughts, heat, and the need to use the bathroom. These factors, in turn, suggest potential improvements to bunk facilities and their use. Ratings of the three aircraft types suggested differences among facilities. Bunks in the MD-11 were rated significantly better than either of the B747 types, and the B747-400 bunks received better ratings than did the older, B747-100/200 facilities.

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

PubMed

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

2013-07-05

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

A survey of diabetes prevalence in zoo-housed primates.

PubMed

Kuhar, C W; Fuller, G A; Dennis, P M

2013-01-01

In humans, type II diabetes mellitus is a condition in which the pancreas is capable of producing insulin but cells do not appropriately respond to insulin with an uptake of glucose. While multiple factors are associated with type II diabetes in humans, a high calorie diet and limited exercise are significant risk factors for the development of this disease. Zoo primates, with relatively high caloric density diets and sedentary lifestyles, may experience similar conditions that could predispose them to the development of diabetes. We surveyed all Association of Zoos and Aquariums (AZA) facilities with primates in their collections to determine the prevalence of diabetes, diagnosis and treatment methods, and treatment outcomes. Nearly 30% of responding institutions reported at least one diabetic primate in their current collection. Although the majority of reported cases were in Old World Monkeys (51%), all major taxonomic groups were represented. Females represented nearly 80% of the diagnosed cases. A wide variety of diagnosing, monitoring, and treatment techniques were reported. It is clear from these results diabetes should be considered prominently in decisions relating to diet, weight and activity levels in zoo-housed primates, as well as discussions surrounding animal health and welfare. © 2012 Wiley Periodicals, Inc.

Segmental Versican Expression in the Trabecular Meshwork and Involvement in Outflow Facility

PubMed Central

Keller, Kate E.; Bradley, John M.; Vranka, Janice A.

2011-01-01

Purpose. Versican is a large proteoglycan with numerous chondroitin sulfate (CS) glycosaminoglycan (GAG) side chains attached. To assess versican's potential contributions to aqueous humor outflow resistance, its segmental distribution in the trabecular meshwork (TM) and the effect on outflow facility of silencing the versican gene were evaluated. Methods. Fluorescent quantum dots (Qdots) were perfused to label outflow pathways of anterior segments. Immunofluorescence with confocal microscopy and quantitative RT-PCR were used to determine versican protein and mRNA distribution relative to Qdot-labeled regions. Lentiviral delivery of shRNA-silencing cassettes to TM cells in perfused anterior segment cultures was used to evaluate the involvement of versican and CS GAG chains in outflow facility. Results. Qdot uptake by TM cells showed considerable segmental variability in both human and porcine outflow pathways. Regional levels of Qdot labeling were inversely related to versican protein and mRNA levels; versican levels were relatively high in sparsely Qdot-labeled regions and low in densely labeled regions. Versican silencing decreased outflow facility in human and increased facility in porcine anterior segments. However, RNAi silencing of ChGn, an enzyme unique to CS GAG biosynthesis, increased outflow facility in both species. The fibrillar pattern of versican immunostaining in the TM juxtacanalicular region was disrupted after versican silencing in perfusion culture. Conclusions. Versican appears to be a central component of the outflow resistance, where it may organize GAGs and other ECM components to facilitate and control open flow channels in the TM. However, the exact molecular organization of this resistance appears to differ between human and porcine eyes. PMID:21596823

Human Research Initiative (HRI)

NASA Technical Reports Server (NTRS)

Motil, Brian

2003-01-01

A code U initiative starting in the FY04 budget includes specific funding for 'Phase Change' and 'Multiphase Flow Research' on the ISS. NASA GRC developed a concept for two facilities based on funding/schedule constraints: 1) Two Phase Flow Facility (TphiFFy) which assumes integrating into FIR; 2) Contact Line Dynamics Experiment Facility (CLiDE) which assumes integration into MSG. Each facility will accommodate multiple experiments conducted by NRA selected PIs with an overall goal of enabling specific NASA strategic objectives. There may also be a significant ground-based component.

Designing Facilities for Collaborative Operations

NASA Technical Reports Server (NTRS)

Norris, Jeffrey; Powell, Mark; Backes, Paul; Steinke, Robert; Tso, Kam; Wales, Roxana

2003-01-01

A methodology for designing operational facilities for collaboration by multiple experts has begun to take shape as an outgrowth of a project to design such facilities for scientific operations of the planned 2003 Mars Exploration Rover (MER) mission. The methodology could also be applicable to the design of military "situation rooms" and other facilities for terrestrial missions. It was recognized in this project that modern mission operations depend heavily upon the collaborative use of computers. It was further recognized that tests have shown that layout of a facility exerts a dramatic effect on the efficiency and endurance of the operations staff. The facility designs (for example, see figure) and the methodology developed during the project reflect this recognition. One element of the methodology is a metric, called effective capacity, that was created for use in evaluating proposed MER operational facilities and may also be useful for evaluating other collaboration spaces, including meeting rooms and military situation rooms. The effective capacity of a facility is defined as the number of people in the facility who can be meaningfully engaged in its operations. A person is considered to be meaningfully engaged if the person can (1) see, hear, and communicate with everyone else present; (2) see the material under discussion (typically data on a piece of paper, computer monitor, or projection screen); and (3) provide input to the product under development by the group. The effective capacity of a facility is less than the number of people that can physically fit in the facility. For example, a typical office that contains a desktop computer has an effective capacity of .4, while a small conference room that contains a projection screen has an effective capacity of around 10. Little or no benefit would be derived from allowing the number of persons in an operational facility to exceed its effective capacity: At best, the operations staff would be underutilized; at worst, operational performance would deteriorate. Elements of this methodology were applied to the design of three operations facilities for a series of rover field tests. These tests were observed by human-factors researchers and their conclusions are being used to refine and extend the methodology to be used in the final design of the MER operations facility. Further work is underway to evaluate the use of personal digital assistant (PDA) units as portable input interfaces and communication devices in future mission operations facilities. A PDA equipped for wireless communication and Ethernet, Bluetooth, or another networking technology would cost less than a complete computer system, and would enable a collaborator to communicate electronically with computers and with other collaborators while moving freely within the virtual environment created by a shared immersive graphical display.

Odor and chemical emissions from dairy and swine facilities: Part 1 - project overview and collection methods

USDA-ARS?s Scientific Manuscript database

Livestock facilities have received numerous criticisms due to their emissions of odorous air and chemicals. Hence, there is a significant need for odor emission factors and identification of principle odorous chemicals. Odor emission factors are used as inputs to odor setback models, while chemica...

78 FR 26879 - Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-08

...: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Proposed rule. SUMMARY: This proposed rule..., especially the teaching status adjustment factor. Therefore, we implemented a 3-year moving average approach... moving average to calculate the facility-level adjustment factors. For FY 2011, we issued a notice to...

Analysis Supporting Factors and Constraints LPMP Performance in Improving the Quality of Education in Jambi Province

ERIC Educational Resources Information Center

Rosadi, Kemas Imron

2015-01-01

Development of education in Indonesia is based on three aspects, namely equity and expansion, quality and relevance, as well as good governance. Quality education is influenced by several factors related to quality education managerial leaders, limited funds, facilities, educational facilities, media, learning resources, tools and training…

Science Based Human Reliability Analysis: Using Digital Nuclear Power Plant Simulators for Human Reliability Research

NASA Astrophysics Data System (ADS)

Shirley, Rachel Elizabeth

Nuclear power plant (NPP) simulators are proliferating in academic research institutions and national laboratories in response to the availability of affordable, digital simulator platforms. Accompanying the new research facilities is a renewed interest in using data collected in NPP simulators for Human Reliability Analysis (HRA) research. An experiment conducted in The Ohio State University (OSU) NPP Simulator Facility develops data collection methods and analytical tools to improve use of simulator data in HRA. In the pilot experiment, student operators respond to design basis accidents in the OSU NPP Simulator Facility. Thirty-three undergraduate and graduate engineering students participated in the research. Following each accident scenario, student operators completed a survey about perceived simulator biases and watched a video of the scenario. During the video, they periodically recorded their perceived strength of significant Performance Shaping Factors (PSFs) such as Stress. This dissertation reviews three aspects of simulator-based research using the data collected in the OSU NPP Simulator Facility: First, a qualitative comparison of student operator performance to computer simulations of expected operator performance generated by the Information Decision Action Crew (IDAC) HRA method. Areas of comparison include procedure steps, timing of operator actions, and PSFs. Second, development of a quantitative model of the simulator bias introduced by the simulator environment. Two types of bias are defined: Environmental Bias and Motivational Bias. This research examines Motivational Bias--that is, the effect of the simulator environment on an operator's motivations, goals, and priorities. A bias causal map is introduced to model motivational bias interactions in the OSU experiment. Data collected in the OSU NPP Simulator Facility are analyzed using Structural Equation Modeling (SEM). Data include crew characteristics, operator surveys, and time to recognize and diagnose the accident in the scenario. These models estimate how the effects of the scenario conditions are mediated by simulator bias, and demonstrate how to quantify the strength of the simulator bias. Third, development of a quantitative model of subjective PSFs based on objective data (plant parameters, alarms, etc.) and PSF values reported by student operators. The objective PSF model is based on the PSF network in the IDAC HRA method. The final model is a mixed effects Bayesian hierarchical linear regression model. The subjective PSF model includes three factors: The Environmental PSF, the simulator Bias, and the Context. The Environmental Bias is mediated by an operator sensitivity coefficient that captures the variation in operator reactions to plant conditions. The data collected in the pilot experiments are not expected to reflect professional NPP operator performance, because the students are still novice operators. However, the models used in this research and the methods developed to analyze them demonstrate how to consider simulator bias in experiment design and how to use simulator data to enhance the technical basis of a complex HRA method. The contributions of the research include a framework for discussing simulator bias, a quantitative method for estimating simulator bias, a method for obtaining operator-reported PSF values, and a quantitative method for incorporating the variability in operator perception into PSF models. The research demonstrates applications of Structural Equation Modeling and hierarchical Bayesian linear regression models in HRA. Finally, the research demonstrates the benefits of using student operators as a test platform for HRA research.

45 CFR 1309.52 - Procurement procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM HEAD START FACILITIES PURCHASE, MAJOR RENOVATION AND CONSTRUCTION Construction and Major Renovation § 1309.52 Procurement procedures. (a) All facility construction and major renovation transactions...

Ground Water Monitoring Requirements for Hazardous Waste Treatment, Storage and Disposal Facilities

EPA Pesticide Factsheets

The groundwater monitoring requirements for hazardous waste treatment, storage and disposal facilities (TSDFs) are just one aspect of the Resource Conservation and Recovery Act (RCRA) hazardous waste management strategy for protecting human health and the

45 CFR 1309.52 - Procurement procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM HEAD START FACILITIES PURCHASE, MAJOR RENOVATION AND CONSTRUCTION Construction and Major Renovation § 1309.52 Procurement procedures. (a) All facility construction and major renovation transactions...

Facility Design Considerations.

ERIC Educational Resources Information Center

Chase, William W.

1967-01-01

Increasing need for vocational education under the impetus of federal aid is generating a demand for vocational teaching facilities. Factors to be considered in planning these facilities inclued--(1) site development, (2) program needs, (3) administrative considerations, (4) environmental controls. (5) mechanical systems, and (6) area and space…

Clonally related methicillin-resistant Staphylococcus aureus isolated from short-finned pilot whales (Globicephala macrorhynchus), human volunteers, and a bayfront cetacean rehabilitation facility.

PubMed

Hower, Suzanne; Phillips, Matthew C; Brodsky, Micah; Dameron, Adrienne; Tamargo, Manuel A; Salazar, Norma C; Jackson, Charlene R; Barrett, John B; Davidson, Maureen; Davis, Johnnie; Mukherjee, Sampa; Ewing, Ruth Y; Gidley, Maribeth L; Sinigalliano, Christopher D; Johns, Lisa; Johnson, Frank E; Adebanjo, Olufunmilola; Plano, Lisa R W

2013-05-01

In May of 2011, a live mass stranding of 26 short-finned pilot whales (Globicephala macrorhynchus) occurred in the lower Florida Keys. Five surviving whales were transferred from the original stranding site to a nearby marine mammal rehabilitation facility where they were constantly attended to by a team of volunteers. Bacteria cultured during the routine clinical care of the whales and necropsy of a deceased whale included methicillin-sensitive and methicillin-resistant Staphylococcus aureus (MSSA and MRSA). In order to investigate potential sources or reservoirs of MSSA and MRSA, samples were obtained from human volunteers, whales, seawater, and sand from multiple sites at the facility, nearby recreational beaches, and a canal. Samples were collected on 3 days. The second collection day was 2 weeks after the first, and the third collection day was 2 months after the last animal was removed from the facility. MRSA and MSSA were isolated on each day from the facility when animals and volunteers were present. MSSA was found at an adjacent beach on all three collection days. Isolates were characterized by utilizing a combination of quantitative real-time PCR to determine the presence of mecA and genes associated with virulence, staphylococcal protein A typing, staphylococcal cassette chromosome mec typing, multilocus sequence typing, and pulsed field gel electrophoresis (PFGE). Using these methods, clonally related MRSA were isolated from multiple environmental locations as well as from humans and animals. Non-identical but genetically similar MSSA and MRSA were also identified from distinct sources within this sample pool. PFGE indicated that the majority of MRSA isolates were clonally related to the prototype human strain USA300. These studies support the notion that S. aureus may be shed into an environment by humans or pilot whales and subsequently colonize or infect exposed new hosts.

45 CFR 1328.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON AGING, OLDER AMERICANS PROGRAMS GRANTS FOR SUPPORTIVE AND... original facility and all physical improvements. Department, means the Department of Health and Human...

On the apparent rarity of epithelial cancers in captive chimpanzees

PubMed Central

Varki, Nissi M.; Varki, Ajit

2015-01-01

Malignant neoplasms arising from epithelial cells are called carcinomas. Such cancers are diagnosed in about one in three humans in ‘developed’ countries, with the most common sites affected being lung, breast, prostate, colon, ovary and pancreas. By contrast, carcinomas are said to be rare in captive chimpanzees, which share more than 99% protein sequence homology with humans (and possibly in other related ‘great apes’—bonobos, gorillas and orangutans). Simple ascertainment bias is an unlikely explanation, as these nonhuman hominids are recipients of excellent veterinary care in research facilities and zoos, and are typically subjected to necropsies when they die. In keeping with this notion, benign tumours and cancers that are less common in humans are well documented in this population. In this brief overview, we discuss other possible explanations for the reported rarity of carcinomas in our closest evolutionary cousins, including inadequacy of numbers surveyed, differences in life expectancy, diet, genetic susceptibility, immune responses or their microbiomes, and other potential environmental factors. We conclude that while relative carcinoma risk is a likely difference between humans and chimpanzees (and possibly other ‘great apes’), a more systematic survey of available data is required for validation of this claim. PMID:26056369

A qualitative study of factors impacting accessing of institutional delivery care in the context of India's cash incentive program.

PubMed

Vellakkal, Sukumar; Reddy, Hanimi; Gupta, Adyya; Chandran, Anil; Fledderjohann, Jasmine; Stuckler, David

2017-04-01

Not all eligible women use the available services under India's Janani Suraksha Yojana (JSY), which provides cash incentives to encourage pregnant women to use institutional care for childbirth; limited evidence exists on demand-side factors associated with low program uptake. This study explores the views of women and ASHAs (community health workers) on the use of the JSY and institutional delivery care facilities. In-depth qualitative interviews, carried out in September-November 2013, were completed in the local language by trained interviewers with 112 participants consisting of JSY users/non-users and ASHAs in Jharkhand, Madhya Pradesh and Uttar Pradesh. The interaction of impeding and enabling factors on the use of institutional care for delivery was explored. We found that ASHAs' support services (e.g., arrangement of transport, escort to and support at healthcare facilities) and awareness generation of the benefits of institutional healthcare emerged as major enabling factors. The JSY cash incentive played a lesser role as an enabling factor because of higher opportunity costs in the use of healthcare facilities versus home for childbirth. Trust in the skills of traditional birth-attendants and the notion of childbirth as a 'natural event' that requires no healthcare were the most prevalent impeding factors. The belief that a healthcare facility would be needed only in cases of birth complications was also highly prevalent. This often resulted in waiting until the last moments of childbirth to seek institutional healthcare, leading to delay/non-availability of transportation services and inability to reach a delivery facility in time. ASHAs opined that interpersonal communication for awareness generation has a greater influence on use of institutional healthcare, and complementary cash incentives further encourage use. Improving health workers' support services focused on marginalized populations along with better public healthcare facilities are likely to promote the uptake of institutional delivery care in resource-poor settings. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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.

Recommendations for Laboratory Containment and Management of Gene Drive Systems in Arthropods.

PubMed

Benedict, Mark Q; Burt, Austin; Capurro, Margareth L; De Barro, Paul; Handler, Alfred M; Hayes, Keith R; Marshall, John M; Tabachnick, Walter J; Adelman, Zach N

2018-01-01

Versatile molecular tools for creating driving transgenes and other invasive genetic factors present regulatory, ethical, and environmental challenges that should be addressed to ensure their safe use. In this article, we discuss driving transgenes and invasive genetic factors that can potentially spread after their introduction into a small proportion of individuals in a population. The potential of invasive genetic factors to increase their number in natural populations presents challenges that require additional safety measures not provided by previous recommendations regarding accidental release of arthropods. In addition to providing physical containment, invasive genetic factors require greater attention to strain management, including their distribution and identity confirmation. In this study, we focus on insects containing such factors with recommendations for investigators who are creating them, institutional biosafety committees charged with ensuring safety, funding agencies providing support, those managing insectaries handling these materials who are responsible for containment, and other persons who will be receiving insects-transgenic or not-from these facilities. We give specific examples of efforts to modify mosquitoes for mosquito-borne disease control, but similar considerations are relevant to other arthropods that are important to human health, the environment, and agriculture.

Recommendations for Laboratory Containment and Management of Gene Drive Systems in Arthropods

PubMed Central

Burt, Austin; Capurro, Margareth L.; De Barro, Paul; Handler, Alfred M.; Hayes, Keith R.; Marshall, John M.; Tabachnick, Walter J.; Adelman, Zach N.

2018-01-01

Abstract Versatile molecular tools for creating driving transgenes and other invasive genetic factors present regulatory, ethical, and environmental challenges that should be addressed to ensure their safe use. In this article, we discuss driving transgenes and invasive genetic factors that can potentially spread after their introduction into a small proportion of individuals in a population. The potential of invasive genetic factors to increase their number in natural populations presents challenges that require additional safety measures not provided by previous recommendations regarding accidental release of arthropods. In addition to providing physical containment, invasive genetic factors require greater attention to strain management, including their distribution and identity confirmation. In this study, we focus on insects containing such factors with recommendations for investigators who are creating them, institutional biosafety committees charged with ensuring safety, funding agencies providing support, those managing insectaries handling these materials who are responsible for containment, and other persons who will be receiving insects—transgenic or not—from these facilities. We give specific examples of efforts to modify mosquitoes for mosquito-borne disease control, but similar considerations are relevant to other arthropods that are important to human health, the environment, and agriculture. PMID:29040058

Development of a safety decision-making scenario to measure worker safety in agriculture.

PubMed

Mosher, G A; Keren, N; Freeman, S A; Hurburgh, C R

2014-04-01

Human factors play an important role in the management of occupational safety, especially in high-hazard workplaces such as commercial grain-handling facilities. Employee decision-making patterns represent an essential component of the safety system within a work environment. This research describes the process used to create a safety decision-making scenario to measure the process that grain-handling employees used to make choices in a safety-related work task. A sample of 160 employees completed safety decision-making simulations based on a hypothetical but realistic scenario in a grain-handling environment. Their choices and the information they used to make their choices were recorded. Although the employees emphasized safety information in their decision-making process, not all of their choices were safe choices. Factors influencing their choices are discussed, and implications for industry, management, and workers are shared.

Communication in health care delivery in developing countries: which way out?

PubMed

Olutimayin, Jide

2002-09-01

Most governments in developing countries have adopted frameworks for health development which stressed community based initiatives and intervention at all levels of the health pyramid (WHO, 1992). But even today, most of the rural communities in these countries are still not developed in terms of available health facilities. What then is/are responsible for these failures? Various authors have come up with various reasons, principal amongst which are inadequate resources, lack of planning, insincerity/non-commitment of the governments, lack of modern information technology, etc. This paper examines some of these factors in relation to how they accentuate or hamper healthcare delivery in developing countries, using African rural communities as a study field. The resultant suggestions are a consortium of varying factors, some of which are economic in nature, policy changes, human resources development, and re-orientation of social and government attitudes towards achieving meaningful results in healthcare delivery, particularly in the rural communities.

Bioreactor concepts for cell culture-based viral vaccine production.

PubMed

Gallo-Ramírez, Lilí Esmeralda; Nikolay, Alexander; Genzel, Yvonne; Reichl, Udo

2015-01-01

Vaccine manufacturing processes are designed to meet present and upcoming challenges associated with a growing vaccine market and to include multi-use facilities offering a broad portfolio and faster reaction times in case of pandemics and emerging diseases. The final products, from whole viruses to recombinant viral proteins, are very diverse, making standard process strategies hardly universally applicable. Numerous factors such as cell substrate, virus strain or expression system, medium, cultivation system, cultivation method, and scale need consideration. Reviewing options for efficient and economical production of human vaccines, this paper discusses basic factors relevant for viral antigen production in mammalian cells, avian cells and insect cells. In addition, bioreactor concepts, including static systems, single-use systems, stirred tanks and packed-beds are addressed. On this basis, methods towards process intensification, in particular operational strategies, the use of perfusion systems for high product yields, and steps to establish continuous processes are introduced.

A GIS-based approach for comparative analysis of potential fire risk assessment

NASA Astrophysics Data System (ADS)

Sun, Ying; Hu, Lieqiu; Liu, Huiping

2007-06-01

Urban fires are one of the most important sources of property loss and human casualty and therefore it is necessary to assess the potential fire risk with consideration of urban community safety. Two evaluation models are proposed, both of which are integrated with GIS. One is the single factor model concerning the accessibility of fire passage and the other is grey clustering approach based on the multifactor system. In the latter model, fourteen factors are introduced and divided into four categories involving security management, evacuation facility, construction resistance and fire fighting capability. A case study on campus of Beijing Normal University is presented to express the potential risk assessment models in details. A comparative analysis of the two models is carried out to validate the accuracy. The results are approximately consistent with each other. Moreover, modeling with GIS promotes the efficiency the potential risk assessment.

The role of institutions on the effectiveness of malaria treatment in the Ghanaian health sector.

PubMed

Amporfu, Eugenia; Nonvignon, Justice

2015-04-19

The Ghanaian health sector has undertaken several policies to help improve the quality of care received by patients. This includes the construction of several health facilities, the increase in the training of health workers, especially nurses, and the introduction of incentive packages (such as salary increase) to motivate health workers. The important question is to what extent does the institutional arrangement between the health facilities and the government as well as between health workers and public health facility administration affect the quality of care? The objective of this study is to find the effect of institutional factors on the quality of care. The institutional factors examined were mainly the extent of decentralization between government and health facilities, as well as between health workers and facility administration, the hiring procedure, and job satisfaction. The study used primary data on former patients from sixty six health facilities in three administrative regions of Ghana: the Northern, the Ashanti and the Greater Accra regions. The quality indicator used was effectiveness of treatment as determined by the patient. Ordered logit regression was run for the indicator with patient and health facility characteristics as well as institutional factors as independent variables. The sample size was 2248. The results showed that the patient's level of formal education had a strong influence on the effectiveness of treatment. In addition, effectiveness of treatment differed according to the administrative region in which the facility was located, and according to the extent of decentralization between health facility and government. The quality of instruments used for treatment, the working conditions for health workers, and job satisfaction had no effect on the effectiveness of treatment. Decentralization, the flow of information from government to health facilities and from health facility administrators to health workers are important in ensuring effectiveness. The study recommends further decentralization between health facilities as well as between health workers and administrators. In addition, the study recommends the involvement of health facilities in malaria programs to ensure the flow of information needed for effectiveness of treatment.

Construction bidding cost of KSC's space shuttle facilities

NASA Technical Reports Server (NTRS)

Brown, Joseph Andrew

1977-01-01

The bidding cost of the major Space Transportation System facilities constructed under the responsibility of the John F. Kennedy Space Center (KSC) is described and listed. These facilities and Ground Support Equipment (GSE) are necessary for the receiving, assembly, testing, and checkout of the Space Shuttle for launch and landing missions at KSC. The Shuttle launch configuration consists of the Orbiter, the External Tank, and the Solid Rocket Boosters (SRB). The reusable Orbiter and SRB's is the major factor in the program that will result in lowering space travel costs. The new facilities are the Landing Facility; Orbiter Processing Facility; Orbiter Approach and Landing Test Facility (Dryden Test Center, California); Orbiter Mating Devices; Sound Suppression Water System; and Emergency Power System for LC-39. Also, a major factor was to use as much Apollo facilities and hardware as possible to reduce the facilities cost. The alterations to existing Apollo facilities are the VAB modifications; Mobile Launcher Platforms; Launch Complex 39 Pads A and B (which includes a new concept - the Rotary Service Structure), which was featured in ENR, 3 Feb. 1977, 'Hinged Space Truss will Support Shuttle Cargo Room'; Launch Control Center mods; External Tank and SRB Processing and Storage; Fluid Test Complex mods; O&C Spacelab mods; Shuttle mods for Parachute Facility; SRB Recovery and Disassembly Facility at Hangar 'AF'; and an interesting GSE item - the SRB Dewatering Nozzle Plug Sets (Remote Controlled Submarine System) used to inspect and acquire for reuse of SRB's.

Employee influenza vaccination in residential care facilities.

PubMed

Apenteng, Bettye A; Opoku, Samuel T

2014-03-01

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

Human and organizational factors affecting telemedicine utilization within U.S. military forces in Europe.

PubMed

Lam, David M; Mackenzie, Colin

2005-02-01

During the past 10 years, the United States Army installed telemedicine capabilities in more than 30 Army medical treatment facilities within the European Theater, including the former Yugoslavia. In spite of favorable reviews of utilization from the early days of the installations, there has been only limited use for patient care. We conducted a field study of the program implementation within a group of military clinics and hospitals using site visits and interviews. Problems leading to underutilization were identified primarily as organizational factors rather than classic "human factors" or "man-machine interface" problems. The majority of those interviewed felt that: they had not been given adequate information on the role of telemedicine systems in provision of health care; operational and support policies had not been developed adequately; cost-benefit of use was not clearly demonstrated; and that many organizational impediments existed. Additionally, the lack of strong clinician proponents was repeatedly cited. Although limited in scope, this study provides insight into the attitudes of clinicians given the opportunity to use various telemedicine modalities, and identifies organizational problems that could be rectified by a defined mission involving the use of telemedicine and a structure encouraging its acceptance in routine clinical practice. As a result of this study, recommendations were made for changes in implementation practices, which may have civil as well as military implications.

Predictors of public and private healthcare utilization and associated health system responsiveness among older adults in Ghana

PubMed Central

Awoke, Mamaru Ayenew; Negin, Joel; Moller, Jette; Farell, Penny; Yawson, Alfred E.; Biritwum, Richard Berko; Kowal, Paul

2017-01-01

ABSTRACT Background: Previous studies investigating factors associated with healthcare utilization by older Ghanaians lack distinction between public and private health services. The present study examined factors associated with public and private healthcare service use, and the resulting perceived health system responsiveness. Objectives: To identify factors associated with public and private healthcare utilization among older adults aged 50 and older in Ghana; and to compare perceived differences in health system responsiveness between the private and public sectors. Methods: Cross-sectional data was analyzed from the World Health Organization Study on global AGEing and adult health (SAGE) Wave 1 in Ghana. Using Andersen’s conceptual framework, public and private outpatient care utilization was examined using multinomial logistic regression to estimate and identify predictor variables associated with the type of outpatient healthcare facility accessed. Health system responsiveness was compared using chi-square tests. Results: Of 2517 respondents who used outpatient care in the 12 months preceding interview, 51.7% of respondents used a public facility, 17.8% a private facility, and 30.5% used other facilities. Older age group, higher education and higher wealth were associated with the use of private outpatient healthcare services. Using public outpatient care facilities was associated with having health insurance. Respondents with two or more chronic conditions were more likely to use public and private outpatient care than other facilities. Perceived health system responsiveness was better in private for-profit than in public and private not-for-profit healthcare facilities. Conclusions: This study suggested that higher wealth and multimorbidity were significant predictors of public and private outpatient healthcare utilization; however, health insurance was a predictor only for the use of public facilities. Future mixed-method studies could further elucidate factors influencing the choice of public and private outpatient healthcare use. PMID:28578615

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

PubMed

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

2018-01-01

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

Investigation of injury/illness data at a nuclear facility. Part II

DOE PAGES

Cournoyer, Michael E.; Garcia, Vincent E.; Sandoval, Arnold N.; ...

2015-07-01

At Los Alamos National Laboratory (LANL), there are several nuclear facilities, accelerator facilities, radiological facilities, explosives sites, moderate- and high-hazard non-nuclear facilities, biosciences laboratory, etc. The Plutonium Science and Manufacturing Directorate (ADPSM) provides special nuclear material research, process development, technology demonstration, and manufacturing capabilities. ADPSM manages the LANL Plutonium Facility. Within the Radiological Control Area at TA-55 (PF-4), chemical and metallurgical operations with plutonium and other hazardous materials are performed. LANL Health and Safety Programs investigate injury and illness data. In this study, statistically significant trends have been identified and compared for LANL, ADPSM, and PF-4 injury/illness cases. A previouslymore » described output metric is used to measures LANL management progress towards meeting its operational safety objectives and goals. Timelines are used to determine trends in Injury/Illness types. Pareto Charts are used to prioritize causal factors. The data generated from analysis of Injury/Illness data have helped identify and reduce the number of corresponding causal factors.« less

Feasibility Assessment of an ISS Artificial Gravity Conditioning Facility by Means of Multi-Body Approach

NASA Astrophysics Data System (ADS)

Toso, Mario; Baldesi, Gianluigi; Moratto, Claudio; De Wilde, Don; Bureo Dacal, Rafael; Castellsaguer, Joaquim

2012-07-01

Even though human exploration of Mars is a distant objective, it is well understood that, for human space voyages of several years duration, crews would be at risk of catastrophic consequences should any of the systems that provide adequate air, water, food, or thermal protection fail. Moreover, crews will face serious health and/or safety risks resulting from severe physiologic deconditioning associated with prolonged weightlessness. The principal ones are related to physical and functional deterioration of the regulation of the blood circulation, decreased aerobic capacity, impaired musculo-skeletal systems, and altered sensory- motor system performance. As the reliance of future space programmes on virtual modelling, simulation and justification has substantially grown together with the proto-flight hardware development approach, a range of simulation capabilities have become increasingly important in the requirements specification, design, verification, testing, launch and operation of new space systems. In this frame, multibody software is a key tool in providing a more coordinated and consistent approach from the preliminary development phases of the most complex systems. From a scientific prospective, an artificial gravity facility, such as the one evaluated in this paper, would be the first in-flight testing of the effectiveness and acceptability of short radius centrifuge as a countermeasure to human deconditioning on orbit. The ISS represents a unique opportunity to perform this research. From an engineering point of view, the preliminary assessment described in this paper, highlights the difficult engineering challenges of such a facility. The outcome proves that a human can be accommodated in the available volume, while respecting the human ergonomic basic requirements and preserving the global structural integrity of the hosting ISS module. In particular, analysis shows that, although the load capacity of the structural interfaces imposes a very low limit on the maximum centre of mass eccentricity of the complete rotating system, the displacements allowed by traditional isolation mountings are incompatible with the available volume in the ISS module. Therefore, in order to manage the eccentricity, alternative counteracting measures shall be foreseen, such as an adjustable balance mass, which is carefully positioned for each astronaut at the beginning of the exercise cycle. However, during operation, the centre of mass is instantaneously disturbed by body fluid migration as well as adjustments of torso, arms and head due to the inevitable physiological degrees of freedom granted to the exercising astronaut. The influence of all the above factors on the transmitted loads is summarised in the paper; in conclusion, an automated system capable of keeping the maximum eccentricity below the allowable boundaries is foreseeable.

42 CFR 456.607 - Notification before inspection.

Code of Federal Regulations, 2012 CFR

2012-10-01

....607 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.607 Notification before inspection. No facility may be...

42 CFR 456.607 - Notification before inspection.

Code of Federal Regulations, 2011 CFR

2011-10-01

....607 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.607 Notification before inspection. No facility may be...

42 CFR 456.607 - Notification before inspection.

Code of Federal Regulations, 2014 CFR

2014-10-01

....607 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.607 Notification before inspection. No facility may be...

42 CFR 456.607 - Notification before inspection.

Code of Federal Regulations, 2013 CFR

2013-10-01

....607 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.607 Notification before inspection. No facility may be...

Transportation informatics : an image analysis system for managing transportation facilities - phase II.

DOT National Transportation Integrated Search

2012-02-01

One of the most important tasks in maintaining transportation facilities such as highways : and streets is the evaluation of the existing condition. Visual evaluation by human : inspectors is subjective in nature, therefore has issues of consistency ...

21 CFR 58.200 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-04-01

... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing Facilities § 58.200 Purpose. (a) The purposes of... testing facility which has failed to comply with the requirements of the good laboratory practice...

21 CFR 58.200 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-04-01

... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing Facilities § 58.200 Purpose. (a) The purposes of... testing facility which has failed to comply with the requirements of the good laboratory practice...

45 CFR 9.1 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Purpose. 9.1 Section 9.1 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION USE OF HHS RESEARCH FACILITIES BY ACADEMIC... and study facilities to academic scientists, engineers, and qualified students. ...

45 CFR 9.1 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Purpose. 9.1 Section 9.1 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION USE OF HHS RESEARCH FACILITIES BY ACADEMIC... and study facilities to academic scientists, engineers, and qualified students. ...

45 CFR 9.1 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Purpose. 9.1 Section 9.1 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION USE OF HHS RESEARCH FACILITIES BY ACADEMIC... and study facilities to academic scientists, engineers, and qualified students. ...

Protein Transfer Into Human Cells by VSV-G-induced Nanovesicles

PubMed Central

Mangeot, Philippe-Emmanuel; Dollet, Sandra; Girard, Mathilde; Ciancia, Claire; Joly, Stéphane; Peschanski, Marc; Lotteau, Vincent

2011-01-01

Identification of new techniques to express proteins into mammal cells is of particular interest for both research and medical purposes. The present study describes the use of engineered vesicles to deliver exogenous proteins into human cells. We show that overexpression of the spike glycoprotein of the vesicular stomatitis virus (VSV-G) in human cells induces the release of fusogenic vesicles named gesicles. Biochemical and functional studies revealed that gesicles incorporated proteins from producer cells and could deliver them to recipient cells. This protein-transduction method allows the direct transport of cytoplasmic, nuclear or surface proteins in target cells. This was demonstrated by showing that the TetR transactivator and the receptor for the murine leukemia virus (MLV) envelope [murine cationic amino acid transporter-1 (mCAT-1)] were efficiently delivered by gesicles in various cell types. We further shows that gesicle-mediated transfer of mCAT-1 confers to human fibroblasts a robust permissiveness to ecotropic vectors, allowing the generation of human-induced pluripotent stem cells in level 2 biosafety facilities. This highlights the great potential of mCAT-1 gesicles to increase the safety of experiments using retro/lentivectors. Besides this, gesicles is a versatile tool highly valuable for the nongenetic delivery of functions such as transcription factors or genome engineering agents. PMID:21750535

Mental health disabilities and human rights protections.

PubMed

Szmukler, G; Bach, M

2015-01-01

Around the world, reports regularly expose persistent and systemic human rights violations of patients in mental health services and facilities, and of those who are unable to access needed supports. A number of factors contribute - political will; the range and quality of services available; public and professional attitudes to mental health; stigma; health professionals' training and expertise; and available resources. This paper examines one of the main determinants, the legal framework. This sets the parameters for mental health policies and services and for applicable human rights norms and standards that can be realized in practice. We provide an overview of international human rights instruments in relation to mental health disabilities, and of the major human rights violations in this area. Key implications for mental health law reform are drawn with a particular focus on discrimination and coercive interventions. The major challenges posed by the UN Convention on the Rights of Persons with Disabilities (2006) are examined. Current mental health laws, to greater or lesser degrees, fail to meet the newly required standards. We discuss reforms based on 'generic law' and 'legal capacity' principles that seek to meet those standards. We outline some emergent and promising examples of reform. The role of civil society and the importance of the standing of those with mental health disabilities in this process is noted.

Baseline experiments in teleoperator control

NASA Technical Reports Server (NTRS)

Hankins, W. W., III; Mixon, R. W.

1986-01-01

Studies have been conducted at the NASA Langley Research Center (LaRC) to establish baseline human teleoperator interface data and to assess the influence of some of the interface parameters on human performance in teleoperation. As baseline data, the results will be used to assess future interface improvements resulting from this research in basic teleoperator human factors. In addition, the data have been used to validate LaRC's basic teleoperator hardware setup and to compare initial teleoperator study results. Four subjects controlled a modified industrial manipulator to perform a simple task involving both high and low precision. Two different schemes for controlling the manipulator were studied along with both direct and indirect viewing of the task. Performance of the task was measured as the length of time required to complete the task along with the number of errors made in the process. Analyses of variance were computed to determine the significance of the influences of each of the independent variables. Comparisons were also made between the LaRC data and data taken earlier by Grumman Aerospace Corp. at their facilities.

Factors related to the burnout of Japanese female nurses with children under 3 years old.

PubMed

Takayama, Yuko; Suzuki, Eiko; Kobiyama, Atsuko; Maruyama, Akiko; Sera, Yoshiko

2017-07-01

Burnout is a common feature among healthcare professionals; however, little systematic research exists on burnout among nurses who are raising children. The burnout-related factors among female nurses with children under the age of 3 years were identified in order to ascertain potential burnout prevention methods. In total, 1681 nurses with children who worked at nine city hospitals in Kanagawa Prefecture, Japan, were sent the Maslach Burnout Inventory-Human Services Survey; 1173 nurses responded in June 2014. They were divided according to their sex and children's ages. A data analysis was undertaken for those female nurses with children who were aged under 3 years who provided valid responses (n = 158). A number of factors related to burnout in female nurses with children aged under 3 years was found via a multiple regression analysis: irritation at being unable to attend to their own affairs, over 4-6 h of overtime work per week, having a child aged under 3 years as the first or second child, little sense of work fulfillment, using a childcare facility outside the workplace, dissatisfaction with their salary, feeling ill-qualified as a parent, and a sense of inadequate support. Child care occurs during a limited period and appropriate support is needed. A workplace environment with no overtime work, a childcare facility in the workplace, and mental health support to reduce "feelings of irritation" and "feeling ill-qualified as a parent" could help to prevent burnout in female nurses with toddlers and infants. © 2016 Japan Academy of Nursing Science.

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.

Logistic regression models of factors influencing the location of bioenergy and biofuels plants

Treesearch

T.M. Young; R.L. Zaretzki; J.H. Perdue; F.M. Guess; X. Liu

2011-01-01

Logistic regression models were developed to identify significant factors that influence the location of existing wood-using bioenergy/biofuels plants and traditional wood-using facilities. Logistic models provided quantitative insight for variables influencing the location of woody biomass-using facilities. Availability of "thinnings to a basal area of 31.7m2/ha...

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

PubMed

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

2008-01-01

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

The Life-and-Death Factor: Focus on Healthcare Facilities

ERIC Educational Resources Information Center

Dessoff, Alan

2009-01-01

With economic pressures restricting campus budgets and healthcare policy issues capturing national attention, facilities managers at university-affiliated hospitals and other healthcare entities say they feel more urgency than ever to provide cost-effective services to patients, providers, medical researchers, and students. Managing facilities at…

Environmental and nursing-staff factors contributing to aggressive and violent behaviour of patients in mental health facilities.

PubMed

van Wijk, Evalina; Traut, Annalene; Julie, Hester

2014-08-14

Aggressive and violent behaviour of inpatients in mental health facilities disrupts the therapeutic alliance and hampers treatment. The aim of the study was to describe patients' perceptions of the possible environmental and staff factors that might contribute to their aggressive and violent behaviour after admission to a mental health facility; and to propose strategies to prevent and manage such behaviour. A qualitative, phenomenological study was utilised, in which purposefully sampled inpatients were interviewed over a six-month period. Inpatients were invited to participate if they had been admitted for at least seven days and were in touch with reality. Forty inpatients in two mental health facilities in Cape Town participated in face-to-face, semi-structured interviews over a period of six months. Tesch's descriptive method of open coding formed the framework for the data analysis and presentation of the results. Trustworthiness was ensured in accordance with the principles of credibility, confirmability, transferability and dependability. Analysis of the data indicates two central categories in the factors contributing to patients' aggressive and violent behaviour, namely, environmental factors and the attitude and behaviour of staff. From the perspective of the inpatients included in this study, aggressive and violent episodes are common and require intervention. Specific strategies for preventing such behaviour are proposed and it is recommended that these strategies be incorporated into the in-service training programmes of the staff of mental health facilities. These strategies could prevent, or reduce, aggressive and violent behaviour in in-patient facilities.

Description of the supporting factors of final project in Mathematics and Natural Sciences Faculty of Syiah Kuala University with multiple correspondence analysis

NASA Astrophysics Data System (ADS)

Rusyana, Asep; Nurhasanah; Maulizasari

2018-05-01

Syiah Kuala University (Unsyiah) is hoped to have graduates who are qualified for working or creating a field of work. A final project course implementation process must be effective. This research uses data from the evaluation conducted by Mathematics and Natural Sciences Faculty (FMIPA) of Unsyiah. Some of the factors that support the completion of the final project are duration, guidance, the final project seminars, facility, public impact, and quality. This research aims to know the factors that have a relationship with the completion of the final project and identify similarities among variables. The factors that support the completion of the final project at every study program in FMIPA are (1) duration, (2) guidance and (3) facilities. These factors are examined for the correlations by chi-square test. After that, the variables are analyzed with multiple correspondence analysis. Based on the plot of correspondence, the activities of the guidance and facilities in Informatics Study Program are included in the fair category, while the guidance and facilities in the Chemistry are included in the best category. Besides that, students in Physics can finish the final project with the fastest completion duration, while students in Pharmacy finish for the longest time.

Noise in a Laboratory Animal Facility from the Human and Mouse Perspectives

PubMed Central

Reynolds, Randall P; Kinard, Will L; Degraff, Jesse J; Leverage, Ned; Norton, John N

2010-01-01

The current study was performed to understand the level of sound produced by ventilated racks, animal transfer stations, and construction equipment that mice in ventilated cages hear relative to what humans would hear in the same environment. Although the ventilated rack and animal transfer station both produced sound pressure levels above the ambient level within the human hearing range, the sound pressure levels within the mouse hearing range did not increase above ambient noise from either noise source. When various types of construction equipment were used 3 ft from the ventilated rack, the sound pressure level within the mouse hearing range was increased but to a lesser degree for each implement than were the sound pressure levels within the human hearing range. At more distant locations within the animal facility, sound pressure levels from the large jackhammer within the mouse hearing range decreased much more rapidly than did those in the human hearing range, indicating that less of the sound is perceived by mice than by humans. The relatively high proportion of low-frequency sound produced by the shot blaster, used without the metal shot that it normally uses to clean concrete, increased the sound pressure level above the ambient level for humans but did not increase sound pressure levels above ambient noise for mice at locations greater than 3 ft from inside of the cage, where sound was measured. This study demonstrates that sound clearly audible to humans in the animal facility may be perceived to a lesser degree or not at all by mice, because of the frequency content of the sound. PMID:20858361

A Human Factors Evaluation of a Methodology for Pressurized Crew Module Acceptability for Zero-Gravity Ingress of Spacecraft

NASA Technical Reports Server (NTRS)

Sanchez, Merri J.

2000-01-01

This project aimed to develop a methodology for evaluating performance and acceptability characteristics of the pressurized crew module volume suitability for zero-gravity (g) ingress of a spacecraft and to evaluate the operational acceptability of the NASA crew return vehicle (CRV) for zero-g ingress of astronaut crew, volume for crew tasks, and general crew module and seat layout. No standard or methodology has been established for evaluating volume acceptability in human spaceflight vehicles. Volume affects astronauts'ability to ingress and egress the vehicle, and to maneuver in and perform critical operational tasks inside the vehicle. Much research has been conducted on aircraft ingress, egress, and rescue in order to establish military and civil aircraft standards. However, due to the extremely limited number of human-rated spacecraft, this topic has been un-addressed. The NASA CRV was used for this study. The prototype vehicle can return a 7-member crew from the International Space Station in an emergency. The vehicle's internal arrangement must be designed to facilitate rapid zero-g ingress, zero-g maneuverability, ease of one-g egress and rescue, and ease of operational tasks in multiple acceleration environments. A full-scale crew module mockup was built and outfitted with representative adjustable seats, crew equipment, and a volumetrically equivalent hatch. Human factors testing was conducted in three acceleration environments using ground-based facilities and the KC-135 aircraft. Performance and acceptability measurements were collected. Data analysis was conducted using analysis of variance and nonparametric techniques.

42 CFR 494.180 - Condition: Governance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... responsibility for the management of the facility and the provision of all dialysis services, including, but not...; and (4) Allocation of necessary staff and other resources for the facility's quality assessment and...

40 CFR 265.31 - Maintenance and operation of facility.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., soil, or surface water which could threaten human health or the -environment. ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Maintenance and operation of facility. 265.31 Section 265.31 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID...

42 CFR 475.105 - Prohibition against contracting with health care facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... facilities. 475.105 Section 475.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS QUALITY IMPROVEMENT ORGANIZATIONS Utilization and Quality Control Quality Improvement Organizations § 475.105 Prohibition against contracting...

78 FR 66848 - Addition of ortho-

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-07

... chemicals annually. These facilities must also report pollution prevention and recycling data for such... effects at concentration levels that are reasonably likely to exist beyond facility site boundaries as a... be anticipated to cause in humans: [cir] cancer or teratogenic effects, or [cir] serious or...

21 CFR 58.210 - Actions upon disqualification.

Code of Federal Regulations, 2011 CFR

2011-04-01

....210 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing Facilities § 58.210... laboratory study conducted by the disqualified testing facility may be examined to determine whether such...

21 CFR 58.210 - Actions upon disqualification.

Code of Federal Regulations, 2010 CFR

2010-04-01

....210 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing Facilities § 58.210... laboratory study conducted by the disqualified testing facility may be examined to determine whether such...

40 CFR 63.5799 - How do I calculate my facility's organic HAP emissions on a tpy basis for purposes of determining...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Emissions Factors for Open Molding and Centrifugal Casting § 63.5799 How do I calculate my facility's... new facility that does not have any of the following operations: Open molding, centrifugal casting... existing facilities, do not include any organic HAP emissions where resin or gel coat is applied to an open...

40 CFR 63.5799 - How do I calculate my facility's organic HAP emissions on a tpy basis for purposes of determining...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Emissions Factors for Open Molding and Centrifugal Casting § 63.5799 How do I calculate my facility's... new facility that does not have any of the following operations: Open molding, centrifugal casting... existing facilities, do not include any organic HAP emissions where resin or gel coat is applied to an open...

Task sharing in Zambia: HIV service scale-up compounds the human resource crisis.

PubMed

Walsh, Aisling; Ndubani, Phillimon; Simbaya, Joseph; Dicker, Patrick; Brugha, Ruairí

2010-09-17

Considerable attention has been given by policy makers and researchers to the human resources for health crisis in Africa. However, little attention has been paid to quantifying health facility-level trends in health worker numbers, distribution and workload, despite growing demands on health workers due to the availability of new funds for HIV/AIDS control scale-up. This study analyses and reports trends in HIV and non-HIV ambulatory service workloads on clinical staff in urban and rural district level facilities. Structured surveys of health facility managers, and health services covering 2005-07 were conducted in three districts of Zambia in 2008 (two urban and one rural), to fill this evidence gap. Intra-facility analyses were conducted, comparing trends in HIV and non-HIV service utilisation with staff trends. Clinical staff (doctors, nurses and nurse-midwives, and clinical officers) numbers and staff population densities fell slightly, with lower ratios of staff to population in the rural district. The ratios of antenatal care and family planning registrants to nurses/nurse-midwives were highest at baseline and increased further at the rural facilities over the three years, while daily outpatient department (OPD) workload in urban facilities fell below that in rural facilities. HIV workload, as measured by numbers of clients receiving antiretroviral treatment (ART) and prevention of mother to child transmission (PMTCT) per facility staff member, was highest in the capital city, but increased rapidly in all three districts. The analysis suggests evidence of task sharing, in that staff designated by managers as ART and PMTCT workers made up a higher proportion of frontline service providers by 2007. This analysis of workforce patterns across 30 facilities in three districts of Zambia illustrates that the remarkable achievements in scaling-up HIV/AIDS service delivery has been on the back of sustained non-HIV workload levels, increasing HIV workload and stagnant health worker numbers. The findings are based on an analysis of routine data that are available to district and national managers. Mixed methods research is needed, combining quantitative analyses of routine health information with follow-up qualitative interviews, to explore and explain workload changes, and to identify and measure where problems are most acute, so that decision makers can respond appropriately. This study provides quantitative evidence of a human resource crisis in health facilities in Zambia, which may be more acute in rural areas.

Academic status does not affect outcome following complex hepato-pancreato-biliary procedures.

PubMed

Altieri, Maria S; Yang, Jie; Groves, Donald; Yin, Donglei; Cagino, Kristen; Talamini, Mark; Pryor, Aurora

2018-05-01

There is a growing debate regarding outcomes following complex hepato-pancreato-biliary (HPB) procedures. The purpose of our study is to examine if facility type has any impact on complications, readmission rates, emergency department (ED) visit rates, and length of stay (LOS) for patients undergoing HPB surgery. The SPARCS administrative database was used to identify patients undergoing complex HPB procedures between 2012 and 2014 in New York. Univariate generalized linear mixed models were fit to estimate the marginal association between outcomes such as overall/severe complication rates, 30-day and 1-year readmission rates, 30-day and 1-year ED-visit rates, and potential risk factors. Univariate linear mixed models were used to estimate the marginal association between possible risk factors and LOS. Facility type, as well as any variables found to be significant in our univariate analysis (p = 0.05), was further included in the multivariable regression models. There were 4122 complex HPB procedures performed. Academic facilities were more likely to have a higher hospital volume (p < 0001). Surgery at academic facilities were less likely to have coexisting comorbidities; however, they were more likely to have metastatic cancer and/or liver disease (p = 0.0114, < 0. 0001, and = 0.0299, respectively). Postoperatively, patients at non-academic facilities experienced higher overall complication rates, and higher severe complication rates, when compared to those at academic facilities (p < 0.0001 and = 0.0018, respectively). Further analysis via adjustment for possible confounding factors, however, revealed no significant difference in the risk of severe complications between the two facility types. Such adjustment also demonstrated higher 30-day readmission risk in patients who underwent their surgery at an academic facility. No significant difference was found when comparing the outcomes of academic and non-academic facilities, after adjusting for age, gender, race, region, insurance, and hospital volume. Patients from academic facilities were more likely to be readmitted within the first 30-days after surgery.

Nuclear Cryogenic Propulsion Stage Affordable Development Strategy

NASA Technical Reports Server (NTRS)

Doughty, Glen E.; Gerrish, H. P.; Kenny, R. J.

2014-01-01

The development of nuclear power for space use in nuclear thermal propulsion (NTP) systems will involve significant expenditures of funds and require major technology development efforts. The development effort must be economically viable yet sufficient to validate the systems designed. Efforts are underway within the National Aeronautics and Space Administration's (NASA) Nuclear Cryogenic Propulsion Stage Project (NCPS) to study what a viable program would entail. The study will produce an integrated schedule, cost estimate and technology development plan. This will include the evaluation of various options for test facilities, types of testing and use of the engine, components, and technology developed. A "Human Rating" approach will also be developed and factored into the schedule, budget and technology development approach.

Space - The long range future

NASA Technical Reports Server (NTRS)

Von Puttkamer, J.

1985-01-01

Space exploration goals for NASA in the year 2000 time frame are examined. A lunar base would offer the opportunity for continuous earth viewing, further cosmogeochemical exploration and rudimentary steps at self-sufficiency in space. The latter two factors are also compelling reasons to plan a manned Mars base. Furthermore, competition and cooperation in a Mars mission and further interplanetary exploration is an attractive substitute for war. The hardware requirements for various configurations of Mars missions are briefly addressed, along with other, unmanned missions to the asteroid belt, Mercury, Venus, Jupiter and the moons of Jupiter and Saturn. Finally, long-range technological requirements for providing adequate living/working facilities for larger human populations in Space Station environments are summarized.

The impact of delays on maternal and neonatal outcomes in Ugandan public health facilities: the role of absenteeism.

PubMed

Ackers, Louise; Ioannou, Elena; Ackers-Johnson, James

2016-11-01

Maternal mortality in low- and middle-income countries continues to remain high. The Ugandan Ministry of Health's Strategic Plan suggests that little, if any, progress has been made in Uganda in terms of improvements in Maternal Health [Millennium Development Goal (MDG) 5] and, more specifically, in reducing maternal mortality. Furthermore, the UNDP report on the MDGs describes Uganda's progress as 'stagnant'. The importance of understanding the impact of delays on maternal and neonatal outcomes in low resource settings has been established for some time. Indeed, the '3-delays' model has exposed the need for holistic multi-disciplinary approaches focused on systems change as much as clinical input. The model exposes the contribution of social factors shaping individual agency and care-seeking behaviour. It also identifies complex access issues which, when combined with the lack of timely and adequate care at referral facilities, contributes to extensive and damaging delays. It would be hard to find a piece of research on this topic that does not reference human resource factors or 'staff shortages' as a key component of this 'puzzle'. Having said that, it is rare indeed to see these human resource factors explored in any detail. In the absence of detailed critique (implicit) 'common sense' presumptions prevail: namely that the economic conditions at national level lead to inadequacies in the supply of suitably qualified health professionals exacerbated by losses to international emigration. Eight years' experience of action-research interventions in Uganda combining a range of methods has lead us to a rather stark conclusion: the single most important factor contributing to delays and associated adverse outcomes for mothers and babies in Uganda is the failure of doctors to be present at work during contracted hours. Failure to acknowledge and respond to this sensitive problem will ultimately undermine all other interventions including professional voluntarism which relies on local 'co-presence' to be effective. Important steps forward could be achieved within the current resource framework, if the political will existed. International NGOs have exacerbated this problem encouraging forms of internal 'brain drain' particularly among doctors. Arguably the system as it is rewards doctors for non-compliance resulting in massive resource inefficiencies. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

The impact of delays on maternal and neonatal outcomes in Ugandan public health facilities: the role of absenteeism

PubMed Central

Ackers, Louise; Ioannou, Elena; Ackers-Johnson, James

2016-01-01

Maternal mortality in low- and middle-income countries continues to remain high. The Ugandan Ministry of Health’s Strategic Plan suggests that little, if any, progress has been made in Uganda in terms of improvements in Maternal Health [Millennium Development Goal (MDG) 5] and, more specifically, in reducing maternal mortality. Furthermore, the UNDP report on the MDGs describes Uganda’s progress as ‘stagnant’. The importance of understanding the impact of delays on maternal and neonatal outcomes in low resource settings has been established for some time. Indeed, the ‘3-delays’ model has exposed the need for holistic multi-disciplinary approaches focused on systems change as much as clinical input. The model exposes the contribution of social factors shaping individual agency and care-seeking behaviour. It also identifies complex access issues which, when combined with the lack of timely and adequate care at referral facilities, contributes to extensive and damaging delays. It would be hard to find a piece of research on this topic that does not reference human resource factors or ‘staff shortages’ as a key component of this ‘puzzle’. Having said that, it is rare indeed to see these human resource factors explored in any detail. In the absence of detailed critique (implicit) ‘common sense’ presumptions prevail: namely that the economic conditions at national level lead to inadequacies in the supply of suitably qualified health professionals exacerbated by losses to international emigration. Eight years’ experience of action-research interventions in Uganda combining a range of methods has lead us to a rather stark conclusion: the single most important factor contributing to delays and associated adverse outcomes for mothers and babies in Uganda is the failure of doctors to be present at work during contracted hours. Failure to acknowledge and respond to this sensitive problem will ultimately undermine all other interventions including professional voluntarism which relies on local ‘co-presence’ to be effective. Important steps forward could be achieved within the current resource framework, if the political will existed. International NGOs have exacerbated this problem encouraging forms of internal ‘brain drain’ particularly among doctors. Arguably the system as it is rewards doctors for non-compliance resulting in massive resource inefficiencies. PMID:27142803

Monte Carlo simulations for the shielding of the future high-intensity accelerator facility FAIR at GSI.

PubMed

Radon, T; Gutermuth, F; Fehrenbacher, G

2005-01-01

The Gesellschaft für Schwerionenforschung (GSI) is planning a significant expansion of its accelerator facilities. Compared to the present GSI facility, a factor of 100 in primary beam intensities and up to a factor of 10,000 in secondary radioactive beam intensities are key technical goals of the proposal. The second branch of the so-called Facility for Antiproton and Ion Research (FAIR) is the production of antiprotons and their storage in rings and traps. The facility will provide beam energies a factor of approximately 15 higher than presently available at the GSI for all ions, from protons to uranium. The shielding design of the synchrotron SIS 100/300 is shown exemplarily by using Monte Carlo calculations with the FLUKA code. The experimental area serving the investigation of compressed baryonic matter is analysed in the same way. In addition, a dose comparison is made for an experimental area operated with medium energy heavy-ion beams. Here, Monte Carlo calculations are performed by using either heavy-ion primary particles or proton beams with intensities scaled by the mass number of the corresponding heavy-ion beam.

Assessment of Volatile Organic Compounds (VOCs) in indooor parking facilities at Houston, Texas

NASA Astrophysics Data System (ADS)

Kristanto, Gabriel Andari

This dissertation identified the types, magnitudes, sources, and assessed risk exposure of VOCs in different types of indoor parking facilities. VOCs are ones of major pollutants emitted from automobiles. The indoor parking facilities included were attached garages, grounds, and underground parking. Modification of method TO15 by EPA had been applied for identifying types and magnitudes of VOCs. Results of these identifications are presented. Eight most abundant VOCs could be identified in every sampling location with toluene as the most abundant compound followed by m,p-xylene, ethylbenzene and benzene. Compare to ground and underground parking, attached garages have the highest concentration of TVOCs. For sources identification, BTEX, m,p-xylene and benzene, and toluene and benzene ratios are calculated. BTEX ratios for ground and underground parking are similar compare to attached garage due to the similar pattern of driving speed and the content of gasoline fuel. On the other hand the ratios of m,p-xylene and benzene and toluene and benzene in attached garage are higher compare to the same ratios for ground and underground parking due to other significant contributor of VOCs such as solvent, household cleanings stored. Cancer and noncancer risk assessment were also calculated. Results showed that cancer and noncancer risk due human exposures to VOC in indoor parking facilities were relatively low. However the risk of the human exposure to VOCs from indoor parking facilities has to be considered as a part of total risks of VOC exposures on human during their daily activities. When people in Houston have already exposed to high VOC concentrations from outdoor environment activities such as traffic and refineries and petrochemical facilities, additional activities causing VOC exposures will add the risk significantly.

U.S. Army Central and U.S. Army Contracting Command-Rock Island Need to Improve Facility Maintenance at King Abdullah II Special Operations Training Center

DTIC Science & Technology

2016-03-23

cleaned so that they are free of dust, dirt, lint and human waste, and trash.” However, the contract did not explicitly state that the facilities...be free of mold/mildew. ACC–RI and ARCENT should review and modify the basic life support services contract, as necessary, to include measures...Responsibility, “The Sand Book,” July 18, 2014. 16 Unified Facility Criteria 1-202-01, “Host Nation Facilities in Support of Military Operations,” September 1

Running to Safety: Analysis of Disaster Susceptibility of Neighborhoods and Proximity of Safety Facilities in Silay City, Philippines

NASA Astrophysics Data System (ADS)

Patiño, C. L.; Saripada, N. A.; Olavides, R. D.; Sinogaya, J.

2016-06-01

Going on foot is the most viable option when emergency responders fail to show up in disaster zones at the quickest and most reasonable time. In the Philippines, the efficacy of disaster management offices is hampered by factors such as, but not limited to, lack of equipment and personnel, distance, and/or poor road networks and traffic systems. In several instances, emergency response times exceed acceptable norms. This study explores the hazard susceptibility, particularly to fire, flood, and landslides, of neighborhoods vis-à-vis their proximity to safety facilities in Silay City, Philippines. Imbang River exposes communities in the city to flooding while the mountainous terrain makes the city landslide prone. Building extraction was done to get the possible human settlements in the city. The building structures were extracted through image processing using a ruleset-based approach in the process of segmentation and classification of LiDAR derivatives and ortho-photos. Neighborhoods were then identified whether they have low to high susceptibility to disaster risks in terms of floods and landslides based on the hazards maps obtained from the Philippines' Mines and Geosciences Bureau (MGB). Service area analyses were performed to determine the safety facilities available to different neighborhoods at varying running times. Locations which are inaccessible or are difficult to run to because of distance and corresponding hazards were determined. Recommendations are given in the form of infrastructure installation, relocation of facilities, safety equipment and vehicle procurement, and policy changes for specific areas in Silay City.

Routine Habitat Change: A Source of Unrecognized Transient Alteration of Intestinal Microbiota in Laboratory Mice

PubMed Central

Ma, Betty W.; Bokulich, Nicholas A.; Castillo, Patricia A.; Kananurak, Anchasa; Underwood, Mark A.; Mills, David A.; Bevins, Charles L.

2012-01-01

The mammalian intestine harbors a vast, complex and dynamic microbial population, which has profound effects on host nutrition, intestinal function and immune response, as well as influence on physiology outside of the alimentary tract. Imbalance in the composition of the dense colonizing bacterial population can increase susceptibility to various acute and chronic diseases. Valuable insights on the association of the microbiota with disease critically depend on investigation of mouse models. Like in humans, the microbial community in the mouse intestine is relatively stable and resilient, yet can be influenced by environmental factors. An often-overlooked variable in research is basic animal husbandry, which can potentially alter mouse physiology and experimental outcomes. This study examined the effects of common husbandry practices, including food and bedding alterations, as well as facility and cage changes, on the gut microbiota over a short time course of five days using three culture-independent techniques, quantitative PCR, terminal restriction fragment length polymorphism (TRFLP) and next generation sequencing (NGS). This study detected a substantial transient alteration in microbiota after the common practice of a short cross-campus facility transfer, but found no comparable alterations in microbiota within 5 days of switches in common laboratory food or bedding, or following an isolated cage change in mice acclimated to their housing facility. Our results highlight the importance of an acclimation period following even simple transfer of mice between campus facilities, and highlights that occult changes in microbiota should be considered when imposing husbandry variables on laboratory animals. PMID:23082164

Facility Planning for Physical Education, Recreation, and Athletics.

ERIC Educational Resources Information Center

Flynn, Richard B., Ed.

This publication reflects the composite knowledge of many professionals on the topic of the planning and construction of facilities for athletics, physical education, and recreation. The text is organized into nine chapters: (1) "Facility Planning Process: Factors To Consider" (H. R. White and J. D. Karabetsos); (2) "Indoor…

42 CFR 435.622 - Individuals in institutions who are eligible under a special income level.

Code of Federal Regulations, 2010 CFR

2010-10-01

... THE STATES, DISTRICT OF COLUMBIA, THE NORTHERN MARIANA ISLANDS, AND AMERICAN SAMOA General Financial..., nursing facilities, and intermediate care facilities for the mentally retarded who would not be eligible... (hospital, nursing facility, or intermediate level care for the mentally retarded), or by other factors...

Key Factors Controlling the Growth of Biological Soil Crusts: Towards a Protocol to Produce Biocrusts in Greenhouse Facilities

NASA Astrophysics Data System (ADS)

Velasco Ayuso, Sergio; María Giraldo Silva, Ana; Nelson, Corey; Barger, Nichole; Antoninka, Anita; Bowker, Matthew; Garcia-Pichel, Ferran

2016-04-01

Biological soil crusts (= biocrusts) are topsoil communities comprise of, but not limited to, cyanobacteria, algae, lichens, and mosses that grow intimately associated with soil particles in drylands. Biocrusts have central ecological roles in these areas as sources of carbon and nutrients, and efficiently retain water and prevent soil erosion, which improves soil structure and promotes soil fertility. However, human activities, such as cattle grazing, hiking or military training, are rapidly striking biocrusts. Although it is well known that the inoculation with cyanobacteria or lichens can enhance the recovery of biocrusts in degraded soils, little is known about the factors that control their growth rates. Using soil and inocula from four different sites located in one cold desert (Utah) and in one hot desert (New Mexico), we performed a fractional factorial experiment involving seven factors (water, light, P, N, calcium carbonate, trace metals and type of inoculum) to screen their effects on the growth of biocrusts. After four months, we measured the concentration of chlorophyll a, and we discovered that water, light and P, N or P+N were the most important factors controlling the growth of biocrusts. In the experimental treatments involving these three factors we measured a similar concentration of chlorophyll a (or even higher) to this found in the field locations. Amplification of the 16S rRNA gene segment using universal bacteria primers revealed a microbial community composition in the biocrusts grown that closely corresponds to initial measurements made on inocula. In summary, based on our success in obtaining biocrust biomass from natural communities in greenhouse facilities, without significantly changing its community composition at the phylum and cyanobacterial level, we are paving the road to propose a protocol to produce a high quality-nursed inoculum aiming to assist restoration of arid and semi-arid ecosystems affected by large-scale disturbances.

Job satisfaction and associated factors among health care providers at public health institutions in Harari region, eastern Ethiopia: a cross-sectional study.

PubMed

Geleto, Ayele; Baraki, Negga; Atomsa, Gudina Egata; Dessie, Yadeta

2015-09-01

Human factor is the primary resource of health care system. For optimal performance of health care system, the workforce needs to be satisfied with the job he/she is doing. This research was aimed to assess the level of job satisfaction and associated factors among health care providers at public health institutions in Harari region, Eastern Ethiopia. Health facility based cross-sectional study was conducted among 405 randomly selected health care providers in Harari regional state, Eastern Ethiopia. Data were collected by self-administered structured questionnaires. Epidata Version 3.1 was used for data entry and analysis was made with SPSS version 17. Level of job satisfaction was measured with a multi item scales derived from Wellness Council of America and Best Companies Group. The average/mean value was used as the cutoff point to determine whether the respondents were satisfied with their job or not. Multivariable logistic regression was used to analyze data and odds ratio with 95% CI at P ≤ 0.05 was used to identify associated factors with level of job satisfaction. Less than half 179 (44.2%) of the respondents were satisfied with their job. Being midwifery in profession [AOR = 1.20; 95% CI (1.11-2.23)], age less than 35 years [AOR = 2.0; 95% CI (1.67-2.88)], having good attitude to stay in the same ward for longer period [AOR = 3.21; 95 % CI (1.33, 5.41)], and safe working environment [AOR = 4.61; 95% CI (3.33, 6.92)] were found were found to be associated with job satisfaction. Less than half (44.2%) of the respondents were satisfied with their current job. Organizational management system, salary and payment and working environment were among factors that affects level of job satisfaction. Thus, regional health bureau and health facility administrators need to pay special attention to improve management system through the application of a health sector reform strategy.

Translating evidence into policy for cardiovascular disease control in India

PubMed Central

2011-01-01

Cardiovascular diseases (CVD) are leading causes of premature mortality in India. Evidence from developed countries shows that mortality from these can be substantially prevented using population-wide and individual-based strategies. Policy initiatives for control of CVD in India have been suggested but evidence of efficacy has emerged only recently. These initiatives can have immediate impact in reducing morbidity and mortality. Of the prevention strategies, primordial involve improvement in socioeconomic status and literacy, adequate healthcare financing and public health insurance, effective national CVD control programme, smoking control policies, legislative control of saturated fats, trans fats, salt and alcohol, and development of facilities for increasing physical activity through better urban planning and school-based and worksite interventions. Primary prevention entails change in medical educational curriculum and improved healthcare delivery for control of CVD risk factors-smoking, hypertension, dyslipidemia and diabetes. Secondary prevention involves creation of facilities and human resources for optimum acute CVD care and secondary prevention. There is need to integrate various policy makers, develop effective policies and modify healthcare systems for effective delivery of CVD preventive care. PMID:21306620

Factors determining the viability of radiation processing in developing countries

NASA Astrophysics Data System (ADS)

van der Linde, HJ; Basson, RA

In the fifteen years since the introduction of radiation processing to South Africa, four commercial irradiation facilities have been established. These are involved in the processing of a large variety of products, from syringes and prostheses to strawberries and sugar yeast. Three of the facilities are devoted mainly to food irradiation and several thousand tonnes are now processed annually. During this period it was repeatedly experienced that the successful introduction of radiation processing in general, and food radurization in particular, on a commercial scale was critically dependent on the following factors: acceptance by the producer, industry and consumer; initial capital expenditure; running costs and overheads in general; and continous throughput. All of these factors contribute to the processing cost which is the ultimate factor in determing the value/price ratio for the potential entrepreneur and customer of this new technology. After a market survey had identified the need for a new food irradiation facility to cope with the growing interest in commercial food radurization in the Western Cape, the above-mentioned factors were of cardinal importance in the design and manufacture of a new irradiator. The resulting batch-pallet facility which was commisioned in August 1986, is rather inefficient as far as energy utilization is concerned but this shortcoming is compensated for by its low cost, versatility and low hold-up. Although the facility has limitations as far as the processing of really large volumes of produce is concerned, it is particularly suitable not only for developing countries, but for developed countries in the introductory phase of commercial food radurization.

Environmental factor(tm) system: RCRA hazardous waste handler information (on CD-ROM). Data file

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

NONE

1995-11-01

Environmental Factor(trademark) RCRA Hazardous Waste Handler Information on CD-ROM unleashes the invaluable information found in two key EPA data sources on hazardous waste handlers and offers cradle-to-grave waste tracking. It`s easy to search and display: (1) Permit status, design capacity, and compliance history for facilities found in the EPA Research Conservation and Recovery Information System (RCRIS) program tracking database; (2) Detailed information on hazardous wastes generation, management, and minimization by companies who are large quantity generators; and (3) Data on the waste management practices of treatment, storage, and disposal (TSD) facilities from the EPA Biennial Reporting System which is collectedmore » every other year. Environmental Factor`s powerful database retrieval system lets you: (1) Search for RCRA facilities by permit type, SIC code, waste codes, corrective action, or violation information, TSD status, generator and transporter status, and more. (2) View compliance information - dates of evaluation, violation, enforcement, and corrective action. (3) Lookup facilities by waste processing categories of marketing, transporting, processing, and energy recovery. (4) Use owner/operator information and names, titles, and telephone numbers of project managers for prospecting. (5) Browse detailed data on TSD facility and large quantity generators` activities such as onsite waste treatment, disposal, or recycling, offsite waste received, and waste generation and management. The product contains databases, search and retrieval software on two CD-ROMs, an installation diskette and User`s Guide. Environmental Factor has online context-sensitive help from any screen and a printed User`s Guide describing installation and step-by-step procedures for searching, retrieving, and exporting.« less

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

PubMed

Castle, Nicholas; Engberg, John B; Wagner, Laura M; Handler, Steven

2017-02-01

This research examined resident and facility-specific factors associated with a diagnosis of a urinary tract infection (UTI) in the nursing home setting. Minimum Data Set and Online Survey, Certification and Reporting system data were used to identify all nursing home residents in the United States on April 1, 2006, who did not have a UTI ( n = 1,138,418). Residents were followed until they contracted a UTI (9.5%), died (8.3%), left the nursing home (33.2%), or the year ended (49.0%). A Cox proportional hazards model was estimated, controlling for resident and facility characteristics and for the state of residence. The presence of an indwelling catheter was the primary predictor of whether a resident contracted a UTI (adjusted incidence ratio = 3.35, p < .001), but only 6.1% of the residents in the sample had such a catheter. Therefore, only one eighth of the UTIs were contracted by residents with a catheter. Thus, subsequent analysis examined the populations with and without catheters separately. Demographic characteristics (such as age) have a much greater association with incidence among residents without catheters. The association with facility factors such as percentage of Medicaid residents, for-profit, and chain status was less significant. Estimates regarding staffing levels indicate that increased contact hours with more highly educated nursing staff are associated with less catheter use. Several facility-specific risk factors are of significance. Of significance, UTIs may be reduced by modifying factors such as staffing levels.

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

Hayes, Birchard P; Michel, Kelly D; Few, Douglas A

From stereophonic, positional sound to high-definition imagery that is crisp and clean, high fidelity computer graphics enhance our view, insight, and intuition regarding our environments and conditions. Contemporary 3-D modeling tools offer an open architecture framework that enables integration with other technologically innovative arenas. One innovation of great interest is Augmented Reality, the merging of virtual, digital environments with physical, real-world environments creating a mixed reality where relevant data and information augments the real or actual experience in real-time by spatial or semantic context. Pairing 3-D virtual immersive models with a dynamic platform such as semi-autonomous robotics or personnel odometrymore » systems to create a mixed reality offers a new and innovative design information verification inspection capability, evaluation accuracy, and information gathering capability for nuclear facilities. Our paper discusses the integration of two innovative technologies, 3-D visualizations with inertial positioning systems, and the resulting augmented reality offered to the human inspector. The discussion in the paper includes an exploration of human and non-human (surrogate) inspections of a nuclear facility, integrated safeguards knowledge within a synchronized virtual model operated, or worn, by a human inspector, and the anticipated benefits to safeguards evaluations of facility operations.« less

Risk factors for fecal colonization with multiple distinct strains of Escherichia coli among long-term care facility residents.

PubMed

Lautenbach, Ebbing; Tolomeo, Pam; Black, Nicole; Maslow, Joel N

2009-05-01

Of 49 long-term care facility residents, 21 (43%) were colonized with 2 or more distinct strains of Escherichia coli. There were no significant risk factors for colonization with multiple strains of E. coli. These results suggest that future efforts to efficiently identify the diversity of colonizing strains will be challenging.

Risk Factors for Fecal Colonization with Multiple Distinct Strains of Escherichia coli Among Long-Term Care Facility Residents

PubMed Central

Lautenbach, Ebbing; Tolomeo, Pam; Black, Nicole; Maslow, Joel N.

2009-01-01

Of 49 long-term care facility residents, 21 (43%) were colonized with two or more distinct strains of Escherichia coli. There were no significant risk factors for colonization with multiple strains of E. coli. These results suggest future efforts to efficiently identify diversity of colonizing strains will be challenging. PMID:19292660

42 CFR 431.105 - Consultation to medical facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... State agencies furnish consultative services to hospitals, nursing homes, home health agencies, clinics... 42 Public Health 4 2010-10-01 2010-10-01 false Consultation to medical facilities. 431.105 Section 431.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

40 CFR 6.207 - Environmental impact statements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... federal actions significantly affecting the quality of the human environment, including actions for which... treated effluent from a new or modified existing facility into a body of water and the discharge is likely... size and location of new and existing facilities, land requirements, operation and maintenance...

40 CFR 6.207 - Environmental impact statements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... federal actions significantly affecting the quality of the human environment, including actions for which... treated effluent from a new or modified existing facility into a body of water and the discharge is likely... size and location of new and existing facilities, land requirements, operation and maintenance...

40 CFR 6.207 - Environmental impact statements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... federal actions significantly affecting the quality of the human environment, including actions for which... treated effluent from a new or modified existing facility into a body of water and the discharge is likely... size and location of new and existing facilities, land requirements, operation and maintenance...

Low prevalence of human pathogens on fresh produce on farms and in packing facilities

USDA-ARS?s Scientific Manuscript database

Foodborne illness burdens individuals around the world. Consumption of produce contaminated with bacterial, parasite, and viral pathogens causes a significant proportion of cases of foodborne illness. Farms and packing facilities provide opportunities for contamination. This research aimed to determ...

Medicaid: Methods for Setting Nursing Home Rates Should be Improved.

DTIC Science & Technology

1986-05-01

care facility SNF skilled nursing facility Page 7 GAO/HRJD.W626 Medicaid Nursing Home Rate Setting A,, I-?A -WI...consumer price index GNP Gross National Product HCFA Health Care Financing Administration HHS Department of Health and Human Services ICF intermediate

9 CFR 3.52 - Facilities, outdoor.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Facilities, outdoor. 3.52 Section 3.52 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...