Multiloop Integral System Test (MIST): MIST Facility Functional Specification

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

Habib, T F; Koksal, C G; Moskal, T E

1991-04-01

The Multiloop Integral System Test (MIST) is part of a multiphase program started in 1983 to address small-break loss-of-coolant accidents (SBLOCAs) specific to Babcock and Wilcox designed plants. MIST is sponsored by the US Nuclear Regulatory Commission, the Babcock Wilcox Owners Group, the Electric Power Research Institute, and Babcock and Wilcox. The unique features of the Babcock and Wilcox design, specifically the hot leg U-bends and steam generators, prevented the use of existing integral system data or existing integral facilities to address the thermal-hydraulic SBLOCA questions. MIST was specifically designed and constructed for this program, and an existing facility --more » the Once Through Integral System (OTIS) -- was also used. Data from MIST and OTIS are used to benchmark the adequacy of system codes, such as RELAP5 and TRAC, for predicting abnormal plant transients. The MIST Functional Specification documents as-built design features, dimensions, instrumentation, and test approach. It also presents the scaling basis for the facility and serves to define the scope of work for the facility design and construction. 13 refs., 112 figs., 38 tabs.« less

26 CFR 1.168A-6 - Depreciation of portion of emergency facility not subject to amortization.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Depreciation of portion of emergency facility... for Individuals and Corporations § 1.168A-6 Depreciation of portion of emergency facility not subject... in lieu of any deduction for depreciation which would otherwise be allowable under section 167 is...

Hospital Ownership of a Postacute Care Facility Influences Discharge Destinations After Emergent Surgery.

PubMed

Abdelsattar, Zaid M; Gonzalez, Andrew A; Hendren, Samantha; Regenbogen, Scott E; Wong, Sandra L

2016-08-01

The aim of the study was to identify hospital characteristics associated with variation in patient disposition after emergent surgery. Colon resections in elderly patients are often done in emergent settings. Although these operations are known to be riskier, there are limited data regarding postoperative discharge destination. We evaluated Medicare beneficiaries who underwent emergent colectomy between 2008 and 2010. Using hierarchical logistic regression, we estimated patient and hospital-level risk-adjusted rates of nonhome discharges. Hospitals were stratified into quintiles based on their nonhome discharge rates. Generalized linear models were used to identify hospital structural characteristics associated with nonhome discharges (comparing discharge to skilled nursing facilities vs home with/without home health services). Of the 122,604 patients surviving to discharge after emergent colectomy at 3012 hospitals, 46.7% were discharged to a nonhome destination. There was a wide variation in risk and reliability-adjusted nonhome discharge rates across hospitals (15% to 80%). Patients at hospitals in the highest quintile of nonhome discharge rates were more likely to have longer hospitalizations (15.1 vs 13.2; P < 0.001) and more complications (43.2% vs 34%; P < 0.001). On multivariable analysis, only hospital ownership of a skilled nursing facility (P < 0.001), teaching status (P = 0.025), and low nurse-to-patient ratios (P = 0.002) were associated with nonhome discharges. Nearly half of Medicare beneficiaries are discharged to a nonhome destination after emergent colectomy. Hospital ownership of a skilled nursing facility and low nurse-to-patient ratios are highly associated with nonhome discharges. This may signify the underlying financial incentives to preferentially utilize postacute care facilities under the traditional fee-for-service payment model.

Mediating Systems of Care: Emergency Calls to Long-Term Care Facilities at Life's End.

PubMed

Waldrop, Deborah P; McGinley, Jacqueline M; Clemency, Brian

2018-04-09

Nursing home (NH) residents account for over 2.2 million emergency department visits yearly; the majority are cared for and transported by prehospital providers (emergency medical technicians and paramedics). The purpose of this study was to investigate prehospital providers' perceptions of emergency calls at life's end. This article focuses on perceptions of end-of-life calls in long-term care (LTC). This pilot study employed a descriptive cross-sectional design. Concepts from the symbolic interaction theory guided the exploration of perceptions and interpretations of emergency calls in LTC facilities. A purposeful sample of prehospital providers was developed from one agency in a small northeastern U.S. city. Semistructured interviews were conducted with 43 prehospital providers to explore their perceptions of factors that trigger emergency end-of-life calls in LTC facilities. Qualitative data analysis involved iterative coding in an inductive process that included open, systematic, focused, and axial coding. Interview themes illustrated the contributing factors as follows: care crises; dying-related turmoil; staffing ratios; and organizational protocols. Distress was crosscutting and present in all four themes. The findings illuminate how prehospital providers become mediators between NHs and emergency departments by managing tension, conflict, and challenges in patient care between these systems and suggest the importance of further exploration of interactions between LTC staff, prehospital providers, and emergency departments. Enhanced communication between LTC facilities and prehospital providers is important to address potentially inappropriate calls and transport requests and to identify means for collaboration in the care of sick frail residents.

Review of emergency obstetric care interventions in health facilities in the Upper East Region of Ghana: a questionnaire survey.

PubMed

Kyei-Onanjiri, Minerva; Carolan-Olah, Mary; Awoonor-Williams, John Koku; McCann, Terence V

2018-03-15

Maternal morbidity and mortality is most prevalent in resource-poor settings such as sub-Saharan Africa and southern Asia. In sub-Saharan Africa, Ghana is one of the countries still facing particular challenges in reducing its maternal morbidity and mortality. Access to emergency obstetric care (EmOC) interventions has been identified as a means of improving maternal health outcomes. Assessing the range of interventions provided in health facilities is, therefore, important in determining capacity to treat obstetric emergencies. The aim of this study was to examine the availability of emergency obstetric care interventions in the Upper East Region of Ghana. A cross-sectional survey of 120 health facilities was undertaken. Status of emergency obstetric care was assessed through an interviewer administered questionnaire to directors/in-charge officers of maternity care units in selected facilities. Data were analysed using descriptive statistics. Eighty per cent of health facilities did not meet the criteria for provision of emergency obstetric care. Comparatively, private health facilities generally provided EmOC interventions less frequently than public health facilities. Other challenges identified include inadequate skill mix of maternity health personnel, poor referral processes, a lack of reliable communication systems and poor emergency transport systems. Multiple factors combine to limit women's access to a range of essential maternal health services. The availability of EmOC interventions was found to be low across the region; however, EmOC facilities could be increased by nearly one-third through modest investments in some existing facilities. Also, the key challenges identified in this study can be improved by enhancing pre-existing health system structures such as Community-based Health Planning and Services (CHPS), training more midwifery personnel, strengthening in-service training and implementation of referral audits as part of health service

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

PubMed Central

2017-01-01

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

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

PubMed

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

2017-01-01

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

Report: EPA Lacks Internal Controls to Prevent Misuse of Emergency Drinking Water Facilities

EPA Pesticide Factsheets

Report #11-P-0001, October 12, 2010. EPA cannot accurately assess the risk of public water systems delivering contaminated drinking water from emergency facilities because of limitations in Safe Drinking Water Information System (SDWIS) data management.

Inter-facility transfer of surgical emergencies in a developing country: effects on management and surgical outcomes.

PubMed

Khan, Salma; Zafar, Hasnain; Zafar, Syed Nabeel; Haroon, Naveed

2014-02-01

Outcomes of surgical emergencies are associated with promptness of the appropriate surgical intervention. However, delayed presentation of surgical patients is common in most developing countries. Delays commonly occur due to transfer of patients between facilities. The aim of the present study was to assess the effect of delays in treatment caused by inter-facility transfers of patients presenting with surgical emergencies as measured by objective and subjective parameters. We prospectively collected data on all patients presenting with an acute surgical emergency at Aga Khan University Hospital (AKUH). Information regarding demographics, social class, reason and number of transfers, and distance traveled were collected. Patients were categorized into two groups, those transferred to AKUH from another facility (transferred) and direct arrivals (non-transfers). Differences between presenting physiological parameters, vital statistics, and management were tested between the two groups by the chi square and t tests. Ninety-nine patients were included, 49 (49.5 %) patients having been transferred from another facility. The most common reason for transfer was "lack of satisfactory surgical care." There were significant differences in presenting pulse, oxygen saturation, respiratory rate, fluid for resuscitation, glasgow coma scale, and revised trauma score (all p values <0.001) between transferred and non-transferred patients. In 56 patients there was a further delay in admission, and the most common reason was bed availability, followed by financial constraints. Three patients were shifted out of the hospital due to lack of ventilator, and 14 patients left against medical advice due to financial limitations. One patient died. Inter-facility transfer of patients with surgical emergencies is common. These patients arrive with deranged physiology which requires complex and prolonged hospital care. Patients who cannot afford treatment are most vulnerable to transfers and

40 CFR 355.10 - Must my facility comply with the emergency planning requirements of this subpart?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 28 2011-07-01 2011-07-01 false Must my facility comply with the emergency planning requirements of this subpart? 355.10 Section 355.10 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS...

Clinical audit of emergency unit before and after establishment of the emergency medicine department.

PubMed

Amini, Afshin; Dindoost, Payam; Moghimi, Mehrdad; Kariman, Hamid; Shahrami, Ali; Dolatabadi, Ali Arhami; Ali-Mohammadi, Hossein; Alavai-Moghaddam, Mostafa; Derakhshanfar, Hojjat; Hatamabadi, HamidReza; Heidari, Kamran; Alamdari, Shahram; Meibodi, Mohammad Kalantar; Shojaee, Majid; Foroozanfar, Mohammad Mehdi; Hashemi, Behrooz; Sabzeghaba, Anita; Kabir, Ali

2012-02-01

To assess the deficiencies and potential areas through a medical audit of the emergency departments, in six general hospitals affiliated to Shahid Beheshti University of Medical Sciences at Tehran, Iran, after preparing specific wards-based international standards. A checklist was completed for all hospitals which met our eligibility criteria mainly observation and interviews with head nurses and managers of the emergency medicine unit of the hospitals before (2003) and after (2008) the establishment of emergency departments there. Domains studied included staffing, education and continuing professional development (CPD), facility (design), equipment, ancillary services, medical records, manuals and references, research, administration, pre-hospital care, information systems, disaster planning, bench-marking and hospital accreditation. Education and CPD (p = 0.042), design and facility (p = 0.027), equipment (p = 0.028), and disaster (p = 0.026) had significantly improved after the establishment of emergency departments. Nearly all domains showed a positive change though it was non-significant in a few. In terms of observation, better improvement was seen in disaster, security, design, and research. According to the score for each domain compared to what it was in the earlier phase, better improvement was observed in hospital accreditation, information systems, security, disaster planning, and research. Security, disaster planning, research, design and facility had improved in hospitals that wave studied, while equipment, records, ancillary services, administration and bench-marking had the lowest improvement even after the establishment of emergency department, and, hence, needed specific attention.

Emergency department access targets and the older patient: a retrospective cohort study of emergency department presentations by people living in residential aged care facilities.

PubMed

Street, Maryann; Marriott, Jonathon R; Livingston, Patricia M

2012-11-01

There is limited research on the effect of emergency access targets on health outcomes for older patients from Residential Aged Care Facilities. The aims were to: (1) identify length of stay for Residential Aged Care patients relative to access targets; and (2) examine hospital admission rates, readmission rates, inpatient costs and mortality. Retrospective cohort study of all emergency presentations for Residential Aged Care patients in 2009 at one Australian metropolitan health service. The 4637 emergency presentations by 3184 Residential Aged Care patients in 2009 represented 3.4% of all emergency presentations. Mean length of stay was 7.9 hours (SD=4.5 hours); 84% of Residential Aged Care patients remained in the Emergency Department longer than four hours. Admitted patients were 3.6 times more likely to spend more than eight hours in the Emergency Department compared with those not admitted (p<0.001). Patients in the urgent triage category were 9.5 times more likely to spend more than eight hours in the Emergency Department compared to patients triaged as non-urgent (p<0.001). Inpatient costs were associated with length of admission and median cost per day was $AUD 1175. Few Residential Aged Care patients were discharged within the four hours access target. This has implications for health care outcomes and costs associated with providing emergency care for patients living in Residential Aged Care Facilities. Copyright © 2012 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

10 CFR Appendix E to Part 50 - Emergency Planning and Preparedness for Production and Utilization Facilities

Code of Federal Regulations, 2013 CFR

2013-01-01

... organization shall be described. The communication steps to be taken to alert or activate emergency personnel... operations facility must include the following: (1) Space for members of an NRC site team and Federal, State, and local responders; (2) Additional space for conducting briefings with emergency response personnel...

10 CFR Appendix E to Part 50 - Emergency Planning and Preparedness for Production and Utilization Facilities

Code of Federal Regulations, 2014 CFR

2014-01-01

... organization shall be described. The communication steps to be taken to alert or activate emergency personnel... operations facility must include the following: (1) Space for members of an NRC site team and Federal, State, and local responders; (2) Additional space for conducting briefings with emergency response personnel...

10 CFR Appendix E to Part 50 - Emergency Planning and Preparedness for Production and Utilization Facilities

Code of Federal Regulations, 2012 CFR

2012-01-01

... organization shall be described. The communication steps to be taken to alert or activate emergency personnel... operations facility must include the following: (1) Space for members of an NRC site team and Federal, State, and local responders; (2) Additional space for conducting briefings with emergency response personnel...

10 CFR 205.379 - Application for approval of the installation of permanent facilities for emergency use only.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PROCEDURES AND SANCTIONS Electric Power System Permits and Reports; Applications; Administrative Procedures and Sanctions Emergency Interconnection of Electric Facilities and the Transfer of Electricity to Alleviate An Emergency Shortage of Electric Power § 205.379 Application for approval of the installation of...

Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities.

PubMed

Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

2014-01-01

Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs' decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: "degree of perceived risk in EMS staffs and their patients." This theme consisted of two main categories: (1) patient's condition' and (2) the context of the EMS mission'. The patent's condition category emerged from "physical health statuses," "socioeconomic statuses," and "cultural background" subcategories. The context of the EMS mission also emerged from two subcategories of "characteristics of the mission" and EMS staffs characteristics'. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients' needs for transportation in a prehospital situation.

Towards the 21st Century. Facilities for Tertiary Education.

ERIC Educational Resources Information Center

Corbett, Anne, Ed.

This report presents observations of experts in planning, design, construction or management of tertiary educational facilities about the emerging issues and the appropriate planning and architectural solutions for higher education facilities as the new millennium approaches. Specific topics discuss the current context of tertiary education…

Improved E-ELT subsystem and component specifications, thanks to M1 test facility

NASA Astrophysics Data System (ADS)

Dimmler, M.; Marrero, J.; Leveque, S.; Barriga, Pablo; Sedghi, B.; Kornweibel, N.

2014-07-01

During the last 2 years ESO has operated the "M1 Test Facility", a test stand consisting of a representative section of the E-ELT primary mirror equipped with 4 complete prototype segment subunits including sensors, actuators and control system. The purpose of the test facility is twofold: it serves to study and get familiar with component and system aspects like calibration, alignment and handling procedures and suitable control strategies on real hardware long before the primary mirror (hereafter M1) components are commissioned. Secondly, and of major benefit to the project, it offered the possibility to evaluate component and subsystem performance and interface issues in a system context in such detail, that issues could be identified early enough to feed back into the subsystem and component specifications. This considerably reduces risk and cost of the production units and allows refocusing the project team on important issues for the follow-up of the production contracts. Experiences are presented in which areas the results of the M1 Test Facility particularly helped to improve subsystem specifications and areas, where additional tests were adopted independent of the main test facility. Presented are the key experiences of the M1 Test Facility which lead to improved specifications or identified the need for additional testing outside of the M1 Test Facility.

Spatial accessibility to specific sport facilities and corresponding sport practice: the RECORD Study

PubMed Central

2013-01-01

Background Physical activity is considered as a major component of a healthy lifestyle. However, few studies have examined the relationships between the spatial accessibility to sport facilities and sport practice with a sufficient degree of specificity. The aim of this study was to investigate the associations between the spatial accessibility to specific types of sports facilities and the practice of the corresponding sports after carefully controlling for various individual socio-demographic characteristics and neighborhood socioeconomic variables. Methods Data from the RECORD Study involving 7290 participants recruited in 2007–2008, aged 30–79 years, and residing in the Paris metropolitan area were analyzed. Four categories of sports were studied: team sports, racket sports, swimming and related activities, and fitness. Spatial accessibility to sport facilities was measured with two complementary approaches that both take into account the street network (distance to the nearest facility and count of facilities around the dwelling). Associations between the spatial accessibility to sport facilities and the practice of the corresponding sports were assessed using multilevel logistic regression after adjusting for individual and contextual characteristics. Results High individual education and high household income were associated with the practice of racket sports, swimming or related activities, and fitness over the previous 7 days. The spatial accessibility to swimming pools was associated with swimming and related sports, even after adjustment for individual/contextual factors. The spatial accessibility to facilities was not related to the practice of other sports. High neighborhood income was associated with the practice of a racket sport and fitness. Conclusions Accessibility is a multi-dimensional concept that integrates educational, financial, and geographical aspects. Our work supports the evidence that strategies to increase participation in sport

Spatial accessibility to specific sport facilities and corresponding sport practice: the RECORD Study.

PubMed

Karusisi, Noëlla; Thomas, Frédérique; Méline, Julie; Chaix, Basile

2013-04-20

Physical activity is considered as a major component of a healthy lifestyle. However, few studies have examined the relationships between the spatial accessibility to sport facilities and sport practice with a sufficient degree of specificity. The aim of this study was to investigate the associations between the spatial accessibility to specific types of sports facilities and the practice of the corresponding sports after carefully controlling for various individual socio-demographic characteristics and neighborhood socioeconomic variables. Data from the RECORD Study involving 7290 participants recruited in 2007-2008, aged 30-79 years, and residing in the Paris metropolitan area were analyzed. Four categories of sports were studied: team sports, racket sports, swimming and related activities, and fitness. Spatial accessibility to sport facilities was measured with two complementary approaches that both take into account the street network (distance to the nearest facility and count of facilities around the dwelling). Associations between the spatial accessibility to sport facilities and the practice of the corresponding sports were assessed using multilevel logistic regression after adjusting for individual and contextual characteristics. High individual education and high household income were associated with the practice of racket sports, swimming or related activities, and fitness over the previous 7 days. The spatial accessibility to swimming pools was associated with swimming and related sports, even after adjustment for individual/contextual factors. The spatial accessibility to facilities was not related to the practice of other sports. High neighborhood income was associated with the practice of a racket sport and fitness. Accessibility is a multi-dimensional concept that integrates educational, financial, and geographical aspects. Our work supports the evidence that strategies to increase participation in sport activities should improve the spatial and

Community-level football injury epidemiology: traumatic injuries treated at Swedish emergency medical facilities.

PubMed

Timpka, Toomas; Schyllander, Jan; Stark Ekman, Diana; Ekman, Robert; Dahlström, Örjan; Hägglund, Martin; Kristenson, Karolina; Jacobsson, Jenny

2018-02-01

Despite the popularity of the sport, few studies have investigated community-level football injury patterns. This study examines football injuries treated at emergency medical facilities using data from three Swedish counties. An open-cohort design was used based on residents aged 0-59 years in three Swedish counties (pop. 645 520). Data were collected from emergency medical facilities in the study counties between 1 January 2007 and 31 December 2010. Injury frequencies and proportions for age groups stratified by sex were calculated with 95% confidence intervals (95% CIs) and displayed per diagnostic group and body location. Each year, more than 1/200 person aged 0-59 years sustained at least one injury during football play that required emergency medical care. The highest injury incidence was observed among adolescent boys [2009 injuries per 100 000 population years (95% CI 1914-2108)] and adolescent girls [1413 injuries per 100 000 population years (95% CI 1333-1498)]. For female adolescents and adults, knee joint/ligament injury was the outstanding injury type (20% in ages 13-17 years and 34% in ages 18-29 years). For children aged 7-12 years, more than half of the treated injuries involved the upper extremity; fractures constituted about one-third of these injuries. One of every 200 residents aged 0-59 years in typical Swedish counties each year sustained a traumatic football injury that required treatment in emergency healthcare. Further research on community-level patterns of overuse syndromes sustained by participation in football play is warranted. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

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

PubMed

Zuber, T J; Henley, D E

1992-03-01

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

Feasibility study for a numerical aerodynamic simulation facility. Volume 2: Hardware specifications/descriptions

NASA Technical Reports Server (NTRS)

Green, F. M.; Resnick, D. R.

1979-01-01

An FMP (Flow Model Processor) was designed for use in the Numerical Aerodynamic Simulation Facility (NASF). The NASF was developed to simulate fluid flow over three-dimensional bodies in wind tunnel environments and in free space. The facility is applicable to studying aerodynamic and aircraft body designs. The following general topics are discussed in this volume: (1) FMP functional computer specifications; (2) FMP instruction specification; (3) standard product system components; (4) loosely coupled network (LCN) specifications/description; and (5) three appendices: performance of trunk allocation contention elimination (trace) method, LCN channel protocol and proposed LCN unified second level protocol.

Gradient Heating Facility. Experiment cartridges. Description and general specifications

NASA Technical Reports Server (NTRS)

Breton, J.

1982-01-01

Specifications that define experiment cartridges that are compatible with the furnace of the gradient heating facility on board the Spacelab are presented. They establish a standard cartridge design independent of the type of experiment to be conducted. By using them, experimenters can design, construct, and test the hot section of the cartridge, known as the high temperature nacelle.

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

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.

OEM Emergency Prevention and Mitigation Information

EPA Pesticide Factsheets

The Office of Emergency Management maintains information relevant to preventing emergencies before they occur, and/or mitigating the effects of emergency when they do occur. A principal element of this data asset is the information managed by the System for Risk Management Plans (SRMP), which compiles risk management plans submitted by facilities in accordance with the Clean Air Act, Section 112(r). Affected facilities are to develop risk management programs which will prevent and minimize consequences of accidental releases of certain hazardous chemicals that could harm public health and the environment.Another component of this data asset are the results generated by the Priority Assessment Model (PAM), which analyzes information concerning low-level chronic emissions from facilities and sets priorities (low, medium, high) for proactive controls on releases that do not necessarily pose imminent threats, but which may under adverse circumstances create unacceptable health or ecological risks.Also included are inspection records compiled by the Oil Inspection Program. Under the Clean Water Act Section 311, EPA regulates oil storage that meets a specific regulatory threshold. Facilities that store oil and meet the regulatory threshold need to prepare and implement a Spill Prevention, Control, and Countermeasures (SPCC) Plan which needs to be reviewed and approved by a professional engineer. Additionally, facilities with larger oil storage capacity may have to pre

Conference on Gender-specific Research in Emergency Care: An Executive Summary

PubMed Central

Safdar, Basmah; Greenberg, Marna Rayl

2015-01-01

With the goal of reducing inequalities in patient care, the 2014 Academic Emergency Medicine (AEM) consensus conference, “Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes,” convened a diverse group of researchers, clinicians, health care providers, patients, and representatives of federal agencies and policy-makers in Dallas, Texas, in May 2014. The executive and steering committees identified seven clinical domains as key to gender-specific emergency care: cardiovascular, neurological, trauma/injury, substance abuse, pain, mental health, and diagnostic imaging. The main aims of the conference were to: 1) summarize and consolidate current data related to sex-and gender-specific research for acute care and identify critical gender-related gaps in knowledge to inform an EM research agenda; 2) create a consensus-driven research agenda that advances sex- and gender-specific research in the prevention, diagnosis, and management of acute diseases and identify strategies to investigate them; and 3) build a multinational interdisciplinary consortium to disseminate and study the sex and gender medicine of acute conditions. Over a 2-year period, this collaborative network of stakeholders identified key areas where sex- and gender-specific research is most likely to improve clinical care and ultimately patient outcomes. The iterative consensus process culminated in a daylong conference on May 13, 2014, with a total of 133 registrants, with the majority being between ages 31 and 50 years (57%), females (71%), and whites (79%). Content experts led the consensus-building workshops at the conference and used the nominal group technique to consolidate consensus recommendations for priority research. In addition, panel sessions addressed funding mechanisms for gender-specific research as well as gender-specific regulatory challenges to product development and approval. This special issue of AEM reports the

A fail safe laser activated switch used as an emergency control link at the Langley Vortex Research Facility

NASA Technical Reports Server (NTRS)

Kassel, P. C., Jr.

1978-01-01

A fail safe light activated switch was used as an emergency control link at the Langley Vortex Research Facility. In this facility aircraft models were towed through a still air test chamber by a gasoline powered vehicle which was launched from one end of a 427-meter track and attained velocities to 31 m/sec in the test chamber. A 5 mW HeNe laser with a mechanical copper provided a connecting link with the moving tow vehicle on which a silicon photodiode receiver with a specially designed amplifier provided a fail safe switching action. This system provided an emergency means of stopping the vehicle by turning off the laser to interrupt the power to the vehicle ignition and brake release systems.

18 CFR 2.60 - Facilities and activities during an emergency-accounting treatment of defense-related expenditures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Facilities and activities during an emergency-accounting treatment of defense-related expenditures. 2.60 Section 2.60 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL...

18 CFR 2.60 - Facilities and activities during an emergency-accounting treatment of defense-related expenditures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Facilities and activities during an emergency-accounting treatment of defense-related expenditures. 2.60 Section 2.60 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL...

18 CFR 2.60 - Facilities and activities during an emergency-accounting treatment of defense-related expenditures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Facilities and activities during an emergency-accounting treatment of defense-related expenditures. 2.60 Section 2.60 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL...

18 CFR 2.60 - Facilities and activities during an emergency-accounting treatment of defense-related expenditures.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Facilities and activities during an emergency-accounting treatment of defense-related expenditures. 2.60 Section 2.60 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL...

[Pre-hospital management of adults with life-threatening emergencies].

PubMed

Wattel, Francis; Dubois, François

2012-01-01

, fewer voluntary firemen, hospital reorganization, tight funding, difficulties of medical dispatching, and the varying skills of "first-on-the-scene "emergency workers. Grievances include late emergency responses, inappropriate medical care, and dispatching to the wrong facility. This raises the question of equal opportunity for all in a country with widely varying geographic features and population density. Improvement in the system's efficiency will require a series of objectives to be met in varied and complementary--Enhanced functional coordination, by speeding up the deployment of the ANTARES digital radio-frequency transmission network (Adaptation Nationale des Transmissions Aux Risques Et aux Secours).--Implementation of a network of emergency services with varying degrees of emergency healthcare management related to the technical nature of the facilities. Three levels of emergency healthcare must be made available: level 1 is provided by local hospitals, level 2 includes support facilities available in general hospitals (not necessarily the nearest hospital), and level 3 provides specialized healthcare in large and/or training hospitals with specialized departments. Life-threatening emergency situations are to be handled by level 2 or 3 facilities. Specific facilities must be selected as reference centers. In France, the ARS (Agences Régionales de Santé) is in charge of this procedure, as it provide funding for healthcare continuity--Reducing inequalities in access to emergency care. This will involve improving the network of SDIS brigades, making local medical facilities more responsive, delegating more medical procedures, on-site telemedicine, providing more helicopters equipped with healthcare facilities, more automated external defibrillators, and more dedicated neuro-vascular units.--First aid training must be made widely available. The French National Academy of Medicine has approved ten recommendations regarding organization and facilities.

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

PubMed

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

2017-07-01

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

Emergent literacy profiles of preschool-age children with specific language impairment.

PubMed

Cabell, Sonia Q; Lomax, Richard G; Justice, Laura M; Breit-Smith, Allison; Skibbe, Lori E; McGinty, Anita S

2010-12-01

The primary aim of the present study was to explore the heterogeneity of emergent literacy skills among preschool-age children with specific language impairment (SLI) through examination of profiles of performance. Fifty-nine children with SLI were assessed on a battery of emergent literacy skills (i.e., alphabet knowledge, print concepts, emergent writing, rhyme awareness) and oral language skills (i.e., receptive/expressive vocabulary and grammar). Cluster analysis techniques identified three emergent literacy profiles: (1) Highest Emergent Literacy, Strength in Alphabet Knowledge; (2) Average Emergent Literacy, Strength in Print Concepts; and (3) Lowest Emergent Literacy across Skills. After taking into account the contribution of child age, receptive and expressive language skills made a small contribution to the prediction of profile membership. The present findings, which may be characterized as exploratory given the relatively modest sample size, suggest that preschool-age children with SLI display substantial individual differences with regard to their emergent literacy skills and that these differences cannot be fully determined by children's age or oral language performance. Replication of the present findings with a larger sample of children is needed.

40 CFR 265.55 - Emergency coordinator.

Code of Federal Regulations, 2010 CFR

2010-07-01

... FACILITIES Contingency Plan and Emergency Procedures § 265.55 Emergency coordinator. At all times, there must... aspects of the facility's contingency plan, all operations and activities at the facility, the location... out the contingency plan. [Comment: The emergency coordinator's responsibilities are more fully...

Surviving the storms: Emergency preparedness in Texas nursing facilities and assisted living facilities.

PubMed

Castro, Carmen; Persson, Diane; Bergstrom, Nancy; Cron, Stanley

2008-08-01

This study assesses the preparedness of long-term care facilities in Texas responding to Hurricanes Katrina and Rita. A 41-item questionnaire was mailed to facilities; the response rate was 42%. Among responding facilities, 4513 residents were evacuated, and 6% of respondents reported resident death. Financial losses were reported by 8% of nursing facilities and 45% of assisted living facilities due to transportation and staff overtime. Respondents indicated the need for improved disaster preparednesstraining, better coordination, and transportation. Changes in policy and practice will lead to better trained staff who will provide the care residents need for improved health outcomes during future public health disasters.

Lack of CT scanner in a rural emergency department increases inter-facility transfers: a pilot study.

PubMed

Bergeron, Catherine; Fleet, Richard; Tounkara, Fatoumata Korika; Lavallée-Bourget, Isabelle; Turgeon-Pelchat, Catherine

2017-12-28

Rural emergency departments (EDs) are an important gateway to care for the 20% of Canadians who reside in rural areas. Less than 15% of Canadian rural EDs have access to a computed tomography (CT) scanner. We hypothesized that a significant proportion of inter-facility transfers from rural hospitals without CT scanners are for CT imaging. Our objective was to assess inter-facility transfers for CT imaging in a rural ED without a CT scanner. We selected a rural ED that offers 24/7 medical care with admission beds but no CT scanner. Descriptive statistics were collected from 2010 to 2015 on total ED visits and inter-facility transfers. Data was accessible through hospital and government databases. Between 2010 and 2014, there were respectively 13,531, 13,524, 13,827, 12,883, and 12,942 ED visits, with an average of 444 inter-facility transfers. An average of 33% (148/444) of inter-facility transfers were to a rural referral centre with a CT scan, with 84% being for CT scan. Inter-facility transfers incur costs and potential delays in patient diagnosis and management, yet current databases could not capture transfer times. Acquiring a CT scan may represent a reasonable opportunity for the selected rural hospital considering the number of required transfers.

40 CFR 266.204 - Standards applicable to emergency responses.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) SOLID WASTES (CONTINUED) STANDARDS FOR THE MANAGEMENT OF SPECIFIC HAZARDOUS WASTES AND SPECIFIC TYPES OF HAZARDOUS WASTE MANAGEMENT FACILITIES Military Munitions § 266.204 Standards applicable to emergency... CFR 262.10(i), 263.10(e), 264.1(g)(8), 265.1(c)(11), and 270.1(c)(3), or alternatively to 40 CFR 270...

40 CFR 266.204 - Standards applicable to emergency responses.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) SOLID WASTES (CONTINUED) STANDARDS FOR THE MANAGEMENT OF SPECIFIC HAZARDOUS WASTES AND SPECIFIC TYPES OF HAZARDOUS WASTE MANAGEMENT FACILITIES Military Munitions § 266.204 Standards applicable to emergency... CFR 262.10(i), 263.10(e), 264.1(g)(8), 265.1(c)(11), and 270.1(c)(3), or alternatively to 40 CFR 270...

40 CFR 266.204 - Standards applicable to emergency responses.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) SOLID WASTES (CONTINUED) STANDARDS FOR THE MANAGEMENT OF SPECIFIC HAZARDOUS WASTES AND SPECIFIC TYPES OF HAZARDOUS WASTE MANAGEMENT FACILITIES Military Munitions § 266.204 Standards applicable to emergency... CFR 262.10(i), 263.10(e), 264.1(g)(8), 265.1(c)(11), and 270.1(c)(3), or alternatively to 40 CFR 270...

Definition of performance specifications for automated Analytical Electrophoresis Facility (AAEF)

NASA Technical Reports Server (NTRS)

Brooks, D. E.

1976-01-01

In order to provide specifications for the automated Analytical Electrophoresis Facility (AAEF) that would satisfy the broadest variety of demands of a future user community, a survey was carried out of all those people who were identified as having published papers on cell electrophoresis in the past four years. A computer search was conducted of the relevant literature from which a list of 87 investigators was derived and defined as the user community for purposes of the mailing. A questionnaire was developed covering the areas of performance which required definition which was subsequently circulated to the user community. Based on the response to this survey performance specifications were assembled.

33 CFR 154.1240 - Specific requirements for animal fats and vegetable oils facilities that could reasonably be...

Code of Federal Regulations, 2011 CFR

2011-07-01

... fats and vegetable oils facilities that could reasonably be expected to cause substantial harm to the... SECURITY (CONTINUED) POLLUTION FACILITIES TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Response Plans for Animal Fats and Vegetable Oils Facilities § 154.1240 Specific requirements for animal fats and vegetable...

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.

Preliminary Concept, Specifications, and Requirements for a Zero-Gravity Combustion Facility for Spacelab

NASA Technical Reports Server (NTRS)

Dewitt, Richard L.

1978-01-01

The preliminary concept, specifications, and requirements of a reusable zero gravity combustion facility (0-GCF) for use by experimenters aboard the spacelab payload of the space transportation system (STS) orbiter are described. The facility will be amenable to any mission of the STS orbiter in which a spacelab habitable segment and pallet segment are integral and for which orbital mission plans specify induced accelerations of 0.0001 g or less for sufficiently long periods so as not to impact experiment performance.

Chemical Entity Semantic Specification: Knowledge representation for efficient semantic cheminformatics and facile data integration

PubMed Central

2011-01-01

Background Over the past several centuries, chemistry has permeated virtually every facet of human lifestyle, enriching fields as diverse as medicine, agriculture, manufacturing, warfare, and electronics, among numerous others. Unfortunately, application-specific, incompatible chemical information formats and representation strategies have emerged as a result of such diverse adoption of chemistry. Although a number of efforts have been dedicated to unifying the computational representation of chemical information, disparities between the various chemical databases still persist and stand in the way of cross-domain, interdisciplinary investigations. Through a common syntax and formal semantics, Semantic Web technology offers the ability to accurately represent, integrate, reason about and query across diverse chemical information. Results Here we specify and implement the Chemical Entity Semantic Specification (CHESS) for the representation of polyatomic chemical entities, their substructures, bonds, atoms, and reactions using Semantic Web technologies. CHESS provides means to capture aspects of their corresponding chemical descriptors, connectivity, functional composition, and geometric structure while specifying mechanisms for data provenance. We demonstrate that using our readily extensible specification, it is possible to efficiently integrate multiple disparate chemical data sources, while retaining appropriate correspondence of chemical descriptors, with very little additional effort. We demonstrate the impact of some of our representational decisions on the performance of chemically-aware knowledgebase searching and rudimentary reaction candidate selection. Finally, we provide access to the tools necessary to carry out chemical entity encoding in CHESS, along with a sample knowledgebase. Conclusions By harnessing the power of Semantic Web technologies with CHESS, it is possible to provide a means of facile cross-domain chemical knowledge integration with full

Chemical Entity Semantic Specification: Knowledge representation for efficient semantic cheminformatics and facile data integration.

PubMed

Chepelev, Leonid L; Dumontier, Michel

2011-05-19

Over the past several centuries, chemistry has permeated virtually every facet of human lifestyle, enriching fields as diverse as medicine, agriculture, manufacturing, warfare, and electronics, among numerous others. Unfortunately, application-specific, incompatible chemical information formats and representation strategies have emerged as a result of such diverse adoption of chemistry. Although a number of efforts have been dedicated to unifying the computational representation of chemical information, disparities between the various chemical databases still persist and stand in the way of cross-domain, interdisciplinary investigations. Through a common syntax and formal semantics, Semantic Web technology offers the ability to accurately represent, integrate, reason about and query across diverse chemical information. Here we specify and implement the Chemical Entity Semantic Specification (CHESS) for the representation of polyatomic chemical entities, their substructures, bonds, atoms, and reactions using Semantic Web technologies. CHESS provides means to capture aspects of their corresponding chemical descriptors, connectivity, functional composition, and geometric structure while specifying mechanisms for data provenance. We demonstrate that using our readily extensible specification, it is possible to efficiently integrate multiple disparate chemical data sources, while retaining appropriate correspondence of chemical descriptors, with very little additional effort. We demonstrate the impact of some of our representational decisions on the performance of chemically-aware knowledgebase searching and rudimentary reaction candidate selection. Finally, we provide access to the tools necessary to carry out chemical entity encoding in CHESS, along with a sample knowledgebase. By harnessing the power of Semantic Web technologies with CHESS, it is possible to provide a means of facile cross-domain chemical knowledge integration with full preservation of data

Education Facilities Sector-Specific Plan: An Annex to the Government Facilities Sector-Specific Plan

ERIC Educational Resources Information Center

US Department of Homeland Security, 2010

2010-01-01

Critical infrastructure and key resources (CIKR) provide the essential services that support basic elements of American society. Compromise of these CIKR could disrupt key government and industry activities, facilities, and systems, producing cascading effects throughout the Nation's economy and society and profoundly affecting the national…

Organization, execution and evaluation of the 2014 Academic Emergency Medicine consensus conference on Gender-Specific Research in Emergency Care - an executive summary.

PubMed

Safdar, Basmah; Greenberg, Marna R

2014-12-01

With the goal of reducing inequalities in patient care, the 2014 Academic Emergency Medicine (AEM) consensus conference, "Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," convened a diverse group of researchers, clinicians, health care providers, patients, and representatives of federal agencies and policy-makers in Dallas, Texas, in May 2014. The executive and steering committees identified seven clinical domains as key to gender-specific emergency care: cardiovascular, neurological, trauma/injury, substance abuse, pain, mental health, and diagnostic imaging. The main aims of the conference were to: 1) summarize and consolidate current data related to sex- and gender-specific research for acute care and identify critical gender-related gaps in knowledge to inform an EM research agenda; 2) create a consensus-driven research agenda that advances sex- and gender-specific research in the prevention, diagnosis, and management of acute diseases and identify strategies to investigate them; and 3) build a multinational interdisciplinary consortium to disseminate and study the sex and gender medicine of acute conditions. Over a 2-year period, this collaborative network of stakeholders identified key areas where sex- and gender-specific research is most likely to improve clinical care and ultimately patient outcomes. The iterative consensus process culminated in a daylong conference on May 13, 2014, with a total of 133 registrants, with the majority being between ages 31 and 50 years (57%), females (71%), and whites (79%). Content experts led the consensus-building workshops at the conference and used the nominal group technique to consolidate consensus recommendations for priority research. In addition, panel sessions addressed funding mechanisms for gender-specific research as well as gender-specific regulatory challenges to product development and approval. This special issue of AEM reports the

A proposed emergency management program for acute care facilities in response to a highly virulent infectious disease.

PubMed

Petinaux, Bruno; Ferguson, Brandy; Walker, Milena; Lee, Yeo-Jin; Little, Gary; Parenti, David; Simon, Gary

2016-01-01

To address the organizational complexities associated with a highly virulent infectious disease (HVID) hazard, such as Ebola Virus Disease (EVD), an acute care facility should institute an emergency management program rooted in the fundamentals of mitigation, preparedness, response, and recovery. This program must address all known facets of the care of a patient with HVID, from unannounced arrival to discharge. The implementation of such a program not only serves to mitigate the risks from an unrecognized exposure but also serves to prepare the organization and its staff to provide for a safe response, and ensure a full recovery. Much of this program is based on education, training, and infection control measures along with resourcing for appropriate personal protective equipment which is instrumental in ensuring an organized and safe response of the acute care facility in the service to the community. This emergency management program approach can serve as a model in the care of not only current HVIDs such as EVD but also future presentations in our healthcare setting.

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

Moderate sensitivity and high specificity of emergency department administrative data for transient ischemic attacks.

PubMed

Yu, Amy Y X; Quan, Hude; McRae, Andrew; Wagner, Gabrielle O; Hill, Michael D; Coutts, Shelagh B

2017-09-18

Validation of administrative data case definitions is key for accurate passive surveillance of disease. Transient ischemic attack (TIA) is a condition primarily managed in the emergency department. However, prior validation studies have focused on data after inpatient hospitalization. We aimed to determine the validity of the Canadian 10th International Classification of Diseases (ICD-10-CA) codes for TIA in the national ambulatory administrative database. We performed a diagnostic accuracy study of four ICD-10-CA case definition algorithms for TIA in the emergency department setting. The study population was obtained from two ongoing studies on the diagnosis of TIA and minor stroke versus stroke mimic using serum biomarkers and neuroimaging. Two reference standards were used 1) the emergency department clinical diagnosis determined by chart abstractors and 2) the 90-day final diagnosis, both obtained by stroke neurologists, to calculate the sensitivity, specificity, positive and negative predictive values (PPV and NPV) of the ICD-10-CA algorithms for TIA. Among 417 patients, emergency department adjudication showed 163 (39.1%) TIA, 155 (37.2%) ischemic strokes, and 99 (23.7%) stroke mimics. The most restrictive algorithm, defined as a TIA code in the main position had the lowest sensitivity (36.8%), but highest specificity (92.5%) and PPV (76.0%). The most inclusive algorithm, defined as a TIA code in any position with and without query prefix had the highest sensitivity (63.8%), but lowest specificity (81.5%) and PPV (68.9%). Sensitivity, specificity, PPV, and NPV were overall lower when using the 90-day diagnosis as reference standard. Emergency department administrative data reflect diagnosis of suspected TIA with high specificity, but underestimate the burden of disease. Future studies are necessary to understand the reasons for the low to moderate sensitivity.

Ethical perspectives on emerging assistive technologies: insights from focus groups with stakeholders in long-term care facilities.

PubMed

Dorsten, Aimee-Marie; Sifford, K Susan; Bharucha, Ashok; Mecca, Laurel Person; Wactlar, Howard

2009-03-01

ASSISTIVE TECHNOLOGIES ARE RELATIVELY novel tools for research and daily care in long-term care (LTC) facilities that are faced with the burgeoning of the older adult population and dwindling staffing resources. The degree to which stakeholders in LTC facilities are receptive to the use of these technologies is poorly understood. Eighteen semi-structured focus groups and one interview were conducted with relevant groups of stakeholders at seven LTC facilities in southwestern Pennsylvania. Common themes identified across all focus groups centered on concerns for privacy, autonomy, cost, and safety associated with implementation of novel technologies. The relative importance of each theme varied by stakeholder group as well as the perceived severity of cognitive and/or physical disability. Our findings suggest that ethical issues are critical to acceptance of novel technologies by their end users, and that stakeholder groups are interdependent and require shared communication about the acceptance of these emerging technologies.

33 CFR 127.1205 - Emergency shutdown.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) WATERFRONT FACILITIES WATERFRONT FACILITIES HANDLING LIQUEFIED NATURAL GAS AND LIQUEFIED HAZARDOUS GAS Waterfront Facilities Handling Liquefied Hazardous Gas Equipment § 127.1205 Emergency shutdown. (a) Each... elements that melt at less than 105 °C (221 °F) and activate the emergency shutdown, or have a sensor that...

33 CFR 127.1205 - Emergency shutdown.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) WATERFRONT FACILITIES WATERFRONT FACILITIES HANDLING LIQUEFIED NATURAL GAS AND LIQUEFIED HAZARDOUS GAS Waterfront Facilities Handling Liquefied Hazardous Gas Equipment § 127.1205 Emergency shutdown. (a) Each... elements that melt at less than 105 °C (221 °F) and activate the emergency shutdown, or have a sensor that...

Emerging pulmonary vasculature lacks fate specification.

PubMed

Schwarz, Margaret A; Caldwell, Lauren; Cafasso, Danielle; Zheng, Haihua

2009-01-01

Lung morphogenesis requires precise coordination between branching morphogenesis and vascularization to generate distal airways capable of supporting respiration at the cell-cell interface. The specific origins and types of blood vessels that initially form in the lung, however, remain obscure. Herein, we definitively show that during the early phases of lung development [i.e., embryonic day (E) 11.5], functional vessels, replete with blood flow, are restricted to the mesenchyme, distal to the epithelium. However, by day E14.5, and in response to epithelial-derived VEGF signals, functional vessels extend from the mesenchyme to the epithelial interface. Moreover, these vessels reside adjacent to multipotent mesenchymal stromal cells that likely play a regulatory role in this process. As well as and distinct from the systemic vasculature, immunostaining for EphrinB2 and EphB4 revealed that arterial and venous identity is not distinguishable in emergent pulmonary vasculature. Collectively, this study provides evidence that lung vascularization initially originates in the mesenchyme, distal to the epithelium, and that arterial-venous specification does not exist in the early lung. At a mechanistic level, we show that basilar epithelial VEGF prompts endothelial cells to move toward the epithelium where they undergo morphogenesis during the proliferative, canalicular stage. Thus our findings challenge existing notions of vascular origin and identity during development.

18 CFR 292.307 - System emergencies.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false System emergencies. 292... § 292.307 System emergencies. (a) Qualifying facility obligation to provide power during system... during a system emergency only to the extent: (1) Provided by agreement between such qualifying facility...

18 CFR 292.307 - System emergencies.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false System emergencies. 292... § 292.307 System emergencies. (a) Qualifying facility obligation to provide power during system... during a system emergency only to the extent: (1) Provided by agreement between such qualifying facility...

Emergency and backup power supplies at Department of Energy facilities: Augmented Evaluation Team -- Final report

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

Not Available

This report documents the results of the Defense Programs (DP) Augmented Evaluation Team (AET) review of emergency and backup power supplies (i.e., generator, uninterruptible power supply, and battery systems) at DP facilities. The review was conducted in response to concerns expressed by former Secretary of Energy James D. Watkins over the number of incidents where backup power sources failed to provide electrical power during tests or actual demands. The AET conducted a series of on-site reviews for the purpose of understanding the design, operation, maintenance, and safety significance of emergency and backup power (E&BP) supplies. The AET found that themore » quality of programs related to maintenance of backup power systems varies greatly among the sites visited, and often among facilities at the same site. No major safety issues were identified. However, there are areas where the AET believes the reliability of emergency and backup power systems can and should be improved. Recommendations for improving the performance of E&BP systems are provided in this report. The report also discusses progress made by Management and Operating (M&O) contractors to improve the reliability of backup sources used in safety significant applications. One area that requires further attention is the analysis and understanding of the safety implications of backup power equipment. This understanding is needed for proper graded-approach implementation of Department of Energy (DOE) Orders, and to help ensure that equipment important to the safety of DOE workers, the public, and the environment is identified, classified, recognized, and treated as such by designers, users, and maintainers. Another area considered important for improving E&BP system performance is the assignment of overall ownership responsibility and authority for ensuring that E&BP equipment performs adequately and that reliability and availability are maintained at acceptable levels.« less

Patients presenting to the emergency department with non-specific complaints: the Basel Non-specific Complaints (BANC) study.

PubMed

Nemec, Marek; Koller, Michael T; Nickel, Christian H; Maile, Silke; Winterhalder, Clemens; Karrer, Christine; Laifer, Gerd; Bingisser, Roland

2010-03-01

Patient management in emergency departments (EDs) is often based on management protocols developed for specific complaints like dyspnea, chest pain, or syncope. To the best of our knowledge, to date no protocols exist for patients with nonspecific complaints (NSCs) such as "weakness,"dizziness," or "feeling unwell." The objectives of this study were to provide a framework for research and a description of patients with NSCs presenting to EDs. Nonspecific complaints were defined as the entity of complaints not part of the set of specific complaints for which evidence-based management protocols for emergency physicians (EPs) exist. "Serious conditions" were defined as potentially life-threatening or those requiring early intervention to prevent health status deterioration. During a 6-month period, all adult nontrauma patients with an Emergency Severity Index (ESI) of 2 or 3 were prospectively enrolled, and serious conditions were identified within a 30-day period. The authors screened 18,261 patients for inclusion. A total of 218 of 1,611 (13.5%) nontrauma ESI 2 and 3 patients presented with NSCs. Median age was 82 years (interquartile range [IQR]=72 to 87), and 24 of 218 (11%) were nursing home inhabitants. A median of 4 (IQR=3 to 5) comorbidities were recorded, most often chronic hypertension, coronary artery disease, and dementia. During the 30-day follow-up period a serious condition was diagnosed in 128 of 218 patients (59%). The 30-day mortality rate was 6%. Patients with NSC presenting to the ED are at high risk of suffering from serious conditions. Sensitive risk stratification tools are needed to identify patients with potentially adverse health outcomes. Copyright (c) 2010 by the Society for Academic Emergency Medicine.

Evaluating the Emergency Notification Systems of the NASA White Sands Test

NASA Technical Reports Server (NTRS)

Chavez, Alfred Paul

2004-01-01

The problem was that the NASA Fire and Emergency Services did not know if the current emergency notification systems on the NASA White Sands Test Facility were appropriate for alerting the employees of an emergency. The purpose of this Applied Research Project was to determine if the current emergency notification systems of the White Sands Test Facility are appropriate for alerting the employees of an emergency. This was a descriptive research project. The research questions were: 1) What are similar facilities using to alert the employees of an emergency?; 2) Are the current emergency notification systems suitable for the community hazards on the NASA White Sands Test Facility?; 3) What is the NASA Fire and Emergency Services currently using to measure the effectiveness of the emergency notification systems?; and 4) What are the current training methods used to train personnel to the emergency notification systems at the NASA White Sands Test Facility? The procedures involved were to research other established facilities, research published material from credible sources, survey the facility to determine the facility perception of the emergency notification systems, and evaluate the operating elements of the established emergency notification systems for the facility. The results were that the current systems are suitable for the type of hazards the facility may endure. The emergency notification systems are tested frequently to ensure effectiveness in the event of an emergency. Personnel are trained and participate in a yearly drill to make certain personnel are educated on the established systems. The recommendations based on the results were to operationally improve the existing systems by developing and implementing one system that can overall notify the facility of a hazard. Existing procedures and training should also be improved to ensure that all personnel are educated on what to do when the emergency notification systems are activated.

33 CFR 146.125 - Emergency drills.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Emergency drills. 146.125 Section... CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.125 Emergency drills. (a) Emergency drills shall be conducted at least once each month by the person in charge of the manned facility. The drill...

33 CFR 146.125 - Emergency drills.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Emergency drills. 146.125 Section... CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.125 Emergency drills. (a) Emergency drills shall be conducted at least once each month by the person in charge of the manned facility. The drill...

33 CFR 146.125 - Emergency drills.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Emergency drills. 146.125 Section... CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.125 Emergency drills. (a) Emergency drills shall be conducted at least once each month by the person in charge of the manned facility. The drill...

33 CFR 146.125 - Emergency drills.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Emergency drills. 146.125 Section... CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.125 Emergency drills. (a) Emergency drills shall be conducted at least once each month by the person in charge of the manned facility. The drill...

33 CFR 146.125 - Emergency drills.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Emergency drills. 146.125 Section... CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.125 Emergency drills. (a) Emergency drills shall be conducted at least once each month by the person in charge of the manned facility. The drill...

Availability of emergency obstetric care (EmOC) among public and private health facilities in rural northwest Bangladesh.

PubMed

Sikder, Shegufta S; Labrique, Alain B; Ali, Hasmot; Hanif, Abu A M; Klemm, Rolf D W; Mehra, Sucheta; West, Keith P; Christian, Parul

2015-01-31

Although safe motherhood strategies recommend that women seek timely care from health facilities for obstetric complications, few studies have described facility availability of emergency obstetric care (EmOC). We sought to describe and compare availability and readiness to provide EmOC among public and private health facilities commonly visited for pregnancy-related complications in two districts of northwest Bangladesh. We also described aspects of financial and geographic access to healthcare and key constraints to EmOC provision. Using data from a large population-based community trial, we identified and surveyed the 14 health facilities (7 public, 7 private) most frequently visited for obstetric complications and near misses as reported by women. Availability of EmOC was based on provision of medical services, assessed through clinician interviews and record review. Levels of EmOC availability were defined as basic or comprehensive. Readiness for EmOC provision was based on scores in four categories: staffing, equipment, laboratory capacity, and medicines. Readiness scores were calculated using unweighted averages. Costs of C-section procedures and geographic locations of facilities were described. Textual analysis was used to identify key constraints. The seven surveyed private facilities offered comprehensive EmOC compared to four of the seven public facilities. With 100% representing full readiness, mean EmOC readiness was 81% (range: 63%-91%) among surveyed private facilities compared to 67% (range: 48%-91%) in public facilities (p = 0.040). Surveyed public clinics had low scores on staffing and laboratory capacity (69%; 50%). The mean cost of the C-section procedure in private clinics was $77 (standard deviation: $16) and free in public facilities. The public sub-district facilities were the only facilities located in rural areas, with none providing comprehensive EmOC. Shortages in specialized staff were listed as the main barrier to EmOC provision in

44 CFR 350.5 - Criteria for review and approval of State and local radiological emergency plans and preparedness.

Code of Federal Regulations, 2010 CFR

2010-10-01

... response by the nuclear facility licensee, and by State and local organizations within the Emergency Planning Zones have been assigned, the emergency responsibilities of the various supporting organizations have been specifically established and each principal response organization has staff to respond to and...

44 CFR 350.5 - Criteria for review and approval of State and local radiological emergency plans and preparedness.

Code of Federal Regulations, 2011 CFR

2011-10-01

... response by the nuclear facility licensee, and by State and local organizations within the Emergency Planning Zones have been assigned, the emergency responsibilities of the various supporting organizations have been specifically established and each principal response organization has staff to respond to and...

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

44 CFR 16.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

...: Existing facilities. 16.150 Section 16.150 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the... facilities accessible to and usable by individuals with handicaps; (2) In the case of historic preservation...

Antibody specific epitope prediction-emergence of a new paradigm.

PubMed

Sela-Culang, Inbal; Ofran, Yanay; Peters, Bjoern

2015-04-01

The development of accurate tools for predicting B-cell epitopes is important but difficult. Traditional methods have examined which regions in an antigen are likely binding sites of an antibody. However, it is becoming increasingly clear that most antigen surface residues will be able to bind one or more of the myriad of possible antibodies. In recent years, new approaches have emerged for predicting an epitope for a specific antibody, utilizing information encoded in antibody sequence or structure. Applying such antibody-specific predictions to groups of antibodies in combination with easily obtainable experimental data improves the performance of epitope predictions. We expect that further advances of such tools will be possible with the integration of immunoglobulin repertoire sequencing data. Copyright © 2015 Elsevier B.V. All rights reserved.

The Japanese tsunami and resulting nuclear emergency at the Fukushima Daiichi power facility: technical, radiologic, and response perspectives.

PubMed

Dauer, Lawrence T; Zanzonico, Pat; Tuttle, R Michael; Quinn, Dennis M; Strauss, H William

2011-09-01

The Fukushima Daiichi nuclear power facility, in the Futaba District of the Fukushima Prefecture in Japan, was severely damaged by the earthquake and ensuing tsunami that struck off the northern coast of the island of Honshu on March 11, 2011. The resulting structural damage to the plant disabled the reactor's cooling systems and led to significant, ongoing environmental releases of radioactivity, triggering a mandatory evacuation of a large area surrounding the plant. The status of the facility continues to change, and permanent control of its radioactive inventory has not yet been achieved. The purpose of this educational article is to summarize the short-term chronology, radiologic consequences, emergency responses, and long-term challenges associated with this event. Although there is ongoing debate on preparedness before the event and the candor of responsible entities in recognizing and disclosing its severity, it largely appears that appropriate key actions were taken by the Japanese authorities during the event that should mitigate any radiologic health impact. These actions include an organized evacuation of over 200,000 inhabitants from the vicinity of the site and areas early in the emergency; monitoring of food and water and placement of radiation limits on such foodstuffs; distribution of stable potassium iodide; and systematic scanning of evacuees. However, the risk of additional fuel damage and of further, perhaps substantial, releases persists. The situation at the Fukushima Daiichi nuclear facility remains fluid, and the long-term environmental and health impact will likely take years to fully delineate.

Emergency Planning for Municipal Wastewater Treatment Facilities.

ERIC Educational Resources Information Center

Lemon, R. A.; And Others

This manual for the development of emergency operating plans for municipal wastewater treatment systems was compiled using information provided by over two hundred municipal treatment systems. It covers emergencies caused by natural disasters, civil disorders and strikes, faulty maintenance, negligent operation, and accidents. The effects of such…

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

PubMed

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

2017-08-01

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

Communities, birth attendants and health facilities: a continuum of emergency maternal and newborn care (the Global Network's EmONC trial).

PubMed

Pasha, Omrana; Goldenberg, Robert L; McClure, Elizabeth M; Saleem, Sarah; Goudar, Shivaprasad S; Althabe, Fernando; Patel, Archana; Esamai, Fabian; Garces, Ana; Chomba, Elwyn; Mazariegos, Manolo; Kodkany, Bhala; Belizan, Jose M; Derman, Richard J; Hibberd, Patricia L; Carlo, Waldemar A; Liechty, Edward A; Hambidge, K Michael; Buekens, Pierre; Wallace, Dennis; Howard-Grabman, Lisa; Stalls, Suzanne; Koso-Thomas, Marion; Jobe, Alan H; Wright, Linda L

2010-12-14

Maternal and newborn mortality rates remain unacceptably high, especially where the majority of births occur in home settings or in facilities with inadequate resources. The introduction of emergency obstetric and newborn care services has been proposed by several organizations in order to improve pregnancy outcomes. However, the effectiveness of emergency obstetric and neonatal care services has never been proven. Also unproven is the effectiveness of community mobilization and community birth attendant training to improve pregnancy outcomes. We have developed a cluster-randomized controlled trial to evaluate the impact of a comprehensive intervention of community mobilization, birth attendant training and improvement of quality of care in health facilities on perinatal mortality in low and middle-income countries where the majority of births take place in homes or first level care facilities. This trial will take place in 106 clusters (300-500 deliveries per year each) across 7 sites of the Global Network for Women's and Children's Health Research in Argentina, Guatemala, India, Kenya, Pakistan and Zambia. The trial intervention has three key elements, community mobilization, home-based life saving skills for communities and birth attendants, and training of providers at obstetric facilities to improve quality of care. The primary outcome of the trial is perinatal mortality. Secondary outcomes include rates of stillbirth, 7-day neonatal mortality, maternal death or severe morbidity (including obstetric fistula, eclampsia and obstetrical sepsis) and 28-day neonatal mortality. In this trial, we are evaluating a combination of interventions including community mobilization and facility training in an attempt to improve pregnancy outcomes. If successful, the results of this trial will provide important information for policy makers and clinicians as they attempt to improve delivery services for pregnant women and newborns in low-income countries. Clinical

Hurricane risk mitigation - Emergency Operations Center

NASA Image and Video Library

2008-07-29

Construction work on a new Emergency Operations Center at Stennis Space Center is nearing completion. Construction is expected to be complete by February 2009, with actual occupancy of the building planned for later that year. The new building will house fire, medical and security teams and will provide a top-grade facility to support storm emergency responder teams and emergency management operations for the south Mississippi facility.

Inter-Facility Transfer of Pediatric Burn Patients from U.S. Emergency Departments

PubMed Central

Johnson, Sarah A.; Shi, Junxin; Groner, Jonathan I.; Thakkar, Rajan K.; Fabia, Renata; Besner, Gail E.; Xiang, Huiyun; Wheeler, Krista K.

2016-01-01

Purpose To describe the epidemiology of pediatric burn patients seen in U.S. emergency departments (EDs) and to determine factors associated with inter-facility transfer. Methods We analyzed data from the 2012 Nationwide Emergency Department Sample. Current American Burn Association (ABA) Guidelines were used to identify children <18 who met criteria for referral to burn centers. Burn patient admission volume was used as a proxy for burn expertise. Logistic models were fitted to examine the odds of transfer from low volume hospitals. Results In 2012, there were an estimated 126,742 (95% CI: 116,104–137,380) pediatric burn ED visits in the U.S. Of the 69,003 (54.4%) meeting referral criteria, 83.2% were in low volume hospitals. Only 8.2% of patients meeting criteria were transferred from low volume hospitals. Of the 52,604 (95% CI: 48,433 – 56,775) not transferred, 98.3% were treated and released and 1.7% were admitted without transfer; 54.7% of burns involved hands. Conclusions Over 90% of pediatric burn ED patients meet ABA burn referral criteria but are not transferred from low volume hospitals. Perhaps a portion of the 92% of patients currently receiving definitive care in low volume hospitals are under-referred and would have improved clinical outcomes if transferred at the time of presentation. PMID:27554628

Impact of specific postoperative complications on the outcomes of emergency general surgery patients.

PubMed

McCoy, Christopher Cameron; Englum, Brian R; Keenan, Jeffrey E; Vaslef, Steven N; Shapiro, Mark L; Scarborough, John E

2015-05-01

The relative contribution of specific postoperative complications on mortality after emergency operations has not been previously described. Identifying specific contributors to postoperative mortality following acute care surgery will allow for significant improvement in the care of these patients. Patients from the 2005 to 2011 American College of Surgeons' National Surgical Quality Improvement Program database who underwent emergency operation by a general surgeon for one of seven diagnoses (gallbladder disease, gastroduodenal ulcer disease, intestinal ischemia, intestinal obstruction, intestinal perforation, diverticulitis, and abdominal wall hernia) were analyzed. Postoperative complications (pneumonia, myocardial infarction, incisional surgical site infection, organ/space surgical site infection, thromboembolic process, urinary tract infection, stroke, or major bleeding) were chosen based on surgical outcome measures monitored by national quality improvement initiatives and regulatory bodies. Regression techniques were used to determine the independent association between these complications and 30-day mortality, after adjustment for an array of patient- and procedure-related variables. Emergency operations accounted for 14.6% of the approximately 1.2 million general surgery procedures that are included in American College of Surgeons' National Surgical Quality Improvement Program but for 53.5% of the 19,094 postoperative deaths. A total of 43,429 emergency general surgery patients were analyzed. Incisional surgical site infection had the highest incidence (6.7%). The second most common complication was pneumonia (5.7%). Stroke, major bleeding, myocardial infarction, and pneumonia exhibited the strongest associations with postoperative death. Given its disproportionate contribution to surgical mortality, emergency surgery represents an ideal focus for quality improvement. Of the potential postoperative targets for quality improvement, pneumonia, myocardial

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;…

44 CFR 331.5 - Production facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Production facilities. 331.5... AND FACILITIES IN LABOR SURPLUS AREAS § 331.5 Production facilities. All Federal departments and... production facilities, including expansion, to the extent that such selection is consistent with existing law...

75 FR 22611 - Recovery Policy RP9523.3, Provision of Temporary Relocation Facilities

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-29

...] Recovery Policy RP9523.3, Provision of Temporary Relocation Facilities AGENCY: Federal Emergency Management... Management Agency (FEMA) is accepting comments on Recovery Policy RP9523.3, Provision of Temporary Relocation... major disaster. Specifically, Section 403(a)(3)(D) of the Stafford Act allows for the provision of...

Satisfaction with emergency obstetric and new born care services among clients using public health facilities in Jimma Zone, Oromia Regional State, Ethiopia; a cross sectional study.

PubMed

Kumsa, Alemayehu; Tura, Gurmessa; Nigusse, Aderajew; Kebede, Getahun

2016-04-25

The 2005 report of United Nations Millennium Project of Transforming Health Systems for women and children concluded that universal access to Emergency Obstetric and New born Care could reduce maternal deaths by 74%. Even though some studies investigated quality of Emergency Obstetric and New born Care in different parts of the world, there is scarcity of data regarding this issue in Ethiopia, particularly in Jimma zone. Therefore, the aim of this study was to assess satisfaction with Emergency Obstetric and new born Care services among clients using public health facilities in Jimma zone, Southwest Ethiopia. A facility-based cross sectional study was conducted in Jimma Zone from April 01-30, 2014. The data were collected by interviewing 403 clients, who gave birth in the past 12 months prior to data collection in 34 randomly selected public health facilities. The collected data were entered by using Epi-info version 3.5.4 and analysed using SPSS version 20.0. Linear regression analysis was done to ascertain the association between covariates and the outcome variable, and finally the results were presented using frequency distribution tables, graphs and texts. The overall mean client satisfaction with Emergency Obstetric and New born Care services in this study was 79.4%; 95% CI (75%, 83%). The result of linear regression analysis revealed that a unit decrease in satisfaction to availability of drugs and equipment, decreased overall clients' satisfaction by 0.23 unit 95% CI (0.15, 0.31). The level of clients' satisfaction with Emergency Obstetric and New born Care services was low in the study area. Factors such as availability of essential equipment and drugs, health workers' communication, health care provided, and attitude of health workers had positive association with client satisfaction with Emergency Obstetric and New born Care services. This in turn could affect utilization of Emergency Obstetric and New born Care services and play a role in contribution to

Gender-specific research for emergency diagnosis and management of ischemic heart disease: proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup.

PubMed

Safdar, Basmah; Nagurney, John T; Anise, Ayodola; DeVon, Holli A; D'Onofrio, Gail; Hess, Erik P; Hollander, Judd E; Legato, Mariane J; McGregor, Alyson J; Scott, Jane; Tewelde, Semhar; Diercks, Deborah B

2014-12-01

Coronary artery disease (CAD) is the most common cause of death for both men and women. However, over the years, emergency physicians, cardiologists, and other health care practitioners have observed varying outcomes in men and women with symptomatic CAD. Women in general are 10 to 15 years older than men when they develop CAD, but suffer worse postinfarction outcomes compared to age-matched men. This article was developed by the cardiovascular workgroup at the 2014 Academic Emergency Medicine (AEM) consensus conference to identify sex- and gender-specific gaps in the key themes and research questions related to emergency cardiac ischemia care. The workgroup had diverse stakeholder representation from emergency medicine, cardiology, critical care, nursing, emergency medical services, patients, and major policy-makers in government, academia, and patient care. We implemented the nominal group technique to identify and prioritize themes and research questions using electronic mail, monthly conference calls, in-person meetings, and Web-based surveys between June 2013 and May 2014. Through three rounds of nomination and refinement, followed by an in-person meeting on May 13, 2014, we achieved consensus on five priority themes and 30 research questions. The overarching themes were as follows: 1) the full spectrum of sex-specific risk as well as presentation of cardiac ischemia may not be captured by our standard definition of CAD and needs to incorporate other forms of ischemic heart disease (IHD); 2) diagnosis is further challenged by sex/gender differences in presentation and variable sensitivity of cardiac biomarkers, imaging, and risk scores; 3) sex-specific pathophysiology of cardiac ischemia extends beyond conventional obstructive CAD to include other causes such as microvascular dysfunction, takotsubo, and coronary artery dissection, better recognized as IHD; 4) treatment and prognosis are influenced by sex-specific variations in biology, as well as patient

44 CFR 19.410 - Comparable facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Comparable facilities. 19.410... Activities Prohibited § 19.410 Comparable facilities. A recipient may provide separate toilet, locker room, and shower facilities on the basis of sex, but such facilities provided for students of one sex shall...

44 CFR 19.410 - Comparable facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Comparable facilities. 19.410... Activities Prohibited § 19.410 Comparable facilities. A recipient may provide separate toilet, locker room, and shower facilities on the basis of sex, but such facilities provided for students of one sex shall...

Emergence and Evolution of Hominidae-Specific Coding and Noncoding Genomic Sequences

PubMed Central

Saber, Morteza Mahmoudi; Adeyemi Babarinde, Isaac; Hettiarachchi, Nilmini; Saitou, Naruya

2016-01-01

Family Hominidae, which includes humans and great apes, is recognized for unique complex social behavior and intellectual abilities. Despite the increasing genome data, however, the genomic origin of its phenotypic uniqueness has remained elusive. Clade-specific genes and highly conserved noncoding sequences (HCNSs) are among the high-potential evolutionary candidates involved in driving clade-specific characters and phenotypes. On this premise, we analyzed whole genome sequences along with gene orthology data retrieved from major DNA databases to find Hominidae-specific (HS) genes and HCNSs. We discovered that Down syndrome critical region 4 (DSCR4) is the only experimentally verified gene uniquely present in Hominidae. DSCR4 has no structural homology to any known protein and was inferred to have emerged in several steps through LTR/ERV1, LTR/ERVL retrotransposition, and transversion. Using the genomic distance as neutral evolution threshold, we identified 1,658 HS HCNSs. Polymorphism coverage and derived allele frequency analysis of HS HCNSs showed that these HCNSs are under purifying selection, indicating that they may harbor important functions. They are overrepresented in promoters/untranslated regions, in close proximity of genes involved in sensory perception of sound and developmental process, and also showed a significantly lower nucleosome occupancy probability. Interestingly, many ancestral sequences of the HS HCNSs showed very high evolutionary rates. This suggests that new functions emerged through some kind of positive selection, and then purifying selection started to operate to keep these functions. PMID:27289096

Emergency positioning system accuracy with infrared LEDs in high-security facilities

NASA Astrophysics Data System (ADS)

Knoch, Sierra N.; Nelson, Charles; Walker, Owens

2017-05-01

Instantaneous personnel location presents a challenge in Department of Defense applications where high levels of security restrict real-time tracking of crew members. During emergency situations, command and control requires immediate accountability of all personnel. Current radio frequency (RF) based indoor positioning systems can be unsuitable due to RF leakage and electromagnetic interference with sensitively calibrated machinery on variable platforms like ships, submarines and high-security facilities. Infrared light provide a possible solution to this problem. This paper proposes and evaluates an indoor line-of-sight positioning system that is comprised of IR and high-sensitivity CMOS camera receivers. In this system the movement of the LEDs is captured by the camera, uploaded and analyzed; the highest point of power is located and plotted to create a blueprint of crewmember location. Results provided evaluate accuracy as a function of both wavelength and environmental conditions. Research will further evaluate the accuracy of the LED transmitter and CMOS camera receiver system. Transmissions in both the 780 and 850nm IR are analyzed.

Cancer-specific variation in emergency presentation by sex, age and deprivation across 27 common and rarer cancers.

PubMed

Abel, G A; Shelton, J; Johnson, S; Elliss-Brookes, L; Lyratzopoulos, G

2015-03-31

Although overall sociodemographic and cancer site variation in the risk of cancer diagnosis through emergency presentation has been previously described, relatively little is known about how this risk may vary differentially by sex, age and deprivation group between patients with a given cancer. Data from the Routes to Diagnosis project on 749,645 patients (2006-2010) with any of 27 cancers that can occur in either sex were analysed. Crude proportions and crude and adjusted odds ratios were calculated for emergency presentation, and interactions between sex, age and deprivation with cancer were examined. The overall proportion of patients diagnosed through emergency presentation varied greatly by cancer. Compared with men, women were at greater risk for emergency presentation for bladder, brain, rectal, liver, stomach, colon and lung cancer (e.g., bladder cancer-specific odds ratio for women vs men, 1.50; 95% CI 1.39-1.60), whereas the opposite was true for oral/oropharyngeal cancer, lymphomas and melanoma (e.g., oropharyngeal cancer-specific odds ratio for women vs men, 0.49; 95% CI 0.32-0.73). Similarly, younger patients were at higher risk for emergency presentation for acute leukaemia, colon, stomach and oesophageal cancer (e.g., colon cancer-specific odds ratio in 35-44- vs 65-74-year-olds, 2.01; 95% CI 1.76-2.30) and older patients for laryngeal, melanoma, thyroid, oral and Hodgkin's lymphoma (e.g., melanoma specific odds ratio in 35-44- vs 65-74-year-olds, 0.20; 95% CI 0.12-0.33). Inequalities in the risk of emergency presentation by deprivation group were greatest for oral/oropharyngeal, anal, laryngeal and small intestine cancers. Among patients with the same cancer, the risk for emergency presentation varies notably by sex, age and deprivation group. The findings suggest that, beyond tumour biology, diagnosis through an emergency route may be associated both with psychosocial processes, which can delay seeking of medical help, and with difficulties in

44 CFR 331.5 - Production facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Production facilities. 331.5 Section 331.5 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF... and essential economic and strategic factors. ...

Validation of temporal and spatial consistency of facility- and speed-specific vehicle-specific power distributions for emission estimation: A case study in Beijing, China.

PubMed

Zhai, Zhiqiang; Song, Guohua; Lu, Hongyu; He, Weinan; Yu, Lei

2017-09-01

Vehicle-specific power (VSP) has been found to be highly correlated with vehicle emissions. It is used in many studies on emission modeling such as the MOVES (Motor Vehicle Emissions Simulator) model. The existing studies develop specific VSP distributions (or OpMode distribution in MOVES) for different road types and various average speeds to represent the vehicle operating modes on road. However, it is still not clear if the facility- and speed-specific VSP distributions are consistent temporally and spatially. For instance, is it necessary to update periodically the database of the VSP distributions in the emission model? Are the VSP distributions developed in the city central business district (CBD) area applicable to its suburb area? In this context, this study examined the temporal and spatial consistency of the facility- and speed-specific VSP distributions in Beijing. The VSP distributions in different years and in different areas are developed, based on real-world vehicle activity data. The root mean square error (RMSE) is employed to quantify the difference between the VSP distributions. The maximum differences of the VSP distributions between different years and between different areas are approximately 20% of that between different road types. The analysis of the carbon dioxide (CO 2 ) emission factor indicates that the temporal and spatial differences of the VSP distributions have no significant impact on vehicle emission estimation, with relative error of less than 3%. The temporal and spatial differences have no significant impact on the development of the facility- and speed-specific VSP distributions for the vehicle emission estimation. The database of the specific VSP distributions in the VSP-based emission models can maintain in terms of time. Thus, it is unnecessary to update the database regularly, and it is reliable to use the history vehicle activity data to forecast the emissions in the future. In one city, the areas with less data can still

Antimicrobial stewardship in long term care facilities: what is effective?

PubMed

Nicolle, Lindsay E

2014-02-12

Intense antimicrobial use in long term care facilities promotes the emergence and persistence of antimicrobial resistant organisms and leads to adverse effects such as C. difficile colitis. Guidelines recommend development of antimicrobial stewardship programs for these facilities to promote optimal antimicrobial use. However, the effectiveness of these programs or the contribution of any specific program component is not known. For this review, publications describing evaluation of antimicrobial stewardship programs for long term care facilities were identified through a systematic literature search. Interventions included education, guidelines development, feedback to practitioners, and infectious disease consultation. The studies reviewed varied in types of facilities, interventions used, implementation, and evaluation. Comprehensive programs addressing all infections were reported to have improved antimicrobial use for at least some outcomes. Targeted programs for treatment of pneumonia were minimally effective, and only for indicators of uncertain relevance for stewardship. Programs focusing on specific aspects of treatment of urinary infection - limiting treatment of asymptomatic bacteriuria or prophylaxis of urinary infection - were reported to be effective. There were no reports of cost-effectiveness, and the sustainability of most of the programs is unclear. There is a need for further evaluation to characterize effective antimicrobial stewardship for long term care facilities.

Hospital all-risk emergency preparedness in Ghana.

PubMed

Norman, I D; Aikins, M; Binka, F N; Nyarko, K M

2012-03-01

This paper assessed the emergency preparedness programs of health facilities for all-risks but focused on Road Traffic Accidents, (RTA) resulting in surge demand. It adopted W. H. O checklist covering hospital preparedness, equipment, manpower and surge capacity planning as best practices for the mitigation of public health emergencies. This is a cross-sectional study of purposively selected health facilities. The method used consisted of site visit, questionnaire survey, literature and internet review. The W. H. O. standard for emergency preparedness of health facilities was used to evaluate and assess the nation's hospitals surge capacity programs. The study was conducted between March-June, 2010. A total of 22 district and regional health facilities including teaching hospitals participated in the study. All 10 regions of the country were covered. These were: (1) many of the nation's hospitals were not prepared for large RTA's resulting in surge demands, and did not possess general emergency preparedness programs. (2) The hospitals' respective abilities to handle large scale RTA's were compromised by the lack of competent medical and allied health personnel and adequate supplies. The inadequacies of the hospital system in responding to emergencies raise serious public health concerns. The biggest challenge facing the hospitals in their emergency intervention is the lack of pre-emergency and emergency preparedness plans as well as the coordination of the hospitals response mechanisms. The paper ended with recommendations on how the nation's hospitals and their supervisory agencies could improve emergency preparedness.

Facilities for chemical decontamination in accident and emergency departments in the United Kingdom

PubMed Central

George, G; Ramsay, K; Rochester, M; Seah, R; Spencer, H; Vijayasankar, D; Vasicuro, L

2002-01-01

Objective: To audit the facilities for chemical decontamination, with special reference to cyanide poisoning, in all major accident and emergency departments in the UK. Method: A simple postal questionnaire was used to audit planning, premises, equipment, protection for staff, and stocks of specific antidotes to cyanide poisoning. Results: 227 questionnaires from 261 departments (87%) were returned and used in the survey. Of the 227 departments who responded, 151 (66%) had a written plan; 168 (74%) departments had premises for decontamination; 55 (24%) were judged to have satisfactory premises; 146 (64%) departments had a shower or hose for decontamination; 60 (26%) departments had a decontamination trolley suitable for "stretcher" patients; 203 (89%) had some protective equipment for staff but only 77 (34%) had complete protection—that is, goggles, chemical resistant clothing, and breathing apparatus. In the authors' opinion only seven (3%) departments had satisfactory premises and equipment to treat "stretcher" patients and full protection for staff. A further 11 (5%) departments were equipped to manage ambulant patients at a similar level. Some 205 (90%) departments stocked one or more antidotes to cyanide and 77 (34%) stocked all four antidotes. Thirty four (15%) departments held all four antidotes to cyanide and had full protection for staff. Only five (2%) departments had satisfactory premises and equipment to treat "stretcher" patients, full protection for staff, and at least three of four antidotes. Conclusions: Most departments had some equipment for chemical decontamination. However, there were major inconsistencies in the range of equipment held and these limited its usefulness. Only a small minority of departments was satisfactorily equipped to deal with a serious chemical incident. PMID:12205006

The association between the availability of ambulatory care and non-emergency treatment in emergency medicine departments: a comprehensive and nationwide validation.

PubMed

Chan, Chien-Lung; Lin, Wender; Yang, Nan-Ping; Huang, Hsin-Tsung

2013-05-01

To quantify dynamic availability of ambulatory care, and to examine possible associations with non-emergency treatments in emergency departments (EDs). Longitudinal data from the Taiwan National health Insurance Research Database were used to evaluate 749,584 emergency-medicine cases occurring between 2005 and 2010 according to a modified New York University algorithm. Multivariable-cumulative-logistic-regression analysis with generalized estimating-equation methods was used to determine associations between availability of ambulatory care and the urgency of patients' medical needs during ED visits. More than half (53.04%) of the ED visits that were evaluated in our study were classified as non-emergencies, and over half of these occurred despite a high availability of ambulatory care facilities (median > 96%). Compared with patients in areas with a low availability of ambulatory care, patients in areas of medium to high availability showed approximately 0.8 times lower odds ratios for associations with non-emergency ED visits. Non-emergency ED visits may be reduced by increasing the availability of ambulatory care facilities in areas with deficits in the availability of such facilities. However, increasing the availability of ambulatory care by raising the number of available ambulatory care physicians or the number of ambulatory care facilities may not reduce non-emergency ED visits in areas with medium to high availability of ambulatory care facilities. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

44 CFR 321.5 - Retention of industrial facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... facilities. 321.5 Section 321.5 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY..., DEPARTMENT OF ENERGY, MARITIME ADMINISTRATION) § 321.5 Retention of industrial facilities. (a) Industrial... components in a mobilization period. (b) Each idle plant in the reserves shall be reviewed annually by the...

Recommendations for Emergency Management Planning for School Facilities.

ERIC Educational Resources Information Center

Texas Education Agency, Austin.

Numerous events, such as hurricanes, floods, and tornadoes, constitute a natural disaster for public schools. Human-caused disasters include hazardous-material emergencies, civil riots, fires, and nuclear accidents. This document contains emergency-management planning guidelines, developed by the Texas Education Agency, to help local school…

Prototype Facility Educational Specifications.

ERIC Educational Resources Information Center

Idaho State Div. of Professional-Technical Education, Boise.

This document presents prototypical educational specifications to guide the building and renovation of Idaho vocational schools so they can help communities meet the advanced, professional-technical programs of the future. The specifications start with points to consider when determining school site suitability. The document then sets forth…

Facilities Specifications Guide.

ERIC Educational Resources Information Center

Athletic Business, 2000

2000-01-01

Provides line drawings of indoor and outdoor sporting fields reflecting the specifications and dimensional standards of each, including where additional information can be found. Sporting events from badminton, baseball, and basketball to lacrosse, swimming/diving, and volleyball are addressed. (GR)

Emergence and Evolution of Hominidae-Specific Coding and Noncoding Genomic Sequences.

PubMed

Saber, Morteza Mahmoudi; Adeyemi Babarinde, Isaac; Hettiarachchi, Nilmini; Saitou, Naruya

2016-07-12

Family Hominidae, which includes humans and great apes, is recognized for unique complex social behavior and intellectual abilities. Despite the increasing genome data, however, the genomic origin of its phenotypic uniqueness has remained elusive. Clade-specific genes and highly conserved noncoding sequences (HCNSs) are among the high-potential evolutionary candidates involved in driving clade-specific characters and phenotypes. On this premise, we analyzed whole genome sequences along with gene orthology data retrieved from major DNA databases to find Hominidae-specific (HS) genes and HCNSs. We discovered that Down syndrome critical region 4 (DSCR4) is the only experimentally verified gene uniquely present in Hominidae. DSCR4 has no structural homology to any known protein and was inferred to have emerged in several steps through LTR/ERV1, LTR/ERVL retrotransposition, and transversion. Using the genomic distance as neutral evolution threshold, we identified 1,658 HS HCNSs. Polymorphism coverage and derived allele frequency analysis of HS HCNSs showed that these HCNSs are under purifying selection, indicating that they may harbor important functions. They are overrepresented in promoters/untranslated regions, in close proximity of genes involved in sensory perception of sound and developmental process, and also showed a significantly lower nucleosome occupancy probability. Interestingly, many ancestral sequences of the HS HCNSs showed very high evolutionary rates. This suggests that new functions emerged through some kind of positive selection, and then purifying selection started to operate to keep these functions. © The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

Geographic Distribution of Disaster-Specific Emergency Department Use After Hurricane Sandy in New York City.

PubMed

Lee, David C; Smith, Silas W; Carr, Brendan G; Doran, Kelly M; Portelli, Ian; Grudzen, Corita R; Goldfrank, Lewis R

2016-06-01

We aimed to characterize the geographic distribution of post-Hurricane Sandy emergency department use in administrative flood evacuation zones of New York City. Using emergency claims data, we identified significant deviations in emergency department use after Hurricane Sandy. Using time-series analysis, we analyzed the frequency of visits for specific conditions and comorbidities to identify medically vulnerable populations who developed acute postdisaster medical needs. We found statistically significant decreases in overall post-Sandy emergency department use in New York City but increased utilization in the most vulnerable evacuation zone. In addition to dialysis- and ventilator-dependent patients, we identified that patients who were elderly or homeless or who had diabetes, dementia, cardiac conditions, limitations in mobility, or drug dependence were more likely to visit emergency departments after Hurricane Sandy. Furthermore, patients were more likely to develop drug-resistant infections, require isolation, and present for hypothermia, environmental exposures, or administrative reasons. Our study identified high-risk populations who developed acute medical and social needs in specific geographic areas after Hurricane Sandy. Our findings can inform coherent and targeted responses to disasters. Early identification of medically vulnerable populations can help to map "hot spots" requiring additional medical and social attention and prioritize resources for areas most impacted by disasters. (Disaster Med Public Health Preparedness. 2016;10:351-361).

Emergency preparedness and planning

NASA Technical Reports Server (NTRS)

Bouvier, Kenneth

1993-01-01

Monsanto's emergency response plan in dealing with hazardous materials at their facilities is presented. Topics discussed include the following: CPR training; emergency medial training; incident reports; contractor injuries; hazardous materials transport; evacuation; and other industrial safety concerns.

Space Station Furnace Facility. Volume 2: Appendix 1: Contract End Item specification (CEI), part 1

NASA Technical Reports Server (NTRS)

Seabrook, Craig

1992-01-01

This specification establishes the performance, design, development, and verification requirements for the Space Station Furnace Facility (SSFF) Core. The definition of the SSFF Core and its interfaces, specifies requirements for the SSFF Core performance, specifies requirements for the SSFF Core design, and construction are presented, and the verification requirements are established.

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.

Applying the lessons of maternal mortality reduction to global emergency health

PubMed Central

Skog, Alexander P; Tenner, Andrea G; Wallis, Lee A

2015-01-01

Abstract Over the last few decades, maternal health has been a major focus of the international community and this has resulted in a substantial decrease in maternal mortality globally. Although, compared with maternal illness, medical and surgical emergencies account for far more morbidity and mortality, there has been less focus on global efforts to improve comprehensive emergency systems. The thoughtful and specific application of the concepts used in the effort to decrease maternal mortality could lead to major improvements in global emergency health services. The so-called three-delay model that was developed for maternal mortality can be adapted to emergency service delivery. Adaptation of evaluation frameworks to include emergency sentinel conditions could allow effective monitoring of emergency facilities and further policy development. Future global emergency health efforts may benefit from incorporating strategies for the planning and evaluation of high-impact interventions. PMID:26240463

The Emergent Literacy Development of Spanish-Speaking Preschool Children with Specific Language Impairment

ERIC Educational Resources Information Center

Pratt, Amy Susan

2017-01-01

This dissertation portfolio is comprised of three first-authored pieces of writing that investigate the oral language and emergent literacy development of Spanish-speaking children with specific language impairment (SLI). Each piece features a unique but complementary aim. The first study investigates group differences on a battery of emergent…

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

Sensitivity and specificity of the gain short-screener for predicting substance use disorders in a large national sample of emerging adults.

PubMed

Smith, Douglas C; Bennett, Kyle M; Dennis, Michael L; Funk, Rodney R

2017-05-01

Emerging Adults (ages 18-25) have the highest prevalence of substance use disorders and rarely receive treatment from the specialty care system. Thus, it is important to have screening instruments specifically developed for emerging adults for use in Screening, Brief Intervention and Referral to Treatment (SBIRT) models. Optimal cutoffs for the widely-used GAIN Short-Screener's (GAIN-SS) Substance Disorder Screener (SDScrY) are not established specifically for emerging adults. Therefore, this study examined the sensitivity and specificity of the SDScrY in predicting emerging adult (ages 18-25) substance use disorders. We analyzed data from emerging adults in a large clinical sample (n=9,808) who completed both the five-item SDScrY (α=0.85) and the full criteria set for DSM-IV Substance Use Disorders. We estimated the sensitivity, specificity and area under the curve to determine optimal cutoffs. Analyses revealed a high correlation between the SDScrY screener and its longer parent scale (r=0.95, p<0.001). Sensitivity (83%) and specificity (95%) were highest at a cutoff score of two (AUC=94%) on the SDScrY for any past year substance use disorder. Sensitivity (85%) was also high at a cutoff score of two on the SDScrY for any past year alcohol disorder. The five-item Substance Use Disorder Screener is a sensitive and specific screener for emerging adults, and could be used to identify emerging adults who may benefit from SBIRT interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

Using principles from emergency management to improve emergency response plans for research animals.

PubMed

Vogelweid, Catherine M

2013-10-01

Animal research regulatory agencies have issued updated requirements for emergency response planning by regulated research institutions. A thorough emergency response plan is an essential component of an institution's animal care and use program, but developing an effective plan can be a daunting task. The author provides basic information drawn from the field of emergency management about best practices for developing emergency response plans. Planners should use the basic principles of emergency management to develop a common-sense approach to managing emergencies in their facilities.

44 CFR 206.252 - Insurance requirements for facilities damaged by flood.

Code of Federal Regulations, 2011 CFR

2011-10-01

... facilities damaged by flood. 206.252 Section 206.252 Emergency Management and Assistance FEDERAL EMERGENCY... Assistance Insurance Requirements § 206.252 Insurance requirements for facilities damaged by flood. (a) Where... insurance policy. (b) The reduction stated above shall not apply to a PNP facility which could not be...

Earth Observatory Satellite system definition study. Report 5: System design and specifications. Volume 6: Specification for EOS Central Data Processing Facility (CDPF)

NASA Technical Reports Server (NTRS)

1974-01-01

The specifications and functions of the Central Data Processing (CDPF) Facility which supports the Earth Observatory Satellite (EOS) are discussed. The CDPF will receive the EOS sensor data and spacecraft data through the Spaceflight Tracking and Data Network (STDN) and the Operations Control Center (OCC). The CDPF will process the data and produce high density digital tapes, computer compatible tapes, film and paper print images, and other data products. The specific aspects of data inputs and data processing are identified. A block diagram of the CDPF to show the data flow and interfaces of the subsystems is provided.

33 CFR 127.205 - Emergency shutdown.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) WATERFRONT FACILITIES WATERFRONT FACILITIES HANDLING LIQUEFIED NATURAL GAS AND LIQUEFIED HAZARDOUS GAS Waterfront Facilities Handling Liquefied Natural Gas Equipment § 127.205 Emergency shutdown. Each transfer... automatically when the fixed sensors under § 127.201(b) measure LNG concentrations exceeding 40% of the lower...

33 CFR 127.205 - Emergency shutdown.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) WATERFRONT FACILITIES WATERFRONT FACILITIES HANDLING LIQUEFIED NATURAL GAS AND LIQUEFIED HAZARDOUS GAS Waterfront Facilities Handling Liquefied Natural Gas Equipment § 127.205 Emergency shutdown. Each transfer... automatically when the fixed sensors under § 127.201(b) measure LNG concentrations exceeding 40% of the lower...

The characteristics of referring facilities and transferred hand surgery patients: factors associated with emergency patient transfers.

PubMed

Kuo, Phoebe; Hartzell, Tristan L; Eberlin, Kyle R; Miao, Diana; Zurakowski, David; Winograd, Jonathan M; Day, Charles S

2014-03-19

As emergency departments (EDs) become increasingly overwhelmed and specialist coverage in some EDs decreases, patients may be transferred to tertiary or quaternary facilities for specialized care to decrease patient load at transferring facilities. Our objective was to determine whether facilities that transferred patients for hand surgery had hand surgery coverage and to evaluate any nonmedical factors that might have been associated with transfer. A retrospective review was conducted for 1167 visits of hand and wrist patients seen in the EDs of two urban level-I trauma centers. The hand surgery capacity of referring facilities was determined by phone calls to the EDs. Univariate and multivariable analyses were conducted to identify nonmedical factors that could potentially affect the decision to transfer. A total of 155 (13.3%) of 1167 patients arrived from other facilities for specialized hand care. These patients were significantly more likely to be male (p = 0.02), have noncommercial insurance (p = 0.04), require an interpreter (p = 0.01), and arrive between 6:00 p.m. and midnight (p = 0.03). In a multivariable analysis, sex and insurance status were significantly associated with transfer (p < 0.05). The subset of ninety-five patients who were transferred from other EDs was significantly more likely to be male (p < 0.01) and arrive on weekends (p < 0.01) or between 6:00 p.m. and midnight (p < 0.01). Of these patients, seventy-seven (81%) were transferred from an ED that reported partial or full hand surgery coverage. However, only eight (10.4%) received a hand surgery evaluation prior to transfer. The low percentage of patients receiving hand surgery evaluations prior to transfer suggests that referring hospitals are not using their own hand surgeon resources. Nonmedical factors, including noncommercial insurance and off-hour time of initial arrival, may be associated with the decision to transfer patients. Identifying nonmedical factors associated

Environmental Assessment for the NASA First Response Facility

NASA Technical Reports Server (NTRS)

Kennedy, Carolyn

2003-01-01

NASA intends to construct a First Response Facility for integrated emergency response and health management. This facility will consolidate the Stennis Space Center fire department, medical clinic, security operations, emergency operations and the energy management and control center. The alternative considered is the "No Action Alternative". The proposed action will correct existing operational weaknesses and enhance capabilities to respond to medical emergencies and mitigate any other possible threats. Environmental impacts include are emissions, wetlands disturbance, solid waste generation, and storm water control.

40 CFR 403.19 - Provisions of specific applicability to the Owatonna Waste Water Treatment Facility.

Code of Federal Regulations, 2011 CFR

2011-07-01

... FOR EXIST-ING AND NEW SOURCES OF POLLUTION § 403.19 Provisions of specific applicability to the... Facility is equal to or less than 0.68 pounds per day of chromium, 0.25 pounds per day of copper, 1.17... Noncompliance subject to the publication requirement in § 403.8(f)(2)(vii) at the Minnesota Pollution Control...

Availability of drugs and medical supplies for emergency obstetric care: experience of health facility managers in a rural District of Tanzania.

PubMed

Mkoka, Dickson Ally; Goicolea, Isabel; Kiwara, Angwara; Mwangu, Mughwira; Hurtig, Anna-Karin

2014-03-19

Provision of quality emergency obstetric care relies upon the presence of skilled health attendants working in an environment where drugs and medical supplies are available when needed and in adequate quantity and of assured quality. This study aimed to describe the experience of rural health facility managers in ensuring the timely availability of drugs and medical supplies for emergency obstetric care (EmOC). In-depth interviews were conducted with a total of 17 health facility managers: 14 from dispensaries and three from health centers. Two members of the Council Health Management Team and one member of the Council Health Service Board were also interviewed. A survey of health facilities was conducted to supplement the data. All the materials were analysed using a qualitative thematic analysis approach. Participants reported on the unreliability of obtaining drugs and medical supplies for EmOC; this was supported by the absence of essential items observed during the facility survey. The unreliability of obtaining drugs and medical supplies was reported to result in the provision of untimely and suboptimal EmOC services. An insufficient budget for drugs from central government, lack of accountability within the supply system and a bureaucratic process of accessing the locally mobilized drug fund were reported to contribute to the current situation. The unreliability of obtaining drugs and medical supplies compromises the timely provision of quality EmOC. Multiple approaches should be used to address challenges within the health system that prevent access to essential drugs and supplies for maternal health. There should be a special focus on improving the governance of the drug delivery system so that it promotes the accountability of key players, transparency in the handling of information and drug funds, and the participation of key stakeholders in decision making over the allocation of locally collected drug funds.

Availability of drugs and medical supplies for emergency obstetric care: experience of health facility managers in a rural District of Tanzania

PubMed Central

2014-01-01

Background Provision of quality emergency obstetric care relies upon the presence of skilled health attendants working in an environment where drugs and medical supplies are available when needed and in adequate quantity and of assured quality. This study aimed to describe the experience of rural health facility managers in ensuring the timely availability of drugs and medical supplies for emergency obstetric care (EmOC). Methods In-depth interviews were conducted with a total of 17 health facility managers: 14 from dispensaries and three from health centers. Two members of the Council Health Management Team and one member of the Council Health Service Board were also interviewed. A survey of health facilities was conducted to supplement the data. All the materials were analysed using a qualitative thematic analysis approach. Results Participants reported on the unreliability of obtaining drugs and medical supplies for EmOC; this was supported by the absence of essential items observed during the facility survey. The unreliability of obtaining drugs and medical supplies was reported to result in the provision of untimely and suboptimal EmOC services. An insufficient budget for drugs from central government, lack of accountability within the supply system and a bureaucratic process of accessing the locally mobilized drug fund were reported to contribute to the current situation. Conclusion The unreliability of obtaining drugs and medical supplies compromises the timely provision of quality EmOC. Multiple approaches should be used to address challenges within the health system that prevent access to essential drugs and supplies for maternal health. There should be a special focus on improving the governance of the drug delivery system so that it promotes the accountability of key players, transparency in the handling of information and drug funds, and the participation of key stakeholders in decision making over the allocation of locally collected drug funds. PMID

44 CFR 312.6 - Materials and facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Materials and facilities. 312... OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER PURPOSES § 312.6 Materials and facilities. FEMA also contributes to the development and...

Emergency service: a strategy for hospital-sponsored ambulatory care satellites.

PubMed

Gregory, D; Klegon, D; Steinhauer, B

1984-01-01

This analysis of the overall market position of free-standing emergency care was based on a telephone survey of 300 randomly chosen households in a southeastern metropolitan area. Results show that consumer preferences for cost and convenience create a strong market for free-standing emergency facilities. Emergicare centers are in an ideal situation to capture the market for acute and minor emergency care. To be worthwhile, the emergency room in a more comprehensive ambulatory care facility should serve as a feeder of new patients and be profitable in its own right. However, free-standing emergency facilities must not only attract patients through convenience and price, but they must also maintain patients through assuring quality care and satisfaction.

Emergency department transfers and hospital admissions from residential aged care facilities: a controlled pre-post design study.

PubMed

Hullick, Carolyn; Conway, Jane; Higgins, Isabel; Hewitt, Jacqueline; Dilworth, Sophie; Holliday, Elizabeth; Attia, John

2016-05-12

Older people living in Residential Aged Care Facilities (RACF) are a vulnerable, frail and complex population. They are more likely than people who reside in the community to become acutely unwell, present to the Emergency Department (ED) and require admission to hospital. For many, hospitalisation carries with it risks. Importantly, evidence suggests that some admissions are avoidable. A new collaborative model of care, the Aged Care Emergency Service (ACE), was developed to provide clinical support to nurses in the RACFs, allowing residents to be managed in place and avoid transfer to the ED. This paper examines the effects of the ACE service on RACF residents' transfer to hospital using a controlled pre-post design. Four intervention RACFs were matched with eight control RACFs based on number of total beds, dementia specific beds, and ratio of high to low care beds in Newcastle, Australia, between March and November 2011. The intervention consisted of a clinical care manual to support care along with a nurse led telephone triage line, education, establishing goals of care prior to ED transfer, case management when in the ED, along with the development of collaborative relationships between stakeholders. Outcomes included ED presentations, length of stay, hospital admission and 28-day readmission pre- and post-intervention. Generalised estimating equations were used to estimate mean differences in outcomes between intervention and controls RACFs, pre- and post-intervention means, and their interaction, accounting for repeated measures and adjusting for matching factors. Residents had a mean age of 86 years. ED presentations ranged between 16 and 211 visits/100 RACF beds/year across all RACFs. There was no overall reduction in ED presentations (OR = 1.17, p = 0.56) with the ACE intervention. However, when compared to the controls, the intervention group reduced their ED length of stay by 45 min (p = 0.0575), and was 40 % less likely to be admitted

Validation of Fall Risk Assessment Specific to the Inpatient Rehabilitation Facility Setting.

PubMed

Thomas, Dan; Pavic, Andrea; Bisaccia, Erin; Grotts, Jonathan

2016-09-01

To evaluate and compare the Morse Fall Scale (MFS) and the Casa Colina Fall Risk Assessment Scale (CCFRA) for identification of patients at risk for falling in an acute inpatient rehabilitation facility. The primary objective of this study was to perform a retrospective validation study of the CCFRAS, specifically for use in the inpatient rehabilitation facility (IRF) setting. Retrospective validation study. The study was approved under expedited review by the local Institutional Review Board. Data were collected on all patients admitted to Cottage Rehabiliation Hospital (CRH), a 38-bed acute inpatient rehabilitation hospital, from March 2012 to August 2013. Patients were excluded from the study if they had a length of stay less than 3 days or age less than 18. The area under the receiver operating characteristic curve (AUC) and the diagnostic odds ratio were used to examine the differences between the MFS and CCFRAS. AUC between fall scales was compared using the DeLong Test. There were 931 patients included in the study with 62 (6.7%) patient falls. The average age of the population was 68.8 with 503 males (51.2%). The AUC was 0.595 and 0.713 for the MFS and CCFRAS, respectively (0.006). The diagnostic odds ratio of the MFS was 2.0 and 3.6 for the CCFRAS using the recommended cutoffs of 45 for the MFS and 80 for the CCFRAS. The CCFRAS appears to be a better tool in detecting fallers vs. nonfallers specific to the IRF setting. The assessment and identification of patients at high risk for falling is important to implement specific precautions and care for these patients to reduce their risk of falling. The CCFRAS is more clinically relevant in identifying patients at high risk for falling in the IRF setting compared to other fall risk assessments. Implementation of this scale may lead to a reduction in fall rate and injuries from falls as it more appropriately identifies patients at high risk for falling. © 2015 Association of Rehabilitation Nurses.

School Emergency Planning Guide.

ERIC Educational Resources Information Center

Benedetto, Harry J.

This guide was prepared to assist Pennsylvania schools and communities in the development of comprehensive emergency plans. Procedures for identifying and responding to potential community and school emergency situations are presented. A plan for developing and organizing mass care centers utilizing school and community facilities and resources is…

A statistical method for determining the dimensions, tolerances and specification of optics for the Laser Megajoule facility (LMJ)

NASA Astrophysics Data System (ADS)

Denis, Vincent

2008-09-01

This paper presents a statistical method for determining the dimensions, tolerance and specifications of components for the Laser MegaJoule (LMJ). Numerous constraints inherent to a large facility require specific tolerances: the huge number of optical components; the interdependence of these components between the beams of same bundle; angular multiplexing for the amplifier section; distinct operating modes between the alignment and firing phases; the definition and use of alignment software in the place of classic optimization. This method provides greater flexibility to determine the positioning and manufacturing specifications of the optical components. Given the enormous power of the Laser MegaJoule (over 18 kJ in the infrared and 9 kJ in the ultraviolet), one of the major risks is damage the optical mounts and pollution of the installation by mechanical ablation. This method enables estimation of the beam occultation probabilities and quantification of the risks for the facility. All the simulations were run using the ZEMAX-EE optical design software.

44 CFR 16.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 16.150 Section 16.150 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FEDERAL EMERGENCY MANAGEMENT AGENCY § 16.150 Program...

Burden of emergency conditions and emergency care utilization: New estimates from 40 countries

PubMed Central

Chang, Cindy Y.; Abujaber, Samer; Reynolds, Teri A.; Camargo, Carlos A.; Obermeyer, Ziad

2016-01-01

Objective To estimate the global and national burden of emergency conditions, and compare them to emergency care utilization rates. Methods We coded all 291 Global Burden of Disease 2010 conditions into three categories to estimate emergency burden: conditions that, if not addressed within hours to days of onset, commonly lead to serious disability or death; conditions with common acute decompensations that lead to serious disability or death; and non-emergencies. Emergency care utilization rates were obtained from a systematic literature review on emergency care facilities in low- and middle-income countries (LMICs), supplemented by national health system reports. Findings All 15 leading causes of death and DALYs globally were conditions with potential emergent manifestations. We identified 41 facility-based reports in 23 countries, 12 of which were in LMICs; data for 17 additional countries were obtained from national or regional reports on emergency utilization. Burden of emergency conditions was the highest in low-income countries, with median DALYs of 47,728 per 100,000 population (IQR 45,253-50,085) in low-income, 25,186 (IQR 21,982-40,480) in middle-income, and 15,691 (IQR 14,649-16,382) in high-income countries. Patterns were similar using deaths to measure burden and excluding acute decompensations from the definition of emergency conditions. Conversely, emergency utilization rates were the lowest in low-income countries, with median 8 visits per 1,000 population (IQR 6-10), 78 (IQR 25-197) in middle-income, and 264 (IQR 177-341) in high-income countries. Conclusion Despite higher burden of emergency conditions, emergency utilization rates are substantially lower in LMICs, likely due to limited access to emergency care. PMID:27334758

Reliable Facility Location Problem with Facility Protection

PubMed Central

Tang, Luohao; Zhu, Cheng; Lin, Zaili; Shi, Jianmai; Zhang, Weiming

2016-01-01

This paper studies a reliable facility location problem with facility protection that aims to hedge against random facility disruptions by both strategically protecting some facilities and using backup facilities for the demands. An Integer Programming model is proposed for this problem, in which the failure probabilities of facilities are site-specific. A solution approach combining Lagrangian Relaxation and local search is proposed and is demonstrated to be both effective and efficient based on computational experiments on random numerical examples with 49, 88, 150 and 263 nodes in the network. A real case study for a 100-city network in Hunan province, China, is presented, based on which the properties of the model are discussed and some managerial insights are analyzed. PMID:27583542

38 CFR 17.1003 - Emergency transportation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Emergency transportation... Facilities § 17.1003 Emergency transportation. Notwithstanding the provisions of § 17.1002, payment or... the emergency transportation; (c) The veteran has no coverage under a health-plan contract for...

38 CFR 17.1003 - Emergency transportation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Emergency transportation... Facilities § 17.1003 Emergency transportation. Notwithstanding the provisions of § 17.1002, payment or... the emergency transportation; (c) The veteran has no coverage under a health-plan contract for...

38 CFR 17.1003 - Emergency transportation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Emergency transportation... Facilities § 17.1003 Emergency transportation. Notwithstanding the provisions of § 17.1002, payment or... the emergency transportation; (c) The veteran has no coverage under a health-plan contract for...

38 CFR 17.1003 - Emergency transportation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Emergency transportation... Facilities § 17.1003 Emergency transportation. Notwithstanding the provisions of § 17.1002, payment or... the emergency transportation; (c) The veteran has no coverage under a health-plan contract for...

38 CFR 17.1003 - Emergency transportation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Emergency transportation... Facilities § 17.1003 Emergency transportation. Notwithstanding the provisions of § 17.1002, payment or... the emergency transportation; (c) The veteran has no coverage under a health-plan contract for...

Access to emergency care services: a transversal ecological study about Brazilian emergency health care network.

PubMed

Rocha, T A H; da Silva, N C; Amaral, P V; Barbosa, A C Q; Rocha, J V M; Alvares, V; de Almeida, D G; Thumé, E; Thomaz, E B A F; de Sousa Queiroz, R C; de Souza, M R; Lein, A; Toomey, N; Staton, C A; Vissoci, J R N; Facchini, L A

2017-12-01

Studies of health geography are important in the planning and allocation of emergency health services. The geographical distribution of health facilities is an important factor in timely and quality access to emergency services; therefore, the present study analyzed the emergency health care network in Brazil, focusing the analysis at the roles of small hospitals (SHs). Cross-sectional ecological study. Data were collected from 9429 hospitals of which 3524 were SHs and 5905 were high-complexity centers (HCCs). For analytical purposes, we considered four specialties when examining the proxies of emergency care capability: adult, pediatrics, neonatal, and obstetric. We analyzed the spatial distribution of hospitals, identifying municipalities that rely exclusively on SHs and the distance of these cities from HCCs. More than 14 and 30 million people were at least 120 km away from HCCs with an adult intensive care unit (ICU) and pediatric ICU, respectively. For neonatal care distribution, 12% of the population was more than 120 km away from a health facility with a neonatal ICU. The maternities situation is different from other specialties, where 81% of the total Brazilian population was within 1 h or less from such health facilities. Our results highlighted a polarization in distribution of Brazilian health care facilities. There is a concentration of hospitals in urban areas more developed and access gaps in rural areas and the Amazon region. Our results demonstrate that the distribution of emergency services in Brazil is not facilitating access to the population due to geographical barriers associated with great distances. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

40 CFR 267.57 - What must the emergency coordinator do after an emergency?

Code of Federal Regulations, 2014 CFR

2014-07-01

... OPERATING UNDER A STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.57 What must the..., or any other material that results from a release, fire, or explosion at the facility. (b) The... completed. (2) All emergency equipment listed in the contingency plan is cleaned and fit for its intended...

40 CFR 267.57 - What must the emergency coordinator do after an emergency?

Code of Federal Regulations, 2012 CFR

2012-07-01

... OPERATING UNDER A STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.57 What must the..., or any other material that results from a release, fire, or explosion at the facility. (b) The... completed. (2) All emergency equipment listed in the contingency plan is cleaned and fit for its intended...

40 CFR 267.57 - What must the emergency coordinator do after an emergency?

Code of Federal Regulations, 2013 CFR

2013-07-01

... OPERATING UNDER A STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.57 What must the..., or any other material that results from a release, fire, or explosion at the facility. (b) The... completed. (2) All emergency equipment listed in the contingency plan is cleaned and fit for its intended...

40 CFR 267.57 - What must the emergency coordinator do after an emergency?

Code of Federal Regulations, 2011 CFR

2011-07-01

... OPERATING UNDER A STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.57 What must the..., or any other material that results from a release, fire, or explosion at the facility. (b) The... completed. (2) All emergency equipment listed in the contingency plan is cleaned and fit for its intended...

Age-related variation in primary care-type presentations to emergency departments.

PubMed

Freed, Gary; Gafforini, Sarah; Carson, Norman

2015-08-01

A significant amount of attention has been paid to the increase in emergency department (ED) presentations in Australia. Questions have arisen regarding whether all of those presenting to the ED are actually in need of true emergency services. Under-standing the characteristics of those patients who may be cared for in non-emergency settings is important for future health system strategies. The aim of this study was to identify age-related variation in primary care type emergency department (ED) presentations over time. A secondary analysis of data from the Victorian emergency minimum dataset (VEMD) between 2002-13 was conducted. The main outcomes were patterns of primary care type ED presentations for different ages groups over time, age-specific patterns of specific primary care type exclusion criteria and primary care type ED presentations by residents from aged care facilities. The proportion of triage category 4 or 5 ED presentations that met the criteria for a primary care type visit was greatest in the 0-4-year age group and tended to decrease as the age of the patient increased. Triage category 4 or 5 presentation by ambulance was uncommon in the younger age groups, surpassed 10% in the 50-54-year age group, and was >70% for those aged >90 years. The greater proportion of residential aged care facility patients who arrived by ambulance resulted in a much smaller proportion of primary care type visits. There are marked differences by age in the proportion of triage category 4 or 5 ED presentations that met the criteria for primary care type visits. These results indicate it was primarily younger patients who presented to the ED with non-urgent conditions. Most might be able to safely receive care in a primary care setting.

An emergency medical planning guide for commercial spaceflight events.

PubMed

Law, Jennifer; Vanderploeg, James

2012-09-01

Commercial spaceflight events transporting paying passengers into space will begin to take place at various spaceports around the country within the next few years. Many spaceports are located in remote areas that are far from major hospitals and trauma centers. Spaceport medical directors should develop emergency medical plans (EMPs) to prepare for potential medical contingencies that may occur during commercial spaceflight events. The aim of this article is to guide spaceport medical directors in emergency medical planning for commercial spaceflight events. This guide is based on our experience and a recently developed EMP for Spaceport America which incorporated a literature review of mass gathering medicine, existing planning guides for mass gathering events, and EMPs for analogous aerospace events. We propose a multipronged approach to emergency medical planning, consisting of event planning, medical reconnaissance, medical personnel, protocols, physical facility and hardware, and documentation. Medical directors should use this guide to develop an emergency medical plan tailored to the resources and constraints specific to their events.

33 CFR 146.110 - Emergency signals.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Emergency signals. 146.110...) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.110 Emergency signals. (a) The owner, the owner's agent, or the person in charge shall establish emergency signals to be used for...

33 CFR 146.110 - Emergency signals.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Emergency signals. 146.110...) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.110 Emergency signals. (a) The owner, the owner's agent, or the person in charge shall establish emergency signals to be used for...

33 CFR 146.110 - Emergency signals.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Emergency signals. 146.110...) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.110 Emergency signals. (a) The owner, the owner's agent, or the person in charge shall establish emergency signals to be used for...

33 CFR 146.110 - Emergency signals.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Emergency signals. 146.110...) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.110 Emergency signals. (a) The owner, the owner's agent, or the person in charge shall establish emergency signals to be used for...

33 CFR 146.110 - Emergency signals.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Emergency signals. 146.110...) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.110 Emergency signals. (a) The owner, the owner's agent, or the person in charge shall establish emergency signals to be used for...

Site Selection and Resource Allocation of Oil Spill Emergency Base for Offshore Oil Facilities

NASA Astrophysics Data System (ADS)

Li, Yunbin; Liu, Jingxian; Wei, Lei; Wu, Weihuang

2018-02-01

Based on the analysis of the historical data about oil spill accidents in the Bohai Sea, this paper discretizes oil spilled source into a limited number of spill points. According to the probability of oil spill risk, the demand for salvage forces at each oil spill point is evaluated. Aiming at the specific location of the rescue base around the Bohai Sea, a cost-benefit analysis is conducted to determine the total cost of disasters for each rescue base. Based on the relationship between the oil spill point and the rescue site, a multi-objective optimization location model for the oil spill rescue base in the Bohai Sea region is established. And the genetic algorithm is used to solve the optimization problem, and determine the emergency rescue base optimization program and emergency resources allocation ratio.

A statewide model program to improve emergency department readiness for pediatric care.

PubMed

Cichon, Mark E; Fuchs, Susan; Lyons, Evelyn; Leonard, Daniel

2009-08-01

Pediatric emergency patients have unique needs, requiring specialized personnel, training, equipment, supplies, and medications. Deficiencies in these areas have resulted in historically poorer outcomes for pediatric patients versus adults. Since 1985, federally funded Emergency Medical Services for Children (EMSC) programs in each state have been working to improve the quality of pediatric emergency care. The Health Resources and Services Administration now requires that all EMSC grantees report on specific performance measures. This includes implementation of a standardized system recognizing hospitals that are able to stabilize or manage pediatric medical emergencies and trauma cases. We describe the steps involved in implementing Illinois' 3-level facility recognition process to illustrate a model that other states might use to provide appropriate pediatric care and comply with new Health Resources and Services Administration performance measures.

KENNEDY SPACE CENTER, FLA. - Emergency crew members transport an “injured” astronaut during a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - Emergency crew members transport an “injured” astronaut during a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

STS-60 Cosmonauts in Weightless Environment Training Facility (WETF) training

NASA Image and Video Library

1993-01-07

S93-26022 (Feb 1993) --- Russian cosmonaut Sergei Krikalev maneuvers a small life raft during bailout training at the Johnson Space Center's (JSC) Weightless Environment Training Facility (WET-F). Shuttle crew members frequently utilize the 25-ft. deep pool to learn proper procedures to follow in the event of emergency egress from their Space Shuttle via the escape pole system. Krikalev is one of two cosmonauts in training for the STS-60 mission. One of the two will serve as primary payload specialist with the other filling an alternate's role. This pool and the facility in which it is housed are titled the WET-F because they are also used by astronauts rehearsing both mission-specific and contingency extravehicular activities (EVA).

Cross-sectional Survey of Long-Term Care Facilities in the Rockaway Peninsula: Preparedness and Response During Hurricane Sandy.

PubMed

Jiang, Lynn; Tedeschi, Christopher; Subaiya, Saleena

2018-04-01

Few studies have described the challenges experienced by long-term care facilities (LTCFs) following Hurricane Sandy. This study examined LTCF preparedness and experiences during and after the storm. A cross-sectional survey was conducted 2 years after Hurricane Sandy to assess LTCF demographics, preparation, and post-storm resources. Surveys were conducted at LTCFs located on the Rockaway Peninsula of New York City. All LTCFs located in a heavily affected area were approached. Of 29 facilities, 1 had closed, 5 did not respond, 9 declined to participate, and 14 participated, yielding a response rate of 50% for open facilities. Twenty-one percent of the facilities had preparations specifically for hurricanes. More than 70% of the facilities had lost electricity, heat, and telephone service, and one-half had evacuated. Twenty-one percent of the facilities reported not receiving any assistance and over one-half reported that relief resources did not meet their needs. Many LTCFs lacked plans specific to such a large-scale event. Since nearly all of the LTCFs in the region were affected, preexisting transportation and housing plans may have been inadequate. Future preparation could include hazard-specific planning and reliance on resources from a wider geographic area. Access to electricity emerged as a top priority. (Disaster Med Public Health Preparedness. 2018;12:194-200).

Hanford Facility dangerous waste permit application, liquid effluent retention facility and 200 area effluent treatment facility

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

Coenenberg, J.G.

1997-08-15

The Hanford Facility Dangerous Waste Permit Application is considered to 10 be a single application organized into a General Information Portion (document 11 number DOE/RL-91-28) and a Unit-Specific Portion. The scope of the 12 Unit-Specific Portion is limited to Part B permit application documentation 13 submitted for individual, `operating` treatment, storage, and/or disposal 14 units, such as the Liquid Effluent Retention Facility and 200 Area Effluent 15 Treatment Facility (this document, DOE/RL-97-03). 16 17 Both the General Information and Unit-Specific portions of the Hanford 18 Facility Dangerous Waste Permit Application address the content of the Part B 19 permit applicationmore » guidance prepared by the Washington State Department of 20 Ecology (Ecology 1987 and 1996) and the U.S. Environmental Protection Agency 21 (40 Code of Federal Regulations 270), with additional information needs 22 defined by the Hazardous and Solid Waste Amendments and revisions of 23 Washington Administrative Code 173-303. For ease of reference, the Washington 24 State Department of Ecology alpha-numeric section identifiers from the permit 25 application guidance documentation (Ecology 1996) follow, in brackets, the 26 chapter headings and subheadings. A checklist indicating where information is 27 contained in the Liquid Effluent Retention Facility and 200 Area Effluent 28 Treatment Facility permit application documentation, in relation to the 29 Washington State Department of Ecology guidance, is located in the Contents 30 Section. 31 32 Documentation contained in the General Information Portion is broader in 33 nature and could be used by multiple treatment, storage, and/or disposal units 34 (e.g., the glossary provided in the General Information Portion). Wherever 35 appropriate, the Liquid Effluent Retention Facility and 200 Area Effluent 36 Treatment Facility permit application documentation makes cross-reference to 37 the General Information Portion, rather than

44 CFR 321.5 - Retention of industrial facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Retention of industrial facilities. 321.5 Section 321.5 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS MAINTENANCE OF THE MOBILIZATION BASE (DEPARTMENT OF DEFENSE...

76 FR 21299 - Emergency Planning and Notification; Emergency Planning and List of Extremely Hazardous...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-15

...EPA is proposing to revise the manner by which the regulated community would apply the threshold planning quantities (TPQs) for those extremely hazardous substances (EHSs) that are non-reactive solid chemicals in solution form. Specifically, facilities with a solid EHS in solution would be subject to the Emergency Planning requirements if the amount of the solid chemical on-site, when multiplied by 0.2, equaled or exceeded the lower published TPQ, based on data that shows less potential for the solid chemical in solution to remain airborne in the event of an accidental release. Previously, EPA assumed that 100% of the chemical could become airborne in the event of an accidental release.

44 CFR 352.6 - FEMA determination on the commitment of Federal facilities and resources.

Code of Federal Regulations, 2011 CFR

2011-10-01

... commitment of Federal facilities and resources. 352.6 Section 352.6 Emergency Management and Assistance... PLANTS: EMERGENCY PREPAREDNESS PLANNING Certifications and Determinations § 352.6 FEMA determination on the commitment of Federal facilities and resources. (a) A licensee request for Federal facilities and...

Definition of Specific Functions and Procedural Skills Required by Cuban Specialists in Intensive Care and Emergency Medicine.

PubMed

Véliz, Pedro L; Berra, Esperanza M; Jorna, Ana R

2015-07-01

INTRODUCTION Medical specialties' core curricula should take into account functions to be carried out, positions to be filled and populations to be served. The functions in the professional profile for specialty training of Cuban intensive care and emergency medicine specialists do not include all the activities that they actually perform in professional practice. OBJECTIVE Define the specific functions and procedural skills required of Cuban specialists in intensive care and emergency medicine. METHODS The study was conducted from April 2011 to September 2013. A three-stage methodological strategy was designed using qualitative techniques. By purposive maximum variation sampling, 82 professionals were selected. Documentary analysis and key informant criteria were used in the first stage. Two expert groups were formed in the second stage: one used various group techniques (focus group, oral and written brainstorming) and the second used a three-round Delphi method. In the final stage, a third group of experts was questioned in semistructured in-depth interviews, and a two-round Delphi method was employed to assess priorities. RESULTS Ultimately, 78 specific functions were defined: 47 (60.3%) patient care, 16 (20.5%) managerial, 6 (7.7%) teaching, and 9 (11.5%) research. Thirty-one procedural skills were identified. The specific functions and procedural skills defined relate to the profession's requirements in clinical care of the critically ill, management of patient services, teaching and research at the specialist's different occupational levels. CONCLUSIONS The specific functions and procedural skills required of intensive care and emergency medicine specialists were precisely identified by a scientific method. This product is key to improving the quality of teaching, research, administration and patient care in this specialty in Cuba. The specific functions and procedural skills identified are theoretical, practical, methodological and social contributions to

44 CFR 206.252 - Insurance requirements for facilities damaged by flood.

Code of Federal Regulations, 2010 CFR

2010-10-01

... facilities damaged by flood. 206.252 Section 206.252 Emergency Management and Assistance FEDERAL EMERGENCY... Assistance Insurance Requirements § 206.252 Insurance requirements for facilities damaged by flood. (a) Where an insurable building damaged by flooding is located in a special flood hazard area identified for...

Essential medicines for emergency care in Africa.

PubMed

Broccoli, Morgan C; Pigoga, Jennifer L; Nyirenda, Mulinda; Wallis, Lee; Calvello Hynes, Emilie J

2018-04-07

Essential medicines lists (EMLs) are efficient means to ensure access to safe and effective medications. The WHO has led this initiative, generating a biannual EML since 1977. Nearly all countries have implemented national EMLs based on the WHO EML. Although EMLs have given careful consideration to many public health priorities, they have yet to comprehensively address the importance of medicines for treating acute illness and injury. We undertook a multistep consensus process to establish an EML for emergency care in Africa. After a review of existing literature and international EMLs, we generated a candidate list for emergency care. This list was reviewed by expert clinicians who ranked the medicines for overall inclusion and strength of recommendation. These medications and recommendations were then evaluated by an expert group. Medications that reached consensus in both the online survey and expert review were included in a draft emergency care EML, which underwent a final inperson consensus process. The final emergency care EML included 213 medicines, 25 of which are not in the 2017 WHO EML, but were deemed essential for clinical practice by regional emergency providers. The final EML has associated recommendations of desirable or essential and is subdivided by facility level. Thirty-nine medicines were recommended for basic facilities, an additional 96 for intermediate facilities (eg, district hospitals) and an additional 78 for advanced facilities (eg, tertiary centres). The 25 novel medications not currently on the WHO EML should be considered by planners when making rational formularies for developing emergency care systems. It is our hope that these resource-stratified lists will allow for easier implementation and will be a useful tool for practical expansion of emergency care delivery in Africa. © 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

Biosafety and biosecurity measures: management of biosafety level 3 facilities.

PubMed

Zaki, Adel N

2010-11-01

With the increasing biological threat from emerging infectious diseases and bioterrorism, it has become essential for governments around the globe to increase awareness and preparedness for identifying and containing those agents. This article introduces the basic concepts of laboratory management, laboratory biosafety and laboratory biosecurity. Assessment criteria for laboratories' biorisk should include both biosafety and biosecurity measures. The assessment requires setting specific goals and selecting management approaches. In order to implement technologies at the laboratory working level, a management team should be created whose role is to implement biorisk policies, rules and regulations appropriate for that facility. Rules and regulations required by government authorities are presented, with special emphasis on methods for air control, and liquid and solid waste management. Management and biorisk measures and appropriate physical facilities must keep pace, ensuring efficient facilities that protect workers, the environment, the product (research, diagnostic and/or vaccine) and the biological pathogen. Published by Elsevier B.V.

Health facility challenges to the provision of Option B+ in western Kenya: a qualitative study

PubMed Central

Akama, Eliud; Bukusi, Elizabeth A; Musoke, Pamela; Nalwa, Wafula Z; Odeny, Thomas A; Onono, Maricianah; Spangler, Sydney A; Turan, Janet M; Wanga, Iris; Abuogi, Lisa L

2017-01-01

Current WHO guidelines recommend lifelong antiretroviral therapy (ART) for all HIV-positive individuals, including pregnant and breastfeeding women (Option B+) in settings with generalized HIV epidemics. While Option B+ is scaled-up in Kenya, insufficient adherence and retention to care could undermine the expected positive impact of Option B+. To explore challenges to the provision of Option B+ at the health facility level, we conducted forty individual gender-matched in-depth interviews with HIV-positive pregnant/postpartum women and their male partners, and four focus groups with thirty health care providers at four health facilities in western Kenya between September-November 2014. Transcripts were coded with the Dedoose software using a coding framework based on the literature, topics from interview guides, and emerging themes from transcripts. Excerpts from broad codes were then fine-coded using an inductive approach. Three major themes emerged: 1) Option B+ specific challenges (same-day initiation into treatment, health care providers unconvinced of the benefits of Option B+, insufficient training); 2) facility resource constraints (staff and drug shortages, long queues, space limitations); and 3) lack of client-friendly services (scolding of patients, inconvenient operating hours, lack of integration of services, administrative requirements). This study highlights important challenges at the health facility level related to Option B+ rollout in western Kenya. Addressing these specific challenges may increase linkage, retention and adherence to life-long ART treatment for pregnant HIV-positive women in Kenya, contribute towards elimination of mother-to-child HIV transmission, and improve maternal and child outcomes. PMID:28207061

Health facility challenges to the provision of Option B+ in western Kenya: a qualitative study.

PubMed

Helova, Anna; Akama, Eliud; Bukusi, Elizabeth A; Musoke, Pamela; Nalwa, Wafula Z; Odeny, Thomas A; Onono, Maricianah; Spangler, Sydney A; Turan, Janet M; Wanga, Iris; Abuogi, Lisa L

2017-03-01

Current WHO guidelines recommend lifelong antiretroviral therapy (ART) for all HIV-positive individuals, including pregnant and breastfeeding women (Option B+) in settings with generalized HIV epidemics. While Option B+ is scaled-up in Kenya, insufficient adherence and retention to care could undermine the expected positive impact of Option B+. To explore challenges to the provision of Option B+ at the health facility level, we conducted forty individual gender-matched in-depth interviews with HIV-positive pregnant/postpartum women and their male partners, and four focus groups with thirty health care providers at four health facilities in western Kenya between September-November 2014. Transcripts were coded with the Dedoose software using a coding framework based on the literature, topics from interview guides, and emerging themes from transcripts. Excerpts from broad codes were then fine-coded using an inductive approach. Three major themes emerged: 1) Option B+ specific challenges (same-day initiation into treatment, health care providers unconvinced of the benefits of Option B+, insufficient training); 2) facility resource constraints (staff and drug shortages, long queues, space limitations); and 3) lack of client-friendly services (scolding of patients, inconvenient operating hours, lack of integration of services, administrative requirements). This study highlights important challenges at the health facility level related to Option B+ rollout in western Kenya. Addressing these specific challenges may increase linkage, retention and adherence to life-long ART treatment for pregnant HIV-positive women in Kenya, contribute towards elimination of mother-to-child HIV transmission, and improve maternal and child outcomes.

Special Considerations for Mass Violence Events in Senior Living Facilities: A Case Report on the Pinelake Health and Rehab Center Shooting.

PubMed

Martin, Cody; Powell, David

2017-02-01

The 2009 Pinelake Health and Rehab Center shooting in Carthage, North Carolina, presents a unique case study for examining the specific considerations for mass violence events in senior living facilities. A variety of factors, including reduced sensory perception, reduced mobility, and cognitive decline, may increase the vulnerability of the populations of senior living facilities during mass violence events. Management of response aspects such as evacuation, relocation, and reunification also require special consideration in the context of mass violence at senior living facilities. Better awareness of these vulnerabilities and response considerations can assist facility administrators and emergency managers when preparing for potential mass violence events at senior living facilities. (Disaster Med Public Health Preparedness. 2017;11:150-152).

40 CFR 267.55 - What is the role of the emergency coordinator?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 26 2010-07-01 2010-07-01 false What is the role of the emergency... STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.55 What is the role of the emergency... familiar with all aspects of the facility's contingency plan, all operations and activities at the facility...

Principles of Emergency Department facility design for optimal management of mass-casualty incidents.

PubMed

Halpern, Pinchas; Goldberg, Scott A; Keng, Jimmy G; Koenig, Kristi L

2012-04-01

The Emergency Department (ED) is the triage, stabilization and disposition unit of the hospital during a mass-casualty incident (MCI). With most EDs already functioning at or over capacity, efficient management of an MCI requires optimization of all ED components. While the operational aspects of MCI management have been well described, the architectural/structural principles have not. Further, there are limited reports of the testing of ED design components in actual MCI events. The objective of this study is to outline the important infrastructural design components for optimization of ED response to an MCI, as developed, implemented, and repeatedly tested in one urban medical center. In the authors' experience, the most important aspects of ED design for MCI have included external infrastructure and promoting rapid lockdown of the facility for security purposes; an ambulance bay permitting efficient vehicle flow and casualty discharge; strategic placement of the triage location; patient tracking techniques; planning adequate surge capacity for both patients and staff; sufficient command, control, communications, computers, and information; well-positioned and functional decontamination facilities; adequate, well-located and easily distributed medical supplies; and appropriately built and functioning essential services. Designing the ED to cope well with a large casualty surge during a disaster is not easy, and it may not be feasible for all EDs to implement all the necessary components. However, many of the components of an appropriate infrastructural design add minimal cost to the normal expenditures of building an ED. This study highlights the role of design and infrastructure in MCI preparedness in order to assist planners in improving their ED capabilities. Structural optimization calls for a paradigm shift in the concept of structural and operational ED design, but may be necessary in order to maximize surge capacity, department resilience, and patient and

A large-scale computer facility for computational aerodynamics

NASA Technical Reports Server (NTRS)

Bailey, F. R.; Ballhaus, W. F., Jr.

1985-01-01

As a result of advances related to the combination of computer system technology and numerical modeling, computational aerodynamics has emerged as an essential element in aerospace vehicle design methodology. NASA has, therefore, initiated the Numerical Aerodynamic Simulation (NAS) Program with the objective to provide a basis for further advances in the modeling of aerodynamic flowfields. The Program is concerned with the development of a leading-edge, large-scale computer facility. This facility is to be made available to Government agencies, industry, and universities as a necessary element in ensuring continuing leadership in computational aerodynamics and related disciplines. Attention is given to the requirements for computational aerodynamics, the principal specific goals of the NAS Program, the high-speed processor subsystem, the workstation subsystem, the support processing subsystem, the graphics subsystem, the mass storage subsystem, the long-haul communication subsystem, the high-speed data-network subsystem, and software.

[Organization of medical equipment and stock supply of military medical facilities and groups of Disaster Medicine Service of the Russian Defense Ministry in emergency situations].

PubMed

Korniushko, I G; Iakovlev, S V; Krasavin, K D; Lemeshkin, R N

2011-10-01

The article outlined the modern concept of medical equipment and stock supply of medical facilities and groups of Disaster Medicine Service of the Russian Defense Ministry involved into the remedial of the medical actions of emergency situations. The structure of the units of medical supplies in these conditions is presented.

Supporting NASA Facilities Through GIS

NASA Technical Reports Server (NTRS)

Ingham, Mary E.

2000-01-01

The NASA GIS Team supports NASA facilities and partners in the analysis of spatial data. Geographic Information System (G[S) is an integration of computer hardware, software, and personnel linking topographic, demographic, utility, facility, image, and other geo-referenced data. The system provides a graphic interface to relational databases and supports decision making processes such as planning, design, maintenance and repair, and emergency response.

STS-60 Cosmonauts in Weightless Environment Training Facility (WETF) training

NASA Image and Video Library

1993-01-07

S93-26021 (Feb 1993) --- Russian cosmonaut Sergei Krikalev maneuvers a small life raft during bailout training at the Johnson Space Center's (JSC) Weightless Environment Training Facility (WET-F). Two SCUBA-equipped divers assisted Krikalev in the STS-60 training exercise. Shuttle crew members frequently utilize the 25-ft. deep pool to learn proper procedures to follow in the event of emergency egress from their Space Shuttle via the escape pole system. Krikalev is one of two cosmonauts in training for the STS-60 mission. One of the two will serve as primary payload specialist with the other filling an alternate's role. This pool and the facility in which it is housed are titled the WET-F, because they are also used by astronauts rehearsing both mission-specific and contingency extravehicular activities (EVA).

Emerging Contaminants and Federal Facility Contaminants of Concern

EPA Pesticide Factsheets

This page links to fact sheets summarizing contaminants of concern and emerging contaminants that present unique issues and challenges to the environmental community in general and to FFRRO in particular.

Burden of emergency conditions and emergency care usage: new estimates from 40 countries.

PubMed

Chang, Cindy Y; Abujaber, Samer; Reynolds, Teri A; Camargo, Carlos A; Obermeyer, Ziad

2016-11-01

To estimate the global and national burden of emergency conditions, and compare them to emergency care usage rates. We coded all 291 Global Burden of Disease 2010 conditions into three categories to estimate emergency burden: conditions that, if not addressed within hours to days of onset, commonly lead to serious disability or death; conditions with common acute decompensations that lead to serious disability or death; and non-emergencies. Emergency care usage rates were obtained from a systematic literature review on emergency care facilities in low-income and middle-income countries (LMICs), supplemented by national health system reports. All 15 leading causes of death and disability-adjusted life years (DALYs) globally were conditions with potential emergent manifestations. We identified 41 facility-based reports in 23 countries, 12 of which were in LMICs; data for 17 additional countries were obtained from national or regional reports on emergency usage. Burden of emergency conditions was the highest in low-income countries, with median DALYs of 47 728 per 100 000 population (IQR 45 253-50 085) in low-income, 25 186 (IQR 21 982-40 480) in middle-income and 15 691 (IQR 14 649-16 382) in high-income countries. Patterns were similar using deaths to measure burden and excluding acute decompensations from the definition of emergency conditions. Conversely, emergency usage rates were the lowest in low-income countries, with median 8 visits per 1000 population (IQR 6-10), 78 (IQR 25-197) in middle-income and 264 (IQR 177-341) in high-income countries. Despite higher burden of emergency conditions, emergency usage rates are substantially lower in LMICs, likely due to limited access to emergency care. 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/.

Determinants of non-urgent Emergency Department attendance among females in Qatar.

PubMed

Read, Jen'nan Ghazal; Varughese, Shinu; Cameron, Peter A

2014-01-01

The use of emergency department (ED) services for non-urgent conditions is well-studied in many Western countries but much less so in the Middle East and Gulf region. While the consequences are universal-a drain on ED resources and poor patient outcomes-the causes and solutions are likely to be region and country specific. Unique social and economic circumstances also create gender-specific motivations for patient attendance. Alleviating demand on ED services requires understanding these circumstances, as past studies have shown. We undertook this study to understand why female patients with low-acuity conditions choose the emergency department in Qatar over other healthcare options. Prospective study at Hamad General Hospital's (HGH) emergency department female "see-and-treat" unit that treats low-acuity cases. One hundred female patients were purposively recruited to participate in the study. Three trained physicians conducted semi-structured interviews with patients over a three-month period after they had been treated and given informed consent. The study found that motivations for ED attendance were systematically influenced by employment status as an expatriate worker. Forty percent of the sample had been directed to the ED by their employers, and the vast majority (89%) of this group cited employer preference as the primary reason for choosing the ED. The interviews revealed that a major obstacle to workers using alternative facilities was the lack of a government-issued health card, which is available to all citizens and residents at a nominal rate. Reducing the number of low-acuity cases in the emergency department at HGH will require interventions aimed at encouraging patients with non-urgent conditions to use alternative healthcare facilities. Potential interventions include policy changes that require employers to either provide workers with a health card or compel employees to acquire one for themselves.

Determinants of non-urgent Emergency Department attendance among females in Qatar

PubMed Central

Read, Jen'nan Ghazal; Varughese, Shinu; Cameron, Peter A.

2014-01-01

Background: The use of emergency department (ED) services for non-urgent conditions is well-studied in many Western countries but much less so in the Middle East and Gulf region. While the consequences are universal—a drain on ED resources and poor patient outcomes—the causes and solutions are likely to be region and country specific. Unique social and economic circumstances also create gender-specific motivations for patient attendance. Alleviating demand on ED services requires understanding these circumstances, as past studies have shown. We undertook this study to understand why female patients with low-acuity conditions choose the emergency department in Qatar over other healthcare options. Setting and design: Prospective study at Hamad General Hospital's (HGH) emergency department female “see-and-treat” unit that treats low-acuity cases. One hundred female patients were purposively recruited to participate in the study. Three trained physicians conducted semi-structured interviews with patients over a three-month period after they had been treated and given informed consent. Results: The study found that motivations for ED attendance were systematically influenced by employment status as an expatriate worker. Forty percent of the sample had been directed to the ED by their employers, and the vast majority (89%) of this group cited employer preference as the primary reason for choosing the ED. The interviews revealed that a major obstacle to workers using alternative facilities was the lack of a government-issued health card, which is available to all citizens and residents at a nominal rate. Conclusion: Reducing the number of low-acuity cases in the emergency department at HGH will require interventions aimed at encouraging patients with non-urgent conditions to use alternative healthcare facilities. Potential interventions include policy changes that require employers to either provide workers with a health card or compel employees to acquire one for

78 FR 65690 - Trees and Plantings Associated With Eligible Facilities, RP9524.5

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-01

...] Trees and Plantings Associated With Eligible Facilities, RP9524.5 AGENCY: Federal Emergency Management... policy Trees and Plantings Associated with Eligible Facilities. The Federal Emergency Management Agency... trees, shrubs, and other plantings, including limited eligibility for replacement of grass and sod...

VIEW OF BUILDING 122 WHICH HOUSES THE ONSITE MEDICAL FACILITIES ...

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

VIEW OF BUILDING 122 WHICH HOUSES THE ON-SITE MEDICAL FACILITIES OF THE ROCKY FLATS PLANT AND THE OCCUPATIONAL HEALTH AND INTERNAL DOSIMETRY ORGANIZATIONS. EMERGENCY MEDICAL SERVICES, DIAGNOSIS, DECONTAMINATION, FIRST AID, X-RAY, MINOR SURGICAL TREATMENT, AND AMBULATORY ACTIVITIES ARE CARRIED OUT IN THIS BUILDING. (1/98) - Rocky Flats Plant, Emergency Medical Services Facility, Southwest corner of Central & Third Avenues, Golden, Jefferson County, CO

Species-Specific Effects of Woody Litter on Seedling Emergence and Growth of Herbaceous Plants

PubMed Central

Koorem, Kadri; Price, Jodi N.; Moora, Mari

2011-01-01

The effect of litter on seedling establishment can influence species richness in plant communities. The effect of litter depends on amount, and also on litter type, but relatively little is known about the species-specific effects of litter. We conducted a factorial greenhouse experiment to examine the effect of litter type, using two woody species that commonly co-occur in boreonemoral forest—evergreen spruce (Picea abies), deciduous hazel (Corylus avellana), and a mixture of the two species—and litter amount—shallow (4 mm), deep (12 mm) and leachate—on seedling emergence and biomass of three understorey species. The effect of litter amount on seedling emergence was highly dependent on litter type; while spruce needle litter had a significant negative effect that increased with depth, seedling emergence in the presence of hazel broadleaf litter did not differ from control pots containing no litter. Mixed litter of both species also had a negative effect on seedling emergence that was intermediate compared to the single-species treatments. Spruce litter had a marginally positive (shallow) or neutral effect (deep) on seedling biomass, while hazel and mixed litter treatments had significant positive effects on biomass that increased with depth. We found non-additive effects of litter mixtures on seedling biomass indicating that high quality hazel litter can reduce the negative effects of spruce. Hazel litter does not inhibit seedling emergence; it increases seedling growth, and creates better conditions for seedling growth in mixtures by reducing the suppressive effect of spruce litter, having a positive effect on understorey species richness. PMID:22028890

Ethiopia's assessment of emergency obstetric and newborn care: setting the gold standard for national facility-based assessments.

PubMed

Keyes, Emily B; Haile-Mariam, Abonesh; Belayneh, Neghist T; Gobezie, Wasihun A; Pearson, Luwei; Abdullah, Muna; Kebede, Henok

2011-10-01

To describe the methods used to implement Ethiopia's 2008 emergency obstetric and newborn care services (EmONC) assessment; highlight how the collaborative process contributed to immediate integration of results into national and subnational planning; and explain how the experience informed the development of a set of tools providing best practices and guidelines for other countries conducting similar assessments. A team of maternal and newborn health experts from the Federal Ministry of Health (FMOH), the United Nations Children's Fund (UNICEF), the World Health Organization (WHO), and the United Nations Population Fund (UNFPA), together with representatives from the Ethiopian Society of Obstetricians and Gynecologists, provided technical guidance for the 18-month process and facilitated demand for and use of the assessment results. Eighty-four trained data collectors administered 9 data collection modules in 806 public and private facilities. Field work and data were managed by a private firm who, together with the core team, implemented a multi-layered plan for data quality. Columbia University's Averting Maternal Death and Disability Program provided technical assistance. Results were published in national and regional reports and in 1-page facility factsheets informing subnational planning activities. Assessment results-which have been published in journal articles-informed water infrastructure improvements, efforts to expand access to magnesium sulfate, and FMOH and UN planning documents. The assessment also established a permanent database for future monitoring of the health system, including geographic locations of surveyed facilities. Ethiopia's assessment was successful largely because of active local leadership, a collaborative process, ample financial and technical support, and rapid integration of results into health system planning. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

40 CFR 264.55 - Emergency coordinator.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Contingency Plan and Emergency Procedures § 264.55 Emergency coordinator. At all times, there must be at least...'s contingency plan, all operations and activities at the facility, the location and characteristics... addition, this person must have the authority to commit the resources needed to carry out the contingency...

KENNEDY SPACE CENTER, FLA. - Emergency crew members assess medical needs on “injured” astronauts removed from the orbiter crew compartment mock-up during a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - Emergency crew members assess medical needs on “injured” astronauts removed from the orbiter crew compartment mock-up during a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

40 CFR 266.204 - Standards applicable to emergency responses.

Code of Federal Regulations, 2013 CFR

2013-07-01

... HAZARDOUS WASTE MANAGEMENT FACILITIES Military Munitions § 266.204 Standards applicable to emergency responses. Explosives and munitions emergencies involving military munitions or explosives are subject to 40...

40 CFR 266.204 - Standards applicable to emergency responses.

Code of Federal Regulations, 2012 CFR

2012-07-01

... HAZARDOUS WASTE MANAGEMENT FACILITIES Military Munitions § 266.204 Standards applicable to emergency responses. Explosives and munitions emergencies involving military munitions or explosives are subject to 40...

40 CFR 265.56 - Emergency procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... FACILITIES Contingency Plan and Emergency Procedures § 265.56 Emergency procedures. (a) Whenever there is an... with designated response roles if their help is needed. (b) Whenever there is a release, fire, or... possible hazards to human health or the environment that may result from the release, fire, or explosion...

40 CFR 265.56 - Emergency procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... FACILITIES Contingency Plan and Emergency Procedures § 265.56 Emergency procedures. (a) Whenever there is an... with designated response roles if their help is needed. (b) Whenever there is a release, fire, or... possible hazards to human health or the environment that may result from the release, fire, or explosion...

40 CFR 265.56 - Emergency procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... FACILITIES Contingency Plan and Emergency Procedures § 265.56 Emergency procedures. (a) Whenever there is an... with designated response roles if their help is needed. (b) Whenever there is a release, fire, or... possible hazards to human health or the environment that may result from the release, fire, or explosion...

40 CFR 265.56 - Emergency procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... FACILITIES Contingency Plan and Emergency Procedures § 265.56 Emergency procedures. (a) Whenever there is an... with designated response roles if their help is needed. (b) Whenever there is a release, fire, or... possible hazards to human health or the environment that may result from the release, fire, or explosion...

44 CFR 352.24 - Provision of technical assistance and Federal facilities and resources.

Code of Federal Regulations, 2011 CFR

2011-10-01

... assistance and Federal facilities and resources. 352.24 Section 352.24 Emergency Management and Assistance... PLANTS: EMERGENCY PREPAREDNESS PLANNING Federal Participation § 352.24 Provision of technical assistance and Federal facilities and resources. (a) Under a determination under subpart A (44 CFR 352.5(f) and...

10 CFR 205.378 - Disconnection of temporary facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Disconnection of temporary facilities. 205.378 Section 205.378 Energy DEPARTMENT OF ENERGY OIL ADMINISTRATIVE PROCEDURES AND SANCTIONS Electric Power System... Electric Facilities and the Transfer of Electricity to Alleviate An Emergency Shortage of Electric Power...

WHO/INRUD patient care and facility-specific drug use indicators at primary health care centres in Eastern province, Saudi Arabia.

PubMed

El Mahalli, A A; Akl, O A M; Al-Dawood, S F; Al-Nehab, A A; Al-Kubaish, H A; Al-Saeed, S; Elkahky, A A A; Salem, A M A A

2012-11-01

This study aimed to measure the performance of primary health care centres in Eastern province, Saudi Arabia, using the WHO/International Network of Rational Use of Drugs patient care and facility-specific drug use indicators. In a cross-sectional study, 10 health centres were selected using systematic random sampling. A total of 300 patients were interviewed while visiting the centre from January to March 2011 and 10 pharmacists from the same centres were interviewed. Average consultation time was 7.3 min (optimal > or = 30 min), percentage of drugs adequately labelled was 10% (optimal 100%) and patient's knowledge of correct dosage was 79.3% (optimal 100%). The percentage of key drugs in stock was only 59.2% (optimal 100%). An overall index of rational facility-specific drug use was calculated and applied to rank the health centres for benchmarking.

Factors influencing the decision to use nurse practitioners in the emergency department.

PubMed

McGee, Laurie A; Kaplan, Louise

2007-10-01

Emergency department overcrowding is a serious problem nationwide. Of an estimated 14 million visits to hospital emergency departments, only 12.9% are considered emergent. Many emergency departments, however, employ only physicians despite the fact that nurse practitioners have a proven record of providing high quality, cost-effective care in the emergency department. The purpose of the study was to determine factors that influence the decision to use nurse practitioners in the emergency department. Interviews were conducted with ED managers in hospitals that both employ and do not employ nurse practitioners in the emergency department. In this study, the primary reason that nurse practitioners were not employed by emergency departments was that physician groups with whom the hospitals contract refuse to use nurse practitioners. Emergency department managers of facilities with nurse practitioners reported high levels of satisfaction with the nurse practitioners performance. The 2 ED managers without nurse practitioners in their facility were highly supportive of having nurse practitioners in the emergency department and have advocated for hiring nurse practitioners. Education needs to occur with emergency departments regarding the value of the nurse practitioner's role to the facility. Research is needed to investigate why emergency department physician groups resist hiring nurse practitioners. Increased staffing with nurse practitioners in the emergency department can serve to reduce overcrowding, reduce waiting times, and increase patient satisfaction.

Emergency department usage by community step-down facilities--patterns and recommendations.

PubMed

Lee, S W; Goh, C; Chan, Y H

2003-09-01

This study examines the interface between institutional community step-down facilities (CSDFs) and acute hospital's Emergency Department (ED). It also provides a comprehensive description of the usage of an ED's services by CSDFs in its vicinity. This is a prospective 12-week observational study conducted in the Accident and Emergency Department of Changi General Hospital in Singapore. All patients from CSDFs transferred to the department were eligible for the study. Hospital records were used to extract relevant clinical data after admission for the length of stay and final discharge diagnosis. There was a total of 201 referrals to the ED over the 3-month period. The age of the patients ranged from 32 to 107 years, with a median of 83 years. Ninety-two patients (45.8%) were male residents. There were more referrals from CSDF on weekdays than on weekends. In particular, the number of referrals from CSDFs on Mondays were significantly higher (P < 0.05, Poisson regression) than other days of the week. Fifty-one per cent of the ED visits occurred during regular working hours. Eighty-two per cent of the transfers were admitted. The main complaint was shortness of breath with cough, followed by fever and falls. The most common investigation ordered was chest radiograph, followed by electrocardiogram and other radiographs. The most common treatment procedure in the ED was placement of an intravenous line. For those admitted residents, average length of hospital stay was 8.27 +/- 8.19 days (median, 5 days). Seventeen patients (10.3%) died within 3 days of admission, while 31 patients (18.8%) stayed less than 3 days. The admitted residents had an average turnaround time (from time of registration to time of leaving the ED and proceeding to ward) of 97.94 minutes. For patients discharged from the ED, the average turnaround time (time from registration to time of leaving the ED) was 177 minutes. Residents from CSDFs are transferred to the ED for a variety of medical reasons

Hypothermia in a Rural Setting: An Emergency Medicine Simulation Scenario

PubMed Central

Jong, Robert; Heroux, Aron; Dubrowski, Adam

2017-01-01

Patients presenting with hypothermia in a rural emergency department can be quite challenging to manage without significant mortality and morbidity. Standard medical school curricula do not fully prepare trainees for the unique aspects of practice in northern rural and remote communities. Training opportunities on site may provide a solution to this lack of experience. However, these communities often have limited simulation-based resources and expertise for conducting and developing simulation scenarios. In this technical report, we outline a hypothermia simulation that utilizes only basic resources and is, thus, practical for rural and remote facilities. The aim of this report is to better equip trainees, clinicians, and emergency department staff who may encounter such a scenario in their practice. While the simulation is specifically designed for medical students, resident doctors, and emergency department staff, it could also be applicable in other low-resource settings, such as military bases, search and rescue stations, and arctic travel and tourism infirmaries. PMID:29511605

VIEW OF BUILDING 122 EXAMINATION FACILITIES THAT SUPPORT ROUTINE EMPLOYEE ...

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

VIEW OF BUILDING 122 EXAMINATION FACILITIES THAT SUPPORT ROUTINE EMPLOYEE AND SUBCONTRACTOR PHYSICAL EXAMINATIONS. (10/85) - Rocky Flats Plant, Emergency Medical Services Facility, Southwest corner of Central & Third Avenues, Golden, Jefferson County, CO

Violent behavior of patients admitted in emergency following drug suicidal attempt: a specific staff educational crisis intervention.

PubMed

Cailhol, Lionel; Allen, Michael; Moncany, Anne-Hélène; Cicotti, Andrei; Virgillito, Salvatore; Barbe, Rémy P; Lazignac, Coralie; Damsa, Cristian

2007-01-01

In spite of much effort to create guidelines on the management of violent behavior (VB) in emergency departments, little is known about the impact of such guidelines on a real-life emergency environment. The aim of this study is to investigate the impact of a staff educational crisis intervention (SECI) on the reduction of VB in patients admitted to emergency departments following drug suicidal attempt. The impact of a SECI on VB of patient consulting the ER following a drug suicide attempt was assessed by comparing the occurrence of VB before (5 months) and after (5 months) the introduction of a SECI. A significant reduction in VB (from 17.32% to 7.14%) was found with the comparison of two 5-month periods: before (254 patients) and after (224 patients) the introduction of a SECI program (chi(2)=11.238; P=.0008). These preliminary data suggest the need for further prospective randomized studies aiming to prevent VB in emergency departments by developing specific SECI programs.

RMP Guidance for Chemical Distributors - Chapter 8: Emergency Response Program

EPA Pesticide Factsheets

Depending on the level of processes at your facility, part 68 may require an emergency response program: an emergency response plan, emergency response equipment procedures, employee training, and procedures to ensure the program is up-to-date.

[Resources and capacity of emergency trauma care services in Peru].

PubMed

Rosales-Mayor, Edmundo; Miranda, J Jaime; Lema, Claudia; López, Luis; Paca-Palao, Ada; Luna, Diego; Huicho, Luis

2011-09-01

The objectives of this study were to evaluate the resources and capacity of emergency trauma care services in three Peruvian cities using the WHO report Guidelines for Essential Trauma Care. This was a cross-sectional study in eight public and private healthcare facilities in Lima, Ayacucho, and Pucallpa. Semi-structured questionnaires were applied to the heads of emergency departments with managerial responsibility for resources and capabilities. Considering the profiles and volume of care in each emergency service, most respondents in all three cities classified their currently available resources as inadequate. Comparison of the health facilities showed a shortage in public services and in the provinces (Ayacucho and Pucallpa). There was a widespread perception that both human and physical resources were insufficient, especially in public healthcare facilities and in the provinces.

Facile fabrication of cobalt oxalate nanostructures with superior specific capacitance and super-long cycling stability

NASA Astrophysics Data System (ADS)

Cheng, Guanhua; Si, Conghui; Zhang, Jie; Wang, Ying; Yang, Wanfeng; Dong, Chaoqun; Zhang, Zhonghua

2016-04-01

Transition metal oxalate materials have shown huge competitive advantages for applications in supercapacitors. Herein, nanostructured cobalt oxalate supported on cobalt foils has been facilely fabricated by anodization, and could directly serve as additive/binder-free electrodes for supercapacitors. The as-prepared cobalt oxalate electrodes present superior specific capacitance of 1269 F g-1 at the current density of 6 A g-1 in the galvanostatic charge/discharge test. Moreover, the retained capacitance is as high as 87.2% as the current density increases from 6 A g-1 to 30 A g-1. More importantly, the specific capacitance of cobalt oxalate retains 91.9% even after super-long cycling of 100,000 cycles. In addition, an asymmetric supercapacitor assembled with cobalt oxalate (positive electrode) and activated carbon (negative electrode) demonstrates excellent capacitive performance with high energy density and power density.

KENNEDY SPACE CENTER, FLA. - A helicopter approaches an orbiter crew compartment mock-up as part of a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews will respond to the volunteer “astronauts” simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - A helicopter approaches an orbiter crew compartment mock-up as part of a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews will respond to the volunteer “astronauts” simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

Music Facilities.

ERIC Educational Resources Information Center

Ontario Dept. of Education, Toronto. School Planning and Building Research Section.

The layouts and specifications in this booklet are intended to assist those involved in planning music facilities for elementary and secondary schools. Drawings, room plans, and text illustrate specifications for location; space relationship; combined and separate instrumental and vocal rooms; practice rooms; and auxiliary areas. Particular…

Practical considerations in emergency management of bleeding in the setting of target-specific oral anticoagulants.

PubMed

Miller, Michael P; Trujillo, Toby C; Nordenholz, Kristen E

2014-04-01

The recent arrival of the target-specific oral anticoagulants (TSOACs) offers potential advantages in the field of anticoagulation. However, there are no rapid and accurate and routinely available laboratory assays to evaluate their contribution to clinical bleeding. With the expanding clinical indications for the TSOACs, and the arrival of newer reversal agents on the market, the emergency clinician will need to be familiar with drug specifics as well as methods for anticoagulation reversal. This review offers a summary of the literature and some practical strategies for the approach to the patient taking TSOACs and the management of bleeding in these cases. Copyright © 2014 Elsevier Inc. All rights reserved.

[Organization of workplace first aid in health care facilities].

PubMed

Ciavarella, M; Sacco, A; Bosco, Maria Giuseppina; Chinni, V; De Santis, A; Pagnanelli, A

2007-01-01

Laws D.Lgs. 626/94 and D.I. 388/03 attach particular importance to the organization of first aid in the workplace. Like every other enterprise, also hospitals and health care facilities have the obligation, as foreseen by the relevant legislation, to organize and manage first aid in the workplace. To discuss the topic in the light of the guidelines contained in the literature. We used the references contained in the relevant literature and in the regulations concerning organization of first aid in health care facilities. The regulations require the general manager of health care facilities to organize the primary intervention in case of emergencies in all health care facilities (health care or administrative, territorial and hospitals). In health care facilities the particular occupational risks, the general access of the public and the presence of patients who are already assumed to have altered states of health, should be the reason for particular care in guaranteeing the best possible management of a health emergency in the shortest time possible.

33 CFR 154.1041 - Specific response information to be maintained on mobile MTR facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... be maintained on mobile MTR facilities. 154.1041 Section 154.1041 Navigation and Navigable Waters... maintained on mobile MTR facilities. (a) Each mobile MTR facility must carry the following information as... respond to a discharge from the mobile MTR facility. (3) List of the appropriate persons and agencies...

Emerging Contaminants – Dinitrotoluene (DNT)

EPA Pesticide Factsheets

This fact sheet, developed by the U.S. Environmental Protection Agency’s Federal Facilities Restoration and Reuse Office (FFRRO), provides a brief summary of the emerging contaminant Dinitrotoluene (DNT) including physical and chemical properties.

Pilot statewide study of pediatric emergency department alignment with national guidelines.

PubMed

Costich, Julia F; Fallat, Mary E; Scaggs, C Morgan; Bartlett, Richard

2013-07-01

The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nursing Association have developed consensus guidelines for pediatric emergency department policies, procedures, supplies, and equipment. Kentucky received funding from the Health Resources and Services Administration through the Emergency Medical Services for Children program to pilot test the guidelines with the state's hospitals. In addition to providing baseline data regarding institutional alignment with the guidelines, the survey supported development of grant funding to procure missing items. Survey administration was undertaken by staff and members of the Kentucky Board of Emergency Medical Services Emergency Medical Services for Children work group and faculty and staff of the University of Kentucky College of Public Health and the University of Louisville School of Medicine. Responses were solicited primarily online with repeated reminders and offers of assistance. Seventy respondents completed the survey section on supplies and equipment either online or by fax. Results identified items unavailable at 20% or more of responding facilities, primarily the smallest sizes of equipment. The survey section addressing policy and procedure received only 16 responses. Kentucky facilities were reasonably well equipped by national standards, but rural facilities and small hospitals did not stock the smallest equipment sizes because of low reported volume of pediatric emergency department cases. Thus, a centralized procurement process that gives them access to an adequate range of pediatric supplies and equipment would support capacity building for the care of children across the entire state. Grant proposals were received from 28 facilities in the first 3 months of funding availability.

9 CFR 3.27 - Facilities, outdoor.

Code of Federal Regulations, 2010 CFR

2010-01-01

... WELFARE STANDARDS Specifications for the Humane Handling, Care, Treatment, and Transportation of Guinea Pigs and Hamsters Facilities and Operating Standards § 3.27 Facilities, outdoor. (a) Hamsters shall not be housed in outdoor facilities. (b) Guinea pigs shall not be housed in outdoor facilities unless...

Preliminary assessment of appropriateness of emergency care service use: actions taken and consultations obtained before emergency care presentation.

PubMed

Tzeng, Huey-Ming

2011-01-01

Inappropriate use of emergency care services can increase hospital readmissions and related costs. This pilot, cross-sectional survey project determined whether home health care patients who receive emergency care services during a Medicare-approved home care episode sought consultation from health care professionals before they made the emergency care visit. The two research questions were: (a) What actions were taken by the patient before making an emergency care visit?; (b) If prior consultation was obtained, what were the suggestions? Preliminary data were obtained from a Michigan-based, Medicare-certified, not-for-profit home health agency affiliated with a university health system. A two-page questionnaire recorded up to three emergency care visits. Volunteer participants were Medicare patients who had no cognitive deficits and were able to communicate with home health care providers (HHCPs) by themselves. Thirty-five emergency care visits were reported; 31 (88.6%) Medicare patients participated and 4 (11.4%) of them had two emergency care visits. Before the patients made an emergency care visit, they most often called their primary care physicians (PCPs; N = 20, 57.1%), followed by the HHCPs (N = 10, 28.6%). All 20 patients who contacted their PCPs and 7 patients who contacted their HHCPs were advised to seek emergency care services. In 20 emergency care visits the patient was admitted for an acute hospital stay; the other 15 patients went home. Most patients contacted their PCPs or HHCPs before they went to an emergency department or urgent care facility. These results implied that PCPs and HHCPs seemed to perceive that the need for emergency care should be determined at an emergency room or urgent care facility. This study was unable to differentiate the need for emergency care services or the appropriateness of the advice given by PCPs or HHCPs when the home care patients were under the care of a medical team.

State Laws on Emergency Holds for Mental Health Stabilization.

PubMed

Hedman, Leslie C; Petrila, John; Fisher, William H; Swanson, Jeffrey W; Dingman, Deirdre A; Burris, Scott

2016-05-01

Psychiatric emergency hold laws permit involuntary admission to a health care facility of a person with an acute mental illness under certain circumstances. This study documented critical variation in state laws, identified important questions for evaluation research, and created a data set of laws to facilitate the public health law research of emergency hold laws' impact on mental health outcomes. The research team built a 50-state, open-source data set of laws currently governing emergency holds. A protocol and codebook were developed so that the study may be replicated and extended longitudinally, allowing future research to accurately capture changes to current laws. Although every state and the District of Columbia have emergency hold laws, state law varies on the duration of emergency holds, who can initiate an emergency hold, the extent of judicial oversight, and the rights of patients during the hold. The core criterion justifying an involuntary hold is mental illness that results in danger to self or others, but many states have added further specifications. Only 22 states require some form of judicial review of the emergency hold process, and only nine require a judge to certify the commitment before a person is hospitalized. Five states do not guarantee assessment by a qualified mental health professional during the emergency hold. The article highlights variability in state law for emergency holds of persons with acute mental illness. How this variability affects the individual, the treatment system, and law enforcement behavior is unknown. Research is needed to guide policy making and implementation on these issues.

24 CFR 576.53 - Use as an emergency shelter.

Code of Federal Regulations, 2010 CFR

2010-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES EMERGENCY SHELTER GRANTS PROGRAM: STEWART B. McKINNEY HOMELESS ASSISTANCE ACT Program Requirements § 576.53 Use as an emergency shelter. (a)(1) Restrictions and definition... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Use as an emergency shelter. 576.53...

45 CFR 671.17 - Cases of emergency.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 3 2011-10-01 2011-10-01 false Cases of emergency. 671.17 Section 671.17 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION WASTE REGULATION... emergency relating to the safety of human life or of ships, aircraft or other equipment and facilities of...

45 CFR 671.17 - Cases of emergency.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 3 2012-10-01 2012-10-01 false Cases of emergency. 671.17 Section 671.17 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION WASTE REGULATION... emergency relating to the safety of human life or of ships, aircraft or other equipment and facilities of...

45 CFR 671.17 - Cases of emergency.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 3 2014-10-01 2014-10-01 false Cases of emergency. 671.17 Section 671.17 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION WASTE REGULATION... emergency relating to the safety of human life or of ships, aircraft or other equipment and facilities of...

45 CFR 671.17 - Cases of emergency.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 3 2013-10-01 2013-10-01 false Cases of emergency. 671.17 Section 671.17 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION WASTE REGULATION... emergency relating to the safety of human life or of ships, aircraft or other equipment and facilities of...

45 CFR 671.17 - Cases of emergency.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Cases of emergency. 671.17 Section 671.17 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION WASTE REGULATION... emergency relating to the safety of human life or of ships, aircraft or other equipment and facilities of...

Management of information within emergencies departments in developing countries: analysis at the National Emergency Department in Benin.

PubMed

Ahanhanzo, Yolaine Glèlè; Kpozehouen, Alphonse; Sopoh, Ghislain; Sossa-Jérôme, Charles; Ouedraogo, Laurent; Wilmet-Dramaix, Michèle

2016-01-01

The management of health information is a key pillar in both emergencies reception and handling facilities, given the strategic position and the potential of these facilities within hospitals, and in the monitoring of public health and epidemiology. With the technological revolution, computerization made the information systems evolve in emergency departments, especially in developed countries, with improved performance in terms of care quality, productivity and patient satisfaction. This study analyses the situation of Benin in this field, through the case of the Academic Clinic of Emergency Department of the National University Teaching Hospital of Cotonou, the national reference hospital. The study is cross-sectional and evaluative. Collection techniques are literature review and structured interviews. The components rated are resources, indicators, data sources, data management and the use-dissemination of the information through a model adapted from Health Metrics Network framework. We used quantitative and qualitative analysis. The absence of a regulatory framework restricts the operation of the system in all components and accounts for the lack and inadequacy of the dedicated resources. Dedication of more resources for this system for crucial needs such as computerization requires sensitization and greater awareness of the administrative authorities about the fact that an effective health information management system is of prime importance in this type of facility.

Emergency Medical Services

MedlinePlus

... need help right away, you should use emergency medical services. These services use specially trained people and ... emergencies, you need help where you are. Emergency medical technicians, or EMTs, do specific rescue jobs. They ...

Elementary School Educational Specifications: Facilities Planning Standards. Edition III.

ERIC Educational Resources Information Center

Jefferson County School District R-1, Denver, CO.

The Jefferson County School District (Denver, Colorado) has published this model standard for the planning and designing of new elementary schools, and the remodeling and modernizing existing schools. It describes the facility requirements to accommodate the instructional program, activities, and support functions to assist architects, school…

Alterations in Hemagglutinin Receptor-Binding Specificity Accompany the Emergence of Highly Pathogenic Avian Influenza Viruses

PubMed Central

Mochalova, Larisa; Harder, Timm; Tuzikov, Alexander; Bovin, Nicolai; Wolff, Thorsten; Matrosovich, Mikhail; Schweiger, Brunhilde

2015-01-01

ABSTRACT Highly pathogenic avian influenza viruses (HPAIVs) of hemagglutinin H5 and H7 subtypes emerge after introduction of low-pathogenic avian influenza viruses (LPAIVs) from wild birds into poultry flocks, followed by subsequent circulation and evolution. The acquisition of multiple basic amino acids at the endoproteolytical cleavage site of the hemagglutinin (HA) is a molecular indicator for high pathogenicity, at least for infections of gallinaceous poultry. Apart from the well-studied significance of the multibasic HA cleavage site, there is only limited knowledge on other alterations in the HA and neuraminidase (NA) molecules associated with changes in tropism during the emergence of HPAIVs from LPAIVs. We hypothesized that changes in tropism may require alterations of the sialyloligosaccharide specificities of HA and NA. To test this hypothesis, we compared a number of LPAIVs and HPAIVs for their HA-mediated binding and NA-mediated desialylation of a set of synthetic receptor analogs, namely, α2-3-sialylated oligosaccharides. NA substrate specificity correlated with structural groups of NAs and did not correlate with pathogenic potential of the virus. In contrast, all HPAIVs differed from LPAIVs by a higher HA receptor-binding affinity toward the trisaccharides Neu5Acα2-3Galβ1-4GlcNAcβ (3′SLN) and Neu5Acα2-3Galβ1-3GlcNAcβ (SiaLec) and by the ability to discriminate between the nonfucosylated and fucosylated sialyloligosaccharides 3′SLN and Neu5Acα2-3Galβ1-4(Fucα1-3)GlcNAcβ (SiaLex), respectively. These results suggest that alteration of the receptor-binding specificity accompanies emergence of the HPAIVs from their low-pathogenic precursors. IMPORTANCE Here, we have found for the first time correlations of receptor-binding properties of the HA with a highly pathogenic phenotype of poultry viruses. Our study suggests that enhanced receptor-binding affinity of HPAIVs for a typical “poultry-like” receptor, 3′SLN, is provided by

Facility Instrumentation for SOFIA: Technical Specifications and Scientific Goals

NASA Astrophysics Data System (ADS)

Stacey, G. J.

2000-05-01

The Stratospheric Observatory for Infrared Astronomy (SOFIA) is NASA's next generation airborne observatory consisting of a 2.5 m telescope in a modified Boeing 747 SP. First light is expected in late 2002. Three "Facility Class" instruments were among the first generation of instruments selected to fly on SOFIA. These instruments, currently under development are (1) a 5 to 38 um imaging photometer based on twin As:Si and Sb:Sb BIB arrays (FORCAST), (2) a 40 to 300 um photometer based on three arrays of bolometers, and (3) a 17 to 210 um eschelle grating spectrometer based on an Sb:Sb BIB array and a Ge:Sb and stressed Ge:Ga array of photoconductors. I will discuss both the technical aspects of these facility instruments, and some of the exciting new science that is possible with these ground breaking instruments on an airborne 2.5 meter telescope. Science topics include circumstellar debris disks, star formation, the Galactic Center, and distant galaxies.

Dramatic Arts Facilities.

ERIC Educational Resources Information Center

Ontario Dept. of Education, Toronto. School Planning and Building Research Section.

This booklet begins by explaining the function, the common planning errors, some location specifications, and the general requirements for any dramatic arts area. Facilities for (1) a single classroom, (2) a double classroom, (3) a specifically designed studio, and (4) a specifically designed studio complex are then described and illustrated.…

Emergency care in 59 low- and middle-income countries: a systematic review

PubMed Central

Abujaber, Samer; Makar, Maggie; Stoll, Samantha; Kayden, Stephanie R; Wallis, Lee A; Reynolds, Teri A

2015-01-01

Abstract Objective To conduct a systematic review of emergency care in low- and middle-income countries (LMICs). Methods We searched PubMed, CINAHL and World Health Organization (WHO) databases for reports describing facility-based emergency care and obtained unpublished data from a network of clinicians and researchers. We screened articles for inclusion based on their titles and abstracts in English or French. We extracted data on patient outcomes and demographics as well as facility and provider characteristics. Analyses were restricted to reports published from 1990 onwards. Findings We identified 195 reports concerning 192 facilities in 59 countries. Most were academically-affiliated hospitals in urban areas. The median mortality within emergency departments was 1.8% (interquartile range, IQR: 0.2–5.1%). Mortality was relatively high in paediatric facilities (median: 4.8%; IQR: 2.3–8.4%) and in sub-Saharan Africa (median: 3.4%; IQR: 0.5–6.3%). The median number of patients was 30 000 per year (IQR: 10 296–60 000), most of whom were young (median age: 35 years; IQR: 6.9–41.0) and male (median: 55.7%; IQR: 50.0–59.2%). Most facilities were staffed either by physicians-in-training or by physicians whose level of training was unspecified. Very few of these providers had specialist training in emergency care. Conclusion Available data on emergency care in LMICs indicate high patient loads and mortality, particularly in sub-Saharan Africa, where a substantial proportion of all deaths may occur in emergency departments. The combination of high volume and the urgency of treatment make emergency care an important area of focus for interventions aimed at reducing mortality in these settings. PMID:26478615

Comparing Utilization and Costs of Care in Freestanding Emergency Departments, Hospital Emergency Departments, and Urgent Care Centers.

PubMed

Ho, Vivian; Metcalfe, Leanne; Dark, Cedric; Vu, Lan; Weber, Ellerie; Shelton, George; Underwood, Howard R

2017-12-01

We compare utilization, price per visit, and the types of care delivered across freestanding emergency departments (EDs), hospital-based EDs, and urgent care centers in Texas. We analyzed insurance claims processed by Blue Cross Blue Shield of Texas from 2012 to 2015 for patient visits to freestanding EDs, hospital-based EDs, or urgent care centers in 16 Texas metropolitan statistical areas containing 84.1% of the state's population. We calculated the aggregate number of visits, average price per visit, proportion of price attributable to facility and physician services, and proportion of price billed to Blue Cross Blue Shield of Texas versus out of pocket, by facility type. Prices for the top 20 diagnoses and procedures by facility type are compared. Texans use hospital-based EDs and urgent care centers much more than freestanding EDs, but freestanding ED utilization increased 236% between 2012 and 2015. The average price per visit was lower for freestanding EDs versus hospital-based EDs in 2012 ($1,431 versus $1,842), but prices in 2015 were comparable ($2,199 versus $2,259). Prices for urgent care centers were only $164 and $168 in 2012 and 2015. Out-of-pocket liability for consumers for all these facilities increased slightly from 2012 to 2015. There was 75% overlap in the 20 most common diagnoses at freestanding EDs versus urgent care centers and 60% overlap for hospital-based EDs and urgent care centers. However, prices for patients with the same diagnosis were on average almost 10 times higher at freestanding and hospital-based EDs relative to urgent care centers. Utilization of freestanding EDs is rapidly expanding in Texas. Higher prices at freestanding and hospital-based EDs relative to urgent care centers, despite substantial overlap in services delivered, imply potential inefficient use of emergency facilities. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

49 CFR 192.167 - Compressor stations: Emergency shutdown.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Components § 192.167 Compressor stations: Emergency shutdown. (a) Except for unattended field compressor... fires, and electrical facilities in the vicinity of gas headers and in the compressor building, except that: (i) Electrical circuits that supply emergency lighting required to assist station personnel in...

49 CFR 192.167 - Compressor stations: Emergency shutdown.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Components § 192.167 Compressor stations: Emergency shutdown. (a) Except for unattended field compressor... fires, and electrical facilities in the vicinity of gas headers and in the compressor building, except that: (i) Electrical circuits that supply emergency lighting required to assist station personnel in...

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

Mother-infant interaction during the first 3 months: the emergence of culture-specific contingency patterns.

PubMed

Kärtner, Joscha; Keller, Heidi; Yovsi, Relindis D

2010-01-01

This study analyzed German and Nso mothers' auditory, proximal, and visual contingent responses to their infants' nondistress vocalizations in postnatal Weeks 4, 6, 8, 10, and 12. Visual contingency scores increased whereas proximal contingency scores decreased over time for the independent (German urban middle-class, N = 20) but not the interdependent sociocultural context (rural Nso farmers, N = 24). It seems, therefore, that culture-specific differences in the modal patterns of contingent responsiveness emerge during the 2nd and 3rd months of life. This differential development was interpreted as the result of the interplay between maturational processes associated with the 2-month shift that are selectively integrated and reinforced in culture-specific mother-infant interaction.

15 CFR 716.6 - Facility agreements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 15 Commerce and Foreign Trade 2 2011-01-01 2011-01-01 false Facility agreements. 716.6 Section 716... ROUTINE INSPECTIONS OF DECLARED FACILITIES § 716.6 Facility agreements. (a) Description and requirements. A facility agreement is a site-specific agreement between the U.S. Government and the OPCW. Its...

15 CFR 716.6 - Facility agreements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 15 Commerce and Foreign Trade 2 2013-01-01 2013-01-01 false Facility agreements. 716.6 Section 716... ROUTINE INSPECTIONS OF DECLARED FACILITIES § 716.6 Facility agreements. (a) Description and requirements. A facility agreement is a site-specific agreement between the U.S. Government and the OPCW. Its...

Variable gravity research facility

NASA Technical Reports Server (NTRS)

Allan, Sean; Ancheta, Stan; Beine, Donna; Cink, Brian; Eagon, Mark; Eckstein, Brett; Luhman, Dan; Mccowan, Daniel; Nations, James; Nordtvedt, Todd

1988-01-01

Spin and despin requirements; sequence of activities required to assemble the Variable Gravity Research Facility (VGRF); power systems technology; life support; thermal control systems; emergencies; communication systems; space station applications; experimental activities; computer modeling and simulation of tether vibration; cost analysis; configuration of the crew compartments; and tether lengths and rotation speeds are discussed.

Emergent Expertise?

ERIC Educational Resources Information Center

McGivern, Patrick

2014-01-01

The concept of emergence appears in various places within the literature on expertise and expert practice. Here, I examine some of these applications of emergence in the light of two prominent accounts of emergence from the philosophy of science and philosophy of mind. I evaluate these accounts with respect to several specific contexts in which…

Pediatric issues in disaster management, Part 1: the emergency medical system and surge capacity.

PubMed

Mace, Sharon E; Sharieff, Ghazala; Bern, Andrew; Benjamin, Lee; Burbulys, Dave; Johnson, Ramon; Schreiber, Merritt

2010-01-01

Although children and infants are likely to be victims in a disaster and are more vulnerable in a disaster than adults, disaster planning and management has often overlooked the specific needs of pediatric patients. The authors discuss key components of disaster planning and management for pediatric patients, including emergency medical services, hospital/facility issues, evacuation centers, family separation/reunification, children with special healthcare needs (SHCNs), mental health issues, and overcrowding/surge capacity. Specific policy recommendations and an appendix with detailed practical information and algorithms are included. The first part of this three-part series on pediatric issues in disaster management addresses the emergency medical system from the field to the hospital and surge capacity including the impact of crowding. The second part addresses the appropriate setup and functioning of evacuation centers and family separation and reunification. The third part deals with special patient populations: children with SHCNs and mental health issues.

Specificity vs. Generalizability: Emergence of Especial Skills in Classical Archery

PubMed Central

Czyż, Stanisław H.; Moss, Sarah J.

2016-01-01

There is evidence that the recall schema becomes more refined after constant practice. It is also believed that massive amounts of constant practice eventually leads to the emergence of especial skills, i.e., skills that have an advantage in performance over other actions from within the same class of actions. This advantage in performance was noticed when one-criterion practice, e.g., basketball free throws, was compared to non-practiced variations of the skill. However, there is no evidence whether multi-criterion massive amounts of practice would give an advantage to the trained variations of the skill over non-trained, i.e., whether such practice would eventually lead to the development of (multi)-especial skills. The purpose of this study was to determine whether massive amount of practice involving four criterion variations of the skill will give an advantage in performance to the criterions over the class of actions. In two experiments, we analyzed data from female (n = 8) and male classical archers (n = 10), who were required to shoot 30 shots from four accustomed distances, i.e., males at 30, 50, 70, and 90 m and females at 30, 50, 60, and 70 m. The shooting accuracy for the untrained distances (16 distances in men and 14 in women) was used to compile a regression line for distance over shooting accuracy. Regression determined (expected) values were then compared to the shooting accuracy of the trained distances. Data revealed no significant differences between real and expected results at trained distances, except for the 70 m shooting distance in men. The F-test for lack of fit showed that the regression computed for trained and non-trained shooting distances was linear. It can be concluded that especial skills emerge only after very specific practice, i.e., constant practice limited to only one variation of the skill. PMID:27547196

Specificity vs. Generalizability: Emergence of Especial Skills in Classical Archery.

PubMed

Czyż, Stanisław H; Moss, Sarah J

2016-01-01

There is evidence that the recall schema becomes more refined after constant practice. It is also believed that massive amounts of constant practice eventually leads to the emergence of especial skills, i.e., skills that have an advantage in performance over other actions from within the same class of actions. This advantage in performance was noticed when one-criterion practice, e.g., basketball free throws, was compared to non-practiced variations of the skill. However, there is no evidence whether multi-criterion massive amounts of practice would give an advantage to the trained variations of the skill over non-trained, i.e., whether such practice would eventually lead to the development of (multi)-especial skills. The purpose of this study was to determine whether massive amount of practice involving four criterion variations of the skill will give an advantage in performance to the criterions over the class of actions. In two experiments, we analyzed data from female (n = 8) and male classical archers (n = 10), who were required to shoot 30 shots from four accustomed distances, i.e., males at 30, 50, 70, and 90 m and females at 30, 50, 60, and 70 m. The shooting accuracy for the untrained distances (16 distances in men and 14 in women) was used to compile a regression line for distance over shooting accuracy. Regression determined (expected) values were then compared to the shooting accuracy of the trained distances. Data revealed no significant differences between real and expected results at trained distances, except for the 70 m shooting distance in men. The F-test for lack of fit showed that the regression computed for trained and non-trained shooting distances was linear. It can be concluded that especial skills emerge only after very specific practice, i.e., constant practice limited to only one variation of the skill.

Emergency and trauma care in Pakistan: a cross-sectional study of healthcare levels

PubMed Central

Razzak, Junaid A; Baqir, Syed M; Khan, Uzma Rahim; Heller, David; Bhatti, Junaid; Hyder, Adnan A

2015-01-01

Background The importance of emergency medical care for the successful functioning of health systems has been increasingly recognised. This study aimed to evaluate emergency and trauma care facilities in four districts of the province of Sindh, Pakistan. Method We conducted a cross-sectional health facility survey in four districts of the province of Sindh in Pakistan using a modified version of WHO’s Guidelines for essential trauma care. 93 public health facilities (81 primary care facilities, nine secondary care hospitals, three tertiary hospitals) and 12 large private hospitals were surveyed. Interviews of healthcare providers and visual inspections of essential equipment and supplies as per guidelines were performed. A total of 141 physicians providing various levels of care were tested for their knowledge of basic emergency care using a validated instrument. Results Only 4 (44%) public secondary, 3 (25%) private secondary hospitals and all three tertiary care hospitals had designated emergency rooms. The majority of primary care health facilities had less than 60% of all essential equipments overall. Most of the secondary level public hospitals (78%) had less than 60% of essential equipments, and none had 80% or more. A fourth of private secondary care facilities and all tertiary care hospitals (n=3; 100%) had 80% or more essential equipments. The average percentage score on the physician knowledge test was 30%. None of the physicians scored above 60% correct responses. Conclusions The study findings demonstrated a gap in both essential equipment and provider knowledge necessary for effective emergency and trauma care. PMID:24157684

75 FR 63209 - Indiana Michigan Power Company; Notice of Consideration of Issuance of Amendment to Facility...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-14

... emergency operating procedures (EOP), and site survey monitoring that support modification of emergency plan... Power Company; Notice of Consideration of Issuance of Amendment to Facility Operating License, Proposed... Regulatory Commission (the Commission) is considering issuance of an amendment to Facility Operating License...

EMERGEncy ID NET: Review of a 20-Year Multisite Emergency Department Emerging Infections Research Network

PubMed Central

Santibanez, Scott; Fischer, Leah S; Krishnadasan, Anusha; Sederdahl, Bethany; Merlin, Toby; Moran, Gregory J; Talan, David A; Mower, William; Sullivan, Matthew; Abrahamian, Fredrick M; Ong, Sam; Gross, Eric; Salhi, Bisan; Heilpern, Katherine; Hess, Jeremy; Karras, David; Biros, Michelle; Dunbar, Lala; Takhar, Sukhjit; Pollack, Charles; Runge, Jeffrey; Cheney, Paul; Rothrock, Stephen; O’Brian, John; Citron, Diane; Goldstein, Ellie; Finegold, Sydney; Nakase, Janet; Newdow, Michael; Merchant, Guy; Pathmarajah, Kavitha; Gonzalez, Eva; Mulrow, Mary; Bussman, Silas; Kalugdnan, Vernon; Peterson, Stephen; Pitts, Seth; Narayan, Kamil; Rubin, Ada; Kemble, Laurie; Beckham, Danielle; Neal, Niccole; Yagapen, Annick; Von Hofen, Carol; Hatala, Kathleen; Fuentes, Shelley; Sibley, Debbi; Colucci, Ashley; Hernandez, Jackeline; Cruse, Hope; Usher, Sarah; Hendrickson, Audrey; Dehnkamp, Kimberly; Zeglin, Britney; Jambaulikar, Guruprasad; Gorwitz, Rachel; Limbago, Brandi; Kuehnert, Matthew; Jarvis, William; Slutsker, Larry; Arvay, Melissa; Conn, Laura

2017-01-01

Abstract As providers of frontline clinical care for patients with acute and potentially life-threatening infections, emergency departments (EDs) have the priorities of saving lives and providing care quickly and efficiently. Although these facilities see a diversity of patients 24 hours per day and can collect prospective data in real time, their ability to conduct timely research on infectious syndromes is not well recognized. EMERGEncy ID NET is a national network that demonstrates that EDs can also collect data and conduct research in real time. This network collaborates with the Centers for Disease Control and Prevention (CDC) and other partners to study and address a wide range of infectious diseases and clinical syndromes. In this paper, we review selected highlights of EMERGEncy ID NET’s history from 1995 to 2017. We focus on the establishment of this multisite research network and the network’s collaborative research on a wide range of ED clinical topics. PMID:29670931

Study of emergency setting for urban facility using microsimulation tool

NASA Astrophysics Data System (ADS)

Campisi, Tiziana; Canale, Antonino; Tesoriere, Giovanni

2017-11-01

Today Public transport is growing not only in terms of high passenger capacity but also considering high efficiency and it has become one of the preferred alternatives to automobile travel. This is evident, as for example, in the case of airport terminal working and management. The same could be for Bus Transport station considering roadway. As a result, many railway stations experience high levels of pedestrian congestion especially during the morning and afternoon peak periods. Traditional design and evaluation procedures for pedestrian transit facilities aim to maintain a desirable Pedestrian Level-Of-Service (PLOS) for the individual pedestrian areas or sub precincts. More in general, transit facilities and their sub-precincts interact with one another so that pedestrian circulation might be better assessed from a broader systems perspective. Microsimulation packages that can model pedestrians (e.g. VISSIM-VISWALK) can be employed to assess these interactions. This research outlines a procedure for the potential implementation of pedestrian flow analysis in a bus/rail transit station using micro-simulation. Base model data requirements are identified which include static (facility layout and locations of temporary equipment) and dynamic data (pedestrian demand and public transport services). Possible model calibration criteria would be also identified. A VISSIM micro-simulation base model would be developed for one of the main Airport terminal in Sicily (Italy) for investigating proposed station operational and infrastructure changes. This case study provided a good example for the potential implementation of micro-simulation models in the analysis of pedestrian circulation.

KENNEDY SPACE CENTER, FLA. - Emergency crew members on the ground take hold of a volunteer “astronaut” lowered from the top of the orbiter crew compartment mock-up that is the scene of a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - Emergency crew members on the ground take hold of a volunteer “astronaut” lowered from the top of the orbiter crew compartment mock-up that is the scene of a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KENNEDY SPACE CENTER, FLA. - Emergency crew members help a volunteer “astronaut” onto the ground after being lowered from the top of the orbiter crew compartment mock-up that is the scene of a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - Emergency crew members help a volunteer “astronaut” onto the ground after being lowered from the top of the orbiter crew compartment mock-up that is the scene of a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KENNEDY SPACE CENTER, FLA. - Emergency crew members lower a volunteer “astronaut” from the top of the orbiter crew compartment mock-up that is the scene of a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer “astronauts” who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - Emergency crew members lower a volunteer “astronaut” from the top of the orbiter crew compartment mock-up that is the scene of a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer “astronauts” who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

10 CFR 62.13 - Contents of a request for emergency access: Alternatives.

Code of Federal Regulations, 2010 CFR

2010-01-01

... radioactive waste in a licensed storage facility; (3) Obtaining access to a disposal facility by voluntary... disposal at a Federal low-level radioactive waste disposal facility in the case of a Federal or defense... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission...

[Demographics, clinical features, treatments, and outcomes of patients who were transferred to emergency facilities in Japan after consuming dangerous drugs].

PubMed

Kamijo, Yoshito

2015-09-01

We conducted a multicenter survey of patients who were transported to emergency facilities in Japan from January 2006 to December 2012 after consuming dangerous drugs. Participants were 518 patients. Harmful behavior was observed at the scene of poisoning for about 10% of patients, including violence to others, and traffic accidents. Some patients had physical complications such as rhabdomyolysis, renal dysfunction, and hepatic dysfunction. Of the 182 patients admitted to hospitals, 29 needed respirators and 21 were hospitalized for ≥ 7 days. Although most patients completely recovered, consuming dangerous drugs can result in physical complications including rhabdomyolysis, as well as physical or neuropsychiatric symptoms, which may require active interventions such as respirator use or prolonged hospitalization.

40 CFR 264.227 - Emergency repairs; contingency plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Emergency repairs; contingency plans... FACILITIES Surface Impoundments § 264.227 Emergency repairs; contingency plans. (a) A surface impoundment... days after detecting the problem. (c) As part of the contingency plan required in subpart D of this...

Sex- and gender-specific research priorities for the emergency management of heart failure and acute arrhythmia: proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup.

PubMed

McGregor, Alyson J; Frank Peacock, W; Marie Chang, Anna; Safdar, Basmah; Diercks, Deborah

2014-12-01

The emergency department (ED) is the point of first contact for patients with acute heart failure and arrhythmias, with 1 million annual ED visits in the United States. Although the total numbers of men and women living with heart failure are similar, female patients are underrepresented in clinical studies, with current knowledge predominantly based on data from male patients. This has led to an underappreciation of the sex-specific differences in clinical characteristics and pathophysiology-based management of heart failure. Similar disparities have been found in management of acute arrhythmias, especially atrial arrhythmias that lead to an increased risk of stroke in women. Additionally, peripartum and postpartum cardiomyopathy represent a diagnostic and treatment dilemma. This article is the result of a breakout session in the cardiovascular and resuscitation work group of the 2014 Academic Emergency Medicine consensus conference "Gender-Specific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes." A nominal group technique was used to identify and prioritize themes and research questions using electronic mail, monthly conference calls, in-person meetings, and Web-based surveys between June 2013 and May 2014. Consensus was achieved through three rounds of nomination followed by the meeting on May 13, 2014, and resulted in seven priority themes that are essential to the common complex clinical syndrome of heart failure for both men and women and include the areas of pathophysiology; presentation and symptomatology; and diagnostic strategies using biomarkers, treatment, and mortality, with special consideration to arrhythmia management and pregnancy. © 2014 by the Society for Academic Emergency Medicine.

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

NASA Astrophysics Data System (ADS)

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

2017-06-01

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

9 CFR 3.25 - Facilities, general.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

Ethical issues in the response to Ebola virus disease in US emergency departments: a position paper of the American College of Emergency Physicians, the Emergency Nurses Association and the Society for Academic Emergency Medicine.

PubMed

Venkat, Arvind; Wolf, Lisa; Geiderman, Joel M; Asher, Shellie L; Marco, Catherine A; McGreevy, Jolion; Derse, Arthur R; Otten, Edward J; Jesus, John E; Kreitzer, Natalie P; Escalante, Monica; Levine, Adam C

2015-03-01

The 2014 outbreak of Ebola Virus Disease (EVD) in West Africa has presented a significant public health crisis to the international health community and challenged US emergency departments to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to US acute care facilities, ethical questions have been raised in both the press and medical literature as to how US emergency departments, emergency physicians, emergency nurses and other stakeholders in the healthcare system should approach the current epidemic and its potential for spread in the domestic environment. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to US emergency physicians, emergency nurses and other stakeholders in the healthcare system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to US emergency departments in how they approach preparation for and management of potential patients with EVD. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

A Guide to Preparing Educational Specifications for Secondary Industrial Arts Facilities. Monograph No. 1.

ERIC Educational Resources Information Center

Steeb, Ralph V.

The guide describes procedures for designing secondary industrial arts facilities based on careful scrutiny of the educational program which the facilities are intended to serve. It offers a four step general outline for planning such facilities and discusses in detail the following considerations with respect to writing subject area…

The Role of a National Biocontainment Laboratory in Emergencies.

PubMed

Le Duc, James W; Ksiazek, Thomas G

2015-01-01

Over a decade ago, the National Institutes of Health awarded partial support for the construction and operation of 2 National Biocontainment Laboratories, with the condition that they would be available to assist in the event of public health emergencies-although how a biocontainment facility located on an academic campus might contribute was not defined. Here we offer examples of how one of these laboratories has contributed to a coordinated response to 2 recent international public health emergencies. Essential assets for success include highly trained and experienced staff, access to reference pathogens and reagents, cutting-edge knowledge of the field, appropriate biocontainment facilities, robust biosafety and biosecurity programs, and availability of modern instrumentation. The ability to marry the strengths of academia in basic and applied research with access to appropriate biocontainment facilities while drawing on a highly skilled cadre of experienced experts has proven extremely valuable in the response to recent national emergencies and will continue to do so in the future. Areas where additional planning and preparation are needed have also been identified through these experiences.

Gender- and sex-specific sports-related injury research in emergency medicine: a consensus on future research direction and focused application.

PubMed

Raukar, Neha P; Zonfrillo, Mark R; Kane, Kathleen; Davenport, Moira; Espinoza, Tamara R; Weiland, Jessica; Franco, Vanessa; Vaca, Federico E

2014-12-01

Title IX, the commercialization of sports, the social change in sports participation, and the response to the obesity epidemic have contributed to the rapid proliferation of participation in both competitive organized sports and nontraditional athletic events. As a consequence, emergency physicians are regularly involved in the acute diagnosis, management, disposition, and counseling of a broad range of sports-related pathology. Three important and highly publicized mechanisms of injury in sports relevant to emergency medicine (EM) include concussion, heat illness, and sudden cardiac death. In conjunction with the 2014 Academic Emergency Medicine consensus conference "Gender-specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," a consensus group consisting of experts in EM, emergency neurology, sports medicine, and public health convened to deliberate and develop research questions that could ultimately advance the field of sports medicine and allow for meaningful application in the emergency department (ED) clinical setting. Sex differences in injury risk, diagnosis, ED treatment, and counseling are identified in each of these themes. This article presents the consensus-based priority research agenda. © 2014 by the Society for Academic Emergency Medicine.

7 CFR 1942.17 - Community facilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... economic purposes a single community having a contiguous boundary. (2) Project selection process. The... efficient management and economical service; and/or enlarge, extend, or otherwise modify existing facilities... account for items such as geographic distribution of funds and emergency conditions caused by economic...

7 CFR 1942.17 - Community facilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... economic purposes a single community having a contiguous boundary. (2) Project selection process. The... efficient management and economical service; and/or enlarge, extend, or otherwise modify existing facilities... account for items such as geographic distribution of funds and emergency conditions caused by economic...

7 CFR 1942.17 - Community facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... economic purposes a single community having a contiguous boundary. (2) Project selection process. The... efficient management and economical service; and/or enlarge, extend, or otherwise modify existing facilities... account for items such as geographic distribution of funds and emergency conditions caused by economic...

7 CFR 1942.17 - Community facilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... economic purposes a single community having a contiguous boundary. (2) Project selection process. The... efficient management and economical service; and/or enlarge, extend, or otherwise modify existing facilities... account for items such as geographic distribution of funds and emergency conditions caused by economic...

The NASA integrated test facility and its impact on flight research

NASA Technical Reports Server (NTRS)

Mackall, D. A.; Pickett, M. D.; Schilling, L. J.; Wagner, C. A.

1988-01-01

The Integrated Test Facility (ITF), being built at NASA Ames-Dryden Flight Research Facility, will provide new test capabilities for emerging research aircraft. An overview of the ITF and the challenges being addressed by this unique facility are outlined. The current ITF capabilities, being developed with the X-29 Forward Swept Wing Program, are discussed along with future ITF activities.

US EPA Region 4 RMP Facilities

EPA Pesticide Factsheets

To improve public health and the environment, the United States Environmental Protection Agency (USEPA) collects information about facilities, sites, or places subject to environmental regulation or of environmental interest. Through the Geospatial Data Download Service, the public is now able to download the EPA Geodata shapefile containing facility and site information from EPA's national program systems. The file is Internet accessible from the Envirofacts Web site (http://www.epa.gov/enviro). The data may be used with geospatial mapping applications. (Note: The shapefile omits facilities without latitude/longitude coordinates.) The EPA Geospatial Data contains the name, location (latitude/longitude), and EPA program information about specific facilities and sites. In addition, the file contains a Uniform Resource Locator (URL), which allows mapping applications to present an option to users to access additional EPA data resources on a specific facility or site.

Planning Requirements for Small School Facilities.

ERIC Educational Resources Information Center

Davis, J. Clark; McQueen, Robert

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

Rebuilding Emergency Care After Hurricane Sandy.

PubMed

Lee, David C; Smith, Silas W; McStay, Christopher M; Portelli, Ian; Goldfrank, Lewis R; Husk, Gregg; Shah, Nirav R

2014-04-09

A freestanding, 911-receiving emergency department was implemented at Bellevue Hospital Center during the recovery efforts after Hurricane Sandy to compensate for the increased volume experienced at nearby hospitals. Because inpatient services at several hospitals remained closed for months, emergency volume increased significantly. Thus, in collaboration with the New York State Department of Health and other partners, the Health and Hospitals Corporation and Bellevue Hospital Center opened a freestanding emergency department without on-site inpatient care. The successful operation of this facility hinged on key partnerships with emergency medical services and nearby hospitals. Also essential was the establishment of an emergency critical care ward and a system to monitor emergency department utilization at affected hospitals. The results of this experience, we believe, can provide a model for future efforts to rebuild emergency care capacity after a natural disaster such as Hurricane Sandy. (Disaster Med Public Health Preparedness. 2014;0:1-4).

77 FR 23161 - Onsite Emergency Response Capabilities

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... entire facility. The emergency diesel generators started at all six units, providing alternating current... known as station blackout (SBO). One diesel generator remained functional on Unit 6. Despite the actions...

Standard Specification for Language Laboratory.

ERIC Educational Resources Information Center

North Carolina State Dept. of Administration, Raleigh.

This specification covers the components of electronic and electromechanical equipment, nonelectronic materials for the teacher-student positions, and other items of a miscellaneous nature to provide for a complete and workable language laboratory facility. Language laboratory facilities covered by this specification are of two types: (1)…

Safeguards Approaches for Black Box Processes or Facilities

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

Diaz-Marcano, Helly; Gitau, Ernest TN; Hockert, John

2013-09-25

The objective of this study is to determine whether a safeguards approach can be developed for “black box” processes or facilities. These are facilities where a State or operator may limit IAEA access to specific processes or portions of a facility; in other cases, the IAEA may be prohibited access to the entire facility. The determination of whether a black box process or facility is safeguardable is dependent upon the details of the process type, design, and layout; the specific limitations on inspector access; and the restrictions placed upon the design information that can be provided to the IAEA. Thismore » analysis identified the necessary conditions for safeguardability of black box processes and facilities.« less

Emergency Care Capabilities in North East Haiti: A Cross-sectional Observational Study.

PubMed

De Wulf, Annelies; Aluisio, Adam R; Muhlfelder, Dana; Bloem, Christina

2015-12-01

The North East Department is a resource-limited region of Haiti. Health care is provided by hospitals and community clinics, with no formal Emergency Medical System and undefined emergency services. As a paucity of information exists on available emergency services in the North East Department of Haiti, the objective of this study was to assess systematically the existing emergency care resources in the region. This cross-sectional observational study was carried out at all Ministry of Public Health and Population (MSPP)-affiliated hospitals in the North East Department and all clinics within the Fort Liberté district. A modified version of the World Health Organization (WHO) Tool for Situational Analysis to Assess Emergency and Essential Surgical Care and Generic Essential Emergency Equipment Lists were completed for each facility. Three MSPP hospitals and five clinics were assessed. Among hospitals, all had a designated emergency ward with 24 hour staffing by a medical doctor. All hospitals had electricity with backup generators and access to running water; however, none had potable water. All hospitals had x-ray and ultrasound capabilities. No computed tomography scanners existed in the region. Invasive airway equipment and associated medications were not present consistently in the hospitals' emergency care areas, but they were available in the operating rooms. Pulse oximetry was unavailable uniformly. One hospital had intermittently functioning defibrillation equipment, and two hospitals had epinephrine. Basic supplies for managing obstetrical and traumatic emergencies were available at all hospitals. Surgical services were accessible at two hospitals. No critical care services were available in the region. Clinics varied widely in terms of equipment availability. They uniformly had limited emergency medical equipment. The clinics also had inconsistent access to basic assessment tools (sphygmomanometers 20% and stethoscopes 60%). A protocol for transferring

40 CFR 372.22 - Covered facilities for toxic chemical release reporting.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 29 2013-07-01 2013-07-01 false Covered facilities for toxic chemical... (CONTINUED) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS TOXIC CHEMICAL RELEASE REPORTING: COMMUNITY RIGHT-TO-KNOW Reporting Requirements § 372.22 Covered facilities for toxic chemical...

Laboratory Animal Facilities. Laboratory Design Notes.

ERIC Educational Resources Information Center

Jonas, Albert M.

1965-01-01

Design of laboratory animal facilities must be functional. Accordingly, the designer should be aware of the complex nature of animal research and specifically the type of animal research which will be conducted in a new facility. The building of animal-care facilities in research institutions requires special knowledge in laboratory animal…

Beyond signal functions in global obstetric care: Using a clinical cascade to measure emergency obstetric readiness

PubMed Central

Dettinger, Julia; Calkins, Kimberly; Kibore, Minnie; Gachuno, Onesmus; Walker, Dilys

2018-01-01

Background Globally, the rate of reduction in delivery-associated maternal and perinatal mortality has been slow compared to improvements in post-delivery mortality in children under five. Improving clinical readiness for basic obstetric emergencies is crucial for reducing facility-based maternal deaths. Emergency readiness is commonly assessed using tracers derived from the maternal signal functions model. Objective-method We compare emergency readiness using the signal functions model and a novel clinical cascade. The cascades model readiness as the proportion of facilities with resources to identify the emergency (stage 1), treat it (stage 2) and monitor-modify therapy (stage 3). Data were collected from 44 Kenyan clinics as part of an implementation trial. Findings Although most facilities (77.0%) stock maternal signal function tracer drugs, far fewer have resources to practically identify and treat emergencies. In hypertensive emergencies for example, 38.6% of facilities have resources to identify the emergency (Stage 1 readiness, including sphygmomanometer, stethoscope, urine collection device, protein test). 6.8% have the resources to treat the emergency (Stage 2, consumables (IV Kit, fluids), durable goods (IV pole) and drugs (magnesium sulfate and hydralazine). No facilities could monitor or modify therapy (Stage 3). Across five maternal emergencies, the signal functions overestimate readiness by 54.5%. A consistent, step-wise pattern of readiness loss across signal functions and care stage emerged and was profoundly consistent at 33.0%. Significance Comparing estimates from the maternal signal functions and cascades illustrates four themes. First, signal functions overestimate practical readiness by 55%. Second, the cascade’s intuitive indicators can support cross-sector health system or program planners to more precisely measure and improve emergency care. Third, adding few variables to existing readiness inventories permits step-wise modeling of

Facile method for site-specific gene integration in Lysobacter enzymogenes for yield improvement of the anti-MRSA antibiotics WAP-8294A and the antifungal antibiotic HSAF.

PubMed

Wang, Yan; Qian, Guoliang; Liu, Fengquan; Li, Yue-Zhong; Shen, Yuemao; Du, Liangcheng

2013-11-15

Lysobacter is a genus of Gram-negative gliding bacteria that are emerged as novel biocontrol agents and new sources of bioactive natural products. The bacteria are naturally resistant to many antibiotics commonly used in transformant selection, which has hampered the genetic manipulations. Here, we described a facile method for quick-and-easy identification of the target transformants from a large population of the wild type and nontarget transformants. The method is based on a distinct yellow-to-black color change as a visual selection marker for site-specific integration of the gene of interest. Through transposon random mutagenesis, we identified a black-colored strain from the yellow-colored L. enzymogenes . The black strain was resulted from a disruption of hmgA, a gene required for tyrosine/phenylalanine metabolism. The disruption of hmgA led to accumulation of dark brown pigments. As proof of principle, we constructed a series of expression vectors for a regulator gene found within the WAP-8294A biosynthetic gene cluster. The yield of WAP-8294A in the black strains increased by 2 fold compared to the wild type. Interestingly, the yield of another antibiotic (HSAF) increased up to 7 fold in the black strains. WAP-8294A is a family of potent anti-MRSA antibiotics and is currently in clinical studies, and HSAF is an antifungal compound with distinct structural features and a novel mode of action. This work represents the first successful metabolic engineering in Lysobacter. The development of this facile method opens a way toward manipulating antibiotic production in the largely unexplored sources.

Development, validation and testing of a nursing home to emergency room transfer checklist.

PubMed

Tsai, Hsiu-Hsin; Tsai, Yun-Fang

2018-01-01

To develop and test the feasibility of an instrument to support patients' nursing home to emergency room transfer. Transfers from a nursing home care facility to an acute care facility such as a hospital emergency room are common. However, the prevalence of an information gap for transferring residents' health data to acute care facility is high. An evidence-based transfer instrument, which could fill this gap, is lacking. Development of a nursing home to emergency room transfer checklist, validation of items using the Delphi method and testing the feasibility and benefits of using the nursing home to emergency room transfer checklist. Items were developed based on qualitative data from previous research. Delphi validation, retrospective chart review (baseline data) and a 6-month prospective study design were applied to test the feasibility of using the checklist. Variables for testing the feasibility of the checklist included residents' 30-day readmission rate and length of hospital stay. Development of the nursing home to emergency room transfer checklist resulted in four main parts: (i) demographic data of the nursing home resident; (ii) critical data for nursing home to emergency room transfer; (iii) contact information and (iv) critical data for emergency room to nursing home transfer. Two rounds of Delphi validation resulted in a mean score (standard deviation) ranging from 4.39 (1.13)-4.98 (.15). Time required to complete the checklist was 3-5 min. Use of the nursing home to emergency room transfer checklist resulted in a 30-day readmission rate of 13.4%, which was lower than the baseline rate of 15.9%. The nursing home to emergency room transfer checklist was developed for transferring nursing home residents to an emergency room. The instrument was found to be an effective tool for this process. Use of the nursing home to emergency room transfer checklist for nursing home transfers could fill the information gap that exists when transferring older adults

An internet-based communication network for information transfer during patient transitions from skilled nursing facility to the emergency department.

PubMed

Hustey, Fredric M; Palmer, Robert M

2010-06-01

To determine whether the implementation of an Internet-based communication system improves the amount of essential information conveyed between a skilled nursing facility (SNF) and the emergency department (ED) during patient care transitions. Interventional; before and after. ED of an urban teaching hospital with approximately 55,000 visits per year and a 55-bed subacute free-standing rehabilitation facility (the SNF). All patients transferred from the SNF to the ED over 16 months. An Internet-based communication network with SNF-ED transfer form for communication during patient care transitions. Nine elements of patient information assessed before and after intervention through chart review. changes in efficiency of information transfer and staff satisfaction. Two hundred thirty-four of 237 preintervention and all 276 postintervention care transitions were reviewed. The Internet communication network was used in 78 (26%) of all care transitions, peaking at 40% by the end of the study. There was more critical patient information (1.85 vs 4.29 of 9 elements; P<.001) contained within fewer pages of transfer documents (24.47 vs 5.15; P<.001) after the intervention. Staff satisfaction with communication was higher among ED physicians after the intervention. The use of an Internet-based system increased the amount of information communicated during SNF-ED care transitions and significantly reduced the number of pages in which this information was contained.

40 CFR 267.56 - What are the required emergency procedures for the emergency coordinator?

Code of Federal Regulations, 2014 CFR

2014-07-01

... FACILITIES OPERATING UNDER A STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.56 What are... designated response roles if their help is needed. (b) Whenever there is a release, fire, or explosion, the... environment that may result from the release, fire, or explosion. This assessment must consider both direct...

40 CFR 267.56 - What are the required emergency procedures for the emergency coordinator?

Code of Federal Regulations, 2012 CFR

2012-07-01

... FACILITIES OPERATING UNDER A STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.56 What are... designated response roles if their help is needed. (b) Whenever there is a release, fire, or explosion, the... environment that may result from the release, fire, or explosion. This assessment must consider both direct...

40 CFR 267.56 - What are the required emergency procedures for the emergency coordinator?

Code of Federal Regulations, 2011 CFR

2011-07-01

... FACILITIES OPERATING UNDER A STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.56 What are... designated response roles if their help is needed. (b) Whenever there is a release, fire, or explosion, the... environment that may result from the release, fire, or explosion. This assessment must consider both direct...

Chemical Emergency Preparedness and Prevention Advisory: Ammonia

EPA Pesticide Factsheets

This advisory recommends ways Local Emergency Planning Committees (LEPCs) and chemical facilities can minimize risks from this extremely hazardous substance, especially when present in excess of its 500 pounds threshold planning quantity.

The Portuguese gamma irradiation facility

NASA Astrophysics Data System (ADS)

Mendes, C. M.; Almeida, J. C.; Botelho, M. L.; Cavaco, M. C.; Almeida-Vara, E.; Andrade, M. E.

A Gamma Radiation Facility was built up in the National Laboratory of Industrial Technology and Engineering (LNETI), Lisbon, Portugal. This plant (UTR GAMA-Pi) is a Cobalt-60 dry storage continuous facility with a nominal capacity of 1.5X10 16 Bq. The initial activity is 1.1X10 16 Bq and the troughput capacity 10 3 ton/year for product with a bulk density of 0.2 g/cm 3 treated with a minimum absorbed dose of 25 kGy. Complementary control devices were installed: ventilation system, closed water refrigeration circuit, internal TV system, detection and extinction fire system and emergency power group. It must be emphasized that the best attention was given to the conception and efficiency of the interlock safety systems. This facility will be utilized mainly for radiosterilization of medical articles and decontamination of wine cork stoppers.

49 CFR 193.2509 - Emergency procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Emergency procedures. 193.2509 Section 193.2509 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY LIQUEFIED NATURAL GAS FACILITIES...

44 CFR 206.253 - Insurance requirements for facilities damaged by disasters other than flood.

Code of Federal Regulations, 2011 CFR

2011-10-01

... facilities damaged by disasters other than flood. 206.253 Section 206.253 Emergency Management and Assistance... ASSISTANCE Public Assistance Insurance Requirements § 206.253 Insurance requirements for facilities damaged... facility and its contents which were damaged by a disaster other than flood, the Grantee shall notify the...

An assessment of Chemical, Biological, Radiologic, Nuclear, and Explosive preparedness among emergency department healthcare providers in an inner city emergency department.

PubMed

Kotora, Joseph G

2015-01-01

Emergency healthcare providers are required to care for victims of Chemical, Biological, Radiologic, Nuclear, and Explosive (CBRNE) agents. However, US emergency departments are often ill prepared to manage CBRNE casualties. Most providers lack adequate knowledge or experience in the areas of patient decontamination, hospital-specific disaster protocols, interagency familiarization, and available supply of necessary medical equipment and medications. This study evaluated the CBRNE preparedness of physicians, nurses, and midlevel providers in an urban tertiary care emergency department. This retrospective observational survey study used a previously constructed questionnaire instrument. A total of 205 e-mail invitations were sent to 191 eligible providers through an online survey distribution tool (Survey Monkey®). Respondents were enrolled from February 1, 2014 to March 15, 2014. Simple frequencies of correct answers were used to determine the level of preparedness of each group. Cronbach's coefficient α was used to validate the precision of the study instrument. Finally, validity coefficients and analysis of variance ANOVA were used to determine the strength of correlation between demographic variables, as well as the variation between individual responses. Fifty-nine providers responded to the questionnaire (31.14 percent response rate). The overall frequency of correct answers was 66.26 percent, indicating a relatively poor level of CBRNE preparedness. The study instrument lacked precision and reliability (coefficient α 0.4050). Significant correlations were found between the frequency of correct answers and the respondents' gender, practice experience, and previous experience with a CBRNE incident. Significant variance exists between how providers believe casualties should be decontaminated, which drugs should be administered, and the interpretation of facility-specific protocols. Emergency care providers are inadequately prepared to manage CBRNE incidents

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

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

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

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

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

High Sensitivity and Specificity of Clinical Microscopy in Rural Health Facilities in Western Kenya Under an External Quality Assurance Program

PubMed Central

Wafula, Rebeccah; Sang, Edna; Cheruiyot, Olympia; Aboto, Angeline; Menya, Diana; O'Meara, Wendy Prudhomme

2014-01-01

Microscopic diagnosis of malaria is a well-established and inexpensive technique that has the potential to provide accurate diagnosis of malaria infection. However, it requires both training and experience. Although it is considered the gold standard in research settings, the sensitivity and specificity of routine microscopy for clinical care in the primary care setting has been reported to be unacceptably low. We established a monthly external quality assurance program to monitor the performance of clinical microscopy in 17 rural health centers in western Kenya. The average sensitivity over the 12-month period was 96% and the average specificity was 88%. We identified specific contextual factors that contributed to inadequate performance. Maintaining high-quality malaria diagnosis in high-volume, resource-constrained health facilities is possible. PMID:24935953

38 CFR 17.1000 - Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

Code of Federal Regulations, 2010 CFR

2010-07-01

... for emergency services for nonservice-connected conditions in non-VA facilities. 17.1000 Section 17.1000 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Payment Or Reimbursement for Emergency Services for Nonservice-Connected Conditions in Non-Va Facilities § 17.1000 Payment...

40 CFR 403.19 - Provisions of specific applicability to the Owatonna Waste Water Treatment Facility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the Owatonna Waste Water Treatment Facility. 403.19 Section 403.19 Protection of Environment... Owatonna Waste Water Treatment Facility. (a) For the purposes of this section, the term “Participating... Industrial User discharging to the Owatonna Waste Water Treatment Facility in Owatonna, Minnesota, when a...

Emergency management training program: Guide to good practice

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

Not Available

1991-07-01

The Emergency Management Training Program Guide to Good Practice is a project of the Training Resources and Data Exchange (TRADE) Emergency Management Issues Special Interest Group (EMI SIG). EMI SIG members expressed interest in a resource to assist in development of a comprehensive emergency management training program. This publication provides guidelines, methods, and materials for EMI SIG members to use, assisting in complete and effective emergency management programs. The purposes of the Emergency Management Training Program Guide to Good Practice are: Provide guidance in the development and management of Emergency Management (EM) training programs; Assist EM trainers to incorporate componentsmore » of the DOE Emergency Management System philosophy of planning, preparedness, readiness assurance, and response into EM training programs; Help EM training managers meet EM training requirements and conditions established by current regulations and policies; Supplement other TRADE EMI SIG documents and complement individual facility training documents. This program is designed for emergency management personnel who are responsible for providing or overseeing EM training but who do not necessarily possess expertise in developing training. It provides good practices from the manager's point of view on how to produce, administer, and document facility EM training programs in the spirit of the DOE EM system philosophy. Basic guidance is also included for personnel who design, develop, deliver, and/or evaluate EM training programs or parts. This guidance includes key points of EM training programs and identifies other documents that contain useful and/or more detailed training information.« less

Emergency management training program: Guide to good practice

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

Not Available

1991-07-01

The Emergency Management Training Program Guide to Good Practice is a project of the Training Resources and Data Exchange (TRADE) Emergency Management Issues Special Interest Group (EMI SIG). EMI SIG members expressed interest in a resource to assist in development of a comprehensive emergency management training program. This publication provides guidelines, methods, and materials for EMI SIG members to use, assisting in complete and effective emergency management programs. The purposes of the Emergency Management Training Program Guide to Good Practice are: Provide guidance in the development and management of Emergency Management (EM) training programs; Assist EM trainers to incorporate componentsmore » of the DOE Emergency Management System philosophy of planning, preparedness, readiness assurance, and response into EM training programs; Help EM training managers meet EM training requirements and conditions established by current regulations and policies; Supplement other TRADE EMI SIG documents and complement individual facility training documents. This program is designed for emergency management personnel who are responsible for providing or overseeing EM training but who do not necessarily possess expertise in developing training. It provides good practices from the manager`s point of view on how to produce, administer, and document facility EM training programs in the spirit of the DOE EM system philosophy. Basic guidance is also included for personnel who design, develop, deliver, and/or evaluate EM training programs or parts. This guidance includes key points of EM training programs and identifies other documents that contain useful and/or more detailed training information.« less

Disaster Response and Preparedness Application: Emergency Environmental Response Tool (EERT)

NASA Technical Reports Server (NTRS)

Smoot, James; Carr, Hugh; Jester, Keith

2003-01-01

In 2000, the National Aeronautics and Space Administration (NASA) Environmental Office at the John C. Stennis Space Center (SSC) developed an Environmental Geographic Information Systems (EGIS) database. NASA had previously developed a GIS database at SSC to assist in the NASA Environmental Office's management of the Center. This GIS became the basis for the NASA-wide EGIS project, which was proposed after the applicability of the SSC database was demonstrated. Since its completion, the SSC EGIS has aided the Environmental Office with noise pollution modeling, land cover assessment, wetlands delineation, environmental hazards mapping, and critical habitat delineation for protected species. At SSC, facility management and safety officers are responsible for ensuring the physical security of the facilities, staff, and equipment as well as for responding to environmental emergencies, such as accidental releases of hazardous materials. All phases of emergency management (planning, mitigation, preparedness, and response) depend on data reliability and system interoperability from a variety of sources to determine the size and scope of the emergency operation. Because geospatial data are now available for all NASA facilities, it was suggested that this data could be incorporated into a computerized management information program to assist facility managers. The idea was that the information system could improve both the effectiveness and the efficiency of managing and controlling actions associated with disaster, homeland security, and other activities. It was decided to use SSC as a pilot site to demonstrate the efficacy of having a baseline, computerized management information system that ultimately was referred to as the Emergency Environmental Response Tool (EERT).

Real-life experience with the specific reversal agent idarucizumab for the management of emergency situations in dabigatran-treated patients: a series of 11 cases.

PubMed

Vosko, Milan R; Bocksrucker, Christof; Drwiła, Rafał; Dulíček, Petr; Hauer, Tomas; Mutzenbach, Johannes; Schlimp, Christoph J; Špinler, David; Wolf, Thomas; Zugwitz, Daša

2017-04-01

Non-vitamin K antagonist oral anticoagulants (NOACs) have a favorable benefit-risk profile compared with vitamin K antagonists. However, the lack of specific reversal agents has made the management of some patients receiving long-term treatment with NOACs problematic in emergency situations such as major bleeding events or urgent procedures. Idarucizumab, a fully humanized Fab antibody fragment that binds specifically and with high affinity to dabigatran, was recently approved for use in adult patients treated with dabigatran when rapid reversal of its anticoagulant effect is required. Clinical experience with idarucizumab is currently limited. We report 11 real-life clinical cases in which idarucizumab was used after multidisciplinary consultation in a variety of emergency situations including severe postoperative bleeding, emergency high-bleeding-risk surgery (hip/spine surgery and neurosurgery), invasive diagnostic testing (lumbar puncture), intracranial bleeding (pre-pontine subarachnoid hemorrhage and lobar intracerebral hemorrhage) and thrombolysis with recombinant tissue plasminogen activator for acute ischemic stroke. This case series illustrates the role of idarucizumab in improving patient safety in rare emergency situations requiring rapid reversal of the anticoagulant effect of dabigatran, while highlighting the importance of information and education about the availability and appropriate use of this recently approved specific reversal agent.

Web-Based Real-Time Emergency Monitoring

NASA Technical Reports Server (NTRS)

Harvey, Craig A.; Lawhead, Joel

2007-01-01

The Web-based Real-Time Asset Monitoring (RAM) module for emergency operations and facility management enables emergency personnel in federal agencies and local and state governments to monitor and analyze data in the event of a natural disaster or other crisis that threatens a large number of people and property. The software can manage many disparate sources of data within a facility, city, or county. It was developed on industry-standard Geo- Spatial software and is compliant with open GIS standards. RAM View can function as a standalone system, or as an integrated plugin module to Emergency Operations Center (EOC) software suites such as REACT (Real-time Emergency Action Coordination Tool), thus ensuring the widest possible distribution among potential users. RAM has the ability to monitor various data sources, including streaming data. Many disparate systems are included in the initial suite of supported hardware systems, such as mobile GPS units, ambient measurements of temperature, moisture and chemical agents, flow meters, air quality, asset location, and meteorological conditions. RAM View displays real-time data streams such as gauge heights from the U.S. Geological Survey gauging stations, flood crests from the National Weather Service, and meteorological data from numerous sources. Data points are clearly visible on the map interface, and attributes as specified in the user requirements can be viewed and queried.

Ethical issues in the response to Ebola virus disease in United States emergency departments: a position paper of the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine.

PubMed

Venkat, Arvind; Asher, Shellie L; Wolf, Lisa; Geiderman, Joel M; Marco, Catherine A; McGreevy, Jolion; Derse, Arthur R; Otten, Edward J; Jesus, John E; Kreitzer, Natalie P; Escalante, Monica; Levine, Adam C

2015-05-01

The 2014 outbreak of Ebola virus disease (EVD) in West Africa has presented a significant public health crisis to the international health community and challenged U.S. emergency departments (EDs) to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to U.S. acute care facilities, ethical questions have been raised in both the press and medical literature as to how U.S. EDs, emergency physicians (EPs), emergency nurses, and other stakeholders in the health care system should approach the current epidemic and its potential for spread in the domestic environment. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to U.S. EPs, emergency nurses, and other stakeholders in the health care system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to U.S. EDs in how they approach preparation for and management of potential patients with EVD. © 2015 by the Society for Academic Emergency Medicine.

A Facile Method for Site-specific Gene Integration in Lysobacter enzymogenes for Yield Improvement of the Anti-MRSA Antibiotics WAP-8294A and the Antifungal Antibiotic HSAF

PubMed Central

Wang, Yan; Qian, Guoliang; Liu, Fengquan; Li, Yue-Zhong; Shen, Yuemao; Du, Liangcheng

2013-01-01

Lysobacter is a genus of Gram -negative gliding bacteria that are emerged as novel biocontrol agents and new sources of bioactive natural products. The bacteria are naturally resistant to many antibiotics commonly used in transformant selection, which has hampered the genetic manipulations. Here, we described a facile method for quick -and-easy identification of the target transformants from a large population of the wild type and non-target transformants. The method is based on a distinct yellow-to-black color change as a visual selection marker for site-specific integration of the gene of interest. Through transposon random mutagenesis, we identified a black-colored strain from the yellow-colored L. enzymogenes. The black strain was resulted from a disruption of hmgA, a gene required for tyrosine /phenylalanine metabolism. The disruption of hmgA led to accumulation of dark brown pigments. As proof of principle, we constructed a series of expression vectors for a regulator gene found within the WAP-8294A biosynthetic gene cluster. The yield of WAP-8294A in the black strains increased by 2 fold compared to the wild type. Interestingly, the yield of another antibiotic (HSAF) increased up to 7 fold in the black strains. WAP-8294A is a family of potent anti-MRSA antibiotics and is currently in clinical studies, and HSAF is an antifungal compound with distinct structural features and a novel mode of action. This work represents the first successful metabolic engineering in Lysobacter. The development of this facile method opens a way toward manipulating antibiotic production in the largely unexplored sources. PMID:23937053

Local Emergency Planning Committee (LEPC) Data

EPA Pesticide Factsheets

The LEPC data set contains over 3000 listings, as of 2008, for name and location data identifying Local Emergency Planning Committees (LEPCs). LEPCs are people responsible to develop an emergency response plan, review it at least annually, and provide information about chemicals in the community to citizens. Plans are developed by LEPCs with stakeholder participation. There is one LEPC for each of the more than 3,000 designated local emergency planning districts. The LEPC membership must include (at a minimum): Elected state and local officials; Police, fire, civil defense, and public health professionals; Environment, transportation, and hospital officials; Facility representatives; Representatives from community groups and the media.

Developing an active emergency medical service system based on WiMAX technology.

PubMed

Li, Shing-Han; Cheng, Kai-An; Lu, Wen-Hui; Lin, Te-Chang

2012-10-01

The population structure has changed with the aging of population. In the present, elders account for 10.63% of the domestic population and the percentage is still gradually climbing. In other words, the demand for emergency services among elders in home environment is expected to grow in the future. In order to improve the efficiency and quality of emergency care, information technology should be effectively utilized to integrate medical systems and facilities, strengthen human-centered operation designs, and maximize the overall performance. The improvement in the quality and survival rate of emergency care is an important basis for better life and health of all people. Through integrated application of medical information systems and information communication technology, this study proposes a WiMAX-based emergency care system addressing the public demands for convenience, speed, safety, and human-centered operation of emergency care. This system consists of a healthcare service center, emergency medical service hospitals, and emergency ambulances. Using the wireless transmission capability of WiMAX, patients' physiological data can be transmitted from medical measurement facilities to the emergency room and emergency room doctors can provide immediate online instructions on emergency treatment via video and audio transmission. WiMAX technology enables the establishment of active emergency medical services.

Construction alternatives for free-standing facilities.

PubMed

Brown, G

1990-01-01

Many hospitals are exploring free-standing facilities as an option for providing more efficient imaging services. Mr. Brown discusses the pros and cons of an emerging building technology, manufactured construction, in which building and site preparation are done simultaneously. He presents the criteria managers should use to make a knowledgeable decision.

10 CFR 62.12 - Contents of a request for emergency access: General information.

Code of Federal Regulations, 2014 CFR

2014-01-01

... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission... the disposal facility or facilities which had been receiving the waste stream of concern before the... the person(s) or company(ies) generating the low-level radioactive waste for which the determination...

10 CFR 62.12 - Contents of a request for emergency access: General information.

Code of Federal Regulations, 2011 CFR

2011-01-01

... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission... the disposal facility or facilities which had been receiving the waste stream of concern before the... the person(s) or company(ies) generating the low-level radioactive waste for which the determination...

10 CFR 62.12 - Contents of a request for emergency access: General information.

Code of Federal Regulations, 2012 CFR

2012-01-01

... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission... the disposal facility or facilities which had been receiving the waste stream of concern before the... the person(s) or company(ies) generating the low-level radioactive waste for which the determination...

10 CFR 62.12 - Contents of a request for emergency access: General information.

Code of Federal Regulations, 2013 CFR

2013-01-01

... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission... the disposal facility or facilities which had been receiving the waste stream of concern before the... the person(s) or company(ies) generating the low-level radioactive waste for which the determination...

Oil Pollution Act (OPA) and Federal Facilities

EPA Pesticide Factsheets

The Oil Pollution Prevention regulation sets forth requirements for prevention of, preparedness for, and response to oil discharges at specific non-transportation-related facilities, including federal facilities.

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

Signal functions for emergency obstetric care as an intervention for reducing maternal mortality: a survey of public and private health facilities in Lusaka District, Zambia.

PubMed

Tembo, Tannia; Chongwe, Gershom; Vwalika, Bellington; Sitali, Lungowe

2017-09-06

Zambia's maternal mortality ratio was estimated at 398/100,000 live births in 2014. Successful aversion of deaths is dependent on availability and usability of signal functions for emergency obstetric and neonatal care. Evidence of availability, usability and quality of signal functions in urban settings in Zambia is minimal as previous research has evaluated their distribution in rural settings. This survey evaluated the availability and usability of signal functions in private and public health facilities in Lusaka District of Zambia. A descriptive cross sectional study was conducted between November 2014 and February 2015 at 35 public and private health facilities. The Service Availability and Readiness Assessment tool was adapted and administered to overall in-charges, hospital administrators or maternity ward supervisors at health facilities providing maternal and newborn health services. The survey quantified infrastructure, human resources, equipment, essential drugs and supplies and used the UN process indicators to determine availability, accessibility and quality of signal functions. Data on deliveries and complications were collected from registers for periods between June 2013 and May 2014. Of the 35 (25.7% private and 74.2% public) health facilities assessed, only 22 (62.8%) were staffed 24 h a day, 7 days a week and had provided obstetric care 3 months prior to the survey. Pre-eclampsia/ eclampsia and obstructed labor accounted for most direct complications while postpartum hemorrhage was the leading cause of maternal deaths. Overall, 3 (8.6%) and 5 (14.3%) of the health facilities had provided Basic and Comprehensive EmONC services, respectively. All facilities obtained blood products from the only blood bank at a government referral hospital. The UN process indicators can be adequately used to monitor progress towards maternal mortality reduction. Lusaka district had an unmet need for BEmONC as health facilities fell below the minimum UN standard

EPCRA Tier II Emergency and Hazardous Chemical Inventory Form

EPA Pesticide Factsheets

Required for Emergency and Hazardous Chemical Inventory reporting. Must provide facility identification, chemical description, indication of physical and health hazards, inventory information, and storage details.

The Effectiveness of an Emergent Literacy Intervention for Teenage Parents

ERIC Educational Resources Information Center

Scott, Amy; van Bysterveldt, Anne; McNeill, Brigid

2016-01-01

This study determined the effectiveness of an experimental emergent literacy intervention, targeting teenage mothers attending an educational facility. Using a pretest/posttest research design, 27 participants completed a 7­-week intervention based in the classroom, targeting a range of emergent literacy skills that they could utilize when reading…

Facility effluent monitoring plan for the plutonium uranium extraction facility

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

Wiegand, D.L.

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

Before the Emergency: A Framework for Evaluating Emergency Preparedness Alternatives at Higher Education Institutions

DTIC Science & Technology

2010-09-01

Operations and Procedures • Logistics and Facilities • Training • Exercises, Evaluation and Corrective Actions • Crisis Communications ...Assessment Team BCA Benefit-cost analysis CEO Chief Executive Officer CERT Community Emergency Response Team CFR Code of Federal Regulations...CHDS Center for Homeland Defense and Security CPG 101 Comprehensive Preparedness Guidelines 101 CPP Community Preparedness and Participation CPW

Chemical Emergency Preparedness and Prevention on Tribal Lands

EPA Pesticide Factsheets

This fact sheet familiarizes tribal leaders with EPCRA and Chemical Accident Prevention Program requirements. Tribal Emergency Response Commissions (TERCs) can appoint LEPCs, develop contingency plans, and review facilities' Risk Management Plans.

High sensitivity and specificity of clinical microscopy in rural health facilities in western Kenya under an external quality assurance program.

PubMed

Wafula, Rebeccah; Sang, Edna; Cheruiyot, Olympia; Aboto, Angeline; Menya, Diana; O'Meara, Wendy Prudhomme

2014-09-01

Microscopic diagnosis of malaria is a well-established and inexpensive technique that has the potential to provide accurate diagnosis of malaria infection. However, it requires both training and experience. Although it is considered the gold standard in research settings, the sensitivity and specificity of routine microscopy for clinical care in the primary care setting has been reported to be unacceptably low. We established a monthly external quality assurance program to monitor the performance of clinical microscopy in 17 rural health centers in western Kenya. The average sensitivity over the 12-month period was 96% and the average specificity was 88%. We identified specific contextual factors that contributed to inadequate performance. Maintaining high-quality malaria diagnosis in high-volume, resource-constrained health facilities is possible. © The American Society of Tropical Medicine and Hygiene.

9 CFR 3.4 - Outdoor housing facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Transportation of Dogs and Cats 1 Facilities and Operating Standards § 3.4 Outdoor housing facilities. (a) Restrictions. (1) The following categories of dogs or cats must not be kept in outdoor facilities, unless that practice is specifically approved by the attending veterinarian: (i) Dogs or cats that are not acclimated...

9 CFR 3.4 - Outdoor housing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Transportation of Dogs and Cats 1 Facilities and Operating Standards § 3.4 Outdoor housing facilities. (a) Restrictions. (1) The following categories of dogs or cats must not be kept in outdoor facilities, unless that practice is specifically approved by the attending veterinarian: (i) Dogs or cats that are not acclimated...

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.

Using Geo-Data Corporately on the Response Phase of Emergency Management

NASA Astrophysics Data System (ADS)

Demir Ozbek, E.; Ates, S.; Aydinoglu, A. C.

2015-08-01

Response phase of emergency management is the most complex phase in the entire cycle because it requires cooperation between various actors relating to emergency sectors. A variety of geo-data is needed at the emergency response such as; existing data provided by different institutions and dynamic data collected by different sectors at the time of the disaster. Disaster event is managed according to elaborately defined activity-actor-task-geodata cycle. In this concept, every activity of emergency response is determined with Standard Operation Procedure that enables users to understand their tasks and required data in any activity. In this study, a general conceptual approach for disaster and emergency management system is developed based on the regulations to serve applications in Istanbul Governorship Provincial Disaster and Emergency Directorate. The approach is implemented to industrial facility explosion example. In preparation phase, optimum ambulance locations are determined according to general response time of the ambulance to all injury cases in addition to areas that have industrial fire risk. Management of the industrial fire case is organized according to defined actors, activities, and working cycle that describe required geo-data. A response scenario was prepared and performed for an industrial facility explosion event to exercise effective working cycle of actors. This scenario provides using geo-data corporately between different actors while required data for each task is defined to manage the industrial facility explosion event. Following developing web technologies, this scenario based approach can be effective to use geo-data on the web corporately.

75 FR 33821 - Recovery Policy RP9524.10; Direct Disaster-Related Damage to Eligible Facilities

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-15

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2010-0024] Recovery Policy RP9524.10; Direct Disaster-Related Damage to Eligible Facilities AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice of availability; request for comments. SUMMARY: The Federal Emergency...

An integrated lean-methods approach to hospital facilities redesign.

PubMed

Nicholas, John

2012-01-01

Lean production methods for eliminating waste and improving processes in manufacturing are now being applied in healthcare. As the author shows, the methods are appropriate for redesigning hospital facilities. When used in an integrated manner and employing teams of mostly clinicians, the methods produce facility designs that are custom-fit to patient needs and caregiver work processes, and reduce operational costs. The author reviews lean methods and an approach for integrating them in the redesign of hospital facilities. A case example of the redesign of an emergency department shows the feasibility and benefits of the approach.

Planning for School Emergencies.

ERIC Educational Resources Information Center

Della-Giustina, Daniel E.

This document is designed to provide civil leaders and school administrators with a resource that will enable them to develop comprehensive contingency plans for specific emergency situations. A discussion of disaster and emergency management planning includes an outline of the objectives of emergency planning that were established for this guide.…

30 CFR 254.23 - What information must I include in the “Emergency response action plan” section?

Code of Federal Regulations, 2011 CFR

2011-07-01

... FOR FACILITIES LOCATED SEAWARD OF THE COAST LINE Oil-Spill Response Plans for Outer Continental Shelf Facilities § 254.23 What information must I include in the “Emergency response action plan” section? The “Emergency response action plan”section is the core of the response plan. Put information in easy-to-use...

41 CFR 102-74.240 - What are Federal agencies' occupant emergency responsibilities?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Occupant Emergency Program § 102-74.240 What are... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What are Federal...

Alimentary tract surgery in the nonagenarian: elective vs. emergent operations.

PubMed

Blansfield, Joseph A; Clark, Susan C; Hofmann, Mary T; Morris, Jon B

2004-01-01

The objective of this study was to compare elective with emergent surgery in patients over the age of 90 years. We retrospectively reviewed the records of patients over 90 years of age who underwent alimentary tract surgery between 1994 and 2002 at a community teaching hospital. Of 100 patients (mean age 92 years; range 90 to 98 years), 82 were women and 18 were men. Seventy-three percent were admitted from private homes or assisted-living facilities, and 27% came from a skilled-nursing facility (SNF). Major comorbid conditions existed in 93%. Procedures included right hemicolectomy (22%), adhesiolysis and/or small bowel resection (19%), cholecystectomy (14%), left-sided or sigmoid colectomy (11%), and perineal proctectomy (8%). Overall morbidity and mortality were 36% and 15%, respectively. Postoperative complications included respiratory failure and pneumonia (11%), arrhythmias (9%), delirium (7%), congestive heart failure and myocardial infarction (6%), and urinary complications (4%). Twenty-eight percent of the operations were elective, and 72% were emergent. Morbidity and mortality were higher in the emergent group (41% and 19%, respectively) than in the elective group (26% and 4%, respectively; P=0.04), especially for patients with an emergent surgical problem who came from a nursing home (22%). Average length of stay was 12 +/- 10 days (range 2 to 69 days) with little difference between elective and emergent cases. Sixty-four percent of patients were discharged to skilled-nursing facilities. Alimentary tract surgery can be performed safely in nonagenarians, and they should not be denied surgical care solely because of age.

AED use in businesses, public facilities and homes by minimally trained first responders.

PubMed

Jorgenson, Dawn B; Skarr, Teresa; Russell, James K; Snyder, David E; Uhrbrock, Karen

2003-11-01

Automated external defibrillators (AEDs) have become increasingly available outside of the Emergency Medical Systems (EMS) community to treat sudden cardiac arrest (SCA). We sought to study the use of AEDs in the home, businesses and other public settings by minimally trained first responders. The frequency of AED use, type of training offered to first responders, and outcomes of AED use were investigated. In addition, minimally trained responders were asked if they had encountered any safety problems associated with the AED. We conducted a telephone survey of businesses and public facilities (2683) and homes (145) owning at least one AED for at least 12 months. Use was defined as an AED taken to a medical emergency thought to be a SCA, regardless of whether the AED was applied to the patient or identified a shockable rhythm. Of owners that participated in the survey, 13% (209/1581) of businesses and 5% (4/73) of homes had responded with the AED to a suspected cardiac arrest. Ninety-five percent of the businesses/public facilities offered training that specifically covered AED use. The rate of use for the AEDs was highest in residential buildings, public places, malls and recreational facilities with an overall usage rate of 11.6% per year. In-depth interviews were conducted with lay responders who had used the AED in a suspected cardiac arrest. In the four cases where the AED was used solely by a lay responder, all four patients survived to hospital admission and two were known to be discharged from the hospital. There were no reports of injury or harm. This survey demonstrates that AEDs purchased by businesses and homes were frequently taken to suspected cardiac arrests. Lay responders were able to successfully use the AEDs in emergency situations. Further, there were no reports of harm or injury to the operators, bystanders or patients from lay responder use of the AEDs.

Prostate-Specific G-Protein Coupled Receptor, an Emerging Biomarker Regulating Inflammation and Prostate Cancer Invasion.

PubMed

Rodriguez, M; Siwko, S; Liu, M

2016-01-01

Prostate cancer is highly prevalent among men in developed countries, but a significant proportion of detected cancers remain indolent, never progressing into aggressive carcinomas. This highlights the need to develop refined biomarkers that can distinguish between indolent and potentially dangerous cases. The prostate-specific G-protein coupled receptor (PSGR, or OR51E2) is an olfactory receptor family member with highly specific expression in human prostate epithelium that is highly overexpressed in PIN and prostate cancer. PSGR has been functionally implicated in prostate cancer cell invasiveness, suggesting a potential role in the transition to metastatic PCa. Recently, transgenic mice overexpressing PSGR in the prostate were reported to develop an acute inflammatory response followed by emergence of low grade PIN, whereas mice with compound PSGR overexpression and loss of PTEN exhibited accelerated formation of invasive prostate adenocarcinoma. This article will review recent PSGR findings with a focus on its role as a potential prostate cancer biomarker and regulator of prostate cancer invasion and inflammation.

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

A comparison of verbal communication and psychiatric medication use by Greek and Italian residents with dementia in Australian ethno-specific and mainstream aged care facilities.

PubMed

Runci, Susannah J; Eppingstall, Barbara J; O'Connor, Daniel W

2012-05-01

Older migrants with dementia and limited English language proficiency in residential care may have unmet needs for social interaction. This project compared verbal communication and prescribed psychiatric medication of Greek and Italian residents with dementia in ethno-specific and mainstream residential care. Participants were 82 older Australians of Greek or Italian background who had been diagnosed with dementia and were residing in mainstream or ethno-specific care. Residents were observed and their language use was recorded. An assessment of cognitive impairment was conducted. A structured interview was held with a family member and a staff member. The observed rate of resident-to-resident communication was higher in the ethno-specific facilities. Staff-to-resident interaction rate did not differ between the facility types. Residents in ethno-specific care were prescribed antipsychotics at a significantly lower rate. Residents with dementia and limited English language proficiency in mainstream care would benefit from greater opportunities to interact with peers in their own language. Prescribed medication should be monitored to ensure that these residents are not misinterpreted as "disruptive," or are not actually more agitated due to difficulty in communicating their needs.

Chemical Emergency Preparedness and Prevention Advisory: Hydrogen Fluoride

EPA Pesticide Factsheets

This advisory recommends ways Local Emergency Planning Committees (LEPCs) and chemical facilities can reduce risks posed by the presence of hydrogen fluoride (HF), a strong inorganic acid used to manufacture CFCs, in their communities.

Theme: Emerging Technologies.

ERIC Educational Resources Information Center

Malpiedi, Barbara J.; And Others

1989-01-01

Consists of six articles discussing the effect of emerging technologies on agriculture. Specific topics include (1) agriscience programs, (2) the National Conference on Agriscience and Emerging Occupations and Technologies, (3) biotechnology, (4) program improvement through technology, (5) the Agriscience Teacher of the Year program, and (6)…

Identification and assessment of site treatment plan implementation opportunities for emerging technologies

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

Bernard, E.A.

1995-12-31

The Department of Energy (DOE), in response to the 1992 Federal Facility Compliance Act, has prepared Site Treatment Plans (STP) for the approximately 2,000 waste streams identified within its mixed waste inventory Concurrently, emerging mixed waste treatment technologies are in final development. This paper defines a three-phase process to identify and assess implementation opportunities for these emerging technologies within the STP. It highlights the first phase, functional matching of expected treatment capabilities with proposed treatment requirements. Matches are based on treatment type, regulated contaminant and waste matrix type, for both capabilities and requirements. Results identify specific waste streams and volumesmore » that could be treated by each emerging technology. A study for Plasma Hearth Process, Delphi DETOX{sup sm}, Supercritical Water Oxidation and Vitrification shows that about 200,000 ml of DOE`s mixed waste inventory can potentially be treated by one or more of these emerging technologies. Actual implementations are small fractions of the treatable inventory. Differences between potential and actual implementations must be minimized to accrue optimum benefit from implementation of emerging or alternative treatment technologies. Functional matching is the first phase in identifying and quantifying benefits, addressing technology system and treatment issues, and providing, in part, the basis for STP implementation decisions. DOE, through EM`s Office of Technology Development, has funded this work.« less

42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

Code of Federal Regulations, 2014 CFR

2014-10-01

... emergency safety intervention. 483.372 Section 483.372 Public Health CENTERS FOR MEDICARE & MEDICAID... Age 21 § 483.372 Medical treatment for injuries resulting from an emergency safety intervention. (a... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility...

42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

Code of Federal Regulations, 2010 CFR

2010-10-01

... emergency safety intervention. 483.372 Section 483.372 Public Health CENTERS FOR MEDICARE & MEDICAID... Age 21 § 483.372 Medical treatment for injuries resulting from an emergency safety intervention. (a... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility...

42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

Code of Federal Regulations, 2013 CFR

2013-10-01

... emergency safety intervention. 483.372 Section 483.372 Public Health CENTERS FOR MEDICARE & MEDICAID... Age 21 § 483.372 Medical treatment for injuries resulting from an emergency safety intervention. (a... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility...

42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

Code of Federal Regulations, 2012 CFR

2012-10-01

... emergency safety intervention. 483.372 Section 483.372 Public Health CENTERS FOR MEDICARE & MEDICAID... Age 21 § 483.372 Medical treatment for injuries resulting from an emergency safety intervention. (a... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility...

42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

Code of Federal Regulations, 2011 CFR

2011-10-01

... emergency safety intervention. 483.372 Section 483.372 Public Health CENTERS FOR MEDICARE & MEDICAID... Age 21 § 483.372 Medical treatment for injuries resulting from an emergency safety intervention. (a... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility...

Multitier specification for NSEP (National Security/Emergency Preparedness) enhancement of fiber-optic long-distance telecommunication networks. Volume 1. The multitier specification - an executive summary. Technical Information Bulletin

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

Peach, D.F.

1987-12-01

Fiber optic telecommunication systems are susceptible to both natural and man-made stress. National Security/Emergency Preparedness (NSEP) is a function of how durable these systems are in light of projected levels of stress. Emergency Preparedness in 1987 is not just a matter of--can they deliver food, water, energy and other essentials--but can they deliver the vital information necessary to maintain corporate function of our country. 'Communication stamina' is a function of 'probability of survival' when faced with stress. This report provides an overview of the enhancements to a fiber-optic communication system/installation that will increase durability. These enhancements are grouped, based onmore » their value in protecting the system, such that a Multitier Specification is created that presents multiple levels of hardness. Mitigation of effects due to high-altitude electromagnetic pulse (HEMP) and gamma radiation, and protection from vandalism and weather events are discussed in the report. The report is presented in two volumes. Volume I presents the Multitier Specification in a format that is usable for management review. The attributes of specified physical parameters, and the levels of protection stated in Volume I, are discussed in more detail in Volume II.« less

Site specific risk assessment of an energy-from-waste thermal treatment facility in Durham Region, Ontario, Canada. Part A: Human health risk assessment.

PubMed

Ollson, Christopher A; Knopper, Loren D; Whitfield Aslund, Melissa L; Jayasinghe, Ruwan

2014-01-01

The regions of Durham and York in Ontario, Canada have partnered to construct an energy-from-waste thermal treatment facility as part of a long term strategy for the management of their municipal solid waste. This paper presents the results of a comprehensive human health risk assessment for this facility. This assessment was based on extensive sampling of baseline environmental conditions (e.g., collection and analysis of air, soil, water, and biota samples) as well as detailed site specific modeling to predict facility-related emissions of 87 identified contaminants of potential concern. Emissions were estimated for both the approved initial operating design capacity of the facility (140,000 tonnes per year) and for the maximum design capacity (400,000 tonnes per year). For the 140,000 tonnes per year scenario, this assessment indicated that facility-related emissions are unlikely to cause adverse health risks to local residents, farmers, or other receptors (e.g., recreational users). For the 400,000 tonnes per year scenarios, slightly elevated risks were noted with respect to inhalation (hydrogen chloride) and infant consumption of breast milk (dioxins and furans), but only during predicted 'upset conditions' (i.e. facility start-up, shutdown, and loss of air pollution control) that represent unusual and/or transient occurrences. However, current provincial regulations require that additional environmental screening would be mandatory prior to expansion of the facility beyond the initial approved capacity (140,000 tonnes per year). Therefore, the potential risks due to upset conditions for the 400,000 tonnes per year scenario should be more closely investigated if future expansion is pursued. © 2013.

7 CFR 15b.38 - Health care facilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... facilities. (a) Communications. A recipient that provides notice concerning benefits or services or written... ensure that qualified handicapped persons, including those with impaired sensory or speaking skills, are... effective communication with persons with impaired hearing for the purpose of providing emergency health...

Development and use of a master health facility list: Haiti's experience during the 2010 earthquake response.

PubMed

Rose-Wood, Alyson; Heard, Nathan; Thermidor, Roody; Chan, Jessica; Joseph, Fanor; Lerebours, Gerald; Zugaldia, Antonio; Konkel, Kimberly; Edwards, Michael; Lang, Bill; Torres, Carmen-Rosa

2014-08-01

Master health facility lists (MHFLs) are gaining attention as a standards-based means to uniquely identify health facilities and to link facility-level data. The ability to reliably communicate information about specific health facilities can support an array of health system functions, such as routine reporting and emergency response operations. MHFLs support the alignment of donor-supported health information systems with county-owned systems. Recent World Health Organization draft guidance promotes the utility of MHFLs and outlines a process for list development and governance. Although the potential benefits of MHFLs are numerous and may seem obvious, there are few documented cases of MHFL construction and use. The international response to the 2010 Haiti earthquake provides an example of how governments, nongovernmental organizations, and others can collaborate within a framework of standards to build a more complete and accurate list of health facilities. Prior to the earthquake, the Haitian Ministry of Health (Ministère de la Santé Publique et de la Population [MSPP]) maintained a list of public-sector health facilities but lacked information on privately managed facilities. Following the earthquake, the MSPP worked with a multinational group to expand the completeness and accuracy of the list of health facilities, including information on post-quake operational status. This list later proved useful in the response to the cholera epidemic and is now incorporated into the MSPP's routine health information system. Haiti's experience demonstrates the utility of MHFL formation and use in crisis as well as in the routine function of the health information system.

Development and use of a master health facility list: Haiti's experience during the 2010 earthquake response

PubMed Central

Rose-Wood, Alyson; Heard, Nathan; Thermidor, Roody; Chan, Jessica; Joseph, Fanor; Lerebours, Gerald; Zugaldia, Antonio; Konkel, Kimberly; Edwards, Michael; Lang, Bill; Torres, Carmen-Rosa

2014-01-01

ABSTRACT Master health facility lists (MHFLs) are gaining attention as a standards-based means to uniquely identify health facilities and to link facility-level data. The ability to reliably communicate information about specific health facilities can support an array of health system functions, such as routine reporting and emergency response operations. MHFLs support the alignment of donor-supported health information systems with county-owned systems. Recent World Health Organization draft guidance promotes the utility of MHFLs and outlines a process for list development and governance. Although the potential benefits of MHFLs are numerous and may seem obvious, there are few documented cases of MHFL construction and use. The international response to the 2010 Haiti earthquake provides an example of how governments, nongovernmental organizations, and others can collaborate within a framework of standards to build a more complete and accurate list of health facilities. Prior to the earthquake, the Haitian Ministry of Health (Ministère de la Santé Publique et de la Population [MSPP]) maintained a list of public-sector health facilities but lacked information on privately managed facilities. Following the earthquake, the MSPP worked with a multinational group to expand the completeness and accuracy of the list of health facilities, including information on post-quake operational status. This list later proved useful in the response to the cholera epidemic and is now incorporated into the MSPP's routine health information system. Haiti's experience demonstrates the utility of MHFL formation and use in crisis as well as in the routine function of the health information system. PMID:25276595

Science Facilities for Mississippi Schools, Grades 1-12.

ERIC Educational Resources Information Center

Mississippi State Dept. of Education, Jackson. Div. of Instruction.

Prepared to assist those planning the construction of new science facilities on the elementary, intermediate, or secondary school level. Standards are outlined and specifications detailed. A statement of fifteen general pricniples for planning science facilities in secondary schools precedes a discussion of--(1) special facilities for different…

18 CFR 153.13 - Emergency reconstruction.

Code of Federal Regulations, 2010 CFR

2010-04-01

... loss of gas supply or capacity are applicable to facilities subject to section 3 of the Natural Gas Act... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Emergency reconstruction. 153.13 Section 153.13 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY...

The National Ignition Facility (NIF) as a User Facility

NASA Astrophysics Data System (ADS)

Keane, Christopher; NIF Team

2013-10-01

The National Ignition Facility (NIF) has made significant progress towards operation as a user facility. Through June 2013, NIF conducted over 1200 experiments in support of ICF, HED science, and development of facility capabilities. The NIF laser has met or achieved all specifications and a wide variety of diagnostic and target fabrication capabilities are in place. A NIF User Group and associated Executive Board have been formed. Two User Group meetings have been conducted since formation of the User Group. NIF experiments in fundamental science have provided important new results. NIF ramp compression experiments have been conducted using diamond and iron, with EOS results obtained at pressures up to approximately 50 Mbar and 8 Mbar, respectively. Initial experiments in supernova hydrodynamics, the fundamental physics of the Rayleigh-Taylor instability, and equation of state in the Gbar pressure regime have also been conducted. This presentation will discuss the fundamental science program at NIF, including the proposal solicitation and scientific review processes and other aspects of user facility operation. This work was performed under the auspices of the Lawrence Livermore National Security, LLC, (LLNS) under Contract No. DE-AC52-07NA27344.

Where to go? Strategic modelling of access to emergency shelters in Mozambique.

PubMed

Gall, Melanie

2004-03-01

This paper, through spatial-analysis techniques, examines the accessibility of emergency shelters for vulnerable populations, and outlines the benefits of an extended and permanently established shelter network in central Mozambique. The raster-based modelling approach considers data on land cover, locations of accommodation centres in 2000, settlements and infrastructure. The shelter analysis is a two-step process determining access for vulnerable communities first, followed by a suitability analysis for additional emergency shelter sites. The results indicate the need for both retrofitting existing infrastructure (schools, health posts) to function as shelters during an emergency, and constructing new facilities - at best multi-purpose facilities that can serve as social infrastructure and shelter. Besides assessing the current situation in terms of availability and accessibility of emergency shelters, this paper provides an example of evaluating the effectiveness of humanitarian assistance without conventional mechanisms like food tonnage and number of beneficiaries.

Health Care Facilities Resilient to Climate Change Impacts

PubMed Central

Paterson, Jaclyn; Berry, Peter; Ebi, Kristie; Varangu, Linda

2014-01-01

Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator’s guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change. PMID:25522050

27 CFR 24.41 - Office facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Office facilities. 24.41... § 24.41 Office facilities. The appropriate TTB officer may require the proprietor to furnish... performing Government duties whether or not such office space is located at the specific premises where...

Emergency Medical Technician.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Center on Education and Training for Employment.

This document, which is designed for use in developing a tech prep competency profile for the occupation of emergency medical technician, lists technical competencies and competency builders for 18 units pertinent to the health technologies cluster in general and 4 units specific to the occupation of emergency medical technician. The following…

40 CFR Appendix F to Part 112 - Facility-Specific Response Plan

Code of Federal Regulations, 2014 CFR

2014-07-01

... into a wellhead protection area as defined by the Safe Drinking Water Act of 1986 (SDWA). 1 The...) Water intakes (drinking, cooling, or other); (2) Schools; (3) Medical facilities; (4) Residential areas... discharge; (2) Proximity to downgradient wells, waterways, and drinking water intakes; (3) Proximity to fish...

Science facilities and stakeholder management: how a pan-European research facility ended up in a small Swedish university town

NASA Astrophysics Data System (ADS)

Thomasson, Anna; Carlile, Colin

2017-06-01

This is the story of how a large research facility of broad European and global interest, the European Spallation Source (ESS), ended up in the small university town of Lund in Sweden. This happened in spite of the fact that a number of influential European countries were at one time or another competitors to host the facility. It is also a story about politics which attempts to illustrate how closely intertwined politics and science are, and how the interplay between those interests affects scientific progress. ESS became an arena for individual ambitions and political manoeuvring. The different stakeholders, in their striving to ensure that their own interests were realised, in various ways and with different degrees of success over the years, have influenced the key decisions that, during the already 30 year history of ESS, have driven the course that this project has taken. What emerges is that the interests of the stakeholders and the interests of the project itself are frequently not in harmony. This imposes challenges on the management of large research facilities as they have to not only navigate in the scientific landscape, which they often are more familiar with, but also in the political landscape. This story is therefore an attempt to shed light on the role of managers of large research facilities and the often delicate balancing act they have to perform when trying to comply with the different and often conflicting stakeholder interests. What is especially worthwhile examining, as we do in this paper, is the role that individuals, and the interaction between individuals, have played in the process. This shows that the focus of stakeholder theory on organisations, rather than the people in the organisations, needs to be redirected on to the individuals representing those organisations and their inter-relationships. At the same time it is clear that the developing field of stakeholder management theory has not emerged into the consciousness of science

A new era of emergency care: planning and design consideration.

PubMed

Zilm, Frank

2007-01-01

Emergency care is one of the most complex, rapidly growing areas of ambulatory care. Providers need to consider new issues related to management of low-acuity patients, capacity for surge events, and the need to integrate patient focused care into the emergency department environment. This article explores these issues and discusses basic organizational topologies for facilities.

Emergency Communications Console

NASA Technical Reports Server (NTRS)

1978-01-01

NASA has applied its communications equipment expertise to development of a communications console that provides, in a compact package only slightly larger than an electric typewriter, all the emergency medical services communications functions needed for a regional hospital. A prototype unit, built by Johnson Space Center, has been installed in the Odessa (Texas) Medical Center Hospital. The hospital is the medical control center for the 17-county Permian Basin Emergency Medical System in west Texas. The console project originated in response to a request to NASA from the Texas governor's office, which sought a better way of providing emergency medical care in rural areas. Because ambulance travel time is frequently long in remote areas of west Texas, it is important that treatment begin at the scene of the emergency rather than at the hospital emergency room. A radio and telephone system linking ambulance emergency technicians and hospital staff makes this possible. But earlier equipment was complex, requiring specialized operators. A highly reliable system was needed to minimize breakdowns and provide controls of utmost simplicity, so that the system could be operated by physicians and nurses rather than by communications specialists. The resulting console has both radio and telephone sections. With the radio equipment, hospital personnel can communicate with ambulance drivers and paramedics, receive incoming electrocardiagrams, consult with other hospitals, page hospital staff and set up a radio-to-telephone "patch." The telephone portion of the system includes a hotline from the Permian Basin Emergency Medical Service's resource control center, an automatic dialer for contacting special care facilities in the Permian Basin network, a hospital intercom terminal and a means of relaying cardioscope displays and other data between hospitals. The integrated system also provides links with local disaster and civil defense organizations and with emergency "Dial 911

76 FR 63353 - Proposed Information Collection (Payment and Reimbursement for Emergency Services for Non Service...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-12

... (Payment and Reimbursement for Emergency Services for Non Service-Connected Conditions in Non-VA Facilities... to determine a claimant's eligibility for reimbursement or payment for emergency medical treatment at... information technology. Title: Payment and Reimbursement for Emergency Services for Non Service-Connected...

Faster response time : effective use of resources : integrating transportation systems and emergency management systems

DOT National Transportation Integrated Search

1999-01-01

This brochure discusses how coordinating the efforts of emergency dispatchers with transportation management agencies can improve efficiency and response times. It is noted that when emergency services agencies share facilities and traffic monitoring...

Survival of the hospital emergency department: strategic alternatives for the future.

PubMed

Widra, L S; Fottler, M D

1988-01-01

Diverse and pervasive environmental forces are reshaping hospital emergency services as hospitals strive to respond to consumer preferences related to cost and convenience. Complacency can no longer serve as a standard operating procedure for hospital emergency departments competing against lower-priced, consumer-oriented, free-standing facilities. Strategic alternatives, a five-step strategy for survival and growth, and a projection of future models of hospital emergency services are examined.

Lunar base launch and landing facility conceptual design, 2nd edition

NASA Technical Reports Server (NTRS)

1988-01-01

This report documents the Lunar Base Launch and Landing Facility Conceptual Design study. The purpose of this study was to examine the requirements for launch and landing facilities for early lunar bases and to prepare conceptual designs for some of these facilities. The emphasis of this study is on the facilities needed from the first manned landing until permanent occupancy. Surface characteristics and flight vehicle interactions are described, and various facility operations are related. Specific recommendations for equipment, facilities, and evolutionary planning are made, and effects of different aspects of lunar development scenarios on facilities and operations are detailed. Finally, for a given scenario, a specific conceptual design is developed and presented.

[Obstetric emergency and non-emergency transfers to the university teaching hospital Yalgado ouedraogo of Ouagadougou: A 3-year study of their epidemiologic, clinical, and prognostic aspects].

PubMed

Ouattara, A; Ouedraogo, C M; Ouedraogo, A; Lankoande, J

2015-01-01

to describe the epidemiologic, clinical, and prognostic aspects of the emergency and non-emergency transfers of obstetric patients to Yalgado Ouédraogo University Hospital Center (UHC-YO) in Ouagadougou. this retrospective descriptive study looked at the outcomes of women transferred, on an emergency basis or not, to the obstetrics department of the UHC-YO. The study population comprised all women transferred to the department during 2010, 2011, and 2012. during the study period, there were 9,806 admissions for obstetric disorders: 43% were transfers. The patients' mean age was 26.11 years [(13-49]. Women transferred from health care facilities within the city of Ouagadougou accounted for 96% of the sample. The leading reason for these transfers - emergency or not - was preeclampsia and eclampsia (24.57%). We recorded a total of 161 maternal deaths, for a mortality rate of 3.9%. Approximately 26.55% of the newborns received immediate intensive care and were then transferred to the neonatology department. maternal and neonatal prognosis is always poor in cases transferred to UHC-YO, despite increased funding for emergency obstetric and neonatal care. Increased population awareness of the importance of prenatal consultation and adequate funding for health care facilities to provide equipment for emergency transfers and staff training in the management of obstetric and neonatal emergencies would probably improve these mortality and morbidity rates.

Astronauts and cosmonauts during emergency bailout training session

NASA Technical Reports Server (NTRS)

1994-01-01

Using small life rafts, several cosmonauts and astronauts participating in joint Russia - United States space missions take part in an emergency bailout training session in the JSC Weightless Environment Training Facility (WETF) 25-feet-deep pool. In the

General RMP Guidance - Chapter 8: Emergency Response Program

EPA Pesticide Factsheets

If you have a Program 2 or 3 process at your facility, 40 CFR Part 68 (risk management program) requires an emergency response program in place if employees respond to some releases involving regulated toxic or flammable substances.

75 FR 67807 - Pipeline Safety: Emergency Preparedness Communications

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-03

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration [Docket No... is issuing an Advisory Bulletin to remind operators of gas and hazardous liquid pipeline facilities... Gas Pipeline Systems. Subject: Emergency Preparedness Communications. Advisory: To further enhance the...

Economically dispatching cogeneration facilities

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

Hernandez, E.

Economic dispatching has been used by utilities to meet the energy demands of their customers for decades. The objective was to first load those units which cost the least to run and slowly increase the loading of more expensive units as the incremental energy price increased. Although this concept worked well for utility based systems where incremental costs rose with peak demand, the independent power producers(IPPs) and the power purchase agreements (PPAs) have drastically changed this notion. Most PPAs structured for the IPP environment have negotiated rates which remain the same during peak periods and base their electrical generation onmore » specific process steam requirements. They also must maintain the required production balance of process steam and electrical load in order to qualify as a Public Utility Regulatory Policies Act (PURPA) facility. Consequently, economically dispatching Cogeneration facilities becomes an exercise in adhering to contractual guidelines while operating the equipment in the most efficient manner possible for the given condition. How then is it possible to dispatch a Cogeneration facility that maintains the electrical load demand of JFK Airport while satisfying all of its heating and cooling needs? Contractually, Kennedy International Airport Cogen (KIAC) has specific obligations concerning electrical and thermal energy exported to JFK Airport. The facility`s impressive array of heating and cooling apparatuses together with the newly installed cogen fulfilled the airport`s needs by utilizing an endless combination of new and previously installed equipment. Moreover, in order to economically operate the plant a well structured operating curriculum was necessary.« less

Construction bidding cost of KSC's space shuttle facilities

NASA Technical Reports Server (NTRS)

Brown, Joseph Andrew

1977-01-01

The bidding cost of the major Space Transportation System facilities constructed under the responsibility of the John F. Kennedy Space Center (KSC) is described and listed. These facilities and Ground Support Equipment (GSE) are necessary for the receiving, assembly, testing, and checkout of the Space Shuttle for launch and landing missions at KSC. The Shuttle launch configuration consists of the Orbiter, the External Tank, and the Solid Rocket Boosters (SRB). The reusable Orbiter and SRB's is the major factor in the program that will result in lowering space travel costs. The new facilities are the Landing Facility; Orbiter Processing Facility; Orbiter Approach and Landing Test Facility (Dryden Test Center, California); Orbiter Mating Devices; Sound Suppression Water System; and Emergency Power System for LC-39. Also, a major factor was to use as much Apollo facilities and hardware as possible to reduce the facilities cost. The alterations to existing Apollo facilities are the VAB modifications; Mobile Launcher Platforms; Launch Complex 39 Pads A and B (which includes a new concept - the Rotary Service Structure), which was featured in ENR, 3 Feb. 1977, 'Hinged Space Truss will Support Shuttle Cargo Room'; Launch Control Center mods; External Tank and SRB Processing and Storage; Fluid Test Complex mods; O&C Spacelab mods; Shuttle mods for Parachute Facility; SRB Recovery and Disassembly Facility at Hangar 'AF'; and an interesting GSE item - the SRB Dewatering Nozzle Plug Sets (Remote Controlled Submarine System) used to inspect and acquire for reuse of SRB's.

LAFD: TA-55 RLUOB/CUB Facility Familiarization Tour, OJT #55265

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

Rutherford, Victor Stephen

2017-09-14

Los Alamos National Laboratory (LANL) conducts familiarization tours for personnel of the Los Alamos County Fire Department (LAFD) at the RLUOB/CUB, technical area (TA)-55, 400/440, facility, Radiological Laboratory Utility Office Building (RLUOB)/Central Utility Building (CUB). These familiarization tours are official LANL business; the purpose of these tours is to orient LAFD firefighters to the facility so that they can respond efficiently and quickly to a variety of emergency situations. This orientation includes, among other topics, the ingress and egress of the area and buildings, layout and organization of the facility, evacuation procedures and assembly points, and areas of concern withinmore » the various buildings at the facility. LAFD firefighters have the skills and abilities to perform firefighting operations and other emergency response tasks that cannot be provided by other LANL personnel who have the required clearance level. This handout provides details of the information, along with maps and diagrams, to be presented during the familiarization tours. The handout is distributed to the trainees at the time of the tour; a corresponding checklist is also used as guidance during the familiarization tours to ensure that all required information is presented to LAFD personnel.« less

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

PubMed

Potančok, Martin; Voříšek, Jiří

2016-09-01

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

Lifesaving emergency obstetric services are inadequate in south-west Ethiopia: a formidable challenge to reducing maternal mortality in Ethiopia.

PubMed

Girma, Meseret; Yaya, Yaliso; Gebrehanna, Ewenat; Berhane, Yemane; Lindtjørn, Bernt

2013-11-04

Most maternal deaths take place during labour and within a few weeks after delivery. The availability and utilization of emergency obstetric care facilities is a key factor in reducing maternal mortality; however, there is limited evidence about how these institutions perform and how many people use emergency obstetric care facilities in rural Ethiopia. We aimed to assess the availability, quality, and utilization of emergency obstetric care services in the Gamo Gofa Zone of south-west Ethiopia. We conducted a retrospective review of three hospitals and 63 health centres in Gamo Gofa. Using a retrospective review, we recorded obstetric services, documents, cards, and registration books of mothers treated and served in the Gamo Gofa Zone health facilities between July 2009 and June 2010. There were three basic and two comprehensive emergency obstetric care qualifying facilities for the 1,740,885 people living in Gamo Gofa. The proportion of births attended by skilled attendants in the health facilities was 6.6% of expected births, though the variation was large. Districts with a higher proportion of midwives per capita, hospitals and health centres capable of doing emergency caesarean sections had higher institutional delivery rates. There were 521 caesarean sections (0.8% of 64,413 expected deliveries and 12.3% of 4,231 facility deliveries). We recorded 79 (1.9%) maternal deaths out of 4,231 deliveries and pregnancy-related admissions at institutions, most often because of post-partum haemorrhage (42%), obstructed labour (15%) and puerperal sepsis (15%). Remote districts far from the capital of the Zone had a lower proportion of institutional deliveries (<2% of expected births compared to an overall average of 6.6%). Moreover, some remotely located institutions had very high maternal deaths (>4% of deliveries, much higher than the average 1.9%). Based on a population of 1.7 million people, there should be 14 basic and four comprehensive emergency obstetric care (Em

Tracking the emerging human pathogen Pseudallescheria boydii by using highly specific monoclonal antibodies.

PubMed

Thornton, Christopher R

2009-05-01

Pseudallescheria boydii has long been known to cause white grain mycetoma in immunocompetent humans, but it has recently emerged as an opportunistic pathogen of humans, causing potentially fatal invasive infections in immunocompromised individuals and evacuees of natural disasters, such as tsunamis and hurricanes. The diagnosis of P. boydii is problematic since it exhibits morphological characteristics similar to those of other hyaline fungi that cause infectious diseases, such as Aspergillus fumigatus and Scedosporium prolificans. This paper describes the development of immunoglobulin M (IgM) and IgG1 kappa-light chain monoclonal antibodies (MAbs) specific to P. boydii and certain closely related fungi. The MAbs bind to an immunodominant carbohydrate epitope on an extracellular 120-kDa antigen present in the spore and hyphal cell walls of P. boydii and Scedosporium apiospermum. The MAbs do not react with S. prolificans, Scedosporium dehoogii, or a large number of clinically relevant fungi, including A. fumigatus, Candida albicans, Cryptococcus neoformans, Fusarium solani, and Rhizopus oryzae. The MAbs were used in immunofluorescence and double-antibody sandwich enzyme-linked immunosorbent assays (DAS-ELISAs) to accurately differentiate P. boydii from other infectious fungi and to track the pathogen in environmental samples. Specificity of the DAS-ELISA was confirmed by sequencing of the internally transcribed spacer 1 (ITS1)-5.8S-ITS2 rRNA-encoding regions of environmental isolates.

14 CFR 139.325 - Airport emergency plan.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., including a communications network; (2) Contain sufficient detail to provide adequate guidance to each... expected to serve; (2) The name, location, telephone number, and emergency capability of each hospital and other medical facility and the business address and telephone number of medical personnel on the airport...

Energy Systems Sensor Laboratory | Energy Systems Integration Facility |

Science.gov Websites

NREL Sensor Laboratory Energy Systems Sensor Laboratory The Energy Systems Integration Facility's Energy Systems Sensor Laboratory is designed to support research, development, testing, and evaluation of advanced hydrogen sensor technologies to support the needs of the emerging hydrogen

Sensitivity and Specificity of Emergency Physicians and Trainees for Identifying Internally Concealed Drug Packages on Abdominal Computed Tomography Scan: Do Lung Windows Improve Accuracy?

PubMed

Asha, Stephen Edward; Cooke, Andrew

2015-09-01

Suspected body packers may be brought to emergency departments (EDs) close to international airports for abdominal computed tomography (CT) scanning. Senior emergency clinicians may be asked to interpret these CT scans. Missing concealed drug packages have important clinical and forensic implications. The accuracy of emergency clinician interpretation of abdominal CT scans for concealed drugs is not known. Limited evidence suggests that accuracy for identification of concealed packages can be increased by viewing CT images on "lung window" settings. To determine the accuracy of senior emergency clinicians in interpreting abdominal CT scans for concealed drugs, and to determine if this accuracy was improved by viewing scans on both abdominal and lung window settings. Emergency clinicians blinded to all patient identifiers and the radiology report interpreted CT scans of suspected body packers using standard abdominal window settings and then with the addition of lung window settings. The reference standard was the radiologist's report. Fifty-five emergency clinicians reported 235 CT scans. The sensitivity, specificity, and accuracy of interpretation using abdominal windows was 89.9% (95% confidence interval [CI] 83.0-94.7), 81.9% (95% CI 73.7-88.4), and 86.0% (95% CI 81.5-90.4), respectively, and with both window settings was 94.1% (95% CI 88.3-97.6), 76.7% (95% CI 68.0-84.1), 85.5% (95% CI 81.0-90.0), respectively. Diagnostic accuracy was similar regardless of the clinician's experience. Interrater reliability was moderate (kappa 0.46). The accuracy of interpretation of abdominal CT scans performed for the purpose of detecting concealed drug packages by emergency clinicians is not high enough to safely discharge these patients from the ED. The use of lung windows improved sensitivity, but at the expense of specificity. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Consequence assessment for Airborne Releases of SO{sub 2} from the Y-12 Pilot Dechlorination Facility

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

Pendergrass, W.R.

The Atmospheric Turbulence and Diffusion Division was requested by the Department of Energy`s Oak Ridge Operations Office to conduct a consequence assessment for potential atmospheric releases of SO{sub 2} from the Y-12 Pilot Dechlorination Facility. The focus of the assessment was to identify ``worst`` case meteorology which posed the highest concentration exposure potential for both on-site as well as off-site populations. A series of plausible SO{sub 2} release scenarios were provided by Y-12 for the consequence assessment. Each scenario was evaluated for predictions of downwind concentration, estimates of a five-minute time weighted average, and estimate of the dimension of themore » puff. The highest hazard potential was associated with Scenario 1, in which a total of eight SO{sub 2} cylinders are released internally to the Pilot Facility and exhausted through the emergency venting system. A companion effort was also conducted to evaluate the potential for impact of releases of SO{sub 2} from the Pilot Facility on the population of Oak Ridge. While specific transport trajectory data is not available for the Pilot Facility, extrapolations based on the Oak Ridge Site Survey and climatological records from the Y-12 meteorological program does not indicate the potential for impact on the city of Oak Ridge. Steering by the local topographical features severely limits the potential impact ares. Due to the lack of specific observational data, both tracer and meteorological, only inferences can be made concerning impact zones. It is recommended tat the Department of Energy Oak Ridge Operations examine the potential for off-site impact and develop the background data to prepare impact zones for releases of hazardous materials from the Y-12 facility.« less

[Structure, organization and capacity problems in emergency medical services, emergency admission and intensive care units].

PubMed

Dick, W

1994-01-01

Emergency medicine is subjected worldwide to financial stringencies and organizational evaluations of cost-effectiveness. The various links in the chain of survival are affected differently. Bystander assistance or bystander CPR is available in only 30% of the emergencies, response intervals--if at all required by legislation--are observed to only a limited degree or are too extended for survival in cardiac arrest. A single emergency telephone number is lacking. Too many different phone numbers for emergency reporting result in confusion and delays. Organizational realities are not fully overcome and impair efficiency. The position of the emergency physician in the EMS System is inadequately defined, the qualification of too many emergency physicians are unsatisfactory. In spite of this, emergency physicians are frequently forced to answer out-of-hospital emergency calls. Conflicts between emergency physicians and EMTs may be overcome by providing both groups with comparable qualifications as well as by providing an explicit definition of emergency competence. A further source of conflict occurs at the juncture of prehospital and inhospital emergency care in the emergency department. Deficiencies on either side play a decisive role. At least in principle there are solutions to the deficiencies in the EMSS and in intensive care medicine. They are among others: Adequate financial compensation of emergency personnel, availability of sufficient numbers of highly qualified personnel, availability of a central receiving area with an adjacent emergency ward, constant information flow to the dispatch center on the number of available emergency beds, maintaining 5% of all beds as emergency beds, establishing intermediate care facilities. Efficiency of emergency physician activities can be demonstrated in polytraumatized patients or in patients with ventricular fibrillation or acute myocardial infarction, in patients with acute myocardial insufficiency and other emergency

Running to Safety: Analysis of Disaster Susceptibility of Neighborhoods and Proximity of Safety Facilities in Silay City, Philippines

NASA Astrophysics Data System (ADS)

Patiño, C. L.; Saripada, N. A.; Olavides, R. D.; Sinogaya, J.

2016-06-01

Going on foot is the most viable option when emergency responders fail to show up in disaster zones at the quickest and most reasonable time. In the Philippines, the efficacy of disaster management offices is hampered by factors such as, but not limited to, lack of equipment and personnel, distance, and/or poor road networks and traffic systems. In several instances, emergency response times exceed acceptable norms. This study explores the hazard susceptibility, particularly to fire, flood, and landslides, of neighborhoods vis-à-vis their proximity to safety facilities in Silay City, Philippines. Imbang River exposes communities in the city to flooding while the mountainous terrain makes the city landslide prone. Building extraction was done to get the possible human settlements in the city. The building structures were extracted through image processing using a ruleset-based approach in the process of segmentation and classification of LiDAR derivatives and ortho-photos. Neighborhoods were then identified whether they have low to high susceptibility to disaster risks in terms of floods and landslides based on the hazards maps obtained from the Philippines' Mines and Geosciences Bureau (MGB). Service area analyses were performed to determine the safety facilities available to different neighborhoods at varying running times. Locations which are inaccessible or are difficult to run to because of distance and corresponding hazards were determined. Recommendations are given in the form of infrastructure installation, relocation of facilities, safety equipment and vehicle procurement, and policy changes for specific areas in Silay City.

10 CFR 62.13 - Contents of a request for emergency access: Alternatives.

Code of Federal Regulations, 2011 CFR

2011-01-01

... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission... following: (1) Storage of low-level radioactive waste at the site of generation; (2) Storage of low-level... disposal at a Federal low-level radioactive waste disposal facility in the case of a Federal or defense...

Tornado Recovery Ongoing at NASA’s Michoud Assembly Facility, New Orleans LA

NASA Image and Video Library

2017-02-07

Teams at NASA’s Michoud Assembly Facility in New Orleans are continuing with recovery efforts following a tornado strike at the facility Tuesday, Feb. 7. Michoud remains closed to all but security and emergency operations crews. For more than half a century, Michoud has been the space agency’s premiere site for manufacturing and assembly of large-scale space structures and systems.

Emerging technology: A key enabler for modernizing pharmaceutical manufacturing and advancing product quality.

PubMed

O'Connor, Thomas F; Yu, Lawrence X; Lee, Sau L

2016-07-25

Issues in product quality have produced recalls and caused drug shortages in United States (U.S.) in the past few years. These quality issues were often due to outdated manufacturing technologies and equipment as well as lack of an effective quality management system. To ensure consistent supply of safe, effective and high-quality drug products available to the patients, the U.S. Food and Drug Administration (FDA) supports modernizing pharmaceutical manufacturing for improvements in product quality. Specifically, five new initiatives are proposed here to achieve this goal. They include: (i) advancing regulatory science for pharmaceutical manufacturing; (ii) establishing a public-private institute for pharmaceutical manufacturing innovation; (iii) creating incentives for investment in the technological upgrade of manufacturing processes and facilities; (iv) leveraging external expertise for regulatory quality assessment of emerging technologies; and (v) promoting the international harmonization of approaches for expediting the global adoption of emerging technologies. Published by Elsevier B.V.

Hypertensive Emergencies in the Emergency Department.

PubMed

Adebayo, Omoyemi; Rogers, Robert L

2015-08-01

Hypertension affects approximately one-third of Americans. An additional 30% are unaware that they harbor the disease. Significantly increased blood pressure constitutes a hypertensive emergency that could lead to end-organ damage. When organs such as the brain, heart, or kidney are affected, an intervention that will lower the blood pressure in several hours is indicated. Several pharmacologic options are available for treatment, with intravenous antihypertensive therapy being the cornerstone, but there is no standard of care. Careful consideration of each patient's specific complaint, history, and physical examination guides the emergency physician through the treatment algorithm. Copyright © 2015 Elsevier Inc. All rights reserved.

Control System Upgrade for a Mass Property Measurement Facility

NASA Technical Reports Server (NTRS)

Chambers, William; Hinkle, R. Kenneth (Technical Monitor)

2002-01-01

The Mass Property Measurement Facility (MPMF) at the Goddard Space Flight Center has undergone modifications to ensure the safety of Flight Payloads and the measurement facility. The MPMF has been technically updated to improve reliability and increase the accuracy of the measurements. Modifications include the replacement of outdated electronics with a computer based software control system, the addition of a secondary gas supply in case of a catastrophic failure to the gas supply and a motor controlled emergency stopping feature instead of a hard stop.

Patient-driven resource planning of a health care facility evacuation.

PubMed

Petinaux, Bruno; Yadav, Kabir

2013-04-01

The evacuation of a health care facility is a complex undertaking, especially if done in an immediate fashion, ie, within minutes. Patient factors, such as continuous medical care needs, mobility, and comprehension, will affect the efficiency of the evacuation and translate into evacuation resource needs. Prior evacuation resource estimates are 30 years old. Utilizing a cross-sectional survey of charge nurses of the clinical units in an urban, academic, adult trauma health care facility (HCF), the evacuation needs of hospitalized patients were assessed periodically over a two-year period. Survey data were collected on 2,050 patients. Units with patients having low continuous medical care needs during an emergency evacuation were the postpartum, psychiatry, rehabilitation medicine, surgical, and preoperative anesthesia care units, the Emergency Department, and Labor and Delivery Department (with the exception of patients in Stage II labor). Units with patients having high continuous medical care needs during an evacuation included the neonatal and adult intensive care units, special procedures unit, and operating and post-anesthesia care units. With the exception of the neonate group, 908 (47%) of the patients would be able to walk out of the facility, 492 (25.5%) would require a wheelchair, and 530 (27.5%) would require a stretcher to exit the HCF. A total of 1,639 patients (84.9%) were deemed able to comprehend the need to evacuate and to follow directions; the remainder were sedated, blind, or deaf. The charge nurses also determined that 17 (6.9%) of the 248 adult intensive care unit patients were too ill to survive an evacuation, and that in 10 (16.4%) of the 61 ongoing surgery cases, stopping the case was not considered to be safe. Heath care facilities can utilize the results of this study to model their anticipated resource requirements for an emergency evacuation. This will permit the Incident Management Team to mobilize the necessary resources both within

Evolving prehospital, emergency department, and "inpatient" management models for geriatric emergencies.

PubMed

Carpenter, Christopher R; Platts-Mills, Timothy F

2013-02-01

Alternative management methods are essential to ensure high-quality and efficient emergency care for the growing number of geriatric adults worldwide. Protocols to support early condition-specific treatment of older adults with acute severe illness and injury are needed. Improved emergency department care for older adults will require providers to address the influence of other factors on the patient's health. This article describes recent and ongoing efforts to enhance the quality of emergency care for older adults using alternative management approaches spanning the spectrum from prehospital care, through the emergency department, and into evolving inpatient or outpatient processes of care. Copyright © 2013 Elsevier Inc. All rights reserved.

NASA Johnson Space Center Usability Testing and Analysis facility (UTAF) Overview

NASA Technical Reports Server (NTRS)

Whitmore, Mihriban; Holden, Kritina L.

2005-01-01

The Usability Testing and Analysis Facility (UTAF) is part of the Space Human Factors Laboratory at the NASA Johnson Space Center in Houston, Texas. The facility performs research for NASA's HumanSystems Integration Program, under the HumanSystems Research and Technology Division. Specifically, the UTAF provides human factors support for space vehicles, including the International Space Station, the Space Shuttle, and the forthcoming Crew Exploration Vehicle. In addition, there are ongoing collaborative research efforts with external corporations and universities. The UTAF provides human factors analysis, evaluation, and usability testing of crew interfaces for space applications. This includes computer displays and controls, workstation systems, and work environments. The UTAF has a unique mix of capabilities, with a staff experienced in both cognitive human factors and ergonomics. The current areas of focus are: human factors applications in emergency medical care and informatics; control and display technologies for electronic procedures and instructions; voice recognition in noisy environments; crew restraint design for unique microgravity workstations; and refinement of human factors processes and requirements. This presentation will provide an overview of ongoing activities, and will address how the UTAF projects will evolve to meet new space initiatives.

Emergency Response Virtual Environment for Safe Schools

NASA Technical Reports Server (NTRS)

Wasfy, Ayman; Walker, Teresa

2008-01-01

An intelligent emergency response virtual environment (ERVE) that provides emergency first responders, response planners, and managers with situational awareness as well as training and support for safe schools is presented. ERVE incorporates an intelligent agent facility for guiding and assisting the user in the context of the emergency response operations. Response information folders capture key information about the school. The system enables interactive 3D visualization of schools and academic campuses, including the terrain and the buildings' exteriors and interiors in an easy to use Web..based interface. ERVE incorporates live camera and sensors feeds and can be integrated with other simulations such as chemical plume simulation. The system is integrated with a Geographical Information System (GIS) to enable situational awareness of emergency events and assessment of their effect on schools in a geographic area. ERVE can also be integrated with emergency text messaging notification systems. Using ERVE, it is now possible to address safe schools' emergency management needs with a scaleable, seamlessly integrated and fully interactive intelligent and visually compelling solution.

Design of Aircraft Deicing Facilities

DOT National Transportation Integrated Search

1993-08-23

Archival copy of original Federal Aviation Administration standards and : specifications for use in the design of aircraft deicing facilities. To ensure : review of all changes, user should consult . ...

Site-specific standard request for underground storage tanks 1219-U, 1222-U, 2082-U, and 2068-U at the rust garage facility buildings 9754-1 and 9720-15: Oak Ridge Y-12 Plant, Oak Ridge, Tennessee, Facility ID No. 0-010117

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

NONE

1994-12-01

This document represents a Site-specific Standard Request for underground storage tanks (USTs) 1219-U,1222-U and 2082-U previously located at former Building 9754-1, and tank 2086-U previously located at Building 9720-15, Oak Ridge Y-12 Plant, Oak Ridge, Tennessee. The tanks previously contained petroleum products. For the purposes of this report, the two building sites will be regarded as a single UST site and will be referred to as the Rust Garage Facility. The current land use associated with the Y-12 Plant is light industrial and the operational period of the plant is projected to be at least 30 years. Thus, potential futuremore » residential exposures are not expected to occur for at least 30 years. Based on the degradation coefficient for benzene (the only carcinogenic petroleum constituent detected in soils or groundwater at the Rust Garage Facility), it is expected that the benzene and other contaminants at the site will likely be reduced prior to expiration of the 30-year plant operational period. As the original sources of petroleum contamination have been removed, and the area of petroleum contamination is limited, a site-specific standard is therefore being requested for the Rust Garage Facility.« less

Facility shows benefit of staying single.

PubMed

Baillie, Jonathan

2010-08-01

Construction of the new 513-bed PFI-funded hospital in Pembury near Tunbridge Wells in Kent, a pound 227 million acute healthcare facility that, on its completion in the autumn of 2011, will be the UK's first to offer 100% single-bed en suite accommodation, is ahead of schedule, "thanks to excellent teamwork and careful planning". During a visit to the now rapidly emerging healthcare facility, located in an Area of Outstanding Natural Beauty (AONB) in a wooded hillside location in the Weald of Kent which Nigel Keen, general manager for the PFI project company, described as "the most attractive site for a hospital I have ever worked on", HEJ editor Jonathan Baillie met key project personnel and discussed the impressive progress made to date.

41 CFR 102-74.230 - Who is responsible for establishing an occupant emergency program?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Occupant Emergency Program § 102-74.230 Who is... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Who is responsible for...

Langley Ground Facilities and Testing in the 21st Century

NASA Technical Reports Server (NTRS)

Ambur, Damodar R.; Kegelman, Jerome T.; Kilgore, William A.

2010-01-01

A strategic approach for retaining and more efficiently operating the essential Langley Ground Testing Facilities in the 21st Century is presented. This effort takes advantage of the previously completed and ongoing studies at the Agency and National levels. This integrated approach takes into consideration the overall decline in test business base within the nation and reduced utilization in each of the Langley facilities with capabilities to test in the subsonic, transonic, supersonic, and hypersonic speed regimes. The strategy accounts for capability needs to meet the Agency programmatic requirements and strategic goals and to execute test activities in the most efficient and flexible facility operating structure. The structure currently being implemented at Langley offers agility to right-size our capability and capacity from a national perspective, to accommodate the dynamic nature of the testing needs, and will address the influence of existing and emerging analytical tools for design. The paradigm for testing in the retained facilities is to efficiently and reliably provide more accurate and high-quality test results at an affordable cost to support design information needs for flight regimes where the computational capability is not adequate and to verify and validate the existing and emerging computational tools. Each of the above goals are planned to be achieved, keeping in mind the increasing small industry customer base engaged in developing unpiloted aerial vehicles and commercial space transportation systems.

Measuring Coverage in MNCH: Validating Women’s Self-Report of Emergency Cesarean Sections in Ghana and the Dominican Republic

PubMed Central

Tunçalp, Özge; Stanton, Cynthia; Castro, Arachu; Adanu, Richard; Heymann, Marilyn; Adu-Bonsaffoh, Kwame; Lattof, Samantha R.; Blanc, Ann; Langer, Ana

2013-01-01

Background Cesarean section is the only surgery for which we have nearly global population-based data. However, few surveys provide additional data related to cesarean sections. Given weaknesses in many health information systems, health planners in developing countries will likely rely on nationally representative surveys for the foreseeable future. The objective is to validate self-reported data on the emergency status of cesarean sections among women delivering in teaching hospitals in the capitals of two contrasting countries: Accra, Ghana and Santo Domingo, Dominican Republic (DR). Methods and Findings This study compares hospital-based data, considered the reference standard, against women’s self-report for two definitions of emergency cesarean section based on the timing of the decision to operate and the timing of the cesarean section relative to onset of labor. Hospital data were abstracted from individual medical records, and hospital discharge interviews were conducted with women who had undergone cesarean section in two hospitals. The study assessed sensitivity, specificity, and positive predictive value of responses to questions regarding emergency versus non-emergency cesarean section and estimated the percent of emergency cesarean sections that would be obtained from a survey, given the observed prevalence, sensitivity, and specificity from this study. Hospital data were matched with exit interviews for 659 women delivered via cesarean section for Ghana and 1,531 for the Dominican Republic. In Ghana and the Dominican Republic, sensitivity and specificity for emergency cesarean section defined by decision time were 79% and 82%, and 50% and 80%, respectively. The validity of emergency cesarean defined by operation time showed less favorable results than decision time in Ghana and slightly more favorable results in the Dominican Republic. Conclusions Questions used in this study to identify emergency cesarean section are promising but insufficient to

Traumatic and non-traumatic adrenal emergencies.

PubMed

Chernyak, Victoria; Patlas, Michael N; Menias, Christine O; Soto, Jorge A; Kielar, Ania Z; Rozenblit, Alla M; Romano, Luigia; Katz, Douglas S

2015-12-01

Multiple traumatic and non-traumatic adrenal emergencies are occasionally encountered during the cross-sectional imaging of emergency department patients. Traumatic adrenal hematomas are markers of severe polytrauma, and can be easily overlooked due to multiple concomitant injuries. Patients with non-traumatic adrenal emergencies usually present to an emergency department with a non-specific clinical picture. The detection and management of adrenal emergencies is based on cross-sectional imaging. Adrenal hemorrhage, adrenal infection, or rupture of adrenal neoplasm require immediate detection to avoid dire consequences. More often however, adrenal emergencies are detected incidentally in patients being investigated for non-specific acute abdominal pain. A high index of suspicion is required for the establishment of timely diagnosis and to avert potentially life-threatening complications. We describe cross-sectional imaging findings in patients with traumatic and non-traumatic adrenal hemorrhage, adrenal infarctions, adrenal infections, and complications of adrenal masses.

Current and Emerging Technologies for the Analysis of the Genome-Wide and Locus-Specific DNA Methylation Patterns.

PubMed

Tost, Jörg

2016-01-01

DNA methylation is the most studied epigenetic modification, and altered DNA methylation patterns have been identified in cancer and more recently also in many other complex diseases. Furthermore, DNA methylation is influenced by a variety of environmental factors, and the analysis of DNA methylation patterns might allow deciphering previous exposure. Although a large number of techniques to study DNA methylation either genome-wide or at specific loci have been devised, they all are based on a limited number of principles for differentiating the methylation state, viz., methylation-specific/methylation-dependent restriction enzymes, antibodies or methyl-binding proteins, chemical-based enrichment, or bisulfite conversion. Second-generation sequencing has largely replaced microarrays as readout platform and is also becoming more popular for locus-specific DNA methylation analysis. In this chapter, the currently used methods for both genome-wide and locus-specific analysis of 5-methylcytosine and as its oxidative derivatives, such as 5-hydroxymethylcytosine, are reviewed in detail, and the advantages and limitations of each approach are discussed. Furthermore, emerging technologies avoiding PCR amplification and allowing a direct readout of DNA methylation are summarized, together with novel applications, such as the detection of DNA methylation in single cells or in circulating cell-free DNA.

Availability of pediatric services and equipment in emergency departments: United States, 2006.

PubMed

Schappert, Susan M; Bhuiya, Farida

2012-03-01

This report presents data on the availability of pediatric services, expertise, and supplies for treating pediatric emergencies in U.S. hospitals. Data in this report are from the Emergency Pediatric Services and Equipment Supplement (EPSES), a self-administered questionnaire added to the 2006 National Hospital Ambulatory Medical Care Survey (NHAMCS). NHAMCS samples nonfederal short-stay and general hospitals in the United States. Sample data were weighted to produce annual estimates of pediatric services, expertise, and equipment availability in hospital emergency departments (EDs). In 2006, only 7.2 percent of hospital EDs had all recommended pediatric emergency supplies, and 45.6 percent had at least 85.0 percent of recommended supplies. EDs in children's hospitals and hospitals with pediatric intensive care units (PICUs) were more likely to meet guidelines for pediatric emergency department services, expertise, and supplies. About 74.0 percent of these facilities had at least 85.0 percent of recommended supplies, compared with 42.4 percent of other facilities. Among children's hospitals and hospitals with PICUs, 66.0 percent had 24 hours a day, 7 days a week access to a board-certified pediatric emergency medicine attending physician; such access was uncommon in other types of hospitals. In general, little change was noted in the availability of emergency pediatric supplies between 2002-2003, when the initial EPSES was conducted, and 2006.

Emerging Propulsion Technologies

NASA Astrophysics Data System (ADS)

Bonometti, J. A.

2004-11-01

The Emerging Propulsion Technologies (EPT) technology area is a branch of the In-Space Program that serves as a bridge to bring high-risk/high-payoff technologies to a higher level of maturity. Emerging technologies are innovative and, if successfully developed, could result in revolutionary science capabilities for NASA science missions. EPT is also charged with the responsibility of assessing the technology readiness level (TRL) of technologies under consideration for inclusion in the ISP portfolio. One such technology is the Momentum-eXchange/Electrodynamic Reboost (MXER) tether concept, which is the current, primary investment of EPT. The MXER tether is a long, rotating cable placed in an elliptical Earth orbit, whose rapid rotation allows its tip to catch a payload in a low Earth orbit and throw that payload to a high-energy orbit. Electrodynamic tether propulsion is used to restore the orbital energy transferred by the MXER tether to the payload and reboost the tether's orbit. This technique uses solar power to drive electrical current collected from the Earth's ionosphere through the tether, resulting in a magnetic interaction with the terrestrial field. Since the Earth itself serves as the reaction mass, the thrust force is generated without propellant and allows the MXER facility to be repeatedly reused without re-supply. Essentially, the MXER facility is a 'propellantless' upper stage that could assist nearly every mission going beyond low Earth orbit. Payloads to interplanetary destinations could especially benefit from the boost provided by the MXER facility, resulting in launch vehicle cost reductions, increased payload fractions and more frequent mission opportunities. Synergistic tether technologies resulting from MXER development could include science sampling in the upper atmosphere, remote probes or attached formation flying, artificial gravity experiments with low Coriolis forces, and other science needs that use long, ultra-light strength or

44 CFR 206.253 - Insurance requirements for facilities damaged by disasters other than flood.

Code of Federal Regulations, 2010 CFR

2010-10-01

... facilities damaged by disasters other than flood. 206.253 Section 206.253 Emergency Management and Assistance... by disasters other than flood. (a) Prior to approval of a Federal grant for the restoration of a facility and its contents which were damaged by a disaster other than flood, the Grantee shall notify the...

Improvement of Patient- and Family-Specific Care for Children with Special Behavioral Needs in the Emergency Setting: A Behavioral Needs Education.

PubMed

Brynes, Nicole; Lee, Heeyoung; Ren, Dianxu; Beach, Michael

2017-05-01

Improvements in staff training, identification, and treatment planning for children with special health care needs who have behavioral issues are routinely recommended, but a literature review revealed no coherent plans targeted specifically toward pediatric ED staff. An educational module was delivered to emergency staff along with a survey before and after and 1 month after the intervention to examine comfort in working with children with behavioral special needs and the ability to deliver specialized care. Child life consultations in the pediatric emergency department were measured 3 months before and 3 months after the education was provided. A total of 122 staff participated and reported clinically significant improvements across all areas of care that were maintained at 1 month. To the best of our knowledge, this project represents the first quality improvement project offering behavioral needs education to emergency staff at a large pediatric hospital with an examination of its impact on staff competence, comfort, and outcomes. A large-scale educational module is a practical option for improvement in pediatric ED staff competence in caring for patients with behavioral special needs. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Long-stay in short-stay inpatient facilities: risk factors and barriers to discharge

PubMed Central

Gigantesco, Antonella; de Girolamo, Giovanni; Santone, Giovanni; Miglio, Rossella; Picardi, Angelo

2009-01-01

Background The aim of the present study was to assess the characteristics of long-stay inpatients in public and private Italian acute inpatient facilities, to identify risk factors and correlates of the long duration of hospital stay in these patients, and to identify possible barriers to alternative placements. Methods All patients in 130 Italian public and private psychiatric inpatient units who had been hospitalized for more than 3 months during a specific index period were assessed with standardized assessment instruments and compared to patients discharged during the same index period, but staying in hospital for less than 3 months (short-stay inpatients). Assessed domains included demographic, clinical, and treatment characteristics, as well as process of care. Logistic regression analysis was used to identify specific variables predicting inpatient long-stay status. Reasons for delaying patient discharge, as reported by treatment teams, were also analyzed. Results No overall differences between long-stay and short-stay patients emerged in terms of symptom severity or diagnostic status. Admission to a private inpatient facility and display of violent behavior during hospital stay were the most powerful predictors of long-stay. Lack of housing and a shortage of community support were the reasons most commonly cited by treatment teams as barriers to discharge. Conclusion Extra-clinical factors are important determinants of prolonged hospitalization in acute inpatient settings. PMID:19698136

Alaska SAR Facility mass storage, current system

NASA Technical Reports Server (NTRS)

Cuddy, David; Chu, Eugene; Bicknell, Tom

1993-01-01

This paper examines the mass storage systems that are currently in place at the Alaska SAR Facility (SAF). The architecture of the facility will be presented including specifications of the mass storage media that are currently used and the performances that we have realized from the various media. The distribution formats and media are also discussed. Because the facility is expected to service future sensors, the new requirements and possible solutions to these requirements are also discussed.

Financing Public School Facilities in Texas: A Case Study.

ERIC Educational Resources Information Center

Dawn, Lisa

A case study is presented of a Texas educational facilities program that was developed to provide long-term state assistance to school districts for the construction or renovation of their facilities by providing equal access to revenue for the specific purpose of repaying debt issued to finance instructional facilities. This report presents a…

10 CFR 62.12 - Contents of a request for emergency access: General information.

Code of Federal Regulations, 2010 CFR

2010-01-01

... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission... the person(s) or company(ies) generating the low-level radioactive waste for which the determination...) Certification that the radioactive waste for which emergency access is requested is low-level radioactive waste...

Legal considerations during pediatric emergency mass critical care events.

PubMed

Courtney, Brooke; Hodge, James G

2011-11-01

Recent public health emergencies, such as the 2009 Influenza A/H1N1 Pandemic and Hurricane Katrina, underscore the importance of developing healthcare response plans and protocols for disasters impacting large populations. Significant research and scholarship, including the 2009 Institute of Medicine report on crisis standards of care and the 2008 Task Force for Mass Critical Care recommendations, provide guidance for healthcare responses to catastrophic emergencies. Most of these efforts recognize but do not focus on the unique needs of pediatric populations. In 2008, the Centers for Disease Control and Prevention supported the formation of a task force to address pediatric emergency mass critical care response issues, including legal issues. Liability is a significant concern for healthcare practitioners and facilities during pediatric emergency mass critical care that necessitates a shift to crisis standards of care. This article describes the legal considerations inherent in planning for and responding to catastrophic health emergencies and makes recommendations for pediatric emergency mass critical care legal preparedness. The Pediatric Emergency Mass Critical Care Task Force, composed of 36 experts from diverse public health, medical, and disaster response fields, convened in Atlanta, GA, on March 29-30, 2010, to review the pediatric emergency mass critical care recommendations developed by a 17-member steering committee. During the meeting, experts determined that the recommendations would be strengthened by a manuscript addressing legal issues. Authors drafted the manuscript through consensus-based study of peer-reviewed research, literature reviews, and expert opinion. The manuscript was reviewed by Pediatric Emergency Mass Critical Care Steering Committee members and additional legal counsel and revised. While the legal issues associated with providing pediatric emergency mass critical care are not unique within the overall context of disaster healthcare

Associations between Source-Specific Fine Particulate Matter and Emergency Department Visits for Respiratory Disease in Four U.S. Cities

PubMed Central

Krall, Jenna R.; Mulholland, James A.; Russell, Armistead G.; Balachandran, Sivaraman; Winquist, Andrea; Tolbert, Paige E.; Waller, Lance A.; Sarnat, Stefanie Ebelt

2016-01-01

Background: Short-term exposure to ambient fine particulate matter (PM2.5) concentrations has been associated with increased mortality and morbidity. Determining which sources of PM2.5 are most toxic can help guide targeted reduction of PM2.5. However, conducting multicity epidemiologic studies of sources is difficult because source-specific PM2.5 is not directly measured, and source chemical compositions can vary between cities. Objectives: We determined how the chemical composition of primary ambient PM2.5 sources varies across cities. We estimated associations between source-specific PM2.5 and respiratory disease emergency department (ED) visits and examined between-city heterogeneity in estimated associations. Methods: We used source apportionment to estimate daily concentrations of primary source-specific PM2.5 for four U.S. cities. For sources with similar chemical compositions between cities, we applied Poisson time-series regression models to estimate associations between source-specific PM2.5 and respiratory disease ED visits. Results: We found that PM2.5 from biomass burning, diesel vehicle, gasoline vehicle, and dust sources was similar in chemical composition between cities, but PM2.5 from coal combustion and metal sources varied across cities. We found some evidence of positive associations of respiratory disease ED visits with biomass burning PM2.5; associations with diesel and gasoline PM2.5 were frequently imprecise or consistent with the null. We found little evidence of associations with dust PM2.5. Conclusions: We introduced an approach for comparing the chemical compositions of PM2.5 sources across cities and conducted one of the first multicity studies of source-specific PM2.5 and ED visits. Across four U.S. cities, among the primary PM2.5 sources assessed, biomass burning PM2.5 was most strongly associated with respiratory health. Citation: Krall JR, Mulholland JA, Russell AG, Balachandran S, Winquist A, Tolbert PE, Waller LA, Sarnat SE. 2017

Associations between Source-Specific Fine Particulate Matter and Emergency Department Visits for Respiratory Disease in Four U.S. Cities.

PubMed

Krall, Jenna R; Mulholland, James A; Russell, Armistead G; Balachandran, Sivaraman; Winquist, Andrea; Tolbert, Paige E; Waller, Lance A; Sarnat, Stefanie Ebelt

2017-01-01

Short-term exposure to ambient fine particulate matter (PM2.5) concentrations has been associated with increased mortality and morbidity. Determining which sources of PM2.5 are most toxic can help guide targeted reduction of PM2.5. However, conducting multicity epidemiologic studies of sources is difficult because source-specific PM2.5 is not directly measured, and source chemical compositions can vary between cities. We determined how the chemical composition of primary ambient PM2.5 sources varies across cities. We estimated associations between source-specific PM2.5 and respiratory disease emergency department (ED) visits and examined between-city heterogeneity in estimated associations. We used source apportionment to estimate daily concentrations of primary source-specific PM2.5 for four U.S. cities. For sources with similar chemical compositions between cities, we applied Poisson time-series regression models to estimate associations between source-specific PM2.5 and respiratory disease ED visits. We found that PM2.5 from biomass burning, diesel vehicle, gasoline vehicle, and dust sources was similar in chemical composition between cities, but PM2.5 from coal combustion and metal sources varied across cities. We found some evidence of positive associations of respiratory disease ED visits with biomass burning PM2.5; associations with diesel and gasoline PM2.5 were frequently imprecise or consistent with the null. We found little evidence of associations with dust PM2.5. We introduced an approach for comparing the chemical compositions of PM2.5 sources across cities and conducted one of the first multicity studies of source-specific PM2.5 and ED visits. Across four U.S. cities, among the primary PM2.5 sources assessed, biomass burning PM2.5 was most strongly associated with respiratory health. Citation: Krall JR, Mulholland JA, Russell AG, Balachandran S, Winquist A, Tolbert PE, Waller LA, Sarnat SE. 2017. Associations between source-specific fine particulate

41 CFR 102-74.245 - Who makes the decision to activate the Occupant Emergency Organization?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Occupant Emergency Program § 102-74.245... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Who makes the decision...

Survey of EPA facilities for solar thermal energy applications

NASA Technical Reports Server (NTRS)

Nelson, E. V.; Overly, P. T.; Bell, D. M.

1980-01-01

A study was done to assess the feasibility of applying solar thermal energy systems to EPA facilities. A survey was conducted to determine those EPA facilities where solar energy could best be used. These systems were optimized for each specific application and the system/facility combinations were ranked on the basis of greatest cost effectiveness.

Emergency Response Manual

NASA Technical Reports Server (NTRS)

Barnett, Traci M.

2004-01-01

Safety and security is very important at NASA. The Security Management and Safeguards Office goal is ensure safety and security for all NASA Lewis and Plum Brook Station visitors and workers. The office protects against theft, sabotage, malicious damage, espionage, and other threats or acts of violence. There are three types of security at NASA: physical, IT, and personnel. IT is concerned with sensitive and classified information and computers. Physical security includes the officers who check visitors and workers in and patrol the facility. Personnel security is concerned with background checks during hiring. During my internship, I met people from and gained knowledge about all three types of security. I primarily worked with Dr. Richard Soppet in physical security. During my experience with physical security, I observed and worked with many aspects of it. I attended various security meetings at both NASA Lewis and Plum Brook. The meetings were about homeland security and other improvements that will be made to both facilities. I also spent time with a locksmith. The locksmith makes copies of keys and unlocks doors for people who need them. I rode around in a security vehicle with an officer as he patrolled. I also observed the officer make a search of a visitor s vehicle. All visitors vehicles are searched upon entering NASA. I spent time and observed in the dispatch office. The officer answers calls and sends out officers when needed. The officer also monitors the security cameras. My primary task was completing an emergency response manual. This manual would assist local law enforcement and fire agencies in case of an emergency. The manual has pictures and descriptions of the buildings. It also contains the information about hazards inside of the buildings. This information will be very helpul to law enforcement so that when called upon during an emergency, they will not create an even bigger problem with collateral damage.

Numerical Simulation of the Emergency Condenser of the SWR-1000

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

Krepper, Eckhard; Schaffrath, Andreas; Aszodi, Attila

The SWR-1000 is a new innovative boiling water reactor (BWR) concept, which was developed by Siemens AG. This concept is characterized in particular by passive safety systems (e.g., four emergency condensers, four building condensers, eight passive pressure pulse transmitters, and six gravity-driven core-flooding lines). In the framework of the BWR Physics and Thermohydraulic Complementary Action to the European Union BWR Research and Development Cluster, emergency condenser tests were performed by Forschungszentrum Juelich at the NOKO test facility. Posttest calculations with ATHLET are presented, which aim at the determination of the removable power of the emergency condenser and its operation mode.more » The one-dimensional thermal-hydraulic code ATHLET was extended by the module KONWAR for the calculation of the heat transfer coefficient during condensation in horizontal tubes. In addition, results of conventional finite difference calculations using the code CFX-4 are presented, which investigate the natural convection during the heatup process at the secondary side of the NOKO test facility.« less

Emergency Operation Center

NASA Technical Reports Server (NTRS)

Chinea, Anoushka Z.

1995-01-01

The Emergency Operation Center (EOC) is a site from which NASA LaRC Emergency Preparedness Officials exercise control and direction in an emergency. Research was conducted in order to determine what makes an effective EOC. Specifically information concerning the various types of equipment and communication capability that an efficient EOC should contain (i.e., computers, software, telephone systems, radio systems, etc.) was documented. With this information a requirements document was written stating a brief description of the equipment and required quantity to be used in an EOC and then compared to current capabilities at the NASA Langley Research Center.

KENNEDY SPACE CENTER, FLA. - An “injured” rescue worker is lifted into an M-113 armored personnel carrier provided for transportation during a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries inside the crew compartment mock-up. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - An “injured” rescue worker is lifted into an M-113 armored personnel carrier provided for transportation during a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries inside the crew compartment mock-up. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

Optimal location of emergency stations in underground mine networks using a multiobjective mathematical model.

PubMed

Lotfian, Reza; Najafi, Mehdi

2018-02-26

Background Every year, many mining accidents occur in underground mines all over the world resulting in the death and maiming of many miners and heavy financial losses to mining companies. Underground mining accounts for an increasing share of these events due to their special circumstances and the risks of working therein. Thus, the optimal location of emergency stations within the network of an underground mine in order to provide medical first aid and transport injured people at the right time, plays an essential role in reducing deaths and disabilities caused by accidents Objective The main objective of this study is to determine the location of emergency stations (ES) within the network of an underground coal mine in order to minimize the outreach time for the injured. Methods A three-objective mathematical model is presented for placement of ES facility location selection and allocation of facilities to the injured in various stopes. Results Taking into account the radius of influence for each ES, the proposed model is capable to reduce the maximum time for provision of emergency services in the event of accident for each stope. In addition, the coverage or lack of coverage of each stope by any of the emergency facility is determined by means of Floyd-Warshall algorithm and graph. To solve the problem, a global criterion method using GAMS software is used to evaluate the accuracy and efficiency of the model. Conclusions 7 locations were selected from among 46 candidates for the establishment of emergency facilities in Tabas underground coal mine. © 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.

Oral healthcare access and adequacy in alternative long-term care facilities.

PubMed

Smith, Barbara J; Ghezzi, Elisa M; Manz, Michael C; Markova, Christiana P

2010-01-01

This study was undertaken to determine practices and perceived barriers to access related to oral health by surveying administrators in Michigan alternative long-term care facilities (ALTCF). A 24-item questionnaire was mailed to all 2,275 Michigan ALTCF serving residents aged 60+. Facility response rate was 22% (n = 508). Eleven percent of facilities had a written dental care plan; 18% stated a dentist examined new residents; and 19% of facilities had an agreement with a dentist to come to the facility, with 52% of those being for emergency care only. The greatest perceived barriers were willingness of general and specialty dentists to treat residents at the nursing facility and/or private offices as well as financial concerns. Substantial barriers to care were uniformly perceived. Oral health policies and practices within Michigan ALTCF vary, as measured by resources, attitudes, and the availability of professional care. There is limited involvement by dental professionals in creating policy and providing consultation and service.

Trends in the Incidence of Hypertensive Emergencies in US Emergency Departments From 2006 to 2013.

PubMed

Janke, Alexander T; McNaughton, Candace D; Brody, Aaron M; Welch, Robert D; Levy, Phillip D

2016-12-05

The incidence of hypertensive emergency in US emergency departments (ED) is not well established. This study is a descriptive epidemiological analysis of nationally representative ED visit-level data from the Nationwide Emergency Department Sample for 2006-2013. Nationwide Emergency Department Sample is a publicly available database maintained by the Healthcare Cost and Utilization Project. An ED visit was considered to be a hypertensive emergency if it met all the following criteria: diagnosis of acute hypertension, at least 1 diagnosis indicating acute target organ damage, and qualifying disposition (admission to the hospital, death, or transfer to another facility). The incidence of adult ED visits for acute hypertension increased monotonically in the period from 2006 through 2013, from 170 340 (1820 per million adult ED visits overall) to 496 894 (4610 per million). Hypertensive emergency was rare overall, accounting for 63 406 visits (677 per million adult ED visits overall) in 2006 to 176 769 visits (1670 per million) in 2013. Among adult ED visits that had any diagnosis of hypertension, hypertensive emergency accounted for 3309 per million in 2006 and 6178 per million in 2013. The estimated number of visits for hypertensive emergency and the rate per million adult ED visits has more than doubled from 2006 to 2013. However, hypertensive emergencies are rare overall, occurring in about 2 in 1000 adult ED visits overall, and 6 in 1000 adult ED visits carrying any diagnosis of hypertension in 2013. This figure is far lower than what has been sometimes cited in previous literature. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Requirements for Emergency Assistance Under the Worker Protection Standard

EPA Pesticide Factsheets

Employers at agricultural establishment must provide emergency assistance to anyone who is or has been employed as a worker or handler if there is reason to believe that the worker or handler has been poisoned or injured by a pesticide at the facility.

Research at a European Planetary Simulation Facility

NASA Astrophysics Data System (ADS)

Merrison, Jonathan; Alois, Stefano; Iversen, Jens Jacob

2016-04-01

A unique environmental simulation facility will be presented which is capable of re-creating extreme terrestrial or other planetary environments. It is supported by EU activities including a volcanology network VERTIGO and a planetology network Europlanet 2020 RI. It is also used as a test facility by ESA for the forthcoming ExoMars 2018 mission. Specifically it is capable of recreating the key physical parameters such as temperature, pressure (gas composition), wind flow and importantly the suspension/transport of dust or sand particulates. This facility is available both to the scientific and industrial community. Details of this laboratory facility will be presented and some of the most recent activities will be summarized. For information on access to this facility please contact the author.

Medication Administration Errors in an Adult Emergency Department of a Tertiary Health Care Facility in Ghana.

PubMed

Acheampong, Franklin; Tetteh, Ashalley Raymond; Anto, Berko Panyin

2016-12-01

This study determined the incidence, types, clinical significance, and potential causes of medication administration errors (MAEs) at the emergency department (ED) of a tertiary health care facility in Ghana. This study used a cross-sectional nonparticipant observational technique. Study participants (nurses) were observed preparing and administering medication at the ED of a 2000-bed tertiary care hospital in Accra, Ghana. The observations were then compared with patients' medication charts, and identified errors were clarified with staff for possible causes. Of the 1332 observations made, involving 338 patients and 49 nurses, 362 had errors, representing 27.2%. However, the error rate excluding "lack of drug availability" fell to 12.8%. Without wrong time error, the error rate was 22.8%. The 2 most frequent error types were omission (n = 281, 77.6%) and wrong time (n = 58, 16%) errors. Omission error was mainly due to unavailability of medicine, 48.9% (n = 177). Although only one of the errors was potentially fatal, 26.7% were definitely clinically severe. The common themes that dominated the probable causes of MAEs were unavailability, staff factors, patient factors, prescription, and communication problems. This study gives credence to similar studies in different settings that MAEs occur frequently in the ED of hospitals. Most of the errors identified were not potentially fatal; however, preventive strategies need to be used to make life-saving processes such as drug administration in such specialized units error-free.

Accuracy of immunization histories provided by adults accompanying preschool children to a pediatric emergency department.

PubMed

Goldstein, K P; Kviz, F J; Daum, R S

1993-11-10

Because some have advocated the use of emergency departments to administer delayed childhood immunizations, we evaluated the accuracy of immunization histories obtained in this setting by comparison with medical records of inner-city health care facilities. Questionnaires were orally administered to adults accompanying children to the emergency department. Individual medical records were reviewed. Pediatric emergency department at Wyler Children's Hospital, University of Chicago and 68 inner-city primary care clinics. Children aged 3 to 65 months registering for medical care. Of the sample, 98% were African American; 75% were Medicaid recipients. Adults' knowledge of immunization histories, immunization cards, and medical records compared with American Academy of Pediatrics/Immunization Practices Advisory Committee recommendations. Of the accompanying adults, 64% stated that their child's general immunization status was "up-to-date"; 65% of these had clinic records confirming that status. Only 8% of specific regimens stated by these adults accurately matched those found in clinic records. Moreover, 45% of adults accompanying children at least 16 months and older provided inaccurate information regarding previous receipt of measles immunization. Information provided by accompanying adults (from recall or from immunization cards) is inadequate to determine accurately which preschoolers in the pediatric emergency department are delayed in immunizations.

Astronaut Stephen Oswald during emergency bailout training

NASA Technical Reports Server (NTRS)

1994-01-01

Suited in a training version of the Shuttle partial-pressure launch and entry garment, astronaut Stephen S. Oswald, STS-67 commander, gets help with a piece of gear from Boeing's David Brandt. The scene was photographed prior to a session of emergency bailout training in the 25-feet deep pool at JSC's Weightless Environment Training Facility (WETF).

HIPAA security standards: is your facility ready?

PubMed

2000-05-01

Now that final rules are emerging related to the Health Insurance Portability and Accountability Act of 1996, it's more important than ever to make sure your facility's data security standards measure up. The best advice? 'Forget HIPAA for the moment and look at what you have in place,' says William Spooner, senior vice president and chief information officer for Sharp Healthcare in San Diego.

Barriers to formal emergency obstetric care services' utilization.

PubMed

Essendi, Hildah; Mills, Samuel; Fotso, Jean-Christophe

2011-06-01

Access to appropriate health care including skilled birth attendance at delivery and timely referrals to emergency obstetric care services can greatly reduce maternal deaths and disabilities, yet women in sub-Saharan Africa continue to face limited access to skilled delivery services. This study relies on qualitative data collected from residents of two slums in Nairobi, Kenya in 2006 to investigate views surrounding barriers to the uptake of formal obstetric services. Data indicate that slum dwellers prefer formal to informal obstetric services. However, their efforts to utilize formal emergency obstetric care services are constrained by various factors including ineffective health decision making at the family level, inadequate transport facilities to formal care facilities and insecurity at night, high cost of health services, and inhospitable formal service providers and poorly equipped health facilities in the slums. As a result, a majority of slum dwellers opt for delivery services offered by traditional birth attendants (TBAs) who lack essential skills and equipment, thereby increasing the risk of death and disability. Based on these findings, we maintain that urban poor women face barriers to access of formal obstetric services at family, community, and health facility levels, and efforts to reduce maternal morbidity and mortality among the urban poor must tackle the barriers, which operate at these different levels to hinder women's access to formal obstetric care services. We recommend continuous community education on symptoms of complications related to pregnancy and timely referral. A focus on training of health personnel on "public relations" could also restore confidence in the health-care system with this populace. Further, we recommend improving the health facilities in the slums, improving the services provided by TBAs through capacity building as well as involving TBAs in referral processes to make access to services timely. Measures can also be

A comprehensive review on nano-molybdenum disulfide/DNA interfaces as emerging biosensing platforms.

PubMed

Kukkar, Manil; Mohanta, Girish C; Tuteja, Satish K; Kumar, Parveen; Bhadwal, Akhshay Singh; Samaddar, Pallabi; Kim, Ki-Hyun; Deep, Akash

2018-06-01

The development of nucleic acid-based portable platforms for the real-time analysis of diseases has attracted considerable scientific and commercial interest. Recently, 2D layered molybdenum sulfide (2D MoS 2 from here on) nanosheets have shown great potential for the development of next-generation platforms for efficient signal transduction. Through combination with DNA as a biorecognition medium, MoS 2 nanostructures have opened new opportunities to design and construct highly sensitive, specific, and commercially viable sensing devices. The use of specific short ssDNA sequences like aptamers has been proven to bind well with the unique transduction properties of 2D MoS 2 nanosheets to realize aptasensing devices. Such sensors can be operated on the principles of fluorescence, electro-cheumuluminescence, and electrochemistry with many advantageous features (e.g., robust biointerfacing through various conjugation chemistries, facile sensor assembly, high stability with regard to temperature/pH, and high affinity to target). This review encompasses the state of the art information on various design tactics and working principles of MoS 2 /DNA sensor technology which is emerging as one of the most sought-after and valuable fields with the advent of nucleic acid inspired devices. To help achieve a new milestone in biosensing applications, great potential of this emerging technique is described further with regard to sensitivity, specificity, operational convenience, and versatility. Copyright © 2018 Elsevier B.V. All rights reserved.

75 FR 44005 - Notice of Submission of Proposed Information Collection to OMB Emergency Comment Request, Capital...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-27

... develop facilities to provide early childhood education, adult education, and/or job training programs for... Proposed Information Collection to OMB Emergency Comment Request, Capital Fund Education and Training... following information: Title of Proposal: Capital Fund Education and Training Community Facilities (CFCF...

Trends in CT scan rates in children and pregnant women: teaching, private, public and nonprofit facilities.

PubMed

Hoshiko, Sumi; Smith, Daniel; Fan, Cathyn; Jones, Carrie R; McNeel, Sandra V; Cohen, Ronald A

2014-05-01

Radiation exposure from medical sources now equals or exceeds that from natural background sources, largely attributable to a 20-fold increase in CT use since 1980. Increasing exposure to children and fetuses is of most concern due to their heightened susceptibility. More recently, CT use may be leveling or decreasing, but it is unclear whether this change is widespread or varies by type of institution. We sought to characterize trends in CT utilization in California hospitals and emergency departments among children and pregnant women, looking at different types of facilities, such as teaching, private, public and nonprofit institutions. We examined frequency of CT examinations by year from 229 facilities reporting CT usage in routinely collected California statewide data for 2005-2012. We modeled trends overall and by facility type. CT scans for pediatric and pregnant patient visits in the emergency department increased initially, then started to decline after 2008. Among hospital admissions, rates declined or leveled after 2005. In the emergency department, CT rates varied between types of facilities, with teaching hospitals reducing use sooner and more sharply than other types of facilities. CT utilization in California among children and pregnant women has begun to level or decline. Still, population exposure remains at historically high levels, warranting consideration of potential public health implications. Further examination of reasons for trends among hospital types, particularly how teaching hospitals have reduced rates of CT utilization, may help identify strategies for CT reduction without compromising patient care.

Perceptions of emergency care in Kenyan communities lacking access to formalised emergency medical systems: a qualitative study

PubMed Central

Broccoli, Morgan C; Calvello, Emilie J B; Skog, Alexander P; Wachira, Benjamin; Wallis, Lee A

2015-01-01

Objectives We undertook this study in Kenya to understand the community's emergency care needs and barriers they face when trying to access care, and to seek community members’ thoughts regarding high impact solutions to expand access to essential emergency services. Design We used a qualitative research methodology to conduct 59 focus groups with 528 total Kenyan community member participants. Data were coded, aggregated and analysed using the content analysis approach. Setting Participants were uniformly selected from all eight of the historical Kenyan provinces (Central, Coast, Eastern, Nairobi, North Eastern, Nyanza, Rift Valley and Western), with equal rural and urban community representation. Results Socioeconomic and cultural factors play a major role both in seeking and reaching emergency care. Community members in Kenya experience a wide range of medical emergencies, and seem to understand their time-critical nature. They rely on one another for assistance in the face of substantial barriers to care—a lack of: system structure, resources, transportation, trained healthcare providers and initial care at the scene. Conclusions Access to emergency care in Kenya can be improved by encouraging recognition and initial treatment of emergent illness in the community, strengthening the pre-hospital care system, improving emergency care delivery at health facilities and creating new policies at a national level. These community-generated solutions likely have a wider applicability in the region. PMID:26586324

DOE LeRC photovoltaic systems test facility

NASA Technical Reports Server (NTRS)

Cull, R. C.; Forestieri, A. F.

1978-01-01

The facility was designed and built and is being operated as a national facility to serve the needs of the entire DOE National Photovoltaic Program. The object of the facility is to provide a place where photovoltaic systems may be assembled and electrically configured, without specific physical configuration, for operation and testing to evaluate their performance and characteristics. The facility as a breadboard system allows investigation of operational characteristics and checkout of components, subsystems and systems before they are mounted in field experiments or demonstrations. The facility as currently configured consist of 10 kW of solar arrays built from modules, two inverter test stations, a battery storage system, interface with local load and the utility grid, and instrumentation and control necessary to make a flexible operating facility. Expansion to 30 kW is planned for 1978. Test results and operating experience are summaried to show the variety of work that can be done with this facility.

Compressed Natural Gas Vehicle Maintenance Facility Modification Handbook

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

Kelly, K.; Melendez, M.; Gonzales, J.

To ensure the safety of personnel and facilities, vehicle maintenance facilities are required by law and by guidelines of the National Fire Protection Association (NFPA) and the International Fire Code (IFC) to exhibit certain design features. They are also required to be fitted with certain fire protection equipment and devices because of the potential for fire or explosion in the event of fuel leakage or spills. All fuels have an explosion or fire potential if specific conditions are present. This handbook covers the primary elements that must be considered when developing a CNG vehicle maintenance facility design that will protectmore » against the ignition of natural gas releases. It also discusses specific protocols and training needed to ensure safety.« less

Emergence of a World Class Atmospheric Science Facility in the Central Himalayan Regions of India

NASA Astrophysics Data System (ADS)

Taori, A.; Sunilkumar, S. V.; Pant, P.; Sagar, R.

A new institute Aryabhatta Research Institute of Observation Sciences ARIES has re-borne in year 2004 when the Department of Science and Technology Govt of India took over the 50 year old State Observatory Nainital situated at 2km above the mean sea level in the Shivalik range of central Himalayas Understanding the importance of Nainital 29 4 N 79 5 E it was decided that prime focus should be to set up a world-class research facility for atmospheric sciences apart from the existing astronomy and astrophysics Reason for the above being the strategic location of Nainital to study the free tropospheric aerosols stratosphere-troposphere exchange monsoon dynamics and atmospheric waves These waves can be seeded by the Himalayan topography and may propagate up to the mesosphere-lower thermosphere altitudes and manifest themselves as an important coupling agent between lower middle and upper atmosphere Advance facilities to study the middle atmospheric dynamics are getting established For this an 84-cm Rayleigh lidar is under development to study the thermal structure of the middle atmosphere which will be commissioned by year 2009 A new project has already been approved to set up a stratosphere-troposphere ST radar facility which will further help understanding the thermal structure and wind field measurements in troposphere-stratosphere altitudes To supplement these several airglow experiments will also be stationed for simultaneous measurements Such facilities are of great importance for coordination with the space borne measurements After

10 CFR 850.27 - Hygiene facilities and practices.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Hygiene facilities and practices. 850.27 Section 850.27 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Specific Program Requirements § 850.27 Hygiene facilities and practices. (a) General. The responsible employer must assure that in...

Photovoltaic Systems Test Facilities: Existing capabilities compilation

NASA Technical Reports Server (NTRS)

Volkmer, K.

1982-01-01

A general description of photovoltaic systems test facilities (PV-STFs) operated under the U.S. Department of Energy's photovoltaics program is given. Descriptions of a number of privately operated facilities having test capabilities appropriate to photovoltaic hardware development are given. A summary of specific, representative test capabilities at the system and subsystem level is presented for each listed facility. The range of system and subsystem test capabilities available to serve the needs of both the photovoltaics program and the private sector photovoltaics industry is given.

Apparent temperature and cause-specific emergency hospital admissions in Greater Copenhagen, Denmark.

PubMed

Wichmann, Janine; Andersen, Zorana; Ketzel, Matthias; Ellermann, Thomas; Loft, Steffen

2011-01-01

One of the key climate change factors, temperature, has potentially grave implications for human health. We report the first attempt to investigate the association between the daily 3-hour maximum apparent temperature (Tapp(max)) and respiratory (RD), cardiovascular (CVD), and cerebrovascular (CBD) emergency hospital admissions in Copenhagen, controlling for air pollution. The study period covered 1 January 2002-31 December 2006, stratified in warm and cold periods. A case-crossover design was applied. Susceptibility (effect modification) by age, sex, and socio-economic status was investigated. For an IQR (8°C) increase in the 5-day cumulative average of Tapp(max), a 7% (95% CI: 1%, 13%) increase in the RD admission rate was observed in the warm period whereas an inverse association was found with CVD (-8%, 95% CI: -13%, -4%), and none with CBD. There was no association between the 5-day cumulative average of Tapp(max) during the cold period and any of the cause-specific admissions, except in some susceptible groups: a negative association for RD in the oldest age group and a positive association for CVD in men and the second highest SES group. In conclusion, an increase in Tapp(max) is associated with a slight increase in RD and decrease in CVD admissions during the warmer months.

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

PubMed

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

2007-08-01

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

Facility Management as a Way of Reducing Costs in Transport Companies

NASA Astrophysics Data System (ADS)

Matusova, Dominika; Gogolova, Martina

2017-10-01

For facility management exists a several interpretations. These interpretations emerged progressively. At the time of the notion of facility management was designed to manage an administrative building, in the United States (US). They can ensure their operation and maintenance. From the US, this trend is further moved to Europe and now it start becoming a current and actual topic also in Slovakia. Facility management is contractually agreed scheme of services, semantically recalls traditional building management. There by finally pushed for activities related to real estates. For facility management is fundamental - certification and certification systems. Therefore, is essential to know, the cost structure of certification. The most commonly occurring austerity measures include: heat pumps, use of renewable energy, solar panels and water savings. These measures can reduce the cost.

The semantic specificity of gestures when verbal communication is not possible: the case of emergency evacuation.

PubMed

Prati, Gabriele; Pietrantoni, Luca

2013-01-01

The aim of the present study was to examine the comprehension of gesture in a situation in which the communicator cannot (or can only with difficulty) use verbal communication. Based on theoretical considerations, we expected to obtain higher semantic comprehension for emblems (gestures with a direct verbal definition or translation that is well known by all members of a group, or culture) compared to illustrators (gestures regarded as spontaneous and idiosyncratic and that do not have a conventional definition). Based on the extant literature, we predicted higher semantic specificity associated with arbitrarily coded and iconically coded emblems compared to intrinsically coded illustrators. Using a scenario of emergency evacuation, we tested the difference in semantic specificity between different categories of gestures. 138 participants saw 10 videos each illustrating a gesture performed by a firefighter. They were requested to imagine themselves in a dangerous situation and to report the meaning associated with each gesture. The results showed that intrinsically coded illustrators were more successfully understood than arbitrarily coded emblems, probably because the meaning of intrinsically coded illustrators is immediately comprehensible without recourse to symbolic interpretation. Furthermore, there was no significant difference between the comprehension of iconically coded emblems and that of both arbitrarily coded emblems and intrinsically coded illustrators. It seems that the difference between the latter two types of gestures was supported by their difference in semantic specificity, although in a direction opposite to that predicted. These results are in line with those of Hadar and Pinchas-Zamir (2004), which showed that iconic gestures have higher semantic specificity than conventional gestures.

The relationship between physical activity facility proximity and leisure-time physical activity in persons with spinal cord injury.

PubMed

Arbour, Kelly P; Martin Ginis, Kathleen A

2009-07-01

Within the general able-bodied population, proximity of one's home to physical activity facilities is modestly associated with physical activity behavior. Currently, no research has examined whether facility proximity is related to physical activity among persons living with disabilities. To examine (1) the level of agreement between perceived and actual proximity to accessible physical activity facilities and (2) the relationship between facility proximity (perceived and actual) and leisure-time physical activity (LTPA) among persons with spinal cord injury (SCI). It was hypothesized that (1) perceived and actual proximity measures would exhibit low agreement and (2) a small, positive relationship would emerge between proximity (perceived and actual) and LTPA. Data from 50 Ontario residents living with SCI (70% male; 52% tetraplegia) were collected for proximity and LTPA. Perceived facility proximity was determined by a self-report "YES" versus "NO" presence measure, while actual facility proximity was assessed using Geographical Information Systems. An SCI-specific instrument, the PARA-SCI, was used to measure LTPA. Low agreement levels were found between perceived and actual proximity. LTPA status (active versus inactive) was shown to moderate the relationship, with higher agreement levels found for participants who reported engaging in mild or heavy LTPA versus their inactive counterparts, but only for the 30-minute wheeling boundary. Contrary to hypothesis, people living within a 30-minute wheel from an accessible facility were less likely to engage in heavy LTPA than were people who did not have an accessible facility located within a 30-minute wheel. No significant associations were found between LTPA and perceived proximity. Living in close proximity to a facility that provides accessible programming and equipment does not necessarily translate into greater physical activity behavior.

Facile preparation of 3D hierarchical coaxial-cable-like Ni-CNTs@beta-(Ni, Co) binary hydroxides for supercapacitors with ultrahigh specific capacitance.

PubMed

Zhang, Manyu; Ma, Xiaowei; Bi, Han; Zhao, Xuebing; Wang, Chao; Zhang, Jie; Li, Yuesheng; Che, Renchao

2017-09-15

A facile chemical method for Co doping Ni-CNTs@α-Ni(OH) 2 combining with an in situ phase transformation process is successfully proposed and employed to synthesize three-dimensional (3D) hierarchical Ni-CNTs@β-(Ni, Co) binary hydroxides. This strategy can effectively maintain the coaxial-cable-like structure of Ni-CNTs@α-Ni(OH) 2 and meanwhile increase the content of Co as much as possible. Eventually, the specific capacitances and electrical conductivity of the composites are remarkably enhanced. The optimized composite exhibits high specific capacitances of 2861.8F g -1 at 1A g -1 (39.48F cm -2 at 15mAcm -2 ), good rate capabilities of 1221.8F g -1 at 20A g -1 and cycling stabilities (87.6% of capacitance retention after 5000cycles at 5A g -1 ). The asymmetric supercapacitor (ASC) constructed with the as-synthesized composite and activated carbon as positive and negative electrode delivers a high specific capacitance of 287.7F g -1 at 1A g -1 . The device demonstrates remarkable energy density (96Whkg -1 ) and high power density (15829.4Wkg -1 ). The retention of capacitance remains 83.5% at the current density of 5A g -1 after 5000cycles. The charged and discharged samples are further studied by ex situ electron energy loss spectroscopy (EELS) analysis, XRD and SEM to figure out the reasons of capacitance fading. Overall, it is believable that this facile synthetic strategy can be applied to prepare various nanostructured metal hydroxide/CNT composites for high performance supercapacitor electrode materials. Copyright © 2017. Published by Elsevier Inc.

The Arab American Experience with Diabetes: Perceptions, Myths and Implications for Culturally-Specific Interventions