Utilization and expenditure at public and private facilities in 39 low-income countries.

PubMed

Saksena, Priyanka; Xu, Ke; Elovainio, Riku; Perrot, Jean

2012-01-01

To document the patterns of health service utilization and health payments at public and private facilities across countries. We used data from the World Health Surveys from 39 low- and low-middle income countries to examine differences between public and private sectors. Utilization of outpatient and inpatient services, out-of-pocket payments (OOP) at public and private facilities, and transportation costs were compared. Utilization and payments to public and private sectors differ widely. Public facilities dominated in most countries for both outpatient and inpatient services. But, whereas use of private facilities is more common among the rich, poor people also use them, to a considerable extent and in almost all the countries in the study. The majority of OOP were incurred at public providers for inpatient services. On average, this was not the case for outpatient services. Medicines accounted for the largest share of OOP for all services except inpatient services at private facilities, where consultation fees did. Transportation costs were considerable. Price competition is certainly not the only factor that guides choice of provider. The results support continued efforts by the governments to engage strategically with the private sector. However, they also highlight the importance of not generalizing conditions across countries. Governments may need to reconsider simplistic user-fee abolition strategies at public providers if they simply focus on consultation fees. Policies to make health services more accessible need to consider a comprehensive benefit package that includes a wider scope of costs related to care such as expenditures on medicines and transportation. © 2011 Blackwell Publishing Ltd.

Common Utilities in the Energy Systems Integration Facility | Energy

Science.gov Websites

Systems Integration Facility. Common utilities include: Power: Three-phase 480/277 VAC, 208/120 VAC, 240 split-phase VAC, and 120 single-phase VAC Water: Process heating and cooling and research cooling

Dialysis Facility and Patient Characteristics Associated with Utilization of Home Dialysis

PubMed Central

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

2010-01-01

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

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

PubMed

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

2010-09-01

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

Family planning utilization and factors associated among women receiving abortion services in health facilities of central zone towns of Tigray, Northern Ethiopia: a cross sectional Study.

PubMed

Hagos, Goshu; Tura, Gurmesa; Kahsay, Gizienesh; Haile, Kebede; Grum, Teklit; Araya, Tsige

2018-06-05

Abortion remains among the leading causes of maternal death worldwide. Post-abortion contraception is significantly effective in preventing unintended pregnancy and abortion if provided before women leave the health facilty. However, the status of post-abortion family planning (PAFP) utilization and the contributing factors are not well studied in Tigray region. So, we conduct study aimed on family planning utilization and factors associated with it among women receiving abortion services. A facility based cross-sectional study design was conducted among women receiving abortion services in central zone of Tigray from December 2015to February 2016 using a total of 416 sample size. Women who came for abortion services were selected using systematic random sampling technique.. The data were collected using a pre-tested interviewer administered questionnair. Data were coded and entered in to Epi info 7 and then exported to SPSS for analysis. Descriptive statisticslike frequencies and mean were computed to display the results. Both Bivariable and multivariable logistic regression was used in the analysis. Variables statistically significant at p < 0.05 in the bivariable analysis were checked in multivariable logistic regration to identify independently associated factors. Then variables which were significantly associated with post abortion family planning utilization at p-value < 0.05 in the multivariable analysis were declared as significantly associated factors. A total of 409 abortion clients were interviewed in this study with 98.3% of response rate. Majority 290 (70.9%) of study participants utilized contracepives after abortion. Type of health facility, the decision maker on timing of having child, knowledge that pregnancy can happen soon after abortion and husband's opposition towards contraceptives were significantly associated with Post-abortion family planning ustilization. About one-third of abortion women failed to receive contraceptive before

TAN HOT SHOP AND SUPPORT FACILITY UTILIZATION STUDY

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

Phillips, Ken Crawforth

2001-11-01

Impacts to the U.S. Department of Energy (DOE) complex caused by early closure (prior to 2018) and Demolition and Dismantlement (D&D) of the Test Area North (TAN) hot shop and its support facilities are explored in this report. Various possible conditions, such as Standby, Safe Store and Lay-up, that the facility may be placed in prior to eventually being turned over to D&D are addressed. The requirements, impacts, and implications to the facility and to the DOE Complex are discussed for each condition presented in the report. Some details of the report reference the Idaho National Engineering and Environmental Laboratorymore » (INEEL) Spent Nuclear Fuel Life Cycle Baseline Plan, the INEEL 2000 Infrastructure Long Range Plan, and other internal INEEL reports.« less

TAN Hot Shop and Support Facility Utilization Study

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

Picker, B.A.

2001-11-16

Impacts to the U.S. Department of Energy (DOE) complex caused by early closure (prior to 2018) and Demolition and Dismantlement (D and D) of the Test Area North (TAN) hot shop and its support facilities are explored in this report. Various possible conditions, such as Standby, Safe Store and Lay-up, that the facility may be placed in prior to eventually being turned over to D and D are addressed. The requirements, impacts, and implications to the facility and to the DOE Complex are discussed for each condition presented in the report. Some details of the report reference the Idaho Nationalmore » Engineering and Environmental Laboratory (INEEL) Spent Nuclear Fuel Life Cycle Baseline Plan, the INEEL 2000 Infrastructure Long Range Plan, and other internal INEEL reports.« less

Regional health care planning: a methodology to cluster facilities using community utilization patterns

PubMed Central

2013-01-01

Background Community-based health care planning and regulation necessitates grouping facilities and areal units into regions of similar health care use. Limited research has explored the methodologies used in creating these regions. We offer a new methodology that clusters facilities based on similarities in patient utilization patterns and geographic location. Our case study focused on Hospital Groups in Michigan, the allocation units used for predicting future inpatient hospital bed demand in the state’s Bed Need Methodology. The scientific, practical, and political concerns that were considered throughout the formulation and development of the methodology are detailed. Methods The clustering methodology employs a 2-step K-means + Ward’s clustering algorithm to group hospitals. The final number of clusters is selected using a heuristic that integrates both a statistical-based measure of cluster fit and characteristics of the resulting Hospital Groups. Results Using recent hospital utilization data, the clustering methodology identified 33 Hospital Groups in Michigan. Conclusions Despite being developed within the politically charged climate of Certificate of Need regulation, we have provided an objective, replicable, and sustainable methodology to create Hospital Groups. Because the methodology is built upon theoretically sound principles of clustering analysis and health care service utilization, it is highly transferable across applications and suitable for grouping facilities or areal units. PMID:23964905

Regional health care planning: a methodology to cluster facilities using community utilization patterns.

PubMed

Delamater, Paul L; Shortridge, Ashton M; Messina, Joseph P

2013-08-22

Community-based health care planning and regulation necessitates grouping facilities and areal units into regions of similar health care use. Limited research has explored the methodologies used in creating these regions. We offer a new methodology that clusters facilities based on similarities in patient utilization patterns and geographic location. Our case study focused on Hospital Groups in Michigan, the allocation units used for predicting future inpatient hospital bed demand in the state's Bed Need Methodology. The scientific, practical, and political concerns that were considered throughout the formulation and development of the methodology are detailed. The clustering methodology employs a 2-step K-means + Ward's clustering algorithm to group hospitals. The final number of clusters is selected using a heuristic that integrates both a statistical-based measure of cluster fit and characteristics of the resulting Hospital Groups. Using recent hospital utilization data, the clustering methodology identified 33 Hospital Groups in Michigan. Despite being developed within the politically charged climate of Certificate of Need regulation, we have provided an objective, replicable, and sustainable methodology to create Hospital Groups. Because the methodology is built upon theoretically sound principles of clustering analysis and health care service utilization, it is highly transferable across applications and suitable for grouping facilities or areal units.

Expert Systems for United States Navy Shore Facilities Utility Operations.

DTIC Science & Technology

1988-03-01

of expertise when assessing the applicability of an expert system. Each of the tasks as similarly ranked to reflect subjective judgement on the...United States Navy Shore Facilities Utility Operations ABSTRACT A technology assessment of expert systems as they might be used in Navy utility...of these applications include design, fault diagnoses, training, data base management, and real-time monitoring. An assessment is given of each

Effect of average flow and capacity utilization on effluent water quality from US municipal wastewater treatment facilities.

PubMed

Weirich, Scott R; Silverstein, Joann; Rajagopalan, Balaji

2011-08-01

There is increasing interest in decentralization of wastewater collection and treatment systems. However, there have been no systematic studies of the performance of small treatment facilities compared with larger plants. A statistical analysis of 4 years of discharge monthly report (DMR) data from 210 operating wastewater treatment facilities was conducted to determine the effect of average flow rate and capacity utilization on effluent biochemical oxygen demand (BOD), total suspended solids (TSS), ammonia, and fecal coliforms relative to permitted values. Relationships were quantified using generalized linear models (GLMs). Small facilities (40 m³/d) had violation rates greater than 10 times that of the largest facilities (400,000 m³/d) for BOD, TSS, and ammonia. For facilities with average flows less than 40,000 m³/d, increasing capacity utilization was correlated with increased effluent levels of BOD and TSS. Larger facilities tended to operate at flows closer to their design capacity while maintaining treatment suggesting greater efficiency. Copyright © 2011 Elsevier Ltd. All rights reserved.

UTILIZATION OF COMPUTER FACILITIES IN THE MATHEMATICS AND BUSINESS CURRICULUM IN A LARGE SUBURBAN HIGH SCHOOL.

ERIC Educational Resources Information Center

RENO, MARTIN; AND OTHERS

A STUDY WAS UNDERTAKEN TO EXPLORE IN A QUALITATIVE WAY THE POSSIBLE UTILIZATION OF COMPUTER AND DATA PROCESSING METHODS IN HIGH SCHOOL EDUCATION. OBJECTIVES WERE--(1) TO ESTABLISH A WORKING RELATIONSHIP WITH A COMPUTER FACILITY SO THAT ABLE STUDENTS AND THEIR TEACHERS WOULD HAVE ACCESS TO THE FACILITIES, (2) TO DEVELOP A UNIT FOR THE UTILIZATION…

Optimum electric utility spot price determinations for small power producing facilities operating under PURPA provisions

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

Ghoudjehbaklou, H.; Puttgen, H.B.

This paper outlines an optimum spot price determination procedure in the general context of the Public Utility Regulatory Policies Act, PURPA, provisions. PURPA stipulates that local utilities must offer to purchase all available excess electric energy from Qualifying Facilities, QF, at fair market prices. As a direct consequence of these PURPA regulations, a growing number of owners are installing power producing facilities and optimize their operational schedules to minimize their utility related costs or, in some cases, actually maximize their revenues from energy sales to the local utility. In turn, the utility strives to use spot prices which maximize itsmore » revenues from any given Small Power Producing Facility, SPPF, a schedule while respecting the general regulatory and contractual framework. the proposed optimum spot price determination procedure fully models the SPPF operation, it enforces the contractual and regulatory restrictions, and it ensures the uniqueness of the optimum SPPF schedule.« less

Optimum electric utility spot price determinations for small power producing facilities operating under PURPA provisions

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

Ghoudjehbaklou, H.; Puttgen, H.B.

The present paper outlines an optimum spot price determination procedure in the general context of the Public Utility Regulatory Policies Act, PURPA, provisions. PURPA stipulates that local utilities must offer to purchase all available excess electric energy from Qualifying Facilities, QF, at fair market prices. As a direct consequence of these PURPA regulations, a growing number of owners are installing power producing facilities and optimize their operational schedules to minimize their utility related costs or, in some cases, actually maximize their revenues from energy sales to the local utility. In turn, the utility will strive to use spot prices whichmore » maximize its revenues from any given Small Power Producing Facility, SPPF, schedule while respecting the general regulatory and contractual framework. The proposed optimum spot price determination procedure fully models the SPPF operation, it enforces the contractual and regulatory restrictions, and it ensures the uniqueness of the optimum SPPF schedule.« less

Analysis of Department of Defense Organic Depot Maintenance Capacity Management and Facility Utilization Factors

DTIC Science & Technology

1991-09-01

System ( CAPMS ) in lieu of using DODI 4151.15H. Facility utilization rate computation is not explicitly defined; it is merely identified as a ratio of...front of a bottleneck buffers the critical resource and protects against disruption of the system. This approach optimizes facility utilization by...run titled BUFFERED BASELINE. Three different levels of inventory were used to evaluate the effect of increasing the inventory level on critical

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

NASA Astrophysics Data System (ADS)

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

2017-06-01

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

A Review of Avian Monitoring and Mitigation Information at Existing Utility-Scale Solar Facilities

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

Walston, Leroy J.; Rollins, Katherine E.; Smith, Karen P.

2015-01-01

There are two basic types of solar energy technology: photovoltaic and concentrating solar power. As the number of utility-scale solar energy facilities using these technologies is expected to increase in the United States, so are the potential impacts on wildlife and their habitats. Recent attention is on the risk of fatality to birds. Understanding the current rates of avian mortality and existing monitoring requirements is an important first step in developing science-based mitigation and minimization protocols. The resulting information also allows a comparison of the avian mortality rates of utility-scale solar energy facilities with those from other technologies and sources,more » as well as the identification of data gaps and research needs. This report will present and discuss the current state of knowledge regarding avian issues at utility-scale solar energy facilities.« less

Hybrid Propulsion In-Situ Resource Utilization Test Facility Results

NASA Technical Reports Server (NTRS)

Karp, Ashley Chandler; Nakazono, Barry; Vaughan, David; Warner, William N.

2015-01-01

Hybrid rockets present a promising alternative to conventional chemical propulsion systems for In-Situ Resource Utilization (ISRU) and in-space applications. While they have many benefits for these applications, there are still many small details that require research before they can be adopted into flight systems. A flexible test facility was developed at JPL to test operation of hybrid motors at small scale (5 cm outer diameter fuel grains) over a range of conditions. Specifically, this paper studies two of the major advantages: low temperature performance and throttling. Paraffin-based hybrid rockets are predicted to have good performance at low temperatures. This could significantly decrease the overall system mass by minimizing the thermal conditioning required for Mars or outer planet applications. Therefore, the coefficient of thermal expansion and glass transition of paraffin are discussed. Additionally, deep throttling has been considered for several applications. This was a natural starting point for hotfire testing using the hybrid propulsion ISRU test facility. Additionally, short length to diameter ratio (L/D) fuel grains are tested to determine if these systems can be packaged into geometrically constrained spaces.

Navajo Tribal Utility Authority Shiprock Wastewater Treatment Facility; Draft NPDES Permit

EPA Pesticide Factsheets

EPA is proposing to issue a NPDES permit (No. NN0020621) to Navajo Tribal Utility Authority (NTUA) for the Shiprock wastewater treatment facility in San Juan County, New Mexico, within the northeastern portion of the Navajo Nation.

Mortality monitoring design for utility-scale solar power facilities

USGS Publications Warehouse

Huso, Manuela; Dietsch, Thomas; Nicolai, Chris

2016-05-27

unique conditions encountered at solar facilities. In particular, unlike at wind-power facilities, the unimpeded access to almost all areas within the facilities, the typically flat terrain, and general absence of thick vegetation allow distance-sampling techniques (Buckland and others, 2001, 2004) to be exploited to advantage at industrial solar sites. These protocols build on the work of Nicolai and others (2011), and as our understanding and techniques for monitoring improve, the methods may be further modified to incorporate improvements in the future. We present case studies based on monitoring methods currently implemented at different utility-scale solar facilities to illustrate how distance-sampling techniques may improve overall detectability without substantially increasing costs. Every facility is unique, and the protocols presented may be adapted based on specific monitoring objectives and conditions at each site.We provide guidance for designing monitoring programs whose objective it is to estimate the total number of bird and bat fatalities occurring at a facility over an extended period of time. We address spatial variation in causes of mortality, as well as potential sources of imperfect detection, for example, animals falling in or moving to unsearched areas, carcasses removed by predators, and carcasses missed by searchers. We suggest methods to estimate and account for each source of imperfect detection. This document focuses on monitoring design only and does not discuss approaches for estimating mortality from collected data. The development of statistically sound estimators relevant to the solar context is a current topic of research, although there are already strong foundations for estimation with distance-sampling methods in similar open, arid environments (Anderson and others, 2001; Freilich and others, 2005). Nonetheless, if protocols described in this document are followed, the resulting data will be adequate and sufficient for estimating

A Methodology for Conducting Space Utilization Studies within Department of Defense Medical Facilities

DTIC Science & Technology

1992-07-01

database programs, such as dBase or Microsoft Excell, to yield statistical reports that can profile the health care facility . Ladeen (1989) feels that the...service specific space status report would be beneficial to the specific service(s) under study, it would not provide sufficient data for facility -wide...change in the Master Space Plan. The revised methodology also provides a mechanism and forum for spuce management education within the facility . The

Utilization Management in Department of Defense Military Treatment Facilities

DTIC Science & Technology

1992-07-01

Health Affairs) Mendez (1992) clearly states that his plan is for the military health services system’s quality assessment and criteria to become more...also worthy of note that second surgical opinions are not part of Assistant Secretary of Defense (Health Affairs) Mendez ’ (1992) memonrandur on...Affairs) Mendez ’ (1992) quality management policy already states that military medical treatment facilities will begin to implement utilization

Utilization of health facilities and predictors of health-seeking behavior for under-five children with acute diarrhea in slums of Addis Ababa, Ethiopia: a community-based cross-sectional study.

PubMed

Adane, Metadel; Mengistie, Bezatu; Mulat, Worku; Kloos, Helmut; Medhin, Girmay

2017-04-04

Information on health-seeking behavior and utilization of health facilities in slums of Addis Ababa is scarce, impeding the implementation of effective interventions. The purpose of this study is to assess the status of health facilities utilization and predictors for health-seeking behavior of mothers/caregivers of under-five children with acute diarrhea in slums of Addis Ababa, Ethiopia. A community-based cross-sectional study design was employed in five rounds of surveys in seven kebeles in slums of Addis Ababa among 472 mothers/caregivers of 472 under-five children with acute diarrhea in reference to Andersen's behavioral model. Data were entered into EpiData Version 3.1 and analyzed using STATA Version 14.0. Descriptive statistics were used to examine patterns of health facilities utilization and multivariable logistic regression analysis was applied to identify predictors associated with health-seeking behavior. Most mothers/caregivers (70.8%) sought care either at home (14.2%) or health facilities (56.6%), whereas 29.2% reported that they did not seek any care. Of those who consulted health facilities, government health facilities (76.9%) were more utilized than private (18.0%) and informal (5.1%) health facilities. Nearly all (93.9%) of the mothers/caregivers using government health facilities used health centers, and of those who took their children to private health facilities (60.9%) used clinics and 26.1% used pharmacies/drug vendors. Mothers/caregivers visiting health facilities obtained mainly oral rehydration salt (ORS) (39.8%) and home-recommended fluids (HRF) (40.3%), but few of them (11.9%) obtained ORS plus zinc supplementation. Predisposing factors of literacy of mothers/caregivers (adjusted odds ratio (AOR) = 2.4; 95% CI 1.4-4.1) and occupation (AOR = 2.6; 95% CI 1.5-4.6), the enabling factors of households monthly income of 50 United States Dollars (US$) and above (AOR = 2.9; 95% CI 1.5-5.6) and availability of nearest health

Factors associated with utilization of dental services in a long-term care facility: a descriptive cross-sectional study.

PubMed

Scannapieco, Frank A; Amin, Summar; Salme, Marc; Tezal, Mine

2017-03-01

To describe factors associated with the utilization of dental services in a long-term care facility (LTCF) in Western New York. A descriptive cross-sectional study reviewed the dental and medical records of residents of an LTCF discharged between January 1, 2008 and December 30, 2012. Information on demographic and health variables at admission was extracted from electronic health records. Information on oral health variables was extracted from patient charts. A total of 2,516 residents were discharged between 2008 and 2012. From those, 259 (10.3%) utilized dental services at least once during their stay. Those who utilized dental services were significantly older at admission (78.5 vs. 82.0 years, p < 0.001), stayed longer (1.6 vs. 3.9 years, p < 0.001), more likely to be female (63.6 vs. 75.6%, p = 0.008), and less likely to be married (37.7 vs. 14.0%, p = < 0.001) compared to those who did not. Patients with endocrine, nutritional, metabolic, and immunity disorders, mental disorders, and circulatory system diseases were more likely to receive dental services. Dental services appear to be underutilized by residents of LTCF. Significant differences exist in demographic and health variables between residents who utilize these services compared to those who do not. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

Assessment of the Availability, Utilization and Management of ICT Facilities in Teaching English Language in Secondary Schools in Kaduna State, Nigeria

ERIC Educational Resources Information Center

Yusuf, Hanna Onyi; Maina, Bashir; Dare, Michael Omotayo

2013-01-01

The study investigated the availability, utilization and management of ICT facilities in teaching English language in secondary schools in Kaduna State, Nigeria. The study adopted a descriptive survey research design. A questionnaire titled "Availability, Utilization and Management of Information and Communication Technology in teaching…

Distance from health facility and mothers' perception of quality related to skilled delivery service utilization in northern Ethiopia.

PubMed

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

2017-01-01

Poor maternal health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia. A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia. Multistage sampling technique was used to select mothers from the identified clusters. Households within a 10 km radius of the health facility were taken as a cluster for a community survey. Data were collected using face-to-face interview at the household level. We compared the mothers who reported giving birth to the index child in a health facility and those who reported delivering at home, in order to identify the predictors of skilled delivery utilization. Multivariable logistic regression model was used to determine the predictors of skilled delivery service utilization. The results are presented with odds ratio (OR) and 95% confidence interval (CI). A total of 1,796 mothers participated in the study, with a 100% response rate. Distance to health facilities (adjusted odds ratio [AOR] =0.53 [95% CI: 0.39, 0.71]), perception of mothers to the availability of adequate equipment in the delivery service in their catchment area (AOR =1.5 [95% CI: 1.11, 2.13]), experiencing any complication during childbirth, using antenatal care, lower birth order and having an educated partner were the significant predictors of skilled delivery service utilization. Implementing community-based intervention programs that will address the physical accessibility of delivery services, such as the ambulance service, road issues and waiting rooms, and improving quality maternity service will likely reduce the current problem.

Distance from health facility and mothers’ perception of quality related to skilled delivery service utilization in northern Ethiopia

PubMed Central

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

2017-01-01

Background Poor maternal health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia. Subjects and methods A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia. Multistage sampling technique was used to select mothers from the identified clusters. Households within a 10 km radius of the health facility were taken as a cluster for a community survey. Data were collected using face-to-face interview at the household level. We compared the mothers who reported giving birth to the index child in a health facility and those who reported delivering at home, in order to identify the predictors of skilled delivery utilization. Multivariable logistic regression model was used to determine the predictors of skilled delivery service utilization. The results are presented with odds ratio (OR) and 95% confidence interval (CI). Results A total of 1,796 mothers participated in the study, with a 100% response rate. Distance to health facilities (adjusted odds ratio [AOR] =0.53 [95% CI: 0.39, 0.71]), perception of mothers to the availability of adequate equipment in the delivery service in their catchment area (AOR =1.5 [95% CI: 1.11, 2.13]), experiencing any complication during childbirth, using antenatal care, lower birth order and having an educated partner were the significant predictors of skilled delivery service utilization. Conclusion Implementing community-based intervention programs that will address the physical accessibility of delivery services, such as the ambulance service, road issues and waiting rooms, and improving quality maternity service will likely reduce the current

Analysis on the Utility of Satellite Imagery for Detection of Agricultural Facility

NASA Astrophysics Data System (ADS)

Kang, J.-M.; Baek, S.-H.; Jung, K.-Y.

2012-07-01

Now that the agricultural facilities are being increase owing to development of technology and diversification of agriculture and the ratio of garden crops that are imported a lot and the crops cultivated in facilities are raised in Korea, the number of vinyl greenhouses is tending upward. So, it is important to grasp the distribution of vinyl greenhouses as much as that of rice fields, dry fields and orchards, but it is difficult to collect the information of wide areas economically and correctly. Remote sensing using satellite imagery is able to obtain data of wide area at the same time, quickly and cost-effectively collect, monitor and analyze information from every object on earth. In this study, in order to analyze the utilization of satellite imagery at detection of agricultural facility, image classification was performed about the agricultural facility, vinyl greenhouse using Formosat-2 satellite imagery. The training set of sea, vegetation, building, bare ground and vinyl greenhouse was set to monitor the agricultural facilities of the object area and the training set for the vinyl greenhouses that are main monitoring object was classified and set again into 3 types according the spectral characteristics. The image classification using 4 kinds of supervise classification methods applied by the same training set were carried out to grasp the image classification method which is effective for monitoring agricultural facilities. And, in order to minimize the misclassification appeared in the classification using the spectral information, the accuracy of classification was intended to be raised by adding texture information. The results of classification were analyzed regarding the accuracy comparing with that of naked-eyed detection. As the results of classification, the method of Mahalanobis distance was shown as more efficient than other methods and the accuracy of classification was higher when adding texture information. Hence the more effective

41 CFR 102-74.310 - What measures must Federal agencies take to improve the utilization of parking facilities?

Code of Federal Regulations, 2010 CFR

2010-07-01

...) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Parking Facilities... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What measures must Federal agencies take to improve the utilization of parking facilities? 102-74.310 Section 102-74.310...

Design summary of a geostationary facility utilized as a communications platform

NASA Technical Reports Server (NTRS)

Barberis, N. J.; Brown, J. V.

1986-01-01

This paper describes the technical aspects of a geostationary platform facility that makes maximum use of the planned NASA space station and its elements, mainly the orbital maneuvering vehicle (OMV) and the orbital transfer vehicles (OTV). The platform design concept is described, with emphasis on the key technologies utilized to configure the platform. Key systems aspects include a design summary with discussion of the controls, telemetry, command and ranging, power, propulsion, control electronics, thermal control subsystems, and space station interfaces. The use of the facility as a communications platform is developed to demonstrate the attractiveness of the concept. The economic benefits are discussed, as well as the concept of servicing for payload upgrade.

Social capital, outpatient care utilization and choice between different levels of health facilities in rural and urban areas of Bhutan.

PubMed

Herberholz, Chantal; Phuntsho, Sonam

2018-06-18

This study examines the factors that explain outpatient care utilization and the choice between different levels of health facilities in Bhutan, focusing on individual social capital, given Bhutan's geography of remote and sparsely populated areas. The more isolated the living, the more important individual social capital may become. Standard factors proposed by the Andersen model of healthcare utilization serve as control variables. Data for 2526 households from the 2012 Bhutan Living Standards Survey, which contains a social capital module covering structural, cognitive and output dimensions of social capital, are used. The results from the logistic regression analysis show that individual social capital is positively related with the probability of seeking treatment when ill or injured. Informal social contacts and perceived help and support are most important in rural areas, whereas specific trust matters in urban areas. The explanatory power of the model using a subset of the data for urban areas only, however, is very low as most predisposing and enabling factors are insignificant, which is not surprising though in view of better access to health facilities in urban areas and the fact that healthcare is provided free of charge in Bhutan. Multinomial regression results further show that structural and output dimensions of social capital influence the likelihood of seeking care at secondary or tertiary care facilities relative to primary care facilities. Moreover, economic status and place of residence are significantly associated with healthcare utilization and choice of health facility. The findings with respect to social capital suggest that strategizing and organizing social capital may help improve healthcare utilization in Bhutan. Copyright © 2018 Elsevier Ltd. All rights reserved.

Some Factors Influencing Effective Utilization of Drinking Water Facilities: Women, Income, and Health in Rural North Ghana

NASA Astrophysics Data System (ADS)

Kendie, S. B.

1996-01-01

In the examination of the implementation of rural drinking water facilities, not enough attention has been paid to analyzing the socioeconomic and political relationships that affect the effective utilization of the facilities, particularly as these relate to women in rural society. This paper suggests that much of the difficulty in instituting the utilization of safe water supply sources has to do with the rather low economic status of women—the main water collectors. Poverty consigns women to long periods of work in activities or jobs that bring little reward. This makes it difficult to effectively digest the messages delivered by program staff and limits the extent of usage of the safe water facilities.

Casas Maternas in the Rural Highlands of Guatemala: A Mixed-Methods Case Study of the Introduction and Utilization of Birthing Facilities by an Indigenous Population.

PubMed

Stollak, Ira; Valdez, Mario; Rivas, Karin; Perry, Henry

2016-03-01

An international NGO, with financial and managerial support from "partner" communities, established Casas Maternas (birthing facilities) in 3 municipalities in the isolated northwestern highlands of the department of Huehuetenango in Guatemala-an area with high maternal mortality ratio (338 maternal deaths per 100,000 live births). Traditional birth attendants are encouraged to bring patients for delivery at the Casas Maternas, where trained staff are present and access to referral care is facilitated. We conducted a mixed-methods study in San Sebastian Coatán municipality to assess the contribution of 2 Casas Maternas to health facility deliveries among partner and non-partner communities, with particular emphasis on equity in access. We surveyed all women who delivered in the study area between April 2013 and March 2014, the first full year in which both Casas Maternas in the study area were operating. In addition, using purposive sampling, we conducted in-depth interviews with 22 women who delivered and 6 focus group discussions with 42 community leaders, traditional birth attendants, and Casas Maternas staff members. We analyzed the quantitative data using descriptive statstics and the qualitative data with descriptive content analysis. Of the 321 women eligible for inclusion in the study, we surveyed 275 women (14.3% could not be located or refused to participate). Between April 2013 and March 2014, 70% of women living in partner communities delivered in a health facility (54% in a Casa Materna) compared with 30% of women living in non-partner communities (17% in a Casa Materna). There was no statistically significant difference in uptake of the Casa Materna by maternal education and only a weak effect by household wealth. In contrast, distance from the Casa Materna had a pronounced effect. Traditional birth attendants were strong advocates for utilization of the Casa Materna and played an important role in the decision regarding where the birth would take

Impact of decentralization on health services in Uganda: a look at facility utilization, prescribing and availability of essential drugs.

PubMed

Anokbonggo, W W; Ogwal-Okeng, J W; Obua, C; Aupont, O; Ross-Degnan, D

2004-02-01

Uganda began implementation of a structural adjustment programme (SAP) in July 1994 in order to improve social services. The decentralization of health services administration to district level was intended to improve the quality of health services and pharmaceutical supplies in the hospitals, with resultant increase in the level of utilization of health facilities. This study evaluated the impact of the decentralization policy on health facility utilization; availability of essential drugs, and prescribing patterns for acute respiratory infections (ARI), diarrhoea, and malaria in two district hospitals in Uganda. Mixed method evaluation design, involving both quantitative and qualitative methods. Time series analyses of data from utilization, pharmacy stock, and prescription records before and after the policy change. Key informant interviews and focus group discussions to obtain information on perceptions and attitude of stakeholders on the process of the policy implementation. STUDY SETTING AND POPULATION: The study was conducted in two district hospitals in northern Uganda. A total of seven years of utilization and pharmacy stock data including 5040 patient records from the hospitals were analysed retrospectively. In-depth interviews were conducted among 11 politicians from each district; 100 open-ended questionnaires were administered to patients in each hospital; 86 health care workers were interviewed using semi-structured questionnaires; and focus group discussions were conducted with 23 health care providers. Facility utilization was evaluated by average monthly attendance in the outpatient department and paediatric ward admissions. Availability was assessed as average number of drugs per month. Prescribing indicator outcomes included: for malaria, percent chloroquine tablets and percent chloroquine injection; for ARI, percent receiving antibiotics or injections; for diarrhoea, use of oral rehydration salts (ORS), antidiarrhoeal mixtures, and antibiotics

Casas Maternas in the Rural Highlands of Guatemala: A Mixed-Methods Case Study of the Introduction and Utilization of Birthing Facilities by an Indigenous Population

PubMed Central

Stollak, Ira; Valdez, Mario; Rivas, Karin; Perry, Henry

2016-01-01

ABSTRACT Background: An international NGO, with financial and managerial support from “partner” communities, established Casas Maternas (birthing facilities) in 3 municipalities in the isolated northwestern highlands of the department of Huehuetenango in Guatemala—an area with high maternal mortality ratio (338 maternal deaths per 100,000 live births). Traditional birth attendants are encouraged to bring patients for delivery at the Casas Maternas, where trained staff are present and access to referral care is facilitated. Methods: We conducted a mixed-methods study in San Sebastian Coatán municipality to assess the contribution of 2 Casas Maternas to health facility deliveries among partner and non-partner communities, with particular emphasis on equity in access. We surveyed all women who delivered in the study area between April 2013 and March 2014, the first full year in which both Casas Maternas in the study area were operating. In addition, using purposive sampling, we conducted in-depth interviews with 22 women who delivered and 6 focus group discussions with 42 community leaders, traditional birth attendants, and Casas Maternas staff members. We analyzed the quantitative data using descriptive statstics and the qualitative data with descriptive content analysis. Results: Of the 321 women eligible for inclusion in the study, we surveyed 275 women (14.3% could not be located or refused to participate). Between April 2013 and March 2014, 70% of women living in partner communities delivered in a health facility (54% in a Casa Materna) compared with 30% of women living in non-partner communities (17% in a Casa Materna). There was no statistically significant difference in uptake of the Casa Materna by maternal education and only a weak effect by household wealth. In contrast, distance from the Casa Materna had a pronounced effect. Traditional birth attendants were strong advocates for utilization of the Casa Materna and played an important role in the

The effect of user fee exemption on the utilization of maternal health care at mission health facilities in Malawi

PubMed Central

Manthalu, Gerald; Yi, Deokhee; Farrar, Shelley; Nkhoma, Dominic

2016-01-01

The Government of Malawi has signed contracts called service level agreements (SLAs) with mission health facilities in order to exempt their catchment populations from paying user fees. Government in turn reimburses the facilities for the services that they provide. SLAs started in 2006 with 28 out of 165 mission health facilities and increased to 74 in 2015. Most SLAs cover only maternal, neonatal and in some cases child health services due to limited resources. This study evaluated the effect of user fee exemption on the utilization of maternal health services. The difference-in-differences approach was combined with propensity score matching to evaluate the causal effect of user fee exemption. The gradual uptake of the policy provided a natural experiment with treated and control health facilities. A second control group, patients seeking non-maternal health care at CHAM health facilities with SLAs, was used to check the robustness of the results obtained using the primary control group. Health facility level panel data for 142 mission health facilities from 2003 to 2010 were used. User fee exemption led to a 15% (P <  0.01) increase in the mean proportion of women who made at least one antenatal care (ANC) visit during pregnancy, a 12% (P < 0.05) increase in average ANC visits and an 11% (P < 0.05) increase in the mean proportion of pregnant women who delivered at the facilities. No effects were found for the proportion of pregnant women who made the first ANC visit in the first trimester and the proportion of women who made postpartum care visits. We conclude that user fee exemption is an important policy for increasing maternal health care utilization. For certain maternal services, however, other determinants may be more important. PMID:27175033

The effect of user fee exemption on the utilization of maternal health care at mission health facilities in Malawi.

PubMed

Manthalu, Gerald; Yi, Deokhee; Farrar, Shelley; Nkhoma, Dominic

2016-11-01

The Government of Malawi has signed contracts called service level agreements (SLAs) with mission health facilities in order to exempt their catchment populations from paying user fees. Government in turn reimburses the facilities for the services that they provide. SLAs started in 2006 with 28 out of 165 mission health facilities and increased to 74 in 2015. Most SLAs cover only maternal, neonatal and in some cases child health services due to limited resources. This study evaluated the effect of user fee exemption on the utilization of maternal health services. The difference-in-differences approach was combined with propensity score matching to evaluate the causal effect of user fee exemption. The gradual uptake of the policy provided a natural experiment with treated and control health facilities. A second control group, patients seeking non-maternal health care at CHAM health facilities with SLAs, was used to check the robustness of the results obtained using the primary control group. Health facility level panel data for 142 mission health facilities from 2003 to 2010 were used. User fee exemption led to a 15% (P <  0.01) increase in the mean proportion of women who made at least one antenatal care (ANC) visit during pregnancy, a 12% (P < 0.05) increase in average ANC visits and an 11% (P < 0.05) increase in the mean proportion of pregnant women who delivered at the facilities. No effects were found for the proportion of pregnant women who made the first ANC visit in the first trimester and the proportion of women who made postpartum care visits. We conclude that user fee exemption is an important policy for increasing maternal health care utilization. For certain maternal services, however, other determinants may be more important. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Measuring the Efficient Utilization of Medical Personnel at Navy Military Treatment Facilities

DTIC Science & Technology

1990-06-01

measures of effectiveness (MOE) for utilizing manpower at a medical treatment facility by analyzing data from Navy hospitals. The MOE will be able to...at Navy facili- ties will be used to compare alternative MOEs., The data resources are categorized into expenditures, Naval health-care statistics ...of years., At the Office of the Chief of Naval Operations, OP-801 maintains financial data of medical budgets, 2. NAVAL HEALTH-CARE STATISTICS The

Effect of Facility Ownership on Utilization of Arthroscopic Shoulder Surgery.

PubMed

Black, Eric M; Reynolds, John; Maltenfort, Mitchell G; Williams, Gerald R; Abboud, Joseph A; Lazarus, Mark D

2018-03-01

We examined practice patterns and surgical indications in the management of common shoulder procedures by surgeons practicing at physician-owned facilities. This study was a retrospective analysis of 501 patients who underwent arthroscopic shoulder procedures performed by five surgeons in our practice at one of five facilities during an 18-month period. Two of the facilities were physician-owned, and three of the five surgeons were shareholders. Demographics, insurance status, symptom duration, time from injury/symptom onset to the decision to perform surgery (at which time surgical consent is obtained), and time to schedule surgery were studied to determine the influence of facility type and physician shareholder status. Median duration of symptoms before surgery was significantly shorter in workers' compensation patients than in non-workers' compensation patients (47% less; P < 0.0001) and in men than in women (31% less; P < 0.001), but was not influenced by shareholder status or facility ownership (P > 0.05). Time between presentation and surgical consent was not influenced by facility ownership (P = 0.39) or shareholder status (P = 0.50). Time from consent to procedure was 13% faster in physician-owned facilities than in non-physician-owned facilities (P = 0.03) and 35% slower with shareholder physicians than with nonshareholder physicians (P < 0.0001). The role of physician investment in private healthcare facilities has caused considerable debate in the orthopaedic surgery field. To our knowledge, this study is the first to examine the effects of shareholder status and facility ownership on surgeons' practice patterns, surgical timing, and measures of nonsurgical treatment before shoulder surgery. Neither shareholder status nor facility ownership characteristics influenced the speed with which surgeons determined that shoulder surgery was indicated or surgeons' use of preoperative nonsurgical treatment. After the need for surgery was determined, patients

Do resource utilization and clinical measures still vary across dialysis chains after controlling for the local practices of facilities and physicians?

PubMed

Hirth, Richard A; Turenne, Marc N; Wheeler, John R C; Ma, Yu; Messana, Joseph M

2010-08-01

Because of adverse survival effects, anemia management and financial incentives to increase doses of erythropoiesis-stimulating agents (ESAs) have been controversial. Prior studies showed more aggressive anemia management in dialysis facilities owned by for-profit chains, but have been criticized for not accounting for practices of individual physicians and facilities. To improve understanding of how dialysis practices and resource utilization are influenced by physicians, facilities, and chains. Mixed models with chain fixed effects and facility and physician random effects. Medicare hemodialysis patients in 2004. A total of 234,158 patients, 3995 facilities, 4838 physicians, and 7 chain classifications were included. Spending per session for dialysis-related services billed separately from the dialysis treatment and for ESAs. Achievement of hematocrit (HCT) and urea reduction ratio (URR) targets. Of the 4 largest for-profit chains, 3 had higher resource use than independents, with differences up to $17.92 higher ESA/session. Utilization was positively associated with achieving target HCT. Despite incurring lower costs, patients treated by a large nonprofit chain were as likely as patients of independents to achieve the HCT target. The largest chains were more likely than independents to achieve the URR target. Substantial variation occurred across physicians and facilities, and adjustment for chain only modestly decreased this variation. Chains' methods of influencing practices were not directly observed. Chains appear to have the ability to implement protocols that shift practices, but not the ability to substantially reduce local variation. Assertions that chain effects found by earlier studies were spurious are not supported.

National facilities study. Volume 5: Space research and development facilities task group

NASA Technical Reports Server (NTRS)

1994-01-01

With the beginnings of the U.S. space program, there was a pressing need to develop facilities that could support the technology research and development, testing, and operations of evolving space systems. Redundancy in facilities that was once and advantage in providing flexibility and schedule accommodation is instead fast becoming a burden on scarce resources. As a result, there is a clear perception in many sectors that the U.S. has many space R&D facilities that are under-utilized and which are no longer cost-effective to maintain. At the same time, it is clear that the U.S. continues to possess many space R&D facilities which are the best -- or among the best -- in the world. In order to remain world class in key areas, careful assessment of current capabilities and planning for new facilities is needed. The National Facility Study (NFS) was initiated in 1992 to develop a comprehensive and integrated long-term plan for future aerospace facilities that meets current and projected government and commercial needs. In order to assess the nation's capability to support space research and development (R&D), a Space R&D Task Group was formed. The Task Group was co-chaired by NASA and DOD. The Task Group formed four major, technologically- and functionally- oriented working groups: Human and Machine Operations; Information and Communications; Propulsion and Power; and Materials, Structures, and Flight Dynamics. In addition to these groups, three supporting working groups were formed: Systems Engineering and Requirements; Strategy and Policy; and Costing Analysis. The Space R&D Task Group examined several hundred facilities against the template of a baseline mission and requirements model (developed in common with the Space Operations Task Group) and a set of excursions from the baseline. The model and excursions are described in Volume 3 of the NFS final report. In addition, as a part of the effort, the group examined key strategic issues associated with space R

Perceived barriers to utilizing maternal and neonatal health services in contracted-out versus government-managed health facilities in the rural districts of Pakistan.

PubMed

Riaz, Atif; Zaidi, Shehla; Khowaja, Asif Raza

2015-03-06

A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs) in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users' perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH) services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted). A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs) conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong community-based behavior change strategies. © 2015 by Kerman University of Medical Sciences.

Perceived barriers to utilizing maternal and neonatal health services in contracted-out versus government-managed health facilities in the rural districts of Pakistan

PubMed Central

Riaz, Atif; Zaidi, Shehla; Khowaja, Asif Raza

2015-01-01

Background: A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs) in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users’ perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH) services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted). Methods: A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs) conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Results: Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Conclusion: Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong community-based behavior change strategies. PMID:25905478

43 CFR 3276.15 - How must I notify BLM of accidents occurring at my utilization facility?

Code of Federal Regulations, 2011 CFR

2011-10-01

... occurring at my utilization facility? You must orally inform us of all accidents that affect operations or create environmental hazards within 24 hours after each accident. When you contact us, we may require you...

Nesting ecology of a population of Gopherus agassizii at a utility-scale wind energy facility in southern California

USGS Publications Warehouse

Ennen, Joshua R.; Lovich, Jeffrey E.; Meyer, Katherin P.; Bjurlin, Curtis; Arundel, Terence R.

2012-01-01

We investigated the annual nesting ecology of a population of Desert Tortoises (Gopherus agassizii) inhabiting a utility-scale renewable energy (USRE) facility in southern California and compared our results with populations inhabiting relatively undisturbed sites. In 2000, 15 radio-tracked females produced 29 clutches, and 24 nests were monitored to examine nest-site selection, nest predation, hatching success, date of emergence of hatchlings, and hatchling mass and carapace length. Overall, the nesting ecology of the population inhabiting the USRE facility was very similar to other populations of Desert Tortoises inhabiting relatively undisturbed habitats. Oviposition occurred from 12 May to 8 July, which was similar to other sites. Nest depths (11.1 cm), nest predation (12%), hatchling emergence date (7 August and 29 September), and hatchling morphometrics (i.e., MCL: 44.5 mm; mass: 23 g) were all within ranges reported in other populations. Unlike within other populations, we observed no relationship between hatchling size and either maternal body size or egg width. We found no evidence of females selecting for a particular burrow for oviposition of eggs based on environmental or anthropogenic variables. Most nests were located in or near burrows, and nest depth was greater for nests near the entrance than those deeper in the burrow. Although this study suggests that the nesting ecology of the Desert Tortoise population we studied was not adversely affected by the USRE facility, this relationship is only correlative because our study was not a before-after-control-impact (BACI) study, which would establish a cause and effect relationship. As pointed out in a recent review, BACI studies are critically needed to address the wildlife impacts of utility-scale renewable energy development.

A preliminary assessment of avian mortality at utility-scale solar energy facilities in the United States

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

Walston, Leroy J.; Rollins, Katherine E.; LaGory, Kirk E.

Despite the benefits of reduced toxic and carbon emissions and a perpetual energy resource, there is potential for negative environmental impacts resulting from utility-scale solar energy (USSE) development. Although USSE development may represent an avian mortality source, there is little knowledge regarding the magnitude of these impacts in the context of other avian mortality sources. In this study we present a first assessment of avian mortality at USSE facilities through a synthesis of available avian monitoring and mortality information at existing USSE facilities. Using this information, we contextualize USSE avian mortality relative to other forms of avian mortality at 2more » spatial scales: a regional scale (confined to southern California) and a national scale. Systematic avian mortality information was available for three USSE facilities in the southern California region. We estimated annual USSE-related avian mortality to be between 16,200 and 59,400 birds in the southern California region, which was extrapolated to between 37,800 and 138,600 birds for all USSE facilities across the United States that are either installed or under construction. We also discuss issues related to avian–solar interactions that should be addressed in future research and monitoring programs.« less

National facilities study. Volume 4: Space operations facilities task group

NASA Technical Reports Server (NTRS)

1994-01-01

The principal objectives of the National Facilities Study (NFS) were to: (1) determine where U.S. facilities do not meet national aerospace needs; (2) define new facilities required to make U.S. capabilities 'world class' where such improvements are in the national interest; (3) define where consolidation and phase-out of existing facilities is appropriate; and (4) develop a long-term national plan for world-class facility acquisition and shared usage. The Space Operations Facilities Task Group defined discrete tasks to accomplish the above objectives within the scope of the study. An assessment of national space operations facilities was conducted to determine the nation's capability to meet the requirements of space operations during the next 30 years. The mission model used in the study to define facility requirements is described in Volume 3. Based on this model, the major focus of the Task Group was to identify any substantive overlap or underutilization of space operations facilities and to identify any facility shortfalls that would necessitate facility upgrades or new facilities. The focus of this initial study was directed toward facility recommendations related to consolidations, closures, enhancements, and upgrades considered necessary to efficiently and effectively support the baseline requirements model. Activities related to identifying facility needs or recommendations for enhancing U.S. international competitiveness and achieving world-class capability, where appropriate, were deferred to a subsequent study phase.

Study of Lyndon B. Johnson Space Center utility systems

NASA Technical Reports Server (NTRS)

Redding, T. E.; Huber, W. C.

1977-01-01

The results of an engineering study of potential energy saving utility system modifications for the NASA Lyndon B. Johnson Space Center are presented. The objective of the study was to define and analyze utility options that would provide facility energy savings in addition to the approximately 25 percent already achieved through an energy loads reduction program. A systems engineering approach was used to determine total system energy and cost savings resulting from each of the ten major options investigated. The results reported include detailed cost analyses and cost comparisons of various options. Cost are projected to the year 2000. Also included are a brief description of a mathematical model used for the analysis and the rationale used for a site survey to select buildings suitable for analysis.

Nonterrestrial utilization of materials: Automated space manufacturing facility

NASA Technical Reports Server (NTRS)

1982-01-01

Four areas related to the nonterrestrial use of materials are included: (1) material resources needed for feedstock in an orbital manufacturing facility, (2) required initial components of a nonterrestrial manufacturing facility, (3) growth and productive capability of such a facility, and (4) automation and robotics requirements of the facility.

Study of the impacts of regulations affecting the acceptance of Integrated Community Energy Systems: public utility, energy facility siting and municipal franchising regulatory programs in Rhode Island. Preliminary background report

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

Feurer, D A; Weaver, C L; Gallagher, K C

1980-01-01

The Rhode Island statutes vest in the Public Utility Commission and the Division of Public Utilities the exclusive power and authority to regulate public utility companies in that state. Both bodies have been established within the Department of Business Regulation but are independent of the Department's director and are not under his jurisdiction. The jurisdiction to regulate utilities is shared by the Commission and the Division. The Commission serves as a quasi-judicial tribunal with jurisdiction, powers, and duties to hold investigations and hearings involving rates, sufficiency and resonableness of facilities, gas, electric, water, and pipeline public utilities. The administrator, whomore » is chief executive officer of the Division, is responsible for exercising the jurisdiction, supervision, powers, and duties not specifically assigned to the Commission. By virtue of his office, the chairman of the Commission serves also as the administrator and he supervises and directs the execution of all laws relating to public utilities and carriers and all regulations and orders of the Commission governing the conduct and charges of public utilities. Public utility regulatory statutes, energy facility siting programs, and municipal franchising authority are examined to identify how they may impact on the ability of an organization, whether or not it be a regulated utility, to construct and operate an ICES.« less

National Facilities study

NASA Technical Reports Server (NTRS)

1994-01-01

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

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

PubMed

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

2002-02-01

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

The Utilization and Design of Physical Facilities for the Rehabilitation of Mentally Retarded. Final Project Report.

ERIC Educational Resources Information Center

Bair, Howard V.; Leland, Henry

To investigate the appropriate design and utilization of physical facilities being constructed as a rehabilitation center, a variety of centers was examined. Conclusions were that flexibility in construction of the physical plant, including nonpermanent walls and fixtures was necessary; program planning should be included in architectural…

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

ERIC Educational Resources Information Center

Usen, Onodiong Mfreke

2016-01-01

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

Capacity utilization study for aviation security cargo inspection queuing system

NASA Astrophysics Data System (ADS)

Allgood, Glenn O.; Olama, Mohammed M.; Lake, Joe E.; Brumback, Daryl

2010-04-01

In this paper, we conduct performance evaluation study for an aviation security cargo inspection queuing system for material flow and accountability. The queuing model employed in our study is based on discrete-event simulation and processes various types of cargo simultaneously. Onsite measurements are collected in an airport facility to validate the queuing model. The overall performance of the aviation security cargo inspection system is computed, analyzed, and optimized for the different system dynamics. Various performance measures are considered such as system capacity, residual capacity, throughput, capacity utilization, subscribed capacity utilization, resources capacity utilization, subscribed resources capacity utilization, and number of cargo pieces (or pallets) in the different queues. These metrics are performance indicators of the system's ability to service current needs and response capacity to additional requests. We studied and analyzed different scenarios by changing various model parameters such as number of pieces per pallet, number of TSA inspectors and ATS personnel, number of forklifts, number of explosives trace detection (ETD) and explosives detection system (EDS) inspection machines, inspection modality distribution, alarm rate, and cargo closeout time. The increased physical understanding resulting from execution of the queuing model utilizing these vetted performance measures should reduce the overall cost and shipping delays associated with new inspection requirements.

Capacity Utilization Study for Aviation Security Cargo Inspection Queuing System

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

Allgood, Glenn O; Olama, Mohammed M; Lake, Joe E

In this paper, we conduct performance evaluation study for an aviation security cargo inspection queuing system for material flow and accountability. The queuing model employed in our study is based on discrete-event simulation and processes various types of cargo simultaneously. Onsite measurements are collected in an airport facility to validate the queuing model. The overall performance of the aviation security cargo inspection system is computed, analyzed, and optimized for the different system dynamics. Various performance measures are considered such as system capacity, residual capacity, throughput, capacity utilization, subscribed capacity utilization, resources capacity utilization, subscribed resources capacity utilization, and number ofmore » cargo pieces (or pallets) in the different queues. These metrics are performance indicators of the system s ability to service current needs and response capacity to additional requests. We studied and analyzed different scenarios by changing various model parameters such as number of pieces per pallet, number of TSA inspectors and ATS personnel, number of forklifts, number of explosives trace detection (ETD) and explosives detection system (EDS) inspection machines, inspection modality distribution, alarm rate, and cargo closeout time. The increased physical understanding resulting from execution of the queuing model utilizing these vetted performance measures should reduce the overall cost and shipping delays associated with new inspection requirements.« less

Study of the impacts of regulations affecting the acceptance of Integrated Community Energy Systems: public utility, energy facility siting and municipal franchising regulatory programs in Nebraska. Preliminary background report

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

Feurer, D A; Weaver, C L; Gallagher, K C

1980-01-01

The state agency with principal authority to regulate electric public utilities is the Power Review Board (Board). However, the Board in fact, exercised little regulatory authority over heat and power utilities because all electrical power in Nebraska is currently supplied by public authorities and is not subject to regulation by the Board. Gas and water utilities are also subject to general supervision by municipalities. The Board is compised of five members - an attorney, an engineer, one accountant, two lay - persons appointed by the governor and confirmed by the legislature. All members are appointed to overlapping four-year terms, andmore » none may serve more than two consecutive terms. Decisions by the Board require the approval of a majority of its members. The Public Service Commission of Nebraska is a constitutionally created body. Its powers and duties include the regulation of rates, service, and general control of common carriers as the legislature may provide by law. Other state agencies also possess limited regulatory jurisdiction which may be relevant to an energy facility. Public utility regulatory statutes, energy facility siting programs, and municipal franchising authority are examined to identify how they may impact on the ability of an organization, whether or not it be a regulated utility, to construct and operate an ICES.« less

Window Observational Research Facility (WORF)

NASA Technical Reports Server (NTRS)

Pelfrey, Joseph; Sledd, Annette

2007-01-01

This viewgraph document concerns the Window Observational Research Facility (WORF) Rack, a unique facility designed for use with the US Lab Destiny Module window. WORF will provide valuable resources for Earth Science payloads along with serving the purpose of protecting the lab window. The facility can be used for remote sensing instrumentation test and validation in a shirt sleeve environment. WORF will also provide a training platform for crewmembers to do orbital observations of other planetary bodies. WORF payloads will be able to conduct terrestrial studies utilizing the data collected from utilizing WORF and the lab window.

21 CFR 200.10 - Contract facilities (including consulting laboratories) utilized as extramural facilities by...

Code of Federal Regulations, 2010 CFR

2010-04-01

... (IND) Application, any information obtained during the inspection of an extramural facility having a... Administration does not consider results of validation studies of analytical and assay methods and control...

Monitoring potential ecological impacts of a utility-scale photovoltaic panel facility on a creosote-bursage plant community

NASA Astrophysics Data System (ADS)

Apodaca, L.; Devitt, D. A.

2016-12-01

High energy demands and greater financial viability have propelled recent growth in the solar energy market. Southern Nevada is poised to become a major contributor of green energy through the commissioning of public and private lands for solar development, but there exists a pressing need to better understand the ecological consequences of these facilities as documentation of the impacts of large-scale solar operations on surrounding environments is severely lacking. The Copper Mountain 2 (CM2) solar facility in Eldorado Valley, Nevada, USA utilizes nearly 1.8 square kilometers of photovoltaic panels to generate enough energy to power about 50,000 homes and is situated within a predominately creosote (Larrea tridentata) and white bursage (Ambrosia dumosa) habitat. Currently, the potential impacts on the local environment related to this massive development are being studied from two perspectives: microclimate effects and alteration of surface hydrology. A series of meteorological towers and ibuttons are being used to monitor microclimate changes in the area of CM2 and the adjacent natural habitat as localized climate within the facility may be altering growing conditions in nearby desert plant communities. Because the placement of CM2 represents a major obstacle to established surface water flow, a transect of soil moisture probe access tubes have been placed in association with creosote plants along a downslope gradient from the facility to observe changes to soil water storage. Individual creosote and bursage plant physiologies are also being monitored to study any potential increase in plant stress influenced by the CM2 solar facility. Most measurements have been ongoing for at least one year. Greater details on the research infrastructure will be presented along with the latest observational data.

Association of Inpatient Antimicrobial Utilization Measures with Antimicrobial Stewardship Activities and Facility Characteristics of Veterans Affairs Medical Centers.

PubMed

Graber, Christopher J; Jones, Makoto M; Chou, Ann F; Zhang, Yue; Goetz, Matthew Bidwell; Madaras-Kelly, Karl; Samore, Matthew H; Glassman, Peter A

2017-05-01

Antimicrobial stewardship programs (ASPs) have been advocated to improve antimicrobial utilization, but program implementation is variable. Antimicrobial stewardship programs (ASPs) have been advocated to improve antimicrobial utilization, but program implementation is variable. To determine associations between ASPs and facility characteristics, and inpatient antimicrobial utilization measures in the Veterans Affairs (VA) system in 2012. In 2012, VA administered a survey on antimicrobial stewardship practices to designated ASP contacts at VA acute care hospitals. From the survey, we identified 34 variables across 3 domains (evidence, organizational context, and facilitation) that were assessed using multivariable least absolute shrinkage and selection operator regression against 4 antimicrobial utilization measures from 2012: aggregate acute care antimicrobial use, antimicrobial use in patients with non-infectious primary discharge diagnoses, missed opportunities to convert from parenteral to oral antimicrobial therapy, and double anaerobic coverage. All 130 VA facilities with acute care services. Variables associated with at least 3 favorable changes in antimicrobial utilization included presence of postgraduate physician/pharmacy training programs, number of antimicrobial-specific order sets, frequency of systematic de-escalation review, presence of pharmacists and/or infectious diseases (ID) attendings on acute care ward teams, and formal ID training of the lead ASP pharmacist. Variables associated with 2 unfavorable measures included bed size, the level of engagement with VA Antimicrobial Stewardship Task Force online resources, and utilization of antimicrobial stop orders. Formalization of ASP processes and presence of pharmacy and ID expertise are associated with favorable utilization. Systematic de-escalation review and order set establishment may be high-yield interventions. Journal of Hospital Medicine 2017;12:301-309. © 2017 Society of Hospital Medicine

In-situ resource utilization in the design of advanced lunar facilities

NASA Technical Reports Server (NTRS)

1990-01-01

Resource utilization will play an important role in the establishment and support of a permanently manned lunar base. At the University of Houston - College of Architecture and the Sasakawa International Center for Space Architecture, a study team recently investigated the potential use of lunar in-situ materials in the design of lunar facilities. The team identified seven potential lunar construction materials; concrete, sulfur concrete, cast basalt, sintered basalt, glass, fiberglass, and metals. Analysis and evaluation of these materials with respect to their physical properties, processes, energy requirements, resource efficiency, and overall advantages and disadvantages lead to the selection of basalt materials as the more likely construction material for initial use on a lunar base. Basalt materials can be formed out of in-situ lunar regolith, with minor material beneficiation, by a simple process of heating and controlled cooling. The team then conceptualized a construction system that combines lunar regolith sintering and casting to make pressurized structures out of lunar resources. The design uses a machine that simultaneously excavates and sinters the lunar regolith to create a cylindrical hole, which is then enclosed with cast basalt slabs, allowing the volume to be pressurized for use as a living or work environment. Cylinder depths of up to 4 to 6 m in the lunar mare or 10 to 12 m in the lunar highlands are possible. Advantages of this construction system include maximum resource utilization, relatively large habitable volumes, interior flexibility, and minimal construction equipment needs. Conclusions of this study indicate that there is significant potential for the use of basalt, a lunar resource derived construction material, as a low cost alternative to Earth-based materials. It remains to be determined when in lunar base phasing this construction method should be implemented.

Utilizing Interns in Facilities Management

ERIC Educational Resources Information Center

Judkins, Clarissa; Morris, John P.; Molocznik, Chuck

2011-01-01

Facilities management is rapidly changing and developing from a position an individual stumbles into--or work one's way up through--to a discipline and vocation all of its own. There is a need for a collaborative strategy among leaders in practice, education, and research to share knowledge and experience and to establish professional and ethical…

The use of music in aged care facilities: A mixed-methods study.

PubMed

Garrido, Sandra; Dunne, Laura; Perz, Janette; Chang, Esther; Stevens, Catherine J

2018-02-01

Music is frequently used in aged care, being easily accessible and cost-effective. Research indicates that certain types of musical engagement hold greater benefits than others. However, it is not clear how effectively music is utilized in aged care facilities and what the barriers are to its further use. This study used a mixed-methods paradigm, surveying 46 aged care workers and conducting in-depth interviews with 5, to explore how music is used in aged care facilities in Australia, staff perceptions of the impact of music on residents, and the barriers to more effective implementation of music in aged care settings.

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

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

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

2013-09-01

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

18 CFR 292.602 - Exemption to qualifying facilities from the Public Utility Holding Company Act and certain State...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 292.602 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE PUBLIC UTILITY REGULATORY POLICIES ACT OF 1978 REGULATIONS UNDER SECTIONS... capacity over 30 megawatts if such facility produces electric energy solely by the use of biomass as a...

Study of the impacts of regulations affecting the acceptance of Integrated Community Energy Systems: public utility, energy facility siting and municipal franchising regulatory programs in Arizona. Preliminary background report

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

Feurer, D.A.; Weaver, C.L.; Gallagher, K.C.

1980-01-01

This report is one of a series of preliminary reports describing the laws and regulatory programs of the United States and each of the 50 states affecting the siting and operation of energy generating facilities likely to be used in Integrated Community Energy Systems (ICES). Public utility regulatory statutes, energy facility siting programs, and municipal franchising authority are examined to identify how they may impact on the ability of an organization, whether or not it be a regulated utility, to construct and operate an ICES. This report describes laws and regulatory programs in Arizona. The Arizona state constitution establishes themore » Arizona Corporation Commission to regulate public service corporations. Within the area of its jurisdiction, the Commission has exclusive power and may not be interfered with by the legislature except in one narrow instance as described in the case Corporation Commission v. Pacific Greyhound Lines.« less

Golden Eagle mortality at a utility-scale wind energy facility near Palm Springs, California

USGS Publications Warehouse

Lovich, Jeffrey E.

2015-01-01

Golden Eagle (Aquila chrysaetos) mortality associated with wind energy turbines and infrastructure is under-reported and weakly substantiated in the published literature. I report two cases of mortality at a utility-scale renewable energy facility near Palm Springs, California. The facility has been in operation since 1984 and included 460 65KW turbines mounted on 24.4 m or 42.7 m lattice-style towers with 8 m rotor diameters. One mortality event involved a juvenile eagle that was struck and killed by a spinning turbine blade on 31 August, 1995. The tower was 24.4 m high. The other involved an immature female that was struck by a spinning blade on another 24.4 m tower on 17 April, 1997 and was later euthanized due to the extent of internal injuries. Other raptor mortalities incidentally observed at the site, and likely attributable to turbines, included three Red-tailed Hawks (Buteo jamaicensis) found near turbines.

Does proximity of women to facilities with better choice of contraceptives affect their contraceptive utilization in rural Ethiopia?

PubMed Central

Spigt, Mark; Seme, Assefa; Amogne, Ayanaw; Skrøvseth, Stein; Desta, Selamawit; Radloff, Scott; GeertJan, Dinant

2017-01-01

decreased as distance from the nearest SDP increased; 41.2%, 27.5%, 22.0%, and 22.6% of women living less than 2 kilometers, 2 to 3.9kilometers, 4 to 5.9 kilometers and 6 or more kilometers, respectively (p-value<0.01). Additionally, women who live close to facilities that offer a wider range of contraceptive methods were significantly more likely to use modern contraceptives. The mCPR ranged from 42.3% among women who live within 2 kilometers of facilities offering 3 or more methods to 22.5% among women living more than 6 kilometers away from the nearest facility with the same number (3 or more methods) available after adjusting for observed covariates. Conclusions Although the majority of the Ethiopian population lives within a relatively close distance to lower level facilities (health posts), the number and range of methods available (method choice) and proximity are independently associated with contraceptive utilization. By demonstrating the extent to which objective measures of distance (of relatively small magnitude) explain variation in contraceptive use among rural women, the study fills an important planning gap for family planning programs operating in resource limited settings. PMID:29131860

Does proximity of women to facilities with better choice of contraceptives affect their contraceptive utilization in rural Ethiopia?

PubMed

Shiferaw, Solomon; Spigt, Mark; Seme, Assefa; Amogne, Ayanaw; Skrøvseth, Stein; Desta, Selamawit; Radloff, Scott; Tsui, Amy; GeertJan, Dinant

2017-01-01

nearest SDP increased; 41.2%, 27.5%, 22.0%, and 22.6% of women living less than 2 kilometers, 2 to 3.9kilometers, 4 to 5.9 kilometers and 6 or more kilometers, respectively (p-value<0.01). Additionally, women who live close to facilities that offer a wider range of contraceptive methods were significantly more likely to use modern contraceptives. The mCPR ranged from 42.3% among women who live within 2 kilometers of facilities offering 3 or more methods to 22.5% among women living more than 6 kilometers away from the nearest facility with the same number (3 or more methods) available after adjusting for observed covariates. Although the majority of the Ethiopian population lives within a relatively close distance to lower level facilities (health posts), the number and range of methods available (method choice) and proximity are independently associated with contraceptive utilization. By demonstrating the extent to which objective measures of distance (of relatively small magnitude) explain variation in contraceptive use among rural women, the study fills an important planning gap for family planning programs operating in resource limited settings.

Project definition study for the National Biomedical Tracer Facility

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

Roozen, K.

The University of Alabama at Birmingham (UAB) has conducted a study of the proposed National Biomedical Tracer Facility (NBTF). In collaboration with General Atomics, RUST International, Coleman Research Corporation (CRC), IsoMed, Ernst and Young and the advisory committees, they have examined the issues relevant to the NBTF in terms of facility design, operating philosophy, and a business plan. They have utilized resources within UAB, CRC and Chem-Nuclear to develop recommendations on environmental, safety and health issues. The Institute of Medicine Panel`s Report on Isotopes for Medicine and the Life Sciences took the results of prior workshops further in developing recommendationsmore » for the mission of the NBTF. The IOM panel recommends that the NBTF accelerator have the capacity to accelerate protons to 80 MeV and a minimum of 750 microamperes of current. The panel declined to recommend a cyclotron or a linac. They emphasized a clear focus on research and development for isotope production including target design, separation chemistry and generator development. The facility needs to emphasize education and training in its mission. The facility must focus on radionuclide production for the research and clinical communities. The formation of a public-private partnership resembling the TRIUMF-Nordion model was encouraged. An advisory panel should assist with the NBTF operations and prioritization.« less

A methodology to identify stranded generation facilities and estimate stranded costs for Louisiana's electric utility industry

NASA Astrophysics Data System (ADS)

Cope, Robert Frank, III

1998-12-01

The electric utility industry in the United States is currently experiencing a new and different type of growing pain. It is the pain of having to restructure itself into a competitive business. Many industry experts are trying to explain how the nation as a whole, as well as individual states, will implement restructuring and handle its numerous "transition problems." One significant transition problem for federal and state regulators rests with determining a utility's stranded costs. Stranded generation facilities are assets which would be uneconomic in a competitive environment or costs for assets whose regulated book value is greater than market value. At issue is the methodology which will be used to estimate stranded costs. The two primary methods are known as "Top-Down" and "Bottom-Up." The "Top-Down" approach simply determines the present value of the losses in revenue as the market price for electricity changes over a period of time into the future. The problem with this approach is that it does not take into account technical issues associated with the generation and wheeling of electricity. The "Bottom-Up" approach computes the present value of specific strandable generation facilities and compares the resulting valuations with their historical costs. It is regarded as a detailed and difficult, but more precise, approach to identifying stranded assets and their associated costs. This dissertation develops a "Bottom-Up" quantitative, optimization-based approach to electric power wheeling within the state of Louisiana. It optimally evaluates all production capabilities and coordinates the movement of bulk power through transmission interconnections of competing companies in and around the state. Sensitivity analysis to this approach is performed by varying seasonal consumer demand, electric power imports, and transmission inter-connection cost parameters. Generation facility economic dispatch and transmission interconnection bulk power transfers, specific

An Application of a Procedures Manual for Assessing the Socioeconomic Impact of the Construction and Operation of Coal Utilization Facilities in the Old West Region.

ERIC Educational Resources Information Center

Old West Regional Commission, Billings, MT.

To evaluate and test the effectiveness of the "Procedures Manual for Assisting the Socioeconomic Impact of the Construction and Operation of Coal Utilization Facilities in the Old West Region," an impact study of a proposed electric generating station on the Laramie River near Wheatland, Wyoming, identifies difficulties encountered in…

Gas-Grain Simulation Facility (GGSF). Volume 1: Stage 1 facility definition studies

NASA Technical Reports Server (NTRS)

Gat, Nahum

1993-01-01

The Gas-Grain Simulation Facility (GGSF) is a facility-type payload to be included in the Space Station Freedom (SSF). The GGSF is a multidisciplinary facility that will accommodate several classes of experiments, including exobiology, planetary science, atmospheric science, and astrophysics. The physical mechanisms envisioned to be investigated include crystal growth, aggregation, nucleation, coagulation, condensation, collisions, fractal growth, cycles of freezing and evaporation, scavenging, longevity of bacteria, and more. TRW performed a Phase A study that included analyses of the science and technical (S&T) requirements, the development of facility functional requirements, and a conceptual design of the facility. The work that was performed under Stage 1 of the Phase A study and the results to date are summarized. In this stage, facility definition studies were conducted in sufficient detail to establish the technical feasibility of the candidate strawman experiments. The studies identified technical difficulties, identified required facility subsystems, surveyed existing technology studies and established preliminary facility weight, volume, power consumption, data systems, interface definition, and crew time requirements. The results of this study served as the basis for Stage 2 of the Phase A study in which a conceptual design and a reference design were performed. The results also served as a basis for a related study for a Gas-Grain Simulation Experiment Module (GGSEM), which is an apparatus intended to perform a subset of the GGSF experiments on board a low-Earth-orbiting platform.

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

NASA Technical Reports Server (NTRS)

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

1991-01-01

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

Locations and attributes of utility-scale solar power facilities in Colorado and New Mexico, 2011

USGS Publications Warehouse

Ignizio, Drew A.; Carr, Natasha B.

2012-01-01

The data series consists of polygonal boundaries for utility-scale solar power facilities (both photovoltaic and concentrating solar power) located within Colorado and New Mexico as of December 2011. Attributes captured for each facility include the following: facility name, size/production capacity (in MW), type of solar technology employed, location, state, operational status, year the facility came online, and source identification information. Facility locations and perimeters were derived from 1-meter true-color aerial photographs (2011) produced by the National Agriculture Imagery Program (NAIP); the photographs have a positional accuracy of about ±5 meters (accessed from the NAIP GIS service: http://gis.apfo.usda.gov/arcgis/services). Solar facility perimeters represent the full extent of each solar facility site, unless otherwise noted. When visible, linear features such as fences or road lines were used to delineate the full extent of the solar facility. All related equipment including buildings, power substations, and other associated infrastructure were included within the solar facility. If solar infrastructure was indistinguishable from adjacent infrastructure, or if solar panels were installed on existing building tops, only the solar collecting equipment was digitized. The "Polygon" field indicates whether the "equipment footprint" or the full "site outline" was digitized. The spatial accuracy of features that represent site perimeters or an equipment footprint is estimated at +/- 10 meters. Facilities under construction or not fully visible in the NAIP imagery at the time of digitization (December 2011) are represented by an approximate site outline based on the best available information and documenting materials. The spatial accuracy of these facilities cannot be estimated without more up-to-date imagery – users are advised to consult more recent imagery as it becomes available. The "Status" field provides information about the operational

Study of the impacts of regulations affecting the acceptance of Integrated Community Energy Systems: public utility, energy facility siting and municipal franchising regulatory programs in Kentucky. Preliminary background report

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

Feurer, D A; Weaver, C L; Gallagher, K C

1980-01-01

Until April 1, 1979, the Public Service Commission had been vested with exclusive jurisdiction over the regulation of rates and service of utilities. As of that date two new agencies, the Energy Regulatory Commission (ERC) and the Utility Regulatory Commission (URC), have replaced the Public Service Commission. The ERC consists of three full-time members appointed by the governor for four year terms and is responsible for enforcing the provisions of the Kentucky statutes relating to electric and gas utilities. The three-member URC is responsible for enforcing the provisions relating to non-energy utilities such as telephone, sewer, and water utilities. Themore » statutes vest all regulatory authority over public utilities in either the ERC or the URC. Local governments retain only the power to grant local franchises. However, it should be noted, that any utility owned or operated by a political subdivision of the state is exempt from regulation. Thus, local government has complete authority over utilities which are self-owned. Public utility regulatory statutes, energy facility siting programs, and municipal franchising authority are examined to identify how they may impact on the ability of an organization, whether or not it be a regulated utility, to construct and operate an ICES.« less

Engineering study for a melting, casting, rolling and fabrication facility for recycled contaminated stainless steel

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

NONE

This Preliminary Report is prepared to study the facilities required for recycling contaminated stainless steel scrap into plate which will be fabricated into boxes suitable for the storage of contaminated wastes and rubble. The study is based upon the underlying premise that the most cost effective way to produce stainless steel is to use the same processes employed by companies now in production of high quality stainless steel. Therefore, the method selected for this study for the production of stainless steel plate from scrap is conventional process using an Electric Arc Furnace for meltdown to hot metal, a Continuous Castermore » for production of cast slabs, and a Reversing Hot Mill for rolling the slabs into plate. The fabrication of boxes from the plate utilizes standard Shears, Punch Presses and welding equipment with Robotic Manipulators. This Study presumes that all process fumes, building dusts and vapors will be cycled through a baghouse and a nuclear grade HEPA filter facility prior to discharge. Also, all process waste water will be evaporated into the hot flue gas stream from the furnace utilizing a quench tank; so there will be no liquid discharges from the facility and all vapors will be processed through a HEPA filter. Even though HEPA filters are used today in controlling radioactive contamination from nuclear facilities there is a sparsity of data concerning radioactivity levels and composition of waste that may be collected from contaminated scrap steel processing. This report suggests some solutions to these problems but it is recommended that additional study must be given to these environmental problems.« less

Race/ethnic disparities in the utilization of treatment for drug dependent inmates in U.S. state correctional facilities.

PubMed

Nowotny, Kathryn M

2015-01-01

Research has documented racial and ethnic disparities in utilization, access, continuity, and quality of care for psychiatric disorders including treatment for substance use disorders among those with similar need in the general community. Currently, the extent of racial and ethnic disparities in treatment within U.S. correctional facilities is unknown. This study examines race/ethnic disparities in treatment for drug dependent inmates using the 2004 Survey of Inmates in State Correctional Facilities. Fixed effects logistic regression is used to analyze treatment outcomes for 5180 inmates housed within 286 prisons. The analysis accounts for differences in background characteristics (i.e., age, gender, marital status, foreign born status, veteran status), socioeconomic characteristics (i.e., education, employment prior to incarceration), mental health (i.e., diagnosis with a serious mental illness), and incarceration experiences (i.e., current conviction, previous incarceration episodes, time served, additional sentencing requirements, external social support, disciplinary violations). The findings identify a remarkable unmet need among drug dependent inmates in that less than one-half of drug dependent inmates had received any type of treatment in prison at the time of the interview with the most common treatment type being self-help groups. Compared to whites, drug dependent Latino inmates have significantly lower odds of utilizing treatment, yet there are no significant black--white disparities found. The current study suggests that treatment for drug dependent inmates needs to be expanded to include clinically or medically based treatment since the failure to address addictions in the criminal legal system has been identified as the single most significant reason for rearrest and recidivism once released. Copyright © 2014 Elsevier Ltd. All rights reserved.

Utilization of the Philippine Research Reactor as a training facility for nuclear power plant operators

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

Palabrica, R.J.

1981-01-01

The Philippines has a 1-MW swimming-pool reactor facility operated by the Philippine Atomic Energy Commission (PAEC). The reactor is light-water moderated and cooled, graphite reflected, and fueled with 90% enriched uranium. Since it became critical in 1963 it has been utilized for research, radioisotope production, and training. It was used initially in the training of PAEC personnel and other research institutions and universities. During the last few years, however, it has played a key role in training personnel for the Philippine Nuclear Power Project (PNPP).

Utilization of Total Joint Arthroplasty in Physician-Owned Specialty Hospitals vs Acute Care Facilities.

PubMed

Chen, Antonia F; Pflug, Emily; O'Brien, Daniel; Maltenfort, Mitchell G; Parvizi, Javad

2017-07-01

The recent emergence of physician-owned specialty hospitals has sparked controversy about overutilization. Thus, the purpose of this study was to compare utilization patterns of total joint arthroplasty (TJA) between physician-specialty hospitals (PSHs) and acute care hospitals (ACHs). A retrospective study was conducted from January 2010 to August 2014 comparing primary TJA patients between a PSH and an ACH; 103 PSH patients were matched to 103 ACH patients by age, gender, BMI, and ASA classification with similar case distribution between facilities. All surgeons in the study operated at both hospitals and were shareholders of the PSH. Information on nonoperative treatments, and timing to the initial appointment, consent, and surgery were analyzed using univariate analysis. Nonoperative treatments before surgery were similar between hospitals (P = 1.00). The time from the initial appointment to consent was longer for PSH (P = .0001). However, the time from consent to the date of surgery (P = .04) and the timing from symptoms to initial appointment (P = .006) was shorter for PSH. The time from initial appointment to the day of surgery was similar between groups (P = .20). Patients were more likely to be consented for surgery on their first clinic visit when undergoing surgery at ACH (87 of 103, 84.4%) compared to PSH (61 of 103; 59.2%; P < .001). Length of stay was significantly shorter for both total knee arthroplasty (P = .001) and total hip arthroplasty patients (P = .001) at PSH. Facility ownership in PSH resulted in similar conservative treatment before TJA. The time to surgical consent after the initial appointment was longer PSH, whereas the time from consent to the date of surgery was shorter at the PSH. Copyright © 2017 Elsevier Inc. All rights reserved.

Race/Ethnic Disparities in the Utilization of Treatment for Drug Dependent Inmates in U.S. State Correctional Facilities

PubMed Central

Nowotny, Kathryn M.

2014-01-01

This study examines race/ethnic disparities in treatment for drug dependent inmates in state correctional facilities. The data come from the 2004 Survey of Inmates in State Correctional Facilities. Fixed effects logistic regression is used to analyze treatment outcomes for 5,180 inmates housed within 286 prisons. The analysis accounts for differences in background characteristics (i.e., age, gender, marital status, foreign born status, veteran status), socioeconomic characteristics (i.e., education, employment prior to incarceration), mental health (i.e., diagnosis with a serious mental illness), and incarceration experiences (i.e., current conviction, previous incarceration episodes, time served, additional sentencing requirements, external social support, disciplinary violations). The findings identify a remarkable unmet need among drug dependent inmates in that less than one-half of drug dependent inmates had received any type of treatment in prison at the time of the interview with the most common treatment type being self-help groups. Compared to whites, drug dependent Latino inmates have significantly lower odds of utilizing treatment, yet there are no significant black-white disparities found. Implications for drug treatment within prisons are discussed. PMID:25270722

Towards 90-90-90 Target: Factors Influencing Availability, Access, and Utilization of HIV Services—A Qualitative Study in 19 Ugandan Districts

PubMed Central

Tumwebaze, Flora; Akakimpa, Denis; Kityo, Cissy; Mugyenyi, Peter; Abongomera, George

2018-01-01

Background UNAIDS has set a new target 90-90-90 by 2020. To achieve this target, current programs need to address challenges that limit access, availability, and utilization of HIV testing and treatment services. Therefore, the aim of this study was to identify the barriers that influence access, availability, and utilization of HIV services in rural Uganda within the setting of a large donor funded program. Methods We conducted key informant interviews with stakeholders at the district level, staff of existing HIV/AIDS projects, and health facilities in 19 districts. Data were also collected from focus group discussions comprised of clients presenting for HIV care and treatment. Data were transcribed and analyzed using content analysis. Results. Barriers identified were as follows: (1) drug shortages including antiretroviral drugs at health facilities. Some patients were afraid to start ART because of worrying about shortages; (2) distance and (3) staffing shortages; (4) stigma persistence; (5) lack of social and economic support initiatives that enhance retention in treatment. Conclusions In conclusion, our study has identified several factors that influence access, availability, and utilization of HIV services. Programs need to address drug and staff shortages, HIV stigma, and long distances to health facilities to broaden access and utilization in order to realize the UNAIDS target. PMID:29750175

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

NASA Technical Reports Server (NTRS)

Robson, F. L.

1981-01-01

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

THE COMPUTER AS A MANAGEMENT TOOL--PHYSICAL FACILITIES INVENTORIES, UTILIZATION, AND PROJECTIONS. 11TH ANNUAL MACHINE RECORDS CONFERENCE PROCEEDINGS (UNIVERSITY OF TENNESSEE, KNOXVILLE, APRIL 25-27, 1966).

ERIC Educational Resources Information Center

WITMER, DAVID R.

WISCONSIN STATE UNIVERSITIES HAVE BEEN USING THE COMPUTER AS A MANAGEMENT TOOL TO STUDY PHYSICAL FACILITIES INVENTORIES, SPACE UTILIZATION, AND ENROLLMENT AND PLANT PROJECTIONS. EXAMPLES ARE SHOWN GRAPHICALLY AND DESCRIBED FOR DIFFERENT TYPES OF ANALYSIS, SHOWING THE CARD FORMAT, CODING SYSTEMS, AND PRINTOUT. EQUATIONS ARE PROVIDED FOR DETERMINING…

Is the closest facility the one actually used? An assessment of travel time estimation based on mammography facilities.

PubMed

Alford-Teaster, Jennifer; Lange, Jane M; Hubbard, Rebecca A; Lee, Christoph I; Haas, Jennifer S; Shi, Xun; Carlos, Heather A; Henderson, Louise; Hill, Deirdre; Tosteson, Anna N A; Onega, Tracy

2016-02-18

Characterizing geographic access depends on a broad range of methods available to researchers and the healthcare context to which the method is applied. Globally, travel time is one frequently used measure of geographic access with known limitations associated with data availability. Specifically, due to lack of available utilization data, many travel time studies assume that patients use the closest facility. To examine this assumption, an example using mammography screening data, which is considered a geographically abundant health care service in the United States, is explored. This work makes an important methodological contribution to measuring access--which is a critical component of health care planning and equity almost everywhere. We analyzed one mammogram from each of 646,553 women participating in the US based Breast Cancer Surveillance Consortium for years 2005-2012. We geocoded each record to street level address data in order to calculate travel time to the closest and to the actually used mammography facility. Travel time between the closest and the actual facility used was explored by woman-level and facility characteristics. Only 35% of women in the study population used their closest facility, but nearly three-quarters of women not using their closest facility used a facility within 5 min of the closest facility. Individuals that by-passed the closest facility tended to live in an urban core, within higher income neighborhoods, or in areas where the average travel times to work was longer. Those living in small towns or isolated rural areas had longer closer and actual median drive times. Since the majority of US women accessed a facility within a few minutes of their closest facility this suggests that distance to the closest facility may serve as an adequate proxy for utilization studies of geographically abundant services like mammography in areas where the transportation networks are well established.

Boiling Experiment Facility for Heat Transfer Studies in Microgravity

NASA Technical Reports Server (NTRS)

Delombard, Richard; McQuillen, John; Chao, David

2008-01-01

Pool boiling in microgravity is an area of both scientific and practical interest. By conducting tests in microgravity, it is possible to assess the effect of buoyancy on the overall boiling process and assess the relative magnitude of effects with regards to other "forces" and phenomena such as Marangoni forces, liquid momentum forces, and microlayer evaporation. The Boiling eXperiment Facility is now being built for the Microgravity Science Glovebox that will use normal perfluorohexane as a test fluid to extend the range of test conditions to include longer test durations and less liquid subcooling. Two experiments, the Microheater Array Boiling Experiment and the Nucleate Pool Boiling eXperiment will use the Boiling eXperiment Facility. The objectives of these studies are to determine the differences in local boiling heat transfer mechanisms in microgravity and normal gravity from nucleate boiling, through critical heat flux and into the transition boiling regime and to examine the bubble nucleation, growth, departure and coalescence processes. Custom-designed heaters will be utilized to achieve these objectives.

Central Computational Facility CCF communications subsystem options

NASA Technical Reports Server (NTRS)

Hennigan, K. B.

1979-01-01

A MITRE study which investigated the communication options available to support both the remaining Central Computational Facility (CCF) computer systems and the proposed U1108 replacements is presented. The facilities utilized to link the remote user terminals with the CCF were analyzed and guidelines to provide more efficient communications were established.

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

NASA Technical Reports Server (NTRS)

Synnestvedt, Robert (Editor)

1990-01-01

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

Facilities Inventory and Utilization Study, Fall of 1994; For the State of North Carolina. Twenty-Eighth Edition.

ERIC Educational Resources Information Center

North Carolina Univ., Chapel Hill. Commission on Higher Education Facilities.

This study presents the results of the 28th annual inventory and utilization study concerning space in North Carolina institutions of higher education during the 1994 fall term. The study provides information on 113 institutions of higher education including the 16 public senior institutions which comprise the University of North Carolina (UNC),…

Facilities Inventory and Utilization Study. Fall of 1995 for the State of North Carolina. Twenty-Ninth Edition.

ERIC Educational Resources Information Center

North Carolina Univ., Chapel Hill. Commission on Higher Education Facilities.

This study presents the results of the 29th annual inventory and utilization study concerning space in North Carolina institutions of higher education during the 1995 fall term. The study provides information on 113 institutions of higher education including the 16 public senior institutions which comprise the University of North Carolina (UNC),…

Mammography facilities are accessible, so why is utilization so low?

PubMed

Mobley, Lee R; Kuo, Tzy-Mey May; Clayton, Laurel J; Evans, W Douglas

2009-08-01

This study examines new socio-ecological variables reflecting community context as predictors of mammography use. The conceptual model is a hybrid of traditional health-behavioral and socio-ecological constructs with an emphasis on spatial interaction among women and their environments, differentiating between several levels of influence for community context. Multilevel probability models of mammography use are estimated. The study sample includes 70,129 women with traditional Medicare fee-for-service coverage for inpatient and outpatient services, drawn from the SEER-Medicare linked data. The study population lives in heterogeneous California, where mammography facilities are dense but utilization rates are low. Several contextual effects have large significant impacts on the probability of mammography use. Women living in areas with higher proportions of elderly in poverty are 33% less likely to use mammography. However, dually eligible women living in these poor areas are 2% more likely to use mammography than those without extra assistance living in these areas. Living in areas with higher commuter intensity, higher violent crime rates, greater land use mix (urbanicity), or more segregated Hispanic communities exhibit -14%, -1%, -6%, and -3% (lower) probability of use, respectively. Women living in segregated American Indian communities or in communities where more elderly women live alone exhibit 16% and 12% (higher) probability of use, respectively. Minority women living in more segregated communities by their minority are more likely to use mammography, suggesting social support, but this is significant for Native Americans only. Women with disability as their original reason for entitlement are found 40% more likely to use mammography when they reside in communities with high commuter intensity, suggesting greater ease of transportation for them in these environments. Socio-ecological variables reflecting community context are important predictors of

Transition in Dental Treatment Utilization in Jammu And Kashmir, India - A 10 Year Retrospective Study

PubMed Central

Batra, Manu; Ishrat, A.

2016-01-01

Background: Utilization of health services is the actual attendance by the members of the public at health care facilities to receive care. Utilization, serves as an important tool for oral health policy decision-making. The aim of the present study was to retrospectively gauge and assess the utilization pattern of the dental treatments which was given in hospital for last 10 years. Materials and Methods: This retrospective infirmary based study was carried out at Sheri Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu and Kashmir, India. The yearly outpatient department (OPD) records for the utilization of specific dental treatment of a total of 103963 patients were assessed retrospectively from 2014 to 2003. Trend analysis was used to assess the trend of utilization of each speciality with best fitted linear trend lines. Results: The pattern of new patients has also shown a constant rise during the study period except for 2008 and 2009. The utilization of oral surgery speciality has shown a tremendous fall from 2003 to 2014 whereas the number of patients coming to periodontics and conservative dentistry has shown an increasing pattern. Conclusion: Utilization of oral health care has long been used as an indicator of oral health related behaviour of a population. In the present study it can be conclude that the outlook of the population under study has changed from blood and vulcanite dentistry outlook and is moving towards restorative dentistry. . PMID:28804675

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

Facilities Inventory and Utilization Study, Fall of 1992: For the State of North Carolina. Twenty-Sixth Edition.

ERIC Educational Resources Information Center

North Carolina Univ., Chapel Hill. Commission on Higher Education Facilities.

This publication presents the results of the twenty-sixth annual inventory and utilization study of the status of space in North Carolina institutions of higher education at the end of the drop-add period of the 1992 fall term. The study provides data for 113 institutions, including the public institutions which comprise the University of North…

Facilities Inventory and Utilization Study, Fall of 1991, for the State of North Carolina. Twenty-Fifth Edition.

ERIC Educational Resources Information Center

North Carolina Univ., Chapel Hill. Commission on Higher Education Facilities.

This publication presents the results of the 25th annual inventory and utilization study of the status of space in North Carolina institutions of higher education at the end of the fall term of 1991. The study provides data for 113 institutions including the public institutions which comprise the University of North Carolina, 39 private non-profit…

Structural dynamics verification facility study

NASA Technical Reports Server (NTRS)

Kiraly, L. J.; Hirchbein, M. S.; Mcaleese, J. M.; Fleming, D. P.

1981-01-01

The need for a structural dynamics verification facility to support structures programs was studied. Most of the industry operated facilities are used for highly focused research, component development, and problem solving, and are not used for the generic understanding of the coupled dynamic response of major engine subsystems. Capabilities for the proposed facility include: the ability to both excite and measure coupled structural dynamic response of elastic blades on elastic shafting, the mechanical simulation of various dynamical loadings representative of those seen in operating engines, and the measurement of engine dynamic deflections and interface forces caused by alternative engine mounting configurations and compliances.

Factors affecting utilization of skilled maternal care in Northwest Ethiopia: a multilevel analysis.

PubMed

Worku, Abebaw Gebeyehu; Yalew, Alemayehu Worku; Afework, Mesganaw Fantahun

2013-04-15

The evaluation of all potential sources of low skilled maternal care utilization is crucial for Ethiopia. Previous studies have largely disregarded the contribution of different levels. This study was planned to assess the effect of individual, communal, and health facility characteristics in the utilization of antenatal, delivery, and postnatal care by a skilled provider. A linked facility and population-based survey was conducted over three months (January - March 2012) in twelve "kebeles" of North Gondar Zone, Amhara Region. A total of 1668 women who had births in the year preceding the survey were selected for analysis. Using a multilevel modelling, we examined the effect of cluster variation and a number of individual, communal (kebele), and facility-related variables for skilled maternal care utilization. About 32.3%, 13.8% and 6.3% of the women had the chance to get skilled providers for their antenatal, delivery and postnatal care, respectively. A significant heterogeneity was observed among clusters for each indicator of skilled maternal care utilization. At the individual level, variables related to awareness and perceptions were found to be much more relevant for skilled maternal service utilization. Preference for skilled providers and previous experience of antenatal care were consistently strong predictors of all indicators of skilled maternal health care utilizations. Birth order, maternal education, and awareness about health facilities to get skilled professionals were consistently strong predictors of skilled antenatal and delivery care use. Communal factors were relevant for both delivery and postnatal care, whereas the characteristics of a health facility were more relevant for use of skilled delivery care than other maternity services. Factors operating at individual and "kebele" levels play a significant role in determining utilization of skilled maternal health services. Interventions to create better community awareness and perception about

Factors affecting utilization of skilled maternal care in Northwest Ethiopia: a multilevel analysis

PubMed Central

2013-01-01

Background The evaluation of all potential sources of low skilled maternal care utilization is crucial for Ethiopia. Previous studies have largely disregarded the contribution of different levels. This study was planned to assess the effect of individual, communal, and health facility characteristics in the utilization of antenatal, delivery, and postnatal care by a skilled provider. Methods A linked facility and population-based survey was conducted over three months (January - March 2012) in twelve “kebeles” of North Gondar Zone, Amhara Region. A total of 1668 women who had births in the year preceding the survey were selected for analysis. Using a multilevel modelling, we examined the effect of cluster variation and a number of individual, communal (kebele), and facility-related variables for skilled maternal care utilization. Result About 32.3%, 13.8% and 6.3% of the women had the chance to get skilled providers for their antenatal, delivery and postnatal care, respectively. A significant heterogeneity was observed among clusters for each indicator of skilled maternal care utilization. At the individual level, variables related to awareness and perceptions were found to be much more relevant for skilled maternal service utilization. Preference for skilled providers and previous experience of antenatal care were consistently strong predictors of all indicators of skilled maternal health care utilizations. Birth order, maternal education, and awareness about health facilities to get skilled professionals were consistently strong predictors of skilled antenatal and delivery care use. Communal factors were relevant for both delivery and postnatal care, whereas the characteristics of a health facility were more relevant for use of skilled delivery care than other maternity services. Conclusion Factors operating at individual and “kebele” levels play a significant role in determining utilization of skilled maternal health services. Interventions to create

Investigating walking environments in and around assisted living facilities: a facility visit study.

PubMed

Lu, Zhipeng

2010-01-01

This study explores assisted living residents' walking behaviors, locations where residents prefer to walk, and walking environments in and around assisted living facilities. Regular walking is beneficial to older adults' physical and psychological health. Yet frail older residents in assisted living are usually too sedentary to achieve these benefits. The physical environment plays an important role in promoting physical activity. However, there is little research exploring this relationship in assisted living settings. The researcher visited 34 assisted living facilities in a major Texas city. Methods included walk-through observation with the Assisted Living Facility Walking Environment Checklist, and interviews with administrators by open- and close-ended questions. The data from 26 facilities were analyzed using descriptive statistics (for quantitative data) and content analysis (for qualitative data). The results indicate that (a) residents were walking both indoors and outdoors for exercise or other purposes (e.g., going to destinations); (b) assisted living facility planning and design details-such as neighborhood sidewalk conditions, facility site selection, availability of seating, walking path configuration (e.g., looped/nonlooped path), amount of shading along the path, presence of handrails, existence of signage, etc.-may influence residents' walking behaviors; and (c) current assisted living facilities need improvement in all aspects to make their environments more walkable for residents. Findings of the study provide recommendations for assisted living facilities to improve the walkability of environments and to create environmental interventions to promote regular walking among their residents. This study also implies several directions for future research.

Phase 0 study for a geothermal superheated water proof of concept facility

NASA Technical Reports Server (NTRS)

Douglass, R. H.; Pearson, R. O.

1974-01-01

A Phase 0 study for the selection of a representative liquid-dominated geothermal resource of moderate salinity and temperature is discussed. Selection and conceptual design of a nominal 10-MWe energy conversion system, and implementation planning for Phase 1: subsystem (component, experiments) and Phase 2: final design, construction, and operation of experimental research facilities are reported. The objective of the overall program is to demonstrate the technical and economic viability of utilizing moderate temperature and salinity liquid-dominated resources with acceptable environmental impact, and thus encourage commercial scale development of geothermal electrical power generation.

Utilization of healthcare services in postpartum women in the Philippines who delivered at home and the effects on their health: a cross-sectional analytical study.

PubMed

Yamashita, Tadashi; Reyes Tuliao, Maria Teresa; Concel Meana, Magdalena; Suplido, Sherri Ann; Llave, Cecilia L; Tanaka, Yuko; Matsuo, Hiroya

2017-01-01

A low ratio of utilization of healthcare services in postpartum women may contribute to maternal deaths during the postpartum period. The maternal mortality ratio is high in the Philippines. The aim of this study was to examine the current utilization of healthcare services and the effects on the health of women in the Philippines who delivered at home. This was a cross-sectional analytical study, based on a self-administrated questionnaire, conducted from March 2015 to February 2016 in Muntinlupa, Philippines. Sixty-three postpartum women who delivered at home or at a facility were enrolled for this study. A questionnaire containing questions regarding characteristics, utilization of healthcare services, and abnormal symptoms during postpartum period was administered. To analyze the questionnaire data, the sample was divided into delivery at home and delivery at a facility. Chi-square test, Fisher's exact test, and Mann-Whitney U test were used. There were significant differences in the type of birth attendant, area of residence, monthly income, and maternal and child health book usage between women who delivered at home and those who delivered at a facility ( P <0.01). There was significant difference in the utilization of antenatal checkup ( P <0.01) during pregnancy, whilst there was no significant difference in utilization of healthcare services during the postpartum period. Women who delivered at home were more likely to experience feeling of irritated eyes and headaches, and continuous abdominal pain ( P <0.05). Financial and environmental barriers might hinder the utilization of healthcare services by women who deliver at home in the Philippines. Low utilization of healthcare services in women who deliver at home might result in more frequent abnormal symptoms during postpartum.

Intersocietal Accreditation Commission Accreditation Status of Outpatient Cerebrovascular Testing Facilities Among Medicare Beneficiaries: The VALUE Study.

PubMed

Brown, Scott C; Wang, Kefeng; Dong, Chuanhui; Farrell, Mary Beth; Heller, Gary V; Gornik, Heather L; Hutchisson, Marge; Needleman, Laurence; Benenati, James F; Jaff, Michael R; Meier, George H; Perese, Susana; Bendick, Phillip; Hamburg, Naomi M; Lohr, Joann M; LaPerna, Lucy; Leers, Steven A; Lilly, Michael P; Tegeler, Charles; Katanick, Sandra L; Alexandrov, Andrei V; Siddiqui, Adnan H; Rundek, Tatjana

2016-09-01

Accreditation of cerebrovascular ultrasound laboratories by the Intersocietal Accreditation Commission (IAC) and equivalent organizations is supported by the Joint Commission certification of stroke centers. Limited information exists on the accreditation status and geographic distribution of cerebrovascular testing facilities in the United States. Our study objectives were to identify the proportion of IAC-accredited outpatient cerebrovascular testing facilities used by Medicare beneficiaries, describe their geographic distribution, and identify variations in cerebrovascular testing procedure types and volumes by accreditation status. As part of the VALUE (Vascular Accreditation, Location, and Utilization Evaluation) Study, we examined the proportion of IAC-accredited facilities that conducted cerebrovascular testing in a 5% Centers for Medicare and Medicaid Services random Outpatient Limited Data Set in 2011 and investigated their geographic distribution using geocoding. Among 7327 outpatient facilities billing Medicare for cerebrovascular testing, only 22% (1640) were IAC accredited. The proportion of IAC-accredited cerebrovascular testing facilities varied by region (χ(2)[3] = 177.1; P < .0001), with 29%, 15%, 13%, and 10% located in the Northeast, South, Midwest, and West, respectively. However, of the total number of cerebrovascular outpatient procedures conducted in 2011 (38,555), 40% (15,410) were conducted in IAC-accredited facilities. Most cerebrovascular testing procedures were carotid duplex, with 40% of them conducted in IAC-accredited facilities. The proportion of facilities conducting outpatient cerebrovascular testing accredited by the IAC is low and varies by region. The growing number of certified stroke centers should be accompanied by more accredited outpatient vascular testing facilities, which could potentially improve the quality of stroke care.

Institutional Delivery Service Utilization among Women from Rural Districts of Wolaita and Dawro Zones, Southern Ethiopia; a Community Based Cross-Sectional Study

PubMed Central

Arba, Mihiretu Alemayehu; Darebo, Tadele Dana; Koyira, Mengistu Meskele

2016-01-01

Introduction The highest number of maternal deaths occur during labour, delivery and the first day after delivery highlighting the critical need for good quality care during this period. Therefore, for the strategies of institutional delivery to be effective, it is essential to understand the factors that influence individual and household factors to utilize skilled birth attendance and institutions for delivery. This study was aimed to assess factors affecting the utilization of institutional delivery service of women in rural districts of Wolaita and Dawro Zones. Methods A community based cross-sectional study was done among mothers who gave birth within the past one year preceding the survey in Wolaita and Dawro Zones, from February 01 –April 30, 2015 by using a three stage sampling technique. Initially, 6 districts were selected randomly from the total of 17 eligible districts. Then, 2 kebele from each district was selected randomly cumulating a total of 12 clusters. Finally, study participants were selected from each cluster by using systematic sampling technique. Accordingly, 957 mothers were included in the survey. Data was collected by using a pretested interviewer administered structured questionnaire. The questionnaire was prepared by including socio-demographic variables and variables of maternal health service utilization factors. Data was entered using Epi-data version 1.4.4.0 and exported to SPSS version 20 for analysis. Bivariate and multiple logistic regressions were applied to identify candidate and predictor variables respectively. Result Only 38% of study participants delivered the index child at health facility. Husband’s educational status, wealth index, average distance from nearest health facility, wanted pregnancy, agreement to follow post-natal care, problem faced during delivery, birth order, preference of health professional for ante-natal care and maternity care were predictors of institutional delivery. Conclusion The use of

Institutional Delivery Service Utilization among Women from Rural Districts of Wolaita and Dawro Zones, Southern Ethiopia; a Community Based Cross-Sectional Study.

PubMed

Arba, Mihiretu Alemayehu; Darebo, Tadele Dana; Koyira, Mengistu Meskele

2016-01-01

The highest number of maternal deaths occur during labour, delivery and the first day after delivery highlighting the critical need for good quality care during this period. Therefore, for the strategies of institutional delivery to be effective, it is essential to understand the factors that influence individual and household factors to utilize skilled birth attendance and institutions for delivery. This study was aimed to assess factors affecting the utilization of institutional delivery service of women in rural districts of Wolaita and Dawro Zones. A community based cross-sectional study was done among mothers who gave birth within the past one year preceding the survey in Wolaita and Dawro Zones, from February 01 -April 30, 2015 by using a three stage sampling technique. Initially, 6 districts were selected randomly from the total of 17 eligible districts. Then, 2 kebele from each district was selected randomly cumulating a total of 12 clusters. Finally, study participants were selected from each cluster by using systematic sampling technique. Accordingly, 957 mothers were included in the survey. Data was collected by using a pretested interviewer administered structured questionnaire. The questionnaire was prepared by including socio-demographic variables and variables of maternal health service utilization factors. Data was entered using Epi-data version 1.4.4.0 and exported to SPSS version 20 for analysis. Bivariate and multiple logistic regressions were applied to identify candidate and predictor variables respectively. Only 38% of study participants delivered the index child at health facility. Husband's educational status, wealth index, average distance from nearest health facility, wanted pregnancy, agreement to follow post-natal care, problem faced during delivery, birth order, preference of health professional for ante-natal care and maternity care were predictors of institutional delivery. The use of institutional delivery service is low in the study

Facility safety study

NASA Technical Reports Server (NTRS)

1979-01-01

The safety of NASA's in house microelectronics facility is addressed. Industrial health standards, facility emission control requirements, operation and safety checklists, and the disposal of epitaxial vent gas are considered.

Essential neonatal care utilization and associated factors among mothers in public health facilities of Aksum Town, North Ethiopia, 2016.

PubMed

Berhe, Megbey; Medhaniye, Araya Abraha; Kahsay, Gizienesh; Birhane, Ermyas; Abay, Mebrahtu

2017-01-01

Globally, neonatal death accounts about 44% of child death in 2013. Ethiopia is one of the ten countries with the highest number of neonatal death. Worldwide, more than 43% of deaths among under five year children is contributed by neonates. Half of the neonatal death occur in the first day of life. Recommendations about newborn care practices may conflict with local beliefs and practices. So, it is important to understand the existing newborn care practice and factors affecting it in order to take interventions so as to decrease neonatal death. To assess magnitude of essential neonatal care utilization and associated factors among women visiting public health facilities in Aksum Town, Tigray, Northern Ethiopia, 2015. Facility based cross sectional study was conducted from December 30, 2015 to January 31, 2016.The sampled population are 423 women who gave live births within the last 6 months prior to data collection. Systematic random sampling technique was employed. Data were entered, coded and cleaned using Epi info version 7, and SPSS Version 21 software was used for analysis. Both bivariable and multivariable logistic regression models were used to determine factors associated with essential neonatal care utilization. Variables with P-value <0.2 in the bivariable logistic regression model were included in to multivariable logistic regression model, and finally variables with P-value <0.05 were considered as independent factors. Odds ratio was used to measure strength of association at 95% confidence level. A total of 423 mothers included in the study. Prevalence of safe cord care, optimal breast feeding, thermal care and baby received Tetracycline eye ointment and vaccine at birth were 42.8%, 63.1%, 32.6% and 44.7% among the respondents respectively. Only 113(26.7%) of the participants fulfilled essential new born care practice. Occupation, parity and counseling on essential new born care during delivery were significantly associated with utilization of

Developing State Agency Facility Plans: A Guide to Planning and Implementation. Michigan Studies in Rehabilitation Utilization Series: 4.

ERIC Educational Resources Information Center

Miller, Juliet V.; Wargel, James F.

Intended for use in inservice training of vocational rehabilitation agency personnel, this facility planning guide is designed to (1) help state agencies understand the new facility planning requirements of the Rehabilitation Comprehensive Services and Developmental Disabilities Amendments of 1978, (2) provide information about a six-step planning…

Utility investigation best practices and effects on TxDOT highway improvement projects.

DOT National Transportation Integrated Search

2013-04-01

The lack of adequate information about the location and characteristics of utility facilities can result in a number of problems, including damages to utilities, disruptions to utility services and traffic, lost utility facilities as constructi...

Husbands' involvement in delivery care utilization in rural Bangladesh: A qualitative study

PubMed Central

2012-01-01

Background A primary cause of high maternal mortality in Bangladesh is lack of access to professional delivery care. Examining the role of the family, particularly the husband, during pregnancy and childbirth is important to understanding women's access to and utilization of professional maternal health services that can prevent maternal mortality. This qualitative study examines husbands' involvement during childbirth and professional delivery care utilization in a rural sub-district of Netrokona district, Bangladesh. Methods Using purposive sampling, ten households utilizing a skilled attendant during the birth of the youngest child were selected and matched with ten households utilizing an untrained traditional birth attendant, or dhatri. Households were selected based on a set of inclusion criteria, such as approximate household income, ethnicity, and distance to the nearest hospital. Twenty semi-structured interviews were conducted in Bangla with husbands in these households in June 2010. Interviews were transcribed, translated into English, and analyzed using NVivo 9.0. Results By purposefully selecting households that differed on the type of provider utilized during delivery, common themes--high costs, poor transportation, and long distances to health facilities--were eliminated as sufficient barriers to the utilization of professional delivery care. Divergent themes, namely husbands' social support and perceived social norms, were identified as underlying factors associated with delivery care utilization. We found that husbands whose wives utilized professional delivery care provided emotional, instrumental and informational support to their wives during delivery and believed that medical intervention was necessary. By contrast, husbands whose wives utilized an untrained dhatri at home were uninvolved during delivery and believed childbirth should take place at home according to local traditions. Conclusions This study provides novel evidence about male

Electric utility pole yard training facility: Designing an effective learning environment

NASA Astrophysics Data System (ADS)

Topping, Robert P.

The primary responsibility of electric utilities is to supply consistent, dependable, and affordable energy to private customers, businesses, and industries. As with many businesses, electric utilities are experiencing the effects of an aging workforce and expending considerable resources to train their current and replacement workers. Community colleges can partner with electric utilities to provide effective learning environments for these workers, and gain access to new sources of revenue and community support for the colleges. The purpose of this study was to describe the functions, features, and major design issues of an effective learning environment for training electric utility industry workers, the electric utility line-worker pole yard. Case studies of three "state of the art" line-worker pole yard training environments provide the basis for the study's findings and implications. The study was guided by the following research questions: (1) What is the function of a line-worker pole yard in supporting effective training? (2) What are the features of present day ("state of the art") line-worker pole yard learning environments? and (3) What are the major issues that need to be addressed in designing a line-worker pole yard learning environment for the future? The study participants included industry representatives, training coordinators, instructors, and students from the three selected "state of the art" line-worker pole yard sites. The overall findings from the study resulted in composites of the desired features of learning outcomes, learning process, and learning environment for a line-worker pole yard training program and major issues that are affecting the future design of these training programs. Composite findings of a pole-yard training environment included unique features associated with: (a) outdoor, (b) indoor, (c) underground, (d) classroom, (e) gathering places, and (f) work-based learning components. Composite findings with regard to major

43 CFR 3271.10 - What do I need to start preparing a site and building and testing a utilization facility on...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false What do I need to start preparing a site and building and testing a utilization facility on Federal land leased for geothermal resources? 3271.10 Section 3271.10 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR...

43 CFR 3271.10 - What do I need to start preparing a site and building and testing a utilization facility on...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false What do I need to start preparing a site and building and testing a utilization facility on Federal land leased for geothermal resources? 3271.10 Section 3271.10 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR...

43 CFR 3271.10 - What do I need to start preparing a site and building and testing a utilization facility on...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false What do I need to start preparing a site and building and testing a utilization facility on Federal land leased for geothermal resources? 3271.10 Section 3271.10 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR...

43 CFR 3271.10 - What do I need to start preparing a site and building and testing a utilization facility on...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false What do I need to start preparing a site and building and testing a utilization facility on Federal land leased for geothermal resources? 3271.10 Section 3271.10 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR...

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;…

Japanese plan for SSF utilization

NASA Technical Reports Server (NTRS)

Mizuno, Toshio

1992-01-01

The Japanese Experiment Module (JEM) program has made significant progress. The JEM preliminary design review was completed in July 1992; construction of JEM operation facilities has begun; and the micro-G airplane, drop shaft, and micro-G experiment rocket are all operational. The national policy for JEM utilization was also established. The Space Experiment Laboratory (SEL) opened in June '92 and will function as a user support center. Eight JEM multiuser facilities are in phase B, and scientific requirements are being defined for 17 candidate multiuser facilities. The National Joint Research Program is about to start. Precursor missions and early Space Station utilization activities are being defined. This paper summarizes the program in outline and graphic form.

A Cross-Sectional Study of the Characteristics and Determinants of Emergency Care Utilization among People with Intellectual Disabilities in Taiwan

ERIC Educational Resources Information Center

Lin, Jin-Ding; Yen, Chia-Feng; Loh, Ching-Hui; Hsu, Shang-Wei; Huang, Hui-Chi; Tang, Chi-Chieh; Li, Chi-Wei; Wu, Jia-Ling

2006-01-01

Aims: The purpose of this study was to identify health characteristics of people with intellectual disabilities (ID) and to assess the use of emergency care facilities by these people and factors affecting this utilization. Method: A cross-sectional study was employed. Subjects were recruited from the Taiwan National Disability Registration…

Initial utilization of the CVIRB video production facility

NASA Technical Reports Server (NTRS)

Parrish, Russell V.; Busquets, Anthony M.; Hogge, Thomas W.

1987-01-01

Video disk technology is one of the central themes of a technology demonstrator workstation being assembled as a man/machine interface for the Space Station Data Management Test Bed at Johnson Space Center. Langley Research Center personnel involved in the conception and implementation of this workstation have assembled a video production facility to allow production of video disk material for this propose. This paper documents the initial familiarization efforts in the field of video production for those personnel and that facility. Although the entire video disk production cycle was not operational for this initial effort, the production of a simulated disk on video tape did acquaint the personnel with the processes involved and with the operation of the hardware. Invaluable experience in storyboarding, script writing, audio and video recording, and audio and video editing was gained in the production process.

A skyshine study for a low-level radwaste storage facility for state compacts

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

Shoemaker, D.C.; Hopkins, W.C.; Jha, S.

1989-11-01

The Central Interstate Compact Facility, to be located in Nebraska, is designed to utilize above-grade concrete vaults for disposal of all classes of waste. Such a low-level radwaste facility (LLRWF) must meet many, and at times competing, design conditions. One of the more rigorous design conditions is to limit the yearly effluent dose and direct radiation dose to the closest resident to the facility to < 0.25 mSv (25 mrem). Thus, a shield designer must assure that the proposed design will not only be cost-effective and provide for the conventional maintenance and operations of the facility, but will also meetmore » the performance criteria. During the operational phase of the facility, the dominant dose quickly becomes the air-scattered dose (skyshine) from the photons emerging from the roofs and walls of the facility. To investigate the sensitivity to skyshine of a preliminary design for an LLRWF, a study was undertaken using a version of the MORSE Monte Carlo program that runs on a PC/386. The effects of source energy were also examined by modeling two difference sources--{sup 60}Co and {sup 137}Cs. It was felt that these two isotopes are representative of the predominant high-energy gamma emitters for the projected waste inventory in the LLRWF. At the end of the design life of the LLRWF (i.e., full capacity at 30 yr), it was found that the difference in the yearly dose between assuring all {sup 60}Co and all {sup 137}Cs was a factor of < 2.« less

National Biomedical Tracer Facility: Project definition study

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

Heaton, R.; Peterson, E.; Smith, P.

The Los Alamos National Laboratory is an ideal institution and New Mexico is an ideal location for siting the National Biomedical Tracer Facility (NBTF). The essence of the Los Alamos proposal is the development of two complementary irradiation facilities that combined with our existing radiochemical processing hot cell facilities and waste handling and disposal facilities provide a low cost alternative to other proposals that seek to satisfy the objectives of the NBTF. We propose the construction of a 30 MeV cyclotron facility at the site of the radiochemical facilities, and the construction of a 100 MeV target station at LAMPFmore » to satisfy the requirements and objectives of the NBTF. We do not require any modifications to our existing radiochemical processing hot cell facilities or our waste treatment and disposal facilities to accomplish the objectives of the NBTF. The total capital cost for the facility defined by the project definition study is $15.2 M. This cost estimate includes $9.9 M for the cyclotron and associated facility, $2.0 M for the 100 MeV target station at LAMPF, and $3.3 M for design.« less

Using Multicriteria Analysis in Issues Concerning Adaptation of Historic Facilities for the Needs of Public Utility Buildings with a Function of a Theatre

NASA Astrophysics Data System (ADS)

Obracaj, Piotr; Fabianowski, Dariusz

2017-10-01

Implementations concerning adaptation of historic facilities for public utility objects are associated with the necessity of solving many complex, often conflicting expectations of future users. This mainly concerns the function that includes construction, technology and aesthetic issues. The list of issues is completed with proper protection of historic values, different in each case. The procedure leading to obtaining the expected solution is a multicriteria procedure, usually difficult to accurately define and requiring designer’s large experience. An innovative approach has been used for the analysis, namely - the modified EA FAHP (Extent Analysis Fuzzy Analytic Hierarchy Process) Chang’s method of a multicriteria analysis for the assessment of complex functional and spatial issues. Selection of optimal spatial form of an adapted historic building intended for the multi-functional public utility facility was analysed. The assumed functional flexibility was determined in the scope of: education, conference, and chamber spectacles, such as drama, concerts, in different stage-audience layouts.

Perceptions of users and providers on barriers to utilizing skilled birth care in mid- and far-western Nepal: a qualitative study

PubMed Central

Onta, Sharad; Choulagai, Bishnu; Shrestha, Binjwala; Subedi, Narayan; Bhandari, Gajananda P.; Krettek, Alexandra

2014-01-01

Background Although skilled birth care contributes significantly to the prevention of maternal and newborn morbidity and mortality, utilization of such care is poor in mid- and far-western Nepal. This study explored the perceptions of service users and providers regarding barriers to skilled birth care. Design We conducted 24 focus group discussions, 12 each with service users and service providers from different health institutions in mid- and far-western Nepal. All discussions examined the perceptions and experiences of service users and providers regarding barriers to skilled birth care and explored possible solutions to overcoming such barriers. Results Our results determined that major barriers to skilled birth care include inadequate knowledge of the importance of services offered by skilled birth attendants (SBAs), distance to health facilities, unavailability of transport services, and poor availability of SBAs. Other barriers included poor infrastructure, meager services, inadequate information about services/facilities, cultural practices and beliefs, and low prioritization of birth care. Moreover, the tradition of isolating women during and after childbirth decreased the likelihood that women would utilize delivery care services at health facilities. Conclusions Service users and providers perceived inadequate availability and accessibility of skilled birth care in remote areas of Nepal, and overall utilization of these services was poor. Therefore, training and recruiting locally available health workers, helping community groups establish transport mechanisms, upgrading physical facilities and services at health institutions, and increasing community awareness of the importance of skilled birth care will help bridge these gaps. PMID:25119066

Perceptions of users and providers on barriers to utilizing skilled birth care in mid- and far-western Nepal: a qualitative study.

PubMed

Onta, Sharad; Choulagai, Bishnu; Shrestha, Binjwala; Subedi, Narayan; Bhandari, Gajananda P; Krettek, Alexandra

2014-01-01

Although skilled birth care contributes significantly to the prevention of maternal and newborn morbidity and mortality, utilization of such care is poor in mid- and far-western Nepal. This study explored the perceptions of service users and providers regarding barriers to skilled birth care. We conducted 24 focus group discussions, 12 each with service users and service providers from different health institutions in mid- and far-western Nepal. All discussions examined the perceptions and experiences of service users and providers regarding barriers to skilled birth care and explored possible solutions to overcoming such barriers. Our results determined that major barriers to skilled birth care include inadequate knowledge of the importance of services offered by skilled birth attendants (SBAs), distance to health facilities, unavailability of transport services, and poor availability of SBAs. Other barriers included poor infrastructure, meager services, inadequate information about services/facilities, cultural practices and beliefs, and low prioritization of birth care. Moreover, the tradition of isolating women during and after childbirth decreased the likelihood that women would utilize delivery care services at health facilities. Service users and providers perceived inadequate availability and accessibility of skilled birth care in remote areas of Nepal, and overall utilization of these services was poor. Therefore, training and recruiting locally available health workers, helping community groups establish transport mechanisms, upgrading physical facilities and services at health institutions, and increasing community awareness of the importance of skilled birth care will help bridge these gaps.

Dual-Spool Turbine Facility Design Overview

NASA Technical Reports Server (NTRS)

Giel, Paul; Pachlhofer, Pete

2003-01-01

The next generation of aircraft engines, both commercial and military, will attempt to capitalize on the benefits of close-coupled, vaneless, counter-rotating turbine systems. Experience has shown that significant risks and challenges are present with close-coupled systems in terms of efficiency and durability. The UEET program needs to demonstrate aerodynamic loading and efficiency goals for close-coupled, reduced-stage HP/LP turbine systems as a Level 1 Milestone for FY05. No research facility exists in the U.S. to provide risk reduction for successful development of close-coupled, high and low pressure turbine systems for the next generations of engines. To meet these objectives, the design, construction, and integrated systems testing of a Dual-Spool Turbine Facility (DSTF) facility has been initiated at the NASA Glenn Research Center. The facility will be a warm (-IOOO'F), continuous flow facility for overall aerodynamic performance and detailed flow field measurement acquisition. The facility will have state-of-the-art instrumentation to capture flow physics details. Accurate and reliable speed control will be achieved by utilizing the existing Variable Frequency Drive System. Utilization of this and other existing GRC centralized utilities will reduce the overall construction costs. The design allows for future installation of a turbine inlet combustor profile simulator. This presentation details the objectives of the facility and the concepts used in specifying its capabilities. Some preliminary design results will be presented along with a discussion of plans and schedules.

The Utility of Continuous Temperature Monitoring of Refrigerators in a Long-Term Care Facility.

PubMed

Worz, Chad; Postolski, Josh; Williams, Kevin

2017-04-01

It is the current practice in most long-term care facilities to use manual logs when documenting refrigerator temperatures. This process is commonly associated with poor or fabricated compliance, little oversight, and documentation errors, both because of overt omissions and unsubstantiated values. It is also well-established that medication storage requirements are mandated by the Centers for Medicare & Medicaid Services (CMS). This analysis demonstrates the potential risk of poor cold-chain management of medications and establishes the possible utility of digitally recorded continuous temperature monitoring over manual logs. This small case-oriented review of a large nursing facility's storage process attempts to expose the risk associated with improper medication storage. The primary outcome of the study was to determine if a difference existed between temperature logs completed manually compared with those done with a continuous monitor. American Thermal Instruments (ATI) thermometers were placed into each of the existing refrigerators in a 147-bed nursing facility. Through a mobile app, the data recorded in each refrigerator were compiled into daily reports. Data were collected from a total of 12 refrigerators, 3 of which were medication refrigerators. Logging intervals were done over a 263-minute period and compiled the lowest recorded temperature, highest recorded temperature, and the average temperature for each refrigerator. In addition, reports showing the real-time results were compiled using the ATI DataNow service. All of the refrigerators analyzed had highest temperature recorded readings exceeding the maximum allowable temperature (50°F for refrigerator). All of the refrigerators had lowest temperature recorded readings below the minimum allowable temperature (32°F for refrigerators). All of the refrigerators also reported average temperatures outside of the allowable temperature range. The results necessitated the replacement of a refrigerator and

Facility fence-line monitoring using passive samplers

EPA Science Inventory

In 2009, the U.S. EPA executed a year-long field study at a refinery in Corpus Christi, Texas, to evaluate the use of passive diffusive sampling technology for assessing time-averaged benzene concentrations at the facility fence line. The study utilized 14-day time-integrated Car...

National facilities study. Volume 2: Task group on aeronautical research and development facilities report

NASA Technical Reports Server (NTRS)

1994-01-01

The Task Group on Aeronautics R&D Facilities examined the status and requirements for aeronautics facilities against the competitive need. Emphasis was placed on ground-based facilities for subsonic, supersonic and hypersonic aerodynamics, and propulsion. Subsonic and transonic wind tunnels were judged to be most critical and of highest priority. Results of the study are presented.

Trauma facilities in Denmark - a nationwide cross-sectional benchmark study of facilities and trauma care organisation.

PubMed

Weile, Jesper; Nielsen, Klaus; Primdahl, Stine C; Frederiksen, Christian A; Laursen, Christian B; Sloth, Erik; Mølgaard, Ole; Knudsen, Lars; Kirkegaard, Hans

2018-03-27

Trauma is a leading cause of death among adults aged < 44 years, and optimal care is a challenge. Evidence supports the centralization of trauma facilities and the use multidisciplinary trauma teams. Because knowledge is sparse on the existing distribution of trauma facilities and the organisation of trauma care in Denmark, the aim of this study was to identify all Danish facilities that care for traumatized patients and to investigate the diversity in organization of trauma management. We conducted a systematic observational cross-sectional study. First, all hospitals in Denmark were identified via online services and clarifying phone calls to each facility. Second, all trauma care manuals on all facilities that receive traumatized patients were gathered. Third, anesthesiologists and orthopedic surgeons on call at all trauma facilities were contacted via telephone for structured interviews. A total of 22 facilities in Denmark were found to receive traumatized patients. All facilities used a trauma care manual and all had a multidisciplinary trauma team. The study found three different trauma team activation criteria and nine different compositions of teams who participate in trauma care. Training was heterogeneous and, beyond the major trauma centers, databases were only maintained in a few facilities. The study established an inventory of the existing Danish facilities that receive traumatized patients. The trauma team activation criteria and the trauma teams were heterogeneous in both size and composition. A national database for traumatized patients, research on nationwide trauma team activation criteria, and team composition guidelines are all called for.

Evaluation of overweight load routing on buried utility facilities

DOT National Transportation Integrated Search

2011-02-01

Overweight traffic movements can negatively affect pavement integrity and quality. However, it is less : known to what degree buried utility plant along and across the right of way is affected by these overweight : loads, especially if the utility fa...

Accreditation Status and Geographic Location of Outpatient Echocardiographic Testing Facilities Among Medicare Beneficiaries: The VALUE-ECHO Study.

PubMed

Brown, Scott C; Wang, Kefeng; Dong, Chuanhui; Yi, Li; Marinovic Gutierrez, Carolina; Di Tullio, Marco R; Farrell, Mary Beth; Burgess, Pamela; Gornik, Heather L; Hamburg, Naomi M; Needleman, Laurence; Orsinelli, David; Robison, Susana; Rundek, Tatjana

2018-02-01

Accreditation of echocardiographic testing facilities by the Intersocietal Accreditation Commission (IAC) is supported by the American College of Cardiology and American Society of Echocardiography. However, limited information exists on the accreditation status and geographic distribution of echocardiographic facilities in the United States. Our study aimed to identify (1) the proportion of outpatient echocardiography facilities used by Medicare beneficiaries that are IAC accredited, (2) their geographic distribution, and (3) variations in procedure type and volume by accreditation status. As part of the VALUE-ECHO (Value of Accreditation, Location, and Utilization Evaluation-Echocardiography) study, we examined the proportion of IAC-accredited echocardiographic facilities performing outpatient echocardiography in the 2013 Centers for Medicare and Medicaid Services outpatient limited data set (100% sample) and their geographic distribution using geocoding in ArcGIS (ESRI, Redlands, CA). Among 4573 outpatient facilities billing Medicare for echocardiographic testing in 2013, 99.6% (n = 4554) were IAC accredited (99.7% in the 50 US states and 86.2% in Puerto Rico). The proportion IAC-accredited echocardiographic facilities varied by region, with 98.7%, 99.9%, 99.9%, 99.5%, and 86.2% of facilities accredited in the Northeast, South, Midwest, West, and Puerto Rico, respectively (P < .01, Fisher exact test). Of all echocardiographic outpatient procedures conducted (n = 1,890,156), 99.8% (n = 1,885,382) were performed in IAC-accredited echocardiographic facilities. Most procedures (90.9%) were transthoracic echocardiograms, of which 99.7% were conducted in IAC-accredited echocardiographic facilities. Almost all outpatient echocardiographic facilities billed by Medicare are IAC accredited. This accreditation rate is substantially higher than previously reported for US outpatient vascular testing facilities (13% IAC accredited). The uniformity of imaging

Sarcopenia and Health Care Utilization in Older Women

PubMed Central

Lui, Li-Yung; McCulloch, Charles E.; Cauley, Jane A.; Paudel, Misti L.; Taylor, Brent; Schousboe, John T.; Ensrud, Kristine E.

2017-01-01

Background: Although there are several consensus definitions of sarcopenia, their association with health care utilization has not been studied. Methods: We included women from the prospective Study of Osteoporotic Fractures with complete assessment of sarcopenia by several definitions at the Study of Osteoporotic Fractures Year 10 (Y10) exam (1997–1998) who also had available data from Medicare Fee- For-Service Claims (N = 566) or Kaiser Encounter data (N = 194). Sarcopenia definitions evaluated were: International Working Group, European Working Group for Sarcopenia in Older Persons, Foundation for the NIH Sarcopenia Project, Baumgartner, and Newman. Hurdle models and logistic regression were used to assess the relation between sarcopenia status (the summary definition and the components of slowness, weakness and/or lean mass) and outcomes that included hospitalizations, cumulative inpatient days/year, short-term (part A paid) skilled nursing facility stay in the 3 years following the Y10 visit. Results: None of the consensus definitions, nor the definition components of weakness or low lean mass, was associated with increased risk of hospitalization or greater likelihood of short-term skilled nursing facility stay. Women with slowness by any criterion definition were about 50% more likely to be hospitalized; had a greater rate of hospitalization days amongst those hospitalized; and had 1.8 to 2.1 times greater likelihood of a short-term skilled nursing facility stay than women without slowness. There was the suggestion of a protective association of low lean mass by the various criterion definitions on short-term skilled nursing facility stay. Conclusion: Estimated effects of sarcopenia on health care utilization were negligible. However, slowness was associated with greater health care utilization. PMID:27402050

The Granite Mountain Atmospheric Sciences Testbed (GMAST): A Facility for Long Term Complex Terrain Airflow Studies

NASA Astrophysics Data System (ADS)

Zajic, D.; Pace, J. C.; Whiteman, C. D.; Hoch, S.

2011-12-01

This presentation describes a new facility at Dugway Proving Ground (DPG), Utah that can be used to study airflow over complex terrain, and to evaluate how airflow over a mountain barrier affects wind patterns over adjacent flatter terrain. DPG's primary mission is to conduct testing, training, and operational assessments of chemical and biological weapon systems. These operations require very precise weather forecasts. Most test operations at DPG are conducted on fairly flat test ranges having uniform surface cover, where airflow patterns are generally well-understood. However, the DPG test ranges are located alongside large, isolated mountains, most notably Granite Mountain, Camelback Mountain, and the Cedar Mountains. Airflows generated over, or influenced by, these mountains can affect wind patterns on the test ranges. The new facility, the Granite Mountain Atmospheric Sciences Testbed, or GMAST, is designed to facilitate studies of airflow interactions with topography. This facility will benefit DPG by improving understanding of how mountain airflows interact with the test range conditions. A core infrastructure of weather sensors around and on Granite Mountain has been developed including instrumented towers and remote sensors, along with automated data collection and archival systems. GMAST is expected to be in operation for a number of years and will provide a reference domain for mountain meteorology studies, with data useful for analysts, modelers and theoreticians. Visiting scientists are encouraged to collaborate with DPG personnel to utilize this valuable scientific resource and to add further equipment and scientific designs for both short-term and long-term atmospheric studies. Several of the upcoming MATERHORN (MountAin TERrain atmospHeric mOdeling and obseRvatioNs) project field tests will be conducted at DPG, giving an example of GMAST utilization and collaboration between DPG and visiting scientists.

Predictors of public and private healthcare utilization and associated health system responsiveness among older adults in Ghana

PubMed Central

Awoke, Mamaru Ayenew; Negin, Joel; Moller, Jette; Farell, Penny; Yawson, Alfred E.; Biritwum, Richard Berko; Kowal, Paul

2017-01-01

ABSTRACT Background: Previous studies investigating factors associated with healthcare utilization by older Ghanaians lack distinction between public and private health services. The present study examined factors associated with public and private healthcare service use, and the resulting perceived health system responsiveness. Objectives: To identify factors associated with public and private healthcare utilization among older adults aged 50 and older in Ghana; and to compare perceived differences in health system responsiveness between the private and public sectors. Methods: Cross-sectional data was analyzed from the World Health Organization Study on global AGEing and adult health (SAGE) Wave 1 in Ghana. Using Andersen’s conceptual framework, public and private outpatient care utilization was examined using multinomial logistic regression to estimate and identify predictor variables associated with the type of outpatient healthcare facility accessed. Health system responsiveness was compared using chi-square tests. Results: Of 2517 respondents who used outpatient care in the 12 months preceding interview, 51.7% of respondents used a public facility, 17.8% a private facility, and 30.5% used other facilities. Older age group, higher education and higher wealth were associated with the use of private outpatient healthcare services. Using public outpatient care facilities was associated with having health insurance. Respondents with two or more chronic conditions were more likely to use public and private outpatient care than other facilities. Perceived health system responsiveness was better in private for-profit than in public and private not-for-profit healthcare facilities. Conclusions: This study suggested that higher wealth and multimorbidity were significant predictors of public and private outpatient healthcare utilization; however, health insurance was a predictor only for the use of public facilities. Future mixed-method studies could further

The relationship between accessibility of healthcare facilities and medical care utilization among the middle-aged and elderly population in Taiwan.

PubMed

Yang, Ya-Ting; Iqbal, Usman; Ko, Hua-Lin; Wu, Chia-Rong; Chiu, Hsien-Tsai; Lin, Yi-Chieh; Lin, Wender; Elsa Hsu, Yi-Hsin

2015-06-01

The purpose of this study was to explore the relationship between accessibility of healthcare facilities and medical care utilization among the middle-aged and elderly population in Taiwan. Cross-sectional study from 2007 Taiwan Longitudinal Study on Ageing (TLSA) survey. Community-based study. A total of 4249 middle-aged and elderly subjects were recruited. None. Outpatient visits within 1 month, and hospitalization, emergency visits as well as to shop in pharmacy stores within 1 year, respectively. Adjusting for important confounding variables, the middle-aged and elderly with National Health Insurance (NHI) and commercial insurance compared with those with NHI alone tended to have outpatient visits. The middle-aged and elderly with longer time to access healthcare facilities were less likely to shop in pharmacy stores compared with those with <30 min. The middle-aged and elderly who perceived inconvenient to access health care tended to shop in pharmacy stores compared with those with perceived convenience. Our study of Taiwan's experience could provide a valuable lesson for countries that are planning to launch universal health insurance system, locate budgets in health care and transportation. The middle-aged and elderly who were facing more challenges in accessing health care, no matter in perceived accessibility or real time to access health care, had less outpatient visits and more drug stores shopping. Strategic policies are needed to improve accessibility in increasing patients' perception on access and escalating convenience of transportation system for improving accessibility. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Factors associated with utilization of motorcycle ambulances by pregnant women in rural eastern Uganda: a cross-sectional study.

PubMed

Ssebunya, Rogers; Matovu, Joseph K B

2016-03-03

Evidence suggests that use of motorcycle ambulances can help to improve health facility deliveries; however, few studies have explored the motivators for and barriers to their usage. We explored the factors associated with utilization of motorcycle ambulances by pregnant women in eastern Uganda. This was a cross-sectional, mixed-methods study conducted among 391 women who delivered at four health facilities supplied with motorcycle ambulances in Mbale district, eastern Uganda, between April and May 2014. Quantitative data were collected on socio-demographic and economic characteristics, pregnancy and delivery history, and community and health facility factors associated with utilization of motorcycle ambulances using semi-structured questionnaires. Qualitative data were collected on the knowledge and attitudes towards using motorcycle ambulances by pregnant women through six focus group discussions. Using STATA v.12, we computed the characteristics of women using motorcycle ambulances and used a logistic regression model to assess the correlates of utilization of motorcycle ambulances. Qualitative data were analyzed manually using a master sheet analysis tool. Of the 391 women, 189 (48.3%) reported that they had ever utilized motorcycle ambulances. Of these, 94.7% were currently married or living together with a partner while 50.8% earned less than 50,000 Uganda shillings (US $20) per month. Factors independently associated with use of motorcycle ambulances were: older age of the mother (≥35 years vs ≤24 years; adjusted Odds Ratio (aOR) = 4.3, 95% CI: 2.03, 9.13), sharing a birth plan with the husband (aOR = 2.5, 95% CI: 1.19, 5.26), husband participating in the decision to use the ambulance (aOR =3.22, 95% CI: 1.92, 5.38), and having discussed the use of the ambulance with a traditional birth attendant (TBA) before using it (aOR =3.12, 95% CI: 1.88, 5.19). Qualitative findings indicated that community members were aware of what motorcycle ambulances

A National Study of Efficiency for Dialysis Centers: An Examination of Market Competition and Facility Characteristics for Production of Multiple Dialysis Outputs

PubMed Central

Ozgen, Hacer; A. Ozcan, Yasar

2002-01-01

Objective To examine market competition and facility characteristics that can be related to technical efficiency in the production of multiple dialysis outputs from the perspective of the industrial organization model. Study Setting Freestanding dialysis facilities that operated in 1997 submitted cost report forms to the Health Care Financing Administration (HCFA), and offered all three outputs—outpatient dialysis, dialysis training, and home program dialysis. Data Sources The Independent Renal Facility Cost Report Data file (IRFCRD) from HCFA was utilized to obtain information on output and input variables and market and facility features for 791 multiple-output facilities. Information regarding population characteristics was obtained from the Area Resources File. Study Design Cross-sectional data for the year 1997 were utilized to obtain facility-specific technical efficiency scores estimated through Data Envelopment Analysis (DEA). A binary variable of efficiency status was then regressed against its market and facility characteristics and control factors in a multivariate logistic regression analysis. Principal Findings The majority of the facilities in the sample are functioning technically inefficiently. Neither the intensity of market competition nor a policy of dialyzer reuse has a significant effect on the facilities' efficiency. Technical efficiency is significantly associated, however, with type of ownership, with the interaction between the market concentration of for-profits and ownership type, and with affiliations with chains of different sizes. Nonprofit and government-owned facilities are more likely than their for-profit counterparts to become inefficient producers of renal dialysis outputs. On the other hand, that relationship between ownership form and efficiency is reversed as the market concentration of for-profits in a given market increases. Facilities that are members of large chains are more likely to be technically inefficient

Utilization of acute care among patients with ESRD discharged home from skilled nursing facilities.

PubMed

Hall, Rasheeda K; Toles, Mark; Massing, Mark; Jackson, Eric; Peacock-Hinton, Sharon; O'Hare, Ann M; Colón-Emeric, Cathleen

2015-03-06

Older adults with ESRD often receive care in skilled nursing facilities (SNFs) after an acute hospitalization; however, little is known about acute care use after SNF discharge to home. This study used Medicare claims for North and South Carolina to identify patients with ESRD who were discharged home from a SNF between January 1, 2010 and August 31, 2011. Nursing Home Compare data were used to ascertain SNF characteristics. The primary outcome was time from SNF discharge to first acute care use (hospitalization or emergency department visit) within 30 days. Cox proportional hazards models were used to identify patient and facility characteristics associated with the outcome. Among 1223 patients with ESRD discharged home from a SNF after an acute hospitalization, 531 (43%) had at least one rehospitalization or emergency department visit within 30 days. The median time to first acute care use was 37 days. Characteristics associated with a shorter time to acute care use were black race (hazard ratio [HR], 1.25; 95% confidence interval [95% CI], 1.04 to 1.51), dual Medicare-Medicaid coverage (HR, 1.24; 95% CI, 1.03 to 1.50), higher Charlson comorbidity score (HR, 1.07; 95% CI, 1.01 to 1.12), number of hospitalizations during the 90 days before SNF admission (HR, 1.12; 95% CI, 1.03 to 1.22), and index hospital discharge diagnoses of cellulitis, abscess, and/or skin ulcer (HR, 2.59; 95% CI, 1.36 to 4.45). Home health use after SNF discharge was associated with a lower rate of acute care use (HR, 0.72; 95% CI, 0.59 to 0.87). There were no statistically significant associations between SNF characteristics and time to first acute care use. Almost one in every two older adults with ESRD discharged home after a post-acute SNF stay used acute care services within 30 days of discharge. Strategies to reduce acute care utilization in these patients are needed. Copyright © 2015 by the American Society of Nephrology.

School Facilities Equity in California: An Empirical Study.

ERIC Educational Resources Information Center

Lowe, Davison Duane

This is an equity study, focusing on the crowdedness and adequacy of California's public school facilities. Facilities data are from a 1988 state survey and include information about building space, age of facilities, air conditioning, and construction type. The research focuses on two equity principles: horizontal equity and facilities…

7 CFR 1735.91 - Location of facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Location of facilities. 1735.91 Section 1735.91 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF... All Acquisitions and Mergers § 1735.91 Location of facilities. Telephone facilities to be acquired...

7 CFR 1738.12 - Location of facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Location of facilities. 1738.12 Section 1738.12 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF... Location of facilities. RUS will make broadband loans for facilities which RUS determines are necessary to...

Study of the Relevance of the Quality of Care, Operating Efficiency and Inefficient Quality Competition of Senior Care Facilities.

PubMed

Lin, Jwu-Rong; Chen, Ching-Yu; Peng, Tso-Kwei

2017-09-11

The purpose of this research is to examine the relation between operating efficiency and the quality of care of senior care facilities. We designed a data envelopment analysis, combining epsilon-based measure and metafrontier efficiency analyses to estimate the operating efficiency for senior care facilities, followed by an iterative seemingly unrelated regression to evaluate the relation between the quality of care and operating efficiency. In the empirical studies, Taiwan census data was utilized and findings include the following: Despite the greater operating scale of the general type of senior care facilities, their average metafrontier technical efficiency is inferior to that of nursing homes. We adopted senior care facility accreditation results from Taiwan as a variable to represent the quality of care and examined the relation of accreditation results and operating efficiency. We found that the quality of care of general senior care facilities is negatively related to operating efficiency; however, for nursing homes, the relationship is not significant. Our findings show that facilities invest more in input resources to obtain better ratings in the accreditation report. Operating efficiency, however, does not improve. Quality competition in the industry in Taiwan is inefficient, especially for general senior care facilities.

Study of the Relevance of the Quality of Care, Operating Efficiency and Inefficient Quality Competition of Senior Care Facilities

PubMed Central

Lin, Jwu-Rong; Chen, Ching-Yu; Peng, Tso-Kwei

2017-01-01

The purpose of this research is to examine the relation between operating efficiency and the quality of care of senior care facilities. We designed a data envelopment analysis, combining epsilon-based measure and metafrontier efficiency analyses to estimate the operating efficiency for senior care facilities, followed by an iterative seemingly unrelated regression to evaluate the relation between the quality of care and operating efficiency. In the empirical studies, Taiwan census data was utilized and findings include the following: Despite the greater operating scale of the general type of senior care facilities, their average metafrontier technical efficiency is inferior to that of nursing homes. We adopted senior care facility accreditation results from Taiwan as a variable to represent the quality of care and examined the relation of accreditation results and operating efficiency. We found that the quality of care of general senior care facilities is negatively related to operating efficiency; however, for nursing homes, the relationship is not significant. Our findings show that facilities invest more in input resources to obtain better ratings in the accreditation report. Operating efficiency, however, does not improve. Quality competition in the industry in Taiwan is inefficient, especially for general senior care facilities. PMID:28892019

Containment Studies of Transgenic Mosquitoes in Disease Endemic Countries: The Broad Concept of Facilities Readiness.

PubMed

Quinlan, M Megan; Birungi, Josephine; Coulibaly, Mamadou B; Diabaté, Abdoulaye; Facchinelli, Luca; Mukabana, Wolfgang Richard; Mutunga, James Mutuku; Nolan, Tony; Raymond, Peter; Traoré, Sékou F

2018-01-01

Genetic strategies for large scale pest or vector control using modified insects are not yet operational in Africa, and currently rely on import of the modified strains to begin preliminary, contained studies. Early involvement of research teams from participating countries is crucial to evaluate candidate field interventions. Following the recommended phased approach for novel strategies, evaluation should begin with studies in containment facilities. Experiences to prepare facilities and build international teams for research on transgenic mosquitoes revealed some important organizing themes underlying the concept of "facilities readiness," or the point at which studies in containment may proceed, in sub-Saharan African settings. First, "compliance" for research with novel or non-native living organisms was defined as the fulfillment of all legislative and regulatory requirements. This is not limited to regulations regarding use of transgenic organisms. Second, the concept of "colony utility" was related to the characteristics of laboratory colonies being produced so that results of studies may be validated across time, sites, and strains or technologies; so that the appropriate candidate strains are moved forward toward field studies. Third, the importance of achieving "defensible science" was recognized, including that study conclusions can be traced back to evidence, covering the concerns of various stakeholders over the long term. This, combined with good stewardship of resources and appropriate funding, covers a diverse set of criteria for declaring when "facilities readiness" has been attained. It is proposed that, despite the additional demands on time and resources, only with the balance of and rigorous achievement of each of these organizing themes can collaborative research into novel strategies in vector or pest control reliably progress past initial containment studies.

The National Transonic Facility: A Research Retrospective

NASA Technical Reports Server (NTRS)

Wahls, R. A.

2001-01-01

An overview of the National Transonic Facility (NTF) from a research utilization perspective is provided. The facility was born in the 1970s from an internationally recognized need for a high Reynolds number test capability based on previous experiences with preflight predictions of aerodynamic characteristics and an anticipated need in support of research and development for future aerospace vehicle systems. Selection of the cryogenic concept to meet the need, unique capabilities of the facility, and the eventual research utilization of the facility are discussed. The primary purpose of the paper is to expose the range of investigations that have used the NTF since being declared operational in late 1984; limited research results are included, though many more can be found in the references.

Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach

PubMed Central

Patel, Rachana; Ladusingh, Laishram

2015-01-01

This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007–08) data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM) and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women’s residing in more urbanized districts increased the utilization. “Inter-district” variation was 14 percent whereas “between-villages” variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and inaccessible

Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach.

PubMed

Patel, Rachana; Ladusingh, Laishram

2015-01-01

This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007-08) data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM) and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women's residing in more urbanized districts increased the utilization. "Inter-district" variation was 14 percent whereas "between-villages" variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and inaccessible considering

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

PubMed

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

2018-06-20

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

Central Facilities Area Sewage Lagoon Evaluation

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

Giesbrecht, Alan

2015-03-01

The Central Facilities Area (CFA) located in Butte County, Idaho at Idaho National Laboratory (INL) has an existing wastewater system to collect and treat sanitary wastewater and non contact cooling water from the facility. The existing treatment facility consists of three cells: Cell 1 has a surface area of 1.7 acres, Cell 2 has a surface area of 10.3 acres, and Cell 3 has a surface area of 0.5 acres. If flows exceed the evaporative capacity of the cells, wastewater is discharged to a 73.5 acre land application site that utilizes a center pivot irrigation sprinkler system. The purpose ofmore » this current study is to update the analysis and conclusions of the December 2013 study. In this current study, the new seepage rate and influent flow rate data have been used to update the calculations, model, and analysis.« less

Factors associated with institutional delivery service utilization in Ethiopia.

PubMed

Kebede, Alemi; Hassen, Kalkidan; Nigussie Teklehaymanot, Aderajew

2016-01-01

Most obstetric complications occur unpredictably during the time of delivery, but they can be prevented with proper medical care in the health facilities. Despite the Ethiopian government's efforts to expand health service facilities and promote health institution-based delivery service in the country, an estimated 85% of births still take place at home. The review was conducted with the aim of generating the best evidence on the determinants of institutional delivery service utilization in Ethiopia. The reviewed studies were accessed through electronic web-based search strategy from PubMed, HINARI, Mendeley reference manager, Cochrane Library for Systematic Reviews, and Google Scholar. Review Manager V5.3 software was used for meta-analysis. Mantel-Haenszel odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated. Heterogeneity of the study was assessed using I (2) test. People living in urban areas (OR =13.16, CI =1.24, 3.68), with primary and above educational level of the mother and husband (OR =4.95, CI =2.3, 4. 8, and OR =4.43, CI =1.14, 3.36, respectively), who encountered problems during pregnancy (OR =2.83, CI =4.54, 7.39), and living at a distance <5 km from nearby health facility (OR =2.6, CI =3.33, 6.57) showed significant association with institutional delivery service utilization. Women's autonomy was not significantly associated with institutional delivery service utilization. Distance to health facility and problems during pregnancy were factors positively and significantly associated with institutional delivery service utilization. Promoting couples education beyond primary education regarding the danger signs of pregnancy and benefits of institutional delivery through available communication networks such as health development army and promotion of antenatal care visits and completion of four standard visits by pregnant women were recommended.

Factors associated with institutional delivery service utilization in Ethiopia

PubMed Central

Kebede, Alemi; Hassen, Kalkidan; Nigussie Teklehaymanot, Aderajew

2016-01-01

Background Most obstetric complications occur unpredictably during the time of delivery, but they can be prevented with proper medical care in the health facilities. Despite the Ethiopian government’s efforts to expand health service facilities and promote health institution-based delivery service in the country, an estimated 85% of births still take place at home. Objective The review was conducted with the aim of generating the best evidence on the determinants of institutional delivery service utilization in Ethiopia. Methods The reviewed studies were accessed through electronic web-based search strategy from PubMed, HINARI, Mendeley reference manager, Cochrane Library for Systematic Reviews, and Google Scholar. Review Manager V5.3 software was used for meta-analysis. Mantel–Haenszel odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated. Heterogeneity of the study was assessed using I2 test. Results People living in urban areas (OR =13.16, CI =1.24, 3.68), with primary and above educational level of the mother and husband (OR =4.95, CI =2.3, 4. 8, and OR =4.43, CI =1.14, 3.36, respectively), who encountered problems during pregnancy (OR =2.83, CI =4.54, 7.39), and living at a distance <5 km from nearby health facility (OR =2.6, CI =3.33, 6.57) showed significant association with institutional delivery service utilization. Women’s autonomy was not significantly associated with institutional delivery service utilization. Conclusion and recommendation Distance to health facility and problems during pregnancy were factors positively and significantly associated with institutional delivery service utilization. Promoting couples education beyond primary education regarding the danger signs of pregnancy and benefits of institutional delivery through available communication networks such as health development army and promotion of antenatal care visits and completion of four standard visits by pregnant women were recommended. PMID:27672342

Microgravity Simulation Facility (MSF)

NASA Technical Reports Server (NTRS)

Richards, Stephanie E. (Compiler); Levine, Howard G.; Zhang, Ye

2016-01-01

The Microgravity Simulator Facility (MSF) at Kennedy Space Center (KSC) was established to support visiting scientists for short duration studies utilizing a variety of microgravity simulator devices that negate the directional influence of the "g" vector (providing simulated conditions of micro or partial gravity). KSC gravity simulators can be accommodated within controlled environment chambers allowing investigators to customize and monitor environmental conditions such as temperature, humidity, CO2, and light exposure.

10 CFR 50.22 - Class 103 licenses; for commercial and industrial facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... facilities. 50.22 Section 50.22 Energy NUCLEAR REGULATORY COMMISSION DOMESTIC LICENSING OF PRODUCTION AND..., transfer, acquire, possess, or use a production or utilization facility for industrial or commercial purposes; Provided, however, That in the case of a production or utilization facility which is useful in...

A Cross-Sectional Analytic Study of Postpartum Health Care Service Utilization in the Philippines

PubMed Central

Yamashita, Tadashi; Suplido, Sherri Ann; Ladines-Llave, Cecilia; Tanaka, Yuko; Senba, Naomi; Matsuo, Hiroya

2014-01-01

Background The maternal mortality ratio in the Philippines remains high; thus, it will be difficult to achieve the Millennium Development Goals 5 by 2015. Approximately two-thirds of all maternal deaths occur during the postpartum period. Therefore, we conducted the present study to examine the current state of postpartum health care service utilization in the Philippines, and identify challenges to accessing postpartum care. Methods A questionnaire and knowledge test were distributed to postpartum women in the Philippines. The questionnaire collected demographical characteristics and information about their utilization of health care services during pregnancy and the postpartum period. The knowledge test consisted of 11 questions regarding 6 topics related to possible physical and mental symptoms after delivery. Sixty-four questionnaires and knowledge tests were analyzed. Results The mean time of first postpartum health care visit was 5.1±5.2 days after delivery. Postpartum utilization of health care services was significantly correlated with delivery location (P<0.01). Women who delivered at home had a lower rate of postpartum health care service utilization than women who delivered at medical facilities. The majority of participants scored low on the knowledge test. Conclusion We found inadequate postpartum health care service utilization, especially for women who delivered at home. Our results also suggest that postpartum women lack knowledge about postpartum health concerns. In the Philippines, Barangay health workers may play a role in educating postpartum women regarding health care service utilization to improve their knowledge of possible concerns and their overall utilization of health care services. PMID:24465626

Bypassing health facilities for childbirth in the context of the JSY cash transfer program to promote institutional birth: A cross-sectional study from Madhya Pradesh, India

PubMed Central

Sabde, Yogesh; Chaturvedi, Sarika; Randive, Bharat; Sidney, Kristi; Salazar, Mariano; De Costa, Ayesha; Diwan, Vishal

2018-01-01

Bypassing health facilities for childbirth can be costly both for women and health systems. There have been some reports on this from Sub-Saharan African and from Nepal but none from India. India has implemented the Janani Suraksha Yojana (JSY), a large national conditional cash transfer program which has successfully increased the number of institutional births in India. This paper aims to study the extent of bypassing the nearest health facility offering intrapartum care in three districts of Madhya Pradesh, India, and to identify individual and facility determinants of bypassing in the context of the JSY program. Our results provide information to support the optimal utilization of facilities at different levels of the healthcare system for childbirth. Data was collected from 96 facilities (74 public) and 720 rural mothers who delivered at these facilities were interviewed. Multilevel logistic regression was used to analyze the data. Facility obstetric care functionality was assessed by the number of emergency obstetric care (EmOC) signal functions performed in the last three months. Thirty eighth percent of the mothers bypassed the nearest public facility for their current delivery. Primiparity, higher education, arriving by hired transport and a longer distance from home to the nearest facility increased the odds of bypassing a public facility for childbirth. The variance partition coefficient showed that 37% of the variation in bypassing the nearest public facility can be attributed to difference between facilities. The number of basic emergency obstetric care signal functions (AOR = 0.59, 95% CI 0.37–0.93), and the availability of free transportation at the nearest facility (AOR = 0.11, 95% CI 0.03–0.31) were protective factors against bypassing. The variation between facilities (MOR = 3.85) was more important than an individual’s characteristics to explain bypassing in MP. This multilevel study indicates that in this setting, a focus on increasing the

Bypassing health facilities for childbirth in the context of the JSY cash transfer program to promote institutional birth: A cross-sectional study from Madhya Pradesh, India.

PubMed

Sabde, Yogesh; Chaturvedi, Sarika; Randive, Bharat; Sidney, Kristi; Salazar, Mariano; De Costa, Ayesha; Diwan, Vishal

2018-01-01

Bypassing health facilities for childbirth can be costly both for women and health systems. There have been some reports on this from Sub-Saharan African and from Nepal but none from India. India has implemented the Janani Suraksha Yojana (JSY), a large national conditional cash transfer program which has successfully increased the number of institutional births in India. This paper aims to study the extent of bypassing the nearest health facility offering intrapartum care in three districts of Madhya Pradesh, India, and to identify individual and facility determinants of bypassing in the context of the JSY program. Our results provide information to support the optimal utilization of facilities at different levels of the healthcare system for childbirth. Data was collected from 96 facilities (74 public) and 720 rural mothers who delivered at these facilities were interviewed. Multilevel logistic regression was used to analyze the data. Facility obstetric care functionality was assessed by the number of emergency obstetric care (EmOC) signal functions performed in the last three months. Thirty eighth percent of the mothers bypassed the nearest public facility for their current delivery. Primiparity, higher education, arriving by hired transport and a longer distance from home to the nearest facility increased the odds of bypassing a public facility for childbirth. The variance partition coefficient showed that 37% of the variation in bypassing the nearest public facility can be attributed to difference between facilities. The number of basic emergency obstetric care signal functions (AOR = 0.59, 95% CI 0.37-0.93), and the availability of free transportation at the nearest facility (AOR = 0.11, 95% CI 0.03-0.31) were protective factors against bypassing. The variation between facilities (MOR = 3.85) was more important than an individual's characteristics to explain bypassing in MP. This multilevel study indicates that in this setting, a focus on increasing the level

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2016-04-09

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

Factors associated with utilization of skilled service delivery among women in rural Northern Ghana: a cross sectional study.

PubMed

Gudu, William; Addo, Bright

2017-05-31

Ghana's current Maternal Mortality Ratio (MMR) of 319 per 100,000 live births makes achievement of the Sustainable Development Goal of 70 maternal deaths per 100,000 live births or less by 2030 appear to be illusory. Skilled assistance during childbirth is a critical strategy to reducing maternal mortality, yet the proportion of deliveries taking place within health facilities where such assistance is provided is very low in Ghana, with huge disparity between urban and rural women. To address the gap in skilled attendance in rural Upper East Region, the Ghana Health Service (GHS) in 2005 piloted a program that involved training of Community Health Officers (CHOs) as midwives. This study explored factors associated with skilled delivery services utilization in a predominantly rural district in Ghana. A cross-sectional study, data was collected from a sample of 400 women between the ages of 15 and 49 years who had given birth a year prior to the study. We used frequencies and percentages for descriptive analysis and chi-square (χ 2 ) test for relationship between independents factors and utilization of skilled delivery services. Of the 400 women included in the analysis, 93.3% of them delivered in a health facility. Almost all of the mothers (97.3%) attended or received antenatal care at their last pregnancy with 75.0% of them having four or more ANC visits. The proportion of women who received ANC and utilized skilled delivery services was high (91.5%). Mother's educational attainment, ANC attendance, frequency of ANC visits, satisfaction with ANC services and possession of valid NHIS card significantly associated with utilisation of skilled delivery services. For a predominantly rural district, the percentage of women who deliver within health facilities where skilled assistance is available is very encouraging and a significant stride towards reducing Ghana's overall MMR. Having four or more ANC visits and improving on the quality of care provided has a great

Utilization of Healthcare in the Typhoid Fever Surveillance in Africa Program.

PubMed

Panzner, Ursula; Pak, Gi Deok; Aaby, Peter; Adu-Sarkodie, Yaw; Ali, Mohammad; Aseffa, Abraham; Baker, Stephen; Bjerregaard-Andersen, Morten; Crump, John A; Deerin, Jessica; Cruz Espinoza, Ligia Maria; Gasmelseed, Nagla; Heriniaina, Jean Noël; Hertz, Julian T; Im, Justin; von Kalckreuth, Vera; Keddy, Karen H; Lankoande, Bruno; Løfberg, Sandra; Meyer, Christian G; Oresto, Michael Munishi; Park, Jin Kyung; Park, Se Eun; Rakotozandrindrainy, Raphaël; Sarpong, Nimako; Soura, Abdramane Bassiahi; Gassama Sow, Amy; Tall, Adama; Teferi, Mekonnen; Worku, Alemayehu; Yeshitela, Biruk; Wierzba, Thomas F; Marks, Florian

2016-03-15

Assessing healthcare utilization is important to identify weaknesses of healthcare systems, to outline action points for preventive measures and interventions, and to more accurately estimate the disease burden in a population. A healthcare utilization survey was developed for the Typhoid Fever Surveillance in Africa Program (TSAP) to adjust incidences of salmonellosis determined through passive, healthcare facility-based surveillance. This cross-sectional survey was conducted at 11 sites in 9 sub-Saharan African countries. Demographic data and healthcare-seeking behavior were assessed at selected households. Overall and age-stratified percentages of each study population that sought healthcare at a TSAP healthcare facility and elsewhere were determined. Overall, 88% (1007/1145) and 81% (1811/2238) of the population in Polesgo and Nioko 2, Burkina Faso, respectively, and 63% (1636/2590) in Butajira, Ethiopia, sought healthcare for fever at any TSAP healthcare facility. A far smaller proportion-namely, 20%-45% of the population in Bissau, Guinea-Bissau (1743/3885), Pikine, Senegal (1473/4659), Wad-Medani, Sudan (861/3169), and Pietermaritzburg, South Africa (667/2819); 18% (483/2622) and 9% (197/2293) in Imerintsiatosika and Isotry, Madagascar, respectively; and 4% (127/3089) in Moshi, Tanzania-sought healthcare at a TSAP healthcare facility. Patients with fever preferred to visit pharmacies in Imerintsiatosika and Isotry, and favored self-management of fever in Moshi. Age-dependent differences in healthcare utilization were also observed within and across sites. Healthcare utilization for fever varied greatly across sites, and revealed that not all studied populations were under optimal surveillance. This demonstrates the importance of assessing healthcare utilization. Survey data were pivotal for the adjustment of the program's estimates of salmonellosis and other conditions associated with fever. © The Author 2016. Published by Oxford University Press for the

Distribution and utilization of curative primary healthcare services in Lahej, Yemen.

PubMed

Bawazir, A A; Bin Hawail, T S; Al-Sakkaf, K A Z; Basaleem, H O; Muhraz, A F; Al-Shehri, A M

2013-09-01

No evidence-based data exist on the availability, accessibility and utilization of healthcare services in Lahej Governorate, Yemen. The aim of this study was to assess the distribution and utilization of curative services in primary healthcare units and centres in Lahej. Cross-sectional study (clustering sample). This study was conducted in three of the 15 districts in Lahej between December 2009 and August 2010. Household members were interviewed using a questionnaire to determine sociodemographic characteristics and types of healthcare services available in the area. The distribution of health centres, health units and hospitals did not match the size of the populations or areas of the districts included in this study. Geographical accessibility was the main obstacle to utilization. Factors associated with the utilization of curative services were significantly related to the time required to reach the nearest facility, seeking curative services during illness and awareness of the availability of health facilities (P < 0.01). There is an urgent need to look critically and scientifically at the distribution of healthcare services in the region in order to ensure accessibility and quality of services. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Suicide Prevention in Juvenile Facilities.

ERIC Educational Resources Information Center

Hayes, Lindsay M.

2000-01-01

Youth suicide is recognized as a serious public health problem, but suicide within juvenile facilities has not received comparable attention, and the extent and nature of these deaths remain unknown. This article utilizes an example of a young man in a juvenile justice facility who succeeded in committing suicide to illustrate these points.…

7 CFR 1735.17 - Facilities financed.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF... Basic Policies § 1735.17 Facilities financed. (a) RUS makes hardship and guaranteed loans to finance the... apparatus owned by the borrower, headquarters facilities, and vehicles not used primarily in construction...

7 CFR 1735.17 - Facilities financed.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF... Basic Policies § 1735.17 Facilities financed. (a) RUS makes hardship and guaranteed loans to finance the... apparatus owned by the borrower, headquarters facilities, and vehicles not used primarily in construction...

7 CFR 1735.17 - Facilities financed.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF... Basic Policies § 1735.17 Facilities financed. (a) RUS makes hardship and guaranteed loans to finance the... apparatus owned by the borrower, headquarters facilities, and vehicles not used primarily in construction...

7 CFR 1735.17 - Facilities financed.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF... Basic Policies § 1735.17 Facilities financed. (a) RUS makes hardship and guaranteed loans to finance the... apparatus owned by the borrower, headquarters facilities, and vehicles not used primarily in construction...

Truckers' parking/rest facility study.

DOT National Transportation Integrated Search

2008-07-01

This study examined the current state of truck parking and rest area facilities in the Northeast Illinois Region to determine if : and how problems from truck parking affect freight transportation infrastructure, safety, and the regions economy an...

Opportunities for Automated Demand Response in California Wastewater Treatment Facilities

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

Aghajanzadeh, Arian; Wray, Craig; McKane, Aimee

Previous research over a period of six years has identified wastewater treatment facilities as good candidates for demand response (DR), automated demand response (Auto-­DR), and Energy Efficiency (EE) measures. This report summarizes that work, including the characteristics of wastewater treatment facilities, the nature of the wastewater stream, energy used and demand, as well as details of the wastewater treatment process. It also discusses control systems and automated demand response opportunities. Furthermore, this report summarizes the DR potential of three wastewater treatment facilities. In particular, Lawrence Berkeley National Laboratory (LBNL) has collected data at these facilities from control systems, submetered processmore » equipment, utility electricity demand records, and governmental weather stations. The collected data were then used to generate a summary of wastewater power demand, factors affecting that demand, and demand response capabilities. These case studies show that facilities that have implemented energy efficiency measures and that have centralized control systems are well suited to shed or shift electrical loads in response to financial incentives, utility bill savings, and/or opportunities to enhance reliability of service. In summary, municipal wastewater treatment energy demand in California is large, and energy-­intensive equipment offers significant potential for automated demand response. In particular, large load reductions were achieved by targeting effluent pumps and centrifuges. One of the limiting factors to implementing demand response is the reaction of effluent turbidity to reduced aeration at an earlier stage of the process. Another limiting factor is that cogeneration capabilities of municipal facilities, including existing power purchase agreements and utility receptiveness to purchasing electricity from cogeneration facilities, limit a facility’s potential to participate in other DR activities.« less

42 CFR 57.409 - Good cause for other use of completed facility.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Grants for Construction of Nurse Training Facilities § 57.409 Good cause for other use of completed... facilities not previously utilized for nurse training will be so utilized and are substantially the...

42 CFR 57.409 - Good cause for other use of completed facility.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Grants for Construction of Nurse Training Facilities § 57.409 Good cause for other use of completed... facilities not previously utilized for nurse training will be so utilized and are substantially the...

Development and utilization of USGS ShakeCast for rapid post-earthquake assessment of critical facilities and infrastructure

USGS Publications Warehouse

Wald, David J.; Lin, Kuo-wan; Kircher, C.A.; Jaiswal, Kishor; Luco, Nicolas; Turner, L.; Slosky, Daniel

2017-01-01

The ShakeCast system is an openly available, near real-time post-earthquake information management system. ShakeCast is widely used by public and private emergency planners and responders, lifeline utility operators and transportation engineers to automatically receive and process ShakeMap products for situational awareness, inspection priority, or damage assessment of their own infrastructure or building portfolios. The success of ShakeCast to date and its broad, critical-user base mandates improved software usability and functionality, including improved engineering-based damage and loss functions. In order to make the software more accessible to novice users—while still utilizing advanced users’ technical and engineering background—we have developed a “ShakeCast Workbook”, a well documented, Excel spreadsheet-based user interface that allows users to input notification and inventory data and export XML files requisite for operating the ShakeCast system. Users will be able to select structure based on a minimum set of user-specified facility (building location, size, height, use, construction age, etc.). “Expert” users will be able to import user-modified structural response properties into facility inventory associated with the HAZUS Advanced Engineering Building Modules (AEBM). The goal of the ShakeCast system is to provide simplified real-time potential impact and inspection metrics (i.e., green, yellow, orange and red priority ratings) to allow users to institute customized earthquake response protocols. Previously, fragilities were approximated using individual ShakeMap intensity measures (IMs, specifically PGA and 0.3 and 1s spectral accelerations) for each facility but we are now performing capacity-spectrum damage state calculations using a more robust characterization of spectral deamnd.We are also developing methods for the direct import of ShakeMap’s multi-period spectra in lieu of the assumed three-domain design spectrum (at 0.3s for

LSU: The Library Space Utilization Methodology.

ERIC Educational Resources Information Center

Hall, Richard B.

A computerized research technique for measuring the space utilization of public library facilities provides a behavioral activity and occupancy analysis for library planning purposes. The library space utilization (LSU) methodology demonstrates that significant information about the functional requirements of a library can be measured and…

Work Smarter Not Harder: Utilizing an Environmental Management Information System to Meet Regulatory Compliance and Reporting Requirements for a Major Source Title V Facility

DTIC Science & Technology

2011-05-10

Environmental Management Information System to Meet Regulatory Compliance and Reporting Requirements for a Major Source Title V Facility. Tannis Danley...AND SUBTITLE Work Smarter Not Harder: Utilizing an Environmental Management Information System to Meet Regulatory Compliance and Reporting...Carson) – EMS (Hawaii Garrison, West Virginia National Guard) Environmental Management Information System (EMIS) National Defense Center for Energy and

43 CFR 3271.14 - What do I need to do to start building and testing a utilization facility if it is not located on...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false What do I need to do to start building and testing a utilization facility if it is not located on Federal lands leased for geothermal resources? 3271.14 Section 3271.14 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE...

43 CFR 3271.14 - What do I need to do to start building and testing a utilization facility if it is not located on...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false What do I need to do to start building and testing a utilization facility if it is not located on Federal lands leased for geothermal resources? 3271.14 Section 3271.14 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE...

43 CFR 3271.14 - What do I need to do to start building and testing a utilization facility if it is not located on...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false What do I need to do to start building and testing a utilization facility if it is not located on Federal lands leased for geothermal resources? 3271.14 Section 3271.14 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE...

43 CFR 3271.14 - What do I need to do to start building and testing a utilization facility if it is not located on...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false What do I need to do to start building and testing a utilization facility if it is not located on Federal lands leased for geothermal resources? 3271.14 Section 3271.14 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE...

Study of the possibility of thermal utilization of contaminated water in low-power boilers

NASA Astrophysics Data System (ADS)

Roslyakov, P. V.; Proskurin, Y. V.; Zaichenko, M. N.

2017-09-01

The utilization of water contaminated with oil products is a topical problem for thermal power plants and boiler houses. It is reasonable to use special water treatment equipment only for large power engineering and industry facilities. Thermal utilization of contaminated water in boiler furnaces is proposed as an alternative version of its utilization. Since there are hot-water fire-tube boilers at many enterprises, it is necessary to study the possibility of thermal utilization of water contaminated with oil products in their furnaces. The object of this study is a KV-GM-2.0 boiler with a heating power of 2 MW. The pressurized burner developed at the Moscow Power Engineering Institute, National Research University, was used as a burner device for supplying liquid fuel. The computational investigations were performed on the basis of the computer simulation of processes of liquid fuel atomization, mixing, ignition, and burnout; in addition, the formation of nitrogen oxides was simulated on the basis of ANSYS Fluent computational dynamics software packages, taking into account radiative and convective heat transfer. Analysis of the results of numerical experiments on the combined supply of crude oil and water contaminated with oil products has shown that the thermal utilization of contaminated water in fire-tube boilers cannot be recommended. The main causes here are the impingement of oil droplets on the walls of the flame tube, as well as the delay in combustion and increased emissions of nitrogen oxides. The thermal utilization of contaminated water combined with diesel fuel can be arranged provided that the water consumption is not more than 3%; however, this increases the emission of nitrogen oxides. The further increase in contaminated water consumption will lead to the reduction of the reliability of the combustion process.

Georgia harvest and utilization study, 2015

Treesearch

David J. Wall; James W. Bentley; James A. Gray; Jason A. Cooper

2018-01-01

In 2014, a harvest and utilization study was conducted on 91 operations throughout Georgia. There were 2,129 total trees measured: 1,842 or 87 percent were softwood, while 287 or 13 percent were hardwood. Results from this study showed that 87 percent of the total softwood volume measured was utilized for a product, and 13 percent was left as logging residue. Seventy-...

Georgia harvest and utilization study, 2009

Treesearch

James W. Bentley

2011-01-01

In 2009, a harvest and utilization study was conducted on 80 operations throughout Georgia. There were 1,981 total trees measured: 1,453 or 73 percent were softwood, while 528 or 27 percent were hardwood. Results from this study showed that 88 percent of the total softwood volume measured was utilized for a product, and 12 percent was left as logging residue. Seventy-...

Georgia harvest and utilization study, 2004

Treesearch

James W. Bentley; Richard a. Harper

2006-01-01

In 2004, a harvest and utilization study was conducted on 96 operations throughout Georgia. There were 2,368 total trees measured, 1,581 or 67 percent were softwood, while 787 or 33 percent were hardwood. Results from this study showed that 86 percent of the total softwood volume measured was utilized for a product, while the other 14 percent was left as logging...

Alabama harvest and utilization study, 2008

Treesearch

James W. Bentley; Tony G. Johnson

2008-01-01

In 2008, a harvest and utilization study was conducted on 80 operations throughout Alabama. There were 2,100 total trees measured; 1,433 or 68 percent were softwood, while 667 or 32 percent were hardwood. Results from this study showed that 88 percent of the total softwood volume measured was utilized for a product, and 12 percent was left as logging residue. Seventy-...

43 CFR 3272.11 - How do I describe the proposed utilization facility?

Code of Federal Regulations, 2011 CFR

2011-10-01

...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) GEOTHERMAL RESOURCE... proposed facility operations, including estimated total production and injection rates; estimated well flow... site(s); (e) The source, quality, and proposed consumption rate of water to be used during facility...

The Aged Residential Care Healthcare Utilization Study (ARCHUS): a multidisciplinary, cluster randomized controlled trial designed to reduce acute avoidable hospitalizations from long-term care facilities.

PubMed

Connolly, Martin J; Boyd, Michal; Broad, Joanna B; Kerse, Ngaire; Lumley, Thomas; Whitehead, Noeline; Foster, Susan

2015-01-01

To assess effect of a complex, multidisciplinary intervention aimed at reducing avoidable acute hospitalization of residents of residential aged care (RAC) facilities. Cluster randomized controlled trial. RAC facilities with higher than expected hospitalizations in Auckland, New Zealand, were recruited and randomized to intervention or control. A total of 1998 residents of 18 intervention facilities and 18 control facilities. A facility-based complex intervention of 9 months' duration. The intervention comprised gerontology nurse specialist (GNS)-led staff education, facility bench-marking, GNS resident review, and multidisciplinary (geriatrician, primary-care physician, pharmacist, GNS, and facility nurse) discussion of residents selected using standard criteria. Primary end point was avoidable hospitalizations. Secondary end points were all acute admissions, mortality, and acute bed-days. Follow-up was for a total of 14 months. The intervention did not affect main study end points: number of acute avoidable hospital admissions (RR 1.07; 95% CI 0.85-1.36; P = .59) or mortality (RR 1.11; 95% CI 0.76-1.61; P = .62). This multidisciplinary intervention, packaging selected case review, and staff education had no overall impact on acute hospital admissions or mortality. This may have considerable implications for resourcing in the acute and RAC sectors in the face of population aging. Australian and New Zealand Clinical Trials Registry (ACTRN12611000187943). Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Preliminary design study for an atomospheric science facility

NASA Technical Reports Server (NTRS)

Hutchison, R.

1972-01-01

The activities and results of the Atmospheric Science Facility preliminary design study are reported. The objectives of the study were to define the scientific goals, to determine the range of experiment types, and to develop the preliminary instrument design requirements for a reusable, general purpose, optical research facility for investigating the earth's atmosphere from a space shuttle orbital vehicle.

Using willingness to pay to investigate regressiveness of user fees in health facilities in Tanzania.

PubMed

Bonu, Sekhar; Rani, Manju; Bishai, David

2003-12-01

The study uses data from the Tanzania Human Resources Development Survey (1994) on willingness to pay (WTP) for desired quality of health care at lower-level health facilities to assess potential regressiveness of user fees - a disproportionately higher negative effect of user fees on utilization of health services among the poor compared with the rich. Despite reports of extensive bypassing of the lower-level health facilities in Tanzania, the WTP for quality health care at these health facilities is surprisingly large. WTP was lower among the poor, female and elderly respondents. Almost one-quarter of the poorest 40% of the population was not willing to pay even when the quality of services met their expectations. The results suggest that: the utilization of health services at lower-level health facilities can be increased by improving the quality of care; and the implementation of uniform user charges in the public facilities may be regressive, adversely affecting utilization among the poor, women and the elderly. An effective system of exemptions and waivers will be required for the very poor who may not be able to pay even when quality of services is improved. The findings of the study have policy implications for the Tanzanian government's recent attempts to expand cost-sharing through community health funds at lower-level health facilities, being introduced since 1998.

Opportunities for Open Automated Demand Response in Wastewater Treatment Facilities in California - Phase II Report. San Luis Rey Wastewater Treatment Plant Case Study

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

Thompson, Lisa; Lekov, Alex; McKane, Aimee

2010-08-20

This case study enhances the understanding of open automated demand response opportunities in municipal wastewater treatment facilities. The report summarizes the findings of a 100 day submetering project at the San Luis Rey Wastewater Treatment Plant, a municipal wastewater treatment facility in Oceanside, California. The report reveals that key energy-intensive equipment such as pumps and centrifuges can be targeted for large load reductions. Demand response tests on the effluent pumps resulted a 300 kW load reduction and tests on centrifuges resulted in a 40 kW load reduction. Although tests on the facility?s blowers resulted in peak period load reductions ofmore » 78 kW sharp, short-lived increases in the turbidity of the wastewater effluent were experienced within 24 hours of the test. The results of these tests, which were conducted on blowers without variable speed drive capability, would not be acceptable and warrant further study. This study finds that wastewater treatment facilities have significant open automated demand response potential. However, limiting factors to implementing demand response are the reaction of effluent turbidity to reduced aeration load, along with the cogeneration capabilities of municipal facilities, including existing power purchase agreements and utility receptiveness to purchasing electricity from cogeneration facilities.« less

Inequality and inequity in healthcare utilization in urban Nepal: a cross-sectional observational study

PubMed Central

Saito, Eiko; Gilmour, Stuart; Yoneoka, Daisuke; Gautam, Ghan Shyam; Rahman, Md Mizanur; Shrestha, Pradeep Krishna; Shibuya, Kenji

2016-01-01

Inequality in access to quality healthcare is a major health policy challenge in many low- and middle-income countries. This study aimed to identify the major sources of inequity in healthcare utilization using a population-based household survey from urban Nepal. A cross-sectional survey was conducted covering 9177 individuals residing in 1997 households in five municipalities of Kathmandu valley between 2011 and 2012. The concentration index was calculated and a decomposition method was used to measure inequality in healthcare utilization, along with a horizontal inequity index (HI) to estimate socioeconomic inequalities in healthcare utilization. Results showed a significant pro-rich distribution of general healthcare utilization in all service providers (Concentration Index: 0.062, P < 0.001; HI: 0.029, P < 0.05) and private service providers (Concentration Index: 0.070, P < 0.001; HI: 0.030, P < 0.05). The pro-rich distribution of probability in general healthcare utilization was attributable to inequalities in the level of household economic status (percentage contribution: 67.8%) and in the self-reported prevalence of non-communicable diseases such as hypertension (36.7%) and diabetes (14.4%). Despite the provision of free services by public healthcare providers, our analysis found no evidence of the poor making more use of public health services (Concentration Index: 0.041, P = 0.094). Interventions to reduce the household economic burden of major illnesses, coupled with improvement in the management of public health facilities, warrant further attention by policy-makers. PMID:26856362

Obstetric Facility Quality and Newborn Mortality in Malawi: A Cross-Sectional Study

PubMed Central

Fink, Günther; Nsona, Humphreys

2016-01-01

results imply a newborn mortality rate of 28 per 1,000 births at low-quality facilities and of 5 per 1,000 births at the top 25% of facilities, accounting for maternal and newborn characteristics. This estimate applies to newborns whose mothers would switch from a lower-quality to a higher-quality facility if one were more accessible. Although we did not find an indication of unmeasured associations between the instrument and outcome, this remains a potential limitation of IV analysis. Conclusions Poor quality of delivery facilities is associated with higher risk of newborn mortality in Malawi. A shift in focus from increasing utilization of delivery facilities to improving their quality is needed if global targets for further reductions in newborn mortality are to be achieved. PMID:27755547

Kentucky harvest and utilization study, 2007

Treesearch

Jason A. Cooper; James W. Bentley

2013-01-01

In 2007, a harvest and utilization study was conducted on 53 operations in Kentucky. There were 1,310 total trees measured: 263 or 20 percent were softwood, while 1,047 or 80 percent were hardwood. Results from this study showed that 82 percent of the total softwood volume measured was utilized for a product, and 18 percent was left as logging residue. Seventy-two...

Utilization of a state run public private emergency transportation service exclusively for childbirth: the Janani (maternal) Express program in Madhya Pradesh, India.

PubMed

Sidney, Kristi; Ryan, Kayleigh; Diwan, Vishal; De Costa, Ayesha

2014-01-01

In 2009 the state government of Madhya Pradesh, India launched an emergency obstetric transportation service, Janani Express Yojana (JEY), to support the cash transfer program that promotes institutional delivery. JEY, a large scale public private partnership, lowers geographical access barriers to facility based care. The state contracts and pays private agencies to provide emergency transportation at no cost to the user. The objective was to study (a) the utilization of JEY among women delivering in health facilities, (b) factors associated with usage, (c) the timeliness of the service. A cross sectional facility based study was conducted in facilities that carried out > ten deliveries a month. Researchers who spent five days in each facility administered a questionnaire to all women who gave birth there to elicit socio-demographic characteristics and transport related details. 35% of women utilised JEY to reach a facility, however utilization varied between study districts. Uptake was highest among women from rural areas (44%), scheduled tribes (55%), and poorly educated women (40%). Living in rural areas and belonging to scheduled tribes were significant predictors for JEY usage. Almost 1/3 of JEY users (n = 104) experienced a transport related delay. The JEY service model complements the cash transfer program by providing transport to a facility to give birth. A study of the distribution of utilization in population subgroups suggests the intervention was successful in reaching the most vulnerable population, promoting equity in access. While 1/3 of women utilized the service and it saved them money; 30% experienced significant transport related delays in reaching a facility, which is comparable to women using public transportation. Further research is needed to understand why utilization is low, to explore if there is a need for service expansion at the community level and to improve the overall time efficiency of JEY.

The Utility-Scale Future - Continuum Magazine | NREL

Science.gov Websites

Spring 2011 / Issue 1 Continuum. Clean Energy Innovation at NREL The Utility-Scale Future Continuum facility will lead the way. Wind Innovation Enables Utility-Scale 02 Wind Innovation Enables Utility-Scale Archives 9 Beyond R&D: Market Impact 8 NREL Analysis 7 Partnering: An Engine for Innovation 6 Energy

43 CFR 3270.10 - What types of geothermal operations are governed by these utilization regulations?

Code of Federal Regulations, 2011 CFR

2011-10-01

... of geothermal resources. This includes: (1) Electrical generation facilities; (2) Direct use facilities; (3) Related utilization facility operations; (4) Actual and allocated well field production and injection; and (5) Related well field operations. (b) The utilization regulations in subparts 3270 through...

Women's social networks and use of facility delivery services for uncomplicated births in North West Ethiopia: a community-based case-control study.

PubMed

Asrese, Kerebih; Adamek, Margaret E

2017-12-28

High maternal mortality has remained an unmet public health challenge in the developing world. Maternal mortality in Ethiopia is among the highest in the world. Since most maternal deaths occur during labor, delivery, and the immediate postpartum period, facility delivery with skilled birth attendants is recommended to reduce maternal mortality. Nonetheless, the majority of women in Ethiopia give birth at home. Individual attributes and availability and accessibility of services deter service utilization. The role of social networks that may facilitate or constrain service use is not well studied. Community-based case-control study was conducted between February and March 2014 in Jabi Tehinan District, North West Ethiopia. Retrospective data were collected from 134 women who had uncomplicated births at health facilities and 140 women who had uncomplicated births at home within a year preceding the survey. Interviews were held with eight women who had uncomplicated births at health facilities and 11 who had uncomplicated births at home. The quantitative data were entered and analyzed using SPSS for Windows versions 16.0 and hierarchical logistic regression model was used for analysis. The qualitative data were transcribed verbatim and data were used to substantiate the quantitative data. The results indicated that social network variables were significantly associated with the use of health facilities for delivery. Taking social networks into account improved the explanation of facility use for delivery services over women's individual attributes. Women embedded within homogeneous network members (Adjusted OR 2.53; 95% CI: 1.26-5.06) and embedded within high SBA endorsement networks (Adjusted OR 7.97; 95% CI: 4.07-12.16) were more likely to deliver at health facilities than their counterparts. Women living in urban areas (Adjusted OR 3.32; 95% CI: 1.37-8.05) and had better knowledge of obstetric complications (Adjusted OR 3.01; 95% CI: 1.46-6.18) were more likely to

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

NASA Astrophysics Data System (ADS)

Soetrisno, D. P.

2017-06-01

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

Service readiness, health facility management practices, and delivery care utilization in five states of Nigeria: a cross-sectional analysis.

PubMed

Gage, Anastasia J; Ilombu, Onyebuchi; Akinyemi, Akanni Ibukun

2016-10-06

Existing studies of delivery care in Nigeria have identified socioeconomic and cultural factors as the primary determinants of health facility delivery. However, no study has investigated the association between supply-side factors and health facility delivery. Our study analyzed the role of supply-side factors, particularly health facility readiness and management practices for provision of quality maternal health services. Using linked data from the 2005 and 2009 health facility and household surveys in the five states in which the Community Participation for Action in the Social Sector (COMPASS) project was implemented, indices of health service readiness and management were developed based on World Health Organization guidelines. Multilevel logistic regression models were run to determine the association between these indices and health facility delivery among 2710 women aged 15-49 years whose last child was born within the five years preceding the surveys and who lived in 51 COMPASS LGAs. The health facility delivery rate increased from 25.4 % in 2005 to 44.1 % in 2009. Basic amenities for antenatal care provision, readiness to deliver basic emergency obstetric and newborn care, and management practices supportive of quality maternal health services were suboptimal in health facilities surveyed and did not change significantly between 2005 and 2009. The LGA mean index of basic amenities for antenatal care provision was more positively associated with the odds of health facility delivery in 2009 than in 2005, and in rural than in urban areas. The LGA mean index of management practices was associated with significantly lower odds of health facility delivery in rural than in urban areas. The LGA mean index of facility readiness to deliver basic emergency obstetric and neonatal care declined slightly from 5.16 in 2005 to 3.98 in 2009 and was unrelated to the odds of health facility delivery. Supply-side factors appeared to play a role in health facility delivery

PERT Planning for Physical Educational Facilities.

ERIC Educational Resources Information Center

Moriarty, R. J.

1973-01-01

Because of the high degree of interest in education and physical education in Canada, there has been a phenomenal growth in physical education facilities. Physical educators must become facility specialists in order to contribute to the planning, procurement, and utilization of the new complexes that are being developed. Among the most difficult…

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…

Utilization of medical care following the Three Mile Island crisis.

PubMed

Houts, P S; Hu, T W; Henderson, R A; Cleary, P D; Tokuhata, G

1984-02-01

Four studies are reported on how utilization of primary health care was affected by the Three Mile Island (TMI) crisis and subsequent distress experienced by persons living in the vicinity of the plant. The studies concerned: 1) Blue Cross-Blue Shield records of claims by primary care physicians in the vicinity of TMI; 2) utilization rates in a family practice located near the facility; 3) interviews with persons living within five miles of TMI following the crisis; and 4) responses to a questionnaire by primary care physicians practicing within 25 miles of TMI. All four studies indicated only slight increases in utilization rates during the year following the crisis. One study found that persons who were upset during the crisis tended to be high practice utilizers both before and after the crisis. These results suggest that, while patterns of physician utilization prior to the TMI crisis predicted emotional response during the crisis, the impact of the TMI crisis on subsequent physician utilization was small.

Utilization of medical care following the Three Mile Island crisis.

PubMed Central

Houts, P S; Hu, T W; Henderson, R A; Cleary, P D; Tokuhata, G

1984-01-01

Four studies are reported on how utilization of primary health care was affected by the Three Mile Island (TMI) crisis and subsequent distress experienced by persons living in the vicinity of the plant. The studies concerned: 1) Blue Cross-Blue Shield records of claims by primary care physicians in the vicinity of TMI; 2) utilization rates in a family practice located near the facility; 3) interviews with persons living within five miles of TMI following the crisis; and 4) responses to a questionnaire by primary care physicians practicing within 25 miles of TMI. All four studies indicated only slight increases in utilization rates during the year following the crisis. One study found that persons who were upset during the crisis tended to be high practice utilizers both before and after the crisis. These results suggest that, while patterns of physician utilization prior to the TMI crisis predicted emotional response during the crisis, the impact of the TMI crisis on subsequent physician utilization was small. PMID:6691524

Peak-Load Pricing and Facility Utilization in Higher Education.

ERIC Educational Resources Information Center

Coats, R. Morris

1995-01-01

This article argues that college pricing policies can be developed to encourage more efficient use of college facilities and reduce the need for capital and operating funding from state or private sources. A survey of 403 students at 1 institution indicates that students would be responsive to discounts in ways that would make such discounts…

Factors Associated With Utilization of Cardiac Rehabilitation Among Patients With Ischemic Heart Disease in the Veterans Health Administration: A QUALITATIVE STUDY.

PubMed

Schopfer, David W; Priano, Susan; Allsup, Kelly; Helfrich, Christian D; Ho, P Michael; Rumsfeld, John S; Forman, Daniel E; Whooley, Mary A

2016-01-01

Cardiac rehabilitation (CR) programs reduce morbidity and mortality in patients with ischemic heart disease but are vastly underutilized in the United States, including the Veterans Health Administration (VA) Healthcare System. Numerous barriers affecting utilization have been identified in other health care systems, but the specific factors affecting Veterans are unknown. We sought to identify barriers and facilitators associated with utilization of CR in VA facilities. We performed a qualitative study of 56 VA patients, providers, and CR program managers at 30 VA facilities across the United States. We conducted semistructured interviews with key informants to explore their attitudes and knowledge toward CR. Interviews were conducted until thematic saturation occurred. Analyses using grounded theory to identify key themes were conducted using the qualitative data analysis package ATLAS.ti. We identified 6 themes as barriers and 5 as facilitators. The most common barriers to participation in CR were patient transportation issues (68%), lack of patient willingness to participate (41%), and no access to a nearby VA hospital with a CR program (30%). The most common facilitators were involvement of a dedicated provider or "clinical champion" (50%), provider knowledge of or experience with CR (48%), and patient desire for additional medical support (32%). Our findings suggest that addressing access issues and educating and activating providers on CR may increase utilization of CR programs. Targeting these specific factors may improve utilization of CR programs.

The utilization of intravenous therapy programs in community long-term care nursing facilities.

PubMed

Weinberg, A D; Pals, J K; Wei, J Y

1997-01-01

To determine if non-federal Boston-area long-term care nursing facilities are actively using intravenous (IV) therapy as a form of treatment, the specific design of such programs and to assess the availability of central line IVs, percutaneous endoscopic gastrostomy (PEG) tubes and hypodermoclysis for hydration in this setting. DESIGN/SETTINGS: A prospective telephone survey of 100 Boston-area skilled nursing facilities, each with a minimum of 50 beds and representing a total of 12,763 beds, certified to provide both Medicaid (Title-19) and Medicare services, to ascertain their ability to provide IV and other modes of hydration for their residents. A series of questions were asked of a member of the staff knowledgeable in the operations of the nursing facility. Questions included whether an IV program was in existence, duration of the program, provider of IV training for nurses, presence of a subacute unit, whether IVs were administered in non-subacute areas, frequency of IV usage, the ability to manage central lines and the use of PEG tubes or hypodermoclysis for hydration. A total of 100 nursing facilities were surveyed between September and October of 1996. A total of 79 nursing facilities had active IV programs (79%) and 54 of those (68%) also managed central lines. However, in those facilities with active IV programs, 73% (N = 58) reported administering a total of less than five IVs per month. Training for 82% of the nursing facilities (N = 65) was by an outside vendor pharmacy and initial training ranged from one to three days in duration. Of the 19 nursing facilities with IV programs available only in subacute or equivalent units, only 26% (N = 5) did not allow direct transfer of residents from other wards into these units. Of the 79 nursing facilities having IV capability, a total of 91% (N = 72) have also used PEG tubes for hydration and nutritional needs although only 6% (N = 5) have ever used hypodermoclysis for hydration. The majority of nursing

Three methods to monitor utilization of healthcare services by the poor

PubMed Central

Bhuiya, Abbas; Hanifi, SMA; Urni, Farhana; Mahmood, Shehrin Shaila

2009-01-01

Background Achieving equity by way of improving the condition of the economically poor or otherwise disadvantaged is among the core goals of contemporary development paradigm. This places importance on monitoring outcome indicators among the poor. National surveys allow disaggregation of outcomes by socioeconomic status at national level and do not have statistical adequacy to provide estimates for lower level administrative units. This limits the utility of these data for programme managers to know how well particular services are reaching the poor at the lowest level. Managers are thus left without a tool for monitoring results for the poor at lower levels. This paper demonstrates that with some extra efforts community and facility based data at the lower level can be used to monitor utilization of healthcare services by the poor. Methods Data used in this paper came from two sources- Chakaria Health and Demographic Surveillance System (HDSS) of ICDDR,B and from a special study conducted during 2006 among patients attending the public and private health facilities in Chakaria, Bangladesh. The outcome variables included use of skilled attendants for delivery and use of facilities. Rate-ratio, rate-difference, concentration index, benefit incidence ratio, sequential sampling, and Lot Quality Assurance Sampling were used to assess how pro-poor is the use of skilled attendants for delivery and healthcare facilities. Findings Poor are using skilled attendants for delivery far less than the better offs. Government health service facilities are used more than the private facilities by the poor. Benefit incidence analysis and sequential sampling techniques could assess the situation realistically which can be used for monitoring utilization of services by poor. The visual display of the findings makes both these methods attractive. LQAS, on the other hand, requires small fixed sample and always enables decision making. Conclusion With some extra efforts monitoring of the

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.

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

Effect of facility on the operative costs of distal radius fractures.

PubMed

Mather, Richard C; Wysocki, Robert W; Mack Aldridge, J; Pietrobon, Ricardo; Nunley, James A

2011-07-01

The purpose of this study was to investigate whether ambulatory surgery centers can deliver lower-cost care and to identify sources of those cost savings. We performed a cost identification analysis of outpatient volar plating for closed distal radius fractures at a single academic medical center. Multiple costs and time measures were taken from an internal database of 130 consecutive patients and were compared by venue of treatment, either an inpatient facility or an ambulatory, stand-alone surgery facility. The relationships between total cost and operative time and multiple variables, including fracture severity, patient age, gender, comorbidities, use of bone graft, concurrent carpal tunnel release, and surgeon experience, were examined, using multivariate analysis and regression modeling to identify other cost drivers or explanatory variables. The mean operative cost was considerably greater at the inpatient facility ($7,640) than at the outpatient facility ($5,220). Cost drivers of this difference were anesthesia services, post-anesthesia care unit, and operating room costs. Total surgical time, nursing time, set-up, and operative times were 33%, 109%, 105%, and 35% longer, respectively, at the inpatient facility. There was no significant difference between facilities for the additional variables, and none of those variables independently affected cost or operative time. The only predictor of cost and time was facility type. This study supports the use of ambulatory stand-alone surgical facilities to achieve efficient resource utilization in the operative treatment of distal radius fractures. We also identified several specific costs and time measurements that differed between facilities, which can serve as potential targets for tertiary facilities to improve utilization. Economic and Decisional Analysis III. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Public Utility Commission manual for Section 210 of PURPA for Vermont

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

Not Available

The Public Utility Regulatory Policies Act of 1978 (PURPA) places obligations on both electric utilities and state regulatory commissions. PURPA requires every electric utility to purchase all energy and capacity made available to it, by a qualifying facility, and to sell energy and capacity to a qualifying facility upon the qualifying facility's request. State regulatory commissions must implement and administer these utility obligations and other requirements that were implemented by the Federal Energy Regulatory Commission's (FERC) final rules, which became effective March 20, 1981, and must set fair rates for electric power purchases and sales between utilities and small powermore » producers. This manual provides a concise, annotated explanation of the final FERC rules, a description of federal and state statutory authorizations, court challenges to these authorizations, analysis of the relationship between federal and state laws, analysis of Vermont's implementation of section 210 of PURPA and for comparison, annotations of selected state regulatory authority decisions.« less

Public Utility Commission manual for Section 210 of PURPA for Montana

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

Not Available

The Public Utility Regulatory Policies Act of 1978 (PURPA) places obligations on both electric utilities and state regulatory commissions. PURPA requires every electric utility to purchase all energy and capacity made available to it, by a qualifying facility, and to sell energy and capacity to a qualifying facility upon the qualifying facility's request. State regulatory commissions must implement and administer these utility obligations and other requirements that were implemented by the Federal Energy Regulatory Commission's (FERC) final rules, which became effective March 20, 1981; and must set fair rates for electric power purchases and sales between utilities and small powermore » producers. This manual provides a concise, annotated explanation of the final FERC rules, a description of federal and state statutory authorizations, court challenges to these authorizations analysis of the relationship between federal and state laws, analysis of Montana's implementation of section 210 of PURPA and for comparison, annotations of selected state regulatory authority decisions.« less

Public Utility Commission manual for Section 210 of PURPA for Arkansas

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

Not Available

The Public Utility Regulatory Policies Act of 1978 (PURPA) places obligations on both electric utilities and state regulatory commissions. PURPA requires every electric utility to purchase all energy and capacity made available to it, by a qualifying facility, and to sell energy and capacity to a qualifying facility upon the qualifying facility's request. State regulatory commissions must implement and administer these utility obligations and other requirements that were implemented by the Federal Energy Regulatory Commission's (FERC) final rules, which became effective March 20, 1981; and must set fair rates for electric power purchases and sales between utilities and small powermore » producers. This manual provides a concise, annotated explanation of the final FERC rules, a description of federal and state statutory authorizations, court challenges to these authorizations, analysis of the relationship between federal and state laws, analysis of Arkansas' implementation of section 210 of PURPA and for comparison, annotations of selected state regulatory authority decisions.« less

The Attached Payload Facility Program: A Family of In-Space Commercial Facilities for Technology, Science and Industry

NASA Technical Reports Server (NTRS)

Avery, Don E.; Kaszubowski, Martin J.; Kearney, Michael E.; Howard, Trevor P.

1996-01-01

It is anticipated that as the utilization of space increases in both the government and commercial sec tors the re will be a high degree of interest in materials and coatings research as well as research in space environment definition, deployable structures, multi-functional structures and electronics. The International Space Station (ISS) is an excellent platform for long-term technology development because it provides large areas for external attached payloads, power and data capability, and ready access for experiment exchange and return. An alliance of SPACEHAB, MicroCraft, Inc. and SpaceTec, Inc. has been formed to satisfy this research need through commercial utilization of the capabilities of ISS. The alliance will provide a family of facilities designed to provide low-cost, reliable access to space for experimenters. This service would start as early as 1997 and mature to a fully functional attached facility on ISS by 2001. The alliances facilities are based on early activities by NASA, Langley Research Center (LaRC) to determine the feasibility of a Material Exposure Facility (MEF).

Shipboard Facilities Maintenance and Manpower Utilization: Problem and Approach

DTIC Science & Technology

1975-11-01

sweeping, butting, polishing, lacquering, stenciling, vacuuming and shampooing , garbage disposal and trash removal, and all manner of sanitary and...spaces, passageways, heads and showers, crew lounge, mess decks, exterior deck and ship sides, and all office spaces; and limited facilities...maintenance in all passageways, heads , mess decks, office spaces, and berthing areas. They will also per- form sanitization and exterior deck and

Inequalities in maternal health care utilization in Benin: a population based cross-sectional study.

PubMed

Yaya, Sanni; Uthman, Olalekan A; Amouzou, Agbessi; Ekholuenetale, Michael; Bishwajit, Ghose

2018-05-31

Ensuring equitable access to maternal health care including antenatal, delivery, postnatal services and fertility control methods, is one of the most critical challenges for public health sector. There are significant disparities in maternal health care indicators across many geographical locations, maternal, economic, socio-demographic factors in many countries in sub-Sahara Africa. In this study, we comparatively explored the utilization level of maternal health care, and examined disparities in the determinants of major maternal health outcomes. This paper used data from two rounds of Benin Demographic and Health Survey (BDHS) to examine the utilization and disparities in factors of maternal health care indicators using logistic regression models. Participants were 17,794 and 16,599 women aged between15-49 years in 2006 and 2012 respectively. Women's characteristics were reported in percentage, mean and standard deviation. Mean (±SD) age of the participants was 29.0 (±9.0) in both surveys. The percentage of at least 4 ANC visits was approximately 61% without any change between the two rounds of surveys, facility based delivery was 93.5% in 2012, with 4.9% increase from 2006; postnatal care was currently 18.4% and contraceptive use was estimated below one-fifth. The results of multivariable logistic regression models showed disparities in maternal health care service utilization, including antenatal care, facility-based delivery, postnatal care and contraceptive use across selected maternal factors. The current BHDS showed age, region, religion were significantly associated with maternal health care services. Educated women, those from households of high wealth index and women currently working were more likely to utilize maternal health care services, compared to women with no formal education, from poorest households or not currently employed. Women who watch television (TV) were 1.31 (OR = 1.31; 95% CI = 1.13-1.52), 1.69 (OR = 1.69; 95% CI�

School Finance and Facilities Study.

ERIC Educational Resources Information Center

Kawakami, Alice J., Ed.

1994-01-01

This document presents findings of a Pacific Region Educational Laboratory (PREL) study on the status of school finance and facilities in the 10 entities of the Pacific region served by PREL--American Samoa, Commonwealth of the Northern Mariana Islands (CNMI), Federated States of Micronesia, Guam, Hawaii, Republic of the Marshall Islands, and the…

Inequality and inequity in healthcare utilization in urban Nepal: a cross-sectional observational study.

PubMed

Saito, Eiko; Gilmour, Stuart; Yoneoka, Daisuke; Gautam, Ghan Shyam; Rahman, Md Mizanur; Shrestha, Pradeep Krishna; Shibuya, Kenji

2016-09-01

Inequality in access to quality healthcare is a major health policy challenge in many low- and middle-income countries. This study aimed to identify the major sources of inequity in healthcare utilization using a population-based household survey from urban Nepal. A cross-sectional survey was conducted covering 9177 individuals residing in 1997 households in five municipalities of Kathmandu valley between 2011 and 2012. The concentration index was calculated and a decomposition method was used to measure inequality in healthcare utilization, along with a horizontal inequity index (HI) to estimate socioeconomic inequalities in healthcare utilization. Results showed a significant pro-rich distribution of general healthcare utilization in all service providers (Concentration Index: 0.062, P < 0.001; HI: 0.029, P < 0.05) and private service providers (Concentration Index: 0.070, P < 0.001; HI: 0.030, P < 0.05). The pro-rich distribution of probability in general healthcare utilization was attributable to inequalities in the level of household economic status (percentage contribution: 67.8%) and in the self-reported prevalence of non-communicable diseases such as hypertension (36.7%) and diabetes (14.4%). Despite the provision of free services by public healthcare providers, our analysis found no evidence of the poor making more use of public health services (Concentration Index: 0.041, P = 0.094). Interventions to reduce the household economic burden of major illnesses, coupled with improvement in the management of public health facilities, warrant further attention by policy-makers. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

National Facilities Study. Volume 1: Facilities Inventory

NASA Technical Reports Server (NTRS)

1994-01-01

The inventory activity was initiated to solve the critical need for a single source of site specific descriptive and parametric data on major public and privately held aeronautics and aerospace related facilities. This a challenging undertaking due to the scope of the effort and the short lead time in which to assemble the inventory and have it available to support the task group study needs. The inventory remains dynamic as sites are being added and the data is accessed and refined as the study progresses. The inventory activity also included the design and implementation of a computer database and analytical tools to simplify access to the data. This volume describes the steps which were taken to define the data requirements, select sites, and solicit and acquire data from them. A discussion of the inventory structure and analytical tools is also provided.

Booster Applications Facility report, phase 2

NASA Astrophysics Data System (ADS)

Thieberger, P.

1991-06-01

This report summarizes studies and planning performed by Brookhaven National Laboratory (BNL) personnel at the request of NASA for the design, construction and operation of experimental areas and facilities for utilization of ion beams from the BNL Booster synchrotron particle accelerator. These facilities would be primarily utilized to simulate space radiation for radiobiological research, shielding studies and detector calibrations. The feasibility of such a project has been established, preliminary designs and cost estimates have been developed and a formal proposal can be submitted pending DOE concurrence. The main body of this report consists of the material presented by BNL during the meeting with a NASA appointed Panel on December 10 and 11, 1990. The individual speakers have provided brief summaries of their talks and explanations of their figures. In addition there are two appendices. One, contains detailed discussion of the shared mode of operation and the corresponding beam compatibility tables. The second appendix contains cost estimate details. An executive summary on budgets and schedules has been added, containing possible phased construction and outfitting scenarios and the corresponding expense and commitment profiles as well as new operational cost estimates. Material contained in the executive summary reflects the correction of some errors and new studies performed in response to the NASA Panel suggestions.

Utilization of travel reimbursement in the Veterans Health Administration.

PubMed

Nelson, Richard E; Hicken, Bret; Cai, Beilei; Dahal, Arati; West, Alan; Rupper, Randall

2014-01-01

To improve access to care, the Veterans Health Administration (VHA) increased its patient travel reimbursement rate from 11 to 28.5 cents per mile on February 1, 2008, and again to 41.5 cents per mile on November 17, 2008. We identified characteristics of veterans more likely to receive travel reimbursements and evaluated the impact of these increases on utilization of the benefit. We examined the likelihood of receiving any reimbursement, number of reimbursements, and dollar amount of reimbursements for VHA patients before and after both reimbursement rate increases. Because of our data's longitudinal nature, we used multivariable generalized estimating equation models for analysis. Rurality and categorical distance from the nearest VHA facility were examined in separate regressions. Our cohort contained 214,376 veterans. During the study period, the average number of reimbursements per veteran was higher for rural patients compared to urban patients, and for those living 50-75 miles from the nearest VHA facility compared to those living closer. Higher reimbursement rates led to more veterans obtaining reimbursement regardless of urban-rural residence or distance traveled to the nearest VHA facility. However, after the rate increases, urban veterans and veterans living <50 miles from the nearest VHA facility increased their travel reimbursement utilization slightly more than other patients. Our findings suggest an inverted U-shaped relationship between veterans' utilization of the VHA travel reimbursement benefit and travel distance. Both urban and rural veterans responded in roughly equal manner to changes to this benefit. © 2013 National Rural Health Association.

State Network Utilization Study: Mississippi Educational Television.

ERIC Educational Resources Information Center

Wilson, Savan; And Others

This document is the result of a utilization study of Mississippi Educational Television where 27 target audiences were identified and surveyed. The following information is included: a draft of and updated state network utilization studies; planning and management strategies; a profile of the survey populations; a distance learning survey report;…

The Generic Data Capture Facility

NASA Technical Reports Server (NTRS)

Connell, Edward B.; Barnes, William P.; Stallings, William H.

1987-01-01

The Generic Data Capture Facility, which can provide data capture support for a variety of different types of spacecraft while enabling operations costs to be carefully controlled, is discussed. The data capture functions, data protection, isolation of users from data acquisition problems, data reconstruction, and quality and accounting are addressed. The TDM and packet data formats utilized by the system are described, and the development of generic facilities is considered.

Impact of state Medicaid coverage on utilization of inpatient rehabilitation facilities among patients with stroke.

PubMed

Skolarus, Lesli E; Burke, James F; Morgenstern, Lewis B; Meurer, William J; Adelman, Eric E; Kerber, Kevin A; Callaghan, Brian C; Lisabeth, Lynda D

2014-08-01

Poststroke rehabilitation is associated with improved outcomes. Medicaid coverage of inpatient rehabilitation facility (IRF) admissions varies by state. We explored the role of state Medicaid IRF coverage on IRF utilization among patients with stroke. Working age ischemic stroke patients with Medicaid were identified from the 2010 Nationwide Inpatient Sample. Medicaid coverage of IRFs (yes versus no) was ascertained. Primary outcome was discharge to IRF (versus other discharge destinations). We fit a logistic regression model that included patient demographics, Medicaid coverage, comorbidities, length of stay, tissue-type plasminogen activator use, state Medicaid IRF coverage, and the interaction between patient Medicaid status and state Medicaid IRF coverage while accounting for hospital clustering. Medicaid did not cover IRFs in 4 (TN, TX, SC, WV) of 42 states. The impact of State Medicaid IRF coverage was limited to Medicaid stroke patients (P for interaction <0.01). Compared with Medicaid stroke patients in states with Medicaid IRF coverage, Medicaid stroke patients hospitalized in states without Medicaid IRF coverage were less likely to be discharged to an IRF of 11.6% (95% confidence interval, 8.5%-14.7%) versus 19.5% (95% confidence interval, 18.3%-20.8%), P<0.01 after full adjustment. State Medicaid coverage of IRFs is associated with IRF utilization among stroke patients with Medicaid. Given the increasing stroke incidence among the working age and Medicaid expansion under the Affordable Care Act, careful attention to state Medicaid policy for poststroke rehabilitation and analysis of its effects on stroke outcome disparities are warranted. © 2014 American Heart Association, Inc.

A History of Educational Facilities Laboratories (EFL)

ERIC Educational Resources Information Center

Marks, Judy

2009-01-01

The Educational Facilities Laboratories (EFL), an independent research organization established by the Ford Foundation, opened its doors in 1958 under the direction of Harold B. Gores, a distinguished educator. Its purpose was to help schools and colleges maximize the quality and utility of their facilities, stimulate research, and disseminate…

In Situ Resource Utilization Technology Research and Facilities Supporting the NASA's Human Systems Research and Technology Life Support Program

NASA Technical Reports Server (NTRS)

Schlagheck, Ronald A.; Sibille, Laurent; Sacksteder, Kurt; Owens, Chuck

2005-01-01

The NASA Microgravity Science program has transitioned research required in support of NASA s Vision for Space Exploration. Research disciplines including the Materials Science, Fluid Physics and Combustion Science are now being applied toward projects with application in the planetary utilization and transformation of space resources. The scientific and engineering competencies and infrastructure in these traditional fields developed at multiple NASA Centers and by external research partners provide essential capabilities to support the agency s new exploration thrusts including In-Situ Resource Utilization (ISRU). Among the technologies essential to human space exploration, the production of life support consumables, especially oxygen and; radiation shielding; and the harvesting of potentially available water are realistically achieved for long-duration crewed missions only through the use of ISRU. Ongoing research in the physical sciences have produced a body of knowledge relevant to the extraction of oxygen from lunar and planetary regolith and associated reduction of metals and silicon for use meeting manufacturing and repair requirements. Activities being conducted and facilities used in support of various ISRU projects at the Glenn Research Center and Marshall Space Flight Center will be described. The presentation will inform the community of these new research capabilities, opportunities, and challenges to utilize their materials, fluids and combustion science expertise and capabilities to support the vision for space exploration.

Postnatal care utilization among urban women in northern Ethiopia: cross-sectional survey.

PubMed

Gebrehiwot, Genet; Medhanyie, Araya Abrha; Gidey, Gebreamlak; Abrha, Kidan

2018-05-30

Postnatal care service enables health professionals to identify post-delivery problems including potential complications for the mother with her baby and to provide treatments promptly. In Ethiopia, postnatal care service is made accessible to all women for free however the utilization of the service is very low. This study assessed the utilization of postnatal care services of urban women and the factors associated in public health facilities in Mekelle city, Tigrai Region, Northern Ethiopia. A facility based cross sectional study design was used to assess post natal service utilization. Using simple random sampling 367 women who visited maternal and child health clinics in Mekelle city for postnatal care services during January 27 to April 2014 were selected. Data was entered and analyzed using SPSS Version 20.0 software. A binary and multivariable logistic regression was used to identify risk factors associated with the outcome variables. P-value less than 0.05 is used to declare statistical significance. The prevalence of women who utilized postnatal care service was low (32.2%). Women who were private employees and business women were more likely to utilize postnatal care services (AOR = 6.46, 95% CI: 1.91-21.86) and (3.35, 95% CI: 1.10-10.19) respectively compared to house wives., Women who had history of one pregnancy were more likely to utilize the service (AOR = 3.19, 95% CI: 1.06-9.57) compared to women who had history of four and above pregnancies. Women who had knowledge of postnatal care service were also more likely to utilize postnatal care service (AOR = 14.46, 95% CI: 7.55-27.75) than women who lacked knowledge about the services. Postnatal care utilization in the study area is low. Knowledge on postnatal care services and occupation of women had positive impact on postnatal care service utilization. The Mekelle city administration health office and other stakeholders should support and encourage urban health extension workers and

CVD facility electrical system captor/dapper study

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

SINGH, G.

1999-10-28

Project W-441, CVD Facility Electrical System CAPTOWDAPPER Study validates Meier's hand calculations. This study includes Load flow, short circuit, voltage drop, protective device coordination, and transient motor starting (TMS) analyses.

National facilities study. Volume 2A: Facility Study Office on the National Wind Tunnel Complex

NASA Technical Reports Server (NTRS)

1994-01-01

The Facility Study Office (FSO) has completed its assigned activities. The results of the FSO efforts, studies, and assessments are documented. An overview of the FSO activities as well as a general comparison of all concepts considered are provided. Detailed information is also provided for the selected concept, Concept D-Option 5. Only findings are presented. The FSO developed recommendations only as a consequence of assumptions for cost and schedule assessments.

49 CFR 199.231 - Access to facilities and records.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Access to facilities and records. 199.231 Section... TESTING Alcohol Misuse Prevention Program § 199.231 Access to facilities and records. (a) Except as... access to all facilities utilized in complying with the requirements of this subpart to the Secretary of...

Space platform utilities distribution study

NASA Technical Reports Server (NTRS)

Lefever, A. E.

1980-01-01

Generic concepts for the installation of power data and thermal fluid distribution lines on large space platforms were discussed. Connections with central utility subsystem modules and pallet interfaces were also considered. Three system concept study platforms were used as basepoints for the detail development. The tradeoff of high voltage low voltage power distribution and the impact of fiber optics as a data distribution mechanism were analyzed. Thermal expansion and temperature control of utility lines and ducts were considered. Technology developments required for implementation of the generic distribution concepts were identified.

ToHajiilee Economic Development, Inc.(TEDI) Feasibility Study for Utility-Scale Solar

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

Burpo, Rob

2012-02-29

To Hajiilee Economic Development, Inc. (TEDI) is the economic development entity representing the ToHajiilee Chapter of the Navajo Nation, also known as the Caoncito Band of Navajo (CBN). Using DOE funding, TEDI assembled a team of qualified advisors to conduct a feasibility study for a utility-scale 30 MW Photovoltaic (PV) solar power generation facility on TEDI trust lands. The goal for this project has been to gather information and practical business commitments to successfully complete the feasibility analysis. The TEDI approach was to successively make informed decisions to select an appropriate technology best suited to the site, determine environmental viabilitymore » of the site, secure options for the sale of generated power, determine practicality of transmission and interconnection of power to the local grid, and secure preliminary commitments on project financing. The feasibility study has been completed and provides TEDI with a practical understanding of its business options in moving forward with developing a solar project on CBN tribal lands. Funding from DOE has allowed TEDI and its team of professional advisors to carefully select technology and business partners and build a business model to develop this utility-scale solar project. As a result of the positive feasibility findings, TEDI is moving forward with finalizing all pre-construction activities for its major renewable energy project.« less

UTILIZATION OF MOBILE FACILITIES FOR DEVELOPMENT OF ENTRY WORK SKILLS FOR ARKANSAS' RURAL UNEMPLOYED AND LOW INCOME EARNERS, A FEASIBILITY STUDY.

ERIC Educational Resources Information Center

Nevada Univ., Reno. School Planning Lab.

THE FEASIBILITY AND METHODS OF USING MOBILE FACILITIES IN UPGRADING THE WORK SKILLS OF RURAL LOW INCOME WAGE EARNERS ARE EXPLORED. SUCH MOBILE FACILITIES WOULD BE DIRECTED TOWARD 3 SPECIFIC GROUPS OF PEOPLE--SMALL ACREAGE FARMERS WHO PRODUCED ONLY A MINIMAL INCOME, THE RURAL LOW-INCOME NEGRO POPULATION, AND YOUNG RURAL SCHOOL DROPOUTS WITH LITTLE…

National Information Utility Seeks to Serve Schools Nationwide.

ERIC Educational Resources Information Center

Platzer, Nancy

1985-01-01

Outlines the pros and cons of the National Information Utility Program, which is designed to provide current updatable courseware to schools nationwide. The information is broadcast over FM radio and television signals to facilities subscribing to the utility. (MD)

The Commuting Student Study, Report IV: Food Facilities.

ERIC Educational Resources Information Center

Williamson, W. J.; And Others

This report presents a detailed analysis of the food facilities at the University of Alberta. Emphasis is placed on the three main supplies of food: the peak production of cafeterias at meal times, the snack facilities, and vending machines. Study results indicate: (1) extensive use of the students' union building cafeterias; (2) reported use of…

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

PubMed

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

2017-12-01

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

Water Utility Management Strategies in Turkey: The current situation and the challenges

NASA Astrophysics Data System (ADS)

Alp, E.; Aksoy, M. N.; Koçer, B.

2013-12-01

As the effects of climate change becomes more prominent, current challenges related to water and wastewater management is becoming more serious. Providing water that satisfies environmental and safety standards in terms of quantity and quality is needed to maintain human life without compromising the need of future generations. Besides providing safe and affordable water, necessary treatment should be achieved according to several important factors such as receiving body standards, discharge standards, water reuse options. Therefore, management of water becomes more crucial than ever that states have to provide accessibility of safe water with affordable cost to its citizens with the means of effective utility management, including water treatment facilities, wastewater treatment facilities, water supply facilities and water distribution systems. Water utilities encounter with several challenges related to cost, infrastructure, population, legislation, workforce and resource. This study aims to determine the current situation and the necessary strategies to improve utility management in Turkish municipalities in a sustainable manner. US Environment Protection Agency (EPA) has formed a tool on effective utility management that assists utilities to provide a solution for both current and future challenges. In this study, we used EPA's guidelines and developed a survey consists of 60 questions under 10 sub-topics (Product Quality, Employee & Leadership Development, Stakeholder Understanding & Support, Operational Optimization, Infrastructure Stability, Financial Viability, Community Sustainability, Customer Satisfaction, Operational Resiliency, and Water Resource Adequacy). This survey was sent to the managers of 25 metropolitan municipalities in Turkey to assess the current condition of municipalities. After the evaluation of the survey results for each topic, including the importance given by managers, facilities were rated according to their level of achievement

Case studies for utilizing groundwater-source and low-enthalpy geothermal resources in Korea

NASA Astrophysics Data System (ADS)

Kim, K.-H.; Shin, J.; Lee, K.-K.; Lee, T. J.

2012-04-01

As one of the top 10 oil-consuming countries in the world, Korea recently has had a great interest in extending the ways to utilize renewable energy. In this regard, geothermal energy resource is attracting more concerns from both of the government and the research field. Korea has neither active volcanic sites nor areas with abnormally higher heat flow. In spite of these natural conditions, many efforts have been exerted to utilize geothermal energy. Here, we introduce two case studies of using groundwater-source geothermal energy with relatively low-enthalpy: One is a riverbank filtration facility, which has been using some of its riverbank filtrate water for the indoor air-conditioning. The other is the first EGS plant planning site, where a few fault-related artesian wells reaching 70C were discovered lately. Numerical simulations to predict the temperature evolution of the two sites, which is dominated by several hydrogeologic factors, were carried out and compared. Simulation of temperature profile of riverbank filtrate water using HydroGeoSphere shows that the primary factor in determining filtrate water temperature is the pumping rate. It also shows that maintaining the facility operation with present pumping rate for the next 30 years will not cause any significant change of water temperature. However, following the new plan of the facility to install additional 37 wells with 6 times higher pumping rate than the current rate might cause about 2C decrease in filtrate water temperature in 10 years after the extension. Simulation for the temperature evolution in a faulted geothermal reservoir in EGS planning site under the supposed injection-extraction operating conditions were carried out using TOUGH2. A MINC model including a hydraulic discontinuity, which reflected the analysis from several geophysical explorations, was generated. Temperature distribution calculated from the simulation shows a rise of relatively hot geothermal water along the fault plane

Integrated Facilities and Infrastructure Plan.

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

Reisz Westlund, Jennifer Jill

Our facilities and infrastructure are a key element of our capability-based science and engineering foundation. The focus of the Integrated Facilities and Infrastructure Plan is the development and implementation of a comprehensive plan to sustain the capabilities necessary to meet national research, design, and fabrication needs for Sandia National Laboratories’ (Sandia’s) comprehensive national security missions both now and into the future. A number of Sandia’s facilities have reached the end of their useful lives and many others are not suitable for today’s mission needs. Due to the continued aging and surge in utilization of Sandia’s facilities, deferred maintenance has continuedmore » to increase. As part of our planning focus, Sandia is committed to halting the growth of deferred maintenance across its sites through demolition, replacement, and dedicated funding to reduce the backlog of maintenance needs. Sandia will become more agile in adapting existing space and changing how space is utilized in response to the changing requirements. This Integrated Facilities & Infrastructure (F&I) Plan supports the Sandia Strategic Plan’s strategic objectives, specifically Strategic Objective 2: Strengthen our Laboratories’ foundation to maximize mission impact, and Strategic Objective 3: Advance an exceptional work environment that enables and inspires our people in service to our nation. The Integrated F&I Plan is developed through a planning process model to understand the F&I needs, analyze solution options, plan the actions and funding, and then execute projects.« less

Web-Based Requesting and Scheduling Use of Facilities

NASA Technical Reports Server (NTRS)

Yeager, Carolyn M.

2010-01-01

Automated User's Training Operations Facility Utilization Request (AutoFUR) is prototype software that administers a Web-based system for requesting and allocating facilities and equipment for astronaut-training classes in conjunction with scheduling the classes. AutoFUR also has potential for similar use in such applications as scheduling flight-simulation equipment and instructors in commercial airplane-pilot training, managing preventive- maintenance facilities, and scheduling operating rooms, doctors, nurses, and medical equipment for surgery. Whereas requesting and allocation of facilities was previously a manual process that entailed examination of documents (including paper drawings) from different sources, AutoFUR partly automates the process and makes all of the relevant information available via the requester s computer. By use of AutoFUR, an instructor can fill out a facility-utilization request (FUR) form on line, consult the applicable flight manifest(s) to determine what equipment is needed and where it should be placed in the training facility, reserve the corresponding hardware listed in a training-hardware inventory database, search for alternative hardware if necessary, submit the FUR for processing, and cause paper forms to be printed. Auto-FUR also maintains a searchable archive of prior FURs.

Results of an Initial Field Study of New Techniques for Citizen Participation in Educational Facilities Planning.

ERIC Educational Resources Information Center

Zucker, Charles B.

The utility of a particular citizen participation planning approach as applied to educational facilities planning is described. With the aid of a clear-cut decisionmaking procedure, citizens could participate effectively in the development of specific planning policy statements. Such statements could be used to discuss planning priorities, focus…

Statistical Evaluation of Utilization of the ISS

NASA Technical Reports Server (NTRS)

Andrews, Ross; Andrews, Alida

2006-01-01

PayLoad Utilization Modeler (PLUM) is a statistical-modeling computer program used to evaluate the effectiveness of utilization of the International Space Station (ISS) in terms of the number of research facilities that can be operated within a specified interval of time. PLUM is designed to balance the requirements of research facilities aboard the ISS against the resources available on the ISS. PLUM comprises three parts: an interface for the entry of data on constraints and on required and available resources, a database that stores these data as well as the program output, and a modeler. The modeler comprises two subparts: one that generates tens of thousands of random combinations of research facilities and another that calculates the usage of resources for each of those combinations. The results of these calculations are used to generate graphical and tabular reports to determine which facilities are most likely to be operable on the ISS, to identify which ISS resources are inadequate to satisfy the demands upon them, and to generate other data useful in allocation of and planning of resources.

Facilities maintenance handbook

NASA Technical Reports Server (NTRS)

1991-01-01

This handbook is a guide for facilities maintenance managers. Its objective is to set minimum facilities maintenance standards. It also provides recommendations on how to meet the standards to ensure that NASA maintains its facilities in a manner that protects and preserves its investment in the facilities in a cost-effective manner while safely and efficiently performing its mission. This handbook implements NMI 8831.1, which states NASA facilities maintenance policy and assigns organizational responsibilities for the management of facilities maintenance activities on all properties under NASA jurisdiction. It is a reference for facilities maintenance managers, not a step-by-step procedural manual. Because of the differences in NASA Field Installation organizations, this handbook does not assume or recommend a typical facilities maintenance organization. Instead, it uses a systems approach to describe the functions that should be included in any facilities maintenance management system, regardless of its organizational structure. For documents referenced in the handbook, the most recent version of the documents is applicable. This handbook is divided into three parts: Part 1 specifies common definitions and facilities maintenance requirements and amplifies the policy requirements contained in NMI 8831. 1; Part 2 provides guidance on how to meet the requirements of Part 1, containing recommendations only; Part 3 contains general facilities maintenance information. One objective of this handbook is to fix commonality of facilities maintenance definitions among the Centers. This will permit the application of uniform measures of facilities conditions, of the relationship between current replacement value and maintenance resources required, and of the backlog of deferred facilities maintenance. The utilization of facilities maintenance system functions will allow the Centers to quantitatively define maintenance objectives in common terms, prepare work plans, and

Assessment of the proportion of neonates and children in low and middle income countries with access to a healthcare facility: A systematic review

PubMed Central

2011-01-01

Background Comprehensive antenatal, perinatal and early postnatal care has the potential to significantly reduce the 3.58 million neonatal deaths that occur annually worldwide. This paper systematically reviews data on the proportion of neonates and children < 5 years of age that have access to health facilities in low and middle income countries. Gaps in available data by WHO region are identified, and an agenda for future research and advocacy is proposed. Methods For this paper, "utilization" was used as a proxy for "access" to a healthcare facility, and the term "facility" was used for any clinic or hospital outside of a person's home staffed by a "medical professional". A systematic literature search was conducted for published studies of children up to 5 years of age that included the neonatal age group with an illness or illness symptoms in which health facility utilization was quantified. In addition, information from available Demographic and Health Surveys (DHS) was extracted. Results The initial broad search yielded 2,239 articles, of which 14 presented relevant data. From the community-based neonatal studies conducted in the Southeast Asia region with the goal of enhancing care-seeking for neonates with sepsis, the 10-48% of sick neonates in the studies' control arms utilized a healthcare facility. Data from cross-sectional surveys involving young children indicate that 12 to 86% utilizing healthcare facilities when sick. From the DHS surveys, a global median of 58.1% of infants < 6 months were taken to a facility for symptoms of ARI. Conclusions There is a scarcity of data regarding the access to facility-based care for sick neonates/young children in many areas of the world; it was not possible to generalize an overall number of neonates or young children that utilize a healthcare facility when showing signs and symptoms of illness. The estimate ranges were broad, and there was a paucity of data from some regions. It is imperative that researchers

Utilization of maternal health-care services by tribal women in Kerala.

PubMed

Jose, Jinu Annie; Sarkar, Sonali; Kumar, S Ganesh; Kar, Sitanshu Sekhar

2014-01-01

The coverage of maternal care services among the tribal women in Kerala is better as compared to other states in India. This study was done to identify the factors contributing to better coverage of maternal care services among the tribal women in Kerala and to study the reasons for remaining differences that exists in utilization of services between tribal and non-tribal pregnant women. This was a descriptive cum qualitative study conducted in Thariode Gramapanchayat in the Wayanad district of Kerala. Among all women who had registered their pregnancies in the 5 sub-centres under CHC Thariode and had delivered between September 2009 and October 2010, equal numbers of tribal and non-tribal ante-natal women, 35 each were interviewed in-depth using a semi-structured questionnaire. Quantitative data was analysed using SPSS Version 16.0. Content analysis was done for qualitative data. The determinants of utilization in tribal women were general awareness, affordability, accessibility and quality of services along with motivation by health workers. Among tribal antenatal women, 85% utilized maternal health care facilities fully compared to 100% among non-tribal women. Lower levels of education and lack of transport facilities were prime factors contributing to under utilization by tribal women. Affordable, accessible and good quality of services in the public health system in Kerala and motivation by health workers were important contributing factors for better utilization of maternal care services.

Utilization of maternal health-care services by tribal women in Kerala

PubMed Central

Jose, Jinu Annie; Sarkar, Sonali; Kumar, S. Ganesh; Kar, Sitanshu Sekhar

2014-01-01

Background: The coverage of maternal care services among the tribal women in Kerala is better as compared to other states in India. Aim: This study was done to identify the factors contributing to better coverage of maternal care services among the tribal women in Kerala and to study the reasons for remaining differences that exists in utilization of services between tribal and non-tribal pregnant women. Settings and Design: This was a descriptive cum qualitative study conducted in Thariode Gramapanchayat in the Wayanad district of Kerala. Materials and Methods: Among all women who had registered their pregnancies in the 5 sub-centres under CHC Thariode and had delivered between September 2009 and October 2010, equal numbers of tribal and non-tribal ante-natal women, 35 each were interviewed in-depth using a semi-structured questionnaire. Statistical Analysis Used: Quantitative data was analysed using SPSS Version 16.0. Content analysis was done for qualitative data. Results: The determinants of utilization in tribal women were general awareness, affordability, accessibility and quality of services along with motivation by health workers. Among tribal antenatal women, 85% utilized maternal health care facilities fully compared to 100% among non-tribal women. Lower levels of education and lack of transport facilities were prime factors contributing to under utilization by tribal women. Conclusions: Affordable, accessible and good quality of services in the public health system in Kerala and motivation by health workers were important contributing factors for better utilization of maternal care services. PMID:24678214

South Carolina harvest and utilization study, 2011

Treesearch

Kerry J.W. Dooley; Jason A. Cooper; James W. Bentley

2015-01-01

In 2011, a harvest and utilization study was conducted on 80 operations throughout South Carolina. There were 1,974 total trees measured; 1,317 or 67 percent were softwood, while 657 or 33 percent were hardwood. Results from this study showed that 86 percent of the total softwood volume measured was utilized for a product, and 14 percent was left as logging residue....

North Carolina harvest and utilization study, 2015

Treesearch

David J. Wall; Jason A. Cooper; James W. Bentley; James A. Gray

2018-01-01

In 2015, a harvest and utilization study was completed on 95 operations throughout North Carolina. There were 2,125 total trees measured: 1,284 or 60 percent were softwood, while 841 or 40 percent were hardwood. Results from this study showed that 85 percent of the total softwood volume measured was utilized for a product, and 15 percent was left as logging residue....

North Carolina harvest and utilization study, 2007

Treesearch

James W. Bentley; Tony G. Johnson

2010-01-01

In 2007, a harvest and utilization study was conducted on 83 operations throughout North Carolina. There were 2,119 total trees measured: 1,323 or 62 percent were softwood, while 796 or 38 percent were hardwood. Results from this study showed that 85 percent of the total softwood volume measured was utilized for a product, and 15 percent was left as logging residue....

North Carolina harvest and utilization study, 2002

Treesearch

James W. Bentley; Tony G. Johnson

2006-01-01

In 2002, a harvest and utilization study was conducted on 108 operations throughout North Carolina. There were 2,926 total trees measured; 1,693, or 58 percent, were softwood, while 1,233, or 42 percent, were hardwood. Results from this study showed that 86 percent of the total softwood volume measured was utilized for a product, and 14 percent was left as logging...

East Texas harvest and utilization study, 2014

Treesearch

Jason A. Cooper; James W. Bentley; James A. Gray; David J. Wall

2017-01-01

In 2014, a harvest and utilization study was completed on 68 logging operations throughout eastern Texas. There were 1,464 total trees measured: 1,149 or 78 percent were softwood, while 315 or 22 percent were hardwood. Results from this study showed that 81 percent of the total softwood volume measured was utilized for a product, and 19 percent was left as logging...

East Texas harvest and utilization study, 2008

Treesearch

Rhonda M. Mathison; James W. Bentley; Tony G. Johnson

2009-01-01

In 2008, a harvest and utilization study was conducted on 80 operations throughout eastern Texas. There were 2,024 total trees measured: 1,335 or 66 percent were softwood, while 689 or 34 percent were hardwood. Results from this study showed that 86 percent of the total softwood volume measured was utilized for a product, and 14 percent was left as logging...

East Oklahoma harvest and utilization study, 2008

Treesearch

Jason A. Cooper; James W. Bentley

2013-01-01

In 2008, a harvest and utilization study was conducted on 28 operations in eastern Oklahoma. There were 682 total trees measured: 509 or 75 percent were softwood, while 173 or 25 percent were hardwood. Results from this study showed that 86 percent of the total softwood volume measured was utilized for a product, and 14 percent was left as logging residue. Seventy-four...

Challenges for proteomics core facilities.

PubMed

Lilley, Kathryn S; Deery, Michael J; Gatto, Laurent

2011-03-01

Many analytical techniques have been executed by core facilities established within academic, pharmaceutical and other industrial institutions. The centralization of such facilities ensures a level of expertise and hardware which often cannot be supported by individual laboratories. The establishment of a core facility thus makes the technology available for multiple researchers in the same institution. Often, the services within the core facility are also opened out to researchers from other institutions, frequently with a fee being levied for the service provided. In the 1990s, with the onset of the age of genomics, there was an abundance of DNA analysis facilities, many of which have since disappeared from institutions and are now available through commercial sources. Ten years on, as proteomics was beginning to be utilized by many researchers, this technology found itself an ideal candidate for being placed within a core facility. We discuss what in our view are the daily challenges of proteomics core facilities. We also examine the potential unmet needs of the proteomics core facility that may also be applicable to proteomics laboratories which do not function as core facilities. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

INTEGRATION OF FACILITY MODELING CAPABILITIES FOR NUCLEAR NONPROLIFERATION ANALYSIS

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

Gorensek, M.; Hamm, L.; Garcia, H.

2011-07-18

Developing automated methods for data collection and analysis that can facilitate nuclear nonproliferation assessment is an important research area with significant consequences for the effective global deployment of nuclear energy. Facility modeling that can integrate and interpret observations collected from monitored facilities in order to ascertain their functional details will be a critical element of these methods. Although improvements are continually sought, existing facility modeling tools can characterize all aspects of reactor operations and the majority of nuclear fuel cycle processing steps, and include algorithms for data processing and interpretation. Assessing nonproliferation status is challenging because observations can come frommore » many sources, including local and remote sensors that monitor facility operations, as well as open sources that provide specific business information about the monitored facilities, and can be of many different types. Although many current facility models are capable of analyzing large amounts of information, they have not been integrated in an analyst-friendly manner. This paper addresses some of these facility modeling capabilities and illustrates how they could be integrated and utilized for nonproliferation analysis. The inverse problem of inferring facility conditions based on collected observations is described, along with a proposed architecture and computer framework for utilizing facility modeling tools. After considering a representative sampling of key facility modeling capabilities, the proposed integration framework is illustrated with several examples.« less

Why some women fail to give birth at health facilities: A comparative study between Ethiopia and Nigeria.

PubMed

Yaya, Sanni; Bishwajit, Ghose; Uthman, Olalekan A; Amouzou, Agbessi

2018-01-01

Obstetric complications and maternal deaths can be prevented through safe delivery process. Facility based delivery significantly reduces maternal mortality by increasing women's access to skilled personnel attendance. However, in sub-Saharan Africa, most deliveries take place without skilled attendants and outside health facilities. Utilization of facility-based delivery is affected by socio-cultural norms and several other factors including cost, long distance, accessibility and availability of quality services. This study examined country-level variations of the self-reported causes of not choosing to deliver at a health facility. Cross-sectional data on 37,086 community dwelling women aged between 15-49 years were collected from DHS surveys in Ethiopia (n = 13,053) and Nigeria (n = 24,033). Outcome variables were the self-reported causes of not delivering at health facilities which were regressed against selected sociodemographic and community level determinants. In total eight items complaints were identified for non-use of facility delivery: 1) Cost too much 2) Facility not open, 3) Too far/no transport, 4) don't trust facility/poor service, 5) No female provider, 6) Husband/family didn't allow, 7) Not necessary, 8) Not customary. Multivariable regression methods were used for measuring the associations. In both countries a large proportion of the women mentioned facility delivery as not necessary, 54.9% (52.3-57.9) in Nigeria and 45.4% (42.0-47.5) in Ethiopia. Significant urban-rural variations were observed in the prevalence of the self-reported causes of non-utilisation. Women in the rural areas are more likely to report delivering at health facility as not customary/not necessary and healthy facility too far/no transport. However, urban women were more likely to complain that husband/family did not allow and that the costs were too high. Women in the rural were more likely to regard facility delivery as unnecessary and complain about transportation and

Facilities Management: A Program for the 1980s.

ERIC Educational Resources Information Center

Kaiser, Harvey H.

1980-01-01

Successful facilities management is described as based on a 10-point comprehensive program including: (1) physical planning policy; (2) facilities analysis; (3) management audit; (4) space utilization; (5) capital programs; (6) deferred maintenance; (7) controlled maintenance; (8) energy conservation; (9) environmental quality, health, and safety;…

Eastern Texas harvest and utilization study, 2003

Treesearch

James W. Bentley; Tony G. Johnson

2004-01-01

In 2003, a harvest and utilization study was conducted on 81 operations throughout eastern Texas. There were 2,072 total trees measured, 1,557 or 75 percent were softwood, while 515 or 25 percent were hardwood. Results from this study showed that 87 percent of the total softwood volume measured was utilized for a product, while the other 13 percent was left as logging...

South Carolina harvest and utilization study, 2006

Treesearch

James W. Bentley; Tony G. Johnson

2008-01-01

In 2006, a harvest and utilization study was conducted on 99 operations throughout South Carolina. There were 2,904 total trees measured; 1,763 or 61 percent were softwood, while 1,141 or 39 percent were hardwood. Results from this study showed that 87 percent of the total softwood volume measured was utilized for a product, and 13 percent was left as logging residue....

Trends in inequalities in utilization of reproductive health services from 2000 to 2011 in Vietnam

PubMed Central

Duc, Nguyen Huu Chau; Nakamura, Keiko; Kizuki, Masashi; Seino, Kaoruko; Rahman, Mosiur

2015-01-01

Objective: This study aimed to examine changes in utilization of reproductive health services by wealth status from 2000 to 2011 in Vietnam. Methods: Data from the Vietnam Multiple Indicator Cluster Surveys in 2000, 2006, and 2011 were used. The subjects were 550, 1023, and 1363 women, respectively, aged between 15 and 49 years who had given birth in the previous one or two years. The wealth index, a composite measure of a household’s ownership of selected assets, materials used for housing construction, and types of water access and sanitation facilities, was used as a measure of wealth status. Main utilization indicators were utilization of antenatal care services, receipt of a tetanus vaccine, receipt of blood pressure measurement, blood examination and urine examination during antenatal care, receipt of HIV testing, skilled birth attendance at delivery, health-facility-based delivery, and cesarean section delivery. Inequalities by wealth index were measured by prevalence ratios, concentration indices, and multivariable adjusted regression coefficients. Results: Significant increase in overall utilization was observed in all indicators (all p < 0.001). The concentration indices were 0.19 in 2000 and 0.06 in 2011 for antenatal care, 0.10 in 2000 and 0.06 in 2011 for tetanus vaccination, 0.23 in 2000 and 0.08 in 2011 for skilled birth attendance, 0.29 in 2006 and 0.12 in 2011 for blood examination, and 0.18 in 2006 and 0.09 in 2011 for health-facility-based delivery. The multivariable adjusted regression coefficients of reproductive health service utilization by wealth category were 0.06 in 2000 and 0.04 in 2011 for antenatal care, 0.07 in 2000 and 0.05 in 2011 for skilled birth attendance, and 0.07 in 2006 and 0.05 in 2011 for health-facility-based delivery. Conclusions: More women utilized reproductive health services in 2011 than in 2000. Inequality by wealth status in utilization of antenatal care, skilled birth attendance, and health-facility-based delivery

Trends in inequalities in utilization of reproductive health services from 2000 to 2011 in Vietnam.

PubMed

Duc, Nguyen Huu Chau; Nakamura, Keiko; Kizuki, Masashi; Seino, Kaoruko; Rahman, Mosiur

2015-01-01

This study aimed to examine changes in utilization of reproductive health services by wealth status from 2000 to 2011 in Vietnam. Data from the Vietnam Multiple Indicator Cluster Surveys in 2000, 2006, and 2011 were used. The subjects were 550, 1023, and 1363 women, respectively, aged between 15 and 49 years who had given birth in the previous one or two years. The wealth index, a composite measure of a household's ownership of selected assets, materials used for housing construction, and types of water access and sanitation facilities, was used as a measure of wealth status. Main utilization indicators were utilization of antenatal care services, receipt of a tetanus vaccine, receipt of blood pressure measurement, blood examination and urine examination during antenatal care, receipt of HIV testing, skilled birth attendance at delivery, health-facility-based delivery, and cesarean section delivery. Inequalities by wealth index were measured by prevalence ratios, concentration indices, and multivariable adjusted regression coefficients. Significant increase in overall utilization was observed in all indicators (all p < 0.001). The concentration indices were 0.19 in 2000 and 0.06 in 2011 for antenatal care, 0.10 in 2000 and 0.06 in 2011 for tetanus vaccination, 0.23 in 2000 and 0.08 in 2011 for skilled birth attendance, 0.29 in 2006 and 0.12 in 2011 for blood examination, and 0.18 in 2006 and 0.09 in 2011 for health-facility-based delivery. The multivariable adjusted regression coefficients of reproductive health service utilization by wealth category were 0.06 in 2000 and 0.04 in 2011 for antenatal care, 0.07 in 2000 and 0.05 in 2011 for skilled birth attendance, and 0.07 in 2006 and 0.05 in 2011 for health-facility-based delivery. More women utilized reproductive health services in 2011 than in 2000. Inequality by wealth status in utilization of antenatal care, skilled birth attendance, and health-facility-based delivery had been reduced.

Extremely Intensive and Conservative Fault Capability Studies on Nuclear Facilities in Japan after the 2011 Tohoku Earthquake and Fukushima Daiichi Incident

NASA Astrophysics Data System (ADS)

Okumura, K.

2013-12-01

Rocks of the Japanese islands are mostly faulted since the Mesozoic Era. The opening of the Sea of Japan in Middle Miocene stretched most of the Japanese crust together with rifting systems. Modern compressional tectonic regime started in Pliocene and accelerated during Quaternary. The ubiquitous bedrock fault prior to the Quaternary had long been regarded as incapable for the future rupturing. This view on the bedrock fault, however, is in question after the March 11, 2011 Tohoku earthquake and tsunamis. There is no scientific reason for the Tohoku earthquake to let the geologists and seismologists worry about the capability of the long-deceased fault. Neither the unexpected April 11, 2011 extensional faulting event on shore in southern Fukushima prefecture has any scientific reason as well. There was no change and no new stress field, but the psychological situation of the scientists and the public welcomed the wrong belief in unexpected stress changes all over Japan, in the same manner that the March 11 M 9 was not expected. Finally, the capabilities of the bedrock faults, fractures, and joints came up to concern about seismic safety of nuclear facilities. After the incidents, the nuclear regulation authority of Japan began reevaluation of the seismic safety of all facilities in Japan. The primary issues of the reevaluation were conjunctive multi-fault mega-earthquakes and the capabilities of the bedrock faults, precisely reflecting the Tohoku events. The former does not require immediate abandonment of a facility. However, the latter now denies any chance of continued operation. It is because of the new (July 2013) safety guide gave top priority to the capability of the displacement under a facility for the evaluation on safe operation. The guide also requires utmost deterministic manner in very conservative ways. The regulators ordered the utility companies to thoroughly examine the capability for several sites, and started review of the studies in late 2012

Experience of socioeconomic-related inequality in dental care utilization among Thai elderly under universal coverage.

PubMed

Somkotra, Tewarit

2013-04-01

To assess the socioeconomic-related inequality in dental care utilization among Thai elderly and to determine factors associated with the observed inequality after the country achieved universal coverage. The data were taken from the nationally representative Thailand Health & Welfare Survey 2007. Data of 10,096 Thai elderly (aged over 60 years) were selected. Descriptive analyses of the features of dental care utilization among Thai elderly were carried out, in addition to the concentration index (Cindex ) being used to quantify the extent of socioeconomic-related inequality in dental care utilization. Logistic regression was used to determine factors associated with inequality in dental care. Socioeconomic-related inequality in dental care utilization among Thai elderly was shown. Also, utilization was more concentrated among wealthier older adults, as shown by the positive value of Cindex (equals 0.244). The poor elderly, however, were more likely to utilize dental care at public facilities, particularly primary care facilities. Multivariate analysis showed that certain demographic, socioeconomic and geographic characteristics were particularly associated with poor-rich differences in dental care utilization among Thai elderly. Although socioeconomic-related inequality in dental care utilization among Thai elderly exists, the pro-poor utilization at public facilities, particularly primary care facilities, substantiates the concerted effort to reducing inequality in dental care utilization for Thai elderly. © 2012 Japan Geriatrics Society.

[Ophthalmologic healthcare utilization of people in need of long-term care : Analyses of health insurance data of the AOK Baden-Württemberg].

PubMed

Schuster, Alexander K; Pick, Julia; Saalmann, Frauke; Pfeiffer, Norbert

2018-04-10

Eye diseases causing visual impairment increase with age. Thus, seeking eye care has a higher probability in older people. In this study, the rate of utilization of outpatient eye care services in Germany was analyzed. The analyses focused on older persons and persons in need of either home-based or facility-based long-term care. A descriptive secondary data analysis of health insurance data of the AOK Baden-Württemberg from 2016 was conducted. The study population comprised all insured persons on 1 January 2016. The cohort of older persons (60 years+) was further stratified by the type of care (home-based/facility-based) and the level of care (0-3). The utilization of outpatient eye care services was defined by the reimbursement for an ophthalmologist's provision of service. While 39.3% of the study population 60+ years old sought eye care, the utilization rate was lower among people in need of home-based (33.0%) and facility-based care (19.3%). The utilization rates showed comparable age-dependent patterns, except for persons in need of facility-based care where rates were similar for all age groups. Utilization rates were negatively associated with increasing care levels. Only people with care level 0 showed lower utilization rates than people with care level 1. Utilization rates of eye healthcare services among older persons are considerably influenced by the need of long-term care, by the form of care as well as by the level of care.

Sources and potential application of waste heat utilization at a gas processing facility

NASA Astrophysics Data System (ADS)

Alshehhi, Alyas Ali

Waste heat recovery (WHR) has the potential to significantly improve the efficiency of oil and gas plants, chemical and other processing facilities, and reduce their environmental impact. In this Thesis a comprehensive energy audit at Abu Dhabi Gas Industries Ltd. (GASCO) ASAB gas processing facilities is undertaken to identify sources of waste heat and evaluate their potential for on-site recovery. Two plants are considered, namely ASAB0 and ASAB1. Waste heat evaluation criteria include waste heat grade (i.e., temperature), rate, accessibility (i.e., proximity) to potential on-site waste heat recovery applications, and potential impact of recovery on installation performance and safety. The operating parameters of key waste heat source producing equipment are compiled, as well as characteristics of the waste heat streams. In addition, potential waste heat recovery applications and strategies are proposed, focusing on utilities, i.e., enhancement of process cooling/heating, electrical/mechanical power generation, and steam production. The sources of waste heat identified at ASAB facilities consist of gas turbine and gas generator exhaust gases, flared gases, excess propane cooling capacity, excess process steam, process gas air-cooler heat dissipation, furnace exhaust gases and steam turbine outlet steam. Of the above waste heat sources, exhaust gases from five gas turbines and one gas generator at ASAB0 plant, as well as from four gas turbines at ASAB1 plant, were found to meet the rate (i.e., > 1 MW), grade (i.e., > 180°C), accessibility (i.e., < 50 m from potential on-site WHR applications) and minimal impact criteria on the performance and safety of existing installations, for potential waste heat recovery. The total amount of waste heat meeting these criteria were estimated at 256 MW and 289 MW at ASAB0 and ASAB1 plants, respectively, both of which are substantial. Of the 289 MW waste generated at ASAB1, approximately 173 MW are recovered by waste heat

Correlates of service utilization among homeless youth.

PubMed

Tyler, Kimberly A; Akinyemi, Sarah L; Kort-Butler, Lisa A

2012-07-01

Though few studies exist on service utilization among homeless youth in the U.S., services are important because without them, many of these young people may resort to delinquent strategies in order to meet their daily survival needs. The current study examines frequency and correlates of service utilization (i.e., shelters, food programs, street outreach, counseling, STI and HIV testing) among a sample of 249 homeless youth ages 14 to 21. Multivariate analysis revealed significant differences in service usage by sex, age, and sexual orientation. Experiencing family physical and/or sexual abuse, being kicked out of the family home, spending more nights per week sleeping on the street, and having ever stayed in a group home facility were significant correlates of homeless youths' service usage.

Research objectives, opportunities, and facilities for microgravity science

NASA Technical Reports Server (NTRS)

Bayuzick, Robert J.

1992-01-01

Microgravity Science in the U.S.A. involves research in fluids science, combustion science, materials science, biotechnology, and fundamental physics. The purpose is to achieve a thorough understanding of the effects of gravitational body forces on physical phenomena relevant to those disciplines. This includes the study of phenomena which are usually overwhelmed by the presence of gravitational body forces and, therefore, chiefly manifested when gravitational forces are weak. In the pragmatic sense, the research involves gravity level as an experimental parameter. Calendar year 1992 is a landmark year for research opportunities in low earth orbit for Microgravity Science. For the first time ever, three Spacelab flights will fly in a single year: IML-1 was launched on January 22; USML-1 was launched on June 25; and, in September, SL-J will be launched. A separate flight involving two cargo bay carriers, USMP-1, will be launched in October. From the beginning of 1993 up to and including the Space Station era (1997), nine flights involving either Spacelab or USMP carriers will be flown. This will be augmented by a number of middeck payloads and get away specials flying on various flights. All of this activity sets the stage for experimentation on Space Station Freedom. Beginning in 1997, experiments in Microgravity Science will be conducted on the Space Station. Facilities for doing experiments in protein crystal growth, solidification, and biotechnology will all be available. These will be joined by middeck-class payloads and the microgravity glove box for conducting additional experiments. In 1998, a new generation protein crystal growth facility and a facility for conducting combustion research will arrive. A fluids science facility and additional capability for conducting research in solidification, as well as an ability to handle small payloads on a quick response basis, will be added in 1999. The year 2000 will see upgrades in the protein crystal growth and

10 CFR 50.78 - Facility information and verification.

Code of Federal Regulations, 2011 CFR

2011-01-01

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

10 CFR 50.78 - Facility information and verification.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

Water and Sewage Utilities Sector (NAICS 2213)

EPA Pesticide Factsheets

Environmental regulation information for water utilities, including drinking and wastewater treatment facilities. Includes links to NESHAP for POTW, compliance information, and information about pretreatment programs.

Advanced Simulation in Undergraduate Pilot Training (ASUPT) Facility Utilization Plan.

ERIC Educational Resources Information Center

Hagin, William V.; Smith, James F.

The capabilities of a flight simulation research facility located at Williams AFB, Arizona are described. Research philosophy to be applied is discussed. Long range and short range objectives are identified. A time phased plan for long range research accomplishment is described. In addition, some examples of near term research efforts which will…

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

NASA Technical Reports Server (NTRS)

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

1989-01-01

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

Determinants of Utilization of Eye Care Services in a Rural Adult Population of a Developing Country

PubMed Central

Olusanya, Bolutife A.; Ashaye, Adeyinka O.; Owoaje, Eme T.; Baiyeroju, Aderonke M.; Ajayi, Benedictus G.

2016-01-01

Purpose: To describe the factors that determine the utilization of eye care services in a rural community in South-Western Nigeria. Methods: A descriptive cross-sectional survey using a multistage sampling technique was conducted. The main outcome measure was self-reported previous consultation of an orthodox medical facility for eye care. Results: The study sample included 643 participants. Only 122 (19%) respondents had previously visited orthodox facilities in search of eye care and 24% of those with presenting visual acuity <6/18 had sought eye care. Characteristics associated with previous utilization of eye care services were age of =70 years (odds ratio [OR] ≥ 1.7, P = 0.02); male gender (OR = 1.5, P = 0.04); literacy (OR = 1.7, P = 0.007); and residing close to an eye care facility (OR = 2.8, P < 0.001). Blind respondents were three times more likely to seek eye care (P < 0.001). Regression analysis revealed that factors associated with increased likelihood of utilization of eye care services included age ≥70 years; literacy; residence close to an eye facility; being diabetic or hypertensive; history of ocular symptoms, and blindness. Conclusions: These findings suggest that a significant proportion (75%) of adults in the study area are not utilizing eye care services and that blindness is an important determinant of utilization of eye care services. Health education and awareness campaigns about the importance and benefits of seeking eye care early, and the provision of community-based eye care programs are essential to boost the uptake of eye care services in this community as well as other rural areas of West Africa. PMID:26957847

Standby power generation under utility curtailment contract agreements

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

Nolan, G.J.; Puccio, V.J.; Calhoun, C.W.

1995-12-31

Many utilities in the US offer large industrial and commercial customers power sales contracts which have attractive rates under a curtailment requirement. This curtailment requirement allows the utility to require the customer to reduce its power demand to a predetermined level within a specific time period. If the required curtailment is not achieved by the customer within the allocated time period, stiff financial penalties are usually enforced by the utility. The attractiveness of the contract rates usually is proportional to the amount of curtailment required. To take advantage of these attractive rates, a customer must be able to withstand themore » curtailment without supplemental generation or must add standby generation to meet its needs. Obviously, the cost of the curtailments to the customer should not exceed the economic benefits of reduced rates. This paper reviews the alternatives faced by a curtailment contract customer together with potential load shedding and standby generation system designs. An example of implementing a curtailment contract at an existing industrial facility is presented. The example facility, Boeing Helicopters of Philadelphia, Pennsylvania required both load shedding and standby generation. The load shedding scheme is fairly complex and is controlled by a programmable logic controller (PLC). The standby generation and load shedding systems for the example facility are examined in detail. Also, lessons learned from implementing the required modifications to the example facility are discussed.« less

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

PubMed Central

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

2017-01-01

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

Effect of Women's autonomy on maternal health service utilization in Nepal: a cross sectional study.

PubMed

Adhikari, Ramesh

2016-05-13

Women's role has been a priority area not only for sustainable development, but also in reproductive health since ICPD 1994. However, very little empirical evidence is available about women's role on maternal health service utilization in Nepal. This paper explores dimensions of women's autonomy and their relationship to utilization of maternal health services. The analysis uses data from the Nepal Demographic and Health Survey, 2011. The analysis is confined to women who had given birth in the 5 years preceding the survey (n = 4,148). Women's autonomy related variables are taken from the standard DHS questionnaire and measured based on decision in household about obtaining health care, large household purchases and visit to family or relative. The net effect of women's autonomy on utilization of maternal health services after controlling for the effect of other predictors has been measured through multivariate logistic regression analysis. The findings indicate only about a half of the women who had given birth in the past 5 years preceding the survey had 4 or more ANC check up for their last birth. Similarly, 40 % of the women had delivered their last child in the health facilities. Furthermore, slightly higher than two-fifth women (43 %) had postnatal check up for their last child. Only slightly higher than a fourth woman (27 %) had utilized all the services (adequate ANC visit, delivered at health institution and post natal check up) for their last child. This study found that many socio-demographic variables such as age of women, number of children born, level of education, ethnicity, place of residence and wealth index are predicators of utilizing the maternal health services of recent child. Notably, higher level autonomy was associated with higher use of maternal health services [adjusted odds ratio (aOR) =1.40; CI 1.18-1.65]. Utilization of maternal health services for the recent child among women is very low. The study results suggest that policy

Women's autonomy and maternal healthcare service utilization in Ethiopia.

PubMed

Tiruneh, Fentanesh Nibret; Chuang, Kun-Yang; Chuang, Ying-Chih

2017-11-13

Most previous studies on healthcare service utilization in low-income countries have not used a multilevel study design to address the importance of community-level women's autonomy. We assessed whether women's autonomy, measured at both individual and community levels, is associated with maternal healthcare service utilization in Ethiopia. We analyzed data from the 2005 and 2011 Ethiopia Demographic and Health Surveys (N = 6058 and 7043, respectively) for measuring women's decision-making power and permissive gender norms associated with wife beating. We used Spearman's correlation and the chi-squared test for bivariate analyses and constructed generalized estimating equation logistic regression models to analyze the associations between women's autonomy indicators and maternal healthcare service utilization with control for other socioeconomic characteristics. Our multivariate analysis showed that women living in communities with a higher percentage of opposing attitudes toward wife beating were more likely to use all three types of maternal healthcare services in 2011 (adjusted odds ratios = 1.21, 1.23, and 1.18 for four or more antenatal care visits, health facility delivery, and postnatal care visits, respectively). In 2005, the adjusted odds ratios were 1.16 and 1.17 for four or more antenatal care visits and health facility delivery, respectively. In 2011, the percentage of women in the community with high decision-making power was positively associated with the likelihood of four or more antenatal care visits (adjusted odds ratio = 1.14). The association of individual-level autonomy on maternal healthcare service utilization was less profound after we controlled for other individual-level and community-level characteristics. Our study shows that women's autonomy was positively associated with maternal healthcare service utilization in Ethiopia. We suggest addressing woman empowerment in national policies and programs would be the optimal solution.

A cross-sectional study to estimate prevalence of periodontal disease in a population of dogs (Canis familiaris) in commercial breeding facilities in Indiana and Illinois

PubMed Central

2018-01-01

The objectives of this cross-sectional study were: 1) to estimate the prevalence and characterize the severity of periodontal disease in a population of dogs housed in commercial breeding facilities; 2) to characterize PD preventive care utilized by facility owners; and 3) to assess inter-rater reliability of a visual scoring assessment tool. Adult dogs (N = 445) representing 42 breeds at 24 CB facilities in Indiana and Illinois were assessed. Periodontal disease was scored visually using the American Veterinary Dental Collage 0-IV scale. Inter-rater reliability was assessed on 198 dogs and facility owners were asked to provide information about the preventive care utilized. The overall prevalence of periodontal disease (Grades I-IV) was 86.3% (95% CI: 82.9, 89.3). An ordered logistic regression analysis found age (OR = 1.4; 95% CI 1.24, 1.54; P<0.0001), facility (OR = 1.13; 95% CI 1.09, 1.18; P<0.0001), sex (OR = 1.7; 95% CI 1.12, 2.65; P = 0.013), and non-professional dental scaling (OR = 2.82; 95% CI 1.34, 5.91; P = 0.006) to be statistically significant. Inter-rater reliability analysis found agreement to be 86.2%, with a weighted kappa of 0.4731 (95% CI 0.3847, 0.5615) indicating moderate agreement. Risk of periodontal disease increased with increasing age. Additionally, a trend toward decreasing risk with increasing weight was also found, although it was not statistically significant. The trends identified agree with studies that have evaluated periodontal disease in the companion dog population and do not support the assumption that the dental health of dogs in commercial breeding facilities is worse than that of the population as a whole. Although there were few cases of severe periodontal disease and all facilities employed some type of preventive care in this sample, the large number of dogs with some degree of disease (Grades I-IV) suggests that further investigation of preventive care is warranted. PMID:29346448

A cross-sectional study to estimate prevalence of periodontal disease in a population of dogs (Canis familiaris) in commercial breeding facilities in Indiana and Illinois.

PubMed

Stella, Judith L; Bauer, Amy E; Croney, Candace C

2018-01-01

The objectives of this cross-sectional study were: 1) to estimate the prevalence and characterize the severity of periodontal disease in a population of dogs housed in commercial breeding facilities; 2) to characterize PD preventive care utilized by facility owners; and 3) to assess inter-rater reliability of a visual scoring assessment tool. Adult dogs (N = 445) representing 42 breeds at 24 CB facilities in Indiana and Illinois were assessed. Periodontal disease was scored visually using the American Veterinary Dental Collage 0-IV scale. Inter-rater reliability was assessed on 198 dogs and facility owners were asked to provide information about the preventive care utilized. The overall prevalence of periodontal disease (Grades I-IV) was 86.3% (95% CI: 82.9, 89.3). An ordered logistic regression analysis found age (OR = 1.4; 95% CI 1.24, 1.54; P<0.0001), facility (OR = 1.13; 95% CI 1.09, 1.18; P<0.0001), sex (OR = 1.7; 95% CI 1.12, 2.65; P = 0.013), and non-professional dental scaling (OR = 2.82; 95% CI 1.34, 5.91; P = 0.006) to be statistically significant. Inter-rater reliability analysis found agreement to be 86.2%, with a weighted kappa of 0.4731 (95% CI 0.3847, 0.5615) indicating moderate agreement. Risk of periodontal disease increased with increasing age. Additionally, a trend toward decreasing risk with increasing weight was also found, although it was not statistically significant. The trends identified agree with studies that have evaluated periodontal disease in the companion dog population and do not support the assumption that the dental health of dogs in commercial breeding facilities is worse than that of the population as a whole. Although there were few cases of severe periodontal disease and all facilities employed some type of preventive care in this sample, the large number of dogs with some degree of disease (Grades I-IV) suggests that further investigation of preventive care is warranted.

Utilities on the primary road system.

DOT National Transportation Integrated Search

1992-05-01

This chapter covers initial placement, adjustment, improvement, relocation, replacement and maintenance of utility facilities in, on, above, or below the right-of-way of primary highways, including attachments to primary highway structures. It embodi...

Strategies to encourage and facilitate utility owner participation in transportation projects : guidebook.

DOT National Transportation Integrated Search

2012-11-01

Utility accommodation policies around the country provide minimum requirements for the accommodation, adjustment, and maintenance of utility facilities within the highway right of way. Many state rules and guidelines are based on utility accommodatio...

18 CFR 292.204 - Criteria for qualifying small power production facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE PUBLIC UTILITY REGULATORY... production capacity of any other small power production facilities that use the same energy resource, are... production facilities within one mile of such facilities. (b) Fuel use. (1)(i) The primary energy source of...

The impact of nonreferral outpatient co-payment on medical care utilization and expenditures in Taiwan.

PubMed

Chen, Li-Chia; Schafheutle, Ellen I; Noyce, Peter R

2009-09-01

Taiwan's National Health Insurance's (NHI) generous coverage and patients' freedom to access different tiers of medical facilities have resulted in accelerating outpatient care utilization and costs. To deter nonessential visits and encourage initial contact in primary care (physician clinics), a differential co-payment was introduced on 15th July 2005. Under this, patients pay more for outpatient consultations at "higher tiers" of medical facilities (local community hospitals, regional hospitals, medical centers), particularly if accessed without referral. This study explored the impact of this policy on outpatient medical activities and expenditures, different co-payment groups, and tiers of medical facilities. A segmented time-series analysis on regional weekly outpatient medical claims (January 2004 to July 2006) was conducted. Outcome variables (number of visits, number of outpatients, total cost of outpatient care) and variables for cost structure were stratified by tiers of medical facilities and co-payment groups. Analysis used the auto-regressive integrated moving-average model in STATA 9.0. The overall number of outpatient visits significantly decreased after policy implementation due to a reduction in the number of patients using outpatient facilities, but total costs of care remained unchanged. The policy had its greatest impact on the number of visits to regional and local community hospitals but had no influence on those to the medical centers. Medical utilization in physician clinics decreased due to an audit of reimbursement declarations. Overall, the policy failed to encourage referrals from primary care to higher tiers because there was no obvious shifting of medical utilization and costs reversely. Differential co-payment policy decreased total medication utilization but not costs to NHI. The results suggest that the increased level of co-payment charge and the strategy of a single cost-sharing policy are not sufficient to promote referrals

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2011 CFR

2011-10-01

....614 Section 456.614 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2013 CFR

2013-10-01

....614 Section 456.614 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2014 CFR

2014-10-01

....614 Section 456.614 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2012 CFR

2012-10-01

....614 Section 456.614 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

Estimation of marginal costs at existing waste treatment facilities.

PubMed

Martinez-Sanchez, Veronica; Hulgaard, Tore; Hindsgaul, Claus; Riber, Christian; Kamuk, Bettina; Astrup, Thomas F

2016-04-01

This investigation aims at providing an improved basis for assessing economic consequences of alternative Solid Waste Management (SWM) strategies for existing waste facilities. A bottom-up methodology was developed to determine marginal costs in existing facilities due to changes in the SWM system, based on the determination of average costs in such waste facilities as function of key facility and waste compositional parameters. The applicability of the method was demonstrated through a case study including two existing Waste-to-Energy (WtE) facilities, one with co-generation of heat and power (CHP) and another with only power generation (Power), affected by diversion strategies of five waste fractions (fibres, plastic, metals, organics and glass), named "target fractions". The study assumed three possible responses to waste diversion in the WtE facilities: (i) biomass was added to maintain a constant thermal load, (ii) Refused-Derived-Fuel (RDF) was included to maintain a constant thermal load, or (iii) no reaction occurred resulting in a reduced waste throughput without full utilization of the facility capacity. Results demonstrated that marginal costs of diversion from WtE were up to eleven times larger than average costs and dependent on the response in the WtE plant. Marginal cost of diversion were between 39 and 287 € Mg(-1) target fraction when biomass was added in a CHP (from 34 to 303 € Mg(-1) target fraction in the only Power case), between -2 and 300 € Mg(-1) target fraction when RDF was added in a CHP (from -2 to 294 € Mg(-1) target fraction in the only Power case) and between 40 and 303 € Mg(-1) target fraction when no reaction happened in a CHP (from 35 to 296 € Mg(-1) target fraction in the only Power case). Although average costs at WtE facilities were highly influenced by energy selling prices, marginal costs were not (provided a response was initiated at the WtE to keep constant the utilized thermal capacity). Failing to systematically

Environmental Assessment (EA): Proposed Software Facilities, Hill Air Force Base, Utah

DTIC Science & Technology

2011-04-19

retention facilities ; • connections to adjacent buried utilities consisting of water, electricity, natural gas, telephone/ data , sanitary sewer, and storm...engineering, development, and testing workloads for F-22 and F-35 aircraft. Military construction (MILCON) project data explain existing facilities ...Existing Facilities MILCON project data state there are no facilities on Hill AFB with adequate security to house the specialized laboratory space or

Occupational disease surveillance of an aircraft rework facility.

PubMed

Fung, F; Bundy, M; Kennon, R

1990-11-01

Analysis of the 1987-1988 morbidity data of an aircraft rework facility's 6,672 employees identified 118 patients with occupational diseases. In our study, 61 cases (52%) involved eye and skin conditions. This was comparable to the State of California occupational diseases report. However, systemic conditions appeared to be higher (24% vs. 7%) in the study group, and this finding may need further investigation to clarify its significance. Patients employed as craftworkers accounted for nearly half of all reported occupational diseases. Federal workers in this facility appeared to have a higher percentage (70%) of "no time lost" when compared with that of the State of California report (54%). The utility of morbidity data in the prevention of occupational diseases is discussed.

Defining personal utility in genomics: A Delphi study.

PubMed

Kohler, J N; Turbitt, E; Lewis, K L; Wilfond, B S; Jamal, L; Peay, H L; Biesecker, L G; Biesecker, B B

2017-09-01

Individual genome sequencing results are valued by patients in ways distinct from clinical utility. Such outcomes have been described as components of "personal utility," a concept that broadly encompasses patient-endorsed benefits, that is operationally defined as non-clinical outcomes. No empirical delineation of these outcomes has been reported. To address this gap, we administered a Delphi survey to adult participants in a National Institute of Health (NIH) clinical exome study to extract the most highly endorsed outcomes constituting personal utility. Forty research participants responded to a Delphi survey to rate 35 items identified by a systematic literature review of personal utility. Two rounds of ranking resulted in 24 items that represented 14 distinct elements of personal utility. Elements most highly endorsed by participants were: increased self-knowledge, knowledge of "the condition," altruism, and anticipated coping. Our findings represent the first systematic effort to delineate elements of personal utility that may be used to anticipate participant expectation and inform genetic counseling prior to sequencing. The 24 items reported need to be studied further in additional clinical genome sequencing studies to assess generalizability in other populations. Further research will help to understand motivations and to predict the meaning and use of results. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Photovoltaic utility/customer interface study

NASA Astrophysics Data System (ADS)

Eichler, C. H.; Hayes, T. P.; Matthews, M. M.; Wilraker, V. F.

1980-12-01

The technical, economic, and legal and regulatory issues of interconnecting small, privately-owned, on-site photovoltaic generating systems to an electric utility are addressed. Baseline residential, commercial and industrial class photovoltaic systems were developed. Technical issues of concern affecting this interconnection were identified and included fault protection, undervoltage protection, lamp flicker, revenue metering, loss of synchromism, electrical safety, prevention of backfeeding a de-energized utility feeder, effects of on-site generation on utility relaying schemes, effects of power conditioner harmonic distortion on the electric utility, system isolation, electromagnetic interference and site power factor as seen by the utility. Typical interconnection wiring diagrams were developed for interconnecting each class of baseline photovoltaic generating system.

Interventions to improve utilization of cataract surgical services by girls: Case studies from Asia and Africa.

PubMed

Adhisesha Reddy, Priya; Kishiki, Elizabeth A; Thapa, Hari Bahadur; Demers, Lisa; Geneau, Robert; Bassett, Ken

2018-06-01

Gender and blindness initiatives continue to make eye care personnel aware of the service utilization inequity strongly favouring men, yet interventions to reduce that inequity, particularly for girls, are under developed. This descriptive study gathered quantitative data on the degree of gender equity at five Child Eye Health Tertiary Facilities (CEHTFs) in Asia and Africa and conducted in-depth interviews with eye care personnel to assess their strategies and capacity to reduce gender inequity. Cataract surgery was utilized to assess the degree of inequity and success of interventions to reduce inequity in case finding, service utilization, and follow-up. CEHTF administrative data showed significant gender inequity in cataract surgical services favouring boys in all settings. CEHTFs actively seek children through community and school-based outreach, yet do not have initiatives to reduce gender inequity. Little gender inequity was found among children receiving surgical and follow-up care, although two out of three children were boys. CEHTF staff, despite being aware, offered no effective means to reduce gender inequity involving cataract surgical services. Interventions that successfully increased service utilization by girls came from individual cases, involving extraordinary effort by a single eye care programme person. Community-based case finders such as Anganwadi workers in India, Female Community Health Volunteers (FCHVs) in Nepal, and Key Informants (KIs) in Africa are necessary to identify children in need of cataract services, but insufficient to increase service utilization by girls. Secondary, often extra-ordinary community-based interventions by eye care personnel are needed in all settings.

One-year trajectories of care and resource utilization for recipients of prolonged mechanical ventilation: a cohort study.

PubMed

Unroe, Mark; Kahn, Jeremy M; Carson, Shannon S; Govert, Joseph A; Martinu, Tereza; Sathy, Shailaja J; Clay, Alison S; Chia, Jessica; Gray, Alice; Tulsky, James A; Cox, Christopher E

2010-08-03

Growing numbers of critically ill patients receive prolonged mechanical ventilation. Little is known about the patterns of care as patients transition from acute care hospitals to postacute care facilities or about the associated resource utilization. To describe 1-year trajectories of care and resource utilization for patients receiving prolonged mechanical ventilation. 1-year prospective cohort study. 5 intensive care units at Duke University Medical Center, Durham, North Carolina. 126 patients receiving prolonged mechanical ventilation (defined as ventilation for >or=4 days with tracheostomy placement or ventilation for >or=21 days without tracheostomy), as well as their 126 surrogates and 54 intensive care unit physicians, enrolled consecutively over 1 year. Patients and surrogates were interviewed in the hospital, as well as 3 and 12 months after discharge, to determine patient survival, functional status, and facility type and duration of postdischarge care. Physicians were interviewed in the hospital to elicit prognoses. Institutional billing records were used to assign costs for acute care, outpatient care, and interfacility transportation. Medicare claims data were used to assign costs for postacute care. 103 (82%) hospital survivors had 457 separate transitions in postdischarge care location (median, 4 transitions [interquartile range, 3 to 5 transitions]), including 68 patients (67%) who were readmitted at least once. Patients spent an average of 74% (95% CI, 68% to 80%) of all days alive in a hospital or postacute care facility or receiving home health care. At 1 year, 11 patients (9%) had a good outcome (alive with no functional dependency), 33 (26%) had a fair outcome (alive with moderate dependency), and 82 (65%) had a poor outcome (either alive with complete functional dependency [4 patients; 21%] or dead [56 patients; 44%]). Patients with poor outcomes were older, had more comorbid conditions, and were more frequently discharged to a postacute care

A cluster randomized implementation trial to measure the effectiveness of an intervention package aiming to increase the utilization of skilled birth attendants by women for childbirth: study protocol

PubMed Central

2014-01-01

Background Nepal is on track to achieve MDG 5 but there is a huge sub-national disparity with existing high maternal mortality in western and hilly regions. The national priority is to reduce this disparity to achieve the goal at sub-national level. Evidences from developing countries show that increasing utilization of skilled attendant at birth is an important indicator for reducing maternal death. Further, there is a very low utilization during childbirth in western and hilly regions of Nepal which clearly depicts the barriers in utilization of skilled birth attendants. So, there is a need to overcome the identified barriers to increase the utilization thereby decreasing the maternal mortality. The hypothesis of this study is that through a package of interventions the utilization of skilled birth attendants will be increased and hence improve maternal health in Nepal. Method/Design This study involves a cluster randomized controlled trial involving approximately 5000 pregnant women in 36 clusters. The 18 intervention clusters will receive the following interventions: i) mobilization of family support for pregnant women to reach the health facility, ii) availability of emergency funds for institutional childbirth, iii) availability of transport options to reach a health facility for childbirth, iv) training to health workers on communication skills, v) security provisions for SBAs to reach services 24/24 through community mobilization; 18 control clusters will not receive the intervention package. The final evaluation of the intervention is planned to be completed by October 2014. Primary study output of this study is utilization of SBA services. Secondary study outputs measure the uptake of antenatal care, post natal checkup for mother and baby, availability of transportation for childbirth, operation of emergency fund, improved reception of women at health services, and improved physical security of SBAs. Discussion The intervention package is designed to

A cluster randomized implementation trial to measure the effectiveness of an intervention package aiming to increase the utilization of skilled birth attendants by women for childbirth: study protocol.

PubMed

Bhandari, Gajananda P; Subedi, Narayan; Thapa, Janak; Choulagai, Bishnu; Maskey, Mahesh K; Onta, Sharad R

2014-03-19

Nepal is on track to achieve MDG 5 but there is a huge sub-national disparity with existing high maternal mortality in western and hilly regions. The national priority is to reduce this disparity to achieve the goal at sub-national level. Evidences from developing countries show that increasing utilization of skilled attendant at birth is an important indicator for reducing maternal death. Further, there is a very low utilization during childbirth in western and hilly regions of Nepal which clearly depicts the barriers in utilization of skilled birth attendants. So, there is a need to overcome the identified barriers to increase the utilization thereby decreasing the maternal mortality. The hypothesis of this study is that through a package of interventions the utilization of skilled birth attendants will be increased and hence improve maternal health in Nepal. This study involves a cluster randomized controlled trial involving approximately 5000 pregnant women in 36 clusters. The 18 intervention clusters will receive the following interventions: i) mobilization of family support for pregnant women to reach the health facility, ii) availability of emergency funds for institutional childbirth, iii) availability of transport options to reach a health facility for childbirth, iv) training to health workers on communication skills, v) security provisions for SBAs to reach services 24/24 through community mobilization; 18 control clusters will not receive the intervention package. The final evaluation of the intervention is planned to be completed by October 2014. Primary study output of this study is utilization of SBA services. Secondary study outputs measure the uptake of antenatal care, post natal checkup for mother and baby, availability of transportation for childbirth, operation of emergency fund, improved reception of women at health services, and improved physical security of SBAs. The intervention package is designed to increase the utilization of skilled

Ready Reserve Civilian Skills Utilization Study (RESCON).

DTIC Science & Technology

1975-11-10

brokers, insurance, business, etc.) 6 Special Skills/Talents 7 Pilots 10 Engineers, Industrial 10 Petrol & Chem 10 Aero 11 EE 12 19 Civil 13- Math ...AD-A123 132 READY RESERVE CIVILIAN SKILLS UTILIZATION STUDY (RESCON)(U) MARINE CORPS VTU 12 -3 NAS MOFFETT FIELD CA E O AGEE ET ALS 10 NOV 75...Nov 7! ?-~1UTILIZATION STUDY (RESCON) 6. PEaRORMING OR011. REPORT MNMER VTU 12 -3 0/F 1. AUTNOR(#) CoB CONTRACT ON GRANT MUMMER(@) Lto R. J. to~r C

Liquefaction chemistry and kinetics: Hydrogen utilization studies

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

Rothenberger, K.S.; Warzinski, R.P.; Cugini, A.V.

1995-12-31

The objectives of this project are to investigate the chemistry and kinetics that occur in the initial stages of coal liquefaction and to determine the effects of hydrogen pressure, catalyst activity, and solvent type on the quantity and quality of the products produced. The project comprises three tasks: (1) preconversion chemistry and kinetics, (2) hydrogen utilization studies, and (3) assessment of kinetic models for liquefaction. The hydrogen utilization studies work will be the main topic of this report. However, the other tasks are briefly described.

Disability rates for cardiovascular and psychological disorders among autoworkers by job category, facility type, and facility overtime hours.

PubMed

Landsbergis, Paul A; Janevic, Teresa; Rothenberg, Laura; Adamu, Mohammed T; Johnson, Sylvia; Mirer, Franklin E

2013-07-01

We examined the association between long work hours, assembly line work and stress-related diseases utilizing objective health and employment data from an employer's administrative databases. A North American automobile manufacturing company provided data for claims for sickness, accident and disability insurance (work absence of at least 4 days) for cardiovascular disease (CVD), hypertension and psychological disorders, employee demographics, and facility hours worked per year for 1996-2001. Age-adjusted claim rates and age-adjusted rate ratios were calculated using Poisson regression, except for comparisons between production and skilled trades workers owing to lack of age denominator data by job category. Associations between overtime hours and claim rates by facility were examined by Poisson regression and multi-level Poisson regression. Claims for hypertension, coronary heart disease, CVD, and psychological disorders were associated with facility overtime hours. We estimate that a facility with 10 more overtime hours per week than another facility would have 4.36 more claims for psychological disorders, 2.33 more claims for CVD, and 3.29 more claims for hypertension per 1,000 employees per year. Assembly plants had the highest rates of claims for most conditions. Production workers tended to have higher rates of claims than skilled trades workers. Data from an auto manufacturer's administrative databases suggest that autoworkers working long hours, and assembly-line workers relative to skilled trades workers or workers in non-assembly facilities, have a higher risk of hypertension, CVD, and psychological disorders. Occupational disease surveillance and disease prevention programs need to fully utilize such administrative data. Copyright © 2013 Wiley Periodicals, Inc.

The utilization of automated external defibrillators in Taiwan.

PubMed

Wang, Tsung-Hsi; Wu, Hsi-Wen; Hou, Peter C; Tseng, Hao-Jui

2018-03-24

Increasing attention to care of patient succumbed to out-of-hospital cardiac arrest (OHCA) and evidence for improved survival have resulted in many countries to encourage the use automated external defibrillators (AEDs) by legislation. In Taiwan, the amendment of the Emergency Medical Services Act mandated the installation of AEDs in designated areas in 2013. Since then, 6151 AEDs have been installed and registered in mandated and non-mandated locations. The purpose of this study was to investigate the utilization of AEDs at mandated and non-mandated locations. This paper analyzed 217 cases in whom AEDs was used between July 11, 2013 and July 31, 2015. Descriptive statistics were used to analyze the data. The highest frequency of AEDs used was in long-term care facilities, accounting for 34 (15.7%) cases. The second and third highest was in schools and commuting stations. The highest utilization rate of registered AED was in long-term care facilities (73.9%), the second was in residential areas, and the third was in hot spring areas. Employees at the designated locations or medical personnel operated the AED in 143 cases (84.6%), and bystanders, relatives, friends or others operated the AEDs in 26 cases (15.4%). On-site Return of Spontaneous Circulation (ROSC) after applying AEDs occurred in 76 cases (45.8%). Long-term care facilities had the highest utilization of AEDs and government should pay more attention to enforce the installing of AEDs in these places. The government also needs to promote the education public on how to search the AEDs locations. Copyright © 2018. Published by Elsevier B.V.

Feasibility study of solar energy utilization in modular integrated utility systems

NASA Technical Reports Server (NTRS)

1975-01-01

The feasibility and benefits were evaluated of solar thermal energy systems on Integrated Utility Systems. The effort included the identification of potential system concepts, evaluation of hardware status, and performance of weighted system evaluations to select promising system concepts deserving of further study.

1977 Nationwide Personal Transportation Study : household vehicle utilization

DOT National Transportation Integrated Search

1981-04-01

This report is part of a series that presents findings from the 1977 Nationwide Personal Transportation Study (NPTS). This report describes patterns of utilization of private vehicles (annual miles driven) in 1977. Utilization is keyed to estimates p...

Utilization of retroperitoneal lymph node dissection for testicular cancer in the United States: Results from the National Cancer Database (1998-2011).

PubMed

Hugen, Cory M; Hu, Brian; Jeldres, Claudio; Burton, Claire; Nichols, Craig R; Porter, Christopher R; Daneshmand, Siamak

2016-11-01

Retroperitoneal lymph node dissection (RPLND) for the treatment of testicular cancer is a relatively rare and complex operation that may contribute to differences in utilization. We sought to characterize the use of RPLND between different categories of cancer center facilities in the United States. The National Cancer Database was queried for patients with germ cell tumors treated at different types of cancer centers between 1998 and 2011. The proportion of patients who underwent RPLND was stratified by stage and histology and then compared between treatment facilities. RPLND utilization was then compared between facility types as a function of time. A total of 59,652 patients met inclusion criteria and 5,475 (9.2%) underwent RPLND. The proportion of patients treated with RPLND for non-seminomatous germ cell tumor (NSGCT) was significantly different between cancer center types for all stages (P<0.001) and used most often in academic comprehensive cancer centers. There was no difference in the proportion of RPLND utilization for stage II and III seminoma stratified by treatment facility. There was a significantly decreased trend in the utilization of RPLND for stage I (P = 0.032) NSGCT whereas utilization was increased for stage III NSGCT (P≤0.001) over the study period. The proportion of patients undergoing RPLND for NSGCT varies significantly by the type of cancer center and is used most often in academic cancer centers. Utilization of RPLND decreased for stage I NSGCT and increased for stage III NSGCTs during the study period. Copyright © 2016 Elsevier Inc. All rights reserved.

New Spaces for Learning: Designing College Facilities to Utilize Instructional Aids and Media. Revised.

ERIC Educational Resources Information Center

Hauf, Harold D.; And Others

Colleges need appropriate large group instructional facilities for effective and efficient use of instructional aids and media. A well planned system of facilities must provide space for learning; production, origination, and support; storage and retrieval. Design begins with a building plan--a statement, made jointly by the administrator and…

From web search to healthcare utilization: privacy-sensitive studies from mobile data.

PubMed

White, Ryen; Horvitz, Eric

2013-01-01

We explore relationships between health information seeking activities and engagement with healthcare professionals via a privacy-sensitive analysis of geo-tagged data from mobile devices. We analyze logs of mobile interaction data stripped of individually identifiable information and location data. The data analyzed consist of time-stamped search queries and distances to medical care centers. We examine search activity that precedes the observation of salient evidence of healthcare utilization (EHU) (ie, data suggesting that the searcher is using healthcare resources), in our case taken as queries occurring at or near medical facilities. We show that the time between symptom searches and observation of salient evidence of seeking healthcare utilization depends on the acuity of symptoms. We construct statistical models that make predictions of forthcoming EHU based on observations about the current search session, prior medical search activities, and prior EHU. The predictive accuracy of the models varies (65%-90%) depending on the features used and the timeframe of the analysis, which we explore via a sensitivity analysis. We provide a privacy-sensitive analysis that can be used to generate insights about the pursuit of health information and healthcare. The findings demonstrate how large-scale studies of mobile devices can provide insights on how concerns about symptomatology lead to the pursuit of professional care. We present new methods for the analysis of mobile logs and describe a study that provides evidence about how people transition from mobile searches on symptoms and diseases to the pursuit of healthcare in the world.

From web search to healthcare utilization: privacy-sensitive studies from mobile data

PubMed Central

Horvitz, Eric

2013-01-01

Objective We explore relationships between health information seeking activities and engagement with healthcare professionals via a privacy-sensitive analysis of geo-tagged data from mobile devices. Materials and methods We analyze logs of mobile interaction data stripped of individually identifiable information and location data. The data analyzed consist of time-stamped search queries and distances to medical care centers. We examine search activity that precedes the observation of salient evidence of healthcare utilization (EHU) (ie, data suggesting that the searcher is using healthcare resources), in our case taken as queries occurring at or near medical facilities. Results We show that the time between symptom searches and observation of salient evidence of seeking healthcare utilization depends on the acuity of symptoms. We construct statistical models that make predictions of forthcoming EHU based on observations about the current search session, prior medical search activities, and prior EHU. The predictive accuracy of the models varies (65%–90%) depending on the features used and the timeframe of the analysis, which we explore via a sensitivity analysis. Discussion We provide a privacy-sensitive analysis that can be used to generate insights about the pursuit of health information and healthcare. The findings demonstrate how large-scale studies of mobile devices can provide insights on how concerns about symptomatology lead to the pursuit of professional care. Conclusion We present new methods for the analysis of mobile logs and describe a study that provides evidence about how people transition from mobile searches on symptoms and diseases to the pursuit of healthcare in the world. PMID:22661560

Florida harvest and utilization study, 2008

Treesearch

James W. Bentley; Tony G. Johnson

2009-01-01

In 2008, a harvest and utilization study was conducted on 82 operationsthroughout Florida. There were 2,114 total trees measured: 1,670 or79 percent were softwood, while 444 or 21 percent were hardwood. Resultsfrom this study showed that 85 percent of the total softwood volumemeasured was...

Virginia harvest and utilization study, 2007

Treesearch

James W. Bentley; Tony G. Johnson

2009-01-01

In 2007, a harvest and utilization study was conducted on 81 operationsthroughout Virginia. There were 2,016 total trees measured; 1,086 or54 percent were softwood, while 930 or 46 percent were hardwood. Resultsfrom this study showed that 86 percent of the total softwood volumemeasured was...

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.

Renewable Energy Feasibility Study Leading to Development of the Native Spirit Solar Energy Facility

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

Carolyn Stewart; Tracey LeBeau

2008-01-31

DOE-funded renewable energy feasibility study conducted by Red Mountain Tribal Energy on behalf of the Southwest Tribal Energy Consortium (SWTEC). During the course of the study, SWTEC members considered multiple options for the organization structure, selected a proposed organization structure, and drafted a Memorandum of Understanding for the SWTEC organization. High-level resource assessments for SWTEC members were completed; surveys were developed and completed to determine each member’s interest in multiple participation options, including on-reservation projects. With the survey inputs in mind, multiple energy project options were identified and evaluated on a high-level basis. That process led to a narrowing ofmore » the field of technology options to solar generation, specifically, utility-scale Concentrating Solar-Powered Generation projects, with a specific, tentative project location identified at the Fort Mojave Indian Reservation -- the Native Spirit Solar Energy Facility.« less

Impact of Predicting Health Care Utilization Via Web Search Behavior: A Data-Driven Analysis.

PubMed

Agarwal, Vibhu; Zhang, Liangliang; Zhu, Josh; Fang, Shiyuan; Cheng, Tim; Hong, Chloe; Shah, Nigam H

2016-09-21

By recent estimates, the steady rise in health care costs has deprived more than 45 million Americans of health care services and has encouraged health care providers to better understand the key drivers of health care utilization from a population health management perspective. Prior studies suggest the feasibility of mining population-level patterns of health care resource utilization from observational analysis of Internet search logs; however, the utility of the endeavor to the various stakeholders in a health ecosystem remains unclear. The aim was to carry out a closed-loop evaluation of the utility of health care use predictions using the conversion rates of advertisements that were displayed to the predicted future utilizers as a surrogate. The statistical models to predict the probability of user's future visit to a medical facility were built using effective predictors of health care resource utilization, extracted from a deidentified dataset of geotagged mobile Internet search logs representing searches made by users of the Baidu search engine between March 2015 and May 2015. We inferred presence within the geofence of a medical facility from location and duration information from users' search logs and putatively assigned medical facility visit labels to qualifying search logs. We constructed a matrix of general, semantic, and location-based features from search logs of users that had 42 or more search days preceding a medical facility visit as well as from search logs of users that had no medical visits and trained statistical learners for predicting future medical visits. We then carried out a closed-loop evaluation of the utility of health care use predictions using the show conversion rates of advertisements displayed to the predicted future utilizers. In the context of behaviorally targeted advertising, wherein health care providers are interested in minimizing their cost per conversion, the association between show conversion rate and predicted

Pregnant Women's Intentions and Subsequent Behaviors Regarding Maternal and Neonatal Service Utilization: Results from a Cohort Study in Nyanza Province, Kenya.

PubMed

Creanga, Andreea A; Odhiambo, George Awino; Odera, Benjamin; Odhiambo, Frank O; Desai, Meghna; Goodwin, Mary; Laserson, Kayla; Goldberg, Howard

2016-01-01

Higher use of maternal and neonatal health (MNH) services may reduce maternal and neonatal mortality in Kenya. This study aims to: 1) prospectively explore women's intentions to use MNH services (antenatal care, delivery in a facility, postnatal care, neonatal care) at <20 and 30-35 weeks' gestation and their actual use of these services; 2) identify predictors of intention-behavior discordance among women with positive service use intentions; 3) examine associations between place of delivery, women's reasons for choosing it, and birthing experiences. We used data from a 2012-2013 population-based cohort of pregnant women in the Demographic Surveillance Site in Nyanza province, Kenya. Of 1,056 women completing the study (89.1% response rate), 948 had live-births and 22 stillbirths, and they represent our analytic sample. Logistic regression analysis identified predictors of intention-behavior discordance regarding delivery in a facility and use of postnatal and neonatal care. At <20 and 30-35 weeks' gestation, most women intended to seek MNH services (≥93.9% and ≥87.5%, respectively, for all services assessed). Actual service use was high for antenatal (98.1%) and neonatal (88.5%) care, but lower for delivery in a facility (76.9%) and postnatal care (51.8%). Woman's age >35 and high-school education were significant predictors of intention-behavior discordance regarding delivery in a facility; several delivery-related factors were significantly associated with intention-behavior discordance regarding use of postnatal and neonatal care. Delivery facilities were chosen based on proximity to women's residence, affordability, and service quality; among women who delivered outside a health facility, 16.3% could not afford going to a facility. Good/very good birth experiences were reported by 93.6% of women who delivered in a facility and 32.6% of women who did not. We found higher MNH service utilization than previously documented in Nyanza province. Further

Place of Delivery Associated With Postnatal Care Utilization Among Childbearing Women in Zambia.

PubMed

Chungu, Charles; Makasa, Mpundu; Chola, Mumbi; Jacobs, Choolwe Nkwemu

2018-01-01

Postnatal care (PNC) utilization is critical to the prevention of maternal morbidity and mortality. Despite its importance, the proportion of women utilizing this service is still low in Zambia. We investigated if place of delivery was associated with PNC utilization in the first 48 h among childbearing women in Zambia. Data from the 2013/14 Zambia Demographic and Health Survey for women, aged 15-49 years, who reported giving birth in the 2 years preceding the survey was used. The data comprised of sociodemographic and other obstetric data, which were cleaned, recoded, and analyzed using STATA version 13 (Stata Corporation, College Station, TX, USA). Multivariate logistic regression was used to examine the association of place of delivery and other background variables. Women who delivered in a health facility were more likely to utilize PNC in the first 48 h compared to those who did not deliver in a health facility: government hospital (AOR 7.24, 95% CI 4.92-11.84), government health center/clinic (AOR 7.15 95% CI 4.79-10.66), other public sector (AOR 23.2 95% CI 3.69-145.91), private hospital/clinic (AOR 10.08 95% CI 3.35-30.35), and Mission hospital/clinic (AOR 8.56 95% CI 4.71-15.53). Additionally, women who were attended to by a skilled personnel during delivery of the baby were more likely to utilize PNC (AOR 2.30, 95% CI 1.57-3.37). Women from rural areas were less likely to utilize PNC in the first 48 h (AOR 0.70, 95% CI 0.53-0.90). Place of delivery was found to be linked with PNC utilization in this population although access to health care is still driven by inequity-related dynamics and imbalances. Given that inequity stresses are heaviest in the rural and poor groups, interventions should aim to reach this group. The study results will help program managers to increase access to health facility delivery and direct interventional efforts toward the affected subpopulations, such as the young and rural women. Furthermore, results will help

Mission definition study for a VLBI station utilizing the Space Shuttle

NASA Technical Reports Server (NTRS)

Burke, B. F.

1982-01-01

The uses of the Space Shuttle transportation system for orbiting VeryLong-Baseline Interferometry (OVLBI) were examined, both with respect to technical feasibility and its scientific possibilities. The study consisted of a critical look at the adaptability of current technology to an orbiting environment, the suitability of current data reduction facilities for the new technique, and a review of the new science that is made possible by using the Space Shuttle as a moving platform for a VLBI terminal in space. The conclusions are positive in all respects: no technological deficiencies exist that would need remedy, the data processing problem can be handled easily by straightforward adaptations of existing systems, and there is a significant new research frontier to be explored, with the Space Shuttle providing the first step. The VLBI technique utilizes the great frequency stability of modern atomic time standards, the power of integrated circuitry to perform real-time signal conditioning, and the ability of magnetic tape recorders to provide essentially error-free data recording, all of which combine to permit the realization of radio interferometry at arbitrarily large baselines.

A study of the operation of selected national research facilities

NASA Technical Reports Server (NTRS)

Eisner, M.

1974-01-01

The operation of national research facilities was studied. Conclusions of the study show that a strong resident scientific staff is required for successful facility operation. No unique scheme of scientific management is revealed except for the obvious fact that the management must be responsive to the users needs and requirements. Users groups provide a convenient channel through which these needs and requirements are communicated.

A national study of efficiency for dialysis centers: an examination of market competition and facility characteristics for production of multiple dialysis outputs.

PubMed

Ozgen, Hacer; Ozcan, Yasar A

2002-06-01

To examine market competition and facility characteristics that can be related to technical efficiency in the production of multiple dialysis outputs from the perspective of the industrial organization model. Freestanding dialysis facilities that operated in 1997 submitted cost report fonns to the Health Care Financing Administration (HCFA), and offered all three outputs--outpatient dialysis, dialysis training, and home program dialysis. The Independent Renal Facility Cost Report Data file (IRFCRD) from HCFA was utilized to obtain information on output and input variables and market and facility features for 791 multiple-output facilities. Information regarding population characteristics was obtained from the Area Resources File. Cross-sectional data for the year 1997 were utilized to obtain facility-specific technical efficiency scores estimated through Data Envelopment Analysis (DEA). A binary variable of efficiency status was then regressed against its market and facility characteristics and control factors in a multivariate logistic regression analysis. The majority of the facilities in the sample are functioning technically inefficiently. Neither the intensity of market competition nor a policy of dialyzer reuse has a significant effect on the facilities' efficiency. Technical efficiency is significantly associated, however, with type of ownership, with the interaction between the market concentration of for-profits and ownership type, and with affiliations with chains of different sizes. Nonprofit and government-owned Facilities are more likely than their for-profit counterparts to become inefficient producers of renal dialysis outputs. On the other hand, that relationship between ownership form and efficiency is reversed as the market concentration of for-profits in a given market increases. Facilities that are members of large chains are more likely to be technically inefficient. Facilities do not appear to benefit from joint production of a variety of

Health facility and skilled birth deliveries among poor women with Jamkesmas health insurance in Indonesia: a mixed-methods study.

PubMed

Brooks, Mohamad I; Thabrany, Hasbullah; Fox, Matthew P; Wirtz, Veronika J; Feeley, Frank G; Sabin, Lora L

2017-02-02

The growing momentum for quality and affordable health care for all has given rise to the recent global universal health coverage (UHC) movement. As part of Indonesia's strategy to achieve the goal of UHC, large investments have been made to increase health access for the poor, resulting in the implementation of various health insurance schemes targeted towards the poor and near-poor, including the Jamkesmas program. In the backdrop of Indonesia's aspiration to reach UHC is the high rate of maternal mortality that disproportionally affects poor women. The objective of this study was to evaluate the association of health facility and skilled birth deliveries among poor women with and without Jamkesmas and explore perceived barriers to health insurance membership and maternal health service utilization. We used a mixed-methods design. Utilizing data from the 2012 Indonesian Demographic and Health Survey (n = 45,607), secondary analysis using propensity score matching was performed on key outcomes of interest: health facility delivery (HFD) and skilled birth delivery (SBD). In-depth interviews (n = 51) were conducted in the provinces of Jakarta and Banten among poor women, midwives, and government representatives. Thematic framework analysis was performed on qualitative data to explore perceived barriers. In 2012, 63.0% of women did not have health insurance; 19.1% had Jamkesmas. Poor women with Jamkesmas were 19% (OR = 1.19 [1.03-1.37]) more likely to have HFD and 17% (OR = 1.17 [1.01-1.35]) more likely to have SBD compared to poor women without insurance. Qualitative interviews highlighted key issues, including: lack of proper documentation for health insurance registration; the preference of pregnant women to deliver in their parents' village; the use of traditional birth attendants; distance to health facilities; shortage of qualified health providers; overcrowded health facilities; and lack of health facility accreditation. Poor women with

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

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

PubMed

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

2015-07-01

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

Analysis of the net energy use impacts of PURPA (Public Utility Regulatory Policy Act) electricity generation under alternative assumptions regarding the technology mix of PURPA generators and displaced utility generators: Final report

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

Not Available

The goals of this study were to explore the magnitude of potential fuel savings (or increased fuel consumption) under different possible combinations of Qualifying Facilities generation and utility displacement, and to identify those combinations which might result in a net increase in fuel consumption. In exploring the impact of cogeneration net heat rate on net savings (or increase) in fuel consumption, the study also addressed the extent to which cogenerator efficiency affects the overall fuel use impact of Public Utility Regulatory Policies Act (PURPA) implementation. This research thus seeks to identify possible scenarios in which PURPA implementation may not resultmore » in the conversation of fossil fuels, and to define possible situations in which the FERC's efficiency standard may lead to energy-inefficient Qualifying Facility development. 9 refs., 6 figs., 6 tabs.« less

Impact of Antimicrobial Stewardship on Physician Practice in a Geriatric Facility

PubMed Central

Kassett, Nina; Sham, Rosalind; Aleong, Rosanne; Yang, Daisy; Kirzner, Michael; Craft, Aidlee

2016-01-01

Background There is a paucity of literature describing the implementation of antimicrobial stewardship programs (ASPs) in long-term care (LTC) facilities. The current study evaluated the impact of an ASP that was implemented across a geriatric facility, which included an inpatient specialty hospital and an LTC facility. The program included prospective audits with feedback, multidisciplinary education, information technology interventions, and guideline development. Objective To investigate the impact of the ASP on physicians’ prescribing practices in this geriatric facility. Methods Utilization data for antibiotics commonly used to treat urinary tract infections were retrieved for the period September 1, 2011, to August 31, 2013. The study examined whether there were significant changes in overall antibiotic use, ciprofloxacin use, and physician prescribing behaviour after program implementation in September 2012. Results There was no significant change in the total number of antibiotic prescriptions for urinary tract infections in the hospital or the LTC facility after ASP implementation. Significant reductions were seen in the average days of therapy initially prescribed and the actual days of therapy after ASP implementation in the LTC facility but not the hospital. Across both facilities, significant reductions were seen in the number of ciprofloxacin prescriptions. Conclusions The current study showed that an ASP can affect physicians’ antibiotic prescribing behaviour and antibiotic usage in an LTC environment. PMID:28123192

Development of a utility conflict management system.

DOT National Transportation Integrated Search

2009-02-01

A critical process for the timely development and delivery of highway construction projects is the early : identification and depiction of utility interests that may interfere with proposed highway facilities. The : effective management of such utili...

Scoping study of integrated resource planning needs in the public utility sector

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

Garrick, C J; Garrick, J M; Rue, D R

Integrated resource planning (IRP) is an approach to utility resource planning that integrates the evaluation of supply- and demand-site options for providing energy services at the least cost. Many utilities practice IRP; however, most studies about IRP focus on investor-owned utilities (IOUs). This scoping study investigates the IRP activities and needs of public utilities (not-for-profit utilities, including federal, state, municipal, and cooperative utilities). This study (1) profiles IRP-related characteristics of the public utility sector, (2) articulates the needs of public utilities in understanding and implementing IRP, and (3) identifies strategies to advance IRP principles in public utility planning.

Quality of life of persons with severe mental illness living in an intermediate care facility.

PubMed

Anderson, R L; Lewis, D A

2000-04-01

This study examined resident characteristics, clinical factors, and mental health service utilization associated with quality of life (QOL) for residents living in an Intermediate Care Facility (ICF). This study also utilized published literature to compare the QOL of ICF residents to persons with psychiatric disorders living in other residential settings. Chart review and interviews were used to study 100 randomly selected residents living in an ICF with a chart diagnosis of schizophrenia. Multivariate analyses suggest that higher levels of QOL are associated with reports that psychological problems did not interfere with work and activities and with lower levels of being a danger to others. Also, a comparison of the QOL scores reported by ICF residents to other published mentally ill populations suggests that residents of the ICF report somewhat higher QOL scores than state hospital patients, but lower scores as compared to other community samples. Data provide insight into the types of problems faced by residents of an intermediate care facility. These findings have implications for understanding the importance of mental health service utilization on QOL.

Zero Gravity Research Facility User's Guide

NASA Technical Reports Server (NTRS)

Thompson, Dennis M.

1999-01-01

The Zero Gravity Research Facility (ZGF) is operated by the Space Experiments Division of the NASA John H. Glenn Research Center (GRC) for investigators sponsored by the Microgravity Science and Applications Division of NASA Headquarters. This unique facility has been utilized by scientists and engineers for reduced gravity experimentation since 1966. The ZGF has provided fundamental scientific information, has been used as an important test facility in the space flight hardware design, development, and test process, and has also been a valuable source of data in the flight experiment definition process. The purpose of this document is to provide information and guidance to prospective researchers regarding the design, buildup, and testing of microgravity experiments.

Schools and Neighborhoods Research Study: School Building Use Study.

ERIC Educational Resources Information Center

Eismann, Donald; And Others

This report documents the findings related to Objective 2 of the Schools and Neighborhoods Research Study. The task was to identify community services provided by the neighborhood school. The study staff reviewed the existing facilities use information from the Seattle Public Schools. Results from the Facilities Utilization Study Survey and the…

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

NASA Technical Reports Server (NTRS)

McDougal, Kristopher J.

2008-01-01

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

Impact of geographic accessibility on utilization of the annual health check-ups by income level in Japan: A multilevel analysis.

PubMed

Fujita, Misuzu; Sato, Yasunori; Nagashima, Kengo; Takahashi, Sho; Hata, Akira

2017-01-01

Although both geographic accessibility and socioeconomic status have been indicated as being important factors for the utilization of health care services, their combined effect has not been evaluated. The aim of this study was to reveal whether an income-dependent difference in the impact of geographic accessibility on the utilization of government-led annual health check-ups exists. Existing data collected and provided by Chiba City Hall were employed and analyzed as a retrospective cohort study. The subjects were 166,966 beneficiaries of National Health Insurance in Chiba City, Japan, aged 40 to 74 years. Of all subjects, 54,748 (32.8%) had an annual health check-up in fiscal year 2012. As an optimal index of geographic accessibility has not been established, five measures were calculated: travel time to the nearest health care facility, density of health care facilities (number facilities within a 30-min walking distance from the district of residence), and three indices based on the two-step floating catchment area method. Three-level logistic regression modeling with random intercepts for household and district of residence was performed. Of the five measures, density of health care facilities was the most compatible according to Akaike's information criterion. Both low density and low income were associated with decreased utilization of the health check-ups. Furthermore, a linear relationship was observed between the density of facilities and utilization of the health check-ups in all income groups and its slope was significantly steeper among subjects with an equivalent income of 0.00 yen than among those with equivalent income of 1.01-2.00 million yen (p = 0.028) or 2.01 million yen or more (p = 0.040). This result indicated that subjects with lower incomes were more susceptible to the effects of geographic accessibility than were those with higher incomes. Thus, better geographic accessibility could increase the health check-up utilization and also

Impact of geographic accessibility on utilization of the annual health check-ups by income level in Japan: A multilevel analysis

PubMed Central

Fujita, Misuzu; Hata, Akira

2017-01-01

Although both geographic accessibility and socioeconomic status have been indicated as being important factors for the utilization of health care services, their combined effect has not been evaluated. The aim of this study was to reveal whether an income-dependent difference in the impact of geographic accessibility on the utilization of government-led annual health check-ups exists. Existing data collected and provided by Chiba City Hall were employed and analyzed as a retrospective cohort study. The subjects were 166,966 beneficiaries of National Health Insurance in Chiba City, Japan, aged 40 to 74 years. Of all subjects, 54,748 (32.8%) had an annual health check-up in fiscal year 2012. As an optimal index of geographic accessibility has not been established, five measures were calculated: travel time to the nearest health care facility, density of health care facilities (number facilities within a 30-min walking distance from the district of residence), and three indices based on the two-step floating catchment area method. Three-level logistic regression modeling with random intercepts for household and district of residence was performed. Of the five measures, density of health care facilities was the most compatible according to Akaike’s information criterion. Both low density and low income were associated with decreased utilization of the health check-ups. Furthermore, a linear relationship was observed between the density of facilities and utilization of the health check-ups in all income groups and its slope was significantly steeper among subjects with an equivalent income of 0.00 yen than among those with equivalent income of 1.01–2.00 million yen (p = 0.028) or 2.01 million yen or more (p = 0.040). This result indicated that subjects with lower incomes were more susceptible to the effects of geographic accessibility than were those with higher incomes. Thus, better geographic accessibility could increase the health check-up utilization and also

Academic Facility Utilization and Survival Outcomes in Adult Head and Neck Sarcomas: An NCDB Analysis.

PubMed

Cannon, Richard B; Carpenter, Patrick S; Boothe, Dustin; Buchmann, Luke O; Hunt, Jason P; Lloyd, Shane; Hitchcock, Ying J; Houlton, Jeffrey J; Weis, John R; Shepherd, Hailey M; Monroe, Marcus M

2018-04-01

Objectives To investigate clinicopathologic and treatment factors associated with survival in adult head and neck sarcomas in the National Cancer Database (NCDB). To analyze whether treatment settings and therapies received influence survival outcomes and to compare trends in utilization via an aggregated national data set. Study Design Prospectively gathered data. Setting NCDB. Subjects and Methods The study comprised a total of 6944 adult patients treated for a head and neck sarcoma from January 2004 to December 2013. Overall survival (OS) was the primary outcome. Results Increased age and tumor size, nodal involvement, and poorly differentiated histology had significantly reduced OS ( P < .001). Angiosarcoma, malignant nerve sheath tumor, malignant fibrous histiocytoma, osteosarcoma, and rhabdomyosarcoma histologic subtypes had significantly reduced OS, while liposarcoma, chondrosarcoma, and chordoma had improved OS ( P < .001). Utilization of surgical therapy was associated with improved OS, while positive surgical margins were associated with treatment at a community-based cancer program and had reduced OS ( P < .001). On multivariate analysis, treatment with radiation and/or chemotherapy was not significantly associated with OS; however, primary treatment with definitive chemoradiotherapy had significantly reduced OS. Patients treated at academic/research cancer programs (n = 3874) had significantly improved 5- and 10-year OS (65% and 54%, respectively) when compared with patients treated at community-based cancer programs (n = 3027; 49% and 29%; P < .001). The percentage utilization of these programs (56% vs 44%) did not change over the study period. Conclusion For adult head and neck sarcomas, treatment at an academic/research cancer program was associated with improved survival; however, despite increasing medical specialization, the percentage utilization of these programs for this rare tumor remains constant.

Concept definition study for an extremely large aerophysics range facility

NASA Technical Reports Server (NTRS)

Swift, H.; Witcofski, R.

1992-01-01

The development of a large aerophysical ballistic range facility is considered to study large-scale hypersonic flows at high Reynolds numbers for complex shapes. A two-stage light gas gun is considered for the hypervelocity launcher, and the extensive range tankage is discussed with respect to blast suppression, model disposition, and the sabot impact tank. A layout is given for the large aerophysics facility, and illustrations are provided for key elements such as the guide rail. The paper shows that such a facility could be used to launch models with diameters approaching 250 mm at velocities of 6.5 km/s with peak achievable accelerations of not more than 85.0 kgs. The envisioned range would provide gas-flow facilities capable of controlling the modeled quiescent atmospheric conditions. The facility is argued to be a feasible and important step in the investigation and experiment of such hypersonic vehicles as the National Aerospace Plane.

NREL, San Diego Gas & Electric Are Advancing Utility Microgrid Performance

Science.gov Websites

in Borrego Springs, California | Energy Systems Integration Facility | NREL NREL, San Diego Gas & Electric Models Utility Microgrid in Borrego Springs NREL, San Diego Gas & Electric Are Advancing Utility Microgrid Performance in Borrego Springs, California San Diego Gas & Electric Company

Determinants of Utilization and Community Experiences with Community Health Volunteers for Treatment of Childhood Illnesses in Rural Sierra Leone.

PubMed

Yansaneh, Aisha I; George, Asha S; Sharkey, Alyssa; Brieger, William R; Moulton, Lawrence H; Yumkella, Fatu; Bangura, Peter; Kabano, Augustin; Diaz, Theresa

2016-04-01

In 2010, at the same time as the national roll out of the Free Health Care Initiative (FHCI), which removed user fees for facility based health care, trained community health volunteers (CHVs) were deployed to provide integrated community case management of diarrhea, malaria and pneumonia to children under 5 years of age (U5) in Kambia and Pujehun districts, Sierra Leone. After 2 years of implementation and in the context of FHCI, CHV utilization rate was 14.0 %. In this study, we examine the factors associated with this level of CHV utilization. A cross-sectional household-cluster survey of 1590 caregivers of 2279 children U5 was conducted in 2012; with CHV utilization assessed using a multiple logistic regression model. Focus groups and in-depth interviews were also conducted to understand communities' experiences with CHVs. Children with diarrhea (OR = 3.17, 95 % CI: 1.17-8.60), from female-headed households (OR = 4.55, 95 % CI: 1.88-11.00), and whose caregivers reported poor quality of care as a barrier to facility care-seeking (OR = 8.53, 95 % CI: 3.13-23.16) were more likely to receive treatment from a CHV. Despite low utilization, caregivers were highly familiar and appreciative of CHVs, but were concerned about the lack of financial remuneration for CHVs. CHVs remained an important source of care for children from female-headed households and whose caregivers reported poor quality of care at health facilities. CHVs are an important strategy for certain populations even when facility utilization is high or when facility services are compromised, as has happened with the recent Ebola epidemic in Sierra Leone.

Access, acceptability and utilization of community health workers using diagnostics for case management of fever in Ugandan children: a cross-sectional study

PubMed Central

2012-01-01

Background Use of diagnostics in integrated community case management (iCCM) of fever is recognized as an important step in improving rational use of drugs and quality of care for febrile under-five children. This study assessed household access, acceptability and utilization of community health workers (CHWs) trained and provided with malaria rapid diagnostic tests (RDTs) and respiratory rate timers (RRTs) to practice iCCM. Methods A total of 423 households with under-five children were enrolled into the study in Iganga district, Uganda. Households were selected from seven villages in Namungalwe sub-county using probability proportionate to size sampling. A semi-structured questionnaire was administered to caregivers in selected households. Data were entered into Epidata statistical software, and analysed using SPSS Statistics 17.0, and STATA version 10. Results Most (86%, 365/423) households resided within a kilometre of a CHW’s home, compared to 26% (111/423) residing within 1 km of a health facility (p < 0.001). The median walking time by caregivers to a CHW was 10 minutes (IQR 5–20). The first option for care for febrile children in the month preceding the survey was CHWs (40%, 242/601), followed by drug shops (33%, 196/601). Fifty-seven percent (243/423) of caregivers took their febrile children to a CHW at least once in the three month period preceding the survey. Households located 1–3 km from a health facility were 72% (AOR 1.72; 95% CI 1.11–2.68) more likely to utilize CHW services compared to households within 1 km of a health facility. Households located 1–3 km from a CHW were 81% (AOR 0.19; 95% CI 0.10–0.36) less likely to utilize CHW services compared to those households residing within 1 km of a CHW. A majority (79%, 336/423) of respondents thought CHWs services were better with RDTs, and 89% (375/423) approved CHWs’ continued use of RDTs. Eighty-six percent (209/243) of respondents who visited a CHW thought RRTs were useful

UTEX: integrated ultraviolet and x-ray astronomy facility on spacelab, phase a study. Volume 2: facility definition. Final report

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

Not Available

1976-07-01

The definition and feasibility study of an integrated ultraviolet and astronomy facility onboard Spacelab are presented. This is based on the scientific aims of different European countries. The accommodation of such a facility in the first and second Spacelab flights was also studied, taking into account external constraints of both flights and the possibility of future missions. Well identified possible work packages are outlined in view of future international cooperation.

Utility of conventional transbronchial needle aspiration with rapid on-site evaluation (c-TBNA-ROSE) at a tertiary care center with endobronchial ultrasound (EBUS) facility

PubMed Central

Madan, Neha Kawatra; Madan, Karan; Jain, Deepali; Walia, Ritika; Mohan, Anant; Hadda, Vijay; Mathur, Sandeep; Iyer, Venkateswaran K; Khilnani, Gopi C; Guleria, Randeep

2016-01-01

Background: Conventional transbronchial needle aspiration (c-TBNA) is an underutilized bronchoscopic modality. Endobronchial ultrasound (EBUS) guided-TBNA though efficacious is an expensive modality, facilities of which are available at only limited centers. c-TBNA is cost-effective and has potential for wide utilization especially in resource-limited settings. Rapid on-site evaluation (ROSE) improves the yield of c-TBNA. Materials and Methods: A retrospective review of the bronchoscopy records (May 2012 to July 2014) was performed. The patients who underwent c-TBNA with ROSE were included in the study and their clinical details were extracted. Convex probe EBUS-TBNA was being regularly performed during the study period by the operators performing c-TBNA. Results: c-TBNA with ROSE was performed in 41 patients with mean age of 42.4 (16.2) years. The most frequently sampled node stations (>90% patients) were the subcarinal and lower right paratracheal. Representative samples could be obtained in 33 out of the 41 patients (80.4%). c-TBNA was diagnostic in 32 [tuberculosis (TB)-8, sarcoidosis-9, and malignancy-15] patients out of the 41 patients. The overall diagnostic yield (sensitivity) of c-TBNA with ROSE was 78%. Mean procedure duration was 18.4 (3.1) min and there were no procedural complications. Conclusion: c-TBNA with ROSE is a safe, efficacious, and cost-effective bronchoscopic modality. When it was performed by operators routinely performing EBUS-TBNA, diagnostic yields similar to that of EBUS-TBNA can be obtained. Even at the centers where EBUS facilities are available, c-TBNA should be routinely performed. PMID:27011437

Microgravity research in NASA ground-based facilities

NASA Technical Reports Server (NTRS)

Lekan, Jack

1989-01-01

An overview of reduced gravity research performed in NASA ground-based facilities sponsored by the Microgravity Science and Applications Program of the NASA Office of Space Science and Applications is presented. A brief description and summary of the operations and capabilities of each of these facilities along with an overview of the historical usage of them is included. The goals and program elements of the Microgravity Science and Applications programs are described and the specific programs that utilize the low gravity facilities are identified. Results from two particular investigations in combustion (flame spread over solid fuels) and fluid physics (gas-liquid flows at microgravity conditions) are presented.

Preliminary design for a maglev development facility

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

Coffey, H.T.; He, J.L.; Chang, S.L.

1992-04-01

A preliminary design was made of a national user facility for evaluating magnetic-levitation (maglev) technologies in sizes intermediate between laboratory experiments and full-scale systems. A technical advisory committee was established and a conference was held to obtain advice on the potential requirements of operational systems and how the facility might best be configured to test these requirements. The effort included studies of multiple concepts for levitating, guiding, and propelling maglev vehicles, as well as the controls, communications, and data-acquisition and -reduction equipment that would be required in operating the facility. Preliminary designs for versatile, dual 2-MVA power supplies capable ofmore » powering attractive or repulsive systems were developed. Facility site requirements were identified. Test vehicles would be about 7.4 m (25 ft) long, would weigh form 3 to 7 metric tons, and would operate at speeds up to 67 m/s (150 mph) on a 3.3-km (2.05-mi) elevated guideway. The facility would utilize modular vehicles and guideways, permitting the substitution of levitation, propulsion, and guideway components of different designs and materials for evaluation. The vehicle would provide a test cell in which individual suspension or propulsion components or subsystems could be tested under realistic conditions. The system would allow economical evaluation of integrated systems under varying weather conditions and in realistic geometries.« less

Effect of an innovative community based health program on maternal health service utilization in north and south central Ethiopia: a community based cross sectional study.

PubMed

Afework, Mesganaw Fantahun; Admassu, Kesteberhan; Mekonnen, Alemayehu; Hagos, Seifu; Asegid, Meselech; Ahmed, Saifuddin

2014-04-04

Among Millennium Development Goals, achieving the fifth goal (MDG-5) of reducing maternal mortality poses the greatest challenge in Sub-Saharan Africa. Ethiopia has one of the highest maternal mortality ratios in the world with unacceptably low maternal health service utilization. The Government of Ethiopia introduced an innovative community-based intervention as a national strategy under the Health Sector Development Program. This new approach, known as the Health Extension Program, aims to improve access to and equity in essential health services through community based Health Extension Workers. The objective of the study is to assess the role of Health Extension Workers in improving women's utilization of antenatal care, delivery at health facility and postnatal care services. A cross sectional household survey was conducted in early 2012 in two districts of northern and south central parts of Ethiopia. Data were collected from 4949 women who had delivered in the two years preceding the survey. Logistic regression analysis was performed to determine the association between visit by Health Extension Workers during pregnancy and use of maternal health services, controlling for the effect of other confounding factors. The non-adjusted analysis showed that antenatal care attendance at least four times during pregnancy was significantly associated with visit by Health Extension Workers [Odds Ratio 3.46(95% CI 3.07,3.91)], whereas health facility delivery (skilled attendance at birth) was not significantly associated with visit by Health Extension Workers during pregnancy [Odds Ratio 0.87(95% CI 0.25,2.96)]. When adjusted for other factors the association of HEWs visit during pregnancy was weaker for antenatal care attendance [Adjusted Odds Ratio: 1.35(95% CI: 1.05, 1.72)] but positively and significantly associated with health facility delivery [Adjusted Odds Ratio 1.96(1.25,3.06)]. In general HEWs visit during pregnancy improved utilization of maternal health

Impact of Predicting Health Care Utilization Via Web Search Behavior: A Data-Driven Analysis

PubMed Central

Zhang, Liangliang; Zhu, Josh; Fang, Shiyuan; Cheng, Tim; Hong, Chloe; Shah, Nigam H

2016-01-01

Background By recent estimates, the steady rise in health care costs has deprived more than 45 million Americans of health care services and has encouraged health care providers to better understand the key drivers of health care utilization from a population health management perspective. Prior studies suggest the feasibility of mining population-level patterns of health care resource utilization from observational analysis of Internet search logs; however, the utility of the endeavor to the various stakeholders in a health ecosystem remains unclear. Objective The aim was to carry out a closed-loop evaluation of the utility of health care use predictions using the conversion rates of advertisements that were displayed to the predicted future utilizers as a surrogate. The statistical models to predict the probability of user’s future visit to a medical facility were built using effective predictors of health care resource utilization, extracted from a deidentified dataset of geotagged mobile Internet search logs representing searches made by users of the Baidu search engine between March 2015 and May 2015. Methods We inferred presence within the geofence of a medical facility from location and duration information from users’ search logs and putatively assigned medical facility visit labels to qualifying search logs. We constructed a matrix of general, semantic, and location-based features from search logs of users that had 42 or more search days preceding a medical facility visit as well as from search logs of users that had no medical visits and trained statistical learners for predicting future medical visits. We then carried out a closed-loop evaluation of the utility of health care use predictions using the show conversion rates of advertisements displayed to the predicted future utilizers. In the context of behaviorally targeted advertising, wherein health care providers are interested in minimizing their cost per conversion, the association between show

18 CFR 292.204 - Criteria for qualifying small power production facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... primary energy source of the facility must be biomass, waste, renewable resources, geothermal resources... FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE PUBLIC UTILITY REGULATORY... production facilities that use the same energy resource, are owned by the same person(s) or its affiliates...

A social systems model of hospital utilization.

PubMed Central

Anderson, J G

1976-01-01

A social systems model for the health services system serving the state of New Mexico is presented. Utilization of short-term general hospitals is viewed as a function of sociodemographic characteristics of the population and of the supply of health manpower and facilities available to that population. The model includes a network specifying the causal relationships hypothesized as existing among a set of social, demographic, and economic variables known to be related to the supply of health manpower and facilities and to their utilization. Inclusion of feedback into the model as well as lagged values of physician supply variables permits examination of the dynamic behavior of the social system over time. A method for deriving the reduced form of the structural model is presented along with the reduced-form equations. These equations provide valuable information for policy decisions regarding the likely consequences of changes in the structure of the population and in the supply of health manpower and facilities. The structural and reduced-form equations have been used to predict the consequences for one New Mexico county of state and federal policies that would affect the organization and delivery of health services. PMID:1017949

Healthcare Utilization Monitoring System in Korea

PubMed Central

Shin, Hyun Chul; Lee, Youn Tae; Jo, Emmanuel C.

2015-01-01

Objectives It is important to monitor the healthcare utilization of patients at the national level to make evidence-based policy decisions and manage the nation's healthcare sector. The Health Insurance Review & Assessment Service (HIRA) has run a Healthcare Utilization Monitoring System (HUMS) since 2008. The objective of this paper is to introduce HIRA's HUMS. Methods This study described the HUMS's system structure, capacity, functionalities, and output formats run by HIRA in the Republic of Korea. Regarding output formats, this study extracted diabetes related health insurance claims through the HUMS from August 1, 2014 to May 31, 2015. Results The HUMS has kept records of health insurance claim data for 4 years. It has a 14-terabyte hardware capacity and employs several easy-to-use programs for maintenance of the system, such as MSTR, SAS, etc. Regarding functionalities, users should input diseases codes, target periods, facility types, and types of attributes, such as the number of healthcare utilizations or healthcare costs. It also has a functionality to predict healthcare utilization and costs. When this study extracted diabetes related data, it was found that the trend of healthcare costs for the treatment of diabetes and the number of patients with diabetes were increasing. Conclusions HIRA's HUMS works well to monitor healthcare utilization of patients at the national level. The HUMS has a high-capacity hardware infrastructure and several operational programs that allows easy access to summaries as well as details to identify contributing factors for abnormality, but it has a limitation in that there is often a time lag between the provision of healthcare to patients and the filing of health claims. PMID:26279955

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.

Pacific Region School Finance and Facilities Study.

ERIC Educational Resources Information Center

Kawakami, Alice J., Ed.

A study of school financing and facilities was conducted in the 10 American-affiliated Pacific entities of the United States. Data were collected from public departments of education in 9 of 10 entities served by the Pacific Region Educational Laboratory (PREL): American Samoa, Commonwealth of the Northern Mariana Islands (CNMI), Federated States…

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

Utilization of health services in a resource-limited rural area in Kenya: Prevalence and associated household-level factors.

PubMed

Ngugi, Anthony K; Agoi, Felix; Mahoney, Megan R; Lakhani, Amyn; Mang'ong'o, David; Nderitu, Esther; Armstrong, Robert; Macfarlane, Sarah

2017-01-01

Knowledge of utilization of health services and associated factors is important in planning and delivery of interventions to improve health services coverage. We determined the prevalence and factors associated with health services utilization in a rural area of Kenya. Our findings inform the local health management in development of appropriately targeted interventions. We used a cluster sample survey design and interviewed household key informants on history of illness for household members and health services utilization in the preceding month. We estimated prevalence and performed random effects logistic regression to determine the influence of individual and household level factors on decisions to utilize health services. 1230/6,440 (19.1%, 95% CI: 18.3%-20.2%) household members reported an illness. Of these, 76.7% (95% CI: 74.2%-79.0%) sought healthcare in a health facility. The majority (94%) of the respondents visited dispensary-level facilities and only 60.1% attended facilities within the study sub-counties. Of those that did not seek health services, 43% self-medicated by buying non-prescription drugs, 20% thought health services were too costly, and 10% indicated that the sickness was not serious enough to necessitate visiting a health facility. In the multivariate analyses, relationship to head of household was associated with utilization of health services. Relatives other than the nuclear family of the head of household were five times less likely to seek medical help (Odds Ratio 0.21 (95% CI: 0.05-0.87)). Dispensary level health facilities are the most commonly used by members of this community, and relations at the level of the household influence utilization of health services during an illness. These data enrich the perspective of the local health management to better plan the allocation of healthcare resources according to need and demand. The findings will also contribute in the development of community-level health coverage interventions that

Young people's use of sports facilities: a Norwegian study on physical activity.

PubMed

Limstrand, Torgeir; Rehrer, Nancy J

2008-07-01

In recent years, sports facilities have formed part of Norwegian public health policies to increase physical activity among children and adolescents. Despite large sums of public money being spent on such facilities, information on usage is limited. Our aim was to study the effects of gender, age and relative activity level on young people's use of sports facilities. We explored 662 young people's (age 6-16 years) usage of 19 different kinds of sports facilities. A questionnaire was administered to students and teachers, and situation plots of students at recess were made. The findings indicate that sports facilities in general were less used by girls, adolescents (14-16 years) and the least active (physically active < or = 1 times/week outside school) than by boys, children (6-13 years) and the most active (physically active > or = 4 times/ week outside school). More general, multifunctional facilities were used to a greater extent than specialized facilities, particularly by the least active. Distance to facility was important for the use of common facilities. These results raise the question of whether sports facilities significantly increase physical activity among "all'' young people, which is the government's stated goal. More research on sports facilities use and physical activity levels among males and females of all ages is warranted.

Utility involvement in cogeneration and small power production since PURPA

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

Hallaron, S.A.

One of the objectives of PURPA was more efficient energy production through cogeneration and the use of renewable resources. Under PURPA regulations, cogeneration and small power-producing plants may file for qualifying status to receive benefits allowed by the National Energy Act. There has been a steady increase in the number of qualifying facilities (QFs) and some electric utilities have increased ownership of small power-producing facilities as well as electric purchases from QFs. QFs are not only exempt from federal and state utility regulations under PURPA, but they also may be eligible for an exemption from the provisions of the Fuelmore » Use Act of 1978 which prohibits or limits use of oil and natural gas in power plants and other major fuel-burning installations. To obtain QF status under PURPA, small power-producing facilities are limited to a capacity of 80 MW or less and must use some combination of biomass, waste, geothermal, or other renewable resource as the primary energy source. Cogenerators are not limited in size or fuel. The purchase of electricity from cogenerators and small power producers can be an attractive alternative for utilities in meeting future demands.« less

Does Travel Time to a Radiation Facility Impact Patient Decision-Making Regarding Treatment for Prostate Cancer? A Study of the New Hampshire State Cancer Registry.

PubMed

Ghali, Fady; Celaya, Maria; Laviolette, Michael; Ingimarsson, Johann; Carlos, Heather; Rees, Judy; Hyams, Elias

2018-02-01

We sought to determine whether further distance from a radiation center is associated with lower utilization of external beam radiation therapy (XRT). We retrospectively identified patients with a new diagnosis of localized prostate cancer (CaP) within the New Hampshire State Cancer Registry from 2004 to 2011. Patients were categorized by age, D'Amico risk category, year of treatment, marital status, season of diagnosis, urban/rural residence, and driving time to the nearest radiation facility. Treatment decisions were stratified into those requiring multiple trips (XRT) or a single trip (surgery or brachytherapy). Multivariable regression analysis was performed. A total of 4,731 patients underwent treatment for newly diagnosed CaP during the study period, including 1,575 multitrip (XRT) and 3,156 single-trip treatments. Of these, 87.6% lived within a 30-minute drive to a radiation facility. In multivariable analysis, time to the nearest radiation facility was not associated with treatment decisions (P = .26). However, higher risk category, older age, married status, and winter diagnosis were associated with XRT (P < .05). More recent year of diagnosis and urban residence were associated with single-trip therapy (primarily surgery) (P < .05). There was a significant interaction between travel time and season of diagnosis (P = .03), as well as a marginally significant interaction with urban/rural status (P = .07). Overall, further travel time to a radiation facility was not associated with lower utilization of XRT. These data are encouraging regarding access to care for CaP in New Hampshire. © 2016 National Rural Health Association.

National Trends (2009-2013) for Palliative Care Utilization for Patients Receiving Prolonged Mechanical Ventilation.

PubMed

Chatterjee, Kshitij; Goyal, Abhinav; Kakkera, Krishna; Harrington, Sarah; Corwin, Howard L

2018-05-04

Patients requiring mechanical ventilation have high morbidity and mortality. Providing palliative care services has been suggested as a way to improve comprehensive management of critically ill patients. We examined the trend in the utilization of palliative care among adults who require prolonged mechanical ventilation. Primary objectives were to determine the trend in palliative care utilization over time, predictors for palliative care utilization, and palliative care impact on hospital length of stay. Retrospective, cross-sectional study. The National Inpatient Sample data between 2009 and 2013 was used for this study. Adults (age ≥ 18 yr) who underwent prolonged mechanical ventilation (≥ 96 consecutive hr) were studied. Palliative care and mechanical ventilation were identified using the corresponding International Classification of Diseases, 9th revision, Clinical Modification, codes. A total of 1,751,870 hospitalizations with prolonged mechanical ventilation were identified between 2009 and 2013. The utilization of palliative care increased yearly from 6.5% in 2009 to 13.1% in 2013 (p < 0.001). Among the mechanically ventilated patients who died, palliative care increased from 15.9% in 2009 to 33.3% in 2013 (p < 0.001). Median hospital length of stay for patients with and without palliative care was 13 and 17 days, respectively (p < 0.001). Patients discharged to either short- or long-term care facilities had a shorter length of stay if palliative care was provided (15 vs 19 d; p < 0.001). The factors associated with a higher palliative care utilization included older age, malignancy, larger hospitals in urban areas, and teaching hospitals. Non-Caucasian race was associated with lower palliative care utilization. Among patients who undergo prolonged mechanical ventilation, palliative care utilization is increasing, particularly in patients who die during hospitalization. Using palliative care for mechanically ventilated patients who are discharged to

Method for utilizing decay heat from radioactive nuclear wastes

DOEpatents

Busey, H.M.

1974-10-14

Management of radioactive heat-producing waste material while safely utilizing the heat thereof is accomplished by encapsulating the wastes after a cooling period, transporting the capsules to a facility including a plurality of vertically disposed storage tubes, lowering the capsules as they arrive at the facility into the storage tubes, cooling the storage tubes by circulating a gas thereover, employing the so heated gas to obtain an economically beneficial result, and continually adding waste capsules to the facility as they arrive thereat over a substantial period of time.

Selection criteria utilized for hyperbaric oxygen treatment of carbon monoxide poisoning.

PubMed

Hampson, N B; Dunford, R G; Kramer, C C; Norkool, D M

1995-01-01

Medical directors of North American hyperbaric oxygen (HBO) facilities were surveyed to assess selection criteria applied for treatment of acute carbon monoxide (CO) poisoning within the hyperbaric medicine community. Responses were received from 85% of the 208 facilities in the United States and Canada. Among responders, 89 monoplace and 58 multiplace chamber facilities treat acute CO poisoning, managing a total of 2,636 patients in 1992. A significant majority of facilities treat CO-exposed patients with coma (98%), transient loss of consciousness (LOC) (77%), ischemic changes on electrocardiogram (91%), focal neurologic deficits (94%), or abnormal psychometric testing (91%), regardless of carboxyhemoglobin (COHb) level. Although 92% would use HBO for a patient presenting with headache, nausea, and COHb 40%, only 62% of facilities utilize a specified minimum COHb level as the sole criterion for HBO therapy of an asymptomatic patient. When COHb is used as an independent criterion to determine HBO treatment, the level utilized varies widely between institutions. Half of responding facilities place limits on the delay to treatment for patients with only transient LOC. Time limits are applied less often in cases with persistent neurologic deficits. While variability exists, majority opinions can be derived for many patient selection criteria regarding the use of HBO in acute CO poisoning.

A facility monitoring system: The single most valuable and cost-effective tool available to an energy manager

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

Holmes, W.A.

Energy engineering and management combines engineering problem-solving and financial management techniques to reduce utility costs. At present, substantial amounts of time and money are being spent in order to attempt to quantify energy consumption and costs and define opportunities for savings. Unfortunately, accurate verification of results is often overlooked. Advances in technology during the last few years have made the installation of a permanent, PC-based monitoring system possible for any facility, often for no more than the cost of a detailed study. By investing initially in a monitoring system rather than audits or studies, the actual consumption and cost datamore » will be available on a continuing basis and can be used to produce immediate operational savings, more accurately analyze opportunities requiring capital investments, and to verify actual savings resulting from changes. A permanent monitoring system, installed as the first step in a utility cost reduction effort, to identify where and how energy is used in a facility on a dynamic and real-time basis, can provide the most valuable and cost-effective tool available to an energy manager. The resulting data allows energy consumption patterns and utility costs to be understood and managed in the same manner as all other costs within a facility.« less

Cost analysis and efficiency of sub-district health facilities in two districts in Ghana.

PubMed

Aboagye, Anthony Q Q; Degboe, Arnold N K

2011-01-01

To establish the full costs borne by sub-district health facilities in providing services, we analysed the costs and revenues of 10 sub-district health facilities located in two districts in Ghana. The full costs were obtained by considering staff costs, cost of utilities, cost of using health facility equipment, cost of non-drug consumables, equipment maintenance expenses, amounts spent on training, community information sessions and other outreach activities as well as all other costs incurred in running the facilities. We found that (i) a large proportion of sub-district health facility costs is made up of staff salaries; (ii) at all facilities, internally generated funds (IGFs) are substantially lower than costs incurred in running the facilities; (iii) average IGF is several times higher in one district than the other; (iv) wide variations exist in efficiency indicators and (v) there is some evidence that sub-district health facilities may not necessarily be financially more efficient than hospitals in using financial resources. We suggest that the study should be replicated in other districts; but in the mean time, the health authorities should take note of the conclusions and recommendations of this study. Efforts should also be made to improve record keeping at these facilities. Copyright © 2010 John Wiley & Sons, Ltd.

Utilizing Data from Cancer Patient & Survivor Studies

Cancer.gov

Utilizing Data from Cancer Patient & Survivor Studies and Understanding the Current State of Knowledge and Developing Future Research Priorities, a 2011 workshop sponsored by the Epidemiology and Genomics Research Program.

Multi-year Content Analysis of User Facility Related Publications

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

Patton, Robert M; Stahl, Christopher G; Hines, Jayson

2013-01-01

Scientific user facilities provide resources and support that enable scientists to conduct experiments or simulations pertinent to their respective research. Consequently, it is critical to have an informed understanding of the impact and contributions that these facilities have on scientific discoveries. Leveraging insight into scientific publications that acknowledge the use of these facilities enables more informed decisions by facility management and sponsors in regard to policy, resource allocation, and influencing the direction of science as well as more effectively understand the impact of a scientific user facility. This work discusses preliminary results of mining scientific publications that utilized resources atmore » the Oak Ridge Leadership Computing Facility (OLCF) at Oak Ridge National Laboratory (ORNL). These results show promise in identifying and leveraging multi-year trends and providing a higher resolution view of the impact that a scientific user facility may have on scientific discoveries.« less

Life science payloads planning study integration facility survey results

NASA Technical Reports Server (NTRS)

Wells, G. W.; Brown, N. E.; Nelson, W. G.

1976-01-01

The integration facility survey effort described is structured to examine the facility resources needed to conduct life science payload (LSP) integration checkout activities at NASA-JSC. The LSP integration facility operations and functions are defined along with the LSP requirements for facility design. A description of available JSC life science facilities is presented and a comparison of accommodations versus requirements is reported.

Residual Barriers for Utilization of Maternal and Child Health Services: Community Perceptions From Rural Pakistan

PubMed Central

Memon, Zahid; Zaidi, Shehla; Riaz, Atif

2016-01-01

Low utilization of maternal and child care services in rural areas has constrained Pakistan from meeting targets of Millennium Development Goals (MDGs) 4 and 5. This study explores community barriers in accessing Maternal and Child Health (MCH) services in ten remote rural districts of Pakistan. It further presents how the barriers differ across a range of MCH services, and also whether the presence of Community Health Workers (CHWs) reduces client barriers. Qualitative methods were used involving altogether sixty focus group discussions with mothers, their spouses and community health workers. Low awareness, formidable distances, expense, and poorly functional services were the main barriers reported, while cultural and religious restrictions were lesser reported. For preventive services including antenatal care (ANC), facility deliveries, postnatal care (PNC), childhood immunization and family planning, the main barrier was low awareness. Conversely, formidable distances and poorly functional services were the main reported constraints in the event of maternal complications and acute child illnesses. The study also found that clients residing in areas served by CHWs had better awareness only of ANC and family planning, while other MCH services were overlooked by the health worker program. The paper highlights that traditional policy emphasis on health facility infrastructure expansion is not likely to address poor utilization rates in remote rural areas. Preventive MCH services require concerted attention to building community awareness, task shifting from facility to community for services provision, and re-energization of CHW program. For maternal and child emergencies there is strong community demand to utilize health facilities, but this will require catalytic support for transport networks and functional health care centers. PMID:26925902

Ground-source heat pump case studies and utility programs

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

Lienau, P.J.; Boyd, T.L.; Rogers, R.L.

1995-04-01

Ground-source heat pump systems are one of the promising new energy technologies that has shown rapid increase in usage over the past ten years in the United States. These systems offer substantial benefits to consumers and utilities in energy (kWh) and demand (kW) savings. The purpose of this study was to determine what existing monitored data was available mainly from electric utilities on heat pump performance, energy savings and demand reduction for residential, school and commercial building applications. In order to verify the performance, information was collected for 253 case studies from mainly utilities throughout the United States. The casemore » studies were compiled into a database. The database was organized into general information, system information, ground system information, system performance, and additional information. Information was developed on the status of demand-side management of ground-source heat pump programs for about 60 electric utility and rural electric cooperatives on marketing, incentive programs, barriers to market penetration, number units installed in service area, and benefits.« less

Studies in a transonic rotor aerodynamics and noise facility

NASA Technical Reports Server (NTRS)

Wright, S. E.; Lee, D. J.; Crosby, W.

1984-01-01

The design, construction and testing of a transonic rotor aerodynamics and noise facility was undertaken, using a rotating arm blade element support technique. This approach provides a research capability intermediate between that of a stationary element in a moving flow and that of a complete rotating blade system, and permits the acoustic properties of blade tip elements to be studied in isolation. This approach is an inexpensive means of obtaining data at high subsonic and transonic tip speeds on the effect of variations in tip geometry. The facility may be suitable for research on broad band noise and discrete noise in addition to high-speed noise. Initial tests were conducted over the Mach number range 0.3 to 0.93 and confirmed the adequacy of the acoustic treatment used in the facility to avoid reflection from the enclosure.

Healthcare utilization and associated barriers experienced by wheelchair users: A pilot study.

PubMed

Stillman, Michael D; Bertocci, Gina; Smalley, Craig; Williams, Steve; Frost, Karen L

2017-10-01

More than twenty-five years after passage of the ADA, little remains known about the experiences of wheelchair users when attempting to access health care and how accessibility may influence health care utilization. To describe health care utilization among wheelchair users and characterize barriers encountered when attempting to obtain access to health care. An internet-based survey of wheelchair users was conducted. Measures included demographics, condition, socioeconomic status, health care utilization and receipt of preventive services within the past year, physical barriers encountered at outpatient facilities, and satisfaction with care. Four hundred thirty-two wheelchair users responded to the survey. Nearly all respondents (97.2%) had a primary care appointment within the past year and most reported 3-5 visits to both primary and specialty care providers. Most encountered physical barriers when accessing care (73.8% primary, 68.5% specialty). Participants received most preventive interventions at rates similar to national averages with the exception of Pap tests. Most participants remained clothed for their primary care evaluation (76.1%), and were examined seated in their wheelchair (69.7%). More than half of participants (54.1%) felt they received incomplete care, and 57% believed their physician had no more than a moderate understanding of their disability-specific medical concerns. Wheelchair users face persistent barriers to care, may receive less than thorough physical evaluations, receive fewer screenings for cervical cancer, and largely believe they receive incomplete care. Copyright © 2017 Elsevier Inc. All rights reserved.

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

PubMed

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

2017-03-09

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

Hualapai Tribal Utility Development Project

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

Hualapai Tribal Nation

The first phase of the Hualapai Tribal Utility Development Project (Project) studied the feasibility of establishing a tribally operated utility to provide electric service to tribal customers at Grand Canyon West (see objective 1 below). The project was successful in completing the analysis of the energy production from the solar power systems at Grand Canyon West and developing a financial model, based on rates to be charged to Grand Canyon West customers connected to the solar systems, that would provide sufficient revenue for a Tribal Utility Authority to operate and maintain those systems. The objective to establish a central powermore » grid over which the TUA would have authority and responsibility had to be modified because the construction schedule of GCW facilities, specifically the new air terminal, did not match up with the construction schedule for the solar power system. Therefore, two distributed systems were constructed instead of one central system with a high voltage distribution network. The Hualapai Tribal Council has not taken the action necessary to establish the Tribal Utility Authority that could be responsible for the electric service at GCW. The creation of a Tribal Utility Authority (TUA) was the subject of the second objective of the project. The second phase of the project examined the feasibility and strategy for establishing a tribal utility to serve the remainder of the Hualapai Reservation and the feasibility of including wind energy from a tribal wind generator in the energy resource portfolio of the tribal utility (see objective 2 below). It is currently unknown when the Tribal Council will consider the implementation of the results of the study. Objective 1 - Develop the basic organizational structure and operational strategy for a tribally controlled utility to operate at the Tribe’s tourism enterprise district, Grand Canyon West. Coordinate the development of the Tribal Utility structure with the development of the Grand

Relationship of initial hematocrit level to discharge destination and resource utilization after ischemic stroke: a pilot study.

PubMed

Diamond, Paul T; Gale, Shawn D; Evans, Brent A

2003-07-01

To examine the association between initial hematocrit level at the time of ischemic stroke, discharge destination, and resource utilization. Case series. University hospital. A total of 1012 consecutive patients with ischemic stroke admitted to a university health system between August 3, 1995, and June 24, 1999. Not applicable. Length of stay, hospital cost, and discharge disposition. Of 1012 patients presenting with ischemic stroke, 58% were discharged home, 10% were discharged home with home care services, 15% were discharged to a rehabilitation hospital, 11% were discharged to a skilled or intermediate care facility, and 6% died. After adjusting for age, sex, race, and comorbidities, a significant association (P=.009) existed between discharge outcome and initial hematocrit level. The probability of achieving an equivalent or less favorable outcome increased at both high and low hematocrit levels, with a minimum probability at a hematocrit level of approximately 45%. An association exists between hematocrit level at the time of ischemic stroke and discharge outcome. Midrange hematocrit levels appear to be associated with discharge to home rather than to an inpatient rehabilitation unit or to a nursing facility. Further study is indicated to examine the relationship among hematocrit level, stroke severity, and outcome.

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

PubMed

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

2014-12-16

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

Institutional environmental impact statement, Michoud Assembly Facility, New Orleans, Louisiana

NASA Technical Reports Server (NTRS)

1978-01-01

A description and analysis of Michoud Assembly Facility as an operational base for both NASA and NASA-related programs and various government tenant-agencies and their contractors is given. Tenant-agencies are governmental agencies or governmental agency contractors which are not involved in a NASA program, but utilize office or manufacturing space at the Michoud Assembly Facility. The statements represent the full description of the likely environmental effects of the facility and are used in the process of making program and project decisions.

Inequities in utilization of reproductive and maternal health services in Ethiopia.

PubMed

Bobo, Firew Tekle; Yesuf, Elias Ali; Woldie, Mirkuzie

2017-06-19

Disparities in health services utilization within and between regional states of countries with diverse socio-cultural and economic conditions such as Ethiopia is a frequent encounter. Understanding and taking measures to address unnecessary and avoidable differences in the use of reproductive and maternal health services is a key concern in Ethiopia. The aim of the study was to examine degree of equity in reproductive and maternal health services utilization in Ethiopia. Data from Ethiopia demographic health survey 2014 was analyzed. We assessed inequities in utilization of modern contraceptive methods, antenatal care, facility based delivery and postnatal checkup. Four standard equity measurement methods were used; equity gaps, rate-ratios, concertation curve and concentration index. Inequities in service utilization were exhibited favoring women in developed regions, urban residents, most educated and the wealthy. Antenatal care by skilled provider was three times higher among women with post-secondary education than mothers with no education. Women in the highest wealth quantile had about 12 times higher skilled birth attendance than those in lowest wealth quantile. The rate of postnatal care use among urban resident was about 6 times that of women in rural area. Use of modern contraceptive methods was more equitably utilized service while, birth at health facility was less equitable across all economic levels, favoring the wealthy. Considerable inequity between and within regions of Ethiopia in the use of maternal health services was demonstrated. Strategically targeting social determinants of health with special emphasis to women education and economic empowerment will substantially contribute for altering the current situation favorably.

18 CFR 292.309 - Termination of obligation to purchase from qualifying facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... POLICIES ACT OF 1978 WITH REGARD TO SMALL POWER PRODUCTION AND COGENERATION Arrangements Between Electric Utilities and Qualifying Cogeneration and Small Power Production Facilities Under Section 210 of the Public... into a new contract or obligation to purchase electric energy from a qualifying cogeneration facility...

18 CFR 292.309 - Termination of obligation to purchase from qualifying facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... POLICIES ACT OF 1978 WITH REGARD TO SMALL POWER PRODUCTION AND COGENERATION Arrangements Between Electric Utilities and Qualifying Cogeneration and Small Power Production Facilities Under Section 210 of the Public... into a new contract or obligation to purchase electric energy from a qualifying cogeneration facility...

18 CFR 292.309 - Termination of obligation to purchase from qualifying facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... POLICIES ACT OF 1978 WITH REGARD TO SMALL POWER PRODUCTION AND COGENERATION Arrangements Between Electric Utilities and Qualifying Cogeneration and Small Power Production Facilities Under Section 210 of the Public... into a new contract or obligation to purchase electric energy from a qualifying cogeneration facility...

18 CFR 292.309 - Termination of obligation to purchase from qualifying facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... POLICIES ACT OF 1978 WITH REGARD TO SMALL POWER PRODUCTION AND COGENERATION Arrangements Between Electric Utilities and Qualifying Cogeneration and Small Power Production Facilities Under Section 210 of the Public... into a new contract or obligation to purchase electric energy from a qualifying cogeneration facility...

18 CFR 292.309 - Termination of obligation to purchase from qualifying facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... POLICIES ACT OF 1978 WITH REGARD TO SMALL POWER PRODUCTION AND COGENERATION Arrangements Between Electric Utilities and Qualifying Cogeneration and Small Power Production Facilities Under Section 210 of the Public... into a new contract or obligation to purchase electric energy from a qualifying cogeneration facility...

Estimating earthquake-induced failure probability and downtime of critical facilities.

PubMed

Porter, Keith; Ramer, Kyle

2012-01-01

Fault trees have long been used to estimate failure risk in earthquakes, especially for nuclear power plants (NPPs). One interesting application is that one can assess and manage the probability that two facilities - a primary and backup - would be simultaneously rendered inoperative in a single earthquake. Another is that one can calculate the probabilistic time required to restore a facility to functionality, and the probability that, during any given planning period, the facility would be rendered inoperative for any specified duration. A large new peer-reviewed library of component damageability and repair-time data for the first time enables fault trees to be used to calculate the seismic risk of operational failure and downtime for a wide variety of buildings other than NPPs. With the new library, seismic risk of both the failure probability and probabilistic downtime can be assessed and managed, considering the facility's unique combination of structural and non-structural components, their seismic installation conditions, and the other systems on which the facility relies. An example is offered of real computer data centres operated by a California utility. The fault trees were created and tested in collaboration with utility operators, and the failure probability and downtime results validated in several ways.

Mobility of Vulnerable Elders (MOVE): study protocol to evaluate the implementation and outcomes of a mobility intervention in long-term care facilities.

PubMed

Slaughter, Susan E; Estabrooks, Carole A; Jones, C Allyson; Wagg, Adrian S

2011-12-16

Almost 90% of residents living in long-term care facilities have limited mobility which is associated with a loss of ability in activities of daily living, falls, increased risk of serious medical problems such as pressure ulcers, incontinence and a significant decline in health-related quality of life. For health workers caring for residents it may also increase the risk of injury. The effectiveness of rehabilitation to facilitate mobility has been studied with dedicated research assistants or extensively trained staff caregivers; however, few investigators have examined the effectiveness of techniques to encourage mobility by usual caregivers in long-term care facilities. This longitudinal, quasi-experimental study is designed to demonstrate the effect of the sit-to-stand activity carried out by residents in the context of daily care with health care aides. In three intervention facilities health care aides will prompt residents to repeat the sit-to-stand action on two separate occasions during each day and each evening shift as part of daily care routines. In three control facilities residents will receive usual care. Intervention and control facilities are matched on the ownership model (public, private for-profit, voluntary not-for-profit) and facility size. The dose of the mobility intervention is assessed through the use of daily documentation flowsheets in the health record. Resident outcome measures include: 1) the 30-second sit-to-stand test; 2) the Functional Independence Measure; 3) the Health Utilities Index Mark 2 and 3; and, 4) the Quality of Life - Alzheimer's Disease. There are several compelling reasons for this study: the widespread prevalence of limited mobility in this population; the rapid decline in mobility after admission to a long-term care facility; the importance of mobility to quality of life; the increased time (and therefore cost) required to care for residents with limited mobility; and, the increased risk of injury for health

Reconstruction of 3d Objects of Assets and Facilities by Using Benchmark Points

NASA Astrophysics Data System (ADS)

Baig, S. U.; Rahman, A. A.

2013-08-01

Acquiring and modeling 3D geo-data of building assets and facility objects is one of the challenges. A number of methods and technologies are being utilized for this purpose. Total station, GPS, photogrammetric and terrestrial laser scanning are few of these technologies. In this paper, points commonly shared by potential facades of assets and facilities modeled from point clouds are identified. These points are useful for modeling process to reconstruct 3D models of assets and facilities stored to be used for management purposes. These models are segmented through different planes to produce accurate 2D plans. This novel method improves the efficiency and quality of construction of models of assets and facilities with the aim utilize in 3D management projects such as maintenance of buildings or group of items that need to be replaced, or renovated for new services.

West Virginia harvest and utilization study, 2008

Treesearch

Jan Wiedenbeck; Shawn Grushecky

2014-01-01

Thirty active harvesting operations were part of a harvest and utilization study conducted in West Virginia in 2008. Data were collected on roundwood product and residue yields obtained from trees of different sizes, species, and qualities. This study was modeled after studies conducted on a regular and frequent basis by the Forest Inventory and Analysis unit in the...

Span graphics display utilities handbook, first edition

NASA Technical Reports Server (NTRS)

Gallagher, D. L.; Green, J. L.; Newman, R.

1985-01-01

The Space Physics Analysis Network (SPAN) is a computer network connecting scientific institutions throughout the United States. This network provides an avenue for timely, correlative research between investigators, in a multidisciplinary approach to space physics studies. An objective in the development of SPAN is to make available direct and simplified procedures that scientists can use, without specialized training, to exchange information over the network. Information exchanges include raw and processes data, analysis programs, correspondence, documents, and graphite images. This handbook details procedures that can be used to exchange graphic images over SPAN. The intent is to periodically update this handbook to reflect the constantly changing facilities available on SPAN. The utilities described within reflect an earnest attempt to provide useful descriptions of working utilities that can be used to transfer graphic images across the network. Whether graphic images are representative of satellite servations or theoretical modeling and whether graphics images are of device dependent or independent type, the SPAN graphics display utilities handbook will be the users guide to graphic image exchange.

National Biomedical Tracer Facility. Project definition study

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

Schafer, R.

We request a $25 million government-guaranteed, interest-free loan to be repaid over a 30-year period for construction and initial operations of a cyclotron-based National Biomedical Tracer Facility (NBTF) in North Central Texas. The NBTF will be co-located with a linear accelerator-based commercial radioisotope production facility, funded by the private sector at approximately $28 million. In addition, research radioisotope production by the NBTF will be coordinated through an association with an existing U.S. nuclear reactor center that will produce research and commercial radioisotopes through neutron reactions. The combined facilities will provide the full range of technology for radioisotope production and research:more » fast neutrons, thermal neutrons, and particle beams (H{sup -}, H{sup +}, and D{sup +}). The proposed NBTF facility includes an 80 MeV, 1 mA H{sup -} cyclotron that will produce proton-induced (neutron deficient) research isotopes.« less

Mobile terawatt laser propagation facility (Conference Presentation)

NASA Astrophysics Data System (ADS)

Shah, Lawrence; Roumayah, Patrick; Bodnar, Nathan; Bradford, Joshua D.; Maukonen, Douglas; Richardson, Martin C.

2017-03-01

This presentation will describe the design and construction status of a new mobile high-energy femtosecond laser systems producing 500 mJ, 100 fs pulses at 10 Hz. This facility is built into a shipping container and includes a cleanroom housing the laser system, a separate section for the beam director optics with a retractable roof, and the environmental control equipment necessary to maintain stable operation. The laser system includes several innovations to improve the utility of the system for "in field" experiments. For example, this system utilizes a fiber laser oscillator and a monolithic chirped Bragg grating stretcher to improve system robustness/size and employs software to enable remote monitoring and system control. Uniquely, this facility incorporates a precision motion-controlled gimbal altitude-azimuth mount with a coudé path to enable aiming of the beam over a wide field of view. In addition to providing the ability to precisely aim at multiple targets, it is also possible to coordinate the beam with separate tracking/diagnostic sensing equipment as well as other laser systems. This mobile platform will be deployed at the Townes Institute Science and Technology Experimental Facility (TISTEF) located at the Kennedy Space Center in Florida, to utilize the 1-km secured laser propagation range and the wide array of meteorological instrumentation for atmospheric and turbulence characterization. This will provide significant new data on the propagation of high peak power ultrashort laser pulses and detailed information on the atmospheric conditions in a coastal semi-tropical environment.

Future Facilities for Gamma-Ray Pulsar Studies

NASA Technical Reports Server (NTRS)

Thompson, D. J.

2003-01-01

Pulsars seen at gamma-ray energies offer insight into particle acceleration to very high energies, along with information about the geometry and interaction processes in the magnetospheres of these rotating neutron stars. During the next decade, a number of new gamma-ray facilities will become available for pulsar studies. This brief review describes the motivation for gamma-ray pulsar studies, the opportunities for such studies, and some specific discussion of the capabilities of the Gamma-ray Large Area Space Telescope (GLAST) Large Area Telescope (LAT) for pulsar measurements.

Institutional delivery service utilization in Munisa Woreda, South East Ethiopia: a community based cross-sectional study.

PubMed

Amano, Abdella; Gebeyehu, Abebaw; Birhanu, Zelalem

2012-10-08

Reducing maternal morbidity and mortality is a global priority which is particularly relevant to developing countries like Ethiopia. One of the key strategies for reducing maternal morbidity and mortality is increasing institutional delivery service utilization of mothers under the care of skilled birth attendants. The aim of this study was to determine the level of institutional delivery service utilization and associated factors. A community-based cross-sectional survey was conducted from April 1-20, 2011, among mothers who gave birth 12 months before the study began in Munesa Woreda, Arsi Zone, Oromia Region, Southeast Ethiopia. A stratified cluster sampling was used to select a sample of 855 participants. Out of all deliveries, only 12.3% took place at health facilities. Women who were urban residents (AOR = 2.27, 95%CI: 1.17, 4.40), women of age at interview less than 20 years (AOR = 6.06, 95%CI: 1.54, 23.78), women with first pregnancy (AOR = 2.41, 95%CI: 1.17, 4.97) and, women who had ANC visit during the last pregnancy (AOR = 4.18, 95%CI: 2.54, 6.89) were more likely to deliver at health institutions. Secondary and above level of mother`s and husband`s education had also a significant effect on health institution delivery with AOR = 4.31 (95%CI: 1.62, 11.46) and AOR = 2.77 (95%CI: 1.07, 7.19) respectively. Institutional delivery service utilization was found to be low in the study area. Secondary and above level of mother`s and husband`s education, urban residence and ANC visit were amongst the main factors that had an influence on health institution delivery. Increasing the awareness of mothers and their partners about the benefits of institutional delivery services are recommended.

Institutional delivery service utilization in Munisa Woreda, South East Ethiopia: a community based cross-sectional study

PubMed Central

2012-01-01

Background Reducing maternal morbidity and mortality is a global priority which is particularly relevant to developing countries like Ethiopia. One of the key strategies for reducing maternal morbidity and mortality is increasing institutional delivery service utilization of mothers under the care of skilled birth attendants. The aim of this study was to determine the level of institutional delivery service utilization and associated factors. Methods A community-based cross-sectional survey was conducted from April 1–20, 2011, among mothers who gave birth 12 months before the study began in Munesa Woreda, Arsi Zone, Oromia Region, Southeast Ethiopia. A stratified cluster sampling was used to select a sample of 855 participants. Results Out of all deliveries, only 12.3% took place at health facilities. Women who were urban residents (AOR = 2.27, 95%CI: 1.17, 4.40), women of age at interview less than 20 years (AOR = 6.06, 95%CI: 1.54, 23.78), women with first pregnancy (AOR = 2.41, 95%CI: 1.17, 4.97) and, women who had ANC visit during the last pregnancy (AOR = 4.18, 95%CI: 2.54, 6.89) were more likely to deliver at health institutions. Secondary and above level of mother`s and husband`s education had also a significant effect on health institution delivery with AOR = 4.31 (95%CI: 1.62, 11.46) and AOR = 2.77 (95%CI: 1.07, 7.19) respectively. Conclusion Institutional delivery service utilization was found to be low in the study area. Secondary and above level of mother`s and husband`s education, urban residence and ANC visit were amongst the main factors that had an influence on health institution delivery. Increasing the awareness of mothers and their partners about the benefits of institutional delivery services are recommended. PMID:23043258

Free-standing health care facilities: financial arrangements, quality assurance and a pilot study.

PubMed

Lavis, J N; Lomas, J; Anderson, G M; Donner, A; Iscoe, N A; Gold, G; Craighead, J

1998-02-10

Free-standing health care facilities now deliver many diagnostic and therapeutic services formerly provided only in hospitals. The financial arrangements available to these facilities differ according to whether the services are uninsured or insured. For an uninsured service, such as cosmetic surgery, the patient pays a fee directly to the service provider. For an insured service, such as cataract surgery, the provincial government uses tax revenues to fund the facility by paying it a facility fee and remunerates the physician who provided the service with a professional fee. No comprehensive, proactive quality assurance efforts have been implemented for either these facilities or the clinical practice provided within them. A pilot study involving therapeutic facilities in Ontario has suggested that a large-scale quality improvement effort could be undertaken in these facilities and rigorously evaluated.

NPDES Permit for Shoshone Utility Organization in Wyoming

EPA Pesticide Factsheets

Under NPDES permit WY-0044580, the Shoshone Utility Organization is authorized to discharge from its wastewater treatment facility located in Fremont County, Wyoming to an unnamed irrigation drainage ditch tributary to the South Fork of the Little Wind R.

Evidence-based practice and research utilization activities among rural nurses.

PubMed

Olade, Rosaline A

2004-01-01

To identify the extent to which rural nurses utilize evidence-based practice guidelines from scientific research in their practice; to describe both previous and current research utilization activities in which they have participated, and to identify the specific barriers they face in their practice settings. Data for this descriptive study were collected through questionnaires with open-ended questions focused on (a) current utilization of nursing research findings, (b) previous involvement in nursing research activities, and (c) participation in medical research activities. The participants were 106 nurses from various practice areas in six rural counties of a southwestern state in the United States. Results revealed that only 20.8% of the participants stated they were currently involved in research utilization, and they were mostly nurses with bachelor's degrees. The two most common areas of current research utilization were pain management and pressure ulcer prevention and management. Barriers to research utilization, such as rural isolation and lack of nursing research consultants, were identified. The types of research utilization activities identified by these nurses indicate how much the facilities in which these nurses work in the rural areas are striving with the utilization of available scientific evidence. Rural nurses face unique barriers related to situational and geographic factors, with implications for nursing administrators, researchers, and educators.

Optimizing the Utility Power of a Geothermal Power Plant using Variable Frequency Drive (VFD) (Case Study: Sibayak Geothermal Power Plant)

NASA Astrophysics Data System (ADS)

Sinaga, R. H. M.; Manik, Y.

2018-03-01

Sibayak Geothermal Power Plant (SGPP) is one of the plants being developed by Pertamina Geothermal Energy (PGE) at the upstream phase. At the downstream phase, State - owned Electricity Company (PLN) through PT. Dizamatra Powerindo is the developer. The gross capacity of the power plant is 13.3 MW, consisting 1 unit of Monoblock (2 MW) developed by PGE and 2 units (2×5.65 MW) operated through Energy Sales Contract by PLN. During the development phase of a geothermal power plant, there is a chance to reduce the utility power in order to increase the overall plant efficiency. Reducing the utility power can be attempted by utilizing the wet bulb temperature fluctuation. In this study, a modeling process is developed by using Engineering Equation Solver (EES) software version 9.430. The possibility of energy saving is indicated by condenser pressure changes as a result of wet bulb temperature fluctuation. The result of this study indicates that the change of condenser pressure is about 50.8% on the constant liquid/gas (L/G) condition of the wet bulb temperature of 15°C to 25°C. Further result indicates that in this power plant, Cooling Tower Fan (CTF) is the facility that has the greatest utility load, followed by Hot Well Pump (HWP). The saving of the greatest utility load is applied trough Variable Frequency Drive (VFD) instrumentation. The result of this modeling has been validated by actual operations data (log sheet). The developed model has also been reviewed trough Specific Steam Consumption (SSC), resulting that constant L/G condition allows the optimum condition on of the wet bulb temperature of 15°C to 25°C.

Technical solutions to overcrowded park and ride facilities

DOT National Transportation Integrated Search

2007-05-01

This report presents the results on potential techniques to more efficiently utilize existing park and ride : technologies and plan for future changes to the park and ride facilities. It presents: : A summary of parking monitoring and parking guidanc...

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

Life sciences utilization of Space Station Freedom

NASA Technical Reports Server (NTRS)

Chambers, Lawrence P.

1992-01-01

Space Station Freedom will provide the United States' first permanently manned laboratory in space. It will allow, for the first time, long term systematic life sciences investigations in microgravity. This presentation provides a top-level overview of the planned utilization of Space Station Freedom by NASA's Life Sciences Division. The historical drivers for conducting life sciences research on a permanently manned laboratory in space as well as the advantages that a space station platform provides for life sciences research are discussed. This background information leads into a description of NASA's strategy for having a fully operational International Life Sciences Research Facility by the year 2000. Achieving this capability requires the development of the five discipline focused 'common core' facilities. Once developed, these facilities will be brought to the space station during the Man-Tended Capability phase, checked out and brought into operation. Their delivery must be integrated with the Space Station Freedom manifest. At the beginning of Permanent Manned Capability, the infrastructure is expected to be completed and the Life Sciences Division's SSF Program will become fully operational. A brief facility description, anticipated launch date and a focused objective is provided for each of the life sciences facilities, including the Biomedical Monitoring and Countermeasures (BMAC) Facility, Gravitational Biology Facility (GBF), Gas Grain Simulation Facility (GGSF), Centrifuge Facility (CF), and Controlled Ecological Life Support System (CELSS) Test Facility. In addition, hardware developed by other NASA organizations and the SSF International Partners for an International Life Sciences Research Facility is also discussed.