Hanford immobilized low-activity tank waste performance assessment

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

Mann, F.M.

1998-03-26

The Hanford Immobilized Low-Activity Tank Waste Performance Assessment examines the long-term environmental and human health effects associated with the planned disposal of the vitrified low-level fraction of waste presently contained in Hanford Site tanks. The tank waste is the by-product of separating special nuclear materials from irradiated nuclear fuels over the past 50 years. This waste has been stored in underground single and double-shell tanks. The tank waste is to be retrieved, separated into low and high-activity fractions, and then immobilized by private vendors. The US Department of Energy (DOE) will receive the vitrified waste from private vendors and plansmore » to dispose of the low-activity fraction in the Hanford Site 200 East Area. The high-level fraction will be stored at Hanford until a national repository is approved. This report provides the site-specific long-term environmental information needed by the DOE to issue a Disposal Authorization Statement that would allow the modification of the four existing concrete disposal vaults to provide better access for emplacement of the immobilized low-activity waste (ILAW) containers; filling of the modified vaults with the approximately 5,000 ILAW containers and filler material with the intent to dispose of the containers; construction of the first set of next-generation disposal facilities. The performance assessment activity will continue beyond this assessment. The activity will collect additional data on the geotechnical features of the disposal sites, the disposal facility design and construction, and the long-term performance of the waste. Better estimates of long-term performance will be produced and reviewed on a regular basis. Performance assessments supporting closure of filled facilities will be issued seeking approval of those actions necessary to conclude active disposal facility operations. This report also analyzes the long-term performance of the currently planned disposal system as a basis to set requirements on the waste form and the facility design that will protect the long-term public health and safety and protect the environment.« less

Alcoa: Plant-Wide Energy Assessment Finds Potential Savings at Aluminum Extrusion Facility. Industrial Technologies Program, Aluminum BestPractices Plant-Wide Assessment Case Study.

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

Not Available

2003-09-01

Alcoa completed an energy assessment of its Engineered Products aluminum extrusion facility in Plant City, Florida, in 2001. The company identified energy conservation opportunities throughout the plant and prepared a report as an example for performing energy assessments at similar Alcoa facilities. If implemented, the cost of energy for the plant would be reduced by more than$800,000 per year by conserving 3 million kWh of electricity and 150,000 MMBtu of natural gas.

Assessing the quality of care in a new nation: South Sudan's first national health facility assessment.

PubMed

Berendes, Sima; Lako, Richard L; Whitson, Donald; Gould, Simon; Valadez, Joseph J

2014-10-01

We adapted a rapid quality of care monitoring method to a fragile state with two aims: to assess the delivery of child health services in South Sudan at the time of independence and to strengthen local capacity to perform regular rapid health facility assessments. Using a two-stage lot quality assurance sampling (LQAS) design, we conducted a national cross-sectional survey among 156 randomly selected health facilities in 10 states. In each of these facilities, we obtained information on a range of access, input, process and performance indicators during structured interviews and observations. Quality of care was poor with all states failing to achieve the 80% target for 14 of 19 indicators. For example, only 12% of facilities were classified as acceptable for their adequate utilisation by the population for sick-child consultations, 16% for staffing, 3% for having infection control supplies available and 0% for having all child care guidelines. Health worker performance was categorised as acceptable in only 6% of cases related to sick-child assessments, 38% related to medical treatment for the given diagnosis and 33% related to patient counselling on how to administer the prescribed drugs. Best performance was recorded for availability of in-service training and supervision, for seven and ten states, respectively. Despite ongoing instability, the Ministry of Health developed capacity to use LQAS for measuring quality of care nationally and state-by-state, which will support efficient and equitable resource allocation. Overall, our data revealed a desperate need for improving the quality of care in all states. © 2014 John Wiley & Sons Ltd.

Rapid assessment of infrastructure of primary health care facilities - a relevant instrument for health care systems management.

PubMed

Scholz, Stefan; Ngoli, Baltazar; Flessa, Steffen

2015-05-01

Health care infrastructure constitutes a major component of the structural quality of a health system. Infrastructural deficiencies of health services are reported in literature and research. A number of instruments exist for the assessment of infrastructure. However, no easy-to-use instruments to assess health facility infrastructure in developing countries are available. Present tools are not applicable for a rapid assessment by health facility staff. Therefore, health information systems lack data on facility infrastructure. A rapid assessment tool for the infrastructure of primary health care facilities was developed by the authors and pilot-tested in Tanzania. The tool measures the quality of all infrastructural components comprehensively and with high standardization. Ratings use a 2-1-0 scheme which is frequently used in Tanzanian health care services. Infrastructural indicators and indices are obtained from the assessment and serve for reporting and tracing of interventions. The tool was pilot-tested in Tanga Region (Tanzania). The pilot test covered seven primary care facilities in the range between dispensary and district hospital. The assessment encompassed the facilities as entities as well as 42 facility buildings and 80 pieces of technical medical equipment. A full assessment of facility infrastructure was undertaken by health care professionals while the rapid assessment was performed by facility staff. Serious infrastructural deficiencies were revealed. The rapid assessment tool proved a reliable instrument of routine data collection by health facility staff. The authors recommend integrating the rapid assessment tool in the health information systems of developing countries. Health authorities in a decentralized health system are thus enabled to detect infrastructural deficiencies and trace the effects of interventions. The tool can lay the data foundation for district facility infrastructure management.

Reproductive health services in Malawi: an evaluation of a quality improvement intervention.

PubMed

Rawlins, Barbara J; Kim, Young-Mi; Rozario, Aleisha M; Bazant, Eva; Rashidi, Tambudzai; Bandazi, Sheila N; Kachale, Fannie; Sanghvi, Harshad; Noh, Jin Won

2013-01-01

this study was to evaluate the impact of a quality improvement initiative in Malawi on reproductive health service quality and related outcomes. (1) post-only quasi-experimental design comparing observed service quality at intervention and comparison health facilities, and (2) a time-series analysis of service statistics. sixteen of Malawi's 23 district hospitals, half of which had implemented the Performance and Quality Improvement (PQI) intervention for reproductive health at the time of the study. a total of 98 reproductive health-care providers (mostly nurse-midwives) and 139 patients seeking family planning (FP), antenatal care (ANC), labour and delivery (L&D), or postnatal care (PNC) services. health facility teams implemented a performance and quality improvement (PQI) intervention over a 3-year period. Following an external observational assessment of service quality at baseline, facility teams analysed performance gaps, designed and implemented interventions to address weaknesses, and conducted quarterly internal assessments to assess progress. Facilities qualified for national recognition by complying with at least 80% of reproductive health clinical standards during an external verification assessment. key measures include facility readiness to provide quality care, observed health-care provider adherence to clinical performance standards during service delivery, and trends in service utilisation. intervention facilities were more likely than comparison facilities to have the needed infrastructure, equipment, supplies, and systems in place to offer reproductive health services. Observed quality of care was significantly higher at intervention than comparison facilities for PNC and FP. Compared with other providers, those at intervention facilities scored significantly higher on client assessment and diagnosis in three service areas, on clinical management and procedures in two service areas, and on counselling in one service area. Service statistics suggest that the PQI intervention increased the number of Caesarean sections, but showed no impact on other indicators of service utilisation and skilled care. the PQI intervention showed a positive impact on the quality of reproductive health services. The effects of the intervention on service utilisation had likely not yet been fully realized, since none of the facilities had achieved national recognition before the evaluation. Staff turnover needs to be reduced to maximise the effectiveness of the intervention. the PQI intervention evaluated here offers an effective way to improve the quality of health services in low-resource settings and should continue to be scaled up in Malawi. Copyright © 2011 Elsevier Ltd. All rights reserved.

Alcoa: Plant-Wide Energy Assessment Finds Potential Savings at Aluminum Extrusion Facility

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

None

2003-09-01

Alcoa completed an energy assessment of its Engineered Products aluminum extrusion facility in Plant City, Florida, in 2001. The company identified energy conservation opportunities throughout the plant and prepared a report as an example for performing energy assessments at similar Alcoa facilities. If implemented, the cost of energy for the plant would be reduced by more than $800,000 per year by conserving 3 million kWh of electricity and 150,000 MMBtu of natural gas.

41 CFR 102-80.60 - Are Federal agencies responsible for performing facility assessments?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT Safety and Environmental Management Facility Assessments... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Are Federal agencies...

Gap analysis: assessing the value perception of consultant pharmacist services and the performance of consultant pharmacists.

PubMed

Clark, Thomas R

2008-09-01

To understand the importance of services provided by consultant pharmacists and to assess perception of their performance of services. Cross-sectional; nursing facility team. Random e-mail survey of consultant pharmacists; phone survey of team members. 233 consultant pharmacists (practicing in a nursing facility); 540 team members (practicing in a nursing facility, interacting with > or = 1 consultant pharmacist): 120 medical directors, 210 directors of nursing, 210 administrators. Consultant pharmacists, directors of nursing, medical directors, and administrators rating importance/performance of 21 services. Gap between teams' ratings of importance and consultant pharmacists' performance is assessed to categorize services. Importance/performance ranked on five-point scale. Mean scores used for gap analysis to cluster services into four categories. Per combined group, six services categorized as "Keep It Up" (important, good performance), consensus with individual groups, except discrepancy with medical directors, for one service. Six services each categorized as "Improve" (important, large gap) and "Improve Second" (lower importance, large gap), with varied responses by individual groups. Three different services were categorized into "Don't Worry," with consensus within individual groups. Consensus from all groups found 5 of 21 services are important and performed well by consultant pharmacists, indicating to maintain performance of services. For three services, consultant pharmacists do not need to worry about their performance. Thirteen services require improvement in consultant pharmacists' performance; various groups differ on extent of improvement needed. Results can serve as benchmark comparisons with results obtained by consultant pharmacists in their own facilities.

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

PubMed

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

2018-01-25

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

Practical Approaches for Assessment of Daily and Post-discharge Room Disinfection in Healthcare Facilities.

PubMed

Deshpande, Abhishek; Donskey, Curtis J

2017-09-01

Cleaning and disinfection in healthcare facilities is essential to ensure patient safety. This review examines practical strategies used to assess and improve the effectiveness of daily and post-discharge manual cleaning in healthcare facilities. Effective implementation of cleaning interventions requires objective monitoring of staff performance with regular feedback on performance. Use of fluorescent markers to assess thoroughness of cleaning and measurement of residual ATP can provide rapid and objective feedback to personnel and have been associated with improved cleaning. Direct observation of cleaning and interviews with front-line staff are useful to identify variations and deficiencies in practice that may not be detected by other methods. Although not recommended for routine monitoring, cultures can be helpful for outbreak investigations. Monitoring and feedback can be effective in improving cleaning and disinfection in healthcare facilities. Ongoing commitment within institutions is needed to sustain successful cleaning and disinfection programs.

Preliminary hazards analysis -- vitrification process

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

Coordes, D.; Ruggieri, M.; Russell, J.

1994-06-01

This paper presents a Preliminary Hazards Analysis (PHA) for mixed waste vitrification by joule heating. The purpose of performing a PHA is to establish an initial hazard categorization for a DOE nuclear facility and to identify those processes and structures which may have an impact on or be important to safety. The PHA is typically performed during and provides input to project conceptual design. The PHA is then followed by a Preliminary Safety Analysis Report (PSAR) performed during Title 1 and 2 design. The PSAR then leads to performance of the Final Safety Analysis Report performed during the facility`s constructionmore » and testing. It should be completed before routine operation of the facility commences. This PHA addresses the first four chapters of the safety analysis process, in accordance with the requirements of DOE Safety Guidelines in SG 830.110. The hazards associated with vitrification processes are evaluated using standard safety analysis methods which include: identification of credible potential hazardous energy sources; identification of preventative features of the facility or system; identification of mitigative features; and analyses of credible hazards. Maximal facility inventories of radioactive and hazardous materials are postulated to evaluate worst case accident consequences. These inventories were based on DOE-STD-1027-92 guidance and the surrogate waste streams defined by Mayberry, et al. Radiological assessments indicate that a facility, depending on the radioactive material inventory, may be an exempt, Category 3, or Category 2 facility. The calculated impacts would result in no significant impact to offsite personnel or the environment. Hazardous materials assessment indicates that a Mixed Waste Vitrification facility will be a Low Hazard facility having minimal impacts to offsite personnel and the environment.« less

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

Energy and Water Conservation Assessment of the Radiochemical Processing Laboratory (RPL) at Pacific Northwest National Laboratory

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

Johnson, Stephanie R.; Koehler, Theresa M.; Boyd, Brian K.

2014-05-31

This report summarizes the results of an energy and water conservation assessment of the Radiochemical Processing Laboratory (RPL) at Pacific Northwest National Laboratory (PNNL). The assessment was performed in October 2013 by engineers from the PNNL Building Performance Team with the support of the dedicated RPL staff and several Facilities and Operations (F&O) department engineers. The assessment was completed for the Facilities and Operations (F&O) department at PNNL in support of the requirements within Section 432 of the Energy Independence and Security Act (EISA) of 2007.

Lessons Learned from Radioactive Waste Storage and Disposal Facilities

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

Esh, David W.; Bradford, Anna H.

2008-01-15

The safety of radioactive waste disposal facilities and the decommissioning of complex sites may be predicated on the performance of engineered and natural barriers. For assessing the safety of a waste disposal facility or a decommissioned site, a performance assessment or similar analysis is often completed. The analysis is typically based on a site conceptual model that is developed from site characterization information, observations, and, in many cases, expert judgment. Because waste disposal facilities are sited, constructed, monitored, and maintained, a fair amount of data has been generated at a variety of sites in a variety of natural systems. Thismore » paper provides select examples of lessons learned from the observations developed from the monitoring of various radioactive waste facilities (storage and disposal), and discusses the implications for modeling of future waste disposal facilities that are yet to be constructed or for the development of dose assessments for the release of decommissioning sites. Monitoring has been and continues to be performed at a variety of different facilities for the disposal of radioactive waste. These include facilities for the disposal of commercial low-level waste (LLW), reprocessing wastes, and uranium mill tailings. Many of the lessons learned and problems encountered provide a unique opportunity to improve future designs of waste disposal facilities, to improve dose modeling for decommissioning sites, and to be proactive in identifying future problems. Typically, an initial conceptual model was developed and the siting and design of the disposal facility was based on the conceptual model. After facility construction and operation, monitoring data was collected and evaluated. In many cases the monitoring data did not comport with the original site conceptual model, leading to additional investigation and changes to the site conceptual model and modifications to the design of the facility. The following cases are discussed: commercial LLW disposal facilities; uranium mill tailings disposal facilities; and reprocessing waste storage and disposal facilities. The observations developed from the monitoring and maintenance of waste disposal and storage facilities provide valuable lessons learned for the design and modeling of future waste disposal facilities and the decommissioning of complex sites.« less

Performance needs assessment of maternal and newborn health service delivery in urban and rural areas of Osun State, South-West, Nigeria.

PubMed

Esan, Oluwaseun T; Fatusi, Adesegun O

2014-06-01

The study aimed to determine performance and compare gaps in maternal and newborn health (MNH) services in urban and rural areas of Osun State, Nigeria, to inform decisions for improved services. This study involved 14 urban and 10 rural-based randomly selected PHC facilities. Using a Performance Needs Assessment framework, desired performances were determined by key stakeholders and actual performances measured by conducting facility survey. Questionnaire interview of 143 health workers and 153 antenatal clients were done. Performance gaps were determined for the urban and rural areas and compared using Chi-square tests with SPSS version 17. PHC facilities and health workers in Osun State, Nigeria, were found to have significant gaps in MNH service performance and this was worse in the rural areas. Root cause of most of the performance gaps was poor political will of local government authorities. Improved government commitment to MNH is needful to address most of the gaps.

Associations Among Health Care Workplace Safety, Resident Satisfaction, and Quality of Care in Long-Term Care Facilities.

PubMed

Boakye-Dankwa, Ernest; Teeple, Erin; Gore, Rebecca; Punnett, Laura

2017-11-01

We performed an integrated cross-sectional analysis of relationships between long-term care work environments, employee and resident satisfaction, and quality of patient care. Facility-level data came from a network of 203 skilled nursing facilities in 13 states in the eastern United States owned or managed by one company. K-means cluster analysis was applied to investigate clustered associations between safe resident handling program (SRHP) performance, resident care outcomes, employee satisfaction, rates of workers' compensation claims, and resident satisfaction. Facilities in the better-performing cluster were found to have better patient care outcomes and resident satisfaction; lower rates of workers compensation claims; better SRHP performance; higher employee retention; and greater worker job satisfaction and engagement. The observed clustered relationships support the utility of integrated performance assessment in long-term care facilities.

An assessment of the use of antimisting fuel in turbofan engines

NASA Technical Reports Server (NTRS)

Fiorentino, A.; Desaro, R.; Franz, T.

1980-01-01

The effects of antimisting kerosene on the performance of the components from the fuel system and the combustor of a JT8D aircraft engine were evaluated. The problems associated with antimisting kerosene were identified and the extent of shearing or degradation required to allow the engine components to achieve satisfactory operation were determined. The performance of the combustor was assessed in a high pressure facility and in an altitude relight/cold ignition facility. The performance of the fuel pump and control system was evaluated in an open loop simulation.

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.

Source term model evaluations for the low-level waste facility performance assessment

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

Yim, M.S.; Su, S.I.

1995-12-31

The estimation of release of radionuclides from various waste forms to the bottom boundary of the waste disposal facility (source term) is one of the most important aspects of LLW facility performance assessment. In this work, several currently used source term models are comparatively evaluated for the release of carbon-14 based on a test case problem. The models compared include PRESTO-EPA-CPG, IMPACTS, DUST and NEFTRAN-II. Major differences in assumptions and approaches between the models are described and key parameters are identified through sensitivity analysis. The source term results from different models are compared and other concerns or suggestions are discussed.

Annual Summary of the Integrated Disposal Facility Performance Assessment 2011

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

Lehman, L. L.

2012-03-12

An annual summary of the adequacy of the Hanford Immobilized Low-Activity Waste (ILAW) Performance Assessment (PA) is required each year (DOE O 435.1 Chg 1,1 DOE M 435.1-1 Chg 1,2 DOE/ORP-2000-013). The most recently approved PA is DOE/ORP-2000-24.4 The ILAW PA evaluated the adequacy of the ILAW disposal facility, now referred to as the Integrated Disposal Facility (IDF), for the safe disposal of vitrified Hanford Site tank waste. More recently, a preliminary evaluation for the disposal of offsite low-level waste and mixed low-level waste was considered in RPP-1583.

Investigation of the Effects of Facility Background Pressure on the Performance and Voltage-Current Characteristics of the High Voltage Hall Accelerator

NASA Technical Reports Server (NTRS)

Kamhawi, Hani; Huang, Wensheng; Haag, Thomas; Spektor, Rostislav

2014-01-01

The National Aeronautics and Space Administration (NASA) Science Mission Directorate In-Space Propulsion Technology office is sponsoring NASA Glenn Research Center to develop a 4 kW-class Hall thruster propulsion system for implementation in NASA science missions. A study was conducted to assess the impact of varying the facility background pressure on the High Voltage Hall Accelerator (HiVHAc) thruster performance and voltage-current characteristics. This present study evaluated the HiVHAc thruster performance in the lowest attainable background pressure condition at NASA GRC Vacuum Facility 5 to best simulate space-like conditions. Additional tests were performed at selected thruster operating conditions to investigate and elucidate the underlying physics that change during thruster operation at elevated facility background pressure. Tests were performed at background pressure conditions that are three and ten times higher than the lowest realized background pressure. Results indicated that the thruster discharge specific impulse and efficiency increased with elevated facility background pressure. The voltage-current profiles indicated a narrower stable operating region with increased background pressure. Experimental observations of the thruster operation indicated that increasing the facility background pressure shifted the ionization and acceleration zones upstream towards the thrusters anode. Future tests of the HiVHAc thruster are planned at background pressure conditions that are expected to be two to three times lower than what was achieved during this test campaign. These tests will not only assess the impact of reduced facility background pressure on thruster performance, voltage-current characteristics, and plume properties; but will also attempt to quantify the magnitude of the ionization.

Assessment of air velocity sensors for use in animal produciton facilities

USDA-ARS?s Scientific Manuscript database

Ventilation is an integral part of thermal environment control in animal production facilities. Accurately measuring the air velocity distribution within these facilities is cumbersome using the traverse method and a distributed velocity measurement system would reduce the time necessary to perform ...

Facilities Performance Indicators Report, 2006-07

ERIC Educational Resources Information Center

Glazner, Steve, Ed.

2008-01-01

The "Facilities Performance Indicators Survey" ("FPI") supersedes and builds upon the two major surveys APPA conducted in the past: the Comparative Costs and Staffing (CCAS) survey and the Strategic Assessment Model (SAM). The "FPI" covers all the materials collected in CCAS and SAM, along with some select new data points and improved survey…

Assessing the capacity for newborn resuscitation and factors associated with providers’ knowledge and skills: a cross-sectional study in Afghanistan

PubMed Central

2013-01-01

Background Resuscitation with bag and mask is a high-impact intervention that can reduce neonatal deaths in resource-poor countries. This study assessed the capacity to perform newborn resuscitation at facilities offering comprehensive emergency obstetric and newborn care (EmONC) in Afghanistan, as well as individual and facility characteristics associated with providers’ knowledge and clinical skills. Methods Assessors interviewed 82 doctors and 142 midwives at 78 facilities on their knowledge of newborn resuscitation and observed them perform the procedure on an anatomical model. Supplies, equipment, and infrastructure were assessed at each facility. Descriptive statistics and simple and multivariate regression analyses were performed using STATA 11.2 and SAS 9.1.3. Results Over 90% of facilities had essential equipment for newborn resuscitation, including a mucus extractor, bag, and mask. More than 80% of providers had been trained on newborn resuscitation, but midwives were more likely than doctors to receive such training as part of pre-service education (59% and 35%, respectively, p < 0.001). No significant differences were found between doctors and midwives on knowledge, clinical skills, or confidence in performing newborn resuscitation. Doctors and midwives scored 71% and 66%, respectively, on knowledge questions and 66% and 71% on the skills assessment; 75% of doctors and 83% of midwives felt very confident in their ability to perform newborn resuscitation. Training was associated with greater knowledge (p < 0.001) and clinical skills (p < 0.05) in a multivariable model that adjusted for facility type, provider type, and years of experience offering EmONC services. Conclusions Lack of equipment and training do not pose major barriers to newborn resuscitation in Afghanistan, but providers’ knowledge and skills need strengthening in some areas. Midwives proved to be as capable as doctors of performing newborn resuscitation, which validates the major investment made in midwifery education. Competency-based pre-service and in-service training, complemented by supportive supervision, is an effective way to build providers’ capacity to perform newborn resuscitation. This kind of training could also help skilled birth attendants based in the community, at private clinics, or at primary care facilities save the lives of newborns. PMID:24020392

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

PubMed

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

2015-10-01

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

An Evaluation of the Performance Diagnostic Checklist-Human Services to Assess an Employee Performance Problem in a Center-Based Autism Treatment Facility

ERIC Educational Resources Information Center

Ditzian, Kyle; Wilder, David A.; King, Allison; Tanz, Jeanine

2015-01-01

The Performance Diagnostic Checklist-Human Services (PDC-HS) is an informant-based tool designed to assess the environmental variables that contribute to poor employee performance in human services settings. We administered the PDC-HS to 3 supervisors to assess the variables that contributed to poor performance by 4 staff members when securing…

Professional Development through Organizational Assessment: Using APPA's Facilities Management Evaluation Program

ERIC Educational Resources Information Center

Medlin, E. Lander; Judd, R. Holly

2013-01-01

APPA's Facilities Management Evaluation Program (FMEP) provides an integrated system to optimize organizational performance. The criteria for evaluation not only provide a tool for organizational continuous improvement, they serve as a compelling leadership development tool essential for today's facilities management professional. The senior…

Optimal siting of solid waste-to-value-added facilities through a GIS-based assessment.

PubMed

Khan, Md Mohib-Ul-Haque; Vaezi, Mahdi; Kumar, Amit

2018-01-01

Siting a solid waste conversion facility requires an assessment of solid waste availability as well as ensuring compliance with environmental, social, and economic factors. The main idea behind this study was to develop a methodology to locate suitable locations for waste conversion facilities considering waste availability as well as environmental and social constraints. A geographic information system (GIS) spatial analysis was used to identify the most suitable areas and to screen out unsuitable lands. The analytic hierarchy process (AHP) was used for a multi-criteria evaluation of relative preferences of different environmental and social factors. A case study was conducted for Alberta, a western province in Canada, by performing a province-wide waste availability assessment. The total available waste considered in this study was 4,077,514tonnes/year for 19 census divisions collected from 79 landfills. Finally, a location-allocation analysis was performed to determine suitable locations for 10 waste conversion facilities across the province. Copyright © 2017 Elsevier B.V. All rights reserved.

Real estate planning for population health.

PubMed

McHugh, Margie

2014-11-01

Factors that health systems should consider when performing strategic assessments of their portfolios of ambulatory facilities include: Inventory. Location Facility condition. Service mix. Space use and capacity. Occupancy metrics. Strategic and economic opportunities.

Joint Assessment of Renewable Energy and Water Desalination Research Center (REWDC) Program Capabilities and Facilities In Radioactive Waste Management

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

Bissani, M; Fischer, R; Kidd, S

2006-04-03

The primary goal of this visit was to perform a joint assessment of the Renewable Energy and Water Desalination Center's (REWDC) program in radioactive waste management. The visit represented the fourth technical and scientific interaction with Libya under the DOE/NNSA Sister Laboratory Arrangement. Specific topics addressed during the visit focused on Action Sheet P-05-5, ''Radioactive Waste Management''. The Team, comprised of Mo Bissani (Team Lead), Robert Fischer, Scott Kidd, and Jim Merrigan, consulted with REWDC management and staff. The team collected information, discussed particulars of the technical collaboration and toured the Tajura facility. The tour included the waste treatment facility,more » waste storage/disposal facility, research reactor facility, hot cells and analytical labs. The assessment team conducted the first phase of Task A for Action Sheet 5, which involved a joint assessment of the Radioactive Waste Management Program. The assessment included review of the facilities dedicated to the management of radioactive waste at the Tourja site, the waste management practices, proposed projects for the facility and potential impacts on waste generation and management.« less

Investigation of the Effects of Facility Background Pressure on the Performance and Voltage-Current Characteristics of the High Voltage Hall Accelerator

NASA Technical Reports Server (NTRS)

Kamhawi, Hani; Huang, Wensheng; Haag, Thomas; Spektor, Rostislav

2014-01-01

The National Aeronautics and Space Administration (NASA) Science Mission Directorate In-Space Propulsion Technology office is sponsoring NASA Glenn Research Center to develop a 4 kW-class Hall thruster propulsion system for implementation in NASA science missions. A study was conducted to assess the impact of varying the facility background pressure on the High Voltage Hall Accelerator (HiVHAc) thruster performance and voltage-current characteristics. This present study evaluated the HiVHAc thruster performance in the lowest attainable background pressure condition at NASA GRC Vacuum Facility 5 to best simulate space-like conditions. Additional tests were performed at selected thruster operating conditions to investigate and elucidate the underlying physics that change during thruster operation at elevated facility background pressure. Tests were performed at background pressure conditions that are three and ten times higher than the lowest realized background pressure. Results indicated that the thruster discharge specific impulse and efficiency increased with elevated facility background pressure. The voltage-current profiles indicated a narrower stable operating region with increased background pressure. Experimental observations of the thruster operation indicated that increasing the facility background pressure shifted the ionization and acceleration zones upstream towards the thruster's anode. Future tests of the HiVHAc thruster are planned at background pressure conditions that are expected to be two to three times lower than what was achieved during this test campaign. These tests will not only assess the impact of reduced facility background pressure on thruster performance, voltage-current characteristics, and plume properties; but will also attempt to quantify the magnitude of the ionization and acceleration zones upstream shifting as a function of increased background pressure.

Composite analysis E-area vaults and saltstone disposal facilities

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

Cook, J.R.

1997-09-01

This report documents the Composite Analysis (CA) performed on the two active Savannah River Site (SRS) low-level radioactive waste (LLW) disposal facilities. The facilities are the Z-Area Saltstone Disposal Facility and the E-Area Vaults (EAV) Disposal Facility. The analysis calculated potential releases to the environment from all sources of residual radioactive material expected to remain in the General Separations Area (GSA). The GSA is the central part of SRS and contains all of the waste disposal facilities, chemical separations facilities and associated high-level waste storage facilities as well as numerous other sources of radioactive material. The analysis considered 114 potentialmore » sources of radioactive material containing 115 radionuclides. The results of the CA clearly indicate that continued disposal of low-level waste in the saltstone and EAV facilities, consistent with their respective radiological performance assessments, will have no adverse impact on future members of the public.« less

How reliable are odour assessments?

PubMed

Bokowa, A; Beukes, J A

2012-01-01

This paper will demonstrate the differences found in odour test results, when odour sampling is performed at the same sources by two different consultants. By examining two case studies, this paper will highlight that the difference between the results can be significant. Both studies are based on odour sampling programs determining the odour removal efficiency of odour control units installed at two different facilities: a pet food facility and an oil/grease recycling facility. The first study is based on odour measurements at the inlet and outlet of the unit installed by Applied Plasma Physics AS at the pet food facility. Odour assessments were performed by two separate consultants at the same time. The second study is based on testing of the odour removal effectiveness of two units: a scrubber and a biofilter at an oil/grease recycling facility. During this study two odour sampling programs were performed by two consultants at different times, but under the same process conditions. This paper will show how varying results can play a role in choosing the adequate odour control technologies. The final results suggest that although, an odour control unit may appear to be insufficient, it actually is successful at removing the odours.

Waste Form Release Data Package for the 2005 Integrated Disposal Facility Performance Assessment. Erratum

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

Smith, Gary L.

2016-09-06

This report refers to or contains K g values for glasses LAWA44, LAWB45 and LAWC22 affected by calculations errors as identified by Papathanassiu et al. (2011). The corrected K g values are reported in an erratum included in the revised version of the original report. The revised report can be referenced as follows: Pierce E. M. et al. (2004) Waste Form Release Data Package for the 2005 Integrated Disposal Facility Performance Assessment. PNNL-14805 Rev. 0 Erratum. Pacific Northwest National Laboratory, Richland, WA, USA.

Waste Form Release Calculations for the 2005 Integrated Disposal Facility Performance Assessment. Erratum

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

Smith, Gary L.

2016-09-06

This report refers to or contains K g values for glasses LAWA44, LAWB45 and LAWC22 affected by calculations errors as identified by Papathanassiu et al. (2011). The corrected K g values are reported in an erratum included in the revised version of the original report. The revised report can be referenced as follows: Pierce E. M. et al. (2004) Waste Form Release Data Package for the 2005 Integrated Disposal Facility Performance Assessment. PNNL-14805 Rev. 0 Erratum. Pacific Northwest National Laboratory, Richland, WA, USA.

First regulatory inspections measuring adherence to Good Pharmacy Practices in the public sector in Uganda: a cross-sectional comparison of performance between supervised and unsupervised facilities.

PubMed

Trap, Birna; Kikule, Kate; Vialle-Valentin, Catherine; Musoke, Richard; Lajul, Grace Otto; Hoppenworth, Kim; Konradsen, Dorthe

2016-01-01

Since its inception, the Uganda National Drug Authority (NDA) has regularly inspected private sector pharmacies to monitor adherence to Good Pharmacy Practices (GPP). This study reports findings from the first public facility inspections following an intervention (SPARS: Supervision, Performance Assessment, and Recognition Strategy) to build GPP and medicines management capacity in the public sector. The study includes 455 public facilities: 417 facilities were inspected after at least four SPARS visits by trained managerial district staff (SPARS group), 38 before any exposure to SPARS. NDA inspectors measured 10 critical, 20 major, and 37 minor GPP indicators in every facility and only accredited facilities that passed all 10 critical and failed no more than 7 major indicators. Lack of compliance for a given indicator was defined as less than 75 % facilities passing that indicator. We assessed factors associated with certification using logistic regression analysis and compared number of failed indicators between the SPARS and comparative groups using two sample t-tests with equal or unequal variance. 57.4 % of inspected facilities obtained GPP certification: 57.1 % in the SPARS and 60.5 % in the comparative group (Adj. OR = 0.91, 95 % CI 0.45-1.85, p = 0.802). Overall, facilities failed an average of 10 indicators. SPARS facilities performed better than comparative facilities (9 (SD 6.1) vs. 13 (SD 7.7) failed indicators respectively; p = 0.017), and SPARS supported facilities scored better on indicators covered by SPARS. For all indicators but one minor, performance in the SPARS group was equal to or significantly better than in unsupervised facilities. Within the SPARS (intervention) group, certified facilities had < 75 % compliance on 7 indicators (all minor), and uncertified facilities on 19 (4 critical, 2 major, and 13 minor) indicators. Half of the Ugandan population obtains medicines from the public sector. Yet, we found only 3/5 of inspected public health facilities meet GPP standards. SPARS facilities tended to perform better than unsupervised facilities, substantiating the value of supporting supervision interventions in GPP areas that need strengthening. None compliant indicators can be improved through practices and behavioral changes; some require infrastructure investments. We conclude that regular NDA inspections of public sector pharmacies in conjunction with interventions to improve GPP adherence can revolutionize patient care in Uganda.

NUMERICAL FLOW AND TRANSPORT SIMULATIONS SUPPORTING THE SALTSTONE FACILITY PERFORMANCE ASSESSMENT

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

Flach, G.

2009-02-28

The Saltstone Disposal Facility Performance Assessment (PA) is being revised to incorporate requirements of Section 3116 of the Ronald W. Reagan National Defense Authorization Act for Fiscal Year 2005 (NDAA), and updated data and understanding of vault performance since the 1992 PA (Cook and Fowler 1992) and related Special Analyses. A hybrid approach was chosen for modeling contaminant transport from vaults and future disposal cells to exposure points. A higher resolution, largely deterministic, analysis is performed on a best-estimate Base Case scenario using the PORFLOW numerical analysis code. a few additional sensitivity cases are simulated to examine alternative scenarios andmore » parameter settings. Stochastic analysis is performed on a simpler representation of the SDF system using the GoldSim code to estimate uncertainty and sensitivity about the Base Case. This report describes development of PORFLOW models supporting the SDF PA, and presents sample results to illustrate model behaviors and define impacts relative to key facility performance objectives. The SDF PA document, when issued, should be consulted for a comprehensive presentation of results.« less

Modelling Pedestrian Travel Time and the Design of Facilities: A Queuing Approach

PubMed Central

Rahman, Khalidur; Abdul Ghani, Noraida; Abdulbasah Kamil, Anton; Mustafa, Adli; Kabir Chowdhury, Md. Ahmed

2013-01-01

Pedestrian movements are the consequence of several complex and stochastic facts. The modelling of pedestrian movements and the ability to predict the travel time are useful for evaluating the performance of a pedestrian facility. However, only a few studies can be found that incorporate the design of the facility, local pedestrian body dimensions, the delay experienced by the pedestrians, and level of service to the pedestrian movements. In this paper, a queuing based analytical model is developed as a function of relevant determinants and functional factors to predict the travel time on pedestrian facilities. The model can be used to assess the overall serving rate or performance of a facility layout and correlate it to the level of service that is possible to provide the pedestrians. It has also the ability to provide a clear suggestion on the designing and sizing of pedestrian facilities. The model is empirically validated and is found to be a robust tool to understand how well a particular walking facility makes possible comfort and convenient pedestrian movements. The sensitivity analysis is also performed to see the impact of some crucial parameters of the developed model on the performance of pedestrian facilities. PMID:23691055

High level waste storage tanks 242-A evaporator S/RID phase II assessment report

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

Biebesheimer, E.

This document, the Standards/Requirements Identification Document (S/RID) Phase 2 Assessment Report for the subject facility, represents the results of a Performance Assessment to determine whether procedures containing S/RID requirements are fully implemented by field personnel in the field. It contains a summary report and three attachments; an assessment schedule, performance objectives, and assessments for selected functional areas.

Implementation research to improve quality of maternal and newborn health care, Malawi.

PubMed

Brenner, Stephan; Wilhelm, Danielle; Lohmann, Julia; Kambala, Christabel; Chinkhumba, Jobiba; Muula, Adamson S; De Allegri, Manuela

2017-07-01

To evaluate the impact of a performance-based financing scheme on maternal and neonatal health service quality in Malawi. We conducted a non-randomized controlled before and after study to evaluate the effects of district- and facility-level performance incentives for health workers and management teams. We assessed changes in the facilities' essential drug stocks, equipment maintenance and clinical obstetric care processes. Difference-in-difference regression models were used to analyse effects of the scheme on adherence to obstetric care treatment protocols and provision of essential drugs, supplies and equipment. We observed 33 health facilities, 23 intervention facilities and 10 control facilities and 401 pregnant women across four districts. The scheme improved the availability of both functional equipment and essential drug stocks in the intervention facilities. We observed positive effects in respect to drug procurement and clinical care activities at non-intervention facilities, likely in response to improved district management performance. Birth assistants' adherence to clinical protocols improved across all studied facilities as district health managers supervised and coached clinical staff more actively. Despite nation-wide stock-outs and extreme health worker shortages, facilities in the study districts managed to improve maternal and neonatal health service quality by overcoming bottlenecks related to supply procurement, equipment maintenance and clinical performance. To strengthen and reform health management structures, performance-based financing may be a promising approach to sustainable improvements in quality of health care.

42 CFR 494.110 - Condition: Quality assessment and performance improvement.

Code of Federal Regulations, 2013 CFR

2013-10-01

... improvement. 494.110 Section 494.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... RENAL DISEASE FACILITIES Patient Care § 494.110 Condition: Quality assessment and performance... renal bone disease. (iv) Anemia management. (v) Vascular access. (vi) Medical injuries and medical...

42 CFR 494.110 - Condition: Quality assessment and performance improvement.

Code of Federal Regulations, 2014 CFR

2014-10-01

... improvement. 494.110 Section 494.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... RENAL DISEASE FACILITIES Patient Care § 494.110 Condition: Quality assessment and performance... renal bone disease. (iv) Anemia management. (v) Vascular access. (vi) Medical injuries and medical...

42 CFR 494.110 - Condition: Quality assessment and performance improvement.

Code of Federal Regulations, 2012 CFR

2012-10-01

... improvement. 494.110 Section 494.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... RENAL DISEASE FACILITIES Patient Care § 494.110 Condition: Quality assessment and performance... renal bone disease. (iv) Anemia management. (v) Vascular access. (vi) Medical injuries and medical...

Evaluation of Low-Level Waste Disposal Receipt Data for Los Alamos National Laboratory Technical Area 54, Area G Disposal Facility - Fiscal Year 2011

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

French, Sean B.; Shuman, Robert

2012-04-17

The Los Alamos National Laboratory (LANL or the Laboratory) generates radioactive waste as a result of various activities. Operational or institutional waste is generated from a wide variety of research and development activities including nuclear weapons development, energy production, and medical research. Environmental restoration (ER), and decontamination and decommissioning (D and D) waste is generated as contaminated sites and facilities at LANL undergo cleanup or remediation. The majority of this waste is low-level radioactive waste (LLW) and is disposed of at the Technical Area 54 (TA-54), Area G disposal facility. U.S. Department of Energy (DOE) Order 435.1 (DOE, 2001) requiresmore » that radioactive waste be managed in a manner that protects public health and safety, and the environment. To comply with this order, DOE field sites must prepare and maintain site-specific radiological performance assessments for LLW disposal facilities that accept waste after September 26, 1988. Furthermore, sites are required to conduct composite analyses that account for the cumulative impacts of all waste that has been (or will be) disposed of at the facilities and other sources of radioactive material that may interact with the facilities. Revision 4 of the Area G performance assessment and composite analysis was issued in 2008 (LANL, 2008). These analyses estimate rates of radionuclide release from the waste disposed of at the facility, simulate the movement of radionuclides through the environment, and project potential radiation doses to humans for several on-site and off-site exposure scenarios. The assessments are based on existing site and disposal facility data and on assumptions about future rates and methods of waste disposal. The accuracy of the performance assessment and composite analysis depends upon the validity of the data used and assumptions made in conducting the analyses. If changes in these data and assumptions are significant, they may invalidate or call into question certain aspects of the analyses. For example, if the volumes and activities of waste disposed of during the remainder of the disposal facility's lifetime differ significantly from those projected, the doses projected by the analyses may no longer apply. DOE field sites are required to implement a performance assessment and composite analysis maintenance program. The purpose of this program is to ensure the continued applicability of the analyses through incremental improvement of the level of understanding of the disposal site and facility. Site personnel are required to conduct field and experimental work to reduce the uncertainty in the data and models used in the assessments. Furthermore, they are required to conduct periodic reviews of waste receipts, comparing them to projected waste disposal rates. The radiological inventory for Area G was updated in conjunction with Revision 4 of the performance assessment and composite analysis (Shuman, 2008). That effort used disposal records and other sources of information to estimate the quantities of radioactive waste that have been disposed of at Area G from 1959, the year the facility started receiving waste on a routine basis, through 2007. It also estimated the quantities of LLW that will require disposal from 2008 through 2044, the year in which it is assumed that disposal operations at Area G will cease. This report documents the fourth review of Area G disposal receipts since the inventory was updated and examines information for waste placed in the ground during fiscal years (FY) 2008 through 2011. The primary objective of the disposal receipt review is to ensure that the future waste inventory projections developed for the performance assessment and composite analysis are consistent with the actual types and quantities of waste being disposed of at Area G. Toward this end, the disposal data that are the subject of this review are used to update the future waste inventory projections for the disposal facility. These projections are compared to the future inventory projections that were developed for Revision 4 of the performance assessment and composite analysis. The approach used to characterize the FY 2008 through 2011 waste is generally the same as that used to characterize the inventory for the Revision 4 analyses (Shuman, 2008). This methodology is described in Section 2. The results of the disposal receipt review are presented in Section 3 and discussed in terms of their significance to the Area G analyses.« less

Geochemical data package for the Hanford immobilized low-activity tank waste performance assessment (ILAW PA)

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

DI Kaplan; RJ Serne

Lockheed Martin Hanford Company (LMHC) is designing and assessing the performance of disposal facilities to receive radioactive wastes that are stored in single- and double-shell tanks at the Hanford Site. The preferred method of disposing of the portion that is classified as low-activity waste is to vitrify the liquid/slurry and place the solid product in near-surface, shallow-land burial facilities. The LMHC project to assess the performance of these disposal facilities is the Hanford Immobilized Low-Activity Tank Waste (ILAW) Performance Assessment (PA) activity. The goal of this project is to provide a reasonable expectation that the disposal of the waste ismore » protective of the general public, groundwater resources, air resources, surface-water resources, and inadvertent intruders. Achieving this goal will require prediction of contaminant migration from the facilities. This migration is expected to occur primarily via the movement of water through the facilities, and the consequent transport of dissolved contaminants in the porewater of the vadose zone. Pacific Northwest National Laboratory assists LMHC in their performance assessment activities. One of the PNNL tasks is to provide estimates of the geochemical properties of the materials comprising the disposal facility, the disturbed region around the facility, and the physically undisturbed sediments below the facility (including the vadose zone sediments and the aquifer sediments in the upper unconfined aquifer). The geochemical properties are expressed as parameters that quantify the adsorption of contaminants and the solubility constraints that might apply for those contaminants that may exceed solubility constraints. The common parameters used to quantify adsorption and solubility are the distribution coefficient (K{sub d}) and the thermodynamic solubility product (K{sub sp}), respectively. In this data package, the authors approximate the solubility of contaminants using a more simplified construct, called the solution concentration limit, a constant value. In future geochemical data packages, they will determine whether a more rigorous measure of solubility is necessary or warranted based on the dose predictions emanating from the ILAW 2001 PA and reviewers' comments. The K{sub d}s and solution concentration limits for each contaminant are direct inputs to subsurface flow and transport codes used to predict the performance of the ILAW system. In addition to the best-estimate K{sub d}s, a reasonable conservative value and a range are provided. They assume that K{sub d} values are log normally distributed over the cited ranges. Currently, they do not give estimates for the range in solubility limits or their uncertainty. However, they supply different values for both the K{sub d}s and solution concentration limits for different spatial zones in the ILAW system and supply time-varying K{sub d}s for the concrete zone, should the final repository design include concrete vaults or cement amendments to buffer the system pH.« less

Industrial Assessment Center Helps Boost Efficiency for Small and Medium Manufacturers

ScienceCinema

Johnson, Mark; Friedman, David

2018-06-12

The Industrial Assessment Center program helps small and medium manufacturers boost efficiency and save energy. It pairs companies with universities as students perform energy assessments and provide recommendations to improve their facilities.

Industrial Assessment Center Helps Boost Efficiency for Small and Medium Manufacturers

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

Johnson, Mark; Friedman, David

The Industrial Assessment Center program helps small and medium manufacturers boost efficiency and save energy. It pairs companies with universities as students perform energy assessments and provide recommendations to improve their facilities.

Facility versus unit level reporting of quality indicators in nursing homes when performance monitoring is the goal

PubMed Central

Norton, Peter G; Murray, Michael; Doupe, Malcolm B; Cummings, Greta G; Poss, Jeff W; Squires, Janet E; Teare, Gary F; Estabrooks, Carole A

2014-01-01

Objectives To demonstrate the benefit of defining operational management units in nursing homes and computing quality indicators on these units as well as on the whole facility. Design Calculation of adjusted Resident Assessment Instrument – Minimum Data Set 2.0 (RAI–MDS 2.0) quality indicators for: PRU05 (prevalence of residents with a stage 2–4 pressure ulcer), PAI0X (prevalence of residents with pain) and DRG01 (prevalence of residents receiving an antipsychotic with no diagnosis of psychosis), for quarterly assessments between 2007 and 2011 at unit and facility levels. Comparisons of these risk-adjusted quality indicators using statistical process control (control charts). Setting A representative sample of 30 urban nursing homes in the three Canadian Prairie Provinces. Measurements Explicit decision rules were developed and tested to determine whether the control charts demonstrated improving, worsening, unchanging or unclassifiable trends over the time period. Unit and facility performance were compared. Results In 48.9% of the units studied, unit control chart performance indicated different changes in quality over the reporting period than did the facility chart. Examples are provided to illustrate that these differences lead to quite different quality interventions. Conclusions Our results demonstrate the necessity of considering facility-level and unit-level measurement when calculating quality indicators derived from the RAI–MDS 2.0 data, and quite probably from any RAI measures. PMID:24523428

Source inventory for Department of Energy solid low-level radioactive waste disposal facilities: What it means and how to get one of your own

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

Smith, M.A.

1991-12-31

In conducting a performance assessment for a low-level waste (LLW) disposal facility, one of the important considerations for determining the source term, which is defined as the amount of radioactivity being released from the facility, is the quantity of radioactive material present. This quantity, which will be referred to as the source inventory, is generally estimated through a review of historical records and waste tracking systems at the LLW facility. In theory, estimating the total source inventory for Department of Energy (DOE) LLW disposal facilities should be possible by reviewing the national data base maintained for LLW operations, the Solidmore » Waste Information Management System (SWIMS), or through the annual report that summarizes the SWIMS data, the Integrated Data Base (IDB) report. However, in practice, there are some difficulties in making this estimate. This is not unexpected, since the SWIMS and the IDB were not developed with the goal of developing a performance assessment source term in mind. The practical shortcomings using the existing data to develop a source term for DOE facilities will be discussed in this paper.« less

A Proposed Approach for Prioritizing Maintenance at NASA Centers

NASA Technical Reports Server (NTRS)

Dunn, Steven C.; Sawyer, Melvin H.

2013-01-01

The National Aeronautics and Space Administration (NASA) manages a vast array of infrastructure assets across ten National Centers with a worth of at least 30 billion dollars. Eighty percent of this infrastructure is greater than 40 years old and is in degraded condition. Maintenance budgets are typically less than one percent of current replacement value (CRV), much less than the 2-4% recommended by the National Research Council. The maintenance backlog was 2.55 billion dollars in FY10 and growing. NASA s annual budgets have flattened and are at risk of being reduced, so the problem is becoming even more difficult. NASA Centers utilize various means to prioritize and accomplish maintenance within available budgets, though data is suspect and processes are variable. This paper offers a structured means to prioritize maintenance based on mission criticality and facility performance (ability of the facility to deliver on its purpose). Mission alignment is assessed using the current timeframe Mission Dependence Index and a measure of facility alignment with the 2011 NASA Strategic Plan for the long-term perspective. Facility performance is assessed by combining specific findings from a structured facility condition assessment and an assessment of actual functional output. These are then combined in a matrix to identify the facilities most critical to mission and able to deliver services. The purpose of this approach is to provide the best benefits for the available funding. Additionally, this rationale can also be applied to the prioritization of investment (recapitalization) projects so that the ultimate customers of this paper, the senior infrastructure managers at each NASA Center, are better able to strategically manage their capabilities.

Laboratory Testing of Bulk Vitrified Low-Activity Waste Forms to Support the 2005 Integrated Disposal Facility Performance Assessment. Erratum

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

Smith, Gary L.

2016-09-06

This report refers to or contains K g values for glasses LAWA44, LAWB45 and LAWC22 affected by calculations errors as identified by Papathanassiu et al. (2011). The corrected K g values are reported in an erratum included in the revised version of the original report. The revised report can be referenced as follows: Pierce E. M. et al. (2004) Waste Form Release Data Package for the 2005 Integrated Disposal Facility Performance Assessment. PNNL-14805 Rev. 0 Erratum. Pacific Northwest National Laboratory, Richland, WA, USA.

Assessment of Space Nuclear Thermal Propulsion Facility and Capability Needs

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

James Werner

The development of a Nuclear Thermal Propulsion (NTP) system rests heavily upon being able to fabricate and demonstrate the performance of a high temperature nuclear fuel as well as demonstrating an integrated system prior to launch. A number of studies have been performed in the past which identified the facilities needed and the capabilities available to meet the needs and requirements identified at that time. Since that time, many facilities and capabilities within the Department of Energy have been removed or decommissioned. This paper provides a brief overview of the anticipated facility needs and identifies some promising concepts to bemore » considered which could support the development of a nuclear thermal propulsion system. Detailed trade studies will need to be performed to support the decision making process.« less

Development of a standardized transfusion ratio as a metric for evaluating dialysis facility anemia management practices.

PubMed

Liu, Jiannong; Li, Suying; Gilbertson, David T; Monda, Keri L; Bradbury, Brian D; Collins, Allan J

2014-10-01

Because transfusion avoidance has been the cornerstone of anemia treatment for patients with kidney disease, direct measurement of red blood cell transfusion use to assess dialysis facility anemia management performance is reasonable. We aimed to explore methods for estimating facility-level standardized transfusion ratios (STfRs) to assess provider anemia treatment practices. Retrospective cohort study. Point prevalent US hemodialysis patients on January 1, 2009, with Medicare as primary payer and dialysis duration of 90 days or longer were included (n = 223,901). All dialysis facilities with eligible patients were included (n = 5,345). Dialysis facility assignment. Receiving a red blood cell transfusion in the inpatient or outpatient setting. We evaluated 3 approaches for estimating STfR: ratio of observed to expected numbers of transfusions (STfR(obs)), a Bayesian approach (STfR(Bayes)), and a modified version of the Bayesian approach (STfR(modBayes)). The overall national transfusion rate in 2009 was 23.2 per 100 patient-years. Our model for predicting the expected number of transfusions performed well. For large facilities, all 3 STfRs worked well. However, for small facilities, while the STfR(modBayes) worked well, STfR(obs) values demonstrated instability and the STfR(Bayes) may produce more bias. Administration of transfusions to dialysis patients reflects medical practice both within and outside the dialysis unit. Some transfusions may be deemed unavoidable and transfusion practices are subject to considerable regional variation. Development of an STfR metric is feasible and reasonable for assessing anemia treatment at dialysis facilities. The STfR(obs) is simple to calculate and works well for larger dialysis facilities. The STfR(modBayes) is more analytically complex, but facilitates comparisons across all dialysis facilities, including small facilities. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

42 CFR 494.110 - Condition: Quality assessment and performance improvement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... time. (c) Standard: Prioritizing improvement activities. The dialysis facility must set priorities for performance improvement, considering prevalence and severity of identified problems and giving priority to...

Cycle O (CY 1991) NLS trade studies and analyses, book 2. Part 1: Avionics and systems

NASA Technical Reports Server (NTRS)

Harris, Richard; Kirkland, Zach

1992-01-01

An assessment was conducted to determine the maximum LH2 tank stretch capability based on the constraints of the manufacturing, tooling and facilities at the Michoud Assembly Facility in New Orleans, Louisiana. The maximum tank stretch was determined to be 5 ft. with minor or no modifications, a stretch of 11 ft. with some possible facility modifications and beyond 11 ft. significant new facilities are required. A cost analysis was performed to evaluate the impacts for various stretch lengths. Tasks that were defined to perform trades and studies regarding the best approach to meet requirements for the National Launch System Avionics are also discussed.

Energy Savings and Sustainability Opportunities at US Army Corps of Engineers Facilities: A Guide to Identify, Prioritize, and Estimate Projects at Complexes That Have Not Conducted a Facility-Level Energy and Water Evaluation

DTIC Science & Technology

2012-06-16

Engineers to help identify and develop energy and water conservation projects in the facilities for which they are responsible. DISCLAIMER: The...and water throughout their facility. To identify energy and water conservation measures (ECMs), an energy manager would generally start by performing...an Energy and Water Conservation Assessment, essentially a facility-level evaluation of the en- ergy and water consuming equipment and systems that

Radiological performance assessment for the E-Area Vaults Disposal Facility. Appendices A through M

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

Cook, J.R.

1994-04-15

These document contains appendices A-M for the performance assessment. They are A: details of models and assumptions, B: computer codes, C: data tabulation, D: geochemical interactions, E: hydrogeology of the Savannah River Site, F: software QA plans, G: completeness review guide, H: performance assessment peer review panel recommendations, I: suspect soil performance analysis, J: sensitivity/uncertainty analysis, K: vault degradation study, L: description of naval reactor waste disposal, M: porflow input file. (GHH)

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

PubMed

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

2017-01-01

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

Improving performance of Zambia Defence Force antiretroviral therapy providers: evaluation of a standards-based approach

PubMed Central

Kim, Young Mi; Banda, Joseph; Kanjipite, Webby; Sarkar, Supriya; Bazant, Eva; Hiner, Cyndi; Tholandi, Maya; Reinhardt, Stephanie; Njobvu, Panganani Dalisani; Kols, Adrienne; Benavides, Bruno

2013-01-01

ABSTRACT Background: The Zambia Defence Force (ZDF) has applied the Standards-Based Management and Recognition (SBM-R®) approach, which uses detailed performance standards, at some health facilities to improve HIV-related services offered to military personnel and surrounding civilian communities. This study examines the effectiveness of the SBM-R approach in improving facility readiness and provider performance at ZDF facilities. Methods: We collected data on facility readiness and provider performance before and after the 2010–2012 intervention at 4 intervention sites selected for their relatively poor performance and 4 comparison sites. Assessors observed whether each facility met 16 readiness standards and whether providers met 9 performance standards during consultations with 354 returning antiretroviral therapy (ART) clients. We then calculated the percentages of criteria achieved for each readiness and performance standard and conducted bivariate and multivariate analyses of provider performance data. Results: Facilities' ART readiness scores exceeded 80% before the intervention at both intervention and comparison sites. At endline, scores improved on 4 facility readiness standards in the intervention group but on only 1 standard in the comparison group. Multivariate analysis found that the overall provider performance score increased significantly in the intervention group (from 58% to 84%; P<.01) but not in the comparison group (from 62% to 70%). The before-and-after improvement in scores was significantly greater among intervention sites than among comparison sites for 2 standards—initial assessment of the client's condition and nutrition counseling. Conclusion: The standards-based approach, which involved intensive and mutually reinforcing intervention activities, showed modest improvements in some aspects of providers' performance during ART consultations. Further research is needed to determine whether improvements in provider performance affect client outcomes such as adherence to ART. PMID:25276534

Annual Report for Los Alamos National Laboratory Technical Area 54, Area G Disposal Facility – Fiscal Year 2015

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

French, Sean B.; Stauffer, Philip H.; Birdsell, Kay H.

As a condition to the disposal authorization statement issued to Los Alamos National Laboratory (LANL or the Laboratory) on March 17, 2010, a comprehensive performance assessment and composite analysis maintenance program must be implemented for the Technical Area 54, Area G disposal facility. Annual determinations of the adequacy of the performance assessment and composite analysis (PA/CA) are to be conducted under the maintenance program to ensure that the conclusions reached by those analyses continue to be valid. This report summarizes the results of the fiscal year (FY) 2015 annual review for Area G.

Program and Management Support for the Office for Military Performance Assessment Technology

DTIC Science & Technology

1993-03-01

AD-A270 790 AD_ _ _ _ CONTRACT NO: DAMDI7-90-C-0061 TITLE: PROGRAM AND MANAGEMENT SUPPORT FOR THE OFFICE FOR MILITARY PERFORMANCE ASSESSMENT... the Office of Military Performance Assessment Technology (OMPAT). 1.1 Bag-kg n m. The OMPAT evolved from the Joint Working Group on Drug Dependent...facility was located, leased and occupied by Morgan Management Systems, Inc. staff and designated as the OMPAT Field Office. The office was located at 12075B

Ballistocraft: a novel facility for microgravity research.

PubMed

Mesland, D; Paris, D; Huijser, R; Lammertse, P; Postema, R

1995-05-01

One of ESA's aims is to provide the microgravity research community with various microgravity exposure facilities. Those facilities include drop towers, sounding rockets, and parabolic flights on board aircraft, in addition to orbital spacecraft. Microgravity flights are usually achieved using large aircraft like the French 'Caravelle' that offer a large payload volume and where a person can be present to perform the experiments and to participate as a human test-subject. However, the microgravity community is also very interested in a flexible, complementary facility that would allow frequent and repetitive exposure to microgravity for a laboratory-type of payload. ESA has therefore undertaken a study of the potential of using a 'ballistocraft', a small unmanned aircraft, to provide a low-cost facility for short-duration (30-40 seconds) microgravity experimentation. Fokker Space & Systems performed the study under an ESA contract, supported by Dutch national funding. To assess the ballistocraft, a simple breadboard of the facility was built and flight tests were performed. The ability of the on-board controller to achieve automated parabolic flights was demonstrated, and the performance of the controller in one-g level flights, and in flights with both zero-g and partial-g setpoints, was evaluated. The partial-g flights are a unique and valuable feature of the facility.

77 FR 48107 - Workshop on Performance Assessments of Near-Surface Disposal Facilities: FEPs Analysis, Scenario...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-13

...) disposal facilities. The workshop has been developed to facilitate communication among Federal and State... and conceptual models, and (3) the selection of computer codes. Information gathered from invited.... NRC Public Meeting The purpose of this public meeting is to facilitate communication and gather...

Elevation of water table and various stratigraphic surfaces beneath e area low level waste disposal facility

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

Bagwell, Laura; Bennett, Patti

2017-11-02

This memorandum describes work that supports revision of the Radiological Performance Assessment (PA) for the E Area Low Level Radioactive Waste Disposal Facility (LLRWDF). The work summarized here addresses portions of the PA Strategic Planning Team's recommendation #148b (Butcher and Phifer, 2016).

Implementation research to improve quality of maternal and newborn health care, Malawi

PubMed Central

Wilhelm, Danielle; Lohmann, Julia; Kambala, Christabel; Chinkhumba, Jobiba; Muula, Adamson S; De Allegri, Manuela

2017-01-01

Abstract Objective To evaluate the impact of a performance-based financing scheme on maternal and neonatal health service quality in Malawi. Methods We conducted a non-randomized controlled before and after study to evaluate the effects of district- and facility-level performance incentives for health workers and management teams. We assessed changes in the facilities’ essential drug stocks, equipment maintenance and clinical obstetric care processes. Difference-in-difference regression models were used to analyse effects of the scheme on adherence to obstetric care treatment protocols and provision of essential drugs, supplies and equipment. Findings We observed 33 health facilities, 23 intervention facilities and 10 control facilities and 401 pregnant women across four districts. The scheme improved the availability of both functional equipment and essential drug stocks in the intervention facilities. We observed positive effects in respect to drug procurement and clinical care activities at non-intervention facilities, likely in response to improved district management performance. Birth assistants’ adherence to clinical protocols improved across all studied facilities as district health managers supervised and coached clinical staff more actively. Conclusion Despite nation-wide stock-outs and extreme health worker shortages, facilities in the study districts managed to improve maternal and neonatal health service quality by overcoming bottlenecks related to supply procurement, equipment maintenance and clinical performance. To strengthen and reform health management structures, performance-based financing may be a promising approach to sustainable improvements in quality of health care. PMID:28670014

Environmental Assessment: Proposed Training Facilities, Hill Air Force Base, Utah

DTIC Science & Technology

2013-08-08

FA8201-09-D-0002 Facilities, Hill Air Force Base, Utah 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Klein, Randal 5d...PERFORMING ORGANIZATION REPORT NUMBER Streamline Consulting, LLC 1713 N. Sweetwater Lane Farmington, Utah 84025...proposes to construct new training facilities at Hill Air Force Base, Utah . The findings of this EA indicate that the proposed action would not have

A multi-site comparison of in vivo safety pharmacology studies conducted to support ICH S7A & B regulatory submissions.

PubMed

Ewart, Lorna; Milne, Aileen; Adkins, Debbie; Benjamin, Amanda; Bialecki, Russell; Chen, Yafei; Ericsson, Ann-Christin; Gardner, Stacey; Grant, Claire; Lengel, David; Lindgren, Silvana; Lowing, Sarah; Marks, Louise; Moors, Jackie; Oldman, Karen; Pietras, Mark; Prior, Helen; Punton, James; Redfern, Will S; Salmond, Ross; Skinner, Matt; Some, Margareta; Stanton, Andrea; Swedberg, Michael; Finch, John; Valentin, Jean-Pierre

2013-01-01

Parts A and B of the ICH S7 guidelines on safety pharmacology describe the in vivo studies that must be conducted prior to first time in man administration of any new pharmaceutical. ICH S7A requires a consideration of the sensitivity and reproducibility of the test systems used. This could encompass maintaining a dataset of historical pre-dose values, power analyses, as well as a demonstration of acceptable model sensitivity and robust pharmacological validation. During the process of outsourcing safety pharmacology studies to Charles River Laboratories, AstraZeneca set out to ensure that models were performed identically in each facility and saw this as an opportunity to review the inter-laboratory variability of these essential models. The five in vivo studies outsourced were the conscious dog telemetry model for cardiovascular assessment, the rat whole body plethysmography model for respiratory assessment, the rat modified Irwin screen for central nervous system assessment, the rat charcoal meal study for gastrointestinal assessment and the rat metabolic cage study for assessment of renal function. Each study was validated with known reference compounds and data were compared across facilities. Statistical power was also calculated for each model. The results obtained indicated that each of the studies could be performed with comparable statistical power and could achieve a similar outcome, independent of facility. The consistency of results obtained from these models across multiple facilities was high thus providing confidence that the models can be run in different facilities and maintain compliance with ICH S7A and B. Copyright © 2013 Elsevier Inc. All rights reserved.

Treatment planning capability assessment of a beam shaping assembly for accelerator-based BNCT.

PubMed

Herrera, M S; González, S J; Burlon, A A; Minsky, D M; Kreiner, A J

2011-12-01

Within the frame of an ongoing project to develop a folded Tandem-Electrostatic-Quadrupole accelerator facility for Accelerator-Based Boron Neutron Capture Therapy (AB-BNCT) a theoretical study was performed to assess the treatment planning capability of different configurations of an optimized beam shaping assembly for such a facility. In particular this study aims at evaluating treatment plans for a clinical case of Glioblastoma. Copyright © 2011 Elsevier Ltd. All rights reserved.

KSC-07pd0889

NASA Image and Video Library

2007-04-16

KENNEDY SPACE CENTER, FLA. -- Pilot Rick Svetkoff taxis a Starfighter F-104 down the runway on the Shuttle Landing Facility at Kennedy Space Center. The aircraft will take part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

KSC-07pd0913

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- The Starfighter F-104 approaches the runway at the KSC Shuttle Landing Facility for a landing after its test flight. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

KSC-07pd0914

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- The Starfighter F-104 lands on the runway at the KSC Shuttle Landing Facility after its test flight. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

KSC-07pd0888

NASA Image and Video Library

2007-04-16

KENNEDY SPACE CENTER, FLA. -- A Starfighter F-104 piloted by Rick Svetkoff lands on the Shuttle Landing Facility at Kennedy Space Center. The aircraft will take part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

KSC-07pd0887

NASA Image and Video Library

2007-04-16

KENNEDY SPACE CENTER, FLA. -- A Starfighter F-104 piloted by Rick Svetkoff approaches the Shuttle Landing Facility at Kennedy Space Center. The aircraft will take part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

KSC-07pd0908

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- On the KSC Shuttle Landing Facility, pilot Rick Svetkoff settles into the cockpit of the Starfighter F-104. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

Evolution in performance assessment modeling as a result of regulatory review

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

Rowat, J.H.; Dolinar, G.M.; Stephens, M.E.

1995-12-31

AECL is planning to build the IRUS (Intrusion Resistant Underground Structure) facility for near-surface disposal of LLRW. The PSAR (preliminary safety assessment report) was subject to an initial regulatory review during mid-1992. The regulatory authority provided comments on many aspects of the safety assessment documentation including a number of questions on specific PA (Performance Assessment) modelling assumptions. As a result of these comments as well as a separate detailed review of the IRUS disposal concept, changes were made to the conceptual and mathematical models. The original disposal concept included a non-sorbing vault backfill, with a strong reliance on the wasteformmore » as a barrier. This concept was altered to decrease reliance on the wasteform by replacing the original backfill with a sand/clinoptilolite mix, which is a better sorber of metal cations. This change lead to changes in the PA models which in turn altered the safety case for the facility. This, and other changes that impacted performance assessment modelling are the subject of this paper.« less

Guidelines for the evaluation and assessment of the sustainable use of resources and of wastes management at healthcare facilities.

PubMed

Townend, William K; Cheeseman, Christopher R

2005-10-01

This paper presents guidelines that can be used by managers of healthcare facilities to evaluate and assess the quality of resources and waste management at their facilities and enabling the principles of sustainable development to be addressed. The guidelines include the following key aspects which need to be considered when completing an assessment. They are: (a) general management; (b) social issues; (c) health and safety; (d) energy and water use; (e) purchasing and supply; (f) waste management (responsibility, segregation, storage and packaging); (g) waste transport; (h) recycling and re-use; (i) waste treatment; and (j) final disposal. They identify actions required to achieve a higher level of performance which can readily be applied to any healthcare facility, irrespective of the local level of social, economic and environmental development. The guidelines are presented, and the characteristics of facilities associated with sustainable (level 4) and unsustainable (level 0) healthcare resource and wastes management are outlined. They have been used to assess a major London hospital, and this highlighted a number of deficiencies in current practice, including a lack of control over purchasing and supply, and very low rates of segregation of municipal solid waste from hazardous healthcare waste.

Monitoring quality of care at dialysis facilities: a case for regulatory parsimony--and beyond.

PubMed

Stivelman, John C

2012-10-01

With the issuance of the new Conditions for Coverage in 2008 and the implementation of the Prospective Payment System in 2011, the Centers for Medicare & Medicaid Services has fundamentally altered the regulatory landscape of quality in the ESRD program. Although these changes-largely through use of tools comparing individual facility performance to regional and national quality expectations-have increased facility accountability for the quality of patient care in many quarters, they have also complicated both substance and process of facility adherence to quality rules in that component of the program. This editorial critically assesses the main quality tools now in use for dialysis facilities and reviews the issues arising from their conjoint use. A scheme for improving the effectiveness of each quality tool is proposed, and an assessment of their future value and effectiveness in quality improvement is offered.

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

PubMed

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

2015-07-01

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

Availability and utilization of obstetric and newborn care in Guinea: A national needs assessment.

PubMed

Baguiya, Adama; Meda, Ivlabèhiré Bertrand; Millogo, Tieba; Kourouma, Mamadou; Mouniri, Halima; Kouanda, Seni

2016-11-01

To assess the availability and utilization of emergency obstetric and neonatal care (EmONC) in Guinea given the high maternal and neonatal mortality rates. We used the Guinea 2012 needs assessment data collected via a national cross-sectional census of health facilities conducted from September to October 2012. All public, private, and faith-based health facilities that performed at least one delivery during the period of the study were included. A total of 502 health facilities were visited, of which 81 were hospitals. Only 15 facilities were classified as fully functioning EmONC facilities, all of which were reference hospitals. None of the first level health facilities were fully functioning EmONC facilities. The ratio of availability of EmONC was one fully functioning EmONC facility for 745 415 inhabitants. The institutional delivery rate was 32.3% and the proportion of all births in EmONC facilities was 7.1%. Met need for EmONC was 12.2%. Among 201 maternal deaths in EmONC facilities, 69 were due to indirect causes. The intrapartum and very early neonatal death rate was 39 deaths per 1000 live births. The study showed low availability of EmONC services and underutilization of the available services. Further investigation is needed to evaluate the effect of the current policy of user fees exemption for deliveries and prenatal care in Guinea. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

VA and DOD Health Care: Department-Level Actions Needed to Assess Collaboration Performance, Address Barriers, and Identify Opportunities

DTIC Science & Technology

2012-09-01

approximately 150 hospitals, 130 nursing homes, 800 community-based outpatient clinics, as well as other facilities to provide care to veterans. VA also...receive care and have to return for rescheduled appointments. Such missed appointments can lead to lost revenue for the military treatment facility

Accreditation of ambulatory facilities.

PubMed

Urman, Richard D; Philip, Beverly K

2014-06-01

With the continued growth of ambulatory surgical centers (ASC), the regulation of facilities has evolved to include new standards and requirements on both state and federal levels. Accreditation allows for the assessment of clinical practice, improves accountability, and better ensures quality of care. In some states, ASC may choose to voluntarily apply for accreditation from a recognized organization, but in others it is mandated. Accreditation provides external validation of safe practices, benchmarking performance against other accredited facilities, and demonstrates to patients and payers the facility's commitment to continuous quality improvement. Copyright © 2014 Elsevier Inc. All rights reserved.

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

PubMed Central

2017-01-01

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

COMPARATIVE ANALYSIS OF HEALTH RISK ASSESSMENTS FOR MUNICIPAL WASTE COMBUSTORS

EPA Science Inventory

Quantitative health risk assessments have been performed for a number of proposed municipal waste combustor (MWC) facilities over the past several years. his article presents the results of a comparative analysis of a total of 21 risk assessments, focusing on seven of the most co...

Practical implications of pre-employment nurse assessments.

PubMed

Kuthy, James E; Ramon, Cheree; Gonzalez, Ronald; Biddle, Dan A

2013-01-01

Hiring nurses is a difficult task that can have serious repercussions for medical facilities. If nurses without proper skills are hired, patients can suffer from insufficient quality of care and potentially life-threatening conditions. Nurse applicants' technical knowledge is extremely important to avoid negative outcomes; however, there are soft skills that factor into their success, such as bedside manner, personality, communication, and decision making. In order for medical facilities to select and maintain high-performing nurse staff, hiring managers must incorporate evaluations for these types of skills in their hiring process. The current study focused on using content/criterion-related validation design to create assessments by which nurse applicants can be evaluated for both technical knowledge/skills and soft skills. The study included participation of more than 876 nursing staff members. To rank applicants on divergent skills, 3 assessment types were investigated, resulting in the creation of an assessment with 3 components. The clinical, situational, and behavioral components that were created measure applicants' job knowledge, interpersonal competency in medical facility-related situations, and aspects of personality and behavior, respectively. Results indicate that using the assessment can predict 45% of a nurse applicant's future job performance. Practical implications include hiring and maintaining a higher quality of nurses and decreased hiring costs.

Facility Energy Decision System (FEDS) Assessment Report for US Army Garrison, Japan - Honshu Installations

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

Kora, Angela R.; Brown, Daryl R.; Dixon, Douglas R.

2010-03-09

This report documents an assessment was performed by a team of engineers from Pacific Northwest National Laboratory (PNNL) under contract to the Installation Management Command (IMCOM) Pacific Region Office (PARO). The effort used the Facility Energy Decision System (FEDS) model to determine how energy is consumed at five U.S. Army Garrison-Japan (USAG-J) installations in the Honshu area, identify the most cost-effective energy retrofit measures, and calculate the potential energy and cost savings.

Association between fine motor skills and binocular visual function in children with reading difficulties.

PubMed

Niechwiej-Szwedo, Ewa; Alramis, Fatimah; Christian, Lisa W

2017-12-01

Performance of fine motor skills (FMS) assessed by a clinical test battery has been associated with reading achievement in school-age children. However, the nature of this association remains to be established. The aim of this study was to assess FMS in children with reading difficulties using two experimental tasks, and to determine if performance is associated with reduced binocular function. We hypothesized that in comparison to an age- and sex-matched control group, children identified with reading difficulties will perform worse only on a motor task that has been shown to rely on binocular input. To test this hypothesis, motor performance was assessed using two tasks: bead-threading and peg-board in 19 children who were reading below expected grade and age-level. Binocular vision assessment included tests for stereoacuity, fusional vergence, amplitude of accommodation, and accommodative facility. In comparison to the control group, children with reading difficulties performed significantly worse on the bead-threading task. In contrast, performance on the peg-board task was similar in both groups. Accommodative facility was the only measure of binocular function significantly associated with motor performance. Findings from our exploratory study suggest that normal binocular vision may provide an important sensory input for the optimal development of FMS and reading. Given the small sample size tested in the current study, further investigation to assess the contribution of binocular vision to the development and performance of FMS and reading is warranted. Copyright © 2017 Elsevier B.V. All rights reserved.

Emergency obstetric and neonatal care availability, use, and quality: a cross-sectional study in the city of Lubumbashi, Democratic Republic of the Congo, 2011.

PubMed

Ntambue, Abel Mukengeshayi; Malonga, Françoise Kaj; Cowgill, Karen D; Dramaix-Wilmet, Michèle; Donnen, Philippe

2017-01-19

While emergency obstetric and neonatal care (EmONC) is a proxy indicator for monitoring maternal and perinatal mortalities, in Democratic Republic of the Congo (DRC), data on this care is rarely available. In the city of Lubumbashi, the second largest in DRC with an estimated population of 1.5 million, the availability, use and quality of EmONC are not known. This study aimed to assess these elements in Lubumbashi. This cross-sectional survey was conducted in April and May 2011. Fifty-three of the 180 health facilities that provide maternity care in Lubumbashi were included in this study. Only health facilities with at least six deliveries per month over the course of 2010 were included. The availability, use and quality of EmONC at each level of the health care system were assessed according to the WHO standards. The availability of EmONC in Lubumbashi falls short of WHO standards. In this study, we found one facility providing Comprehensive EmONC (CEmONC) for a catchment area of 918,819 inhabitants. Apart from the tertiary hospital (Sendwe), no other facility provided all the basic emergency obstetric and neonatal care (BEmONC) signal functions. However, all had carried out at least one of the nine signal functions during the 3 months preceding our survey: 73.6% of 53 facilities had administered parenteral antibiotics, 79.2% had systematically offered oxytocics, 39.6% had administered magnesium sulfate, 73.6% had manually evacuated placentas, 81.1% had removed retained placenta products, 54.7% had revived newborns, 35.8% had performed caesarean sections, and 47.2% had performed blood transfusions. Function 6, vaginal delivery assisted by ventouse or forceps, was performed in only two (3.8%) facilities. If this signal function was not taken into account in our assessment of EmONC availability, there would be five facilities providing CEmONC for 918,819 inhabitants, rather than one. In 2010, all the women in the surveyed facilities with obstetric complications delivered in facilities that had carried out at least one signal function in the 3 months before our survey; 7.0% of these women delivered in the facility which provided CEmONC. Mortality due to direct obstetric causes was 3.9% in the health facility that provided CEmONC. The intrapartum mortality was also high in this facility (5.1%). None of the maternity ward managers in any of the facilities surveyed had received training on the EmONC package. Essential supplies and equipment for performing certain EmONC functions were not available in all the surveyed facilities. Audits of maternal and neonatal deaths and near-misses should be established and used as a basis for monitoring the quality of care in Lubumbashi. To reduce maternal and perinatal mortality, it is essential that staff skills regarding EmONC be strengthened, the availability of supplies and equipment be increased, and that care processes be standardized in all health facilities in Lubumbashi.

An assessment of the use of antimisting fuel in turbofan engines

NASA Technical Reports Server (NTRS)

Fiorentino, A. J.; Planell, J. R.

1983-01-01

An evaluation was made on the effects of using antimisting kerosene (AMK) on the performance of the components from the fuel system and the combustor of current in service JT8D aircraft engines. The objectives were to identify if there were any problems associated with using antimisting kerosene and to determine the extent of shearing or degradation required to allow the engine components to achieve satisfactory operation. The program consisted of a literature survey and a test program which evaluated the antimisting kerosene fuel in laboratory and bench component testing, and assessed the performance of the combustor in a high pressure facility and in an altitude relight/cold ignition facility.

PERFORMANCE ASSESSMENT ASSISTANCE ACTIVITIES IN THE DOE COMPLEX

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

Seitz, R.

2012-01-23

The United States Department of Energy Office of Environmental Management (DOE-EM) has established a Performance Assessment Community of Practice (PA CoP) to foster the sharing of information among performance assessment (PA) and risk assessment practitioners, regulators and oversight personnel. The general intent is to contribute to continuous improvement in the consistency, technical adequacy and quality of implementation of PAs and risk assessments around the DOE Complex. The PA CoP activities have involved commercial disposal facilities and international participants to provide a global perspective. The PA CoP has also sponsored annual technical exchanges as a means to foster improved communication andmore » to share lessons learned from on-going modelling activities. The PA CoP encourages activities to provide programmatic and technical assistance in the form of sharing experience and lessons learned with practitioners during the development of PAs and risk assessments. This assistance complements DOE-EM reviews through the Low-Level Waste Disposal Facility Federal Review Group (LFRG) that are conducted after modelling efforts are completed. Such up-front assistance is providing additional value in terms of improving consistency and sharing of information. There has been a substantial increase in the amount of assistance being provided. The assistance has been well received by practitioners and regulators that have been involved. The paper highlights assistance and sharing of information that has been conducted in the last two years to support activities underway in support of proposed disposal facilities at Paducah, Portsmouth, and the Idaho National Laboratory and tank closure at Hanford.« less

25 CFR 900.113 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... include performing a needs assessment, completing and/or verifying master plans, developing justification... environmental, archeological, cultural resource, historic preservation, and conduct of similar assessments. (d...; programmatic needs; and, for facilities projects, a detailed room-by-room listing of spaces, including net and...

25 CFR 900.113 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... include performing a needs assessment, completing and/or verifying master plans, developing justification... environmental, archeological, cultural resource, historic preservation, and conduct of similar assessments. (d...; programmatic needs; and, for facilities projects, a detailed room-by-room listing of spaces, including net and...

25 CFR 900.113 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... include performing a needs assessment, completing and/or verifying master plans, developing justification... environmental, archeological, cultural resource, historic preservation, and conduct of similar assessments. (d...; programmatic needs; and, for facilities projects, a detailed room-by-room listing of spaces, including net and...

25 CFR 900.113 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... include performing a needs assessment, completing and/or verifying master plans, developing justification... environmental, archeological, cultural resource, historic preservation, and conduct of similar assessments. (d...; programmatic needs; and, for facilities projects, a detailed room-by-room listing of spaces, including net and...

Addressing social aspects associated with wastewater treatment facilities

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

Padilla-Rivera, Alejandro; Morgan-Sagastume, Juan Manuel; Noyola, Adalberto

In wastewater treatment facilities (WWTF), technical and financial aspects have been considered a priority, while other issues, such as social aspects, have not been evaluated seriously and there is not an accepted methodology for assessing it. In this work, a methodology focused on social concerns related to WWTF is presented. The methodology proposes the use of 25 indicators as a framework for measuring social performance to evaluate the progress in moving towards sustainability. The methodology was applied to test its applicability and effectiveness in two WWTF in Mexico (urban and rural). This evaluation helped define the key elements, stakeholders andmore » barriers in the facilities. In this context, the urban facility showed a better overall performance, a result that may be explained mainly by the better socioeconomic context of the urban municipality. Finally, the evaluation of social aspects using the semi-qualitative approach proposed in this work allows for a comparison between different facilities and for the identification of strengths and weakness, and it provides an alternative tool for achieving and improving wastewater management. - Highlights: • The methodology proposes 25 indicators as a framework for measuring social performance in wastewater treatment facilities. • The evaluation helped to define the key elements, stakeholders and barriers in the wastewater treatment facilities. • The evaluation of social aspects allows the identification of strengths and weakness for improving wastewater management. • It provides a social profile of the facility that highlights the best and worst performances.« less

42 CFR 412.608 - Patients' rights regarding the collection of patient assessment data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Patients' rights regarding the collection of... Patients' rights regarding the collection of patient assessment data. (a) Before performing an assessment... inpatient rehabilitation facility will inform the Medicare patient of— (1) Their privacy rights under the...

Regulatory Guide on Conducting a Security Vulnerability Assessment

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

Ek, David R.

This document will provide guidelines on conducting a security vulnerability assessment at a facility regulated by the Radiation Protection Centre. The guidelines provide a performance approach assess security effectiveness. The guidelines provide guidance for a review following the objectives outlined in IAEA NSS#11 for Category 1, 2, & 3 sources.

42 CFR 412.608 - Patients' rights regarding the collection of patient assessment data.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Patients' rights regarding the collection of... Patients' rights regarding the collection of patient assessment data. (a) Before performing an assessment... inpatient rehabilitation facility will inform the Medicare patient of— (1) Their privacy rights under the...

42 CFR 412.608 - Patients' rights regarding the collection of patient assessment data.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Patients' rights regarding the collection of... Patients' rights regarding the collection of patient assessment data. (a) Before performing an assessment... inpatient rehabilitation facility will inform the Medicare patient of— (1) Their privacy rights under the...

42 CFR 412.608 - Patients' rights regarding the collection of patient assessment data.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Patients' rights regarding the collection of... Patients' rights regarding the collection of patient assessment data. (a) Before performing an assessment... inpatient rehabilitation facility will inform the Medicare patient of— (1) Their privacy rights under the...

42 CFR 412.608 - Patients' rights regarding the collection of patient assessment data.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Patients' rights regarding the collection of... Patients' rights regarding the collection of patient assessment data. (a) Before performing an assessment... inpatient rehabilitation facility will inform the Medicare patient of— (1) Their privacy rights under the...

Calculation Package for the Analysis of Performance of Cells 1-6, with Underdrain, of the Environmental Management Waste Management Facility Oak Ridge, Tennessee

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

Gonzales D.

2010-03-30

This calculation package presents the results of an assessment of the performance of the 6 cell design of the Environmental Management Waste Management Facility (EMWMF). The calculations show that the new cell 6 design at the EMWMF meets the current WAC requirement. QA/QC steps were taken to verify the input/output data for the risk model and data transfer from modeling output files to tables and calculation.

E-Area Low-Level Waste Facility Vadose Zone Model: Confirmation of Water Mass Balance for Subsidence Scenarios

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

Dyer, J. A.

In preparation for the next revision of the E-Area Low-Level Waste Facility (LLWF) Performance Assessment (PA), a mass balance model was developed in Microsoft Excel to confirm correct implementation of intact- and subsided-area infiltration profiles for the proposed closure cap in the PORFLOW vadose-zone model. The infiltration profiles are based on the results of Hydrologic Evaluation of Landfill Performance (HELP) model simulations for both intact and subsided cases.

KSC-07pd0904

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- On the KSC Shuttle Landing Facility, a Starfighter F-104 aircraft is being prepared for test flights. Behind the plane is Dave Waldrop, co-pilot. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

KSC-07pd0906

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- On the KSC Shuttle Landing Facility, pilot Rick Svetkoff (left) and co-pilot Dave Waldrop are ready to climb into the cockpit of the Starfighter F-104. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

KSC-07pd0905

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- On the KSC Shuttle Landing Facility, a Starfighter F-104 aircraft is being prepared for test flights. Ready to climb into the cockpit is the pilot, Rick Svetkoff. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

KSC-07pd0915

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- The Starfighter F-104 comes to a stop on the KSC Shuttle Landing Facility after its test flight. The pilot is Rick Svetkoff; the co-pilot is Dave Waldrop.The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

KSC-07pd0909

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- On the KSC Shuttle Landing Facility, the Starfighter F-104 starts to taxi to the runway. The pilot is Rick Svetkoff; the co-pilot is Dave Waldrop. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

KSC-07pd0910

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- From the KSC Shuttle Landing Facility, the Starfighter F-104 picks up speed on the runway for takeoff. The pilot is Rick Svetkoff; the co-pilot is Dave Waldrop. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

KSC-07pd0911

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- The Starfighter F-104 is airborne after taking off from the KSC Shuttle Landing Facility. The pilot is Rick Svetkoff; the co-pilot is Dave Waldrop. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

KSC-07pd0907

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- On the KSC Shuttle Landing Facility, pilot Rick Svetkoff (left) climbs toward the cockpit of the Starfighter F-104 while co-pilot Dave Waldrop settles in his seat. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

KSC-07pd0912

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- The Starfighter F-104 banks for a turn after taking off from the KSC Shuttle Landing Facility. The pilot is Rick Svetkoff; the co-pilot is Dave Waldrop. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

Event-based knowledge elicitation of operating room management decision-making using scenarios adapted from information systems data

PubMed Central

2011-01-01

Background No systematic process has previously been described for a needs assessment that identifies the operating room (OR) management decisions made by the anesthesiologists and nurse managers at a facility that do not maximize the efficiency of use of OR time. We evaluated whether event-based knowledge elicitation can be used practically for rapid assessment of OR management decision-making at facilities, whether scenarios can be adapted automatically from information systems data, and the usefulness of the approach. Methods A process of event-based knowledge elicitation was developed to assess OR management decision-making that may reduce the efficiency of use of OR time. Hypothetical scenarios addressing every OR management decision influencing OR efficiency were created from published examples. Scenarios are adapted, so that cues about conditions are accurate and appropriate for each facility (e.g., if OR 1 is used as an example in a scenario, the listed procedure is a type of procedure performed at the facility in OR 1). Adaptation is performed automatically using the facility's OR information system or anesthesia information management system (AIMS) data for most scenarios (43 of 45). Performing the needs assessment takes approximately 1 hour of local managers' time while they decide if their decisions are consistent with the described scenarios. A table of contents of the indexed scenarios is created automatically, providing a simple version of problem solving using case-based reasoning. For example, a new OR manager wanting to know the best way to decide whether to move a case can look in the chapter on "Moving Cases on the Day of Surgery" to find a scenario that describes the situation being encountered. Results Scenarios have been adapted and used at 22 hospitals. Few changes in decisions were needed to increase the efficiency of use of OR time. The few changes were heterogeneous among hospitals, showing the usefulness of individualized assessments. Conclusions Our technical advance is the development and use of automated event-based knowledge elicitation to identify suboptimal OR management decisions that decrease the efficiency of use of OR time. The adapted scenarios can be used in future decision-making. PMID:21214905

Event-based knowledge elicitation of operating room management decision-making using scenarios adapted from information systems data.

PubMed

Dexter, Franklin; Wachtel, Ruth E; Epstein, Richard H

2011-01-07

No systematic process has previously been described for a needs assessment that identifies the operating room (OR) management decisions made by the anesthesiologists and nurse managers at a facility that do not maximize the efficiency of use of OR time. We evaluated whether event-based knowledge elicitation can be used practically for rapid assessment of OR management decision-making at facilities, whether scenarios can be adapted automatically from information systems data, and the usefulness of the approach. A process of event-based knowledge elicitation was developed to assess OR management decision-making that may reduce the efficiency of use of OR time. Hypothetical scenarios addressing every OR management decision influencing OR efficiency were created from published examples. Scenarios are adapted, so that cues about conditions are accurate and appropriate for each facility (e.g., if OR 1 is used as an example in a scenario, the listed procedure is a type of procedure performed at the facility in OR 1). Adaptation is performed automatically using the facility's OR information system or anesthesia information management system (AIMS) data for most scenarios (43 of 45). Performing the needs assessment takes approximately 1 hour of local managers' time while they decide if their decisions are consistent with the described scenarios. A table of contents of the indexed scenarios is created automatically, providing a simple version of problem solving using case-based reasoning. For example, a new OR manager wanting to know the best way to decide whether to move a case can look in the chapter on "Moving Cases on the Day of Surgery" to find a scenario that describes the situation being encountered. Scenarios have been adapted and used at 22 hospitals. Few changes in decisions were needed to increase the efficiency of use of OR time. The few changes were heterogeneous among hospitals, showing the usefulness of individualized assessments. Our technical advance is the development and use of automated event-based knowledge elicitation to identify suboptimal OR management decisions that decrease the efficiency of use of OR time. The adapted scenarios can be used in future decision-making.

On-Line Mathematics Assessment: The Impact of Mode on Performance and Question Answering Strategies

ERIC Educational Resources Information Center

Johnson, Martin; Green, Sylvia

2006-01-01

The transition from paper-based to computer-based assessment raises a number of important issues about how mode might affect children's performance and question answering strategies. In this project 104 eleven-year-olds were given two sets of matched mathematics questions, one set on-line and the other on paper. Facility values were analyzed to…

Improving the Quality of School Facilities through Building Performance Assessment: Educational Reform and School Building Quality in Sao Paulo, Brazil

ERIC Educational Resources Information Center

Ornstein, Sheila Walbe; Moreira, Nanci Saraiva; Ono, Rosaria; Limongi Franca, Ana J. G.; Nogueira, Roselene A. M. F.

2009-01-01

Purpose: The paper describes the purpose of and strategies for conducting post-occupancy evaluations (POEs) as a method for assessing school building performance. Set within the larger context of global efforts to develop and apply common indicators of school building quality, the authors describe research conducted within the newest generation of…

Using Mobile Devices and the Adobe Connect Web Conferencing Tool in the Assessment of EFL Student Teacher Performance

ERIC Educational Resources Information Center

Bolona Lopez, Maria del Carmen; Ortiz, Margarita Elizabeth; Allen, Christopher

2015-01-01

This paper describes a project to use mobile devices and video conferencing technology in the assessment of student English as a Foreign Language (EFL) teacher performance on teaching practice in Ecuador. With the increasing availability of mobile devices with video recording facilities, it has become easier for trainers to capture teacher…

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

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

SM Narbutovskih

2000-03-31

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

Quality of antenatal and childbirth care in rural health facilities in Burkina Faso, Ghana and Tanzania: an intervention study.

PubMed

Duysburgh, Els; Temmerman, Marleen; Yé, Maurice; Williams, Afua; Massawe, Siriel; Williams, John; Mpembeni, Rose; Loukanova, Svetla; Haefeli, Walter E; Blank, Antje

2016-01-01

To assess the impact of an intervention consisting of a computer-assisted clinical decision support system and performance-based incentives, aiming at improving quality of antenatal and childbirth care. Intervention study in rural primary healthcare (PHC) facilities in Burkina Faso, Ghana and Tanzania. In each country, six intervention and six non-intervention PHC facilities, located in one intervention and one non-intervention rural districts, were selected. Quality was assessed in each facility by health facility surveys, direct observation of antenatal and childbirth care, exit interviews, and reviews of patient records and maternal and child health registers. Findings of pre- and post-intervention and of intervention and non-intervention health facility quality assessments were analysed and assessed for significant (P < 0.05) quality of care differences. Post-intervention quality scores do not show a clear difference to pre-intervention scores and scores at non-intervention facilities. Only a few variables had a statistically significant better post-intervention quality score and when this is the case this is mostly observed in only one study-arm, being pre-/post-intervention or intervention/non-intervention. Post-intervention care shows similar deficiencies in quality of antenatal and childbirth care and in detection, prevention, and management of obstetric complications as at baseline and non-intervention study facilities. Our intervention study did not show a significant improvement in quality of care during the study period. However, the use of new technology seems acceptable and feasible in rural PHC facilities in resource-constrained settings, creating the opportunity to use this technology to improve quality of care. © 2015 John Wiley & Sons Ltd.

Proliferation resistance assessments during the design phase of a recycling facility as a means of reducing proliferation risks

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

Lindell, M.A.; Grape, S.; Haekansson, A.

The sustainability criterion for Gen IV nuclear energy systems inherently presumes the availability of efficient fuel recycling capabilities. One area for research on advanced fuel recycling concerns safeguards aspects of this type of facilities. Since a recycling facility may be considered as sensitive from a non-proliferation perspective, it is important to address these issues early in the design process, according to the principle of Safeguards By Design. Presented in this paper is a mode of procedure, where assessments of the proliferation resistance (PR) of a recycling facility for fast reactor fuel have been performed so as to identify the weakestmore » barriers to proliferation of nuclear material. Two supplementing established methodologies have been applied; TOPS (Technological Opportunities to increase Proliferation resistance of nuclear power Systems) and PR-PP (Proliferation Resistance and Physical Protection evaluation methodology). The chosen fuel recycling facility belongs to a small Gen IV lead-cooled fast reactor system that is under study in Sweden. A schematic design of the recycling facility, where actinides are separated using solvent extraction, has been examined. The PR assessment methodologies make it possible to pinpoint areas in which the facility can be improved in order to reduce the risk of diversion. The initial facility design may then be slightly modified and/or safeguards measures may be introduced to reduce the total identified proliferation risk. After each modification of design and/or safeguards implementation, a new PR assessment of the revised system can then be carried out. This way, each modification can be evaluated and new ways to further enhance the proliferation resistance can be identified. This type of iterative procedure may support Safeguards By Design in the planning of new recycling plants and other nuclear facilities. (authors)« less

Recharge Data Package for the Immobilized Low-Activity Waste 2001 Performance Assessment

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

MJ Fayer; EM Murphy; JL Downs

2000-01-18

Lockheed Martin Hanford Company (LMHC) is designing and assessing the performance of disposal facilities to receive radioactive wastes that are currently stored in single- and double-shell tanks at the Hanford Site. The preferred method of disposing of the portion that is classified as immobilized low-activity waste (ILAW) is to vitrify the waste and place the product in near-surface, shallow-land burial facilities. The LMHC project to assess the performance of these disposal facilities is known as the Hanford ILAW Performance Assessment (PA) Activity, hereafter called the ILAW PA project. The goal of this project is to provide a reasonable expectation thatmore » the disposal of the waste is protective of the general public, groundwater resources, air resources, surface-water resources, and inadvertent intruders. Achieving this goal will require predictions of contaminant migration from the facility. To make such predictions will require estimates of the fluxes of water moving through the sediments within the vadose zone around and beneath the disposal facility. These fluxes, loosely called recharge rates, are the primary mechanism for transporting contaminants to the groundwater. Pacific Northwest National Laboratory (PNNL) assists LMHC in their performance assessment activities. One of the PNNL tasks is to provide estimates of recharge rates for current conditions and long-term scenarios involving the shallow-land disposal of ILAW. Specifically, recharge estimates are needed for a filly functional surface cover; the cover sideslope, and the immediately surrounding terrain. In addition, recharge estimates are needed for degraded cover conditions. The temporal scope of the analysis is 10,000 years, but could be longer if some contaminant peaks occur after 10,000 years. The elements of this report compose the Recharge Data Package, which provides estimates of recharge rates for the scenarios being considered in the 2001 PA. Table S.1 identifies the surface features and time periods evaluated. The most important feature, the surface cover, is expected to be the modified RCRA Subtitle C design. This design uses a 1-m-thick silt loam layer above sand and gravel filter layers to create a capillary break. A 0.15-m-thick asphalt layer underlies the filter layers to function as a backup barrier and to promote lateral drainage. Cover sideslopes are expected to be constructed with 1V:10H slopes using sandy gravel. The recharge estimates for each scenario were derived from lysimeter and tracer data collected by the ILAW PA and other projects and from modeling analyses.« less

Energy poverty in healthcare facilities: a "silent barrier" to improved healthcare in sub-Saharan Africa.

PubMed

Ouedraogo, Nadia S; Schimanski, Caroline

2018-06-27

This paper addresses an important topic, energy poverty in healthcare facilities. We try to provide an interesting perspective on bringing together two SDGs. The SDG 7, which seeks to ensure access to affordable, sustainable, and modern energy for all, is interlinked with Goal 3 on Health. The literature studies as well as data on the subject are sparse. Nevertheless, a systematic documentation of the levels and variation in access to energy at the health-facility level is important for designing effective policies to improve the quality of healthcare and the ultimate health of the population. Using the 2012-2013 Senegal Service Provision Assessment (SCSPA), we assessed energy access in health facilities and health systems' performance. Data were also geocoded using ArcGIS 10.3 to give a snapshot of the situation.

Measuring the preparedness of health facilities to deliver emergency obstetric care in a South African district.

PubMed

Thwala, Siphiwe Bridget Pearl; Blaauw, Duane; Ssengooba, Freddie

2018-01-01

Improving the delivery of emergency obstetric care (EmNOC) remains critical in addressing direct causes of maternal mortality. United Nations (UN) agencies have promoted standard methods for evaluating the availability of EmNOC facilities although modifications have been proposed by others. This study presents an assessment of the preparedness of public health facilities to provide EmNOC using these methods in one South African district with a persistently high maternal mortality ratio. Data collection took place in the final quarter of 2014. Cross-sectional surveys were conducted to classify the 7 hospitals and 8 community health centres (CHCs) in the district as either basic EmNOC (BEmNOC) or comprehensive EmNOC (CEmNOC) facilities using UN EmNOC signal functions. The required density of EmNOC facilities was calculated using UN norms. We also assessed the availability of EmNOC personnel, resuscitation equipment, drugs, fluids, and protocols at each facility. The workload of skilled EmNOC providers at hospitals and CHCs was compared. All 7 hospitals in the district were classified as CEmNOC facilities, but none of the 8 CHCs performed all required signal functions to be classified as BEmNOC facilities. UN norms indicated that 25 EmNOC facilities were required for the district population, 5 of which should be CEmNOCs. None of the facilities had 100% of items on the EmNOC checklists. Hospital midwives delivered an average of 36.4±14.3 deliveries each per month compared to only 7.9±3.2 for CHC midwives (p<0.001). The analysis indicated a shortfall of EmNOC facilities in the district. Full EmNOC services were centralised to hospitals to assure patient safety even though national policy guidelines sanction more decentralisation to CHCs. Studies measuring EmNOC availability need to consider facility opening hours, capacity and staffing in addition to the demonstrated performance of signal functions.

Measuring the preparedness of health facilities to deliver emergency obstetric care in a South African district

PubMed Central

Blaauw, Duane; Ssengooba, Freddie

2018-01-01

Background Improving the delivery of emergency obstetric care (EmNOC) remains critical in addressing direct causes of maternal mortality. United Nations (UN) agencies have promoted standard methods for evaluating the availability of EmNOC facilities although modifications have been proposed by others. This study presents an assessment of the preparedness of public health facilities to provide EmNOC using these methods in one South African district with a persistently high maternal mortality ratio. Methods Data collection took place in the final quarter of 2014. Cross-sectional surveys were conducted to classify the 7 hospitals and 8 community health centres (CHCs) in the district as either basic EmNOC (BEmNOC) or comprehensive EmNOC (CEmNOC) facilities using UN EmNOC signal functions. The required density of EmNOC facilities was calculated using UN norms. We also assessed the availability of EmNOC personnel, resuscitation equipment, drugs, fluids, and protocols at each facility. The workload of skilled EmNOC providers at hospitals and CHCs was compared. Results All 7 hospitals in the district were classified as CEmNOC facilities, but none of the 8 CHCs performed all required signal functions to be classified as BEmNOC facilities. UN norms indicated that 25 EmNOC facilities were required for the district population, 5 of which should be CEmNOCs. None of the facilities had 100% of items on the EmNOC checklists. Hospital midwives delivered an average of 36.4±14.3 deliveries each per month compared to only 7.9±3.2 for CHC midwives (p<0.001). Conclusions The analysis indicated a shortfall of EmNOC facilities in the district. Full EmNOC services were centralised to hospitals to assure patient safety even though national policy guidelines sanction more decentralisation to CHCs. Studies measuring EmNOC availability need to consider facility opening hours, capacity and staffing in addition to the demonstrated performance of signal functions. PMID:29596431

Consideration of liners and covers in performance assessments

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

Phifer, Mark A.; Seitz, Robert R.; Suttora, Linda C.

2014-09-18

On-site disposal cells are in use and being considered at several United States Department of Energy (USDOE) sites as the final disposition for large amounts of waste associated with cleanup of contaminated areas and facilities. These disposal cells are typically regulated by States and/or the U.S. Environmental Protection Agency under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) in addition to having to comply with requirements in DOE Order 435.1, Radioactive Waste Management due to the radioactive waste. The USDOE-Environmental Management Office of Site Restoration formed a working group to foster improved communication and sharing of information for personnelmore » associated with these CERCLA disposal cells and work towards more consistent assumptions, as appropriate, for technical and policy considerations related to CERCLA risk assessments and DOE Order 435.1 performance assessments in support of a Record of Decision and Disposal Authorization Statement, respectively. One of the issues considered by the working group, which is addressed in this report, was how to appropriately consider the performance of covers and liners/leachate collections systems in the context of a DOE Order 435.1 performance assessment (PA). This same information may be appropriate for consideration within CERCLA risk assessments for these facilities. These OSDCs are generally developed to meet hazardous waste (HW) disposal design standards under the Resource Conservation and Recovery Act (RCRA) as well as the DOE Order 435.1 performance based standards for disposal of radioactive waste. To meet the standards for HW, the facilities typically include engineered covers and liner/leachate collection systems. Thus, when considering such facilities in the context of a DOE Order 435.1 PA, there is a need to address the evolution of performance of covers and liner/leachate collection systems in the context of meeting a performance standard considering time frames of 1,000 years for compliance and potentially thousands of years based on the wastes to test the robustness of the system. Experience has shown that there are a range of expectations and perspectives from the different regulators involved at different sites when reviewing assumptions related to cover and liner/leachate collection system performance. However for HW disposal alone under RCRA the design standards are typically considered sufficient by the regulators without a requirement to assess long-term performance thus avoiding the need to consider the details addressed in this report. This report provides suggestions for a general approach to address covers and liners/leachate collection systems in a DOE Order 435.1 PA and how to integrate assessments with defense-in-depth considerations such as design, operations, and waste acceptance criteria to address uncertainties. The emphasis is on water balances and management in such assessments. Specific information and references are provided for details needed to address the evolution of individual components of cover and liner/leachate collection systems. This information was then synthesized into suggestions for best practices for cover and liner system design and examples of approaches to address the performance of covers and liners as part of a performance assessment of the disposal system. Numerous references are provided for sources of information to help describe the basis for performance of individual components of cover and liner systems.« less

Assessing patient safety in Canadian ambulatory surgery facilities: A national survey

PubMed Central

Ahmad, Jamil; Ho, Olivia A; Carman, Wayne W; Thoma, Achilles; Lalonde, Donald H; Lista, Frank

2014-01-01

BACKGROUND: There has been increased interest regarding patient safety and standards of care in Canadian ambulatory surgery facilities where surgical procedures are performed. The Canadian Association for Accreditation of Ambulatory Surgical Facilities (CAAASF) is a national organization formed to establish and maintain standards to ensure that surgical procedures conducted outside of public hospitals are performed safely. OBJECTIVE: To determine how many procedures are performed annually at CAAASF member sites, and to examine complication rates and several key patient safety practices. METHODS: All 69 facilities accredited by the CAAASF were surveyed. The survey focused on procedural data, complication rates and patient safety interventions. RESULTS: In 2010, 40,240 estimated procedures were performed. A total of 263 (0.007%) complications were reported. Sixteen (0.0004%) patients required reoperations in hospital and 19 (0.0004%) patients required transfer to hospital on the day of surgery. There were only two mortalities within 30 days of surgery reported in the past five years. With regard to patient safety practices, 93% used antimicrobial prophylaxis, 100% used strategies to maintain normothermia and 82% used measures for venous thromboembolism prevention. CONCLUSION: The present study is the first to report on the Canadian experience in ambulatory surgery facilities and provides insight into current practices at these facilities. Appropriate accreditation of ambulatory surgery facilities, well-established patient safety-related standards of care, careful patient selection and procedures performed by qualified health care professionals with appropriate certification practicing within the scope of their practice form the basis for safe and effective ambulatory surgery. PMID:25152645

Benchmarking Heavy Ion Transport Codes FLUKA, HETC-HEDS MARS15, MCNPX, and PHITS

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

Ronningen, Reginald Martin; Remec, Igor; Heilbronn, Lawrence H.

Powerful accelerators such as spallation neutron sources, muon-collider/neutrino facilities, and rare isotope beam facilities must be designed with the consideration that they handle the beam power reliably and safely, and they must be optimized to yield maximum performance relative to their design requirements. The simulation codes used for design purposes must produce reliable results. If not, component and facility designs can become costly, have limited lifetime and usefulness, and could even be unsafe. The objective of this proposal is to assess the performance of the currently available codes PHITS, FLUKA, MARS15, MCNPX, and HETC-HEDS that could be used for designmore » simulations involving heavy ion transport. We plan to access their performance by performing simulations and comparing results against experimental data of benchmark quality. Quantitative knowledge of the biases and the uncertainties of the simulations is essential as this potentially impacts the safe, reliable and cost effective design of any future radioactive ion beam facility. Further benchmarking of heavy-ion transport codes was one of the actions recommended in the Report of the 2003 RIA R&D Workshop".« less

Secondary Waste Cementitious Waste Form Data Package for the Integrated Disposal Facility Performance Assessment

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

Cantrell, Kirk J.; Westsik, Joseph H.; Serne, R Jeffrey

A review of the most up-to-date and relevant data currently available was conducted to develop a set of recommended values for use in the Integrated Disposal Facility (IDF) performance assessment (PA) to model contaminant release from a cementitious waste form for aqueous wastes treated at the Hanford Effluent Treatment Facility (ETF). This data package relies primarily upon recent data collected on Cast Stone formulations fabricated with simulants of low-activity waste (LAW) and liquid secondary wastes expected to be produced at Hanford. These data were supplemented, when necessary, with data developed for saltstone (a similar grout waste form used at themore » Savannah River Site). Work is currently underway to collect data on cementitious waste forms that are similar to Cast Stone and saltstone but are tailored to the characteristics of ETF-treated liquid secondary wastes. Recommended values for key parameters to conduct PA modeling of contaminant release from ETF-treated liquid waste are provided.« less

Mentoring, Task Sharing, and Community Outreach Through the TutoratPlus Approach: Increasing Use of Long-Acting Reversible Contraceptives in Senegal.

PubMed

Gueye, Babacar; Wesson, Jennifer; Koumtingue, Djimadoum; Stratton, Sara; Viadro, Claire; Talla, Hawa; Dioh, Etienne; Cissé, Carol; Sebikali, Boniface; Mamadou Daff, Bocar

2016-08-11

To broaden access to family planning in rural areas and improve contraceptive prevalence, Senegal, in the context of wide method choice, is promoting implants and the intrauterine device, currently used throughout the country by only 5.6% of women of reproductive age who are in union, primarily urban women. The TutoratPlus performance improvement approach strengthens family planning clinical skills, particularly for long-acting reversible contraceptives (LARCs), through mentoring, task sharing, and community outreach. Following a 2013 baseline situation analysis, 290 participating facilities in 12 of Senegal's 14 regions developed action plans to address gaps identified in 3 areas: provider performance, equipment, and infrastructure. Between 2013 and 2014, 85 trained mentors coached, demonstrated skills, and observed 857 providers, including nurses, nonclinical family planning counselors, and community health workers (CHWs), in LARC service provision through two 5-day visits per facility at 21-day intervals. We used routine service delivery data and TutoratPlus mentoring data to assess changes in contraceptive use, including LARCs, 6 months before and 6 months after the mentoring intervention among 100 of the facilities with complete data. The baseline assessment of 290 facilities found that fewer than half (47%) had a provider who could offer at least 1 LARC method, and 64% to 69% lacked kits. Post-intervention, all 290 facilities were adequately equipped and clinically able to offer LARCs. Among the 552 clinical providers, the percentage with acceptable LARC performance (at least 80% of observation checklist items correct) doubled from 32% to 67% over the 2 mentoring visits. In the 100 facilities with available comparison data, the number of new LARC users rose from 1,552 to 2,879 in the 6 months pre- and post-intervention-an 86% increase. Success of the TutoratPlus approach in Senegal is likely in part attributable to addressing facility-specific needs, using on-site mentoring to assess provider capacity, and achieving workplace enhancements through community engagement. Without CHW-initiated community outreach, LARC uptake might have been lower. Although task sharing requires institutionalization within national health systems, TutoratPlus demonstrates that provider skills can be improved, facilities can be better equipped, and demand can be promoted using existing government and community resources. © Gueye et al.

State Regulatory Authority (SRA) Coordination of Safety, Security, and Safeguards of Nuclear Facilities: A Framework for Analysis

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

Mladineo, Stephen V.; Frazar, Sarah L.; Kurzrok, Andrew J.

This paper will explore the development of a framework for conducting an assessment of safety-security-safeguards integration within a State. The goal is to examine State regulatory structures to identify conflicts and gaps that hinder management of the three disciplines at nuclear facilities. Such an analysis could be performed by a State Regulatory Authority (SRA) to provide a self-assessment or as part of technical cooperation with either a newcomer State, or to a State with a fully developed SRA.

Pollution prevention opportunity assessment for Facilities Maintenance Team (FMT) paint shop.

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

Klossner, Kristin Ann

This Pollution Prevention Opportunity Assessment (PPOA) was conducted for Sandia National Laboratories/California Facilities Maintenance Team Paint Shop Operations in August and September 2002. The primary purpose of this PPOA is to provide recommendations to assist Paint Shop personnel in reducing the generation of waste and improving the efficiency of their processes. This report contains a summary of the information collected and analyses performed and recommends options for implementation. The Sandia National Laboratories Pollution Prevention staff will continue to work with the Paint Shop to implement the recommendations.

Performance assessment for continuing and future operations at solid waste storage area 6

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

NONE

1997-09-01

This revised performance assessment (PA) for the continued disposal operations at Solid Waste Storage Area (SWSA) 6 on the Oak Ridge Reservation (ORR) has been prepared to demonstrate compliance with the performance objectives for low-level radioactive waste (LLW) disposal contained in the US Department of Energy (DOE) Order 5820.2A. This revised PA considers disposal operations conducted from September 26, 1988, through the projects lifetime of the disposal facility.

NASA low-speed centrifugal compressor for 3-D viscous code assessment and fundamental flow physics research

NASA Technical Reports Server (NTRS)

Hathaway, M. D.; Wood, J. R.; Wasserbauer, C. A.

1991-01-01

A low speed centrifugal compressor facility recently built by the NASA Lewis Research Center is described. The purpose of this facility is to obtain detailed flow field measurements for computational fluid dynamic code assessment and flow physics modeling in support of Army and NASA efforts to advance small gas turbine engine technology. The facility is heavily instrumented with pressure and temperature probes, both in the stationary and rotating frames of reference, and has provisions for flow visualization and laser velocimetry. The facility will accommodate rotational speeds to 2400 rpm and is rated at pressures to 1.25 atm. The initial compressor stage being tested is geometrically and dynamically representative of modern high-performance centrifugal compressor stages with the exception of Mach number levels. Preliminary experimental investigations of inlet and exit flow uniformly and measurement repeatability are presented. These results demonstrate the high quality of the data which may be expected from this facility. The significance of synergism between computational fluid dynamic analysis and experimentation throughout the development of the low speed centrifugal compressor facility is demonstrated.

Validity of self-assessment in a quality improvement collaborative in Ecuador.

PubMed

Hermida, Jorge; Broughton, Edward I; Miller Franco, Lynne

2011-12-01

Health care quality improvement (QI) efforts commonly use self-assessment to measure compliance with quality standards. This study investigates the validity of self-assessment of quality indicators. Cross sectional. A maternal and newborn care improvement collaborative intervention conducted in health facilities in Ecuador in 2005. Four external evaluators were trained in abstracting medical records to calculate six indicators reflecting compliance with treatment standards. About 30 medical records per month were examined at 12 participating health facilities for a total of 1875 records. The same records had already been reviewed by QI teams at these facilities (self-assessment). Overall compliance, agreement (using the Kappa statistic), sensitivity and specificity were analyzed. We also examined patterns of disagreement and the effect of facility characteristics on levels of agreement. External evaluators reported compliance of 69-90%, while self-assessors reported 71-92%, with raw agreement of 71-95% and Kappa statistics ranging from fair to almost perfect agreement. Considering external evaluators as the gold standard, sensitivity of self-assessment ranged from 90 to 99% and specificity from 48 to 86%. Simpler indicators had fewer disagreements. When disagreements occurred between self-assessment and external valuators, the former tended to report more positive findings in five of six indicators, but this tendency was not of a magnitude to change program actions. Team leadership, understanding of the tools and facility size had no overall impact on the level of agreement. When compared with external evaluation (gold standard), self-assessment was found to be sufficiently valid for tracking QI team performance. Sensitivity was generally higher than specificity. Simplifying indicators may improve validity.

A review of HOV lane performance and policy options in the United States

DOT National Transportation Integrated Search

2008-12-01

The report provides an assessment of performance of existing HOV lane facilities in the United States, and explores policy alternatives and effects related to conversion of existing HOV lanes to HOT lane operations. The report includes sketch plannin...

Toxicity Bioassays for Ecological Risk Assessment in Arid and Semiarid Ecosystems. Reviews Environmental Contamination and Toxicology 168:43-98.

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

Markwiese, J.T.; Ryti, R.T.; Hooten, M.M.

2001-02-01

This paper discusses current limitations for performing ecological risk assessments in dry environments (i.e., ecosystems that are characteristic of many DOE Facilities) and presents novel approaches to addressing ecological risk in such systems.

Experiments, conceptual design, preliminary cost estimates and schedules for an underground research facility

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

Korbin, G.; Wollenberg, H.; Wilson, C.

Plans for an underground research facility are presented, incorporating techniques to assess the hydrological and thermomechanical response of a rock mass to the introduction and long-term isolation of radioactive waste, and to assess the effects of excavation on the hydrologic integrity of a repository and its subsequent backfill, plugging, and sealing. The project is designed to utilize existing mine or civil works for access to experimental areas and is estimated to last 8 years at a total cost for contruction and operation of $39.0 million (1981 dollars). Performing the same experiments in an existing underground research facility would reduce themore » duration to 7-1/2 years and cost $27.7 million as a lower-bound estimate. These preliminary plans and estimates should be revised after specific sites are identified which would accommodate the facility.« less

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

PubMed Central

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

2015-01-01

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

Space Nuclear Facility test capability at the Baikal-1 and IGR sites Semipalatinsk-21, Kazakhstan

NASA Astrophysics Data System (ADS)

Hill, T. J.; Stanley, M. L.; Martinell, J. S.

1993-01-01

The International Space Technology Assessment Program was established 1/19/92 to take advantage of the availability of Russian space technology and hardware. DOE had two delegations visit CIS and assess its space nuclear power and propulsion technologies. The visit coincided with the Conference on Nuclear Power Engineering in Space Nuclear Rocket Engines at Semipalatinsk-21 (Kurchatov, Kazakhstan) on Sept. 22-25, 1992. Reactor facilities assessed in Semipalatinski-21 included the IVG-1 reactor (a nuclear furnace, which has been modified and now called IVG-1M), the RA reactor, and the Impulse Graphite Reactor (IGR), the CIS version of TREAT. Although the reactor facilities are being maintained satisfactorily, the support infrastructure appears to be degrading. The group assessment is based on two half-day tours of the Baikals-1 test facility and a brief (2 hr) tour of IGR; because of limited time and the large size of the tour group, it was impossible to obtain answers to all prepared questions. Potential benefit is that CIS fuels and facilities may permit USA to conduct a lower priced space nuclear propulsion program while achieving higher performance capability faster, and immediate access to test facilities that cannot be available in this country for 5 years. Information needs to be obtained about available data acquisition capability, accuracy, frequency response, and number of channels. Potential areas of interest with broad application in the U.S. nuclear industry are listed.

Indoor air quality investigation and health risk assessment at correctional institutions.

PubMed

Ofungwu, Joseph

2005-04-01

A comprehensive indoor air-quality (IAQ) investigation was conducted at a state correctional facility in New Jersey, USA with a lengthy history of IAQ problems. The IAQ investigation comprised preliminary indoor air screening using direct readout instrumentation, indoor air/surface wipe sampling and laboratory analysis, as well as a heating, ventilation, and air-conditioning system evaluation, and a building envelope survey. In addition to air sampling, a human health risk assessment was performed to evaluate the potential for exposure to site-related air contaminants with respect to the inmate and worker populations. The risk assessment results for the prison facility indicated the potential for significant health risks for the inmate population, possibly reflecting the effects of their confinement and extended exposure to indoor air contaminants, as compared to the prison guard and worker population. Based on the results of the risk assessment, several mitigation measures are recommended to minimize prison population health risks and improve indoor air quality at prison facilities.

Hydrologic evaluation methodology for estimating water movement through the unsaturated zone at commercial low-level radioactive waste disposal site

USGS Publications Warehouse

Meyer, P.D.; Rockhold, M.L.; Nichols, W.E.; Gee, G.W.

1996-01-01

This report identifies key technical issues related to hydrologic assessment of water flow in the unsaturated zone at low-level radioactive waste (LLW) disposal facilities. In addition, a methodology for incorporating these issues in the performance assessment of proposed LLW disposal facilities is identified and evaluated. The issues discussed fall into four areas:Estimating the water balance at a site (i.e., infiltration, runoff, water storage, evapotranspiration, and recharge);Analyzing the hydrologic performance of engineered components of a facility;Evaluating the application of models to the prediction of facility performance; andEstimating the uncertainty in predicted facility performance.An estimate of recharge at a LLW site is important since recharge is a principal factor in controlling the release of contaminants via the groundwater pathway. The most common methods for estimating recharge are discussed in Chapter 2. Many factors affect recharge; the natural recharge at an undisturbed site is not necessarily representative either of the recharge that will occur after the site has been disturbed or of the flow of water into a disposal facility at the site. Factors affecting recharge are discussed in Chapter 2.At many sites engineered components are required for a LLW facility to meet performance requirements. Chapter 3 discusses the use of engineered barriers to control the flow of water in a LLW facility, with a particular emphasis on cover systems. Design options and the potential performance and degradation mechanisms of engineered components are also discussed.Water flow in a LLW disposal facility must be evaluated before construction of the facility. In addition, hydrologic performance must be predicted over a very long time frame. For these reasons, the hydrologic evaluation relies on the use of predictive modeling. In Chapter 4, the evaluation of unsaturated water flow modeling is discussed. A checklist of items is presented to guide the evaluation. Several computer simulation codes that were used in the examples (Chapter 6) are discussed with respect to this checklist. The codes used include HELP, UNSAT-H, and VAM3DCG.To provide a defensible estimate of water flow in a LLW disposal facility, the uncertainty associated with model predictions must be considered. Uncertainty arises because of the highly heterogeneous nature of most subsurface environments and the long time frame required in the analysis. Sources of uncertainty in hydrologic evaluation of the unsaturated zone and several approaches for analysis are discussed in Chapter 5. The methods of analysis discussed include a bounding approach, sensitivity analysis, and Monte Carlo simulation.To illustrate the application of the discussion in Chapters 2 through 5, two examples are presented in Chapter 6. The first example is of a below ground vault located in a humid environment. The second example looks at a shallow land burial facility located in an arid environment. The examples utilize actual site-specific data and realistic facility designs. The two examples illustrate the issues unique to humid and arid sites as well as the issues common to all LLW sites. Strategies for addressing the analytical difficulties arising in any complex hydrologic evaluation of the unsaturated zone are demonstrated.The report concludes with some final observations and recommendations.

Monitoring maternal and newborn health outcomes in Bauchi State, Nigeria: an evaluation of a standards-based quality improvement intervention.

PubMed

Kabo, Ibrahim; Otolorin, Emmanuel; Williams, Emma; Orobaton, Nosa; Abdullahi, Hannatu; Sadauki, Habib; Abdulkarim, Masduk; Abegunde, Dele

2016-10-01

This study assessed the correlation between compliance with set performance standards and maternal and neonatal deaths in health facilities. Baseline and three annual follow-up assessments were conducted, and each was followed by a quality improvement initiative using the Standards Based Management and Recognition (SBM-R) approach. Twenty-three secondary health facilities of Bauchi state, Nigeria. Health care workers and maternity unit patients. We examined trends in: (i) achievement of SBM-R set performance standards based on annual assessment data, (ii) the use of maternal and newborn health (MNH) service delivery practices based on data from health facility registers and supportive supervision and (iii) MNH outcomes based on routine service statistics. At the baseline assessment in 2010, the facilities achieved 4% of SBM-R standards for MNH, on average, and this increased to 86% in 2013. Over the same time period, the study measured an increase in the administration of uterotonic for active management of third stage of labor from 10% to 95% and a decline in the incidence of postpartum hemorrhage from 3.3% to 1.9%. Institutional neonatal mortality rate decreased from 9 to 2 deaths per 1000 live births, while the institutional maternal mortality ratio dropped from 4113 to 1317 deaths per 100 000 live births. Scaling up SBM-R for quality improvement has the potential to prevent maternal and neonatal deaths in Nigeria and similar settings. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care.

Evaluating building performance in healthcare facilities: an organizational perspective.

PubMed

Steinke, Claudia; Webster, Lynn; Fontaine, Marie

2010-01-01

Using the environment as a strategic tool is one of the most cost-effective and enduring approaches for improving public health; however, it is one that requires multiple perspectives. The purpose of this article is to highlight an innovative methodology that has been developed for conducting comprehensive performance evaluations in public sector health facilities in Canada. The building performance evaluation methodology described in this paper is a government initiative. The project team developed a comprehensive building evaluation process for all new capital health projects that would respond to the aforementioned need for stakeholders to be more accountable and to better integrate the larger organizational strategy of facilities. The Balanced Scorecard, which is a multiparadigmatic, performance-based business framework, serves as the underlying theoretical framework for this initiative. It was applied in the development of the conceptual model entitled the Building Performance Evaluation Scorecard, which provides the following benefits: (1) It illustrates a process to link facilities more effectively to the overall mission and goals of an organization; (2) It is both a measurement and a management system that has the ability to link regional facilities to measures of success and larger business goals; (3) It provides a standardized methodology that ensures consistency in assessing building performance; and (4) It is more comprehensive than traditional building evaluations. The methodology presented in this paper is both a measurement and management system that integrates the principles of evidence-based design with the practices of pre- and post-occupancy evaluation. It promotes accountability and continues throughout the life cycle of a project. The advantage of applying this framework is that it engages health organizations in clarifying a vision and strategy for their facilities and helps translate those strategies into action and measurable performance outcomes.

Development and Validation of Pathogen Environmental Monitoring Programs for Small Cheese Processing Facilities.

PubMed

Beno, Sarah M; Stasiewicz, Matthew J; Andrus, Alexis D; Ralyea, Robert D; Kent, David J; Martin, Nicole H; Wiedmann, Martin; Boor, Kathryn J

2016-12-01

Pathogen environmental monitoring programs (EMPs) are essential for food processing facilities of all sizes that produce ready-to-eat food products exposed to the processing environment. We developed, implemented, and evaluated EMPs targeting Listeria spp. and Salmonella in nine small cheese processing facilities, including seven farmstead facilities. Individual EMPs with monthly sample collection protocols were designed specifically for each facility. Salmonella was detected in only one facility, with likely introduction from the adjacent farm indicated by pulsed-field gel electrophoresis data. Listeria spp. were isolated from all nine facilities during routine sampling. The overall Listeria spp. (other than Listeria monocytogenes ) and L. monocytogenes prevalences in the 4,430 environmental samples collected were 6.03 and 1.35%, respectively. Molecular characterization and subtyping data suggested persistence of a given Listeria spp. strain in seven facilities and persistence of L. monocytogenes in four facilities. To assess routine sampling plans, validation sampling for Listeria spp. was performed in seven facilities after at least 6 months of routine sampling. This validation sampling was performed by independent individuals and included collection of 50 to 150 samples per facility, based on statistical sample size calculations. Two of the facilities had a significantly higher frequency of detection of Listeria spp. during the validation sampling than during routine sampling, whereas two other facilities had significantly lower frequencies of detection. This study provides a model for a science- and statistics-based approach to developing and validating pathogen EMPs.

CONCEPTUAL DESIGN ASSESSMENT FOR THE CO-FIRING OF BIO-REFINERY SUPPLIED LIGNIN PROJECT

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

Ted Berglund; Jeffrey T. Ranney; Carol L. Babb

2001-01-01

The major aspects of this project are proceeding toward completion. Prior to this quarter, design criteria, tentative site selection, facility layout, and preliminary facility cost estimates have been completed and issued for review. Processing of bio-solids was completed, providing material for the pilot operations. Pilot facility design, equipment selection, and modification were completed during the fourth quarter. Initial pilot facility shakedown was completed during the fourth quarter. During pilot plant shakedown operations, several production batch test runs were performed. These pilot tests were coupled with laboratory testing to confirm pilot results. In initial batches of operations, cellulose to glucose conversionsmore » of 62.5% and 64.8% were observed in laboratory hydrolysis. As part of this testing, lignin dewatering was tested using laboratory and vendor-supplied filtration equipment. Dewatering tests reported moisture contents in the lignin of between 50% and 60%. Dewatering parameters and options will continue to be investigated during lignin production. After some unavoidable delays, a suitable representative supply of MSW feed material was procured. Shredding of the feed material was completed and final drying of the feed is expected to be completed by late January. Once feed drying is completed, pilot facility production will begin to produce lignin for co-fire testing. Facility modifications are expected to continue to improve facility operations and performance during the first quarter of 2001. The TVA-Colbert facility continues to make progress in evaluating the co-location of the Masada facility on the operation of the power generation facility. The TVA-Colbert fossil plant is fully capable of providing a reliable steam supply. The preferred steam supply connection points and steam pipeline routing have been identified. The environmental review of the pipeline routing has been completed and no major impacts have been identified. Detailed assessment of steam export impacts on the Colbert boiler system continues.« less

Computational Analyses in Support of Sub-scale Diffuser Testing for the A-3 Facility. Part 1; Steady Predictions

NASA Technical Reports Server (NTRS)

Allgood, Daniel C.; Graham, Jason S.; Ahuja, Vineet; Hosangadi, Ashvin

2010-01-01

Simulation technology can play an important role in rocket engine test facility design and development by assessing risks, providing analysis of dynamic pressure and thermal loads, identifying failure modes and predicting anomalous behavior of critical systems. Advanced numerical tools assume greater significance in supporting testing and design of high altitude testing facilities and plume induced testing environments of high thrust engines because of the greater inter-dependence and synergy in the functioning of the different sub-systems. This is especially true for facilities such as the proposed A-3 facility at NASA SSC because of a challenging operating envelope linked to variable throttle conditions at relatively low chamber pressures. Facility designs in this case will require a complex network of diffuser ducts, steam ejector trains, fast operating valves, cooling water systems and flow diverters that need to be characterized for steady state performance. In this paper, we will demonstrate with the use of CFD analyses s advanced capability to evaluate supersonic diffuser and steam ejector performance in a sub-scale A-3 facility at NASA Stennis Space Center (SSC) where extensive testing was performed. Furthermore, the focus in this paper relates to modeling of critical sub-systems and components used in facilities such as the A-3 facility. The work here will address deficiencies in empirical models and current CFD analyses that are used for design of supersonic diffusers/turning vanes/ejectors as well as analyses for confined plumes and venting processes. The primary areas that will be addressed are: (1) supersonic diffuser performance including analyses of thermal loads (2) accurate shock capturing in the diffuser duct; (3) effect of turning duct on the performance of the facility (4) prediction of mass flow rates and performance classification for steam ejectors (5) comparisons with test data from sub-scale diffuser testing and assessment of confidence levels in CFD based flowpath modeling of the facility. The analyses tools used here expand on the multi-element unstructured CFD which has been tailored and validated for impingement dynamics of dry plumes, complex valve/feed systems, and high pressure propellant delivery systems used in engine and component test stands at NASA SSC. The analyses performed in the evaluation of the sub-scale diffuser facility explored several important factors that influence modeling and understanding of facility operation such as (a) importance of modeling the facility with Real Gas approximation, (b) approximating the cluster of steam ejector nozzles as a single annular nozzle, (c) existence of mixed subsonic/supersonic flow downstream of the turning duct, and (d) inadequacy of two-equation turbulence models in predicting the correct pressurization in the turning duct and expansion of the second stage steam ejectors. The procedure used for modeling the facility was as follows: (i) The engine, test cell and first stage ejectors were simulated with an axisymmetric approximation (ii) the turning duct, second stage ejectors and the piping downstream of the second stage ejectors were analyzed with a three-dimensional simulation utilizing a half-plane symmetry approximation. The solution i.e. primitive variables such as pressure, velocity components, temperature and turbulence quantities were passed from the first computational domain and specified as a supersonic boundary condition for the second simulation. (iii) The third domain comprised of the exit diffuser and the region in the vicinity of the facility (primary included to get the correct shock structure at the exit of the facility and entrainment characteristics). The first set of simulations comprising the engine, test cell and first stage ejectors was carried out both as a turbulent real gas calculation as well as a turbulent perfect gas calculation. A comparison for the two cases (Real Turbulent and Perfect gas turbulent) of the Ma Number distribution and temperature distributions are shown in Figures 1 and 2 respectively.

Using Workflow Diagrams to Address Hand Hygiene in Pediatric Long-Term Care Facilities1

PubMed Central

Carter, Eileen J.; Cohen, Bevin; Murray, Meghan T.; Saiman, Lisa; Larson, Elaine L.

2015-01-01

Hand hygiene (HH) in pediatric long-term care settings has been found to be sub-optimal. Multidisciplinary teams at three pediatric long-term care facilities developed step-by-step workflow diagrams of commonly performed tasks highlighting HH opportunities. Diagrams were validated through observation of tasks and concurrent diagram assessment. Facility teams developed six workflow diagrams that underwent 22 validation observations. Four main themes emerged: 1) diagram specificity, 2) wording and layout, 3) timing of HH indications, and 4) environmental hygiene. The development of workflow diagrams is an opportunity to identify and address the complexity of HH in pediatric long-term care facilities. PMID:25773517

Advanced Hypervelocity Aerophysics Facility Workshop

NASA Technical Reports Server (NTRS)

Witcofski, Robert D. (Compiler); Scallion, William I. (Compiler)

1989-01-01

The primary objective of the workshop was to obtain a critical assessment of a concept for a large, advanced hypervelocity ballistic range test facility powered by an electromagnetic launcher, which was proposed by the Langley Research Center. It was concluded that the subject large-scale facility was feasible and would provide the required ground-based capability for performing tests at entry flight conditions (velocity and density) on large, complex, instrumented models. It was also concluded that advances in remote measurement techniques and particularly onboard model instrumentation, light-weight model construction techniques, and model electromagnetic launcher (EML) systems must be made before any commitment for the construction of such a facility can be made.

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

PubMed

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

2016-07-01

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

Variations in pretransfusion practices.

PubMed

Padget, B J; Hannon, J L

2003-01-01

A variety of pretransfusion tests have been developed to improve the safety and effectiveness of transfusion. Recently, a number of traditional tests have been shown to offer limited clinical benefit and have been eliminated in many facilities. A survey of pretransfusion test practices was distributed to 116 hospital transfusion services. Routine test practices and facility size were analyzed. Ninety-one responses were received. Many smaller laboratories include tests such as anti-A,B, an autocontrol, and DAT, and immediate spin and 37 degrees Celsius microscopic readings. Nine percent never perform an Rh control with anti-D typing on patient samples. Various antibody screening and crossmatch methods are utilized. Individual laboratory test practices should be periodically assessed to ensure that they comply with standards, represent the recognized best practice, and are cost-effective. The survey responses indicate that many laboratories perform tests that are not necessary or cost-effective. These facilities should review their processes to determine which tests contribute to transfusion safety. Smaller facilities may be reluctant to change or lack the expertise necessary for this decision making and often continue to perform tests that have been eliminated in larger facilities. Consultation with larger hospital transfusion services may provide guidance for this change.

Summary

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

Powell, Danny H; Elwood Jr, Robert H

2011-01-01

An effective risk assessment system is needed to address the threat posed by an active or passive insider who, acting alone or in collusion, could attempt diversion or theft of nuclear material. The material control and accountability (MC&A) system effectiveness tool (MSET) is a self-assessment or inspection tool utilizing probabilistic risk assessment (PRA) methodology to calculate the system effectiveness of a nuclear facility's material protection, control, and accountability (MPC&A) system. The MSET process is divided into four distinct and separate parts: (1) Completion of the questionnaire that assembles information about the operations of every aspect of the MPC&A system; (2)more » Conversion of questionnaire data into numeric values associated with risk; (3) Analysis of the numeric data utilizing the MPC&A fault tree and the SAPHIRE computer software; and (4) Self-assessment using the MSET reports to perform the effectiveness evaluation of the facility's MPC&A system. The process should lead to confirmation that mitigating features of the system effectively minimize the threat, or it could lead to the conclusion that system improvements or upgrades are necessary to achieve acceptable protection against the threat. If the need for system improvements or upgrades is indicated when the system is analyzed, MSET provides the capability to evaluate potential or actual system improvements or upgrades. A facility's MC&A system can be evaluated at a point in time. The system can be reevaluated after upgrades are implemented or after other system changes occur. The total system or specific subareas within the system can be evaluated. Areas of potential system improvement can be assessed to determine where the most beneficial and cost-effective improvements should be made. Analyses of risk importance factors show that sustainability is essential for optimal performance and reveals where performance degradation has the greatest impact on total system risk. The risk importance factors show the amount of risk reduction achievable with potential upgrades and the amount of risk reduction achieved after upgrades are completed. Applying the risk assessment tool gives support to budget prioritization by showing where budget support levels must be sustained for MC&A functions most important to risk. Results of the risk assessment are also useful in supporting funding justifications for system improvements that significantly reduce system risk. The functional model, the system risk assessment tool, and the facility evaluation questionnaire are valuable educational tools for MPC&A personnel. These educational tools provide a framework for ongoing dialogue between organizations regarding the design, development, implementation, operation, assessment, and sustainability of MPC&A systems. An organization considering the use of MSET as an analytical tool for evaluating the effectiveness of its MPC&A system will benefit from conducting a complete MSET exercise at an existing nuclear facility.« less

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

PubMed

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

2018-06-01

Improving access and quality of obstetric service has the potential to avert preventable maternal, neonatal and stillborn deaths, yet little is known about the quality of care received. This study sought to assess obstetric service availability, readiness and coverage within and between 17 low- and middle-income countries. We linked health facility data from the Service Provision Assessments and Service Availability and Readiness Assessments, with corresponding household survey data obtained from the Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Based on performance of obstetric signal functions, we defined four levels of facility emergency obstetric care (EmOC) functionality: comprehensive (CEmOC), basic (BEmOC), BEmOC-2, and low/substandard. Facility readiness was evaluated based on the direct observation of 23 essential items; facilities "ready to provide obstetric services" had ≥20 of 23 items available. Across countries, we used medians to characterize service availability and readiness, overall and by urban-rural location; analyses also adjusted for care-seeking patterns to estimate population-level coverage of obstetric services. Of the 111 500 health facilities surveyed, 7545 offered obstetric services and were included in the analysis. The median percentages of facilities offering EmOC and "ready to provide obstetric services" were 19% and 10%, respectively. There were considerable urban-rural differences, with absolute differences of 19% and 29% in the availability of facilities offering EmOC and "ready to provide obstetric services", respectively. Adjusting for care-seeking patterns, results from the linking approach indicated that among women delivering in a facility, a median of 40% delivered in facilities offering EmOC, and 28% delivered in facilities "ready to provide obstetric services". Relatively higher coverage of facility deliveries (≥65%) and coverage of deliveries in facilities "ready to provide obstetric services" (≥30% of facility deliveries) were only found in three countries. The low levels of availability, readiness and coverage of obstetric services documented represent substantial missed opportunities within health systems. Global and national efforts need to prioritize upgrading EmOC functionality and improving readiness to deliver obstetric service, particularly in rural areas. The approach of linking health facility and household surveys described here could facilitate the tracking of progress towards quality obstetric care.

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

PubMed Central

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

2018-01-01

Background Improving access and quality of obstetric service has the potential to avert preventable maternal, neonatal and stillborn deaths, yet little is known about the quality of care received. This study sought to assess obstetric service availability, readiness and coverage within and between 17 low- and middle-income countries. Methods We linked health facility data from the Service Provision Assessments and Service Availability and Readiness Assessments, with corresponding household survey data obtained from the Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Based on performance of obstetric signal functions, we defined four levels of facility emergency obstetric care (EmOC) functionality: comprehensive (CEmOC), basic (BEmOC), BEmOC-2, and low/substandard. Facility readiness was evaluated based on the direct observation of 23 essential items; facilities “ready to provide obstetric services” had ≥20 of 23 items available. Across countries, we used medians to characterize service availability and readiness, overall and by urban-rural location; analyses also adjusted for care-seeking patterns to estimate population-level coverage of obstetric services. Results Of the 111 500 health facilities surveyed, 7545 offered obstetric services and were included in the analysis. The median percentages of facilities offering EmOC and “ready to provide obstetric services” were 19% and 10%, respectively. There were considerable urban-rural differences, with absolute differences of 19% and 29% in the availability of facilities offering EmOC and “ready to provide obstetric services”, respectively. Adjusting for care-seeking patterns, results from the linking approach indicated that among women delivering in a facility, a median of 40% delivered in facilities offering EmOC, and 28% delivered in facilities “ready to provide obstetric services”. Relatively higher coverage of facility deliveries (≥65%) and coverage of deliveries in facilities “ready to provide obstetric services” (≥30% of facility deliveries) were only found in three countries. Conclusions The low levels of availability, readiness and coverage of obstetric services documented represent substantial missed opportunities within health systems. Global and national efforts need to prioritize upgrading EmOC functionality and improving readiness to deliver obstetric service, particularly in rural areas. The approach of linking health facility and household surveys described here could facilitate the tracking of progress towards quality obstetric care. PMID:29862026

Assessing the need for an update of a probabilistic seismic hazard analysis using a SSHAC Level 1 study and the Seismic Hazard Periodic Reevaluation Methodology

DOE PAGES

Payne, Suzette J.; Coppersmith, Kevin J.; Coppersmith, Ryan; ...

2017-08-23

A key decision for nuclear facilities is evaluating the need for an update of an existing seismic hazard analysis in light of new data and information that has become available since the time that the analysis was completed. We introduce the newly developed risk-informed Seismic Hazard Periodic Review Methodology (referred to as the SHPRM) and present how a Senior Seismic Hazard Analysis Committee (SSHAC) Level 1 probabilistic seismic hazard analysis (PSHA) was performed in an implementation of this new methodology. The SHPRM offers a defensible and documented approach that considers both the changes in seismic hazard and engineering-based risk informationmore » of an existing nuclear facility to assess the need for an update of an existing PSHA. The SHPRM has seven evaluation criteria that are employed at specific analysis, decision, and comparison points which are applied to seismic design categories established for nuclear facilities in United States. The SHPRM is implemented using a SSHAC Level 1 study performed for the Idaho National Laboratory, USA. The implementation focuses on the first six of the seven evaluation criteria of the SHPRM which are all provided from the SSHAC Level 1 PSHA. Finally, to illustrate outcomes of the SHPRM that do not lead to the need for an update and those that do, the example implementations of the SHPRM are performed for nuclear facilities that have target performance goals expressed as the mean annual frequency of unacceptable performance at 1x10 -4, 4x10 -5 and 1x10 -5.« less

Assessing the need for an update of a probabilistic seismic hazard analysis using a SSHAC Level 1 study and the Seismic Hazard Periodic Reevaluation Methodology

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

Payne, Suzette J.; Coppersmith, Kevin J.; Coppersmith, Ryan

A key decision for nuclear facilities is evaluating the need for an update of an existing seismic hazard analysis in light of new data and information that has become available since the time that the analysis was completed. We introduce the newly developed risk-informed Seismic Hazard Periodic Review Methodology (referred to as the SHPRM) and present how a Senior Seismic Hazard Analysis Committee (SSHAC) Level 1 probabilistic seismic hazard analysis (PSHA) was performed in an implementation of this new methodology. The SHPRM offers a defensible and documented approach that considers both the changes in seismic hazard and engineering-based risk informationmore » of an existing nuclear facility to assess the need for an update of an existing PSHA. The SHPRM has seven evaluation criteria that are employed at specific analysis, decision, and comparison points which are applied to seismic design categories established for nuclear facilities in United States. The SHPRM is implemented using a SSHAC Level 1 study performed for the Idaho National Laboratory, USA. The implementation focuses on the first six of the seven evaluation criteria of the SHPRM which are all provided from the SSHAC Level 1 PSHA. Finally, to illustrate outcomes of the SHPRM that do not lead to the need for an update and those that do, the example implementations of the SHPRM are performed for nuclear facilities that have target performance goals expressed as the mean annual frequency of unacceptable performance at 1x10 -4, 4x10 -5 and 1x10 -5.« less

Experimental investigation of an ejector-powered free-jet facility

NASA Technical Reports Server (NTRS)

Long, Mary JO

1992-01-01

NASA Lewis Research Center's (LeRC) newly developed Nozzle Acoustic Test Rig (NATR) is a large free-jet test facility powered by an ejector system. In order to assess the pumping performance of this ejector concept and determine its sensitivity to various design parameters, a 1/5-scale model of the NATR was built and tested prior to the operation of the actual facility. This paper discusses the results of the 1/5-scale model tests and compares them with the findings from the full-scale tests.

Control Limits for Building Energy End Use Based on Engineering Judgment, Frequency Analysis, and Quantile Regression

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

Henze, Gregor P.; Pless, Shanti; Petersen, Anya

2014-02-01

Approaches are needed to continuously characterize the energy performance of commercial buildings to allow for (1) timely response to excess energy use by building operators; and (2) building occupants to develop energy awareness and to actively engage in reducing energy use. Energy information systems, often involving graphical dashboards, are gaining popularity in presenting energy performance metrics to occupants and operators in a (near) real-time fashion. Such an energy information system, called Building Agent, has been developed at NREL and incorporates a dashboard for public display. Each building is, by virtue of its purpose, location, and construction, unique. Thus, assessing buildingmore » energy performance is possible only in a relative sense, as comparison of absolute energy use out of context is not meaningful. In some cases, performance can be judged relative to average performance of comparable buildings. However, in cases of high-performance building designs, such as NREL's Research Support Facility (RSF) discussed in this report, relative performance is meaningful only when compared to historical performance of the facility or to a theoretical maximum performance of the facility as estimated through detailed building energy modeling.« less

Data Packages for the Hanford Immobilized Low Activity Tank Waste Performance Assessment 2001 Version [SEC 1 THRU 5

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

MANN, F.M.

Data package supporting the 2001 Immobilized Low-Activity Waste Performance Analysis. Geology, hydrology, geochemistry, facility, waste form, and dosimetry data based on recent investigation are provided. Verification and benchmarking packages for selected software codes are provided.

77 FR 21595 - Applications and Amendments to Facility Operating Licenses and Combined Licenses Involving...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-10

... must be one which, if proven, would entitle the requestor/petitioner to relief. A requestor/ petitioner..., and fire modeling calculations, have been performed to demonstrate that the performance-based... may include engineering evaluations, probabilistic safety assessments, and fire modeling calculations...

Impact of a function-based payment model on the financial performance of acute inpatient medical rehabilitation providers: a simulation analysis.

PubMed

Sutton, J P; DeJong, G; Song, H; Wilkerson, D

1997-12-01

To operationalize research findings about a medical rehabilitation classification and payment model by building a prototype of a prospective payment system, and to determine whether this prototype model promotes payment equity. This latter objective is accomplished by identifying whether any facility or payment model characteristics are systematically associated with financial performance. This study was conducted in two phases. In Phase 1 the components of a diagnosis-related group (DRG)-like payment system, including a base rate, function-related group (FRG) weights, and adjusters, were identified and estimated using hospital cost functions. Phase 2 consisted of a simulation analysis in which each facility's financial performance was modeled, based on its 1990-1991 case mix. A multivariate regression equation was conducted to assess the extent to which characteristics of 42 rehabilitation facilities contribute toward determining financial performance under the present Medicare payment system as well as under the hypothetical model developed. Phase 1 (model development) included 61 rehabilitation hospitals. Approximately 59% were rehabilitation units within a general hospital and 48% were teaching facilities. The number of rehabilitation beds averaged 52. Phase 2 of the stimulation analysis included 42 rehabilitation facilities, subscribers to UDS in 1990-1991. Of these, 69% were rehabilitation units and 52% were teaching facilities. The number of rehabilitation beds averaged 48. Financial performance, as measured by the ratio of reimbursement to average costs. Case-mix index is the primary determinant of financial performance under the present Medicare payment system. None of the facility characteristics included in this analysis were associated with financial performance under the hypothetical FRG payment model. The most notable impact of an FRG-based payment model would be to create a stronger link between resource intensity and level of reimbursement, resulting in greater equity in the reimbursement of inpatient medical rehabilitation hospitals.

Approaches to consider covers and liners in a low-level waste disposal facility performance assessment

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

Seitz, Roger; Phifer, Mark; Suttora, Linda

2015-03-17

On-site disposal cells are in use and being considered at several USDOE sites as the final disposition for large amounts of waste associated with cleanup of contaminated areas and facilities. These disposal cells are typically regulated by States and/or the USEPA in addition to having to comply with requirements in DOE Order 435.1, Radioactive Waste Management. The USDOE-EM Office of Site Restoration formed a working group to foster improved communication and sharing of information for personnel associated with these Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) disposal cells and work towards more consistent assumptions, as appropriate, for technical andmore » policy considerations related to performance and risk assessments in support of a Record of Decision and Disposal Authorization Statement. One task completed by the working group addressed approaches for considering the performance of covers and liners/leachate collection systems in the context of a performance assessment (PA). A document has been prepared which provides recommendations for a general approach to address covers and liners/leachate collection systems in a PA and how to integrate assessments with defense-in-depth considerations such as design, operations and waste acceptance criteria to address uncertainties. Specific information and references are provided for details needed to address the evolution of individual components of cover and liner/leachate collection systems. This information is then synthesized into recommendations for best practices for cover and liner system design and examples of approaches to address the performance of covers and liners as part of a performance assessment of the disposal system.« less

Quality of care in contraceptive services provided to young people in two Ugandan districts: a simulated client study.

PubMed

Nalwadda, Gorrette; Tumwesigye, Nazarius M; Faxelid, Elisabeth; Byamugisha, Josaphat; Mirembe, Florence

2011-01-01

Low and inconsistent use of contraceptives by young people contributes to unintended pregnancies. This study assessed quality of contraceptive services for young people aged 15-24 in two rural districts in Uganda. Five female and two male simulated clients (SCs) interacted with 128 providers at public, private not-for-profit (PNFP), and private for profit (PFP) health facilities. After consultations, SCs were interviewed using a structured questionnaire. Six aspects of quality of care (client's needs, choice of contraceptive methods, information given to users, client-provider interpersonal relations, constellation of services, and continuity mechanisms) were assessed. Descriptive statistics and factor analysis were performed. Means and categorized quality scores for all aspects of quality were low in both public and private facilities. The lowest quality scores were observed in PFP, and medium scores in PNFP facilities. The choice of contraceptive methods and interpersonal relations quality scores were slightly higher in public facilities. Needs assessment scores were highest in PNFP facilities. All facilities were classified as having low scores for appropriate constellation of services. Information given to users was suboptimal and providers promoted specific contraceptive methods. Minority of providers offered preferred method of choice and showed respect for privacy. The quality of contraceptive services provided to young people was low. Concurrent quality improvements and strengthening of health systems are needed.

Quality of Care in Contraceptive Services Provided to Young People in Two Ugandan Districts: A Simulated Client Study

PubMed Central

Nalwadda, Gorrette; Tumwesigye, Nazarius M.; Faxelid, Elisabeth; Byamugisha, Josaphat; Mirembe, Florence

2011-01-01

Background Low and inconsistent use of contraceptives by young people contributes to unintended pregnancies. This study assessed quality of contraceptive services for young people aged 15–24 in two rural districts in Uganda. Methods Five female and two male simulated clients (SCs) interacted with 128 providers at public, private not-for-profit (PNFP), and private for profit (PFP) health facilities. After consultations, SCs were interviewed using a structured questionnaire. Six aspects of quality of care (client's needs, choice of contraceptive methods, information given to users, client-provider interpersonal relations, constellation of services, and continuity mechanisms) were assessed. Descriptive statistics and factor analysis were performed. Results Means and categorized quality scores for all aspects of quality were low in both public and private facilities. The lowest quality scores were observed in PFP, and medium scores in PNFP facilities. The choice of contraceptive methods and interpersonal relations quality scores were slightly higher in public facilities. Needs assessment scores were highest in PNFP facilities. All facilities were classified as having low scores for appropriate constellation of services. Information given to users was suboptimal and providers promoted specific contraceptive methods. Minority of providers offered preferred method of choice and showed respect for privacy. Conclusions The quality of contraceptive services provided to young people was low. Concurrent quality improvements and strengthening of health systems are needed. PMID:22132168

Meeting the community halfway to reduce maternal deaths? Evidence from a community-based maternal death review in Uttar Pradesh, India

PubMed Central

Raj, Sunil Saksena; Maine, Deborah; Sahoo, Pratap Kumar; Manthri, Suneedh; Chauhan, Kavita

2013-01-01

ABSTRACT Background: Uttar Pradesh (UP) is the most populous state in India with the second highest reported maternal mortality ratio in the country. In an effort to analyze the reasons for maternal deaths and implement appropriate interventions, the Government of India introduced Maternal Death Review guidelines in 2010. Methods: We assessed causes of and factors leading to maternal deaths in Unnao District, UP, through 2 methods. First, we conducted a facility gap assessment in 15 of the 16 block-level and district health facilities to collect information on the performance of the facilities in terms of treating obstetric complications. Second, teams of trained physicians conducted community-based maternal death reviews (verbal autopsies) in a sample of maternal deaths occurring between June 1, 2009, and May 31, 2010. Results: Of the 248 maternal deaths that would be expected in this district in a year, we identified 153 (62%) through community workers and conducted verbal autopsies with families of 57 of them. Verbal autopsies indicated that 23% and 30% of these maternal deaths occurred at home and on the way to a health facility, respectively. Most of the women who died had been taken to at least 2 health facilities. The facility assessment revealed that only the district hospital met the recommended criteria for either basic or comprehensive emergency obstetric and neonatal care. Conclusions: Life-saving treatment of obstetric complications was not offered at the appropriate level of government facilities in a representative district in UP, and an inadequate referral system provided fatal delays. Expensive transportation costs to get pregnant women to a functioning medical facility also contributed to maternal death. The maternal death review, coupled with the facility gap assessment, is a useful tool to address the adequacy of emergency obstetric and neonatal care services to prevent further maternal deaths. PMID:25276519

KSC-07pd0922

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- After a test flight of the Starfighter F-104, Pilot Rick Svetkoff addresses the media on the KSC Shuttle Landing Facility. Behind him are Al Wassel (left), a representative from the FAA Office of Commercial Space, and (right) Bill Parsons, director of Kennedy Space Center. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

Nuclear criticality safety assessment of the low level radioactive waste disposal facility trenches

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

Kahook, S.D.

1994-04-01

Results of the analyses performed to evaluate the possibility of nuclear criticality in the Low Level Radioactive Waste Disposal Facility (LLRWDF) trenches are documented in this report. The studies presented in this document are limited to assessment of the possibility of criticality due to existing conditions in the LLRWDF. This document does not propose nor set limits for enriched uranium (EU) burial in the LLRWDF and is not a nuclear criticality safety evaluation nor analysis. The calculations presented in the report are Level 2 calculations as defined by the E7 Procedure 2.31, Engineering Calculations.

Site specific risk assessment of an energy-from-waste/thermal treatment facility in Durham Region, Ontario, Canada. Part B: Ecological risk assessment.

PubMed

Ollson, Christopher A; Whitfield Aslund, Melissa L; Knopper, Loren D; Dan, Tereza

2014-01-01

The regions of Durham and York in Ontario, Canada have partnered to construct an energy-from-waste (EFW) thermal treatment facility as part of a long term strategy for the management of their municipal solid waste. In this paper we present the results of a comprehensive ecological risk assessment (ERA) for this planned facility, based on baseline sampling and site specific modeling to predict facility-related emissions, which was subsequently accepted by regulatory authorities. Emissions were estimated for both the approved initial operating design capacity of the facility (140,000 tonnes per year) and the maximum design capacity (400,000 tonnes per year). In general, calculated ecological hazard quotients (EHQs) and screening ratios (SRs) for receptors did not exceed the benchmark value (1.0). The only exceedances noted were generally due to existing baseline media concentrations, which did not differ from those expected for similar unimpacted sites in Ontario. This suggests that these exceedances reflect conservative assumptions applied in the risk assessment rather than actual potential risk. However, under predicted upset conditions at 400,000 tonnes per year (i.e., facility start-up, shutdown, and loss of air pollution control), a potential unacceptable risk was estimated for freshwater receptors with respect to benzo(g,h,i)perylene (SR=1.1), which could not be attributed to baseline conditions. Although this slight exceedance reflects a conservative worst-case scenario (upset conditions coinciding with worst-case meteorological conditions), further investigation of potential ecological risk should be performed if this facility is expanded to the maximum operating capacity in the future. © 2013.

Preparedness of lower-level health facilities and the associated factors for the outpatient primary care of hypertension: Evidence from Tanzanian national survey.

PubMed

Bintabara, Deogratius; Mpondo, Bonaventura C T

2018-01-01

Sub-Saharan Africa is experiencing a rapid rise in the burden of non-communicable diseases in both urban and rural areas. Data on health system preparedness to manage hypertension and other non-communicable diseases remains scarce. This study aimed to assess the preparedness of lower-level health facilities for outpatient primary care of hypertension in Tanzania. This study used data from the 2014-2015 Tanzania Service Provision Assessment survey. The facility was considered as prepared for the outpatient primary care of hypertension if reported at least half (≥50%) of the items listed from each of the three domains (staff training and guideline, basic diagnostic equipment, and basic medicines) as identified by World Health Organization-Service Availability and Readiness Assessment manual. Data were analyzed using Stata 14. An unadjusted logistic regression model was used to assess the association between outcome and explanatory variables. All variables with a P value < 0.2 were fitted into the multiple logistic regression models using a 5% significance level. Out of 725 health facilities involved in the current study, about 68% were public facilities and 73% located in rural settings. Only 28% of the assessed facilities were considered prepared for the outpatient primary care of hypertension. About 9% and 42% of the assessed facilities reported to have at least one trained staff and guidelines for hypertension respectively. In multivariate analysis, private facilities [AOR = 2.7, 95% CI; 1.2-6.1], urban location [AOR = 2.2, 95% CI; 1.2-4.2], health centers [AOR = 5.2, 95% CI; 3.1-8.7] and the performance of routine management meetings [AOR = 2.6, 95% CI; 1.1-5.9] were significantly associated with preparedness for the outpatient primary care of hypertension. The primary healthcare system in Tanzania is not adequately equipped to cope with the increasing burden of hypertension and other non-communicable diseases. Rural location, public ownership, and absence of routine management meetings were associated with being not prepared. There is a need to strengthen the primary healthcare system in Tanzania for better management of chronic diseases and curb their rising impact on health outcomes.

Assessing post-abortion care in health facilities in Afghanistan: a cross-sectional study.

PubMed

Ansari, Nasratullah; Zainullah, Partamin; Kim, Young Mi; Tappis, Hannah; Kols, Adrienne; Currie, Sheena; Haver, Jaime; van Roosmalen, Jos; Broerse, Jacqueline E W; Stekelenburg, Jelle

2015-02-03

Complications of abortion are one of the leading causes of maternal mortality worldwide, along with hemorrhage, sepsis, and hypertensive diseases of pregnancy. In Afghanistan little data exist on the capacity of the health system to provide post-abortion care (PAC). This paper presents findings from a national emergency obstetric and neonatal care needs assessment related to PAC, with the aim of providing insight into the current situation and recommendations for improvement of PAC services. A national Emergency Obstetric and Neonatal Care Needs Assessment was conducted from December 2009 through February 2010 at 78 of the 127 facilities designated to provide emergency obstetric and neonatal care services in Afghanistan. Research tools were adapted from the Averting Maternal Death and Disability Program Needs Assessment Toolkit and national midwifery education assessment tools. Descriptive statistics were used to summarize facility characteristics, and linear regression models were used to assess the factors associated with providers' PAC knowledge and skills. The average number of women receiving PAC in the past year in each facility was 244, with no significant difference across facility types. All facilities had at least one staff member who provided PAC services. Overall, 70% of providers reported having been trained in PAC and 68% felt confident in their ability to perform these services. On average, providers were able to identify 66% of the most common complications of unsafe or incomplete abortion and 57% of the steps to take in examining and managing women with these complications. Providers correctly demonstrated an average of 31% of the tasks required for PAC during a simulated procedure. Training was significantly associated with PAC knowledge and skills in multivariate regression models, but other provider and facility characteristics were not. While designated emergency obstetric facilities in Afghanistan generally have most supplies and equipment for PAC, the capacity of healthcare providers to deliver PAC is limited. Therefore, we strongly recommend training all skilled birth attendants in PAC services. In addition, a PAC training package should be integrated into pre-service medical education.

33 CFR 105.305 - Facility Security Assessment (FSA) requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Facility Security Assessment (FSA... SECURITY MARITIME SECURITY MARITIME SECURITY: FACILITIES Facility Security Assessment (FSA) § 105.305 Facility Security Assessment (FSA) requirements. (a) Background. The facility owner or operator must ensure...

33 CFR 105.305 - Facility Security Assessment (FSA) requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Facility Security Assessment (FSA... SECURITY MARITIME SECURITY MARITIME SECURITY: FACILITIES Facility Security Assessment (FSA) § 105.305 Facility Security Assessment (FSA) requirements. (a) Background. The facility owner or operator must ensure...

33 CFR 105.305 - Facility Security Assessment (FSA) requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Facility Security Assessment (FSA... SECURITY MARITIME SECURITY MARITIME SECURITY: FACILITIES Facility Security Assessment (FSA) § 105.305 Facility Security Assessment (FSA) requirements. (a) Background. The facility owner or operator must ensure...

33 CFR 105.305 - Facility Security Assessment (FSA) requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Facility Security Assessment (FSA... SECURITY MARITIME SECURITY MARITIME SECURITY: FACILITIES Facility Security Assessment (FSA) § 105.305 Facility Security Assessment (FSA) requirements. (a) Background. The facility owner or operator must ensure...

33 CFR 105.305 - Facility Security Assessment (FSA) requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Facility Security Assessment (FSA... SECURITY MARITIME SECURITY MARITIME SECURITY: FACILITIES Facility Security Assessment (FSA) § 105.305 Facility Security Assessment (FSA) requirements. (a) Background. The facility owner or operator must ensure...

Annual Status Report (FY2017): Performance Assessment for the Environmental Restoration Disposal Facility.

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

Nichols, Will E.

In accordance with U.S. Department of Energy (DOE) requirements in DOE O 435.1 Chg 11 and DOE M 435.1-1 Chg 1,2 a determination of continued adequacy of the performance assessment (PA), composite analysis (CA), and disposal authorization statement (DAS) is required on an annual basis. This determination must consider the results of data collection and analysis from research, field studies, and monitoring.

Issuance of a final RCRA Part B Subpart X permit for open burning/open detonation (OB/OD) of explosives at Eglin AFB, Florida

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

Johnson, G.E.; Culp, J.C.; Jenness, S.R.

1997-12-31

Treatment and disposal of explosives and munitions items have represented a significant management challenge for Department of Defense (DOD) facilities, particularly in light of increased regulatory scrutiny under the Federal Facilities Compliance Act provisions of the Resource Conservation and Recovery Act (RCRA). Subpart X of the RCRA regulations for storage, treatment, and disposal of hazardous wastes was drafted specifically to address explosive wastes. Until just recently, any DOD facility that was performing open burning/open detonation (OB/OD) of explosives was doing so under interim status for RCRA Part B Subpart X. In August 1996, Eglin Air Force Base (AFB), Florida becamemore » the first Air Force facility to be issued a final Part B Subpart X permit to perform OB/OD operations at two Eglin AFB active test ranges. This presentation will examine how Eglin AFB worked proactively with the State of Florida Department of Environmental Protection (FDEP) and EPA Region IV to develop permit conditions based upon risk assessment considerations for both air and ground-water exposure pathways. It will review the role of air emissions and air dispersion modeling in assessing potential exposure and impacts to both onsite and offsite receptors, and will discuss how air monitoring will be used to assure that the facility remains in compliance during OB/OD activities. The presentation will also discuss the soil and ground-water characterization program and associated risk assessment provisions for quarterly ground-water monitoring to assure permit compliance. The project is an excellent example of how a collaborative working relationship among the permittee, their consultant and state, and EPA can result in an environmentally protective permit that assures operational flexibility and mission sensitivity.« less

Options to improve energy efficiency for educational building

NASA Astrophysics Data System (ADS)

Jahan, Mafruha

The cost of energy is a major factor that must be considered for educational facility budget planning purpose. The analysis of energy related issues and options can be complex and requires significant time and detailed effort. One way to facilitate the inclusion of energy option planning in facility planning efforts is to utilize a tool that allows for quick appraisal of the facility energy profile. Once such an appraisal is accomplished, it is then possible to rank energy improvement options consistently with other facility needs and requirements. After an energy efficiency option has been determined to have meaningful value in comparison with other facility planning options, it is then possible to utilize the initial appraisal as the basis for an expanded consideration of additional facility and energy use detail using the same analytic system used for the initial appraisal. This thesis has developed a methodology and an associated analytic model to assist in these tasks and thereby improve the energy efficiency of educational facilities. A detailed energy efficiency and analysis tool is described that utilizes specific university building characteristics such as size, architecture, envelop, lighting, occupancy, thermal design which allows reducing the annual energy consumption. Improving the energy efficiency of various aspects of an educational building's energy performance can be complex and can require significant time and experience to make decisions. The approach developed in this thesis initially assesses the energy design for a university building. This initial appraisal is intended to assist administrators in assessing the potential value of energy efficiency options for their particular facility. Subsequently this scoping design can then be extended as another stage of the model by local facility or planning personnel to add more details and engineering aspects to the initial screening model. This approach can assist university planning efforts to identify the most cost effective combinations of energy efficiency strategies. The model analyzes and compares the payback periods of all proposed Energy Performance Measures (EPMs) to determine which has the greatest potential value.

Review of the Need for a Large-scale Test Facility for Research on the Effects of Extreme Winds on Structures

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

R. G. Little

1999-03-01

The Idaho National Engineering and Environmental Laboratory (INEEL), through the US Department of Energy (DOE), has proposed that a large-scale wind test facility (LSWTF) be constructed to study, in full-scale, the behavior of low-rise structures under simulated extreme wind conditions. To determine the need for, and potential benefits of, such a facility, the Idaho Operations Office of the DOE requested that the National Research Council (NRC) perform an independent assessment of the role and potential value of an LSWTF in the overall context of wind engineering research. The NRC established the Committee to Review the Need for a Large-scale Testmore » Facility for Research on the Effects of Extreme Winds on Structures, under the auspices of the Board on Infrastructure and the Constructed Environment, to perform this assessment. This report conveys the results of the committee's deliberations as well as its findings and recommendations. Data developed at large-scale would enhanced the understanding of how structures, particularly light-frame structures, are affected by extreme winds (e.g., hurricanes, tornadoes, sever thunderstorms, and other events). With a large-scale wind test facility, full-sized structures, such as site-built or manufactured housing and small commercial or industrial buildings, could be tested under a range of wind conditions in a controlled, repeatable environment. At this time, the US has no facility specifically constructed for this purpose. During the course of this study, the committee was confronted by three difficult questions: (1) does the lack of a facility equate to a need for the facility? (2) is need alone sufficient justification for the construction of a facility? and (3) would the benefits derived from information produced in an LSWTF justify the costs of producing that information? The committee's evaluation of the need and justification for an LSWTF was shaped by these realities.« less

Environmental Assessment Building 5745, Historical Building Demolition, Barksdale Air Force Base, Louisiana

DTIC Science & Technology

2012-12-01

PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 2d Civil Engineer Squadron (2 CES/CEAO),Barksdale AFB,LA,71110 8. PERFORMING ORGANIZATION REPORT...Housing, Unaccompanied 26 0.1 VOQ, VAQ, BAQ, dormitories, transient facilities Outdoor Recreation 142 0.6 Softball fields, tennis courts, football field

Conceptual Modeling Framework for E-Area PA HELP Infiltration Model Simulations

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

Dyer, J. A.

A conceptual modeling framework based on the proposed E-Area Low-Level Waste Facility (LLWF) closure cap design is presented for conducting Hydrologic Evaluation of Landfill Performance (HELP) model simulations of intact and subsided cap infiltration scenarios for the next E-Area Performance Assessment (PA).

Effect of Educational Outreach Timing and Duration on Facility Performance for Infectious Disease Care in Uganda: A Trial with Pre-Post and Cluster Randomized Controlled Components

PubMed Central

Burnett, Sarah M.; Mbonye, Martin K.; Naikoba, Sarah; Zawedde-Muyanja, Stella; Kinoti, Stephen N.; Ronald, Allan; Rubashembusya, Timothy; Willis, Kelly S.; Colebunders, Robert; Manabe, Yukari C.; Weaver, Marcia R.

2015-01-01

Background Classroom-based learning is often insufficient to ensure high quality care and application of health care guidelines. Educational outreach is garnering attention as a supplemental method to enhance health care worker capacity, yet there is little information about the timing and duration required to improve facility performance. We sought to evaluate the effects of an infectious disease training program followed by either immediate or delayed on-site support (OSS), an educational outreach approach, on nine facility performance indicators for emergency triage, assessment, and treatment; malaria; and pneumonia. We also compared the effects of nine monthly OSS visits to extended OSS, with three additional visits over six months. Methods This study was conducted at 36 health facilities in Uganda, covering 1,275,960 outpatient visits over 23 months. From April 2010 to December 2010, 36 sites received infectious disease training; 18 randomly selected sites in arm A received nine monthly OSS visits (immediate OSS) and 18 sites in arm B did not. From March 2011 to September 2011, arm A sites received three additional visits every two months (extended OSS), while the arm B sites received eight monthly OSS visits (delayed OSS). We compared the combined effect of training and delayed OSS to training followed by immediate OSS to determine the effect of delaying OSS implementation by nine months. We also compared facility performance in arm A during the extended OSS to immediate OSS to examine the effect of additional, less frequent OSS. Results Delayed OSS, when combined with training, was associated with significant pre/post improvements in four indicators: outpatients triaged (44% vs. 87%, aRR = 1.54, 99% CI = 1.11, 2.15); emergency and priority patients admitted, detained, or referred (16% vs. 31%, aRR = 1.74, 99% CI = 1.10, 2.75); patients with a negative malaria test result prescribed an antimalarial (53% vs. 34%, aRR = 0.67, 99% CI = 0.55, 0.82); and pneumonia suspects assessed for pneumonia (6% vs. 27%, aRR = 2.97, 99% CI = 1.44, 6.17). Differences between the delayed OSS and immediate OSS arms were not statistically significant for any of the nine indicators (all adjusted relative RR (aRRR) between 0.76–1.44, all p>0.06). Extended OSS was associated with significant improvement in two indicators (outpatients triaged: aRR = 1.09, 99% CI = 1.01; emergency and priority patients admitted, detained, or referred: aRR = 1.22, 99% CI = 1.01, 1.38) and decline in one (pneumonia suspects assessed for pneumonia: aRR: 0.93; 99% CI = 0.88, 0.98). Conclusions Educational outreach held up to nine months after training had similar effects on facility performance as educational outreach started within one month post-training. Six months of bi-monthly educational outreach maintained facility performance gains, but incremental improvements were heterogeneous. PMID:26352257

Assessment of accessible facilities for disabled passenger movement in aerodrome terminals in Klang Valley

NASA Astrophysics Data System (ADS)

Ramli, M. Z.; Hasnol., J. N. E.; Hamid, N. B.; Ismail, N.; Zawawi, M. H.; Zainal, M. Z.

2017-09-01

The effectiveness of accessibility in public transport has prompted a great deal of weakness and confines many disabled from moving around unreservedly. As far as the built-up environment is concerned, it is important that it should be barrier-free and adapted to fulfill the needs of all people equally. The consideration of equal accessibility to outdoor environments is still lacking. These cause the problems with poor accessibility, the disabled people face more challenges and difficulties while travelling and using the public transport. Therefore, the aim of the study is to evaluate the performance of accessible facilities for disabled movement in aerodrome terminals in Klang Valley. An assessment rating was developed from an established guideline to assess the disabled facilities provided in the Aerodrome Terminal 1 and Aerodrome Terminal 2 by using manual observation and measurement technique. Based on the results obtained, the facility for disabled people in both aerodrome terminals are moderate. Aerodrome Terminal 1 is averagely 63.46% while for Aerodrome Terminal 2 is 67.31%. Results demonstrated that effort is needed by the respective agencies and there was a demand on re-designing the current facility, so that disabled people will not face any difficulty while traveling through public transport stations or terminals.

Sport Fields as Potential Catalysts for Physical Activity in the Neighbourhood

PubMed Central

Cutumisu, Nicoleta; Spence, John C.

2012-01-01

Physical activity is associated with access to recreational facilities such as sports fields. Because it is not clear whether objectively- or subjectively-assessed access to facilities exerts a stronger influence on physical activity, we investigated the association between the objective and perceived accessibility of sport fields and the levels of self-reported physical activity among adults in Edmonton, Canada. A sample of 2879 respondents was surveyed regarding their socio-demographics, health status, self-efficacy, levels of physical activity, as well as their perceptions of built environment in relation to physical activity. Neighbourhood-level data were obtained for each respondent based on their residence. Accessibility to facilities was assessed using the enhanced Two-Step Floating Catchment Area method. Geographic Information Systems were employed. A logistic regression was performed to predict physical activity using individual- and neighbourhood-level variables. Women, older individuals, and individuals with higher educational attainment were less likely to be physically active. Also, individuals with higher self-efficacy and higher objectively-assessed access to facilities were more likely to be physically active. Interventions that integrate provision of relevant programs for various population groups and of improved recreational facilities may contribute to sport fields becoming catalysts for physical activity by generating movement both on the site and in the neighbourhood. PMID:22470293

Systematic monitoring of male circumcision scale-up in Nyanza, Kenya: exploratory factor analysis of service quality instrument and performance ranking.

PubMed

Omondi Aduda, Dickens S; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane

2014-01-01

Considerable conceptual and operational complexities related to service quality measurements and variability in delivery contexts of scaled-up medical male circumcision, pose real challenges to monitoring implementation of quality and safety. Clarifying latent factors of the quality instruments can enhance contextual applicability and the likelihood that observed service outcomes are appropriately assessed. To explore factors underlying SYMMACS service quality assessment tool (adopted from the WHO VMMC quality toolkit) and; determine service quality performance using composite quality index derived from the latent factors. Using a comparative process evaluation of Voluntary Medical Male Circumcision Scale-Up in Kenya site level data was collected among health facilities providing VMMC over two years. Systematic Monitoring of the Medical Male Circumcision Scale-Up quality instrument was used to assess availability of guidelines, supplies and equipment, infection control, and continuity of care services. Exploratory factor analysis was performed to clarify quality structure. Fifty four items and 246 responses were analyzed. Based on Eigenvalue >1.00 cut-off, factors 1, 2 & 3 were retained each respectively having eigenvalues of 5.78; 4.29; 2.99. These cumulatively accounted for 29.1% of the total variance (12.9%; 9.5%; 6.7%) with final communality estimates being 13.06. Using a cut-off factor loading value of ≥0.4, fifteen items loading on factor 1, five on factor 2 and one on factor 3 were retained. Factor 1 closely relates to preparedness to deliver safe male circumcisions while factor two depicts skilled task performance and compliance with protocols. Of the 28 facilities, 32% attained between 90th and 95th percentile (excellent); 45% between 50th and 75th percentiles (average) and 14.3% below 25th percentile (poor). the service quality assessment instrument may be simplified to have nearly 20 items that relate more closely to service outcomes. Ranking of facilities and circumcision procedure using a composite index based on these items indicates that majority performed above average.

Defining modeling parameters for juniper trees assuming pleistocene-like conditions at the NTS

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

Tarbox, S.R.; Cochran, J.R.

1994-12-31

This paper addresses part of Sandia National Laboratories` (SNL) efforts to assess the long-term performance of the Greater Confinement Disposal (GCD) facility located on the Nevada Test Site (NTS). Of issue is whether the GCD site complies with 40 CFR 191 standards set for transuranic (TRU) waste burial. SNL has developed a radionuclide transport model which can be used to assess TRU radionuclide movement away from the GCD facility. An earlier iteration of the model found that radionuclide uptake and release by plants is an important aspect of the system to consider. Currently, the shallow-rooted plants at the NTS domore » not pose a threat to the integrity of the GCD facility. However, the threat increases substantially it deeper-rooted woodland species migrate to the GCD facility, given a shift to a wetter climate. The model parameters discussed here will be included in the next model iteration which assumes a climate shift will provide for the growth of juniper trees at the GCD facility. Model parameters were developed using published data and wherever possible, data were taken from juniper and pinon-juniper studies that mirrored as many aspects of the GCD facility as possible.« less

NASA in-house Commercially Developed Space Facility (CDSF) study report. Volume 1: Concept configuration definition

NASA Technical Reports Server (NTRS)

Deryder, L. J.; Chiger, H. D.; Deryder, D. D.; Detweiler, K. N.; Dupree, R. L.; Gillespie, V. P.; Hall, J. B.; Heck, M. L.; Herrick, D. C.; Katzberg, S. J.

1989-01-01

The results of a NASA in-house team effort to develop a concept definition for a Commercially Developed Space Facility (CDSF) are presented. Science mission utilization definition scenarios are documented, the conceptual configuration definition system performance parameters qualified, benchmark operational scenarios developed, space shuttle interface descriptions provided, and development schedule activity was assessed with respect to the establishment of a proposed launch date.

Applications study of advanced power generation systems utilizing coal-derived fuels, volume 2

NASA Technical Reports Server (NTRS)

Robson, F. L.

1981-01-01

Technology readiness and development trends are discussed for three advanced power generation systems: combined cycle gas turbine, fuel cells, and magnetohydrodynamics. Power plants using these technologies are described and their performance either utilizing a medium-Btu coal derived fuel supplied by pipeline from a large central coal gasification facility or integrated with a gasification facility for supplying medium-Btu fuel gas is assessed.

Cleaning and disinfection programs against Campylobacter jejuni for broiler chickens: productive performance, microbiological assessment and characterization1

PubMed Central

Deliberali Lelis, Karoline; Granghelli, Carlos Alexandre; Carão de Pinho, Agatha Cristina; Ribeiro Almeida Queiroz, Sabrina; Fernandes, Andrezza Maria; Moro de Souza, Ricardo Luiz; Gaglianone Moro, Maria Estela; de Andrade Bordin, Roberto; de Albuquerque, Ricardo

2017-01-01

Abstract Detailed cleaning and disinfection programs aims to reduce infection pressure from microorganisms from one flock to the next. However, studies evaluating the benefits to poultry performance, the sanitary status of the facilities, and the sanitary quality of the meat are rarely found. Thus, this study was designed to evaluate 2 cleaning and disinfecting programs regarding their influence on productive performance, elimination of Campylobacter, and characterization of Campylobacter jejuni strains when applied to broiler chickens’ facilities. Two subsequent flocks with 960 birds each were distributed into 32 pens containing 30 birds each. In the first, the whole flock was inoculated with a known strain of Campylobacter jejuni in order to contaminate the environment. In the second flock, performance and microbiological evaluations were done, characterizing an observational study between 2 cleaning and disinfection programs, regular and proposed. The regular program consisted of sweeping facilities, washing equipment and environment with water and neutral detergent. The proposed cleaning program consisted of dry and wet cleaning, application of 2 detergents (one acid and one basic) and 2 disinfectants (250 g/L glutaraldehyde and 185 g/L formaldehyde at 0.5% and 210 g/L para-chloro-meta-cresol at 4%). Total microorganism count in the environment and Campylobacter spp. identification were done for the microbiological assessment of the environment and carcasses. The positive samples were submitted to molecular identification of Campylobacter spp. and posterior genetic sequencing of the species identified as Campylobacter jejuni. The birds housed in the facilities and submitted to the proposed treatment had better performance when compared to the ones in the regular treatment, most likely because there was a smaller total microorganism count on the floor, walls, feeders and drinkers. The proposed program also resulted in a reduction of Campylobacter spp. on floors, drinkers and birds. Moreover, it was possible to identify 6 different Campylobacter jejuni strains in the facilities. The proposed treatment resulted in a positive influence on the birds’ performance and reduction of environment contamination for broiler chickens. PMID:28854757

Cleaning and disinfection programs against Campylobacter jejuni for broiler chickens: productive performance, microbiological assessment and characterization.

PubMed

Castro Burbarelli, Maria Fernanda de; do Valle Polycarpo, Gustavo; Deliberali Lelis, Karoline; Granghelli, Carlos Alexandre; Carão de Pinho, Agatha Cristina; Ribeiro Almeida Queiroz, Sabrina; Fernandes, Andrezza Maria; Moro de Souza, Ricardo Luiz; Gaglianone Moro, Maria Estela; de Andrade Bordin, Roberto; de Albuquerque, Ricardo

2017-09-01

Detailed cleaning and disinfection programs aims to reduce infection pressure from microorganisms from one flock to the next. However, studies evaluating the benefits to poultry performance, the sanitary status of the facilities, and the sanitary quality of the meat are rarely found. Thus, this study was designed to evaluate 2 cleaning and disinfecting programs regarding their influence on productive performance, elimination of Campylobacter, and characterization of Campylobacter jejuni strains when applied to broiler chickens' facilities. Two subsequent flocks with 960 birds each were distributed into 32 pens containing 30 birds each. In the first, the whole flock was inoculated with a known strain of Campylobacter jejuni in order to contaminate the environment. In the second flock, performance and microbiological evaluations were done, characterizing an observational study between 2 cleaning and disinfection programs, regular and proposed. The regular program consisted of sweeping facilities, washing equipment and environment with water and neutral detergent. The proposed cleaning program consisted of dry and wet cleaning, application of 2 detergents (one acid and one basic) and 2 disinfectants (250 g/L glutaraldehyde and 185 g/L formaldehyde at 0.5% and 210 g/L para-chloro-meta-cresol at 4%). Total microorganism count in the environment and Campylobacter spp. identification were done for the microbiological assessment of the environment and carcasses. The positive samples were submitted to molecular identification of Campylobacter spp. and posterior genetic sequencing of the species identified as Campylobacter jejuni. The birds housed in the facilities and submitted to the proposed treatment had better performance when compared to the ones in the regular treatment, most likely because there was a smaller total microorganism count on the floor, walls, feeders and drinkers. The proposed program also resulted in a reduction of Campylobacter spp. on floors, drinkers and birds. Moreover, it was possible to identify 6 different Campylobacter jejuni strains in the facilities. The proposed treatment resulted in a positive influence on the birds' performance and reduction of environment contamination for broiler chickens. © The Author 2017. Published by Oxford University Press on behalf of Poultry Science Association.

Payment methods for outpatient care facilities

PubMed Central

Yuan, Beibei; He, Li; Meng, Qingyue; Jia, Liying

2017-01-01

Background Outpatient care facilities provide a variety of basic healthcare services to individuals who do not require hospitalisation or institutionalisation, and are usually the patient's first contact. The provision of outpatient care contributes to immediate and large gains in health status, and a large portion of total health expenditure goes to outpatient healthcare services. Payment method is one of the most important incentive methods applied by purchasers to guide the performance of outpatient care providers. Objectives To assess the impact of different payment methods on the performance of outpatient care facilities and to analyse the differences in impact of payment methods in different settings. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), 2016, Issue 3, part of the Cochrane Library (searched 8 March 2016); MEDLINE, OvidSP (searched 8 March 2016); Embase, OvidSP (searched 24 April 2014); PubMed (NCBI) (searched 8 March 2016); Dissertations and Theses Database, ProQuest (searched 8 March 2016); Conference Proceedings Citation Index (ISI Web of Science) (searched 8 March 2016); IDEAS (searched 8 March 2016); EconLit, ProQuest (searched 8 March 2016); POPLINE, K4Health (searched 8 March 2016); China National Knowledge Infrastructure (searched 8 March 2016); Chinese Medicine Premier (searched 8 March 2016); OpenGrey (searched 8 March 2016); ClinicalTrials.gov, US National Institutes of Health (NIH) (searched 8 March 2016); World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (searched 8 March 2016); and the website of the World Bank (searched 8 March 2016). In addition, we searched the reference lists of included studies and carried out a citation search for the included studies via ISI Web of Science to find other potentially relevant studies. We also contacted authors of the main included studies regarding any further published or unpublished work. Selection criteria Randomised trials, non-randomised trials, controlled before-after studies, interrupted time series, and repeated measures studies that compared different payment methods for outpatient health facilities. We defined outpatient care facilities in this review as facilities that provide health services to individuals who do not require hospitalisation or institutionalisation. We only included methods used to transfer funds from the purchaser of healthcare services to health facilities (including groups of individual professionals). These include global budgets, line-item budgets, capitation, fee-for-service (fixed and unconstrained), pay for performance, and mixed payment. The primary outcomes were service provision outcomes, patient outcomes, healthcare provider outcomes, costs for providers, and any adverse effects. Data collection and analysis At least two review authors independently extracted data and assessed the risk of bias. We conducted a structured synthesis. We first categorised the comparisons and outcomes and then described the effects of different types of payment methods on different categories of outcomes. We used a fixed-effect model for meta-analysis within a study if a study included more than one indicator in the same category of outcomes. We used a random-effects model for meta-analysis across studies. If the data for meta-analysis were not available in some studies, we calculated the median and interquartile range. We reported the risk ratio (RR) for dichotomous outcomes and the relative change for continuous outcomes. Main results We included 21 studies from Afghanistan, Burundi, China, Democratic Republic of Congo, Rwanda, Tanzania, the United Kingdom, and the United States of health facilities providing primary health care and mental health care. There were three kinds of payment comparisons. 1) Pay for performance (P4P) combined with some existing payment method (capitation or different kinds of input-based payment) compared to the existing payment method We included 18 studies in this comparison, however we did not include five studies in the effects analysis due to high risk of bias. From the 13 studies, we found that the extra P4P incentives probably slightly improved the health professionals' use of some tests and treatments (adjusted RR median = 1.095, range 1.01 to 1.17; moderate-certainty evidence), and probably led to little or no difference in adherence to quality assurance criteria (adjusted percentage change median = -1.345%, range -8.49% to 5.8%; moderate-certainty evidence). We also found that P4P incentives may have led to little or no difference in patients' utilisation of health services (adjusted RR median = 1.01, range 0.96 to 1.15; low-certainty evidence) and may have led to little or no difference in the control of blood pressure or cholesterol (adjusted RR = 1.01, range 0.98 to 1.04; low-certainty evidence). 2) Capitation combined with P4P compared to fee-for-service (FFS) One study found that compared with FFS, a capitated budget combined with payment based on providers' performance on antibiotic prescriptions and patient satisfaction probably slightly reduced antibiotic prescriptions in primary health facilities (adjusted RR 0.84, 95% confidence interval 0.74 to 0.96; moderate-certainty evidence). 3) Capitation compared to FFS Two studies compared capitation to FFS in mental health centres in the United States. Based on these studies, the effects of capitation compared to FFS on the utilisation and costs of services were uncertain (very low-certainty evidence). Authors' conclusions Our review found that if policymakers intend to apply P4P incentives to pay health facilities providing outpatient services, this intervention will probably lead to a slight improvement in health professionals' use of tests or treatments, particularly for chronic diseases. However, it may lead to little or no improvement in patients' utilisation of health services or health outcomes. When considering using P4P to improve the performance of health facilities, policymakers should carefully consider each component of their P4P design, including the choice of performance measures, the performance target, payment frequency, if there will be additional funding, whether the payment level is sufficient to change the behaviours of health providers, and whether the payment to facilities will be allocated to individual professionals. Unfortunately, the studies included in this review did not help to inform those considerations. Well-designed comparisons of different payment methods for outpatient health facilities in low- and middle-income countries and studies directly comparing different designs (e.g. different payment levels) of the same payment method (e.g. P4P or FFS) are needed. Payment methods for outpatient care facilities Review aim The aim of this Cochrane review was to assess the effect of different payment systems for outpatient care facilities. We collected and analysed all relevant studies to answer this question and included 21 studies. Key messages Pay-for-performance systems probably have only small benefits or make little or no difference to healthcare provider behaviour or patients' use of healthcare services. We are uncertain whether they cause harm. We are uncertain about the benefits and harms of other payments systems because the research is lacking or of very low certainty. What was studied in the review? Many healthcare services are offered to patients through outpatient facilities rather than to inpatients in hospitals. Outpatient facilities are also known as ambulatory care facilities, and include primary healthcare centres, outpatient clinics, urgent care centres, family planning centres, mental health centres, and dental clinics. Different systems to reimburse outpatient (ambulatory) care facilities for their services are available to governments and health insurers. These systems include: • budget systems, where the facility is given a fixed amount of money in advance to cover expenses for a fixed period; • capitation payment systems, where the facility is paid a fixed amount of money in advance to provide specific services to each enrolled patient for a fixed period; • fee-for-service systems, where payment is based on the specific services that the healthcare facility provides; • pay-for-performance systems, where payment is partly based on the performance of the facility's healthcare providers. Different payment systems can have different effects on how healthcare facilities deliver care. These changes can be intentional or unintentional and can lead to both benefits and harms. At best, a payment system can encourage healthcare providers to offer the right healthcare services to the right patients in the best and most cost-efficient way. However, payment systems can also lead providers to offer poor-quality, expensive, and unnecessary care, which can ultimately have a negative impact on patients' health. This Cochrane review assessed the effect of different payment systems for outpatient care facilities. Other Cochrane reviews have assessed the effect of different payment systems for individual healthcare professionals and for inpatient facilities. Main results We found 21 relevant studies from the United Kingdom, the United States, Rwanda, Burundi, Tanzania, Afghanistan, China, and Democratic Republic of Congo. Most of the studies were from primary healthcare facilities. The studies assessed capitation systems, fee-for-service systems, and different types of pay-for-performance systems. Pay-for-performance systems: • probably slightly improve providers' use of some tests and treatments; • probably lead to little or no difference in providers' compliance with quality assurance criteria; • may lead to little or no difference in patients' use of health services; • may lead to little or no difference in patients' health status. Capitation combined with a pay-for-performance system targeted at reducing antibiotic use probably slightly reduces antibiotic prescriptions when compared to a fee-for-service system. Two studies compared capitation with fee-for-service systems, however, we assessed the certainty of the evidence as very low. We did not find any relevant studies that assessed budget systems. How up-to-date is this review? We searched for studies that had been published up to March 2016. PMID:28253540

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

PubMed

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

2015-11-25

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

Report on the oversight assessment of the operational readiness review of the Replacement Tritium Facility at Savannah River Site

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

Lee, B.T.

1993-03-01

This report presents the results of an oversight assessment (OA) conducted by the US Department of Energy's (DOE) Office of Environment, Safety and Health (EH) of operational readiness review (ORR) activities for the Replacement Tritium Facility (RTF) located at Savannah River Site (SRS). The EH OA of this facility took place concurrently with an ORR conducted by the DOE Office of Defense Programs (DP). The DP ORR was conducted from January 19 through February 5, 1993. The EH OA was performed in accordance with the protocol and procedures specified in EH Program for Oversight Assessment of Operational Readiness Evaluations formore » Startups and Restarts,'' dated September 15, 1992. The EH OA Team evaluated the DP ORR to determine whether it was thorough and demonstrated sufficient inquisitiveness to verify that the implementation of programs and procedures adequately ensures the protection of worker safety and health. The EH OA Team performed its evaluation of the DP ORR in the following technical areas: occupational safety, industrial hygiene, and respiratory protection; fire protection; and chemical safety. In the areas of fire protection and chemical safety, the EH OA Team conducted independent vertical-slice reviews to confirm DP ORR results. Within each technical area, the EH OA Team reviewed the DP ORR Plan, including the Criteria Review and Approach Documents (CRADs); the qualifications of individual DP ORR team members; the performance of planned DP ORR activities; and the results of the DP ORR.« less

Report on the oversight assessment of the operational readiness review of the Replacement Tritium Facility at Savannah River Site

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

Lee, B.T.

1993-03-01

This report presents the results of an oversight assessment (OA) conducted by the US Department of Energy`s (DOE) Office of Environment, Safety and Health (EH) of operational readiness review (ORR) activities for the Replacement Tritium Facility (RTF) located at Savannah River Site (SRS). The EH OA of this facility took place concurrently with an ORR conducted by the DOE Office of Defense Programs (DP). The DP ORR was conducted from January 19 through February 5, 1993. The EH OA was performed in accordance with the protocol and procedures specified in ``EH Program for Oversight Assessment of Operational Readiness Evaluations formore » Startups and Restarts,`` dated September 15, 1992. The EH OA Team evaluated the DP ORR to determine whether it was thorough and demonstrated sufficient inquisitiveness to verify that the implementation of programs and procedures adequately ensures the protection of worker safety and health. The EH OA Team performed its evaluation of the DP ORR in the following technical areas: occupational safety, industrial hygiene, and respiratory protection; fire protection; and chemical safety. In the areas of fire protection and chemical safety, the EH OA Team conducted independent vertical-slice reviews to confirm DP ORR results. Within each technical area, the EH OA Team reviewed the DP ORR Plan, including the Criteria Review and Approach Documents (CRADs); the qualifications of individual DP ORR team members; the performance of planned DP ORR activities; and the results of the DP ORR.« less

Propfan test assessment testbed aircraft stability and control/performance 1/9-scale wind tunnel tests

NASA Technical Reports Server (NTRS)

Little, B. H., Jr.; Tomlin, K. H.; Aljabri, A. S.; Mason, C. A.

1988-01-01

One-ninth scale wind tunnel model tests of the Propfan Test Assessment (PTA) aircraft were performed in three different NASA facilities. Wing and propfan nacelle static pressures, model forces and moments, and flow field at the propfan plane were measured in these tests. Tests started in June 1985 and were completed in January 1987. These data were needed to assure PTA safety of flight, predict PTA performance, and validate analytical codes that will be used to predict flow fields in which the propfan will operate.

Assessment of the Vapor Phase Catalytic Ammonia Removal (VPCAR) Technology at the MSFC ECLS Test Facility

NASA Technical Reports Server (NTRS)

Tomes, Kristin; Long, David; Carter, Layne; Flynn, Michael

2007-01-01

The Vapor Phase Catalytic Ammonia. Removal (VPCAR) technology has been previously discussed as a viable option for. the Exploration Water Recovery System. This technology integrates a phase change process with catalytic oxidation in the vapor phase to produce potable water from exploration mission wastewaters. A developmental prototype VPCAR was designed, built and tested under funding provided by a National Research. Announcement (NRA) project. The core technology, a Wiped Film Rotating Device (WFRD) was provided by Water Reuse Technologies under the NRA, whereas Hamilton Sundstrand Space Systems International performed the hardware integration and acceptance test. of the system. Personnel at the-Ames Research Center performed initial systems test of the VPCAR using ersatz solutions. To assess the viability of this hardware for Exploration. Life Support (ELS) applications, the hardware has been modified and tested at the MSFC ECLS Test facility. This paper summarizes the hardware modifications and test results and provides an assessment of this technology for the ELS application.

Assurance Policy Evaluation - Spacecraft and Strategic Systems

DTIC Science & Technology

2014-09-17

electromechanical (EEE) parts, software, design and workmanship, work instructions, manufacturing and tooling, cleanrooms, electrostatic discharge ...T9001B.  An external group, called the Evaluation and Assessment Team, made up of product assurance subject matter experts from NSWC Corona performs...NSWC, Corona and SSP Technical Branch(es). The FTPE, performed every 3 years, is an objective evaluation of facility performance to assure proper

Methods for nuclear air-cleaning-system accident-consequence assessment

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

Andrae, R.W.; Bolstad, J.W.; Gregory, W.S.

1982-01-01

This paper describes a multilaboratory research program that is directed toward addressing many questions that analysts face when performing air cleaning accident consequence assessments. The program involves developing analytical tools and supportive experimental data that will be useful in making more realistic assessments of accident source terms within and up to the atmospheric boundaries of nuclear fuel cycle facilities. The types of accidents considered in this study includes fires, explosions, spills, tornadoes, criticalities, and equipment failures. The main focus of the program is developing an accident analysis handbook (AAH). We will describe the contents of the AAH, which include descriptionsmore » of selected nuclear fuel cycle facilities, process unit operations, source-term development, and accident consequence analyses. Three computer codes designed to predict gas and material propagation through facility air cleaning systems are described. These computer codes address accidents involving fires (FIRAC), explosions (EXPAC), and tornadoes (TORAC). The handbook relies on many illustrative examples to show the analyst how to approach accident consequence assessments. We will use the FIRAC code and a hypothetical fire scenario to illustrate the accident analysis capability.« less

CONCEPTUAL DESIGN ASSESSMENT FOR THE CO-FIRING OF BIO-REFINERY SUPPLIED LIGNIN PROJECT

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

Ted Berglund; Jeffrey T. Ranney; Carol L. Babb

2001-04-01

The major aspects of this project are proceeding toward completion. Prior to this quarter, design criteria, tentative site selection, facility layout, and preliminary facility cost estimates have been completed and issued for review. Processing of bio-solids was completed, providing material for the pilot operations. Pilot facility design, equipment selection, and modification were completed during the fourth quarter of 2000. Initial pilot facility shakedown was completed during the fourth quarter. After some unavoidable delays, a suitable representative supply of municipal solid waste (MSW) feed material was procured. During this quarter (first quarter of 2001), shredding of the feed material was completedmore » and final feed conditioning was completed. Pilot facility hydrolysis production was completed to produce lignin for co-fire testing. Pilot facility modifications continued to improve facility operations and performance during the first quarter of 2001. Samples of the co-fire fuel material were sent to the co-fire facility for evaluation. The TVA-Colbert facility has neared completion of the task to evaluate the co-location of the Masada facility on the operation of the power generation facility. The TVA-Colbert fossil plant is fully capable of providing a reliable steam supply. The preferred steam supply connection points and steam pipeline routing have been identified. The environmental review of the pipeline routing has been completed and no major impacts have been identified. Detailed assessment of steam export impacts on the Colbert boiler system have been completed and a cost estimate for steam supply system is being developed.« less

Quality of Midwife-provided Intrapartum Care in Amhara Regional State, Ethiopia.

PubMed

Yigzaw, Tegbar; Abebe, Fantu; Belay, Lalem; Assaye, Yewulsew; Misganaw, Equlinet; Kidane, Ashebir; Ademie, Desalegn; van Roosmalen, Jos; Stekelenburg, Jelle; Kim, Young-Mi

2017-08-16

Despite much progress recently, Ethiopia remains one of the largest contributors to the global burden of maternal and newborn deaths and stillbirths. Ethiopia's plan to meet the sustainable development goals for maternal and child health includes unprecedented emphasis on improving quality of care. The purpose of this study was to assess the quality of midwifery care during labor, delivery and immediate postpartum period. A cross-sectional study using multiple data collection methods and a 2-stage cluster sampling technique was conducted from January 25 to February 14, 2015 in government health facilities of the Amhara National Regional State of Ethiopia. Direct observation of performance was used to determine competence of midwives in providing care during labor, delivery, and the first 6 h after childbirth. Inventory of drugs, medical equipment, supplies, and infrastructure was conducted to identify availability of resources in health facilities. Structured interview was done to assess availability of resources and performance improvement opportunities. Data analysis involved calculating percentages, means and chi-square tests. A total of 150 midwives and 56 health facilities were included in the study. The performance assessment showed 16.5% of midwives were incompetent, 72.4% were competent, and 11.1% were outstanding in providing routine intrapartum care. Forty five midwives were observed while managing 54 obstetric and newborn complications and 41 (91%) of them were rated competent. Inventory of resources found that the proportion of facilities with more than 75% of the items in each category was 32.6% for drugs, 73.1% for equipment, 65.4% for supplies, 47.9% for infection prevention materials, and 43.6% for records and forms. Opportunities for performance improvement were inadequate, with 31.3% reporting emergency obstetric and newborn care training, and 44.7% quarterly or more frequent supportive supervision. Health centers fared worse in provider competence, physical resources, and quality improvement practices except for supportive supervision visits and in-service training. Although our findings indicate most midwives are competent in giving routine and emergency intrapartum care, the major gaps in the enabling environment and the significant proportion of midwives with unsatisfactory performance suggest that the conditions for providing quality intrapartum care are not optimal.

Risk assessment associated to possible concrete degradation of a near surface disposal facility

NASA Astrophysics Data System (ADS)

Capra, B.; Billard, Y.; Wacquier, W.; Gens, R.

2013-07-01

This article outlines a risk analysis of possible concrete degradation performed in the framework of the preparation of the Safety Report of ONDRAF/NIRAS, the Belgian Agency for Radioactive Waste and Enriched Fissile Materials, for the construction and operation of a near surface disposal facility of category A waste - short-lived low and intermediate level waste - in Dessel. The main degradation mechanism considered is the carbonation of different concrete components over different periods (from the building phase up to 2000 years), which induces corrosion of the rebars. A dedicated methodology mixing risk analysis and numerical modeling of concrete carbonation has been developed to assess the critical risks of the disposal facility at different periods. According to the results obtained, risk mapping was used to assess the impact of carbonation of concrete on the different components at the different stages. The most important risk is related to an extreme situation with complete removal of the earth cover and side embankment.

KSC-07pd0920

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- After a test flight of the Starfighter F-104, Al Wassel, a representative from the FAA Office of Commercial Space, addresses the media on the KSC Shuttle Landing Facility. At left is the F-104 pilot, Rick Svetkoff. At right is Bill Parsons, director of Kennedy Space Center. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

KSC-07pd0919

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- Bill Parsons, director of Kennedy Space Center, addresses the media at the KSC Shuttle Landing Facility after a test flight of the Starfighter F-104. Behind Parsons, at left, is the pilot Rick Svetkoff. At right is Al Wassel, a representative from the FAA Office of Commercial Space. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

Supplemental Immobilization of Hanford Low-Activity Waste: Cast Stone Screening Tests

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

Westsik, Joseph H.; Piepel, Gregory F.; Lindberg, Michael J.

2013-09-30

More than 56 million gallons of radioactive and hazardous waste are stored in 177 underground storage tanks at the U.S. Department of Energy’s (DOE’s) Hanford Site in southeastern Washington State. The Hanford Tank Waste Treatment and Immobilization Plant (WTP) is being constructed to treat the wastes and immobilize them in a glass waste form. The WTP includes a pretreatment facility to separate the wastes into a small volume of high-level waste (HLW) containing most of the radioactivity and a larger volume of low-activity waste (LAW) containing most of the nonradioactive chemicals. The HLW will be converted to glass in themore » HLW vitrification facility for ultimate disposal at an offsite federal repository. At least a portion (~35%) of the LAW will be converted to glass in the LAW vitrification facility and will be disposed of onsite at the Integrated Disposal Facility (IDF). The pretreatment and HLW vitrification facilities will have the capacity to treat and immobilize the wastes destined for each facility. However, a second LAW immobilization facility will be needed for the expected volume of LAW requiring immobilization. A cementitious waste form known as Cast Stone is being considered to provide the required additional LAW immobilization capacity. The Cast Stone waste form must be acceptable for disposal in the IDF. The Cast Stone waste form and immobilization process must be tested to demonstrate that the final Cast Stone waste form can comply with the waste acceptance criteria for the disposal facility and that the immobilization processes can be controlled to consistently provide an acceptable waste form product. Further, the waste form must be tested to provide the technical basis for understanding the long-term performance of the waste form in the disposal environment. These waste form performance data are needed to support risk assessment and performance assessment (PA) analyses of the long-term environmental impact of the waste disposal in the IDF. The PA is needed to satisfy both Washington State IDF Permit and DOE Order requirements. Cast Stone has been selected for solidification of radioactive wastes including WTP aqueous secondary wastes treated at the Effluent Treatment Facility (ETF) at Hanford. A similar waste form called Saltstone is used at the Savannah River Site (SRS) to solidify its LAW tank wastes.« less

Good Manufacturing Practices (GMP) manufacturing of advanced therapy medicinal products: a novel tailored model for optimizing performance and estimating costs.

PubMed

Abou-El-Enein, Mohamed; Römhild, Andy; Kaiser, Daniel; Beier, Carola; Bauer, Gerhard; Volk, Hans-Dieter; Reinke, Petra

2013-03-01

Advanced therapy medicinal products (ATMP) have gained considerable attention in academia due to their therapeutic potential. Good Manufacturing Practice (GMP) principles ensure the quality and sterility of manufacturing these products. We developed a model for estimating the manufacturing costs of cell therapy products and optimizing the performance of academic GMP-facilities. The "Clean-Room Technology Assessment Technique" (CTAT) was tested prospectively in the GMP facility of BCRT, Berlin, Germany, then retrospectively in the GMP facility of the University of California-Davis, California, USA. CTAT is a two-level model: level one identifies operational (core) processes and measures their fixed costs; level two identifies production (supporting) processes and measures their variable costs. The model comprises several tools to measure and optimize performance of these processes. Manufacturing costs were itemized using adjusted micro-costing system. CTAT identified GMP activities with strong correlation to the manufacturing process of cell-based products. Building best practice standards allowed for performance improvement and elimination of human errors. The model also demonstrated the unidirectional dependencies that may exist among the core GMP activities. When compared to traditional business models, the CTAT assessment resulted in a more accurate allocation of annual expenses. The estimated expenses were used to set a fee structure for both GMP facilities. A mathematical equation was also developed to provide the final product cost. CTAT can be a useful tool in estimating accurate costs for the ATMPs manufactured in an optimized GMP process. These estimates are useful when analyzing the cost-effectiveness of these novel interventions. Copyright © 2013 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

Radon Assessment of Occupational Facilities, Homestead ARB, FL

DTIC Science & Technology

2013-11-21

electrets is directly measured and used to calculate radon levels. The radon detectors were placed in the test locations for greater than 90 days in...of USAFSAM’s radon analysis. A proficiency test was last performed and passed on 18 July 2012. (2) Blanks: Six field blanks were used during the...voltage. 5. CONCLUSIONS AND RECOMMENDATIONS: a. All 46 facilities tested had radon concentrations below the action limit of 4 pCi/L; no radon

Faraday Probe Analysis, Part 2: Evaluation of Facility Effects on Ion Migration in a Hall Thruster Plume (Preprint)

DTIC Science & Technology

2010-02-24

A nested Faraday probe was designed and fabricated to assess facility effects in a systematic study of ion migration in a Hall thruster plume...Current density distributions were studied at 8, 12, 16, and 20 thruster diameters downstream of the Hall thruster exit plane with four probe configurations...measurements are a significant improvement for comparisons with numerical simulations and investigations of Hall thruster performance.

Improving energy efficiency of facilities.

DOT National Transportation Integrated Search

2016-10-01

The Indiana Department of Transportation (INDOT) has entered into an agreement with the Purdue University Manufacturing Extension Partnership (MEP) to perform energy assessments on six sites. The six sites were selected to represent a variety of type...

Development and application of a safety assessment methodology for waste disposals

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

Little, R.H.; Torres, C.; Schaller, K.H.

1996-12-31

As part of a European Commission funded research programme, QuantiSci (formerly the Environmental Division of Intera Information Technologies) and Instituto de Medio Ambiente of the Centro de Investigaciones Energeticas Medioambientales y Tecnologicas (IMA/CIEMAT) have developed and applied a comprehensive, yet practicable, assessment methodology for post-disposal safety assessment of land-based disposal facilities. This Safety Assessment Comparison (SACO) Methodology employs a systematic approach to the collection, evaluation and use of waste and disposal system data. It can be used to assess engineered barrier performance, the attenuating properties of host geological formations, and the long term impacts of a facility on the environmentmore » and human health, as well as allowing the comparison of different disposal options for radioactive, mixed and non-radioactive wastes. This paper describes the development of the methodology and illustrates its use.« less

A Testing Platform for Validation of Overhead Conductor Aging Models and Understanding Thermal Limits

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

Irminger, Philip; Starke, Michael R; Dimitrovski, Aleksandar D

2014-01-01

Power system equipment manufacturers and researchers continue to experiment with novel overhead electric conductor designs that support better conductor performance and address congestion issues. To address the technology gap in testing these novel designs, Oak Ridge National Laboratory constructed the Powerline Conductor Accelerated Testing (PCAT) facility to evaluate the performance of novel overhead conductors in an accelerated fashion in a field environment. Additionally, PCAT has the capability to test advanced sensors and measurement methods for accessing overhead conductor performance and condition. Equipped with extensive measurement and monitoring devices, PCAT provides a platform to improve/validate conductor computer models and assess themore » performance of novel conductors. The PCAT facility and its testing capabilities are described in this paper.« less

KSC-07pd0923

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- The media swarm around Pilot Rick Svetkoff after his test flight of the Starfighter F-104, in the background. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

KSC-07pd0916

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- After returning from a test flight, pilot Rick Svetkoff climbs out of the cockpit of the Starfighter F-104. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

KSC-07pd0917

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- Bill Parsons (left), director of Kennedy Space Center, greets pilot Rick Svetkoff after a test flight of the Starfighter F-104. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

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

PubMed

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

2014-12-01

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

Assessing the damage at Mt. Coffee

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

Johnson, J.C.; Macauley, L.D.

1995-12-31

The Mt. Coffee Hydroelectric Project was damaged during the Liberian civil unrest in early 1990`s. A team of engineers performed a damage assessment of the project with the hope that funding could be obtained to reconstruct the project. The damage done to the plant had far greater impacts to the country than merely the cost to rebuild the facility.

DSN Array Simulator

NASA Technical Reports Server (NTRS)

Tikidjian, Raffi; Mackey, Ryan

2008-01-01

The DSN Array Simulator (wherein 'DSN' signifies NASA's Deep Space Network) is an updated version of software previously denoted the DSN Receive Array Technology Assessment Simulation. This software (see figure) is used for computational modeling of a proposed DSN facility comprising user-defined arrays of antennas and transmitting and receiving equipment for microwave communication with spacecraft on interplanetary missions. The simulation includes variations in spacecraft tracked and communication demand changes for up to several decades of future operation. Such modeling is performed to estimate facility performance, evaluate requirements that govern facility design, and evaluate proposed improvements in hardware and/or software. The updated version of this software affords enhanced capability for characterizing facility performance against user-defined mission sets. The software includes a Monte Carlo simulation component that enables rapid generation of key mission-set metrics (e.g., numbers of links, data rates, and date volumes), and statistical distributions thereof as functions of time. The updated version also offers expanded capability for mixed-asset network modeling--for example, for running scenarios that involve user-definable mixtures of antennas having different diameters (in contradistinction to a fixed number of antennas having the same fixed diameter). The improved version also affords greater simulation fidelity, sufficient for validation by comparison with actual DSN operations and analytically predictable performance metrics.

Going beyond the vertical: leveraging a national HIV quality improvement programme to address other health priorities in Haiti.

PubMed

Joseph, Jean Paul; Jerome, Gregory; Lambert, Wesler; Almazor, Patrick; Cupidon, Colette Eugene; Hirschhorn, Lisa R

2015-07-01

Although the central role of quality to achieve targeted population health goals is widely recognized, how to spread the capacity to measure and improve quality across programmes has not been widely studied. We describe the successful leveraging of expertise and framework of a national HIV quality improvement programme to spread capacity and improve quality across a network of clinics in HIV and other targeted areas of healthcare delivery in rural Haiti.The work was led by Zamni LaSante, a Haitian nongovernment organization and its sister organization, Partners In Health working in partnership with the Haitian Ministry of Health in the Plateau Central and Lower Artibonite regions in 12 public sector facilities.Data included routinely collected organizational assessments of facility quality improvement capacity, national HIV performance measures and Zamni LaSante programme records.We found that facility quality improvement capacity increased with spread from HIV to other areas of inpatient and outpatient care, including tuberculosis (TB), maternal health and inpatient services in all 12 supported healthcare facilities. A significant increase in the quality of HIV care was also seen in most areas, including CD4 monitoring, TB screening, HIV treatment (all P < 0.01) and nutritional assessment and prevention of mother-to-child transmission (both P < .05), with an increase in average facility performance from 39 to 72% (P < .01).In conclusion, using a diagonal approach to leverage a national vertical programme for wider benefit resulted in accelerated change in professional culture and increased capacity to spread quality improvement activities across facilities and areas of healthcare delivery. This led to improvement within and beyond HIV care and contributed to the goal of quality of care for all.

Assessing park-and-ride impacts.

DOT National Transportation Integrated Search

2010-06-01

Efficient transportation systems are vital to quality-of-life and mobility issues, and an effective park-and-ride (P&R) : network can help maximize system performance. Properly placed P&R facilities are expected to result in fewer calls : to increase...

Scenario-based modeling for multiple allocation hub location problem under disruption risk: multiple cuts Benders decomposition approach

NASA Astrophysics Data System (ADS)

Yahyaei, Mohsen; Bashiri, Mahdi

2017-12-01

The hub location problem arises in a variety of domains such as transportation and telecommunication systems. In many real-world situations, hub facilities are subject to disruption. This paper deals with the multiple allocation hub location problem in the presence of facilities failure. To model the problem, a two-stage stochastic formulation is developed. In the proposed model, the number of scenarios grows exponentially with the number of facilities. To alleviate this issue, two approaches are applied simultaneously. The first approach is to apply sample average approximation to approximate the two stochastic problem via sampling. Then, by applying the multiple cuts Benders decomposition approach, computational performance is enhanced. Numerical studies show the effective performance of the SAA in terms of optimality gap for small problem instances with numerous scenarios. Moreover, performance of multi-cut Benders decomposition is assessed through comparison with the classic version and the computational results reveal the superiority of the multi-cut approach regarding the computational time and number of iterations.

Preparedness of lower-level health facilities and the associated factors for the outpatient primary care of hypertension: Evidence from Tanzanian national survey

PubMed Central

Mpondo, Bonaventura C. T.

2018-01-01

Introduction Sub-Saharan Africa is experiencing a rapid rise in the burden of non-communicable diseases in both urban and rural areas. Data on health system preparedness to manage hypertension and other non-communicable diseases remains scarce. This study aimed to assess the preparedness of lower-level health facilities for outpatient primary care of hypertension in Tanzania. Methods This study used data from the 2014–2015 Tanzania Service Provision Assessment survey. The facility was considered as prepared for the outpatient primary care of hypertension if reported at least half (≥50%) of the items listed from each of the three domains (staff training and guideline, basic diagnostic equipment, and basic medicines) as identified by World Health Organization-Service Availability and Readiness Assessment manual. Data were analyzed using Stata 14. An unadjusted logistic regression model was used to assess the association between outcome and explanatory variables. All variables with a P value < 0.2 were fitted into the multiple logistic regression models using a 5% significance level. Results Out of 725 health facilities involved in the current study, about 68% were public facilities and 73% located in rural settings. Only 28% of the assessed facilities were considered prepared for the outpatient primary care of hypertension. About 9% and 42% of the assessed facilities reported to have at least one trained staff and guidelines for hypertension respectively. In multivariate analysis, private facilities [AOR = 2.7, 95% CI; 1.2–6.1], urban location [AOR = 2.2, 95% CI; 1.2–4.2], health centers [AOR = 5.2, 95% CI; 3.1–8.7] and the performance of routine management meetings [AOR = 2.6, 95% CI; 1.1–5.9] were significantly associated with preparedness for the outpatient primary care of hypertension. Conclusion The primary healthcare system in Tanzania is not adequately equipped to cope with the increasing burden of hypertension and other non-communicable diseases. Rural location, public ownership, and absence of routine management meetings were associated with being not prepared. There is a need to strengthen the primary healthcare system in Tanzania for better management of chronic diseases and curb their rising impact on health outcomes. PMID:29447231

The use of an automated flight test management system in the development of a rapid-prototyping flight research facility

NASA Technical Reports Server (NTRS)

Duke, Eugene L.; Hewett, Marle D.; Brumbaugh, Randal W.; Tartt, David M.; Antoniewicz, Robert F.; Agarwal, Arvind K.

1988-01-01

An automated flight test management system (ATMS) and its use to develop a rapid-prototyping flight research facility for artificial intelligence (AI) based flight systems concepts are described. The ATMS provides a flight test engineer with a set of tools that assist in flight planning and simulation. This system will be capable of controlling an aircraft during the flight test by performing closed-loop guidance functions, range management, and maneuver-quality monitoring. The rapid-prototyping flight research facility is being developed at the Dryden Flight Research Facility of the NASA Ames Research Center (Ames-Dryden) to provide early flight assessment of emerging AI technology. The facility is being developed as one element of the aircraft automation program which focuses on the qualification and validation of embedded real-time AI-based systems.

Coupled Facility-Payload Vibration Modeling Improvements

NASA Technical Reports Server (NTRS)

Carnahan, Timothy M.; Kaiser, Michael A.

2015-01-01

A major phase of aerospace hardware verification is vibration testing. The standard approach for such testing is to use a shaker to induce loads into the payload. In preparation for vibration testing at National Aeronautics and Space Administration/Goddard Space Flight Center an analysis is performed to assess the responses of the payload. A new method of modeling the test is presented that takes into account dynamic interactions between the facility and the payload. This dynamic interaction has affected testing in the past, but been ignored or adjusted for during testing. By modeling the combined dynamics of the facility and test article (payload) it is possible to improve the prediction of hardware responses. Many aerospace test facilities work in similar way to those at NASA/Goddard Space Flight Center. Lessons learned here should be applicable to other test facilities with similar setups.

External quality assessment of AFB smear microscopy performances and its associated factors in selected private health facilities in Addis Ababa, Ethiopia.

PubMed

Mosissa, Lemi; Kebede, Abebaw; Mindaye, Tedla; Getahun, Muluwork; Tulu, Sisay; Desta, Kassu

2016-01-01

Tuberculosis (TB) is still a public health problem in sub Saharan African countries. In resource-limited settings, TB diagnosis relies on sputum smear microscopy, with low and variable sensitivities, especially in paucibacillary pediatric and HIV-associated TB patients. Tuberculosis microscopy centers have several weaknesses like overworking, insufficiently trained personnel, inconsistent reagent supplies, and poorly maintained equipments; thus, there is a critical need for investments in laboratory infrastructure, capacity building, and quality assurance schemes. The performance of TB microscopy centers in the private health facilities in Addis Ababa is not known so far. The main objective of the study was to assess laboratory performance of acid fast bacilli (AFB) smear microscopy and its associated factors in selected private health facilities in Addis Ababa, Ethiopia. A cross-sectional study was conducted in 33 selected private health facilities of Addis Ababa, Ethiopia comprising 7 hospitals, 2 NGO health centers, 23 higher clinics and 1 diagnostic laboratory that provide AFB smear microscopy services. The study was conducted from January to April 2014. A total of 283 stained sputum smears were randomly collected from participant laboratories for blinded rechecking, 320 panel slides were sent to 32 microscopy centers to evaluate their performance on AFB reading, staining and reporting. Checklists were used to assess quality issues of laboratories. Data were captured, cleaned, and analyzed using SPSS version 16.0; χ(2) tests, kappa statistics were used for comparison purpose. P value < 0.05 considered statistically significant. Among the 32 participant laboratories, 2-scored 100%, 15 scored 80-95% & the remaining 15 scored 50-75% for overall proficiency test performance. There were 10 (3.15%) major errors and 121 (37.8%) minor errors. The sensitivity, specificity, PPV and NPV of panel reading by microscopy centers were 89%, 96%, 96%, and 90% respectively. Out of 283 randomly selected slides for blind rechecking, 11 (3.9%) slides interpreted falsely for AFB, with overall agreement of 97.5%, sensitivity of 88.4% and specificity of 99.3%. In terms of slide quality assessment, 71.6% of AFB slides were graded as good for evenness, cleanness, thickness, size, staining and labeling. The performance score for AFB slide evenness was 56.9% (161 slides) and for labeling quality was 90.8% (257 slides); having significant difference in slide quality (p value < 0.05). On-site evaluation indicated problems in terms of infrastructure, standard operating procedure, reagent quality; equipment maintenance, data management and training issues. Most of the health facilities had poor maintenance scheme for microscope (53.5%) and poor inventory management (25.0%) system. Microscopy centers that scored a proficiency of 75.5%; which is below the acceptable minimum score of 80% and an overall error rate of 3.9% for blinded rechecking needs attention. Moreover, there are gaps identified through on site assessment including poor SOP, reagent quality, equipment maintenance, data management & lack of updated training on AFB microscopy techniques, requiring a concerted effort to alleviate the bottle neck problems and strengthening the public private partnership to control TB.

External quality assessment of AFB smear microscopy performances and its associated factors in selected private health facilities in Addis Ababa, Ethiopia

PubMed Central

Mosissa, Lemi; Kebede, Abebaw; Mindaye, Tedla; Getahun, Muluwork; Tulu, Sisay; Desta, Kassu

2016-01-01

Tuberculosis (TB) is still a public health problem in sub Saharan African countries. In resource-limited settings, TB diagnosis relies on sputum smear microscopy, with low and variable sensitivities, especially in paucibacillary pediatric and HIV-associated TB patients. Tuberculosis microscopy centers have several weaknesses like overworking, insufficiently trained personnel, inconsistent reagent supplies, and poorly maintained equipments; thus, there is a critical need for investments in laboratory infrastructure, capacity building, and quality assurance schemes. The performance of TB microscopy centers in the private health facilities in Addis Ababa is not known so far. The main objective of the study was to assess laboratory performance of acid fast bacilli (AFB) smear microscopy and its associated factors in selected private health facilities in Addis Ababa, Ethiopia. A cross-sectional study was conducted in 33 selected private health facilities of Addis Ababa, Ethiopia comprising 7 hospitals, 2 NGO health centers, 23 higher clinics and 1 diagnostic laboratory that provide AFB smear microscopy services. The study was conducted from January to April 2014. A total of 283 stained sputum smears were randomly collected from participant laboratories for blinded rechecking, 320 panel slides were sent to 32 microscopy centers to evaluate their performance on AFB reading, staining and reporting. Checklists were used to assess quality issues of laboratories. Data were captured, cleaned, and analyzed using SPSS version 16.0; χ2 tests, kappa statistics were used for comparison purpose. P value < 0.05 considered statistically significant. Among the 32 participant laboratories, 2-scored 100%, 15 scored 80-95% & the remaining 15 scored 50-75% for overall proficiency test performance. There were 10 (3.15%) major errors and 121 (37.8%) minor errors. The sensitivity, specificity, PPV and NPV of panel reading by microscopy centers were 89%, 96%, 96%, and 90% respectively. Out of 283 randomly selected slides for blind rechecking, 11 (3.9%) slides interpreted falsely for AFB, with overall agreement of 97.5%, sensitivity of 88.4% and specificity of 99.3%. In terms of slide quality assessment, 71.6% of AFB slides were graded as good for evenness, cleanness, thickness, size, staining and labeling. The performance score for AFB slide evenness was 56.9% (161 slides) and for labeling quality was 90.8% (257 slides); having significant difference in slide quality (p value < 0.05). On-site evaluation indicated problems in terms of infrastructure, standard operating procedure, reagent quality; equipment maintenance, data management and training issues. Most of the health facilities had poor maintenance scheme for microscope (53.5%) and poor inventory management (25.0%) system. Microscopy centers that scored a proficiency of 75.5%; which is below the acceptable minimum score of 80% and an overall error rate of 3.9% for blinded rechecking needs attention. Moreover, there are gaps identified through on site assessment including poor SOP, reagent quality, equipment maintenance, data management & lack of updated training on AFB microscopy techniques, requiring a concerted effort to alleviate the bottle neck problems and strengthening the public private partnership to control TB. PMID:27642463

Patient satisfaction with quality of primary health care in Benghazi, Libya.

PubMed

Salam, Asharaf Abdul; Alshekteria, Amina Abdulla; Abd Alhadi, Hana; Ahmed, Mariam; Mohammed, Anees

2010-10-21

The Libyan National Health System (LNHS) is debated for the paradox of its performance versus impact. It has poor performance, but the national health statistics are good and competitive. There are concerted efforts to manage health care services and to regain the lost trust. A primary health care (PHC) system that focuses on preventive and promotive care is the core focus of LNHS efforts. To assess patient satisfaction with quality of PHC assessed in terms of (a) customer profile, (b) patient satisfaction, and (c) health care-seeking behavior. A sample of nine health centers and seven polyclinics from various locations in Benghazi, Libya were selected for gathering information by structured face-to-face interviews. A total of 310 beneficiaries were interviewed by using an Arabic translation of the Charleston Psychiatric Outpatient Satisfaction Scale. The beneficiaries appear to be quite satisfied with the quality of services. Geographical zone, marital status of beneficiary, and type of facility are satisfaction-related factors. There are preferences for facilities located within the City Centre over those located elsewhere. There is also an interaction effect of the geographical zone and the type of facility in creating differences in satisfaction. A customer-friendly facility concept that emphasizes reception, physician interaction, and cordiality shall add value. Polyclinics require more attention as does the Al Slawy area. A few utility services might also be considered.

Measuring Work Environment and Performance in Nursing Homes

PubMed Central

Temkin-Greener, Helena; Zheng, Nan (Tracy); Katz, Paul; Zhao, Hongwei; Mukamel, Dana B.

2008-01-01

Background Qualitative studies of the nursing home work environment have long suggested that such attributes as leadership and communication may be related to nursing home performance, including residents' outcomes. However, empirical studies examining these relationships have been scant. Objectives This study is designed to: develop an instrument for measuring nursing home work environment and perceived work effectiveness; test the reliability and validity of the instrument; and identify individual and facility-level factors associated with better facility performance. Research Design and Methods The analysis was based on survey responses provided by managers (N=308) and direct care workers (N=7,418) employed in 162 facilities throughout New York State. Exploratory factor analysis, Chronbach's alphas, analysis of variance, and regression models were used to assess instrument reliability and validity. Multivariate regression models, with fixed facility effects, were used to examine factors associated with work effectiveness. Results The reliability and the validity of the survey instrument for measuring work environment and perceived work effectiveness has been demonstrated. Several individual (e.g. occupation, race) and facility characteristics (e.g. management style, workplace conditions, staffing) that are significant predictors of perceived work effectiveness were identified. Conclusions The organizational performance model used in this study recognizes the multidimensionality of the work environment in nursing homes. Our findings suggest that efforts at improving work effectiveness must also be multifaceted. Empirical findings from such a line of research may provide insights for improving the quality of the work environment and ultimately the quality of residents' care. PMID:19330892

Evaluating and improving pressure ulcer care: the VA experience with administrative data.

PubMed

Berlowitz, D R; Halpern, J

1997-08-01

A number of state initiatives are using databases originally developed for nursing home reimbursements to assess the quality of care. Since 1991 the Department of Veterans Affairs (VA; Washington, DC) has been using a long term care administrative database to calculate facility-specific rates of pressure ulcer development. This information is disseminated to all 140 long term care facilities as part of a quality assessment and improvement program. Assessments are performed on all long term care residents on April 1 and October 1, as well as at the time of admission or transfer to a long term care unit. Approximately 18,000 long term care residents are evaluated in each six-month period; the VA rate of pressure ulcer development is approximately 3.5%. Reports of the rates of pressure ulcer development are then disseminated to all facilities, generally within two months of the assessment date. The VA's more than five years' experience in using administrative data to assess outcomes for long term care highlights several important issues that should be considered when using outcome measures based on administrative data. These include the importance of carefully selecting the outcome measure, the need to consider the structure of the database, the role of case-mix adjustment, strategies for reporting rates to small facilities, and methods for information dissemination. Attention to these issues will help ensure that results from administrative databases lead to improvements in the quality of care.

Life-Cycle Assessments of Selected NASA Ground-Based Test Facilities

NASA Technical Reports Server (NTRS)

Sydnor, George Honeycutt

2012-01-01

In the past two years, two separate facility-specific life cycle assessments (LCAs) have been performed as summer student projects. The first project focused on 13 facilities managed by NASA s Aeronautics Test Program (ATP), an organization responsible for large, high-energy ground test facilities that accomplish the nation s most advanced aerospace research. A facility inventory was created for each facility, and the operational-phase carbon footprint and environmental impact were calculated. The largest impacts stemmed from electricity and natural gas used directly at the facility and to generate support processes such as compressed air and steam. However, in specialized facilities that use unique inputs like R-134a, R-14, jet fuels, or nitrogen gas, these sometimes had a considerable effect on the facility s overall environmental impact. The second LCA project was conducted on the NASA Ames Arc Jet Complex and also involved creating a facility inventory and calculating the carbon footprint and environmental impact. In addition, operational alternatives were analyzed for their effectiveness at reducing impact. Overall, the Arc Jet Complex impact is dominated by the natural-gas fired boiler producing steam on-site, but alternatives were provided that could reduce the impact of the boiler operation, some of which are already being implemented. The data and results provided by these LCA projects are beneficial to both the individual facilities and NASA as a whole; the results have already been used in a proposal to reduce carbon footprint at Ames Research Center. To help future life cycle projects, several lessons learned have been recommended as simple and effective infrastructure improvements to NASA, including better utility metering and data recording and standardization of modeling choices and methods. These studies also increased sensitivity to and appreciation for quantifying the impact of NASA s activities.

Case-mix and quality indicators in Chinese elder care homes: are there differences between government-owned and private-sector facilities?

PubMed

Liu, Chang; Feng, Zhanlian; Mor, Vincent

2014-02-01

To assess the association between ownership of Chinese elder care facilities and their performance quality and to compare the case-mix profile of residents and facility characteristics in government-owned and private-sector homes. Cross-sectional study. Census of elder care homes surveyed in Nanjing (2009) and Tianjin (2010). Elder care facilities located in urban Nanjing (n = 140, 95% of all) and urban Tianjin (n = 157, 97% of all). A summary case-mix index based on activity of daily living (ADL) limitations and cognitive impairment was created to measure levels of care needs of residents in each facility. Structure, process, and outcome measures were selected to assess facility-level quality of care. A structural quality measure, understaffing relative to resident levels of care needs, which indicates potentially inadequate staffing given resident case-mix, was also developed. Government-owned homes had significantly higher occupancy rates, presumably reflecting popular demand for publicly subsidized beds, but served residents who, on average, have fewer ADL and cognitive functioning limitations than those in private-sector facilities. Across a range of structure, process, and outcome measures of quality, there is no clear evidence suggesting advantages or disadvantages of either ownership type, although when staffing-to-resident ratio is gauged relative to resident case-mix, private-sector facilities were more likely to be understaffed than government-owned facilities. In Nanjing and Tianjin, private-sector homes were more likely to be understaffed, although their residents were sicker and frailer on average than those in government facilities. It is likely that the case-mix differences are the result of selective admission policies that favor healthier residents in government facilities than in private-sector homes. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Associations between Moderate-to-Vigorous Physical Activity and Neighbourhood Recreational Facilities: The Features of the Facilities Matter

PubMed Central

Lee, Ka Yiu; Lee, Paul H.; Macfarlane, Duncan

2014-01-01

Objectives: To examine the associations between objectively-assessed moderate-to-vigorous physical activity (MVPA) and perceived/objective measures of neighbourhood recreational facilities categorized into indoor or outdoor, public, residential or commercial facilities. The associations between facility perceptions and objectively-assessed numbers of recreational facilities were also examined. Method: A questionnaire was used on 480 adults to measure local facility perceptions, with 154 participants wearing ActiGraph accelerometers for ≥4 days. The objectively-assessed number of neighbourhood recreational facilities were examined using direct observations and Geographical Information System data. Results: Both positive and negative associations were found between MVPA and perceived/objective measures of recreational facilities. Some associations depended on whether the recreational facilities were indoor or outdoor, public or residential facilities. The objectively-assessed number of most public recreational facilities was associated with the corresponding facility perceptions, but the size of effect was generally lower than for residential recreational facilities. Conclusions: The objectively-assessed number of residential outdoor table tennis courts and public indoor swimming pools, the objectively-assessed presence of tennis courts and swimming pools, and the perceived presence of bike lanes and swimming pools were positive determinants of MVPA. It is suggested to categorize the recreational facilities into smaller divisions in order to identify unique associations with MVPA. PMID:25485980

Scale-Dependent Solute Dispersion in Variably Saturated Porous Media

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

Rockhold, Mark L.; Zhang, Z. F.; Bott, Yi-Ju

2016-03-29

This work was performed to support performance assessment (PA) calculations for the Integrated Disposal Facility (IDF) at the Hanford Site. PA calculations require defensible estimates of physical, hydraulic, and transport parameters to simulate subsurface water flow and contaminant transport in both the near- and far-field environments. Dispersivity is one of the required transport parameters.

Rating long-term care facilities on pressure ulcer development: importance of case-mix adjustment.

PubMed

Berlowitz, D R; Ash, A S; Brandeis, G H; Brand, H K; Halpern, J L; Moskowitz, M A

1996-03-15

To determine the importance of case-mix adjustment in interpreting differences in rates of pressure ulcer development in Department of Veterans Affairs long- term care facilities. A sample assembled from the Patient Assessment File, a Veterans Affairs administrative database, was used to derive predictors of pressure ulcer development; the resulting model was validated in a separate sample. Facility-level rates of pressure ulcer development, both unadjusted and adjusted for case mix using the predictive model, were compared. Department of Veterans Affairs long-term care facilities. The derivation sample consisted of 31 150 intermediate medicine and nursing home residents who were initially free of pressure ulcers and were institutionalized between October 1991 and April 1993. The validation sample consisted of 17 946 residents institutionalized from April 1993 to October 1993. Development of a stage 2 or greater pressure ulcer. 11 factors predicted pressure ulcer development. Validated performance properties of the resulting model were good. Model-predicted rates of pressure ulcer development at individual long-term care facilities varied from 1.9% to 6.3%, and observed rates ranged from 0% to 10.9%. Case-mix-adjusted rates and ranks of facilities differed considerably from unadjusted ratings. For example, among five facilities that were identified as high outliers on the basis of unadjusted rates, two remained as outliers after adjustment for case mix. Long-term care facilities differ in case mix. Adjustments for case mix result in different judgments about facility performance and should be used when facility incidence rates are compared.

Fan Noise Control Using Herschel-Quincke Resonators

NASA Astrophysics Data System (ADS)

Burdisso, Ricardo A.; Ng, Wing F.

2003-01-01

The research effort proposed for this NASA NRA is mainly experimental. In addition, Virginia Tech is working in partnership with Goodrich Aerospace, Aerostructures Group for the analytical development needed to support the experimental endeavor, i.e. model development, design, and system studies. In this project, Herschel-Quincke (HQ)liner technology experiments will be performed at the NASA Glenn Active Noise Control Fan (ANCF) facility. A schematic of both inlet and aft HQ-liner systems installed in the ANCF rig as well as a picture of the Glenn facility is shown. The main goal is to simultaneously test in both the inlet and bypass duct sections. The by-pass duct will have HQ-systems in both the inner and outer duct walls. The main advantages of performing tests at the ANCF facility are that the effect of the inlet HQ-system on the by-pass HQ-system and vice versa, can be accurately determined from the in-duct modal data. Another significant advantage is that it offers the opportunity to assess (on a common basis) the proposed noise reduction concept on the ANCF rig which in the past has been used for assessing other active and passive noise reduction strategies.

Selected radionuclides important to low-level radioactive waste management

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

NONE

1996-11-01

The purpose of this document is to provide information to state representatives and developers of low level radioactive waste (LLW) management facilities about the radiological, chemical, and physical characteristics of selected radionuclides and their behavior in the environment. Extensive surveys of available literature provided information for this report. Certain radionuclides may contribute significantly to the dose estimated during a radiological performance assessment analysis of an LLW disposal facility. Among these are the radionuclides listed in Title 10 of the Code of Federal Regulations Part 61.55, Tables 1 and 2 (including alpha emitting transuranics with half-lives greater than 5 years). Thismore » report discusses these radionuclides and other radionuclides that may be significant during a radiological performance assessment analysis of an LLW disposal facility. This report not only includes essential information on each radionuclide, but also incorporates waste and disposal information on the radionuclide, and behavior of the radionuclide in the environment and in the human body. Radionuclides addressed in this document include technetium-99, carbon-14, iodine-129, tritium, cesium-137, strontium-90, nickel-59, plutonium-241, nickel-63, niobium-94, cobalt-60, curium -42, americium-241, uranium-238, and neptunium-237.« less

Report on the emergency response to the event on May 14, 1997, at the plutonuim reclamation facility, Hanford Site, Richland,Washington

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

Shoop, D.S.

1997-08-20

On the evening of May 14,1997, a chemical explosion Occurred at the Plutonium Reclamation Facility (PRF) in the 200 West Area(200-W) of the Hanford Site. The event warranted the declaration of an Alert emergency, activation of the Hanford Emergency Response Organization (BRO), and notification of offsite agencies. As a result of the emergency declaration, a subsequent evaluation was conducted to assess: 9 the performance of the emergency response organization o the occupational health response related to emergency activities o event notifications to offsite and environmental agencies. Additionally, the evaluation was designed to: 9 document the chronology of emergency and occupationalmore » health responses and environmental notifications connected with the explosion at the facility 0 assess the adequacy of the Hanford Site emergency preparedness activities; response readiness; and emergency management actions, occupational health, and environmental actions 0 provide an analysis of the causes of the deficiencies and weaknesses in the preparedness and response system that have been identified in the evaluation of the response a assign organizational responsibility to correct deficiencies and weaknesses a improve future performance 0 adjust elements of emergency implementing procedures and emergency preparedness activities.« less

Fan Noise Control Using Herschel-quincke Resonators

NASA Technical Reports Server (NTRS)

Burdisso, Ricardo A.; Ng, Wing F.; Provenza, Andrew (Technical Monitor)

2003-01-01

The research effort proposed for this NASA NRA is mainly experimental. In addition, Virginia Tech is working in partnership with Goodrich Aerospace, Aerostructures Group for the analytical development needed to support the experimental endeavor, i.e. model development, design, and system studies. In this project, Herschel-Quincke (HQ)liner technology experiments will be performed at the NASA Glenn Active Noise Control Fan (ANCF) facility. A schematic of both inlet and aft HQ-liner systems installed in the ANCF rig as well as a picture of the Glenn facility is shown. The main goal is to simultaneously test in both the inlet and bypass duct sections. The by-pass duct will have HQ-systems in both the inner and outer duct walls. The main advantages of performing tests at the ANCF facility are that the effect of the inlet HQ-system on the by-pass HQ-system and vice versa, can be accurately determined from the in-duct modal data. Another significant advantage is that it offers the opportunity to assess (on a common basis) the proposed noise reduction concept on the ANCF rig which in the past has been used for assessing other active and passive noise reduction strategies.

Measuring client satisfaction and the quality of family planning services: A comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana

PubMed Central

2011-01-01

Background Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Methods Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Results Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Conclusions Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory and monitoring structures to ensure quality at both public and private facilities. In the meantime, private providers appear to be fulfilling an important gap in the provision of FP services in these countries. PMID:21864335

Measuring client satisfaction and the quality of family planning services: a comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana.

PubMed

Hutchinson, Paul L; Do, Mai; Agha, Sohail

2011-08-24

Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory and monitoring structures to ensure quality at both public and private facilities. In the meantime, private providers appear to be fulfilling an important gap in the provision of FP services in these countries.

Cross-sectional observational assessment of quality of newborn care immediately after birth in health facilities across six sub-Saharan African countries

PubMed Central

de Graft-Johnson, Joseph; Vesel, Linda; Rosen, Heather E; Rawlins, Barbara; Abwao, Stella; Mazia, Goldy; Bozsa, Robert; Mwebesa, Winifrede; Khadka, Neena; Kamunya, Rosemary; Getachew, Ashebir; Tibaijuka, Gaudiosa; Rakotovao, Jean Pierre; Tekleberhan, Alemnesh

2017-01-01

Objective To present information on the quality of newborn care services and health facility readiness to provide newborn care in 6 African countries, and to advocate for the improvement of providers' essential newborn care knowledge and skills. Design Cross-sectional observational health facility assessment. Setting Ethiopia, Kenya, Madagascar, Mozambique, Rwanda and Tanzania. Participants Health workers in 643 facilities. 1016 health workers were interviewed, and 2377 babies were observed in the facilities surveyed. Main outcome measures Indicators of quality of newborn care included (1) provision of immediate essential newborn care: thermal care, hygienic cord care, and early and exclusive initiation of breast feeding; (2) actual and simulated resuscitation of asphyxiated newborn infants; and (3) knowledge of health workers on essential newborn care, including resuscitation. Results Sterile or clean cord cutting instruments, suction devices, and tables or firm surfaces for resuscitation were commonly available. 80% of newborns were immediately dried after birth and received clean cord care in most of the studied facilities. In all countries assessed, major deficiencies exist for essential newborn care supplies and equipment, as well as for health worker knowledge and performance of key routine newborn care practices, particularly for immediate skin-to-skin contact and breastfeeding initiation. Of newborns who did not cry at birth, 89% either recovered on their own or through active steps taken by the provider through resuscitation with initial stimulation and/or ventilation. 11% of newborns died. Assessment of simulated resuscitation using a NeoNatalie anatomic model showed that less than a third of providers were able to demonstrate ventilation skills correctly. Conclusions The findings shared in this paper call attention to the critical need to improve health facility readiness to provide quality newborn care services and to ensure that service providers have the necessary equipment, supplies, knowledge and skills that are critical to save newborn lives. PMID:28348194

Transmittal of the Calculation Package that Supports the Analysis of Performance of the Environmental Management Waste Management Facility Oak Ridge, Tennessee (Based 5-Cell Design Issued 8/14/09)

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

Williams M.J.

2009-09-14

This document presents the results of an assessment of the performance of a build-out of the Environmental Management Waste Management Facility (EMWMF). The EMWMF configuration that was assessed includes the as-constructed Cells 1 through 4, with a groundwater underdrain that was installed beneath Cell 3 during the winter of 2003-2004, and Cell 5, whose proposed design is an Addendum to Remedial Design Report for the Disposal of Oak Ridge Reservation Comprehensive Environmental Response, Compensation, and Liability Act of 1980 Waste, Oak Ridge, Tennessee, DOE/OR/01-1873&D2/A5/R1. The total capacity of the EMWMF with 5 cells is about 1.7 million cubic yards. Thismore » assessment was conducted to determine the conditions under which the approved Waste Acceptance Criteria (WAC) for the EMWMF found in the Attainment Plan for Risk/Toxicity-Based Waste Acceptance Criteria at the Oak Ridge Reservation, Oak Ridge, Tennessee [U.S. Department of Energy (DOE) 2001a], as revised for constituents added up to October 2008, would remain protective of public health and safety for a five-cell disposal facility. For consistency, the methods of analyses and the exposure scenario used to predict the performance of a five-cell disposal facility were identical to those used in the Remedial Investigation and Feasibility Study (RI/FS) and its addendum (DOE 1998a, DOE 1998b) to develop the approved WAC. To take advantage of new information and design changes departing from the conceptual design, the modeling domain and model calibration were upaded from those used in the RI/FS and its addendum. It should be noted that this analysis is not intended to justify or propose a change in the approved WAC.« less

Performance assessment through pre- and post-training evaluation of continuing medical education courses in prevention and management of cardio-vascular diseases in primary health care facilities of Armenia.

PubMed

Khachatryan, Lilit; Balalian, Arin

2013-12-01

To assess the difference of pre- and post-training performance evaluation of continuing medical education (CME) courses in cardio-vascular diseases (CVD) management among physicians at primary health care facilities of Armenian regions we conducted an evaluation survey. 212 medical records were surveyed on assessment of performance before and after the training courses through a self-employed structured questionnaire. Analysis of survey revealed statistically significant differences (p < 0.05) in a number of variables: threefold increased recording of lipids and body mass index (p = 0.001); moderate increased recording of comorbidities and aspirin prescription (p < 0.012); eightfold increased recording of dyslipidemia management plan, twofold increased recording for CVD management plan and fivefold increased recording for CVD absolute risk (p = 0.000). Missing records of electrocardiography and urine/creatinine analyses decreased statistically significantly (p < 0.05). Statistically significant decrease was observed in prescription of thiazides and angiotensin receptor blockers/angiotensin converting enzyme inhibitors (p < 0.005), while prescription of statins and statins with diet for dyslipidemia management showed increased recording (p < 0.05). Similarly, we observed increased records for counseling of rehabilitation physical activity (p = 0.006). In this survey most differences in pre- and post-evaluation of performance assessment may be explained by improved and interactive training modes, more advanced methods of demonstration of modeling. Current findings may serve a basis for future planning of CME courses for physicians of remote areas facing challenges in upgrading their knowledge, as well as expand the experience of performance assessment along with evaluation of knowledge scores.

Using a quality improvement model to enhance providers' performance in maternal and newborn health care: a post-only intervention and comparison design.

PubMed

Ayalew, Firew; Eyassu, Gizachew; Seyoum, Negash; van Roosmalen, Jos; Bazant, Eva; Kim, Young Mi; Tekleberhan, Alemnesh; Gibson, Hannah; Daniel, Ephrem; Stekelenburg, Jelle

2017-04-12

The Standards Based Management and Recognition (SBM-R © ) approach to quality improvement has been implemented in Ethiopia to strengthen routine maternal and newborn health (MNH) services. This evaluation assessed the effect of the intervention on MNH providers' performance of routine antenatal care (ANC), uncomplicated labor and delivery and immediate postnatal care (PNC) services. A post-only evaluation design was conducted at three hospitals and eight health centers implementing SBM-R and the same number of comparison health facilities. Structured checklists were used to observe MNH providers' performance on ANC (236 provider-client interactions), uncomplicated labor and delivery (226 provider-client interactions), and immediate PNC services in the six hours after delivery (232 provider-client interactions); observations were divided equally between intervention and comparison groups. Main outcomes were provider performance scores, calculated as the percentage of essential tasks in each service area completed by providers. Multilevel analysis was used to calculate adjusted mean percentage performance scores and standard errors to compare intervention and comparison groups. There was no statistically significant difference between intervention and comparison facilities in overall mean performance scores for ANC services (63.4% at intervention facilities versus 61.0% at comparison facilities, p = 0.650) or in any specific ANC skill area. MNH providers' overall mean performance score for uncomplicated labor and delivery care was 11.9 percentage points higher in the intervention than in the comparison group (77.5% versus 65.6%; p = 0.002). Overall mean performance scores for immediate PNC were 22.2 percentage points higher at intervention than at comparison facilities (72.8% versus 50.6%; p = 0.001); and there was a significant difference of 22 percentage points between intervention and comparison facilities for each PNC skill area: care for the newborn and health check for the mother. The SBM-R quality improvement intervention made a significant positive impact on MNH providers' performance during labor and delivery and immediate PNC services, but not during ANC services. Scaling up the intervention to other facilities and regions may increase the availability of good quality MNH services across Ethiopia. The findings will also guide implementation of the government's five-year (2015-2020) health sector transformation plan and health care quality strategies needed to meet the country's MNH goals.

The NASA JSC Hypervelocity Impact Test Facility (HIT-F)

NASA Technical Reports Server (NTRS)

Crews, Jeanne L.; Christiansen, Eric L.

1992-01-01

The NASA Johnson Space Center Hypervelocity Impact Test Facility was created in 1980 to study the hypervelocity impact characteristics of composite materials. The facility consists of the Hypervelocity Impact Laboratory (HIRL) and the Hypervelocity Analysis Laboratory (HAL). The HIRL supports three different-size light-gas gun ranges which provide the capability of launching particle sizes from 100 micron spheres to 12.7 mm cylinders. The HAL performs three functions: (1) the analysis of data collected from shots in the HIRL, (2) numerical and analytical modeling to predict impact response beyond test conditions, and (3) risk and damage assessments for spacecraft exposed to the meteoroid and orbital debris environments.

Comparison of methods for measuring travel time at Florida freeways and arterials.

DOT National Transportation Integrated Search

2014-07-01

Travel time is an important performance measure used to assess the traffic operational quality of various types of highway : facilities. Previous research funded by the Florida Department of Transportation (FDOT) on travel time reliability developed,...

Evaluation of the long-term performance of six alternative disposal methods for LLRW

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

Kossik, R.; Sharp, G.; Chau, T.

1995-12-31

The State of New York has carried out a comparison of six alternative disposal methods for low-level radioactive waste (LLRW). An important part of these evaluations involved quantitatively analyzing the long-term (10,000 yr) performance of the methods with respect to dose to humans, radionuclide concentrations in the environment, and cumulative release from the facility. Four near-surface methods (covered above-grade vault, uncovered above-grade vault, below-grade vault, augered holes) and two mine methods (vertical shaft mine and drift mine) were evaluated. Each method was analyzed for several generic site conditions applicable for the state. The evaluations were carried out using RIP (Repositorymore » Integration Program), an integrated, total system performance assessment computer code which has been applied to radioactive waste disposal facilities both in the U.S. (Yucca Mountain, WIPP) and worldwide. The evaluations indicate that mines in intact low-permeability rock and near-surface facilities with engineered covers generally have a high potential to perform well (within regulatory limits). Uncovered above-grade vaults and mines in highly fractured crystalline rock, however, have a high potential to perform poorly, exceeding regulatory limits.« less

Creating peer groups for assessing and comparing nursing home performance.

PubMed

Byrne, Margaret M; Daw, Christina; Pietz, Ken; Reis, Brian; Petersen, Laura A

2013-11-01

Publicly reported performance data for hospitals and nursing homes are becoming ubiquitous. For such comparisons to be fair, facilities must be compared with their peers. To adapt a previously published methodology for developing hospital peer groupings so that it is applicable to nursing homes and to explore the characteristics of "nearest-neighbor" peer groupings. Analysis of Department of Veterans Affairs administrative databases and nursing home facility characteristics. The nearest-neighbor methodology for developing peer groupings involves calculating the Euclidean distance between facilities based on facility characteristics. We describe our steps in selection of facility characteristics, describe the characteristics of nearest-neighbor peer groups, and compare them with peer groups derived through classical cluster analysis. The facility characteristics most pertinent to nursing home groupings were found to be different from those that were most relevant for hospitals. Unlike classical cluster groups, nearest neighbor groups are not mutually exclusive, and the nearest-neighbor methodology resulted in nursing home peer groupings that were substantially less diffuse than nursing home peer groups created using traditional cluster analysis. It is essential that healthcare policy makers and administrators have a means of fairly grouping facilities for the purposes of quality, cost, or efficiency comparisons. In this research, we show that a previously published methodology can be successfully applied to a nursing home setting. The same approach could be applied in other clinical settings such as primary care.

Scenario for the safety assessment of near surface radioactive waste disposal in Serpong, Indonesia

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

Purnomo, A.S.

2007-07-01

Near surface disposal has been practiced for some decades, with a wide variation in sites, types and amounts of wastes, and facility designs employed. Experience has shown that the effective and safe isolation of waste depends on the performance of the overall disposal system, which is formed by three major components or barriers: the site, the disposal facility and the waste form. The objective of radioactive waste disposal is to isolate waste so that it does not result in undue radiation exposure to humans and the environment. In near surface disposal, the disposal facility is located on or below themore » ground surface, where the protective covering is generally a few meters thick. These facilities are intended to contain low and intermediate level waste without appreciable quantities of long-lived radionuclides. Safety is the most important aspect in the applications of nuclear technology and the implementation of nuclear activities in Indonesia. This aspect is reflected by a statement in the Act Number 10 Year 1997, that 'The Development and use of nuclear energy in Indonesia has to be carried out in such away to assure the safety and health of workers, the public and the protection of the environment'. Serpong are one of the sites for a nuclear research center facility, it is the biggest one in Indonesia. In the future will be developed the first near surface disposal on site of the nuclear research facility in Serpong. The paper will mainly focus on scenario of the safety assessments of near-surface radioactive waste disposal is often important to evaluate the performance of the disposal system (disposal facility, geosphere and biosphere). It will give detail, how at the present and future conditions, including anticipated and less probable events in order to prevent radionuclide migration to human and environment. Refer to the geology characteristic and ground water table is enable to place something Near Surface Disposal on unsaturated zone in Serpong site. (authors)« less

KSC-07pd0918

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- Bill Parsons (left), director of Kennedy Space Center, greets pilot Rick Svetkoff and co-pilot Dave Waldrop after a test flight of the Starfighter F-104. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

Assessing the Impact of Community Engagement Interventions on Health Worker Motivation and Experiences with Clients in Primary Health Facilities in Ghana: A Randomized Cluster Trial

PubMed Central

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F.

2016-01-01

Background Health worker density per 1000 population in Ghana is one of the lowest in the world estimated to be 2.3, below the global average of 9.3. Low health worker motivation induced by poor working conditions partly explain this challenge. Albeit the wage bill for public sector health workers is about 90% of domestic government expenditure on health in countries such as Ghana, staff motivation and performance output remain a challenge, suggesting the need to complement financial incentives with non-financial incentives through a community-based approach. In this study, a systematic community engagement (SCE) intervention was implemented to engage community groups in healthcare quality assessment to promote mutual collaboration between clients and healthcare providers, and enhance health worker motivation levels. SCE involves structured use of existing community groups and associations to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements made and rewards given to best performing facilities for closing quality care gaps. Purpose To evaluate the effect of SCE interventions on health worker motivation and experiences with clients. Methods The study is a cluster randomized trial involving health workers in private (n = 38) and public (n = 26) primary healthcare facilities in two administrative regions in Ghana. Out of 324 clinical and non-clinical staff randomly interviewed at baseline, 234 (72%) were successfully followed at end-line and interviewed on workplace motivation factors and personal experiences with clients. Propensity score matching and difference-in-difference estimations were used to estimate treatment effect of the interventions on staff motivation. Results Intrinsic (non-financial) work incentives including cordiality with clients and perceived career prospects appeared to be prime sources of motivation for health staff interviewed in intervention health facilities while financial incentives were ranked lowest. Intervention health facilities that were assessed by female community groups (Coef. = 0.2720, p = 0.0118) and informal groups with organized leadership structures like Artisans (Coef. = 0.2268, p = 0.0368) associated positively with higher intrinsic motivation levels of staff. Conclusion Community-based approach to health worker motivation is a potential complementary strategy that needs policy deliberation to explore its prospects. Albeit financial incentives remain critical sources of staff motivation, innovative non-financial approaches like SCE should complement the latter. PMID:27439012

Assessing the Impact of Community Engagement Interventions on Health Worker Motivation and Experiences with Clients in Primary Health Facilities in Ghana: A Randomized Cluster Trial.

PubMed

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F

2016-01-01

Health worker density per 1000 population in Ghana is one of the lowest in the world estimated to be 2.3, below the global average of 9.3. Low health worker motivation induced by poor working conditions partly explain this challenge. Albeit the wage bill for public sector health workers is about 90% of domestic government expenditure on health in countries such as Ghana, staff motivation and performance output remain a challenge, suggesting the need to complement financial incentives with non-financial incentives through a community-based approach. In this study, a systematic community engagement (SCE) intervention was implemented to engage community groups in healthcare quality assessment to promote mutual collaboration between clients and healthcare providers, and enhance health worker motivation levels. SCE involves structured use of existing community groups and associations to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements made and rewards given to best performing facilities for closing quality care gaps. To evaluate the effect of SCE interventions on health worker motivation and experiences with clients. The study is a cluster randomized trial involving health workers in private (n = 38) and public (n = 26) primary healthcare facilities in two administrative regions in Ghana. Out of 324 clinical and non-clinical staff randomly interviewed at baseline, 234 (72%) were successfully followed at end-line and interviewed on workplace motivation factors and personal experiences with clients. Propensity score matching and difference-in-difference estimations were used to estimate treatment effect of the interventions on staff motivation. Intrinsic (non-financial) work incentives including cordiality with clients and perceived career prospects appeared to be prime sources of motivation for health staff interviewed in intervention health facilities while financial incentives were ranked lowest. Intervention health facilities that were assessed by female community groups (Coef. = 0.2720, p = 0.0118) and informal groups with organized leadership structures like Artisans (Coef. = 0.2268, p = 0.0368) associated positively with higher intrinsic motivation levels of staff. Community-based approach to health worker motivation is a potential complementary strategy that needs policy deliberation to explore its prospects. Albeit financial incentives remain critical sources of staff motivation, innovative non-financial approaches like SCE should complement the latter.

Alternative measures of spatial distribution and availability of health facilities for the delivery of emergency obstetric services in island communities.

PubMed

Oyerinde, Koyejo; Baravilala, Wame

2014-12-01

International guidelines and recommendations for availability and spatial distribution of emergency obstetric care services do not adequately address the challenges of providing emergency health services in island communities. The isolation and small population sizes that are typical of islands and remote populations limit the applicability of international guidelines in such communities. Universal access to emergency obstetric care services, when pregnant women encounter complications, is one of the three key strategies for reducing maternal and newborn mortality; the other two being family planning and skilled care during labor. The performance of selected lifesaving clinical interventions (signal functions) over a 3-month period is commonly used to assess and assign performance categories to health facilities but island communities might not have a large enough population to generate demand for all the signal functions over a 3-month period. Similarly, availability and spatial distribution recommendations are typically based on the size of catchment populations, but the populations of island communities tend to be sparsely distributed. With illustrations from six South Pacific Island states, we argue that the recommendation for availability of health facilities, that there should be at least five emergency obstetric care facilities (including at least one comprehensive facility) for every 500,000 population, and the recommendation for equitable distribution of health facilities, that all subnational areas meet the availability recommendation, can be substituted with a focus on access to blood transfusion and obstetric surgical care within 2 hours for all pregnant residents of islands. Island communities could replace the performance of signal functions over a 3-month period with a demonstrated capacity to perform signal functions if the need arises.

Assessment of methodologies for analysis of the dungeness B accidental aircraft crash risk.

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

LaChance, Jeffrey L.; Hansen, Clifford W.

2010-09-01

The Health and Safety Executive (HSE) has requested Sandia National Laboratories (SNL) to review the aircraft crash methodology for nuclear facilities that are being used in the United Kingdom (UK). The scope of the work included a review of one method utilized in the UK for assessing the potential for accidental airplane crashes into nuclear facilities (Task 1) and a comparison of the UK methodology against similar International Atomic Energy Agency (IAEA), United States (US) Department of Energy (DOE), and the US Nuclear Regulatory Commission (NRC) methods (Task 2). Based on the conclusions from Tasks 1 and 2, an additionalmore » Task 3 would provide an assessment of a site-specific crash frequency for the Dungeness B facility using one of the other methodologies. This report documents the results of Task 2. The comparison of the different methods was performed for the three primary contributors to aircraft crash risk at the Dungeness B site: airfield related crashes, crashes below airways, and background crashes. The methods and data specified in each methodology were compared for each of these risk contributors, differences in the methodologies were identified, and the importance of these differences was qualitatively and quantitatively assessed. The bases for each of the methods and the data used were considered in this assessment process. A comparison of the treatment of the consequences of the aircraft crashes was not included in this assessment because the frequency of crashes into critical structures is currently low based on the existing Dungeness B assessment. Although the comparison found substantial differences between the UK and the three alternative methodologies (IAEA, NRC, and DOE) this assessment concludes that use of any of these alternative methodologies would not change the conclusions reached for the Dungeness B site. Performance of Task 3 is thus not recommended.« less

Feasibilty analyses of electroepitaxial research and development accomodations. Volume 1: Accommodations assessment

NASA Technical Reports Server (NTRS)

1983-01-01

A preliminary assessment of the feasibility of accommodating the on-orbit R&D requirements for electroepitaxial crystal growth using the Orbiter middeck, the Materials Experiment Assembly or the Get-Away Special cans was performed. The study is based on the proposed electroepitaxial growth of single crystals of gallium arsenide (GaAs). Baseline R&D requirements, synthesizing furnace and facility conceptual design requirements, accommodation requirements, preliminary compatibility assessments are established. The systems engineering approach employed for the individual assessments is outlined.

Industrial energy systems and assessment opportunities

NASA Astrophysics Data System (ADS)

Barringer, Frank Leonard, III

Industrial energy assessments are performed primarily to increase energy system efficiency and reduce energy costs in industrial facilities. The most common energy systems are lighting, compressed air, steam, process heating, HVAC, pumping, and fan systems, and these systems are described in this document. ASME has produced energy assessment standards for four energy systems, and these systems include compressed air, steam, process heating, and pumping systems. ASHRAE has produced an energy assessment standard for HVAC systems. Software tools for energy systems were developed for the DOE, and there are software tools for almost all of the most common energy systems. The software tools are AIRMaster+ and LogTool for compressed air systems, SSAT and 3E Plus for steam systems, PHAST and 3E Plus for process heating systems, eQUEST for HVAC systems, PSAT for pumping systems, and FSAT for fan systems. The recommended assessment procedures described in this thesis are used to set up an energy assessment for an industrial facility, collect energy system data, and analyze the energy system data. The assessment recommendations (ARs) are opportunities to increase efficiency and reduce energy consumption for energy systems. A set of recommended assessment procedures and recommended assessment opportunities are presented for each of the most common energy systems. There are many assessment opportunities for industrial facilities, and this thesis describes forty-three ARs for the seven different energy systems. There are seven ARs for lighting systems, ten ARs for compressed air systems, eight ARs for boiler and steam systems, four ARs for process heating systems, six ARs for HVAC systems, and four ARs for both pumping and fan systems. Based on a history of past assessments, average potential energy savings and typical implementation costs are shared in this thesis for most ARs. Implementing these ARs will increase efficiency and reduce energy consumption for energy systems in industrial facilities. This thesis does not explain all energy saving ARs that are available, but does describe the most common ARs.

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

Ergonomics Climate Assessment: A measure of operational performance and employee well-being.

PubMed

Hoffmeister, Krista; Gibbons, Alyssa; Schwatka, Natalie; Rosecrance, John

2015-09-01

Ergonomics interventions have the potential to improve operational performance and employee well-being. We introduce a framework for ergonomics climate, the extent to which an organization emphasizes and supports the design and modification of work to maximize both performance and well-being outcomes. We assessed ergonomics climate at a large manufacturing facility twice during a two-year period. When the organization used ergonomics to promote performance and well-being equally, and at a high level, employees reported less work-related pain. A larger discrepancy between measures of operational performance and employee well-being was associated with increased reports of work-related pain. The direction of this discrepancy was not significantly related to work-related pain, such that it didn't matter which facet was valued more. The Ergonomics Climate Assessment can provide companies with a baseline assessment of the overall value placed on ergonomics and help prioritize areas for improving operational performance and employee well-being. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

ELECTRICAL RESISTIVITY TECHNIQUE TO ASSESS THE INTEGRITY OF GEOMEMBRANE LINERS

EPA Science Inventory

Two-dimensional electrical modeling of a liner system was performed using computer techniques. The modeling effort examined the voltage distributions in cross sections of lined facilities with different leak locations. Results confirmed that leaks in the liner influenced voltage ...

10 CFR 55.43 - Written examination: Senior operators.

Code of Federal Regulations, 2011 CFR

2011-01-01

... operator will contain a representative selection of questions on the knowledge, skills, and abilities needed to perform licensed senior operator duties. The knowledge, skills, and abilities will be... contamination conditions. (5) Assessment of facility conditions and selection of appropriate procedures during...

Clean room survey and assessment, volume 5, appendix H

NASA Technical Reports Server (NTRS)

1991-01-01

The scope of this task is to perform a comparative analysis of the various Environmental Control Life Support System (ECLSS) options for different growth scenarios. The Space Station Freedom ECLSS design and existing ground-based clean room facilities are used as a baseline for comparison. Specifically addressed here are the ground based clean room facilities at the Marshall Space Flight Center (MSFC). Given here is an evaluation of the facilities, equipment, technologies, and procedures used to maintain specified environments in typical aerospace industrial areas. Twenty-five specific clean rooms are evaluated. The objectives were to collect, compare, and catalog data for each specified facility in the areas of engineering and design, construction materials, work stations, contamination control, particulate elimination, entry systems, and instrumentation, and to make recommendations concerning enhancements required to assure an efficient and orderly evolution of MSFC clean room environmental control facilities.

Background radiation measurements at high power research reactors

NASA Astrophysics Data System (ADS)

Ashenfelter, J.; Balantekin, B.; Baldenegro, C. X.; Band, H. R.; Barclay, G.; Bass, C. D.; Berish, D.; Bowden, N. S.; Bryan, C. D.; Cherwinka, J. J.; Chu, R.; Classen, T.; Davee, D.; Dean, D.; Deichert, G.; Dolinski, M. J.; Dolph, J.; Dwyer, D. A.; Fan, S.; Gaison, J. K.; Galindo-Uribarri, A.; Gilje, K.; Glenn, A.; Green, M.; Han, K.; Hans, S.; Heeger, K. M.; Heffron, B.; Jaffe, D. E.; Kettell, S.; Langford, T. J.; Littlejohn, B. R.; Martinez, D.; McKeown, R. D.; Morrell, S.; Mueller, P. E.; Mumm, H. P.; Napolitano, J.; Norcini, D.; Pushin, D.; Romero, E.; Rosero, R.; Saldana, L.; Seilhan, B. S.; Sharma, R.; Stemen, N. T.; Surukuchi, P. T.; Thompson, S. J.; Varner, R. L.; Wang, W.; Watson, S. M.; White, B.; White, C.; Wilhelmi, J.; Williams, C.; Wise, T.; Yao, H.; Yeh, M.; Yen, Y.-R.; Zhang, C.; Zhang, X.; Prospect Collaboration

2016-01-01

Research reactors host a wide range of activities that make use of the intense neutron fluxes generated at these facilities. Recent interest in performing measurements with relatively low event rates, e.g. reactor antineutrino detection, at these facilities necessitates a detailed understanding of background radiation fields. Both reactor-correlated and naturally occurring background sources are potentially important, even at levels well below those of importance for typical activities. Here we describe a comprehensive series of background assessments at three high-power research reactors, including γ-ray, neutron, and muon measurements. For each facility we describe the characteristics and identify the sources of the background fields encountered. The general understanding gained of background production mechanisms and their relationship to facility features will prove valuable for the planning of any sensitive measurement conducted therein.

Development of Risk Insights for Regulatory Review of a Near-Surface Disposal Facility for Radioactive Waste

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

Esh, D.W.; Ridge, A.C.; Thaggard, M.

2006-07-01

Section 3116 of the Ronald W. Reagan National Defense Authorization Act for Fiscal Year 2005 (NDAA) requires the Department of Energy (DOE) to consult with the Nuclear Regulatory Commission (NRC) about non-High Level Waste (HLW) determinations. In its consultative role, NRC performs technical reviews of DOE's waste determinations but does not have regulatory authority over DOE's waste disposal activities. The safety of disposal is evaluated by comparing predicted disposal facility performance to the performance objectives specified in NRC regulations for the disposal of low-level waste (10 CFR Part 61 Subpart C). The performance objectives contain criteria for protection of themore » public, protection of inadvertent intruders, protection of workers, and stability of the disposal site after closure. The potential radiological dose to receptors typically is evaluated with a performance assessment (PA) model that simulates the release of radionuclides from the disposal site, transport of radionuclides through the environment, and exposure of potential receptors to residual contamination for thousands of years. This paper describes NRC's development and use of independent performance assessment modeling to facilitate review of DOE's non-HLW determination for the Saltstone Disposal Facility (SDF) at the Savannah River Site. NRC's review of the safety of near-surface disposal of radioactive waste at the SDF was facilitated and focused by risk insights developed with an independent PA model. The main components of NRC's performance assessment model are presented. The development of risk insights that allow the staff to focus review efforts on those areas that are most important to satisfying the performance objectives is discussed. Uncertainty analysis was performed of the full stochastic model using genetic variable selection algorithms. The results of the uncertainty analysis were then used to guide the development of simulations of other scenarios to understand the key risk drivers and risk limiters of the SDF. Review emphasis was placed on those aspects of the disposal system that were expected to drive performance: the physical and chemical performance of the cementitious wasteform and concrete vaults. Refinement of the modeling of the degradation and release from the cementitious wasteform had a significant effect on the predicted dose to a member of the public. (authors)« less

Waste Estimates for a Future Recycling Plant in the US Based Upon AREVA Operating Experience - 13206

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

Foare, Genevieve; Meze, Florian; Bader, Sven

2013-07-01

Estimates of process and secondary wastes produced by a recycling plant built in the U.S., which is composed of a used nuclear fuel (UNF) reprocessing facility and a mixed oxide (MOX) fuel fabrication facility, are performed as part of a U.S. Department of Energy (DOE) sponsored study [1]. In this study, a set of common inputs, assumptions, and constraints were identified to allow for comparison of these wastes between different industrial teams. AREVA produced a model of a reprocessing facility, an associated fuel fabrication facility, and waste treatment facilities to develop the results for this study. These facilities were dividedmore » into a number of discrete functional areas for which inlet and outlet flow streams were clearly identified to allow for an accurate determination of the radionuclide balance throughout the facility and the waste streams. AREVA relied primarily on its decades of experience and feedback from its La Hague (reprocessing) and MELOX (MOX fuel fabrication) commercial operating facilities in France to support this assessment. However, to perform these estimates for a U.S. facility with different regulatory requirements and to take advantage of some technological advancements, such as in the potential treatment of off-gases, some deviations from this experience were necessary. A summary of AREVA's approach and results for the recycling of 800 metric tonnes of initial heavy metal (MTIHM) of LWR UNF per year into MOX fuel under the assumptions and constraints identified for this DOE study are presented. (authors)« less

Facilities Performance Indicators Report 2012-13: Tracking Your Facilities Vital Signs

ERIC Educational Resources Information Center

APPA: Association of Higher Education Facilities Officers, 2014

2014-01-01

This paper features an expanded Web-based "Facilities Performance Indicators (FPI) Report." The purpose of APPA's Facilities Performance Indicators is to provide a representative set of statistics about facilities in educational institutions. "The Facilities Performance Indicators Report" is designed for survey…

Hazardous Waste Minimization Assessment: Fort Meade, MD

DTIC Science & Technology

1991-01-01

Manual TSCA Toxic Substances Control Act TSDF T.xatment. Storage, and Disposal Facility USACERL U.S. Army Construction Engineering Research Laboratory...generation; and current methods of treatment, storage, and disposal, researchers conducted feasibility and economicanalyses of milnimizaion options...Bernard A. Donahue 7. PERFORMING ORGANIZATION NAME(S) ANO ADO ESS(ES) S. PERFORMING ORGANIZATION REPORT NUMBER U.S. Army Construction Engineering Research

Sustainability of a person-centered ward atmosphere and possibility to provide person-centered forensic psychiatric care after facility relocation.

PubMed

Alexiou, Eirini; Wijk, Helle; Ahlquist, Gustaf; Kullgren, Anette; Degl' Innocenti, Alessio

2018-05-01

This longitudinal study aims to assess the sustainability of staff perceptions of ward atmosphere and their possibility to provide person-centered forensic psychiatric care after relocation to new hospitals that aimed to provide supportive work conditions for the staff to be able to perform care of high quality. In this study we only present the result for the repeated measures, that is, only the individuals that performed both the questionnaires at baseline and at the three follow-ups. Data were collected prospectively between 2010 and 2016; before (baseline) and after relocation of the forensic psychiatric clinics to new buildings, i.e., after six months (follow-up 1), after one year (follow-up 2) and after two years (follow-up 3), respectively. Data were obtained by employing structured validated questionnaires. The main findings of this study display an improvement in the staff assessment of a person-centered atmosphere from baseline to follow-up 3 in the domains of safety, everydayness and community where safety was evaluated the highest. No sustainable significant changes were found concerning staff's assessment of the support for them to provide person-centered care. The findings show sustainability of person-centered ward atmosphere in forensic psychiatric care according to staff's assessment after relocation from traditional health care facilities to evidence-based designed premises. In this study the increased staff perception of the possibility to provide person-centered care in the new facilities could not be revealed as sustainability over the two years of follow-up. Copyright © 2018. Published by Elsevier Ltd.

Characterizing the Benefits of Seismic Isolation for Nuclear Structures: A Framework for Risk-Based Decision Making

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

Bolisetti, Chandrakanth; Yu, Chingching; Coleman, Justin

This report provides a framework for assessing the benefits of seismic isolation and exercises the framework on a Generic Department of Energy Nuclear Facility (GDNF). These benefits are (1) reduction in the risk of unacceptable seismic performance and a dramatic reduction in the probability of unacceptable performance at beyond-design basis shaking, and (2) a reduction in capital cost at sites with moderate to high seismic hazard. The framework includes probabilistic risk assessment and estimates of overnight capital cost for the GDNF.

Development and Validation of an Index to Measure the Quality of Facility-Based Labor and Delivery Care Processes in Sub-Saharan Africa

PubMed Central

Tripathi, Vandana; Stanton, Cynthia; Strobino, Donna; Bartlett, Linda

2015-01-01

Background High quality care is crucial in ensuring that women and newborns receive interventions that may prevent and treat birth-related complications. As facility deliveries increase in developing countries, there are concerns about service quality. Observation is the gold standard for clinical quality assessment, but existing observation-based measures of obstetric quality of care are lengthy and difficult to administer. There is a lack of consensus on quality indicators for routine intrapartum and immediate postpartum care, including essential newborn care. This study identified key dimensions of the quality of the process of intrapartum and immediate postpartum care (QoPIIPC) in facility deliveries and developed a quality assessment measure representing these dimensions. Methods and Findings Global maternal and neonatal care experts identified key dimensions of QoPIIPC through a modified Delphi process. Experts also rated indicators of these dimensions from a comprehensive delivery observation checklist used in quality surveys in sub-Saharan African countries. Potential QoPIIPC indices were developed from combinations of highly-rated indicators. Face, content, and criterion validation of these indices was conducted using data from observations of 1,145 deliveries in Kenya, Madagascar, and Tanzania (including Zanzibar). A best-performing index was selected, composed of 20 indicators of intrapartum/immediate postpartum care, including essential newborn care. This index represented most dimensions of QoPIIPC and effectively discriminated between poorly and well-performed deliveries. Conclusions As facility deliveries increase and the global community pays greater attention to the role of care quality in achieving further maternal and newborn mortality reduction, the QoPIIPC index may be a valuable measure. This index complements and addresses gaps in currently used quality assessment tools. Further evaluation of index usability and reliability is needed. The availability of a streamlined, comprehensive, and validated index may enable ongoing and efficient observation-based assessment of care quality during labor and delivery in sub-Saharan Africa, facilitating targeted quality improvement. PMID:26107655

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

PubMed Central

Jennings, Larissa; Bertrand, Jane; Rech, Dino; Harvey, Steven A.; Hatzold, Karin; Samkange, Christopher A.; Omondi Aduda, Dickens S.; Fimbo, Bennett; Cherutich, Peter; Perry, Linnea; Castor, Delivette; Njeuhmeli, Emmanuel

2014-01-01

Background The rapid expansion of voluntary medical male circumcision (VMMC) has raised concerns whether health systems can deliver and sustain VMMC according to minimum quality criteria. Methods and Findings A comparative process evaluation was used to examine data from SYMMACS, the Systematic Monitoring of the Voluntary Medical Male Circumcision Scale-Up, among health facilities providing VMMC across two years of program scale-up. Site-level assessments examined the availability of guidelines, supplies and equipment, infection control, and continuity of care services. Direct observation of VMMC surgeries were used to assess care quality. Two sample tests of proportions and t-tests were used to examine differences in the percent of facilities meeting requisite preparedness standards and the mean number of directly-observed surgical tasks performed correctly. Results showed that safe, high quality VMMC can be implemented and sustained at-scale, although substantial variability was observed over time. In some settings, facility preparedness and VMMC service quality improved as the number of VMMC facilities increased. Yet, lapses in high performance and expansion of considerably deficient services were also observed. Surgical tasks had the highest quality scores, with lower performance levels in infection control, pre-operative examinations, and post-operative patient monitoring and counseling. The range of scale-up models used across countries additionally underscored the complexity of delivering high quality VMMC. Conclusions Greater efforts are needed to integrate VMMC scale-up and quality improvement processes in sub-Saharan African settings. Monitoring of service quality, not just adverse events reporting, will be essential in realizing the full health impact of VMMC for HIV prevention. PMID:24801073

Operational CryoSat Product Quality Assessment

NASA Astrophysics Data System (ADS)

Mannan, Rubinder; Webb, Erica; Hall, Amanda; Bouzinac, Catherine

2013-12-01

The performance and quality of the CryoSat data products are routinely assessed by the Instrument Data quality Evaluation and Analysis Service (IDEAS). This information is then conveyed to the scientific and user community in order to allow them to utilise CryoSat data with confidence. This paper presents details of the Quality Control (QC) activities performed for CryoSat products under the IDEAS contract. Details of the different QC procedures and tools deployed by IDEAS to assess the quality of operational data are presented. The latest updates to the Instrument Processing Facility (IPF) for the Fast Delivery Marine (FDM) products and the future update to Baseline-C are discussed.

Efficacy of an Exercise and Nutritional Supplement Program on Physical Performance and Nutritional Status in Older Adults With Mobility Limitations Residing at Senior Living Facilities.

PubMed

Corcoran, Michael P; Nelson, Miriam E; Sacheck, Jennifer M; Reid, Kieran F; Kirn, Dylan; Fielding, Roger A; Chui, Kenneth K H; Folta, Sara C

2017-07-01

This cluster-randomized trial was designed to determine the efficacy of a 6-month exercise-nutritional supplement program (ENP) on physical function and nutritional status for older adults and the feasibility of implementing this program in a senior living setting. Twenty senior-living facilities were randomized to either a 3 day per week group-based ENP led by a trained facility staff member or a health education program (SAP). Participants (N = 121) completed a short physical performance battery, 400-m walk, handgrip strength test, and mini-nutrition assessment. 25-hydroxyvitamin D [25(OH)D], insulin-like growth-factor 1 (IGF-1), and activity level were also measured. The ENP did not significantly improve physical function or nutritional status compared with the SAP. Compared with baseline, participants in the ENP engaged in 39 min less physical activity per week at 6 months. Several facility characteristics hindered implementation of the ENP. This study highlights the complexity of implementing an evidence-based program in a field setting.

Performance Assessment Program for the Savannah River Site Liquid Waste Facilities - 13610

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

Rosenberger, Kent H.

2013-07-01

The Liquid Waste facilities at the U.S. Department of Energy's (DOE) Savannah River Site (SRS) are operated by Liquid Waste Operations contractor Savannah River Remediation LLC (SRR). A separate Performance Assessment (PA) is prepared to support disposal operations at the Saltstone Disposal Facility and closure evaluations for the two liquid waste tank farm facilities at SRS, F-Tank Farm and H-Tank Farm. A PA provides the technical basis and results to be used in subsequent documents to demonstrate compliance with the pertinent requirements identified in operations and closure regulatory guidance. The Saltstone Disposal Facility is subject to a State of Southmore » Carolina industrial solid waste landfill permit and the tank farms are subject to a state industrial waste water permit. The three Liquid Waste facilities are also subject to a Federal Facility Agreement approved by the State, DOE and the Environmental Protection Agency (EPA). Due to the regulatory structure, a PA is a key technical document reviewed by the DOE, the State of South Carolina and the EPA. As the waste material disposed of in the Saltstone Disposal Facility and the residual material in the closed tank farms is also subject to reclassification prior to closure via a waste determination pursuant to Section 3116 of the Ronald W. Reagan National Defense Authorization Act of Fiscal Year 2005, the U.S. Nuclear Regulatory Commission (NRC) is also a reviewing agency for the PAs. Pursuant to the Act, the NRC also has a continuing role to monitor disposal actions to assess compliance with stated performance objectives. The Liquid Waste PA program at SRS represents a continual process over the life of the disposal and closure operations. When the need for a PA or PA revision is identified, the first step is to develop a conceptual model to best represent the facility conditions. The conceptual model will include physical dimensions of the closed system, both the engineered and natural system, and modeling input parameters associated with the modeled features, both initial values (at the time of facility closure) and degradation rates/values. During the development of the PA, evaluations are conducted to reflect not only the results associated with the best available information at the time but also to evaluate potential uncertainties and sensitivities associated with the modeled system. While the PA will reflect the modeled system results from the best available information, it will also identify areas for future work to reduce overall PA uncertainties moving forward. DOE requires a PA Maintenance Program such that work continues to reduce model uncertainties, thus bolstering confidence in PA results that support regulatory decisions. This maintenance work may include new Research and Development activities or modeling as informed by previous PA results and other new information that becomes available. As new information becomes available, it is evaluated against previous PAs and appropriate actions are taken to ensure continued confidence in the regulatory decisions. Therefore, the PA program is a continual process that is not just the development of a PA but seeks to incorporate new information to reduce overall model uncertainty and provide continuing confidence in regulatory decisions. (author)« less

Enhancing compliance at Department of Defense facilities: comparison of three environmental audit tools.

PubMed

Hepler, Jeff A; Neumann, Cathy

2003-04-01

To enhance environmental compliance, the U.S. Department of Defense (DOD) recently developed and implemented a standardized environmental audit tool called The Environmental Assessment and Management (TEAM) Guide. Utilization of a common audit tool (TEAM Guide) throughout DOD agencies could be an effective agent of positive change. If, however, the audit tool is inappropriate, environmental compliance at DOD facilities could worsen. Furthermore, existing audit systems such as the U.S. Environmental Protection Agency's (U.S. EPA's) Generic Protocol for Conducting Environmental Audits of Federal Facilities and the International Organization for Standardization's (ISO's) Standard 14001, "Environmental Management System Audits," may be abandoned even if they offer significant advantages over TEAM Guide audit tool. Widespread use of TEAM Guide should not take place until thorough and independent evaluation has been performed. The purpose of this paper is to compare DOD's TEAM Guide audit tool with U.S. EPA's Generic Protocol for Conducting Environmental Audits of Federal Facilities and ISO 14001, in order to assess which is most appropriate and effective for DOD facilities, and in particular those operated by the U.S. Army Corps of Engineers (USACE). USACE was selected as a result of one author's recent experience as a district environmental compliance coordinator responsible for the audit mission at this agency. Specific recommendations for enhancing the quality of environmental audits at all DOD facilities also are given.

Facilities Performance Indicators Report 2013-14: Tracking Your Facilities Vital Signs

ERIC Educational Resources Information Center

APPA: Association of Higher Education Facilities Officers, 2015

2015-01-01

This paper features an expanded Web-based "Facilities Performance Indicators (FPI) Report." The purpose of APPA: Association of Higher Education Facilities Officers (APPA's) Facilities Performance Indicators is to provide a representative set of statistics about facilities in educational institutions. "The Facilities Performance…

SPECIAL ANALYSIS AIR PATHWAY MODELING OF E-AREA LOW-LEVEL WASTE FACILITY

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

Hiergesell, R.; Taylor, G.

This Special Analysis (SA) was initiated to address a concern expressed by the Department of Energy's Low Level Waste Disposal Facility Federal Review Group (LFRG) Review Team during their review of the 2008 E-Area Performance Assessment (PA) (WSRC, 2008). Their concern was the potential for overlapping of atmospheric plumes, emanating from the soil surface above SRS LLW disposal facilities within the E-Area, to contribute to the dose received by a member of the public during the Institutional Control (IC) period. The implication of this concern was that the dose to the maximally-exposed individual (MEI) located at the SRS boundary mightmore » be underestimated during this time interval. To address this concern a re-analysis of the atmospheric pathway releases from E-Area was required. In the process of developing a new atmospheric release model (ARM) capable of addressing the LFRG plume overlap concern, it became obvious that new and better atmospheric pathway disposal limits should be developed for each of the E-Area disposal facilities using the new ARM. The scope of the SA was therefore expanded to include the generation of these new limits. The initial work conducted in this SA was to develop a new ARM using the GoldSim{reg_sign} program (GTG, 2009). The model simulates the subsurface vapor diffusion of volatile radionuclides as they release from E-Area disposal facility waste zones and migrate to the land surface. In the process of this work, many new features, including several new physical and chemical transport mechanisms, were incorporated into the model. One of the most important improvements was to incorporate a mechanism to partition volatile contaminants across the water-air interface within the partially saturated pore space of the engineered and natural materials through which vapor phase transport occurs. A second mechanism that was equally important was to incorporate a maximum concentration of 1.9E-07 Ci/m{sup 3} of {sup 14}CO{sub 2} in the air-filled pores of cementitious materials. The ARM also combines the individual transport models constructed for each E-Area disposal facility into a single model, and was ultimately used to analyze the LFRG concern regarding the potential for atmospheric plume overlap at the SRS boundary during the IC period. To evaluate the plume overlap issue, a conservative approach was adopted whereby the MEI at the SRS boundary was exposed to the releases from all E-Area disposal facilities simultaneously. This is equivalent to a 100% overlap of all atmospheric plumes emanating from E-Area. Should the dose received from this level of atmospheric plume overlap still fall below the permissible exposure level of 10 mrem/yr, then the LFRG concern would be alleviated. The structuring of the ARM enables this evaluation to be easily performed. During the IC period, the peak of the 'total plume overlap dose' was computed to be 1.9E-05 mrem/yr, which is five orders of magnitude lower than the 10 mrem/yr PA performance objective for the atmospheric release pathway. The main conclusion of this study is that for atmospheric releases from the E-Area disposal facilities, plume overlap does not cause the total dose to the MEI at the SRS boundary during the IC to exceed the Performance Assessment (PA) performance objective. Additionally, the potential for plume overlap was assessed in the post-Institutional Control period. Atmospheric plume overlap is less likely to occur during this period but conceivably could occur if the prevailing wind direction shifted so as to pass directly over all EArea disposal facilities and transport airborne radionuclides to the MEI at the 100 m point of compliance (POC). This concern was also demonstrated of little concern, as the maximum plume overlap dose was found to be 1.45E+00 mrem/yr (or {approx}15% of the performance measure) during this period and under these unlikely conditions.« less

Training practices of cell processing laboratory staff: analysis of a survey by the Alliance for Harmonization of Cellular Therapy Accreditation.

PubMed

Keever-Taylor, Carolyn A; Slaper-Cortenbach, Ineke; Celluzzi, Christina; Loper, Kathy; Aljurf, Mahmoud; Schwartz, Joseph; Mcgrath, Eoin; Eldridge, Paul

2015-12-01

Methods for processing products used for hematopoietic progenitor cell (HPC) transplantation must ensure their safety and efficacy. Personnel training and ongoing competency assessment is critical to this goal. Here we present results from a global survey of methods used by a diverse array of cell processing facilities for the initial training and ongoing competency assessment of key personnel. The Alliance for Harmonisation of Cellular Therapy Accreditation (AHCTA) created a survey to identify facility type, location, activity, personnel, and methods used for training and competency. A survey link was disseminated through organizations represented in AHCTA to processing facilities worldwide. Responses were tabulated and analyzed as a percentage of total responses and as a percentage of response by region group. Most facilities were based at academic medical centers or hospitals. Facilities with a broad range of activity, product sources and processing procedures were represented. Facilities reported using a combination of training and competency methods. However, some methods predominated. Cellular sources for training differed for training versus competency and also differed based on frequency of procedures performed. Most facilities had responsibilities for procedures in addition to processing for which training and competency methods differed. Although regional variation was observed, training and competency requirements were generally consistent. Survey data showed the use of a variety of training and competency methods but some methods predominated, suggesting their utility. These results could help new and established facilities in making decisions for their own training and competency programs. Copyright © 2015 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

24 CFR 1710.114 - Recreational facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

...'s annual cost or assessments (1) Facility. Identify each recreational facility. Identify closely... chart state “none”. (6) Buyer's annual cost or assessments. State the lot buyer's annual cost or assessments for using the facility. These costs should include any applicable property owners' association...

24 CFR 1710.114 - Recreational facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

...'s annual cost or assessments (1) Facility. Identify each recreational facility. Identify closely... chart state “none”. (6) Buyer's annual cost or assessments. State the lot buyer's annual cost or assessments for using the facility. These costs should include any applicable property owners' association...

24 CFR 1710.114 - Recreational facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

...'s annual cost or assessments (1) Facility. Identify each recreational facility. Identify closely... chart state “none”. (6) Buyer's annual cost or assessments. State the lot buyer's annual cost or assessments for using the facility. These costs should include any applicable property owners' association...

24 CFR 1710.114 - Recreational facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

...'s annual cost or assessments (1) Facility. Identify each recreational facility. Identify closely... chart state “none”. (6) Buyer's annual cost or assessments. State the lot buyer's annual cost or assessments for using the facility. These costs should include any applicable property owners' association...

24 CFR 1710.114 - Recreational facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

...'s annual cost or assessments (1) Facility. Identify each recreational facility. Identify closely... chart state “none”. (6) Buyer's annual cost or assessments. State the lot buyer's annual cost or assessments for using the facility. These costs should include any applicable property owners' association...

Experimental and analytical studies for the NASA carbon fiber risk assessment

NASA Technical Reports Server (NTRS)

1980-01-01

Various experimental and analytical studies performed for the NASA carbon fiber risk assessment program are described with emphasis on carbon fiber characteristics, sensitivity of electrical equipment and components to shorting or arcing by carbon fibers, attenuation effect of carbon fibers on aircraft landing aids, impact of carbon fibers on industrial facilities. A simple method of estimating damage from airborne carbon fibers is presented.

High-Performance Computing User Facility | Computational Science | NREL

Science.gov Websites

User Facility High-Performance Computing User Facility The High-Performance Computing User Facility technologies. Photo of the Peregrine supercomputer The High Performance Computing (HPC) User Facility provides Gyrfalcon Mass Storage System. Access Our HPC User Facility Learn more about these systems and how to access

Simulation Facilities and Test Beds for Galileo

NASA Astrophysics Data System (ADS)

Schlarmann, Bernhard Kl.; Leonard, Arian

2002-01-01

Galileo is the European satellite navigation system, financed by the European Space Agency (ESA) and the European Commission (EC). The Galileo System, currently under definition phase, will offer seamless global coverage, providing state-of-the-art positioning and timing services. Galileo services will include a standard service targeted at mass market users, an augmented integrity service, providing integrity warnings when fault occur and Public Regulated Services (ensuring a continuity of service for the public users). Other services are under consideration (SAR and integrated communications). Galileo will be interoperable with GPS, and will be complemented by local elements that will enhance the services for specific local users. In the frame of the Galileo definition phase, several system design and simulation facilities and test beds have been defined and developed for the coming phases of the project, respectively they are currently under development. These are mainly the following tools: Galileo Mission Analysis Simulator to design the Space Segment, especially to support constellation design, deployment and replacement. Galileo Service Volume Simulator to analyse the global performance requirements based on a coverage analysis for different service levels and degrades modes. Galileo System Simulation Facility is a sophisticated end-to-end simulation tool to assess the navigation performances for a complete variety of users under different operating conditions and different modes. Galileo Signal Validation Facility to evaluate signal and message structures for Galileo. Galileo System Test Bed (Version 1) to assess and refine the Orbit Determination &Time Synchronisation and Integrity algorithms, through experiments relying on GPS space infrastructure. This paper presents an overview on the so called "G-Facilities" and describes the use of the different system design tools during the project life cycle in order to design the system with respect to availability, continuity and integrity requirements. It gives more details on two of these system design tools: the Galileo Signal Validation Facility (GSVF) and the Galileo System Simulation Facility (GSSF). It will describe the operational use of these facilities within the complete set of design tools and especially the combined use of GSVF and GSSF will be described. Finally, this paper presents also examples and results obtained with these tools.

Note: Establishing α-particle radiation damage experiments using the Dalton Cumbrian Facility's 5 MV tandem pelletron.

PubMed

Bower, W R; Smith, A D; Pattrick, R A D; Pimblott, S M

2015-04-01

Evaluating the radiation stability of mineral phases is a vital research challenge when assessing the performance of the materials employed in a Geological Disposal Facility for radioactive waste. This report outlines the setup and methodology for efficiently allowing the determination of the dose dependence of damage to a mineral from a single ion irradiated sample. The technique has been deployed using the Dalton Cumbrian Facility's 5 MV tandem pelletron to irradiate a suite of minerals with a controlled α-particle ((4)He(2+)) beam. Such minerals are proxies for near-field clay based buffer material surrounding radioactive canisters, as well as the sorbent components of the host rock.

Note: Establishing α-particle radiation damage experiments using the Dalton Cumbrian Facility's 5 MV tandem pelletron

NASA Astrophysics Data System (ADS)

Bower, W. R.; Smith, A. D.; Pattrick, R. A. D.; Pimblott, S. M.

2015-04-01

Evaluating the radiation stability of mineral phases is a vital research challenge when assessing the performance of the materials employed in a Geological Disposal Facility for radioactive waste. This report outlines the setup and methodology for efficiently allowing the determination of the dose dependence of damage to a mineral from a single ion irradiated sample. The technique has been deployed using the Dalton Cumbrian Facility's 5 MV tandem pelletron to irradiate a suite of minerals with a controlled α-particle (4He2+) beam. Such minerals are proxies for near-field clay based buffer material surrounding radioactive canisters, as well as the sorbent components of the host rock.

Performance evaluation of the essential dimensions of the primary health care services in six localities of Bogota–Colombia: a cross-sectional study

PubMed Central

2013-01-01

Background The high segmentation and fragmentation in the provision of services are some of the main problems of the Colombian health system. In 2004 the district government of Bogota decided to implement a Primary Health Care (PHC) strategy through the Home Health program. PHC was conceived as a model for transforming health care delivery within the network of the first-level public health care facilities. This study aims to evaluate the performance of the essential dimensions of the PHC strategy in six localities geographically distributed throughout Bogotá city. Methods The rapid assessment tool to measure PHC performance, validated in Brazil, was applied. The perception of participants (users, professionals, health managers) in public health facilities where the Home Health program was implemented was compared with the perception of participants in private health facilities not implementing the program. A global performance index and specific indices for each primary care dimension were calculated. A multivariate logistic regression analysis was conducted to determine possible associations between the performance of the PHC dimensions and the self-perceived health status of users. Results The global performance index was rated as good for all participants interviewed. In general, with the exception of professionals, the differences in most of the essential dimensions seemed to favor public health care facilities where the Home Health program was implemented. The weakest dimensions were the family focus and community orientation—rated as critical by users; the distribution of financial resources—rated as critical by health managers; and, accessibility—rated as intermediate by users. Conclusions The overall findings suggest that the Home Health program could be improving the performance of the network of the first-level public health care facilities in some PHC essential dimensions, but significant efforts to achieve its objectives and raise its visibility in the community are required. PMID:23947574

Case-Mix and Quality Indicators in Chinese Elder Care Homes: Are There Differences between Government-owned and Private-sector Facilities?

PubMed Central

Liu, Chang

2015-01-01

Objective To assess the association between ownership of Chinese elder care facilities and their performance quality; and to compare the case-mix profile of residents and facility characteristics in government-owned and private-sector homes. Design Cross-sectional study. Setting Census of elder care homes surveyed in Nanjing (in 2009) and Tianjin (in 2010). Population 140 (or 95% of all) elder care facilities located in urban Nanjing, and 157 (or 97% of all) facilities in urban Tianjin. Main study outcome measures We created a summary case-mix index based on activities of daily living (ADL) limitations and cognitive impairment to measure levels of care needs among residents in each facility. We selected structure, process, and outcome measures to assess facility-level quality of care. We also developed a structural quality measure, under-staffing relative to residents’ levels of care needs, which indicates potentially inadequate staffing given the residents’ case-mix. Results Government-owned homes have significantly higher occupancy rates, presumably reflecting popular demand for publicly subsidized beds, but they serve residents who, on average, have fewer ADL and cognitive functioning limitations than do private-sector facilities. Across a range of structure, process, and outcome measures of quality, there is no clear evidence suggesting advantages or disadvantages to either ownership type. However, when staffing to resident ratio is gauged relative to residents’ case-mix, private-sector facilities were more likely to be under-staffed than government-owned facilities. Conclusions In Nanjing and Tianjin, private-sector homes were more likely to be understaffed, although their residents were sicker and frailer, on average, than those in government facilities. The case-mix differences are likely the result of selective admission policies that favor relatively healthier residents in government facilities than in private-sector homes. PMID:24433350

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

Radioactive Waste Management Complex performance assessment: Draft

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

Case, M.J.; Maheras, S.J.; McKenzie-Carter, M.A.

1990-06-01

A radiological performance assessment of the Radioactive Waste Management Complex at the Idaho National Engineering Laboratory was conducted to demonstrate compliance with appropriate radiological criteria of the US Department of Energy and the US Environmental Protection Agency for protection of the general public. The calculations involved modeling the transport of radionuclides from buried waste, to surface soil and subsurface media, and eventually to members of the general public via air, ground water, and food chain pathways. Projections of doses were made for both offsite receptors and individuals intruding onto the site after closure. In addition, uncertainty analyses were performed. Resultsmore » of calculations made using nominal data indicate that the radiological doses will be below appropriate radiological criteria throughout operations and after closure of the facility. Recommendations were made for future performance assessment calculations.« less

Decision Support System For Management Of Low-Level Radioactive Waste Disposal At The Nevada Test Site

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

Shott, G.; Yucel, V.; Desotell, L.

2006-07-01

The long-term safety of U.S. Department of Energy (DOE) low-level radioactive disposal facilities is assessed by conducting a performance assessment -- a systematic analysis that compares estimated risks to the public and the environment with performance objectives contained in DOE Manual 435.1-1, Radioactive Waste Management Manual. Before site operations, facilities design features such as final inventory, waste form characteristics, and closure cover design may be uncertain. Site operators need a modeling tool that can be used throughout the operational life of the disposal site to guide decisions regarding the acceptance of problematic waste streams, new disposal cell design, environmental monitoringmore » program design, and final site closure. In response to these needs the National Nuclear Security Administration Nevada Site Office (NNSA/NSO) has developed a decision support system for the Area 5 Radioactive Waste Management Site in Frenchman Flat on the Nevada Test Site. The core of the system is a probabilistic inventory and performance assessment model implemented in the GoldSim{sup R} simulation platform. The modeling platform supports multiple graphic capabilities that allow clear documentation of the model data sources, conceptual model, mathematical implementation, and results. The combined models have the capability to estimate disposal site inventory, contaminant concentrations in environmental media, and radiological doses to members of the public engaged in various activities at multiple locations. The model allows rapid assessment and documentation of the consequences of waste management decisions using the most current site characterization information, radionuclide inventory, and conceptual model. The model is routinely used to provide annual updates of site performance, evaluate the consequences of disposal of new waste streams, develop waste concentration limits, optimize the design of new disposal cells, and assess the adequacy of environmental monitoring programs. (authors)« less

Computational Analyses in Support of Sub-scale Diffuser Testing for the A-3 Facility. Part 1; Steady Predictions

NASA Technical Reports Server (NTRS)

Allgood, Daniel C.; Graham, Jason S.; Ahuja, Vineet; Hosangadi, Ashvin

2008-01-01

Simulation technology can play an important role in rocket engine test facility design and development by assessing risks, providing analysis of dynamic pressure and thermal loads, identifying failure modes and predicting anomalous behavior of critical systems. Advanced numerical tools assume greater significance in supporting testing and design of high altitude testing facilities and plume induced testing environments of high thrust engines because of the greater inter-dependence and synergy in the functioning of the different sub-systems. This is especially true for facilities such as the proposed A-3 facility at NASA SSC because of a challenging operating envelope linked to variable throttle conditions at relatively low chamber pressures. Facility designs in this case will require a complex network of diffuser ducts, steam ejector trains, fast operating valves, cooling water systems and flow diverters that need to be characterized for steady state performance. In this paper, we will demonstrate with the use of CFD analyses s advanced capability to evaluate supersonic diffuser and steam ejector performance in a sub-scale A-3 facility at NASA Stennis Space Center (SSC) where extensive testing was performed. Furthermore, the focus in this paper relates to modeling of critical sub-systems and components used in facilities such as the A-3 facility. The work here will address deficiencies in empirical models and current CFD analyses that are used for design of supersonic diffusers/turning vanes/ejectors as well as analyses for confined plumes and venting processes. The primary areas that will be addressed are: (1) supersonic diffuser performance including analyses of thermal loads (2) accurate shock capturing in the diffuser duct; (3) effect of turning duct on the performance of the facility (4) prediction of mass flow rates and performance classification for steam ejectors (5) comparisons with test data from sub-scale diffuser testing and assessment of confidence levels in CFD based flowpath modeling of the facility. The analyses tools used here expand on the multi-element unstructured CFD which has been tailored and validated for impingement dynamics of dry plumes, complex valve/feed systems, and high pressure propellant delivery systems used in engine and component test stands at NASA SSC. The analyses performed in the evaluation of the sub-scale diffuser facility explored several important factors that influence modeling and understanding of facility operation such as (a) importance of modeling the facility with Real Gas approximation, (b) approximating the cluster of steam ejector nozzles as a single annular nozzle, (c) existence of mixed subsonic/supersonic flow downstream of the turning duct, and (d) inadequacy of two-equation turbulence models in predicting the correct pressurization in the turning duct and expansion of the second stage steam ejectors. The procedure used for modeling the facility was as follows: (i) The engine, test cell and first stage ejectors were simulated with an axisymmetric approximation (ii) the turning duct, second stage ejectors and the piping downstream of the second stage ejectors were analyzed with a three-dimensional simulation utilizing a half-plane symmetry approximation. The solution i.e. primitive variables such as pressure, velocity components, temperature and turbulence quantities were passed from the first computational domain and specified as a supersonic boundary condition for the second simulation. (iii) The third domain comprised of the exit diffuser and the region in the vicinity of the facility (primary included to get the correct shock structure at the exit of the facility and entrainment characteristics). The first set of simulations comprising the engine, test cell and first stage ejectors was carried out both as a turbulent real gas calculation as well as a turbulent perfect gas calculation. A comparison for the two cases (Real Turbulent and Perfect gas turbulent) of the Ma Number distribution and temperature distributions are shown in Figures 1 and 2 respectively. The Mach Number distribution shows small yet distinct differences between the two cases such as locations of shocks/shock reflections and a slightly different impingement point on the wall of the diffuser from the expansion at the exit of the nozzle. Similarly the temperature distribution indicates different flow recirculation patterns in the test cell. Both cases capture all the essential flow phenomena such as the shock-boundary layer interaction, plume expansion, expansion of the first stage ejectors, mixing between the engine plume and the first stage ejector flow and pressurization due to the first stage ejectors. The final paper will discuss thermal loads on the walls of the diffuser and cooling mechanisms investigated.

Variation in the level of detail in pediatric voiding cystourethrogram reports.

PubMed

Schaeffer, Anthony J; Chow, Jeanne S; Ivanova, Anastasia; Cui, Gang; Greenfield, Saul P; Zerin, J Michael; Hoberman, Alejandro; Mathews, Ranjiv I; Mattoo, Tej K; Carpenter, Myra A; Moxey-Mims, Marva; Chesney, Russell W; Nelson, Caleb P

2017-06-01

Voiding cystourethrogram (VCUG) provides a wealth of data on urinary tract function and anatomy, but few standards exist for reporting VCUG findings. We aimed to assess variability in VCUG reports and to test our hypothesis that VCUG reports from pediatric facilities and pediatric radiologists are more complete than those performed at other facilities or by non-pediatric radiologists. We analyzed original VCUG reports from children enrolled in the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial. A 23-item checklist was created and used to evaluate reporting of technical (e.g. catheter size), anatomic (e.g. vesicoureteral reflux (VUR) presence and grade, bladder shape), and functional information (e.g. bladder emptying). Radiologists were classified as pediatric or non-pediatric radiologists. Facilities were categorized as to whether they were a free-standing pediatric hospital (FSPH), a pediatric "hospital within a hospital" (PHWH), a non-pediatric hospital (NPH), or an outpatient radiology facility (ORF). Multivariate linear regression was used to analyze factors associated with the completeness of the VCUG reports (percent of items reported from the 23-item checklist). Six-hundred and two VCUGs were performed at 90 institutions. Of those, 76% were read by a pediatric radiologist, and 49% were performed at a FSPH (Table). On average, less than half of the 23 items in our standardized assessment tool were included in VCUG reports (mean 48%, SD 12). The completeness of reports varied by facility type: 51% complete at FSPH (SD 11), 50% at PHWH (SD 10), 36% at NPH (SD 11), and 43% at ORF (SD 8) (p < 0.0001). In multivariate analysis, VCUG reports generated at NPH or ORF had 8% fewer items included (95% CI 3.0-12.8, p < 0.01), and those generated at PHWH did not differ from those generated at FSPH. Reports read by a non-pediatric radiologist had 6% fewer items included (95% CI 3-9.7; p < 0.01) compared with those read by a pediatric radiologist. There is substantial underreporting of findings in VCUG reports when assessing a widely represented sample of routine, community-generated reports using an idealized standard. Although VUR was often reported, other crucial anatomic and functional findings of the VCUG were consistently underreported across all facility types. Although pediatric radiologist and pediatric hospitals generated more complete VCUG reports compared with those having non-pediatric origins, the differences are small when considering the substantial underreporting of VCUG findings in general. This underscores the opportunities for improvement in reporting of VCUG findings. Copyright © 2016. Published by Elsevier Ltd.

Facilities Performance Indicators Report, 2008-09

ERIC Educational Resources Information Center

Hills, Christina, Ed.

2010-01-01

This paper features another expanded Web-based Facilities Performance Indicators Report (FPI). The purpose of APPA's Facilities Performance Indicators is to provide a representative set of statistics about facilities in educational institutions. The 2008-09 iteration of the Web-based Facilities Performance Indicators Survey was posted and…

Regulatory Requirements and Technical Analysis for Department of Energy Regulated Performance Assessments of Shallow-Trench Disposal of Low-Level Radioactive Waste at the Nevada Test Site

NASA Astrophysics Data System (ADS)

Crowe, B.; Black, P.; Tauxe, J.; Yucel, V.; Rawlinson, S.; Colarusso, A.; DiSanza, F.

2001-12-01

The National Nuclear Security Administration, Nevada Operations Office (NNSA/NV) operates and maintains two active facilities on the Nevada Test Site (NTS) that dispose Department of Energy (DOE) defense-generated low-level radioactive (LLW), mixed radioactive, and classified waste in shallow trenches, pits and large-diameter boreholes. The operation and maintenance of the LLW disposal sites are self-regulated under DOE Order 435.1, which requires review of a Performance Assessment for four performance objectives: 1) all pathways 25 mrem/yr limit; 2) atmospheric pathways 10 mrem/yr limit; 3) radon flux density of 20 pCi/m2/s; and 4) groundwater resource protection (Safe Drinking Water Act; 4 mrem/yr limit). The inadvertent human intruder is protected under a dual 500- and 100-mrem limit (acute and chronic exposure). In response to the Defense Nuclear Facilities Safety Board Recommendation 92 2, a composite analysis is required that must examine all interacting sources for compliance against both 30 and 100 mrem/yr limits. A small component of classified transuranic waste is buried at intermediate depths in 3-meter diameter boreholes at the Area 5 LLW disposal facility and is assessed through DOE-agreement against the requirements of the Environmental Protection Agency (EPA)'s 40 CFR 191. The hazardous components of mixed LLW are assessed against RCRA requirements. The NTS LLW sites fall directly under three sets of federal regulations and the regulatory differences result not only in organizational challenges, but also in different decision objectives and technical paths to completion. The DOE regulations require deterministic analysis for a 1,000-year compliance assessment supplemented by probabilistic analysis under a long-term maintenance program. The EPA regulations for TRU waste are probabilistically based for a compliance interval of 10,000 years. Multiple steps in the assessments are strongly dependent on assumptions for long-term land use policies. Integrating the different requirements into coherent and consistent sets of conceptual models of the disposal setting, alternative scenarios, and system models of fate, transport and dose-based assessments is technically challenging. Environmental assessments for these sites must be broad-based and flexible to accommodate the multiple objectives.

Performance assessment methodology and preliminary results for low-level radioactive waste disposal in Taiwan.

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

Arnold, Bill Walter; Chang, Fu-lin; Mattie, Patrick D.

2006-02-01

Sandia National Laboratories (SNL) and Taiwan's Institute for Nuclear Energy Research (INER) have teamed together to evaluate several candidate sites for Low-Level Radioactive Waste (LLW) disposal in Taiwan. Taiwan currently has three nuclear power plants, with another under construction. Taiwan also has a research reactor, as well as medical and industrial wastes to contend with. Eventually the reactors will be decomissioned. Operational and decommissioning wastes will need to be disposed in a licensed disposal facility starting in 2014. Taiwan has adopted regulations similar to the US Nuclear Regulatory Commission's (NRC's) low-level radioactive waste rules (10 CFR 61) to govern themore » disposal of LLW. Taiwan has proposed several potential sites for the final disposal of LLW that is now in temporary storage on Lanyu Island and on-site at operating nuclear power plants, and for waste generated in the future through 2045. The planned final disposal facility will have a capacity of approximately 966,000 55-gallon drums. Taiwan is in the process of evaluating the best candidate site to pursue for licensing. Among these proposed sites there are basically two disposal concepts: shallow land burial and cavern disposal. A representative potential site for shallow land burial is located on a small island in the Taiwan Strait with basalt bedrock and interbedded sedimentary rocks. An engineered cover system would be constructed to limit infiltration for shallow land burial. A representative potential site for cavern disposal is located along the southeastern coast of Taiwan in a tunnel system that would be about 500 to 800 m below the surface. Bedrock at this site consists of argillite and meta-sedimentary rocks. Performance assessment analyses will be performed to evaluate future performance of the facility and the potential dose/risk to exposed populations. Preliminary performance assessment analyses will be used in the site-selection process and to aid in design of the disposal system. Final performance assessment analyses will be used in the regulatory process of licensing a site. The SNL/INER team has developed a performance assessment methodology that is used to simulate processes associated with the potential release of radionuclides to evaluate these sites. The following software codes are utilized in the performance assessment methodology: GoldSim (to implement a probabilistic analysis that will explicitly address uncertainties); the NRC's Breach, Leach, and Transport - Multiple Species (BLT-MS) code (to simulate waste-container degradation, waste-form leaching, and transport through the host rock); the Finite Element Heat and Mass Transfer code (FEHM) (to simulate groundwater flow and estimate flow velocities); the Hydrologic Evaluation of Landfill performance Model (HELP) code (to evaluate infiltration through the disposal cover); the AMBER code (to evaluate human health exposures); and the NRC's Disposal Unit Source Term -- Multiple Species (DUST-MS) code (to screen applicable radionuclides). Preliminary results of the evaluations of the two disposal concept sites are presented.« less

Alaska road weather project : technical performance assessment report Fairbanks field demonstration 2013-2014.

DOT National Transportation Integrated Search

2014-02-01

The Alaska Department of Transportation and Public Facilities began implementation of a Maintenance Decision Support System in an : effort to improve snow and ice control in the Fairbanks area. As part of the project the reliability of the weather fo...

76 FR 75885 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-05

... mental health assessments practices for inmates; credentials of staff performing screenings; vaccinations... regarding the capacity of prison facilities to deliver medical and mental health services, NCHS in...) of healthcare services and specialty healthcare services; and the types of of medical, dental, mental...

Radon Assessment of Occupational Facilities, Grissom ARB, IN

DTIC Science & Technology

2012-11-28

4) EPA 402-R-92-014, Radon Measurements in Schools , July 1993 b. Measurement Device Protocols: The following protocols were used when placing...Performance Tests : A biennial performance test from commercial vendors evaluates the proficiency of USAFSAM’s radon analysis. A proficiency test ...listing of duplicates and analysis. (4) Calibration Tests : Please see Attachment 4 for calibration certificates. 3. RESULTS: In total, 106 radon monitors

The dominance of the private sector in the provision of emergency obstetric care: studies from Gujarat, India.

PubMed

Salazar, Mariano; Vora, Kranti; De Costa, Ayesha

2016-07-07

India has experienced a steep rise in institutional childbirth. The relative contributions of public and private sector facilities to emergency obstetric care (EmOC) has not been studied in this setting. This paper aims to study in three districts of Gujarat state, India:(a) the availability of EmOC facilities in the public and private sectors; (b) the availability and distribution of human resources for birth attendance in the two sectors; and (c) to benchmark the above against 2005 World Health Report benchmarks (WHR2005). A cross-sectional survey of obstetric care facilities reporting 30 or more births in the last three months was conducted (n = 159). Performance of EmOC signal functions and availability of human resources were assessed. EmOC provision was dominated by private facilities (112/159) which were located mainly in district headquarters or small urban towns. The number of basic and comprehensive EmOC facilities was below WHR2005 benchmarks. A high number of private facilities performed C-sections but not all basic signal functions (72/159). Public facilities were the main EmOC providers in rural areas and 40/47 functioned at less than basic EmOC level. The rate of obstetricians per 1000 births was higher in the private sector. The private sector is the dominant EmOC provider in the state. Given the highly skewed distribution of facilities and resources in the private sector, state led partnerships with the private sector so that all women in the state receive care is important alongside strengthening the public sector.

Posttest examination of Sodium Loop Safety Facility experiments. [LMFBR

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

Holland, J.W.

In-reactor, safety experiments performed in the Sodium Loop Safety Facility (SLSF) rely on comprehensive posttest examinations (PTE) to characterize the postirradiation condition of the cladding, fuel, and other test-subassembly components. PTE information and on-line instrumentation data, are analyzed to identify the sequence of events and the severity of the accident for each experiment. Following in-reactor experimentation, the SLSF loop and test assembly are transported to the Hot Fuel Examination Facility (HFEF) for initial disassembly. Goals of the HFEF-phase of the PTE are to retrieve the fuel bundle by dismantling the loop and withdrawing the test assembly, to assess the macro-conditionmore » of the fuel bundle by nondestructive examination techniques, and to prepare the fuel bundle for shipment to the Alpha-Gamma Hot Cell Facility (AGHCF) at Argonne National Laboratory.« less

Background radiation measurements at high power research reactors

DOE PAGES

Ashenfelter, J.; Yeh, M.; Balantekin, B.; ...

2015-10-23

Research reactors host a wide range of activities that make use of the intense neutron fluxes generated at these facilities. Recent interest in performing measurements with relatively low event rates, e.g. reactor antineutrino detection, at these facilities necessitates a detailed understanding of background radiation fields. Both reactor-correlated and naturally occurring background sources are potentially important, even at levels well below those of importance for typical activities. Here we describe a comprehensive series of background assessments at three high-power research reactors, including γ-ray, neutron, and muon measurements. For each facility we describe the characteristics and identify the sources of the backgroundmore » fields encountered. Furthermore, the general understanding gained of background production mechanisms and their relationship to facility features will prove valuable for the planning of any sensitive measurement conducted therein.« less

Time history prediction of direct-drive implosions on the Omega facility

DOE PAGES

Laffite, S.; Bourgade, J. L.; Caillaud, T.; ...

2016-01-14

We present in this article direct-drive experiments that were carried out on the Omega facility [T. R. Boehly et al., Opt. Commun. 133, 495 (1997)]. Two different pulse shapes were tested in order to vary the implosion stability of the same target whose parameters, dimensions and composition, remained the same. The direct-drive configuration on the Omega facility allows the accurate time-resolvedmeasurement of the scattered light. We show that, provided the laser coupling is well controlled, the implosion time history, assessed by the “bang-time” and the shell trajectory measurements, can be predicted. This conclusion is independent on the pulse shape. Inmore » contrast, we show that the pulse shape affects the implosion stability, assessed by comparing the target performances between prediction and measurement. For the 1-ns square pulse, the measuredneutron number is about 80% of the prediction. Lastly, for the 2-step 2-ns pulse, we test here that this ratio falls to about 20%.« less

Quality Improvement in Skilled Nursing Facilities for Residents With Alzheimer's Disease.

PubMed

Farlow, Martin R; Borson, Soo; Connor, Stephen R; Grossberg, George T; Mittelman, Mary S

2016-03-01

This report describes a quality improvement continuing medical education activity designed to enhance the recognition and treatment of residents with Alzheimer's disease (AD) or other dementias in skilled-nursing facilities (SNFs). Charts were compared in 6 areas prior to and following (stages A and C) a live, faculty-led workshop (stage B). Four SNFs completed stages A (n = 67 residents) and B, and 3 SNFs completed stage C (n = 52 residents). All charts came from residents with AD or a diagnosis of dementia or dementia-like symptoms. The SNFs had >95% baseline performance in both the frequency of cognitive assessments and documented medication reviews. The percentage of residents who received a quality-of-life assessment and those who had a mental health care plan in place represent areas for improvement. As part of this activity, a toolkit was developed to help guide facilities and clinicians in instituting care improvements for residents with AD/dementia. © The Author(s) 2015.

Time history prediction of direct-drive implosions on the Omega facility

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

Laffite, S.; Bourgade, J. L.; Caillaud, T.

We present in this article direct-drive experiments that were carried out on the Omega facility [T. R. Boehly et al., Opt. Commun. 133, 495 (1997)]. Two different pulse shapes were tested in order to vary the implosion stability of the same target whose parameters, dimensions and composition, remained the same. The direct-drive configuration on the Omega facility allows the accurate time-resolvedmeasurement of the scattered light. We show that, provided the laser coupling is well controlled, the implosion time history, assessed by the “bang-time” and the shell trajectory measurements, can be predicted. This conclusion is independent on the pulse shape. Inmore » contrast, we show that the pulse shape affects the implosion stability, assessed by comparing the target performances between prediction and measurement. For the 1-ns square pulse, the measuredneutron number is about 80% of the prediction. Lastly, for the 2-step 2-ns pulse, we test here that this ratio falls to about 20%.« less

Time history prediction of direct-drive implosions on the Omega facility

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

Laffite, S.; Bourgade, J. L.; Caillaud, T.

We present in this article direct-drive experiments that were carried out on the Omega facility [T. R. Boehly et al., Opt. Commun. 133, 495 (1997)]. Two different pulse shapes were tested in order to vary the implosion stability of the same target whose parameters, dimensions and composition, remained the same. The direct-drive configuration on the Omega facility allows the accurate time-resolved measurement of the scattered light. We show that, provided the laser coupling is well controlled, the implosion time history, assessed by the “bang-time” and the shell trajectory measurements, can be predicted. This conclusion is independent on the pulse shape.more » In contrast, we show that the pulse shape affects the implosion stability, assessed by comparing the target performances between prediction and measurement. For the 1-ns square pulse, the measured neutron number is about 80% of the prediction. For the 2-step 2-ns pulse, we test here that this ratio falls to about 20%.« 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.

Measuring Inpatient Rehabilitation Facility Quality of Care: Discharge Self-Care Functional Status Quality Measure.

PubMed

Pardasaney, Poonam K; Deutsch, Anne; Iriondo-Perez, Jeniffer; Ingber, Melvin J; McMullen, Tara

2018-06-01

To describe the calculation and psychometric properties of the discharge self-care functional status quality measure implemented in the Centers for Medicare & Medicaid Services' (CMS) Inpatient Rehabilitation Facility (IRF) Quality Reporting Program on October 1, 2016. Medicare fee-for-service (FFS) patients from 38 IRFs that participated in the CMS Post-Acute Care Payment Reform Demonstration were included in this cohort study. Data came from the Continuity Assessment Record and Evaluation Item Set, IRF-Patient Assessment Instrument, and Medicare claims. For each patient, we calculated an expected discharge self-care score, risk-adjusted for demographic and baseline clinical characteristics. The performance score of each IRF equaled the percentage of patient stays where the observed discharge self-care score met or exceeded the expected score. We assessed the measure's discriminatory ability across IRFs and reliability. IRFs. Medicare FFS patients aged ≥21 years (N=4769). Not applicable. Facility-level discharge self-care quality measure performance score. A total of 4769 patient stays were included; 57% of stays were in women, and 12.1% were in patients aged <65 years. Stroke was the most common diagnosis (21.8%). The mean±SD performance score was 55.1%±16.6% (range, 25.8%-100%). About 54% of IRFs had scores significantly different from the percentage of stays that met or exceeded the expected discharge self-care score in the overall demonstration sample. The quality measure showed strong reliability, with intraclass correlation coefficients of .91. The discharge self-care quality measure showed strong discriminatory ability and reliability, representing an important initial step in evaluation of IRF self-care outcomes. A wide range in performance scores suggested a gap in quality of care across IRFs. Future work should include testing the measure with nationwide data from all IRFs. Published by Elsevier Inc.

Energy Efficiency, Water Efficiency, and Renewable Energy Site Assessment: Seneca Rocks Discovery Center, Seneca Rocks, West Virginia

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

Kiatreungwattana, Kosol; Salasovich, James; Kandt, Alicen

As part of ongoing efforts by the U.S. Forest Service to reduce energy use and incorporate renewable energy technologies into its facilities, the Department of Energy's National Renewable Energy Laboratory performed an energy efficiency and renewable energy site assessment of the Seneca Rocks Discovery Center in Seneca Rocks, West Virginia. This report documents the findings of this assessment, and provides site-specific information for the implementation of energy and water conservation measures, and renewable energy measures.

Mapping the Characteristics of Critical Care Facilities: Assessment, Distribution, and Level of Critical Care Facilities from Central India.

PubMed

Saigal, Saurabh; Sharma, Jai Prakash; Pakhare, Abhijit; Bhaskar, Santosh; Dhanuka, Sanjay; Kumar, Sanjay; Sabde, Yogesh; Bhattacharya, Pradip; Joshi, Rajnish

2017-10-01

In low- and middle-income countries such as India, where health systems are weak, the number of available Critical Care Unit (Intensive Care Unit [ICU]) beds is expected to be low. There is no study from the Indian subcontinent that has reported the characteristics and distribution of existing ICUs. We performed this study to understand the characteristics and distribution of ICUs in Madhya Pradesh (MP) state of Central India. We also aimed to develop a consensus scoring system and internally validate it to define levels of care and to improve health system planning and to strengthen referral networks in the state. We obtained a list of potential ICU facilities from various sources and then performed a cross-sectional survey by visiting each facility and determining characteristics for each facility. We collected variables with respect to infrastructure, human resources, equipment, support services, procedures performed, training courses conducted, and in-place policies or standard operating procedure documents. We identified a total of 123 ICUs in MP. Of 123 ICUs, 35 were level 1 facilities, 74 were level 2 facilities, and only 14 were level 3 facilities. Overall, there were 0.17 facilities per 100,000 population (95* confidence interval [CI] 0.14-0.20 per 100,000 populations). There were a total of 1816 ICU beds in the state, with an average of 2.5 beds per 100,000 population (95* CI 2.4-2.6 per 100,000 population). Of the total number of ICU beds, 250 are in level 1, 1141 are in level 2, and 425 are in level 3 facilities. This amounts to 0.34, 1.57, and 0.59 ICU beds per 100,000 population for levels 1, 2, and 3, respectively. This study could just be an eye opener for our healthcare authorities at both state and national levels to estimate the proportion of ICU beds per lac population. Similar mapping of intensive care services from other States will generate national data that is hitherto unknown.

Integrated Disposal Facility FY2011 Glass Testing Summary Report. Erratum

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

Smith, Gary L.

2016-09-06

This report refers to or contains K g values for glasses LAWA44, LAWB45 and LAWC22 affected by calculations errors as identified by Papathanassiu et al. (2011). The corrected K g values are reported in an erratum included in the revised version of the original report. The revised report can be referenced as follows: Pierce E. M. et al. (2004) Waste Form Release Data Package for the 2005 Integrated Disposal Facility Performance Assessment. PNNL-14805 Rev. 0 Erratum. Pacific Northwest National Laboratory, Richland, WA, USA.

Integrated Disposal Facility FY 2012 Glass Testing Summary Report, Erratum

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

Smith, Gary L.

2016-09-02

This report refers to or contains K g values for glasses LAWA44, LAWB45 and LAWC22 affected by calculations errors as identified by Papathanassiu et al. (2011) The corrected K g values are reported in an erratum included in the revised version of the original report. The revised report can be referenced as follows: Pierce E. M. et al. (2004) Waste Form Release Data Package for the 2005 Integrated Disposal Facility Performance Assessment. PNNL-14805 Rev. 0 Erratum. Pacific Northwest National Laboratory, Richland, WA, USA.

Knowledge, Skills, and Attitudes in Caring for Older Adults With Advanced Illness Among Staff Members of Long-Term Care and Assisted Living Facilities: An Educational Needs Assessment.

PubMed

Cimino, Nina M; Lockman, Kashelle; Grant, Marian; McPherson, Mary Lynn

2016-05-01

In long-term care and assisted living facilities, many groups of health care professionals contribute to the work of the health care team. These staff members perform essential, direct patient care activities. An educational needs assessment was conducted to determine the learning needs and preferences of staff members related to providing care for patients with life-limiting illnesses. Staff members placed importance on understanding topics such as principles of palliative care, pain assessment, pain management, and nonpain symptom management. The majority of survey respondents were also interested in learning more about these topics. The results of this educational needs analysis suggest staff members would benefit from a course tailored to these identified educational needs and designed to overcome previously identified educational barriers. © The Author(s) 2014.

Environmental projects, volume 11. Environmental assessment: Addition to operations building, Mars site

NASA Technical Reports Server (NTRS)

1990-01-01

An Environmental Assessment was performed of the proposed addition to building G-86 at the Mars Site, which will provide space for new electronic equipment to consolidate the Deep Space Network (DSN) support facilities from other Goldstone Deep Space Communication Complex (GDSCC) sites at the Mars Site, and will include a fifth telemetry and command group with its associated link monitor, control processor, and operator consoles. The addition of these facilities will increase the capability of the DSN to support future sophisticated NASA spacecraft missions such as the International Solar and Terrestrial Physics (ISTP) Program. The planned construction of this building addition requires an Environmental Assessment (EA) document that records the existing environmental conditions at the Mars Site, that analyzes the environmental effects that possibly could be expected from the construction and use of the new building addition, and that recommends measures to be taken to mitigate any possible deleterious environmental effects.

Approach to proliferation risk assessment based on multiple objective analysis framework

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

Andrianov, A.; Kuptsov, I.; Studgorodok 1, Obninsk, Kaluga region, 249030

2013-07-01

The approach to the assessment of proliferation risk using the methods of multi-criteria decision making and multi-objective optimization is presented. The approach allows the taking into account of the specifics features of the national nuclear infrastructure, and possible proliferation strategies (motivations, intentions, and capabilities). 3 examples of applying the approach are shown. First, the approach has been used to evaluate the attractiveness of HEU (high enriched uranium)production scenarios at a clandestine enrichment facility using centrifuge enrichment technology. Secondly, the approach has been applied to assess the attractiveness of scenarios for undeclared production of plutonium or HEU by theft of materialsmore » circulating in nuclear fuel cycle facilities and thermal reactors. Thirdly, the approach has been used to perform a comparative analysis of the structures of developing nuclear power systems based on different types of nuclear fuel cycles, the analysis being based on indicators of proliferation risk.« less

Can India’s primary care facilities deliver? A cross-sectional assessment of the Indian public health system’s capacity for basic delivery and newborn services

PubMed Central

Leslie, Hannah H; Regan, Mathilda; Nambiar, Devaki; Kruk, Margaret E

2018-01-01

Objectives To assess input and process capacity for basic delivery and newborn (intrapartum care hereafter) care in the Indian public health system and to describe differences in facility capacity between rural and urban areas and across states. Design Cross-sectional study. Setting Data from the nationally representative 2012–2014 District Level Household and Facility Survey, which includes a census of community health centres (CHC) and sample of primary health centres (PHC) across 30 states and union territories in India. Participants 8536 PHCs and 4810 CHCs. Outcome measures We developed a summative index of 33 structural and process capacity items matching the Indian Public Health Standards for PHCs as a metric of minimum facility capacity for intrapartum care. We assessed differences in performance on this index across facility type and location. Results About 30% of PHCs and 5% of CHCs reported not offering any intrapartum care. Among those offering services, volumes were low: median monthly delivery volume was 8 (IQR=13) in PHCs and 41 (IQR=73) in CHCs. Both PHCs and CHCs failed to meet the national standards for basic intrapartum care capacity. Mean facility capacity was low in PHCs in both urban (0.64) and rural (0.63) areas, while in CHCs, capacity was slightly higher in urban areas (0.77vs0.74). Gaps were most striking in availability of skilled human resources and emergency obstetric services. Poor capacity facilities were more concentrated in the more impoverished states, with 37% of districts from these states receiving scores in the lowest third of the facility capacity index (<0.70), compared with 21% of districts otherwise. Conclusions Basic intrapartum care capacity in Indian public primary care facilities is weak in both rural and urban areas, especially lacking in the poorest states with worst health outcomes. Improving maternal and newborn health outcomes will require focused attention to quality measurement, accountability mechanisms and quality improvement. Policies to address deficits in skilled providers and emergency service availability are urgently required. PMID:29866726

Can India's primary care facilities deliver? A cross-sectional assessment of the Indian public health system's capacity for basic delivery and newborn services.

PubMed

Sharma, Jigyasa; Leslie, Hannah H; Regan, Mathilda; Nambiar, Devaki; Kruk, Margaret E

2018-06-04

To assess input and process capacity for basic delivery and newborn (intrapartum care hereafter) care in the Indian public health system and to describe differences in facility capacity between rural and urban areas and across states. Cross-sectional study. Data from the nationally representative 2012-2014 District Level Household and Facility Survey, which includes a census of community health centres (CHC) and sample of primary health centres (PHC) across 30 states and union territories in India. 8536 PHCs and 4810 CHCs. We developed a summative index of 33 structural and process capacity items matching the Indian Public Health Standards for PHCs as a metric of minimum facility capacity for intrapartum care. We assessed differences in performance on this index across facility type and location. About 30% of PHCs and 5% of CHCs reported not offering any intrapartum care. Among those offering services, volumes were low: median monthly delivery volume was 8 (IQR=13) in PHCs and 41 (IQR=73) in CHCs. Both PHCs and CHCs failed to meet the national standards for basic intrapartum care capacity. Mean facility capacity was low in PHCs in both urban (0.64) and rural (0.63) areas, while in CHCs, capacity was slightly higher in urban areas (0.77vs0.74). Gaps were most striking in availability of skilled human resources and emergency obstetric services. Poor capacity facilities were more concentrated in the more impoverished states, with 37% of districts from these states receiving scores in the lowest third of the facility capacity index (<0.70), compared with 21% of districts otherwise. Basic intrapartum care capacity in Indian public primary care facilities is weak in both rural and urban areas, especially lacking in the poorest states with worst health outcomes. Improving maternal and newborn health outcomes will require focused attention to quality measurement, accountability mechanisms and quality improvement. Policies to address deficits in skilled providers and emergency service availability are urgently required. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Environmental assessment for the proposed effluent limitations guidelines, pretreatment standards, and new source performance standards for the centralized waste treatment industry

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

NONE

1998-12-01

This report assesses the water quality related benefits that would be expected if the US Environmental Protection Agency (EPA) adopts the proposed effluent limitations, guidelines and pretreatment standards for the Centralized Waste Treatment (CWT) Industry. EPA estimates that under baseline conditions 205 CWT facilities discharge approximately 5.22 million lbs/year of metal and organic pollutants.

Predicting the seismic performance of typical R/C healthcare facilities: emphasis on hospitals

NASA Astrophysics Data System (ADS)

Bilgin, Huseyin; Frangu, Idlir

2017-09-01

Reinforced concrete (RC) type of buildings constitutes an important part of the current building stock in earthquake prone countries such as Albania. Seismic response of structures during a severe earthquake plays a vital role in the extent of structural damage and resulting injuries and losses. In this context, this study evaluates the expected performance of a five-story RC healthcare facility, representative of common practice in Albania, designed according to older codes. The design was based on the code requirements used in this region during the mid-1980s. Non-linear static and dynamic time history analyses were conducted on the structural model using the Zeus NL computer program. The dynamic time history analysis was conducted with a set of ground motions from real earthquakes. The building responses were estimated in global levels. FEMA 356 criteria were used to predict the seismic performance of the building. The structural response measures such as capacity curve and inter-story drift under the set of ground motions and pushover analyses results were compared and detailed seismic performance assessment was done. The main aim of this study is considering the application and methodology for the earthquake performance assessment of existing buildings. The seismic performance of the structural model varied significantly under different ground motions. Results indicate that case study building exhibit inadequate seismic performance under different seismic excitations. In addition, reasons for the poor performance of the building is discussed.

Cross-sectional observational assessment of quality of newborn care immediately after birth in health facilities across six sub-Saharan African countries.

PubMed

de Graft-Johnson, Joseph; Vesel, Linda; Rosen, Heather E; Rawlins, Barbara; Abwao, Stella; Mazia, Goldy; Bozsa, Robert; Mwebesa, Winifrede; Khadka, Neena; Kamunya, Rosemary; Getachew, Ashebir; Tibaijuka, Gaudiosa; Rakotovao, Jean Pierre; Tekleberhan, Alemnesh

2017-03-27

To present information on the quality of newborn care services and health facility readiness to provide newborn care in 6 African countries, and to advocate for the improvement of providers' essential newborn care knowledge and skills. Cross-sectional observational health facility assessment. Ethiopia, Kenya, Madagascar, Mozambique, Rwanda and Tanzania. Health workers in 643 facilities. 1016 health workers were interviewed, and 2377 babies were observed in the facilities surveyed. Indicators of quality of newborn care included (1) provision of immediate essential newborn care: thermal care, hygienic cord care, and early and exclusive initiation of breast feeding; (2) actual and simulated resuscitation of asphyxiated newborn infants; and (3) knowledge of health workers on essential newborn care, including resuscitation. Sterile or clean cord cutting instruments, suction devices, and tables or firm surfaces for resuscitation were commonly available. 80% of newborns were immediately dried after birth and received clean cord care in most of the studied facilities. In all countries assessed, major deficiencies exist for essential newborn care supplies and equipment, as well as for health worker knowledge and performance of key routine newborn care practices, particularly for immediate skin-to-skin contact and breastfeeding initiation. Of newborns who did not cry at birth, 89% either recovered on their own or through active steps taken by the provider through resuscitation with initial stimulation and/or ventilation. 11% of newborns died. Assessment of simulated resuscitation using a NeoNatalie anatomic model showed that less than a third of providers were able to demonstrate ventilation skills correctly. The findings shared in this paper call attention to the critical need to improve health facility readiness to provide quality newborn care services and to ensure that service providers have the necessary equipment, supplies, knowledge and skills that are critical to save newborn lives. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

System design package for the solar heating and cooling central data processing system

NASA Technical Reports Server (NTRS)

1978-01-01

The central data processing system provides the resources required to assess the performance of solar heating and cooling systems installed at remote sites. These sites consist of residential, commercial, government, and educational types of buildings, and the solar heating and cooling systems can be hot-water, space heating, cooling, and combinations of these. The instrumentation data associated with these systems will vary according to the application and must be collected, processed, and presented in a form which supports continuity of performance evaluation across all applications. Overall software system requirements were established for use in the central integration facility which transforms raw data collected at remote sites into performance evaluation information for assessing the performance of solar heating and cooling systems.

76 FR 31853 - Safety Zone; Commencement Bay, Tacoma, WA

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-02

... inspection or copying at the Docket Management Facility (M-30), U.S. Department of Transportation, West..., to include rescue simulations performed by low-flying helicopters. This rule expands the safety zone... 12866, Regulatory Planning and Review, and does not require an assessment of potential costs and...

Assessment of Water Quality of Runoff from Sealed Asphalt Surfaces

EPA Science Inventory

This report discusses the results of runoff tests from recently-sealed asphalt surfaces conducted at EPA's Urban Watershed Research Facility (UWRF) in Edison, New Jersey. Both bench-scale panels and full-scale test plots were evaluated. Full-scale tests were performed on an asp...

Usefulness of the UCSD Performance-based Skills Assessment (UPSA) for Predicting Residential Independence in Patients with Chronic Schizophrenia

PubMed Central

Mausbach, Brent T.; Bowie, Christopher R.; Harvey, Philip D.; Twamley, Elizabeth W.; Goldman, Sherrill R.; Jeste, Dilip V.; Patterson, Thomas L.

2009-01-01

The objective of this study was to examine the sensitivity and specificity of a performance-based measure of functional capacity, the UCSD Performance-Based Skills Assessment (UPSA) for the prediction of independent living status in patients with chronic schizophrenia-related conditions. A sample of 434 adults with schizophrenia or schizoaffective disorder was administered the UPSA and assessed for independent living status. Participants were classified as “independent” if they were living alone in an apartment, house, or single-resident occupancy (e.g., hotel room) and non-independent if they resided in a care facility (e.g., Board-and-Care home, Skilled Nursing Facility). Receiver Operator Characteristic (ROC) curves were calculated with the UPSA and Mattis’ Dementia Rating Scale (DRS) scores as predictor variables and residential independence as the state variable. Of the 434 participants, 99 (23%) were living independently at the time of assessment. The discriminant validity of the UPSA was adequate (ROC area under the curve = 0.74; 95% CI: 0.68–0.79), with greatest dichotomization for the UPSA at a cutoff score of 75 (68% accuracy, 69% sensitivity, 66% specificity), or 80 (68% accuracy, 59% sensitivity, 76% specificity). The UPSA was also a significantly better predictor of living status than was the DRS, based on ROC (z = 2.43, p = .015). The UPSA is a brief measure of functional capacity that predicts the ability of patients with schizophrenia to reside independently in the community. PMID:17303168

FY11 Facility Assessment Study for Aeronautics Test Program

NASA Technical Reports Server (NTRS)

Loboda, John A.; Sydnor, George H.

2013-01-01

This paper presents the approach and results for the Aeronautics Test Program (ATP) FY11 Facility Assessment Project. ATP commissioned assessments in FY07 and FY11 to aid in the understanding of the current condition and reliability of its facilities and their ability to meet current and future (five year horizon) test requirements. The principle output of the assessment was a database of facility unique, prioritized investments projects with budgetary cost estimates. This database was also used to identify trends for the condition of facility systems.

Development of a shuttle recovery Commercial Materials Processing in Space (CMPS) program

NASA Technical Reports Server (NTRS)

1989-01-01

The work performed has covered the following tasks: update commercial users requirements; assess availability of carriers and facilities; shuttle availability assessment; development of optimum accommodations plan; and payload documentation requirements assessment. The results from the first four tasks are presented. To update commercial user requirements, contacts were made with the JEA and CCDS partners to obtain copies of their most recent official flight requests. From these requests the commercial partners' short and long range plans for flight dates, flight frequency, experiment hardware and carriers was determined. A 34 by 44 inch chart was completed to give a snapshot view of the progress of commercialization in space. Further, an assessment was made of the availability of carriers and facilities. Both existing carriers and those under development were identified for use by the commercial partners. A data base was compiled to show the capabilities of the carriers. A shuttle availability assessment was performed using the primary and secondary shuttle manifests released by NASA. Analysis of the manifest produced a flight-by-flight list of flight opportunities available to commercial users. Using inputs from the first three tasks, an Optimum Accommodations Plan was developed. The Accommodation Plan shows the commercial users manifested by flight, the experiment flown, the carrier used and complete list of commercial users that could not be manifested in each calendar year.

Complaints in for-profit, non-profit and public nursing homes in two Canadian provinces

PubMed Central

McGregor, Margaret J; Cohen, Marcy; Stocks-Rankin, Catherine-Rose; Cox, Michelle B; Salomons, Kia; McGrail, Kimberlyn M; Spencer, Charmaine; Ronald, Lisa A; Schulzer, Michael

2011-01-01

Background Nursing homes provide long-term housing, support and nursing care to frail elders who are no longer able to function independently. Although studies conducted in the United States have demonstrated an association between for-profit ownership and inferior quality, relatively few Canadian studies have made performance comparisons with reference to type of ownership. Complaints are one proxy measure of performance in the nursing home setting. Our study goal was to determine whether there is an association between facility ownership and the frequency of nursing home complaints. Methods We analyzed publicly available data on complaints, regulatory measures, facility ownership and size for 604 facilities in Ontario over 1 year (2007/08) and 62 facilities in British Columbia (Fraser Health region) over 4 years (2004–2008). All analyses were carried out at the facility level. Negative binomial regression analysis was used to assess the association between type of facility ownership and frequency of complaints. Results The mean (standard deviation) number of verified/substantiated complaints per 100 beds per year in Ontario and Fraser Health was 0.45 (1.10) and 0.78 (1.63) respectively. Most complaints related to resident care. Complaints were more frequent in facilities with more citations, i.e., violations of the legislation or regulations governing a home, (Ontario) and inspection violations (Fraser Health). Compared with Ontario’s for-profit chain facilities, adjusted incident rate ratios and 95% confidence intervals of verified complaints were 0.56 (0.27–1.16), 0.58 (0.34–1.00), 0.43 (0.21– 0.88), and 0.50 (0.30– 0.84) for for-profit single-site, non-profit, charitable, and public facilities respectively. In Fraser Health, the adjusted incident rate ratio of substantiated complaints in non-profit facilities compared with for-profit facilities was 0.18 (0.07–0.45). Interpretation Compared with for-profit chain facilities, non-profit, charitable and public facilities had significantly lower rates of complaints in Ontario. Likewise, in British Columbia’s Fraser Health region, non-profit owned facilities had significantly lower rates of complaints compared with for-profit owned facilities. PMID:22567074

Does quality influence utilization of primary health care? Evidence from Haiti.

PubMed

Gage, Anna D; Leslie, Hannah H; Bitton, Asaf; Jerome, J Gregory; Joseph, Jean Paul; Thermidor, Roody; Kruk, Margaret E

2018-06-20

Expanding coverage of primary healthcare services such as antenatal care and vaccinations is a global health priority; however, many Haitians do not utilize these services. One reason may be that the population avoids low quality health facilities. We examined how facility infrastructure and the quality of primary health care service delivery were associated with community utilization of primary health care services in Haiti. We constructed two composite measures of quality for all Haitian facilities using the 2013 Service Provision Assessment survey. We geographically linked population clusters from the Demographic and Health Surveys to nearby facilities offering primary health care services. We assessed the cross-sectional association between quality and utilization of four primary care services: antenatal care, postnatal care, vaccinations and sick child care, as well as one more complex service: facility delivery. Facilities performed poorly on both measures of quality, scoring 0.55 and 0.58 out of 1 on infrastructure and service delivery quality respectively. In rural areas, utilization of several primary cares services (antenatal care, postnatal care, and vaccination) was associated with both infrastructure and quality of service delivery, with stronger associations for service delivery. Facility delivery was associated with infrastructure quality, and there was no association for sick child care. In urban areas, care utilization was not associated with either quality measure. Poor quality of care may deter utilization of beneficial primary health care services in rural areas of Haiti. Improving health service quality may offer an opportunity not only to improve health outcomes for patients, but also to expand coverage of key primary health care services.

Monitoring the ability to deliver care in low- and middle-income countries: a systematic review of health facility assessment tools

PubMed Central

Nickerson, Jason W; Adams, Orvill; Attaran, Amir; Hatcher-Roberts, Janet; Tugwell, Peter

2015-01-01

Introduction Health facilities assessments are an essential instrument for health system strengthening in low- and middle-income countries. These assessments are used to conduct health facility censuses to assess the capacity of the health system to deliver health care and to identify gaps in the coverage of health services. Despite the valuable role of these assessments, there are currently no minimum standards or frameworks for these tools. Methods We used a structured keyword search of the MEDLINE, EMBASE and HealthStar databases and searched the websites of the World Health Organization, the World Bank and the International Health Facilities Assessment Network to locate all available health facilities assessment tools intended for use in low- and middle-income countries. We parsed the various assessment tools to identify similarities between them, which we catalogued into a framework comprising 41 assessment domains. Results We identified 10 health facility assessment tools meeting our inclusion criteria, all of which were included in our analysis. We found substantial variation in the comprehensiveness of the included tools, with the assessments containing indicators in 13 to 33 (median: 25.5) of the 41 assessment domains included in our framework. None of the tools collected data on all 41 of the assessment domains we identified. Conclusions Not only do a large number of health facility assessment tools exist, but the data they collect and methods they employ are very different. This certainly limits the comparability of the data between different countries’ health systems and probably creates blind spots that impede efforts to strengthen those systems. Agreement is needed on the essential elements of health facility assessments to guide the development of specific indicators and for refining existing instruments. PMID:24895350

An assessment technique for computer-socket manufacturing

PubMed Central

Sanders, Joan; Severance, Michael

2015-01-01

An assessment strategy is presented for testing the quality of carving and forming of individual computer aided manufacturing facilities. The strategy is potentially useful to facilities making sockets and companies marketing manufacturing equipment. To execute the strategy, an evaluator fabricates a collection of test models and sockets using the manufacturing suite under evaluation, and then measures their shapes using scanning equipment. Overall socket quality is assessed by comparing socket shapes with electronic file shapes. Then model shapes are compared with electronic file shapes to characterize carving performance. Socket shapes are compared with model shapes to characterize forming performance. The mean radial error (MRE), which is the average difference in radii between the two shapes being compared, provides insight into sizing quality. Inter-quartile range (IQR), the range of radial error for the best matched half of the points on the surfaces being compared, provides insight into shape quality. By determining MRE and IQR for carving and forming separately, the source(s) of socket shape error may be pinpointed. The developed strategy may provide a useful tool to the prosthetics community and industry to help identify problems and limitations in computer aided manufacturing and insight into appropriate modifications to overcome them. PMID:21938663

Radiation Testing at Sandia National Laboratories: Sandia – JPL Collaboration for Europa Lander

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

Hattar, Khalid Mikhiel; Olszewska-Wasiolek, Maryla Aleksandra

Sandia National Laboratories (SNL) is assisting Jet Propulsion Laboratory in undertaking feasibility studies and performance assessments for the Planetary Protection aspect of the Europa Lander mission. The specific areas of interest for this project are described by task number. This white paper presents the evaluation results for Task 2, Radiation Testing, which was stated as follows: Survey SNL facilities and capabilities for simulating the Europan radiation environment and assess suitability for: A. Testing batteries, electronics, and other component and subsystems B. Exposing biological organisms to assess their survivability metrics. The radiation environment the Europa Lander will encounter on route andmore » in orbit upon arrival at its destination consists primarily of charged particles, energetic protons and electrons with the energies up to 1 GeV. The charged particle environments can be simulated using the accelerators at the Ion Beam Laboratory. The Gamma Irradiation Facility and its annex, the Low Dose Rate Irradiation Facility, offer irradiations using Co-60 gamma sources (1.17 and 1.33 MeV), as well as Cs-137 gamma (0.661 MeV) AmBe neutron (0-10 MeV) sources.« less

National Assessment of Data Quality and Associated Systems-Level Factors in Malawi

PubMed Central

O'Hagan, Richael; Marx, Melissa A; Finnegan, Karen E; Naphini, Patrick; Ng'ambi, Kumbukani; Laija, Kingsley; Wilson, Emily; Park, Lois; Wachepa, Sautso; Smith, Joseph; Gombwa, Lewis; Misomali, Amos; Mleme, Tiope; Yosefe, Simeon

2017-01-01

ABSTRACT Background: Routine health data can guide health systems improvements, but poor quality of these data hinders use. To address concerns about data quality in Malawi, the Ministry of Health and National Statistical Office conducted a data quality assessment (DQA) in July 2016 to identify systems-level factors that could be improved. Methods: We used 2-stage stratified random sampling methods to select health centers and hospitals under Ministry of Health auspices, included those managed by faith-based entities, for this DQA. Dispensaries, village clinics, police and military facilities, tertiary-level hospitals, and private facilities were excluded. We reviewed client registers and monthly reports to verify availability, completeness, and accuracy of data in 4 service areas: antenatal care (ANC), family planning, HIV testing and counseling, and acute respiratory infection (ARI). We also conducted interviews with facility and district personnel to assess health management information system (HMIS) functioning and systems-level factors that may be associated with data quality. We compared systems and quality factors by facility characteristics using 2-sample t tests with Welch's approximation, and calculated verification ratios comparing total entries in registers to totals from summarized reports. Results: We selected 16 hospitals (of 113 total in Malawi), 90 health centers (of 466), and 16 district health offices (of 28) in 16 of Malawi's 28 districts. Nearly all registers were available and complete in health centers and district hospitals, but data quality varied across service areas; median verification ratios comparing register and report totals at health centers ranged from 0.78 (interquartile range [IQR]: 0.25, 1.07) for ARI and 0.99 (IQR: 0.82, 1.36) for family planning to 1.00 (IQR: 0.96, 1.00) for HIV testing and counseling and 1.00 (IQR: 0.80, 1.23) for ANC. More than half (60%) of facilities reported receiving a documented supervisory visit for HMIS in the prior 6 months. A recent supervision visit was associated with better availability of data (P=.05), but regular district- or central-level supervision was not. Use of data by the facility to track performance toward targets was associated with both improved availability (P=.04) and completeness of data (P=.02). Half of facilities had a full-time statistical clerk, but their presence did not improve the availability or completeness of data (P=.39 and P=.69, respectively). Conclusion: Findings indicate both strengths and weaknesses in Malawi's HMIS performance, with key weaknesses including infrequent data quality checks and unreliable supervision. Efforts to strengthen HMIS in low- and middle-income countries should be informed by similar assessments. PMID:28963173

The Benefits of Guided Facility Self-Assessments

ERIC Educational Resources Information Center

O'Leary, Keith

2012-01-01

A growing number of educational institutions have discovered that a guided self-assessment solution helps them to consistently and cost-effectively obtain facility condition information and make better-informed capital planning decisions. Facility self-assessment employs a consistent, repeatable process for internal staff to quickly assess assets…

40 CFR 256.41 - Recommendations for assessing the need for facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... facilities and practices and the need for new or expanded facilities and practices. (1) The needs assessment... require new capacity development, based on the needs assessment. ... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Recommendations for assessing the need...

40 CFR 256.41 - Recommendations for assessing the need for facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... facilities and practices and the need for new or expanded facilities and practices. (1) The needs assessment... require new capacity development, based on the needs assessment. ... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Recommendations for assessing the need...

40 CFR 256.41 - Recommendations for assessing the need for facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... facilities and practices and the need for new or expanded facilities and practices. (1) The needs assessment... require new capacity development, based on the needs assessment. ... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Recommendations for assessing the need...

Ageing management program for the Spanish low and intermediate level waste disposal and spent fuel and high-level waste centralised storage facilities

NASA Astrophysics Data System (ADS)

Zuloaga, P.; Ordoñez, M.; Andrade, C.; Castellote, M.

2011-04-01

The generic design of the centralised spent fuel storage facility was approved by the Spanish Safety Authority in 2006. The planned operational life is 60 years, while the design service life is 100 years. Durability studies and surveillance of the behaviour have been considered from the initial design steps, taking into account the accessibility limitations and temperatures involved. The paper presents an overview of the ageing management program set in support of the Performance Assessment and Safety Review of El Cabril low and intermediate level waste (LILW) disposal facility. Based on the experience gained for LILW, ENRESA has developed a preliminary definition of the Ageing Management Plan for the Centralised Interim Storage Facility of spent Fuel and High Level Waste (HLW), which addresses the behaviour of spent fuel, its retrievability, the confinement system and the reinforced concrete structure. It includes tests plans and surveillance design considerations, based on the El Cabril LILW disposal facility.

Infection prevention and control practices related to Clostridium difficile infection in Canadian acute and long-term care institutions.

PubMed

Wilkinson, Krista; Gravel, Denise; Taylor, Geoffrey; McGeer, Allison; Simor, Andrew; Suh, Kathryn; Moore, Dorothy; Kelly, Sharon; Boyd, David; Mulvey, Michael; Mounchili, Aboubakar; Miller, Mark

2011-04-01

Clostridium difficile is an important pathogen in Canadian health care facilities, and infection prevention and control (IPC) practices are crucial to reducing C difficile infections (CDIs). We performed a cross-sectional study to identify CDI-related IPC practices in Canadian health care facilities. A survey assessing facility characteristics, CDI testing strategies, CDI contact precautions, and antimicrobial stewardship programs was sent to Canadian health care facilities in February 2005. Responses were received from 943 (33%) facilities. Acute care facilities were more likely than long-term care (P < .001) and mixed care facilities (P = .03) to submit liquid stools from all patients for CDI testing. Physician orders were required before testing for CDI in 394 long-term care facilities (66%)-significantly higher than the proportions in acute care (41%; P < .001) and mixed care sites (49%; P < .001). A total of 841 sites (93%) had an infection control manual, 639 (76%) of which contained CDI-specific guidelines. Antimicrobial stewardship programs were reported by 40 (29%) acute care facilities; 19 (54%) of these sites reported full enforcement of the program. Canadian health care facilities have widely varying C difficile IPC practices. Opportunities exist for facilities to take a more active role in IPC policy development and implementation, as well as antimicrobial stewardship. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

Design and implementation of community engagement interventions towards healthcare quality improvement in Ghana: a methodological approach.

PubMed

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Arhinful, Daniel Kojo

2016-12-01

Nearly four decades after the Alma-Ata declaration of 1978 on the need for active client/community participation in healthcare, not much has been achieved in this regard particularly in resource constrained countries like Ghana, where over 70 % of communities in rural areas access basic healthcare from primary health facilities. Systematic Community Engagement (SCE) in healthcare quality assessment remains a grey area in many health systems in Africa, albeit the increasing importance in promoting universal access to quality basic healthcare services. Design and implement SCE interventions that involve existing community groups engaged in healthcare quality assessment in 32 intervention primary health facilities. The SCE interventions form part of a four year randomized controlled trial (RCT) in the Greater Accra and Western regions of Ghana. Community groups (n = 52) were purposively recruited and engaged to assess non-technical components of healthcare quality, recommend quality improvement plans and reward best performing facilities. The interventions comprised of five cyclical implementation steps executed for nearly a year. Wilcoxon sign rank test was used to ascertain differences in group perceptions of service quality during the first and second assessments, and ordered logistic regression analysis performed to determine factors associated with groups' perception of healthcare quality. Healthcare quality was perceived to be lowest in non-technical areas such as: information provision to clients, directional signs in clinics, drug availability, fairness in queuing, waiting times, and information provision on use of suggestion boxes and feedback on clients' complaints. Overall, services in private health facilities were perceived to be better than public facilities (p < 0.05). Community groups dominated by artisans and elderly members (60 + years) had better perspectives on healthcare quality than youthful groups (Coef. =1.78; 95 % CI = [-0.16 3.72]) and other categories of community groups (Coef. = 0.98; 95 % CI = [-0.10 2.06]). Non-technical components of healthcare quality remain critical to clients and communities served by primary healthcare providers. The SCE concept is a potential innovative and complementary quality improvement strategy that could help enhance client experiences, trust and confidence in healthcare providers. SCE interventions are more cost effective, community-focused and could easily be scaled-up and sustained by local health authorities.

HIV point of care diagnosis: preventing misdiagnosis experience from a pilot of rapid test algorithm implementation in selected communes in Vietnam.

PubMed

Nguyen, Van Thi Thuy; Best, Susan; Pham, Hong Thang; Troung, Thi Xuan Lien; Hoang, Thi Thanh Ha; Wilson, Kim; Ngo, Thi Hong Hanh; Chien, Xuan; Lai, Kim Anh; Bui, Duc Duong; Kato, Masaya

2017-08-29

In Vietnam, HIV testing services had been available only at provincial and district health facilities, but not at the primary health facilities. Consequently, access to HIV testing services had been limited especially in rural areas. In 2012, Vietnam piloted decentralization and integration of HIV services at commune health stations (CHSs). As a part of this pilot, a three-rapid test algorithm was introduced at CHSs. The objective of this study was to assess the performance of a three-rapid test algorithm and the implementation of quality assurance measures to prevent misdiagnosis, at primary health facilities. The three-rapid test algorithm (Determine HIV-1/2, followed by ACON HIV 1/2 and DoubleCheckGold HIV 1&2 in parallel) was piloted at CHSs from August 2012 to December 2013. Commune health staff were trained to perform HIV testing. Specimens from CHSs were sent to the provincial confirmatory laboratory (PCL) for confirmatory and validation testing. Quality assurance measures were undertaken including training, competency assessment, field technical assistance, supervision and monitoring and external quality assessment (EQA). Data on HIV testing were collected from the testing logbooks at commune and provincial facilities. Descriptive analysis was conducted. Sensitivity and specificity of the rapid testing algorithm were calculated. A total of 1,373 people received HIV testing and counselling (HTC) at CHSs. Eighty people were diagnosed with HIV infection (5.8%). The 755/1244 specimens reported as HIV negative at the CHS were sent to PCL and confirmed as negative, and all 80 specimens reported as HIV positive at CHS were confirmed as positive at the PCL. Forty-nine specimens that were reactive with Determine but negative with ACON and DoubleCheckGold at the CHSs were confirmed negative at the PCL. The results show this rapid test algorithm to be 100% sensitive and 100% specific. Of 21 CHSs that received two rounds of EQA panels, 20 CHSs submitted accurate results. Decentralization of HIV confirmatory testing to CHS is feasible in Vietnam. The results obtained from this pilot provided strong evidence of the feasibility of HIV testing at primary health facilities. Quality assurance measures including training, competency assessment, regular monitoring and supervision and an EQA scheme are essential for prevention of misdiagnosis.

DETERMINING THE "MARGIN OF INCREMENTAL EXPOSURE": AN APPROACH TO ASSESSING NON-CANCER HEALTH EFFECTS OF DIOXINS

EPA Science Inventory

U.S. Environmental Protection Agency (EPA) guidance issued in April 1994 for performing screening level risk analyses of emissions from facilities that burn hazardous waste does not address the evaluation of non-cancer health effects from dioxin emissions. Historically, EPA has ...

46 CFR 11.309 - Coast Guard-accepted training other than approved courses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... training or providing instruction; (iv) The identification of other media or facilities to be used in... objectives. (4) Neither a specialist in a particular field of nonmaritime education, such as mathematics or... practice in performing required skills. (7) A process for routinely assessing the effectiveness of the...

Manipulator system man-machine interface evaluation program. [technology assessment

NASA Technical Reports Server (NTRS)

Malone, T. B.; Kirkpatrick, M.; Shields, N. L.

1974-01-01

Application and requirements for remote manipulator systems for future space missions were investigated. A manipulator evaluation program was established to study the effects of various systems parameters on operator performance of tasks necessary for remotely manned missions. The program and laboratory facilities are described. Evaluation criteria and philosophy are discussed.

Highway traffic noise measurements at acoustically hard ground sites compared to predictions from FHWA's Traffic Noise Model

DOT National Transportation Integrated Search

2001-10-29

In order to better assess the accuracy and make recommendations on the use of TNM for the FHWA, : the Volpe Center Acoustics Facility is performing an extensive validation study. The study involves highway : noise data collection and TNM modeling for...

Boiling Experiment Facility (BXF): Post Flight Assessment Anomaly Investigation Report

NASA Technical Reports Server (NTRS)

Booth, Wendell H.

2012-01-01

This document serves as the report for presenting the results and conclusions of investigation activities that were performed to determine the root causes of the anomaly, camera misalignment, and dissolved gas concentration issues and to verify the calibration and accuracy of the pressure and temperature measurements.

Factors Influencing Achievement in Junior School Certificate Examination (JSCE) in Home Economics in Nigeria

ERIC Educational Resources Information Center

Badmus, Medinat M. O.

2007-01-01

This study was undertaken to assess the contributions of teachers' knowledge of Curriculum Characteristics, value internalization and commitment, perception of adequacy of facilities, equipment and materials, and degree of performance of implementation roles/behaviours to achievements in Junior Secondary Certificate Examination in Home Economics.…

Assessing the Performance of Military Treatment Facilities

DTIC Science & Technology

2011-01-01

NUMBER OF PAGES 140 19a. NAME OF RESPONSIBLE PERSON a. REPORT unclassified b. ABSTRACT unclassified c . THIS PAGE unclassified Standard Form...Benchmark Analysis of MTF Outcomes . . . . . . . . 73 C . Outpatient utilization and MTF Size...and FY 2006, Mean by MTF Size Quintile . . . . . . . . . . . . . . . . . . . . . 99 C .1. Regression of Outpatient Utilization

Tracking the quality of care for sick children using lot quality assurance sampling: targeting improvements of health services in Jigawa, Nigeria.

PubMed

Oladele, Edward Adekola; Ormond, Louise; Adeyemi, Olusegun; Patrick, David; Okoh, Festus; Oresanya, Olusola Bukola; Valadez, Joseph J

2012-01-01

In Nigeria, 30% of child deaths are due to malaria. The National Malaria Control Program of Nigeria (NMCP) during 2009 initiated a program to improve the quality of paediatric malaria services delivered in health facilities (HF). This study reports a rapid approach used to assess the existing quality of services in Jigawa state at decentralised levels of the health system. NMCP selected Lot Quality Assurance Sampling (LQAS) to identify the variation in HF service quality among Senatorial Districts (SD). LQAS was selected because it was affordable and could be used by local health workers (HW) in a population-based survey. NMCP applied a 2-stage LQAS using a structured Rapid Health Facility Assessment (R-HFA) tool to identify high and low performing SD for specified indicators. LQAS identified variations in HF performance (n = 21) and enabled resources to be targeted to address priorities. All SD exhibited deficient essential services, supplies and equipment. Only 9.7% of HF had Artemisinin-based Combination Therapies and other first-line treatments for childhood illnesses. No SD and few HF exhibited adequate HW performance for the assessment, treatment or counselling of sick children. Using the IMCI algorithm, 17.5% of HW assessed the child's vaccination status, 46.8% assessed nutritional status, and 65.1% assessed children for dehydration. Only 5.1% of HW treatments were appropriate for the assessment. Exit interviews revealed that 5.1% of caregivers knew their children's illness, and only 19.9% could accurately describe how to administer the prescribed drug. This R-HFA, using LQAS principles, is a rapid, simple tool for assessing malaria services and can be used at scale. It identified technical deficiencies that could be corrected by improved continuing medical education, targeted supervision, and recurrent R-HFA assessments of the quality of services.

Tracking the Quality of Care for Sick Children Using Lot Quality Assurance Sampling: Targeting Improvements of Health Services in Jigawa, Nigeria

PubMed Central

Oladele, Edward Adekola; Ormond, Louise; Adeyemi, Olusegun; Patrick, David; Okoh, Festus; Oresanya, Olusola Bukola; Valadez, Joseph J.

2012-01-01

Background In Nigeria, 30% of child deaths are due to malaria. The National Malaria Control Program of Nigeria (NMCP) during 2009 initiated a program to improve the quality of paediatric malaria services delivered in health facilities (HF). This study reports a rapid approach used to assess the existing quality of services in Jigawa state at decentralised levels of the health system. Methods NMCP selected Lot Quality Assurance Sampling (LQAS) to identify the variation in HF service quality among Senatorial Districts (SD). LQAS was selected because it was affordable and could be used by local health workers (HW) in a population-based survey. NMCP applied a 2-stage LQAS using a structured Rapid Health Facility Assessment (R-HFA) tool to identify high and low performing SD for specified indicators. Findings LQAS identified variations in HF performance (n = 21) and enabled resources to be targeted to address priorities. All SD exhibited deficient essential services, supplies and equipment. Only 9.7% of HF had Artemisinin-based Combination Therapies and other first-line treatments for childhood illnesses. No SD and few HF exhibited adequate HW performance for the assessment, treatment or counselling of sick children. Using the IMCI algorithm, 17.5% of HW assessed the child’s vaccination status, 46.8% assessed nutritional status, and 65.1% assessed children for dehydration. Only 5.1% of HW treatments were appropriate for the assessment. Exit interviews revealed that 5.1% of caregivers knew their children’s illness, and only 19.9% could accurately describe how to administer the prescribed drug. Conclusion This R-HFA, using LQAS principles, is a rapid, simple tool for assessing malaria services and can be used at scale. It identified technical deficiencies that could be corrected by improved continuing medical education, targeted supervision, and recurrent R-HFA assessments of the quality of services. PMID:23028519

Temporal Wind Pairs for Space Launch Vehicle Capability Assessment and Risk Mitigation

NASA Technical Reports Server (NTRS)

Decker, Ryan K.; Barbre, Robert E., Jr.

2015-01-01

Space launch vehicles incorporate upper-level wind assessments to determine wind effects on the vehicle and for a commit to launch decision. These assessments make use of wind profiles measured hours prior to launch and may not represent the actual wind the vehicle will fly through. Uncertainty in the winds over the time period between the assessment and launch introduces uncertainty in assessment of vehicle controllability and structural integrity that must be accounted for to ensure launch safety. Temporal wind pairs are used in engineering development of allowances to mitigate uncertainty. Five sets of temporal wind pairs at various times (0.75, 1.5, 2, 3 and 4-hrs) at the United States Air Force Eastern Range and Western Range, as well as the National Aeronautics and Space Administration's Wallops Flight Facility are developed for use in upper-level wind assessments on vehicle performance. Historical databases are compiled from balloon-based and vertically pointing Doppler radar wind profiler systems. Various automated and manual quality control procedures are used to remove unacceptable profiles. Statistical analyses on the resultant wind pairs from each site are performed to determine if the observed extreme wind changes in the sample pairs are representative of extreme temporal wind change. Wind change samples in the Eastern Range and Western Range databases characterize extreme wind change. However, the small sample sizes in the Wallops Flight Facility databases yield low confidence that the sample population characterizes extreme wind change that could occur.

Temporal Wind Pairs for Space Launch Vehicle Capability Assessment and Risk Mitigation

NASA Technical Reports Server (NTRS)

Decker, Ryan K.; Barbre, Robert E., Jr.

2014-01-01

Space launch vehicles incorporate upper-level wind assessments to determine wind effects on the vehicle and for a commit to launch decision. These assessments make use of wind profiles measured hours prior to launch and may not represent the actual wind the vehicle will fly through. Uncertainty in the winds over the time period between the assessment and launch introduces uncertainty in assessment of vehicle controllability and structural integrity that must be accounted for to ensure launch safety. Temporal wind pairs are used in engineering development of allowances to mitigate uncertainty. Five sets of temporal wind pairs at various times (0.75, 1.5, 2, 3 and 4-hrs) at the United States Air Force Eastern Range and Western Range, as well as the National Aeronautics and Space Administration's Wallops Flight Facility are developed for use in upper-level wind assessments on vehicle performance. Historical databases are compiled from balloon-based and vertically pointing Doppler radar wind profiler systems. Various automated and manual quality control procedures are used to remove unacceptable profiles. Statistical analyses on the resultant wind pairs from each site are performed to determine if the observed extreme wind changes in the sample pairs are representative of extreme temporal wind change. Wind change samples in the Eastern Range and Western Range databases characterize extreme wind change. However, the small sample sizes in the Wallops Flight Facility databases yield low confidence that the sample population characterizes extreme wind change that could occur.

Observations of infection prevention and control practices in primary health care, Kenya.

PubMed

Bedoya, Guadalupe; Dolinger, Amy; Rogo, Khama; Mwaura, Njeri; Wafula, Francis; Coarasa, Jorge; Goicoechea, Ana; Das, Jishnu

2017-07-01

To assess compliance with infection prevention and control practices in primary health care in Kenya. We used an observational, patient-tracking tool to assess compliance with infection prevention and control practices by 1680 health-care workers during outpatient interactions with 14 328 patients at 935 health-care facilities in 2015. Compliance was assessed in five domains: hand hygiene; protective glove use; injections and blood sampling; disinfection of reusable equipment; and waste segregation. We calculated compliance by dividing the number of correct actions performed by the number of indications and evaluated associations between compliance and the health-care worker's and facility's characteristics. Across 106 464 observed indications for an infection prevention and control practice, the mean compliance was 0.318 (95% confidence interval, CI: 0.315 to 0.321). The compliance ranged from 0.023 (95% CI: 0.021 to 0.024) for hand hygiene to 0.871 (95% CI: 0.866 to 0.876) for injection and blood sampling safety. Compliance was weakly associated with the facility's characteristics (e.g. public or private, or level of specialization) and the health-care worker's knowledge of, and training in, infection prevention and control practices. The observational tool was effective for assessing compliance with infection prevention and control practices across multiple domains in primary health care in a low-income country. Compliance varied widely across infection prevention and control domains. The weak associations observed between compliance and the characteristics of health-care workers and facilities, such as knowledge and the availability of supplies, suggest that a broader focus on behavioural change is required.

Resources and Capabilities of the Department of Veterans Affairs to Provide Timely and Accessible Care to Veterans

PubMed Central

Hussey, Peter S.; Ringel, Jeanne S.; Ahluwalia, Sangeeta; Price, Rebecca Anhang; Buttorff, Christine; Concannon, Thomas W.; Lovejoy, Susan L.; Martsolf, Grant R.; Rudin, Robert S.; Schultz, Dana; Sloss, Elizabeth M.; Watkins, Katherine E.; Waxman, Daniel; Bauman, Melissa; Briscombe, Brian; Broyles, James R.; Burns, Rachel M.; Chen, Emily K.; DeSantis, Amy Soo Jin; Ecola, Liisa; Fischer, Shira H.; Friedberg, Mark W.; Gidengil, Courtney A.; Ginsburg, Paul B.; Gulden, Timothy; Gutierrez, Carlos Ignacio; Hirshman, Samuel; Huang, Christina Y.; Kandrack, Ryan; Kress, Amii; Leuschner, Kristin J.; MacCarthy, Sarah; Maksabedian, Ervant J.; Mann, Sean; Matthews, Luke Joseph; May, Linnea Warren; Mishra, Nishtha; Miyashiro, Lisa; Muchow, Ashley N.; Nelson, Jason; Naranjo, Diana; O'Hanlon, Claire E.; Pillemer, Francesca; Predmore, Zachary; Ross, Rachel; Ruder, Teague; Rutter, Carolyn M.; Uscher-Pines, Lori; Vaiana, Mary E.; Vesely, Joseph V.; Hosek, Susan D.; Farmer, Carrie M.

2016-01-01

Abstract The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the Department of Veterans Affairs (VA) current and projected health care capabilities and resources. An examination of data from a variety of sources, along with a survey of VA medical facility leaders, revealed the breadth and depth of VA resources and capabilities: fiscal resources, workforce and human resources, physical infrastructure, interorganizational relationships, and information resources. The assessment identified barriers to the effective use of these resources and capabilities. Analysis of data on access to VA care and the quality of that care showed that almost all veterans live within 40 miles of a VA health facility, but fewer have access to VA specialty care. Veterans usually receive care within 14 days of their desired appointment date, but wait times vary considerably across VA facilities. VA has long played a national leadership role in measuring the quality of health care. The assessment showed that VA health care quality was as good or better on most measures compared with other health systems, but quality performance lagged at some VA facilities. VA will require more resources and capabilities to meet a projected increase in veterans' demand for VA care over the next five years. Options for increasing capacity include accelerated hiring, full nurse practice authority, and expanded use of telehealth. PMID:28083424

Measuring facility capability to provide routine and emergency childbirth care to mothers and newborns: An appeal to adjust for delivery caseload of facilities

PubMed Central

Allen, Stephanie M.; Opondo, Charles; Campbell, Oona M. R.

2017-01-01

Background Measurement of Emergency Obstetric Care capability is common, and measurement of newborn and overall routine childbirth care has begun in recent years. These assessments of facility capabilities can be used to identify geographic inequalities in access to functional health services and to monitor improvements over time. This paper develops an approach for monitoring the childbirth environment that accounts for the delivery caseload of the facility. Methods We used data from the Kenya Service Provision Assessment to examine facility capability to provide quality childbirth care, including infrastructure, routine maternal and newborn care, and emergency obstetric and newborn care. A facility was considered capable of providing a function if necessary tracer items were present and, for emergency functions, if the function had been performed in the previous three months. We weighted facility capability by delivery caseload, and compared results with those generated using traditional “survey weights”. Results Of the 403 facilities providing childbirth care, the proportion meeting criteria for capability were: 13% for general infrastructure, 6% for basic emergency obstetric care, 3% for basic emergency newborn care, 13% and 11% for routine maternal and newborn care, respectively. When the new caseload weights accounting for delivery volume were applied, capability improved and the proportions of deliveries occurring in a facility meeting capability criteria were: 51% for general infrastructure, 46% for basic emergency obstetric care, 12% for basic emergency newborn care, 36% and 18% for routine maternal and newborn care, respectively. This is because most of the caseload was in hospitals, which generally had better capability. Despite these findings, fewer than 2% of deliveries occurred in a facility capable of providing all functions. Conclusion Reporting on the percentage of facilities capable of providing certain functions misrepresents the capacity to provide care at the national level. Delivery caseload weights allow adjustment for patient volume, and shift the denominator of measurement from facilities to individual deliveries, leading to a better representation of the context in which facility births take place. These methods could lead to more standardized national datasets, enhancing their ability to inform policy at a national and international level. PMID:29049412

Masticatory performance-related factors in preschool children: establishing a method to assess masticatory performance in preschool children using colour-changeable chewing gum.

PubMed

Hama, Y; Hosoda, A; Komagamine, Y; Gotoh, S; Kubota, C; Kanazawa, M; Minakuchi, S

2017-12-01

A knowledge gap regarding masticatory performance in preschool children exists, which in turn delays intervention for preventive care; therefore, a method to easily assess performance is needed. The purpose of this study is to investigate the feasibility of assessing masticatory performance using colour-changeable chewing gum and to investigate masticatory performance-related factors in preschool children. This cross-sectional survey was conducted in two childcare facilities and our laboratory. First, a one-third quantity of colour-changeable chewing gum was masticated by six adults to assess the nature and progression of colour changes in this quantity. Then, masticatory performance in 370 children 4-6 years of age was assessed using the same quantity of colour-changeable chewing gum (60 chew strokes). The maximum bite force, body height, weight, age and number of healthy teeth were recorded. A t-test was performed to determine whether gum-chewing experience or lack thereof produced a significant difference in masticatory performance. The Spearman's rank correlation coefficient was then determined for masticatory performance assessment values and other factors solely for children with gum-chewing experience. Measurements from 259 children were obtained. Children with gum-chewing experience demons trated significantly higher assessment values and were deemed to have been correctly assessed. A very weak but significant positive correlation was observed only between masticatory performance and the number of healthy teeth. The masticatory performance of preschool children was easily assessed using colour-changeable chewing gum. The assessment values demonstrated significant correlation with the number of healthy teeth, but not with maximum bite force, body height, weight or age. © 2017 John Wiley & Sons Ltd.

Facility-level outcome performance measures for nursing homes.

PubMed

Porell, F; Caro, F G

1998-12-01

Risk-adjusted nursing home performance scores were developed for four health outcomes and five quality indicators from resident-level longitudinal case-mix reimbursement data for Medicaid residents of more than 500 nursing homes in Massachusetts. Facility performance was measured by comparing actual resident outcomes with expected outcomes derived from quarterly predictions of resident-level econometric models over a 3-year period (1991-1994). Performance measures were tightly distributed among facilities in the state. The intercorrelations among the nine outcome performance measures were relatively low and not uniformly positive. Performance measures were not highly associated with various structural facility attributes. For most outcomes, longitudinal analyses revealed only modest correlations between a facility's performance score from one time period to the next. Relatively few facilities exhibited consistent superior or inferior performance over time. The findings have implications toward the practical use of facility outcome performance measures for quality assurance and reimbursement purposes in the near future.

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

PubMed

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

2010-12-01

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

KSC-07pd0921

NASA Image and Video Library

2007-04-17

KENNEDY SPACE CENTER, FLA. -- After a test flight of the Starfighter F-104, Jim Ball, KSC Spaceport Development manager, addresses the media. Behind him are Pilot Rick Svetkoff; Al Wassel, a representative from the FAA Office of Commercial Space; and Bill Parsons, director of Kennedy Space Center. The aircraft is taking part in a series of pathfinder test missions from the space shuttle runway. Two flights will generate test data to validate sonic boom assumptions about the potential impacts of suborbital and orbital commercial spaceflight from the facility. NASA is assessing the environmental impact of such flights. Starfighters Inc. of Clearwater, Fla., will perform the flights to help in assessing suborbital space launch trajectories from the runway and paving the way for future commercial space tourism and research flights from the facility. Photo credit: NASA/Kim Shiflett

Full-beam performances of a PET detector with synchrotron therapeutic proton beams.

PubMed

Piliero, M A; Pennazio, F; Bisogni, M G; Camarlinghi, N; Cerello, P G; Del Guerra, A; Ferrero, V; Fiorina, E; Giraudo, G; Morrocchi, M; Peroni, C; Pirrone, G; Sportelli, G; Wheadon, R

2016-12-07

Treatment quality assessment is a crucial feature for both present and next-generation ion therapy facilities. Several approaches are being explored, based on prompt radiation emission or on PET signals by [Formula: see text]-decaying isotopes generated by beam interactions with the body. In-beam PET monitoring at synchrotron-based ion therapy facilities has already been performed, either based on inter-spill data only, to avoid the influence of the prompt radiation, or including both in-spill and inter-spill data. However, the PET images either suffer of poor statistics (inter-spill) or are more influenced by the background induced by prompt radiation (in-spill). Both those problems are expected to worsen for accelerators with improved duty cycle where the inter-spill interval is reduced to shorten the treatment time. With the aim of assessing the detector performance and developing techniques for background reduction, a test of an in-beam PET detector prototype was performed at the CNAO synchrotron-based ion therapy facility in full-beam acquisition modality. Data taken with proton beams impinging on PMMA phantoms showed the system acquisition capability and the resulting activity distribution, separately reconstructed for the in-spill and the inter-spill data. The coincidence time resolution for in-spill and inter-spill data shows a good agreement, with a slight deterioration during the spill. The data selection technique allows the identification and rejection of most of the background originated during the beam delivery. The activity range difference between two different proton beam energies (68 and 72 MeV) was measured and found to be in sub-millimeter agreement with the expected result. However, a slightly longer (2 mm) absolute profile length is obtained for in-spill data when compared to inter-spill data.

Application of the Life Safety Code to a Historic Test Stand

NASA Technical Reports Server (NTRS)

Askins, Bruce; Lemke, Paul R.; Lewis, William L.; Covell, Carol C.

2011-01-01

NASA has conducted a study to assess alternatives to refurbishing existing launch vehicle modal test facilities as opposed to developing new test facilities to meet the demands of a very fiscally constrained test and evaluation environment. The results of this study showed that Marshall Space Flight Center (MSFC) Test Stand (TS) 4550 could be made compliant, within reasonable cost and schedule impacts, if safety processes and operational limitations were put in place to meet the safety codes and concerns of the Fire Marshall. Trades were performed with key selection criteria to ensure that appropriate levels of occupant safety are incorporated into test facility design modifications. In preparation for the ground vibration tests that were to be performed on the Ares I launch vehicle, the Ares Flight and Integrated Test Office (FITO) organization evaluated the available test facility options, which included the existing mothballed structural dynamic TS4550 used by Apollo and Shuttle, alternative ground vibration test facilities at other locations, and construction of a new dynamic test stand. After an exhaustive assessment of the alternatives, the results favored modifying the TS4550 because it was the lowest cost option and presented the least schedule risk to the NASA Constellation Program for Ares Integrated Vehicle Ground Vibration Test (IVGVT). As the renovation design plans and drawings were being developed for TS4550, a safety concern was discovered the original design for the construction of the test stand, originally built for the Apollo Program and renovated for the Shuttle Program, was completed before NASA s adoption of the currently imposed safety and building codes per National Fire Protection Association Life Safety Code [NFPA 101] and International Building Codes. The initial FITO assessment of the design changes, required to make TS4550 compliant with current safety and building standards, identified a significant cost increase and schedule impact. An effort was launched to thoroughly evaluate the applicable life safety requirements, examine the context in which they were derived, and determine a means by which the TS4550 modifications could be made within budget and on schedule, while still providing the occupants with appropriate levels of safety.

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.

Production of medical radioactive isotopes using KIPT electron driven subcritical facility.

PubMed

Talamo, Alberto; Gohar, Yousry

2008-05-01

Kharkov Institute of Physics and Technology (KIPT) of Ukraine in collaboration with Argonne National Laboratory (ANL) has a plan to construct an electron accelerator driven subcritical assembly. One of the facility objectives is the production of medical radioactive isotopes. This paper presents the ANL collaborative work performed for characterizing the facility performance for producing medical radioactive isotopes. First, a preliminary assessment was performed without including the self-shielding effect of the irradiated samples. Then, more detailed investigation was carried out including the self-shielding effect, which defined the sample size and location for producing each medical isotope. In the first part, the reaction rates were calculated as the multiplication of the cross section with the unperturbed neutron flux of the facility. Over fifty isotopes have been considered and all transmutation channels are used including (n, gamma), (n, 2n), (n, p), and (gamma, n). In the second part, the parent isotopes with high reaction rate were explicitly modeled in the calculations. Four irradiation locations were considered in the analyses to study the medical isotope production rate. The results show the self-shielding effect not only reduces the specific activity but it also changes the irradiation location that maximizes the specific activity. The axial and radial distributions of the parent capture rates have been examined to define the irradiation sample size of each parent isotope.

REVIEW OF MECHANISTIC UNDERSTANDING AND MODELING AND UNCERTAINTY ANALYSIS METHODS FOR PREDICTING CEMENTITIOUS BARRIER PERFORMANCE

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

Langton, C.; Kosson, D.

2009-11-30

Cementitious barriers for nuclear applications are one of the primary controls for preventing or limiting radionuclide release into the environment. At the present time, performance and risk assessments do not fully incorporate the effectiveness of engineered barriers because the processes that influence performance are coupled and complicated. Better understanding the behavior of cementitious barriers is necessary to evaluate and improve the design of materials and structures used for radioactive waste containment, life extension of current nuclear facilities, and design of future nuclear facilities, including those needed for nuclear fuel storage and processing, nuclear power production and waste management. The focusmore » of the Cementitious Barriers Partnership (CBP) literature review is to document the current level of knowledge with respect to: (1) mechanisms and processes that directly influence the performance of cementitious materials (2) methodologies for modeling the performance of these mechanisms and processes and (3) approaches to addressing and quantifying uncertainties associated with performance predictions. This will serve as an important reference document for the professional community responsible for the design and performance assessment of cementitious materials in nuclear applications. This review also provides a multi-disciplinary foundation for identification, research, development and demonstration of improvements in conceptual understanding, measurements and performance modeling that would be lead to significant reductions in the uncertainties and improved confidence in the estimating the long-term performance of cementitious materials in nuclear applications. This report identifies: (1) technology gaps that may be filled by the CBP project and also (2) information and computational methods that are in currently being applied in related fields but have not yet been incorporated into performance assessments of cementitious barriers. The various chapters contain both a description of the mechanism or and a discussion of the current approaches to modeling the phenomena.« less

Trends in Maternity Care Practice Skin-to-Skin Contact Indicators: United States, 2007-2015.

PubMed

Boundy, Ellen O; Perrine, Cria G; Barrera, Chloe M; Li, Ruowei; Hamner, Heather C

2018-05-21

Mother-infant skin-to-skin contact (SSC) immediately after birth helps transition infants to the post-uterine environment and increases the likelihood of breastfeeding initiation and duration. This study examines trends in U.S. maternity practices related to SSC, and variations by facility demographics. Data were from the Maternity Practices in Infant Nutrition and Care (mPINC) surveys (2007-2015), a biennial assessment of all U.S. maternity facilities. Facilities reported how often patients were encouraged to practice mother-infant SSC for ≥30 minutes within 1 hour of uncomplicated vaginal birth and 2 hours of uncomplicated cesarean birth, and how often routine infant procedures are performed while in SSC. We calculated the percentage of maternity facilities reporting these indicators for ≥90% of patients across the United States for each survey year. Estimates by facility characteristics (size, type, and state) were calculated for 2015 only. The percentage of facilities reporting "Most (≥90%)" women, which were encouraged to practice early SSC, increased from 2007 to 2015 following both vaginal (40.4% to 83.0%) and cesarean (29.3% to 69.9%) births. The percentage of facilities reporting routine infant procedures were performed "Almost always (≥90%)," while mother and infant were SSC increased from 16.6% to 49.5% (2007 to 2015) for vaginal births and from 2.2% to 10.7% (2009 to 2015) for cesarean births. Variations in SSC practice by facility type, size, and state were noted. Significant progress has been made in increasing hospital encouragement of early SSC for both vaginal and cesarean births. Continued efforts to support evidence-based maternity practices are needed.

Building Energy Audit Report, for Hickam AFB, HI

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

Chvala, William D.; De La Rosa, Marcus I.; Brown, Daryl R.

2010-09-30

A building energy assessment was performed by a team of engineers from Pacific Northwest National Laboratory (PNNL) under contract to the Department of Energy/Federal Energy Management program (FEMP). The effort used the Facility Energy Decision System (FEDS) model to determine how energy is consumed at Hickam AFB, identify the most cost-effective energy retrofit measures, and calculate the potential energy and cost savings. This documents reports the results of that assessment.

Building Energy Audit Report for Camp Smith, HI

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

Chvala, William D.; De La Rosa, Marcus I.; Brown, Daryl R.

2010-09-30

A detailed energy assessment was performed by a team of engineers from Pacific Northwest National Laboratory (PNNL) under contract to the Department of Energy/Federal Energy Management program (FEMP). The effort used the Facility Energy Decision System (FEDS) model to determine how energy is consumed at Camp Smith, identify the most cost-effective energy retrofit measures, and calculate the potential energy and cost savings. This report documents the results of that assessment.

Trends in Facility Management Technology: The Emergence of the Internet, GIS, and Facility Assessment Decision Support.

ERIC Educational Resources Information Center

Teicholz, Eric

1997-01-01

Reports research on trends in computer-aided facilities management using the Internet and geographic information system (GIS) technology for space utilization research. Proposes that facility assessment software holds promise for supporting facility management decision making, and outlines four areas for its use: inventory; evaluation; reporting;…

Conceptual design assessment for the co-firing of bio-refinery supplied lignin project. Quarterly report, July 1--September 30, 2000

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

Berglund, T.; Ranney, J.T.; Babb, C.L.

2000-10-01

The initial design criteria of the MSW to ethanol facility have been completed along with preliminary site identification and layouts for the processing facility. These items are the first step in evaluating the feasibility of this co-located facility. Pilot facility design and modification are underway for the production and dewatering of the lignin fuel. Major process equipment identification has been completed and several key unit operations will be accomplished on rental equipment. Equipment not available for rental or at TVA has been ordered and facility modification and shakedown will begin in October. The study of the interface and resulting impactsmore » on the TVA Colbert facility are underway. The TVA Colbert fossil plant is fully capable of providing a reliable steam supply for the proposed Masada waste processing facility. The preferred supply location in the Colbert steam cycle has been identified as have possible steam pipeline routes to the Colbert boundary. Additional analysis is underway to fully predict the impact of the steam supply on Colbert plant performance and to select a final steam pipeline route.« less

[Perceptions of primary health care among users and health professionals: a comparison of units with and without family health care in Central-West Brazil].

PubMed

van Stralen, Cornelis Johannes; Belisário, Soraya Almeida; van Stralen, Terezinha Berenice de Sousa; Lima, Angela Maria Dayrell de; Massote, Alice Werneck; Oliveira, Cláudia di Lorenzo

2008-01-01

This study analyzes perceptions of performance by primary health care facilities with and without the Family Health Program in municipalities with more than 100,000 inhabitants. Questionnaires from the Primary Care Assessment Tool developed by John Hopkins University and adapted to Brazil, contemplating eight dimensions of primary health care, were applied to users and professionals from a sample of 36 family health care facilities and 28 traditional primary care facilities. Thirty health professionals with university education, 207 with secondary education, 490 adult users, and 133 family members answered the questionnaires. The overall result did not show significant differences between perceptions of family health care facilities as compared to traditional primary health care facilities, but perceptions of health professionals were consistently more favorable than those of users. Comparing the scores for each dimension, family health care facilities always scored better (with the exception of level of access), but the difference in scores between facilities with and without the Family Health Strategy was only statistically significant for all three categories of respondents in relation to the items "family focus" and "community orientation".

6 CFR 27.215 - Security vulnerability assessments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Security vulnerability assessments. 27.215... FACILITY ANTI-TERRORISM STANDARDS Chemical Facility Security Program § 27.215 Security vulnerability...-risk, the facility must complete a Security Vulnerability Assessment. A Security Vulnerability...

Technical Insights for Saltstone PA Maintenance

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

Flach, G.; Sarkar, S.; Mahadevan, S.

2011-07-20

The Cementitious Barriers Partnership (CBP) is a collaborative program sponsored by the US DOE Office of Waste Processing. The objective of the CBP is to develop a set of computational tools to improve understanding and prediction of the long-term structural, hydraulic, and chemical performance of cementitious barriers and waste forms used in nuclear applications. CBP tools are expected to better characterize and reduce the uncertainties of current methodologies for assessing cementitious barrier performance and increase the consistency and transparency of the assessment process, as the five-year program progresses. In September 2009, entering its second year of funded effort, the CBPmore » sought opportunities to provide near-term tangible support to DOE Performance Assessments (PAs). The Savannah River Saltstone Disposal Facility (SDF) was selected for the initial PA support effort because (1) cementitious waste forms and barriers play a prominent role in the performance of the facility, (2) certain important long-term behaviors of cementitious materials composing the facility are uncertain, (3) review of the SDF PA by external stakeholders is ongoing, and (4) the DOE contractor responsible for the SDF PA is open to receiving technical assistance from the CBP. A review of the current (SRR Closure & Waste Disposal Authority 2009) and prior Saltstone PAs (e.g., Cook et al. 2005) suggested five potential opportunities for improving predictions. The candidate topics considered were (1) concrete degradation from external sulfate attack, (2) impact of atmospheric exposure to concrete and grout before closure, such as accelerated slag and Tc-99 oxidation, (3) mechanistic prediction of geochemical conditions, (4) concrete degradation from rebar corrosion due to carbonation, and (5) early age cracking from drying and/or thermal shrinkage. The candidate topics were down-selected considering the feasibility of addressing each issue within approximately six months, and compatibility with existing CBP expertise and already-planned activities. Based on these criteria, the five original topics were down-selected to two: external sulfate attack and mechanistic geochemical prediction. For each of the selected topics, the CBP communicated with the PA analysts and subject matter experts at Savannah River to acquire input data specific to the Saltstone facility and related laboratory experiments. Simulations and analyses were performed for both topics using STADIUM (SIMCO 2008), LeachXS/ORCHESTRA (ECN 2007, Meeussen 2003), and other software tools. These supplemental CBP analyses produced valuable technical insights that can be used to strengthen the Saltstone PA using the ongoing PA maintenance process. This report in part summarizes key information gleaned from more comprehensive documents prepared by Sarkar et al. (2010), Samson (2010), and Sarkar (2010).« less

Verification of Data Accuracy in Japan Congenital Cardiovascular Surgery Database Including Its Postprocedural Complication Reports.

PubMed

Takahashi, Arata; Kumamaru, Hiraku; Tomotaki, Ai; Matsumura, Goki; Fukuchi, Eriko; Hirata, Yasutaka; Murakami, Arata; Hashimoto, Hideki; Ono, Minoru; Miyata, Hiroaki

2018-03-01

Japan Congenital Cardiovascluar Surgical Database (JCCVSD) is a nationwide registry whose data are used for health quality assessment and clinical research in Japan. We evaluated the completeness of case registration and the accuracy of recorded data components including postprocedural mortality and complications in the database via on-site data adjudication. We validated the records from JCCVSD 2010 to 2012 containing congenital cardiovascular surgery data performed in 111 facilities throughout Japan. We randomly chose nine facilities for site visit by the auditor team and conducted on-site data adjudication. We assessed whether the records in JCCVSD matched the data in the source materials. We identified 1,928 cases of eligible surgeries performed at the facilities, of which 1,910 were registered (99.1% completeness), with 6 cases of duplication and 1 inappropriate case registration. Data components including gender, age, and surgery time (hours) were highly accurate with 98% to 100% concordance. Mortality at discharge and at 30 and 90 postoperative days was 100% accurate. Among the five complications studied, reoperation was the most frequently observed, with 16 and 21 cases recorded in the database and source materials, respectively, having a sensitivity of 0.67 and a specificity of 0.99. Validation of JCCVSD database showed high registration completeness and high accuracy especially in the categorical data components. Adjudicated mortality was 100% accurate. While limited in numbers, the recorded cases of postoperative complications all had high specificities but had lower sensitivity (0.67-1.00). Continued activities for data quality improvement and assessment are necessary for optimizing the utility of these registries.

Quality of Post-Acute Care in Skilled Nursing Facilities That Disproportionately Serve Black and Hispanic Patients.

PubMed

Rivera-Hernandez, Maricruz; Rahman, Momotazur; Mukamel, Dana B; Mor, Vincent; Trivedi, Amal N

2018-04-25

Understanding and addressing racial and ethnic disparities in the quality of post-acute care in skilled nursing facilities is an important health policy issue, particularly as the Medicare program initiates value-based payments for these institutions. Our final cohort included 649,187 Medicare beneficiaries in either the fee-for-service or Medicare Advantage programs, who were 65 and older and were admitted to a skilled nursing facility following an acute hospital stay, from 8,375 skilled nursing facilities. We examined the quality of care in skilled nursing facilities that disproportionately serve minority patients compared to non-Hispanic whites. Three measures, all calculated at the level of the facility, were used to assess quality of care in skilled nursing facilities: 1) 30-day rehospitalization rate; 2) successful discharge from the facility to the community; and 3) Medicare five-star quality ratings. We found that African-American post-acute patients are highly concentrated in a small number of institutions, with 28% of facilities accounting for 80% of all post-acute admissions for African-American patients. Similarly, just 20% of facilities accounted for 80% of all admissions for Hispanics. Skilled nursing facilities with higher fractions of African-American patients had worse performance for three publicly-reported quality measures: rehospitalization, successful discharge to the community, and the star rating indicator. Efforts to address disparities should focus attention on institutions that disproportionately serve minority patients and monitor unintended consequences of value-based payments to skilled nursing facilities.

Invasive group A Streptococcus infections associated with liposuction surgery at outpatient facilities not subject to state or federal regulation.

PubMed

Beaudoin, Amanda L; Torso, Lauren; Richards, Katherine; Said, Maria; Van Beneden, Chris; Longenberger, Allison; Ostroff, Stephen; Wendt, Joyanna; Dooling, Kathleen; Wise, Matthew; Blythe, David; Wilson, Lucy; Moll, Mària; Perz, Joseph F

2014-07-01

Liposuction is one of the most common cosmetic surgery procedures in the United States. Tumescent liposuction, in which crystalloid fluids, lidocaine, and epinephrine are infused subcutaneously before cannula-assisted aspiration of fat, can be performed without intravenous or general anesthesia, often at outpatient facilities. However, some of these facilities are not subject to state or federal regulation and may not adhere to appropriate infection control practices. To describe an outbreak of severe group A Streptococcus (GAS) infections among persons undergoing tumescent liposuction at 2 outpatient cosmetic surgery facilities not subject to state or federal regulation. Outbreak investigation (including cohort analysis of at-risk patients), interviews using a standardized questionnaire, medical record review, facility assessment, and laboratory analysis of GAS isolates. Patients undergoing liposuction at 2 outpatient facilities, one in Maryland and the other in Pennsylvania, between July 1 and September 14, 2012. Confirmed invasive GAS infections (isolation of GAS from a normally sterile site or wound of a patient with necrotizing fasciitis or streptococcal toxic shock syndrome), suspected GAS infections (inflamed surgical site and either purulent discharge or fever and chills in a patient with no alternative diagnosis), postsurgical symptoms and patient-reported experiences related to his or her procedure, and emm types, T-antigen types, and antimicrobial susceptibility of GAS isolates. We identified 4 confirmed cases and 9 suspected cases, including 1 death (overall attack rate, 20% [13 of 66]). One instance of likely secondary GAS transmission to a household member occurred. All confirmed case patients had necrotizing fasciitis and had undergone surgical debridement. Procedures linked to illness were performed by a single surgical team that traveled between the 2 locations; 2 team members (1 of whom reported recent cellulitis) were colonized with a GAS strain that was indistinguishable by laboratory analysis of the isolates from the case patients. Facility assessments and patient reports indicated substandard infection control, including errors in equipment sterilization and infection prevention training. This outbreak of severe GAS infections was likely caused by transmission from colonized health care workers to patients during liposuction procedures. Additional oversight of outpatient cosmetic surgery facilities is needed to assure that they maintain appropriate infection control practices and other patient protections.

Feasibility Study of Economics and Performance of Solar Photovoltaics at the Tronox Facility in Savannah, Georgia. A Study Prepared in Partnership with the Environmental Protection Agency for the RE-Powering America's Land Initiative: Siting Renewable Energy on Potentially Contaminated Land and Mine Sites

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

Kiatreungwattana, K.; Geiger, J.; Healey, V.

2013-03-01

The U.S. Environmental Protection Agency (EPA), in accordance with the RE-Powering America's Land initiative, selected the Tronox Facility site in Savannah, Georgia, for a feasibility study of renewable energy production. The National Renewable Energy Laboratory (NREL) provided technical assistance for this project. The purpose of this report is to assess the site for a possible photovoltaic (PV) system installation and estimate the cost, performance, and site impacts of different PV options. In addition, the report recommends financing options that could assist in the implementation of a PV system at the site.

Advance assessment for movement of Haz Cat 3 radioactive materials.

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

Vosburg, Susan K.

2010-04-01

The current packaging of most HC-3 radioactive materials at SNL/NM do not meet DOT requirements for offsite shipment. SNL/NM is transporting HC-3 quantities of radioactive materials from their storage locations in the Manzano Nuclear Facilities bunkers to facilities in TA-5 to be repackaged for offsite shipment. All transportation of HC-3 rad material by SNL/NM is onsite (performed within the confines of KAFB). Transport is performed only by the Regulated Waste/Nuclear Material Disposition Department. Part of the HC3T process is to provide the CAT with the following information at least three days prior to the move: (1) RFt-Request for transfer; (2)more » HC3T movement report; (3) Radiological survey; and (4) Transportation Route Map.« less

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

Carlsbad Field Office

The Performance Demonstration Program (PDP) for headspace gases distributes blind audit samples in a gas matrix for analysis of volatile organic compounds (VOCs). Participating measurement facilities (i.e., fixed laboratories, mobile analysis systems, and on-line analytical systems) are located across the United States. Each sample distribution is termed a PDP cycle. These evaluation cycles provide an objective measure of the reliability of measurements performed for transuranic (TRU) waste characterization. The primary documents governing the conduct of the PDP are the Quality Assurance Program Document (QAPD) (DOE/CBFO-94-1012) and the Waste Isolation Pilot Plant (WIPP) Waste Analysis Plan (WAP) contained in the Hazardousmore » Waste Facility Permit (NM4890139088-TSDF) issued by the New Mexico Environment Department (NMED). The WAP requires participation in the PDP; the PDP must comply with the QAPD and the WAP. This plan implements the general requirements of the QAPD and the applicable requirements of the WAP for the Headspace Gas (HSG) PDP. Participating measurement facilities analyze blind audit samples of simulated TRU waste package headspace gases according to the criteria set by this PDP Plan. Blind audit samples (hereafter referred to as PDP samples) are used as an independent means to assess each measurement facility’s compliance with the WAP quality assurance objectives (QAOs). To the extent possible, the concentrations of VOC analytes in the PDP samples encompass the range of concentrations anticipated in actual TRU waste package headspace gas samples. Analyses of headspace gases are required by the WIPP to demonstrate compliance with regulatory requirements. These analyses must be performed by measurement facilities that have demonstrated acceptable performance in this PDP. These analyses are referred to as WIPP analyses and the TRU waste package headspace gas samples on which they are performed are referred to as WIPP samples in this document. Participating measurement facilities must analyze PDP samples using the same procedures used for routine waste characterization analyses of WIPP samples.« less

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

Carlsbad Field Office

The Performance Demonstration Program (PDP) for headspace gases distributes sample gases of volatile organic compounds (VOCs) for analysis. Participating measurement facilities (i.e., fixed laboratories, mobile analysis systems, and on-line analytical systems) are located across the United States. Each sample distribution is termed a PDP cycle. These evaluation cycles provide an objective measure of the reliability of measurements performed for transuranic (TRU) waste characterization. The primary documents governing the conduct of the PDP are the Quality Assurance Program Document (QAPD) (DOE/CBFO-94-1012) and the Waste Isolation Pilot Plant (WIPP) Waste Analysis Plan (WAP) contained in the Hazardous Waste Facility Permit (NM4890139088-TSDF) issuedmore » by the New Mexico Environment Department (NMED). The WAP requires participation in the PDP; the PDP must comply with the QAPD and the WAP. This plan implements the general requirements of the QAPD and the applicable requirements of the WAP for the Headspace Gas (HSG) PDP. Participating measurement facilities analyze blind audit samples of simulated TRU waste package headspace gases according to the criteria set by this PDP Plan. Blind audit samples (hereafter referred to as PDP samples) are used as an independent means to assess each measurement facility’s compliance with the WAP quality assurance objectives (QAOs). To the extent possible, the concentrations of VOC analytes in the PDP samples encompass the range of concentrations anticipated in actual TRU waste package headspace gas samples. Analyses of headspace gases are required by the WIPP to demonstrate compliance with regulatory requirements. These analyses must be performed by measurement facilities that have demonstrated acceptable performance in this PDP. These analyses are referred to as WIPP analyses and the TRU waste package headspace gas samples on which they are performed are referred to as WIPP samples in this document. Participating measurement facilities must analyze PDP samples using the same procedures used for routine waste characterization analyses of WIPP samples.« less

RCRA Facility Investigation/Remedial Investigation Report with Baseline Risk Assessment for the Fire Department Hose Training Facility (904-113G)

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

Palmer, E.

1997-04-01

This report documents the Resource Conservation and Recovery Act (RCRA) Facility Investigation/Remedial Investigation/Baseline Risk Assessment (RFI/RI/BRA) for the Fire Department Hose Training Facility (FDTF) (904-113G).

Performance assessment for continuing and future operations at Solid Waste Storage Area 6

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

Not Available

1994-02-01

This radiological performance assessment for the continued disposal operations at Solid Waste Storage Area 6 (SWSA 6) on the Oak Ridge Reservation (ORR) has been prepared to demonstrate compliance with the requirements of the US DOE. The analysis of SWSA 6 required the use of assumptions to supplement the available site data when the available data were incomplete for the purpose of analysis. Results indicate that SWSA 6 does not presently meet the performance objectives of DOE Order 5820.2A. Changes in operations and continued work on the performance assessment are expected to demonstrate compliance with the performance objectives for continuingmore » operations at the Interim Waste Management Facility (IWMF). All other disposal operations in SWSA 6 are to be discontinued as of January 1, 1994. The disposal units at which disposal operations are discontinued will be subject to CERCLA remediation, which will result in acceptable protection of the public health and safety.« less

Facilities Performance Indicators Report 2011-12: Tracking Your Facilities Vital Signs

ERIC Educational Resources Information Center

APPA: Association of Higher Education Facilities Officers, 2013

2013-01-01

This paper provides an expanded Web-based "Facilities Performance Indicators (FPI) Report." The purpose of APPA's Facilities Performance Indicators is to provide a representative set of statistics about facilities in educational institutions. APPA's Information and Research Committee's goal for this year was to enhance the…

Updated Liquid Secondary Waste Grout Formulation and Preliminary Waste Form Qualification

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

Saslow, Sarah A.; Um, Wooyong; Russell, Renee L.

This report describes the results from liquid secondary waste grout (LSWG) formulation and cementitious waste form qualification tests performed by Pacific Northwest National Laboratory (PNNL) for Washington River Protection Solutions, LLC (WRPS). New formulations for preparing a cementitious waste form from a high-sulfate liquid secondary waste stream simulant, developed for Effluent Management Facility (EMF) process condensates merged with low activity waste (LAW) caustic scrubber, and the release of key constituents (e.g. 99Tc and 129I) from these monoliths were evaluated. This work supports a technology development program to address the technology needs for Hanford Site Effluent Treatment Facility (ETF) liquid secondarymore » waste (LSW) solidification and supports future Direct Feed Low-Activity Waste (DFLAW) operations. High-priority activities included simulant development, LSWG formulation, and waste form qualification. The work contained within this report relates to waste form development and testing and does not directly support the 2017 integrated disposal facility (IDF) performance assessment (PA). However, this work contains valuable information for use in PA maintenance past FY17, and for future waste form development efforts. The provided data should be used by (i) cementitious waste form scientists to further understanding of cementitious dissolution behavior, (ii) IDF PA modelers who use quantified constituent leachability, effective diffusivity, and partitioning coefficients to advance PA modeling efforts, and (iii) the U.S. Department of Energy (DOE) contractors and decision makers as they assess the IDF PA program. The results obtained help fill existing data gaps, support final selection of a LSWG waste form, and improve the technical defensibility of long-term waste form performance estimates.« less

Performance-assessment progress for the Rozan low-level waste disposal facility

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

Smietanski, L.; Mitrega, J.; Frankowski, Z.

1995-12-31

The paper presents a condensed progress report on the performance assessment of Poland`s low-level waste disposal facility which is operating since 1961. The Rozan repository is of near-surface type with facilities which are the concrete fortifications built about 1910. Site characterization activities supplied information on regional geology, geohydrology, climatic and hydrologic conditions and terrain surface evolution due to geodynamic processes. Field surveys enabled to decode lithological, hydrogeological and geochemical site specific conditions. From the laboratory tests the data on groundwater chemistry and soil geochemical and hydraulic characteristics were obtained. The site geohydrologic main vulnerable element is the upmost directly endangeredmore » unconfined aquifer which is perched in relation to the region-wide hydraulic system. Heterogeneity of this system reflects in a wide range of hydraulic conductivity and thickness variations. It strongly affects velocity and flow directions. The chemistry of groundwater is unstable due to large sensitivity to external impacts. Modeling of the migration of the critical long-lived radionuclides Tc-99, U-238 and Pu-239 showed that the nearly 20 m thick unsaturated zone plays crucial role as an effective protective barrier. These radionuclides constitute minor part of the total inventory. Modeling of the development of the H-3 plume pointed out the role the macrodispersion plays in the unsaturated zone beneath the repository.« less

Enhancing resiliency for elderly populations : Shelter-in-place planning and training at facilities serving elderly populations through the Rhode Island Senior Resiliency Project.

PubMed

Smith, Richard; Mozzer, Michael; Albanese, Joseph; Paturas, James; Gold, Julia

2017-06-01

Elderly populations are disproportionately affected by disasters. In part, this is true because for many older adults, special assistance is needed to mitigate the consequences of disasters on their health and wellbeing. In addition, many older adults may reside in diverse living complexes such as long-term care facilities, assisted living facilities and independent-living senior housing complexes. Planning for each type of facility is different and the unique features of these facilities must be considered to develop readiness to deal with disasters. Based on this, the Rhode Island Department of Health established the Senior Resiliency Project to bolster the level of resiliency for the types of living facilities housing older adults. The project involves performing onsite assessments of energy resources, developing site-specific sheltering-inplace and energy resiliency plans, and educating and training facility employees and residents on these plans and steps they can take to be better prepared. Based on the feasibility of conducting these activities within a variety of facilities housing older adults, the project is segmented into three phases. This paper describes survey findings, outcomes of interventions, challenges and recommendations for bridging gaps observed in phases 1 and 2 of the project.

Future directions for LDEF ionizing radiation modeling and assessments

NASA Technical Reports Server (NTRS)

Armstrong, T. W.; Colborn, B. L.

1993-01-01

A calculational program utilizing data from radiation dosimetry measurements aboard the Long Duration Exposure Facility (LDEF) satellite to reduce the uncertainties in current models defining the ionizing radiation environment is in progress. Most of the effort to date has been on using LDEF radiation dose measurements to evaluate models defining the geomagnetically trapped radiation, which has provided results applicable to radiation design assessments being performed for Space Station Freedom. Plans for future data comparisons, model evaluations, and assessments using additional LDEF data sets (LET spectra, induced radioactivity, and particle spectra) are discussed.

Tiger Team Assessment of the Los Alamos National Laboratory

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

Not Available

1991-11-01

The purpose of the safety and health assessment was to determine the effectiveness of representative safety and health programs at the Los Alamos National Laboratory (LANL). Within the safety and health programs at LANL, performance was assessed in the following technical areas: Organization and Administration, Quality Verification, Operations, Maintenance, Training and Certification, Auxiliary Systems, Emergency Preparedness, Technical Support, Packaging and Transportation, Nuclear Criticality Safety, Security/Safety Interface, Experimental Activities, Site/Facility Safety Review, Radiological Protection, Personnel Protection, Worker Safety and Health (OSHA) Compliance, Fire Protection, Aviation Safety, Explosives Safety, Natural Phenomena, and Medical Services.

Developing an SSAC Self-Assessment Tool for Operators and Regulators

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

Frazar, Sarah L.; Innes-Jones, Gemma; Hamilton, Ian

Enabling an SSAC to understand why it is performing inefficiently can help it allocate resources more effectively to better support IAEA safeguards implementation. In collaboration with international consulting firm, Environmental Resources Management (ERM) and a U.S. based nuclear fuel cycle facility, the Pacific Northwest National Laboratory (PNNL) has been developing a framework for a future self-assessment tool for nuclear operators and regulators. This paper will describe the effort to date, with particular emphasis on the steps the team took to align the framework with relevant IAEA self-assessment tools.

Toucan hand feeding and nestling growth.

PubMed

St Leger, Judy; Vince, Martin; Jennings, Jerry; McKerney, Erin; Nilson, Erika

2012-05-01

A retrospective analysis of hand-feeding records and growth data from 3 facilities was performed to determine the growth pattern for 8 toucan species raised in captivity. General philosophies of breeding and rearing were similar but approaches to hand-feeding varied. General hand-feeding and chick management records from hatch to fledging were reviewed for 2 of the 3 facilities. Effective hand-feeding formulas were commercially available and minimally modified. Growth curves were developed. Curves approximated typical expected patterns of nestling growth with no loss of weight at fledging. This study provides a basis for hand-feeding protocols and growth curves to assess development.

Environmental Assessment For the Proposed Construction of A Hazardous Materials Issue Facility and a Hazardous Wastes Storage Facility at Buckley Air Force Base, Colorado

DTIC Science & Technology

2005-04-01

July 2002, and expires 30 June 2007 (BAFB 2001). In July 2002, the CDPHE performed an inspection of...months during the winter, spring, and fall to 9.8 million gallons for the summer months, such as July . BAFB disposed of approximately 1,477 tons of...assistance, please contact Amy Pallante , our Section 106 Compliance Coordinator, at (303) 866-4678. Sincerely, 1 " . ~"l·v’\\. /,. , fl: ··[;uf. . UV’"\\.:\\... .. ~oc-Georgianna Contigugli v State Historic Preservation Officer

Test facility for 6000 hour life test of 30 cm mercury ion thruster

NASA Technical Reports Server (NTRS)

Caldwell, J. J.

1973-01-01

The environmental and instrumentation requirements for long term testing of electrical propulsion thrusters which impose severe and unusual requirements upon the simulation facility were studied. High speed ions ejected from a mercury thruster erode material from collecting surfaces, which is then scattered and redeposited upon other surfaces, with resultant damage to the chamber and test article. By collecting the thruster plume on a frozen mercury surface damage to the thruster and chamber by back-scattered erosion products was minimized. Provisions for unattended operation, remote data acquisition, personnel safety, and instrumentation for assessing thruster performance are also discussed.

Annual Report for Los Alamos National Laboratory Technical Area 54, Area G Disposal Facility - Fiscal Year 2016

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

Birdsell, Kay Hanson; Stauffer, Philip H.; Atchley, Adam Lee

As a condition to the disposal authorization statement issued to Los Alamos National Laboratory (LANL or the Laboratory) on March 17, 2010, a comprehensive performance assessment and composite analysis (PA/CA) maintenance program must be implemented for the Technical Area 54, Area G disposal facility. Annual determinations of the adequacy of the PA/CA are to be conducted under the maintenance program to ensure that the conclusions reached by those analyses continue to be valid. This report summarizes the results of the fiscal year (FY) 2016 annual review for Area G.

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

PubMed

Kubota, Satoshi; Kawai, Hiromi

2015-01-01

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

Challenges in Routine Implementation and Quality Control of Rapid Diagnostic Tests for Malaria–Rufiji District, Tanzania

PubMed Central

McMorrow, Meredith L.; Masanja, M. Irene; Abdulla, Salim M. K.; Kahigwa, Elizeus; Kachur, S. Patrick

2018-01-01

Rapid diagnostic tests (RDTs) represent an alternative to microscopy for malaria diagnosis and have shown high sensitivity and specificity in a variety of study settings. Current World Health Organization (WHO) guidelines for quality control of RDTs provide detailed instructions on pre-field testing, but offer little guidance for quality assurance once RDTs are deployed in health facilities. From September 2006 to April 2007, we introduced a histidine-rich protein II (HRP2)-based RDT (Paracheck) for suspected malaria cases five years of age and older in nine health facilities in Rufiji District, Tanzania, to assess sensitivity and specificity of RDTs in routine use at rural health facilities. Thick blood smears were collected for all patients tested with RDTs and stained and read by laboratory personnel in each facility. Thick smears were subsequently reviewed by a reference microscopist to determine RDT sensitivity and specificity. In all nine health facilities, there were significant problems with the quality of staining and microscopy. Sensitivity and specificity of RDTs were difficult to assess given the poor quality of routine blood smear staining. Mean operational sensitivity of RDTs based on reference microscopy was 64.8%, but varied greatly by health facility, range 18.8–85.9%. Sensitivity of RDTs increased with increasing parasite density. Specificity remained high at 87.8% despite relatively poor slide quality. Institution of quality control of RDTs based on poor quality blood smear staining may impede reliable measurement of sensitivity and specificity and undermine confidence in the new diagnostic. There is an urgent need for the development of alternative quality control procedures for rapid diagnostic tests that can be performed at the facility level. PMID:18784230

Removing user fees for basic health services: a pilot study and national roll-out in Afghanistan

PubMed Central

Steinhardt, Laura C; Aman, Iqbal; Pakzad, Iqbalshah; Kumar, Binay; Singh, Lakhwinder P; Peters, David H

2011-01-01

Background User fees for primary care tend to suppress utilization, and many countries are experimenting with fee removal. Studies show that additional inputs are needed after removing fees, although well-documented experiences are lacking. This study presents data on the effects of fee removal on facility quality and utilization in Afghanistan, based on a pilot experiment and subsequent nationwide ban on fees. Methods Data on utilization and observed structural and perceived overall quality of health care were compared from before-and-after facility assessments, patient exit interviews and catchment area household surveys from eight facilities where fees were removed and 14 facilities where fee levels remained constant, as part of a larger health financing pilot study from 2005 to 2007. After a national user fee ban was instituted in 2008, health facility administrative data were analysed to assess subsequent changes in utilization and quality. Results The pilot study analysis indicated that observed and perceived quality increased across facilities but did not differ by fee removal status. Difference-in-difference analysis showed that utilization at facilities previously charging both service and drug fees increased by 400% more after fee removal, prompting additional inputs from service providers, compared with facilities that previously only charged service fees or had no change in fees (P = 0.001). Following the national fee ban, visits for curative care increased significantly (P < 0.001), but institutional deliveries did not. Services typically free before the ban—immunization and antenatal care—had immediate increases in utilization but these were not sustained. Conclusion Both pilot and nationwide data indicated that curative care utilization increased following fee removal, without differential changes in quality. Concerns raised by non-governmental organizations, health workers and community leaders over the effects of lost revenue and increased utilization require continued effort to raise revenues, monitor health worker and patient perceptions, and carefully manage health facility performance. PMID:22027924

Prevalence of, and Resident and Facility Characteristics Associated With Antipsychotic Use in Assisted Living vs. Long-Term Care Facilities: A Cross-Sectional Analysis from Alberta, Canada.

PubMed

Stock, Kathryn J; Amuah, Joseph E; Lapane, Kate L; Hogan, David B; Maxwell, Colleen J

2017-01-01

Potentially inappropriate antipsychotic use in long-term care (LTC) facilities has been the focus of significant policy and clinical attention over the past 20 years. However, most initiatives aimed at reducing the use of these medications have overlooked assisted living (AL) settings. We sought to compare the prevalence of antipsychotic use (including potentially inappropriate use) among older AL and LTC residents and to explore the resident and facility-level factors associated with use in these two populations. We performed cross-sectional analyses of 1089 residents (mean age 85 years; 77% female) from 59 AL facilities and 1000 residents (mean age 85 years; 66% female) from 54 LTC facilities, in Alberta, Canada. Research nurses completed comprehensive resident assessments at baseline (2006-2007). Facility-level factors were assessed using standardized administrator interviews. Generalized linear models were used to estimate odds ratios for associations, accounting for clustering by facility. Over a quarter of residents in AL (26.4%) and LTC (31.8%) were using antipsychotics (p = 0.006). Prevalence of potentially inappropriate use was similar in AL and LTC (23.4 vs. 26.8%, p = 0.09). However, among users, the proportion of antipsychotic use deemed potentially inappropriate was significantly higher in AL than LTC (AL: 231/287 = 80.5%; LTC: 224/318 = 70.4%; p = 0.004). In both settings, comparable findings regarding associations between resident characteristics (including dementia, psychiatric disorders, frailty, behavioral symptoms, and antidepressant use) and antipsychotic use were observed. Few facility characteristics were associated with overall antipsychotic use, but having a pharmacist on staff (AL), or an affiliated physician (LTC) was associated with a lower likelihood of potentially inappropriate antipsychotic use. Our findings illustrate the importance of including AL settings in clinical and policy initiatives aimed at reducing inappropriate antipsychotic use among older vulnerable residents.

Assessing access to surgical care in Nepal via a cross-sectional, countrywide survey.

PubMed

Boeck, Marissa A; Nagarajan, Neeraja; Gupta, Shailvi; Varadaraj, Varshini; Groen, Reinou S; Shrestha, Sunil; Gurung, Susant; Kushner, Adam L; Nwomeh, Benedict; Swaroop, Mamta

2016-08-01

Adequate surgical care is lacking in many low- and middle-income countries because of diverse barriers preventing patients from reaching providers. We sought to assess perceived difficulties to accessing surgical care in Nepal using the Surgeons OverSeas Assessment of Surgical Need tool. Fifteen of 75 Nepali districts were selected proportionate to the population, with 1,350 households surveyed. Household heads answered questions regarding access to health facilities, and 2 household members were interviewed for medical history. Continuous and categorical variables were analyzed via Wilcoxon rank sum test and Pearson χ(2) test. Multivariable logistic regressions for independent predictors of care access were performed controlling for age, sex, location, and literacy. Of respondents with a surgical condition (n = 1,342), 650 (48.4%) accessed care and 237 (17.7%) did not. Unadjusted analyses showed greater median travel times to all facilities (P < .001) and median transport costs to secondary and tertiary centers (P < .001) for those who did not access care versus those who did. Literate respondents were more likely to access care across all facilities and access variables in adjusted models (odds ratio 1.66-1.80, P < .01). Those without transport money were less likely to access care at any facility in all analyses (P < .01). The data project that at least 2.4 million individuals lack access to needed surgical care in Nepal during their lifetimes, with those not accessing health facilities having lower literacy rates and fewer transport resources. Promoting education, outreach programs, and transportation access could lessen barriers but will require further exploration. Copyright © 2016 Elsevier Inc. All rights reserved.

IMPLEMENTATION OF DEFENSE NUCLEAR FACILITY SAFETY BOARD RECOMMENDATION 2000-2 AT WIPP

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

Jackson, K.; Wu, C.

2002-02-26

The Defense Nuclear Safeties Board (DNFSB) issued Recommendation 2000-2 on March 8, 2000, concerning the degrading conditions of vital safety systems, or systems important to nuclear safety, at DOE sites across the nation. The Board recommended that the DOE take action to assess the condition of its nuclear systems to ensure continued operational readiness of vital safety systems that are important for safely accomplishing the DOE's mission. To verify the readiness of vital safety systems, a two-phased approach was established. Phase I consisted of a qualitative assessment to approved criteria of the defined vital safety systems by operating contractor personnel,more » overseen by Federal field office personnel. Based on Phase I Assessment results, vital safety systems with significant deficiencies would be further assessed in Phase II, a more extensive quantitative assessment, by a contractor and Federal team, using a second set of criteria. In addition, Defense Nuclear Facility Safety Board Recommendation 2000-2 concluded that the degradation of confinement ventilation systems was of major concern, and issued a separate set of criteria to perform a Phase II Assessment on confinement ventilation systems.« less

Automation of electromagnetic compatability (EMC) test facilities

NASA Technical Reports Server (NTRS)

Harrison, C. A.

1986-01-01

Efforts to automate electromagnetic compatibility (EMC) test facilities at Marshall Space Flight Center are discussed. The present facility is used to accomplish a battery of nine standard tests (with limited variations) deigned to certify EMC of Shuttle payload equipment. Prior to this project, some EMC tests were partially automated, but others were performed manually. Software was developed to integrate all testing by means of a desk-top computer-controller. Near real-time data reduction and onboard graphics capabilities permit immediate assessment of test results. Provisions for disk storage of test data permit computer production of the test engineer's certification report. Software flexibility permits variation in the tests procedure, the ability to examine more closely those frequency bands which indicate compatibility problems, and the capability to incorporate additional test procedures.

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

Allgood, Tiffany L.; Sorter, Andy

The Coeur d'Alene Tribe's Energy Efficiency Feasibility Study (EEFS) is the culminating document that compiles the energy efficiency and building performance assessment and project prioritization process completed on 36 Tribally owned and operated facilities within Tribal lands. The EEFS contains sections on initial findings, utility billing analyses, energy conservation measures and prioritization and funding sources and strategies for energy project implementation.

Capsule modeling of high foot implosion experiments on the National Ignition Facility

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

Clark, D. S.; Kritcher, A. L.; Milovich, J. L.

This study summarizes the results of detailed, capsule-only simulations of a set of high foot implosion experiments conducted on the National Ignition Facility (NIF). These experiments span a range of ablator thicknesses, laser powers, and laser energies, and modeling these experiments as a set is important to assess whether the simulation model can reproduce the trends seen experimentally as the implosion parameters were varied. Two-dimensional (2D) simulations have been run including a number of effects—both nominal and off-nominal—such as hohlraum radiation asymmetries, surface roughness, the capsule support tent, and hot electron pre-heat. Selected three-dimensional simulations have also been run tomore » assess the validity of the 2D axisymmetric approximation. As a composite, these simulations represent the current state of understanding of NIF high foot implosion performance using the best and most detailed computational model available. While the most detailed simulations show approximate agreement with the experimental data, it is evident that the model remains incomplete and further refinements are needed. Nevertheless, avenues for improved performance are clearly indicated.« less

Range Process Simulation Tool

NASA Technical Reports Server (NTRS)

Phillips, Dave; Haas, William; Barth, Tim; Benjamin, Perakath; Graul, Michael; Bagatourova, Olga

2005-01-01

Range Process Simulation Tool (RPST) is a computer program that assists managers in rapidly predicting and quantitatively assessing the operational effects of proposed technological additions to, and/or upgrades of, complex facilities and engineering systems such as the Eastern Test Range. Originally designed for application to space transportation systems, RPST is also suitable for assessing effects of proposed changes in industrial facilities and large organizations. RPST follows a model-based approach that includes finite-capacity schedule analysis and discrete-event process simulation. A component-based, scalable, open architecture makes RPST easily and rapidly tailorable for diverse applications. Specific RPST functions include: (1) definition of analysis objectives and performance metrics; (2) selection of process templates from a processtemplate library; (3) configuration of process models for detailed simulation and schedule analysis; (4) design of operations- analysis experiments; (5) schedule and simulation-based process analysis; and (6) optimization of performance by use of genetic algorithms and simulated annealing. The main benefits afforded by RPST are provision of information that can be used to reduce costs of operation and maintenance, and the capability for affordable, accurate, and reliable prediction and exploration of the consequences of many alternative proposed decisions.

Capsule modeling of high foot implosion experiments on the National Ignition Facility

DOE PAGES

Clark, D. S.; Kritcher, A. L.; Milovich, J. L.; ...

2017-03-21

This study summarizes the results of detailed, capsule-only simulations of a set of high foot implosion experiments conducted on the National Ignition Facility (NIF). These experiments span a range of ablator thicknesses, laser powers, and laser energies, and modeling these experiments as a set is important to assess whether the simulation model can reproduce the trends seen experimentally as the implosion parameters were varied. Two-dimensional (2D) simulations have been run including a number of effects—both nominal and off-nominal—such as hohlraum radiation asymmetries, surface roughness, the capsule support tent, and hot electron pre-heat. Selected three-dimensional simulations have also been run tomore » assess the validity of the 2D axisymmetric approximation. As a composite, these simulations represent the current state of understanding of NIF high foot implosion performance using the best and most detailed computational model available. While the most detailed simulations show approximate agreement with the experimental data, it is evident that the model remains incomplete and further refinements are needed. Nevertheless, avenues for improved performance are clearly indicated.« less

Quality of child healthcare at primary healthcare facilities: a national assessment of the Integrated Management of Childhood Illnesses in Afghanistan.

PubMed

Mansoor, Ghulam Farooq; Chikvaidze, Paata; Varkey, Sherin; Higgins-Steele, Ariel; Safi, Najibullah; Mubasher, Adela; Yusufi, Khaksar; Alawi, Sayed Alisha

2017-02-01

To assess quality of the national Integrated Management of Childhood Illness (IMCI) program services provided for sick children at primary health facilities in Afghanistan. Mixed methods including cross-sectional study. Thirteen (of thirty-four) provinces in Afghanistan. Observation of case management and re-examination of 177 sick children, exit interviews with caretakers and review of equipment/supplies at 44 health facilities. Introduction and scale up of Integrated Management of Childhood Illnesses at primary health care facilities. Care of sick children according to IMCI guidelines, health worker skills and essential health system elements. Thirty-two (71%) of the health workers were trained in IMCI and five (11%) received supervision in clinical case management during the past 6 months. On average, 5.4 out of 10 main assessment tasks were performed during cases observed, the index being higher in children seen by trained providers than untrained (6.3 vs 3.5, 95% CI 5.8-6.8 vs 2.9-4.1). In all, 74% of the 104 children who needed oral antibiotics received prescriptions, while 30% received complete and correct advice and 30% were overprescribed, and more so by untrained providers. Home care counseling was associated with provider training status (41.3% by trained and 24.5% by untrained). Essential oral and pre-referral injectable medicine and equipment/supplies were available in 66%, 23%, and 45% of health facilities, respectively. IMCI training improved assessment, rational use of antibiotics and counseling; further investment in IMCI in Afghanistan, continuing provider capacity building and supportive supervision for improved quality of care and counseling for sick children is needed, especially given high burden treatable childhood illness. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Dialysis Facility Transplant Philosophy and Access to Kidney Transplantation in the Southeast.

PubMed

Gander, Jennifer; Browne, Teri; Plantinga, Laura; Pastan, Stephen O; Sauls, Leighann; Krisher, Jenna; Patzer, Rachel E

2015-01-01

Little is known about the impact of dialysis facility treatment philosophy on access to transplant. The aim of our study was to determine the relationship between the dialysis facility transplant philosophy and facility-level access to kidney transplant waitlisting. A 25-item questionnaire administered to Southeastern dialysis facilities (n = 509) in 2012 captured the facility transplant philosophy (categorized as 'transplant is our first choice', 'transplant is a great option for some', and 'transplant is a good option, if the patient is interested'). Facility-level waitlisting and facility characteristics were obtained from the 2008-2011 Dialysis Facility Report. Multivariable logistic regression was used to examine the association between the dialysis facility transplant philosophy and facility waitlisting performance (dichotomized using the national median), where low performance was defined as fewer than 21.7% of dialysis patients waitlisted within a facility. Fewer than 25% (n = 124) of dialysis facilities reported 'transplant is our first option'. A total of 131 (31.4%) dialysis facilities in the Southeast were high-performing facilities with respect to waitlisting. Adjusted analysis showed that facilities who reported 'transplant is our first option' were twice (OR 2.0; 95% CI 1.0-3.9) as likely to have high waitlisting performance compared to facilities who reported that 'transplant is a good option, if the patient is interested'. Facilities with staff who had a more positive transplant philosophy were more likely to have better facility waitlisting performance. Future prospective studies are needed to further investigate if improving the kidney transplant philosophy in dialysis facilities improves access to transplantation.

Public Health Investigation After the Discovery of Ricin in a South Carolina Postal Facility

PubMed Central

Schier, Joshua G.; Patel, Manish M.; Belson, Martin G.; Patel, Amee; Schwartz, Michael; Fitzpatrick, Nicole; Drociuk, Dan; Deitchman, Scott; Meyer, Richard; Litovitz, Toby; Watson, William A.; Rubin, Carol H.; Kiefer, Max

2007-01-01

Objectives. In October 2003, a package containing ricin and a note threatening to poison water supplies was discovered in a South Carolina postal facility, becoming the first potential chemical terrorism event involving ricin in the United States. We examined the comprehensive public health investigation that followed and discuss the lessons learned from it. Methods. An investigation consisting primarily of environmental sampling for ricin contamination, performance of health assessments on affected personnel, and local, regional, and national surveillance for ricin-associated illness. Results. Laboratory analysis of 75 environmental sampling specimens revealed no ricin contamination. Health assessments of 36 affected employees were completed. Local surveillance initially identified 3 suspected cases, and national surveillance identified 399 outliers during the 2-week period after the incident. No confirmed cases of ricin-associated illness were identified. Conclusions. A multifaceted and multidisciplinary approach is required for an effective public health response to a chemical threat such as ricin. The results of all of the described activities were used to determine that the facility was safe to reopen and that no public health threat existed. PMID:17413057

Hazardous Materials Verification and Limited Characterization Report on Sodium and Caustic Residuals in Materials and Fuel Complex Facilities MFC-799/799A

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

Gary Mecham

2010-08-01

This report is a companion to the Facilities Condition and Hazard Assessment for Materials and Fuel Complex Sodium Processing Facilities MFC-799/799A and Nuclear Calibration Laboratory MFC-770C (referred to as the Facilities Condition and Hazards Assessment). This report specifically responds to the requirement of Section 9.2, Item 6, of the Facilities Condition and Hazards Assessment to provide an updated assessment and verification of the residual hazardous materials remaining in the Sodium Processing Facilities processing system. The hazardous materials of concern are sodium and sodium hydroxide (caustic). The information supplied in this report supports the end-point objectives identified in the Transition Planmore » for Multiple Facilities at the Materials and Fuels Complex, Advanced Test Reactor, Central Facilities Area, and Power Burst Facility, as well as the deactivation and decommissioning critical decision milestone 1, as specified in U.S. Department of Energy Guide 413.3-8, “Environmental Management Cleanup Projects.” Using a tailored approach and based on information obtained through a combination of process knowledge, emergency management hazardous assessment documentation, and visual inspection, this report provides sufficient detail regarding the quantity of hazardous materials for the purposes of facility transfer; it also provides that further characterization/verification of these materials is unnecessary.« less

Anesthesia Care Capacity at Health Facilities in 22 Low- and Middle-Income Countries.

PubMed

Hadler, Rachel A; Chawla, Sagar; Stewart, Barclay T; McCunn, Maureen C; Kushner, Adam L

2016-05-01

Globally, an estimated 2 billion people lack access to surgical and anesthesia care. We sought to pool results of anesthesia care capacity assessments in low- and middle-income countries (LMICs) to identify patterns of deficits and provide useful targets for advocacy and intervention. A systematic review of PubMed, Cochrane Database of Systematic Reviews, and Google Scholar identified reports that documented anesthesia care capacity from LMICs. When multiple assessments from one country were identified, only the study with the most facilities assessed was included. Patterns of availability or deficit were described. We identified 22 LMICs (15 low- and 8 middle-income countries) with anesthesia care capacity assessments (614 facilities assessed). Anesthesia care resources were often unavailable, including relatively low-cost ones (e.g., oxygen and airway supplies). Capacity varied markedly between and within countries, regardless of the national income. The availability of fundamental resources for safe anesthesia, such as airway supplies and functional pulse oximeters, was often not reported (72 and 36 % of hospitals assessed, respectively). Anesthesia machines and the capability to perform general anesthesia were unavailable in 43 % (132/307 hospitals) and 56 % (202/361) of hospitals, respectively. We identified a pattern of critical deficiencies in anesthesia care capacity in LMICs, including some low-cost, high-value added resources. The global health community should advocate for improvements in anesthesia care capacity and the potential benefits of doing so to health system planners. In addition, better quality data on anesthesia care capacity can improve advocacy, as well as the monitoring and evaluation of changes over time and the impact of capacity improvement interventions.

British Military surgical key performance indicators: time for an update?

PubMed

Marsden, Max Er; Sharrock, A E; Hansen, C L; Newton, N J; Bowley, D M; Midwinter, M

2016-10-01

Key performance indicators (KPIs) are metrics that compare actual care against an ideal structure, process or outcome standard. KPIs designed to assess performance in deployed military surgical facilities have previously been published. This study aimed to review the overall performance of surgical trauma care for casualties treated at Role 3 Camp Bastion, Medical Treatment Facility, Afghanistan, in light of the existing Defence Medical Services (DMS) KPIs. The secondary aims were to assess the utility of the surgical KPIs and make recommendations for future surgical trauma care review. Data on 22 surgical parameters were prospectively collected for 150 injured patients who had primary surgery at Camp Bastion between 1 May 2013 and 20 August 2013. Additional information for these patients was obtained using the Joint Theatre Trauma Register. The authors assessed data recording, applicability and compliance with the KPIs. Median data recording was 100% (IQR 98%-100%), median applicability was 56% (IQR 10%-99%) and median compliance was 78% (IQR 58%-93%). One KPI was not applicable to any patient in our population. Eleven KPIs achieved >80% compliance, five KPIs had 80%-60% compliance and five KPIs had <60% compliance. Recommendations are made for minor modifications to the current KPIs. 78% compliance with the DMS KPIs provides a snapshot of the performance of the surgical aspect of military trauma care in 2013. The KPIs highlight areas for improvement in service delivery. Individual KPI development should be driven by evidence and reflect advances in practice and knowledge. A method of stakeholder consultation, and sequential refinement following evidence review, may be the right process to develop the future set of DMS KPIs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Availability and Quality of Emergency Obstetric and Newborn Care in Bangladesh

PubMed Central

Wichaidit, Wit; Alam, Mahbub-Ul; Halder, Amal K.; Unicomb, Leanne; Hamer, Davidson H.; Ram, Pavani K.

2016-01-01

Bangladesh's maternal mortality and neonatal mortality remain unacceptably high. We assessed the availability and quality of emergency obstetric care (EmOC) and emergency newborn care (EmNC) services at health facilities in Bangladesh. We randomly sampled 50 rural villages and 50 urban neighborhoods throughout Bangladesh and interviewed the director of eight and nine health facilities nearest to each sampled area. We categorized health facilities into different quality levels (high, moderate, low, and substandard) based on staffing, availability of a phone or ambulance, and signal functions (six categories for EmOC and four categories for EmNC). We interviewed the directors of 875 health facilities. Approximately 28% of health facilities did not have a skilled birth attendant on call 24 hours per day. The least commonly performed EmOC signal function was administration of anticonvulsants (67%). The quality of EmOC services was high in 33% and moderate in 52% of the health facilities. The least common EmNC signal function was kangaroo mother care (7%). The quality of EmNC was high in 2% and moderate in 33% of the health facilities. Approximately one-third of health facilities lack 24-hour availability of skilled birth attendants, increasing the risk of peripartum complications. Most health facilities offered moderate to high quality services for EmOC and low to substandard quality for EmNC. PMID:27273640

40 CFR 256.41 - Recommendations for assessing the need for facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Recommendations for assessing the need for facilities. 256.41 Section 256.41 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... their impact on facility needs should be assessed. (3) Current and projected movement of solid and...

40 CFR 256.41 - Recommendations for assessing the need for facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Recommendations for assessing the need for facilities. 256.41 Section 256.41 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... their impact on facility needs should be assessed. (3) Current and projected movement of solid and...

WTP Pretreatment Facility Potential Design Deficiencies--Sliding Bed and Sliding Bed Erosion Assessment

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

Hansen, E. K.

2015-05-06

This assessment is based on readily available literature and discusses both Newtonian and non-Newtonian slurries with respect to sliding beds and erosion due to sliding beds. This report does not quantify the size of the sliding beds or erosion rates due to sliding beds, but only assesses if they could be present. This assessment addresses process pipelines in the Pretreatment (PT) facility and the high level waste (HLW) transfer lines leaving the PT facility to the HLW vitrification facility concentrate receipt vessel.

Taking Risk Assessment and Management to the Next Level: Program-Level Risk Analysis to Enable Solid Decision-Making on Priorities and Funding

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

Nelson, J. G.; Morton, R. L.; Castillo, C.

2011-02-01

A multi-level (facility and programmatic) risk assessment was conducted for the facilities in the Nevada National Security Site (NNSS) Readiness in Technical Base and Facilities (RTBF) Program and results were included in a new Risk Management Plan (RMP), which was incorporated into the fiscal year (FY) 2010 Integrated Plans. Risks, risk events, probability, consequence(s), and mitigation strategies were identified and captured, for most scope areas (i.e., risk categories) during the facilitated risk workshops. Risk mitigations (i.e., efforts in addition to existing controls) were identified during the facilitated risk workshops when the risk event was identified. Risk mitigation strategies fell intomore » two broad categories: threats or opportunities. Improvement projects were identified and linked to specific risks they mitigate, making the connection of risk reduction through investments for the annual Site Execution Plan. Due to the amount of that was collected, analysis to be performed, and reports to be generated, a Risk Assessment/ Management Tool (RAMtool) database was developed to analyze the risks in real-time, at multiple levels, which reinforced the site-level risk management process and procedures. The RAMtool database was developed and designed to assist in the capturing and analysis of the key elements of risk: probability, consequence, and impact. The RAMtool calculates the facility-level and programmatic-level risk factors to enable a side-by-side comparison to see where the facility manager and program manager should focus their risk reduction efforts and funding. This enables them to make solid decisions on priorities and funding to maximize the risk reduction. A more active risk management process was developed where risks and opportunities are actively managed, monitored, and controlled by each facility more aggressively and frequently. risk owners have the responsibility and accountability to manage their assigned risk in real-time, using the RAMtool database.« less

FPI: FM Success through Analytics

ERIC Educational Resources Information Center

Hickling, Duane

2013-01-01

The APPA Facilities Performance Indicators (FPI) is perhaps one of the most powerful analytical tools that institutional facilities professionals have at their disposal. It is a diagnostic facilities performance management tool that addresses the essential questions that facilities executives must answer to effectively perform their roles. It…

Flood risk assessment of land pollution hotspots

NASA Astrophysics Data System (ADS)

Masi, Matteo; Arrighi, Chiara; Iannelli, Renato

2017-04-01

Among the risks caused by extreme events, the potential spread of pollutants stored in land hotspots due to floods is an aspect that has been rarely examined with a risk-based approach. In this contribution, an attempt to estimate pollution risks related to flood events of land pollution hotspots was carried out. Flood risk has been defined as the combination of river flood hazard, hotspots exposure and vulnerability to contamination of the area, i.e. the expected severity of the environmental impacts. The assessment was performed on a geographical basis, using geo-referenced open data, available from databases of land management institutions, authorities and agencies. The list of land pollution hotspots included landfills and other waste handling facilities (e.g., temporary storage, treatment and recycling sites), municipal wastewater treatment plants, liquid waste treatment facilities and contaminated sites. The assessment was carried out by combining geo-referenced data of pollution hotspots with flood hazard maps. We derived maps of land pollution risk based on geographical and geological properties and source characteristics available from environmental authorities. These included information about soil particle size, soil hydraulic conductivity, terrain slope, type of stored pollutants, the type of facility, capacity, size of the area, land use, etc. The analysis was carried out at catchment scale. The case study of the Arno river basin in Tuscany (central Italy) is presented.

Natural phenomena hazards design and evaluation criteria for Department of Energy Facilities

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

NONE

1996-01-01

The Department of Energy (DOE) has issued an Order 420.1 which establishes policy for its facilities in the event of natural phenomena hazards (NPH) along with associated NPH mitigation requirements. This DOE Standard gives design and evaluation criteria for NPH effects as guidance for implementing the NPH mitigation requirements of DOE Order 420.1 and the associated implementation Guides. These are intended to be consistent design and evaluation criteria for protection against natural phenomena hazards at DOE sites throughout the United States. The goal of these criteria is to assure that DOE facilities can withstand the effects of natural phenomena suchmore » as earthquakes, extreme winds, tornadoes, and flooding. These criteria apply to the design of new facilities and the evaluation of existing facilities. They may also be used for modification and upgrading of existing facilities as appropriate. The design and evaluation criteria presented herein control the level of conservatism introduced in the design/evaluation process such that earthquake, wind, and flood hazards are treated on a consistent basis. These criteria also employ a graded approach to ensure that the level of conservatism and rigor in design/evaluation is appropriate for facility characteristics such as importance, hazards to people on and off site, and threat to the environment. For each natural phenomena hazard covered, these criteria consist of the following: Performance Categories and target performance goals as specified in the DOE Order 420.1 NPH Implementation Guide, and DOE-STD-1 021; specified probability levels from which natural phenomena hazard loading on structures, equipment, and systems is developed; and design and evaluation procedures to evaluate response to NPH loads and criteria to assess whether or not computed response is permissible.« less

Urban-rural inequality regarding drug prescriptions in primary care facilities - a pre-post comparison of the National Essential Medicines Scheme of China.

PubMed

Yao, Qiang; Liu, Chaojie; Ferrier, J Adamm; Liu, Zhiyong; Sun, Ju

2015-07-30

To assess the impact of the National Essential Medicines Scheme (NEMS) with respect to urban-rural inequalities regarding drug prescriptions in primary care facilities. A stratified two-stage random sampling strategy was used to sample 23,040 prescriptions from 192 primary care facilities from 2009 to 2010. Difference-in-Difference (DID) analyses were performed to test the association between NEMS and urban-rural gaps in prescription patterns. Between-Group Variance and Theil Index were calculated to measure urban-rural absolute and relative disparities in drug prescriptions. The use of the Essential Medicines List (EML) achieved a compliance rate of up to 90% in both urban and rural facilities. An overall reduction of average prescription cost improved economic access to drugs for patients in both areas. However, we observed an increased urban-rural disparity in average expenditure per prescription. The rate of antibiotics and glucocorticoids prescription remained high, despite a reduced disparity between urban and rural facilities. The average incidence of antibiotic prescription increased slightly in urban facilities (62 to 63%) and reduced in rural facilities (67% to 66%). The urban-rural disparity in the use of parenteral administration (injections and infusions) increased, albeit at a high level in both areas (44%-52%). NEMS interventions are effective in reducing the overall average prescription costs. Despite the increased use of the EML, indicator performances with respect to rational drug prescribing and use remain poor and exceed the WHO/INRUD recommended cutoff values and worldwide benchmarks. There is an increased gap between urban and rural areas in the use of parenteral administration and expenditure per prescription.

Current Realities of Delivering Mammography Services in the Community: Do Challenges with Staffing and Scheduling Exist?

PubMed Central

D'Orsi, Carl; Tu, Shin-Ping; Nakano, Connie; Carney, Patricia A.; Abraham, Linn A.; Taplin, Stephen H.; Hendrick, R. Edward; Cutter, Gary R.; Berns, Eric; Barlow, William E.; Elmore, Joann G.

2011-01-01

PURPOSE To evaluate the current (2001–2002) capacity of community-based mammography facilities to deliver screening and diagnostic services in the United States. MATERIALS AND METHODS Institutional review board approvals and patient consent were obtained. A mailed survey was sent to 53 eligible mammography facilities in three states (Washington, New Hampshire, and Colorado). Survey questions assessed equipment and staffing availability, as well as appointment waiting times for screening and diagnostic mammography services. Criterion-related content and construct validity were obtained first by means of a national advisory committee of academic, scientific, and clinical colleagues in mammography that reviewed literature on existing surveys and second by pilot testing a series of draft surveys among community mammography facilities not inclusive of the study facilities. The final survey results were independently double entered into a relational database with programmed data checks. The data were sent encrypted by means of file transfer protocol to a central analytical center at Group Health Cooperative. A two-sided P value with α = .05 was considered to show statistical significance in all analyses. RESULTS Forty-five of 53 eligible mammography facilities (85%) returned the survey. Shortages of radiologists relative to the mammographic volume were found in 44% of mammography facilities overall, with shortages of radiologists higher in not-for-profit versus for-profit facilities (60% vs 28% reported). Shortages of Mammography Quality Standards Act–qualified technologists were reported by 20% of facilities, with 46% reporting some level of difficulty in maintaining qualified technologists. Waiting times for diagnostic mammography ranged from less than 1 week to 4 weeks, with 85% performed within 1 week. Waiting times for screening mammography ranged from less than 1 week to 8 weeks, with 59% performed between 1 week and 4 weeks. Waiting times for both diagnostic and screening services were two to three times higher in high-volume compared with low-volume facilities. CONCLUSION Survey results show shortages of radiologists and certified mammography technologists. PMID:15798153

Development of computer-based analytical tool for assessing physical protection system

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

Mardhi, Alim, E-mail: alim-m@batan.go.id; Chulalongkorn University, Faculty of Engineering, Nuclear Engineering Department, 254 Phayathai Road, Pathumwan, Bangkok Thailand. 10330; Pengvanich, Phongphaeth, E-mail: ppengvan@gmail.com

Assessment of physical protection system effectiveness is the priority for ensuring the optimum protection caused by unlawful acts against a nuclear facility, such as unauthorized removal of nuclear materials and sabotage of the facility itself. Since an assessment based on real exercise scenarios is costly and time-consuming, the computer-based analytical tool can offer the solution for approaching the likelihood threat scenario. There are several currently available tools that can be used instantly such as EASI and SAPE, however for our research purpose it is more suitable to have the tool that can be customized and enhanced further. In this work,more » we have developed a computer–based analytical tool by utilizing the network methodological approach for modelling the adversary paths. The inputs are multi-elements in security used for evaluate the effectiveness of the system’s detection, delay, and response. The tool has capability to analyze the most critical path and quantify the probability of effectiveness of the system as performance measure.« less

RCRA facility investigation and risk assessment, McAlester Army Ammunition Plant, McAlester, Oklahoma. Supplemental phase 2 RFI report, Solid Waste Management Units 32 and 33

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

NONE

1994-11-30

This report presents the results of the Supplemental Phase 2 Resource Conservation and Recovery Act (RCRA) Facility Investigation (RFI) conducted for Solid Waste Management Units (SWMU) Number 32 and Number 33 at McAlester Army Ammunition Plant (MCAAP). The supplemental action of the RFI was conducted as part of the actions required in connection with the application for a RCRA permit for the management of hazardous waste at MCAAP. The objective of this Supplemental Phase 2 RFI is to collect and analyze soil samples from Solid Waste Management Unit (SWMU) 32 and SWMU 33 for dioxins/dibenzofurans. The purpose of this reportmore » is to describe the procedures used to perform the Supplemental Phase 2 RFI to present and assess the results obtained in terms of the nature and extent of any contamination found, to present the results of human health and ecological risk assessments, and to recommend future actions.« less

Scaled Eagle Nebula Experiments on NIF

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

Pound, Marc W.

We performed scaled laboratory experiments at the National Ignition Facility laser to assess models for the creation of pillar structures in star-forming clouds of molecular hydrogen, in particular the famous Pillars of the Eagle Nebula. Because pillars typically point towards nearby bright ultraviolet stars, sustained directional illumination appears to be critical to pillar formation. The experiments mock up illumination from a cluster of ultraviolet-emitting stars, using a novel long duration (30--60 ns), directional, laser-driven x-ray source consisting of multiple radiation cavities illuminated in series. Our pillar models are assessed using the morphology of the Eagle Pillars observed with the Hubblemore » Space Telescope, and measurements of column density and velocity in Eagle Pillar II obtained at the BIMA and CARMA millimeter wave facilities. In the first experiments we assess a shielding model for pillar formation. The experimental data suggest that a shielding pillar can match the observed morphology of Eagle Pillar II, and the observed Pillar II column density and velocity, if augmented by late time cometary growth.« less

Development of computer-based analytical tool for assessing physical protection system

NASA Astrophysics Data System (ADS)

Mardhi, Alim; Pengvanich, Phongphaeth

2016-01-01

Assessment of physical protection system effectiveness is the priority for ensuring the optimum protection caused by unlawful acts against a nuclear facility, such as unauthorized removal of nuclear materials and sabotage of the facility itself. Since an assessment based on real exercise scenarios is costly and time-consuming, the computer-based analytical tool can offer the solution for approaching the likelihood threat scenario. There are several currently available tools that can be used instantly such as EASI and SAPE, however for our research purpose it is more suitable to have the tool that can be customized and enhanced further. In this work, we have developed a computer-based analytical tool by utilizing the network methodological approach for modelling the adversary paths. The inputs are multi-elements in security used for evaluate the effectiveness of the system's detection, delay, and response. The tool has capability to analyze the most critical path and quantify the probability of effectiveness of the system as performance measure.

Underwater Facilities Inspection and Assessment at Magnetic Silencing Facility, Naval Submarine Base, Trident Support Site, Bangor, Washington.

DTIC Science & Technology

1980-10-01

failure was noted in any other area of the facility. :’.. - . - ..- UNDERWATER FACILITI ES INSPECTION AND ASSESSMENT AT S- MAGNETIC SILENCING FACILITY...piling were found to be in excellent condition. No damage or failure was noted in any other * area of the facility. EXECUTIVE SUI’IARY TABLE U Piling...5-1 LEGEND TO TABLES. .... ........... ........ T-1 - -TABLE 1: REMAINING CROSS-SECTIONAL AREA AND DESCRIPTION OF DAMAGE TO

RH-LLW Disposal Facility Project CD-2/3 to Design/Build Proposal Reconciliation Report

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

Annette L. Schafer

2012-06-01

A reconciliation plan was developed and implemented to address potential gaps and responses to gaps between the design/build vendor proposals and the Critical Decision-2/3 approval request package for the Remote-Handled Low Level Waste Disposal Facility Project. The plan and results of the plan implementation included development of a reconciliation team comprised of subject matter experts from Battelle Energy Alliance and the Department of Energy Idaho Operations Office, identification of reconciliation questions, reconciliation by the team, identification of unresolved/remaining issues, and identification of follow-up actions and subsequent approvals of responses. The plan addressed the potential for gaps to exist in themore » following areas: • Department of Energy Order 435.1, “Radioactive Waste Management,” requirements, including the performance assessment, composite analysis, monitoring plan, performance assessment/composite analysis maintenance plan, and closure plan • Environmental assessment supporting the National Environmental Policy Act • Nuclear safety • Safeguards and security • Emplacement operations • Requirements for commissioning • General project implementation. The reconciliation plan and results of the plan implementation are provided in a business-sensitive project file. This report provides the reconciliation plan and non-business sensitive summary responses to identified gaps.« less

An Assessment of the Influence of Emerging Social and Economic Trends on the People and Management of the Coast Guard. Volume I.

DTIC Science & Technology

1979-12-01

the trend projections derived from the cross- impact analysis described above and the weighted areas of concern components. In order to perform this... performed on shore rather than by the crew at sea. This will 60 TABLE 4-4. IMPACTS OF HIGH PROBABILITY EVENTS ON MANPOWER MANAGDENT Ca4PONqfS... impacts would include the operating economics produced by the performance of ship maintenance by shore facilities rather than crews and the reduction of

Environmental Assessment: Construct Munitions Maintenance Facility Building 543, Project ZQEL 05 - 0007, Youngstown Air Reserve Station

DTIC Science & Technology

2006-06-01

SPONSOR/MONITOR’S ACRONYM( S ) 11. SPONSOR/MONITOR’S REPORT NUMBER( S ) 12. DISTRIBUTION /AVAILABILITY STATEMENT Approved for public release; distribution ...NUMBER 6. AUTHOR( S ) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) Weston Solutions...Inc,711 E. Monument Avenue,Dayton,OH,45402 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME( S ) AND ADDRESS(ES) 10

Dialysis Facility Transplant Philosophy and Access to Kidney Transplantation in the Southeast

PubMed Central

Gander, Jennifer; Browne, Teri; Plantinga, Laura; Pastan, Stephen O; Sauls, Leighann; Krisher, Jenna; Patzer, Rachel E

2015-01-01

Background Little is known about the impact of dialysis facility treatment philosophy on access to transplant. The aim of our study was to determine the relationship between dialysis facility transplant philosophy and facility-level access to kidney transplant waitlisting. Methods A 25-item questionnaire administered to Southeastern dialysis facilities (n=509) in 2012 captured facility transplant philosophy (categorized as “transplant is our first choice,” “transplant is a great option for some,” and “transplant is a good option, if the patient is interested”) .. Facility-level waitlisting and facility characteristics were obtained from the 2008-2011 Dialysis Facility Report. Multivariable logistic regression was used to examinethe association between dialysis facility transplant philosophy and facility waitlisting performance (dichotomized using the national median), where low performance was defined as less than 21.7% of dialysis patients waitlisted within a facility. Results Fewer than 25% (n=124) of dialysis facilities reported “transplant is our first option.” A total of 131 (31.4%) dialysis facilities in the Southeast were high-performing with respect to waitlisting. Adjusted analysis showed that facilities who reported “transplant is our first option” were twice (OR=2.0, 95% CI 1.0, 3.9) as likely to have high waitlisting performance compared to facilities who reported “transplant is a good option, if the patient is interested.” Conclusions Facilities with staff who had a more positive transplant philosophy were more likely to have better facility waitlisting performance. Future prospective studies are needed to further transplantation. PMID:26278585

Mars Sample Handling and Requirements Panel (MSHARP)

NASA Technical Reports Server (NTRS)

Carr, Michael H.; McCleese, Daniel J.; Bada, Jeffrey L.; Bogard, Donald D.; Clark, Benton C.; DeVincenzi, Donald; Drake, Michael J.; Nealson, Kenneth H.; Papike, James J.; Race, Margaret S.;

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

Wyatt, Douglas

Planning for ultimate Decontamination and Decommissioning (D and D) of a nuclear facility is as much a part of a successful nuclear strategy as is the ultimate disposal of radioactive waste. As facilities, in this case radioactive waste disposal trenches, are closed and abandoned leading to ultimate decommissioning, long term monitoring may be required. However, preplanning by characterizing, modeling, and monitoring the environment around the facility prior to and during operations will allow a performance assessment to be made and future behavior predicted. In the radioactive waste burial grounds of the Savannah River Site new slit trenches were constructed tomore » receive demolition debris associated with site foot print reduction. Some of the construction debris and associated process waste contained small amounts of tritium. Since the trenches were constructed over an existing tritium groundwater plume the monitoring and performance assessment of the trench, particularly with respect to tritium contributions to the vadose zone and groundwater, were important. These disposal trenches vary in length and width but are typically constructed within the upper 7 to 8 meters (21 to 24 feet) of the local sediments. The unconfined aquifer (water table) typically underlies the area at depths varying from 20 to 24 meters (60 to 72 feet), depending on elevation. Therefore, with downward flow and 13 to 16 meters (40 to 48 feet) of unsaturated sediments separating the base of the waste trenches from the unconfined aquifer, there was potential for an environmental impact to the sediments within the vadose zone and to the underlying groundwater. Monitoring and predicting this impact can support ultimate D and D activities and future performance assessment evaluation. From this work several key observations were made that will support long term monitoring and subsequent D and D: - The observed lateral variation of thinly bedded sands and clays may be less than 20 meters particularly if lenticular sands are present. Ultimate D and D should consider monitoring and remedial activities that consider sampling on scales to address this issue. - The detailed modeling, when compared with the modeled depositional patterns, indicates flow paths for vadose zone fluids, therefore a plan should allow for these flow paths. - Detailed lithostratigraphic modeling, when based on correlations between soil properties, CPT soundings and borehole geophysical logs, can aid in precision placement of subsurface sensors and sample points for performance monitoring and D and D assessment.« less

Assessment of the response to cholera outbreaks in two districts in Ghana.

PubMed

Ohene, Sally-Ann; Klenyuie, Wisdom; Sarpeh, Mark

2016-11-02

Despite recurring outbreaks of cholera in Ghana, very little has been reported on assessments of outbreak response activities undertaken in affected areas. This study assessed the response activities undertaken in two districts, Akatsi District in Volta Region and Komenda-Edina-Eguafo-Abirem (KEEA) Municipal in Central Region during the 2012 cholera epidemic in Ghana. We conducted a retrospective assessment of the events, strengths and weaknesses of the cholera outbreak response activities in the two districts making use of the WHO cholera evaluation tool. Information sources included surveillance and facility records, reports and interviews with relevant health personnel involved in the outbreak response from both district health directorates and health facilities. We collected data on age, sex, area of residence, date of reporting to health facility of cholera cases, district population data and information on the outbreak response activities and performed descriptive analyses of the outbreak data by person, time and place. The cholera outbreak in Akatsi was explosive with a high attack rate (AR) of 374/100,000 and case fatality rate (CFR) of 1.2 % while that in KEEA was on a relatively smaller scale AR of 23/100,000 but with a high case fatality rate of 18.8 %. For both districts, we identified multiple strengths in the response to the outbreak including timely notification of the district health officials which triggered prompt investigation of the suspected outbreak facilitating confirmation of cholera and initiation of public health response activities. Others were coordination of the activities by multi-sectoral committees, instituting water, sanitation and hygiene measures and appropriate case management at health facilities. We also found areas that needed improvement in both districts including incomplete surveillance data, sub-optimal community based surveillance considering the late reporting and the deaths in the community and the inadequate community knowledge about cholera preventive measures. The assessment of the cholera outbreak response in the two districts highlighted strengths in the epidemic control activities. There was however need to strengthen preparedness especially in the area of improving community surveillance and awareness about cholera prevention and the importance of seeking prompt treatment in health facilities in the event of an outbreak.

Implementing iRound: A Computer-Based Auditing Tool.

PubMed

Brady, Darcie

Many hospitals use rounding or auditing as a tool to help identify gaps and needs in quality and process performance. Some hospitals are also using rounding to help improve patient experience. It is known that purposeful rounding helps improve Hospital Consumer Assessment of Healthcare Providers and Systems scores by helping manage patient expectations, provide service recovery, and recognize quality caregivers. Rounding works when a standard method is used across the facility, where data are comparable and trustworthy. This facility had a pen-and-paper process in place that made data reporting difficult, created a silo culture between departments, and most audits and rounds were completed differently on each unit. It was recognized that this facility needed to standardize the rounding and auditing process. The tool created by the Advisory Board called iRound was chosen as the tool this facility would use for patient experience rounds as well as process and quality rounding. The success of the iRound tool in this facility depended on several factors that started many months before implementation to current everyday usage.

A taxonomy of chemicals of emerging concern based on observed fate at water resource recovery facilities.

PubMed

Jones, Steven M; Chowdhury, Zaid K; Watts, Michael J

2017-03-01

As reuse of municipal water resource recovery facility (WRRF) effluent becomes vital to augment diminishing fresh drinking water resources, concern exists that conventional barriers may prove deficient, and the upcycling of chemicals of emerging concern (CECs) could prove harmful to human health and aquatic species if more effective and robust treatment barriers are not in place. A multiple month survey, of both primary and secondary effluents, from three (3) WRRFs, for 95 CECs was conducted in 2014 to classify CECs by their persistence through conventional water reclamation processes. By sampling the participating WRRF process trains at their peak performance (as determined by measured bulk organics and particulates removal), a short-list of recalcitrant CECs that warrant monitoring to assess treatment performance at advanced water reclamation and production facilities. The list of identified CECs for potable water reclamation (indirect or direct potable reuse) include a herbicide and its degradants, prescription pharmaceuticals and antibiotics, a female hormone, an artificial sweetener, and chlorinated flame retardants. Copyright © 2016 Elsevier Ltd. All rights reserved.

Testing of focal plane arrays at the AEDC

NASA Astrophysics Data System (ADS)

Nicholson, Randy A.; Mead, Kimberly D.; Smith, Robert W.

1992-07-01

A facility was developed at the Arnold Engineering Development Center (AEDC) to provide complete radiometric characterization of focal plane arrays (FPAs). The highly versatile facility provides the capability to test single detectors, detector arrays, and hybrid FPAs. The primary component of the AEDC test facility is the Focal Plane Characterization Chamber (FPCC). The FPCC provides a cryogenic, low-background environment for the test focal plane. Focal plane testing in the FPCC includes flood source testing, during which the array is uniformly irradiated with IR radiation, and spot source testing, during which the target radiation is focused onto a single pixel or group of pixels. During flood source testing, performance parameters such as power consumption, responsivity, noise equivalent input, dynamic range, radiometric stability, recovery time, and array uniformity can be assessed. Crosstalk is evaluated during spot source testing. Spectral response testing is performed in a spectral response test station using a three-grating monochromator. Because the chamber can accommodate several types of testing in a single test installation, a high throughput rate and good economy of operation are possible.

An Overview of Facilities and Capabilities to Support the Development of Nuclear Thermal Propulsion

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

James Werner; Sam Bhattacharyya; Mike Houts

Abstract. The future of American space exploration depends on the ability to rapidly and economically access locations of interest throughout the solar system. There is a large body of work (both in the US and the Former Soviet Union) that show that Nuclear Thermal Propulsion (NTP) is the most technically mature, advanced propulsion system that can enable this rapid and economical access by its ability to provide a step increase above what is a feasible using a traditional chemical rocket system. For an NTP system to be deployed, the earlier measurements and recent predictions of the performance of the fuelmore » and the reactor system need to be confirmed experimentally prior to launch. Major fuel and reactor system issues to be addressed include fuel performance at temperature, hydrogen compatibility, fission product retention, and restart capability. The prime issue to be addressed for reactor system performance testing involves finding an affordable and environmentally acceptable method to test a range of engine sizes using a combination of nuclear and non-nuclear test facilities. This paper provides an assessment of some of the capabilities and facilities that are available or will be needed to develop and test the nuclear fuel, and reactor components. It will also address briefly options to take advantage of the greatly improvement in computation/simulation and materials processing capabilities that would contribute to making the development of an NTP system more affordable. Keywords: Nuclear Thermal Propulsion (NTP), Fuel fabrication, nuclear testing, test facilities.« less

Assessment of a combined dry anaerobic digestion and post-composting treatment facility for source-separated organic household waste, using material and substance flow analysis and life cycle inventory.

PubMed

Jensen, Morten Bang; Møller, Jacob; Scheutz, Charlotte

2017-08-01

The fate of total solids, volatile solids, total organic carbon, fossil carbon, biogenic carbon and 17 substances (As, Ca, CaCO 3 , Cd, Cl, Cr, Cu, H, Hg, K, Mg, N, Ni, O, P, Pb, S, Zn) in a combined dry anaerobic digestion and post-composting facility were assessed. Mass balances showed good results with low uncertainties for non-volatile substances, while balances for nitrogen, carbon, volatile solids and total organic carbon showed larger but reasonable uncertainties, due to volatilisation and emissions into the air. Material and substance flow analyses were performed in order to obtain transfer coefficients for a combined dry anaerobic digestion and post-composting facility. All metals passed through the facility and ended up in compost or residues, but all concentrations of metals in the compost complied with legislation. About 23% of the carbon content of the organic waste was transferred to the biogas, 24% to the compost, 13% to residues and 40% into the atmosphere. For nitrogen, 69% was transferred to the compost, 10% volatilised to the biofilter, 11% directly into the atmosphere and 10% to residues. Finally, a full life cycle inventory was conducted for the combined dry anaerobic digestion and post-composting facility, including waste received, fuel consumption, energy use, gaseous emissions, products, energy production and chemical composition of the compost produced. Copyright © 2017. Published by Elsevier Ltd.

Building 211 cyclotron characterization survey report

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

NONE

1998-03-30

The Building 211 Cyclotron Characterization Survey includes an assessment of the radioactive and chemical inventory of materials stored within the facility; an evaluation of the relative distribution of accelerator-produced activation products within various cyclotron components and adjacent structures; measurement of the radiation fields throughout the facility; measurement and assessment of internal and external radioactive surface contamination on various equipment, facility structures, and air-handling systems; and an assessment of lead (Pb) paint and asbestos hazards within the facility.

Prototyping Control and Data Acquisition for the ITER Neutral Beam Test Facility

NASA Astrophysics Data System (ADS)

Luchetta, Adriano; Manduchi, Gabriele; Taliercio, Cesare; Soppelsa, Anton; Paolucci, Francesco; Sartori, Filippo; Barbato, Paolo; Breda, Mauro; Capobianco, Roberto; Molon, Federico; Moressa, Modesto; Polato, Sandro; Simionato, Paola; Zampiva, Enrico

2013-10-01

The ITER Neutral Beam Test Facility will be the project's R&D facility for heating neutral beam injectors (HNB) for fusion research operating with H/D negative ions. Its mission is to develop technology to build the HNB prototype injector meeting the stringent HNB requirements (16.5 MW injection power, -1 MeV acceleration energy, 40 A ion current and one hour continuous operation). Two test-beds will be built in sequence in the facility: first SPIDER, the ion source test-bed, to optimize the negative ion source performance, second MITICA, the actual prototype injector, to optimize ion beam acceleration and neutralization. The SPIDER control and data acquisition system is under design. To validate the main architectural choices, a system prototype has been assembled and performance tests have been executed to assess the prototype's capability to meet the control and data acquisition system requirements. The prototype is based on open-source software frameworks running under Linux. EPICS is the slow control engine, MDSplus is the data handler and MARTe is the fast control manager. The prototype addresses low and high-frequency data acquisition, 10 kS/s and 10 MS/s respectively, camera image acquisition, data archiving, data streaming, data retrieval and visualization, real time fast control with 100 μs control cycle and supervisory control.

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

Casbon, M. A.; Nichols, W. E.

DOE O 435.1, Radioactive Waste Management, and DOE M 435.1-1, Radioactive Waste Management Manual, require that a determination of continued adequacy of the performance assessment (PA), composite analysis (CA), and disposal authorization statement (DAS) be made on an annual basis, and it must consider the results of data collection and analysis from research, field studies, and monitoring. Annual summaries of low-level waste (LLW) disposal operations must be prepared with respect to the conclusions and recommendations of the PA and CA, and a determination of the need to revise the PA or CA must be made. The annual summary requirement providesmore » a structured approach for demonstrating the continued adequacy of the PA and CA in demonstrating a reasonable expectation that the performance objectives will be met. This annual summary addresses only the status of the Environmental Restoration Disposal Facility (ERDF) PA (CP-60089, Performance Assessment for the Environmental Restoration Disposal Facility, Hanford Site, Washington, formerly WCH-520 Rev. 1)1. The CA for ERDF is supported by DOE/RL-2016-62, Annual Status Report (FY 2016): Composite Analysis of Low Level Waste Disposal in the Central Plateau at the Hanford Site. The ERDF PA portion of the CA document is found in Section 3.1.4, and the ERDF operations portion is found in Section 3.3.3.2 of that document.« less

Facilities Performance Indicators Report, 2004-05. Facilities Core Data Survey

ERIC Educational Resources Information Center

Glazner, Steve, Ed.

2006-01-01

The purpose of "Facilities Performance Indicators" is to provide a representative set of statistics about facilities in educational institutions. The second iteration of the web-based Facilities Core Data Survey was posted and available to facilities professionals at more than 3,000 institutions in the Fall of 2005. The website offered a printed…

Nursing home report card and performance gap.

PubMed

Kim, Ae-Sook

2016-01-01

With the aging of our society, concerns about the quality of nursing homes have been increasing. The Nursing Home Compare (NHC) report card is believed to reduce information asymmetry between the facility and potential residents and, consequently, improve nursing home quality. However, there is limited evidence about how nursing homes use this publicly disseminated performance information. The aim of this study was to analyze the performance gap between nursing home administrators' self-assessment and the NHC report card performance ratings and explore the factors contributing to the gap. All 515 Medicare- and Medicaid-certified nursing homes in Indiana were surveyed between August and December 2013. The response rate was approximately 45%. The survey data were compared with the NHC data to identify the gap. Ordered logistic regression analysis was conducted. Despite voluntary participation, a reasonably high response rate, and anonymity, this study found that 62% of respondents either under- or overrated their facilities' performance, with the majority overrating their performance. The following factors were associated with a smaller performance gap: nonprofit or government-owned status, higher staffing levels, a higher percentage of hours worked by registered nurses, and a higher market concentration. Longer work experience and greater county occupancy rates were associated with a larger performance gap. The significant gap implies that administrators either do not regularly review the NHC report card or do not concur with the NHC ratings. To reduce the gap and thereby improve performance, it is necessary to stabilize the administrators' position so that administrators know how they stand in the market and are consequently better equipped to successfully respond to the market. Facilities may also need to provide regular training on current technologies and facilitate use of the NHC report card, targeting administrators who are old and have many years of work experience.

Telemedicine Versus Face-to-Face Evaluations by Respiratory Therapists of Mechanically Ventilated Neonates and Children: A Pilot Study.

PubMed

Bell, Rebecca C; Yager, Phoebe H; Clark, Maureen E; Roumiantsev, Serguei; Venancio, Heather L; Chipman, Daniel W; Kacmarek, Robert M; Noviski, Natan N

2016-02-01

Mechanical ventilation is one of the most important therapeutic interventions in neonatal and pediatric ICUs. Telemedicine has been shown to reliably extend pediatric intensivist expertise to facilities where expertise is limited. If reliable, telemedicine may extend the reach of pediatric respiratory therapists (RTs) to facilities where expertise does not exist or free up existing RT resources for important face-to-face activities in facilities where expertise is limited. The aim of this study was to determine how well respiratory assessments for ventilated neonates and children correlated when performed simultaneously by 2 RTs face-to-face and via telemedicine. We conducted a pilot study including 40 assessments by 16 RTs on 11 subjects (5 neonatal ICU; 6 pediatric ICU). Anonymously completed intake forms by 2 different RTs concurrently assessing 14 ventilator-derived and patient-based respiratory variables were used to determine correlations. Forty paired assessments were performed. Median telemedicine assessment time was 8 min. The Pearson correlation coefficient (r) was used to determine agreement between continuous data, and the Cohen kappa statistics were used for binary variables. Pressure control, PEEP, breathing frequency, and FIO2 perfectly correlated (r = 1, all P < .001) as did the presence of a CO2 monitor and need for increased ventilatory support (kappa = 1). The Pearson correlation coefficient for VT, minute ventilation, mean airway pressure, and oxygen saturation ranged from 0.84 to 0.97 (all P < .001). kappa = 0.41 (95% CI 0.02-0.80) for patient-triggered breaths, and kappa = 0.57 (95% CI 0.19-0.94) for breathing frequency higher than set frequency. kappa = -0.25 (95% CI -0.46 to -0.04) for need for suctioning. Telemedicine technology was acceptable to RTs. Telemedicine evaluations highly correlated with face-to-face for 10 of 14 aspects of standard bedside respiratory assessment. Poor correlation was noted for more complex, patient-generated parameters, highlighting the importance of further investigation incorporating a virtual stethoscope. Copyright © 2016 by Daedalus Enterprises.

ANTARES: Spacecraft Simulation for Multiple User Communities and Facilities

NASA Technical Reports Server (NTRS)

Acevedo, Amanda; Berndt, Jon; Othon, William; Arnold, Jason; Gay, Robet

2007-01-01

The Advanced NASA Technology Architecture for Exploration Studies (ANTARES) simulation is the primary tool being used for requirements assessment of the NASA Orion spacecraft by the Guidance Navigation and Control (GN&C) teams at Johnson Space Center (JSC). ANTARES is a collection of packages and model libraries that are assembled and executed by the Trick simulation environment. Currently, ANTARES is being used for spacecraft design assessment, performance analysis, requirements validation, Hardware In the Loop (HWIL) and Human In the Loop (HIL) testing.

Performance Contracting and Energy Efficiency in the State Government Market

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

Bharvirkar, Ranjit; Goldman, Charles; Gilligan, Donald

There is growing interest in energy efficiency (EE) among state policymakers as a result of increasing environmental concerns, rising electricity and natural gas prices, and lean economic times that motivate states to look more aggressively for cost-saving opportunities in public sector buildings. One logical place for state policymakers to demonstrate their commitment to energy efficiency is to 'lead by example' by developing and implementing strategies to reduce the energy consumption of state government facilities through investments in energy efficient technologies. Traditionally, energy efficiency improvements at state government facilities are viewed as a subset in the general category of building maintenancemore » and construction. These projects are typically funded through direct appropriations. However, energy efficiency projects are often delayed or reduced in scope whereby not all cost-effective measures are implemented because many states have tight capital budgets. Energy Savings Performance Contracting (ESPC) offers a potentially useful strategy for state program and facility managers to proactively finance and develop energy efficiency projects. In an ESPC project, Energy Service Companies (ESCOs) typically guarantee that the energy and cost savings produced by the project will equal or exceed all costs associated with implementing the project over the term of the contract. ESCOs typically provide turnkey design, installation, and maintenance services and also help arrange project financing. Between 1990 and 2006, U.S. ESCOs reported market activity of {approx}$28 Billion, with about {approx}75-80% of that activity concentrated in the institutional markets (K-12 schools, colleges/universities, state/local/federal government and hospitals). In this study, we review the magnitude of energy efficiency investment in state facilities and identify 'best practices' while employing performance contracting in the state government sector. The state government market is defined to include state offices, state universities, correctional facilities, and other state facilities. This study is part of a series of reports prepared by Lawrence Berkeley National Laboratory (LBNL) and the National Association of Energy Services Companies (NAESCO) on the ESCO market and industry trends. The scope of previous reports was much broader: Goldman et al. (2002) analyzed ESCO project costs and savings in public and private sector facilities, Hopper et al. (2005) focused on ESCO project activity in all public and institutional sectors, while Hopper et al (2007) provided aggregate results of a comprehensive survey of ESCOs on current industry activity and future prospects. We decided to focus the current study on ESCO and energy efficiency activity and potential market barriers in the state government market because previous studies suggested that this institutional sector has significant remaining energy efficiency opportunities. Moreover, ESCO activity in the state government market has lagged behind other institutional markets (e.g., K-12 schools, local governments, and the federal market). Our primary objectives were as follows: (1) Assess existing state agency energy information and data sources that could be utilized to develop performance metrics to assess progress among ESPC programs in states; (2) Conduct a comparative review of the performance of selected state ESPC programs in reducing energy usage and costs in state government buildings; and (3) Delineate the extent to which state government sector facilities are implementing energy efficiency projects apart from ESPC programs using other strategies (e.g. utility ratepayer-funded energy efficiency programs, loan funds).« less

40 CFR 125.137 - As an owner or operator of a new offshore oil and gas extraction facility, must I perform...

Code of Federal Regulations, 2014 CFR

2014-07-01

... offshore oil and gas extraction facility, must I perform monitoring? 125.137 Section 125.137 Protection of... operator of a new offshore oil and gas extraction facility, must I perform monitoring? As an owner or operator of a new offshore oil and gas extraction facility, you will be required to perform monitoring to...

40 CFR 125.137 - As an owner or operator of a new offshore oil and gas extraction facility, must I perform...

Code of Federal Regulations, 2012 CFR

2012-07-01

... offshore oil and gas extraction facility, must I perform monitoring? 125.137 Section 125.137 Protection of... operator of a new offshore oil and gas extraction facility, must I perform monitoring? As an owner or operator of a new offshore oil and gas extraction facility, you will be required to perform monitoring to...

40 CFR 125.137 - As an owner or operator of a new offshore oil and gas extraction facility, must I perform...

Code of Federal Regulations, 2013 CFR

2013-07-01

... offshore oil and gas extraction facility, must I perform monitoring? 125.137 Section 125.137 Protection of... operator of a new offshore oil and gas extraction facility, must I perform monitoring? As an owner or operator of a new offshore oil and gas extraction facility, you will be required to perform monitoring to...

40 CFR 125.137 - As an owner or operator of a new offshore oil and gas extraction facility, must I perform...

Code of Federal Regulations, 2011 CFR

2011-07-01

... offshore oil and gas extraction facility, must I perform monitoring? 125.137 Section 125.137 Protection of... operator of a new offshore oil and gas extraction facility, must I perform monitoring? As an owner or operator of a new offshore oil and gas extraction facility, you will be required to perform monitoring to...

Quality of Malaria Case Management in Malawi: Results from a Nationally Representative Health Facility Survey

PubMed Central

Steinhardt, Laura C.; Chinkhumba, Jobiba; Wolkon, Adam; Luka, Madalitso; Luhanga, Misheck; Sande, John; Oyugi, Jessica; Ali, Doreen; Mathanga, Don; Skarbinski, Jacek

2014-01-01

Background Malaria is endemic throughout Malawi, but little is known about quality of malaria case management at publicly-funded health facilities, which are the major source of care for febrile patients. Methods In April–May 2011, we conducted a nationwide, geographically-stratified health facility survey to assess the quality of outpatient malaria diagnosis and treatment. We enrolled patients presenting for care and conducted exit interviews and re-examinations, including reference blood smears. Moreover, we assessed health worker readiness (e.g., training, supervision) and health facility capacity (e.g. availability of diagnostics and antimalarials) to provide malaria case management. All analyses accounted for clustering and unequal selection probabilities. We also used survey weights to produce estimates of national caseloads. Results At the 107 facilities surveyed, most of the 136 health workers interviewed (83%) had received training on malaria case management. However, only 24% of facilities had functional microscopy, 15% lacked a thermometer, and 19% did not have the first-line artemisinin-based combination therapy (ACT), artemether-lumefantrine, in stock. Of 2,019 participating patients, 34% had clinical malaria (measured fever or self-reported history of fever plus a positive reference blood smear). Only 67% (95% confidence interval (CI): 59%, 76%) of patients with malaria were correctly prescribed an ACT, primarily due to missed malaria diagnosis. Among patients without clinical malaria, 31% (95% CI: 24%, 39%) were prescribed an ACT. By our estimates, 1.5 million of the 4.4 million malaria patients seen in public facilities annually did not receive correct treatment, and 2.7 million patients without clinical malaria were inappropriately given an ACT. Conclusions Malawi has a high burden of uncomplicated malaria but nearly one-third of all patients receive incorrect malaria treatment, including under- and over-treatment. To improve malaria case management, facilities must at minimum have basic case management tools, and health worker performance in diagnosing malaria must be improved. PMID:24586497

Quality of malaria case management in Malawi: results from a nationally representative health facility survey.

PubMed

Steinhardt, Laura C; Chinkhumba, Jobiba; Wolkon, Adam; Luka, Madalitso; Luhanga, Misheck; Sande, John; Oyugi, Jessica; Ali, Doreen; Mathanga, Don; Skarbinski, Jacek

2014-01-01

Malaria is endemic throughout Malawi, but little is known about quality of malaria case management at publicly-funded health facilities, which are the major source of care for febrile patients. In April-May 2011, we conducted a nationwide, geographically-stratified health facility survey to assess the quality of outpatient malaria diagnosis and treatment. We enrolled patients presenting for care and conducted exit interviews and re-examinations, including reference blood smears. Moreover, we assessed health worker readiness (e.g., training, supervision) and health facility capacity (e.g. availability of diagnostics and antimalarials) to provide malaria case management. All analyses accounted for clustering and unequal selection probabilities. We also used survey weights to produce estimates of national caseloads. At the 107 facilities surveyed, most of the 136 health workers interviewed (83%) had received training on malaria case management. However, only 24% of facilities had functional microscopy, 15% lacked a thermometer, and 19% did not have the first-line artemisinin-based combination therapy (ACT), artemether-lumefantrine, in stock. Of 2,019 participating patients, 34% had clinical malaria (measured fever or self-reported history of fever plus a positive reference blood smear). Only 67% (95% confidence interval (CI): 59%, 76%) of patients with malaria were correctly prescribed an ACT, primarily due to missed malaria diagnosis. Among patients without clinical malaria, 31% (95% CI: 24%, 39%) were prescribed an ACT. By our estimates, 1.5 million of the 4.4 million malaria patients seen in public facilities annually did not receive correct treatment, and 2.7 million patients without clinical malaria were inappropriately given an ACT. Malawi has a high burden of uncomplicated malaria but nearly one-third of all patients receive incorrect malaria treatment, including under- and over-treatment. To improve malaria case management, facilities must at minimum have basic case management tools, and health worker performance in diagnosing malaria must be improved.

Variation in Management of Patients With Obstructive Coronary Artery Disease: Insights From the Veterans Affairs Clinical Assessment and Reporting Tool (VA CART) Program.

PubMed

Sandhu, Amneet; Stanislawski, Maggie A; Grunwald, Gary K; Guinn, Kathryn; Valle, Javier; Matlock, Daniel; Ho, P Michael; Maddox, Thomas M; Bradley, Steven M

2017-09-12

Little is known about facility-level variation in the use of revascularization procedures for the management of stable obstructive coronary artery disease. Furthermore, it is unknown if variation in the use of coronary revascularization is associated with use of other cardiovascular procedures. We evaluated all elective coronary angiograms performed in the Veterans Affairs system between September 1, 2007, and December 31, 2011, using the Clinical Assessment and Reporting Tool and identified patients with obstructive coronary artery disease. Patients were considered managed with revascularization if they received percutaneous coronary intervention (PCI) or coronary artery bypass grafting within 30 days of diagnosis. We calculated risk-adjusted facility-level rates of overall revascularization, PCI, and coronary artery bypass grafting. In addition, we determined the association between facility-level rates of revascularization and post-PCI stress testing. Among 15 650 patients at 51 Veterans Affairs sites who met inclusion criteria, the median rate of revascularization was 59.6% (interquartile range, 55.7%-66.7%). Across all facilities, risk-adjusted rates of overall revascularization varied from 41.5% to 88.1%, rate of PCI varied from 23.2% to 80.6%, and rate of coronary artery bypass graftingvariedfrom 7.5% to 36.5%. Of 6179 patients who underwent elective PCI, the median rate of stress testing in the 2 years after PCI was 33.7% (interquartile range, 30.7%-47.1%). There was no evidence of correlation between facility-level rate of revascularization and follow-up stress testing. Within the Veterans Affairs system, we observed large facility-level variation in rates of revascularization for obstructive coronary artery disease, with variation driven primarily by PCI. There was no association between facility-level use of revascularization and follow-up stress testing, suggesting use rates are specific to a particular procedure and not a marker of overall facility-level use. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Transportation Infrastructure Robustness : Joint Engineering and Economic Analysis

DOT National Transportation Integrated Search

2017-11-01

The objectives of this study are to develop a methodology for assessing the robustness of transportation infrastructure facilities and assess the effect of damage to such facilities on travel demand and the facilities users welfare. The robustness...

78 FR 66911 - Texas Eastern Transmission, LP; Notice of Intent To Prepare an Environmental Assessment for the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-07

... mining of coal. The Commission will use this EA in its decision-making process to determine whether the... work to be performed for the planned longwall coal mining activities of Emerald Coal Resources, LP... pipeline facilities at their certificated design capacities during the planned longwall mining activities...

Anatomy Practical Examinations: How Does Student Performance on Computerized Evaluation Compare with the Traditional Format?

ERIC Educational Resources Information Center

Inuwa, Ibrahim Muhammad; Taranikanti, Varna; Al-Rawahy, Maimouna; Habbal, Omar

2012-01-01

Practical examinations in anatomy are usually conducted on specimens in the anatomy laboratory (referred to here as the "traditional" method). Recently, we have started to administer similar examinations online using the quiz facility in Moodle[TM]. In this study, we compare student scores between two assessment environments viz. online and…

Nurses' Assessment of Rehabilitation Potential and Prediction of Functional Status at Discharge from Inpatient Rehabilitation

ERIC Educational Resources Information Center

Myers, Jamie S.; Grigsby, Jim; Teel, Cynthia S.; Kramer, Andrew M.

2009-01-01

The goals of this study were to evaluate the accuracy of nurses' predictions of rehabilitation potential in older adults admitted to inpatient rehabilitation facilities and to ascertain whether the addition of a measure of executive cognitive function would enhance predictive accuracy. Secondary analysis was performed on prospective data collected…

Water, sanitation and hygiene infrastructure and quality in rural healthcare facilities in Rwanda.

PubMed

Huttinger, Alexandra; Dreibelbis, Robert; Kayigamba, Felix; Ngabo, Fidel; Mfura, Leodomir; Merryweather, Brittney; Cardon, Amelie; Moe, Christine

2017-08-03

WHO and UNICEF have proposed an action plan to achieve universal water, sanitation and hygiene (WASH) coverage in healthcare facilities (HCFs) by 2030. The WASH targets and indicators for HCFs include: an improved water source on the premises accessible to all users, basic sanitation facilities, a hand washing facility with soap and water at all sanitation facilities and patient care areas. To establish viable targets for WASH in HCFs, investigation beyond 'access' is needed to address the state of WASH infrastructure and service provision. Patient and caregiver use of WASH services is largely unaddressed in previous studies despite being critical for infection control. The state of WASH services used by staff, patients and caregivers was assessed in 17 rural HCFs in Rwanda. Site selection was non-random and predicated upon piped water and power supply. Direct observation and semi-structured interviews assessed drinking water treatment, presence and condition of sanitation facilities, provision of soap and water, and WASH-related maintenance and record keeping. Samples were collected from water sources and treated drinking water containers and analyzed for total coliforms, E. coli, and chlorine residual. Drinking water treatment was reported at 15 of 17 sites. Three of 18 drinking water samples collected met the WHO guideline for free chlorine residual of >0.2 mg/l, 6 of 16 drinking water samples analyzed for total coliforms met the WHO guideline of <1 coliform/100 mL and 15 of 16 drinking water samples analyzed for E. coli met the WHO guideline of <1 E. coli/100 mL. HCF staff reported treating up to 20 L of drinking water per day. At all sites, 60% of water access points (160 of 267) were observed to be functional, 32% of hand washing locations (46 of 142) had water and soap and 44% of sanitary facilities (48 of 109) were in hygienic condition and accessible to patients. Regular maintenance of WASH infrastructure consisted of cleaning; no HCF had on-site capacity for performing repairs. Quarterly evaluations of HCFs for Rwanda's Performance Based Financing system included WASH indicators. All HCFs met national policies for water access, but WHO guidelines for environmental standards including water quality were not fully satisfied. Access to WASH services at the HCFs differed between staff and patients and caregivers.

Recent Upgrades at the Safety and Tritium Applied Research Facility

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

Cadwallader, Lee Charles; Merrill, Brad Johnson; Stewart, Dean Andrew

This paper gives a brief overview of the Safety and Tritium Applied Research (STAR) facility operated by the Fusion Safety Program (FSP) at the Idaho National Laboratory (INL). FSP researchers use the STAR facility to carry out experiments in tritium permeation and retention in various fusion materials, including wall armor tile materials. FSP researchers also perform other experimentation as well to support safety assessment in fusion development. This lab, in its present two-building configuration, has been in operation for over ten years. The main experiments at STAR are briefly described. This paper discusses recent work to enhance personnel safety atmore » the facility. The STAR facility is a Department of Energy less than hazard category 3 facility; the personnel safety approach calls for ventilation and tritium monitoring for radiation protection. The tritium areas of STAR have about 4 to 12 air changes per hour, with air flow being once through and then routed to the facility vent stack. Additional radiation monitoring has been installed to read the laboratory room air where experiments with tritium are conducted. These ion chambers and bubblers are used to verify that no significant tritium concentrations are present in the experiment rooms. Standby electrical power has been added to the facility exhaust blower so that proper ventilation will now operate during commercial power outages as well as the real-time tritium air monitors.« less

42 CFR 413.343 - Resident assessment data.

Code of Federal Regulations, 2013 CFR

2013-10-01

...; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Prospective Payment for Skilled Nursing Facilities § 413.343 Resident assessment data. (a) Submission of resident assessment data...

42 CFR 413.343 - Resident assessment data.

Code of Federal Regulations, 2010 CFR

2010-10-01

...; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Prospective Payment for Skilled Nursing Facilities § 413.343 Resident assessment data. (a) Submission of resident assessment data...

Influence of environmental pollution with creosote oil or its vapors on biomass and selected physiological groups of microorganisms

NASA Astrophysics Data System (ADS)

Krzyśko-Łupicka, Teresa; Cybulska, Krystyna; Kołosowski, Paweł; Telesiński, Arkadiusz; Sudoł, Adam

2017-11-01

Survival of microorganisms in soils from treatment facility and landfill of wooden railway sleepers contaminated with creosote oil as well as in two types of soils with different content of organic carbon, treated with creosote oil vapors, was assessed. Microbiological assays including determination of: the biomass of living microorganisms method and the number of proteolytic, lipolytic and amylolytic microorganisms were carried out under laboratory conditions. Chromatography analysis of the soil extract from railway sleepers treatment facility was performed using GC/MS. The highest biomass and the number of tested microorganisms were determined in soils from wooden railway sleepers landfill, while the lowest in soil from the railway sleepers treatment facility. Vapors of creosote oil, regardless of the soil type, significantly increased only the number of lipolytic bacteria.

Hohlraum-driven mid-Z (SiO2) double-shell implosions on the omega laser facility and their scaling to NIF.

PubMed

Robey, H F; Amendt, P A; Milovich, J L; Park, H-S; Hamza, A V; Bono, M J

2009-10-02

High-convergence, hohlraum-driven implosions of double-shell capsules using mid-Z (SiO2) inner shells have been performed on the OMEGA laser facility [T. R. Boehly, Opt. Commun. 133, 495 (1997)]. These experiments provide an essential extension of the results of previous low-Z (CH) double-shell implosions [P. A. Amendt, Phys. Rev. Lett. 94, 065004 (2005)] to materials of higher density and atomic number. Analytic modeling, supported by highly resolved 2D numerical simulations, is used to account for the yield degradation due to interfacial atomic mixing. This extended experimental database from OMEGA enables a validation of the mix model, and provides a means for quantitatively assessing the prospects for high-Z double-shell implosions on the National Ignition Facility [Paisner, Laser Focus World 30, 75 (1994)].

Veg-01 Plant Harvest

NASA Image and Video Library

2014-06-10

Commander Steve Swanson harvests plants for the VEG-01 investigation. He is harvesting them on the Maintenance Work Area (MWA) in the Node 2/Harmony. The Veg-01 hardware validation test investigation utilizes the Veggie facility on ISS. This investigation will assess on-orbit function and performance of the Veggie,and focus on the growth and development of Outredgeous Lettuce (Lactuca sativa ) seedlings in the spaceflight environment and the effects of the spaceflight environment on composition of microbial flora on the Veggie-grown plants and the Veggie facility. Lettuce plants are harvested on-orbit, frozen at <-80oC and returned to the ground for post-flight evaluation. Microbial sampling swabs will be taken of the Veggie facility and plant material, frozen and returned to the ground for environmental microbiological examination. Rooting pillows and water sample syringes will also be returned for microbial sampling and root analysis.

Potential Impacts of Accelerated Climate Change

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

Leung, L. R.; Vail, L. W.

2016-05-31

This research project is part of the U.S. Nuclear Regulatory Commission’s (NRC’s) Probabilistic Flood Hazard Assessment (PFHA) Research plan in support of developing a risk-informed licensing framework for flood hazards and design standards at proposed new facilities and significance determination tools for evaluating potential deficiencies related to flood protection at operating facilities. The PFHA plan aims to build upon recent advances in deterministic, probabilistic, and statistical modeling of extreme precipitation events to develop regulatory tools and guidance for NRC staff with regard to PFHA for nuclear facilities. The tools and guidance developed under the PFHA plan will support and enhancemore » NRC’s capacity to perform thorough and efficient reviews of license applications and license amendment requests. They will also support risk-informed significance determination of inspection findings, unusual events, and other oversight activities.« less

Quality Improvement Intervention for Reduction of Redundant Testing.

PubMed

Ducatman, Alan M; Tacker, Danyel H; Ducatman, Barbara S; Long, Dustin; Perrotta, Peter L; Lawther, Hannah; Pennington, Kelly; Lander, Owen; Warden, Mary; Failinger, Conard; Halbritter, Kevin; Pellegrino, Ronald; Treese, Marney; Stead, Jeffrey A; Glass, Eric; Cianciaruso, Lauren; Nau, Konrad C

2017-01-01

Laboratory data are critical to analyzing and improving clinical quality. In the setting of residual use of creatine kinase M and B isoenzyme testing for myocardial infarction, we assessed disease outcomes of discordant creatine kinase M and B isoenzyme +/troponin I (-) test pairs in order to address anticipated clinician concerns about potential loss of case-finding sensitivity following proposed discontinuation of routine creatine kinase and creatine kinase M and B isoenzyme testing. Time-sequenced interventions were introduced. The main outcome was the percentage of cardiac marker studies performed within guidelines. Nonguideline orders dominated at baseline. Creatine kinase M and B isoenzyme testing in 7496 order sets failed to detect additional myocardial infarctions but was associated with 42 potentially preventable admissions/quarter. Interruptive computerized soft stops improved guideline compliance from 32.3% to 58% ( P < .001) in services not receiving peer leader intervention and to >80% ( P < .001) with peer leadership that featured dashboard feedback about test order performance. This successful experience was recapitulated in interrupted time series within 2 additional services within facility 1 and then in 2 external hospitals (including a critical access facility). Improvements have been sustained postintervention. Laboratory cost savings at the academic facility were estimated to be ≥US$635 000 per year. National collaborative data indicated that facility 1 improved its order patterns from fourth to first quartile compared to peer norms and imply that nonguideline orders persist elsewhere. This example illustrates how pathologists can provide leadership in assisting clinicians in changing laboratory ordering practices. We found that clinicians respond to local laboratory data about their own test performance and that evidence suggesting harm is more compelling to clinicians than evidence of cost savings. Our experience indicates that interventions done at an academic facility can be readily instituted by private practitioners at external facilities. The intervention data also supplement existing literature that electronic order interruptions are more successful when combined with modalities that rely on peer education combined with dashboard feedback about laboratory order performance. The findings may have implications for the role of the pathology laboratory in the ongoing pivot from quantity-based to value-based health care.

The medical director and quality requirements in the dialysis facility.

PubMed

Schiller, Brigitte

2015-03-06

Four decades after the successful implementation of the ESRD program currently providing life-saving dialysis therapy to >430,000 patients, the definitions of and demands for a high-quality program have evolved and increased at the same time. Through substantial technological advances ESRD care improved, with a predominant focus on the technical aspects of care and the introduction of medications such as erythropoiesis-stimulating agents and active vitamin D for anemia and bone disease management. Despite many advances, the size of the program and the increasingly older and multimorbid patient population have contributed to continuing challenges for providing consistently high-quality care. Medicare's Final Rule of the Conditions for Coverage (April 2008) define the medical director of the dialysis center as the leader of the interdisciplinary team and the person ultimately accountable for quality, safety, and care provided in the center. Knowledge and active leadership with a hands-on approach in the quality assessment and performance improvement process (QAPI) is essential for the achievement of high-quality outcomes in dialysis centers. A collaborative approach between the dialysis provider and medical director is required to optimize outcomes and deliver evidence-based quality care. In 2011 the Centers for Medicare & Medicaid Services introduced a pay-for-performance program-the ESRD quality incentive program (QIP)- with yearly varying quality metrics that result in payment reductions in subsequent years when targets are not achieved during the performance period. Success with the QIP requires a clear understanding of the structure, metrics, and scoring methods. Information on achievement and nonachievement is publicly available, both in facilities (through the facility performance score card) and on public websites (including Medicare's Dialysis Facility Compare). By assuming the leadership role in the quality program of dialysis facilities, the medical director is given an important opportunity to improve patients' lives and effect true change in a patient population dealing with a very challenging chronic disease. This article in the series on the role of the medical director summarizes the medical director's specific role in the quality improvement process in the dialysis facility and the associated requirements and programs, including QAPI and QIP. Copyright © 2015 by the American Society of Nephrology.

Evaluation of the Performance of Routine Information System Management (PRISM) framework: evidence from Uganda.

PubMed

Hotchkiss, David R; Aqil, Anwer; Lippeveld, Theo; Mukooyo, Edward

2010-07-03

Sound policy, resource allocation and day-to-day management decisions in the health sector require timely information from routine health information systems (RHIS). In most low- and middle-income countries, the RHIS is viewed as being inadequate in providing quality data and continuous information that can be used to help improve health system performance. In addition, there is limited evidence on the effectiveness of RHIS strengthening interventions in improving data quality and use. The purpose of this study is to evaluate the usefulness of the newly developed Performance of Routine Information System Management (PRISM) framework, which consists of a conceptual framework and associated data collection and analysis tools to assess, design, strengthen and evaluate RHIS. The specific objectives of the study are: a) to assess the reliability and validity of the PRISM instruments and b) to assess the validity of the PRISM conceptual framework. Facility- and worker-level data were collected from 110 health care facilities in twelve districts in Uganda in 2004 and 2007 using records reviews, structured interviews and self-administered questionnaires. The analysis procedures include Cronbach's alpha to assess internal consistency of selected instruments, test-retest analysis to assess the reliability and sensitivity of the instruments, and bivariate and multivariate statistical techniques to assess validity of the PRISM instruments and conceptual framework. Cronbach's alpha analysis suggests high reliability (0.7 or greater) for the indices measuring a promotion of a culture of information, RHIS tasks self-efficacy and motivation. The study results also suggest that a promotion of a culture of information influences RHIS tasks self-efficacy, RHIS tasks competence and motivation, and that self-efficacy and the presence of RHIS staff have a direct influence on the use of RHIS information, a key aspect of RHIS performance. The study results provide some empirical support for the reliability and validity of the PRISM instruments and the validity of the PRISM conceptual framework, suggesting that the PRISM approach can be effectively used by RHIS policy makers and practitioners to assess the RHIS and evaluate RHIS strengthening interventions. However, additional studies with larger sample sizes are needed to further investigate the value of the PRISM instruments in exploring the linkages between RHIS data quality and use, and health systems performance.

Assessing performance of Botswana’s public hospital system: the use of the World Health Organization Health System Performance Assessment Framework

PubMed Central

Seitio-Kgokgwe, Onalenna; Gauld, Robin DC; Hill, Philip C; Barnett, Pauline

2014-01-01

Background: Very few studies have assessed performance of Botswana public hospitals. We draw from a large research study assessing performance of the Botswana Ministry of Health (MoH) to evaluate the performance of public hospital system using the World Health Organization Health Systems Performance Assessment Framework (WHO HSPAF). We aimed to evaluate performance of Botswana public hospital system; relate findings of the assessment to the potential for improvements in hospital performance; and determine the usefulness of the WHO HSPAF in assessing performance of hospital systems in a developing country. Methods: This article is based on data collected from document analysis, 54 key informants comprising senior managers and staff of the MoH (N= 40) and senior officers from stakeholder organizations (N= 14), and surveys of 42 hospital managers and 389 health workers. Data from documents and transcripts were analyzed using content and thematic analysis while data analysis for surveys was descriptive determining proportions and percentages. Results: The organizational structure of the Botswana’s public hospital system, authority and decision-making are highly centralized. Overall physical access to health services is high. However, challenges in the distribution of facilities and inpatient beds create inequities and inefficiencies. Capacity of the hospitals to deliver services is limited by inadequate resources. There are significant challenges with the quality of care. Conclusion: While Botswana invested considerably in building hospitals around the country resulting in high physical access to services, the organization and governance of the hospital system, and inadequate resources limit service delivery. The ongoing efforts to decentralize management of hospitals to district level entities should be expedited. The WHO HSPAF enabled us to conduct a comprehensive assessment of the public hospital system. Though relatively new, this approach proved useful in this study. PMID:25279380

Waste management facility accident analysis (WASTE ACC) system: software for analysis of waste management alternatives

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

Kohout, E.F.; Folga, S.; Mueller, C.

1996-03-01

This paper describes the Waste Management Facility Accident Analysis (WASTE{underscore}ACC) software, which was developed at Argonne National Laboratory (ANL) to support the US Department of Energy`s (DOE`s) Waste Management (WM) Programmatic Environmental Impact Statement (PEIS). WASTE{underscore}ACC is a decision support and database system that is compatible with Microsoft{reg_sign} Windows{trademark}. It assesses potential atmospheric releases from accidents at waste management facilities. The software provides the user with an easy-to-use tool to determine the risk-dominant accident sequences for the many possible combinations of process technologies, waste and facility types, and alternative cases described in the WM PEIS. In addition, its structure willmore » allow additional alternative cases and assumptions to be tested as part of the future DOE programmatic decision-making process. The WASTE{underscore}ACC system demonstrates one approach to performing a generic, systemwide evaluation of accident risks at waste management facilities. The advantages of WASTE{underscore}ACC are threefold. First, the software gets waste volume and radiological profile data that were used to perform other WM PEIS-related analyses directly from the WASTE{underscore}MGMT system. Second, the system allows for a consistent analysis across all sites and waste streams, which enables decision makers to understand more fully the trade-offs among various policy options and scenarios. Third, the system is easy to operate; even complex scenario runs are completed within minutes.« less

DOSE PROFILE MODELING OF IDAHO NATIONAL LABORATORY’S ACTIVE NEUTRON INTERROGATION TEST FACILITY

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

D. L. Chichester; E. H. Seabury; J. M. Zabriskie

2009-06-01

A new research and development laboratory has been commissioned at Idaho National Laboratory for performing active neutron interrogation research and development. The facility is designed to provide radiation shielding for DT fusion (14.1 MeV) neutron generators (2 x 108 neutrons per second), DD fusion (2.5 MeV) neutron generators (up to 2 x 106 neutrons per second), and 252Cf spontaneous fission neutron sources (6.7 x 107 neutrons per second, 30 micrograms). Shielding at the laboratory is comprised of modular concrete shield blocks 0.76 m thick with tongue-in-groove features to prevent radiation streaming, arranged into one small and one large test vault.more » The larger vault is designed to allow operation of the DT generator and has walls 3.8 m tall, an entrance maze, and a fully integrated electrical interlock system; the smaller test vault is designed for 252Cf and DD neutron sources and has walls 1.9 m tall and a simple entrance maze. Both analytical calculations and numerical simulations were used in the design process for the building to assess the performance of the shielding walls and to ensure external dose rates are within required facility limits. Dose rate contour plots have been generated for the facility to visualize the effectiveness of the shield wall and entrance maze and to illustrate the spatial profile of the radiation dose field above the facility and the effects of skyshine around the vaults.« less

Historical Background on Assessment the Performance of the Waste Isolation Pilot Plant

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

Rechard, R.P.

1999-06-01

In 1979, six years after selecting the Delaware Basin as a potential disposal area, Congress authorized the US Department of Energy to build the Waste Isolation Pilot Plant (WIPP) near Carlsbad, New Mexico, as a research and development facility for the safe management, storage, and disposal of waste contaminated with transuranic radioisotopes. In 1998, 19 years after authorization and 25 years after site selection, the US Environmental Protection Agency (EPA) certified that the WIPP disposal system complied with its regulations. The EPA's decision was primarily based on the results from a performance assessment conducted in 1996. This performance assessment wasmore » the culmination of four preliminary performance assessments conducted between 1989 and 1992. This report provides a historical setting and context for how the performance of the deep geologic repository at the WIPP was analyzed. Also included is background on political forces acting on the project. For example, the federal requirement to provide environmental impact statements and negotiated agreements with the State of New Mexico influenced the type of scientific areas that were investigated and the engineering analysis prior to 1989 for the WIPP.« less

Theory of hydro-equivalent ignition for inertial fusion and its applications to OMEGA and the National Ignition Facility

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

Nora, R.; Betti, R.; Bose, A.

The theory of ignition for inertial confinement fusion capsules [R. Betti et al., Phys. Plasmas 17, 058102 (2010)] is used to assess the performance requirements for cryogenic implosion experiments on the Omega Laser Facility. The theory of hydrodynamic similarity is developed in both one and two dimensions and tested using multimode hydrodynamic simulations with the hydrocode DRACO [P. B. Radha et al., Phys. Plasmas 12, 032702 (2005)] of hydro-equivalent implosions (implosions with the same implosion velocity, adiabat, and laser intensity). The theory is used to scale the performance of direct-drive OMEGA implosions to the National Ignition Facility (NIF) energy scalesmore » and determine the requirements for demonstrating hydro-equivalent ignition on OMEGA. Hydro-equivalent ignition on OMEGA is represented by a cryogenic implosion that would scale to ignition on the NIF at 1.8 MJ of laser energy symmetrically illuminating the target. It is found that a reasonable combination of neutron yield and areal density for OMEGA hydro-equivalent ignition is 3 to 6 × 10{sup 13} and ∼0.3 g/cm{sup 2}, respectively, depending on the level of laser imprinting. This performance has not yet been achieved on OMEGA.« less

Respirator use and its impact on particulate matter exposure in aluminum manufacturing facilities.

PubMed

Liu, Sa; Noth, Elizabeth; Eisen, Ellen; Cullen, Mark R; Hammond, Katharine

2018-05-31

Objectives As part of a large epidemiologic study of particulate health effect, this study aimed to report respirator use among total particulate matter (TPM) samples collected in a major aluminum manufacturing company from 1966‒2013 and evaluate the impact of respirator-use adjustment on exposure estimation. Methods Descriptive analyses were performed to evaluate respirator use across facilities and by facility type and job. Protection factors were applied to TPM measurements for recorded respirator use. Estimated TPM exposure for each job ‒ before and after respirator-use adjustment ‒ were compared to assess the impact of adjustment on exposure estimation. Results Respirator use was noted for 37% of 12 402 full-shift personal TPM samples. Measured TPM concentration ranged from less than detectable to 8220 mg/m3, with arithmetic mean, median and standard deviation being 10.6, 0.87 and 130 mg/m 3 , respectively. Respirators were used more often in smelting facilities (52% of TPM measurements) than in fabricating (17%) or refinery facilities (28%) (P<0.01). Sixty-two percent of jobs in smelting facilities were subject to respirator-use adjustment, whereas it was 20% and 70% in fabricating and refinery facilities, respectively. Applying protection factors to TPM measurements significantly reduced estimated job mean TPM exposures and changed exposure categories in these facilities, with larger impact in smelting than fabricating facilities. Conclusions Respirator use varied by time, facility and job. Adjusting respirator use resulted in differential impact in smelting and fabricating facilities, which will need to be incorporated into ongoing epidemiologic studies accordingly.

Performance of indirectly driven capsule implosions on the National Ignition Facility using adiabat-shaping

DOE PAGES

Robey, H. F.; Smalyuk, V. A.; Milovich, J. L.; ...

2016-04-01

A series of indirectly driven capsule implosions has been performed on the National Ignition Facility to assess the relative contributions of ablation-front instability growth vs. fuel compression on implosion performance. Laser pulse shapes for both low and high-foot pulses were modified to vary ablation-front growth & fuel adiabat, separately and controllably. Two principal conclusions are drawn from this study: 1) It is shown that an increase in laser picket energy reduces ablation-front instability growth in low-foot implosions resulting in a substantial (3-10X) increase in neutron yield with no loss of fuel compression. 2.) It is shown that a decrease inmore » laser trough power reduces the fuel adiabat in high-foot implosions results in a significant (36%) increase in fuel compression together with no reduction in neutron yield. These results taken collectively bridge the space between the higher compression low-foot results and the higher yield high-foot results.« less

Agility assessment using fuzzy logic approach: a case of healthcare dispensary.

PubMed

Suresh, M; Patri, Rojalin

2017-06-09

Agile concepts are not only beneficial for manufacturing sector but also for service sector such as healthcare. However, assessment of agility has been predominantly done in manufacturing enterprises. This study demonstrates a means to measure agility of a healthcare organization by assessing agility of a university dispensary. Its contribution to the knowledge base is twofold. First, it proposes a means to measure the agility of a healthcare organization and second, it identifies the attributes that prevent agile performance and outlines the suggestive measure to enhance its agile capabilities. A case study approach has been adopted and fuzzy logic has been employed to measure the agility of the case dispensary. At first, the measures of assessment which include four enablers, fifteen criteria and forty-five attributes have been identified from the literature and rated by the experts indicating the importance of the measures in the assessment. Then, the case dispensary has been assessed on those measures by collecting observed performance rating from decision makers. At last, Fuzzy logic has been applied on the performance rating data to analyze and interpret the agile capability of the dispensary. The findings suggest that transparent information flow, adequate salary and bonuses for caregivers, reading error in medical descriptions, in house/nearby pathology laboratory services, technical up-gradation of dispensary equipments and facilities, minimization of patient throughput time and adequate training programme for safety practices are the attributes that weakens agile capability of the University dispensary. The current agility of the dispensary was found to be 'Agile' which is average in relation to the agility labels. Attributes such as transparent information flow, adequate salary and bonuses for caregivers, elimination of reading error in medical descriptions, in house/nearby pathology laboratory services, technical up-gradation of dispensary equipments and facilities, minimization of patient throughput time and adequate training programme for safety practices are extremely crucial for enhancing agile capability of a healthcare organization.

Taurus II Stage Test Simulations: Using Large-Scale CFD Simulations to Provide Critical Insight into Plume Induced Environments During Design

NASA Technical Reports Server (NTRS)

Struzenberg, L. L.; West, J. S.

2011-01-01

This paper describes the use of targeted Loci/CHEM CFD simulations to evaluate the effects of a dual-engine first-stage hot-fire test on an evolving integrated launch pad/test article design. This effort was undertaken as a part of the NESC Independent Assessment of the Taurus II Stage Test Series. The underlying conceptual model included development of a series of computational models and simulations to analyze the plume induced environments on the pad, facility structures and test article. A pathfinder simulation was first developed, capable of providing quick-turn around evaluation of plume impingement pressures on the flame deflector. Results from this simulation were available in time to provide data for an ongoing structural assessment of the deflector. The resulting recommendation was available in a timely manner and was incorporated into construction schedule for the new launch stand under construction at Wallops Flight Facility. A series of Reynolds-Averaged Navier-Stokes (RANS) quasi-steady simulations representative of various key elements of the test profile was performed to identify potential concerns with the test configuration and test profile. As required, unsteady Hybrid-RANS/LES simulations were performed, to provide additional insight into critical aspects of the test sequence. Modifications to the test-specific hardware and facility structures thermal protection as well as modifications to the planned hot-fire test profile were implemented based on these simulation results.

Dynamics of aircraft antiskid braking systems. [conducted at the Langley aircraft landing loads and traction facility

NASA Technical Reports Server (NTRS)

Tanner, J. A.; Stubbs, S. M.; Dreher, R. C.; Smith, E. G.

1982-01-01

A computer study was performed to assess the accuracy of three brake pressure-torque mathematical models. The investigation utilized one main gear wheel, brake, and tire assembly of a McDonnell Douglas DC-9 series 10 airplane. The investigation indicates that the performance of aircraft antiskid braking systems is strongly influenced by tire characteristics, dynamic response of the antiskid control valve, and pressure-torque response of the brake. The computer study employed an average torque error criterion to assess the accuracy of the models. The results indicate that a variable nonlinear spring with hysteresis memory function models the pressure-torque response of the brake more accurately than currently used models.

Savannah River Laboratory quality assurance manual. Revision 2

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

Not Available

1985-02-01

The SRL quality assurance program is a management activity that verifies that the results of our research and development are adequate for their intended use and that our facilities function properly. The program is based on Savannah River Quality Assurance Plan (DPW-82-111-2, Rev 0) as applied through Quality Assurance Procedures and Divisional Plans (following section). The AED policy states that ''all activities shall be conducted to achieve a high quality of product and performance...'' The policy contains 18 considerations to be applied ''proportional to needs, based on the technical and professional judgment of responsible Du Pont employees.'' Quality is themore » responsibility of each individual and his line organization, as is safety. To ensure that quality is being considered for all SRL activities, all research programs are reviewed, and all facilities are assessed. These assessments and reviews are the nucleus of the Quality Assurance program.« less

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.

The MOVE study: a study protocol for a randomised controlled trial assessing interventions to maximise attendance at physical activity facilities.

PubMed

Newton, Joshua D; Klein, Ruth; Bauman, Adrian; Newton, Fiona J; Mahal, Ajay; Gilbert, Kara; Piterman, Leon; Ewing, Michael T; Donovan, Robert J; Smith, Ben J

2015-04-18

Physical activity is associated with a host of health benefits, yet many individuals do not perform sufficient physical activity to realise these benefits. One approach to rectifying this situation is through modifying the built environment to make it more conducive to physical activity, such as by building walking tracks or recreational physical activity facilities. Often, however, modifications to the built environment are not connected to efforts aimed at encouraging their use. The purpose of the Monitoring and Observing the Value of Exercise (MOVE) study is to evaluate the effectiveness of two interventions designed to encourage the ongoing use of a new, multi-purpose, community-based physical activity facility. A two-year, randomised controlled trial with yearly survey points (baseline, 12 months follow-up, 24 months follow-up) will be conducted among 1,300 physically inactive adult participants aged 18-70 years. Participants will be randomly assigned to one of three groups: control, intervention 1 (attendance incentives), or intervention 2 (attendance incentives and tailored support following a model based on customer relationship management). Primary outcome measures will include facility usage, physical activity participation, mental and physical wellbeing, community connectedness, social capital, friendship, and social support. Secondary outcome measures will include stages of change for facility usage and social cognitive decision-making variables. This study will assess whether customer relationship management systems, a tool commonly used in commercial marketing settings, can encourage the ongoing use of a physical activity facility. Findings may also indicate the population segments among which the use of such systems are most effective, as well as their cost-effectiveness. Australian New Zealand Clinical Trials Registry: ACTRN12615000012572 (registered 9 January 2015).

Air modelling as an alternative to sampling for low-level radioactive airborne releases

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

Morgenstern, M.Y.; Hueske, K.

1995-05-01

This paper describes our efforts to assess the effect of airborne releases at one DOE laboratory using air modelling based on historical data. Among the facilities affected by these developments is Los Alamos National Laboratory (LANL) in New Mexico. RCRA, as amended by the Hazardous and Solid Waste Amendments (HSWA) in 1984, requires all facilities which involve the treatment, storage, and disposal of hazardous waste obtain a RCRA/HSWA waste facility permit. LANL complied with CEARP by initiating a process of identifying potential release sites associated with LANL operations prior to filing a RCRA/HSWA permit application. In the process of preparingmore » the RCRA/HSWA waste facility permit application to the U.S. Environmental Protection Agency (EPA), a total of 603 Solid Waste Management Units (SWMUs) were identified as part of the requirements of the HSWA Module VIH permit requirements. The HSWA Module VIII permit requires LANL to determine whether there have been any releases of hazardous waste or hazardous constituents from SWMUs at the facility dating from the 1940`s by performing a RCRA Facility Investigation to address known or suspected releases from specified SWMUs to affected media (i.e. soil, groundwater, surface water, and air). Among the most troublesome of the potential releases sites are those associated with airborne radioactive releases. In order to assess health risks associated with radioactive contaminants in a manner consistent with exposure standards currently in place, the DOE and LANL have established Screening Action Levels (SALs) for radioactive soil contamination. The SALs for each radionuclide in soil are derived from calculations based on a residential scenario in which individuals are exposed to contaminated soil via inhalation and ingestion as well as external exposure to gamma emitters in the soil. The applicable SALs are shown.« less

Final postflight hardware evaluation report RSRM-32 (STS-57)

NASA Technical Reports Server (NTRS)

Nielson, Greg

1993-01-01

This document is the final report for the postflight assessment of the RSRM-32 (STS-57) flight set. This report presents the disassembly evaluations performed at the Thiokol facilities in Utah and is a continuation of the evaluations performed at KSC (TWR-64239). The PEEP for this assessment is outlined in TWR-50051, Revision B. The PEEP defines the requirements for evaluating RSRM hardware. Special hardware issues pertaining to this flight set requiring additional or modified assessment are outlined in TWR-64237. All observed hardware conditions were documented on PFOR's which are included in Appendix A. Observations were compared against limits defined in the PEEP. Any observation that was categorized as reportable or had no defined limits was documented on a preliminary PFAR by the assessment engineers. Preliminary PFAR's were reviewed by the Thiokol SPAT Executive Board to determine if elevation to PFAR's was required.

The effects of small-scale, homelike facilities for older people with dementia on residents, family caregivers and staff: design of a longitudinal, quasi-experimental study.

PubMed

Verbeek, Hilde; van Rossum, Erik; Zwakhalen, Sandra M G; Ambergen, Ton; Kempen, Gertrudis I J M; Hamers, Jan P H

2009-01-20

Small-scale and homelike facilities for older people with dementia are rising in current dementia care. In these facilities, a small number of residents live together and form a household with staff. Normal, daily life and social participation are emphasized. It is expected that these facilities improve residents' quality of life. Moreover, it may have a positive influence on staff's job satisfaction and families involvement and satisfaction with care. However, effects of these small-scale and homelike facilities have hardly been investigated. Since the number of people with dementia increases, and institutional long-term care is more and more organized in small-scale and homelike facilities, more research into effects is necessary. This paper presents the design of a study investigating effects of small-scale living facilities in the Netherlands on residents, family caregivers and nursing staff. A longitudinal, quasi-experimental study is carried out, in which 2 dementia care settings are compared: small-scale living facilities and regular psychogeriatric wards in traditional nursing homes. Data is collected from residents, their family caregivers and nursing staff at baseline and after 6 and 12 months of follow-up. Approximately 2 weeks prior to baseline measurement, residents are screened on cognition and activities of daily living (ADL). Based on this screening profile, residents in psychogeriatric wards are matched to residents living in small-scale living facilities. The primary outcome measure for residents is quality of life. In addition, neuropsychiatric symptoms, depressive symptoms and social engagement are assessed. Involvement with care, perceived burden and satisfaction with care provision are primary outcome variables for family caregivers. The primary outcomes for nursing staff are job satisfaction and motivation. Furthermore, job characteristics social support, autonomy and workload are measured. A process evaluation is performed to investigate to what extent small-scale living facilities and psychogeriatric wards are designed as they were intended. In addition, participants' satisfaction and experiences with small-scale living facilities are investigated. A longitudinal, quasi-experimental study is presented to investigate effects of small-scale living facilities. Although some challenges concerning this design exist, it is currently the most feasible method to assess effects of this relatively new dementia care setting.

Simplified spacecraft vulnerability assessments at component level in early design phase at the European Space Agency's Concurrent Design Facility

NASA Astrophysics Data System (ADS)

Kempf, Scott; Schäfer, Frank K.; Cardone, Tiziana; Ferreira, Ivo; Gerené, Sam; Destefanis, Roberto; Grassi, Lilith

2016-12-01

During recent years, the state-of-the-art risk assessment of the threat posed to spacecraft by micrometeoroids and space debris has been expanded to the analysis of failure modes of internal spacecraft components. This method can now be used to perform risk analyses for satellites to assess various failure levels - from failure of specific sub-systems to catastrophic break-up. This new assessment methodology is based on triple-wall ballistic limit equations (BLEs), specifically the Schäfer-Ryan-Lambert (SRL) BLE, which is applicable for describing failure threshold levels for satellite components following a hypervelocity impact. The methodology is implemented in the form of the software tool Particle Impact Risk and vulnerability Analysis Tool (PIRAT). During a recent European Space Agency (ESA) funded study, the PIRAT functionality was expanded in order to provide an interface to ESA's Concurrent Design Facility (CDF). The additions include a geometry importer and an OCDT (Open Concurrent Design Tool) interface. The new interface provides both the expanded geometrical flexibility, which is provided by external computer aided design (CAD) modelling, and an ease of import of existing data without the need for extensive preparation of the model. The reduced effort required to perform vulnerability analyses makes it feasible for application during early design phase, at which point modifications to satellite design can be undertaken with relatively little extra effort. The integration of PIRAT in the CDF represents the first time that vulnerability analyses can be performed in-session in ESA's CDF and the first time that comprehensive vulnerability studies can be applied cost-effectively in early design phase in general.