Sample records for quality management district
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-29
... Municipal Air Quality Management District and South Coast Air Quality Management District AGENCY... Quality Management District (SMAQMD) and South Coast Air Quality Management District (SCAQMD) portions of...,'' revised September 20, 2010. (D) Sacramento Metropolitan Air Quality Management District. (1) Rule 466...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-26
... the California State Implementation Plan, Northern Sierra Air Quality Management District, Sacramento Metropolitan Air Quality Management District, and South Coast Air Quality Management District AGENCY... the Northern Sierra Air Quality Management District (NSAQMD), Sacramento Metropolitan Air Quality...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-11
... the California State Implementation Plan, Butte County Air Quality Management District and Sacramento Metropolitan Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION: Direct... Quality Management District (BCAQMD) and Sacramento Metropolitan Air Quality Management District (SMAQMD...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-26
... California State Implementation Plan, Northern Sierra Air Quality Management District, Sacramento Metropolitan Air Quality Management District, and South Coast Air Quality Management District AGENCY... approve revisions to the Northern Sierra Air Quality Management District (NSAQMD), Sacramento Metropolitan...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-01
... the California State Implementation Plan, Antelope Valley Air Quality Management District and Mojave Desert Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION: Direct final... Quality Management District (AVAQMD) and Mojave Desert Air Quality Management District (MDAQMD) portion of...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-29
... Municipal Air Quality Management District and South Coast Air Quality Management District AGENCY... the Santa Barbara Air Pollution Control District (SBAPCD), Sacramento Municipal Air Quality Management District (SMAQMD) and South Coast Air Quality Management District (SCAQMD) portions of the California State...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-12-10
... Quality Implementation Plans; California; South Coast Air Quality Management District; Prevention of... Implementation Plan (SIP) revision for the South Coast Air Quality Management District (SCAQMD or District... in a August 15, 2012 letter from the South Coast Air Quality Management District regarding specific...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-14
... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District and South Coast Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION... Metropolitan Air Quality Management District (SMAQMD) and South Coast Air Quality Management District (SCAQMD...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-29
... Quality Implementation Plan; California; Sacramento Metropolitan Air Quality Management District... to the Sacramento Metropolitan Air Quality Management District (SMAQMD or District) portion of the..., Sacramento Metropolitan Air Quality Management District, Rule 214 (Federal New Source Review), Rule 203...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-14
... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District and South Coast Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION... Management District (SMAQMD) and South Coast Air Quality Management District (SCAQMD) portions of the...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-15
... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... approve revisions to the South Coast Air Quality Management District (SCAQMD) portion of the California... Governor's Designee. (i) Incorporation by reference. (A) South Coast Air Quality Management District. (1...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-08
... California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY: Environmental...-Solano Air Quality Management District portion of the California State Implementation Plan (SIP). This... the following local rule: Yolo-Solano Air Quality Management District Rule 2.41, Expandable...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-08-04
... the California State Implementation Plan; South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District portion of the California State Implementation Plan... following local rule: South Coast Air Quality Management District Rule 1175, Control of Emissions from the...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-03-28
... California State Implementation Plan, South Coast Air Quality Management District AGENCY: Environmental... revision to the South Coast Air Quality Management District (SCAQMD) portion of the California State...) * * * (411) * * * (i) * * * (F) South Coast Air Quality Management District. (1) Rule 463, ``Organic Liquid...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-10-25
... the California State Implementation Plan, Mojave Desert Air Quality Management District AGENCY... limited disapproval of revisions to the Mojave Desert Air Quality Management District (MDAQMD) portion of.... * * * * * (c) * * * (379) * * * (i) * * * (E) Mojave Desert Air Quality Management District. (1) Rule 1159...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-08
... California State Implementation Plan; Yolo-Solano Air Quality Management District AGENCY: Environmental... revision to the Yolo-Solano Air Quality Management District portion of the California State Implementation...-Solano Air Quality Management District (YSAQMD) Rule 2.41, adopted on September 10, 2008, and submitted...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-29
... the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California State...) * * * (i) * * * (C) Yolo Solano Air Quality Management District (1) Rule 3.21, ``Rice Straw Emission...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-09-26
...] Revisions to the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State...'s Designee. (i) Incorporation by Reference. (A) South Coast Air Quality Management District. (1...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-01
... the California State Implementation Plan, Feather River Air Quality Management District AGENCY... limited disapproval of revisions to the Feather River Air Quality Management District (FRAQMD) portion of.... * * * * * (c) * * * (378) * * * (i) * * * (E) Feather River Air Quality Management District. (1) Rule 3.22...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-10
... the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... approve revisions to the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California... Identification of plan. * * * * * (c) * * * (377) * * * (i) * * * (B) Yolo Solano Air Quality Management District...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-18
... the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... approve revisions to the Yolo-Solano Air Quality Management District (Yolo-Solano AQMD) portion of the.... * * * * * (381) * * * (i) * * * (I) Yolo-Solano Air Quality Management District. (1) Rule 2.3, ``Ringelmann Chart...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-09-24
... the California State Implementation Plan, Antelope Valley Air Quality Management District, Santa Barbara County Air Pollution Control District, South Coast Air Quality Management District and Ventura.... SUMMARY: EPA is finalizing approval of revisions to the Antelope Valley Air Quality Management District...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-20
... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District... Metropolitan Air Quality Management District (SMAQMD or District) portion of the California State... Designee. (i) Incorporation by Reference. (A) Sacramento Metropolitan Air Quality Management District. (1...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-20
... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... approve a revision to the South Coast Air Quality Management District (SCAQMD) portion of the California... Reference (A) South Coast Air Quality Management District (1) Rule 2005, ``New Source Review for RECLAIM...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-08-04
... California State Implementation Plan; South Coast Air Quality Management District AGENCY: Environmental... revision to the South Coast Air Quality Management District portion of the California State Implementation... Submittal A. What rule did the State submit? We are approving South Coast Air Quality Management District...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-20
... the California State Implementation Plan, Mojave Desert Air Quality Management District AGENCY... approve revisions to the Mojave Desert Air Quality Management District (MDAQMD) portion of the California... approving with the dates that they were adopted by the Mojave Desert Air Quality Management District (MDAQMD...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-05
... Metropolitan Air Quality Management District, San Joaquin Valley Unified Air Pollution Control District, and South Coast Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION... Air Pollution Control District (PCAPCD), Sacramento Metropolitan Air Quality Management District...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-05
... Metropolitan Air Quality Management District, San Joaquin Valley Unified Air Pollution Control District, and South Coast Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION... District (PCAPCD), Sacramento Metropolitan Air Quality Management District (SMAQMD), San Joaquin Valley...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-06-24
... Determination To Defer Sanctions; California; South Coast Air Quality Management District AGENCY: Environmental... Quality Management District's (SCAQMD) portion of the California State Implementation Plan (SIP) published... California submitted the ``South Coast Air Quality Management District Proposed Contingency Measures for the...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-18
... the California State Implementation Plan, Antelope Valley Air Quality Management District and Imperial... Quality Management District (AVAQMD) and Imperial County Air Pollution Control District (ICAPCD) portions... Technology (RACT),'' adopted on February 23, 2010. * * * * * (G) Antelope Valley Air Quality Management...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-26
... the California State Implementation Plan, Antelope Valley Air Quality Management District AGENCY... the Antelope Valley Air Quality Management District (AVAQMD) portion of the California State... for the South Coast Air Quality Management District (SCAQMD). The Antelope Valley Air Pollution...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-01
... the California State Implementation Plan, Antelope Valley Air Quality Management District and Mojave Desert Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY: EPA is proposing to approve revisions to the Antelope Valley Air Quality Management District...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-01
... the California State Implementation Plan, Antelope Valley Air Quality Management District AGENCY... approve revisions to the Antelope Valley Air Quality Management District (AVAQMD) portion of the... approving with the dates that they were adopted by the Antelope Valley Air Quality Management District...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-27
... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State... overwhelmingly formed as a secondary pollutant. (South Coast 2007 Air Quality Management Plan, page ES-9...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-29
... the California State Implementation Plan, Antelope Valley Air Quality Management District, Santa Barbara County Air Pollution Control District, South Coast Air Quality Management District and Ventura... rule. SUMMARY: EPA is proposing to approve revisions to the Antelope Valley Air Quality Management...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-09
... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District... final action to approve revisions to the Sacramento Metropolitan Air Quality Management District (SMAQMD...) * * * (362) * * * (i) * * * (C) Sacramento Metropolitan Air Quality Management District. (1) Rule 450...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-29
... Quality Implementation Plans; California; South Coast Air Quality Management District; Prevention of... rule. SUMMARY: EPA is proposing approval of a permitting rule submitted for the South Coast Air Quality Management District (District) portion of the California State Implementation Plan (SIP). The State is...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-10-05
... the California State Implementation Plan; Sacramento Metropolitan Air Quality Management District... approve a revision to the Sacramento Metropolitan Air Quality Management District's portion of the... Metropolitan Air Quality Management District (SMAQMD) adopted the ``Ozone State Implementation Plan Revision...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-12
... the California State Implementation Plan; Sacramento Metropolitan Air Quality Management District... a revision to the Sacramento Metropolitan Air Quality Management District's portion of the... (Permit No. 17359), which was issued by the Sacramento Metropolitan Air Quality Management District...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-10-05
... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State... Measure for Architectural Coatings,'' CARB, October 2007. 4. ``Improving Air Quality with Economic...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-07
... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State... Control Measure for Architectural Coatings,'' CARB, October 2007. 4. ``Improving Air Quality with Economic...
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40 CFR 52.222 - Negative declarations.
Code of Federal Regulations, 2010 CFR
2010-07-01
...) Mojave Desert Air Quality Management District. (i) Natural Gas and Gasoline Processing Equipment and...) Sacramento Metropolitan Air Quality Management District. (i) Plastic Parts Coating: Business Machines and...) Sacramento Metropolitan Air Quality Management District. (i) Nitric and Adipic Acid Manufacturing Plants...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-16
... the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California State.... ``Improving Air Quality with Economic Incentive Programs,'' EPA- 452/R-01-001, January 2001. B. Does the rule...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-08
... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... approve revisions to the South Coast Air Quality Management District (SCAQMD) portion of the California... submit regulations that control the primary and secondary National Ambient Air Quality Standards (NAAQS...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-08
... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... limited disapproval of revisions to the South Coast Air Quality Management District (SCAQMD) portion of... designated nonattainment for the fine particulate matter (PM2.5) National Ambient Air Quality Standards...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-06-24
... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State... Quality Index rather than on 1-hour ozone forecasted values; (b) forecast criteria for allowing a...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-28
... the California State Implementation Plan, Mojave Desert Air Quality Management District AGENCY... limited disapproval of revisions to the Mojave Desert Air Quality Management District (MDAQMD) portion of...,'' Northeast States for Coordinated Air Use Management, December 2000. B. Does the rule meet the evaluation...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-04
... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... approve revisions to the South Coast Air Quality Management District (SCAQMD) portion of the California..., this action: Is not a ``significant regulatory action'' subject to review by the Office of Management...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-06
... the California State Implementation Plan, Feather River Air Quality Management District AGENCY... limited disapproval of revisions to the Feather River Air Quality Management District (FRAQMD) portion of..., Regulatory Planning and Review The Office of Management and Budget (OMB) has exempted this regulatory action...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-08-12
... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State... not a ``significant regulatory action'' subject to review by the Office of Management and Budget under...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-03-26
... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State...'' subject to review by the Office of Management and Budget under Executive Order 12866 (58 FR 51735, October...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-22
... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District portion of the California State Implementation Plan... Office of Management and Budget under Executive Order 12866 (58 FR 51735, October 4, 1993); Does not...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-23
... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State... ``significant regulatory action'' subject to review by the Office of Management and Budget under Executive Order...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-07
... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State... Office of Management and Budget under Executive Order 12866 (58 FR 51735, October 4, 1993); Does not...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-01
... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... approve a revision to the South Coast Air Quality Management District (SCAQMD) portion of the California... action: Is not a ``significant regulatory action'' subject to review by the Office of Management and...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-09-13
...] Revisions to the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State... the Office of Management and Budget under Executive Order 12866 (58 FR 51735, October 4, 1993); does...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-14
... Quality Implementation Plan; California; Sacramento Metropolitan Air Quality Management District... Sacramento Metropolitan Air Quality Management District (SMAQMD or District) portion of the California State... sources within the areas covered by the plan as necessary to assure that the National Ambient Air Quality...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-19
... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District... Metropolitan Air Quality Management District (SMAQMD or District) portion of the California State... action: Is not a ``significant regulatory action'' subject to review by the Office of Management and...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-03-18
... Grant: South Coast Air Quality Management District; Opportunity for Pubic Hearing AGENCY: Environmental... expenditures of non-Federal funds for the South Coast Air Quality Management District (SCAQMD) in support of... to a non-selective reduction in the expenditures in the programs of the South Coast Air Quality...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-10
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2009-0573; FRL-9146-5] Disapproval of State Implementation Plan Revisions, South Coast Air Quality Management District AGENCY: Environmental... South Coast Air Quality Management District (SCAQMD) portion of the California State Implementation Plan...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-15
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2011-0537; FRL-9432-1] Revisions to the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-20
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2011-0897; FRL-9499-8] Revisions to the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-18
... taking direct final action to approve revisions to the Northern Sierra Air Quality Management District (NSAQMD) and Sacramento Metropolitan Air Quality Management District (SMAQMD) portions of the California...) Northern Sierra Air Quality Management District. (i) Flexible Package Printing, Flat Wood Paneling Coatings...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-20
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2011-0030; FRL-9308-4] Revisions to the California State Implementation Plan, Mojave Desert Air Quality Management District AGENCY... the Mojave Desert Air Quality Management District (MDAQMD) portion of the California State...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-04
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2010-0503; FRL-9183-5] Revisions to the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-10
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2010-0286; FRL-9138-7] Revisions to the California State Implementation Plan, Yolo Solano Air Quality Management District AGENCY... the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California State...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-16
... California State Implementation Plan, Antelope Valley Air Quality Management District and Ventura County Air...: EPA is taking direct final action to approve revisions to the Antelope Valley Air Quality Air Management District (AVAQMD) and Ventura County Air Pollution Control District (VCAPCD) portions of the...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-18
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0180; FRL-9652-3] Revisions to the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... the Yolo-Solano Air Quality Management District portion of the California State Implementation Plan...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-01
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0236; FRL-9670-9] Revisions to the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District portion of the California State Implementation Plan...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-08
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2010-0276; FRL-9139-8] Revisions to the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District portion of the California State Implementation Plan...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-01
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2011-0537; FRL-9457-6] California State Implementation Plan, South Coast Air Quality Management District; Withdrawal of Direct Final Rule... Implementation Plan (SIP). This revision concerned South Coast Air Quality Management District (SCAQMD) Rule 1143...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-10-25
...] Approval of Air Quality Implementation Plans; California; El Dorado County Air Quality Management District... California for the El Dorado County Air Quality Management District (EDAQMD) portion of the California SIP... 24, 1987 Federal Register, May 25, 1988, U.S. EPA, Air Quality Management Division, Office of Air...
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2014-01-01
Background Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of health services by the community. Existing evidence of the effect of quality management on health worker performance in these contexts has important limitations, and the feasibility of expanding quality management to the community level is unknown. We aim to assess quality management at the district, facility, and community levels, supported by information from high-quality, continuous surveys, and report effects of the quality management intervention on the utilization and quality of services in Tanzania and Uganda. Methods In Uganda and Tanzania, the Expanded Quality Management Using Information Power (EQUIP) intervention is implemented in one intervention district and evaluated using a plausibility design with one non-randomly selected comparison district. The quality management approach is based on the collaborative model for improvement, in which groups of quality improvement teams test new implementation strategies (change ideas) and periodically meet to share results and identify the best strategies. The teams use locally-generated community and health facility data to monitor improvements. In addition, data from continuous health facility and household surveys are used to guide prioritization and decision making by quality improvement teams as well as for evaluation of the intervention. These data include input, process, output, coverage, implementation practice, and client satisfaction indicators in both intervention and comparison districts. Thus, intervention districts receive quality management and continuous surveys, and comparison districts-only continuous surveys. Discussion EQUIP is a district-scale, proof-of-concept study that evaluates a quality management approach for maternal and newborn health including communities, health facilities, and district health managers, supported by high-quality data from independent continuous household and health facility surveys. The study will generate robust evidence about the effectiveness of quality management and will inform future nationwide implementation approaches for health system strengthening in low-resource settings. Trial registration PACTR201311000681314 PMID:24690284
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Hanson, Claudia; Waiswa, Peter; Marchant, Tanya; Marx, Michael; Manzi, Fatuma; Mbaruku, Godfrey; Rowe, Alex; Tomson, Göran; Schellenberg, Joanna; Peterson, Stefan
2014-04-02
Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of health services by the community. Existing evidence of the effect of quality management on health worker performance in these contexts has important limitations, and the feasibility of expanding quality management to the community level is unknown. We aim to assess quality management at the district, facility, and community levels, supported by information from high-quality, continuous surveys, and report effects of the quality management intervention on the utilization and quality of services in Tanzania and Uganda. In Uganda and Tanzania, the Expanded Quality Management Using Information Power (EQUIP) intervention is implemented in one intervention district and evaluated using a plausibility design with one non-randomly selected comparison district. The quality management approach is based on the collaborative model for improvement, in which groups of quality improvement teams test new implementation strategies (change ideas) and periodically meet to share results and identify the best strategies. The teams use locally-generated community and health facility data to monitor improvements. In addition, data from continuous health facility and household surveys are used to guide prioritization and decision making by quality improvement teams as well as for evaluation of the intervention. These data include input, process, output, coverage, implementation practice, and client satisfaction indicators in both intervention and comparison districts. Thus, intervention districts receive quality management and continuous surveys, and comparison districts-only continuous surveys. EQUIP is a district-scale, proof-of-concept study that evaluates a quality management approach for maternal and newborn health including communities, health facilities, and district health managers, supported by high-quality data from independent continuous household and health facility surveys. The study will generate robust evidence about the effectiveness of quality management and will inform future nationwide implementation approaches for health system strengthening in low-resource settings. PACTR201311000681314.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-11
... the California State Implementation Plan, Butte County Air Quality Management District and Sacramento Metropolitan Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY: EPA is proposing to approve revisions to the Butte County Air Quality Management...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-09-30
...] Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management District... of plan. * * * * * (c) * * * (428) * * * (i) * * * (B) Antelope Valley Air Quality Management...) * * * (i) * * * (B) Antelope Valley Air Quality Management District. (1) Rule 431.1, ``Sulfur Content of...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-23
... we are adding to our docket to revise the South Coast Air Quality Management District (District or... Quality Management Plan (AQMP) is appropriate for determining the base year to evaluate the availability... offsets; and (3) which District Air Quality Management Plan is appropriate for determining the base year...
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EPA is taking final action to approve a revision to the Butte County Air Quality Management District (BCAQMD) portion of the California State Implementation Plan (SIP). This revision concerns the District's New Source Review (NSR) permitting program.
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Introducing quality management into primary health care services in Uganda.
Omaswa, F.; Burnham, G.; Baingana, G.; Mwebesa, H.; Morrow, R.
1997-01-01
In 1994, a national quality assurance programme was established in Uganda to strengthen district-level management of primary health care services. Within 18 months both objective and subjective improvements in the quality of services had been observed. In the examples documented here, there was a major reduction in maternal mortality among pregnant women referred to Jinja District Hospital, a reduction in waiting times and increased patient satisfaction at Masaka District Hospital, and a marked reduction in reported cases of measles in Arua District. Beyond these quantitative improvements, increased morale of district health team members, improved satisfaction among patients, and greater involvement of local government in the decisions of district health committees have been observed. At the central level, the increased coordination of activities has led to new guidelines for financial management and the procurement of supplies. District quality management workshops followed up by regular support visits from the Ministry of Health headquarters have led to a greater understanding by central staff of the issues faced at the district level. The quality assurance programme has also fostered improved coordination among national disease-control programmes. Difficulties encountered at the central level have included delays in carrying out district support visits and the failure to provide appropriate support. At the district level, some health teams tackled problems over which they had little control or which were overly complex; others lacked the management capacity for problem solving. PMID:9185368
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-04
... the California State Implementation Plan, South Coast Air Quality Management District, Proposed Rule... approve a revision to the South Coast Air Quality Management District (SCAQMD) portion of the California... digesters. Rule 1127 was designed to implement the 2003 Air Quality Management Plan (AQMP) control measure...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-01
... Metro Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION: Direct... Pollution Control District (PCAPCD) and Sacramento Metro Air Quality Management District (SMAQMD) portions..., this action: Is not a ``significant regulatory action'' subject to review by the Office of Management...
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Final Environmental Assessment. Physical Fitness Center Los Angeles Air Force Base
2000-10-13
Coast Air Quality Management District (SCAQMD). 1996. Final 1997 Air Qaulity Management Plan. November. South Coast Air Quality Management District...resources including land use, geology and soils, water resources, biological resources, air quality, noise, traffic and transportation, waste management ...3-8 3.8 Solid and Hazardous Waste Management and Disposal
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ERIC Educational Resources Information Center
Desimone, Laura; Porter, Andrew C.; Birman, Beatrice F.; Garet, Michael S.; Yoon, Kwang Suk
2002-01-01
Examined policy mechanisms and processes that districts used to provide high quality inservice professional development to teachers. Data from a national probability sample of professional development coordinators in districts that received federal funding for professional development highlighted specific management and implementation strategies…
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-09
... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District... final action to approve revisions to the Sacramento Metropolitan Air Quality Management District portion... ``significant regulatory action'' subject to review by the Office of Management and Budget under Executive Order...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-10-17
... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District... final action to approve revisions to the Sacramento Metropolitan Air Quality Management District (SMAQMD..., this action: Is not a ``significant regulatory action'' subject to review by the Office of Management...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-01
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2011-0383; FRL-9428-1] Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management District AGENCY... the Antelope Valley Air Quality Management District (AVAQMD) portion of the California State...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-09
...EPA is proposing to approve revisions to the Mojave Desert Air Quality Management District (MDAQMD), Northern Sierra Air Quality Management District (NSAQMD), Sacramento Metropolitan Air Quality Management District (SMAQMD) and San Diego County Air Pollution Control District (SDCAPCD) portions of the California State Implementation Plan (SIP). These revisions concern volatile organic compound (VOC) emissions from automotive parts and component, automobile refinishing, metal parts and products, and miscellaneous coating and refinishing operations. We are proposing to approve local rules to regulate these emission sources under the Clean Air Act as amended in 1990 (CAA or the Act).
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EPA is proposing to approve a revision to the Butte County Air Quality Management District (BCAQMD) portion of the California SIP concerning the District's New Source Review (NSR) permitting program for new and modified sources of air pollution.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-14
... Determination To Stay and Defer Sanctions, Sacramento Metropolitan Air Quality Management District AGENCY... on a proposed approval of a revision to the Sacramento Metropolitan Air Quality Management District... therefore is not subject to review by the Office of Management and Budget. This action is not subject to...
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40 CFR 52.270 - Significant deterioration of air quality.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 83-01, 5/6/83. (2) The PSD rules for North Coast Unified Air Quality Management District are approved... part of the State plan for California for the North Coast Unified Air Quality Management District for... quality. 52.270 Section 52.270 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-15
... control agencies in the area: Sacramento Metropolitan Air Quality Management District, Placer County Air Pollution Control District, and Yolo-Solano Air Quality Management District. Based on these reviews, EPA..., 2007) (Miami, Arizona area); and 75 FR 27944 (May 19, 2010) (Coso Junction, California area). Thus EPA...
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Quality Management and System Change in Three Suburban Public School Districts.
ERIC Educational Resources Information Center
Obisesan, Anthonia A.
This report examines the potential of Quality Management (QM) to enhance system change by analyzing its implementation in three suburban public school districts. The paper assessed the capacity of QM to increase the efficiency and productivity of the school districts, validated the potential to sustain systemic change in a school organization, and…
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-18
... proposing to approve revisions to the Northern Sierra Air Quality Management District (NSAQMD) and Sacramento Metropolitan Air Quality Management District (SMAQMD) portions of the California State... the California State Implementation Plan, Northern Sierra and Sacramento Metropolitan Air Quality...
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Employer Invested Emissions Reduction Funding - South Coast The South Coast Air Quality Management District (SCAQMD) administers the Air Quality Investment Program (AQIP). AQIP provides funding to allow Coast Air Quality Management District Phone: (909) 396-3296 Fax: (909) 396-3252 vyardemian@aqmd.gov http
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-09
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2010-0045; FRL-9124-4] Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District... approve revisions to the Sacramento Metropolitan Air Quality Management District (SMAQMD) portion of the...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-10-17
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0754; FRL-9740-6] Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality Management Districts... approve revisions to the Sacramento Metropolitan Air Quality Management District (SMAQMD) portion of the...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-09
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0311; FRL-9687-2] Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District... approve revisions to the Sacramento Metropolitan Air Quality Management District (SMAQMD) portion of the...
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EPA is proposing to approve a revision to the Antelope Valley Air Quality Management District portion of the California SIP concerning emissions of volatile organic compounds (VOCs) from motor vehicle assembly coating operations.
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Lin, Shao; Kielb, Christine L; Reddy, Amanda L; Chapman, Bonnie R; Hwang, Syni-An
2012-03-01
Good school indoor air quality (IAQ) can affect the health and functioning of school occupants. Thus, it is important to assess the degree to which schools and districts employ strategies to ensure good IAQ management. We examined and compared the patterns of IAQ management strategies between public elementary schools and their school districts in New York State. District-level information obtained from surveys of district facilities managers in 326 districts was described and stratified by district size and socioeconomic status. School-level information obtained from surveys of head custodians in 770 elementary schools was then compared with the district-level information in 241 districts. About 47% of participating school districts reported having a district-wide IAQ program, with a large range in the prevalence of specific IAQ management strategies. Airing out newly painted areas was the most commonly reported (92%) and having a classroom animal policy was the least commonly reported (29%). Larger districts and districts with a district-wide IAQ program were more likely to report certain IAQ strategies than other districts. Elementary schools and their districts were most likely to report airing out newly painted areas (76%). The most common area of disagreement was construction after hours (50%). The top strategy not reported at either level was having an IAQ coordinator (53%). Many school districts lack key IAQ management strategies, and differences exist between district-level policy and school-level practice. Districts and schools should work together to formalize and expand existing IAQ policies and inform stakeholders about these strategies. © 2012, American School Health Association.
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Quality-assurance plan for water-resources activities of the U.S. Geological Survey in Idaho
Packard, F.A.
1996-01-01
To ensure continued confidence in its products, the Water Resources Division of the U.S. Geological Survey implemented a policy that all its scientific work be performed in accordance with a centrally managed quality-assurance program. This report establishes and documents a formal policy for current (1995) quality assurance within the Idaho District of the U.S. Geological Survey. Quality assurance is formalized by describing district organization and operational responsibilities, documenting the district quality-assurance policies, and describing district functions. The districts conducts its work through offices in Boise, Idaho Falls, Twin Falls, Sandpoint, and at the Idaho National Engineering Laboratory. Data-collection programs and interpretive studies are conducted by two operating units, and operational and technical assistance is provided by three support units: (1) Administrative Services advisors provide guidance on various personnel issues and budget functions, (2) computer and reports advisors provide guidance in their fields, and (3) discipline specialists provide technical advice and assistance to the district and to chiefs of various projects. The district's quality-assurance plan is based on an overall policy that provides a framework for defining the precision and accuracy of collected data. The plan is supported by a series of quality-assurance policy statements that describe responsibilities for specific operations in the district's program. The operations are program planning; project planning; project implementation; review and remediation; data collection; equipment calibration and maintenance; data processing and storage; data analysis, synthesis, and interpretation; report preparation and processing; and training. Activities of the district are systematically conducted under a hierarchy of supervision an management that is designed to ensure conformance with Water Resources Division goals quality assurance. The district quality-assurance plan does not describe detailed technical activities that are commonly termed "quality-control procedures." Instead, it focuses on current policies, operations, and responsibilities that are implemented at the management level. Contents of the plan will be reviewed annually and updated as programs and operations change.
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North Coast Unified Air Quality Management District: PSD Delegation Agreements
Agreements for Partial Delegation of the Federal Prevention of Significant Deterioration (PSD) Program Set Forth in 40 CPR 52.21 by the United States Environmental Protection Agency, Region 9 to the North Coast Unified Air Quality Management District.
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EPA is taking final action to approve a revision to the Northern Sierra Air Quality Management District (NSAQMD) portion of the California SIP concerning emissions of particulate matter (PM) from wood burning devices.
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Improving Indoor Air Quality in St. Cloud Schools.
ERIC Educational Resources Information Center
Forer, Mike; Haus, El
2000-01-01
Describes how the St. Cloud Area School District (Minnesota), using Tools for Schools provided by the U.S. Environmental Protection Agency, managed the improvement of their school building indoor air quality (IAQ). The district goals of the IAQ Management Committee and the policy elements used to maintain high classroom air quality are…
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Guidelines for preparing a quality assurance plan for district offices of the U.S. Geological Survey
Schroder, L.J.; Shampine, W.J.
1992-01-01
The U.S. Geological Survey has a policy that requires each District office to prepare a Quality Assurance Plan. This plan is a combination of a District's management principles and quality assurance processes. The guidelines presented in this report provide a framework or expanded outline that a District can use to prepare a plan. Parti- cular emphasis is given to a District's: (1) quality assurance policies; (2) organization and staff responsibilities; and (3) program and project planning. The guidelines address the 'how', 'what', and 'who' questions that need to be answered when a District Quality Assurance Plan is prepared.
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ERIC Educational Resources Information Center
Everett Jones, Sherry; Doroski, Brenda; Glick, Sherry
2015-01-01
Nationally representative data from the 2012 School Health Policies and Practices Study examined whether state assistance on indoor air quality (IAQ) was associated with district-level policies and practices related to IAQ and integrated pest management (IPM). Districts in states that provided assistance on IAQ were more likely than districts not…
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Old Wine in New Bottles: The Quality of Work Life in Schools and School Districts.
ERIC Educational Resources Information Center
Bacharach, Samuel B.; Mitchell, Stephen M.
This essay reviews quality of work life as a management technique and argues that quality-of-work-life programs, conceptualized multidimensionally, offer a unique mechanism for improving working conditions in schools and within districts. A brief analysis of major management ideologies concludes that some techniques advocated under the label of…
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EPA is taking final action to approve a revision to the Antelope Valley Air Quality Management District (AVAQMD) portion of the California SIP concerning the emissions of volatile organic compounds (VOCs) from motor vehicle assembly coating operations.
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ERIC Educational Resources Information Center
Schoch, Robert
2002-01-01
Describes how the School District of Lancaster, Pennsylvania, implemented a districtwide quality-management system based on the Geneva-based International Standards Organization 9001, a major component of which is the documentation of procedures. Includes sections on implementation, procedure manuals, quality management, uniformity, formatting,…
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ERIC Educational Resources Information Center
Lin, Shao; Kielb, Christine L.; Reddy, Amanda L.; Chapman, Bonnie R.; Hwang, Syni-An
2012-01-01
Background: Good school indoor air quality (IAQ) can affect the health and functioning of school occupants. Thus, it is important to assess the degree to which schools and districts employ strategies to ensure good IAQ management. We examined and compared the patterns of IAQ management strategies between public elementary schools and their school…
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-12
... approve South Coast Air Quality Management District (SCAQMD) Rule 317, ``Clean Air Act Non- Attainment Fee... Rule 317, an equivalent alternative program, is not less stringent than the program required by section... equivalent alternative programs, and, if so, whether Rule 317 would constitute an approvable equivalent...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-12-14
... of South Coast Air Quality Management District (SCAQMD) Rule 317, ``Clean Air Act Non- Attainment Fee... determined that SCAQMD's alternative fee-equivalent program is not less stringent than the program required by section 185, and, therefore, is approvable as an equivalent alternative program, consistent with...
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Implementation research to improve quality of maternal and newborn health care, Malawi.
Brenner, Stephan; Wilhelm, Danielle; Lohmann, Julia; Kambala, Christabel; Chinkhumba, Jobiba; Muula, Adamson S; De Allegri, Manuela
2017-07-01
To evaluate the impact of a performance-based financing scheme on maternal and neonatal health service quality in Malawi. We conducted a non-randomized controlled before and after study to evaluate the effects of district- and facility-level performance incentives for health workers and management teams. We assessed changes in the facilities' essential drug stocks, equipment maintenance and clinical obstetric care processes. Difference-in-difference regression models were used to analyse effects of the scheme on adherence to obstetric care treatment protocols and provision of essential drugs, supplies and equipment. We observed 33 health facilities, 23 intervention facilities and 10 control facilities and 401 pregnant women across four districts. The scheme improved the availability of both functional equipment and essential drug stocks in the intervention facilities. We observed positive effects in respect to drug procurement and clinical care activities at non-intervention facilities, likely in response to improved district management performance. Birth assistants' adherence to clinical protocols improved across all studied facilities as district health managers supervised and coached clinical staff more actively. Despite nation-wide stock-outs and extreme health worker shortages, facilities in the study districts managed to improve maternal and neonatal health service quality by overcoming bottlenecks related to supply procurement, equipment maintenance and clinical performance. To strengthen and reform health management structures, performance-based financing may be a promising approach to sustainable improvements in quality of health care.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-11
...EPA is proposing to approve revisions to the Antelope Valley Air Quality Management District (AVAQMD), Monterey Bay Unified Air Pollution Control District (MBUAPCD) and Santa Barbara County Air Pollution Control District (SCAPCD) portions of the California State Implementation Plan (SIP). We are proposing to approve revisions local rules that address emission statements for AVAQMD, rule rescissions that address public records for MBUAPCD, and define terms for SBCAPCD, under the Clean Air Act as amended in 1990 (CAA or the Act).
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EPA is taking final action to approve a revision to the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California SIP concerning YSAQMD regarding RACT)requirements the 1997 8-hour ozone NAAQS and approve negative declarations into SIP.
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Introducing quality improvement management methods into primary health care services in Uganda.
Omaswa, F; Burnham, G; Baingana, G; Mwebesa, H; Morrow, R
1996-01-01
Uganda's National Quality Assurance Program was established in 1994 to monitor the process of decentralization of primary health care services. Guidelines were developed to address problems (e.g., in obtaining health funds channeled through local government) identified at district meetings. Bringing together District Health Teams with local administrators and political leaders to share responsibility for strengthening health services has been a significant program achievement. A smoother functioning referral system from health units to district hospitals has resulted. The response to a measles outbreak in the Arua district in 1993-94 confirmed the utility of the quality management approach. Weaknesses in the district cold chain, problems with diagnostic accuracy, and a poorly functioning information system were identified as key causative factors, and corrective action in these areas led to a subsequent decline in measles cases. Patient dissatisfaction with long waiting times at Masaka Hospital was another concern addressed through the quality assurance approach. Five salient areas were identified for action: low health worker morale, supply shortages, inadequate supervision by hospital management, poor patient flow, and inefficient drug dispensing. As a result, long delays were eliminated and utilization of hospital outpatient services increased by 28%.
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Effective team management by district nurses.
Bliss, Julie
2004-12-01
This article considers the key role played by the district nurse in managing the district nursing team in order to provide high quality health care. It considers how the district nurse can use key managerial roles (interpersonal, informational and decision-making) in order to ensure unity within the team. The importance of shared goals and trust to achieve unity is explored and a strategy for managing conflict is discussed. Finally, the article suggests a set of ground rules which could be used to facilitate effective team working.
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2012-01-01
Background Quality hospital care is important in ensuring that the needs of severely ill children are met to avert child mortality. However, the quality of hospital care for children in developing countries has often been found poor. As the first step of a country road map for improving hospital care for children, we assessed the baseline situation with respect to the quality of care provided to children under-five years age in district and sub-district level hospitals in Bangladesh. Methods Using adapted World Health Organization (WHO) hospital assessment tools and standards, an assessment of 18 randomly selected district (n=6) and sub-district (n=12) hospitals was undertaken. Teams of trained assessors used direct case observation, record review, interviews, and Management Information System (MIS) data to assess the quality of clinical case management and monitoring; infrastructure, processes and hospital administration; essential hospital and laboratory supports, drugs and equipment. Results Findings demonstrate that the overall quality of care provided in these hospitals was poor. No hospital had a functioning triage system to prioritise those children most in need of immediate care. Laboratory supports and essential equipment were deficient. Only one hospital had all of the essential drugs for paediatric care. Less than a third of hospitals had a back-up power supply, and just under half had functioning arrangements for safe-drinking water. Clinical case management was found to be sub-optimal for prevalent illnesses, as was the quality of neonatal care. Conclusion Action is needed to improve the quality of paediatric care in hospital settings in Bangladesh, with a particular need to invest in improving newborn care. PMID:23268650
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Suh, Siri; Moreira, Philippe; Ly, Moussa
2007-11-29
In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers' competence. In response to this challenge, Management Sciences for Health (MSH) has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. This study evaluated changes in service quality and community involvement after two rounds of supervision in 45 health facilities in four districts of Senegal. We used checklists to assess quality in four areas of service delivery: infrastructure, staff and services management, record-keeping, and technical competence. We also measured community involvement in improving service quality using the completion rates of action plans. The most notable improvement across regions was in infection prevention.Management of staff, services, and logistics also consistently improved across the four districts. Record-keeping skills showed variable but lower improvement by region. The completion rates of action plans suggest that communities are engaged in improving service quality in all four districts. Formative supervision can improve the quality of reproductive health services, especially in areas where there is on-site skill building and refresher training. This approach can also mobilize communities to participate in improving service quality.
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Suh, Siri; Moreira, Philippe; Ly, Moussa
2007-01-01
Background In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers' competence. In response to this challenge, Management Sciences for Health (MSH) has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. Methods This study evaluated changes in service quality and community involvement after two rounds of supervision in 45 health facilities in four districts of Senegal. We used checklists to assess quality in four areas of service delivery: infrastructure, staff and services management, record-keeping, and technical competence. We also measured community involvement in improving service quality using the completion rates of action plans. Results The most notable improvement across regions was in infection prevention. Management of staff, services, and logistics also consistently improved across the four districts. Record-keeping skills showed variable but lower improvement by region. The completion rates of action plans suggest that communities are engaged in improving service quality in all four districts. Conclusion Formative supervision can improve the quality of reproductive health services, especially in areas where there is on-site skill building and refresher training. This approach can also mobilize communities to participate in improving service quality. PMID:18047678
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ERIC Educational Resources Information Center
Suleman, Qaiser; Gul, Rizwana
2015-01-01
The current study explores the challenges faced by public secondary schools in successful implementation of total quality management (TQM) in Kohat District. A sample of 25 heads and 75 secondary school teachers selected from 25 public secondary schools through simple random sampling technique was used. Descriptive research designed was used and a…
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Hydrology, water quality, and phosphorus loading of Kirby Lake, Barron County, Wisconsin
Rose, William J.; Robertson, Dale M.
1998-01-01
In 1992, residents near Kirby Lake, located about five miles northwest of Cumberland, in Barron County, Wisconsin, formed the Kirby Lake Management District. The Lake District immediately began to gather information needed for the preparation of a comprehensive lake-management plan that would be used to protect the natural and recreational assets of the lake. The Lake District completed a land-use inventory of the watershed and an evaluation of available lake water-quality data. The land-use data were used to assess the potential contribution of nutrients to the lake from the watershed. The evaluation of lake water-quality data, which were collected as part of the Wisconsin Department of Natural Resources (WDNR) Self-Help Monitoring Program, indicated the lake has relatively good water quality. Before a comprehensive lake-management plan could be prepared, however, a better understanding of several aspects of the lake and its surroundings was needed. To address those aspects including the definition of the lake's hydrology and the principal sources of nutrients, and the relation of the lake's water quality to nutrient loading the U.S. Geological Survey, in cooperation with the Lake District and the WDNR (through a Lake Management Planning Grant), conducted a study of Kirby Lake and its watershed. This Fact Sheet presents the results of that study.
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Implementation research to improve quality of maternal and newborn health care, Malawi
Wilhelm, Danielle; Lohmann, Julia; Kambala, Christabel; Chinkhumba, Jobiba; Muula, Adamson S; De Allegri, Manuela
2017-01-01
Abstract Objective To evaluate the impact of a performance-based financing scheme on maternal and neonatal health service quality in Malawi. Methods We conducted a non-randomized controlled before and after study to evaluate the effects of district- and facility-level performance incentives for health workers and management teams. We assessed changes in the facilities’ essential drug stocks, equipment maintenance and clinical obstetric care processes. Difference-in-difference regression models were used to analyse effects of the scheme on adherence to obstetric care treatment protocols and provision of essential drugs, supplies and equipment. Findings We observed 33 health facilities, 23 intervention facilities and 10 control facilities and 401 pregnant women across four districts. The scheme improved the availability of both functional equipment and essential drug stocks in the intervention facilities. We observed positive effects in respect to drug procurement and clinical care activities at non-intervention facilities, likely in response to improved district management performance. Birth assistants’ adherence to clinical protocols improved across all studied facilities as district health managers supervised and coached clinical staff more actively. Conclusion Despite nation-wide stock-outs and extreme health worker shortages, facilities in the study districts managed to improve maternal and neonatal health service quality by overcoming bottlenecks related to supply procurement, equipment maintenance and clinical performance. To strengthen and reform health management structures, performance-based financing may be a promising approach to sustainable improvements in quality of health care. PMID:28670014
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-04
...EPA is proposing to approve revisions to the Antelope Valley Air Quality Management District (AVAQMD), Eastern Kern Air Pollution Control District (EKAPCD), and Santa Barbara County Air Pollution Control District (SBCAPCD) portions of the California State Implementation Plan (SIP). We are proposing to approve revisions to local rules that define terms used in other air pollution regulations in these areas and a rule rescission that address Petroleum Coke Calcining Operations--Oxides of Sulfur, under the Clean Air Act as amended in 1990 (CAA or the Act).
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-11
...EPA is taking direct final action to approve revisions to the Antelope Valley Air Quality Management District (AVAQMD) and Monterey Bay Unified Air Pollution Control District (MBUAPCD) and Santa Barbara County Air Pollution Control District (SBCAPCD) portions of the California State Implementation Plan (SIP). Under authority of the Clean Air Act as amended in 1990 (CAA or the Act), we are approving local rules that address emission statements for AVAQMD, rule rescissions that addresses public records for MBUAPCD, and define terms for SBCAPCD.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-22
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2013-0094; FRL-9783-2] Revision of Air Quality Implementation Plan; California; Placer County Air Pollution Control District and Feather River Air Quality Management District; Stationary Source Permits AGENCY: Environmental Protection Agency...
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2007-02-01
control AVAQMD Antelope Valley Air Quality Management District AQMD Air Quality Management Districts BACT Best Available Control Technology BLM Bureau...Aeronautics NAGPRA Native American Graves Protection and Repatriation Act NASA National Aeronautics and Space Administration NBCC nuclear, biological...support of the National Aeronautics and Space Administration ( NASA ) shuttle program is required to be maintained. This includes rescue, medical evaluation
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Valadez, Joseph J; Devkota, Baburam; Pradhan, Madan Mohan; Meherda, Pramod; Sonal, G S; Dhariwal, Akshay; Davis, Rosemary
2014-10-01
This paper reports the first trial of Lot Quality Assurance Sampling (LQAS) assessing associations between access to LQAS data and subsequent improvements in district programming. This trial concerns India's approach to addressing an increase in malaria-attributable deaths by training community health workers to diagnose, treat and prevent malaria, while using LQAS to monitor sub-district performance and make programme improvements. The Ministry of Health introduced LQAS into four matched high malaria burden districts (Annual Parasite Incidence >5) (N > 5 million). In each sub-district, we sampled four populations in three 6-monthly surveys: households, children <5 years, people with fever in the last 2 weeks and community health workers. In three districts, trained local staff collected, analysed and used data for programme management; in one control district, non-local staff collected data and did not disseminate results. For eight indicators, we calculated the change in proportion from survey one to three and used a Difference-in-Differences test to compare the relative change between intervention and control districts. Coverage increased from survey one to three for 24 of 32 comparisons. Difference-in-Differences tests revealed that intervention districts exhibited significantly greater change in four of six vertical strategies (insecticide treated bed-nets and indoor residual spraying), one of six treatment-seeking behaviours and four of 12 health worker capacity indicators. The control district displayed greater improvement than two intervention districts for one health worker capacity indicator. One district with poor management did not improve. In this study, LQAS results appeared to support district managers to increase coverage in underperforming areas, especially for vertical strategies in the presence of diligent managers. © 2014 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-01-31
... the California State Implementation Plan, Santa Barbara Air Pollution Control District, Antelope Valley Air Quality Management District, Ventura County Air Pollution Control District and Placer County Air Pollution Control District AGENCY: Environmental Protection Agency (EPA). ACTION: Direct final...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-01-31
... the California State Implementation Plan, Santa Barbara Air Pollution Control District, Placer County Air Pollution Control District, Antelope Valley Air Quality Management District, and Ventura County Air Pollution Control District AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule...
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ERIC Educational Resources Information Center
Marshall, Jon; Pritchard, Ruie; Gunderson, Betsey
2004-01-01
The purpose of this study was to determine the congruence among W. E. Deming's 14 points for Total Quality Management (TQM), the organizational health of school districts, and student achievement. Based on Kanter's (1983) concept of a Culture of Pride with a Climate of Success, healthy districts were defined as having an organizational culture…
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NASA Astrophysics Data System (ADS)
Webster, A.; Cadenasso, M. L.
2016-12-01
Interactions among runoff, riparian and stream ecosystems, and water quality remain uncertain in many settings, particularly those heavily impacted by human activities. For example, waterways in the irrigated agricultural landscape of California's Central Valley are seasonally disconnected from groundwater tables and are extensively modified by infrastructure and management. These conditions make the impact of riparian and channel management difficult to predict across scales, which hinders efforts to promote best management practices to improve water quality. We seek to link observations across catchment, reach, and patch scales to understand patterns of nitrate and turbidity in waterways draining irrigated cropland. Data was collected on 80 reaches spanning two water management districts. At the catchment scale, water districts implemented waterway and riparian management differently: one water district had a decentralized approach, allowing individual land owners to manage their waterway channels and banks, while the other had a centralized approach, in which land owners defer management to a district-run program. At the reach scale, riparian and waterway vegetation, geomorphic complexity, and flow conditions were quantified. Reach-scale management such as riparian planting projects and channel dredging frequency were also considered. At the patch scale, denitrification potential and organic matter were measured in riparian toe-slope soils and channel sediments, along with associated vegetation and geomorphic features. All factors were tested for their ability to predict water quality using generalized linear mixed effects models and the consistency of predictors within and across scales was evaluated. A hierarchy of predictors emerges: catchment-scale management regimes predict reach-scale geomorphic and vegetation complexity, which in turn predicts sediment denitrification potential - the patch-scale factor most associated with low nitrate. Similarly, turbidity conveyance was most associated with reach-scale factors. These findings suggest that, in the absence of other regulations, a decentralized management approach to riparian zones and waterways allows reach-scale complexity to arise, which in turn promotes ecosystem function and improved water quality.
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School District Reorganization. Educational Management Review Series Number 12.
ERIC Educational Resources Information Center
Templeton, Ian
This review surveys recent documents previously announced in RIE that are concerned with school district reorganization. The review begins with a survey of literature on three interrelated variables that affect district consolidation and redistricting -- district size, educational quality, and educational costs. Succeeding sections present a…
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Implementing Continuous Improvement Management (CIM) in the Public Schools.
ERIC Educational Resources Information Center
Borgers, William E.; Thompson, Tommy A.
This book traces the restructuring of a Texas school district that moved from management by coercion to continuous improvement for quality. In 1990, the Dickinson Independent School District (Texas) began implementation of Continuous Improvement Management (CIM), based on the teachings of W. Edwards Deming, William Glasser, and J. M. Juran.…
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76 FR 30739 - Notice of Public Meeting, Salem District Resource Advisory Committee Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-26
.... ADDRESSES: BLM Salem District Office, 1717 Fabry Road, SE., Salem, OR 97306. FOR FURTHER INFORMATION CONTACT... Hatfield, BLM Salem District Designated Official, 1717 Fabry Road, SE., Salem, OR 97306--(503) 375-5682... quality, land health, forest ecosystems, and infrastructure. Miles R. Brown, BLM Salem District Manager...
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Rockers, Peter C; Bärnighausen, Till
2013-04-30
District managers are playing an increasingly important role in determining the performance of health systems in low- and middle-income countries as a result of decentralization. To assess the effectiveness of interventions to hire, retain and train district health systems managers in low- and middle-income countries. We searched a wide range of international databases, including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. We also searched online resources of international agencies, including the World Bank, to find relevant grey literature. Searches were conducted in December 2011. District health systems managers are those persons who are responsible for overseeing the operations of the health system within a defined, subnational geographical area that is designated as a district. Hiring and retention interventions include those that aim to increase the attractiveness of district management positions, as well as those related to hiring and retention processes, such as private contracting. Training interventions include education programs to develop future managers and on-the-job training programs for current managers. To be included, studies needed to use one of the following study designs: randomized controlled trial, nonrandomized controlled trial, controlled before-and-after study, and interrupted time series analysis. We report measures of effect in the same way that the primary study authors have reported them. Due to the varied nature of interventions included in this review we could not pool data across studies. Two studies met our inclusion criteria. The findings of one study conducted in Cambodia provide low quality evidence that private contracts with international nongovernmental organizations (NGOs) for district health systems management ('contracting-in') may improve health care access and utilization. Contracting-in increased use of antenatal care by 28% and use of public facilities by 14%. However, contracting-in was not found to have an effect on population health outcomes. The findings of the other study provide low quality evidence that intermittent training courses over 18 months may improve district health system managers' performance. In three countries in Latin America, managers who did not receive the intermittent training courses had between 2.4 and 8.3 times more management deficiencies than managers who received the training courses. No studies that aimed to investigate interventions for retaining district health systems managers met our study selection criteria for inclusion in this review. There is low quality evidence that contracting-in may improve health care accessibility and utilization and that intermittent training courses may improve district health systems managers' performance. More evidence is required before firm conclusions can be drawn regarding the effectiveness of these interventions in diverse settings. Other interventions that might be promising candidates for hiring and retaining (e.g., government regulations, professional support programs) as well as training district health systems managers (e.g., in-service workshops with on-site support) have not been adequately investigated.
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Tabrizi, Jafar Sadegh; Gholipour, Kamal; Iezadi, Shabnam; Farahbakhsh, Mostafa; Ghiasi, Akbar
2018-01-01
The aim was to design a district health management performance framework for Iran's healthcare system. The mixed-method study was conducted between September 2015 and May 2016 in Tabriz, Iran. In this study, the indicators of district health management performance were obtained by analyzing the 45 semi-structured surveys of experts in the public health system. Content validity of performance indicators which were generated in qualitative part were reviewed and confirmed based on content validity index (CVI). Also content validity ratio (CVR) was calculated using data acquired from a survey of 21 experts in quantitative part. The result of this study indicated that, initially, 81 indicators were considered in framework of district health management performance and, at the end, 53 indicators were validated and confirmed. These indicators were classified in 11 categories which include: human resources and organizational creativity, management and leadership, rules and ethics, planning and evaluation, district managing, health resources management and economics, community participation, quality improvement, research in health system, health information management, epidemiology and situation analysis. The designed framework model can be used to assess the district health management and facilitates performance improvement at the district level.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-08-17
... the California State Implementation Plan, South Coast Air Quality Management District (SCAQMD) AGENCY... sources, to achieve emissions reductions milestones, to attain and maintain ambient air quality standards... ``significant regulatory action'' subject to review by the Office of Management and Budget under Executive Order...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-01
...EPA is proposing to approve revisions to the Antelope Valley Air Quality Management District (AVAQMD) and San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portions of the California State Implementation Plan (SIP). These revisions concern negative declarations for volatile organic compound (VOC) and oxides of sulfur source categories. We are proposing to approve these negative declarations under the Clean Air Act as amended in 1990 (CAA or the Act).
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Garn, H.S.
2002-01-01
This surface-water quality-assurance plan documents the standards, policies, and procedures used by the Wisconsin District of the U.S. Geological Survey, Water Resources Division, for activities related to the collection, processing, storage, analysis, management, and publication of surface-water data. The roles and responsibilities of District personnel in following these policies and procedures including those related to safety and training are presented.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-18
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2011-0987; FRL-9617-5] Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management District and Imperial... rule. SUMMARY: EPA is proposing to approve revisions to the Antelope Valley Air Quality Management...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-16
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2013-0394; FRL-9845-4] Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management District and Ventura... rule. SUMMARY: EPA is proposing to approve revisions to the Antelope Valley Air Quality Management...
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Everett Jones, Sherry; Doroski, Brenda; Glick, Sherry
2015-12-01
Nationally representative data from the 2012 School Health Policies and Practices Study examined whether state assistance on indoor air quality (IAQ) was associated with district-level policies and practices related to IAQ and integrated pest management (IPM). Districts in states that provided assistance on IAQ were more likely than districts not in such states to (1) have an IAQ management program (p < .001); (2) require schools to conduct periodic inspections of the heating, ventilation, and air conditioning system (p < .05); of the building for cracks, leaks, or past water damage (p < .01); for mold (p < .01); for clutter that prevents effective cleaning and maintenance (p < .05); of the plumbing system (p < .01); and for condensation in and around school facilities (p < .001); (3) have an engine idling reduction program ( < .001); (4) have a policy to purchase low-emitting products (p < .05); and (5) require IPM strategies (p < .05). Increasing the number of states that provide IAQ-related assistance to school districts and schools may improve school IAQ. © The Author(s) 2015.
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40 CFR 52.270 - Significant deterioration of air quality.
Code of Federal Regulations, 2013 CFR
2013-07-01
... applicable State plan for the State of California. (b) District PSD Plans. (1) The PSD rules for Sacramento... of PSD increments. (ii) Those projects which are major stationary sources or major modifications... 83-01, 5/6/83. (2) The PSD rules for North Coast Unified Air Quality Management District are approved...
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40 CFR 52.270 - Significant deterioration of air quality.
Code of Federal Regulations, 2012 CFR
2012-07-01
... applicable State plan for the State of California. (b) District PSD Plans. (1) The PSD rules for Sacramento... of PSD increments. (ii) Those projects which are major stationary sources or major modifications... 83-01, 5/6/83. (2) The PSD rules for North Coast Unified Air Quality Management District are approved...
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40 CFR 52.270 - Significant deterioration of air quality.
Code of Federal Regulations, 2011 CFR
2011-07-01
... applicable State plan for the State of California. (b) District PSD Plans. (1) The PSD rules for Sacramento... of PSD increments. (ii) Those projects which are major stationary sources or major modifications... 83-01, 5/6/83. (2) The PSD rules for North Coast Unified Air Quality Management District are approved...
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40 CFR 52.270 - Significant deterioration of air quality.
Code of Federal Regulations, 2014 CFR
2014-07-01
... applicable State plan for the State of California. (b) District PSD Plans. (1) The PSD rules for Sacramento... of PSD increments. (ii) Those projects which are major stationary sources or major modifications... 83-01, 5/6/83. (2) The PSD rules for North Coast Unified Air Quality Management District are approved...
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Developing quality indicators for community services: the case of district nursing.
Davies, Philippa; Wye, Lesley; Horrocks, Sue; Salisbury, Chris; Sharp, Debbie
2011-01-01
Quality indicators exist for the acute and primary care sectors in the National Health Service (NHS), but until recently little attention has been given to measuring the quality of community services. The innovative project described in this paper attempted to address that gap. To produce a framework for developing quality indicators for Bristol Community Health services. To develop a set of initial indicators for Bristol Community Health services using the proposed framework. After familiarising ourselves with community services and NHS policy, gathering the views of stakeholders and consulting the literature on quality indicators, we designed a framework for indicator development, using the 'test' case of the district nursing service. The long list of possible indicators came from best practice guidelines for wound, diabetes and end of life care, the three conditions most commonly treated by district nurses. To narrow down this list we surveyed and held workshops with district nurses, interviewed service users by telephone and met with commissioners and senior community health managers. The final set of quality indicators for district nurses included 23 organisational and clinical process and outcome indicators and eight patient experience indicators. These indicators are now being piloted, together with two potential tools identified to capture patient reported outcomes. Developing quality indicators for community services is time consuming and resource intensive. A range of skills are needed including clinical expertise, project management and skills in evidence-based medicine. The commitment and involvement of front-line professionals is crucial.
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33 CFR 385.35 - Achievement of the benefits of the Plan.
Code of Federal Regulations, 2010 CFR
2010-07-01
... and quality. (1) Not later than June 14, 2004 the Corps of Engineers and the South Florida Water Management District shall, in consultation with the Department of the Interior, the Miccosukee Tribe of... Engineers and the South Florida Water Management District in determining if existing legal sources of water...
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33 CFR 385.35 - Achievement of the benefits of the Plan.
Code of Federal Regulations, 2011 CFR
2011-07-01
... and quality. (1) Not later than June 14, 2004 the Corps of Engineers and the South Florida Water Management District shall, in consultation with the Department of the Interior, the Miccosukee Tribe of... Engineers and the South Florida Water Management District in determining if existing legal sources of water...
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Managing Smallness: Promising Fiscal Practices for Rural School District Administrators.
ERIC Educational Resources Information Center
Freitas, Deborah Inman
Based on a mail survey of over 100 rural school administrators in 34 states, this handbook outlines common problems and successful strategies in the financial management of rural, small school districts. Major problems are related to revenue and cash flow, increasing expenditures, providing quality education programs, and staffing to handle the…
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Strengthening Teacher Evaluation: What District Leaders Can Do
ERIC Educational Resources Information Center
Donaldson, Morgaen L.; Donaldson, Gordon A., Jr.
2012-01-01
School districts have typically not done a good job of managing the human side of teacher evaluation. In general, neither supervisors nor teachers find performance assessment a constructive, interpersonally respectful experience. District leaders can cultivate high-quality teaching--and attend to the human side of assessment--by taking five…
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40 CFR 55.15 - Specific designation of corresponding onshore areas.
Code of Federal Regulations, 2014 CFR
2014-07-01
... corresponding onshore areas. (a) California. (1) The South Coast Air Quality Management District is designated... Air Pollution Control District is designated as the COA for the following OCS facilities: Grace, Gilda, Gail and Gina. (3) The Santa Barbara County Air Pollution Control District is designated as the COA for...
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40 CFR 55.15 - Specific designation of corresponding onshore areas.
Code of Federal Regulations, 2012 CFR
2012-07-01
... corresponding onshore areas. (a) California. (1) The South Coast Air Quality Management District is designated... Air Pollution Control District is designated as the COA for the following OCS facilities: Grace, Gilda, Gail and Gina. (3) The Santa Barbara County Air Pollution Control District is designated as the COA for...
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40 CFR 55.15 - Specific designation of corresponding onshore areas.
Code of Federal Regulations, 2013 CFR
2013-07-01
... corresponding onshore areas. (a) California. (1) The South Coast Air Quality Management District is designated... Air Pollution Control District is designated as the COA for the following OCS facilities: Grace, Gilda, Gail and Gina. (3) The Santa Barbara County Air Pollution Control District is designated as the COA for...
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40 CFR 55.15 - Specific designation of corresponding onshore areas.
Code of Federal Regulations, 2010 CFR
2010-07-01
... corresponding onshore areas. (a) California. (1) The South Coast Air Quality Management District is designated... Air Pollution Control District is designated as the COA for the following OCS facilities: Grace, Gilda, Gail and Gina. (3) The Santa Barbara County Air Pollution Control District is designated as the COA for...
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40 CFR 55.15 - Specific designation of corresponding onshore areas.
Code of Federal Regulations, 2011 CFR
2011-07-01
... corresponding onshore areas. (a) California. (1) The South Coast Air Quality Management District is designated... Air Pollution Control District is designated as the COA for the following OCS facilities: Grace, Gilda, Gail and Gina. (3) The Santa Barbara County Air Pollution Control District is designated as the COA for...
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75 FR 28056 - Cachuma Lake Resource Management Plan, Santa Barbara County, CA
Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-19
...: (1) Ensure safe storage and timely delivery of high-quality water to users while enhancing natural... provides irrigation, domestic, and municipal and industrial water supplies to the City of Santa Barbara, Goleta Water District, Montecito Water District, Carpinteria Valley Water District, and Santa Ynez River...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-21
... the California State Implementation Plan, Placer County Air Pollution Control District and Sacramento... Pollution Control District (PCAPCD) and Sacramento Metropolitan Air Quality Management District (SMAQMD... Guidelines for Miscellaneous Metal and Plastic Parts Coatings,'' EPA-453/R-08-003, September 2008. 7...
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Macías Fernández, Antonio José; Gutiérrez-Castañeda, Carlos; Carmona González, Francisco Jesús; Crespillo Vílchez, Daniel
2016-05-01
To examine the relationship between "Quality of Professional Life" and "Perceived Emotional Intelligence" and the relationship of both of these with the level of achievement of occupational objectives in the Costa del Sol Primary Health Care District. Multicentre descriptive cross-sectional observational study. The Costa del Sol Primary Health Care District in the province of Málaga. Sample of Employees of all categories in fixed and contracted employment in the Management Units of the Costa del Sol District. (N=303). Respondents 247 (81.5%) The data collected was that of the percentage of achievement of objectives in 2010 and the socio-demographic data of the participants, using ad hoc designed self-report questionnaires. The TMMS -24 questionnaire was used to measure the "Perceived Emotional Intelligence", with the following dimensions: Perception, comprehension, and emotional control, and the CVP-35 measuring: management support, work demands, and intrinsic motivation. Significant correlationas were observed between Quality of Professional Life and Emotional Intelligence in the Regulation (p<.01) and Comprehension categories (p<0.05). There were also significant correlations between the profession and the type of contract in the achievement of objectives (p<.005), and quality of professional life and type of contract (p<.05). The perceived quality of professional life is related to perception and regulation dimensions of Emotional Intelligence. Knowledge of emotion management methods should be promoted by management organisations for all employees. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.
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Odaga, John; Henriksson, Dorcus K; Nkolo, Charles; Tibeihaho, Hector; Musabe, Richard; Katusiime, Margaret; Sinabulya, Zaccheus; Mucunguzi, Stephen; Mbonye, Anthony K; Valadez, Joseph J
2016-01-01
Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting priority interventions for child survival.
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Odaga, John; Henriksson, Dorcus K.; Nkolo, Charles; Tibeihaho, Hector; Musabe, Richard; Katusiime, Margaret; Sinabulya, Zaccheus; Mucunguzi, Stephen; Mbonye, Anthony K.; Valadez, Joseph J.
2016-01-01
Background Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Design Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. Results All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. Conclusions In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting priority interventions for child survival. PMID:27225791
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Quality Management for Schools.
ERIC Educational Resources Information Center
Mulligan, Dorothy
1992-01-01
W. Edwards Deming introduced management principles that helped Japan become a world economic power. Virginia is attempting to adapt these techniques to education with a grant that provides training and support for school personnel in several school districts. Describes a quality management program at Christa McAuliffe Elementary School that has…
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Steve W. Blecker; Lisa L. Stillings; Michael C. Amacher; James A. Ippolito; Nicole M. DeCrappeo
2010-01-01
The myriad definitions of soil/ecosystem quality or health are often driven by ecosystem and management concerns, and they typically focus on the ability of the soil to provide functions relating to biological productivity and/or environmental quality (Doran and Parkin, 1994; Karlen and others, 1997). A variety of attempts have been made to create indices that quantify...
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Moreland, Joe A.
1991-01-01
As the Nation's principal earth-science information agency, the U.S. Geological Survey has developed a worldwide reputation for collecting accurate data and producing factual, impartial interpretive reports. To ensure continued confidence in the pro- ducts, the Water Resources Division of the U.S. Geological Survey has implemented a policy that all scientific work will be performed in accordance with a centrally managed quality-assurance program. The formal policy for quality assurance within the Montana District was established and documented in USGS Open-File Report 91-194. This report has been revised to reflect changes in personnel and organi- zational structure that have occurred since 1991. Quality assurance is formalized by describing organization and operational responsibilities, the quality-assurance policy, and the quality- assurance responsibilities for performing District functions. The District conducts its work through offices in Helena, Billings, Kalispell, and Fort Peck. Data-collection programs and interpretive studies are conducted by three operating sections and four support units. Discipline specialists provide technical advice and assistance. Management advisors provide guidance on various personnel issues and support functions.
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Quality-assurance plan for water-resources activities of the U.S. Geological Survey in Montana--1995
Moreland, Joe A.
1995-01-01
As the Nation's principal earth-science information agency, the U.S. Geological Survey has developed a worldwide reputation for collecting accurate data and producing factual, impartial interpretive reports. To ensure continued confidence in the pro- ducts, the Water Resources Division of the U.S. Geological Survey has implemented a policy that all scientific work will be performed in accordance with a centrally managed quality-assurance program. The formal policy for quality assurance within the Montana District was established and documented in USGS Open-File Report 91-194. This report has been revised to reflect changes in personnel and organi- zational structure that have occurred since 1991. Quality assurance is formalized by describing organization and operational responsibilities, the quality-assurance policy, and the quality- assurance responsibilities for performing District functions. The District conducts its work through offices in Helena, Billings, Kalispell, and Fort Peck. Data-collection programs and interpretive studies are conducted by three operating sections and four support units. Discipline specialists provide technical advice and assistance. Management advisors provide guidance on various personnel issues and support functions.
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ERIC Educational Resources Information Center
Dougherty, Chrys
2015-01-01
This report summarizes how school and district leaders and academic coaches in two Texas school districts used assessment and other types of data to assess the quality of teaching and learning, to coach and supervise teachers, and to guide management decisions. The report also describes how district and school leaders supported teachers' use of…
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-01
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2011-0382; FRL-9477-3] Revisions to the California State Implementation Plan, Placer County Air Pollution Control District AGENCY... the Placer County Air Pollution Control District (PCAPCD) and Sacramento Metro Air Quality Management...
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Teacher Unions and TQE: Building Quality Labor Relations.
ERIC Educational Resources Information Center
Streshly, William A.; DeMitchell, Todd A.
This book is designed to provide school administrators and labor leaders with ideas about how to improve school district labor relations by incorporating the principles of Total Quality Management (TQM). In schools that apply the principles of Total Quality Education (TQE)--that is TQM as it modified to school practice--labor and management can…
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Managing work-related stress in the district nursing workplace.
Burke, Michelle
2013-11-01
This article aims to highlight the issue of work-related stress within the district nursing workplace. It will acknowledge how the management of work-related stress has previously been discussed within nursing literature and will consider the emerging relationship between staff working conditions, staff wellbeing and quality of patient care. It will reintroduce the Health and Safety Executive's (HSE's) Management Standards approach to tackling work-related stress, which provides management support to reduce environmental work stressors and encourage enabling work environments and a positive workplace culture.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-09-04
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0236; FRL-9711-2] Revisions to the California State Implementation Plan, South Coast Air Quality Management District (SCAQMD) AGENCY... ``significant regulatory action'' subject to review by the Office of Management and Budget under Executive Order...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-08-08
... Implementation Plan; Prevention of Significant Deterioration; California; North Coast Unified Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION: Final rule. SUMMARY: EPA is finalizing a limited Federal Implementation Plan (FIP) for the North Coast Unified Air Quality Management...
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Evaluation of the district health management fellowship training programme: a case study in Iran
Gholipour, Kamal; Tabrizi, Jafar Sadegh; Farahbakhsh, Mostafa; Iezadi, Shabnam; Ghiasi, Akbar; Jahanbin, Hasan
2018-01-01
Objective To evaluate the district health management fellowship training programme in the north-west of Iran. Data sources/study setting The programme was introduced to build the managerial capacity of district health managers in Iran. Eighty-nine heads of units in the province’s health centre, district health managers and the health deputies of the district health centres in the north-west provinces of Iran had registered for the district health management fellowship training programme in Tabriz in 2015–2016. Study design This was an educational evaluation study to evaluate training courses to measure participants' reactions and learning and, to a lesser extent, application of training to their job and the organisational impact. Data collection/extraction methods Valid and reliable questionnaires were used to assess learning techniques and views towards the fellowship, and self-assessment of health managers’ knowledge and skills. Also, pretest and post-test examinations were conducted in each course and a portfolio was provided to the trainees to be completed in their work settings. Principal findings About 63% of the participants were medical doctors and 42.3% of them had over 20 years of experience. Learning by practice (scored 18.37 out of 20) and access to publications (17.27) were the most useful methods of training in health planning and management from the participants’ perspective. Moreover, meeting peers from other districts and the academic credibility of teachers were the most important features of the current programme. Based on the managers’ self-assessment, they were most skilful in quality improvement, managing, planning and evaluation of the district. The results of the post-test analysis on data collected from district health managers showed the highest scores in managing the district (77 out of 100) and planning and evaluation (69) of the courses. Conclusion The results of this study indicated that training courses, methods and improvement in managers' knowledge about the health system and the skills necessary to manage their organisation were acceptable. PMID:29525773
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Fos, Peter J; Lee, Jae Eun; Sung, Jung Hye; Zuniga, Miguel A; Amy, Brian W
2005-01-01
This study describes Mississippi's statewide latent tuberculosis infection (LTBI) control management efforts to improve treatment outcomes using scientific quality improvement tools. LTBI medication completion rates were observed by month and by nine administrative health districts for a 12-month period. Analysis of variance (ANOVA) was conducted to see if there was any significant change between preintervention and postintervention in medication completion rates. Regression analysis was performed to test the linearity of change across the monthly rates. A change from a rate of 79.7 percent to 90.5 percent completion of the LTBI medication regimen was observed after the quality improvement intervention was instituted. During the quality improvement intervention, the mean reached 96.5 percent completion, followed by a slight decline at the end of the intervention to 90.5 percent. The analysis revealed that the mean LTBI medication completion rate across the nine administrative health districts was significantly increased and variability was decreased across all administrative health districts, with minor exceptions. A quality improvement team approach was shown to be effective in disease management by increasing LTBI medication completion. New baseline expectations can be established when quality improvement initiatives are implemented. This success can be linked, in part, to the use of scientific methods, precise and valid data, persuasive and clear goal setting, appropriate feedback, and ongoing monitoring.
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Toward a System of Total Quality Management: Applying the Deming Approach to the Education Setting.
ERIC Educational Resources Information Center
McLeod, Willis B.; And Others
1992-01-01
Recently, the Petersburg (Virginia) Public Schools have moved away from a highly centralized organizational structure to a Total Quality Management system featuring shared decision making and school-based management practices. The district was guided by Deming's philosophy that all stakeholders should be involved in defining the level of products…
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-22
... District's use of the negative NSR balances and other pre-1990 era offsets to fund the NSR tracking system... negative NSR balances and other pre-1990 era offsets. Proposed SCAMQD NSR Offset Tracking System, Oct. 14... District made in October 2005 to the existing NSR tracking system significantly decreased the balance of...
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Tabrizi, Jafar Sadegh; Gholipour, Kamal; Farahbakhsh, Mostafa; Jahanbin, Hasan; Karamuz, Majid
2016-11-01
To assess districts health managers educational needs and develop management training programmes. This mixed-method study was carried out between August 2014 and August 2015 in Tabriz, Iran. Four focus group discussion sessions and three semi-structured face-to-face interviews were conducted among district health managers and experts of a health centre. Besides, 52 questionnaires were completed to weigh and finalise management education module and courses. Interviews and focus group discussions were tape-recorded, transcribed and analysed using content analysis method. Data was analysed using SPSS17. There were 52 participants, of whom 40(78.8%) were men and 12(21.2%) were women. All of the subjects (100%) took part in the quantitative phase, while 25(48.08%) participated in the qualitative phase. In the qualitative section, 11(44%) participants were heads of unit/departments in provincial health centre and 14(56%) were district health managers. In the quantitative phase, 30(57.7%) participants were district health managers and 8(28.8%) were heads of units/departments. Moreover, 33(63.4%) participants had medical education. The job experience of 3(5.8%) participants in the current position was below five years. Districts health management training programme consisted of 10modules with 53 educational topics. The normalised score out of a total of 100 for rules and ethics was 75.51, health information management 71.19, management and leadership 69.27, district management 68.08, human resources and organisational creativity 67.58,quality improvement 66.6, health resources management 62.37, planning and evaluation 61.87, research in health system 59.15, and community participation was 53.15. Considering district health managers' qualification in health and medicine, they had not been trained in basic management. Almost all the management and leadership courses were prioritised as most necessary.
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Yourkavitch, Jennifer; Zalisk, Kirsten; Prosnitz, Debra; Luhanga, Misheck; Nsona, Humphreys
2016-11-01
The World Health Organization contracted annual data quality assessments of Rapid Access Expansion (RAcE) projects to review integrated community case management (iCCM) data quality and the monitoring and evaluation (M&E) system for iCCM, and to suggest ways to improve data quality. The first RAcE data quality assessment was conducted in Malawi in January 2014 and we present findings pertaining to data from the health management information system at the community, facility and other sub-national levels because RAcE grantees rely on that for most of their monitoring data. We randomly selected 10 health facilities (10% of eligible facilities) from the four RAcE project districts, and collected quantitative data with an adapted and comprehensive tool that included an assessment of Malawi's M&E system for iCCM data and a data verification exercise that traced selected indicators through the reporting system. We rated the iCCM M&E system across five function areas based on interviews and observations, and calculated verification ratios for each data reporting level. We also conducted key informant interviews with Health Surveillance Assistants and facility, district and central Ministry of Health staff. Scores show a high-functioning M&E system for iCCM with some deficiencies in data management processes. The system lacks quality controls, including data entry verification, a protocol for addressing errors, and written procedures for data collection, entry, analysis and management. Data availability was generally high except for supervision data. The data verification process identified gaps in completeness and consistency, particularly in Health Surveillance Assistants' record keeping. Staff at all levels would like more training in data management. This data quality assessment illuminates where an otherwise strong M&E system for iCCM fails to ensure some aspects of data quality. Prioritizing data management with documented protocols, additional training and approaches to create efficient supervision practices may improve iCCM data quality. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Janssen, Willy; Ngirabega, Jean de Dieu; Matungwa, Michel; Van Bastelaere, Stefaan
2015-01-01
Since 2000 performance-based financing (PBF) made its way to sub-Saharan health systems in an attempt to improve service delivery. In Rwanda initial experiences in 2001 and 2002 led to a scaling up of the initiative to all health centres (HC) and district hospitals (DH). In 2008 PBF became national strategy. PBF was introduced in Rwanda in 2006 at the DH level. Evaluation on their service delivery was carried out quarterly in the following areas: hospital management, support to the health centres and clinical activities. We studied four DHs. After 5 years, an improvement in the quantity of clinical activities was observed, as well as quality in hospital management, in HC support and in clinical activities. PBF proves to be a promising approach in strengthening and maintaining quality service delivery in the sub-Saharan district hospitals. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
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Francy, D.S.; Jones, A.L.; Myers, Donna N.; Rowe, G.L.; Eberle, Michael; Sarver, K.M.
1998-01-01
The U.S. Geological Survey (USGS), Water Resources Division (WRD), requires that quality-assurance/quality-control (QA/QC) activities be included in any sampling and analysis program. Operational QA/QC procedures address local needs while incorporating national policies. Therefore, specific technical policies were established for all activities associated with water-quality project being done by the Ohio District. The policies described in this report provide Ohio District personnel, cooperating agencies, and others with a reference manual on QA/QC procedures that are followed in collecitng and analyzing water-quality samples and reporting water-quality information in the Ohio District. The project chief, project support staff, District Water-Quality Specialist, and District Laboratory Coordinator are all involved in planning and implementing QA/QC activities at the district level. The District Chief and other district-level managers provide oversight, and the Regional Water-Quality Specialist, Office of Water Quality (USGS headquarters), and the Branch of Quality Systems within the Office of Water Quality create national QA/QC polices and provide assistance to District personnel. In the literature, the quality of all measurement data is expressed in terms of precision, variability, bias, accuracy, completeness, representativeness, and comparability. In the Ohio District, bias and variability will be used to describe quality-control data generated from samples in the field and laboratory. Each project chief must plan for implementation and financing of QA/QC activities necessary to achieve data-quality objectives. At least 15 percent of the total project effort must be directed toward QA/QC activities. Of this total, 5-10 percent will be used for collection and analysis of quality-control samples. This is an absolute minimum, and more may be required based on project objectives. Proper techniques must be followed in the collection and processing of surface-water, ground-water, biological, precipitation, bed-sediment, bedload, suspended-sediment, and solid-phase samples. These techniques are briefly described in this report and are extensively documented. The reference documents listed in this report will be kept by the District librarian and District Water-Quality Specialist and updated regularly so that they are available to all District staff. Proper handling and documentation before, during, and after field activities are essential to ensure the integrity of the sample and to correct erroneous reporting of data results. Field sites are to be properly identified and entered into the data base before field data-collection activities begin. During field activities, field notes are to be completed and sample bottles appropriately labeled a nd stored. After field activities, all paperwork is to be completed promptly and samples transferred to the laboratory within allowable holding times. All equipment used by District personnel for the collection and processing of water-quality samples is to be properly operated, maintained, and calibrated by project personnel. This includes equipment for onsite measurement of water-quality characteristics (temperature, specific conductance, pH, dissolved oxygen, alkalinity, acidity, and turbidity) and equipment and instruments used for biological sampling. The District Water-Quality Specialist and District Laboratory Coordinator are responsible for preventive maintenance and calibration of equipment in the Ohio District laboratory. The USGS National Water Quality Laboratory in Arvada, Colo., is the primary source of analytical services for most project work done by the Ohio District. Analyses done at the Ohio District laboratory are usually those that must be completed within a few hours of sample collection. Contract laboratories or other USGS laboratories are sometimes used instead of the NWQL or the Ohio District laboratory. When a contract laboratory is used, the projec
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ERIC Educational Resources Information Center
Richie, Mark L.
This book shows how the quality management approach pioneered in Japan by Dr. W. Edwards Deming allows educational service centers to expand services and be more flexible by reducing waste and rework. Deming's method shows how to change from reactive management to a dynamic system of continuous improvement that restores worker pride, increases…
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40 CFR 52.279 - Food processing facilities.
Code of Federal Regulations, 2010 CFR
2010-07-01
...), adopted on August 21, 1984, and submitted on October 5, 1984. (2) Bay Area Air Quality Management District... relaxations will not interfere with the attainment and maintenance of the National Ambient Air Quality...
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Public Health Nurses in Israel: A Case Study on a Quality Improvement Project of Nurse's Work Life.
Kagan, Ilya; Shachaf, Sara; Rapaport, Zofia; Livne, Tzipi; Madjar, Batya
2017-01-01
Public health nurses (PHNs) working in Well Baby Clinic in Israel's Haifa district were voicing great distress to inspectors-the impossibility of meeting their workload, feeling overwhelmed, poor physical, and technological conditions. They were feeling tired and frustrated and burn-out was rising. The district's nursing management took the decision, together with Tel Aviv University's nursing research unit, to conduct a quality improvement project based on issues that arose from meetings with focus groups on the nurses' difficulties. This paper is a case study of a quality improvement project targeting nurses daily working life. One of its chief contributions is as a study of meeting PHNs' frustration by integrating focus groups and round-table brainstorming (involving nurses, clinic managers and nursing inspectors) in order to identify targets for practical intervention. This strategy has been very successful. It has provided the district's nursing management a battery of forcefully argued and realistically grounded proposals for making the work of Well Baby clinics more relevant to their communities and giving nurses (a) the conditions to meet their assignments and (b) greater professional self-respect. © 2016 Wiley Periodicals, Inc.
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Code of Federal Regulations, 2010 CFR
2010-01-01
... portion of the 208 water-quality management plan. (s) OMB Circular A-34. “Instructions on Budget Execution... needed to attain water quality standards or water quality goals. Fifty (50) percent of the adequate level... agency. A soil conservation district, State soil and water conservation agency, or State water quality...
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Code of Federal Regulations, 2011 CFR
2011-01-01
... portion of the 208 water-quality management plan. (s) OMB Circular A-34. “Instructions on Budget Execution... needed to attain water quality standards or water quality goals. Fifty (50) percent of the adequate level... agency. A soil conservation district, State soil and water conservation agency, or State water quality...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-02
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0236; FRL-9690-9] Withdrawal of Direct Final Rule Revising the California State Implementation Plan, South Coast Air Quality Management... State Implementation Plan (SIP). This revision concerned South Coast Air Quality Management District...
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ERIC Educational Resources Information Center
Ibach, Kimberly L.
2014-01-01
This body of work presents the summary of findings; explanation of implications; discussion of conclusions; and recommendations about practice, policy and future research regarding principal leadership in school districts recognized as national Baldrige Award winners. This study widened the scope and definition of quality management in education…
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Waiswa, Peter; O'Connell, Thomas; Bagenda, Danstan; Mullachery, Pricila; Mpanga, Flavia; Henriksson, Dorcus Kiwanuka; Katahoire, Anne Ruhweza; Ssegujja, Eric; Mbonye, Anthony K; Peterson, Stefan Swartling
2016-03-11
Innovative and sustainable strategies to strengthen districts and other sub-national health systems and management are urgently required to reduce child mortality. Although highly effective evidence-based and affordable child survival interventions are well-known, at the district level, lack of data, motivation, analytic and planning capacity often impedes prioritization and management weaknesses impede implementation. The Community and District Empowerment for Scale-up (CODES) project is a complex management intervention designed to test whether districts when empowered with data and management tools can prioritize and implement evidence-based child survival interventions equitably. The CODES strategy combines management, diagnostic, and evaluation tools to identify and analyze the causes of bottlenecks to implementation, build capacity of district management teams to implement context-specific solutions, and to foster community monitoring and social accountability to increase demand for services. CODES combines UNICEF tools designed to systematize priority setting, allocation of resources and problem solving with Community dialogues based on Citizen Report Cards and U-Reports used to engage and empower communities in monitoring health service provision and to demand for quality services. Implementation and all data collection will be by the districts teams or local Community-based Organizations who will be supported by two local implementing partners. The study will be evaluated as a cluster randomized trial with eight intervention and eight comparison districts over a period of 3 years. Evaluation will focus on differences in uptake of child survival interventions and will follow an intention-to-treat analysis. We will also document and analyze experiences in implementation including changes in management practices. By increasing the District Health Management Teams' capacity to prioritize and implement context-specific solutions, and empowering communities to become active partners in service delivery, coverage of child survival interventions will increase. Lessons learned on strengthening district-level managerial capacities and mechanisms for community monitoring may have implications, not only in Uganda but also in other similar settings, especially with regard to accelerating effective coverage of key child survival interventions using locally available resources. ISRCTN15705788 , Date of registration; 24 July 2015.
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Turnaround in Texas: How One District Closed Its Minority Achievement Gap.
ERIC Educational Resources Information Center
Cook, Glenn
2003-01-01
Describes how one district closed its minority achievement gap by employing the Brazosport model, a combination of effective-schools research and Total Quality Management principles. The model includes an eight-step "plan-do-check" instructional cycle for teachers and emphasizes teacher training and tracking data. Student-achievement…
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Farmer Heroes Manage Nutrients On Farm
These featured farmers have been identified by the National Association of Conservation Districts and EPA for implementing specific best management practices to reduce pollution while also improving or sustaining their profits, soil quality or yields.
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ERIC Educational Resources Information Center
Cooper, David E.
This Congressional testimony focuses on the challenges faced by the District of Columbia in modernizing its public schools. Specifically, it addresses: (1) increases in the cost of modernizing the schools; (2) delays in completing the schools; (3) quality inspection problems; and (4) concerns about managing asbestos hazards. The testimony…
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40 CFR 52.280 - Fuel burning equipment.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 17, 1981. (1) South Coast Air Quality Management District. (i) Rules 67, Fuel Burning Equipment, and... interfere with the attainment and maintenance of the National Ambient Air Quality Standards. (1) Mountain... attainment and maintenance of the national ambient air quality standards has not been submitted: (1...
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Mpofu, Mulamuli; Semo, Bazghina-Werq; Grignon, Jessica; Lebelonyane, Refeletswe; Ludick, Steven; Matshediso, Ellah; Sento, Baraedi; Ledikwe, Jenny H
2014-10-03
The demand for quality data and the interest in health information systems has increased due to the need for country-level progress reporting towards attainment of the United Nations Millennium Development Goals and global health initiatives. To improve monitoring and evaluation (M&E) of health programs in Botswana, 51 recent university graduates with no experience in M&E were recruited and provided with on-the-job training and mentoring to develop a new cadre of health worker: the district M&E officer. Three years after establishment of the cadre, an assessment was conducted to document achievements and lessons learnt. This qualitative assessment included in-depth interviews at the national level (n = 12) with officers from government institutions, donor agencies, and technical organizations; and six focus group discussions separately with district M&E officers, district managers, and program officers coordinating different district health programs. Reported achievements of the cadre included improved health worker capacity to monitor and evaluate programs within the districts; improved data quality, management, and reporting; increased use of health data for disease surveillance, operational research, and planning purposes; and increased availability of time for nurses and other health workers to concentrate on core clinical duties. Lessons learnt from the assessment included: the importance of clarifying roles for newly established cadres, aligning resources and equipment to expectations, importance of stakeholder collaboration in implementation of sustainable programs, and ensuring retention of new cadres. The development of a dedicated M&E cadre at the district level contributed positively to health information systems in Botswana by helping build M&E capacity and improving data quality, management, and data use. This assessment has shown that such cadres can be developed sustainably if the initiative is country-led, focusing on recruitment and capacity-development of local counterparts, with a clear government retention plan.
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40 CFR 52.275 - Particulate matter control.
Code of Federal Regulations, 2010 CFR
2010-07-01
... National Ambient Air Quality Standards or any other applicable requirement of the Clean Air Act. (1) South Coast Air Quality Management District. (i) Rule 401, submitted on January 12, 1999. [43 FR 25675, June... interfere with the attainment and maintenance of the National Ambient Air Quality Standards. (1) Amador...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-02
... Register on February 28, 2012 and concern glass furnaces and biomass boilers. We are approving local rules... MDAQMD 1165 Glass Melting Furnaces......... 08/12/08 12/23/08 YSAQMD 2.43 Biomass Boilers 11/10/10 04/05.... * * * * * (388) * * * (i) * * * (F) Yolo-Solano Air Quality Management District. (1) Rule 2.43, ``Biomass Boilers...
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Kanawha River Basin Water Quality Modeling
1986-07-01
was performed by Mr. R. G. Willey with the technical assistance of Mr. Keith Knight. Mr. Don Smith of Resource Management Associates provided advice...during critical parts of the study. The study was managed under the direcLion of Dr. Richard Punnett of the Huntington District who was also responsible...to provide better system water quality analysis capabilities in support of the Corps’ water control management program. The focus of this program is
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Going to Scale with TQM. The Pinellas County Schools' Journey toward Quality.
ERIC Educational Resources Information Center
Shipley, Jim; Collins, Chris
Quality improvement, or Total Quality Management (TQM), has been used for years in the corporate world to help companies achieve better customer satisfaction, increase market share, and improve profitability. More recently, TQM has emerged as a promising strategy for school improvement and educational reform. In 1991, the school district of…
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Managing Teacher Retention in a Rural School District in South Africa
ERIC Educational Resources Information Center
Mafora, Patrick
2013-01-01
Retaining quality teachers is a global challenge for schools, particularly those in rural districts. A nation-wide study conducted by the Human Sciences Research Council (HSRC) found that 55 % of teachers in South Africa would leave teaching if they could. Resignation was found to be one of the three largest causes of attrition (Hall et al.…
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-12
.... Miscellaneous manufacturing 3391, 3399 Waste management and remediation....... 5622, 5629 Hospitals/Nursing and... NSR New Source Review NTTAA National Technology Transfer and Advancement Act OMB Office of Management... SCAQMD South Coast Air Quality Management District SIP State Implementation Plan tpy Tons Per Year UMRA...
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Street, A; Strong, J; Karp, S
2001-01-01
One of the most frequently cited reasons for poor recruitment to multicentre randomized clinical trials is the additional workload placed on clinical staff. We report the effect on patient recruitment of employing a data manager to support clinical staff in an English district general hospital (DGH). In addition, we explore the effect data managers have on the quality of data collected, proxied by the number of queries arising with the trial organizers. We estimate that the cost of employing a data manager on a full-time basis is 502 per patient recruited but may amount to 326 if the appointment is part-time. Data quality is high when full responsibility lies with a data manager but falls when responsibility is shared. Whether the costs of employing a data manager to recruit patients from a DGH are worth incurring depends on the value placed on the speed at which multicentre trials can be completed, how important it is to broaden the research base beyond the traditional setting of teaching hospitals, and the amount of evaluative data required.
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Restructuring Schools by Applying Deming's Management Theories.
ERIC Educational Resources Information Center
Melvin, Charles A., III
1991-01-01
Four school districts adopted a school restructuring project using Deming's business management method. Deming offered alternative views of organizations based on psychology, systems, perceptual framework, and causes of variance. He listed 14 points for quality improvement. Evaluation indicated that key staff members willingly engaged in…
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Liu, Yungui; Yao, Ying; Shangguan, Shihao; Gu, Qun; Gao, Wuming; Chen, Yaoshui
2014-05-01
Study the current quality management situation of enterprises marketing corneal contact lens via systemic investigations and explore effective administration countermeasures in the future. The quality management indicators of sixty-two corneal contact lens marketing enterprises in Xuhui district of Shanghai were systematically investigated and enterprises of different operation models was compared and analyzed. Wholesale enterprises and retail chain enterprises are apparently better than independent enterprises almost in all facets. Facilitate market accession of corneal contact lens marketing enterprises, encourage the business model of retail chain, enhance supervision of corneal contact lens marketing enterprises, especially independent franchisors.
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Islam, Farzana; Rahman, Aminur; Halim, Abdul; Eriksson, Charli; Rahman, Fazlur; Dalal, Koustuv
2015-06-19
Bangladesh has achieved remarkable progress in healthcare with a steady decline in maternal and under-5 child mortality rates in efforts to achieve Millennium Development Goals 4 and 5. However, the mortality rates are still very high compared with high-income countries. The quality of healthcare needs improve to reduce mortality rates further. It is essential to investigate the current quality of healthcare before implementing any interventions. The study was conducted to explore the perception of healthcare providers about the quality of maternal and neonatal health (MNH) care. The study also investigated patient satisfaction with the MNH care received from district and sub-district hospitals. Both qualitative and quantitative methods were used in the study. Two district and 12 sub-district hospitals in Thakurgaon and Jamalpur in Bangladesh were the study settings. Fourteen group discussions and 56 in-depth interviews were conducted among the healthcare providers. Client exit interviews were conducted with 112 patients and their attendants from maternity, labor, and neonatal wards before being discharged from the hospitals. Eight physicians and four anthropologists collected data between November and December 2011 using pretested guidelines. The hospital staff identified several key factors that affected the quality of patient care: shortage of staff and logistics; lack of laboratory support; under use of patient-management protocols; a lack of training; and insufficient supervision. Doctors were unable to provide optimal care because of the high volume of patients. The exit interviews revealed that 85 % of respondents were satisfied with the hospital services received. Seven out of 14 respondents were satisfied with the cleanliness of the hospital facilities. More than half of the respondents were satisfied with the drugs they received. In half of the facilities, patients did not get an opportunity to ask the healthcare providers questions about their health conditions and treatments. The quality of healthcare is poor in district and sub-district hospitals in Bangladesh because of the lack of healthcare personnel and logistic support. An integrated quality improvement approach is needed to improve MNH care service in district and sub-district hospitals in Bangladesh.
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Nisingizwe, Marie Paul; Iyer, Hari S; Gashayija, Modeste; Hirschhorn, Lisa R; Amoroso, Cheryl; Wilson, Randy; Rubyutsa, Eric; Gaju, Eric; Basinga, Paulin; Muhire, Andrew; Binagwaho, Agnès; Hedt-Gauthier, Bethany
2014-01-01
Health data can be useful for effective service delivery, decision making, and evaluating existing programs in order to maintain high quality of healthcare. Studies have shown variability in data quality from national health management information systems (HMISs) in sub-Saharan Africa which threatens utility of these data as a tool to improve health systems. The purpose of this study is to assess the quality of Rwanda's HMIS data over a 5-year period. The World Health Organization (WHO) data quality report card framework was used to assess the quality of HMIS data captured from 2008 to 2012 and is a census of all 495 publicly funded health facilities in Rwanda. Factors assessed included completeness and internal consistency of 10 indicators selected based on WHO recommendations and priority areas for the Rwanda national health sector. Completeness was measured as percentage of non-missing reports. Consistency was measured as the absence of extreme outliers, internal consistency between related indicators, and consistency of indicators over time. These assessments were done at the district and national level. Nationally, the average monthly district reporting completeness rate was 98% across 10 key indicators from 2008 to 2012. Completeness of indicator data increased over time: 2008, 88%; 2009, 91%; 2010, 89%; 2011, 90%; and 2012, 95% (p<0.0001). Comparing 2011 and 2012 health events to the mean of the three preceding years, service output increased from 3% (2011) to 9% (2012). Eighty-three percent of districts reported ratios between related indicators (ANC/DTP1, DTP1/DTP3) consistent with HMIS national ratios. Conclusion and policy implications: Our findings suggest that HMIS data quality in Rwanda has been improving over time. We recommend maintaining these assessments to identify remaining gaps in data quality and that results are shared publicly to support increased use of HMIS data.
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Nisingizwe, Marie Paul; Iyer, Hari S.; Gashayija, Modeste; Hirschhorn, Lisa R.; Amoroso, Cheryl; Wilson, Randy; Rubyutsa, Eric; Gaju, Eric; Basinga, Paulin; Muhire, Andrew; Binagwaho, Agnès; Hedt-Gauthier, Bethany
2014-01-01
Background Health data can be useful for effective service delivery, decision making, and evaluating existing programs in order to maintain high quality of healthcare. Studies have shown variability in data quality from national health management information systems (HMISs) in sub-Saharan Africa which threatens utility of these data as a tool to improve health systems. The purpose of this study is to assess the quality of Rwanda's HMIS data over a 5-year period. Methods The World Health Organization (WHO) data quality report card framework was used to assess the quality of HMIS data captured from 2008 to 2012 and is a census of all 495 publicly funded health facilities in Rwanda. Factors assessed included completeness and internal consistency of 10 indicators selected based on WHO recommendations and priority areas for the Rwanda national health sector. Completeness was measured as percentage of non-missing reports. Consistency was measured as the absence of extreme outliers, internal consistency between related indicators, and consistency of indicators over time. These assessments were done at the district and national level. Results Nationally, the average monthly district reporting completeness rate was 98% across 10 key indicators from 2008 to 2012. Completeness of indicator data increased over time: 2008, 88%; 2009, 91%; 2010, 89%; 2011, 90%; and 2012, 95% (p<0.0001). Comparing 2011 and 2012 health events to the mean of the three preceding years, service output increased from 3% (2011) to 9% (2012). Eighty-three percent of districts reported ratios between related indicators (ANC/DTP1, DTP1/DTP3) consistent with HMIS national ratios. Conclusion and policy implications Our findings suggest that HMIS data quality in Rwanda has been improving over time. We recommend maintaining these assessments to identify remaining gaps in data quality and that results are shared publicly to support increased use of HMIS data. PMID:25413722
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Phoenix: Quantum Quality at Maricopa: TQM on Campus, Case Study Number Two.
ERIC Educational Resources Information Center
Assar, Kathleen E.
1993-01-01
Implementation of the Total Quality Management approach in the Maricopa County Community College District (Arizona), a large 10-campus system, is described. The program's current early stages are reported noting the serious administrative commitment and thorough training, seen as key factors in potential success. (MSE)
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Sa'avu, Martin; Duke, Trevor; Matai, Sens
2014-05-01
In developing countries such as Papua New Guinea (PNG), district hospitals play a vital role in clinical care, training health-care workers, implementing immunization and other public health programmes and providing necessary data on disease burdens and outcomes. Pneumonia and neonatal conditions are a major cause of child admission and death in hospitals throughout PNG. Oxygen therapy is an essential component of the management of pneumonia and neonatal conditions, but facilities for oxygen and care of the sick newborn are often inadequate, especially in district hospitals. Improving this area may be a vehicle for improving overall quality of care. A qualitative study of five rural district hospitals in the highlands provinces of Papua New Guinea was undertaken. A structured survey instrument was used by a paediatrician and a biomedical technician to assess the quality of paediatric care, the case-mix and outcomes, resources for delivery of good-quality care for children with pneumonia and neonatal illnesses, existing oxygen systems and equipment, drugs and consumables, infection-control facilities and the reliability of the electricity supply to each hospital. A floor plan was drawn up for the installation of the oxygen concentrators and a plan for improving care of sick neonates, and a process of addressing other priorities was begun. In remote parts of PNG, many district hospitals are run by under-resourced non-government organizations. Most hospitals had general wards in which both adults and children were managed together. Paediatric case-loads ranged between 232 and 840 patients per year with overall case-fatality rates (CFR) of 3-6% and up to 15% among sick neonates. Pneumonia accounts for 28-37% of admissions with a CFR of up to 8%. There were no supervisory visits by paediatricians, and little or no continuing professional development of staff. Essential drugs were mostly available, but basic equipment for the care of sick neonates was often absent or incomplete. Infection control measures were inadequate in most hospitals. Cylinders were the major source of oxygen for the district hospitals, and logistical problems and large indirect costs meant that oxygen was under-utilized. There were multiple electricity interruptions, but hospitals had back-up generators to enable the use of oxygen concentrators. After 6 months in each of the five hospitals, high-dependency care areas were planned, oxygen concentrators installed, staff trained in their use, and a plan was set out for improving neonatal care. If MGD-4 targets for child health are to be met, reducing neonatal mortality and deaths from pneumonia will have to include better quality services in district hospitals. Establishing better oxygen supplies with a systems approach can be a vehicle for addressing other areas of quality and safety in district hospitals.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-10-16
... FXRS1265066CCP0] Huron Wetland Management District, Madison Wetland Management District, and Sand Lake Wetland... assessment (EA) involving Huron, Madison, and Sand Lake Wetland Management Districts (Districts). In this..., Madison Wetland Management District, Sand Lake Wetland Management District final CCP'' in the subject line...
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Does TQM Affect Teaching and Learning?
ERIC Educational Resources Information Center
Mauriel, John J.; And Others
Many schools and school districts are attempting to introduce principles and practices of Total Quality Management (TQM). These attempts take many forms with varying degrees of commitment of resources and management attention. This paper describes the research design of a study intended to identify best current practices in applying TQM concepts…
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Code of Federal Regulations, 2010 CFR
2010-07-01
... Air Quality Management District, 200 Litton Drive, P.O. Box 2509, Grass Valley, CA 95945-2509... delegation status, see paragraph (c) of this section. (H) State of Connecticut, Bureau of Air Management... Requirements, Alternate Means of Emission Limitation; § 61.13(h), Major Change to an Emissions Test; § 61.14(g...
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Intelligent community management system based on the devicenet fieldbus
NASA Astrophysics Data System (ADS)
Wang, Yulan; Wang, Jianxiong; Liu, Jiwen
2013-03-01
With the rapid development of the national economy and the improvement of people's living standards, people are making higher demands on the living environment. And the estate management content, management efficiency and service quality have been higher required. This paper in-depth analyzes about the intelligent community of the structure and composition. According to the users' requirements and related specifications, it achieves the district management systems, which includes Basic Information Management: the management level of housing, household information management, administrator-level management, password management, etc. Service Management: standard property costs, property charges collecting, the history of arrears and other property expenses. Security Management: household gas, water, electricity and security and other security management, security management district and other public places. Systems Management: backup database, restore database, log management. This article also carries out on the Intelligent Community System analysis, proposes an architecture which is based on B / S technology system. And it has achieved a global network device management with friendly, easy to use, unified human - machine interface.
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Som, Meena; Panda, Bhuputra; Pati, Sanghamitra; Nallala, Srinivas; Anasuya, Anita; Chauhan, Abhimanyu Singh; Sen, Ashish Kumar; Zodpey, Sanjay
2014-06-30
Routine immunization is a key child survival intervention. Issues related to quality of service delivery pose operational challenges in delivering effective immunization services. Accumulated evidences suggest that "supportive supervision" improves the quality of health care services. During 2009-10, Govt. of Odisha (GoO) and UNICEF jointly piloted this strategy in four districts to improve routine immunization. The present study aims to assess the effect of supportive supervision strategy on improvement of knowledge and practices on routine immunization among service providers. We adopted a 'post-test only' study design to compare the knowledge and practices of frontline health workers and their supervisors in four intervention districts with that of two control districts. Altogether we interviewed 170 supervisors and supervisees (health workers), each, using semi-structured interview schedules. We also directly observed 25 ice lined refrigerator (ILR) points in both groups of districts. The findings were compared with the baseline information, available only for the intervention districts. The health workers in the intervention districts displayed a higher knowledge score in selected items than in the control group. No significant difference in knowledge was observed between control and intervention supervisors. The management practices at ILR points on key routine immunization components were found to have improved significantly in intervention districts. The observed improvements in the ILR management practices indicate positive influence of supportive supervision. Higher level of domain knowledge among intervention health workers on specific items related to routine immunization could be due to successful transfer of knowledge from supervisors. A 'pre-post' study design should be undertaken to gain insights into the effectiveness of supportive supervision in improving routine immunization services.
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The Role of Central Level Staff in Supporting High Quality Instruction
ERIC Educational Resources Information Center
Gamble, Matthew Tanner
2013-01-01
The central office manages and directs a school system. In the wake of district and school reforms, the impact of the central office on schools and quality instruction has not been fully dissected. This study explores the role of the central office in the support of high quality instruction. Further, it analyzes the perceptions of those central…
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Impact of the community-based newborn care package in Nepal: a quasi-experimental evaluation
Paudel, Deepak; Shrestha, Ishwar B; Siebeck, Matthias; Rehfuess, Eva
2017-01-01
Objective To evaluate the impact of the community-based newborn care package (CBNCP) on six essential practices to improve neonatal health. Methods CBNCP pilot districts were matched to comparison districts using propensity scores. Impact on birth preparedness, antenatal care seeking, antenatal care quality, delivery by skilled birth attendant, immediate newborn care and postnatal care within 48 hours were assessed using Demographic and Health Survey (DHS) and Health Management Information System (HMIS) data through difference-in-differences and multivariate logistic regression analyses. Findings Changes over time in intervention and comparison areas were similar in difference-in-differences analysis of DHS and HMIS data. Logistic regression of DHS data also did not reveal any significant improvement in combined outcomes: birth preparedness, adjusted OR (aOR)=0.8 (95% CI 0.4 to 1.7); antenatal care seeking, aOR=1.0 (0.6 to 1.5); antenatal care quality, aOR=1.4 (0.9 to 2.1); delivery by skilled birth attendant, aOR=1.5 (1.0 to 2.3); immediate newborn care, aOR=1.1 (0.7 to 1.9); postnatal care, aOR=1.3 (0.9 to 1.9). Health providers’ knowledge and skills in intervention districts were fair but showed much variation between different providers and districts. Conclusions This study, while representing an early assessment of impact, did not identify significant improvements in newborn care practices and raises concerns regarding CBNCP implementation. It has contributed to revisions of the package and it being merged with the Integrated Management of Neonatal and Childhood Illness programme. This is now being implemented in 35 districts and carefully monitored for quality and impact. The study also highlights general challenges in evaluating the impacts of a complex health intervention under ‘real life’ conditions. PMID:28982810
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Maruti, Phidelis M; Mulianga, Ekesa A; Wambani, Lorna N; Wafula, Melda N; Mambo, Fidelis A; Mutisya, Shadrack M; Wakaria, Eric N; Mbati, Erick M; Amayo, Angela A; Majani, Jonathan M; Nyary, Bryan; Songwe, Kilian A
2014-01-01
Bungoma District Hospital Laboratory (BDHL), which supports a 200-bed referral facility, began its Strengthening Laboratory Management Toward Accreditation (SLMTA) journey in 2011 together with eight other laboratories in the second round of SLMTA rollout in Kenya. To describe how the SLMTA programme and enhanced quality interventions changed the culture and management style at BDHL and instilled a quality system designed to sustain progress for years to come. SLMTA implementation followed the standard three-workshop series, mentorship site visits and audits. In order to build sustainability of progress, BDHL integrated quality improvement processes into its daily operations. The lab undertook a process of changing its internal culture to align all hospital stakeholders - including upper management, clinicians, laboratory staff and maintenance staff - to the mission of sustainable quality practices at BDHL. After 16 months in the SLMTA programme, BDHL improved from zero stars (38%) to four stars (89%). Over a period of two to three years, external quality assessment results improved from 47% to 87%; staff punctuality increased from 49% to 82%; clinician complaints decreased from 83% to 16; rejection rates decreased from 12% to 3%; and annual equipment repairs decreased from 40 to 15. Twelve months later the laboratory scored three stars (81%) in an external surveillance audit conducted by Kenya Accreditation Service (KENAS). Management buy-in, staff participation, use of progress-monitoring tools and feedback systems, as well as incorporation of improvement processes into routine daily activities, were vital in developing and sustaining a culture of quality improvement.
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ERIC Educational Resources Information Center
Neil, Kirk
2002-01-01
Discusses events affecting parental school-safety concerns and what school districts can do to alleviate those concerns. Addresses post-September 11 crisis-management procedures, preventing sports-related student deaths, maintaining healthy indoor air quality. (PKP)
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Country experience in organizing for quality: Niger.
Marquez, L; Madubuike, C
1999-01-01
This article describes the efforts of Niger's Ministry of Health Tahoua Quality Assurance Project (QAP) since 1994. QAP aims to improve the delivery of critical primary health care (PHC) services by integrating and institutionalizing the QA approach in the PHC system in 1 demonstration site (Tahoua) and eventually, countrywide. The QAP selected 8 clinical interventions in its package of minimum services. The QAP project provided training, clarified and communicated clinical and management standards, and monitored and initiated a process for preventing and correcting problems. During 1994-96, QAP collaborated with BASICS to assist all 7 District Health Management Teams (DHMTs) in developing data collection tools for rapid performance assessments of the Integrated Management of Childhood Illnesses program. The pilot program proved that measurable gains in QA were possible, even with limited resources. DHMTs will have oversight of QA activities. A special unit within the MOH is not yet fully staffed. The central strategy has been to train teams of health staff at the regional and district level. A multilevel team developed manuals for norms and standards for vaccinations and for managerial operating procedures. The Quality Council redesigned the supervision system. Performance is monitored at quarterly regional and district meetings. A quarterly bulletin is the main dissemination tool. The loss of USAID support led to the loss of technical support from the QAP. The MOH is committed to QA and plans to institutionalize the process. The World Bank and UNICEF agreed to support QA projects in 1999.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-14
... business information (CBI) or other information whose disclosure is restricted by statute. Certain other... www.regulations.gov or in hard copy for public inspection during normal business hours at the Air.... The history of this SIP, the NSR Reform Program, and South Coast Air Quality Management District v...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-10-17
... Conservation Resources, FL; Louisville Metro Air Pollution Control District, KY; Forsyth County Environmental... Carolina Regional Air Quality Agency, NC; Chattanooga-Hamilton County Air Pollution Control Bureau, TN; Shelby County Health Department, TN; Knox County Department of Air Quality Management, TN; and...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-28
... Conservation Resources, FL; Louisville Metro Air Pollution Control District, KY; Forsyth County Environmental... Carolina Regional Air Quality Agency, NC; Chattanooga-Hamilton County Air Pollution Control Bureau, TN; Shelby County Health Department, TN; Knox County Department of Air Quality Management, TN; and...
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The district nursing service: a national treasure.
Oldman, Crystal
2014-08-01
District nurses are a national treasure. They are the key professionals who will enable the agenda of patients being cared for at home to be realised. They are highly trusted and valued by communities who lead and manage teams of nurses and nursing assistants expertly to deliver high-quality care in the patient's own home. In an era where the focus is now turning to the community for more care, more actions are required to increase our district nursing workforce. This article discusses the above issues in relation to recent reports on the current status of community nursing.
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Leighton, David A.; Fio, John L.
1995-01-01
An evaluation was made of an existing monitoring program in the Panoche Water District for 1986-93. The Panoche Water District is an agricultural area located in the western San Joaquin Valley of California. Because irrigation drainage from this area has high concentrations of dissolved solids and selenium, management strategies have been developed to improve the quality of drainwater discharge. The purpose of the Panoche Water District's monitoring program is to assess the effects of water- and land-use practices on local ground water and drain flow from the district. Drainflow from the district consists of the discharge from 50 separate on-farm underground tile-drainage systems. The Panoche Water District maintains information on water deliveries, planned and actual crop types, and planned and actual acreages planted each year. In addition, the water district monitors ground-water and drainage-system discharges using a variety of data-collection methods. A total of 62 observation well sites are used to monitor ground-water level and quality. A total of 42 sites were monitored for drainflow quantity, and drain flow quality samples were collected from the outlets of each of the 50 drainage systems. However, these data were collected inconsistently and (or) intermittently during the period studied. All data obtained from the water district were compiled and stored in a geographic information system database. Water delivered for irrigation by the Panoche Water District is a mix of imported water and local ground water pumped directly into delivery canals. Although delivered water is a mix, information on the proportion of water from the two sources is not reported. Also, individual growers pump directly to their crops unknown quantities of ground water, the total of which could be greater than 60 percent of total applications during years when water district deliveries are greatly reduced (for example, the years during and following a drought). To evaluate the effects of irrigation on ground-water and drainflow quality, data on the combined chemical characteristics and the volume of water applied to crops are needed as part of the district's monitoring program. For example, without these data, this study could estimate only the effects of irrigation on ground-water recharge for 1986 (60.4 106 m3/y), 1987 (74.2 106 m3/y), and 1988 (56.0 106 m3/y) in the Panoche Water District water years when the amount of ground water pumped by individual growers was probably small. Water-level data show a significant decline of the water table in the upslope, undrained parts of the study area, and little or no significant change in the down slope, drained parts of the study area. Pumping from productions wells, most of which are located in the upslope part of the study area, may have contributed to the decline of the water table in the upslope area. The quantities of drainflow, dissolved solids, and selenium discharged from the study area decreased during the study period. However, drainflow, dissolved solids, and selenium discharged from individual on-farm drainage systems did not decrease. These data also illustrate the need for consistent and regular monitoring of the factors that affect drainage in the western San Joaquin Valley.
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Mahmood, Mohammad Afzal; Mufidah, Ismi; Scroggs, Steven; Siddiqui, Amna Rehana; Raheel, Hafsa; Wibdarminto, Koentijo; Dirgantoro, Bernardus; Vercruyssen, Jorien; Wahabi, Hayfaa A
2018-01-01
Despite significant reduction in maternal mortality, there are still many regions in the world that suffer from high mortality. District Kutai Kartanegara, Indonesia, is one such region where consistently high maternal mortality was observed despite high rate of delivery by skilled birth attendants. Thirty maternal deaths were reviewed using verbal autopsy interviews, terminal event reporting, medical records' review, and Death Audit Committee reports, using a comprehensive root-cause analysis framework including Risk Identification, Signal Services, Emergency Obstetrics Care Evaluation, Quality, and 3 Delays. The root causes were found in poor quality of care, which caused hospital to be unprepared to manage deteriorating patients. In hospital, poor implementation of standard operating procedures was rooted in inadequate skills, lack of forward planning, ineffective communication, and unavailability of essential services. In primary care, root causes included inadequate risk management, referrals to facilities where needed services are not available, and lack of coordination between primary healthcare and hospitals. There is an urgent need for a shift in focus to quality of care through knowledge, skills, and support for consistent application of protocols, making essential services available, effective risk assessment and management, and facilitating timely referrals to facilities that are adequately equipped.
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Mufidah, Ismi; Scroggs, Steven; Siddiqui, Amna Rehana; Raheel, Hafsa; Wibdarminto, Koentijo; Dirgantoro, Bernardus; Vercruyssen, Jorien
2018-01-01
Background Despite significant reduction in maternal mortality, there are still many regions in the world that suffer from high mortality. District Kutai Kartanegara, Indonesia, is one such region where consistently high maternal mortality was observed despite high rate of delivery by skilled birth attendants. Method Thirty maternal deaths were reviewed using verbal autopsy interviews, terminal event reporting, medical records' review, and Death Audit Committee reports, using a comprehensive root-cause analysis framework including Risk Identification, Signal Services, Emergency Obstetrics Care Evaluation, Quality, and 3 Delays. Findings The root causes were found in poor quality of care, which caused hospital to be unprepared to manage deteriorating patients. In hospital, poor implementation of standard operating procedures was rooted in inadequate skills, lack of forward planning, ineffective communication, and unavailability of essential services. In primary care, root causes included inadequate risk management, referrals to facilities where needed services are not available, and lack of coordination between primary healthcare and hospitals. Conclusion There is an urgent need for a shift in focus to quality of care through knowledge, skills, and support for consistent application of protocols, making essential services available, effective risk assessment and management, and facilitating timely referrals to facilities that are adequately equipped. PMID:29682538
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ERIC Educational Resources Information Center
Consortium for Policy Research in Education, 2009
2009-01-01
The Strategic Management of Human Capital in Education Project was founded in 2008 with one goal: to improve student achievement dramatically in the 100 largest urban school districts. Unless teaching quality and principal leadership improve significantly, lasting education improvement is impossible. In policy terms, without "strategic management"…
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Quality control and quality assurance plan for bridge channel-stability assessments in Massachusetts
Parker, Gene W.; Pinson, Harlow
1993-01-01
A quality control and quality assurance plan has been implemented as part of the Massachusetts bridge scour and channel-stability assessment program. This program is being conducted by the U.S. Geological Survey, Massachusetts-Rhode Island District, in cooperation with the Massachusetts Highway Department. Project personnel training, data-integrity verification, and new data-management technologies are being utilized in the channel-stability assessment process to improve current data-collection and management techniques. An automated data-collection procedure has been implemented to standardize channel-stability assessments on a regular basis within the State. An object-oriented data structure and new image management tools are used to produce a data base enabling management of multiple data object classes. Data will be reviewed by assessors and data base managers before being merged into a master bridge-scour data base, which includes automated data-verification routines.
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Sa’avu, Martin; Duke, Trevor; Matai, Sens
2014-01-01
Background In developing countries such as Papua New Guinea (PNG), district hospitals play a vital role in clinical care, training health-care workers, implementing immunization and other public health programmes and providing necessary data on disease burdens and outcomes. Pneumonia and neonatal conditions are a major cause of child admission and death in hospitals throughout PNG. Oxygen therapy is an essential component of the management of pneumonia and neonatal conditions, but facilities for oxygen and care of the sick newborn are often inadequate, especially in district hospitals. Improving this area may be a vehicle for improving overall quality of care. Method A qualitative study of five rural district hospitals in the highlands provinces of Papua New Guinea was undertaken. A structured survey instrument was used by a paediatrician and a biomedical technician to assess the quality of paediatric care, the case-mix and outcomes, resources for delivery of good-quality care for children with pneumonia and neonatal illnesses, existing oxygen systems and equipment, drugs and consumables, infection-control facilities and the reliability of the electricity supply to each hospital. A floor plan was drawn up for the installation of the oxygen concentrators and a plan for improving care of sick neonates, and a process of addressing other priorities was begun. Results In remote parts of PNG, many district hospitals are run by under-resourced non-government organizations. Most hospitals had general wards in which both adults and children were managed together. Paediatric case-loads ranged between 232 and 840 patients per year with overall case-fatality rates (CFR) of 3–6% and up to 15% among sick neonates. Pneumonia accounts for 28–37% of admissions with a CFR of up to 8%. There were no supervisory visits by paediatricians, and little or no continuing professional development of staff. Essential drugs were mostly available, but basic equipment for the care of sick neonates was often absent or incomplete. Infection control measures were inadequate in most hospitals. Cylinders were the major source of oxygen for the district hospitals, and logistical problems and large indirect costs meant that oxygen was under-utilized. There were multiple electricity interruptions, but hospitals had back-up generators to enable the use of oxygen concentrators. After 6 months in each of the five hospitals, high-dependency care areas were planned, oxygen concentrators installed, staff trained in their use, and a plan was set out for improving neonatal care. Interpretation If MGD-4 targets for child health are to be met, reducing neonatal mortality and deaths from pneumonia will have to include better quality services in district hospitals. Establishing better oxygen supplies with a systems approach can be a vehicle for addressing other areas of quality and safety in district hospitals. PMID:24621233
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Dallas's Nonprofit Foundation Founders.
ERIC Educational Resources Information Center
Levin, Dan
1979-01-01
Describes the scandals that have destroyed the Foundation for Quality Education, the foundation the Dallas (Texas) school district created to raise money for the schools through real estate management and the marketing of school-system-developed curriculum materials. (Author/IRT)
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-19
...EPA is proposing a limited approval and limited disapproval of permitting rules submitted for the Placer County Air Pollution Control District (PCAPCD) and Feather River Air Quality Management District (FRAQMD) portion of the California State Implementation Plan (SIP). The districts are required under Part D of title I of the Clean Air Act (CAA) to adopt and implement a SIP-approved New Source Review (NSR) permit program. These rules update and revise the District's NSR permitting program for new and modified sources of air pollution. If EPA finalizes the limited approval and limited disapproval action, as proposed, then a sanctions clock would be triggered. We are taking comments on this proposal and plan to follow with a final action.
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Belaid, Loubna; Ridde, Valéry
2012-12-08
To bring down its high maternal mortality ratio, Burkina Faso adopted a national health policy in 2007 that designed to boost the assisted delivery rate and improving quality of emergency obstetrical and neonatal care. The cost of transportation from health centres to district hospitals is paid by the policy. The worst-off are exempted from all fees. The objectives of this paper are to analyze perceptions of this policy by health workers, assess how this health policy was implemented at the district level, identify difficulties faced during implementation, and highlight interactional factors that have an influence on the implementation process. A multiple site case study was conducted at 6 health centres in the district of Djibo in Burkina Faso. The following sources of data were used: 1) district documents (n = 23); 2) key interviews with district health managers (n = 10), health workers (n = 16), traditional birth attendants (n = 7), and community management committees (n = 11); 3) non-participant observations in health centres; 4) focus groups in communities (n = 62); 5) a feedback session on the findings with 20 health staff members. All the activities were implemented as planned except for completely subsidizing the worst-off, and some activities such as surveys for patients and the quality assurance service team aiming to improve quality of care. District health managers and health workers perceived difficulties in implementing this policy because of the lack of clarity on some topics in the guidelines. Entering the data into an electronic database and the long delay in reimbursing transportation costs were the principal challenges perceived by implementers. Interactional factors such as relations between providers and patients and between health workers and communities were raised. These factors have an influence on the implementation process. Strained relations between the groups involved may reduce the effectiveness of the policy. Implementation analysis in the context of improving financial access to health care in African countries is still scarce, especially at the micro level. The strained relations of the providers with patients and the communities may have an influence on the implementation process and on the effects of this health policy. Therefore, power relations between actors of the health system and the community should be taken into consideration. More studies are needed to better understand the influence of power relations on the implementation process in low-income countries.
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2012-01-01
Background To bring down its high maternal mortality ratio, Burkina Faso adopted a national health policy in 2007 that designed to boost the assisted delivery rate and improving quality of emergency obstetrical and neonatal care. The cost of transportation from health centres to district hospitals is paid by the policy. The worst-off are exempted from all fees. Methods The objectives of this paper are to analyze perceptions of this policy by health workers, assess how this health policy was implemented at the district level, identify difficulties faced during implementation, and highlight interactional factors that have an influence on the implementation process. A multiple site case study was conducted at 6 health centres in the district of Djibo in Burkina Faso. The following sources of data were used: 1) district documents (n = 23); 2) key interviews with district health managers (n = 10), health workers (n = 16), traditional birth attendants (n = 7), and community management committees (n = 11); 3) non-participant observations in health centres; 4) focus groups in communities (n = 62); 5) a feedback session on the findings with 20 health staff members. Results All the activities were implemented as planned except for completely subsidizing the worst-off, and some activities such as surveys for patients and the quality assurance service team aiming to improve quality of care. District health managers and health workers perceived difficulties in implementing this policy because of the lack of clarity on some topics in the guidelines. Entering the data into an electronic database and the long delay in reimbursing transportation costs were the principal challenges perceived by implementers. Interactional factors such as relations between providers and patients and between health workers and communities were raised. These factors have an influence on the implementation process. Strained relations between the groups involved may reduce the effectiveness of the policy. Conclusions Implementation analysis in the context of improving financial access to health care in African countries is still scarce, especially at the micro level. The strained relations of the providers with patients and the communities may have an influence on the implementation process and on the effects of this health policy. Therefore, power relations between actors of the health system and the community should be taken into consideration. More studies are needed to better understand the influence of power relations on the implementation process in low-income countries. PMID:23216874
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ERIC Educational Resources Information Center
Levy, Marian; Heffner, Brenda; Stewart, Tara; Beeman, Gail
2006-01-01
Pediatric asthma rates are reaching epidemic proportions, adversely affecting children's quality of life, educational potential, and health care costs, especially those in the inner city. This study evaluated the effectiveness of a school-based asthma case management (CM) approach with medically undeserved inner-city children attending Memphis…
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NASA Astrophysics Data System (ADS)
Wardhani, D. K.; Azmi, D. S.; Purnamasari, W. D.
2017-06-01
RW 3 Sukun Malang was one of kampong that won the competition kampong environment and had managed to maintain the preservation of the kampong. Society of RW 3 Sukun undertake various activities to manage the environment by optimizing the use of kampong space. Despite RW 3 Sukun had conducted environmental management activities, there are several locations in the kampong space that less well maintained. The purpose of this research was to determine the relation of environmental management with the quality of kampong space in RW 3 Sukun. This research used qualitative and quantitative research approaches. Quantitative research conducted by using descriptive statistical analysis in assessing the quality of kampong space with weighting, scoring, and overlay maps. Quantitative research was also conducted on the relation analysis of environmental management with the quality of kampong space by using typology analysis and pearson correlation analysis. Qualitative research conducted on the analysis of environmental management and the relation analysis of environmental management with the quality of kampong space. Result of this research indicates that environmental management in RW 3 Sukun have relation with the quality of kampong space.
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Knowledge management systems success in healthcare: Leadership matters.
Ali, Nor'ashikin; Tretiakov, Alexei; Whiddett, Dick; Hunter, Inga
2017-01-01
To deliver high-quality healthcare doctors need to access, interpret, and share appropriate and localised medical knowledge. Information technology is widely used to facilitate the management of this knowledge in healthcare organisations. The purpose of this study is to develop a knowledge management systems success model for healthcare organisations. A model was formulated by extending an existing generic knowledge management systems success model by including organisational and system factors relevant to healthcare. It was tested by using data obtained from 263 doctors working within two district health boards in New Zealand. Of the system factors, knowledge content quality was found to be particularly important for knowledge management systems success. Of the organisational factors, leadership was the most important, and more important than incentives. Leadership promoted knowledge management systems success primarily by positively affecting knowledge content quality. Leadership also promoted knowledge management use for retrieval, which should lead to the use of that better quality knowledge by the doctors, ultimately resulting in better outcomes for patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-09-24
...EPA is finalizing a limited approval and limited disapproval of two permitting rules submitted by California as a revision to the Placer County Air Pollution Control District (PCAPCD) and Feather River Air Quality Management District (FRAQMD) portion of the California State Implementation Plan (SIP). These revisions were proposed in the Federal Register on February 22, 2013 and concern construction and modification of stationary sources of air pollution within each District. We are approving local rules that regulate these emission sources under the Clean Air Act as amended in 1990 (CAA). Final approval of these rules makes the rules federally enforceable and corrects program deficiencies identified in a previous EPA rulemaking (76 FR 44809, July 27, 2011). EPA is also making a technical amendment to the Code of Federal Regulations (CFR) to reflect this previous rulemaking, which removed an obsolete provision from the California SIP.
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Code of Federal Regulations, 2010 CFR
2010-07-01
..., Rule 465 Vacuum Producing Devices or Systems, submitted on August 2, 1976. (2) South Coast Air Quality Management District. (i) Regulation IV, Rule 461 Gasoline Transfer and Dispensing, submitted on June 6, 1977...
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Hydrology and water quality of East Lake Tohopekaliga, Osceola County, Florida
Schiffer, Donna M.
1987-01-01
East Lake Tohopekaliga, one of the major lakes in central Florida, is located in the upper Kissimmee River basin in north-east Osceola County. It is one of numerous lakes in the upper basin used for flood control, in addition to recreation and some irrigation of surrounding pasture. This report is the fourth in a series of lake reconnaissance studies in the Kissimmee River basin prepared in cooperation with the South Florida Water Management District. The purpose of the report is to provide government agencies and the public with a brief summary of the lake 's hydrology and water quality. Site information is given and includes map number, site name, location, and type of data available (specific conductivity, pH, alkalinity, turbidity, color, dissolved oxygen, hardness, dissolved chlorides, dissolved sodium, dissolved calcium, dissolved magnesium, dissolved potassium, nitrogen, ammonia, nitrates, carbon and phosphorus). The U.S. Geological Survey (USGS) maintained a lake stage gaging station on East Lake Tohopekaliga from 1942 to 1968. The South Florida Water Management District has recorded lake stage since 1963. Periodic water quality samples have been collected from the lake by the South Florida Water Management District and USGS. Water quality and discharge data have been collected for one major tributary to the lake, Boggy Creek. Although few groundwater data are available for the study area, results of previous studies of the groundwater resources of Osceola County are included in this report. To supplement the water quality data for East Lake Tohopekaliga, water samples were collected at selected sites in November 1982 (dry season) and in August 1983 (rainy season). Samples were taken at inflow points, and in the lake, and vertical profiles of dissolved oxygen and temperature were measured in the lake. A water budget from an EPA report on the lake is also included. (Lantz-PTT)
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Bonenberger, Marc; Aikins, Moses; Akweongo, Patricia; Wyss, Kaspar
2016-01-14
There is increasing evidence that good district management practices can improve health system performance and conversely, that poor and inefficient management practices have detrimental effects. The aim of the present study was to identify factors contributing to inefficient management practices of district health managers and ways to improve their overall efficiency. Nineteen semi-structured interviews were conducted with district health managers in three districts of the Eastern Region in Ghana. The 19 interviews conducted comprised 90% of the managerial workforce in these districts in 2013. A thematic analysis was carried out using the WHO's leadership and management strengthening framework to structure the results. Key factors for inefficient district health management practices were identified to be: human resource shortages, inadequate planning and communication skills, financial constraints, and a narrow decision space that constrains the authority of district health managers and their ability to influence decision-making. Strategies that may improve managerial efficiency at both an individual and organizational level included improvements to planning, communication, and time management skills, and ensuring the timely release of district funds. Filling District Health Management Team vacancies, developing leadership and management skills of district health managers, ensuring a better flow of district funds, and delegating more authority to the districts seems to be a promising intervention package, which may result in better and more efficient management practices and stronger health system performance.
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KirungaTashobya, Christine; Ssengooba, Freddie; Nabyonga-Orem, Juliet; Bataringaya, Juliet; Macq, Jean; Marchal, Bruno; Musila, Timothy; Criel, Bart
2018-05-10
In 2003 the Uganda Ministry of Health (MoH) introduced the District League Table (DLT) to track district performance. This review of the DLT is intended to add to the evidence base on Health Systems Performance Assessment (HSPA) globally, with emphasis on Low and Middle Income Countries (LMICs), and provide recommendations for adjustments to the current Ugandan reality. A normative HSPA framework was used to inform the development of a Key Informant Interview (KII) tool. Thirty Key Informants were interviewed, purposively selected from the Ugandan health system on the basis of having developed or used the DLT. KII data and information from published and grey literature on the Uganda health system was analyzed using deductive analysis. Stakeholder involvement in the development of the DLT was limited, including MoH officials and development partners, and a few district technical managers. Uganda policy documents articulate a conceptually broad health system whereas the DLT focuses on a healthcare system. The complexity and dynamism of the Uganda health system was insufficiently acknowledged by the HSPA framework. Though DLT objectives and indicators were articulated, there was no conceptual reference model and lack of clarity on the constitutive dimensions. The DLT mechanisms for change were not explicit. The DLT compared markedly different districts and did not identify factors behind observed performance. Uganda lacks a designated institutional unit for the analysis and presentation of HSPA data, and there are challenges in data quality and range. The critique of the DLT using a normative model supported the development of recommendation for Uganda district HSPA and provides lessons for other LMICs. A similar approach can be used by researchers and policy makers elsewhere for the review and development of other frameworks. Adjustments in Uganda district HSPA should consider: wider stakeholder involvement with more district managers including political, administrative and technical; better anchoring within the national health system framework; integration of the notion of complexity in the design of the framework; and emphasis on facilitating district decision-making and learning. There is need to improve data quality and range and additional approaches for data analysis and presentation.
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Spahr, Norman E.; Hartle, David M.; Diaz, Paul
2008-01-01
Population growth and changes in land use have the potential to affect water quality and quantity in the upper Gunnison River Basin. In 1995, the U.S. Geological Survey (USGS), in cooperation with the Bureau of Land Management, City of Gunnison, Colorado River Water Conservation District, Crested Butte South Metropolitan District, Gunnison County, Hinsdale County, Mount Crested Butte Water and Sanitation District, National Park Service, Town of Crested Butte, Upper Gunnison River Water Conservancy District, and Western State College, established a water-quality monitoring program in the upper Gunnison River Basin to characterize current water-quality conditions and to assess the effects of increased urban development and other land-use changes on water quality. The monitoring network has evolved into two groups of stations - stations that are considered long term and stations that are considered rotational. The long-term stations are monitored to assist in defining temporal changes in water quality (how conditions may change over time). The rotational stations are monitored to assist in the spatial definition of water-quality conditions (how conditions differ throughout the basin) and to address local and short-term concerns. Some stations in the rotational group were changed beginning in water year 2007. Annual summaries of the water-quality data from the monitoring network provide a point of reference for discussions regarding water-quality monitoring in the upper Gunnison River Basin. This summary includes data collected during water years 2004 and 2005. The introduction provides a map of the sampling sites, definitions of terms, and a one-page summary of selected water-quality conditions at the network stations. The remainder of the summary is organized around the data collected at individual stations. Data collected during water years 2004 and 2005 are compared to historical data, State water-quality standards, and Federal water-quality guidelines. Data were collected following USGS protocols.
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Solberg, P.A.; Moore, Bryan; Smits, Dennis
2009-01-01
Population growth and changes in land use have the potential to affect water quality and quantity in the upper Gunnison River basin. In 1995, the U.S. Geological Survey (USGS), in cooperation with the Bureau of Land Management, City of Gunnison, Colorado River Water Conservation District, Crested Butte South Metropolitan District, Gunnison County, Hinsdale County, Mount Crested Butte Water and Sanitation District, National Park Service, Town of Crested Butte, Upper Gunnison River Water Conservancy District, and Western State College established a water-quality monitoring program in the upper Gunnison River basin to characterize current water-quality conditions and to assess the effects of increased urban development and other land-use changes on water quality. The monitoring network has evolved into two groups of stations - stations that are considered long term and stations that are considered rotational. The long-term stations are monitored to assist in defining temporal changes in water quality (how conditions may change over time). The rotational stations are monitored to assist in the spatial definition of water-quality conditions (how conditions differ throughout the basin) and to address local and short-term concerns. Some stations in the rotational group were changed beginning in water year 2007. Annual summaries of the water-quality data from the monitoring network provide a point of reference for discussions regarding water-quality monitoring in the upper Gunnison River basin. This summary includes data collected during water years 2006 and 2007. The introduction provides a map of the sampling sites, definitions of terms, and a one-page summary of selected water-quality conditions at the network stations. The remainder of the summary is organized around the data collected at individual stations. Data collected during water years 2006 and 2007 are compared to historical data, State water-quality standards, and Federal water-quality guidelines. Data were collected following USGS protocols (U.S. Geological Survey, variously dated).
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Belrhiti, Zakaria; Booth, Andrew; Marchal, Bruno; Verstraeten, Roosmarijn
2016-04-27
District health managers play a key role in the effectiveness of decentralized health systems in low- and middle-income countries. Inadequate management and leadership skills often hamper their ability to improve quality of care and effectiveness of health service delivery. Nevertheless, significant investments have been made in capacity-building programmes based on site-based training, mentoring, and operational research. This systematic review aims to review the effectiveness of site-based training, mentoring, and operational research (or action research) on the improvement of district health system management and leadership. Our secondary objectives are to assess whether variations in composition or intensity of the intervention influence its effectiveness and to identify enabling and constraining contexts and underlying mechanisms. We will search the following databases: MEDLINE, PsycInfo, Cochrane Library, CRD database (DARE), Cochrane Effective Practice and Organisation of Care (EPOC) group, ISI Web of Science, Health Evidence.org, PDQ-Evidence, ERIC, EMBASE, and TRIP. Complementary search will be performed (hand-searching journals and citation and reference tracking). Studies that meet the following PICO (Population, Intervention, Comparison, Outcome) criteria will be included: P: professionals working at district health management level; I: site-based training with or without mentoring, or operational research; C: normal institutional arrangements; and O: district health management functions. We will include cluster randomized controlled trials, controlled before-and-after studies, interrupted time series analysis, quasi-experimental designs, and cohort and longitudinal studies. Qualitative research will be included to contextualize findings and identify barriers and facilitators. Primary outcomes that will be reported are district health management and leadership functions. We will assess risk of bias with the Cochrane Collaboration's tools for randomized controlled trials (RCT) and non RCT studies and Critical Appraisal Skills Programme checklists for qualitative studies. We will assess strength of recommendations with the GRADE tool for quantitative studies, and the CERQual approach for qualitative studies. Synthesis of quantitative studies will be performed through meta-analysis when appropriate. Best fit framework synthesis will be used to synthesize qualitative studies. This protocol paper describes a systematic review assessing the effectiveness of site-based training (with or without mentoring programmes or operational research) on the improvement of district health system management and leadership. PROSPERO CRD42015032351.
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Impact of the community-based newborn care package in Nepal: a quasi-experimental evaluation.
Paudel, Deepak; Shrestha, Ishwar B; Siebeck, Matthias; Rehfuess, Eva
2017-10-05
To evaluate the impact of the community-based newborn care package (CBNCP) on six essential practices to improve neonatal health. CBNCP pilot districts were matched to comparison districts using propensity scores. Impact on birth preparedness, antenatal care seeking, antenatal care quality, delivery by skilled birth attendant, immediate newborn care and postnatal care within 48 hours were assessed using Demographic and Health Survey (DHS) and Health Management Information System (HMIS) data through difference-in-differences and multivariate logistic regression analyses. Changes over time in intervention and comparison areas were similar in difference-in-differences analysis of DHS and HMIS data. Logistic regression of DHS data also did not reveal any significant improvement in combined outcomes: birth preparedness, adjusted OR (aOR)=0.8 (95% CI 0.4 to 1.7); antenatal care seeking, aOR=1.0 (0.6 to 1.5); antenatal care quality, aOR=1.4 (0.9 to 2.1); delivery by skilled birth attendant, aOR=1.5 (1.0 to 2.3); immediate newborn care, aOR=1.1 (0.7 to 1.9); postnatal care, aOR=1.3 (0.9 to 1.9). Health providers' knowledge and skills in intervention districts were fair but showed much variation between different providers and districts. This study, while representing an early assessment of impact, did not identify significant improvements in newborn care practices and raises concerns regarding CBNCP implementation. It has contributed to revisions of the package and it being merged with the Integrated Management of Neonatal and Childhood Illness programme. This is now being implemented in 35 districts and carefully monitored for quality and impact. The study also highlights general challenges in evaluating the impacts of a complex health intervention under 'real life' conditions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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ERIC Educational Resources Information Center
Taniguchi, Kyoko; Hirakawa, Yukiko
2016-01-01
School management in many sub-Saharan African countries has been enhanced through community participation in an attempt to improve education quality. This study uses field research in a rural district of Malawi to assess how community and parent participation differs between schools, the intentions of communities and parents when carrying out…
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Fusheini, Adam; Eyles, John
2016-10-07
Universal Health Coverage (UHC) has emerged as a major goal for health care delivery in the post-2015 development agenda. It is viewed as a solution to health care needs in low and middle countries with growing enthusiasm at both national and global levels. Throughout the world, however, the paths of countries to UHC have differed. South Africa is currently reforming its health system with UHC through developing a national health insurance (NHI) program. This will be practically achieved through a decentralized approach, the district health system, the main vehicle for delivering services since democracy. We utilize a review of relevant documents, conducted between September 2014 and December 2015 of district health systems (DHS) and UHC and their ideological underpinnings, to explore the opportunities and challenges, of the district health system in achieving UHC in South Africa. Review of data from the NHI pilot districts suggests that as South Africa embarks on reforms toward UHC, there is a need for a minimal universal coverage and emphasis on district particularity and positive discrimination so as to bridge health inequities. The disparities across districts in relation to health profiles/demographics, health delivery performance, management of health institutions or district management capacity, income levels/socio-economic status and social determinants of health, compliance with quality standards and above all the burden of disease can only be minimised through positive discrimination by paying more attention to underserved and disadavantaged communities. We conclude that in South Africa the DHS is pivotal to health reform and UHC may be best achieved through minimal universal coverage with positive discrimination to ensure disparities across districts in relation to disease burden, human resources, financing and investment, administration and management capacity, service readiness and availability and the health access inequalities are consciously implicated. Yet ideological and practical issues make its achievement problematic.
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Langston, Anne; Weiss, Jennifer; Landegger, Justine; Pullum, Thomas; Morrow, Melanie; Kabadege, Melene; Mugeni, Catherine; Sarriot, Eric
2014-08-01
The Kabeho Mwana project (2006-2011) supported the Rwanda Ministry of Health (MOH) in scaling up integrated community case management (iCCM) of childhood illness in 6 of Rwanda's 30 districts. The project trained and equipped community health workers (CHWs) according to national guidelines. In project districts, Kabeho Mwana staff also trained CHWs to conduct household-level health promotion and established supervision and reporting mechanisms through CHW peer support groups (PSGs) and quality improvement systems. The 2005 and 2010 Demographic and Health Surveys were re-analyzed to evaluate how project and non-project districts differed in terms of care-seeking for fever, diarrhea, and acute respiratory infection symptoms and related indicators. We developed a logit regression model, controlling for the timing of the first CHW training, with the district included as a fixed categorical effect. We also analyzed qualitative data from the final evaluation to examine factors that may have contributed to improved outcomes. While there was notable improvement in care-seeking across all districts, care-seeking from any provider for each of the 3 conditions, and for all 3 combined, increased significantly more in the project districts. CHWs contributed a larger percentage of consultations in project districts (27%) than in non-project districts (12%). Qualitative data suggested that the PSG model was a valuable sub-level of CHW organization associated with improved CHW performance, supervision, and social capital. The iCCM model implemented by Kabeho Mwana resulted in greater improvements in care-seeking than those seen in the rest of the country. Intensive monitoring, collaborative supervision, community mobilization, and CHW PSGs contributed to this success. The PSGs were a unique contribution of the project, playing a critical role in improving care-seeking in project districts. Effective implementation of iCCM should therefore include CHW management and social support mechanisms. Finally, re-analysis of national survey data improved evaluation findings by providing impact estimates.
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Afanvi, Kossivi Agbelenko
2015-01-01
The ultimate goal of every tuberculosis (TB) treatment program is a high treatment success rate. Treatment success is extremely important because, when the rate is high, it significantly contributes to declining numbers of new cases by reducing the number and period of infectious cases, TB morbidity and mortality, and prevents the emergence of resistant strains. Our aim was to decrease TB mortality by increasing pulmonary TB patients’ treatment success rate to at least 85 % in Lacs Health District by end of July 2014. A systems and dialogic analysis of the public health system related to TB patients’ treatment revealed that it was not performing well; we found weak coverage and quality of TB services, a poorly-functioning TB health information system, poor-performing health workforce, poor availability of HIV tests and antiretroviral for TB patients, and low degree of patients’ participation in their care. We redesigned the system to correct those weaknesses. The effectiveness of these changes was monitored using plan, do, study, act (PDSA) cycles. We increased TB patient success rate from 80% to 95% between February 2012 and July 2014.The mortality rate dropped from 13% to 3% and the failure to follow-up rate dropped from 3% to 2%. In conclusion, district health systems performance depends on factors such as the closeness of services to population; skilled workforce; the ability to collect and analyze data and use information for action; population empowerment, and good management and improvement capabilities of management team especially the public health director. High TB patients’ success rate depends also on the availability of antiretroviral drugs. It is highly important that every district health management team member develops improvement capabilities. PMID:26734412
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A case study of outsourced primary healthcare services in Sindh, Pakistan: is this a real reform?
Tanzil, Sana; Zahidie, Aysha; Ahsan, Adeel; Kazi, Ambreen; Shaikh, Babar Tasneem
2014-06-25
Since a decade, low and middle income countries have a rising trend of contracting their primary healthcare services to NGOs. In Pakistan, public sector often lacks capacity to effectively & equitably manage the healthcare services. It led the government to outsource the administration of primary health care services to a semi-autonomous government entity i.e. Peoples' Primary Healthcare Initiative (PPHI). This small scale study has assessed the quality of healthcare services at the contracted Basic Health Units (BHUs) with the PPHI and compared it with those managed by the local district government in the province of Sindh. A cross-sectional mix methods survey was conducted in November 2011. Two BHUs of each type were selected from the districts Karachi and Thatta in Sindh province. BHUs were selected randomly and a purposive sampling technique was used to recruit the study participants at the two study sites. Focus group discussions were conducted with patients visiting the facility while in-depth interviews were conducted with service providers. An observation based resource availability checklist was also administered. There was a significant difference between the PPHI and the district government administered BHUs with regard to infrastructure, availability of essential medicines, basic medical appliances, mini-lab facilities and vehicles for referrals. These BHUs were found to have sufficient number of trained clinical staff and no punctuality and retention issues whatsoever. The district government administered BHUs presented a dismal picture in all the aspects. Out-sourcing of primary healthcare facilities has resulted in significantly improved certain aspects quality and responsiveness of primary healthcare services. This strategy is likely to achieve an efficient and perhaps an equitable healthcare delivery in low and middle income countries where governments have limited capacity to manage healthcare services.
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A case study of outsourced primary healthcare services in Sindh, Pakistan: is this a real reform?
2014-01-01
Background Since a decade, low and middle income countries have a rising trend of contracting their primary healthcare services to NGOs. In Pakistan, public sector often lacks capacity to effectively & equitably manage the healthcare services. It led the government to outsource the administration of primary health care services to a semi-autonomous government entity i.e. Peoples’ Primary Healthcare Initiative (PPHI). This small scale study has assessed the quality of healthcare services at the contracted Basic Health Units (BHUs) with the PPHI and compared it with those managed by the local district government in the province of Sindh. Methods A cross-sectional mix methods survey was conducted in November 2011. Two BHUs of each type were selected from the districts Karachi and Thatta in Sindh province. BHUs were selected randomly and a purposive sampling technique was used to recruit the study participants at the two study sites. Focus group discussions were conducted with patients visiting the facility while in-depth interviews were conducted with service providers. An observation based resource availability checklist was also administered. Results There was a significant difference between the PPHI and the district government administered BHUs with regard to infrastructure, availability of essential medicines, basic medical appliances, mini-lab facilities and vehicles for referrals. These BHUs were found to have sufficient number of trained clinical staff and no punctuality and retention issues whatsoever. The district government administered BHUs presented a dismal picture in all the aspects. Conclusion Out-sourcing of primary healthcare facilities has resulted in significantly improved certain aspects quality and responsiveness of primary healthcare services. This strategy is likely to achieve an efficient and perhaps an equitable healthcare delivery in low and middle income countries where governments have limited capacity to manage healthcare services. PMID:24965769
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The impact of asbestos in Illinois public schools
DOE Office of Scientific and Technical Information (OSTI.GOV)
Marucco, T.E.
The Asbestos Hazard Emergency Response Act (AHERA) was signed into law providing a framework for addressing asbestos problems in secondary and elementary schools. This study examines the perceived attitudes of Illinois School personnel relative to the impact of asbestos in their buildings. Conclusions are: (1) All districts regardless of size, type, and enrollment have the largest concentration of non-friable asbestos in floor tile. (2) All school districts are surveying their asbestos and report that they are managing it properly following AHERA and state guidelines; removal is the most accepted method of abatement. (3) Administrators, schools boards, teachers, and maintenance staffmore » in general showed a high concern about asbestos abatement. (4) Governmental agencies have exerted the greatest pressure on school districts to manage existing asbestos properly. (5) External pressure does not appear to influence school districts regarding asbestos abatement. (6) Current attitudes and activities would change little if AHERA were repealed. (7) Asbestos abatement activities have taken place when schools are vacated. (8) Most administrators regard radon, leaded water, toxic chemicals, indoor air quality, and air pollution equal to or more threatening than asbestos.« less
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Quality DOTS management and empowering tuberculosis patients.
Chugh, Satish
2009-03-01
Central Tuberculosis Division (CTD) has covered whole of India under DOTS. IMA is a proud partner of RNTCP which is managed by CTD. International Standards for Tuberculosis Care is expected from all healthcare providers. The basic principles of care is same worldwide. IMA GFATM RNTCP PPM is completing 2 years of its inception. Sensitisation programme and district training programmes has yielded DOTS/DMC centres in the target states. IMA is having 100% commitment for containing tuberculosis in India. There are International Standards for quality management in tuberculosis control, some of the Standards are elaborated in this write-up. In the Indian context, DOTS needs some innovations that is discussed in this article.
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30 CFR 71.301 - Respirable dust control plan; approval by District Manager and posting.
Code of Federal Regulations, 2010 CFR
2010-07-01
... District Manager and posting. 71.301 Section 71.301 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION... plan; approval by District Manager and posting. (a) The District Manager will approve respirable dust control plans on a mine-by-mine basis. When approving respirable dust control plans, the District Manager...
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ERIC Educational Resources Information Center
Dinklocker, Christina
1992-01-01
After training in the Total Quality Management concept, a suburban Ohio school district created a Deming Users' Group to link agencies, individuals, and ideas. The group has facilitated ongoing school/business collaboration, networking among individuals from diverse school systems, mentoring and cooperative learning activities, and resource…
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Air Sensor Kit Performance Testing and Pollutant Mapping Supports Community Air Monitoring Project
EPA is collaborating on a research project with the South Coast Air Quality Management District in Diamond Bar, Calif. to gain an enhanced understanding of fine particulate matter (PM2.5) and ozone concentrations across the study area.
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Forouhar, Amir; Hasankhani, Mahnoosh
2018-04-01
Urban decay is the process by which a historical city center, or an old part of a city, falls into decrepitude and faces serious problems. Urban management, therefore, implements renewal mega projects with the goal of physical and functional revitalization, retrieval of socioeconomic capacities, and improving of quality of life of residents. Ignoring the complexities of these large-scale interventions in the old and historical urban fabrics may lead to undesirable consequences, including an additional decline of quality of life. Thus, the present paper aims to assess the impact of renewal mega projects on residents' subjective quality of life, in the historical religious district of the holy city of Mashhad (Samen District). A combination of quantitative and qualitative methods of impact assessment, including questionnaires, semi-structured personal interviews, and direct observation, is used in this paper. The results yield that the Samen Renewal Project has significantly reduced the resident's subjective quality of life, due to its undesirable impacts on physical, socio-cultural, and economic environments.
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Water withdrawals in Florida, 2012
Marella, Richard L.
2015-09-01
The largest percentage of freshwater withdrawals was from the South Florida Water Management District (46 percent), followed by the St. Johns River Water Management District (20 percent), Southwest Florida Water Management District (19 percent), Northwest Florida Water Management District (9 percent), and Suwannee River Water Management District (6 percent). The South Florida Water Management District accounted for the largest percentage of freshwater withdrawals for public-supply use (46 percent), commercial-industrial-mining self-supplied use (24 percent), agricultural self-supplied use (59 percent), and recreational-landscape irrigation use (63 percent). The Northwest Florida Water Management District accounted for the largest percentage of freshwater withdrawals for power-generation use (44 percent), and the Southwest Florida Water Management District accounted for the largest percentage of saline-water withdrawals for power-generation use (58 percent).
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Koni, Phillip; Chishinga, Nathaniel; Nyirenda, Lameck; Kasonde, Prisca; Nsakanya, Richard; Welsh, Michael
2015-01-01
The FHI360-led Zambia Prevention Care and Treatment partnership II (ZPCT II) with funding from United States Agency for International Development, supports the Zambian Ministry of Health in scaling up HIV/AIDS services. To improve the quality of HIV/AIDS services, ZPCT II provides technical assistance until desired standards are met and districts are weaned-off intensive technical support, a process referred to as district graduation. This study describes the graduation process and determines performance domains associated with district graduation. Data were collected from 275 health facilities in 39 districts in 5 provinces of Zambia between 2008 and 2012. Performance in technical capacity, commodity management, data management and human resources domains were assessed in the following services areas: HIV counselling and testing and prevention of mother to child transmission, antiretroviral therapy/clinical care, pharmacy and laboratory. The overall mean percentage score was calculated by obtaining the mean of mean percentage scores for the four domains. Logistic regression models were used to obtain odds ratios (OR) and 95% confidence intervals (CI) for the domain mean percentage scores in graduated versus non-graduated districts; according to rural-urban, and province strata. 24 districts out of 39 graduated from intensive donor supported technical assistance while 15 districts did not graduate. The overall mean percentage score for all four domains was statistically significantly higher in graduated than non-graduated districts (93.2% versus 91.2%, OR = 1.34, 95%CI:1.20-1.49); including rural settings (92.4% versus 89.4%, OR = 1.43,95%CI:1.24-1.65). The mean percentage score in human resource domain was statistically significantly higher in graduated than non-graduated districts (93.6% versus 71.6%, OR = 5.81, 95%CI: 4.29-7.86) and in both rural and urban settings. QA/QI tools can be used to assess performance at health facilities and determine readiness for district graduation. Human resources management domain was found to be an important factor associated with district graduation.
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Koni, Phillip; Chishinga, Nathaniel; Nyirenda, Lameck; Kasonde, Prisca; Nsakanya, Richard; Welsh, Michael
2015-01-01
Introduction The FHI360-led Zambia Prevention Care and Treatment partnership II (ZPCT II) with funding from United States Agency for International Development, supports the Zambian Ministry of Health in scaling up HIV/AIDS services. To improve the quality of HIV/AIDS services, ZPCT II provides technical assistance until desired standards are met and districts are weaned-off intensive technical support, a process referred to as district graduation. This study describes the graduation process and determines performance domains associated with district graduation. Methods Data were collected from 275 health facilities in 39 districts in 5 provinces of Zambia between 2008 and 2012. Performance in technical capacity, commodity management, data management and human resources domains were assessed in the following services areas: HIV counselling and testing and prevention of mother to child transmission, antiretroviral therapy/clinical care, pharmacy and laboratory. The overall mean percentage score was calculated by obtaining the mean of mean percentage scores for the four domains. Logistic regression models were used to obtain odds ratios (OR) and 95% confidence intervals (CI) for the domain mean percentage scores in graduated versus non-graduated districts; according to rural-urban, and province strata. Results 24 districts out of 39 graduated from intensive donor supported technical assistance while 15 districts did not graduate. The overall mean percentage score for all four domains was statistically significantly higher in graduated than non-graduated districts (93.2% versus 91.2%, OR = 1.34, 95%CI:1.20–1.49); including rural settings (92.4% versus 89.4%, OR = 1.43,95%CI:1.24–1.65). The mean percentage score in human resource domain was statistically significantly higher in graduated than non-graduated districts (93.6% versus 71.6%, OR = 5.81, 95%CI: 4.29–7.86) and in both rural and urban settings. Conclusions QA/QI tools can be used to assess performance at health facilities and determine readiness for district graduation. Human resources management domain was found to be an important factor associated with district graduation. PMID:26098555
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Environmental Policy Tools: A User’s Guide.
1995-09-01
Quality RTUs Remote Terminal Units EG&S Environmental Goods and Services SAB (EPA) Science Advisory Board ( Industry ) SCAQMD South Coast Air Quality...Management EPA Environmental Protection Agency District EPCRA Emergency Planning and Community- SIC Standard Industrial Code Right-To-Know Act SIP State...solution will be significantly different than complicate the decision. Foremost among these today’s? is: Will costs and burdens to industry and gov
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Rowe, Alexander K
2009-06-01
Well-funded initiatives are challenging developing countries to increase health intervention coverage and show impact. Despite substantial resources, however, major obstacles include weak health systems, a lack of reasonably accurate monitoring data, and inadequate use of data for managing programs. This report discusses how integrated continuous surveys and quality management (I-Q), which are well-recognized approaches in wealthy countries, could support intervention scale-up, monitoring and evaluation, quality control for commodities, capacity building, and implementation research in low-resource settings. Integrated continuous surveys are similar to existing national cross-sectional surveys of households and health facilities, except data are collected over several years by permanent teams, and most results are reported monthly at the national, province, and district levels. Quality management involves conceptualizing work as processes, involving all workers in quality improvement, monitoring quality, and teams that improve quality with "plan-do-study-act" cycles. Implementing and evaluating I-Q in a low-income country would provide critical information on the value of this approach.
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30 CFR 90.301 - Respirable dust control plan; approval by District Manager; copy to part 90 miner.
Code of Federal Regulations, 2010 CFR
2010-07-01
... District Manager; copy to part 90 miner. 90.301 Section 90.301 Mineral Resources MINE SAFETY AND HEALTH... control plan; approval by District Manager; copy to part 90 miner. (a) The District Manager will approve... District Manager shall consider whether: (1) The respirable dust control measures would be likely to...
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Funk, Luke M; Conley, Dante M; Berry, William R; Gawande, Atul A
2013-11-01
Sub-Saharan Africa has a high surgical burden of disease but performs a disproportionately low volume of surgery. Closing this surgical gap will require increased surgical productivity of existing systems. We examined specific hospital management practices in three sub-Saharan African hospitals that are associated with surgical productivity and quality. We conducted 54 face-to-face, structured interviews with administrators, clinicians, and technicians at a teaching hospital, district hospital, and religious mission hospital across two countries in sub-Saharan Africa. Questions focused on recommended general management practices within five domains: goal setting, operations management, talent management, quality monitoring, and financial oversight. Records from each interview were analyzed in a qualitative fashion. Each hospital's management practices were scored according to the degree of implementation of the management practices (1 = none; 3 = some; 5 = systematic). The mission hospital had the highest number of employees per 100 beds (226), surgeons per operating room (3), and annual number of operations per operating room (1,800). None of the three hospitals had achieved systematic implementation of management practices in all 14 measures. The mission hospital had the highest total management score (44/70 points; average = 3.1 for each of the 14 measures). The teaching and district hospitals had statistically significantly lower management scores (average 1.3 and 1.1, respectively; p < .001). It is possible to meaningfully assess hospital management practices in low resource settings. We observed substantial variation in implementation of basic management practices at the three hospitals. Future research should focus on whether enhancing management practices can improve surgical capacity and outcomes.
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EPA is taking final action to approve a revision to the YSAQMD portion of the California SIP concerning YSAQMD negative declarations for several VOC source categories included in its RACT State Implementation Plan Analysis.
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RESEARCH AND PRODUCT DEVELOPMENT OF LOW-VOC WOOD COATINGS
The report discusses a project, cofunded by the South Coast Air Quality Management District (SCAQMD) and the U.S. EPA, to develop a new, low volatile organic compound (VOC) wood coating. Traditional wood furniture coating technologies contain organic solvents which become air pol...
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California; Bay Area Air Quality Management District; Determination To Defer Sanctions
EPA is making an interim final determination to defer imposition of sanctions based on a proposed determination that CARB submitted rules on behalf of BAAQMD that satisfy part D of the Clean Air Act for areas under the jurisdiction of the BAAQMD.
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National Assessment of Data Quality and Associated Systems-Level Factors in Malawi
O'Hagan, Richael; Marx, Melissa A; Finnegan, Karen E; Naphini, Patrick; Ng'ambi, Kumbukani; Laija, Kingsley; Wilson, Emily; Park, Lois; Wachepa, Sautso; Smith, Joseph; Gombwa, Lewis; Misomali, Amos; Mleme, Tiope; Yosefe, Simeon
2017-01-01
ABSTRACT Background: Routine health data can guide health systems improvements, but poor quality of these data hinders use. To address concerns about data quality in Malawi, the Ministry of Health and National Statistical Office conducted a data quality assessment (DQA) in July 2016 to identify systems-level factors that could be improved. Methods: We used 2-stage stratified random sampling methods to select health centers and hospitals under Ministry of Health auspices, included those managed by faith-based entities, for this DQA. Dispensaries, village clinics, police and military facilities, tertiary-level hospitals, and private facilities were excluded. We reviewed client registers and monthly reports to verify availability, completeness, and accuracy of data in 4 service areas: antenatal care (ANC), family planning, HIV testing and counseling, and acute respiratory infection (ARI). We also conducted interviews with facility and district personnel to assess health management information system (HMIS) functioning and systems-level factors that may be associated with data quality. We compared systems and quality factors by facility characteristics using 2-sample t tests with Welch's approximation, and calculated verification ratios comparing total entries in registers to totals from summarized reports. Results: We selected 16 hospitals (of 113 total in Malawi), 90 health centers (of 466), and 16 district health offices (of 28) in 16 of Malawi's 28 districts. Nearly all registers were available and complete in health centers and district hospitals, but data quality varied across service areas; median verification ratios comparing register and report totals at health centers ranged from 0.78 (interquartile range [IQR]: 0.25, 1.07) for ARI and 0.99 (IQR: 0.82, 1.36) for family planning to 1.00 (IQR: 0.96, 1.00) for HIV testing and counseling and 1.00 (IQR: 0.80, 1.23) for ANC. More than half (60%) of facilities reported receiving a documented supervisory visit for HMIS in the prior 6 months. A recent supervision visit was associated with better availability of data (P=.05), but regular district- or central-level supervision was not. Use of data by the facility to track performance toward targets was associated with both improved availability (P=.04) and completeness of data (P=.02). Half of facilities had a full-time statistical clerk, but their presence did not improve the availability or completeness of data (P=.39 and P=.69, respectively). Conclusion: Findings indicate both strengths and weaknesses in Malawi's HMIS performance, with key weaknesses including infrequent data quality checks and unreliable supervision. Efforts to strengthen HMIS in low- and middle-income countries should be informed by similar assessments. PMID:28963173
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Diep, Phuong Phuong; Lien, Lars; Hofman, Jan
2007-01-01
Malaria is a major threat to global health and is one of the leading causes of death worldwide. It is estimated that 2.3 billion people live in areas of malaria risk and each year 300-500 million cases of Plasmodium falciparum malaria occur worldwide. This parasitic infection is one of the major causes of morbidity and mortality in Africa and approximately 90% of cases which include life-threatening malaria are in children, the highest mortality rate being found in children under the age of five. Improvement in case-management of malaria in children is one of the strategies in the prevention of infant mortality. In particular, the health system needs to concentrate on good quality care at the first referral level of the district hospital, as health care provided at this level is crucial for reducing child mortality and for a credible and effective support for the primary health care system. The conduct of systematic assessments of clinical care of malaria including the diagnostic process, medical treatment and nursing care in order to reveal shortcomings in case-management and make improvements are vital. Clinical audit is now routinely used and accepted as part of quality assurance in the health care services of many developed countries, but it has yet to be widely applied to the developing world. The principal objective of the study conducted, was therefore to assess the clinical care of children with malaria at district hospital level in a low-income African country to highlight potential areas of improvement in the quality of care of malaria. At the same time, the specific objectives involved: Assessment of diagnostic process, medical treatment and nursing care; Identification of strengths and deficiencies in current practice; Identification of factors contributing to poor quality of care; Finding strategies to improve current practice.
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Arp, Christopher D.; Jones, Benjamin M.
2009-01-01
Lakes are abundant landforms and important ecosystems in Alaska, but are unevenly distributed on the landscape with expansive lake-poor regions and several lake-rich regions. Such lake-rich areas are termed lake districts and have landscape characteristics that can be considered distinctive in similar respects to mountain ranges. In this report, we explore the nature of lake-rich areas by quantitatively identifying Alaska's lake districts, describing and comparing their physical characteristics, and analyzing how Alaska lake districts are naturally organized and correspond to climatic and geophysical characteristics, as well as studied and managed by people. We use a digital dataset (National Hydrography Dataset) of lakes greater than 1 hectare, which includes 409,040 individual lakes and represents 3.3 percent of the land-surface area of Alaska. The selection criteria we used to identify lake districts were (1) a lake area (termed limnetic ratio, in percent) greater than the mean for the State, and (2) a lake density (number of lakes per unit area) greater than the mean for the State using a pixel size scaled to the area of interest and number of lakes in the census. Pixels meeting these criteria were grouped and delineated and all groups greater than 1,000 square kilometers were identified as Alaska's lake districts. These lake districts were described according to lake size-frequency metrics, elevation distributions, geology, climate, and ecoregions to better understand their similarities and differences. We also looked at where lake research and relevant ecological monitoring has occurred in Alaska relative to lake districts and how lake district lands and waters are currently managed. We identified and delineated 20 lake districts in Alaska representing 16 percent of the State, but including 65 percent of lakes and 75 percent of lake area. The largest lake districts identified are the Yukon-Kuskokwim Delta, Arctic Coastal Plain, and Iliamna lake districts with high limnetic ratios of 19, 17, and 21 percent, respectively. The three smallest districts we considered were Tetlin in the eastern interior, Menhiskof on the Alaska Peninsula, and Matanuska-Susitna at the head of Cook Inlet with limnetic ratios of 14, 9, and 9 percent, respectively. Lake density and limnetic ratio were poorly related among lake districts, such that some districts had a few large lakes like Iliamna with Lakes Iliamna and Becharof - the two largest in the State, compared to other districts with many very small lakes like Yukon-Kuskokwim Delta with 111,130 lakes and 63 percent of these less than 10 hectares. Most lake districts are in regions with relatively low precipitation, but temperature regimes varied widely among lake districts. Approximately one-half of lake districts were glaciated during the Pleistocene and similar numbers occur in regions classified as having continuous, discontinuous, and sporadic permafrost, or perennially unfrozen soils. Most districts are at low elevations (less than 250 meters) with two important exceptions being Tetlin with a mean elevation of 530 meters and Ahtna with a mean elevation of 760 meters. These higher elevation districts, particularly Ahtna, had distinct characteristics from other lake districts such as continuous permafrost and Pleistocene glaciation. Several lake districts share similar boundaries to defined ecoregions with lake districts occurring in less than one-half of these 32 ecoregions of Alaska. Most lake districts are lands fully or partly managed by the U.S. Fish and Wildlife Service and the National Park Service, with other land management by the Bureau of Land Management and State and borough government. Much of the U.S. Geological Survey's lake water-quality sampling efforts has been done in the Arctic Coastal Plain, Matanuska-Susitna, and Iliamna districts but no recorded collections in nine lake districts. Similarly, most lake limnological studies in Alaska were site-specific an
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Liu, Xiuhua; Li, Lin; Hu, Anyan
2013-03-01
The Jinghuiqu irrigation district is located in the semi-arid regions of northwestern China, where groundwater is the most important natural source for local industry, agriculture and residents. The present work was conducted in the Jinghuiqu irrigation district to characterize the groundwater aquifer, which has undergone long-term flood irrigation for over 2000 years. Isotopic and hydrochemical analyses, along with geological and hydrogeological tools, were used to determine the chemical properties and evolutionary processes of the groundwater aquifer. Results showed that the groundwater chemistry had changed significantly from 1990 to 2009. Water with concentrations of CaMgSO4 had decreased significantly, from 60% to 28% of the total water samples, during the period, while water with concentrations of NaSO4 and NaCl increased significantly, from 28% to 72%. The salinity of the groundwater increased rapidly and the affected area had expanded to most of the irrigation district. Stable isotope studies showed that most of the groundwater concentrations were derived from sulfate mineral dissolution. The minerals saturation indices (SI), ion ratios and oxygen isotope values of the groundwater indicated that the shallow groundwater had mainly experienced mineral dissolution, cation exchange, and mixing of the irrigated surface waters and groundwater. The groundwater quality had continuously evolved toward salinization as concentrations of SO4(2-) and Na+ grew to dominate it. Water quality risk analyses showed that most of the saline groundwater is not suitable for domestic and irrigation uses, especially in the middle and eastern parts of the irrigation district. These findings indicate that the irrigation district should strengthen the groundwater resources management.
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Nash, J. Thomas
2002-01-01
This report describes reconnaissance hydrogeochemical investigations of 22 mining districts on the Western Slope of Colorado in the Gunnison and Uncompahgre National Forests and adjacent public lands administered by the Bureau of Land Management. Sources and fates of contaminants from historic mines, mine waste, and mill tailings are interpreted from chemical analyses for 190 samples of surface waters; 185 samples of mined rocks, mill tailings, and altered rocks; and passive leach analyses of 116 samples of those mineralized materials. Short reaches of several headwater streams show relatively low level effects of historic mining; the headwaters of the Uncompahgre River are highly contaminated by mines and unmined altered rocks in the Red Mountain district. There is encouraging evidence that natural processes attenuate mine-related contamination in most districts.
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Water-quality data for canals in eastern Broward County, Florida, 1975-78
Sonntag, W.H.
1980-01-01
Increased urbanization in Broward County has contributed to canals being used as receptacles for urban wastes, sewage effluent, and stormwater runoff. The introduction of contaminants into the canals may affect the water quality. In 1969 the U.S. Geological Survey, in cooperation with the Broward County Pollution Control Board and the South Florida Water Management District, began to monitor the water-quality in canals of eastern Broward County. This report presents selected water-quality data collected from the canals, October 1974 through September 1978, in eastern Broward County. (Kosco-USGS)
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District decision-making for health in low-income settings: a systematic literature review
Avan, Bilal Iqbal
2016-01-01
Health management information systems (HMIS) produce large amounts of data about health service provision and population health, and provide opportunities for data-based decision-making in decentralized health systems. Yet the data are little-used locally. A well-defined approach to district-level decision-making using health data would help better meet the needs of the local population. In this second of four papers on district decision-making for health in low-income settings, our aim was to explore ways in which district administrators and health managers in low- and lower-middle-income countries use health data to make decisions, to describe the decision-making tools they used and identify challenges encountered when using these tools. A systematic literature review, following PRISMA guidelines, was undertaken. Experts were consulted about key sources of information. A search strategy was developed for 14 online databases of peer reviewed and grey literature. The resources were screened independently by two reviewers using pre-defined inclusion criteria. The 14 papers included were assessed for the quality of reported evidence and a descriptive evidence synthesis of the review findings was undertaken. We found 12 examples of tools to assist district-level decision-making, all of which included two key stages—identification of priorities, and development of an action plan to address them. Of those tools with more steps, four included steps to review or monitor the action plan agreed, suggesting the use of HMIS data. In eight papers HMIS data were used for prioritization. Challenges to decision-making processes fell into three main categories: the availability and quality of health and health facility data; human dynamics and financial constraints. Our findings suggest that evidence is available about a limited range of processes that include the use of data for decision-making at district level. Standardization and pre-testing in diverse settings would increase the potential that these tools could be used more widely. PMID:27591202
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-22
...EPA is making an interim final determination to stay the imposition of offset sanctions and to defer the imposition of highway sanctions based on a proposed approval of a revision to the Placer County Air Pollution Control District (PCAPCD) and Feather River Air Quality Management District (FRAQMD) portion of the California State Implementation Plan (SIP) published elsewhere in this Federal Register. The SIP revision concerns two permitting rules submitted by the PCAPCD and FRAQMD, respectively: Rule 502, New Source Review, and Rule 10.1, New Source Review.
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ERIC Educational Resources Information Center
Congress of the U.S., Washington, DC. Senate Committee on Governmental Affairs.
The focus of this hearing was on lessons learned in the District of Columbia public schools in the year preceding the hearing. In his opening remarks, Senator Brownback (Kansas) remarked that one of the first lessons is that the academic quality of the schools is not good enough and is in dire need of improvement. A second set of lessons focuses…
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Naranjo-Gil, David; Ruiz-Muñoz, David
2015-01-01
Healthcare supply expenses consume a large part of the financial resources allocated to public health. The aim of this study was to analyze the use of a benchmarking process in the management of hospital purchases, as well as its effect on product cost reduction and quality improvement. Data were collected through a survey conducted in 29 primary healthcare districts from 2010 to 2011, and through a healthcare database on the prices, quality, delivery time and supplier characteristics of 5373 products. The use of benchmarking processes reduced or eliminated products with a low quality and high price. These processes increased the quality of products by 10.57% and reduced their purchase price by 28.97%. The use of benchmarking by healthcare centers can reduce expenditure and allow more efficient management of the healthcare supply chain. It also facilitated the acquisition of products at lower prices and higher quality. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.
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Translating Deming's 14 Points for Education.
ERIC Educational Resources Information Center
Melvin, Charles A., III
1991-01-01
A consortium of four Wisconsin school districts has decided to stop tinkering with the educational system and apply W. Edward Deming's 14 management points to total system improvement. The rewritten precepts involve creating and adopting a fitting purpose, infusing quality into the educational "product," and working toward zero defects…
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DEVELOPMENT OF HAZARDOUS AIR POLLUTANT EMISSION FACTORS FROM STATE SOURCE TEST PROGRAMS
The report gives results of a study in which emission factors were evolved from test data obtained from several Air Quality Management Districts in California and from state environmental agencies in Louisiana, Maryland, New Jersey, and Texas. The emission factors were developed...
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Di Maria, Francesco, E-mail: francesco.dimaria@unipg.it; Micale, Caterina; Morettini, Emanuela
2015-10-15
Highlights: • LCA analysis of two option for residual waste management. • Exploitation of mechanical physical sorting facility for extracting recyclable from RMSW. • Processing the mechanically sorted organic fraction in bioreactor landfill. • Sensitivity analysis demonstrate high influence for impact assessment of substitution ratio for recycle materials. - Abstract: Starting from an existing waste management district without thermal treatment facilities, two different management scenarios for residual waste were compared by life cycle assessment (LCA). The adoption of a bioreactor landfill for managing the mechanically sorted organic fraction instead of bio-stabilization led to reduction of global warming and fresh watermore » eutrophication by 50% and 10%, respectively. Extraction of recyclables from residual waste led to avoided emissions for particulate matter, acidification and resource depletion impact categories. Marginal energy and the amount of energy recovered from landfill gas marginally affected the LCA results. On the contrary the quality of the recyclables extracted can significantly modify the eco profile of the management schemes.« less
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Seasonal Variation of Groundwater Quality in Erode District, Tamil Nadu, India.
Kavidha, R; Elangovan, K
2014-07-01
In recent years, the recurring environmental issues regarding hazardous waste, global climate change, stratospheric ozone depletion, groundwater contamination, disaster mitigation and removal of pollutant have become the focus of environmental attention. In the management of water resources, quality of water is just as important as its quantity. In order to assess the quality and/or suitability of groundwater for drinking and irrigation in Erode District, 144 water samples each in post-monsoon and pre-monsoon during the year 2007 were collected and analyzed for various parameters. These parameters were compared with IS: 10500-1991 drinking water standards. Out of 144 samples, 29 samples exceeded the permissible limit for both the monsoons, 71 samples were within the permissible limit for both the monsoons and the remaining samples exceeded the permissible limit for any one of the monsoon. During both monsoons, except some samples, most of the samples were suitable for drinking and irrigation.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-10-21
...] Huron, Madison, and Sand Lake Wetland Management District; Comprehensive Conservation Plan AGENCY: Fish... (CCP) and environmental assessment (EA) for the Huron, Madison, and Sand Lake Wetland Management...), Madison Wetland Management District, and Sand Lake Wetland Management District are part of the National...
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Antwi, Edward; Klipstein-Grobusch, Kerstin; Quansah Asare, Gloria; Koram, Kwadwo A; Grobbee, Diederick; Agyepong, Irene A
2016-01-01
The objectives were to assess the quality of health management information system (HMIS) data needed for assessment of local area variation in pregnancy-induced hypertension (PIH) incidence and to describe district and regional variations in PIH incidence. A retrospective review of antenatal and delivery records of 2682 pregnant women in 10 district hospitals in the Greater Accra and Upper West regions of Ghana was conducted in 2013. Quality of HMIS data was assessed by completeness of reporting. The incidence of PIH was estimated for each district. Key variables for routine assessment of PIH such as blood pressure (BP) at antenatal visits, weight and height were 95-100% complete. Fundal height, gestational age and BP at delivery were not consistently reported. The incidence of PIH differed significantly between Greater Accra region (6.1%) and Upper West region (3.2%). Prevalence of obesity among pregnant women in Greater Accra region (13.9%) was significantly higher than that of women in Upper West region (2.2%). More attention needs to be given to understanding local area variations in PIH and possible relationships with urbanisation and lifestyle changes that promote obesity, to inform maternal and newborn health policy. This can be done with good quality routine HMIS data. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
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Odhiambo-Otieno, George W; Odero, Wilson W O
2005-03-01
The District Health Management Information Systems (DHMISs) were established by the Ministry of Health (MoH) in Kenya more than two decades ago. Since then, no comprehensive evaluation has been undertaken. This can partly be attributed to lack of defined criteria for evaluating them. To propose evaluation criteria for assessing the design, implementation and impact of DHMIS in the management of the District Health System (DHS) in Kenya. A descriptive cross-sectional study conducted in three DHSs in Kenya: Bungoma, Murang'a and Uasin Gishu districts. Data was collected through focus group discussions, key informant interviews, and documents' review. The respondents, purposely selected from the Ministry of Health headquarters and the three DHS districts, included designers, managers and end-users of the systems. A set of evaluation criteria for DHMISs was identified for each of the three phases of implementation: pre-implementation evaluation criteria (categorised as policy and objectives, technical feasibility, financial viability, political viability and administrative operability) to be applied at the design stage; concurrent implementation evaluation criteria to be applied during implementation of the new system; and post-implementation evaluation criteria (classified as internal - quality of information; external - resources and managerial support; ultimate - systems impact) to be applied after implementation of the system for at least three years. In designing a DHMIS model there is need to have built-in these three sets of evaluation criteria which should be used in a phased manner. Pre-implementation evaluation criteria should be used to evaluate the system's viability before more resources are committed to it; concurrent (operational) - implementation evaluation criteria should be used to monitor the process; and post-implementation evaluation criteria should be applied to assess the system's effectiveness.
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Palmer, Celia; Bycroft, Janine; Healey, Kate; Field, Adrian; Ghafel, Mazin
2012-12-01
Auckland District Health Board was one of four District Health Boards to trial the Breakthrough Series (BTS) methodology to improve the management of long-term conditions in New Zealand, with support from the Ministry of Health. To improve clinical outcomes, facilitate planned care and promote quality improvement within participating practices in Auckland. Implementation of the Collaborative followed the improvement model / Institute for Healthcare Improvement methodology. Three topic areas were selected: system redesign, cardio-vascular disease/diabetes, and self-management support. An expert advisory group and the Improvement Foundation Australia helped guide project development and implementation. Primary Health Organisation facilitators were trained in the methodology and 15 practice teams participated in the three learning workshops and action periods over 12 months. An independent evaluation study using both quantitative and qualitative methods was conducted. Improvements were recorded in cardiovascular disease risk assessment, practice-level systems of care, self-management systems and follow-up and coordination for patients. Qualitative research found improvements in coordination and teamwork, knowledge of practice populations and understanding of managing long-term conditions. The Collaborative process delivered some real improvements in the systems of care for people with long-term conditions and a change in culture among participating practices. The findings suggest that by strengthening facilitation processes, improving access to comprehensive population audit tools and lengthening the time frame, the process has the potential to make significant improvements in practice. Other organisations should consider this approach when investigating quality improvement programmes.
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Solberg, Patricia A.; Moore, Bryan; Blacklock, Ty D.
2012-01-01
Population growth and changes in land use have the potential to affect water quality and quantity in the upper Gunnison River Basin. In 1995, the U.S. Geological Survey (USGS), in cooperation with the Bureau of Land Management, City of Gunnison, Colorado River Water Conservation District, Crested Butte South Metropolitan District, Gunnison County, Hinsdale County, Mount Crested Butte Water and Sanitation District, National Park Service, Town of Crested Butte, U.S. Forest Service, Upper Gunnison River Water Conservancy District, and Western State College, established a water-quality monitoring program in the upper Gunnison River Basin to characterize current water-quality conditions and to assess the effects of increased urban development and other land-use changes on water quality. The monitoring network has evolved into two groups of sites: (1) sites that are considered long term and (2) sites that are considered rotational. Data from the long-term sites assist in defining temporal changes in water quality (how conditions may change over time). The rotational sites assist in the spatial definition of water-quality conditions (how conditions differ throughout the basin) and address local and short-term concerns. Biannual summaries of the water-quality data from the monitoring network provide a point of reference for stakeholder discussions regarding the location and purpose of water-quality monitoring sites in the upper Gunnison River Basin. This report compares and summarizes the data collected during water years 2008 and 2009 to the historical data available at these sites. The introduction provides a map of the sampling sites, definitions of terms, and a one-page summary of selected water-quality conditions at the network sites. The remainder of the report is organized around the data collected at individual sites. Data collected during water years 2008 and 2009 are compared to historical data, State water-quality standards, and Federal water-quality guidelines. A seasonal Kendall test for trend analysis is completed when there is sufficient data (typically >5 years) at the station. Data were collected following USGS protocols.
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77 FR 65905 - Meeting of the California Desert District Advisory Council
Federal Register 2010, 2011, 2012, 2013, 2014
2012-10-31
... updates by council members, the BLM California Desert District manager, five field office managers, and...) 697-5220. Dated: October 23, 2012. Teresa A. Raml, District Manager, California Desert District. [FR...
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14 CFR 91.1017 - Amending program manager's management specifications.
Code of Federal Regulations, 2014 CFR
2014-01-01
... proposed amendment. (2) The Flight Standards District Office that issued the program manager's management... presented, the Flight Standards District Office that issued the program manager's management specifications... Standards District Office that issued the program manager's management specifications issues an amendment of...
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14 CFR 91.1017 - Amending program manager's management specifications.
Code of Federal Regulations, 2012 CFR
2012-01-01
... proposed amendment. (2) The Flight Standards District Office that issued the program manager's management... presented, the Flight Standards District Office that issued the program manager's management specifications... Standards District Office that issued the program manager's management specifications issues an amendment of...
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WebDMS: A Web-Based Data Management System for Environmental Data
NASA Astrophysics Data System (ADS)
Ekstrand, A. L.; Haderman, M.; Chan, A.; Dye, T.; White, J. E.; Parajon, G.
2015-12-01
DMS is an environmental Data Management System to manage, quality-control (QC), summarize, document chain-of-custody, and disseminate data from networks ranging in size from a few sites to thousands of sites, instruments, and sensors. The server-client desktop version of DMS is used by local and regional air quality agencies (including the Bay Area Air Quality Management District, the South Coast Air Quality Management District, and the California Air Resources Board), the EPA's AirNow Program, and the EPA's AirNow-International (AirNow-I) program, which offers countries the ability to run an AirNow-like system. As AirNow's core data processing engine, DMS ingests, QCs, and stores real-time data from over 30,000 active sensors at over 5,280 air quality and meteorological sites from over 130 air quality agencies across the United States. As part of the AirNow-I program, several instances of DMS are deployed in China, Mexico, and Taiwan. The U.S. Department of State's StateAir Program also uses DMS for five regions in China and plans to expand to other countries in the future. Recent development has begun to migrate DMS from an onsite desktop application to WebDMS, a web-based application designed to take advantage of cloud hosting and computing services to increase scalability and lower costs. WebDMS will continue to provide easy-to-use data analysis tools, such as time-series graphs, scatterplots, and wind- or pollution-rose diagrams, as well as allowing data to be exported to external systems such as the EPA's Air Quality System (AQS). WebDMS will also provide new GIS analysis features and a suite of web services through a RESTful web API. These changes will better meet air agency needs and allow for broader national and international use (for example, by the AirNow-I partners). We will talk about the challenges and advantages of migrating DMS to the web, modernizing the DMS user interface, and making it more cost-effective to enhance and maintain over time.
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Improving Tanzanian childbirth service quality.
Jaribu, Jennie; Penfold, Suzanne; Green, Cathy; Manzi, Fatuma; Schellenberg, Joanna
2018-04-16
Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.
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ERIC Educational Resources Information Center
Utah State Univ., Logan. Center for Persons with Disabilities.
This project studied the effects of implementing a computerized management information system developed for special education administrators. The Intelligent Administration Support Program (IASP), an expert system and database program, assisted in information acquisition and analysis pertaining to the district's quality of decisions and procedures…
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RAND Review. Volume 28, Number 2, Summer 2004
2004-01-01
received an average of 23 percent district of Tijuana , more for unprotected sex (and up to 46 percent more if Mexico, displays the workers were judged...management. "Improvement in access to medica - eral ways, according to the reports. Vulnerable elders tions without quality assurance may result in a mere
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40 CFR 59.508 - What test methods must I use?
Code of Federal Regulations, 2010 CFR
2010-07-01
... the metal content of metallic aerosol coating products, you must use South Coast Air Quality Management District (SCAQMD) Method 318-95, Determination of Weight Percent Elemental Metal in Coatings by X-ray Diffraction, July, 1996, in 40 CFR part 59 (incorporated by reference in § 59.515). To determine...
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40 CFR 59.508 - What test methods must I use?
Code of Federal Regulations, 2011 CFR
2011-07-01
... the metal content of metallic aerosol coating products, you must use South Coast Air Quality Management District (SCAQMD) Method 318-95, Determination of Weight Percent Elemental Metal in Coatings by X-ray Diffraction, July, 1996, in 40 CFR part 59 (incorporated by reference in § 59.515). To determine...
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J.R. Simpson; E.G. McPherson
2011-01-01
Urban trees can produce a number of benefits, among them improved air quality. Biogenic volatile organic compounds (BVOCs) emitted by some species are ozone precursors. Modifying future tree planting to favor lower-emitting species can reduce these emissions and aid air management districts in meeting federally mandated emissions reductions for these compounds. Changes...
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South Coast Air Quality Management District Truck Testing | Transportation
movement of cargo containers, also known as drayage, creates substantial air pollution in the vicinity of and U.S. Hybrid Corporation, transport cargo containers between the port complex and local rail yards and distribution centers. Utilizing advanced batteries and high-efficiency components, the electric
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Advisory on Relocatable and Renovated Classrooms. IAQ Info Sheet.
ERIC Educational Resources Information Center
California State Dept. of Health Services, Berkeley.
Many California school districts, in complying with the Class Size Reduction Program, will obtain relocatable classrooms directly from manufacturers who are under no specific guidelines or codes relative to indoor air quality (IAQ). This document, designed to aid school facility managers in minimizing potential IAQ problems, summarizes the indoor…
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-10-14
...-year evaluations of eight state air pollution control programs (Alabama Department of Environmental... Management, FL; Louisville Metro Air Pollution Control District, KY; Forsyth County Environmental Affairs... Regional Air Quality Agency, NC; Chattanooga-Hamilton County Air Pollution Control Bureau, TN; Memphis...
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30 CFR 75.337 - Construction and repair of seals.
Code of Federal Regulations, 2010 CFR
2010-07-01
... record shall be countersigned by the mine foreman or equivalent mine official by the end of the mine foreman's or equivalent mine official's next regularly scheduled working shift. The record shall be kept... quality control results to the District Manager for seal material properties specified by § 75.335 within...
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30 CFR 75.337 - Construction and repair of seals.
Code of Federal Regulations, 2011 CFR
2011-07-01
... record shall be countersigned by the mine foreman or equivalent mine official by the end of the mine foreman's or equivalent mine official's next regularly scheduled working shift. The record shall be kept... quality control results to the District Manager for seal material properties specified by § 75.335 within...
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EPA is making an interim final determination to defer imposition of sanctions based on a proposed determination that CARB submitted rules on behalf of BAAQMD that satisfy part D of the Clean Air Act for areas under the jurisdiction of the BAAQMD.
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[The operation of the health program SICALIDAD: the role of managers in primary care and hospitals].
Granados-Cosme, José Arturo; Tetelboin-Henrion, Carolina; Torres-Cruz, César; Pineda-Pérez, Dayana; Villa-Contreras, Blanca Margarita
2011-01-01
To characterize the role of quality managers in health care units and health districts, identifying the constraints they experience in their performance. An interview guide and a questionnaire were carried out and were applied to quality managers in nine states as well as in Mexico City´s Health Services, in a Reference Federal Hospital and in a National Institute of Health. These instruments were analyzed using SPSS and Atlas.ti software. The activities done by the managers depend on the organizational level of services, which can be a care unit or the health jurisdiction. For each of these, we identified different order constraints that affect the performance of the role of management in the strategies to improve the quality of the services for population without social insurance, which together make up the government program called Integrated Quality Health System. Jurisdictional managers are the link between care units and state authorities in the management of information, while the medical units' managers drive operational strategies to improve the quality. Although the health program is implemented with the personal and infrastructure of the health system, it requires a greater institutionalization and strengthening of its structure and integration, as well as greater human and material resources.
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Gower, Amy L; Cousin, Molly; Borowsky, Iris W
2017-03-01
Although nearly all states in the United States require school districts to adopt anti-bullying policies, little research examines the effect of these policies on student bullying and health. Using a statewide sample, we investigated associations between the quality of school district anti-bullying policies and student bullying involvement and adjustment. School district anti-bullying policies (N = 208) were coded for their quality based on established criteria. District-level data were combined with student reports of bullying involvement, emotional distress, and school connectedness from a state surveillance survey of 6th, 9th, and 12th grade students (N = 93,437). Results indicated that policy quality was positively related to bullying victimization. Furthermore, students reporting frequent perpetration/victimization who also attended districts with high-quality policies reported more emotional distress and less school connectedness compared with students attending districts with low quality policies. Although statistically significant, the magnitude of these associations was small. Having a high-quality school district anti-bullying policy is not sufficient to reduce bullying and protect bullying-involved young people. Future studies examining policy implementation will inform best practices in bullying prevention. © 2017, American School Health Association.
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Twum-Danso, Nana A Y; Akanlu, George B; Osafo, Enoch; Sodzi-Tettey, Sodzi; Boadu, Richard O; Atinbire, Solomon; Adondiwo, Ane; Amenga-Etego, Isaac; Ashagbley, Francis; Boadu, Eric A; Dasoberi, Ireneous; Kanyoke, Ernest; Yabang, Elma; Essegbey, Ivan T; Adjei, George A; Buckle, Gilbert B; Awoonor-Williams, J Koku; Nang-Beifubah, Alexis; Twumasi, Akwasi; McCannon, C Joseph; Barker, Pierre M
2012-12-01
The gap between evidence-based guidelines and practice of care is reflected, in low- and middle-income countries, by high rates of maternal and child mortality and limited effectiveness of large-scale programing to decrease those rates. We designed a phased, rapid, national scale-up quality improvement (QI) intervention to accelerate the achievement of Millennium Development Goal Four in Ghana. Our intervention promoted systems thinking, active participation of managers and frontline providers, generation and testing of local change ideas using iterative learning from transparent district and local data, local ownership and sustainability. After 50 months of implementation, we have completed two prototype learning phases and have begun regional spread phases to all health facilities in all 38 districts of the three northernmost regions and all 29 Catholic hospitals in the remaining regions of the country. To accelerate the spread of improvement, we developed 'change packages' of rigorously tested process changes along the continuum of care from pregnancy to age 5 in both inpatient and outpatient settings. The primary successes for the project so far include broad and deep adoption of QI by local stakeholders for improving system performance, widespread capacitation of leaders, managers and frontline providers in QI methods, incorporation of local ideas into change packages and successful scale-up to approximately 25% of the country's districts in 3 years. Implementation challenges include variable leadership uptake and commitment at the district level, delays due to recruiting and scheduling barriers, weak data systems and repeated QI training due to high staff turnover.
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Langston, Anne; Weiss, Jennifer; Landegger, Justine; Pullum, Thomas; Morrow, Melanie; Kabadege, Melene; Mugeni, Catherine; Sarriot, Eric
2014-01-01
ABSTRACT Background: The Kabeho Mwana project (2006–2011) supported the Rwanda Ministry of Health (MOH) in scaling up integrated community case management (iCCM) of childhood illness in 6 of Rwanda's 30 districts. The project trained and equipped community health workers (CHWs) according to national guidelines. In project districts, Kabeho Mwana staff also trained CHWs to conduct household-level health promotion and established supervision and reporting mechanisms through CHW peer support groups (PSGs) and quality improvement systems. Methods: The 2005 and 2010 Demographic and Health Surveys were re-analyzed to evaluate how project and non-project districts differed in terms of care-seeking for fever, diarrhea, and acute respiratory infection symptoms and related indicators. We developed a logit regression model, controlling for the timing of the first CHW training, with the district included as a fixed categorical effect. We also analyzed qualitative data from the final evaluation to examine factors that may have contributed to improved outcomes. Results: While there was notable improvement in care-seeking across all districts, care-seeking from any provider for each of the 3 conditions, and for all 3 combined, increased significantly more in the project districts. CHWs contributed a larger percentage of consultations in project districts (27%) than in non-project districts (12%). Qualitative data suggested that the PSG model was a valuable sub-level of CHW organization associated with improved CHW performance, supervision, and social capital. Conclusions: The iCCM model implemented by Kabeho Mwana resulted in greater improvements in care-seeking than those seen in the rest of the country. Intensive monitoring, collaborative supervision, community mobilization, and CHW PSGs contributed to this success. The PSGs were a unique contribution of the project, playing a critical role in improving care-seeking in project districts. Effective implementation of iCCM should therefore include CHW management and social support mechanisms. Finally, re-analysis of national survey data improved evaluation findings by providing impact estimates. PMID:25276593
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Pesticide poisoning in south India: opportunities for prevention and improved medical management.
Srinivas Rao, Ch; Venkateswarlu, V; Surender, T; Eddleston, Michael; Buckley, Nick A
2005-06-01
Warangal district in Andhra Pradesh, southern India, records >1000 pesticide poisoning cases each year and hundreds of deaths. We aimed to describe their frequency and distribution, and to assess quality of management and subsequent outcomes from pesticide poisoning in one large hospital in the district. We reviewed data on all patients admitted with pesticide poisoning to a district government hospital for the years 1997 to 2002. For 2002, details of the particular pesticide ingested and management were abstracted from the medical files. During these 6 years, 8040 patients were admitted to the hospital with pesticide poisoning. The overall case fatality ratio was 22.6%. More detailed data from 2002 revealed that two-thirds of the patients were <30 years old, 57% were male and 96% had intentionally poisoned themselves. Two compounds, monocrotophos and endosulfan, accounted for the majority of deaths with known pesticides in 2002. Low fixed-dose regimens were used in the majority of cases for the most commonly used antidotes (atropine and pralidoxime). Inappropriate antidotes were also used in some patients. It is likely that these findings reflect the situation in many rural hospitals of the Asia Pacific region. Even without an increase in resources, there appear to be significant opportunities for reducing mortality by better medical management and further restrictions on the most toxic pesticides.
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NASA Astrophysics Data System (ADS)
Bedsworth, L. W.; Ekstrom, J.
2017-12-01
As the climate continues to shift, projections show amplified and more frequent extreme events, including coastal and inland flooding, wildfires, prolonged droughts, and heatwaves. Vital public goods, both air quality and water quality, can be critically affected by such extreme events. Climate change will make it increasingly difficult for managers to achieve public health targets for air and water quality. Successfully preparing governance structures developed to maintain and improve air and water quality may benefit from preventative strategies to avoid public health impacts and costs of climate change locally. Perceptions of climate change and its risks, actions taken so far, and perceived barriers to adaptation give insight into the needs of managers for preparing for climate change impacts. This paper compares results of two surveys that looked at local level management of air quality and water quality in California. Air quality managers consistently reported to recognize the risks of climate change on their sector, where water quality managers' perceptions varied between no concern to high concern. We explore the differences in governance, capacity influence the ill-defined responsibility and assumed roles of water and air districts in adaptation to extreme events increasing with climate change. The chain and network of managing air quality is compared with that of water quality - laying out similarities and differences. Then we compare how the survey respondents differed in terms of extreme weather-influenced threats to environmental quality. We end with a discussion of responsibility - where in the chain of managing these life-critical ecosystem services, is the need greatest for adapting to climate change and what does this mean for the other levels in the chain beyond the local management.
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Bonenberger, Marc; Aikins, Moses; Akweongo, Patricia; Bosch-Capblanch, Xavier; Wyss, Kaspar
2015-01-01
Ineffective district health management potentially impacts on health system performance and service delivery. However, little is known about district health managing practices and time allocation in resource-constrained health systems. Therefore, a time use study was conducted in order to understand current time use practices of district health managers in Ghana. All 21 district health managers working in three districts of the Eastern Region were included in the study and followed for a period of three months. Daily retrospective interviews about their time use were conducted, covering 1182 person-days of observation. Total time use of the sample population was assessed as well as time use stratified by managerial position. Differences of time use over time were also evaluated. District health managers used most of their working time for data management (16.6%), attending workshops (12.3%), financial management (8.7%), training of staff (7.1%), drug and supply management (5.0%), and travelling (9.6%). The study found significant variations of time use across the managerial cadres as well as high weekly variations of time use impulsed mainly by a national vertical program. District health managers in Ghana use substantial amounts of their working time in only few activities and vertical programs greatly influence their time use. Our findings suggest that efficiency gains are possible for district health managers. However, these are unlikely to be achieved without improvements within the general health system, as inefficiencies seem to be largely caused by external factors.
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Quality of integrated chronic disease care in rural South Africa: user and provider perspectives
Klipstein-Grobusch, Kerstin; D’ambruoso, Lucia; Kahn, Kathleen; Tollman, Stephen M; Gómez-Olivé, Francesc Xavier
2017-01-01
The integrated chronic disease management (ICDM) model was introduced as a response to the dual burden of HIV/AIDS and non-communicable diseases (NCDs) in South Africa, one of the first of such efforts by an African Ministry of Health. The aim of the ICDM model is to leverage HIV programme innovations to improve the quality of chronic disease care. There is a dearth of literature on the perspectives of healthcare providers and users on the quality of care in the novel ICDM model. This paper describes the viewpoints of operational managers and patients regarding quality of care in the ICDM model. In 2013, we conducted a case study of the seven PHC facilities in the rural Agincourt sub-district in northeast South Africa. Focus group discussions (n = 8) were used to obtain data from 56 purposively selected patients ≥18 years. In-depth interviews were conducted with operational managers of each facility and the sub-district health manager. Donabedian’s structure, process and outcome theory for service quality evaluation underpinned the conceptual framework in this study. Qualitative data were analysed, with MAXQDA 2 software, to identify 17 a priori dimensions of care and unanticipated themes that emerged during the analysis. The manager and patient narratives showed the inadequacies in structure (malfunctioning blood pressure machines and staff shortage); process (irregular prepacking of drugs); and outcome (long waiting times). There was discordance between managers and patients regarding reasons for long patient waiting time which managers attributed to staff shortage and missed appointments, while patients ascribed it to late arrival of managers to the clinics. Patients reported anti-hypertension drug stock-outs (structure); sub-optimal defaulter-tracing (process); rigid clinic appointment system (process). Emerging themes showed that patients reported HIV stigmatisation in the community due to defaulter-tracing activities of home-based carers, while managers reported treatment of chronic diseases by traditional healers and reduced facility-related HIV stigma because HIV and NCD patients attended the same clinic. Leveraging elements of HIV programmes for NCDs, specifically hypertension management, is yet to be achieved in the study setting in part because of malfunctioning blood pressure machines and anti-hypertension drug stock-outs. This has implications for the nationwide scale up of the ICDM model in South Africa and planning of an integrated chronic disease care in other low- and middle-income countries. PMID:28207046
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Quality of integrated chronic disease care in rural South Africa: user and provider perspectives.
Ameh, Soter; Klipstein-Grobusch, Kerstin; D'ambruoso, Lucia; Kahn, Kathleen; Tollman, Stephen M; Gómez-Olivé, Francesc Xavier
2017-03-01
The integrated chronic disease management (ICDM) model was introduced as a response to the dual burden of HIV/AIDS and non-communicable diseases (NCDs) in South Africa, one of the first of such efforts by an African Ministry of Health. The aim of the ICDM model is to leverage HIV programme innovations to improve the quality of chronic disease care. There is a dearth of literature on the perspectives of healthcare providers and users on the quality of care in the novel ICDM model. This paper describes the viewpoints of operational managers and patients regarding quality of care in the ICDM model. In 2013, we conducted a case study of the seven PHC facilities in the rural Agincourt sub-district in northeast South Africa. Focus group discussions (n = 8) were used to obtain data from 56 purposively selected patients ≥18 years. In-depth interviews were conducted with operational managers of each facility and the sub-district health manager. Donabedian’s structure, process and outcome theory for service quality evaluation underpinned the conceptual framework in this study. Qualitative data were analysed, with MAXQDA 2 software, to identify 17 a priori dimensions of care and unanticipated themes that emerged during the analysis. The manager and patient narratives showed the inadequacies in structure (malfunctioning blood pressure machines and staff shortage); process (irregular prepacking of drugs); and outcome (long waiting times). There was discordance between managers and patients regarding reasons for long patient waiting time which managers attributed to staff shortage and missed appointments, while patients ascribed it to late arrival of managers to the clinics. Patients reported anti-hypertension drug stock-outs (structure); sub-optimal defaulter-tracing (process); rigid clinic appointment system (process). Emerging themes showed that patients reported HIV stigmatisation in the community due to defaulter-tracing activities of home-based carers, while managers reported treatment of chronic diseases by traditional healers and reduced facility-related HIV stigma because HIV and NCD patients attended the same clinic. Leveraging elements of HIV programmes for NCDs, specifically hypertension management, is yet to be achieved in the study setting in part because of malfunctioning blood pressure machines and anti-hypertension drug stock-outs. This has implications for the nationwide scale up of the ICDM model in South Africa and planning of an integrated chronic disease care in other low- and middle-income countries.
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Summaries of Minnehaha Creek Watershed District Plans/Studies/Reports
2004-01-30
34+ Management of all wetland functional assessment data in a Microsoft Access© database "+ Development of a GIS wetland data management system "+ Recommendations...General Task B Design GIS -Based Decision Making Model: Scenario-Based $125,000 $125,000 Model of Landuse Hydro Data Monitoring Task C Water Quality...Landuse and Land cover data + Watershed GIS data layers + Flood Insurance Rate Maps + Proposed project locations + Stream miles, reaches and conditions
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Şahin, Charlotte; Iseringhausen, Olaf; Hower, Kira; Liebe, Constanze; Rethmeier-Hanke, Anja; Wedmann, Bernd
2018-04-01
Regional planning of healthcare requires special consideration for the complex needs of elderly, multimorbid people living in a domestic environment. In the District of Lippe, a hospital (Klinikum Lippe) and network of ambulatory care physicians (Ärztenetz Lippe) developed and tested a geriatric care network based on case management for geriatric patients living in a domestic environment. The establishment of the geriatric care network (e.g. promoting networking acceptance and implementation) was formatively evaluated, e. g. with qualitative methods. Data were acquired by guideline-based interviews with experts and analyzed by qualitative content analysis according to Mayring. Structural effects included forming a cross-sectoral and interdisciplinary network for a functioning care network and a geriatric care pathway. The practical work of case managers (CM) is essential for communication with patients, family members and care providers as well as integrating providers into the network. A critical factor was working together with general practitioners and the close cooperation with the hospital's department of geriatric. The quality of care is improved because of exchange of information between sectors and continuity in the course of care. In the District of Lippe the quality of care was improved and structures of care were integrated by the network according to the needs of the target group. The integrative perspective was achieved in particular by the geriatric care pathway and integration of providers into the communication and care process; however, the scope of this care model could not be extended into routine care due to the rigid and subdivided health care system.
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School policies and practices that improve indoor air quality.
Everett Jones, Sherry; Smith, Alisa M; Wheeler, Lani S; McManus, Tim
2010-06-01
To determine whether schools with a formal indoor air quality management program were more likely than schools without a formal program to have policies and practices that promote superior indoor air quality. This study analyzed school-level data from the 2006 School Health Policies and Programs Study, a national study of school health programs and policies at the state, district, and school levels. Using chi-square analyses, the rates of policies and practices that promote indoor air quality were compared between schools with and schools without a formal indoor air quality program. The findings of this study show that 51.4% of schools had a formal indoor air quality management program, and that those schools were significantly more likely than were schools without a program to have policies and use strategies to promote superior indoor air quality. These findings suggest that schools with a formal indoor air quality program are more likely support policies and engage in practices that promote superior indoor air quality.
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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. Copyright © 2012 John Wiley & Sons, Ltd.
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A district confidential enquiry into deaths due to asthma.
Wareham, N. J.; Harrison, B. D.; Jenkins, P. F.; Nicholls, J.; Stableforth, D. E.
1993-01-01
BACKGROUND--The aim was to establish a continuing district based confidential enquiry into deaths from asthma. METHODS--A confidential enquiry was conducted in an English health district. Subjects comprised 24 residents of the Norwich health district aged between 16 and 65 years who had died between 1988 and 1991 with asthma as the principal cause of death. RESULTS--Twenty one of the patients (88%) died away from hospital. Overall the routine asthma management was appropriate in all respects in only four patients. In five cases the drug treatment was considered inappropriate, in 10 cases (42%) there was no written evidence that the patient had received advice and education, and only six cases had a written management plan. In 17 patients (71%) the fatal attack of asthma developed rapidly (in under three hours). The medical care during the final attack was found to have been inappropriate in six cases. Seventeen cases (71%) had psychological or social factors that were considered to have been of potential importance. CONCLUSIONS--This study has shown the feasibility of organising a confidential enquiry into asthma deaths within a health district. The distinguishing features of such an enquiry are that it is continuing, that the quality of care given to those patients who died is compared against a recognised standard, and that there is a structured system for feeding back the conclusions of the enquiry to the local medical community. PMID:8296254
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NASA Astrophysics Data System (ADS)
Wang, Xiaohan; Yang, Jianghua; Pu, Lijie; Chen, Xinjian
2017-04-01
Large area of tidal flats in Chinese coast has been reclaimed to support agriculture and urban development because of rapid population and economic growth. Knowledge of soil development mechanisms is essential for efficient management of land resources in coastal zone. So far, most studies have focused on consequences of soil physico-chemical properties on soil quality evolution after tideland reclamation for cultivation; yet a large part of soil bioprocess drives many soil processes. The effect of organism composition on the performance of soil development remains unclear. The purpose of our work was to reveal the organism composition change and its influence on soil quality impotent. In this study, we choose seven reclamation districts along a chronosequence in eastern coast of China, which were respectively reclaimed in 1956, 1971, 1980, 1997, 2009, 2013 and unenclosed tidal flat. The latest districts reclaimed in 2013 were left to succession fallow which were covered with halophytic vegetation and the rest districts were agriculturally managed. Soil samples at 0-20 cm were collected in each district. Soil physical, chemical and biological properties and wheat yields were measured. The result showed after the transformation from tidal flat to cropland, longer tillage time (>5 year) lead to higher soil clay and silt, SOC contents and lower bulk density, while soil clay and C contents declined within the first 5 years after reclamation. Agricultural reclamation significantly improved SOC contents of 0-20 cm depth form 0.11±0.05% to 0.77±0.10%. It needs about 35 years to achieve stable yield level after reclamation. Meanwhile, the soil community composition changed strongly over time. More significant relationships were found among soil physicochemical properties and bacteria community. And the variation trend of soil community richness (chao1) is similar to soil C contents, dropped at first 5 years and then significantly increased. Our results indicate that the soil biodiversity growth promotes the soil quality recovery after crop cultivation. Both the soil physical environment and fertility were improved.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-27
...EPA is finalizing a limited approval and limited disapproval of permitting rules submitted for the Placer County Air Pollution Control District (PCAPCD) and Feather River Air Quality Management District (FRAQMD) portions of the California State Implementation Plan (SIP). These revisions were proposed in the Federal Register on May 19, 2011 and concern New Source Review (NSR) permit programs for new and modified major stationary sources of air pollution. We are approving local rules that regulate these emission sources under the Clean Air Act as amended in 1990 (CAA or the Act).
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Bonenberger, Marc; Aikins, Moses; Akweongo, Patricia; Bosch-Capblanch, Xavier; Wyss, Kaspar
2015-01-01
Background Ineffective district health management potentially impacts on health system performance and service delivery. However, little is known about district health managing practices and time allocation in resource-constrained health systems. Therefore, a time use study was conducted in order to understand current time use practices of district health managers in Ghana. Methods All 21 district health managers working in three districts of the Eastern Region were included in the study and followed for a period of three months. Daily retrospective interviews about their time use were conducted, covering 1182 person-days of observation. Total time use of the sample population was assessed as well as time use stratified by managerial position. Differences of time use over time were also evaluated. Results District health managers used most of their working time for data management (16.6%), attending workshops (12.3%), financial management (8.7%), training of staff (7.1%), drug and supply management (5.0%), and travelling (9.6%). The study found significant variations of time use across the managerial cadres as well as high weekly variations of time use impulsed mainly by a national vertical program. Conclusions District health managers in Ghana use substantial amounts of their working time in only few activities and vertical programs greatly influence their time use. Our findings suggest that efficiency gains are possible for district health managers. However, these are unlikely to be achieved without improvements within the general health system, as inefficiencies seem to be largely caused by external factors. PMID:26068907
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Small Districts in Big Trouble: How Four Arizona School Systems Responded to Charter Competition.
ERIC Educational Resources Information Center
Hess, Frederick; Maranto, Robert; Milliman, Scott
2001-01-01
Examined the responses to charter school competition of four small Arizona school districts. Overall, districts lost students to charter schools because they did not satisfy significant constituencies. Their responses depended on overall enrollment trends, quality of charter competition, quality of district leadership, and district size. Responses…
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Alleyne, Jo; Jumaa, Mansour Olawale
2007-03-01
The general aims of this article were to facilitate primary care nurses (District Nurse Team Leaders) to link management and leadership theories with clinical practice and to improve the quality of the service provided to their patients. The specific aim was to identify, create and evaluate effective processes for collaborative working so that the nurses' capacity for clinical decision-making could be improved. This article, part of a doctoral study on Clinical Leadership in Nursing, has wider application in the workplace of the future where professional standards based on collaboration will be more critical in a world of work that will be increasingly complex and uncertain. This article heralds the type of research and development activities that the nursing and midwifery professions should give premier attention to, particularly given the recent developments within the National Health Service in the United Kingdom. The implications of: Agenda for Change, the Knowledge and Skills Framework, 'Our Health, Our Care, Our Say' and the recent proposals from the article 'Modernising Nursing Career', to name but a few, are the key influences impacting on and demanding new ways of clinical supervision for nurses and midwives to improve the quality of patient management and services. The overall approach was based on an action research using a collaborative enquiry within a case study. This was facilitated by a process of executive co-coaching for focused group clinical supervision sessions involving six district nurses as co-researchers and two professional doctoral candidates as the main researchers. The enquiry conducted over a period of two and a half years used evidence-based management and leadership interventions to assist the participants to develop 'actionable knowledge'. Group clinical supervision was not practised in this study as a form of 'therapy' but as a focus for the development of actionable knowledge, knowledge needed for effective clinical management and leadership in the workplace. 1. Management and leadership interventions and approaches have significantly influenced the participants' capacity to improve the quality of services provided to their patients. 2. Using various techniques, tools, methods and frameworks presented at the sessions increased participants' confidence to perform. 3. A structured approach like the Clinical Nursing Leadership Learning and Action Process (CLINLAP) model makes implementing change more practical and manageable within a turbulent care environment. The process of Stakeholder Mapping and Management made getting agreement to do things differently much easier. Generally it is clear that many nurses and midwives, according to the participants, have to carry out management and leadership activities in their day-to-day practice. The traditional boundary between the private, the public and the voluntary sector management is increasingly becoming blurred. It is conclusive that the district nurses on this innovative programme demonstrated how they were making sense of patterns from the past, planning for the future and facilitating the clinical nursing leadership processes today to improve quality patient services tomorrow. Their improved capacity to manage change and lead people was demonstrated, for example, through their questioning attitudes about the dominance of general practitioners. They did this, for example, by initiating and leading case conferences with the multi-disciplinary teams. It became evident from this study that to use group clinical supervision with an executive co-coaching approach for the implementation and to sustain quality service demand that 'good nursing' is accepted as being synonymous with 'good management'. This is the future of 'new nursing'.
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Management Models and Cost Analysis for Regional Special Education Programs.
ERIC Educational Resources Information Center
Connors, Eugene T.
The implementation of the Education for All Handicapped Children Act (PL 94-142) has placed an enormous financial burden on local districts. In order to create special education programs that combine cost effectiveness and high quality, a regional model has been developed. The Therapeutic Residential Experience for Emotional Stability (TREES) in…
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Construction Management, in a Miami Test, Saves $1.5 Million
ERIC Educational Resources Information Center
Architectural Record, 1977
1977-01-01
In direct comparison with a high school built according to traditional design and contracting, a new prototype for the Dade County School District resulted in substantial savings without sacrificing quality. Available from: McGraw Hill Inc., 1221 Avenue of the Americas, New York, New York 10020, $5.00 single copy. (Author)
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-16
... volatile organic compound (VOC) emissions from paint thinners and multi-purpose solvents and from... waterborne chemistry, while coatings that required thinning with solvents accounted for only 0.28% of the... 2010 data indicates that 93.2% of the coatings sold were of waterborne chemistry.\\6\\ Therefore, the...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-07
... Cabell and Wayne Counties in their entireties and a portion of Mason County (Graham Tax District) in West... reasonable further progress (RFP) plan, contingency measures, and other planning State Implementation Plan... Regulatory Development Section, Air Planning Branch, Air, Pesticides and Toxics Management Division, U.S...
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75 FR 19990 - Lake Casitas Resource Management Plan, Ventura County, CA
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-16
... RMP would: (1) Ensure safe storage and timely delivery of high-quality water to users while enhancing..., California. The dam, which stores water for irrigation, municipal and industrial use within the Casitas Municipal Water District (CMWD), was completed in November 1958. Lake Casitas has a storage capacity of 254...
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ERIC Educational Resources Information Center
Elyria City Board of Education, OH.
Total Quality Management (TQM) is a process and strategy designed to improve an organization's effectiveness and efficiency. The Elyria Schools, named as Ohio's model urban school district in 1991, uses TQM to implement updated strategic goals through a process emphasizing teamwork, best knowledge, prevention, and commitment to continuous…
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Does Your Health Plan Measure Up? How Can You Tell?
ERIC Educational Resources Information Center
Edwards, Tom
1999-01-01
Describes the process behind health-plan selection for school district employees and offers suggestions on how managers might enhance their current healthcare plan purchasing process. Areas of health-plan review and critique are listed as are tips for measuring plan performance and advice on acquiring backup data on plan quality. (GR)
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Environmental Justice and Green-Technology Adoption
ERIC Educational Resources Information Center
Ong, Paul
2012-01-01
This paper presents an analysis of an environmental justice (EJ) program adopted by the South Coast Air Quality Management District (SCAQMD) as a part of its regulation to phase out a toxic chemical used by dry cleaners. SCAQMD provided financial incentives to switch early and gave establishments in EJ neighborhoods priority in applying for…
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NASA Astrophysics Data System (ADS)
Sahoo, S.; Kaur, A.; Litoria, P.; Pateriya, B.
2014-11-01
Over period of time, the water usage and management is under stress for various reasons including pollution in both surface and subsurface. The groundwater quality decreases due to the solid waste from urban and industrial nodes, rapid use of insecticides and pesticides in agricultural practices. In this study, ground water quality maps for Rupnagar district of Punjab has been prepared using geospatial interpolation technique through Inverse Distance Weighted (IDW) approach. IDW technique has been used for major ground water quality parameters observed from the field samples like Arsenic, Hardness, pH, Iron, Fluoride, TDS, and Sulphate. To assess the ground water quality of the Rupnagar district, total 280 numbers of samples from various sources of tubewells for both pre and post monsoon have collected. Out of which, 80 to 113 samples found Iron with non potable limits ranging 0.3-1.1mg/l and 0.3-1.02mg/l according to BIS standard for both the seasons respectively. Chamkaur Sahib, Rupnagar, Morinda blocks have been found non potable limit of iron in both pre & post-monsoon. 11 to 52 samples in this region have sulphate with permissible limits in both the season ranging 200-400mg/l and 201-400mg/l. But arsenic had acceptable limit in both the season. Various parameters-wise ground water quality map is generated using the range values of drinking water quality to know the distribution of different parameters and diversification in the concentration of different elements. These maps are very much needful for human being to expand awareness among the people to maintain the Cleanness of water at their highest quality and purity levels to achieve a healthy life.
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The role of quality assurance in future midwifery practice.
Dawson, J
1993-08-01
Recent recommendations have been made which would give midwives a more central role in maternity care and a greater degree of independence than they currently enjoy. This paper argues that midwives' current attitudes to quality assurance are incompatible with this enhanced role. Research conducted in three health districts is described, which explored the perceptions of nurses, midwives and managers towards quality assurance. The findings indicate that quality assurance (in whatever form that concept is operationalized) is a demonstration of accountability. For managers this accountability is primarily for the service as a whole, whilst nurses and midwives view their accountability as being owed to patients/clients. The main methodology which the study identified as being used for monitoring nursing care was the development and auditing of explicit standards. This approach has been actively promoted by the Royal College of Nursing, enabling nurses to regain control of the purely professional aspects of the nursing profession. Midwives in the study districts showed a marked reluctance to adopt such a strategy, taking the view that as independent practitioners consensus standards would be unacceptable. It is argued that this attitude is inconsistent with the basic principle that professionals are accountable for both demonstrating and developing the quality of professional practice. It is further suggested that midwives currently have an opportunity to regain professional control of midwifery practice, which will be lost unless they are prepared to take responsibility for evaluating the standards for which they are accountable.
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Building Teacher Quality in the Kansas City, Missouri School District
ERIC Educational Resources Information Center
Corso, Aileen; Franck, Valerie; Kelliher, Kate; McCorry, Betsy
2011-01-01
This study looks at the policies and practices shaping teacher quality in the Kansas City, Missouri School District (KCMSD). It is part of a series of analyses by the National Council on Teacher Quality (NCTQ) in school districts across the nation. Framing this analysis are five policy goals for improving teacher quality: (1) Staffing. Teacher…
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Impact of Lean on patient cycle and waiting times at a rural district hospital in KwaZulu-Natal
Naidoo, Logandran
2016-01-01
Background Prolonged waiting time is a source of patient dissatisfaction with health care and is negatively associated with patient satisfaction. Prolonged waiting times in many district hospitals result in many dissatisfied patients, overworked and frustrated staff, and poor quality of care because of the perceived increased workload. Aim The aim of the study was to determine the impact of Lean principles techniques, and tools on the operational efficiency in the outpatient department (OPD) of a rural district hospital. Setting The study was conducted at the Catherine Booth Hospital (CBH) – a rural district hospital in KwaZulu-Natal, South Africa. Methods This was an action research study with pre-, intermediate-, and post-implementation assessments. Cycle and waiting times were measured by direct observation on two occasions before, approximately two-weekly during, and on two occasions after Lean implementation. A standardised data collection tool was completed by the researcher at each of the six key service nodes in the OPD to capture the waiting times and cycle times. Results All six service nodes showed a reduction in cycle times and waiting times between the baseline assessment and post-Lean implementation measurement. Significant reduction was achieved in cycle times (27%; p < 0.05) and waiting times (from 11.93 to 10 min; p = 0.03) at the Investigations node. Although the target reduction was not achieved for the Consulting Room node, there was a significant reduction in waiting times from 80.95 to 74.43 min, (p < 0.001). The average efficiency increased from 16.35% (baseline) to 20.13% (post-intervention). Conclusion The application of Lean principles, tools and techniques provides hospital managers with an evidence-based management approach to resolving problems and improving quality indicators. PMID:27543283
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Irrigation efficiency and quality of irrigation return flows in the Ebro River Basin: an overview.
Causapé, J; Quílez, D; Aragüés, R
2006-06-01
The review analysis of twenty two irrigation efficiency (IE) studies carried out in the Ebro River Basin shows that IE is low (average IE)(avg)(= 53%) in surface-irrigated areas with high-permeable and shallow soils inadequate for this irrigation system, high (IE)(avg)(= 79%) in surface-irrigated areas with appropriate soils for this system, and very high (IE)(avg)(= 94%) in modern, automated and well managed sprinkler-irrigated areas. The unitary salt (total dissolved solids) and nitrate loads exported in the irrigation return flows (IRF) of seven districts vary, depending on soil salinity and on irrigation and N fertilization management, between 3-16 Mg salt/ha x year and 23-195 kg NO)(3) (-)-N/ha x year, respectively. The lower nitrate loads exported from high IE districts show that a proper irrigation design and management is a key factor to reduce off-site nitrogen pollution. Although high IE's also reduce off-site salt pollution, the presence of salts in the soil or subsoil may induce relatively high salt loads (>or=14 Mg/ha x year) even in high IE districts. Two important constrains identified in our revision were the short duration of most surveys and the lack of standards for conducting irrigation efficiency and mass balance studies at the irrigation district level. These limitations {emphasize the need for the establishment of a permanent and standardized network of drainage monitoring stations for the appropriate off-site pollution diagnosis and control of irrigated agriculture.
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78 FR 5196 - Meeting of the California Desert District Advisory Council
Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-24
... BLM California Desert District manager, five field office managers, and council subgroups. Final...) 697-5220. Dated: January 3, 2013. Timothy J. Wakefield, Associate District Manager, California Desert...
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Younger, D; Martin, G W
2000-11-01
The audit reported in this paper and submitted to the Psychiatry of Old Age Management group, assessed six units within each of two health districts in the UK. Using a nonparticipatory observation method in the units selected, the aim was to measure quality and the environment of care. Dependency levels of the clients/residents were also estimated to give a clearer picture of the setting and the care requirements. This was intended to establish a baseline for the units mapped and to enable care developments to be focussed upon intended outcomes. Results led to a number of observations related to the levels of interaction between staff and clients/residents, the need for a wider range of activities to promote person-centred care, and a suggested route to the improvement in quality of life for this vulnerable group of people. Assessment of dependency levels linked to the results of the mapping showed that high dependency does not lead automatically to a lower quality of person centred care.
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District decision-making for health in low-income settings: a systematic literature review.
Wickremasinghe, Deepthi; Hashmi, Iram Ejaz; Schellenberg, Joanna; Avan, Bilal Iqbal
2016-09-01
Health management information systems (HMIS) produce large amounts of data about health service provision and population health, and provide opportunities for data-based decision-making in decentralized health systems. Yet the data are little-used locally. A well-defined approach to district-level decision-making using health data would help better meet the needs of the local population. In this second of four papers on district decision-making for health in low-income settings, our aim was to explore ways in which district administrators and health managers in low- and lower-middle-income countries use health data to make decisions, to describe the decision-making tools they used and identify challenges encountered when using these tools. A systematic literature review, following PRISMA guidelines, was undertaken. Experts were consulted about key sources of information. A search strategy was developed for 14 online databases of peer reviewed and grey literature. The resources were screened independently by two reviewers using pre-defined inclusion criteria. The 14 papers included were assessed for the quality of reported evidence and a descriptive evidence synthesis of the review findings was undertaken. We found 12 examples of tools to assist district-level decision-making, all of which included two key stages-identification of priorities, and development of an action plan to address them. Of those tools with more steps, four included steps to review or monitor the action plan agreed, suggesting the use of HMIS data. In eight papers HMIS data were used for prioritization. Challenges to decision-making processes fell into three main categories: the availability and quality of health and health facility data; human dynamics and financial constraints. Our findings suggest that evidence is available about a limited range of processes that include the use of data for decision-making at district level. Standardization and pre-testing in diverse settings would increase the potential that these tools could be used more widely. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.
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Govender, Indira; Ehrlich, Rodney; Van Vuuren, Unita; De Vries, Elma; Namane, Mosedi; De Sa, Angela; Murie, Katy; Schlemmer, Arina; Govender, Strini; Isaacs, Abdul; Martell, Rob
2012-12-01
To determine whether clinical audit improved the performance of diabetic clinical processes in the health district in which it was implemented. Patient folders were systematically sampled annually for review. Primary health-care facilities in the Metro health district of the Western Cape Province in South Africa. Health-care workers involved in diabetes management. Clinical audit and feedback. The Skillings-Mack test was applied to median values of pooled audit results for nine diabetic clinical processes to measure whether there were statistically significant differences between annual audits performed in 2005, 2007, 2008 and 2009. Descriptive statistics were used to illustrate the order of values per process. A total of 40 community health centres participated in the baseline audit of 2005 that decreased to 30 in 2009. Except for two routine processes, baseline medians for six out of nine processes were below 50%. Pooled audit results showed statistically significant improvements in seven out of nine clinical processes. The findings indicate an association between the application of clinical audit and quality improvement in resource-limited settings. Co-interventions introduced after the baseline audit are likely to have contributed to improved outcomes. In addition, support from the relevant government health programmes and commitment of managers and frontline staff contributed to the audit's success.
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Using mobile phone text messaging for malaria surveillance in rural Kenya
2014-01-01
Background Effective surveillance systems are required to track malaria testing and treatment practices. A 26-week study “SMS for Life” was piloted in five rural districts of Kenya to examine whether SMS reported surveillance data could ensure real-time visibility of accurate data and their use by district managers to impact on malaria case-management. Methods Health workers from 87 public health facilities used their personal mobile phones to send a weekly structured SMS text message reporting the counts of four basic surveillance data elements to a web-based system accessed by district managers. Longitudinal monitoring of SMS reported data through the web-based system and two rounds of cross-sectional health facility surveys were done to validate accuracy of data. Results Mean response rates were 96% with 87% of facilities reporting on time. Fifty-eight per cent of surveillance data parameters were accurately reported. Overall mean testing rates were 37% with minor weekly variations ranging from 32 to 45%. Overall test positivity rate was 24% (weekly range: 17-37%). Ratio of anti-malarial treatments to test positive cases was 1.7:1 (weekly range: 1.3:1–2.2:1). District specific trends showed fluctuating patterns in testing rates without notable improvement over time but the ratio of anti-malarial treatments to test positive cases improved over short periods of time in three out of five districts. Conclusions The study demonstrated the feasibility of using simple mobile phone text messages to transmit timely surveillance data from peripheral health facilities to higher levels. However, accuracy of data reported was suboptimal. Future work should focus on improving quality of SMS reported surveillance data. PMID:24642130
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77 FR 19684 - Meeting of the California Desert District Advisory Council
Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-02
... members, the BLM California Desert District manager, five field office managers, and council subgroups...) 697-5220. Dated: March 19, 2012. Raymond Lee, Acting Associate District Manager, California Desert...
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Map showing potential metal-mine drainage hazards in Colorado, based on mineral-deposit geology
Plumlee, Geoffrey S.; Streufert, Randall K.; Smith, Kathleen S.; Smith, Steven M.; Wallace, Alan R.; Toth, Margo I.; Nash, J. Thomas; Robinson, Rob A.; Ficklin, Walter H.; Lee, Gregory K.
1995-01-01
This map, compiled by the U.S. Geological Survey (USGS) in cooperation with the Colorado Geological Survey (CGS) and the U. S. Bureau of Land Management (BLM), shows potential mine-drainage hazards that may exist in Colorado metal-mining districts, as indicated by the geologic characteristics of the mineral deposits that occur in the respective districts. It was designed to demonstrate how geologic and geochemical information can be used on a regional scale to help assess the potential for mining-related and natural drainage problems in mining districts, unmined mineralized areas, and surrounding watersheds. The map also provides information on the distribution of different mineral deposit types across Colorado. A GIS (Geographic Information System) format was used to integrate geologic, geochemical, water-quality, climate, landuse, and ecological data from diverse sources. Likely mine-drainage signatures were defined for each mining district based on: (1) a review of the geologic characteristics of the mining district, including mineralogy, trace-element content, host-rock lithology, and wallrock alteration, and; (2) results of site specific studies on the geologic controls on mine-drainage composition.
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Pesticide Poisoning in South India – Opportunities for Prevention and Improved Medical Management
Rao, CH Srinivas; Venkateswarlu, V; Surender, T; Eddleston, Michael; Buckley, Nick A
2006-01-01
Objective Warangal district in Andhra Pradesh, southern India, records over one thousand pesticide poisoning cases each year and hundreds of deaths. We aimed to describe the frequency, distribution, and assess quality of management and subsequent outcomes from pesticide poisoning in one large hospital in the district. Methods We reviewed data on all patients admitted with pesticide poisoning to a district government hospital for the years 1997 to 2002. For 2002, details of the particular pesticide ingested and management were abstracted from the medical files. Findings During these six years, 8040 patients were admitted to the hospital with pesticide poisoning. The overall case fatality ratio was 22.6%. More detailed data from 2002 reveals two thirds of the patients were less than 30 years old, 57% were male and 96% had intentionally poisoned themselves. Two compounds, monocrotophos and endosulfan, accounted for the majority of deaths with known pesticides in 2002. Low fixed dose regimens were used in the majority of cases for the most commonly used antidotes (atropine and pralidoxime). Inappropriate antidotes were also used in some patients. Conclusions It is likely that these findings reflect the situation in many rural hospitals of the Asia Pacific region. Even without an increase in resources, there appear to be significant opportunities for reducing mortality by better medical management and further restrictions on the most toxic pesticides. PMID:15941422
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Ronveaux, O.; Rickert, D.; Hadler, S.; Groom, H.; Lloyd, J.; Bchir, A.; Birmingham, M.
2005-01-01
OBJECTIVE: To evaluate the consistency and quality of immunization monitoring systems in 27 countries during 2002-03 using standardized data quality audits (DQAs) that had been launched within the framework of the Global Alliance for Vaccines and Immunization. METHODS: The consistency of reporting systems was estimated by determining the proportion of third doses of diphtheria-tetanuspertussis (DTP-3) vaccine reported as being administered that could be verified by written documentation at health facilities and districts. The quality of monitoring systems was measured using quality indices for different components of the monitoring systems. These indices were applied to each level of the health service (health unit, district and national). FINDINGS: The proportion of verified DTP-3 doses was lower than 85% in 16 countries. Difficulties in verifying the doses administered often arose at the peripheral level of the health service, usually as the result of discrepancies in information between health units and their corresponding districts or because completed recording forms were not available from health units. All countries had weaknesses in their monitoring systems; these included the inconsistent use of monitoring charts; inadequate monitoring of vaccine stocks, injection supplies and adverse events; unsafe computer practices; and poor monitoring of completeness and timeliness of reporting. CONCLUSION: Inconsistencies in immunization data occur in many countries, hampering their ability to manage their immunization programmes. Countries should use these findings to strengthen monitoring systems so that data can reliably guide programme activities. The DQA is an innovative tool that provides a way to independently assess the quality of immunization monitoring systems at all levels of a health service and serves as a point of entry to make improvements. It provides a useful example for other global health initiatives. PMID:16175824
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Code of Federal Regulations, 2013 CFR
2013-01-01
... planning tool and with sensitivity to the Agency's mission. 3. After the Administrator approves the natural... high water quality, or scenic or recreational value; n. Agricultural districts or other similar zoning... executed in May 1979 between the Soil Conservation Service (SCS) and FmHA or its successor agency under...
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Code of Federal Regulations, 2014 CFR
2014-01-01
... planning tool and with sensitivity to the Agency's mission. 3. After the Administrator approves the natural... high water quality, or scenic or recreational value; n. Agricultural districts or other similar zoning... executed in May 1979 between the Soil Conservation Service (SCS) and FmHA or its successor agency under...
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Code of Federal Regulations, 2012 CFR
2012-01-01
... planning tool and with sensitivity to the Agency's mission. 3. After the Administrator approves the natural... high water quality, or scenic or recreational value; n. Agricultural districts or other similar zoning... executed in May 1979 between the Soil Conservation Service (SCS) and FmHA or its successor agency under...
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The manual discusses reducing the risk associated with an accidental release of chlorine. It identifies some of the potential causes of accidental releases that apply to the processes that use chlorine. It also identifies examples of potential causes, as well as measures that may...
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75 FR 30859 - Notice of Lodging of Consent Decree Under the Clean Air Act
Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-02
... DEPARTMENT OF JUSTICE Notice of Lodging of Consent Decree Under the Clean Air Act Notice is hereby given that on May 24, 2010, a proposed Consent Decree in United States, and South Coast Air Quality Management District v. Lifoam Industries, LLC, Civil Action No. 10-CV-03825-AHM- FFM was lodged with the...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-09-19
... Implementation Plan (SIP). These revisions concern lead emissions from large lead-acid battery recycling....1 Emissions Standard For Lead 11/5/10 9/27/11 From Large Lead-Acid Battery Recycling Facilities. On.... SCAQMD Rule 1420.1 imposes these revised emission standards for large lead-acid battery recycling...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-25
... concern lead emissions from large lead-acid battery recycling facilities. We are approving a local rule.../10 9/27/11 Lead From Large Lead- Acid Battery Recycling Facilities. We proposed to approve this rule...) * * * (2) Rule 1420.1, ``Emissions Standard For Lead From Large Lead-Acid Battery Recycling Facilities...
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Dusabe-Richards, John N; Tesfaye, Hayley Teshome; Mekonnen, Jarso; Kea, Aschenaki; Theobald, Sally; Datiko, Daniel G
2016-12-27
This study assesses the feasibility of female health extension workers (HEWs) using eHealth within their core duties, supporting both the design and capacity building for an eHealth system project focussed initially on tuberculosis, maternal child health, and gender equity. Health extension workers, Health Centre Heads, District Health Officers, Zonal Health Department and Regional Health Bureau representatives in Southern Ethiopia. The study was undertaken in Southern Ethiopia with three districts in Sidama zone (population of 3.5 million) and one district in Gedeo zone (control zone with similar health service coverage and population density). Mixed method baseline data collection was undertaken, using quantitative questionnaires (n = 57) and purposively sampled qualitative face-to-face semi-structured interviews (n = 10) and focus group discussions (n = 3). Themes were identified relating to HEW commitment and role, supervision, and performance management. The Health Management Information System (HMIS) was seen as important by all participants, but with challenges of information quality, accuracy, reliability and timeliness. Participants' perceptions varied by group regarding the purpose and benefits of HMIS as well as the potential of an eHealth system. Mobile phones were used regularly by all participants. eHealth technology presents a new opportunity for the Ethiopian health system to improve data quality and community health. Front-line female HEWs are a critical bridge between communities and health systems. Empowering HEWs, supporting them and responding to the challenges they face will be an important part of ensuring the sustainability and responsiveness of eHealth strategies. Findings have informed the subsequent eHealth technology design and implementation, capacity strengthening approach, supervision, and performance management approach.
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Bianchini, A; Pellegrini, M; Saccani, C
2011-01-01
This paper analyses the way numerical data on Municipal Solid Waste (MSW) quantities are recorded, processed and then reported for six of the most meaningful Italian Districts and shows the difficulties found during the comparison of these Districts, starting from the lack of homogeneity and the fragmentation of the data indispensable to make this critical analysis. These aspects are often ignored, but data certainty are the basis for serious MSW planning. In particular, the paper focuses on overall Source Separation Level (SSL) definition and on the influence that Special Waste (SW) assimilated to MSW has on it. An investigation was then necessary to identify new parameters in place of overall SSL. Moreover, these parameters are not only important for a waste management system performance measure, but are fundamental in order to design and check management plan and to identify possible actions to improve it. Copyright © 2011 Elsevier Ltd. All rights reserved.
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Development of the Champlain primary care cardiovascular disease prevention and management guideline
Montoya, Lorraine; Liddy, Clare; Hogg, William; Papadakis, Sophia; Dojeiji, Laurie; Russell, Grant; Akbari, Ayub; Pipe, Andrew; Higginson, Lyall
2011-01-01
Abstract Problem addressed A well documented gap remains between evidence and practice for clinical practice guidelines in cardiovascular disease (CVD) care. Objective of program As part of the Champlain CVD Prevention Strategy, practitioners in the Champlain District of Ontario launched a large quality-improvement initiative that focused on increasing the uptake in primary care practice settings of clinical guidelines for heart disease, stroke, diabetes, and CVD risk factors. Program description The Champlain Primary Care CVD Prevention and Management Guideline is a desktop resource for primary care clinicians working in the Champlain District. The guideline was developed by more than 45 local experts to summarize the latest evidence-based strategies for CVD prevention and management, as well as to increase awareness of local community-based programs and services. Conclusion Evidence suggests that tailored strategies are important when implementing specific practice guidelines. This article describes the process of creating an integrated clinical guideline for improvement in the delivery of cardiovascular care. PMID:21673196
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Caraballo, Manuel A; Macías, Francisco; Nieto, José Miguel; Ayora, Carlos
2016-01-01
Water resources management and restoration strategies, and subsequently ecological and human life quality, are highly influenced by the presence of short and long term cycles affecting the intensity of a targeted pollution. On this respect, a typical acid mine drainage (AMD) groundwater from a sulfide mining district with dry Mediterranean climate (Iberian Pyrite Belt, SW Spain) was studied to unravel the effect of long term weather changes in water flow rate and metal pollutants concentration. Three well differentiated polluting stages were observed and the specific geochemical, mineralogical and hydrological processes involved (pyrite and enclosing rocks dissolution, evaporitic salts precipitation-redisolution and pluviometric long term fluctuations) were discussed. Evidencing the importance of including longer background monitoring stage in AMD management and restoration strategies, the present study strongly advise a minimum 5-years period of AMD continuous monitoring previous to the design of any AMD remediation system in regions with dry Mediterranean climate. Copyright © 2015 Elsevier B.V. All rights reserved.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Bianchini, A.; Pellegrini, M.; Saccani, C., E-mail: cesare.saccani@unibo.it
2011-09-15
This paper analyses the way numerical data on Municipal Solid Waste (MSW) quantities are recorded, processed and then reported for six of the most meaningful Italian Districts and shows the difficulties found during the comparison of these Districts, starting from the lack of homogeneity and the fragmentation of the data indispensable to make this critical analysis. These aspects are often ignored, but data certainty are the basis for serious MSW planning. In particular, the paper focuses on overall Source Separation Level (SSL) definition and on the influence that Special Waste (SW) assimilated to MSW has on it. An investigation wasmore » then necessary to identify new parameters in place of overall SSL. Moreover, these parameters are not only important for a waste management system performance measure, but are fundamental in order to design and check management plan and to identify possible actions to improve it.« less
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Mlotshwa, Mandla; Smit, Sandra; Williams, Seymour; Reddy, Carl; Medina-Marino, Andrew
2017-01-01
Tuberculosis (TB) surveillance data are crucial to the effectiveness of National TB Control Programs. In South Africa, few surveillance system evaluations have been undertaken to provide a rigorous assessment of the platform from which the national and district health systems draws data to inform programs and policies. Evaluate the attributes of Eden District's TB surveillance system, Western Cape Province, South Africa. Data quality, sensitivity and positive predictive value were assessed using secondary data from 40,033 TB cases entered in Eden District's ETR.Net from 2007 to 2013, and 79 purposively selected TB Blue Cards (TBCs), a medical patient file and source document for data entered into ETR.Net. Simplicity, flexibility, acceptability, stability and usefulness of the ETR.Net were assessed qualitatively through interviews with TB nurses, information health officers, sub-district and district coordinators involved in the TB surveillance. TB surveillance system stakeholders report that Eden District's ETR.Net system was simple, acceptable, flexible and stable, and achieves its objective of informing TB control program, policies and activities. Data were less complete in the ETR.Net (66-100%) than in the TBCs (76-100%), and concordant for most variables except pre-treatment smear results, antiretroviral therapy (ART) and treatment outcome. The sensitivity of recorded variables in ETR.Net was 98% for gender, 97% for patient category, 93% for ART, 92% for treatment outcome and 90% for pre-treatment smear grading. Our results reveal that the system provides useful information to guide TB control program activities in Eden District. However, urgent attention is needed to address gaps in clinical recording on the TBC and data capturing into the ETR.Net system. We recommend continuous training and support of TB personnel involved with TB care, management and surveillance on TB data recording into the TBCs and ETR.Net as well as the implementation of a well-structured quality control and assurance system.
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Activities of the Water Resources Division, California District, in the 1987 fiscal year
Griner, C.A.; Anttila, P.W.
1988-01-01
The mission of the Water Resources Division is to provide the hydrologic information and understanding needed for the optimum utilization and management of the Nation 's water resources for the overall benefit of the people of the United States. Several of the most relevant and visible studies being conducted by the California District deal with selenium toxicity in the western San Joaquin Valley; groundwater export from the Owens Valley, coupled with vegetation survivability studies; hydrodynamics variability in San Francisco Bay; reclaimed water use; seawater intrusion in the Santa Barbara area; and involvement in the water-quality standard/water-rights hearing for the San Francisco Bay/Delta. Thirty-nine project summaries are provided. Water Resources Division basic mission and program, California District organization and funding, and 1987 water conditions are also summarized. (Lantz-PTT)
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-17
... the Arizona State Implementation Plan, Pinal County Air Quality Control District AGENCY: Environmental... disapproval of a revision to the Pinal County Air Quality Control District portion of the Arizona State... the Control Officer to determine whether the manner of control of fugitive emissions is satisfactory...
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77 FR 4059 - Meeting of the California Desert District Advisory Council
Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-26
... California Desert District manager, five field office managers, and council subgroups. Final agenda items... A. Raml, California Desert District Manager. [FR Doc. 2012-1630 Filed 1-25-12; 8:45 am] BILLING CODE...
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30 CFR 250.529 - What if my casing pressure request is denied?
Code of Federal Regulations, 2010 CFR
2010-07-01
... the respective District Manager within 30 days of receiving the denial. The District Manager will... respective District Manager within 30 days after completion of your corrected action. (b) You must submit the...
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Research to More Effectively Manage Critical Ground-Water Basins
Nickles, James
2008-01-01
As the regional management agency for two of the most heavily used ground-water basins in California, the Water Replenishment District of Southern California (WRD) plays a vital role in sheparding the water resources of southern Los Angeles County. WRD is using the results of the U.S. Geological Survey (USGS) studies to help more effectively manage the Central and West Coast basins in the most efficient, cost-effective way. In partnership with WRD, the USGS is using the latest research tools to study the geohydrology and geochemistry of the two basins. USGS scientists are: *Drilling and collecting detailed data from over 40 multiple-well monitoring sites, *Conducting regional geohydrologic and geochemical analyses, *Developing and applying a computer simulation model of regional ground-water flow. USGS science is providing a more detailed understanding of ground-water flow and quality. This research has enabled WRD to more effectively manage the basins. It has helped the District improve the efficiency of its spreading ponds and barrier injection wells, which replenish the aquifers and control seawater intrusion into the ground-water system.
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ERIC Educational Resources Information Center
Hoffman, Pamela K.; Davey, Cynthia S.; Larson, Nicole; Grannon, Katherine Y.; Hanson, Carlie; Nanney, Marilyn S.
2016-01-01
Weight-related outcomes were examined among high school students in Minnesota public school districts according to the quality of district wellness policies. Wellness policy strength and comprehensiveness were scored using the Wellness School Assessment Tool (WellSAT) for 325 Minnesota public school districts in 2013. The associations between…
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The Development Effectiveness Management Model for Sub-District Secondary School
ERIC Educational Resources Information Center
Butsankom, Akachai; Sirishuthi, Chaiyuth; Lammana, Preeda
2016-01-01
The purposes of this research were to study the factors of effectiveness management model for subdistrict secondary school, to investigate current situations and desirable situations of effectiveness management model for sub-district secondary school, to develop the effectiveness management model for sub-district secondary school and to study the…
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Joseph, Chakupewa; Maluka, Stephen Oswald
2016-09-26
In early 1990s, Tanzania like other African countries, adopted health sector reform (HSR). The most strongly held centralisation system that informed the nature of services provision including health was, thus, disintegrated giving rise to decentralisation system. It was within the realm of HSR process, user fees were introduced in the health sector. Along with user fees, various types of health insurances, including the Community Health Fund (CHF), were introduced. While the country's level of enrolment in the CHF is low, there are marked variations among districts. This paper highlights the role of decentralised health management and leadership practices in the uptake of the CHF in Tanzania. A comparative exploratory case study of high and low performing districts was carried out. In-depth interviews were conducted with the members of the Council Health Service Board (CHSB), Council Health Management Team (CHMT), Health Facility Committees (HFCs), in-charges of health facilities, healthcare providers, and Community Development Officers (CDOs). Minutes of the meetings of the committees and district annual health plans and district annual implementation reports were also used to verify and triangulate the data. Thematic analysis was adopted to analyse the collected data. We employed both inductive and deductive (mixed coding) to arrive to the themes. There were no differences in the level of education and experience of the district health managers in the two study districts. Almost all district health managers responsible for the management of the CHF had attended some training on management and leadership. However, there were variations in the personal initiatives of the top-district health leaders, particularly the district health managers, the council health services board and local government officials. Similarly, there were differences in the supervision mechanisms, and incentives available for the health providers, HFCs and board members in the two study districts. This paper adds to the stock of knowledge on CHFs functioning in Tanzania. By comparing the best practices with the worst practices, the paper contributes valuable insights on how CHF can be scaled up and maintained. The study clearly indicates that the performance of the community-based health financing largely depends on the personal initiatives of the top-district health leaders, particularly the district health managers and local government officials. This implies that the regional health management team (RHMT) and the Ministry of Health and Social Welfare (MoHSW) should strengthen supportive supervision mechanisms to the district health managers and health facilities. More important, there is need for the MoHSW to provide opportunities for the well performing districts to share good practices to other districts in order to increase uptake of the community-based health insurance.
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Majrooh, Muhammad Ashraf; Hasnain, Seema; Akram, Javaid; Siddiqui, Arif; Memon, Zahid Ali
2014-01-01
Antenatal care is a very important component of maternal health services. It provides the opportunity to learn about risks associated with pregnancy and guides to plan the place of deliveries thereby preventing maternal and infant morbidity and mortality. In 'Pakistan' antenatal services to rural population are being provided through a network of primary health care facilities designated as 'Basic Health Units and Rural Health Centers. Pakistan is a developing country, consisting of four provinces and federally administered areas. Each province is administratively subdivided in to 'Divisions' and 'Districts'. By population 'Punjab' is the largest province of Pakistan having 36 districts. This study was conducted to assess the coverage and quality antenatal care in the primary health care facilities in 'Punjab' province of 'Pakistan'. Quantitative and Qualitative methods were used to collect data. Using multistage sampling technique nine out of thirty six districts were selected and 19 primary health care facilities of public sector (seventeen Basic Health Units and two Rural Health Centers were randomly selected from each district. Focus group discussions and in-depth interviews were conducted with clients, providers and health managers. The overall enrollment for antenatal checkup was 55.9% and drop out was 32.9% in subsequent visits. The quality of services regarding assessment, treatment and counseling was extremely poor. The reasons for low coverage and quality were the distant location of facilities, deficiency of facility resources, indifferent attitude and non availability of the staff. Moreover, lack of client awareness about importance of antenatal care and self empowerment for decision making to seek care were also responsible for low coverage. The coverage and quality of the antenatal care services in 'Punjab' are extremely compromised. Only half of the expected pregnancies are enrolled and out of those 1/3 drop out in follow-up visits.
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75 FR 11557 - Meeting of the California Desert District Advisory Council
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-11
... updates by Council members and reports from the BLM District Manager and five field office managers...) 697-5220. Dated: March 3, 2010. Jack L. Hamby, Acting District Manager. [FR Doc. 2010-5365 Filed 3-10...
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Quinones, Ferdinand; Balthrop, B.H.; Baker, E.G.
1989-01-01
This report contains a summation of water resources projects which were active in the Tennessee District during 1988 or 1989. Given in each summary is the name of the project chief, the objective of the project, the progress of results of the study to date, and the name of the cooperator. The basic data programs conducted by the Tennessee District provide streamflow, quality of water, and groundwater levels information essential to the assessment and management of the State 's water resources. Long-term streamflow, quality of water, and groundwater levels networks are operated as part of the Hydrologic Data Section. Field operations are about equally divided among field offices in Memphis, Nashville, and Knoxville. The data collected as part of the networks are published in the series of annual data reports entitled ' Water Resources Data for Tennessee'. (USGS)
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Afari, Henrietta; Hirschhorn, Lisa R; Michaelis, Annie; Barker, Pierre; Sodzi-Tettey, Sodzi
2014-01-01
Objective To describe healthcare worker (HCW)-identified system-based bottlenecks and the value of local engagement in designing strategies to improve referral processes related to emergency obstetric care in rural Ghana. Design Qualitative study using semistructured interviews of participants to obtain provider narratives. Setting Referral systems in obstetrics in Assin North Municipal Assembly, a rural district in Ghana. This included one district hospital, six health centres and four local health posts. This work was embedded in an ongoing quality improvement project in the district addressing barriers to existing referral protocols to lessen delays. Participants 18 HCWs (8 midwives, 4 community health officers, 3 medical assistants, 2 emergency room nurses, 1 doctor) at different facility levels within the district. Results We identified important gaps in referral processes in Assin North, with the most commonly noted including recognising danger signs, alerting receiving units, accompanying critically ill patients, documenting referral cases and giving and obtaining feedback on referred cases. Main root causes identified by providers were in four domains: (1) transportation, (2) communication, (3) clinical skills and management and (4) standards of care and monitoring, and suggested interventions that target these barriers. Mapping these challenges allowed for better understanding of next steps for developing comprehensive, evidence-based solutions to identified referral gaps within the district. Conclusions Providers are an important source of information on local referral delays and in the development of approaches to improvement responsive to these gaps. Better engagement of HCWs can help to identify and evaluate high-impact holistic interventions to address faulty referral systems which result in poor maternal outcomes in resource-poor settings. These perspectives need to be integrated with patient and community perspectives. PMID:24833695
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76 FR 13430 - Meeting of the California Desert District Advisory Council
Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-11
... members and reports from the BLM District Manager and five field office managers. In addition, the agenda...: March 2, 2011. Jack L. Hamby, Associate District Manager. [FR Doc. 2011-5456 Filed 3-10-11; 8:45 am...
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ERIC Educational Resources Information Center
Silvernail, David L.; Linet, Sarah R.
2014-01-01
The goal of this study was to: (1) identify challenges faced by Maine school districts in providing high quality public education; (2) describe the magnitude of the challenges; and (3) identify areas where school districts were experiencing some success in meeting these challenges. The School Districts Challenge Survey was distributed online to…
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An Empirical Validation of a Management Construct for District Level Supervisors.
ERIC Educational Resources Information Center
Snyder, Karolyn J.; And Others
Findings of a study that examined the effects of a management/leadership program on school district work culture are presented in this paper. The Pasco County (Florida) school district under study was involved in school restructuring, part of which included participation in a management training program, Managing Productive Programs (MPP). MPP…
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Reddy, Michael M.; Gunther, Charmaine D.
2012-01-01
This report presents results of chemical analysis for samples collected during March, 1995, as part of a study to quantify the interaction of aquatic organic material (referred to here as dissolved organic carbon with dissolved metal ions). The work was done in conjunction with the South Florida Water Management District, the U.S. Environmental Protection Agency, the U.S. Geological Survey South Florida Ecosystems Initiative, and the South Florida National Water Quality Assessment Study Unit. Samples were collected from surface canals and from marsh sites. Results are based on onsite and laboratory measurements for 27 samples collected at 10 locations. The data file contains sample description, dissolved organic carbon concentration and specific ultraviolet absorbance, and additional analytical data for samples collected at several sites in the Water Conservation Areas, the Everglades, south Florida.
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ERIC Educational Resources Information Center
Watson, John; Gemin, Butch
2009-01-01
Online learning is growing rapidly as states and districts are creating new online schools, and existing programs are adding new courses and students. The growth reflects the spreading understanding that online courses and programs can serve a wide variety of students and needs. These include: (1) Creating opportunities for small and rural school…
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-25
.... Comment 1: CSE's first comment provides an overview of the reasonable further progress (RFP) and base year... year (i.e. pre-1997) emissions credits for particulate matter of 10 microns or less (PM 10 ) and sulfur... base- year requirement.'') [Footnote omitted] CSE's basis for concluding the 2003 AQMP is not ``valid...
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ERIC Educational Resources Information Center
Puryear, Pamela Ann
2012-01-01
Novice teachers often lack effective teaching strategies and exhibit poor classroom management, which creates disruptions in the classroom that lessen the quality of instructional time for students. The purpose of this program evaluation was to examine a teacher-mentor training program and the experiences provided to participants to gain a deeper…
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ERIC Educational Resources Information Center
Myung, Jeannie; Loeb, Susanna; Horng, Eileen
2011-01-01
Purpose: In light of the difficulty many districts face finding quality principal candidates, this article explores an informal recruitment mechanism of teachers to become principals, which the authors call tapping. The authors assess the extent to which current teachers are being approached by school leaders to consider leadership and whether…
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A Handbook for School District Financial Management.
ERIC Educational Resources Information Center
Dembowski, Frederick L.
Designed for school business officials, this handbook provides research information and guidelines on school district banking and cash management systems. Section 1 gives an overview of district financial management operations, discussing the administrative framework, cash budgeting, information and control systems, collection and disbursement…
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Blecker, Steve W.; Stillings, Lisa L.; Amacher, Michael C.; Ippolito, James A.; DeCrappeo, Nicole M.
2010-01-01
The myriad definitions of soil/ecosystem quality or health are often driven by ecosystem and management concerns, and they typically focus on the ability of the soil to provide functions relating to biological productivity and/or environmental quality. A variety of attempts have been made to create indices that quantify the complexities of soil quality and provide a means of evaluating the impact of various natural and anthropogenic disturbances. Though not without their limitations, indices can improve our understanding of the controls behind ecosystem processes and allow for the distillation of information to help link scientific and management communities. In terrestrial systems, indices were initially developed and modified for agroecosystems; however, the number of studies implementing such indices in nonagricultural systems is growing. Soil quality indices (SQIs) are typically composed of biological (and sometimes physical and chemical) parameters that attempt to reduce the complexity of a system into a metric of a soil’s ability to carry out one or more functions.The indicators utilized in SQIs can be as varied as the studies themselves, reflecting the complexity of the soil and ecosystems in which they function. Regardless, effective soil quality indicators should correlate well with soil or ecosystem processes, integrate those properties and processes, and be relevant to management practices. Commonly applied biological indicators include measures associated with soil microbial activity or function (for example, carbon and nitrogen mineralization, respiration, microbial biomass, enzyme activity. Cost, accessibility, ease of interpretation, and presence of existing data often dictate indicator selection given the number of available measures. We employed a large number of soil biological, chemical, and physical measures, along with measures of vegetation cover, density, and productivity, in order to test the utility and sensitivity of these measures within various mineralized terranes. We were also interested in examining these relations in the context of determining appropriate reference conditions with which to compare reclamation efforts.The purpose of this report is to present the data used to develop indices of soil and ecosystem quality associated with mineralized terranes (areas enriched in metal-bearing minerals), specifically podiform chromite, quartz alunite, and Mo/Cu porphyry systems. Within each of these mineralized terranes, a nearby unmineralized counterpart was chosen for comparison. The data consist of soil biological, chemical, and physical parameters, along with vegetation measurements for each of the sites described below. Synthesis of these data and index development will be the subject of future publications.
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Perceptions on diabetes care provision among health providers in rural Tanzania: a qualitative study
Geubbels, Eveline; Klatser, Paul; Dieleman, Marjolein
2017-01-01
Abstract Diabetes prevalence in Tanzania was estimated at 9.1% in 2012 among adults aged 24–65 years — higher than the HIV prevalence in the general population at that time. Health systems in lower- and middle-income countries are not designed for chronic health care, yet the rising burden of non-communicable diseases such as diabetes demands chronic care services. To inform policies on diabetes care, we conducted a study on the health services in place to diagnose, treat and care for diabetes patients in rural Tanzania. The study was an exploratory and descriptive study involving qualitative methods (in-depth interviews, observations and document reviews) and was conducted in a rural district in Tanzania. Fifteen health providers in four health facilities at different levels of the health care system were interviewed. The health care organization elements of the Innovative Care for Chronic Conditions (ICCC) framework were used to guide assessment of the diabetes services in the district. We found that diabetes care in this district was centralized at the referral and district facilities, with unreliable supply of necessary commodities for diabetes care and health providers who had some knowledge of what was expected of them but felt ill-prepared for diabetes care. Facility and district level guidance was lacking and the continuity of care was broken within and between facilities. The HMIS could not produce reliable data on diabetes. Support for self-management to patients and their families was weak at all levels. In conclusion, the rural district we studied did not provide diabetes care close to the patients. Guidance on diabetes service provision and human resource management need strengthening and policies related to task-shifting need adjustment to improve quality of service provision for diabetes patients in rural settings. PMID:27935802
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de Souza, Dziedzom K; Yirenkyi, Eric; Otchere, Joseph; Biritwum, Nana-Kwadwo; Ameme, Donne K; Sackey, Samuel; Ahorlu, Collins; Wilson, Michael D
2016-03-01
The activities of the Global Programme for the Elimination of Lymphatic Filariasis have been in operation since the year 2000, with Mass Drug Administration (MDA) undertaken yearly in disease endemic communities. Information collected during MDA-such as population demographics, age, sex, drugs used and remaining, and therapeutic and geographic coverage-can be used to assess the quality of the data reported. To assist country programmes in evaluating the information reported, the WHO, in collaboration with NTD partners, including ENVISION/RTI, developed an NTD Data Quality Assessment (DQA) tool, for use by programmes. This study was undertaken to evaluate the tool and assess the quality of data reported in some endemic communities in Ghana. A cross sectional study, involving review of data registers and interview of drug distributors, disease control officers, and health information officers using the NTD DQA tool, was carried out in selected communities in three LF endemic Districts in Ghana. Data registers for service delivery points were obtained from District health office for assessment. The assessment verified reported results in comparison with recounted values for five indicators: number of tablets received, number of tablets used, number of tablets remaining, MDA coverage, and population treated. Furthermore, drug distributors, disease control officers, and health information officers (at the first data aggregation level), were interviewed, using the DQA tool, to determine the performance of the functional areas of the data management system. The results showed that over 60% of the data reported were inaccurate, and exposed the challenges and limitations of the data management system. The DQA tool is a very useful monitoring and evaluation (M&E) tool that can be used to elucidate and address data quality issues in various NTD control programmes.
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The sudden removal of user fees: the perspective of a frontline manager in Burundi.
Nimpagaritse, Manassé; Bertone, Maria Paola
2011-11-01
In May 2006, the President of Burundi announced the removal of user fees in all health centres and hospitals for children under 5 and women giving birth. As other studies also point out, the policy was adopted extremely suddenly, without much reflection on its ultimate aims and on the operational dimension of its implementation. From the perspective of a frontline manager, this paper provides a descriptive case study of the abolition of user fees in the Muramvya District and a first-hand account of the effects of the sudden reform in the management of a district and a district hospital. The analysis highlights the challenges that the district and hospital teams faced. The main issues were: the reduction of financial flows, which prevented the possibility of investments and caused frequent drugs stock-outs; the reduced quality of the services and the disruption of the referral system; the motivation of the health staff who saw the administrative workload increase (not necessarily because of increased utilization) and faced 'ethical dilemmas' caused by the imprecise targeting of the reform. Undoubtedly, the removal of user fees for certain groups was an equitable and necessary measure in an extremely poor country such as Burundi. However, the suddenness of the decision and the lack of preparation had critical and long-lasting consequences for the entire health system. This analysis, performed from the frontline perspective, clarifies the importance of a rigorous planning of any reform, as well as of involving peripheral actors and understanding the complex challenges that they face.
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Teacher Quality Roadmap: Improving Policies and Practices in Pittsburgh Public Schools
ERIC Educational Resources Information Center
Gonzalez, Angel; Kumar, Sudipti; Waymack, Nancy
2014-01-01
The Pittsburgh Public Schools study is the 12th district study since the National Council on Teacher Quality (NCTQ) began studying districts in-depth in 2009. The intent of these studies is to give select communities a comprehensive look at what is happening in their local school districts that may be either helping or hurting teacher quality, and…
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30 CFR 250.612 - Field well-workover rules.
Code of Federal Regulations, 2010 CFR
2010-07-01
... District Manager to determine specific operating requirements, field well-workover rules may be established on the District Manager's initiative or in response to a request from a lessee. Such rules may modify... initiative of the District Manager or upon the request of a lessee. ...
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30 CFR 250.512 - Field well-completion rules.
Code of Federal Regulations, 2010 CFR
2010-07-01
... the District Manager to determine specific operating requirements, field well-completion rules may be established on the District Manager's initiative or in response to a request from a lessee. Such rules may... the initiative of the District Manager or upon the request of a lessee. ...
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Wagaarachchi, P T; Graham, W J; Penney, G C; McCaw-Binns, A; Yeboah Antwi, K; Hall, M H
2001-08-01
The objective of the study described is to assess the feasibility and effectiveness of using a criterion-based clinical audit to measure and improve the quality of obstetric care at the district hospital level in developing countries. The focus is on the management of five life-threatening obstetric complications--hemorrhage, eclampsia, genital tract infection, obstructed labor and uterine rupture was audited using a "before and after" design. The five steps of the audit cycle were followed: establish criteria of good quality care; measure current practice (Review I); feedback findings and set targets; take action to change practice; and re-evaluate practice (Review II). Systematic literature review, panel discussions and pilot work led to the development of 31 audit criteria. Review I included 555 life-threatening complications occurring over 66 hospital-months; Review II included 342 complications over 42 hospital-months. Many common areas for improvement were identified across the four hospitals. Agreed mechanisms for achieving these improvements included clinical protocols, reviews of staffing, and training workshops. Some aspects of clinical monitoring, drug use and record keeping improved significantly between Reviews I and II. Criterion-based clinical audit in four typical district hospitals in Ghana and Jamaica is a feasible and acceptable method for quality assurance and appears to have improved the management of life-threatening obstetric complications.
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The Creative Cost Management Strategies of Two School Districts.
ERIC Educational Resources Information Center
Pheasant, Marilyn
1984-01-01
Two Oregon schools districts that have been effective in managing their resources are Reedsport, a smaller district and the subject of part 1 of this bulletin; and Beaverton, one of the largest districts in the state, the focus of part 2. The Reedsport district plans the use of its funds based on a goal-setting process in the areas of instruction,…
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Kawonga, Mary; Blaauw, Duane; Fonn, Sharon
2016-11-01
Administrative integration of disease control programmes (DCPs) within the district health system has been a health sector reform priority in South Africa for two decades. The reforms entail district managers assuming authority for the planning and monitoring of DCPs in districts, with DCP managers providing specialist support. There has been little progress in achieving this, and a dearth of research exploring why. Using a case study of HIV programme monitoring and evaluation (M&E), this article explores whether South Africa's health system is configured to support administrative integration. The article draws on data from document reviews and interviews with 54 programme and district managers in two of nine provinces, exploring their respective roles in decision-making regarding HIV M&E system design and in using HIV data for monitoring uptake of HIV interventions in districts. Using Mintzberg's configurations framework, we describe three organizational parameters: (a) extent of centralization (whether district managers play a role in decisions regarding the design of the HIV M&E system); (b) key part of the organization (extent to which sub-national programme managers vs district managers play the central role in HIV monitoring in districts); and (c) coordination mechanisms used (whether highly formalized and rules-based or more output-based to promote agency). We find that the health system can be characterized as Mintzberg's machine bureaucracy. It is centralized and highly formalized with structures, management styles and practices that promote programme managers as lead role players in the monitoring of HIV interventions within districts. This undermines policy objectives of district managers assuming this leadership role. Our study enhances the understanding of organizational factors that may limit the success of administrative integration reforms and suggests interventions that may mitigate this. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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EBMUD Drought Planning Put to the Test in 2014
NASA Astrophysics Data System (ADS)
Bray, B. S.
2014-12-01
The East Bay Municipal Utility District faced challenges in the unprecedented 2014 drought managing limited supplies to reliably serve its customers. The District's successful drought planning required a multi-faceted plan to preserve a reliable water supply, now and into the future. Planning has included investments in recycled water projects, passive and active customer conservation programs, and pursuit of alternative water supply options. EBMUD's drought planning efforts have been tested in 2014 when California experienced one of the driest years on record and the 2nd driest year in the Mokelumne Watershed, the source of 90% of the District's water supply. This presentation will highlight the effectiveness of drought planning in three areas: (1) implementing 10% water conservation as of July 2014, (2) the securing of nearly 20TAF of supplemental water supply conveyed through the Freeport Regional Water Project, and (3) operating EBMUD's Mokelumne River Project to meet fishery flow and water quality objectives.
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Conflict Management in Declining School Districts.
ERIC Educational Resources Information Center
Boyd, William Lowe; Wheaton, Dennis R.
1983-01-01
Professional literature about managing conflicts associated with declining enrollments indicates the existing tension in this area. A research study shows that, while upper-middle class districts may succeed using a rational approach to decision making, lower class districts, for various reasons, may not. Special problems of urban districts are…
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2010-01-01
Background The success of the Global Polio Eradication Initiative was remarkable, but four countries - Afghanistan, Pakistan, India and Nigeria - never interrupted polio transmission. Pakistan reportedly achieved all milestones except interrupting virus transmission. The aim of the study was to establish valid and reliable estimate for: routine oral polio vaccine (OPV) coverage, logistics management and the quality of monitoring systems in health facilities, NIDs OPV coverage, the quality of NIDs service delivery in static centers and mobile teams, and to ultimately provide scientific evidence for tailoring future interventions. Methods A cross-sectional study using lot quality assessment sampling was conducted in the District Nankana Sahib of Pakistan's Punjab province. Twenty primary health centers and their catchment areas were selected randomly as 'lots'. The study involved the evaluation of 1080 children aged 12-23 months for routine OPV coverage, 20 health centers for logistics management and quality of monitoring systems, 420 households for NIDs OPV coverage, 20 static centers and 20 mobile teams for quality of NIDs service delivery. Study instruments were designed according to WHO guidelines. Results Five out of twenty lots were rejected for unacceptably low routine immunization coverage. The validity of coverage was questionable to extent that all lots were rejected. Among the 54.1% who were able to present immunization cards, only 74.0% had valid immunization. Routine coverage was significantly associated with card availability and socioeconomic factors. The main reasons for routine immunization failure were absence of a vaccinator and unawareness of need for immunization. Health workers (96.9%) were a major source of information. All of the 20 lots were rejected for poor compliance in logistics management and quality of monitoring systems. Mean compliance score and compliance percentage for logistics management were 5.4 ± 2.0 (scale 0-9) and 59.4% while those for quality of monitoring systems were 3.3 ± 1.2 (scale 0-6) and 54.2%. The 15 out of 20 lots were rejected for unacceptably low NIDs coverage by finger-mark. All of the 20 lots were rejected for poor NIDs service delivery (mean compliance score = 11.7 ± 2.1 [scale 0-16]; compliance percentage = 72.8%). Conclusion Low coverage, both routine and during NIDs, and poor quality of logistics management, monitoring systems and NIDs service delivery were highlighted as major constraints in polio eradication and these should be considered in prioritizing future strategies. PMID:20144212
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Mushtaq, Muhammad Umair; Majrooh, Muhammad Ashraf; Ullah, Mohsin Zia Sana; Akram, Javed; Siddiqui, Arif Mahmood; Shad, Mushtaq Ahmad; Waqas, Muhammad; Abdullah, Hussain Muhammad; Ahmad, Waqar; Shahid, Ubeera; Khurshid, Usman
2010-02-09
The success of the Global Polio Eradication Initiative was remarkable, but four countries - Afghanistan, Pakistan, India and Nigeria - never interrupted polio transmission. Pakistan reportedly achieved all milestones except interrupting virus transmission. The aim of the study was to establish valid and reliable estimate for: routine oral polio vaccine (OPV) coverage, logistics management and the quality of monitoring systems in health facilities, NIDs OPV coverage, the quality of NIDs service delivery in static centers and mobile teams, and to ultimately provide scientific evidence for tailoring future interventions. A cross-sectional study using lot quality assessment sampling was conducted in the District Nankana Sahib of Pakistan's Punjab province. Twenty primary health centers and their catchment areas were selected randomly as 'lots'. The study involved the evaluation of 1080 children aged 12-23 months for routine OPV coverage, 20 health centers for logistics management and quality of monitoring systems, 420 households for NIDs OPV coverage, 20 static centers and 20 mobile teams for quality of NIDs service delivery. Study instruments were designed according to WHO guidelines. Five out of twenty lots were rejected for unacceptably low routine immunization coverage. The validity of coverage was questionable to extent that all lots were rejected. Among the 54.1% who were able to present immunization cards, only 74.0% had valid immunization. Routine coverage was significantly associated with card availability and socioeconomic factors. The main reasons for routine immunization failure were absence of a vaccinator and unawareness of need for immunization. Health workers (96.9%) were a major source of information. All of the 20 lots were rejected for poor compliance in logistics management and quality of monitoring systems. Mean compliance score and compliance percentage for logistics management were 5.4 +/- 2.0 (scale 0-9) and 59.4% while those for quality of monitoring systems were 3.3 +/- 1.2 (scale 0-6) and 54.2%. The 15 out of 20 lots were rejected for unacceptably low NIDs coverage by finger-mark. All of the 20 lots were rejected for poor NIDs service delivery (mean compliance score = 11.7 +/- 2.1 [scale 0-16]; compliance percentage = 72.8%). Low coverage, both routine and during NIDs, and poor quality of logistics management, monitoring systems and NIDs service delivery were highlighted as major constraints in polio eradication and these should be considered in prioritizing future strategies.
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Barnes, Carole; Sutherland, Sandra; Brattesani, Madeline; Wilhoit, Larry; Messenger, Belinda
2012-04-01
The U.S. Environmental Protection Agency encourages school officials to adopt integrated pest management (IPM) to reduce children's exposure to potentially harmful pesticides. In California, the Healthy Schools Act of 2000 (HSA) establishes right-to-know requirements for pesticide use in public schools; requires school districts to designate an IPM coordinator; and requires the California Department of Pesticide Regulation (DPR) to collect pesticide-use information from pest control businesses, conduct IPM training workshops, and promote least-toxic pest management practices. DPR periodically surveys school districts statewide to measure compliance with the HSA and the use of least-toxic management practices compatible with IPM and to guide DPR's training and outreach efforts. Results from three surveys, conducted in 2001, 2002, and 2004, show that an increasing number of districts use ant management practices compatible with IPM; however, fewer districts use IPM-compatible weed management practices. DPR's California School IPM program plans to develop technical materials and to conduct training workshops that will provide districts with more information about how to use an IPM program to prevent and manage weeds.
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30 CFR 250.1607 - Field rules.
Code of Federal Regulations, 2010 CFR
2010-07-01
... engineering information in a field enables a District Manager to determine specific operating requirements, field rules may be established for drilling, well completion, or well workover on the District Manager's... cause at any time upon the initiative of the District Manager or upon the request of a lessee. ...
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25 CFR 167.5 - Land management districts.
Code of Federal Regulations, 2011 CFR
2011-04-01
... present land management districts within the Navajo Indian Reservation, based on the social and economic... changes may be made when deemed necessary and advisable by the District Grazing Committees, Central...
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25 CFR 167.5 - Land management districts.
Code of Federal Regulations, 2010 CFR
2010-04-01
... present land management districts within the Navajo Indian Reservation, based on the social and economic... changes may be made when deemed necessary and advisable by the District Grazing Committees, Central...
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Strengthening integrated primary health care in Sofala, Mozambique
2013-01-01
Background Large increases in health sector investment and policies favoring upgrading and expanding the public sector health network have prioritized maternal and child health in Mozambique and, over the past decade, Mozambique has achieved substantial improvements in maternal and child health indicators. Over this same period, the government of Mozambique has continued to decentralize the management of public sector resources to the district level, including in the health sector, with the aim of bringing decision-making and resources closer to service beneficiaries. Weak district level management capacity has hindered the decentralization process, and building this capacity is an important link to ensure that resources translate to improved service delivery and further improvements in population health. A consortium of the Ministry of Health, Health Alliance International, Eduardo Mondlane University, and the University of Washington are implementing a health systems strengthening model in Sofala Province, central Mozambique. Description of implementation The Mozambique Population Health Implementation and Training (PHIT) Partnership focuses on improving the quality of routine data and its use through appropriate tools to facilitate decision making by health system managers; strengthening management and planning capacity and funding district health plans; and building capacity for operations research to guide system-strengthening efforts. This seven-year effort covers all 13 districts and 146 health facilities in Sofala Province. Evaluation design A quasi-experimental controlled time-series design will be used to assess the overall impact of the partnership strategy on under-5 mortality by examining changes in mortality pre- and post-implementation in Sofala Province compared with neighboring Manica Province. The evaluation will compare a broad range of input, process, output, and outcome variables to strengthen the plausibility that the partnership strategy led to health system improvements and subsequent population health impact. Discussion The Mozambique PHIT Partnership expects to provide evidence on the effect of efforts to improve data quality coupled with the introduction of tools, training, and supervision to improve evidence-based decision making. This contribution to the knowledge base on what works to enhance health systems is highly replicable for rapid scale-up to other provinces in Mozambique, as well as other sub-Saharan African countries with limited resources and a commitment to comprehensive primary health care. PMID:23819552
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77 FR 17093 - Notice of Public Meeting, Idaho Falls District Resource Advisory Council
Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-23
... Public Meeting, Idaho Falls District Resource Advisory Council AGENCY: Bureau of Land Management... Interior, Bureau of Land Management (BLM) Idaho Falls District Resource Advisory Council (RAC), will meet as indicated below. DATES: The Idaho Falls District RAC will meet in Salmon, Idaho on April 24-25...
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Developing, Managing, and Gaining Public Support for the School District Budget.
ERIC Educational Resources Information Center
Holly, William J.
1987-01-01
This bulletin focuses on four aspects of budget development and management in local school districts. Chapter 1 describes the general budget development process, highlighting variations some Oregon districts have found useful. The chapter outlines the responsibilities of educational agencies and district staff members at various levels and reviews…
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76 FR 28450 - Meeting of the California Desert District Advisory Council
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-17
... updates by council members and reports from the BLM California Desert District manager and five field office managers. In addition, the agenda will include updates on special recreation permits, council...) 697-5220. Dated: April 29, 2011. Teresa A. Raml, California Desert District Manager. [FR Doc. 2011...
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30 CFR 250.463 - Who establishes field drilling rules?
Code of Federal Regulations, 2010 CFR
2010-07-01
... Drilling Requirements § 250.463 Who establishes field drilling rules? (a) The District Manager may... drilling rules and nonconflicting requirements of this subpart. The District Manager may amend or cancel field drilling rules at any time. (b) You may request the District Manager to establish, amend, or...
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Hermeston, Mark W.
2002-07-19
Proposed Action: Vegetation Management for facilities located in the Snohomish District. BPA proposes total vegetation management (bareground) in the electrical substations, and, noxious weed management and maintenance of landscaping within the property boundaries of the listed facilities. These facilities are all located within the Snohomish District of the Snohomish Region.
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Prashanth, N. S.; Marchal, Bruno; Kegels, Guy; Criel, Bart
2014-01-01
Performance of local health services managers at district level is crucial to ensure that health services are of good quality and cater to the health needs of the population in the area. In many low- and middle-income countries, health services managers are poorly equipped with public health management capacities needed for planning and managing their local health system. In the south Indian Tumkur district, a consortium of five non-governmental organizations partnered with the state government to organize a capacity-building program for health managers. The program consisted of a mix of periodic contact classes, mentoring and assignments and was spread over 30 months. In this paper, we develop a theoretical framework in the form of a refined program theory to understand how such a capacity-building program could bring about organizational change. A well-formulated program theory enables an understanding of how interventions could bring about improvements and an evaluation of the intervention. In the refined program theory of the intervention, we identified various factors at individual, institutional, and environmental levels that could interact with the hypothesized mechanisms of organizational change, such as staff’s perceived self-efficacy and commitment to their organizations. Based on this program theory, we formulated context–mechanism–outcome configurations that can be used to evaluate the intervention and, more specifically, to understand what worked, for whom and under what conditions. We discuss the application of program theory development in conducting a realist evaluation. Realist evaluation embraces principles of systems thinking by providing a method for understanding how elements of the system interact with one another in producing a given outcome. PMID:25121081
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Prashanth, N S; Marchal, Bruno; Kegels, Guy; Criel, Bart
2014-01-01
Performance of local health services managers at district level is crucial to ensure that health services are of good quality and cater to the health needs of the population in the area. In many low- and middle-income countries, health services managers are poorly equipped with public health management capacities needed for planning and managing their local health system. In the south Indian Tumkur district, a consortium of five non-governmental organizations partnered with the state government to organize a capacity-building program for health managers. The program consisted of a mix of periodic contact classes, mentoring and assignments and was spread over 30 months. In this paper, we develop a theoretical framework in the form of a refined program theory to understand how such a capacity-building program could bring about organizational change. A well-formulated program theory enables an understanding of how interventions could bring about improvements and an evaluation of the intervention. In the refined program theory of the intervention, we identified various factors at individual, institutional, and environmental levels that could interact with the hypothesized mechanisms of organizational change, such as staff's perceived self-efficacy and commitment to their organizations. Based on this program theory, we formulated context-mechanism-outcome configurations that can be used to evaluate the intervention and, more specifically, to understand what worked, for whom and under what conditions. We discuss the application of program theory development in conducting a realist evaluation. Realist evaluation embraces principles of systems thinking by providing a method for understanding how elements of the system interact with one another in producing a given outcome.
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Qazi, Muhammad Suleman; Ali, Moazzam
2011-12-01
Use of data generated through the Health Management Information System (HMIS) in decision making has been facing various challenges ever since its inception in Pakistan. This descriptive qualitative study attempts to explore the perceptions of health managers to identify the status and issues in use of HMIS. Overall 26 managers (all men, ages ranging from 26 to 49 years; selected from federal level (2), provincial (4) and seven selected districts (20) from all four provinces) were interviewed face to face. The respondents identified a number of hurdles resulting in non-use, misuse and disuse of data. These included limited scope of HMIS, dubious data quality, political motives behind demand of data and an element of corruption in data reporting etc. A great deal of political and administrative will is required to institutionalize transparency in decision making in health management and HMIS is an important tool for doing so. Appropriate legislation and regulations are needed to create a conducive policy environment that would help in changing the existing decision making culture. The effective use of information requires that besides capacity development of district health managers in understanding and use of data, the higher level decision makers are provided with relevant data timely and in an easily understandable form along with the recommended actions pertinent to this data.
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ERIC Educational Resources Information Center
Al dakeel, Taghreed M.; Almannie, Mohamed A.
2015-01-01
The general school district of Riyadh is one of largest in the country of (45) school districts in Saudi Arabia. The school districts play an important roles in the development of education, therefore the objective of the study is to examine the roles of the management in the school districts to see if it is achieving competitive advantage. After…
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ERIC Educational Resources Information Center
Holmes, Lawrence W. O.; And Others
Development of an instrument to measure baseline levels of applied Total Quality Management (TQM) practices in South Dakota before the introduction and dissemination of TQM theory to the state's educational leaders is described. Using the interpretation of Deming's 14 points that was developed by J. J. Bonstigl, a 115-item initial item pool was…
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ERIC Educational Resources Information Center
Boyd, Don; Lankford, Hamp; Loeb, Susanna; Ronfeldt, Matthew; Wyckoff, Jim
2011-01-01
Many large urban school districts are rethinking their personnel management strategies, often giving increased control to schools in the hiring of teachers, reducing, for example, the importance of seniority. If school hiring authorities are able to make good decisions about whom to hire, these reforms have the potential to benefit schools and…
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NASA Astrophysics Data System (ADS)
Caballero, L. B.; Castillo, M. M.; Van Balen, K.
2017-08-01
Recent policies adopted in Cuba are producing a significant turn into the country's socioeconomic dynamics. Past shifting circumstances have demonstrated the positive and negative implications on heritage sites. In this regard, this paper presents a first stage of a research project aimed at monitoring the impact of socioeconomic dynamics on local heritage sites. The research partial results focus on the documentation of the evolution of a case study: Vista Alegre District in the city of Santiago de Cuba. Scholars have noted that the District's urban design and historic building stock represent its most significant heritage values. Such qualities are under permanent threat due to transformations and deterioration. In order to analyse current site condition, and to understand transformations as a result of socioeconomic dynamics, a Geographic Information System (GIS) was implemented as a monitoring and documenting tool. The GIS allowed integrating data related to the evolution of the urban layout, and the heritage buildings. Data was sourced from heritage management and urban planning offices, as well as from previous studies on the site. In addition, the analysis of remote sensing imagery, and a field survey helped to update the existing records, and to include new information with the purpose of assessing the integrity of heritage values. At this stage, maps that describe the site evolution, the significant changes over time, and the alterations to character defining elements served to identify sectors of different scenic qualities. Results are essential to contribute to draft management strategies as part of decision making.
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78 FR 19522 - Notice of Public Meeting, Idaho Falls District Resource Advisory Council Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-01
... Public Meeting, Idaho Falls District Resource Advisory Council Meeting AGENCY: Bureau of Land Management... Interior, Bureau of Land Management (BLM) Idaho Falls District Resource Advisory Council (RAC), will meet as indicated below. DATES: The Idaho Falls District RAC will meet in Challis, Idaho, April 23-24...
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75 FR 27360 - Notice of Public Meeting, Idaho Falls District Resource Advisory Council Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-14
... Public Meeting, Idaho Falls District Resource Advisory Council Meeting AGENCY: Bureau of Land Management... Interior, Bureau of Land Management (BLM) Idaho Falls District Resource Advisory Council (RAC), will meet as indicated below. DATES: The Idaho Falls District RAC will meet in Salmon, Idaho on June 22-23...
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77 FR 49826 - Notice of Public Meeting, Idaho Falls District Resource Advisory Council Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-17
... Public Meeting, Idaho Falls District Resource Advisory Council Meeting AGENCY: Bureau of Land Management... Interior, Bureau of Land Management (BLM) Idaho Falls District Resource Advisory Council (RAC), will meet as indicated below. DATES: The Idaho Falls District RAC will meet in Idaho Falls, Idaho on September...
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78 FR 38071 - Notice of Public Meeting, Idaho Falls District Resource Advisory Council Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2013-06-25
... Public Meeting, Idaho Falls District Resource Advisory Council Meeting AGENCY: Bureau of Land Management... Interior, Bureau of Land Management (BLM) Idaho Falls District Resource Advisory Council (RAC), will meet as indicated below. DATES: The Idaho Falls District RAC will meet in Pocatello, Idaho, August 27-28...
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78 FR 17716 - Notice of Public Meeting, Idaho Falls District Resource Advisory Council Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2013-03-22
... Public Meeting, Idaho Falls District Resource Advisory Council Meeting AGENCY: Bureau of Land Management... Interior, Bureau of Land Management (BLM) Idaho Falls District Resource Advisory Council (RAC), will meet as indicated below. DATES: The Idaho Falls District RAC will meet in Challis, Idaho, April 23-24...
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School District Cash Management. Program Audit.
ERIC Educational Resources Information Center
New York State Legislative Commission on Expenditure Review, Albany.
New York State law permits school districts to invest cash not immediately needed for district operation and also specifies the kinds of investments that may be made in order to ensure the safety and liquidity of public funds. This audit examines cash management and investment practices in New York state's financially independent school districts.…
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Translating childhood tuberculosis case management research into operational policies.
Safdar, N; Hinderaker, S G; Baloch, N A; Enarson, D A; Khan, M A; Morkve, O
2011-08-01
The control of childhood tuberculosis (TB) has been of low priority in TB programmes in high-burden settings. The objective of this paper was to describe the development and testing of tools for the management of childhood TB. The Pakistan National TB Control Programme embarked on a number of activities, including the establishment of policy guidelines for the management of childhood TB and later a guidance document, 'Case Management Desk Guide and Structured Monitoring', to demonstrate the implementation of childhood TB interventions in a programme context. Initial results showed improved case finding and treatment outcome in implementation sites compared with control districts. However, further programme attention is required to improve quality.
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Mwaniki, Michael K; Vaid, Sonali; Chome, Isaac Mwamuye; Amolo, Dorcas; Tawfik, Youssef
2014-09-21
Health-related millennium development goals are off track in most of the countries in the sub-Saharan African region. Lack of access to, and low utilization of essential services and high-impact interventions, together with poor quality of health services, may be partially responsible for this lack of progress. We explored whether improvement approaches can be applied to increase utilization of antenatal care (ANC), health facility deliveries, prevention of mother-to-child transmission services and adherence to ANC standards of care in a rural district in Kenya. We targeted improvement of ANC services because ANC is a vital point of entry for most high-impact interventions targeting the pregnant mother. Healthcare workers in 21 public health facilities in Kwale District, Kenya formed improvement teams that met regularly to examine performance gaps in service delivery, identify root causes of such gaps, then develop and implement change ideas to address the gaps. Data were collected and entered into routine government registers by the teams on a daily basis. Data were abstracted from the government registers monthly to evaluate 20 indicators of care quality for improvement activities. For the purposes of this study, aggregate data for the district were collected from the District Health Management Office. The number of pregnant mothers starting ANC within the first trimester and those completing at least four ANC checkups increased significantly (from 41 (8%) to 118 (24%) p=0.002 and from 186 (37%) to 316 (64%) p<0.001, respectively). The proportions of ANC visits in which provision of care adhered to the required standards increased from <40% to 80-100% within three to six months (X2 for trend 4.07, p<0.001). There was also a significant increase in the number of pregnant women delivering in health facilities each month from 164 (33%) to 259 (52%) (p=0.012). Improvement approaches can be applied in rural health care facilities in low-income settings to increase utilization of services and adherence to standards of care. Using the quality improvement methodology to target integrated health services is feasible. Longer follow-up periods are needed to gather more evidence on the sustainability of quality improvement initiatives in low-income countries.
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Water-use data by category, county, and water management district in Florida, 1950-90
Marella, R.L.
1995-01-01
The population for Florida in 1990 was estimated at 12.94 million, an increase of nearly 10.17 million (370 percent) from the population of 2.77 million in 1950. Consequently, water use (fresh and saline) in Florida increased nearly 510 percent (15,175 million gallons per day) between 1950 and 1990. The resident population of the State is projected to surpass 20 million by the year 2020. Through the cooperation of the Florida Department of Environ- mental Protection and the U.S. Geologial Survey, water-use data for the period between 1950 and 1990 has been consolidated into one publication. This report aggregates and summarizes the quantities of water withdrawn annually for all water-use categories (public supply, self-supplied domestic, self-supplied commercial-industrial, agriculture, and thermoelectric power generation), by counties, and water management districts in Florida from 1950 through 1990. Total water withdrawn in Florida increased from 2,923 million gallons per day in 1950 to 17,898 million gallons per day in 1990. Surface- water withdrawals during 1950 totaled 2,333 million gallons per day but were not differentiated between fresh and saline, therefore, comparisons between fresh and saline water were made beginning with 1955 data. Freshwater withdrawals increased 245 percent between 1955 and 1990. Saline water withdrawals increased more than 1,500 percent between 1955 and 1990. In 1955, more than 47 percent of the fresh- water used was withdrawn from ground-water sources and 53 percent was withdrawn from surface-water sources. In 1990, nearly 62 percent of the fresh- water withdrawn was from ground-water sources, while 38 percent was withdrawn from surface-water sources. The steady increase in ground-water withdrawals since the 1950's primarily is a result of the ability to drill and pump water more economically from large, deep wells and the reliability of both the quality and quantity of water from these wells. Water withdrawn for public supply in Florida increased 1,030 percent between 1950 and 1990. The population served by public supply increased from 1.66 million in 1950 to 11.23 million in 1990, and the percentage of the population served by public supply increased from 60 percent in 1950 to nearly 88 percent in 1990. Freshwater withdrawn for self- supplied domestic use in Florida increased 1,010 percent, self-supplied commercial-industrial uses increased 170 percent, and agriculture increased 915 percent between 1950 and 1990. Freshwater with- drawals for thermoelectric power generation decreased 8 percent between 1955 and 1990, while saline water withdrawals increased nearly 1,540 percent between 1955 and 1990. Between 1965 and 1990, total freshwater withdrawals increased in 58 of the 67 counties in Florida. Fresh ground-water was withdrawn in all 67 counties in 1965 through 1990, and increased in 65 counties between 1965 and 1990. Fresh surface-water was withdrawn in 60 counties from 1965 to 1990, and increased in 42 counties between 1965 and 1990. The change in total freshwater withdrawals within the water management districts between 1975 and 1990 were as follows: Northwest Florida Water Management District increased 3 percent, St. Johns River Water Management District decreased 6 percent, South Florida Water Management District increased 37 percent, Southwest Florida Water Management District decreased 1 percent, and Suwannee River Water Management District increased 8 percent.(USGS)
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Auditing the Immunization Data Quality from Routine Reports in Shangyu District, East China
Hu, Yu; Zhang, Xinpei; Li, Qian; Chen, Yaping
2016-01-01
Objective: To evaluate the immunization data quality in Shangyu District, East China. Methods: An audit for immunization data for the year 2014 was conducted in 20 vaccination clinics of Shangyu District. The consistency of immunization data was estimated by verification factors (VFs), which was the proportion of vaccine doses reported as being administered that could be verified by written documentation at vaccination clinics. The quality of monitoring systems was evaluated using the quality index (QI). Results: The VFs of 20 vaccine doses ranged from 0.94 to 1.04 at the district level. The VFs for the 20 vaccination clinics ranged from 0.57 to 1.07. The VFs for Shangyu District was 0.98. The mean of total QI score of the 20 vaccination clinics was 80.32%. A significant correlation between the VFs of the 3rd dose of the diphtheria–tetanus–pertussis combined vaccine (DTP) and QI scores was observed at the vaccination clinic level. Conclusions: Deficiencies in data consistency and immunization reporting practice in Shangyu District were observed. Targeted measures are suggested to improve the quality of the immunization reporting system in vaccination clinics with poor data consistency. PMID:27869729
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Auditing the Immunization Data Quality from Routine Reports in Shangyu District, East China.
Hu, Yu; Zhang, Xinpei; Li, Qian; Chen, Yaping
2016-11-18
Objective: To evaluate the immunization data quality in Shangyu District, East China. Methods: An audit for immunization data for the year 2014 was conducted in 20 vaccination clinics of Shangyu District. The consistency of immunization data was estimated by verification factors (VFs), which was the proportion of vaccine doses reported as being administered that could be verified by written documentation at vaccination clinics. The quality of monitoring systems was evaluated using the quality index (QI). Results: The VFs of 20 vaccine doses ranged from 0.94 to 1.04 at the district level. The VFs for the 20 vaccination clinics ranged from 0.57 to 1.07. The VFs for Shangyu District was 0.98. The mean of total QI score of the 20 vaccination clinics was 80.32%. A significant correlation between the VFs of the 3rd dose of the diphtheria-tetanus-pertussis combined vaccine (DTP) and QI scores was observed at the vaccination clinic level. Conclusions: Deficiencies in data consistency and immunization reporting practice in Shangyu District were observed. Targeted measures are suggested to improve the quality of the immunization reporting system in vaccination clinics with poor data consistency.
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Impact of Lean on patient cycle and waiting times at a rural district hospital in KwaZulu-Natal.
Naidoo, Logandran; Mahomed, Ozayr H
2016-07-26
Prolonged waiting time is a source of patient dissatisfaction with health care and is negatively associated with patient satisfaction. Prolonged waiting times in many district hospitals result in many dissatisfied patients, overworked and frustrated staff, and poor quality of care because of the perceived increased workload. The aim of the study was to determine the impact of Lean principles techniques, and tools on the operational efficiency in the outpatient department (OPD) of a rural district hospital. The study was conducted at the Catherine Booth Hospital (CBH) - a rural district hospital in KwaZulu-Natal, South Africa. This was an action research study with pre-, intermediate-, and post-implementation assessments. Cycle and waiting times were measured by direct observation on two occasions before, approximately two-weekly during, and on two occasions after Lean implementation. A standardised data collection tool was completed by the researcher at each of the six key service nodes in the OPD to capture the waiting times and cycle times. All six service nodes showed a reduction in cycle times and waiting times between the baseline assessment and post-Lean implementation measurement. Significant reduction was achieved in cycle times (27%; p < 0.05) and waiting times (from 11.93 to 10 min; p = 0.03) at the Investigations node. Although the target reduction was not achieved for the Consulting Room node, there was a significant reduction in waiting times from 80.95 to 74.43 min, (p < 0.001). The average efficiency increased from 16.35% (baseline) to 20.13% (post-intervention). The application of Lean principles, tools and techniques provides hospital managers with an evidence-based management approach to resolving problems and improving quality indicators.
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NASA Astrophysics Data System (ADS)
Gilani, H.; Jain, A. K.
2016-12-01
This study assembles information from three sources - remote sensing, terrestrial photography and ground-based inventory data, to understand the dynamics of Nepal's tropical and sub-tropical forests and plantation sites for the period 1990-2015. Our study focuses on following three specific district areas, which have conserved forests through social and agroforestry management practices: 1. Dolakha district: This site has been selected to study the impact of community-based forest management on land cover change using repeat photography and satellite imagery, in combination with interviews with community members. The study time period is during the period 1990-2010. We determined that satellite data with ground photographs can provide transparency for long term monitoring. The initial results also suggests that community-based forest management program in the mid-hills of Nepal was successful. 2. Chitwan district: Here we use high resolution remote sensing data and optimized community field inventories to evaluate potential application and operational feasibility of community level REDD+ measuring, reporting and verification (MRV) systems. The study uses temporal dynamics of land cover transitions, tree canopy size classes and biomass over a Kayar khola watershed REDD+ study area with community forest to evaluate satellite Image segmentation for land cover, linear regression model for above ground biomass (AGB), and estimation and monitoring field data for tree crowns and AGB. We study three specific years 2002, 2009, 2012. Using integration of WorldView-2 and airborne LiDAR data for tree species level. 3. Nuwakot district: This district was selected to study the impact of establishment of tree plantation on total barren/fallow. Over the last 40 year, this area has went through a drastic changes, from barren land to forest area with tree species consisting of Dalbergia sissoo, Leucaena leucocephala, Michelia champaca, etc. In 1994, this district area was registered and established to grow and process high quality trees shaded of Arabica coffee beans. Here we use temporal satellite images and repeat terrestrial and aerial photographs, along with plot level biomass to show impact of this positive transformation of the landscape on above and below ground carbon masses. The study time period is 1990-2015.
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ERIC Educational Resources Information Center
Schmidbauer, Hollace J.
2010-01-01
In the late 1990s, teachers in five pilot districts in Ohio were trained during the Baldrige in Education Initiative (BiE IN). Training included Baldrige's theory, quality process and quality tools. The study was a follow-up to determine the effect of the use of the Ohio Baldrige Initiative training in the pilot districts (and other early…
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Sodzi-Tettey, S; Aikins, M; Awoonor-Williams, J K; Agyepong, I A
2012-12-01
In 2004, Ghana started implementing a National Health Insurance Scheme (NHIS) to remove cost as a barrier to quality healthcare. Providers were initially paid by fee - for - service. In May 2008, this changed to paying providers by a combination of Ghana - Diagnostic Related Groupings (G-DRGs) for services and fee - for - service for medicines through the claims process. The study evaluated the claims management processes for two District MHIS in the Upper East Region of Ghana. Retrospective review of secondary claims data (2008) and a prospective observation of claims management (2009) were undertaken. Qualitative and quantitative approaches were used for primary data collection using interview guides and checklists. The reimbursements rates and value of rejected claims were calculated and compared for both districts using the z test. The null hypothesis was that no differences existed in parameters measured. Claims processes in both districts were similar and predominantly manual. There were administrative capacity, technical, human resource and working environment challenges contributing to delays in claims submission by providers and vetting and payment by schemes. Both Schemes rejected less than 1% of all claims submitted. Significant differences were observed between the Total Reimbursement Rates (TRR) and the Total Timely Reimbursement Rates (TTRR) for both schemes. For TRR, 89% and 86% were recorded for Kassena Nankana and Builsa Schemes respectively while for TTRR, 45% and 28% were recorded respectively. Ghana's NHIS needs to reform its provider payment and claims submission and processing systems to ensure simpler and faster processes. Computerization and investment to improve the capacity to administer for both purchasers and providers will be key in any reform.
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ERIC Educational Resources Information Center
Liberatos, Penny; Leone, Jennifer; Craig, Ann Marie; Frei, Elizabeth Mary; Fuentes, Natalie; Harris, India Marie
2013-01-01
Background: School nurses play a central role in assisting elementary school children in managing their asthma, especially those in higher-risk school districts that are at increased risk of uncontrolled asthma. Study purposes are to (1) identify barriers to asthma management by school nurses in higher-risk school districts; and (2) assess the…
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The Art of Investing School District Funds: Rules of the Game.
ERIC Educational Resources Information Center
Flynn, Jeffrey
The "art" of investment and the relationships between the cash manager and the outside professionals who implement the steps that entail cash management are the subjects of the 11 chapters of this guide to investing school district funds. Chapter 1 describes the role and responsibility of the small school district cash manager. Chapter 2 discusses…
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-01
... Extension of Call for Nominations for the Bureau of Land Management's California Desert District Advisory... Management's (BLM) California Desert District is extending the call for nominations from the public for six..., California Desert District Office, 22835 Calle San Juan De Los Lagos, Moreno Valley, CA 92553. FOR FURTHER...
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ERIC Educational Resources Information Center
General Accounting Office, Washington, DC. Health, Education, and Human Services Div.
School districts nationwide are experimenting with a range of reform options, one of which is private management of public schools. This General Accounting Office (GAO) report describes the early experiences of four school districts that contracted with private companies for management of their public schools. Specifically, the report describes:…
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ERIC Educational Resources Information Center
New York State Education Dept., Albany. Div. of Elementary and Secondary Education Planning.
Designed to provide assistance to school district personnel who seek to develop a plan for information management and related applications of technology, this guide presents the School District Information Study (SDIS) model for the review of management policies, procedures, and activities related to information processing done by school district…
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-02
... Promulgation of Air Quality Implementation Plans; District of Columbia; Regional Haze State Implementation Plan... of Columbia Regional Haze Plan, a revision to the District of Columbia State Implementation Plan (SIP... existing anthropogenic impairment of visibility in mandatory Class I areas through a regional haze program...
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Bhat, Shirish; Motz, Louis H; Pathak, Chandra; Kuebler, Laura
2015-01-01
A geostatistical method was applied to optimize an existing groundwater-level monitoring network in the Upper Floridan aquifer for the South Florida Water Management District in the southeastern United States. Analyses were performed to determine suitable numbers and locations of monitoring wells that will provide equivalent or better quality groundwater-level data compared to an existing monitoring network. Ambient, unadjusted groundwater heads were expressed as salinity-adjusted heads based on the density of freshwater, well screen elevations, and temperature-dependent saline groundwater density. The optimization of the numbers and locations of monitoring wells is based on a pre-defined groundwater-level prediction error. The newly developed network combines an existing network with the addition of new wells that will result in a spatial distribution of groundwater monitoring wells that better defines the regional potentiometric surface of the Upper Floridan aquifer in the study area. The network yields groundwater-level predictions that differ significantly from those produced using the existing network. The newly designed network will reduce the mean prediction standard error by 43% compared to the existing network. The adoption of a hexagonal grid network for the South Florida Water Management District is recommended to achieve both a uniform level of information about groundwater levels and the minimum required accuracy. It is customary to install more monitoring wells for observing groundwater levels and groundwater quality as groundwater development progresses. However, budget constraints often force water managers to implement cost-effective monitoring networks. In this regard, this study provides guidelines to water managers concerned with groundwater planning and monitoring.
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Buja, Alessandra; Damiani, Gianfranco; Gini, Rosa; Visca, Modesta; Federico, Bruno; Donato, Daniele; Francesconi, Paolo; Marini, Alessandro; Donatini, Andrea; Brugaletta, Salvatore; Baldo, Vincenzo; Donata Bellentani, Maria
2014-01-01
Our interest in chronic conditions is due to the fact that, worldwide, chronic diseases have overtaken infectious diseases as the leading cause of death and disability, so their management represents an important challenge for health systems. The aim of this study was to compare the performance of primary health care services in managing diabetes, congestive heart failure (CHF) and coronary heart disease (CHD), by age group. This population-based retrospective cohort study was conducted in Italy, enrolling 1,948,622 residents ≥ 16 years old. A multilevel regression model was applied to analyze compliance to care processes with explanatory variables at both patient and district level, using age group as an independent variable, and adjusting for sex, citizenship, disease duration, and Charlson index on the first level, and for District Health Unit on the second level. The quality of chronic disease management showed an inverted U-shaped relationship with age. In particular, our findings indicate lower levels for young adults (16-44 year-olds), adults (45-64), and oldest old (+85) than for patients aged 65-74 in almost all quality indicators of CHD, CHF and diabetes management. Young adults (16-44 y), adults (45-64 y), the very old (75-84 y) and the oldest old (+85 y) patients with CHD, CHF and diabetes are less likely than 65-74 year-old patients to be monitored and treated using evidence-based therapies, with the exceptions of echocardiographic monitoring for CHF in young adult patients, and renal monitoring for CHF and diabetes in the very old. Our study shows that more effort is needed to ensure that primary health care systems are sensitive to chronic conditions in the young and in the very elderly.
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Forecasting in an integrated surface water-ground water system: The Big Cypress Basin, South Florida
NASA Astrophysics Data System (ADS)
Butts, M. B.; Feng, K.; Klinting, A.; Stewart, K.; Nath, A.; Manning, P.; Hazlett, T.; Jacobsen, T.
2009-04-01
The South Florida Water Management District (SFWMD) manages and protects the state's water resources on behalf of 7.5 million South Floridians and is the lead agency in restoring America's Everglades - the largest environmental restoration project in US history. Many of the projects to restore and protect the Everglades ecosystem are part of the Comprehensive Everglades Restoration Plan (CERP). The region has a unique hydrological regime, with close connection between surface water and groundwater, and a complex managed drainage network with many structures. Added to the physical complexity are the conflicting needs of the ecosystem for protection and restoration, versus the substantial urban development with the accompanying water supply, water quality and flood control issues. In this paper a novel forecasting and real-time modelling system is presented for the Big Cypress Basin. The Big Cypress Basin includes 272 km of primary canals and 46 water control structures throughout the area that provide limited levels of flood protection, as well as water supply and environmental quality management. This system is linked to the South Florida Water Management District's extensive real-time (SCADA) data monitoring and collection system. Novel aspects of this system include the use of a fully distributed and integrated modeling approach and a new filter-based updating approach for accurately forecasting river levels. Because of the interaction between surface- and groundwater a fully integrated forecast modeling approach is required. Indeed, results for the Tropical Storm Fay in 2008, the groundwater levels show an extremely rapid response to heavy rainfall. Analysis of this storm also shows that updating levels in the river system can have a direct impact on groundwater levels.
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Getting by on credit: how district health managers in Ghana cope with the untimely release of funds
Asante, Augustine D; Zwi, Anthony B; Ho, Maria T
2006-01-01
Background District health systems in Africa depend largely on public funding. In many countries, not only are these funds insufficient, but they are also released in an untimely fashion, thereby creating serious cash flow problems for district health managers. This paper examines how the untimely release of public sector health funds in Ghana affects district health activities and the way district managers cope with the situation. Methods A qualitative approach using semi-structured interviews was adopted. Two regions (Northern and Ashanti) covering the northern and southern sectors of Ghana were strategically selected. Sixteen managers (eight directors of health services and eight district health accountants) were interviewed between 2003/2004. Data generated were analysed for themes and patterns. Results The results showed that untimely release of funds disrupts the implementation of health activities and demoralises district health staff. However, based on their prior knowledge of when funds are likely to be released, district health managers adopt a range of informal mechanisms to cope with the situation. These include obtaining supplies on credit, borrowing cash internally, pre-purchasing materials, and conserving part of the fourth quarter donor-pooled funds for the first quarter of the next year. While these informal mechanisms have kept the district health system in Ghana running in the face of persistent delays in funding, some of them are open to abuse and could be a potential source of corruption in the health system. Conclusion Official recognition of some of these informal managerial strategies will contribute to eliminating potential risks of corruption in the Ghanaian health system and also serve as an acknowledgement of the efforts being made by local managers to keep the district health system functioning in the face of budgetary constraints and funding delays. It may boost the confidence of the managers and even enhance service delivery. PMID:16916445
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Getting by on credit: how district health managers in Ghana cope with the untimely release of funds.
Asante, Augustine D; Zwi, Anthony B; Ho, Maria T
2006-08-17
District health systems in Africa depend largely on public funding. In many countries, not only are these funds insufficient, but they are also released in an untimely fashion, thereby creating serious cash flow problems for district health managers. This paper examines how the untimely release of public sector health funds in Ghana affects district health activities and the way district managers cope with the situation. A qualitative approach using semi-structured interviews was adopted. Two regions (Northern and Ashanti) covering the northern and southern sectors of Ghana were strategically selected. Sixteen managers (eight directors of health services and eight district health accountants) were interviewed between 2003/2004. Data generated were analysed for themes and patterns. The results showed that untimely release of funds disrupts the implementation of health activities and demoralises district health staff. However, based on their prior knowledge of when funds are likely to be released, district health managers adopt a range of informal mechanisms to cope with the situation. These include obtaining supplies on credit, borrowing cash internally, pre-purchasing materials, and conserving part of the fourth quarter donor-pooled funds for the first quarter of the next year. While these informal mechanisms have kept the district health system in Ghana running in the face of persistent delays in funding, some of them are open to abuse and could be a potential source of corruption in the health system. Official recognition of some of these informal managerial strategies will contribute to eliminating potential risks of corruption in the Ghanaian health system and also serve as an acknowledgement of the efforts being made by local managers to keep the district health system functioning in the face of budgetary constraints and funding delays. It may boost the confidence of the managers and even enhance service delivery.
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Kwamie, Aku; van Dijk, Han; Agyepong, Irene Akua
2014-06-16
Although there is widespread agreement that strong district manager decision-making improves health systems, understanding about how the design and implementation of capacity-strengthening interventions work is limited. The Ghana Health Service has adopted the Leadership Development Programme (LDP) as one intervention to support the development of management and leadership within district teams. This paper seeks to address how and why the LDP 'works' when it is introduced into a district health system in Ghana, and whether or not it supports systems thinking in district teams. We undertook a realist evaluation to investigate the outcomes, contexts, and mechanisms of the intervention. Building on two working hypotheses developed from our earlier work, we developed an explanatory case study of one rural district in the Greater Accra Region of Ghana. Data collection included participant observation, document review, and semi-structured interviews with district managers prior to, during, and after the intervention. Working backwards from an in-depth analysis of the context and observed short- and medium-term outcomes, we drew a causal loop diagram to explain interactions between contexts, outcomes, and mechanisms. The LDP was a valuable experience for district managers and teams were able to attain short-term outcomes because the novel approach supported teamwork, initiative-building, and improved prioritisation. However, the LDP was not institutionalised in district teams and did not lead to increased systems thinking. This was related to the context of high uncertainty within the district, and hierarchical authority of the system, which triggered the LDP's underlying goal of organisational control. Consideration of organisational context is important when trying to sustain complex interventions, as it seems to influence the gap between short- and medium-term outcomes. More explicit focus on systems thinking principles that enable district managers to better cope with their contexts may strengthen the institutionalisation of the LDP in the future.
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2014-01-01
Background Although there is widespread agreement that strong district manager decision-making improves health systems, understanding about how the design and implementation of capacity-strengthening interventions work is limited. The Ghana Health Service has adopted the Leadership Development Programme (LDP) as one intervention to support the development of management and leadership within district teams. This paper seeks to address how and why the LDP ‘works’ when it is introduced into a district health system in Ghana, and whether or not it supports systems thinking in district teams. Methods We undertook a realist evaluation to investigate the outcomes, contexts, and mechanisms of the intervention. Building on two working hypotheses developed from our earlier work, we developed an explanatory case study of one rural district in the Greater Accra Region of Ghana. Data collection included participant observation, document review, and semi-structured interviews with district managers prior to, during, and after the intervention. Working backwards from an in-depth analysis of the context and observed short- and medium-term outcomes, we drew a causal loop diagram to explain interactions between contexts, outcomes, and mechanisms. Results The LDP was a valuable experience for district managers and teams were able to attain short-term outcomes because the novel approach supported teamwork, initiative-building, and improved prioritisation. However, the LDP was not institutionalised in district teams and did not lead to increased systems thinking. This was related to the context of high uncertainty within the district, and hierarchical authority of the system, which triggered the LDP’s underlying goal of organisational control. Conclusions Consideration of organisational context is important when trying to sustain complex interventions, as it seems to influence the gap between short- and medium-term outcomes. More explicit focus on systems thinking principles that enable district managers to better cope with their contexts may strengthen the institutionalisation of the LDP in the future. PMID:24935521
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Kawonga, Mary; Blaauw, Duane; Fonn, Sharon
2015-06-01
With increasing interest in maximising synergies between disease control programmes (DCP) and general health services (GHS), methods are needed to measure interactions between DCP and GHS actors. In South Africa, administrative integration reforms make GHS managers at decentralised level (district managers) responsible for the oversight of DCP operations within districts, with DCP managers (programme managers) providing specialist support. The reforms necessitate interdependence, but these actors work together ineffectively. Communication is crucial for joint working, but no research to assess communication between these actors has been done. This study explores the use of social network analysis (SNA) to measure the extent to which programme and district managers in South Africa communicate, using HIV monitoring and evaluation (M&E) as an exemplar. Data were collected from fifty one managers in two provinces during 2010-2011, to measure: a) one-on-one task-related communication - talking about the collation (verification, reporting) and use of HIV data for monitoring HIV interventions; and b) group communication through co-participating in management committees where HIV data are used for monitoring HIV interventions in districts. SNA measures were computed to describe actor centrality, network density (cohesion), and communication within and between respective manager groups. Block modelling was applied to identify management committees that connect respective manager groups. Results show HIV programme managers located at higher level communicated largely amongst themselves as a group (homophily), seldom talked to the district managers to whom they are supposed to provide specialist HIV M&E support, and rarely participated with them in management committees. This research demonstrates the utility of SNA as a tool for measuring the extent of communication between DCP and GHS actors at sub-national level. Actions are needed to bridge observed communication gaps in order to promote collaborative monitoring of HIV programme interventions within districts. Copyright © 2015 Elsevier Ltd. All rights reserved.
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ERIC Educational Resources Information Center
Walker, Elaine M.
2002-01-01
Studied the implementation of school-based management in 30 of the poorest school districts in New Jersey (the Abbott districts). Findings show that genuine autonomy has been usurped by increased state power and authority, and that state elites allow little opportunity for capacity building at the district level. The level of democratization has…
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Motebang, David; Mathabo, Lebina; Rotz, Philip J.; Wanyoike, Joseph; Peter, Trevor
2012-01-01
Background The improvment of the quality of testing services in public laboratories is a high priority in many countries. Consequently, initiatives to train laboratory staff on quality management are being implemented, for example, the World Health Organization Regional Headquarters for Africa (WHO-AFRO) Strengthening Laboratory Management Towards Accreditation (SLMTA). Mentorship may be an effective way to augment these efforts. Methods Mentorship was implemented at four hospital laboratories in Lesotho, three districts and one central laboratory, between June 2009 and December 2010. The mentorship model that was implemented had the mentor fully embedded within the operations of each of the laboratories. It was delivered in a series of two mentoring engagements of six and four week initial and follow-up visits respectively. In total, each laboratory received 10 weeks mentorship that was separated by 6–8 weeks. Quality improvements were measured at baseline and at intervals during the mentorship using the WHO-AFRO Strengthening Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist and scoring system. Results At the beginning of the mentorship, all laboratories were at the SLIPTA zero star rating. After the initial six weeks of mentorship, two of the three district laboratories had improved from zero to one (out of five) star although the difference between their baseline (107.7) and the end of the six weeks (136.3) average scores was not statistically significant (p = 0.25). After 10 weeks of mentorship there was a significant improvement in average scores (182.3; p = 0.034) with one laboratory achieving WHO-AFRO three out of a possible five star status and the two remaining laboratories achieving a two star status. At Queen Elizabeth II (QE II) Central Laboratory, the average baseline score was 44%, measured using a section-specific checklist. There was a significant improvement by five weeks (57.2%; p = 0.021). Conclusion The mentorship programme in this study resulted in significant measurable improvements towards preparation for the WHO-AFRO SLIPTA process in less than six months. We recommend that mentorship be incorporated into laboratory quality improvement and management training programmes such as SLMTA, in order to accelerate the progress of laboratories towards achieving accreditation. PMID:29062726
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ERIC Educational Resources Information Center
Boyd, Donald; Lankford, Hamilton; Loeb, Susanna; Ronfeldt, Matthew; Wyckoff, James
2010-01-01
Many large urban school districts are rethinking their personnel management strategies, often giving increased control to schools in the hiring of teachers, reducing, for example, the importance of seniority. If school hiring authorities are able to make good decisions about whom to hire, these reforms have the potential to benefit schools and…
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Laparoscopic approach to gastrointestinal malignancies: Toward the future with caution
Bencini, Lapo; Bernini, Marco; Farsi, Marco
2014-01-01
After the rapid acceptance of laparoscopy to manage multiple benign diseases arising from gastrointestinal districts, some surgeons started to treat malignancies by the same way. However, if the limits of laparoscopy for benign diseases are mainly represented by technical issues, oncologic outcomes remain the foundation of any procedures to cure malignancies. Cancerous patients represent an important group with peculiar aspects including reduced survival expectancy, worsened quality of life due to surgery itself and adjuvant therapies, and challenging psychological impact. All these issues could, potentially, receive a better management with a laparoscopic surgical approach. In order to confirm such aspects, similarly to testing the newest weapons (surgical or pharmacologic) against cancer, long-term follow-up is always recommendable to assess the real benefits in terms of overall survival, cancer-free survival and quality of life. Furthermore, it seems of crucial importance that surgeons will be correctly trained in specific oncologic principles of surgical oncology as well as in modern miniinvasive technologies. Therefore, laparoscopic treatment of gastrointestinal malignancies requires more caution and deep analysis of published evidences, as compared to those achieved for inflammatory bowel diseases, gastroesophageal reflux disease or diverticular disease. This review tries to examine the evidence available to date for the use of laparoscopy and robotics in malignancies arising from the gastrointestinal district. PMID:24587655
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Agricultural area impacts within a natural area: Cades cove, a case history
NASA Astrophysics Data System (ADS)
Bratton, Susan Power; Mathews, Raymond C.; White, Peter S.
1980-09-01
Agricultural management in Cades Cove, an historic district in Great Smoky Mountains National Park, has affected natural resources both within the district and in the adjoining natural areas. Aquatic impacts of haying and cattle grazing included increases in water temperatures, turbidity, nutrient loading, and bacterial counts and decreases in benthic macroinvertebrate density and fish biomass. Wildlife populations, including groundhogs, wild turkeys, and white-tailed deer, have increased in the open fields and around the periphery of the historic district. Intensive deer foraging has removed deciduous seedlings and saplings from woodlots, lowering species diversity and favoring coniferous reproduction. Cades Cove has limestone habitats unique in the park, and both deer browse and cattle grazing may have disturbed populations of rare plant species. Effects on water quality are detectable at a campground 15 stream km from the agricultural area, and the effects of deer foraging extend about 1 km beyond the open fields. Since “historic landscape” preservation is presently a goal of the park, managing for open vistas in Cades Cove will require some sort of continuing disturbance. Conversion of cattle pastures to hayfields would reduce aquatic impacts but the deer herd might increase as a result of reduced competition for forage. Retarding old field succession would increase populations of native plant species dependent on sunlight, but would require government-funded mowing. Other options are discussed. Completely eliminating the effects of the historic district on adjoining areas may be impossible, at least under present economic constraints.
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Mir, Ali Mohammad; Gull, Sadaf
2012-12-01
To identify the challenges confronting the Pakistan province of Punjab in delivering maternal and child health services at the district level. The qualitative assessment was done from May 15 to June 15, 2010, comprising 5 focus group discussions, 5 in-depth interviews with district managers, 49 in-depth interviews with providers, and direct observation of 19 facilities providing comprehensive emergency obstetric care in the districts of Multan, Muzaffargarh, Bahawalpur, Khanewal and Jhelum. Using skilled birth attendance coverage as an indicator, Punjab districts were stratified into three socio-economic strata, and from these the five-districts were selected. Distribution of basic emergency obstetric care facilities by population size was found to be inadequate in all districts. Quality of care was compromised by lack of staff and equipment. No anaesthetist was available in majority of the district hospitals and tehsil facilities. Half of the teshil headquarter hospitals were devoid of staff nurses. Vital medicines used in obstetric care were not available. Partograph was not being used in any of the tehsil-level facilities. Chlorine solution was not present in any of the facilities. Governance issues included multiplicity of command channels, delays in receipt of medicines and political interference. If the province has to achieve the related Millennium Development Goals (MDGs), related to maternal and child health, the existing facilities are not adequate. To achieve progress, proven and innovative approaches will have to be put in place that may influence the continuum of care from the household to the health facility.
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Code of Federal Regulations, 2010 CFR
2010-07-01
... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Use of nonpermissible explosives and nonpermissible shot-firing units; approval by Health and Safety District Manager. 77.1909-1 Section 77.1909-1...; approval by Health and Safety District Manager. Where the Coal Mine Health and Safety District Manager has...
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Li, Jing-Zhi; Zhu, Xiang; Li, Jing-Bao; Xu, Mei
2013-06-01
By using analytic hierarchy process and entropy method, the evaluation index system and the response relationship model of comprehensive development level of urbanization and comprehensive development and utilization potential of water resources in Dongting Lake District were constructed, with the key affecting factors, their change characteristics, and response characteristics from 2001 to 2010 analyzed. During the study period, the Dongting Lake District was undergoing a rapid development of urbanization, and at a scale expansion stage. The economic and social development level was lagged behind the population and area increase, and the quality and efficiency of urbanization were still needed to be improved. With the advance of urbanization, the water consumption increased yearly, and the water resources utilization efficiency and management level improved steadily. However, the background condition of water resources and their development and utilization level were more affected by hydrological environment rather than urbanization. To a certain extent, the development of urbanization in 2001, 2002, 2005, 2006, 2007, 2009 was slowed down by the shortage of water resources. At present, Dongting Lake region was confronted with the dual task of improving the level and quality of urbanization, and hence, it would be necessary to reform the traditional epitaxial expansion of urbanization and to enhance the water resource support capability.
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Project management training : final report.
DOT National Transportation Integrated Search
2011-01-01
In 2005 the Indiana Department of Transportation (INDOT) went through a complete reorganization of its operations going from centralized to decentralized (District) management. This reorganization gave Districts autonomy to manage construction projec...
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Project management training : [technical summary].
DOT National Transportation Integrated Search
2011-01-01
In 2005, the Indiana Department of Transportation (INDOT) went through a complete reorganization of its operations going from centralized to decentralized (District) management. This reorganization gave Districts autonomy to manage construction proje...
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ERIC Educational Resources Information Center
Gower, Amy L.; Cousin, Molly; Borowsky, Iris W.
2017-01-01
Background: Although nearly all states in the United States require school districts to adopt anti-bullying policies, little research examines the effect of these policies on student bullying and health. Using a statewide sample, we investigated associations between the quality of school district anti-bullying policies and student bullying…
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-23
... Promulgation of Air Quality Implementation Plans; District of Columbia; the 2002 Base Year Inventory AGENCY... particulate matter (PM 2.5 ) 2002 base year emissions inventory portion of the District of Columbia State... 2002 base year PM 2.5 emissions inventory submitted by DDOE in accordance with the requirements of the...
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Recruiting New Teachers to Urban School Districts: What Incentives Will Work?
ERIC Educational Resources Information Center
Milanowski, Anthony Thomas; Longwell-Grice, Hope; Saffold, Felicia; Jones, Janice; Schomisch, Kristen; Odden, Allan
2009-01-01
Many urban districts in the United States have difficulty attracting and retaining quality teachers, yet they are often the most in need of them. In response, U.S. states and districts are experimenting with financial incentives to attract and retain high-quality teachers in high-need, low-achieving, or hard-to-staff urban schools. However,…
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A Hybrid Interval-Robust Optimization Model for Water Quality Management.
Xu, Jieyu; Li, Yongping; Huang, Guohe
2013-05-01
In water quality management problems, uncertainties may exist in many system components and pollution-related processes ( i.e. , random nature of hydrodynamic conditions, variability in physicochemical processes, dynamic interactions between pollutant loading and receiving water bodies, and indeterminacy of available water and treated wastewater). These complexities lead to difficulties in formulating and solving the resulting nonlinear optimization problems. In this study, a hybrid interval-robust optimization (HIRO) method was developed through coupling stochastic robust optimization and interval linear programming. HIRO can effectively reflect the complex system features under uncertainty, where implications of water quality/quantity restrictions for achieving regional economic development objectives are studied. By delimiting the uncertain decision space through dimensional enlargement of the original chemical oxygen demand (COD) discharge constraints, HIRO enhances the robustness of the optimization processes and resulting solutions. This method was applied to planning of industry development in association with river-water pollution concern in New Binhai District of Tianjin, China. Results demonstrated that the proposed optimization model can effectively communicate uncertainties into the optimization process and generate a spectrum of potential inexact solutions supporting local decision makers in managing benefit-effective water quality management schemes. HIRO is helpful for analysis of policy scenarios related to different levels of economic penalties, while also providing insight into the tradeoff between system benefits and environmental requirements.
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A Good Business Manager Can Save You Money.
ERIC Educational Resources Information Center
Nowakowski, Ben C.; Schneider, Robert
1996-01-01
Financially troubled districts could benefit by investing in a school business manager's salary. This article discusses how business managers can save districts money or increase revenue by streamlining cash management, fiscal accounting and reporting, financial planning and budgeting, grantsmanship, construction management, insurance and risk…
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Guindo, Gabriel; Dubourg, Dominique; Marchal, Bruno; Blaise, Pierre; De Brouwere, Vincent
2004-10-01
A national retrospective survey on the unmet need for major obstetric surgery using the Unmet Obstetric Need Approach was carried out in Mali in 1999. In Koutiala, the district health team decided to carry on the monitoring of the met need for several years in order to assess their progress over time. The first prospective study, for 1999, estimated that more than 100 women in need of obstetric care never reached the hospital and probably died as a consequence. This surprising result shocked the district health team and the resulting increased awareness of service deficits triggered operational measures to tackle the problem. The Unmet Obstetric Need study in Koutiala district was implemented without financial support and only limited external technical back-up. The appropriation of the study by the district team for solving local problems of access to obstetric care may have contributed to the success of the experience. Used as a health service management tool, the study and its results started a dialogue between the hospital staff and both health centre staff and community representatives. This had not only the effect of triggering consideration of coverage, but also of quality of obstetric care. Copyright 2004 Oxford University Press
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ERIC Educational Resources Information Center
Johnson, Clarence; Kritsonis, William Allan
2007-01-01
This article addresses several key ongoing issues in a large urban school district. Literature focuses on what make a large urban school district effective in Human Resource Management. The effectiveness is addressed through recruitment and retention practices. A comparison of the school district with current research is the main approach to the…
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Mutemwa, Richard I
2006-01-01
At the onset of health system decentralization as a primary health care strategy, which constituted a key feature of health sector reforms across the developing world, efficient and effective health management information systems (HMIS) were widely acknowledged and adopted as a critical element of district health management strengthening programmes. The focal concern was about the performance and long-term sustainability of decentralized district health systems. The underlying logic was that effective and efficient HMIS would provide district health managers with the information required to make effective strategic decisions that are the vehicle for district performance and sustainability in these decentralized health systems. However, this argument is rooted in normative management and decision theory without significant unequivocal empirical corroboration. Indeed, extensive empirical evidence continues to indicate that managers' decision-making behaviour and the existence of other forms of information outside the HMIS, within the organizational environment, suggest a far more tenuous relationship between the presence of organizational management information systems (such as HMIS) and effective strategic decision-making. This qualitative comparative case-study conducted in two districts of Zambia focused on investigating the presence and behaviour of five formally identified, different information forms, including that from HMIS, in the strategic decision-making process. The aim was to determine the validity of current arguments for HMIS, and establish implications for current HMIS policies. Evidence from the eight strategic decision-making processes traced in the study confirmed the existence of different forms of information in the organizational environment, including that provided by the conventional HMIS. These information forms attach themselves to various organizational management processes and key aspects of organizational routine. The study results point to the need for a radical re-think of district health management information solutions in ways that account for the existence of other information forms outside the formal HMIS in the district health system.
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ERIC Educational Resources Information Center
BRI Systems, Inc., Phoenix, AZ.
This publication is a guide for school districts to reduce pupil transportation costs and save energy. The information presented is based upon: (1) energy saving programs implemented by school districts; (2) government and industry research efforts in fuel economy; (3) the successful experiences of commercial trucking fleets to save fuel; and (4)…
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NASA Astrophysics Data System (ADS)
Wanda, Elijah M. M.; Gulula, Lewis C.; Phiri, Ambrose
Irrigation water quality is an essential component of sustainable agriculture. Irrigation water quality concerns have often been neglected over concerns of quantity in most irrigation projects in Malawi. In this study, a hydrochemical assessment of groundwater was carried out to characterize, classify groundwater and evaluate its suitability for irrigation use in Karonga and Rumphi districts, Northern Malawi. Groundwater samples were collected during wet (January-April 2011) and dry (July-September 2011) seasons from 107 shallow wells and boreholes drilled for rural water supply using standard sampling procedures. The water samples were analysed for pH, major ions, total dissolved solids and electrical conductivity (EC), using standard methods. Multivariate chemometric (such as Kruskal Wallis test), hydrographical methods (i.e. Piper diagram) and PHREEQC geochemical modelling program were used to characterise the groundwater quality. Electrical conductivity, percentage sodium ion (% Na+), residual sodium carbonate (RSC), total dissolved solids (TDS), sodium adsorption ratio (SAR), Kelly’s ratio (KR) and permeability index (PI) were used to evaluate the suitability of water for irrigation. It was established that groundwater is neutral to alkaline and mostly freshwater (TDS < 1000 mg/l) of Ca-HCO3- type. Groundwater is of low mineralisation which did not show statistically significant variations with respect to depth of shallow wells and boreholes, location and seasonality at 5% significance level. Groundwater from Karonga District was largely oversaturated with respect to both calcite and dolomite, where as that from Rumphi District was undersaturated with respect to both calcite and dolomite. However, the calculated PCO2 values suggested that the groundwater system was open to soil CO2 and that there was possibility of degassing of CO2 during flow, which could increase the pH and subsequently result in the oversaturation of calcite in both districts. Groundwater water samples were stable towards calcite and kaolinite stability field. This suggested that equilibrium of the groundwater with silicates is an important indicator of the hydrogeochemical processes behind groundwater quality in the study area. The calculated values of SAR, KR and % Na+ indicated good and permissible quality of water for irrigation uses. However, samples with doubtful RSC (6% from Karonga district), unsuitable PI (5% and 3% from Karonga and Rumphi, respectively) and a high salinity hazard (56.2% and 20.3% from Karonga and Rumphi, respectively) values restrict the suitability of the groundwater for agricultural purposes, and plants with good salt tolerance should be selected for such groundwaters. A detailed hydro-geochemical investigation and integrated water management is suggested for sustainable development of the water resources for better plant growth, long-term as well as maintaining human health in the study area.
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Belaid, Loubna; Ridde, Valéry
2015-01-01
Burkina Faso implemented a national subsidy for emergency obstetric and neonatal care (EmONC) covering 80% of the cost of normal childbirth in public health facilities. The objective was to increase coverage of facility-based deliveries. After implementation of the EmONC policy, coverage increased across the country, but disparities were observed between districts and between primary healthcare centres (PHC). To understand the variation in coverage, we assessed the contextual factors and the implementation of EmONC in six PHCs in a district. We conducted a contrasted multiple case study. We interviewed women (n = 71), traditional birth attendants (n = 7), clinic management committees (n = 11), and health workers and district health managers (n = 26). Focus groups (n = 62) were conducted within communities. Observations were carried out in the six PHCs. Implementation was nearly homogeneous in the six PHCs but the contexts and human factors appeared to explain the variations observed on the coverage of facility-based deliveries. In the PHCs of Nogo and Tara, the immediate increase in coverage was attributed to health workers’ leadership in creatively promoting facility-based deliveries and strengthening relationships of trust with communities, users’ positive perceptions of quality of care and the arrival of female professional staff. The change of healthcare team at Iata’s PHC and a penalty fee imposed for home births in Belem may have caused the delayed effects there. Finally, the unchanged coverage in the PHCs of Fati and Mata was likely due to lack of promotion of facility-based deliveries, users’ negative perceptions of quality of care, and conflicts between health workers and users. Before implementation, decision-makers should perform pilot studies to adapt policies according to contexts and human factors. PMID:24633914
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School District Energy Manual.
ERIC Educational Resources Information Center
Association of School Business Officials International, Reston, VA.
This manual serves as an energy conservation reference and management guide for school districts. The School District Energy Program (SDEP) is designed to provide information and/or assistance to school administrators planning to implement a comprehensive energy management program. The manual consists of 15 parts. Part 1 describes the SDEP; Parts…
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ERIC Educational Resources Information Center
Cobb, Paul; Jackson, Kara; Smith, Thomas; Sorum, Michael; Henrick, Erin
2013-01-01
This chapter describes a partnership with four urban districts that aimed to develop an empirically grounded theory of action for improving the quality of mathematics instruction at scale. Each year, we conducted a data collection, analysis, and feedback cycle in each district that involved documenting the district's improvement strategies,…
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ERIC Educational Resources Information Center
Hough, Heather J.; Loeb, Susanna
2013-01-01
In this policy brief, Heather Hough and Susanna Loeb examine the effect of the Quality Teacher and Education Act of 2008 (QTEA) on teacher recruitment, retention, and overall teacher quality in the San Francisco Unified School District (SFUSD). They provide evidence that a salary increase can improve a school district's attractiveness within their…
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Iyengar, Kirti; Jain, Motilal; Thomas, Sunil; Dashora, Kalpana; Liu, William; Saini, Paramsukh; Dattatreya, Rajesh; Parker, Indrani; Iyengar, Sharad
2014-08-13
After the launch of Janani Suraksha Yojana, a conditional cash transfer scheme in India, the proportion of women giving birth in institutions has rapidly increased. However, there are important gaps in quality of childbirth services during institutional deliveries. The aim of this intervention was to improve the quality of childbirth services in selected high caseload public health facilities of 10 districts of Rajasthan. This intervention titled "Parijaat" was designed by Action Research & Training for Health, in partnership with the state government and United Nations Population Fund. The intervention was carried out in 44 public health facilities in 10 districts of Rajasthan, India. These included district hospitals (9), community health centres (32) and primary health centres (3). The main intervention was orientation training of doctors and program managers and regular visits to facilities involving assessment, feedback, training and action. The adherence to evidence based practices before, during and after this intervention were measured using structured checklists and scoring sheets. Main outcome measures included changes in practices during labour, delivery or immediate postpartum period. Use of several unnecessary or harmful practices reduced significantly. Most importantly, proportion of facilities using routine augmentation of labour reduced (p = 0), episiotomy for primigravidas (p = 0.0003), fundal pressure (p = 0.0003), and routine suction of newborns (0 = 0.0005). Among the beneficial practices, use of oxytocin after delivery increased (p = 0.0001) and the practice of listening foetal heart sounds during labour (p = 0.0001). Some practices did not show any improvements, such as dorsal position for delivery, use of partograph, and hand-washing. An intervention based on repeated facility visits combined with actions at the level of decision makers can lead to substantial improvements in quality of childbirth practices at health facilities.
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Caseload management methods for use within district nursing teams: a literature review.
Roberson, Carole
2016-05-01
Effective and efficient caseload management requires extensive skills to ensure that patients receive the right care by the right person at the right time. District nursing caseloads are continually increasing in size and complexity, which requires specialist district nursing knowledge and skills. This article reviews the literature related to caseload management with the aim of identifying the most effective method for district nursing teams. The findings from this review are that there are different styles and methods of caseload management. The literature review was unable to identify a single validated tool or method, but identified themes for implementing effective caseload management, specifically caseload analysis; workload measurement; work allocation; service and practice development and workforce planning. This review also identified some areas for further research.
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Liberatos, Penny; Leone, Jennifer; Craig, Ann Marie; Frei, Elizabeth Mary; Fuentes, Natalie; Harris, India Marie
2013-12-01
School nurses play a central role in assisting elementary school children in managing their asthma, especially those in higher-risk school districts that are at increased risk of uncontrolled asthma. Study purposes are to (1) identify barriers to asthma management by school nurses in higher-risk school districts; and (2) assess the extent to which National Asthma Education and Prevention Program (NAEPP) recommendations are followed in these districts. School districts containing at least one zipcode with high asthma hospitalization rates among children (0-14 years) in a New York State county were identified. Nurses in 44 elementary schools were surveyed about asthma management during 2008. Both quantitative and qualitative data were collected. Study nurses learned of children with asthma mainly through school records and when students presented with symptoms rather than through parents. The major obstacles to asthma management were communication with parents and parental support. Reluctance of some physicians to diagnose asthma in these children presented a barrier and contributed to the nurses' ability to gain parental cooperation. Adherence to the NAEPP school recommendations was inconsistent. Improvement in the communication among parents, school nurses, and providers is critical to the improvement of asthma management for children in high-risk school districts. © 2013, American School Health Association.
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Seeking Accountability through State-Appointed Emergency District Management
ERIC Educational Resources Information Center
Arsen, David; Mason, Mary L.
2013-01-01
Michigan's Local Government and School District Accountability Act of 2011 empowers the governor to appoint emergency managers (EMs) in financially troubled school districts. EMs assume all powers of the superintendent and school board. They can reshape academic programs, nullify labor contracts, and open and close schools. This article analyzes…
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Garcia, Patricia; Hughes, James; Carcamo, Cesar; Holmes, King K.
2003-01-01
OBJECTIVES: To determine the effectiveness of an intervention for pharmacy workers in improving their recognition and management of sexually transmitted disease (STD) syndromes. METHODS: We randomly selected 14 districts (total population nearly 4 million) from the 24 districts of low socioeconomic status in Lima, Peru. We randomly assigned paired districts to receive training and support for management and prevention of STDs or a control intervention about management of diarrhoea. The STD intervention included interactive luncheon seminars on recognition and management of four STD syndromes (urethral discharge, vaginal discharge, genital ulcers, and pelvic inflammatory disease) and STD/HIV prevention counselling; monthly pharmacy visits by "prevention salespersons" who distributed materials that included "STD/HIV prevention packets" containing information, condoms, and cards given to patients for referral of their sex partners; and workshops for physicians on managing patients with STD syndromes referred from pharmacies. Standardized simulated patients visited pharmacies in intervention and control districts at one, three, and six months after training to assess outcomes. FINDINGS: Standardized simulated patients reported significantly better recognition and management (appropriate antimicrobial regimens provided for discharge syndromes and referral to specially trained physicians for genital ulcers or pelvic inflammatory disease) by pharmacy workers of all four STD syndromes. They also reported significantly more frequent recommendations for use of condoms and treatment of partners at pharmacies in intervention districts than in control districts (by "intention-to-train" analyses, P<0.05 for 47/48 primary outcome comparisons). CONCLUSION: Training was feasible and effectively improved pharmacy workers' practices. PMID:14758407
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The path dependence of district manager decision-space in Ghana
Kwamie, Aku; van Dijk, Han; Ansah, Evelyn K; Agyepong, Irene Akua
2016-01-01
The district health system in Ghana today is characterized by high resource-uncertainty and narrow decision-space. This article builds a theory-driven historical case study to describe the influence of path-dependent administrative, fiscal and political decentralization processes on development of the district health system and district manager decision-space. Methods included a non-exhaustive literature review of democratic governance in Ghana, and key informant interviews with high-level health system officials integral to the development of the district health system. Through our analysis we identified four periods of district health system progression: (1) development of the district health system (1970–85); (2) Strengthening District Health Systems Initiative (1986–93); (3) health sector reform planning and creation of the Ghana Health Service (1994–96) and (4) health sector reform implementation (1997–2007). It was observed that district manager decision-space steadily widened during periods (1) and (2), due to increases in managerial profile, and concerted efforts at managerial capacity strengthening. Periods (3) and (4) saw initial augmentation of district health system financing, further widening managerial decision-space. However, the latter half of period 4 witnessed district manager decision-space contraction. Formalization of Ghana Health Service structures influenced by self-reinforcing tendencies towards centralized decision-making, national and donor shifts in health sector financing, and changes in key policy actors all worked to the detriment of the district health system, reversing early gains from bottom-up development of the district health system. Policy feedback mechanisms have been influenced by historical and contemporary sequencing of local government and health sector decentralization. An initial act of administrative decentralization, followed by incomplete political and fiscal decentralization has ensured that the balance of power has remained at national level, with strong vertical accountabilities and dependence of the district on national level. This study demonstrates that the rhetoric of decentralization does not always mirror actual implementation, nor always result in empowered local actors. PMID:26318537
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Choowong, Jiraporn; Tillgren, Per; Söderbäck, Maja
2016-07-28
Thailand is 18th out of the 22 countries with the highest tuberculosis (TB) burden. It will be a challenge for Thailand to achieve the UN Millennium Development target for TB, as well as the new WHO targets for eliminating TB by 2035. More knowledge and a new approach are needed to tackle the complex challenges of managing the DOT program in Thailand. Contextual factors strongly influence the local implementation of evidence in practice. Using the PARIHS model, the aim has been to explore district leaders' perceptions of the management of the DOT program in Trang province, Thailand. A phenomenographic approach was used to explore the perceptions among district DOT program leaders in Trang province. We conducted semi-structured interviews with district leaders responsible for managing the DOT program in five districts. The analysis of the data transcriptions was done by grouping similarities and differences of perceptions, which were constructed in a hierarchical outcome space that shows a set of descriptive categories. The first descriptive category revealed a common perception of the leaders' duty and wish to comply with the NTP guidelines when managing and implementing the DOT program in their districts. More varied perceptions among the leaders concerned how to achieve successful treatment. Other perceptions concerned practical dilemmas, which included fear of infection, mutual distrust, and inadequate knowledge about TB. Further, the leaders perceived a need for improved management practices in implementing the TB guidelines. Using the PARIHS framework to gain a retrospective perspective on the district-level policy implementation of the DOT program and studying the leadership's perceptions about applying the guidelines to practice, has brought new knowledge about management practices. Additional support and resources from the regional level are needed to manage the challenges.
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Kajankova, Maria; Oswald, Jennifer M; Terranova, Lauren M; Kaplen, Michael V; Ambrose, Anne F; Spielman, Lisa A; Gordon, Wayne A
2017-06-01
By 2014, all states implemented concussion laws that schools must translate into daily practice; yet, limited knowledge exists regarding implementation of these laws. We examined the extent to which concussion management policies and procedure (P&P) documents of New York State school districts comply with the State's Concussion Awareness and Management Act (the Act). We also aimed to identify barriers to compliance. Forty-seven school districts provided P&P documents. We examined compliance with the Act and the relationship between compliance and each district's demographics. Compliance varied across school districts, with higher overall compliance in large city school districts compared to county districts. However, there was low compliance for several critical items. We found no statistically significant relationship between compliance and demographics. School districts need to increase compliance with concussion legislation to ensure the adequate implementation necessary for the law to impact health and educational outcomes. The results provide important information to individuals charged with the responsibility of implementation and ultimately reducing the negative outcomes associated with brain injuries in schools. © 2017, American School Health Association.
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Sears, David; Mpimbaza, Arthur; Kigozi, Ruth; Sserwanga, Asadu; Chang, Michelle A.; Kapella, Bryan K.; Yoon, Steven; Kamya, Moses R.; Dorsey, Grant; Ruel, Theodore
2015-01-01
Background A better understanding of case management practices is required to improve inpatient pediatric care in resource-limited settings. Here we utilize data from a unique health facility-based surveillance system at six Ugandan hospitals to evaluate the quality of pediatric case management and the factors associated with appropriate care. Methods All children up to the age of 14 years admitted to six district or regional hospitals over 15 months were included in the study. Four case management categories were defined for analysis: suspected malaria, selected illnesses requiring antibiotics, suspected anemia, and diarrhea. The quality of case management for each category was determined by comparing recorded treatments with evidence-based best practices as defined in national guidelines. Associations between variables of interest and the receipt of appropriate case management were estimated using multivariable logistic regression. Results A total of 30,351 admissions were screened for inclusion in the analysis. Ninety-two percent of children met criteria for suspected malaria and 81% received appropriate case management. Thirty-two percent of children had selected illnesses requiring antibiotics and 89% received appropriate antibiotics. Thirty percent of children met criteria for suspected anemia and 38% received appropriate case management. Twelve percent of children had diarrhea and 18% received appropriate case management. Multivariable logistic regression revealed large differences in the quality of care between health facilities. There was also a strong association between a positive malaria diagnostic test result and the odds of receiving appropriate case management for comorbid non-malarial illnesses - children with a positive malaria test were more likely to receive appropriate care for anemia and less likely for illnesses requiring antibiotics and diarrhea. Conclusions Appropriate management of suspected anemia and diarrhea occurred infrequently. Pediatric quality improvement initiatives should target deficiencies in care unique to each health facility, and interventions should focus on the simultaneous management of multiple diagnoses. PMID:25992620
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Groundwater quality from a part of Prakasam District, Andhra Pradesh, India
NASA Astrophysics Data System (ADS)
Subba Rao, N.
2018-03-01
Quality of groundwater is assessed from a part of Prakasam district, Andhra Pradesh, India. Groundwater samples collected from thirty locations from the study area were analysed for pH, electrical conductivity (EC), total dissolved solids (TDS), calcium (Ca2+), magnesium (Mg2+), sodium (Na+), potassium (K+), bicarbonate ( {HCO}3^{ - } ), chloride (Cl-), sulphate ( {SO}4^{2 - } ), nitrate ( {NO}3^{ - } ) and fluoride (F-). The results of the chemical analysis indicate that the groundwater is alkaline in nature and are mainly characterized by Na+- {HCO}3^{ - } and Na+-Cl- facies. Groundwater chemistry reflects the dominance of rock weathering and is subsequently modified by human activities, which are supported by genetic geochemical evolution and hydrogeochemical relations. Further, the chemical parameters (pH, TDS, Ca2+, Mg2+, Na+, {HCO}3^{ - } , Cl-, {SO}4^{2 - } , {NO}3^{ - } and F-) were compared with the drinking water quality standards. The sodium adsorption ratio, percent sodium, permeability index, residual sodium carbonate, magnesium ratio and Kelly's ratio were computed and USSL, Wilcox and Doneen's diagrams were also used for evaluation of groundwater quality for irrigation. For industrial purpose, the pH, TDS, {HCO}3^{ - } , Cl- and {SO}4^{2 - } were used to assess the impact of incrustation and corrosion activities on metal surfaces. As a whole, it is observed that the groundwater quality is not suitable for drinking, irrigation and industrial purposes due to one or more chemical parameters exceeding their standard limits. Therefore, groundwater management measures were suggested to improve the water quality.
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ERIC Educational Resources Information Center
Epstein, Joyce L.; Galindo, Claudia L.; Sheldon, Steven B.
2011-01-01
Purpose: This study tests key constructs of sociocultural and organizational learning theories with quantitative methods to better understand the nature and impact of district and school leadership and actions on the quality of programs of family and community involvement. Research Design: Survey data from a "nested" sample of 24 districts and 407…
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ERIC Educational Resources Information Center
Jordan, Brian C.
2012-01-01
Information gained from the present study should provide important policy insights into whether adjustments to the School District Finance and Quality Performance Accreditation (SDFQPA) Act funding formula have supported the original goal behind SDFQPA, which was to provide more equal funding to public elementary and secondary pupils in Kansas.…
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ERIC Educational Resources Information Center
Jordan, Brian C.
2012-01-01
Information gained from the present study should provide important policy insights into whether adjustments to the School District Finance and Quality Performance Accreditation (SDFQPA) Act funding formula have supported the original goal behind SDFQPA, which was to provide more equal funding to public elementary and secondary pupils in Kansas.…
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76 FR 33342 - Final Supplementary Rules for Public Lands Managed by the California Desert District
Federal Register 2010, 2011, 2012, 2013, 2014
2011-06-08
... DEPARTMENT OF THE INTERIOR Bureau of Land Management [L12200000.NO0000.LLCAD00000] Final Supplementary Rules for Public Lands Managed by the California Desert District AGENCY: Bureau of Land Management... Land Management (BLM), CDD office and the five field offices within the CDD, are issuing Final...
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Best management practices to exchange information between the TOC and district offices.
DOT National Transportation Integrated Search
2009-06-01
The objective of this study was to develop best management practices for exchange information between the Transportation Operation Center (TOC) and the district offices and regional traffic management centers. Data collected for this study included: ...
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Oncology data management in the UK--BODMA's view. British Oncology Data Managers Association.
Riley, D.; Ward, L.; Young, T.
1994-01-01
Over the past 10 years, the original partnership of clinician and statistician for the running of clinical research projects, especially clinical trials, has come to be supplemented by the data manager and trial coordinator. Increasing numbers of such personnel are now being employed, covering a wide diversity of work areas, including clinical research, medical audit and the cancer registries. The British Oncology Data Managers Association (BODMA) was founded in 1987 and is now in a good position to review the current status of data management in the UK. It is proposed that a national network of data managers and trial coordinators within specialist trials centres, oncology departments and district general hospitals, with a good training programme, plus a recognised career structure, is the way to make the best use of this key resource. BODMA is addressing many of these issues and aims to improve and maintain the quality of data management. PMID:8080719
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Managing Technology Resourcefully: Part II--Working with Your District's Technology
ERIC Educational Resources Information Center
Weeks, Richard
2009-01-01
A large school district may have a technology department staffed by a chief technology officer who supervises two or more directors of operations, project managers, and technicians. On the other hand, a small district may employ an information technologist who works with technicians, consultants, volunteers with a knack for technology, and…
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ERIC Educational Resources Information Center
California Association of School Business Officials, Sacramento.
This publication is designed to provide school district administrators and boards of education with information they can use in developing, administering, and evaluating their district's risk management needs. In particular, it is meant to help school officials 1) identify local insurance needs consistent with California's statutory requirements,…
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ERIC Educational Resources Information Center
Hoffman, Tony
Sophisticated database management systems (DBMS) for microcomputers are becoming increasingly easy to use, allowing small school districts to develop their own autonomous databases for tracking enrollment and student progress in special education. DBMS applications can be designed for maintenance by district personnel with little technical…
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76 FR 76179 - Notice of Public Meeting, Idaho Falls District Resource Advisory Council Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-06
... Public Meeting, Idaho Falls District Resource Advisory Council Meeting AGENCY: Bureau of Land Management... Interior, Bureau of Land Management (BLM) Idaho Falls District Resource Advisory Council (RAC), will meet as indicated below. DATES: The RAC will next meet in Idaho Falls, Idaho on January 24-25, 2012 for a...
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77 FR 74203 - Notice of Public Meeting, Idaho Falls District Resource Advisory Council Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2012-12-13
... Public Meeting, Idaho Falls District Resource Advisory Council Meeting AGENCY: Bureau of Land Management... Interior, Bureau of Land Management (BLM) Idaho Falls District Resource Advisory Council (RAC), will meet as indicated below. DATES: The RAC will next meet in Idaho Falls, Idaho on January 22-23, 2013 for a...
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Seeking Accountability through State-Appointed Emergency District Management. Working Paper #28
ERIC Educational Resources Information Center
Arsen, David; Mason, Mary L.
2012-01-01
Michigan's Local Government and School District Accountability Act of 2011 empowers the governor to appoint emergency managers (EMs) in financially-troubled school districts. EMs assume all powers of the superintendent and school board. They can reshape academic programs, nullify labor contracts, and open and close schools. This paper analyzes the…
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ERIC Educational Resources Information Center
Whitaker, Kathryn
2006-01-01
Nationwide, school district administrators are puzzling about how to increase the number of high quality principal candidates. Some districts have started programs to grow their own administrators. These districts, sometimes in conjunction with university programs, are providing training and mentoring for future school leaders. Some districts are…
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Controlled drugs and the principle of double effect: the role of the district nurse.
Griffith, Richard
2016-12-02
The role of district nurses in the effective management of pain in palliative care has been strengthened by the Misuse of Drugs (Amendment No.2) (England, Wales and Scotland) Regulations 2012 that allow district nurses who are independent or supplementary prescribers to prescribe and administer controlled drugs. However, prescribing controlled drugs brings increased responsibility and accountability for the safe management of these medicines. In this article Richard Griffith considers the principle of double effect that seeks to ensure that patients in intractable pain receive the analgesia they require to manage that pain while district nurses avoid liability and prosecution under the law of murder.
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Site-Based Management: Crisis or Opportunity?
ERIC Educational Resources Information Center
Lausberg, Clement H.
1990-01-01
If appropriate planning occurs, business officials can support site-based management. Districts need to develop new working relationships that appropriately balance the responsibility of the business office for district finances and support services with more site-based management at the school level. (MLF)
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Hydrology, water quality, and phosphorus loading of Little St Germain Lake, Vilas County, Wisconsin
Robertson, Dale M.; Rose, William J.
2000-01-01
The lake was monitored in detail again during 1991-94 by the U.S. Geological Survey (USGS) as part of a cooperative study with the Lake District. This study demonstrated water-quality variation among the basins of Little St. Germain Lake and extensive areas of winter anoxia (absence of oxygen). Further in-depth studies were then conducted during 1994-2000 to define the extent of winter anoxia, refine the hydrologic and phosphorus budgets of the lake, quantify the effects of annual drawdowns, and provide information needed to develop a comprehensive lake-management plan. This report presents the results of the studies since 1991.
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le Roux, K W D P; Couper, I
2015-06-01
The re-engineering of primary healthcare (PHC) is regarded as an essential precursor to the implementation of National Health Insurance in South Africa, but improvements in the provision of PHC services have been patchy. The authors contend that the role of well- functioning rural district hospitals as a hub from which PHC services can be most efficiently managed has been underestimated, and that the management of district hospitals and PHC clinics need to be co-located at the level of the rural district hospital, to allow for proper integration of care and effective healthcare provision.
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NASA Astrophysics Data System (ADS)
Rosenberg, D. E.; Aljuaidi, A. E.; Kaluarachchi, J. J.
2009-12-01
We include demands for water of different salinity concentrations as input parameters and decision variables in a regional hydro-economic optimization model. This specification includes separate demand functions for saline water. We then use stochastic non-linear programming to jointly identify the benefit maximizing set of infrastructure expansions, operational allocations, and use of different water quality types under climate variability. We present a detailed application for the Gaza Strip. The application considers building desalination and waste-water treatment plants and conveyance pipelines, initiating water conservation and leak reduction programs, plus allocating and transferring water of different qualities among agricultural, industrial, and urban sectors and among districts. Results show how to integrate a mix of supply enhancement, conservation, water quality improvement, and water quality management actions into a portfolio that can economically and efficiently respond to changes and uncertainties in surface and groundwater availability due to climate variability. We also show how to put drawn-down and saline Gaza aquifer water to more sustainable and economical use.
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Berndt, Marian P.; Katz, Brian G.
2000-01-01
In accordance with guidelines set forth by the Office of Water Quality in the Water Resources Division of the U.S. Geological Survey, a quality-assurance plan was created for use by the Florida District's North Florida Program Office in conducting water-quality activities. This plan documents the standards, policies, and procedures used by the North Florida Program Office for activities related to the collection, processing, storage, analysis, and publication of water-quality data.
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Preparedness for End of Life-a Survey of Jerusalem District Nursing Homes.
Shaulov, Adir; Frankel, Meir; Rubinow, Alan; Maaravi, Yoram; Brezis, Mayer
2015-10-01
To evaluate the quality of end-of-life (EOL) care in nursing homes. Survey and semistructured interviews. Jerusalem district nursing homes. Staff members of 28 long-term care and skilled nursing facilities in the Jerusalem area in Israel of various ethnic, religious, and administrative affiliations (N = 207). Qualitative analysis of semistructured interviews and statistical analysis of questionnaires. Most staff members reported that EOL preferences were unknown for more than 90% of residents and that fewer than 10% had a healthcare proxy. Most staff members recalled conducting fewer than five EOL conversations over the past year with residents or family members and could recall fewer than five cases in which a resident was allowed to die in the nursing home. According to staff opinions the prevalence of tube feeding was estimated at greater than 10%, initiated because of aspiration, malnutrition, and understaffing, often against family's preferences. More than 25% of staff members believed that pain management was inadequate. Knowledge about management of chronic pain was poor in half of nurses and nearly one-third of physicians. Most staff would rather not receive the treatments they administered to residents. Nursing homes in Jerusalem lack competency for quality EOL care, and there are multiple psychological, training, and policy challenges to improvement. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.
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ERIC Educational Resources Information Center
Johnson, Susan Moore; Marietta, Geoff; Higgins, Monica C.; Mapp, Karen L.; Grossman, Allen
2015-01-01
"Achieving Coherence in District Improvement" focuses on a problem of practice faced by educational leaders across the nation: how to effectively manage the relationship between the central office and schools. The book is based on a study of five large urban districts that have demonstrated improvement in student achievement. The…
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A Hybrid Interval–Robust Optimization Model for Water Quality Management
Xu, Jieyu; Li, Yongping; Huang, Guohe
2013-01-01
Abstract In water quality management problems, uncertainties may exist in many system components and pollution-related processes (i.e., random nature of hydrodynamic conditions, variability in physicochemical processes, dynamic interactions between pollutant loading and receiving water bodies, and indeterminacy of available water and treated wastewater). These complexities lead to difficulties in formulating and solving the resulting nonlinear optimization problems. In this study, a hybrid interval–robust optimization (HIRO) method was developed through coupling stochastic robust optimization and interval linear programming. HIRO can effectively reflect the complex system features under uncertainty, where implications of water quality/quantity restrictions for achieving regional economic development objectives are studied. By delimiting the uncertain decision space through dimensional enlargement of the original chemical oxygen demand (COD) discharge constraints, HIRO enhances the robustness of the optimization processes and resulting solutions. This method was applied to planning of industry development in association with river-water pollution concern in New Binhai District of Tianjin, China. Results demonstrated that the proposed optimization model can effectively communicate uncertainties into the optimization process and generate a spectrum of potential inexact solutions supporting local decision makers in managing benefit-effective water quality management schemes. HIRO is helpful for analysis of policy scenarios related to different levels of economic penalties, while also providing insight into the tradeoff between system benefits and environmental requirements. PMID:23922495
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Cultivating Leadership Development for Support Staff.
ERIC Educational Resources Information Center
Russell, Sharon
1997-01-01
Describes an urban school district's focus on leadership development for support staff. The project identified and trained 500 front-line supervisors representing office managers, food service managers, head custodians, and district maintenance supervisors. This paper explains program design, objectives, participants, management support, content,…
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State of the District Address, 1982.
ERIC Educational Resources Information Center
Koltai, Leslie
This address by the Chancellor of the Los Angeles Community College District (LACCD) discusses recent and long-term changes in the district's programs, educational quality, and financial standing, and suggests means for future improvements. First, the paper highlights the district's achievements in improving transfer education and developing new…
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Stakeholder Experiences in District-University Administrator Preparation Partnerships
ERIC Educational Resources Information Center
Sanzo, Karen L.; Wilson, Jacob McKinley, III
2016-01-01
Our qualitative study explores the lived experiences of district stakeholders in university-district leadership preparation programs. Collaborative partnerships between school districts and universities focused on developing quality school leader are a part of recent efforts to provide the field of public education with exemplary leadership. The…
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-20
... Ranger District, Rio Grande National Forest; CO; Black Mesa Vegetation Management Project AGENCY: Forest... Web site http://www.fs.usda.gov/riogrande under ``Land & Resource Management'', then ``Projects'' on... need for the Black Mesa Vegetation Management Project is move toward achieving long-term desired...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-05
...In accordance with the National Environmental Policy Act of 1969, as amended (NEPA); the Federal Land Policy and Management Act of 1976, as amended; and the California Environmental Quality Act of 1970 (CEQA), the Bureau of Land Management (BLM), the United States Forest Service (USFS), and the Great Basin Unified Air Pollution Control District (GBUAPCD), a California State agency, have prepared a Final Environmental Impact Statement (EIS)/Environmental Impact Report (EIR) for the proposed Casa Diablo IV Geothermal Development Project near the town of Mammoth Lakes in Mono County, California, and by this notice are announcing its availability.
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ERIC Educational Resources Information Center
Ouda, James Bill; Opiyo, Rose Atieno; Wambiya, Pascal
2015-01-01
Conditions of learning are critical in determining quality of education. There have been real concerns raised by stakeholders regarding the quality of education for pastoralists in public primary schools in Kajiado Central District in Kenya. Interventions have been put in place to address the issue of quality education. One such intervention is…
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Quinones, Ferdinand; Balthrop, B.H.; Baker, E.G.
1988-01-01
This report contains a summation of 44 projects which were active in the Tennessee District during 1987 and 1988. Given in each summary is the name of the project chief, the objective of the project, the progress or results of the study to date, and the name of the cooperator. Hydrologic data are the backbone of the investigations conducted by the U.S Geological Survey (USGS). The basic data programs conducted by the Tennessee District provide streamflow, quality of water, and groundwater levels information essential to the assessment and management of the State 's water resources. Long-term streamflow, quality of water, and groundwater levels network are operated as part of the Hydrologic Data Section. Field operations are about equally divided among field offices in Memphis, Nashville, and Knoxville. A staff of about 40 engineers, hydrologists, and hydrologic technicians labor in the operation of the long-term network as well as short-term efforts in support of areal investigations. The data collected as part of the networks are published in the series of annual data reports. (USGS)
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The Environmental Impact Study Of Micro Hydro Power In Pekalongan Indonesia
NASA Astrophysics Data System (ADS)
Suwarto; Hadi, Sudharto P.; Hermawan
2018-02-01
Curugmuncar II micro hydro power (MHP) located in Petungkriyono sub district is one of three MHPs installed in Pekalongan district. This study aims to analyze the MHP operation environmental impact. The study used qualitative method, with interviews, observations, and material testing. The data used are primary and secondary data. This research was conducted in Curugmuncar Village, Petungkriyono Subdistrict, Pekalongan Regency, Indonesia. MHP has power capacity of 100 KW with power usage of 50 KW. MHP used by 155 users with load capacity 2 A 220 volt AC. The community more used of lights as the houses and street lighting. The MHP operation had several environmental factors such as: sociology, technically feasible, hydrology, physical and chemical water quality, ergonomics, economically feasible, irrigation, clean water supply, government policy, and others. The supporting factors sustainability of MHP were sociology, irrigation, ergonomics, clean water supply, physical and chemical water quality, hydrology, and government policy. The inhibiting factors of MHP operation were technically feasible, economically feasible, and government policy. The results showed that the MHP environment requires a professional management system to achieve the MHP sustainability
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Application of GPS data for benefits of air quality assessment and fleet management
NASA Astrophysics Data System (ADS)
Hao, Song; Fat Lam, Yun; Cheong Ying, Chi; Chan, Ka Lok
2017-04-01
In the modern digitizedsociety, traffic data can be easily collected for use in roadway development, urban planning and vehicle emission. These data are then further parameterized to support traffic simulation and roadside emission calculations. With the commercialization of AGPS/GPS technology, GPS data are widely utilized to study habit and travelling behaviors. GPS on franchised buses can provide not only positioning information for fleet management but also raw data to analyze traffic situations. In HK, franchised buses account for 6% of RSP and 20% of NOx emissions among the whole vehicle fleet. Being the most heavily means of public transport, the setting up of bus travelling trajectories and service frequency always raise concern from citizens. On this basis, there is an increasing interest and as well as to design and realize an effective cost benefit fleet management strategy. In this study, data collection analysis is carried out on all bus routes (i.e. 112) in Shatin district, one of the 18 districts in Hong Kong. The GPS/AGPS data through Esri ArcGIS investigate the potential benefit of GPS data in different emission scenarios (such as engine type over whole bus fleet). Building on the emission factors from EMFC-HK model, we accounted for factors like travelling distance, idling time, occupancy rate, service frequency, tire and break emissions. Through the simple emission developed model we demonstrate how GPS are data are utilized to assess bus fleet emissions. Further amelioration on the results involve tuning the model with field measurement so as to assess district level emission change after fleet optimization.
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The path dependence of district manager decision-space in Ghana.
Kwamie, Aku; van Dijk, Han; Ansah, Evelyn K; Agyepong, Irene Akua
2016-04-01
The district health system in Ghana today is characterized by high resource-uncertainty and narrow decision-space. This article builds a theory-driven historical case study to describe the influence of path-dependent administrative, fiscal and political decentralization processes on development of the district health system and district manager decision-space. Methods included a non-exhaustive literature review of democratic governance in Ghana, and key informant interviews with high-level health system officials integral to the development of the district health system. Through our analysis we identified four periods of district health system progression: (1) development of the district health system (1970-85); (2) Strengthening District Health Systems Initiative (1986-93); (3) health sector reform planning and creation of the Ghana Health Service (1994-96) and (4) health sector reform implementation (1997-2007). It was observed that district manager decision-space steadily widened during periods (1) and (2), due to increases in managerial profile, and concerted efforts at managerial capacity strengthening. Periods (3) and (4) saw initial augmentation of district health system financing, further widening managerial decision-space. However, the latter half of period 4 witnessed district manager decision-space contraction. Formalization of Ghana Health Service structures influenced by self-reinforcing tendencies towards centralized decision-making, national and donor shifts in health sector financing, and changes in key policy actors all worked to the detriment of the district health system, reversing early gains from bottom-up development of the district health system. Policy feedback mechanisms have been influenced by historical and contemporary sequencing of local government and health sector decentralization. An initial act of administrative decentralization, followed by incomplete political and fiscal decentralization has ensured that the balance of power has remained at national level, with strong vertical accountabilities and dependence of the district on national level. This study demonstrates that the rhetoric of decentralization does not always mirror actual implementation, nor always result in empowered local actors. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.