Treatment planning capability assessment of a beam shaping assembly for accelerator-based BNCT.

PubMed

Herrera, M S; González, S J; Burlon, A A; Minsky, D M; Kreiner, A J

2011-12-01

Within the frame of an ongoing project to develop a folded Tandem-Electrostatic-Quadrupole accelerator facility for Accelerator-Based Boron Neutron Capture Therapy (AB-BNCT) a theoretical study was performed to assess the treatment planning capability of different configurations of an optimized beam shaping assembly for such a facility. In particular this study aims at evaluating treatment plans for a clinical case of Glioblastoma. Copyright © 2011 Elsevier Ltd. All rights reserved.

The University of Texas M.D. Anderson Cancer Center Proton Therapy Facility

NASA Astrophysics Data System (ADS)

Smith, Alfred; Newhauser, Wayne; Latinkic, Mitchell; Hay, Amy; McMaken, Bruce; Styles, John; Cox, James

2003-08-01

The University of Texas M.D. Anderson Cancer Center (MDACC), in partnership with Sanders Morris Harris Inc., a Texas-based investment banking firm, and The Styles Company, a developer and manager of hospitals and healthcare facilities, is building a proton therapy facility near the MDACC main complex at the Texas Medical Center in Houston, Texas USA. The MDACC Proton Therapy Center will be a freestanding, investor-owned radiation oncology center offering state-of-the-art proton beam therapy. The facility will have four treatment rooms: three rooms will have rotating, isocentric gantries and the fourth treatment room will have capabilities for both large and small field (e.g. ocular melanoma) treatments using horizontal beam lines. There will be an additional horizontal beam room dedicated to physics research and development, radiation biology research, and outside users who wish to conduct experiments using proton beams. The first two gantries will each be initially equipped with a passive scattering nozzle while the third gantry will have a magnetically swept pencil beam scanning nozzle. The latter will include enhancements to the treatment control system that will allow for the delivery of proton intensity modulation treatments. The proton accelerator will be a 250 MeV zero-gradient synchrotron with a slow extraction system. The facility is expected to open for patient treatments in the autumn of 2005. It is anticipated that 675 patients will be treated during the first full year of operation, while full capacity, reached in the fifth year of operation, will be approximately 3,400 patients per year. Treatments will be given up to 2-shifts per day and 6 days per week.

Use of information systems in Air Force medical treatment facilities in strategic planning and decision-making.

PubMed

Yap, Glenn A; Platonova, Elena A; Musa, Philip F

2006-02-01

An exploratory study used Ansoff's strategic planning model as a framework to assess perceived effectiveness of information systems in supporting strategic business plan development at Air Force medical treatment facilities (MTFs). Results showed information systems were most effective in supporting historical trend analysis, strategic business plans appeared to be a balance of operational and strategic plans, and facilities perceived a greater need for new clinical, vice administrative, information systems to support strategic planning processes. Administrators believed information systems should not be developed at the local level and perceived information systems have the greatest impact on improving clinical quality outcomes, followed by ability to deliver cost effective care and finally, ability to increase market share.

A Guide for Developing Standard Operating Job Procedures for the Sludge Conditioning & Dewatering Process Wastewater Treatment Facility. SOJP No. 11.

ERIC Educational Resources Information Center

Schwing, Carl M.

This guide describes standard operating job procedures for the sludge conditioning and dewatering process of wastewater treatment facilities. In this process, sludge is treated with chemicals to make the sludge coagulate and give up its water more easily. The treated sludge is then dewatered using a vacuum filter. The guide gives step-by-step…

Project for the development of the linac based NCT facility in University of Tsukuba.

PubMed

Kumada, H; Matsumura, A; Sakurai, H; Sakae, T; Yoshioka, M; Kobayashi, H; Matsumoto, H; Kiyanagi, Y; Shibata, T; Nakashima, H

2014-06-01

A project team headed by University of Tsukuba launched the development of a new accelerator based BNCT facility. In the project, we have adopted Radio-Frequency Quadrupole (RFQ)+Drift Tube Linac (DTL) type linac as proton accelerators. Proton energy generated from the linac was set to 8MeV and average current was 10mA. The linac tube has been constructed by Mitsubishi Heavy Industry Co. For neutron generator device, beryllium is selected as neutron target material; high intensity neutrons are generated by the reaction with beryllium and the 80kW proton beam. Our team chose beryllium as the neutron target material. At present beryllium target system is being designed with Monte-Carlo estimations and heat analysis with ANSYS. The neutron generator consists of moderator, collimator and shielding. It is being designed together with the beryllium target system. We also acquired a building in Tokai village; the building has been renovated for use as BNCT treatment facility. It is noteworthy that the linac tube had been installed in the facility in September 2012. In BNCT procedure, several medical devices are required for BNCT treatment such as treatment planning system, patient positioning device and radiation monitors. Thus these are being developed together with the linac based neutron source. For treatment planning system, we are now developing a new multi-modal Monte-Carlo treatment planning system based on JCDS. The system allows us to perform dose estimation for BNCT as well as particle radiotherapy and X-ray therapy. And the patient positioning device can navigate a patient to irradiation position quickly and properly. Furthermore the device is able to monitor movement of the patient׳s position during irradiation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Korean Waste Management Law and Waste Disposal Forms.

DTIC Science & Technology

1991-03-01

disinfection facility, dewatering facility, and other auxiliary facilities 2) An aerobic treatment facility composed of intake, detention basin, aerobic ... digestion or oxidation treatment facility, biological treatment facility, disinfection facility, dewatering facility, and other auxiliary facilities

109(b) State Training Center Facility Assessment, Program Evaluation, and Guide Development. Final Report.

ERIC Educational Resources Information Center

Miklas, Michael P., Jr.

Section 109(b) of the 1972 Federal Water Pollution Control Act Amendments authorized funding for the construction of statewide water treatment training facilities. Described in this report is work conducted by Southwest Research Institute (SwRI) to: (1) aid in developing updated 109(b) Guidance Documents; (2) characterize and evaluate existing…

[Structure of pain management facilities in Germany : Classification of medical and psychological pain treatment services-Consensus of the Joint Commission of the Professional Societies and Organizations for Quality in Pain Medicine].

PubMed

Müller-Schwefe, G H H; Nadstawek, J; Tölle, T; Nilges, P; Überall, M A; Laubenthal, H J; Bock, F; Arnold, B; Casser, H R; Cegla, T H; Emrich, O M D; Graf-Baumann, T; Henning, J; Horlemann, J; Kayser, H; Kletzko, H; Koppert, W; Längler, K H; Locher, H; Ludwig, J; Maurer, S; Pfingsten, M; Schäfer, M; Schenk, M; Willweber-Strumpf, A

2016-06-01

On behalf of the Medical/Psychological Pain Associations, Pain Patients Alliance and the Professional Association of Pain Physicians and Psychologists, the Joint Commission of Professional Societies and Organizations for Quality in Pain Medicine, working in close collaboration with the respective presidents, has developed verifiable structural and process-related criteria for the classification of medical and psychological pain treatment facilities in Germany. Based on the established system of graded care in Germany and on existing qualifications, these criteria also argue for the introduction of a basic qualification in pain medicine. In addition to the first-ever comprehensive description of psychological pain facilities, the criteria presented can be used to classify five different levels of pain facilities, from basic pain management facilities, to specialized institutions, to the Centre for Interdisciplinary Pain Medicine. The recommendations offer binding and verifiable criteria for quality assurance in pain medicine and improved pain treatment.

40 CFR 270.65 - Research, development, and demonstration permits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) SOLID WASTES (CONTINUED) EPA ADMINISTERED PERMIT PROGRAMS: THE HAZARDOUS WASTE PERMIT PROGRAM... may issue a research, development, and demonstration permit for any hazardous waste treatment facility which proposes to utilize an innovative and experimental hazardous waste treatment technology or process...

40 CFR 270.65 - Research, development, and demonstration permits.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) SOLID WASTES (CONTINUED) EPA ADMINISTERED PERMIT PROGRAMS: THE HAZARDOUS WASTE PERMIT PROGRAM... may issue a research, development, and demonstration permit for any hazardous waste treatment facility which proposes to utilize an innovative and experimental hazardous waste treatment technology or process...

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

Final Environmental Assessment: For Okaloosa County Wastewater Treatment Facility Eglin Air Force Base, Florida

DTIC Science & Technology

2004-04-01

growth , area development, and additional wastewater from Okaloosa Island that is being pumped to the wastewater treatment facility, it is approaching its...a wavelength of 254 nanometers (nm) kill viruses, bacteria , and protozoan, including Giardia and Cryptosporidium. Currently, the vast majority of...from the Proposed Action. Given the highly disturbed condition of the site and surrounding area, expansion at this site would not adversely

Development of a standardized transfusion ratio as a metric for evaluating dialysis facility anemia management practices.

PubMed

Liu, Jiannong; Li, Suying; Gilbertson, David T; Monda, Keri L; Bradbury, Brian D; Collins, Allan J

2014-10-01

Because transfusion avoidance has been the cornerstone of anemia treatment for patients with kidney disease, direct measurement of red blood cell transfusion use to assess dialysis facility anemia management performance is reasonable. We aimed to explore methods for estimating facility-level standardized transfusion ratios (STfRs) to assess provider anemia treatment practices. Retrospective cohort study. Point prevalent US hemodialysis patients on January 1, 2009, with Medicare as primary payer and dialysis duration of 90 days or longer were included (n = 223,901). All dialysis facilities with eligible patients were included (n = 5,345). Dialysis facility assignment. Receiving a red blood cell transfusion in the inpatient or outpatient setting. We evaluated 3 approaches for estimating STfR: ratio of observed to expected numbers of transfusions (STfR(obs)), a Bayesian approach (STfR(Bayes)), and a modified version of the Bayesian approach (STfR(modBayes)). The overall national transfusion rate in 2009 was 23.2 per 100 patient-years. Our model for predicting the expected number of transfusions performed well. For large facilities, all 3 STfRs worked well. However, for small facilities, while the STfR(modBayes) worked well, STfR(obs) values demonstrated instability and the STfR(Bayes) may produce more bias. Administration of transfusions to dialysis patients reflects medical practice both within and outside the dialysis unit. Some transfusions may be deemed unavoidable and transfusion practices are subject to considerable regional variation. Development of an STfR metric is feasible and reasonable for assessing anemia treatment at dialysis facilities. The STfR(obs) is simple to calculate and works well for larger dialysis facilities. The STfR(modBayes) is more analytically complex, but facilitates comparisons across all dialysis facilities, including small facilities. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

42 CFR 3.20 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., health care quality, or health care outcomes; and (A) Which are assembled or developed by a provider for... (includes a group practice), long term care facility, behavior health residential treatment facility..., psychologist, certified social worker, registered dietitian or nutrition professional, physical or occupational...

42 CFR 3.20 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., health care quality, or health care outcomes; and (A) Which are assembled or developed by a provider for... (includes a group practice), long term care facility, behavior health residential treatment facility..., psychologist, certified social worker, registered dietitian or nutrition professional, physical or occupational...

42 CFR 3.20 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., health care quality, or health care outcomes; and (A) Which are assembled or developed by a provider for... (includes a group practice), long term care facility, behavior health residential treatment facility..., psychologist, certified social worker, registered dietitian or nutrition professional, physical or occupational...

Design of patient rooms and automatic radioiodine-131 waste water management system for a thyroid cancer treatment ward: 'Suandok Model'.

PubMed

Vilasdechanon, N; Ua-Apisitwong, S; Chatnampet, K; Ekmahachai, M; Vilasdechanon, J

2014-09-01

The great benefit of (131)I radionuclide treatment for differentiated thyroid cancer (DTC) was acknowledged by the long survival rate. The main requirements for (131)I therapy in hospital were treatment facilities and a radiation safety plan that assured radiation protection and safety to patient, hospital worker, public, and environment. To introduce the concepts and methods of radiation safety design for a patient's room in a (131)I treatment ward and a system of radioactive waste water management in hospital. The design was based on principles of external and internal radiation protection for unsealed source and radioactive waste management. Planning for treatment facilities was concluded from clinical evidence, physical and physiological information for (131)I, radiation safety criteria, hospital resources and budget. The three phases of the working process were: construction, software development, and radiation safety assessment. The (131)I treatment facility and automatic radioactive waste water management system was completely implemented in 2009. The radiation waste water management system known as the 'Suandok Model' was highly recommended by the national regulator to hospitals who desire to provide (131)I treatment for thyroid cancer. In 2011, the Nuclear Medicine Division, Chiang Mai University was rewarded by the national authority for a very good radiation practice in development of safe working conditions and environment. The Suandok Model was a facility design that fulfilled requirements for the safe use of high radiation (131)I doses for thyroid cancer treatment in hospital. The facility presented in this study may not be suitable for all hospitals but the design concepts could be applied according to an individual hospital context and resources. People who use or gain benefit from radiation applications have to emphasise the responsibility to control and monitor radiation effects on individuals, communities and the environment.

Design of an epithermal column for BNCT based on D D fusion neutron facility

NASA Astrophysics Data System (ADS)

Durisi, E.; Zanini, A.; Manfredotti, C.; Palamara, F.; Sarotto, M.; Visca, L.; Nastasi, U.

2007-05-01

Boron Neutron Capture Therapy (BNCT) is currently performed on patients at nuclear reactors. At the same time the international BNCT community is engaged in the development of alternative facilities for in-hospital treatments. This paper investigates the potential of a novel high-output D-D neutron generator, developed at Lawrence Berkeley National Laboratory (CA, USA), for BNCT. The simulation code MCNP-4C is used to realize an accurate study of the epithermal column in view of the treatment of deep tumours. Different materials and Beam Shaping Assemblies (BSA) are investigated and an optimized configuration is proposed. The neutron beam quality is defined by the standard free beam parameters, calculated averaging over the collimator aperture. The results are discussed and compared with the performances of other facilities.

Comparison of survival in adult antiretroviral treatment naïve patients treated in primary health care centers versus those treated in hospitals: retrospective cohort study; Oromia region, Ethiopia.

PubMed

Megerso, Abebe; Garoma, Sileshi

2016-10-18

Antiretroviral treatment (ART) service scaling up has been practiced in the Ethiopia since 2006. Regardless of increasing number of primary health care centers providing the service, the existing hospitals are still overcrowded with ART service seeking patients may be because of the common belief that treatment outcome is better for hospital patients than those treated at the primary health centers. However, documented evidence comparing the treatment outcome for the two categories of health facilities is scarce in the study setting. The purpose of the current study was to compare major treatment outcomes among new patients treated at the two health facility categories. Retrospective cohort study was implemented using secondary data from medical records collected between October 2010 and January 2014 in the selected health facilities. All patients (1895) who started the treatment in the facilities during the period were included in the study. Univariate analyses were made using descriptive methods such as frequency distributions and measures of central tendency. Bivariate and multivariate analyses were made using Kaplan Meier and Cox regression models respectively to compare the mean survival time between the two facility categories. P-value less than 0.05 was considered as statistically significant. A total of 1895 patient records were followed for 27,990 person-months. Risks of unwanted treatment outcomes (death and lose-to-follow-up) were the same for both categories of patients. The median survival probability was similar to the facility categories (P-value = 0.11). Baseline performance scale III/IV (AHR, 2.4; 95 % CI: 2.0, 3.0), baseline WHO clinical stages III/IV (AHR, 2.8; 95 % CI: 2.3, 3.4), and low adherence (<95 %) to ART drugs (AHR, 3.4; 95 % CI: 2.8, 5.2) were the independent predictors of the unwanted treatment outcomes. Antiretroviral treatment service delivery at primary health care facilities did not compromise the treatment outcomes among adult ART naïve patients. This implies that, ART services decentralization can result in acceptable treatment outcome in less developed settings. Therefore, treatment requiring patients should be encouraged to start the treatment in either of the health facilities as early as possible.

Quiet Clean Short-Haul Experimental Engine (QCSEE): Acoustic treatment development and design

NASA Technical Reports Server (NTRS)

Clemons, A.

1979-01-01

Acoustic treatment designs for the quiet clean short-haul experimental engines are defined. The procedures used in the development of each noise-source suppressor device are presented and discussed in detail. A complete description of all treatment concepts considered and the test facilities utilized in obtaining background data used in treatment development are also described. Additional supporting investigations that are complementary to the treatment development work are presented. The expected suppression results for each treatment configuration are given in terms of delta SPL versus frequency and in terms of delta PNdB.

Performance of the NIRS fast scanning system for heavy-ion radiotherapy.

PubMed

Furukawa, Takuji; Inaniwa, Taku; Sato, Shinji; Shirai, Toshiyuki; Takei, Yuka; Takeshita, Eri; Mizushima, Kota; Iwata, Yoshiyuki; Himukai, Takeshi; Mori, Shinichiro; Fukuda, Shigekazu; Minohara, Shinichi; Takada, Eiichi; Murakami, Takeshi; Noda, Koji

2010-11-01

A project to construct a new treatment facility, as an extension of the existing HIMAC facility, has been initiated for the further development of carbon-ion therapy at NIRS. This new treatment facility is equipped with a 3D irradiation system with pencil-beam scanning. The challenge of this project is to realize treatment of a moving target by scanning irradiation. To achieve fast rescanning within an acceptable irradiation time, the authors developed a fast scanning system. In order to verify the validity of the design and to demonstrate the performance of the fast scanning prior to use in the new treatment facility, a new scanning-irradiation system was developed and installed into the existing HIMAC physics-experiment course. The authors made strong efforts to develop (1) the fast scanning magnet and its power supply, (2) the high-speed control system, and (3) the beam monitoring. The performance of the system including 3D dose conformation was tested by using the carbon beam from the HIMAC accelerator. The performance of the fast scanning system was verified by beam tests. Precision of the scanned beam position was less than +/-0.5 mm. By cooperating with the planning software, the authors verified the homogeneity of the delivered field within +/-3% for the 3D delivery. This system took only 20 s to deliver the physical dose of 1 Gy to a spherical target having a diameter of 60 mm with eight rescans. In this test, the average of the spot-staying time was considerably reduced to 154 micros, while the minimum staying time was 30 micros. As a result of this study, the authors verified that the new scanning delivery system can produce an accurate 3D dose distribution for the target volume in combination with the planning software.

Energy intensity modeling for wastewater treatment technologies.

PubMed

Molinos-Senante, María; Sala-Garrido, Ramón; Iftimi, Adina

2018-07-15

Wastewater treatment plants (WWTPs) are energy intensive facilities; therefore increased pressure has been placed on managers and policy makers to reduce the facilities' energy use. Several studies were conducted to compare the energy intensity (EI) of WWTPs, which showed large dispersion in EI among the facilities. In the present study, the degree EI influenced WWTPs was tested using a set of technical variables by modeling the EI of a 305 WWTP sample grouped into five secondary treatment technologies. Results indicated the following two major findings: i) WWTPs using conventional activated sludge, extended aeration, trickling biofilters, and biodisks exhibited significant economies of scale in energy use; and ii) pollutant removal efficiency demonstrated low impacts on WWTP EI. The methodology and results of this study are of value to policy makers in planning new WWTPs and developing management plans to improve energy efficiency of wastewater treatment. Copyright © 2018. Published by Elsevier B.V.

Biogasification of Walt Disney World biomass waste blend. Annual report Jan-Dec 82

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

Biljetina, R.; Chynoweth, D.P.; Janulis, J.

1983-05-01

The objective of this research is to develop efficient processes for conversion of biomass-waste blends to methane and other resources. To evaluate the technical and economic feasibility, an experimental test facility (ETU) is being designed and installed at the Reedy Creek Wastewater Treatment Plant at Walt Disney World, Orlando, Florida. The facility will integrate a biomethanogenic conversion process with a waste-water treatment process employing water hyacinth ponds for secondary and tertiary treatment of sewage produced at Walt Disney World. The ETU will be capable of feeding 1-wet ton per day of water hyacinth-sludge blends to the digestion system for productionmore » of methane and other byproducts. The detailed design of the facility has been completed and procurement of equipment is in progress.« less

Decontamination Workshop for Emergency Responding Personnel How Clean is Clean Enough 12-14 September 2007

DTIC Science & Technology

2008-09-01

refers to a Medical Treatment Facility (MTF), can we assume that disrobing is sufficient? Is it possible to develop specific site clearance criteria ...o First responders , medical personnel, and the HAZMAT team o Incident Commanders o Public information officials o Hospitals and hospital networks ...clean personnel (both victims and first responders ) need to be when they are released from the incident site (or treatment facility for those that make

A measure for provisional-and-urgent sanitary improvement in developing countries: septic-tank performance improvement.

PubMed

Harada, H; Dong, N T; Matsui, S

2008-01-01

Although many cities have planed to develop sewerages in developing countries, sewerage establishment still requires huge investment and engineering efforts. Improvement of existing sanitation facilities may contribute the betterment of urban sanitation before sewerage establishment. The purpose of this study is to propose a measure to improve urban sanitation in areas where a sewerage development plan is proposed but has not been yet established, based on a case study in Hanoi, Vietnam. We found that 90.5% of human excreta flowed into septic tanks. However, 89.6% of septic tanks have never been desludged in the past and their performance was observed to be at a low level. The study also showed that if they introduce regular desludging with a frequency of once a year, they can eliminate 72.8% of COD loads from septic tanks. It was indicated that the performance can be dramatically recovered by regular desludging, which could contribute urban sanitation improvement in Hanoi. In conclusion, the performance recovery of septic tanks by regular desludging was proposed as a provisional-and-urgent measure for urban sanitation improvement, together with the septage treatment in sewage sludge treatment facilities, which should be established earlier than other facilities of sewage treatment systems. IWA Publishing 2008.

Systematic Review of Multidisciplinary Chronic Pain Treatment Facilities

PubMed Central

Fashler, Samantha R.; Cooper, Lynn K.; Oosenbrug, Eric D.; Burns, Lindsay C.; Razavi, Shima; Goldberg, Lauren; Katz, Joel

2016-01-01

This study reviewed the published literature evaluating multidisciplinary chronic pain treatment facilities to provide an overview of their availability, caseload, wait times, and facility characteristics. A systematic literature review was conducted using PRISMA guidelines following a search of MEDLINE, PsycINFO, and CINAHL databases. Inclusion criteria stipulated that studies be original research, survey more than one pain treatment facility directly, and describe a range of available treatments. Fourteen articles satisfied inclusion criteria. Results showed little consistency in the research design used to describe pain treatment facilities. Availability of pain treatment facilities was scarce and the reported caseloads and wait times were generally high. A wide range of medical, physical, and psychological pain treatments were available. Most studies reported findings on the percentage of practitioners in different health care professions employed. Future studies should consider using more comprehensive search strategies to survey facilities, improving clarity on what is considered to be a pain treatment facility, and reporting on a consistent set of variables to provide a clear summary of the status of pain treatment facilities. This review highlights important information for policymakers on the scope, demand, and accessibility of pain treatment facilities. PMID:27445618

Clinician perceptions and patient experiences of antiretroviral treatment integration in primary health care clinics, Tshwane, South Africa.

PubMed

Mathibe, Maphuthego D; Hendricks, Stephen J H; Bergh, Anne-Marie

2015-10-02

Primary Health Care (PHC) clinicians and patients are major role players in the South African antiretroviral treatment programme. Understanding their perceptions and experiences of integrated care and the management of people living with HIV and AIDS in PHC facilities is necessary for successful implementation and sustainability of integration. This study explored clinician perceptions and patient experiences of integration of antiretroviral treatment in PHC clinics. An exploratory, qualitative study was conducted in four city of Tshwane PHC facilities. Two urban and two rural facilities following different models of integration were included. A self-administered questionnaire with open-ended items was completed by 35 clinicians and four focus group interviews were conducted with HIV-positive patients. The data were coded and categories were grouped into sub-themes and themes. Workload, staff development and support for integration affected clinicians' performance and viewpoints. They perceived promotion of privacy, reduced discrimination and increased access to comprehensive care as benefits of service integration. Delays, poor patient care and patient dissatisfaction were viewed as negative aspects of integration. In three facilities patients were satisfied with integration or semi-integration and felt common queues prevented stigma and discrimination, whilst the reverse was true in the facility with separate services. Single-month issuance of antiretroviral drugs and clinic schedule organisation was viewed negatively, as well as poor staff attitudes, poor communication and long waiting times. Although a fully integrated service model is preferable, aspects that need further attention are management support from health authorities for health facilities, improved working conditions and appropriate staff development opportunities.

Emergency Planning for Municipal Wastewater Treatment Facilities.

ERIC Educational Resources Information Center

Lemon, R. A.; And Others

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

FIELD MEASUREMENT OF GREENHOUSE GAS EMISSION RATES AND DEVELOPMENT OF EMISSION FACTORS FOR WASTEWATER TREATMENT

EPA Science Inventory

The report gives results of field testing to develop more reliable green house gas (GHG) emission estimates for Wastewater treatment (WWT) lagoons. (NOTE: Estimates are available for the amount of methane (CH4) emitted from certain types of waste facilities, but there is not adeq...

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

PubMed Central

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

2016-01-01

Decentralizing health services, including those for HIV prevention and treatment, is one strategy for maximizing the use of limited resources and expanding treatment options; yet few methods exist for systematically identifying where investments for service expansion might be most effective, in terms of meeting needs and rapid availability of improved services. The Nigerian Government, the United States Government under the President's Emergency Plan for AIDS Relief (PEPFAR) program and other donors are expanding services for prevention of mother-to-child transmission (PMTCT) of HIV to primary health care facilities in Nigeria. Nigerian primary care facilities vary greatly in their readiness to deliver HIV/AIDS services. In 2012, MEASURE Evaluation assessed 268 PEPFAR-supported primary health care facilities in Nigeria and developed a systematic method for prioritizing these facilities for expansion of PMTCT services. Each assessed facility was scored based on two indices with multiple, weighted variables: one measured facility readiness to provide PMTCT services, the other measured local need for the services and feasibility of expansion. These two scores were compiled and the summary score used as the basis for prioritizing facilities for PMTCT service expansion. The rationale was that using need and readiness to identify where to expand PMTCT services would result in more efficient allocation of resources. A review of the results showed that the indices achieved the desired effect—that is prioritizing facilities with high need even when readiness was problematic and also prioritizing facilities where rapid scale-up was feasible. This article describes the development of the two-part index and discusses advantages of using this approach when planning service expansion. The authors' objective is to contribute to development of methodologies for prioritizing investments in HIV, as well as other public health arenas, that should improve cost-effectiveness and strengthen services and systems in resource-limited countries. PMID:26363172

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

PubMed

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

2016-04-01

Decentralizing health services, including those for HIV prevention and treatment, is one strategy for maximizing the use of limited resources and expanding treatment options; yet few methods exist for systematically identifying where investments for service expansion might be most effective, in terms of meeting needs and rapid availability of improved services. The Nigerian Government, the United States Government under the President's Emergency Plan for AIDS Relief (PEPFAR) program and other donors are expanding services for prevention of mother-to-child transmission (PMTCT) of HIV to primary health care facilities in Nigeria. Nigerian primary care facilities vary greatly in their readiness to deliver HIV/AIDS services. In 2012, MEASURE Evaluation assessed 268 PEPFAR-supported primary health care facilities in Nigeria and developed a systematic method for prioritizing these facilities for expansion of PMTCT services. Each assessed facility was scored based on two indices with multiple, weighted variables: one measured facility readiness to provide PMTCT services, the other measured local need for the services and feasibility of expansion. These two scores were compiled and the summary score used as the basis for prioritizing facilities for PMTCT service expansion. The rationale was that using need and readiness to identify where to expand PMTCT services would result in more efficient allocation of resources. A review of the results showed that the indices achieved the desired effect-that is prioritizing facilities with high need even when readiness was problematic and also prioritizing facilities where rapid scale-up was feasible. This article describes the development of the two-part index and discusses advantages of using this approach when planning service expansion. The authors' objective is to contribute to development of methodologies for prioritizing investments in HIV, as well as other public health arenas, that should improve cost-effectiveness and strengthen services and systems in resource-limited countries. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

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

Page, Brandi R., E-mail: bpage@wakehealth.edu; Hudson, Alana D.; Brown, Derek W.

The international growth of cancer and lack of available treatment is en route to become a global crisis. With >60% of cancer patients needing radiation therapy at some point during their treatment course, the lack of available facilities and treatment programs worldwide is extremely problematic. The number of deaths from treatable cancers is projected to increase to 11.5 million deaths in 2030 because the international population is aging and growing. In this review, we present how best to answer the need for radiation therapy facilities from a technical standpoint. Specifically, we examine whether cobalt teletherapy machines or megavoltage linear acceleratormore » machines are best equipped to handle the multitudes in need of radiation therapy treatment in the developing world.« less

Is bigger better? Driving factors of POTW performance in New York.

PubMed

Rahm, Brian G; Morse, Natalie; Bowen, Michelle; Choi, Jun; Mehta, Dhaval; Vedachalam, Sridhar

2018-05-15

Like many regions around the world, New York State, USA, faces challenges in meeting wastewater treatment quality standards because of aging infrastructure, limited funding, shifting demographics and increasingly stringent environmental regulations. In recent decades construction of new wastewater treatment and distribution infrastructure in NY has most often occurred in exurban communities and suburban developments that are less dense than traditional urban cores. Here, we examine the role of size and capacity utilization on wastewater treatment effectiveness with respect to critical effluent parameters, and additionally explore which common facility engineering controls influence water quality treatment using a unique dataset of descriptive information. Our results challenge conventional wisdom, suggesting that the largest facilities (>30,000 m 3 /d), not the smallest (<300 m 3 /d), discharge TSS, BOD, and coliform at significantly higher relative effluent concentrations (i.e., the ratio of discharged concentrations to allowable limits). Capacity utilization was also positively correlated to higher concentrations of TSS, BOD, and coliform effluent concentrations in larger facilities, though those concentrations were often within regulated limits. This implies that smaller-sized facilities may perform better in terms of environmental quality, but that the largest facilities demonstrate efficiency in the sense that they are not "over-treating" wastewater while avoiding violations. Results from NY suggest that medium sized facilities (300-30,000 m 3 /d) are sophisticated enough to incorporate appropriate unit processes, and employ operators with sufficient training and oversight, to reach treatment outcomes that are both reliable and of high quality. Copyright © 2018 Elsevier Ltd. All rights reserved.

Not ''just'' pump and treat

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

Angleberger, K; Bainer, R W

2000-12-12

The Lawrence Livermore National Laboratory (LLNL) has been consistently improving the site cleanup methods by adopting new philosophies, strategies and technologies to address constrained or declining budgets, lack of useable space due to a highly industrialized site, and significant technical challenges. As identified in the ROD, the preferred remedy at the LLNL Livermore Site is pump and treat, although LLNL has improved this strategy to bring the remediation of the ground water to closure as soon as possible. LLNL took the logical progression from a pump and treat system to the philosophy of ''Smart Pump and Treat'' coupled with themore » concepts of ''Hydrostratigraphic Unit Analysis,'' ''Engineered Plume Collapse,'' and ''Phased Source Remediation,'' which led to the development of new, more cost-effective technologies which have accelerated the attainment of cleanup goals significantly. Modeling is also incorporated to constantly develop new, cost-effective methodologies to accelerate cleanup and communicate the progress of cleanup to stakeholders. In addition, LLNL improved on the efficiency and flexibility of ground water treatment facilities. Ground water cleanup has traditionally relied on costly and obtrusive fixed treatment facilities. LLNL has designed and implemented various portable ground water treatment units to replace the fixed facilities; the application of each type of facility is determined by the amount of ground water flow and contaminant concentrations. These treatment units have allowed for aggressive ground water cleanup, increased cleanup flexibility, and reduced capital and electrical costs. After a treatment unit has completed ground water cleanup at one location, it can easily be moved to another location for additional ground water cleanup.« less

Determinants of health system delay at public and private directly observed treatment, short course facilities in Lagos State, Nigeria: A cross-sectional study.

PubMed

Adejumo, Olusola Adedeji; Daniel, Olusoji James; Otesanya, Andrew Folarin; Adejumo, Esther Ngozi

2016-09-01

Despite several studies on health system delay (HSD) among tuberculosis (TB) patients in Nigeria, no study has compared HSD in private and public health facilities. This study assessed the determinants of HSD in public and private health facilities offering the directly observed treatment, short course (DOTS). A descriptive cross-sectional study was conducted. A total of 470 new smear-positive TB patients aged 14years and older were consecutively recruited between October 1, 2012, and December 31, 2012, from 34 (23 public and 11 private) DOTS facilities that offered treatment and microscopy services. Mann-Whitney U test and logistic regression were used to assess the determinants of HSD. The median HSD was longer at public DOTS facilities (14days; interquartile range [IQR] 10-21days) than private DOTS facilities (12.5days; IQR 10.0-14.0days, p=.002). Age and human immunodeficiency virus status were determinants of HSD at the public DOTS facilities, whereas sex and income were determinants of HSD at the private DOTS facilities. TB patients who first visited a nonhospital facility were over four times more likely (odds ratio 4.12; 95% confidence interval 2.25-7.54) to have prolonged HSD than those who first visited the government hospital when they first developed the symptoms of TB after controlling for other factors in the model. Determinants of HSD at the public and private DOTS facilities vary. Strategies to reduce HSD at both public and private DOTS facilities in Lagos State, Nigeria, are urgently needed. Copyright © 2016 Asian-African Society for Mycobacteriology. Published by Elsevier Ltd. All rights reserved.

[For the history of creation of central anatomicopathological facility of the Ministry of Defence].

PubMed

Chirskiĭ, V S; Sibirev, S A; Bushurov, S E

2012-12-01

The system of anatomicopathological facilities was created in 30s of XX century and first years of the Great Patriotic War. The goal of this system was to increase the effectiveness of Sanitary Corps of the Red Army. These anatomicopathological facilities analyzed causes of death of injured soldiers during all stages of the system of treatment-evacuative support of troops and mistakes made by medical specialists during first aid treatment. Organisational forms of anatomicopathological activity were changed and developed according to acquired battle experience. The main stage of formation of anatomicopathological service of the Red Army, and in fact the finished period in organisational formation of anatomicopathological service, was establishment of Central anatomicopathological facility - main methodological, organisational, coordinating and monioring center of anatomicopathological activity of the Armed Forces of the Russian Federation.

Medical Applications of Non-Medical Research: Applications Derived from BES-Supported Research and Research at BES Facilities

DOE R&D Accomplishments Database

1998-07-01

This publication contains stories that illustrate how the Office of Basic Energy Sciences (BES) research and major user facilities have impacted the medical sciences in the selected topical areas of disease diagnosis, treatment (including drug development, radiation therapy, and surgery), understanding, and prevention.

Risk assessment of CST-7 proposed waste treatment and storage facilities Volume I: Limited-scope probabilistic risk assessment (PRA) of proposed CST-7 waste treatment & storage facilities. Volume II: Preliminary hazards analysis of proposed CST-7 waste storage & treatment facilities

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

Sasser, K.

1994-06-01

In FY 1993, the Los Alamos National Laboratory Waste Management Group [CST-7 (formerly EM-7)] requested the Probabilistic Risk and Hazards Analysis Group [TSA-11 (formerly N-6)] to conduct a study of the hazards associated with several CST-7 facilities. Among these facilities are the Hazardous Waste Treatment Facility (HWTF), the HWTF Drum Storage Building (DSB), and the Mixed Waste Receiving and Storage Facility (MWRSF), which are proposed for construction beginning in 1996. These facilities are needed to upgrade the Laboratory`s storage capability for hazardous and mixed wastes and to provide treatment capabilities for wastes in cases where offsite treatment is not availablemore » or desirable. These facilities will assist Los Alamos in complying with federal and state requlations.« less

Scaling-up health information systems to improve HIV treatment: An assessment of initial patient monitoring systems in Mozambique.

PubMed

Hochgesang, Mindy; Zamudio-Haas, Sophia; Moran, Lissa; Nhampossa, Leopoldo; Packel, Laura; Leslie, Hannah; Richards, Janise; Shade, Starley B

2017-01-01

The rapid scale-up of HIV care and treatment in resource-limited countries requires concurrent, rapid development of health information systems to support quality service delivery. Mozambique, a country with an 11.5% prevalence of HIV, has developed nation-wide patient monitoring systems (PMS) with standardized reporting tools, utilized by all HIV treatment providers in paper or electronic form. Evaluation of the initial implementation of PMS can inform and strengthen future development as the country moves towards a harmonized, sustainable health information system. This assessment was conducted in order to 1) characterize data collection and reporting processes and PMS resources available and 2) provide evidence-based recommendations for harmonization and sustainability of PMS. This baseline assessment of PMS was conducted with eight non-governmental organizations that supported the Ministry of Health to provide 90% of HIV care and treatment in Mozambique. The study team conducted structured and semi-structured surveys at 18 health facilities located in all 11 provinces. Seventy-nine staff were interviewed. Deductive a priori analytic categories guided analysis. Health facilities have implemented paper and electronic monitoring systems with varying success. Where in use, robust electronic PMS facilitate facility-level reporting of required indicators; improve ability to identify patients lost to follow-up; and support facility and patient management. Challenges to implementation of monitoring systems include a lack of national guidelines and norms for patient level HIS, variable system implementation and functionality, and limited human and infrastructure resources to maximize system functionality and information use. This initial assessment supports the need for national guidelines to harmonize, expand, and strengthen HIV-related health information systems. Recommendations may benefit other countries with similar epidemiologic and resource-constrained environments seeking to improve PMS implementation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

7 CFR 305.5 - Treatment requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 5 2010-01-01 2010-01-01 false Treatment requirements. 305.5 Section 305.5... SERVICE, DEPARTMENT OF AGRICULTURE PHYTOSANITARY TREATMENTS Chemical Treatments § 305.5 Treatment requirements. (a) Certified facility. The fumigation treatment facility must be certified by APHIS. Facilities...

Nurse-led HIV services and quality of care at health facilities in Kenya, 2014-2016.

PubMed

Rabkin, Miriam; Lamb, Matthew; Osakwe, Zainab T; Mwangi, Peter R; El-Sadr, Wafaa M; Michaels-Strasser, Susan

2017-05-01

To develop a novel measure to characterize human immunodeficiency virus (HIV) programme quality at health facilities in Kenya and explore its associations with patient- and facility-level characteristics. We developed a composite indicator to measure quality of HIV care, comprising: assessment of eligibility for antiretroviral therapy (ART); initiation of ART; and retention on ART or in care, if ineligible for ART, for 12 months. We applied the comprehensive retention indicator to routinely collected clinical data from 13 331 patients enrolled in HIV care and treatment at 63 health facilities in the Eastern and Nyanza regions of Kenya from 1 January 2014 to 31 March 2016. We explored the association between facility- and patient-level characteristics and the primary outcome: appropriate staging and management of HIV, and retention in care over 12 months. Of the enrolled patients, 8404 (63%) achieved comprehensive retention 12 months after enrolment in care. In univariate analyses, patients at facilities where nurses delivered HIV treatment services (including eligibility assessment, initiation and follow up of ART) had significantly higher comprehensive retention rates at 12 months. In multivariate analyses, after adjusting for both facility- and patient-level characteristics, patients at facilities where nurses initiated ART had significantly higher comprehensive retention in care at 12 months (relative risk, RR: 1.22; 95% confidence interval, CI: 1.00-1.48). Nurse-led HIV services were significantly associated with quality of care, confirming the central role of nurses in the achievement of global health goals, and the need for further investment in nursing education, training and mentoring.

77 FR 42621 - Irradiation Treatment; Location of Facilities in the Southern United States

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-20

.... APHIS-2009-0100] RIN 0579-AD35 Irradiation Treatment; Location of Facilities in the Southern United... amending the phytosanitary treatment regulations to provide generic criteria for new irradiation treatment facilities in the Southern States of the United States. This action will allow irradiation facilities to be...

Substance Abuse Treatment in Adult and Juvenile Correctional Facilities: Findings from the Uniform Facility Data Set 1997 Survey of Correctional Facilities.

ERIC Educational Resources Information Center

Marsden, Mary Ellen, Ed.; Straw, Richard S., Ed.

This report presents methodology and findings from the Uniform Facility Data Set (UFDS) 1997 Survey of Correctional Facilities, which surveyed about 7,600 adult and juvenile correctional facilities to identify those that provide on-site substance abuse treatment to their inmates or residents. The survey assesses substance abuse treatment provided…

40 CFR 270.65 - Research, development, and demonstration permits.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 28 2012-07-01 2012-07-01 false Research, development, and... Special Forms of Permits § 270.65 Research, development, and demonstration permits. (a) The Administrator may issue a research, development, and demonstration permit for any hazardous waste treatment facility...

40 CFR 270.65 - Research, development, and demonstration permits.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 28 2013-07-01 2013-07-01 false Research, development, and... Special Forms of Permits § 270.65 Research, development, and demonstration permits. (a) The Administrator may issue a research, development, and demonstration permit for any hazardous waste treatment facility...

A Guide for Developing Standard Operating Job Procedures for the Tertiary Chemical Treatment - Lime Precipitation Process Wastewater Treatment Facility. SOJP No. 6.

ERIC Educational Resources Information Center

Petrasek, Al, Jr.

This guide describes the standard operating job procedures for the tertiary chemical treatment - lime precipitation process of wastewater treatment plants. Step-by-step instructions are given for pre-start up, start-up, continuous operation, and shut-down procedures. In addition, some theoretical material is presented along with some relevant…

Designing Decentralized Water and Electricity Supply System for Small Recreational Facilities in the South of Russia

NASA Astrophysics Data System (ADS)

Kasharin, D. V.

2017-11-01

The article tackles the issues of designing seasonal water and power supply systems for small recreational facilities in the south of Russia based on intelligent decision support systems. The paper proposes modular prefabricated shell water and power supply works (MPSW&PW) along with energy-efficient standalone water-treatment plants as the principal facilities compliant with the environmental and infrastructural requirements applied to specially protected areas and ensuring the least possible damage to the environment due to a maximum possible use of local construction materials characterized by impressive safety margins in highly seismic environments. The task of designing water and power supply systems requires the consideration of issues pertaining to the development of an intelligent GIS-based system for the selection of water intake sites that facilitate automation of data-processing systems using a priori scanning methods with a variable step and random directions. The paper duly addresses such issues and develops parameterized optimization algorithms for MPSW&PW shell facilities. It equally provides the substantiation of water-treatment plants intelligent design based on energy recovery reverse osmosis and nanofiltration plants that enhance the energy efficiency of such plants serving as the optimum solution for the decentralized water supply of small recreational facilities from renewable energy sources.

Effectiveness of mouse minute virus inactivation by high temperature short time treatment technology: a statistical assessment.

PubMed

Murphy, Marie; Quesada, Guillermo Miro; Chen, Dayue

2011-11-01

Viral contamination of mammalian cell cultures in GMP manufacturing facility represents a serious safety threat to biopharmaceutical industry. Such adverse events usually require facility shutdown for cleaning/decontamination, and thus result in significant loss of production and/or delay of product development. High temperature short time (HTST) treatment of culture media has been considered as an effective method to protect GMP facilities from viral contaminations. Log reduction factor (LRF) has been commonly used to measure the effectiveness of HTST treatment for viral inactivation. However, in order to prevent viral contaminations, HTST treatment must inactivate all infectious viruses (100%) in the medium batch since a single virus is sufficient to cause contamination. Therefore, LRF may not be the most appropriate indicator for measuring the effectiveness of HTST in preventing viral contaminations. We report here the use of the probability to achieve complete (100%) virus inactivation to assess the effectiveness of HTST treatment. By using mouse minute virus (MMV) as a model virus, we have demonstrated that the effectiveness of HTST treatment highly depends upon the level of viral contaminants in addition to treatment temperature and duration. We believe that the statistical method described in this report can provide more accurate information about the power and potential limitation of technologies such as HTST in our shared quest to mitigate the risk of viral contamination in manufacturing facilities. Copyright © 2011 The International Alliance for Biological Standardization. Published by Elsevier Ltd. All rights reserved.

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

Renovating existing space to meet special needs for outpatient paediatric oncology.

PubMed

Rhodes, D A

1999-01-01

Many existing hospital buildings are inadequate to meet needs caused by a tremendous shift from inpatient to outpatient care. Expensive diagnostic and treatment facilities must still be shared by inpatients and outpatients, which in many cases makes renovations to existing facilities on site more appealing than new free-standing facilities; However, care must be taken in the planning and design to make sure that existing hospital operations can be maintained throughout this work. St. Jude Children's Research Hospital in Memphis, an internationally acclaimed institution devoted to the research and treatment of catastrophic illnesses in children has experienced a large growth in its outpatients' care due mainly to changes in treatment modalities and the development of more effective cures. The result has been an extreme overcrowding and unpleasant experiences for patient and family due to awkward patient flow and work processes attempting to respond to the inadequate facility conditions. This paper will not only review the planning issues, but will discuss the renovation which will require several phases in order to minimise disruption to the ongoing activities.

Commonwealth of Pennsylvania. [Establishment of hazardous waste facilities

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

Not Available

Environmental Resources Secretary Arthur A. Davis and Commerce Secretary Raymond R. Christman have announced a joint initiative to establish commercial hazardous waste treatment and disposal facilities Pennsylvania. The state Hazardous Sites Cleanup Act, which Gov. Robert P. Casey signed into law last October, called for accelerated efforts in this regard. These included an expedited permitting process for facilities, requiring the Department of Environmental Resources (DER) to appoint a special sitting team to review permit applications, and designation of sitting coordinator within the Department of Commerce to identify potential developers of the facilities and encourage them to operate within Pennsylvania.

Illegal drugs in Grenada: arrests and drug treatment from 2001-2009.

PubMed

Fagorala, A

2013-09-01

Illegal drug use and abuse has increased in the Caribbean since the 1990s. In Grenada, statistical indicators such as admission rates to treatment facilities and drug arrests have provided evidence for the increased rates of illegal drug use and abuse. This study reviewed these statistical indicators and explored drug treatment options in Grenada from 2001 to 2009. A search of statistical records from the Drug Control Secretariat and the Grenada Drug Information Network/National Observatory on Drugs (GRENDIN/NOD) was performed. Literature review of relevant articles from search engines was used to support findings. Additionally, semi-structured interviews of key stakeholders from government and health agencies involved in drug prevention in Grenada were conducted to obtain information on recent developments surrounding drug arrests and treatments in Grenada. From 2001 to 2009, there were a 118% and a 23% increase in the arrest rate for males and females,respectively. There was also an increase in demand for drug treatment at the sole drug treatment facility. Preventive measures in schools and several forms of media programmes have raised awareness. However,drug use/abuse/activities still persist at a significant rate. Programmes that target improvement of treatment facilities and increased inter-agency collaboration may be successful in enhancing drug arrests and treatments.

[The topical problems of pediatric balneotherapy and the spa and health resort-based treatment of the children].

PubMed

Razumov, A N; Khan, M A

2016-01-01

This article is devoted to the topical problems of pediatric balneotherapy with special reference to the organization of the spa and health resort-based treatment of the children in the Russian Federation. The main issues discussed by the authors include the current state of health resort care for the children, the problem of statutory regulation of the activities of the children's spa and health resort facilities, the approaches to increasing the availability of the spa and health resort-based treatment for the children at the enhanced risk of the development of chronic diseases, disabilities, and tuberculosis. Also considered are the problems of the development of the regulatory framework for the medical rehabilitation of the children based at the spa and health resort facilities. The principal goals to be sought in climatotherapy, physiotherapy, balneotherapy, and pelotherapy in the pediatric context are outlined along with the further prospects for the development of the main areas of pediatric balneology.

Sustainable mechanical biological treatment of solid waste in urbanized areas with low recycling rates.

PubMed

Trulli, Ettore; Ferronato, Navarro; Torretta, Vincenzo; Piscitelli, Massimiliano; Masi, Salvatore; Mancini, Ignazio

2018-01-01

Landfill is still the main technological facility used to treat and dispose municipal solid waste (MSW) worldwide. In developing countries, final dumping is applied without environmental monitoring and soil protection since solid waste is mostly sent to open dump sites while, in Europe, landfilling is considered as the last option since reverse logistic approaches or energy recovery are generally encouraged. However, many regions within the European Union continue to dispose of MSW to landfill, since modern facilities have not been introduced owing to unreliable regulations or financial sustainability. In this paper, final disposal activities and pre-treatment operations in an area in southern Italy are discussed, where final disposal is still the main option for treating MSW and the recycling rate is still low. Mechanical biological treatment (MBT) facilities are examined in order to evaluate the organic stabilization practices applied for MSW and the efficiencies in refuse derived fuel production, organic waste stabilization and mass reduction. Implementing MBT before landfilling the environmental impact and waste mass are reduced, up to 30%, since organic fractions are stabilized resulting an oxygen uptake rate less than 1600 mgO 2  h -1  kg -1 VS , and inorganic materials are exploited. Based on experimental data, this work examines MBT application in contexts where recycling and recovery activities have not been fully developed. The evidence of this study led to state that the introduction of MBT facilities is recommended for developing regions with high putrescible waste production in order to decrease environmental pollution and enhance human healthy. Copyright © 2017 Elsevier Ltd. All rights reserved.

42 CFR 483.354 - General requirements for psychiatric residential treatment facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... treatment facilities. 483.354 Section 483.354 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... LONG TERM CARE FACILITIES Condition of Participation for the Use of Restraint or Seclusion in Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under...

Healing the community to heal the individual

PubMed Central

Jiwa, Ashifa; Kelly, Len; Pierre-Hansen, Natalie

2008-01-01

ABSTRACT OBJECTIVE To understand the development of culturally based and community-based alcohol and substance abuse treatment programs for aboriginal patients in an international context. SOURCES OF INFORMATION MEDLINE, HealthSTAR, and PsycINFO databases and government documents were searched from 1975 to 2007. MeSH headings included the following: Indians, North American, Pacific ancestry group, aboriginal, substance-related disorders, alcoholism, addictive behaviour, community health service, and indigenous health. The search produced 150 articles, 34 of which were relevant; most of the literature comprised opinion pieces and program descriptions (level III evidence). MAIN MESSAGE Substance abuse in some aboriginal communities is a complex problem requiring culturally appropriate, multidimensional approaches. One promising perspective supports community-based programs or community mobile treatment. These programs ideally cover prevention, harm reduction, treatment, and aftercare. They often eliminate the need for people to leave their remote communities. They become focuses of community development, as the communities become the treatment facilities. Success requires solutions developed within communities, strong community interest and engagement, leadership, and sustainable funding. CONCLUSION Community-based addictions programs are appropriate alternatives to treatment at distant residential addictions facilities. The key components of success appear to be strong leadership in this area; strong community-member engagement; funding for programming and organizing; and the ability to develop infrastructure for long-term program sustainability. Programs require increased documentation of their inroads in this developing field. PMID:18625824

Healing the community to heal the individual: literature review of aboriginal community-based alcohol and substance abuse programs.

PubMed

Jiwa, Ashifa; Kelly, Len; Pierre-Hansen, Natalie

2008-07-01

To understand the development of culturally based and community-based alcohol and substance abuse treatment programs for aboriginal patients in an international context. MEDLINE, HealthSTAR, and PsycINFO databases and government documents were searched from 1975 to 2007. MeSH headings included the following: Indians, North American, Pacific ancestry group, aboriginal, substance-related disorders, alcoholism, addictive behaviour, community health service, and indigenous health. The search produced 150 articles, 34 of which were relevant; most of the literature comprised opinion pieces and program descriptions (level III evidence). Substance abuse in some aboriginal communities is a complex problem requiring culturally appropriate, multidimensional approaches. One promising perspective supports community-based programs or community mobile treatment. These programs ideally cover prevention, harm reduction, treatment, and aftercare. They often eliminate the need for people to leave their remote communities. They become focuses of community development, as the communities become the treatment facilities. Success requires solutions developed within communities, strong community interest and engagement, leadership, and sustainable funding. Community-based addictions programs are appropriate alternatives to treatment at distant residential addictions facilities. The key components of success appear to be strong leadership in this area; strong community-member engagement; funding for programming and organizing; and the ability to develop infrastructure for longterm program sustainability. Programs require increased documentation of their inroads in this developing field.

Dosimetric and clinical experience in eye proton treatment at INFN-LNS

NASA Astrophysics Data System (ADS)

Cirrone, G. A. P.; Cuttone, G.; Di Rosa, F.; Lojacono, P.; Mongelli, V.; Lo Nigro, S.; Ott, J.; Patti, I. V.; Pittera, S.; Privitera, G.; Raffaele, L.; Reibaldi, A.; Russo, G.; Salamone, V.; Sabini, M. G.; Spatola, C.; Valastro, L. M.

2009-05-01

After six years of activity 155 patients have been treated inside the CATANA (Centro di AdroTerapia ed Applicazioni Nucleari Avanzate) facility. CATANA is the first and unique proton therapy facility in which the 62 MeV proton beams, accelerated by a Superconducting Cyclotron, are used for the radio-therapeutic treatments of choroidal and iris melanomas. Inside CATANA new absolute and relative dosimetric techniques have been developed in order to achieve the best results in terms of treatment precision and dose release accuracy. The follow-up results for 42 patients demonstrated the efficacy of high energy protons in the radiotherapeutic field and encouraged us in our activity in the battle against cancer

An overview of the space medicine program and development of the Health Maintenance Facility for Space Station

NASA Technical Reports Server (NTRS)

Pool, Sam Lee

1988-01-01

Because the prolonged stay on board the Space Station will increase the risk of possible inflight medical problems from that on Skylab missions, the Health Maintenance Facility (HMF) planned for the Space Station is much more sophisticated than the small clinics of the Skylab missions. The development of the HMF is directed by the consideration of three primary factors: prevention, diagnosis, and treatment of injuries and illnesses that may occur in flight. The major components of the HMF include the clinical laboratory, pharmacy, imaging system, critical-care system, patient-restraint system, data-management system, exercise system, surgical system, electrophysiologic-monitoring system, introvenous-fluid system, dental system, and hyperbaric-treatment-support system.

Department of Energy Technology Readiness Assessments - Process Guide and Training Plan

DTIC Science & Technology

2008-09-12

Hanford Waste Treatment and Immobilization Plant ( WTP ) Analytical Laboratory, Low Activity Waste (LAW) Facility and Balance of Facilities (3 TRAs... WTP High-Level Waste (HLW) Facility – WTP Pre-Treatment (PT) Facility – Hanford River Protection Project Low Activity Waste Treatment Alternatives

76 FR 41154 - Review and Approval of Projects

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-13

... development project to an out-of-basin treatment or disposal facility; insert language authorizing ``renewal... formations that may be the subject of natural gas development using hydrofracture stimulation and replace with a generic category-- ``unconventional natural gas development;'' broaden the scope of ABRs issued...

Westinghouse Cementation Facility of Solid Waste Treatment System - 13503

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

Jacobs, Torsten; Aign, Joerg

2013-07-01

During NPP operation, several waste streams are generated, caused by different technical and physical processes. Besides others, liquid waste represents one of the major types of waste. Depending on national regulation for storage and disposal of radioactive waste, solidification can be one specific requirement. To accommodate the global request for waste treatment systems Westinghouse developed several specific treatment processes for the different types of waste. In the period of 2006 to 2008 Westinghouse awarded several contracts for the design and delivery of waste treatment systems related to the latest CPR-1000 nuclear power plants. One of these contracts contains the deliverymore » of four Cementation Facilities for waste treatment, s.c. 'Follow on Cementations' dedicated to three locations, HongYanHe, NingDe and YangJiang, of new CPR-1000 nuclear power stations in the People's Republic of China. Previously, Westinghouse delivered a similar cementation facility to the CPR-1000 plant LingAo II, in Daya Bay, PR China. This plant already passed the hot functioning tests successfully in June 2012 and is now ready and released for regular operation. The 'Follow on plants' are designed to package three 'typical' kind of radioactive waste: evaporator concentrates, spent resins and filter cartridges. The purpose of this paper is to provide an overview on the Westinghouse experience to design and execution of cementation facilities. (authors)« less

Optimal capacity design of LID facility for conserving natural water cycle and its sensitivity analysis

NASA Astrophysics Data System (ADS)

Lee, O.; Choi, J.; Lee, J.; Kim, S.

2017-12-01

Since the 20th century, urbanization has resulted in increased impermeable land surface and reduced infiltration capacity in catchment scale. Especially, when agriculture area or forest area would be developed into urban area, it can cause more runoff in the same climate condition. Such urbanization causes problems such as changes in hydrological cycle and ecosystem disturbance. Various methods have been proposed worldwide to reduce the impact of such urbanization. Among the various strategies, the low-impact development is a development strategy that aims to return to pre-development state by minimizing the change of the hydrological cycle due to urbanization. In this strategy, the infiltration and/or surface storage of stormwater runoff can be increased through the installation of various facilities. In this study, a facility capacity design strategy is proposed to return into the natural water cycle through the installation of various LID facilities. This is accomplished by determining the optimal LID facility design capacity through which flow duration curves remain the same before and after urban development. For this purpose, EPA-SWMM is constructed with a part of Busan Metropolitan City Noksan Industrial Complex as a virtual processing area. Under the various land-use scenarios, the optimum design capacity of various LID facilities capable of retaining the flow duration curve before and after development is determined. In addition, the sensitivity of the optimal design capacity of LID facilities is analyzed according to the design specifications of various LID facilities, the local rainfall characteristics, and the size of the treatment area. Acknowledgement This research was supported by a grant (2016000200002) from Public Welfare Technology Development Program funded by Ministry of Environment of Korean government.

24 CFR 576.65 - Recordkeeping.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY FACILITIES EMERGENCY SHELTER GRANTS PROGRAM: STEWART B. McKINNEY HOMELESS ASSISTANCE ACT... ensure confidentiality of records pertaining to the provision of family violence prevention or treatment...

24 CFR 576.65 - Recordkeeping.

Code of Federal Regulations, 2011 CFR

2011-04-01

... ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY FACILITIES EMERGENCY SHELTER GRANTS PROGRAM: STEWART B. McKINNEY HOMELESS ASSISTANCE ACT Grant... confidentiality of records pertaining to the provision of family violence prevention or treatment services with...

Hazardous air pollutant (HAP) emission characterization of sewage treatment facilities in Korea.

PubMed

Kang, Kyoung-Hee; Dong, Jong-In

2010-04-01

Until recently, nearly all sewage treatment-related regulations and researches have focused on the removal of the conventional and toxic pollutants from liquid effluents. The discharge of toxic compounds to the atmosphere has been implicitly regarded as a way of removal or destruction. During sewage treatment, the fate mechanism of volatilization/stripping, sorption and biotransformation primarily determines the fate of volatile HAPs. The objectives of this study are to investigate the emission characteristics of HAPs, which are generated from the liquid surface of sewage treatment facilities, by using an emission isolation flux chamber. HAP emissions increased at the inlet of the aerobic chamber during summer due to the relatively high atmospheric temperature. The percent ratio of flux for toluene reached its peak in winter, accounting for 33.6-34.2% of the total, but decreased to 25.1-28.6% in summer. In autumn, trichloroethene (TCE) was the highest, recording 17.6-18.1%, with chloroform and toluene showing similar levels. It seems that the ratio of chlorinated hydrocarbons increases in both summer and autumn because the chamber temperature during that time is higher than winter. This study is the initial study to investigate the emission characteristics of volatile HAPs emitted from domestic sewage treatment facilities to the air in Korea. Therefore, the isolation flux chamber will be used as an emission estimations tool to measure HAPs from sewage treatment facilities and may be applied to develop the emission factor and national source inventory of HAPs.

N-nitrosodimethylamine (NDMA) removal by reverse osmosis and UV treatment and analysis via LC-MS/MS.

PubMed

Plumlee, Megan H; López-Mesas, Montserrat; Heidlberger, Andy; Ishida, Kenneth P; Reinhard, Martin

2008-01-01

N-nitrosodimethylamine (NDMA) is a probable human carcinogen found in ng/l concentrations in chlorinated and chloraminated water. A method was developed for the determination of ng/l levels of NDMA using liquid chromatography-tandem mass spectrometry (LC-MS/MS) preceded by sample concentration via solid-phase extraction with activated charcoal. Recoveries were greater than 90% and allowed a method reporting limit as low as 2ng/l. Using this method, the removal of NDMA was determined for the Interim Water Purification Facility (IWPF), an advanced wastewater treatment facility operated by the Orange County Water District (OCWD) in Southern California. The facility treats effluent from an activated sludge treatment plant with microfiltration (MF), reverse osmosis (RO), and an ultraviolet-hydrogen peroxide advanced oxidation process (UV-AOP). Six nitrosamines were surveyed: NDMA, N-nitrosomethylethylamine (NMEA), N-nitrosodiethylamine (NDEA), N-nitrosodi-n-propylamine (NDPA), N-nitrosopiperidine (NPip), and N-nitrosopyrrolidine (NPyr). Only NDMA was detected and at all treatment steps in the IWPF, with influent concentrations ranging from 20 to 59 ng/l. Removals for RO and UV ranged from 24% to 56% and 43% to 66%, respectively. Overall, 69+/-7% of the original NDMA concentration was removed from the product water across the advanced treatment process and, in combination with blending, the final concentration did not exceed the California drinking water notification level of 10 ng/l. NDMA removal data are consistent with findings reviewed for other advanced treatment facilities and laboratory studies.

NATIONAL SCREENING SURVEY OF EDCS IN MUNICIPAL WASTEWATER TREATMENT FACILITIES

EPA Science Inventory

In 2002 and 2003 the USEPA's Office of Research and Development asked Regional EPA inspectors, state EPA inspectors and municipal plant operators to collect four gallons effluent, either as a grab or composite sample, from up to 50 wastewater treatment plants (WWTP), and ship the...

Marketing Residential Treatment Programs for Eating Disorders: A Call for Transparency.

PubMed

Attia, Evelyn; Blackwood, Kristy L; Guarda, Angela S; Marcus, Marsha D; Rothman, David J

2016-06-01

Residential behavioral treatment is a growing sector of the health care industry and is used by a large proportion of adolescent and adult patients with eating disorders. These programs and the organizations that own them have developed extensive marketing strategies that target clinicians and include promotional gifts, meals, travel reimbursement, and continuing education credit. Legislation and policy changes have limited these types of activities when conducted by the pharmaceutical industry, and awareness of conflicts of interest associated with clinician-targeted advertising of drugs and devices has increased. However, similar practices by the behavioral health care industry have evolved without oversight. The authors urge clinicians to consider how marketing strategies by treatment facilities may influence their referral behaviors and call for improved transparency regarding gifts and payments from treatment facilities.

76 FR 57642 - TRICARE: Unfortunate Sequelae From Noncovered Services in a Military Treatment Facility

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-16

... TRICARE: Unfortunate Sequelae From Noncovered Services in a Military Treatment Facility AGENCY: Office of... treatment of complications (unfortunate sequelae) resulting from a noncovered incident of treatment provided in a Military Treatment Facility (MTF), when the initial noncovered service has been authorized by...

Solid waste management complex site development plan

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

Greager, T.M.

1994-09-30

The main purpose of this Solid Waste Management Complex Site Development Plan is to optimize the location of future solid waste treatment and storage facilities and the infrastructure required to support them. An overall site plan is recommended. Further, a series of layouts are included that depict site conditions as facilities are constructed at the SWMC site. In this respect the report serves not only as the siting basis for future projects, but provides siting guidance for Project W-112, as well. The plan is intended to function as a template for expected growth of the site over the next 30more » years so that future facilities and infrastructure will be properly integrated.« less

24 CFR 576.56 - Homeless assistance and participation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY FACILITIES EMERGENCY SHELTER GRANTS PROGRAM: STEWART B. McKINNEY... violence prevention or treatment services with assistance under this part are set forth in 42 U.S.C. 11375...

A Movable Combined Water Treatment Facility for Rainwater Harvesting

NASA Astrophysics Data System (ADS)

Zhang, L.; Liao, L.

2003-12-01

Alarming water shortage and increased water scarcity world wide has led to increased interests in alternative water sources. Rainwater harvesting is one of them which is getting more and more attention. There is a huge potential for generalization and extension of rainwater harvesting system as an alternative water supply. This is especially important for arid and semi-arid regions where the water shortage blocks further social, economical development. Earlier laboratory experiments and field study showed that harvested rainwater requires treatments of different degrees in order to meet the WHO drinking water standards. The main focus of this study is to ascertain the quality of stored rainwater for drinking purposes with emphasis on water disinfection and pollutants removal. A movable, low-cost, fully functional small scale treatment facility is proposed and tested under simulated field condition. A number of actual and potential hazardous pollutants were identified in the collected water samples together with laboratory test. The corresponding water purification procedure and fresh-keeping methods are discussed. The final proposal of this movable facility needs to be further examined to achieve optimal combined treatment efficiency.

Jointly optimizing selection of fuel treatments and siting of forest biomass-based energy production facilities for landscape-scale fire hazard reduction.

Treesearch

Peter J. Daugherty; Jeremy S. Fried

2007-01-01

Landscape-scale fuel treatments for forest fire hazard reduction potentially produce large quantities of material suitable for biomass energy production. The analytic framework FIA BioSum addresses this situation by developing detailed data on forest conditions and production under alternative fuel treatment prescriptions, and computes haul costs to alternative sites...

Draft Site Treatment Plan (DSTP), Volumes I and II

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

D`Amelio, J.

1994-08-30

Site Treatment Plans (STP) are required for facilities at which the DOE generates or stores mixed waste. This Draft Site Treatment Plan (DSTP) the second step in a three-phase process, identifies the currently preferred options for treating mixed waste at the Savannah River Site (SRS) or for developing treatment technologies where technologies do not exist or need modification. The DSTP reflects site-specific preferred options, developed with the state`s input and based on existing available information. To the extent possible, the DSTP identifies specific treatment facilities for treating the mixed waste and proposes schedules. Where the selection of specific treatment facilitiesmore » is not possible, schedules for alternative activities such as waste characterization and technology assessment are provided. All schedule and cost information presented is preliminary and is subject to change. The DSTP is comprised of two volumes: this Compliance Plan Volume and the Background Volume. This Compliance Plan Volume proposes overall schedules with target dates for achieving compliance with the land disposal restrictions (LDR) of RCRA and procedures for converting the target dates into milestones to be enforced under the Order. The more detailed discussion of the options contained in the Background Volume is provided for informational purposes only.« less

76 FR 60390 - Irradiation Treatment; Location of Facilities in the Southern United States

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

... [Docket No. APHIS-2009-0100] RIN 0579-AD35 Irradiation Treatment; Location of Facilities in the Southern... irradiation treatment facilities in the Southern States of the United States. This action would allow irradiation facilities to be located anywhere in these States, subject to approval, rather than only in the...

Evaluation of outcomes of tuberculosis management in private for profit and private-not-for profit directly observed treatment short course facilities in Lagos State, Nigeria.

PubMed

Adejumo, Olusola Adedeji; Daniel, Olusoji James; Otesanya, Andrew Folarin; Salisu-Olatunj, Shukrat Olajumoke; Abdur-Razzaq, Husseine A

2017-01-01

The engagement of private practitioners in the public-private mix of tuberculosis (TB) management started in 2007 in Lagos State Nigeria. This study compared the treatment outcomes of patients managed at private for profit (PFP) and private not for profit (PNFP) directly observed treatment short course (DOTS) facilities. A retrospective review of treatment cards of TB patients managed between January 1, 2012, and June 30, 2012, in seven PFP and four PNFP DOTS facilities that served as treatment and microscopy center under the Lagos State TB and Leprosy Control Programme (LSTBLCP) at least 2 years before data collection was conducted. A total of 372 treatment cards of TB patients were reviewed, of which 132 (35.5%) and 240 (64.5%) were from PFP and PNFP DOTS facilities, respectively. Treatment success rate was higher among patients managed at PFP (89.4%) DOTS facilities than PNFP (81.3%) DOTS facilities ( P = 0.04). The proportion of patients lost to follow-up (12.5% vs. 8.3%), dead (3.3% vs. 1.5%) and treatment failure (2.5% vs. 0.8%) was higher among patients managed at PNFP DOTS facilities ( P > 0.05). The odds that patients treated at PFP DOTS facilities had treatment success were about four times higher than PNFP DOTS facilities when other variables have been controlled for ( P < 0.05). There is need by the LSTBLCP to engage more private practitioners to increase case detection and improve treatment outcomes of TB patients.

Modelling the energy costs of the wastewater treatment process: The influence of the aging factor.

PubMed

Castellet-Viciano, Lledó; Hernández-Chover, Vicent; Hernández-Sancho, Francesc

2018-06-01

Wastewater treatment plants (WWTPs) are aging and its effects on the process are more evident as time goes by. Due to the deterioration of the facilities, the efficiency of the treatment process decreases gradually. Within this framework, this paper proves the increase in the energy consumption of the WWTPs with time, and finds differences among facilities size. Accordingly, the paper aims to develop a dynamic energy cost function capable of predicting the energy cost of the process in the future. The time variable is used to introduce the aging effects on the energy cost estimation in order to increase the accuracy of the estimation. For this purpose, the evolution of energy costs will be assessed and modelled for a group of WWTPs using the methodology of cost functions. The results will be useful for the managers of the facilities in the decision making process. Copyright © 2017 Elsevier B.V. All rights reserved.

Design study of a raster scanning system for moving target irradiation in heavy-ion radiotherapy.

PubMed

Furukawa, Takuji; Inaniwa, Taku; Sato, Shinji; Tomitani, Takehiro; Minohara, Shinichi; Noda, Koji; Kanai, Tatsuaki

2007-03-01

A project to construct a new treatment facility as an extension of the existing heavy-ion medical accelerator in chiba (HIMAC) facility has been initiated for further development of carbon-ion therapy. The greatest challenge of this project is to realize treatment of a moving target by scanning irradiation. For this purpose, we decided to combine the rescanning technique and the gated irradiation method. To determine how to avoid hot and/or cold spots by the relatively large number of rescannings within an acceptable irradiation time, we have studied the scanning strategy, scanning magnets and their control, and beam intensity dynamic control. We have designed a raster scanning system and carried out a simulation of irradiating moving targets. The result shows the possibility of practical realization of moving target irradiation with pencil beam scanning. We describe the present status of our design study of the raster scanning system for the HIMAC new treatment facility.

Conceptual Site Treatment Plan Laboratory for Energy-Related Health Research Environmental Restoration Project

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

Chapman, T.E.

1993-10-01

The Federal Facilities Compliance Act (the Act) of 1992 waives sovereign immunity for federal facilities for fines and penalties under the provisions of the Resource Recovery and Conservation Act, state, interstate, and local hazardous and solid waste management requirements. However, for three years the Act delays the waiver for violations involving US Department of Energy (DOE) facilities. The Act, however, requires that the DOE prepare a Conceptual Site Treatment Plan (CSTP) for each of its sites that generate or store mixed wastes (MWs). The purpose of the CSTP is to present DOE`s preliminary evaluations of the development of treatment capacitiesmore » and technologies for treating a site`s MW. This CSTP presents the preliminary capacity and technology evaluation for the Laboratory for Energy-Related Health Research (LEHR). The five identified MW streams at LEHR are evaluated to the extent possible given available information. Only one MW stream is sufficiently well defined to permit a technology evaluation to be performed. Two other MW streams are in the process of being characterized so that an evaluation can be performed. The other two MW streams will be generated by the decommissioning of inactive facilities onsite within the next five years.« less

Mental health issues in Australian nursing homes.

PubMed

Lie, David

2003-07-01

Mental illness is common, under detected and often poorly managed in residential aged care facilities. These concerns have achieved greater prominence as the worldwide population ages. Over 80% of people in nursing home care fulfill criteria for one or more psychiatric disorders in an environment that often presents significant difficulties for assessment and treatment. This article aims to provide an overview of the important mental health issues involved in providing medical care for patients with behavioural and psychological problems in residential aged care facilities. Recent developments in education and training, service development and assessment and treatment strategies show some promise of improving the outcome for aged care residents with mental health problems. This is of especial relevance for primary care physicians who continue to provide the bulk of medical care for this population.

Emissions model of waste treatment operations at the Idaho Chemical Processing Plant

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

Schindler, R.E.

1995-03-01

An integrated model of the waste treatment systems at the Idaho Chemical Processing Plant (ICPP) was developed using a commercially-available process simulation software (ASPEN Plus) to calculate atmospheric emissions of hazardous chemicals for use in an application for an environmental permit to operate (PTO). The processes covered by the model are the Process Equipment Waste evaporator, High Level Liquid Waste evaporator, New Waste Calcining Facility and Liquid Effluent Treatment and Disposal facility. The processes are described along with the model and its assumptions. The model calculates emissions of NO{sub x}, CO, volatile acids, hazardous metals, and organic chemicals. Some calculatedmore » relative emissions are summarized and insights on building simulations are discussed.« less

[The development of the system of medical rehabilitation based at the Russian health resort facilities: investment prospects].

PubMed

Povazhnaya, E L; Gusakova, E V; Moiseenko, S V

2018-05-21

The present work is devoted to the prospects for attracting investments for the maintenance and development of the medical rehabilitation practices based at the Russian health resort facilities. The article describes the prerequisites for the enhancement of the investment attractiveness of the development of the system of medical rehabilitation in the said institutions including the formulation and strengthening of the legal and regulatory framework, the capacity for the organization of the second and third stages of medical rehabilitation in the existing spa and health resort facilities, the attraction of the funds of compulsory medical insurance as an additional source of the financial support. The main legal documents regulating the organization and provision of medical rehabilitation based at the spa and health resort facilities are presented. The results of the implementation of the investment concept of the development of medical rehabilitation in the framework of the system of health resort treatment as exemplified by the experience of JSC «The group of companies «Medsi» are discussed. It is shown that the development of medical rehabilitation based at the spa and health resort facilities greatly contributes to the significant expansion of the potential customer base and promotes the further growth of business scale.

Perceptions of Organizational Functioning in Substance Abuse Treatment Facilities in South Africa

ERIC Educational Resources Information Center

Bowles, Steven; Louw, Johann; Myers, Bronwyn

2011-01-01

Directors' and treatment staff's perceptions of organizational functioning within substance abuse treatment facilities in four provinces in South Africa were examined via the Texas Christian University's Organizational Readiness for Change instrument. Forty-four treatment facilities (out of 89) participated in the study. Results indicated that…

NPDES Permit for Riverview Estates Wastewater Treatment Facility in North Dakota

EPA Pesticide Factsheets

Under National Pollutant Discharge Elimination System permit number ND-0031143, the Riverview Estates Wastewater Treatment Facility is authorized to discharge from its wastewater treatment facility in designated locations as described in the permit.

Rates of trauma-informed counseling at substance abuse treatment facilities: reports from over 10,000 programs.

PubMed

Capezza, Nicole M; Najavits, Lisa M

2012-04-01

Trauma-informed treatment increasingly is recognized as an important component of service delivery. This study examined differences in treatment-related characteristics of facilities that offer moderate or high levels of trauma-informed counseling versus those that offer no or low levels of such counseling. Responses from 13,223 substance abuse treatment facilities surveyed in 2009 by the National Survey of Substance Abuse Treatment Services (NSSATS) were used. A majority (66.6%) of facilities reported using trauma counseling sometimes or always or often. Facilities that provided moderate or high levels of trauma counseling were more likely to provide additional treatment services, such as disease testing and specialized group therapy, as well as child care, employment counseling, and other ancillary services. A majority of facilities reported provision of trauma counseling. Additional training and resources may be needed for programs that reported low rates of trauma counseling.

Differences between U.S. substance abuse treatment facilities that do and do not offer domestic violence services.

PubMed

Cohn, Amy; Najavits, Lisa M

2014-04-01

Victimization by and perpetration of domestic violence are associated with co-occurring mental and substance use disorders. This study used data from the National Survey of Substance Abuse Treatment Services to examine differences in organizational factors, treatment approaches offered, and client-level factors among 13,342 substance abuse treatment facilities by whether or not they offered domestic violence services. Only 36% of the facilities offered domestic violence services. Those that offered such services were more likely than those that did not to treat clients with co-occurring disorders. Principal-components analysis reduced eight treatment approaches to two factors: psychosocial services and traditional substance abuse services. Regression models indicated that the frequency with which psychosocial services were offered depended on the percentage of clients with co-occurring disorders who were being treated in the facility and whether or not that facility offered domestic violence services. Specifically, facilities that did not offer domestic violence services and that had a high percentage of clients with co-occurring disorders were more likely to offer psychosocial services than facilities that offered domestic violence services. A larger proportion of facilities offering domestic violence services offered traditional substance abuse treatment services, compared with facilities not offering domestic violence services, but this relationship was not contingent on the percentage of clients with co-occurring disorders at each facility. Improved efforts should be made to tailor treatments to accommodate the links between domestic violence, mental disorders, and substance abuse.

A brief, standardized tool for measuring HIV-related stigma among health facility staff: results of field testing in China, Dominica, Egypt, Kenya, Puerto Rico and St. Christopher & Nevis.

PubMed

Nyblade, Laura; Jain, Aparna; Benkirane, Manal; Li, Li; Lohiniva, Anna-Leena; McLean, Roger; Turan, Janet M; Varas-Díaz, Nelson; Cintrón-Bou, Francheska; Guan, Jihui; Kwena, Zachary; Thomas, Wendell

2013-11-13

Within healthcare settings, HIV-related stigma is a recognized barrier to access of HIV prevention and treatment services and yet, few efforts have been made to scale-up stigma reduction programs in service delivery. This is in part due to the lack of a brief, simple, standardized tool for measuring stigma among all levels of health facility staff that works across diverse HIV prevalence, language and healthcare settings. In response, an international consortium led by the Health Policy Project, has developed and field tested a stigma measurement tool for use with health facility staff. Experts participated in a content-development workshop to review an item pool of existing measures, identify gaps and prioritize questions. The resulting questionnaire was field tested in six diverse sites (China, Dominica, Egypt, Kenya, Puerto Rico and St. Christopher & Nevis). Respondents included clinical and non-clinical staff. Questionnaires were self- or interviewer-administered. Analysis of item performance across sites examined both psychometric properties and contextual issues. The key outcome of the process was a substantially reduced questionnaire. Eighteen core questions measure three programmatically actionable drivers of stigma within health facilities (worry about HIV transmission, attitudes towards people living with HIV (PLHIV), and health facility environment, including policies), and enacted stigma. The questionnaire also includes one short scale for attitudes towards PLHIV (5-item scale, α=0.78). Stigma-reduction programmes in healthcare facilities are urgently needed to improve the quality of care provided, uphold the human right to healthcare, increase access to health services, and maximize investments in HIV prevention and treatment. This brief, standardized tool will facilitate inclusion of stigma measurement in research studies and in routine facility data collection, allowing for the monitoring of stigma within healthcare facilities and evaluation of stigma-reduction programmes. There is potential for wide use of the tool either as a stand-alone survey or integrated within other studies of health facility staff.

History of the development of radiotherapy in Latin America.

PubMed

Pinillos, Luis; Pinto, Joseph A; Sarria, Gustavo

2017-01-01

Radiotherapy was the first nonsurgical treatment for malignant tumours and represents one of the oldest disciplines of oncology. In Latin America, as in many parts of the world, the history of modern oncology begins with the implementation of radiation therapy facilities. The development of radiotherapy in Latin America was possible thanks to the seminal work of radiation oncologists in different countries. As a large territory, there is a need to implement modern facilities and equipment, but unfortunately there are disparities in the access and quality of radiotherapy services across Latin America and even within individual countries. In this review, we describe the history, challenges and success in the implementation of radiotherapy and the frustration caused by the lack of facilities in several Latin American countries.

Current Capabilities and Capacity of Ebola Treatment Centers in the United States.

PubMed

Herstein, Jocelyn J; Biddinger, Paul D; Kraft, Colleen S; Saiman, Lisa; Gibbs, Shawn G; Le, Aurora B; Smith, Philip W; Hewlett, Angela L; Lowe, John J

2016-03-01

To describe current Ebola treatment center (ETC) locations, their capacity to care for Ebola virus disease patients, and infection control infrastructure features. A 19-question survey was distributed electronically in April 2015. Responses were collected via email by June 2015 and analyzed in an electronic spreadsheet. The survey was sent to and completed by site representatives of each ETC. The survey was sent to all 55 ETCs; 47 (85%) responded. Of the 47 responding ETCs, there are 84 isolation beds available for adults and 91 for children; of these pediatric beds, 35 (38%) are in children's hospitals. In total, the simultaneous capacity of the 47 reporting ETCs is 121 beds. On the basis of the current US census, there are 0.38 beds per million population. Most ETCs have negative pressure isolation rooms, anterooms, and a process for category A waste sterilization, although only 11 facilities (23%) have the capability to sterilize infectious waste on site. Facilities developed ETCs on the basis of Centers for Disease Control and Prevention guidance, but specific capabilities are not mandated at this present time. Owing to the complex and costly nature of Ebola virus disease treatment and variability in capabilities from facility to facility, in conjunction with the lack of regulations, nationwide capacity in specialized facilities is limited. Further assessments should determine whether ETCs can adapt to safely manage other highly infectious disease threats.

Comparing the Costs of Military Treatment Facilities with Private Sector Care

DTIC Science & Technology

2016-02-01

Log: H 15-000527 Comparing the Costs of Military Treatment Facilities with Private Sector Care Philip M. Lurie INSTITUTE FOR DEFENSE ANALYSES 4850 Mark...other national challenges. Comparing the Costs of Military Treatment Facilities with Private Sector Care Philip M. Lurie I N S T I T U T E F O R D...members. The latter benefit, known as TRICARE, serves 9.5 million beneficiaries worldwide, and consists of care in Military Treatment Facilities (MTFs

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.

Guidelines to Career Development for Wastewater Treatment Plant Personnel.

ERIC Educational Resources Information Center

Environmental Protection Agency, Washington, DC. Office of Education and Manpower Planning.

The guidelines were written to promote job growth and improvement in the personnel who manage, operate, and maintain wastewater treatment plants. Trained operators and technicians are the key components in any water pollution control facility. The approach is to move from employment to training through specific modules for 21 standard job…

Gender Comparison in Referrals and Treatment Completion to Residential and Outpatient Alcohol Treatment.

PubMed

Bazargan-Hejazi, Shahrzad; De Lucia, Valory; Pan, Deyu; Mojtahedzadeh, Mona; Rahmani, Elham; Jabori, Sinan; Zahmatkesh, Golara; Bazargan, Mohsen

2016-01-01

Residential treatment for alcoholism is associated with high completion rates for clients, yet there appear to be gender disparities in patient referrals and treatment completion rates. We studied whether (A) gender is associated with differential patient placement to outpatient vs. residential treatment facilities and (B) completion rates differ by gender. In this cross-sectional study, we analyzed the admission and discharge data from 185 publicly funded substance abuse treatment facilities across Los Angeles County between 2005 and 2010. Among the 33,745 studied cases, women were referred to residential treatment facilities less frequently than men (75% vs. 66%). The adjusted results derived from logistic regression models confirmed that females were more likely to be referred to outpatient treatment than to residential treatment facilities (odds ratio [OR]: 1.15, 95% confidence interval [CI]: 1.05-1.26). In addition, we observed that compared to White/Caucasian patients, all other races were associated with more referral to outpatient facilities (ie, less referral to residential facilities), indicating a racial disparity on the top of the observed gender disparity. However, there was no significant link between gender and treatment completion rates (OR: 0.93, 95% CI: 0.86-1.00). Women seem to have treatment completion rates comparable to men, yet they are less likely to be referred to residential treatment facilities. Hence, there still remains a gender disparity in alcoholic patient referrals. Further studies should delineate which specific therapeutic aspects and programmatic components of women-focused treatments are essential to augment positive treatment outcomes.

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

ERIC Educational Resources Information Center

Myers, Bronwyn; Fakier, Nuraan

2009-01-01

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

24 CFR 960.205 - Drug use by applicants: Obtaining information from drug treatment facility.

Code of Federal Regulations, 2012 CFR

2012-04-01

.... This section addresses a PHA's authority to request and obtain information from drug abuse treatment... household member. (2) Drug abuse treatment facility. An entity: (i) That holds itself out as providing, and... consent forms signed by such household member that: (i) Requests any drug abuse treatment facility to...

24 CFR 960.205 - Drug use by applicants: Obtaining information from drug treatment facility.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... This section addresses a PHA's authority to request and obtain information from drug abuse treatment... household member. (2) Drug abuse treatment facility. An entity: (i) That holds itself out as providing, and... consent forms signed by such household member that: (i) Requests any drug abuse treatment facility to...

24 CFR 960.205 - Drug use by applicants: Obtaining information from drug treatment facility.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... This section addresses a PHA's authority to request and obtain information from drug abuse treatment... household member. (2) Drug abuse treatment facility. An entity: (i) That holds itself out as providing, and... consent forms signed by such household member that: (i) Requests any drug abuse treatment facility to...

24 CFR 960.205 - Drug use by applicants: Obtaining information from drug treatment facility.

Code of Federal Regulations, 2013 CFR

2013-04-01

.... This section addresses a PHA's authority to request and obtain information from drug abuse treatment... household member. (2) Drug abuse treatment facility. An entity: (i) That holds itself out as providing, and... consent forms signed by such household member that: (i) Requests any drug abuse treatment facility to...

24 CFR 960.205 - Drug use by applicants: Obtaining information from drug treatment facility.

Code of Federal Regulations, 2014 CFR

2014-04-01

.... This section addresses a PHA's authority to request and obtain information from drug abuse treatment... household member. (2) Drug abuse treatment facility. An entity: (i) That holds itself out as providing, and... consent forms signed by such household member that: (i) Requests any drug abuse treatment facility to...

State parity laws and access to treatment for substance use disorder in the United States: implications for federal parity legislation.

PubMed

Wen, Hefei; Cummings, Janet R; Hockenberry, Jason M; Gaydos, Laura M; Druss, Benjamin G

2013-12-01

The passage of the 2008 Mental Health Parity and Addiction Equity Act and the 2010 Affordable Care Act incorporated parity for substance use disorder (SUD) treatment into federal legislation. However, prior research provides us with scant evidence as to whether federal parity legislation will hold the potential for improving access to SUD treatment. To examine the effect of state-level SUD parity laws on state-aggregate SUD treatment rates and to shed light on the impact of the recent federal SUD parity legislation. We conducted a quasi-experimental study using a 2-way (state and year) fixed-effect method. We included all known specialty SUD treatment facilities in the United States and examined treatment rates from October 1, 2000, through March 31, 2008. Our main source of data was the National Survey of Substance Abuse Treatment Services, which provides facility-level information on specialty SUD treatment. State-level SUD parity laws during the study period. State-aggregate SUD treatment rates in (1) all specialty SUD treatment facilities and (2) specialty SUD treatment facilities accepting private insurance. The implementation of any SUD parity law increased the treatment rate by 9% (P < .001) in all specialty SUD treatment facilities and by 15% (P = .02) in facilities accepting private insurance. Full parity and parity only if SUD coverage is offered increased the SUD treatment rate by 13% (P = .02) and 8% (P = .04), respectively, in all facilities and by 21% (P = .03) and 10% (P = .04), respectively, in facilities accepting private insurance. We found a positive effect of the implementation of state SUD parity legislation on access to specialty SUD treatment. Furthermore, the positive association is more pronounced in states with more comprehensive parity laws. Our findings suggest that federal parity legislation holds the potential to improve access to SUD treatment.

42 CFR 483.352 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the Use of Restraint or Seclusion in Psychiatric Residential Treatment Facilities Providing Inpatient... effect of restricting the resident's freedom of movement; and (3) Is not a standard treatment for the... another. Psychiatric Residential Treatment Facility means a facility other than a hospital, that provides...

National Biomedical Tracer Facility: Project definition study

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

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

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

Challenges in implementing uncomplicated malaria treatment in children: a health facility survey in rural Malawi.

PubMed

Kabaghe, Alinune N; Phiri, Mphatso D; Phiri, Kamija S; van Vugt, Michèle

2017-10-18

Prompt and effective malaria treatment are key in reducing transmission, disease severity and mortality. With the current scale-up of artemisinin-based combination therapy (ACT) coverage, there is need to focus on challenges affecting implementation of the intervention. Routine indicators focus on utilization and coverage, neglecting implementation quality. A health system in rural Malawi was assessed for uncomplicated malaria treatment implementation in children. A cross-sectional health facility survey was conducted in six health centres around the Majete Wildlife Reserve in Chikwawa district using a health system effectiveness approach to assess uncomplicated malaria treatment implementation. Interviews with health facility personnel and exit interviews with guardians of 120 children under 5 years were conducted. Health workers appropriately prescribed an ACT and did not prescribe an ACT to 73% (95% CI 63-84%) of malaria rapid diagnostic test (RDT) positive and 98% (95% CI 96-100%) RDT negative children, respectively. However, 24% (95% CI 13-37%) of children receiving artemisinin-lumefantrine had an inappropriate dose by weight. Health facility findings included inadequate number of personnel (average: 2.1 health workers per 10,000 population), anti-malarial drug stock-outs or not supplied, and inconsistent health information records. Guardians of 59% (95% CI 51-69%) of children presented within 24 h of onset of child's symptoms. The survey presents an approach for assessing treatment effectiveness, highlighting bottlenecks which coverage indicators are incapable of detecting, and which may reduce quality and effectiveness of malaria treatment. Health service provider practices in prescribing and dosing anti-malarial drugs, due to drug stock-outs or high patient load, risk development of drug resistance, treatment failure and exposure to adverse effects.

Secondary Waste Simulant Development for Cast Stone Formulation Testing

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

Russell, Renee L.; Westsik, Joseph H.; Rinehart, Donald E.

Washington River Protection Solutions, LLC (WRPS) funded Pacific Northwest National Laboratory (PNNL) to conduct a waste form testing program to implement aspects of the Secondary Liquid Waste Treatment Cast Stone Technology Development Plan (Ashley 2012) and the Hanford Site Secondary Waste Roadmap (PNNL 2009) related to the development and qualification of Cast Stone as a potential waste form for the solidification of aqueous wastes from the Hanford Site after the aqueous wastes are treated at the Effluent Treatment Facility (ETF). The current baseline is that the resultant Cast Stone (or grout) solid waste forms would be disposed at the Integratedmore » Disposal Facility (IDF). Data and results of this testing program will be used in the upcoming performance assessment of the IDF and in the design and operation of a solidification treatment unit planned to be added to the ETF. The purpose of the work described in this report is to 1) develop simulants for the waste streams that are currently being fed and future WTP secondary waste streams also to be fed into the ETF and 2) prepare simulants to use for preparation of grout or Cast Stone solid waste forms for testing.« less

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

Cirrone, G. A. P.; Cuttone, G.; Di Rosa, F.

After six years of activity 155 patients have been treated inside the CATANA (Centro di AdroTerapia ed Applicazioni Nucleari Avanzate) facility. CATANA is the first and unique proton therapy facility in which the 62 MeV proton beams, accelerated by a Superconducting Cyclotron, are used for the radio-therapeutic treatments of choroidal and iris melanomas. Inside CATANA new absolute and relative dosimetric techniques have been developed in order to achieve the best results in terms of treatment precision and dose release accuracy. The follow-up results for 42 patients demonstrated the efficacy of high energy protons in the radiotherapeutic field and encouraged usmore » in our activity in the battle against cancer.« less

Screening and prioritization of micropollutants in wastewaters from on-site sewage treatment facilities.

PubMed

Gros, Meritxell; Blum, Kristin M; Jernstedt, Henrik; Renman, Gunno; Rodríguez-Mozaz, Sara; Haglund, Peter; Andersson, Patrik L; Wiberg, Karin; Ahrens, Lutz

2017-04-15

A comprehensive screening of micropollutants was performed in wastewaters from on-site sewage treatment facilities (OSSFs) and urban wastewater treatment plants (WWTPs) in Sweden. A suspect screening approach, using high resolution mass spectrometry, was developed and used in combination with target analysis. With this strategy, a total number of 79 micropollutants were successfully identified, which belong to the groups of per- and polyfluoroalkyl substances (PFASs), pesticides, phosphorus-containing flame retardants (PFRs) and pharmaceuticals and personal care products (PPCPs). Results from this screening indicate that concentrations of micropollutants are similar in influents and effluents of OSSFs and WWTPs, respectively. Removal efficiencies of micropollutants were assessed in the OSSFs and compared with those observed in WWTPs. In general, removal of PFASs and PFRs was higher in package treatment OSSFs, which are based on biological treatments, while removal of PPCPs was more efficient in soil bed OSSFs. A novel comprehensive prioritization strategy was then developed to identify OSSF specific chemicals of environmental relevance. The strategy was based on the compound concentrations in the wastewater, removal efficiency, frequency of detection in OSSFs and on in silico based data for toxicity, persistency and bioaccumulation potential. Copyright © 2016 Elsevier B.V. All rights reserved.

Detailed costing document for the centralized waste treatment industry

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

NONE

1998-12-01

In this document, EPA presents the costs estimated for compliance with the proposed CWT effluent limitations guidelines and standards. Section 1 provides a general description of how the individual treatment technology and regulatory option costs were developed. In Sections 2 through 4, EPA describes the development of costs for each of the wastewater and sludge treatment technologies. In Section 5, EPA presents additional compliance costs to be incurred by facilities, which are not technology specific. These additional items are retrofit costs, monitoring costs, RCRA permit modification costs, and land costs.

How to improve patient retention in an antiretroviral treatment program in Ethiopia: a mixed-methods study

PubMed Central

2014-01-01

Background Patient retention, defined as continuous engagement of patients in care, is one of the crucial indicators for monitoring and evaluating the performance of antiretroviral treatment (ART) programs. It has been identified that suboptimal patient retention in care is one of the challenges of ART programs in many settings. ART programs have, therefore, been striving hard to identify and implement interventions that improve their suboptimal levels of retention. The objective of this study was to develop a framework for improving patient retention in care based on interventions implemented in health facilities that have achieved higher levels of retention in care. Methods A mixed-methods study, based on the positive deviance approach, was conducted in Ethiopia in 2011/12. Quantitative data were collected to estimate and compare the levels of retention in care in nine health facilities. Key informant interviews and focus group discussions were conducted to identify a package of interventions implemented in the health facilities with relatively higher or improving levels of retention. Results Retention in care in the Ethiopian ART program was found to be variable across health facilities. Among hospitals, the poorest performer had 0.46 (0.35, 0.60) times less retention than the reference; among health centers, the poorest performers had 0.44 (0.28, 0.70) times less retention than the reference. Health facilities with higher and improving patient retention were found to implement a comprehensive package of interventions: (1) retention promoting activities by health facilities, (2) retention promoting activities by community-based organizations, (3) coordination of these activities by case manager(s), and (4) patient information systems by data clerk(s). On the contrary, such interventions were either poorly implemented or did not exist in health facilities with lower retention in care. A framework to improve retention in care was developed based on the evidence found by applying the positive deviance approach. Conclusion A framework for improving retention in care of patients on ART was developed. We recommend that health facilities implement the framework, monitor and evaluate their levels of retention in care, and, if necessary, adapt the framework to their own contexts. PMID:24475889

Development and operation of innovative scum to biodiesel pilot-system for the treatment of floatable wastewater scum.

PubMed

Anderson, Erik; Addy, Min; Chen, Paul; Ruan, Roger

2018-02-01

A novel process was developed for the biorefining of floatable wastewater scum and other waste oils from water treatment facilities into biodiesel and other value-added bio-products. To test the scalability and commercial potential of the technology, a 7000 l/year pilot-scale system was designed and built. Scum from a wastewater treatment facility, located in St. Paul, Mn, was collected and converted into methyl esters (biodiesel) according to the process chemistry. All of the incoming and outgoing process streams were sampled, tested, weighed and recorded to calculate both the process efficiency and product quality. Data from the pilot-scale system operation was compared to laboratory results and the theoretically expected values for each individual unit operation. The biodiesel was tested using a third party laboratory and confirmed it met all of the US EPA's test requirements for commercial-grade biodiesel. Copyright © 2017 Elsevier Ltd. All rights reserved.

Neutron medical treatment of tumours — a survey of facilities

NASA Astrophysics Data System (ADS)

Wagner, F. M.; Loeper-Kabasakal, B.; Breitkreutz, H.

2012-03-01

Neutron therapy has two branches: Fast Neutron Therapy (FNT) and Boron Neutron Capture Therapy (BNCT). The mean neutron energies used for FNT range from 2 MeV to 25 MeV whereas the maximum energy for BNCT is about 10 keV. Neutron generators for FNT have been cyclotrons, accelerators and reactors, whereas BNCT is so far bound to reactors. Both therapies use the effects of high-LET radiation (secondary recoil protons and alpha particles, respectively) and can attack otherwise radioresistant tumours, however, with the hazard of adverse effects for irradiated healthy tissue. FNT has been administered to about 30,000 patients world-wide. From formerly 40 facilities, only eight are operational or stand-by today. The reasons for this development have been, on the one hand, related to technical and economical conditions; on the other hand, strong side effects and insufficient proof of clinical results in the early years as well as increasing competition with new clinical methods have reduced patient numbers. In fact, strict observations of indications, appropriate therapy-planning including low-LET radiation, and consequent treatment of side effects have lead to remarkable results in the meantime. BNCT initially was developed for the treatment of extremely aggressive forms of brain tumour, taking advantage of the action of the blood-brain-barrier which allows for a boronated compound to be selectively enriched in tumour cells. Meanwhile, also malignant melanoma (MM) and Head-and-Neck (H&T) tumours are treated because of their relative radioresistance. At present, epithermal beams with sufficient flux are available only at two facilities. Existing research reactors were indispensable in the development of BNCT, but are to be replaced by hospital-based epithermal neutron sources. Clinical results indicate significantly increased survival times, but the number of patients ever treated is still below 1,000. 3D-dose calculation systems have been developed at several facilities and guarantee a high safety for both therapies, FNT and BNCT.

Refining the W1 and SE1 Facilities

NASA Technical Reports Server (NTRS)

Chambers, Rodney D.

2004-01-01

The Engine Research Building (ERB) houses more than 60 test rigs that study all aspects of engine development. By working with Mary Gibson in the SE1 and W1A Turbine Facilities, I became aware of her responsibilities and better acquainted with the inner workings of the ERB. The SE1 Supersonic/Subsonic Wind Tunnel Facility contains 2 small wind tunnels. The first tunnel uses an atmospheric inlet, while the second uses treated 40-psig air. Both of the tunnels are capable of subsonic and supersonic operation. An auxiliary air supply and exhaust piping providing both test sections with suction, blowing, and crossfire capabilities. The current configuration of SE1 consists of a curved diffuser that studies the blockage along the endwalls. The W1A Low Speed Compressor Facility provides insight for the complex flow phenomena within its 4-stage axial compressor, sand the data obtained from W 1A is used to develop advanced models for fluid dynamic assessment. W1A is based off of a low speed research compressor developed by GE in the 1950's. This compressor has a removable casing treatment under rotor 1, which allows for various tip treatment studies. The increased size and low speed allows instrumentation to be located in the compressor s complex flow paths. Air enters the facility through a filtered roof vent, conditioned for temperature and turbulence, and then passed through the compressor W1A is described as a dynamic facility with many projects taking place simultaneously. This current environment makes it challenging to follow the various affairs that are taking place within the area. During my first 4 weeks at the NASA Glenn Research Center, I have assisted Mary Gibson in multiple tasks such as facility documents, record keeping, maintenance and upgrades. The facility has lube systems for its gearbox and compressor. These systems are critical in the successful operation of the facility. I was assigned the task of creating a facility estimate list, which included the filters and strainers required for the compressor. For my remaining time spent here, we expect to complete a facility parts listing and a virtual project summary so that W1A and SE1 will become ergonomic facilities that will make it easier for people to observe the capabilities and history of the area and the employees that operate. Bolstering our efforts in achieving these goal are the online technical tutorials, software such as Microsoft Excel. Macromedia Flash MX Macromedia Dreamweaver MX, Photoshop 6.0 and the assistance of several NASA employees.

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

PubMed

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

2011-08-01

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

Factors affecting the availability and use of hemodialysis facilities.

PubMed

Cleary, P D; Schlesinger, M; Blumenthal, D

1991-01-01

This article describes factors related to the geographic distribution of hemodialysis facilities and the relationship between availability and use. Such facilities tend to be concentrated in the same types of areas as other medical resources, and the number of medical specialists in an area is related to the rate of treatment for renal diseases. The proportion of treatment stations in an area owned by for-profit organizations is not related to the total treatment rate, but the market share of for-profit facilities is positively related to in-center treatment and negatively related to home treatment.

Application of nuclear physics in medical physics and nuclear medicine

NASA Astrophysics Data System (ADS)

Hoehr, Cornelia

2016-09-01

Nuclear physics has a long history of influencing and advancing medical fields. At TRIUMF we use the applications of nuclear physics to diagnose several diseases via medical isotopes and treat cancer by using proton beams. The Life Science division has a long history of producing Positron Emission Tomography (PET) isotopes but we are also investigating the production of SPECT and PET isotopes with a potential shortage for clinical operation or otherwise limited access to chemists, biologists and medical researchers. New targets are being developed, aided by a simulation platform investigating the processes inside a target under proton irradiation - nuclear, thermodynamic, and chemical. Simulations also aid in the development of new beam-shaping devices for TRIUMF's Proton Therapy facility, Canada's only proton therapy facility, as well as new treatment testing systems. Both promise improved treatment delivery for cancer patients.

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

Mundy, D; Tryggestad, E; Beltran, C

Purpose: To develop daily and monthly quality assurance (QA) programs in support of a new spot-scanning proton treatment facility using a combination of commercial and custom equipment and software. Emphasis was placed on efficiency and evaluation of key quality parameters. Methods: The daily QA program was developed to test output, spot size and position, proton beam energy, and image guidance using the Sun Nuclear Corporation rf-DQA™3 device and Atlas QA software. The program utilizes standard Atlas linear accelerator tests repurposed for proton measurements and a custom jig for indexing the device to the treatment couch. The monthly QA program wasmore » designed to test mechanical performance, image quality, radiation quality, isocenter coincidence, and safety features. Many of these tests are similar to linear accelerator QA counterparts, but many require customized test design and equipment. Coincidence of imaging, laser marker, mechanical, and radiation isocenters, for instance, is verified using a custom film-based device devised and manufactured at our facility. Proton spot size and position as a function of energy are verified using a custom spot pattern incident on film and analysis software developed in-house. More details concerning the equipment and software developed for monthly QA are included in the supporting document. Thresholds for daily and monthly tests were established via perturbation analysis, early experience, and/or proton system specifications and associated acceptance test results. Results: The periodic QA program described here has been in effect for approximately 9 months and has proven efficient and sensitive to sub-clinical variations in treatment delivery characteristics. Conclusion: Tools and professional guidelines for periodic proton system QA are not as well developed as their photon and electron counterparts. The program described here efficiently evaluates key quality parameters and, while specific to the needs of our facility, could be readily adapted to other proton centers.« less

The Protein Crystallization Facility STS-95

NASA Technical Reports Server (NTRS)

2004-01-01

The Protein Crystallization Facility will be used to grow crystals of human insulin. Insulin is the primary treatment for diabetes, the fourth leading cause of death by disease. Research on STS-95 is aimed at producing crystals of even higher quality, which when combined with new analysis techniques will permit a better understanding of the interaction between insulin and its receptor. This has the potential to aid in the development of a new commercially available insulin product with unique time release properties that could reduce fluctuations in a patient's blood sugar level. The Protein Crystallization Facility supports large-scale commercial investigations.

40 CFR 440.14 - New source performance standards (NSPS).

Code of Federal Regulations, 2010 CFR

2010-07-01

.... (2) In the event that the annual precipitation falling on the treatment facility and the drainage area contributing surface runoff to the treatment facility exceeds the annual evaporation, a volume of water equal to the difference between annual precipitation falling on the treatment facility and the...

Development and piloting of a treatment foster care program for older youth with psychiatric problems.

PubMed

McMillen, J Curtis; Narendorf, Sarah Carter; Robinson, Debra; Havlicek, Judy; Fedoravicius, Nicole; Bertram, Julie; McNelly, David

2015-01-01

Older youth in out-of-home care often live in restrictive settings and face psychiatric issues without sufficient family support. This paper reports on the development and piloting of a manualized treatment foster care program designed to step down older youth with high psychiatric needs from residential programs to treatment foster care homes. A team of researchers and agency partners set out to develop a treatment foster care model for older youth based on Multi-dimensional Treatment Foster Care (MTFC). After matching youth by mental health condition and determining for whom randomization would be allowed, 14 youth were randomized to treatment as usual or a treatment foster home intervention. Stakeholders were interviewed qualitatively at multiple time points. Quantitative measures assessed mental health symptoms, days in locked facilities, employment and educational outcomes. Development efforts led to substantial variations from the MTFC model and a new model, Treatment Foster Care for Older Youth was piloted. Feasibility monitoring suggested that it was difficult, but possible to recruit and randomize youth from and out of residential homes and that foster parents could be recruited to serve them. Qualitative data pointed to some qualified clinical successes. Stakeholders viewed two team roles - that of psychiatric nurse and skills coaches - very highly. However, results also suggested that foster parents and some staff did not tolerate the intervention well and struggled to address the emotion dysregulation issues of the young people they served. Quantitative data demonstrated that the intervention was not keeping youth out of locked facilities. The intervention needed further refinement prior to a broader trial. Intervention development work continued until components were developed to help address emotion regulation problems among fostered youth. Psychiatric nurses and skills coaches who work with youth in community settings hold promise as important supports for older youth with psychiatric needs.

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

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

Thompson, Lisa; Lekov, Alex; McKane, Aimee

2010-08-20

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

Region 9 NPDES Facilities - Waste Water Treatment Plants

EPA Pesticide Factsheets

Point geospatial dataset representing locations of NPDES Waste Water Treatment Plant Facilities. NPDES (National Pollution Discharge Elimination System) is an EPA permit program that regulates direct discharges from facilities that discharge treated waste water into waters of the US. Facilities are issued NPDES permits regulating their discharge as required by the Clean Water Act. A facility may have one or more outfalls (dischargers). The location represents the facility or operating plant.

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 Guide for Developing Standard Operating Job Procedures for the Primary Sedimentation Process Wastewater Treatment Facility. SOJP No. 4.

ERIC Educational Resources Information Center

Charles County Community Coll., La Plata, MD.

This guide describes standard operating job procedures for the primary sedimentation process of wastewater treatment plants. The primary sedimentation process involves removing settleable and suspended solids, in part, from wastewater by gravitational forces, and scum and other floatable solids from wastewater by mechanical means. Step-by-step…

Art Therapy for Individuals with Traumatic Brain Injury: A Comprehensive Neurorehabilitation-Informed Approach to Treatment

ERIC Educational Resources Information Center

Kline, Tori

2016-01-01

I describe an approach to art therapy treatment for survivors of traumatic brain injury developed at a rehabilitation facility for adults that serves inpatient, outpatient, and long-term residential clients. This approach is based on a review of the literature on traumatic brain injury, comprehensive neurorehabilitation, brain plasticity, and art…

Waste Estimates for a Future Recycling Plant in the US Based Upon AREVA Operating Experience - 13206

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

Foare, Genevieve; Meze, Florian; Bader, Sven

2013-07-01

Estimates of process and secondary wastes produced by a recycling plant built in the U.S., which is composed of a used nuclear fuel (UNF) reprocessing facility and a mixed oxide (MOX) fuel fabrication facility, are performed as part of a U.S. Department of Energy (DOE) sponsored study [1]. In this study, a set of common inputs, assumptions, and constraints were identified to allow for comparison of these wastes between different industrial teams. AREVA produced a model of a reprocessing facility, an associated fuel fabrication facility, and waste treatment facilities to develop the results for this study. These facilities were dividedmore » into a number of discrete functional areas for which inlet and outlet flow streams were clearly identified to allow for an accurate determination of the radionuclide balance throughout the facility and the waste streams. AREVA relied primarily on its decades of experience and feedback from its La Hague (reprocessing) and MELOX (MOX fuel fabrication) commercial operating facilities in France to support this assessment. However, to perform these estimates for a U.S. facility with different regulatory requirements and to take advantage of some technological advancements, such as in the potential treatment of off-gases, some deviations from this experience were necessary. A summary of AREVA's approach and results for the recycling of 800 metric tonnes of initial heavy metal (MTIHM) of LWR UNF per year into MOX fuel under the assumptions and constraints identified for this DOE study are presented. (authors)« less

Municipal Development of Anaerobic Digestion/ Combined Heat and Power in Massachusetts

NASA Astrophysics Data System (ADS)

Pike, Brenda

With a commercial food waste ban going into effect in Massachusetts in October 2014, businesses, institutions, and municipalities are considering alternatives to landfills and incinerators for organic waste. Anaerobic digestion is one such alternative. Similar to composting, but in an environment devoid of oxygen, anaerobic digestion produces byproducts such as methane (which can be burned for heat or electricity) and liquid or solid digestate (which can be used as fertilizer, cattle bedding, and more). Thus, disposal of food waste and other organic materials can become a source of revenue rather than just an expense. Municipalities interested in developing anaerobic digestion/combined heat and power (AD/CHP) facilities have the benefit of desirable options for sites, such as landfill gas facilities and wastewater treatment plants, and potential feedstocks in source-separated residential or municipal food waste or wastewater. This thesis examines the opportunities and challenges for municipal development of AD/CHP facilities in Massachusetts.

38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

Code of Federal Regulations, 2011 CFR

2011-07-01

... other community-based treatment facilities, when considered to be medically advantageous and cost... dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. 17... rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or abuse...

40 CFR 440.42 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2010 CFR

2010-07-01

... annual precipitation falling on the treatment facility and the drainage area contributing surface runoff... difference between annual precipitation falling on the treatment facility and the drainage area contributing surface runoff to the treatment facility and annual evaporation may be discharged subject to the...

40 CFR 440.44 - New source performance standards (NSPS).

Code of Federal Regulations, 2010 CFR

2010-07-01

... December 3, 1982. (2) In the event that the annual precipitation falling on the treatment facility and the drainage area contributing surface runoff to the treatment facility exceeds the annual evaporation, a volume of water equal to the difference between annual precipitation falling on the treatment facility...

7 CFR 305.15 - Treatment requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 5 2010-01-01 2010-01-01 false Treatment requirements. 305.15 Section 305.15... SERVICE, DEPARTMENT OF AGRICULTURE PHYTOSANITARY TREATMENTS Cold Treatments § 305.15 Treatment requirements. (a) Approval of treatment facilities. All facilities or locations used for refrigerating fruits...

Multi-country analysis of treatment costs for HIV/AIDS (MATCH): facility-level ART unit cost analysis in Ethiopia, Malawi, Rwanda, South Africa and Zambia.

PubMed

Tagar, Elya; Sundaram, Maaya; Condliffe, Kate; Matatiyo, Blackson; Chimbwandira, Frank; Chilima, Ben; Mwanamanga, Robert; Moyo, Crispin; Chitah, Bona Mukosha; Nyemazi, Jean Pierre; Assefa, Yibeltal; Pillay, Yogan; Mayer, Sam; Shear, Lauren; Dain, Mary; Hurley, Raphael; Kumar, Ritu; McCarthy, Thomas; Batra, Parul; Gwinnell, Dan; Diamond, Samantha; Over, Mead

2014-01-01

Today's uncertain HIV funding landscape threatens to slow progress towards treatment goals. Understanding the costs of antiretroviral therapy (ART) will be essential for governments to make informed policy decisions about the pace of scale-up under the 2013 WHO HIV Treatment Guidelines, which increase the number of people eligible for treatment from 17.6 million to 28.6 million. The study presented here is one of the largest of its kind and the first to describe the facility-level cost of ART in a random sample of facilities in Ethiopia, Malawi, Rwanda, South Africa and Zambia. In 2010-2011, comprehensive data on one year of facility-level ART costs and patient outcomes were collected from 161 facilities, selected using stratified random sampling. Overall, facility-level ART costs were significantly lower than expected in four of the five countries, with a simple average of $208 per patient-year (ppy) across Ethiopia, Malawi, Rwanda and Zambia. Costs were higher in South Africa, at $682 ppy. This included medications, laboratory services, direct and indirect personnel, patient support, equipment and administrative services. Facilities demonstrated the ability to retain patients alive and on treatment at these costs, although outcomes for established patients (2-8% annual loss to follow-up or death) were better than outcomes for new patients in their first year of ART (77-95% alive and on treatment). This study illustrated that the facility-level costs of ART are lower than previously understood in these five countries. While limitations must be considered, and costs will vary across countries, this suggests that expanded treatment coverage may be affordable. Further research is needed to understand investment costs of treatment scale-up, non-facility costs and opportunities for more efficient resource allocation.

Analysis of factors of treatment completion in dots health facilities in metro Manila, Philippines: a case-control study.

PubMed

Lagrada, Leizel P; Uehara, Naruo; Kawahara, Kazuo

2008-12-01

STUDY BACKGROUND AND OBJECTIVES: The Philippines is one of the 22 countries with high TB burden. DOTS was adopted not only by purely public providers (PP) but also by public-private mix (PPM) facilities. This study aims to identify the patient and facility factors that promote completion of TB treatment in DOTS facilities in an urban setting. The study also explores the difference between the PP and PPM DOTS facilities in terms of case management and treatment outcomes. [Methods] A case control study was done by interviewing 394 patients sampled from TB cohort report between 2003 and 2005 of 14 DOTS facilities in Metro Manila. Statistical analyses used include chi-square test and logistic regression analysis. Being female and aged 30-44 (OR = 7.04; 95% CI 1.12-44.35), unemployed (OR = 2.73; 95% CI 1.18-6.33), being above per capita poverty threshold (OR = 2.03; 95% CI 1.03-3.99), having experienced at least one of the signs and symptoms of TB (OR = 4.64; 95% CI 1.29-16.67), taking the medication at health facility (OR = 3.87; 95% CI 1.48-10.16) and patient's understanding of DOT (OR = 2.67; 95% CI 1.37-5.23) predict TB treatment completion. Public-private mix type of DOTS facility was also significantly associated with completing treatment (chi 2 (1) = 54.76, p = 0.000). Patient factors like middle-aged female compared to female aged more than 60, being above per capita poverty threshold, unemployment and having experienced at least one signs and symptoms of TB and facility factors like providing treatment at the facility and explaining the DOT to patient increase the likelihood of completing treatment. Thus, encouraging patients to take their medication at the facility and helping the patients understand the importance of DOT can increase TB treatment completion. The seemingly better DOTS implementation and treatment outcomes by the PPM must be evaluated further through cost effectiveness and efficiency studies.

Iran seeking help in regaining prerevolution oil and gas flow

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

Tippee, B.

1996-02-19

This paper reviews the goals of the Iranian oil and gas industry to rebuild their oil and gas production facilities by using foreign investment. It discusses the historical consequences of war in the region to diminish the production and postpone the recovery of natural gas which is currently flared. It describes the major projects Iran hopes to develop through international partnerships and includes field development, pipeline construction, gas reinjection, gas treatment facilities, and new offshore operation. The paper also reviews the US policy on Iran and its attempt to apply sanctions towards this country.

Ecological Assessment of Substance-abuse Experiences (EASE): findings from a new instrument development pilot study.

PubMed

Matto, Holly C; Miller, Keith; Spera, Christopher

2005-08-01

A newly developed instrument that assesses a client's orientation to addiction or recovery communities using social context referents was pilot tested with a sample of 103 adults seeking treatment for substance abuse at outpatient and residential treatment facilities on the East Coast. Preliminary findings show promising subscale reliabilities, and suggest that drug- and recovery-related social identities are related to drug-use severity and drug-use concern; and drug-related attitudinal congruence between the treatment-seeker and family and treatment-seeker and other significant persons are related to intention to make behavioral changes in reducing substance abuse.

Summary Report of Ecological Risk Assessment for the Operation of the Explosives Waste Treatment Facility at Site 300 of the Lawrence Livermore National Laboratory.

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

Gallegos, Gretchen M.; Terusaki, Stan H.

2013-12-01

An ecological risk assessment is required as part of the Resource Recovery and Conservation Act (RCRA) permit renewal process for Miscellaneous Units subject to 22 CCR 66270.23. This risk assessment is prepared in support of the RCRA permit renewal for the Explosives Waste Treatment Facility (EWTF) at Site 300 of the Lawrence Livermore National Laboratory (LLNL). LLNL collected soil samples and used the resulting data to produce a scoping-level ecological risk assessment pursuant to the Department of Toxic Substances Control, Guidance for Ecological Risk Assessment at Hazardous Waste Sites and Permitted Facilities, Part A: Overview, July 4, 1996. The scoping-levelmore » ecological risk assessment provides a framework to determine the potential interaction between ecological receptors and chemicals of concern from hazardous waste treatment operations in the area of EWTF. A scoping-level ecological risk assessment includes the step of conducting soil sampling in the area of the treatment units. The Sampling Plan in Support of the Human Health and Ecological Risk Assessment for the Operation of the Explosives Waste Treatment Facility at Site 300 of the Lawrence Livermore National Laboratory, (Terusaki, 2007), outlines the EWTF project-specific soil sampling requirements. Soil samples were obtained and analyzed for constituents from four chemical groups: furans, explosives, semi-volatiles and metals. Analytical results showed that furans, explosives and semi-volatiles were not detected; therefore, no further analysis was conducted. The soil samples did show the presence of metals. Soil samples analyzed for metals were compared to site-wide background levels, which had been developed for site -wide cleanup activities pursuant to the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA). Total metal concentrations from 28 discrete soil samples obtained in the EWTF area were all below CERCLA-developed background levels. Therefore, following DTSC 1996 guidance, the EWTF hazardous waste treatment units exit the ecological risk evaluation process upon completion of the requirements of a scoping-level assessment report. This summary report documents that the requirements of a scoping-level assessment have been met.« less

Health worker perspectives on the possible use of intramuscular artesunate for the treatment of severe malaria at lower-level health facilities in settings with poor access to referral facilities in Nigeria: a qualitative study.

PubMed

Adesoro, Olatunde; Shumba, Constance; Kpamor, John; Achan, Jane; Kivumbi, Harriet; Dada, John; Maxwell, Kolawole; Tibenderana, James; Marasciulo, Madeline; Hamade, Prudence; Oresanya, Olusola; Nankabirwa, Joanita; Baba, Ebenezer

2016-10-12

Innovative strategies are needed to reduce malaria mortality in high burden countries like Nigeria. Given that one of the important reasons for this high malaria mortality is delay in receiving effective treatment, improved access to such treatment is critical. Intramuscular artesunate could be used at lower-level facilities given its proven efficacy, ease of use and excellent safety profile. The objective of this study was therefore to explore health workers' perspectives on the possible use of intramuscular artesunate as definitive treatment for severe malaria at lower-level facilities, especially when access to referral facilities is challenging. The study was to provide insight as a formative step into the conduct of future experimental studies to ascertain the feasibility of the use of intramuscular artesunate for definitive treatment of severe malaria in lower level facilities where access to referral care is limited. This qualitative study was done across three southern States in Nigeria (Oyo, Cross River and Enugu). Key informant interviews were conducted over a period of three months between October and December 2014 among 90 purposively selected health workers with different roles in malaria case management from primary care to policy level. A thematic content analysis was used to analyse data. Overall, most of health workers and other key informant groups thought that the use of intramuscular artesunate for definitive treatment of severe malaria at lower-level facilities was possible. They however reported human resource and infrastructure constraints as factors affecting the feasibility of intramuscular artesunate use as definitive treatment for severe malaria in lower-level facilities.. Specifically identified barriers included limited numbers of skilled health workers available to manage potential complications of severe malaria and poorly equipped facilities for supportive treatment. Intramuscular artesunate was considered easy to administer and the proximity of lower-level facilities to communities was deemed important in considering the possibility of its use at lower-level facilities. Health workers also emphasised the important role of operational research to provide additional evidence to guide the implementation of existing policy recommendations and inform future policy revisions. From the perspective of health workers, use of intramuscular artesunate for definitive treatment of severe malaria at lower-level health facilities in Nigeria is possible but dependent on availability of skilled workers, well-equipped lower-level facilities to provide supportive treatment There is need for further operational research to establish feasibility and guide the implementation of such an intervention.

Application countermeasures of non-incineration technologies for medical waste treatment in China.

PubMed

Chen, Yang; Ding, Qiong; Yang, Xiaoling; Peng, Zhengyou; Xu, Diandou; Feng, Qinzhong

2013-12-01

By the end of 2012, there were 272 modern, high-standard, centralized medical waste disposal facilities operating in various cities in China. Among these facilities nearly 50% are non-incineration treatment facilities, including the technologies of high temperature steam, chemical disinfection and microwave. Each of the non-incineration technologies has its advantages and disadvantages, and any single technology cannot offer a panacea because of the complexity of medical waste disposal. Although non-incineration treatment of medical waste can avoid the release of polychlorinated dibenzo-p-dioxins/dibenzofurans, it is still necessary to decide how to best meet the local waste management needs while minimizing the impact on the environment and public health. There is still a long way to go to establish the sustainable application and management mode of non-incineration technologies. Based on the analysis of typical non-incineration process, pollutant release, and the current tendency for technology application and development at home and abroad, this article recommends the application countermeasures of non-incineration technologies as the best available techniques and best environmental practices in China.

Region 9 NPDES Facilities 2012- Waste Water Treatment Plants

EPA Pesticide Factsheets

Point geospatial dataset representing locations of NPDES Waste Water Treatment Plant Facilities. NPDES (National Pollution Discharge Elimination System) is an EPA permit program that regulates direct discharges from facilities that discharge treated waste water into waters of the US. Facilities are issued NPDES permits regulating their discharge as required by the Clean Water Act. A facility may have one or more outfalls (dischargers). The location represents the facility or operating plant.

Research on common methods for evaluating the operation effect of integrated wastewater treatment facilities of iron and steel enterprises

NASA Astrophysics Data System (ADS)

Bingsheng, Xu

2017-04-01

Considering the large quantities of wastewater generated from iron and steel enterprises in China, this paper is aimed to research the common methods applied for evaluating the integrated wastewater treatment effect of iron and steel enterprises. Based on survey results on environmental protection performance, technological economy, resource & energy consumption, services and management, an indicator system for evaluating the operation effect of integrated wastewater treatment facilities is set up. By discussing the standards and industrial policies in and out of China, 27 key secondary indicators are further defined on the basis of investigation on main equipment and key processes for wastewater treatment, so as to determine the method for setting key quantitative and qualitative indicators for evaluation indicator system. It is also expected to satisfy the basic requirements of reasonable resource allocation, environmental protection and sustainable economic development, further improve the integrated wastewater treatment effect of iron and steel enterprises, and reduce the emission of hazardous substances and environmental impact.

Accumulation of radium in sediments from continued disposal of produced water and hydraulic fracturing flowback water

NASA Astrophysics Data System (ADS)

Warner, N. R.; Menio, E. C.; Landis, J. D.; Vengosh, A.; Lauer, N.; Harkness, J.; Kondash, A.

2014-12-01

Recent public interest in high volume slickwater hydraulic fracturing (HVHF) has drawn increased interest in wastewater management practices by the public, researchers, industry, and regulators. The management of wastes, including both fluids and solids, poses many engineering challenges, including elevated total dissolved solids and elevated activities of naturally occurring radioactive materials (NORM). One management option for wastewater in particular, which is used in western Pennsylvania, USA, is treatment at centralized waste treatment facilities [1]. Previous studies conducted from 2010-2012 indicated that one centralized facility, the Josephine Brine Treatment facility, removed the majority of radium from produced water and hydraulic fracturing flowback fluid (HFFF) during treatment, but low activities of radium remained in treated effluent and were discharged to surface water [2]. Despite the treatment process and radium reduction, high activities (200 times higher than upstream/background) accumulated in stream sediments at the point of effluent discharge. Here we present new results from sampling conducted at two additional centralized waste treatment facilities (Franklin Brine Treatment and Hart Brine Treatment facilities) and Josephine Brine Treatment facility conducted in June 2014. Preliminary results indicate radium is released to surface water at very low (<50 pCi/L) to non-detectable activities, however; radium continues to accumulate in sediments surrounding the area of effluent release. Combined, the data indicate that 1) radium continues to be released to surface water streams in western Pennsylvania despite oil and gas operators voluntary ban on treatment and disposal of HFFF in centralized waste treatment facilities, 2) radium accumulation in sediments occurred at multiple brine treatment facilities and is not isolated to a single accidental release of contaminants or a single facility. [1] Wilson, J. M. and J. M. VanBriesen (2012). "Oil and Gas Produced Water Management and Surface Drinking Water Sources in Pennsylvania." Environmental Practice 14(04): 288-300. [2] Warner, N. R., C. A. Christie, R. B. Jackson and A. Vengosh (2013). "Impacts of Shale Gas Wastewater Disposal on Water Quality in Western Pennsylvania." ES&T 47(20): 11849-11857.

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

PubMed

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

2014-02-01

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

Financial Assurance Requirements for Hazardous Waste Treatment, Storage and Disposal Facilities

EPA Pesticide Factsheets

The Resource Conservation and Recovery Act (RCRA) requires all treatment, storage and disposal facilities (TSDFs) to demonstrate that they will have the financial resources to properly close the facility

The role of institutions on the effectiveness of malaria treatment in the Ghanaian health sector.

PubMed

Amporfu, Eugenia; Nonvignon, Justice

2015-04-19

The Ghanaian health sector has undertaken several policies to help improve the quality of care received by patients. This includes the construction of several health facilities, the increase in the training of health workers, especially nurses, and the introduction of incentive packages (such as salary increase) to motivate health workers. The important question is to what extent does the institutional arrangement between the health facilities and the government as well as between health workers and public health facility administration affect the quality of care? The objective of this study is to find the effect of institutional factors on the quality of care. The institutional factors examined were mainly the extent of decentralization between government and health facilities, as well as between health workers and facility administration, the hiring procedure, and job satisfaction. The study used primary data on former patients from sixty six health facilities in three administrative regions of Ghana: the Northern, the Ashanti and the Greater Accra regions. The quality indicator used was effectiveness of treatment as determined by the patient. Ordered logit regression was run for the indicator with patient and health facility characteristics as well as institutional factors as independent variables. The sample size was 2248. The results showed that the patient's level of formal education had a strong influence on the effectiveness of treatment. In addition, effectiveness of treatment differed according to the administrative region in which the facility was located, and according to the extent of decentralization between health facility and government. The quality of instruments used for treatment, the working conditions for health workers, and job satisfaction had no effect on the effectiveness of treatment. Decentralization, the flow of information from government to health facilities and from health facility administrators to health workers are important in ensuring effectiveness. The study recommends further decentralization between health facilities as well as between health workers and administrators. In addition, the study recommends the involvement of health facilities in malaria programs to ensure the flow of information needed for effectiveness of treatment.

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

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

Coenenberg, J.G.

1997-08-15

The Hanford Facility Dangerous Waste Permit Application is considered to 10 be a single application organized into a General Information Portion (document 11 number DOE/RL-91-28) and a Unit-Specific Portion. The scope of the 12 Unit-Specific Portion is limited to Part B permit application documentation 13 submitted for individual, `operating` treatment, storage, and/or disposal 14 units, such as the Liquid Effluent Retention Facility and 200 Area Effluent 15 Treatment Facility (this document, DOE/RL-97-03). 16 17 Both the General Information and Unit-Specific portions of the Hanford 18 Facility Dangerous Waste Permit Application address the content of the Part B 19 permit applicationmore » guidance prepared by the Washington State Department of 20 Ecology (Ecology 1987 and 1996) and the U.S. Environmental Protection Agency 21 (40 Code of Federal Regulations 270), with additional information needs 22 defined by the Hazardous and Solid Waste Amendments and revisions of 23 Washington Administrative Code 173-303. For ease of reference, the Washington 24 State Department of Ecology alpha-numeric section identifiers from the permit 25 application guidance documentation (Ecology 1996) follow, in brackets, the 26 chapter headings and subheadings. A checklist indicating where information is 27 contained in the Liquid Effluent Retention Facility and 200 Area Effluent 28 Treatment Facility permit application documentation, in relation to the 29 Washington State Department of Ecology guidance, is located in the Contents 30 Section. 31 32 Documentation contained in the General Information Portion is broader in 33 nature and could be used by multiple treatment, storage, and/or disposal units 34 (e.g., the glossary provided in the General Information Portion). Wherever 35 appropriate, the Liquid Effluent Retention Facility and 200 Area Effluent 36 Treatment Facility permit application documentation makes cross-reference to 37 the General Information Portion, rather than duplicating text. 38 39 Information provided in this Liquid Effluent Retention Facility and 40 200 Area Effluent Treatment Facility permit application documentation is 41 current as of June 1, 1997.« less

Problem Severity Profiles of Substance Abusing Women in Therapeutic Treatment Facilities

ERIC Educational Resources Information Center

Isralowitz, Richard; Reznik, Alexander

2009-01-01

This article aims to examine specific substance use profiles among former Soviet Union (FSU) immigrant and native-born women in Israeli therapeutic treatment facilities. Individuals were sampled at drug treatment facilities and assessed using the Addiction Severity Index. ASI scores suggest differences between the two groups. Among the findings…

26 CFR 1.274-7 - Treatment of certain expenditures with respect to entertainment-type facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 3 2014-04-01 2014-04-01 false Treatment of certain expenditures with respect to entertainment-type facilities. 1.274-7 Section 1.274-7 Internal Revenue INTERNAL REVENUE SERVICE... § 1.274-7 Treatment of certain expenditures with respect to entertainment-type facilities. If...

26 CFR 1.274-7 - Treatment of certain expenditures with respect to entertainment-type facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 3 2010-04-01 2010-04-01 false Treatment of certain expenditures with respect to entertainment-type facilities. 1.274-7 Section 1.274-7 Internal Revenue INTERNAL REVENUE SERVICE... Treatment of certain expenditures with respect to entertainment-type facilities. If deductions are...

26 CFR 1.274-7 - Treatment of certain expenditures with respect to entertainment-type facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 3 2012-04-01 2012-04-01 false Treatment of certain expenditures with respect to entertainment-type facilities. 1.274-7 Section 1.274-7 Internal Revenue INTERNAL REVENUE SERVICE... § 1.274-7 Treatment of certain expenditures with respect to entertainment-type facilities. If...

26 CFR 1.274-7 - Treatment of certain expenditures with respect to entertainment-type facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 3 2013-04-01 2013-04-01 false Treatment of certain expenditures with respect to entertainment-type facilities. 1.274-7 Section 1.274-7 Internal Revenue INTERNAL REVENUE SERVICE... § 1.274-7 Treatment of certain expenditures with respect to entertainment-type facilities. If...

26 CFR 1.274-7 - Treatment of certain expenditures with respect to entertainment-type facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 3 2011-04-01 2011-04-01 false Treatment of certain expenditures with respect to entertainment-type facilities. 1.274-7 Section 1.274-7 Internal Revenue INTERNAL REVENUE SERVICE... § 1.274-7 Treatment of certain expenditures with respect to entertainment-type facilities. If...

40 CFR 440.13 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2010 CFR

2010-07-01

.... (2) In the event that the annual precipitation falling on the treatment facility and the drainage area contributing surface runoff to the treatment facility exceeds the annual evaporation, a volume of water equal to the difference between annual precipitation falling on the treatment facility and the...

40 CFR 440.12 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2010 CFR

2010-07-01

.... (2) In the event that the annual precipitation falling on the treatment facility and the drainage area contributing surface runoff to the treatment facility exceeds the annual evaporation, a volume of water equivalent to the difference between annual precipitation falling on the treatment facility and...

Proton Radiation Therapy in the Hospital Environment: Conception, Development, and Operation of the Initial Hospital-Based Facility

NASA Astrophysics Data System (ADS)

Slater, James M.; Slater, Jerry D.; Wroe, Andrew J.

The world's first hospital-based proton treatment center opened at Loma Linda University Medical Center in 1990, following two decades of development. Patients' needs were the driving force behind its conception, development, and execution; the primary needs were delivery of effective conformal doses of ionizing radiation and avoidance of normal tissue to the maximum extent possible. The facility includes a proton synchrotron and delivery system developed in collaboration with physicists and engineers at Fermi National Accelerator Laboratory and from other high-energy-physics laboratories worldwide. The system, operated and maintained by Loma Linda personnel, was designed to be safe, reliable, flexible in utilization, efficient in use, and upgradeable to meet demands of changing patient needs and advances in technology. Since the facility opened, nearly 14,000 adults and children have been treated for a wide range of cancers and other diseases. Ongoing research is expanding the applications of proton therapy, while reducing costs.

Survey on the possibility of introducing new energy to regional development plans

NASA Astrophysics Data System (ADS)

1988-03-01

This report covers nationwide large-scale resort plans and at the same time studies the possibility of introducing new energy systems, mainly cogeneration, and their effects. Japanese industrial structure is rapidly moving toward information and service areas, and the development of resorts has become very active. With the increase of resort demands, much is expected of resort development as a means of regional promotion. Special features of energy consumption in resort facilities are that annual demand is large, that energy consumption fluctuates greatly, and that energy supply cost is high. These features are especially conspicuous in smaller facilities. Most suited for resort lodging facilities is a co-generation system, especially a diesel engine system. This system is expected to conserve energy; but to promote this system, it is necessary to revise the preferential tax treatment and Fire Service Act to meet the actual circumstances, and to develop a highly reliable system that can be operated unattended. An economical system in view of overall costs is also essential.

Ultra violet disinfection: A 3-year history

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

Tubesing, R.R.; Lindeke, D.R.

1998-07-01

The Stillwater Wastewater Treatment Facility is one of nine wastewater treatment facilities operated by the Metropolitan Council Environmental Services in the Minneapolis-St. Paul Metropolitan Area. The facility services the cities of Stillwater, Oak Park Heights, and Bayport. In 1993, an ultra violet disinfection facility began operation to provide the disinfection for the Facility. This presentation discusses the reasons for using ultra violet disinfection in lieu of chlorination/dechlorination facilities, the operating performance, and operating cost factors.

Development and pilot testing of a mental healthcare plan in Nepal

PubMed Central

Jordans, M. J. D.; Luitel, N. P.; Pokhrel, P.; Patel, V.

2016-01-01

Background Mental health service delivery models that are grounded in the local context are needed to address the substantial treatment gap in low- and middle-income countries. Aims To present the development, and content, of a mental healthcare plan (MHCP) in Nepal and assess initial feasibility. Method A mixed methods formative study was conducted. Routine monitoring and evaluation data, including client flow and reports of satisfaction, were obtained from patients (n = 135) during the pilot-testing phase in two health facilities. Results The resulting MHCP consists of 12 packages, divided over community, health facility and organisation platforms. Service implementation data support the real-life applicability of the MHCP, with reasonable treatment uptake. Key barriers were identified and addressed, namely dissatisfaction with privacy, perceived burden among health workers and high drop-out rates. Conclusions The MHCP follows a collaborative care model encompassing community and primary healthcare interventions. PMID:26447173

Development and pilot testing of a mental healthcare plan in Nepal.

PubMed

Jordans, M J D; Luitel, N P; Pokhrel, P; Patel, V

2016-01-01

Mental health service delivery models that are grounded in the local context are needed to address the substantial treatment gap in low- and middle-income countries. To present the development, and content, of a mental healthcare plan (MHCP) in Nepal and assess initial feasibility. A mixed methods formative study was conducted. Routine monitoring and evaluation data, including client flow and reports of satisfaction, were obtained from patients (n = 135) during the pilot-testing phase in two health facilities. The resulting MHCP consists of 12 packages, divided over community, health facility and organisation platforms. Service implementation data support the real-life applicability of the MHCP, with reasonable treatment uptake. Key barriers were identified and addressed, namely dissatisfaction with privacy, perceived burden among health workers and high drop-out rates. The MHCP follows a collaborative care model encompassing community and primary healthcare interventions. © The Royal College of Psychiatrists 2016.

Liquid secondary waste. Waste form formulation and qualification

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

Cozzi, A. D.; Dixon, K. L.; Hill, K. A.

The Hanford Site Effluent Treatment Facility (ETF) currently treats aqueous waste streams generated during Site cleanup activities. When the Hanford Tank Waste Treatment and Immobilization Plant (WTP) begins operations, a liquid secondary waste (LSW) stream from the WTP will need to be treated. The volume of effluent for treatment at the ETF will increase significantly. Washington River Protection Solutions is implementing a Secondary Liquid Waste Immobilization Technology Development Plan to address the technology needs for a waste form and solidification process to treat the increased volume of waste planned for disposal at the Integrated Disposal Facility IDF). Waste form testingmore » to support this plan is composed of work in the near term to demonstrate the waste form will provide data as input to a performance assessment (PA) for Hanford’s IDF.« less

Fabrication of superhydrophilic and underwater superoleophobic metal mesh by laser treatment and its application

NASA Astrophysics Data System (ADS)

Yu, Peng; Lian, Zhongxu; Xu, Jinkai; Yu, Zhanjiang; Ren, Wanfei; Yu, Huadong

2018-04-01

In this paper, a lot of micron-sized sand granular structures were formed on the substrate of the stainless steel mesh (SSM) by laser treatment. The rough surface with sand granular structures showed superhydrophilic in air and superoleophobic under water. With its special wettability, the SSM by laser treatment could achieve the separation of the oil/water mixture, showing good durability and high separation efficiency, which was very useful in the practical application of large-scale oil/water separation facility for reducing the impacts of oil leaked on the environment. In addition, it showed that the laser-treated SSM had a very high separation rate. The development of the laser-treated SSM is a simple, environmental, economical and high-efficiency method, which provides a new approach to the production of high efficiency facilities for oil/water separation.

Recent advancements in bioremediation of dye: Current status and challenges.

PubMed

Vikrant, Kumar; Giri, Balendu Shekhar; Raza, Nadeem; Roy, Kangkan; Kim, Ki-Hyun; Rai, Birendra Nath; Singh, Ram Sharan

2018-04-01

The rampant industrialization and unchecked growth of modern textile production facilities coupled with the lack of proper treatment facilities have proliferated the discharge of effluents enriched with toxic, baleful, and carcinogenic pollutants including dyes, heavy metals, volatile organic compounds, odorants, and other hazardous materials. Therefore, the development of cost-effective and efficient control measures against such pollution is imperative to safeguard ecosystems and natural resources. In this regard, recent advances in biotechnology and microbiology have propelled bioremediation as a prospective alternative to traditional treatment methods. This review was organized to address bioremediation as a practical option for the treatment of dyes by evaluating its performance and typical attributes. It further highlights the current hurdles and future prospects for the abatement of dyes via biotechnology-based remediation techniques. Copyright © 2018 Elsevier Ltd. All rights reserved.

Radioactive Waste Management and Nuclear Facility Decommissioning Progress in Iraq - 13216

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

Al-Musawi, Fouad; Shamsaldin, Emad S.; Jasim, Hadi

2013-07-01

Management of Iraq's radioactive wastes and decommissioning of Iraq's former nuclear facilities are the responsibility of Iraq's Ministry of Science and Technology (MoST). The majority of Iraq's former nuclear facilities are in the Al-Tuwaitha Nuclear Research Center located a few kilometers from the edge of Baghdad. These facilities include bombed and partially destroyed research reactors, a fuel fabrication facility and radioisotope production facilities. Within these facilities are large numbers of silos, approximately 30 process or waste storage tanks and thousands of drums of uncharacterised radioactive waste. There are also former nuclear facilities/sites that are outside of Al-Tuwaitha and these includemore » the former uranium processing and waste storage facility at Jesira, the dump site near Adaya, the former centrifuge facility at Rashdiya and the former enrichment plant at Tarmiya. In 2005, Iraq lacked the infrastructure needed to decommission its nuclear facilities and manage its radioactive wastes. The lack of infrastructure included: (1) the lack of an organization responsible for decommissioning and radioactive waste management, (2) the lack of a storage facility for radioactive wastes, (3) the lack of professionals with experience in decommissioning and modern waste management practices, (4) the lack of laws and regulations governing decommissioning or radioactive waste management, (5) ongoing security concerns, and (6) limited availability of electricity and internet. Since its creation eight years ago, the MoST has worked with the international community and developed an organizational structure, trained staff, and made great progress in managing radioactive wastes and decommissioning Iraq's former nuclear facilities. This progress has been made, despite the very difficult implementing conditions in Iraq. Within MoST, the Radioactive Waste Treatment and Management Directorate (RWTMD) is responsible for waste management and the Iraqi Decommissioning Directorate (IDD) is responsible for decommissioning activities. The IDD and the RWTMD work together on decommissioning projects. The IDD has developed plans and has completed decommissioning of the GeoPilot Facility in Baghdad and the Active Metallurgical Testing Laboratory (LAMA) in Al-Tuwaitha. Given this experience, the IDD has initiated work on more dangerous facilities. Plans are being developed to characterize, decontaminate and decommission the Tamuz II Research Reactor. The Tammuz Reactor was destroyed by an Israeli air-strike in 1981 and the Tammuz II Reactor was destroyed during the First Gulf War in 1991. In addition to being responsible for managing the decommissioning wastes, the RWTMD is responsible for more than 950 disused sealed radioactive sources, contaminated debris from the first Gulf War and (approximately 900 tons) of naturally-occurring radioactive materials wastes from oil production in Iraq. The RWTMD has trained staff, rehabilitated the Building 39 Radioactive Waste Storage building, rehabilitated portions of the French-built Radioactive Waste Treatment Station, organized and secured thousands of drums of radioactive waste organized and secured the stores of disused sealed radioactive sources. Currently, the IDD and the RWTMD are finalizing plans for the decommissioning of the Tammuz II Research Reactor. (authors)« less

A Guide for Developing Standard Operating Job Procedures for the Grit Removal Process Wastewater Treatment Facility. SOJP No. 2.

ERIC Educational Resources Information Center

Deal, Gerald A.; Montgomery, James A.

This guide describes standard operating job procedures for the grit removal process of wastewater treatment plants. Step-by-step instructions are given for pre-start up inspection, start-up, continuous operation, and shut-down procedures. A description of the equipment used in the process is given. Some theoretical material is presented. (BB)

A Guide for Developing Standard Operating Job Procedures for the Tertiary Multimedia Filtration Process Wastewater Treatment Facility. SOJP No. 7.

ERIC Educational Resources Information Center

Petrasek, Al, Jr.

This guide describes the standard operating job procedures for the tertiary multimedia filtration process of wastewater treatment plants. The major objective of the filtration process is the removal of suspended solids from the reclaimed wastewater. The guide gives step-by-step instructions for pre-start up, start-up, continuous operation, and…

Opportunities for Energy Efficiency and Open Automated Demand Response in Wastewater Treatment Facilities in California -- Phase I Report

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

Lekov, Alex; Thompson, Lisa; McKane, Aimee

This report summarizes the Lawrence Berkeley National Laboratory?s research to date in characterizing energy efficiency and automated demand response opportunities for wastewater treatment facilities in California. The report describes the characteristics of wastewater treatment facilities, the nature of the wastewater stream, energy use and demand, as well as details of the wastewater treatment process. It also discusses control systems and energy efficiency and automated demand response opportunities. In addition, several energy efficiency and load management case studies are provided for wastewater treatment facilities.This study shows that wastewater treatment facilities can be excellent candidates for open automated demand response and thatmore » facilities which have implemented energy efficiency measures and have centralized control systems are well-suited to shift or shed electrical loads in response to financial incentives, utility bill savings, and/or opportunities to enhance reliability of service. Control technologies installed for energy efficiency and load management purposes can often be adapted for automated demand response at little additional cost. These improved controls may prepare facilities to be more receptive to open automated demand response due to both increased confidence in the opportunities for controlling energy cost/use and access to the real-time data.« less

RETROFITTING CONTROL FACILITIES FOR WET-WEATHER FLOW TREATMENT

EPA Science Inventory

Available technologies were evaluated to demonstrate the technical feasibility and cost effectiveness of retrofitting existing facilities to handle wet-weather flow. Cost/benefit relationships were also compared to construction of new conventional control and treatment facilities...

Project C-018H, 242-A Evaporator/PUREX Plant Process Condensate Treatment Facility, functional design criteria. Revision 3

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

Sullivan, N.

1995-05-02

This document provides the Functional Design Criteria (FDC) for Project C-018H, the 242-A Evaporator and Plutonium-Uranium Extraction (PUREX) Plant Condensate Treatment Facility (Also referred to as the 200 Area Effluent Treatment Facility [ETF]). The project will provide the facilities to treat and dispose of the 242-A Evaporator process condensate (PC), the Plutonium-Uranium Extraction (PUREX) Plant process condensate (PDD), and the PUREX Plant ammonia scrubber distillate (ASD).

Single particle ICP-MS characterization of titanium dioxide, silver, and gold nanoparticles during drinking water treatment.

PubMed

Donovan, Ariel R; Adams, Craig D; Ma, Yinfa; Stephan, Chady; Eichholz, Todd; Shi, Honglan

2016-02-01

One of the most direct means for human exposure to nanoparticles (NPs) released into the environment is drinking water. Therefore, it is critical to understand the occurrence and fate of NPs in drinking water systems. The objectives of this study were to develop rapid and reliable analytical methods and apply them to investigate the fate and transportation of NPs during drinking water treatments. Rapid single particle ICP-MS (SP-ICP-MS) methods were developed to characterize and quantify titanium-containing, titanium dioxide, silver, and gold NP concentration, size, size distribution, and dissolved metal element concentration in surface water and treated drinking water. The effectiveness of conventional drinking water treatments (including lime softening, alum coagulation, filtration, and disinfection) to remove NPs from surface water was evaluated using six-gang stirrer jar test simulations. The selected NPs were nearly completely (97 ± 3%) removed after lime softening and alum coagulation/activated carbon adsorption treatments. Additionally, source and drinking waters from three large drinking water treatment facilities utilizing similar treatments with the simulation test were collected and analyzed by the SP-ICP-MS methods. Ti-containing particles and dissolved Ti were present in the river water samples, but Ag and Au were not present. Treatments used at each drinking water treatment facility effectively removed over 93% of the Ti-containing particles and dissolved Ti from the source water. Copyright © 2015 Elsevier Ltd. All rights reserved.

Physical, chemical, and biological characteristics of the Boise River from Veterans Memorial Parkway, Boise to Star, Idaho, October 1987 to March 1988

USGS Publications Warehouse

Frenzel, S.A.

1988-01-01

Physical, chemical, and biological characteristics of the Boise River were examined from October 1987 to March 1988 to determine whether trace elements in effluents from two Boise wastewater treatment facilities were detrimental to aquatic communities. Cadmium, chromium, hexavalent chromium, cyanide, lead, nickel, and silver concentrations in the Boise River were less than or near analytical detection levels and were less than chronic toxicity criteria when detectable. Arsenic, copper, and zinc were detected in concentrations less than chronic toxicity criteria. Concentrations of trace elements in bottom material generally were small and could not be attributed to effluents from wastewater treatment facilities. From October to December 1987, mean density of benthic invertebrates colonizing artificial substrates was from 6,100 individuals/substrate downstream from the West Boise wastewater treatment facility to 14,000 individuals per substrate downstream from the Lander Street wastewater treatment facility. From January to March 1988 , mean density of benthic invertebrates colonizing artificial substrates was from 7,100 individuals per substrate downstream from the West Boise facility to 10,000 individuals per substrate near Star. Insect communities upstream and downstream from the wastewater treatment facilities were strongly associated, and coeffients of community loss indicated that effluents had benign enriching effects. Distribution of mayflies indicates that trace-element concentrations in effluents did not adversely affect intolerant organisms in the Boise River. Condition factor of whitefish was significantly increased downstream from the Lander Street wastewater treatment facility and was significantly decreased downstream from the West Boise wastewater treatment facility.

40 CFR 258.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

...; plastics and resins manufacturing; pulp and paper industry; rubber and miscellaneous plastic products... wastewater treatment plant, water supply treatment plant, or air pollution control facility exclusive of the... a wastewater treatment plant, water supply treatment plant, or air pollution control facility and...

DISPOSITION PATHS FOR ROCKY FLATS GLOVEBOXES: EVALUATING OPTIONS

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

Lobdell, D.; Geimer, R.; Larsen, P.

2003-02-27

The Kaiser-Hill Company, LLC has the responsibility for closure activities at the Rocky Flats Environmental Technology Site (RFETS). One of the challenges faced for closure is the disposition of radiologically contaminated gloveboxes. Evaluation of the disposition options for gloveboxes included a detailed analysis of available treatment capabilities, disposal facilities, and lifecycle costs. The Kaiser-Hill Company, LLC followed several processes in determining how the gloveboxes would be managed for disposition. Currently, multiple disposition paths have been chosen to accommodate the needs of the varying styles and conditions of the gloveboxes, meet the needs of the decommissioning team, and to best managemore » lifecycle costs. Several challenges associated with developing a disposition path that addresses both the radiological and RCRA concerns as well as offering the most cost-effective solution were encountered. These challenges included meeting the radiological waste acceptance criteria of available disposal facilities, making a RCRA determination, evaluating treatment options and costs, addressing void requirements associated with disposal, and identifying packaging and transportation options. The varying disposal facility requirements affected disposition choices. Facility conditions that impacted decisions included radiological and chemical waste acceptance criteria, physical requirements, and measurement for payment options. The facility requirements also impacted onsite activities including management strategies, decontamination activities, and life-cycle cost.« less

Association Between Treatment at High-Volume Facilities and Improved Overall Survival in Soft Tissue Sarcomas.

PubMed

Venigalla, Sriram; Nead, Kevin T; Sebro, Ronnie; Guttmann, David M; Sharma, Sonam; Simone, Charles B; Levin, William P; Wilson, Robert J; Weber, Kristy L; Shabason, Jacob E

2018-03-15

Soft tissue sarcomas (STS) are rare malignancies that require complex multidisciplinary management. Therefore, facilities with high sarcoma case volume may demonstrate superior outcomes. We hypothesized that STS treatment at high-volume (HV) facilities would be associated with improved overall survival (OS). Patients aged ≥18 years with nonmetastatic STS treated with surgery and radiation therapy at a single facility from 2004 through 2013 were identified from the National Cancer Database. Facilities were dichotomized into HV and low-volume (LV) cohorts based on total case volume over the study period. OS was assessed using multivariable Cox regression with propensity score-matching. Patterns of care were assessed using multivariable logistic regression analysis. Of 9025 total patients, 1578 (17%) and 7447 (83%) were treated at HV and LV facilities, respectively. On multivariable analysis, high educational attainment, larger tumor size, higher grade, and negative surgical margins were statistically significantly associated with treatment at HV facilities; conversely, black race and non-metropolitan residence were negative predictors of treatment at HV facilities. On propensity score-matched multivariable analysis, treatment at HV facilities versus LV facilities was associated with improved OS (hazard ratio, 0.87, 95% confidence interval, 0.80-0.95; P = .001). Older age, lack of insurance, greater comorbidity, larger tumor size, higher tumor grade, and positive surgical margins were associated with statistically significantly worse OS. In this observational cohort study using the National Cancer Database, receipt of surgery and radiation therapy at HV facilities was associated with improved OS in patients with STS. Potential sociodemographic disparities limit access to care at HV facilities for certain populations. Our findings highlight the importance of receipt of care at HV facilities for patients with STS and warrant further study into improving access to care at HV facilities. Copyright © 2017 Elsevier Inc. All rights reserved.

Solid-phase microextraction of organophosphate pesticides in source waters for drinking water treatment facilities.

PubMed

Flynt, Elizabeth; Dupuy, Aubry; Kennedy, Charles; Bennett, Shanda

2006-09-01

The rapid detection of contaminants in our nation's drinking water has become a top homeland security priority in this time of increased national vigilance. Real-time monitoring of drinking water for deliberate or accidental contamination is key to national security. One method that can be employed for the rapid screening of pollutants in water is solid-phase microextraction (SPME). SPME is a rapid, sensitive, solvent-free system that can be used to screen for contaminants that have been accidentally or intentionally introduced into a water system. A method using SPME has been developed and optimized for the detection of seven organophosphate pesticides in drinking water treatment facility source waters. The method is tested in source waters for drinking water treatment facilities in Mississippi and Alabama. Water is collected from a deepwater well at Stennis Space Center (SSC), MS, the drinking water source for SSC, and from the Converse Reservoir, the main drinking water supply for Mobile, AL. Also tested are samples of water collected from the Mobile Alabama Water and Sewer System drinking water treatment plant prior to chlorination. The method limits of detection for the seven organophosphates were comparable to those described in several Environmental Protection Agency standard methods. They range from 0.25 to 0.94 microg/L.

Multi-Country Analysis of Treatment Costs for HIV/AIDS (MATCH): Facility-Level ART Unit Cost Analysis in Ethiopia, Malawi, Rwanda, South Africa and Zambia

PubMed Central

Tagar, Elya; Sundaram, Maaya; Condliffe, Kate; Matatiyo, Blackson; Chimbwandira, Frank; Chilima, Ben; Mwanamanga, Robert; Moyo, Crispin; Chitah, Bona Mukosha; Nyemazi, Jean Pierre; Assefa, Yibeltal; Pillay, Yogan; Mayer, Sam; Shear, Lauren; Dain, Mary; Hurley, Raphael; Kumar, Ritu; McCarthy, Thomas; Batra, Parul; Gwinnell, Dan; Diamond, Samantha; Over, Mead

2014-01-01

Background Today's uncertain HIV funding landscape threatens to slow progress towards treatment goals. Understanding the costs of antiretroviral therapy (ART) will be essential for governments to make informed policy decisions about the pace of scale-up under the 2013 WHO HIV Treatment Guidelines, which increase the number of people eligible for treatment from 17.6 million to 28.6 million. The study presented here is one of the largest of its kind and the first to describe the facility-level cost of ART in a random sample of facilities in Ethiopia, Malawi, Rwanda, South Africa and Zambia. Methods & Findings In 2010–2011, comprehensive data on one year of facility-level ART costs and patient outcomes were collected from 161 facilities, selected using stratified random sampling. Overall, facility-level ART costs were significantly lower than expected in four of the five countries, with a simple average of $208 per patient-year (ppy) across Ethiopia, Malawi, Rwanda and Zambia. Costs were higher in South Africa, at $682 ppy. This included medications, laboratory services, direct and indirect personnel, patient support, equipment and administrative services. Facilities demonstrated the ability to retain patients alive and on treatment at these costs, although outcomes for established patients (2–8% annual loss to follow-up or death) were better than outcomes for new patients in their first year of ART (77–95% alive and on treatment). Conclusions This study illustrated that the facility-level costs of ART are lower than previously understood in these five countries. While limitations must be considered, and costs will vary across countries, this suggests that expanded treatment coverage may be affordable. Further research is needed to understand investment costs of treatment scale-up, non-facility costs and opportunities for more efficient resource allocation. PMID:25389777

7 CFR 305.8 - Heat treatment requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 5 2011-01-01 2011-01-01 false Heat treatment requirements. 305.8 Section 305.8... SERVICE, DEPARTMENT OF AGRICULTURE PHYTOSANITARY TREATMENTS § 305.8 Heat treatment requirements. (a... operations conducted at the facility. In order to be certified, a heat treatment facility must: (1) Have...

7 CFR 305.8 - Heat treatment requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 5 2013-01-01 2013-01-01 false Heat treatment requirements. 305.8 Section 305.8... SERVICE, DEPARTMENT OF AGRICULTURE PHYTOSANITARY TREATMENTS § 305.8 Heat treatment requirements. (a... operations conducted at the facility. In order to be certified, a heat treatment facility must: (1) Have...

7 CFR 305.8 - Heat treatment requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 5 2014-01-01 2014-01-01 false Heat treatment requirements. 305.8 Section 305.8... SERVICE, DEPARTMENT OF AGRICULTURE PHYTOSANITARY TREATMENTS § 305.8 Heat treatment requirements. (a... operations conducted at the facility. In order to be certified, a heat treatment facility must: (1) Have...

Supplemental Immobilization Cast Stone Technology Development and Waste Form Qualification Testing Plan

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

Westsik, Joseph H.; Serne, R. Jeffrey; Pierce, Eric M.

2013-05-31

The Hanford Tank Waste Treatment and Immobilization Plant (WTP) is being constructed to treat the 56 million gallons of radioactive waste stored in 177 underground tanks at the Hanford Site. The WTP includes a pretreatment facility to separate the wastes into high-level waste (HLW) and low-activity waste (LAW) fractions for vitrification and disposal. The LAW will be converted to glass for final disposal at the Integrated Disposal Facility (IDF). The pretreatment facility will have the capacity to separate all of the tank wastes into the HLW and LAW fractions, and the HLW Vitrification Facility will have the capacity to vitrifymore » all of the HLW. However, a second immobilization facility will be needed for the expected volume of LAW requiring immobilization. A number of alternatives, including Cast Stone—a cementitious waste form—are being considered to provide the additional LAW immobilization capacity.« less

An Effective Web Presence for Substance Abuse Treatment Facilities.

PubMed

Link, Thomas W; Hefner, Jennifer L; Ford, Eric W; Huerta, Timothy R

2016-01-01

Website development for health care has only been prevalent in the last two and a half decades. The first websites were electronic versions of brochures providing hardly any interaction with the consumer or potential consumer. The percentage of consumers that use the internet during the decision-making process for health care providers continues to rise. As a result, the websites of health care providers are becoming more of a representation of the facility and creating an organizational image rather than a brochure-like informational page. The purpose of this study was to analyze substance abuse treatment center's websites in the State of California with the goal of informing the management of substance abuse centers regarding an effective and inexpensive means to closing the marketing gaps in the industry. This brief research report presents the results of employing an automated web-crawler to assess website quality along five dimensions: accessibility, content, marketing, technology, and usability score. The sample mean scores for all dimensions were between 4 and 6 on a 10-point scale. On average larger facilities had higher quality websites. The low mean scores on these dimensions indicate that that substance abuse centers have significant room for improvement of their website's. Efficiently spending marketing funds to increase the effectiveness of a treatment center's website can be a low cost way for even small facilities to increase market competitiveness.

A Guide for Developing Standard Operating Job Procedures for the Pump Station Process Wastewater Treatment Facility. SOJP No. 3.

ERIC Educational Resources Information Center

Perley, Gordon F.

This is a guide for standard operating job procedures for the pump station process of wastewater treatment plants. Step-by-step instructions are given for pre-start up inspection, start-up procedures, continuous routine operation procedures, and shut-down procedures. A general description of the equipment used in the process is given. Two…

Synchronisation of the follicular wave with GnRH and PGF2α analogue for a timed breeding programme in dromedary camels (Camelus dromedarius).

PubMed

Manjunatha, B M; Al-Bulushi, Samir; Pratap, N

2015-09-01

This study was conducted to develop a hormone protocol that precisely synchronises follicular development for a timed breeding (TB) programme in dromedary camels. To examine the effect of GnRH treatment at four known stages of follicular development, animals were treated with GnRH when the largest follicle of the wave was 4-7, 8-11, 12-17 and 18-27 mm in diameter. Transrectal ultrasonography was carried out daily up to 20 days after treatment. A hormone protocol (FWsynch) for the synchronisation of follicular wave and TB consisting of GnRH-1 (GnRH) on Day 0, PG-1 (PGF2α) on Day 7, GnRH-2 on Day 10 and PG-2 on Day 17 was initiated at four known stages of follicular development. Ovarian structures were monitored by ultrasonography. The FWsynch protocol was initiated at random stages of follicle development and animals were bred by natural mating at a fixed time at the research facility and in field. The pregnancy was diagnosed by ultrasonography. GnRH treatment in animals with a dominant follicle (DF) of ≥ 11 mm in diameter resulted in synchronous new follicular wave emergence, whereas in animals with a DF ≤ 10 mm, the treatment did not alter the development of the existing follicular wave. The FWsynch protocol was effective in synchronising the follicular wave for TB irrespective of the stage of follicular development at the beginning of the protocol. TB using FWsynch protocol resulted in a pregnancy rate of 60.2% in a research facility and 53.6% and 45.6% in normal and infertile camels respectively under field conditions. Copyright © 2015 Elsevier B.V. All rights reserved.

Efficiency of U.S. Dialysis Centers: An Updated Examination of Facility Characteristics That Influence Production of Dialysis Treatments

PubMed Central

Shreay, Sanatan; Ma, Martin; McCluskey, Jill; Mittelhammer, Ron C; Gitlin, Matthew; Stephens, J Mark

2014-01-01

Objective To explore the relative efficiency of dialysis facilities in the United States and identify factors that are associated with efficiency in the production of dialysis treatments. Data Sources/Study Setting Medicare cost report data from 4,343 free-standing dialysis facilities in the United States that offered in-center hemodialysis in 2010. Study Design A cross-sectional, facility-level retrospective database analysis, utilizing data envelopment analysis (DEA) to estimate facility efficiency. Data Collection/Extraction Methods Treatment data and cost and labor inputs of dialysis treatments were obtained from 2010 Medicare Renal Cost Reports. Demographic data were obtained from the 2010 U.S. Census. Principal Findings Only 26.6 percent of facilities were technically efficient. Neither the intensity of market competition nor the profit status of the facility had a significant effect on efficiency. Facilities that were members of large chains were less likely to be efficient. Cost and labor savings due to changes in drug protocols had little effect on overall dialysis center efficiency. Conclusions The majority of free-standing dialysis facilities in the United States were functioning in a technically inefficient manner. As payment systems increasingly employ capitation and bundling provisions, these institutions will need to evaluate their efficiency to remain competitive. PMID:24237043

40 CFR 35.917-5 - Public participation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... identification and evaluation of locations for waste water treatment facilities and of alternative treatment... treatment, reduce waste water volume, and encourage multiple use of facilities; (3) The evaluation of social... planning issues and decisions. (b) Basic Public Participation Program. Since waste water treatment...

[Sibutramine administration in polycystic ovary syndrome treatment].

PubMed

Olszanecka-Glinianowicz, Magdalena; Zahorska-Markiewicz, Barbara; Jochemczyk-Banek, Urszula; Banaś, Michał; Zurakowski, Aleksander

2004-06-01

Obesity is considered important factor contributing development of PCOS. Insulin resistance, low level of serum SHBG and activation of pituitary-adrenal axis plays a major role in pathogenesis and symptoms of PCOS. The achievement of weight loss is an important factor in treatment of PCOS, but difficulties with adherences to the dietary regiment discourage physicians to use this method. In our paper we would like to show the effectiveness of such treatment and pay attention to possibilities of drug facilities in dietary approach in treatment of PCOS coexisting with obesity.

In-Plant Reuse of Pollution Abated Waters.

DTIC Science & Technology

1984-08-01

Carbon Treatment Facility Prefilters D-10 Spent Carbon Receiving Tank EZ D-11 Powdered Carbon Feeder System E. Process Chemical Assay/Monitoring...PBA manufacturing complex, several wastewater treatment facilities were built to treat wastewater from various plants . This task deals with...all of which discharge to the Central Treatment Facility (Appendix K-I). The plant is permitted (Appendix I-I) by EPA and consists of a lime/alum

A rational procedure for estimation of greenhouse-gas emissions from municipal wastewater treatment plants.

PubMed

Monteith, Hugh D; Sahely, Halla R; MacLean, Heather L; Bagley, David M

2005-01-01

Municipal wastewater treatment may lead to the emission of greenhouse gases. The current Intergovenmental Panel on Climate Change (Geneva, Switzerland) approach attributes only methane emissions to wastewater treatment, but this approach may overestimate greenhouse gas emissions from the highly aerobic processes primarily used in North America. To better estimate greenhouse gas emissions, a procedure is developed that can be used either with plant-specific data or more general regional data. The procedure was evaluated using full-scale data from 16 Canadian wastewater treatment facilities and then applied to all 10 Canadian provinces. The principal greenhouse gas emitted from municipal wastewater treatment plants was estimated to be carbon dioxide (CO2), with very little methane expected. The emission rates ranged from 0.005 kg CO2-equivalent/m3 treated for primary treatment facilities to 0.26 kg CO2-equivalent/m3 for conventional activated sludge, with anaerobic sludge digestion to over 0.8 kg CO2-equivalent/m3 for extended aeration with aerobic digestion. Increasing the effectiveness of biogas generation and use will decrease the greenhouse gas emissions that may be assigned to the wastewater treatment plant.

Programme development of drug abuse control in Baluchistan, Pakistan.

PubMed

Zaidi, S M; Ashraf, S M; Afridi, A A

1982-01-01

The drug abuse control programme in Baluchistan is inter-disciplinary and progressive. Its main thrust consists of constant vigilance on border check-points by law enforcement agencies, developing in-patient and out-patient facilities for treatment and rehabilitation of addicted persons, and a preventive education programme using the mass media and students from higher educational institutions.

Patient handling system for carbon ion beam scanning therapy

PubMed Central

Shirai, Toshiyuki; Takei, Yuka; Furukawa, Takuji; Inaniwa, Taku; Matsuzaki, Yuka; Kumagai, Motoki; Murakami, Takeshi; Noda, Koji

2012-01-01

Our institution established a new treatment facility for carbon ion beam scanning therapy in 2010. The major advantages of scanning beam treatment compared to the passive beam treatment are the following: high dose conformation with less excessive dose to the normal tissues, no bolus compensator and patient collimator/ multi‐leaf collimator, better dose efficiency by reducing the number of scatters. The new facility was designed to solve several problems encountered in the existing facility, at which several thousand patients were treated over more than 15 years. Here, we introduce the patient handling system in the new treatment facility. The new facility incorporates three main systems, a scanning irradiation system (S‐IR), treatment planning system (TPS), and patient handling system (PTH). The PTH covers a wide range of functions including imaging, geometrical/position accuracy including motion management (immobilization, robotic arm treatment bed), layout of the treatment room, treatment workflow, software, and others. The first clinical trials without respiratory gating have been successfully started. The PTH allows a reduction in patient stay in the treatment room to as few as 7 min. The PTH plays an important role in carbon ion beam scanning therapy at the new institution, particularly in the management of patient handling, application of image‐guided therapy, and improvement of treatment workflow, and thereby allows substantially better treatment at minimum cost. PACS numbers: 87.56.‐v; 87.57.‐s; 87.55.‐x PMID:23149784

Multi-criteria Decision Support System (DSS) for optimal locations of Soil Aquifer Treatment (SAT) facilities.

PubMed

Tsangaratos, P; Kallioras, A; Pizpikis, Th; Vasileiou, E; Ilia, I; Pliakas, F

2017-12-15

Managed Aquifer Recharge is a wide-spread well-established groundwater engineering method which is largely seen as sound and sustainable solution to water scarcity hydrologically sensitive areas, such as the Circum Mediterranean. The process of site selection for the installation of a MAR facility is of paramount importance for the feasibility and effectiveness of the project itself, especially when the facility will include the use of waters of impaired quality as a recharge source, as in the case of Soil-Aquifer-Treatment systems. The main objective of this study is to present the developed framework of a multi-criteria Decision Support System (DSS) that integrates within a dynamic platform the main groundwater engineering parameters associated with MAR applications together with the general geographical features which determine the effectiveness of such a project. The proposed system will provide an advanced coupled DSS-GIS tool capable of handling local MAR-related issues -such as hydrogeology, topography, soil, climate etc., and spatially distributed variables -such as societal, economic, administrative, legislative etc., with special reference to Soil-Aquifer-Treatment technologies. Copyright © 2017 Elsevier B.V. All rights reserved.

Secondary Waste Form Development and Optimization—Cast Stone

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

Sundaram, S. K.; Parker, Kent E.; Valenta, Michelle M.

2011-07-14

Washington River Protection Services is considering the design and construction of a Solidification Treatment Unit (STU) for the Effluent Treatment Facility (ETF) at Hanford. The ETF is a Resource Conservation and Recovery Act-permitted, multi-waste, treatment and storage unit and can accept dangerous, low-level, and mixed wastewaters for treatment. The STU needs to be operational by 2018 to receive secondary liquid wastes generated during operation of the Hanford Tank Waste Treatment and Immobilization Plant (WTP). The STU to ETF will provide the additional capacity needed for ETF to process the increased volume of secondary wastes expected to be produced by WTP.

42 CFR 50.202 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... statute, in a correctional or rehabilitative facility, including a mental hospital or other facility for the care and treatment of mental illness, or (2) confined, under a voluntary commitment, in a mental hospital or other facility for the care and treatment of mental illness. Mentally incompetent individual...

Characteristics of U.S. Substance Abuse Treatment Facilities Offering HIV Services: Results From a National Survey.

PubMed

Cohn, Amy; Stanton, Cassandra; Elmasry, Hoda; Ehlke, Sarah; Niaura, Ray

2016-06-01

Substance use disorders are common among persons with HIV/AIDS. This study examined the prevalence and correlates of the provision of four HIV services in a national sample of substance abuse treatment facilities. Data were from the 2011 National Survey of Substance Abuse Treatment Services. Prevalence estimates indicated that 28% of facilities offered HIV testing, 26% early intervention, 58% HIV/AIDS education, and 8% special programs for HIV/AIDS. Facilities offering inpatient substance abuse care were more than six times as likely to offer HIV testing but not more likely to offer any other type of HIV service. Facilities offering methadone treatment were 2.5 times more likely to offer HIV services. Given the high rates of substance use among persons with HIV, the prevalence of facilities offering HIV services was low in most domains, with different barriers identified in multivariable models. Integrating comprehensive HIV prevention, testing, and support services into programs that address substance abuse is needed.

Treatment and prevention of malaria in pregnancy in the private health sector in Uganda: implications for patient safety.

PubMed

Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus; Clarke, Siân E; Lal, Sham; Hansen, Kristian S; Magnussen, Pascal; LaRussa, Philip

2016-04-14

Malaria in pregnancy is a major public health problem in Uganda; and it is the leading cause of anaemia among pregnant women and low birth weight in infants. Previous studies have noted poor quality of care in the private sector. Thus there is need to explore ways of improving quality of care in the private sector that provides almost a half of health services in Uganda. A survey was conducted from August to October 2014 within 57 parishes in Mukono district, central Uganda. The selected parishes had a minimum of 200 households and at least one registered drug shop, pharmacy or private clinic. Data was collected using a structured questionnaire targeting one provider who was found on duty in each selected private health facility and consented to the study. The main variables were: provider characteristics, previous training received, type of drugs stocked, treatment and prevention practices for malaria among pregnant women. The main study outcome was the proportion of private health facilities who prescribe treatment of fever among pregnant women as recommended in the guidelines. A total of 241 private health facilities were surveyed; 70.5 % were registered drug shops, 24.5 % private clinics and 5.0 % pharmacies. Treatment of fever among pregnant women in accordance with the national treatment guidelines was poor: 40.7 % in private clinics, decreasing to 28.2 % in drug shops and 16.7 % at pharmacies. Anti-malarial monotherapies sulphadoxine-pyrimethamine and quinine were commonly prescribed, often without consideration of gestational age. The majority of providers (>75 %) at all private facilities prescribed SP for intermittent preventive treatment but artemisinin-based combination therapy was prescribed: 8.3, 6.9 and 8.3 % respectively at drug shops, private clinics and pharmacies for prevention of malaria in pregnancy. Few facilities had malaria treatment guidelines; (44.1 % of private clinics, 17.9 % of drug shops, and 41.7 % at pharmacies. Knowledge of people at risk of malaria, P = 0.02 and availability of malaria treatment guidelines, P = 0.03 were the factors that most influenced correct treatment of fever in pregnancy. Treatment of fever during pregnancy was poor in this study setting. These data highlight the need to develop interventions to improve patient safety and quality of care for pregnant women in the private health sector in Uganda.

Developing Treatment, Treatment Validation, and Treatment Scope in the Setting of an Autism Clinical Trial

DTIC Science & Technology

2010-10-01

from AGRE are at the Bionomics Research and Technology Center of UMDNJ- RWJ /Rutgers (SNP High Throughput Facility) and are ready for genotyping...Neurogenetics & AGRE samples, 6-30 months for new autism cases, E. Stenroos). The samples from AGRE are at the Bionomics Research and Technology Center of...Prepare samples for GSTM1*0 Real Time PCR genotyping (6-30 months, E. Stenroos). The samples from AGRE are at the Bionomics Research and Technology

Availability of Youth Services in U.S. Mental Health Treatment Facilities

PubMed Central

Cummings, Janet R.; Case, Brady G.; Ji, Xu; Marcus, Steven C.

2015-01-01

Despite concern about access to mental health (MH) services for youth, little is known about the specialty treatment infrastructure serving this population. We used national data to examine which types of MH treatment facilities (hospital- and community-based) were most likely to offer youth services and which types of communities were most likely to have this infrastructure. Larger (p<0.001) and privately owned (p<0.001) facilities were more likely to offer youth services. Rural counties, counties in which a majority of residents were nonwhite, and/or counties with a higher percentage of uninsured residents were less likely to have a community-based MH treatment facility that served youth (p<0.001). PMID:26467795

Guidelines for the evaluation and assessment of the sustainable use of resources and of wastes management at healthcare facilities.

PubMed

Townend, William K; Cheeseman, Christopher R

2005-10-01

This paper presents guidelines that can be used by managers of healthcare facilities to evaluate and assess the quality of resources and waste management at their facilities and enabling the principles of sustainable development to be addressed. The guidelines include the following key aspects which need to be considered when completing an assessment. They are: (a) general management; (b) social issues; (c) health and safety; (d) energy and water use; (e) purchasing and supply; (f) waste management (responsibility, segregation, storage and packaging); (g) waste transport; (h) recycling and re-use; (i) waste treatment; and (j) final disposal. They identify actions required to achieve a higher level of performance which can readily be applied to any healthcare facility, irrespective of the local level of social, economic and environmental development. The guidelines are presented, and the characteristics of facilities associated with sustainable (level 4) and unsustainable (level 0) healthcare resource and wastes management are outlined. They have been used to assess a major London hospital, and this highlighted a number of deficiencies in current practice, including a lack of control over purchasing and supply, and very low rates of segregation of municipal solid waste from hazardous healthcare waste.

Real Science, Real Scientists: Student's Experiments with Natural and Artificial Wastewater Treatment in the Classroom

ERIC Educational Resources Information Center

Erdogan, Ibrahim

2006-01-01

In this extended biology, ecology, and earth science activity, students construct hands-on models of natural wastewater treatment and wastewater treatment facilities to achieve an understanding of wastewater treatment process in nature and wastewater treatment facilities. During this simulation activity, students have opportunities to learn…

Low-level liquid radioactive waste treatment at Murmansk, Russia: Technical design and review of facility upgrade and expansion

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

Dyer, R.S.; Diamante, J.M.; Duffey, R.B.

1996-07-01

The governments of Norway and the US have committed their mutual cooperation and support the Murmansk Shipping Company (MSCo) to expand and upgrade the Low-Level Liquid Radioactive Waste (LLRW) treatment system located at the facilities of the Russian company RTP Atomflot, in Murmansk, Russia. RTP Atomflot provides support services to the Russian icebreaker fleet operated by the MSCo. The objective is to enable Russia to permanently cease disposing of this waste in Arctic waters. The proposed modifications will increase the facility`s capacity from 1,200 m{sup 3} per year to 5,000 m{sup 3} per year, will permit the facility to processmore » high-salt wastes from the Russian Navy`s Northern fleet, and will improve the stabilization and interim storage of the processed wastes. The three countries set up a cooperative review of the evolving design information, conducted by a joint US and Norwegian technical team from April through December, 1995. To ensure that US and Norwegian funds produce a final facility which will meet the objectives, this report documents the design as described by Atomflot and the Russian business organization, ASPECT, both in design documents and orally. During the detailed review process, many questions were generated, and many design details developed which are outlined here. The design is based on the adsorption of radionuclides on selected inorganic resins, and desalination and concentration using electromembranes. The US/Norwegian technical team reviewed the available information and recommended that the construction commence; they also recommended that a monitoring program for facility performance be instituted.« less

Paving the Road for Modern Particle Therapy - What Can We Learn from the Experience Gained with Fast Neutron Therapy in Munich?

PubMed

Specht, Hanno M; Neff, Teresa; Reuschel, Waltraud; Wagner, Franz M; Kampfer, Severin; Wilkens, Jan J; Petry, Winfried; Combs, Stephanie E

2015-01-01

While neutron therapy was a highly topical subject in the 70s and 80s, today there are only a few remaining facilities offering fast neutron therapy (FNT). Nevertheless, up to today more than 30,000 patients were treated with neutron therapy. For some indications like salivary gland tumors and malignant melanoma, there is clinical evidence that the addition of FNT leads to superior local control compared to photon treatment alone. FNT was available in Munich from 1985 until 2000 at the Reactor Neutron Therapy (RENT) facility. Patient treatment continued at the new research reactor FRM II in 2007 under improved treatment conditions, and today it can still be offered to selected patients as an individual treatment option. As there is a growing interest in high-linear energy transfer (LET) therapy with new hadron therapy centers emerging around the globe, the clinical data generated by neutron therapy might help to develop biologically driven treatment planning algorithms. Also FNT might experience its resurgence as a combinational partner of modern immunotherapies.

Paving the Road for Modern Particle Therapy – What Can We Learn from the Experience Gained with Fast Neutron Therapy in Munich?

PubMed Central

Specht, Hanno M.; Neff, Teresa; Reuschel, Waltraud; Wagner, Franz M.; Kampfer, Severin; Wilkens, Jan J.; Petry, Winfried; Combs, Stephanie E.

2015-01-01

While neutron therapy was a highly topical subject in the 70s and 80s, today there are only a few remaining facilities offering fast neutron therapy (FNT). Nevertheless, up to today more than 30,000 patients were treated with neutron therapy. For some indications like salivary gland tumors and malignant melanoma, there is clinical evidence that the addition of FNT leads to superior local control compared to photon treatment alone. FNT was available in Munich from 1985 until 2000 at the Reactor Neutron Therapy (RENT) facility. Patient treatment continued at the new research reactor FRM II in 2007 under improved treatment conditions, and today it can still be offered to selected patients as an individual treatment option. As there is a growing interest in high-linear energy transfer (LET) therapy with new hadron therapy centers emerging around the globe, the clinical data generated by neutron therapy might help to develop biologically driven treatment planning algorithms. Also FNT might experience its resurgence as a combinational partner of modern immunotherapies. PMID:26640777

Proton therapy detector studies under the experience gained at the CATANA facility

NASA Astrophysics Data System (ADS)

Cuttone, G.; Cirrone, G. A. P.; Di Rosa, F.; Lojacono, P. A.; Lo Nigro, S.; Marino, C.; Mongelli, V.; Patti, I. V.; Pittera, S.; Raffaele, L.; Russo, G.; Sabini, M. G.; Salamone, V.; Valastro, L. M.

2007-10-01

Proton therapy represents the most promising radiotherapy technique for external tumor treatments. At Laboratori Nazionali del Sud of the Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania (I), a proton therapy facility is active since March 2002 and 140 patients, mainly affected by choroidal and iris melanoma, have been successfully treated. Proton beams are characterized by higher dose gradients and linear energy transfer with respect to the conventional photon and electron beams, commonly used in medical centers for radiotherapy.In this paper, we report the experience gained in the characterization of different dosimetric systems, studied and/or developed during the last ten years in our proton therapy facility.

Infection prevention and control in deployed military medical treatment facilities.

PubMed

Hospenthal, Duane R; Green, Andrew D; Crouch, Helen K; English, Judith F; Pool, Jane; Yun, Heather C; Murray, Clinton K

2011-08-01

Infections have complicated the care of combat casualties throughout history and were at one time considered part of the natural history of combat trauma. Personnel who survived to reach medical care were expected to develop and possibly succumb to infections during their care in military hospitals. Initial care of war wounds continues to focus on rapid surgical care with debridement and irrigation, aimed at preventing local infection and sepsis with bacteria from the environment (e.g., clostridial gangrene) or the casualty's own flora. Over the past 150 years, with the revelation that pathogens can be spread from patient to patient and from healthcare providers to patients (including via unwashed hands of healthcare workers, the hospital environment and fomites), a focus on infection prevention and control aimed at decreasing transmission of pathogens and prevention of these infections has developed. Infections associated with combat-related injuries in the recent operations in Iraq and Afghanistan have predominantly been secondary to multidrug-resistant pathogens, likely acquired within the military healthcare system. These healthcare-associated infections seem to originate throughout the system, from deployed medical treatment facilities through the chain of care outside of the combat zone. Emphasis on infection prevention and control, including hand hygiene, isolation, cohorting, and antibiotic control measures, in deployed medical treatment facilities is essential to reducing these healthcare-associated infections. This review was produced to support the Guidelines for the Prevention of Infections Associated With Combat-Related Injuries: 2011 Update contained in this supplement of Journal of Trauma.

Operation and Maintenance of Wastewater Treatment Facilities.

ERIC Educational Resources Information Center

Drury, Douglas D.

1978-01-01

Presents the 1978 literature review of wastewater treatment: (1) operators, training, and certification; (2) solutions to operating problems; (3) collection systems; (4) operations manuals; (5) wastewater treatment facility case histories; (5) land application; and (6) treatment of industrial wastes. A list of 36 references is also presented. (HM)

Application of a Bimetallic Treatment System (BTS) for PCB Removal from Older Structures on DoD Facilities. Cost and Performance Report

DTIC Science & Technology

2011-11-01

Bimetallic Treatment System (BTS) for PCB Removal from Older Structures on DoD Facilities By Thomas Krug and Suzanne O’Hara, Geosyntec...COST AND PERFORMANCE REPORT FOR: Application of a Bimetallic Treatment System (BTS) for PCB Removal from Older Structures on DOD Facilities...11 3.4 Reduction in PCB concentrations in treated paint to less

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...

Facility Volume and Survival in Nasopharyngeal Carcinoma.

PubMed

Yoshida, Emi J; Luu, Michael; David, John M; Kim, Sungjin; Mita, Alain; Scher, Kevin; Shiao, Stephen L; Tighiouart, Mourad; Lee, Nancy Y; Ho, Allen S; Zumsteg, Zachary S

2018-02-01

Definitive treatment of nasopharyngeal carcinoma (NPC) is challenging owing to its rarity, complicated regional anatomy, and the intensity of therapy. In contrast to other head and neck cancers, the effect of facility volume has not been well described for NPC. The National Cancer Database was queried for patients with stage II-IVB NPC diagnosed from 2004 to 2014 and treated with definitive radiation. Patients with incomplete staging, unknown receipt or timing of treatment, unknown follow-up duration, incomplete socioeconomic information, or treatment outside the reporting facility were excluded. High-volume facilities (HVFs) were defined as the top 5% of facilities according to the annual facility volume. The present analysis included 3941 NPC patients treated at 804 facilities with a median follow-up duration of 59.4 months, including 1025 patients (26.0%) treated at HVFs. Treatment at HVFs was associated with significantly improved overall survival (OS) on multivariable analysis (hazard ratio 0.79, 95% confidence interval 0.69-0.90; P=.001). In propensity score-matched cohorts, 5-year OS was 69.1% versus 63.3% at HVFs versus lower volume facilities (LVFs), respectively (P=.003). Similar results were seen when facility volume was analyzed as a continuous variable. The effect of facility volume on survival varied by academic status (P=.002 for interaction). At academic centers, the propensity score-matched cohorts had 5-year OS of 71.4% compared with 62.4% (P<.001) at HVFs and LVFs, respectively. In contrast, the 5-year OS was 63.5% versus 67.9% (P=.68) in propensity score-matched patients at nonacademic HVFs and LVFs. Treatment at HVFs was associated with improved OS for patients with NPC, with the effect exclusively seen at academic centers. Copyright © 2017 Elsevier Inc. All rights reserved.

Gaps in the implementation of antenatal syphilis detection and treatment in health facilities across sub-Saharan Africa.

PubMed

Kanyangarara, Mufaro; Walker, Neff; Boerma, Ties

2018-01-01

Syphilis in pregnancy is an under-recognized public health problem, especially in sub-Saharan Africa which accounts for over 60% of the global burden of syphilis. If left untreated, more than half of maternal syphilis cases will result in adverse pregnancy outcomes including stillbirth and fetal loss, neonatal death, prematurity or low birth weight, and neonatal infections. Achieving universal coverage of antenatal syphilis screening and treatment has been the focus of the global campaign for the elimination of mother-to-child transmission of syphilis. However, little is known about the availability of antenatal syphilis screening and treatment across sub-Saharan Africa. The objective of this study was to estimate the 'likelihood of appropriate care' for antenatal syphilis screening and treatment by analyzing health facility surveys and household surveys conducted from 2010 to 2015 in 12 sub-Saharan African countries. In this secondary data analysis, we linked indicators of health facility readiness to provide antenatal syphilis detection and treatment from Service Provision Assessments (SPAs) and Service Availability and Readiness Assessments (SARAs) to indicators of ANC use from the Demographic and Health Surveys (DHS) to compute estimates of the 'likelihood of appropriate care'. Based on data from 5,593 health facilities that reported offering antenatal care (ANC) services, the availability of syphilis detection and treatment in ANC facilities ranged from 2% to 83%. The availability of syphilis detection and treatment was substantially lower in ANC facilities in West Africa compared to the other sub-regions. Levels of ANC attendance were high (median 94.9%), but only 27% of ANC attendees initiated care at less than 4 months gestation. We estimated that about one in twelve pregnant women received ANC early (<4 months) at a facility ready to provide syphilis detection and treatment (median 8%, range 7-32%). The largest implementation bottleneck identified was low health facility readiness, followed by timeliness of the first ANC visit. While access was fairly high, the low levels of likelihood of antenatal syphilis detection and treatment identified reinforce the need to improve the availability of syphilis rapid diagnostic tests and treatment and the timeliness of antenatal care-seeking across sub-Saharan Africa.

40 CFR 403.16 - Upset provision.

Code of Federal Regulations, 2010 CFR

2010-07-01

... operational error, improperly designed treatment facilities, inadequate treatment facilities, lack of... usual exercise of prosecutorial discretion, Agency enforcement personnel should review any claims that...

Human Health and Ecological Risk Assessment for the Operation of the Explosives Waste Treatment Facility at Site 300 of the Lawrence Livermore National Laboratory Volume 1: Report of Results

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

Gallegos, G; Daniels, J; Wegrecki, A

2006-04-24

This document contains the human health and ecological risk assessment for the Resource Recovery and Conservation Act (RCRA) permit renewal for the Explosives Waste Treatment Facility (EWTF). Volume 1 is the text of the risk assessment, and Volume 2 (provided on a compact disc) is the supporting modeling data. The EWTF is operated by the Lawrence Livermore National Laboratory (LLNL) at Site 300, which is located in the foothills between the cities of Livermore and Tracy, approximately 17 miles east of Livermore and 8 miles southwest of Tracy. Figure 1 is a map of the San Francisco Bay Area, showingmore » the location of Site 300 and other points of reference. One of the principal activities of Site 300 is to test what are known as ''high explosives'' for nuclear weapons. These are the highly energetic materials that provide the force to drive fissionable material to criticality. LLNL scientists develop and test the explosives and the integrated non-nuclear components in support of the United States nuclear stockpile stewardship program as well as in support of conventional weapons and the aircraft, mining, oil exploration, and construction industries. Many Site 300 facilities are used in support of high explosives research. Some facilities are used in the chemical formulation of explosives; others are locations where explosive charges are mechanically pressed; others are locations where the materials are inspected radiographically for such defects as cracks and voids. Finally, some facilities are locations where the machined charges are assembled before they are sent to the on-site test firing facilities, and additional facilities are locations where materials are stored. Wastes generated from high-explosives research are treated by open burning (OB) and open detonation (OD). OB and OD treatments are necessary because they are the safest methods for treating explosives wastes generated at these facilities, and they eliminate the requirement for further handling and transportation that would be required if the wastes were treated off site.« less

Public preferences for establishing nephrology facilities in Greenland: estimating willingness-to-pay using a discrete choice experiment.

PubMed

Kjær, Trine; Bech, Mickael; Kronborg, Christian; Mørkbak, Morten Raun

2013-10-01

At present there are no nephrology facilities in Greenland. Greenlandic patients with renal failure needing dialysis thus have to travel to Denmark to obtain treatment. For patients in haemodialysis this necessitates a permanent residence in Denmark. Our study was aimed at examining Greenlanders' preferences for establishing nephrology facilities in Greenland at Queen Ingrid's Hospital in Nuuk, and to estimate the associated change in welfare. Preferences were elicited using a discrete choice experiment (DCE). A random sample of 500 individuals of the general population was sent a postal questionnaire in which they were asked to consider the trade-offs of establishing nephrology facilities in Greenland as opposed to the current situation. This involved trading off the benefits of having such facilities in their home country against the costs of the intervention. Besides including a payment attribute described in terms of incremental tax payment, the DCE included two interventions attributes related to (1) the organisation of labour, and (2) the physical settings of the patients. Respondents succeeded in answering the DCE despite cultural and linguistic disparity. We found that all the included attributes had a significant effect on respondents' choices, and that respondents' answers to the DCE were in keeping with their values as stated in the questionnaire. DCE data was analyzed using a random parameter logit model reparametrized in willingness-to-pay space. The results showed that establishing facilities in Greenland were preferred to the current treatment in Denmark. The welfare estimate from the DCE, at DKK 18.74 million, exceeds the estimated annual costs of establishing treatment facilities for patients with chronic renal failure. Given the estimated confidence interval this result seems robust. Establishing facilities in Greenland therefore would appear to be welfare-improving, deriving positive net benefits. Despite the relatively narrow policy focus, we believe that our findings provide some insight into individuals' preferences for decentralization of public services and on citizens' views of 'self-governance' that go beyond the case of Greenland. More generally, this paper illustrates how DCE can be applied successfully to developing countries with culturally, demographically, and geographically distinct features.

Human Health and Ecological Risk Assessment for the Operation of the Explosives Waste Treatment Facility at Site 300 of the Lawrence Livermore National Laboratory

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

Gallegos, G; Daniels, J; Wegrecki, A

2007-10-01

This document contains the human health and ecological risk assessment for the Resource Recovery and Conservation Act (RCRA) permit renewal for the Explosives Waste Treatment Facility (EWTF). Volume 1 is the text of the risk assessment, and Volume 2 (provided on a compact disc) is the supporting modeling data. The EWTF is operated by the Lawrence Livermore National Laboratory (LLNL) at Site 300, which is located in the foothills between the cities of Livermore and Tracy, approximately 17 miles east of Livermore and 8 miles southwest of Tracy. Figure 1 is a map of the San Francisco Bay Area, showingmore » the location of Site 300 and other points of reference. One of the principal activities of Site 300 is to test what are known as 'high explosives' for nuclear weapons. These are the highly energetic materials that provide the force to drive fissionable material to criticality. LLNL scientists develop and test the explosives and the integrated non-nuclear components in support of the United States nuclear stockpile stewardship program as well as in support of conventional weapons and the aircraft, mining, oil exploration, and construction industries. Many Site 300 facilities are used in support of high explosives research. Some facilities are used in the chemical formulation of explosives; others are locations where explosive charges are mechanically pressed; others are locations where the materials are inspected radiographically for such defects as cracks and voids. Finally, some facilities are locations where the machined charges are assembled before they are sent to the onsite test firing facilities, and additional facilities are locations where materials are stored. Wastes generated from high-explosives research are treated by open burning (OB) and open detonation (OD). OB and OD treatments are necessary because they are the safest methods for treating explosives wastes generated at these facilities, and they eliminate the requirement for further handling and transportation that would be required if the wastes were treated off site.« less

Cost and affordability of non-communicable disease screening, diagnosis and treatment in Kenya: Patient payments in the private and public sectors

PubMed Central

Gakunga, Robai; Kibachio, Joseph; Gathecha, Gladwell; Edwards, Patrick; Ogola, Elijah; Yonga, Gerald; Busakhala, Naftali; Munyoro, Esther; Chakaya, Jeremiah; Ngugi, Nancy; Mwangi, Nyawira; Von Rege, Daniel; Wangari, Lili-Marie; Wata, David; Makori, Robert; Mwangi, Julius; Mwanda, Walter

2018-01-01

Introduction The prevalence of non-communicable diseases (NCDs) is rising in low- and middle-income countries, including Kenya, disproportionately to the rest of the world. Our objective was to quantify patient payments to obtain NCD screening, diagnosis, and treatment services in the public and private sector in Kenya and evaluate patients’ ability to pay for the services. Methods and findings We collected payment data on cardiovascular diseases, diabetes, breast and cervical cancer, and respiratory diseases from Kenyatta National Hospital, the main tertiary public hospital, and the Kibera South Health Center—a public outpatient facility, and private sector practitioners and hospitals. We developed detailed treatment frameworks for each NCD and used an itemization cost approach to estimate payments. Patient affordability metrics were derived from Kenyan government surveys and national datasets. Results compare public and private costs in U.S. dollars. NCD screening costs ranged from $4 to $36, while diagnostic procedures, particularly for breast and cervical cancer, were substantially more expensive. Annual hypertension medication costs ranged from $26 to $234 and $418 to $987 in public and private facilities, respectively. Stroke admissions ($1,874 versus $16,711) and dialysis for chronic kidney disease ($5,338 versus $11,024) were among the most expensive treatments. Cervical and breast cancer treatment cost for stage III (curative approach) was about $1,500 in public facilities and more than $7,500 in the private facilities. A large proportion of Kenyans aged 15 to 49 years do not have health insurance, which makes NCD services unaffordable for most people given the overall high cost of services relative to income (average household expenditure per adult is $413 per annum). Conclusions There is substantial variation in patient costs between the public and private sectors. Most NCD diagnosis and treatment costs, even in the public sector, represent a substantial economic burden that can result in catastrophic expenditures. PMID:29304049

Economic analysis of effluent limitation guidelines and standards for the centralized waste treatment industry

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

Wheeler, W.

1998-12-01

This report estimates the economic and financial effects and the benefits of compliance with the proposed effluent limitations guidelines and standards for the Centralized Waste Treatment (CWT) industry. The Environmental Protection Agency (EPA) has measured these impacts in terms of changes in the profitability of waste treatment operations at CWT facilities, changes in market prices to CWT services, and changes in the quantities of waste management at CWT facilities in six geographic regions. EPA has also examined the impacts on companies owning CWT facilities (including impacts on small entities), on communities in which CWT facilities are located, and on environmentalmore » justice. EPA examined the benefits to society of the CWT effluent limitations guidelines and standards by examining cancer and non-cancer health effects of the regulation, recreational benefits, and cost savings to publicly owned treatment works (POTWs) to which indirect-discharging CWT facilities send their wastewater.« less

Operation, Maintenance and Management of Wastewater Treatment Facilities: A Bibliography of Technical Documents.

ERIC Educational Resources Information Center

Himes, Dottie

This is an annotated bibliography of wastewater treatment manuals. Fourteen manuals are abstracted including: (1) A Planned Maintenance Management System for Municipal Wastewater Treatment Plants; (2) Anaerobic Sludge Digestion, Operations Manual; (3) Emergency Planning for Municipal Wastewater Treatment Facilities; (4) Estimating Laboratory Needs…

32 CFR 732.18 - Notification of illness or injury.

Code of Federal Regulations, 2010 CFR

2010-07-01

... NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.18 Notification of... medical or dental attention in a non-Federal facility. The member will also assure (request the facility... or dental facility rendering treatment. (iii) Date(s) of such treatment. (iv) Nature and extent of...

32 CFR 732.18 - Notification of illness or injury.

Code of Federal Regulations, 2014 CFR

2014-07-01

... NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.18 Notification of... medical or dental attention in a non-Federal facility. The member will also assure (request the facility... or dental facility rendering treatment. (iii) Date(s) of such treatment. (iv) Nature and extent of...

32 CFR 732.18 - Notification of illness or injury.

Code of Federal Regulations, 2012 CFR

2012-07-01

... NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.18 Notification of... medical or dental attention in a non-Federal facility. The member will also assure (request the facility... or dental facility rendering treatment. (iii) Date(s) of such treatment. (iv) Nature and extent of...

32 CFR 732.18 - Notification of illness or injury.

Code of Federal Regulations, 2011 CFR

2011-07-01

... NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.18 Notification of... medical or dental attention in a non-Federal facility. The member will also assure (request the facility... or dental facility rendering treatment. (iii) Date(s) of such treatment. (iv) Nature and extent of...

32 CFR 732.18 - Notification of illness or injury.

Code of Federal Regulations, 2013 CFR

2013-07-01

... NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.18 Notification of... medical or dental attention in a non-Federal facility. The member will also assure (request the facility... or dental facility rendering treatment. (iii) Date(s) of such treatment. (iv) Nature and extent of...

GIS based location optimization for mobile produced water treatment facilities in shale gas operations

NASA Astrophysics Data System (ADS)

Kitwadkar, Amol Hanmant

Over 60% of the nation's total energy is supplied by oil and natural gas together and this demand for energy will continue to grow in the future (Radler et al. 2012). The growing demand is pushing the exploration and exploitation of onshore oil and natural gas reservoirs. Hydraulic fracturing has proven to not only create jobs and achieve economic growth, but also has proven to exert a lot of stress on natural resources---such as water. As water is one of the most important factors in the world of hydraulic fracturing, proper fluids management during the development of a field of operation is perhaps the key element to address a lot of these issues. Almost 30% of the water used during hydraulic fracturing comes out of the well in the form of flowback water during the first month after the well is fractured (Bai et. al. 2012). Handling this large amount of water coming out of the newly fractured wells is one of the major issues as the volume of the water after this period drops off and remains constant for a long time (Bai et. al. 2012) and permanent facilities can be constructed to take care of the water over a longer period. This paper illustrates development of a GIS based tool for optimizing the location of a mobile produced water treatment facility while development is still occurring. A methodology was developed based on a multi criteria decision analysis (MCDA) to optimize the location of the mobile treatment facilities. The criteria for MCDA include well density, ease of access (from roads considering truck hauls) and piping minimization if piping is used and water volume produced. The area of study is 72 square miles east of Greeley, CO in the Wattenberg Field in northeastern Colorado that will be developed for oil and gas production starting in the year 2014. A quarterly analysis is done so that we can observe the effect of future development plans and current circumstances on the location as we move from quarter to quarter. This will help the operators to make long-term decisions and also they can make decisions about the well pad siting and well densities. Three different scenarios---baseline, retroactive and proactive---were considered to see what could be the proper way to answer the question of optimal fluids management (OFM). Once the locations were obtained the results from different scenarios were compared for piping distances from each well going towards the facility, assuming the pipeline distance as the criteria to be minimized. The results obtained were pretty robust and observed to be fulfilling the intended purpose.

Development and evaluation of an aged care specific Advance Care Plan.

PubMed

Silvester, William; Parslow, Ruth A; Lewis, Virginia J; Fullam, Rachael S; Sjanta, Rebekah; Jackson, Lynne; White, Vanessa; Hudson, Rosalie

2013-06-01

To report on the quality of advance care planning (ACP) documents in use in residential aged care facilities (RACF) in areas of Victoria Australia prior to a systematic intervention; to report on the development and performance of an aged care specific Advance Care Plan template used during the intervention. An audit of the quality of pre-existing documentation used to record resident treatment preferences and end-of-life wishes at participating RACFs; development and pilot of an aged care specific Advance Care Plan template; an audit of the completeness and quality of Advance Care Plans completed on the new template during a systematic ACP intervention. 19 selected RACFs (managed by 12 aged care organisations) in metropolitan and regional areas of Victoria. Documentation in use at facilities prior to the ACP intervention most commonly recorded preferences regarding hospital transfer, life prolonging treatment and personal/cultural/religious wishes. However, 7 of 12 document sets failed to adequately and clearly specify the resident's preferences as regards life prolonging medical treatment. The newly developed aged care specific Advance Care Plan template was met with approval by participating RACFs. Of 203 Advance Care Plans completed on the template throughout the project period, 49% included the appointment of a Medical Enduring Power of Attorney. Requests concerning medical treatment were specified in almost all completed documents (97%), with 73% nominating the option of refusal of life-prolonging treatment. Over 90% of plans included information concerning residents' values and beliefs, and future health situations that the resident would find to be unacceptable were specified in 78% of completed plans. Standardised procedures and documentation are needed to improve the quality of processes, documents and outcomes of ACP in the residential aged care sector.

Evaporative oxidation treatability test report

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

NONE

1995-04-01

In 1992, Congress passed the Federal Facilities Compliance Act that requires the U.S. Department of Energy (DOE) to treat and dispose of its mixed waste in accordance with the Resource Conservation and Recovery Act (RCRA) land disposal restrictions (LDRs). In response to the need for mixed-waste treatment capacity where available off-site commercial treatment facilities do not exist or cannot be used, the DOE Albuquerque Operations Office (DOE-AL) organized a Treatment Selection Team to match mixed wastes with treatment options and develop a strategy for treatment of its mixed wastes. DOE-AL manages operations at nine sites with mixed-waste inventories. The Treatmentmore » Selection Team determined a need to develop mobile treatment capacity to treat wastes at the sites where the wastes are generated. Treatment processes used for mixed waste not only must address the hazardous component (i.e., meet LDRs) but also must contain the radioactive component in a form that allows final disposal while protecting workers, the public, and the environment. On the basis of recommendations of the Treatment Selection Team, DOE-AL assigned projects to the sites to bring mixed-waste treatment capacity on-line. The three technologies assigned to the DOE Grand Junction Projects Office (GJPO) are evaporative oxidation, thermal desorption, and treated wastewater evaporation. Rust Geotech, the DOE-GJPO prime contractor, was assigned to design and fabricate mobile treatment units (MTUs) for these three technologies and to deliver the MTUs to selected DOE-AL sites. To conduct treatability tests at the GJPO, Rust leased a pilot-scale evaporative oxidation unit from the Clemson Technical Center (CTC), Anderson, South Carolina. The purpose of this report is to document the findings and results of tests performed using this equipment.« less

Radioactive Liquid Waste Treatment Facility: Environmental Information Document

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

Haagenstad, H.T.; Gonzales, G.; Suazo, I.L.

1993-11-01

At Los Alamos National Laboratory (LANL), the treatment of radioactive liquid waste is an integral function of the LANL mission: to assure U.S. military deterrence capability through nuclear weapons technology. As part of this mission, LANL conducts nuclear materials research and development (R&D) activities. These activities generate radioactive liquid waste that must be handled in a manner to ensure protection of workers, the public, and the environment. Radioactive liquid waste currently generated at LANL is treated at the Radioactive Liquid Waste Treatment Facility (RLWTF), located at Technical Area (TA)-50. The RLWTF is 30 years old and nearing the end ofmore » its useful design life. The facility was designed at a time when environmental requirements, as well as more effective treatment technologies, were not inherent in engineering design criteria. The evolution of engineering design criteria has resulted in the older technology becoming less effective in treating radioactive liquid wastestreams in accordance with current National Pollutant Discharge Elimination System (NPDES) and Department of Energy (DOE) regulatory requirements. Therefore, to support ongoing R&D programs pertinent to its mission, LANL is in need of capabilities to efficiently treat radioactive liquid waste onsite or to transport the waste off site for treatment and/or disposal. The purpose of the EID is to provide the technical baseline information for subsequent preparation of an Environmental Impact Statement (EIS) for the RLWTF. This EID addresses the proposed action and alternatives for meeting the purpose and need for agency action.« less

2011 Annual Wastewater Reuse Report for the Idaho National Laboratory Site’s Central Facilities Area Sewage Treatment Plant

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

Michael G. Lewis

2012-02-01

This report describes conditions, as required by the state of Idaho Wastewater Reuse Permit (LA-000141-03), for the wastewater land application site at Idaho National Laboratory Site's Central Facilities Area Sewage Treatment Plant from November 1, 2010, through October 31, 2011. The report contains the following information: (1) Site description; (2) Facility and system description; (3) Permit required monitoring data and loading rates; (4) Status of special compliance conditions and activities; and (5) Discussion of the facility's environmental impacts. During the 2011 permit year, approximately 1.22 million gallons of treated wastewater was land-applied to the irrigation area at Central Facilities Areamore » Sewage Treatment plant.« less

Development of forensic mental health services in Japan: working towards the reintegration of offenders with mental disorders.

PubMed

Fujii, Chiyo; Fukuda, Yusuke; Ando, Kumiko; Kikuchi, Akiko; Okada, Takayuki

2014-01-01

Until the recent enactment of the Medical Treatment and Supervision Act (MTSA) in 2005, neither legislations nor facilities for mentally disordered offenders were available in Japan. The aim of the country's forensic mental health services, based on this new law, is to improve the social reintegration of mentally disordered offenders. In order to provide optimal psychiatric care to these individuals, specialised court proceedings, treatment facilities, and concrete guidelines have been established. The aim of this study was to review the current status of the new system and to clarify future challenges for improving services. The authors collected official statistics regarding the new system published separately by the Ministry of Health, Labour and Welfare, the Ministry of Justice, and the Supreme Court of Japan. We aggregated the data and examined the system's current implementation status, nationwide. There were 2,750 requests for enrolment in the MTSA system between its initiation in 2005 and 31 December 2012. Of those requests, 2,724 cases had been concluded in court. In 63.1% of the cases, an inpatient treatment order had been made; 82.4% of those inpatients were diagnosed with schizophrenia. By the end of March 2012, two patients completing treatment under the MTSA had re-committed a serious offense. While overall designated inpatient and outpatient treatment facilities have reached national targets in terms of resources and beds available, a regional gap in MTSA designated facilities remains and the number of patients under inpatient treatment order is on the increase. Overall, the MTSA system has been running smoothly without encountering any serious problems. However, several concerns have emerged, such as the accumulation of patients under inpatient treatment order and insufficient regional resources. To more successfully promote the reintegration of mentally disordered offenders, improvements in outpatient treatment and welfare services are crucial. In order to install effective measures to help improve the system, a nationwide database of patients being treated under order of the MTSA should be properly built and maintained.

Availability of Youth Services in U.S. Mental Health Treatment Facilities.

PubMed

Cummings, Janet R; Case, Brady G; Ji, Xu; Marcus, Steven C

2016-09-01

Despite concern about access to mental health (MH) services for youth, little is known about the specialty treatment infrastructure serving this population. We used national data to examine which types of MH treatment facilities (hospital- and community-based) were most likely to offer youth services and which types of communities were most likely to have this infrastructure. Larger (p < 0.001) and privately owned (p < 0.001) facilities were more likely to offer youth services. Rural counties, counties in which a majority of residents were nonwhite, and/or counties with a higher percentage of uninsured residents were less likely to have a community-based MH treatment facility that served youth (p < 0.001).

Development of a Multileaf Collimator for Proton Radiotherapy

DTIC Science & Technology

2011-06-01

to treat shallow depths was also simulated and commissioned in Eclipse . In order to calibrate the number of simulated protons per MU, a reference ...beam technology for proton radiotherapy, and the fourth year of the project to develop image guided treatment protocols for proton therapy. This...radiotherapy to proton therapy, and to develop a decision-making algorithm to maximize the efficiency of the facility. This report describes the

An empirical study on energy efficiency improvement through photovoltaic systems and a LED lighting control system

NASA Astrophysics Data System (ADS)

Choi, Young Kwan; Lee, Jae Hyeong

2015-09-01

In this research, a facility was constructed and its performance was analyzed to improve the energy efficiency of a vertical-type water treatment building. After the design and construction of a fixed tilt Photovoltaic in Building (PVIB) on the rooftop using a crystalline silicon solar cell module and photovoltaic generator integrated with the building by using a Building Integrated Photovoltaic System (BIPV), a thin-film module on the rooftop and outer wall of water treatment building, and the generation efficiency was analyzed. Also, a DC distribution was established for use of a brushless DC (BLDC) pump motor, and the existing lighting-facility-based manual on-off method was turned into a system for energy conservation by controlling light emitting diode (LED) through a wireless motion sensor and dimming control. In addition, a Building Energy Management System (BEMS) for a real-time analysis of the energy efficiency for a vertical0type water treatment building was prepared and tested. The vertical-type water treatment building developed in this study is currently operating the BEMS. The vertical-type water treatment building reported in this paper is expected to reduce energy consumption by about 30% compared to existing water treatment systems.

K-Basins Sludge Treatment and Packaging at the Hanford Site - 13585

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

Fogwell, Thomas W.; Honeyman, James O.; Stegen, Gary

Highly radioactive sludge resulting from the storage of degraded spent nuclear fuel has been consolidated in Engineered Containers (ECs) in the 105-K West Storage Basin located on the Hanford site near the Columbia River in Washington State. CH2M Hill Plateau Remediation Company (CHPRC) is proceeding with a project to retrieve the sludge, place it in Sludge Transport and Storage Containers (STSCs) and store those filled containers within the T Plant Canyon facility on the Hanford Site Central Plateau (Phase 1). Retrieval and transfer of the sludge material will enable removal of the 105-K West Basin and allow remediation of themore » subsurface contamination plumes under the basin. The U.S. Department of Energy (DOE) plans to treat and dispose of this K Basins sludge (Phase 2) as Remote Handled Transuranic Waste (RH TRU) at the Waste Isolation Pilot Plant (WIPP) located in New Mexico. The K Basin sludge currently contains uranium metal which reacts with water present in the stored slurry, generating hydrogen and other byproducts. The established transportation and disposal requirements require the transformation of the K Basins sludge to a chemically stable, liquid-free, packaged waste form. The Treatment and Packaging Project includes removal of the containerised sludge from T Plant, the treatment of the sludge as required, and packaging of all the sludge into a form that is certifiable for transportation to and disposal at WIPP. Completion of this scope will require construction and operation of a Sludge Treatment and Packaging Facility (STPF), which could be either a completely new facility or a modification of an existing Hanford Site facility. A Technology Evaluation and Alternatives Analysis (TEAA) for the STP Phase 2 was completed in 2011. A Request for Technology Information (RFI) had been issued in October 2009 to solicit candidate technologies for use in Phase 2. The RFI also included a preliminary definition of Phase 2 functions and requirements. Potentially applicable technologies were identified through a commercial procurement process, technical workshops, and review of the numerous previous sludge treatment technology studies. The identified technology approaches were screened using the criteria established in the Decision Plan, and focused bench top feasibility testing was conducted. Engineering evaluations of the costs, schedules, and technical maturity were developed and evaluated. Recommendations were developed based on technical evaluations. The criteria used in the evaluation process were as follows: (1) Safety, (2) Regulatory/stakeholder acceptance, (3) Technical maturity, (4) Operability and maintainability, (5) Life cycle cost and schedule, (6) Potential for beneficial integration with ongoing STP-Phase 1 activities, and (7) Integration with Site-wide RH-TRU processing/packaging, planning, schedule, and approach. The TEAA recommended Warm Water Oxidation (WWO) as the baseline treatment technology and two risk reduction enhancement options for further consideration during development of the process - size reduction and chemical oxidation (Fenton's reagent). The enhancement options would potentially allow a useful reduction in the total operating time required to process the K Basins sludge. The U.S. Department of Energy's Richland Field Office (DOE-RL) has approved this recommended technical approach. The baseline process can be broken down into the following main process steps: (1) STSC transfer from T Plant to the Sludge Treatment and Packaging Facility (STPF). (2) Retrieval of sludge from the STSCs and transfer to the Receipt and Reaction Tank (RRT). (3) Preparation for immobilization by oxidation using heated water (i.e., WWO) for those batches that require it and concentration by evaporating water at about atmospheric pressure in the RRT. (4) Immobilization by using additives to eliminate free liquids and packaging of the treated sludge into drums. (5) Inspection and handling of the filled drums prior to transfer to a separate storage and shipping facility. (6) Handling of vapor, condensate, and other waste streams generated by the process. Each of these steps is discussed in the paper, together with the current state of progress in developing the technology and requirements for continued development. A schematic of the recommended baseline WWO treatment process is given below. (authors)« less

The control system of the multi-strip ionization chamber for the HIMM

NASA Astrophysics Data System (ADS)

Li, Min; Yuan, Y. J.; Mao, R. S.; Xu, Z. G.; Li, Peng; Zhao, T. C.; Zhao, Z. L.; Zhang, Nong

2015-03-01

Heavy Ion Medical Machine (HIMM) is a carbon ion cancer treatment facility which is being built by the Institute of Modern Physics (IMP) in China. In this facility, transverse profile and intensity of the beam at the treatment terminals will be measured by the multi-strip ionization chamber. In order to fulfill the requirement of the beam position feedback to accomplish the beam automatic commissioning, less than 1 ms reaction time of the Data Acquisition (DAQ) of this detector must be achieved. Therefore, the control system and software framework for DAQ have been redesigned and developed with National Instruments Compact Reconfigurable Input/Output (CompactRIO) instead of PXI 6133. The software is Labview-based and developed following the producer-consumer pattern with message mechanism and queue technology. The newly designed control system has been tested with carbon beam at the Heavy Ion Research Facility at Lanzhou-Cooler Storage Ring (HIRFL-CSR) and it has provided one single beam profile measurement in less than 1 ms with 1 mm beam position resolution. The fast reaction time and high precision data processing during the beam test have verified the usability and maintainability of the software framework. Furthermore, such software architecture is easy-fitting to applications with different detectors such as wire scanner detector.

Do drug treatment facilities increase clients' exposure to potential neighborhood-level triggers for relapse? A small-area assessment of a large, public treatment system.

PubMed

Jacobson, Jerry O

2006-03-01

Research on drug treatment facility locations has focused narrowly on the issue of geographic proximity to clients. We argue that neighborhood conditions should also enter into the facility location decision and illustrate a formal assessment of neighborhood conditions at facilities in a large, metropolitan area, taking into account conditions clients already face at home. We discuss choice and construction of small-area measures relevant to the drug treatment context, including drug activity, disadvantage, and violence as well as statistical comparisons of clients' home and treatment locations with respect to these measures. Analysis of 22,707 clients discharged from 494 community-based outpatient and residential treatment facilities that received public funds during 1998-2000 in Los Angeles County revealed no significant mean differences between home and treatment neighborhoods. However, up to 20% of clients are exposed to markedly higher levels of disadvantage, violence, or drug activity where they attend treatment than where they live, suggesting that it is not uncommon for treatment locations to increase clients' exposure to potential environmental triggers for relapse. Whereas on average both home and treatment locations exhibit higher levels of these measures than the household locations of the general population, substantial variability in public treatment clients' home neighborhoods calls into question the notion that they hail exclusively from poor, high drug activity areas. Shortcomings of measures available for neighborhood assessment of treatment locations and implications of the findings for other areas of treatment research are also discussed.

CHANGES IN BACTERIAL COMPOSITION OF BIOFILM IN A METROPOLITAN DRINKING WATER DISTRIBUTION SYSTEM

EPA Science Inventory

This study examined the development of bacterial biofilms within a metropolitan distribution system. The distribution system is fed with different source water (i.e., groundwater, GW and surface water, SW) and undergoes different treatment processes in separate facilities. The b...

Recent Development in Chemical Depolymerization of Lignin: A Review

DOE PAGES

Wang, Hai; Tucker, Melvin; Ji, Yun

2013-01-01

This article reviewed recent development of chemical depolymerization of lignins. There were five types of treatment discussed, including base-catalyzed, acid-catalyzed, metallic catalyzed, ionic liquids-assisted, and supercritical fluids-assisted lignin depolymerizations. The methods employed in this research were described, and the important results were marked. Generally, base-catalyzed and acid-catalyzed methods were straightforward, but the selectivity was low. The severe reaction conditions (high pressure, high temperature, and extreme pH) resulted in requirement of specially designed reactors, which led to high costs of facility and handling. Ionic liquids, and supercritical fluids-assisted lignin depolymerizations had high selectivity, but the high costs of ionic liquids recyclingmore » and supercritical fluid facility limited their applications on commercial scale biomass treatment. Metallic catalyzed depolymerization had great advantages because of its high selectivity to certain monomeric compounds and much milder reaction condition than base-catalyzed or acid-catalyzed depolymerizations. It would be a great contribution to lignin conversion if appropriate catalysts were synthesized.« less

SECONDARY WASTE MANAGEMENT FOR HANFORD EARLY LOW ACTIVITY WASTE VITRIFICATION

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

UNTERREINER BJ

2008-07-18

More than 200 million liters (53 million gallons) of highly radioactive and hazardous waste is stored at the U.S. Department of Energy's Hanford Site in southeastern Washington State. The DOE's Hanford Site River Protection Project (RPP) mission includes tank waste retrieval, waste treatment, waste disposal, and tank farms closure activities. This mission will largely be accomplished by the construction and operation of three large treatment facilities at the Waste Treatment and Immobilization Plant (WTP): (1) a Pretreatment (PT) facility intended to separate the tank waste into High Level Waste (HLW) and Low Activity Waste (LAW); (2) a HLW vitrification facilitymore » intended to immobilize the HLW for disposal at a geologic repository in Yucca Mountain; and (3) a LAW vitrification facility intended to immobilize the LAW for shallow land burial at Hanford's Integrated Disposal Facility (IDF). The LAW facility is on target to be completed in 2014, five years prior to the completion of the rest of the WTP. In order to gain experience in the operation of the LAW vitrification facility, accelerate retrieval from single-shell tank (SST) farms, and hasten the completion of the LAW immobilization, it has been proposed to begin treatment of the low-activity waste five years before the conclusion of the WTP's construction. A challenge with this strategy is that the stream containing the LAW vitrification facility off-gas treatment condensates will not have the option of recycling back to pretreatment, and will instead be treated by the Hanford Effluent Treatment Facility (ETF). Here the off-gas condensates will be immobilized into a secondary waste form; ETF solid waste.« less

Opportunities for Automated Demand Response in California Wastewater Treatment Facilities

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

Aghajanzadeh, Arian; Wray, Craig; McKane, Aimee

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

Process wastewater treatability study for Westinghouse fluidized-bed coal gasification

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

Winton, S.L.; Buvinger, B.J.; Evans, J.M.

1983-11-01

In the development of a synthetic fuels facility, water usage and wastewater treatment are major areas of concern. Coal gasification processes generally produce relatively large volumes of gas condensates. These wastewaters are typically composed of a variety of suspended and dissolved organic and inorganic solids and dissolved gaseous contaminants. Fluidized-bed coal gasification (FBG) processes are no exception to this rule. The Department of Energy's Morgantown Energy Technology Center (METC), the Gas Research Institute (GRI), and the Environmental Protection Agency (EPA/IERLRTP) recognized the need for a FBG treatment program to provide process design data for FBG wastewaters during the environmental, health,more » and safety characterization of the Westinghouse Process Development Unit (PDU). In response to this need, METC developed conceptual designs and a program plan to obtain process design and performance data for treating wastewater from commercial-scale Westinghouse-based synfuels plants. As a result of this plan, METC, GRI, and EPA entered into a joint program to develop performance data, design parameters, conceptual designs, and cost estimates for treating wastewaters from a FBG plant. Wastewater from the Westinghouse PDU consists of process quench and gas cooling condensates which are similar to those produced by other FBG processes such as U-Gas, and entrained-bed gasification processes such as Texaco. Therefore, wastewater from this facility was selected as the basis for this study. This paper outlines the current program for developing process design and cost data for the treatment of these wastewaters.« less

Combining medically assisted treatment and Twelve-Step programming: a perspective and review.

PubMed

Galanter, Marc

2018-01-01

People with severe substance use disorders require long-term rehabilitative care after the initial treatment. There is, however, a deficit in the availability of such care. This may be due both to inadequate medical coverage and insufficient use of community-based Twelve-Step programs in many treatment facilities. In order to address this deficit, rehabilitative care for severe substance use disorders could be promoted through collaboration between practitioners of medically assisted treatment, employing medications, and Twelve-Step-oriented practitioners. To describe the limitations and benefits in applying biomedical approaches and Twelve-Step resources in the rehabilitation of persons with severe substance use disorders; and to assess how the two approaches can be employed together to improve clinical outcome. Empirical literature focusing on clinical and manpower issues is reviewed with regard (a) to limitations in available treatment options in ambulatory and residential addiction treatment facilities for persons with severe substance use disorders, (b) problems of long-term rehabilitation particular to opioid-dependent persons, associated with the limitations of pharmacologic approaches, (c) the relative effectiveness of biomedical and Twelve-Step approaches in the clinical context, and (d) the potential for enhanced use of these approaches, singly and in combination, to address perceived deficits. The biomedical and Twelve-Step-oriented approaches are based on differing theoretical and empirically grounded models. Research-based opportunities are reviewed for improving addiction rehabilitation resources with enhanced collaboration between practitioners of these two potentially complementary practice models. This can involve medications for both acute and chronic treatment for substances for which such medications are available, and Twelve-Step-based support for abstinence and long-term rehabilitation. Clinical and Scientific Significance: Criteria for developing evidence-based approaches for combined treatment should be developed, and research for evidence-based treatment on this basis can be undertaken in order to develop improved clinical outcome.

Treatment of yellow scorpion (Leiurus quinquestriatus) sting: a case report.

PubMed

Shalita, Eric A; Wells, Ryan D

2007-01-01

To report the treatment given to a 26-year-old Air Force medic who was stung twice by a yellow scorpion (Leiurus quinquestriatus) while stationed in Iraq and to describe the problems and issues related to the use of the scorpion antivenin. The patient presented 2 hours after envenomation to the local military treatment facility, where she was minimally symptomatic initially. Shortness of breath and anxiety developed, and the patient was sedated, intubated, and evacuated to a large Air Force medical facility for more advanced care. Vasopressor support was required during flight. At the medical facility, antivenin was administered, and the patient's cardiac condition was stabilized with norepinephrine drip, mild hydration, and vasopressor support. A second dose of antivenin diluted in sodium chloride and further pressor support were required. ST-segment depression eventually resolved, and the patient was gradually taken off norepinephrine and extubated. She recovered fully within 2 weeks and returned to active duty. Because the antivenin used is not licensed by the Food and Drug Administration, informed consent was needed; however, it could not be obtained because the patient was unconscious, intubated, and in a life-or-death situation. Antivenin selection is based on the species of scorpion and symptom severity; therefore, the scorpion should be, with great care, killed for identification. In the military setting, inventory control, storage, and accountability are vital issues surrounding antivenin use, and these are discussed in this article. Immediate action and effective communication, along with timely antivenin administration and well-equipped intensive care facilities, were integral in saving the life of this victim of a yellow scorpion envenomation. All level 3 facilities in Southwest Asia must be familiar with ordering, administering, and documenting this antivenin because it is difficult to obtain and infrequently available.

Snakebite in bedroom kills a physician in Cameroon: a case report.

PubMed

Nkwescheu, Armand; Mbasso, Leopold Cyriaque Donfack; Pouth, Franky Baonga Ba; Dzudie, Anastase; Billong, Serge Clotaire; Ngouakam, Hermann; Diffo, Joseph Le Doux; Eyongorock, Hanny; Mbacham, Wilfred

2016-01-01

The World Health Organization (WHO) classifies snake bites as neglected public health problem affecting mostly tropical and subtropical countries. In Africa there are an estimated 1 million snake bites annually with about half needing a specific treatment. Women, children and farmers in poor rural communities in developing countries are the most affected. Case management of snake bites are not adequate in many health facilities in developing countries where personnel are not always abreast with the new developments in snake bite management and in addition, quite often the anti-venom serum is lacking. We report the case of a medical doctor bitten by a cobra in the rural area of Poli, Cameroon while asleep in his bedroom. Lack of facilities coupled with poor case management resulted in a fatal outcome.

Young Adult Male Satisfaction with Drug & Alcohol Rehabilitation Facilities: Interior Design Implications.

ERIC Educational Resources Information Center

Potthoff, Joy K.

1991-01-01

Examined young adult male patient (n=18) satisfaction with interior environments of three different in-patient drug and alcohol rehabilitation facilities: renovated Elk's Club; hospital wing; and facility built for drug and alcohol treatment. Findings indicated satisfaction declined over four-week treatment period; familiar objects were missed;…

Sewage Management Changes in the North-eastern Poland After Accession to the European Union

NASA Astrophysics Data System (ADS)

Skarżyński, Szymon; Bartkowska, Izabela

2018-02-01

Poland's accession to the European Union contributed to the infrastructure development of the whole country. One of the elements of the modernized infrastructure is the sewage network and facilities on this network, as well as facilities for waste water treatment and disposal of sludge. A wide stream of funds flowing to the country, and consequently also to the north-eastern polish voivodeships (Podlaskie, Warmian-Masurian, Lublin), allowed modernization, organize, and sometimes to build a new sewage management of this part of the country. The main factors and parameters that allow us to evaluate the development of the sewage management in north-eastern Poland are included: percentage of population using sewage treatment plants, number of municipal sewage plants with the division of their type, number of industrial plants, number of septic tanks, amount of sewage purified in a year, amount of sludge produced in the year, design capacity of sewage treatment plant, size of plant in population equivalent (PE). From a number of investments in the field of wastewater management carried out in the discussed area in the period after Poland's accession to the European Union, 9 investments were considered the most important, 3 from each of the voivodeships.

Development of digital reconstructed radiography software at new treatment facility for carbon-ion beam scanning of National Institute of Radiological Sciences.

PubMed

Mori, Shinichiro; Inaniwa, Taku; Kumagai, Motoki; Kuwae, Tsunekazu; Matsuzaki, Yuka; Furukawa, Takuji; Shirai, Toshiyuki; Noda, Koji

2012-06-01

To increase the accuracy of carbon ion beam scanning therapy, we have developed a graphical user interface-based digitally-reconstructed radiograph (DRR) software system for use in routine clinical practice at our center. The DRR software is used in particular scenarios in the new treatment facility to achieve the same level of geometrical accuracy at the treatment as at the imaging session. DRR calculation is implemented simply as the summation of CT image voxel values along the X-ray projection ray. Since we implemented graphics processing unit-based computation, the DRR images are calculated with a speed sufficient for the particular clinical practice requirements. Since high spatial resolution flat panel detector (FPD) images should be registered to the reference DRR images in patient setup process in any scenarios, the DRR images also needs higher spatial resolution close to that of FPD images. To overcome the limitation of the CT spatial resolution imposed by the CT voxel size, we applied image processing to improve the calculated DRR spatial resolution. The DRR software introduced here enabled patient positioning with sufficient accuracy for the implementation of carbon-ion beam scanning therapy at our center.

Opportunities for Combined Heat and Power at Wastewater Treatment Facilities: Market Analysis and Lessons from the Field

EPA Pesticide Factsheets

This report presents the opportunities for combined heat and power (CHP) applications in the municipal wastewater treatment sector, and it documents the experiences of the wastewater treatment facility (WWTF) operators who have employed CHP.

Managing Waste Inventory and License Limits at the Perma-Fix Northwest Facility to Meet CH2M Hill Plateau Remediation Company (CHPRC) American Recovery and Reinvestment Act (ARRA) Deliverables - 12335

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

Moak, Don J.; Grondin, Richard L.; Triner, Glen C.

CH2M Hill Plateau Remediation Company (CHRPC) is a prime contractor to the U.S. Department of Energy (DOE) focused on the largest ongoing environmental remediation project in the world at the DOE Hanford Site Central Plateau, i.e. the DOE Hanford Plateau Remediation Contract. The East Tennessee Materials and Energy Corporation (M and EC); a wholly owned subsidiary of Perma-Fix Environmental Services, Inc. (PESI), is a small business team member to CHPRC. Our scope includes project management; operation and maintenance of on-site storage, repackaging, treatment, and disposal facilities; and on-site waste management including waste receipt from generators and delivery to on-site andmore » off-site treatment, storage, and disposal facilities. As part of this scope, M and EC staffs the centralized Waste Support Services organization responsible for all waste characterization and acceptance required to support CHPRC and waste generators across the Hanford Site. At the time of the CHPRC contract award (August 2008) slightly more than 9,000 cubic meters (m{sup 3}) of legacy waste was defined as 'no-path-forward waste'. A significant portion of this waste (7,650 m{sup 3}) comprised wastes with up to 50 grams of special nuclear materials (SNM) in oversized packages recovered during retrieval operations and large glove boxes removed from the Plutonium Finishing Plant (PFP). Through a collaborative effort between the DOE, CHPRC, and Perma-Fix Environmental Services, Inc. (PESI), pathways for these problematic wastes were developed that took advantage of commercial treatment capabilities at a nearby vendor facility, Perma-Fix Northwest (PFNW). In the spring of 2009, CHPRC initiated a pilot program under which they began shipping large package, low gram suspect TRU (<15 g SNM per container), and large package contact and remote handled MLLW to the off-site PFNW facility for treatment. PFNW is restricted by the SNM limits set for the total quantity of SNM allowed at the facility in accordance with the facility's radioactive materials license(s) (RML). While both CHPRC and PFNW maintain waste databases to track all waste movements, it became evident early in the process that a tool was needed that married the two systems to better track SNM inventories and sequence waste from the point of generation, through the PFNW facility, and back to the Hanford site for final disposition. This tool, known as the Treatment Integration and Planning Tool (TIPT), has become a robust planning tool that provides real-time data to support compliant and efficient waste generation, transportation, treatment, and disposition. TIPT is developing into the next generation tool that will change the way in which legacy wastes, retrieval wastes and decontamination and decommissioning operations are conducted on the Plateau Remediation Contract (PRC). The real value of the TIPT is its predictive capability. It allows the W and FMP to map out optimal windows for processing waste through the PFNW facility, or through any process that is in some way resource limited. It allows project managers to identify and focus on problem areas before shipments are affected. It has been modified for use in broader applications to predict turnaround times and identify windows of opportunity for processing higher gram wastes through PFNW and to allow waste generators, site-wide, to accurately predict scope, cost, and schedule for waste generation to optimize processing and eliminate storage, double handling, and related costs and unnecessary safety risks. The TIPT addresses the years old problem of how to effectively predict not only what needs to be done, but when. 'When' is the key planning parameter that has been ignored by the generator and processor for many years, but has proven to be the most important parameter for both parties. While further refinement is a natural part of any development process, the current improvements on the TIPT have shown that prediction is a powerful consideration. Even in lean times expected for the foreseeable future, the improved TIPT continues to play a central role in managing our way through those times to assure facilities remain viable and available. It is recommended that other major remediation projects and waste processing facilities incorporate a tool such as TIPT to improve customer-commercial supplier communications and better optimization of resources. (authors)« less

State Parity Laws and Access to Treatment for Substance Use Disorder in the United States: Implications for Federal Parity Legislation

PubMed Central

Wen, Hefei; Cummings, Janet R.; Hockenberry, Jason M.; Gaydos, Laura M.; Druss, Benjamin G.

2014-01-01

Context The passage of the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA) and the 2010 Affordable Care Act (ACA) incorporated parity for substance use disorder (SUD) into federal legislation. Yet prior research provides us with scant evidence as to whether federal parity legislation will hold the potential for improving access to SUD treatment. Objective This study examined the effect of state-level SUD parity laws on state-aggregate SUD treatment rates from 2000 to 2008, to shed light on the impact of the recent federal-level SUD parity legislation. Design A quasi-experimental study design using a two-way (state and year) fixed-effect method Setting and Participants All known specialty SUD treatment facilities in the United States Interventions State-level SUD parity laws between 2000 and 2008 Main Outcome Measures State-aggregate SUD treatment rates in: (1) all specialty SUD treatment facilities, and (2) specialty SUD treatment facilities accepting private insurance Results The implementation of any SUD parity law increased the treatment rate by 9 percent (p<0.01) in all specialty SUD treatment facilities and by 15 percent (p<0.05) in facilities accepting private insurance. Full parity and parity-if-offered (i.e., parity only if SUD coverage is offered) increased SUD treatment rate by 13 percent (p<0.05) and 8 percent (p<0.05) in all facilities, and by 21 percent (p<0.05) and 10 percent (p<0.05) in those accepting private insurance. Conclusions We found a positive effect of the implementation of state SUD parity legislation on access to specialty SUD treatment. Furthermore, the positive association was more pronounced in states with more comprehensive parity laws. Our findings suggest that federal parity legislation holds the potential to improve access to SUD treatment. PMID:24154931

Distributed mixed-integer fuzzy hierarchical programming for municipal solid waste management. Part II: scheme analysis and mechanism revelation.

PubMed

Cheng, Guanhui; Huang, Guohe; Dong, Cong; Xu, Ye; Chen, Jiapei; Chen, Xiujuan; Li, Kailong

2017-03-01

As presented in the first companion paper, distributed mixed-integer fuzzy hierarchical programming (DMIFHP) was developed for municipal solid waste management (MSWM) under complexities of heterogeneities, hierarchy, discreteness, and interactions. Beijing was selected as a representative case. This paper focuses on presenting the obtained schemes and the revealed mechanisms of the Beijing MSWM system. The optimal MSWM schemes for Beijing under various solid waste treatment policies and their differences are deliberated. The impacts of facility expansion, hierarchy, and spatial heterogeneities and potential extensions of DMIFHP are also discussed. A few of findings are revealed from the results and a series of comparisons and analyses. For instance, DMIFHP is capable of robustly reflecting these complexities in MSWM systems, especially for Beijing. The optimal MSWM schemes are of fragmented patterns due to the dominant role of the proximity principle in allocating solid waste treatment resources, and they are closely related to regulated ratios of landfilling, incineration, and composting. Communities without significant differences among distances to different types of treatment facilities are more sensitive to these ratios than others. The complexities of hierarchy and heterogeneities pose significant impacts on MSWM practices. Spatial dislocation of MSW generation rates and facility capacities caused by unreasonable planning in the past may result in insufficient utilization of treatment capacities under substantial influences of transportation costs. The problems of unreasonable MSWM planning, e.g., severe imbalance among different technologies and complete vacancy of ten facilities, should be gained deliberation of the public and the municipal or local governments in Beijing. These findings are helpful for gaining insights into MSWM systems under these complexities, mitigating key challenges in the planning of these systems, improving the related management practices, and eliminating potential socio-economic and eco-environmental issues resulting from unreasonable management.

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

A one-dimensional, steady-state, dissolved-oxygen model and waste-load assimilation study for Cedar Creek, Dekalb and Allen counties, Indiana

USGS Publications Warehouse

Wilber, William G.; Peters, J.G.; Ayers, M.A.; Crawford, Charles G.

1979-01-01

A digital model calibrated to conditions in Cedar Creek was used to develop alternatives for future waste loadings that would be compatible with Indiana stream water-quality standards defined for two critical hydrologic conditions, summer and winter low flows. The model indicates that the dissolved-oxygen concentration of the Auburn wastewater effluent and nitrification are the most significant factors affecting the dissolved-oxygen concentration in Cedar Creek during summer low flows. The observed dissolved-oxygen concentration of the Auburn wastewater effluent was low and averaged 30 percent of saturation. Projected nitrogenous biochemical-oxygen demand loads, from the Indiana State Board of Health, for the Auburn and Waterloo wastewater-treatment facilities will result in violations of the current instream dissolved-oxygen standard (5 mg/l), even with an effluent dissolved-oxygen concentration of 80 percent saturation. Natural streamflow for Cedar Creek upstream from the confluence of Willow and Little Cedar Creeks is small compared with the waste discharge, so benefits of dilution for Waterloo and Auburn are minimal. The model also indicates that, during winter low flows, ammonia toxicity, rather than dissolved oxygen, is the limiting water-quality criterion in the reach of Cedar Creek downstream from the wastewater-treatment facility at Auburn and the confluence of Garrett ditch. Ammonia-nitrogen concentrations predicted for 1978 through 2000 downstream from the Waterloo wastewater-treatment facility do not exceed Indiana water-quality standards for streams. Calculations of the stream 's assimilative capacity indicate that future waste discharge in the Cedar Creek basin will be limited to the reaches between the Auburn wastewater-treatment facility and County Road 68. (Kosco-USGS)

2012 Annual Wastewater Reuse Report for the Idaho National Laboratory Site's Central facilities Area Sewage Treatment Plant

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

Mike Lewis

2013-02-01

This report describes conditions, as required by the state of Idaho Wastewater Reuse Permit (#LA-000141-03), for the wastewater land application site at Idaho National Laboratory Site’s Central Facilities Area Sewage Treatment Plant from November 1, 2011, through October 31, 2012. The report contains the following information: • Site description • Facility and system description • Permit required monitoring data and loading rates • Status of compliance conditions and activities • Discussion of the facility’s environmental impacts. During the 2012 permit year, no wastewater was land-applied to the irrigation area of the Central Facilities Area Sewage Treatment Plant.

Health systems challenges in cervical cancer prevention program in Malawi.

PubMed

Maseko, Fresier C; Chirwa, Maureen L; Muula, Adamson S

2015-01-01

Cervical cancer remains the leading cause of cancer death among women in sub-Saharan Africa. In Malawi, very few women have undergone screening and the incidence of cervical cancer is on the increase as is the case in most developing countries. We aimed at exploring and documenting health system gaps responsible for the poor performance of the cervical cancer prevention program in Malawi. The study was carried out in 14 randomly selected districts of the 29 districts of Malawi. All cervical cancer service providers in these districts were invited to participate. Two semi-structured questionnaires were used, one for the district cervical cancer coordinators and the other for the service providers. The themes of both questionnaires were based on World Health Organization (WHO) health system frameworks. A checklist was also developed to audit medical supplies and equipment in the cervical cancer screening facilities. The two questionnaires together with the medical supplies and equipment checklist were piloted in Chikwawa district before being used as data collection tools in the study. Quantitative data were analyzed using STATA and qualitative in NVIVO. Forty-one service providers from 21 health facilities and 9 district coordinators participated in the study. Our findings show numerous health system challenges mainly in areas of health workforce and essential medical products and technologies. Seven out of the 21 health facilities provided both screening and treatment. RESULTS showed challenges in the management of the cervical cancer program at district level; inadequate service providers who are poorly supervised; lack of basic equipment and stock-outs of basic medical supplies in some health facilities; and inadequate funding of the program. In most of the health facilities, services providers were not aware of the policy which govern their work and that they did not have standards and guidelines for cervical cancer screening and treatment. Numerous health system challenges are prevailing in the cervical cancer prevention program in Malawi. These challenges need to be addressed if the health system is to improve on the coverage of cervical cancer screening and treatment.

Racial/ethnic differences in access to substance abuse treatment.

PubMed

Lo, Celia C; Cheng, Tyrone C

2011-05-01

A secondary dataset, Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003, was employed to examine racial/ethnic differences in access to specialty and non-specialty substance abuse treatment (compared with no access to treatment). The study found that non-Hispanic White Americans were (1) likelier than members of all racial/ethnic minority groups (other than Hispanics) to address substance abuse by accessing care through specialty addiction-treatment facilities, and were (2) also less likely to access substance abuse care through non-specialty facilities. Because non-specialty facilities may have staffs whose professional training does not target treating chronic, bio-psycho-social illness such as substance abuse, our results imply that treatment facilities deemed non-specialty may need to enhance staff training, in order to ensure individuals are properly screened for substance use conditions and are referred for or provided with effective counseling and medications as appropriate.

Facility-level, state, and financial factors associated with changes in the provision of smoking cessation services in US substance abuse treatment facilities: Results from the National Survey of Substance Abuse Treatment Services 2006 to 2012.

PubMed

Cohn, Amy; Elmasry, Hoda; Niaura, Ray

2017-06-01

Cigarette smoking is common among patients in substance abuse treatment. Tobacco control programs have advocated for integrated tobacco dependence treatment into behavioral healthcare, including within substance abuse treatment facilities (SATFs) to reduce the public health burden of tobacco use. This study used data from seven waves (2006 to 2012) of the National Survey of Substance Abuse Treatment Services (n=94,145) to examine state and annual changes in the provision of smoking cessation services within US SATFs and whether changes over time could be explained by facility-level (private vs public ownership, receipt of earmarks, facility admissions, acceptance of government insurance) and state-level factors (cigarette tax per pack, smoke free policies, and percent of CDC recommended tobacco prevention spending). Results showed that the prevalence of SATFs offering smoking cessation services increased over time, from 13% to 65%. The amount of tax per cigarette pack, accepting government insurance, government (vs private) ownership, facility admissions, and CDC recommended tobacco prevention spending (per state) were the strongest correlates of the provision of smoking cessation programs in SATFs. Facilities that received earmarks were less likely to provide cessation services. Adult smoking prevalence and state-level smoke free policies were not significant correlates of the provision of smoking cessation services over time. Policies aimed at increasing the distribution of tax revenues to cessation services in SATFs may offset tobacco-related burden among those with substance abuse problems. Copyright © 2017. Published by Elsevier Inc.

Removal of Dissolved Salts and Particulate Contaminants from Seawater: Village Marine Tec., Expeditionary Unit Water Purifier, Generation 1

EPA Science Inventory

The EUWP was developed to treat challenging water sources with variable turbidity, chemical contamination, and very high total dissolved solids (TDS), including seawater, during emergency situations when other water treatment facilities are incapacitated. The EUWP components incl...

75 FR 65551 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-25

... at a $3.00 PFC Level: New terminal development schematic preliminary engineering study and design... for Collection and Use: Air carrier apron. Pavement condition inventory. New terminal building... construction. De-icing treatment plant. Domestic water service. CTX design and installation. Landside planning...

Correspondence regarding 'Assefa Y, et al., BMC Health Services Research. 2011; 11 (1):81 and 2014; 14(1):45': The Positive-Deviance approach for translating evidence into practice to improve patient retention in HIV care.

PubMed

Assefa, Yibeltal; Hill, Peter S; Kloos, Helmut; Ooms, Gorik; Van Damme, Wim

2018-03-21

The purpose of this correspondence is to describe how the positive-deviance approach can be used to translate evidence into practice, based on successive studies conducted in Ethiopia. In earlier studies, it was identified that retention in antiretroviral treatment care was variable across health facilities; and, seeking compliance across facilities, a framework was developed based on the practices of those positive-deviant health facilities, where performance was noted to be markedly better. It was found that the positive deviance approach was effective in facilitating the transfer of innovative practices (using different mechanisms) from positive-deviant health facilities to negative-deviant health facilities. As a result, the variability in retention in care across health facilities narrowed over time, increasing from 83 to 96% in 2007/8 to 95-97% in 2013/14. In conclusion, the positive-deviance approach is a valuable tool to translate evidence into practice, spread good practices, and help achieving universal health coverage.

Lessons Learned from the 200 West Pump and Treatment Facility Construction Project at the US DOE Hanford Site - A Leadership for Energy and Environmental Design (LEED) Gold-Certified Facility - 13113

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

Dorr, Kent A.; Freeman-Pollard, Jhivaun R.; Ostrom, Michael J.

CH2M Hill Plateau Remediation Company (CHPRC) designed, constructed, commissioned, and began operation of the largest groundwater pump and treatment facility in the U.S. Department of Energy's (DOE) nationwide complex. This one-of-a-kind groundwater pump and treatment facility, located at the Hanford Nuclear Reservation Site (Hanford Site) in Washington State, was built to an accelerated schedule with American Recovery and Reinvestment Act (ARRA) funds. There were many contractual, technical, configuration management, quality, safety, and Leadership in Energy and Environmental Design (LEED) challenges associated with the design, procurement, construction, and commissioning of this $95 million, 52,000 ft groundwater pump and treatment facility tomore » meet DOE's mission objective of treating contaminated groundwater at the Hanford Site with a new facility by June 28, 2012. The project team's successful integration of the project's core values and green energy technology throughout design, procurement, construction, and start-up of this complex, first-of-its-kind Bio Process facility resulted in successful achievement of DOE's mission objective, as well as attainment of LEED GOLD certification (Figure 1), which makes this Bio Process facility the first non-administrative building in the DOE Office of Environmental Management complex to earn such an award. (authors)« less

Climate Adaptation Capacity for Conventional Drinking Water Treatment Facilities

NASA Astrophysics Data System (ADS)

Levine, A.; Goodrich, J.; Yang, J.

2013-12-01

Water supplies are vulnerable to a host of climate- and weather-related stressors such as droughts, intense storms/flooding, snowpack depletion, sea level changes, and consequences from fires, landslides, and excessive heat or cold. Surface water resources (lakes, reservoirs, rivers, and streams) are especially susceptible to weather-induced changes in water availability and quality. The risks to groundwater systems may also be significant. Typically, water treatment facilities are designed with an underlying assumption that water quality from a given source is relatively predictable based on historical data. However, increasing evidence of the lack of stationarity is raising questions about the validity of traditional design assumptions, particularly since the service life of many facilities can exceed fifty years. Given that there are over 150,000 public water systems in the US that deliver drinking water to over 300 million people every day, it is important to evaluate the capacity for adapting to the impacts of a changing climate. Climate and weather can induce or amplify changes in physical, chemical, and biological water quality, reaction rates, the extent of water-sediment-air interactions, and also impact the performance of treatment technologies. The specific impacts depend on the watershed characteristics and local hydrological and land-use factors. Water quality responses can be transient, such as erosion-induced increases in sediment and runoff. Longer-term impacts include changes in the frequency and intensity of algal blooms, gradual changes in the nature and concentration of dissolved organic matter, dissolved solids, and modulation of the microbiological community structure, sources and survival of pathogens. In addition, waterborne contaminants associated with municipal, industrial, and agricultural activities can also impact water quality. This presentation evaluates relationships between climate and weather induced water quality variability and the capacity of treatment facilities and supporting water infrastructure to deliver safe drinking water consistently and reliably. Simulation models of water treatment facilities are used to evaluate the outcome of specific source water quality scenarios on treatment system performance and reliability. Modeling results are used to evaluate the process and operational capacity to respond to transient water quality changes and adapt to longer-term variability in water quality and availability. In some cases, changes in temperature and mineral content serve to improve the overall treatment performance. In addition, the integration of microbially enhanced treatment systems such as biological filtration can provide additional capacity. Conversely, changes in the nutrient and temperature dynamics can trigger algal and cyanobacterial blooms that can impair performance. Research needs are identified and the importance of developing more integrated modeling systems is highlighted.

Delayed treatment of decompression sickness with short, no-air-break tables: review of 140 cases.

PubMed

Cianci, Paul; Slade, John B

2006-10-01

Most cases of decompression sickness (DCS) in the U.S. are treated with hyperbaric oxygen using U.S. Navy Treatment Tables 5 and 6, although detailed analysis shows that those tables were based on limited data. We reviewed the development of these protocols and offer an alternative treatment table more suitable for monoplace chambers that has proven effective in the treatment of DCS in patients presenting to our facility. We reviewed the outcomes for 140 cases of DCS in civilian divers treated with the shorter tables at our facility from January 1983 through December 2002. Onset of symptoms averaged 9.3 h after surfacing. At presentation, 44% of the patients demonstrated mental aberration. The average delay from onset of symptoms to treatment was 93.5 h; median delay was 48 h. Complete recovery in the total group of 140 patients was 87%. When 30 patients with low probability of DCS were excluded, the recovery rate was 98%. All patients with cerebral symptoms recovered. Patients with the highest severity scores showed a high rate of complete recovery (97.5%). Short oxygen treatment tables as originally described by Hart are effective in the treatment of DCS, even with long delays to definitive recompression that often occur among civilian divers presenting to a major Divers Alert Network referral center.

Controversy about Management of Hydrocephalus - Shunt vs. Endoscopic Third Ventriculostomy.

PubMed

Kumar, Vikas; Bodeliwala, Shaam; Singh, Daljit

2017-08-01

The best management of hydrocephalus is still controversial in the twenty-first century. Shunt treatment for hydrocephalus is the most common procedure performed in neurosurgical practice and is associated with the highest complications rate. But during the last 2 decades, the treatment of hydrocephalus has improved with better shunt devices available today, increased facilities for investigations and newer approaches like endoscopic third ventriculostomy. The recent advances in development of better endoscopes have provided the patient and treating doctor with an option for an alternative surgery for treatment of hydrocephalus.

77 FR 58470 - Irradiation Treatment; Location of Facilities in the Southern United States; Technical Amendment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-21

.... APHIS-2009-0100] RIN 0579-AD35 Irradiation Treatment; Location of Facilities in the Southern United... things, allow for irradiation treatment of mangoes from India upon arrival in the mainland United States... 20, 2012, we amended the regulations in Sec. 319.56-46 to allow for irradiation treatment of mangoes...

78 FR 77009 - Section 306D Water Systems for Rural and Native Villages in Alaska

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-20

... ``establish a program designed to provide safe water and hygienic disposal facilities in the State of Alaska... treatment facilities and wastewater treatment and collection facilities. Drinking water was hauled from... CFR Part 1784 RIN 0572-AC28 Section 306D Water Systems for Rural and Native Villages in Alaska AGENCY...

Water treatment capacity of forward osmosis systems utilizing power plant waste heat

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

Zhou, Xingshi; Gingerich, Daniel B.; Mauter, Meagan S.

Forward osmosis (FO) has the potential to improve the energy efficiency of membrane-based water treatment by leveraging waste heat from steam electric power generation as the primary driving force for separation. In this study, we develop a comprehensive FO process model, consisting of membrane separation, heat recovery, and draw solute regeneration (DSR) models. We quantitatively characterize three alternative processes for DSR: distillation, steam stripping, and air stripping. We then construct a mathematical model of the distillation process for DSR that incorporates hydrodynamics, mass and heat transport resistances, and reaction kinetics, and we integrate this into a model for the fullmore » FO process. Finally, we utilize this FO process model to derive a first-order approximation of the water production capacity given the rejected heat quantity and quality available at U.S. electric power facilities. We find that the upper bound of FO water treatment capacity using low-grade heat sources at electric power facilities exceeds process water treatment demand for boiler water make-up and flue gas desulfurization wastewater systems.« less

The feasibility of a holistic wellness program for HIV/AIDS patients residing in a voluntary inpatient treatment program.

PubMed

Morgan, Vanessa

2014-03-01

The purpose of this project was to examine the feasibility of an ongoing holistic wellness program in a residential facility treating persons with HIV/AIDS. The goal was to create a voluntary, four week holistic wellness intensive within the established inpatient behavioral health treatment program. Participants were given practicable holistic self care tools to effectively manage HIV related symptoms, general medical issues, addiction, depression, stress and anxiety. The program incorporated evidence-based holistic activities including yoga, therapeutic dance, meditation, Reiki, and reflective journaling. Narrative survey results and post-program evaluation support that an ongoing holistic wellness program within the existing treatment model is feasible and could have numerous potential beneficial effects. This project clearly exemplified the ideal opportunity for holistic nurses to implement innovative holistic interventions within the current healthcare delivery system. It is the author's observation that future studies with a larger participant group to further examine measurable benefits can lend valuable information and insight into the future development of holistic wellness programs for residential treatment facilities.

Water treatment capacity of forward osmosis systems utilizing power plant waste heat

DOE PAGES

Zhou, Xingshi; Gingerich, Daniel B.; Mauter, Meagan S.

2015-06-11

Forward osmosis (FO) has the potential to improve the energy efficiency of membrane-based water treatment by leveraging waste heat from steam electric power generation as the primary driving force for separation. In this study, we develop a comprehensive FO process model, consisting of membrane separation, heat recovery, and draw solute regeneration (DSR) models. We quantitatively characterize three alternative processes for DSR: distillation, steam stripping, and air stripping. We then construct a mathematical model of the distillation process for DSR that incorporates hydrodynamics, mass and heat transport resistances, and reaction kinetics, and we integrate this into a model for the fullmore » FO process. Finally, we utilize this FO process model to derive a first-order approximation of the water production capacity given the rejected heat quantity and quality available at U.S. electric power facilities. We find that the upper bound of FO water treatment capacity using low-grade heat sources at electric power facilities exceeds process water treatment demand for boiler water make-up and flue gas desulfurization wastewater systems.« less

Evaluation of a TB infection control implementation initiative in out-patient HIV clinics in Zambia and Botswana.

PubMed

Emerson, C; Lipke, V; Kapata, N; Mwananyambe, N; Mwinga, A; Garekwe, M; Lanje, S; Moshe, Y; Pals, S L; Nakashima, A K; Miller, B

2016-07-01

Out-patient human immunodeficiency virus (HIV) care and treatment clinics in Zambia and Botswana, countries with a high burden of HIV and TB infection. To develop a tuberculosis infection control (TB IC) training and implementation package and evaluate the implementation of TB IC activities in facilities implementing the package. Prospective program evaluation of a TB IC training and implementation package using a standardized facility risk assessment tool, qualitative interviews with facility health care workers and measures of pre- and post-test performance. A composite measure of facility performance in TB IC improved from 32% at baseline to 50% at 1 year among eight facilities in Zambia, and from 27% to 80% at 6 months among 10 facilities in Botswana. Although there was marked improvement in indicators of managerial, administrative and environmental controls, key ongoing challenges remained in ensuring access to personal protective equipment and implementing TB screening in health care workers. TB IC activities at out-patient HIV clinics in Zambia and Botswana improved after training using the implementation package. Continued infrastructure support, as well as monitoring and evaluation, are needed to support the scale-up and sustainability of TB IC programs in facilities in low-resource countries.

Water Recovery from Advanced Water Purification Facility Reverse Osmosis Concentrate by Photobiological Treatment Followed by Secondary Reverse Osmosis.

PubMed

Ikehata, Keisuke; Zhao, Yuanyuan; Kulkarni, Harshad; Li, Yuan; Snyder, Shane A; Ishida, Kenneth P; Anderson, Michael A

2018-06-19

Reverse osmosis (RO)-based desalination and advanced water purification facilities have inherent challenges associated with concentrate management and disposal. Although enhanced permeate recovery and concentrate minimization are desired, membrane scaling due to inorganic constituents such as silica, calcium, phosphate, and iron hinders the process. To solve this problem, a new diatom-based photobiological process has been developed to remove these scaling constituents by biological uptake and precipitation. In this study, RO concentrate samples were collected from a full-scale advanced water reclamation facility in California and were treated in 3.8- and 57-L photobioreactors inoculated with a brackish water diatom Pseudostaurosira trainorii PEWL001 using light-emitting diode bulbs or natural sunlight as a light source. The photobiological treatment removed 95% of reactive silica and 64% of calcium and enabled additional water recovery using a secondary RO at a recovery rate up to 66%. This represents 95% overall recovery including 85% recovery in the primary RO unit. In addition to the scaling constituents, the photobiological treatment removed twelve pharmaceuticals and personal care products, as well as N-nitrosodimethylamine, from RO concentrate samples primarily via photolysis. This novel approach has a strong potential for application to brackish water desalination and advanced water purification in arid and semi-arid areas.

The GEANT4 toolkit capability in the hadron therapy field: simulation of a transport beam line

NASA Astrophysics Data System (ADS)

Cirrone, G. A. P.; Cuttone, G.; Di Rosa, F.; Raffaele, L.; Russo, G.; Guatelli, S.; Pia, M. G.

2006-01-01

At Laboratori Nazionali del Sud of the Instituto Nazionale di Fisica Nucleare of Catania (Sicily, Italy), the first Italian hadron therapy facility named CATANA (Centro di AdroTerapia ed Applicazioni Nucleari Avanzate) has been realized. Inside CATANA 62 MeV proton beams, accelerated by a superconducting cyclotron, are used for the radiotherapeutic treatments of some types of ocular tumours. Therapy with hadron beams still represents a pioneer technique, and only a few centers worldwide can provide this advanced specialized cancer treatment. On the basis of the experience so far gained, and considering the future hadron-therapy facilities to be developed (Rinecker, Munich Germany, Heidelberg/GSI, Darmstadt, Germany, PSI Villigen, Switzerland, CNAO, Pavia, Italy, Centro di Adroterapia, Catania, Italy) we decided to develop a Monte Carlo application based on the GEANT4 toolkit, for the design, the realization and the optimization of a proton-therapy beam line. Another feature of our project is to provide a general tool able to study the interactions of hadrons with the human tissue and to test the analytical-based treatment planning systems actually used in the routine practice. All the typical elements of a hadron-therapy line, such as diffusers, range shifters, collimators and detectors were modelled. In particular, we simulated the Markus type ionization chamber and a Gaf Chromic film as dosimeters to reconstruct the depth (Bragg peak and Spread Out Bragg Peak) and lateral dose distributions, respectively. We validated our simulated detectors comparing the results with the experimental data available in our facility.

A one-dimensional, steady-state, dissolved-oxygen model and waste-load assimilation study for Silver Creek, Clark and Floyd counties, Indiana

USGS Publications Warehouse

Wilber, William G.; Crawford, Charles G.; Peters, James G.

1979-01-01

The Indiana State Board of Health is developing a State water-quality management plan that includes establishing limits for wastewater effluents discharged into Indiana streams. A digital model calibrated to conditions in Silver Creek was used to develop alternatives for future waste loadings that would be compatible with Indiana stream water-quality standards defined for two critical hydrologic conditions, summer and winter low flows. Effluents from the Sellersburg and Clarksville-North wastewater-treatment facilities are the only point-source waste loads that significantly affect the water quality in the modeled segment of Silver Creek. Model simulations indicate that nitrification is the most significant factor affecting the dissolved-oxygen concentration in Silver Creek during summer and winter low flows. Natural streamflow in Silver Creek during the summer and annual 7-day, 10-year low flow is zero, so no benefit from dilution is provided. Present ammonia-nitrogen and dissolved-oxygen concentrations of effluent from the Sellersburg and Clarksville-North wastewater-treatment facilities will violate current Indiana water-quality standards for ammonia toxicity and dissolved oxygen during summer and winter low flows. The current biochemical-oxygen demand limits for the Sellersburg and Clarksville-North wastewater-treatment facilities are not sufficient to maintain an average dissolved-oxygen concentration of at least 5 milligrams per liter, the State 's water-quality standard for streams. Calculations of the stream 's assimilative capacity indicate that Silver Creek cannot assimilate additional waste loadings and meet current Indiana water-quality standards. (Kosco-USGS)

Financing CHP Projects at Wastewater Treatment Facilities with Clean Water State Revolving Funds

EPA Pesticide Factsheets

This factsheet provides information about CHP at wastewater treatment facilities, including applications, financial challenges, and financial opportunities, such as the Clean Water State Revolving Fund.

40 CFR 35.2127 - Federal facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works § 35.2127 Federal facilities... day or 5 percent of the design flow of the complete waste treatment system, whichever is less...

Evaluation and use of U.S. Environmental Protection Agency Clean Watersheds Needs Survey data to quantify nutrient loads to surface water, 1978–2012

USGS Publications Warehouse

Ivahnenko, Tamara I.

2017-12-07

Changes in municipal and industrial point-source discharges over time have been an important factor affecting nutrient trends in many of the Nation’s streams and rivers. This report documents how three U.S. Environmental Protection Agency (EPA) national datasets—the Permit Compliance System, the Integrated Compliance Information System, and the Clean Watersheds Needs Survey—were evaluated for use in the U.S. Geological Survey National Water-Quality Assessment project to assess the causes of nutrient trends. This report also describes how a database of total nitrogen load and total phosphorous load was generated for select wastewater treatment facilities in the United States based on information reported in the EPA Clean Watersheds Needs Survey. Nutrient loads were calculated for the years 1978, 1980, 1982, 1984, 1986, 1988, 1990, 1992, 1996, 2000, 2004, 2008, and 2012 based on average nitrogen and phosphorous concentrations for reported treatment levels and on annual reported flow values.The EPA Permit Compliance System (PCS) and Integrated Compliance Information System (ICIS), which monitor point-source facility discharges, together are the Nation’s most spatially comprehensive dataset for nutrients released to surface waters. However, datasets for many individual facilities are incomplete, the PCS/ICIS historical data date back only to 1989, and historical data are available for only a limited number of facilities. Additionally, inconsistencies in facility reporting make it difficult to track or identify changes in nutrient discharges over time. Previous efforts made by the U.S. Geological Survey to “fill in” gaps in the PCS/ICIS data were based on statistical methods—missing data were filled in through the use of a statistical model based on the Standard Industrial Classification code, size, and flow class of the facility and on seasonal nutrient discharges of similar facilities. This approach was used to estimate point-source loads for a single point in time; it was not evaluated for use in generating a consistent data series over time.Another national EPA dataset that is available is the Clean Watersheds Needs Survey (CWNS), conducted every 4 years beginning 1973. The CWNS is an assessment of the capital needs of wastewater facilities to meet the water-quality goals set in the Clean Water Act. Data collected about these facilities include location and contact information for the facilities; population served; flow and treatment level of the facility; estimated capital needs to upgrade, repair, or improve facilities for water quality; and nonpoint-source best management practices.Total nitrogen and total phosphorous load calculations for each of the CWNS years were based on treatment level information and average annual outflow (in million gallons per day) from each of the facilities that had reported it. Treatment levels categories (such as Primary, Secondary, or Advanced) were substituted with average total nitrogen and total phosphorous concentrations for each treatment level based on those reported in literature. The CWNS dataset, like the PCS/ICIS dataset, has years where facilities did not report either a treatment level or an annual average outflow, or both. To fill in the data gaps, simple linear assumptions were made based on each facility’s responses to the survey in years bracketing the data gap or immediately before or after the data gap if open ended. Treatment level and flow data unique to each facility were used to complete the CWNS dataset for that facility.

A clinical decision rule for triage of children under 5 years of age with hydrocarbon (kerosene) aspiration in developing countries.

PubMed

Bond, G R; Pièche, S; Sonicki, Z; Gamaluddin, H; El Guindi, M; Sakr, M; El Seddawy, A; Abouzaid, M; Youssef, A

2008-03-01

Unintended hydrocarbon ingestion is a common reason for pediatric hospitalization in the developing world. To derive a clinical decision rule, to identify patients likely to require a higher level facility (resource-requiring cases), that can be used at primary health care facilities with limited diagnostic and therapeutic resources. A prospective study of children 2 to 59 months old presenting to a poison treatment facility within 2 hours of oral hydrocarbon exposure. History and objective signs were recorded at admission and at 6, 12, 24 and, if present, 48 hours. Inclusion in the resource-requiring outcome group required: oxygen saturation <94%; any CNS depression; any treatment with (salbutamol); any care in the ICU; or death. 256 met the inclusion criteria and completed the study. Of these, 170 had a course requiring resources unavailable at most primary health care facilities, and 86 did not. The presence of wheezing, any alteration in consciousness (lethargy or any restlessness), or a rapid respiratory rate for age (RR >or= 50/min if age < 12 mo, >or= 40/min if age >or= 12 mo) at presentation identified 167 of 170 of these patients (sensitivity 0.98). Thirty-six of 86 patients classified as non-resource requiring were correctly identified (specificity 0.42). No combination of clinical symptoms provided better discrimination while preserving sensitivity. This study suggests a triage decision rule based on the presence of wheezing, altered consciousness, or a rapid respiratory rate within 2 hours of hydrocarbon exposure. Such a rule requires validation in other settings.

Cost and cost-effectiveness of community based and health facility based directly observed treatment of tuberculosis in Dar es Salaam, Tanzania

PubMed Central

Wandwalo, Eliud; Robberstad, Bjarne; Morkve, Odd

2005-01-01

Background Identifying new approaches to tuberculosis treatment that are effective and put less demand to meagre health resources is important. One such approach is community based direct observed treatment (DOT). The purpose of the study was to determine the cost and cost effectiveness of health facility and community based directly observed treatment of tuberculosis in an urban setting in Tanzania. Methods Two alternative strategies were compared: health facility based directly observed treatment by health personnel and community based directly observed treatment by treatment supervisors. Costs were analysed from the perspective of health services, patients and community in the year 2002 in US $ using standard methods. Treatment outcomes were obtained from a randomised-controlled trial which was conducted alongside the cost study. Smear positive, smear negative and extra-pulmonary TB patients were included. Cost-effectiveness was calculated as the cost per patient successfully treated. Results The total cost of treating a patient with conventional health facility based DOT and community based DOT were $ 145 and $ 94 respectively. Community based DOT reduced cost by 35%. Cost fell by 27% for health services and 72% for patients. When smear positive and smear negative patients were considered separately, community DOT was associated with 45% and 19% reduction of the costs respectively. Patients used about $ 43 to follow their medication to health facility which is equivalent to their monthly income. Indirect costs were as important as direct costs, contributing to about 49% of the total patient's cost. The main reason for reduced cost was fewer number of visits to the TB clinic. Community based DOT was more cost-effective at $ 128 per patient successfully treated compared to $ 203 for a patient successfully treated with health facility based DOT. Conclusion Community based DOT presents an economically attractive option to complement health facility based DOT. This is particularly important in settings where TB clinics are working beyond capacity under limited resources. PMID:16018806

Protecting Lake Ontario - Treating Wastewater from the Remediated Low-Level Radioactive Waste Management Facility - 13227

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

Freihammer, Till; Chaput, Barb; Vandergaast, Gary

2013-07-01

The Port Granby Project is part of the larger Port Hope Area Initiative, a community-based program for the development and implementation of a safe, local, long-term management solution for historic low level radioactive waste (LLRW) and marginally contaminated soils (MCS). The Port Granby Project involves the relocation and remediation of up to 0.45 million cubic metres of such waste from the current Port Granby Waste Management Facility located in the Municipality of Clarington, Ontario, adjacent to the shoreline of Lake Ontario. The waste material will be transferred to a new suitably engineered Long-Term Waste Management Facility (LTWMF) to be locatedmore » inland approximately 700 m from the existing site. The development of the LTWMF will include construction and commissioning of a new Wastewater Treatment Plant (WWTP) designed to treat wastewater consisting of contaminated surface run off and leachate generated during the site remediation process at the Port Granby Waste Management Facility as well as long-term leachate generated at the new LTWMF. Numerous factors will influence the variable wastewater flow rates and influent loads to the new WWTP during remediation. The treatment processes will be comprised of equalization to minimize impacts from hydraulic peaks, fine screening, membrane bioreactor technology, and reverse osmosis. The residuals treatment will comprise of lime precipitation, thickening, dewatering, evaporation and drying. The distribution of the concentration of uranium and radium - 226 over the various process streams in the WWTP was estimated. This information was used to assess potential worker exposure to radioactivity in the various process areas. A mass balance approach was used to assess the distribution of uranium and radium - 226, by applying individual contaminant removal rates for each process element of the WTP, based on pilot scale results and experience-based assumptions. The mass balance calculations were repeated for various flow and load scenarios. (authors)« less

Facility Practice Variation to Help Understand the Effects of Public Policy: Insights from the Dialysis Outcomes and Practice Patterns Study (DOPPS).

PubMed

Fuller, Douglas S; Robinson, Bruce M

2017-01-06

Recent Centers for Medicare & Medicaid Services policies have used dialysis facility practice variation to develop public ratings and adjust payments. In the Dialysis Facility Compare star rating system (DFC SRS), facility-relative rates of performance-based clinical measures varied nearly two-fold for mortality (standardized mortality ratio; 10th/90th percentiles: 0.71, 1.34) and hospitalization (standardized hospitalization ratio; 10th/90th percentiles: 0.64, 1.37), and nearly four-fold for transfusion (standardized transfusion ratio; 10th/90th percentiles: 0.43, 1.65). Medicare claims data (from July of 2014) demonstrate that facility variation for the proportions of patients on hemodialysis hospitalized (10th/90th percentiles: 27%, 50%) and transfused (10th/90th percentiles: 3%, 17%) within 6 months that far exceeds relatively modest recent overall longitudinal trends. DFC SRS-rated facility variation is also substantial for fistula (10th/90th percentiles: 50%, 78%) and catheter use >90 days (10th/90th percentiles: 3%, 19%). By contrast, DFC SRS-rated facility distributions for adult hemodialysis Kt/V>1.2 (10th/90th percentiles: 84%, 97%) and total serum calcium >10.2 mg/dl (median, 1%; 75th/90th percentiles: 3%, 5%) are quite narrow and may be of questionable value. Likewise, variation in the US Dialysis Outcomes and Practice Patterns Study is over two-fold for facility median serum parathyroid hormone (10th/90th percentiles: 290 pg/ml, 629 pg/ml) and ferritin (10th/90th percentiles: 469 ng/ml, 1143 ng/ml) levels, and facility mean treatment time varies by 30 minutes (10th/90th percentiles: 204 minutes, 234 minutes). Rising serum parathyroid hormone and ferritin levels, and generally short dialysis treatment time, represent areas unchecked by existing policy; both overall trends and facility variation in these values may reflect unintended consequences of policy or reimbursement pressures and therefore raise concern. Additionally, outcomes in the transition period from advanced CKD to dialysis remain poor, and policy initiatives and performance accountability in this area remain insufficient. Innovative models of comprehensive care in advanced CKD and the early dialysis period which are more amenable to policy oversight are needed. In summary, facility variation is typically larger than prevailing longitudinal trends, and should not be overlooked. The combination of nationally representative observational databases (e.g., the Dialysis Outcomes and Practice Patterns Study) and ESRD registries can provide policy makers with additional tools to evaluate facility variation, develop policies, and monitor unintended effects. Copyright © 2016 by the American Society of Nephrology.

Breast health in developing countries.

PubMed

Yip, C H; Taib, N A

2014-12-01

Breast cancer is one of the leading cancers world-wide. While the incidence in developing countries is lower than in developed countries, the mortality is much higher. Of the estimated 1 600 000 new cases of breast cancer globally in 2012, 794 000 were in the more developed world compared to 883 000 in the less developed world; however, there were 198 000 deaths in the more developed world compared to 324 000 in the less developed world (data from Globocan 2012, IARC). Survival from breast cancer depends on two main factors--early detection and optimal treatment. In developing countries, women present with late stages of disease. The barriers to early detection are physical, such as geographical isolation, financial as well as psychosocial, including lack of education, belief in traditional medicine and lack of autonomous decision-making in the male-dominated societies that prevail in the developing world. There are virtually no population-based breast cancer screening programs in developing countries. However, before any screening program can be implemented, there must be facilities to treat the cancers that are detected. Inadequate access to optimal treatment of breast cancer remains a problem. Lack of specialist manpower, facilities and anticancer drugs contribute to the suboptimal care that a woman with breast cancer in a low-income country receives. International groups such as the Breast Health Global Initiative were set up to develop economically feasible, clinical practice guidelines for breast cancer management to improve breast health outcomes in countries with limited resources.

Shock Incarceration in New York: Focus on Treatment.

ERIC Educational Resources Information Center

Clark, Cherie L.; And Others

Shock incarceration facilities, or boot camp prisons, for young adults are being developed in city, county, state, and federal jurisdictions. This report focuses on one state's program. Two key components of this boot camp program include substance abuse education and a therapeutic approach which seeks to support successful reintegration of…

Helping Schools Say "Yes" to Children Who Say "No."

ERIC Educational Resources Information Center

Osterhaus, Nancy; Lowe, Dennis

1997-01-01

Describes a school program, developed in partnership with a treatment facility for troubled youth, that is committed to surrounding difficult students with the support and controls they need to succeed. Focuses on the Behavior Intervention Support Team in which teachers, counselors, and administrators respond with grace and not punishment. (RJM)

9 CFR 3.27 - Facilities, outdoor.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

DESIGN MANUAL: ODOR AND CORROSION CONTROL IN SANITARY SEWERAGE SYSTEMS AND TREATMENT PLANTS

EPA Science Inventory

Wastewater is known to the public for its potential to create odor nuisance. Sometimes it is the odors escaping from sewer manholes that cause complaints; more commonly, the odor source is a wastewater treatment facility. Yet there are wastewater treatment facilities that are fr...

7 CFR 305.6 - Cold treatment requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) The cold treatment facility must remain locked during non-working hours. (v) Black light or sticky... hours. (vi) Black light or sticky paper must be used within the cold treatment facility, and other... remain locked during non-working hours. (viii) Black lights or sticky paper must be used within the cold...

9 CFR 72.18 - Movement interstate; specification by the Deputy Administrator, Veterinary Services of treatment...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Movement interstate; specification by the Deputy Administrator, Veterinary Services of treatment required when dipping facilities..., Veterinary Services of treatment required when dipping facilities unavailable. (a) Tick-infested cattle...

9 CFR 72.18 - Movement interstate; specification by the Deputy Administrator, Veterinary Services of treatment...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Movement interstate; specification by the Deputy Administrator, Veterinary Services of treatment required when dipping facilities..., Veterinary Services of treatment required when dipping facilities unavailable. (a) Tick-infested cattle...

Successful experience utilizing dexrazoxane treatment for an anthracycline extravasation.

PubMed

Tyson, Abby Mercer; Gay, Wendy E

2010-05-01

To describe a successful case of dexrazoxane treatment after an extravasation of doxorubicin and share a creative solution for formulary cost management. A 42-year-old female diagnosed with breast cancer was receiving doxorubicin as adjuvant treatment. The patient recently underwent a right mastectomy for a 3-centimeter grade 3 invasive ductal carcinoma. Three of 20 lymph nodes were positive, and the patient was stage 2B at presentation, with an estrogen receptor/progesterone receptor-positive and HER-2/neu-negative tumor. At an outside hospital, the patient was receiving doxorubicin through an infusion port when extravasation was noted after approximately 15 mL had been infused. She was transferred to Riverside Methodist Hospital and dexrazoxane treatment was initiated within 6 hours after extravasation. She received a full 3-day course of dexrazoxane treatment without complication and was discharged home. Significant delays in chemotherapy administration were avoided, and the patient successfully completed her planned chemotherapy course. Dexrazoxane has the potential to minimize tissue damage and treatment delays after an anthracycline extravasation. Although dexrazoxane is commercially marketed for 2 separate treatment indications, Totect is the Food and Drug Administration-approved product for anthracycline extravasations. Facilities administering anthracyclines should proactively resolve how to obtain, process, prepare, and administer this antidote to a patient within 6 hours of an extravasation event. Developing a preprinted chemotherapy extravasation order may facilitate the incorporation of the most recent Oncology Nursing Society guidelines to utilize dexrazoxane for an anthracycline extravasation. Cost sharing with other institutions may offer a creative solution to lessen the financial impact of stocking dexrazoxane therapy. Ensuring expedient treatment and accessibility to dexrazoxane therapy after an anthracycline extravasation is critical to the success of the treatment. All facilities utilizing anthracycline chemotherapy should purchase dexrazoxane or secure agreements with other facilities to guarantee the administration of this medication should extravasation occur.

Strengthening Critical Infrastructure: Combined Heat and Power at Wastewater Treatment Facilities (Webinar) – November 15, 2011

EPA Pesticide Factsheets

This webinar provides information about CHP at wastewater treatment facilities (WWTFs), including advantages and challenges, financial incentives and funding programs, and technical and economic potential.

NPDES Permit for Yellowtail Visitor Center Wastewater Treatment Facility in Montana

EPA Pesticide Factsheets

NPDES permit MT-0029106 for United States Bureau of Reclamation discharge from its Yellowtail Visitor Center wastewater treatment facility into the Bighorn Lake/Bighorn River in Big Horn County, Montana.

40 CFR 60.150 - Applicability and designation of affected facility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Performance for Sewage Treatment Plants § 60.150 Applicability and designation of affected facility. (a) The... (dry basis) produced by municipal sewage treatment plants, or each incinerator that charges more than...

Radiation shielding design of a new tomotherapy facility.

PubMed

Zacarias, Albert; Balog, John; Mills, Michael

2006-10-01

It is expected that intensity modulated radiation therapy (IMRT) and image guided radiation therapy (IGRT) will replace a large portion of radiation therapy treatments currently performed with conventional MLC-based 3D conformal techniques. IGRT may become the standard of treatment in the future for prostate and head and neck cancer. Many established facilities may convert existing vaults to perform this treatment method using new or upgraded equipment. In the future, more facilities undoubtedly will be considering de novo designs for their treatment vaults. A reevaluation of the design principles used in conventional vault design is of benefit to those considering this approach with a new tomotherapy facility. This is made more imperative as the design of the TomoTherapy system is unique in several aspects and does not fit well into the formalism of NCRP 49 for a conventional linear accelerator.

Treatment in Kenyan rural health facilities: projected drug costs using the WHO-UNICEF integrated management of childhood illness (IMCI) guidelines.

PubMed Central

Boulanger, L. L.; Lee, L. A.; Odhacha, A.

1999-01-01

Guidelines for the integrated management of childhood illness (IMCI) in peripheral health facilities have been developed by WHO and UNICEF to improve the recognition and treatment of common causes of childhood death. To evaluate the impact of the guidelines on treatment costs, we compared the cost of drugs actually prescribed to a sample of 747 sick children aged 2-59 months in rural health facilities in western Kenya with the cost of drugs had the children been managed using the IMCI guidelines. The average cost of drugs actually prescribed per child was US$ 0.44 (1996 US$). Antibiotics were the most costly component, with phenoxymethylpenicillin syrup accounting for 59% of the cost of all the drugs prescribed. Of the 295 prescriptions for phenoxymethylpenicillin syrup, 223 (76%) were for treatment of colds or cough. The cost of drugs that would have been prescribed had the same children been managed with the IMCI guidelines ranged from US$ 0.16 per patient (based on a formulary of larger-dose tablets and a home remedy for cough) to US$ 0.39 per patient (based on a formulary of syrups or paediatric-dose tablets and a commercial cough preparation). Treatment of coughs and colds with antibiotics is not recommended in the Kenyan or in the IMCI guidelines. Compliance with existing treatment guidelines for the management of acute respiratory infections would have halved the cost of the drugs prescribed. The estimated cost of the drugs needed to treat children using the IMCI guidelines was less than the cost of the drugs actually prescribed, but varied considerably depending on the dosage forms and whether a commercial cough preparation was used. PMID:10593034

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

Measuring the efficiency of a healthcare waste management system in Serbia with data envelopment analysis.

PubMed

Ratkovic, Branislava; Andrejic, Milan; Vidovic, Milorad

2012-06-01

In 2007, the Serbian Ministry of Health initiated specific activities towards establishing a workable model based on the existing administrative framework, which corresponds to the needs of healthcare waste management throughout Serbia. The objective of this research was to identify the reforms carried out and their outcomes by estimating the efficiencies of a sample of 35 healthcare facilities engaged in the process of collection and treatment of healthcare waste, using data envelopment analysis. Twenty-one (60%) of the 35 healthcare facilities analysed were found to be technically inefficient, with an average level of inefficiency of 13%. This fact indicates deficiencies in the process of collection and treatment of healthcare waste and the information obtained and presented in this paper could be used for further improvement and development of healthcare waste management in Serbia.

Adherence to the Otitis Media with Effusion Clinical Practice Guideline by Providers in a United States Air Force Medical Treatment Facility

DTIC Science & Technology

1999-05-07

making. The United States Agency for Health Care Policy and Research published the Otitis Media with Effusion (OME) in Young Children Clinical Practice...diagnosed with otitis media were audited using a checklist developed from the treatment algorithm. Twenty-three of these children had OME. Using summary...of pneumatic otoscopy and/or tympanometry to evaluate the tympanic membrane for OME and acute otitis media .

The Irish health system: developments in strategy, structure, funding and delivery since 1980.

PubMed

Wiley, Miriam M

2005-09-01

As the Irish health system embarks upon its first major structural reorganisation in over 30 years, developments within this system over the past two decades are assessed. Real cuts in health expenditure achieved in the 1980s contrast sharply with the unprecedented increase in resources devoted to the health system in the 1990s. While successive statements of health strategy have prioritised the objectives of equity, efficiency and quality of care, questions arise regarding the return achieved with the increased investment. With higher levels of economic growth, more people have been buying private health insurance such that almost half the population are now privately insured. At the same time, the numbers with eligibility for health services without charge have decreased while those from lower socio-economic groups continue to have higher levels of utilisation. Equity issues arise, however, with regard to access to public hospitals as the rate of growth in admissions for private patients outstrips that for public patients. The establishment of a National Treatment Purchase Fund to purchase treatment in private facilities for public patients on waiting lists raises efficiency and equity questions as the treatment of private patients in public hospitals is heavily subsidised while the State pays full cost for the treatment of public patients in private facilities. Copyright (c) 2005 John Wiley & Sons, Ltd.

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

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.

Secondary Waste Cementitious Waste Form Data Package for the Integrated Disposal Facility Performance Assessment

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

Cantrell, Kirk J.; Westsik, Joseph H.; Serne, R Jeffrey

A review of the most up-to-date and relevant data currently available was conducted to develop a set of recommended values for use in the Integrated Disposal Facility (IDF) performance assessment (PA) to model contaminant release from a cementitious waste form for aqueous wastes treated at the Hanford Effluent Treatment Facility (ETF). This data package relies primarily upon recent data collected on Cast Stone formulations fabricated with simulants of low-activity waste (LAW) and liquid secondary wastes expected to be produced at Hanford. These data were supplemented, when necessary, with data developed for saltstone (a similar grout waste form used at themore » Savannah River Site). Work is currently underway to collect data on cementitious waste forms that are similar to Cast Stone and saltstone but are tailored to the characteristics of ETF-treated liquid secondary wastes. Recommended values for key parameters to conduct PA modeling of contaminant release from ETF-treated liquid waste are provided.« less

The BioDyn facility on ISS: Advancing biomaterial production in microgravity for commercial applications

NASA Astrophysics Data System (ADS)

Myers, Niki; Wessling, Francis; Deuser, Mark; Anderson, C. D.; Lewis, Marian

1999-01-01

The primary goals of the BioDyn program are to foster use of the microgravity environment for commercial production of bio-materials from cells, and to develop services and processes for obtaining these materials through space processing. The scope of products includes commercial bio-molecules such as cytokines, other cell growth regulatory proteins, hormones, monoclonal antibodies and enzymes; transplantable cells or tissues which can be improved by low-G processes, or which cannot be obtained through standard processes in earth gravity; agriculture biotechnology products from plant cells; microencapsulation for diabetes treatment; and factors regulating cellular aging. To facilitate BioDyn's commercial science driven goals, hardware designed for ISS incorporates the flexibility for interchange between the different ISS facilities including the glovebox, various thermal units and centrifuges. By providing a permanent research facility, ISS is the critical space-based platform required by scientists for carrying out the long-term experiments necessary for developing bio-molecules and tissues using several cell culture modalities including suspension and anchorage-dependent cell types.

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.

Process development for scum to biodiesel conversion.

PubMed

Bi, Chong-hao; Min, Min; Nie, Yong; Xie, Qing-long; Lu, Qian; Deng, Xiang-yuan; Anderson, Erik; Li, Dong; Chen, Paul; Ruan, Roger

2015-06-01

A novel process was developed for converting scum, a waste material from wastewater treatment facilities, to biodiesel. Scum is an oily waste that was skimmed from the surface of primary and secondary settling tanks in wastewater treatment plants. Currently scum is treated either by anaerobic digestion or landfilling which raised several environmental issues. The newly developed process used a six-step method to convert scum to biodiesel, a higher value product. A combination of acid washing and acid catalyzed esterification was developed to remove soap and impurities while converting free fatty acids to methyl esters. A glycerol washing was used to facilitate the separation of biodiesel and glycerin after base catalyzed transesterification. As a result, 70% of dried and filtered scum was converted to biodiesel which is equivalent to about 134,000 gallon biodiesel per year for the Saint Paul waste water treatment plant in Minnesota. Copyright © 2015 Elsevier Ltd. All rights reserved.

Quarterly report for the NGA FFCA project, July 1--September 30, 1994

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

NONE

1994-12-31

Summaries are presented of activities and meetings related to the National Governor`s Association (NGA) Federal Facilities Compliance Act (FFCA) project. The objective of this project is the management of mixed radioactive and hazardous wastes. Activities include: execution of grants to states to fund a review and development of the site treatment plans; determination of interest in a proposed cost model to be developed by EG and G; determination of the major issues that need to be addressed prior to the release of the Draft Site Treatment Plans; and development of a draft Commercial Mixed Waste Issue Paper which was distributedmore » for review and comment.« less

Malaria prevalence and treatment of febrile patients at health facilities and medicine retailers in Cameroon.

PubMed

Mangham, Lindsay J; Cundill, Bonnie; Achonduh, Olivia A; Ambebila, Joel N; Lele, Albertine K; Metoh, Theresia N; Ndive, Sarah N; Ndong, Ignatius C; Nguela, Rachel L; Nji, Akindeh M; Orang-Ojong, Barnabas; Wiseman, Virginia; Pamen-Ngako, Joelle; Mbacham, Wilfred F

2012-03-01

To investigate the quality of malaria case management in Cameroon 5 years after the adoption of artemisinin-based combination therapy (ACT). Treatment patterns were examined in different types of facility, and the factors associated with being prescribed or receiving an ACT were investigated. A cross-sectional cluster survey was conducted among individuals of all ages who left public and private health facilities and medicine retailers in Cameroon and who reported seeking treatment for a fever. Prevalence of malaria was determined by rapid diagnostic tests (RDTs) in consenting patients attending the facilities and medicine retailers. Among the patients, 73% were prescribed or received an antimalarial, and 51% were prescribed or received an ACT. Treatment provided to patients significantly differed by type of facility: 65% of patients at public facilities, 55% of patients at private facilities and 45% of patients at medicine retailers were prescribed or received an ACT (P = 0.023). The odds of a febrile patient being prescribed or receiving an ACT were significantly higher for patients who asked for an ACT (OR = 24.1, P < 0.001), were examined by the health worker (OR = 1.88, P = 0.021), had not previously sought an antimalarial for the illness (OR = 2.29, P = 0.001) and sought treatment at a public (OR = 3.55) or private facility (OR = 1.99, P = 0.003). Malaria was confirmed in 29% of patients and 70% of patients with a negative result were prescribed or received an antimalarial. Malaria case management could be improved. Symptomatic diagnosis is inefficient because two-thirds of febrile patients do not have malaria. Government plans to extend malaria testing should promote rational use of ACT; though, the introduction of rapid diagnostic testing needs to be accompanied by updated clinical guidelines that provide clear guidance for the treatment of patients with negative test results. © 2011 Blackwell Publishing Ltd.

Addressing social aspects associated with wastewater treatment facilities

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

Padilla-Rivera, Alejandro; Morgan-Sagastume, Juan Manuel; Noyola, Adalberto

In wastewater treatment facilities (WWTF), technical and financial aspects have been considered a priority, while other issues, such as social aspects, have not been evaluated seriously and there is not an accepted methodology for assessing it. In this work, a methodology focused on social concerns related to WWTF is presented. The methodology proposes the use of 25 indicators as a framework for measuring social performance to evaluate the progress in moving towards sustainability. The methodology was applied to test its applicability and effectiveness in two WWTF in Mexico (urban and rural). This evaluation helped define the key elements, stakeholders andmore » barriers in the facilities. In this context, the urban facility showed a better overall performance, a result that may be explained mainly by the better socioeconomic context of the urban municipality. Finally, the evaluation of social aspects using the semi-qualitative approach proposed in this work allows for a comparison between different facilities and for the identification of strengths and weakness, and it provides an alternative tool for achieving and improving wastewater management. - Highlights: • The methodology proposes 25 indicators as a framework for measuring social performance in wastewater treatment facilities. • The evaluation helped to define the key elements, stakeholders and barriers in the wastewater treatment facilities. • The evaluation of social aspects allows the identification of strengths and weakness for improving wastewater management. • It provides a social profile of the facility that highlights the best and worst performances.« less

NPDES Permit for Keller Transport, Inc. Groundwater Remediation Treatment Facility in Montana

EPA Pesticide Factsheets

Under National Pollutant Discharge Elimination System permit number MT0030805, Keller Transport, Inc. is authorized to discharge from its groundwater remediation treatment facility in Lake County, Montana, to Flathead Lake.

Potable Water Treatment Facility General Permit (PWTF GP) for Massachusetts & New Hampshire

EPA Pesticide Factsheets

Documents, links & contacts for the Notice of Availability of the draft NPDES General Permit for Discharges from Potable Water Treatment Facilities in Massachusetts (MAG640000) and New Hampshire (NHG640000).

NPDES Permit for Soap Creek Associates Wastewater Treatment Facility in Montana

EPA Pesticide Factsheets

Under National Pollutant Discharge Elimination System permit number MT-0023183, Soap Creek Associates, Inc. is authorized to discharge from its wastewater treatment facility located in West, Bighorn County, Montana, to Soap Creek.

NPDES Permit for Lame Deer Lagoon Wastewater Treatment Facility in Montana

EPA Pesticide Factsheets

Final permit authorizes the Northern Cheyenne Utilities Commission to discharge from its Lame Deer Lagoon wastewater treatment facility located in Rosebud County, Montana to Lame Deer Creek, a tributary to Rosebud Creek.

NPDES Permit: Shiprock Wastewater Treatment Facility, Shiprock, New Mexico

EPA Pesticide Factsheets

NPDES Permit, Fact Sheet, and Response to Comments explaining EPA's issue of NPDES Permit No. NN0020621 to the Navajo Tribal Utility Authority Shiprock Wastewater Treatment Facility, Shiprock, San Juan County, New Mexico.

NPDES Permit for City of Polson Wastewater Treatment Facility in Montana

EPA Pesticide Factsheets

Under National Pollutant Discharge Elimination System permit number MT-0020559, the City of Polson is authorized to discharge from its wastewater treatment facility located in Lake County, Montana to the Flathead River.

Dosimetry and radiobiology at the new RA-3 reactor boron neutron capture therapy (BNCT) facility: application to the treatment of experimental oral cancer.

PubMed

Pozzi, E; Nigg, D W; Miller, M; Thorp, S I; Heber, E M; Zarza, L; Estryk, G; Monti Hughes, A; Molinari, A J; Garabalino, M; Itoiz, M E; Aromando, R F; Quintana, J; Trivillin, V A; Schwint, A E

2009-07-01

The National Atomic Energy Commission of Argentina (CNEA) constructed a novel thermal neutron source for use in boron neutron capture therapy (BNCT) applications at the RA-3 research reactor facility located in Buenos Aires. The aim of the present study was to perform a dosimetric characterization of the facility and undertake radiobiological studies of BNCT in an experimental model of oral cancer in the hamster cheek pouch. The free-field thermal flux was 7.1 x 10(9) n cm(-2)s(-1) and the fast neutron flux was 2.5 x 10(6) n cm(-2)s(-1), indicating a very well-thermalized neutron field with negligible fast neutron dose. For radiobiological studies it was necessary to shield the body of the hamster from the neutron flux while exposing the everted cheek pouch bearing the tumors. To that end we developed a lithium (enriched to 95% in (6)Li) carbonate enclosure. Groups of tumor-bearing hamsters were submitted to BPA-BNCT, GB-10-BNCT, (GB-10+BPA)-BNCT or beam only treatments. Normal (non-cancerized) hamsters were treated similarly to evaluate normal tissue radiotoxicity. The total physical dose delivered to tumor with the BNCT treatments ranged from 6 to 8.5 Gy. Tumor control at 30 days ranged from 73% to 85%, with no normal tissue radiotoxicity. Significant but reversible mucositis in precancerous tissue surrounding tumors was associated to BPA-BNCT. The therapeutic success of different BNCT protocols in treating experimental oral cancer at this novel facility was unequivocally demonstrated.

Managed Care’s Dual Impact on Outpatient Substance Abuse Treatment: Methadone Maintenance vs. Drug Free

PubMed Central

Sindelar, Jody L.; Olmstead, Todd A.

2013-01-01

The number and type of services offered at substance abuse treatment (SAT) facilities are important aspects of the quality of care. Managed care (MC) is a growing presence in SAT and has been shown to affect the provision of treatment. We expand on earlier work and examine the impact of managed care on the number and type of services offered by methadone maintenance (MM) and drug-free (DF) outpatient treatment facilities. We use the econometric technique of instrumental variables to address the issue of endogeneity of MC and service offerings, thereby allowing a causal interpretation of results. Using data from the 2000 National Survey of Substance Abuse Treatment Services, we find that MC significantly increases the total number of services offered in MM outpatient facilities by four, yet decreases the number by two in DF outpatient facilities. We also show how the impact on specific services differs by modality and provide explanations for our findings. PMID:24062595

Aquatic Plants and Wastewater Treatment (an Overview)

NASA Technical Reports Server (NTRS)

Wolverton, B. C.

1986-01-01

The technology for using water hyacinth to upgrade domestic sewage effluent from lagoons and other wastewater treatment facilities to secondary and advanced secondary standards has been sufficiently developed to be used where the climate is warm year round. The technology of using emergent plants such as bulrush combined with duckweed is also sufficiently developed to make this a viable wastewater treatment alternative. This system is suited for both temperate and semi-tropical areas found throughout most of the U.S. The newest technology in artificial marsh wastewater treatment involves the use of emergent plant roots in conjunction with high surface area rock filters. Smaller land areas are required for these systems because of the increased concentration of microorganisms associated with the rock and plant root surfaces. Approximately 75 percent less land area is required for the plant-rock system than is required for a strict artificial wetland to achieve the same level of treatment.

9 CFR 590.548 - Drying, blending, packaging, and heat treatment rooms and facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Drying, blending, packaging, and heat..., blending, packaging, and heat treatment rooms and facilities. (a) General. Processing rooms shall be... vacuum cleaned daily. (c) The heat treatment room shall be of an approved construction and be maintained...

9 CFR 590.548 - Drying, blending, packaging, and heat treatment rooms and facilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Drying, blending, packaging, and heat..., blending, packaging, and heat treatment rooms and facilities. (a) General. Processing rooms shall be... vacuum cleaned daily. (c) The heat treatment room shall be of an approved construction and be maintained...

9 CFR 590.548 - Drying, blending, packaging, and heat treatment rooms and facilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Drying, blending, packaging, and heat..., blending, packaging, and heat treatment rooms and facilities. (a) General. Processing rooms shall be... vacuum cleaned daily. (c) The heat treatment room shall be of an approved construction and be maintained...

9 CFR 590.548 - Drying, blending, packaging, and heat treatment rooms and facilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Drying, blending, packaging, and heat..., blending, packaging, and heat treatment rooms and facilities. (a) General. Processing rooms shall be... vacuum cleaned daily. (c) The heat treatment room shall be of an approved construction and be maintained...

38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

Code of Federal Regulations, 2010 CFR

2010-07-01

... dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. 17... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or abuse...

Improving the Quality of Services in Residential Treatment Facilities: A Strength-Based Consultative Review Process

ERIC Educational Resources Information Center

Pavkov, Thomas W.; Lourie, Ira S.; Hug, Richard W.; Negash, Sesen

2010-01-01

This descriptive case study reports on the positive impact of a consultative review methodology used to conduct quality assurance reviews as part of the Residential Treatment Center Evaluation Project. The study details improvement in the quality of services provided to youth in unmonitored residential treatment facilities. Improvements were…

Process Control Manual for Aerobic Biological Wastewater Treatment Facilities.

ERIC Educational Resources Information Center

Environmental Protection Agency, Washington, DC. Office of Water Programs.

This Environmental Protection Agency (EPA) publication is an operations manual for activated sludge and trickling filter wastewater treatment facilities. The stated purpose of the manual is to provide an on-the-job reference for operators of these two types of treatment plants. The overall objective of the manual is to aid the operator in…

40 CFR 35.935-17 - Training facility.

Code of Federal Regulations, 2011 CFR

2011-07-01

... STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.935-17 Training facility. If assistance has been provided for the construction of a treatment works required to train and upgrade waste treatment personnel under §§ 35.930-1(b) and 35.920-3(e), the grantee must...

40 CFR 35.935-17 - Training facility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.935-17 Training facility. If assistance has been provided for the construction of a treatment works required to train and upgrade waste treatment personnel under §§ 35.930-1(b) and 35.920-3(e), the grantee must...

CLOSED-LOOP TREATMENT OF ELECTROLYTIC AND ELECTROLESS NICKEL RINSE WATER BY POINT-OF-USE ION EXCHANGE: A CASE STUDY

EPA Science Inventory

Many recent pilot tests have demonstrated the benefits and cost effectiveness of point-of-use treatment technologies as opposed to centralized wastewater treatment for all sizes of plating facilities. A 9-month case study at a small plating facility in Cincinnati, OH utilizing po...

Technical and Regulatory Guidance for In Situ Chemical Oxidation of Contaminated Soil and Groundwater

DTIC Science & Technology

2001-06-01

B12 6. Former Wood Treatment Facility, Sonoma County , CA . . . . . . . . . . . . . . . . . . . . . B12 7. San Francisco Bay Sites, CA...aromatic hydrocarbons (PAHs) to below regulatory limits. Site: Former Wood Treatment Facility, Sonoma County , CA Technology: Ozone Summary: An array...manufacturing facility, located in Sonoma County , California (Clayton, 2000b). Primary contaminants are pentachlorophenol (PCP) and creosote (i.e., polycyclic

NPDES Permit for City of Wagner Wastewater Treatment Facility in South Dakota

EPA Pesticide Factsheets

Under NPDES permit SD-0020184, the City of Wagner, South Dakota is authorized to discharge from its wastewater treatment facility in Charles Mix County, South Dakota, to an unnamed tributary of Choteau Creek.

NPDES Permit for Town of Hot Springs Wastewater Treatment Facility in Montana

EPA Pesticide Factsheets

Under NPDES permit MT0020591, the Town of Hot Springs, Montana, is authorized to discharge from its wastewater treatment facility located in Sanders County, Montana, to a ditch discharging to Hot Springs Creek.

NPDES Permit for Charlo Wastewater Treatment Facility in Montana

EPA Pesticide Factsheets

Under NPDES permit MT-0022551, the Consolidated Charlo-Lake County Water & Sewer District is authorized to discharge from its wastewater treatment facility located in Lake County, Montana to an unnamed swale that runs to Dublin Gulch.

RETROFITTING CONTROL FACILITIES FOR WET WEATHER FLOW TREATMENT

EPA Science Inventory

Available technologies were evaluated to demonstrate the technical feasibility and cost-effectiveness of retrofitting existing facilities to handle wet-weather flow. Cost/benefit relationships were also compared to construction of new conventional control and treatment facilitie...

Adoption and Diffusion of Evidence-Based Addiction Medications in Substance Abuse Treatment

PubMed Central

Heinrich, Carolyn J; Cummings, Grant R

2014-01-01

ObjectiveTo examine the roles of facility-and state-level factors in treatment facilities’ adoption and diffusion of pharmaceutical agents used in addiction treatment. Data SourcesSecondary data from the National Survey of Substance Abuse Treatment Services (N-SSATS), Substance Abuse and Mental Health Services Administration (SAMHSA), Centers for Medicare and Medicaid Services, Alcohol Policy Information System, and Kaiser Family Foundation. Study DesignWe estimate ordered logit and multinomial logit models to examine the relationship of state and treatment facility characteristics to the adoption and diffusion of three pharmaceutical agents over 4 years when each was at a different stage of adoption or diffusion. Data CollectionN-SSATS data with facility codes, obtained directly from SAMHSA, were linked by state identifiers to the other publicly available, secondary data. Principal FindingsThe analysis confirms the importance of awareness and exposure to the adoption behavior of others, dissemination of information about the feasibility and effectiveness of innovations, geographical clustering, and licensing and accreditation in legitimizing facilities’ adoption and continued use of pharmacotherapies in addiction treatment. ConclusionsPolicy and administrative levers exist to increase the availability of pharmaceutical technologies and their continued use by substance abuse treatment facilities. PMID:23855719

Patients' costs and cost-effectiveness of tuberculosis treatment in DOTS and non-DOTS facilities in Rio de Janeiro, Brazil.

PubMed

Steffen, Ricardo; Menzies, Dick; Oxlade, Olivia; Pinto, Marcia; de Castro, Analia Zuleika; Monteiro, Paula; Trajman, Anete

2010-11-17

Costs of tuberculosis diagnosis and treatment may represent a significant burden for the poor and for the health system in resource-poor countries. The aim of this study was to analyze patients' costs of tuberculosis care and to estimate the incremental cost-effectiveness ratio (ICER) of the directly observed treatment (DOT) strategy per completed treatment in Rio de Janeiro, Brazil. We interviewed 218 adult patients with bacteriologically confirmed pulmonary tuberculosis. Information on direct (out-of-pocket expenses) and indirect (hours lost) costs, loss in income and costs with extra help were gathered through a questionnaire. Healthcare system additional costs due to supervision of pill-intake were calculated considering staff salaries. Effectiveness was measured by treatment completion rate. The ICER of DOT compared to self-administered therapy (SAT) was calculated. DOT increased costs during the treatment phase, while SAT increased costs in the pre-diagnostic phase, for both the patient and the health system. Treatment completion rates were 71% in SAT facilities and 79% in DOT facilities. Costs per completed treatment were US$ 194 for patients and U$ 189 for the health system in SAT facilities, compared to US$ 336 and US$ 726 in DOT facilities. The ICER was US$ 6,616 per completed DOT treatment compared to SAT. Costs incurred by TB patients are high in Rio de Janeiro, especially for those under DOT. The DOT strategy doubles patients' costs and increases by fourfold the health system costs per completed treatment. The additional costs for DOT may be one of the contributing factors to the completion rates below the targeted 85% recommended by WHO.

Design and Shielding of Radiotherapy Treatment Facilities; IPEM Report 75, 2nd Edition

NASA Astrophysics Data System (ADS)

Horton, Patrick; Eaton, David

2017-07-01

Design and Shielding of Radiotherapy Treatment Facilities provides readers with a single point of reference for protection advice to the construction and modification of radiotherapy facilities. The book assembles a faculty of national and international experts on all modalities including megavoltage and kilovoltage photons, brachytherapy and high-energy particles, and on conventional and Monte Carlo shielding calculations. This book is a comprehensive reference for qualified experts and radiation-shielding designers in radiation physics and also useful to anyone involved in the design of radiotherapy facilities.

The economic burden of inpatient paediatric care in Kenya: household and provider costs for treatment of pneumonia, malaria and meningitis

PubMed Central

Ayieko, Philip; Akumu, Angela O; Griffiths, Ulla K; English, Mike

2009-01-01

Background Knowledge of treatment cost is essential in assessing cost effectiveness in healthcare. Evidence of the potential impact of implementing available interventions against childhood illnesses in developing countries challenges us to define the costs of treating these diseases. The purpose of this study is to describe the total costs associated with treatment of pneumonia, malaria and meningitis in children less than five years in seven Kenyan hospitals. Methods Patient resource use data were obtained from largely prospective evaluation of medical records and household expenditure during illness was collected from interviews with caretakers. The estimates for costs per bed day were based on published data. A sensitivity analysis was conducted using WHO-CHOICE values for costs per bed day. Results Treatment costs for 572 children (pneumonia = 205, malaria = 211, meningitis = 102 and mixed diagnoses = 54) and household expenditure for 390 households were analysed. From the provider perspective the mean cost per admission at the national hospital was US $95.58 for malaria, US $177.14 for pneumonia and US $284.64 for meningitis. In the public regional or district hospitals the mean cost per child treated ranged from US $47.19 to US $81.84 for malaria and US $54.06 to US $99.26 for pneumonia. The corresponding treatment costs in the mission hospitals were between US $43.23 to US $88.18 for malaria and US $ 43.36 to US $142.22 for pneumonia. Meningitis was treated for US $ 189.41 at the regional hospital and US $ 201.59 at one mission hospital. The total treatment cost estimates were sensitive to changes in the source of bed day costs. The median treatment related household payments within quintiles defined by total household expenditure differed by type of facility visited. Public hospitals recovered up to 40% of provider costs through user charges while mission facilities recovered 44% to 100% of costs. Conclusion Treatments cost for inpatient malaria, pneumonia and meningitis vary by facility type, with mission and tertiary referral facilities being more expensive compared to primary referral. Households of sick children contribute significantly towards provider cost through payment of user fees. These findings could be used in cost effectiveness analysis of health interventions. PMID:19161598

Effects of wastewater effluent discharge and treatment facility upgrades on environmental and biological conditions of the upper Blue River, Johnson County, Kansas and Jackson County, Missouri, January 2003 through March 2009

USGS Publications Warehouse

Graham, Jennifer L.; Stone, Mandy L.; Rasmussen, Teresa J.; Poulton, Barry C.

2010-01-01

The Johnson County Blue River Main Wastewater Treatment Facility discharges into the upper Blue River near the border between Johnson County, Kansas and Jackson County, Missouri. During 2005 through 2007 the wastewater treatment facility underwent upgrades to increase capacity and include biological nutrient removal. The effects of wastewater effluent on environmental and biological conditions of the upper Blue River were assessed by comparing an upstream site to two sites located downstream from the wastewater treatment facility. Environmental conditions were evaluated using previously and newly collected discrete and continuous data, and were compared with an assessment of biological community composition and ecosystem function along the upstream-downstream gradient. This evaluation is useful for understanding the potential effects of wastewater effluent on water quality, biological community structure, and ecosystem function. In addition, this information can be used to help achieve National Pollution Discharge Elimination System (NPDES) wastewater effluent permit requirements after additional studies are conducted. The effects of wastewater effluent on the water-quality conditions of the upper Blue River were most evident during below-normal and normal streamflows (about 75 percent of the time), when wastewater effluent contributed more than 20 percent to total streamflow. The largest difference in water-quality conditions between the upstream and downstream sites was in nutrient concentrations. Total and inorganic nutrient concentrations at the downstream sites during below-normal and normal streamflows were 4 to 15 times larger than at the upstream site, even after upgrades to the wastewater treatment facility were completed. However, total nitrogen concentrations decreased in wastewater effluent and at the downstream site following wastewater treatment facility upgrades. Similar decreases in total phosphorus were not observed, likely because the biological phosphorus removal process was not optimized until after the study was completed. Total nitrogen and phosphorus from the wastewater treatment facility contributed a relatively small percentage (14 to 15 percent) to the annual nutrient load in the upper Blue River, but contributed substantially (as much as 75 percent) to monthly loads during seasonal low-flows in winter and summer. During 2007 and 2008, annual discharge from the wastewater treatment facility was about one-half maximum capacity, and estimated potential maximum annual loads were 1.6 to 2.4 times greater than annual loads before capacity upgrades. Even when target nutrient concentrations are met, annual nutrient loads will increase when the wastewater treatment facility is operated at full capacity. Regardless of changes in annual nutrient loads, the reduction of nutrient concentrations in the Blue River Main wastewater effluent will help prevent further degradation of the upper Blue River. The Blue River Main Wastewater Treatment Facility wastewater effluent caused changes in concentrations of several water-quality constituents that may affect biological community structure and function including larger concentrations of bioavailable nutrients (nitrate and orthophosphorus) and smaller turbidities. Streambed-sediment conditions were similar along the upstream-downstream gradient and measured constituents did not exceed probable effect concentrations. Habitat conditions declined along the upstream-downstream gradient, largely because of decreased canopy cover and riparian buffer width and increased riffle-substrate fouling. Algal biomass, primary production, and the abundance of nutrient-tolerant diatoms substantially increased downstream from the wastewater treatment facility. Likewise, the abundance of intolerant macroinvertebrate taxa and Kansas Department of Health and Environment aquatic-life-support scores, derived from macroinvertebrate data, significantly decreased downstream from the wastewater

Genetic variation and genomic context of antibiotic resistance genes and mobile genetic elements in Salmonella from animals and food production facilities

USDA-ARS?s Scientific Manuscript database

Background: From 1998-2008, Salmonella was the most common bacterial cause of foodborne disease outbreaks and antibiotic resistant Salmonella are considered a serious threat when treatment is warranted. Both agricultural and clinical uses of antibiotics contribute to the development of resistant Sal...

Removal of Inorganic, Microbial, and Particulate Contaminants from Secondary Treated Wastewater - Village Marine Tec. Expeditionary Unit Water Purifier, Generation 1 at Gallup, NM

EPA Science Inventory

The EUWP was developed to treat challenging water sources with variable turbidity, chemical contamination, and very high total dissolved solids (TDS) including seawater, during emergency situations when other water treatment facilities are incapacitated. The EUWP components are ...

Detection, composition and treatment of volatile organic compounds from waste treatment plants.

PubMed

Font, Xavier; Artola, Adriana; Sánchez, Antoni

2011-01-01

Environmental policies at the European and global level support the diversion of wastes from landfills for their treatment in different facilities. Organic waste is mainly treated or valorized through composting, anaerobic digestion or a combination of both treatments. Thus, there are an increasing number of waste treatment plants using this type of biological treatment. During waste handling and biological decomposition steps a number of gaseous compounds are generated or removed from the organic matrix and emitted. Different families of Volatile Organic Compounds (VOC) can be found in these emissions. Many of these compounds are also sources of odor nuisance. In fact, odors are the main source of complaints and social impacts of any waste treatment plant. This work presents a summary of the main types of VOC emitted in organic waste treatment facilities and the methods used to detect and quantify these compounds, together with the treatment methods applied to gaseous emissions commonly used in composting and anaerobic digestion facilities.

Detection, Composition and Treatment of Volatile Organic Compounds from Waste Treatment Plants

PubMed Central

Font, Xavier; Artola, Adriana; Sánchez, Antoni

2011-01-01

Environmental policies at the European and global level support the diversion of wastes from landfills for their treatment in different facilities. Organic waste is mainly treated or valorized through composting, anaerobic digestion or a combination of both treatments. Thus, there are an increasing number of waste treatment plants using this type of biological treatment. During waste handling and biological decomposition steps a number of gaseous compounds are generated or removed from the organic matrix and emitted. Different families of Volatile Organic Compounds (VOC) can be found in these emissions. Many of these compounds are also sources of odor nuisance. In fact, odors are the main source of complaints and social impacts of any waste treatment plant. This work presents a summary of the main types of VOC emitted in organic waste treatment facilities and the methods used to detect and quantify these compounds, together with the treatment methods applied to gaseous emissions commonly used in composting and anaerobic digestion facilities. PMID:22163835

Criteria for solid recovered fuels as a substitute for fossil fuels--a review.

PubMed

Beckmann, Michael; Pohl, Martin; Bernhardt, Daniel; Gebauer, Kathrin

2012-04-01

The waste treatment, particularly the thermal treatment of waste has changed fundamentally in the last 20 years, i.e. from facilities solely dedicated to the thermal treatment of waste to facilities, which in addition to that ensure the safe plant operation and fulfill very ambitious criteria regarding emission reduction, resource recovery and energy efficiency as well. Therefore this contributes to the economic use of raw materials and due to the energy recovered from waste also to the energy provision. The development described had the consequence that waste and solid recovered fuels (SRF) has to be evaluated based on fuel criteria as well. Fossil fuels - coal, crude oil, natural gas etc. have been extensively investigated due to their application in plants for energy conversion and also due to their use in the primary industry. Thereby depending on the respective processes, criteria on fuel technical properties can be derived. The methods for engineering analysis of regular fuels (fossil fuels) can be transferred only partially to SRF. For this reason methods are being developed or adapted to current analytical methods for the characterization of SRF. In this paper the possibilities of the energetic utilization of SRF and the characterization of SRF before and during the energetic utilization will be discussed.

Evaluation of Client Services (ECS): a measure of treatment satisfaction for people with chronic mental illnesses.

PubMed

Berghofer, Gerlinde; Castille, Dorothy M; Link, Bruce

2011-08-01

This article describes the development and psychometric assessment of the Evaluation of Client Services (ECS) measure of treatment satisfaction for people with chronic mental illnesses in community treatment settings. The ECS, a 20-item instrument, was validated in a sample of 184 individuals receiving outpatient mental health treatment in New York City. The four dimensions of the ECS, (1) treatment management and treatment outcome, (2) treatment relationship, (3) communication and information exchange, and (4) reachability of treatment facilities are internally consistent and stable over time. Analyses also show that the ECS is a valid indicator of satisfaction with mental health services which meaningfully correlates with quality of life and another measure of treatment satisfaction. The ECS is a brief and easy to understand treatment satisfaction tool with good psychometric properties.

Evaluation of staff performance and material resources for integrated schistosomiasis control in northern Senegal.

PubMed

van der Werf, Marieke J; Mbaye, Amadou; Sow, Seydou; Gryseels, Bruno; de Vlas, Sake J

2002-01-01

A project to improve integrated control of schistosomiasis in the primary health care system of northern Senegal was implemented from February 1995 until September 1999, shortly after a Schistosoma mansoni outbreak. The activities included additional training of doctors and nurses in symptom-based treatment and making praziquantel (PZQ) available for an affordable price. To investigate staff performance and the availability and costs of diagnostic materials and PZQ at the end of this intervention project. We performed structured interviews with staff from 55 health care facilities in five districts. Respondents from 23 health care facilities reported both S. haematobium and S. mansoni in the coverage area, 32 reported only S. haematobium and three only S. mansoni. The average cost to patients for consultation, diagnosis, treatment and transportation to a referral health care facility was approximately 1.60 Euro. Fifty-seven per cent of the health care facilities with reported S. haematobium in the coverage area treated patients presenting with haematuria on symptoms; 56% of the health care facilities with reported S. mansoni in the coverage area treated patients presenting with blood in stool on symptoms. Thirteen per cent performed a diagnostic test for patients presenting with haematuria and 12% for patients presenting with blood in stool. The remainder, approximately one-third of the health care facilities, referred their patients to another facility for a diagnostic test. Implementation of symptom-based treatment in all health care facilities will reduce the total costs by 0.43 Euro (29%) for patients infected with S. haematobium and 0.78 Euro (46%) for patients infected with S. mansoni. Of the 53 health care facilities with schistosomiasis in their area, 37 had PZQ in stock of which 33 (88%) sold PZQ for the recommended retail price of 0.15 Euro per tablet (or 0.60 Euro per course of four tablets) or lower. Four years after the start of the intervention project, patients presenting with schistosomiasis related symptoms can generally expect proper diagnosis and treatment at all levels of the health care system in Northern Senegal, either at the initial visited health care facility or after referral. However, a further reduction of the total costs of treatment is still possible by a better implementation of symptom-based treatment and further reduction of the costs of PZQ.

Ground Water Monitoring Requirements for Hazardous Waste Treatment, Storage and Disposal Facilities

EPA Pesticide Factsheets

The groundwater monitoring requirements for hazardous waste treatment, storage and disposal facilities (TSDFs) are just one aspect of the Resource Conservation and Recovery Act (RCRA) hazardous waste management strategy for protecting human health and the

NPDES Permit for Woodcock Home Addition Wastewater Treatment Facility in Montana

EPA Pesticide Factsheets

Under NPDES permit MT-0030554, the Salish and Kootenai Housing Authority is authorized to discharge from its Woodcock Home Addition Wastewater Treatment Facility in Lake County, Montana, to a swale draining to Middle Crow Creek.

NPDES Permit for Rosebud Casino and Hotel Wastewater Treatment Facility in South Dakota

EPA Pesticide Factsheets

Under NPDES permit SD-0034584, Rosebud Casino and Hotel, South Dakota, is authorized to discharge from its wastewater treatment facility in Todd County, South Dakota to an unnamed drainageway(s) tributary to Rock Creek.

Environmental impact statement for Manned Spacecraft Center and White Sands Test Facility

NASA Technical Reports Server (NTRS)

1971-01-01

This environment has not only attracted people and increased payrolls, but has also created a broader base for the local economy. The activity of the center was a catalyst to private enterprise and has led to sizeable residential and commercial developments. Adequate treatment of domestic and industrial waste water was maintained. A feasibility study is now being conducted to establish a plan for a coordinated, centerwide plan for advanced treatment of domestic and industrial waste water.

NCI support for particle therapy: past, present, future.

PubMed

Deye, James A

2012-11-01

In light of the rising worldwide interest in particle therapy, and proton therapy specifically in the United States, the National Cancer Institute (NCI) is being asked more often about funding for such research and facilities. Many of the questions imply that NCI is naive to the exciting possibilities inherent in particle therapies, and thus they wish to encourage NCI to initiate and underwrite such programs. In fact, NCI has a long track record of support for the translation of hadrons from the physics laboratory to the therapy clinic by way of technology development and scientific investigations of physical and biological processes as well as clinical outcomes. Early work has included continuous funding since 1961 of proton treatments for more than 15,000 patients and facility construction at the Harvard/Massachusetts General Hospital (MGH) site; treatment of 227 patients with the pi-meson facility at Los Alamos between 1974 and 1981; funding of more than $69M for seven neutron therapy centers between 1971 and 1989; many funded projects in boron neutron capture radiation therapy through the present time; and numerous radiobiology projects over the past 50 y. NCI continues to play an active role in the incorporation of protons into randomized clinical trials through the Children's Oncology Group, Radiation Therapy Oncology Group, and the Program Project Grant (P01), which is co-directed by the MGH and MD Anderson Cancer Center. This has required funding development and implementation of guidelines that enable intercomparison of dosimetry and treatment between facilities. NCI has also funded recent efforts to develop new physical processes for the production of particles such as protons. With regard to the future, while it is true that there are no specific funding opportunity announcements directed to particle therapy research, it is also true that NCI remains open to reviewing any research that is compatible with an established mechanism. However, given the very substantial resources that these facilities currently require along with the highly competitive economic environment that now exists, it is clear that scientific review of such grant applications will look to leverage the scientific pursuits that are the NCI mandate with the reality of the clinical practices, just as is the case for photon radiation research. Such leveraging should be enhanced by the growing opportunities and need for international collaborations. On the other hand, these collaborations are complicated by the fact that these particle therapies are now fully reimbursable modalities, which makes it difficult to separate research (the NCI mission) from clinical practice development. This paper seeks to illuminate these new realities in order to encourage the pursuit and funding of the scientific underpinnings of physical methods, radiobiology, and clinical practice with particle therapy.

9 CFR 3.25 - Facilities, general.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

Present Status and Future Developments in Proton Therapy

NASA Astrophysics Data System (ADS)

Smith, Alfred R.

2009-07-01

Within the past few years, interest in proton therapy has significantly increased. This interest has been generated by a number of factors including: 1) the reporting of positive clinical results using proton beams; 2) approval of reimbursement for delivery of proton therapy; 3) the success of hospital-based proton therapy centers; and 4) the availability of modern, integrated proton therapy technology for hospital-based facilities. In the United States, this increased interest has occurred particularly at the level of smaller academic hospitals, community medical centers, and large private practices; however, interest from large academic centers continues to be strong. Particular interest exists regarding smaller and less-expensive proton therapy systems, especially the so-called "single-room" systems. In this paper, the advantages and disadvantages of 1-room proton therapy systems will be discussed. The emphasis on smaller and cheaper proton therapy facilities has also generated interest in new proton-accelerating technologies such as superconducting cyclotrons and synchrocyclotrons, laser acceleration, and dielectric-wall accelerators. Superconducting magnets are also being developed to decrease the size and weight of isocentric gantries. Another important technical development is spot-beam scanning, which offers the ability to deliver intensity-modulated proton treatments (IMPT). IMPT has the potential to provide dose distributions that are superior to those for photon intensity modulation techniques (IMXT) and to improve clinical outcomes for patients undergoing cancer therapy. At the present time, only two facilities—one in Europe and one in the United States—have the ability to deliver IMPT treatments, however, within the next year or two several additional facilities are expected to achieve this capability.

Race/ethnicity and geographic access to Medicaid substance use disorder treatment facilities in the United States.

PubMed

Cummings, Janet R; Wen, Hefei; Ko, Michelle; Druss, Benjamin G

2014-02-01

Although substance use disorders (SUDs) are prevalent and associated with adverse consequences, treatment rates remain low. Unlike physical and mental health problems, treatment for SUDs is predominantly provided in a separate specialty sector and more heavily financed by public sources. Medicaid expansion under the Patient Protection and Affordable Care Act has the potential to increase access to treatment for SUDs but only if an infrastructure exists to serve new enrollees. To examine the availability of outpatient SUD treatment facilities that accept Medicaid across US counties and whether counties with a higher percentage of racial/ethnic minorities are more likely to have gaps in this infrastructure. We used data from the 2009 National Survey of Substance Abuse Treatment Services public use file and the 2011-2012 Area Resource file to examine sociodemographic factors associated with county-level access to SUD treatment facilities that serve Medicaid enrollees. Counties in all 50 states were included. We estimated a probit model with state indicators to adjust for state-level heterogeneity in demographics, politics, and policies. Independent variables assessed county racial/ethnic composition (ie, percentage black and percentage Hispanic), percentage living in poverty, percentage living in a rural area, percentage insured with Medicaid, percentage uninsured, and total population. Dichotomous indicator for counties with at least 1 outpatient SUD treatment facility that accepts Medicaid. Approximately 60% of US counties have at least 1 outpatient SUD facility that accepts Medicaid, although this rate is lower in many Southern and Midwestern states than in other areas of the country. Counties with a higher percentage of black (marginal effect [ME],  -3.1; 95% CI,  -5.2% to -0.9%), rural (-9.2%; -11.1% to -7.4%), and/or uninsured (-9.5%; -13.0% to -5.9%) residents are less likely to have one of these facilities. The potential for increasing access to SUD treatment via Medicaid expansion may be tempered by the local availability of facilities to provide care, particularly for counties with a high percentage of black and/or uninsured residents and for rural counties. Although states that opt in to the expansion will secure additional federal funds for the SUD treatment system, additional policies may need to be implemented to ensure that adequate geographic access exists across local communities to serve new enrollees.

Health and safety impacts of nuclear, geothermal, and fossil-fuel electric generation in California. Volume 9. Methodologies for review of the health and safety aspects of proposed nuclear, geothermal, and fossil-fuel sites and facilities

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

Nero, A.V.; Quinby-Hunt, M.S.

1977-01-01

This report sets forth methodologies for review of the health and safety aspects of proposed nuclear, geothermal, and fossil-fuel sites and facilities for electric power generation. The review is divided into a Notice of Intention process and an Application for Certification process, in accordance with the structure to be used by the California Energy Resources Conservation and Development Commission, the first emphasizing site-specific considerations, the second examining the detailed facility design as well. The Notice of Intention review is divided into three possible stages: an examination of emissions and site characteristics, a basic impact analysis, and an assessment of publicmore » impacts. The Application for Certification review is divided into five possible stages: a review of the Notice of Intention treatment, review of the emission control equipment, review of the safety design, review of the general facility design, and an overall assessment of site and facility acceptability.« less

Water-quality conditions of the lower Boise River, Ada and Canyon Counties, Idaho, May 1994 through February 1997

USGS Publications Warehouse

Mullins, William H.

1998-01-01

Agricultural land and water use, wastewater treatment facility discharges, land development, road construction, urban runoff, confined-animal feeding operations, reservoir operations, and river channelization affect the water quality and biotic integrity of the lower Boise River between Lucky Peak Dam and the river's mouth at Parma, Idaho. During May 1994 through February 1997, 4 sites on the Boise River, 12 tributary/drain sites, and 3 wastewater treatment facilities were sampled at various intervals during the irrigation (high-flow) and post-irrigation (low-flow) seasons to determine sources, concentrations, and relative loads of nutrients and suspended sediment. Discharge entering the Boise River from the 12 tributary/drain sites and 3 wastewater treatment facilities was measured to determine the nutrient loads being contributed from each source. Total nitrogen, total phosphorus, and suspended sediment concentrations and loads tended to increase in a downstream direction along the Boise River. Among the 15 sources of discharge to the Boise River, 3 southside tributary/drains and the West Boise wastewater treatment facility contributed the largest loads of total nitrogen; the median daily load was more than 2,000 pounds per day. The West Boise wastewater treatment facility contributed the largest median daily load of total phosphorus (810 pounds per day); Dixie Drain contributed the largest median daily load of suspended sediment (26.4 tons per day). Nitrogen-to-phosphorus ratios at the four Boise River sites indicated that phosphorus could be limiting algal growth at the Diversion Dam site, whereas nitrogen could be limiting algal growth at the Glenwood and Middleton sites during some parts of the year. Algal growth in the Boise River near Parma did not appear to be nutrient limited. Because of the complexity of the plumbing system in the lower Boise River (numerous diversions and inflow points), accurate comparisons between discharge and nutrient loads entering the river at measured sites during high-flow sampling periods were difficult. During low-flow sampling periods, southside tributary/drains contributed most of the discharge and total nitrogen load, and wastewater treatment facilities contributed most of the total phosphorus load to the Boise River. During the 50-day period July 18 through September 5, 1996, the Idaho State standard for maximum daily average temperature for coldwater biota was exceeded by 34 percent at Middleton, 48 percent at Caldwell, and 80 percent near Parma. Violations of State standards for primary and secondary contact recreation were observed at all tributary/ drains and in the Boise River near Parma. Median instantaneous concentrations of fecal coliform bacteria exceeded State standards for primary contact recreation at five tributary/drains and exceeded standards for secondary contact recreation at one tributary/drain (Dixie Drain).

Smoking behavior and beliefs about the impact of smoking on anti-tuberculosis treatment among health care workers.

PubMed

Magee, M J; Darchia, L; Kipiani, M; Chakhaia, T; Kempker, R R; Tukvadze, N; Berg, C J; Blumberg, H M

2017-09-01

Tuberculosis (TB) health care facilities throughout Georgia. To describe smoking behaviors among health care workers (HCWs) at TB facilities and determine HCWs' knowledge and beliefs regarding the impact of tobacco use on anti-tuberculosis treatment. Cross-sectional survey from May to December 2014 in Georgia. Adult HCWs (age 18 years) at TB facilities were eligible. We administered a 60-question anonymous survey about tobacco use and knowledge of the effect of smoking on anti-tuberculosis treatment. Of the 431 HCWs at TB facilities who participated, 377 (87.5%) were female; the median age was 50 years (range 20-77). Overall, 59 (13.7%) HCWs were current smokers and 35 (8.1%) were past smokers. Prevalence of current smoking was more common among physicians than among nurses (18.6% vs. 7.9%, P < 0.0001). Among HCWs, 115 (26.7%) believed smoking does not impact anti-tuberculosis treatment, and only 25.3% of physicians/nurses received formal training in smoking cessation approaches. Physicians who smoked were significantly more likely to believe that smoking does not impact anti-tuberculosis treatment than non-smoking physicians (aOR 5.11, 95%CI 1.46-17.90). Additional education about the effect of smoking on TB treatment outcomes is needed for staff of TB health care facilities in Georgia. Nurses and physicians need more training about smoking cessation approaches for patients with TB.

Developing and Implementing a Quality Assurance Strategy for Electroconvulsive Therapy.

PubMed

Hollingsworth, Jessa; Baliko, Beverly; McKinney, Selina; Rosenquist, Peter

2018-04-17

The literature provides scant guidance in effective quality assurance strategies concerning the use of electroconvulsive therapy (ECT) for the treatment of psychiatric conditions. Numerous guidelines are published that provide guidance in the delivery of care; however, little has been done to determine how a program or facility might ensure compliance to best practice for safety, tolerability, and efficacy in performing ECT. The objective of this project was to create a quality assurance strategy specific to ECT. Determining standards for quality care and clarifying facility policy were key outcomes in establishing an effective quality assurance strategy. An audit tool was developed utilizing quality criteria derived from a systematic review of ECT practice guidelines, peer review, and facility policy. All ECT procedures occurring over a 2-month period of May to June 2017 were retrospectively audited and compared against target compliance rates set for the facility's ECT program. Facility policy was adapted to reflect quality standards, and audit findings were used to inform possible practice change initiatives, were used to create benchmarks for continuous quality monitoring, and were integrated into regular hospital quality meetings. Clarification on standards of care and the use of clinical auditing in ECT was an effective starting point in the development of a quality assurance strategy. Audit findings were successfully integrated into the hospital's overall quality program, and recognition of practice compliance informed areas for future quality development and policy revision in this small community-based hospital in the southeastern United States. This project sets the foundation for a quality assurance strategy that can be used to help monitor procedural safety and guide future improvement efforts in delivering ECT. Although it is just the first step in creating meaningful quality improvement, setting clear standards and identifying areas of greatest clinical need were crucial beginning for this hospital's growing program.

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.

Co-Occurring Disorders: A Challenge for Mexican Community-Based Residential Care Facilities for Substance Use.

PubMed

Marín-Navarrete, Rodrigo; Medina-Mora, María Elena; Horigian, Viviana E; Salloum, Ihsan M; Villalobos-Gallegos, Luis; Fernández-Mondragón, José

2016-01-01

In Mexico, specialized treatment services for people with co-occurring disorders are limited within public health services, while private options are deemed too costly. More than 2,000 community-based residential care facilities have risen as an alternative and are the main source of treatment for individuals with substance use disorders; however, suboptimal practices within such facilities are common. Information on the clinical characteristics of patients receiving care in these facilities is scarce and capacity to provide high-quality care for co-occurring disorders is unknown. The aims of this study were to examine the prevalence of co-occurring disorders in patients receiving treatment for substance use in these community-based residential centers and to assess whether the presence of co-occurring disorders is associated with higher severity of substance use, psychiatric symptomatology, and other health risks. This study was conducted with 601 patients receiving treatment for substance use disorders at 30 facilities located in five Mexican states, recruited in 2013 and 2014. Patients were assessed with self-report measures on substance use, service utilization, suicidality, HIV risk behaviors, psychiatric symptomatology, and psychiatric disorder diagnostic criteria. The prevalence of any co-occurring disorder in this sample was 62.6%. Antisocial personality disorder was the most prevalent (43.8%), followed by major depressive disorder (30.9%). The presence of a co-occurring disorder was associated with higher severity of psychiatric symptoms (aB = .496, SE = .050, p < .05); more days of substance use (aB = .219, SE = .019, p < .05); current suicidal ideation (aOR = 5.07, 95% CI [2.58, 11.17]; p < .05), plans (aOR = 5.17 95% CI [2.44, 12.73]; p < .05), and attempts (aOR = 6.43 95% CI [1.83, 40.78]; p < .05); more sexual risk behaviors; and more contact with professional services (aOR = 1.77, 95% CI [1.26, 2.49], p < .05). Co-occurring disorders are highly prevalent in community-based residential centers in Mexico and are associated with significantly increased probability of other health risks. This highlights the need to develop care standards for this population and the importance of clinical research in these settings.

NPDES Draft Permit for MHA Interpretive Center Wastewater Treatment Facility in North Dakota

EPA Pesticide Factsheets

Under draft NPDES permit ND0031160, the Mandan, Hidatsa, and Arikara (MHA) Nation Public Works is authorized to discharge from its MHA Interpretive Center wastewater treatment facility to Missouri River as set forth in the permit.

NPDES Draft Permit for Southern Ute Indian Tribe Wastewater Treatment Facility in Colorado

EPA Pesticide Factsheets

Under NPDES draft permit number CO-0022853, the Southern Ute Indian Tribe is authorized to discharge from its wastewater treatment facility in La Plata County, Colorado,to Rock Creek, a tributary of the Los Pinos River.

Village of Pender, Nebraska Wastewater Treatment Facility, Pender, Nebraska - Clean Water Act Public Notice

EPA Pesticide Factsheets

The EPA is providing notice of proposed Administrative Penalty Assessment against the Village of Pender, Nebraska Wastewater Treatment Facility (“Respondent”) for alleged violations of Sections 301 and/or 404 of the Clean Water Act

NPDES Permit for City of Eagle Butte Wastewater Treatment Facility in South Dakota

EPA Pesticide Factsheets

Under NPDES permit SD-0020192, the City of Eagle Butte, South Dakota, is authorized to discharge from its wastewater treatment facility within the Cheyenne River Sioux Reservation in Dewey County, South Dakota, to Green Grass Creek.

NPDES Permit for Yellowtail Dam Wastewater Treatment Facility in Montana

EPA Pesticide Factsheets

Under NPDES permit MT-0022993, the U.S. Bureau of Reclamation is authorized to discharge from its wastewater treatment facility located at the Yellowtail Dam Field Office in Big Horn County, Montana, to the Yellowtail Afterbay Reservoir/Bighorn River.

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

EPA Pesticide Factsheets

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

NPDES Permit for Fort Carson Wastewater Treatment Facility in Colorado

EPA Pesticide Factsheets

Under NPDES permit no. CO-0021181 the United States Department of the Army, Fort Carson, in authorized to discharge from its sanitary wastewater treatment facility in El Paso County, Colorado, to Clover Ditch, a tributary of Fountain Creek.

Tobacco Cessation Interventions and Smoke-Free Policies in Mental Health and Substance Abuse Treatment Facilities - United States, 2016.

PubMed

Marynak, Kristy; VanFrank, Brenna; Tetlow, Sonia; Mahoney, Margaret; Phillips, Elyse; Jamal Mbbs, Ahmed; Schecter, Anna; Tipperman, Doug; Babb, Stephen

2018-05-11

Persons with mental or substance use disorders or both are more than twice as likely to smoke cigarettes as persons without such disorders and are more likely to die from smoking-related illness than from their behavioral health conditions (1,2). However, many persons with behavioral health conditions want to and are able to quit smoking, although they might require more intensive treatment (2,3). Smoking cessation reduces smoking-related disease risk and could improve mental health and drug and alcohol recovery outcomes (1,3,4). To assess tobacco-related policies and practices in mental health and substance abuse treatment facilities (i.e., behavioral health treatment facilities) in the United States (including Puerto Rico), CDC and the Substance Abuse and Mental Health Services Administration (SAMHSA) analyzed data from the 2016 National Mental Health Services Survey (N-MHSS) and the 2016 National Survey of Substance Abuse Treatment Services (N-SSATS). In 2016, among mental health treatment facilities, 48.9% reported screening patients for tobacco use, 37.6% offered tobacco cessation counseling, 25.2% offered nicotine replacement therapy (NRT), 21.5% offered non-nicotine tobacco cessation medications, and 48.6% prohibited smoking in all indoor and outdoor locations (i.e., smoke-free campus). In 2016, among substance abuse treatment facilities, 64.0% reported screening patients for tobacco use, 47.4% offered tobacco cessation counseling, 26.2% offered NRT, 20.3% offered non-nicotine tobacco cessation medications, and 34.5% had smoke-free campuses. Full integration of tobacco cessation interventions into behavioral health treatment, coupled with implementation of tobacco-free campus policies in behavioral health treatment settings, could decrease tobacco use and tobacco-related disease and could improve behavioral health outcomes among persons with mental and substance use disorders (1-4).

On-site or off-site treatment of medical waste: a challenge

PubMed Central

2014-01-01

Treating hazardous-infectious medical waste can be carried out on-site or off-site of health-care establishments. Nevertheless, the selection between on-site and off-site locations for treating medical waste sometimes is a controversial subject. Currently in Iran, due to policies of Health Ministry, the hospitals have selected on-site-treating method as the preferred treatment. The objectives of this study were to assess the current condition of on-site medical waste treatment facilities, compare on-site medical waste treatment facilities with off-site systems and find the best location of medical waste treatment. To assess the current on-site facilities, four provinces (and 40 active hospitals) were selected to participate in the survey. For comparison of on-site and off-site facilities (due to non availability of an installed off-site facility) Analytical Hierarchy Process (AHP) was employed. The result indicated that most on-site medical waste treating systems have problems in financing, planning, determining capacity of installations, operation and maintenance. AHP synthesis (with inconsistency ratio of 0.01 < 0.1) revealed that, in total, the off-site treatment of medical waste was in much higher priority than the on-site treatment (64.1% versus 35.9%). According to the results of study it was concluded that the off-site central treatment can be considered as an alternative. An amendment could be made to Iran’s current medical waste regulations to have infectious-hazardous waste sent to a central off-site installation for treatment. To begin and test this plan and also receive the official approval, a central off-site can be put into practice, at least as a pilot in one province. Next, if it was practically successful, it could be expanded to other provinces and cities. PMID:24739145

Treatment compliance and challenges among tuberculosis patients across selected health facilities in Osun State Nigeria.

PubMed

Ajao, K O; Ogundun, O A; Afolabi, O T; Ojo, T O; Atiba, B P; Oguntunase, D O

2014-12-01

Tuberculosis (TB) is a major public health problem in the world and Africa has approximately one quarter of the world's cases. One of the greatest challenges facing most TB programmes is the non-compliance to TB treatment among TB patients. This study aimed at determining the challenges of management of tuberculosis (TB) across selected Osun State health facilities. The study employed a descriptive cross-sectional design. A semi-structured questionnaire was used to collect data from 102 TB patients in the health facilities. The instrument measured socio-demographic variables, patient related factors, socio-economic variables, health care system related factors to TB disease and treatment. Data were analysed and summarized using descriptive and inferential statistics. Statistical significance was placed at p < 0.05. TB patients who had no formal education (χ2 = 12.941, p < 0.05), who were smoking during treatment (χ2 = 13.194, p < 0.001), who consumed alcohol during TB treatment (χ2 = 6.371, p < 0.05) and those who were HIV positive (χ2 = 23.039, p < 0.001) significantly failed to comply with TB treatment. TB patients who waited for one hour or more at heath facilities (χ2 = 21.761, p < 0.001), who reported that TB treatment should be stopped before six month (χ2 = 9.804, p < 0.05) or when patient felt better (χ2 = 35.185, p < 0.001) and travelled for 10 km or more (χ2 = 13.610, p < 0.001) significantly failed to comply with TB treatment. This study concluded that non-compliance rate to tuberculosis treatment among TB patients in this study is high. Both health facility and patient-related factors were largely responsible.

A one-dimensional, steady-state, dissolved-oxygen model and waste-load assimilation study for Clear Creek, Monroe County, Indiana

USGS Publications Warehouse

Wilber, William G.; Crawford, Charles G.; Peters, J.G.; Girardi, F.P.

1979-01-01

A digital model calibrated to conditions in Clear Creek, Monroe County, IN, was used to develop alternatives for future waste loadings that would be compatible with Indiana stream water-quality standards defined for two critical hydrologic conditions, summer and winter low flows. The Winston Thomas wastewater-treatment facility is the only point-source waste load affecting the modeled reach of Clear Creek. A new waste-water-treatment facility under construction at Dillman Road (river mile 13.78) will replace the Winston Thomas wastewater-treatment facility (river mile 16.96) in 1980. Natural streamflow during the summer and annual 7-day, 10-year low flow is zero, so no benefit from dilution is provided. The model indicates that ammonia-nitrogen toxicity is the most significant factor affecting the stream water quality during summer and winter low flows. The ammonia-nitrogen concentration of the wastewater effluent exceeds the maximum total ammonia-nitrogen concentration of 2.5 milligrams per liter for summer months (June through August) and 4.0 milligrams per liter for winter months (November through March) required for Indiana streams. Nitrification, benthic-oxygen demand, and algal respiration were the most significant factors affecting the dissolved-oxygen concentration in Clear Creek during the model calibration. Nitrification should not significantly affect the dissolved-oxygen concentration in Clear Creek during summer low flows when the ammonia-nitrogen toxicity standards are met. (USGS)

Impact of coastal processes on resource development with an example from Icy Bay, Alaska

USGS Publications Warehouse

Molnia, Bruce F.

1978-01-01

The coastline of Alaska is dynamic and continually readjusting to changes in the many processes that operate in the coastal zone. Because of this dynamic nature, special consideration must be made in planning for development, and. caution must be exercised in site selection for facilities to be emplaced in the coastal zone. All types of coastal processes from continuously active normal processes to the low frequency-high intensity rare event must be considered. Site-specific evaluation-s considering the broad range of possible processes must precede initiation of development. An example of the relation between coastal processes and a proposed resource treatment facility is presented for Icy Bay, Alaska. Icy Bay is the only sheltered bay near many of the offshore tracts leased for petroleum exploration in the 1976 northern Gulf of Alaska OCS (Outer Continental Shelf) lease sale. Consequently, it has been selected as a primary onshore staging site for the support of offshore exploration and development. The environment of Icy Bay has many potentially hazardous features, including a submarine moraine at the bay mouth and actively calving glaciers at the bay's head which produce many icebergs. But most significant from the point of view of locating onshore facilities and pipeline corridors are the high rates of shoreline erosion and sediment deposition. If pipelines or any onshore staging facilities are to be placed in the coastal areas of Icy Bay, then the dynamic changes in shoreline position must be considered so that man-made structures will not be eroded away or be silted in before the completion of development.

Impact of Family Planning and Business Trainings on Private-Sector Health Care Providers in Nigeria.

PubMed

Ugaz, Jorge; Leegwater, Anthony; Chatterji, Minki; Johnson, Doug; Baruwa, Sikiru; Toriola, Modupe; Kinnan, Cynthia

2017-06-01

Private health care providers are an important source of modern contraceptives in Sub-Saharan Africa, yet they face many challenges that might be addressed through targeted training. This study measures the impact of a package of trainings and supportive supervision activities targeted to private health care providers in Lagos State, Nigeria, on outcomes including range of contraceptive methods offered, providers' knowledge and quality of counseling, recordkeeping practices, access to credit and revenue. A total of 965 health care facilities were randomly assigned to treatment and control groups. Facilities in the treatment group-but not those in the control group-were offered a training package that included a contraceptive technology update and interventions to improve counseling and clinical skills and business practices. Multivariate regression analysis of data collected through facility and mystery client surveys was used to estimate effects. The training program had a positive effect on the range of contraceptive methods offered, with facilities in the treatment group providing more methods than facilities in the control group. The training program also had a positive impact on the quality of counseling services, especially on the range of contraceptive methods discussed by providers, their interpersonal skills and overall knowledge. Facilities in the treatment group were more likely than facilities in the control group to have good recordkeeping practices and to have obtained loans. No effect was found on revenue generation. Targeted training programs can be effective tools to improve the provision of family planning services through private providers.

The care of Filipino juvenile offenders in residential facilities evaluated using the risk-need-responsivity model.

PubMed

Spruit, Anouk; Wissink, Inge B; Stams, Geert Jan J M

2016-01-01

According to the risk-need-responsivity model of offender, assessment and rehabilitation treatment should target specific factors that are related to re-offending. This study evaluates the residential care of Filipino juvenile offenders using the risk-need-responsivity model. Risk analyses and criminogenic needs assessments (parenting style, aggression, relationships with peers, empathy, and moral reasoning) have been conducted using data of 55 juvenile offenders in four residential facilities. The psychological care has been assessed using a checklist. Statistical analyses showed that juvenile offenders had a high risk of re-offending, high aggression, difficulties in making pro-social friends, and a delayed socio-moral development. The psychological programs in the residential facilities were evaluated to be poor. The availability of the psychological care in the facilities fitted poorly with the characteristics of the juvenile offenders and did not comply with the risk-need-responsivity model. Implications for research and practice are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

[The Contribution of GMP-grade Hospital Preparation to Translational Research].

PubMed

Yonezawa, Atsushi; Kajiwara, Moto; Minami, Ikuko; Omura, Tomohiro; Nakagawa, Shunsaku; Matsubara, Kazuo

2015-01-01

Translational research is important for applying the outcomes of basic research studies to practical medical treatments. In exploratory early-phase clinical trials for an innovative therapy, researchers should generally manufacture investigational agents by themselves. To provide investigational agents with safety and high quality in clinical studies, appropriate production management and quality control are essential. In the Department of Pharmacy of Kyoto University Hospital, a manufacturing facility for sterile drugs was established, independent of existing manufacturing facilities. Manuals on production management and quality control were developed according to Good Manufacturing Practices (GMP) for Investigational New Drugs (INDs). Advanced clinical research has been carried out using investigational agents manufactured in our facility. These achievements contribute to both the safety of patients and the reliability of clinical studies. In addition, we are able to do licensing-out of our technique for the manufacture of investigational drugs. In this symposium, we will introduce our GMP grade manufacturing facility for sterile drugs and discuss the role of GMP grade hospital preparation in translational research.

Estimation of marginal costs at existing waste treatment facilities.

PubMed

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

2016-04-01

This investigation aims at providing an improved basis for assessing economic consequences of alternative Solid Waste Management (SWM) strategies for existing waste facilities. A bottom-up methodology was developed to determine marginal costs in existing facilities due to changes in the SWM system, based on the determination of average costs in such waste facilities as function of key facility and waste compositional parameters. The applicability of the method was demonstrated through a case study including two existing Waste-to-Energy (WtE) facilities, one with co-generation of heat and power (CHP) and another with only power generation (Power), affected by diversion strategies of five waste fractions (fibres, plastic, metals, organics and glass), named "target fractions". The study assumed three possible responses to waste diversion in the WtE facilities: (i) biomass was added to maintain a constant thermal load, (ii) Refused-Derived-Fuel (RDF) was included to maintain a constant thermal load, or (iii) no reaction occurred resulting in a reduced waste throughput without full utilization of the facility capacity. Results demonstrated that marginal costs of diversion from WtE were up to eleven times larger than average costs and dependent on the response in the WtE plant. Marginal cost of diversion were between 39 and 287 € Mg(-1) target fraction when biomass was added in a CHP (from 34 to 303 € Mg(-1) target fraction in the only Power case), between -2 and 300 € Mg(-1) target fraction when RDF was added in a CHP (from -2 to 294 € Mg(-1) target fraction in the only Power case) and between 40 and 303 € Mg(-1) target fraction when no reaction happened in a CHP (from 35 to 296 € Mg(-1) target fraction in the only Power case). Although average costs at WtE facilities were highly influenced by energy selling prices, marginal costs were not (provided a response was initiated at the WtE to keep constant the utilized thermal capacity). Failing to systematically address and include costs in existing waste facilities in decision-making may unintendedly lead to higher overall costs at societal level. To avoid misleading conclusions, economic assessment of alternative SWM solutions should not only consider potential costs associated with alternative treatment but also include marginal costs associated with existing facilities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Implementing Trauma-Informed Treatment for Youth in a Residential Facility: First-Year Outcomes

ERIC Educational Resources Information Center

Greenwald, Ricky; Siradas, Lynn; Schmitt, Thomas A.; Reslan, Summar; Fierle, Julia; Sande, Brad

2012-01-01

Training in the Fairy Tale model of trauma-informed treatment was provided to clinical and direct care staff working with 53 youth in a residential treatment facility. Compared to the year prior to training, in the year of the training the average improvement in presenting problems was increased by 34%, time to discharge was reduced by 39%, and…

75 FR 12233 - New York State Prohibition of Discharges of Vessel Sewage; Receipt of Petition and Tentative...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-15

... Hours of Operation: 7 a.m.-9 p.m. Facility Fee: $5.00 Vessel Size: 50' Disposal/Treatment: Holding Tank...' Disposal/Treatment: Holding Tank Name: Chazy Yacht Club Inc Phone Number: 518-298-2866 Lat/Long: 44.934336... p.m. Facility Fee: $ 5.00 Vessel Size: 50' Disposal/Treatment: Holding Tank Name: Gilbert Brook...

38 CFR 1.301 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., including any necessary buildings and structures, garage or parking facility. (e) Parking facilities... whom the Secretary is authorized to furnish medical examination or treatment. (c) Garage means a structure or part of a structure in which vehicles may be parked. (d) Medical facility means any facility or...

38 CFR 1.301 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., including any necessary buildings and structures, garage or parking facility. (e) Parking facilities... whom the Secretary is authorized to furnish medical examination or treatment. (c) Garage means a structure or part of a structure in which vehicles may be parked. (d) Medical facility means any facility or...

38 CFR 1.301 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., including any necessary buildings and structures, garage or parking facility. (e) Parking facilities... whom the Secretary is authorized to furnish medical examination or treatment. (c) Garage means a structure or part of a structure in which vehicles may be parked. (d) Medical facility means any facility or...

38 CFR 1.301 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., including any necessary buildings and structures, garage or parking facility. (e) Parking facilities... whom the Secretary is authorized to furnish medical examination or treatment. (c) Garage means a structure or part of a structure in which vehicles may be parked. (d) Medical facility means any facility or...

38 CFR 1.301 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., including any necessary buildings and structures, garage or parking facility. (e) Parking facilities... whom the Secretary is authorized to furnish medical examination or treatment. (c) Garage means a structure or part of a structure in which vehicles may be parked. (d) Medical facility means any facility or...

42 CFR 483.374 - Facility reporting.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Facility reporting. 483.374 Section 483.374 Public...) STANDARDS AND CERTIFICATION REQUIREMENTS FOR STATES AND LONG TERM CARE FACILITIES Condition of Participation for the Use of Restraint or Seclusion in Psychiatric Residential Treatment Facilities Providing...

Irradiation treatment for the protection and conservation of cultural heritage artefacts in Croatia

NASA Astrophysics Data System (ADS)

Katušin-Ražem, Branka; Ražem, Dušan; Braun, Mario

2009-07-01

The application of irradiation treatment for the protection of cultural heritage artefacts in Croatia was made possible by the development of radiation processing procedures at the Radiation Chemistry and Dosimetry Laboratory of the Ruđer Bo\\vsković Institute. After the upgrading of the 60Co gamma irradiation source in the panoramic irradiation facility in 1983 it became possible to perform both research and pilot plant-scale irradiations for sterilization, pasteurization and decontamination of various materials, including medical supplies, pharmaceuticals, cosmetics and foods, but also for disinfestation of cultural heritage artefects. The demand for irradiation treatment of cultural heritage objects has particularly increased as the increasing number of these objects, especially polychromic wooden sculptures, were requiring salvation, restauration and conservation as a consequence of direct and indirect damages inflicted to them during the war in Croatia, 1991-1995. The irradiation facility at the Ruđer Bo\\vsković Institute is briefly described and an account of its fifteen years' activities in the irradiation treatment of cultural heritage objects is given. Some case studies performed in cooperation with the Croatian Conservation Institute and other interested parties are presented, as well as some cases of protective and curative treatments for disinfestation and decontamination. International cooperations and activities are also mentioned.

NPDES Permit for U.S. Air Force Academy Wastewater Treatment Facility in Colorado

EPA Pesticide Factsheets

Under NPDES permit CO-0020974, the U.S. Air Force Academy is authorized to discharge from its wastewater treatment facility in El Paso County, Colorado, to Non-Potable Reservoir No. 1 on Lehman Run and to Monument Creek.

NPDES Permit for Dakota Magic Casino Wastewater Treatment Facility in North Dakota

EPA Pesticide Factsheets

Under NPDES permit ND-0030813, the Dakota Nation Gaming Enterprise is authorized to discharge from the wastewater treatment facility in Richland County, North Dakota, to a roadside ditch flowing to an unnamed tributary to the Bois de Sioux.

NPDES Permit for Town of Lodge Grass Wastewater Treatment Facility in Montana

EPA Pesticide Factsheets

Under National Pollutant Discharge Elimination System permit number MT0021890, the Town of Lodge Grass is authorized to discharge from from its wastewater treatment facility in Big Horn County to an unnamed slough to the Little Bighorn River.

NPDES Permit for the St. Ignatius-Southside Wastewater Treatment Facility in Montana

EPA Pesticide Factsheets

Under NPDES permit MT-0029017, the Salish and Kootenai Housing Authority of the Confederated Salish and Kootenai Tribes is authorized to discharge from its wastewater treatment facility in Lake County, Montana to an unnamed tributary of Sabine Creek.

Bilogical Treatment for Ammonia Oxidation in Drinking Water Facilities

EPA Science Inventory

Ammonia is an unregulated compound, but is naturally occurring in many drinking water sources. It is also used by some treatment facilities to produce chloramines for disinfection purposes. Because ammonia is non-toxic, its presence in drinking water is often disregarded. Thro...

Medical Applications of Synchrotron Radiation

NASA Astrophysics Data System (ADS)

Prezado, Yolanda; Martínez-Rovira, Immaculada

This chapter describes the state-of-art of synchrotron radiation therapies in the treatment of radioresistant tumors. The tolerance of the surrounding healthy tissue severely limits the achievement of a curative treatment for some brain tumors, like gliomas. This restriction is especially important in children, due to the high risk of complications in the development of the central nervous system. In addition, the treatment of tumors close to an organ at risk, like the spinal cord, is also restrained. One possible solution is the development of new radiotherapy techniques would exploit radically different irradiation modes, as it is the case of synchrotron radiotherapies. Their distinct features allow to modify the biological equivalent doses. In this chapter the three new approaches under development at the European Synchrotron Radiation Facility (ESRF), in Grenoble (France), will be described, namely: stereotactic synchrotron radiation therapy, microbeam radiation therapy and minibeam radiation therapy. The promising results obtained in the treatment of high grade brain tumors in preclinical studies have paved the way to the forthcoming clinical trials, currently in preparation.

Referral and Receipt of Treatment for Hepatocellular Carcinoma in United States Veterans: Effect of Patient and Non-Patient Factors

PubMed Central

Davila, Jessica A.; Kramer, Jennifer R.; Duan, Zhigang; Richardson, Peter A.; Tyson, Gia L.; Sada, Yvonne H.; Kanwal, Fasiha; El-Serag, Hashem B.

2014-01-01

Background The delivery of treatment for hepatocellular carcinoma (HCC) could be influenced by place of HCC diagnosis (hospitalization vs. outpatient), subspecialty referral following diagnosis, as well as physician and facility factors. We conducted a study to examine the effect of patient and non-patient factors on the place of HCC diagnosis, referral, and treatment in Veterans Administration (VA) hospitals in the United States. Methods Using the VA Hepatitis C Clinical Case Registry, we identified HCV-infected patients who developed HCC during 1998–2006. All cases were verified and staged according to Barcelona Clinic Liver Cancer (BCLC) criteria. The main outcomes were place of HCC diagnosis, being seen by a surgeon or oncologist, and treatment. We examined factors related to these outcomes using hierarchical logistic regression. These factors included HCC stage, HCC surveillance, physician specialty, and facility factors, in addition to risk factors, co-morbidity, and liver disease indicators. Results Approximately 37.2% of the 1,296 patients with HCC were diagnosed during hospitalization, 31.0% were seen by a surgeon or oncologist, and 34.3% received treatment. Being seen by a surgeon or oncologist was associated with surveillance (adjusted odds ratio (aOR)=1.47;95%CI:1.20–1.80) and varied by geography (1.74;1.09–2.77). Seeing a surgeon or oncologist was predictive of treatment (aOR=1.43;95%CI:1.24–1.66). There was a significant increase in treatment among patients who received surveillance (aOR=1.37; 95%CI:1.02–1.71), were seen by gastroenterology (1.65;1.21–2.24) or were diagnosed at a transplant facility (1.48;1.15–1.90). Conclusions Approximately 40% of patients were diagnosed during hospitalization. Most patients were not seen by a surgeon or oncologist for treatment evaluation and only 34% received treatment. Only receipt of HCC surveillance was associated with increased likelihood of outpatient diagnosis, being seen by a surgeon or oncologist, and treatment. PMID:23359313

Assessing the costs of municipal solid waste treatment technologies in developing Asian countries.

PubMed

Aleluia, João; Ferrão, Paulo

2017-11-01

The management of municipal solid waste (MSW) is one of the main costs incurred by local authorities in developing countries. According to some estimates, these costs can account for up to 50% of city government budgets. It is therefore of importance that policymakers, urban planners and practitioners have an adequate understanding of what these costs consist of, from collection to final waste disposal. This article focuses on a specific stage of the MSW value chain, the treatment of waste, and it aims to identify cost patterns associated with the implementation and operation of waste treatment approaches in developing Asian countries. An analysis of the capital (CAPEX) and operational expenditures (OPEX) of a number of facilities located in countries of the region was conducted based on a database gathering nearly 100 projects and which served as basis for assessing four technology categories: composting, anaerobic digestion (AD), thermal treatment, and the production of refuse-derived fuel (RDF). Among these, it was found that the least costly to invest, asa function of the capacity to process waste, are composting facilities, with an average CAPEX per ton of 21,493 USD 2015 /ton. Conversely, at the upper end featured incineration plants, with an average CAPEX of 81,880 USD 2015 /ton, with this treatment approach ranking by and large as the most capital intensive of the four categories assessed. OPEX figures of the plants, normalized and analyzed in the form of OPEX/ton, were also found to be higher for incineration than for biological treatment methods, although on this component differences amongst the technology groups were less pronounced than those observed for CAPEX. While the results indicated the existence of distinct cost implications for available treatment approaches in the developing Asian context, the analysis also underscored the importance of understanding the local context asa means to properly identify the cost structure of each specific plant. Moreover, even though CAPEX and OPEX figures are important elements to assess the costs of a waste treatment system, these should not be considered on a standalone basis for decision making purposes. In complement to this internal cost dimension, the broader impacts - to the economy, society and the environment - resulting from the adoption of a certain treatment approach should be properly understood and, ideally, measured and expressed in monetary terms. Copyright © 2017 Elsevier Ltd. All rights reserved.

Treating and preventing influenza in aged care facilities: a cluster randomised controlled trial.

PubMed

Booy, Robert; Lindley, Richard I; Dwyer, Dominic E; Yin, Jiehui K; Heron, Leon G; Moffatt, Cameron R M; Chiu, Clayton K; Rosewell, Alexander E; Dean, Anna S; Dobbins, Timothy; Philp, David J; Gao, Zhanhai; MacIntyre, C Raina

2012-01-01

Influenza is an important cause of morbidity and mortality for frail older people. Whilst the antiviral drug oseltamivir (a neuraminidase inhibitor) is approved for treatment and prophylaxis of influenza during outbreaks, there have been no trials comparing treatment only (T) versus treatment and prophylaxis (T&P) in Aged Care Facilities (ACFs). Our objective was to compare a policy of T versus T&P for influenza outbreaks in ACFs. We performed a cluster randomised controlled trial in 16 ACFs, that followed a policy of either "T"-oseltamivir treatment (75 mg twice a day for 5 days)-or "T&P"-treatment and prophylaxis (75 mg once a day for 10 days) for influenza outbreaks over three years, in addition to enhanced surveillance. The primary outcome measure was the attack rate of influenza. Secondary outcomes measures were deaths, hospitalisation, pneumonia and adverse events. Laboratory testing was performed to identify the viral cause of influenza-like illness (ILI) outbreaks. The study period 30 June 2006 to 23 December 2008 included three southern hemisphere winters. During that time, influenza was confirmed as the cause of nine of the 23 ILI outbreaks that occurred amongst the 16 ACFs. The policy of T&P resulted in a significant reduction in the influenza attack rate amongst residents: 93/255 (36%) in residents in T facilities versus 91/397 (23%) in T&P facilities (p=0.002). We observed a non-significant reduction in staff: 46/216 (21%) in T facilities versus 47/350 (13%) in T&P facilities (p=0.5). There was a significant reduction in mean duration of outbreaks (T=24 days, T&P=11 days, p=0.04). Deaths, hospitalisations and pneumonia were non-significantly reduced in the T&P allocated facilities. Drug adverse events were common but tolerated. Our trial lacked power but these results provide some support for a policy of "treatment and prophylaxis" with oseltamivir in controlling influenza outbreaks in ACFs. [corrected] Australian Clinical Trials Registry ACTRN12606000278538.

Pest management in traditional maize stores in West Africa: a farmer's perspective.

PubMed

Meikle, W G; Markham, R H; Nansen, C; Holst, N; Degbey, P; Azoma, K; Korie, S

2002-10-01

Farmers in the Republic of Benin have few resources to invest in protection of stored maize, and prophylactic pesticide application is often recommended by extension and development agencies. Neither the efficacy nor profitability of such an application in traditional maize storage facilities has been addressed quantitatively. In this study, existing management options for stored maize were evaluated monthly over 6 mo in central and southern Benin with respect to their effects on grain injury and on densities of Prostephanus truncatus (Horn) and Sitophilus zeamais Motschulsky. P. truncatus infested 54% of the experimental stores in the study even though Teretrius nigrescens (Lewis), a natural enemy introduced against P. truncatus, was well established in the region. S. zeamais was the most common pest, found in 85% of the experimental storage facilities. Prophylactically treated maize was, on average, worth more than untreated maize for month 1 through 5 in southern Benin, after taking into account market price, pesticide costs, percentage grain damage and weight loss, but maize storage was not profitable overall. No difference was observed between treatments in central Benin. After 6 mo treated storage facilities were not significantly different from untreated storage facilities in terms of either percentage damage or profit in either region. A rapid scouting plan intended to provide farmers with a means for identifying storage facilities at greatest risk of severe P. truncatus infestation was field validated. Given that unsafe pesticide use is prevalent in Benin, research and extension services should clearly state the limitations to prophylactic treatment and increase the effort to educate farmers on appropriate pesticide use, store monitoring and marketing.

Boron neutron capture therapy (BNCT) in Finland: technological and physical prospects after 20 years of experiences.

PubMed

Savolainen, Sauli; Kortesniemi, Mika; Timonen, Marjut; Reijonen, Vappu; Kuusela, Linda; Uusi-Simola, Jouni; Salli, Eero; Koivunoro, Hanna; Seppälä, Tiina; Lönnroth, Nadja; Välimäki, Petteri; Hyvönen, Heini; Kotiluoto, Petri; Serén, Tom; Kuronen, Antti; Heikkinen, Sami; Kosunen, Antti; Auterinen, Iiro

2013-05-01

Boron Neutron Capture Therapy (BNCT) is a binary radiotherapy method developed to treat patients with certain malignant tumours. To date, over 300 treatments have been carried out at the Finnish BNCT facility in various on-going and past clinical trials. In this technical review, we discuss our research work in the field of medical physics to form the groundwork for the Finnish BNCT patient treatments, as well as the possibilities to further develop and optimize the method in the future. Accordingly, the following aspects are described: neutron sources, beam dosimetry, treatment planning, boron imaging and determination, and finally the possibilities to detect the efficacy and effects of BNCT on patients. Copyright © 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

COMP report: CPQR technical quality control guidelines for low-dose-rate permanent seed brachytherapy.

PubMed

Beaulieu, Luc; Radford, Dee-Ann; Eduardo Villarreal-Barajas, J

2018-03-14

The Canadian Organization of Medical Physicists (COMP), in close partnership with the Canadian Partnership for Quality Radiotherapy (CPQR) has developed a series of Technical Quality Control (TQC) guidelines for radiation treatment equipment. These guidelines outline the performance objectives that equipment should meet in order to ensure an acceptable level of radiation treatment quality. The TQC guidelines have been rigorously reviewed and field tested in a variety of Canadian radiation treatment facilities. The development process enables rapid review and update to keep the guidelines current with changes in technology. This article contains detailed performance objectives and safety criteria for low-dose-rate (LDR) permanent seed brachytherapy. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Assessment of Directly Observed Therapy (DOT) following tuberculosis regimen change in Addis Ababa, Ethiopia: a qualitative study.

PubMed

Fiseha, Daniel; Demissie, Meaza

2015-09-30

Tuberculosis remains a major public health problem in Ethiopia. In 2010 the TB treatment regimen was shortened from 8 to 6-months treatment. With this new regimen, the full course of treatment should be taken under Directly Observed Therapy (DOT) unlike the 8-month regimen where TB patients were only observed during the intensive phase, this has not been tried before and may be difficult to implement. Therefore this study aimed to investigate the experiences from both TB patients and health care providers' perspective of implementing DOT for the full course of TB treatment. Qualitative study consisted of 11 in-depth interviews and 4 Focus Group Discussions (FDGs) were conducted between March and April, 2014. Overall, 18 TB patients and 16 HCPs were involved from three selected public health facilities (2 Health Centers and 1 Hospital) in Addis Ababa, Ethiopia. Qualitative data analysis software (Open Code Version 3.5) was employed to identify the key issues from these interviews through coding, categorization and grouping into emergent themes. Participants reported that making a daily visit to health facilities for DOT was difficult due to the distance of the facilities from their residences, lack of or high transportation cost and had undesired implications on their work and social lives. TB patients had to overcome many challenges to comply with TB treatment on a daily basis. HCPs also indicated the difficulties of implementing facility based daily DOT mainly due the implication it had on their TB patients and stated DOT had not always been implemented for the full course as recommended. HCPs also shared deep concern regarding the risk of acquiring multiple drug resistant TB. This study indicated there are several challenges associated with facility based daily DOT as a method of TB treatment supervision in public health facilities in Addis Ababa. This may be indicative of the situation in other health facilities in Addis Ababa as well as elsewhere in the country. Hence the TB control program has to explore how best to improve TB treatment delivery options to ensure adequate treatment. A more patient-centered approach could be strengthened by further decentralizing the DOT to the community level in order to ensure adherence of patients to their TB treatment.

A multi-objective model for sustainable recycling of municipal solid waste.

PubMed

Mirdar Harijani, Ali; Mansour, Saeed; Karimi, Behrooz

2017-04-01

The efficient management of municipal solid waste is a major problem for large and populated cities. In many countries, the majority of municipal solid waste is landfilled or dumped owing to an inefficient waste management system. Therefore, an optimal and sustainable waste management strategy is needed. This study introduces a recycling and disposal network for sustainable utilisation of municipal solid waste. In order to optimise the network, we develop a multi-objective mixed integer linear programming model in which the economic, environmental and social dimensions of sustainability are concurrently balanced. The model is able to: select the best combination of waste treatment facilities; specify the type, location and capacity of waste treatment facilities; determine the allocation of waste to facilities; consider the transportation of waste and distribution of processed products; maximise the profit of the system; minimise the environmental footprint; maximise the social impacts of the system; and eventually generate an optimal and sustainable configuration for municipal solid waste management. The proposed methodology could be applied to any region around the world. Here, the city of Tehran, Iran, is presented as a real case study to show the applicability of the methodology.

Public-private mix in tuberculosis control: an assessment of level of implementation in Jos, Plateau State.

PubMed

Daboer, J C; Lar, L A; Afolaranmi, T O; Bupwatda, P W; Dani, N

2013-12-01

After the initial gains in Tuberculosis case detection and cure rates, progress became stunted by persisting constraints and challenges in the implementation of the Directly Observed Treatment Short course strategy. This prompted the Stop Tuberculosis partners in 2006 to adopt innovative approaches including the Public-Private Mix, to improve access to and quality of care. This paper assesses the level of Public-Private Mix in Tuberculosis control in Jos, Plateau State. This was a facility-based, cross sectional study where data from all consenting private health care facilities owned by medically trained personnel and private medical practitioners in Jos North and Jos South Local Government Areas was collected using structured questionnaires. Eight (47.1%) of all 17 facilities assessed gave anti Tuberculosis drugs on clinical suspicion of Tuberculosis, 5(29.4%) required Acid Fast Bacillus result and 3(17.6%) referred elsewhere for the Tuberculosis management. Only 6 facilities (35.3%) were microscopy, treatment centres, or both. Ten (58.8%) of the facilities had the Directly Observed Treatment Short course guidelines, but these could be sighted in only 5 (29.4%), while six (35.3%) had Tuberculosis record and referral forms. In 13 (76.5%) of the facilities, no local government Tuberculosis and Leprosy supervisors had ever visited them. Only 30 (57.7%) medical practitioners had access to the Directly Observed Treatment Short course. Thirty two (61.5%) respondents treated Tuberculosis according to the Directly Observed Treatment Short course strategy, but 19 (36.5%) still used the conventional method. Only 22(42.3%) practitioners had ever received any training on the Directly Observed Treatment Short course strategy. The level of Public-Private Mix in Tuberculosis control in Jos is low.

Environmental Management vitrification activities

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

Krumrine, P.H.

1996-05-01

Both the Mixed Waste and Landfill Stabilization Focus Areas as part of the Office of Technology Development efforts within the Department of Energy`s (DOE) Environmental Management (EM) Division have been developing various vitrification technologies as a treatment approach for the large quantities of transuranic (TRU), TRU mixed and Mixed Low Level Wastes that are stored in either landfills or above ground storage facilities. The technologies being developed include joule heated, plasma torch, plasma arc, induction, microwave, combustion, molten metal, and in situ methods. There are related efforts going into development glass, ceramic, and slag waste form windows of opportunity formore » the diverse quantities of heterogeneous wastes needing treatment. These studies look at both processing parameters, and long term performance parameters as a function of composition to assure that developed technologies have the right chemistry for success.« less

A change roadmap towards research paradigm in low-resource countries: retinoblastoma model in Egypt.

PubMed

Alfaar, Ahmad Samir; Nour, Radwa; Bakry, Mohamed Sabry; Kamal, Mohamed; Hassanain, Omneya; Labib, Rania M; Rashed, Wafaa M; Elzomor, Hossam; Alieldin, Adel; Taha, Hala; Zaghloul, Mohamed Saad; Ezzat, Sameera; AboElnaga, Sherif

2017-02-01

Research on childhood diseases represents a great global challenge. This challenge is maximized in both childhood cancer disciplines and developing world. In this paper, we aim at describing our institution experience in starting a structured childhood cancer research program in one of the developing countries in a short time based on philanthropic efforts. We used retinoblastoma as an example for what was conducted in this program. Starting in 2008, this program included improving clinical practice and its related supporting services besides developing new research services that both complement the clinical activities and pave the way towards creating a research foundation in the country. Results included developing hospital standard treatment protocols, developing national clinical trials, joining international consortia for childhood cancers clinical trials, developing data collection tools and real-time analytics, establishing a biobanking facility, and developing highly qualified team for conducting clinical, epidemiologic, and translational research studies. Moreover, this effort resulted in improving both clinical practice and patients' awareness nationally. This model can be used for other startup facilities that aim at finding answers for their national health problems in low-resource setting.

Local Barriers and Solutions to Improve Care-Seeking for Childhood Pneumonia, Diarrhoea and Malaria in Kenya, Nigeria and Niger: A Qualitative Study

PubMed Central

Bedford, K. Juliet A.; Sharkey, Alyssa B.

2014-01-01

We present qualitative research findings on care-seeking and treatment uptake for pneumonia, diarrhoea and malaria among children under 5 in Kenya, Nigeria and Niger. The study aimed to determine the barriers caregivers face in accessing treatment for these conditions; to identify local solutions that facilitate more timely access to treatment; and to present these findings as a platform from which to develop context-specific strategies to improve care-seeking for childhood illness. Kenya, Nigeria and Niger are three high burden countries with low rates of related treatment coverage, particularly in underserved areas. Data were collected in Homa Bay County in Nyanza Province, Kenya; in Kebbi and Cross River States, Nigeria; and in the Maradi and Tillabéri regions of Niger. Primary caregivers of children under 5 who did not regularly engage with health services or present their child at a health facility during illness episodes were purposively selected for interview. Data underwent rigorous thematic analysis. We organise the identified barriers and related solutions by theme: financial barriers; distance/location of health facilities; socio-cultural barriers and gender dynamics; knowledge and information barriers; and health facility deterrents. The relative importance of each differed by locality. Participant suggested solutions ranged from community-level actions to facility-level and more policy-oriented actions, plus actions to change underlying problems such as social perceptions and practices and gender dynamics. We discuss the feasibility and implications of these suggested solutions. Given the high burden of childhood morbidity and mortality due to pneumonia, diarrhoea and malaria in Kenya, Nigeria and Niger, this study provides important insights relating to demand-side barriers and locally proposed solutions. Significant advancements are possible when communities participate in both problem identification and resolution, and are engaged as important partners in improving child health and survival. PMID:24971642

Development of an integrated transuranic waste management system for a large research facility: NUCEF

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

Mineo, Hideaki; Matsumura, Tatsuro; Takeshita, Isao

1997-03-01

The Nuclear Fuel Cycle Safety Engineering Research Facility (NUCEF) is a large complex of research facilities where transuranic (TRU) elements are used. Liquid and solid waste containing TRU elements is generated mainly in the treatment of fuel for critical experiments and in the research of reprocessing and TRU waste management in hot cells and glove boxes. The rational management of TRU wastes is a very important issue not only for NUCEF but also for Japan. An integrated TRU waste management system is being developed with NUCEF as the test bed. The basic policy for establishing the system is to classifymore » wastes by TRU concentration, to reduce waste volume, and to maximize reuse of TRU elements. The principal approach of the development program is to apply the outcomes of the research carried out in NUCEF. Key technologies are TRU measurement for classification of solid wastes and TRU separation and volume reduction for organic and aqueous wastes. Some technologies required for treating the wastes specific to the research activities in NUCEF need further development. Specifically, the separation and stabilization technologies for americium recovery from concentrated aqueous waste, which is generated in dissolution of mixed oxide when preparing fuel for critical experiments, needs further research.« less

Why are there delays in seeking treatment for childhood diarrhoea in India?

PubMed

Malhotra, Nisha; Upadhyay, Ravi Prakash

2013-09-01

To examine the barriers and facilitating factors for seeking treatment for childhood diarrhoea and to determine the main causes for delay in seeking treatment. Data from Indian Demographic and Health survey 2005-06 (NFHS-III) were used. Mothers were asked whether their children (<5-years) had suffered from diarrhoea during the 2 weeks preceding the survey. Data were collected on the time of seeking treatment after start of the illness and days waited to seek treatment after the diarrhoea started. Multivariate logistic regression analysis was performed to find the determinants of seeking treatment at the health facility and the factors responsible for the 'delay' in seeking advice/treatment. Of a sample of 41 287 children, 3890 (9.4%) reportedly had diarrhoea. Sixty percentage of children with diarrhoea were taken to a health facility. Mother's education till higher secondary and above (OR 1.65; 95% CI, 1.08-2.54), richest (OR 1.76; 95% CI, 1.24-2.48) wealth index, and possession of a health card by the mother (OR 1.35; 95% CI, 1.12-1.62) increased the odds of seeking treatment. There was a strong gender bias; a male child had lower odds of experiencing a 'delay' in seeking treatment, compared with a female child (OR 0.71; 95% CI, 0.55-0.92). Access to a health facility still remains a major issue: treatment seeking was delayed when distance to a health facility was reported as a 'major problem' (OR 1.33; 95% CI, 1.01-1.76). Improved care seeking for childhood diarrhoea in India is still constrained by access to a health facility and requires expansion and strengthening of the public health system. The caregivers, especially the mothers need to be educated about the importance of seeking timely treatment and the benefits of oral rehydration solution. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

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

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.

Exploration of Antecedents of Environmentally Responsible Behavior by Stakeholders in Grand Lake Watershed

ERIC Educational Resources Information Center

Holmes, Teri S.

2013-01-01

Grand Lake O' the Cherokees in Oklahoma is one of two lakes in the State of Oklahoma that allows private ownership and development of the shoreline. This has created water quality issues attributed to phosphorus levels in effluent waste water from septic systems and municipal water treatment facilities, as well as nutrient and sediment…

40 CFR 63.1312 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

....111) Owner or operator (§ 63.2) Performance evaluation (§ 63.2) Performance test (§ 63.2) Permitting...) Research and development facility (§ 63.101) Routed to a process or route to a process (§ 63.161) Run (§ 63... vessel (§ 63.161) Temperature monitoring device (§ 63.111) Test method (§ 63.2) Treatment process (§ 63...

The Healthy School Handbook. Conquering the Sick Building Syndrome and Other Environmental Hazards In and Around Your School.

ERIC Educational Resources Information Center

Miller, Norma L., Ed.

This book compiles 22 articles concerning sick building syndrome in educational facilities in following three areas: determining whether a school is sick; assessing causes and initiating treatment; and developing interventions. Articles address such topics as managing the psycho-social aspects of sick building syndrome; how indoor air quality…

Dewatered sewage biosolids provide a productive larval habitat for stable flies and house flies (Diptera: Muscidae)

USDA-ARS?s Scientific Manuscript database

Species diversity and seasonal abundance of muscoid flies (Diptera: Muscidae) developing in biosolid cake (dewatered biosolids) stored at a wastewater treatment facility in northeastern Kansas was evaluated. Emergence traps were deployed 19 May-20 Oct 2009 (22 wk) and 27 May-18 Nov 2010 (25 wk). A t...

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

Dorr, Kent A.; Ostrom, Michael J.; Freeman-Pollard, Jhivaun R.

CH2M Hill Plateau Remediation Company (CHPRC) designed, constructed, commissioned, and began operation of the largest groundwater pump and treatment facility in the U.S. Department of Energy's (DOE) nationwide complex. This one-of-a-kind groundwater pump and treatment facility, located at the Hanford Nuclear Reservation Site (Hanford Site) in Washington State, was built in an accelerated manner with American Recovery and Reinvestment Act (ARRA) funds and has attained Leadership in Energy and Environmental Design (LEED) GOLD certification, which makes it the first non-administrative building in the DOE Office of Environmental Management complex to earn such an award. There were many contractual, technical, configurationmore » management, quality, safety, and LEED challenges associated with the design, procurement, construction, and commissioning of this $95 million, 52,000 ft groundwater pump and treatment facility. This paper will present the Project and LEED accomplishments, as well as Lessons Learned by CHPRC when additional ARRA funds were used to accelerate design, procurement, construction, and commissioning of the 200 West Groundwater Pump and Treatment (2W P&T) Facility to meet DOE's mission of treating contaminated groundwater at the Hanford Site with a new facility by June 28, 2012.« less

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

Einck, John P., E-mail: jeinck@ucsd.edu; Hudson, Alana; Shulman, Adam C.

West Africa has one of the highest incidence rates of carcinoma of the cervix in the world. The vast majority of women do not have access to screening or disease treatment, leading to presentation at advanced stages and to high mortality rates. Compounding this problem is the lack of radiation treatment facilities in Senegal and many other parts of the African continent. Senegal, a country of 13 million people, had a single {sup 60}Co teletherapy unit before our involvement and no brachytherapy capabilities. Radiating Hope, a nonprofit organization whose mission is to provide radiation therapy equipment to countries in themore » developing world, provided a high-dose-rate afterloading unit to the cancer center for curative cervical cancer treatment. Here we describe the implementation of high-dose-rate brachytherapy in Senegal requiring a nonstandard fractionation schedule and a novel treatment planning approach as a possible blueprint to providing this technology to other developing countries.« less

Assess and improve the sustainability of water treatment facility using Computational Fluid Dynamics

NASA Astrophysics Data System (ADS)

Zhang, Jie; Tejada-Martinez, Andres; Lei, Hongxia; Zhang, Qiong

2016-11-01

Fluids problems in water treatment industry are often simplified or omitted since the focus is usually on chemical process only. However hydraulics also plays an important role in determining effluent water quality. Recent studies have demonstrated that computational fluid dynamics (CFD) has the ability to simulate the physical and chemical processes in reactive flows in water treatment facilities, such as in chlorine and ozone disinfection tanks. This study presents the results from CFD simulations of reactive flow in an existing full-scale ozone disinfection tank and in potential designs. Through analysis of the simulation results, we found that baffling factor and CT10 are not optimal indicators of disinfection performance. We also found that the relationship between effluent CT (the product of disinfectant concentration and contact time) obtained from CT transport simulation and baffling factor depends on the location of ozone release. In addition, we analyzed the environmental and economic impacts of ozone disinfection tank designs and developed a composite indicator to quantify the sustainability of ozone disinfection tank in technological, environmental and economic dimensions.

Pharmacotherapy for alcohol dependence: perceived treatment barriers and action strategies among Veterans Health Administration service providers.

PubMed

Harris, Alex H S; Ellerbe, Laura; Reeder, Rachelle N; Bowe, Thomas; Gordon, Adam J; Hagedorn, Hildi; Oliva, Elizabeth; Lembke, Anna; Kivlahan, Daniel; Trafton, Jodie A

2013-11-01

Although access to and consideration of pharmacological treatments for alcohol dependence are consensus standards of care, receipt of these medications by patients is generally rare and highly variable across treatment settings. The goal of the present project was to survey and interview the clinicians, managers, and pharmacists affiliated with addiction treatment programs within Veterans Health Administration (VHA) facilities to learn about their perceptions of barriers and facilitators regarding greater and more reliable consideration of pharmacological treatments for alcohol dependence. Fifty-nine participants from 19 high-adopting and 11 low-adopting facilities completed the survey (facility-level response rate = 50%) and 23 participated in a structured interview. The top 4 barriers to increased consideration and use of pharmacotherapy for alcohol dependence were consistent across high- and low-adopting facilities and included perceived low patient demand, pharmacy procedures or formulary restrictions, lack of provider skills or knowledge regarding pharmacotherapy for alcohol dependence, and lack of confidence in treatment effectiveness. Low patient demand was rated as the most important barrier for oral naltrexone and disulfiram, whereas pharmacy or formulary restrictions were rated as the most important barrier for acamprosate and extended-release naltrexone. The 4 strategies rated across low- and high-adopting facilities as most likely to facilitate consideration and use of pharmacotherapy for alcohol dependence were more education to patients about existing medications, more education to health care providers about medications, increased involvement of physicians in treatment for alcohol dependence, and more compelling research on existing medications. This knowledge provides a foundation for designing, deploying, and evaluating targeted implementation efforts.

NPDES Draft Permit for Dakota Magic Casino Wastewater Treatment Facility in North Dakota

EPA Pesticide Factsheets

Under NPDES draft permit ND0030813, the Dakota Magic Hotel and Casino WWTF is authorized to discharge, in accordance with the requirements as contained in the provisions of this Permit, from its wastewater treatment facility to the Bois de Sioux.

42 CFR 441.251 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., including a mental hospital or other facility for the care and treatment of mental illness; or (b) confined, under a voluntary commitment, in a mental hospital or other facility for the care and treatment of mental illness. Mentally incompetent individual means an individual who has been declared mentally...

40 CFR 35.2030 - Facilities planning.

Code of Federal Regulations, 2010 CFR

2010-07-01

... STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works § 35.2030 Facilities planning. (a... ponds, trickling filters, oxidation ditches, or overland-flow land treatment; and for unsewered portions... a schedule the State accepts and such schedule is inserted as a special condition of the grant...

Energy Efficiency Strategies for Municipal Wastewater Treatment Facilities

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

Daw, J.; Hallett, K.; DeWolfe, J.

2012-01-01

Water and wastewater systems are significant energy consumers with an estimated 3%-4% of total U.S. electricity consumption used for the movement and treatment of water and wastewater. Water-energy issues are of growing importance in the context of water shortages, higher energy and material costs, and a changing climate. In this economic environment, it is in the best interest for utilities to find efficiencies, both in water and energy use. Performing energy audits at water and wastewater treatment facilities is one way community energy managers can identify opportunities to save money, energy, and water. In this paper the importance of energymore » use in wastewater facilities is illustrated by a case study of a process energy audit performed for Crested Butte, Colorado's wastewater treatment plant. The energy audit identified opportunities for significant energy savings by looking at power intensive unit processes such as influent pumping, aeration, ultraviolet disinfection, and solids handling. This case study presents best practices that can be readily adopted by facility managers in their pursuit of energy and financial savings in water and wastewater treatment. This paper is intended to improve community energy managers understanding of the role that the water and wastewater sector plays in a community's total energy consumption. The energy efficiency strategies described provide information on energy savings opportunities, which can be used as a basis for discussing energy management goals with water and wastewater treatment facility managers.« less

Which organizational characteristics are associated with increased management of depression using antidepressants in US nursing homes?

PubMed

Lapane, Kate L; Hughes, Carmel M

2004-10-01

There is universal agreement that organizational characteristics of nursing facilities can and do influence the quality of care and resident outcomes. This study evaluated the relation between organizational characteristics and management of depression using antidepressants. This was a cross-sectional study of Medicare/Medicaid certified nursing homes in 6 states in 2000. We studied 87,907 residents with depression in 2,128 facilities. Minimum Data Set (MDS) provided information regarding use of antidepressants and resident factors. On-line Survey and Certification of Automated Records (OSCAR) provided facility characteristics information including structural, resource, and staffing levels. Adjusted estimates of organizational effects on antidepressant drug use were derived from generalized estimating equations. Increased treatment of depression with antidepressants was associated with facilities with a higher percentage of residents from payer sources other than Medicare/Medicaid (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02-1.06) and more professional nursing staff (OR, 1.15; 95% CI, 1.05-1.26). Decreased treatment tended to be related to larger homes (OR, 0.76; 95% CI, 0.68-0.84) or if the home employed full-time physicians (OR, 0.87; 95% CI, 0.78-0.96). Once the decision to treat was made, treatment with tricyclics tended to be inversely related to larger homes, for-profit facilities, and homes with more Medicare residents. Facilities that are required to be more fiscally conservative, be it larger facilities with fewer private pay patients or for profit facilities, have lower rates of pharmacologic treatment. Resource and structural characteristics influence the type of antidepressant being prescribed; resident characteristics may not be the over-riding factor in prescribing.

Development of a membrane-based process for the treatment of oily waste waters. Final report, March 4, 1992--March 5, 1994

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

McCray, S.B.

1994-05-25

This is a final report from Bend Research, Inc., (BRI) to the U.S. Department of Energy (DOE) for work performed under Contract No. DE-AC22-92MT92005, titled {open_quotes}Development of a Membrane-Based Process for the Treatment of Oily Waste Waters.{close_quotes} This report covers the period from March 4, 1992, to March 5, 1994. The overall goal of this program was to develop an economical oily-water treatment system based on reverse osmosis (RO). The RO system would be used to (1) reduce oil production costs by reducing the volume of waste water that must be disposed of, (2) form the basis of a genericmore » waste-water treatment system that can easily be integrated into oil-field operations, especially at production facilities that are small or in remote locations; and (3) produce water clean enough to meet existing and anticipated environmental regulations. The specific focus of this program was the development of a hollow-fiber membrane module capable of treating oily waste waters.« less

Can Technological Improvements Reduce the Cost of Proton Radiation Therapy?

PubMed

Schippers, Jacobus Maarten; Lomax, Anthony; Garonna, Adriano; Parodi, Katia

2018-04-01

In recent years there has been increasing interest in the more extensive application of proton therapy in a clinical and preferably hospital-based environment. However, broader adoption of proton therapy has been hindered by the costs of treatment, which are still much higher than those in advanced photon therapy. This article presents an overview of on-going technical developments, which have a reduction of the capital investment or operational costs either as a major goal or as a potential outcome. Developments in instrumentation for proton therapy, such as gantries and accelerators, as well as facility layout and efficiency in treatment logistics will be discussed in this context. Some of these developments are indeed expected to reduce the costs. The examples will show, however, that a dramatic cost reduction of proton therapy is not expected in the near future. Although current developments will certainly contribute to a gradual decrease of the treatment costs in the coming years, many steps will still have to be made to achieve a much lower cost per treatment. Copyright © 2018. Published by Elsevier Inc.

The importance of public sector health facility-level data for monitoring changes in maternal mortality risks among communities: the case of pakistan.

PubMed

Jain, Anrudh K; Sathar, Zeba; Salim, Momina; Shah, Zakir Hussain

2013-09-01

This paper illustrates the importance of monitoring health facility-level information to monitor changes in maternal mortality risks. The annual facility-level maternal mortality ratios (MMRs), complications to live births ratios and case fatality ratios (CFRs) were computed from data recorded during 2007 and 2009 in 31 upgraded public sector health facilities across Pakistan. The facility-level MMR declined by about 18%; both the number of Caesarean sections and the episodes of complications as a percentage of live births increased; and CFR based on Caesarean sections and episodes of complications declined by 29% and 37%, respectively. The observed increases in the proportion of women with complications among those who come to these facilities point to a reduction in the delay in reaching facilities (first and second delays; Thaddeus & Maine, 1994); the decrease in CFRs points to improvements in treating obstetric complications and a reduction in the delay in receiving treatment once at facilities (the third delay). These findings point to a decline in maternal mortality risks among communities served by these facilities. A system of woman-level data collection instituted at health facilities with comprehensive emergency obstetric care is essential to monitor changes in the effects of any reduction in the three delays and any improvement in quality of care or the effectiveness of treating pregnancy-related complications among women reaching these facilities. Such a system of information gathering at these health facilities would also help policymakers and programme mangers to measure and improve the effectiveness of safe-motherhood initiatives and to monitor progress being made toward achieving the fifth Millennium Development Goal.

A facility-wide approach to recreation programming for adults who are severely and profoundly retarded.

PubMed

Burch, M R; Reiss, M; Bailey, J S

1985-01-01

A facility-wide recreation program was designed and implemented in order to increase staff and client participation in daily leisure activities at an intermediate care facility for severely and profoundly mentally retarded adults. The baseline phase of the study consisted of having recreational materials available during scheduled recreation periods. The treatment was a package program consisting of (1) providing the staff with preplanned materials and activities, (2) assigning staff to specific roles, and (3) monitoring staff and providing feedback by supervisors. The treatment was implemented on the two living units of the Liberty Intermediate Care Facility. Treatment effects were similar on both units. Client participation increased from a baseline average of less than 10% to nearly 50% and staff participation increased from less than 10% to an average of 60% during program implementation.

Development of the Technologies for Stabilization Treatment of the Water of the Recycling Cooling Systems at Thermal Power Plants

NASA Astrophysics Data System (ADS)

Vlasov, S. M.; Chichirova, N. D.; Chichirov, A. A.; Vlasova, A. Yu.; Filimonova, A. A.; Prosvirnina, D. V.

2018-02-01

A turbine-condensate cooling system is one of the less stable and most hard-to-control systems of maintaining optimal water chemistry. A laboratory recycling cooling water test facility, UVO-0.3, was developed for physical simulation of innovative zero-discharge water chemistry conditions and improvement of technological flowcharts of stabilization treatment of the initial and circulating water of the recycling cooling systems at thermal power plants. Experiments were conducted in the UVO-0.3 facility to investigate the processes that occur in the recycling water supply system and master new technologies of stabilization of the initial and circulating water. It is shown that, when using untreated initial water, scaling cannot be prevented even under low concentration levels. The main reason for the activation of scale depositing is the desorption of carbon dioxide that results in alkalization of the circulating water and, as a consequence, a displacement of the chemical reaction equilibrium towards the formation of slightly soluble hardness ions. Some techniques, viz., liming and alkalization of the initial water and the by-pass treatment of the circulating water, are considered. New engineering solutions have been developed for reducing the amount of scale-forming substances in the initial and circulating water. The best results were obtained by pretreating the initial water with alkalizing agents and simultaneously bypassing and treating part of the circulating water. The obtained experimental data underlie the process flowcharts of stabilization treatment of the initial and circulating TPP water that ensure scale-free and noncorrosive operation and meet the corresponding environmental requirements. Under the bypassing, the specific rates of the agents and the residual hardness are reduced compared with the conventional pretreatment.

Construction and Organization of a BSL-3 Cryo-Electron Microscopy Laboratory at UTMB

PubMed Central

Sherman, Michael B.; Trujillo, Juan; Leahy, Ian; Razmus, Dennis; DeHate, Robert; Lorcheim, Paul; Czarneski, Mark A.; Zimmerman, Domenica; Newton, Je T’Aime M.; Haddow, Andrew D.; Weaver, Scott C.

2013-01-01

A unique cryo-electron microscopy facility has been designed and constructed at the University of Texas Medical Branch (UTMB) to study the three-dimensional organization of viruses and bacteria classified as select agents at biological safety level (BSL)-3, and their interactions with host cells. A 200 keV high-end cryo-electron microscope was installed inside a BSL-3 containment laboratory and standard operating procedures were developed and implemented to ensure its safe and efficient operation. We also developed a new microscope decontamination protocol based on chlorine dioxide gas with a continuous flow system, which allowed us to expand the facility capabilities to study bacterial agents including spore-forming species. The new unified protocol does not require agent-specific treatment in contrast to the previously used heat decontamination. To optimize the use of the cryo-electron microscope and to improve safety conditions, it can be remotely controlled from a room outside of containment, or through a computer network world-wide. Automated data collection is provided by using JADAS (single particle imaging) and SerialEM (tomography). The facility has successfully operated for more than a year without an incident and was certified as a select agent facility by the Centers for Disease Control. PMID:23274136

Construction and organization of a BSL-3 cryo-electron microscopy laboratory at UTMB.

PubMed

Sherman, Michael B; Trujillo, Juan; Leahy, Ian; Razmus, Dennis; Dehate, Robert; Lorcheim, Paul; Czarneski, Mark A; Zimmerman, Domenica; Newton, Je T'aime M; Haddow, Andrew D; Weaver, Scott C

2013-03-01

A unique cryo-electron microscopy facility has been designed and constructed at the University of Texas Medical Branch (UTMB) to study the three-dimensional organization of viruses and bacteria classified as select agents at biological safety level (BSL)-3, and their interactions with host cells. A 200keV high-end cryo-electron microscope was installed inside a BSL-3 containment laboratory and standard operating procedures were developed and implemented to ensure its safe and efficient operation. We also developed a new microscope decontamination protocol based on chlorine dioxide gas with a continuous flow system, which allowed us to expand the facility capabilities to study bacterial agents including spore-forming species. The new unified protocol does not require agent-specific treatment in contrast to the previously used heat decontamination. To optimize the use of the cryo-electron microscope and to improve safety conditions, it can be remotely controlled from a room outside of containment, or through a computer network world-wide. Automated data collection is provided by using JADAS (single particle imaging) and SerialEM (tomography). The facility has successfully operated for more than a year without an incident and was certified as a select agent facility by the Centers for Disease Control. Copyright © 2012 Elsevier Inc. All rights reserved.

Feasibility study for a biomedical experimental facility based on LEIR at CERN.

PubMed

Abler, Daniel; Garonna, Adriano; Carli, Christian; Dosanjh, Manjit; Peach, Ken

2013-07-01

In light of the recent European developments in ion beam therapy, there is a strong interest from the biomedical research community to have more access to clinically relevant beams. Beamtime for pre-clinical studies is currently very limited and a new dedicated facility would allow extensive research into the radiobiological mechanisms of ion beam radiation and the development of more refined techniques of dosimetry and imaging. This basic research would support the current clinical efforts of the new treatment centres in Europe (for example HIT, CNAO and MedAustron). This paper presents first investigations on the feasibility of an experimental biomedical facility based on the CERN Low Energy Ion Ring LEIR accelerator. Such a new facility could provide beams of light ions (from protons to neon ions) in a collaborative and cost-effective way, since it would rely partly on CERN's competences and infrastructure. The main technical challenges linked to the implementation of a slow extraction scheme for LEIR and to the design of the experimental beamlines are described and first solutions presented. These include introducing new extraction septa into one of the straight sections of the synchrotron, changing the power supply configuration of the magnets, and designing a new horizontal beamline suitable for clinical beam energies, and a low-energy vertical beamline for particular radiobiological experiments.

Feasibility study for a biomedical experimental facility based on LEIR at CERN

PubMed Central

Abler, Daniel; Garonna, Adriano; Carli, Christian; Dosanjh, Manjit; Peach, Ken

2013-01-01

In light of the recent European developments in ion beam therapy, there is a strong interest from the biomedical research community to have more access to clinically relevant beams. Beamtime for pre-clinical studies is currently very limited and a new dedicated facility would allow extensive research into the radiobiological mechanisms of ion beam radiation and the development of more refined techniques of dosimetry and imaging. This basic research would support the current clinical efforts of the new treatment centres in Europe (for example HIT, CNAO and MedAustron). This paper presents first investigations on the feasibility of an experimental biomedical facility based on the CERN Low Energy Ion Ring LEIR accelerator. Such a new facility could provide beams of light ions (from protons to neon ions) in a collaborative and cost-effective way, since it would rely partly on CERN's competences and infrastructure. The main technical challenges linked to the implementation of a slow extraction scheme for LEIR and to the design of the experimental beamlines are described and first solutions presented. These include introducing new extraction septa into one of the straight sections of the synchrotron, changing the power supply configuration of the magnets, and designing a new horizontal beamline suitable for clinical beam energies, and a low-energy vertical beamline for particular radiobiological experiments. PMID:23824122

Brown Grease to Biodiesel Demonstration Project Report

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

San Francisco Public Utilities Commission; URS Corporation; Biofuels, Blackgold

Municipal wastewater treatment facilities have typically been limited to the role of accepting wastewater, treating it to required levels, and disposing of its treatment residuals. However, a new view is emerging which includes wastewater treatment facilities as regional resource recovery centers. This view is a direct result of increasingly stringent regulations, concerns over energy use, carbon footprint, and worldwide depletion of fossil fuel resources. Resources in wastewater include chemical and thermal energy, as well as nutrients, and water. A waste stream such as residual grease, which concentrates in the drainage from restaurants (referred to as Trap Waste), is a goodmore » example of a resource with an energy content that can be recovered for beneficial reuse. If left in wastewater, grease accumulates inside of the wastewater collection system and can lead to increased corrosion and pipe blockages that can cause wastewater overflows. Also, grease in wastewater that arrives at the treatment facility can impair the operation of preliminary treatment equipment and is only partly removed in the primary treatment process. In addition, residual grease increases the demand in treatment materials such as oxygen in the secondary treatment process. When disposed of in landfills, grease is likely to undergo anaerobic decay prior to landfill capping, resulting in the atmospheric release of methane, a greenhouse gas (GHG). This research project was therefore conceptualized and implemented by the San Francisco Public Utilities Commission (SFPUC) to test the feasibility of energy recovery from Trap Waste in the form of Biodiesel or Methane gas. The research goals are given below: To validate technology performance; To determine the costs and benefits [including economic, socioeconomic, and GHG emissions reduction] associated with co-locating this type of operation at a municipal wastewater treatment plant (WWTP); To develop a business case or model for replication of the program by other municipal agencies (as applicable). In order to accomplish the goals of the project, the following steps were performed: 1. Operation of a demonstration facility designed to receive 10,000 to 12,000 gallons of raw Trap Waste each day from private Trap Waste hauling companies. The demonstration facility was designed and built by Pacific Biodiesel Technologies (PBTech). The demonstration facility would also recover 300 gallons of Brown Grease per day from the raw Trap Waste. The recovered Brown Grease was expected to contain no more than 2% Moisture, Insolubles, and Unsaponifiables (MIU) combined. 2. Co-digestion of the side streams (generated during the recovery of 300 gallons of Brown Grease from the raw Trap Waste) with wastewater sludge in the WWTP's anaerobic digesters. The effects of the side streams on anaerobic digestion were quantified by comparison with baseline data. 3. Production of 240 gallons per day of ASTM D6751-S15 grade Biodiesel fuel via a Biodiesel conversion demonstration facility, with the use of recovered Brown Grease as a feedstock. The demonstration facility was designed and built by Blackgold Biofuels (BGB). Side streams from this process were also co-digested with wastewater sludge. Bench-scale anaerobic digestion testing was conducted on side streams from both demonstration facilities to determine potential toxicity and/or changes in biogas production in the WWTP anaerobic digester. While there is a lot of theoretical data available on the lab-scale production of Biodiesel from grease Trap Waste, this full-scale demonstration project was one of the first of its kind in the United States. The project's environmental impacts were expected to include: Reduction of greenhouse gas emissions by prevention of the release of methane at landfills. Although the combustion product of Biodiesel and Methane gas produced in the Anaerobic digester, Carbon Dioxide, is also a greenhouse gas; it is 20 times weaker for the same amount (per mole) released, making its discharge preferable to that of Methane. The use of Biodiesel in place of fossil-fuel derived Diesel was expected to reduce net Carbon Dioxide, Ash Particulate, Sulfate, Silicate, and Soot emissions, thereby improving air quality.« less

Report: American Recovery and Reinvestment Act Site Visit of the Wastewater Treatment Facility Improvements Project, Perkins, Oklahoma

EPA Pesticide Factsheets

Report #11-R-0214, May 2, 2011. We conducted an unannounced visit of the construction site of the Perkins Public Works Authority’s wastewater treatment facility improvements project in Perkins, Oklahoma, on April 19–22, 2010.

40 CFR 60.150 - Applicability and designation of affected facility.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Sewage Treatment Plants § 60.150 Applicability and designation of affected facility. (a) The... (dry basis) produced by municipal sewage treatment plants, or each incinerator that charges more than...

42 CFR 2.13 - Confidentiality restrictions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.13 Confidentiality restrictions... place where only alcohol or drug abuse diagnosis, treatment, or referral is provided may be acknowledged... facility if the facility is not publicy identified as only an alcohol or drug abuse diagnosis, treatment or...

42 CFR 2.13 - Confidentiality restrictions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.13 Confidentiality restrictions... place where only alcohol or drug abuse diagnosis, treatment, or referral is provided may be acknowledged... facility if the facility is not publicy identified as only an alcohol or drug abuse diagnosis, treatment or...

42 CFR 2.13 - Confidentiality restrictions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.13 Confidentiality restrictions... place where only alcohol or drug abuse diagnosis, treatment, or referral is provided may be acknowledged... facility if the facility is not publicy identified as only an alcohol or drug abuse diagnosis, treatment or...

42 CFR 2.13 - Confidentiality restrictions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.13 Confidentiality restrictions... place where only alcohol or drug abuse diagnosis, treatment, or referral is provided may be acknowledged... facility if the facility is not publicy identified as only an alcohol or drug abuse diagnosis, treatment or...

42 CFR 2.13 - Confidentiality restrictions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.13 Confidentiality restrictions... place where only alcohol or drug abuse diagnosis, treatment, or referral is provided may be acknowledged... facility if the facility is not publicy identified as only an alcohol or drug abuse diagnosis, treatment or...

Association between Gastrointestinal Illness and Precipitation in Areas Impacted by Combined Sewer Systems: Utilizing a Distributed Lag Model

EPA Science Inventory

Combined sewer systems 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 combined sewer over...

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

PubMed Central

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

2017-01-01

Background Utilization of antenatal care (ANC) services has increased over the past two decades. Continued gains in maternal and newborn health will require an understanding of both access and quality of ANC services. We linked health facility and household survey data to examine the quality of service provision for five ANC interventions across health facilities in sub–Saharan Africa. Methods Using data from 20 nationally representative health facility assessments – the Service Provision Assessment (SPA) and the Service Availability and Readiness Assessment (SARA), we estimated facility level readiness to deliver five ANC interventions: tetanus toxoid vaccine for pregnant women, intermittent preventive treatment for malaria in pregnancy (IPTp), syphilis detection and treatment in pregnancy, iron supplementation and hypertensive disease case management. Facility level indicators were stratified by health facility type, managing authority and location, then linked to estimates of ANC utilization in that stratum from the corresponding Demographic and Health Surveys (DHS) to generate population level estimates of the ‘likelihood of appropriate care’. Finally, the association between estimates of the ‘likelihood of appropriate care’ from the linking approach and estimates of coverage levels from the DHS were assessed. Findings A total of 10 534 health facilities were surveyed in the 20 health facility assessments, of which 8742 reported offering ANC services and were included in the analysis. Health facility readiness to deliver IPTp, iron supplementation, and tetanus toxoid vaccination was higher (median: 84.1%, 84.9% and 82.8% respectively) than readiness to deliver hypertensive disease case management and syphilis detection and treatment (median: 23.0% and 19.9% respectively). Coverage of at least 4 ANC visits ranged from 24.8% to 75.8%. Estimates of the likelihood of appropriate care derived from linking health facility and household survey data showed marked gaps for all interventions, particularly hypertensive disease case management and syphilis detection and treatment. There was fairly good concordance between our estimates of high likelihood of appropriate care and DHS estimates of coverage for iron supplementation, IPTp, and tetanus toxoid vaccination. Conclusion Linking household surveys to health facility assessments revealed marked gaps in population–level coverage of quality ANC interventions and underscored the need for a double–pronged approach to increase ANC utilization and improve the quality of ANC services. PMID:29163936

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

PubMed

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

2017-12-01

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

The consistency between treatments provided to nursing facility residents and orders on the physician orders for life-sustaining treatment form.

PubMed

Hickman, Susan E; Nelson, Christine A; Moss, Alvin H; Tolle, Susan W; Perrin, Nancy A; Hammes, Bernard J

2011-11-01

To evaluate the consistency between treatments provided and Physician Orders for Life-Sustaining Treatment (POLST) orders. Retrospective chart abstraction. Stratified, random sample of 90 nursing facilities in Oregon, Wisconsin, and West Virginia. Eight hundred seventy living and deceased nursing facility residents aged 65 and older with a minimum 60-day stay. Chart data about POLST form orders and related treatments over a 60-day period were abstracted. Decision rules were created to determine whether the rationale for each treatment was consistent with POLST orders. Most residents (85.2%) had the same POLST form in place during the review period. A majority of treatments provided to residents with orders for comfort measures only (74.3%) and limited antibiotics (83.3%) were consistent with POLST orders because they were primarily comfort focused rather than life-prolonging, but antibiotics were provided to 32.1% of residents with orders for no antibiotics. Overall consistency rates between treatments and POLST orders were high for resuscitation (98%), medical interventions (91.1%), and antibiotics (92.9%) and modest for feeding tubes (63.6%). In all, POLST orders were consistent with treatments provided 94.0% of the time. With the exception of feeding tubes and antibiotic use in residents with orders for no antibiotics, the use of medical treatments was nearly always consistent with POLST orders to provide or withhold life-sustaining interventions. The POLST program is a useful tool for ensuring that the treatment preferences of nursing facility residents are honored. © 2011, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.

Construction and Operation Costs of Wastewater Treatment and Implications for the Paper Industry in China.

PubMed

Niu, Kunyu; Wu, Jian; Yu, Fang; Guo, Jingli

2016-11-15

This paper aims to develop a construction and operation cost model of wastewater treatment for the paper industry in China and explores the main factors that determine these costs. Previous models mainly involved factors relating to the treatment scale and efficiency of treatment facilities for deriving the cost function. We considered the factors more comprehensively by adding a regional variable to represent the economic development level, a corporate ownership factor to represent the plant characteristics, a subsector variable to capture pollutant characteristics, and a detailed-classification technology variable. We applied a unique data set from a national pollution source census for the model simulation. The major findings include the following: (1) Wastewater treatment costs in the paper industry are determined by scale, technology, degree of treatment, ownership, and regional factors; (2) Wastewater treatment costs show a large decreasing scale effect; (3) The current level of pollutant discharge fees is far lower than the marginal treatment costs for meeting the wastewater discharge standard. Key implications are as follows: (1) Cost characteristics and impact factors should be fully recognized when planning or making policies relating to wastewater treatment projects or technology development; (2) There is potential to reduce treatment costs by centralizing wastewater treatment via industrial parks; (3) Wastewater discharge fee rates should be increased; (4) Energy efficient technology should become the future focus of wastewater treatment.

An analysis of the market potential of water hyacinth-based systems for municipal wastewater treatment

NASA Technical Reports Server (NTRS)

Robinson, A. C.; Gorman, H. J.; Hillman, M.; Lawhon, W. T.; Maase, D. L.; Mcclure, T. A.

1976-01-01

The potential U.S. market for tertiary municipal wastewater treatment facilities which make use of water hyacinths was investigated. A baseline design was developed which approximates the "typical" or "average" situation under which hyacinth-based systems can be used. The total market size for tertiary treatment was then estimated for those geographical regions in which hyacinths appear to be applicable. Market penetration of the baseline hyacinth system when competing with conventional chemical and physical processing systems was approximated, based primarily on cost differences. A limited analysis was made of the sensitivity of market penetration to individual changes in these assumptions.

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

Dorr, Kent A.; Ostrom, Michael J.; Freeman-Pollard, Jhivaun R.

CH2M Hill Plateau Remediation Company (CHPRC) designed, constructed, commissioned, and began operation of the largest groundwater pump and treatment facility in the U.S. Department of Energy’s (DOE) nationwide complex. This one-of-a-kind groundwater pump and treatment facility, located at the Hanford Nuclear Reservation Site (Hanford Site) in Washington State, was built to an accelerated schedule with American Recovery and Reinvestment Act (ARRA) funds. There were many contractual, technical, configuration management, quality, safety, and Leadership in Energy and Environmental Design (LEED) challenges associated with the design, procurement, construction, and commissioning of this $95 million, 52,000 ft groundwater pump and treatment facility tomore » meet DOE’s mission objective of treating contaminated groundwater at the Hanford Site with a new facility by June 28, 2012. The project team’s successful integration of the project’s core values and green energy technology throughout design, procurement, construction, and start-up of this complex, first-of-its-kind Bio Process facility resulted in successful achievement of DOE’s mission objective, as well as attainment of LEED GOLD certification, which makes this Bio Process facility the first non-administrative building in the DOE Office of Environmental Management complex to earn such an award.« less

Decision making tools for selecting sustainable wastewater treatment technologies in Thailand

NASA Astrophysics Data System (ADS)

Wongburi, Praewa; Park, Jae K.

2018-05-01

Wastewater consists of valuable resources that could be recovered or reused. Still it is under threat because of ineffective wastewater management and systems. In Thailand, less than 25% of wastewater generated may be treated while then rest is inadequately treated and sent back directly into waterbodies or the environment. Furthermore, the technologies that have been applied may be inefficient and unsustainable. Efficiency, sustainability, and simplicity are important concepts when designing an appropriate wastewater treatment system in developing countries. The objectives of this study were to review and evaluate wastewater treatment technologies and propose a method to improve or select an appropriate technology. An expert system in Excel® program was developed to determine the best solution. Sensitivity analysis was applied to compare and assess uncertainty factors. Due to the different conditions of each area, the key factor of interest was varied. Furthermore, Robust Decision Making tool was applied to determine the best way to improve existing wastewater treatment facility and to choose the most appropriate wastewater treatment technology.

The safety improvement of Romanian radioactive waste facilities as an example for human and environmental protection

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

Barariu, Gheorghe

2013-07-01

According to IAEA classification, Romania with two nuclear research centres, with 2 Nuclear Power Units in operation at Cernavoda Town and with 2 new Units envisaged to be in operation soon, can be considered as a country with an average nuclear activity. In Romania there was an extensive interest in management of radioactive wastes generated by the use of nuclear technology in industry and research. Using the most advanced technologies in the mentioned time periods, Romania successfully accomplished to solve all management issues related to radioactive wastes being addressed all safety concerns. Every step of nuclear activity development was accompaniedmore » by the suitable waste management facilities. So that, in order to improve the existing treatment and disposal capacities for institutional waste, the existing Radioactive Waste Treatment Facility (STDR) and the National Repository Radioactive Wastes (DNDR) at Baita, Bihor, will be improved to actual requirements on the occasion of VVR-S Research Reactor decommissioning. This activity is in development into the frame of a National funded project related to disposal galleries filling improvement and repository closure for DNDR Baita, Bihor. All improvements will be approved by Environmental Protection Authority and Regulatory Body, being a guaranty of human and environmental protection. Also, in accordance with national specific and international policies and taking into account decommissioning activities related to the present operating NPPs, all necessary measures were considered in order to avoid unnecessary generation of radioactive wastes, to minimize, as much as possible, waste production and accumulation and the necessity to develop optimum solutions for a new repository with the assurance of improved nuclear safety. (authors)« less

40 CFR 35.917-9 - Revision or amendment of facilities plan.

Code of Federal Regulations, 2012 CFR

2012-07-01

... OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.917-9 Revision or amendment of facilities plan. A facilities plan may provide the basis...

40 CFR 35.917-9 - Revision or amendment of facilities plan.

Code of Federal Regulations, 2013 CFR

2013-07-01

... OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.917-9 Revision or amendment of facilities plan. A facilities plan may provide the basis...

40 CFR 35.917-9 - Revision or amendment of facilities plan.

Code of Federal Regulations, 2014 CFR

2014-07-01

... OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.917-9 Revision or amendment of facilities plan. A facilities plan may provide the basis...

40 CFR 35.917-9 - Revision or amendment of facilities plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

... OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.917-9 Revision or amendment of facilities plan. A facilities plan may provide the basis...

RETROFITTING CONTROL FACILITIES FOR WET-WEATHER FLOW CONTROL

EPA Science Inventory

Available technologies were evaluated to demonstrate the feasibility and cost effectiveness of retrofitting existing facilities to handle wet-weather flow (WWF). Cost/benefit relationships were compared to construction of new conventional control and treatment facilities. Desktop...

NPDES Permit for Dakota Magic Casino and Hotel Wastewater Treatment Facility in North Dakota

EPA Pesticide Factsheets

Under NPDES permit ND0030813, the the Dakota Magic Casino and Hotel is authorized is authorized to discharge from its wastewater treatment facility in Richland County, North Dakota, to a roadside ditch flowing to an unnamed tributary to the Bois de Sioux.

9 CFR 166.5 - Licensed garbage-treatment facility standards.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Licensed garbage-treatment facility standards. 166.5 Section 166.5 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE... where insects and rodents may breed is prohibited. (b) Equipment used for handling untreated garbage...

42 CFR 412.23 - Excluded hospitals: Classifications.

Code of Federal Regulations, 2014 CFR

2014-10-01

... primarily for treatment of and research on cancer (that is, the facility is not a subunit of an acute... diagnosis and treatment of mentally ill persons; and (3) Meet the conditions of participation for hospitals... or the long-term care hospital satellite facility as of October 1, 2011. (f) Cancer hospitals—(1...

Notification: EPA Region 10 Management Controls Over Allowing Substantial Public Funds to Construct the Spokane County Wastewater Treatment Facility

EPA Pesticide Factsheets

January 20, 2012. This EPA's OIG is initiating a review from an OIG hotline complaint regarding whether federal funds were properly used to construct the new Spokane County wastewater treatment facility in accordance with 40 CFR 35, Subpart K.

75 FR 79345 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-20

... accounting system for health care billing practices. It shall assist military treatment facilities in the... accounting system for health care billing practices. It shall assist military treatment facilities in the...; System of Records AGENCY: Office of the Secretary of Defense, DoD. ACTION: Notice to Alter a System of...

40 CFR 141.714 - Requirements for uncovered finished water storage facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 23 2014-07-01 2014-07-01 false Requirements for uncovered finished water storage facilities. 141.714 Section 141.714 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Enhanced Treatment for Cryptosporidium Treatment Technique...

Treatment Study Plan for Nitrate Salt Waste Remediation Revision 1.0

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

Juarez, Catherine L.; Funk, David John; Vigil-Holterman, Luciana R.

2016-03-07

The two stabilization treatment methods that are to be examined for their effectiveness in the treatment of both the unremediated and remediated nitrate salt wastes include (1) the addition of zeolite and (2) cementation. Zeolite addition is proposed based on the results of several studies and analyses that specifically examined the effectiveness of this process for deactivating nitrate salts. Cementation is also being assessed because of its prevalence as an immobilization method used for similar wastes at numerous facilities around the DOE complex, including at Los Alamos. The results of this Treatment Study Plan will be used to provide themore » basis for a Resource Conservation and Recovery Act (RCRA) permit modification request of the LANL Hazardous Waste Facility Permit for approval by the New Mexico Environment Department-Hazardous Waste Bureau (NMED-HWB) of the proposed treatment process and the associated facilities.« less

Treatment of taste and odor causing compounds 2-methyl isoborneol and geosmin in drinking water: a critical review.

PubMed

Srinivasan, Rangesh; Sorial, George A

2011-01-01

Problems due to the taste and odor in drinking water are common in treatment facilities around the world. Taste and odor are perceived by the public as the primary indicators of the safely and acceptability of drinking water and are mainly caused by the presence of two semi-volatile compounds--2-methyl isoborneol (MIB) and geosmin. A review of these two taste and odor causing compounds in drinking water is presented. The sources for the formation of these compounds in water are discussed along with the health and regulatory implications. The recent developments in the analysis of MIB/geosmin in water which have allowed for rapid measurements in the nanogram per liter concentrations are also discussed. This review focuses on the relevant treatment alternatives, that are described in detail with emphasis on their respective advantages and problems associated with their implementation in a full-scale facility. Conventional treatment processes in water treatment plants, such as coagulation, sedimentation and chlorination have been found to be ineffective for removal of MIB/geosmin. Studies have shown powdered activated carbon, ozonation and biofiltration to be effective in treatment of these two compounds. Although some of these technologies are more effective and show more promise than the others, much work remains to be done to optimize these technologies so that they can be retrofitted or installed with minimal impact on the overall operation and effectiveness of the treatment system.

A New Image for the Water Hyacinth

NASA Technical Reports Server (NTRS)

1980-01-01

Walt Disney Company activated a sewage treatment plan using NASA technology to create water hyacinths to clean wastewater by absorbing and metabolizing pollutants. Plants have exciting promise as a natural water purification system which can be established at a fraction of the cost of a conventional sewage treatment facility. Harvested plants can be used as fertilizer. They can also be heat-treated to produce consumer energy in the form of methane gas. If an economical method of drying plants can be developed they may find further utility as high protein animal feed.

40 CFR 112.12 - Spill Prevention, Control, and Countermeasure Plan requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... drainage system or facility effluent treatment system, except where facility systems are designed to...), (iii), and (iv) of this section. (3) Design facility drainage systems from undiked areas with a... engineer facility drainage systems to prevent a discharge as described in § 112.1(b) in case there is an...

Alcohol and drug abusers' reasons for seeking treatment.

PubMed

Cunningham, J A; Sobell, L C; Sobell, M B; Gaskin, J

1994-01-01

Clients at two different treatment facilities were asked at assessment how influential each of 10 possible reasons were in their decision to change their alcohol or drug use. Clients at both facilities most often endorsed "weighing the pros and cons of drinking or drug use" and a "warning from spouse." Client's reasons for seeking treatment were also examined in relation to treatment compliance. Three reasons--"weighing the pros and cons," "hitting rock bottom," and experiencing a "major lifestyle change"--were predictive of treatment compliance. Clients who rated any of these reasons as influential were more likely to enter and complete treatment. Although more research is needed, knowledge of clients' reasons for seeking treatment might be useful in treatment matching.

A Rasch Model Analysis of Evidence-Based Treatment Practices Used in the Criminal Justice System

PubMed Central

Henderson, Craig E.; Taxman, Faye S.; Young, Douglas W.

2008-01-01

This study used item response theory (IRT) to examine the extent to which criminal justice facilities and community-based agencies are using evidence-based substance abuse treatment practices (EBPs), which EBPs are most commonly used, and how EBPs cluster together. The study used data collected from wardens, justice administrators, and treatment directors as part of the National Criminal Justice Treatment Practices survey (NCJTP; Taxman et al., 2007a), and includes both adult criminal and juvenile justice samples. Results of Rasch modeling demonstrated that a reliable measure can be formed to gauge the extent to which juvenile and adult correctional facilities, and community treatment agencies serving offenders, have adopted various treatment practices supported by research. We also demonstrated the concurrent validity of the measure by showing that features of the facilities’ organizational contexts were associated with the extent to which facilities were using EBPs, and which EBPs they were using. Researchers, clinicians, and program administrators may find these results interesting not only because they show the program factors most strongly related to EBP use, but the results also suggest that certain treatment practices are generally clustered together, which may help stakeholders plan and prioritize the adoption of new EBPs in their facilities. The study has implications for future research focused on understanding the adoption and implementation of EBPs in correctional environments. PMID:18029116

Experiential acceptance, motivation for recovery, and treatment outcome in eating disorders

PubMed Central

Espel, Hallie M.; Goldstein, Stephanie P.; Manasse, Stephanie M.; Juarascio, Adrienne S.

2016-01-01

Purpose This study sought to test whether the relationship between experiential acceptance (EA) and treatment outcome among eating disorder (ED) patients was mediated by motivation. Methods Upon admission to a residential ED treatment facility, female patients completed measures of EA, motivation, and baseline ED symptom severity (covariate); symptom severity was reassessed at discharge. Results Higher levels of baseline EA predicted significantly greater symptom reduction during treatment. Moreover, results from bootstrapped mediation analyses indicated that the relationship between EA and treatment outcome was partially mediated by motivation: increased EA was associated with greater motivation to give up ED behaviors at the beginning of treatment, and this led to greater symptom reduction from admission to discharge. Conclusions Motivation appears to be one mechanism by which EA facilitates improved treatment outcomes in EDs. Further development of interventions that promote EA as a means for improving motivation and subsequent ED treatment response may be warranted. PMID:26511501

Experiential acceptance, motivation for recovery, and treatment outcome in eating disorders.

PubMed

Espel, Hallie M; Goldstein, Stephanie P; Manasse, Stephanie M; Juarascio, Adrienne S

2016-06-01

This study sought to test whether the relationship between experiential acceptance (EA) and treatment outcome among eating disorder (ED) patients was mediated by motivation. Upon admission to a residential ED treatment facility, female patients completed measures of EA, motivation, and baseline ED symptom severity (covariate); symptom severity was reassessed at discharge. Higher levels of baseline EA predicted significantly greater symptom reduction during treatment. Moreover, results from bootstrapped mediation analyses indicated that the relationship between EA and treatment outcome was partially mediated by motivation: increased EA was associated with greater motivation to give up ED behaviors at the beginning of treatment, and this led to greater symptom reduction from admission to discharge. Motivation appears to be one mechanism by which EA facilitates improved treatment outcomes in EDs. Further development of interventions that promote EA as a means for improving motivation and subsequent ED treatment response may be warranted.

2013 Annual Wastewater Reuse Report for the Idaho National Laboratory Site’s Central Facilities Area Sewage Treatment Plant

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

Mike Lewis

2014-02-01

This report describes conditions, as required by the state of Idaho Wastewater Reuse Permit (#LA-000141-03), for the wastewater land application site at the Idaho National Laboratory Site’s Central Facilities Area Sewage Treatment Plant from November 1, 2012, through October 31, 2013. The report contains, as applicable, the following information: • Site description • Facility and system description • Permit required monitoring data and loading rates • Status of compliance conditions and activities • Discussion of the facility’s environmental impacts. During the 2013 permit year, no wastewater was land-applied to the irrigation area of the Central Facilities Area Sewage Treatment Plantmore » and therefore, no effluent flow volumes or samples were collected from wastewater sampling point WW-014102. However, soil samples were collected in October from soil monitoring unit SU-014101.« less

Veterans Affairs facility performance on Washington Circle indicators and casemix-adjusted effectiveness.

PubMed

Harris, Alex H S; Humphreys, Keith; Finney, John W

2007-12-01

Self-administered Addiction Severity Index (ASI) data were collected on 5,723 patients who received substance abuse treatment in 1 of 110 programs located at 73 Veterans Affairs facilities. The associations between each of three Washington Circle (WC) performance indicator scores (identification, initiation, and engagement) and their casemix-adjusted facility-level improvement in ASI drug and alcohol composites 7 months after intake were estimated. Higher initiation rates were not associated with facility-level improvement in ASI alcohol composite scores but were modestly associated with greater improvements in ASI drug composite scores. Identification and engagement rates were unrelated to 7-month outcomes. WC indicators focused on the early stages of treatment may tap necessary but insufficient processes for patients with substance use disorder to achieve good posttreatment outcomes. Ideally, the WC indicators would be supplemented with other measures of treatment quality.

A review of the use of tanning beds as a dermatological treatment.

PubMed

Radack, Kyle P; Farhangian, Michael E; Anderson, Kathryn L; Feldman, Steven R

2015-03-01

In-office phototherapy is an effective treatment for many dermatologic conditions, however, many patients are unable to adhere to the rigorous travel and time commitments sometimes needed. Tanning bed facilities are nearly ubiquitous in modern society and could represent a more convenient means to obtain ultraviolet (UV) exposure when office phototherapy is not feasible. The purpose of this study was to review available evidence on the use of tanning facilities as a treatment for dermatologic conditions. PubMed was searched on February 2015 for "tanning beds" and "phototherapy", and with some dermatologic conditions sensitive to UV light, including "psoriasis", "mycosis fungoides", "acne", "atopic dermatitis" and "eczema". From there, further articles were found using the reference sections of the initial papers. A similar methodology was used with the Google Scholar search engine. Only articles in English and prospective studies were included in this review. We found studies validating the use of tanning facilities for psoriasis treatment. Use as a treatment option for atopic dermatitis, mycosis fungoides, acne, scleroderma, vitiligo, and pruritus, as well as other UV sensitive dermatoses, may also be beneficial. This study is limited by the lack of double-blind, placebo-controlled trials, long-term follow-up studies, and meta-analyses for tanning facility use in dermatologic phototherapy, and by the lack of standardization of both tanning facilities and exposure dosing. Unsupervised sun exposure is a standard recommendation for some patients to obtain phototherapy. Selected use of commercial tanning beds in the treatment of dermatologic conditions may be another useful and effective treatment for those patients with an inability to access office-based or home-based phototherapy.

Biotechnology Facility: An ISS Microgravity Research Facility

NASA Technical Reports Server (NTRS)

Gonda, Steve R.; Tsao, Yow-Min

2000-01-01

The International Space Station (ISS) will support several facilities dedicated to scientific research. One such facility, the Biotechnology Facility (BTF), is sponsored by the Microgravity Sciences and Applications Division (MSAD) and developed at NASA's Johnson Space Center. The BTF is scheduled for delivery to the ISS via Space Shuttle in April 2005. The purpose of the BTF is to provide: (1) the support structure and integration capabilities for the individual modules in which biotechnology experiments will be performed, (2) the capability for human-tended, repetitive, long-duration biotechnology experiments, and (3) opportunities to perform repetitive experiments in a short period by allowing continuous access to microgravity. The MSAD has identified cell culture and tissue engineering, protein crystal growth, and fundamentals of biotechnology as areas that contain promising opportunities for significant advancements through low-gravity experiments. The focus of this coordinated ground- and space-based research program is the use of the low-gravity environment of space to conduct fundamental investigations leading to major advances in the understanding of basic and applied biotechnology. Results from planned investigations can be used in applications ranging from rational drug design and testing, cancer diagnosis and treatments and tissue engineering leading to replacement tissues.

Overview summary of clinical heavier-ion progress in Japan

NASA Astrophysics Data System (ADS)

Matsufuji, N.

2017-06-01

Swift ion beams such as carbon has unique characteristics suitable for treating deep-seated tumours. In Japan, carbon-ion radiotherapy was started in 1994 at Heavy Ion Medical Accelerator in Chiba (HIMAC) at National Institute of Radiological Sciences and more than 10,000 patients have been treated by Aug. 2016. Clinical outcomes show superior efficacy of carbon ions even against radioresistant tumour while keeping the quality of life at high level, and also the usefulness of hypofractionated irradiation down to the completion of the course of lung-cancer treatment in 1 day. During the decades, the improvement of hardware and software technology such as 3D scanning technique, superconducting rotating gantry or biology model have been carried out aiming at further optimized ion-beam radiotherapy as well as reducing the cost of the facility. The developed technology has been transferred to the following facilities. As of 2016, 5 carbon ion radiotherapy facilities are in operation in Japan.

Developing a cost effective environmental solution for produced water and creating a ''new'' water resource

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

Doran, Glenn; Leong, Lawrence Y.C.

2000-05-01

The project goal is to convert a currently usable by-product of oil production, produced water, into a valuable drinking water resource. The project was located at the Placate Oil Field in Santa Clarita, California, approximately 25 miles north of Los Angeles. The project included a literature review of treatment technologies; preliminary bench-scale studies to refine a planning level cost estimate; and a 10-100 gpm pilot study to develop the conceptual design and cost estimate for a 44,000 bpd treatment facility. A reverse osmosis system was constructed, pilot tested, and the data used to develop a conceptual design and operation ofmore » four operational scenarios, two industrial waters levels and two irrigation/potable water.« less

WASTE MINIMIZATION AUDIT REPORT: CASE STUDIES OF MINIMIZATION OF SOLVENT WASTES AND ELECTROPLATING WASTES AT A DOD (DEPARTMENT OF DEFENSE) INSTALLATION

EPA Science Inventory

The report results of a waste minimization audit carried out in 1987 at a tank reconditioning facility operated by the DOD. The audit team developed recommendations for reducing the generation FOO6 wastewater treatment sludge, and FOO2, and FOO4 solvent wastes. In addition to det...

Integrated, long term, sustainable, cost effective biosolids management at a large Canadian wastewater treatment facility.

PubMed

Leblanc, R J; Allain, C J; Laughton, P J; Henry, J G

2004-01-01

The Greater Moncton Sewerage Commission's 115,000 m3/d advanced, chemically assisted primary wastewater treatment facility located in New Brunswick, Canada, has developed an integrated, long term, sustainable, cost effective programme for the management and beneficial utilization of biosolids from lime stabilized raw sludge. The paper overviews biosolids production, lime stabilization, conveyance, and odour control followed by an indepth discussion of the wastewater sludge as a resource programme, namely: composting, mine site reclamation, landfill cover, land application for agricultural use, tree farming, sod farm base as a soil enrichment, topsoil manufacturing. The paper also addresses the issues of metals, pathogens, organic compounds, the quality control program along with the regulatory requirements. Biosolids capital and operating costs are presented. Research results on removal of metals from primary sludge using a unique biological process known as BIOSOL as developed by the University of Toronto, Canada to remove metals and destroy pathogens are presented. The paper also discusses an ongoing cooperative research project with the Université de Moncton where various mixtures of plant biosolids are composted with low quality soil. Integration, approach to sustainability and "cumulative effects" as part of the overall biosolids management strategy are also discussed.

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.

Initiation of a ring approach to infection prevention and control at non-Ebola health care facilities - Liberia, January-February 2015.

PubMed

Nyenswah, Tolbert; Massaquoi, Moses; Gbanya, Miatta Zenabu; Fallah, Mosoka; Amegashie, Fred; Kenta, Adolphus; Johnson, Kumblytee L; Yahya, Disu; Badini, Mehboob; Soro, Lacina; Pessoa-Silva, Carmem L; Roger, Isabelle; Selvey, Linda; VanderEnde, Kristin; Murphy, Matthew; Cooley, Laura A; Olsen, Sonja J; Christie, Athalia; Vertefeuille, John; Navin, Thomas; McElroy, Peter; Park, Benjamin J; Esswein, Eric; Fagan, Ryan; Mahoney, Frank

2015-05-15

From mid-January to mid-February 2015, all confirmed Ebola virus disease (Ebola) cases that occurred in Liberia were epidemiologically linked to a single index patient from the St. Paul Bridge area of Montserrado County. Of the 22 confirmed patients in this cluster, eight (36%) sought and received care from at least one of 10 non-Ebola health care facilities (HCFs), including clinics and hospitals in Montserrado and Margibi counties, before admission to an Ebola treatment unit. After recognition that three patients in this emerging cluster had received care from a non-Ebola treatment unit, and in response to the risk for Ebola transmission in non-Ebola treatment unit health care settings, a focused infection prevention and control (IPC) rapid response effort for the immediate area was developed to target facilities at increased risk for exposure to a person with Ebola (Ring IPC). The Ring IPC approach, which provided rapid, intensive, and short-term IPC support to HCFs in areas of active Ebola transmission, was an addition to Liberia's proposed longer term national IPC strategy, which focused on providing a comprehensive package of IPC training and support to all HCFs in the country. This report describes possible health care worker exposures to the cluster's eight patients who sought care from an HCF and implementation of the Ring IPC approach. On May 9, 2015, the World Health Organization (WHO) declared the end of the Ebola outbreak in Liberia.

Evaluating the Treatment Costs for Uncomplicated Malaria at a Public Healthcare Facility in Nigeria and the Implications.

PubMed

Ezenduka, Charles C; Falleiros, Daniel Resende; Godman, Brian B

2017-09-01

Accurate information on the facility costs of treatment is essential to enhance decision making and funding for malaria control. The objective of this study was to estimate the costs of providing treatment for uncomplicated malaria through a public health facility in Nigeria. Hospital costs were estimated from a provider perspective, applying a standard costing procedure. Capital and recurrent expenditures were estimated using an ingredient approach combined with step-down methodology. Costs attributable to malaria treatment were calculated based on the proportion of malaria cases to total outpatient visits. The costs were calculated in local currency [Naira (N)] and converted to US dollars at the 2013 exchange rate. Total annual costs of N28.723 million (US$182,953.65) were spent by the facility on the treatment of uncomplicated malaria, at a rate of US$31.49 per case, representing approximately 25% of the hospital's total expenditure in the study year. Personnel accounted for over 82.5% of total expenditure, followed by antimalarial medicines at 6.6%. More than 45% of outpatients visits were for uncomplicated malaria. Changes in personnel costs, drug prices and malaria prevalence significantly impacted on the study results, indicating the need for improved efficiency in the use of hospital resources. Malaria treatment currently consumes a considerable amount of resources in the facility, driven mainly by personnel cost and a high proportion of malaria cases. There is scope for enhanced efficiency to prevent waste and reduce costs to the provider and ultimately the consumer.

Political economy of decentralising HIV and AIDS treatment services to primary healthcare facilities in three Nigerian states.

PubMed

Mbachu, Chinyere; Onwujekwe, Obinna; Ezumah, Nkoli; Ajayi, Olayinka; Sanwo, Olusola; Uzochukwu, Benjamin

2016-09-01

Decentralisation is defined as the dispersion, distribution or transfer of resources, functions and decision-making power from a central authority to regional and local authorities. It is usually accompanied by assignment of accountability and responsibility for results. Fundamental to understanding decentralisation is learning what motivates central governments to give up power and resources to local governments, and the practical significance of this on their positions regarding decentralisation. This study examined key political and institutional influences on role-players' capacity to support decentralisation of HIV and AIDS treatment services to primary healthcare facilities, and implications for sustainability. In-depth interviews were conducted with 55 purposively selected key informants, drawn from three Nigerian states that were at different stages of decentralising HIV and AIDS treatment services to primary care facilities. Key informants represented different categories of role-players involved in HIV and AIDS control programmes. Thematic framework analysis of data was done. Support for decentralisation of HIV and AIDS treatment services to primary healthcare facilities was substantial among different categories of actors. Political factors such as the local and global agenda for health, political tenure and party affiliations, and institutional factors such as consolidation of decision-making power and improvements in career trajectories, influenced role-players support for decentralisation of HIV and AIDS treatment services. It is feasible and acceptable to decentralise HIV and AIDS treatment services to primary healthcare facilities, to help improve coverage. However, role-players' support largely depends on how well the reform aligns with political structures and current institutional practices.

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

PubMed

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

2018-02-01

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

Perceptions of the importance of physical setting in substance abuse treatment.

PubMed

Grosenick, J K; Hatmaker, C M

2000-01-01

Research indicates that architectural design can provide therapeutic effects. Six setting characteristics are considered of primary importance in health-care facilities: comforts and conveniences, safety, attractiveness, size, privacy, and arrangement/location. This study presents the perceptions regarding these and other setting features held by female clients and staff from a substance abuse treatment facility. Results support the importance of these six setting characteristics in influencing clients' treatment goals. Four other setting variables emerged as important to women's recovery: participation in a residential, drug-free, gender-specific program that provides on-site child care. Attention to these variables may provide facilities with an advantage in today's competitive market for clients.

Advanced High-Level Waste Glass Research and Development Plan

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

Peeler, David K.; Vienna, John D.; Schweiger, Michael J.

2015-07-01

The U.S. Department of Energy Office of River Protection (ORP) has implemented an integrated program to increase the loading of Hanford tank wastes in glass while meeting melter lifetime expectancies and process, regulatory, and product quality requirements. The integrated ORP program is focused on providing a technical, science-based foundation from which key decisions can be made regarding the successful operation of the Hanford Tank Waste Treatment and Immobilization Plant (WTP) facilities. The fundamental data stemming from this program will support development of advanced glass formulations, key process control models, and tactical processing strategies to ensure safe and successful operations formore » both the low-activity waste (LAW) and high-level waste (HLW) vitrification facilities with an appreciation toward reducing overall mission life. The purpose of this advanced HLW glass research and development plan is to identify the near-, mid-, and longer-term research and development activities required to develop and validate advanced HLW glasses and their associated models to support facility operations at WTP, including both direct feed and full pretreatment flowsheets. This plan also integrates technical support of facility operations and waste qualification activities to show the interdependence of these activities with the advanced waste glass (AWG) program to support the full WTP mission. Figure ES-1 shows these key ORP programmatic activities and their interfaces with both WTP facility operations and qualification needs. The plan is a living document that will be updated to reflect key advancements and mission strategy changes. The research outlined here is motivated by the potential for substantial economic benefits (e.g., significant increases in waste throughput and reductions in glass volumes) that will be realized when advancements in glass formulation continue and models supporting facility operations are implemented. Developing and applying advanced glass formulations will reduce the cost of Hanford tank waste management by reducing the schedule for tank waste treatment and reducing the amount of HLW glass for storage, transportation, and disposal. Additional benefits will be realized if advanced glasses are developed that demonstrate more tolerance for key components in the waste (such as Al 2O 3, Cr 2O 3, SO 3 and Na 2O) above the currently defined WTP constraints. Tolerating these higher concentrations of key waste loading limiters may reduce the burden on (or even eliminate the need for) leaching to remove Cr and Al and washing to remove excess S and Na from the HLW fraction. Advanced glass formulations may also make direct vitrification of the HLW fraction without significant pretreatment more cost effective. Finally, the advanced glass formulation efforts seek not only to increase waste loading in glass, but also to increase glass production rate. When coupled with higher waste loading, ensuring that all of the advanced glass formulations are processable at or above the current contract processing rate leads to significant improvements in waste throughput (the amount of waste being processed per unit time),which could significantly reduce the overall WTP mission life. The integration of increased waste loading, reduced leaching/washing requirements, and improved melting rates provides a system-wide approach to improve the effectiveness of the WTP process.« less

Biological nitrogen removal from plating wastewater by submerged membrane bioreactor packed with granular sulfur.

PubMed

Moon, Jinyoung; Hwang, Yongwoo; Kim, Junbeum; Kwak, Inho

Recent toughened water quality standards have necessitated improvements for existing sewer treatment facilities through advanced treatment processes. Therefore, an advanced treatment process that can be installed through simple modification of existing sewer treatment facilities needs to be developed. In this study, a new submerged membrane bioreactor process packed with granular sulfur (MBR-GS) was developed and operated to determine the biological nitrogen removal behaviors of plating wastewater containing a high concentration of NO3(-). Continuous denitrification was carried out at various nitrogen loading rates at 20 °C using synthetic wastewater, which was comprised of NO3(-) and HCO3(-), and actual plating wastewater, which was collected from the effluent water of a plating company called 'H Metals'. High-rate denitrification in synthetic plating wastewater was accomplished at 0.8 kg NO3(-)-N/m(3)·day at a nitrogen loading rate of 0.9 kg NO3(-)-N/m(3)·day. The denitrification rate further increased in actual plating wastewater to 0.91 kg NO3(-)-N/m(3)·day at a nitrogen loading rate of 1.11 kg NO3(-)-N/m(3)·day. Continuous filtration was maintained for up to 30 days without chemical cleaning with a transmembrane pressure in the range of 20 cmHg. Based on stoichiometry, SO4(2-) production and alkalinity consumption could be calculated theoretically. Experimental alkalinity consumption was lower than the theoretical value. This newly proposed MBR-GS process, capable of high-rate nitrogen removal by compulsive flux, is expected to be applicable as an alternative renovation technique for nitrogen treatment of plating wastewater as well as municipal wastewater with a low C/N ratio.

Issuance of a final RCRA Part B Subpart X permit for open burning/open detonation (OB/OD) of explosives at Eglin AFB, Florida

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

Johnson, G.E.; Culp, J.C.; Jenness, S.R.

1997-12-31

Treatment and disposal of explosives and munitions items have represented a significant management challenge for Department of Defense (DOD) facilities, particularly in light of increased regulatory scrutiny under the Federal Facilities Compliance Act provisions of the Resource Conservation and Recovery Act (RCRA). Subpart X of the RCRA regulations for storage, treatment, and disposal of hazardous wastes was drafted specifically to address explosive wastes. Until just recently, any DOD facility that was performing open burning/open detonation (OB/OD) of explosives was doing so under interim status for RCRA Part B Subpart X. In August 1996, Eglin Air Force Base (AFB), Florida becamemore » the first Air Force facility to be issued a final Part B Subpart X permit to perform OB/OD operations at two Eglin AFB active test ranges. This presentation will examine how Eglin AFB worked proactively with the State of Florida Department of Environmental Protection (FDEP) and EPA Region IV to develop permit conditions based upon risk assessment considerations for both air and ground-water exposure pathways. It will review the role of air emissions and air dispersion modeling in assessing potential exposure and impacts to both onsite and offsite receptors, and will discuss how air monitoring will be used to assure that the facility remains in compliance during OB/OD activities. The presentation will also discuss the soil and ground-water characterization program and associated risk assessment provisions for quarterly ground-water monitoring to assure permit compliance. The project is an excellent example of how a collaborative working relationship among the permittee, their consultant and state, and EPA can result in an environmentally protective permit that assures operational flexibility and mission sensitivity.« less

Quality differentials and reproductive health service utilisation determinants in India.

PubMed

Anand, Sandip; Sinha, R K

2010-01-01

This paper seeks to establish relationships between women's reproductive health service use, assessed longitudinally and by facility type, with service quality perceptions related to public or private health facilities. The study was mainly secondary and quantitative in nature. It included analysing data collected by the International Institute for Population Sciences (IIPS) and The Johns Hopkins University (JHU) as a follow-up study to the 1998-1999 National Family Health Survey (NFHS-2). The follow-up survey was carried out in Tamil Nadu, Maharashtra, Bihar and Jharkhand. In 2002-2003, these four states were selected to capture socio-economic and demographic variations. Analysis includes composite indices and logistic regression analysis. A scale was constructed to measure utilisation levels. Dimensions include: service proximity, doctor availability, waiting time, medicines, facility cleanliness, dignified treatment, privacy, service affordability and treatment effectiveness. Findings indicate that doctor availability, waiting time, cleanliness, privacy and affordability at private health facilities enhance the probability that a health facility will be used for any reproductive health purpose. At the combined states level, medicine availability and treatment effectiveness at public health facilities enhances service use. The major limitation is that the study includes only selected Indian states. The findings may enhance Indian service-quality policy. The paper's main contribution is that seemingly for the first time in India, healthcare service use has been measured longitudinally and then explained through service quality variables by comparing public and private health facilities.

Consumer and carer perspectives in the development of a mental health research, treatment and teaching facility: A thematic analysis.

PubMed

Katsikitis, M; Lane, B R; Ozols, I; Statham, D

2017-09-01

WHAT IS KNOWN ON THE SUBJECT?: Around the world, recovery has become a focus in mental health policy. The participation of people accessing mental health services (consumers) and carers of such individuals in decision-making related to services forms part of this recovery orientation and studies suggest positive outcomes following such participation. However, little is known about consumer and carer desires at the earliest stages of development of new services. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Consumers and carers desire changes to how mental health services are provided. Many factors affect consumer and carer experiences, including language use, physical design of spaces, accessibility, consideration of individual needs, practical help and how well care is continued from hospital to community settings. Carers may feel sidelined in treatment and be distressed as a result. They wish to be respected and involved in recovery. Consumers and carers wish for focus on broader health, with care taken to address physical health, psychological needs, social needs and treatment of the whole person rather than just an illness. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Consumers and carers desire partnership with professionals in recovery. Tokenistic participation should be avoided. Flexibility in how services are provided and less formality may help engage consumers and carers. Specifically, professionals may help by linking consumers and carers to services that address practical needs. Professionals should communicate with carers to draw on their expertise about the individual accessing the mental health service and help carers understand how they can assist the individual's recovery. Introduction Recovery-oriented mental health policies recognize consumer and carer participation in service decision-making as essential, but little is known about the views of these individuals in the earliest stages of service development. Aim This study sought consumer and carer perspectives addressing the establishment of a mental health research, treatment and teaching facility in their region. Methods Two 2-hr focus groups were conducted, with separate groups held for mental health consumers (n = 9) and carers (n = 9), respectively. Discussions pertained to mental health literacy, gaps in current services, desires for an ideal facility (in terms of physical design and services offered) and what would help in recovery. Results Inductive thematic analysis was used to generate three themes: care outside of consultations, carer involvement in recovery and holistic approaches to mental health care. Consumers desired a facility that could cater to individual needs. Carers felt excluded in recovery and unable to provide effective support. Both groups preferred holistic approaches to mental health, expressing ambivalence towards medication and hospitalization. Discussion Consumers and carers have many needs that conventional practices may not meet. Implications for practice They have clear desires for equal partnership in recovery and for transformation of conventional treatment methods. © 2017 John Wiley & Sons Ltd.

2015 Annual Wastewater Reuse Report for the Idaho National Laboratory Site’s Central Facilities Area Sewage Treatment Plant

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

Lewis, Michael George

This report describes conditions, as required by the state of Idaho Wastewater Reuse Permit (#LA-000141-03), for the wastewater land application site at the Idaho National Laboratory Site’s Central Facilities Area Sewage Treatment Plant from November 1, 2014, through October 31, 2015.

20 CFR 416.414 - Amount of benefits; eligible individual or eligible couple in a medical treatment facility.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Amount of benefits; eligible individual or eligible couple in a medical treatment facility. 416.414 Section 416.414 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Amount of Benefits...

20 CFR 416.414 - Amount of benefits; eligible individual or eligible couple in a medical treatment facility.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Amount of benefits; eligible individual or eligible couple in a medical treatment facility. 416.414 Section 416.414 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Amount of Benefits...

20 CFR 416.414 - Amount of benefits; eligible individual or eligible couple in a medical treatment facility.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Amount of benefits; eligible individual or eligible couple in a medical treatment facility. 416.414 Section 416.414 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Amount of Benefits...