Science.gov

Sample records for pages health facilities

  1. Health Facilities

    MedlinePlus

    Health facilities are places that provide health care. They include hospitals, clinics, outpatient care centers, and specialized care centers, ... psychiatric care centers. When you choose a health facility, you might want to consider How close it ...

  2. Insights into Facebook Pages: an early adolescent health research study page targeted at parents.

    PubMed

    Amon, Krestina L; Paxton, Karen; Klineberg, Emily; Riley, Lisa; Hawke, Catherine; Steinbeck, Katharine

    2016-02-01

    Facebook has been used in health research, but there is a lack of literature regarding how Facebook may be used to recruit younger adolescents. A Facebook Page was created for an adolescent cohort study on the effects of puberty hormones on well-being and behaviour in early adolescence. Used as a communication tool with existing participants, it also aimed to alert potential participants to the study. The purpose of this paper is to provide a detailed description of the development of the study Facebook Page and present the fan response to the types of posts made on the Page using the Facebook-generated Insights data. Two types of posts were made on the study Facebook Page. The first type was study-related update posts and events. The second was relevant adolescent and family research and current news posts. Observations on the use of and response to the Page were made over 1 year across three phases (phase 1, very low Facebook use; phase 2, high Facebook use; phase 3, low Facebook use). Most Page fans were female (88.6%), with the largest group of fans aged between 35 and 44 years. Study-related update posts with photographs were the most popular. This paper provides a model on which other researchers could base Facebook communication and potential recruitment in the absence of established guidelines.

  3. Enriching the trustworthiness of health-related web pages.

    PubMed

    Gaudinat, Arnaud; Cruchet, Sarah; Boyer, Celia; Chrawdhry, Pravir

    2011-06-01

    We present an experimental mechanism for enriching web content with quality metadata. This mechanism is based on a simple and well-known initiative in the field of the health-related web, the HONcode. The Resource Description Framework (RDF) format and the Dublin Core Metadata Element Set were used to formalize these metadata. The model of trust proposed is based on a quality model for health-related web pages that has been tested in practice over a period of thirteen years. Our model has been explored in the context of a project to develop a research tool that automatically detects the occurrence of quality criteria in health-related web pages.

  4. Key-phrase based classification of public health web pages.

    PubMed

    Dolamic, Ljiljana; Boyer, Célia

    2013-01-01

    This paper describes and evaluates the public health web pages classification model based on key phrase extraction and matching. Easily extendible both in terms of new classes as well as the new language this method proves to be a good solution for text classification faced with the total lack of training data. To evaluate the proposed solution we have used a small collection of public health related web pages created by a double blind manual classification. Our experiments have shown that by choosing the adequate threshold value the desired value for either precision or recall can be achieved.

  5. Code JEF Facilities Engineering Home Page for the Internet

    NASA Technical Reports Server (NTRS)

    Mahaffey, Valerie A.; Harrison, Marla J. (Technical Monitor)

    1995-01-01

    There are always many activities going on in JEF. We work on and manage the Construction of Facilities (C of F) projects at NASA-Ames. We are constantly designing or analyzing a new facility or project, or a modification to an existing facility. Every day we answer numerous questions about engineering policy, codes and standards, we attend design reviews, we count dollars and we make sure that everything at the Center is designed and built according to good engineering judgment. In addition, we study literature and attend conferences to make sure that we keep current on new legislation and standards.

  6. Using Facebook Page Insights Data to Determine Posting Best Practices in an Academic Health Sciences Library

    ERIC Educational Resources Information Center

    Houk, Kathryn M.; Thornhill, Kate

    2013-01-01

    Tufts University Hirsh Health Sciences Library created a Facebook page and a corresponding managing committee in March 2010. Facebook Page Insights data collected from the library's Facebook page were statistically analyzed to investigate patterns of user engagement. The committee hoped to improve posting practices and increase user engagement…

  7. National Institute of Environmental Health Sciences Kids' Pages

    MedlinePlus

    ... Environment & Health Healthy Living Pollution Reduce, Reuse, Recycle Science – How It Works The Natural World Games Brainteasers Puzzles Riddles Songs ... environment clean, will help keep us all healthy. Science – How It Works Use science to find out more about nature ...

  8. Industrial Sanitation and Personal Facilities. Module SH-13. Safety and Health.

    ERIC Educational Resources Information Center

    Center for Occupational Research and Development, Inc., Waco, TX.

    This student module on industrial sanitation and personal facilities is one of 50 modules concerned with job safety and health. This module deals wth many facets of industrial sanitation and the facilities industries should provide so that proper health procedures may be followed. Following the introduction, 14 objectives (each keyed to a page in…

  9. Health on the Net Foundation: assessing the quality of health web pages all over the world.

    PubMed

    Boyer, Célia; Gaudinat, Arnaud; Baujard, Vincent; Geissbühler, Antoine

    2007-01-01

    The Internet provides a great amount of information and has become one of the communication media which is most widely used [1]. However, the problem is no longer finding information but assessing the credibility of the publishers as well as the relevance and accuracy of the documents retrieved from the web. This problem is particularly relevant in the medical area which has a direct impact on the well-being of citizens. In this paper, we assume that the quality of web pages can be controlled, even when a huge amount of documents has to be reviewed. But this must be supported by both specific automatic tools and human expertise. In this context, we present various initiatives of the Health on the Net Foundation informing the citizens about the reliability of the medical content on the web.

  10. Health Resources Statistics; Health Manpower and Health Facilities, 1969.

    ERIC Educational Resources Information Center

    National Center for Health Statistics (DHEW/PHS), Hyattsville, MD.

    Intended to provide current statistics on health manpower and inpatient health facilities for the evaluation, planning, and administration of health programs, data were gathered from college and university records, state licensing records, association membership records, and agencies and establishments that provide health services. About 3.7…

  11. Evaluation of literacy level of patient education pages in health-related journals.

    PubMed

    Cotugna, Nancy; Vickery, Connie E; Carpenter-Haefele, Kara M

    2005-06-01

    The purpose of this study was to evaluate the reading level of patient education material from selected current health care journals. Ten patient education pages from a variety of health care journals were entered into a Microsoft Word program. Applying the Flesch-Kincaid readability formula available from Microsoft Word, a reading level for each page was established and compared to recommended standards. Only 2 of 10 patient education pages fell within the recommended reading levels for health-related materials, and 5 of 10 were above the estimated mean U.S. reading level of 8th grade. A 5th to 6th grade level is recommended for patient education materials. This study suggests that although it is known that low health literacy is a widespread problem, it is not always considered when patient-targeted materials are developed. Health care professionals need to become more active in addressing the literacy needs of the intended receiver of written health-related information.

  12. Evaluation of the quality of the general health information webpages in Spain: influence of page source.

    PubMed

    Conesa-Fuentes, Maria C; Aguinaga-Ontoso, Enrique; Hernandez-Morante, Juan J

    2013-12-01

    The Internet, regardless of whether or not it is reliable, is considered the main source of health information. However, the lay-user does not know which sources offer good quality information. The main objective of the present study, therefore, was to evaluate the quality of Spanish health-related webpages, and to determine whether the webpage source influences this quality. To this end, 36 webpages were selected through the PageRank® system. The webpages from all the Regional Health Services of Spain (19 sites) were also included. The quality evaluation, which was carried out by applying the Andalusian Health Quality Agency Test, indicated that the quality information offered by Spanish webpages is very low, since no site reached the maximum score. In addition, several important aspects, including those related with personal data management and the updating of information, were not considered by most of the evaluated pages. In summary, this work shows that quality of the health information webpages in Spain is generally low, and draws particular attention to certain responsibilities, that are not met by most evaluated webpages, including sites from the Regional Health Services.

  13. Cost effective operations through informed risk taking at the DuPage County wastewater facility Knollwood WWTP phase III

    SciTech Connect

    Rafter, J.C.; Palmer, R.A.; Bowles, B.

    1998-07-01

    Using a proactive approach to responsible wastewater collection and treatment, DuPage County, Illinois in conjunction with CTE identified and presented adverse compliance challenges to the IEPA regarding the capabilities of the Region IX-East collection and treatment facilities. This approach contained an element of risk on the County's part, knowing that the IEPA's non-compliance penalties regarding these issues were severe and that a resolution within a court ordered time schedule. A careful plan was developed to involve all the parties, the County, the regulatory agencies, the engineer and the contractor to solve the potential challenges facing the County based on anticipated increases in wastewater flow due to population growth in the Region. Regional IX-Easts' customers are served by the Knollwood Wastewater Treatment Plant (Knollwood). The Knollwood site is located just north of forest preserve property along the Des Plaines River in Burr Ridge, Illinois. The surrounding area to the west consists of a commercial industrial park. A residential development is located to the north of the plant approximately 1000 feet from the nearest treatment plant processing unit. The Knollwood Plant was rated to treat an average daily flow of 8.3 mgd prior to the construction of the new facilities. The new facilities allow the plant to treat an average daily flow of 10 mgd and peak flows up to 50 mgd.

  14. Challenges, alternatives, and paths to sustainability: better public health promotion using social networking pages as key tools.

    PubMed

    Zaidan, A A; Zaidan, B B; Kadhem, Z; Larbani, M; Lakulu, M B; Hashim, M

    2015-02-01

    This paper discusses the possibility of promoting public health and implementing educational health services using Facebook. We discuss the challenges and strengths of using such a platform as a tool for public health care systems from two different perspectives, namely, the view of IT developers and that of physicians. We present a new way of evaluating user interactivity in health care systems from tools provided by Facebook that measure statistical traffic in the Internet. Findings show that Facebook is a very promising tool in promoting e-health services in Web 2.0. Results from statistical traffic show that a Facebook page is more efficient than other pages in promoting public health.

  15. FDA Kids' Home Page

    MedlinePlus

    ... kids learn about health and safety. To Help You Stay Healthy! Kids & Teens CVM Kid's Page National Agricultural Library Kids and Teens page Spotlight Pill Bottle Pete More in For Kids Resources for You Consumer Updates Children's Health Page Last Updated: 10/ ...

  16. Health Policy on the pages of Revista de Saúde Pública

    PubMed Central

    Bousquat, Aylene; Tanaka, Oswaldo Yoshimi

    2016-01-01

    ABSTRACT We carried out a narrative review of the scientific production in the area of Policy, Planning and Management in Revista de Saúde Pública (RSP), between 1967 and 2015. All the fascicles of RSP, in the period, were accessed via SciELO platform, which provides all articles online. We selected and classified the articles according to the main topics of scientific production in the area of Policy, Planning and Management. Revista de Saúde Pública has published 343 articles on this subject, with significant growth in the last two decades. The most discussed topics were Health Economics, Primary Health-care, Access and Use of Health Services, and Evaluation of Services and Programs. In the last decade, the topics of Policy and Access to Medicines and Public-Private Relationship, including judicialization, gained importance. The pages of RSP embraced the vast and diverse production of Policy, Planning and Management in its first 50 years, contributing to the consolidation of the area in Brazil. PMID:27849292

  17. VA Health Care Facilities Locator

    MedlinePlus

    ... Loan Guaranty Medical Care Vocational Rehabilitation and Employment Health Care Benefits: 1-877-222-8387 Additional Numbers and Websites Resource Phone Number Website Bereavement Counseling 1-202-461-6530 Children of Women ... Civilian Health and Medical Program (CHAMPVA) 1-800-733-8387 ...

  18. Optimization of preventive health care facility locations

    PubMed Central

    2010-01-01

    Background Preventive health care programs can save lives and contribute to a better quality of life by diagnosing serious medical conditions early. The Preventive Health Care Facility Location (PHCFL) problem is to identify optimal locations for preventive health care facilities so as to maximize participation. When identifying locations for preventive health care facilities, we need to consider the characteristics of the preventive health care services. First, people should have more flexibility to select service locations. Second, each preventive health care facility needs to have a minimum number of clients in order to retain accreditation. Results This paper presents a new methodology for solving the PHCFL problem. In order to capture the characteristics of preventive health care services, we define a new accessibility measurement that combines the two-step floating catchment area method, distance factor, and the Huff-based competitive model. We assume that the accessibility of preventive health care services is a major determinant for participation in the service. Based on the new accessibility measurement, the PHCFL problem is formalized as a bi-objective model based on efficiency and coverage. The bi-objective model is solved using the Interchange algorithm. In order to accelerate the solving process, we implement the Interchange algorithm by building two new data structures, which captures the spatial structure of the PHCFL problem. In addition, in order to measure the spatial barrier between clients and preventive health care facilities accurately and dynamically, this paper estimates travelling distance and travelling time by calling the Google Maps Application Programming Interface (API). Conclusions Experiments based on a real application for the Alberta breast cancer screening program show that our work can increase the accessibility of breast cancer screening services in the province. PMID:20298608

  19. Health Policy on the pages of Revista de Saúde Pública.

    PubMed

    Bousquat, Aylene; Tanaka, Oswaldo Yoshimi

    2016-11-10

    We carried out a narrative review of the scientific production in the area of Policy, Planning and Management in Revista de Saúde Pública (RSP), between 1967 and 2015. All the fascicles of RSP, in the period, were accessed via SciELO platform, which provides all articles online. We selected and classified the articles according to the main topics of scientific production in the area of Policy, Planning and Management. Revista de Saúde Pública has published 343 articles on this subject, with significant growth in the last two decades. The most discussed topics were Health Economics, Primary Health-care, Access and Use of Health Services, and Evaluation of Services and Programs. In the last decade, the topics of Policy and Access to Medicines and Public-Private Relationship, including judicialization, gained importance. The pages of RSP embraced the vast and diverse production of Policy, Planning and Management in its first 50 years, contributing to the consolidation of the area in Brazil. RESUMO Foi realizada revisão narrativa da produção científica do campo de Política, Planejamento e Gestão veiculada na Revista de Saúde Pública (RSP), entre 1967 e 2015. Todos os fascículos da RSP, no período, foram acessados via plataforma SciELO, que disponibiliza todos os artigos online. Foram selecionados e classificados os artigos segundo os principais temas da produção científica da área de Política, Planejamento e Gestão. Foram publicados 343 artigos, com crescimento expressivo nas últimas duas décadas. Economia da Saúde, Atenção Primária à Saúde, Acesso e Utilização de Serviços de Saúde e Avaliação de Serviços e Programas foram os temas mais abordados. Na última década, os temas Política e Acesso a Medicamentos e Relação Público-Privado, incluindo a judicialização, ganharam importância. As páginas da RSP abrigaram vasta e diversa produção de Política, Planejamento e Gestão nos seus primeiros 50 anos, contribuindo para

  20. Design considerations for mental health facilities.

    PubMed

    Willis, V J

    1980-07-01

    The design environment of mental health facilities can facilitate the human interactions essential to treatment and can help in meeting clients' basic needs for safety and security, for self-esteem, and for the development of interpersonal and social skills. To determine the factors in the design of interior spaces that optimize clients' response to therapy, the author made a study of six Indiana community mental health centers. Drawing on that study and other sources, she presents design recommendations for mental health facilities for such areas as reception and admission areas, corridors and stairwells, therapists' offices, inpatient rooms, and dayrooms. Other discussions cover the relation of color, visual patterning, and light, and the selection of materials and finishes.

  1. Selecting and Effectively Using a Health/Fitness Facility

    MedlinePlus

    ... Information On… Selecting and Effectively Using A Health/Fitness Facility The health/fitness facility should provide a variety of equipment and programs to meet your personal fitness goals and interests. First, be sure to establish ...

  2. 42 CFR 476.78 - Responsibilities of health care facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Responsibilities of health care facilities. 476.78... § 476.78 Responsibilities of health care facilities. (a) Every hospital seeking payment for services... records to the QIO. When the QIO does postadmission, preprocedure review, the facility must provide...

  3. 42 CFR 476.76 - Cooperation with health care facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Cooperation with health care facilities. 476.76... § 476.76 Cooperation with health care facilities. Before implementation of review, a QIO must make a... care facility....

  4. 42 CFR 476.76 - Cooperation with health care facilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  5. 42 CFR 476.76 - Cooperation with health care facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Cooperation with health care facilities. 476.76 Section 476.76 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... § 476.76 Cooperation with health care facilities. Before implementation of review, a QIO must make...

  6. 42 CFR 476.76 - Cooperation with health care facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Cooperation with health care facilities. 476.76 Section 476.76 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... § 476.76 Cooperation with health care facilities. Before implementation of review, a QIO must make...

  7. Manned Mars mission health maintenance facility

    NASA Technical Reports Server (NTRS)

    Degioanni, Joseph C.

    1986-01-01

    The Health Maintenance Facility (HMF) requirements which enable/enhance manned Mars missions (MMMs) are addressed. It does not attempt to resolve any issues that may affect the feasibility of any given element in the HMF. Reference is made to current work being conducted in the design of the space station HMF. The HMF requirements are discussed within the context of two distinctly different scenarios: HMF as part of the Mars surface infrastructure, and HMF as part of the nine months translation from low Earth orbit to Mars orbit. Requirements for an HMF are provided, and a concept of HMF is shown.

  8. Health maintenance facility: Dental equipment requirements

    NASA Technical Reports Server (NTRS)

    Young, John; Gosbee, John; Billica, Roger

    1991-01-01

    The objectives were to test the effectiveness of the Health Maintenance Facility (HMF) dental suction/particle containment system, which controls fluids and debris generated during simulated dental treatment, in microgravity; to test the effectiveness of fiber optic intraoral lighting systems in microgravity, while simulating dental treatment; and to evaluate the operation and function of off-the-shelf dental handheld instruments, namely a portable dental hand drill and temporary filling material, in microgravity. A description of test procedures, including test set-up, flight equipment, and the data acquisition system, is given.

  9. A health maintenance facility for space station freedom

    NASA Technical Reports Server (NTRS)

    Billica, R. D.; Doarn, C. R.

    1991-01-01

    We describe a health care facility to be built and used on an orbiting space station in low Earth orbit. This facility, called the health maintenance facility, is based on and modeled after isolated terrestrial medical facilities. It will provide a phased approach to health care for the crews of Space Station Freedom. This paper presents the capabilities of the health maintenance facility. As Freedom is constructed over the next decade there will be an increase in activities, both construction and scientific. The health maintenance facility will evolve with this process until it is a mature, complete, stand-alone health care facility that establishes a foundation to support interplanetary travel. As our experience in space continues to grow so will the commitment to providing health care.

  10. Psychiatric and Medical Health Care Policies in Juvenile Detention Facilities

    ERIC Educational Resources Information Center

    Pajer, Kathleen A.; Kelleher, Kelly; Gupta, Ravindra A.; Rolls, Jennifer; Gardner, William

    2007-01-01

    A study aims to examine the existing health care policies in U.S. juvenile detention centres. The results conclude that juvenile detention facilities have many shortfalls in providing care for adolescents, particularly mental health care.

  11. [Education in health on REBEn's pages in the period from 1995 to 2005].

    PubMed

    Carvalho, Viviane Lemes de Silva; Clementino, Viviane de Queiroz; Pinho, Lícia Maria de Oliveira

    2008-01-01

    During our graduation, we live deeply many practical of education in health that motivated us to carry through this study. The objectives are to describe practical educative developed by nurses; identify the people, the place and describe the results gotten with the educative practical. Study of the systemize bibliographical type. The information had been collected through the election and analysis, of articles on education in health, published in the Brazilian Magazine of Nursing (REBEn), in the period of 1995 to 2005. After the analysis, 38 articles had been selected and grouped. We could observe that the educative practical happen more frequently at the hospital, the used strategies have been very creative, they enclose users of all ages and the nurses are the ones that more develop educative practices.

  12. Health Research Facilities: A survey of Doctorate-Granting Institutions.

    ERIC Educational Resources Information Center

    Atelsek, Frank J.; Gomberg, Irene L.

    The survey data cover three broad categories: (1) the status of existing health research facilities at doctorate-granting institutions (including their current value, adequacy, and condition); (2) the volume of new construction in progress; and (3) the additions to health research facilities anticipated during the next 5 years…

  13. Health maintenance facility system effectiveness testing

    NASA Technical Reports Server (NTRS)

    Lloyd, Charles W.; Gosbee, John; Bueker, Richard; Kupra, Debra; Ruta, Mary

    1993-01-01

    The Medical Simulations Working Group conducted a series of medical simulations to evaluate the proposed Health Maintenance Facility (HMF) Preliminary Design Review (PDR) configuration. The goal of these simulations was to test the system effectiveness of the HMF PDR configurations. The objectives of the medical simulations are to (1) ensure fulfillment of requirements with this HMF design, (2) demonstrate the conformance of the system to human engineering design criteria, and (3) determine whether undesirable design or procedural features were introduced into the design. The simulations consisted of performing 6 different medical scenarios with the HMF mockup in the KRUG laboratory. The scenarios included representative medical procedures and used a broad spectrum of HMF equipment and supplies. Scripts were written and simulations performed by medical simulations working group members under observation from others. Data were collected by means of questionnaires, debriefings, and videotapes. Results were extracted and listed in the individual reports. Specific issues and recommendations from each simulation were compiled into the individual reports. General issues regarding the PDR design of the HMF are outlined in the summary report.

  14. 42 CFR 476.76 - Cooperation with health care facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Cooperation with health care facilities. 476.76 Section 476.76 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Responsibilities of Quality Improvement Organizations (QIOs) General Provisions § 476.76 Cooperation with...

  15. Health care facilities resilient to climate change impacts.

    PubMed

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

    2014-12-01

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

  16. Health Care Facilities Resilient to Climate Change Impacts

    PubMed Central

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

    2014-01-01

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

  17. 7 CFR 15b.38 - Health care facilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 1 2011-01-01 2011-01-01 false Health care facilities. 15b.38 Section 15b.38... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Other Aid, Benefits, or Services § 15b.38 Health care... impaired. A recipient hospital that provides health services or benefits shall establish a procedure...

  18. 7 CFR 15b.38 - Health care facilities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 1 2012-01-01 2012-01-01 false Health care facilities. 15b.38 Section 15b.38... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Other Aid, Benefits, or Services § 15b.38 Health care... impaired. A recipient hospital that provides health services or benefits shall establish a procedure...

  19. 7 CFR 15b.38 - Health care facilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 1 2014-01-01 2014-01-01 false Health care facilities. 15b.38 Section 15b.38... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Other Aid, Benefits, or Services § 15b.38 Health care... impaired. A recipient hospital that provides health services or benefits shall establish a procedure...

  20. 7 CFR 15b.38 - Health care facilities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 1 2013-01-01 2013-01-01 false Health care facilities. 15b.38 Section 15b.38... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Other Aid, Benefits, or Services § 15b.38 Health care... impaired. A recipient hospital that provides health services or benefits shall establish a procedure...

  1. 75 FR 54627 - Best Management Practices for Unused Pharmaceuticals at Health Care Facilities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-08

    ... AGENCY Best Management Practices for Unused Pharmaceuticals at Health Care Facilities AGENCY... guidance document entitled, Best Management Practices for Unused Pharmaceuticals at Health Care Facilities... been studying unused pharmaceutical disposal practices at health care facilities, prompted by...

  2. Communicating public health preparedness information to pregnant and postpartum women: an assessment of Centers for Disease Control and Prevention web pages.

    PubMed

    McDonough, Brianna; Felter, Elizabeth; Downes, Amia; Trauth, Jeanette

    2015-04-01

    Pregnant and postpartum women have special needs during public health emergencies but often have inadequate levels of disaster preparedness. Thus, improving maternal emergency preparedness is a public health priority. More research is needed to identify the strengths and weaknesses of various approaches to how preparedness information is communicated to these women. A sample of web pages from the Centers for Disease Control and Prevention intended to address the preparedness needs of pregnant and postpartum populations was examined for suitability for this audience. Five of the 7 web pages examined were considered adequate. One web page was considered not suitable and one the raters split between not suitable and adequate. None of the resources examined were considered superior. If these resources are considered some of the best available to pregnant and postpartum women, more work is needed to improve the suitability of educational resources, especially for audiences with low literacy and low incomes.

  3. Development of a Master Health Facility List in Nigeria

    PubMed Central

    Azeez, Aderemi; Bamidele, Samson; Oyemakinde, Akin; Oyediran, Kolawole Azeez; Adebayo, Wura; Fapohunda, Bolaji; Abioye, Abimbola; Mullen, Stephanie

    2014-01-01

    Abstract Introduction Routine Health Information Systems (RHIS) are increasingly transitioning to electronic platforms in several developing countries. Establishment of a Master Facility List (MFL) to standardize the allocation of unique identifiers for health facilities can overcome identification issues and support health facility management. The Nigerian Federal Ministry of Health (FMOH) recently developed a MFL, and we present the process and outcome. Methods The MFL was developed from the ground up, and includes a state code, a local government area (LGA) code, health facility ownership (public or private), the level of care, and an exclusive LGA level health facility serial number, as part of the unique identifier system in Nigeria. To develop the MFL, the LGAs sent the list of all health facilities in their jurisdiction to the state, which in turn collated for all LGAs under them before sending to the FMOH. At the FMOH, a group of RHIS experts verified the list and identifiers for each state. Results The national MFL consists of 34,423 health facilities uniquely identified. The list has been published and is available for worldwide access; it is currently used for planning and management of health services in Nigeria. Discussion Unique identifiers are a basic component of any information system. However, poor planning and execution of implementing this key standard can diminish the success of the RHIS. Conclusion Development and adherence to standards is the hallmark for a national health information infrastructure. Explicit processes and multi-level stakeholder engagement is necessary to ensuring the success of the effort. PMID:25422720

  4. Human health risk characterization of petroleum coke calcining facility emissions.

    PubMed

    Singh, Davinderjit; Johnson, Giffe T; Harbison, Raymond D

    2015-12-01

    Calcining processes including handling and storage of raw petroleum coke may result in Particulate Matter (PM) and gaseous emissions. Concerns have been raised over the potential association between particulate and aerosol pollution and adverse respiratory health effects including decrements in lung function. This risk characterization evaluated the exposure concentrations of ambient air pollutants including PM10 and gaseous pollutants from a petroleum coke calciner facility. The ambient air pollutant levels were collected through monitors installed at multiple locations in the vicinity of the facility. The measured and modeled particulate levels in ambient air from the calciner facility were compared to standards protective of public health. The results indicated that exposure levels were, on occasions at sites farther from the facility, higher than the public health limit of 150 μg/m(3) 24-h average for PM10. However, the carbon fraction demonstrated that the contribution from the calciner facility was de minimis. Exposure levels of the modeled SO2, CO, NOx and PM10 concentrations were also below public health air quality standards. These results demonstrate that emissions from calcining processes involving petroleum coke, at facilities that are well controlled, are below regulatory standards and are not expected to produce a public health risk.

  5. ACSM's Health/Fitness Facility Standards and Guidelines. Second Edition.

    ERIC Educational Resources Information Center

    Peterson, James A., Ed; Tharrett, Stephen J., Ed.

    The American College of Sports Medicine (ACSM) sets the industry standard for certifying professionals involved in health and fitness and their clinical applications. This 5-part publication provides a revised edition of six standards representing the industry's consensus on design and operation of a safe and high-quality health/fitness facility.…

  6. Web Page Design.

    ERIC Educational Resources Information Center

    Lindsay, Lorin

    Designing a web home page involves many decisions that affect how the page will look, the kind of technology required to use the page, the links the page will provide, and kinds of patrons who can use the page. The theme of information literacy needs to be built into every web page; users need to be taught the skills of sorting and applying…

  7. Current trends in health facility planning, design, and construction.

    PubMed

    Beale, Craig; Kittredge, Frank D

    2014-01-01

    It is critical now more than ever for today's healthcare facilities to serve as more than just a backdrop to the care provided--they can, and should, be an integral part of that care. In addition to promoting efficacy, delighting the senses, and placing patients and families at ease, facilities need to be high-performing, sustainable, and healthy environments. Creating today's healthcare facilities requires breaking through barriers in unexpected ways, and it often requires looking outside the healthcare profession for guidance. In this article, we explore current trends in health facility planning, design, and construction. Our focus is on the buildings that serve as venues for the provision of healthcare services across the full continuum, from prevention to critical care. In particular, we discuss four current broad trends and conclude with thoughts on future developments.

  8. 77 FR 49007 - Changes in Certain Multifamily Housing and Health Care Facility Mortgage Insurance Premiums for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-15

    ... URBAN DEVELOPMENT Changes in Certain Multifamily Housing and Health Care Facility Mortgage Insurance... premiums (MIPs) for certain Federal Housing Administration (FHA) Multifamily Housing, Health Care... active mortgage insurance programs for multifamily housing or health care facilities. This...

  9. Imbalances in the health labour force: an assessment using data from three national health facility surveys.

    PubMed

    Barden-O'Fallon, Janine; Angeles, Gustavo; Tsui, Amy

    2006-03-01

    Accurate knowledge of the characteristics of the health labour force that can affect health care production is of critical importance to health planners and policymakers. This study uses health facility survey data to examine characteristics of the primary health care labour force in Nicaragua, Tanzania and Bangladesh. The characteristics examined are those that are likely to affect service provision, including urban/rural distribution, demographic characteristics, and experience and in-service training, for three types of providers (physicians, nurses and auxiliary nurses). The profiles suggest a pattern of urban/rural imbalances in Nicaragua and Tanzania. The Bangladesh facility survey did not include hospitals, thereby making concrete conclusions on the supply and distribution of providers difficult to make. Multivariate logistic regressions are used to assess the relationship between the urban/rural placement of providers by health need, population demand and facility characteristics. Health need, as measured by child mortality rates, does not have a significant association with the placement of providers in either country, unlike population size and annual growth rates. The mean number of years providers have worked at a facility is significantly associated with a decreased likelihood of rural placement for the three types of providers in Nicaragua. The mean age and percentage of female providers at each facility has a negative association with the placement of rural providers in Tanzania. The use of health facility data to profile the health care labour force is also discussed.

  10. Financial Health of Child Care Facilities Affects Quality of Care.

    ERIC Educational Resources Information Center

    Brower, Mary R.; Sull, Theresa M.

    2003-01-01

    Contends that child care facility owners, boards of directors, staff, and parents need to focus on financial management, as poor financial health compromises the quality of care for children. Specifically addresses the issues of: (1) concern for providing high quality child care; (2) the connection between quality and money; and (3) strengthening…

  11. Maryland Health and Higher Educational Facilities Authority. 1996 Annual Report.

    ERIC Educational Resources Information Center

    Maryland State Health and Higher Educational Facilities Authority, Baltimore.

    The Maryland Health and Higher Educational Facilities Authority performs various functions including: issuing bonds and bond anticipation notes; fixing rates and collecting user rents and fees; constructing, acquiring, and maintaining institutional projects; contracting for operation and maintenance of projects; establishing rules and regulations…

  12. [Supply services at health facilities: measuring performance].

    PubMed

    Dacosta Claro, I

    2001-01-01

    Performance measurement, in their different meanings--either balance scorecard or outputs measurement--have become an essential tool in today's organizations (World-Class organizations) to improve service quality and reduce costs. This paper presents a performance measurement system for the hospital supply chain. The system is organized in different levels and groups of indicators in order to show a hierarchical, coherent and integrated vision of the processes. Thus, supply services performance is measured according to (1) financial aspects, (2) customers satisfaction aspects and (3) internal aspects of the processes performed. Since the informational needs of the managers vary within the administrative structure, the performance measurement system is defined in three hierarchical levels. Firstly, the whole supply chain, with the different interrelation of activities. Secondly, the three main processes of the chain--physical management of products, purchasing and negotiation processes and the local storage units. And finally, the performance measurement of each activity involved. The system and the indicators have been evaluated with the participation of 17 health services of Quebec (Canada), however, and due to the similarities of the operation, could be equally implemented in Spanish hospitals.

  13. The seven deadly sins of yellow-page advertising...and why most health-care providers commit them!

    PubMed

    Cody, Michael

    2004-01-01

    Yellow-page advertising is thought to be necessary for many practices. Purchasing such advertising is a relatively complex and expensive undertaking. This article outlines some of the pitfalls managers should consider when making such purchases. They should not be left to a neophyte. They should be considered within the general context of the practice's ability to market to patients directly, and careful attention must be given to the type, pricing, and placement of the advertising.

  14. Identifying health facilities outside the enterprise: challenges and strategies for supporting health reform and meaningful use.

    PubMed

    Dixon, Brian E; Colvard, Cyril; Tierney, William M

    2014-06-24

    Objective: To support collation of data for disability determination, we sought to accurately identify facilities where care was delivered across multiple, independent hospitals and clinics. Methods: Data from various institutions' electronic health records were merged and delivered as continuity of care documents to the United States Social Security Administration (SSA). Results: Electronic records for nearly 8000 disability claimants were exchanged with SSA. Due to the lack of standard nomenclature for identifying the facilities in which patients received the care documented in the electronic records, SSA could not match the information received with information provided by disability claimants. Facility identifiers were generated arbitrarily by health care systems and therefore could not be mapped to the existing international standards. Discussion: We propose strategies for improving facility identification in electronic health records to support improved tracking of a patient's care between providers to better serve clinical care delivery, disability determination, health reform and meaningful use. Conclusion: Accurately identifying the facilities where health care is delivered to patients is important to a number of major health reform and improvement efforts underway in many nations. A standardized nomenclature for identifying health care facilities is needed to improve tracking of care and linking of electronic health records.

  15. 42 CFR 476.90 - Lack of cooperation by a health care facility or practitioner.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Lack of cooperation by a health care facility or...) Qio Review Functions § 476.90 Lack of cooperation by a health care facility or practitioner. (a) If a health care facility or practitioner refuses to allow a QIO to enter and perform the duties and...

  16. Staff Report to the Senior Department Official on Recognition Compliance Issues. Recommendation Page: Council on Education for Public Health

    ERIC Educational Resources Information Center

    US Department of Education, 2010

    2010-01-01

    Between 1945-1973, the American Public Health Association (APHA), a membership organization for public professionals, accredited graduate programs in public health. In 1974, the APHA and the Association of Schools of Public Health (ASPH), a national association representing deans, faculty, and students of accredited schools of public health,…

  17. The structural quality of Tanzanian primary health facilities.

    PubMed Central

    Gilson, L.; Magomi, M.; Mkangaa, E.

    1995-01-01

    Structural quality is a key element in the quality of care provided at the primary level, which aims to offer health care interventions of proven efficacy. This assessment of the structural quality of Tanzanian primary health services indicated serious weaknesses in the available physical infrastructure, as well as supervision and other support, both for government and nongovernmental services and for dispensary and first referral-level services. Addressing these weaknesses is likely to require some additional funding and review of the functions of different groups of health care facilities within the primary care system. Although district health management teams have an important role to play in tackling the weaknesses, the existing division of management responsibilities indicates that they can only do so with the support of the regional and national levels of the health management structure. Study methods might be adapted to facilitate improved supervision and management. PMID:7704920

  18. Community health facility preparedness for a cholera surge in Haiti.

    PubMed

    Mobula, Linda Meta; Jacquet, Gabrielle A; Weinhauer, Kristin; Alcidas, Gladys; Thomas, Hans-Muller; Burnham, Gilbert

    2013-01-01

    With increasing population displacement and worsening water insecurity after the 2010 earthquake, Haiti experienced a large cholera outbreak. Our goal was to evaluate the strengths and weaknesses of seven community health facilities' ability to respond to a surge in cholera cases. Since 2010, Catholic Relief Services (CRS) with a number of public and private donors has been working with seven health facilities in an effort to reduce morbidity and mortality from cholera infection. In November 2012, CRS through the Centers for Disease Control and Prevention (CDC)'s support, asked the Johns Hopkins Center for Refugee and Disaster Response to conduct a cholera surge simulation tabletop exercise at these health facilities to improve each facility's response in the event of a cholera surge. Using simulation development guidelines from the Pan American Health Organization and others, a simulation scenario script was produced that included situations of differing severity, supply chain, as well as a surge of patients. A total of 119 hospital staff from seven sites participated in the simulation exercise including community health workers, clinicians, managers, pharmacists, cleaners, and security guards. Clinics that had challenges during the simulated clinical care of patients were those that did not appropriately treat all cholera patients according to protocol, particularly those that were vulnerable, those that would need additional staff to properly treat patients during a surge of cholera, and those that required a better inventory of supplies. Simulation-based activities have the potential to identify healthcare delivery system vulnerabilities that are amenable to intervention prior to a cholera surge.

  19. Mental health care in juvenile detention facilities: a review.

    PubMed

    Desai, Rani A; Goulet, Joseph L; Robbins, Judith; Chapman, John F; Migdole, Scott J; Hoge, Michael A

    2006-01-01

    Juvenile detention facilities have come under increasing legal pressure to provide mental health services to detainees, and mental health clinicians may be asked to design and implement programs in detention facilities. However, there is little consensus on what types of services should be provided, and virtually no data on the effectiveness of such services in a detention setting. The objective of this article is to provide an overview of the existing literature on mental health services in juvenile detention and to make suggestions about future research needs. Specifically, it highlights the tension surrounding the provision of mental health care in juvenile detention, presents data on the prevalence of psychiatric problems in detention settings and what types of services are currently provided, and draws on the larger child and adolescent mental health literature to suggest what types of services might be most appropriate for juvenile detention settings. We conclude that, although there are some suggestions of promising interventions that may be appropriate, much more research, specifically in detention settings, is needed to determine their effectiveness.

  20. Health facility committees and facility management - exploring the nature and depth of their roles in Coast Province, Kenya

    PubMed Central

    2011-01-01

    Background Community participation has been emphasized internationally as a way of enhancing accountability, as well as a means to enhance health goals in terms of coverage, access and effective utilization. In rural health facilities in Kenya, initiatives to increase community accountability have focused on Health Facility Committees (HFCs). In Coast Province the role of HFCs has been expanded with the introduction of direct funding of rural facilities. We explored the nature and depth of managerial engagement of HFCs at the facility level in two rural districts in this Coastal setting, and how this has contributed to community accountability Methods We conducted structured interviews with the health worker in-charge and with patients in 30 health centres and dispensaries. These data were supplemented with in-depth interviews with district managers, and with health workers and HFC members in 12 health centres and dispensaries. In-depth interviews with health workers and HFC members included a participatory exercise to stimulate discussion of the nature and depth of their roles in facility management. Results HFCs were generally functioning well and played an important role in facility operations. The breadth and depth of engagement had reportedly increased after the introduction of direct funding of health facilities which allowed HFCs to manage their own budgets. Although relations with facility staff were generally good, some mistrust was expressed between HFC members and health workers, and between HFC members and the broader community, partially reflecting a lack of clarity in HFC roles. Moreover, over half of exit interviewees were not aware of the HFC's existence. Women and less well-educated respondents were particularly unlikely to know about the HFC. Conclusions There is potential for HFCs to play an active and important role in health facility management, particularly where they have control over some facility level resources. However, to optimise their

  1. 42 CFR 475.105 - Prohibition against contracting with health care facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... facilities. 475.105 Section 475.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... with health care facilities. (a) Basic rule. Except as permitted under paragraph (b) of this section, the following are not eligible for QIO contracts: (1) A health care facility in the QIO area. (2)...

  2. 77 FR 21580 - Changes in Certain Multifamily Housing and Health Care Facility Mortgage Insurance Premiums for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-10

    ... URBAN DEVELOPMENT Changes in Certain Multifamily Housing and Health Care Facility Mortgage Insurance...) Multifamily Housing, Health Care Facilities, and Hospital Mortgage Insurance programs for commitments to be... multifamily housing, health care facility, and hospital loans. The increases will not apply to Low...

  3. Airborne infection control in India: Baseline assessment of health facilities

    PubMed Central

    Parmar, Malik M.; Sachdeva, K.S.; Rade, Kiran; Ghedia, Mayank; Bansal, Avi; Nagaraja, Sharath Burugina; Willis, Matthew D.; Misquitta, Dyson P.; Nair, Sreenivas A.; Moonan, Patrick K.; Dewan, Puneet K.

    2016-01-01

    Background Tuberculosis transmission in health care settings represents a major public health problem. In 2010, national airborne infection control (AIC) guidelines were adopted in India. These guidelines included specific policies for TB prevention and control in health care settings. However, the feasibility and effectiveness of these guidelines have not been assessed in routine practice. This study aimed to conduct baseline assessments of AIC policies and practices within a convenience sample of 35 health care settings across 3 states in India and to assess the level of implementation at each facility after one year. Method A multi-agency, multidisciplinary panel of experts performed site visits using a standardized risk assessment tool to document current practices and review resource capacity. At the conclusion of each assessment, facility-specific recommendations were provided to improve AIC performance to align with national guidelines. Result Upon initial assessment, AIC systems were found to be poorly developed and implemented. Administrative controls were not commonly practiced and many departments needed renovation to achieve minimum environmental standards. One year after the baseline assessments, there were substantial improvements in both policy and practice. Conclusion A package of capacity building and systems development that followed national guidelines substantially improved implementation of AIC policies and practice. PMID:26970461

  4. Regulation and oversight of independent health facilities in Canada.

    PubMed

    Pries, Charlene R; Vanin, Sharon; Cartagena, Rosario G

    2014-02-01

    Independent health facilities ("IHFs") are an important part of Canada's health care system existing at the interface of public and private care. They offer benefits to individual patients and the public at large, such as improved access to care, reduced wait times, improved choice in the delivery of care, and more efficient use of health care resources. They can also provide physicians greater autonomy, control of resources, and opportunity for profit compared to other practice settings, particularly because IHFs can deliver services outside of publicly-funded health care plans. IHFs also present challenges, particularly around quality of care and patient safety, and the potential to breach the principles of "Medicare" under the Canada Health Act. Various measures are in place to address these challenges, while still enabling the benefits IHFs can offer. IHFs are primarily regulated and overseen at the provincial level through legislation, regulations and provincial medical regulatory College by-laws. Health Canada is responsible for administering the overarching framework for "Medicare". Oversight and regulatory provisions vary across Canada, and are notably absent in the Maritime provinces and the territories. This article provides an overview of specific provisions related to IHFs across the country and how they can co-exist with the Canada Health Act.

  5. Designing eHealth Applications to Reduce Cognitive Effort for Persons With Severe Mental Illness: Page Complexity, Navigation Simplicity, and Comprehensibility

    PubMed Central

    Spring, Michael R; Hanusa, Barbara H; Eack, Shaun M; Haas, Gretchen L

    2017-01-01

    Background eHealth technologies offer great potential for improving the use and effectiveness of treatments for those with severe mental illness (SMI), including schizophrenia and schizoaffective disorder. This potential can be muted by poor design. There is limited research on designing eHealth technologies for those with SMI, others with cognitive impairments, and those who are not technology savvy. We previously tested a design model, the Flat Explicit Design Model (FEDM), to create eHealth interventions for individuals with SMI. Subsequently, we developed the design concept page complexity, defined via the design variables we created of distinct topic areas, distinct navigation areas, and number of columns used to organize contents and the variables of text reading level, text reading ease (a newly added variable to the FEDM), and the number of hyperlinks and number of words on a page. Objective The objective of our study was to report the influence that the 19 variables of the FEDM have on the ability of individuals with SMI to use a website, ratings of a website’s ease of use, and performance on a novel usability task we created termed as content disclosure (a measure of the influence of a homepage’s design on the understanding user’s gain of a website). Finally, we assessed the performance of 3 groups or dimensions we developed that organize the 19 variables of the FEDM, termed as page complexity, navigational simplicity, and comprehensibility. Methods We measured 4 website usability outcomes: ability to find information, time to find information, ease of use, and a user’s ability to accurately judge a website’s contents. A total of 38 persons with SMI (chart diagnosis of schizophrenia or schizoaffective disorder) and 5 mental health websites were used to evaluate the importance of the new design concepts, as well as the other variables in the FEDM. Results We found that 11 of the FEDM’s 19 variables were significantly associated with all 4

  6. Full Page Departmental Advertising.

    ERIC Educational Resources Information Center

    Van Zante, Ben

    1978-01-01

    States that many school newspapers are condensing all advertising into one or two pages. Indicates that advertisers find this to be acceptable, students continue to read the ads, and the content pages look better. (TJ)

  7. Health Resources Statistics; Health Manpower and Health Facilities, 1968. Public Health Service Publication No. 1509.

    ERIC Educational Resources Information Center

    National Center for Health Statistics (DHEW/PHS), Hyattsville, MD.

    This report is a part of the program of the National Center for Health Statistics to provide current statistics as baseline data for the evaluation, planning, and administration of health programs. Part I presents data concerning the occupational fields: (1) administration, (2) anthropology and sociology, (3) data processing, (4) basic sciences,…

  8. Does the Health Maintenance Facility Provide Speciality Capabilities?

    NASA Technical Reports Server (NTRS)

    Boyce, Joey; Wurgler, James; Broadwell, Kim; Martin, William; Stiernberg, Charles M.; Bove, Alfred; Fromm, Rob; O'Neill, Daniel

    1991-01-01

    The Health Maintenance Facility (HMF) is capable of handling all minor illnesses, most moderate illnesses, and some major illnesses on board a space station. Its primary purpose should be to treat problems that are mission threatening, not life threatening. The HMF will have greater medical capabilities than those currently on Navy submarines. Much of the discussion in this document focuses on the possibilities of treating specific medical conditions on board a space station. The HMF will be limited to caring for critically ill patients for a few days, so a crew return vehicle will be important.

  9. NIF conventional facilities construction health and safety plan

    SciTech Connect

    Benjamin, D W

    1998-05-14

    The purpose of this Plan is to outline the minimum health and safety requirements to which all participating Lawrence Livermore National Laboratory (LLNL) and non-LLNL employees (excluding National Ignition Facility [NIF] specific contractors and subcontractors covered under the construction subcontract packages (e.g., CSP-9)-see Construction Safety Program for the National Ignition Facility [CSP] Section I.B. ''NIF Construction Contractors and Subcontractors'' for specifics) shall adhere to for preventing job-related injuries and illnesses during Conventional Facilities construction activities at the NIF Project. For the purpose of this Plan, the term ''LLNL and non-LLNL employees'' includes LLNL employees, LLNL Plant Operations staff and their contractors, supplemental labor, contract labor, labor-only contractors, vendors, DOE representatives, personnel matrixed/assigned from other National Laboratories, participating guests, and others such as visitors, students, consultants etc., performing on-site work or services in support of the NIF Project. Based upon an activity level determination explained in Section 1.2.18, in this document, these organizations or individuals may be required by site management to prepare their own NIF site-specific safety plan. LLNL employees will normally not be expected to prepare a site-specific safety plan. This Plan also outlines job-specific exposures and construction site safety activities with which LLNL and non-LLNL employees shall comply.

  10. Use of scrubs and related apparel in health care facilities.

    PubMed

    Belkin, N L

    1997-10-01

    There is no scientific evidence that the use of scrubs or other related apparel contributes to either the cause or the prevention of infections associated with health care facilities. However, because this type of apparel is now used so commonly as a replacement for the more traditional type of uniform, its original function as an ensemble worn by surgical personnel no longer prevails. The variety of these applications actually raises a new series of issues and challenges that would be best resolved by a multidisciplinary health care group with representatives from administration, nursing, medicine, materials management, human resources, infection control, and other affected departments. The purpose of this report is to facilitate this process.

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

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  12. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  13. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  14. [Potential vulnerability to flooding at public health facilities in four northern regions of Peru].

    PubMed

    Hernández-Vásquez, Akram; Arroyo-Hernández, Hugo; Bendezú-Quispe, Guido; Díaz-Seijas, Deysi; Vilcarromero, Stalin; Rubilar-González, Juan; Gutierrez-Lagos, Edith

    2016-03-01

    In order to determine the potential vulnerability of public health facilities in four northern regions of Peru to the possible effects of El Niño-Southern Oscillation (ENSO) phenomenon. An exploratory spatial analysis was performed using the geo-referenced points for at-risk areas based on the activation of gullies that were reported by the National Water Authority, and the location of the four regional public health facilities of the Ministry of Health. Concentric areas of influence were simulate from the points of risk towards the public health facilities using radii of 200, 1000 and 1500 meters. The Tumbes region would be the most affected with 37.2% of its health facilities being affected by floods and landslides. The I-2 and I-3 categories of health facilities appeared to be the most affected with 28.9% and 31.6% respectively. Therefore, public health facilities near the risk zones may be affected by the ENSO.

  15. [Simulation in health care, a partnership between a training institute and a health care facility].

    PubMed

    Appelshaeuser, Michèle; Sengel, Danièle

    2017-03-01

    A system of collaboration around simulation, between a health care facility and a training institute, has been put in place. It has enabled the challenges for both institutions to be identified, thereby confirming the need to continue this project. In this context, interprofessionalality and intergenerationality are key elements.

  16. Versatile page numbering analysis

    NASA Astrophysics Data System (ADS)

    Déjean, Hervé; Meunier, Jean-Luc

    2008-01-01

    In this paper, we revisit the problem of detecting the page numbers of a document. This work is motivated by a need for a generic method which applies on a large variety of documents, as well as the need for analyzing the document page numbering scheme rather than spotting one number per page. We propose here a novel method, based on the notion of sequence, which goes beyond any previous described work, and we report on an extensive evaluation of its performance.

  17. 42 CFR 431.110 - Participation by Indian Health Service facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Participation by Indian Health Service facilities... facilities. (a) Basis. This section is based on section 1902(a)(4) of the Act, proper and efficient administration; 1902(a)(23), free choice of provider; and 1911, reimbursement of Indian Health Service...

  18. The impact of health facilities on healthcare workers' well-being and performance.

    PubMed

    Rechel, Bernd; Buchan, James; McKee, Martin

    2009-07-01

    The impact of health facilities on patients has been extensively researched. Yet, while there is a growing recognition of the need for healthy working environments, little is known about how health facilities affect the staff working in them. This paper explores how the design of health facilities impacts on the well-being and performance of healthcare workers. The article is based on a review of published literature, identified through PubMed and Google, as well as through searches of websites of relevant organizations. Many traditionally designed health facilities seem to impact negatively on the well-being of healthcare workers, as well as on staff recruitment, retention and performance. Better-designed health facilities can improve working conditions and staff safety, and enable staff to do their job more efficiently. The needs of healthcare workers should be taken into account at the initial design stage of health facilities, ideally though direct involvement or meaningful consultation.

  19. Lifting teams in health care facilities: a literature review.

    PubMed

    Haiduven, Donna

    2003-05-01

    1. Manual lifting and transfer activities are job tasks frequently associated with back injuries in nursing personnel. One approach with potential to decrease these injuries is the lifting team. 2. In program evaluations completed to date, there have been numerous benefits and several limitations attributed to use of lifting teams in health care facilities. 3. Benefits of lifting teams include reductions in lost time workdays, restricted workdays, workers' compensation claims, and injuries to lifting team members; satisfaction of patients, staff, and lifting team members; and capacity of the lifting team to absorb the majority of high risk lifts and transfers on shifts in which they operate. 4. Lifting teams may not be appropriate for all settings, require infrastructure and lifting team equipment to support their use, and require careful consideration related to staffing. However, when their use is appropriate, efforts to overcome their limitations can be accomplished with careful evaluation of outcome measures and indicators.

  20. PLANNING AREAS AND FACILITIES FOR HEALTH, PHYSICAL EDUCATION, AND RECREATION BY PARTICIPANTS IN NATIONAL FACILITIES CONFERENCE. REVISED 1965.

    ERIC Educational Resources Information Center

    American Association for Health, Physical Education, and Recreation, Washington, DC.

    SPECIFIC INFORMATION IS PROVIDED IN THIS GUIDE TO PLANNERS OF AREAS AND FACILITIES FOR ATHLETICS, RECREATION, OUTDOOR EDUCATION, AND PHYSICAL AND HEALTH EDUCATION. PART ONE CONCERNS BASIC CONCEPTS PERTINENT TO THE AREA OF CONSIDERATION. THE AIMS OF PHYSICAL EDUCATION, HEALTH AND SAFETY EDUCATION, AND RECREATION ARE LISTED. PLANNING PRINCIPLES,…

  1. Health physics manual of good practices for accelerator facilities

    SciTech Connect

    Casey, W.R.; Miller, A.J.; McCaslin, J.B.; Coulson, L.V.

    1988-04-01

    It is hoped that this manual will serve both as a teaching aid as well as a useful adjunct for program development. In the context of application, this manual addresses good practices that should be observed by management, staff, and designers since the achievement of a good radiation program indeed involves a combined effort. Ultimately, radiation safety and good work practices become the personal responsibility of the individual. The practices presented in this manual are not to be construed as mandatory rather they are to be used as appropriate for the specific case in the interest of radiation safety. As experience is accrued and new data obtained in the application of this document, ONS will update the guidance to assure that at any given time the guidance reflects optimum performance consistent with current technology and practice.The intent of this guide therefore is to: define common health physics problems at accelerators; recommend suitable methods of identifying, evaluating, and managing accelerator health physics problems; set out the established safety practices at DOE accelerators that have been arrived at by consensus and, where consensus has not yet been reached, give examples of safe practices; introduce the technical literature in the accelerator health physics field; and supplement the regulatory documents listed in Appendix D. Many accelerator health physics problems are no different than those at other kinds of facilities, e.g., ALARA philosophy, instrument calibration, etc. These problems are touched on very lightly or not at all. Similarly, this document does not cover other hazards such as electrical shock, toxic materials, etc. This does not in any way imply that these problems are not serious. 160 refs.

  2. Wetlands and Web Pages.

    ERIC Educational Resources Information Center

    Tisone-Bartels, Dede

    1998-01-01

    Argues that the preservation of areas like the Shoreline Park (California) wetlands depends on educating students about the value of natural resources. Describes the creation of a Web page on the wetlands for third-grade students by seventh-grade art and ecology students. Outlines the technical process of developing a Web page. (DSK)

  3. Differences in essential newborn care at birth between private and public health facilities in eastern Uganda.

    PubMed

    Waiswa, Peter; Akuze, Joseph; Peterson, Stefan; Kerber, Kate; Tetui, Moses; Forsberg, Birger C; Hanson, Claudia

    2015-01-01

    Background In Uganda and elsewhere, the private sector provides an increasing and significant proportion of maternal and child health services. However, little is known whether private care results in better quality services and improved outcomes compared to the public sector, especially regarding care at the time of birth. Objective To describe the characteristics of care-seekers and assess newborn care practices and services received at public and private facilities in rural eastern Uganda. Design Within a community-based maternal and newborn care intervention with health systems strengthening, we collected data from mothers with infants at baseline and endline using a structured questionnaire. Descriptive, bivariate, and multivariate data analysis comparing nine newborn care practices and three composite newborn care indicators among private and public health facilities was conducted. Results The proportion of women giving birth at private facilities decreased from 25% at baseline to 17% at endline, whereas overall facility births increased. Private health facilities did not perform significantly better than public health facilities in terms of coverage of any essential newborn care interventions, and babies were more likely to receive thermal care practices in public facilities compared to private (68% compared to 60%, p=0.007). Babies born at public health facilities received an average of 7.0 essential newborn care interventions compared to 6.2 at private facilities (p<0.001). Women delivering in private facilities were more likely to have higher parity, lower socio-economic status, less education, to seek antenatal care later in pregnancy, and to have a normal delivery compared to women delivering in public facilities. Conclusions In this setting, private health facilities serve a vulnerable population and provide access to service for those who might not otherwise have it. However, provision of essential newborn care practices was slightly lower in private

  4. Parent and Health Care Professional Perspectives on Family-Centered Care for Children with Special Health Care Needs: Are We on the Same Page?

    ERIC Educational Resources Information Center

    Bellin, Melissa H.; Osteen, Philip; Heffernan, Caitlin; Levy, Judy M.; Snyder-Vogel, Mary E.

    2011-01-01

    A family-centered approach to health care for children with special health care needs (CSHCN) is widely acknowledged as the ideal model of service delivery, but less is known about the actual practice of family-centered care (FCC), especially from the viewpoints of parents and health care professionals. This cross-sectional research compared…

  5. New Architecture for Mental Health; New York State Health and Mental Hygiene Facilities Improvement Corporation - Report to the Governor, 1969.

    ERIC Educational Resources Information Center

    New York State Health and Mental Hygiene Facilities Improvement Corp., Albany.

    The accomplishments of The Health and Mental Hygiene Facilities Improvement Corporation during the past years in creating needed hospitals and health centers for the mentally disabled is documented. The new facilities show awareness of architectural trends and new objectives in design in order to better serve the needs of the patient. Pictures and…

  6. The Health Literacy Environment of Hospitals and Health Centers. Partners for Action: Making Your Healthcare Facility Literacy-Friendly

    ERIC Educational Resources Information Center

    Rudd, Rima E.; Anderson, Jennie E.

    2006-01-01

    The "health literacy environment" of a healthcare facility represents the expectations, preferences, and skills of those providing health information and services. Some of these demands are in the form of physical aspects of the hospital or health center, such as signs and postings. At the same time, access to and navigation of health services…

  7. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  8. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

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

    ERIC Educational Resources Information Center

    Myers, Bronwyn; Fakier, Nuraan

    2009-01-01

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

  10. Sign language Web pages.

    PubMed

    Fels, Deborah I; Richards, Jan; Hardman, Jim; Lee, Daniel G

    2006-01-01

    The WORLD WIDE WEB has changed the way people interact. It has also become an important equalizer of information access for many social sectors. However, for many people, including some sign language users, Web accessing can be difficult. For some, it not only presents another barrier to overcome but has left them without cultural equality. The present article describes a system that allows sign language-only Web pages to be created and linked through a video-based technique called sign-linking. In two studies, 14 Deaf participants examined two iterations of signlinked Web pages to gauge the usability and learnability of a signing Web page interface. The first study indicated that signing Web pages were usable by sign language users but that some interface features required improvement. The second study showed increased usability for those features; users consequently couldnavigate sign language information with ease and pleasure.

  11. Making Pages That Move.

    ERIC Educational Resources Information Center

    Gepner, Ivan

    2001-01-01

    Explains the mechanism of producing dynamic computer pages which is based on three technologies: (1) the document object model; (2) cascading stylesheets; and (3) javascript. Discusses the applications of these techniques in genetics and developmental biology. (YDS)

  12. TCRC Fertility Page

    MedlinePlus

    The Testicular Cancer Resource Center The TCRC Fertility Page Testicular Cancer and fertility are interrelated in numerous ways. TC usually ... Orchiectomy: As I mentioned, many men who have testicular cancer also already have fertility problems. In some, the ...

  13. [Nosocomial infections in long-term health care facilities].

    PubMed

    Serrano, Marcos; Barcenilla, Fernando; Limón, Enrique

    2014-03-01

    The long-term care facilities (LTCF) are the health care level that integrates medical assistance and social services according to the requirements of its beneficiaries. There is a great variability depending on the users profile, the professional staff and accessibility to technical resources for diagnosis, treatment or rehabilitation. In LTCF different factors are shaping a challenge in the infection control. These factors are high prevalence of infection and colonization by multiresistant microorganisms (MROs), a high rate of, often inadequate, antibiotic prescriptions, the high transfer of hospital patients, and the lack of diagnostic resources. In infection studies in LTCF, one of the main problems is the lack of standard, and well defined, infection criteria. The special features of infections in the elderly population, together with the limited resources, make it necessary to establish standard and worldwide validated criteria in order achieve appropriate monitoring and control of infection. The most common infection is the respiratory, followed by the urinary, skin and soft tissue, gastro-intestinal tract, and eyes. The problematic microorganisms most frequently identified in LTCF are enterobacteriaceae extended spectrum beta lactamase, Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA). A successful infection control mainly depends on two actions. First, a high compliance of standard precautions and second, patient organization according to the risk of transmission of a particular MROs infection, especially MRSA. This risk classification may be a way to rationalize application measures, and the incorporation of ethical and legal issues. The level of stratification is established mainly according to the condition of being colonized or infected, the MROs anatomical location, and the degree of behavioral disorders suffered by the patient. Implementation of extensive screening programs or complex monitoring programs, as in acute care

  14. Uses of inorganic hypochlorite (bleach) in health-care facilities.

    PubMed

    Rutala, W A; Weber, D J

    1997-10-01

    Hypochlorite has been used as a disinfectant for more than 100 years. It has many of the properties of an ideal disinfectant, including a broad antimicrobial activity, rapid bactericidal action, reasonable persistence in treated potable water, ease of use, solubility in water, relative stability, relative nontoxicity at use concentrations, no poisonous residuals, no color, no staining, and low cost. The active species is undissociated hypochlorous acid (HOCl). Hypochlorites are lethal to most microbes, although viruses and vegetative bacteria are more susceptible than endospore-forming bacteria, fungi, and protozoa. Activity is reduced by the presence of heavy metal ions, a biofilm, organic material, low temperature, low pH, or UV radiation. Clinical uses in health-care facilities include hyperchlorination of potable water to prevent Legionella colonization, chlorination of water distribution systems used in hemodialysis centers, cleaning of environmental surfaces, disinfection of laundry, local use to decontaminate blood spills, disinfection of equipment, decontamination of medical waste prior to disposal, and dental therapy. Despite the increasing availability of other disinfectants, hypochlorites continue to find wide use in hospitals.

  15. Uses of inorganic hypochlorite (bleach) in health-care facilities.

    PubMed Central

    Rutala, W A; Weber, D J

    1997-01-01

    Hypochlorite has been used as a disinfectant for more than 100 years. It has many of the properties of an ideal disinfectant, including a broad antimicrobial activity, rapid bactericidal action, reasonable persistence in treated potable water, ease of use, solubility in water, relative stability, relative nontoxicity at use concentrations, no poisonous residuals, no color, no staining, and low cost. The active species is undissociated hypochlorous acid (HOCl). Hypochlorites are lethal to most microbes, although viruses and vegetative bacteria are more susceptible than endospore-forming bacteria, fungi, and protozoa. Activity is reduced by the presence of heavy metal ions, a biofilm, organic material, low temperature, low pH, or UV radiation. Clinical uses in health-care facilities include hyperchlorination of potable water to prevent Legionella colonization, chlorination of water distribution systems used in hemodialysis centers, cleaning of environmental surfaces, disinfection of laundry, local use to decontaminate blood spills, disinfection of equipment, decontamination of medical waste prior to disposal, and dental therapy. Despite the increasing availability of other disinfectants, hypochlorites continue to find wide use in hospitals. PMID:9336664

  16. Page turning system

    NASA Technical Reports Server (NTRS)

    Kerley, James J. (Inventor); Eklund, Wayne D. (Inventor)

    1992-01-01

    A device for holding reading materials for use by readers without arm mobility is presented. The device is adapted to hold the reading materials in position for reading with the pages displayed to enable turning by use of a rubber tipped stick that is held in the mouth and has a pair of rectangular frames. The frames are for holding and positioning the reading materials opened in reading posture with the pages displayed at a substantially unobstructed sighting position for reading. The pair of rectangular frames are connected to one another by a hinge so the angle between the frames may be varied thereby varying the inclination of the reading material. A pair of bent spring mounted wires for holding opposing pages of the reading material open for reading without substantial visual interference of the pages is mounted to the base. The wires are also adjustable to the thickness of the reading material and have a variable friction adjustment. This enables the force of the wires against the pages to be varied and permits the reader to manipulate the pages with the stick.

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

    PubMed

    Wang, Tiankai; Wang, Yangmei; Moczygemba, Jackie

    2014-01-01

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

  18. The role of civil society in strengthening intercultural maternal health care in local health facilities: Puno, Peru

    PubMed Central

    Samuel, Jeannie

    2016-01-01

    Background and objective Peru's Ministry of Health has made efforts to increase the cultural inclusiveness of maternal health services. In 2005, the Ministry adopted an intercultural birthing policy (IBP) that authorizes and encourages the use of culturally acceptable birthing practices in government-run health facilities. However, studies suggest that indigenous women may receive inconsistent benefits from these kinds of policies. This article examines whether a grassroots accountability initiative based on citizen monitoring of local health facilities by indigenous women can help to promote the objectives of the IBP and improve intercultural maternal health care. Design Findings are drawn from a larger qualitative research study completed in 2015 that included fieldwork done between 2010 and 2011. Semi-structured interviews were conducted with 23 women working as citizen monitors in local health facilities in Puno and 30 key informants, including frontline health workers, health officials, and civil society actors in Puno and Lima, and human rights lawyers from the Defensoría del Pueblo Office in Puno. Results Monitors confirmed from their own personal experiences in the 1990s and early 2000s that respect for intercultural aspects of maternal health care, including traditional indigenous birthing practices, were not readily accepted in publicly funded health facilities. It was also common for indigenous women to face discrimination when seeking health service provided by the state. Although the government's adoption of the IBP in 2005 was a positive step, considerable efforts are still needed to ensure high-quality, culturally appropriate maternal health care is consistently available in local health facilities. Conclusions Despite important progress in the past two decades, policies aimed at improving intercultural maternal health care are unevenly implemented in local health facilities. Civil society, in particular indigenous women themselves, can play an

  19. The role of civil society in strengthening intercultural maternal health care in local health facilities: Puno, Peru.

    PubMed

    Samuel, Jeannie

    2016-01-01

    Background and objective Peru's Ministry of Health has made efforts to increase the cultural inclusiveness of maternal health services. In 2005, the Ministry adopted an intercultural birthing policy (IBP) that authorizes and encourages the use of culturally acceptable birthing practices in government-run health facilities. However, studies suggest that indigenous women may receive inconsistent benefits from these kinds of policies. This article examines whether a grassroots accountability initiative based on citizen monitoring of local health facilities by indigenous women can help to promote the objectives of the IBP and improve intercultural maternal health care. Design Findings are drawn from a larger qualitative research study completed in 2015 that included fieldwork done between 2010 and 2011. Semi-structured interviews were conducted with 23 women working as citizen monitors in local health facilities in Puno and 30 key informants, including frontline health workers, health officials, and civil society actors in Puno and Lima, and human rights lawyers from the Defensoría del Pueblo Office in Puno. Results Monitors confirmed from their own personal experiences in the 1990s and early 2000s that respect for intercultural aspects of maternal health care, including traditional indigenous birthing practices, were not readily accepted in publicly funded health facilities. It was also common for indigenous women to face discrimination when seeking health service provided by the state. Although the government's adoption of the IBP in 2005 was a positive step, considerable efforts are still needed to ensure high-quality, culturally appropriate maternal health care is consistently available in local health facilities. Conclusions Despite important progress in the past two decades, policies aimed at improving intercultural maternal health care are unevenly implemented in local health facilities. Civil society, in particular indigenous women themselves, can play an

  20. Health providers' perception towards safe abortion service at selected health facilities in Addis Ababa.

    PubMed

    Abdi, Jemilla; Gebremariam, Mulugeta B

    2011-03-01

    In Ethiopia, unsafe abortion accounts up to 32% of maternal deaths. The perception of health providers towards safe abortion provision at selected health facilities in Addis Ababa, Ethiopia was assessed. A stratified random sampling was used to select 431 health providers. A cross-sectional study was conducted from March 25-April 15, 2008 using a structured self-administered questionnaire. The results were interpreted using descriptive statistics and odds ratios. A majority of the health providers (96.4%) recognized that unsafe abortion was a serious health problem. Providers who had safe abortion practice were 2.57 (95% CI 1.49-4.44) times more likely to have favorable attitude towards safe abortion than those without practice. Similarly, providers who knew the law governing abortion were 1.77 (95% CI 1.12-2.78) times more likely to have this favorable attitude than those who lack this knowledge. In conclusion, training of health providers on safe abortion and reproductive rights are essential to reduce maternal mortality.

  1. 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.

  2. 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

  3. Cost recovery of NGO primary health care facilities: a case study in Bangladesh

    PubMed Central

    2010-01-01

    Background Little is known about the cost recovery of primary health care facilities in Bangladesh. This study estimated the cost recovery of a primary health care facility run by Building Resources Across Community (BRAC), a large NGO in Bangladesh, for the period of July 2004 - June 2005. This health facility is one of the seven upgraded BRAC facilities providing emergency obstetric care and is typical of the government and private primary health care facilities in Bangladesh. Given the current maternal and child mortality in Bangladesh and the challenges to addressing health-related Millennium Development Goal (MDG) targets the financial sustainability of such facilities is crucial. Methods The study was designed as a case study covering a single facility. The methodology was based on the 'ingredient approach' using the allocation techniques by inpatient and outpatient services. Cost recovery of the facility was estimated from the provider's perspective. The value of capital items was annualized using 5% discount rate and its market price of 2004 (replacement value). Sensitivity analysis was done using 3% discount rate. Results The cost recovery ratio of the BRAC primary care facility was 59%, and if excluding all capital costs, it increased to 72%. Of the total costs, 32% was for personnel while drugs absorbed 18%. Capital items were17% of total costs while operational cost absorbed 12%. Three-quarters of the total cost was variable costs. Inpatient services contributed 74% of total revenue in exchange of 10% of total utilization. An average cost per patient was US$ 10 while it was US$ 67 for inpatient and US$ 4 for outpatient. Conclusion The cost recovery of this NGO primary care facility is important for increasing its financial sustainability and decreasing donor dependency, and achieving universal health coverage in a developing country setting. However, for improving the cost recovery of the health facility, it needs to increase utilization, efficient

  4. Bypassing health facilities for childbirth: a multilevel study in three districts of Gujarat, India

    PubMed Central

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

    2016-01-01

    Background Bypassing available facilities for childbirth has important implications for maternal health service delivery and human resources within a health system. The results are the additional expenses imposed on the woman and her family, as well as the inefficient use of health system resources. Bypassing often indicates a lack of confidence in the care provided by the facility nearest to the mother, which implies a level of dysfunctionality that the health system needs to address. Over the past decade, India has experienced a steep rise in the proportion of facility births. The initiation of programs promoting facility births resulted in a rise from 39% in 2005 to 85% in 2014. There have been no reports on bypassing facilities for childbirth from India. In the context of steeply rising facility births, it is important to quantify the occurrence of and study the relative contributions of maternal characteristics and facility functionality to bypassing. Objectives 1) To determine the extent of bypassing health facilities for childbirth among rural mothers in three districts of Gujarat, India, 2) to identify associations between the functionality of an obstetric care (OC) facility and it being bypassed, and 3) to assess the relative contribution of maternal and facility characteristics to bypassing. Design A cross-sectional survey of 166 public and private OC facilities reporting ≥30 births in the 3 months before the survey was conducted in three purposively selected districts (Dahod, Sabarkantha, and Surendranagar) in the state of Gujarat, India. Besides information on each facility, data from 946 women giving birth at these facilities were also gathered. Data were analyzed using a multilevel mixed-effects logistic regression model. Results Off all mothers, 37.7% bypassed their nearest facility for childbirth. After adjusting for maternal characteristics, for every one-unit increase in the facility's emergency obstetric care (EmOC) signal functions, the odds

  5. Bypassing health facilities for childbirth: a multilevel study in three districts of Gujarat, India.

    PubMed

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

    2016-01-01

    Background Bypassing available facilities for childbirth has important implications for maternal health service delivery and human resources within a health system. The results are the additional expenses imposed on the woman and her family, as well as the inefficient use of health system resources. Bypassing often indicates a lack of confidence in the care provided by the facility nearest to the mother, which implies a level of dysfunctionality that the health system needs to address. Over the past decade, India has experienced a steep rise in the proportion of facility births. The initiation of programs promoting facility births resulted in a rise from 39% in 2005 to 85% in 2014. There have been no reports on bypassing facilities for childbirth from India. In the context of steeply rising facility births, it is important to quantify the occurrence of and study the relative contributions of maternal characteristics and facility functionality to bypassing. Objectives 1) To determine the extent of bypassing health facilities for childbirth among rural mothers in three districts of Gujarat, India, 2) to identify associations between the functionality of an obstetric care (OC) facility and it being bypassed, and 3) to assess the relative contribution of maternal and facility characteristics to bypassing. Design A cross-sectional survey of 166 public and private OC facilities reporting ≥30 births in the 3 months before the survey was conducted in three purposively selected districts (Dahod, Sabarkantha, and Surendranagar) in the state of Gujarat, India. Besides information on each facility, data from 946 women giving birth at these facilities were also gathered. Data were analyzed using a multilevel mixed-effects logistic regression model. Results Off all mothers, 37.7% bypassed their nearest facility for childbirth. After adjusting for maternal characteristics, for every one-unit increase in the facility's emergency obstetric care (EmOC) signal functions, the odds

  6. Medicare and Medicaid Programs; Fire Safety Requirements for Certain Health Care Facilities. Final rule.

    PubMed

    2016-05-04

    This final rule will amend the fire safety standards for Medicare and Medicaid participating hospitals, critical access hospitals (CAHs), long-term care facilities, intermediate care facilities for individuals with intellectual disabilities (ICF-IID), ambulatory surgery centers (ASCs), hospices which provide inpatient services, religious non-medical health care institutions (RNHCIs), and programs of all-inclusive care for the elderly (PACE) facilities. Further, this final rule will adopt the 2012 edition of the Life Safety Code (LSC) and eliminate references in our regulations to all earlier editions of the Life Safety Code. It will also adopt the 2012 edition of the Health Care Facilities Code, with some exceptions.

  7. Tuberculosis infection control in health facilities in Lithuania: lessons learnt from a capacity support project.

    PubMed

    Turusbekova, N; Ljungqvist, I; Davidavičiene, E; Mikaityte, J; van der Werf, M J

    2016-03-21

    Tuberculosis (TB) infection control (IC) is key in controlling TB transmission in health facilities in Lithuania. This article presents a project that aimed at supporting health care facilities in Lithuania in implementing TB-IC. The project consisted of 1) facility TB-IC assessments, 2) development of facility TB-IC plans, 3) TB-IC training and 4) site visits. We assessed the impact of these activities through a self-assessment questionnaire. The project resulted in limited improvements. Most progress was seen in administrative and managerial activities. Possible reasons for the limited improvements are challenges with funding and the lack of supportive legislation and a national TB-IC plan.

  8. Participation in health planning in a decentralised health system: Experiences from facility governing committees in the Kongwa district of Tanzania.

    PubMed

    Frumence, Gasto; Nyamhanga, Tumaini; Mwangu, Mughwira; Hurtig, Anna-Karin

    2014-01-01

    Tanzania introduced the decentralisation of its health systems in the 1990s in order to provide opportunities for community participation in health planning. Health facility governing committees (HFGCs) were then established to provide room for communities to participate in the management of health service delivery. The objective of this study was to explore the challenges and benefits for the participation of HFGCs in health planning in a decentralised health system. Data were collected using semi-structured interviews and focus group discussions (FGDs). A total of 13 key informants were interviewed from the council and lower-level health facilities. Five FGDs were conducted from five health facilities in one district. Data generated were analysed for themes and patterns. The results of the study suggest that HFGCs are instrumental organs in health planning at the community level and there are several benefits resulting from their participation including an opportunity to address community needs and mobilisation of resources. However, there are some challenges associated with the participation of HFGCs in health planning including a low level of education among committee members and late approval of funds for running health facilities. In conclusion, HFGCs potentially play a significant role in health planning. However, their participation is ineffective due to their limited capacities and disabling environment.

  9. 42 CFR 476.88 - Examination of the operations and records of health care facilities and practitioners.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... care facilities and practitioners. 476.88 Section 476.88 Public Health CENTERS FOR MEDICARE & MEDICAID... health care facilities and practitioners. (a) Authorization to examine records. A facility claiming...— (i) DRG validation; (ii) Outlier review in facilities under a prospective payment system; and...

  10. Assessing Organizational Readiness for a Participatory Occupational Health/Health Promotion Intervention in Skilled Nursing Facilities.

    PubMed

    Zhang, Yuan; Flum, Marian; West, Cheryl; Punnett, Laura

    2015-09-01

    The long-term care sector is characterized by high morbidity and employee turnover, along with associated costs. Effective health protection and health promotion are important to improve physical and psychosocial well-being of caregivers. Assessment of organizational readiness for change is an essential precursor to the successful implementation of workplace programs addressing work climate, structure of tasks and relationships, and other issues that may be perceived as challenging by some within the institution. This study qualitatively assessed readiness of five skilled nursing facilities for a participatory occupational health/health promotion intervention. Selection criteria were developed to screen for program feasibility and ability to conduct prospective evaluations, and information was collected from managers and employees (interviews and focus groups). Three centers were selected for the program, and the first year of formative evaluation and intervention experience was then reviewed to evaluate and modify our selection criteria after the fact. Lessons learned include adding assessment of communication and the structure of problem solving to our selection criteria, improving methods to assess management support in a concrete (potentially nonverbal) form, and obtaining a stated financial commitment and resources to enable the team to function. Assessment of organizational readiness for change is challenging, although necessary to implement effective and sustainable health promotion programs in specific organizations.

  11. Health and Safety Management for Small-scale Methane Fermentation Facilities

    NASA Astrophysics Data System (ADS)

    Yamaoka, Masaru; Yuyama, Yoshito; Nakamura, Masato; Oritate, Fumiko

    In this study, we considered health and safety management for small-scale methane fermentation facilities that treat 2-5 ton of biomass daily based on several years operation experience with an approximate capacity of 5 t·d-1. We also took account of existing knowledge, related laws and regulations. There are no qualifications or licenses required for management and operation of small-scale methane fermentation facilities, even though rural sewerage facilities with a relative similar function are required to obtain a legitimate license. Therefore, there are wide variations in health and safety consciousness of the operators of small-scale methane fermentation facilities. The industrial safety and health laws are not applied to the operation of small-scale methane fermentation facilities. However, in order to safely operate a small-scale methane fermentation facility, the occupational safety and health management system that the law recommends should be applied. The aims of this paper are to clarify the risk factors in small-scale methane fermentation facilities and encourage planning, design and operation of facilities based on health and safety management.

  12. Supportive supervision for medicines management in government health facilities in Kiambu County, Kenya: a health workers’ perspective

    PubMed Central

    Agoro, Oscar Otieno; Osuga, Ben Onyango; Adoyo, Maureen

    2015-01-01

    Introduction Effective supportive supervision is widely recognized as essential for optimal management of medicines in government health facilities and also in contributing towards improved access and utilization of health services. This study sought to examine the extent supportive supervision for medicines management in government health facilities from a health worker perspective. Methods A cross-sectional study was done targeting health workers managing medicines in government health facilities in Kiambu County. One hundred and thirty eight respondents took part in the study which explored the quality of supportive supervision from a health worker's perspective, and also examined the factors influencing their contentment with the level of supervision received. A statistical analysis was done using SPSS 21 and Excel 2013. Results Supervisory visits from all levels of health management were not regularly done, standard checklists were not routinely used, and action plans irregularly developed and followed up. Only 54 (38.6%) respondents were satisfied with the levels of supportive supervision that they received, with satisfaction significantly differing across the professional cadres, χ2 (12, n = 138) = 29.762, p = .003; across the different tiers of health facilities, rs (138) = 0.341, p < .001; and with the education levels of the respondents, rs (138) = 0.381, p < .001. Conclusion The study concluded that supportive supervision for medicines management that government health facilities received was still inadequate, and health workers were dissatisfied with the level of supervision that they received. The study recommends a review of the support supervision policy at the county level to address the unearthed inefficiencies and improve supervision for medicines management in government health facilities. PMID:27386033

  13. The ADA in action at health care facilities.

    PubMed

    Story, Molly F; Kailes, June I; Donald, Christie Mac

    2010-10-01

    The purpose of the work documented here was to assist defendants in legal actions to comply with settlement agreements, consent decrees, and memoranda of understanding. The work involved surveying medical center facilities and interviewing the staff and, based on the results, developing recommendations for compliance. Recommendations are offered for exam tables and chairs, weight scales, and ancillary aids. Guidance on interior design barriers and communication barriers is also provided. Finally, recommendations regarding facility policies and procedures and staff training are outlined.

  14. Title and title page.

    PubMed

    Peh, W C G; Ng, K H

    2008-08-01

    The title gives the first impression of a scientific article, and should accurately convey to a reader what the whole article is about. A good title is short, informative and attractive. The title page provides information about the authors, their affiliations and the corresponding author's contact details.

  15. Physical access to health facilities and contraceptive use in Kenya: evidence from the 2008-2009 Kenya Demographic and Health Survey.

    PubMed

    Ettarh, Remare R; Kyobutungi, Catherine

    2012-09-01

    The objective of the study was to determine the spatial variation in modern contraceptive use and unmet need for family planning across the counties of Kenya and to examine whether the spatial patterns were associated with inequalities in physical access to health facilities. Data were obtained from the 2008-2009 Kenya Demographic and Health Survey and linked to the location of health facilities in the country. Multivariate logistic regression was used to examine the influence of distance to the nearest health facility and health facility density, in addition to other covariates, on modern contraceptive use and unmet need. Overall, the prevalence of modern contraceptive use and unmet need among women aged 15-49 in Kenya was 42.1% and 19.7% respectively. Among the respondents who lived more than 5 km from the nearest health facility modern contraceptive use was significantly less likely compared to women resident 5 km or less from the nearest health facility. Women from counties with higher health facility density were 53% more likely to use modern contraceptives compared to women in counties with low health facility density. Distance and health facility density in the county were not significantly associated with unmet need. Physical access to health facilities is an important determinant of modern contraceptive use and unmet need in Kenya. Strategies should be developed in underserved counties to mitigate the challenge of distance to health facilities, such as delivering services by outreach and mobile facilities.

  16. New Construction, Renovation and Remodeling: What School Nurses Have Learned from Planning New Health Office Facilities

    ERIC Educational Resources Information Center

    Cooper, Leslie

    2005-01-01

    Many school nurses across the nation have had the opportunity to be involved with school renovation and new construction projects in their districts. Renovation and new construction projects allow school nurses the opportunity to work with facilities planners, school officials, and architects to design school health office facilities that enhance…

  17. Older Adult Participation in Health Promotion Programs: Perspectives of Facility Administrators

    ERIC Educational Resources Information Center

    Wright, Tim; Hyner, Gerald C.

    2011-01-01

    Administrators of older adult-centered facilities must identify barriers to the planning and implementation of health promotion programs. In this qualitative research those barriers were identified through in-depth interviews with administrators of older adult-centered facilities. As identified by administrators, the predominant barriers to the…

  18. Public health response to a measles outbreak in a large correctional facility, Queensland, 2013.

    PubMed

    Chatterji, Madhumati; Baldwin, Anne M; Prakash, Rajendra; Vlack, Susan A; Lambert, Stephen B

    2014-12-31

    This report documents the prompt, co-ordinated and effective public health response to a measles outbreak in Queensland in 2013. There were 17 cases in a large, high-security, regional correctional facility, a setting with unique challenges. Recommendations are provided to reduce the likelihood and magnitude of measles outbreaks in correctional facilities.

  19. College and University Facilities Guide for Health, Physical Education, Recreation, and Athletics.

    ERIC Educational Resources Information Center

    American Association for Health, Physical Education, and Recreation, Washington, DC.

    This guide presents information concerned with the planning of areas and facilities for athletics, recreation, outdoor education, and physical and health education. Swimming pools, service areas, ice skating, field houses, arenas, and stadiums are among the many facilities which are considered. Included are many diagrams and sketches giving…

  20. Background Report: Recommendations on Guidance for Diagnostic X-Ray Studies in Federal Health Care Facilities

    EPA Pesticide Factsheets

    This document shares the guidance developed by the Interagency Working Group which was formed to develop guidance to reduce unnecessary radiation exposures from the use of x-rays in the healing arts in Federal health care facilities.

  1. Enhancing the sustainability and climate resiliency of health care facilities: a comparison of initiatives and toolkits.

    PubMed

    Balbus, John; Berry, Peter; Brettle, Meagan; Jagnarine-Azan, Shalini; Soares, Agnes; Ugarte, Ciro; Varangu, Linda; Prats, Elena Villalobos

    2016-09-01

    Extreme weather events have revealed the vulnerability of health care facilities and the extent of devastation to the community when they fail. With climate change anticipated to increase extreme weather and its impacts worldwide-severe droughts, floods, heat waves, and related vector-borne diseases-health care officials need to understand and address the vulnerabilities of their health care systems and take action to improve resiliency in ways that also meet sustainability goals. Generally, the health sector is among a country's largest consumers of energy and a significant source of greenhouse gas emissions. Now it has the opportunity lead climate mitigation, while reducing energy, water, and other costs. This Special Report summarizes several initiatives and compares three toolkits for implementing sustainability and resiliency measures for health care facilities: the Canadian Health Care Facility Climate Change Resiliency Toolkit, the U.S. Sustainable and Climate Resilient Health Care Facilities Toolkit, and the PAHO SMART Hospitals Toolkit of the World Health Organization/Pan American Health Organization. These tools and the lessons learned can provide a critical starting point for any health system in the Americas.

  2. 7 CFR 15b.38 - Health care facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... care. (c) Drug and alcohol addicts. A recipient to which this subpart applies that operates a general hospital or outpatient facility may not discriminate in admission or treatment against a drug or alcohol abuser or alcoholic who is suffering from a medical condition, because of the person's drug or...

  3. Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania

    PubMed Central

    Kuchibanda, Kizito; Mayo, Aloyce W.

    2015-01-01

    The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interview, and observation checklist. The results revealed that healthcare wastes are not quantified or segregated in all the three hospitals. Healthcare wastes at the Shinyanga Regional Referral Hospital are disposed of by on-site incineration and burning and some wastes are disposed off-site. At Kolandoto DDH only on-site burning and land disposal are practiced, while at Kambarage UHC healthcare solid wastes are incinerated, disposed of on land disposal, and burned. Waste management workers do not have formal training in waste management techniques and the hospital administrations pay very little attention to appropriate management of healthcare wastes. In light of this, it is evident that management of healthcare solid wastes is not practiced in accordance with the national and WHO's recommended standards. PMID:26779565

  4. A study of health facilities: implications for reproductive health and HIV/AIDS programs in southern Sudan.

    PubMed

    Mandal, Mahua; Purdin, Susan; McGinn, Therese

    In October 2001, a pilot project to design strategies to reduce HIV/AIDS transmission and improve related reproductive health practices was initiated in southern Sudan. A health facility assessment was conducted in order to determine the type and scope of care given to clients with sexually transmitted infections (STIs). It was found that many health care practitioners did not have basic training in STI diagnosis and management, and no practitioner had training in the syndromic approach. Standardized drug kits received by public facilities did not provide enough STI drugs to serve the population. Private drug stores were the only facilities where condoms were available, though condoms were not sold to women who came to purchase them without their husbands. An adequately functioning health system will be difficult to achieve without ongoing training and supervision, adequate supplies and equipment, and proper rebuilding of infrastructure and systems, such as roads, communication, and education.

  5. Detainee Health Care: Essential Element of Stability Operations

    DTIC Science & Technology

    2012-03-22

    15. SUBJECT TERMS Prisoner of War, Theater Internment Facility Rehabilitative Center, Ministry of Health 16. SECURITY CLASSIFICATION OF: 17...PAGES: 38 KEY TERMS: Prisoner of War, Theater Internment Facility Rehabilitative Center, Ministry of Health CLASSIFICATION: Unclassified The...capabilities. A fully staffed detainee primary care clinic (DPCC) is located within the Theater Internment Facility Rehabilitation Center (TIFRC

  6. Perception and prevalence of work-related health hazards among health care workers in public health facilities in southern India

    PubMed Central

    Senthil, Arasi; Anandh, Balasubramanian; Jayachandran, Palsamy; Thangavel, Gurusamy; Josephin, Diana; Yamini, Ravindran; Kalpana, Balakrishnan

    2015-01-01

    Background: Health care workers (HCWs) are exposed to occupational related health hazards. Measuring worker perception and the prevalence of these hazards can help facilitate better risk management for HCWs, as these workers are envisaged to be the first point of contact, especially in resource poor settings. Objective: To describe the perception of occupational health hazards and self-reported exposure prevalence among HCWs in Southern India. Methods: We used cross sectional design with stratified random sampling of HCWs from different levels of health facilities and categories in a randomly selected district in Southern India. Data on perception and exposure prevalence were collected using a structured interview schedule developed by occupational health experts and administered by trained investigators. Results: A total of 482 HCWs participated. Thirty nine percent did not recognize work-related health hazards, but reported exposure to at least one hazard upon further probing. Among the 81·5% who reported exposure to biological hazard, 93·9% had direct skin contact with infectious materials. Among HCWs reporting needle stick injury, 70·5% had at least one in the previous three months. Ergonomic hazards included lifting heavy objects (42%) and standing for long hours (37%). Psychological hazards included negative feelings (20·3%) and verbal or physical abuse during work (20·5%). Conclusion: More than a third of HCWs failed to recognize work-related health hazards. Despite training in handling infectious materials, HCWs reported direct skin contact with infectious materials and needle stick injuries. Results indicate the need for training oriented toward behavioral change and provision of occupational health services. PMID:25482656

  7. Health physics manual of good practices for tritium facilities

    SciTech Connect

    Blauvelt, R.K.; Deaton, M.R.; Gill, J.T.

    1991-12-01

    The purpose of this document is to provide written guidance defining the generally accepted good practices in use at Department of Energy (DOE) tritium facilities. A {open_quotes}good practice{close_quotes} is an action, policy, or procedure that enhances the radiation protection program at a DOE site. The information selected for inclusion in this document should help readers achieve an understanding of the key radiation protection issues at tritium facilities and provide guidance as to what characterizes excellence from a radiation protection point of view. The ALARA (As Low as Reasonable Achievable) program at DOE sites should be based, in part, on following the good practices that apply to their operations.

  8. Multiplex PageRank.

    PubMed

    Halu, Arda; Mondragón, Raúl J; Panzarasa, Pietro; Bianconi, Ginestra

    2013-01-01

    Many complex systems can be described as multiplex networks in which the same nodes can interact with one another in different layers, thus forming a set of interacting and co-evolving networks. Examples of such multiplex systems are social networks where people are involved in different types of relationships and interact through various forms of communication media. The ranking of nodes in multiplex networks is one of the most pressing and challenging tasks that research on complex networks is currently facing. When pairs of nodes can be connected through multiple links and in multiple layers, the ranking of nodes should necessarily reflect the importance of nodes in one layer as well as their importance in other interdependent layers. In this paper, we draw on the idea of biased random walks to define the Multiplex PageRank centrality measure in which the effects of the interplay between networks on the centrality of nodes are directly taken into account. In particular, depending on the intensity of the interaction between layers, we define the Additive, Multiplicative, Combined, and Neutral versions of Multiplex PageRank, and show how each version reflects the extent to which the importance of a node in one layer affects the importance the node can gain in another layer. We discuss these measures and apply them to an online multiplex social network. Findings indicate that taking the multiplex nature of the network into account helps uncover the emergence of rankings of nodes that differ from the rankings obtained from one single layer. Results provide support in favor of the salience of multiplex centrality measures, like Multiplex PageRank, for assessing the prominence of nodes embedded in multiple interacting networks, and for shedding a new light on structural properties that would otherwise remain undetected if each of the interacting networks were analyzed in isolation.

  9. Race Differences in Mental Health Service Access in a Secure Male Juvenile Justice Facility

    ERIC Educational Resources Information Center

    Dalton, Richard F.; Evans, Lisa J.; Cruise, Keith R.; Feinstein, Ronald A.; Kendrick, Rhonda F.

    2009-01-01

    This study examined whether African American and Caucasian male youths had similar rates of referral to mental health services in a juvenile justice secure facility when controlling for differences obtained in the initial screening and assessment process. Data from the Massachusetts Youth Screening Instrument-2 (MAYSI-2), Initial Health Care…

  10. Training the Auxiliary Health Workers; An Analysis of Functions, Training Content, Training Costs, and Facilities.

    ERIC Educational Resources Information Center

    Health Services and Mental Health Administration (DHEW), Bethesda, MD.

    The booklet describes what each type of worker is allowed to do and presents an overview of the substantive content of the training, length of training, training costs, and kinds of facilities and staff needed. The types of workers include community health aide, homemaker-home health aide, social worker aide, food service supervisor, physical…

  11. Health Professions Education Facilities in the Non-Profit Sector. 1973.

    ERIC Educational Resources Information Center

    Health Resources Administration (DHEW/PHS), Bethesda, MD. Bureau of Health Manpower.

    In this study of the physical facilities of the nation's health professions schools, all schools of dentistry, medicine, optometry, osteopathy, pharmacy, podiatry, public health, and veterinary medicine, and all parent institutions of the schools, were surveyed in May of 1973. The major goals of this pioneering survey were to assess the nature and…

  12. Prevention by Design: Construction and Renovation of Health Care Facilities for Patient Safety and Infection Prevention.

    PubMed

    Olmsted, Russell N

    2016-09-01

    The built environment supports the safe care of patients in health care facilities. Infection preventionists and health care epidemiologists have expertise in prevention and control of health care-associated infections (HAIs) and assist with designing and constructing facilities to prevent HAIs. However, design elements are often missing from initial concepts. In addition, there is a large body of evidence that implicates construction and renovation as being associated with clusters of HAIs, many of which are life threatening for select patient populations. This article summarizes known risks and prevention strategies within a framework for patient safety.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-04-01

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

  15. Factors associated with delivery outside a health facility: cross-sectional study in rural Malawi

    PubMed Central

    Mazalale, Jacob; Kambala, Christabel; Brenner, Stephan; Chinkhumba, Jobiba; Lohmann, Julia; Mathanga, Don P; Robberstad, Bjarne; Muula, Adamson S; De Allegri, Manuela

    2015-01-01

    Objective To identify factors associated with delivery outside a health facility in rural Malawi. Method A cross-sectional survey was conducted in Balaka, Dedza, Mchinji and Ntcheu districts in Malawi in 2013 among women who had completed a pregnancy 12 months prior to the day of the survey. Multilevel logistic regression was used to assess factors associated with delivery outside a facility. Results Of the 1812 study respondents, 9% (n = 159) reported to have delivered outside a facility. Unmarried women were significantly more likely [OR = 1.88; 95% CI (1.086–3.173)] to deliver outside a facility, while women from households with higher socio-economic status [third-quartile OR = 0.51; 95% CI (0.28–0.95) and fourth-quartile OR = 0.48; 95% CI (0.29–0.79)] and in urban areas [OR = 0.39; 95%-CI (0.23–0.67)] were significantly less likely to deliver outside a facility. Women without formal education [OR 1.43; 95% CI (0.96–2.14)] and multigravidae [OR = 1.14; 95% CI (0.98–1.73)] were more likely to deliver outside a health facility at 10% level of significance. Conclusion About 9% of women deliver outside a facility. Policies to encourage facility delivery should not only focus on health systems but also be multisectoral to address women's vulnerability and inequality. Facility-based delivery can contribute to curbing the high maternal illness burden if authorities provide incentives to those not delivering at the facility without losing existing users. PMID:25656750

  16. Needs and opportunities for improving the health, safety, and productivity of medical research facilities.

    PubMed Central

    Hodgson, M; Brodt, W; Henderson, D; Loftness, V; Rosenfeld, A; Woods, J; Wright, R

    2000-01-01

    Medical research facilities, indeed all the nation's constructed facilities, must be designed, operated, and maintained in a manner that supports the health, safety, and productivity of the occupants. The National Construction Goals, established by the National Science and Technology Council, envision substantial improvements in occupant health and worker productivity. The existing research and best practices case studies support this conclusion, but too frequently building industry professionals lack the knowledge to design, construct, operate, and maintain facilities at these optimum levels. There is a need for more research and more collaborative efforts between medical and facilities engineering researchers and practitioners in order to attain the National Construction Goals. Such collaborative efforts will simultaneously support attainment of the National Health Goals. This article is the summary report of the Healthy Buildings Committee for the Leadership Conference: Biomedical Facilities and the Environment sponsored by the National Institutes of Health, the National Association of Physicians for the Environment, and the Association of Higher Education Facilities Officers on 1--2 November 1999 in Bethesda, Maryland, USA. PMID:11124125

  17. Adoption and utilization of electronic health record systems by long-term care facilities in Texas.

    PubMed

    Wang, Tiankai; Biedermann, Sue

    2012-01-01

    Long-term care (LTC) is an important sector in the healthcare industry; however, the adoption of electronic health record (EHR) systems in LTC facilities lags behind that in other sectors of healthcare. This study examines the adoption and utilization of EHRs in LTC facilities in Texas and identifies the barriers preventing implementation of EHRs. A survey instrument was mailed to all Texas LTC facilities between October 2010 and March 2011. The survey found that in Texas, 39.5 percent of LTC facilities have fully or partially implemented EHR systems and 15 percent of LTC facilities have no plans to adopt EHRs yet. There is significant variation in the use of EHR functionalities across the LTC facilities in Texas. In the LTC facilities, the administrative functions of EHRs have been more widely adopted and are more widely utilized than the clinical functions of EHRs. Among the clinical functions adopted, the resident assessment, physician orders, care management plan, and census management are the leading functions used by the LTC facilities in Texas. Lack of capital resources is still the greatest barrier to EHR adoption and implementation. Policy makers, vendors, LTC administrators, educators, and researchers should make more effort to improve EHR adoption in LTC facilities.

  18. Facilities

    NASA Technical Reports Server (NTRS)

    1999-01-01

    An expansion of medical data collection facilities was necessary to implement the Extended Duration Orbiter Medical Project (EDOMP). The primary objective of the EDOMP was to ensure the capability of crew members to reenter the Earth's atmosphere, land, and egress safely following a 16-day flight. Therefore, access to crew members as soon as possible after landing was crucial for most data collection activities. Also, with the advent of EDOMP, the quantity of investigations increased such that the landing day maximum data collection time increased accordingly from two hours to four hours. The preflight and postflight testing facilities at the Johnson Space Center (JSC) required only some additional testing equipment and minor modifications to the existing laboratories in order to fulfill EDOMP requirements. Necessary modifications at the landing sites were much more extensive.

  19. Determinants of Quality of Family Planning Counseling among Private Health Facilities in Lagos.

    PubMed

    Johnson, Doug; Ugaz, Jorge

    2016-09-01

    We use a unique dataset that includes an objective measure of the quality of family planning counseling from 927 private health facilities in Lagos State, Nigeria, to determine which variables at the facility and provider levels are most closely correlated with the quality of family planning counseling. Our data on quality come from mystery client surveys in which the clients posed as women seeking family planning counseling. We find that quality is strongly associated with the cadre of provider, with doctors delivering substantially higher-quality counselling than nurses. Doctors not only outperform nurses overall, but also perform better on each category of quality and spend nearly three minutes longer on average counseling the mystery client. Location, fees charged for the service, and facility type are also strongly correlated with quality. The degree to which a facility specializes in family planning and facility size are only weakly predictive of quality.

  20. Strengthening health facilities for maternal and newborn care: experiences from rural eastern Uganda.

    PubMed

    Namazzi, Gertrude; Waiswa, Peter; Nakakeeto, Margaret; Nakibuuka, Victoria K; Namutamba, Sarah; Najjemba, Maria; Namusaabi, Ruth; Tagoola, Abner; Nakate, Grace; Ajeani, Judith; Peterson, Stefan; Byaruhanga, Romano N

    2015-01-01

    Background In Uganda maternal and neonatal mortality remains high due to a number of factors, including poor quality of care at health facilities. Objective This paper describes the experience of building capacity for maternal and newborn care at a district hospital and lower-level health facilities in eastern Uganda within the existing system parameters and a robust community outreach programme. Design This health system strengthening study, part of the Uganda Newborn Study (UNEST), aimed to increase frontline health worker capacity through district-led training, support supervision, and mentoring at one district hospital and 19 lower-level facilities. A once-off supply of essential medicines and equipment was provided to address immediate critical gaps. Health workers were empowered to requisition subsequent supplies through use of district resources. Minimal infrastructure adjustments were provided. Quantitative data collection was done within routine process monitoring and qualitative data were collected during support supervision visits. We use the World Health Organization Health System Building Blocks to describe the process of district-led health facility strengthening. Results Seventy two per cent of eligible health workers were trained. The mean post-training knowledge score was 68% compared to 32% in the pre-training test, and 80% 1 year later. Health worker skills and competencies in care of high-risk babies improved following support supervision and mentoring. Health facility deliveries increased from 3,151 to 4,115 (a 30% increase) in 2 years. Of 547 preterm babies admitted to the newly introduced kangaroo mother care (KMC) unit, 85% were discharged alive to continue KMC at home. There was a non-significant declining trend for in-hospital neonatal deaths across the 2-year study period. While equipment levels remained high after initial improvement efforts, maintaining supply of even the most basic medications was a challenge, with less than 40% of

  1. Preventing Airborne Disease Transmission: Review of Methods for Ventilation Design in Health Care Facilities

    PubMed Central

    Aliabadi, Amir A.; Rogak, Steven N.; Bartlett, Karen H.; Green, Sheldon I.

    2011-01-01

    Health care facility ventilation design greatly affects disease transmission by aerosols. The desire to control infection in hospitals and at the same time to reduce their carbon footprint motivates the use of unconventional solutions for building design and associated control measures. This paper considers indoor sources and types of infectious aerosols, and pathogen viability and infectivity behaviors in response to environmental conditions. Aerosol dispersion, heat and mass transfer, deposition in the respiratory tract, and infection mechanisms are discussed, with an emphasis on experimental and modeling approaches. Key building design parameters are described that include types of ventilation systems (mixing, displacement, natural and hybrid), air exchange rate, temperature and relative humidity, air flow distribution structure, occupancy, engineered disinfection of air (filtration and UV radiation), and architectural programming (source and activity management) for health care facilities. The paper describes major findings and suggests future research needs in methods for ventilation design of health care facilities to prevent airborne infection risk. PMID:22162813

  2. Health and climate benefits of offshore wind facilities in the Mid-Atlantic United States

    NASA Astrophysics Data System (ADS)

    Buonocore, Jonathan J.; Luckow, Patrick; Fisher, Jeremy; Kempton, Willett; Levy, Jonathan I.

    2016-07-01

    Electricity from fossil fuels contributes substantially to both climate change and the health burden of air pollution. Renewable energy sources are capable of displacing electricity from fossil fuels, but the quantity of health and climate benefits depend on site-specific attributes that are not often included in quantitative models. Here, we link an electrical grid simulation model to an air pollution health impact assessment model and US regulatory estimates of the impacts of carbon to estimate the health and climate benefits of offshore wind facilities of different sizes in two different locations. We find that offshore wind in the Mid-Atlantic is capable of producing health and climate benefits of between 54 and 120 per MWh of generation, with the largest simulated facility (3000 MW off the coast of New Jersey) producing approximately 690 million in benefits in 2017. The variability in benefits per unit generation is a function of differences in locations (Maryland versus New Jersey), simulated years (2012 versus 2017), and facility generation capacity, given complexities of the electrical grid and differences in which power plants are offset. This work demonstrates health and climate benefits of offshore wind, provides further evidence of the utility of geographically-refined modeling frameworks, and yields quantitative insights that would allow for inclusion of both climate and public health in benefits assessments of renewable energy.

  3. 8. Photocopy of printed page (original Page 30 of the ...

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

    8. Photocopy of printed page (original Page 30 of the Souvenir Program 1867-1967 Ridgely Centennial) Photographer unknown. Circa 1967. VIEW NORTHEAST, SOUTHWEST FRONT Ridgely's centennial was celebrated in 1967 and included in the souvenir brochure was page 30. This view shows the subject building with the 1950 modifications to provide for automotive traffic. It was a print of a current photograph. - 510 Central Avenue (Commercial Building), Ridgely, Caroline County, MD

  4. Health providers' perception of quality of care for neonates in health facilities in a municipality in Southern Ghana.

    PubMed

    Elikplim Pomevor, Kokui; Adomah-Afari, Augustine

    2016-10-10

    Purpose The purpose of this paper is to assess available human resources for neonatal care and their skills, in order to explore health providers' perceptions of quality of neonatal care in health facilities in Ghana. Design/methodology/approach Data were gathered using qualitative interviews with health providers working in the maternity and paediatric wards and midwives; direct observation; and documentary review at a regional hospital, a municipal hospital and four health centres in a municipality in a region in Southern Ghana. Data were analysed using thematic framework through the process of coding in six phases to create and establish meaningful patterns. Findings The study revealed that health providers were concerned about the number of staff available, their competence and also equipment available for them to work more efficiently. Some essential equipment for neonatal care was either not available or was non-functional where it was available, while aseptic procedures were not adhered to. Moreover, personal protective equipment such as facemask, caps, aprons were not used except in the labour wards where staff had to change their footwear before entering. Research limitations/implications Limited number of health providers and facilities used, lack of exploration of parents of neonates' perspective of quality of neonatal care in this study and other settings, including the teaching hospitals. The authors did not examine issues related to the ineffective use of IV cannulation for neonates by nurses as well as referral of neonates. Additionally, the authors did not explore the perspectives of management of the municipal and regional health directorates or policy makers of the Ministry of Health and Ghana Health Service regarding the shortage of staff, inadequate provision of medical equipment and infrastructure. Practical implications This paper suggests the need for policy makers to redirect their attention to the issues that would improve the quality of

  5. Antenatal Care as a Means of Increasing Birth in the Health Facility and Reducing Maternal Mortality: A Systematic Review

    PubMed Central

    Berhan, Yifru; Berhan, Asres

    2014-01-01

    Background Although there is a general agreement on the importance of antenatal care to improve the maternal and perinatal health, little is known about its importance to improve health facility delivery in developing countries. The objective of this study was to assess the association of antenatal care with birth in health facility. Methods A systematic review with meta-analysis of Mantel-Haenszel odds ratios was conducted by including seventeen small scale studies that compared antenatal care and health facility delivery between 2003 and 2013. Additionally, national survey data of African countries which included antenatal care, health facility delivery and maternal mortality in their report were included. Data were accessed via a computer based search from MEDLINE, African Journals Online, HINARI and Google Scholar databases. Results The regression analysis of antenatal care with health facility delivery revealed a positive correlation. The pooled analysis also demonstrated that woman attending antenatal care had more than 7 times increased chance of delivering in a health facility. The comparative descriptive analysis, however, demonstrated a big gap between the proportion of antenatal care and health facility delivery by the same individuals (27%–95% vs 4%–45%). Antenatal care and health facility delivery had negative correlation with maternal mortality. Conclusion The present regression and meta-analysis has identified the relative advantage of having antenatal care to give birth in health facilities. However, the majority of women who had antenatal care did not show up to a health facility for delivery. Therefore, future research needs to give emphasis to identifying barriers to health facility delivery despite having antenatal care follow up. PMID:25489186

  6. Gender equality and childbirth in a health facility: Nigeria and MDG5.

    PubMed

    Singh, Kavita; Bloom, Shelah; Haney, Erica; Olorunsaiye, Comfort; Brodish, Paul

    2012-09-01

    This paper examined how addressing gender equality can lead to reductions in maternal mortality in Nigeria through an increased use of facility delivery. Because the majority of maternal complications cannot be predicted and often arise suddenly during labor, delivery and the immediate postpartum period, childbirth in a health facility is key to reducing maternal mortality. This paper used data from the 2008 Nigeria Demographic and Health Survey (DHS) to examine associations of gender measures on the utilization of facility delivery after controlling for socio-demographic factors. Four gender equality measures were studied: household decision-making, financial decision-making, attitudes towards wife beating, and attitudes regarding a wife's ability to refuse sex. Results found older, more educated, wealthier, urban, and working women were more likely to have a facility delivery than their counterparts. In addition ethnicity was a significant variable indicating the importance of cultural and regional diversity. Notably, after controlling for the socioeconomic variables, two of the gender equality variables were significant: household decision-making and attitudes regarding a wife's ability to refuse sex. In resource-poor settings such as Nigeria, women with more decision-making autonomy are likely better able to advocate for and access a health facility for childbirth. Thus programs and policies that focus on gender in addition to focusing on education and poverty have the potential to reduce maternal mortality even further.

  7. Prevalence of Respiratory Protective Devices in U.S. Health Care Facilities

    PubMed Central

    Wizner, Kerri; Stradtman, Lindsay; Novak, Debra; Shaffer, Ronald

    2016-01-01

    An online questionnaire was developed to explore respiratory protective device (RPD) prevalence in U.S. health care facilities. The survey was distributed to professional nursing society members in 2014 and again in 2015 receiving 322 and 232 participant responses, respectively. The purpose of this study was to explore if the emergency preparedness climate associated with Ebola virus disease changed the landscape of RPD use and awareness. Comparing response percentages from the two sampling time frames using bivariate analysis, no significant changes were found in types of RPDs used in health care settings. N95 filtering facepiece respirators continue to be the most prevalent RPD used in health care facilities, but powered air-purifying respirators are also popular, with regional use highest in the West and Midwest. Understanding RPD use prevalence could ensure that health care workers receive appropriate device trainings as well as improve supply matching for emergency RPD stockpiling. PMID:27462029

  8. ACSM Fit Society Page

    MedlinePlus

    ... 2011 -- Exercise for Special Populations 2011 -- Behavior Change & Exercise Adherence 2011 -- Nutrition 2011 -- Winter Health 2010 -- Healthy Aging 2010 -- Weight Loss & Weight Management 2010 -- Fitness Assessment & Injury Prevention 2009 -- Strength Training 2009 -- Menopause ...

  9. Keeping health facilities safe: one way of strengthening the interaction between disease-specific programmes and health systems.

    PubMed

    Harries, Anthony D; Zachariah, Rony; Tayler-Smith, Katie; Schouten, Erik J; Chimbwandira, Frank; Van Damme, Wim; El-Sadr, Wafaa M

    2010-12-01

    The debate on the interaction between disease-specific programmes and health system strengthening in the last few years has intensified as experts seek to tease out common ground and find solutions and synergies to bridge the divide. Unfortunately, the debate continues to be largely academic and devoid of specificity, resulting in the issues being irrelevant to health care workers on the ground. Taking the theme 'What would entice HIV- and tuberculosis (TB)-programme managers to sit around the table on a Monday morning with health system experts', this viewpoint focuses on infection control and health facility safety as an important and highly relevant practical topic for both disease-specific programmes and health system strengthening. Our attentions, and the examples and lessons we draw on, are largely aimed at sub-Saharan Africa where the great burden of TB and HIV ⁄ AIDS resides, although the principles we outline would apply to other parts of the world as well. Health care infections, caused for example by poor hand hygiene, inadequate testing of donated blood, unsafe disposal of needles and syringes, poorly sterilized medical and surgical equipment and lack of adequate airborne infection control procedures, are responsible for a considerable burden of illness amongst patients and health care personnel, especially in resource-poor countries. Effective infection control in a district hospital requires that all the components of a health system function well: governance and stewardship, financing,infrastructure, procurement and supply chain management, human resources, health information systems, service delivery and finally supervision. We argue in this article that proper attention to infection control and an emphasis on safe health facilities is a concrete first step towards strengthening the interaction between disease-specific programmes and health systems where it really matters – for patients who are sick and for the health care workforce who provide

  10. Assessment of Newborn Care Corner in Public Health Facilities of Ludhiana, India.

    PubMed

    Gulati, Samridhi; Sharma, Sarit; Gulati, Rajinder

    2017-03-15

    In this cross-sectional study of 15 public health facilities in Ludhiana, India, we evaluated 22 delivery points for equipment and trained health personal available at Newborn Care Corner (NBCC) for neonatal resuscitation. NBCCs were established at all the delivery points except one, with radiant warmers in place including non-functional warmers at four (18%) delivery points. Self-inflating resuscitation bag was available at 20 delivery points but shoulder roll and masks of both sizes were available at only 4 (18%) and 5 (27%) delivery points, respectively. Only 4 (27%) facilities had round-the-clock availability of a nurse or midwife trained in neonatal resuscitation, whereas none of the facility had round the clock availability of medical officer trained in neonatal resuscitation.

  11. Self-reported performance improvement strategies of highly successful Veterans Health Administration facilities.

    PubMed

    Craig, Thomas J; Perlin, Jonathan B; Fleming, Barbara B

    2007-01-01

    The Veterans Health Administration (VHA) has achieved considerable success in improving health care through the use of clinical performance measures. This report examines the self-reported strategies used by the most successful facilities in the VHA system. For fiscal year 2002, facilities that scored the highest on any of 24 clinical performance measures were queried as to which strategies they used to achieve their level of performance. The most commonly cited strategies across all performance categories were organizational change (55.6%), clinical reminders (41.4%), audit and feedback to providers (39.6%), and staff education (32.5%). Certain strategies were more likely to be cited for 1 or more specific performance categories (eg, clinical reminders for immunization [61.1%], screening [60.6%]). These findings suggest that successful facilities are generally using evidence-based strategies to achieve high clinical performance. However, some evidence-based implementation strategies were rarely cited (eg, use of clinical champions).

  12. Assessment of Clinical Profile of the Patients Treated at Ayurvedic Health Facilities in North India

    PubMed Central

    Kumar, Dinesh; Quasmi, Nafis Ahmed; Chandel, Jameer Khan; Bhardwaj, Ashok Kumar; Raina, Sunil Kumar; Sharma, Y. K.

    2013-01-01

    Since a very long time, a significant number of patients have been seeking treatment at Complementary and Alternative Medicine health facilities, but the disease burden at these facilities has never been assessed and documented. Present cross-sectional study was carried out at Ayurvedic tertiary care hospital to document and to assess the rationale of disease reporting at Ayurvedic institutions of the northern state of India from January 2011 to October 2011. Almost half of the patients’ morbidities were not classified at all into any of the disease categories. The common reported morbidities at study hospital were: Respiratory (10.5%), neuromuscular (9.5%), digestive (9.2%) and circulatory (9.1%) disorders. As the majority of diseases were unclassified, so mainstreaming of the effective disease surveillance would be required to understand the morbidity pattern and successful treatment practices at health facilities. PMID:24130953

  13. [Gerodontology consultation in geriatric facilities: general health status (I)].

    PubMed

    Katsoulis, Joannis; Huber, Sandra; Mericske-Stern, Regina

    2009-01-01

    Dental undertreatment is often seen in the older population. This is particularly true for the elderly living in nursing homes and geriatric hospitals. The progression of chronic diseases results in loss of their independence. They rely on daily support and care due to physical or mental impairment. The visit of a dentist in private praxis becomes difficult or impossible and is a logistic problem. These elderly patients are often not aware of oral and dental problems or these are not addressed. The geriatric hospital Bern, Ziegler, has integrated dental care in the concept of physical rehabilitation of geriatric patients. A total of 139 patients received dental treatment in the years 2005/2006. Their mean age was 83 years, but the segment with > 85 years of age amounted to 46%. The general health examinations reveald multiple and complex disorders. The ASA classification (American Society of Anesthesiologists, Physical Status Classification System) was applied and resulted in 15% = P2 (mild systemic disease, no functional limitation), 47% = P3 (severe systemic disease, definite functional limitations) and 38% = P4 (severe systemic disease, constant threat to life). Eighty-seven of the patients exhibited 3 or more chronic diseases with a prevalence of cardiovascular diseases, musculoskelettal disorders and dementia. Overall the differences between men and women were small, but broncho-pulmonary dieseases were significantly more frequent in women, while men were more often diagnosed with dementia and depression. Verbal communication was limited or not possible with 60% of the patients due to cognitive impairment or aphasia after a stroke. Although the objective treatment need is high, providing dentistry for frail and geriatric patients is characterized by risks due to poor general health conditions, difficulties in communication, limitations in feasibility and lack of adequate aftercare. In order to prevent the problem of undertreatment, elderly independently living

  14. Horizontal equity and efficiency at primary health care facilities in rural Afghanistan: a seemingly unrelated regression approach.

    PubMed

    Johns, Benjamin; Steinhardt, Laura; Walker, Damian G; Peters, David H; Bishai, David

    2013-07-01

    Producing services efficiently and equitably are important goals for health systems. Many countries pursue horizontal equity - providing people with the same illnesses equal access to health services - by locating facilities in remote areas. Staff are often paid incentives to work at such facilities. However, there is little evidence on how many fewer people are treated at remote facilities than facilities in more densely settled areas. This research explores if there is an association between the efficiency of health centers in Afghanistan and the remoteness of their location. Survey teams collected data on facility level inputs and outputs at a stratified random sample of 579 health centers in 2005. Quality of care was measured by observing staff interact with patients and determining if staff completed a set of normative patient care tasks. We used seemingly unrelated regression to determine if facilities in remote areas have fewer outpatient visits than other rural facilities. In this analysis, one equation compares the number of outpatient visits to facility inputs, while another compares quality of care to determinants of quality. The results indicate remote facilities have about 13% fewer outpatient visits than non-remote facilities, holding inputs constant. Our analysis suggests that facilities in remote areas are realizing horizontal equity since their clients are receiving comparable quality of care to those at non-remote facilities. However, we find the average labor cost for a visit at a remote facility is $1.44, but only $0.97 at other rural facilities, indicating that a visit in a remote facility would have to be 'worth' 1.49 times a visit at a rural facility for there to be no equity - efficiency trade-off. In determining where to build or staff health centers, this loss of efficiency may be offset by progress toward a social policy objective of providing services to disadvantaged rural populations.

  15. Environmental Assessment for the Health Protection Instrument Calibration Facility at the Savannah River Site

    SciTech Connect

    Not Available

    1993-08-01

    The purpose of this Environmental Assessment (EA) is to review the possible environmental consequences associated with the construction and operation of a Health Protection Instrument Calibration Facility on the Savannah River Site (SRS). The proposed replacement calibration facility would be located in B Area of SRS and would replace an inadequate existing facility currently located within A Area of SRS (Building 736-A). The new facility would provide laboratories, offices, test equipment and the support space necessary for the SRS Radiation Monitoring Instrument Calibration Program to comply with DOE Orders 5480.4 (Environmental Protection, Safety and Health Protection Standards) and 5480.11 (Radiation Protection for Occupational Workers). The proposed facility would serve as the central site source for the evaluation, selection, inspection, testing, calibration, and maintenance of all SRS radiation monitoring instrumentation. The proposed facility would be constructed on a currently undeveloped portion in B Area of SRS. The exact plot associated with the proposed action is a 1.2 hectare (3 acre) tract of land located on the west side of SRS Road No. 2. The proposed facility would lie approximately 4.4 km (2.75 mi) from the nearest SRS site boundary. The proposed facility would also lie within the confines of the existing B Area, and SRS safeguards and security systems. Archaeological, ecological, and land use reviews have been conducted in connection with the use of this proposed plot of land, and a detailed discussion of these reviews is contained herein. Socioeconomic, operational, and accident analyses were also examined in relation to the proposed project and the findings from these reviews are also contained in this EA.

  16. Turning the page

    PubMed Central

    2015-01-01

    in hand to allow for a more limited production of a paper version of the Annals for RCS fellows and members who continue to elect to receive their Annals in the traditional format. Medical colleges around the world are currently undergoing similar deliberations and for some a digital version may represent the only opportunity to maintain editorial independence – unhindered by the implications of a commercial publishing partner. It is however hoped that for the vast majority of fellows and members, the new and enhanced digital platform will offer significant advantages such that the digital version becomes the de facto medium of choice. Matt Whitaker and the team at the Annals should be congratulated for their sterling efforts in making this transition. The new site, now live at http://publishing.rcseng.ac.uk, will enhance the experience of finding, accessing, reading, citing, sharing and saving articles from the Annals, Bulletin and FDJ. Sign-on will be much easier; page load times quicker and the search engine more powerful and intuitive. The new platform boasts improved functionality, full in-page article text and multi-media, citation tracking, reference generators and advanced social media integration. We are simultaneously launching a new video library where we will be hosting our technical videos. It will, I am certain, become a huge resource for our surgical fraternity. Our new platform will be followed later this year by the inevitable and ubiquitous app, which will allow readers to download issues of the Annals and read them offline and at leisure on whatever their tablet of choice might be. It is my belief that these and forthcoming changes herald the transformation of the Annals into a truly modern journal with all the digital services that authors and readers now rightly expect from their RCS publication. Tim Lane Editor-in-Chief, rcsannalseditor@gmail.com

  17. 7 CFR 1956.143 - Debt restructuring-hospitals and health care facilities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... analysis, a familiarity with the problems of rural health care facilities, a knowledge of the particular... (a) of this section; (6) Information that details what the debtor must do to apply for restructuring... documented information, and make an eligibility determination. (i) Eligibility determination. The...

  18. [3D printing in health care facilities: What legislation in France?].

    PubMed

    Montmartin, M; Meyer, C; Euvrard, E; Pazart, L; Weber, E; Benassarou, M

    2015-11-01

    Health care facilities more and more use 3D printing, including making their own medical devices (MDs). However, production and marketing of MDs are regulated. The goal of our work was to clarify what is the current French regulation that should be applied concerning the production of custom-made MDs produced by 3D printing in a health care facility. MDs consist of all devices used for diagnosis, prevention, or treatment of diseases in patients. Prototypes and anatomic models are not considered as MDs and no specific laws apply to them. Cutting guides, splints, osteosynthesis plates or prosthesis are MDs. In order to become a MD manufacturer in France, a health care facility has to follow the requirements of the 93/42/CEE directive. In addition, custom-made 3D-printed MDs must follow the annex VIII of the directive. This needs the writing of a declaration of conformity and the respect of the essential requirements (proving that a MD is secure and conform to what is expected), the procedure has to be qualified, a risk analysis and a control of the biocompatibility of the material have to be fulfilled. The documents proving that these rules have been respected have to be available. Becoming a regulatory manufacturer of MD in France is possible for a health care facility but the specifications have to be respected.

  19. Adoption factors associated with electronic health record among long-term care facilities: a systematic review

    PubMed Central

    Kruse, Clemens Scott; Mileski, Michael; Alaytsev, Vyachelslav; Carol, Elizabeth; Williams, Ariana

    2015-01-01

    Objectives The Health Information Technology for Economic and Clinical Health (HITECH) Act created incentives for adopting electronic health records (EHRs) for some healthcare organisations, but long-term care (LTC) facilities are excluded from those incentives. There are realisable benefits of EHR adoption in LTC facilities; however, there is limited research about this topic. The purpose of this systematic literature review is to identify EHR adoption factors for LTC facilities that are ineligible for the HITECH Act incentives. Setting We conducted systematic searches of Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete via Ebson B. Stephens Company (EBSCO Host), Google Scholar and the university library search engine to collect data about EHR adoption factors in LTC facilities since 2009. Participants Search results were filtered by date range, full text, English language and academic journals (n=22). Interventions Multiple members of the research team read each article to confirm applicability and study conclusions. Primary and secondary outcome measures Researchers identified common themes across the literature: specifically facilitators and barriers to adoption of the EHR in LTC. Results Results identify facilitators and barriers associated with EHR adoption in LTC facilities. The most common facilitators include access to information and error reduction. The most prevalent barriers include initial costs, user perceptions and implementation problems. Conclusions Similarities span the system selection phases and implementation process; of those, cost was the most common mentioned. These commonalities should help leaders in LTC facilities align strategic decisions to EHR adoption. This review may be useful for decision-makers attempting successful EHR adoption, policymakers trying to increase adoption rates without expanding incentives and vendors that produce EHRs. PMID:25631311

  20. Assessing the Contributions of Private Health Facilities in a Pioneer Private-Public Partnership in Childhood Immunization in Nigeria

    PubMed Central

    Oluoha, Chukwuemeka; Ahaneku, Hycienth

    2014-01-01

    The vision of Nigeria’s immunization program is to reach and sustain routine immunization coverage of greater than 90% for all vaccines by 2020. In order to achieve this, Abia state embarked on a unique private-public partnership (PPP) between private health facilities and the Abia state ministry of health. The aim of this partnership was to collaborate with private health facilities to provide free childhood immunization services in the state - the first of its kind in Nigeria. This is a retrospective study of the 2011 Abia state, Nigeria monthly immunization data. In the 4 local governments operating the PPP, 45% (79/175) of the health facilities that offered immunization services in 2011 were private health facilities and 55% (96/175) were public health facilities. However, 21% of the immunization services took place in private health facilities while 79% took place in public health facilities. Private health facilities were shown to have a modest contribution to immunization in the 4 local governments involved in the PPP. Efforts should be made to expand PPP in immunization nationally to improve immunization services in Nigeria. PMID:28299112

  1. Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study

    PubMed Central

    2012-01-01

    Background Violence at work is one of the major concerns in health care activities. The aim of this study was to identify the prevalence of physical and non-physical violence in a general health care facility in Italy and to assess the relationship between violence and psychosocial factors, thereby providing a basis for appropriate intervention. Methods All health care workers from a public health care facility were invited to complete a questionnaire containing questions on workplace violence. Three questionnaire-based cross-sectional surveys were conducted. The response rate was 75 % in 2005, 71 % in 2007, and 94 % in 2009. The 2009 questionnaire contained the VIF (Violent Incident Form) for reporting violent incidents, the DCS (demand/control/support) model for job strain, the Colquitt 20 item questionnaire for perceived organizational justice, and the GHQ-12 General Health Questionnaire for the assessment of mental health. Results One out of ten workers reported physical assault, and one out of three exposure to non-physical violence in the workplace in the previous year. Nurses and physicians were the most exposed occupational categories, whereas the psychiatric and emergency departments were the services at greatest risk of violence. Workers exposed to non-physical violence were subject to high job strain, low support, low perceived organizational justice, and high psychological distress. Conclusion Our study shows that health care workers in an Italian local health care facility are exposed to violence. Workplace violence was associated with high demand and psychological disorders, while job control, social support and organizational justice were protective factors. PMID:22551645

  2. Comment: PAGES: Always Bottom Up

    NASA Astrophysics Data System (ADS)

    Bradley, Raymond

    2004-06-01

    In a recent article titled ``Back to the Future'' (Eos, 16 March, p. 107) L. C. Witton lays out the goals of IGBP-PAGES for the next few years, noting that, ``PAGES is aiming to become a truly bottom-up organization that is driven by the insights of individual scientists....'' In fact, PAGES has always been a truly bottom-up organization, and this statement unfortunately fosters the view that it has been otherwise. Those who promote such a view choose to overlook the countless workshops that PAGES has organized, largely at the suggestion of those ``at the bottom,'' and the numerous publications that have resulted from these meetings.

  3. Webinar Presentation: Environmental Exposures and Health Risks in California Child Care Facilities: First Steps to Improve Environmental Health where Children Spend Time

    EPA Pesticide Factsheets

    This presentation, Environmental Exposures and Health Risks in California Child Care Facilities: First Steps to Improve Environmental Health where Children Spend Time, was given at the NIEHS/EPA Children's Centers 2016 Webinar Series: Exposome.

  4. Effects of health and safety problem recognition on small business facility investment

    PubMed Central

    2013-01-01

    Objectives This study involved a survey of the facility investment experiences, which was designed to recognize the importance of health and safety problems, and industrial accident prevention. Ultimately, we hope that small scale industries will create effective industrial accident prevention programs and facility investments. Methods An individual survey of businesses’ present physical conditions, recognition of the importance of the health and safety problems, and facility investment experiences for preventing industrial accidents was conducted. The survey involved 1,145 business operators or management workers in small business places with fewer than 50 workers in six industrial complexes. Results Regarding the importance of occupational health and safety problems (OHS), 54.1% said it was “very important”. Received technical and financial support, and industrial accidents that occurred during the past three years were recognized as highly important for OHS. In an investigation regarding facility investment experiences for industrial accident prevention, the largest factors were business size, greater numbers of industrial accidents, greater technical and financial support received, and greater recognition of the importance of the OHS. The related variables that decided facility investment for industry accident prevention in a logistic regression analysis were the experiences of business facilities where industrial accidents occurred during the past three years, received technical and financial support, and recognition of the OHS. Those considered very important were shown to be highly significant. Conclusions Recognition of health and safety issues was higher when small businesses had experienced industrial accidents or received financial support. The investment in industrial accidents was greater when health and safety issues were recognized as important. Therefore, the goal of small business health and safety projects is to prioritize health and safety

  5. Health Facilities Safety in Natural Disasters: Experiences and Challenges from South East Europe

    PubMed Central

    Radovic, Vesela; Vitale, Ksenija; Tchounwou, Paul B.

    2012-01-01

    The United Nations named 2010 as a year of natural disasters, and launched a worldwide campaign to improve the safety of schools and hospitals from natural disasters. In the region of South East Europe, Croatia and Serbia have suffered the greatest impacts of natural disasters on their communities and health facilities. In this paper the disaster management approaches of the two countries are compared, with a special emphasis on the existing technological and legislative systems for safety and protection of health facilities and people. Strategic measures that should be taken in future to provide better safety for health facilities and populations, based on the best practices and positive experiences in other countries are recommended. Due to the expected consequences of global climate change in the region and the increased different environmental risks both countries need to refine their disaster preparedness strategies. Also, in the South East Europe, the effects of a natural disaster are amplified in the health sector due to its critical medical infrastructure. Therefore, the principles of environmental security should be implemented in public health policies in the described region, along with principles of disaster management through regional collaborations. PMID:22754465

  6. Implementation of a Zebrafish Health Program in a Research Facility: A 4-Year Retrospective Study

    PubMed Central

    Pereira, Nuno; Franco, Maysa; Vale, Liliana; Pereira, Margarida; Cunha, Mónica V.; Amaro, Ana; Albuquerque, Teresa; Rebelo, Manuel

    2016-01-01

    Abstract In the past two decades, zebrafish (Danio rerio)-based research has contributed to significant scientific advances. Still, husbandry and health programs did not evolve at the same pace, as evidenced by the absence of general guidelines. Health monitoring is essential to animal welfare, to permit animal exchanges across facilities, to contribute to robust experimental results, and for data reproducibility. In this study, we report a health program implemented in a zebrafish research facility to prevent, monitor, and control pathogen, and disease dissemination. This program includes quarantine, routine health screening of sentinels, and nonroutine screenings of retired animals and sick/moribund individuals. An extensive list of clinical signs, lesions, and pathogens was monitored based on: daily observation of fish, necropsy, histology, and bacterial culture. The results indicate that the combined analysis of sentinels with the evaluation of sick/moribund animals enables a comprehensive description not only of pathogen prevalence but also of clinical and histopathologic lesions of resident animals. The establishment of a quarantine program revealed to be effective in the reduction of Pseudoloma neurophilia frequency in the main aquaria room. Finally, characterization of the colony health status based on this multiapproach program shows a low prevalence of lesions and pathogens in the facility. PMID:27186875

  7. Implementation of a Zebrafish Health Program in a Research Facility: A 4-Year Retrospective Study.

    PubMed

    Borges, Ana C; Pereira, Nuno; Franco, Maysa; Vale, Liliana; Pereira, Margarida; Cunha, Mónica V; Amaro, Ana; Albuquerque, Teresa; Rebelo, Manuel

    2016-07-01

    In the past two decades, zebrafish (Danio rerio)-based research has contributed to significant scientific advances. Still, husbandry and health programs did not evolve at the same pace, as evidenced by the absence of general guidelines. Health monitoring is essential to animal welfare, to permit animal exchanges across facilities, to contribute to robust experimental results, and for data reproducibility. In this study, we report a health program implemented in a zebrafish research facility to prevent, monitor, and control pathogen, and disease dissemination. This program includes quarantine, routine health screening of sentinels, and nonroutine screenings of retired animals and sick/moribund individuals. An extensive list of clinical signs, lesions, and pathogens was monitored based on: daily observation of fish, necropsy, histology, and bacterial culture. The results indicate that the combined analysis of sentinels with the evaluation of sick/moribund animals enables a comprehensive description not only of pathogen prevalence but also of clinical and histopathologic lesions of resident animals. The establishment of a quarantine program revealed to be effective in the reduction of Pseudoloma neurophilia frequency in the main aquaria room. Finally, characterization of the colony health status based on this multiapproach program shows a low prevalence of lesions and pathogens in the facility.

  8. Behind bars: the compelling case for academic health centers partnering with correctional facilities.

    PubMed

    Trestman, Robert L; Ferguson, Warren; Dickert, Jeff

    2015-01-01

    Academic health centers (AHCs), particularly those that are publicly funded institutions, have as their mission the treatment of disadvantaged populations, the training of the next generation of clinicians, and the development and dissemination of new knowledge to reduce the burden of disease and improve the health of individuals and populations. Incarcerated populations have the most prevalent and acute disease burden and health disparities in the United States, even in comparison with inner-city populations. Yet, only a small proportion of AHCs have reached out to incarcerated populations to fulfill their mission. Those AHCs that have partnered with correctional facilities have overcome concerns about the value and popularity of "training behind bars"; the cost, liability, and pragmatics of caring for a medically complicated population; and the viability of correctional health research and extramural research funding. They have done so to great benefit to patients, students, and faculty. Partnering with correctional facilities to provide health care offers opportunities for AHCs to fulfill their core missions of clinical service, education, and research, while also enhancing their financial stability, to the benefit of all. In this Commentary, the authors discuss, based on their experiences, these concerns, how existing partnerships have overcome them, and the benefits of such relationships to both AHCs and correctional facilities.

  9. Treatment of uncomplicated malaria at public health facilities and medicine retailers in south-eastern Nigeria

    PubMed Central

    2011-01-01

    Background At primary care facilities in Nigeria, national treatment guidelines state that malaria should be symptomatically diagnosed and treated with artemisinin-based combination therapy (ACT). Evidence from households and health care providers indicates that many patients do not receive the recommended treatment. This study sought to determine the extent of the problem by collecting data as patients and caregivers leave health facilities, and determine what influences the treatment received. Methods A cross-sectional cluster survey of 2,039 respondents exiting public health centres, pharmacies and patent medicine dealers was undertaken in urban and rural settings in Enugu State, south-eastern Nigeria. Results Although 79% of febrile patients received an anti-malarial, only 23% received an ACT. Many patients (38%) received sulphadoxine-pyrimethamine (SP). A further 13% of patients received an artemisinin-derivative as a monotherapy. An estimated 66% of ACT dispensed was in the correct dose. The odds of a patient receiving an ACT was highly associated with consumer demand (OR: 55.5, p < 0.001). Conclusion Few febrile patients attending public health facilities, pharmacies and patent medicine dealers received an ACT, and the use of artemisinin-monotherapy and less effective anti-malarials is concerning. The results emphasize the importance of addressing both demand and supply-side influences on malaria treatment and the need for interventions that target consumer preferences as well as seek to improve health service provision. PMID:21651787

  10. A Medical Decision Support System for the Space Station Health Maintenance Facility

    PubMed Central

    Ostler, David V.; Gardner, Reed M.; Logan, James S.

    1988-01-01

    NASA is developing a Health Maintenance Facility (HMF) to provide the equipment and supplies necessary to deliver medical care in the Space Station. An essential part of the Health Maintenance Facility is a computerized Medical Decision Support System (MDSS) that will enhance the ability of the medical officer (“paramedic” or “physician”) to maintain the crew's health, and to provide emergency medical care. The computer system has four major functions: 1) collect and integrate medical information into an electronic medical record from Space Station medical officers, HMF instrumentation, and exercise equipment; 2) provide an integrated medical record and medical reference information management system; 3) manage inventory for logistical support of supplies and secure pharmaceuticals; 4) supply audio and electronic mail communications between the medical officer and ground based flight surgeons. ImagesFigure 1

  11. The Mistreatment of Women during Childbirth in Health Facilities Globally: A Mixed-Methods Systematic Review

    PubMed Central

    Bohren, Meghan A.; Vogel, Joshua P.; Hunter, Erin C.; Lutsiv, Olha; Makh, Suprita K.; Souza, João Paulo; Aguiar, Carolina; Saraiva Coneglian, Fernando; Diniz, Alex Luíz Araújo; Tunçalp, Özge; Javadi, Dena; Oladapo, Olufemi T.; Khosla, Rajat; Hindin, Michelle J.; Gülmezoglu, A. Metin

    2015-01-01

    Background Despite growing recognition of neglectful, abusive, and disrespectful treatment of women during childbirth in health facilities, there is no consensus at a global level on how these occurrences are defined and measured. This mixed-methods systematic review aims to synthesize qualitative and quantitative evidence on the mistreatment of women during childbirth in health facilities to inform the development of an evidence-based typology of the phenomenon. Methods and Findings We searched PubMed, CINAHL, and Embase databases and grey literature using a predetermined search strategy to identify qualitative, quantitative, and mixed-methods studies on the mistreatment of women during childbirth across all geographical and income-level settings. We used a thematic synthesis approach to synthesize the qualitative evidence and assessed the confidence in the qualitative review findings using the CERQual approach. In total, 65 studies were included from 34 countries. Qualitative findings were organized under seven domains: (1) physical abuse, (2) sexual abuse, (3) verbal abuse, (4) stigma and discrimination, (5) failure to meet professional standards of care, (6) poor rapport between women and providers, and (7) health system conditions and constraints. Due to high heterogeneity of the quantitative data, we were unable to conduct a meta-analysis; instead, we present descriptions of study characteristics, outcome measures, and results. Additional themes identified in the quantitative studies are integrated into the typology. Conclusions This systematic review presents a comprehensive, evidence-based typology of the mistreatment of women during childbirth in health facilities, and demonstrates that mistreatment can occur at the level of interaction between the woman and provider, as well as through systemic failures at the health facility and health system levels. We propose this typology be adopted to describe the phenomenon and be used to develop measurement tools

  12. Heat stress and inadequate sanitary facilities at workplaces - an occupational health concern for women?

    PubMed

    Venugopal, Vidhya; Rekha, Shanmugam; Manikandan, Krishnamoorthy; Latha, Perumal Kamalakkannan; Vennila, Viswanathan; Ganesan, Nalini; Kumaravel, Perumal; Chinnadurai, Stephen Jeremiah

    2016-01-01

    Background Health concerns unique to women are growing with the large number of women venturing into different trades that expose them to hot working environments and inadequate sanitation facilities, common in many Indian workplaces. Objective The study was carried out to investigate the health implications of exposures to hot work environments and inadequate sanitation facilities at their workplaces for women workers. Design A cross-sectional study was conducted with 312 women workers in three occupational sectors in 2014-2015. Quantitative data on heat exposures and physiological heat strain indicators such as core body temperature (CBT), sweat rate (SwR), and urine specific gravity (USG) were collected. A structured questionnaire captured workers perceptions about health impacts of heat stress and inadequate sanitary facilities at the workplace. Results Workplace heat exposures exceeded the threshold limit value for safe manual work for 71% women (Avg. wet bulb globe temperature=30°C±2.3°C) during the study period. Eighty-seven percent of the 200 women who had inadequate/no toilets at their workplaces reported experiencing genitourinary problems periodically. Above normal CBT, SwR, and USG in about 10% women workers indicated heat strain and moderate dehydration that corroborated well with their perceptions. Observed significant associations between high-heat exposures and SwR (t=-2.3879, p=0.0192), inadequate toilet facilities and self-reported adverse heat-related health symptoms (χ (2)=4.03, p=0.0444), and prevalence of genitourinary issues (χ (2)=42.92, p=0.0005×10(-7)) reemphasize that heat is a risk and lack of sanitation facilities is a major health concern for women workers. Conclusions The preliminary evidence suggests that health of women workers is at risk due to occupational heat exposures and inadequate sanitation facilities at many Indian workplaces. Intervention through strong labor policies with gender sensitivity is the need of the hour

  13. Heat stress and inadequate sanitary facilities at workplaces – an occupational health concern for women?

    PubMed Central

    Venugopal, Vidhya; Rekha, Shanmugam; Manikandan, Krishnamoorthy; Latha, Perumal Kamalakkannan; Vennila, Viswanathan; Ganesan, Nalini; Kumaravel, Perumal; Chinnadurai, Stephen Jeremiah

    2016-01-01

    Background Health concerns unique to women are growing with the large number of women venturing into different trades that expose them to hot working environments and inadequate sanitation facilities, common in many Indian workplaces. Objective The study was carried out to investigate the health implications of exposures to hot work environments and inadequate sanitation facilities at their workplaces for women workers. Design A cross-sectional study was conducted with 312 women workers in three occupational sectors in 2014–2015. Quantitative data on heat exposures and physiological heat strain indicators such as core body temperature (CBT), sweat rate (SwR), and urine specific gravity (USG) were collected. A structured questionnaire captured workers perceptions about health impacts of heat stress and inadequate sanitary facilities at the workplace. Results Workplace heat exposures exceeded the threshold limit value for safe manual work for 71% women (Avg. wet bulb globe temperature=30°C±2.3°C) during the study period. Eighty-seven percent of the 200 women who had inadequate/no toilets at their workplaces reported experiencing genitourinary problems periodically. Above normal CBT, SwR, and USG in about 10% women workers indicated heat strain and moderate dehydration that corroborated well with their perceptions. Observed significant associations between high-heat exposures and SwR (t=−2.3879, p=0.0192), inadequate toilet facilities and self-reported adverse heat-related health symptoms (χ2=4.03, p=0.0444), and prevalence of genitourinary issues (χ2=42.92, p=0.0005×10−7) reemphasize that heat is a risk and lack of sanitation facilities is a major health concern for women workers. Conclusions The preliminary evidence suggests that health of women workers is at risk due to occupational heat exposures and inadequate sanitation facilities at many Indian workplaces. Intervention through strong labor policies with gender sensitivity is the need of the hour to

  14. Parent-Friendly Web Pages.

    ERIC Educational Resources Information Center

    Farmer, Lesley S. J.

    2000-01-01

    Discusses how librarians can help parents become more knowledgeable about the Internet so they can guide their children in Internet use and become technologically independent. Recommends that school libraries develop Web pages that parents can access and discusses Web page design, content for children, and content for parents. (LRW)

  15. Web Page Design (Part Three).

    ERIC Educational Resources Information Center

    Descy, Don E.

    1997-01-01

    Discusses fonts as well as design considerations that should be reviewed when designing World Wide Web pages and sites to make them easier for clients to use and easier to maintain. Also discusses the simplicity of names; organization of pages, folders, and files; and sites to help build Web sites. (LRW)

  16. People, Process and Technology: Strategies for Assuring Sustainable Implementation of EMRs at Public-Sector Health Facilities in Kenya.

    PubMed

    Kang'a, Samuel G; Muthee, Veronica M; Liku, Nzisa; Too, Diana; Puttkammer, Nancy

    2016-01-01

    The Ministry of Health (MoH) rollout of electronic medical record systems (EMRs) has continuously been embraced across health facilities in Kenya since 2012. This has been driven by a government led process supported by PEPFAR that recommended standardized systems for facilities. Various strategies were deployed to assure meaningful and sustainable EMRs implementation: sensitization of leadership; user training, formation of health facility-level multi-disciplinary teams; formation of county-level Technical Working Groups; data migration; routine data quality assessments; point of care adoption; successive release of software upgrades; and power provision. Successes recorded include goodwill and leadership from the county management (22 counties), growth in the number of EMR trained users (2561 health care workers), collaboration in among other things, data migration(90 health facilities completed) and establishment of county TWGs (13 TWGs). Sustenance of EMRs demand across facilities is possible through; county TWGs oversight, timely resolution of users' issues and provision of reliable power.

  17. People, Process and Technology: Strategies for Assuring Sustainable Implementation of EMRs at Public-Sector Health Facilities in Kenya

    PubMed Central

    Kang’a, Samuel G.; Muthee, Veronica M.; Liku, Nzisa; Too, Diana; Puttkammer, Nancy

    2016-01-01

    The Ministry of Health (MoH) rollout of electronic medical record systems (EMRs) has continuously been embraced across health facilities in Kenya since 2012. This has been driven by a government led process supported by PEPFAR that recommended standardized systems for facilities. Various strategies were deployed to assure meaningful and sustainable EMRs implementation: sensitization of leadership; user training, formation of health facility-level multi-disciplinary teams; formation of county-level Technical Working Groups; data migration; routine data quality assessments; point of care adoption; successive release of software upgrades; and power provision. Successes recorded include goodwill and leadership from the county management (22 counties), growth in the number of EMR trained users (2561 health care workers), collaboration in among other things, data migration(90 health facilities completed) and establishment of county TWGs (13 TWGs). Sustenance of EMRs demand across facilities is possible through; county TWGs oversight, timely resolution of users’ issues and provision of reliable power. PMID:28269864

  18. A 'mystery client' evaluation of adolescent sexual and reproductive health services in health facilities from two regions in Tanzania.

    PubMed

    Mchome, Zaina; Richards, Esther; Nnko, Soori; Dusabe, John; Mapella, Elizabeth; Obasi, Angela

    2015-01-01

    Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people's access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region) trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning). The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers' mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people's efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed.

  19. A case study of potential human health impacts from petroleum coke transfer facilities.

    PubMed

    Dourson, Michael L; Chinkin, Lyle R; MacIntosh, David L; Finn, Jennifer A; Brown, Kathleen W; Reid, Stephen B; Martinez, Jeanelle M

    2016-11-01

    Petroleum coke or "petcoke" is a solid material created during petroleum refinement and is distributed via transfer facilities that may be located in densely populated areas. The health impacts from petcoke exposure to residents living in proximity to such facilities were evaluated for a petcoke transfer facilities located in Chicago, Illinois. Site-specific, margin of safety (MOS) and margin of exposure (MOE) analyses were conducted using estimated airborne and dermal exposures. The exposure assessment was based on a combined measurement and modeling program that included multiyear on-site air monitoring, air dispersion modeling, and analyses of soil and surfaces in residential areas adjacent to two petcoke transfer facilities located in industrial areas. Airborne particulate matter less than 10 microns (PM10) were used as a marker for petcoke. Based on daily fence line monitoring, the average daily PM10 concentration at the KCBX Terminals measured on-site was 32 μg/m(3), with 89% of 24-hr average PM10 concentrations below 50 μg/m(3) and 99% below 100 μg/m(3). A dispersion model estimated that the emission sources at the KCBX Terminals produced peak PM10 levels attributed to the petcoke facility at the most highly impacted residence of 11 μg/m(3) on an annual average basis and 54 μg/m(3) on 24-hr average basis. Chemical indicators of petcoke in soil and surface samples collected from residential neighborhoods adjacent to the facilities were equivalent to levels in corresponding samples collected at reference locations elsewhere in Chicago, a finding that is consistent with limited potential for off-site exposure indicated by the fence line monitoring and air dispersion modeling. The MOE based upon dispersion model estimates ranged from 800 to 900 for potential inhalation, the primary route of concern for particulate matter. This indicates a low likelihood of adverse health effects in the surrounding community. Implications: Handling of petroleum coke at

  20. Reese Sorenson's Individual Professional Page

    NASA Technical Reports Server (NTRS)

    Sorenson, Reese; Nixon, David (Technical Monitor)

    1998-01-01

    The subject document is a World Wide Web (WWW) page entitled, "Reese Sorenson's Individual Professional Page." Its can be accessed at "http://george.arc.nasa.gov/sorenson/personal/index.html". The purpose of this page is to make the reader aware of me, who I am, and what I do. It lists my work assignments, my computer experience, my place in the NASA hierarchy, publications by me, awards received by me, my education, and how to contact me. Writing this page was a learning experience, pursuant to an element in my Job Description which calls for me to be able to use the latest computers. This web page contains very little technical information, none of which is classified or sensitive.

  1. Trident Web page

    SciTech Connect

    Johnson, Randall P.; Fernandez, Juan C.

    2012-06-25

    An Extensive Diagnostic Suite Enables Cutting-edge Research at Trident The Trident Laser Facility at Los Alamos National Laboratory is an extremely versatile Nd:glass laser system dedicated to high energy density physics research and fundamental laser-matter interactions. Trident's Unique Laser Capabilities Provide an Ideal Platform for Many Experiments. The laser system consists of three high energy beams which can be delivered into two independent target experimental areas. The target areas are equipped with an extensive suite of diagnostics for research in ultra-intense laser matter interactions, dynamic material properties, and laser-plasma instabilities. Several important discoveries and first observations have been made at Trident including laser-accelerated MeV mono-energetic ions, nonlinear kinetic plasma waves, transition between kinetic and fluid nonlinear behavior, as well as other fundamental laser-matter interaction processes. Trident's unique long-pulse capabilities have enabled state-of-the-art innovations in laser-launched flyer-plates, and other unique loading techniques for material dynamics research.

  2. The way we were: health library life seen through the pages of the Medical Library Bulletin of the Thames Regions, 1974-94.

    PubMed

    Sawers, Caroline

    2005-09-01

    The Medical Library Bulletin of the Thames Regions reflected the development of health-service libraries over the 20 years it existed. Originally begun as a practical aid to improving services by encouraging co-operation, improving communication and giving instructive advice, it charted the work of health-service librarians and the growth of their services. The articles contained in it covered professional developments and wider political issues as they occurred, and illustrated the extension of the librarians' knowledge and skills. Leslie Morton, Library Adviser to the British Postgraduate Medical Federation, edited almost every issue, starting at a time when there was little guidance or professional literature available for health-service librarians.

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

    PubMed Central

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

    2016-01-01

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

  4. [Medicolegal opinions assessing the ability to undergo imprisonment vs. capacity of the Prison Health Service facilities].

    PubMed

    Jurek, Tomasz; Bujak, Marek; Szostak, Maciej; Swiatek, Barbara

    2008-01-01

    Estimating the subject's ability to undergo imprisonment has become a medicolegal opinionating problem. Polish penal law indicates the presence of negative prerequisites, such as a "serious disease" and "important health-associated reasons". In these cases, the conditions of imprisonment pose a direct danger of death or detriment to health. Interruption of imprisonment or remission of the penalty of imprisonment must constitute the only possibility of avoiding such dangers. In his opinion, the expert should define the health-associated needs of the condemned and the possibilities of meeting such needs in the situation of imprisonment, also taking into consideration the capacity of the prison health service facility and its cooperation with regular health care institutions.

  5. Satisfaction with a computerized practitioner order-entry system at two military health care facilities.

    PubMed

    Wilson, J P; Bulatao, P T; Rascati, K L

    2000-12-01

    User satisfaction with a computerized practitioner order-entry (POE) system at two military health care facilities was studied. A survey was mailed in May 1998 to providers authorized to enter drug orders into the Composite Health Care System (CHCS) (including two clinical pharmacists) and pharmacy staff members at two department of defense (DOD) medical treatment facilities. Of 189 questionnaires with the potential to be returned completed, 112 were usable, for a net response rate of 59.3%. The internal consistency of the survey items measuring user satisfaction (Cronbach's alpha) was 0.86. The typical respondent was male, was employed by the DOD, had fair to excellent computer and typing skills, had received eight hours or less of training on the CHCS POE system, had been using the system for two years or less, and had been a health care practitioner for 10 years or less. Overall, users were satisfied with the POE system (mean +/- S.D. rating of 3.78 +/- 0.87 on a 5-point scale where 5 represented the highest satisfaction level). Satisfaction was correlated most strongly with ratings of the POE system's efficiency. Nonphysicians were more satisfied, on average, than physicians. No significant relationship was found between other individual characteristics and satisfaction. Qualitative analysis reinforced the finding that users were interested in efficiency issues. Overall, users at two military health care facilities were satisfied with a computerized POE system. Satisfaction was most strongly correlated with the perceived efficiency of the system.

  6. Facility type and primary care performance in sub-district health promotion hospitals in Northern Thailand

    PubMed Central

    Kitreerawutiwong, Nithra; Jordan, Sue; Hughes, David

    2017-01-01

    Background Poor and middle-income Thai people rely heavily on primary care health services. These are staffed by a range of professionals. However, it is unknown whether the performance of primary care varies according to the staffing and organization of local service delivery units. Tambon (sub-district) health promotion hospitals (THPHs) were introduced in 2009 to upgrade the services offered by the previous health centres, but were faced with continuing shortages of doctors and nurses. The Ministry of Public Health (MoPH) designated three categories of THPH, defined according to whether they were regularly staffed by a medical practitioner, a qualified nurse or non-clinical public health officers. This study aimed to compare the performance of primary care offered by the three different types of primary care facilities in one public health region of Northern Thailand (Public Health Region 2). Methods A cross-sectional survey was undertaken in 2013. Data were collected on accessibility, continuity, comprehensiveness, co-ordination and community orientation of care from 825 patients attending 23 primary care facilities. These were selected to include the three officially-designated types of Tambon (sub-district) health promotion hospitals (THPHs) led by medical, nursing or public health personnel. Survey scores were compared in unadjusted and adjusted analyses. Results THPHs staffed only by public health officers achieved the highest performance score (Mean = 85.14, SD. = 7.30), followed by THPHs staffed by qualified nurses (Mean = 82.86, SD. = 7.06). THPHs staffed by a doctor on rotation returned the lowest scores (Mean = 81.63, SD. = 7.22). Conclusions Differences in overall scores resulted mainly from differences in reported accessibility, continuity, and comprehensiveness of care, rather than staff skill-mix per se. Policy on quality improvement should therefore focus on improving performance in these areas. PMID:28339494

  7. Examining Inequities in Incidence of Catastrophic Health Expenditures on Different Healthcare Services and Health Facilities in Nigeria

    PubMed Central

    Onwujekwe, Obinna; Hanson, Kara; Uzochukwu, Benjamin

    2012-01-01

    Objective There is limited evidence about levels of socio-economic and other differences in catastrophic health spending in Nigeria and in many sub-Saharan African countries. The study estimated the level of catastrophic healthcare expenditures for different healthcare services and facilities and their distribution across socioeconomic status (SES) groups. Methods The study took place in four Local Government Areas in southeast Nigeria. Data were collected using interviewer-administered questionnaires administered to 4873 households. Catastrophic health expenditures (CHE) were measured using a threshold of 40% of monthly non-food expenditure. We examined both total monthly health expenditure and disaggregated expenditure by source and type of care. Results The average total household health expenditure per month was 2354 Naira ($19.6). For outpatient services, average monthly expenditure was 1809 Naira ($15.1), whilst for inpatient services it was 610 Naira ($5.1). Higher health expenditures were incurred by urban residents and the better-off SES groups. Overall, 27% of households incurred CHE, higher for poorer socioeconomic groups and for rural residents. Only 1.0% of households had a member that was enrolled in a health insurance scheme. Conclusion The worse-off households (the poorest SES and rural dwellers) experienced the highest burden of health expenditure. There was almost a complete lack of financial risk protection. Health reform mechanisms are needed to ensure universal coverage with financial risk protection mechanisms. PMID:22815828

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

    PubMed

    Arnold, Shaye Beverly

    2014-10-01

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

  9. Measuring the quality of child health care at first-level facilities.

    PubMed

    Gouws, Eleanor; Bryce, Jennifer; Pariyo, George; Armstrong Schellenberg, Joanna; Amaral, João; Habicht, Jean-Pierre

    2005-08-01

    Sound policy and program decisions require timely information based on valid and relevant measures. Recent findings suggest that despite the availability of effective and affordable guidelines for the management of sick children in first-level health facilities in developing countries, the quality and coverage of these services remains low. We report on the development and evaluation of a set of summary indices reflecting the quality of care received by sick children in first-level facilities. The indices were first developed through a consultative process to achieve face validity by involving technical experts and policymakers. The definition of evaluation measures for many public health programs stops at this point. We added a second phase in which standard statistical techniques were used to evaluate the content and construct validity of the indices and their reliability, drawing on data sets from the multi-country evaluation of integrated management of childhood illness (MCE) in Brazil, Tanzania and Uganda. The statistical evaluation identified important conceptual errors in the indices arising from the theory-driven expert review. The experts had combined items into inappropriate indicators resulting in summary indices that were difficult to interpret and had limited validity for program decision making. We propose a revised set of summary indices for the measurement of child health care in developing countries that is supported by both expert and statistical reviews and that led to similar programmatic insights across the three countries. We advocate increased cross-disciplinary research within public health to improve measurement approaches. Child survival policymakers, program planners and implementers can use these tools to improve their monitoring and so increase the health impact of investments in health facility care.

  10. Label Review Training: Module 1: Label Basics, Page 6

    EPA Pesticide Factsheets

    Page 6, Pesticide labels translate results of our extensive evaluations of pesticide products into conditions, directions and precautions that define parameters for use of a pesticide with the goal of ensuring protection of human health and the environment

  11. Assessment of Malaria Reporting and Epidemic Preparedness Systems in Health Facilities in Eldoret West District, Uasin Gishu County, Kenya

    PubMed Central

    Kirinyet, Ruth C.; Juma, Ahmad

    2016-01-01

    The most important factor in reducing the impact of an epidemic is a timely response with implementation of effective control measures at the point of detection. This study sought to assess the malaria reporting and epidemic preparedness systems of health facilities in Eldoret West District, Kenya. A cross-sectional study design was adapted. A census technique was used to select all the forty five health facilities in the district comprising of government, mission and non-governmental facilities. An interviewer administered questionnaire was used for data collection and analysis done using Stata. Categorical variables were summarized as frequencies and corresponding percentages. The overall reporting rate was 91.7% for all the health facilities. Only 15 health facilities (33%) plotted malaria trend lines for number of cases of malaria. Malaria epidemics were reported within 24 hours in 22 health facilities but they lacked the appropriate supplies to respond to confirmed cases or epidemics. The overall malaria reporting completeness rate was above 90% implying that the malaria surveillance system was generally good. Concerted efforts by concerned stakeholders should ensure improvement of malaria epidemic preparedness system in all health facilities and provision of information to health personnel on malaria outbreak response strategies. PMID:28299154

  12. Preparedness of County Referral Health Facilities in Implementing Adolescent Friendly Health Services: A Case Study of Mama Lucy Kibaki Hosptal

    PubMed Central

    Owuondo, Pacific Akinyi; Mwaura-Tenembergen, Wanja; Adoyo, Maureen; Kiilu, Elizabeth M.

    2015-01-01

    Health service delivery is a key pillar of the health system management .The World Health Organization recently emphasized the need to develop adolescent -friendly health services to improve the care provided to young people throughout the world. However, there is limited peer reviewed literature on this subject therefore necessitating assessment of whether the existing health facilities are prepared to implement the adolescent friendly health services. Adolescent friendly health services remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. After International Conference on Population and Development in 1994, countries started implementing adolescent friendly health services. The Government of Kenya together with partners in an attempt to address the health challenges came up with the Adolescent package of care (APOC) in 2013 whose guidelines were finalized in November 2014 and released for use by service providers . Despite this package of care, there is still ineffective staff capacity in relation to skills and knowledge gap of health professionals, training needs, health resources as well as health system factors that can affect implementation of AFHS. The study explored ways of mitigating or addressing the barriers to implementation of these services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 348 health care providers and 472 adolescents in Mam Lucy Kibaki Hospital from 3rd May 2014 to 16 June 2014 .The key informants were mainly nurses, clinical officers and Medical doctors who were working at the health service delivery area at the time of study and were interviewed using an interview guide. The managers at the hospital were interviewed using an in-depth interview guide while the adolescents were interviewed through interview guide and focused

  13. Management of diabetes mellitus and hypertension at UNRWA primary health care facilities in Lebanon.

    PubMed

    Yusef, J I

    2000-01-01

    A cross-sectional descriptive study was conducted at all UNRWA primary health care facilities in Lebanon Field, to assess the quality of care of diabetes mellitus and hypertension. The study reviewed 2202 records of diabetic and hypertensive patients. Both diseases were present at an early age (< 40 years), with family history, obesity and sedentary lifestyle being the main risk factors. The major complication was cardiovascular disease followed by retinopathy. Action-oriented measures to improve the organization and management of the health care services were identified.

  14. Psychiatric components of a Health Maintenance Facility (HMF) on Space Station

    NASA Technical Reports Server (NTRS)

    Santy, Patricia A.

    1987-01-01

    The operational psychiatric requirements for a comprehensive Health Maintenance Facility (HMF) on a permanently manned Space Station are examined. Consideration is given to the psychological health maintenance program designed for the diagnosis of mental distress in astronauts during flight and for prevention of mental breakdown. The types of mental disorders that can possibly affect the astronauts in flight are discussed, including various organic, psychotic, and affective mental disorders, as well as anxiety, adjustment, and somatoform/dissociative disorders. Special attention is given to therapeutic considerations for psychiatric operations on Space Station, such as restraints, psychopharmacology, psychotherapy, and psychosocial support.

  15. Compliance with infection prevention and control in oral health-care facilities: a global perspective.

    PubMed

    Oosthuysen, Jeanné; Potgieter, Elsa; Fossey, Annabel

    2014-12-01

    Many publications are available on the topic of compliance with infection prevention and control in oral health-care facilities all over the world. The approaches of developing and developed countries show wide variation, but the principles of infection prevention and control are the same globally. This study is a systematic review and global perspective of the available literature on infection prevention and control in oral health-care facilities. Nine focus areas on compliance with infection-control measures were investigated: knowledge of infectious occupational hazards; personal hygiene and care of hands; correct application of personal protective equipment; use of environmental barriers and disposable items; sterilisation (recirculation) of instruments and handpieces; disinfection (surfaces) and housekeeping; management of waste disposal; quality control of dental unit waterlines, biofilms and water; and some special considerations. Various international studies from developed countries have reported highly scientific evidence-based information. In developed countries, the resources for infection prevention and control are freely available, which is not the case in developing countries. The studies in developing countries also indicate serious shortcomings with regard to infection prevention and control knowledge and education in oral health-care facilities. This review highlights the fact that availability of resources will always be a challenge, but more so in developing countries. This presents unique challenges and the opportunity for innovative thinking to promote infection prevention and control.

  16. Celebrating Dr. King. Poetry Pages.

    ERIC Educational Resources Information Center

    Fina, Allan de

    1992-01-01

    Poetry that relates to the beliefs and actions of Martin Luther King, Jr. can be used to help students appreciate the civil rights leader's contributions, examine their own aspirations, and critically analyze poems. A reproducible poetry page is included. (IAH)

  17. Code AI Personal Web Pages

    NASA Technical Reports Server (NTRS)

    Garcia, Joseph A.; Smith, Charles A. (Technical Monitor)

    1998-01-01

    The document consists of a publicly available web site (george.arc.nasa.gov) for Joseph A. Garcia's personal web pages in the AI division. Only general information will be posted and no technical material. All the information is unclassified.

  18. Health facility service availability and readiness for intrapartum and immediate postpartum care in Malawi: A cross-sectional survey.

    PubMed

    Kozuki, Naoko; Oseni, Lolade; Mtimuni, Angella; Sethi, Reena; Rashidi, Tambudzai; Kachale, Fannie; Rawlins, Barbara; Gupta, Shivam

    2017-01-01

    This analysis seeks to identify strengths and gaps in the existing facility capacity for intrapartum and immediate postpartum fetal and neonatal care, using data collected as a part of Malawi's Helping Babies Breath program evaluation. From August to September 2012, the Maternal and Child Health Integrated Program (MCHIP) conducted a cross-sectional survey in 84 Malawian health facilities to capture current health facility service availability and readiness and health worker capacity and practice pertaining to labor, delivery, and immediate postpartum care. The survey collected data on availability of equipment, supplies, and medications, and health worker knowledge and performance scores on intrapartum care simulation and actual management of real clients at a subset of facilities. We ran linear regression models to identify predictors of high simulation performance of routine delivery care and management of asphyxiated newborns across all facilities surveyed. Key supplies for infection prevention and thermal care of the newborn were found to be missing in many of the surveyed facilities. At the health center level, 75% had no clinician trained in basic emergency obstetric care or newborn care and 39% had no midwife trained in the same. We observed that there were no proportional increases in available transport and staff at a facility as catchment population increased. In simulations of management of newborns with breathing problems, health workers were able to complete a median of 10 out of 16 tasks for a full-term birth case scenario and 20 out of 30 tasks for a preterm birth case scenario. Health workers who had more years of experience appeared to perform worse. Our study provides a benchmark and highlights gaps for future evaluations and studies as Malawi continues to make strides in improving facility-based care. Further progress in reducing the burden of neonatal and fetal death in Malawi will be partly predicated on guaranteeing properly equipped and

  19. Health facility service availability and readiness for intrapartum and immediate postpartum care in Malawi: A cross-sectional survey

    PubMed Central

    Oseni, Lolade; Mtimuni, Angella; Sethi, Reena; Rashidi, Tambudzai; Kachale, Fannie; Rawlins, Barbara; Gupta, Shivam

    2017-01-01

    This analysis seeks to identify strengths and gaps in the existing facility capacity for intrapartum and immediate postpartum fetal and neonatal care, using data collected as a part of Malawi’s Helping Babies Breath program evaluation. From August to September 2012, the Maternal and Child Health Integrated Program (MCHIP) conducted a cross-sectional survey in 84 Malawian health facilities to capture current health facility service availability and readiness and health worker capacity and practice pertaining to labor, delivery, and immediate postpartum care. The survey collected data on availability of equipment, supplies, and medications, and health worker knowledge and performance scores on intrapartum care simulation and actual management of real clients at a subset of facilities. We ran linear regression models to identify predictors of high simulation performance of routine delivery care and management of asphyxiated newborns across all facilities surveyed. Key supplies for infection prevention and thermal care of the newborn were found to be missing in many of the surveyed facilities. At the health center level, 75% had no clinician trained in basic emergency obstetric care or newborn care and 39% had no midwife trained in the same. We observed that there were no proportional increases in available transport and staff at a facility as catchment population increased. In simulations of management of newborns with breathing problems, health workers were able to complete a median of 10 out of 16 tasks for a full-term birth case scenario and 20 out of 30 tasks for a preterm birth case scenario. Health workers who had more years of experience appeared to perform worse. Our study provides a benchmark and highlights gaps for future evaluations and studies as Malawi continues to make strides in improving facility-based care. Further progress in reducing the burden of neonatal and fetal death in Malawi will be partly predicated on guaranteeing properly equipped and

  20. A guide to population-related home pages on the World Wide Web.

    PubMed

    Malsawma, Z

    1996-10-01

    The number of home pages on the World Wide Web is increasing, and the information they contain is constantly being updated. The Australian National University's Demography and Population Studies World-Wide Web Virtual Library (http://coombs.anu.edu.au/ResFacilities DemographyPage.html) has links to 155 pertinent sites. Some of the outstanding home pages containing population information pertaining to the US or generated by US agencies include that of 1) the US Census Bureau, 2) the US state census data centers, 3) the National Center for Health Statistics, 4) the National Institute on Aging, 5) American Demographics, Inc., 6) the UN Population Information Network, 7) the Demographic and Health Surveys, 8) the Population Reference Bureau, 9) the Population Index, 10) the US Census Bureau's International Programs Center, and 11) POPLINE. International development information can be found by visiting the web sites of 1) the International Institute for Sustainable Development, 2) USAID, 3) the UN Development Programme, and 4) the World Bank. Population Associations which have web sites include 1) the Population Association of America, 2) the Association of Population Libraries and Information Centers-International, and 3) the Association of Population Centers. Collections of population web sites can be found at Internet Resources for Demographers and Population and Reproductive Health. Finally, a directory of population organizations is also available.

  1. Physical Exposure to Seismic Hazards of Health Facilities in Mexico City, Mexico

    NASA Astrophysics Data System (ADS)

    Rodriguez, S. M.; Novelo Casanova, D.

    2010-12-01

    Although health facilities are essential infrastructure during disasters and emergencies, they are also usually highly vulnerable installations in the case of the occurrence of large and major earthquakes. Hospitals are one of the most complex critical facilities in modern cities and they are used as first response in emergency situations. The operability of a hospital must be maintained after the occurrence of a local strong earthquake in order to satisfy the need for medical care of the affected population. If a health facility is seriously damaged, it cannot fulfill its function when most is needed. In this case, hospitals become a casualty of the disaster. To identify the level of physical exposure of hospitals to seismic hazards in Mexico City, we analyzed their geographic location with respect to the seismic response of the different type of soils of the city from past earthquakes, mainly from the events that occurred on September 1985 (Ms= 8.0) and April 1989 (Ms= 6.9). Seismic wave amplification in this city is the result of the interaction of the incoming seismic waves with the soft and water saturated clay soils, on which a large part of Mexico City is built. The clay soils are remnants of the lake that existed in the Valley of Mexico and which has been drained gradually to accommodate the growing urban sprawl. Hospital facilities were converted from a simple database of names and locations into a map layer of resources. This resource layer was combined with other map layers showing areas of seismic microzonation in Mexico City. This overlay was then used to identify those hospitals that may be threatened by the occurrence of a large or major seismic event. We analyzed the public and private hospitals considered as main health facilities. Our results indicate that more than 50% of the hospitals are highly exposed to seismic hazards. Besides, in most of these health facilities we identified the lack of preventive measures and preparedness to reduce their

  2. FACTORS INFLUENCING THE CHOICE OF HEALTH CARE PROVIDING FACILITY AMONG WORKERS IN A LOCAL GOVERNMENT SECRETARIAT IN SOUTH WESTERN NIGERIA

    PubMed Central

    Uchendu, O.C.; Ilesanmi, O.S.; Olumide, A.E.

    2013-01-01

    Background: There is increasing interest in the choice of health care providing facility in Nigeria. Objectives: This study aimed to assess the factors influencing choice and satisfaction with health service providers among local government staff. Methods: A cross sectional survey of all 312 workers in a Local Government Secretariat in South West Nigeria was done. Chi Square and logistic regression analysis was done. Results: The mean age was 38.6 ± 7.5 years, 55% were females and 71.7% had tertiary education. The median monthly family income of the respondents was N 28, 000 (N3,000 – N500,000), with 24.4% earning a monthly income of N21, 000 to N30, 000. Many (72.3%) utilized public health facilities attributing the choice to the low cost of services. Respondents who are satisfied with their usual care providing facilities are 12.2 times more likely to have used public facilities than private facilities (95%, CI 3.431 – 43.114). Respondents who described the quality with ease of getting care/short waiting times as being good are 3.9 times more likely to have private facilities as their chosen health care providing facility (95%, CI 1.755 – 8.742). Cost/payment for service is 2.9 times more likely to predict the use of public health facility as the usual health care provider. Conclusion: Private facilities though costlier do not appear to be providing better services than public facilities. To increase access to health care the cost of services and the waiting time are important factors to address. PMID:25161426

  3. Have computers, will travel: providing on-site library instruction in rural health facilities using a portable computer lab.

    PubMed

    Neilson, Christine J

    2010-01-01

    The Saskatchewan Health Information Resources Partnership (SHIRP) provides library instruction to Saskatchewan's health care practitioners and students on placement in health care facilities as part of its mission to provide province-wide access to evidence-based health library resources. A portable computer lab was assembled in 2007 to provide hands-on training in rural health facilities that do not have computer labs of their own. Aside from some minor inconveniences, the introduction and operation of the portable lab has gone smoothly. The lab has been well received by SHIRP patrons and continues to be an essential part of SHIRP outreach.

  4. Current status of sharps waste management in the lower-level health facilities in Tanzania.

    PubMed

    Manyele, Samwel V; Mujuni, Churchil M

    2010-10-01

    Sharps waste is part of infectious medical waste, management of which is a critical problem in Tanzanian health facilities. This study aimed at assessing the current status of sharps waste management in lower level health facilities (LLHFs) in Ilala Municipality in Tanzania. In this study a sample of 135 LLHFs (103 dispensaries, 13 clinics, 11 laboratories, and 8 health centers) was involved. The average number of workers per facility was 10, with positively skewed probability density function (up to 80 workers). The average patient-to-workers ratio was 5.87. About 59% of the LLHFs improvised sharps waste containers (SWCs). Sharps waste was transported by hands in 77% of LLHFs leading to high risks of exposure to needle stick injuries. Boots, aprons and masks were among the personal protective equipment (PPE) missing in most LLHFs, while latex gloves that cannot protect workers from injuries caused by sharps waste were readily available. Most facilities stored sharps waste for about 72 hours (before treatment), which is beyond the recommended maximum storage time of 24 hours. About 39.3% of LLHFs utilized on-site single-chamber incinerators for sharps waste treatment, which are of poor design, have rusted mechanical parts, short and rusted chimneys, and without automatic flame ignition burners. It is concluded that sharps waste management in LLHFs is poor, which puts workers, the public and the environment at risk of exposure to blood-borne pathogens. It is, therefore, important that the municipality should establish a waste processing center which will collect and incinerate all sharps waste.

  5. A Healthy Investment: Building the Facilities to Train the Next Generation of Nursing and Allied Health Professionals

    ERIC Educational Resources Information Center

    Woods, Bob

    2013-01-01

    A growing number of community colleges are investing in new facilities and programs to train health care workers in a variety of professions, including nursing, radiology, health information technology, physical therapy, dentistry, and surgical technology. Community colleges have historically offered job training programs in health care, but with…

  6. Occupational traumatic injuries among workers in health care facilities - United States, 2012-2014.

    PubMed

    Gomaa, Ahmed E; Tapp, Loren C; Luckhaupt, Sara E; Vanoli, Kelly; Sarmiento, Raymond Francis; Raudabaugh, William M; Nowlin, Susan; Sprigg, Susan M

    2015-04-24

    In 2013, one in five reported nonfatal occupational injuries occurred among workers in the health care and social assistance industry, the highest number of such injuries reported for all private industries. In 2011, U.S. health care personnel experienced seven times the national rate of musculoskeletal disorders compared with all other private sector workers. To reduce the number of preventable injuries among health care personnel, CDC's National Institute for Occupational Safety and Health (NIOSH), with collaborating partners, created the Occupational Health Safety Network (OHSN) to collect detailed injury data to help target prevention efforts. OHSN, a free, voluntary surveillance system for health care facilities, enables prompt and secure tracking of occupational injuries by type, occupation, location, and risk factors. This report describes OHSN and reports on current findings for three types of injuries. A total of 112 U.S. facilities reported 10,680 OSHA-recordable* patient handling and movement (4,674 injuries); slips, trips, and falls (3,972 injuries); and workplace violence (2,034 injuries) injuries occurring from January 1, 2012-September 30, 2014. Incidence rates for patient handling; slips, trips, and falls; and workplace violence were 11.3, 9.6, and 4.9 incidents per 10,000 worker-months,† respectively. Nurse assistants and nurses had the highest injury rates of all occupations examined. Focused interventions could mitigate some injuries. Data analyzed through OHSN identify where resources, such as lifting equipment and training, can be directed to potentially reduce patient handling injuries. Using OHSN can guide institutional and national interventions to protect health care personnel from common, disabling, preventable injuries.

  7. Newborn Care in the Home and Health Facility: Formative Findings for Intervention Research in Cambodia

    PubMed Central

    Bazzano, Alessandra N.; Taub, Leah; Oberhelman, Richard A.; Var, Chivorn

    2016-01-01

    Global coverage and scale up of interventions to reduce newborn mortality remains low, though progress has been achieved in improving newborn survival in many low-income settings. An important factor in the success of newborn health interventions, and moving to scale, is appropriate design of community-based programs and strategies for local implementation. We report the results of formative research undertaken to inform the design of a newborn health intervention in Cambodia. Information was gathered on newborn care practices over a period of three months using multiple qualitative methods of data collection in the primary health facility and home setting. Analysis of the data indicated important gaps, both at home and facility level, between recommended newborn care practices and those typical in the study area. The results of this formative research have informed strategies for behavior change and improving referral of sick infants in the subsequent implementation study. Collection and dissemination of data on newborn care practices from settings such as these can contribute to efforts to advance survival, growth and development of newborns for intervention research, and for future newborn health programming. PMID:28009812

  8. Newborn Care in the Home and Health Facility: Formative Findings for Intervention Research in Cambodia.

    PubMed

    Bazzano, Alessandra N; Taub, Leah; Oberhelman, Richard A; Var, Chivorn

    2016-12-21

    Global coverage and scale up of interventions to reduce newborn mortality remains low, though progress has been achieved in improving newborn survival in many low-income settings. An important factor in the success of newborn health interventions, and moving to scale, is appropriate design of community-based programs and strategies for local implementation. We report the results of formative research undertaken to inform the design of a newborn health intervention in Cambodia. Information was gathered on newborn care practices over a period of three months using multiple qualitative methods of data collection in the primary health facility and home setting. Analysis of the data indicated important gaps, both at home and facility level, between recommended newborn care practices and those typical in the study area. The results of this formative research have informed strategies for behavior change and improving referral of sick infants in the subsequent implementation study. Collection and dissemination of data on newborn care practices from settings such as these can contribute to efforts to advance survival, growth and development of newborns for intervention research, and for future newborn health programming.

  9. A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana.

    PubMed

    Ahiabu, Mary-Anne; Tersbøl, Britt P; Biritwum, Richard; Bygbjerg, Ib C; Magnussen, Pascal

    2016-03-01

    Resistance to antibiotics is increasing globally and is a threat to public health. Research has demonstrated a correlation between antibiotic use and resistance development. Developing countries are the most affected by resistance because of high infectious disease burden, limited access to quality assured antibiotics and more optimal drugs and poor antibiotic use practices. The appropriate use of antibiotics to slow the pace of resistance development is crucial. The study retrospectively assessed antibiotic prescription practices in four public and private primary health-care facilities in Eastern Region, Ghana using the WHO/International Network for the Rational Use of Drugs rational drug use indicators. Using a systematic sampling procedure, 400 prescriptions were selected per facility for the period April 2010 to March 2011. Rational drug use indicators were assessed in the descriptive analysis and logistic regression was used to explore for predictors of antibiotic prescription. Average number of medicines prescribed per encounter was 4.01, and 59.9% of prescriptions had antibiotics whilst 24.2% had injections. In total, 79.2% and 88.1% of prescribed medicines were generics and from the national essential medicine list, respectively. In the multivariate analysis, health facility type (odds ratio [OR] = 2.05; 95% confidence interval [CI]: 1.42, 2.95), patient age (OR = 0.97; 95% CI: 0.97, 0.98), number of medicines on a prescription (OR = 1.85; 95% CI: 1.63, 2.10) and 'no malaria drug' on prescription (OR = 5.05; 95% CI: 2.08, 12.25) were associated with an antibiotic prescription. A diagnosis of upper respiratory tract infection was positively associated with antibiotic use. The level of antibiotic use varied depending on the health facility type and was generally high compared with the national average estimated in 2008. Interventions that reduce diagnostic uncertainty in illness management should be considered. The National Health Insurance

  10. Determinants and trends in health facility-based deliveries and caesarean sections among married adolescent girls in Bangladesh

    PubMed Central

    Shahabuddin, A S M; Delvaux, Thérèse; Utz, Bettina; Bardají, Azucena; De Brouwere, Vincent

    2016-01-01

    Objective To identify the determinants and measure the trends in health facility-based deliveries and caesarean sections among married adolescent girls in Bangladesh. Methods In order to measure the trends in health facility-based deliveries and caesarean sections, Bangladesh Demographic Health Survey (BDHS) data sets were analysed (BDHS; 1993–1994, 1996–1997, 1999–2000, 2004, 2007, 2011). The BDHS 2011 data sets were analysed to identify the determinants of health facility-based deliveries and caesarean sections. A total of 2813 adolescent girls (aged 10–19 years) were included for analysis. Bivariate and multivariate analyses were performed. Results Health facility-based deliveries have continuously increased among adolescents in Bangladesh over the past two decades from 3% in 1993–1994 to 24.5% in 2011. Rates of population-based and facility-based caesarean sections have increased linearly among all age groups of women including adolescents. Although the country's overall (population-based) caesarean section rate among adolescents was within acceptable range (11.6%), a rate of nearly 50% health facility level caesarean sections among adolescent girls is alarming. Among adolescent girls, use of antenatal care (ANC) appeared to be the most important predictor of health facility-based delivery (OR: 4.04; 95% CI 2.73 to 5.99), whereas the wealth index appeared as the most important predictor of caesarean sections (OR: 5.7; 95% CI 2.74 to 12.1). Conclusions Maternal health-related interventions should be more targeted towards adolescent girls in order to encourage them to access ANC and promote health facility-based delivery. Rising trends of caesarean sections require further investigation on indication and provider–client-related determinants of these interventions among adolescent girls in Bangladesh. PMID:27633641

  11. DOE standard: Integration of environment, safety, and health into facility disposition activities. Volume 2: Appendices

    SciTech Connect

    1998-05-01

    This volume contains the appendices that provide additional environment, safety, and health (ES and H) information to complement Volume 1 of this Standard. Appendix A provides a set of candidate DOE ES and H directives and external regulations, organized by hazard types that may be used to identify potentially applicable directives to a specific facility disposition activity. Appendix B offers examples and lessons learned that illustrate implementation of ES and H approaches discussed in Section 3 of Volume 1. Appendix C contains ISMS performance expectations to guide a project team in developing and implementing an effective ISMS and in developing specific performance criteria for use in facility disposition. Appendix D provides guidance for identifying potential Applicable or Relevant and Appropriate Requirements (ARARs) when decommissioning facilities fall under the Comprehensive Environmental Response, Compensation, Liability Act (CERCLA) process. Appendix E discusses ES and H considerations for dispositioning facilities by privatization. Appendix F is an overview of the WSS process. Appendix G provides a copy of two DOE Office of Nuclear Safety Policy and Standards memoranda that form the bases for some of the guidance discussed within the Standard. Appendix H gives information on available hazard analysis techniques and references. Appendix I provides a supplemental discussion to Sections 3.3.4, Hazard Baseline Documentation, and 3.3.6, Environmental Permits. Appendix J presents a sample readiness evaluation checklist.

  12. Electronic health records use and barriers and benefits to use in skilled nursing facilities.

    PubMed

    Filipova, Anna A

    2013-07-01

    The purpose of this study was to determine the levels of automation for 21 clinical functions and the benefits and barriers to electronic health records use in skilled nursing facilities in one of the Midwestern states in the US. A cross-sectional design was implemented. Data were collected from nursing home administrators using a mail and online survey approach. A total of 156 usable questionnaires of 397 distributed were returned, for a 39.30% response rate. While many facilities reported fully automated Minimum Data Set assessments, licensed nurse clinical notes, and care plans, there remained a predominant reliance on paper for functions, such as diagnostic tests and consults. Although many facilities had advanced toward using automation to produce quality reports, they were lagging behind in the use of automated clinical decision support and summary reports. The top two barriers included the amount of capital needed and the cost for hardware and infrastructure. Facilities with paper records were more likely to identify those barriers for functions, such as clinical notes and assessments. The top three benefits were quality patient care monitoring, management control of performance, and anywhere/anytime easier access to clinical data. The study concludes with recommendations to nursing home leaders and other stakeholders.

  13. Potential community and public health impacts of medically supervised safer smoking facilities for crack cocaine users

    PubMed Central

    Shannon, Kate; Ishida, Tomiye; Morgan, Robert; Bear, Arthur; Oleson, Megan; Kerr, Thomas; Tyndall, Mark W

    2006-01-01

    There is growing evidence of the public health and community harms associated with crack cocaine smoking, particularly the risk of blood-borne transmission through non-parenteral routes. In response, community advocates and policy makers in Vancouver, Canada are calling for an exemption from Health Canada to pilot a medically supervised safer smoking facility (SSF) for non-injection drug users (NIDU). Current reluctance on the part of health authorities is likely due to the lack of existing evidence surrounding the extent of related harm and potential uptake of such a facility among NIDUs in this setting. In November 2004, a feasibility study was conducted among 437 crack cocaine smokers. Univariate analyses were conducted to determine associations with willingness to use a SSF and logistic regression was used to adjust for potentially confounding variables (p < 0.05). Variables found to be independently associated with willingness to use a SSF included recent injection drug use (OR = 1.72, 95% CI: 1.09–2.70), having equipment confiscated or broken by police (OR = 1.96, 95% CI: 1.24–2.85), crack bingeing (OR = 2.16, 95% CI: 1.39–3.12), smoking crack in public places (OR = 2.48, 95% CI: 1.65–3.27), borrowing crack pipes (OR = 2.50, 95% CI: 1.86–3.40), and burns/ inhaled brillo due to rushing smoke in public places (OR = 4.37, 95% CI: 2.71–8.64). The results suggest a strong potential for a SSF to reduce the health related harms and address concerns of public order and open drug use among crack cocaine smokers should a facility be implemented in this setting. PMID:16403229

  14. Three Genome Sequences of Legionella pneumophila subsp. pascullei Associated with Colonization of a Health Care Facility

    PubMed Central

    Kozak-Muiznieks, Natalia A.; Morrison, Shatavia S.; Sammons, Scott; Rowe, Lori A.; Sheth, Mili; Frace, Michael; Lucas, Claressa E.; Loparev, Vladimir N.; Raphael, Brian H.

    2016-01-01

    Here, we report the complete genome sequences of three Legionella pneumophila subsp. pascullei strains (including both serogroup 1 and 5 strains) that were found in the same health care facility in 1982 and 2012. PMID:27151801

  15. Medicare and Medicaid programs; fire safety requirements for certain health care facilities; amendment. Final rule.

    PubMed

    2006-09-22

    This final rule adopts the substance of the April 15, 2004 tentative interim amendment (TIA) 00-1 (101), Alcohol Based Hand Rub Solutions, an amendment to the 2000 edition of the Life Safety Code, published by the National Fire Protection Association (NFPA). This amendment allows certain health care facilities to place alcohol-based hand rub dispensers in egress corridors under specified conditions. This final rule also requires that nursing facilities at least install battery-operated single station smoke alarms in resident rooms and common areas if they are not fully sprinklered or they do not have system-based smoke detectors in those areas. Finally, this final rule confirms as final the provisions of the March 25, 2005 interim final rule with changes and responds to public comments on that rule.

  16. Newborn care practices at home and in health facilities in 4 regions of Ethiopia

    PubMed Central

    2013-01-01

    Background Ethiopia is one of the ten countries with the highest number of neonatal deaths globally, and only 1 in 10 women deliver with a skilled attendant. Promotion of essential newborn care practices is one strategy for improving newborn health outcomes that can be delivered in communities as well as facilities. This article describes newborn care practices reported by recently-delivered women (RDWs) in four regions of Ethiopia. Methods We conducted a household survey with two-stage cluster sampling to assess newborn care practices among women who delivered a live baby in the period 1 to 7 months prior to data collection. Results The majority of women made one antenatal care (ANC) visit to a health facility, although less than half made four or more visits and women were most likely to deliver their babies at home. About one-fifth of RDWs in this survey had contact with Health Extension Workers (HEWS) during ANC, but nurse/midwives were the most common providers, and few women had postnatal contact with any health provider. Common beneficial newborn care practices included exclusive breastfeeding (87.6%), wrapping the baby before delivery of the placenta (82.3%), and dry cord care (65.2%). Practices contrary to WHO recommendations that were reported in this population of recent mothers include bathing during the first 24 hours of life (74.7%), application of butter and other substances to the cord (19.9%), and discarding of colostrum milk (44.5%). The results suggest that there are not large differences for most essential newborn care indicators between facility and home deliveries, with the exception of delayed bathing and skin-to-skin care. Conclusions Improving newborn care and newborn health outcomes in Ethiopia will likely require a multifaceted approach. Given low facility delivery rates, community-based promotion of preventive newborn care practices, which has been effective in other settings, is an important strategy. For this strategy to be

  17. The Faculty Web Page: Contrivance or Continuation?

    ERIC Educational Resources Information Center

    Lennex, Lesia

    2007-01-01

    In an age of Internet education, what does it mean for a tenure/tenure-track faculty to have a web page? How many professors have web pages? If they have a page, what does it look like? Do they really need a web page at all? Many universities have faculty web pages. What do those collective pages look like? In what way do they represent the…

  18. Mental health issues among pregnant women in correctional facilities: a systematic review.

    PubMed

    Mukherjee, Soumyadeep; Pierre-Victor, Dudith; Bahelah, Raed; Madhivanan, Purnima

    2014-01-01

    Incarceration-induced stress makes pregnant women in correctional facilities a high-risk group for mental health problems, resulting in adverse maternal and fetal outcomes. A systematic review was conducted to examine the prevalence and correlates of mental health issues among pregnant inmates. Databases searched included PubMed, Medline, CINAHL Plus, PsycINFO, National Criminal Justice Reference System, Social Work Abstracts, Cochrane and Campbell libraries, which were searched for studies published in English from 1950 till July 2013. Eleven studies were included of pregnant women in correctional facilities and addressed at least one mental illness. Quality score was assigned to these eligible articles. Due to heterogeneity, a narrative review was performed. All of the studies were conducted in the United States, with quality scores ranging from 7 to 10 out of 10. Only one of these studies used mixed methods, the rest were quantitative. Tobacco use among pregnant inmates exceeded 50%, with some studies reporting as high as 84%. Alcohol use was common; 36% of the inmates used illicit drugs in one study. Depression and anxiety levels were high-some studies reported depression among 80% of inmates. Findings suggest that mental health among pregnant prisoners is a huge concern that has not been adequately addressed.

  19. Ready, aim fire! Mental health nurses under siege in acute inpatient facilities.

    PubMed

    Ward, Louise

    2013-04-01

    It has been clearly acknowledged and well-documented that physical, emotional, and psychological violence is a central theme and an expected workplace hazard for registered nurses working in acute inpatient mental health care facilities. Limited research, however, has focused on how registered nurses have been able to cope within this environment and adequately protect themselves from harm. A critical feminist research project recently explored the lived experience of 13 Australian, female, registered nurses working in a busy metropolitan acute inpatient mental health care facility. "Fear" was exposed as the precursor to violence and aggression, both "fear as experienced by the nurse" and "fear as experienced by the patient." The participants reported experiencing a sense of fear when they could not accurately or confidently anticipate a patient response or reaction. They identified this relationship with fear as being "part of the job" and part of the unpredictable nature of caring for people experiencing complex distortions in thinking and behavior. The participants believed, however, that additional workplace pressures complicated the therapeutic environment, resulting in a distraction from patient care and observation. This distraction could lead to nurse-patient miscommunication and the potential for violence. This article discusses a major theme to emerge from this study, "Better the devil you know!" The theme highlights how mental health nurses cope with violence and why they choose to continue working in this complex care environment.

  20. Induced abortion and associated factors in health facilities of Guraghe zone, southern Ethiopia.

    PubMed

    Tesfaye, Gezahegn; Hambisa, Mitiku Teshome; Semahegn, Agumasie

    2014-01-01

    Unsafe abortion is one of the major medical and public health problems in developing countries including Ethiopia. However, there is a lack of up-to-date and reliable information on induced abortion distribution and its determinant factors in the country. This study was intended to assess induced abortion and associated factors in health facilities of Guraghe zone, Southern Ethiopia. Institution based cross-sectional study was conducted in eight health facilities in Guraghe zone. Client exit interview was conducted on 400 patients using a structured questionnaire. Bivariate and multivariate logistic regression analysis was performed to identify factors associated with induced abortion. Out of 400 women, 75.5% responded that the current pregnancy that ended in abortion is unwanted. However, only 12.3% of the respondents have admitted interference to the current pregnancy. Having more than four pregnancies (AOR = 4.28, CI: (1.24-14.71)), age of 30-34 years (AOR = 0.15, CI: (0.04-0.55)), primary education (AOR = 0.26, CI: (0.13-0.88)), and wanted pregnancy (AOR = 0.44, CI: (0.14-0.65)) were found to have association with induced abortion. The study revealed high level of induced abortion which is underpinned by high magnitude of unwanted pregnancy. There is requirement for widespread expansion of increased access to high quality family planning service and post-abortion care.

  1. An assessment of clinical chemical sensing technology for potential use in space station health maintenance facility

    NASA Technical Reports Server (NTRS)

    1987-01-01

    A Health Maintenance Facility is currently under development for space station application which will provide capabilities equivalent to those found on Earth. This final report addresses the study of alternate means of diagnosis and evaluation of impaired tissue perfusion in a microgravity environment. Chemical data variables related to the dysfunction and the sensors required to measure these variables are reviewed. A technology survey outlines the ability of existing systems to meet these requirements. How the candidate sensing system was subjected to rigorous testing is explored to determine its suitability. Recommendations for follow-on activities are included that would make the commercial system more appropriate for space station applications.

  2. [Water as a reservoir for nosocomial infections in health care facilities, prevention and control].

    PubMed

    Exner, M; Kramer, A; Kistemann, T; Gebel, J; Engelhart, S

    2007-03-01

    New epidemiological and microbiological investigations using molecular typing methods to link patient and environmental strains demonstrate a strong association between water-borne pathogens and nosocomial infections. Avoiding patient exposure to these pathogens results in a decreased incidence of water-borne nosocomial infections. There remains a tremendous potential to reduce hospital acquired infections previously viewed as inevitable and unavoidable through intervention and preventive measures. The characteristics of water application in health care facilities, the vulnerability of patients, the spectrum of relevant pathogens and their ecologic aspects, legal issues and important measures for prevention and control are discussed.

  3. Using geographical information systems for defining the accessibility to health care facilities in Jeddah City, Saudi Arabia.

    PubMed

    Murad, Abdulkader A

    2014-12-01

    Spatial data play an important role in the planning of health care facilities and their allocation. Today, geographical information systems (GIS) provide useful techniques for capturing, maintaining and analysing health care spatial data; indeed health geoinformatics is an emerging discipline that uses innovative geospatial technology to investigate health issues. The purpose of this paper is to define how GIS can be used for assessing the level of accessibility to health care. The paper identifies the advantages of using GIS in health care planning and covers GIS-based international accessibility with a focus on GIS applications for health care facilities in Jeddah city, Saudi Arabia. A geodatabase that includes location of health services, road networks, health care demand and population districts was created using ArcGIS software. The geodatabase produced is based on collected data and covers issues, such as defining the spatial distribution of health care facilities, evaluating health demand types and modelling health service areas based on analysis of driving-time and straight-line distances.

  4. Tracking implementation and (un)intended consequences: a process evaluation of an innovative peripheral health facility financing mechanism in Kenya.

    PubMed

    Waweru, Evelyn; Goodman, Catherine; Kedenge, Sarah; Tsofa, Benjamin; Molyneux, Sassy

    2016-03-01

    In many African countries, user fees have failed to achieve intended access and quality of care improvements. Subsequent user fee reduction or elimination policies have often been poorly planned, without alternative sources of income for facilities. We describe early implementation of an innovative national health financing intervention in Kenya; the health sector services fund (HSSF). In HSSF, central funds are credited directly into a facility's bank account quarterly, and facility funds are managed by health facility management committees (HFMCs) including community representatives. HSSF is therefore a finance mechanism with potential to increase access to funds for peripheral facilities, support user fee reduction and improve equity in access. We conducted a process evaluation of HSSF implementation based on a theory of change underpinning the intervention. Methods included interviews at national, district and facility levels, facility record reviews, a structured exit survey and a document review. We found impressive achievements: HSSF funds were reaching facilities; funds were being overseen and used in a way that strengthened transparency and community involvement; and health workers' motivation and patient satisfaction improved. Challenges or unintended outcomes included: complex and centralized accounting requirements undermining efficiency; interactions between HSSF and user fees leading to difficulties in accessing crucial user fee funds; and some relationship problems between key players. Although user fees charged had not increased, national reduction policies were still not being adhered to. Finance mechanisms can have a strong positive impact on peripheral facilities, and HFMCs can play a valuable role in managing facilities. Although fiduciary oversight is essential, mechanisms should allow for local decision-making and ensure that unmanageable paperwork is avoided. There are also limits to what can be achieved with relatively small funds in

  5. Quality of newborn care: a health facility assessment in rural Ghana using survey, vignette and surveillance data

    PubMed Central

    Vesel, Linda; Manu, Alexander; Lohela, Terhi J; Gabrysch, Sabine; Okyere, Eunice; ten Asbroek, Augustinus H A; Hill, Zelee; Agyemang, Charlotte Tawiah; Owusu-Agyei, Seth; Kirkwood, Betty R

    2013-01-01

    Objective To assess the structural capacity for, and quality of, immediate and essential newborn care (ENC) in health facilities in rural Ghana, and to link this with demand for facility deliveries and admissions. Design Health facility assessment survey and population-based surveillance data. Setting Seven districts in Brong Ahafo Region, Ghana. Participants Heads of maternal/neonatal wards in all 64 facilities performing deliveries. Main outcome measures Indicators include: the availability of essential infrastructure, newborn equipment and drugs, and personnel; vignette scores and adequacy of reasons given for delayed discharge of newborn babies; and prevalence of key immediate ENC practices that facilities should promote. These are matched to the percentage of babies delivered in and admitted to each type of facility. Results 70% of babies were delivered in health facilities; 56% of these and 87% of neonatal admissions were in four referral level hospitals. These had adequate infrastructure, but all lacked staff trained in ENC and some essential equipment (including incubators and bag and masks) and/or drugs. Vignette scores for care of very low-birth-weight babies were generally moderate-to-high, but only three hospitals achieved high overall scores for quality of ENC. We estimate that only 33% of babies were born in facilities capable of providing high quality, basic resuscitation as assessed by a vignette plus the presence of a bag and mask. Promotion of immediate ENC practices in facilities was also inadequate, with coverage of early initiation of breastfeeding and delayed bathing both below 50% for babies born in facilities; this represents a lost opportunity. Conclusions Unless major gaps in ENC equipment, drugs, staff, practices and skills are addressed, strategies to increase facility utilisation will not achieve their potential to save newborn lives. Trial registration http://clinicaltrials.gov NCT00623337. PMID:23667161

  6. Learning through Web Page Design.

    ERIC Educational Resources Information Center

    Peel, Deborah

    2001-01-01

    Describes and evaluates the use of Web page design in an undergraduate course in the United Kingdom on town planning. Highlights include incorporating information and communication technologies into higher education; and a theoretical framework for the use of educational technology. (LRW)

  7. Web Page Design (Part One).

    ERIC Educational Resources Information Center

    Descy, Don E.

    1997-01-01

    Discusses rules for Web page design: consider audiences' Internet skills and equipment; know your content; outline the material; map or sketch the site; be consistent; regulate size of graphics to control download time; place eye catching material in the first 300 pixels; moderate use of color to control file size and bandwidth; include a…

  8. Design of Educational Web Pages

    ERIC Educational Resources Information Center

    Galan, Jose Gomez; Blanco, Soledad Mateos

    2004-01-01

    The methodological characteristics of teaching in primary and secondary education make it necessary to revise the pedagogical and instructive lines with which to introduce the new Information and Communication Technologies into the school context. The construction of Web pages that can be used to improve student learning is, therefore, fundamental…

  9. Why give birth in health facility? Users’ and providers’ accounts of poor quality of birth care in Tanzania

    PubMed Central

    2013-01-01

    Background In Tanzania, half of all pregnant women access a health facility for delivery. The proportion receiving skilled care at birth is even lower. In order to reduce maternal mortality and morbidity, the government has set out to increase health facility deliveries by skilled care. The aim of this study was to describe the weaknesses in the provision of acceptable and adequate quality care through the accounts of women who have suffered obstetric fistula, nurse-midwives at both BEmOC and CEmOC health facilities and local community members. Methods Semi-structured interviews involving 16 women affected by obstetric fistula and five nurse-midwives at maternity wards at both BEmOC and CEmOC health facilities, and Focus Group Discussions with husbands and community members were conducted between October 2008 and February 2010 at Comprehensive Community Based Rehabilitation in Tanzania and Temeke hospitals in Dar es Salaam, and Mpwapwa district in Dodoma region. Results Health care users and health providers experienced poor quality caring and working environments in the health facilities. Women in labour lacked support, experienced neglect, as well as physical and verbal abuse. Nurse-midwives lacked supportive supervision, supplies and also seemed to lack motivation. Conclusions There was a consensus among women who have suffered serious birth injuries and nurse midwives staffing both BEmOC and CEmOC maternity wards that the quality of care offered to women in birth was inadequate. While the birth accounts of women pointed to failure of care, the nurses described a situation of disempowerment. The bad birth care experiences of women undermine the reputation of the health care system, lower community expectations of facility birth, and sustain high rates of home deliveries. The only way to increase the rate of skilled attendance at birth in the current Tanzanian context is to make facility birth a safer alternative than home birth. The findings from this study

  10. Doing Your Own Time: Peer Integration, Aggression and Mental Health in Dutch Male Detainment Facilities

    PubMed Central

    Kreager, Derek A.; Palmen, Hanneke; Dirkzwager, Anja J.E.; Nieuwbeerta, Paul

    2016-01-01

    Background Prior research demonstrates a strong positive association between social integration (e.g., strong social ties) and individual health. However, researchers also emphasize that this correlation may vary by context and potentially reverse direction under certain conditions. In this study, we draw on competing criminological theories of peer relations to examine if social integration, measured by trust in peers, is positively or negatively associated with violence and mental health of men detained in pre-trial confinement facilities. Methods We test our hypotheses with peer network and health data from 502 Dutch male pre-trial detainees. Results Results suggest that peer trust has no direct association with reported rates of peer aggression while detained and low peer trust is generally protective for mental health. Conclusions Our study thus adds to a small body of literature finding that social integration within certain correctional settings may not operate in the same way that it does in the general population and may actually contribute to adverse mental health outcomes. PMID:26794247

  11. Capacity of Health Facilities to Manage Hypertension in Mukono and Buikwe Districts in Uganda: Challenges and Recommendations

    PubMed Central

    Musinguzi, Geofrey; Bastiaens, Hilde; Wanyenze, Rhoda K.; Mukose, Aggrey; Van geertruyden, Jean-Pierre; Nuwaha, Fred

    2015-01-01

    Background The burden of chronic diseases is increasing in both low- and middle-income countries. However, healthcare systems in low-income countries are inadequately equipped to deal with the growing disease burden, which requires chronic care for patients. The aim of this study was to assess the capacity of health facilities to manage hypertension in two districts in Uganda. Methods In a cross-sectional study conducted between June and October 2012, we surveyed 126 health facilities (6 hospitals, 4 Health Center IV (HCIV), 23 Health Center III (HCIII), 41 Health Center II (HCII) and 52 private clinics/dispensaries) in Mukono and Buikwe districts in Uganda. We assessed records, conducted structured interviews with heads of facilities, and administered questionnaires to 271 health workers. The study assessed service provision for hypertension, availability of supplies such as medicines, guidelines and equipment, in-service training for hypertension, knowledge of hypertension management, challenges and recommendations. Results Of the 126 health facilities, 92.9% reported managing (diagnosing/treating) patients with hypertension, and most (80.2%) were run by non-medical doctors or non-physician health workers (NPHW). Less than half (46%) of the facilities had guidelines for managing hypertension. A 10th of the facilities lacked functioning blood pressure devices and 28% did not have stethoscopes. No facilities ever calibrated their BP devices except one. About a half of the facilities had anti-hypertensive medicines in stock; mainly thiazide diuretics (46%), beta blockers (56%) and calcium channel blockers (48.4%). Alpha blockers, mixed alpha & beta blockers and angiotensin II receptor antagonists were only stocked by private clinics/dispensaries. Most HCIIs lacked anti-hypertensive medicines, including the first line thiazide diuretics. Significant knowledge gaps in classification of patients as hypertensive were noted among respondents. All health workers (except 5

  12. Health-hazard evaluation report HETA 89-270-2080, Harrisburg Steam Generation Facility, Harrisburg, Pennsylvania

    SciTech Connect

    Seitz, T.A.

    1990-11-01

    In response to a request from the City of Harrisburg, Pennsylvania, a health hazard evaluation was conducted at the Harrisburg Steam Generation Facility (HSGF)(SIC-4953) concerning possible exposure to fly ash, combustion products and asbestos (1332214). The facility was a waste to energy site where municipal refuse was incinerated at approximately 1400 degrees-F. The steam generated was either sold directly or converted to electricity via an on site turbine. Employees used hard hats, safety shoes and glasses, work clothes and single use disposable dust and mist respirators. There was a potential for exposure to fly ash for employees working in the boiler and basement areas. Total particulate exposures ranged from 5 to llmg/m3 for laborers. The concentration of lead (7439921) exceeded the standards set by OSHA permissible exposure level of 0.05mg/kg in three of the personal breathing zone air samples. Amosite (12172735) and chrysotile (12001295) asbestos were identified in bulk samples of insulation and asbestos taken from a settled dust sample in the boiler area. Surface wipe samples indicated the possibility of hand to mouth contact with fly ash, particularly in the break and locker rooms. The author concludes that there is a need for reducing worker exposure to fly ash particulate. The author recommends engineering and work practice controls to reduce particulate exposures, increased cleaning and maintenance activities; and further evaluation of asbestos contamination at the facility.

  13. A guide to treating military personnel in a civilian mental health facility.

    PubMed

    Levitt, Gwen A

    2014-11-01

    As the number of troops returning home from the Middle East continues to rise, so does the need for psychiatric treatment. More and more often, civilian mental health facilities will be faced with treating active duty service members. Because the patients are active duty status, civilian providers need to become familiar with the unique intricacies and challenges of interacting with military command and mental health clinics. Concepts such as confidentiality and consent have a slightly different meaning in the military that affects care in the civilian realm. Diagnoses, medication choices, and treatment planning can also have an impact on a service member's career in the military that civilian providers may not recognize. This guide serves as a "beginner's" manual for working with active duty service members.

  14. Sunlight and health: attitudes of older people living in intermediate care facilities in southern Australia.

    PubMed

    Durvasula, Seeta; Kok, Cindy; Sambrook, Philip N; Cumming, Robert G; Lord, Stephen R; March, Lynette M; Mason, Rebecca S; Seibel, Markus J; Simpson, Judy M; Cameron, Ian D

    2010-01-01

    Older people have a high prevalence of falls and fractures, partly due to vitamin D deficiency. Sunlight is a major source of vitamin D, but many older people living in intermediate care facilities have inadequate sunlight exposure. The aim of this study was to determine the sun exposure practices and attitudes to sunlight in this population. Fifty-seven older residents of intermediate care facilities in Sydney, Australia were interviewed to determine their sun exposure practices, their views on sunlight and health and whether these have changed over their lives, factors affecting sunlight exposure and their knowledge of vitamin D. Sixty percent of the participants preferred to be outdoors, despite more than 92% believing that sunlight was healthy. In their youth however, almost 90% had preferred to be outdoors. Poor health, physical constraints and a sense of lack of ownership of outdoor spaces were barriers to sunlight exposure. Improved physical access, more outdoor leisure activities and promotion of greater autonomy may improve safe and appropriate sunlight exposure in this population.

  15. Hazardous medical waste generation rates of different categories of health-care facilities.

    PubMed

    Komilis, Dimitrios; Fouki, Anastassia; Papadopoulos, Dimitrios

    2012-07-01

    Goal of this work was to calculate the hazardous medical waste unit generation rates (HMWUGR), in kg bed(-1)d(-1), using data from 132 health-care facilities in Greece. The calculations were based on the weights of the hazardous medical wastes that were regularly transferred to the sole medical waste incinerator in Athens over a 22-month period during years 2009 and 2010. The 132 health-care facilities were grouped into public and private ones, and, also, into seven sub-categories, namely: birth, cancer treatment, general, military, pediatric, psychiatric and university hospitals. Results showed that there is a large variability in the HMWUGR, even among hospitals of the same category. Average total HMWUGR varied from 0.012 kg bed(-1)d(-1), for the public psychiatric hospitals, to up to 0.72 kg bed(-1)d(-1), for the public university hospitals. Within the private hospitals, average HMWUGR ranged from 0.0012 kg bed(-1)d(-1), for the psychiatric clinics, to up to 0.49 kg bed(-1)d(-1), for the birth clinics. Based on non-parametric statistics, HMWUGR were statistically similar for the birth and general hospitals, in both the public and private sector. The private birth and general hospitals generated statistically more wastes compared to the corresponding public hospitals. The infectious/toxic and toxic medical wastes appear to be 10% and 50% of the total hazardous medical wastes generated by the public cancer treatment and university hospitals, respectively.

  16. Rapid diagnostic tests for malaria and health workers’ adherence to test results at health facilities in Zambia

    PubMed Central

    2014-01-01

    Background In Zambia, there has been a large scaling up of interventions to control malaria in recent years including the deployment of rapid diagnostic tests (RDTs) to improve malaria surveillance data as well as guide malaria treatment in health facilities. The practical challenge is the impact of RDT results on subsequent management of patients. This study explored the role of RDTs in malaria diagnosis and the health workers’ adherence to test results. Methods An observational prospective study was carried out at health centres in four districts, namely Chibombo, Chingola, Chipata, and Choma. Children under the age of five years with history of fever were recruited and the clinicians’ use of RDT results was observed to establish whether prescriptions were issued prior to the availability of parasitological results or after, and whether RDT results influenced their prescriptions. Results Of the 2, 393 recruited children, 2, 264 had both RDT and microscopic results. Two in three (68.6%) children were treated with anti-malarials despite negative RDT results and almost half (46.2%) of these were prescribed Coartem®. Only 465 (19.4%) of the 2,393 children were prescribed drugs before receiving laboratory results. A total of 76.5% children were prescribed drugs after laboratory results. Children with RDT positive results were 2.66 (95% CI (2.00, 3.55)) times more likely to be prescribed anti-malarial drugs. Children who presented with fever at admission (although history of fever or presence of fever at admission was an entry criterion) were 42% less likely to be prescribed an anti-malarial drug compared to children who had no fever (AOR = 0.58; 95% CI (0.52, 0.65)). It was noted that proportions of children who were RDT- and microscopy-positive significantly declined over the years from 2005 to 2008. Conclusions RDTs may contribute to treatment of febrile illness by confirming malaria cases from non-malaria cases in children under the age of five. However

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

    PubMed Central

    2014-01-01

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

  18. Tracking implementation and (un)intended consequences: a process evaluation of an innovative peripheral health facility financing mechanism in Kenya

    PubMed Central

    Waweru, Evelyn; Goodman, Catherine; Kedenge, Sarah; Tsofa, Benjamin; Molyneux, Sassy

    2016-01-01

    In many African countries, user fees have failed to achieve intended access and quality of care improvements. Subsequent user fee reduction or elimination policies have often been poorly planned, without alternative sources of income for facilities. We describe early implementation of an innovative national health financing intervention in Kenya; the health sector services fund (HSSF). In HSSF, central funds are credited directly into a facility’s bank account quarterly, and facility funds are managed by health facility management committees (HFMCs) including community representatives. HSSF is therefore a finance mechanism with potential to increase access to funds for peripheral facilities, support user fee reduction and improve equity in access. We conducted a process evaluation of HSSF implementation based on a theory of change underpinning the intervention. Methods included interviews at national, district and facility levels, facility record reviews, a structured exit survey and a document review. We found impressive achievements: HSSF funds were reaching facilities; funds were being overseen and used in a way that strengthened transparency and community involvement; and health workers’ motivation and patient satisfaction improved. Challenges or unintended outcomes included: complex and centralized accounting requirements undermining efficiency; interactions between HSSF and user fees leading to difficulties in accessing crucial user fee funds; and some relationship problems between key players. Although user fees charged had not increased, national reduction policies were still not being adhered to. Finance mechanisms can have a strong positive impact on peripheral facilities, and HFMCs can play a valuable role in managing facilities. Although fiduciary oversight is essential, mechanisms should allow for local decision-making and ensure that unmanageable paperwork is avoided. There are also limits to what can be achieved with relatively small funds in

  19. The Impact of Health Information Technology Adoption by Outpatient Facilities on Pregnancy Outcomes

    PubMed Central

    Deily, Mary E; Hu, Tianyan; Terrizzi, Sabrina; Chou, Shin-Yi; Meyerhoefer, Chad D

    2013-01-01

    Objective Examine whether health information technology (HIT) at nonhospital facilities (NHFs) improves health outcomes and decreases resource use at hospitals within the same heath care network, and whether the impact of HIT varies as providers gain experience using the technologies. Data Sources Administrative claims data on 491,832 births in Pennsylvania during 1998–2004 from the Pennsylvania Health Care Cost Containment Council and HIT applications data from the Dorenfest Institute. Study Design Fixed-effects regression analysis of the impact of HIT at NHFs on adverse birth outcomes and resource use. Principal Findings Greater use of clinical HIT applications by NHFs is associated with reduced incidence of obstetric trauma and preventable complications, as well as longer lengths of stay. In addition, the beneficial effects of HIT increase the longer that technologies have been in use. However, we find no consistent evidence on whether or how nonclinical HIT in NHFs affects either resource use or health outcomes. Conclusions Clinical HIT applications at NHFs may reduce the likelihood of adverse birth outcomes, particularly after physicians and staff gain experience using the technologies. PMID:22742682

  20. Utilisation of health services and geography: deconstructing regional differences in barriers to facility-based delivery in Nepal.

    PubMed

    Hodge, Andrew; Byrne, Abbey; Morgan, Alison; Jimenez-Soto, Eliana

    2015-03-01

    While established that geographical inaccessibility is a key barrier to the utilisation of health services, it remains unknown whether disparities are driven only by limited access to these services, or are also attributable to health behaviour. Significant disparities exist in health outcomes and the coverage of many critical health services between the mountains region of Nepal and the rest of the country, yet the principal factors driving these regional disparities are not well understood. Using national representative data from the 2011 Nepal Demographic and Health Survey, we examine the extent to which observable factors explain the overall differences in the utilisation of maternal health services. We apply nonlinear Blinder-Oaxaca-type decomposition methods to quantify the effect that differences in measurable characteristics have on the regional coverage gap in facility-based delivery. The mean coverage of facility-based deliveries was 18.6 and 36.3 % in the mountains region and the rest of Nepal, respectively. Between 54.8 and 74.1 % of the regional coverage gap was explained by differences in observed characteristics. Factors influencing health behaviours (proxied by mothers' education, TV viewership and tobacco use, and household wealth) and subjective distance to the health facility were the major factors, contributing between 52.9 and 62.5 % of the disparity. Mothers' birth history was also noteworthy. Policies simultaneously addressing access and health behaviours appear necessary to achieve greater coverage and better health outcomes for women and children in isolated areas.

  1. Market study: Tactile paging system

    NASA Technical Reports Server (NTRS)

    1977-01-01

    A market survey was conducted regarding the commercialization potential and key market factors relevant to a tactile paging system for deaf-blind people. The purpose of the tactile paging system is to communicate to the deaf-blind people in an institutional environment. The system consists of a main console and individual satellite wrist units. The console emits three signals by telemetry to the wrist com (receiving unit) which will measure approximately 2 x 4 x 3/4 inches and will be fastened to the wrist by a strap. The three vibration signals are fire alarm, time period indication, and a third signal which will alert the wearer of the wrist com to the fact that the pin on the top of the wrist is emitting a morse coded message. The Morse code message can be felt and recognized with the finger.

  2. Are Health Facility Management Committees in Kenya ready to implement financial management tasks: findings from a nationally representative survey

    PubMed Central

    2013-01-01

    Background Community participation in peripheral public health facilities has in many countries focused on including community representatives in Health Facility Management Committees (HFMCs). In Kenya, HFMC roles are being expanded with the phased implementation of the Health Sector Services Fund (HSSF). Under HSSF, HFMCs manage facility funds which are dispersed directly from central level into facility bank accounts. We assessed how prepared HFMCs were to undertake this new role in advance of HSSF roll out, and considered the implications for Kenya and other similar settings. Methods Data were collected through a nationally representative sample of 248 public health centres and dispensaries in 24 districts in 2010. Data collection included surveys with in-charges (n = 248), HFMC members (n = 464) and facility users (n = 698), and record reviews. These data were supplemented by semi-structured interviews with district health managers in each district. Results Some findings supported preparedness of HFMCs to take on their new roles. Most facilities had bank accounts and HFMCs which met regularly. HFMC members and in-charges generally reported positive relationships, and HFMC members expressed high levels of motivation and job satisfaction. Challenges included users’ low awareness of HFMCs, lack of training and clarity in roles among HFMCs, and some indications of strained relations with in-charges. Such challenges are likely to be common to many similar settings, and are therefore important considerations for any health facility based initiatives involving HFMCs. Conclusion Most HFMCs have the basic requirements to operate. However to manage their own budgets effectively and meet their allocated roles in HSSF implementation, greater emphasis is needed on financial management training, targeted supportive supervision, and greater community awareness and participation. Once new budget management roles are fully established, qualitative and quantitative

  3. Role of Health Insurance Status in Inter-facility Transfers of Patients with ST-Elevation Myocardial Infarction

    PubMed Central

    Ward, Michael J.; Kripalani, Sunil; Zhu, Yuwei; Storrow, Alan B.; Wang, Thomas J.; Speroff, Theodore; Munoz, Daniel; Dittus, Robert S.; Harrell, Frank E.; Self, Wesley H.

    2016-01-01

    Lack of health insurance is associated with inter-facility transfer from emergency departments for several non-emergent conditions, but its association with transfers for ST-elevation myocardial infarction (STEMI), which requires timely definitive care for optimal outcomes, is unknown. Our objective was to determine whether insurance status is a predictor of inter-facility transfer for emergency department visits with STEMI. We analyzed data from the 2006 through 2011 Nationwide Emergency Department Sample examining all emergency department visits for patients age 18 years and older with a diagnosis of STEMI and a disposition of inter-facility transfer or hospitalization at the same institution. For emergency department visits with STEMI, our multivariable logistic regression model included emergency department disposition status (inter-facility transfer vs hospitalization at the same institution) as the primary outcome, and insurance status (none vs. any [including Medicare, Medicaid, and private insurance]) as the primary exposure. We found that among 1,377,827 emergency department STEMI visits, including 249,294 (18.1%) transfers, patients without health insurance (adjusted odds ratio: 1.6, 95% CI: 1.5, 1.7) were more likely to be transferred than those with insurance. Lack of health insurance status was also an independent risk factor for transfer compared to each sub-category of health insurance, including Medicare, Medicaid and private insurance. In conclusion, among patients presenting to United States emergency departments with STEMI, lack of insurance was an independent predictor of inter-facility transfer. In conclusion, because inter-facility transfer is associated with longer delays to definitive STEMI therapy than treatment at the same facility, lack of health insurance may lead to important health disparities among patients with STEMI. PMID:27282834

  4. Planetary Photojournal Home Page Graphic

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This image is an unannotated version of the Planetary Photojournal Home Page graphic. This digital collage contains a highly stylized rendition of our solar system and points beyond. As this graphic was intended to be used as a navigation aid in searching for data within the Photojournal, certain artistic embellishments have been added (color, location, etc.). Several data sets from various planetary and astronomy missions were combined to create this image.

  5. Photojournal Home Page Graphic 2007

    NASA Technical Reports Server (NTRS)

    2008-01-01

    This image is an unannotated version of the Photojournal Home Page graphic released in October 2007. This digital collage contains a highly stylized rendition of our solar system and points beyond. As this graphic was intended to be used as a navigation aid in searching for data within the Photojournal, certain artistic embellishments have been added (color, location, etc.). Several data sets from various planetary and astronomy missions were combined to create this image.

  6. Functional Multiplex PageRank

    NASA Astrophysics Data System (ADS)

    Iacovacci, Jacopo; Rahmede, Christoph; Arenas, Alex; Bianconi, Ginestra

    2016-10-01

    Recently it has been recognized that many complex social, technological and biological networks have a multilayer nature and can be described by multiplex networks. Multiplex networks are formed by a set of nodes connected by links having different connotations forming the different layers of the multiplex. Characterizing the centrality of the nodes in a multiplex network is a challenging task since the centrality of the node naturally depends on the importance associated to links of a certain type. Here we propose to assign to each node of a multiplex network a centrality called Functional Multiplex PageRank that is a function of the weights given to every different pattern of connections (multilinks) existent in the multiplex network between any two nodes. Since multilinks distinguish all the possible ways in which the links in different layers can overlap, the Functional Multiplex PageRank can describe important non-linear effects when large relevance or small relevance is assigned to multilinks with overlap. Here we apply the Functional Page Rank to the multiplex airport networks, to the neuronal network of the nematode C. elegans, and to social collaboration and citation networks between scientists. This analysis reveals important differences existing between the most central nodes of these networks, and the correlations between their so-called pattern to success.

  7. Assessing the population-level impact of vouchers on access to health facility delivery for women in Kenya.

    PubMed

    Obare, Francis; Warren, Charlotte; Abuya, Timothy; Askew, Ian; Bellows, Ben

    2014-02-01

    Although available evidence indicates that vouchers improve service utilization among the target populations, we do not know whether increased utilization results from improved access (new clients who would not have used services without the voucher) or from shifting clients from non-accredited to contracted service providers. This paper examines whether the safe motherhood voucher program in Kenya is associated with improved access to health facility delivery using information on births within two years preceding the survey in voucher and comparison sites. Data were collected in 2010-2011 and in 2012 among 2933 and 3094 women aged 15-49 years reporting 962 and 1494 births within two years before the respective surveys. Analysis entails cross-tabulations and estimation of multilevel random-intercept logit models. The results show that the proportion of births occurring at home declined by more than 10 percentage points while the proportion of births delivered in health facilities increased by a similar margin over time in voucher sites. The increase in facility-based births occurred in both public and private health facilities. There was also a significant increase in the likelihood of facility-based delivery (odds ratios [OR]: 2.04; 95% confidence interval [CI]: 1.40-2.98 in the 2006 voucher arm; OR: 1.72; 95% CI: 1.22-2.43 in the 2010-2011 voucher arm) in voucher sites over time. In contrast, there were no significant changes in the likelihood of facility-based delivery in the comparison arm over time. These findings suggest that the voucher program contributed to improved access to institutional delivery by shifting births from home to health facilities. However, available evidence from qualitative data shows that some women who purchased the vouchers did not use them because of high transportation costs to accredited facilities. The implication is that substantial improvements in service uptake could be achieved if the program subsidized transportation costs as

  8. Police and public health partnerships: evidence from the evaluation of Vancouver's supervised injection facility.

    PubMed

    DeBeck, Kora; Wood, Evan; Zhang, Ruth; Tyndall, Mark; Montaner, Julio; Kerr, Thomas

    2008-05-07

    In various settings, drug market policing strategies have been found to have unintended negative effects on health service use among injection drug users (IDU). This has prompted calls for more effective coordination of policing and public health efforts. In Vancouver, Canada, a supervised injection facility (SIF) was established in 2003. We sought to determine if local police impacted utilization of the SIF. We used generalized estimating equations (GEE) to prospectively identify the prevalence and correlates of being referred by local police to Vancouver's SIF among IDU participating in the Scientific Evaluation of Supervised Injecting (SEOSI) cohort during the period of December 2003 to November 2005. Among 1090 SIF clients enrolled in SEOSI, 182 (16.7%) individuals reported having ever been referred to the SIF by local police. At baseline, 22 (2.0%) participants reported that they first learned of the SIF via police. In multivariate analyses, factors positively associated with being referred to the SIF by local police when injecting in public include: sex work (Adjusted Odds Ratio [AOR] = 1.80, 95%CI 1.28-2.53); daily cocaine injection (AOR = 1.54, 95%CI 1.14-2.08); and unsafe syringe disposal (AOR = 1.46, 95%CI 1.00-2.11). These findings indicate that local police are facilitating use of the SIF by IDU at high risk for various adverse health outcomes. We further found that police may be helping to address public order concerns by referring IDU who are more likely to discard used syringes in public spaces. Our study suggests that the SIF provides an opportunity to coordinate policing and public health efforts and thereby resolve some of the existing tensions between public order and health initiatives.

  9. Medicare and Medicaid programs; fire safety requirements for certain health care facilities; amendment. Interim final rule with comment period.

    PubMed

    2005-03-25

    This interim final rule with comment period adopts the substance of the April 15, 2004 temporary interim amendment (TIA) 00-1 (101), Alcohol Based Hand Rub Solutions, an amendment to the 2000 edition of the Life Safety Code, published by the National Fire Protection Association (NFPA). This amendment will allow certain health care facilities to place alcohol-based hand rub dispensers in egress corridors under specified conditions. This interim final rule with comment period also requires that nursing facilities install smoke detectors in resident rooms and public areas if they do not have a sprinkler system installed throughout the facility or a hard-wired smoke detection system in those areas.

  10. Direct facility funding as a response to user fee reduction: implementation and perceived impact among Kenyan health centres and dispensaries

    PubMed Central

    Opwora, Antony; Kabare, Margaret; Molyneux, Sassy; Goodman, Catherine

    2010-01-01

    There is increasing pressure for reduction of user fees, but this can have adverse effects by decreasing facility-level funds. To address this, direct facility funding (DFF) was piloted in Coast Province, Kenya, with health facility committees (HFCs) responsible for managing the funds. We evaluated the implementation and perceived impact 2.5 years after DFF introduction. Quantitative data collection at 30 public health centres and dispensaries included a structured interview with the in-charge, record reviews and exit interviews. In addition, in-depth interviews were conducted with the in-charge and HFC members at 12 facilities, and with district staff and other stakeholders. DFF procedures were well established: HFCs met regularly and accounting procedures were broadly followed. DFF made an important contribution to facility cash income, accounting for 47% in health centres and 62% in dispensaries. The main items of expenditure were wages for support staff (32%), travel (21%), and construction and maintenance (18%). DFF was perceived to have a highly positive impact through funding support staff such as cleaners and patient attendants, outreach activities, renovations, patient referrals and increasing HFC activity. This was perceived to have improved health worker motivation, utilization and quality of care. A number of problems were identified. HFC training was reportedly inadequate, and no DFF documentation was available at facility level, leading to confusion. Charging user fees above those specified in the national policy remained common, and understanding of DFF among the broader community was very limited. Finally, relationships between HFCs and health workers were sometimes characterized by mistrust and resentment. Relatively small increases in funding may significantly affect facility performance when the funds are managed at the periphery. Kenya plans to scale up DFF nationwide. Our findings indicate this is warranted, but should include improved training

  11. Applications of ultraviolet germicidal irradiation disinfection in health care facilities: effective adjunct, but not stand-alone technology.

    PubMed

    Memarzadeh, Farhad; Olmsted, Russell N; Bartley, Judene M

    2010-06-01

    This review evaluates the applicability and relative contribution of ultraviolet germicidal irradiation (UVGI) to disinfection of air in health care facilities. A section addressing the use of UVGI for environmental surfaces is also included. The germicidal susceptibility of biologic agents is addressed, but with emphasis on application in health care facilities. The balance of scientific evidence indicates that UVGI should be considered as a disinfection application in a health care setting only in conjunction with other well-established elements, such as appropriate heating, ventilating, and air-conditioning (HVAC) systems; dynamic removal of contaminants from the air; and preventive maintenance in combination with through cleaning of the care environment. We conclude that although UVGI is microbiocidal, it is not "ready for prime time" as a primary intervention to kill or inactivate infectious microorganisms; rather, it should be considered an adjunct. Other factors, such as careful design of the built environment, installation and effective operation of the HVAC system, and a high level of attention to traditional cleaning and disinfection, must be assessed before a health care facility can decide to rely solely on UVGI to meet indoor air quality requirements for health care facilities. More targeted and multiparameter studies are needed to evaluate the efficacy, safety, and incremental benefit of UVGI for mitigating reservoirs of microorganisms and ultimately preventing cross-transmission of pathogens that lead to health care-associated infections.

  12. Health hazard evaluation report HETA 98-0041-2741, San Francisco Municipal Railway, Flynn Facility, San Francisco, California

    SciTech Connect

    Blade, L.M.; Mortimer, V.D.

    1999-06-01

    The Director of Public Transportation for the City and County of San Francisco, California, requested that the National Institute of Occupational Safety and Health (NIOSHS) conduct a health hazard evaluation (HHE) at the San Francisco Municipal Railway's Flynn Facility. This facility serves as a base of operations for approximately 123 diesel-powered buses, leading to employee exposures to diesel-engine exhaust emissions in the workplace air. The requester, concerned about the potential adverse effects of these exposures on workers' health and about the apparent ineffectiveness of the facility's ventilation systems and other exposure-control measures, asked that NIOSH evaluate workplace exposures along with the ventilation system and other control measure and recommend appropriate improvements.

  13. [The material and technical base of fluorographic units of primary health care facilities and its development promises].

    PubMed

    Sterlikov, S A; Bogorodskaia, E M; Ponomareva, E G; Grigor'ev, A V

    2011-01-01

    The goal of the study was to assess the status of equipment and the staff potential in the fluorography and X-ray units of primary health care facilities and to define priorities and the volume of investments for their modernization. Two hundred and seventy-two health care facilities were studied through the use of questionnaires. The data were processed using standard statistical methods, such as calculation of the mean, median, and 95% confidence intervals. Prognosis was made for the idling period of equipment during stagnation of measures to improve the material and technical base of fluorography units. Priorities for modernizing the material and technical base and the staff potential were defined for the fluorography units of primary health care facilities. The volume of investments required for the modernization was estimated.

  14. Paediatric liver transplantation for children treated at public health facilities in South Africa: time for change.

    PubMed

    Lala, S G; Britz, R; Botha, J; Loveland, J

    2014-11-01

    Paediatric liver transplantation (PLT) is the only therapeutic option for many children with end-stage chronic liver disease or irreversible fulminant hepatic failure, and is routinely considered as a therapy by paediatric gastroenterologists and surgeons working in developed countries. In South Africa (SA), a PLT programme has been available at Red Cross War Memorial Children's Hospital in Cape Town since November 1991, and another has rapidly developed at the Wits Donald Gordon Medical Centre in Johannesburg over the past decade. However, for most children with progressive chronic liver disease who are reliant on the services provided at state facilities in SA, PLT is not an option because of a lack of resources in a mismanaged public health system. This article briefly outlines the services offered at Chris Hani Baragwanath Academic Hospital--which is typical of state facilities in SA--and proposes that resources be allocated to establish an innovative, nationally funded centre that would enable greater numbers of children access to a PLT programme.

  15. DOE standard: Integration of environment, safety, and health into facility disposition activities. Volume 1: Technical standard

    SciTech Connect

    1998-05-01

    This Department of Energy (DOE) technical standard (referred to as the Standard) provides guidance for integrating and enhancing worker, public, and environmental protection during facility disposition activities. It provides environment, safety, and health (ES and H) guidance to supplement the project management requirements and associated guidelines contained within DOE O 430.1A, Life-Cycle Asset Management (LCAM), and amplified within the corresponding implementation guides. In addition, the Standard is designed to support an Integrated Safety Management System (ISMS), consistent with the guiding principles and core functions contained in DOE P 450.4, Safety Management System Policy, and discussed in DOE G 450.4-1, Integrated Safety Management System Guide. The ISMS guiding principles represent the fundamental policies that guide the safe accomplishment of work and include: (1) line management responsibility for safety; (2) clear roles and responsibilities; (3) competence commensurate with responsibilities; (4) balanced priorities; (5) identification of safety standards and requirements; (6) hazard controls tailored to work being performed; and (7) operations authorization. This Standard specifically addresses the implementation of the above ISMS principles four through seven, as applied to facility disposition activities.

  16. [Engineering aspects of seismic behavior of health-care facilities: lessons from California earthquakes].

    PubMed

    Rutenberg, A

    1995-03-15

    The construction of health-care facilities is similar to that of other buildings. Yet the need to function immediately after an earthquake, the helplessness of the many patients and the high and continuous occupancy of these buildings, require that special attention be paid to their seismic performance. Here the lessons from the California experience are invaluable. In this paper the behavior of California hospitals during destructive earthquakes is briefly described. Adequate structural design and execution, and securing of nonstructural elements are required to ensure both safety of occupants, and practically uninterrupted functioning of equipment, mechanical and electrical services and other vital systems. Criteria for post-earthquake functioning are listed. In view of the hazards to Israeli hospitals, in particular those located along the Jordan Valley and the Arava, a program for the seismic evaluation of medical facilities should be initiated. This evaluation should consider the hazards from nonstructural elements, the safety of equipment and systems, and their ability to function after a severe earthquake. It should not merely concentrate on safety-related structural behavior.

  17. Evaluation of prototype air/fluid separator for Space Station Freedom Health Maintenance Facility

    NASA Technical Reports Server (NTRS)

    Billica, Roger; Smith, Maureen; Murphy, Linda; Kizzee, Victor D.

    1991-01-01

    A prototype air/fluid separator suction apparatus proposed as a possible design for use with the Health Maintenance Facility aboard Space Station Freedom (SSF) was evaluated. A KC-135 parabolic flight test was performed for this purpose. The flights followed the standard 40 parabola profile with 20 to 25 seconds of near-zero gravity in each parabola. A protocol was prepared to evaluate the prototype device in several regulator modes (or suction force), using three fluids of varying viscosity, and using either continuous or intermittent suction. It was felt that a matrixed approach would best approximate the range of utilization anticipated for medical suction on SSF. The protocols were performed in one-gravity in a lab setting to familiarize the team with procedures and techniques. Identical steps were performed aboard the KC-135 during parabolic flight.

  18. Quality of care for under-fives in first-level health facilities in one district of Bangladesh.

    PubMed Central

    Arifeen, S. E.; Bryce, J.; Gouws, E.; Baqui, A. H.; Black, R. E.; Hoque, D. M. E.; Chowdhury, E. K.; Yunus, M.; Begum, N.; Akter, T.; Siddique, A.

    2005-01-01

    OBJECTIVE: The multi-country evaluation of Integrated Management of Childhood Illness (IMCI) effectiveness, cost and impact (MCE) is a global evaluation to determine the impact of IMCI on health outcomes and its cost-effectiveness. MCE studies are under way in Bangladesh, Brazil, Peru, Uganda and the United Republic of Tanzania. The objective of this analysis from the Bangladesh MCE study was to describe the quality of care delivered to sick children under 5 years old in first-level government health facilities, to inform government planning of child health programmes. METHODS: Generic MCE Health Facility Survey tools were adapted, translated and pre-tested. Medical doctors trained in IMCI and these tools conducted the survey in all 19 health facilities in the study areas. The data were collected using observations, exit interviews, inventories and interviews with facility providers. FINDINGS: Few of the sick children seeking care at these facilities were fully assessed or correctly treated, and almost none of their caregivers were advised on how to continue the care of the child at home. Over one-third of the sick children whose care was observed were managed by lower-level workers who were significantly more likely than higher-level workers to classify the sick child correctly and to provide correct information on home care to the caregiver. CONCLUSION: These results demonstrate an urgent need for interventions to improve the quality of care provided for sick children in first-level facilities in Bangladesh, and suggest that including lower-level workers as targets for IMCI case-management training may be beneficial. The findings suggest that the IMCI strategy offers a promising set of interventions to address the child health service problems in Bangladesh. PMID:15868016

  19. Characteristics and Factors Associated With Antihypertensive Medication Use in Patients Attending Peruvian Health Facilities

    PubMed Central

    Mejia, Christian R; Failoc-Rojas, Virgilio E; Cervantes, Carmen; Aspajo, Antonio J; Leandro, Jesus Galileo; Cordova-De La Cruz, Jhomar; Charri, Julio C; García-Auqui, Kevin E; Coronel-Chucos, Lelis Gabriela; Justo-Pinto, Luz Delia; Mamani-Apaza, Marisol Stefanie; Paz-Campos, Neil Arón; Correa, Ricardo

    2017-01-01

    Introduction  Hypertension is a very common disease worldwide, and medication is needed to prevent its short-term and long-term complications. Our objective was to determine the characteristics and factors associated with antihypertensive medication use in patients attending Peruvian health facilities. Materials & Methods We performed a multicenter, cross-sectional study with secondary data. We obtained self-reported antihypertensive medication from patients attending health facilities in 10 departments of Peru. We looked for associations of the antihypertensive treatment according to sociopathological factors and obtained p values using generalized linear models. Results Of the 894 patients with hypertension, 61% (547) were women and 60% (503) were on antihypertensive treatment, of which 82% (389) had monotherapy and 52% (258) had recently taken their medication. Antihypertensive treatment was positively correlated with the patient's age (adjusted prevalence ratio [aPR]: 1.01; 95% confidence interval [CI]: 1.007 to 1.017; p value < 0.001), diabetes (aPR: 1.31; 95% CI: 1.11 to 1.55; p value = 0.001) and cardiovascular disease (aPR: 1.38; 95% CI: 1.26 to 1.51; p value < 0.001). Conversely, the frequency of antihypertensive treatment decreases with physical activity (aPR: 0.80; 95% CI: 0.70 to 0.92; p value = 0.001). Conclusion Patients who have comorbidities and advanced age are more likely to be on antihypertensive treatment. In contrast, patients with increased physical activity have a lower frequency of antihypertensive treatment. It is important to consider these factors for future preventive programs and to improve therapeutic compliance. PMID:28331773

  20. Piloting Laboratory Quality System Management in Six Health Facilities in Nigeria

    PubMed Central

    Mbah, Henry; Ojo, Emmanuel; Ameh, James; Musuluma, Humphrey; Negedu-Momoh, Olubunmi Ruth; Jegede, Feyisayo; Ojo, Olufunmilayo; Uwakwe, Nkem; Ochei, Kingsley; Dada, Michael; Udah, Donald; Chiegil, Robert; Torpey, Kwasi

    2014-01-01

    Background Achieving accreditation in laboratories is a challenge in Nigeria like in most African countries. Nigeria adopted the World Health Organization Regional Office for Africa Stepwise Laboratory (Quality) Improvement Process Towards Accreditation (WHO/AFRO– SLIPTA) in 2010. We report on FHI360 effort and progress in piloting WHO-AFRO recognition and accreditation preparedness in six health facility laboratories in five different states of Nigeria. Method Laboratory assessments were conducted at baseline, follow up and exit using the WHO/AFRO– SLIPTA checklist. From the total percentage score obtained, the quality status of laboratories were classified using a zero to five star rating, based on the WHO/AFRO quality improvement stepwise approach. Major interventions include advocacy, capacity building, mentorship and quality improvement projects. Results At baseline audit, two of the laboratories attained 1- star while the remaining four were at 0- star. At follow up audit one lab was at 1- star, two at 3-star and three at 4-star. At exit audit, four labs were at 4- star, one at 3-star and one at 2-star rating. One laboratory dropped a ‘star’ at exit audit, while others consistently improved. The two weakest elements at baseline; internal audit (4%) and occurrence/incidence management (15%) improved significantly, with an exit score of 76% and 81% respectively. The elements facility and safety was the major strength across board throughout the audit exercise. Conclusion This effort resulted in measurable and positive impact on the laboratories. We recommend further improvement towards a formal international accreditation status and scale up of WHO/AFRO– SLIPTA implementation in Nigeria. PMID:25542022

  1. Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana

    PubMed Central

    Alhassan, Robert Kaba; Duku, Stephen Opoku; Janssens, Wendy; Nketiah-Amponsah, Edward; Spieker, Nicole; van Ostenberg, Paul; Arhinful, Daniel Kojo; Pradhan, Menno; Rinke de Wit, Tobias F.

    2015-01-01

    Background Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients’ decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will help determine more effective quality improvement interventions and health insurance sustainability strategies, especially in resource constrained countries in Africa where universal access to good quality care remains a challenge. Purpose To examine the differences in perceptions of clients and health staff on quality healthcare and determine if these perceptions are associated with technical quality proxies in health facilities. Implications of the findings for a sustainable National Health Insurance Scheme (NHIS) in Ghana are also discussed. Methods This is a cross-sectional study in two southern regions in Ghana involving 64 primary health facilities: 1,903 households and 324 health staff. Data collection lasted from March to June, 2012. A Wilcoxon-Mann-Whitney test was performed to determine differences in client and health staff perceptions of quality healthcare. Spearman’s rank correlation test was used to ascertain associations between perceived and technical quality care proxies in health facilities, and ordered logistic regression employed to predict the determinants of client and staff-perceived quality healthcare. Results Negative association was found between technical quality and client-perceived quality care (coef. = -0.0991, p<0.0001). Significant staff-client perception differences were found in all healthcare quality proxies, suggesting some level of unbalanced commitment to quality improvement and potential information asymmetry between clients and service providers. Overall, the findings suggest that increased efforts towards technical quality care alone will not necessarily translate into better client-perceived quality care and willingness to

  2. Emergency and urgent care capacity in a resource-limited setting: an assessment of health facilities in western Kenya

    PubMed Central

    Burke, Thomas F; Hines, Rosemary; Ahn, Roy; Walters, Michelle; Young, David; Anderson, Rachel Eleanor; Tom, Sabrina M; Clark, Rachel; Obita, Walter; Nelson, Brett D

    2014-01-01

    Objective Injuries, trauma and non-communicable diseases are responsible for a rising proportion of death and disability in low-income and middle-income countries. Delivering effective emergency and urgent healthcare for these and other conditions in resource-limited settings is challenging. In this study, we sought to examine and characterise emergency and urgent care capacity in a resource-limited setting. Methods We conducted an assessment within all 30 primary and secondary hospitals and within a stratified random sampling of 30 dispensaries and health centres in western Kenya. The key informants were the most senior facility healthcare provider and manager available. Emergency physician researchers utilised a semistructured assessment tool, and data were analysed using descriptive statistics and thematic coding. Results No lower level facilities and 30% of higher level facilities reported having a defined, organised approach to trauma. 43% of higher level facilities had access to an anaesthetist. The majority of lower level facilities had suture and wound care supplies and gloves but typically lacked other basic trauma supplies. For cardiac care, 50% of higher level facilities had morphine, but a minority had functioning ECG, sublingual nitroglycerine or a defibrillator. Only 20% of lower level facilities had glucometers, and only 33% of higher level facilities could care for diabetic emergencies. No facilities had sepsis clinical guidelines. Conclusions Large gaps in essential emergency care capabilities were identified at all facility levels in western Kenya. There are great opportunities for a universally deployed basic emergency care package, an advanced emergency care package and facility designation scheme, and a reliable prehospital care transportation and communications system in resource-limited settings. PMID:25260371

  3. Ondvrejov solar radio WWW page

    NASA Astrophysics Data System (ADS)

    Jivrivcka, Karel; Meszarosova, Hana

    Since mid 1997 the Solar Radio Astronomy Group of the Astronomical Institute in Ondvrejov has been running a new WWW page. You can find us at the address --- http://sunkl.asu.cas.cz/radio/ --- where information about our instruments, observed frequencies, as well as about our data archive is available. The home page includes four main topics: 1. Observation & Instrumentation --- here you can find information about which instruments are currently in use, observed frequencies, time resolutions etc. Presently we use for solar radio observations three dedicated instruments: RT3 -- single frequency 3 GHz receiver with 10 ms time resolution RT4 -- radio spectrograph 2.0--4.5 GHz with 100 ms time resolution RT5 -- radio spectrograph 0.8--2.0 GHz with 100 ms time resolution The observations are run daily, while the Sun is higher then 5 degrees above the horizon. Because of the tremendous amount of data, only chosen time intervals with radio events are archived. Event Archive Info: --- here you can find information about archived data (date, time interval) as well as overall images of individual events in GIF format (the image names are at the same time hyperlinks for direct loading) sorted by date and time of observation. Gallery: --- here you can find some representative examples of spectra of solar radio events, recorded by our instruments. Anonymous FTP Server: --- enables direct FTP access to our image archive. This WWW page should give you an insight, what data are available and what the events look roughly like. The uncalibrated rough data from our archive can be processed only by special programs and are not generally free. But if you are interested in a particular event from our archive, you can contact us via e-mail address: radio@asu.cas.cz This work has been supported by the Czech Academy of Sciences through grant no.A3003707.

  4. Environmental Management Waste Management Facility (EMWMF) Site-Specific Health and Safety Plan, Oak Ridge, Tennessee

    SciTech Connect

    Flynn, N.C. Bechtel Jacobs

    2008-04-21

    The Bechtel Jacobs Company LLC (BJC) policy is to provide a safe and healthy workplace for all employees and subcontractors. The implementation of this policy requires that operations of the Environmental Management Waste Management Facility (EMWMF), located one-half mile west of the U.S. Department of Energy (DOE) Y-12 National Security Complex, be guided by an overall plan and consistent proactive approach to environment, safety and health (ES&H) issues. The BJC governing document for worker safety and health, BJC/OR-1745, 'Worker Safety and Health Program', describes the key elements of the BJC Safety and Industrial Hygiene (IH) programs, which includes the requirement for development and implementation of a site-specific Health and Safety Plan (HASP) where required by regulation (refer also to BJC-EH-1012, 'Development and Approval of Safety and Health Plans'). BJC/OR-1745, 'Worker Safety and Health Program', implements the requirements for worker protection contained in Title 10 Code of Federal Regulations (CFR) Part 851. The EMWMF site-specific HASP requirements identifies safe operating procedures, work controls, personal protective equipment, roles and responsibilities, potential site hazards and control measures, site access requirements, frequency and types of monitoring, site work areas, decontamination procedures, and outlines emergency response actions. This HASP will be available on site for use by all workers, management and supervisors, oversight personnel and visitors. All EMWMF assigned personnel will be briefed on the contents of this HASP and will be required to follow the procedures and protocols as specified. The policies and procedures referenced in this HASP apply to all EMWMF operations activities. In addition the HASP establishes ES&H criteria for the day-to-day activities to prevent or minimize any adverse effect on the environment and personnel safety and health and to meet standards that define acceptable waste management practices. The

  5. Interstellar Initiative Web Page Design

    NASA Technical Reports Server (NTRS)

    Mehta, Alkesh

    1999-01-01

    This summer at NASA/MSFC, I have contributed to two projects: Interstellar Initiative Web Page Design and Lenz's Law Relative Motion Demonstration. In the Web Design Project, I worked on an Outline. The Web Design Outline was developed to provide a foundation for a Hierarchy Tree Structure. The Outline would help design a Website information base for future and near-term missions. The Website would give in-depth information on Propulsion Systems and Interstellar Travel. The Lenz's Law Relative Motion Demonstrator is discussed in this volume by Russell Lee.

  6. Quality of malaria case management at outpatient health facilities in Angola

    PubMed Central

    2009-01-01

    Background Angola's malaria case-management policy recommends treatment with artemether-lumefantrine (AL). In 2006, AL implementation began in Huambo Province, which involved training health workers (HWs), supervision, delivering AL to health facilities, and improving malaria testing with microscopy and rapid diagnostic tests (RDTs). Implementation was complicated by a policy that was sometimes ambiguous. Methods Fourteen months after implementation began, a cross-sectional survey was conducted in 33 outpatient facilities in Huambo Province to assess their readiness to manage malaria and the quality of malaria case-management for patients of all ages. Consultations were observed, patients were interviewed and re-examined, and HWs were interviewed. Results Ninety-three HWs and 177 consultations were evaluated, although many sampled consultations were missed. All facilities had AL in-stock and at least one HW trained to use AL and RDTs. However, anti-malarial stock-outs in the previous three months were common, clinical supervision was infrequent, and HWs had important knowledge gaps. Except for fever history, clinical assessments were often incomplete. Although testing was recommended for all patients with suspected malaria, only 30.7% of such patients were tested. Correct testing was significantly associated with caseloads < 25 patients/day (odds ratio: 18.4; p < 0.0001) and elevated patient temperature (odds ratio: 2.5 per 1°C increase; p = 0.007). Testing was more common among AL-trained HWs, but the association was borderline significant (p = 0.072). When the malaria test was negative, HWs often diagnosed patients with malaria (57.8%) and prescribed anti-malarials (60.0%). Sixty-six percent of malaria-related diagnoses were correct, 20.1% were minor errors, and 13.9% were major (potentially life-threatening) errors. Only 49.0% of malaria treatments were correct, 5.4% were minor errors, and 45.6% were major errors. HWs almost always dosed AL correctly and gave

  7. Improving district facility readiness: a 12-month evaluation of a data-driven health systems strengthening intervention in rural Rwanda

    PubMed Central

    Iyer, Hari S.; Kamanzi, Emmanuel; Mugunga, Jean Claude; Finnegan, Karen; Uwingabiye, Alice; Shyaka, Edward; Niyonzima, Saleh; Hirschhorn, Lisa R.; Drobac, Peter C.

    2015-01-01

    Background While health systems strengthening (HSS) interventions are recommended by global health policy experts to improve population health in resource-limited settings, few examples exist of evaluations of HSS interventions conducted at the district level. In 2009, a partnership between Partners In Health (PIH), a non-governmental organization, and the Rwandan Ministry of Health (RMOH) was provided funds to implement and evaluate a district-level HSS intervention in two rural districts of Rwanda. Design The partnership provided limited funds to 14 health centers for targeted systems support in 2010; six others received support prior to the intervention (reference). RMOH health systems norms were mapped across the WHO HSS framework, scored from 0 to 10 and incorporated into a rapid survey assessing 11 domains of facility readiness. Stakeholder meetings allowed partnership leaders to review results, set priorities, and allocate resources. Investments included salary support, infrastructure improvements, medical equipment, and social support for patients. We compared facility domain scores from the start of the intervention to 12 months and tested for correlation between change in score and change in funding allocation to assess equity in our approach. Results We found significant improvements among intervention facilities from baseline to 12 months across several domains [infrastructure (+4, p=0.0001), clinical services (+1.2, p=0.03), infection and sanitation control (+0.6, p=0.03), medical equipment (+1.0, p=0.02), information use (+2, p=0.002)]. Composite score across domains improved from 6.2 at baseline to 7.4 at 12 months (p=0.002). Across facilities, 50% had composite scores greater than the average score among reference facilities (7.4) at 12 months compared to none at baseline. Conclusions Rapid facility surveys, stakeholder engagement, and information feedback can be used for gap analysis and resource allocation. This approach can achieve effective use

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

    PubMed Central

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

    2015-01-01

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

  9. First experiences in the implementation of biometric technology to link data from Health and Demographic Surveillance Systems with health facility data

    PubMed Central

    Serwaa-Bonsu, Adwoa; Herbst, Abraham J.; Reniers, Georges; Ijaa, Wilfred; Clark, Benjamin; Kabudula, Chodziwadziwa; Sankoh, Osman

    2010-01-01

    Background In developing countries, Health and Demographic Surveillance Systems (HDSSs) provide a framework for tracking demographic and health dynamics over time in a defined geographical area. Many HDSSs co-exist with facility-based data sources in the form of Health Management Information Systems (HMIS). Integrating both data sources through reliable record linkage could provide both numerator and denominator populations to estimate disease prevalence and incidence rates in the population and enable determination of accurate health service coverage. Objective To measure the acceptability and performance of fingerprint biometrics to identify individuals in demographic surveillance populations and those attending health care facilities serving the surveillance populations. Methodology Two HDSS sites used fingerprint biometrics for patient and/or surveillance population participant identification. The proportion of individuals for whom a fingerprint could be successfully enrolled were characterised in terms of age and sex. Results Adult (18–65 years) fingerprint enrolment rates varied between 94.1% (95% CI 93.6–94.5) for facility-based fingerprint data collection at the Africa Centre site to 96.7% (95% CI 95.9–97.6) for population-based fingerprint data collection at the Agincourt site. Fingerprint enrolment rates in children under 1 year old (Africa Centre site) were only 55.1% (95% CI 52.7–57.4). By age 5, child fingerprint enrolment rates were comparable to those of adults. Conclusion This work demonstrates the feasibility of fingerprint-based individual identification for population-based research in developing countries. Record linkage between demographic surveillance population databases and health care facility data based on biometric identification systems would allow for a more comprehensive evaluation of population health, including the ability to study health service utilisation from a population perspective, rather than the more restrictive

  10. [Certain medico-economic prerequisites for the integration of spa and resort facilities into the system of compulsory health insurance].

    PubMed

    Artem'eva, G B; Gekht, I A

    2013-01-01

    The involvement of spa and resort facilities in the system of compulsory health insurance is of primary importance for the improvement of medical aid provided to the population. The application of the methods for the calculation of differential expenditures on the spa and resort-based treatment and estimation of their dependence on a variety of factors may facilitate the more rational use of the available resources of compulsory health insurance.

  11. A Link Taxonomy for Web Pages.

    ERIC Educational Resources Information Center

    Haas, Stephanie W.; Grams, Erika S.

    1998-01-01

    Presents the results of an investigation of the use of links on Web pages; a content analysis was performed on 75 Web pages and their links. Results will provide a conceptual framework in which Web page design can be considered, including issues of authoring, retrieval, and built-in and on-the-fly guidance for reading and browsing. (Author/AEF)

  12. Web Page Design and Network Analysis.

    ERIC Educational Resources Information Center

    Wan, Hakman A.; Chung, Chi-wai

    1998-01-01

    Examines problems in Web-site design from the perspective of network analysis. In view of the similarity between the hypertext structure of Web pages and a generic network, network analysis presents concepts and theories that provide insight for Web-site design. Describes the problem of home-page location and control of number of Web pages and…

  13. Job satisfaction and determinant factors among midwives working at health facilities in Addis Ababa city, Ethiopia

    PubMed Central

    Bekru, Eyasu Tamru; Cherie, Amsale; Anjulo, Antehun Alemayehu

    2017-01-01

    Background Midwives are the primary source of care and support for mothers and newborns at the most vulnerable time in their lives.The Ethiopian National Reproductive Health Strategy targeted reduction of Maternal Mortality rate to 267/100,000 live births in the years 2006–2015. Midwives play a crucial role in the care of pregnant women, from the first antenatal visit right through to the delivery and the postpartum period. Methodology Institution based cross-sectional study was carried out from March 2015 to April 2015 in Addis Ababa city, Ethiopia to assess job satisfaction and its determinants among midwives working at government health facilities. A total of 234 midwives were involved from 84 health centers and 8 governmental hospitals proportional to the size of health centers and hospitals using simple random sampling method. A total of 175 and 59 midwives were taken from health centers and government hospitals respectively. Different variables like Socio demographic, Job related domain and Organizational domain were collected using pre structured questionnaire after getting written consent. Data entry and analysis were done using SPSS 21.00. Binary logistic regression was used to determine factors affecting job satisfaction. P-values less than 0.05 were considered statistically significant. Result From 234 eligible respondents 221 midwives participated in this study which makes a response rate of 94.44%. The overall mean job satisfaction was 52.9%. Independent predictors of job satisfaction includes Sex [AOR = 4.07 (95%CI: 1.36–12.37)], working unit [AOR = 0.04 (95%CI:(0.001–0.45)], Educational status [AOR = 5.74(95%CI: 1.48–40.47)], Marital status [AOR = 3.48 [1.01–11.97)], supervision [AOR = 4.33 (95%CI: 1.53–20.22)], standard of care[AOR 4.80, (3.38–50.10)] and work load [AOR 8.94, (95%CI 2.37–22.65)]. Midwives were least satisfied from salary, extrinsic reward and professional opportunity subscales while they were most satisfied from

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

    SciTech Connect

    Cheng, J. -J.; Chang, Y. -S.; Hartmann, H.; Wescott, K.; Kygeris, C.

    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).

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

    PubMed Central

    2009-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  17. Hazardous medical waste generation rates of different categories of health-care facilities

    SciTech Connect

    Komilis, Dimitrios; Fouki, Anastassia; Papadopoulos, Dimitrios

    2012-07-15

    Highlights: Black-Right-Pointing-Pointer We calculated hazardous medical waste generation rates (HMWGR) from 132 hospitals. Black-Right-Pointing-Pointer Based on a 22-month study period, HMWGR were highly skewed to the right. Black-Right-Pointing-Pointer The HMWGR varied from 0.00124 to 0.718 kg bed{sup -1} d{sup -1}. Black-Right-Pointing-Pointer A positive correlation existed between the HMWGR and the number of hospital beds. Black-Right-Pointing-Pointer We used non-parametric statistics to compare rates among hospital categories. - Abstract: Goal of this work was to calculate the hazardous medical waste unit generation rates (HMWUGR), in kg bed{sup -1} d{sup -1}, using data from 132 health-care facilities in Greece. The calculations were based on the weights of the hazardous medical wastes that were regularly transferred to the sole medical waste incinerator in Athens over a 22-month period during years 2009 and 2010. The 132 health-care facilities were grouped into public and private ones, and, also, into seven sub-categories, namely: birth, cancer treatment, general, military, pediatric, psychiatric and university hospitals. Results showed that there is a large variability in the HMWUGR, even among hospitals of the same category. Average total HMWUGR varied from 0.012 kg bed{sup -1} d{sup -1}, for the public psychiatric hospitals, to up to 0.72 kg bed{sup -1} d{sup -1}, for the public university hospitals. Within the private hospitals, average HMWUGR ranged from 0.0012 kg bed{sup -1} d{sup -1}, for the psychiatric clinics, to up to 0.49 kg bed{sup -1} d{sup -1}, for the birth clinics. Based on non-parametric statistics, HMWUGR were statistically similar for the birth and general hospitals, in both the public and private sector. The private birth and general hospitals generated statistically more wastes compared to the corresponding public hospitals. The infectious/toxic and toxic medical wastes appear to be 10% and 50% of the total hazardous medical wastes

  18. South Yorkshire Cohort: a 'cohort trials facility' study of health and weight - Protocol for the recruitment phase

    PubMed Central

    2011-01-01

    Background Growing levels of both obesity and chronic disease in the general population pose a major public health problem. In the UK, an innovative 'health and weight' cohort trials facility, the 'South Yorkshire Cohort', is being built in order to provide robust evidence to inform policy, commissioning and clinical decisions in this field. This protocol reports the design of the facility and outlines the recruitment phase methods. Method/Design The South Yorkshire Cohort health and weight study uses the cohort multiple randomised controlled trial design. This design recruits a large observational cohort of patients with the condition(s) of interest which then provides a facility for multiple randomised controlled trials (with large representative samples of participants, long term outcomes as standard, increased comparability between each trial conducted within the cohort and increased efficiency particularly for trials of expensive interventions) as well as ongoing information as to the natural history of the condition and treatment as usual. This study aims to recruit 20,000 participants to the population based South Yorkshire Cohort health and weight research trials facility. Participants are recruited by invitation letters from their General Practitioners. Data is collected using postal and/or online patient self completed Health Questionnaires. NHS numbers will be used to facilitate record linkage and access to routine data. Participants are eligible if they are: aged 16 - 85 years, registered with one of 40 practices in South Yorkshire, provide consent for further contact from the researchers and to have their information used to look at the benefit of health treatments. The first wave of data is being collected during 2010/12 and further waves are planned at 2 - 5 year intervals for the planned 20 year duration of the facility. Discussion The South Yorkshire Cohort combines the strengths of the standard observational, longitudinal cohort study design with

  19. Monitoring System for Storm Readiness and Recovery of Test Facilities: Integrated System Health Management (ISHM) Approach

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Morris, Jon; Turowski, Mark; Franzl, Richard; Walker, Mark; Kapadia, Ravi; Venkatesh, Meera; Schmalzel, John

    2010-01-01

    Severe weather events are likely occurrences on the Mississippi Gulf Coast. It is important to rapidly diagnose and mitigate the effects of storms on Stennis Space Center's rocket engine test complex to avoid delays to critical test article programs, reduce costs, and maintain safety. An Integrated Systems Health Management (ISHM) approach and technologies are employed to integrate environmental (weather) monitoring, structural modeling, and the suite of available facility instrumentation to provide information for readiness before storms, rapid initial damage assessment to guide mitigation planning, and then support on-going assurance as repairs are effected and finally support recertification. The system is denominated Katrina Storm Monitoring System (KStorMS). Integrated Systems Health Management (ISHM) describes a comprehensive set of capabilities that provide insight into the behavior the health of a system. Knowing the status of a system allows decision makers to effectively plan and execute their mission. For example, early insight into component degradation and impending failures provides more time to develop work around strategies and more effectively plan for maintenance. Failures of system elements generally occur over time. Information extracted from sensor data, combined with system-wide knowledge bases and methods for information extraction and fusion, inference, and decision making, can be used to detect incipient failures. If failures do occur, it is critical to detect and isolate them, and suggest an appropriate course of action. ISHM enables determining the condition (health) of every element in a complex system-of-systems or SoS (detect anomalies, diagnose causes, predict future anomalies), and provide data, information, and knowledge (DIaK) to control systems for safe and effective operation. ISHM capability is achieved by using a wide range of technologies that enable anomaly detection, diagnostics, prognostics, and advise for control: (1

  20. Integration of Chiropractic Services in Military and Veteran Health Care Facilities: A Systematic Review of the Literature.

    PubMed

    Green, Bart N; Johnson, Claire D; Daniels, Clinton J; Napuli, Jason G; Gliedt, Jordan A; Paris, David J

    2016-04-01

    This literature review examined studies that described practice, utilization, and policy of chiropractic services within military and veteran health care environments. A systematic search of Medline, CINAHL, and Index to Chiropractic Literature was performed from inception through April 2015. Thirty articles met inclusion criteria. Studies reporting utilization and policy show that chiropractic services are successfully implemented in various military and veteran health care settings and that integration varies by facility. Doctors of chiropractic that are integrated within military and veteran health care facilities manage common neurological, musculoskeletal, and other conditions; severe injuries obtained in combat; complex cases; and cases that include psychosocial factors. Chiropractors collaboratively manage patients with other providers and focus on reducing morbidity for veterans and rehabilitating military service members to full duty status. Patient satisfaction with chiropractic services is high. Preliminary findings show that chiropractic management of common conditions shows significant improvement.

  1. Accessibility of State Department of Education Home Pages and Special Education Pages.

    ERIC Educational Resources Information Center

    Opitz, Christine; Savenye, Wilhelmina; Rowland, Cyndi

    2003-01-01

    This study evaluated State Department of Education Internet home pages and special education pages for accessibility compliance with standards of the World Wide Web Consortium and Section 508 of the revised Rehabilitation Act. Only 26% of state department home pages and 52% of special education pages achieved W3C compliance and fewer conformed…

  2. Interprofessional education in aged-care facilities: Tensions and opportunities among undergraduate health student cohorts.

    PubMed

    Annear, Michael; Walker, Kim; Lucas, Peter; Lo, Amanda; Robinson, Andrew

    2016-09-01

    This article examines the reflective discourses of medical, nursing, and paramedic students participating in interprofessional education (IPE) activities in the context of aged-care clinical placements. The intent of the research is to explore how students engage with their interprofessional colleagues in an IPE assessment and care planning activity and elucidate how students configure their role as learners within the context of a non-traditional aged-care training environment. Research participants included cohorts of volunteer medical (n = 61), nursing (n = 46), and paramedic (n = 20) students who were on clinical placements at two large teaching aged-care facilities in Tasmania, Australia, over a period of 18 months. A total of 39 facilitated focus group discussions were undertaken with cohorts of undergraduate student volunteers from three health professions between February 2013 and October 2014. Thematic analysis of focus group transcripts was assisted by NVIVO software and verified through secondary coding and member checking procedures. With an acceptable level of agreement across two independent coders, four themes were identified from student focus group transcripts that described the IPE relations and perceptions of the aged-care environment. Emergent themes included reinforcement of professional hierarchies, IPE in aged care perceived as mundane and extraneous, opportunities for reciprocal teaching and learning, and understanding interprofessional roles. While not all students can be engaged with IPE activities in aged care, our evidence suggests that within 1 week of clinical placements there is a possibility to develop reciprocal professional relations, affirm a positive identity within a collaborative healthcare team, and support the health of vulnerable older adults with complex care needs. These important clinical learnings support aged-care-based IPE as a potentially powerful context for undergraduate learning in the 21st Century.

  3. Socio-cultural factors explaining timely and appropriate use of health facilities for degedege in south-eastern Tanzania

    PubMed Central

    Dillip, Angel; Hetzel, Manuel W; Gosoniu, Dominic; Kessy, Flora; Lengeler, Christian; Mayumana, Iddy; Mshana, Christopher; Mshinda, Hassan; Schulze, Alexander; Makemba, Ahmed; Pfeiffer, Constanze; Weiss, Mitchell G; Obrist, Brigit

    2009-01-01

    Background Convulsions is one of the key signs of severe malaria among children under five years of age, potentially leading to serious complications or death. Several studies of care-seeking behaviour have revealed that local illness concepts linked to convulsions (referred to as degedege in Tanzanian Kiswahili) called for traditional treatment practices while modern treatment was preferred for common fevers. However, recent studies found that even children with convulsions were first brought to health facilities. This study integrated ethnographic and public health approaches in order to investigate this seemingly contradictory evidence. Carefully drawn random samples were used to maximize the representativity of the results. Methods The study used a cultural epidemiology approach and applied a locally adapted version of the Explanatory Model Interview Catalogue (EMIC), which ensures a comprehensive investigation of disease perception and treatment patterns. The tool was applied in three studies; i) the 2004 random sample cross-sectional community fever survey (N = 80), ii) the 2004–2006 longitudinal degedege study (N = 129), and iii) the 2005 cohort study on fever during the main farming season (N = 29). Results 71.1% of all convulsion cases were brought to a health facility in time, i.e. within 24 hours after onset of first symptoms. This compares very favourably with a figure of 45.6% for mild fever cases in children. The patterns of distress associated with less timely health facility use and receipt of anti-malarials among children with degedege were generalized symptoms, rather than the typical symptoms of convulsions. Traditional and moral causes were associated with less timely health facility use and receipt of anti-malarials. However, the high rate of appropriate action indicates that these ideas were not so influential any more as in the past. Reasons given by caretakers who administered anti-malarials to children without attending a health facility

  4. Evidence from facility level inputs to improve quality of care for maternal and newborn health: interventions and findings

    PubMed Central

    2014-01-01

    Most of the maternal and newborn deaths occur at birth or within 24 hours of birth. Therefore, essential lifesaving interventions need to be delivered at basic or comprehensive emergency obstetric care facilities. Facilities provide complex interventions including advice on referrals, post discharge care, long-term management of chronic conditions along with staff training, managerial and administrative support to other facilities. This paper reviews the effectiveness of facility level inputs for improving maternal and newborn health outcomes. We considered all available systematic reviews published before May 2013 on the pre-defined facility level interventions and included 32 systematic reviews. Findings suggest that additional social support during pregnancy and labour significantly decreased the risk of antenatal hospital admission, intrapartum analgesia, dissatisfaction, labour duration, cesarean delivery and instrumental vaginal birth. However, it did not have any impact on pregnancy outcomes. Continued midwifery care from early pregnancy to postpartum period was associated with reduced medical procedures during labour and shorter length of stay. Facility based stress training and management interventions to maintain well performing and motivated workforce, significantly reduced job stress and improved job satisfaction while the interventions tailored to address identified barriers to change improved the desired practice. We found limited and inconclusive evidence for the impacts of physical environment, exit interviews and organizational culture modifications. At the facility level, specialized midwifery teams and social support during pregnancy and labour have demonstrated conclusive benefits in improving maternal newborn health outcomes. However, the generalizability of these findings is limited to high income countries. Future programs in resource limited settings should utilize these findings to implement relevant interventions tailored to their needs

  5. Seroprevalence of yellow fever virus in selected health facilities in Western Kenya from 2010 to 2012.

    PubMed

    Kwallah, Allan ole; Inoue, Shingo; Thairu-Muigai, Anne Wangari; Kuttoh, Nancy; Morita, Kouichi; Mwau, Matilu

    2015-01-01

    Yellow fever (YF), which is caused by a mosquito-borne virus, is an important viral hemorrhagic fever endemic in equatorial Africa and South America. Yellow fever virus (YFV) is the prototype of the family Flaviviridae and genus Flavivirus. The aim of this study was to determine the seroprevalence of YFV in selected health facilities in Western Kenya during the period 2010-2012. A total of 469 serum samples from febrile patients were tested for YFV antibodies using in-house IgM-capture ELISA, in-house indirect IgG ELISA, and 50% focus reduction neutralization test (FRNT50). The present study did not identify any IgM ELISA-positive cases, indicating absence of recent YFV infection in the area. Twenty-eight samples (6%) tested positive for YFV IgG, because of either YFV vaccination or past exposure to various flaviviruses including YFV. Five cases were confirmed by FRNT50; of these, 4 were either vaccination or natural infection during the YF outbreak in 1992-1993 or another period and 1 case was confirmed as a West Nile virus infection. Domestication and routine performance of arboviral differential diagnosis will help to address the phenomenon of pyrexia of unknown origin, contribute to arboviral research in developing countries, and enhance regular surveillance.

  6. [A guide to good practice for information security in the handling of personal health data by health personnel in ambulatory care facilities].

    PubMed

    Sánchez-Henarejos, Ana; Fernández-Alemán, José Luis; Toval, Ambrosio; Hernández-Hernández, Isabel; Sánchez-García, Ana Belén; Carrillo de Gea, Juan Manuel

    2014-04-01

    The appearance of electronic health records has led to the need to strengthen the security of personal health data in order to ensure privacy. Despite the large number of technical security measures and recommendations that exist to protect the security of health data, there is an increase in violations of the privacy of patients' personal data in healthcare organizations, which is in many cases caused by the mistakes or oversights of healthcare professionals. In this paper, we present a guide to good practice for information security in the handling of personal health data by health personnel, drawn from recommendations, regulations and national and international standards. The material presented in this paper can be used in the security audit of health professionals, or as a part of continuing education programs in ambulatory care facilities.

  7. Environmental Assessment for the construction and operation of the Health Physics Site Support Facility on the Savannah River Site

    SciTech Connect

    1995-07-01

    DOE has prepared an environmental assessment for the proposed construction and operation of the Health Physics Site Support Facility on the Savannah River Site. This (new) facility would meet requirements of the site radiological protection program and would ensure site compliance with regulations. It was determined that the proposed action is not a major Federal action significantly affecting the quality of the environment within the meaning of NEPA. Therefore, a finding of no significant impact is made, and no environmental impact statement is needed.

  8. Reducing the risk of aspiration pneumonia among elderly patients in long-term care facilities through oral health interventions.

    PubMed

    Sarin, Jaya; Balasubramaniam, Ramesh; Corcoran, Amy M; Laudenbach, Joel M; Stoopler, Eric T

    2008-02-01

    Aspiration pneumonia is a leading cause of morbidity and mortality of elderly residents in long-term care facilities. The microflora present in the oral cavity because of poor oral hygiene has been associated with aspiration pneumonia. There is evidence that improved oral care can reduce the risk of developing aspiration pneumonia in the elderly. The purpose of this paper is to review aspiration pneumonia and provide oral health care guidelines in an effort to help reduce the risk of aspiration pneumonia in the elderly residing in long-term care facilities.

  9. MOVE: weight management program across the veterans health administration: patient- and facility-level predictors of utilization

    PubMed Central

    2013-01-01

    Background Health care systems initiating major behavioral health programs often face challenges with variable implementation and uneven patient engagement. One large health care system, Veterans Health Administration (VHA), recently initiated the MOVE!® Weight Management Program, but it is unclear if veterans most in need of MOVE!® services are accessing them. The purpose of this study was to examine patient and facility factors associated with MOVE!® utilization (defined as 1 or more visits) across all VHA facilities. Methods Using national administrative data in a retrospective cohort study of eligible overweight (25 < = body mass index (BMI) < 30 and at least one obesity associated comorbidity) and obese (BMI > =30) VHA outpatients, we examined variation in and predictors of MOVE!® utilization in fiscal year (FY) 2010 using generalized linear mixed models. Results 4.39% (n = 90,230) of all eligible overweight and obese patients using VHA services utilized MOVE!® services at least once in FY 2010. Facility-level MOVE! Utilization rates ranged from 0.05% to 16%. Veterans were more likely to have at least one MOVE!® visit if they had a higher BMI, were female, unmarried, younger, a minority, or had a psychiatric or obesity-related comorbidity. Conclusions Although substantial variation exists across VHA facilities in MOVE!® utilization rates, Veterans most in need of obesity management services were more likely to access MOVE!®, although at a low level. However, there may still be many Veterans who might benefit but are not accessing these services. More research is needed to examine the barriers and facilitators of MOVE!® utilization, particularly in facilities with unusually high and low reach. PMID:24325730

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

    PubMed

    Oyerinde, Koyejo; Baravilala, Wame

    2014-12-01

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

  11. Use of a Balanced Scorecard in strengthening health systems in developing countries: an analysis based on nationally representative Bangladesh Health Facility Survey.

    PubMed

    Khan, M Mahmud; Hotchkiss, David R; Dmytraczenko, Tania; Zunaid Ahsan, Karar

    2013-01-01

    This paper illustrates the importance of collecting facility-based data through regular surveys to supplement the administrative data, especially for developing countries of the world. In Bangladesh, measures based on facility survey indicate that only 70% of very basic medical instruments and 35% of essential drugs were available in health facilities. Less than 2% of officially designated obstetric care facilities actually had required drugs, injections and personnel on-site. Majority of (80%) referral hospitals at the district level were not ready to provide comprehensive emergency obstetric care. Even though the Management Information System reports availability of diagnostic machines in all district-level and sub-district-level facilities, it fails to indicate that 50% of these machines are not functional. In terms of human resources, both physicians and nurses are in short supply at all levels of the healthcare system. The physician-nurse ratio also remains lower than the desirable level of 3.0. Overall job satisfaction index was less than 50 for physicians and 66 for nurses. Patient satisfaction score, however, was high (86) despite the fact that process indicators of service quality were poor. Facility surveys can help strengthen not only the management decision-making process but also the quality of administrative data.

  12. Rotordynamic Analysis and Feasibility Study of a Disk Spin Test Facility for Rotor Health Monitoring

    NASA Technical Reports Server (NTRS)

    Sawicki, Jerzy T.

    2005-01-01

    Recently, National Aeronautics and Space Administration (NASA) initiated a program to achieve the significant improvement in aviation safety. One of the technical challenges is the design and development of accelerated experiments that mimic critical damage cases encountered in engine components. The Nondestructive Evaluation (NDE) Group at the NASA Glenn Research Center (GRC) is currently addressing the goal concerning propulsion health management and the development of propulsion system specific technologies intended to detect potential failures prior to catastrophe. For this goal the unique disk spin simulation system was assembled at NASA GRC, which allows testing of rotors with the spinning speeds up to 10K RPM, and at the elevated temperature environment reaching 540 C (1000 F). It is anticipated that the facility can be employed for detection of Low Cycle Fatigue disk cracking and further High Cycle Fatigue blade vibration. The controlled crack growth studies at room and elevated temperatures can be conducted on the turbine wheels, and various NDE techniques can be integrated and assessed as in-situ damage monitoring tools. Critical rotating parts in advanced gas turbine engines such as turbine disks frequently operate at high temperature and stress for long periods of time. The integrity of these parts must be proven by non-destructive evaluation (NDE) during various machining steps ranging from forging blank to finished shape, and also during the systematic overhaul inspections. Conventional NDE methods, however, have unacceptable limits. Some of these techniques are time-consuming and inconvenient for service aircraft testing. Almost all of these techniques require that the vicinity of the damage is known in advance. These experimental techniques can provide only local information and no indication of the structural strength at a component and/or system level. The shortcomings of currently available NDE methods lead to the requirement of new damage

  13. Client satisfaction and unmet needs assessment: evaluation of an HIV ambulatory health care facility in Sydney, Australia.

    PubMed

    Chow, Maria Yui Kwan; Li, Mu; Quine, Susan

    2012-03-01

    A mixed-methods approach study was conducted at an ambulatory HIV health care facility in Sydney during 2007/2008. A quantitative self-administered structured questionnaire survey (phase 1) was conducted to assess client satisfaction levels, followed by qualitative semistructured interviews (phase 2) to investigate reasons for satisfaction/dissatisfaction and unmet needs. The mean overall satisfaction score of the 166 respondents in phase 1 was high (86 out of 100). Participants were most satisfied with the "knowledge" and "attitudes" of health care providers (HCP) and "maintenance of confidentiality." They were least satisfied with "waiting time before consultation." "Knowledge of HCP" and "rapport, care, and trust towards HCP" emerged as most important aspects of satisfaction. The broad range of HCP and services provided at one location was particularly appreciated. Health care service evaluation by assessing client satisfaction using mixed methods provided valuable insight into health care service quality. It can be applied to a broader range of health care services.

  14. Developing a plan for primary health care facilities in Soweto, South Africa. Part II: Applying locational criteria.

    PubMed

    Doherty, J; Rispel, L; Webb, N

    1996-12-01

    This article is the second of a two-part series describing the development of a ten-year plan for primary health care facility development in Soweto. The first article concentrated on the political problems and general methodological approach of the project. This second article describes how the technical problem of planning in the context of scanty information was overcome. The reasoning behind the various assumptions and criteria which were used to assist the planning of the location of facilities is explained, as well as the process by which they were applied. The merits and limitations of this planning approach are discussed, and it is suggested that the approach may be useful to other facility planners, particularly in the developing world.

  15. Social Bookmarking Induced Active Page Ranking

    NASA Astrophysics Data System (ADS)

    Takahashi, Tsubasa; Kitagawa, Hiroyuki; Watanabe, Keita

    Social bookmarking services have recently made it possible for us to register and share our own bookmarks on the web and are attracting attention. The services let us get structured data: (URL, Username, Timestamp, Tag Set). And these data represent user interest in web pages. The number of bookmarks is a barometer of web page value. Some web pages have many bookmarks, but most of those bookmarks may have been posted far in the past. Therefore, even if a web page has many bookmarks, their value is not guaranteed. If most of the bookmarks are very old, the page may be obsolete. In this paper, by focusing on the timestamp sequence of social bookmarkings on web pages, we model their activation levels representing current values. Further, we improve our previously proposed ranking method for web search by introducing the activation level concept. Finally, through experiments, we show effectiveness of the proposed ranking method.

  16. Realistic page-turning of electronic books

    NASA Astrophysics Data System (ADS)

    Fan, Chaoran; Li, Haisheng; Bai, Yannan

    2014-01-01

    The booming electronic books (e-books), as an extension to the paper book, are popular with readers. Recently, many efforts are put into the realistic page-turning simulation o f e-book to improve its reading experience. This paper presents a new 3D page-turning simulation approach, which employs piecewise time-dependent cylindrical surfaces to describe the turning page and constructs smooth transition method between time-dependent cylinders. The page-turning animation is produced by sequentially mapping the turning page into the cylinders with different radii and positions. Compared to the previous approaches, our method is able to imitate various effects efficiently and obtains more natural animation of turning page.

  17. Effect of Community Engagement Interventions on Patient Safety and Risk Reduction Efforts in Primary Health Facilities: Evidence from Ghana

    PubMed Central

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

    2015-01-01

    Background Patient safety and quality care remain major challenges to Ghana’s healthcare system. Like many health systems in Africa, this is largely because demand for healthcare is outstripping available human and material resource capacity of healthcare facilities and new investment is insufficient. In the light of these demand and supply constraints, systematic community engagement (SCE) in healthcare quality assessment can be a feasible and cost effective option to augment existing quality improvement interventions. SCE entails structured use of existing community groups to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements identified and rewards provided if the quality gaps are closed. Purpose This paper evaluates whether or not SCE, through the assessment of health service quality, improves patient safety and risk reduction efforts by staff in healthcare facilities. Methods A randomized control trail was conducted in 64 primary healthcare facilities in the Greater Accra and Western regions of Ghana. Patient risk assessments were conducted in 32 randomly assigned intervention and control facilities. Multivariate multiple regression test was used to determine effect of the SCE interventions on staff efforts towards reducing patient risk. Spearman correlation test was used to ascertain associations between types of community groups engaged and risk assessment scores of healthcare facilities. Findings Clinic staff efforts towards increasing patient safety and reducing risk improved significantly in intervention facilities especially in the areas of leadership/accountability (Coef. = 10.4, p<0.05) and staff competencies (Coef. = 7.1, p<0.05). Improvement in service utilization and health resources could not be attributed to the interventions because these were outside the control of the study and might have been influenced by institutional or national level developments between the

  18. Library links on medical school home pages.

    PubMed

    Thomas, Sheila L

    2011-01-01

    The purpose of this study was to assess the websites of American Association of Medical Colleges (AAMC)-member medical schools for the presence of library links. Sixty-one percent (n = 92) of home pages of the 150 member schools of the AAMC contain library links. For the 58 home pages not offering such links, 50 provided a pathway of two or three clicks to a library link. The absence of library links on 39% of AAMC medical school home pages indicates that the designers of those pages did not consider the library to be a primary destination for their visitors.

  19. 7 CFR 1956.143 - Debt restructuring-hospitals and health care facilities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... net recovery value and level of debt the facility will support will be made. It is anticipated that... conjunction with an extension of the term of the loan to the remaining useful life of the facility or 40 years.... Also, operating statistics including number of beds, patient days of care, outpatient visits,...

  20. 7 CFR 1956.143 - Debt restructuring-hospitals and health care facilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    .... Operations review. A study of management and business operations of the facility by an independent expert. For example, a study of a hospital and nursing home would include such areas as: general and... included in the study which would indicate the creditworthiness of the facility and its ability to...

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

    SciTech Connect

    Burger, Joanna; Gochfeld, Michael; Clarke, James; Powers, Charles W.; Kosson, David

    2012-07-01

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

  2. Limited electricity access in health facilities of sub-Saharan Africa: a systematic review of data on electricity access, sources, and reliability

    PubMed Central

    Adair-Rohani, Heather; Zukor, Karen; Bonjour, Sophie; Wilburn, Susan; Kuesel, Annette C; Hebert, Ryan; Fletcher, Elaine R

    2013-01-01

    ABSTRACT Background: Access to electricity is critical to health care delivery and to the overarching goal of universal health coverage. Data on electricity access in health care facilities are rarely collected and have never been reported systematically in a multi-country study. We conducted a systematic review of available national data on electricity access in health care facilities in sub-Saharan Africa. Methods: We identified publicly-available data from nationally representative facility surveys through a systematic review of articles in PubMed, as well as through websites of development agencies, ministries of health, and national statistics bureaus. To be included in our analysis, data sets had to be collected in or after 2000, be nationally representative of a sub-Saharan African country, cover both public and private health facilities, and include a clear definition of electricity access. Results: We identified 13 health facility surveys from 11 sub-Saharan African countries that met our inclusion criteria. On average, 26% of health facilities in the surveyed countries reported no access to electricity. Only 28% of health care facilities, on average, had reliable electricity among the 8 countries reporting data. Among 9 countries, an average of 7% of facilities relied solely on a generator. Electricity access in health care facilities increased by 1.5% annually in Kenya between 2004 and 2010, and by 4% annually in Rwanda between 2001 and 2007. Conclusions: Energy access for health care facilities in sub-Saharan African countries varies considerably. An urgent need exists to improve the geographic coverage, quality, and frequency of data collection on energy access in health care facilities. Standardized tools should be used to collect data on all sources of power and supply reliability. The United Nations Secretary-General's “Sustainable Energy for All” initiative provides an opportunity to comprehensively monitor energy access in health care

  3. Client-centered design of residential addiction and mental health care facilities: staff perceptions of their work environment.

    PubMed

    Novotná, Gabriela; Urbanoski, Karen A; Rush, Brian R

    2011-11-01

    In this article we discuss the findings from a series of focus groups conducted as part of a 3-year, mixed-method evaluation of clinical programs in a large mental health and substance use treatment facility in Canada. We examined the perceptions of clinical personnel on the physical design of new treatment units and the impact on service delivery and the work environment. The new physical design appeared to support client recovery and reduce stigma; however, it brought certain challenges. Participants reported a compromised ability to monitor clients, a lack of designated therapeutic spaces, and insufficient workspace for staff. They also thought that physical design positively facilitated communication and therapeutic relationships among clinicians and clients, and increased team cohesion. We suggest that, from these findings, new avenues for research on achieving the important balance between client and staff needs in health facility design can be explored.

  4. Effects of Linear Texts in Page Scrolling and Page-by-Page Reading Forms on Reading Comprehension Introduction

    ERIC Educational Resources Information Center

    Sahin, Ayfer

    2011-01-01

    This research aims to analyse the Effect of Scrolling and page by page moving Static Texts on Comprehension of Screen Reading of 4th grade students. The sample was composed of 46 students of 4th grade students of a elementary school in Kirsehir Central Province. The classrooms of the participants were selected by random sampling method and…

  5. Management of severely ill children at first-level health facilities in sub-Saharan Africa when referral is difficult.

    PubMed Central

    Simoes, Eric A. F.; Peterson, Stefan; Gamatie, Youssouf; Kisanga, Felix S.; Mukasa, Gelasius; Nsungwa-Sabiiti, Jesca; Were, M. Wilson; Weber, Martin W.

    2003-01-01

    OBJECTIVES: To quantify the main reasons for referral of infants and children from first-level health facilities to referral hospitals in sub-Saharan Africa and to determine what further supplies, equipment, and legal empowerment might be needed to manage such children when referral is difficult. METHODS: In an observational study at first-level health facilities in Uganda, the United Republic of Tanzania, and Niger, over 3-5 months, we prospectively documented the diagnoses and severity of diseases in children using the standardized Integrated Management of Childhood Illness (IMCI) guidelines. We reviewed the facilities for supplies and equipment and examined the legal constraints of health personnel working at these facilities. FINDINGS: We studied 7195 children aged 2-59 months, of whom 691 (9.6%) were classified under a severe IMCI classification that required urgent referral to a hospital. Overall, 226 children had general danger signs, 292 had severe pneumonia or very severe disease, 104 were severely dehydrated, 31 had severe persistent diarrhoea, 207 were severely malnourished, and 98 had severe anaemia. Considerably more ill were 415 young infants aged one week to two months: nearly three-quarters of these required referral. Legal constraints and a lack of simple equipment (suction pumps, nebulizers, and oxygen concentrators) and supplies (nasogastric tubes and 50% glucose) could prevent health workers from dealing more appropriately with sick children when referral was not possible. CONCLUSION: When referral is difficult or impossible, some additional supplies and equipment, as well as provision of simple guidelines, may improve management of seriously ill infants and children. PMID:12973645

  6. A ‘Mystery Client’ Evaluation of Adolescent Sexual and Reproductive Health services in Health Facilities from Two Regions in Tanzania

    PubMed Central

    Mchome, Zaina; Richards, Esther; Nnko, Soori; Dusabe, John; Mapella, Elizabeth; Obasi, Angela

    2015-01-01

    Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people’s access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region) trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning). The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers’ mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people’s efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed. PMID:25803689

  7. Cardiology Patient Page: Electronic Cigarettes

    MedlinePlus

    ... review. Circulation . 2014 ; 129 : 1972 – 1986 . OpenUrl FREE Full Text 2. ↵ Vardavas CI , Anagnostopoulos N , Kougias M , Evangelopoulou ... Circulation . 2005 ; 111 : 2684 – 2698 . OpenUrl Abstract / FREE Full Text 4. ↵ Tverdal A , Bjartveit K . Health consequences of ...

  8. Factors influencing early health facility contact and low default rate among new sputum smear positive tuberculosis patients, India.

    PubMed

    Bhardwaj, Ashok Kumar; Kashyap, Surender; Bansal, Pradeep; Kumar, Dinesh; Raina, Sunil Kumar; Chander, Vishav; Sharma, Sushant

    2014-01-01

    Early case identification and prompt treatment of new sputum smear positive case are important to reduce the spread of tuberculosis (TB). Present study was planned to study the associated factors for duration to contact the health facility since appearance of symptoms and treatment default. Methodology. It was prospective cohort study of TB patients already registered for treatment in randomly selected TB units (TUs) in Himachal Pradesh, India. Relative risk (RR) was calculated as risk estimate to find out the explanatory variables for early contact and default. Results. Total 1607 patients were recruited and 25 (1.5%) defaulted treatment. Patients from nuclear family (aRR: 1.37; 1.09-1.73), ashamed of TB (aRR: 1.32; 1.03-1.70), wishing to disclose disease status (aRR: 1.79; 1.43-2.24), but aware of curable nature (aRR: 1.67; 1.17-2.39) and preventable (aRR: 1.35; 1.07-1.70) nature of disease, contacted health facility early since appearance of symptoms. Conclusion. Better awareness and less misconceptions about disease influences the early contact of health facility and low default rate in North India.

  9. Health physics manual of good practices for plutonium facilities. [Contains glossary

    SciTech Connect

    Brackenbush, L.W.; Heid, K.R.; Herrington, W.N.; Kenoyer, J.L.; Munson, L.F.; Munson, L.H.; Selby, J.M.; Soldat, K.L.; Stoetzel, G.A.; Traub, R.J.

    1988-05-01

    This manual consists of six sections: Properties of Plutonium, Siting of Plutonium Facilities, Facility Design, Radiation Protection, Emergency Preparedness, and Decontamination and Decommissioning. While not the final authority, the manual is an assemblage of information, rules of thumb, regulations, and good practices to assist those who are intimately involved in plutonium operations. An in-depth understanding of the nuclear, physical, chemical, and biological properties of plutonium is important in establishing a viable radiation protection and control program at a plutonium facility. These properties of plutonium provide the basis and perspective necessary for appreciating the quality of control needed in handling and processing the material. Guidance in selecting the location of a new plutonium facility may not be directly useful to most readers. However, it provides a perspective for the development and implementation of the environmental surveillance program and the in-plant controls required to ensure that the facility is and remains a good neighbor. The criteria, guidance, and good practices for the design of a plutonium facility are also applicable to the operation and modification of existing facilities. The design activity provides many opportunities for implementation of features to promote more effective protection and control. The application of ''as low as reasonably achievable'' (ALARA) principles and optimization analyses are generally most cost-effective during the design phase. 335 refs., 8 figs., 20 tabs.

  10. Effectiveness of Qigong in promoting the health of wheelchair-bound older adults in long-term care facilities.

    PubMed

    Kuan, Shu-Chien; Chen, Kuei-Min; Wang, Chi

    2012-04-01

    Institutional wheelchair-bound older adults often do not get regular exercise and are prone to health problems. The aim of this study was to test the effects of a 12-week qigong exercise program on the physiological and psychological health of wheelchair-bound older adults in long-term care facilities. Study design was quasi-experimental, pre-post test, nonequivalent control group. Participants comprised a convenience sample of 72 wheelchair-bound older adults (qigong = 34; control = 38). The qigong group exercised 35 min/day, 5 days/week for 12 weeks. Measures for physical health (blood pressure, heart rate variability, and distal skin temperature) and psychological health (Brief Symptom Rating Scale-5) were collected before and during study Weeks 4, 8, and 12. The qigong group participants' blood pressure, distal skin temperature, and psychological health were significantly improved (all p < .001). These findings suggest that qigong exercise is a suitable daily activity for elderly residents in long-term care facilities and may help in the control of blood pressure among older adults.

  11. Spatial Analysis of the Level of Exposure to Seismic Hazards of Health Facilities in Mexico City, Mexico

    NASA Astrophysics Data System (ADS)

    Moran, S.; Novelo-Casanova, D. A.

    2011-12-01

    Although health facilities are essential infrastructure during disasters and emergencies, they are also usually highly vulnerable installations in the case of the occurrence of large and major earthquakes. Hospitals are one of the most complex critical facilities in modern cities and they are used as first response in emergency situations. The operability of a hospital must be maintained after the occurrence of a local strong earthquake in order to satisfy the need for medical care of the affected population. If a health facility is seriously damaged, it cannot fulfill its function when most is needed. In this case, hospitals become a casualty of the disaster. To identify the level of physical exposure of hospitals to seismic hazards in Mexico City, we analyzed their geographic location with respect to the seismic response of the different type of soils of the city from past earthquakes, mainly from the events that occurred on September 1985 (Ms= 8.0) and April 1989 (Ms= 6.9). Seismic wave amplification in this city is the result of the interaction of the incoming seismic waves with the soft and water saturated clay soils, on which a large part of Mexico City is built. The clay soils are remnants of the lake that existed in the Valley of Mexico and which has been drained gradually to accommodate the growing urban sprawl. Hospital facilities were converted from a simple database of names and locations into a map layer of resources. This resource layer was combined with other map layers showing areas of seismic microzonation in Mexico City. This overlay was then used to identify those hospitals that may be threatened by the occurrence of a large or major seismic event. We analyzed the public and private hospitals considered as main health facilities. Our results indicate that more than 50% of the hospitals are highly exposed to seismic hazards. Besides, in most of these health facilities we identified the lack of preventive measures and preparedness to reduce their

  12. Exposures and Health Outcomes in Relation to Bioaerosol Emissions From Composting Facilities: A Systematic Review of Occupational and Community Studies

    PubMed Central

    Pearson, Clare; Littlewood, Emma; Douglas, Philippa; Robertson, Sarah; Gant, Timothy W.; Hansell, Anna L.

    2015-01-01

    The number of composting sites in Europe is rapidly increasing, due to efforts to reduce the fraction of waste destined for landfill, but evidence on possible health impacts is limited. This article systematically reviews studies related to bioaerosol exposures within and near composting facilities and associated health effects in both community and occupational health settings. Six electronic databases and bibliographies from January 1960 to July 2014 were searched for studies reporting on health outcomes and/or bioaerosol emissions related to composting sites. Risk of bias was assessed using a customized score. Five hundred and thirty-six papers were identified and reviewed, and 66 articles met the inclusion criteria (48 exposure studies, 9 health studies, 9 health and exposure studies). Exposure information was limited, with most measurements taken in occupational settings and for limited time periods. Bioaerosol concentrations were highest on-site during agitation activities (turning, shredding, and screening). Six studies detected concentrations of either Aspergillus fumigatus or total bacteria above the English Environment Agency’s recommended threshold levels beyond 250 m from the site. Occupational studies of compost workers suggested elevated risks of respiratory illnesses with higher bioaerosol exposures. Elevated airway irritation was reported in residents near composting sites, but this may have been affected by reporting bias. The evidence base on health effects of bioaerosol emissions from composting facilities is still limited, although there is sufficient evidence to support a precautionary approach for regulatory purposes. While data to date are suggestive of possible respiratory effects, further study is needed to confirm this and to explore other health outcomes. PMID:25825807

  13. 40 CFR 1502.7 - Page limits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Page limits. 1502.7 Section 1502.7 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY ENVIRONMENTAL IMPACT STATEMENT § 1502.7 Page limits. The text of final environmental impact statements (e.g., paragraphs (d) through (g) of §...

  14. Teacher Web Pages that Build Parent Partnerships.

    ERIC Educational Resources Information Center

    Johnson, Doug

    2000-01-01

    Discusses the importance of collaboration between teachers and parents to help support students and describes teacher-created Web pages that help simplify communication and planning. Explains Web page design that can include general class descriptions, unit outlines and timetables, unit and project information, and student progress reports. (LRW)

  15. Web Page Authoring Tools: Comparison and Trends.

    ERIC Educational Resources Information Center

    Craney, Linda

    Initially available from universities and individual enthusiasts, software tools to author World Wide Web pages are maturing into very feature-rich applications and are now offered by large corporations. These applications are enabling more companies to create and maintain pages themselves on the Web or on corporate Intranets. The market continues…

  16. Minimal Guidelines for Authors of Web Pages.

    ERIC Educational Resources Information Center

    ADE Bulletin, 2002

    2002-01-01

    Presents guidelines that recommend the minimal reference information that should be provided on Web pages intended for use by students, teachers, and scholars in the modern languages. Suggests the inclusion of information about responsible parties, copyright declaration, privacy statements, and site information. Makes a note on Web page style. (SG)

  17. Unit Pages: Differentiation for 200 Students

    ERIC Educational Resources Information Center

    Carver, Andrea; Bailey, Janelle M.

    2010-01-01

    Based upon the models of differentiated instruction (Tomlinson and Edison 2003) and Layered Curriculum (Nunley 2004), the author created the Unit Pages strategy. Just like Layered Curriculum, the pages can be handed directly to students, allowing them to take charge of their own learning rather than requiring the teacher to individually monitor…

  18. Automated Title Page Cataloging: A Feasibility Study.

    ERIC Educational Resources Information Center

    Weibel, Stuart; And Others

    1989-01-01

    Describes the design of a prototype rule-based system for the automation of descriptive cataloging from title pages. The discussion covers the results of tests of the prototype, major impediments to automatic cataloging from title pages, and prospects for further progress. The rules implemented in the prototype are appended. (16 references)…

  19. EPA FRS Facilities State Single File CSV Download

    EPA Pesticide Factsheets

    This page provides state comma separated value (CSV) files containing key information of all facilities and sites within the Facility Registry System (FRS). Each state zip file contains a single CSV file of key facility-level information.

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

    PubMed Central

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

    2016-01-01

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

  1. 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

  2. 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

  3. Utilisation of a community-based health facility in a low-income urban community in Ibadan, Nigeria

    PubMed Central

    Asuzu, Michael C.

    2015-01-01

    Background Primary healthcare is established to ensure that people have access to health services through facilities located in their community. However, utilisation of health facilities in Nigeria remains low in many communities. Aim To assess the utilisation of community-based health facility (CBHF) amongst adults in Ibadan, Nigeria Settings A low-income community in Ibadan North West Local Government Area of Oyo State. Methods A cross-sectional survey was conducted using a simple random sampling technique to select one adult per household in all 586 houses in the community. A semi-structured interviewer-administered questionnaire was used to collect information on respondents' sociodemographic characteristics, knowledge and utilisation of the CBHF. Data analysis included descriptive statistics and association testing using the Chi-square test at p = 0.05. Results The mean age of the respondents was 46.5 ± 16.0 years; 46.0% were men and 81.0% married; 26% had no formal education and 38.0% had secondary-level education and above; traders constituted 52.0% of the sample; and 85.2% were of low socioeconomic standing; 90% had patronised the CBHF. The main reasons for non-utilisation were preference for general hospitals (13.8%) and self-medication (12.1%). Respondents who had secondary education and above, were in a higher socioeconomic class, who had good knowledge of the facility and were satisfied with care, utilised the CBHF three months significantly more than their counterparts prior to the study (p < 0.05). However, only satisfaction with care was found to be a significant predictor of utilisation of the CBHF. Conclusion The utilisation of the CBHF amongst adults in the study setting is high, driven mostly by satisfaction with the care received previously. Self-medication, promoted by uncontrolled access to drugs through pharmacies and patent medicine stores, threatens this high utilisation. PMID:26245600

  4. Factors Associated with Treatment Delay among Pulmonary Tuberculosis Patients in Public and Private Health Facilities in Addis Ababa, Ethiopia

    PubMed Central

    Adenager, Getinet Shewaseged; Alemseged, Fessahaye; Asefa, Henok

    2017-01-01

    Background. Early detection and diagnosis of tuberculosis (TB) and the timely commencement of antituberculosis (anti-TB) treatment are the parts of efficient tuberculosis prevention and control program. Delay in the commencement of anti-TB treatment worsens the prognosis and increases the risk of death and the chance of transmission in the community and among health care workers. Objective. To assess tuberculosis treatment delay and associated factors among pulmonary TB patients in Addis Ababa, Ethiopia. Methods. A cross-sectional study was conducted in 10 public and 10 private health facilities that provide TB treatment. The data were collected from 425 newly registered pulmonary TB patients using pretested structured questionnaire from April to June 2012. Data were entered in EPI info version 3.5.1 and analyzed using SPSS version 16.0. Findings. The median durations of a patient, health care system, and total treatment delays were 17, 9, and 35 days, respectively. Overall 179 (42.1%), 233 (54.8%), and 262 (61.6%) of patients experienced patient delay, health care system delay, and total treatment delay, respectively. Distance more than 2.5 km from TB treatment health facility [AOR = 1.6, 95% CI (1.1–2.5)] and the presence of TB-associated stigma [AOR = 2.1, 95% CI (1.3, 3.4)] indicate higher odds of patient delay, whereas, being unemployed, patients with the hemoptysis symptom complain indicated lower odds of health care system delay [AOR = 0.41, 95% CI (0.24, 0.70)] and [AOR = 0.61 (0.39, 0.94)], respectively. Conclusions. A significant proportion of clients experienced patient and health care system delay. Thus, there is a need for designing and implementing appropriate strategies to decrease the delays. Efforts to reduce delays should give focus on integrating prevention programs such as active case detection and expanding access to TB care. PMID:28348887

  5. Evaluation of the impact of a simple hand-washing and water-treatment intervention in rural health facilities on hygiene knowledge and reported behaviours of health workers and their clients, Nyanza Province, Kenya, 2008.

    PubMed

    Sreenivasan, N; Gotestrand, S A; Ombeki, S; Oluoch, G; Fischer, T K; Quick, R

    2015-03-01

    Many clinics in rural western Kenya lack access to safe water and hand-washing facilities. To address this problem, in 2005 a programme was initiated to install water stations for hand washing and drinking water in 109 health facilities, train health workers on water treatment and hygiene, and motivate clients to adopt these practices. In 2008, we evaluated this intervention's impact by conducting observations at facilities, and interviewing staff and clients about water treatment and hygiene. Of 30 randomly selected facilities, 97% had water stations in use. Chlorine residuals were detectable in at least one container at 59% of facilities. Of 164 interviewed staff, 79% knew the recommended water-treatment procedure. Of 298 clients, 45% had received training on water treatment at a facility; of these, 68% knew the recommended water-treatment procedure. Use of water stations, water treatment, and client training were sustained in some facilities for up to 3 years.

  6. Why are babies born before arrival at health facilities in King Sabata Dalindyebo Local Municipality, Eastern Cape, South Africa? A qualitative study

    PubMed Central

    Alabi, Adeyinka A.; Wright, Graham; Ntsaba, Mohlomi J.

    2015-01-01

    Introduction Babies born before arrival at a health facility have a higher risk of neonatal death and their mothers a higher risk of maternal death compared with those born in-facility. The study explored the reasons for mothers giving birth before arrival (BBA) at health facilities and their experiences of BBA. Methods A qualitative research design was used. Individual and focus group interviews of BBA mothers and of nurses were undertaken at a community health centre and a district hospital in King Sabata Dalindyebo Local Municipality. Results Reasons for BBA included a lack of transport, a lack of security at night that deterred mothers from travelling, precipitate labour, failure to identify true labour, and a lack of waiting areas at health facilities. Traditional and cultural beliefs favouring childbirth at home and nurses’ negative attitudes during antenatal care and labour influenced mothers to go to health facilities when in advanced labour. Mothers were aware of possible complications associated with BBA. Conclusion Socio-economic, individual, cultural and health system factors influence the occurrence of BBA. Relevant parties need to address these factors to ensure that all babies in the King Sabata Dalindyebo Local Municipality are delivered within designated health facilities. PMID:26842514

  7. Diversion of drugs within health care facilities, a multiple-victim crime: patterns of diversion, scope, consequences, detection, and prevention.

    PubMed

    Berge, Keith H; Dillon, Kevin R; Sikkink, Karen M; Taylor, Timothy K; Lanier, William L

    2012-07-01

    Mayo Clinic has been involved in an ongoing effort to prevent the diversion of controlled substances from the workplace and to rapidly identify and respond when such diversion is detected. These efforts have found that diversion of controlled substances is not uncommon and can result in substantial risk not only to the individual who is diverting the drugs but also to patients, co-workers, and employers. We believe that all health care facilities should have systems in place to deter controlled substance diversion and to promptly identify diversion and intervene when it is occurring. Such systems are multifaceted and require close cooperation between multiple stakeholders including, but not limited to, departments of pharmacy, safety and security, anesthesiology, nursing, legal counsel, and human resources. Ideally, there should be a broad-based appreciation of the dangers that diversion creates not only for patients but also for all employees of health care facilities, because diversion can occur at any point along a long supply chain. All health care workers must be vigilant for signs of possible diversion and must be aware of how to engage a preexisting group with expertise in investigating possible diversions. In addition, clear policies and procedures should be in place for dealing with such investigations and for managing the many possible outcomes of a confirmed diversion. This article provides an overview of the multiple types of risk that result from drug diversion from health care facilities. Further, we describe a system developed at Mayo Clinic for evaluating episodes of potential drug diversion and for taking action once diversion is confirmed.

  8. DoD Needs to Improve the Billing System for Health Care Provided to Contractors at Medical Treatment Facilities in Southwest Asia

    DTIC Science & Technology

    2012-06-27

    Report No. DODIG-2012-106 June 27, 2012 DoD Needs to Improve the Billing System for Health Care Provided to Contractors at Medical Treatment ...Billing System for Health Care Provided to Contractors at Medical Treatment Facilities in Southwest Asia 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...General MTF Medical Treatment Facility SPOT Synchronized Predeployment and Operational Tracker TMDS Theater Medical Data Store USD(AT&L) Under

  9. Health system changes under pay-for-performance: the effects of Rwanda's national programme on facility inputs.

    PubMed

    Ngo, Diana K L; Sherry, Tisamarie B; Bauhoff, Sebastian

    2017-02-01

    Pay-for-performance (P4P) programmes have been introduced in numerous developing countries with the goal of increasing the provision and quality of health services through financial incentives. Despite the popularity of P4P, there is limited evidence on how providers achieve performance gains and how P4P affects health system quality by changing structural inputs. We explore these two questions in the context of Rwanda's 2006 national P4P programme by examining the programme's impact on structural quality measures drawn from international and national guidelines. Given the programme's previously documented success at increasing institutional delivery rates, we focus on a set of delivery-specific and more general structural inputs. Using the programme's quasi-randomized roll-out, we apply multivariate regression analysis to short-run facility data from the 2007 Service Provision Assessment. We find positive programme effects on the presence of maternity-related staff, the presence of covered waiting areas and a management indicator and a negative programme effect on delivery statistics monitoring. We find no effects on a set of other delivery-specific physical resources, delivery-specific human resources, delivery-specific operations, general physical resources and general human resources. Using mediation analysis, we find that the positive input differences explain a small and insignificant fraction of P4P's impact on institutional delivery rates. The results suggest that P4P increases provider availability and facility operations but is only weakly linked with short-run structural health system improvements overall.

  10. Healthcare Providers’ Level of Involvement in Provision of Smoking Cessation Interventions in Public Health Facilities in Kenya

    PubMed Central

    Gichuki, Judy W.; Opiyo, Rose; Mugyenyi, Possy; Namusisi, Kellen

    2015-01-01

    Healthcare providers can play a major role in tobacco control by providing smoking cessation interventions to smoking patients. The objective of this study was to establish healthcare providers’ practices regarding smoking cessation interventions in selected health facilities in Kiambu County, Kenya. This was a descriptive cross-sectional study carried out among healthcare providers working in public health facilities in Kiambu County, Kenya. Self-administered questionnaires were distributed to 400 healthcare providers selected using a two-stage stratified sampling technique. Only 35% of the healthcare providers surveyed reported that they always asked patients about their smoking status. Less than half (44%) reported that they always advised smoking patients to quit. Respondents who had received training on smoking cessation interventions were 3.7 times more likely to have higher practice scores than those without training (OR = 3.66; 95%CI: 1.63-8.26; P = 0.003). Majority of the healthcare providers do not routinely provide smoking cessation interventions to their patients. Measures are needed to increase health worker’s involvement in provision of smoking cessation care in Kenya.

  11. 16 CFR 436.3 - Cover page.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... business address, telephone number, and, if applicable, email address and primary home page address. (c) A... is a complex investment. The information in this disclosure document can help you make up your...

  12. 16 CFR 436.3 - Cover page.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... business address, telephone number, and, if applicable, email address and primary home page address. (c) A... is a complex investment. The information in this disclosure document can help you make up your...

  13. Best Practices for Searchable Collection Pages

    EPA Pesticide Factsheets

    Searchable Collection pages are stand-alone documents that do not have any web area navigation. They should not recreate existing content on other sites and should be tagged with quality metadata and taxonomy terms.

  14. Comparing classical and quantum PageRanks

    NASA Astrophysics Data System (ADS)

    Loke, T.; Tang, J. W.; Rodriguez, J.; Small, M.; Wang, J. B.

    2017-01-01

    Following recent developments in quantum PageRanking, we present a comparative analysis of discrete-time and continuous-time quantum-walk-based PageRank algorithms. Relative to classical PageRank and to different extents, the quantum measures better highlight secondary hubs and resolve ranking degeneracy among peripheral nodes for all networks we studied in this paper. For the discrete-time case, we investigated the periodic nature of the walker's probability distribution for a wide range of networks and found that the dominant period does not grow with the size of these networks. Based on this observation, we introduce a new quantum measure using the maximum probabilities of the associated walker during the first couple of periods. This is particularly important, since it leads to a quantum PageRanking scheme that is scalable with respect to network size.

  15. TEST PAGE Air Data From Richmond, VA

    EPA Pesticide Factsheets

    This page presents graphs showing radiation air monitoring data for Riverside, CA from EPA's RadNet system. RadNet is a nationwide network of monitoring stations that measure radiation in air, drinking water and precipitation.

  16. 7 CFR 1956.143 - Debt restructuring-hospitals and health care facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., unforeseeable costs incurred for compliance with State or Federal regulatory requirements, or the loss of key.... Operations review. A study of management and business operations of the facility by an independent expert... 103-354 reserve account for the next 3 years; (7) A discussion of FmHA or its successor agency...

  17. Effectiveness of a Staff Promoted Wellness Program to Improve Health in Residents of a Mental Health Long-Term Care Facility.

    PubMed

    Hutchison, Shari L; Terhorst, Lauren; Murtaugh, Stephanie; Gross, Sarah; Kogan, Jane N; Shaffer, Sherry L

    2016-01-01

    The current study describes physical and mental health outcomes during a health promotion program for individuals with serious mental illness (SMI). A sample of 43 adults in a long-term residential facility volunteered for an individualized, healthy lifestyle program designed to promote physical activity and combat premature mortality among individuals with SMI. Nurses and residential counselors were trained in the program and encouraged to work collaboratively with the program's personal trainers. Weekly nutrition and activity logs were obtained over the year-long evaluation. Assessments of physical and psychological health indicators were collected quarterly. Qualitative data through focus groups described staff experience. Self-report of moderate and vigorous physical activity improved over time as did fitness level as measured through a walking challenge (p = .001). Significant decreases in weight (p < .001), BMI (p = .001), and total cholesterol (p < .001) were observed from baseline through 12 months. Mean recovery scores (RMQ) were significantly higher between baseline and all time points (p < .001). Participants reported decreasing levels of depression (PHQ-9) by the 12-month time point (p < .001). Staff encouraged participation in physical activity and observed improved motivation and socialization among participants. A health promotion program with participation encouraged by health care staff is effective for increasing physical activity and improving physical and mental health outcomes in individuals with SMI in long-term residential care.

  18. A Web Page Summarization for Mobile Phones

    NASA Astrophysics Data System (ADS)

    Hasegawa, Takaaki; Nishikawa, Hitoshi; Imamura, Kenji; Kikui, Gen'ichiro; Okumur, Manabu

    Recently, web pages for mobile devices are widely spread on the Internet and a lot of people can access web pages through search engines by mobile devices as well as personal computers. A summary of a retrieved web page is important because the people judge whether or not the page would be relevant to their information need according to the summary. In particular, the summary must be not only compact but also grammatical and meaningful when the users retrieve information using a mobile phone with a small screen. Most search engines seem to produce a snippet based on the keyword-in-context (KWIC) method. However, this simple method could not generate a refined summary suitable for mobile phones because of low grammaticality and content overlap with the page title. We propose a more suitable method to generate a snippet for mobile devices using sentence extraction and sentence compression methods. First, sentences are biased based on whether they include the query terms from the users or words that are relevant to the queries, as well as whether they do not overlap with the page title based on maximal marginal relevance (MMR). Second, the selected sentences are compressed based on their phrase coverage, which is measured by the scores of words, and their phrase connection probability measured based on the language model, according to the dependency structure converted from the sentence. The experimental results reveal the proposed method outperformed the KWIC method in terms of relevance judgment, grammaticality, non-redundancy and content coverage.

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

    PubMed

    Martin, Cody; Powell, David

    2017-02-01

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

  20. Performance Evaluation of Malaria Microscopists at Defense Health Facilities in Addis Ababa and Its Surrounding Areas, Ethiopia

    PubMed Central

    Nega, Desalegn; Tasew, Geremew; Taye, Bineyam; Desta, Kassu

    2016-01-01

    Background Blood film microscopy is the gold standard approach for malaria diagnosis, and preferred method for routine patient diagnosis in health facilities. However, the inability of laboratory professionals to correctly detect and identify malaria parasites microscopically leads to an inappropriate administration of anti-malarial drugs to the patients and incorrect findings in research areas. This study was carried out to evaluate the performance of laboratory professionals in malaria diagnosis in health facilities under the Defense Health Main Department in Addis Ababa and its surroundings, Ethiopia. Method A cross sectional study was conducted from June to July 2015. Totally, 60 laboratory professionals out of the selected 16 health facilities were included in the study. Data were collected by distributing standardized pre-validated malaria slide-panels and self-administered questionnaires among professionals, onsite in each study facility. Sensitivity, specificity, and strength of agreement (with kappa score) in performance among the study participants against WHO-certified expert malaria microscopists were calculated. Result Of the 60 study participants, 8.3% (5/60) correctly read all the distributed slides in terms of parasite detection, species identification and parasite counting; whereas, each of the remaining 55(91.7%) interpreted at least two slides incorrectly. The overall sensitivity and specificity of participants’ performance in detection of malaria parasites were 65.7% and 100%, respectively. Overall, fair agreement (71.4%; Kappa: 0.4) in detection of malaria parasite was observed between the study subjects and expert readers. The overall sensitivity and specificity of participants in species identification of malaria parasites were respectively 41.3% and 100%. Overall, slight agreement (51.1%; kappa: 0.04) in identification of malaria species was observed. Generally, agreement was lower in parasite detection and species identification at low

  1. Health and safety plan for characterization sampling of ETR and MTR facilities

    SciTech Connect

    Baxter, D.E.

    1994-10-01

    This health and safety plan establishes the procedures and requirements that will be used to minimize health and safety risks to persons performing Engineering Test Reactor and Materials Test Reactor characterization sampling activities, as required by the Occupational Safety and Health Administration standard, 29 CFR 1910.120. It contains information about the hazards involved in performing the tasks, and the specific actions and equipment that will be used to protect persons working at the site.

  2. Knowledge and Use of Zinc Supplementation in the Management of Childhood Diarrhoea among Health Care Workers in Public Primary Health Facilities in Benin-City, Nigeria

    PubMed Central

    Omuemu, Vivian O.; Ofuani, Ifeanyi J.; Kubeyinje, Itse C.

    2012-01-01

    Zinc supplementation reduces the severity, duration and recurrence of childhood acute diarrhoea. These beneficial effects of zinc in the treatment of diarrhoea led to the inclusion of a 10-14 days treatment regimen by the WHO/UNICEF. This study assessed the level of knowledge and use of zinc supplementation in the management of childhood diarrhoea among health care workers in public primary health facilities in Benin-City, Nigeria. Methodology: This cross-sectional study was carried out among the total population of health care providers in public primary health facilities in Benin-City. Data collection was done using a pre-tested, structured, self-administered questionnaire and data was analyzed using SPSS version 15.0. Results: A total of 168 health care workers participated in the study. Two-thirds of them were aware of zinc supplementation but specific knowledge of zinc supplementation in the management of childhood acute diarrhoea was poor. Thirty-five percent of them prescribed zinc when managing childhood diarrhoea and only 10% of these do so for every case of childhood diarrhoea. About 84.6% of them prescribed the correct dose of zinc while less than half of them prescribe it for the correct duration. All but one of them prescribed zinc in addition to ORS in line with the WHO guideline. Discussion: The study revealed a gap in the knowledge and practice of use of zinc supplementation in the management of childhood diarrhoea. It is recommended that nationwide campaigns should be embarked on to promote the use of zinc supplementation in the clinical management of childhood diarrhoea. PMID:22980153

  3. [Medicine on mission: The international health reform of Seventh-Day Adventists and their health care facilities in Sweden].

    PubMed

    Eklöf, Motzi

    2008-01-01

    The international non-conformist denomination, Seventh-day Adventists, have since their foundation in 1863, had a distinctive health care model for their members. The life-style has included vegetarian diet, abstinence from alcohol, tobacco and other drugs and the observance of a day of rest once a week. The health policy has striven to care for God's creation in the hope of resurrection at the Day of Judgment and to reform the conventional medical practice. The Adventists have pursued an extensive international health care system--from the start based on dietary and physical treatment methods, such as hydrotherapy, massage and physiotherapy--in line with the Christian mission. Health care establishments have been inaugurated around the world as a vehicle for enabling the Christian health care message to reach the upper classes. With Adventist and Doctor, John Harvey Kellogg's Battle Creek Sanatorium in Michigan as both inspirational source and educational institution, the health care mission--including a vegetarian health food industry, following in the footsteps of cornflakes--spread to the Nordic countries by the turn of the century, 1900. Skodsborgs Badesanatorium near Copenhagen became the model institution for several health care establishments in Sweden during the 1900's, such as Hultafors Sanatorium. The American-Nordic link has manifested itself through co-publication of papers, exchange of health care personnel and reporting to the central Adventist church. The American non-conformist domain as well as a private sphere of activity, aiming mainly from the outset at society's upper classes, has encountered certain difficulties in maintaining this distinction in Sweden's officially increasing secularised society, and in relation to a state health insurance and a publicly financed health care system. With the passing of time, the socioeconomic composition of patients at Hultafors became more heterogeneous, and conventional medical procedures were increasingly

  4. Strategic planning for information services at multi-facility health systems.

    PubMed

    Bridle, J G

    1990-12-01

    Without benefit of an up-to-date, in-depth appraisal of any specific multi-facility's organization, the healthcare facility's mission statement and philosophy, and a detailed understanding of the current situation within each of the IS divisions and/or Data Processing departments, it is merely possible to generically assess the needs in light of today's readily available technology, and to subjectively and logically apply ones past experience to determine a preferred approach. Therefore, this overview of strategic planning considerations ought to be used with caution. A workable plan requires extensive on-going effort, and comes alive only when it is adopted by management. In the event that no previous information services planning activity has occurred within the organization, or where a prior strategic plan is more than three years old, prudent advice would include a strong recommendation to begin such a process without delay.

  5. Success Providing Postpartum Intrauterine Devices in Private-Sector Health Care Facilities in Nigeria: Factors Associated With Uptake

    PubMed Central

    Eluwa, George IE; Atamewalen, Ronke; Odogwu, Kingsley; Ahonsi, Babatunde

    2016-01-01

    ABSTRACT Background: Use of modern contraceptive methods in Nigeria remained at 10% between 2008 and 2013 despite substantive investments in family planning services. Many women in their first postpartum year, in particular, have an unmet need for family planning. We evaluated use of postpartum intrauterine device (IUD) insertion and determined factors associated with its uptake in Nigeria. Methods: Data were collected between May 2014 and February 2015 from 11 private health care facilities in 6 southern Nigerian states. Women attending antenatal care in participating facilities were counseled on all available contraceptive methods including the postpartum IUD. Data were abstracted from participating facility records and evaluated using a cross-sectional analysis. Categorical variables were calculated as proportions while continuous variables were calculated as medians with the associated interquartile range (IQR). Multivariate logistic regression analysis was used to identify factors associated with uptake of the postpartum IUD while controlling for potential confounding factors, including age, educational attainment, marital status, parity, number of living children, and previous use of contraception. Results: During the study period, 728 women delivered in the 11 facilities. The median age was 28 years, and most women were educated (73% had completed at least the secondary level). The majority (96%) of the women reported they were married, and the median number of living children was 3 (IQR, 2–4). Uptake of the postpartum IUD was 41% (n = 300), with 8% (n = 25) of the acceptors experiencing expulsion of the IUD within 6 weeks post-insertion. After controlling for potential confounding factors, several characteristics were associated with greater likelihood of choosing the postpartum IUD, including lower education, having a higher number of living children, and being single. Women who had used contraceptives previously were less likely to choose the

  6. New York State School Facilities and Student Health, Achievement, and Attendance: A Data Analysis Report

    ERIC Educational Resources Information Center

    Boese, Stephen; Shaw, John

    2005-01-01

    Students who attend schools with environmental hazards that impact indoor air quality are more likely to miss class, and therefore lose learning opportunities. Yet school environmental health and safety remains largely unregulated and there is no state or federal agency in charge of protecting children's environmental health in schools. This…

  7. Construction Grants for Educational Facilities. Fiscal Years 1965-76. Health Manpower References.

    ERIC Educational Resources Information Center

    Health Resources Administration (DHEW/PHS), Bethesda, MD. Bureau of Health Manpower.

    This publication provides information on construction assistance awarded during fiscal years 1965 through 1976 by the Bureau of Health Manpower (BHM) and its predecessors to schools of medicine, osteopathic medicine, dentistry, optometry, pharmacy, podiatric medicine, veterinary medicine, public health, and nursing. In addition, it provides data…

  8. Critical Factors in Mental Health Programming for Juveniles in Corrections Facilities

    ERIC Educational Resources Information Center

    Underwood, Lee A.; Phillips, Annie; von Dresner, Kara; Knight, Pamela D.

    2006-01-01

    Juveniles with mental health and other specialized needs are overrepresented in the juvenile justice system, and while juvenile corrections have not historically provided standardized and evidence-based mental health services for its incarcerated youth, the demand is evident. The reality is that juveniles with serious mental illness are committed…

  9. Description Meta Tags in Public Home and Linked Pages.

    ERIC Educational Resources Information Center

    Craven, Timothy C.

    2001-01-01

    Random samples of 1,872 Web pages registered with Yahoo! And 1,638 pages reachable from Yahoo!-registered pages were analyzed for use of meta tags and specifically those containing descriptions. Results: 727 (38.8%) of the Yahoo!-registered pages and 442 (27%) of the other pages included descriptions in meta tages. Some descriptions greatly…

  10. Linking household and facility data for better coverage measures in reproductive, maternal, newborn, and child health care: systematic review

    PubMed Central

    Do, Mai; Micah, Angela; Brondi, Luciana; Campbell, Harry; Marchant, Tanya; Eisele, Thomas; Munos, Melinda

    2016-01-01

    Background Currently many measures of intervention coverage obtained from household surveys do not measure actual health intervention/service delivery, resulting in a need for linking reports of care–seeking with assessments of the service environment in order to improve measurements. This systematic review aims to identify evidence of different methods used to link household surveys and service provision assessments, with a focus on reproductive, maternal, newborn and child health care, in low– and middle–income countries. Methods Using pre–defined search terms, articles published in peer–reviewed journals and the grey literature after 1990 were identified, their reference lists scanned and linking methods synthesized. Findings A total of 59 articles and conference presentations were carefully reviewed and categorized into two groups based on the linking method used: 1) indirect/ecological linking that included studies in which health care–seeking behavior was linked to all or the nearest facilities or providers of certain types within a geographical area, and 2) direct linking/exact matching where individuals were linked with the exact provider or facility where they sought care. The former approach was employed in 51 of 59 included studies, and was particularly common among studies that were based on independent sources of household and facility data that were nationally representative. Only eight of the 59 reviewed studies employed direct linking methods, which were typically done at the sub–national level (eg, district level) and often in rural areas, where the number of providers was more limited compared to urban areas. Conclusions Different linking methods have been reported in the literature, each category has its own set of advantages and limitations, in terms of both methodology and practicality for scale–up. Future studies that link household and provider/facility data should also take into account factors such as sources of data, the

  11. Legionella spp. and legionellosis in southeastern Italy: disease epidemiology and environmental surveillance in community and health care facilities

    PubMed Central

    2010-01-01

    Background Following the publication of the Italian Guidelines for the control and prevention of legionellosis an environmental and clinical surveillance has been carried out in Southeastern Italy. The aim of the study is to identify the risk factors for the disease, so allowing better programming of the necessary prevention measures. Methods During the period January 2000 - December 2009 the environmental surveillance was carried out by water sampling of 129 health care facilities (73 public and 56 private hospitals) and 533 buildings within the community (63 private apartments, 305 hotels, 19 offices, 4 churches, 116 gyms, 3 swimming pools and 23 schools). Water sampling and microbiological analysis were carried out following the Italian Guidelines. From January 2005, all facilities were subject to risk analysis through the use of a standardized report; the results were classified as good (G), medium (M) and bad (B). As well, all the clinical surveillance forms for legionellosis, which must be compiled by physicians and sent to the Regional Centre for Epidemiology (OER), were analyzed. Results Legionella spp. was found in 102 (79.1%) health care facilities and in 238 (44.7%) community buildings. The percentages for the contamination levels < 1,000, 1,000-10,000, > 10,000 cfu/L were respectively 33.1%, 53.4% and 13.5% for samples from health care facilities and 33.5%, 43.3% and 23.2% for samples from the community. Both in hospital and community environments, Legionella pneumophila serogroup (L. pn sg) 2-14 was the most frequently isolate (respectively 54.8% and 40.8% of positive samples), followed by L. pn sg 1 (respectively 31.3% and 33%). The study showed a significant association between M or B score at the risk analysis and Legionella spp. positive microbiological test results (p < 0.001). From clinical surveillance, during the period January 2001 - August 2009, 97 cases of legionellosis were reported to the OER: 88 of community origin and 9 nosocomial. The

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

    PubMed Central

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

    2016-01-01

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

  13. Information needs for siting new, and evaluating current, nuclear facilities: ecology, fate and transport, and human health.

    PubMed

    Burger, Joanna; Clarke, James; Gochfeld, Michael

    2011-01-01

    The USA is entering an era of energy diversity, and increasing nuclear capacity and concerns focus on accidents, security, waste, and pollution. Physical buffers that separate outsiders from nuclear facilities often support important natural ecosystems but may contain contaminants. The US Nuclear Regulatory Commission (NRC) licenses nuclear reactors; the applicant provides environmental assessments that serve as the basis for Environmental Impact Statements developed by NRC. We provide a template for the types of information needed for safe siting of nuclear facilities with buffers in three categories: ecological, fate and transport, and human health information that can be used for risk evaluations. Each item on the lists is an indicator for evaluation, and individual indicators can be selected for specific region. Ecological information needs include biodiversity (species, populations, communities) and structure and functioning of ecosystems, habitats, and landscapes, in addition to common, abundant, and unique species and endangered and rare ones. The key variables of fate and transport are sources of release for radionuclides and other chemicals, nature of releases (atmospheric vapors, subsurface liquids), features, and properties of environmental media (wind speed, direction and atmospheric stability, hydraulic gradient, hydraulic conductivity, groundwater chemistry). Human health aspects include receptor populations (demography, density, dispersion, and distance), potential pathways (drinking water sources, gardening, fishing), and exposure opportunities (lifestyle activities). For each of the three types of information needs, we expect that only a few of the indicators will be applicable to a particular site and that stakeholders should agree on a site-specific suite.

  14. Vacation health care

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/001937.htm Vacation health care To use the sharing features on this page, ... and help you avoid problems. Talk to your health care provider or visit a travel clinic 4 to ...

  15. Defining and Negotiating the Social Value of Research in Public Health Facilities: Perceptions of Stakeholders in a Research-Active Province of South Africa.

    PubMed

    Lutge, Elizabeth; Slack, Catherine; Wassenaar, Douglas

    2017-02-01

    This article reports on qualitative research conducted in KwaZulu-Natal, South Africa, among researchers and gate-keepers of health facilities in the province. Results suggest disparate but not irreconcilable perceptions of the social value of research in provincial health facilities. This study found that researchers tended to emphasize the contribution of research to the generation of knowledge and to the health of future patients while gate-keepers of health facilities tended to emphasize its contribution to the healthcare system and to current patients. Furthermore, relations between research stakeholders were perceived to be somewhat fragile, making it difficult for stakeholders to achieve consensus about the social value of research, as well as on ways to maximize value. Interventions to negotiate a shared perspective on the social value of research would appear to be warranted, and the findings of this study suggest some focus areas for such intervention.

  16. Provider-initiated HIV testing and counseling in health facilities--what does this mean for the health and human rights of pregnant women?

    PubMed

    Gruskin, Sofia; Ahmed, Shahira; Ferguson, Laura

    2008-04-01

    Since the introduction of drugs to prevent vertical transmission of HIV, the purpose of and approach to HIV testing of pregnant women has increasingly become an area of major controversy. In recent years, many strategies to increase the uptake of HIV testing have focused on offering HIV tests to women in pregnancy-related services. New global guidance issued by the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) specifically notes these services as an entry point for provider-initiated HIV testing and counseling (PITC). The guidance constitutes a useful first step towards a framework within which PITC sensitive to health, human rights and ethical concerns can be provided to pregnant women in health facilities. However, a number of issues will require further attention as implementation moves forward. It is incumbent on all those involved in the scale up of PITC to ensure that it promotes long-term connection with relevant health services and does not result simply in increased testing with no concrete benefits being accrued by the women being tested. Within health services, this will require significant attention to informed consent, pre- and post-test counseling, patient confidentiality, referrals and access to appropriate services, as well as reduction of stigma and discrimination. Beyond health services, efforts will be needed to address larger societal, legal, policy and contextual issues. The health and human rights of pregnant women must be a primary consideration in how HIV testing is implemented; they can benefit greatly from PITC but only if it is carried out appropriately.

  17. APIC state-of-the-Art report: the role of infection control during construction in health care facilities.

    PubMed

    Bartley, J M

    2000-04-01

    The Association for Professionals in Infection Control and Epidemiology, Inc (APIC), is a multidisciplinary organization of more than 12,000 health care professionals who practice infection control and epidemiology within a variety of health care settings. This report reviews issues the infection control professional should consider related to construction and renovation projects in health care facilities. Preventing transmission of infectious agents to vulnerable patient populations, health care workers, and visitors remains an important component of infection control programs. Environmental dispersal of microorganisms during construction, resulting in nosocomial infections, has been described previously, and select examples are provided in Table I as a reminder that there is a solid, scientific basis for these concerns. Environmental airborne contaminants and infectious agents are closely related to water and moisture-related conditions and figure prominently in construction activity. Weems et al have established construction activity as an independent variable for infectious risks in such circumstances. Construction-related outbreak literature will not be revisited in detail; however, pertinent citations will identify resources as appropriate.

  18. [Risk factors associated with non-adherence to anti-hypertensive medication among patients treated in family health care facilities].

    PubMed

    Santa-Helena, Ernani Tiaraju de; Nemes, Maria Ines Battistella; Eluf Neto, José

    2010-12-01

    In order to estimate the prevalence of treatment non-adherence and associated factors among individuals with systemic arterial hypertension treated at family health care facilities, a cross-sectional study was performed with 595 patients. The dependent variable non-adherence was measured with a Medication Adherence Questionnaire (MAQ). A hierarchical logistic regression model was used to analyze socioeconomic, health care-related, personal, and treatment-related variables. Prevalence of non-adherence was 53%. Variables associated with non-adherence were: (1) socioeconomic--belonging to economic classes C, D, or E; work market participation in unskilled labor; (2) health care--out-of-pocket payment for medication; more than six months since last physician consultation; and (3) personal and treatment characteristics--previous interruption of treatment; being on treatment for less than three years; and presence of a common mental disorder. The study of determinants of non-adherence articulated in a hierarchical model suggests that social inequalities are either directly associated with non-adherence or mediated by personal and health services factors.

  19. Current issues in the design of academic health sciences libraries: findings from three recent facility projects*

    PubMed Central

    Nelson, Patricia P.

    2003-01-01

    Planning a new health sciences library at the beginning of the twenty-first century is a tremendous challenge. Technology has radically changed the way libraries function in an academic environment and the services they provide. Some individuals question whether the library as place will continue to exist as information becomes increasingly available electronically. To understand how libraries resolve programming and building design issues, visits were made to three academic health sciences libraries that have had significant renovation or completed new construction. The information gathered will be valuable for planning a new library for the University of Colorado Health Sciences Center and may assist other health sciences librarians as they plan future library buildings. PMID:12883559

  20. Current issues in the design of academic health sciences libraries: findings from three recent facility projects.

    PubMed

    Nelson, Patricia P

    2003-07-01

    Planning a new health sciences library at the beginning of the twenty-first century is a tremendous challenge. Technology has radically changed the way libraries function in an academic environment and the services they provide. Some individuals question whether the library as place will continue to exist as information becomes increasingly available electronically. To understand how libraries resolve programming and building design issues, visits were made to three academic health sciences libraries that have had significant renovation or completed new construction. The information gathered will be valuable for planning a new library for the University of Colorado Health Sciences Center and may assist other health sciences librarians as they plan future library buildings.

  1. Quality of Antimalarial Drugs and Antibiotics in Papua New Guinea: A Survey of the Health Facility Supply Chain

    PubMed Central

    Hetzel, Manuel W.; Page-Sharp, Madhu; Bala, Nancy; Pulford, Justin; Betuela, Inoni; Davis, Timothy M. E.; Lavu, Evelyn K.

    2014-01-01

    Background Poor-quality life-saving medicines are a major public health threat, particularly in settings with a weak regulatory environment. Insufficient amounts of active pharmaceutical ingredients (API) endanger patient safety and may contribute to the development of drug resistance. In the case of malaria, concerns relate to implications for the efficacy of artemisinin-based combination therapies (ACT). In Papua New Guinea (PNG), Plasmodium falciparum and P. vivax are both endemic and health facilities are the main source of treatment. ACT has been introduced as first-line treatment but other drugs, such as primaquine for the treatment of P. vivax hypnozoites, are widely available. This study investigated the quality of antimalarial drugs and selected antibiotics at all levels of the health facility supply chain in PNG. Methods and Findings Medicines were obtained from randomly sampled health facilities and selected warehouses and hospitals across PNG and analysed for API content using validated high performance liquid chromatography (HPLC). Of 360 tablet/capsule samples from 60 providers, 9.7% (95% CI 6.9, 13.3) contained less, and 0.6% more, API than pharmacopoeial reference ranges, including 29/37 (78.4%) primaquine, 3/70 (4.3%) amodiaquine, and one sample each of quinine, artemether, sulphadoxine-pyrimethamine and amoxicillin. According to the package label, 86.5% of poor-quality samples originated from India. Poor-quality medicines were found in 48.3% of providers at all levels of the supply chain. Drug quality was unrelated to storage conditions. Conclusions This study documents the presence of poor-quality medicines, particularly primaquine, throughout PNG. Primaquine is the only available transmission-blocking antimalarial, likely to become important to prevent the spread of artemisinin-resistant P. falciparum and eliminating P. vivax hypnozoites. The availability of poor-quality medicines reflects the lack of adequate quality control and regulatory

  2. Releases of Contaminants from Oak Ridge Facilities and Risks to Public Health; Final Report of the Oak Ridge Health Agreement Steering Panel

    SciTech Connect

    Alexander, James; Brooks, Barbara; Erwin, Paul; Hamilton, Joseph; Holloway, Jacqueline; Lipford, Patrick; Morin, Norma; Peelle, Robert; Smith, James; Voilleque, Paul; Zawia, Nasser; Williams, Leo

    1999-12-01

    In the early 1990s, concern about the Oak Ridge Reservation's past releases of contaminants to the environment prompted Tennessee's public health officials to pursue an in-depth study of potential off-site health effects at Oak Ridge. This study, the Oak Ridge dose reconstruction, was supported by an agreement between the U.S. Department of Energy (DOE) and the State of Tennessee, and was overseen by a 12-member panel appointed by Tennessee's Commissioner of Health. The following report, "Releases of Contaminants from Oak Ridge Facilities and Risks to Public Health," was written by the Oak Ridge Health Agreement Steering Panel (ORHASP) for the following purposes: (1) to explain the components and process of the lengthy, complex study; (2) to summarize important study results in less technical language; and (3) to provide the State with the Panel's recommendations for future actions concerning the Oak Ridge communities.The dose reconstruction process involved the examination of thousands of historical records to obtain information relating to past operations at each facility. It resulted in hundreds of documents being declassified and provided an avenue for a complete public accounting of past practices and releases. Researchers used this information to identify released contaminants of concern, to estimate the quantity and timing of these releases, to evaluate the routes taken by contaminants through the environment to nearby populations, and to estimate the doses and health risks to exposed groups.The results suggest it is likely that some people's risks of developing various types of cancers or other health effects were increased because of the releases. Two groups were most likely to have been harmed: local children drinking milk, in the early 1950's, from a "backyard" cow or goat that had grazed on pastures contaminated with iodine-131, and fetuses carried in the 1950's and early 1960's by women who routinely ate fish taken from nearby creeks and rivers

  3. The mediating role of facebook fan pages.

    PubMed

    Chih, Wen-Hai; Hsu, Li-Chun; Wang, Kai-Yu; Lin, Kuan-Yu

    2014-01-01

    Using the dual mediation hypothesis, this study investigates the role of interestingness (the power of attracting or holding one's attention) attitude towards the news, in the formation of Facebook Fan Page users' electronic word-of-mouth intentions. A total of 599 Facebook fan page users in Taiwan were recruited and structural equation modeling (SEM) was used to test the research hypotheses. The results show that both perceived news entertainment and informativeness positively influence interestingness attitude towards the news. Interestingness attitude towards the news subsequently influences hedonism and utilitarianism attitudes towards the Fan Page, which then influence eWOM intentions. Interestingness attitude towards the news plays a more important role than hedonism and utilitarianism attitudes in generating electronic word-of-mouth intentions. Based on the findings, the implications and future research suggestions are provided.

  4. A rendering approach for stereoscopic web pages

    NASA Astrophysics Data System (ADS)

    Zhang, Jianlong; Wang, Wenmin; Wang, Ronggang; Chen, Qinshui

    2014-03-01

    Web technology provides a relatively easy way to generate contents for us to recognize the world, and with the development of stereoscopic display technology, the stereoscopic devices will become much more popular. The combination of web technology and stereoscopic display technology will bring revolutionary visual effect. The Stereoscopic 3D (S3D) web pages, in which text, image and video may have different depth, can be displayed on stereoscopic display devices. This paper presents the approach about how to render two viewing S3D web pages including text, images, widgets: first, an algorithm should be developed in order to display stereoscopic elements like text, widgets by using 2D graphic library; second, a method should be presented to render stereoscopic web page based on current framework of the browser; third, a rough solution is invented to fix the problem that comes out in the method.

  5. European user trial of paging by satellite

    NASA Technical Reports Server (NTRS)

    Fudge, R. E.; Fenton, C. J.

    1990-01-01

    British Telecom conceived the idea of adapting their existing paging service, together with the use of existing terrestrial pagers, to yield a one way data (i.e., paging) satellite service to mobiles. The user trial of paging by satellites was successful. It demonstrated that services could be provided over a wide geographical area to low priced terminals. Many lessons were learned in unexpected areas. These include the need for extensive liaison with all users involved, especially the drivers, to ensure they understood the potential benefits. There was a significant desire for a return acknowledgement channel or even a return data channel. Above all there is a need to ensure that the equipment can be taken across European borders and legitimately used in all European countries. The next step in a marketing assessment would be to consider the impact of two way data messaging such as INMARSAT-C.

  6. Information technology systems in public sector health facilities in developing countries: the case of South Africa

    PubMed Central

    2013-01-01

    Background The public healthcare sector in developing countries faces many challenges including weak healthcare systems and under-resourced facilities that deliver poor outcomes relative to total healthcare expenditure. Global references demonstrate that information technology has the ability to assist in this regard through the automation of processes, thus reducing the inefficiencies of manually driven processes and lowering transaction costs. This study examines the impact of hospital information systems implementation on service delivery, user adoption and organisational culture within two hospital settings in South Africa. Methods Ninety-four interviews with doctors, nurses and hospital administrators were conducted in two public sector tertiary healthcare facilities (in two provinces) to record end-user perceptions. Structured questionnaires were used to conduct the interviews with both qualitative and quantitative information. Results Noteworthy differences were observed among the three sample groups of doctors, nurses and administrators as well as between our two hospital groups. The impact of automation in terms of cost and strategic value in public sector hospitals is shown to have yielded positive outcomes with regard to patient experience, hospital staff workflow enhancements, and overall morale in the workplace. Conclusion The research provides insight into the reasons for investing in system automation, the associated outcomes, and organisational factors that impact the successful adoption of IT systems. In addition, it finds that sustainable success in these initiatives is as much a function of the technology as it is of the change management function that must accompany the system implementation. PMID:23347433

  7. National Ignition Facility start-up/operations engineering and special equipment construction health and safety plan

    SciTech Connect

    Huddleston, P C

    1998-05-08

    This document sets forth the responsibilities, interfaces, guidelines, rules, policy, and regulations for all workers involved in the S/O and SE construction, installation, and acceptance testing. This document is enforced from the first day that S/O and SE workers set foot on the NIF construction site until the end of the Project at Critical Decision 4. This document is applicable only to site activities, which are defined as those that occur within the perimeter of the fenced-off NIF construction zone and the Target Chamber Assembly Area (Helipad). The associated Special Equipment laydown and construction support areas listed in Appendix B are not under this plan; their safety provisions are discussed in the Appendix. Prototype and other support activities, such as the Amplifier Laboratory and Frame Assembly Unit assembly area, are not included in this plan. After completion of the Operational Readiness Review, the Facility Safety Procedure, Operational Safety Requirements, and Operational Safety Procedures are the governing safety documents for the operating facility. The S/O and SE project elements are required to implement measures that create a universal awareness of and promote safe job practices at the site. This includes all Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory, Sandia National Laboratories, University of Rochester, supplement labor organization, and subcontractor employees; visitors; and guests serving the S/O and SE effort.

  8. Determinants of life satisfaction among Japanese elderly women attending health care and welfare service facilities.

    PubMed

    Onishi, Chiemi; Yuasa, Kyoko; Sei, Masako; Ewis, Ashraf A; Nakano, Takuro; Munakata, Hokuma; Nakahori, Yutaka

    2010-02-01

    Prolonged life expectancy must be recognized as an excellent achievement of modern medicine, but not all the elderly people are satisfied with their lives. Life satisfaction is a multi-dimensional issue that depends on many objective and subjective characteristics. In this study, we aimed at investigating the factors affecting life satisfaction of 314 elderly Japanese women attending in 28 elderly-care and welfare facilities at Tokushima Prefecture, Japan. Our results indicated that elderly subjects with depression tendencies always show significantly lower degrees of life satisfaction than others who are not depressed (p<0.001) regardless of their cognitive status. Furthermore, elderly women who shared decision for their living place and whose opinions were considered for daily life decisions reported significantly more life satisfaction levels than others. We conclude that elderly life satisfaction is affected by various determinants however, with different influencing weight. Life satisfaction of elderly people, with or without dementia, is greatly affected by their mood status and share in decision making. Avoiding elderly people depressive mood, sharing them in various daily decisions, considering their opinions, and allowing them to decide their elderly-care facility placement are crucial determinants for their life satisfaction and essential for their coping, adaptation, well-being and successful aging.

  9. Laser Based Information Systems (Selected Pages),

    DTIC Science & Technology

    1986-05-22

    CO lasers . Microwaves, 1967, M* 7. 85. W e I s s P. F., T o h n s o n R. E. Laser tracking wiht automatic reacquisi- tion capability. Appl. Optics, 1968, Vol. 7, M* 6. I it 313 lab- Now - ...DIVISIONCD LASER BASED INFORMATION SYSTEMS (Selected Pages) bDTIC L.Z. Kriksunov EL’, %N16 86 4. I’, Approved for public release; Distribution...HUMAN TRANSLATION FTD-ID(RS)T-0563-85 22 May 1986 MICROFICHE NR: FTD-86-C-O01863 LASER BASED INFORMATION SYSTEMS (Selected Pages) By: L.Z.

  10. Competence of health care providers on care of newborns at birth in a level-1 health facility in Yaoundé, Cameroon

    PubMed Central

    Monebenimp, Francisca; Tenefopa, Makudjou; Mve Koh, Valere; Kago, Innocent

    2012-01-01

    Introduction This is an observational study which was carried out at a level one health facility in Yaoundé from June to July 2009. The aim was to evaluate the competence of health care providers towards newborns’ care at birth Methods Ten health care providers took care of three hundred and thirty-five pregnant women who were enrolled for the study after informed verbal consent in the delivery room. Results Out of 340 offspring delivered and taken care of, 179 (52.6%) were male and 161 (47.4%) were female. Only two out of ten health workers had a WHO Essential Newborn Care (ENC) training. None of them had received any refresher course for the past two years. The mean gestational age of women was 39.5±3.5 weeks. Resuscitation was carried out on 21 (6.2%) of the newborns including 7 (33.3%) who had birth asphyxia. Health care providers scored 100% in performing the following tasks: warming up the baby, applying eye drops, injecting vitamin K, identifying the neonate, searching for any apparent life threatening congenital malformations, preventing for infection after procedures and initiating breastfeeding. The score was 24% at neonatal resuscitation tasks. Low level of education was associated with poor competence on applying ENC tasks (p<0.001). Lack of WHO ENC training was associated with poor competence on ENC tasks (p<0.001) and poor skills on resuscitation (p=0.03). Conclusion There is a need to reinforce the capacity of health care providers by training in WHO ENC course with emphasis on providing skills on resuscitation in order to reduce the burden of neonatal intrapartum-related deaths. PMID:22593781

  11. Patients' perception and satisfaction with health care professionals at primary care facilities in Trinidad and Tobago.

    PubMed Central

    Singh, H.; Haqq, E. D.; Mustapha, N.

    1999-01-01

    This paper endeavours to identify the background characteristics of health centre users in Trinidad and Tobago and their perceptions of the efficiency of the services provided. Multistage sampling was employed to select 1451 users. Data were obtained during structured interviews on regular clinic days. Of the people using the health centres, 80.4% were unemployed and 75.9% were women. People aged over 60 accounted for 25.4% of the sample. Users included a disproportionately high number of persons from the lower socioeconomic categories. The proportions of persons of different ethnic and religious groups closely reflected those in the country's general population. Approximately 74% of the interviewees were satisfied with the performance of the doctors in the health centres. For nurses the satisfaction rating was about 10% higher. The greatest needs for improvement were perceived to be in pharmacists' and doctors' services, with particular reference to waiting times. PMID:10327716

  12. [Hygienic maintenance of public health in the Republic of Belarus in the design of facilities].

    PubMed

    Naumenko, T E; Sokolov, C M; Shevchuk, L M; Gritsenko, T D; Pshegroda, A E; Pershin, I G

    2012-01-01

    A number of sanitary norms, rules and hygienic standards governing the sizes of the sanitary protection zone for a safety to human health from the harmful (chemical, biological, physical) effects of objects has been upgraded and improved. The harmonization of ambient air quality standards with international guidelines and obligations of the Republic of Belarus on international conventions has been performed. To assess the risk to public health from the impacts of a planned activity the project of instruction for the use and the algorithm of computer software for the risk assessment have been delivered.

  13. [Native electrophoresis in cell proteomics: BN-PAGE and CN-PAGE].

    PubMed

    Shykoliukov, S A

    2011-01-01

    The presented mini-review aims to attract the attention of domestic researchers for rapid, cheap and easily reproducible method of native polyacrylamide gel electrophoresis (PAGE), which for some reason has not yet found application in our country. The review collected the most interesting examples of the use of three types of native electrophoresis (BN-PAGE, CN-PAGE and hrCN-PAGE) to study the peculiarities of proteomes of various animal, plant and bacterial cells. The references to fundamental reviews, basic protocols, modifications of the initial methods and the examples of the combination of native electrophoresis with other chemical or physical methods are presented. Particular attention to the principles of BN-, CN- and hrCN-PAGE as well as to their advantages and disadvantages is paid.

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

    PubMed Central

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

    2017-01-01

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

  15. Innovation Problems of the Fortification of Health Youth Facility of the Physical Culture

    ERIC Educational Resources Information Center

    Panachev, Valeriy; Zelenin, Leonid; Opletin, Anatoliy; Kudryshov, Evgeniy; Oborin, Aleksandr; Nohrin, Mihail; Annenkova, Svetlana; Solonitsin, Roman; Korepanova, Yulia; Fazleev, Marat

    2016-01-01

    In referencing the Russia President to Federal Meeting said, that one of the main problems of the future development of the social state is an increasing life's quality of the Russians, the improvement of health to nations and demographic situation in Russian Federation. Per annum 72-years Victories in Great Domestic war sharply cost the questions…

  16. [Health problems of the city of Split on the pages of the first newspaper written in Croatian language: "Il Regio Dalmata-Kraglski Dalmatin" (1806-1810): on the occasion of the 200th anniversary of termination of its publication].

    PubMed

    Brisky, Livia

    2010-01-01

    At the beginning of the 19th century, one of the most important cultural events in Dalmatia was the publication of a bilingual newspaper Il Regio Dalmata - Kraglski Dalmatin in Italian and Croatian, issued by the French government in Zadar between 12 July 1806 and 22 January 1808. Between 29 January 1808 and 1 April 1810 it changed name to Il Regio Dalmata. The journal paid much attention to the health problems of the city of Split, especially between 1806 and 1808. The aim of this study was to analyze the original articles published in this first newspaper in Croatian language and to understand the role of this publication as means of promoting health policies in Split. The journal published articles about health care for the poor and foundlings, about the need for charity institutions to refer them to the city hospital and to the foundling home, and encouraged citizens to help maintain these institutions. Great attention was also dedicated to vaccination against smallpox and demographic problems of Split. Thanks to Croatian, Il Regio Dalmata-Kraglski Dalmatin informed a wider audience about the existing health conditions in the city of Split and about the efforts of the French government for its improvement.

  17. Perceived health status and environmental quality in the assessment of external costs of waste disposal facilities. An empirical investigation.

    PubMed

    Giaccaria, Sergio; Frontuto, Vito

    2012-08-01

    Taxation for urban waste management has been reformed in Italy by the introduction of an environmental law in 2006. In the planning phase of waste management, externalities generated by new facilities remain widely unaccounted, with a consequent distortion for prices, often raising local conflicts. The paper presents a survey based on the choice modelling methodology, aimed to evaluate on a monetary scale the disamenity effect perceived by incinerator and landfills in an Italian urban context: the city of Turin. In a random utility framework the behaviour of respondents, whose choices are found to be driven by the endowment of information about technological options, socio-economic characteristics as income, education, family composition, and also by their health status was modelled. Furthermore, empirical evidence that the behaviour in residential location choices is affected by different aspects of the respondent life and in particular by the health status was found. Distinct estimates of willingness to accept compensation for disamenity effects of incinerator (Euro 2670) and landfill (Euro 3816) are elicited. The effect of health status of the respondents, their level of information about the waste disposal infrastructure, the presence of a subjective strong aversion (NIMBY) and the actual endowment and concentration of infrastructures are demonstrated to be significant factors determining the choice behaviour, but differentiated and specific for incinerators and landfills.

  18. 24 CFR 1710.105 - Cover page.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 5 2014-04-01 2014-04-01 false Cover page. 1710.105 Section 1710.105 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued....C. 1718; sec. 7(d), Dept. of Housing and Urban Development Act, 42 U.S.C. 3535(d))...

  19. Monitoring and Managing Links on Your Pages

    EPA Pesticide Factsheets

    Some of these tools can be used on Drupal pages that are not published yet, or on non-Drupal content. Some, such as the Bookmarklet tools, can help make checking and correcting your links easier when used alongside Drupal's link reports.

  20. Referencing web pages and e-journals.

    PubMed

    Bryson, David

    2013-12-01

    One of the areas that can confuse students and authors alike is how to reference web pages and electronic journals (e-journals). The aim of this professional development article is to go back to first principles for referencing and see how with examples these should be referenced.

  1. Thomas Jefferson, Page Design, and Desktop Publishing.

    ERIC Educational Resources Information Center

    Hartley, James

    1991-01-01

    Discussion of page design for desktop publishing focuses on the importance of functional issues as opposed to aesthetic issues, and criticizes a previous article that stressed aesthetic issues. Topics discussed include balance, consistency in text structure, and how differences in layout affect the clarity of "The Declaration of…

  2. Reconfigurable Full-Page Braille Displays

    NASA Technical Reports Server (NTRS)

    Garner, H. Douglas

    1994-01-01

    Electrically actuated braille display cells of proposed type arrayed together to form full-page braille displays. Like other braille display cells, these provide changeable patterns of bumps driven by digitally recorded text stored on magnetic tapes or in solid-state electronic memories. Proposed cells contain electrorheological fluid. Viscosity of such fluid increases in strong electrostatic field.

  3. Efficient Web Change Monitoring with Page Digest

    SciTech Connect

    Buttler, D J; Rocco, D; Liu, L

    2004-02-20

    The Internet and the World Wide Web have enabled a publishing explosion of useful online information, which has produced the unfortunate side effect of information overload: it is increasingly difficult for individuals to keep abreast of fresh information. In this paper we describe an approach for building a system for efficiently monitoring changes to Web documents. This paper has three main contributions. First, we present a coherent framework that captures different characteristics of Web documents. The system uses the Page Digest encoding to provide a comprehensive monitoring system for content, structure, and other interesting properties of Web documents. Second, the Page Digest encoding enables improved performance for individual page monitors through mechanisms such as short-circuit evaluation, linear time algorithms for document and structure similarity, and data size reduction. Finally, we develop a collection of sentinel grouping techniques based on the Page Digest encoding to reduce redundant processing in large-scale monitoring systems by grouping similar monitoring requests together. We examine how effective these techniques are over a wide range of parameters and have seen an order of magnitude speed up over existing Web-based information monitoring systems.

  4. Perspectives on the Consecutive Pages Problem

    ERIC Educational Resources Information Center

    Srinivasan, V. K.

    2011-01-01

    This article presents different approaches to a problem, dubbed by the author as "the consecutive pages problem". The aim of this teaching-oriented article is to promote the teaching of abstract concepts in mathematics, by selecting a challenging amusement problem and then presenting various solutions in such a way that it can engage the attention…

  5. What's Not Funny about the Funny Pages?

    ERIC Educational Resources Information Center

    Lum, Lydia

    2008-01-01

    As a kid, Darrin Bell devoured newspaper comic strips. So it was disappointing whenever editors refused years later to add his comic strip, "Candorville," to their funny pages as soon as they saw that his lead characters were minorities. The editors would say they already carried a so-called Black strip. It is difficult for cartoonists like Bell…

  6. Adding Graphics to Your WWW Page.

    ERIC Educational Resources Information Center

    Descy, Don E.

    1995-01-01

    Explains how to retrieve graphics that are available on the World Wide Web and add them to a Web page using a word processor that can save documents in an ASCII (American Standard Code Information Interchange) text format and a new version of Netscape. A list of various, unrelated Internet resources is also included. (LRW)

  7. 16 CFR 436.3 - Cover page.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... with a cover page, in the order and form as follows: (a) The title “FRANCHISE DISCLOSURE DOCUMENT” in... begin operation of a franchise is . This includes that must be paid to the franchisor or affiliate. (2) This disclosure document summarizes certain provisions of your franchise agreement and...

  8. 16 CFR 436.3 - Cover page.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... with a cover page, in the order and form as follows: (a) The title “FRANCHISE DISCLOSURE DOCUMENT” in... begin operation of a franchise is . This includes that must be paid to the franchisor or affiliate. (2) This disclosure document summarizes certain provisions of your franchise agreement and...

  9. Accounting Programs' Home Pages: What's Happening.

    ERIC Educational Resources Information Center

    Peek, Lucia E.; Roxas, Maria L.

    2002-01-01

    Content analysis of 62 accounting programs' websites indicated the following: 53% include mission statements; 62.9% list accreditation; many faculty biographies and personal pages used inconsistent formats; provision of information on financial aid, student organizations, career services, and certified public accountant requirements varied. Many…

  10. ORNL necessary and sufficient standards for environment, safety, and health. Final report of the Identification Team for other industrial, radiological, and non-radiological hazard facilities

    SciTech Connect

    1998-07-01

    This Necessary and Sufficient (N and S) set of standards is for Other Industrial, Radiological, and Non-Radiological Hazard Facilities at Oak Ridge National Laboratory (ORNL). These facility classifications are based on a laboratory-wide approach to classify facilities by hazard category. An analysis of the hazards associated with the facilities at ORNL was conducted in 1993. To identify standards appropriate for these Other Industrial, Radiological, and Non-Radiological Hazard Facilities, the activities conducted in these facilities were assessed, and the hazards associated with the activities were identified. A preliminary hazards list was distributed to all ORNL organizations. The hazards identified in prior hazard analyses are contained in the list, and a category of other was provided in each general hazard area. A workshop to assist organizations in properly completing the list was held. Completed hazard screening lists were compiled for each ORNL division, and a master list was compiled for all Other Industrial, Radiological Hazard, and Non-Radiological facilities and activities. The master list was compared against the results of prior hazard analyses by research and development and environment, safety, and health personnel to ensure completeness. This list, which served as a basis for identifying applicable environment, safety, and health standards, appears in Appendix A.

  11. Implementation of Home based management of malaria in children reduces the work load for peripheral health facilities in a rural district of Burkina Faso

    PubMed Central

    Tiono, Alfred B; Kaboré, Youssouf; Traoré, Abdoulaye; Convelbo, Nathalie; Pagnoni, Franco; Sirima, Sodiomon B

    2008-01-01

    Background Home Management of Malaria (HMM) is one of the key strategies to reduce the burden of malaria for vulnerable population in endemic countries. It is based on the evidence that well-trained communities health workers can provide prompt and adequate care to patients close to their homes. The strategy has been shown to reduce malaria mortality and severe morbidity and has been adopted by the World Health Organization as a cornerstone of malaria control in Africa. However, the potential fall-out of this community-based strategy on the work burden at the peripheral health facilities level has never been investigated. Methods A two-arm interventional study was conducted in a rural health district of Burkina Faso. The HMM strategy has been implemented in seven community clinics catchment's area (intervention arm). For the other seven community clinics in the control arm, no HMM intervention was implemented. In each of the study arms, presumptive treatment was provided for episodes of fevers/malaria (defined operationally as malaria). The study drug was artemether-lumefantrine, which was sold at a subsidized price by community health workers/Key opinion leaders at the community level and by the pharmacists at the health facility level. The outcome measured was the proportion of malaria cases among all health facility attendance (all causes diseases) in both arms throughout the high transmission season. Results A total of 7,621 children were enrolled in the intervention arm and 7,605 in the control arm. During the study period, the proportions of malaria cases among all health facility attendance (all causes diseases) were 21.0%, (445/2,111, 95% CI [19.3%–22.7%]) and 70.7% (2,595/3,671, 95% CI 68.5%–71.5%), respectively in the intervention and control arms (p << 0.0001). The relative risk ratio for a fever/malaria episode to be treated at the HF level was 30% (0.30 < RR < 0.32). The number of malaria episodes treated in the intervention arm was much higher

  12. 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.

  13. Construction-related nosocomial infections in patients in health care facilities. Decreasing the risk of Aspergillus, Legionella and other infections.

    PubMed

    2001-07-01

    Construction and renovation projects in health care facilities are a risk for certain patients, particularly those who are immunocompromised. A proactive approach must be taken to limit construction-related nosocomial infections. This requires having a multidisciplinary team, supported by administration, to plan and implement preventive measures throughout the duration of the construction project. The ICP should be an active team member in all phases of the project. The ICP plays a major role by providing education to personnel; ensuring that preventive measures are identified, initiated, and maintained; and carrying out surveillance for infections in patients. By ensuring that the appropriate preventive measures are in place and clear lines of communication exist among the personnel, patient safety will be enhanced.

  14. Environmental health-risk assessment for tritium releases from the National Tritium Labeling Facility (NTLF) at Lawrence Berkeley Laboratory

    SciTech Connect

    McKone, T.E.; Brand, K.P.

    1994-12-01

    This report is a health risk assessment that addresses continuous releases of tritium to the environment from the National Tritium Labeling Facility (NTLF) at the Lawrence Berkeley Laboratory (LBL). The NTLF contributes approximately 95% of all tritium releases from LBL. Transport and transformation models were used to determine the movement of tritium releases from the NRLF to the air, surface water, soils, and plants and to determine the subsequent doses to humans. These models were calibrated against environmental measurements of tritium levels in the vicinity of the NTLF and in the surrounding community. Risk levels were determined for human populations in each of these zones. Risk levels to both individuals and populations were calculated. In this report population risks and individual risks were calculated for three types of diseases--cancer, heritable genetic effects, and developmental and reproductive effects.

  15. An overview of the space medicine program and development of the Health Maintenance Facility for Space Station

    NASA Technical Reports Server (NTRS)

    Pool, Sam Lee

    1988-01-01

    Because the prolonged stay on board the Space Station will increase the risk of possible inflight medical problems from that on Skylab missions, the Health Maintenance Facility (HMF) planned for the Space Station is much more sophisticated than the small clinics of the Skylab missions. The development of the HMF is directed by the consideration of three primary factors: prevention, diagnosis, and treatment of injuries and illnesses that may occur in flight. The major components of the HMF include the clinical laboratory, pharmacy, imaging system, critical-care system, patient-restraint system, data-management system, exercise system, surgical system, electrophysiologic-monitoring system, introvenous-fluid system, dental system, and hyperbaric-treatment-support system.

  16. Low Prevalence of Substandard and Falsified Antimalarial and Antibiotic Medicines in Public and Faith-Based Health Facilities of Southern Malawi.

    PubMed

    Khuluza, Felix; Kigera, Stephen; Heide, Lutz

    2017-02-20

    Substandard and falsified antimalarial and antibiotic medicines represent a serious problem for public health, especially in low- and middle-income countries. However, information on the prevalence of poor-quality medicines is limited. In the present study, samples of six antimalarial and six antibiotic medicines were collected from 31 health facilities and drug outlets in southern Malawi. Random sampling was used in the selection of health facilities. For sample collection, an overt approach was used in licensed facilities, and a mystery shopper approach in nonlicensed outlets. One hundred and fifty-five samples were analyzed by visual and physical examination and by rapid prescreening tests, that is, disintegration testing and thin-layer chromatography using the GPHF-Minilab. Fifty-six of the samples were analyzed according to pharmacopeial monographs in a World Health Organization-prequalified quality control laboratory. Seven out-of-specification medicines were identified. One sample was classified as falsified, lacking the declared active ingredients, and containing other active ingredients instead. Three samples were classified as substandard with extreme deviations from the pharmacopeial standards, and three further samples as substandard with nonextreme deviations. Of the substandard medicines, three failed in dissolution testing, two in the assay for the content of the active pharmaceutical ingredient, and one failed in both dissolution testing and assay. Six of the seven out-of-specification medicines were from private facilities. Only one out-of-specification medicine was found within the samples from public and faith-based health facilities. Although the observed presence of substandard and falsified medicines in Malawi requires action, their low prevalence in public and faith-based health facilities is encouraging.

  17. In-flight demonstration of the Space Station Freedom Health Maintenance Facility fluid therapy system (E300/E05)

    NASA Technical Reports Server (NTRS)

    Lloyd, Charles W.

    1993-01-01

    The Space Station Freedom (SSF) Health Maintenance Facility (HMF) will provide medical care for crew members for up to 10 days. An integral part of the required medical care consists of providing intravenous infusion of fluids, electrolyte solutions, and nutrients to sustain an ill or injured crew member. In terrestrial health care facilities, intravenous solutions are normally stored in large quantities. However, due to the station's weight and volume constraints, an adequate supply of the required solutions cannot be carried onboard SSF. By formulating medical fluids onboard from concentrates and station water as needed, the Fluid Therapy System (FTS) eliminates weight and volume concerns regarding intravenous fluids. The first full-system demonstration of FTS is continuous microgravity will be conducted in Spacelab-Japan (SL-J). The FTS evaluation consists of two functional objectives and an in-flight demonstration of intravenous administration of fluids. The first is to make and store sterile water and IV solutions onboard the spacecraft. If intravenous fluids are to be produced in SSF, successful sterilization of water and reconstituting of IV solutions must be achieved. The second objective is to repeat the verification of the FTS infusion pump, which had been performed in Spacelab Life Sciences - 1 (SLS-1). during SLS-1, the FTS IV pump was operated in continuous microgravity for the first time. The pump functioned successfully, and valuable knowledge on its performance in continuous microgravity was obtained. Finally, the technique of starting an IF in microgravity will be demonstrated. The IV technique requires modifications in microgravity, such as use of restraints for equipment and crew members involved.

  18. Formal and informal payments in health care facilities in two Russian cities, Tyumen and Lipetsk.

    PubMed

    Aarva, Pauliina; Ilchenko, Irina; Gorobets, Pavel; Rogacheva, Anastasiya

    2009-09-01

    Informal payments for health care services are common in many transition countries, including Russia. While the Russian government proclaims its policy goal of improving access to and quality of free-of-charge health services, it has approved regulations that give local authorities the right to provide services against payment. This paper reports the results of a population-based survey (n = 2001) examining the prevalence of the use of medical services for which people pay formally or informally in two regional capitals of different economic status. The purpose of the study was to reveal any differences in the forms of and reasons for payments between the two cities and between socio-economic groups. The results indicate that formal payments were more common in the capital of the wealthier region, Tyumen, while the prevalence of informal payments was higher in the capital of the poorer region, Lipetsk. Around 15% of respondents had made informal payments in the past 3 years. Being a female (OR = 1.57), having a chronic disease (OR = 1.62), being a pensioner (OR = 2.8) and being willing to pay for additional medical information (OR = 2.48) increased the probability of informal payments. The survey demonstrates that in Russia access to and quality of publicly funded health care services may be under serious threat due to the current unclear, non-transparent financial rules. The practice of informal payments exists along with the introduction of formal chargeable government services, which may hamper the government's efforts to enhance equality among health service users.

  19. A Comparative Analysis of the Functional Disability Levels of Adult Day Care, Adult Day Health and ICF-Level Nursing Home Elderly in Hawaii.

    ERIC Educational Resources Information Center

    Hayashida, Cullen T.

    This study compared the functional disability levels of participants in adult day centers with patients in intermediate care facilities (ICFs). A three-page questionnaire measuring demographics, social resources, physical health, mental health, and activities of daily living as assessed by the Activities of Daily Living scale and the Instrumental…

  20. Health Systems Readiness to Manage the Hypertension Epidemic in Primary Health Care Facilities in the Western Cape, South Africa: A Study Protocol

    PubMed Central

    Yaya, Sanni; Labonté, Ronald

    2016-01-01

    the International Development Research Centre (IDRC). The study is currently in the data analysis phase and results are expected during the first half of 2016. Conclusions This investigation will highlight the detailed processes in place for the care of hypertensive patients in primary health care facilities, and thus also identify the challenges. It will also describe the drug supply chain management systems in place and identify their strengths and weaknesses. The findings, along with the estimates from modeling and simulation, will inform the health system minimum requirements to scale-up interventions to manage and control the hypertension epidemic in the Western Cape province of South Africa. PMID:26925539

  1. Expanding Access to the Intrauterine Device in Public Health Facilities in Ethiopia: A Mixed-Methods Study

    PubMed Central

    Tilahun, Yewondwossen; Mehta, Sarah; Zerihun, Habtamu; Lew, Candace; Brooks, Mohamad I; Nigatu, Tariku; Hagos, Kidest Lulu; Asnake, Mengistu; Tasissa, Adeba; Ali, Seid; Desalegn, Ketsela; Adane, Girmay

    2016-01-01

    ABSTRACT In Ethiopia, modern contraceptive prevalence among currently married women nearly tripled over the last decade, but the method mix remains skewed toward short-acting methods. Since 2011, the Integrated Family Health Program (IFHP+), jointly implemented by Pathfinder International and John Snow Inc., has supported the Federal Ministry of Health to introduce intrauterine devices (IUDs) in more than 800 health centers across 4 regions to improve access to a wider range of methods. Between March and August 2014, Pathfinder conducted a mixed-methods study in 40 purposively selected health centers to assess shifts in the contraceptive method mix following introduction of IUDs using data from family planning registers; determine the characteristics of IUD users through a cross-sectional survey of 2,943 family planning clients who accepted the IUD; explore reasons for method discontinuation among 165 clients seeking IUD removal services; and identify facilitators and barriers to IUD use through focus group discussions (N = 115 clients) and key informant interviews (N = 36 providers, facility heads, and health office heads). Introduction of IUDs into the 40 health centers participating in the study was correlated with a statistically significant increase in the contribution of all long-acting reversible contraceptives (LARCs)—both IUDs and implants—to the method mix, from 6.9% in 2011 to 20.5% in 2014 (P<.001). Our study found that latent demand for the IUD was more prevalent than anticipated and that the method was acceptable to a broad cross-section of women. Of the 2,943 women who sought IUDs during the 6-month study period, 18.0% were new contraceptive users (i.e., those using a contraceptive method for the first time ever), 44.7% reported no educational attainment, 62.5% were from rural areas, and 59.3% were younger than 30 years old, with almost 3 in 10 (27.7%) under the age of 25. The most commonly cited reason for seeking IUD removal services

  2. Use of geographic information systems technology to track critical health code violations in retail facilities available to populations of different socioeconomic status and demographics.

    PubMed

    Darcey, Valerie L; Quinlan, Jennifer J

    2011-09-01

    Research shows that community socioeconomic status (SES) predicts, based on food service types available, whether a population has access to healthy food. It is not known, however, if a relationship exists between SES and risk for foodborne illness (FBI) at the community level. Geographic information systems (GIS) give researchers the ability to pinpoint health indicators to specific geographic locations and detect resulting environmental gradients. It has been used extensively to characterize the food environment, with respect to access to healthy foods. This research investigated the utility of GIS in determining whether community SES and/or demographics relate to access to safe food, as measured by food service critical health code violations (CHV) as a proxy for risk for FBI. Health inspection records documenting CHV for 10,859 food service facilities collected between 2005 and 2008 in Philadelphia, PA, were accessed. Using an overlay analysis through GIS, CHV were plotted over census tracts of the corresponding area. Census tracts (n = 368) were categorized into quintiles, based on poverty level. Overall, food service facilities in higher poverty areas had a greater number of facilities (with at least one CHV) and had more frequent inspections than facilities in lower poverty areas. The facilities in lower poverty areas, however, had a higher average number of CHV per inspection. Analysis of CHV rates in census tracts with high concentrations of minority populations found Hispanic facilities had more CHV than other demographics, and Hispanic and African American facilities had fewer days between inspections. This research demonstrates the potential for utilization of GIS mapping for tracking risks for FBI. Conversely, it sheds light on the subjective nature of health inspections, and indicates that underlying factors might be affecting inspection frequency and identification of CHV, such that CHV might not be a true proxy for risk for FBI.

  3. Charging for Ambulatory Care in Military Health Care Facilities: An Evaluation and Analysis

    DTIC Science & Technology

    1983-04-25

    3436% Increase Budgeted to Cut CHAMPUS Deficits," Navy - Times, 14 February 1983, 4. 19 Martha Lynn Craver, "The Stopgap Bill," Navy Times, 3 January...1983, 1. 20 Smith, ൬% Increase...,". 21 Martha Lynn Craver, "’Clinic Fee’ Rebuffed as CHAMPUS Tonic," Navy Times, 4 October 1982, 30. 22 Martha Lynn ...787-806. 42 Jay Wolfson, et al, "Effects of Cost-Sharing on Users of a State’s Health Service Program," Medical Care, 20, December 1982, 1178-1187. 43

  4. Giving cell phones to pregnant women and improving services may increase primary health facility utilization: a case–control study of a Nigerian project

    PubMed Central

    2014-01-01

    Background Worldwide, about 287 000 women die each year from mostly preventable complications related to pregnancy and childbirth. A disproportionately high number of these deaths occur in sub-Saharan Africa. The Abiye (‘Safe Motherhood’) project in the Ifedore Local Government Area (LGA) of Ondo-State of Nigeria aimed at improving facility utilization and maternal health through the use of cell phones and generally improved health care services for pregnant women, including Health Rangers, renovated Health Centres, and improved means of transportation. Methods A one-year sample of retrospective data was collected from hospital records and patients’ case files from Ifedore (the project area) and Idanre (control area) and was analyzed to determine healthcare facility utilization rates in each location. Semi-structured questionnaires were used to generate supplemental data. Results The total facility utilization rate of pregnant women was significantly higher in Ifedore than in Idanre. The facility utilization rate of the primary health care centres was significantly higher in Ifedore than in Idanre. The number of recorded cases of the five major causes of maternal death in the two LGAs was not significantly different, possibly because the project was new. Conclusions Giving cell phones to pregnant women and generally improving services could increase their utilization of the primary healthcare system. PMID:24438150

  5. Operational research in primary health care planning: a theoretical model for estimating the coverage achieved by different distributions of staff and facilities

    PubMed Central

    Kemball-Cook, D.; Vaughan, J. P.

    1983-01-01

    This report outlines a basic operational research model for estimating the coverage achieved by different distributions of primary health care staff and facilities, using antenatal home visiting as an illustrative example. Coverage is estimated in terms of the average number of patient contacts achieved per annum. The model takes into account such features as number of facilities and health workers per 10 000 population, the radius of the health facility area, the overall population density in the region, the number of working days in the year, and the health worker's travelling time and work rate. A theoretical planning situation is also presented, showing the application of the model in defining various possible strategies, using certain planning norms for new levels of staff and facilities. This theoretical model is presented as an example of the use of operational research in primary health care, but it requires to be tested and validated in known situations before its usefulness can be assessed. Some indications are given of the ways in which the model could be adapted and improved for application to a real planning situation. PMID:6602666

  6. Health care providers and facilities: medical malpractice and tort reform--2005. End of Year Issue Brief.

    PubMed

    McKinley, Andrew

    2005-12-31

    As health care professionals continue to feel the crunch of rising malpractice insurance rates and increased jury awards, medical malpractice remains a priority for acute care professionals. Medical associations claim that rapidly increasing premiums and the declining number of insurers often lead physicians to stop practicing medicine or to relocate. This may lead to a shortage of physicians, particularly physicians who practice high-risk specialties such as neurology. The pressure to retain an adequate supply of health care professionals is particularly acute in rural areas. It is difficult to pinpoint the origins of the escalating cost of medical malpractice coverage. Insurers and physicians claim excessive litigation and overly generous jury awards have hardened the market. Trial lawyers and consumer advocacy groups assert insurance premium rates have not reflected increasing medical inflation or the payouts of jury awards during the last 30 years. The majority of states have some form of basic coverage requirement that medical malpractice insurers must offer. However, because of the complexities and variety of coverage plans, physicians often are unaware that gaps in coverage exist. As of May 2005, the American Medical Association (AMA) has declared a state

  7. Health risks associated with ingesting venison from a uranium enrichment facility with multiple operable units

    SciTech Connect

    Duncan, J.; Welsh, C.

    1995-12-31

    Ingestion of game, including venison, may be a significant exposure pathway in human health risk assessments at hazardous waste sites. The difficulty associated with modeling contaminant tissue concentrations in a wide-ranging herbivorous mammal is compounded when the home range of the mammal extends over multiple operable units (OUs) of varying size and media contaminant concentration. Using biotransfer factors extracted from the literature and species-specific parameter information (e.g., home range size, diet, forage and water ingestion rates) the authors estimate contaminant concentrations in venison based on soil and surface water contaminant concentrations and determine the contribution of individual OUs to modeled venison tissue concentrations. Estimated tissue concentrations are calculated through the use of site foraging factors (SFFS) that adjust exposure contributions from individual OUs to account for the size of the OU in relation to the animals home range. The authors then use the venison tissue concentrations to estimate human health risk associated with ingesting venison under both a current and future exposure scenario.

  8. Assessment of laboratory logistics management information system practice for HIV/AIDS and tuberculosis laboratory commodities in selected public health facilities in Addis Ababa, Ethiopia

    PubMed Central

    Desale, Adino; Taye, Bineyam; Belay, Getachew; Nigatu, Alemayehu

    2013-01-01

    Introduction Logistics management information system for health commodities remained poorly implemented in most of developing countries. To assess the status of laboratory logistics management information system for HIV/AIDS and tuberculosis laboratory commodities in public health facilities in Addis Ababa. Methods A cross-sectional descriptive study was conducted from September 2010-January 2011 at selected public health facilities. A stratified random sampling method was used to include a total of 43 facilities which, were investigated through quantitative methods using structured questionnaires interviews. Focus group discussion with the designated supply chain managers and key informant interviews were conducted for the qualitative method. Results There exists a well-designed logistics system for laboratory commodities with trained pharmacy personnel, distributed standard LMIS formats and established inventory control procedures. However, majority of laboratory professionals were not trained in LMIS. Majority of the facilities (60.5%) were stocked out for at least one ART monitoring and TB laboratory reagents and the highest stock out rate was for chemistry reagents. Expired ART monitoring laboratory commodities were found in 25 (73.5%) of facilities. Fifty percent (50%) of the assessed hospitals and 54% of health centers were currently using stock/bin cards for all HIV/AIDS and TB laboratory commodities in main pharmacy store, among these only 25% and 20.8% of them were updated with accurate information matching with the physical count done at the time of visit for hospitals and health centers respectively. Conclusion Even though there exists a well designed laboratory LMIS, keeping quality stock/bin cards and LMIS reports were very low. Key ART monitoring laboratory commodities were stock out at many facilities at the day of visit and during the past six months. Based on findings, training of laboratory personnel's managing laboratory commodities and keeping

  9. Developing a web page: bringing clinics online.

    PubMed

    Peterson, Ronnie; Berns, Susan

    2004-01-01

    Introducing clinical staff education, along with new policies and procedures, to over 50 different clinical sites can be a challenge. As any staff educator will confess, getting people to attend an educational inservice session can be difficult. Clinical staff request training, but no one has time to attend training sessions. Putting the training along with the policies and other information into "neat" concise packages via the computer and over the company's intranet was the way to go. However, how do you bring the clinics online when some of the clinical staff may still be reluctant to turn on their computers for anything other than to gather laboratory results? Developing an easy, fun, and accessible Web page was the answer. This article outlines the development of the first training Web page at the University of Wisconsin Medical Foundation, Madison, WI.

  10. Environmental health-risk assessment for tritium releases at the National Tritium Labeling Facility at Lawrence Berkeley National Laboratory

    SciTech Connect

    McKone, T.E.; Brand, K.P.; Shan, C.

    1997-04-01

    This risk assessment calculates the probability of experiencing health effects, including cancer incidence due to tritium exposure for three groups of people: (1) LBNL workers near the LBNL facility--Building 75--that uses tritium; (2) other workers at LBNL and nearby neighbors; and (3) people who use the UC Berkeley campus area, and some Berkeley residents. All of these groups share the same probability of health effects from the background radiation from natural sources in the Berkeley area environment, including an increased risk of developing a cancer of 11,000 chances per million. In calculating risk the authors assumed continuous operation in Building 75 for at least a human lifetime. Under this assumption, LBNL workers located near Building 75 have an additional risk of 60 chances out of one million to suffer a cancer; other workers at LBNL and people who live near LBNL have an additional risk of six chances out of one million over a lifetime of exposure; and users of the UC Berkeley campus area and other residents of Berkeley have an additional risk of less than once chance out of one million over a lifetime.

  11. A Recovery-Oriented Care Approach: Weighing the Pros and Cons of a Newly Built Mental Health Facility.

    PubMed

    Ahern, Catherine Clark; Bieling, Peter; McKinnon, Margaret C; McNeely, Heather E; Langstaff, Karen

    2016-02-01

    The current study adopted a recovery-oriented care approach by emphasizing patients' perspectives and experiences regarding changes to a newly built mental health facility. The inpatient entrance, or "portal," intended to balance the aims of recovery-oriented care with minimizing risk. A mixed-methods study of the portal's pros and cons was conducted, according to four themes: (a) autonomy versus inconvenience; (b) safety and security versus stigma; (c) unit door versus portal operating costs; and (d) privacy versus community integration. Focus groups engaging with patients (N = 39) indicated that the design effectively supported recovery-oriented care. Patients did not find the portal to be stigmatizing or triggering and valued the safety and privacy it created, and visitors also generally had a positive experience. Survey responses (N = 101) from portal users were also positive about the new design. The study findings suggest that the pros outweighed the cons of the new design. [Journal of Psychosocial Nursing and Mental Health Services, 54(2), 39-48.].

  12. Savings analysis of a 1 MW cogeneration system at a Texas mental health facility

    SciTech Connect

    Athar, A.; Turner, W.D.; Caton, J.A.; McClean, G.

    1995-12-31

    Cogeneration is defined as the generation of electric power and coincident recovery of useful thermal energy from a single prime mover using a single fuel. The 1 MW gas turbine cogeneration system at Texas Department of Mental Health and Mental Retardation (TDMHMR), Austin, came on line in March, 1992 and is a unique application of federal and state funds. This system has been analyzed for its present performance and loads using hourly measured data. The Energy Systems Laboratory (ESL) at Texas A and M University has been collecting hourly data for natural gas use and the electrical energy produced by the engine since August, 1992. Waste heat recovered by the Waste Heat Recovery Boiler (WHRB) is also monitored. This paper describes the present system, analyzes the system using hourly monitored data, calculates energy and dollar savings, compares the measured results with the estimated savings, and discusses some of the problems encountered during the first year of operation.

  13. Evolving dynamic web pages using web mining

    NASA Astrophysics Data System (ADS)

    Menon, Kartik; Dagli, Cihan H.

    2003-08-01

    The heterogeneity and the lack of structure that permeates much of the ever expanding information sources on the WWW makes it difficult for the user to properly and efficiently access different web pages. Different users have different needs from the same web page. It is necessary to train the system to understand the needs and demands of the users. In other words there is a need for efficient and proper web mining. In this paper issues and possible ways of training the system and providing high level of organization for semi structured data available on the web is discussed. Web pages can be evolved based on history of query searches, browsing, links traversed and observation of the user behavior like book marking and time spent on viewing. Fuzzy clustering techniques help in grouping natural users and groups, neural networks, association rules and web traversals patterns help in efficient sequential anaysis based on previous searches and queries by the user. In this paper we analyze web server logs using above mentioned techniques to know more about user interactions. Analyzing these web server logs help to closely understand the user behavior and his/her web access pattern.

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

    PubMed Central

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

    2016-01-01

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

  15. Relationship between national mental health expenditure and quality of care in longer-term psychiatric and social care facilities in Europe: cross-sectional study.

    PubMed

    Taylor Salisbury, Tatiana; Killaspy, Helen; King, Michael

    2017-03-16

    BackgroundIt is not known whether increased mental health expenditure is associated with better outcomes.AimsTo estimate the association between national mental health expenditure and (a) quality of longer-term mental healthcare, (b) service users' ratings of that care in eight European countries.MethodNational mental health expenditure (per cent of health budget spent on mental health) was calculated from international sources. Multilevel models were developed to assess associations with quality of care and service user experiences of care using ratings of 171 facility managers and 1429 service users.ResultsSignificant positive associations were found between mental health spend and (a) six of seven quality of care domains; and (b) service user autonomy and experiences of care.ConclusionsGreater national mental health expenditure was associated with higher quality of care and better service user experience.

  16. Improving antimicrobial use among health workers in first-level facilities: results from the multi-country evaluation of the Integrated Management of Childhood Illness strategy.

    PubMed Central

    Gouws, Eleanor; Bryce, Jennifer; Habicht, Jean-Pierre; Amaral, João; Pariyo, George; Schellenberg, Joanna Armstrong; Fontaine, Olivier

    2004-01-01

    OBJECTIVE: The objective of this study was to assess the effect of Integrated Management of Childhood Illness (IMCI) case management training on the use of antimicrobial drugs among health-care workers treating young children at first-level facilities. Antimicrobial drugs are an essential child-survival intervention. Ensuring that children younger than five who need these drugs receive them promptly and correctly can save their lives. Prescribing these drugs only when necessary and ensuring that those who receive them complete the full course can slow the development of antimicrobial resistance. METHODS: Data collected through observation-based surveys in randomly selected first-level health facilities in Brazil, Uganda and the United Republic of Tanzania were statistically analysed. The surveys were carried out as part of the multi-country evaluation of IMCI effectiveness, cost and impact (MCE). FINDINGS: Results from three MCE sites show that children receiving care from health workers trained in IMCI are significantly more likely to receive correct prescriptions for antimicrobial drugs than those receiving care from workers not trained in IMCI.They are also more likely to receive the first dose of the drug before leaving the health facility, to have their caregiver advised how to administer the drug, and to have caregivers who are able to describe correctly how to give the drug at home as they leave the health facility. CONCLUSIONS: IMCI case management training is an effective intervention to improve the rational use of antimicrobial drugs for sick children visiting first-level health facilities in low-income and middle-income countries. PMID:15508195

  17. Integration of Traditional Birth Attendants into Prevention of Mother-to-Child Transmission at Primary Health Facilities in Kaduna, North-West Nigeria

    PubMed Central

    Nsirim, Reward O.; Iyongo, Joseph A.; Adekugbe, Olayinka; Ugochuku, Maureen

    2015-01-01

    One of the fundamental challenges to implementing successful prevention of mother-to-child transmission (PMTCT) programs in Nigeria is the uptake of PMTCT services at health facilities. Several issues usually discourage many pregnant women from receiving antenatal care services at designated health facilities within their communities. The CRS Nigeria PMTCT Project funded by the Global Fund in its Round 9 Phase 1 in Nigeria, sought to increase demand for HIV counseling and testing services for pregnant women at 25 supported primary health centers (PHCs) in Kaduna State, North-West Nigeria by integrating traditional birth attendants (TBAs) across the communities where the PHCs were located into the project. Community dialogues were held with the TBAs, community leaders and women groups. These dialogues focused on modes of mother to child transmission of HIV and the need for TBAs to refer their clients to PHCs for testing. Subsequently, data on number of pregnant women who were counseled, tested and received results was collected on a monthly basis from the 25 facilities using the national HIV/AIDS tools. Prior to this integration, the average number of pregnant women that were counseled, tested and received results was 200 pregnant women across all the 25 health facilities monthly. After the integration of TBAs into the program, the number of pregnant women that were counseled, tested and received results kept increasing month after month up to an average of 1500 pregnant women per month across the 25 health facilities. TBAs can thus play a key role in improving service uptake and utilization for pregnant women at primary health centers in the community – especially in the context of HIV/AIDS. They thus need to be integrated, rather than alienated, from primary healthcare service delivery. PMID:28299134

  18. Counting the cost of not costing HIV health facilities accurately: pay now, or pay more later.

    PubMed

    Beck, Eduard J; Avila, Carlos; Gerbase, Sofia; Harling, Guy; De Lay, Paul

    2012-10-01

    The HIV pandemic continues to be one of our greatest contemporary public health threats. Policy makers in many middle- and low-income countries are in the process of scaling up HIV prevention, treatment and care services in the context of a reduction in international HIV funding due to the global economic downturn. In order to scale up services that are sustainable in the long term, policy makers and implementers need to have access to robust and contemporary strategic information, including financial information on expenditure and cost, in order to be able to plan, implement, monitor and evaluate HIV services. A major problem in middle- and low-income countries continues to be a lack of basic information on the use of services, their cost, outcome and impact, while those few costing studies that have been performed were often not done in a standardized fashion. Some researchers handle this by transposing information from one country to another, developing mathematical or statistical models that rest on assumptions or information that may not be applicable, or using top-down costing methods that only provide global financial costs rather than using bottom-up ingredients-based costing. While these methods provide answers in the short term, countries should develop systematic data collection systems to store, transfer and produce robust and contemporary strategic financial information for stakeholders at local, sub-national and national levels. National aggregated information should act as the main source of financial data for international donors, agencies or other organizations involved with the global HIV response. This paper describes the financial information required by policy makers and other stakeholders to enable them to make evidence-informed decisions and reviews the quantity and quality of the financial information available, as indicated by cost studies published between 1981 and 2008. Among the lessons learned from reviewing these studies, a need was

  19. Lack of access to treatment as a barrier to HCV screening: a facility-based assessment in the Indian health service.

    PubMed

    Reilley, Brigg; Leston, Jessica; Redd, John T; Geiger, Rebecca

    2014-01-01

    The US Centers for Disease Control and Prevention recently issued new recommendations to screen persons born between 1945 and 1965 for hepatitis C virus. Federal facilities in the US Indian Health Service were surveyed on knowledge and support for the hepatitis C virus recommendations, as well as barriers and concerns.

  20. Study--The Feasibility, Practicability and Cost of the Soundproofing of Schools, Hospitals, and Public Health Facilities Located Near Airports. Report to Congress.

    ERIC Educational Resources Information Center

    Federal Aviation Administration (DOT), Washington, DC.

    This report fulfills the requirement of Public Law 94-353 that requires the Secretary of Transportation to report to the Congress with respect to the feasibility, practicability, and cost of soundproofing noise-impacted schools, hospitals, and public health facilities, in order to reduce the possible adverse effects of aircraft noise. A survey of…

  1. Adults with Intellectual Disabilities Living in Hong Kong's Residential Care Facilities: A Descriptive Analysis of Health and Disease Patterns by Sex, Age, and Presence of Down Syndrome

    ERIC Educational Resources Information Center

    Wong, Chi Wai

    2011-01-01

    The aim of this study was to describe the health status profile and identify the healthcare needs of adults with intellectual disability (ID) residing in 18 of Hong Kong's residential care facilities. The author employed a cross-sectional study using a structured questionnaire survey to collect data on 811 persons with ID (432 males, 53.3%, and…

  2. Seeking refuge: Why asylum facilities might still be relevant for mental health care services today.

    PubMed

    Garton, Stephen

    2009-01-01

    This article reassesses the history of mental asylums in New South Wales, arguing that far from being 'cemeteries for the still breathing,' Victorian and Edwardian asylums served multiple purposes, providing genuinely therapeutic conditions for many patients, while warehousing chronic incurables and those without networks of support. Mental asylums in nineteenth century New South Wales rarely resorted to measures of restraint and seclusion and had a notable record of high rates of recovery and low rates of readmission. The marked institutional decline of the twentieth century that eventually prompted critics from many quarters to demand the closure of large asylums represented more a loss of faith in institutionalisation and the desire of psychiatrists to achieve higher status and more lucrative remuneration treating new middle class populations of neurotics than inherent flaws in the asylum ideal itself. Thus deinstitutionalisation policies were built on a fundamentally revisionist history that failed to consider the reality of care in these institutions, an insight that opens up opportunities to rethink the role and function of refuge in contemporary mental health policy.

  3. Improving neonatal care in district and community health facilities in South Africa.

    PubMed

    Woods, David Lawrance

    2015-08-01

    A high standard of newborn care, especially at a primary level, is needed to address the neonatal mortality rate in South Africa. The current approach to continuing training of health-care workers uses traditional methods of centralised teaching by formal tutors away from the place of work. This is no longer affordable, achievable or desirable, particularly in rural areas. An innovative system of self-directed learning by groups of nurses caring for mothers and their newborn infants uses specially prepared course books without the need for trainers. Using self-study supported by peer discussion groups, nurses can take responsibility for their own professional growth. This builds competence, confidence and a sense of pride. Since 1993, the Perinatal Education Programme has provided continuing learning opportunities for thousands of nurses in Southern Africa. A number of prospective trials have demonstrated that study groups can significantly improve knowledge and understanding, attitudes, clinical skills and quality of care provided to mothers and infants. A recent review of 10,000 successful participants across a wide range of provinces, ages and home languages documented the success of the project. Using a question-and-answer format to promote problem-solving, case studies, simple skills workshops and multiple choice tests, each module addresses common conditions with appropriate care practices such as thorough drying at birth, delayed cord-clamping, skin-to-skin care, breast feeding, basic resuscitation, correct use of oxygen therapy, hand-washing, blood glucose monitoring and promotion of parental bonding. The training material is now also available free of charge on an on-line website as well as being presented as e-books which can be downloaded onto personal computers, tablet readers and smart phones. This is supplemented by regular SMS text messages providing nurses with relevant 'knowledge bites'. All nurses caring for newborn infants now have easy

  4. Environment, safety, health at DOE Facilities. Annual report, Fiscal Year 1980

    SciTech Connect

    Not Available

    1981-07-01

    The Department of Energy's occupational safety and property protection performance in fiscal year 1980 was excellent in all reported categories with loss rates generally less than one-third of comparable industry figures. The Department of Energy's fiscal year 1980 incidence rate per 200,000 work hours was 1.1 lost workday cases and 18.2 lost workdays compared to 1.1 lost workday cases and 17.2 lost workdays during fiscal year 1979. The recorded occupational illness rate, based on only 70 cases, was 0.05 cases per 200,000 work hours compared to 0.06 cases per 200,000 work hours for fiscal year 1979. Ten fatalities involving Federal or contractor employees occurred in fiscal year 1980 compared to nine for fiscal year 1979. Four of those in fiscal year 1980 resulted from two aircraft accidents. Total reported property loss during fiscal year 1980 was $7.1 million with $3.5 million attributable to earthquake damage sustained by the Lawrence Livermore and Sandia National Laboratories on January 24, 1980. A total of 131 million vehicle miles of official vehicular travel during fiscal year 1980 resulted in 768 accidents and $535,145 in property damages. The 104,986 monitored Department of Energy and Department of Energy contractor employees received a total dose of 9040 REM in calendar year 1979. Both the total dose and the 1748 employees receiving radiation exposures greater than 1 REM in 1979 represent a continuing downward trend from the calendar year 1978 total dose of 9380 REM and the 1826 employees who received radiation exposures greater than 1 REM. The fifty-nine appraisals conducted indicate that generally adequate plans have been developed and effective organizational structures have been established to carry out the Department of Energy's Environmental Protection, Safety, and Health Protection (ES and H) Program.

  5. Risk Factors for Birth Asphyxia in an Urban Health Facility in Cameroon

    PubMed Central

    CHIABI, Andreas; NGUEFACK, Seraphin; MAH, Evelyne; NODEM, Sostenne; MBUAGBAW, Lawrence; MBONDA, Elie; TCHOKOTEU, Pierre-Fernand; DOH FRCOG, Anderson

    2013-01-01

    Objective The World Health Organization (WHO) estimates that 4 million children are born with asphyxia every year, of which 1 million die and an equal number survive with severe neurologic sequelae. The purpose of this study was to identify the risk factors of birth asphyxia and the hospital outcome of affected neonates. Materials & Methods This study was a prospective case-control study on term neonates in a tertiary hospital in Yaounde, with an Apgar score of < 7 at the 5th minute as the case group, that were matched with neonates with an Apgar score of ≥ 7 at the 5th minute as control group. Statistical analysis of relevant variables of the mother and neonates was carried out to determine the significant risk factors. Results The prevalence of neonatal asphyxia was 80.5 per 1000 live births. Statistically significant risk factors were the single matrimonial status, place of antenatal visits, malaria, pre-eclampsia/eclampsia, prolonged labor, arrest of labour, prolonged rupture of membranes, and non-cephalic presentation. Hospital mortality was 6.7%, that 12.2% of them had neurologic deficits and/or abnormal transfontanellar ultrasound/electroencephalogram on discharge, and 81.1% had a satisfactory outcome. Conclusion The incidence of birth asphyxia in this study was 80.5% per1000 live birth with a mortality of 6.7%. Antepartum risk factors were: place of antenatal visit, malaria during pregnancy, and preeclampsia/eclampsia. Whereas prolonged labor, stationary labor, and term prolonged rupture of membranes were intrapartum risk faktors. Preventive measures during prenatal visits through informing and communicating with pregnant women should be reinforced. PMID:24665306

  6. Advantages and limitations of clear-native PAGE.

    PubMed

    Wittig, Ilka; Schägger, Hermann

    2005-11-01

    Clear-native PAGE (CN-PAGE) separates acidic water-soluble and membrane proteins (pI < 7) in an acrylamide gradient gel, and usually has lower resolution than blue-native PAGE (BN-PAGE). The migration distance depends on the protein intrinsic charge, and on the pore size of the gradient gel. This complicates estimation of native masses and oligomerization states when compared to BN-PAGE, which uses negatively charged protein-bound Coomassie-dye to impose a charge shift on the proteins. Therefore, BN-PAGE rather than CN-PAGE is commonly used for standard analyses. However, CN-PAGE offers advantages whenever Coomassie-dye interferes with techniques required to further analyze the native complexes, e.g., determination of catalytic activities, as shown here for mitochondrial ATP synthase, or efficient microscale separation of membrane protein complexes for fluorescence resonance energy transfer (FRET) analyses. CN-PAGE is milder than BN-PAGE. Especially the combination of digitonin and CN-PAGE can retain labile supramolecular assemblies of membrane protein complexes that are dissociated under the conditions of BN-PAGE. Enzymatically active oligomeric states of mitochondrial ATP synthase previously not detected using BN-PAGE were identified by CN-PAGE.

  7. Chasm in primary care provision in a universal health system: Findings from a nationally representative survey of health facilities in Malaysia

    PubMed Central

    Sivasampu, Sheamini; Khoo, Ee Ming; Mohamad Noh, Kamaliah

    2017-01-01

    Background Malaysia has achieved universal health coverage since 1980s through the expansion of direct public provision, particularly in rural areas. However, no systematic examination of the rural-urban distribution of primary care services and resources has been conducted to date for policy impact evaluation. Methods We conducted a national cross-sectional survey of 316 public and 597 private primary care clinics, selected through proportionate stratified random sampling, from June 2011 through February 2012. Using a questionnaire developed based on the World Health Organization toolkits on monitoring health systems strengthening, we examined the availability of primary care services/resources and the associations between service/resource availability and clinic ownership, locality, and patient load. Data were weighted for all analyses to account for the complex survey design and produce unbiased national estimates. Results Private primary care clinics and doctors outnumbered their public counterparts by factors of 5.6 and 3.9, respectively, but the private clinics were significantly less well-equipped with basic facilities and provided a more limited range of services. Per capita densities of primary care clinics and workforce were higher in urban areas (2.2 clinics and 15.1 providers per 10,000 population in urban areas versus 1.1 clinics and 11.7 providers per 10,000 population in rural areas). Within the public sector, the distribution of health services and resources was unequal and strongly favored the urban clinics. Regression analysis revealed that rural clinics had lower availability of services and resources after adjusting for ownership and patient load, but the associations were not significant except for workforce availability (adjusted odds ratio [OR]: 0.82; 95% confidence interval [CI]: 0.71–0.96). Conclusions Targeted primary care expansion in rural areas could be an effective first step towards achieving universal health coverage, especially in

  8. Definitions of Health Terms: General Health

    MedlinePlus

    ... this page: https://medlineplus.gov/definitions/generalhealthdefinitions.html Definitions of Health Terms: General Health To use the ... by learning these general health terms. Find more definitions on Fitness | General Health | Minerals | Nutrition | Vitamins Basal ...

  9. Gasoline Distribution Facilities (Bulk Gasoline Terminals and Pipeline Breakout Stations) Air Toxics Rule Fact Sheets

    EPA Pesticide Factsheets

    This page contains a November 1994 fact sheet for the final NESHAP for Gasoline Distribution Facilities. This page also contains a December fact sheet with information regarding the final amendments to the 2003 final rule for the NESHAP.

  10. Creating a nursing home page on the World Wide Web.

    PubMed

    Shellenbarger, T; Thomas, S

    1996-01-01

    The authors provide a brief overview of the internet and home pages on the World Wide Web. Definitions of Web terminology are provided to help the reader understand home page creation. The authors also describe the steps in electronic publishing and how to create a home page. Supplemental tables provide internet addresses for nursing and non-nursing sites for reviewal of other home pages. The article continues with information about design, formatting, adding text and images, and dissemination suggestions for home pages. Examples of home pages and instruction commands (tags) are provided. The future of Web publishing is discussed, and issues and concerns are raised regarding electronic publishing.

  11. Quantifying the impact of PM2.5 and associated heavy metals on respiratory health of children near metallurgical facilities.

    PubMed

    Dunea, Daniel; Iordache, Stefania; Liu, Hai-Ying; Bøhler, Trond; Pohoata, Alin; Radulescu, Cristiana

    2016-08-01

    The aim of this study was to link the concentrations of particulate matter with an aerodynamic diameter below 2.5 μm (PM2.5) and associated heavy metals with occurrence of wheezing and hospitalizations due to wheezing in 111 children who live near metallurgical plants in Targoviste City, Romania. A group of 72 children with high levels of immunoglobulin E (IgE) and eosinophils, as well as frequent wheezing episodes, was geolocated on digital thematic maps. Monitoring campaigns and medical assessments were performed over two consecutive years (2013-2014). The multiannual average concentrations of PM2.5 ranged from 4.6 to 22.5 μg m(-3), up to a maximum value of 102 μg m(-3). Significant correlations (p < 0.01) were observed between the locations of the children with respiratory issues and the PM2.5 multiannual average (r = 0.985) and PM2.5 maximum (r = 0.813). Fe, Ni, Cd, and Cr were the main marker elements of the emissions from steel production and metal-working facilities in the Targoviste area. The results support the hypothesis that increased PM2.5 levels directly influence wheezing symptom and asthma attacks in the analyzed group. IgE, eosinophils, and wheezing episodes may be considered key indicators with which to evaluate the adverse effects of PM2.5 air pollution on children's health.

  12. Factors Influencing Job Satisfaction and Anticipated Turnover among Nurses in Sidama Zone Public Health Facilities, South Ethiopia

    PubMed Central

    Belachew, Tefera; Yimam, Ebrahim

    2014-01-01

    Background. Workplace turnover is destructive to nursing and patient outcomes as it leads to losing competent and qualified nurses. However, developments of coping strategies demand a clear understanding of workplace variables that either motivate nurses to remain employed or lead them to leave their current jobs. Objective. This study was designed toassess factors influencing job satisfaction and intention to turnover among nurses in Sidama zone public health facilities, in Southern Ethiopia. Method. Cross-sectional study design was carried out on 278 nurses using both qualitative and quantitative data collection methods from May 12 to June 05, 2010. Result. A total of 242 nurses were interviewed giving a response rate of 87%. Nearly two-third (68.6%) of the participants were female, and the mean age was 28 (±6.27) years for both sexes. All job satisfaction subscale except benefit and salary subscale were significant predictors of overall job satisfaction. Satisfactions with work environment and group cohesion (AOR: 0.25 [95% CI: 0.12, 0.51]), single cohesion (AOR: 2.56 [95% CI: 1.27, 5.13]), and working in hospital (AOR: 2.19 [95% CI: 1.12, 4.30]) were the final significant predictors of anticipated turnover of Sidama zone nurses. Conclusions. More than any factors managers should consider the modification of working environment and group cohesions rather than trying to modify nurses to retain and maintain more experienced nurses for the organizations. PMID:24707397

  13. Europe sees mixed results from public-private partnerships for building and managing health care facilities and services.

    PubMed

    Barlow, James; Roehrich, Jens; Wright, Steve

    2013-01-01

    Prompted in part by constrained national budgets, European governments are increasingly partnering with the private sector to underwrite the costs of constructing and operating public hospitals and other health care facilities and delivering services. Through such public-private partnerships, governments hope to avoid up-front capital expenditure and to harness private-sector efficiencies, while private-sector partners aim for a return on investment. Our research indicates that to date, experience with these partnerships has been mixed. Early models of these partnerships-for example, in which a private firm builds a hospital and carries out building maintenance, which we term an "accommodation-only" model-arguably have not met expectations for achieving greater efficiencies at lower costs. Newer models described in this article offer greater opportunities for efficiency gains but are administratively harder to set up and manage. Given the shortages in public capital for new infrastructure, it seems likely that the attractiveness of these partnerships to European governments will grow.

  14. A retrospective review of 61 cases of adenomatoid odontogenic tumour seen in five tertiary health facilities in Nigeria

    PubMed Central

    Adisa, Akinyele Olumuyiwa; Lawal, Ahmed Oluwatoyin; Effiom, Olajumoke Ajibola; Soyele, Olujide Oladele; Omitola, Olufemi Gbenga; Olawuyi, Adetokunbo; Fomete, Benjamin

    2016-01-01

    Introduction Adenomatoid odontogenic tumor (AOT) is a benign lesion originating from the dental lamina or its remnants. It is a relatively uncommon neoplasm representing about 3% of all odontogenic tumors. The aim of this study was to examine the clinical and radiological characteristics of AOTs in five major tertiary centres in Nigeria. Methods Archival hospital-based data stores of five tertiary health facilities in Nigeria were accessed. Case files and biopsy records were retrieved to obtain relevant information. Data was collected according to a proforma for standardization and entered into and analysed using SPSS for Windows (version 20.0; SPSS Inc. Chicago, IL). Results 61 (4.5%) cases of AOT were documented. The age range was 8-46 years with a mean age of 20.4±9.9 years. Male: Female ratio was 1:1.3. The anterior maxilla had 34 (55.8%) cases and the anterior mandible had 20 (32.8%) cases. 40 (65.6%) follicular cases, 20 (32.8%) extra-follicular cases and 1(1.6%) extra-osseous case were found. 31 cases (61.1%) were associated with impacted teeth and the upper canine was involved in 19 (57.6%) cases. Conclusion This study showed AOT to be more common in the maxilla, more in females, most often associated with impacted canines, however, the suggestion of AOT being a “Two third tumour” was not observed in this study. PMID:27642441

  15. Facebook's personal page modelling and simulation

    NASA Astrophysics Data System (ADS)

    Sarlis, Apostolos S.; Sakas, Damianos P.; Vlachos, D. S.

    2015-02-01

    In this paper we will try to define the utility of Facebook's Personal Page marketing method. This tool that Facebook provides, is modelled and simulated using iThink in the context of a Facebook marketing agency. The paper has leveraged the system's dynamic paradigm to conduct Facebook marketing tools and methods modelling, using iThink™ system to implement them. It uses the design science research methodology for the proof of concept of the models and modelling processes. The following model has been developed for a social media marketing agent/company, Facebook platform oriented and tested in real circumstances. This model is finalized through a number of revisions and iterators of the design, development, simulation, testing and evaluation processes. The validity and usefulness of this Facebook marketing model for the day-to-day decision making are authenticated by the management of the company organization. Facebook's Personal Page method can be adjusted, depending on the situation, in order to maximize the total profit of the company which is to bring new customers, keep the interest of the old customers and deliver traffic to its website.

  16. Resources and infrastructure for the delivery of antiretroviral therapy at primary health care facilities in the Free State Province, South Africa.

    PubMed

    Janse van Rensburg-Bonthuyzen, Ega; Engelbrecht, Michelle; Steyn, Francois; Jacobs, Nandi; Schneider, Helen; van Rensburg, Dingie

    2008-09-01

    There are concerns as to whether South Africa's public health system has sufficient resources, human and otherwise, to ensure universal access to antiretroviral treatment (ART). We report on public sector implementation of the Comprehensive Care Management and Treatment (CCMT) programme in the Free State Province, South Africa, in particular whether the primary health care (PHC) infrastructure was able to mobilise the necessary inputs to effectively provide ART, without undermining other services within facilities. A longitudinal study was conducted of the first 16 PHC facilities accredited to provide ART in the province. The facilities were visited on three occasions over 2 years, involving both structured and open-ended interviews with professional and lay staff, and observations of available resources. The resources assessed were staffing, space, essential equipment, drug supplies and laboratory systems. Approximately one-fifth (20%) of professional nurses were allocated to the CCMT programme in the facilities, although the overall number of professional nurses increased by only 14%. This process resulted in some displacement of professional nurses towards the CCMT Programme away from other services in the facilities. However, this could have been partially compensated for by task shifting towards community health workers and the appointment of additional support staff. Staff were largely positive about the programme. Drug supplies, availability of equipment and laboratory systems, although good at the baseline, improved further over the period of observation. The lack of adequate space to accommodate the new programme was a frequently reported problem. Overall, our assessment is that the PHC infrastructure in the Free State's public health system is capable of implementing and benefiting from the CCMT programme. Nevertheless, constraints in the availability of professional staff threaten future implementation of both the CCMT and other PHC programmes.

  17. Women's Education Level, Maternal Health Facilities, Abortion Legislation and Maternal Deaths: A Natural Experiment in Chile from 1957 to 2007

    PubMed Central

    Koch, Elard; Thorp, John; Bravo, Miguel; Gatica, Sebastián; Romero, Camila X.; Aguilera, Hernán; Ahlers, Ivonne

    2012-01-01

    Background The aim of this study was to assess the main factors related to maternal mortality reduction in large time series available in Chile in context of the United Nations' Millennium Development Goals (MDGs). Methods Time series of maternal mortality ratio (MMR) from official data (National Institute of Statistics, 1957–2007) along with parallel time series of education years, income per capita, fertility rate (TFR), birth order, clean water, sanitary sewer, and delivery by skilled attendants were analysed using autoregressive models (ARIMA). Historical changes on the mortality trend including the effect of different educational and maternal health policies implemented in 1965, and legislation that prohibited abortion in 1989 were assessed utilizing segmented regression techniques. Results During the 50-year study period, the MMR decreased from 293.7 to 18.2/100,000 live births, a decrease of 93.8%. Women's education level modulated the effects of TFR, birth order, delivery by skilled attendants, clean water, and sanitary sewer access. In the fully adjusted model, for every additional year of maternal education there was a corresponding decrease in the MMR of 29.3/100,000 live births. A rapid phase of decline between 1965 and 1981 (−13.29/100,000 live births each year) and a slow phase between 1981 and 2007 (−1.59/100,000 live births each year) were identified. After abortion was prohibited, the MMR decreased from 41.3 to 12.7 per 100,000 live births (−69.2%). The slope of the MMR did not appear to be altered by the change in abortion law. Conclusion Increasing education level appears to favourably impact the downward trend in the MMR, modulating other key factors such as access and utilization of maternal health facilities, changes in women's reproductive behaviour and improvements of the sanitary system. Consequently, different MDGs can act synergistically to improve maternal health. The reduction in the MMR is not related to the legal status of

  18. Systematic review of facility-based sexual and reproductive health services for female sex workers in Africa

    PubMed Central

    2014-01-01

    Background Several biological, behavioural, and structural risk factors place female sex workers (FSWs) at heightened risk of HIV, sexually transmitted infections (STIs), and other adverse sexual and reproductive health (SRH) outcomes. FSW projects in many settings have demonstrated effective ways of altering this risk, improving the health and wellbeing of these women. Yet the optimum delivery model of FSW projects in Africa is unclear. This systematic review describes intervention packages, service-delivery models, and extent of government involvement in these services in Africa. Methods On 22 November 2012, we searched Web of Science and MEDLINE, without date restrictions, for studies describing clinical and non-clinical facility-based SRH prevention and care services for FSWs in low- and middle-income countries in Africa. We also identified articles in key non-indexed journals and on websites of international organizations. A single reviewer screened titles and abstracts, and extracted data from articles using standardised tools. Results We located 149 articles, which described 54 projects. Most were localised and small-scale; focused on research activities (rather than on large-scale service delivery); operated with little coordination, either nationally or regionally; and had scanty government support (instead a range of international donors generally funded services). Almost all sites only addressed HIV prevention and STIs. Most services distributed male condoms, but only 10% provided female condoms. HIV services mainly encompassed HIV counselling and testing; few offered HIV care and treatment such as CD4 testing or antiretroviral therapy (ART). While STI services were more comprehensive, periodic presumptive treatment was only provided in 11 instances. Services often ignored broader SRH needs such as family planning, cervical cancer screening, and gender-based violence services. Conclusions Sex work programmes in Africa have limited coverage and a narrow

  19. Some Guidelines for Creating World Wide Web Home Page Files.

    ERIC Educational Resources Information Center

    van Brakel, Pieter A.; And Others

    1995-01-01

    Provides guidelines for home page design, and suggests that the physical appearance of a home page is similar to that of a good graphical user interface. In designing a complete home page file, the premise is that basic hypertext design principles could also be applied in the World Wide Web environment. (Author/JKP)

  20. World Wide Web Pages--Tools for Teaching and Learning.

    ERIC Educational Resources Information Center

    Beasley, Sarah; Kent, Jean

    Created to help educators incorporate World Wide Web pages into teaching and learning, this collection of Web pages presents resources, materials, and techniques for using the Web. The first page focuses on tools for teaching and learning via the Web, providing pointers to sites containing the following: (1) course materials for both distance and…

  1. Digital Ethnography: Library Web Page Redesign among Digital Natives

    ERIC Educational Resources Information Center

    Klare, Diane; Hobbs, Kendall

    2011-01-01

    Presented with an opportunity to improve Wesleyan University's dated library home page, a team of librarians employed ethnographic techniques to explore how its users interacted with Wesleyan's current library home page and web pages in general. Based on the data that emerged, a group of library staff and members of the campus' information…

  2. Required Discussion Web Pages in Psychology Courses and Student Outcomes

    ERIC Educational Resources Information Center

    Pettijohn, Terry F., II; Pettijohn, Terry F.

    2007-01-01

    We conducted 2 studies that investigated student outcomes when using discussion Web pages in psychology classes. In Study 1, we assigned 213 students enrolled in Introduction to Psychology courses to either a mandatory or an optional Web page discussion condition. Students used the discussion Web page significantly more often and performed…

  3. Young Children's Interpretations of Page Breaks in Contemporary Picture Storybooks

    ERIC Educational Resources Information Center

    Sipe, Lawrence R.; Brightman, Anne E.

    2009-01-01

    This article reports on a study of the responses of a second-grade class to the page breaks in contemporary picturebooks. In a picturebook, the text and accompanying illustrations are divided into a series of facing pages called openings, and the divisions between the openings are called page breaks or turns. Unlike a novel, in which the page…

  4. Crises and Resilience at the Frontline—Public Health Facility Managers under Devolution in a Sub-County on the Kenyan Coast

    PubMed Central

    Nyikuri, Mary; Tsofa, Benjamin; Barasa, Edwine; Okoth, Philip; Molyneux, Sassy

    2015-01-01

    Background Public primary health care (PHC) facilities are for many individuals the first point of contact with the formal health care system. These facilities are managed by professional nurses or clinical officers who are recognised to play a key role in implementing health sector reforms and facilitating initiatives aimed at strengthening community involvement. Little in-depth research exists about the dimensions and challenges of these managers’ jobs, or on the impact of decentralisation on their roles and responsibilities. In this paper, we describe the roles and responsibilities of PHC managers–or ‘in-charges’ in Kenya, and their challenges and coping strategies, under accelerated devolution. Methods The data presented in this paper is part of a wider set of activities aimed at understanding governance changes under devolution in Kenya, under the umbrella of a ‘learning site’. A learning site is a long term process of collaboration between health managers and researchers deciding together on key health system questions and interventions. Data were collected through seven formal in depth interviews and observations at four PHC facilities as well as eight in depth interviews and informal interactions with sub-county managers from June 2013 to July 2014. Drawing on the Aragon framework of organisation capacity we discuss the multiple accountabilities, daily routines, challenges and coping strategies among PHC facility managers. Results PHC in-charges perform complex and diverse roles in a difficult environment with relatively little formal preparation. Their key concerns are lack of job clarity and preparedness, the difficulty of balancing multidirectional accountability responsibilities amidst significant resource shortages, and remuneration anxieties. We show that day-to-day management in an environment of resource constraints and uncertainty requires PHC in-charges who are resilient, reflective, and continuously able to learn and adapt. We

  5. Our Health Page--The Child and His Needs.

    ERIC Educational Resources Information Center

    Ransome-Kuti, O.

    1985-01-01

    Discusses the problems of social adjustment for children as Nigeria struggles with two cultures--its traditional culture and its Western colonial past. Identifies effects on present day child rearing practices in families and villages. (DST)

  6. Health and safety plan for the Isotopes Facilities Deactivation Project at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    SciTech Connect

    1996-08-01

    This HASP describes the process for identifying the requirements, written safety documentation, and procedures for protecting personnel involved in the Isotopes Facilities Deactivation Project. Objective of this project is to place 19 former isotope production facilities at ORNL in a safe condition in anticipation of an extended period of minimum surveillance and maintenance.

  7. Evaluation of a Public Child Eye Health Tertiary Facility for Pediatric Cataract in Southern Nigeria I: Visual Acuity Outcome

    PubMed Central

    Duke, Roseline E.; Adio, Adedayo; Oparah, Sidney K.; Odey, Friday; Eyo, Okon A.

    2016-01-01

    Purpose: A retrospective study of the outcome of congenital and developmental cataract surgery was conducted in a public child eye health tertiary facility in children <16 years of age in Southern Nigeria, as part of an evaluation. Materials and Method: Manual Small Incision Cataract Surgery with or without anterior vitrectomy was performed. The outcome measures were visual acuity (VA) and change (gain) in visual acuity. The age of the child at onset, duration of delay in presentation, ocular co-morbidity, non ocular co-morbidity, gender, and pre operative visual acuity were matched with postoperative visual acuity. A total of 66 children were studied for a period of six weeks following surgery. Results: Forty eight (72.7%) children had bilateral congenital cataracts and 18 (27.3%) children had bilateral developmental cataracts. There were 38(57.6%) males and 28 (42.4%) females in the study. Thirty Five (53%) children had good visual outcome (normal vision range 6/6/ -6/18) post-operatively. The number of children with blindness (vision <3/60) decreased from 61 (92.4%) pre-operatively to 4 (6.1%) post-operatively. Post operative complication occurred in 6.8% of cases six week after surgery. Delayed presentation had an inverse relationship with change (gain) in visual acuity (r = - 0.342; p-value = 0.005). Pre-operative visual acuity had a positive relationship with post operative change (gain) in visual acuity (r = 0.618; p-value = 0.000). Conclusion: Predictors of change in visual acuity in our study were; delayed presentation and pre-operative VA. Cataract surgery in children showed clinical benefit. PMID:27347247

  8. Prevalence of HIV-Associated Neurocognitive Disorder (HAND) among Patients Attending a Tertiary Health Facility in Northern Nigeria

    PubMed Central

    Yusuf, Abdulkareem Jika; Hassan, Abdulaziz; Mamman, Aisha Indo; Muktar, Haruna Mohammed; Sulieman, Aishatu Maude; Baiyewu, Olusegun

    2014-01-01

    Background HIV-associated neurocognitive disorder (HAND) is a great source of morbidity in sub-Saharan African region. However, the magnitude of this problem remains largely uninvestigated despite having the largest number of population with HIV/AIDS. The aim of this study is to determine the prevalence of HAND among patients attending a tertiary health facility in Nigeria. Method We conducted a cross-sectional study among HIV-positive patients on antiretroviral therapy (ART) for at least 1 year. They were assessed using the International HIV Dementia Scale, Word Recall Test, Stick Design Test, Subjective Cognitive Complaint Questionnaire, Alcohol Use Disorder Identification Test, Drug Abuse Screening Test, Center for Epidemiological Study–Depression Scale, Instrumental Activity of Daily Living, and neurological examination. The CD4 count and viral load were determined for all the participants. A consensus diagnosis was made on each case based on the Frascati criteria. Data obtained were analyzed using “SPSS” for Windows version 15. Results A total of 418 HIV-positive patients participated in the study, of which 325 (77.8%) are females. The mean age (standard deviation) of the participants was 37.2 (9.3) years. The prevalence of HAND was 21.5% (95% confidence interval [CI] = 17.6%-25.4%), of which 9.6% were asymptomatic. The significant predictors of HAND in this study are duration of illness (odds ratio [OR] = 1.33 P < .001), detectable viral load (OR = 0.19, P < .001), CD4 count (OR = 0.99, P < .001), education (OR = 0.94, P = .011), stopping medication (OR = 3.55 P = .01), and severity of illness (OR = 1.24, P = .005). Conclusion One-fifth of the HIV-positive patients in this study had HAND. Various sociodemographic and clinical features were related to the prevalence of HAND. PMID:25331222

  9. Comparing the knowledge, attitude and practices of health care workers in public and private primary care facilities in Lagos State on Ebola virus disease

    PubMed Central

    Idris, Bilqisu Jibril; Inem, Victor; Balogun, Mobolanle

    2015-01-01

    Introduction The West African sub-region is currently witnessing an outbreak of EVD that began in December 2013. The first case in Nigeria was diagnosed in Lagos, at a private medical facility in July 2014. Health care workers are known amplifiers of the disease. The study aimed to determine and compare EVD knowledge, attitude and practices among HCWs in public and private primary care facilities in Lagos, Nigeria. Methods This was a comparative cross-sectional study. Seventeen public and private primary care facilities were selected from the 3 senatorial districts that make up Lagos State. 388 respondents from these facilities were selected at random and interviewed using a structured questionnaire. Results Proportion of respondents with good knowledge and practice among public HCWs was 98.5% and 93.8%; and among private HCW, 95.9% and 89.7%. Proportion of respondents with positive attitude was 67% (public) and 72.7% (private). Overall, there were no statistically significant differences between the knowledge, attitude and preventive practices of public HCWs and that of private HCWs, (p≤0.05). Conclusion Timely and intense social mobilization and awareness campaigns are the best tools to educate all segments of the community about public health emergencies. There exists significant surmountable gaps in EVD knowledge, negative attitude and sub-standard preventive practices that can be eliminated through continued training of HCW and provision of adequate material resources. PMID:26740847

  10. Readers, Authors, and Page Structure: A Discussion of Four Questions Arising from a Content Analysis of Web Pages.

    ERIC Educational Resources Information Center

    Haas, Stephanie W.; Grams, Erika S.

    2000-01-01

    Discusses research describing Web page and link classification systems resulting from a content analysis of over 75 Web pages. Topics include the decision-making processes of Web page authors and readers; syntactic analysis of labeled and isolated anchors; expansion and resource links; and where links lead. (Author/LRW)

  11. The impact of delays on maternal and neonatal outcomes in Ugandan public health facilities: the role of absenteeism

    PubMed Central

    Ackers, Louise; Ioannou, Elena; Ackers-Johnson, James

    2016-01-01

    Maternal mortality in low- and middle-income countries continues to remain high. The Ugandan Ministry of Health’s Strategic Plan suggests that little, if any, progress has been made in Uganda in terms of improvements in Maternal Health [Millennium Development Goal (MDG) 5] and, more specifically, in reducing maternal mortality. Furthermore, the UNDP report on the MDGs describes Uganda’s progress as ‘stagnant’. The importance of understanding the impact of delays on maternal and neonatal outcomes in low resource settings has been established for some time. Indeed, the ‘3-delays’ model has exposed the need for holistic multi-disciplinary approaches focused on systems change as much as clinical input. The model exposes the contribution of social factors shaping individual agency and care-seeking behaviour. It also identifies complex access issues which, when combined with the lack of timely and adequate care at referral facilities, contributes to extensive and damaging delays. It would be hard to find a piece of research on this topic that does not reference human resource factors or ‘staff shortages’ as a key component of this ‘puzzle’. Having said that, it is rare indeed to see these human resource factors explored in any detail. In the absence of detailed critique (implicit) ‘common sense’ presumptions prevail: namely that the economic conditions at national level lead to inadequacies in the supply of suitably qualified health professionals exacerbated by losses to international emigration. Eight years’ experience of action-research interventions in Uganda combining a range of methods has lead us to a rather stark conclusion: the single most important factor contributing to delays and associated adverse outcomes for mothers and babies in Uganda is the failure of doctors to be present at work during contracted hours. Failure to acknowledge and respond to this sensitive problem will ultimately undermine all other interventions including

  12. Human Health and Ecological Risk Assessment for the Operation of the Explosives Waste Treatment Facility at Site 300 of the Lawrence Livermore National Laboratory

    SciTech Connect

    Gallegos, G; Daniels, J; Wegrecki, A

    2007-10-01

    This document contains the human health and ecological risk assessment for the Resource Recovery and Conservation Act (RCRA) permit renewal for the Explosives Waste Treatment Facility (EWTF). Volume 1 is the text of the risk assessment, and Volume 2 (provided on a compact disc) is the supporting modeling data. The EWTF is operated by the Lawrence Livermore National Laboratory (LLNL) at Site 300, which is located in the foothills between the cities of Livermore and Tracy, approximately 17 miles east of Livermore and 8 miles southwest of Tracy. Figure 1 is a map of the San Francisco Bay Area, showing the location of Site 300 and other points of reference. One of the principal activities of Site 300 is to test what are known as 'high explosives' for nuclear weapons. These are the highly energetic materials that provide the force to drive fissionable material to criticality. LLNL scientists develop and test the explosives and the integrated non-nuclear components in support of the United States nuclear stockpile stewardship program as well as in support of conventional weapons and the aircraft, mining, oil exploration, and construction industries. Many Site 300 facilities are used in support of high explosives research. Some facilities are used in the chemical formulation of explosives; others are locations where explosive charges are mechanically pressed; others are locations where the materials are inspected radiographically for such defects as cracks and voids. Finally, some facilities are locations where the machined charges are assembled before they are sent to the onsite test firing facilities, and additional facilities are locations where materials are stored. Wastes generated from high-explosives research are treated by open burning (OB) and open detonation (OD). OB and OD treatments are necessary because they are the safest methods for treating explosives wastes generated at these facilities, and they eliminate the requirement for further handling and

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

    PubMed

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

    2011-12-01

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

  14. Provision of CT Scanning Capability to VA/DoD (Veterans Administration/ Department of Defense) Health Care Facilities through a Shared Mobile CT Unit: A Feasibility Study

    DTIC Science & Technology

    1984-07-27

    all Federal sectoT facilities. Shared services have long been recna, nzed as one way to reduce costs, throuph optima’ itilizaticn of capacity, but...stock arguments against shared services . A CT scanner may be installed in a mobile van and the service moved in its entirety from hospital to hospital...annually. This severely restricted further acquisition by hospitals in most health service areas (5,9,14). Shared Services : A Response to Regulation

  15. Facility Focus: Science Facilities.

    ERIC Educational Resources Information Center

    College Planning & Management, 2001

    2001-01-01

    Discusses design and architectural features of two new science facilities at the Florida Institute of Technology in Melbourne, Florida, and a new graduate research tower the University of Wisconsin at Madison. Notes the important convenience associated with interior windows in these facilities, which allow researchers, faculty, and students to see…

  16. Automating indicator data reporting from health facility EMR to a national aggregate data system in Kenya: An Interoperability field-test using OpenMRS and DHIS2

    PubMed Central

    Kariuki, James M.; Manders, Eric-Jan; Richards, Janise; Oluoch, Tom; Kimanga, Davies; Wanyee, Steve; Kwach, James O.; Santas, Xenophon

    2016-01-01

    Introduction:Developing countries are increasingly strengthening national health information systems (HIS) for evidence-based decision-making. However, the inability to report indicator data automatically from electronic medical record systems (EMR) hinders this process. Data are often printed and manually re-entered into aggregate reporting systems. This affects data completeness, accuracy, reporting timeliness, and burdens staff who support routine indicator reporting from patient-level data. Method: After conducting a feasibility test to exchange indicator data from Open Medical Records System (OpenMRS) to District Health Information System version 2 (DHIS2), we conducted a field test at a health facility in Kenya. We configured a field-test DHIS2 instance, similar to the Kenya Ministry of Health (MOH) DHIS2, to receive HIV care and treatment indicator data and the KenyaEMR, a customized version of OpenMRS, to generate and transmit the data from a health facility. After training facility staff how to send data using DHIS2 reporting module, we compared completeness, accuracy and timeliness of automated indicator reporting with facility monthly reports manually entered into MOH DHIS2. Results: All 45 data values in the automated reporting process were 100% complete and accurate while in manual entry process, data completeness ranged from 66.7% to 100% and accuracy ranged from 33.3% to 95.6% for seven months (July 2013-January 2014). Manual tally and entry process required at least one person to perform each of the five reporting activities, generating data from EMR and manual entry required at least one person to perform each of the three reporting activities, while automated reporting process had one activity performed by one person. Manual tally and entry observed in October 2013 took 375 minutes. Average time to generate data and manually enter into DHIS2 was over half an hour (M=32.35 mins, SD=0.29) compared to less than a minute for automated submission (M=0

  17. The Potential Trajectory of Carbapenem-Resistant Enterobacteriaceae, an Emerging Threat to Health-Care Facilities, and the Impact of the Centers for Disease Control and Prevention Toolkit.

    PubMed

    Lee, Bruce Y; Bartsch, Sarah M; Wong, Kim F; McKinnell, James A; Slayton, Rachel B; Miller, Loren G; Cao, Chenghua; Kim, Diane S; Kallen, Alexander J; Jernigan, John A; Huang, Susan S

    2016-03-01

    Carbapenem-resistant Enterobacteriaceae (CRE), a group of pathogens resistant to most antibiotics and associated with high mortality, are a rising emerging public health threat. Current approaches to infection control and prevention have not been adequate to prevent spread. An important but unproven approach is to have hospitals in a region coordinate surveillance and infection control measures. Using our Regional Healthcare Ecosystem Analyst (RHEA) simulation model and detailed Orange County, California, patient-level data on adult inpatient hospital and nursing home admissions (2011-2012), we simulated the spread of CRE throughout Orange County health-care facilities under 3 scenarios: no specific control measures, facility-level infection control efforts (uncoordinated control measures), and a coordinated regional effort. Aggressive uncoordinated and coordinated approaches were highly similar, averting 2,976 and 2,789 CRE transmission events, respectively (72.2% and 77.0% of transmission events), by year 5. With moderate control measures, coordinated regional control resulted in 21.3% more averted cases (n = 408) than did uncoordinated control at year 5. Our model suggests that without increased infection control approaches, CRE would become endemic in nearly all Orange County health-care facilities within 10 years. While implementing the interventions in the Centers for Disease Control and Prevention's CRE toolkit would not completely stop the spread of CRE, it would cut its spread substantially, by half.

  18. Applying the sisterhood method for estimating maternal mortality to a health facility-based sample: a comparison with results from a household-based sample.

    PubMed

    Danel, I; Graham, W; Stupp, P; Castillo, P

    1996-10-01

    Researchers compared maternal mortality estimates using the sisterhood method in a household survey conducted in November 1991 and in an outpatient health facility survey conducted in July 1992. Both surveys were conducted in Region I, a predominantly rural, mountainous area in northern Nicaragua. They analyzed data from 9232 interviews with adults younger than 49. The estimated lifetime risk of maternal death and the corresponding maternal mortality ratio were essentially identical for both the household and health facility surveys (0.145 and 0.144 [i.e., 1 in 69 of reproductive age died due to pregnancy-related events] and 243 and 241/100,000 live births, respectively). The estimates were similar for both surveys, even when the results were standardized for age, residence, and socioeconomic characteristics. An important limitation to the sisterhood method of estimating maternal mortality is that it estimates maternal mortality for a period about 10-12 years before the study and therefore cannot be used to assess the immediate effect of interventions to reduce maternal mortality. Nevertheless, in areas with poor maternal mortality surveillance or where no alternative exists to collecting population-based data, the sisterhood method can reliably estimate maternal mortality. These findings suggest that health facilities-based studies using the sisterhood method is a feasible, low-cost, and efficient method to estimate maternal mortality in certain settings at subnational levels.

  19. Calibrating page sized Gafchromic EBT3 films

    SciTech Connect

    Crijns, W.; Maes, F.; Heide, U. A. van der; Van den Heuvel, F.

    2013-01-15

    Purpose: The purpose is the development of a novel calibration method for dosimetry with Gafchromic EBT3 films. The method should be applicable for pretreatment verification of volumetric modulated arc, and intensity modulated radiotherapy. Because the exposed area on film can be large for such treatments, lateral scan errors must be taken into account. The correction for the lateral scan effect is obtained from the calibration data itself. Methods: In this work, the film measurements were modeled using their relative scan values (Transmittance, T). Inside the transmittance domain a linear combination and a parabolic lateral scan correction described the observed transmittance values. The linear combination model, combined a monomer transmittance state (T{sub 0}) and a polymer transmittance state (T{sub {infinity}}) of the film. The dose domain was associated with the observed effects in the transmittance domain through a rational calibration function. On the calibration film only simple static fields were applied and page sized films were used for calibration and measurements (treatment verification). Four different calibration setups were considered and compared with respect to dose estimation accuracy. The first (I) used a calibration table from 32 regions of interest (ROIs) spread on 4 calibration films, the second (II) used 16 ROIs spread on 2 calibration films, the third (III), and fourth (IV) used 8 ROIs spread on a single calibration film. The calibration tables of the setups I, II, and IV contained eight dose levels delivered to different positions on the films, while for setup III only four dose levels were applied. Validation was performed by irradiating film strips with known doses at two different time points over the course of a week. Accuracy of the dose response and the lateral effect correction was estimated using the dose difference and the root mean squared error (RMSE), respectively. Results: A calibration based on two films was the optimal

  20. Acute antimicrobial pesticide-related illnesses among workers in health-care facilities - California, Louisiana, Michigan, and Texas, 2002-2007.

    PubMed

    2010-05-14

    Antimicrobial pesticides (e.g., sterilizers, disinfectants, and sanitizers) are chemicals used to destroy or suppress the growth of harmful microorganisms on inanimate objects and surfaces. Health-care facilities use antimicrobial pesticides to prevent pathogen transmission from contaminated environmental surfaces. Occupational exposures to antimicrobial pesticides are known to cause adverse health effects. To assess the nature and frequency of such exposures in health-care settings, CDC analyzed data from pesticide poisoning surveillance programs in California, Louisiana, Michigan, and Texas (the only four states that regularly collect data on antimicrobial pesticide-related illness) for the period 2002-2007. This report summarizes the results of that analysis, which identified 401 cases of work-related illness associated with antimicrobial pesticide exposures in health-care facilities. Most cases were identified through workers compensation systems (61%) and occurred among females (82%) and persons aged 25-54 years (73%). The most frequent occupations reported were janitors/housekeepers (24%) and nursing/medical assistants (16%). The reported mechanism of injury usually was splashes/spills (51%). The eyes were the most common organ/system affected (55%); only 15% of the 265 persons who had exposures while handling antimicrobial pesticides reported using eye protection. Reported symptoms were mostly mild and temporary. One fatality due to acute asthma and subsequent cardiopulmonary collapse was identified. Health-care facilities should educate workers about antimicrobial pesticide hazards, promote the use of personal protective equipment (PPE) as appropriate, and implement effective risk communication strategies for antimicrobial pesticide use to prevent bystander exposure. Improved design of handling equipment might prevent handler and bystander exposure.

  1. 14 CFR 1251.301 - Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...; assignment of aides to beneficiaries; home visits; delivery of health, welfare, or other social services at alternate accessible sites; alteration of existing facilities and construction of new facilities...

  2. 10 CFR 1040.72 - Existing facilities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... to beneficiaries, home visits, delivery of health, welfare, or other social services at alternate accessible sites, alteration of existing facilities and construction of new facilities in conformance...

  3. 10 CFR 1040.72 - Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... to beneficiaries, home visits, delivery of health, welfare, or other social services at alternate accessible sites, alteration of existing facilities and construction of new facilities in conformance...

  4. 14 CFR 1251.301 - Existing facilities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...; assignment of aides to beneficiaries; home visits; delivery of health, welfare, or other social services at alternate accessible sites; alteration of existing facilities and construction of new facilities...

  5. 10 CFR 1040.72 - Existing facilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... to beneficiaries, home visits, delivery of health, welfare, or other social services at alternate accessible sites, alteration of existing facilities and construction of new facilities in conformance...

  6. 10 CFR 1040.72 - Existing facilities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... to beneficiaries, home visits, delivery of health, welfare, or other social services at alternate accessible sites, alteration of existing facilities and construction of new facilities in conformance...

  7. Implementation of co-trimoxazole preventive therapy policy for malaria in HIV-infected pregnant women in the public health facilities in Tanzania

    PubMed Central

    Kamuhabwa, Appolinary AR; Gordian, Richard; Mutagonda, Ritah F

    2016-01-01

    Background In 2011, Tanzania adopted a policy for provision of daily co-trimoxazole prophylaxis to HIV-infected pregnant women for prevention of malaria and other opportunistic infections. As per the policy, HIV-infected pregnant women should not be given sulfadoxine-pyrimethamine (SP) for intermittent preventive therapy. The challenges associated with this policy change and the extent to which the new policy for prevention of malaria in pregnant women coinfected with HIV was implemented need to be assessed. Aim To assess the implementation of malaria-preventive therapy policy among HIV-infected pregnant women in the public health facilities in Dar es Salaam, Tanzania. Methodology The study was conducted in Kinondoni Municipality, Dar es Salaam, Tanzania, from January 2015 to July 2015. Three hundred and fifty-three HIV-infected pregnant women who were attending antenatal clinics (ANCs) and using co-trimoxazole for prevention of malaria were interviewed. Twenty-six health care workers working at the ANCs were also interviewed regarding provision of co-trimoxazole prophylaxis to pregnant women. A knowledge scale was used to grade the level of knowledge of health care providers. Focus group discussions were also conducted with 18 health care workers to assess the level of implementation of the policy and the challenges encountered. Results Twenty-three (6.5%) pregnant women with known HIV serostatus were using co-trimoxazole for prevention of opportunistic infections even before they became pregnant. Out of the 353 HIV-infected pregnant women, eight (2.5%) were coadministered with both SP and co-trimoxazole. Sixty (16.7%) pregnant women had poor adherence to co-trimoxazole prophylaxis. Out of the 26 interviewed health care providers, 20 had high level of knowledge regarding malaria-preventive therapy in HIV-infected pregnant women. Lack of adequate supply of co-trimoxazole in health facilities and inadequate training of health care providers were among the factors

  8. Mixed and low-level waste treatment project: Appendix C, Health and safety criteria for the mixed and low-level waste treatment facility at the Idaho National Engineering Laboratory

    SciTech Connect

    Neupauer, R.M.; Thurmond, S.M.

    1992-09-01

    This report contains health and safety information relating to the chemicals that have been identified in the mixed waste streams at the Waste Treatment Facility at the Idaho National Engineering Laboratory. Information is summarized in two summary sections--one for health considerations and one for safety considerations. Detailed health and safety information is presented in material safety data sheets (MSDSs) for each chemical.

  9. Mixed and low-level waste treatment project: Appendix C, Health and safety criteria for the mixed and low-level waste treatment facility at the Idaho National Engineering Laboratory. Part 2, Chemical constituents

    SciTech Connect

    Neupauer, R.M.; Thurmond, S.M.

    1992-09-01

    This report contains health and safety information relating to the chemicals that have been identified in the mixed waste streams at the Waste Treatment Facility at the Idaho National Engineering Laboratory. Information is summarized in two summary sections--one for health considerations and one for safety considerations. Detailed health and safety information is presented in material safety data sheets (MSDSs) for each chemical.

  10. If You Build (and Moderate) It, They Will Come: The Smokefree Women Facebook Page

    PubMed Central

    2013-01-01

    This analysis explores the impact of modifying the Smokefree Women Facebook social media strategy, from primarily promoting resources to encouraging participation in communications about smoking cessation by posting user-generated content. Analyses were performed using data from the Smokefree Women Facebook page to assess the impact of the revised strategy on reach and engagement. Fan engagement increased 430%, and a strong and statistically significant correlation (P < .05) between the frequency of moderator posts and community engagement was observed. The reach of the page also increased by 420%. Our findings indicate that the strategy shift had a statistically significant and positive effect on the frequency of interactions on the Facebook page, providing an example of an approach that may prove useful for reaching and engaging users in online communities. Additional research is needed to assess the association between engagement in virtual communities and health behavior outcomes. PMID:24395993

  11. If you build (and moderate) it, they will come: the Smokefree Women Facebook page.

    PubMed

    Post, Samantha D; Taylor, Shani C; Sanders, Amy E; Goldfarb, Jeffrey M; Hunt, Yvonne M; Augustson, Erik M

    2013-12-01

    This analysis explores the impact of modifying the Smokefree Women Facebook social media strategy, from primarily promoting resources to encouraging participation in communications about smoking cessation by posting user-generated content. Analyses were performed using data from the Smokefree Women Facebook page to assess the impact of the revised strategy on reach and engagement. Fan engagement increased 430%, and a strong and statistically significant correlation (P < .05) between the frequency of moderator posts and community engagement was observed. The reach of the page also increased by 420%. Our findings indicate that the strategy shift had a statistically significant and positive effect on the frequency of interactions on the Facebook page, providing an example of an approach that may prove useful for reaching and engaging users in online communities. Additional research is needed to assess the association between engagement in virtual communities and health behavior outcomes.

  12. NINDS Traumatic Brain Injury Information Page

    MedlinePlus

    ... Strategy Current Research Research Funded by NINDS Basic Neuroscience Clinical Research Translational Research Research at NINDS Focus ... Health (NIH) in Bethesda, Maryland. The Center for Neuroscience and Regenerative Medicine (CNRM) is a TBI research ...

  13. Situation analysis and issues in management of biomedical waste in select small health care facilities in a ward under Bruhat Bengaluru Mahanagara Palike, Bangalore, India.

    PubMed

    Chethana, Thirthahalli; Thapsey, Hemanth; Gautham, Melur Sukumar; Sreekantaiah, Pruthvish; Suryanarayana, Suradhenupura Puttajois

    2014-04-01

    Smaller health care facilities especially clinics though believed to generate lesser quantum/categories of medical waste, the number of clinics/small health care settings are considerable. The movement to manage biomedical waste in a safe and scientific manner has gathered momentum among the medium and large hospitals in Bangalore, but there has been a little understanding and focus on the smaller health care facilities/clinics in this aspect. It is important to gather evidence regarding the current situation of bio-medical waste (BMW) management and issues in smaller health care settings, so as to expand the safe management to all points of generation in Bangalore and will also help to plan relevant interventional strategies for the same. Hence an exploratory study was conducted to assess the current situation and issues in management of BMW among small health care facilities (sHCF). This cross sectional study was conducted in T. Dasarahalli (ward number 15) under Bruhat Bengaluru Mahanagar Palike (BBMP) of Bangalore. Data was collected from a convenient sample of 35 nursing homes (<50 beds) and clinics in December 2011. The results of this study indicate that 3 (20 %) of nursing homes had a Policy for Health Care Waste Management, though committees for Infection control and Hospital waste management were absent. Recording system like injury and waste management registers were non-existent. In our study the Common Bio-medical Waste Treatment Facility operator collected waste from 28 (80 %) of the sHCF. Segregation at the point of generation was present in 22 (62.9 %) of the sHCF. Segregation process was compliant as per BMW rules 1998 among 5 (16.1 %) of the sHCF. 18 sHCF workers were vaccinated with hepatitis B and tetanus. Deficiencies were observed in areas of containment, sharps management and disinfection. It was observed that though the quantum and category of waste generated was limited there exist deficiencies which warrant initiation of system development

  14. Layout Improvement Study to Reduce Staff Walking Distance in a Large Health Care Facility: How to Not Walk an Extra 4740 Miles.

    PubMed

    Ley-Chavez, Adriana; Hmar-Lagroun, Tatiana; Douglas-Ntagha, Pamela; Cumbo, Charlotte L

    2016-01-01

    Inefficient facility layouts have been found to be a challenge in health care, with excessive walking adding to the demands of staff and creating delays, which can impact the quality of care. Minimizing unnecessary transportation during care delivery improves efficiency, reduces delays, and frees up resources for use on value-added activities. This article presents a methodology and application of facility design to improve responsiveness and efficiency at a large hospital. The approach described provides the opportunity to improve existing layouts in facilities in which the floor plan is already defined, but there is some flexibility to relocate key areas. The existing physical constraints and work flows are studied and taken into consideration, and the volume of traffic flow throughout the facility guides the decision of where to relocate areas for maximum efficiency. Details on the steps followed and general recommendations to perform the necessary process and data analyses are provided. We achieved a 34.8% reduction in distance walked (4740 miles saved per year) and a 30% reduction in floors traveled in elevators (344 931 floors, which translate to 842 hours spent using elevators) by relocating 4 areas in which frequently used resources are housed.

  15. The Department of Energy`s Rocky Flats Plant: A guide to record series useful for health-related research. Volume III, facilities and equipment

    SciTech Connect

    1995-08-01

    This is the third in a series of seven volumes which constitute a guide to records of the Rocky Flats Plant useful for conducting health-related research. The primary purpose of Volume M is to describe record series pertaining to facilities and equipment at the Department of Energy`s (DOE) Rocky Flats Plant, now named the Rocky Flats Environmental Technology Site, near Denver, Colorado. History Associates Incorporated (HAI) prepared this guide as part of its work as the support services contractor for DOE`s Epidemiologic Records Inventory Project. This introduction briefly describes the Epidemiologic Records Inventory Project and HAI`s role in the project, provides a history of facilities and equipment practices at Rocky Flats, and identifies organizations contributing to facilities and equipment policies and activities. Other topics include the scope and arrangement of this volume and the organization to contact for access to these records. Comprehensive introductory and background information is available in Volume I. Other volumes in the guide pertain to administrative and general subjects, production and materials handling, workplace and environmental monitoring, employee health, and waste management. In addition, HAI has produced a subject-specific guide, titled The September 1957 Rocky Flats Fire: A Guide to Record Series of the Department of Energy and Its Contractors, which researchers should consult for further information about records related to this incident.

  16. Survey cover pages: to take or not to take.

    PubMed

    Sansone, Randy A; Lam, Charlene; Wiederman, Michael W

    2010-01-01

    In survey research, the elements of informed conset, including contact information for the researchers and the Institutional Review Board, may be located on a cover page, which participants are advised that they may take. To date, we are not aware of any studies examining the percentage of research participants that actually take these cover pages, which was the purpose of this study. Among a consecutive sample of 419 patients in an internal medicine setting, 16% removed the cover page. There were no demographic predictors regarding who took versus did not take the cover page.

  17. 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.

  18. Nuclear proteasomes carry a constitutive posttranslational modification which derails SDS-PAGE (but not CTAB-PAGE).

    PubMed

    Pitcher, David S; de Mattos-Shipley, Kate; Wang, Ziming; Tzortzis, Konstantinos; Goudevenou, Katerina; Flynn, Helen; Bohn, Georg; Rahemtulla, Amin; Roberts, Irene; Snijders, Ambrosius P; Karadimitris, Anastasios; Kleijnen, Maurits F

    2014-12-01

    We report that subunits of human nuclear proteasomes carry a previously unrecognised, constitutive posttranslational modification. Subunits with this modification are not visualised by SDS-PAGE, which is used in almost all denaturing protein gel electrophoresis. In contrast, CTAB-PAGE readily visualises such modified subunits. Thus, under most experimental conditions, with identical samples, SDS-PAGE yielded gel electrophoresis patterns for subunits of nuclear proteasomes which were misleading and strikingly different from those obtained with CTAB-PAGE. Initial analysis indicates a novel modification of a high negative charge with some similarity to polyADP-ribose, possibly explaining compatibility with (positively-charged) CTAB-PAGE but not (negatively-charged) SDS-PAGE and providing a mechanism for how nuclear proteasomes may interact with chromatin, DNA and other nuclear components.

  19. Socorro Students Translate NRAO Web Pages Into Spanish

    NASA Astrophysics Data System (ADS)

    2002-07-01

    Six Socorro High School students are spending their summer working at the National Radio Astronomy Observatory (NRAO) on a unique project that gives them experience in language translation, World Wide Web design, and technical communication. Under the project, called "Un puente a los cielos," the students are translating many of NRAO's Web pages on astronomy into Spanish. "These students are using their bilingual skills to help us make basic information about astronomy and radio telescopes available to the Spanish-speaking community," said Kristy Dyer, who works at NRAO as a National Science Foundation postdoctoral fellow and who developed the project and obtained funding for it from the National Aeronautics and Space Administration. The students are: Daniel Acosta, 16; Rossellys Amarante, 15; Sandra Cano, 16; Joel Gonzalez, 16; Angelica Hernandez, 16; and Cecilia Lopez, 16. The translation project, a joint effort of NRAO and the NM Tech physics department, also includes Zammaya Moreno, a teacher from Ecuador, Robyn Harrison, NRAO's education officer, and NRAO computer specialist Allan Poindexter. The students are translating NRAO Web pages aimed at the general public. These pages cover the basics of radio astronomy and frequently-asked questions about NRAO and the scientific research done with NRAO's telescopes. "Writing about science for non-technical audiences has to be done carefully. Scientific concepts must be presented in terms that are understandable to non-scientists but also that remain scientifically accurate," Dyer said. "When translating this type of writing from one language to another, we need to preserve both the understandability and the accuracy," she added. For that reason, Dyer recruited 14 Spanish-speaking astronomers from Argentina, Mexico and the U.S. to help verify the scientific accuracy of the Spanish translations. The astronomers will review the translations. The project is giving the students a broad range of experience. "They are

  20. HIV/AIDS among inmates of and releasees from US correctional facilities, 2006: declining share of epidemic but persistent public health opportunity.

    PubMed

    Spaulding, Anne C; Seals, Ryan M; Page, Matthew J; Brzozowski, Amanda K; Rhodes, William; Hammett, Theodore M

    2009-11-11

    Because certain groups at high risk for HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) come together in correctional facilities, seroprevalence was high early in the epidemic. The share of the HIV/AIDS epidemic borne by inmates of and persons released from jails and prisons in the United States (US) in 1997 was estimated in a previous paper. While the number of inmates and releasees has risen, their HIV seroprevalence rates have fallen. We sought to determine if the share of HIV/AIDS borne by inmates and releasees in the US decreased between 1997 and 2006. We created a new model of population flow in and out of correctional facilities to estimate the number of persons released in 1997 and 2006. In 1997, approximately one in five of all HIV-infected Americans was among the 7.3 million who left a correctional facility that year. Nine years later, only one in seven (14%) of infected Americans was among the 9.1 million leaving, a 29.3% decline in the share. For black and Hispanic males, two demographic groups with heightened incarceration rates, recently released inmates comprise roughly one in five of those groups' total HIV-infected persons, a figure similar to the proportion borne by the correctional population as a whole in 1997. Decreasing HIV seroprevalence among those admitted to jails and prisons, prolonged survival and aging of the US population with HIV/AIDS beyond the crime-prone years, and success with discharge planning programs targeting HIV-infected prisoners could explain the declining concentration of the epidemic among correctional populations. Meanwhile, the number of persons with HIV/AIDS leaving correctional facilities remains virtually identical. Jails and prisons continue to be potent targets for public health interventions. The fluid nature of incarcerated populations ensures that effective interventions will be felt not only in correctional facilities but also in communities to which releasees return.

  1. Predictors of Poor Pregnancy Outcomes Among Antenatal Care Attendees in Primary Health Care Facilities in Cross River State, Nigeria: A Multilevel Model.

    PubMed

    Ameh, Soter; Adeleye, Omokhoa A; Kabiru, Caroline W; Agan, Thomas; Duke, Roseline; Mkpanam, Nkese; Nwoha, Doris

    2016-08-01

    Objectives Pregnancy carries a high risk for millions of women and varies by urban-rural location in Nigeria, a country with the second highest maternal deaths in the world. Addressing multilevel predictors of poor pregnancy outcomes among antenatal care (ANC) attendees in primary health care (PHC) facilities could reduce the high maternal mortality rate in Nigeria. This study utilised the "Risk Approach" strategy to (1) compare the risks of poor pregnancy outcomes among ANC attendees by urban-rural location; and (2) determine predictors of poor pregnancy outcomes among ANC attendees in urban-rural PHC facilities in Cross River State, Nigeria. Methods A cross-sectional survey was conducted in 2011 among 400 ANC attendees aged 15-49 years recruited through multistage sampling. Data on risk factors of poor pregnancy outcomes were collected using interviewer-administered questionnaires and clinic records. Respondents were categorised into low, medium or high risk of poor pregnancy outcomes, based on their overall risk scores. Predictors of poor pregnancy outcomes were determined by multilevel ordinal logistic regression. Results A greater proportion of the women in the rural areas were below the middle socio-economic quintile (75 vs. 4 %, p < 0.001), had no education (12 vs. 2 %, p < 0.001), and were in the 15-24 age group (58 vs. 35 %, p < 0.001) whereas women in the urban areas were older than 35 years (10 vs. 5 %, p < 0.001). The women attending antenatal care in the urban PHC facilities had a low overall risk of poor pregnancy outcomes than those in the rural facilities (64 vs. 50 %, p = 0.034). Pregnant women in the urban areas had decreased odds of being at high risk of poor pregnancy outcomes versus the combined medium and low risks compared with those in the rural areas (OR 0.55, 95 % CI 0.09-0.65). Conclusions for Practice Pregnant women attending antenatal care in rural PHC facilities are more at risk of poor pregnancy outcomes than those

  2. Understanding health insurance plans

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000879.htm Understanding health insurance plans To use the sharing features on this ... plan for you and your family. Types of Health Insurance Plans Depending on how you get your health ...

  3. Home Health Care

    MedlinePlus

    ... Page Resize Text Printer Friendly Online Chat Home Health Care Home health care helps older adults live independently for as long ... need for long-term nursing home care. Home health care may include occupational and physical therapy, speech therapy, ...

  4. The Effectiveness of Vaccine Day and Educational Interventions on Influenza Vaccine Coverage Among Health Care Workers at Long-Term Care Facilities

    PubMed Central

    Kimura, Akiko C.; Nguyen, Christine N.; Higa, Jeffrey I.; Hurwitz, Eric L.; Vugia, Duc J.

    2007-01-01

    Objectives. We examined barriers to influenza vaccination among long-term care facility (LTCF) health care workers in Southern California and developed simple, effective interventions to improve influenza vaccine coverage of these workers. Methods. In 2002, health care workers at LTCFs were surveyed regarding their knowledge and attitudes about influenza and the influenza vaccine. Results were used to develop 2 interventions, an educational campaign and Vaccine Day (a well-publicized day for free influenza vaccination of all employees at the worksite). Seventy facilities were recruited to participate in an intervention trial and randomly assigned to 4 study groups. Results. The combination of Vaccine Day and an educational campaign was most effective in increasing vaccine coverage (53% coverage; prevalence ratio [PR]=1.45; 95% confidence interval [CI]=1.24, 1.71, compared with 27% coverage in the control group). Vaccine Day alone was also effective (46% coverage; PR= 1.41; 95% CI=1.17, 1.71). The educational campaign alone was not effective in improving coverage levels (34% coverage; PR=1.18; 95% CI=0.93, 1.50). Conclusion. Influenza vaccine coverage of LTCF health care workers can be improved by providing free vaccinations at the worksite with a well-publicized Vaccine Day. PMID:17329659

  5. Using business intelligence for efficient inter-facility patient transfer.

    PubMed

    Haque, Waqar; Derksen, Beth Ann; Calado, Devin; Foster, Lee

    2015-01-01

    In the context of inter-facility patient transfer, a transfer operator must be able to objectively identify a destination which meets the needs of a patient, while keeping in mind each facility's limitations. We propose a solution which uses Business Intelligence (BI) techniques to analyze data related to healthcare infrastructure and services, and provides a web based system to identify optimal destination(s). The proposed inter-facility transfer system uses a single data warehouse with an Online Analytical Processing (OLAP) cube built on top that supplies analytical data to multiple reports embedded in web pages. The data visualization tool includes map based navigation of the health authority as well as an interactive filtering mechanism which finds facilities meeting the selected criteria. The data visualization is backed by an intuitive data entry web form which safely constrains the data, ensuring consistency and a single version of truth. The overall time required to identify the destination for inter-facility transfers is reduced from hours to a few minutes with this interactive solution.

  6. 20/20 vision. To celebrate our 20th anniversary, Health Facilities Management explores emerging industry trends.

    PubMed

    Eagle, Amy

    2008-10-01

    In the past 20 years, hospital design has evolved from institutional to evidence-based and patient-centered, medical and information technologies have advanced at unprecedented rates, infection control and security concerns have become more pronounced and environmental issues have broadened hospitals' healing mission to include the facility's impact on the community and the world at large.

  7. Strengthening the delivery of asthma and chronic obstructive pulmonary disease care at primary health-care facilities: study design of a cluster randomized controlled trial in Pakistan

    PubMed Central

    Khan, Muhammad Amir; Ahmed, Maqsood; Anil, Shirin; Walley, John

    2015-01-01

    Background Respiratory diseases, namely asthma and chronic obstructive pulmonary disease (COPD), account for one-fourth of the patients at the primary health-care (PHC) facilities in Pakistan. Standard care practices to manage these diseases are necessary to reduce the morbidity and mortality rate associated with non-communicable diseases in developing countries. Objective To develop and measure the effectiveness of operational guidelines and implementation materials, with sound scientific evidence, for expanding lung health care, especially asthma and COPD through PHC facilities already strengthened for tuberculosis (TB) care in Pakistan. Design A cluster randomized controlled trial with two arms (intervention and control), with qualitative and costing study components, is being conducted in 34 clusters; 17 clusters per arm (428 asthma and 306 COPD patients), in three districts in Pakistan from October 2014 to December 2016. The intervention consists of enhanced case management of asthma and COPD patients through strengthening of PHC facilities. The main outcomes to be measured are asthma and COPD control among the registered cases at 6 months. Cluster- and individual-level analyses will be done according to intention to treat. Residual confounding will be addressed by multivariable logistic and linear regression models for asthma and COPD control, respectively. The trial is registered with ISRCTN registry (ISRCTN 17409338). Conclusions Currently, only about 20% of the estimated prevalent asthma and COPD cases are being identified and reported through the respective PHC network. Lung health care and prevention has not been effectively integrated into the core PHC package, although a very well-functioning TB program exists at the PHC level. Inclusion of these diseases in the already existent TB program is expected to increase detection rates and care for asthma and COPD. PMID:26578109

  8. Professional dental services: the yellow pages advertising decision.

    PubMed

    Sanchez, P M

    1998-01-01

    Yellow pages advertising decisions are among the most important marketing decisions made by dental services professionals. Yet, little empirical evidence is available to guide these decisions. Through a literature review, the purpose of this article is to synthesize available knowledge in this area and provide guidelines for more effective yellow pages advertising.

  9. Toward a User-Centered Academic Library Home Page

    ERIC Educational Resources Information Center

    McHale, Nina

    2008-01-01

    In the past decade, academic libraries have struggled with the design of an effective library home page. Since librarians' mental models of information architecture differ from those of their patrons, usability assessments are necessary in designing a user-centered home page. This study details a usability sequence of card sort and paper and…

  10. JavaScript: Convenient Interactivity for the Class Web Page.

    ERIC Educational Resources Information Center

    Gray, Patricia

    This paper shows how JavaScript can be used within HTML pages to add interactive review sessions and quizzes incorporating graphics and sound files. JavaScript has the advantage of providing basic interactive functions without the use of separate software applications and players. Because it can be part of a standard HTML page, it is…

  11. Dynamic Web Pages: Performance Impact on Web Servers.

    ERIC Educational Resources Information Center

    Kothari, Bhupesh; Claypool, Mark

    2001-01-01

    Discussion of Web servers and requests for dynamic pages focuses on experimentally measuring and analyzing the performance of the three dynamic Web page generation technologies: CGI, FastCGI, and Servlets. Develops a multivariate linear regression model and predicts Web server performance under some typical dynamic requests. (Author/LRW)

  12. An Analysis of Academic Library Web Pages for Faculty

    ERIC Educational Resources Information Center

    Gardner, Susan J.; Juricek, John Eric; Xu, F. Grace

    2008-01-01

    Web sites are increasingly used by academic libraries to promote key services and collections to teaching faculty. This study analyzes the content, location, language, and technological features of fifty-four academic library Web pages designed especially for faculty to expose patterns in the development of these pages.

  13. Evaluating Information Quality: Hidden Biases on the Children's Web Pages

    ERIC Educational Resources Information Center

    Kurubacak, Gulsun

    2006-01-01

    As global digital communication continues to flourish, the Children's Web pages become more critical for children to realize not only the surface but also breadth and deeper meanings in presenting these milieus. These pages not only are very diverse and complex but also enable intense communication across social, cultural and political…

  14. A one-page orofacial myofunctional assessment form: a proposal.

    PubMed

    Paskay, Licia Coceani

    2012-11-01

    The author presents her own proposal of a one-page orofacial myofunctional assessment and for each item on the list a brief rationale is provided. The protocol is an easy but comprehensive form that can be faxed or emailed to referral sources as needed. As science provides more objective assessment and evaluation tools, this one-page form can be easily modified.

  15. Automatic page layout using genetic algorithms for electronic albuming

    NASA Astrophysics Data System (ADS)

    Geigel, Joe; Loui, Alexander C. P.

    2000-12-01

    In this paper, we describe a flexible system for automatic page layout that makes use of genetic algorithms for albuming applications. The system is divided into two modules, a page creator module which is responsible for distributing images amongst various album pages, and an image placement module which positions images on individual pages. Final page layouts are specified in a textual form using XML for printing or viewing over the Internet. The system makes use of genetic algorithms, a class of search and optimization algorithms that are based on the concepts of biological evolution, for generating solutions with fitness based on graphic design preferences supplied by the user. The genetic page layout algorithm has been incorporated into a web-based prototype system for interactive page layout over the Internet. The prototype system is built using client-server architecture and is implemented in java. The system described in this paper has demonstrated the feasibility of using genetic algorithms for automated page layout in albuming and web-based imaging applications. We believe that the system adequately proves the validity of the concept, providing creative layouts in a reasonable number of iterations. By optimizing the layout parameters of the fitness function, we hope to further improve the quality of the final layout in terms of user preference and computation speed.

  16. Paging and Scrolling: Cognitive Styles in Learning from Hypermedia

    ERIC Educational Resources Information Center

    Eyuboglu, Filiz; Orhan, Feza

    2011-01-01

    This study investigates the navigational patterns and learning achievement of university students with different cognitive styles, on hypermedia learning environments using paging or scrolling. The global-local subscales of Sternberg's Thinking Styles Inventory, two hypermedia, one using paging, the other using scrolling, a multiple choice…

  17. The Library as Information Provider: The Home Page.

    ERIC Educational Resources Information Center

    Clyde, Laurel A.

    1996-01-01

    Discusses ways in which libraries are using the World Wide Web to provide information via a home page, based on information from a survey in Iceland as well as a larger study that conducted content analyses of home pages of public and school libraries in 13 countries. (Author/LRW)

  18. World Wide Web Page Design: A Structured Approach.

    ERIC Educational Resources Information Center

    Gregory, Gwen; Brown, M. Marlo

    1997-01-01

    Describes how to develop a World Wide Web site based on structured programming concepts. Highlights include flowcharting, first page design, evaluation, page titles, documenting source code, text, graphics, and browsers. Includes a template for HTML writers, tips for using graphics, a sample homepage, guidelines for authoring structured HTML, and…

  19. CrazyEgg Reports for Single Page Analysis

    EPA Pesticide Factsheets

    CrazyEgg provides an in depth look at visitor behavior on one page. While you can use GA to do trend analysis of your web area, CrazyEgg helps diagnose the design of a single Web page by visually displaying all visitor clicks during a specified time.

  20. Evaluation of prototype Advanced Life Support (ALS) pack for use by the Health Maintenance Facility (HMF) on Space Station Freedom (SSF)

    NASA Technical Reports Server (NTRS)

    Krupa, Debra T.; Gosbee, John; Murphy, Linda; Kizzee, Victor D.

    1991-01-01

    The purpose is to evaluate the prototype Advanced Life Support (ALS) Pack which was developed for the Health Maintenance Facility (HMF). This pack will enable the Crew Medical Officer (CMO) to have ready access to advanced life support supplies and equipment for time critical responses to any situation within the Space Station Freedom. The objectives are: (1) to evaluate the design of the pack; and (2) to collect comments for revision to the design of the pack. The in-flight test procedures and other aspects of the KC-135 parabolic test flight to simulate weightlessness are presented.