40 CFR 90.704 - Maintenance of records; submission of information.

Code of Federal Regulations, 2013 CFR

2013-07-01

... paper) or reduced to microfilm, floppy disk, or some other method of data storage, depending upon the..., associated storage facility or port facility, and the date the engine was received at the testing facility...

40 CFR 90.704 - Maintenance of records; submission of information.

Code of Federal Regulations, 2011 CFR

2011-07-01

... paper) or reduced to microfilm, floppy disk, or some other method of data storage, depending upon the..., associated storage facility or port facility, and the date the engine was received at the testing facility...

40 CFR 90.704 - Maintenance of records; submission of information.

Code of Federal Regulations, 2012 CFR

2012-07-01

... paper) or reduced to microfilm, floppy disk, or some other method of data storage, depending upon the..., associated storage facility or port facility, and the date the engine was received at the testing facility...

Multidimensional team-based intervention using musical cues to reduce odds of facility-acquired pressure ulcers in long-term care: a paired randomized intervention study.

PubMed

Yap, Tracey L; Kennerly, Susan M; Simmons, Mark R; Buncher, Charles R; Miller, Elaine; Kim, Jay; Yap, Winston Y

2013-09-01

To test the effectiveness of a pressure ulcer (PU) prevention intervention featuring musical cues to remind all long-term care (LTC) staff (nursing and ancillary) to help every resident move or reposition every 2 hours. Twelve-month paired-facility two-arm (with one-arm crossover) randomized intervention trial. Ten midwestern U.S. LTC facilities. Four treatment facilities received intervention during Months 1 to 12, four comparison facilities received intervention during Months 7 to 12, and two pseudo-control facilities received no intervention. LTC facility residents (N = 1,928). All facility staff received in-person education, video, and handouts, and visiting family members received informational pamphlets on PU prevention and an intervention featuring musical cues. Nurse-led multidisciplinary staff teams presented the cues as prompts for staff and family to reposition residents or remind them to move. Musical selections (with and without lyrics) customized to facility preferences were played daily over the facility intercom or public address system every 2 hours for the 12-hour daytime period. Primary outcome measure was the frequency of new facility-acquired PUs divided by the total number of facility Minimum Data Set (MDS) resident assessments conducted during the study period. Odds of a new PU were lower in intervention facilities (P = .08) for MDS 2.0 assessments and were significantly lower (P = .05) for MDS 3.0. Mean odds ratios suggested intervention facility residents were 45% less likely than comparison facility residents to develop a new PU. Customized musical cues that prompt multidisciplinary staff teams to encourage or enable movement of all residents hold promise for reducing facility-acquired PUs in LTC settings. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

Measuring Quality Gaps in TB Screening in South Africa Using Standardised Patient Analysis.

PubMed

Christian, Carmen S; Gerdtham, Ulf-G; Hompashe, Dumisani; Smith, Anja; Burger, Ronelle

2018-04-12

This is the first multi-district Standardised Patient (SP) study in South Africa. It measures the quality of TB screening at primary healthcare (PHC) facilities. We hypothesise that TB screening protocols and best practices are poorly adhered to at the PHC level. The SP method allows researchers to observe how healthcare providers identify, test and advise presumptive TB patients, and whether this aligns with clinical protocols and best practice. The study was conducted at PHC facilities in two provinces and 143 interactions at 39 facilities were analysed. Only 43% of interactions resulted in SPs receiving a TB sputum test and being offered an HIV test. TB sputum tests were conducted routinely (84%) while HIV tests were offered less frequently (47%). Nurses frequently neglected to ask SPs whether their household contacts had confirmed TB (54%). Antibiotics were prescribed without taking temperatures in 8% of cases. The importance of returning to the facility to receive TB test results was only explained in 28%. The SP method has highlighted gaps in clinical practice, signalling missed opportunities. Early detection of sub-optimal TB care is instrumental in decreasing TB-related morbidity and mortality. The findings provide the rationale for further quality improvement work in TB management.

Ceramic high temperature receiver design and tests

NASA Technical Reports Server (NTRS)

Davis, S. B.

1982-01-01

The High Temperature Solar Thermal Receiver, which was tested a Edwards AFB, CA during the winter of 1980-1981, evolved from technologies developed over a five year period of work. This receiver was tested at the Army Solar Furnace at White Sands, NM in 1976. The receiver, was tested successfully at 1768 deg F and showed thermal efficiencies of 85%. The results were sufficiently promising to lead ERDA to fund our development and test of a 250 kW receiver to measure the efficiency of an open cavity receiver atop a central tower of a heliostat field. This receiver was required to be design scalable to 10, 50, and 100 MW-electric sizes to show applicability to central power tower receivers. That receiver employed rectagular silicon carbide panels and vertical stanchions to achieve scalability. The construction was shown to be fully scalable; and the receiver was operated at temperatures up to 2000 deg F to achieve the performance goals of the experiment during tests at the GIT advanced components test facility during the fall of 1978.

Measuring Quality Gaps in TB Screening in South Africa Using Standardised Patient Analysis

PubMed Central

Christian, Carmen S.; Gerdtham, Ulf-G.; Hompashe, Dumisani; Smith, Anja; Burger, Ronelle

2018-01-01

This is the first multi-district Standardised Patient (SP) study in South Africa. It measures the quality of TB screening at primary healthcare (PHC) facilities. We hypothesise that TB screening protocols and best practices are poorly adhered to at the PHC level. The SP method allows researchers to observe how healthcare providers identify, test and advise presumptive TB patients, and whether this aligns with clinical protocols and best practice. The study was conducted at PHC facilities in two provinces and 143 interactions at 39 facilities were analysed. Only 43% of interactions resulted in SPs receiving a TB sputum test and being offered an HIV test. TB sputum tests were conducted routinely (84%) while HIV tests were offered less frequently (47%). Nurses frequently neglected to ask SPs whether their household contacts had confirmed TB (54%). Antibiotics were prescribed without taking temperatures in 8% of cases. The importance of returning to the facility to receive TB test results was only explained in 28%. The SP method has highlighted gaps in clinical practice, signalling missed opportunities. Early detection of sub-optimal TB care is instrumental in decreasing TB-related morbidity and mortality. The findings provide the rationale for further quality improvement work in TB management. PMID:29649095

Accreditation status and geographic location of outpatient vascular testing facilities among Medicare beneficiaries: the VALUE (Vascular Accreditation, Location & Utilization Evaluation) study.

PubMed

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

2014-10-01

There is limited information on the accreditation status and geographic distribution of vascular testing facilities in the US. The Centers for Medicare & Medicaid Services (CMS) provide reimbursement to facilities regardless of accreditation status. The aims were to: (1) identify the proportion of Intersocietal Accreditation Commission (IAC) accredited vascular testing facilities in a 5% random national sample of Medicare beneficiaries receiving outpatient vascular testing services; (2) describe the geographic distribution of these facilities. The VALUE (Vascular Accreditation, Location & Utilization Evaluation) Study examines the proportion of IAC accredited facilities providing vascular testing procedures nationally, and the geographic distribution and utilization of these facilities. The data set containing all facilities that billed Medicare for outpatient vascular testing services in 2011 (5% CMS Outpatient Limited Data Set (LDS) file) was examined, and locations of outpatient vascular testing facilities were obtained from the 2011 CMS/Medicare Provider of Services (POS) file. Of 13,462 total vascular testing facilities billing Medicare for vascular testing procedures in a 5% random Outpatient LDS for the US in 2011, 13% (n=1730) of facilities were IAC accredited. The percentage of IAC accredited vascular testing facilities in the LDS file varied significantly by US region, p<0.0001: 26%, 12%, 11%, and 7% for the Northeast, South, Midwest, and Western regions, respectively. Findings suggest that the proportion of outpatient vascular testing facilities that are IAC accredited is low and varies by region. Increasing the number of accredited vascular testing facilities to improve test quality is a hypothesis that should be tested in future research. © The Author(s) 2014.

2-kW Solar Dynamic Space Power System Tested in Lewis' Thermal Vacuum Facility

NASA Technical Reports Server (NTRS)

1995-01-01

Working together, a NASA/industry team successfully operated and tested a complete solar dynamic space power system in a large thermal vacuum facility with a simulated sun. This NASA Lewis Research Center facility, known as Tank 6 in building 301, accurately simulates the temperatures, high vacuum, and solar flux encountered in low-Earth orbit. The solar dynamic space power system shown in the photo in the Lewis facility, includes the solar concentrator and the solar receiver with thermal energy storage integrated with the power conversion unit. Initial testing in December 1994 resulted in the world's first operation of an integrated solar dynamic system in a relevant environment.

A low-density boundary-layer wind tunnel facility

NASA Technical Reports Server (NTRS)

White, B. R.

1987-01-01

This abstract describes a low-density wind-tunnel facility that was established at NASA Ames in order to aid interpretation and understanding of data received from the Mariner and Viking spacecraft through earth-based simulation. The wind tunnel is a boundary-layer type which is capable of operating over a range of air densities ranging from 0.01 to 1.24 kg/cu m, with the lower values being equivalent to the near-surface density of the planet Mars. Although the facility was developed for space and extraterrestrial simulation, it also can serve as a relatively large-scale, low-density aerodynamic test facility. A description of this unique test facility and some Pitot-tube and hot-wire anemometry data acquired in the facility are presented.

The CDC SHIELD Orange County Project – Baseline Multi Drug-Resistant Organism (MDRO) Prevalence in a Southern California Region

PubMed Central

Singh, Raveena D; Jernigan, John A; Slayton, Rachel B; Stone, Nimalie D; McKinnell, James A; Miller, Loren G; Kleinman, Ken; Heim, Lauren; Dutciuc, Tabitha D; Estevez, Marlene; Gussin, Gabrielle; Chang, Justin; Peterson, Ellena M; Evans, Kaye D; Lee, Bruce Y; Mueller, Leslie E; Bartsch, Sarah M; Zahn, Matthew; Janssen, Lynn; Weinstein, Robert A; Hayden, Mary K; Gohil, Shruti K; Park, Steven; Tam, Steven; Saavedra, Raheeb; Yamaguchi, Stacey; Custodio, Harold; Nguyen, Jenny; Tjoa, Thomas; He, Jiayi; O’Donnell, Kathleen; Coady, Micaela H; Platt, Richard; Huang, Susan S

2017-01-01

Abstract Background MDROs can spread between hospitals, nursing homes (NH), and long-term acute care facilities (LTACs) via shared patients. SHIELD OC is a regional decolonization collaborative involving 38 of 104 countywide adult facilities identified by their high degree of direct and indirect patient sharing with one another. We report baseline MDRO prevalence in these facilities. Methods Adult patients in 38 facilities (17 hospitals, 18 NHs, 3 LTACs) underwent point-prevalence screening between September 2016–April 2017 for MRSA, VRE, ESBL, and CRE using nares, skin (axilla/groin), and peri-rectal swabs. In NHs and LTACs, residents were randomly selected until 50 sets of swabs were obtained. Swabbing in hospitals involved all patients in contact precautions. An additional set of swabs were also performed for all LTAC admissions from November 2016–February 2017. Results The overall prevalence of any MDRO among patients was 64% (44%–88%) in NHs, 80% (range 72%–86%) in LTACs, and 64% (54–84%) in hospitals (contact precaution patients) (Table 1). Only 25%, 64%, and 81% of patients were already known to harbor an MDRO in NHs, LTACs, and hospitals, respectively. Known MDRO patients also harbored another MDRO 49%, 63%, and 34% of the time for NHs, LTACs, and hospitals, respectively. In LTACs, MDRO point prevalence was 38% higher than the usual admission prevalence (65% higher for MRSA, 34% higher for VRE, 95% higher for ESBL, and 50% higher for CRE). Conclusion MDRO carriage in highly inter-connected NHs and LTACs was widespread, rivaling that found in hospitalized patients on contact precautions. MRSA, VRE, and ESBL carriage far outnumbered CRE carriage. A history of MDRO was insensitive for identifying MDRO carriers, and many patients carried multiple MDROs. The extensive MDRO burden and transmission in long-term care settings suggests that regional MDRO prevention efforts must include MDRO control in long-term care facilities. Disclosures R. D. Singh, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; J. A. McKinnell, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; L. G. Miller, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; K. Kleinman, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Molnlycke: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; L. Heim, Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; T. D. Dutciuc, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; M. Estevez, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; G. Gussin, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; L’Oreal: Consultant, Consulting fee; J. Chang, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; E. M. Peterson, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; B. Y. Lee, GSK: Consultant, Consulting fee; R. A. Weinstein, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Molnlycke: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; OpGen Company: Study support, Provided services at no charge; M. K. Hayden, Sage Products: Receipt of contributed product, Sage is contributing product to healthcare facilities participating in a regional collaborative on which I am a co-investigator. Neither I nor my hospital receive product.; Clorox: Receipt of contributed product, Research support; CDC: Grant Investigator and Receipt of contributed product, Research grant; Molnlycke: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; OpGen Company: Study support, Provided services at no charge for studies; S. K. Gohil, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; S. Park, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; S. Tam, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; R. Saavedra, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; S. Yamaguchi, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; H. Custodio, Xttrium Laboratories: Study coordination, Conducting studies in healthcare facilities that are receiving contributed product; Sage Products: Study coordination, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Study coordination, Conducting studies in healthcare facilities that are receiving contributed product; J. Nguyen, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; T. Tjoa, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; J. He, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; M. H. Coady, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Molnlycke: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; R. Platt, Sage Products: Receipt of contributed product, Conducting clinical studies in which participating healthcare facilities are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting clinical studies in which participating healthcare facilities are receiving contributed product; Clorox: Receipt of contributed product, Conducting clinical studies in which participating healthcare facilities are receiving contributed product; receive research funds from Clorox, but Clorox has no role in the design; Molnlycke: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; S. S. Huang, Sage Products: Receipt of contributed product, Conducting studies in which participating healthcare facilities are receiving contributed product (no contribution in submitted abstract), Participating healthcare facilities in my studies received contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in which participating healthcare facilities are receiving contributed product (no contribution in submitted abstract), Participating healthcare facilities in my studies received contributed product; Clorox: Receipt of contributed product, Conducting studies in which participating healthcare facilities are receiving contributed product (no contribution in submitted abstract), Participating healthcare facilities in my studies received contributed product; 3M: Receipt of contributed product, Conducting studies in which participating healthcare facilities are receiving contributed product (no contribution in submitted abstract), Participating healthcare facilities in my studies received contributed product; Molnlycke: Receipt of contributed product, Conducting studies in which participating healthcare facilities are receiving contributed product (no contribution in submitted abstract), Participating healthcare facilities in my studies received contributed product

When a Home is Not a Home: MultiDrug-Resistant Organism (MDRO) Colonization and Environmental Contamination in 28 Nursing Homes (NHs)

PubMed Central

McKinnell, James A; Miller, Loren; Singh, Raveena D; Mendez, Job; Franco, Ryan; Gussin, Gabrielle; Chang, Justin; Dutciuc, Tabitha D; Saavedra, Raheeb; Kleinman, Ken; Peterson, Ellena M; Evans, Kaye D; Heim, Lauren; Miner, Aaron; Estevez, Marlene; Custodio, Harold; Yamaguchi, Stacey; Nguyen, Jenny; Varasteh, Alex; Launer, Bryn; Agrawal, Shalini; Tjoa, Thomas; He, Jiayi; Park, Steven; Tam, Steven; Gohil, Shruti K; Stone, Nimalie D; Steinberg, Karl; Montgomery, Jocelyn; Beecham, Nancy; Huang, Susan S

2017-01-01

Abstract Background The majority of healthcare-associated infections due to MDROs occur in the post-discharge setting. Understanding MDRO spread and containment in NHs can help identify infection prevention activities needed to care for vulnerable patients in a medical home setting. Methods We conducted a baseline point prevalence study of MDRO colonization in residents of 28 Southern California NHs participating in a decolonization trial. In Fall 2016, residents were randomly sampled to obtain a set of 50 nares and skin (axilla/groin) swabs from each NH. Nasal swabs were processed for MRSA and skin swabs were processed for MRSA, VRE, ESBL, and CRE. In addition, environmental swabs were collected from high touch objects in resident rooms (bedrail, call button/TV remote, door knobs, light switch, bathroom) and common areas (nursing station, table, chair, railing, and drinking fountain). Results A total of 2,797 body swabs were obtained from 1400 residents. Overall, 48.6% (N = 680) of residents harbored MDROs. MRSA was found in 37% of residents (29.5% nares, 24.4% skin), followed by ESBL in 16% (Table 1). Resident MDRO status was only known for 11% of MRSA (59/518), 18% ESBL (40/228), 4% VRE (4/99), and none of the CRE (0/13) carriers. Colonization did not differ between long stay (48.8%, 534/1094) vs. post-acute (47.7%, 146/306) residents (P = NS), but bedbound residents were more likely to be MDRO colonized (58.7%, 182/310) vs. ambulatory residents (45.7%, 497/1088, P < 0.001). A total of 560 environmental swabs were obtained with 93% of common areas and 74% of resident rooms having an MDRO+ object with an average of 2.5 and 1.9 objects found to be contaminated (Table 2). Conclusion One in two NH residents are colonized with MDROs, which is largely unknown to the facility. MDRO carriage is associated with total care needs, but not long stay status. Environmental contamination in resident rooms and common areas is common. The burden of MDRO colonization and contamination is sufficiently high that universal strategies to reduce colonization and transmission are warranted. Disclosures J. A. McKinnell, Allergan: Research Contractor, Scientific Advisor and Speaker’s Bureau, Consulting fee, Research support and Speaker honorarium; Achaogen: Research Contractor, Scientific Advisor and Shareholder, Research support; Cempra: Research Contractor and Scientific Advisor, Research support; Theravance: Research Contractor, Research support; Science 37: Research Contractor, Salary; Expert Stewardship, LLC: Board Member and Employee, Salary; Thermo Fisher: Scientific Advisor, Salary; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; L. Miller, 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; R. D. Singh, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; J. Mendez, Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; R. Franco, Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; G. Gussin, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; L’Oreal: Consultant, Consulting fee; J. Chang, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; T. D. Dutciuc, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; R. Saavedra, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; K. Kleinman, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Molnlycke: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; E. M. Peterson, Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; L. Heim, Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; A. Miner, Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; M. Estevez, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; H. Custodio, Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; S. Yamaguchi, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; J. Nguyen, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; A. Varasteh, Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Sage Product: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; B. Launer, 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; S. Agrawal, Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; T. Tjoa, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; J. He, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; S. Park, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; S. Tam, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; S. K. Gohil, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; S. S. Huang, Sage Products: Receipt of contributed product, Conducting studies in which participating healthcare facilities are receiving contributed product (no contribution in submitted abstract), Participating healthcare facilities in my studies received contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in which participating healthcare facilities are receiving contributed product (no contribution in submitted abstract), Participating healthcare facilities in my studies received contributed product; Clorox: Receipt of contributed product, Conducting studies in which participating healthcare facilities are receiving contributed product (no contribution in submitted abstract), Participating healthcare facilities in my studies received contributed product; 3M: Receipt of contributed product, Conducting studies in which participating healthcare facilities are receiving contributed product (no contribution in submitted abstract), Participating healthcare facilities in my studies received contributed product; Molnlycke: Receipt of contributed product, Conducting studies in which participating healthcare facilities are receiving contributed product (no contribution in submitted abstract), Participating healthcare facilities in my studies received contributed product

30 CFR 285.640 - What is a General Activities Plan (GAP)?

Code of Federal Regulations, 2010 CFR

2010-07-01

... RENEWABLE ENERGY ALTERNATE USES OF EXISTING FACILITIES ON THE OUTER CONTINENTAL SHELF Plans and Information... conceptual decommissioning plans for all planned facilities, including testing of technology devices and... easements for the assessment and development of your limited lease or grant. (b) You must receive MMS...

PROGRESS REPORT: COFIRING PROJECTS FOR WILLOW ISLAND AND ALBRIGHT GENERATING STATIONS

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

K. Payette; D. Tillman

During the period April 1, 2001--June 30, 2001, Allegheny Energy Supply Co., LLC (Allegheny) accelerated construction of the Willow Island cofiring project, completed the installation of foundations for the fuel storage facility, the fuel receiving facility, and the processing building. Allegheny received all processing equipment to be installed at Willow Island. Allegheny completed the combustion modeling for the Willow Island project. During this time period construction of the Albright Generating Station cofiring facility was completed, with few items left for final action. The facility was dedicated at a ceremony on June 29. Initial testing of cofiring at the facility commenced.more » This report summarizes the activities associated with the Designer Opportunity Fuel program, and demonstrations at Willow Island and Albright Generating Stations. It details the construction activities at both sites along with the combustion modeling at the Willow Island site.« less

Development, application, and validation of a survey for infectious disease control practices at equine boarding facilities.

PubMed

Kirby, Alanna T; Traub-Dargatz, Josie L; Hill, Ashley E; Kogan, Lori R; Morley, Paul S; Heird, James C

2010-11-15

To develop a questionnaire for self-assessment of biosecurity practices at equine boarding facilities and to evaluate infectious disease control practices in these facilities in Colorado. Cross-sectional study. 64 equine boarding facilities in Colorado. Survey questions were rated according to importance for prevention and containment of equine infectious diseases. Point values (range, 0 to 20) were assigned for possible responses, with greater values given for optimal infection control methods. Questionnaires were mailed to equine boarding facilities in Colorado advertised on the World Wide Web. Survey responses were compared with assessments made by a member of the research team during visits to 30 randomly selected facilities. Agreement among results was analyzed via a kappa test and rated as poor, fair, moderate, substantial, or nearly perfect. Survey responses were received for 64 of 163 (39%) equine boarding facilities. Scores ranged from 106 to 402 points (maximum possible score, 418). Most facilities received better scores for movement and housing of equids than for other sections of the survey. Respondents at 24 of 48 (50%) facilities that routinely received new equids reported isolation of new arrivals. Agreement between self-assessment by survey respondents and evaluation by a member of the research team was determined to be fair to substantial. Most equine boarding facilities have opportunities to improve measures for prevention or containment of contagious diseases (eg, isolation of newly arrived equids and use of written health management protocols). Most self-assessments of infection control practices were accurate.

Progress towards implementation of ACT malaria case-management in public health facilities in the Republic of Sudan: a cluster-sample survey

PubMed Central

2012-01-01

Background Effective malaria case-management based on artemisinin-based combination therapy (ACT) and parasitological diagnosis is a major pillar within the 2007-2012 National Malaria Strategic Plan in the Sudan. Three years after the launch of the strategy a health facility survey was undertaken to evaluate case-management practices and readiness of the health facilities and health workers to implement a new malaria case-management strategy. Methods A cross-sectional, cluster sample survey was undertaken at public health facilities in 15 states of Sudan. Data were collected using quality-of-care assessment methods. The main outcomes were the proportions of facilities with ACTs and malaria diagnostics; proportions of health workers exposed to malaria related health systems support activities; and composite and individual indicators of case-management practices for febrile outpatients stratified by age, availability of ACTs and diagnostics, use of malaria diagnostics, and test result. Results We evaluated 244 facilities, 294 health workers and 1,643 consultations for febrile outpatients (425 < 5 years and 1,218 ≥ 5 years). Health facility and health worker readiness was variable: chloroquine was available at only 5% of facilities, 73% stocked recommended artesunate and sulfadoxine/pyrimethamine (AS+SP), 51% had the capacity to perform parasitological diagnosis, 53% of health workers had received in-service training on ACTs, 24% were trained in the use of malaria Rapid Diagnostic Tests, and 19% had received a supervisory visit including malaria case-management. At all health facilities 46% of febrile patients were parasitologically tested and 35% of patients were both, tested and treated according to test result. At facilities where AS+SP and malaria diagnostics were available 66% of febrile patients were tested and 51% were both, tested and treated according to test result. Among test positive patients 64% were treated with AS+SP but 24% were treated with artemether monotherapy. Among test negative patients only 17% of patients were treated for malaria. The majority of ACT dispensing and counseling practices were suboptimal. Conclusions Five years following change of the policy from chloroquine to ACTs and 3 years before the end of the new malaria strategic plan chloroquine was successfully phased out from public facilities in Sudan, however, an important gap remained in the availability of ACTs, diagnostic capacities and coverage with malaria case-management activities. The national scale-up of diagnostics, using the findings of this survey as well as future qualitative research, should present an opportunity not only to expand existing testing capacities but also to implement effective support interventions to bridge the health systems gaps and support corrective case-management measures, including the discontinuation of artemether monotherapy treatment. PMID:22221821

Variations in pretransfusion practices.

PubMed

Padget, B J; Hannon, J L

2003-01-01

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

Development and testing of the Shenandoah collector

NASA Technical Reports Server (NTRS)

Kinoshita, G. S.

1981-01-01

The test and development of the 7-meter Shenandoah parabolic dish collector incorporating an FEK-244 film reflective surface and cavity receiver are described. Four prototypes tested in the midtemperature Solar System Test Facility indicate, with changes incorporated from these development tests, that the improvements should lead to predicted performance levels in the production collectors.

GAMMA FACILITY, TRA611, INTERIOR. WITH HELP OF OVERHEAD CHAIN AND ...

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

GAMMA FACILITY, TRA-611, INTERIOR. WITH HELP OF OVERHEAD CHAIN AND HOOK, SCIENTIST GUIDES METAL CONTAINER (HOLDING POTATOES, IN THIS CASE) INTO RECEIVING "COLUMN" IN THE GAMMA CANAL. NOTE OTHER COLUMNS AT RIGHT AND LEFT WALLS OF CANAL. NEAR BOTTOM OF CANAL, SPENT MTR FUEL WILL IRRADIATE POTATOES. INL NEGATIVE NO. 56-439. R.G. Larsen, Photographer, 2/8/1956 - Idaho National Engineering Laboratory, Test Reactor Area, Materials & Engineering Test Reactors, Scoville, Butte County, ID

NASA chief technologist visits Stennis

NASA Image and Video Library

2010-08-26

NASA Chief Technologist Bobby Braun visited John C. Stennis Space Center on Aug. 26. While at Stennis, he spoke to employees and the media about innovation and technology in NASA's future and the important role Stennis will play in space exploration programs. Braun also toured facilities and received briefings on work under way at the nation's premier rocket engine test facility.

Concentrating Solar Power Central Receiver Panel Component Fabrication and Testing FINAL REPORT

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

McDowell, Michael W; Miner, Kris

The objective of this project is to complete a design of an advanced concentrated solar panel and demonstrate the manufacturability of key components. Then confirm the operation of the key components under prototypic solar flux conditions. This work is an important step in reducing the levelized cost of energy (LCOE) from a central receiver solar power plant. The key technical risk to building larger power towers is building the larger receiver systems. Therefore, this proposed technology project includes the design of an advanced molten salt prototypic sub-scale receiver panel that can be utilized into a large receiver system. Then completemore » the fabrication and testing of key components of the receive design that will be used to validate the design. This project shall have a significant impact on solar thermal power plant design. Receiver panels of suitable size for utility scale plants are a key element to a solar power tower plant. Many subtle and complex manufacturing processes are involved in producing a reliable, robust receiver panel. Given the substantial size difference between receiver panels manufactured in the past and those needed for large plant designs, the manufacture and demonstration on prototype receiver panel components with representative features of a full-sized panel will be important to improving the build process for commercial success. Given the thermal flux limitations of the test facility, the panel components cannot be rendered full size. Significance changes occurred in the projects technical strategies from project initiation to the accomplishments described herein. The initial strategy was to define cost improvements for the receiver, design and build a scale prototype receiver and test, on sun, with a molten salt heat transport system. DOE had committed to constructing a molten salt heat transport loop to support receiver testing at the top of the NSTTF tower. Because of funding constraints this did not happen. A subsequent plan to test scale prototype receiver, off sun but at temperature, at a molten salt loop at ground level adjacent to the tower also had to be abandoned. Thus, no test facility existed for a molten salt receiver test. As a result, PWR completed the prototype receiver design and then fabricated key components for testing instead of fabricating the complete prototype receiver. A number of innovative design ideas have been developed. Key features of the receiver panel have been identified. This evaluation includes input from Solar 2, personal experience of people working on these programs and meetings with Sandia. Key components of the receiver design and key processes used to fabricate a receiver have been selected for further evaluation. The Test Plan, Concentrated Solar Power Receiver In Cooperation with the Department of Energy and Sandia National Laboratory was written to define the scope of the testing to be completed as well as to provide details related to the hardware, instrumentation, and data acquisition. The document contains a list of test objectives, a test matrix, and an associated test box showing the operating points to be tested. Test Objectives: 1. Demonstrate low-cost manufacturability 2. Demonstrate robustness of two different tube base materials 3. Collect temperature data during on sun operation 4. Demonstrate long term repeated daily operation of heat shields 5. Complete pinhole tube weld repairs 6. Anchor thermal models This report discusses the tests performed, the results, and implications for design improvements and LCOE reduction.« less

The minimum test battery to screen for binocular vision anomalies: report 3 of the BAND study.

PubMed

Hussaindeen, Jameel Rizwana; Rakshit, Archayeeta; Singh, Neeraj Kumar; Swaminathan, Meenakshi; George, Ronnie; Kapur, Suman; Scheiman, Mitchell; Ramani, Krishna Kumar

2018-03-01

This study aims to report the minimum test battery needed to screen non-strabismic binocular vision anomalies (NSBVAs) in a community set-up. When large numbers are to be screened we aim to identify the most useful test battery when there is no opportunity for a more comprehensive and time-consuming clinical examination. The prevalence estimates and normative data for binocular vision parameters were estimated from the Binocular Vision Anomalies and Normative Data (BAND) study, following which cut-off estimates and receiver operating characteristic curves to identify the minimum test battery have been plotted. In the receiver operating characteristic phase of the study, children between nine and 17 years of age were screened in two schools in the rural arm using the minimum test battery, and the prevalence estimates with the minimum test battery were found. Receiver operating characteristic analyses revealed that near point of convergence with penlight and red filter (> 7.5 cm), monocular accommodative facility (< 10 cycles per minute), and the difference between near and distance phoria (> 1.25 prism dioptres) were significant factors with cut-off values for best sensitivity and specificity. This minimum test battery was applied to a cohort of 305 children. The mean (standard deviation) age of the subjects was 12.7 (two) years with 121 males and 184 females. Using the minimum battery of tests obtained through the receiver operating characteristic analyses, the prevalence of NSBVAs was found to be 26 per cent. Near point of convergence with penlight and red filter > 10 cm was found to have the highest sensitivity (80 per cent) and specificity (73 per cent) for the diagnosis of convergence insufficiency. For the diagnosis of accommodative infacility, monocular accommodative facility with a cut-off of less than seven cycles per minute was the best predictor for screening (92 per cent sensitivity and 90 per cent specificity). The minimum test battery of near point of convergence with penlight and red filter, difference between distance and near phoria, and monocular accommodative facility yield good sensitivity and specificity for diagnosis of NSBVAs in a community set-up. © 2017 Optometry Australia.

Construction bidding cost of KSC's space shuttle facilities

NASA Technical Reports Server (NTRS)

Brown, Joseph Andrew

1977-01-01

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

Fixed Equipment in the Energy Systems Integration Facility | Energy Systems

Science.gov Websites

dynamic simulation of future energy systems. Photo of a robot used to test hydrogen coupling hardware. At test chambers (rated up to 60°C) for testing HVAC systems under simulated loading conditions Two bench performance Test stand for measuring performance of receiver tubes for concentrating solar power applications

75 FR 53371 - Liquefied Natural Gas Facilities: Obtaining Approval of Alternative Vapor-Gas Dispersion Models

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-31

... factors as the approved models, are validated by experimental test data, and receive the Administrator's... stage of the MEP involves applying the model against a database of experimental test cases including..., particularly the requirement for validation by experimental test data. That guidance is based on the MEP's...

GPS-ABC Radiated Chamber Testing Overview and Results : GPS-ABC Workshop V RTCA Washington, DC October 14, 2016.

DOT National Transportation Integrated Search

2016-10-14

GPS receiver testing was carried out April 2529, 2016 at the Army : Research Laboratory's (ARL) Electromagnetic Vulnerability Assessment : Facility (EMVAF), White Sands Missile Range (WSMR), NM : EMVAF 100 x 70 x 40 Anechoic C...

It's Time to Develop a New "Draft Test Protocol" for a Mars Sample Return Mission (or Two…).

PubMed

Rummel, John D; Kminek, Gerhard

2018-04-01

The last time NASA envisioned a sample return mission from Mars, the development of a protocol to support the analysis of the samples in a containment facility resulted in a "Draft Test Protocol" that outlined required preparations "for the safe receiving, handling, testing, distributing, and archiving of martian materials here on Earth" (Rummel et al., 2002 ). This document comprised a specific protocol to be used to conduct a biohazard test for a returned martian sample, following the recommendations of the Space Studies Board of the US National Academy of Sciences. Given the planned launch of a sample-collecting and sample-caching rover (Mars 2020) in 2 years' time, and with a sample return planned for the end of the next decade, it is time to revisit the Draft Test Protocol to develop a sample analysis and biohazard test plan to meet the needs of these future missions. Key Words: Biohazard detection-Mars sample analysis-Sample receiving facility-Protocol-New analytical techniques-Robotic sample handling. Astrobiology 18, 377-380.

78 FR 13695 - Information Collection: Renewable Energy and Alternate Uses of Existing Facilities on the Outer...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-28

... activities, facilities, safety equipment, inspections and tests, and natural and manmade hazards near the... one line on BOEM-0005 to match language on a similar form for the oil and gas program; this does not.... 111 Within 30 days of .5 4 fee submissions. 2 receiving bill, submit processing fee payments for BOEM...

Using pay for performance incentives (P4P) to improve management of suspected malaria fevers in rural Kenya: a cluster randomized controlled trial.

PubMed

Menya, Diana; Platt, Alyssa; Manji, Imran; Sang, Edna; Wafula, Rebeccah; Ren, Jing; Cheruiyot, Olympia; Armstrong, Janice; Neelon, Brian; O'Meara, Wendy Prudhomme

2015-10-16

Inappropriate treatment of non-malaria fevers with artemisinin-based combination therapies (ACTs) is a growing concern, particularly in light of emerging artemisinin resistance, but it is a behavior that has proven difficult to change. Pay for performance (P4P) programs have generated interest as a mechanism to improve health service delivery and accountability in resource-constrained health systems. However, there has been little experimental evidence to establish the effectiveness of P4P in developing countries. We tested a P4P strategy that emphasized parasitological diagnosis and appropriate treatment of suspected malaria, in particular reduction of unnecessary consumption of ACTs. A random sample of 18 health centers was selected and received a refresher workshop on malaria case management. Pre-intervention baseline data was collected from August to September 2012. Facilities were subsequently randomized to either the comparison (n = 9) or intervention arm (n = 9). Between October 2012 and November 2013, facilities in the intervention arm received quarterly incentive payments based on seven performance indicators. Incentives were for use by facilities rather than as payments to individual providers. All non-pregnant patients older than 1 year of age who presented to a participating facility and received either a malaria test or artemether-lumefantrine (AL) were eligible to be included in the analysis. Our primary outcome was prescription of AL to patients with a negative malaria diagnostic test (n = 11,953). Our secondary outcomes were prescription of AL to patients with laboratory-confirmed malaria (n = 2,993) and prescription of AL to patients without a malaria diagnostic test (analyzed at the cluster level, n = 178 facility-months). In the final quarter of the intervention period, the proportion of malaria-negative patients in the intervention arm who received AL was lower than in the comparison arm (7.3% versus 10.9%). The improvement from baseline to quarter 4 in the intervention arm was nearly three times that of the comparison arm (ratio of adjusted odds ratios for baseline to quarter 4 = 0.36, 95% CI: 0.24-0.57). The rate of prescription of AL to patients without a test was five times lower in the intervention arm (adjusted incidence rate ratio = 0.18, 95% CI: 0.07-0.48). Prescription of AL to patients with confirmed infection was not significantly different between the groups over the study period. Facility-based incentives coupled with training may be more effective than training alone and could complement other quality improvement approaches. This study was registered with ClinicalTrials.gov (NCT01809873) on 11 March 2013.

Antenatal care service quality increases the odds of utilizing institutional delivery in Bahir Dar city administration, North Western Ethiopia: A prospective follow up study.

PubMed

Ejigu Tafere, Tadese; Afework, Mesganaw Fanthahun; Yalew, Alemayehu Worku

2018-01-01

In Ethiopia, more than 62% of pregnant women attend antenatal care at least once, yet only about one in four women give birth at health facility. This gap has fueled the need to investigate on the quality of ANC services at public health facilities and its link with the use of institutional delivery. To assess the linkage between ANC quality and the use of institutional delivery among pregnant women attending ANC at public health facilities of BDR City Administration. A facility based prospective follow up study was conducted. and nine hundred seventy pregnant women with gestational age ≤ 16 weeks who came for their first ANC visit were enrolled.Women were followed from their first ANC visit until delivery. Longitudinal data was collected during consultation with ANC providers using structured observation checklist. ANC service was considered as acceptable quality if women received ≥75th percentile of the essential ANC services. Generalized Estimating Equation (GEE) was carried out to control cluster effect among women who received ANC in the same facility. Among 823 pregnant women who completed follow up, only about one third (27.6%) received acceptable quality of ANC services. In one health facility syphilis test was not done at all for the last two years. The odds of giving birth at health institution among pregnant women who received acceptable ANC quality service was about 3.38 times higher than among pregnant women who received unacceptable ANC quality service (AOR = 3.38, 95% CI: 1.67, 6.83). In this study the quality of ANC service provision in public health facilities was compromised/low. Provision of quality ANC service had a great role in promoting institutional delivery. Therefore the local authorities at each level of health sector or the nongovernmental organizations working to improve maternal health need to provide training on focused antenatal care protocol for ANC providers.

Antenatal care service quality increases the odds of utilizing institutional delivery in Bahir Dar city administration, North Western Ethiopia: A prospective follow up study

PubMed Central

Afework, Mesganaw Fanthahun; Yalew, Alemayehu Worku

2018-01-01

Background In Ethiopia, more than 62% of pregnant women attend antenatal care at least once, yet only about one in four women give birth at health facility. This gap has fueled the need to investigate on the quality of ANC services at public health facilities and its link with the use of institutional delivery. Objective To assess the linkage between ANC quality and the use of institutional delivery among pregnant women attending ANC at public health facilities of BDR City Administration Methods A facility based prospective follow up study was conducted. and nine hundred seventy pregnant women with gestational age ≤ 16 weeks who came for their first ANC visit were enrolled.Women were followed from their first ANC visit until delivery. Longitudinal data was collected during consultation with ANC providers using structured observation checklist. ANC service was considered as acceptable quality if women received ≥75th percentile of the essential ANC services. Generalized Estimating Equation (GEE) was carried out to control cluster effect among women who received ANC in the same facility. Results Among 823 pregnant women who completed follow up, only about one third (27.6%) received acceptable quality of ANC services. In one health facility syphilis test was not done at all for the last two years. The odds of giving birth at health institution among pregnant women who received acceptable ANC quality service was about 3.38 times higher than among pregnant women who received unacceptable ANC quality service (AOR = 3.38, 95% CI: 1.67, 6.83). Conclusion and recommendation In this study the quality of ANC service provision in public health facilities was compromised/low. Provision of quality ANC service had a great role in promoting institutional delivery. Therefore the local authorities at each level of health sector or the nongovernmental organizations working to improve maternal health need to provide training on focused antenatal care protocol for ANC providers. PMID:29420598

Direct observation of outpatient management of malaria in a rural Ghanaian district.

PubMed

Ameme, Donne Kofi; Afari, Edwin Andrews; Nyarko, Kofi Mensah; Malm, Keziah Laurencia; Sackey, Samuel; Wurapa, Fred

2014-01-01

In Ghana, malaria continues to top outpatient morbidities; accounting for about 40% of all attendances. Effective case-management is key to its control. We evaluated case-management practices of uncomplicated malaria in Kwahu South District (KSD) health facilities to determine their conformity to guidelines. We conducted a cross sectional survey at all public health facilities in three randomly selected sub-districts in KSD. A non-participatory observation of suspected malaria consultations was conducted. Suspected malaria was defined as any person with fever (by history or measured axillary temperature > or equal 37.5 oC) presenting at the selected health facilities between 19th and 29th April 2013. Findings were expressed as frequencies, relative frequencies, mean (± standard deviation) and median. Of 70 clinical observations involving 10 prescribers in six health facilities, 40 (57.1%) were females and 16 (22.9%) were below five years. Median age was 18 years (interquartile range: 5-33). Overall, 63 (90.0%) suspected case-patients had diagnostic tests. Two (3.6%) were treated presumptively. All 31 confirmed and 10 (33.3%) of the test negative case-patients received Artemisinin-based Combination Therapies (ACTs). However, only 12 (27.9%) of the 43 case-patients treated with ACT received Artesunate-Amodiaquine (AA). Only three (18.8%) of the under-fives were examined for non-malarial causes of fever. Mean number of drugs per patient was 3.7 drugs (± 1.1). Only 45 (64.3%) patients received at least one counseling message. Conformity of malaria case-management practices to guidelines in KSD was suboptimal. Apart from high rate of diagnostic testing and ACT use, prescription of AA, physical examination and counseling needed improvement.

The relationship of age and place of delivery with postpartum contraception prior to discharge in Mexico: A retrospective cohort study.

PubMed

Darney, Blair G; Sosa-Rubi, Sandra G; Servan-Mori, Edson; Rodriguez, Maria I; Walker, Dilys; Lozano, Rafael

2016-06-01

To test the association of age (adolescents vs. older women) and place of delivery with receipt of immediate postpartum contraception in Mexico. Retrospective cohort study, Mexico, nationally representative sample of women 12-39years old at last delivery. We used multivariable logistic regression to test the association of self-reported receipt of postpartum contraception prior to discharge with age and place of delivery (public, employment based, private, or out of facility). We included individual and household-level confounders and calculated relative and absolute multivariable estimates of association. Our analytic sample included 7022 women (population, N=9,881,470). Twenty percent of the population was 12-19years old at last birth, 55% aged 20-29 and 25% 30-39years old. Overall, 43% of women reported no postpartum contraceptive method. Age was not significantly associated with receipt of a method, controlling for covariates. Women delivering in public facilities had lower odds of receipt of a method (Odds Ratio=0.52; 95% Confidence Interval (CI)=0.40-0.68) compared with employment-based insurance facilities. We estimated 76% (95% CI=74-78%) of adolescents (12-19years) who deliver in employment-based insurance facilities leave with a method compared with 59% (95% CI=56-62%) who deliver in public facilities. Both adolescents and women ages 20-39 receive postpartum contraception, but nearly half of all women receive no method. Place of delivery is correlated with receipt of postpartum contraception, with lower rates in the public sector. Lessons learned from Mexico are relevant to other countries seeking to improve adolescent health through reducing unintended pregnancy. Adolescents receive postpartum contraception as often as older women in Mexico, but half of all women receive no method. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

A survey of the perception of the quality of and preference of healthcare services amongst residents of Abeokuta South Local Government, Ogun State, Nigeria.

PubMed

Oredola, A S; Odusanya, O O

2017-09-01

The choice of healthcare facilities by individuals is determined in part by their taste, satisfaction with services, and the perceived quality of care provided. The aim of the study was to explore the healthcare preferences of residents of Abeokuta South Local Government Area (LGA) and their perception of quality of services received, and to determine the factors influencing their choice of healthcare facilities. A descriptive cross-sectional study design was used to assess perception of clients regarding quality of healthcare received and their choice of healthcare service delivery. Data were collected using a pre-tested interviewer-administered questionnaire, and analysis was done using SPSS version 17. Statistical significance was set at P <0.05. The mean age of respondents was 45.7 ± 11.7 years. Government-owned general hospitals were preferred for common health problems such as body pain and fever. Overall, about 73% of the respondents preferred government-owned facilities. Determinants of the preference of the government facilities were reduced cost (P< 0.001) and effectiveness of care (P= 0.024), whereas private facilities were preferred more significantly because of short waiting time and good attitude of staff (P = < 0.001). Almost 78% of the respondents were satisfied with the quality of care received. Government-owned general hospitals were the preferred source of health services and the quality of healthcare services received was generally perceived to be high.

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

PubMed

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

2011-04-01

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

Solar Stirling power generation - Systems analysis and preliminary tests

NASA Technical Reports Server (NTRS)

Selcuk, M. K.; Wu, Y.-C.; Moynihan, P. I.; Day, F. D., III

1977-01-01

The feasibility of an electric power generation system utilizing a sun-tracking parabolic concentrator and a Stirling engine/linear alternator is being evaluated. Performance predictions and cost analysis of a proposed large distributed system are discussed. Design details and preliminary test results are presented for a 9.5 ft diameter parabolic dish at the Jet Propulsion Laboratory (Caltech) Table Mountain Test Facility. Low temperature calorimetric measurements were conducted to evaluate the concentrator performance, and a helium flow system is being used to test the solar receiver at anticipated working fluid temperatures (up to 650 or 1200 C) to evaluate the receiver thermal performance. The receiver body is designed to adapt to a free-piston Stirling engine which powers a linear alternator assembly for direct electric power generation. During the next phase of the program, experiments with an engine and receiver integrated into the concentrator assembly are planned.

Mobile CARS - IRS Instrument for Simultaneous Spectroscopic Measurement of Multiple Properties in Gaseous Flows

NASA Technical Reports Server (NTRS)

Bivolaru, Daniel; Lee, Joseph W.; Jones, Stephen B.; Tedder, Sarah A.; Danehy, Paul M.; Weikl, M. C.; Magnotti, G.; Cutler, Andrew D.

2007-01-01

This paper describes a measurement system based on the dual-pump coherent anti-Stokes Raman spectroscopy (CARS) and interferometric Rayleigh scattering (IRS) methods. The IRS measurement is performed simultaneously with the CARS measurement using a common green laser beam as a narrow-band light source. The mobile CARS-IRS instrument is designed for the use both in laboratories as well as in ground-based combustion test facilities. Furthermore, it is designed to be easily transported between laboratory and test facility. It performs single-point spatially and temporally resolved simultaneous measurements of temperature, species mole fraction of N2, O2, and H2, and two-components of velocity. A mobile laser system can be placed inside or outside the test facility, while a beam receiving and monitoring system is placed near the measurement location. Measurements in a laboratory small-scale Mach 1.6 H2-air combustion-heated supersonic jet were performed to test the capability of the system. Final setup and pretests of a larger scale reacting jet are ongoing at NASA Langley Research Center s Direct Connect Supersonic Combustor Test Facility (DCSCTF).

42 CFR 51c.507 - Facility which has previously received Federal grant.

Code of Federal Regulations, 2010 CFR

2010-10-01

... § 51c.507 Facility which has previously received Federal grant. No grant for the acquisition of a facility which has previously received a Federal grant for construction, acquisition, or equipment shall... 42 Public Health 1 2010-10-01 2010-10-01 false Facility which has previously received Federal...

Associations between Mode of HIV Testing and Consent, Confidentiality, and Referral: A Comparative Analysis in Four African Countries

PubMed Central

Obermeyer, Carla Makhlouf; Neuman, Melissa; Desclaux, Alice; Wanyenze, Rhoda; Ky-Zerbo, Odette; Cherutich, Peter; Namakhoma, Ireen; Hardon, Anita

2012-01-01

Background Recommendations about scaling up HIV testing and counseling highlight the need to provide key services and to protect clients' rights, but it is unclear to what extent different modes of testing differ in this respect. This paper examines whether practices regarding consent, confidentiality, and referral vary depending on whether testing is provided through voluntary counseling and testing (VCT) or provider-initiated testing. Methods and Findings The MATCH (Multi-Country African Testing and Counseling for HIV) study was carried out in Burkina Faso, Kenya, Malawi, and Uganda. Surveys were conducted at selected facilities. We defined eight outcome measures related to pre- and post-test counseling, consent, confidentiality, satisfactory interactions with providers, and (for HIV-positive respondents) referral for care. These were compared across three types of facilities: integrated facilities, where testing is provided along with medical care; stand-alone VCT facilities; and prevention of mother-to-child transmission (PMTCT) facilities, where testing is part of PMTCT services. Tests of bivariate associations and modified Poisson regression were used to assess significance and estimate the unadjusted and adjusted associations between modes of testing and outcome measures. In total, 2,116 respondents tested in 2007 or later reported on their testing experience. High percentages of clients across countries and modes of testing reported receiving recommended services and being satisfied. In the unadjusted analyses, integrated testers were less likely to meet with a counselor before testing (83% compared with 95% of VCT testers; p<0.001), but those who had a pre-test meeting were more likely to have completed consent procedures (89% compared with 83% among VCT testers; p<0.001) and pre-test counseling (78% compared with 73% among VCT testers; p = 0.015). Both integrated and PMTCT testers were more likely to receive complete post-test counseling than were VCT testers (59% among both PMTCT and integrated testers compared with 36% among VCT testers; p<0.001). Adjusted analyses by country show few significant differences by mode of testing: only lower satisfaction among integrated testers in Burkina Faso and Uganda, and lower frequency of referral among PMTCT testers in Malawi. Adjusted analyses of pooled data across countries show a higher likelihood of pre-test meeting for those testing at VCT facilities (adjusted prevalence ratio: 1.22, 95% CI: 1.07–1.38) and higher satisfaction for stand-alone VCT facilities (adjusted prevalence ratio: 1.15; 95% CI: 1.06–1.25), compared to integrated testing, but no other associations were statistically significant. Conclusions Overall, in this study most respondents reported favorable outcomes for consent, confidentiality, and referral. Provider-initiated ways of delivering testing and counseling do not appear to be associated with less favorable outcomes for clients than traditional, client-initiated VCT, suggesting that testing can be scaled up through multiple modes without detriment to clients' rights. Please see later in the article for the Editors' Summary PMID:23109914

Associations between mode of HIV testing and consent, confidentiality, and referral: a comparative analysis in four African countries.

PubMed

Obermeyer, Carla Makhlouf; Neuman, Melissa; Desclaux, Alice; Wanyenze, Rhoda; Ky-Zerbo, Odette; Cherutich, Peter; Namakhoma, Ireen; Hardon, Anita

2012-01-01

Recommendations about scaling up HIV testing and counseling highlight the need to provide key services and to protect clients' rights, but it is unclear to what extent different modes of testing differ in this respect. This paper examines whether practices regarding consent, confidentiality, and referral vary depending on whether testing is provided through voluntary counseling and testing (VCT) or provider-initiated testing. The MATCH (Multi-Country African Testing and Counseling for HIV) study was carried out in Burkina Faso, Kenya, Malawi, and Uganda. Surveys were conducted at selected facilities. We defined eight outcome measures related to pre- and post-test counseling, consent, confidentiality, satisfactory interactions with providers, and (for HIV-positive respondents) referral for care. These were compared across three types of facilities: integrated facilities, where testing is provided along with medical care; stand-alone VCT facilities; and prevention of mother-to-child transmission (PMTCT) facilities, where testing is part of PMTCT services. Tests of bivariate associations and modified Poisson regression were used to assess significance and estimate the unadjusted and adjusted associations between modes of testing and outcome measures. In total, 2,116 respondents tested in 2007 or later reported on their testing experience. High percentages of clients across countries and modes of testing reported receiving recommended services and being satisfied. In the unadjusted analyses, integrated testers were less likely to meet with a counselor before testing (83% compared with 95% of VCT testers; p<0.001), but those who had a pre-test meeting were more likely to have completed consent procedures (89% compared with 83% among VCT testers; p<0.001) and pre-test counseling (78% compared with 73% among VCT testers; p = 0.015). Both integrated and PMTCT testers were more likely to receive complete post-test counseling than were VCT testers (59% among both PMTCT and integrated testers compared with 36% among VCT testers; p<0.001). Adjusted analyses by country show few significant differences by mode of testing: only lower satisfaction among integrated testers in Burkina Faso and Uganda, and lower frequency of referral among PMTCT testers in Malawi. Adjusted analyses of pooled data across countries show a higher likelihood of pre-test meeting for those testing at VCT facilities (adjusted prevalence ratio: 1.22, 95% CI: 1.07-1.38) and higher satisfaction for stand-alone VCT facilities (adjusted prevalence ratio: 1.15; 95% CI: 1.06-1.25), compared to integrated testing, but no other associations were statistically significant. Overall, in this study most respondents reported favorable outcomes for consent, confidentiality, and referral. Provider-initiated ways of delivering testing and counseling do not appear to be associated with less favorable outcomes for clients than traditional, client-initiated VCT, suggesting that testing can be scaled up through multiple modes without detriment to clients' rights. Please see later in the article for the Editors' Summary.

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

PubMed

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

2017-08-29

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

Progress in solar thermal distributed receiver technology

NASA Astrophysics Data System (ADS)

Leonard, J. A.; Otts, J. V.

A brief discussion is given on the fundamentals of parabolic dish collectors. Private and Department of Energy supported projects which employ parabolic dish collector systems are described. These projects include: the Distribution Receiver Test Facility, Shenandoah Solar Total Energy Project, Vangurd I, Solar Plant No. 1, the Dish/Stirling Solar Electric Generating System, the Organic Rankine Cycle, and the Solarized Automotive Gas Turbine.

Impact of SMS/GPRS Printers in Reducing Time to Early Infant Diagnosis Compared With Routine Result Reporting: A Systematic Review and Meta-Analysis

PubMed Central

Markby, Jessica; Boeke, Caroline; Penazzato, Martina; Urick, Brittany; Ghadrshenas, Anisa; Harris, Lindsay; Ford, Nathan; Peter, Trevor

2017-01-01

Background: Despite significant gains made toward improving access, early infant diagnosis (EID) testing programs suffer from long test turnaround times that result in substantial loss to follow-up and mortality associated with delays in antiretroviral therapy initiation. These delays in treatment initiation are particularly impactful because of significant HIV-related infant mortality observed by 2–3 months of age. Short message service (SMS) and general packet radio service (GPRS) printers allow test results to be transmitted immediately to health care facilities on completion of testing in the laboratory. Methods: We conducted a systematic review and meta-analysis to assess the benefit of using SMS/GPRS printers to increase the efficiency of EID test result delivery compared with traditional courier paper–based results delivery methods. Results: We identified 11 studies contributing data for over 16,000 patients from East and Southern Africa. The test turnaround time from specimen collection to result received at the health care facility with courier paper–based methods was 68.0 days (n = 6835), whereas the test turnaround time with SMS/GPRS printers was 51.1 days (n = 6711), resulting in a 2.5-week (25%) reduction in the turnaround time. Conclusions: Courier paper–based EID test result delivery methods are estimated to add 2.5 weeks to EID test turnaround times in low resource settings and increase the risk that infants receive test results during or after the early peak of infant mortality. SMS/GPRS result delivery to health care facility printers significantly reduced test turnaround time and may reduce this risk. SMS/GPRS printers should be considered for expedited delivery of EID and other centralized laboratory test results. PMID:28825941

Cryogenic Fluid Management Facility

NASA Technical Reports Server (NTRS)

Eberhardt, R. N.; Bailey, W. J.

1985-01-01

The Cryogenic Fluid Management Facility is a reusable test bed which is designed to be carried within the Shuttle cargo bay to investigate the systems and technologies associated with the efficient management of cryogens in space. Cryogenic fluid management consists of the systems and technologies for: (1) liquid storage and supply, including capillary acquisition/expulsion systems which provide single-phase liquid to the user system, (2) both passive and active thermal control systems, and (3) fluid transfer/resupply systems, including transfer lines and receiver tanks. The facility contains a storage and supply tank, a transfer line and a receiver tank, configured to provide low-g verification of fluid and thermal models of cryogenic storage and transfer processes. The facility will provide design data and criteria for future subcritical cryogenic storage and transfer system applications, such as Space Station life support, attitude control, power and fuel depot supply, resupply tankers, external tank (ET) propellant scavenging, and ground-based and space-based orbit transfer vehicles (OTV).

49 CFR 599.401 - Requirements and limitations for disposal facilities that receive trade-in vehicles under the...

Code of Federal Regulations, 2010 CFR

2010-10-01

... facilities that receive trade-in vehicles under the CARS program. 599.401 Section 599.401 Transportation... facilities that receive trade-in vehicles under the CARS program. (a) The disposal facility must: (1) Not... or shredded, report the vehicle to NMVTIS as crushed or shredded. (b) The disposal facility may not...

Mobile/Modular BSL-4 Facilities for Meeting Restricted Earth Return Containment Requirements

NASA Technical Reports Server (NTRS)

Calaway, M. J.; McCubbin, F. M.; Allton, J. H.; Zeigler, R. A.; Pace, L. F.

2017-01-01

NASA robotic sample return missions designated Category V Restricted Earth Return by the NASA Planetary Protection Office require sample containment and biohazard testing in a receiving laboratory as directed by NASA Procedural Requirement (NPR) 8020.12D - ensuring the preservation and protection of Earth and the sample. Currently, NPR 8020.12D classifies Restricted Earth Return for robotic sample return missions from Mars, Europa, and Enceladus with the caveat that future proposed mission locations could be added or restrictions lifted on a case by case basis as scientific knowledge and understanding of biohazards progresses. Since the 1960s, sample containment from an unknown extraterrestrial biohazard have been related to the highest containment standards and protocols known to modern science. Today, Biosafety Level (BSL) 4 standards and protocols are used to study the most dangerous high-risk diseases and unknown biological agents on Earth. Over 30 BSL-4 facilities have been constructed worldwide with 12 residing in the United States; of theses, 8 are operational. In the last two decades, these brick and mortar facilities have cost in the hundreds of millions of dollars dependent on the facility requirements and size. Previous mission concept studies for constructing a NASA sample receiving facility with an integrated BSL-4 quarantine and biohazard testing facility have also been estimated in the hundreds of millions of dollars. As an alternative option, we have recently conducted an initial trade study for constructing a mobile and/or modular sample containment laboratory that would meet all BSL-4 and planetary protection standards and protocols at a faction of the cost. Mobile and modular BSL-2 and 3 facilities have been successfully constructed and deployed world-wide for government testing of pathogens and pharmaceutical production. Our study showed that a modular BSL-4 construction could result in approximately 90% cost reduction when compared to traditional construction methods without compromising the preservation of the sample or Earth.

Unravelling the quality of HIV counselling and testing services in the private and public sectors in Zambia

PubMed Central

Ron Levey, Ilana; Wang, Wenjuan

2014-01-01

Background Despite the substantial investment for providing HIV counselling and testing (VCT) services in Zambia, there has been little effort to systematically evaluate the quality of VCT services provided by various types of health providers. This study, conducted in 2009, examines VCT in the public and private sectors including private for-profit and NGO/faith-based sectors in Copperbelt and Luapula. Methods The study used five primary data collection methods to gauge quality of VCT services: closed-ended client interviews with clients exiting VCT sites; open-ended client interviews; interviews with facility managers; review of service statistics; and an observation of the physical environment for VCT by site. Over 400 clients and 87 facility managers were interviewed from almost 90 facilities. Sites were randomly selected and results are generalizable at the provincial level. Results The study shows concerning levels of underperformance in VCT services across the sectors. It reveals serious underperformance in counselling about key risk-reduction methods. Less than one-third of clients received counselling on reducing number of sexual partners and only approximately 5% of clients received counselling about disclosing test results to partners. In terms of client profiles, the NGO sector attracts the most educated clients and less educated Zambians seek VCT services at very low rates (7%). The private for-profit performs equally or sometimes better than other sectors even though this sector is not adequately integrated into the Zambian national response to HIV. Conclusion The private for-profit sector provides VCT services on par in quality with the other sectors. Most clients did not receive counselling on partner reduction or disclosure of HIV test results to partners. In a generalized HIV epidemic where multiple concurrent sexual partners are a significant problem for transmitting the disease, risk-reduction methods and discussion should be a main focus of pre-test and post-test counselling. PMID:25012796

Unravelling the quality of HIV counselling and testing services in the private and public sectors in Zambia.

PubMed

Ron Levey, Ilana; Wang, Wenjuan

2014-07-01

Despite the substantial investment for providing HIV counselling and testing (VCT) services in Zambia, there has been little effort to systematically evaluate the quality of VCT services provided by various types of health providers. This study, conducted in 2009, examines VCT in the public and private sectors including private for-profit and NGO/faith-based sectors in Copperbelt and Luapula. The study used five primary data collection methods to gauge quality of VCT services: closed-ended client interviews with clients exiting VCT sites; open-ended client interviews; interviews with facility managers; review of service statistics; and an observation of the physical environment for VCT by site. Over 400 clients and 87 facility managers were interviewed from almost 90 facilities. Sites were randomly selected and results are generalizable at the provincial level. The study shows concerning levels of underperformance in VCT services across the sectors. It reveals serious underperformance in counselling about key risk-reduction methods. Less than one-third of clients received counselling on reducing number of sexual partners and only approximately 5% of clients received counselling about disclosing test results to partners. In terms of client profiles, the NGO sector attracts the most educated clients and less educated Zambians seek VCT services at very low rates (7%). The private for-profit performs equally or sometimes better than other sectors even though this sector is not adequately integrated into the Zambian national response to HIV. The private for-profit sector provides VCT services on par in quality with the other sectors. Most clients did not receive counselling on partner reduction or disclosure of HIV test results to partners. In a generalized HIV epidemic where multiple concurrent sexual partners are a significant problem for transmitting the disease, risk-reduction methods and discussion should be a main focus of pre-test and post-test counselling. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Performance and durability testing of parabolic trough receivers

NASA Astrophysics Data System (ADS)

Lei, Dongqiang; Fu, Xuqiang; Zhao, Dongming; Yuan, Guofeng; Wang, Zhifeng; Guo, Minghuan

2017-06-01

The paper describes the key performance and durability testing facilities of the parabolic trough receiver developed by Institute of Electrical Engineering, Chinese Academy of Sciences. The indoor heat loss test can be applied at 4-7 different temperature levels within 200-550 on receivers. The optical efficiency test bench consists of 12 metal halide lamps as the solar simulator and a 5 m length half-elliptical cylinder reflector with flat end reflectors. 3 ultra-precision temperature sensors are used in receiver each end to get the temperature difference. The residual gas analysis test bench is applied to analyze and predict the vacuum lifetime of the receiver. It can test the variations of composition and partial pressure of residual gases with temperature and time in the receiver annulus space by a high sensitivity quadrupole mass spectrometer gas analyzer. A coating accelerated ageing test bench, which is also used to test the thermal cycle, has been developed. This test bench uses the absorber tube of the recevier as the resistance heater to heat up the whole receiver. The coating lifetime can be predicted by the Arrhenius parameters. For the cycling test, the compressed air is used to directly cool the inner surface of the absorber tube. The thermal cycling test is performed with temperature cycles from 150 °C to 450 °C for 160 cycles. The maximum thermal cycling frequency is 8 cycles per day. The mechanical fatigue test bench is used to test the bellows and the glass-to-metal seals durability at the same time. Both bellows are expanded and compressed to 6.5 mm in turn with 10,000 cycles. A new rotating test bench was also developed to test the thermal efficiency of the receiver.

Integrating postabortion care, menstrual regulation and family planning services in Bangladesh: a pre-post evaluation.

PubMed

Biswas, Kamal K; Pearson, Erin; Shahidullah, S M; Sultana, Sharmin; Chowdhury, Rezwana; Andersen, Kathryn L

2017-03-11

In Bangladesh, abortion is restricted except to save the life of a woman, but menstrual regulation is allowed to induce menstruation and return to non-pregnancy after a missed period. MR services are typically provided through the Directorate General of Family Planning, while postabortion care services for incomplete abortion are provided by facilities under the Directorate General of Health Services. The bifurcated health system results in reduced quality of care, particularly for postabortion care patients whose procedures are often performed using sub-optimal uterine evacuation technology and typically do not receive postabortion contraceptive services. This study evaluated the success of a pilot project that aimed to integrate menstrual regulation, postabortion care and family planning services across six Directorate General of Health Services and Directorate General of Family Planning facilities by training providers on woman-centered abortion care and adding family planning services at sites offering postabortion care. A pre-post evaluation was conducted in the six large intervention facilities. Structured client exit interviews were administered to all uterine evacuation clients presenting in the 2-week data collection period for each facility at baseline (n = 105; December 2011-January 2012) and endline (n = 107; February-March 2013). Primary outcomes included service integration indicators such as provision of menstrual regulation, postabortion care and family planning services in both facility types, and quality of care indicators such as provision of pain management, provider communication and women's satisfaction with the services received. Outcomes were compared between baseline and endline for Directorate General of Family Planning and Directorate General of Health Services facilities, and chi-square tests and t-tests were used to test for differences between baseline and endline. At the end of the project there was an increase in menstrual regulation service provision in Directorate General of Health Services facilities, from none at baseline to 44.1% of uterine evacuation services at endline (p < 0.001). The proportion of women accepting a postabortion contraceptive method increased from 14.3% at baseline to 69.2% at endline in Directorate General of Health Services facilities (p = 0.006). Provider communication and women's rating of the care they received increased significantly in both Directorate General of Health Services and Directorate General of Family Planning facilities. Integration of menstrual regulation, postabortion care and family planning services is feasible in Bangladesh over a relatively short period of time. The intervention's focus on woman-centered abortion care also improved quality of care. This model can be scaled up through the public health system to ensure women's access to safe uterine evacuation services across all facility types in Bangladesh.

Quality Assurance of Rapid Diagnostic Tests for Malaria in Routine Patient Care in Rural Tanzania

PubMed Central

McMorrow, Meredith L.; Masanja, M. Irene; Kahigwa, Elizeus; Abdulla, Salim M. K.; Kachur, S. Patrick

2010-01-01

Histidine-rich protein II (HRP2)-based malaria rapid diagnostic tests (RDTs) have shown high sensitivity and specificity for detecting Plasmodium falciparum malaria in a variety of study settings. However, RDTs are susceptible to heat and humidity and variation in individual performance, which may affect their use in field settings. We evaluated sensitivity and specificity of RDTs during routine use for malaria case management in peripheral health facilities. From December 2007 to October 2008, HRP2-based ParaHIT-f RDTs were introduced in 12 facilities without available microscopy in Rufiji District, Tanzania. Health workers received a single day of instruction on how to perform an RDT and thick blood smear. Job aids, Integrated Management of Childhood Illness guidelines, and national malaria treatment algorithms were reviewed. For quality assurance (QA), thick blood smears for reference microscopy were collected for 2 to 3 days per week from patients receiving RDTs; microscopy was not routinely performed at the health facilities. Slides were stained and read centrally within 72 hours of collection by a reference microscopist. When RDT and blood smear results were discordant, blood smears were read by additional reference microscopists blinded to earlier results. Facilities were supervised monthly by the district laboratory supervisor or a member of the study team. Ten thousand six hundred fifty (10,650) patients were tested with RDTs, and 51.5% (5,488/10,650) had a positive test result. Blood smear results were available for 3,914 patients, of whom 40.1% (1,577/3,914) were positive for P. falciparum malaria. Overall RDT sensitivity was 90.7% (range by facility 85.7–96.5%) and specificity was 73.5% (range 50.0–84.3%). Sensitivity increased with increasing parasite density. Successful implementation of RDTs was achieved in peripheral health facilities with adequate training and supervision. Quality assurance is essential to the adequate performance of any laboratory test. Centralized staining and reading of blood smears provided useful monitoring of RDT performance. However, this level of QA may not be sustainable nationwide. PMID:20065013

Comparison of facility type outcomes for oral cavity cancer: Analysis of the national cancer database.

PubMed

Rubin, Samuel J; Cohen, Michael B; Kirke, Diana N; Qureshi, Muhammad M; Truong, Minh Tam; Jalisi, Scharukh

2017-11-01

Determine whether facility type effects overall survival in patients with oral cavity cancer. Retrospective cohort study. Patients included in the National Cancer Database who were diagnosed with oral cavity cancer between 1998 and 2011 were included in the study. Data was stratified by facility where care was provided, including community cancer programs (CCP), comprehensive community cancer programs (CCCP), and academic centers (AC). Univariate analysis was performed using analysis of variance, chi squared, and log-rank test, whereas multivariate analysis was performed using Cox regression. A total of 32,510 patients were included in the study, with 7.58% of patients receiving care at CCPs (n = 2,553), 39.53% at CCCPs (n = 12,852), and 52.61% at ACs (n = 17,105). Between 1998 and 2011, there was a greater percentage of patients receiving care at ACs, and a greater percentage of patients receiving surgical therapy versus nonsurgical therapy. Patients treated at ACs had the best 5-year overall survival of 51.26%, with a significant difference across facility types (P < 0.01). After adjusting for confounders, receiving care at ACs was a positive predictor of survival (hazard ratio: 0.95 95% confidence interval [0.91,0.98])). Patients treated at ACs are more likely to receive surgical treatment, and have a greater 5-year overall survival compared to those patients treated at CCPs and CCCPs. Therefore, we advocate referring patients with advanced oral cavity cancers to ACs. 4. Laryngoscope, 127:2551-2557, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Central implementation strategies outperform local ones in improving HIV testing in Veterans Healthcare Administration facilities.

PubMed

Goetz, Matthew Bidwell; Hoang, Tuyen; Knapp, Herschel; Burgess, Jane; Fletcher, Michael D; Gifford, Allen L; Asch, Steven M

2013-10-01

Pilot data suggest that a multifaceted approach may increase HIV testing rates, but the scalability of this approach and the level of support needed for successful implementation remain unknown. To evaluate the effectiveness of a scaled-up multi-component intervention in increasing the rate of risk-based and routine HIV diagnostic testing in primary care clinics and the impact of differing levels of program support. Three arm, quasi-experimental implementation research study. Veterans Health Administration (VHA) facilities. Persons receiving primary care between June 2009 and September 2011 INTERVENTION: A multimodal program, including a real-time electronic clinical reminder to facilitate HIV testing, provider feedback reports and provider education, was implemented in Central and Local Arm Sites; sites in the Central Arm also received ongoing programmatic support. Control Arm sites had no intervention Frequency of performing HIV testing during the 6 months before and after implementation of a risk-based clinical reminder (phase I) or routine clinical reminder (phase II). The adjusted rate of risk-based testing increased by 0.4 %, 5.6 % and 10.1 % in the Control, Local and Central Arms, respectively (all comparisons, p < 0.01). During phase II, the adjusted rate of routine testing increased by 1.1 %, 6.3 % and 9.2 % in the Control, Local and Central Arms, respectively (all comparisons, p < 0.01). At study end, 70-80 % of patients had been offered an HIV test. Use of clinical reminders, provider feedback, education and social marketing significantly increased the frequency at which HIV testing is offered and performed in VHA facilities. These findings support a multimodal approach toward achieving the goal of having every American know their HIV status as a matter of routine clinical practice.

Use of antibiotics in paediatric long-term care facilities.

PubMed

Murray, M T; Johnson, C L; Cohen, B; Jackson, O; Jones, L K; Saiman, L; Larson, E L; Neu, N

2018-06-01

Adult long-term care (LTC) facilities have high rates of antibiotic use, raising concerns about antimicrobial resistance. Few studies have examined antibiotic use in paediatric LTC facilities. To describe antibiotic use in three paediatric LTC facilities and to describe the factors associated with use. A retrospective cohort study was conducted from September 2012 to December 2015 in three paediatric LTC facilities. Medical records were reviewed for demographics, healthcare-associated infections (HAIs), antimicrobial use and diagnostic testing. Logistic regression was used to identify predictors for antibiotic use. The association between susceptibility testing results and appropriate antibiotic coverage was determined using Chi-squared test. Fifty-eight percent (413/717) of residents had at least one HAI, and 79% (325/413) of these residents were treated with at least one antibiotic course, totalling 2.75 antibiotic courses per 1000 resident-days. Length of enrolment greater than one year, having a neurological disorder, having a tracheostomy, and being hospitalized at least once during the study period were significantly associated with receiving antibiotics when controlling for facility (all P < 0.001). Diagnostic testing was performed for 40% of antibiotic-treated HAIs. Eighty-six percent of antibiotic courses for identified bacterial pathogens (201/233) provided appropriate coverage. Access to susceptibility testing was not associated with appropriate antibiotic choice (P = 0.26). Use of antibiotics in paediatric LTC facilities is widespread. There is further need to assess antibiotic use in paediatric LTC facilities. Evaluation of the adverse outcomes associated with inappropriate antibiotic use, including the prevalence of resistant organisms in paediatric LTC facilities, is critical. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

SRF test facility for the superconducting LINAC ``RAON'' — RRR property and e-beam welding

NASA Astrophysics Data System (ADS)

Jung, Yoochul; Hyun, Myungook; Joo, Jongdae; Joung, Mijoung

2015-02-01

Equipment, such as a vacuum furnace, high pressure rinse (HPR), eddy current test (ECT) and buffered chemical polishing (BCP), are installed in the superconducting radio frequency (SRF) test facility. Three different sizes of cryostats (diameters of 600 mm for a quarter wave resonator (QWR), 900 mm for a half wave resonator (HWR), and 1200 mm for single spoke resonator 1&2 (SSR 1&2)) for vertical RF tests are installed for testing cavities. We confirmed that as-received niobium sheets (ASTM B393, RRR300) good electrical properties because they showed average residual resistance ratio (RRR) values higher than 300. However, serious RRR degradation occurred after joining two pieces of Nb by e-beam welding because the average RRR values of the samples were ˜179, which was only ˜60% of as-received RRR value. From various e-beam welding experiments in which the welding current and a speed at a fixed welding voltage were changed, we confirmed that good welding results were obtained at a 53 mA welding current and a 20-mm/s welding speed at a fixed welding voltage of 150 kV.

Acceptance test procedure for the L-070 project mechanical equipment and instrumentation

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

Loll, C.M.

1996-04-19

This document contains the acceptance test procedure for the mechanical equipment and instrumentation installed per the L-070 Project. The specific system to be tested are the pump controls for the 3906 Lift Station and 350-A Lift Station. In addition, verification that signals are being received by the 300 Area Treated Effluent Disposal Facility control system, is also performed.

Completing the circle: follow-up screening of STD patients in three clinics of the United States Indian Health Service.

PubMed

Reilley, B; Redd, J T; Giberson, S; Sunde, S; Cullen, T

2011-01-01

We reviewed charts of newly diagnosed STD patients in three health facilities to determine the proportion who received follow-up STD screening. In a 12-month period, the three facilities had 140 STD cases. STD screening was not indicated for 50 (36%) patients. Among the 90 remaining STD patients, 29 (32%) were screened and 61 (68%) not screened. Among non-screened patients, 36% (22/61) were tested, but outside the time parameters allowed by the audit. The remaining 64% (39/61) received no screening at all, and represented clinical missed opportunities; in this group, nearly all (95%) had chlamydia but were not screened for HIV or syphilis. Linking chlamydia patients with a screen for HIV and syphilis using a clinical reminder in the facilities' electronic health record (EHR) or other tool, would eliminate 95% of the missed opportunities in this sample.

CSER-98-002: Criticality analysis for the storage of special nuclear material sources and standards in the WRAP facility

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

GOLDBERG, H.J.

1999-05-18

The Waste Receiving and Processing (WRAP) Facility will store uranium and transuranic (TRU) sources and standards for certification that WRAP meets the requirements of the Quality Assurance Program Plan (QAPP) for the Waste Isolation Pilot Plant (WIPP). In addition, WRAP must meet internal requirements for testing and validation of measuring instruments for nondestructive assay (NDA). In order to be certified for WIPP, WRAP will participate in the NDA Performance Demonstration Program (PDP). This program is a blind test of the NDA capabilities for TRU waste. It is intended to ensure that the NDA capabilities of this facility satisfy the requirementsmore » of the quality assurance program plan for the WIPP. The PDP standards have been provided by the Los Alamos National Laboratory (LANL) for this program. These standards will be used in the WRAP facility.« less

KSC-2011-1449

NASA Image and Video Library

2011-02-15

CAPE CANAVERAL, Fla. -- At NASA's Kennedy Space Center in Florida, workers receive training atop a mast climber that is attached to launch simulation towers outside the Launch Equipment Test Facility. The training includes attaching carrier plates, water and air systems, and electricity to the climber to simulate working in Kennedy's Vehicle Assembly Building (VAB). Mast climbers can be substituted for fixed service structures currently inside the VAB to provide access to any type of launch vehicle. Since 1977, the facility has supported NASA’s Launch Services, shuttle, International Space Station, and Constellation programs, as well as commercial providers. Last year, the facility underwent a major upgrade to support even more programs, projects and customers. It houses a 6,000-square-foot high bay, cable fabrication and molding shop, pneumatics shop, machine and weld shop and full-scale control room. Outside, the facility features a water flow test loop, vehicle motion simulator and a cryogenic system. Photo credit: NASA/Jim Grossmann

KSC-2011-1446

NASA Image and Video Library

2011-02-15

CAPE CANAVERAL, Fla. -- At NASA's Kennedy Space Center in Florida, workers receive training atop a mast climber that is attached to launch simulation towers outside the Launch Equipment Test Facility. The training includes attaching carrier plates, water and air systems, and electricity to the climber to simulate working in Kennedy's Vehicle Assembly Building (VAB). Mast climbers can be substituted for fixed service structures currently inside the VAB to provide access to any type of launch vehicle. Since 1977, the facility has supported NASA’s Launch Services, shuttle, International Space Station, and Constellation programs, as well as commercial providers. Last year, the facility underwent a major upgrade to support even more programs, projects and customers. It houses a 6,000-square-foot high bay, cable fabrication and molding shop, pneumatics shop, machine and weld shop and full-scale control room. Outside, the facility features a water flow test loop, vehicle motion simulator and a cryogenic system. Photo credit: NASA/Jim Grossmann

KSC-2011-1448

NASA Image and Video Library

2011-02-15

CAPE CANAVERAL, Fla. -- At NASA's Kennedy Space Center in Florida, workers receive training atop a mast climber that is attached to launch simulation towers outside the Launch Equipment Test Facility. The training includes attaching carrier plates, water and air systems, and electricity to the climber to simulate working in Kennedy's Vehicle Assembly Building (VAB). Mast climbers can be substituted for fixed service structures currently inside the VAB to provide access to any type of launch vehicle. Since 1977, the facility has supported NASA’s Launch Services, shuttle, International Space Station, and Constellation programs, as well as commercial providers. Last year, the facility underwent a major upgrade to support even more programs, projects and customers. It houses a 6,000-square-foot high bay, cable fabrication and molding shop, pneumatics shop, machine and weld shop and full-scale control room. Outside, the facility features a water flow test loop, vehicle motion simulator and a cryogenic system. Photo credit: NASA/Jim Grossmann

KSC-2011-1447

NASA Image and Video Library

2011-02-15

CAPE CANAVERAL, Fla. -- At NASA's Kennedy Space Center in Florida, workers receive training on a mast climber that is attached to launch simulation towers outside the Launch Equipment Test Facility. The training includes attaching carrier plates, water and air systems, and electricity to the climber to simulate working in Kennedy's Vehicle Assembly Building (VAB). Mast climbers can be substituted for fixed service structures currently inside the VAB to provide access to any type of launch vehicle. Since 1977, the facility has supported NASA’s Launch Services, shuttle, International Space Station, and Constellation programs, as well as commercial providers. Last year, the facility underwent a major upgrade to support even more programs, projects and customers. It houses a 6,000-square-foot high bay, cable fabrication and molding shop, pneumatics shop, machine and weld shop and full-scale control room. Outside, the facility features a water flow test loop, vehicle motion simulator and a cryogenic system. Photo credit: NASA/Jim Grossmann

CSP cogeneration of electricity and desalinated water at the Pentakomo field facility

NASA Astrophysics Data System (ADS)

Papanicolas, C. N.; Bonanos, A. M.; Georgiou, M. C.; Guillen, E.; Jarraud, N.; Marakkos, C.; Montenon, A.; Stiliaris, E.; Tsioli, E.; Tzamtzis, G.; Votyakov, E. V.

2016-05-01

The Cyprus Institute's Pentakomo Field Facility (PFF) is a major infrastructure for research, development and testing of technologies relating to concentrated solar power (CSP) and solar seawater desalination. It is located at the south coast of Cyprus near the sea and its environmental conditions are fully monitored. It provides a test facility specializing in the development of CSP systems suitable for island and coastal environments with particular emphasis on small units (<25 MWth) endowed with substantial storage, suitable for use in isolation or distributed in small power grids. The first major experiment to take place at the PFF concerns the development of a pilot/experimental facility for the co-generation of electricity and desalinated seawater from CSP. Specifically, the experimental plant consists of a heliostat-central receiver system for solar harvesting, thermal energy storage in molten salts followed by a Rankine cycle for electricity production and a multiple-effect distillation (MED) unit for desalination.

Assessing Very Early Infant Diagnosis Turnaround Times: Findings from a Birth Testing Pilot in Lesotho

PubMed Central

Hoffman, Heather J.; Mokone, Majoalane; Tukei, Vincent J.; Nchephe, Matsepeli; Phalatse, Mamakhetha; Tiam, Appolinaire; Guay, Laura; Mofenson, Lynne

2017-01-01

Very early infant diagnosis (VEID) (testing within two weeks of life), combined with rapid treatment initiation, could reduce early infant mortality. Our study evaluated turnaround time (TAT) to receipt of infants' HIV test results and ART initiation if HIV-infected, with and without birth testing availability. Data from facility records and national databases were collected for 12 facilities offering VEID, as part of an observational prospective cohort study, and 10 noncohort facilities. HIV-exposed infants born in January–June 2016 and any cohort infant diagnosed as HIV-infected at birth or six weeks were included. The median TAT from blood draw to caregiver result receipt was 76.5 days at birth and 63 and 70 days at six weeks at cohort and noncohort facilities, respectively. HIV-exposed infants tested at birth were approximately one month younger when their caregivers received results versus those tested at six weeks. Infants diagnosed at birth initiated ART about two months earlier (median 6.4 weeks old) than those identified at six weeks (median 14.8 weeks). However, the long TAT for testing at both birth and six weeks illustrates the prolonged process for specimen transport and result return that could compromise the effectiveness of adding VEID to existing overburdened EID systems. PMID:29410914

Feasibility of Ground Testing a Moon and Mars Surface Power Reactor in EBR-II

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

Sheryl Morton; Carl Baily; Tom Hill

Ground testing of a surface fission power system would be necessary to verify the design and validate reactor performance to support safe and sustained human exploration of the Moon and Mars. The Idaho National Laboratory (INL) has several facilities that could be adapted to support a ground test. This paper focuses on the feasibility of ground testing at the Experimental Breeder Reactor II (EBR-II) facility and using other INL existing infrastructure to support such a test. This brief study concludes that the INL EBR-II facility and supporting infrastructure are a viable option for ground testing the surface power system. Itmore » provides features and attributes that offer advantages to locating and performing ground testing at this site, and it could support the National Aeronautics and Space Administration schedules for human exploration of the Moon. This study used the initial concept examined by the U.S. Department of Energy Inter-laboratory Design and Analysis Support Team for surface power, a lowtemperature, liquid-metal, three-loop Brayton power system. With some facility modification, the EBR-II can safely house a test chamber and perform long-term testing of the space reactor power system. The INL infrastructure is available to receive and provide bonded storage for special nuclear materials. Facilities adjacent to EBR-II can provide the clean room environment needed to assemble and store the test article assembly, disassemble the power system at the conclusion of testing, and perform posttest examination. Capability for waste disposal is also available at the INL.« less

Feasibility of Ground Testing a Moon and Mars Surface Power Reactor in EBR-II

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

Morton, Sheryl L.; Baily, Carl E.; Hill, Thomas J.

Ground testing of a surface fission power system would be necessary to verify the design and validate reactor performance to support safe and sustained human exploration of the Moon and Mars. The Idaho National Laboratory (INL) has several facilities that could be adapted to support a ground test. This paper focuses on the feasibility of ground testing at the Experimental Breeder Reactor II (EBR-II) facility and using other INL existing infrastructure to support such a test. This brief study concludes that the INL EBR-II facility and supporting infrastructure are a viable option for ground testing the surface power system. Itmore » provides features and attributes that offer advantages to locating and performing ground testing at this site, and it could support the National Aeronautics and Space Administration schedules for human exploration of the Moon. This study used the initial concept examined by the U.S. Department of Energy Inter-laboratory Design and Analysis Support Team for surface power, a low-temperature, liquid-metal, three-loop Brayton power system. With some facility modification, the EBR-II can safely house a test chamber and perform long-term testing of the space reactor power system. The INL infrastructure is available to receive and provide bonded storage for special nuclear materials. Facilities adjacent to EBR-II can provide the clean room environment needed to assemble and store the test article assembly, disassemble the power system at the conclusion of testing, and perform posttest examination. Capability for waste disposal is also available at the INL.« less

Feasibility of Ground Testing a Moon and Mars Surface Power Reactor in EBR-II

NASA Astrophysics Data System (ADS)

Morton, Sheryl L.; Baily, Carl E.; Hill, Thomas J.; Werner, James E.

2006-01-01

Ground testing of a surface fission power system would be necessary to verify the design and validate reactor performance to support safe and sustained human exploration of the Moon and Mars. The Idaho National Laboratory (INL) has several facilities that could be adapted to support a ground test. This paper focuses on the feasibility of ground testing at the Experimental Breeder Reactor II (EBR-II) facility and using other INL existing infrastructure to support such a test. This brief study concludes that the INL EBR-II facility and supporting infrastructure are a viable option for ground testing the surface power system. It provides features and attributes that offer advantages to locating and performing ground testing at this site, and it could support the National Aeronautics and Space Administration schedules for human exploration of the Moon. This study used the initial concept examined by the U.S. Department of Energy Inter-laboratory Design and Analysis Support Team for surface power, a low-temperature, liquid-metal, three-loop Brayton power system. With some facility modification, the EBR-II can safely house a test chamber and perform long-term testing of the space reactor power system. The INL infrastructure is available to receive and provide bonded storage for special nuclear materials. Facilities adjacent to EBR-II can provide the clean room environment needed to assemble and store the test article assembly, disassemble the power system at the conclusion of testing, and perform posttest examination. Capability for waste disposal is also available at the INL.

Quality of Inpatient Pediatric Case Management for Four Leading Causes of Child Mortality at Six Government-Run Ugandan Hospitals

PubMed Central

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

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

NASA Technical Reports Server (NTRS)

Kassel, P. C., Jr.

1978-01-01

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

The radioactive beam facility ALTO

NASA Astrophysics Data System (ADS)

Essabaa, Saïd; Barré-Boscher, Nicole; Cheikh Mhamed, Maher; Cottereau, Evelyne; Franchoo, Serge; Ibrahim, Fadi; Lau, Christophe; Roussière, Brigitte; Saïd, Abdelhakim; Tusseau-Nenez, Sandrine; Verney, David

2013-12-01

The Transnational Access facility ALTO (TNA07-ENSAR/FP7) has been commissioned and received from the French safety authorities, the operation license. It is allowed to run at nominal intensity to produce 1011 fissions/s in a thick uranium carbide target by photo-fission using a 10 μA, 50 MeV electron beam. In addition the recent success in operating the selective laser ion source broadens the physics program with neutron-rich nuclear beams possible at this facility installed at IPN Orsay. The facility also aims at being a test bench for the SPIRAL2 project. In that framework an ambitious R&D program on the target ion source system is being developed.

Low utilization of HIV testing during pregnancy: What are the barriers to HIV testing for women in rural India?

PubMed

Sinha, Gita; Dyalchand, Ashok; Khale, Manisha; Kulkarni, Gopal; Vasudevan, Shubha; Bollinger, Robert C

2008-02-01

Sixty percent of India's HIV cases occur in rural residents. Despite government policy to expand antenatal HIV screening and prevention of maternal-to-child transmission (PMTCT), little is known about HIV testing among rural women during pregnancy. Between January and March 2006, a cross-sectional sample of 400 recently pregnant women from rural Maharashtra was administered a questionnaire regarding HIV awareness, risk, and history of antenatal HIV testing. Thirteen women (3.3%) reported receiving antenatal HIV testing. Neither antenatal care utilization nor history of sexually transmitted infection (STI) symptoms influenced odds of receiving HIV testing. Women who did not receive HIV testing, compared with women who did, were 95% less likely to have received antenatal HIV counseling (odds ratio = 0.05, 95% confidence interval: 0.02 to 0.17) and 80% less aware of an existing HIV testing facility (odds ratio = 0.19, 95% confidence interval: 0.04 to 0.75). Despite measurable HIV prevalence, high antenatal care utilization, and STI symptom history, recently pregnant rural Indian women report low HIV testing. Barriers to HIV testing during pregnancy include lack of discussion by antenatal care providers and lack of awareness of existing testing services. Provider-initiated HIV counseling and testing during pregnancy would optimize HIV prevention for women throughout rural India.

Design of the Sandia-Israel 20-kW reflux heat-pipe solar receiver/reactor

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

Diver, R.B.; Ginn, W.C.

1987-09-01

This report describes the design and fabrication of a 20-kW sodium reflux heat-pipe solar receiver/reactor for CO/sub 2/ reforming of methane. This project is part of a bilateral agreement between the United States and Israel. Under the terms of the agreement the solar receiver/reactor has been designed and built by Sandia National Laboratories for testing in the 7-meter solar furnace facility at the Weizmann Institute of Science in Rehovot, Israel. 16 refs., 11 figs., 2 tabs.

Cabana Multi-User Spaceport Tour/CRS-10

NASA Image and Video Library

2017-02-17

Robert Cabana, director of NASA’s Kennedy Space Center, accompanied news media on Friday, February 17 for a three-part tour of facilities in the Launch Complex 39 area at Kennedy. Media received an update on the transition of government facilities to the aerospace industry, and how that approach enables NASA and industry success. The tour included the Vehicle Assembly Building, where extensive work is being completed to prepare not only for NASA’s Space Launch System, but also enables members of the aerospace industry to use the facility between NASA missions. The tour completed at Boeing’s Commercial Crew and Cargo Processing Facility, previously a shuttle processing facility, where the company is manufacturing its Starliner spacecraft for flight tests and ultimately crew rotation missions with NASA’s Commercial Crew Program.

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

PubMed

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

2018-06-05

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

Patterns and predictors of malaria care-seeking, diagnostic testing, and artemisinin-based combination therapy for children under five with fever in Northern Nigeria: a cross-sectional study.

PubMed

Millar, Kathryn R; McCutcheon, Jennifer; Coakley, Eugenie H; Brieger, William; Ibrahim, Mohammed A; Mohammed, Zainab; Bassi, Amos; Sambisa, William

2014-11-21

Despite recent improvements in malaria prevention strategies, malaria case management remains a weakness in Northern Nigeria, which is underserved and suffers the country's highest rates of under-five child mortality. Understanding malaria care-seeking patterns and comparing case management outcomes to World Health Organization (WHO) and Nigeria's National Malaria Control Programme (NMCP) guidelines are necessary to identify where policy and programmatic strategies should focus to prevent malaria mortality and morbidity. A cross-sectional survey based on lot quality assurance sampling was used to collect data on malaria care-seeking for children under five with fever in the last two weeks throughout Sokoto and Bauchi States. The survey assessed if the child received NMCP/WHO recommended case management: prompt treatment, a diagnostic blood test, and artemisinin-based combination therapy (ACT). Deviations from this pathway and location of treatment were also assessed. Lastly, logistic regression was used to assess predictors of seeking treatment. Overall, 76.7% of children were brought to treatment-45.5% to a patent medicine vendor and 43.8% to a health facility. Of children brought to treatment, 61.5% sought treatment promptly, but only 9.8% received a diagnostic blood test and 7.2% received a prompt ACT. When assessing adherence to the complete case management pathway, only 1.0% of children received NMCP/WHO recommended treatment. When compared to other treatment locations, health facilities provided the greatest proportion of children with NMCP/WHO recommended treatment. Lastly, children 7-59 months old were at 1.74 (p = 0.003) greater odds of receiving treatment than children ≤6 months. Northern Nigeria's coverage rates of NMCP/WHO standard malaria case management for children under five with fever fall short of the NMCP goal of 80% coverage by 2010 and universal coverage thereafter. Given the ability to treat a child with malaria differs greatly between treatment locations, policy and logistics planning should address the shortages of essential malaria supplies in recommended and frequently accessed treatment locations. Particular emphasis should be placed on integrating the private sector into standardized care and educating caregivers on the necessity for testing before treatment and the availability of free ACT in public health facilities for uncomplicated malaria.

System design of a 1 MW north-facing, solid particle receiver

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

Christian, J.; Ho, C.

Falling solid particle receivers (SPR) utilize small particles as a heat collecting medium within a cavity receiver structure. The components required to operate an SPR include the receiver (to heat the particles), bottom hopper (to catch the falling particles), particle lift elevator (to lift particles back to the top of the receiver), top hopper (to store particles before being dropped through the receiver), and ducting. In addition to the required components, there are additional features needed for an experimental system. These features include: a support structure to house all components, calibration panel to measure incident radiation, cooling loops, and sensorsmore » (flux gages, thermocouples, pressure gages). Each of these components had to be designed to withstand temperatures ranging from ambient to 700 °C. Thermal stresses from thermal expansion become a key factor in these types of high temperature systems. The SPR will be housing ~3000 kg of solid particles. The final system will be tested at the National Solar Thermal Test Facility in Albuquerque, NM.« less

System design of a 1 MW north-facing, solid particle receiver

DOE PAGES

Christian, J.; Ho, C.

2015-05-01

Falling solid particle receivers (SPR) utilize small particles as a heat collecting medium within a cavity receiver structure. The components required to operate an SPR include the receiver (to heat the particles), bottom hopper (to catch the falling particles), particle lift elevator (to lift particles back to the top of the receiver), top hopper (to store particles before being dropped through the receiver), and ducting. In addition to the required components, there are additional features needed for an experimental system. These features include: a support structure to house all components, calibration panel to measure incident radiation, cooling loops, and sensorsmore » (flux gages, thermocouples, pressure gages). Each of these components had to be designed to withstand temperatures ranging from ambient to 700 °C. Thermal stresses from thermal expansion become a key factor in these types of high temperature systems. The SPR will be housing ~3000 kg of solid particles. The final system will be tested at the National Solar Thermal Test Facility in Albuquerque, NM.« less

Improved diagnostic testing and malaria treatment practices in Zambia.

PubMed

Hamer, Davidson H; Ndhlovu, Micky; Zurovac, Dejan; Fox, Matthew; Yeboah-Antwi, Kojo; Chanda, Pascalina; Sipilinyambe, Naawa; Simon, Jonathon L; Snow, Robert W

2007-05-23

Improving the accuracy of malaria diagnosis with rapid antigen-detection diagnostic tests (RDTs) has been proposed as an approach for reducing overtreatment of malaria in the current era of widespread implementation of artemisinin-based combination therapy in sub-Saharan Africa. To assess the association between use of microscopy and RDT and the prescription of antimalarials. Cross-sectional, cluster sample survey, carried out between March and May 2006, of all outpatients treated during 1 working day at government and mission health facilities in 4 sentinel districts in Zambia. Proportions of patients undergoing malaria diagnostic procedures and receiving antimalarial treatment. Seventeen percent of the 104 health facilities surveyed had functional microscopy, 63% had RDTs available, and 73% had 1 or more diagnostics available. Of patients with fever (suspected malaria), 27.8% (95% confidence interval [CI], 13.1%-42.5%) treated in health facilities with malaria diagnostics were tested and 44.6% had positive test results. Of patients with negative blood smear results, 58.4% (95% CI, 36.7%-80.2%) were prescribed an antimalaria drug, as were 35.5% (95% CI, 16.0%-55.0%) of those with a negative RDT result. Of patients with fever who did not have diagnostic tests done, 65.9% were also prescribed antimalarials. In facilities with artemether-lumefantrine in stock, this antimalarial was prescribed to a large proportion of febrile patients with a positive diagnostic test result (blood smear, 75.0% [95% CI, 51.7%-98.3%]; RDT, 70.4% [95% CI, 39.3%-100.0%]), but also to some of those with a negative diagnostic test result (blood smear, 30.4% [95% CI, 8.0%-52. 9%]; RDT, 26.7% [95% CI, 5.7%-47.7%]). Despite efforts to expand the provision of malaria diagnostics in Zambia, they continue to be underused and patients with negative test results frequently receive antimalarials. Provision of new tools to reduce inappropriate use of new expensive antimalarial treatments must be accompanied by a major change in clinical treatment of patients presenting with fever but lacking evidence of malaria infection.

Ground facility for information reception, processing, dissemination and scientific instruments management setup in the CORONAS-PHOTON space project

NASA Astrophysics Data System (ADS)

Buslov, A. S.; Kotov, Yu. D.; Yurov, V. N.; Bessonov, M. V.; Kalmykov, P. A.; Oreshnikov, E. M.; Alimov, A. M.; Tumanov, A. V.; Zhuchkova, E. A.

2011-06-01

This paper deals with the organizational structure of ground-based receiving, processing, and dissemination of scientific information created by the Astrophysics Institute of the Scientific Research Nuclear University, Moscow Engineering Physics Institute. Hardware structure and software features are described. The principles are given for forming sets of control commands for scientific equipment (SE) devices, and statistics data are presented on the operation of facility during flight tests of the spacecraft (SC) in the course of one year.

Baseline performance of solar collectors for NASA Langley solar building test facility

NASA Technical Reports Server (NTRS)

Knoll, R. H.; Johnson, S. M.

1977-01-01

The solar collector field contains seven collector designs. Before operation in the field, the experimental performances (thermal efficiencies) of the seven collector designs were measured in an indoor solar simulator. The resulting data provided a baseline for later comparison with actual field test data. The simulator test results are presented for the collectors as received, and after several weeks of outdoor exposure with no coolant (dry operation). Six of the seven collector designs tested showed substantial reductions in thermal efficiency after dry operation.

Preliminary Results, Analysis, and Overview of Part-1 of the GOLD Experiment

NASA Technical Reports Server (NTRS)

Wilson, K. E.; Jeganathan, M.

1996-01-01

The Ground/Orbiter Lasercomm Demonstration (GOLD) is an optical communications demonstraton between the Japanese Engineering Test Satellite (ETS-VI) and an optical ground transmitting and receiving station at the Table Mountain Facility. GOLD was an experiment that demonstrated real-time international collaboration.

Biological shielding test of hot cells with high active source 60Co (300 TBq)

NASA Astrophysics Data System (ADS)

Švrčula, P.; Zoul, D.; Zimina, M.; Petříčková, A.; Adamíková, T.; Schulc, M.; Srba, O.

2017-11-01

This article describes a method for testing of the efficiency of the biological shielding of the hot cell facility, which were constructed as a part of the project SUSEN. Ten hot cells and one semi-hot cell are present in the facility Radiochemistry II. The shielding is made from steel plates. In order to demonstrate sufficient efficiency of the biological shielding of the hot cells and a correspondence between measured and contractual values at selected points. The test was done using sealed high activity 60Co sources. The results are also used as a proof of the optimization of radiation protection for the workplace of this type. The results confirm significant optimization of radiation protection at the workplace. The dose received by a staff do not exceed one tens of annual limit during active service. Obtained results fulfill general requirements of radiation protection and will be used for further active service of hot cells facility.

DESIGNING AN OPPORTUNITY FUEL WITH BIOMASS AND TIRE-DERIVED FUEL FOR COFIRING AT WILLOW ISLAND GENERATING STATION AND COFIRING SAWDUST WITH COAL AT ALBRIGHT GENERATING STATION

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

K. Payette; D. Tillman

During the period July 1, 2001--September 30, 2001, Allegheny Energy Supply Co., LLC (Allegheny) continued construction of the Willow Island cofiring project, completed the installation of the fuel storage facility, the fuel receiving facility, and the processing building. All mechanical equipment has been installed and electrical construction has proceeded. During this time period significant short term testing of the Albright Generating Station cofiring facility was completed, and the 100-hour test was planned for early October. The testing demonstrated that cofiring at the Albright Generating Station could contribute to a ''4P Strategy''--reduction of SO{sub 2}, NO{sub x}, mercury, and greenhouse gasmore » emissions. This report summarizes the activities associated with the Designer Opportunity Fuel program, and demonstrations at Willow Island and Albright Generating Stations. It details the construction activities at both sites along with the combustion modeling at the Willow Island site.« less

Preliminary Analysis of Fluctuations in the Received Uplink-Beacon-Power Data Obtained From the GOLD Experiments

NASA Technical Reports Server (NTRS)

Jeganathan, M.; Wilson, K. E.; Lesh, J. R.

1996-01-01

Uplink data from recent free-space optical communication experiments carried out between the Table Mountain Facility and the Japanese Engineering Test Satellite are used to study fluctuations caused by beam propagation through the atmosphere. The influence of atmospheric scintillation, beam wander and jitter, and multiple uplink beams on the statistics of power received by the satellite is analyzed and compared to experimental data. Preliminary analysis indicates the received signal obeys an approximate lognormal distribution, as predicted by the weak-turbulence model, but further characterization of other sources of fluctuations is necessary for accurate link predictions.

Preliminary analysis of fluctuations in the received uplink-beacon-power data obtained from the GOLD experiments

NASA Technical Reports Server (NTRS)

Jeganathan, M.; Wilson, K. E.; Lesh, J. R.

1996-01-01

Uplink data from recent free-space optical communication experiments carried out between the Table Mountain Facility and the Japanese Engineering Test Satellite are used to study fluctuations caused by beam propagation through the atmosphere. The influence of atmospheric scintillation, beam wander and jitter, and multiple uplink beams on the statistics of power received by the satellite is analyzed and compared to experimental data. Preliminary analysis indicates the received signal obeys an approximate lognormal distribution, as predicted by the weak-turbulence model, but further characterization of other sources of fluctuations is necessary for accurate link predictions.

Feasibility and effectiveness of a combined individual and psychoeducational group intervention in psychiatric residential facilities: A controlled, non-randomized study.

PubMed

Magliano, Lorenza; Puviani, Marta; Rega, Sonia; Marchesini, Nadia; Rossetti, Marisa; Starace, Fabrizio

2016-01-30

This controlled, non-randomized study explored the feasibility of introducing a Combined Individual and Group Intervention (CIGI) for users with mental disorders in residential facilities, and tested whether users who received the CIGI had better functioning than users who received the Treatment-As-Usual (TAU), at two-year follow up. In the CIGI, a structured cognitivebehavioral approach called VADO (in English, Skills Assessment and Definition of Goals) was used to set specific goals with each user, while Falloon's psychoeducational treatment was applied with the users as a group. Thirty-one professionals attended a training course in CIGI, open to users' voluntary participation, and applied it for two years with all users living in 8 residential facilities of the Mental Health Department of Modena, Italy. In the same department, 5 other residential facilities providing TAU were used as controls. ANOVA for repeated measures showed a significant interaction effect between users' functioning at baseline and follow up assessments, and the intervention. In particular, change in global functioning was higher in the 55 CIGI users than in the 44 TAU users. These results suggest that CIGI can be successfully introduced in residential facilities and may be useful to improve functioning in users with severe mental disorders. Copyright © 2016. Published by Elsevier Ireland Ltd.

On-sun testing of an advanced falling particle receiver system

NASA Astrophysics Data System (ADS)

Ho, Clifford K.; Christian, Joshua M.; Yellowhair, Julius; Siegel, Nathan; Jeter, Sheldon; Golob, Matthew; Abdel-Khalik, Said I.; Nguyen, Clayton; Al-Ansary, Hany

2016-05-01

A 1 MWth high-temperature falling particle receiver was constructed and tested at the National Solar Thermal Test Facility at Sandia National Laboratories. The continuously recirculating system included a particle elevator, top and bottom hoppers, and a cavity receiver that comprised a staggered array of porous chevron-shaped mesh structures that slowed the particle flow through the concentrated solar flux. Initial tests were performed with a peak irradiance of ~300 kW/m2 and a particle mass flow rate of 3.3 kg/s. Peak particle temperatures reached over 700 °C near the center of the receiver, but the particle temperature increase near the sides was lower due to a non-uniform irradiance distribution. At a particle inlet temperature of ~440 °C, the particle temperature increase was 27 °C per meter of drop length, and the thermal efficiency was ~60% for an average irradiance of 110 kW/m2. At an average irradiance of 211 kW/m2, the particle temperature increase was 57.1 °C per meter of drop length, and the thermal efficiency was ~65%. Tests with higher irradiances are being performed and are expected to yield greater particle temperature increases and efficiencies.

Project Hermes 'Use of Smartphones for Receiving Telemetry and Commanding a Satellite'

NASA Technical Reports Server (NTRS)

Maharaja, Rishabh (Principal Investigator)

2016-01-01

TCPIP protocols can be applied for satellite command, control, and data transfer. Project Hermes was an experiment set-up to test the use of the TCPIP protocol for communicating with a space bound payload. The idea was successfully demonstrated on high altitude balloon flights and on a sub-orbital sounding rocket launched from NASAs Wallops Flight Facility. TCPIP protocols can be applied for satellite command, control, and data transfer. Project Hermes was an experiment set-up to test the use of the TCPIP protocol for communicating with a space bound payload. The idea was successfully demonstrated on high altitude balloon flights and on a sub-orbital sounding rocket launched from NASAs Wallops Flight Facility.

Results of the Analyses of Screening Surface and Well Water Samples from Decatur, Alabama for Selected Perfluorinated Compounds

EPA Science Inventory

EPA has conducted testing of agricultural sites in Alabama where sewage sludge was applied from a local wastewater treatment plant that receives wastewater from numerous industrial sources, including facilities that manufacture and use perfluorooctanoic acid (PFOA) and other perf...

Innovative Coatings Potentially Lower Facility Maintenance Costs

NASA Technical Reports Server (NTRS)

2013-01-01

Through extensive testing at Stennis Space Center, Nanocepts Inc. of Lexington, Kentucky, received key validation of the effectiveness of its photocatalytic coatings. Now a NASA Dual Use Technology partner, the company s commercial coatings offer unique environmental and medical benefits, and their self-cleaning properties help limit grime buildup on buildings.

7 CFR 3300.58 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... States or in test facilities located in, and approved by, a foreign country which is a Contracting Party... may receive a U.S. ATP certiticate in exchange for the Foreign-ATP certificate issued by the country... and approved by a foreign country which is a Contracting Party. (f) In accordance with ATP, Annex 1...

7 CFR 3300.58 - General.

Code of Federal Regulations, 2011 CFR

2011-01-01

... States or in test facilities located in, and approved by, a foreign country which is a Contracting Party... may receive a U.S. ATP certiticate in exchange for the Foreign-ATP certificate issued by the country... and approved by a foreign country which is a Contracting Party. (f) In accordance with ATP, Annex 1...

Bottlenecks and opportunities for delivering integrated pediatric HIV services in Nepal

PubMed Central

Diese, Mulamba; Shrestha, Lexman; Pradhan, Birendra; Singh, Dipendra; Raaijmakers, Hendrikus; Kisesa, Annefrida; Chamla, Dick; Ntambue, Mukengeshayi Abel

2016-01-01

Background In children, integration of HIV in MNCH services has been shown to incr. ease uptake of early infant diagnosis. This article examines bottlenecks and opportunities for scaling up integrated pediatric HIV services in Nepal. Methods This is a descriptive study using both mixed qualitative and quantitative methods, conducted in January 2015 in 19 facilities in five regions of Nepal most affected by HIV epidemic. The qualitative methods comprised in-depth structured interviews with key informants (leadership of The National Center for AIDS and STD Control and National Public Health Laboratory, district management teams, medical officers in charge of health facilities and HIV clinics, frontline staff at antenatal care and HIV clinics and laboratory). The quantitative methods were used to abstract data of HIV-infected pregnant women seen between January and December 2014, HIV-exposed infants aged less than 12 months, and HIV infected children aged less than 15 years who were initiated HIV treatment from 2010 to 2014. Structured tools were used to collect data which were analysed using IBM SPSS. Results Of the 19 facilities assessed, 18(98%), 18(98%), 14(75%), and 11(58%) provided prevention of mother-to-child transmission (PMTCT), Expanded Program on Immunization (EPI), pediatric ART and nutrition rehabilitation services, respectively. However, only 1(5%) facility collected onsite dried blood spots (DBS) for PCR HIV testing and 6(32%) facilities provided counselling and referral for DBS. In 2014, of the 121 HIV-exposed infants recorded, only 21(17%) received PCR test. The median turnaround time of the PCR test results was 54 days. Of the 21 records with PCR test, 11(52.5%) were from PMTCT clinics, 7(33%) from Nutritional rehabilitation clinics, and 3(14.5%) from pediatric outpatient clinic. Conversely, 934 children were initiated ART between 2010 and 2014, of which 5% were infants and 29% aged between 1 and 5 years. 298(32%) had comorbidities of which 64% had malnutrition. A total of 534(57%) had tuberculosis (TB) status assessed of which 58(11%) had active TB. Infants had lowest retention (63%), high mortality (17.4%), and loss to follow-up (10.9%). Conclusion Few facilities collect DBS and few children receive PCR tests with limited linkage to ART. This has led to late ART initiation, comorbidities, including TB coinfections and poor outcomes. The results indicate that there are opportunities for improving HIV case finding among HIV-exposed infants in PMTCT, EPI, TB, and nutrition services if provider initiated testing and counselling at the point of service delivery is institutionalized in these settings. PMID:26945139

First Results of Field Absolute Calibration of the GPS Receiver Antenna at Wuhan University.

PubMed

Hu, Zhigang; Zhao, Qile; Chen, Guo; Wang, Guangxing; Dai, Zhiqiang; Li, Tao

2015-11-13

GNSS receiver antenna phase center variations (PCVs), which arise from the non-spherical phase response of GNSS signals have to be well corrected for high-precision GNSS applications. Without using a precise antenna phase center correction (PCC) model, the estimated position of a station monument will lead to a bias of up to several centimeters. The Chinese large-scale research project "Crustal Movement Observation Network of China" (CMONOC), which requires high-precision positions in a comprehensive GPS observational network motived establishment of a set of absolute field calibrations of the GPS receiver antenna located at Wuhan University. In this paper the calibration facilities are firstly introduced and then the multipath elimination and PCV estimation strategies currently used are elaborated. The validation of estimated PCV values of test antenna are finally conducted, compared with the International GNSS Service (IGS) type values. Examples of TRM57971.00 NONE antenna calibrations from our calibration facility demonstrate that the derived PCVs and IGS type mean values agree at the 1 mm level.

Multilevel predictors of colorectal cancer testing modality among publicly and privately insured people turning 50.

PubMed

Wheeler, Stephanie B; Kuo, Tzy-Mey; Meyer, Anne Marie; Martens, Christa E; Hassmiller Lich, Kristen M; Tangka, Florence K L; Richardson, Lisa C; Hall, Ingrid J; Smith, Judith Lee; Mayorga, Maria E; Brown, Paul; Crutchfield, Trisha M; Pignone, Michael P

2017-06-01

Understanding multilevel predictors of colorectal cancer (CRC) screening test modality can help inform screening program design and implementation. We used North Carolina Medicare, Medicaid, and private, commercially available, health plan insurance claims data from 2003 to 2008 to ascertain CRC test modality among people who received CRC screening around their 50th birthday, when guidelines recommend that screening should commence for normal risk individuals. We ascertained receipt of colonoscopy, fecal occult blood test (FOBT) and fecal immunochemical test (FIT) from billing codes. Person-level and county-level contextual variables were included in multilevel random intercepts models to understand predictors of CRC test modality, stratified by insurance type. Of 12,570 publicly-insured persons turning 50 during the study period who received CRC testing, 57% received colonoscopy, whereas 43% received FOBT/FIT, with significant regional variation. In multivariable models, females with public insurance had lower odds of colonoscopy than males (odds ratio [OR] = 0.68; p < 0.05). Of 56,151 privately-insured persons turning 50 years old who received CRC testing, 42% received colonoscopy, whereas 58% received FOBT/FIT, with significant regional variation. In multivariable models, females with private insurance had lower odds of colonoscopy than males (OR = 0.43; p < 0.05). People living 10-15 miles away from endoscopy facilities also had lower odds of colonoscopy than those living within 5 miles (OR = 0.91; p < 0.05). Both colonoscopy and FOBT/FIT are widely used in North Carolina among insured persons newly age-eligible for screening. The high level of FOBT/FIT use among privately insured persons and women suggests that renewed emphasis on FOBT/FIT as a viable screening alternative to colonoscopy may be important.

On Fast Post-Processing of Global Positioning System Simulator Truth Data and Receiver Measurements and Solutions Data

NASA Technical Reports Server (NTRS)

Kizhner, Semion; Day, John H. (Technical Monitor)

2000-01-01

Post-processing of data, related to a GPS receiver test in a GPS simulator and test facility, is an important step towards qualifying a receiver for space flight. Although the GPS simulator provides all the parameters needed to analyze a simulation, as well as excellent analysis tools on the simulator workstation, post-processing is not a GPS simulator or receiver function alone, and it must be planned as a separate pre-flight test program requirement. A GPS simulator is a critical resource, and it is desirable to move off the pertinent test data from the simulator as soon as a test is completed. The receiver and simulator databases are used to extract the test data files for postprocessing. These files are then usually moved from the simulator and receiver systems to a personal computer (PC) platform, where post-processing is done typically using PC-based commercial software languages and tools. Because of commercial software systems generality their functions are notoriously slow and more than often are the bottleneck even for short duration simulator-based tests. There is a need to do post-processing faster and within an hour after test completion, including all required operations on the simulator and receiver to prepare and move off the post-processing files. This is especially significant in order to use the previous test feedback for the next simulation setup or to run near back-to-back simulation scenarios. Solving the post-processing timing problem is critical for a pre-flight test program success. Towards this goal an approach was developed that allows to speed-up post-processing by an order of a magnitude. It is based on improving the post-processing bottleneck function algorithm using a priory information that is specific to a GPS simulation application and using only the necessary volume of truth data. The presented postprocessing scheme was used in support of a few successful space flight missions carrying GPS receivers.

Health systems readiness and management of febrile outpatients under low malaria transmission in Vanuatu.

PubMed

Zurovac, Dejan; Guintran, Jean-Olivier; Donald, Wesley; Naket, Esau; Malinga, Josephine; Taleo, George

2015-12-02

Vanuatu, an archipelago country in Western Pacific harbouring low Plasmodium falciparum and Plasmodium vivax malaria transmission, has been implementing a malaria case management policy, recommending parasitological testing of patients with fever and anti-malarial treatment for test-positive only patients. A health facility survey to evaluate the health systems readiness to implement the policy and the quality of outpatient management for patients with fever was undertaken. A cross-sectional, cluster sample survey, using a range of quality-of-care methods, included all health centres and hospitals in Vanuatu. The main outcome measures were coverage of health facilities and health workers with commodities and support interventions, adherence to test and treatment recommendations, and factors influencing malaria testing. The survey was undertaken in 2014 during the low malaria season and included 41 health facilities, 67 health workers and 226 outpatient consultations for patients with fever. All facilities had capacity for parasitological diagnosis, 95.1 % stocked artemether-lumefantrine and 63.6 % primaquine. The coverage of health workers with support interventions ranged from 50 to 70 %. Health workers' knowledge was high only regarding treatment policy for uncomplicated P. falciparum malaria (83.4 %). History taking and clinical examination practices were sub-optimal. Some 35.0 % (95 % CI 23.4-48.6) of patients with fever were tested for malaria, of which all results were negative and only one patient received anti-malarial treatment. Testing was significantly higher for patients age 5 years and older (OR = 2.33; 95 % CI 1.48-5.02), seen by less qualified health workers (OR = 2.73; 95 % CI 1.48-5.02), health workers who received malaria case management training (OR = 2.39; 95 % CI 1.28-4.47) and patients with increased temperature (OR = 2.56; 95 % CI 1.17-5.57), main complaint of fever (OR = 5.82; 95 % CI 1.26-26.87) and without runny nose (OR = 3.75; 95 % CI 1.36-10.34). Antibiotic use was very high (77.4 %) with sub-optimal dispensing and counselling practices. Health facility and health worker readiness to implement policy is higher for falciparum than vivax malaria. Clinical and malaria testing practices are sub-optimal, however adherence to test negative results is nearly universal. Use of antibiotics is irrational. Quantitative and qualitative improvements of ongoing interventions are needed to re-inforce clinical practices in this area characterized by difficult access, human resource shortages but aspiring towards malaria elimination.

47 CFR 25.151 - Public notice period.

Code of Federal Regulations, 2012 CFR

2012-10-01

... authorizations; (2) The receipt of applications for license or registration of receive-only earth stations; (3... of space station facilities, transmitting earth station facilities, or international receive-only earth station facilities; (6) Significant Commission actions regarding applications; (7) Information...

47 CFR 25.151 - Public notice period.

Code of Federal Regulations, 2011 CFR

2011-10-01

... authorizations; (2) The receipt of applications for license or registration of receive-only earth stations; (3... of space station facilities, transmitting earth station facilities, or international receive-only earth station facilities; (6) Significant Commission actions regarding applications; (7) Information...

47 CFR 25.151 - Public notice period.

Code of Federal Regulations, 2013 CFR

2013-10-01

... authorizations; (2) The receipt of applications for license or registration of receive-only earth stations; (3... of space station facilities, transmitting earth station facilities, or international receive-only earth station facilities; (6) Significant Commission actions regarding applications; (7) Information...

47 CFR 25.151 - Public notice period.

Code of Federal Regulations, 2014 CFR

2014-10-01

... authorizations; (2) The receipt of applications for license or registration of receive-only earth stations; (3... of space station facilities, transmitting earth station facilities, or international receive-only earth station facilities; (6) Significant Commission actions regarding applications; (7) Information...

47 CFR 25.151 - Public notice period.

Code of Federal Regulations, 2010 CFR

2010-10-01

... authorizations; (2) The receipt of applications for license or registration of receive-only earth stations; (3... of space station facilities, transmitting earth station facilities, or international receive-only earth station facilities; (6) Significant Commission actions regarding applications; (7) Information...

Marketing cardiac CT programs.

PubMed

Scott, Jason

2010-01-01

There are two components of cardiac CT discussed in this article: coronary artery calcium scoring (CACS) and coronary computed tomography angiography (CCTA).The distinctive advantages of each CT examination are outlined. In order to ensure a successful cardiac CT program, it is imperative that imaging facilities market their cardiac CT practices effectively in order to gain a competitive advantage in this valuable market share. If patients receive quality care by competent individuals, they are more likely to recommend the facility's cardiac CT program. Satisfied patients will also be more willing to come back for any further testing.

Special Operations Forces Language and Culture Needs Assessment Project: Defense Language Aptitude Battery (DLAB): Perspectives from the Field

DTIC Science & Technology

2010-09-29

facilities (the room was 100 degrees in the middle of a hot North Carolina summer) and because our drill sergeants did not let us get enough sleep the...inadquate facilities (the room was 100 degrees in the middle of a hot North Carolina summer) and because our drill sergeants did not let us get enough ...environment was too hot. Furthermore, some operators reported they did not receive adequate sleep the night before the test due to other training

Comparison of hospitalization rates among for-profit and nonprofit dialysis facilities.

PubMed

Dalrymple, Lorien S; Johansen, Kirsten L; Romano, Patrick S; Chertow, Glenn M; Mu, Yi; Ishida, Julie H; Grimes, Barbara; Kaysen, George A; Nguyen, Danh V

2014-01-01

The vast majority of US dialysis facilities are for-profit and profit status has been associated with processes of care and outcomes in patients on dialysis. This study examined whether dialysis facility profit status was associated with the rate of hospitalization in patients starting dialysis. This was a retrospective cohort study of Medicare beneficiaries starting dialysis between 2005 and 2008 using data from the US Renal Data System. All-cause hospitalization was examined and compared between for-profit and nonprofit dialysis facilities through 2009 using Poisson regression. Companion analyses of cause-specific hospitalization that are likely to be influenced by dialysis facility practices including hospitalizations for heart failure and volume overload, access complications, or hyperkalemia were conducted. The cohort included 150,642 patients. Of these, 12,985 (9%) were receiving care in nonprofit dialysis facilities. In adjusted models, patients receiving hemodialysis in for-profit facilities had a 15% (95% confidence interval [95% CI], 13% to 18%) higher relative rate of hospitalization compared with those in nonprofit facilities. Among patients receiving peritoneal dialysis, the rate of hospitalization in for-profit versus nonprofit facilities was not significantly different (relative rate, 1.07; 95% CI, 0.97 to 1.17). Patients on hemodialysis receiving care in for-profit dialysis facilities had a 37% (95% CI, 31% to 44%) higher rate of hospitalization for heart failure or volume overload and a 15% (95% CI, 11% to 20%) higher rate of hospitalization for vascular access complications. Hospitalization rates were significantly higher for patients receiving hemodialysis in for-profit compared with nonprofit dialysis facilities.

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

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

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

2001-10-01

The major aspects of this project are proceeding toward completion. Prior to this quarter, design criteria, tentative site selection, facility layout, and preliminary facility cost estimates were completed and issued. Processing of bio-solids was completed, providing material for the pilot operations. Pilot facility design, equipment selection, and modification were completed during the fourth quarter of 2000. Initial pilot facility shakedown was completed. After some unavoidable delays, a suitable representative supply of MSW feed material was procured. During this first quarter of 2001, shredding of the feed material and final feed conditioning were completed. Pilot facility hydrolysis production was completed tomore » produce lignin for co-fire testing and the lignin fuel was washed and dewatered. Both the lignin and bio-solids fuel materials for co-fire testing were sent to the co-fire facility (EERC) for evaluation and co-firing. EERC has received coal typical of the fuel to the TVA-Colbert boilers. This material will be used at EERC as baseline material and for mixing with the bio-fuel for combustion testing. EERC combustion testing of the bio-based fuels is scheduled to begin in October of 2001. The TVA-Colbert facility has neared completion of the task to evaluate co-location of the Masada facility on the operation of the power generation facility. The TVA-Colbert fossil plant is fully capable of providing a reliable steam supply. The preferred steam supply connection points and steam pipeline routing have been identified. The environmental review of the pipeline routing has been completed and no major impacts have been identified. Detailed assessment of steam export impacts on the Colbert boiler system have been completed and a cost estimate for steam supply system was completed. The cost estimate and the output and heat rate impacts will be used to determine a preliminary price for the exported steam.« less

Towards elimination of mother-to-child transmission of HIV: performance of different models of care for initiating lifelong antiretroviral therapy for pregnant women in Malawi (Option B+).

PubMed

van Lettow, Monique; Bedell, Richard; Mayuni, Isabell; Mateyu, Gabriel; Landes, Megan; Chan, Adrienne K; van Schoor, Vanessa; Beyene, Teferi; Harries, Anthony D; Chu, Stephen; Mganga, Andrew; van Oosterhout, Joep J

2014-01-01

Malawi introduced a new strategy to improve the effectiveness of prevention of mother-to-child HIV transmission (PMTCT), the Option B+ strategy. We aimed to (i) describe how Option B+ is provided in health facilities in the South East Zone in Malawi, identifying the diverse approaches to service organization (the "model of care") and (ii) explore associations between the "model of care" and health facility-level uptake and retention rates for pregnant women identified as HIV-positive at antenatal (ANC) clinics. A health facility survey was conducted in all facilities providing PMTCT/antiretroviral therapy (ART) services in six of Malawi's 28 districts to describe and compare Option B+ service delivery models. Associations of identified models with program performance were explored using facility cohort reports. Among 141 health facilities, four "models of care" were identified: A) facilities where newly identified HIV-positive women are initiated and followed on ART at the ANC clinic until delivery; B) facilities where newly identified HIV-positive women receive only the first dose of ART at the ANC clinic, and are referred to the ART clinic for follow-up; C) facilities where newly identified HIV-positive women are referred from ANC to the ART clinic for initiation and follow-up of ART; and D) facilities serving as ART referral sites (not providing ANC). The proportion of women tested for HIV during ANC was highest in facilities applying Model A and lowest in facilities applying Model B. The highest retention rates were reported in Model C and D facilities and lowest in Model B facilities. In multivariable analyses, health facility factors independently associated with uptake of HIV testing and counselling (HTC) in ANC were number of women per HTC counsellor, HIV test kit availability, and the "model of care" applied; factors independently associated with ART retention were district location, patient volume and the "model of care" applied. A large variety exists in the way health facilities have integrated PMTCT Option B+ care into routine service delivery. This study showed that the "model of care" chosen is associated with uptake of HIV testing in ANC and retention in care on ART. Further patient-level research is needed to guide policy recommendations.

Health Care Resource Utilization for Outpatient Cardiovascular Disease and Diabetes Care Delivery Among Advanced Practice Providers and Physician Providers in Primary Care.

PubMed

Virani, Salim S; Akeroyd, Julia M; Ramsey, David J; Deswal, Anita; Nasir, Khurram; Rajan, Suja S; Ballantyne, Christie M; Petersen, Laura A

2018-06-01

Although effectiveness of diabetes or cardiovascular disease (CVD) care delivery between physicians and advanced practice providers (APPs) has been shown to be comparable, health care resource utilization between these 2 provider types in primary care is unknown. This study compared health care resource utilization between patients with diabetes or CVD receiving care from APPs or physicians. Diabetes (n = 1,022,588) or CVD (n = 1,187,035) patients with a primary care visit between October 2013 and September 2014 in 130 Veterans Affairs facilities were identified. Using hierarchical regression adjusting for covariates including patient illness burden, the authors compared number of primary or specialty care visits and number of lipid panels and hemoglobinA1c (HbA1c) tests among diabetes patients, and number of primary or specialty care visits and number of lipid panels and cardiac stress tests among CVD patients receiving care from physicians and APPs. Physicians had significantly larger patient panels compared with APPs. In adjusted analyses, diabetes patients receiving care from APPs received fewer primary and specialty care visits and a greater number of lipid panels and HbA1c tests compared with patients receiving care from physicians. CVD patients receiving care from APPs received more frequent lipid testing and fewer primary and specialty care visits compared with those receiving care from physicians, with no differences in the number of stress tests. Most of these differences, although statistically significant, were numerically small. Health care resource utilization among diabetes or CVD patients receiving care from APPs or physicians appears comparable, although physicians work with larger patient panels.

Recent Accomplishments in Laser-Photovoltaic Wireless Power Transmission

NASA Technical Reports Server (NTRS)

Fikes, John C.; Henley, Mark W.; Mankins, John C.; Howell, Joe T.; Fork, Richard L.; Cole, Spencer T.; Skinner, Mark

2003-01-01

Wireless power transmission can be accomplished over long distances using laser power sources and photovoltaic receivers. Recent research at AMOS has improved our understanding of the use of this technology for practical applications. Research by NASA, Boeing, the University of Alabama-Huntsville, the University of Colorado, Harvey Mudd College, and the Naval Postgraduate School has tested various commercial lasers and photovoltaic receiver configurations. Lasers used in testing have included gaseous argon and krypton, solid-state diodes, and fiber optic sources, at wavelengths ranging from the visible to the near infra-red. A variety of Silicon and Gallium Arsenide photovoltaic have been tested with these sources. Safe operating procedures have been established, and initial tests have been conducted in the open air at AMOS facilities. This research is progressing toward longer distance ground demonstrations of the technology and practical near-term space demonstrations.

Quality choice in Medicaid markets. The case of nursing homes.

PubMed

McKay, N L

1989-01-01

This article examines whether private patients, who typically pay a price higher than the Medicaid reimbursement rate, receive the same or higher quality services than Medicaid patients in the same health care facility. Because the mix of patients will affect the firm's cost only when Medicaid and private patients receive different levels of quality, the cost function can be used to test for the presence of quality differences. Estimates of a cost function for Texas nursing home in 1983 indicate that the mix of patients does not affect the firm's cost. Thus, private and Medicaid patients in the same nursing home receive the same level of quality.

Quality of antenatal and delivery care before and after the implementation of a prevention of mother-to-child HIV transmission programme in Côte d'Ivoire.

PubMed

Delvaux, Thérèse; Konan, Jean-Paul Diby; Aké-Tano, Odile; Gohou-Kouassi, Valérie; Bosso, Patrice Emery; Buvé, Anne; Ronsmans, Carine

2008-08-01

To assess whether implementation of a prevention of mother-to-child HIV transmission (PMTCT) programme in Côte d'Ivoire improved the quality of antenatal and delivery care services. Quality of antenatal and delivery care services was assessed in five urban health facilities before (2002-2003) and after (2005) the implementation of a PMTCT programme through review of facility data; observation of antenatal consultations (n = 606 before; n = 591 after) and deliveries (n = 229 before; n = 231 after) and exit interviews of women; and interviews of health facility staff. HIV testing was never proposed at baseline and was proposed to 63% of women at the first ANC visit after PMTCT implementation. The overall testing rate was 42% and 83% of tested HIV-infected pregnant women received nevirapine. In addition, inter-personal communication and confidentiality significantly improved in all health facilities. In the maternity ward, quality of obstetrical care at admission, delivery and post-partum care globally improved in all facilities after the implementation of the programme although some indicators remained poor, such as filling in the partograph directly during labour. Episiotomy rates among primiparous women dropped from 64% to 25% (P < 0.001) after PMTCT implementation. Global scores for quality of antenatal and delivery care significantly improved in all facilities after the implementation of the programme. Introducing comprehensive PMTCT services can improve the quality of antenatal and delivery care in general.

Towards elimination of mother-to-child transmission of HIV: performance of different models of care for initiating lifelong antiretroviral therapy for pregnant women in Malawi (Option B+)

PubMed Central

van Lettow, Monique; Bedell, Richard; Mayuni, Isabell; Mateyu, Gabriel; Landes, Megan; Chan, Adrienne K; van Schoor, Vanessa; Beyene, Teferi; Harries, Anthony D; Chu, Stephen; Mganga, Andrew; van Oosterhout, Joep J

2014-01-01

Introduction Malawi introduced a new strategy to improve the effectiveness of prevention of mother-to-child HIV transmission (PMTCT), the Option B+ strategy. We aimed to (i) describe how Option B+ is provided in health facilities in the South East Zone in Malawi, identifying the diverse approaches to service organization (the “model of care”) and (ii) explore associations between the “model of care” and health facility–level uptake and retention rates for pregnant women identified as HIV-positive at antenatal (ANC) clinics. Methods A health facility survey was conducted in all facilities providing PMTCT/antiretroviral therapy (ART) services in six of Malawi's 28 districts to describe and compare Option B+ service delivery models. Associations of identified models with program performance were explored using facility cohort reports. Results Among 141 health facilities, four “models of care” were identified: A) facilities where newly identified HIV-positive women are initiated and followed on ART at the ANC clinic until delivery; B) facilities where newly identified HIV-positive women receive only the first dose of ART at the ANC clinic, and are referred to the ART clinic for follow-up; C) facilities where newly identified HIV-positive women are referred from ANC to the ART clinic for initiation and follow-up of ART; and D) facilities serving as ART referral sites (not providing ANC). The proportion of women tested for HIV during ANC was highest in facilities applying Model A and lowest in facilities applying Model B. The highest retention rates were reported in Model C and D facilities and lowest in Model B facilities. In multivariable analyses, health facility factors independently associated with uptake of HIV testing and counselling (HTC) in ANC were number of women per HTC counsellor, HIV test kit availability, and the “model of care” applied; factors independently associated with ART retention were district location, patient volume and the “model of care” applied. Conclusions A large variety exists in the way health facilities have integrated PMTCT Option B+ care into routine service delivery. This study showed that the “model of care” chosen is associated with uptake of HIV testing in ANC and retention in care on ART. Further patient-level research is needed to guide policy recommendations. PMID:25079437

Tritium protective clothing

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

Fuller, T. P.; Easterly, C. E.

Occupational exposures to radiation from tritium received at present nuclear facilities and potential exposures at future fusion reactor facilities demonstrate the need for improved protective clothing. Important areas relating to increased protection factors of tritium protective ventilation suits are discussed. These areas include permeation processes of tritium through materials, various tests of film permeability, selection and availability of suit materials, suit designs, and administrative procedures. The phenomenological nature of film permeability calls for more standardized and universal test methods, which would increase the amount of directly useful information on impermeable materials. Improvements in suit designs could be expedited and bettermore » communicated to the health physics community by centralizing devlopmental equipment, manpower, and expertise in the field of tritium protection to one or two authoritative institutions.« less

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

Piette, Mary Ann; Sezgen, Osman; Watson, David S.

This report describes the results of a research project to develop and evaluate the performance of new Automated Demand Response (Auto-DR) hardware and software technology in large facilities. Demand Response (DR) is a set of activities to reduce or shift electricity use to improve electric grid reliability, manage electricity costs, and ensure that customers receive signals that encourage load reduction during times when the electric grid is near its capacity. The two main drivers for widespread demand responsiveness are the prevention of future electricity crises and the reduction of electricity prices. Additional goals for price responsiveness include equity through costmore » of service pricing, and customer control of electricity usage and bills. The technology developed and evaluated in this report could be used to support numerous forms of DR programs and tariffs. For the purpose of this report, we have defined three levels of Demand Response automation. Manual Demand Response involves manually turning off lights or equipment; this can be a labor-intensive approach. Semi-Automated Response involves the use of building energy management control systems for load shedding, where a preprogrammed load shedding strategy is initiated by facilities staff. Fully-Automated Demand Response is initiated at a building or facility through receipt of an external communications signal--facility staff set up a pre-programmed load shedding strategy which is automatically initiated by the system without the need for human intervention. We have defined this approach to be Auto-DR. An important concept in Auto-DR is that a facility manager is able to ''opt out'' or ''override'' an individual DR event if it occurs at a time when the reduction in end-use services is not desirable. This project sought to improve the feasibility and nature of Auto-DR strategies in large facilities. The research focused on technology development, testing, characterization, and evaluation relating to Auto-DR. This evaluation also included the related decisionmaking perspectives of the facility owners and managers. Another goal of this project was to develop and test a real-time signal for automated demand response that provided a common communication infrastructure for diverse facilities. The six facilities recruited for this project were selected from the facilities that received CEC funds for new DR technology during California's 2000-2001 electricity crises (AB970 and SB-5X).« less

Effectiveness of educational outreach in infectious diseases management: a cluster randomized trial in Uganda.

PubMed

Mbonye, Martin Kayitale; Burnett, Sarah M; Naikoba, Sarah; Ronald, Allan; Colebunders, Robert; Van Geertruyden, Jean-Pierre; Weaver, Marcia R

2016-08-04

Integrated Infectious Diseases Capacity Building Evaluation (IDCAP) teams designed and implemented two health worker in-service training approaches: 1) an off-site classroom-based integrated management of infectious diseases (IMID) course with distance learning aspects, and 2) on-site support (OSS), an educational outreach intervention. We tested the effects of OSS on workload and 12 facility performance indicators for emergency triage assessment and treatment, HIV testing, and malaria and pneumonia case management among outpatients by two subgroups: 1) mid-level practitioners (MLP) who attended IMID training (IMID-MLP) and 2) health workers who did not (No-IMID). Thirty-six health facilities participated in the IDCAP trial, with 18 randomly assigned to Arm A and 18 to Arm B. Two MLP in both arms received IMID. All providers at Arm A facilities received nine monthly OSS visits from April to December 2010 while Arm B did not. From November 2009 to December 2010, 777,667 outpatient visits occurred. We analyzed 669,580 (86.1 %) outpatient visits, where provider cadre was reported. Treatment was provided by 64 IMID-MLP and 1,515 No-IMID providers. The effect of OSS was measured by the difference in pre/post changes across arms after controlling for covariates (adjusted ratio of relative risks = a RRR). The effect of OSS on patients-per-provider-per-day (workload) among IMID-MLP (aRRR = 1.21; p = 0.48) and No-IMID (aRRR = 0.90; p = 0.44) was not statistically significant. Among IMID-MLP, OSS was effective for three indicators: malaria cases receiving an appropriate antimalarial (aRRR = 1.26, 99 % CI = 1.02-1.56), patients with negative malaria test result prescribed an antimalarial (aRRR = 0.49, 99 % CI = 0.26-0.92), and patients with acid-fast bacilli smear negative result receiving empiric treatment for acute respiratory infection (aRRR = 2.04, 99 % CI = 1.06-3.94). Among No-IMID, OSS was effective for two indicators: emergency and priority patients admitted, detained or referred (aRRR = 2.12, 99 % CI = 1.05-4.28) and emergency patients receiving at least one appropriate treatment (aRRR = 1.98, 99 % CI = 1.21-3.24). Effects of OSS on workload were not statistically significant. Significant OSS effects on facility performance across subgroups were heterogeneous. OSS supported MLP who diagnosed and treated patients to apply IMID knowledge. For other providers, OSS supported team work to manage emergency patients. This evidence on OSS effectiveness could inform interventions to improve health workers' capacity to deliver better quality infectious diseases care.

New recreational facilities for the young and the old in Los Angeles: policy and programming implications.

PubMed

Cohen, Deborah A; Sehgal, Amber; Williamson, Stephanie; Marsh, Terry; Golinelli, Daniela; McKenzie, Thomas L

2009-01-01

It is assumed that higher quality recreation facilities promote physical activity and serve communities better. We tested this assumption by comparing changes in the use of an expanded and renovated skate park (a facility for skateboarding) and a modernized senior citizen's center to two similar facilities that were not refurbished. The skate park was nearly tripled in size, and the senior center was remodeled and received new exercise equipment, a courtyard garden, and modern architectural features. We assessed use of these facilities through direct observation and surveyed both facility users and residents living within 2 miles of each facility. We found that making improvements to facilities alone will not always guarantee increased use. Although there was a 510% increase in use of the expanded skate park compared to a 77% increase in the comparison skate park, the senior center had substantially fewer users and provided fewer hours of exercise classes and other programmed activities after the facility was renovated. The implication of our study is that use results from a complex equation that includes not only higher quality recreation facilities but also progamming, staffing, fees, hours of operation, marketing, outreach, and perhaps a host of other human factors.

Comparison of Hospitalization Rates among For-Profit and Nonprofit Dialysis Facilities

PubMed Central

Johansen, Kirsten L.; Romano, Patrick S.; Chertow, Glenn M.; Mu, Yi; Ishida, Julie H.; Grimes, Barbara; Kaysen, George A.; Nguyen, Danh V.

2014-01-01

Summary Background and objectives The vast majority of US dialysis facilities are for-profit and profit status has been associated with processes of care and outcomes in patients on dialysis. This study examined whether dialysis facility profit status was associated with the rate of hospitalization in patients starting dialysis. Design, setting, participants, & methods This was a retrospective cohort study of Medicare beneficiaries starting dialysis between 2005 and 2008 using data from the US Renal Data System. All-cause hospitalization was examined and compared between for-profit and nonprofit dialysis facilities through 2009 using Poisson regression. Companion analyses of cause-specific hospitalization that are likely to be influenced by dialysis facility practices including hospitalizations for heart failure and volume overload, access complications, or hyperkalemia were conducted. Results The cohort included 150,642 patients. Of these, 12,985 (9%) were receiving care in nonprofit dialysis facilities. In adjusted models, patients receiving hemodialysis in for-profit facilities had a 15% (95% confidence interval [95% CI], 13% to 18%) higher relative rate of hospitalization compared with those in nonprofit facilities. Among patients receiving peritoneal dialysis, the rate of hospitalization in for-profit versus nonprofit facilities was not significantly different (relative rate, 1.07; 95% CI, 0.97 to 1.17). Patients on hemodialysis receiving care in for-profit dialysis facilities had a 37% (95% CI, 31% to 44%) higher rate of hospitalization for heart failure or volume overload and a 15% (95% CI, 11% to 20%) higher rate of hospitalization for vascular access complications. Conclusions Hospitalization rates were significantly higher for patients receiving hemodialysis in for-profit compared with nonprofit dialysis facilities. PMID:24370770

Longitudinal Comparison of the Microbiota During Klebsiella pneumoniae Carbapenemase-Producing Klebsiella pneumoniae (KPC-Kp) Acquisition in Long-Term Acute Care Hospital (LTACH) patients

PubMed Central

Seekatz, Anna; Bassis, Christine M; Lolans, Karen; Yelin, Rachel D; Moore, Nicholas M; Okamoto, Koh; Rhee, Yoona; Bell, Pamela; Dangana, Thelma; Sidimirova, Galina; Weinstein, Robert A; Fogg, Louis; Lin, Michael Y; Young, Vincent B; Hayden, Mary K

2017-01-01

Abstract Background Colonization with KPC-Kp precedes infection and represents a potential target for intervention. To identify microbial signatures associated with KPC-Kp acquisition, we conducted a prospective, longitudinal study of the fecal microbiota in LTACH patients at risk of acquiring KPC-Kp. Methods We collected admission and weekly rectal swab samples from patients admitted to one LTACH from May 2015 to May 2016. Patients were screened for KPC-Kp by PCR at each sampling time. KPC acquisition was confirmed by culture of KPC-Kp. To assess changes in the microbiota related to acquisition, we sequenced the 16S rRNA gene (V4 region) from collected rectal swabs. Diversity, intra-individual changes, and the relative abundance of the operational taxonomic unit (OTU) that contains KPC-Kp were compared in patients who were KPC-Kp negative upon admission and who had at least one additional swab sample collected. Results 318 patients (1247 samples) were eligible for analysis; 3.7 samples (mean) were collected per patient. Sixty-two patients (19.5%) acquired KPC-Kp (cases) and 256 patients remained negative for all carbapenem-resistant Enterobacteriaceae throughout their stay (controls). Median length of stay before KPC-Kp detection was 14.5 days. At time of KPC-Kp acquisition, levels of an Enterobacteriaceae OTU increased significantly compared with pre-acquisition samples and to samples from control patients (Wilcoxon test, P < 0.0001). Similarly, we observed a decrease in total diversity of the fecal microbiota at time of acquisition in cases (P < 0.01). Compared with controls, cases exhibited decreased intra-individual fecal microbiota similarity immediately prior to acquisition of KPC-Kp (P < 0.01). Comparison of microbial features at time of admission using random forest revealed a higher abundance of Enterococcus and Escherichia OTUs in controls vs cases. Conclusion We observed intra-individual changes in the fecal microbiota of case patients prior to acquisition of KPC-Kp. Compared with patients who did not acquire KPC-Kp, cases exhibited significant changes in microbiota diversity and increased abundance of potential KPC-Kp at acquisition. Our results suggest that shifts in the microbiota may precede colonization by KPC-Kp. Disclosures N. M. Moore, Cepheid: Research Contractor, Funded and provided reagents for associated research projects; R. A. Weinstein, OpGen: Receipt of donated laboratory services for project, Research support; CLorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Molnlycke: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; M. Y. Lin, Sage, Inc.: receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; OpGen, Inc.: receipt of in-kind laboratory services, Conducting studies in healthcare facilities that are receiving contributed product; M. K. Hayden, OpGen, Inc.: Receipt of donated laboratory services for project, Research support; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Molnlycke: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product.

Single event test methodology for integrated optoelectronics

NASA Technical Reports Server (NTRS)

Label, Kenneth A.; Cooley, James A.; Stassinopoulos, E. G.; Marshall, Paul; Crabtree, Christina

1993-01-01

A single event upset (SEU), defined as a transient or glitch on the output of a device, and its applicability to integrated optoelectronics are discussed in the context of spacecraft design and the need for more than a bit error rate viewpoint for testing and analysis. A methodology for testing integrated optoelectronic receivers and transmitters for SEUs is presented, focusing on the actual test requirements and system schemes needed for integrated optoelectronic devices. Two main causes of single event effects in the space environment, including protons and galactic cosmic rays, are considered along with ground test facilities for simulating the space environment.

Burden of laboratory-confirmed Campylobacter infections in Guatemala 2008–2012: Results from a facility-based surveillance system

PubMed Central

Benoit, Stephen R.; Lopez, Beatriz; Arvelo, Wences; Henao, Olga; Parsons, Michele B.; Reyes, Lissette; Moir, Juan Carlos; Lindblade, Kim

2015-01-01

Introduction Campylobacteriosis is one of the leading causes of gastroenteritis worldwide. This study describes the epidemiology of laboratory-confirmed Campylobacter diarrheal infections in two facility-based surveillance sites in Guatemala. Methods Clinical, epidemiologic, and laboratory data were collected on patients presenting with acute diarrhea from select healthcare facilities in the departments of Santa Rosa and Quetzaltenango, Guatemala, from January 2008 through August 2012. Stool specimens were cultured for Campylobacter and antimicrobial susceptibility testing was performed on a subset of isolates. Multidrug resistance (MDR) was defined as resistance to ≥3 antimicrobial classes. Results Campylobacter was isolated from 306 (6.0%) of 5137 stool specimens collected. For children <5 years of age, annual incidence was as high as 1288.8 per 100,000 children in Santa Rosa and 185.5 per 100,000 children in Quetzaltenango. Among 224 ambulatory care patients with Campylobacter, 169 (75.5%) received metronidazole or trimethoprim-sulfamethoxazole, and 152 (66.7%) received or were prescribed oral rehydration therapy. Antimicrobial susceptibilities were tested in 96 isolates; 57 (59.4%) were resistant to ciprofloxacin and 12 (12.5%) were MDR. Conclusion Campylobacter was a major cause of diarrhea in children in two departments in Guatemala; antimicrobial resistance was high, and treatment regimens in the ambulatory setting which included metronidazole and trimethoprim-sulfamethoxazole and lacked oral rehydration were sub-optimal. PMID:24534336

Burden of laboratory-confirmed Campylobacter infections in Guatemala 2008-2012: results from a facility-based surveillance system.

PubMed

Benoit, Stephen R; Lopez, Beatriz; Arvelo, Wences; Henao, Olga; Parsons, Michele B; Reyes, Lissette; Moir, Juan Carlos; Lindblade, Kim

2014-03-01

Campylobacteriosis is one of the leading causes of gastroenteritis worldwide. This study describes the epidemiology of laboratory-confirmed Campylobacter diarrheal infections in two facility-based surveillance sites in Guatemala. Clinical, epidemiologic, and laboratory data were collected on patients presenting with acute diarrhea from select healthcare facilities in the departments of Santa Rosa and Quetzaltenango, Guatemala, from January 2008 through August 2012. Stool specimens were cultured for Campylobacter and antimicrobial susceptibility testing was performed on a subset of isolates. Multidrug resistance (MDR) was defined as resistance to ≥3 antimicrobial classes. Campylobacter was isolated from 306 (6.0%) of 5137 stool specimens collected. For children <5 years of age, annual incidence was as high as 1288.8 per 100,000 children in Santa Rosa and 185.5 per 100,000 children in Quetzaltenango. Among 224 ambulatory care patients with Campylobacter, 169 (75.5%) received metronidazole or trimethoprim-sulfamethoxazole, and 152 (66.7%) received or were prescribed oral rehydration therapy. Antimicrobial susceptibilities were tested in 96 isolates; 57 (59.4%) were resistant to ciprofloxacin and 12 (12.5%) were MDR. Campylobacter was a major cause of diarrhea in children in two departments in Guatemala; antimicrobial resistance was high, and treatment regimens in the ambulatory setting which included metronidazole and trimethoprim-sulfamethoxazole and lacked oral rehydration were sub-optimal. Published by Elsevier Ltd.

Acceptance test report, 241-SY-101 Flexible Receiver System, Phase 2 testing

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

Ritter, G.A.

1995-02-06

This document summarizes the results of the Phase 2 acceptance test of the 241-SY-101 Flexible Receiver System (FRS). The FRS is one of six major components of the Equipment Removal System, which has been designed to retrieve, transport, and store the test mixer pump currently installed in Tank 241-SY-101. The purpose of this acceptance test is to verify the strength of the containment bag and bag bottom cinching mechanism. It is postulated that 68 gallons of waste could be trapped inside the pump internals. The bag must be capable of supporting this waste if it shakes loose and drains tomore » the bottom of the bag after the bag bottom has been cinched closed. This acceptance test was performed at the Maintenance and Storage Facility (MASF) Facility in the 400 area on January 23, 1995. The bag assembly supported the weight of 920 kg (2,020 lbs) of water with no leakage or damage to the bag. This value meets the acceptance criteria of 910 kg of water and therefore the results were found to be acceptable. The maximum volume of liquid expected to be held up in the pump internals is 258 L (68 gallons), which corresponds to 410 kg. This test weight gives just over a safety factor of 2. The bag also supported a small shock load while it was filled with water when the crane hoisted the bag assembly up and down. Based on the strength rating of the bag components, the bag assembly should support 2--3 times the test weight of 910 kg.« less

Do Diagnosis Delays Impact Receipt of Test Results? Evidence from the HIV Early Infant Diagnosis Program in Uganda

PubMed Central

Mugambi, Melissa Latigo; Deo, Sarang; Kekitiinwa, Adeodata; Kiyaga, Charles; Singer, Mendel E.

2013-01-01

Background There is scant evidence on the association between diagnosis delays and the receipt of test results in HIV Early Infant Diagnosis (EID) programs. We determine the association between diagnosis delays and other health care system and patient factors on result receipt. Methods We reviewed 703 infant HIV test records for tests performed between January 2008 and February 2009 at a regional referral hospital and level four health center in Uganda. The main outcome was caregiver receipt of the test result. The primary study variable was turnaround time (time between sample collection and result availability at the health facility). Additional variables included clinic entry point, infant age at sample collection, reported HIV status and receipt of antiretroviral prophylaxis for prevention of mother-to-child transmission. We conducted a pooled analysis in addition to separate analyses for each facility. We estimated the relative risk of result receipt using modified Poisson regression with robust standard errors. Results Overall, the median result turnaround time, was 38 days. 59% of caregivers received infant test results. Caregivers were less likely to receive results at turnaround times greater than 49 days compared to 28 days or fewer (ARR = 0.83; 95% CI = 0.70–0.98). Caregivers were more likely to receive results at the PMTCT clinic (ARR = 1.81; 95% CI = 1.40–2.33) and less likely at the pediatric ward (ARR = 0.54; 95% CI = 0.37–0.81) compared to the immunization clinic. At the level four health center, result receipt was half as likely among infants older than 9 months compared to 3 months and younger (ARR= 0.47; 95% CI = 0.25–0.93). Conclusion In this study setting, we find evidence that longer turnaround times, clinic entry point and age at sample collection may be associated with receipt of infant HIV test results. PMID:24282502

Variation in Management of Patients With Obstructive Coronary Artery Disease: Insights From the Veterans Affairs Clinical Assessment and Reporting Tool (VA CART) Program.

PubMed

Sandhu, Amneet; Stanislawski, Maggie A; Grunwald, Gary K; Guinn, Kathryn; Valle, Javier; Matlock, Daniel; Ho, P Michael; Maddox, Thomas M; Bradley, Steven M

2017-09-12

Little is known about facility-level variation in the use of revascularization procedures for the management of stable obstructive coronary artery disease. Furthermore, it is unknown if variation in the use of coronary revascularization is associated with use of other cardiovascular procedures. We evaluated all elective coronary angiograms performed in the Veterans Affairs system between September 1, 2007, and December 31, 2011, using the Clinical Assessment and Reporting Tool and identified patients with obstructive coronary artery disease. Patients were considered managed with revascularization if they received percutaneous coronary intervention (PCI) or coronary artery bypass grafting within 30 days of diagnosis. We calculated risk-adjusted facility-level rates of overall revascularization, PCI, and coronary artery bypass grafting. In addition, we determined the association between facility-level rates of revascularization and post-PCI stress testing. Among 15 650 patients at 51 Veterans Affairs sites who met inclusion criteria, the median rate of revascularization was 59.6% (interquartile range, 55.7%-66.7%). Across all facilities, risk-adjusted rates of overall revascularization varied from 41.5% to 88.1%, rate of PCI varied from 23.2% to 80.6%, and rate of coronary artery bypass graftingvariedfrom 7.5% to 36.5%. Of 6179 patients who underwent elective PCI, the median rate of stress testing in the 2 years after PCI was 33.7% (interquartile range, 30.7%-47.1%). There was no evidence of correlation between facility-level rate of revascularization and follow-up stress testing. Within the Veterans Affairs system, we observed large facility-level variation in rates of revascularization for obstructive coronary artery disease, with variation driven primarily by PCI. There was no association between facility-level use of revascularization and follow-up stress testing, suggesting use rates are specific to a particular procedure and not a marker of overall facility-level use. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

A quarantine protocol for analysis of returned extraterrestrial samples

NASA Technical Reports Server (NTRS)

Bagby, J. R.; Sweet, H. C.; Devincenzi, D. L.

1983-01-01

A protocol is presented for the analysis at an earth-orbiting quarantine facility of return samples of extraterrestrial material that might contain (nonterrestrial) life forms. The protocol consists of a series of tests designed to determine whether the sample, conceptualized as a 1-kg sample of Martian soil, is free from nonterrestrial biologically active agents and so may safely be sent to a terrestrial containment facility, or it exhibits biological activity requiring further (second-order) testing outside the biosphere. The first-order testing procedure seeks to detect the presence of any replicating organisms or toxic substances through a series of experiments including gas sampling, analysis of radioactivity, stereomicroscopic inspection, chemical analysis, microscopic examination, the search for metabolic products under growth conditions, microbiologicl assays, and the challenge of cultured cells with any agents found or with the extraterrestrial material as is. Detailed plans for the second-order testing would be developed in response to the actual data received from primary testing.

Prior HIV testing among STD patients in Guangdong Province, China: opportunities for expanding detection of sexually transmitted HIV infection.

PubMed

Tucker, Joseph D; Yang, Li-Gang; Yang, Bin; Young, Darwin; Henderson, Gail E; Huang, Shu-Jie; Lu, He-Kun; Chen, Xiang-Sheng; Cohen, Myron S

2012-03-01

Expanding HIV testing is important among individuals at increased risk for sexual HIV transmission in China, but little is known about prior HIV testing experiences among sexually transmitted disease (STD) patients. This cross-sectional study of 1792 outpatients from 6 public STD clinics in Guangdong Province recorded detailed information about ever having been tested for HIV infection in addition to sociodemographic variables, health seeking, clinical STD history, and HIV stigma using a validated survey instrument. A total of 456 (25.4%) of the STD patients in this sample had ever been tested for HIV infection. STD patients who were male, had higher income, more education, were at City A and City C, received STD services at public facilities, had used intravenous drugs, and had a history of an STD were more likely to ever receive an HIV test in multivariate analysis. Low perceived HIV risk was the most common reason for not receiving an HIV test. Only 7.7% of the sample reported fear of discrimination or loss of face as influencing their lack of HIV testing. Incomplete prior HIV screening among STD patients in China suggests the need for broadening HIV testing opportunities at STD clinics and similar clinical settings attended by those with increased sexual risk.

Performance Assessment of Two GPS Receivers on Space Shuttle

NASA Technical Reports Server (NTRS)

Schroeder, Christine A.; Schutz, Bob E.

1996-01-01

Space Shuttle STS-69 was launched on September 7, 1995, carrying the Wake Shield Facility (WSF-02) among its payloads. The mission included two GPS receivers: a Collins 3M receiver onboard the Endeavour and an Osborne flight TurboRogue, known as the TurboStar, onboard the WSF-02. Two of the WSF-02 GPS Experiment objectives were to: (1) assess the ability to use GPS in a relative satellite positioning mode using the receivers on Endeavour and WSF-02; and (2) assess the performance of the receivers to support high precision orbit determination at the 400 km altitude. Three ground tests of the receivers were conducted in order to characterize the respective receivers. The analysis of the tests utilized the Double Differencing technique. A similar test in orbit was conducted during STS-69 while the WSF-02 was held by the Endeavour robot arm for a one hour period. In these tests, biases were observed in the double difference pseudorange measurements, implying that biases up to 140 m exist which do not cancel in double differencing. These biases appear to exist in the Collins receiver, but their effect can be mitigated by including measurement bias parameters to accommodate them in an estimation process. An additional test was conducted in which the orbit of the combined Endeavour/WSF-02 was determined independently with each receiver. These one hour arcs were based on forming double differences with 13 TurboRogue receivers in the global IGS network and estimating pseudorange biases for the Collins. Various analyses suggest the TurboStar overall orbit accuracy is about one to two meters for this period, based on double differenced phase residuals of 34 cm. These residuals indicate the level of unmodeled forces on Endeavour produced by gravitational and nongravitational effects. The rms differences between the two independently determined orbits are better than 10 meters, thereby demonstrating the accuracy of the Collins-determined orbit at this level as well as the accuracy of the relative positioning using these two receivers.

Does health facility service environment matter for the receipt of essential newborn care? Linking health facility and household survey data in Malawi.

PubMed

Carvajal-Aguirre, Liliana; Mehra, Vrinda; Amouzou, Agbessi; Khan, Shane M; Vaz, Lara; Guenther, Tanya; Kalino, Maggie; Zaka, Nabila

2017-12-01

Health facility service environment is an important factor for newborns survival and well-being in general and in particular in high mortality settings such as Malawi where despite high coverage of essential interventions, neonatal mortality remains high. The aim of this study is to assess whether the quality of the health service environment at birth is associated with quality of care received by the newborn. We used data from the Malawi Millennium Development Goals Endline household survey conducted as part of MICS survey program and Service Provision Assessment Survey carried out in 2014. The analysis is based on 6218 facility births that occurred during the past 2 years. Descriptive statistics, bivariate and multivariate random effect models are used to assess the association of health facility service readiness score for normal deliveries and newborn care with newborns receiving appropriate newborn care, defined for this analysis as receiving 5 out of 6 recommended interventions during the first 2 days after birth. Newborns in districts with top facility service readiness score have 1.5 higher odds of receiving appropriate newborn care (adjusted odds ratio (aOR) = 1.52, 95% confidence interval CI = 1.19-1.95, P  = 0.001), as compared to newborns in districts with a lower facility score after adjusting for potential confounders. Newborns in the Northern region were two times more likely to receive 5 newborn care interventions as compared to newborns in the Southern region (aOR = 2.06, 95% CI = 1.50-2.83, P  < 0.001). Living in urban or rural areas did not have an impact on receiving appropriate newborn care. There is need to increase the level of service readiness across all facilities, so that all newborns irrespective of the health facility, district or region of delivery are able to receive all recommended essential interventions. Investments in health systems in Malawi should concentrate on increasing training and availability of health staff in facilities that offer normal delivery and newborn care services at all levels in the country.

42 CFR 413.350 - Periodic interim payments for skilled nursing facilities receiving payment under the skilled...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Periodic interim payments for skilled nursing facilities receiving payment under the skilled nursing facility prospective payment system for Part A...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING...

42 CFR 413.350 - Periodic interim payments for skilled nursing facilities receiving payment under the skilled...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Periodic interim payments for skilled nursing facilities receiving payment under the skilled nursing facility prospective payment system for Part A...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING...

42 CFR 413.350 - Periodic interim payments for skilled nursing facilities receiving payment under the skilled...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Periodic interim payments for skilled nursing facilities receiving payment under the skilled nursing facility prospective payment system for Part A...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING...

42 CFR 413.350 - Periodic interim payments for skilled nursing facilities receiving payment under the skilled...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Periodic interim payments for skilled nursing facilities receiving payment under the skilled nursing facility prospective payment system for Part A...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING...

42 CFR 413.350 - Periodic interim payments for skilled nursing facilities receiving payment under the skilled...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Periodic interim payments for skilled nursing facilities receiving payment under the skilled nursing facility prospective payment system for Part A...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING...

Missed Opportunities along the Prevention of Mother-to-Child Transmission Services Cascade in South Africa: Uptake, Determinants, and Attributable Risk (the SAPMTCTE)

PubMed Central

Woldesenbet, Selamawit; Jackson, Debra; Lombard, Carl; Dinh, Thu-Ha; Puren, Adrian; Sherman, Gayle; Ramokolo, Vundli; Doherty, Tanya; Mogashoa, Mary; Bhardwaj, Sanjana; Chopra, Mickey; Shaffer, Nathan; Pillay, Yogan; Goga, Ameena

2015-01-01

Objectives We examined uptake of prevention of mother-to-child HIV transmission (PMTCT) services, predictors of missed opportunities, and infant HIV transmission attributable to missed opportunities along the PMTCT cascade across South Africa. Methods A cross-sectional survey was conducted among 4–8 week old infants receiving first immunisations in 580 nationally representative public health facilities in 2010. This included maternal interviews and testing infants’ dried blood spots for HIV. A weighted analysis was performed to assess uptake of antenatal and perinatal PMTCT services along the PMTCT cascade (namely: maternal HIV testing, CD4 count test/result, and receiving maternal and infant antiretroviral treatment) and predictors of dropout. The population attributable fraction associated with dropouts at each service point are estimated. Results Of 9,803 mothers included, 31.7% were HIV-positive as identified by reactive infant antibody tests. Of these 80.4% received some form of maternal and infant antiretroviral treatment. More than a third (34.9%) of mothers dropped out from one or more steps in the PMTCT service cascade. In a multivariable analysis, the following characteristics were associated with increased dropout from the PMTCT cascade: adolescent (<20 years) mothers, low socioeconomic score, low education level, primiparous mothers, delayed first antenatal visit, homebirth, and non-disclosure of HIV status. Adolescent mothers were twice (adjusted odds ratio: 2.2, 95% confidence interval: 1.5–3.3) as likely to be unaware of their HIV-positive status and had a significantly higher rate (85.2%) of unplanned pregnancies compared to adults aged ≥20 years (55.5%, p = 0.0001). A third (33.8%) of infant HIV infections were attributable to dropout in one or more steps in the cascade. Conclusion A third of transmissions attributable to missed opportunities of PMTCT services can be prevented by optimizing the uptake of PMTCT services. Identified risk factors for low PMTCT service uptake should be addressed through health facility and community-level interventions, including raising awareness, promoting women education, adolescent focused interventions, and strengthening linkages/referral-system between communities and health facilities. PMID:26147598

Joint IRIS/PASSCAL UNAVCO Seismic and GPS Installations, Testing, and Development

NASA Astrophysics Data System (ADS)

Fowler, J.; Alvarez, M.; Beaudoin, B.; Jackson, M.; Feaux, K.; Ruud, O.; Andreatta, V.; Meertens, C.; Ingate, S.

2002-12-01

Future large-scale deformation initiatives such as EarthScope (http://www.earthscope.org/) will provide an opportunity for collocation and integration of GPS receivers and broadband and short period seismic instruments. Example integration targets include PBO backbone and cluster sites with USArray Transportable (Bigfoot) and Permanent Array. A GPS seismic integration and testing facility at the IRIS/PASSCAL Instrument Center in Socorro, NM is currently performing side-by-side testing of different seismometers, GPS receivers, communications hardware, power systems and data streaming software. One configuration tested uses an integrated VSAT data communications system and a broadband seismometer collocated with a geodetic quality GPS system. Data are routed through a VSAT hub and distributed to the UNAVCO Data Archive in Boulder and the IRIS Data Management Center in Seattle. Preliminary results indicate data availability approaching 100% with a maximum latency of 5 sec.

Where Do Patients With Cancer in Iowa Receive Radiation Therapy?

PubMed Central

Ward, Marcia M.; Ullrich, Fred; Matthews, Kevin; Rushton, Gerard; Tracy, Roger; Goldstein, Michael A.; Bajorin, Dean F.; Kosty, Michael P.; Bruinooge, Suanna S.; Hanley, Amy; Jacobson, Geraldine M.; Lynch, Charles F.

2014-01-01

Purpose: Multiple studies have shown survival benefits in patients with cancer treated with radiation therapy, but access to treatment facilities has been found to limit its use. This study was undertaken to examine access issues in Iowa and determine a methodology for conducting a similar national analysis. Patients and Methods: All Iowa residents who received radiation therapy regardless of where they were diagnosed or treated were identified through the Iowa Cancer Registry (ICR). Radiation oncologists were identified through the Iowa Physician Information System (IPIS). Radiation facilities were identified through IPIS and classified using the Commission on Cancer accreditation standard. Results: Between 2004 and 2010, 113,885 invasive cancers in 106,603 patients, 28.5% of whom received radiation treatment, were entered in ICR. Mean and median travel times were 25.8 and 20.1 minutes, respectively, to the nearest facility but 42.4 and 29.1 minutes, respectively, to the patient's chosen treatment facility. Multivariable analysis predicting travel time showed significant relationships for disease site, age, residence location, and facility category. Residents of small and isolated rural towns traveled nearly 3× longer than urban residents to receive radiation therapy, as did patients using certain categories of facilities. Conclusion: Half of Iowa patients could reach their nearest facility in 20 minutes, but instead, they traveled 30 minutes on average to receive treatment. The findings identified certain groups of patients with cancer who chose more distant facilities. However, other groups of patients with cancer, namely those residing in rural areas, had less choice, and some had to travel considerably farther to radiation facilities than urban patients. PMID:24443730

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

PubMed

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

2013-07-01

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

Solar dynamic power module design

NASA Technical Reports Server (NTRS)

Secunde, Richard R.; Labus, Thomas L.; Lovely, Ronald G.

1989-01-01

Studies have shown that use of solar dynamic (SD) power for the growth eras of the Space Station Freedom program will result in life cycle cost savings when compared to power supplied by photovoltaic sources. In the SD power module, a concentrator collects and focuses solar energy into a heat receiver which has integral thermal energy storage. A power conversion unit (PCU) based on the closed Brayton thermodynamic cycle removes thermal energy from the receiver and converts that energy to electrical energy. Since the closed Brayton cycle is a single phase gas cycle, the conversion hardware (heat exchangers, turbine, compressor, etc.) can be designed for operation in low earth orbit, and tested with confidence in test facilities on earth before launch into space. The concentrator subassemblies will be aligned and the receiver/PCU/radiator combination completely assembled and charged with gas and cooling liquid on earth before launch to, and assembly on orbit.

First Results of Field Absolute Calibration of the GPS Receiver Antenna at Wuhan University

PubMed Central

Hu, Zhigang; Zhao, Qile; Chen, Guo; Wang, Guangxing; Dai, Zhiqiang; Li, Tao

2015-01-01

GNSS receiver antenna phase center variations (PCVs), which arise from the non-spherical phase response of GNSS signals have to be well corrected for high-precision GNSS applications. Without using a precise antenna phase center correction (PCC) model, the estimated position of a station monument will lead to a bias of up to several centimeters. The Chinese large-scale research project “Crustal Movement Observation Network of China” (CMONOC), which requires high-precision positions in a comprehensive GPS observational network motived establishment of a set of absolute field calibrations of the GPS receiver antenna located at Wuhan University. In this paper the calibration facilities are firstly introduced and then the multipath elimination and PCV estimation strategies currently used are elaborated. The validation of estimated PCV values of test antenna are finally conducted, compared with the International GNSS Service (IGS) type values. Examples of TRM57971.00 NONE antenna calibrations from our calibration facility demonstrate that the derived PCVs and IGS type mean values agree at the 1 mm level. PMID:26580616

Recent Enhancements to the NASA Langley Structural Acoustics Loads and Transmission (SALT) Facility

NASA Technical Reports Server (NTRS)

Rizzi, Stephen A.; Cabell, Randolph H.; Allen, Albert R.

2013-01-01

The Structural Acoustics Loads and Transmission (SALT) facility at the NASA Langley Research Center is comprised of an anechoic room and a reverberant room, and may act as a transmission loss suite when test articles are mounted in a window connecting the two rooms. In the latter configuration, the reverberant room acts as the noise source side and the anechoic room as the receiver side. The noise generation system used for qualification testing in the reverberant room was previously shown to achieve a maximum overall sound pressure level of 141 dB. This is considered to be marginally adequate for generating sound pressure levels typically required for launch vehicle payload qualification testing. Recent enhancements to the noise generation system increased the maximum overall sound pressure level to 154 dB, through the use of two airstream modulators coupled to 35 Hz and 160 Hz horns. This paper documents the acoustic performance of the enhanced noise generation system for a variety of relevant test spectra. Additionally, it demonstrates the capability of the SALT facility to conduct transmission loss and absorption testing in accordance with ASTM and ISO standards, respectively. A few examples of test capabilities are shown and include transmission loss testing of simple unstiffened and built up structures and measurement of the diffuse field absorption coefficient of a fibrous acoustic blanket.

Cell module and fuel conditioner

NASA Technical Reports Server (NTRS)

Hoover, D. Q., Jr.

1980-01-01

The computer code for the detailed analytical model of the MK-2 stacks is described. An ERC proprietary matrix is incorporated in the stacks. The mechanical behavior of the stack during thermal cycles under compression was determined. A 5 cell stack of the MK-2 design was fabricated and tested. Designs for the next three stacks were selected and component fabrication initiated. A 3 cell stack which verified the use of wet assembly and a new acid fill procedure were fabricated and tested. Components for the 2 kW test facility were received or fabricated and construction of the facility is underway. The definition of fuel and water is used in a study of the fuel conditioning subsystem. Kinetic data on several catalysts, both crushed and pellets, was obtained in the differential reactor. A preliminary definition of the equipment requirements for treating tap and recovered water was developed.

Chemical, biological, and DNA markers for tracing slaughterhouse effluent.

PubMed

Harvey, P J; Taylor, M P; Handley, H K; Foster, S; Gillings, M R; Asher, A J

2017-07-01

Agricultural practices, if not managed correctly, can have a negative impact on receiving environments via waste disposal and discharge. In this study, a chicken slaughter facility on the rural outskirts of Sydney, Australia, has been identified as a possible source of persistent effluent discharge into a peri-urban catchment. Questions surrounding the facility's environmental management practices go back more than four decades. Despite there having never been a definitive determination of the facility's impact on local stream water quality, the New South Wales Environment Protection Authority (NSW EPA) has implemented numerous pollution reduction requirements to manage noise and water pollution at the slaughter facility. However, assessment of compliance remains complicated by potential additional sources of pollution in the catchment. To unravel this long-standing conundrum related to water pollution we apply a forensic, multiple lines of evidence approach to delineate the origin of the likely pollution source(s). Water samples collected between 2014 and 2016 from irrigation pipes and a watercourse exiting the slaughter facility had elevated concentrations of ammonia (max: 63,000µg/L), nitrogen (max: 67,000µg/L) and phosphorus (max: 39,000µg/L), which were significantly higher than samples from adjacent streams that did not receive direct runoff from the facility. Arsenic, sometimes utilised in growth promoting compounds, was detected in water discharging from the facility up to ~4 times (max 3.84µg/L) local background values (<0.5µg/L), with inorganic As (∑V+III) being the dominant species. The spatial association of elevated water pollution to the facility could not unequivocally distinguish a source and consequently DNA analysis of a suspected pollution discharge event was undertaken. Analysis of catchment runoff from several local streams showed that only water sampled at the downstream boundary of the facility tested positive for chicken DNA, with traces of duck DNA being absent, which was a potential confounder given that wild ducks are present in the area. Further, PCR analysis showed that only the discharge water emanating from the slaughter facility tested positive for a generalized marker of anthropogenic pollution, the clinical class 1 integron-integrase gene. The environmental data collected over a three-year period demonstrates that the slaughter facility is indisputably the primary source of water-borne pollution in the catchment. Moreover, application of DNA and PCR for confirming pollution sources demonstrates its potential for application by regulators in fingerprinting pollution sources. Copyright © 2017 Elsevier Inc. All rights reserved.

40 CFR 761.213 - Use of manifest-Commercial storage and disposal facility requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., PROCESSING, DISTRIBUTION IN COMMERCE, AND USE PROHIBITIONS PCB Waste Disposal Records and Reports § 761.213... or disposal facility receives PCB waste accompanied by a manifest, the owner, operator or his/her... discrepancy space. (2) If a commercial storage or disposal facility receives an off-site shipment of PCB waste...

40 CFR 761.213 - Use of manifest-Commercial storage and disposal facility requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., PROCESSING, DISTRIBUTION IN COMMERCE, AND USE PROHIBITIONS PCB Waste Disposal Records and Reports § 761.213... or disposal facility receives PCB waste accompanied by a manifest, the owner, operator or his/her... discrepancy space. (2) If a commercial storage or disposal facility receives an off-site shipment of PCB waste...

Cross-sectional survey of treatment practices for urethritis at pharmacies, private clinics and government health facilities in coastal Kenya: many missed opportunities for HIV prevention.

PubMed

Mugo, Peter M; Duncan, Sarah; Mwaniki, Samuel W; Thiong'o, Alexander N; Gichuru, Evanson; Okuku, Haile Selassie; van der Elst, Elise M; Smith, Adrian D; Graham, Susan M; Sanders, Eduard J

2013-11-01

While bacterial sexually transmitted infections (STIs) are important cofactors for HIV transmission, STI control has received little attention in recent years. The aim of this study was to assess STI treatment and HIV testing referral practices among health providers in Kenya. In 2011 we assessed quality of case management for male urethritis at pharmacies, private clinics and government health facilities in coastal Kenya using simulated visits at pharmacies and interviews at pharmacies and health facilities. Quality was assessed using Ministry of Health guidelines. Twenty (77%) of 26 pharmacies, 20 (91%) of 22 private clinics and all four government facilities in the study area took part. The median (IQR) number of adult urethritis cases per week was 5 (2-10) at pharmacies, 3 (1-3) at private clinics and 5 (2-17) at government facilities. During simulated visits, 10% of pharmacies prescribed recommended antibiotics at recommended dosages and durations and, during interviews, 28% of pharmacies and 27% of health facilities prescribed recommended antibiotics at recommended dosages and durations. Most regimens were quinolone-based. HIV testing was recommended during 10% of simulated visits, 20% of pharmacy interviews and 25% of health facility interviews. In an area of high STI burden, most men with urethritis seek care at pharmacies and private clinics. Most providers do not comply with national guidelines and very few recommend HIV testing. In order to reduce the STI burden and mitigate HIV transmission, there is an urgent need for innovative dissemination of up-to-date guidelines and inclusion of all health providers in HIV/STI programmes.

Facility Systems, Ground Support Systems, and Ground Support Equipment General Design Requirements

NASA Technical Reports Server (NTRS)

Thaxton, Eric A.

2014-01-01

KSC-DE-512-SM establishes overall requirements and best design practices to be used at the John F. Kennedy Space Center (KSC) for the development of ground systems (GS) in support of operations at launch, landing, and retrieval sites. These requirements apply to the design and development of hardware and software for ground support equipment (GSE), ground support systems (GSS), and facility ground support systems (F-GSS) used to support the KSC mission for transportation, receiving, handling, assembly, test, checkout, servicing, and launch of space vehicles and payloads and selected flight hardware items for retrieval. This standards manual supplements NASA-STD-5005 by including KSC-site-specific and local environment requirements. These requirements and practices are optional for equipment used at manufacturing, development, and test sites.

NASA Langley's AirSTAR Testbed: A Subscale Flight Test Capability for Flight Dynamics and Control System Experiments

NASA Technical Reports Server (NTRS)

Jordan, Thomas L.; Bailey, Roger M.

2008-01-01

As part of the Airborne Subscale Transport Aircraft Research (AirSTAR) project, NASA Langley Research Center (LaRC) has developed a subscaled flying testbed in order to conduct research experiments in support of the goals of NASA s Aviation Safety Program. This research capability consists of three distinct components. The first of these is the research aircraft, of which there are several in the AirSTAR stable. These aircraft range from a dynamically-scaled, twin turbine vehicle to a propeller driven, off-the-shelf airframe. Each of these airframes carves out its own niche in the research test program. All of the airplanes have sophisticated on-board data acquisition and actuation systems, recording, telemetering, processing, and/or receiving data from research control systems. The second piece of the testbed is the ground facilities, which encompass the hardware and software infrastructure necessary to provide comprehensive support services for conducting flight research using the subscale aircraft, including: subsystem development, integrated testing, remote piloting of the subscale aircraft, telemetry processing, experimental flight control law implementation and evaluation, flight simulation, data recording/archiving, and communications. The ground facilities are comprised of two major components: (1) The Base Research Station (BRS), a LaRC laboratory facility for system development, testing and data analysis, and (2) The Mobile Operations Station (MOS), a self-contained, motorized vehicle serving as a mobile research command/operations center, functionally equivalent to the BRS, capable of deployment to remote sites for supporting flight tests. The third piece of the testbed is the test facility itself. Research flights carried out by the AirSTAR team are conducted at NASA Wallops Flight Facility (WFF) on the Eastern Shore of Virginia. The UAV Island runway is a 50 x 1500 paved runway that lies within restricted airspace at Wallops Flight Facility. The facility provides all the necessary infrastructure to conduct the research flights in a safe and efficient manner. This paper gives a comprehensive overview of the development of the AirSTAR testbed.

Hepatitis B maternal screening, infant vaccination, and infant prophylaxis practices in North Carolina.

PubMed

Pierce, R L; Smith, S; Rowe-West, B; Sterritt, B

1999-06-01

To determine if the Advisory Committee on Immunization Practices hepatitis B screening, vaccination, and prophylaxis recommendations were being followed in North Carolina, and to establish a baseline hepatitis B seroprevalence rate. A survey of mother and infant birthing facility medical records. Four birthing facilities selected from each of the 7 districts in North Carolina (a total of 28 facilities). A probability proportional to size survey design was used to select 4763 mother-infant record pairs. All records came from the 1996 birth cohort. Maternal hepatitis B screening status, infant vaccination status, infants prophylaxis status, hepatitis B seroprevalence rate, demographic and clinical predictors for maternal infection, failure to receive prenatal care or for whom status was unknown, failure to screen, and failure to vaccinate. Ninety-two percent of pregnant women were screened for hepatitis B surface antigen. Eighty-six percent of infants received dose 1 of the hepatitis B vaccine. Four of the 9 infants with mothers who were hepatitis B surface antigen-positive did not receive both vaccine and hepatitis B immune globulin. The hepatitis B seroprevalence rate was 0.2%. Mothers who were not screened for infection were 3.4 times more likely to have infants who were not vaccinated. White mothers were twice as likely not to have their child vaccinated as mothers of other races. Not all infants with hepatitis B-infected mothers were receiving vaccine and hepatitis B immune globulin as recommended. Seroprevalence of hepatitis B infection may be lower in North Carolina than in other states. Hepatitis B laboratory test results should be included in every mother's medical record.

Experimental Validation: Subscale Aircraft Ground Facilities and Integrated Test Capability

NASA Technical Reports Server (NTRS)

Bailey, Roger M.; Hostetler, Robert W., Jr.; Barnes, Kevin N.; Belcastro, Celeste M.; Belcastro, Christine M.

2005-01-01

Experimental testing is an important aspect of validating complex integrated safety critical aircraft technologies. The Airborne Subscale Transport Aircraft Research (AirSTAR) Testbed is being developed at NASA Langley to validate technologies under conditions that cannot be flight validated with full-scale vehicles. The AirSTAR capability comprises a series of flying sub-scale models, associated ground-support equipment, and a base research station at NASA Langley. The subscale model capability utilizes a generic 5.5% scaled transport class vehicle known as the Generic Transport Model (GTM). The AirSTAR Ground Facilities encompass the hardware and software infrastructure necessary to provide comprehensive support services for the GTM testbed. The ground facilities support remote piloting of the GTM aircraft, and include all subsystems required for data/video telemetry, experimental flight control algorithm implementation and evaluation, GTM simulation, data recording/archiving, and audio communications. The ground facilities include a self-contained, motorized vehicle serving as a mobile research command/operations center, capable of deployment to remote sites when conducting GTM flight experiments. The ground facilities also include a laboratory based at NASA LaRC providing near identical capabilities as the mobile command/operations center, as well as the capability to receive data/video/audio from, and send data/audio to the mobile command/operations center during GTM flight experiments.

Conceptual Design of an In-Space Cryogenic Fluid Management Facility

NASA Technical Reports Server (NTRS)

Willen, G. S.; Riemer, D. H.; Hustvedt, D. C.

1981-01-01

The conceptual design of a Spacelab experiment to develop the technology associated with low gravity propellant management is presented. The proposed facility consisting of a supply tank, receiver tank, pressurization system, instrumentation, and supporting hardware, is described. The experimental objectives, the receiver tank to be modeled, and constraints imposed on the design by the space shuttle, Spacelab, and scaling requirements, are described. The conceptual design, including the general configurations, flow schematics, insulation systems, instrumentation requirements, and internal tank configurations for the supply tank and the receiver tank, is described. Thermal, structural, fluid, and safety and reliability aspects of the facility are analyzed. The facility development plan, including schedule and cost estimates for the facility, is presented. A program work breakdown structure and master program schedule for a seven year program are included.

CONCEPTUAL DESIGN ASSESSMENT FOR THE COFIRING OF BIOREFINERY SUPPLIED LIGNIN PROJECT

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

David J. Webster; Jeffrey T. Ranney; Jacqueline G. Broder

2002-07-01

The major aspects of this project are proceeding toward completion. Prior to this quarter, design criteria, tentative site selection, facility layout, and preliminary facility cost estimates were completed. Processing of biosolids and pilot facility hydrolysis production have been completed to produce lignin for cofire testing. EERC had received all the biomass and baseline coal fuels for use in testing. All the combustion and fuel handling tests at EERC have been completed. During fuel preparation EERC reported no difficulties in fuel blending and handling. Preliminary cofire test results indicate that the blending of lignin and biosolids with the Colbert coal blendmore » generally reduces NOx emissions, increases the reactivity of the coal, and increases the ash deposition rate on superheater surfaces. Deposits produced from the fuel blends, however, are more friable and hence easier to remove from tube surfaces relative to those produced from the baseline Colbert coal blend. A draft of the final cofire technical report entitled ''Effects of Cofiring Lignin and Biosolids with Coal on Fireside Performance and Combustion Products'' has been prepared and is currently being reviewed by project team members. A final report is expected by mid-third quarter 2002. The TVA-Colbert facility has neared completion of the task to evaluate co-location of the Masada facility on the operation of the power generation facility. The TVA-Colbert fossil plant is fully capable of providing a reliable steam supply. The environmental review, preferred steam supply connection points and steam pipeline routing, and assessment of steam export impacts have been completed without major issue. A cost estimate for the steam supply system was also completed. TVA is further evaluating the impacts of adding lignin to the coal fuel blend and how the steam cost is impacted by proximity of the Masada biomass facility. TVA has provided a draft final report that is under review by team members.« less

Neighborhood support network, perceived proximity to community facilities and depressive symptoms among low socioeconomic status Chinese elders.

PubMed

Chen, Yan-Yan; Wong, Gloria H Y; Lum, Terry Y; Lou, Vivian W Q; Ho, Andy H Y; Luo, Hao; Tong, Tracy L W

2016-01-01

Depressive symptoms are common in older people; most previous research on elderly depression focused on individual-level characteristics or neighborhood socioeconomic status. Modifiable neighborhood characteristics of older people dwelling in low-income communities are under-studied. This study aims to identify potentially modifiable social and physical neighborhood characteristics that influence depressive symptoms independent of individual-level characteristics among older Chinese. Data came from a cross-sectional survey conducted in four low-income public rental housing estates in Hong Kong in 2012. We interviewed a total of 400 elderly residents. The structured questionnaire covered demographics, activities of daily living, recent fall history, neighborhood support networks, and perceived proximity by walk to community facilities. Multiple regression was used to test whether inclusion of neighborhood factors in addition to individual characteristics increases model fit in explaining depressive symptoms in elders with low socioeconomic status. At individual level, activities of daily living and income significantly predicted depressive symptoms. Receiving support from friends or neighbors is associated with fewer depressive symptoms. However, participants who received organizational support had a 1.17 points of increase on the 15-item Geriatric Depression Scale (GDS-15). At-ease walkable proximity to medical facilities was positively associated with a better GDS score. Neighborhood support networks and perceived proximity by walk to community facilities contribute significantly to depressive symptoms among low-income elders. Programs and policies that facilitate neighborhood support and commuting or promote facility accessibility may help ameliorate depressive symptoms common among low-income elders.

Stockouts of HIV commodities in public health facilities in Kinshasa: Barriers to end HIV

PubMed Central

Bossard, Claire; Verdonck, Kristien; Owiti, Philip; Casteels, Ilse; Mashako, Maria; Van Cutsem, Gilles; Ellman, Tom

2018-01-01

Stockouts of HIV commodities increase the risk of treatment interruption, antiretroviral resistance, treatment failure, morbidity and mortality. The study objective was to assess the magnitude and duration of stockouts of HIV medicines and diagnostic tests in public facilities in Kinshasa, Democratic Republic of the Congo. This was a cross-sectional survey involving visits to facilities and warehouses in April and May 2015. All zonal warehouses, all public facilities with more than 200 patients on antiretroviral treatment (ART) (high-burden facilities) and a purposive sample of facilities with 200 or fewer patients (low-burden facilities) in Kinshasa were selected. We focused on three adult ART formulations, cotrimoxazole tablets, and HIV diagnostic tests. Availability of items was determined by physical check, while stockout duration until the day of the survey visit was verified with stock cards. In case of ART stockouts, we asked the pharmacist in charge what the facility coping strategy was for patients needing those medicines. The study included 28 high-burden facilities and 64 low-burden facilities, together serving around 22000 ART patients. During the study period, a national shortage of the newly introduced first-line regimen Tenofovir-Lamivudine-Efavirenz resulted in stockouts of this regimen in 56% of high-burden and 43% of low-burden facilities, lasting a median of 36 (interquartile range 29–90) and 44 days (interquartile range 24–90) until the day of the survey visit, respectively. Each of the other investigated commodities were found out of stock in at least two low-burden and two high-burden facilities. In 30/41 (73%) of stockout cases, the commodity was absent at the facility but present at the upstream warehouse. In 30/57 (54%) of ART stockout cases, patients did not receive any medicines. In some cases, patients were switched to different ART formulations or regimens. Stockouts of HIV commodities were common in the visited facilities. Introduction of new ART regimens needs additional planning. PMID:29351338

Stockouts of HIV commodities in public health facilities in Kinshasa: Barriers to end HIV.

PubMed

Gils, Tinne; Bossard, Claire; Verdonck, Kristien; Owiti, Philip; Casteels, Ilse; Mashako, Maria; Van Cutsem, Gilles; Ellman, Tom

2018-01-01

Stockouts of HIV commodities increase the risk of treatment interruption, antiretroviral resistance, treatment failure, morbidity and mortality. The study objective was to assess the magnitude and duration of stockouts of HIV medicines and diagnostic tests in public facilities in Kinshasa, Democratic Republic of the Congo. This was a cross-sectional survey involving visits to facilities and warehouses in April and May 2015. All zonal warehouses, all public facilities with more than 200 patients on antiretroviral treatment (ART) (high-burden facilities) and a purposive sample of facilities with 200 or fewer patients (low-burden facilities) in Kinshasa were selected. We focused on three adult ART formulations, cotrimoxazole tablets, and HIV diagnostic tests. Availability of items was determined by physical check, while stockout duration until the day of the survey visit was verified with stock cards. In case of ART stockouts, we asked the pharmacist in charge what the facility coping strategy was for patients needing those medicines. The study included 28 high-burden facilities and 64 low-burden facilities, together serving around 22000 ART patients. During the study period, a national shortage of the newly introduced first-line regimen Tenofovir-Lamivudine-Efavirenz resulted in stockouts of this regimen in 56% of high-burden and 43% of low-burden facilities, lasting a median of 36 (interquartile range 29-90) and 44 days (interquartile range 24-90) until the day of the survey visit, respectively. Each of the other investigated commodities were found out of stock in at least two low-burden and two high-burden facilities. In 30/41 (73%) of stockout cases, the commodity was absent at the facility but present at the upstream warehouse. In 30/57 (54%) of ART stockout cases, patients did not receive any medicines. In some cases, patients were switched to different ART formulations or regimens. Stockouts of HIV commodities were common in the visited facilities. Introduction of new ART regimens needs additional planning.

Preliminary Results, Analysis and Overview of Part -1 of the GOLD Experiment

NASA Technical Reports Server (NTRS)

Wilson, K. E.; Jeganathan, M.

1996-01-01

The Ground/Orbiter Lasercomm Demonstration (GOLD) is an optical communications demonstration between Japanese Engineering Test Satellite (ETS-V1) and an optical ground transmitting and receiving station at the Table Mountain Facility in Wrightwood California. Laser transmissions to the satellite were performed approximately four hours every third night when the satellite was at above Table Mountain.

KSC-06pd0022

NASA Image and Video Library

2006-01-11

KENNEDY SPACE CENTER, FLA. - In the Thermal Protection System Facility, Tim Wright, engineering manager with United Space Alliance, tests a new tile, called "Boeing replacement insulation" or "BRI-18." The new tiles will gradually replace older tiles around main landing gear doors, external tank doors and nose landing gear doors. Currently, 10 tiles have been processed inside the facility. Discovery will receive the first BRI-18 tiles. Technicians inside the Orbiter Processing Facility are performing fit checks and will begin bonding the tiles to the vehicle this month. The raw material is manufactured by The Boeing Company in Huntington Beach, Calif. Replacing older tile with the BRI-18 tile in strategic areas is one of the Columbia Accident Investigation Board's recommendations to strengthen the orbiters. The tiles are more impact resistant than previous designs, enhancing the crew’s safety.

KSC-06pd0021

NASA Image and Video Library

2006-01-11

KENNEDY SPACE CENTER, FLA. - In the Thermal Protection System Facility, Tim Wright, engineering manager with United Space Alliance, tests a new tile, called "Boeing replacement insulation" or "BRI-18." The new tiles will gradually replace older tiles around main landing gear doors, external tank doors and nose landing gear doors. Currently, 10 tiles have been processed inside the facility. Discovery will receive the first BRI-18 tiles. Technicians inside the Orbiter Processing Facility are performing fit checks and will begin bonding the tiles to the vehicle this month. The raw material is manufactured by The Boeing Company in Huntington Beach, Calif. Replacing older tile with the BRI-18 tile in strategic areas is one of the Columbia Accident Investigation Board's recommendations to strengthen the orbiters. The tiles are more impact resistant than previous designs, enhancing the crew’s safety.

Opt-out HIV testing of inmates in North Carolina prisons: Factors associated with not wanting a test and not knowing they were tested

PubMed Central

Grodensky, Catherine A.; Rosen, David L.; Hino, Sayaka; Golin, Carol E.; Wohl, David A.

2017-01-01

Opt-out HIV testing is recommended for correctional settings but may occur without inmates’ knowledge or against their wishes. Through surveying inmates receiving opt-out testing in a large prison system, we estimated the proportion unaware of being tested or not wanting a test, and associations (prevalence ratios [PRs]) with inmate characteristics. Of 871 tested, 11.8% were unknowingly tested and 10.8% had unwanted tests. Not attending an educational HIV course (PR=2.34, 95% CI 1.47–3.74), lower HIV knowledge (PR=0.95, 95% CI 0.91–0.98), and thinking testing is not mandatory (PR=9.84, 95% CI 4.93–19.67) were associated with unawareness of testing. No prior incarcerations (PR=1.59, 95% CI 1.03–2.46) and not using crack/cocaine recently (PR=2.37, 95% CI 1.21–4.64) were associated with unwanted testing. Residence at specific facilities was associated with both outcomes. Increased assessment of inmate understanding and enhanced implementation are needed to ensure inmates receive full benefits of opt-out testing: being informed and tested according to their wishes. PMID:26386591

The Single-Visit Approach as a Cervical Cancer Prevention Strategy Among Women With HIV in Ethiopia: Successes and Lessons Learned.

PubMed

Shiferaw, Netsanet; Salvador-Davila, Graciela; Kassahun, Konjit; Brooks, Mohamad I; Weldegebreal, Teklu; Tilahun, Yewondwossen; Zerihun, Habtamu; Nigatu, Tariku; Lulu, Kidest; Ahmed, Ismael; Blumenthal, Paul D; Asnake, Mengistu

2016-03-01

Cervical cancer is the second most common form of cancer for women in Ethiopia. Using a single-visit approach to prevent cervical cancer, the Addis Tesfa (New Hope) project in Ethiopia tested women with HIV through visual inspection of the cervix with acetic acid wash (VIA) and, if tests results were positive, offered immediate cryotherapy of the precancerous lesion or referral for loop electrosurgical excision procedure (LEEP). The objective of this article is to review screening and treatment outcomes over nearly 4 years of project implementation and to identify lessons learned to improve cervical cancer prevention programs in Ethiopia and other resource-constrained settings. We analyzed aggregate client data from August 2010 to March 2014 to obtain the number of women with HIV who were counseled, screened, and treated, as well as the number of annual follow-up visits made, from the 14 tertiary- and secondary-level health facilities implementing the single-visit approach. A health facility assessment (HFA) was also implemented from August to December 2013 to examine the effects of the single-visit approach on client flow, staff workload, and facility infrastructure 3 years after initiating the approach. Almost all (99%) of the 16,632 women with HIV counseled about the single-visit approach were screened with VIA during the study period; 1,656 (10%) of them tested VIA positive (VIA+) for precancerous lesions. Among those who tested VIA+ and were thus eligible for cryotherapy, 1,481 (97%) received cryotherapy treatment, but only 80 (63%) women eligible for LEEP actually received the treatment. The HFA results showed frequent staff turnover, some shortage of essential supplies, and rooms that were judged by providers to be too small for delivery of cervical cancer prevention services. The high proportions of VIA screening and cryotherapy treatment in the Addis Tesfa project suggest high acceptance of such services by women with HIV and feasibility of implementation in secondary- and tertiary-level health facilities. However, success of cervical cancer prevention programming must address wider health system challenges to ensure sustainability and appropriate scale-up to the general population of Ethiopia and other resource-constrained settings. © Shiferaw et al.

Prevalence and correlates of human immunodeficiency virus testing and posttest counseling among outpatients with serious mental illness.

PubMed

Desai, Mayur M; Rosenheck, Robert A; Desai, Rani A

2007-09-01

This study examined the prevalence and correlates of receipt of human immunodeficiency virus (HIV) testing, test results, and posttest counseling among outpatients with serious mental illness at 3 public-sector facilities in Connecticut (N = 487). A substantial proportion (41.9%) reported never having been tested for HIV, including fully one-third of those who were "very afraid" of getting acquired immune deficiency syndrome. Independent correlates of HIV testing included younger age, felony criminal history, stronger therapeutic alliance with one's primary clinician, and increased drug problems and psychological distress. Of those tested, nearly all (96.5%) reported receiving the test results; however, only half (50.5%) reported receiving any posttest counseling. Independent correlates of posttest counseling included higher educational level, felony criminal history, and receipt of community-based case management services. Greater efforts are needed to increase HIV testing and counseling among persons with serious mental illness to better identify and care for HIV-positive individuals and potentially reduce future transmission of the virus in this vulnerable, at-risk population.

Triamcinolone Acetonide Decreases Outflow Facility in C57BL/6 Mouse Eyes

PubMed Central

Kumar, Sandeep; Shah, Shaily; Deutsch, Emily Rose; Tang, Hai Michael; Danias, John

2013-01-01

Purpose. To determine the effect of triamcinolone acetonide (TA) on outflow facility in mice. Methods. Animals received 20 μL of TA (40 mg/mL) suspension subconjunctivally either bilaterally or unilaterally and were euthanized after either 1 week or 3 weeks. Before mice were killed, IOP was measured with a rebound tonometer. Outflow facility was determined using simultaneous pressure and flow measurements. Another set of animals received bilateral injection of anecortave acetate (AA) with or without bilateral TA injection and their outflow facility was also determined. Myocilin expression was investigated in a subset of eyes using quantitative PCR (qPCR). Results. Outflow facility of eyes in animals receiving bilateral TA injection (TABL) and TA-treated eyes of animals receiving unilateral injection (TAUL) was significantly decreased compared to naïve control eyes (Cnaive) after 1 week and 3 weeks of TA treatment (ANOVA P < 0.01, P < 0.001, respectively). Eyes treated with AA (with or without TA) had higher outflow facility than animals treated with TA (P < 0.05). IOP data did not show any significant difference between groups. qPCR analysis revealed significant decrease in myocilin expression in eyes receiving AA compared to naïve control and TA-treated eyes (ANOVA P < 0.001). Conclusions. Steroid treatment significantly decreases outflow facility in C57BL/6 mice despite having small effect on IOP. This animal model can be useful for studying the pathogenesis of steroid-induced glaucoma. PMID:23322580

Quality Improvement Intervention for Reduction of Redundant Testing.

PubMed

Ducatman, Alan M; Tacker, Danyel H; Ducatman, Barbara S; Long, Dustin; Perrotta, Peter L; Lawther, Hannah; Pennington, Kelly; Lander, Owen; Warden, Mary; Failinger, Conard; Halbritter, Kevin; Pellegrino, Ronald; Treese, Marney; Stead, Jeffrey A; Glass, Eric; Cianciaruso, Lauren; Nau, Konrad C

2017-01-01

Laboratory data are critical to analyzing and improving clinical quality. In the setting of residual use of creatine kinase M and B isoenzyme testing for myocardial infarction, we assessed disease outcomes of discordant creatine kinase M and B isoenzyme +/troponin I (-) test pairs in order to address anticipated clinician concerns about potential loss of case-finding sensitivity following proposed discontinuation of routine creatine kinase and creatine kinase M and B isoenzyme testing. Time-sequenced interventions were introduced. The main outcome was the percentage of cardiac marker studies performed within guidelines. Nonguideline orders dominated at baseline. Creatine kinase M and B isoenzyme testing in 7496 order sets failed to detect additional myocardial infarctions but was associated with 42 potentially preventable admissions/quarter. Interruptive computerized soft stops improved guideline compliance from 32.3% to 58% ( P < .001) in services not receiving peer leader intervention and to >80% ( P < .001) with peer leadership that featured dashboard feedback about test order performance. This successful experience was recapitulated in interrupted time series within 2 additional services within facility 1 and then in 2 external hospitals (including a critical access facility). Improvements have been sustained postintervention. Laboratory cost savings at the academic facility were estimated to be ≥US$635 000 per year. National collaborative data indicated that facility 1 improved its order patterns from fourth to first quartile compared to peer norms and imply that nonguideline orders persist elsewhere. This example illustrates how pathologists can provide leadership in assisting clinicians in changing laboratory ordering practices. We found that clinicians respond to local laboratory data about their own test performance and that evidence suggesting harm is more compelling to clinicians than evidence of cost savings. Our experience indicates that interventions done at an academic facility can be readily instituted by private practitioners at external facilities. The intervention data also supplement existing literature that electronic order interruptions are more successful when combined with modalities that rely on peer education combined with dashboard feedback about laboratory order performance. The findings may have implications for the role of the pathology laboratory in the ongoing pivot from quantity-based to value-based health care.

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

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

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

2002-04-01

The major aspects of this project are proceeding toward completion. Prior to this quarter, design criteria, tentative site selection, facility layout, and preliminary facility cost estimates were completed and issued. Processing of bio-solids was completed, providing material for the pilot operations. Pilot facility hydrolysis production has been completed to produce lignin for co-fire testing and the lignin fuel was washed and dewatered. Both the lignin and bio-solids fuel materials for co-fire testing were sent to the co-fire facility (EERC) for evaluation and co-firing. EERC has received coal typical of the fuel to the TVA-Colbert boilers. This material was used atmore » EERC as baseline material and for mixing with the bio-fuel for combustion testing. All the combustion and fuel handling tests at EERC have been completed. During fuel preparation EERC reported no difficulties in fuel blending and handling. Preliminary co-fire test results indicate that the blending of lignin and bio-solids with the Colbert coal blend generally reduces NO{sub x} emissions, increases the reactivity of the coal, and increases the ash deposition rate on superheater surfaces. Deposits produced from the fuel blends, however, are more friable and hence easier to remove from tube surfaces relative to those produced from the baseline Colbert coal blend. The final co-fire testing report is being prepared at EERC and will be completed by the end of the second quarter of 2002. The TVA-Colbert facility has neared completion of the task to evaluate co-location of the Masada facility on the operation of the power generation facility. The TVA-Colbert fossil plant is fully capable of providing a reliable steam supply. The preferred steam supply connection points and steam pipeline routing have been identified. The environmental review of the pipeline routing has been completed and no major impacts have been identified. Detailed assessment of steam export impacts on the Colbert boiler system have been completed and a cost estimate for the steam supply system was completed. The cost estimate and output and heat rate impacts have been used to determine a preliminary price for the exported steam. TVA is further evaluating the impacts of adding lignin to the coal fuel blend and how the steam cost is impacted by proximity of the Masada biomass facility.« less

Prior HIV Testing among STD Patients in Guangdong Province, China: Opportunities for Expanding Detection of Sexually Transmitted HIV Infection

PubMed Central

Tucker, Joseph D; Yang, Li-Gang; Yang, Bin; Young, Darwin; Henderson, Gail E; Huang, Shu-Jie; Lu, He-Kun; Chen, Xiang-Sheng; Cohen, Myron S

2011-01-01

Background Expanding HIV testing is important among individuals at increased risk for sexual HIV transmission in China, but little is known about prior HIV testing experiences among sexually transmitted disease (STD) patients. Methods This cross-sectional study of 1792 outpatients from six public sexually transmitted disease (STD) clinics in Guangdong Province recorded detailed information about ever having been tested for HIV infection in addition to socio-demographic variables, health seeking, clinical STD history, and HIV stigma using a validated survey instrument. Results 456 (25.4%) of the STD patients in this sample had ever been tested for HIV infection. STD patients who were male, had higher income, more education, were at City A and City C, received STD services at public facilities, had used intravenous drugs, and had a history of an STD were more likely to ever receive an HIV test in multivariate analysis. Low perceived HIV risk was the most common reason for not receiving an HIV test. Only 7.7% of the sample reported fear of discrimination or loss of face as influencing their lack of HIV testing. Conclusion Incomplete prior HIV screening among STD patients in China suggests the need for broadening HIV testing opportunities at STD clinics and similar clinical settings attended by those with increased sexual risk. PMID:22337103

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

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

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

2001-07-01

The major aspects of this project are proceeding toward completion. Prior to this quarter, design criteria, tentative site selection, facility layout, and preliminary facility cost estimates were completed and issued. Processing of bio-solids was completed, providing material for the pilot operations. Pilot facility design, equipment selection, and modification were completed during the fourth quarter of 2000. Initial pilot facility shakedown was completed during the fourth quarter. After some unavoidable delays, a suitable representative supply of MSW feed material was procured. During this first quarter of 2001, shredding of the feed material and final feed conditioning were completed. Pilot facility hydrolysismore » production was completed to produce lignin for co-fire testing. During this quarter, TVA completed the washing and dewatering of the lignin material produced from the MSW hydrolysis. Seven drums of lignin material were washed to recover the acid and sugar from the lignin and provide an improved fuel for steam generation. Samples of both the lignin and bio-solids fuel materials for co-fire testing were sent to the co-fire facility (EERC) for evaluation. After sample evaluation, EERC approved sending the material and all of the necessary fuel for testing was shipped to EERC. EERC has requested and will receive coal typical of the fuel to the TVA-Colbert boilers. This material will be used at EERC as baseline material and for mixing with the bio-fuel for combustion testing. EERC combustion testing of the bio based fuels is scheduled to begin in August of 2001. The TVA-Colbert facility has neared completion of the task to evaluate the co-location of the Masada facility on the operation of the power generation facility. The TVA-Colbert fossil plant is fully capable of providing a reliable steam supply. The preferred steam supply connection points and steam pipeline routing have been identified. The environmental review of the pipeline routing has been completed and no major impacts have been identified. Detailed assessment of steam export impacts on the Colbert boiler system have been completed and a cost estimate for steam supply system was completed. The cost estimate and the output and heat rate impacts will be used to determine a preliminary price for the exported steam. The preliminary steam price will be determined in the next quarter.« less

ESO adaptive optics facility progress report

NASA Astrophysics Data System (ADS)

Arsenault, Robin; Madec, Pierre-Yves; Paufique, Jerome; La Penna, Paolo; Stroebele, Stefan; Vernet, Elise; Pirard, Jean-Francois; Hackenberg, Wolfgang; Kuntschner, Harald; Jochum, Lieselotte; Kolb, Johann; Muller, Nicolas; Le Louarn, Miska; Amico, Paola; Hubin, Norbert; Lizon, Jean-Louis; Ridings, Rob; Abad, Jose A.; Fischer, Gert; Heinz, Volker; Kiekebusch, Mario; Argomedo, Javier; Conzelmann, Ralf; Tordo, Sebastien; Donaldson, Robert; Soenke, Christian; Duhoux, Philippe; Fedrigo, Enrico; Delabre, Bernard; Jost, Andreas; Duchateau, Michel; Downing, Mark; Moreno, Javier R.; Dorn, Reinhold; Manescau, Antonio; Bonaccini Calia, Domenico; Quattri, Marco; Dupuy, Christophe; Guidolin, Ivan M.; Comin, Mauro; Guzman, Ronald; Buzzoni, Bernard; Quentin, Jutta; Lewis, Steffan; Jolley, Paul; Kraus, Maximilian; Pfrommer, Thomas; Biasi, Roberto; Gallieni, Daniele; Bechet, Clementine; Stuik, Remko

2012-07-01

The ESO Adaptive Optics Facility (AOF) consists in an evolution of one of the ESO VLT unit telescopes to a laser driven adaptive telescope with a deformable mirror in its optical train. The project has completed the procurement phase and several large structures have been delivered to Garching (Germany) and are being integrated (the AO modules GRAAL and GALACSI and the ASSIST test bench). The 4LGSF Laser (TOPTICA) has undergone final design review and a pre-production unit has been built and successfully tested. The Deformable Secondary Mirror is fully integrated and system tests have started with the first science grade thin shell mirror delivered by SAGEM. The integrated modules will be tested in stand-alone mode in 2012 and upon delivery of the DSM in late 2012, the system test phase will start. A commissioning strategy has been developed and will be updated before delivery to Paranal. A substantial effort has been spent in 2011-2012 to prepare the unit telescope to receive the AOF by preparing the mechanical interfaces and upgrading the cooling and electrical network. This preparation will also simplify the final installation of the facility on the telescope. A lot of attention is given to the system calibration, how to record and correct any misalignment and control the whole facility. A plan is being developed to efficiently operate the AOF after commissioning. This includes monitoring a relevant set of atmospheric parameters for scheduling and a Laser Traffic control system to assist the operator during the night and help/support the observing block preparation.

An assessment of mother-to-child HIV transmission prevention in 16 pilot antenatal clinics in Jamaica.

PubMed

Harvey, K M; Figueroa, J P; Tomlinson, J; Gebre, Y; Forbes, S; Toyloy, T; Thompson, T; Thompson, K

2004-10-01

This study aims to determine the number and age distribution of pregnant women testing positive for HIV at 16 selected clinics in Jamaica between 2001 and 2002; the utilization of therapeutic interventions to minimize the risk of mother-to-child transmission (MTCT) and the current status of the HIV-exposed infants and, finally, the number of children who received testing for detection of HIV and to calculate the incidence of MTCT in these children. A retrospective study was carried out at sixteen pilot clinic sites by examining the patient records for all confirmed HIV-positive pregnant mothers and the resultant infants at these facilities for the period January 2001 to December 2002. One hundred and twenty-three of 8116 pregnant women newly tested positive during the period January 2001 to December 2002; however, 176 HIV+ women delivered. Fifty-three (30%) knew their HIV status prior to participating in the programme. Sixty-two (1.4%) and 61 (1.6%) tested positive in 2001 and 2002, respectively. One hundred and ten (77%) and 113 (83%) mothers and infants, respectively, received ARV therapy, (92% - nevirapine, 8% - zidovudine). Twenty-three per cent of pregnant women received no ARV Forty-four (25.0%) of the 176 infants had a documented ELISA HIV test before eighteen months of age, none had a PCR test. The health status of 40 (23%) of these children was known: 30 (75%) were alive and well, five of whom did not receive any ARV, one (2.5%) was alive and ill and nine (22.5%) were reported dead, five of whom received ARV; 28.6% of infants who did not receive ARV were reported as either dead or ill compared to 13.8% of those receiving ARV CONCLUSION: Though the majority of pregnant women discovered their HIV status during pregnancy, a significant number got pregnant knowing that they were HIV+. The majority of mothers and infants received ARV but the follow-up and testing of infants was limited. Nevirapine is clearly protective in the prevention of MTCT of HIV and should be made universally accessible. All infants delivered to HIV+ mothers should be identified and tested for HIV.

Radiological Worker II Training, Course 20301 (Live), Course 12909 (Test)

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

Harris, Jimmy D.

Radiological worker training is the basic building block for any additional radiological training you may receive. Upon completing radiological worker training, you will have the basic knowledge needed to work safely, using proper radiological practices, in areas where radiological hazards exist. You will also have a better understanding of the hazards and responsibilities associated with radiological work to help prevent the carelessness that can occur when working continually with or around radioactive material. This course does not qualify you for any specific radiological work. You may be required to take additional training at individual facilities to address facility- and job-specificmore » hazards and procedures.« less

Molten salt thermal energy storage subsystem for Solar Thermal Central Receiver plants

NASA Astrophysics Data System (ADS)

Wells, P. B.; Nassopoulos, G. P.

The development of a low-cost thermal energy storage subsystem for large solar plants is analyzed. Molten nitrate salt is used as both the plant's working fluid and as the storage medium. The storage system comprises a specially designed hot tank to hold salt at a storage temperature of 839 K (1050 F) and a separate carbon steel cold tank to hold the salt after its thermal energy has been extracted to generate steam. The hot tank is lined with insulating firebrick to lower the shell temperature to 561 K (550 F) so that a low-cost carbon steel shell can be used. A preliminary design is described for a large commercial-size plant (1200 MWht). Also described are a laboratory test program for the critical components and the design, construction, and test of a small-scale research experiment at the Central Receiver Test Facility in Albuquerque, New Mexico.

Health Workers' Use of Malaria Rapid Diagnostic Tests (RDTs) to Guide Clinical Decision Making in Rural Dispensaries, Tanzania

PubMed Central

Masanja, M. Irene; McMorrow, Meredith; Kahigwa, Elizeus; Kachur, S. Patrick; McElroy, Peter D.

2010-01-01

Rapid diagnostic tests (RDTs) were developed as an alternative to microscopy for malaria diagnosis. The RDTs detect malaria parasite antigen(s) in whole blood with high sensitivity and specificity. We assessed health worker malaria treatment practices after the introduction of RDTs in peripheral health facilities without microscopy. From December 2007 to October 2008, we introduced histidine-rich protein II (HRP-2)-based ParaHIT RDTs for routine use in 12 health facilities in Rufiji District, Tanzania. Health workers received training on how to perform RDTs for patients 5 years of age or older with fever or suspected malaria. Children < 5 years of age were to be treated empirically per national guidelines. Among the 30,195 patients seen at these 12 health facilities, 10,737 (35.6%) were tested with an RDT for malaria. 88.3% (9,405/10,648) of tested patients reported fever or history of fever and 2.7% (289/10,677) of all tested individuals were children < 5 years of age. The RDT results were recorded for 10,650 patients (99.2%). Among the 5,488 (51.5%) RDT-positive patients, 5,256 (98.6%) were treated with an appropriate first-line antimalarial per national guidelines (artemether-lumefantrine or quinine). Among the 5,162 RDT-negative patients, only 205 (4.0%) were treated with an antimalarial. Other reported treatments included antibiotics and antipyretics. Implementation of RDTs in rural health facilities resulted in high adherence to national treatment guidelines. Patients testing negative by RDT were rarely treated with antimalarials. Unapproved antimalarials were seldom used. Health workers continued to follow guidelines for the empiric treatment of febrile children. PMID:21118927

Effect of travel distance and time to radiotherapy on likelihood of receiving mastectomy.

PubMed

Goyal, Sharad; Chandwani, Sheenu; Haffty, Bruce G; Demissie, Kitaw

2015-04-01

Breast-conserving surgery (BCS) followed by adjuvant radiation therapy (RT) is the standard of care for women with early-stage breast cancer as an alternative to mastectomy. The purpose of this study was to examine the relationship between receipt of mastectomy and travel distance and time to RT facility in New Jersey (NJ). Data were collected from a cohort of 634 NJ women diagnosed with early-stage breast cancer. In patients receiving RT, the precise RT facility was used, whereas in patients not receiving RT, surgeons were contacted to determine the location of RT referral. Travel distance and time to RT facility from the patients' residential address were modeled separately using multiple binomial regression to examine their association with choice of surgery while adjusting for clinical and sociodemographic factors. Overall, 58.5 % patients underwent BCS with median travel distance to the radiation facility of 4.8 miles (vs. 6.6 miles for mastectomy) and median travel time of 12.0 min (vs. 15.0 min for mastectomy). Patients residing > 9.2 miles compared with ≤ 9.2 miles from radiation facility were 44 % more likely to receive mastectomy. Additionally, patients requiring > 19 min compared with ≤ 19 min of travel time were 36 % more likely to receive mastectomy. These data found that travel distance and time from RT facility act as barriers to undergoing BCS in women with early-stage breast cancer. Despite being in an urban region, a significant number of women in NJ with early-stage breast cancer did not receive BCS.

Design requirements, challenges, and solutions for high-temperature falling particle receivers

NASA Astrophysics Data System (ADS)

Christian, Joshua; Ho, Clifford

2016-05-01

Falling particle receivers (FPR) utilize small particles as a heat collecting medium within a cavity receiver structure. Previous analysis for FPR systems include computational fluid dynamics (CFD), analytical evaluations, and experiments to determine the feasibility and achievability of this CSP technology. Sandia National Laboratories has fabricated and tested a 1 MWth FPR that consists of a cavity receiver, top hopper, bottom hopper, support structure, particle elevator, flux target, and instrumentation. Design requirements and inherent challenges were addressed to enable continuous operation of flowing particles under high-flux conditions and particle temperatures over 700 °C. Challenges include being able to withstand extremely high temperatures (up to 1200°C on the walls of the cavity), maintaining particle flow and conveyance, measuring temperatures and mass flow rates, filtering out debris, protecting components from direct flux spillage, and measuring irradiance in the cavity. Each of the major components of the system is separated into design requirements, associated challenges and corresponding solutions. The intent is to provide industry and researchers with lessons learned to avoid pitfalls and technical problems encountered during the development of Sandia's prototype particle receiver system at the National Solar Thermal Test Facility (NSTTF).

Design, Fabrication, and Shakeout Testing of ATALANTE Dissolver Off-Gas Sorbent-Based Capture System

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

Walker, Jr, Joseph Franklin; Jubin, Robert Thomas; Jordan, Jacob A.

A sorbent-based capture system designed for integration into the existing dissolver off-gas (DOG) treatment system at the ATelier Alpha et Laboratoires pour ANalyses, Transuraniens et Etudes de retraitement (ATALANTE) facility has been successfully designed and fabricated and has undergone shakeout testing. Discussions with personnel from the ATALANTE facility provided guidance that was used for the design. All components for this system were specified, procured, and received on site at Oak Ridge National Laboratory (ORNL). The system was then fabricated and tested at ORNL to verify operation. Shakeout testing resulted in a simplified system. This system should be easily installed intomore » the existing facility and should be straightforward to operate during future experimental testing. All parts were selected to be compatible with ATALANTE power supplies, space requirements, and the existing DOG treatment system. Additionally, the system was demonstrated to meet all of four design requirements. These include (1) a dissolver off-gas flow rate of ≤100 L/h (1.67 L/min), (2) an external temperature of ≤50°C for all system components placed in the hot cell, (3) a sorbent bed temperature of ~150°C, and (4) a gas temperature of ~150°C upon entry into the sorbent bed. The system will be ready for shipment and installation in the existing DOG treatment system at ATALANTE in FY 2016.« less

Fractal-Like Materials Design with Optimized Radiative Properties for High-Efficiency Solar Energy Conversion

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

Ho, Clifford K.; Ortega, Jesus D.; Christian, Joshua Mark

Novel designs to increase light trapping and thermal efficiency of concentrating solar receivers at multiple length scales have been conceived, designed, and tested. The fractal-like geometries and features are introduced at both macro (meters) and meso (millimeters to centimeters) scales. Advantages include increased solar absorptance, reduced thermal emittance, and increased thermal efficiency. Radial and linear structures at the meso (tube shape and geometry) and macro (total receiver geometry and configuration) scales redirect reflected solar radiation toward the interior of the receiver for increased absorptance. Hotter regions within the interior of the receiver can reduce thermal emittance due to reduced localmore » view factors to the environment, and higher concentration ratios can be employed with similar surface irradiances to reduce the effective optical aperture, footprint, and thermal losses. Coupled optical/fluid/thermal models have been developed to evaluate the performance of these designs relative to conventional designs. Modeling results showed that fractal-like structures and geometries can increase the effective solar absorptance by 5 – 20% and the thermal efficiency by several percentage points at both the meso and macro scales, depending on factors such as intrinsic absorptance. Meso-scale prototypes were fabricated using additive manufacturing techniques, and a macro-scale bladed receiver design was fabricated using Inconel 625 tubes. On-sun tests were performed using the solar furnace and solar tower at the National Solar Thermal Test facility. The test results demonstrated enhanced solar absorptance and thermal efficiency of the fractal-like designs.« less

A NOVEL PROCESS TO USE SALT CAVERNS TO RECEIVE SHIP BORNE LNG

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

Michael M. McCall; William M. Bishop; Marcus Krekel

2005-05-31

This cooperative research project validates use of man made salt caverns to receive and store the cargoes of LNG ships in lieu of large liquid LNG tanks. Salt caverns will not tolerate direct injection of LNG because it is a cryogenic liquid, too cold for contact with salt. This research confirmed the technical processes and the economic benefits of pressuring the LNG up to dense phase, warming it to salt compatible temperatures and then directly injecting the dense phase gas into salt caverns for storage. The use of salt caverns to store natural gas sourced from LNG imports, particularly whenmore » located offshore, provides a highly secure, large scale and lower cost import facility as an alternative to tank based LNG import terminals. This design can unload a ship in the same time as unloading at a tank based terminal. The Strategic Petroleum Reserve uses man made salt caverns to securely store large quantities of crude oil. Similarly, this project describes a novel application of salt cavern gas storage technologies used for the first time in conjunction with LNG receiving. The energy industry uses man made salt caverns to store an array of gases and liquids but has never used man made salt caverns directly in the importation of LNG. This project has adapted and expanded the field of salt cavern storage technology and combined it with novel equipment and processes to accommodate LNG importation. The salt cavern based LNG receiving terminal described in the project can be located onshore or offshore, but the focus of the design and cost estimates has been on an offshore location, away from congested channels and ports. The salt cavern based terminal can provide large volumes of gas storage, high deliverability from storage, and is simplified in operation compared to tank based LNG terminals. Phase I of this project included mathematical modeling that proved a salt cavern based receiving terminal could be built at lower capital cost, and would have significantly higher delivery capacity, shorter construction time, and be much more secure than a conventional liquid tank based terminal. Operating costs of a salt cavern terminal are lower than tank based terminals because ''boil off'' is eliminated and maintenance costs of caverns are lower than LNG tanks. Phase II included the development of offshore mooring designs, wave tank tests, high pressure LNG pump field tests, heat exchanger field tests, and development of a model offshore LNG facility and cavern design. Engineers designed a model facility, prepared equipment lists, and confirmed capital and operating costs. In addition, vendors quoted fabrication and installation costs, confirming that an offshore salt cavern based LNG terminal would have lower capital and operating costs than a similarly sized offshore tank based terminal. Salt cavern storage is infinitely more secure than surface storage tanks, far less susceptible to accidents or purposeful damage, and much more acceptable to the community. More than thirty industry participants provided cost sharing, technical expertise, and guidance in the conduct and evaluation of the field tests, facility design and operating and cost estimates. Their close participation has accelerated the industry's acceptance of the conclusions of this research. The industry participants also developed and submitted several alternative designs for offshore mooring and for high pressure LNG heat exchangers in addition to those that were field tested in this project. HNG Storage, a developer, owner, and operator of natural gas storage facilities, and a participant in the DOE research has announced they will lead the development of the first offshore salt cavern based LNG import facility. Which will be called the Freedom LNG Terminal. It will be located offshore Louisiana, and is expected to be jointly developed with other members of the research group yet to be named. An offshore port license application is scheduled to be filed by fourth quarter 2005 and the terminal could be operational by 2009. This terminal allows the large volume importation of LNG without disrupting coastal port operations by being offshore, out of sight of land.« less

Malaria rapid diagnostic test in children: The Zamfara, Nigeria experience.

PubMed

Abdulkadir, Isa; Rufai, Hafsah Ahmad; Ochapa, Sunday Onazi; Malam, Mado Sani; Garba, Bilkisu Ilah; Oloko, Adebayo Ganiyu Yusuf; George, Idemudia Itoya

2015-01-01

Malaria remains a major cause of under-five morbidity and mortality in Nigeria, and prompt diagnosis occupies a strategic position in its management. Malaria rapid diagnostic test (RDT), a nontechnical, easy to perform test promises to meet this need. It is important to locally document the usefulness of the use of RDT in making prompt malaria diagnosis in children. To determine the prevalence of malaria and evaluate the diagnostic performance of malaria RDT kit in febrile under-five children presenting to a Tertiary Health Facility in Gusau, North-Western Nigeria. A cross-sectional study of children aged 6-59 months, evaluated for malaria in a tertiary health facility from August 2012 to January 2013. Information was obtained from care providers of all subjects with fever and a presumptive diagnosis of malaria. All subjects were investigated using Giemsa stain microscopy and Carestart™ malaria RDT. The prevalence of malaria in 250 febrile under-five children was 54%. Three-quarter (79%) of the children received inappropriate nonrecommended antimalaria prior to their presentation, including 20% who received chloroquine. The overall sensitivity of RDT was 40.3%. The specificity, positive and negative predictive values were 89.6%, 81.8%, and 56.5%, respectively. Use of RDT should be encouraged for screening and diagnosis using a protocol such that febrile children with positive RDT results are confirmed as having malaria while those with negative results are further evaluated using microscopy.

A Cabled Acoustic Telemetry System for Detecting and Tracking Juvenile Salmon: Part 1. Engineering Design and Instrumentation

PubMed Central

Weiland, Mark A.; Deng, Z. Daniel; Seim, Tom A.; LaMarche, Brian L.; Choi, Eric Y.; Fu, Tao; Carlson, Thomas J.; Thronas, Aaron I.; Eppard, M. Brad

2011-01-01

In 2001 the U.S. Army Corps of Engineers, Portland District (OR, USA), started developing the Juvenile Salmon Acoustic Telemetry System, a nonproprietary sensing technology, to meet the needs for monitoring the survival of juvenile salmonids through eight large hydroelectric facilities within the Federal Columbia River Power System (FCRPS). Initial development focused on coded acoustic microtransmitters and autonomous receivers that could be deployed in open reaches of the river for detection of the juvenile salmonids implanted with microtransmitters as they passed the autonomous receiver arrays. In 2006, the Pacific Northwest National Laboratory began the development of an acoustic receiver system for deployment at hydropower facilities (cabled receiver) for detecting fish tagged with microtransmitters as well as tracking them in two or three dimensions for determining route of passage and behavior as the fish passed at the facility. The additional information on route of passage, combined with survival estimates, is used by the dam operators and managers to make structural and operational changes at the hydropower facilities to improve survival of fish as they pass the facilities through the FCRPS. PMID:22163918

High-Efficiency Low-Cost Solar Receiver for Use Ina a Supercritical CO 2 Recompression Cycle

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

Sullivan, Shaun D.; Kesseli, James; Nash, James

This project has performed solar receiver designs for two supercritical carbon dioxide (sCO 2) power cycles. The first half of the program focused on a nominally 2 MWe power cycle, with a receiver designed for test at the Sandia Solar Thermal Test Facility. This led to an economical cavity-type receiver. The second half of the program focused on a 10 MWe power cycle, incorporating a surround open receiver. Rigorous component life and performance testing was performed in support of both receiver designs. The receiver performance objectives are set to conform to the US DOE goals of 6¢/kWh by 2020 .more » Key findings for both cavity-type and direct open receiver are highlighted below: A tube-based absorber design is impractical at specified temperatures, pressures and heat fluxes for the application; a plate-fin architecture however has been shown to meet performance and life targets; the $148/kW th cost of the design is significantly less than the SunShot cost target with a margin of 30%; the proposed receiver design is scalable, and may be applied to both modular cavity-type installations as well as large utility-scale open receiver installations; the design may be integrated with thermal storage systems, allowing for continuous high-efficiency electrical production during off-sun hours; costs associated with a direct sCO 2 receiver for a sCO 2 Brayton power cycle are comparable to those of a typical molten salt receiver; lifetimes in excess of the 90,000 hour goal are achievable with an optimal cell geometry; the thermal performance of the Brayton receiver is significantly higher than the industry standard, and enables at least a 30% efficiency improvement over the performance of the baseline steam-Rankine boiler/cycle system; brayton’s patent-pending quartz tube window provides a greater than five-percent efficiency benefit to the receiver by reducing both convection and radiation losses.« less

Early Results from Solar Dynamic Space Power System Testing

NASA Technical Reports Server (NTRS)

Shaltens, Richard K.; Mason, Lee S.

1996-01-01

A government/industry team designed, built and tested a 2-kWe solar dynamic space power system in a large thermal vacuum facility with a simulated Sun at the NASA Lewis Research Center. The Lewis facility provides an accurate simulation of temperatures, high vacuum and solar flux as encountered in low-Earth orbit. The solar dynamic system includes a Brayton power conversion unit integrated with a solar receiver which is designed to store energy for continuous power operation during the eclipse phase of the orbit. This paper reviews the goals and status of the Solar Dynamic Ground Test Demonstration project and describes the initial testing, including both operational and performance data. System testing to date has accumulated over 365 hours of power operation (ranging from 400 watts to 2.0-W(sub e)), including 187 simulated orbits, 16 ambient starts and 2 hot restarts. Data are shown for an orbital startup, transient and steady-state orbital operation and shutdown. System testing with varying insolation levels and operating speeds is discussed. The solar dynamic ground test demonstration is providing the experience and confidence toward a successful flight demonstration of the solar dynamic technologies on the Space Station Mir in 1997.

Factors associated with regular dental visits among hemodialysis patients

PubMed Central

Yoshioka, Masami; Shirayama, Yasuhiko; Imoto, Issei; Hinode, Daisuke; Yanagisawa, Shizuko; Takeuchi, Yuko; Bando, Takashi; Yokota, Narushi

2016-01-01

AIM To investigate awareness and attitudes about preventive dental visits among dialysis patients; to clarify the barriers to visiting the dentist. METHODS Subjects included 141 dentate outpatients receiving hemodialysis treatment at two facilities, one with a dental department and the other without a dental department. We used a structured questionnaire to interview participants about their awareness of oral health management issues for dialysis patients, perceived oral symptoms and attitudes about dental visits. Bivariate analysis using the χ2 test was conducted to determine associations between study variables and regular dental check-ups. Binominal logistic regression analysis was used to determine factors associated with regular dental check-ups. RESULTS There were no significant differences in patient demographics between the two participating facilities, including attitudes about dental visits. Therefore, we included all patients in the following analyses. Few patients (4.3%) had been referred to a dentist by a medical doctor or nurse. Although 80.9% of subjects had a primary dentist, only 34.0% of subjects received regular dental check-ups. The most common reasons cited for not seeking dental care were that visits are burdensome and a lack of perceived need. Patients with gum swelling or bleeding were much more likely to be in the group of those not receiving routine dental check-ups (χ2 test, P < 0.01). Logistic regression analysis demonstrated that receiving dental check-ups was associated with awareness that oral health management is more important for dialysis patients than for others and with having a primary dentist (P < 0.05). CONCLUSION Dialysis patients should be educated about the importance of preventive dental care. Medical providers are expected to participate in promoting dental visits among dialysis patients. PMID:27648409

Description of European Space Agency (ESA) Concept Development for a Mars Sample Receiving Facility (MSRF)

NASA Astrophysics Data System (ADS)

Vrublevskis, J.; Berthoud, L.; Guest, M.; Smith, C.; Bennett, A.; Gaubert, F.; Schroeven-Deceuninck, H.; Duvet, L.; van Winnendael, M.

2018-04-01

This presentation gives an overview of the several studies conducted for the European Space Agency (ESA) since 2007, which progressively developed layouts for a potential implementation of a Mars Sample Receiving Facility (MSRF).

The impact of facility audits, evaluation reports and incentives on motivation and supply management among family planning service providers: an interventional study in two districts in Maputo Province, Mozambique.

PubMed

Vermandere, Heleen; Galle, Anna; Griffin, Sally; de Melo, Málica; Machaieie, Lino; Van Braeckel, Dirk; Degomme, Olivier

2017-05-02

Good progress is being made towards universal access to contraceptives, however stock-outs still jeopardize progress. A seldom considered but important building block in optimizing supply management is the degree to which health workers feel motivated and responsible for monitoring supply. We explored how and to what extent motivation can be improved, and the impact this can have on avoiding stock-outs. Fifteen health facilities in Maputo Province, Mozambique, were divided into 3 groups (2 intervention groups and 1 control), and 10 monthly audits were implemented in each of these 15 facilities to collect data through examination of stock cards and stock-counts of 6 contraceptives. Based on these audits, the 2 intervention groups received a monthly evaluation report reflecting the quality of their supply management. One of these 2 groups was also awarded material incentives conditional on their performance. A Wilcoxon-Mann Whitney test was used to detect differences between the groups in the average number of stocked-out centres, while changes over time were verified through applying a Friedman test. Additionally, staff motivation was measured through interviewing health care providers of all centres at baseline, and after 5 and 10 months. To detect differences between the groups and changes over time, a Kruskal Wallis and a Wilcoxon signed-rank test were applied, respectively. Motivation reported by providers (n = 55, n = 40 and n = 39 at baseline, 1st and 2nd follow-up respectively) was high in all groups, during all rounds, and did not change over time. Facilities in the intervention groups had better supply management results (including less stock-outs) during the entire intervention period compared with those in the control group, but the difference was only significant for the group receiving both material incentives and a monthly evaluation. However, our data also suggest that supply management also improved in control facilities, receiving only a monthly audit. During this study, more stock-outs occurred for family planning methods with lower demand, but the number of stock-outs per family planning method in the intervention groups was only significantly lower, compared with the control group, for female condoms. While a rise in motivation was not measurable, stock management was enhanced possibly as a result of the monthly audits. This activity was primarily for data collection, but was described as motivating and supportive, indicating the importance of feedback on health workers' accomplishments. More research is needed to quantify the additional impact of the interventions (distribution of evaluation reports and material incentives) on staff motivation and supply management. Special attention should be paid to supply management of less frequently used contraceptive methods.

Randomized Multilevel Intervention to Improve Outcomes of Residents in Nursing Homes in Need of Improvement

PubMed Central

Rantz, Marilyn J.; Nahm, Helen E.; Zwygart-Stauffacher, Mary; Hicks, Lanis; Mehr, David; Flesner, Marcia; Petroski, Gregory F.; Madsen, Richard W.; Scott-Cawiezell, Jill

2012-01-01

Purpose A comprehensive multilevel intervention was tested to build organizational capacity to create and sustain improvement in quality of care and subsequently improve resident outcomes in nursing homes in need of improvement. Intervention facilities (n=29) received a two-year multilevel intervention with monthly on-site consultation from expert nurses with graduate education in gerontological nursing. Attention control facilities (n=29) that also needed to improve resident outcomes received monthly information about aging and physical assessment of elders. Design and Methods Randomized clinical trial of nursing homes in need of improving resident outcomes of bladder and bowel incontinence, weight loss, pressure ulcers, and decline in activities of daily living (ADL). It was hypothesized that following the intervention, experimental facilities would have better resident outcomes, higher quality of care, higher staff retention, more organizational attributes of improved working conditions than control facilities, similar staffing and staff mix, and lower total and direct care costs. Results The intervention did improve quality of care (p=0.02); there were improvements in pressure ulcers (p=0.05), weight loss (p=0.05). Staff retention, organizational working conditions, staffing, and staff mix and most costs were not affected by the intervention. Leadership turnover was surprisingly excessive in both intervention and control groups. Implications Some facilities that are in need of improving quality of care and resident outcomes are able to build the organizational capacity to improve while not increasing staffing or costs of care. Improvement requires continuous supportive consultation and leadership willing to involve staff and work together to build the systematic improvements in care delivery needed. PMID:21816681

Systems analysis and improvement to optimize pMTCT (SAIA): a cluster randomized trial

PubMed Central

2014-01-01

Background Despite significant increases in global health investment and the availability of low-cost, efficacious interventions to prevent mother-to-child HIV transmission (pMTCT) in low- and middle-income countries with high HIV burden, the translation of scientific advances into effective delivery strategies has been slow, uneven and incomplete. As a result, pediatric HIV infection remains largely uncontrolled. A five-step, facility-level systems analysis and improvement intervention (SAIA) was designed to maximize effectiveness of pMTCT service provision by improving understanding of inefficiencies (step one: cascade analysis), guiding identification and prioritization of low-cost workflow modifications (step two: value stream mapping), and iteratively testing and redesigning these modifications (steps three through five). This protocol describes the SAIA intervention and methods to evaluate the intervention’s impact on reducing drop-offs along the pMTCT cascade. Methods This study employs a two-arm, longitudinal cluster randomized trial design. The unit of randomization is the health facility. A total of 90 facilities were identified in Côte d’Ivoire, Kenya and Mozambique (30 per country). A subset was randomly selected and assigned to intervention and comparison arms, stratified by country and service volume, resulting in 18 intervention and 18 comparison facilities across all three countries, with six intervention and six comparison facilities per country. The SAIA intervention will be implemented for six months in the 18 intervention facilities. Primary trial outcomes are designed to assess improvements in the pMTCT service cascade, and include the percentage of pregnant women being tested for HIV at the first antenatal care visit, the percentage of HIV-infected pregnant women receiving adequate prophylaxis or combination antiretroviral therapy in pregnancy, and the percentage of newborns exposed to HIV in pregnancy receiving an HIV diagnosis eight weeks postpartum. The Consolidated Framework for Implementation Research (CFIR) will guide collection and analysis of qualitative data on implementation process. Discussion This study is a pragmatic trial that has the potential benefit of improving maternal and infant outcomes by reducing drop-offs along the pMTCT cascade. The SAIA intervention is designed to provide simple tools to guide decision-making for pMTCT program staff at the facility level, and to identify low cost, contextually appropriate pMTCT improvement strategies. Trial registration ClinicalTrials.gov NCT02023658 PMID:24885976

Systems analysis and improvement to optimize pMTCT (SAIA): a cluster randomized trial.

PubMed

Sherr, Kenneth; Gimbel, Sarah; Rustagi, Alison; Nduati, Ruth; Cuembelo, Fatima; Farquhar, Carey; Wasserheit, Judith; Gloyd, Stephen

2014-05-08

Despite significant increases in global health investment and the availability of low-cost, efficacious interventions to prevent mother-to-child HIV transmission (pMTCT) in low- and middle-income countries with high HIV burden, the translation of scientific advances into effective delivery strategies has been slow, uneven and incomplete. As a result, pediatric HIV infection remains largely uncontrolled. A five-step, facility-level systems analysis and improvement intervention (SAIA) was designed to maximize effectiveness of pMTCT service provision by improving understanding of inefficiencies (step one: cascade analysis), guiding identification and prioritization of low-cost workflow modifications (step two: value stream mapping), and iteratively testing and redesigning these modifications (steps three through five). This protocol describes the SAIA intervention and methods to evaluate the intervention's impact on reducing drop-offs along the pMTCT cascade. This study employs a two-arm, longitudinal cluster randomized trial design. The unit of randomization is the health facility. A total of 90 facilities were identified in Côte d'Ivoire, Kenya and Mozambique (30 per country). A subset was randomly selected and assigned to intervention and comparison arms, stratified by country and service volume, resulting in 18 intervention and 18 comparison facilities across all three countries, with six intervention and six comparison facilities per country. The SAIA intervention will be implemented for six months in the 18 intervention facilities. Primary trial outcomes are designed to assess improvements in the pMTCT service cascade, and include the percentage of pregnant women being tested for HIV at the first antenatal care visit, the percentage of HIV-infected pregnant women receiving adequate prophylaxis or combination antiretroviral therapy in pregnancy, and the percentage of newborns exposed to HIV in pregnancy receiving an HIV diagnosis eight weeks postpartum. The Consolidated Framework for Implementation Research (CFIR) will guide collection and analysis of qualitative data on implementation process. This study is a pragmatic trial that has the potential benefit of improving maternal and infant outcomes by reducing drop-offs along the pMTCT cascade. The SAIA intervention is designed to provide simple tools to guide decision-making for pMTCT program staff at the facility level, and to identify low cost, contextually appropriate pMTCT improvement strategies. ClinicalTrials.gov NCT02023658.

Association Between Facility-Level Utilization of Non-pharmacologic Chronic Pain Treatment and Subsequent Initiation of Long-Term Opioid Therapy.

PubMed

Carey, Evan P; Nolan, Charlotte; Kerns, Robert D; Ho, P Michael; Frank, Joseph W

2018-05-01

Expert guidelines recommend non-pharmacologic treatments and non-opioid medications for chronic pain and recommend against initiating long-term opioid therapy (LTOT). We examined whether veterans with incident chronic pain receiving care at facilities with greater utilization of non-pharmacologic treatments and non-opioid medications are less likely to initiate LTOT. Retrospective cohort study PARTICIPANTS: Veterans receiving primary care from a Veterans Health Administration facility with incident chronic pain between 1/1/2010 and 12/31/2015 based on either of 2 criteria: (1) persistent moderate-to-severe patient-reported pain and (2) diagnoses "likely to represent" chronic pain. The independent variable was facility-level utilization of pain-related treatment modalities (non-pharmacologic, non-opioid medications, LTOT) in the prior calendar year. The dependent variable was patient-level initiation of LTOT (≥ 90 days within 365 days) in the subsequent year, adjusting for patient characteristics. Among 1,094,569 veterans with incident chronic pain from 2010 to 2015, there was wide facility-level variation in utilization of 10 pain-related treatment modalities, including initiation of LTOT (median, 16%; range, 5-32%). Veterans receiving care at facilities with greater utilization of non-pharmacologic treatments were less likely to initiate LTOT in the year following incident chronic pain. Conversely, veterans receiving care at facilities with greater non-opioid and opioid medication utilization were more likely to initiate LTOT; this association was strongest for past year facility-level LTOT initiation (adjusted rate ratio, 2.10; 95% confidence interval, 2.06-2.15, top vs. bottom quartile of facility-level LTOT initiation in prior calendar year). Facility-level utilization patterns of non-pharmacologic, non-opioid, and opioid treatments for chronic pain are associated with subsequent patient-level initiation of LTOT among veterans with incident chronic pain. Further studies should seek to understand facility-level variation in chronic pain care and to identify facility-level utilization patterns that are associated with improved patient outcomes.

A Draft Protocol for Detecting Possible Biohazards in Martian Samples Returned to Earth

NASA Technical Reports Server (NTRS)

Viso, M.; DeVincenzi, D. L.; Race, M. S.; Schad, P. J.; Stabekis, P. D.; Acevedo, S. E.; Rummel, J. D.

2002-01-01

In preparation for missions to Mars that will involve the return of samples, it is necessary to prepare for the safe receiving, handling, testing, distributing, and archiving of martian materials here on Earth. Previous groups and committees have studied selected aspects of sample return activities, but a specific protocol for handling and testing of returned -=1 samples from Mars remained to be developed. To refine the requirements for Mars sample hazard testing and to develop criteria for the subsequent release of sample materials from precautionary containment, NASA Planetary Protection Officer, working in collaboration with CNES, convened a series of workshops to produce a Protocol by which returned martian sample materials could be assessed for biological hazards and examined for evidence of life (extant or extinct), while safeguarding the samples from possible terrestrial contamination. The Draft Protocol was then reviewed by an Oversight and Review Committee formed specifically for that purpose and composed of senior scientists. In order to preserve the scientific value of returned martian samples under safe conditions, while avoiding false indications of life within the samples, the Sample Receiving Facility (SRF) is required to allow handling and processing of the Mars samples to prevent their terrestrial contamination while maintaining strict biological containment. It is anticipated that samples will be able to be shipped among appropriate containment facilities wherever necessary, under procedures developed in cooperation with international appropriate institutions. The SRF will need to provide different types of laboratory environments for carrying out, beyond sample description and curation, the various aspects of the protocol: Physical/Chemical analysis, Life Detection testing, and Biohazard testing. The main principle of these tests will be described and the criteria for release will be discussed, as well as the requirements for the SRF and its personnel.

Satellite remote sensing facility for oceanograhic applications

NASA Technical Reports Server (NTRS)

Evans, R. H.; Kent, S. S.; Seidman, J. B.

1980-01-01

The project organization, design process, and construction of a Remote Sensing Facility at Scripps Institution of Oceanography at LaJolla, California are described. The facility is capable of receiving, processing, and displaying oceanographic data received from satellites. Data are primarily imaging data representing the multispectral ocean emissions and reflectances, and are accumulated during 8 to 10 minute satellite passes over the California coast. The most important feature of the facility is the reception and processing of satellite data in real time, allowing investigators to direct ships to areas of interest for on-site verifications and experiments.

Refusal of Recommended Chemotherapy for Ovarian Cancer: Risk Factors and Outcomes; a National Cancer Data Base Study.

PubMed

Wallace, Sumer K; Lin, Jeff F; Cliby, William A; Leiserowitz, Gary S; Tergas, Ana I; Bristow, Robert E

2016-05-01

To identify risk factors associated with refusal of recommended chemotherapy and its impact on patients with epithelial ovarian cancer (EOC). We identified patients in the National Cancer Data Base diagnosed with EOC from January 1998 to December 2011. Patients who refused chemotherapy were identified and compared with those who received recommended, multiagent chemotherapy. Univariate and multivariable analyses were performed using chi-square test with Bonferroni correction, binary logistic regression, log-rank test, and Cox proportional hazards modeling. The threshold for statistical significance was set at a P value of less than 0.05. From a cohort of 147,713 eligible patients, 2,707 refused chemotherapy. These patients were compared with 92,212 patients who received recommended multiagent chemotherapy. Older age, more medical comorbidities, not having insurance, and later year of diagnosis were directly and significantly associated with chemotherapy refusal when analyzed using multivariable logistic regression. In addition, lower-than-expected facility adherence to NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Ovarian Cancer, treatment at low-volume center, lower grade, and higher stage were all significantly and independently associated with chemotherapy refusal. Median overall survival of patients who received multiagent chemotherapy was significantly longer than that of those who refused chemotherapy (43 vs 4.8 months; P<.0005). After controlling for known patient, facility, and disease prognostic factors, chemotherapy refusal is significantly associated with increased risk of death. Refusal of recommended chemotherapy carries significant risk of early death from ovarian cancer. Our data demonstrate that the decision to refuse chemotherapy is multifactorial and, in addition to unalterable factors (eg, stage/grade, age), involves factors that can be changed, including facility type and payor. Efforts at addressing these discrepancies in care can improve compliance with chemotherapy recommendations in the NCCN Guidelines for Ovarian Cancer and outcomes. Copyright © 2016 by the National Comprehensive Cancer Network.

Improving antimicrobial use among health workers in first-level facilities: results from the multi-country evaluation of the Integrated Management of Childhood Illness strategy.

PubMed Central

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

2004-01-01

OBJECTIVE: The objective of this study was to assess the effect of Integrated Management of Childhood Illness (IMCI) case management training on the use of antimicrobial drugs among health-care workers treating young children at first-level facilities. Antimicrobial drugs are an essential child-survival intervention. Ensuring that children younger than five who need these drugs receive them promptly and correctly can save their lives. Prescribing these drugs only when necessary and ensuring that those who receive them complete the full course can slow the development of antimicrobial resistance. METHODS: Data collected through observation-based surveys in randomly selected first-level health facilities in Brazil, Uganda and the United Republic of Tanzania were statistically analysed. The surveys were carried out as part of the multi-country evaluation of IMCI effectiveness, cost and impact (MCE). FINDINGS: Results from three MCE sites show that children receiving care from health workers trained in IMCI are significantly more likely to receive correct prescriptions for antimicrobial drugs than those receiving care from workers not trained in IMCI.They are also more likely to receive the first dose of the drug before leaving the health facility, to have their caregiver advised how to administer the drug, and to have caregivers who are able to describe correctly how to give the drug at home as they leave the health facility. CONCLUSIONS: IMCI case management training is an effective intervention to improve the rational use of antimicrobial drugs for sick children visiting first-level health facilities in low-income and middle-income countries. PMID:15508195

Demonstration/Validation of Environmentally-Preferable Coatings for Launch Facilities

NASA Technical Reports Server (NTRS)

Lewis, Pattie

2011-01-01

Kennedy Space Center (KSC) is responsible for a number of facilities/structures with metallic structural and non-structural components in a highly corrosive environment. Metals require periodic maintenance activity to guard against the insidious effects of corrosion and thus ensure that structures meet or exceed design or performance life. The standard practice for protecting metallic substrates in atmospheric environments is the application of an applied coating system. Applied coating systems work via a variety of methods (barrier, galvanic and/or inhibitor) and adhere to the substrate through a combination of chemical and physical bonds. Maintenance at KSC and other NASA Centers is governed by NASA-STD-50088 (Protective Coating of Carbon Steel, Stainless Steel, and Aluminum on Launch Structures, Facilities, and Ground Support Equipment) which establishes practices for the protective coating of ground support equipment and related facilities used by or for NASA programs and projects. The Standard is for the design of non-flight hardware used to support the operations of receiving, transportation, handling, assembly, inspection, test, checkout, service, and launch of space vehicles and payloads at NASA launch, landing, or retrieval sites. These criteria and practices contained within the Standard may be used for items used at the manufacturing, development, and test sites upstream of the launch, landing, or retrieval sites. The objective of this effort is to demonstrate and validate environmentally-preferable alternatives in accordance with NASA-STD-50088 and KSC requirements which can then be added to the Approved Products List. This Test Protocol contains the critical requirements and tests necessary to qualify alternatives for structural steel applications. These tests were derived from engineering, performance, and operational impact (supportability) requirements defined by a consensus of KSC participants. A Test Report will document the results of the testing as well as any test modifications made during the execution of the testing. Users of this Test Protocol should check the project's Test Report for additional test details or minor modifications that may have been necessary in the execution of the testing. The technical stakeholders will have agreed upon test procedures modifications documented in the Test Report.

Violations of the international code of marketing of breast milk substitutes: prevalence in four countries

PubMed Central

Taylor, Anna

1998-01-01

Objective: To estimate the prevalence of violations of the international code of marketing of substitutes for breast milk in one city in each of Bangladesh, Poland, South Africa, and Thailand. Design: Multistage random sampling was used to select pregnant women and mothers of infants ⩽6 months old to interview at health facilities. Women were asked whether they had received free samples of substitutes for breast milk (including infant formula designed to meet the nutritional needs of infants from birth to 4 to 6 months of age, follow on formula designed to replace infant formula at the age of 4 to 6 months, and complementary foods for infants aged ⩽6 months), bottles, or teats. The source of the free sample and when it had been given to the women was also determined. 3 health workers were interviewed at each facility to assess whether the facility had received free samples, to determine how they had been used, and to determine whether gifts had been given to health workers by companies that manufactured or distributed breast milk substitutes. Compliance with the marketing code for information given to health workers was evaluated using a checklist. Setting: Health facilities in Dhaka, Bangladesh; Warsaw, Poland; Durban, South Africa; and Bangkok, Thailand. Subjects: 1468 pregnant women, 1582 mothers of infants aged ⩽6 months, and 466 health workers at 165 health facilities. Main outcome measures: Number of free samples received by pregnant women, mothers, and health workers; number of gifts given to health workers; and availability of information that violated the code in health facilities. Results: 97 out of 370 (26%) mothers in Bangkok reported receiving free samples of breast milk substitutes, infant formula, bottles, or teats compared with only 1 out of 385 mothers in Dhaka. Across the four cities from 3 out of 40 (8%) to 20 out of 40 (50%) health facilities had received free samples which were not being used for research or professional evaluation; from 2 out of 123 (2%) to 21 out of 119 (18%) health workers had received gifts from companies involved in the manufacturing or distribution of breast milk substitutes. From 6 out of 40 (15%) to 22 out of 39 (56%) health facilities information that violated the code had been provided by companies and was available to staff. Conclusion: Violations of the code were detected with a simple survey instrument in all of the four countries studied. Governmental and non-governmental agencies should monitor the prevalence of code violations using the simple methodology developed for this study. Key messages A simple multistage random sampling procedure can be used to interview women and health professionals to assess whether violations of the international code of marketing of substitutes for breast milk are occurring 3050 women and 466 health professionals were interviewed at 165 health facilities in Bangladesh, Poland, South Africa, and Thailand 97 out of 370 mothers in Bangkok reported receiving free samples of breast milk substitutes, infant formula, bottles, or teats compared with only 1 out of 385 mothers in Dhaka. In Bangkok health workers reported that 20 out of 40 health facilities had also received free samples. Most free samples were distributed by health facilities In Warsaw 56% of facilities surveyed were found to have information available for health workers that had been provided by manufacturers or distributors of breast milk substitutes in contravention of the code; 18% of health workers in Warsaw had received free gifts from manufacturers PMID:9552947

The effectiveness of empowering in-service training programs for foreign nurse aides in community-based long-term care facilities.

PubMed

Wu, Li-yu; Yin, Teresa J C; Li, I-chuan

2005-01-01

The objective of the study was to examine the effectiveness of empowering in-service training programs for foreign nurse aides working in community-based long-term care (LTC) facilities. The design was a pretest and post-test design with experiment and control groups. The sample consisted of purposeful sampling from 10 LTC facilities in the Shihlin and Peitou areas of Taipei. A total of 35 foreign nurse aides participated in this study; 16 in the experimental group and 19 in the control group. The experimental group attended the training program for a 3-month period, whereas the control group did not receive any training. The research findings reveal that the training program was effective in increasing the work stress of workload/scheduling (Z = 2.01, p

42 CFR 412.426 - Transition period.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Services of Inpatient Psychiatric Facilities § 412.426 Transition period. (a) Duration of transition period... psychiatric facility receives a payment comprised of a blend of the estimated Federal per diem payment amount... new inpatient psychiatric facilities. New inpatient psychiatric facilities, are facilities that under...

Opt-Out HIV Testing of Inmates in North Carolina Prisons: Factors Associated with not Wanting a Test and not Knowing They Were Tested.

PubMed

Grodensky, Catherine A; Rosen, David L; Hino, Sayaka; Golin, Carol E; Wohl, David A

2016-04-01

Opt-out HIV testing is recommended for correctional settings but may occur without inmates' knowledge or against their wishes. Through surveying inmates receiving opt-out testing in a large prison system, we estimated the proportion unaware of being tested or not wanting a test, and associations [prevalence ratios (PRs)] with inmate characteristics. Of 871 tested, 11.8 % were unknowingly tested and 10.8 % had unwanted tests. Not attending an educational HIV course [PR = 2.34, 95 % confidence interval (CI) 1.47-3.74], lower HIV knowledge (PR = 0.95, 95 % CI 0.91-0.98), and thinking testing is not mandatory (PR = 9.84, 95 % CI 4.93-19.67) were associated with unawareness of testing. No prior incarcerations (PR = 1.59, 95 % CI 1.03-2.46) and not using crack/cocaine recently (PR = 2.37, 95 % CI 1.21-4.64) were associated with unwanted testing. Residence at specific facilities was associated with both outcomes. Increased assessment of inmate understanding and enhanced implementation are needed to ensure inmates receive full benefits of opt-out testing: being informed and tested according to their wishes.

Service Delivery and Patient Outcomes in Ryan White HIV/AIDS Program–Funded and –Nonfunded Health Care Facilities in the United States

PubMed Central

Weiser, John; Beer, Linda; Frazier, Emma L.; Patel, Roshni; Dempsey, Antigone; Hauck, Heather; Skarbinski, Jacek

2016-01-01

IMPORTANCE Outpatient human immunodeficiency virus (HIV) health care facilities receive funding from the Ryan White HIV/AIDS Program (RWHAP) to provide medical care and essential support services that help patients remain in care and adhere to treatment. Increased access to Medicaid and private insurance for HIV-infected persons may provide coverage for medical care but not all needed support services and may not supplant the need for RWHAP funding. OBJECTIVE To examine differences between RWHAP-funded and non–RWHAP-funded facilities and in patient outcomes between the 2 systems. DESIGN, SETTING, AND PARTICIPANTS The study was conducted from June 1, 2009, to May 31, 2012, using data from the 2009 and 2011 cycles of the Medical Monitoring Project, a national probability sample of 8038 HIV-infected adults receiving medical care at 989 outpatient health care facilities providing HIV medical care. MAIN OUTCOMES AND MEASURES Data were used to compare patient characteristics, service needs, and access to services at RWHAP-funded vs non–RWHAP-funded facilities. Differences in prescribed antiretroviral treatment and viral suppression were assessed. Data analysis was performed between February 2012 and June 2015. RESULTS Overall, 34.4% of facilities received RWHAP funding and 72.8% of patients received care at RWHAP-funded facilities. With results reported as percentage (95% CI), patients attending RWHAP-funded facilities were more likely to be aged 18 to 29 years (8.5%[7.4%–9.5%] vs 5.0%[3.9%–6.2%]), female (29.2%[27.2%–31.2%] vs 20.1%[17.0%–23.1%]), black (47.5% [41.5%–53.5%] vs 25.8% [20.6%–31.0%]) or Hispanic (22.5%[16.4%–28.6%] vs 12.9%[10.6%–15.2%]), have less than a high school education (26.1% [24.0%–28.3%] vs 10.9%[8.7%–13.1%]), income at or below the poverty level (53.6%[50.3%–56.9%] vs 23.9%[19.7%–28.0%]), and lack health care coverage (25.0%[21.9%–28.1%] vs 6.1% [4.1%–8.0%]). The RWHAP-funded facilities were more likely to provide case management (76.1% [69.9%–82.2%] vs 15.4%[10.4%–20.4%]) as well as mental health (64.0%[57.0%–71.0%] vs 18.0%[14.0%–21.9%]), substance abuse (33.6%[27.0%–40.2%] vs 12.0%[8.0%–16.0%]), and other support services; patients attending RWHAP-funded facilities were more likely to receive these services. After adjusting for patient characteristics, the percentage prescribed ART antiretroviral therapy, reported as adjusted prevalence ratio (95% CI), was similar between RWHAP-funded and non–RWHAP-funded facilities (1.01 [0.99–1.03]), but among poor patients, those attending RWHAP-funded facilities were more likely to be virally suppressed (1.09 [1.02–1.16]). CONCLUSIONS AND RELEVANCE A total of 72.8% of HIV-positive patients received care at RWHAP-funded facilities. Many had multiple social determinants of poor health and used services at RWHAP-funded facilities associated with improved outcomes. Without facilities supported by the RWHAP, these patients may have had reduced access to services elsewhere. Poor patients were more likely to achieve viral suppression if they received care at a RWHAP-funded facility. PMID:26322677

Service Delivery and Patient Outcomes in Ryan White HIV/AIDS Program-Funded and -Nonfunded Health Care Facilities in the United States.

PubMed

Weiser, John; Beer, Linda; Frazier, Emma L; Patel, Roshni; Dempsey, Antigone; Hauck, Heather; Skarbinski, Jacek

2015-10-01

Outpatient human immunodeficiency virus (HIV) health care facilities receive funding from the Ryan White HIV/AIDS Program (RWHAP) to provide medical care and essential support services that help patients remain in care and adhere to treatment. Increased access to Medicaid and private insurance for HIV-infected persons may provide coverage for medical care but not all needed support services and may not supplant the need for RWHAP funding. To examine differences between RWHAP-funded and non-RWHAP-funded facilities and in patient outcomes between the 2 systems. The study was conducted from June 1, 2009, to May 31, 2012, using data from the 2009 and 2011 cycles of the Medical Monitoring Project, a national probability sample of 8038 HIV-infected adults receiving medical care at 989 outpatient health care facilities providing HIV medical care. Data were used to compare patient characteristics, service needs, and access to services at RWHAP-funded vs non-RWHAP-funded facilities. Differences in prescribed antiretroviral treatment and viral suppression were assessed. Data analysis was performed between February 2012 and June 2015. Overall, 34.4% of facilities received RWHAP funding and 72.8% of patients received care at RWHAP-funded facilities. With results reported as percentage (95% CI), patients attending RWHAP-funded facilities were more likely to be aged 18 to 29 years (8.5% [7.4%-9.5%] vs 5.0% [3.9%-6.2%]), female (29.2% [27.2%-31.2%] vs 20.1% [17.0%-23.1%]), black (47.5% [41.5%-53.5%] vs 25.8% [20.6%-31.0%]) or Hispanic (22.5% [16.4%-28.6%] vs 12.9% [10.6%-15.2%]), have less than a high school education (26.1% [24.0%-28.3%] vs 10.9% [8.7%-13.1%]), income at or below the poverty level (53.6% [50.3%-56.9%] vs 23.9% [19.7%-28.0%]), and lack health care coverage (25.0% [21.9%-28.1%] vs 6.1% [4.1%-8.0%]). The RWHAP-funded facilities were more likely to provide case management (76.1% [69.9%-82.2%] vs 15.4% [10.4%-20.4%]) as well as mental health (64.0% [57.0%-71.0%] vs 18.0% [14.0%-21.9%]), substance abuse (33.6% [27.0%-40.2%] vs 12.0% [8.0%-16.0%]), and other support services; patients attending RWHAP-funded facilities were more likely to receive these services. After adjusting for patient characteristics, the percentage prescribed ART antiretroviral therapy, reported as adjusted prevalence ratio (95% CI), was similar between RWHAP-funded and non-RWHAP-funded facilities (1.01 [0.99-1.03]), but among poor patients, those attending RWHAP-funded facilities were more likely to be virally suppressed (1.09 [1.02-1.16]). A total of 72.8% of HIV-positive patients received care at RWHAP-funded facilities. Many had multiple social determinants of poor health and used services at RWHAP-funded facilities associated with improved outcomes. Without facilities supported by the RWHAP, these patients may have had reduced access to services elsewhere. Poor patients were more likely to achieve viral suppression if they received care at a RWHAP-funded facility.

Effects of long duration exposure to simulated space environment on nonmetallic materials properties

NASA Technical Reports Server (NTRS)

Peacock, C. L., Jr.; Whitaker, A. F.

1983-01-01

Nonmetallic materials specimens from the Viking program were tested in situ invacuo after continuous thermal vacuum exposure from 1971/1972 to the present. Eleven tests were done on appropriate specimens of 30 materials; however, no single material received all the tests. Some specimens also were exposed to 1 or 2.5 MeV electrons at differing fluences before testing. Baseline exposure data is reported for graphite/epoxy specimens that were exposed to vacuum since 1974. These materials were transferred to the thermal vacuum storage facility for future in situ testing and irradiation. Thin G/E specimens were tensile tested after thermal-vacuum cycling exposure. Photomicrographic examinations and SEM analyses were done on the failed specimens.

50 CFR 20.82 - Records required.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PLANTS (CONTINUED) MIGRATORY BIRD HUNTING Migratory Bird Preservation Facilities § 20.82 Records required. (a) No migratory bird preservation facility shall: (1) Receive or have in custody any migratory game bird unless accurate records are maintained which can identify each bird received by, or in the custody...

50 CFR 20.82 - Records required.

Code of Federal Regulations, 2011 CFR

2011-10-01

... PLANTS (CONTINUED) MIGRATORY BIRD HUNTING Migratory Bird Preservation Facilities § 20.82 Records required. (a) No migratory bird preservation facility shall: (1) Receive or have in custody any migratory game bird unless accurate records are maintained which can identify each bird received by, or in the custody...

Postpartum family planning integration with maternal, newborn and child health services: a cross-sectional analysis of client flow patterns in India and Kenya.

PubMed

Mackenzie, Devon; Pfitzer, Anne; Maly, Christina; Waka, Charles; Singh, Gajendra; Sanyal, Abanti

2018-04-03

Maternal, newborn and child health (MNCH) services represent opportunities to integrate postpartum family planning (PPFP). Objectives were to determine levels of MNCH-family planning (FP) integration and associations between integration, client characteristics and service delivery factors in facilities that received programmatic PPFP support. Cross-sectional client flow assessment conducted during May-July 2014, over 5 days at 10 purposively selected public sector facilities in India (4 hospitals) and Kenya (2 hospitals and 4 health centres). 2158 client visits tracked (1294 India; 864 Kenya). Women aged 18 or older accessing services while pregnant and/or with a child under 2 years. PPFP/postpartum intrauterine device-Bihar, India (2012-2013); Jharkhand, India (2009-2014); Embu, Kenya (2006-2010). Maternal, infant and young child nutrition/FP integration-Bondo, Kenya (2011-2014). Proportion of visits where clients received integrated MNCH-FP services, client characteristics as predictors of MNCH-FP integration and MNCH-FP integration as predictor of length of time spent at facility. Levels of MNCH-FP integration varied widely across facilities (5.3% to 63.0%), as did proportion of clients receiving MNCH-FP integrated services by service area. Clients travelling 30-59 min were half as likely to receive integrated services versus those travelling under 30 min (OR 0.5, 95% CI 0.4 to 0.7, P<0.001). Clients receiving MNCH-FP services (vs MNCH services only) spent an average of 10.5 min longer at the facility (95% CI -0.1 to 21.9, not statistically significant). Findings suggest importance of focused programmatic support for integration by MNCH service area. FP integration was highest in areas receiving specific support. Integration does not seem to impose an undue burden on clients in terms of time spent at the facility. Clients living furthest from facilities are least likely to receive integrated services. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Notes from the field: listeriosis associated with stone fruit--United States, 2014.

PubMed

Jackson, Brendan R; Salter, Monique; Tarr, Cheryl; Conrad, Amanda; Harvey, Emily; Steinbock, Lisa; Saupe, Amy; Sorenson, Alida; Katz, Lee; Stroika, Steven; Jackson, Kelly A; Carleton, Heather; Kucerova, Zuzana; Melka, David; Strain, Errol; Parish, Mickey; Mody, Rajal K

2015-03-20

On July 19, 2014, a packing company in California (company A) voluntarily recalled certain lots of stone fruits, including whole peaches, nectarines, plums, and pluots, because of concern about contamination with Listeria monocytogenes based on internal company testing. On July 31, the recall was expanded to cover all fruit packed at their facility during June 1-July 17. After the initial recall, clinicians, state and local health departments, CDC, and the Food and Drug Administration (FDA) received many inquiries about listeriosis from concerned consumers, many of whom had received automated telephone calls informing them that they had purchased recalled fruit. During July 19-31, the CDC Listeria website received >500,000 page views, more than seven times the views received during the previous 52 weeks. However, no molecular information from L. monocytogenes isolates was available to assess whether human illnesses might be linked to these products.

Preliminary Results of the Ground/Orbiter Lasercomm Demonstration Experiment between Table Mountain and teh ETS-V1 Satellite

NASA Technical Reports Server (NTRS)

Wilson, K. E.; Lesh, J. R.; Araki, K.; Arimoto, Y.

1996-01-01

The Ground/Orbiter Lasercomm Demonstration (GOLD) is an optical communications demonstration between the Japanese Engineering Test Satellite (ETS-V1) and an optical ground transmitting and receiving station at the Table Mountain FAcility in Wrightwood California. Laser transmissions to the satellite are performed approximately four hours every third night when the satellite is at apogee above Table Mountain.

Stennis Space Center observes Disability Awareness Day

NASA Image and Video Library

2009-10-15

Members of STARC, a non-profit organization in Slidell, La., that seeks to help people with disabilities lead meaningful, productive lives, pose with their appreciation awards during Disability Awareness Day at Stennis Space Center on Oct. 15. The group members received appreciation awards for their dedicated service to the rocket engine testing facility. Disability Awareness Day was hosted by the Stennis Diversity Council and included guest speakers from several area agencies.

Stennis Space Center observes Disability Awareness Day

NASA Technical Reports Server (NTRS)

2009-01-01

Members of STARC, a non-profit organization in Slidell, La., that seeks to help people with disabilities lead meaningful, productive lives, pose with their appreciation awards during Disability Awareness Day at Stennis Space Center on Oct. 15. The group members received appreciation awards for their dedicated service to the rocket engine testing facility. Disability Awareness Day was hosted by the Stennis Diversity Council and included guest speakers from several area agencies.

Evaluation of a safety training program in three food service companies.

PubMed

Sinclair, Raymond C; Smith, Randall; Colligan, Michael; Prince, Mary; Nguyen, Trang; Stayner, Leslie

2003-01-01

Outcome measures for safety training effectiveness research often do not include measures such as occupational injury experience. Effectiveness mediators also receive sparse attention. A new safety training curriculum was delivered to workers in a stratified random sample of food service facilities across three companies. A similar group of facilities received usual training. We collected post-test measures of demographic variables, safety knowledge, perceptions of transfer of training climate, and workers' compensation claim data for one year after the initial training activities. Knowledge test scores were apparently higher in the new-training units than in the usual-training units. Some demographic variables were inconsistently associated with these differences. Evidence for reduction of the injury rate associated with the new training was observed from two companies but only approached significance for one company. A second company revealed a similar but non-significant trend. Knowledge scores were not significantly associated with lower injury rates. We found evidence that safety training increases knowledge and reduces injuries. We found almost no evidence of effects of training effectiveness mediators, including no relationship between safety knowledge and injury experience. Methodological issues related to conducting a large study may have influenced these results. Although safety training leads to greater knowledge and, in some cases, reduced occupational injuries, the influence of mediating variables remains to be fully explained.

Project management plan, Waste Receiving and Processing Facility, Module 1, Project W-026

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

Starkey, J.G.

1993-05-01

The Hanford Waste Receiving and Processing Facility Module 1 Project (WRAP 1) has been established to support the retrieval and final disposal of approximately 400K grams of plutonium and quantities of hazardous components currently stored in drums at the Hanford Site.

The Increased Effectiveness of HIV Preventive Intervention among Men Who Have Sex with Men and of Follow-Up Care for People Living with HIV after ‘Task-Shifting’ to Community-Based Organizations: A ‘Cash on Service Delivery’ Model in China

PubMed Central

Yan, Hongjing; Zhang, Min; Zhao, Jinkou; Huan, Xiping; Ding, Jianping; Wu, Susu; Wang, Chenchen; Xu, Yuanyuan; Liu, Li; Xu, Fei; Yang, Haitao

2014-01-01

Background A large number of men who have sex with men (MSM) and people living with HIV/AIDS (PLHA) are underserved despite increased service availability from government facilities while many community based organizations (CBOs) are not involved. We aimed to assess the feasibility and effectiveness of the task shifting from government facilities to CBOs in China. Methods HIV preventive intervention for MSM and follow-up care for PLHA were shifted from government facilities to CBOs. Based on ‘cash on service delivery’ model, 10 USD per MSM tested for HIV with results notified, 82 USD per newly HIV cases diagnosed, and 50 USD per PLHA received a defined package of follow-up care services, were paid to the CBOs. Cash payments were made biannually based on the verified results in the national web-based HIV/AIDS information system. Findings After task shifting, CBOs gradually assumed preventive intervention for MSM and follow-up care for PLHA from 2008 to 2012. HIV testing coverage among MSM increased from 4.1% in 2008 to 22.7% in 2012. The baseline median CD4 counts of newly diagnosed HIV positive MSM increased from 309 to 397 cells/µL. HIV tests among MSM by CBOs accounted for less than 1% of the total HIV tests in Nanjing but the share of HIV cases detected by CBOs was 12.4% in 2008 and 43.6% in 2012. Unit cost per HIV case detected by CBOs was 47 times lower than that by government facilities. The coverage of CD4 tests and antiretroviral therapy increased from 71.1% and 78.6% in 2008 to 86.0% and 90.1% in 2012, respectively. Conclusion It is feasible to shift essential HIV services from government facilities to CBOs, and to verify independently service results to adopt ‘cash on service delivery’ model. Services provided by CBOs are cost-effective, as compared with that by government facilities. PMID:25050797

Garrett solar Brayton engine/generator status

NASA Astrophysics Data System (ADS)

Anson, B.

1982-07-01

The solar advanced gas turbine (SAGT-1) is being developed by the Garrett Turbine Engine Company, for use in a Brayton cycle power conversion module. The engine is derived from the advanced gas turbine (AGT101) now being developd by Garrett and Ford Motor Company for automotive use. The SAGT Program is presently funded for the design, fabrication and test of one engine at Garrett's Phoenix facility. The engine when mated with a solar receiver is called a power conversion module (PCU). The PCU is scheduled to be tested on JPL's test bed concentrator under a follow on phase of the program. Approximately 20 kw of electrical power will be generated.

Gain Evaluation of Micro-Channel-Plate Photomultipliers in the Upgraded High-B Test Facility at Jefferson Lab

NASA Astrophysics Data System (ADS)

Barber, Corinne; DIRC at EIC Collaboration

2015-10-01

The High-B test facility at Thomas Jefferson National Accelerator Facility allows researchers to evaluate the gain of compact photon sensors, such as Micro-Channel-Plate Photomultipliers (MCP-PMTs), in magnetic fields up to 5 T. These ongoing studies support the development of a Detector of Internally Reflected Cherenkov light (DIRC) to be used in an Electron Ion Collider (EIC). Here, we present our summer 2015 activities to upgrade and improve the facility, and we show results for MCP-PMT gain changes in high B-fields. To monitor the light stability delivered to the MCP-PMTs being tested, we implemented a Silicon Photomultiplier (SiPM) in the setup and calibrated the ADC reading this sensor. A 405-nm Light-Emitting Diode (LED) housed in an optical tube compatible with neutral density filters was also installed. The filters provide an alternative way of reducing the light output of the LED to operate the MCP-PMTs in a single-photon mode. We calibrated a set of filters by means of a photodiode and measured the photon flux at multiple positions relative to the LED. This information helped us to design 3D-printed holders unique to each MCP-PMT so that the photocathode receives the greatest amount of light. The improvements to the setup allow for more precise PMT gain evaluation. This team includes 7 collaborators/co-authors besides myself: Yordanka Ilieva, Kijun Park, Greg Kalicy, Carl Zorn, Pawel Nadel-Turonski, Tongtong Cao, and Lee.

Does decentralisation of tuberculosis care influence treatment outcomes? The case of Oromia Region, Ethiopia

PubMed Central

Raya, J.; Workineh, T.; Klinkenberg, E.; Enquselassie, F.

2014-01-01

Setting: Oromia Region, Ethiopia. Objective: To investigate the effect of decentralised care on anti-tuberculosis treatment outcomes and identify factors affecting outcome among new smear-positive tuberculosis (TB) patients. Design: This was a retrospective cohort study comparing patients treated in the community during the continuation phase with those managed throughout treatment in health facilities. Data were collected from TB registers and patient cards using a pre-tested data capture form. Results: Of the 2226 new smear-positive TB patients registered from July 2010 to June 2012 who were included in the study, 1599 (72.6%) received treatment in health facilities, and the rest in the community. Overall treatment success was 94.7%. Patients treated in the community had comparable treatment success with those managed in health facilities (aOR 1.7, 95%CI 0.80–3.57). Missing doses (OR 0.22, 95%CI 0.08–0.55), supervision during the continuation phase (OR 2.6, 95%CI 1.34–5.05), positive sputum at month 2 (OR 0.07, 95%CI 0.04–0.13) and human immunodeficiency virus infection (OR 0.25, 95%CI 0.13–0.46) were independent predictors of treatment success. Conclusion: Overall treatment success is high in new smear-positive TB patients in Oromia. Patients receiving treatment in the community during the continuation phase have treatment success comparable with that of patients managed in health facilities. PMID:26478507

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

PubMed

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

2018-03-27

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

Task-shifting point-of-care CD4+ testing to lay health workers in HIV care and treatment services in Namibia.

PubMed

Kaindjee-Tjituka, Francina; Sawadogo, Souleymane; Mutandi, Graham; Maher, Andrew D; Salomo, Natanael; Mbapaha, Claudia; Neo, Marytha; Beukes, Anita; Gweshe, Justice; Muadinohamba, Alexinah; Lowrance, David W

2017-01-01

Access to CD4+ testing remains a common barrier to early initiation of antiretroviral therapy among persons living with HIV/AIDS in low- and middle-income countries. The feasibility of task-shifting of point-of-care (POC) CD4+ testing to lay health workers in Namibia has not been evaluated. From July to August 2011, Pima CD4+ analysers were used to improve access to CD4+ testing at 10 selected public health facilities in Namibia. POC Pima CD4+ testing was performed by nurses or lay health workers. Venous blood samples were collected from 10% of patients and sent to centralised laboratories for CD4+ testing with standard methods. Outcomes for POC Pima CD4+ testing and patient receipt of results were compared between nurses and lay health workers and between the POC method and standard laboratory CD4+ testing methods. Overall, 1429 patients received a Pima CD4+ test; 500 (35.0%) tests were performed by nurses and 929 (65.0%) were performed by lay health workers. When Pima CD4+ testing was performed by a nurse or a lay health worker, 93.2% and 95.2% of results were valid ( p = 0.1); 95.6% and 98.1% of results were received by the patient ( p = 0.007); 96.2% and 94.0% of results were received by the patient on the same day ( p = 0.08). Overall, 97.2% of Pima CD4+ results were received by patients, compared to 55.4% of standard laboratory CD4+ results ( p < 0.001). POC CD4+ testing was feasible and effective when task-shifted to lay health workers. Rollout of POC CD4+ testing via task-shifting can improve access to CD4+ testing and retention in care between HIV diagnosis and antiretroviral therapy initiation in low- and middle-income countries.

78 FR 4393 - Sunshine Act Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-22

... DEFENSE NUCLEAR FACILITIES SAFETY BOARD Sunshine Act Notice AGENCY: Defense Nuclear Facilities... given of the Defense Nuclear Facilities Safety Board's (Board) public meeting and hearing described... Session II, the Board will receive testimony concerning safety at Pantex defense nuclear facilities. The...

Promoting male partner HIV testing and safer sexual decision making through secondary distribution of self-tests by HIV-negative female sex workers and women receiving antenatal and post-partum care in Kenya: a cohort study.

PubMed

Thirumurthy, Harsha; Masters, Samuel H; Mavedzenge, Sue Napierala; Maman, Suzanne; Omanga, Eunice; Agot, Kawango

2016-06-01

Increased uptake of HIV testing by men in sub-Saharan Africa is essential for the success of combination prevention. Self-testing is an emerging approach with high acceptability, but little evidence exists on the best strategies for test distribution. We assessed an approach of providing multiple self-tests to women at high risk of HIV acquisition to promote partner HIV testing and to facilitate safer sexual decision making. In this cohort study, HIV-negative women aged 18-39 years were recruited at two sites in Kisumu, Kenya: a health facility with antenatal and post-partum clinics and a drop-in centre for female sex workers. Participants gave informed consent and were instructed on use of oral fluid based rapid HIV tests. Participants enrolled at the health facility received three self-tests and those at the drop-in centre received five self-tests. Structured interviews were conducted with participants at enrolment and over 3 months to determine how self-tests were used. Outcomes included the number of self-tests distributed by participants, the proportion of participants whose sexual partners used a self-test, couples testing, and sexual behaviour after self-testing. Between Jan 14, 2015, and March 13, 2015, 280 participants were enrolled (61 in antenatal care, 117 in post-partum care, and 102 female sex workers); follow-up interviews were completed for 265 (96%). Most participants with primary sexual partners distributed self-tests to partners: 53 (91%) of 58 participants in antenatal care, 91 (86%) of 106 in post-partum care, and 64 (75%) of 85 female sex workers. 82 (81%) of 101 female sex workers distributed more than one self-test to commercial sex clients. Among self-tests distributed to and used by primary sexual partners of participants, couples testing occurred in 27 (51%) of 53 in antenatal care, 62 (68%) of 91 from post-partum care, and 53 (83%) of 64 female sex workers. Among tests received by primary and non-primary sexual partners, two (4%) of 53 tests from participants in antenatal care, two (2%) of 91 in post-partum care, and 41 (14%) of 298 from female sex workers had positive results. Participants reported sexual intercourse with 235 (62%) of 380 sexual partners who tested HIV-negative, compared with eight (18%) of 45 who tested HIV-positive (p<0·0001); condoms were used in all eight intercourse events after positive results compared with 104 (44%) after of negative results (p<0·0018). Four participants reported intimate partner violence as a result of self-test distribution: two in the post-partum care group and two female sex workers. No other adverse events were reported. Provision of multiple HIV self-tests to women at high risk of HIV infection was successful in promoting HIV testing among their sexual partners and in facilitating safer sexual decisions. This novel strategy warrants further consideration as countries develop self-testing policies and programmes. Bill & Melinda Gates Foundation. Copyright © 2016 Elsevier Ltd. All rights reserved.

26 CFR 1.132-7 - Employer-operated eating facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Employer-operated eating facilities. (a) In general—(1) Condition for exclusion—(i) General rule. The value... determine the number of meals received by volunteers who receive food and beverages at a hospital, free or... volunteers. If an employer charges nonemployees a greater amount than employees, in determining whether the...

26 CFR 1.132-7 - Employer-operated eating facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Employer-operated eating facilities. (a) In general—(1) Condition for exclusion—(i) General rule. The value... determine the number of meals received by volunteers who receive food and beverages at a hospital, free or... volunteers. If an employer charges nonemployees a greater amount than employees, in determining whether the...

26 CFR 1.132-7 - Employer-operated eating facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Employer-operated eating facilities. (a) In general—(1) Condition for exclusion—(i) General rule. The value... determine the number of meals received by volunteers who receive food and beverages at a hospital, free or... volunteers. If an employer charges nonemployees a greater amount than employees, in determining whether the...

Planning for progress, productivity, and performance.

PubMed

Benedict, J M

1983-10-01

A project is described for the interim renovation of a labor intensive existing foodservice facility. The renovated area will provide effective food management during the hospital's redevelopment period, including a new foodservice. Objectives of the interim project were to conserve labor while emphasizing control and centralization, provide economic foodservices with improved quality, and incorporate one tray distribution system throughout the hospital complex. Immediate measures were necessary in order to generate funds to proceed. Renovations had to occur without disrupting food-service to patients. The project was planned over a three year period and included an ingredient control area, two patient tray service centres, a renewed production kitchen and test kitchen facility. Each phase has been financed on the understanding that the costs of construction and equipment will be repaid within one fiscal year of operating the renovated facility. Positive results are being achieved, attributable to the support and encouragement received from staff during the change process.

Automated Transmission Loss Measurement in the Structural Acoustic Loads and Transmission Facility at NASA Langley Research Center

NASA Technical Reports Server (NTRS)

Klos, J.; Brown, S. A.

2002-01-01

A technique to measure the radiated acoustic intensity and transmission loss of panels is documented in this paper. This facility has been upgraded to include a test fixture that scans the acoustic intensity radiated from a panel on the anechoic receiving room side of the transmission loss window. The acoustic intensity incident on the panel from the reverberant side of the transmission loss window is estimated from measurements made using six stationary microphones in the reverberant source room. From the measured incident and radiated intensity, the sound power transmission loss is calculated. The setup of the facility and data acquisition system are documented. A transmission loss estimate of a typical panel is shown. The measurement-to-measurement and setup-to-setup repeatability of the transmission loss estimate are assessed. Conclusions are drawn about the ability to measure changes in transmission loss due to changes in panel construction.

The Single-Visit Approach as a Cervical Cancer Prevention Strategy Among Women With HIV in Ethiopia: Successes and Lessons Learned

PubMed Central

Shiferaw, Netsanet; Salvador-Davila, Graciela; Kassahun, Konjit; Brooks, Mohamad I; Weldegebreal, Teklu; Tilahun, Yewondwossen; Zerihun, Habtamu; Nigatu, Tariku; Lulu, Kidest; Ahmed, Ismael; Blumenthal, Paul D; Asnake, Mengistu

2016-01-01

ABSTRACT Introduction: Cervical cancer is the second most common form of cancer for women in Ethiopia. Using a single-visit approach to prevent cervical cancer, the Addis Tesfa (New Hope) project in Ethiopia tested women with HIV through visual inspection of the cervix with acetic acid wash (VIA) and, if tests results were positive, offered immediate cryotherapy of the precancerous lesion or referral for loop electrosurgical excision procedure (LEEP). The objective of this article is to review screening and treatment outcomes over nearly 4 years of project implementation and to identify lessons learned to improve cervical cancer prevention programs in Ethiopia and other resource-constrained settings. Methods: We analyzed aggregate client data from August 2010 to March 2014 to obtain the number of women with HIV who were counseled, screened, and treated, as well as the number of annual follow-up visits made, from the 14 tertiary- and secondary-level health facilities implementing the single-visit approach. A health facility assessment (HFA) was also implemented from August to December 2013 to examine the effects of the single-visit approach on client flow, staff workload, and facility infrastructure 3 years after initiating the approach. Results: Almost all (99%) of the 16,632 women with HIV counseled about the single-visit approach were screened with VIA during the study period; 1,656 (10%) of them tested VIA positive (VIA+) for precancerous lesions. Among those who tested VIA+ and were thus eligible for cryotherapy, 1,481 (97%) received cryotherapy treatment, but only 80 (63%) women eligible for LEEP actually received the treatment. The HFA results showed frequent staff turnover, some shortage of essential supplies, and rooms that were judged by providers to be too small for delivery of cervical cancer prevention services. Conclusion: The high proportions of VIA screening and cryotherapy treatment in the Addis Tesfa project suggest high acceptance of such services by women with HIV and feasibility of implementation in secondary- and tertiary-level health facilities. However, success of cervical cancer prevention programming must address wider health system challenges to ensure sustainability and appropriate scale-up to the general population of Ethiopia and other resource-constrained settings. PMID:27016546

21 CFR 212.100 - What do I do if I receive a complaint about a PET drug product produced at my facility?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false What do I do if I receive a complaint about a PET... if I receive a complaint about a PET drug product produced at my facility? (a) Written complaint... concerning the quality or purity of, or possible adverse reactions to, a PET drug product. (b) Complaint...

Robot-assisted therapy for improving social interactions and activity participation among institutionalized older adults: a pilot study.

PubMed

Sung, Huei-Chuan; Chang, Shu-Min; Chin, Mau-Yu; Lee, Wen-Li

2015-03-01

Animal-assisted therapy is gaining popularity as part of therapeutic activities for older adults in many long-term care facilities. However, concerns about dog bites, allergic responses to pets, disease, and insufficient available resources to care for a real pet have led to many residential care facilities to ban this therapy. There are situations where a substitute artificial companion, such as robotic pet, may serve as a better alternative. This pilot study used a one-group pre- and posttest design to evaluate the effect of a robot-assisted therapy for older adults. Sixteen eligible participants participated in the study and received a group robot-assisted therapy using a seal-like robot pet for 30 minutes twice a week for 4 weeks. All participants received assessments of their communication and interaction skills using the Assessment of Communication and Interaction Skills (ACIS-C) and activity participation using the Activity Participation Scale at baseline and at week 4. A total of 12 participants completed the study. Wilcoxon signed rank test showed that participants' communication and interaction skills (z = -2.94, P = 0.003) and activity participation (z = -2.66, P = 0.008) were significantly improved after receiving 4-week robot-assisted therapy. By interacting with a robot pet, such as Paro, the communication, interaction skills, and activity participation of the older adults can be improved. The robot-assisted therapy can be provided as a routine activity program and has the potential to improve social health of older adults in residential care facilities. Copyright © 2014 Wiley Publishing Asia Pty Ltd.

US Department of Energy Nevada Operations Office annual site environmental report: 1993. Volume 1

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

Black, S.C.; Glines, W.M.; Townsend, Y.E.

1994-09-01

Monitoring and surveillance on and around the Nevada Test Site (NTS) by DOE contractors and NTS user organizations during 1993 indicated that operations on the NTS were conducted in compliance with applicable federal and DOE guidelines, i.e., the dose the maximally exposed offsite individual could have received was less than 0.04 percent of the 10 mrem per year guide for air exposure. No nuclear tests were conducted due to the moratorium. All discharges of radioactive liquids remained onsite in containment ponds, and there was no indication of potential migration of radioactivity to the offsite area through groundwater. Surveillance around themore » NTS indicated that airborne radioactivity from diffusion, evaporation of effluents, or resuspension was not detectable offsite, and no measurable net exposure to members of the offsite population was detected through the offsite dosimetry program. Using the CAP88-PC model and NTS radionuclide emissions data, the calculated effective dose equivalent to the maximally exposed individual offsite would have been 0.004 mrem. Any person receiving this dose would also have received 97 mrem from natural background radiation. There were no nonradiological releases to the offsite area. Hazardous wastes were shipped offsite to approved disposal facilities. Compliance with the various regulations stemming from the National Environmental Policy Act is being achieved and, where mandated, permits for air and water discharges and waste management have been obtained from the appropriate agencies. Support facilities at off-NTS locations compiled with the requirements of air quality permits and state or local wastewater discharge and hazardous waste permits.« less

Performance evaluation of the Russian SPT-100 thruster at NASA LeRC

NASA Technical Reports Server (NTRS)

Sankovic, John M.; Hamley, John A.; Haag, Thomas W.

1994-01-01

Performance measurements of a Russian flight-model SPT-100 thruster were obtained as part of a comprehensive program to evaluate engineering issues pertinent to integration with Western spacecraft. Power processing was provided by a US Government developed laboratory power conditioner. When received the thruster had been subjected to only a few hours of acceptance testing by the manufacturer. Accumulated operating time during this study totalled 148 h and included operation of both cathodes. Cathode flow fraction was controlled both manually and using the flow splitter contained within the supplied xenon flow controller. Data were obtained at current levels ranging from 3 A to 5 A and thruster voltages ranging from 200 V to 300 V. Testing centered on the design power of 1.35 kW with a discharge current of 4.5 A. The effects of facility pressure on thruster operation were examined by varying the pressure via injection of xenon into the vacuum chamber. The facility pressure had a significant effect on thruster performance and stability at the conditions tested. Periods of current instabilities were noted throughout the testing period and became more frequent as testing progressed. Performance during periods of stability agreed with previous data obtained in Russian laboratories.

Main outcomes of an RCT to pilot test reporting and feedback to foster research integrity climates in the VA.

PubMed

Martinson, Brian C; Mohr, David C; Charns, Martin P; Nelson, David; Hagel-Campbell, Emily; Bangerter, Ann; Bloomfield, Hanna E; Owen, Richard; Thrush, Carol R

2017-01-01

Assessing the integrity of research climates and sharing such information with research leaders may support research best practices. We report here results of a pilot trial testing the effectiveness of a reporting and feedback intervention using the Survey of Organizational Research Climate (SOuRCe). We randomized 41 Veterans Health Administration (VA) facilities to a phone-based intervention designed to help research leaders understand their survey results (enhanced arm) or to an intervention in which results were simply distributed to research leaders (basic arm). Primary outcomes were (1) whether leaders took action, (2) whether actions taken were consistent with the feedback received, and (3) whether responses differed by receptivity to quality improvement input. Research leaders from 25 of 42 (59%) VA facilities consented to participate in the study intervention and follow-up, of which 14 were at facilities randomized to the enhanced arm. We completed follow-up interviews with 21 of the 25 leaders (88%), 12 from enhanced arm facilities. While not statistically significant, the proportion of leaders reporting taking some action in response to the feedback was twice as high in the enhanced arm than in the basic arm (67% vs. 33%, p = .20). While also not statistically significant, a higher proportion of actions taken among facilities in the enhanced arm were responsive to the survey results than in the basic arm (42% vs. 22%, p = .64). Enhanced feedback of survey results appears to be a promising intervention that may increase the likelihood of responsive action to improve organizational climates. Due to the small sample size of this pilot study, even large percentage-point differences between study arms are not statistically distinguishable. This hypothesis should be tested in a larger trial.

Research and test facilities for development of technologies and experiments with commercial applications

NASA Technical Reports Server (NTRS)

1989-01-01

One of NASA'S agency-wide goals is the commercial development of space. To further this goal NASA is implementing a policy whereby U.S. firms are encouraged to utilize NASA facilities to develop and test concepts having commercial potential. Goddard, in keeping with this policy, will make the facilities and capabilities described in this document available to private entities at a reduced cost and on a noninterference basis with internal NASA programs. Some of these facilities include: (1) the Vibration Test Facility; (2) the Battery Test Facility; (3) the Large Area Pulsed Solar Simulator Facility; (4) the High Voltage Testing Facility; (5) the Magnetic Field Component Test Facility; (6) the Spacecraft Magnetic Test Facility; (7) the High Capacity Centrifuge Facility; (8) the Acoustic Test Facility; (9) the Electromagnetic Interference Test Facility; (10) the Space Simulation Test Facility; (11) the Static/Dynamic Balance Facility; (12) the High Speed Centrifuge Facility; (13) the Optical Thin Film Deposition Facility; (14) the Gold Plating Facility; (15) the Paint Formulation and Application Laboratory; (16) the Propulsion Research Laboratory; (17) the Wallops Range Facility; (18) the Optical Instrument Assembly and Test Facility; (19) the Massively Parallel Processor Facility; (20) the X-Ray Diffraction and Scanning Auger Microscopy/Spectroscopy Laboratory; (21) the Parts Analysis Laboratory; (22) the Radiation Test Facility; (23) the Ainsworth Vacuum Balance Facility; (24) the Metallography Laboratory; (25) the Scanning Electron Microscope Laboratory; (26) the Organic Analysis Laboratory; (27) the Outgassing Test Facility; and (28) the Fatigue, Fracture Mechanics and Mechanical Testing Laboratory.

Community-Based Evaluation of PMTCT Uptake in Nyanza Province, Kenya

PubMed Central

Kohler, Pamela K.; Okanda, John; Kinuthia, John; Mills, Lisa A.; Olilo, George; Odhiambo, Frank; Laserson, Kayla F.; Zierler, Brenda; Voss, Joachim; John-Stewart, Grace

2014-01-01

Introduction Facility-based assessments of prevention of mother-to-child HIV transmission (PMTCT) programs may overestimate population coverage. There are few community-based studies that evaluate PMTCT coverage and uptake. Methods During 2011, a cross-sectional community survey among women who gave birth in the prior year was performed using the KEMRI-CDC Health and Demographic Surveillance System in Western Kenya. A random sample (n = 405) and a sample of women known to be HIV-positive through previous home-based testing (n = 247) were enrolled. Rates and correlates of uptake of antenatal care (ANC), HIV-testing, and antiretrovirals (ARVs) were determined. Results Among 405 women in the random sample, 379 (94%) reported accessing ANC, most of whom (87%) were HIV tested. Uptake of HIV testing was associated with employment, higher socioeconomic status, and partner HIV testing. Among 247 known HIV-positive women, 173 (70%) self-disclosed their HIV status. Among 216 self-reported HIV-positive women (including 43 from the random sample), 82% took PMTCT ARVs, with 54% completing the full antenatal, peripartum, and postpartum course. Maternal ARV use was associated with more ANC visits and having an HIV tested partner. ARV use during delivery was lowest (62%) and associated with facility delivery. Eighty percent of HIV infected women reported having their infant HIV tested, 11% of whom reported their child was HIV infected, 76% uninfected, 6% declined to say, 7% did not recall; 79% of infected children were reportedly receiving HIV care and treatment. Conclusions Community-based assessments provide data that complements clinic-based PMTCT evaluations. In this survey, antenatal HIV test uptake was high; most HIV infected women received ARVs, though many women did not self-disclose HIV status to field team. Community-driven strategies that encourage early ANC, partner involvement, and skilled delivery, and provide PMTCT education, may facilitate further reductions in vertical transmission. PMID:25360758

Association Between Facility Type During Pediatric Inpatient Rehabilitation and Functional Outcomes

PubMed Central

Fuentes, Molly M.; Apkon, Susan; Jimenez, Nathalia; Rivara, Frederick P.

2017-01-01

Objective To compare functional outcomes between children receiving inpatient rehabilitation at children’s hospitals and those at other facilities. Design Retrospective cohort study. Setting Inpatient rehabilitation facilities. Participants Children (N=28,793) aged 6 months to 18 years who received initial inpatient rehabilitation. Interventions Not applicable. Main Outcome Measures Total, cognitive, and motor developmental functional quotients (DFQs; which is the WeeFIM score divided by age-adjusted norms and multiplied by 100) at discharge from inpatient rehabilitation and WeeFIM efficiency (the change in WeeFIM score from admission to discharge divided by the length of the rehabilitation stay), adjusting for age, sex, race, insurance, region, admission function, impairment type, discharge year, and length of stay. Results A total of 12,732 children received rehabilitation at 25 children’s hospitals and 16,061 at 36 other facilities (general hospitals or freestanding rehabilitation hospitals). Adjusting for clustering by facility, patients at children’s hospitals had a lower cognitive DFQ at admission (difference between children’s hospitals and other facility types, −3.8; 95% confidence interval [CI], −7.7 to −0.1), a shorter length of stay (median, 16d vs 22d; P<.001), and a higher WeeFIM efficiency (difference, 0.63; 95% CI, 0.25–1.00) than did children at other facility types. Rehabilitation in a children’s hospital was independently associated with a higher discharge cognitive DFQ (regression coefficient, 2.3; 95% CI, 0.3–4.2) and more efficient rehabilitation admissions (regression coefficient, 0.3; 95% CI, 0.1–0.6). Conclusions Children who receive inpatient rehabilitation at children’s hospitals have more efficient inpatient rehabilitation admissions, a shorter median length of stay, and a slight improvement in cognitive function than do children at other facility types. PMID:27026580

WRATS Integrated Data Acquisition System

NASA Technical Reports Server (NTRS)

Piatak, David J.

2008-01-01

The Wing and Rotor Aeroelastic Test System (WRATS) data acquisition system (DAS) is a 64-channel data acquisition display and analysis system specifically designed for use with the WRATS 1/5-scale V-22 tiltrotor model of the Bell Osprey. It is the primary data acquisition system for experimental aeroelastic testing of the WRATS model for the purpose of characterizing the aeromechanical and aeroelastic stability of prototype tiltrotor configurations. The WRATS DAS was also used during aeroelastic testing of Bell Helicopter Textron s Quad-Tiltrotor (QTR) design concept, a test which received international attention. The LabVIEW-based design is portable and capable of powering and conditioning over 64 channels of dynamic data at sampling rates up to 1,000 Hz. The system includes a 60-second circular data archive, an integrated model swashplate excitation system, a moving block damping application for calculation of whirl flutter mode subcritical damping, a loads and safety monitor, a pilot-control console display, data analysis capabilities, and instrumentation calibration functions. Three networked computers running custom-designed LabVIEW software acquire data through National Instruments data acquisition hardware. The aeroelastic model (see figure) was tested with the DAS at two facilities at NASA Langley, the Transonic Dynamics Tunnel (TDT) and the Rotorcraft Hover Test Facility (RHTF). Because of the need for seamless transition between testing at these facilities, DAS is portable. The software is capable of harmonic analysis of periodic time history data, Fast Fourier Transform calculations, power spectral density calculations, and on-line calibration of test instrumentation. DAS has a circular buffer archive to ensure critical data is not lost in event of model failure/incident, as well as a sample-and-hold capability for phase-correct time history data.

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

PubMed

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

2015-01-01

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

49 CFR 599.401 - Requirements and limitations for disposal facilities that receive trade-in vehicles under the...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false Requirements and limitations for disposal facilities that receive trade-in vehicles under the CARS program. 599.401 Section 599.401 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED)...

49 CFR 599.401 - Requirements and limitations for disposal facilities that receive trade-in vehicles under the...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 7 2012-10-01 2012-10-01 false Requirements and limitations for disposal facilities that receive trade-in vehicles under the CARS program. 599.401 Section 599.401 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED)...

49 CFR 599.401 - Requirements and limitations for disposal facilities that receive trade-in vehicles under the...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Requirements and limitations for disposal facilities that receive trade-in vehicles under the CARS program. 599.401 Section 599.401 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED)...

49 CFR 599.401 - Requirements and limitations for disposal facilities that receive trade-in vehicles under the...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false Requirements and limitations for disposal facilities that receive trade-in vehicles under the CARS program. 599.401 Section 599.401 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED)...

Making Charter School Facilities More Affordable: State-driven Policy Approaches. Innovations in Education

ERIC Educational Resources Information Center

US Department of Education, 2008

2008-01-01

Securing appropriate facilities can be a significant challenge for those intending to open a charter school. Although, like all public schools, charter schools receive per-pupil dollars from the state, they generally receive considerably less. Additionally, because traditional public schools rely on their district to provide their school…

Intention to receive the seasonal influenza vaccine among nurses working in a long-term care facility.

PubMed

Shahar, Irit; Mendelson, Gad; Ben Natan, Merav

2017-04-01

The factors affecting influenza vaccine uptake among nurses might vary between different medical facilities. The purpose of the present study was to explore factors that affect the intention of nurses at a long-term care facility to receive the influenza vaccine and whether the health belief model predicts this intention. In this cross-sectional quantitative correlational study, a convenience sample of 150 nurses employed at a large long-term care facility in central Israel completed a questionnaire based on the health belief model. Data collection took place between January and February of 2016. Forty-two percent of the respondents reported having been vaccinated against influenza in the current year. The health belief model explained 53% of the variance (p < .01), with perceived (personal) benefits of the vaccine being the most significant factor. The number of times of receiving the influenza vaccine in the past was strongly correlated with the intention to receive the vaccine (p < .01). To improve nurses' compliance with influenza vaccination at long-term care facilities, we find that it is necessary to emphasize the benefits of vaccination and, particularly, the personal benefits. Annual vaccination behavior should be promoted to make it become a routine. © 2017 John Wiley & Sons Australia, Ltd.

Cost-effectiveness of the treatment of uncomplicated severe acute malnutrition by community health workers compared to treatment provided at an outpatient facility in rural Mali.

PubMed

Rogers, Eleanor; Martínez, Karen; Morán, Jose Luis Alvarez; Alé, Franck G B; Charle, Pilar; Guerrero, Saul; Puett, Chloe

2018-02-20

The Malian Nutrition Division of the Ministry of Health and Action Against Hunger tested the feasibility of integrating treatment of severe acute malnutrition (SAM) into the existing Integrated Community Case Management package delivered by community health workers (CHWs). This study assessed costs and cost-effectiveness of CHW-delivered care compared to outpatient facility-based care. Activity-based costing methods were used, and a societal perspective employed to include all relevant costs incurred by institutions, beneficiaries and communities. The intervention and control arm enrolled different numbers of children so a modelled scenario sensitivity analysis was conducted to assess the cost-effectiveness of the two arms, assuming equal numbers of children enrolled. In the base case, with unequal numbers of children in each arm, for CHW-delivered care, the cost per child treated was 244 USD and cost per child recovered was 259 USD. Outpatient facility-based care was less cost-effective at 442 USD per child and 501 USD per child recovered. The conclusions of the analysis changed in the modelled scenario sensitivity analysis, with outpatient facility-based care being marginally more cost-effective (cost per child treated is 188 USD, cost per child recovered is 214 USD), compared to CHW-delivered care. This suggests that achieving good coverage is a key factor influencing cost-effectiveness of CHWs delivering treatment for SAM in this setting. Per week of treatment, households receiving CHW-delivered care spent half of the time receiving treatment and three times less money compared with those receiving treatment from the outpatient facility. This study supports existing evidence that the delivery of treatment by CHWs is a cost-effective intervention, provided that good coverage is achieved. A major benefit of this strategy was the lower cost incurred by the beneficiary household when treatment is available in the community. Further research is needed on the implementation costs that would be incurred by the government to increase the operability of these results.

A Low Cost GPS System for Real-Time Tracking of Sounding Rockets

NASA Technical Reports Server (NTRS)

Markgraf, M.; Montenbruck, O.; Hassenpflug, F.; Turner, P.; Bull, B.; Bauer, Frank (Technical Monitor)

2001-01-01

This paper describes the development as well as the on-ground and the in-flight evaluation of a low cost Global Positioning System (GPS) system for real-time tracking of sounding rockets. The flight unit comprises a modified ORION GPS receiver and a newly designed switchable antenna system composed of a helical antenna in the rocket tip and a dual-blade antenna combination attached to the body of the service module. Aside from the flight hardware a PC based terminal program has been developed to monitor the GPS data and graphically displays the rocket's path during the flight. In addition an Instantaneous Impact Point (IIP) prediction is performed based on the received position and velocity information. In preparation for ESA's Maxus-4 mission, a sounding rocket test flight was carried out at Esrange, Kiruna, on 19 Feb. 2001 to validate existing ground facilities and range safety installations. Due to the absence of a dedicated scientific payload, the flight offered the opportunity to test multiple GPS receivers and assess their performance for the tracking of sounding rockets. In addition to the ORION receiver, an Ashtech G12 HDMA receiver and a BAE (Canadian Marconi) Allstar receiver, both connected to a wrap-around antenna, have been flown on the same rocket as part of an independent experiment provided by the Goddard Space Flight Center. This allows an in-depth verification and trade-off of different receiver and antenna concepts.

Integration of TB-HIV services at an ANC facility in Frances Baard District, Northern Cape, South Africa.

PubMed

Peters, J A; Heunis, C; Kigozi, G; Osoba, T; van der Walt, M

2015-03-21

Integrated tuberculosis-human immunodeficiency virus (TB-HIV) service delivery as part of maternal health services, including antenatal care (ANC), is widely recommended. This study assessed the implementation of collaborative TB-HIV service delivery at a hospital-based ANC service unit. A record review of a random sample of 308 pregnant women attending the ANC service between April 2011 and February 2012 was conducted. Data were extracted from registers and patient case notes. Outcomes included the proportion of women who underwent HIV counselling and testing (HCT), CD4 count testing, antiretroviral treatment (ART), cotrimoxazole preventive treatment (CPT), TB screening and isoniazid preventive treatment (IPT). Analysis measured variations in patient characteristics associated with service delivery. All women underwent HCT; 80% of those who tested HIV-positive were screened for TB. Most (85.9%) of the HIV-positive women received a CD4 count. However, only 12.9% of eligible women received ART prophylaxis onsite, only 35.7% were referred for initiation of ART, only 42.3% commenced IPT and none received CPT or further investigations for TB. HIV-negative women had 2.6 higher odds (95%CI 1.3-5.3) of receiving TB screening than their HIV-positive counterparts. Although the identification of HIV-positive women and TB suspects was adequate, implementation of other TB-HIV collaborative activities was sub-optimal.

Do Recipients of an Association-Sponsored Quality Award Program Experience Better Quality Outcomes Compared With Other Nursing Facilities Across the United States?

PubMed

Castle, Nicholas; Olson, Doug; Shah, Urvi; Hansen, Kevin

2016-09-01

This study explores the relationship between recipients of an association-sponsored Quality Award Program and select measures of quality in U.S. nursing facilities, examined both cross-sectionally and over time. Data used came from Quality Award Program recipients over 9 years (2003-2011) and a set of quality indicators from the Online Survey Certification and Reporting (OSCAR) database. These data were analyzed using a variety of multivariate regression techniques. Cross-sectionally, the award recipients demonstrated higher performance on most of the quality indicators, compared with both the broader field of nursing facilities and also a more stringent comparison group of facilities. Comparing quality from the 4 years before the award was received to the 4 years after the award, the majority of quality indicators demonstrated improvement in those facilities receiving an award. These results indicate that, in general, the nursing facilities that participate in and receive the Silver or Gold American Health Care Association (AHCA) and National Center for Assisted Living (NCAL) National Quality Award perform at a higher level of quality for residents and sustain that heightened performance over a period of time.

Contribution of patient, physician, and environmental factors to demographic and health variation in colonoscopy follow-up for abnormal colorectal cancer screening test results.

PubMed

Partin, Melissa R; Gravely, Amy A; Burgess, James F; Haggstrom, David A; Lillie, Sarah E; Nelson, David B; Nugent, Sean M; Shaukat, Aasma; Sultan, Shahnaz; Walter, Louise C; Burgess, Diana J

2017-09-15

Patient, physician, and environmental factors were identified, and the authors examined the contribution of these factors to demographic and health variation in colonoscopy follow-up after a positive fecal occult blood test/fecal immunochemical test (FOBT/FIT) screening. In total, 76,243 FOBT/FIT-positive patients were identified from 120 Veterans Health Administration (VHA) facilities between August 16, 2009 and March 20, 2011 and were followed for 6 months. Patient demographic (race/ethnicity, sex, age, marital status) and health characteristics (comorbidities), physician characteristics (training level, whether primary care provider) and behaviors (inappropriate FOBT/FIT screening), and environmental factors (geographic access, facility type) were identified from VHA administrative records. Patient behaviors (refusal, private sector colonoscopy use) were estimated with statistical text mining conducted on clinic notes, and follow-up predictors and adjusted rates were estimated using hierarchical logistic regression. Roughly 50% of individuals completed a colonoscopy at a VHA facility within 6 months. Age and comorbidity score were negatively associated with follow-up. Blacks were more likely to receive follow-up than whites. Environmental factors attenuated but did not fully account for these differences. Patient behaviors (refusal, private sector colonoscopy use) and physician behaviors (inappropriate screening) fully accounted for the small reverse race disparity and attenuated variation by age and comorbidity score. Patient behaviors (refusal and private sector colonoscopy use) contributed more to variation in follow-up rates than physician behaviors (inappropriate screening). In the VHA, blacks are more likely to receive colonoscopy follow-up for positive FOBT/FIT results than whites, and follow-up rates markedly decline with advancing age and comorbidity burden. Patient and physician behaviors explain race variation in follow-up rates and contribute to variation by age and comorbidity burden. Cancer 2017;123:3502-12. Published 2017. This article is a US Government work and is in the public domain in the USA. © 2017 American Cancer Society.

Records of wells, test borings, and some measured geologic sections near the Western New York Nuclear Service Center, Cattaraugus County, New York

USGS Publications Warehouse

Bergeron, M.P.

1985-01-01

The Western New York Nuclear Service Center (WNYNSC) is a 3 ,336-acre tract of land in northern Cattaraugus County, NY, about 30 mi south of Buffalo. In 1963, 247 acres within the WNYNSC was developed for a nuclear-fuel reprocessing plant and ancillary facilities, including (1) a receiving and storage facility to store fuel prior to reprocessing, (2) underground storage tanks for liquid high-level radioactive wastes from fuel reprocessing, (3) a low-level wastewater treatment plant, and (4) two burial grounds for shallow burial of solid radioactive waste. A series of geologic and hydrologic investigations was done as part of the initial development and construction of the facilities by numerous agencies during 1960-62; these produced a large quantity of well data, some of which are difficult to locate or obtain. This report is a compilation of well and boring data collected during this period. The data include records of 236 wells, geologic logs of 145 wells and 167 test borings, and descriptions of 20 measured geologic sections. Two oversized maps show locations of the reported data. (USGS)

Satellite Power System (SPS). State and local regulations as applied to satellite power system microwave receiving antenna facilities

NASA Technical Reports Server (NTRS)

Kotin, A. D.

1978-01-01

State and local regulation of power plant construction and operation of solar power satellite (SPS) receiving stations is presented. Each receiving antenna station occupies a land area 100-200 km square, receives microwave transmissions from the solar power satellite, and converts them into electricity for transmission to the power grid. The long lead time associated with the SPS and the changing status of state and local regulation dictated emphasis on: generic classification of the types of regulation, and identification of regulatory vectors which affect rectenna facilities.

Effects of a gerotranscendence educational program on gerotranscendence recognition, attitude towards aging and behavioral intention towards the elderly in long-term care facilities: A quasi-experimental study.

PubMed

Lin, Yen-Chun; Wang, Chi-Jane; Wang, Jing-Jy

2016-01-01

Caregivers in long-term care (LTC) facilities have to uphold a positive attitude toward the elderly, so they will be more willing to provide the elderly with care of higher quality. Theory of Gerotranscendence is a theory which can assist the elderly in developing more mature and intellectual state of mind. It is hoped that the caregivers who receive gerotranscendence education may apply its concept to the care for the elderly. To evaluate the effects of the gerotranscendence educational program on caregivers' gerotranscendence recognition, attitude towards aging, and behavioral intention towards caring for the elderly. A quasi-experimental design with repeated measures was conducted. A total of 41 caregivers in LTC facilities participated and completed the study. Participants were invited to participate in a 2-day gerotranscendence educational program, and measurement took place at baseline, the end of the program (post-test) and three months after the program (follow-up test). The research tools included Gerotranscendence Recognition Scale-Chinese version, Aging Attitude scale, and Caregivers' Behavioral Intention Scale. This study used GLM repeated measures to perform analysis. There was a statistically significant difference in three repeated measures of participants' gerotranscendence recognition and behavior intention toward caring for the elderly (p=.002, .002, respectively) but not in the aging attitude score (p=.21). The post hoc comparison showed that the scores of these two outcomes in the post-test were significantly higher than those in the pre-test (p=.000; .024). However, the scores in the follow-up test were almost the same as those in the pre-test. The gerotranscendence educational program had timely effects on caregivers' gerotranscendence recognition and behavioral intention towards aging, and so caregivers working in LTC facilities may require ongoing training in the gerotranscendence educational program to ensure that these positive effects remain strong. Copyright © 2015 Elsevier Ltd. All rights reserved.

Are facilities following best practices of pediatric abdominal CT scans?

PubMed

Nosek, Amy E; Hartin, Charles W; Bass, Kathryn D; Glick, Philip L; Caty, Michael G; Dayton, Merril T; Ozgediz, Doruk E

2013-05-01

Established guidelines for pediatric abdominal CT scans include reduced radiation dosage to minimize cancer risk and the use of intravenous (IV) contrast to obtain the highest-quality diagnostic images. We wish to determine if these practices are being used at nonpediatric facilities that transfer children to a pediatric facility. Children transferred to a tertiary pediatric facility over a 16-mo period with abdominal CT scans performed for evaluation of possible appendicitis were retrospectively reviewed for demographics, diagnosis, radiation dosage, CT contrast use, and scan quality. If CT scans were repeated, the radiation dosage between facilities was compared using Student t-test. Ninety-one consecutive children transferred from 29 different facilities had retrievable CT scan images and clinical information. Half of CT scans from transferring institutions used IV contrast. Due to poor quality or inconclusive CT scans, 19 patients required a change in management. Children received significantly less radiation at our institution compared to the referring adult facility for the same body area scanned on the same child (9.7 mSv versus 19.9 mSv, P = 0.0079). Pediatric facilities may be using less radiation per CT scan due to a heightened awareness of radiation risks and specific pediatric CT scanning protocols. The benefits of IV contrast for the diagnostic yield of pediatric CT scans should be considered to obtain the best possible image and to prevent additional imaging. Every facility performing pediatric CT scans should minimize radiation exposure, and pediatric facilities should provide feedback and education to other facilities scanning children. Copyright © 2013 Elsevier Inc. All rights reserved.

Medical surveillance and programs on industrial hygiene at RCRA facilities

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

Murphy, T.E.

1994-12-31

Some special areas where much progress in industrial hygiene and safety has been made in the past few years are; training, personal protective equipment, uniforms, personal monitoring, area monitoring, and medical surveillance. Before one can begin to construct programs for worker protection, some knowledge of potential exposures must be gained. The best place to start is the Waste Analysis Plan, and the list of wastes that a particular site is authorized to receive. Waste Codes are listed within a facility`s Part A and Part B permits. Actual facility receipt of wastes are well documented within Load Records and other documentation.more » A facility`s training program forms the heart of a health and safety program. Every TSD facility should have developed a matrix of job titles and required training. Every facility must also make a commitment to providing a wide range of personal protective equipment, including a wide array of disposables. Some facilities will benefit from the occasional use of the newer respirator quantitative fit-testing devices. All facilities are urged to rent or borrow this type of equipment periodically. Quantitative respirator fit-testers are capable of revealing important deficiencies in a respirator program. Providing uniforms is a newer means of protecting workers. The use of uniforms is an effective means for addressing the idea of carry-home-waste. The use of disposables including boots, must be integrated into a Uniform Program if the program is to be effective. In addition, employees must strictly understand that uniforms must not leave the facility at any time, including lunch time.« less

Determinants of Integrated Management of Childhood Illness (IMCI) non-severe pneumonia classification and care in Malawi health facilities: Analysis of a national facility census.

PubMed

Johansson, Emily White; Nsona, Humphreys; Carvajal-Aguirre, Liliana; Amouzou, Agbessi; Hildenwall, Helena

2017-12-01

Research shows inadequate Integrated Management of Childhood Illness (IMCI)-pneumonia care in various low-income settings but evidence is largely from small-scale studies with limited evidence of patient-, provider- and facility-levels determinants of IMCI non-severe pneumonia classification and its management. The Malawi Service Provision Assessment 2013-2014 included 3149 outpatients aged 2-59 months with completed observations, interviews and re-examinations. Mixed-effects logistic regression models quantified the influence of patient-, provider and facility-level determinants on having IMCI non-severe pneumonia and its management in observed consultations. Among 3149 eligible outpatients, 590 (18.7%) had IMCI non-severe pneumonia classification in re-examination. 228 (38.7%) classified cases received first-line antibiotics and 159 (26.9%) received no antibiotics. 18.6% with cough or difficult breathing had 60-second respiratory rates counted during consultations, and conducting this assessment was significantly associated with IMCI training ever received (odds ratio (OR) = 2.37, 95% confidence interval (CI): 1.29-4.31) and negative rapid diagnostic test results (OR = 3.21, 95% CI: 1.45-7.13). Older children had lower odds of assessments than infants (OR = 48-59 months: 0.35, 95% CI: 0.16-0.75). Children presenting with any of the following complaints also had reduced odds of assessment: fever, diarrhea, skin problem or any danger sign. First-line antibiotic treatment for classified cases was significantly associated with high temperatures (OR = 3.26, 95% CI: 1.24-8.55) while older children had reduced odds of first-line treatment compared to infants (OR = 48-59 months: 0.29, 95% CI: 0.10-0.83). RDT-confirmed malaria was a significant predictor of no antibiotic receipt for IMCI non-severe pneumonia (OR = 10.65, 95% CI: 2.39-47.36). IMCI non-severe pneumonia care was sub-optimal in Malawi health facilities in 2013-2014 with inadequate assessments and prescribing practices that must be addressed to reduce this leading cause of mortality. Child's symptoms and age, malaria diagnosis and provider training were primary influences on assessment and treatment practices. Current evidence could be used to better target IMCI training and support to improve pneumonia care for sick children in Malawi facilities.

The Mars Sample Return Lab(s) - Lessons from the Past and Implications for the Future

NASA Technical Reports Server (NTRS)

Allen, Carlton

2012-01-01

It has been widely understood for many years that an essential component of a Mars Sample Return mission is a Sample Receiving Facility (SRF). The purpose of such a facility would be to take delivery of the flight hardware that lands on Earth, open the spacecraft and extract the sample container and samples, and conduct an agreed upon test protocol, while ensuring strict containment and contamination control of the samples while in the SRF. Any samples that are found to be non-hazardous (or are rendered non-hazardous by sterilization) would then be transferred to long-term curation. Although the general concept of an SRF is relatively straightforward, there has been considerable discussion about implementation planning.

University of Washington Clinical Neutron Facility: Report on 26 Years of Operation

NASA Astrophysics Data System (ADS)

Laramore, George E.; Emery, Robert; Reid, David; Banerian, Stefani; Kalet, Ira; Jacky, Jonathan; Risler, Ruedi

2011-12-01

Particle radiotherapy facilities are highly capital intensive and must operate over decades to recoup the original investment. We describe the successful, long-term operation of a neutron radiotherapy center at the University of Washington, which has been operating continuously since September 1984. To date, 2836 patients have received neutron radiotherapy. The mission of the facility has also evolved to include the production of unique radioisotopes that cannot be made with the low-energy cyclotrons more commonly found in nuclear medicine departments. The facility is also used for neutron damage testing for industrial devices. In this paper, we describe the challenges of operating such a facility over an extended time period, including a planned maintenance and upgrade program serving diverse user groups, and summarize the major clinical results in terms of tumor control and normal tissue toxicity. Over time, the mix of patients being treated has shifted from common tumors such as prostate cancer, lung cancer, and squamous cell tumors of the head and neck to the rarer tumors such as salivary gland tumors and sarcomas due to the results of clinical trials. Current indications for neutron radiotherapy are described and neutron tolerance doses for a range of normal tissues presented.

They receive antenatal care in health facilities, yet do not deliver there: predictors of health facility delivery by women in rural Ghana.

PubMed

Boah, Michael; Mahama, Abraham B; Ayamga, Emmanuel A

2018-05-03

Research has shown that use of antenatal services by pregnant women and delivery in health facilities with skilled birth attendants contribute to better delivery outcomes. However, a gap exists in Ghana between the use of antenatal care provided by health facilities and delivery in health facilities with skilled birth attendants by pregnant women. This study sought to identify the predictors of health facility delivery by women in a rural district in Ghana. This was a cross-sectional study conducted in June 2016. Women who delivered in the past 6 months preceding the study were interviewed. Data on socio-demographic characteristics, use of antenatal care, place of delivery and reasons for home delivery were collected from study participants. Chi-square test and multiple logistic regression analysis were used to assess an association between women's socio-demographic and obstetric characteristics and place of delivery at 95% confidence interval. The study found that 98.8% of women received antenatal care services at least once during their recent pregnancy, and 67.9% attended antenatal care at least four times before delivery. However, 61.9% of the women delivered in a health facility with a skilled attendant. The frequently mentioned reason for home delivery was "unaware of onset of labour and delivery". The odds for delivery at a health facility were reduced among women with four living children [(AOR = 0.07, CI = 0.15-0.36, p = 0.001)], with no exposure to delivery care information [(AOR = 0.06, CI = 0.01-0.34, p = 0.002), who started their first ANC visit from the second trimester of pregnancy[(AOR = 0.003, CI = 0.01-0.15, p < 0.001)] and increased among women who made at least four ANC visits before delivery [(AOR = 17.53, CI = 6.89-44.61, p < 0.001)]. Findings from this study revealed a low rate of delivery at health facilities although visits to antenatal care sessions were high, an indication that there was the need to intensify health education on early initiation of antenatal care, signs of labour and delivery, and importance of health facility delivery.

Integrating repositories with fuel cycles: The airport authority model

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

Forsberg, C.

2012-07-01

The organization of the fuel cycle is a legacy of World War II and the cold war. Fuel cycle facilities were developed and deployed without consideration of the waste management implications. This led to the fuel cycle model of a geological repository site with a single owner, a single function (disposal), and no other facilities on site. Recent studies indicate large economic, safety, repository performance, nonproliferation, and institutional incentives to collocate and integrate all back-end facilities. Site functions could include geological disposal of spent nuclear fuel (SNF) with the option for future retrievability, disposal of other wastes, reprocessing with fuelmore » fabrication, radioisotope production, other facilities that generate significant radioactive wastes, SNF inspection (navy and commercial), and related services such as SNF safeguards equipment testing and training. This implies a site with multiple facilities with different owners sharing some facilities and using common facilities - the repository and SNF receiving. This requires a different repository site institutional structure. We propose development of repository site authorities modeled after airport authorities. Airport authorities manage airports with government-owned runways, collocated or shared public and private airline terminals, commercial and federal military facilities, aircraft maintenance bases, and related operations - all enabled and benefiting the high-value runway asset and access to it via taxi ways. With a repository site authority the high value asset is the repository. The SNF and HLW receiving and storage facilities (equivalent to the airport terminal) serve the repository, any future reprocessing plants, and others with needs for access to SNF and other wastes. Non-public special-built roadways and on-site rail lines (equivalent to taxi ways) connect facilities. Airport authorities are typically chartered by state governments and managed by commissions with members appointed by the state governor, county governments, and city governments. This structure (1) enables state and local governments to work together to maximize job and tax benefits to local communities and the state, (2) provides a mechanism to address local concerns such as airport noise, and (3) creates an institutional structure with large incentives to maximize the value of the common asset, the runway. A repository site authority would have a similar structure and be the local interface to any national waste management authority. (authors)« less

Determinants of the use of specialist mental health services by nursing home residents.

PubMed Central

Shea, D G; Streit, A; Smyer, M A

1994-01-01

OBJECTIVE. This study examines the effects of resident and facility characteristics on the probability of nursing home residents receiving treatment by mental health professionals. DATA SOURCES/STUDY SETTING. The study uses data from the Institutional Population Component of the 1987 National Medical Expenditure Survey, a secondary data source containing data on 3,350 nursing home residents living in 810 nursing homes as of January 1, 1987. STUDY DESIGN. Andersen's health services use model (1968) is used to estimate a multivariate logistic equation for the effects of independent variables on the probability that a resident has received services from mental health professionals. Important variables include resident race, sex, and age; presence of several behaviors and reported mental illnesses; and facility ownership, facility size, and facility certification. DATA COLLECTION/EXTRACTION METHODS. Data on 188 residents were excluded from the sample because information was missing on several important variables. For some additional variables residents who had missing information were coded as negative responses. This left 3,162 observations for analysis in the logistic regressions. PRINCIPAL FINDINGS. Older residents and residents with more ADL limitations are much less likely than other residents to have received treatment from a mental health professional. Residents with reported depression, schizophrenia, or psychoses, and residents who are agitated or hallucinating are more likely to have received treatment. Residents in government nursing homes, homes run by chains, and homes with low levels of certification are less likely to have received treatment. CONCLUSIONS. Few residents receive treatment from mental health professionals despite need. Older, physically disabled residents need special attention. Care in certain types of facilities requires further study. New regulations mandating treatment for mentally ill residents will demand increased attention from nursing home administrators and mental health professionals. PMID:8005788

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

PubMed

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

1995-01-01

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

Assessing infection control practices to protect health care workers and patients in Malawi from nosocomial transmission of Mycobacterium tuberculosis.

PubMed

Flick, Robert J; Munthali, Adamson; Simon, Katherine; Hosseinipour, Mina; Kim, Maria H; Mlauzi, Lameck; Kazembe, Peter N; Ahmed, Saeed

2017-01-01

Transmission of Mycobacterium tuberculosis (TB) in health settings threatens health care workers and people living with HIV in sub-Saharan Africa. Nosocomial transmission is reduced with implementation of infection control (IC) guidelines. The objective of this study is to describe implementation of TB IC measures in Malawi. We conducted a cross-sectional study utilizing anonymous health worker questionnaires, semi-structured interviews with facility managers, and direct observations at 17 facilities in central Malawi. Of 592 health care workers surveyed, 34% reported that all patients entering the facility were screened for cough and only 8% correctly named the four most common signs and symptoms of TB in adults. Of 33 managers interviewed, 7 (21%) and 1 (3%) provided the correct TB screening questions for use in adults and children, respectively. Of 592 health workers, only 2.4% had been screened for TB in the previous year. Most (90%) reported knowing their HIV status, 53% were tested at their facility of employment, and half reported they would feel comfortable receiving ART or TB treatment at their facility of employment. We conclude that screening is infrequently conducted and knowledge gaps may undercut its effectiveness. Further, health care workers do not routinely access TB and HIV diagnostic and treatment services at their facility of employment.

Cockpit weather information needs

NASA Technical Reports Server (NTRS)

Scanlon, Charles H.

1992-01-01

The primary objective is to develop an advanced pilot weather interface for the flight deck and to measure its utilization and effectiveness in pilot reroute decision processes, weather situation awareness, and weather monitoring. Identical graphical weather displays for the dispatcher, air traffic control (ATC), and pilot crew should also enhance the dialogue capabilities for reroute decisions. By utilizing a broadcast data link for surface observations, forecasts, radar summaries, lightning strikes, and weather alerts, onboard weather computing facilities construct graphical displays, historical weather displays, color textual displays, and other tools to assist the pilot crew. Since the weather data is continually being received and stored by the airborne system, the pilot crew has instantaneous access to the latest information. This information is color coded to distinguish degrees of category for surface observations, ceiling and visibilities, and ground radar summaries. Automatic weather monitoring and pilot crew alerting is accomplished by the airborne computing facilities. When a new weather information is received, the displays are instantaneously changed to reflect the new information. Also, when a new surface or special observation for the intended destination is received, the pilot crew is informed so that information can be studied at the pilot's discretion. The pilot crew is also immediately alerted when a severe weather notice, AIRMET or SIGMET, is received. The cockpit weather display shares a multicolor eight inch cathode ray tube and overlaid touch panel with a pilot crew data link interface. Touch sensitive buttons and areas are used for pilot selection of graphical and data link displays. Time critical ATC messages are presented in a small window that overlays other displays so that immediate pilot alerting and action can be taken. Predeparture and reroute clearances are displayed on the graphical weather system so pilot review of weather along the route can be accomplished prior to pilot acceptance of the clearance. An ongoing multiphase test series is planned for testing and modifying the graphical weather system. Preliminary data shows that the nine test subjects considered the graphical presentation to be much better than their current weather information source for situation awareness, flight safety, and reroute decision making.

Billing and accounts receivable: fundamentals for improvement.

PubMed

Bizon, M M

1993-07-01

If a healthcare facility's accounts receivable operation is experiencing problems, the patient accounts manager should survey all areas of his or her responsibility to determine the best method of resolving the difficulties. One effective technique to reduce billing problems is to take a proactive--not reactive--approach. If mistakes can be corrected before they get out of control, and if the patient accounts manager can ensure that claims will not be denied, a healthcare facility's accounts receivable should remain in good condition.

Development and operation of a mobile test facility for education

NASA Astrophysics Data System (ADS)

Davis, Christopher T.

The automotive industry saw a large shift towards vehicle electrification after the turn of the century. It became necessary to ensure that new and existing engineers were qualified to design and calibrate these new systems. To ensure this training, Michigan Tech received a grant to develop a curriculum based around vehicle electrification. As part of this agenda, the Michigan Tech Mobile Laboratory was developed to provide hands-on training for professional engineers and technicians in hybrid electric vehicles and vehicle electrification. The Mobile Lab has since then increased the scope of the delivered curriculum to include other automotive areas and even customizable course content to meet specific needs. This thesis outlines the development of the Mobile Laboratory and its powertrain test facilities. The focus of this thesis is to discuss the different hardware and software systems within the lab and test cells. Detailed instructions on the operation and maintenance of each of the systems are discussed. In addition, this thesis outlines the setup and operation of the necessary equipment for several of the experiments for the on and off campus courses and seminars.

Ammonia Oxidation Plant at Plum Brook Ordnance Works

NASA Image and Video Library

1943-06-21

An ammonia oxidation plant at the Plum Brook Ordnance Works near Sandusky, Ohio, which later became the National Aeronautics and Space Administration’s (NASA) Plum Brook Station. During World War II the ordnance works produced trinitroluene (TNT), dinitrotoluene (DNT), and pentolite which were crated and shipped to an arsenal in Ravenna, Ohio. There, the explosives were packed into shells and sent to Allied forces overseas. Plum Brook was the third largest producer of TNT during World War II. Toluene, sulfuric acid, and nitric acid were used to manufacture the TNT. Nitric Acid is made by oxidizing ammonia, adding water, and concentrating it. The facility in this photograph was used for this oxidation. The structure included air compressors, filters, aftercoolers, power recovery systems, air receivers, heaters, ammonia gasifiers, gas mixers, cooler condensers, absorption columns, and bleaching columns. The Plum Brook Ordnance Works was shut down immediately after the war and remained vacant for the next ten years. NASA’s predecessor, the National Advisory Committee for Aeronautics (NACA), acquired the 500 acres of the site in 1955 to build a nuclear test reactor. By 1963, the agency had acquired the entire 9000 acres from the Army. Almost all of the military facilities were removed in the early 1960s. Plum Brook Station contained over 30 test facilities at its peak in the late 1960s. Today there are four major facilities in operation.

A proton irradiation test facility for space research in Ankara, Turkey

NASA Astrophysics Data System (ADS)

Gencer, Ayşenur; Yiǧitoǧlu, Merve; Bilge Demirköz, Melahat; Efthymiopoulos, Ilias

2016-07-01

Space radiation often affects the electronic components' performance during the mission duration. In order to ensure reliable performance, the components must be tested to at least the expected dose that will be received in space, before the mission. Accelerator facilities are widely used for such irradiation tests around the world. Turkish Atomic Energy Authority (TAEA) has a 15MeV to 30MeV variable proton cyclotron in Ankara and the facility's main purpose is to produce radioisotopes in three different rooms for different target systems. There is also an R&D room which can be used for research purposes. This paper will detail the design and current state of the construction of a beamline to perform Single Event Effect (SEE) tests in Ankara for the first time. ESA ESCC No.25100 Standard Single Event Effect Test Method and Guidelines is being considered for these SEE tests. The proton beam kinetic energy must be between 20MeV and 200MeV according to the standard. While the proton energy is suitable for SEE tests, the beam size must be 15.40cm x 21.55cm and the flux must be between 10 ^{5} p/cm ^{2}/s to at least 10 ^{8} p/cm ^{2}/s according to the standard. The beam size at the entrance of the R&D room is mm-sized and the current is variable between 10μA and 1.2mA. Therefore, a defocusing beam line has been designed to enlarge the beam size and reduce the flux value. The beam line has quadrupole magnets to enlarge the beam size and the collimators and scattering foils are used for flux reduction. This facility will provide proton fluxes between 10 ^{7} p/cm ^{2}/s and 10 ^{10} p/cm ^{2}/s for the area defined in the standard when completed. Also for testing solar cells developed for space, the proton beam energy will be lowered below 10MeV. This project has been funded by Ministry of Development in Turkey and the beam line construction will finish in two years and SEE tests will be performed for the first time in Turkey.

The 10 MWe solar thermal central receiver pilot plant solar facilities design integration, RADL item 1-10

NASA Astrophysics Data System (ADS)

1980-07-01

Accomplishments are reported in the areas of: program management, system integration, the beam characterization system, receiver unit, thermal storage subsystems, master control system, plant support subsystem and engineering services. A solar facilities design integration program action items update is included. Work plan changes and cost underruns are discussed briefly. (LEW)

34 CFR 222.172 - What activities may an LEA conduct with funds received under this program?

Code of Federal Regulations, 2010 CFR

2010-07-01

... for free public education to ensure the health and safety of students and personnel, including... facility used for free public education to provide school facilities that support a contemporary... 34 Education 1 2010-07-01 2010-07-01 false What activities may an LEA conduct with funds received...

Development and applications of nondestructive evaluation at Marshall Space Flight Center

NASA Technical Reports Server (NTRS)

Whitaker, Ann F.

1990-01-01

A brief description of facility design and equipment, facility usage, and typical investigations are presented for the following: Surface Inspection Facility; Advanced Computer Tomography Inspection Station (ACTIS); NDE Data Evaluation Facility; Thermographic Test Development Facility; Radiographic Test Facility; Realtime Radiographic Test Facility; Eddy Current Research Facility; Acoustic Emission Monitoring System; Advanced Ultrasonic Test Station (AUTS); Ultrasonic Test Facility; and Computer Controlled Scanning (CONSCAN) System.

Measuring The Impact Of Cash Transfers And Behavioral 'Nudges' On Maternity Care In Nairobi, Kenya.

PubMed

Cohen, Jessica; Rothschild, Claire; Golub, Ginger; Omondi, George N; Kruk, Margaret E; McConnell, Margaret

2017-11-01

Many patients in low-income countries express preferences for high-quality health care but often end up with low-quality providers. We conducted a randomized controlled trial with pregnant women in Nairobi, Kenya, to analyze whether cash transfers, enhanced with behavioral "nudges," can help women deliver in facilities that are consistent with their preferences and are of higher quality. We tested two interventions. The first was a labeled cash transfer (LCT), which explained that the cash was to help women deliver where they wanted. The second was a cash transfer that combined labeling and a commitment by the recipient to deliver in a prespecified desired facility as a condition of receiving the final payment (L-CCT). The L-CCT improved patient-perceived quality of interpersonal care but not perceived technical quality of care. It also increased women's likelihood of delivering in facilities that met standards for routine and emergency newborn care but not the likelihood of delivering in facilities that met standards for obstetric care. The LCT had fewer measured benefits. Women preferred facilities with high technical and interpersonal care quality, but these quality measures were often negatively correlated within facilities. Even with cash transfers, many women still used poor-quality facilities. A larger study is warranted to determine whether the L-CCT can improve maternal and newborn outcomes.

Compliance to follow up and adherence to medication in hypertensive patients in an urban informal settlement in Kenya: comparison of three models of care.

PubMed

Kuria, Ng'endo; Reid, Anthony; Owiti, Philip; Tweya, Hannock; Kibet, Caleb Kipkurui; Mbau, Lilian; Manzi, Marcel; Murunga, Victor; Namusonge, Tecla; Kibachio, Joseph

2018-05-19

To determine and compare, among three models of care, compliance to scheduled clinic appointments and adherence to anti-hypertensive medication of patients in an informal settlement of Kibera, Kenya. Routinely collected patient data were used from three health facilities, six walkway clinics and one weekend/church clinic. Patients were eligible if they had received hypertension care for more than six months. Compliance with clinic appointments and self-reported adherence to medication were determined from clinic records and compared using the Chi-square test. Univariate and multivariate logistic regression models estimated the odds of overall adherence to medication. 785 patients received hypertension treatment eligible for analysis, of whom two-thirds were women. Between them, there were 5879 clinic visits with an overall compliance to appointments of 63%. Compliance was high in the health facilities and walkway clinics but men were more likely to attend the weekend/church clinics. Self-reported adherence to medication by those complying with scheduled clinic visits was 94%. Patients in the walkway clinics were two times more likely to adhere to anti-hypertensive medication than patients at the health facility (OR 1.97, 95%CI 1.25-3.10). Walkway clinics outperformed health facilities and weekend clinics. Use of multiple sites for the management of hypertensive patients led to good compliance with scheduled clinic visits and very good self-reported adherence to medication in a low-resource setting. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Quality assurance in the HIV/AIDS laboratory network of China.

PubMed

Jiang, Yan; Qiu, Maofeng; Zhang, Guiyun; Xing, Wenge; Xiao, Yao; Pan, Pinliang; Yao, Jun; Ou, Chin-Yih; Su, Xueli

2010-12-01

In 2009, there were 8273 local screening laboratories, 254 confirmatory laboratories, 35 provincial confirmatory central laboratories and 1 National AIDS Reference Laboratory (NARL) in China. These laboratories were located in Center for Disease Control and Prevention (CDC) facilities, hospitals, blood donation clinics, maternal and child health (MCH) hospitals and border health quarantine health-care facilities. The NARL and provincial laboratories provide quality assurance through technical, bio-safety and managerial training; periodic proficiency testing; on-site supervisory inspections; and commercial serologic kit evaluations. From 2002 to 2009, more than 220 million HIV antibody tests were performed at screening laboratories, and all reactive and indeterminate samples were confirmed at confirmatory laboratories. The use of highly technically complex tests, including CD4 cell enumeration, viral load, dried blood spot (DBS)-based early infant diagnosis (EID), drug resistance (DR) genotyping, HIV-1 subtyping and incidence assays, have increased in recent years and their performance quality is closely monitored. China has made significant progress in establishing a well-coordinated HIV laboratory network and QA systems. However, the coverage and intensity of HIV testing and quality assurance programmes need to be strengthened so as to ensure that more infected persons are diagnosed and that they receive timely prevention and treatment services.

Costs of HIV/AIDS outpatient services delivered through Zambian public health facilities.

PubMed

Bratt, John H; Torpey, Kwasi; Kabaso, Mushota; Gondwe, Yebo

2011-01-01

To present evidence on unit and total costs of outpatient HIV/AIDS services in ZPCT-supported facilities in Zambia; specifically, to measure unit costs of selected outpatient HIV/AIDS services, and to estimate total annual costs of antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT) in Zambia. Cost data from 2008 were collected in 12 ZPCT-supported facilities (hospitals and health centres) in four provinces. Costs of all resources used to produce ART, PMTCT and CT visits were included, using the perspective of the provider. All shared costs were distributed to clinic visits using appropriate allocation variables. Estimates of annual costs of HIV/AIDS services were made using ZPCT and Ministry of Health data on numbers of persons receiving services in 2009. Unit costs of visits were driven by costs of drugs, laboratory tests and clinical labour, while variability in visit costs across facilities was explained mainly by differences in utilization. First-year costs of ART per client ranged from US$278 to US$523 depending on drug regimen and facility type; costs of a complete course of antenatal care (ANC) including PMTCT were approximately US$114. Annual costs of ART provided in ZPCT-supported facilities were estimated at US$14.7-$40.1 million depending on regimen, and annual costs of antenatal care including PMTCT were estimated at US$16 million. In Zambia as a whole, the respective estimates were US$41.0-114.2 million for ART and US$57.7 million for ANC including PMTCT. Consistent with the literature, total costs of services were dominated by drugs, laboratory tests and clinical labour. For each visit type, variability across facilities in total costs and cost components suggests that some potential exists to reduce costs through greater harmonization of care protocols and more intensive use of fixed resources. Improving facility-level information on the costs of resources used to produce services should be emphasized as an element of health systems strengthening. © 2010 Blackwell Publishing Ltd.

Characterization of wood mulch and leachate/runoff from three wood recycling facilities.

PubMed

Kannepalli, Sarat; Strom, Peter F; Krogmann, Uta; Subroy, Vandana; Giménez, Daniel; Miskewitz, Robert

2016-11-01

Large-scale open storage of wood mulch is common practice at wood recycling facilities. During rain and snow melt, leachate with soluble compounds and suspended particles is released from mulch stockpiles. The objective of this study was to determine the quality of leachate/runoff from wood recycling facilities to evaluate its potential to contaminate receiving waterbodies. Wood mulch (n = 30) and leachate/runoff (n = 26) samples were collected over 1.5 years from three wood recycling facilities in New Jersey, USA. Differences by site were found (p < 0.05) for most of the 21 constituents tested in the solid wood mulch samples. Biochemical oxygen demand (range <20-3000 mg/L), chemical oxygen demand (134-6000 mg/L) and total suspended solids (69-401 mg/L) median concentrations of the leachate/runoff samples were comparable to those of untreated domestic wastewater. Total Kjeldahl N, total P and fecal coliform median values were slightly lower than typical wastewater values. Dose-response studies with leachate/runoff samples using zebrafish (Danio rerio) embryos showed that mortality and developmental defects typically did not occur even at the highest concentration tested, indicating low toxicity, although delayed development did occur. Based on this study, leachate/runoff from wood recycling facilities should not be released to surface waters as it is a potential source of organic contamination and low levels of nutrients. A study in which runoff from a controlled drainage area containing wood mulch of known properties is monitored would allow for better assessment of the potential impact of stormwater runoff from wood recycling facilities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Quantification of wind flow in the European Mars Simulation Wind Tunnel Facility

NASA Astrophysics Data System (ADS)

Holstein-Rathlou, C.; Merrison, J. P.; Iversen, J. J.; Nornberg, P.

2012-04-01

We present the European Mars Simulation Wind Tunnel facility, a unique prototype facility capable of simulating a wide range of environmental conditions, such as those which can be found at the surface of Earth or Mars. The chamber complements several other large-scale simulation facilities at Aarhus University, Denmark. The facility consists of a 50 m3 environmental chamber capable of operating at low pressure (0.02 - 1000 mbar) and cryogenic temperatures (-130 °C up to +60 °C). This chamber houses a re-circulating wind tunnel capable of generating wind speeds up to 25 m/s and has a dust injection system that can produce suspended particulates (aerosols). It employs a unique LED based optical illumination system (solar simulator) and an advanced network based control system. Laser based optoelectronic instrumentation is used to quantify and monitor wind flow, dust suspension and deposition. This involves a commercial Laser Doppler Anemometer (LDA) and a Particle Dynamics Analysis receiver (PDA), which are small laser based instruments specifically designed for measuring wind speed and sizes of particles situated in a wind flow. Wind flow calibrations will be performed with the LDA system and presented. Pressure and temperature calibrations will follow in order to enable the facility to be used for the testing, development, calibration and comparison of e.g. meteorological sensors under a wide range of environmental conditions as well as multi-disciplinary scientific studies. The wind tunnel is accessible to international collaborators and space agencies for instrument testing, calibration and qualification. It has been financed by the European Space Agency (ESA) as well as the Aarhus University Science Faculty and the Villum Kann Rasmussen Foundation.

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

PubMed

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

2015-01-01

Effective supportive supervision is widely recognized as essential for optimal management of medicines in government health facilities and also in contributing towards improved access and utilization of health services. This study sought to examine the extent supportive supervision for medicines management in government health facilities from a health worker perspective. A cross-sectional study was done targeting health workers managing medicines in government health facilities in Kiambu County. One hundred and thirty eight respondents took part in the study which explored the quality of supportive supervision from a health worker's perspective, and also examined the factors influencing their contentment with the level of supervision received. A statistical analysis was done using SPSS 21 and Excel 2013. Supervisory visits from all levels of health management were not regularly done, standard checklists were not routinely used, and action plans irregularly developed and followed up. Only 54 (38.6%) respondents were satisfied with the levels of supportive supervision that they received, with satisfaction significantly differing across the professional cadres, χ (2) (12, n = 138) = 29.762, p = .003; across the different tiers of health facilities, r s (138) = 0.341, p < .001; and with the education levels of the respondents, r s (138) = 0.381, p < .001. The study concluded that supportive supervision for medicines management that government health facilities received was still inadequate, and health workers were dissatisfied with the level of supervision that they received. The study recommends a review of the support supervision policy at the county level to address the unearthed inefficiencies and improve supervision for medicines management in government health facilities.

Perceptions of HIV Self-Testing Among Men Who Have Sex With Men in the United States: A Qualitative Analysis.

PubMed

Freeman, Arin E; Sullivan, Patrick; Higa, Darrel; Sharma, Akshay; MacGowan, Robin; Hirshfield, Sabina; Greene, George J; Gravens, Laura; Chavez, Pollyanna; McNaghten, A D; Johnson, Wayne D; Mustanski, Brian

2018-02-01

HIV testing is the gateway into both prevention and treatment services. It is important to understand how men who have sex with men (MSM) perceive HIV self-tests. We conducted focus groups and individual interviews to collect feedback on two HIV self-tests, and on a dried blood spot (DBS) specimen collection kit. Perceptions and attitudes around HIV self-testing (HIVST), and willingness to distribute HIV self-tests to others were assessed. MSM reported HIVST to be complementary to facility-based testing, and liked this approach because it offers privacy and convenience, does not require counseling, and could lead to linkage to care. However, they also had concerns around the accuracy of HIV self-tests, their cost, and receiving a positive test result without immediate access to follow-up services. Despite these issues, they perceived HIVST as a positive addition to their HIV prevention toolbox.

Planning Considerations for a Mars Sample Receiving Facility: Summary and Interpretation of Three Design Studies

NASA Astrophysics Data System (ADS)

Beaty, David W.; Allen, Carlton C.; Bass, Deborah S.; Buxbaum, Karen L.; Campbell, James K.; Lindstrom, David J.; Miller, Sylvia L.; Papanastassiou, Dimitri A.

2009-10-01

It has been widely understood for many years that an essential component of a Mars Sample Return mission is a Sample Receiving Facility (SRF). The purpose of such a facility would be to take delivery of the flight hardware that lands on Earth, open the spacecraft and extract the sample container and samples, and conduct an agreed-upon test protocol, while ensuring strict containment and contamination control of the samples while in the SRF. Any samples that are found to be non-hazardous (or are rendered non-hazardous by sterilization) would then be transferred to long-term curation. Although the general concept of an SRF is relatively straightforward, there has been considerable discussion about implementation planning. The Mars Exploration Program carried out an analysis of the attributes of an SRF to establish its scope, including minimum size and functionality, budgetary requirements (capital cost, operating costs, cost profile), and development schedule. The approach was to arrange for three independent design studies, each led by an architectural design firm, and compare the results. While there were many design elements in common identified by each study team, there were significant differences in the way human operators were to interact with the systems. In aggregate, the design studies provided insight into the attributes of a future SRF and the complex factors to consider for future programmatic planning.

Planning considerations for a Mars Sample Receiving Facility: summary and interpretation of three design studies.

PubMed

Beaty, David W; Allen, Carlton C; Bass, Deborah S; Buxbaum, Karen L; Campbell, James K; Lindstrom, David J; Miller, Sylvia L; Papanastassiou, Dimitri A

2009-10-01

It has been widely understood for many years that an essential component of a Mars Sample Return mission is a Sample Receiving Facility (SRF). The purpose of such a facility would be to take delivery of the flight hardware that lands on Earth, open the spacecraft and extract the sample container and samples, and conduct an agreed-upon test protocol, while ensuring strict containment and contamination control of the samples while in the SRF. Any samples that are found to be non-hazardous (or are rendered non-hazardous by sterilization) would then be transferred to long-term curation. Although the general concept of an SRF is relatively straightforward, there has been considerable discussion about implementation planning. The Mars Exploration Program carried out an analysis of the attributes of an SRF to establish its scope, including minimum size and functionality, budgetary requirements (capital cost, operating costs, cost profile), and development schedule. The approach was to arrange for three independent design studies, each led by an architectural design firm, and compare the results. While there were many design elements in common identified by each study team, there were significant differences in the way human operators were to interact with the systems. In aggregate, the design studies provided insight into the attributes of a future SRF and the complex factors to consider for future programmatic planning.

Out-of-pocket expenses for maternity care in rural Bangladesh: a public-private comparison.

PubMed

Rahman, Moshiur; Rob, Ubaidur; Noor, Forhana Rahman; Bellows, Benjamin

Out-of-pocket expenses incurred by women for availing maternal healthcare services at public and private health facilities in Bangladesh were examined using a baseline household survey evaluating the impact of demand side financing vouchers on utilization and service delivery for maternal healthcare. The survey was conducted in 2010 among 3,300 women who gave birth in the previous 12 months from the start of data collection. Information on costs incurred to receive antenatal, delivery, and postnatal care services was collected. Findings reveal that the majority of women reported paying out-of-pocket expenses for availing maternal healthcare services both at public and private health facilities. Out-of-pocket expenses include registration, consultation, laboratory examination, medicine, transportation, and other associated costs incurred for receiving maternal healthcare services. On average, women paid US$3.60 out-of-pocket expenses for receiving antenatal care at public health facilities and US$12.40 at private health facilities. Similarly, women paid one and half times more for normal (US$42.30) and cesarean deliveries (US$136.20) at private health facilities compared to public health facilities. On the other hand, costs for postnatal care services did not vary significantly between public and private health facilities. Utilization of maternal healthcare services can be improved if out-of-pocket expenses can be minimized. At the same time, effective demand generation strategies are necessary to encourage women to utilize health facilities.

Estimating retention in HIV care accounting for patient transfers: A national laboratory cohort study in South Africa.

PubMed

Fox, Matthew P; Bor, Jacob; Brennan, Alana T; MacLeod, William B; Maskew, Mhairi; Stevens, Wendy S; Carmona, Sergio

2018-06-01

Systematic reviews have described high rates of attrition in patients with HIV receiving antiretroviral therapy (ART). However, migration and clinical transfer may lead to an overestimation of attrition (death and loss to follow-up). Using a newly linked national laboratory database in South Africa, we assessed national retention in South Africa's national HIV program. Patients receiving care in South Africa's national HIV program are monitored through regular CD4 count and viral load testing. South Africa's National Health Laboratory Service has maintained a database of all public-sector CD4 count and viral load results since 2004. We linked individual laboratory results to patients using probabilistic matching techniques, creating a national HIV cohort. Validation of our approach in comparison to a manually matched dataset showed 9.0% undermatching and 9.5% overmatching. We analyzed data on patients initiating ART in the public sector from April 1, 2004, to December 31, 2006, when ART initiation could be determined based on first viral load among those whose treatment followed guidelines. Attrition occurred on the date of a patient's last observed laboratory measure, allowing patients to exit and reenter care prior to that date. All patients had 6 potential years of follow-up, with an additional 2 years to have a final laboratory measurement to be retained at 6 years. Data were censored at December 31, 2012. We assessed (a) national retention including all laboratory tests regardless of testing facility and (b) initiating facility retention, where laboratory tests at other facilities were ignored. We followed 55,836 patients initiating ART between 2004 and 2006. At ART initiation, median age was 36 years (IQR: 30-43), median CD4 count was 150 cells/mm3 (IQR: 81-230), and 66.7% were female. Six-year initiating clinic retention was 29.1% (95% CI: 28.7%-29.5%). After allowing for transfers, national 6-year retention was 63.3% (95% CI: 62.9%-63.7%). Results differed little when tightening or relaxing matching procedures. We found strong differences in retention by province, ranging from 74.2% (95% CI: 73.2%-75.2%) in Western Cape to 52.2% (95% CI: 50.6%-53.7%) in Mpumalanga at 6 years. National attrition was higher among patients initiating at lower CD4 counts and higher viral loads, and among patients initiating ART at larger facilities. The study's main limitation is lack of perfect cohort matching, which may lead to over- or underestimation of retention. We also did not have data from KwaZulu-Natal province prior to 2010. In this study, HIV care retention was substantially higher when viewed from a national perspective than from a facility perspective. Our results suggest that traditional clinical cohorts underestimate retention.

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

PubMed Central

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

2015-01-01

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

Description of a Remote Ionospheric Scintillation Data Collection Facility

DOT National Transportation Integrated Search

1973-03-01

An experimental technique is described which measures L-band ionospheric scintillation at a remote, unmanned site. Details of an automatic data collection facility are presented. The remote facility comprises an L-band receiver, and a complete VHF co...

38 CFR 21.346 - Facility temporarily not offering training or rehabilitation services.

Code of Federal Regulations, 2014 CFR

2014-07-01

... and Employment Under 38 U.S.C. Chapter 31 Leaves of Absence § 21.346 Facility temporarily not offering... leaves of absence required. A veteran, who wishes to receive subsistence allowance while the facility...

38 CFR 21.346 - Facility temporarily not offering training or rehabilitation services.

Code of Federal Regulations, 2011 CFR

2011-07-01

... and Employment Under 38 U.S.C. Chapter 31 Leaves of Absence § 21.346 Facility temporarily not offering... leaves of absence required. A veteran, who wishes to receive subsistence allowance while the facility...

38 CFR 21.346 - Facility temporarily not offering training or rehabilitation services.

Code of Federal Regulations, 2013 CFR

2013-07-01

... and Employment Under 38 U.S.C. Chapter 31 Leaves of Absence § 21.346 Facility temporarily not offering... leaves of absence required. A veteran, who wishes to receive subsistence allowance while the facility...

38 CFR 21.346 - Facility temporarily not offering training or rehabilitation services.

Code of Federal Regulations, 2012 CFR

2012-07-01

... and Employment Under 38 U.S.C. Chapter 31 Leaves of Absence § 21.346 Facility temporarily not offering... leaves of absence required. A veteran, who wishes to receive subsistence allowance while the facility...

38 CFR 21.346 - Facility temporarily not offering training or rehabilitation services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and Employment Under 38 U.S.C. Chapter 31 Leaves of Absence § 21.346 Facility temporarily not offering... leaves of absence required. A veteran, who wishes to receive subsistence allowance while the facility...

(abstract) The Evolving Spaceborne Radar Data Support to Earth Science and Operations at the Alaska SAR Facility

NASA Technical Reports Server (NTRS)

Carsey, Frank D.

1996-01-01

The Alaska SAR Facility (ASF) has been receiving, processing, archiving, and distributing data for Earth scientists and operations since it began receiving data in 1991. Four radar satellites are now being handled. Recent developments have served to increase the level of services of ASF to the Earth science community considerably. These developments are discussed.

76 FR 78631 - Questar Pipeline Company; Notice of Intent To Prepare an Environmental Assessment for the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-19

... are currently exposed, which would be removed. Questar would also construct a pig launcher/receiver \\1\\ facility at its new Mainline 103/68 junction. \\1\\ A pipeline ``pig'' is a device used to clean or inspect the pipeline. A pig launcher/receiver is an aboveground facility where pigs are inserted or retrieved...

Development of Thermoacoustic Sensors for Sodium-cooled Fast Reactors

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

Heibel, Michael D.; Carvajal, Jorge V.; Ferroni, Paolo

This Final Report refers to the project “Development of Thermoacoustic Sensors for Sodium-cooled Fast Reactor Systems”, which was led by Westinghouse Electric Company (Westinghouse) and carried out in collaboration with Argonne National Laboratory (ANL) and University of Pittsburgh. Thermo-acoustic Power Sensors (TAPS) are self-powered, wireless sensors envisioned for measuring key parameters, such as local temperature and neutron flux, in a nuclear reactor core. This project was intended to specifically investigate their applicability to Sodium-cooled Fast Reactors (SFR). TAPS are non-invasive (wireless) and passive (self-powered) devices. The passivity derives from their ability to use conditions that “naturally” exist in a nuclearmore » reactor, such as gamma and neutron flux, as power sources. They generate oscillating pressure waves (i.e., sound waves) which, with a frequency and amplitude dependent upon these conditions, can travel through the core and associated structures, and reach the outside of the reactor vessel where a properly designed network of receivers can detect and interpret them. These receivers require a very small amount of power which, during loss of power events, can be provided for example by harvesting gamma radiation energy, thus resulting in a monitoring system that can function both during normal operation and during loss of power events. The project aimed at TAPS development through a series of tasks which are listed and briefly discussed as follows. TASK 1 – Sensor hardware design Subtask 1a: Assessment of sensor applications to SFRs Subtask 1b: Development of sensor functional requirements Subtask 1c: Definition of sensor hardware design specifications Task description: TAPS design was informed by considerations on their application (Subtask 1a), both the ultimate one in an SFR and the actual one in the ANL testing facilities that was intended to be used in support of the project. Considerations were made to identify optimum sensor design features that optimize the sensor size, materials, and output signal, for installation inside an SFR core. These considerations led to the development of Functional Requirements (Subtask 1b) and Design Requirements (Subtask 1c). TASK 2 – Sensor Hardware Manufacture Subtask 2a: Sensor hardware construction drawing development Subtask 2b: Sensor manufacture and assembly Task description: TAPS technical drawings were developed (Subtask 2a) using the Design Requirements established under Task 1. Subsequently, in spite of some problems which ultimately caused the program to be delayed, TAPS manufacturing was completed based on drawings (Subtask 2b). TASK 3 – Development of TAPS Signal Measurement System and TAPS Testing in Water Subtask 3a: Design, assembly and testing of signal measurement system, and TAPS testing in water Subtask 3b: Signal prediction-correction methodology development Task description: An assessment was performed on the techniques that can potentially be used to detect the signals emitted by the TAPS, e.g. a fiber-optic based acoustic signal measurement system, a laser vibrometer system, or an accelerometer-based system. The most suited technology, i.e. the accelerometer-based system, was developed further, and tested in water (Subtask 3a). Moreover, efforts were made to develop the methodology required to determine the actual system temperature and neutron flux distribution using differences between the measured and predicted TAPS responses (Subtask 3b). TASK 4 – Sensor System Testing in Sodium Subtask 4a: Test plan development Subtask 4b: Design, assembly and testing in small-scale sodium facility Subtask 4c: Design, assembly and testing in large-scale sodium and structures facility Task description: Upon proper test plan development (Subtask 4a), the fabricated TAPS was planned to be tested in sodium, by using two sodium facilities at ANL having different size and different purpose. The Under Sodium Viewing (USV) small-scale facility was intended to be used to investigate the effect of sodium on the sensor and its performance (Subtask 4b). The Mechanism Engineering Test Loop (METL) large-scale facility was instead intended to be used to assess the additional effect of prototypical SFR structures, such as fuel assembly mockup or parts of the core restrain structure, on sensor performance (Subtask 4c). As discussed in Section 3.2.2.7, unexpected issues during the TAPS manufacturing process resulted in some activities being delayed, with the TAPS and USV facility developed to the point to be ready for testing in sodium, however without the possibility to actually perform such testing (including the testing in METL) due to the end of the program’s performance period. Overall, through the development and testing (in water only) of two TAPS devices (a First-Generation TAPS followed by an optimized Second-Generation TAPS), the project confirmed the capability of this technology to generate acoustic signals proportional to temperature, which can be detected through a network of accelerometers identified as the best-suited type of receivers for acoustic signal detection. Moreover, the project also developed a computational model to predict the characteristics of the acoustic signals being generated, which combines thermal analysis of the TAPS with Finite Element Modeling (FEM)-aided acoustic characterization of the system. This model was benchmarked against experimental data collected during the project and, although general agreement was obtained, some limitations of the modeling methods were identified, which require additional development. Additional testing is needed in order to assess the effect, on TAPS operation and performance, of environmental changes resulting from the transition from water to liquid sodium. Such testing, which is suggested to be performed in the future, should look specifically at 1) both the effect resulting from the different thermoacoustic behavior of sodium (relative to water) and the effects of higher temperature on TAPS performance, and 2) the performance of the sensor-receiver system when multiple TAPS are used simultaneously and prototypical reactor structures are positioned in the testing environment. The latter testing is needed to assess the effects that potential signal attenuation/ distortion phenomena, as well as potential interference between signals emitted simultaneously, have on the performance of the technology for ultimate application in a nuclear reactor.« less

A cabled acoustic telemetry system for detecting and tracking juvenile salmon: Part 1. Engineering design and instrumentation

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

Weiland, Mark A.; Deng, Zhiqun; Seim, Thomas A.

2011-05-26

The U.S. Army Corps of Engineers-Portland District started development of the Juvenile Salmon Acoustic Telemetry System (JSATS), a nonproprietary technology, in 2001 to meet the needs for monitoring the survival of juvenile salmonids through the 31 federal dams in the Federal Columbia River Power System (FCRPS). Initial development focused on coded acoustic microtransmitters, and autonomous receivers that could be deployed in open reaches of the river for detection of the juvenile salmonids implanted with microtransmitters as they passed the autonomous receiver arrays. In 2006 the Pacific Northwest National Laboratory (PNNL) was tasked with development of an acoustic receiver system formore » deployment at hydropower facilities (cabled receiver) for detecting fish tagged with microtransmitters as well as tracking them in 2 or 3-dimensions as the fish passed at the facility for determining route of passage. The additional route of passage information, combined with survival estimates, is used by the dam operators and managers to make structural and operational changes at the hydropower facilities to improve survival of fish as they pass the facilities and through the FCRPS.« less

Current status of accreditation for drug testing in hair.

PubMed

Cooper, Gail; Moeller, Manfred; Kronstrand, Robert

2008-03-21

At the annual meeting of the Society of Hair Testing in Vadstena, Sweden in 2006, a committee was appointed to address the issue of guidelines for hair testing and to assess the current status of accreditation amongst laboratories offering drug testing in hair. A short questionnaire was circulated amongst the membership and interested parties. Fifty-two responses were received from hair testing laboratories providing details on the amount and type of hair tests they offered and the status of accreditation within their facilities. Although the vast majority of laboratories follow current guidelines (83%), only nine laboratories were accredited to ISO/IEC 17025 for hair testing. A significant number of laboratories reporting that they were in the process of developing quality systems with a view to accrediting their methods within 2-3 years. This study provides an insight into the status of accreditation in hair testing laboratories and supports the need for guidelines to encourage best practice.

Design and realization of test system for testing parallelism and jumpiness of optical axis of photoelectric equipment

NASA Astrophysics Data System (ADS)

Shi, Sheng-bing; Chen, Zhen-xing; Qin, Shao-gang; Song, Chun-yan; Jiang, Yun-hong

2014-09-01

With the development of science and technology, photoelectric equipment comprises visible system, infrared system, laser system and so on, integration, information and complication are higher than past. Parallelism and jumpiness of optical axis are important performance of photoelectric equipment,directly affect aim, ranging, orientation and so on. Jumpiness of optical axis directly affect hit precision of accurate point damage weapon, but we lack the facility which is used for testing this performance. In this paper, test system which is used fo testing parallelism and jumpiness of optical axis is devised, accurate aim isn't necessary and data processing are digital in the course of testing parallelism, it can finish directly testing parallelism of multi-axes, aim axis and laser emission axis, parallelism of laser emission axis and laser receiving axis and first acuualizes jumpiness of optical axis of optical sighting device, it's a universal test system.

Effects assessment of 10 functioning years on the main components of the molten salt PCS experimental facility of ENEA

NASA Astrophysics Data System (ADS)

Gaggioli, Walter; Di Ascenzi, Primo; Rinaldi, Luca; Tarquini, Pietro; Fabrizi, Fabrizio

2016-05-01

In the frame of the Solar Thermodynamic Laboratory, ENEA has improved CSP Parabolic Trough technologies by adopting new advanced solutions for linear tube receivers and by implementing a binary mixture of molten salt (60% NaNO3 and 40% KNO3) [1] as both heat transfer fluid and heat storage medium in solar field and in storage tanks, thus allowing the solar plants to operate at high temperatures up to 550°C. Further improvements have regarded parabolic mirror collectors, piping and process instrumentation. All the innovative components developed by ENEA, together with other standard parts of the plant, have been tested and qualified under actual solar operating conditions on the PCS experimental facility at the ENEA Casaccia Research Center in Rome (Italy). The PCS (Prova Collettori Solari, i.e. Test of Solar Collectors) facility is the main testing loop built by ENEA and it is unique in the world for what concerns the high operating temperature and the fluid used (mixture of molten salt). It consists in one line of parabolic trough collectors (test section of 100 m long life-size solar collectors) using, as heat transfer fluid, the aforesaid binary mixture of molten salt up to 10 bar, at high temperature in the range 270° and 550°C and a flow rate up to 6.5 kg/s. It has been working since early 2004 [2] till now; it consists in a unique closed loop, and it is totally instrumented. In this paper the effects of over ten years qualification tests on the pressurized tank will be presented, together with the characterization of the thermal losses of the piping of the molten salt circuit, and some observations performed on the PCS facility during its first ten years of operation.

Requirements for facilities transferring or receiving select agents. Final rule.

PubMed

2001-08-31

CDC administers regulations that govern the transfer of certain biological agents and toxins ("select agents"). These regulations require entities that transfer or receive select agents to register with CDC and comply with biosafety standards contained in the Third Edition of the CDC/NIH publication "Biosafety in Microbiological and Biomedical Laboratories ("BMBL")." On October 28,1999, CDC published a Notice of Proposed Rulemaking ("NPRM") seeking both to revise the biosafety standards facilities must follow when handling select agents and to provide new biosecurity standards for such facilities. These new standards are contained in the Fourth Edition of BMBL, which the NPRM proposed to incorporate by reference, thereby replacing the Third Edition. No comments were received in response to this proposal. CDC is therefore amending its regulations to incorporate the Fourth Edition.

Integrated Solar Upper Stage Technical Support

NASA Technical Reports Server (NTRS)

Jaworske, Donald A.

1998-01-01

NASA Lewis Research Center is participating in the Integrated Solar Upper Stage (ISUS) program. This program is a ground-based demonstration of an upper stage concept that will be used to generate both solar propulsion and solar power. Solar energy collected by a primary concentrator is directed into the aperture of a secondary concentrator and further concentrated into the aperture of a heat receiver. The energy stored in the receiver-absorber-converter is used to heat hydrogen gas to provide propulsion during the orbital transfer portion of the mission. During the balance of the mission, electric power is generated by thermionic diodes. Several materials issues were addressed as part of the technical support portion of the ISUS program, including: 1) Evaluation of primary concentrator coupons; 2) Evaluation of secondary concentrator coupons; 3) Evaluation of receiver-absorber-converter coupons; 4) Evaluation of in-test witness coupons. Two different types of primary concentrator coupons were evaluated from two different contractors-replicated coupons made from graphite-epoxy composite and coupons made from microsheet glass. Specular reflectivity measurements identified the replicated graphite-epoxy composite coupons as the primary concentrator material of choice. Several different secondary concentrator materials were evaluated, including a variety of silver and rhodium reflectors. The specular reflectivity of these materials was evaluated under vacuum at temperatures up to 800 C. The optical properties of several coupons of rhenium on graphite were evaluated to predict the thermal performance of the receiver-absorber-converter. Finally, during the ground test demonstration, witness coupons placed in strategic locations throughout the thermal vacuum facility were evaluated for contaminants. All testing for the ISUS program was completed successfully in 1997. Investigations related to materials issues have proven helpful in understanding the operation of the test article, leading to a potential ISUS flight test in 2002.

Flight Performance Evaluation of Three GPS Receivers for Sounding Rocket Tracking

NASA Technical Reports Server (NTRS)

Bull, Barton; Diehl, James; Montenbruck, Oliver; Markgraf, Markus; Bauer, Frank (Technical Monitor)

2001-01-01

In preparation for the European Space Agency Maxus-4 mission, a sounding rocket test flight was carried out at Esrange,, near Kiruna, Sweden on February 19, 2001 to validate existing ground facilities and range safety installations. Due to the absence of a dedicated scientific payload, the flight offered the opportunity to test multiple GPS receivers and assess their performance for the tracking of sounding rockets. The receivers included an Ashtech G12 HDMA receiver, a BAE (Canadian Marconi) Allstar receiver and a Mitel Orion receiver. All of them provide CIA code tracking on the L1 frequency to determine the user position and make use of Doppler measurements to derive the instantaneous velocity. Among the receivers, the G12 has been optimized for use under highly dynamic conditions and has earlier been flown successfully on NASA sounding rockets [Bull, ION-GPS-2000]. The Allstar is representative of common single frequency receivers for terrestrial applications and received no particular modification, except for the disabling of the common altitude and velocity constraints that would otherwise inhibit its use for space application. The Orion receiver, finally, employs the same Mitel chipset as the Allstar, but has received various firmware modifications by DLR to safeguard it against signal losses and improve its tracking performance [Montenbruck et al., ION-GPS-2000]. While the two NASA receivers were driven by a common wrap-around antenna, the DLR experiment made use of a switchable antenna system comprising a helical antenna in the tip of the rocket and two blade antennas attached to the body of the vehicle. During the boost a peak acceleration of roughly 17g's was achieved which resulted in a velocity of about 1100 m/s at the end of the burn. At apogee, the rocket reached a maximum altitude of over 80 km. A detailed analysis of the attained flight data will be given in the paper together with a evaluation of different receiver designs and antenna concepts.

Flight Performance Evaluation of Three GPS Receivers for Sounding Rocket Tracking

NASA Technical Reports Server (NTRS)

Bull, Barton; Diehl, James; Montenbruck, Oliver; Markgraf, Markus; Bauer, Frank (Technical Monitor)

2002-01-01

In preparation for the European Space Agency Maxus-4 mission, a sounding rocket test flight was carried out at Esrange, near Kiruna, Sweden on February 19, 2001 to validate existing ground facilities and range safety installations. Due to the absence of a dedicated scientific payload, the flight offered the opportunity to test multiple GPS receivers and assess their performance for the tracking of sounding rockets. The receivers included an Ashtech G12 HDMA receiver, a BAE (Canadian Marconi) Allstar receiver and a Mitel Orion receiver. All of them provide C/A code tracking on the L1 frequency to determine the user position and make use of Doppler measurements to derive the instantaneous velocity. Among the receivers, the G12 has been optimized for use under highly dynamic conditions and has earlier been flown successfully on NASA sounding rockets. The Allstar is representative of common single frequency receivers for terrestrial applications and received no particular modification, except for the disabling of the common altitude and velocity constraints that would otherwise inhibit its use for space application. The Orion receiver, finally, employs the same Mitel chipset as the Allstar, but has received various firmware modifications by DLR to safeguard it against signal losses and improve its tracking performance. While the two NASA receivers were driven by a common wrap-around antenna, the DLR experiment made use of a switchable antenna system comprising a helical antenna in the tip of the rocket and two blade antennas attached to the body of the vehicle. During the boost a peak acceleration of roughly l7g's was achieved which resulted in a velocity of about 1100 m/s at the end of the burn. At apogee, the rocket reached an altitude of over 80 km. A detailed analysis of the attained flight data is given together with a evaluation of different receiver designs and antenna concepts.

Does postacute care site matter? A longitudinal study assessing functional recovery after a stroke.

PubMed

Deutsch, Anne

2013-04-01

Patients with stroke may receive postacute rehabilitation services from one or more types of postacute care providers. An article in this issue of Archives of Physical Medicine and Rehabilitation compares the outcomes of patients who received rehabilitation care from an inpatient rehabilitation facility, a skilled nursing facility, a home health agency, or did not receive any postacute care. This commentary discusses challenges in conducting this type of observation study. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Small engine components test facility compressor testing cell at NASA Lewis Research Center

NASA Technical Reports Server (NTRS)

Brokopp, Richard A.; Gronski, Robert S.

1992-01-01

LeRC has designed and constructed a new test facility. This facility, called the Small Engine Components Facility (SECTF) is used to test gas turbines and compressors at conditions similar to actual engine conditions. The SECTF is comprised of a compressor testing cell and a turbine testing cell. Only the compressor testing cell is described. The capability of the facility, the overall facility design, the instrumentation used in the facility, and the data acquisition system are discussed in detail.

A comparison between antenatal care quality in public and private sector in rural Hebei, China.

PubMed

Chen, Li; Dai, Yaohua; Zhang, Yanfeng; Wu, Qiong; Rudan, Diana; Saftić, Vanja; van Velthoven, Michelle H M M T; Su, Jianqiang; Tan, Zangwen; Scherpbier, Robert W

2013-04-01

To evaluate the quality of antenatal care (ANC) in Hebei Province and compare it between the public and private sector and within the public sector. We conducted a Maternal, Newborn and Child Health Household Survey in 2010 using a two-stage sampling procedure and included 1079 mothers. The quality of ANC was assessed on the basis of the number of ANC visits, the time of the first ANC visit, 16 different ANC procedures, owning a maternal health care booklet, and the type of service provider. Almost all women (98%) received ANC services at least once, 80% at least four times, and 54% at least five times. About half of the women (46%) visited ANC facility within their first trimester. Neither public nor private sector provided all 16 standardized services, but significantly more women in public sector received ANC procedures. Most women received ANC in county or higher-level hospitals (75%) and very few in township hospitals (8%). Significantly fewer women were weighed and tested for HIV/AIDS in township than in county or higher-level hospitals. The quality of ANC in Hebei was poorer than required by China's national and World Health Organization norms. Although the public sector performed better than the private sector, the utilization and quality of care of ANC services in this sector varied and women generally visited county or higher-level health facilities.

Overview of innovative PMI research on NSTX-U and associated PMI facilities at PPPL

DOE PAGES

M. Ono; Jaworski, M.; Kaita, R.; ...

2013-05-01

Developing a reactor compatible divertor and managing the associated plasma material interaction (PMI) has been identified as a high priority research area for magnetic confinement fusion. Accordingly on NSTX-U, the PMI research has received a strong emphasis. Moreover, with ˜15 MW of auxiliary heating power, NSTX-U will be able to test the PMI physics with the peak divertor plasma facing component (PFC) heat loads of up to 40-60 MW/m 2.

Purchased Behavioral Health Care Received by Military Health System Beneficiaries in Civilian Medical Facilities, 2000-2014.

PubMed

Wooten, Nikki R; Brittingham, Jordan A; Pitner, Ronald O; Tavakoli, Abbas S; Jeffery, Diana D; Haddock, K Sue

2018-02-06

Behavioral health conditions are a significant concern for the U.S. military and the Military Health System (MHS) because of decreased military readiness and increased health care utilization. Although MHS beneficiaries receive direct care in military treatment facilities, a disproportionate majority of behavioral health treatment is purchased care received in civilian facilities. Yet, limited evidence exists about purchased behavioral health care received by MHS beneficiaries. This longitudinal study (1) estimated the prevalence of purchased behavioral health care and (2) identified patient and visit characteristics predicting receipt of purchased behavioral health care in acute care facilities from 2000 to 2014. Medical claims with Major Diagnostic Code 19 (mental disorders/diseases) or 20 (alcohol/drug disorders) as primary diagnoses and TRICARE as the primary/secondary payer were analyzed for MHS beneficiaries (n = 17,943) receiving behavioral health care in civilian acute care facilities from January 1, 2000, to December 31, 2014. The primary dependent variable, receipt of purchased behavioral health care, was modeled for select mental health and substance use disorders from 2000 to 2014 using generalized estimating equations. Patient characteristics included time, age, sex, and race/ethnicity. Visit types included inpatient hospitalization and emergency department (ED). Time was measured in days and visits were assumed to be correlated over time. Behavioral health care was described by both frequency of patients and visit type. The University of South Carolina Institutional Review Board approved this study. From 2000 to 2014, purchased care visits increased significantly for post-traumatic stress disorder, adjustment, anxiety, mood, bipolar, tobacco use, opioid/combination opioid dependence, nondependent cocaine abuse, psychosocial problems, and suicidal ideation among MHS beneficiaries. The majority of care was received for mental health disorders (78.8%) and care was most often received in EDs (56%). Most commonly treated diagnoses included mood, tobacco use, and alcohol use disorders. ED visits were associated with being treated for anxiety (excluding post-traumatic stress disorder; Adjusted odds ratio [AOR]: 9.14 [95% confidence interval (CI): 8.26, 10.12]), alcohol use disorders (AOR = 1.67 [95% CI: 1.53, 1.83]), tobacco use (AOR = 1.16 [95% CI: 1.06, 1.26]), nondependent cocaine abuse (AOR = 5.47 [95% CI: 3.28, 9.12]), nondependent mixed/unspecified drug abuse (AOR = 7.30 [95% CI: 5.11, 10.44]), and psychosis (AOR = 1.38 [95% CI: 1.20, 1.58]). Compared with adults age 60 yr and older, adolescents (ages 12-17 yr), and adults under age 60 yr were more likely to be treated for suicidal ideation, adjustment, mood, bipolar, post-traumatic stress disorder, nondependent cocaine, and mixed/unspecified drug abuse. Adults under age 60 yr also had increased odds of being treated for tobacco use disorders, alcohol use disorders, and opioid/combination opioid dependence compared with adults age 60 yr and older. Over the past 15 yr, purchased behavioral health care received by MHS beneficiaries in acute care facilities increased significantly. MHS beneficiaries received the majority of purchased behavioral health care for mental health disorders and were treated most often in the ED. Receiving behavioral health care in civilian EDs raises questions about access to outpatient behavioral health care and patient-centered care coordination between civilian and military facilities. Given the influx of new Veterans Health Administration users from the MHS, findings have implications for military, veteran, and civilian facilities providing behavioral health care to military and veteran populations. © Association of Military Surgeons of the United States 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

28 CFR 54.410 - Comparable facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

....410 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex... provide separate toilet, locker room, and shower facilities on the basis of sex, but such facilities...

45 CFR 86.33 - Comparable facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 86.33 Comparable facilities. A recipient may provide separate toilet, locker room, and shower facilities on the basis of sex, but such...

43 CFR 41.410 - Comparable facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 41.410 Comparable facilities. A recipient may provide separate toilet, locker room, and shower facilities on the basis of sex, but such...

45 CFR 86.33 - Comparable facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 86.33 Comparable facilities. A recipient may provide separate toilet, locker room, and shower facilities on the basis of sex, but such...

45 CFR 605.23 - New construction.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE... that the facility or part of the facility is readily accessible to and usable by qualified handicapped... portion of the facility is readily accessible to and usable by qualified handicapped persons. (c...

Space technology test facilities at the NASA Ames Research Center

NASA Technical Reports Server (NTRS)

Gross, Anthony R.; Rodrigues, Annette T.

1990-01-01

The major space research and technology test facilities at the NASA Ames Research Center are divided into five categories: General Purpose, Life Support, Computer-Based Simulation, High Energy, and the Space Exploraton Test Facilities. The paper discusses selected facilities within each of the five categories and discusses some of the major programs in which these facilities have been involved. Special attention is given to the 20-G Man-Rated Centrifuge, the Human Research Facility, the Plant Crop Growth Facility, the Numerical Aerodynamic Simulation Facility, the Arc-Jet Complex and Hypersonic Test Facility, the Infrared Detector and Cryogenic Test Facility, and the Mars Wind Tunnel. Each facility is described along with its objectives, test parameter ranges, and major current programs and applications.

Microbial Condition of Water Samples from Foreign Fuel Storage Facilities

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

Berry, C.J.; Fliermans, C.B.; Santo Domingo, J.

1997-10-30

In order to assess the microbial condition of foreign nuclear fuel storage facilities, fourteen different water samples were received from facilities outside the United States that have sent spent nuclear fuel to SRS for wet storage. Each water sample was analyzed for microbial content and activity as determined by total bacteria, viable aerobic bacteria, viable anaerobic bacteria, viable sulfate- reducing bacteria, viable acid-producing bacteria and enzyme diversity. The results for each water sample were then compared to other foreign samples and to data from the receiving basin for off- site fuel (RBOF) at SRS.

40 CFR 160.43 - Test system care facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... testing facility shall have a number of animal rooms or other test system areas separate from those... GOOD LABORATORY PRACTICE STANDARDS Facilities § 160.43 Test system care facilities. (a) A testing facility shall have a sufficient number of animal rooms or other test system areas, as needed, to ensure...

40 CFR 160.43 - Test system care facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... testing facility shall have a number of animal rooms or other test system areas separate from those... GOOD LABORATORY PRACTICE STANDARDS Facilities § 160.43 Test system care facilities. (a) A testing facility shall have a sufficient number of animal rooms or other test system areas, as needed, to ensure...

Molten salt thermal energy storage subsystem for solar thermal central receiver plants

NASA Astrophysics Data System (ADS)

Wells, P. B.; Nassopoulos, G. P.

1982-02-01

The development of a low cost thermal energy storage subsystem for large solar plants is described. Molten nitrate salt is used as both the solar plant working fluid and the storage medium. The storage system consists of a specially designed hot tank to hold salt at a storage temperature of 839K (1050 deg F) and a separate carbon steel cold tank to hold the salt after its thermal energy has been extracted to generate steam. The hot tank is lined with insulating firebrick to reduce the shell temperature to 561K (550 deg F) so that a low cost carbon steel shell is used. The internal insulation is protected from the hot salt by a unique metal liner with orthogonal corrugations to allow for numerous cycles of thermal expansion and contraction. A preliminary design for a large commercial size plant (1200 MWh sub +), a laboratory test program for the critical components, and the design, construction, and test of a small scale (7 MWH sub t) research experiment at the Central Receiver Test Facility in Albuquerque, New Mexico is described.

The design, development, and flight test results of the Boeing 737 aircraft antennas for the ICAO demonstration of the TRSB microwave landing system

NASA Technical Reports Server (NTRS)

Campbell, T. G.; White, W. E.; Gilreath, M. C.

1976-01-01

The Research Support Flight System, a modified Boeing 737, was used to evaluate the performance of several aircraft antennas and locations for the Time Reference Scanning Beam (TRSB) Microwave Landing System (MLS). These tests were conducted at the National Aviation Facilities Experimental Center (NAFEC), Atlantic City, New Jersey on December 18, 1975. The flight tests measured the signal strength and all pertinent MLS data during a straight-in approach, a racetrack approach, and ICAO approach profiles using the independent antenna-receiver combinations simultaneously on the aircraft. Signal drop-outs were experienced during the various approaches but only a small percentage could be attributed to antenna pattern effects.

Effective coverage of essential inpatient care for small and sick newborns in a high mortality urban setting: a cross-sectional study in Nairobi City County, Kenya.

PubMed

Murphy, Georgina A V; Gathara, David; Mwachiro, Jacintah; Abuya, Nancy; Aluvaala, Jalemba; English, Mike

2018-05-22

Effective coverage requires that those in need can access skilled care supported by adequate resources. There are, however, few studies of effective coverage of facility-based neonatal care in low-income settings, despite the recognition that improving newborn survival is a global priority. We used a detailed retrospective review of medical records for neonatal admissions to public, private not-for-profit (mission) and private-for-profit (private) sector facilities providing 24×7 inpatient neonatal care in Nairobi City County to estimate the proportion of small and sick newborns receiving nationally recommended care across six process domains. We used our findings to explore the relationship between facility measures of structure and process and estimate effective coverage. Of 33 eligible facilities, 28 (four public, six mission and 18 private), providing an estimated 98.7% of inpatient neonatal care in the county, agreed to partake. Data from 1184 admission episodes were collected. Overall performance was lowest (weighted mean score 0.35 [95% confidence interval or CI: 0.22-0.48] out of 1) for correct prescription of fluid and feed volumes and best (0.86 [95% CI: 0.80-0.93]) for documentation of demographic characteristics. Doses of gentamicin, when prescribed, were at least 20% higher than recommended in 11.7% cases. Larger (often public) facilities tended to have higher process and structural quality scores compared with smaller, predominantly private, facilities. We estimate effective coverage to be 25% (estimate range: 21-31%). These newborns received high-quality inpatient care, while almost half (44.5%) of newborns needed care but did not receive it and a further 30.4% of newborns received an inadequate service. Failure to receive services and gaps in quality of care both contribute to a shortfall in effective coverage in Nairobi City County. Three-quarters of small and sick newborns do not have access to high-quality facility-based care. Substantial improvements in effective coverage will be required to tackle high neonatal mortality in this urban setting with high levels of poverty.

The conservation message of the rehabilitated facilities of the International Institute of Tropical Forestry

Treesearch

Ariel Lugo; J. Rullan

2015-01-01

Over a period of about 20 years, the International Institute of Tropical Forestry (the Institute) and its collaborators developed and implemented a facilities plan that included both new and restored facilities. Among the restored facilities, the historic Headquarters Building received a Leadership in Energy and Environmental Design (LEED) Gold certificate, and was...

Liquid Transfer Cryogenic Test Facility: Initial hydrogen and nitrogen no-vent fill data

NASA Astrophysics Data System (ADS)

Moran, Matthew E.; Nyland, Ted W.; Papell, S. Stephen

1990-03-01

The Liquid Transfer Cryogenic Test Facility is a versatile testbed for ground-based cryogenic fluid storage, handling, and transfer experimentation. The test rig contains two well instrumented tanks, and a third interchangeable tank, designed to accommodate liquid nitrogen or liquid hydrogen testing. The internal tank volumes are approx. 18, 5, and 1.2 cu. ft. Tank pressures can be varied from 2 to 30 psia. Preliminary no vent fill tests with nitrogen and hydrogen were successfully completed with the test rig. Initial results indicate that no vent fills of nitrogen above 90 percent full are achievable using this test configuration, in a 1-g environment, and with inlet liquid temperatures as high as 143 R, and an average tank wall temperature of nearly 300 R. This inlet temperature corresponds to a saturation pressure of 19 psia for nitrogen. Hydrogen proved considerably more difficult to transfer between tanks without venting. The highest temperature conditions resulting in a fill level greater than 90 percent were with an inlet liquid temperature of 34 R, and an estimated tank wall temperature of slightly more than 100 R. Saturation pressure for hydrogen at this inlet temperature is 10 psia. All preliminary no vent fill tests were performed with a top mounted full cone nozzle for liquid injection. The nozzle produces a 120 degree conical droplet spray at a differential pressure of 10 psi. Pressure in the receiving tank was held to less than 30 psia for all tests.

Liquid Transfer Cryogenic Test Facility: Initial hydrogen and nitrogen no-vent fill data

NASA Technical Reports Server (NTRS)

Moran, Matthew E.; Nyland, Ted W.; Papell, S. Stephen

1990-01-01

The Liquid Transfer Cryogenic Test Facility is a versatile testbed for ground-based cryogenic fluid storage, handling, and transfer experimentation. The test rig contains two well instrumented tanks, and a third interchangeable tank, designed to accommodate liquid nitrogen or liquid hydrogen testing. The internal tank volumes are approx. 18, 5, and 1.2 cu. ft. Tank pressures can be varied from 2 to 30 psia. Preliminary no vent fill tests with nitrogen and hydrogen were successfully completed with the test rig. Initial results indicate that no vent fills of nitrogen above 90 percent full are achievable using this test configuration, in a 1-g environment, and with inlet liquid temperatures as high as 143 R, and an average tank wall temperature of nearly 300 R. This inlet temperature corresponds to a saturation pressure of 19 psia for nitrogen. Hydrogen proved considerably more difficult to transfer between tanks without venting. The highest temperature conditions resulting in a fill level greater than 90 percent were with an inlet liquid temperature of 34 R, and an estimated tank wall temperature of slightly more than 100 R. Saturation pressure for hydrogen at this inlet temperature is 10 psia. All preliminary no vent fill tests were performed with a top mounted full cone nozzle for liquid injection. The nozzle produces a 120 degree conical droplet spray at a differential pressure of 10 psi. Pressure in the receiving tank was held to less than 30 psia for all tests.

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

PubMed Central

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

2014-01-01

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

Assessing infection control practices to protect health care workers and patients in Malawi from nosocomial transmission of Mycobacterium tuberculosis

PubMed Central

Simon, Katherine; Hosseinipour, Mina; Kim, Maria H.; Mlauzi, Lameck; Kazembe, Peter N.; Ahmed, Saeed

2017-01-01

Transmission of Mycobacterium tuberculosis (TB) in health settings threatens health care workers and people living with HIV in sub-Saharan Africa. Nosocomial transmission is reduced with implementation of infection control (IC) guidelines. The objective of this study is to describe implementation of TB IC measures in Malawi. We conducted a cross-sectional study utilizing anonymous health worker questionnaires, semi-structured interviews with facility managers, and direct observations at 17 facilities in central Malawi. Of 592 health care workers surveyed, 34% reported that all patients entering the facility were screened for cough and only 8% correctly named the four most common signs and symptoms of TB in adults. Of 33 managers interviewed, 7 (21%) and 1 (3%) provided the correct TB screening questions for use in adults and children, respectively. Of 592 health workers, only 2.4% had been screened for TB in the previous year. Most (90%) reported knowing their HIV status, 53% were tested at their facility of employment, and half reported they would feel comfortable receiving ART or TB treatment at their facility of employment. We conclude that screening is infrequently conducted and knowledge gaps may undercut its effectiveness. Further, health care workers do not routinely access TB and HIV diagnostic and treatment services at their facility of employment. PMID:29211793

10 CFR 26.123 - Testing facility capabilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Testing facility capabilities. 26.123 Section 26.123 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.123 Testing facility capabilities. Each licensee testing facility shall have the capability, at the same...

10 CFR 26.123 - Testing facility capabilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Testing facility capabilities. 26.123 Section 26.123 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.123 Testing facility capabilities. Each licensee testing facility shall have the capability, at the same...

10 CFR 26.123 - Testing facility capabilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Testing facility capabilities. 26.123 Section 26.123 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.123 Testing facility capabilities. Each licensee testing facility shall have the capability, at the same...

10 CFR 26.123 - Testing facility capabilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Testing facility capabilities. 26.123 Section 26.123 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.123 Testing facility capabilities. Each licensee testing facility shall have the capability, at the same...

10 CFR 26.123 - Testing facility capabilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Testing facility capabilities. 26.123 Section 26.123 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.123 Testing facility capabilities. Each licensee testing facility shall have the capability, at the same...

High-Flux, High-Temperature Thermal Vacuum Qualification Testing of a Solar Receiver Aperture Shield

NASA Technical Reports Server (NTRS)

Kerslake, Thomas W.; Mason, Lee S.; Strumpf, Hal J.

1997-01-01

As part of the International Space Station (ISS) Phase 1 program, NASA Lewis Research Center (LERC) and the Russian Space Agency (RSA) teamed together to design, build and flight test the world's first orbital Solar Dynamic Power System (SDPS) on the Russian space station Mir. The Solar Dynamic Flight Demonstration (SDFD) program was to operate a nominal 2 kWe SDPS on Mir for a period up to 1-year starting in late 1997. Unfortunately, the SDFD mission was demanifested from the ISS phase 1 shuttle program in early 1996. However, substantial flight hardware and prototypical flight hardware was built including a heat receiver and aperture shield. The aperture shield comprises the front face of the cylindrical cavity heat receiver and is located at the focal plane of the solar concentrator. It is constructed of a stainless steel plate with a 1-m outside diameter, a 0.24-m inside diameter and covered with high-temperature, refractory metal Multi-Foil Insulation (MFI). The aperture shield must minimize heat loss from the receiver cavity, provide a stiff, high strength structure to accommodate shuttle launch loads and protect receiver structures from highly concentrated solar fluxes during concentrator off-pointing events. To satisfy Mir operational safety protocols, the aperture shield was required to accommodate direct impingement of the intensely concentrated solar image for a 1-hour period. To verify thermal-structural durability under the anticipated high-flux, high-temperature loading, an aperture shield test article was constructed and underwent a series of two tests in a large thermal vacuum chamber configured with a reflective, point-focus solar concentrator and a solar simulator. The test article was positioned near the focal plane and exposed to concentrated solar flux for a period of 1-hour. In the first test, a near equilibrium temperature of 1862 K was attained in the center of the shield hot spot. In the second test, with increased incident flux, a near equilibrium temperature of 2072 K was achieved. The aperture shield sustained no visible damage as a result of the exposures. This paper describes the aperture shield thermal-vacuum qualification test program including the test article, test facility, procedures, data collection, test success criteria, results and conclusions.

A Regional Outbreak of Clostridium difficile PCR-Ribotype 027 Infections in Southeastern France from a Single Long-Term Care Facility.

PubMed

Cassir, Nadim; Delarozière, Jean-Christophe; Dubourg, Gregory; Delord, Marion; Lagier, Jean-Christophe; Brouqui, Phillipe; Fenollar, Florence; Raoult, Didier; Fournier, Pierre Edouard

2016-11-01

OBJECTIVE To describe and analyze a large outbreak of Clostridium difficile 027 (CD-027) infections. METHODS Confirmed CD-027 cases were defined as CD infection plus real-time polymerase chain reaction assay (PCR) positive for CD-027. Clinical and microbiological data on patients with CD-027 infection were collected from January 2013 to December 2015 in the Provence-Alpes-Côte-d'Azur region (southeastern France). RESULTS In total, 19 healthcare facilities reported 144 CD-027 infections (112 confirmed and 32 probable CD-027 infections) during a 22-month period outbreak. Although the incidence rate per 10,000 bed days was lower in long-term care facilities (LTCFs) than in acute care facilities (0.05 vs 0.14; P<.001), cases occurred mainly in LTCFs, one of which was the probable source of this outbreak. After centralization of CD testing, the rate of confirmed CD-027 cases from LTCFs or residential-care homes increased significantly (69% vs 92%; P<.001). Regarding confirmed CD-027 patients, the sex ratio and the median age were 0.53 and 84.2 years, respectively. The 30-day crude mortality rate was 31%. Most patients (96%) had received antibiotics within 3 months prior to the CD colitis diagnosis. During the study period, the rate of patients with CD-027 (compared with all patients tested in the point-of-care laboratories) decreased significantly (P=.03). CONCLUSIONS A large CD-027 outbreak occurred in southeastern France as a consequence of an initial cluster of cases in a single LTCF. Successful interventions included rapid isolation and testing of residents with potentially infectious diarrhea and cohorting of case patients in a specialized infectious diseases ward to optimize management. Infect Control Hosp Epidemiol 2016;1-5.

49 CFR 25.410 - Comparable facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Transportation Office of the Secretary of Transportation NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in... toilet, locker room, and shower facilities on the basis of sex, but such facilities provided for students...

40 CFR 5.410 - Comparable facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 5.410 Comparable facilities. A recipient may provide separate toilet, locker room, and shower facilities on the basis of sex, but such...

45 CFR 605.22 - Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE... accessible to qualified handicapped persons. This paragraph does not require a recipient to make each of its existing facilities or every part of a facility accessible to and usable by qualified handicapped persons...

40 CFR 5.410 - Comparable facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 5.410 Comparable facilities. A recipient may provide separate toilet, locker room, and shower facilities on the basis of sex, but such...

7 CFR 319.8-8 - Lint, linters, and waste.

Code of Federal Regulations, 2013 CFR

2013-01-01

... vacuum fumigation by approved methods at any port where approved fumigation facilities are available. (ii... facilities are available, for the required vacuum fumigation. (iii) Such lint, linters, and waste compressed... where approved fumigation facilities are available, there to receive the required vacuum fumigation...

7 CFR 319.8-8 - Lint, linters, and waste.

Code of Federal Regulations, 2014 CFR

2014-01-01

... vacuum fumigation by approved methods at any port where approved fumigation facilities are available. (ii... facilities are available, for the required vacuum fumigation. (iii) Such lint, linters, and waste compressed... where approved fumigation facilities are available, there to receive the required vacuum fumigation...

Quality improvement intervention to increase adherence to ART prescription policy at HIV treatment clinics in Lusaka, Zambia: A cluster randomized trial

PubMed Central

Subramaniam, Hamsa L.; Prust, Margaret L.; Prescott, Marta R.; Mpasela, Felton; Mwango, Albert; Namonje, Leah; Moyo, Crispin; Chibuye, Benjamin; van den Broek, Jan Willem; Hehman, Lindsey; Moberley, Sarah

2017-01-01

Introduction In urban areas, crowded HIV treatment facilities with long patient wait times can deter patients from attending their clinical appointments and picking up their medications, ultimately disrupting patient care and compromising patient retention and adherence. Methods Formative research at eight facilities in Lusaka revealed that only 46% of stable HIV treatment patients were receiving a three-month refill supply of antiretroviral drugs, despite it being national policy for stable adult patients. We designed a quality improvement intervention to improve the operationalization of this policy. We conducted a cluster-randomized controlled trial in sixteen facilities in Lusaka with the primary objective of examining the intervention’s impact on the proportion of stable patients receiving three-month refills. The secondary objective was examining whether the quality improvement intervention reduced facility congestion measured through two proxy indicators: daily volume of clinic visits and average clinic wait times for services. Results The mean change in the proportion of three-month refills among control facilities from baseline to endline was 10% (from 38% to 48%), compared to a 25% mean change (an increase from 44% to 69%) among intervention facilities. This represents a significant 15% mean difference (95% CI: 2%-29%; P = 0.03) in the change in proportion of patients receiving three-month refills. On average, control facilities had 15 more visits per day in the endline than in the baseline, while intervention facilities had 20 fewer visits per day in endline than in baseline, a mean difference of 35 fewer visits per day (P = 0.1). The change in the mean facility total wait time for intervention facilities dropped 19 minutes between baseline and endline when compared to control facilities (95% CI: -10.2–48.5; P = 0.2). Conclusion A more patient-centred service delivery schedule of three-month prescription refills for stable patients is viable. We encourage the expansion of this sustainable intervention in Zambia’s urban clinics. PMID:28419106

Quality improvement intervention to increase adherence to ART prescription policy at HIV treatment clinics in Lusaka, Zambia: A cluster randomized trial.

PubMed

McCarthy, Elizabeth A; Subramaniam, Hamsa L; Prust, Margaret L; Prescott, Marta R; Mpasela, Felton; Mwango, Albert; Namonje, Leah; Moyo, Crispin; Chibuye, Benjamin; van den Broek, Jan Willem; Hehman, Lindsey; Moberley, Sarah

2017-01-01

In urban areas, crowded HIV treatment facilities with long patient wait times can deter patients from attending their clinical appointments and picking up their medications, ultimately disrupting patient care and compromising patient retention and adherence. Formative research at eight facilities in Lusaka revealed that only 46% of stable HIV treatment patients were receiving a three-month refill supply of antiretroviral drugs, despite it being national policy for stable adult patients. We designed a quality improvement intervention to improve the operationalization of this policy. We conducted a cluster-randomized controlled trial in sixteen facilities in Lusaka with the primary objective of examining the intervention's impact on the proportion of stable patients receiving three-month refills. The secondary objective was examining whether the quality improvement intervention reduced facility congestion measured through two proxy indicators: daily volume of clinic visits and average clinic wait times for services. The mean change in the proportion of three-month refills among control facilities from baseline to endline was 10% (from 38% to 48%), compared to a 25% mean change (an increase from 44% to 69%) among intervention facilities. This represents a significant 15% mean difference (95% CI: 2%-29%; P = 0.03) in the change in proportion of patients receiving three-month refills. On average, control facilities had 15 more visits per day in the endline than in the baseline, while intervention facilities had 20 fewer visits per day in endline than in baseline, a mean difference of 35 fewer visits per day (P = 0.1). The change in the mean facility total wait time for intervention facilities dropped 19 minutes between baseline and endline when compared to control facilities (95% CI: -10.2-48.5; P = 0.2). A more patient-centred service delivery schedule of three-month prescription refills for stable patients is viable. We encourage the expansion of this sustainable intervention in Zambia's urban clinics.

Safe and Effective Deactivation of Metallic Sodium Filled Scrap and Cold Traps From Sodium-cooled Nuclear Reactor D and D - 12176

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

Nester, Dean; Crocker, Ben; Smart, Bill

2012-07-01

As part of the Plateau Remediation Project at US Department of Energy's Hanford, Washington site, CH2M Hill Plateau Remediation Company (CHPRC) contracted with IMPACT Services, LLC to receive and deactivate approximately 28 cubic meters of sodium metal contaminated debris from two sodium-cooled research reactors (Enrico Fermi Unit 1 and the Fast Flux Test Facility) which had been stored at Hanford for over 25 years. CHPRC found an off-site team composed of IMPACT Services and Commodore Advanced Sciences, Inc., with the facilities and technological capabilities to safely and effectively perform deactivation of this sodium metal contaminated debris. IMPACT Services provided themore » licensed fixed facility and the logistical support required to receive, store, and manage the waste materials before treatment, and the characterization, manifesting, and return shipping of the cleaned material after treatment. They also provided a recycle outlet for the liquid sodium hydroxide byproduct resulting from removal of the sodium from reactor parts. Commodore Advanced Sciences, Inc. mobilized their patented AMANDA unit to the IMPACT Services site and operated the unit to perform the sodium removal process. Approximately 816 Kg of metallic sodium were removed and converted to sodium hydroxide, and the project was accomplished in 107 days, from receipt of the first shipment at the IMPACT Services facility to the last outgoing shipment of deactivated scrap metal. There were no safety incidents of any kind during the performance of this project. The AMANDA process has been demonstrated in this project to be both safe and effective for deactivation of sodium and NaK. It has also been used in other venues to treat other highly reactive alkali metals, such as lithium (Li), potassium (K), NaK and Cesium (Cs). (authors)« less

Increasing time to treatment initiation for head and neck cancer: an analysis of the National Cancer Database.

PubMed

Murphy, Colin T; Galloway, Thomas J; Handorf, Elizabeth A; Wang, Lora; Mehra, Ranee; Flieder, Douglas B; Ridge, John A

2015-04-15

The objective of this study was to identify trends and predictors of the time to treatment initiation (TTI) for patients with head and neck squamous cell carcinoma (HNSCC). The National Cancer Database (NCDB) was reviewed for the following head and neck cancer sites: oral tongue, oropharynx, larynx, and hypopharynx. TTI was defined as the number of days from diagnosis to the initiation of definitive treatment and was measured according to covariates. Significant differences in the median TTI across each covariate were measured using the Kruskal-Wallis test, and the Spearman test was used to measure trends within covariates. For multivariate analysis, a zero-inflated, negative, binomial regression model was used to estimate the expected TTI, which was expressed in the predicted number of days; and the Vuong test was used to identify the predictors of TTI. In total, 274,630 patients were included. Between 1998 and 2011, the median TTI for all patients was 26 days, and it increased from 19 days to 30 days (P < .0001). Treatment with chemoradiation (CRT) (P < .0001), treatment at academic facilities (P < .0001), and stage IV disease (P < .0001) were associated with increased TTI. TTI significantly increased for each disease stage (P < .0001), treatment modality (P < .0001), and facility type (P < .0001) over time. In addition, patients became more likely to transition care between facilities after diagnosis for treatment initiation (P < .0001) over time. On multivariate analysis, treatment at academic facilities (33 days), transitioning care (37 days), and receipt of CRT (39 days) predicted for a longer TTI. TTI is rising for patients with HNSCC. Those who have advanced-stage disease, receive treatment with CRT, are treated at academic facilities, and who have a transition in care realized the greatest increases in TTI. © 2014 American Cancer Society.

Factors Associated With Late Specialized Rehabilitation among Veterans with Lower Extremity Amputation Who Underwent Immediate Postoperative Rehabilitation

PubMed Central

Kurichi, Jibby E.; Xie, Dawei; Kwong, Pui L.; Bates, Barbara E.; Vogel, W. Bruce; Stineman, Margaret G.

2011-01-01

Objective To determine what patient- and facility-level characteristics drive late specialized rehabilitation among veterans who already received immediate postoperative services. Design Data were obtained from 8 administrative databases for 2,453 patients who underwent lower extremity amputation in Veterans Affairs Medical Centers in 2002-2004. A Cox proportional hazards model was used to determine the hazards ratios and 95% confidence intervals of the factors associated with days to readmission for late services after discharge from the surgical hospitalization. Results There were 2,304 patients who received only immediate postoperative services, while 152 also received late specialized rehabilitation. After adjustment, veterans who were less disabled physically, residing in the South Central compared to the Southeast region, and had their surgeries in CARF accredited facilities were all more likely to receive late services. The hazards ratios for type of immediate postoperative rehabilitation were not constant over time. At hospital discharge, there was no difference in receipt, however, after 3 months, those who received early specialized rehabilitation were significantly less likely to receive late services. Conclusion The factors associated with late specialized rehabilitation were due mainly to facility-level characteristics and care process variables. Knowledge of these factors may help with decision-making policies regarding CARF accredited units. PMID:21389847

Surgery and Adjuvant Chemotherapy Use Among Veterans With Colon Cancer: Insights From a California Study

PubMed Central

Hynes, Denise M.; Tarlov, Elizabeth; Durazo-Arvizu, Ramon; Perrin, Ruth; Zhang, Qiuying; Weichle, Thomas; Ferreira, M. Rosario; Lee, Todd; Benson, Al B.; Bhoopalam, Nirmala; Bennett, Charles L.

2010-01-01

Purpose US veterans have been shown to be a vulnerable population with high cancer rates, and cancer care quality in Veterans Affairs (VA) hospitals is the focus of a congressionally mandated review. We examined rates of surgery and chemotherapy use among veterans with colon cancer at VA and non-VA facilities in California to gain insight into factors associated with quality of cancer care. Methods A retrospective cohort of incident colon cancer patients from the California Cancer Registry, who were ≥ 66 years old and eligible to use VA and Medicare between 1999 and 2001, were observed for 6 months after diagnosis. Results Among 601 veterans with colon cancer, 72% were initially diagnosed and treated in non-VA facilities. Among veterans with stage I to III cancer, those diagnosed and initially treated in VA facilities experienced similar colectomy rates as those at non-VA facilities. Stage III patients diagnosed and initially treated in VA versus non-VA facilities had similar odds of receiving adjuvant chemotherapy. In both settings, older patients had lower odds of receiving chemotherapy than their younger counterparts even when race and comorbidity were considered (age 76 to 85 years: odds ratio [OR] = 0.18; 95% CI, 0.07 to 0.46; age ≥ 86 years: OR = 0.17; 95% CI, 0.04 to 0.73). Conclusion In California, older veterans with colon cancer used both VA and non-VA facilities for cancer treatment, and odds of receiving cancer-directed surgery and chemotherapy were similar in both systems. Among stage III patients, older age lowered odds of receiving adjuvant chemotherapy in both systems. Further studies should continue to explore potential health system effects on quality of colon cancer care across the United States. PMID:20406940

21 CFR 212.100 - What do I do if I receive a complaint about a PET drug product produced at my facility?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 4 2012-04-01 2012-04-01 false What do I do if I receive a complaint about a PET... complaint about a PET drug product produced at my facility? (a) Written complaint procedures. You must... quality or purity of, or possible adverse reactions to, a PET drug product. (b) Complaint review. The...

21 CFR 212.100 - What do I do if I receive a complaint about a PET drug product produced at my facility?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 4 2011-04-01 2011-04-01 false What do I do if I receive a complaint about a PET... complaint about a PET drug product produced at my facility? (a) Written complaint procedures. You must... quality or purity of, or possible adverse reactions to, a PET drug product. (b) Complaint review. The...

21 CFR 212.100 - What do I do if I receive a complaint about a PET drug product produced at my facility?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 4 2013-04-01 2013-04-01 false What do I do if I receive a complaint about a PET... complaint about a PET drug product produced at my facility? (a) Written complaint procedures. You must... quality or purity of, or possible adverse reactions to, a PET drug product. (b) Complaint review. The...

21 CFR 212.100 - What do I do if I receive a complaint about a PET drug product produced at my facility?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 4 2014-04-01 2014-04-01 false What do I do if I receive a complaint about a PET... complaint about a PET drug product produced at my facility? (a) Written complaint procedures. You must... quality or purity of, or possible adverse reactions to, a PET drug product. (b) Complaint review. The...

10 CFR 1042.410 - Comparable facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... DEPARTMENT OF ENERGY (GENERAL PROVISIONS) NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or..., and shower facilities on the basis of sex, but such facilities provided for students of one sex shall...

29 CFR 36.410 - Comparable facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... of the Secretary of Labor NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or..., and shower facilities on the basis of sex, but such facilities provided for students of one sex shall...

45 CFR 618.410 - Comparable facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 618.410 Comparable facilities. A recipient may provide separate toilet, locker room, and shower facilities on the basis of sex, but...

29 CFR 36.410 - Comparable facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... of the Secretary of Labor NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or..., and shower facilities on the basis of sex, but such facilities provided for students of one sex shall...

40 CFR 265.16 - Personnel training.

Code of Federal Regulations, 2010 CFR

2010-07-01

... successfully complete a program of classroom instruction or on-the-job training that teaches them to perform... facility employees that receive emergency response training pursuant to Occupational Safety and Health... documents and records at the facility: (1) The job title for each position at the facility related to...

Association between Gastrointestinal Illness and Precipitation in Areas Impacted by Combined Sewer Facilities: Analysis of Massachusetts Data, 2003-2007

EPA Science Inventory

Background: Combined sewer systems (CSS) collect rainwater runoff, sewage, and industrial wastewater for transit to treatment facilities. With heavy precipitation, volumes can exceed capacity of treatment facilities, and wastewater discharges directly to receiving waters. These c...

Condition of Florida Educational Facilities and Balancing Budgets

ERIC Educational Resources Information Center

Jones, Margaret Moore

2012-01-01

The purpose of this study was to examine if relationships existed between the condition of instructional facilities within Florida Coastal School District, as measured by the Facilities Condition Index (FCI), and enrollment percentages for special education students, African American students, Caucasian students, and students receiving free and…

A national study of prescribed drugs in institutions and community residential facilities for mentally retarded people.

PubMed

Hill, B K; Balow, E A; Bruininks, R H

1985-01-01

The prevalence of psychotropic and nonpsychotropic drug prescriptions in institutions and community residential facilities in 1978-79 was assessed. The data were gathered as an incidental part of a comprehensive national interview study of the characteristics of residential facilities and their residents. The study included 2271 retarded individuals in 236 residential facilities in the US. Facilities were selected through a 2-stage probability sample design in such a way that the probability of a facility's selection was proportionate to its size (number of residents) and so that the distribution of sample facilities across census regions and size classes was in close agreement with the distribution of facilities nationally. Interviews at 75 institutions and 161 private facilities were conducted between September 1978 and April 1979. Demographic information about individual residents, including date of birth, date of admission, previous type of residential placement, age, height, weight, diagnosed degree of retardation, and diagnosis of epilepsy, autism, or mental illness, was obtained from each resident's records. The staff person most familiar with each resident was then identified and interviewed about the resident. Care persons were asked whether and for what purpose drugs were prescribed for each resident. 75.8% of institutionalized residents and 54.3% of community facility residents were reported to be receiving at least 1 type of regularly prescribed medication. Percentages reported for specific drugs should be considered minimums, because drug names were not always elicited if the drug's purpose was known. Drugs not named, but reported to be prescribed for a chronic health condition, epilepsy, a psychiatric problem, for sleeping, or for birth control, were listed with "other" within tentative categories. Multiple regression was used to examine the relationships among drug use and several resident and facility characteristics. The institutionalized and community-based samples were combined for these analyses. Drugs reported to be prescribed for chronic health problems most frequently were used by older, nonambulatory residents who had health problems. Use of antiepilepsy drugs was most closely associated with a history of seizures. Only 1.3% of community facility residents and 1.6% of institutionalized residents whose records did not document epilepsy were reported to be receiving antiepilepsy drugs. Psychotropic drugs most often were prescribed for residents with behavior problems or for those with a recorded mention of mental illness or autism. Older, heavier, and more severely retarded residents also were more likely to receive psychotropic drugs. Contraceptive drugs were predicted by age, sex, ability, and minority status. Younger and less retarded women were more likely to receive birth control methods, as were minorities.

Conceptual design report: Nuclear materials storage facility renovation. Part 6, Alternatives study

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

NONE

1995-07-14

The Nuclear Materials Storage Facility (NMSF) at the Los Alamos National Laboratory (LANL) was a Fiscal Year (FY) 1984 line-item project completed in 1987 that has never been operated because of major design and construction deficiencies. This renovation project, which will correct those deficiencies and allow operation of the facility, is proposed as an FY 97 line item. The mission of the project is to provide centralized intermediate and long-term storage of special nuclear materials (SNM) associated with defined LANL programmatic missions and to establish a centralized SNM shipping and receiving location for Technical Area (TA)-55 at LANL. Based onmore » current projections, existing storage space for SNM at other locations at LANL will be loaded to capacity by approximately 2002. This will adversely affect LANUs ability to meet its mission requirements in the future. The affected missions include LANL`s weapons research, development, and testing (WRD&T) program; special materials recovery; stockpile survelliance/evaluation; advanced fuels and heat sources development and production; and safe, secure storage of existing nuclear materials inventories. The problem is further exacerbated by LANL`s inability to ship any materials offsite because of the lack of receiver sites for material and regulatory issues. Correction of the current deficiencies and enhancement of the facility will provide centralized storage close to a nuclear materials processing facility. The project will enable long-term, cost-effective storage in a secure environment with reduced radiation exposure to workers, and eliminate potential exposures to the public. This report is organized according to the sections and subsections outlined by Attachment 111-2 of DOE Document AL 4700.1, Project Management System. It is organized into seven parts. This document, Part VI - Alternatives Study, presents a study of the different storage/containment options considered for NMSF.« less

A comparison of parent satisfaction in an open-bay and single-family room neonatal intensive care unit.

PubMed

Stevens, Dennis C; Helseth, Carol C; Khan, M Akram; Munson, David P; Reid, E J

2011-01-01

The purpose of this research was to test the hypothesis that parental satisfaction with neonatal intensive care is greater in a single-family room facility as compared with a conventional open-bay neonatal intensive care unit (NICU). This investigation was a prospective cohort study comparing satisfaction survey results for parents who responded to a commercially available parent NICU satisfaction survey following the provision of NICU care in open-bay and single-family room facilities. A subset of 16 items indicative of family-centered care was also computed and compared for these two NICU facilities. Parents whose babies received care in the single-family room facility expressed significantly improved survey responses in regard to the NICU environment, overall assessment of care, and total survey score than did parents of neonates in the open-bay facility. With the exception of the section on nursing in which scores in both facilities were high, nonsignificant improvement in median scores for the sections on delivery, physicians, discharge planning, and personal issues were noted. The total median item score for family-centered care was significantly greater in the single-family room than the open-bay facility. Parental satisfaction with care in the single-family room NICU was improved in comparison with the traditional open-bay NICU. The single-family room environment appears more conducive to the provision of family-centered care. Improved parental satisfaction with care and the potential for enhanced family-centered care need to be considered in decisions made regarding the configuration of NICU facilities in the future.

National Ignition Facility project acquisition plan

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

Callaghan, R.W.

The purpose of this National Ignition Facility Acquisition Plan is to describe the overall procurement strategy planned for the National Ignition Facility (NIF) Project. The scope of the plan describes the procurement activities and acquisition strategy for the following phases of the NIF Project, each of which receives either plant and capital equipment (PACE) or other project cost (OPC) funds: Title 1 and 2 design and Title 3 engineering (PACE); Optics manufacturing facilitization and pilot production (OPC); Convention facility construction (PACE); Procurement, installation, and acceptance testing of equipment (PACE); and Start-up (OPC). Activities that are part of the base Inertialmore » Confinement Fusion (ICF) Program are not included in this plan. The University of California (UC), operating Lawrence Livermore National Laboratory (LLNL) and Los Alamos National Laboratory, and Lockheed-Martin, which operates Sandia National Laboratory (SNL) and the University of Rochester Laboratory for Laser Energetics (UR-LLE), will conduct the acquisition of needed products and services in support of their assigned responsibilities within the NIF Project structure in accordance with their prime contracts with the Department of Energy (DOE). LLNL, designated as the lead Laboratory, will have responsibility for all procurements required for construction, installation, activation, and startup of the NIF.« less

Rain gauge calibration and testing

NASA Technical Reports Server (NTRS)

Wilkerson, John

1994-01-01

Prior to the Tropical Oceans Global Atmosphere-Coupled Ocean Atmosphere Response Experiment (TOGA-COARE), 42 Model 100 series optical gauges were tested in the rain simulator facility at Wallops Island before shipment to the field. Baseline measurements at several rain rates were made simultaneously with collector cans, tipping bucket, and a precision weighing gauge and held for post-COARE evaluation with a repeat set of measurements that were to be recorded after the instruments were returned. This was done as a means of detecting any calibration changes that might have occurred while deployed. Although it was known that the artificial rain in the simulator did not contain the required exponential distribution for accurate optical rain gauge rate measurements, use of the facility was necessary because it was the only means available for taking controlled observations with instruments that were received, tested, and shipped out in groups over a period of months. At that point, it was believed that these measurements would be adequately precise for detecting performance changes over time. However, analysis of the data by STI now indicates that this may not be true. Further study of the data will be undertaken to resolve this.

A West Valley Demonstration Project Milestone - Achieving Certification to Ship Waste to the Nevada Test Site

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

Jackson, J. P.; Pastor, R. S.

2002-02-28

The West Valley Demonstration Project (WVDP) has successfully pretreated and vitrified nearly all of the 600,000 gallons of liquid high-level radioactive waste that was generated at the site of the only commercial nuclear fuel reprocessing plant to have operated in the United States. Low-level waste (LLW) generated during the course of the cleanup effort now requires disposal. Currently the WVDP only ships Class A LLW for off-site disposal. It has been shipping Class A wastes to Envirocare of Utah, Inc. since 1997. However, the WVDP may also have a future need to ship Class B and Class C waste, whichmore » Envirocare is not currently authorized to accept. The Nevada Test Site (NTS), a U.S. Department of Energy (DOE) facility, can accept all three waste classifications. The WVDP set a goal to receive certification to begin shipping Class A wastes to NTS by 2001. Formal certification/approval was granted by the DOE Nevada Operations Office on July 12, 2001. This paper discusses how the WVDP contractor, West Valley Nuclear Services Company (WVNSCO), completed the activities required to achieve NTS certification in 2001 to ship waste to its facility. The information and lessons learned provided are significant because the WVDP is the only new generator receiving certification based on an NTS audit in January 2001 that resulted in no findings and only two observations--a rating that is unparalleled in the DOE Complex.« less

Quality of antenatal care in Zambia: a national assessment

PubMed Central

2012-01-01

Background Antenatal care (ANC) is one of the recommended interventions to reduce maternal and neonatal mortality. Yet in most Sub-Saharan African countries, high rates of ANC coverage coexist with high maternal and neonatal mortality. This disconnect has fueled calls to focus on the quality of ANC services. However, little conceptual or empirical work exists on the measurement of ANC quality at health facilities in low-income countries. We developed a classification tool and assessed the level of ANC service provision at health facilities in Zambia on a national scale and compared this to the quality of ANC received by expectant mothers. Methods We analysed two national datasets with detailed antenatal provider and user information, the 2005 Zambia Health Facility Census and the 2007 Zambia Demographic and Health Survey (DHS), to describe the level of ANC service provision at 1,299 antenatal facilities in 2005 and the quality of ANC received by 4,148 mothers between 2002 and 2007. Results We found that only 45 antenatal facilities (3%) fulfilled our developed criteria for optimum ANC service, while 47% of facilities provided adequate service, and the remaining 50% offered inadequate service. Although 94% of mothers reported at least one ANC visit with a skilled health worker and 60% attended at least four visits, only 29% of mothers received good quality ANC, and only 8% of mothers received good quality ANC and attended in the first trimester. Conclusions DHS data can be used to monitor “effective ANC coverage” which can be far below ANC coverage as estimated by current indicators. This “quality gap” indicates missed opportunities at ANC for delivering effective interventions. Evaluating the level of ANC provision at health facilities is an efficient way to detect where deficiencies are located in the system and could serve as a monitoring tool to evaluate country progress. PMID:23237601

Factors related to the decision-making for moving the older adults into long-term care facilities in Taiwan.

PubMed

Hsieh, Yen-Ping; Huang, Ying-Chia; Lan, Shou-Jen; Ho, Ching-Sung

2017-09-01

To investigate the relationships between demographic characteristics of the elderly, type of long-term care (LTC) facilities, and the reasons for moving into LTC facilities. Research participants included people aged over 65 years, living in LTC facilities. A total of 1280 questionnaires were distributed to 111 LTC facilities in Taiwan; 480 questionnaires were retrieved, and 232 were included in the valid sample. The study used a non-linear canonical correlation analysis, which assesses the relationships among similar sets of categorical variables. The results showed that the older adults in quadrant I were characterized by being involved in the decision-making regarding the choice of LTC facilities and received economic support from their children. The older adults in quadrant II mainly lived in LTC facilities to receive medical care, whereas those in quadrant III typically included individuals with low income, who did not choose to live in LTC facilities. Furthermore, those in quadrant IV had positive cognitions associated with LTC facilities. We believe that the results of the present study will facilitate policy-making in the field of LTC, provide reference to the practitioners and the older adults, and identify the types of decisions older adults make when moving into LTC facilities, thus assisting older adults to improve their strategies regarding staying in LTC facilities. Geriatr Gerontol Int 2017; 17: 1319-1327. © 2016 Japan Geriatrics Society.

Digital Audio Radio Broadcast Systems Laboratory Testing Nearly Complete

NASA Technical Reports Server (NTRS)

2005-01-01

Radio history continues to be made at the NASA Lewis Research Center with the completion of phase one of the digital audio radio (DAR) testing conducted by the Consumer Electronics Group of the Electronic Industries Association. This satellite, satellite/terrestrial, and terrestrial digital technology will open up new audio broadcasting opportunities both domestically and worldwide. It will significantly improve the current quality of amplitude-modulated/frequency-modulated (AM/FM) radio with a new digitally modulated radio signal and will introduce true compact-disc-quality (CD-quality) sound for the first time. Lewis is hosting the laboratory testing of seven proposed digital audio radio systems and modes. Two of the proposed systems operate in two modes each, making a total of nine systems being tested. The nine systems are divided into the following types of transmission: in-band on-channel (IBOC), in-band adjacent-channel (IBAC), and new bands. The laboratory testing was conducted by the Consumer Electronics Group of the Electronic Industries Association. Subjective assessments of the audio recordings for each of the nine systems was conducted by the Communications Research Center in Ottawa, Canada, under contract to the Electronic Industries Association. The Communications Research Center has the only CCIR-qualified (Consultative Committee for International Radio) audio testing facility in North America. The main goals of the U.S. testing process are to (1) provide technical data to the Federal Communication Commission (FCC) so that it can establish a standard for digital audio receivers and transmitters and (2) provide the receiver and transmitter industries with the proper standards upon which to build their equipment. In addition, the data will be forwarded to the International Telecommunications Union to help in the establishment of international standards for digital audio receivers and transmitters, thus allowing U.S. manufacturers to compete in the world market.

Predictors of Nursing Facility Entry by Medicaid-Only Older Adults and Persons With Disabilities in California

PubMed Central

Ko, Michelle; Newcomer, Robert J.; Harrington, Charlene; Hulett, Denis; Kang, Taewoon; Bindman, Andrew B.

2018-01-01

Nearly one-third of adult Medicaid beneficiaries who receive long-term services and supports (LTSS) consist of older adults and persons with disabilities who are not eligible for Medicare. Beneficiaries, advocates, and policymakers have all sought to shift LTSS to home and community settings as an alternative to institutional care. We conducted a retrospective cohort study of Medicaid-only adults in California with new use of LTSS in 2006-2007 (N = 31 849) to identify unique predictors of entering nursing facilities versus receiving Medicaid home and community-based services (HCBS). Among new users, 18.3% entered into nursing facilities, whereas 81.7% initiated HCBS. In addition to chronic conditions, functional and cognitive limitations, substance abuse disorders (odds ratio [OR] 1.35; 95% confidence interval [CI]: 1.23, 1.48), and homelessness (OR: 4.35, 9% CI: 3.72, 5.08) were associated with higher odds of nursing facility entry. For older adults and persons with disabilities covered by Medicaid only, integration with housing and behavioral health services may be key to enabling beneficiaries to receive LTSS in noninstitutional settings. PMID:29633899

10 CFR 20.1906 - Procedures for receiving and opening packages.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Procedures for receiving and opening packages. 20.1906 Section 20.1906 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION... received at the licensee's facility if it is received during the licensee's normal working hours, or not...

10 CFR 20.1906 - Procedures for receiving and opening packages.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Procedures for receiving and opening packages. 20.1906 Section 20.1906 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION... received at the licensee's facility if it is received during the licensee's normal working hours, or not...

10 CFR 20.1906 - Procedures for receiving and opening packages.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Procedures for receiving and opening packages. 20.1906 Section 20.1906 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION... received at the licensee's facility if it is received during the licensee's normal working hours, or not...

10 CFR 20.1906 - Procedures for receiving and opening packages.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Procedures for receiving and opening packages. 20.1906 Section 20.1906 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION... received at the licensee's facility if it is received during the licensee's normal working hours, or not...

10 CFR 20.1906 - Procedures for receiving and opening packages.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Procedures for receiving and opening packages. 20.1906 Section 20.1906 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION... received at the licensee's facility if it is received during the licensee's normal working hours, or not...

Barriers to providing palliative care in long-term care facilities

PubMed Central

Brazil, Kevin; Bédard, Michel; Krueger, Paul; Taniguchi, Alan; Kelley, Mary Lou; McAiney, Carrie; Justice, Christopher

2006-01-01

OBJECTIVE To assess challenges in providing palliative care in long-term care (LTC) facilities from the perspective of medical directors. DESIGN Cross-sectional mailed survey. A questionnaire was developed, reviewed, pilot-tested, and sent to 450 medical directors representing 531 LTC facilities. Responses were rated on 2 different 5-point scales. Descriptive analyses were conducted on all responses. SETTING All licensed LTC facilities in Ontario with designated medical directors. PARTICIPANTS Medical directors in the facilities. MAIN OUTCOME MEASURES Demographic and practice characteristics of physicians and facilities, importance of potential barriers to providing palliative care, strategies that could be helpful in providing palliative care, and the kind of training in palliative care respondents had received. RESULTS Two hundred seventy-five medical directors (61%) representing 302 LTC facilities (57%) responded to the survey. Potential barriers to providing palliative care were clustered into 3 groups: facility staff’s capacity to provide palliative care, education and support, and the need for external resources. Two thirds of respondents (67.1%) reported that inadequate staffing in their facilities was an important barrier to providing palliative care. Other barriers included inadequate financial reimbursement from the Ontario Health Insurance Program (58.5%), the heavy time commitment required (47.3%), and the lack of equipment in facilities (42.5%). No statistically significant relationship was found between geographic location or profit status of facilities and barriers to providing palliative care. Strategies respondents would use to improve provision of palliative care included continuing medical education (80.0%), protocols for assessing and monitoring pain (77.7%), finding ways to increase financial reimbursement for managing palliative care residents (72.1%), providing educational material for facility staff (70.7%), and providing practice guidelines related to assessing and managing palliative care patients (67.8%). CONCLUSION Medical directors in our study reported that their LTC facilities were inadequately staffed and lacked equipment. The study also highlighted the specialized role of medical directors, who identified continuing medical education as a key strategy for improving provision of palliative care. PMID:17327890

Barriers to providing palliative care in long-term care facilities.

PubMed

Brazil, Kevin; Bédard, Michel; Krueger, Paul; Taniguchi, Alan; Kelley, Mary Lou; McAiney, Carrie; Justice, Christopher

2006-04-01

To assess challenges in providing palliative care in long-term care (LTC) facilities from the perspective of medical directors. Cross-sectional mailed survey. A questionnaire was developed, reviewed, pilot-tested, and sent to 450 medical directors representing 531 LTC facilities. Responses were rated on 2 different 5-point scales. Descriptive analyses were conducted on all responses. All licensed LTC facilities in Ontario with designated medical directors. Medical directors in the facilities. Demographic and practice characteristics of physicians and facilities, importance of potential barriers to providing palliative care, strategies that could be helpful in providing palliative care, and the kind of training in palliative care respondents had received. Two hundred seventy-five medical directors (61%) representing 302 LTC facilities (57%) responded to the survey. Potential barriers to providing palliative care were clustered into 3 groups: facility staff's capacity to provide palliative care, education and support, and the need for external resources. Two thirds of respondents (67.1%) reported that inadequate staffing in their facilities was an important barrier to providing palliative care. Other barriers included inadequate financial reimbursement from the Ontario Health Insurance Program (58.5%), the heavy time commitment required (47.3%), and the lack of equipment in facilities (42.5%). No statistically significant relationship was found between geographic location or profit status of facilities and barriers to providing palliative care. Strategies respondents would use to improve provision of palliative care included continuing medical education (80.0%), protocols for assessing and monitoring pain (77.7%), finding ways to increase financial reimbursement for managing palliative care residents (72.1%), providing educational material for facility staff (70.7%), and providing practice guidelines related to assessing and managing palliative care patients (67.8%). Medical directors in our study reported that their LTC facilities were inadequately staffed and lacked equipment. The study also highlighted the specialized role of medical directors, who identified continuing medical education as a key strategy for improving provision of palliative care.

Processing loaner instruments in an ambulatory surgery center.

PubMed

Huter-Kunish, Gloria G

2009-05-01

Loaner instruments often do not arrive at receiving facilities in the time frame or the condition that is needed to use them safely. Their cleaning and decontamination status may be unknown. There may be no inventory of what has been loaned or information about processing requirements for the instrument's use. These situations can create problems for both the loaning facility and the receiving facility and must be addressed to reduce costs from damage to or loss of instruments.The use of documents and checklists to verify the cleaning,decontamination, and sterilization processes used allows ambulatory surgery centers to solve these problems,cut costs, and protect staff members and patients.

Research and test facilities

NASA Technical Reports Server (NTRS)

1993-01-01

A description is given of each of the following Langley research and test facilities: 0.3-Meter Transonic Cryogenic Tunnel, 7-by 10-Foot High Speed Tunnel, 8-Foot Transonic Pressure Tunnel, 13-Inch Magnetic Suspension & Balance System, 14-by 22-Foot Subsonic Tunnel, 16-Foot Transonic Tunnel, 16-by 24-Inch Water Tunnel, 20-Foot Vertical Spin Tunnel, 30-by 60-Foot Wind Tunnel, Advanced Civil Transport Simulator (ACTS), Advanced Technology Research Laboratory, Aerospace Controls Research Laboratory (ACRL), Aerothermal Loads Complex, Aircraft Landing Dynamics Facility (ALDF), Avionics Integration Research Laboratory, Basic Aerodynamics Research Tunnel (BART), Compact Range Test Facility, Differential Maneuvering Simulator (DMS), Enhanced/Synthetic Vision & Spatial Displays Laboratory, Experimental Test Range (ETR) Flight Research Facility, General Aviation Simulator (GAS), High Intensity Radiated Fields Facility, Human Engineering Methods Laboratory, Hypersonic Facilities Complex, Impact Dynamics Research Facility, Jet Noise Laboratory & Anechoic Jet Facility, Light Alloy Laboratory, Low Frequency Antenna Test Facility, Low Turbulence Pressure Tunnel, Mechanics of Metals Laboratory, National Transonic Facility (NTF), NDE Research Laboratory, Polymers & Composites Laboratory, Pyrotechnic Test Facility, Quiet Flow Facility, Robotics Facilities, Scientific Visualization System, Scramjet Test Complex, Space Materials Research Laboratory, Space Simulation & Environmental Test Complex, Structural Dynamics Research Laboratory, Structural Dynamics Test Beds, Structures & Materials Research Laboratory, Supersonic Low Disturbance Pilot Tunnel, Thermal Acoustic Fatigue Apparatus (TAFA), Transonic Dynamics Tunnel (TDT), Transport Systems Research Vehicle, Unitary Plan Wind Tunnel, and the Visual Motion Simulator (VMS).

77 FR 14725 - Notice of Request for Extension of Approval of an Information Collection; Standards for Privately...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-13

... Quarantine Facilities for Ruminants AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION... privately owned quarantine facilities for ruminants. DATES: We will consider all comments that we receive on... privately owned quarantine facilities for ruminants, contact Dr. Langston Hull, Senior Staff Veterinarian...

42 CFR 483.35 - Dietary services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... receives and the facility provides at least three meals daily, at regular times comparable to normal.... (a) Staffing. The facility must employ a qualified dietitian either full-time, part-time, or on a consultant basis. (1) If a qualified dietitian is not employed full-time, the facility must designate a...

42 CFR 483.35 - Dietary services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... receives and the facility provides at least three meals daily, at regular times comparable to normal.... (a) Staffing. The facility must employ a qualified dietitian either full-time, part-time, or on a consultant basis. (1) If a qualified dietitian is not employed full-time, the facility must designate a...

Facilities Spending Criticized as Uneven

ERIC Educational Resources Information Center

Greifner, Laura

2006-01-01

This article features a report on states and school districts spending almost $600 billion on building and renovating schools from 1995 to 2004, an amount that far exceed earlier expectations. The report also emphasized the uneven facilities spending between minority and affluent districts. Besides receiving the least money for facilities, the…

78 FR 55328 - Agency Information Collection Activities: Requests for Comments; Clearance of Renewed Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-10

... Passenger Facility Charge (PFC) or to receive a grant under the Airport Improvement Program (AIP). DATES..., Passenger Facility Charges AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice and request... Number: 2120-0661. Title: Competition Plans, Passenger Facility Charges. Form Numbers: There are no FAA...

Suicide Prevention in Juvenile Facilities.

ERIC Educational Resources Information Center

Hayes, Lindsay M.

2000-01-01

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

University of Maryland MRSEC - For Members: Publications

Science.gov Websites

-MRSEC at the University of Maryland, DMR 0520471." Authors who use MRSEC Shared Experimental Facilities, should acknowledge the MRSEC-SEF: Authors who use MRSEC Shared Experimental Facilities and also Experimental Facilities, but do not receive other MRSEC support should still acknowledge the MRSEC-SEF: "

22 CFR 217.22 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Existing facilities. 217.22 Section 217.22... PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Accessibility § 217.22 Existing facilities... necessary to achieve full accessibility under § 217.22(a) and, if the time period of the transition plan is...

22 CFR 217.22 - Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Existing facilities. 217.22 Section 217.22... PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Accessibility § 217.22 Existing facilities... necessary to achieve full accessibility under § 217.22(a) and, if the time period of the transition plan is...

22 CFR 217.22 - Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Existing facilities. 217.22 Section 217.22... PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Accessibility § 217.22 Existing facilities... necessary to achieve full accessibility under § 217.22(a) and, if the time period of the transition plan is...

22 CFR 217.22 - Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Existing facilities. 217.22 Section 217.22... PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Accessibility § 217.22 Existing facilities... necessary to achieve full accessibility under § 217.22(a) and, if the time period of the transition plan is...

22 CFR 217.22 - Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Existing facilities. 217.22 Section 217.22... PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Accessibility § 217.22 Existing facilities... necessary to achieve full accessibility under § 217.22(a) and, if the time period of the transition plan is...

77 FR 73614 - Notice of Request for Extension of Approval of an Information Collection; Permanent, Privately...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-11

... Horse Quarantine Facilities AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Extension..., privately owned horse quarantine facilities. DATES: We will consider all comments that we receive on or... for permanent, privately owned horse quarantine facilities, contact Dr. Ellen Buck, Staff Veterinary...

42 CFR 442.2 - Terms.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., harm, impairment, or death to an individual receiving care in a facility. New admission means the... discharged or had voluntarily left the facility. The term does not include the following: (a) Individuals who were in the facility before the effective date of denial of payment for new admissions, even if they...

42 CFR 442.2 - Terms.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., harm, impairment, or death to an individual receiving care in a facility. New admission means the... discharged or had voluntarily left the facility. The term does not include the following: (a) Individuals who were in the facility before the effective date of denial of payment for new admissions, even if they...

Univariate and multivariate spatial models of health facility utilisation for childhood fevers in an area on the coast of Kenya.

PubMed

Ouma, Paul O; Agutu, Nathan O; Snow, Robert W; Noor, Abdisalan M

2017-09-18

Precise quantification of health service utilisation is important for the estimation of disease burden and allocation of health resources. Current approaches to mapping health facility utilisation rely on spatial accessibility alone as the predictor. However, other spatially varying social, demographic and economic factors may affect the use of health services. The exclusion of these factors can lead to the inaccurate estimation of health facility utilisation. Here, we compare the accuracy of a univariate spatial model, developed only from estimated travel time, to a multivariate model that also includes relevant social, demographic and economic factors. A theoretical surface of travel time to the nearest public health facility was developed. These were assigned to each child reported to have had fever in the Kenya demographic and health survey of 2014 (KDHS 2014). The relationship of child treatment seeking for fever with travel time, household and individual factors from the KDHS2014 were determined using multilevel mixed modelling. Bayesian information criterion (BIC) and likelihood ratio test (LRT) tests were carried out to measure how selected factors improve parsimony and goodness of fit of the time model. Using the mixed model, a univariate spatial model of health facility utilisation was fitted using travel time as the predictor. The mixed model was also used to compute a multivariate spatial model of utilisation, using travel time and modelled surfaces of selected household and individual factors as predictors. The univariate and multivariate spatial models were then compared using the receiver operating area under the curve (AUC) and a percent correct prediction (PCP) test. The best fitting multivariate model had travel time, household wealth index and number of children in household as the predictors. These factors reduced BIC of the time model from 4008 to 2959, a change which was confirmed by the LRT test. Although there was a high correlation of the two modelled probability surfaces (Adj R 2  = 88%), the multivariate model had better AUC compared to the univariate model; 0.83 versus 0.73 and PCP 0.61 versus 0.45 values. Our study shows that a model that uses travel time, as well as household and individual-level socio-demographic factors, results in a more accurate estimation of use of health facilities for the treatment of childhood fever, compared to one that relies on only travel time.

Space Based Communications

NASA Technical Reports Server (NTRS)

Simpson, James; Denson, Erik; Valencia, Lisa; Birr, Richard

2003-01-01

Current space lift launches on the Eastern and Western Range require extensive ground-based real-time tracking, communications and command/control systems. These are expensive to maintain and operate and cover only limited geographical areas. Future spaceports will require new technologies to provide greater launch and landing opportunities, support simultaneous missions, and offer enhanced decision support models and simulation capabilities. These ranges must also have lower costs and reduced complexity while continuing to provide unsurpassed safety to the public, flight crew, personnel, vehicles and facilities. Commercial and government space-based assets for tracking and communications offer many attractive possibilities to help achieve these goals. This paper describes two NASA proof-of-concept projects that seek-to exploit the advantages of a space-based range: Iridium Flight Modem and Space-Based Telemetry and Range Safety (STARS). Iridium Flight Modem uses the commercial satellite system Iridium for extremely low cost, low rate two-way communications and has been successfully tested on four aircraft flights. A sister project at Goddard Space Flight Center's (GSFC) Wallops Flight Facility (WFF) using the Globalstar system has been tested on one rocket. The basic Iridium Flight Modem system consists of a L1 carrier Coarse/Acquisition (C/A)-Code Global Positioning System (GPS) receiver, an on-board computer, and a standard commercial satellite modem and antennas. STARS uses the much higher data rate NASA owned Tracking and Data Relay Satellite System (TDRSS), a C/A-Code GPS receiver, an experimental low-power transceiver, custom built command and data handler processor, and digitized flight termination system (FTS) commands. STARS is scheduled to fly on an F-15 at Dryden Flight Research Center in the spring of 2003, with follow-on tests over the next several years.

Initial Efficacy of a Cardiac Rehabilitation Transition Program: Cardiac TRUST

PubMed Central

Zullo, Melissa; Boxer, Rebecca; Moore, Shirley M.

2012-01-01

Patients recovering from cardiac events are increasingly using postacute care, such as home health care and skilled nursing facility services. The purpose of this pilot study was to test the initial efficacy, feasibility, and safety of a specially designed postacute care transitional rehabilitation intervention for cardiac patients. Cardiac Transitional Rehabilitation Using Self- Management Techniques (Cardiac TRUST) is a family-focused intervention that includes progressive low-intensity walking and education in self-management skills to facilitate recovery following a cardiac event. Using a randomized two-group design, exercise self-efficacy, steps walked, and participation in an outpatient cardiac rehabilitation program were compared in a sample of 38 older adults; 17 who received the Cardiac TRUST program and 21 who received usual care only. At discharge from postacute care, the intervention group had a trend for higher levels of self-efficacy for exercise outcomes (X=39.1, SD=7.4) than the usual care group (X=34.5; SD=7.0) (t-test 1.9, p=.06). During the 6 weeks following discharge, compared with the usual care group, the intervention group had more attendance in out-patient cardiac rehabilitation (33% compared to 11.8%, F=7.1, p=.03) and a trend toward more steps walked during the first week (X=1,307, SD=652 compared to X=782, SD=544, t-test 1.8, p=.07). The feasibility of the intervention was better for the home health participants than for those in the skilled nursing facility and there were no safety concerns. The provision of cardiac-focused rehabilitation during postacute care has the potential to bridge the gap in transitional services from hospitalization to outpatient cardiac rehabilitation for these patients at high risk for future cardiac events. Further evidence of the efficacy of Cardiac TRUST is warranted. PMID:22084960

Application of federal indicators in nursing-home drug-regimen review.

PubMed

Shannon, R C; De Muth, J E

1984-05-01

Numbers of medications per patient and rate of drug administration errors were compared in Wisconsin long-term care facilities that used federal indicators in conducting drug-regimen review versus facilities that did not use the indicators. Data were collected from 1132 charts in 24 facilities randomly selected from a state survey schedule for June-October 1982. Both prescription and nonprescription drugs that patients received during the 30-day period preceding the survey were counted. Medication use was compared by facility type--skilled-nursing facility (SNF), intermediate-care facility (ICF), or ICF for the mentally retarded. The federal indicators were used in 10 facilities. Mean number of medications used per patient where indicators were applied (5.4 versus 6.6 for SNFs and 3.4 versus 5.8 for ICFs ) was not significantly different. In SNFs using the indicators, patients received 5.6 medications where the consultant pharmacist was also the provider and 5.2 where the consultant was not the provider. Medication use was not significantly different by facility type. The number of drug administration irregularities per 100 residents was significantly greater where indicators were not applied. Further study is needed to determine whether use of federal indicators encourages more efficient and appropriate drug therapy for patients in long-term care facilities.

Health worker adherence to malaria treatment guidelines at outpatient health facilities in southern Malawi following implementation of universal access to diagnostic testing.

PubMed

Namuyinga, Ruth J; Mwandama, Dyson; Moyo, Dubulao; Gumbo, Austin; Troell, Peter; Kobayashi, Miwako; Shah, Monica; Bauleni, Andrew; Vanden Eng, Jodi; Rowe, Alexander K; Mathanga, Don P; Steinhardt, Laura C

2017-01-23

Appropriate diagnosis and treatment are essential for reducing malaria mortality. A cross-sectional outpatient health facility (HF) survey was conducted in southern Malawi from January to March 2015 to determine appropriate malaria testing and treatment practices four years after implementation of a policy requiring diagnostic confirmation before treatment. Enrolled patients were interviewed, examined and had their health booklet reviewed. Health workers (HWs) were asked about training, supervision and access to the 2013 national malaria treatment guidelines. HFs were assessed for malaria diagnostic and treatment capacity. Weighted descriptive analyses and logistic regression of patient, HW and HF characteristics related to testing and treatment were performed. An evaluation of 105 HFs, and interviews of 150 HWs and 2342 patients was completed. Of 1427 suspect uncomplicated malaria patients seen at HFs with testing available, 1072 (75.7%) were tested, and 547 (53.2%) tested positive. Testing was more likely if patients spontaneously reported fever (odds ratio (OR) 2.6; 95% confidence interval (CI) 1.7-4.0), headache (OR 1.5; 95% CI 1.1-2.1) or vomiting (OR 2.0; 95% CI 1.0-4.0) to HWs and less likely if they reported skin problems (OR 0.4; 95% CI 0.2-0.6). Altogether, 511 (92.7%) confirmed cases and 98 (60.3%) of 178 presumed uncomplicated malaria patients (at HFs without testing) were appropriately treated, while 500 (96.6%) of 525 patients with negative tests did not receive anti-malarials. Only eight (5.7%) suspect severe malaria patients received appropriate pre-referral treatment. Appropriate treatment was more likely for presumed uncomplicated malaria patients (at HFs without testing) with elevated temperature (OR 1.5/1 °C increase; 95% CI 1.1-1.9), who reported fever to HWs (OR 5.7; 95% CI 1.9-17.6), were seen by HWs with additional supervision visits in the previous 6 months (OR 1.2/additional visit; 95% CI 1.0-1.4), or were seen by older HWs (OR 1.1/year of age; 95% CI 1.0-1.1). Correct testing and treatment practices were reasonably good for uncomplicated malaria when testing was available. Pre-referral treatment for suspect severe malaria was unacceptably rare. Encouraging HWs to elicit and appropriately respond to patient symptoms may improve practices.

Conducting an audit to improve the facilitation of emergency maternal and newborn referral in northern Ghana.

PubMed

Awoonor-Williams, John Koku; Bailey, Patricia E; Yeji, Francis; Adongo, Ayire Emmanuel; Baffoe, Peter; Williams, Afua; Mercer, Sarah

2015-10-01

Ghana Health Service conducted an audit to strengthen the referral system for pregnant or recently pregnant women and newborns in northern Ghana. The audit took place in 16 facilities with two 3-month cycles of data collection in 2011. Midwife-led teams tracked 446 referred women until they received definitive treatment. Between the two audit cycles, teams identified and implemented interventions to address gaps in referral services. During this time period, we observed important increases in facilitating referral mechanisms, including a decrease in the dependence on taxis in favour of national or facility ambulances/vehicles; an increase in health workers escorting referrals to the appropriate receiving facility; greater use of referral slips and calling ahead to alert receiving facilities and higher feedback rates. As referral systems require attention from multiple levels of engagement, on the provider end we found that regional managers increasingly resolved staffing shortages; district management addressed the costliness and lack of transport and increased midwives' ability to communicate with pregnant women and drivers; and that facility staff increasingly adhered to guidelines and facilitating mechanisms. By conducting an audit of maternal and newborn referrals, the Ghana Health Service identified areas for improvement that service providers and management at multiple levels addressed, demonstrating a platform for problem solving that could be a model elsewhere.

CORROSION STUDY FOR THE EFFLUENT TREATMENT FACILITY (ETF) CHROME (VI) REDUCTANT SOLUTION USING 304 & 316L STAINLESS STEEL

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

DUNCAN, J.B.

2007-06-27

The Effluent Treatment Facility has developed a method to regenerate spent resin from the groundwater pump and treat intercepting chrome(VI) plumes (RPP-RPT-32207, Laboratory Study on Regeneration of Spent DOWEX 21K 16-20 Mesh Ion Exchange Resin). Subsequent laboratory studies have shown that the chrome(VI) may be reduced to chrome(III) by titrating with sodium metabisulfite to an oxidation reduction potential (ORP) of +280 mV at a pH of 2. This test plan describes the use of cyclic potentiodynamic polarization and linear polarization techniques to ascertain the electrochemical corrosion and pitting propensity of the 304 and 316L stainless steel in the acidified reducingmore » the solution that will be contained in either the secondary waste receiver tank or concentrate tank.« less

Returning HIV-1 viral load results to participant-selected health facilities in national Population-based HIV Impact Assessment (PHIA) household surveys in three sub-Saharan African Countries, 2015 to 2016.

PubMed

Saito, Suzue; Duong, Yen T; Metz, Melissa; Lee, Kiwon; Patel, Hetal; Sleeman, Katrina; Manjengwa, Julius; Ogollah, Francis M; Kasongo, Webster; Mitchell, Rick; Mugurungi, Owen; Chimbwandira, Frank; Moyo, Crispin; Maliwa, Vusumuzi; Mtengo, Helecks; Nkumbula, Tepa; Ndongmo, Clement B; Vere, Nora Skutayi; Chipungu, Geoffrey; Parekh, Bharat S; Justman, Jessica; Voetsch, Andrew C

2017-11-01

Logistical complexities of returning laboratory test results to participants have precluded most population-based HIV surveys conducted in sub-Saharan Africa from doing so. For HIV positive participants, this presents a missed opportunity for engagement into clinical care and improvement in health outcomes. The Population-based HIV Impact Assessment (PHIA) surveys, which measure HIV incidence and the prevalence of viral load (VL) suppression in selected African countries, are returning VL results to health facilities specified by each HIV positive participant within eight weeks of collection. We describe the performance of the specimen and data management systems used to return VL results to PHIA participants in Zimbabwe, Malawi and Zambia. Consenting participants underwent home-based counseling and HIV rapid testing as per national testing guidelines; all confirmed HIV positive participants had VL measured at a central laboratory on either the Roche CAP/CTM or Abbott m2000 platform. On a bi-weekly basis, a dedicated data management team produced logs linking the VL test result with the participants' contact information and preferred health facility; project staff sent test results confidentially via project drivers, national courier systems, or electronically through an adapted short message service (SMS). Participants who provided cell phone numbers received SMS or phone call alerts regarding availability of VL results. From 29,634 households across the three countries, 78,090 total participants 0 to 64 years in Zimbabwe and Malawi and 0 to 59 years in Zambia underwent blood draw and HIV testing. Of the 8391 total HIV positive participants identified, 8313 (99%) had VL tests performed and 8245 (99%) of these were returned to the selected health facilities. Of the 5979 VL results returned in Zimbabwe and Zambia, 85% were returned within the eight-week goal with a median turnaround time of 48 days (IQR: 33 to 61). In Malawi, where exact return dates were unavailable all 2266 returnable results reached the health facilities by 11 weeks. The first three PHIA surveys returned the vast majority of VL results to each HIV positive participant's preferred health facility within the eight-week target. Even in the absence of national VL monitoring systems, a system to return VL results from a population-based survey is feasible, but it requires developing laboratory and data management systems and dedicated staff. These are likely important requirements to strengthen return of results systems in routine clinical care. © 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

Apollo Program Summary Report: Synopsis of the Apollo Program Activities and Technology for Lunar Exploration

NASA Technical Reports Server (NTRS)

1975-01-01

Overall program activities and the technology developed to accomplish lunar exploration are discussed. A summary of the flights conducted over an 11-year period is presented along with specific aspects of the overall program, including lunar science, vehicle development and performance, lunar module development program, spacecraft development testing, flight crew summary, mission operations, biomedical data, spacecraft manufacturing and testing, launch site facilities, equipment, and prelaunch operations, and the lunar receiving laboratory. Appendixes provide data on each of the Apollo missions, mission type designations, spacecraft weights, records achieved by Apollo crewmen, vehicle histories, and a listing of anomalous hardware conditions noted during each flight beginning with Apollo 4.

Mental Illness Training for Licensed Staff in Long-Term Care

PubMed Central

Irvine, A. Blair; Billow, Molly B.; Eberhage, Mark G.; Seeley, John R.; McMahon, Edward; Bourgeois, Michelle

2013-01-01

Licensed care staff working in long-term care facilities may be poorly prepared to work with residents with mental illness. This research reports on the program evaluation of Caring Skills: Working with Mental Illness, a training program delivered on the Internet. It was tested with a randomized treatment-control design, with an eight-week follow-up. The training provided video-based behavioral skills and knowledge training. Measures included video situations testing and assessment of psycho-social constructs including empathy and stigmatization. ANCOVA analysis at 4-weeks posttest showed significant positive effects with medium-large effect sizes, which were largely maintained at the 8-week follow-up. The training was well-received by the users. PMID:22364430

Ultra-accelerated natural sunlight exposure testing facilities

DOEpatents

Lewandowski, Allan A.; Jorgensen, Gary J.

2003-08-12

A multi-faceted concentrator apparatus for providing ultra-accelerated natural sunlight exposure testing for sample materials under controlled weathering conditions comprising: facets that receive incident natural sunlight, transmits VIS/NIR and reflects UV/VIS to deliver a uniform flux of UV/VIS onto a sample exposure plane located near a center of a facet array in chamber means that provide concurrent levels of temperature and/or relative humidity at high levels of up to 100.times. of natural sunlight that allow sample materials to be subjected to accelerated irradiance exposure factors for a significant period of time of about 3 to 10 days to provide a corresponding time of about at least a years worth representative weathering of sample materials.

Brazilian remote sensing receiving, recording and processing ground systems in the 1980's

NASA Technical Reports Server (NTRS)

Parada, N. D. J. (Principal Investigator)

1984-01-01

A ground station was built in Brazil to receive, record, and process TM data from LANDSAT satellites. The receiving/recording subsystem and the processing subsystem are discussed. Functional design specifications for the facility are addressed.

Electromagnetic Interference/Compatibility (EMI/EMC) Control Test and Measurement Facility: User Test Planning Guide

NASA Technical Reports Server (NTRS)

Scully, Robert C.

2011-01-01

Test process, milestones and inputs are unknowns to first-time users of the EMI/EMC Test Facility. The User Test Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their test engineering personnel in test planning and execution. Material covered includes a roadmap of the test process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, test article interfaces, and inputs necessary to define test scope, cost, and schedule are included as an appendix to the guide.

Overview of the Orion Vibroacoustic Test Capability at NASA Glenn Research Center

NASA Technical Reports Server (NTRS)

Hughes, William O.; Hozman, Aron D.; McNelis, Mark E.; Otten, Kim D.

2008-01-01

In order to support the environmental test needs for our new Orion and Constellation program, NASA is developing unique world-class test facilities. To optimize this testing of spaceflight hardware while minimizing transportation issues, a one-stop, under one roof test capability is being developed at the Space Power Facility at the NASA Glenn Research Center's Plum Brook Station. This facility will provide the capability to perform the following environmental testing: (1) reverberation acoustic testing, (2) mechanical base-shake sine testing, (3) modal testing, (4) thermal-vacuum testing, and (5) EMI/EMC (electromagnetic interference and compatibility) testing. An overview of this test capability will be provided in this presentation, with special focus on the two new vibroacoustic test facilities currently being designed and built, the Reverberant Acoustic Test Facility (RATF) and the Mechanical Vibration Facility (MVF). Testing of the engineering developmental hardware and qualification hardware of the Orion (Crew Exploration Vehicle) will commence shortly after the facilities are commissioned.

Developing a space network interface simulator: The NTS approach

NASA Technical Reports Server (NTRS)

Hendrzak, Gary E.

1993-01-01

This paper describes the approach used to redevelop the Network Control Center (NCC) Test System (NTS), a hardware and software facility designed to make testing of the NCC Data System (NCCDS) software efficient, effective, and as rigorous as possible prior to operational use. The NTS transmits and receives network message traffic in real-time. Data transfer rates and message content are strictly controlled and are identical to that of the operational systems. NTS minimizes the need for costly and time-consuming testing with the actual external entities (e.g., the Hubble Space Telescope (HST) Payload Operations Control Center (POCC) and the White Sands Ground Terminal). Discussed are activities associated with the development of the NTS, lessons learned throughout the project's lifecycle, and resulting productivity and quality increases.

Dose escalation of definitive radiation is not associated with improved survival for cervical esophageal cancer: a National Cancer Data Base (NCDB) analysis.

PubMed

De, B; Rhome, R; Doucette, J; Buckstein, M

2017-04-01

For cervical esophageal cancer (CEC), National Comprehensive Cancer Network guidelines support RT to 50-50.4 Gy with chemotherapy but acknowledge higher doses may be appropriate. This study uses the National Cancer Database (NCDB) to characterize RT practices and identify if a dose-response relationship exists for overall survival (OS) for definitive treatment of CEC. We queried the NCDB for patients diagnosed with Stage I-III CEC from 2004 to 2013, and selected patients receiving definitive RT with doses between 50 and 74 Gy. Using multivariate logistic regression, the database was analyzed to determine factors associated with use of RT > 50.4 Gy. Patients were then stratified into three dose categories. Predictors of OS were analyzed with univariate and multivariate methods using the Kaplan-Meier curves, the log-rank test, and the Cox proportional hazards analysis. We stratified 789 patients with CEC who were treated with definitive radiation ± chemotherapy: 50-50.4 Gy ('standard'), >50.4 and <66 Gy ('medium'), and 66-74 Gy ('high'). Of these patients, 215 (27%) received standard doses, 375 (48%) received medium doses, and 199 (25%) received high doses. Patients with Medicaid insurance and those with Stage II disease were less likely (P < 0.05) to receive >50.4 Gy. Sex, histology, distance to treatment facility, and academic/community facility type were not significantly associated with receipt of >50.4 Gy. There was no association between dose and OS for the medium or high groups when using univariate analysis or analysis adjusted for demographic, facility, and clinical attributes. Stage III disease and the Charlson-Deyo scores of 1 or 2 were associated with higher mortality (P < 0.05), while female sex and use of chemotherapy were associated with lower mortality (P < 0.01). Nearly three-fourths of CEC patients in the United States are treated with RT > 50.4 Gy. Higher radiation doses were not associated with increased OS in CEC patients in the NCDB. © The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

42 CFR 71.47 - Special provisions relating to airports: Office and isolation facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Requirements Upon Arrival at U.S... facilities. Each U.S. airport which receives international traffic shall provide without cost to the...

42 CFR 71.47 - Special provisions relating to airports: Office and isolation facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Requirements Upon Arrival at U.S... facilities. Each U.S. airport which receives international traffic shall provide without cost to the...

42 CFR 71.47 - Special provisions relating to airports: Office and isolation facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Requirements Upon Arrival at U.S... facilities. Each U.S. airport which receives international traffic shall provide without cost to the...

42 CFR 71.47 - Special provisions relating to airports: Office and isolation facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Requirements Upon Arrival at U.S... facilities. Each U.S. airport which receives international traffic shall provide without cost to the...

CDC Vital Signs: Making Health Care Safer

MedlinePlus

... safety efforts happening across the state. Health care facility CEOs/administrators can: Implement systems to alert receiving ... Germs spread between patients and across health care facilities. Antibiotic resistance is a threat. Nightmare germs called ...

Material growth and characterization directed toward improving III-V heterojunction solar cells

NASA Technical Reports Server (NTRS)

Stefanakos, E. K.; Alexander, W. E.; Collis, W.; Abul-Fadl, A.

1979-01-01

In addition to the existing materials growth laboratory, the photolithographic facility and the device testing facility were completed. The majority of equipment for data acquisition, solar cell testing, materials growth and device characterization were received and are being put into operation. In the research part of the program, GaAs and GaA1As layers were grown reproducibly on GaAs substrates. These grown layers were characterized as to surface morphology, thickness and thickness uniformity. The liquid phase epitaxial growth process was used to fabricate p-n junctions in Ga(1-x)A1(x)As. Sequential deposition of two alloy layers was accomplished and detailed analysis of the effect of substrate quality and dopant on the GaA1As layer quality is presented. Finally, solar cell structures were formed by growing a thin p-GaA1As layer upon an epitaxial n-GaA1As layer. The energy gap corresponding to the long wavelength cutoff of the spectral response characteristic was 1.51-1.63 eV. Theoretical calculations of the spectral response were matched to the measured response.

Space Environmental Effects Knowledgebase

NASA Technical Reports Server (NTRS)

Wood, B. E.

2007-01-01

This report describes the results of an NRA funded program entitled Space Environmental Effects Knowledgebase that received funding through a NASA NRA (NRA8-31) and was monitored by personnel in the NASA Space Environmental Effects (SEE) Program. The NASA Project number was 02029. The Satellite Contamination and Materials Outgassing Knowledgebase (SCMOK) was created as a part of the earlier NRA8-20. One of the previous tasks and part of the previously developed Knowledgebase was to accumulate data from facilities using QCMs to measure the outgassing data for satellite materials. The main object of this current program was to increase the number of material outgassing datasets from 250 up to approximately 500. As a part of this effort, a round-robin series of materials outgassing measurements program was also executed that allowed comparison of the results for the same materials tested in 10 different test facilities. Other programs tasks included obtaining datasets or information packages for 1) optical effects of contaminants on optical surfaces, thermal radiators, and sensor systems and 2) space environmental effects data and incorporating these data into the already existing NASA/SEE Knowledgebase.

A comparison between antenatal care quality in public and private sector in rural Hebei, China

PubMed Central

Chen, Li; Dai, Yaohua; Zhang, Yanfeng; Wu, Qiong; Rudan, Diana; Saftić, Vanja; van Velthoven, Michelle H.M.M.T.; Su, Jianqiang; Tan, Zangwen; Scherpbier, Robert W.

2013-01-01

Aim To evaluate the quality of antenatal care (ANC) in Hebei Province and compare it between the public and private sector and within the public sector. Methods We conducted a Maternal, Newborn and Child Health Household Survey in 2010 using a two-stage sampling procedure and included 1079 mothers. The quality of ANC was assessed on the basis of the number of ANC visits, the time of the first ANC visit, 16 different ANC procedures, owning a maternal health care booklet, and the type of service provider. Results Almost all women (98%) received ANC services at least once, 80% at least four times, and 54% at least five times. About half of the women (46%) visited ANC facility within their first trimester. Neither public nor private sector provided all 16 standardized services, but significantly more women in public sector received ANC procedures. Most women received ANC in county or higher-level hospitals (75%) and very few in township hospitals (8%). Significantly fewer women were weighed and tested for HIV/AIDS in township than in county or higher-level hospitals. Conclusion The quality of ANC in Hebei was poorer than required by China’s national and World Health Organization norms. Although the public sector performed better than the private sector, the utilization and quality of care of ANC services in this sector varied and women generally visited county or higher-level health facilities. PMID:23630142

33 CFR 158.310 - Reception facilities: General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... order to pass the inspection under § 158.160, must— (1) Be a reception facility as defined under § 158... residue; (5) Be capable of receiving NLS residue from an oceangoing ship within 24 hours after notice by that ship of the need for reception facilities; and (6) Be capable of completing the transfer of NLS...

42 CFR 71.47 - Special provisions relating to airports: Office and isolation facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Special provisions relating to airports: Office and isolation facilities. 71.47 Section 71.47 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... facilities. Each U.S. airport which receives international traffic shall provide without cost to the...

38 CFR 59.130 - General requirements for all State home facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... all State home facilities. 59.130 Section 59.130 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.130 General requirements for all State home facilities. As a condition for receiving a grant and grant funds...

38 CFR 59.130 - General requirements for all State home facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... all State home facilities. 59.130 Section 59.130 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.130 General requirements for all State home facilities. As a condition for receiving a grant and grant funds...

38 CFR 59.130 - General requirements for all State home facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... all State home facilities. 59.130 Section 59.130 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.130 General requirements for all State home facilities. As a condition for receiving a grant and grant funds...

38 CFR 59.130 - General requirements for all State home facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... all State home facilities. 59.130 Section 59.130 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.130 General requirements for all State home facilities. As a condition for receiving a grant and grant funds...

78 FR 36816 - Petition for Exemption; Summary of Petition Received

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-19

... your comments electronically. Mail: Send comments to the Docket Management Facility; U.S. Department of...: Fax comments to the Docket Management Facility at 202-493-2251. Hand Delivery: Bring comments to the Docket Management Facility in Room W12-140 of the West Building Ground Floor at 1200 New Jersey Avenue SE...

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

Code of Federal Regulations, 2014 CFR

2014-01-01

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

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

Code of Federal Regulations, 2011 CFR

2011-01-01

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

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

Code of Federal Regulations, 2012 CFR

2012-01-01

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

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

Code of Federal Regulations, 2013 CFR

2013-01-01

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

78 FR 35593 - Special Local Regulation; Christmas Boat Parade, San Juan Harbor; San Juan, PR

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2013-06-13

...: Docket Management Facility (M-30), U.S. Department of Transportation, West Building Ground Floor, Room... Coast Guard when it is received at the Docket Management Facility. We recommend that you include your... the line associated with this rulemaking. You may also visit the Docket Management Facility in Room...

76 FR 78330 - Petition for Exemption; Summary of Petition Received

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-16

....regulations.gov at any time or to the Docket Management Facility in Room W12-140 of the West Building Ground... instructions for sending your comments electronically. Mail: Send comments to the Docket Management Facility; U...-140, Washington, DC 20590. Fax: Fax comments to the Docket Management Facility at (202) 493-2251. Hand...

77 FR 50760 - Petition for Exemption; Summary of Petition Received

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-22

....regulations.gov at any time or to the Docket Management Facility in Room W12-140 of the West Building Ground... for sending your comments electronically. Mail: Send comments to the Docket Management Facility; U.S..., Washington, DC 20590. Fax: Fax comments to the Docket Management Facility at 202-493-2251. Hand Delivery...

77 FR 64581 - Petition for Exemption; Summary of Petition Received

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-22

... your comments electronically. Mail: Send comments to the Docket Management Facility; U.S. Department of...: Fax comments to the Docket Management Facility at 202-493-2251. Hand Delivery: Bring comments to the Docket Management Facility in Room W12-140 of the West Building Ground Floor at 1200 New Jersey Avenue SE...

77 FR 31063 - Petition for Exemption; Summary of Petition Received

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-24

... time or to the Docket Management Facility in Room W12-140 of the West Building Ground Floor at 1200 New... comments electronically. Mail: Send comments to the Docket Management Facility; U.S. Department of...: Fax comments to the Docket Management Facility at 202-493-2251. Hand Delivery: Bring comments to the...

77 FR 44309 - Petition for Exemption; Summary of Petition Received

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-27

... your comments electronically. Mail: Send comments to the Docket Management Facility; U.S. Department of...: Fax comments to the Docket Management Facility at 202-493-2251. Hand Delivery: Bring comments to the Docket Management Facility in Room W12-140 of the West Building Ground Floor at 1200 New Jersey Avenue SE...

76 FR 33807 - Petition for Exemption; Summary of Petition Received

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-09

... at any time or to the Docket Management Facility in Room W12-140 of the West Building Ground Floor at... your comments electronically. Mail: Send comments to the Docket Management Facility; U.S. Department of...: Fax comments to the Docket Management Facility at 202-493-2251. Hand Delivery: Bring comments to the...

Review of nuclear pharmacy practice in hospitals

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

Kawada, T.K.; Tubis, M.; Ebenkamp, T.

1982-02-01

An operational profile for nuclear pharmacy practice is presented, and the technical and professional role of nuclear pharmacists is reviewed. Key aspects of nuclear pharmacy practice in hospitals discussed are the basic facilities and equipment for the preparation, quality control, and distribution of radioactive drug products. Standards for receiving, storing, and processing radioactive material are described. The elements of a radiopharmaceutical quality assurance program, including the working procedures, documentation systems, data analysis, and specific control tests, are presented. Details of dose preparation and administration and systems of inventory control for radioactive products are outlined.

Thermal energy storage for organic Rankine cycle solar dynamic space power systems

NASA Astrophysics Data System (ADS)

Heidenreich, G. R.; Parekh, M. B.

An organic Rankine cycle-solar dynamic power system (ORC-SDPS) comprises a concentrator, a radiator, a power conversion unit, and a receiver with a thermal energy storage (TES) subsystem which charges and discharges energy to meet power demands during orbital insolation and eclipse periods. Attention is presently given to the criteria used in designing and evaluating an ORC-SDPS TES, as well as the automated test facility employed. It is found that a substantial data base exists for the design of an ORC-SDPS TES subsystem.

KSC-2009-6236

NASA Image and Video Library

2009-11-09

CAPE CANAVERAL, Fla. – At the Astrotech Space Operations facility in Titusville, Fla., the Solar Dynamics Observatory, or SDO, with its solar arrays deployed, is ready to receive signal commands to test the release mechanism sequence for the arrays. SDO is the first space weather research network mission in NASA's Living With a Star Program. The spacecraft's long-term measurements will give solar scientists in-depth information about changes in the sun's magnetic field and insight into how they affect Earth. Liftoff on an Atlas V rocket is scheduled for Feb. 3, 2010. Photo credit: NASA/Jack Pfaller

Johnson Space Center: Workmanship Training

NASA Technical Reports Server (NTRS)

Patterson, Ashley; Sikes, Larry; Corbin, Cheryl; Rucka, Becky

2015-01-01

Special processes require special skills, knowledge and experienced application. For over 15 years, the NASA Johnson Space Center's Receiving, Inspection and Test Facility (RITF) has provided Agency-wide NASA Workmanship Standards compliance training, issuing more than 500 to 800 training completion certificates annually. It is critical that technicians and inspectors are trained and that they maintain their proficiency to implement the applicable standards and specifications. Training services include "hands-on" training to engineers, technicians, and inspectors in the areas of electrostatic discharge (ESD), soldering, surface mount technology (SMT), crimping, conformal coating, and fiber-optic terminations.

Workmanship Training Industry

NASA Technical Reports Server (NTRS)

Patterson, Ashley; Sikes, Larry; Corbin, Cheryl; Rucka, Rebecca

2015-01-01

Special processes require special skills, knowledge and experienced application. For over 15 years, the NASA Johnson Space Center's Receiving, Inspection and Test Facility (RITF) has provided Workmanship Standards compliance training, issuing more than 500 to 800 training completion certificates annually. It is critical that technicians and inspectors are trained and that they maintain their proficiency to implement the applicable standards and specifications. Training services include 'hands-on' training to engineers, technicians, and inspectors in the areas of electrostatic discharge (ESD), soldering, fiber optics, lithium battery handling, torque and wire safety, and wire wrapping.

Use of Osteoporosis Medications in Older Nursing Facility Residents

PubMed Central

Wright, Rollin M.

2007-01-01

Introduction Epidemiologic studies demonstrated that 70 – 85% of nursing home residents have osteoporosis. Few studies report comprehensive information about treatment of osteoporosis in nursing facilities. Objective To determine the prevalence osteoporosis treatment and identify resident characteristics associated with the use of anti-resorptive medications or supplements indicated to treat osteoporosis in nursing homes. Methods The study design was cross-sectional. The Systematic Assessment of Geriatric Drug Use via Epidemiology database provided the data. From this database, 186,221 residents were identified as newly admitted to nursing facilities in Kansas, Maine, Missouri, Ohio, and South Dakota between 1998 and 2000. The outcome measure was the use of anti-resorptive medications (alendronate, risedronate, calcitonin, estrogen, raloxifene) or supplements (calcium with vitamin D) indicated for treatment of osteoporosis. The independent variables included demographic, health status and fracture risk factors. Results Of the overall sample, 9.1% received anti-resorptive medications and/or supplements indicated for osteoporosis treatment. The most commonly used treatment was the combination of calcium and vitamin D (5.0%). Calcitonin (2.5%) use exceeded that of any other anti-resorptive. Multivariable logistic regression analyses revealed that a diagnosis of osteoporosis and female gender were strongly associated with being more likely to receive an osteoporosis treatment (OR 6.34 with 95% CI 6.11–6.64 and OR 2.67 with 95% CI 2.53–2.83 respectively). The number of medications residents received was also strongly associated with receiving osteoporosis treatment. Being black and having four or more active diagnoses were strongly associated with lower odds of receiving treatment (OR 0.63 with 95% CI 0.57–0.68 and OR 0.71 with 95% CI 0.68–0.74 for 4 to 6 diagnoses). Discussion Newly admitted nursing facility residents infrequently received an indicated osteoporosis treatment, including calicum with vitamin D, despite the expected high prevalence of osteoporosis in this setting. Few demographic, health status and fracture risk factors were strongly associated with receiving indicated treatment. PMID:17845948

Standard Engineering Installation Package, Technical Control Facility, Technical Control Improvement Program (TCIP)

DTIC Science & Technology

1979-10-01

software. This document may not be cited for purpose of advertisement . AVAILABILITY This publication is available to non-Government agencies and may be...voltage interface requirements for repeaters. This supply occupies one slot in the 10306 mounting shelf. 1.4.2.8.5 Teletypewriter monitor. The AN/ UGC -61X...The AN/ UGC -61X keyboard send-receive (KSR) TTY set is an electromechanical apparatus that provides terminal facilities with two receive only, one KSR

Waste receiving and processing facility module 1 data management system software project management plan

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

Clark, R.E.

1994-11-02

This document provides the software development plan for the Waste Receiving and Processing (WRAP) Module 1 Data Management System (DMS). The DMS is one of the plant computer systems for the new WRAP 1 facility (Project W-026). The DMS will collect, store, and report data required to certify the low level waste (LLW) and transuranic (TRU) waste items processed at WRAP 1 as acceptable for shipment, storage, or disposal.

Waste Management Facilities Cost Information report for Greater-Than-Class C and DOE equivalent special case waste

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

Feizollahi, F.; Shropshire, D.

This Waste Management Facility Cost Information (WMFCI) report for Greater-Than-Class C low-level waste (GTCC LLW) and DOE equivalent special case waste contains preconceptual designs and planning level life-cycle cost (PLCC) estimates for treatment, storage, and disposal facilities needed for management of GTCC LLW and DOE equivalent waste. The report contains information on 16 facilities (referred to as cost modules). These facilities are treatment facility front-end and back-end support functions (administration support, and receiving, preparation, and shipping cost modules); seven treatment concepts (incineration, metal melting, shredding/compaction, solidification, vitrification, metal sizing and decontamination, and wet/air oxidation cost modules); two storage concepts (enclosedmore » vault and silo); disposal facility front-end functions (disposal receiving and inspection cost module); and four disposal concepts (shallow-land, engineered shallow-land, intermediate depth, and deep geological cost modules). Data in this report allow the user to develop PLCC estimates for various waste management options. A procedure to guide the U.S. Department of Energy (DOE) and its contractor personnel in the use of estimating data is also included in this report.« less

Activation of the E1 Ultra High Pressure Propulsion Test Facility at Stennis Space Center

NASA Technical Reports Server (NTRS)

Messer, Bradley; Messer, Elisabeth; Sewell, Dale; Sass, Jared; Lott, Jeff; Dutreix, Lionel, III

2001-01-01

After a decade of construction and a year of activation the El Ultra High Pressure Propulsion Test Facility at NASA's Stennis Space Center is fully operational. The El UHP Propulsion Test Facility is a multi-cell, multi-purpose component and engine test facility . The facility is capable of delivering cryogenic propellants at low, high, and ultra high pressures with flow rates ranging from a few pounds per second up to two thousand pounds per second. Facility activation is defined as a series of tasks required to transition between completion of construction and facility operational readiness. Activating the El UHP Propulsion Test Facility involved independent system checkouts, propellant system leak checks, fluid and gas sampling, gaseous system blow downs, pressurization and vent system checkouts, valve stability testing, valve tuning cryogenic cold flows, and functional readiness tests.

Lewis Research Center space station electric power system test facilities

NASA Technical Reports Server (NTRS)

Birchenough, Arthur G.; Martin, Donald F.

1988-01-01

NASA Lewis Research Center facilities were developed to support testing of the Space Station Electric Power System. The capabilities and plans for these facilities are described. The three facilities which are required in the Phase C/D testing, the Power Systems Facility, the Space Power Facility, and the EPS Simulation Lab, are described in detail. The responsibilities of NASA Lewis and outside groups in conducting tests are also discussed.

Nuclear thermal propulsion test facility requirements and development strategy

NASA Technical Reports Server (NTRS)

Allen, George C.; Warren, John; Clark, J. S.

1991-01-01

The Nuclear Thermal Propulsion (NTP) subpanel of the Space Nuclear Propulsion Test Facilities Panel evaluated facility requirements and strategies for nuclear thermal propulsion systems development. High pressure, solid core concepts were considered as the baseline for the evaluation, with low pressure concepts an alternative. The work of the NTP subpanel revealed that a wealth of facilities already exists to support NTP development, and that only a few new facilities must be constructed. Some modifications to existing facilities will be required. Present funding emphasis should be on long-lead-time items for the major new ground test facility complex and on facilities supporting nuclear fuel development, hot hydrogen flow test facilities, and low power critical facilities.

The Zadko Telescope: Exploring the Transient Universe

NASA Astrophysics Data System (ADS)

Coward, D. M.; Gendre, B.; Tanga, P.; Turpin, D.; Zadko, J.; Dodson, R.; Devogéle, M.; Howell, E. J.; Kennewell, J. A.; Boër, M.; Klotz, A.; Dornic, D.; Moore, J. A.; Heary, A.

2017-01-01

The Zadko telescope is a 1 m f/4 Cassegrain telescope, situated in the state of Western Australia about 80-km north of Perth. The facility plays a niche role in Australian astronomy, as it is the only meter class facility in Australia dedicated to automated follow-up imaging of alerts or triggers received from different external instruments/detectors spanning the entire electromagnetic spectrum. Furthermore, the location of the facility at a longitude not covered by other meter class facilities provides an important resource for time critical projects. This paper reviews the status of the Zadko facility and science projects since it began robotic operations in March 2010. We report on major upgrades to the infrastructure and equipment (2012-2014) that has resulted in significantly improved robotic operations. Second, we review the core science projects, which include automated rapid follow-up of gamma ray burst (GRB) optical afterglows, imaging of neutrino counterpart candidates from the ANTARES neutrino observatory, photometry of rare (Barbarian) asteroids, supernovae searches in nearby galaxies. Finally, we discuss participation in newly commencing international projects, including the optical follow-up of gravitational wave (GW) candidates from the United States and European GW observatory network and present first tests for very low latency follow-up of fast radio bursts. In the context of these projects, we outline plans for a future upgrade that will optimise the facility for alert triggered imaging from the radio, optical, high-energy, neutrino, and GW bands.

Sentinel Surveillance for Expedited Partner Therapy Prescriptions Using Pharmacy Data, in 2 New York City Neighborhoods, 2015.

PubMed

Okah, Ebiere; Arya, Vibhuti; Rogers, Meighan; Kim, Michelle; Schillinger, Julia Ann

2017-02-01

Expedited partner therapy (EPT) for Chlamydia trachomatis (Ct) is the practice of providing Ct-infected patients with medication, or prescription (prescription-EPT) to deliver to their sex partners without first examining those partners. New York City (NYC) providers commonly use prescription-EPT, yet NYC pharmacists report only occasional receipt of EPT prescriptions. This project assessed the frequency of EPT prescriptions filled in 2 NYC neighborhoods. The 2 NYC facilities reporting the most frequent use of prescription-EPT were identified from Ct provider case reports and contacted to ascertain their EPT practices. Providers at the first facility (facility 1) prescribed two 1-g doses of azithromycin, including sex partner treatment on the index patient's electronic prescription. Providers at the second facility (facility 2) gave patients paper prescriptions for sex partners. We reviewed prescriptions filled in 2015 for azithromycin, 1 or 2 g at pharmacies near these facilities; prescriptions indicating partner therapy were classified "EPT prescriptions". Facility 1 providers submitted 112 Ct case reports indicating prescription-EPT, compared with 114 submitted by facility 2 providers. Twelve of 26 identified pharmacies agreed to participate. At 7 pharmacies near facility 1, we found 61 EPT prescriptions from facility 1 and 37 from other facilities. At 5 pharmacies near facility 2, we found only 1 EPT prescription from facility 2 and 3 from other facilities. Expedited partner therapy prescriptions were received in NYC pharmacies near to EPT-prescribing facilities, but with great variability and at a lower frequency than suggested by provider case reports. Provider EPT prescribing practices may impact the likelihood that partners receive medication and should be further evaluated.

Association between access to accelerated partial breast irradiation and use of adjuvant radiotherapy.

PubMed

Wang, Elyn H; Park, Henry S; Rutter, Charles E; Gross, Cary P; Soulos, Pamela R; Yu, James B; Evans, Suzanne B

2017-02-01

The current study was performed to determine whether access to facilities performing accelerated partial breast irradiation (APBI) is associated with differences in the use of adjuvant radiotherapy (RT). Using the National Cancer Data Base, the authors performed a retrospective study of women aged ≥50 years who were diagnosed with early-stage breast cancer between 2004 and 2013 and treated with breast-conserving surgery (BCS). Facilities performing APBI in ≥10% of their eligible patients within a given year were defined as APBI facilities whereas those not performing APBI were defined as non-APBI facilities. All other facilities were excluded. The authors identified independent factors associated with RT use using multivariable logistic regression with clustering in the overall sample as well as in subsets of patients with standard-risk invasive cancer, low-risk invasive cancer, and ductal carcinoma in situ. Among 222,544 patients, 76.6% underwent BCS plus RT and 23.4% underwent BCS alone. The likelihood of RT receipt in the overall sample did not appear to differ significantly between APBI and non-APBI facilities (adjusted odds ratio [AOR], 1.02; P = .61). Subgroup multivariable analysis demonstrated that among patients with standard-risk invasive cancer, there was no association between evaluation at an APBI facility and receipt of RT (AOR, 0.98; P = .69). However, patients with low-risk invasive cancer were found to be significantly more likely to receive RT (54.4% vs 59.5%; AOR, 1.22 [P<.001]), whereas patients with ductal carcinoma in situ were less likely to receive RT (56.9% vs 55.3%; AOR, 0.89 [P = .04]) at APBI facilities. Patients who were eligible for observation were more likely to receive RT in APBI facilities but no difference was observed among patients with standard-risk invasive cancer who would most benefit from RT. Cancer 2017;123:502-511. © 2016 American Cancer Society. © 2016 American Cancer Society.

STD testing policies and practices in U.S. city and county jails.

PubMed

Parece, M S; Herrera, G A; Voigt, R F; Middlekauff, S L; Irwin, K L

1999-09-01

Studies have shown that sexually transmitted disease (STD) rates are high in the incarcerated population. However, little is known about STD testing policies or practices in jails. To assess STD testing policies and practices in jails. The Division of STD Prevention developed and distributed an e-mail survey to 94 counties reporting more than 40 primary and secondary cases in 1996 or having cities with more than 200,000 persons. State and local STD program managers completed the assessment in collaboration with health departments and the main jail facilities in the selected counties. Most facilities (52-77%) had a policy for STD screening based only on symptoms or by arrestee request, and in these facilities, 0.2% to 6% of arrestees were tested. Facilities having a policy of offering routine testing tested only 3% to 45% of arrestees. Large facilities, facilities using public providers, and facilities routinely testing for syphilis using Stat RPR tested significantly more arrestees (P<0.05). Approximately half of the arrestees were released within 48 hours after intake, whereas 45% of facilities did not have STD testing results until after 48 hours. Most facilities had a policy for STD screening based only on symptoms or by arrestee request. Facilities having a policy of routine STD testing are not testing most of the arrestees. There is a small window (<48 hours) for STD testing and treatment before release. Smaller jails and facilities using private providers may need additional resources to increase STD testing levels. Correctional facilities should be considered an important setting for STD public health intervention where routine rapid STD screening and treatment on-site could be implemented.

Viability of Existing INL Facilities for Dry Storage Cask Handling

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

Randy Bohachek; Charles Park; Bruce Wallace

2013-04-01

This report evaluates existing capabilities at the INL to determine if a practical and cost effective method could be developed for opening and handling full-sized dry storage casks. The Idaho Nuclear Technology and Engineering Center (INTEC) CPP-603, Irradiated Spent Fuel Storage Facility, provides the infrastructure to support handling and examining casks and their contents. Based on a reasonable set of assumptions, it is possible to receive, open, inspect, remove samples, close, and reseal large bolted-lid dry storage casks at the INL. The capability can also be used to open and inspect casks that were last examined at the TAN Hotmore » Shop over ten years ago. The Castor V/21 and REA-2023 casks can provide additional confirmatory information regarding the extended performance of low-burnup (<45 GWD/MTU) used nuclear fuel. Once a dry storage cask is opened inside CPP-603, used fuel retrieved from the cask can be packaged in a shipping cask, and sent to a laboratory for testing. Testing at the INL’s Materials and Fuels Complex (MFC) can occur starting with shipment of samples from CPP-603 over an on-site road, avoiding the need to use public highways. This reduces cost and reduces the risk to the public. The full suite of characterization methods needed to establish the condition of the fuel exists and MFC. Many other testing capabilities also exist at MFC, but when those capabilities are not adequate, samples can be prepared and shipped to other laboratories for testing. This report discusses how the casks would be handled, what work needs to be done to ready the facilities/capabilities, and what the work will cost.« less

Viability of Existing INL Facilities for Dry Storage Cask Handling

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

Bohachek, Randy; Wallace, Bruce; Winston, Phil

2013-04-30

This report evaluates existing capabilities at the INL to determine if a practical and cost effective method could be developed for opening and handling full-sized dry storage casks. The Idaho Nuclear Technology and Engineering Center (INTEC) CPP-603, Irradiated Spent Fuel Storage Facility, provides the infrastructure to support handling and examining casks and their contents. Based on a reasonable set of assumptions, it is possible to receive, open, inspect, remove samples, close, and reseal large bolted-lid dry storage casks at the INL. The capability can also be used to open and inspect casks that were last examined at the TAN Hotmore » Shop over ten years ago. The Castor V/21 and REA-2023 casks can provide additional confirmatory information regarding the extended performance of low-burnup (<45 GWD/MTU) used nuclear fuel. Once a dry storage cask is opened inside CPP-603, used fuel retrieved from the cask can be packaged in a shipping cask, and sent to a laboratory for testing. Testing at the INL’s Materials and Fuels Complex (MFC) can occur starting with shipment of samples from CPP-603 over an on-site road, avoiding the need to use public highways. This reduces cost and reduces the risk to the public. The full suite of characterization methods needed to establish the condition of the fuel exists and MFC. Many other testing capabilities also exist at MFC, but when those capabilities are not adequate, samples can be prepared and shipped to other laboratories for testing. This report discusses how the casks would be handled, what work needs to be done to ready the facilities/capabilities, and what the work will cost.« less

[Security Management in Clinical Laboratory Departments and Facilities: Current Status and Issues].

PubMed

Ishida, Haku; Nakamura, Junji; Yoshida, Hiroshi; Koike, Masaru; Inoue, Yuji

2014-11-01

We conducted a questionnaire survey regarding the current activities for protecting patients' privacy and the security of information systems (IS) related to the clinical laboratory departments of university hospitals, certified training facilities for clinical laboratories, and general hospitals in Yamaguchi Prefecture. The response rate was 47% from 215 medical institutions, including three commercial clinical laboratory centers. The results showed that there were some differences in management activities among facilities with respect to continuing education, the documentation or regulation of operational management for paper records, electronic information, remaining samples, genetic testing, and laboratory information for secondary use. They were suggested to be caused by differences in functions between university and general hospitals, differences in the scale of hospitals, or whether or not hospitals have received accreditation or ISO 15189. Regarding the IS, although the majority of facilities had sufficiently employed the access control to IS, there was some room for improvement in the management of special cases such as VIPs and patients with HIV infection. Furthermore, there were issues regarding the login method for computers shared by multiple staff, the showing of the names of personnel in charge of reports, and the risks associated with direct connections to systems and the Internet and the use of portable media such as USB memory sticks. These results indicated that further efforts are necessary for each facility to continue self-assessment and make improvements.

Effects of payment changes on trends in post-acute care.

PubMed

Buntin, Melinda Beeuwkes; Colla, Carrie Hoverman; Escarce, José J

2009-08-01

To test how the implementation of new Medicare post-acute payment systems affected the use of inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), and home health agencies. Medicare acute hospital, IRF, and SNF claims; provider of services file; enrollment file; and Area Resource File data. We used multinomial logit models to measure realized access to post-acute care and to predict how access to alternative sites of care changed in response to prospective payment systems. A file was constructed linking data for elderly Medicare patients discharged from acute care facilities between 1996 and 2003 with a diagnosis of hip fracture, stroke, or lower extremity joint replacement. Although the effects of the payment systems on the use of post-acute care varied, most reduced the use of the site of care they directly affected and boosted the use of alternative sites of care. Payment system changes do not appear to have differentially affected the severely ill. Payment system incentives play a significant role in determining where Medicare beneficiaries receive their post-acute care. Changing these incentives results in shifting of patients between post-acute sites.

78 FR 10168 - Agency Information Collection Activities: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... Facilities. After a Credit Guarantee Facility (CGF) has been authorized by Ex-Im Bank and legal documentation.../pub/pending/EIB 12-02 CGF Disbursement Request.pdf. DATES: Comments should be received on or before...

Evolution of the health sector response to HIV in Myanmar: progress, challenges and the way forward.

PubMed

Oo, Htun Nyunt; Hone, San; Fujita, Masami; Maw-Naing, Amaya; Boonto, Krittayawan; Jacobs, Marjolein; Phyu, Sabe; Bollen, Phavady; Cheung, Jacquie; Aung, Htin; Aung Sang, May Thu; Myat Soe, Aye; Pendse, Razia; Murphy, Eamonn

2016-11-28

Critical building blocks for the response to HIV were made until 2012 despite a series of political, social and financial challenges. A rapid increase of HIV service coverage was observed from 2012 to 2015 through collaborative efforts of government and non-governmental organisations (NGOs). Government facilities, in particular, demonstrated their capacity to expand services for antiretroviral therapy (ART), prevention of mother-to-child transmission (PMTCT) of HIV, tuberculosis and HIV co-infection and methadone-maintenance therapy (MMT). After nearly three decades into the response to HIV, Myanmar has adopted strategies to provide the right interventions to the right people in the right places to maximise impact and cost efficiency. In particular, the country is now using strategic information to classify areas into high-, medium- and low-HIV burden and risk of new infections for geographical prioritisation - as HIV remains concentrated among key population (KP) groups in specific geographical areas. Ways forward include: •Addressing structural barriers for KP to access services, and identifying and targeting KPs at higher risk;•Strengthening the network of public facilities, NGOs and general practitioners and introducing a case management approach to assist KPs and other clients with unknown HIV status, HIV-negative clients and newly diagnosed clients to access the health services across the continuum to increase the number of people testing for HIV and to reduce loss to follow-up in both prevention and treatment;•Increasing the availability of HIV testing and counselling services for KPs, clients of female sex workers (FSW), and other populations at risk, and raising the demand for timely testing including expansion of outreach and client-initiated voluntary counselling and testing (VCT) services;•Monitoring and maximising retention from HIV diagnosis to ART initiation and expanding quality HIV laboratory services, especially viral load;•Prioritising integration of HIV and related services in high-burden areas;•Increasing the proportion of PLHIV receiving testing and treatment at public facilities by improving human resources and increasing public facilities providing these services to ensure sustainability;•Obtaining intelligence and tailoring services in hard-to-reach/under-served areas;•Strengthening planning, monitoring, and coordination capacity especially at regional levels.

Microplastic pollution is widely detected in US municipal wastewater treatment plant effluent.

PubMed

Mason, Sherri A; Garneau, Danielle; Sutton, Rebecca; Chu, Yvonne; Ehmann, Karyn; Barnes, Jason; Fink, Parker; Papazissimos, Daniel; Rogers, Darrin L

2016-11-01

Municipal wastewater effluent has been proposed as one pathway for microplastics to enter the aquatic environment. Here we present a broad study of municipal wastewater treatment plant effluent as a pathway for microplastic pollution to enter receiving waters. A total of 90 samples were analyzed from 17 different facilities across the United States. Averaging all facilities and sampling dates, 0.05 ± 0.024 microparticles were found per liter of effluent. Though a small value on a per liter basis, even minor municipal wastewater treatment facilities process millions of liters of wastewater each day, yielding daily discharges that ranged from ∼50,000 up to nearly 15 million particles. Averaging across the 17 facilities tested, our results indicate that wastewater treatment facilities are releasing over 4 million microparticles per facility per day. Fibers and fragments were found to be the most common type of particle within the effluent; however, some fibers may be derived from non-plastic sources. Considerable inter- and intra-facility variation in discharge concentrations, as well as the relative proportions of particle types, was observed. Statistical analysis suggested facilities serving larger populations discharged more particles. Results did not suggest tertiary filtration treatments were an effective means of reducing discharge. Assuming that fragments and pellets found in the effluent arise from the 'microbeads' found in many cosmetics and personal care products, it is estimated that between 3 and 23 billion (with an average of 13 billion) of these microplastic particles are being released into US waterways every day via municipal wastewater. This estimate can be used to evaluate the contribution of microbeads to microplastic pollution relative to other sources (e.g., plastic litter and debris) and pathways (e.g., stormwater) of discharge. Published by Elsevier Ltd.

SERIIUS-MAGEEP Visiting Scholars Program

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

Ortega, Jesus D.

2014-08-28

Recent studies have assessed closed-loop supercritical carbon dioxide (s-CO 2) Brayton cycles to be a higher energy-density system in comparison to equivalent superheated steam Rankine systems. At turbine inlet conditions of 700°C and 20 MPa, a cycle thermal efficiency of ~50% can be achieved. Achieving these high efficiencies will help concentrating solar power (CSP) technologies to become a competitive alternative to current power generation methods. To incorporate an s-CO 2 Brayton power cycle in a solar power tower system, the development of a solar receiver capable of providing an outlet temperature of 700°C (at 20 MPa) is necessary. To satisfymore » the temperature requirements of an s-CO 2 Brayton cycle with recuperation and recompression, the s-CO 2 must undergo a temperature rise of ~200°C as it flows through the solar receiver. The main objective is to develop an optical-thermal-fluid and structural model to validate a tubular receiver that will receive a heat input ~0.33 MWth from the heliostat field at the National Solar Thermal Test Facility (NSTTF), Albuquerque, NM, USA. We also commenced the development of computational models and testing of air receivers being developed by the Indian Institute of Science (IISc) and the Indian Institute of Technology in Bombay (IIT-B). The helical tubular receiver is expected to counteract the effect of thermal expansion while using a cavity to reduce the radiative and convective losses. Initially, this receiver will be tested for a temperature range of 100-300°C under 1 MPa of pressurized air. The helical air receiver will be exposed to 10kWth to achieve a temperature rise of ~200°C. Preliminary tests to validate the modeling will be performed before the design and construction of a larger scale receiver. Lastly, I focused on the development of a new computational tool that would allow us to perform a nodal creep-fatigue analysis on the receivers and heat exchangers being developed. This tool was developed using MATLAB and is capable of processing the results obtained from ANSYS Fluent and Structural combined, which was limited when using commercial software. The main advantage of this code is that it can be modified to run in parallel making it more affordable and faster compared to commercial codes available. The code is in the process of validation and is currently being compared to nCode Design Life.« less

Wake Shield Facility Modal Survey Test in Vibration Acoustic Test Facility

NASA Image and Video Library

1991-10-09

Astronaut Ronald M. Sega stands beside the University of Houston's Wake Shield Facility before it undergoes a Modal Survey Test in the Vibration and Acoustic Test Facility Building 49, prior to being flown on space shuttle mission STS-60.

Triggers of self-conscious emotions in the sexually transmitted infection testing process

PubMed Central

2010-01-01

Background Self-conscious emotions (shame, guilt and embarrassment) are part of many individuals' experiences of seeking STI testing. These emotions can have negative impacts on individuals' interpretations of the STI testing process, their willingness to seek treatment and their willingness to inform sexual partners in light of positive STI diagnoses. Because of these impacts, researchers have called for more work to be completed on the connections between shame, guilt, embarrassment and STI testing. We examine the specific events in the STI testing process that trigger self-conscious emotions in young adults who seek STI testing; and to understand what it is about these events that triggers these emotions. Semi-structured interviews with 30 adults (21 women, 9 men) in the Republic of Ireland. Findings Seven specific triggers of self-conscious emotions were identified. These were: having unprotected sex, associated with the initial reason for seeking STI testing; talking to partners and peers about the intention to seek STI testing; the experience of accessing STI testing facilities and sitting in clinic waiting rooms; negative interactions with healthcare professionals; receiving a positive diagnosis of an STI; having to notify sexual partners in light of a positive STI diagnosis; and accessing healthcare settings for treatment for an STI. Self-conscious emotions were triggered in each case by a perceived threat to respondents' social identities. Conclusion There are multiple triggers of self-conscious emotions in the STI testing process, ranging from the initial decision to seek testing, right through to the experience of accessing treatment. The role of self-conscious emotions needs to be considered in each component of service design from health promotion approaches, through facility layout to the training of all professionals involved in the STI testing process. PMID:20716339

Noninterference Systems Developed for Measuring and Monitoring Rotor Blade Vibrations

NASA Technical Reports Server (NTRS)

Kurkov, Anatole P.

2003-01-01

In the noninterference measurement of blade vibrations, a laser light beam is transmitted to the rotor blade tips through a single optical fiber, and the reflected light from the blade tips is collected by a receiving fiber-optic bundle and conducted to a photodetector. Transmitting and receiving fibers are integrated in an optical probe that is enclosed in a metal tube which also houses a miniature lens that focuses light on the blade tips. Vibratory blade amplitudes can be deduced from the measurement of the instantaneous time of arrival of the blades and the knowledge of the rotor speed. The in-house noninterference blade-vibration measurement system was developed in response to requirements to monitor blade vibrations in several tests where conventional strain gauges could not be installed or where there was a need to back up strain gauges should critical gauges fail during the test. These types of measurements are also performed in the aircraft engine industry using proprietary in-house technology. Two methods of measurement were developed for vibrations that are synchronous with a rotor shaft. One method requires only one sensor; however, it is necessary to continuously record the data while the rotor is being swept through the resonance. In the other method, typically four sensors are employed and the vibratory amplitude is deduced from the data by performing a least square fit to a harmonic function. This method does not require continuous recording of data through the resonance and, therefore, is better suited for monitoring. The single-probe method was tested in the Carl facility at the Wright- Patterson Air Force Base, and the multiple-probe method was tested in NASA Glenn Research Center's Spin Rig facility, which uses permanent magnets to excite synchronous vibrations. Representative results from this test are illustrated in the bar chart. Nonsynchronous vibrations were measured online during testing of the Quiet High Speed Fan in Glenn s 9- by 15-Foot Low-Speed Wind Tunnel. Three sensors were employed, enabling a reconstruction of the vibratory patterns at the leading and trailing edges at the tip span, as well as a determination of vibratory amplitudes for every blade.

Use of malaria RDTs in various health contexts across sub-Saharan Africa: a systematic review.

PubMed

Boyce, Matthew R; O'Meara, Wendy P

2017-05-18

The World Health Organization recommends parasitological confirmation of malaria prior to treatment. Malaria rapid diagnostic tests (RDTs) represent one diagnostic method that is used in a variety of contexts to overcome limitations of other diagnostic techniques. Malaria RDTs increase the availability and feasibility of accurate diagnosis and may result in improved quality of care. Though RDTs are used in a variety of contexts, no studies have compared how well or effectively RDTs are used across these contexts. This review assesses the diagnostic use of RDTs in four different contexts: health facilities, the community, drug shops and schools. A comprehensive search of the Pubmed database was conducted to evaluate RDT execution, test accuracy, or adherence to test results in sub-Saharan Africa. Original RDT and Plasmodium falciparum focused studies conducted in formal health care facilities, drug shops, schools, or by CHWs between the year 2000 and December 2016 were included. Studies were excluded if they were conducted exclusively in a research laboratory setting, where staff from the study team conducted RDTs, or in settings outside of sub-Saharan Africa. The literature search identified 757 reports. A total of 52 studies were included in the analysis. Overall, RDTs were performed safely and effectively by community health workers provided they receive proper training. Analogous information was largely absent for formal health care workers. Tests were generally accurate across contexts, except for in drug shops where lower specificities were observed. Adherence to RDT results was higher among drug shop vendors and community health workers, while adherence was more variable among formal health care workers, most notably with negative test results. Malaria RDTs are generally used well, though compliance with test results is variable - especially in the formal health care sector. If low adherence rates are extrapolated, thousands of patients may be incorrectly diagnosed and receive inappropriate treatment resulting in a low quality of care and unnecessary drug use. Multidisciplinary research should continue to explore determinants of good RDT use, and seek to better understand how to support and sustain the correct use of this diagnostic tool.

Survey of aircraft icing simulation test facilities in North America

NASA Technical Reports Server (NTRS)

Olsen, W.

1981-01-01

A survey was made of the aircraft icing simulation facilities in North America: there are 12 wind tunnels, 28 engine test facilities, 6 aircraft tankers and 14 low velocity facilities, that perform aircraft icing tests full or part time. The location and size of the facility, its speed and temperature range, icing cloud parameters, and the technical person to contact are surveyed. Results are presented in tabular form. The capabilities of each facility were estimated by its technical contact person. The adequacy of these facilities for various types of icing tests is discussed.

Current status of collaborative relationships between dialysis facilities and dental facilities in Japan: results of a nationwide survey.

PubMed

Yoshioka, Masami; Shirayama, Yasuhiko; Imoto, Issei; Hinode, Daisuke; Yanagisawa, Shizuko; Takeuchi, Yuko

2015-02-12

Recent studies have reported an association between periodontal disease and mortality among dialysis patients. Therefore, preventive dental care should be considered very important for this population. In Japan, no systematic education has been undertaken regarding the importance of preventive dental care for hemodialysis patients--even though these individuals tend to have oral and dental problems. The aim of this study was to investigate the current state of collaborative relationships between hemodialysis facilities and dental services in Japan and also to identify strategies to encourage preventive dental visits among hemodialysis outpatients. A nationwide questionnaire on the collaborative relationship between dialysis facilities and dental facilities was sent by mail to all medical facilities in Japan offering outpatient hemodialysis treatment. Responses were obtained from 1414 of 4014 facilities (35.2%). Among the 1414 facilities, 272 (19.2%) had a dental service department. Approximately 100,000 dialysis outpatients were receiving treatment at these participating facilities, which amounts to one-third of all dialysis patients in Japan. Of those patients, 82.9% received hemodialysis at medical facilities without dental departments. Only 87 of 454 small clinics without in-house dental departments (19.2%) had collaborative registered dental clinics. Medical facilities with registered dental clinics demonstrated a significantly more proactive attitude to routine collaboration on dental matters than facilities lacking such clinics. Our nationwide survey revealed that most dialysis facilities in Japan have neither an in-house dental department nor a collaborative relationship with a registered dental clinic. Registration of dental clinics appears to promote collaboration with dental facilities on a routine basis, which would be beneficial for oral health management in hemodialysis patients.

VIEW LOOKING SOUTH AT THE SATURN V (BLDG. 4550) AND ...

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

VIEW LOOKING SOUTH AT THE SATURN V (BLDG. 4550) AND SATURN I (BLDG. 4557) STRUCTURAL TEST FACILITIES, SATURN V TEST FACILITY IS IN THE FOREGROUND RIGHT. THE SATURN I TEST FACILITY IS IN THE BACKGROUND CENTER. - Marshall Space Flight Center, Saturn V Dynamic Test Facility, East Test Area, Huntsville, Madison County, AL

PIE preparation of the MEGAPIE target

NASA Astrophysics Data System (ADS)

Wohlmuther, Michael; Wagner, Werner

2012-12-01

The MEGAPIE target, after successfully operating for 4 months at a beam power of 0.77 MW, is now being prepared for post irradiation examination PIE. The lead-bismuth eutectic (LBE) target was irradiated from August until December 2006, and in this period received a beam charge of 2.8 A h of 575 MeV protons. After that, the target was stored in the target storage facility of PSI, waiting for its post irradiation examination. In the meantime several campaigns of tests have been conducted by PSI and ZWILAG, the interim storage facility of Swiss nuclear power plants. In these tests the feasibility of the conditioning of the target and the extraction of sample material for the PIE has been proven. After transport to the hot cell facility at ZWILAG in June 2009, the dismantling of the MEGAPIE target started. It finally was cut into 21 pieces. Ten of these pieces will be shipped to the Hot Laboratory of PSI ('PSI hotlab') to extract samples from the structural materials as well as from the LBE. Currently it is foreseen that the sample extraction will start in the first half of 2011. The remaining parts of the MEGAPIE target were conditioned as radioactive waste. The present paper will mainly focus on the dismantling and first visual inspection of the MEGAPIE target. In addition an outlook on the PIE phase of MEGAPIE is given.

An Operator Perspective from a Facility Evaluation of an RFID-Based UF6 Cylinder Accounting and Tracking System

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

Martyn, Rose; Fitzgerald, Peter; Stehle, Nicholas D

An operational field test of a Radio-Frequency Identification (RFID) system for tracking and accounting UF6 cylinders was conducted at the Global Nuclear Fuel Americas (GNF) fuel fabrication plant in 2009. The Cylinder Accountability and Tracking System (CATS) was designed and deployed by Oak Ridge National Laboratory (ORNL) and evaluated in cooperation with GNF. The system required that passive RFID be attached to several UF6 30B cylinders as they were received at the site; then the cylinders were tracked as they proceeded to interim storage, to processing in an autoclave, and eventually to disposition from the site. This CATS deployment alsomore » provided a direct integration of scale data from the site accountability scales. The integration of this information into the tracking data provided an attribute for additional safeguards for evaluation. The field test provided insight into the advantages and challenges of using RFID at an operating nuclear facility. The RFID system allowed operators to interact with the technology and demonstrated the survivability of the tags and reader equipment in the process environment. This paper will provide the operator perspective on utilizing RFID technology for locating cylinders within the facility, thereby tracking the cylinders for process and for Material Control & Accounting functions. The paper also will present the operator viewpoint on RFID implemented as an independent safeguards system.« less

Advanced Test Reactor National Scientific User Facility (ATR NSUF) Monthly Report October 2014

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

Ogden, Dan

Advanced Test Reactor National Scientific User Facility (ATR NSUF) Monthly Report October 2014 Highlights • Rory Kennedy, Dan Ogden and Brenden Heidrich traveled to Germantown October 6-7, for a review of the Infrastructure Management mission with Shane Johnson, Mike Worley, Bradley Williams and Alison Hahn from NE-4 and Mary McCune from NE-3. Heidrich briefed the group on the project progress from July to October 2014 as well as the planned path forward for FY15. • Jim Cole gave two invited university seminars at Ohio State University and University of Florida, providing an overview of NSUF including available capabilities and themore » process for accessing facilities through the peer reviewed proposal process. • Jim Cole and Rory Kennedy co-chaired the NuMat meeting with Todd Allen. The meeting, sponsored by Elsevier publishing, was held in Clearwater, Florida, and is considered one of the premier nuclear fuels and materials conferences. Over 340 delegates attended with 160 oral and over 200 posters presented over 4 days. • Thirty-one pre-applications were submitted for NSUF access through the NE-4 Combined Innovative Nuclear Research Funding Opportunity Announcement. • Fourteen proposals were received for the NSUF Rapid Turnaround Experiment Summer 2014 call. Proposal evaluations are underway. • John Jackson and Rory Kennedy attended the Nuclear Fuels Industry Research meeting. Jackson presented an overview of ongoing NSUF industry research.« less

Preventing Mother-to-Child Transmission of HIV in Resource-Limited Settings: The Elizabeth Glaser Pediatric AIDS Foundation Experience

PubMed Central

Sripipatana, Tabitha; Turner, Abigail Norris; Hoblitzelle, Chuck; Robinson, Joanna; Wilfert, Catherine

2009-01-01

Objectives. In September 1999, the Elizabeth Glaser Pediatric AIDS Foundation initiated a multicountry, service-based programmatic effort in the developing world to reduce perinatally acquired HIV infection. We review 6½ years of one of the world's largest programs for the prevention of mother-to-child transmission (PMTCT) of HIV. Methods. Each PMTCT facility records patient data in antenatal clinics and labor and delivery settings about counseling, testing, HIV status, and antiretroviral prophylaxis and submits the data to foundation staff. Results. More than 2.6 million women have accessed foundation-affiliated services through June 2006. Overall, 92.9% of women who received antenatal care or were eligible for PMTCT services in labor and delivery have been counseled, and 82.8% of those counseled accepted testing. Among women identified as HIV positive, 75.0% received antiretroviral prophylaxis (most a single dose of nevirapine), as did 45.6% of their infants. Conclusions. The foundation's experience has demonstrated that opt-out testing, supplying mothers with medication at time of diagnosis, and providing the infant dose early have measurably improved program efficiency. PMTCT should be viewed as an achievable paradigm and an essential part of the continuum of care. PMID:18703458

40 CFR 792.31 - Testing facility management.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Testing facility management. 792.31... facility management. For each study, testing facility management shall: (a) Designate a study director as... appropriately tested for identity, strength, purity, stability, and uniformity, as applicable. (e) Assure that...

77 FR 55436 - Special Local Regulation; Partnership in Education, Dragon Boat Race; Maumee River, Toledo, OH

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-10

... Delivery: Docket Management Facility (M-30), U.S. Department of Transportation, West Building Ground Floor... by the Coast Guard when the comment is received at the Docket Management Facility. We recommend that... also visit the Docket Management Facility in Room W12-140 on the ground floor of the Department of...

Antenna Test Facility (ATF): User Test Planning Guide

NASA Technical Reports Server (NTRS)

Lin, Greg

2011-01-01

Test process, milestones and inputs are unknowns to first-time users of the ATF. The User Test Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their test engineering personnel in test planning and execution. Material covered includes a roadmap of the test process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, test article interfaces, and inputs necessary to define test scope, cost, and schedule are included as an appendix to the guide.

Radiant Heat Test Facility (RHTF): User Test Planning Guide

NASA Technical Reports Server (NTRS)

DelPapa, Steven

2011-01-01

Test process, milestones and inputs are unknowns to first-time users of the RHTF. The User Test Planning Guide aids in establishing expectations for both NASA and non- NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their test engineering personnel in test planning and execution. Material covered includes a roadmap of the test process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, test article interfaces, and inputs necessary to define test scope, cost, and schedule are included as an appendix to the guide.

The ALMA Band 3 (84-116 GHz) receiver production plan

NASA Astrophysics Data System (ADS)

Yeung, Keith; Claude, Stéphane; Loop, David

2008-07-01

The NRC Herzberg Institute of Astrophysics (NRC-HIA) is currently responsible to contribute Band 3 (84-116 GHz) receivers to the international ALMA project - a partnership involving North America, Europe and, now, Asia. Not only are the technical requirements for these receivers far more stringent than those for any existing radio astronomy receivers operating at these frequencies, but the delivery schedule for these receivers is equally challenging. Since the Asian partnership joined the ALMA project in 2006, NRC-HIA has been asked to deliver an additional 11 cartridges, for a total of 73 units. Some of these new cartridges will be used for the ALMA Compact Array (ACA) and others as spares. Moreover, the project has also requested that these additional cartridges be delivered in the same time period as the original 62 units. To meet this requirement, production must increase from the existing rate of one unit every four weeks to one every two, taxing the existing production infrastructure at NRC-HIA. Additional test facilities and human resources must be planned to sustain the required production rate over the next several years. Industrial involvement is one of the important elements in our production plan. In order to supplement the existing human resources at NRC-HIA, we are planning to outsource a number of low-risk and labor-intensive tasks to industry. However, NRC-HIA will retain overall project management responsibility and will conduct all the cartridge integration and acceptance test activities in-house. This paper focuses on the resource estimation, planning and project management required to deliver the Band 3 receivers to the ALMA project on time and on budget.

Monitoring compliance with the International Code of Marketing of Breastmilk Substitutes in west Africa: multisite cross sectional survey in Togo and Burkina Faso.

PubMed

Aguayo, Victor M; Ross, Jay S; Kanon, Souleyman; Ouedraogo, Andre N

2003-01-18

To monitor compliance with the International Code of Marketing of Breastmilk Substitutes in health systems, sales outlets, distribution points, and the news media in Togo and Burkina Faso, west Africa. Multisite cross sectional survey. Staff at 43 health facilities and 66 sales outlets and distribution points, 186 health providers, and 105 mothers of infants aged < or =5 months in 16 cities. Six (14%) health facilities had received donations of breast milk substitutes. All donations were being given to mothers free of charge. Health providers in five (12%) health facilities had received free samples of breast milk substitutes for purposes other than professional research or evaluation. Health professionals in five (12%) health facilities had received promotional gifts from manufacturers. Promotional materials of commercial breast milk substitutes were found in seven (16%) health facilities. Special displays to market commercial breast milk substitutes were found in 29 (44%) sales and distribution points. Forty commercial breast milk substitutes violated the labelling standards of the code: 21 were manufactured by Danone, 11 by Nestlé, and eight by other national and international manufacturers. Most (148, 90%) health providers had never heard of the code, and 66 mothers (63%) had never received any counselling on breast feeding by their health providers. In west Africa manufacturers are violating the code of marketing of breast milk substitutes. Comparable levels of code violations are observed with (Burkina Faso) or without (Togo) regulating legislation. Legislation must be accompanied by effective information, training, and monitoring systems to ensure that healthcare providers and manufacturers comply with evidence based practice and the code.

Materials Test Laboratory activities at the NASA-Johnson Space Center White Sands Test Facility (WSTF)

NASA Technical Reports Server (NTRS)

Stradling, J.; Pippen, D. L.

1985-01-01

The NASA Johnson Space Center White Sands Test Facility (WSTF) performs aerospace materials testing and evaluation. Established in 1963, the facility grew from a NASA site dedicated to the development of space engines for the Apollo project to a major test facility. In addition to propulsion tests, it tests materials and components, aerospace fluids, and metals and alloys in simulated space environments.

11 Foot Unitary Plan Tunnel Facility Optical Improvement Large Window Analysis

NASA Technical Reports Server (NTRS)

Hawke, Veronica M.

2015-01-01

The test section of the 11 by 11-foot Unitary Plan Transonic Wind Tunnel (11-foot UPWT) may receive an upgrade of larger optical windows on both the North and South sides. These new larger windows will provide better access for optical imaging of test article flow phenomena including surface and off body flow characteristics. The installation of these new larger windows will likely produce a change to the aerodynamic characteristics of the flow in the Test Section. In an effort understand the effect of this change, a computational model was employed to predict the flows through the slotted walls, in the test section and around the model before and after the tunnel modification. This report documents the solid CAD model that was created and the inviscid computational analysis that was completed as a preliminary estimate of the effect of the changes.

40 CFR 160.31 - Testing facility management.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Testing facility management. 160.31... GOOD LABORATORY PRACTICE STANDARDS Organization and Personnel § 160.31 Testing facility management. For each study, testing facility management shall: (a) Designate a study director as described in § 160.33...

[Effectiveness of incorporating a quality management system].

PubMed

Seki, Akira; Hankins, Raleigh W; Miya, Tetsumasa

2010-01-01

In 2003, the ISO 15189 international standardization program on the quality and competence of the clinical reference laboratory was introduced. To date, 46 facilities have committed themselves to providing a higher level of medical service by incorporating a quality management system (QMS) and acquiring accreditation. QMS is defined as "setting up a policy and goals pertaining to quality, and adopting an appropriate system," and is a scheme that includes all managerial and technical factors that can affect test results. Regarding the Health Sciences Research Institute Group, 4 facilities have previously received the accreditation described above, but in the process of implementing the QMS, a number of problems have been identified. Here, we report on the effectiveness of adopting such a QMS based on the results of employee questionnaires, internal audits, customer complaint analyses, and external audits by the Japan Accreditation Board for Conformity Assessment (JAB), the official inspection body for accreditation.

Substance Use Treatment Provider Behavior and Healthcare Reform: Evidence from Massachusetts.

PubMed

Maclean, Johanna Catherine; Saloner, Brendan

2018-01-01

We examine the impact of the 2006 Massachusetts healthcare reform on substance use disorder (SUD) treatment facilities' provision of care. We test the impact of the reform on treatment quantity and access. We couple data on the near universe of specialty SUD treatment providers in the USA with a synthetic control method approach. We find little evidence that the reform lead to changes in treatment quantity or access. Reform effects were similar among for-profit and non-profit facilities. In an extension, we show that the reform altered the setting in which treatment is received, the number of offered services, and the number of programs for special populations. These findings may be useful in predicting the implications of major health insurance expansions on the provision of SUD treatment. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Facility-level association of preoperative stress testing and postoperative adverse cardiac events.

PubMed

Valle, Javier A; Graham, Laura; Thiruvoipati, Thejasvi; Grunwald, Gary; Armstrong, Ehrin J; Maddox, Thomas M; Hawn, Mary T; Bradley, Steven M

2018-06-22

Despite limited indications, preoperative stress testing is often used prior to non-cardiac surgery. Patient-level analyses of stress testing and outcomes are limited by case mix and selection bias. Therefore, we sought to describe facility-level rates of preoperative stress testing for non-cardiac surgery, and to determine the association between facility-level preoperative stress testing and postoperative major adverse cardiac events (MACE). We identified patients undergoing non-cardiac surgery within 2 years of percutaneous coronary intervention in the Veterans Affairs (VA) Health Care System, from 2004 to 2011, facility-level rates of preoperative stress testing and postoperative MACE (death, myocardial infarction (MI) or revascularisation within 30 days). We determined risk-standardised facility-level rates of stress testing and postoperative MACE, and the relationship between facility-level preoperative stress testing and postoperative MACE. Among 29 937 patients undergoing non-cardiac surgery at 131 VA facilities, the median facility rate of preoperative stress testing was 13.2% (IQR 9.7%-15.9%; range 6.0%-21.5%), and 30-day postoperative MACE was 4.0% (IQR 2.4%-5.4%). After risk standardisation, the median facility-level rate of stress testing was 12.7% (IQR 8.4%-17.4%) and postoperative MACE was 3.8% (IQR 2.3%-5.6%). There was no correlation between risk-standardised stress testing and composite MACE at the facility level (r=0.022, p=0.81), or with individual outcomes of death, MI or revascularisation. In a national cohort of veterans undergoing non-cardiac surgery, we observed substantial variation in facility-level rates of preoperative stress testing. Facilities with higher rates of preoperative stress testing were not associated with better postoperative outcomes. These findings suggest an opportunity to reduce variation in preoperative stress testing without sacrificing patient outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

PubMed Central

2013-01-01

Objectives This study involved a survey of the facility investment experiences, which was designed to recognize the importance of health and safety problems, and industrial accident prevention. Ultimately, we hope that small scale industries will create effective industrial accident prevention programs and facility investments. Methods An individual survey of businesses’ present physical conditions, recognition of the importance of the health and safety problems, and facility investment experiences for preventing industrial accidents was conducted. The survey involved 1,145 business operators or management workers in small business places with fewer than 50 workers in six industrial complexes. Results Regarding the importance of occupational health and safety problems (OHS), 54.1% said it was “very important”. Received technical and financial support, and industrial accidents that occurred during the past three years were recognized as highly important for OHS. In an investigation regarding facility investment experiences for industrial accident prevention, the largest factors were business size, greater numbers of industrial accidents, greater technical and financial support received, and greater recognition of the importance of the OHS. The related variables that decided facility investment for industry accident prevention in a logistic regression analysis were the experiences of business facilities where industrial accidents occurred during the past three years, received technical and financial support, and recognition of the OHS. Those considered very important were shown to be highly significant. Conclusions Recognition of health and safety issues was higher when small businesses had experienced industrial accidents or received financial support. The investment in industrial accidents was greater when health and safety issues were recognized as important. Therefore, the goal of small business health and safety projects is to prioritize health and safety issues in terms of business management and recognition of importance. Therefore, currently various support projects are being conducted. However, there are issues regarding the limitations of the target businesses and inadequacies in maintenance and follow-up. Overall, it is necessary to provide various incentives for onsite participation that can lead to increased recognition of health and safety issues and practical investments, while perfecting maintenance and follow up measures by thoroughly revising existing operating systems. PMID:24472180

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

PubMed

Park, Jisu; Jeong, Harin; Hong, Sujin; Park, Jong-Tae; Kim, Dae-Sung; Kim, Jongseo; Kim, Hae-Joon

2013-10-23

This study involved a survey of the facility investment experiences, which was designed to recognize the importance of health and safety problems, and industrial accident prevention. Ultimately, we hope that small scale industries will create effective industrial accident prevention programs and facility investments. An individual survey of businesses' present physical conditions, recognition of the importance of the health and safety problems, and facility investment experiences for preventing industrial accidents was conducted. The survey involved 1,145 business operators or management workers in small business places with fewer than 50 workers in six industrial complexes. Regarding the importance of occupational health and safety problems (OHS), 54.1% said it was "very important". Received technical and financial support, and industrial accidents that occurred during the past three years were recognized as highly important for OHS. In an investigation regarding facility investment experiences for industrial accident prevention, the largest factors were business size, greater numbers of industrial accidents, greater technical and financial support received, and greater recognition of the importance of the OHS. The related variables that decided facility investment for industry accident prevention in a logistic regression analysis were the experiences of business facilities where industrial accidents occurred during the past three years, received technical and financial support, and recognition of the OHS. Those considered very important were shown to be highly significant. Recognition of health and safety issues was higher when small businesses had experienced industrial accidents or received financial support. The investment in industrial accidents was greater when health and safety issues were recognized as important. Therefore, the goal of small business health and safety projects is to prioritize health and safety issues in terms of business management and recognition of importance. Therefore, currently various support projects are being conducted. However, there are issues regarding the limitations of the target businesses and inadequacies in maintenance and follow-up. Overall, it is necessary to provide various incentives for onsite participation that can lead to increased recognition of health and safety issues and practical investments, while perfecting maintenance and follow up measures by thoroughly revising existing operating systems.

Assessment of the responsiveness of a public health service from the perspective of older adults

PubMed Central

Melo, Denise da Silva; Martins, René Duarte; de Jesus, Renata Patrícia Freitas Soares; Samico, Isabella Chagas; Santo, Antônio Carlos Gomes do Espírito

2017-01-01

ABSTRACT OBJECTIVE To assess the quality of health care of older adults using as a parameter the assessment of the responsiveness of the service. METHODS This is a descriptive cross-sectional study conducted in a reference unit of the Brazilian Unified Health System at the outpatient level. The sample was probabilistic and had 385 older adults; data collection occurred in 2014. The domains assessed were: choice, autonomy, confidentiality, dignity, communication, physical facilities, and fast service. To this end, we used Pearson correlation test and Fisher’s exact test. RESULTS The domains of dignity, confidentiality, and communication reached the highest level of adequate responsiveness. On the other hand, freedom of choice and fast service received the worst assessments. Participation in decision-making regarding treatment was significantly lower among the older adults who had no education. In addition, the older adults that self-reported as black receive a lower quality of care regarding clear explanation and respected privacy in the appointment, when compared to users of any other race. CONCLUSIONS Although most domains studied have receive a positive assessment, we have found a need for an equal care by the health professionals, regardless of race, education level, or any other adjective characteristic of older adults, users of public health services. PMID:28678911

Calibration of ultra-low infrared power at NIST

NASA Astrophysics Data System (ADS)

Woods, Solomon I.; Carr, Stephen M.; Carter, Adriaan C.; Jung, Timothy M.; Datla, Raju U.

2010-07-01

The Low Background Infrared (LBIR) facility has developed and tested the components of a new detector for calibration of infrared greater than 1 pW, with 0.1 % uncertainty. Calibration of such low powers could be valuable for the quantitative study of weak astronomical sources in the infrared. The pW-ACR is an absolute cryogenic radiometer (ACR) employing a high resolution transition edge sensor (TES) thermometer, ultra-weak thermal link and miniaturized receiver to achieve a noise level of around 1 fW at a temperature of 2 K. The novel thermometer employs the superconducting transition of a tin (Sn) core and has demonstrated a temperature noise floor less than 3 nK/Hz1/2. Using an applied magnetic field from an integrated solenoid to suppress the Sn transition temperature, the operating temperature of the thermometer can be tuned to any temperature below 3.6 K. The conical receiver is coated on the inside with infrared-absorbing paint and has a demonstrated absorptivity of 99.94 % at 10.6 μm. The thermal link is made from a thin-walled polyimide tube and has exhibited very low thermal conductance near 2x10-7 W/K. In tests with a heater mounted on the receiver, the receiver/thermal-link assembly demonstrated a thermal time constant of about 15 s. Based on these experimental results, it is estimated that an ACR containing these components can achieve noise levels below 1 fW, and the design of a radiometer merging the new thermometer, receiver and thermal link will be discussed.

TOPEX/POSEIDON operational orbit determination results using global positioning satellites

NASA Technical Reports Server (NTRS)

Guinn, J.; Jee, J.; Wolff, P.; Lagattuta, F.; Drain, T.; Sierra, V.

1994-01-01

Results of operational orbit determination, performed as part of the TOPEX/POSEIDON (T/P) Global Positioning System (GPS) demonstration experiment, are presented in this article. Elements of this experiment include the GPS satellite constellation, the GPS demonstration receiver on board T/P, six ground GPS receivers, the GPS Data Handling Facility, and the GPS Data Processing Facility (GDPF). Carrier phase and P-code pseudorange measurements from up to 24 GPS satellites to the seven GPS receivers are processed simultaneously with the GDPF software MIRAGE to produce orbit solutions of T/P and the GPS satellites. Daily solutions yield subdecimeter radial accuracies compared to other GPS, LASER, and DORIS precision orbit solutions.

A case control study of multiple myeloma at four nuclear facilities.

PubMed

Wing, S; Richardson, D; Wolf, S; Mihlan, G; Crawford-Brown, D; Wood, J

2000-04-01

Reported elevations of multiple myeloma among nuclear workers exposed to external penetrating ionizing radiation, based on small numbers of cases, prompted this multi-facility study of workers at US Department of Energy facilities. Ninety-eight multiple myeloma deaths and 391 age-matched controls were selected from the combined roster of 115,143 workers hired before 1979 at Hanford, Los Alamos National Laboratory, Oak Ridge National Laboratory, and the Savannah River site. These workers were followed for vital status through 1990 (1986 for Hanford). Demographic, work history, and occupational exposure data were derived from personnel, occupational medicine, industrial hygiene, and health physics records. Exposure-disease associations were evaluated using conditional logistic regression. Cases were disproportionately African American, male, and hired prior to 1948. Lifetime cumulative whole body ionizing radiation dose was not associated with multiple myeloma, however, there was a significant effect of age at exposure, with positive associations between multiple myeloma and doses received at older ages. Dose response associations increased in magnitude with exposure age (from 40 to 50) and lag assumption (from 5 to 15 years), while a likelihood ratio goodness of fit test reached the highest value for cumulative doses received at ages above 45 with a 5-year lag (X2=5.43,1 df; relative risk = 6.9% per 10 mSv). Dose response associations persisted with adjustment for potential confounders. Multiple myeloma was associated with low level whole body penetrating ionizing radiation doses at older ages. The exposure age effect is at odds with interpretations of A-bomb survivor studies but in agreement with several studies of cancer among nuclear workers.

Adaptive array technique for differential-phase reflectometry in QUEST

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

Idei, H., E-mail: idei@triam.kyushu-u.ac.jp; Hanada, K.; Zushi, H.

2014-11-15

A Phased Array Antenna (PAA) was considered as launching and receiving antennae in reflectometry to attain good directivity in its applied microwave range. A well-focused beam was obtained in a launching antenna application, and differential-phase evolution was properly measured by using a metal reflector plate in the proof-of-principle experiment at low power test facilities. Differential-phase evolution was also evaluated by using the PAA in the Q-shu University Experiment with Steady State Spherical Tokamak (QUEST). A beam-forming technique was applied in receiving phased-array antenna measurements. In the QUEST device that should be considered as a large oversized cavity, standing wave effectmore » was significantly observed with perturbed phase evolution. A new approach using derivative of measured field on propagating wavenumber was proposed to eliminate the standing wave effect.« less

Results for the Fourth Quarter Calendar Year 2015 Tank 50H Salt Solution Sample

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

Crawford, C.

In this memorandum, the chemical and radionuclide contaminant results from the Fourth Quarter Calendar Year 2015 (CY15) sample of Tank 50H salt solution are presented in tabulated form. The Fourth Quarter CY15 Tank 50H samples were obtained on October 29, 2015 and received at Savannah River National Laboratory (SRNL) on October 30, 2015. The information from this characterization will be used by Defense Waste Processing Facility (DWPF) & Saltstone Facility Engineering for the transfer of aqueous waste from Tank 50H to the Salt Feed Tank in the Saltstone Production Facility, where the waste will be treated and disposed of inmore » the Saltstone Disposal Facility. This memorandum compares results, where applicable, to Saltstone Waste Acceptance Criteria (WAC) limits and targets. Data pertaining to the regulatory limits for Resource Conservation and Recovery Act (RCRA) metals will be documented at a later time per the Task Technical and Quality Assurance Plan (TTQAP) for the Tank 50H saltstone task. The chemical and radionuclide contaminant results from the characterization of the Fourth Quarter Calendar Year 2015 (CY15) sampling of Tank 50H were requested by SRR personnel and details of the testing are presented in the SRNL Task Technical and Quality Assurance Plan.« less

Early malnutrition screening and low cost protein supplementation in elderly patients admitted to a skilled nursing facility.

PubMed

Harding, Krystal M; Dyo, Melissa; Goebel, Joy R; Gorman, Nik; Levine, Julia

2016-08-01

Malnutrition among skilled nursing facility (SNF) patients can lead to hospital readmissions and multiple complications. To evaluate the effect of an existing malnutrition screening and management program on prealbumin levels of patients in skilled nursing facilities. A retrospective design was used to evaluate baseline admission data including a prealbumin level. Patients with malnutrition received an oral protein supplement according to protocol. A comparison prealbumin level was obtained at 30days. Nearly half of the patients were severely malnourished on admission. Patients receiving the prescribed protocol had significantly increased prealbumin levels at 30days than those patients that did not receive the protocol as prescribed. A prealbumin level upon admission at a SNF could represent a reliable tool to evaluate malnutrition. Initiation of an early malnutrition screening and protein supplement program in this setting is essential to identifying and treating at-risk patients before complications occur. Copyright © 2015 Elsevier Inc. All rights reserved.

Estimating the cost of referral and willingness to pay for referral to higher-level health facilities: a case series study from an integrated community case management programme in Uganda.

PubMed

Nanyonjo, Agnes; Bagorogoza, Benson; Kasteng, Frida; Ayebale, Godfrey; Makumbi, Fredrick; Tomson, Göran; Källander, Karin

2015-08-28

Integrated community case management (iCCM) relies on community health workers (CHWs) managing children with malaria, pneumonia, diarrhoea, and referring children when management is not possible. This study sought to establish the cost per sick child referred to seek care from a higher-level health facility by a CHW and to estimate caregivers' willingness to pay (WTP) for referral. Caregivers of 203 randomly selected children referred to higher-level health facilities by CHWs were interviewed in four Midwestern Uganda districts. Questionnaires and document reviews were used to capture direct, indirect and opportunity costs incurred by caregivers, CHWs and health facilities managing referred children. WTP for referral was assessed through the 'bidding game' approach followed by an open-ended question on maximum WTP. Descriptive analysis was conducted for factors associated with referral completion and WTP using logistic and linear regression methods, respectively. The cost per case referred to higher-level health facilities was computed from a societal perspective. Reasons for referral included having fever with a negative malaria test (46.8%), danger signs (29.6%) and drug shortage (37.4%). Among the referred, less than half completed referral (45.8%). Referral completion was 2.8 times higher among children with danger signs (p = 0.004) relative to those without danger signs, and 0.27 times lower among children who received pre-referral treatment (p < 0.001). The average cost per case referred was US$ 4.89 and US$7.35 per case completing referral. For each unit cost per case referred, caregiver out of pocket expenditure contributed 33.7%, caregivers' and CHWs' opportunity costs contributed 29.2% and 5.1% respectively and health facility costs contributed 39.6%. The mean (SD) out of pocket expenditure was US$1.65 (3.25). The mean WTP for referral was US$8.25 (14.70) and was positively associated with having received pre-referral treatment, completing referral and increasing caregiver education level. The mean WTP for referral was higher than the average out of pocket expenditure. This, along with suboptimal referral completion, points to barriers in access to higher-level facilities as the primary cause of low referral. Community mobilisation for uptake of referral is necessary if the policy of referring children to the nearest health facility is to be effective.

[An investigative report concerning safety and management in the magnetic resonance environment: there are more accidents than expected].

PubMed

Doi, Tsukasa; Yamatani, Yuya; Ueyama, Tsuyoshi; Nishiki, Shigeo; Ogura, Akio; Kawamitsu, Hideaki; Tsuchihashi, Toshio; Okuaki, Tomoyuki; Matsuda, Tsuyoshi; Kumashiro, Masayuki

2011-01-01

Using a questionnaire, we surveyed 2,500 facilities in Japan to clarify medical accidents concerning the magnetic resonance device and its environment. Data derived from 1,319 valid responses (52.8%), allowed us to analyze the situation of (or the reason for) the occurrence of the accidents and their environmental factors. Five hundred and nine facilities (39% of all facilities) had the experience of magnetically induced displacement of the large ferromagnetic material. Intravenous (I.V.) drip stands were involved the largest number of them: 31% (228 cases). Oxygen bottles had the second largest number of incidents: 20%. There were also many incidents involving various materials brought in by non-medical staff (e.g. stepladder for construction). About 20% of the accidents occurred outside of working hours. Patients in 12% of the facilities (154 facilities) experienced burns. In 39 of the cases, burns were received to the inside of the thighs. In 38 of the cases, patients received burns from an electrical cable touching the skin. There were also frequent incidents of burning regarding the boa. We received reports of burns and pain from the halo vest even though it's required to be worn for MR safety. Regarding incidents of contraindications, 280 patients with pacemakers were brought into the magnetic resonance (MR) inspection room. Twelve percent of the facilities experienced natural quench. Lack of training for the staff who introduce and operate high magnetic field devices are considered involving frequently occurring accidents of attractions and burns at hospitals with over 500 beds caused by carrying in materials.

Energy Systems Test Area (ESTA). Power Systems Test Facilities

NASA Technical Reports Server (NTRS)

Situ, Cindy H.

2010-01-01

This viewgraph presentation provides a detailed description of the Johnson Space Center's Power Systems Facility located in the Energy Systems Test Area (ESTA). Facilities and the resources used to support power and battery systems testing are also shown. The contents include: 1) Power Testing; 2) Power Test Equipment Capabilities Summary; 3) Source/Load; 4) Battery Facilities; 5) Battery Test Equipment Capabilities Summary; 6) Battery Testing; 7) Performance Test Equipment; 8) Battery Test Environments; 9) Battery Abuse Chambers; 10) Battery Abuse Capabilities; and 11) Battery Test Area Resources.