Al dakeel, Taghreed M.; Almannie, Mohamed A.
The general school district of Riyadh is one of largest in the country of (45) school districts in Saudi Arabia. The school districts play an important roles in the development of education, therefore the objective of the study is to examine the roles of the management in the school districts to see if it is achieving competitive advantage. After…
Max Joseph Herman
Full Text Available Drug is one of the essential elements in healthcare that should be effectively and efficiently managed. Following thedecentralization in 2001 in Indonesia, drug management has changed in district drug management units and also in District General Hospitals. Certainly this condition influences the sustainability of drug access in primary health care such as in Community Health Center and District General Hospital, especially in drug financing policy. A cross sectional descriptive study to obtain information on drug management in public healthcare in district had been carried out between July and December 2006 in 10 District Public Drug Management Units from 10 district health offices and 9 district general hospitals as samples. Data were collected by interviewing heads of Drug Section in District Health Offices and heads of Hospital Pharmacies using structured questionnaires and observing drug storage in District Drug Management Units, Community Health Centers, and Hospital Pharmacies. Results of the study show that drug planning in District Health Offices and General Hospitals did not meet the basic real need in some districts nor District Hospitals. The minimum health service standards had no been achieved yet. Furthermore, drug procurement, storage and recording as well as reporting was not good enough either, such as shown by the existence of expired drugs. Lead time for drug delivery to community health centers in some districts was longer than the average of lead time in the past 3 years.
McCarron, M O; Wade, C; McCarron, P
Diagnostic accuracy in neurology frequently depends on clinical assessment and neuroimaging interpretation. We assessed neuroimaging discrepancy rates in reported findings between general radiologists and neuroradiologists among patients from a district general hospital (DGH). A neuroradiologist's report was sought on selected DGH patients over 28 months. Pre-planned outcomes included comparisons of primary findings (main diagnosis or abnormality), secondary findings (differential diagnoses and incidental findings) and advice from neuroradiologists for further investigations. A total of 233 patients (119 men and 114 women), mean age 47.2 (SD 17.8) years were studied: 43 had a computed tomography (CT) brain scan only, 37 had CT and magnetic resonance imaging (MRI) scans and 153 had only MRI scans. Discrepancies in the primary diagnosis/abnormality were identified in 33 patients (14.2%). This included 7 of 43 patients (16.3%) who had a CT brain scan as their only neuroimaging. Secondary outcomes differed in 50 patients (21.5%). Neuroradiologists recommended further neuroimaging for 29 patients (12.4%). The most common discrepancies in the primary diagnosis/abnormality were misinterpreting normal for hippocampal sclerosis and missed posterior fossa lesions. There was no evidence of temporal changes in discrepancy rates. Selecting CT and MR neuroimaging studies from general hospitals for reviewing by neuroradiologists is an important and effective way of optimising management of neurological patients.
Gurjar, S V; Roshanzamir, S; Patel, Sandeep; Harinath, G
An adverse event (AE) is defined as an unintended injury or complication caused by healthcare management rather than the disease process that may prolong admission and lead to disability or death. This study retrospectively assessed all reported general surgery-related AEs in a district general hospital in the south-east of England. All general surgical AEs arising from adult inpatient admissions between 2002 and 2007, that had been reported to the risk management team, following completion of the standard 'Adverse Incident Report Form', were retrospectively reviewed. There were 24,185 general surgical admissions over the period of the study; 461 AEs were reported (1.9% mean annual incident rate; 95% CI, 1.3%-2.5%). The majority (85%) were near miss or no injury events (category I and II) while serious/serious near-miss incidents accounted for just 2% of events. Communicative or administrative problems were implicated in 54% of cases while 12% arose from theatre/surgery-related failure. Of 58 medico-legal claims (0.24% of admissions) that were made, 16 (27.5%) progressed to the law courts for formal settlement. The reported annual AE incident rate of approximately 2% is well below the national average: this may be due to pre-selection of general surgery-related AEs or represent under-reporting of incidents. The vast majority of AEs were related to administrative and communicative error. These areas must be addressed if patient safety and outcome is to be significantly improved. Crown Copyright Â© 2010. Published by Elsevier Ltd. All rights reserved.
Aarons, E J; Beeching, N J
OBJECTIVE--To evaluate the local use of written "Do not resuscitate" orders to designate inpatients unsuitable for cardiopulmonary resuscitation in the event of cardiac arrest. DESIGN--Point prevalence questionnaire survey of inpatients' medical and nursing records. SETTING--10 acute medical and six acute surgical wards of a district general hospital. PARTICIPANTS--Questionnaires were filled in anonymously by nurses and doctors working on the wards surveyed. MAIN OUTCOME MEASURES--Responses t...
The objective of the master plan project is to improve the heat supply in Istra. The considerable system losses from the fuel supplied to the end-users are one issue for improvement. At the same time, the current system operation results in poor quality heat for the consumers. Due to the inflexibility of the system the dwellings/premises of the consumers are either overheated or insufficiently heated. The financial situation in Istra, the legal ownership of the district heating system and consumers' lacking ability to pay limit the possibilities for system improvements. The Master Plan and Feasibility Study evaluates four different development scenarios. Each of the scenarios is compared to the current situation in Istra, where nothing is done to change the system, but only to operate the present system in a sustainable way. The sustainable operation of the district heating system includes all necessary renovations and component replacements necessary. The project does not take into account the present financial situation in Istra, which has resulted in less maintenance than necessary. This situation is not a comparable parameter, as it is not sustainable and will lead to a breakdown of the heat supply within a short time horizon. The General Technical Report evaluates the technical situation and describes system improvements at a general level. The intention with this report is to provide important information useful to other district heating companies in Russia. (au)
Swarnkar, K.; Stamatakis, J. D.; Young, W. T.
INTRODUCTION: Endoscopic retrograde cholangiopancreaticography (ERCP) is available in many district general hospitals in the UK. Most of the published literature on ERCP in cases with Billroth II gastrectomy reflects teaching hospital experience. The aim of this study was to evaluate this procedure in the district general hospital setting, over a 10-year period. PATIENTS AND METHODS: Details of 41 consecutive patients, whom had previously undergone Billroth II gastrectomy and were referred fo...
Ayres, Lachlan; Hughes, Rebecca; Brooklyn, Trevor; Shaw, Ian; Valori, Roland
The majority of physicians work a weekly timetable consisting of programmed activities (PAs) defined by the consultant contract. This paper describes the implementation of an annualised contract within a gastroenterology department, which is located across two district general hospital sites within the same trust. The perceived benefits of the system include the introduction of a new out-of-hours emergency endoscopy service, more efficient backfilling of vacant endoscopy lists and greater transparency of work patterns and workload between colleagues and within the trust.
Full Text Available Abstract Background Primary health care specialists have a key role in the management of obesity. Through understanding how they conceive the encounter with patients with obesity, treatment may be improved. The aim of this study was thus to explore general practitioners' and district nurses' conceptions of encountering patients with obesity in primary health care. Method Data were collected through semi-structured interviews, and analysed using a phenomenographic approach. The participants were 10 general practitioners (6 women, 4 men and 10 district nurses (7 women, 3 men from 19 primary health care centres within a well-defined area of Sweden. Results Five descriptive categories were identified: Adequate primary health care, Promoting lifestyle change, Need for competency, Adherence to new habits and Understanding patient attitudes. All participants, independent of gender and profession, were represented in the descriptive categories. Some profession and gender differences were, however, found in the underlying conceptions. The general staff view was that obesity had to be prioritised. However, there was also the contradictory view that obesity is not a disease and therefore not the responsibility of primary health care. Despite this, staff conceived it as important that patients were met with respect and that individual solutions were provided which could be adhered to step-by-step by the patient. Patient attitudes, such as motivation to change, evasive behaviour, too much trust in care and lack of self-confidence, were, however, conceived as major barriers to a fruitful encounter. Conclusions Findings from this study indicate that there is a need for development and organisation of weight management in primary health care. Raising awareness of staff's negative views of patient attitudes is important since it is likely that it affects the patient-staff relationship and staff's treatment efforts. More research is also needed on gender and
Dongola, N.A.; Guy, R.L.; Giles, J.A.; Ward, S.
Purpose: This study was performed to evaluate the accuracy of upper abdominal ultrasound (US) scanning performed by sonographers in a district general hospital, to identify potential areas of weakness and to make recommendations to improve the service. Materials and methods: Upper abdominal US examinations performed and reported by sonographers over a 4-week period were retrospectively reviewed. The accuracy of the imaging findings and reports were assessed against other imaging, surgical, histological or laboratory findings and against clinical outcome. Results: A heterogenous group of 104 patients were included in the study, 62 of whom had an US abnormality. Errors of scanning or interpretation were identified in 10 patients (9.6%) of whom five (4.8%) were felt to be potentially significant. Conclusions: The sonographers' accuracy in reporting upper abdominal US scans was 90%. However, on the basis of this study we have implemented specific recommendations to improve the quality of the service
Andrews, Hannah; Singh, Yogen
Following the Safe and Sustainable review of Paediatric Services in 2012/2013, National Health Service England recommended that local paediatric cardiology services should be provided by specially trained paediatricians with expertise in cardiology in all non-specialist hospitals. To understand the variation in local paediatric cardiology services provided across district general hospitals in the United Kingdom. An internet-based questionnaire was sent out via the Paediatrician with Expertise in Cardiology Special Interest Group and the Neonatologists with Interest in Cardiology and Haemodynamics contact databases and the National Health Service directory. Non-responders were followed-up via telephone. The response rate was 80% (141 of 177 hospitals), and paediatricians with expertise in cardiology were available in 68% of those. Local cardiology clinics led by paediatricians with expertise in cardiology were provided in 96 hospitals (68%), whereas specialist outreach clinics were held in 123 centres (87%). A total of 11 hospitals provided neither specialist outreach clinics nor any local cardiology clinics led by paediatricians with expertise in cardiology. Paediatric echocardiography services were provided in 83% of the hospitals, 12-lead electrocardiogram in 96%, Holter electrocardiogram in 91%, and exercise testing in only 47% of the responding hospitals. Telemedicine facilities were established in only 52% of the centres, where sharing echocardiogram images via picture archiving and communication system was used most commonly. There has been a substantial increase in the availability of paediatricians with expertise in cardiology since 2008. Most of the hospitals are well-supported by specialist cardiology centres via outreach clinics; however, there remains significant variation in the local paediatric cardiology services provided across district general hospitals in the United Kingdom.
Berggren, Erika; Ödlund Olin, Ann; Orrevall, Ylva; Strang, Peter; Johansson, Sven-Erik; Törnkvist, Lena
Teamwork is important in early palliative home care, and interprofessional education is required to achieve teamwork. It is thus crucial to ensure that interprofessional education works well for the members of all participating professions because levels of knowledge and educational needs may vary. To evaluate, by profession, the effectiveness of an interprofessional educational intervention for district nurses and general practitioners on three areas of nutritional care for patients in a palliative phase. A quasi-experimental study that used a computer-based, study-specific questionnaire to evaluate the effectiveness of the intervention. The continuing education in primary health care (ConPrim ® ) model was used to create the intervention. ConPrim includes a web-based program, a practical exercise and a case seminar, all with interprofessional training. Primary health care centers in Stockholm County, Sweden. Intervention group (n = 87; 48 district nurses, 39 general practitioners); control group (n = 53; 36 district nurses, 17 general practitioners). The total intervention effect was significant in all three areas, p = 0.000-0.004. The intervention effects were similar and significant for both professions in areas 1 and 2. In area 3, the intervention effects were significant for general practitioners but not for district nurses. The intervention seems promising, as it may create better prerequisites for teamwork and caring for patients living at home. However, it needs to be optimized to better increase district nurses' level of knowledge (area 3).
Morsley, Klara; Berntzen, Berna; Erwood, Lisa; Bellerby, Toby; Williamson, Lyn
Rheumatoid cachexia is common in rheumatoid arthritis (RA) patients and develops soon after diagnosis, despite adequate drug therapy. It is associated with multiple adverse effects on body composition, function and mortality. Progressive resistance training (PRT) improves these outcomes but is not widely prescribed outside of a research setting. The aim of the present study was to explore the practicality and effectiveness of providing PRT to patients in a district general hospital within the constraints of existing resources. Patients attending a rheumatology clinic were invited to participate in a weekly PRT class for 6 weeks, supervised by a physiotherapist. Outcome measures included: body composition measures (waist and hip circumference, weight, percentage body fat); functional measures (grip strength, 60-s sit-to-stand test, single leg stance, Health Assessment Questionnaire); mood; fatigue and disease activity measures (sleep scale, hospital anxiety and depression scale, Functional Assessment of Chronic Illness Therapy, pain visual analogue scale). These were measured at baseline and at 6 weeks. A total of 83 patients completed the programme (60% female, mean age 51.2 years), of whom 34.9% had early RA. Improvements were seen in multiple measures inpatients with early RA and with established inflammatory arthritis, and were not affected by age or gender. Patients with early and established inflammatory arthritis alike benefited from a 6-week PRT programme provided within a National Health Service setting. Although further work is needed to look at long-term effects, we suggest that this intervention should be more widely available. Copyright © 2017 John Wiley & Sons, Ltd.
Yamagishi, Akemi; Morita, Tatsuya; Miyashita, Mitsunori; Ichikawa, Takayuki; Akizuki, Nobuya; Shirahige, Yutaka; Akiyama, Miki; Eguchi, Kenji
The role of general practitioners (GPs) and district nurses (DNs) is increasingly important to achieve dying at home. The primary aim of this region-based representative study was to clarify 1) clinical exposure of GPs and DNs to cancer patients dying at home, 2) availability of symptom control procedures, 3) willingness to participate in out-of-hours cooperation and palliative care consultation services, and 4) reasons for hospital admission of terminally ill cancer patients. Questionnaires were sent to 1106 GP clinics and 70 district nursing services in four areas across Japan. Two hundred thirty-five GPs and 56 district nursing services responded. In total, 53% of GPs reported that they saw no cancer patients dying at home per year, and 40% had one to 10 such patients. In contrast, 31% of district nursing services cared for more than 10 cancer patients dying at home per year, and 59% had one to 10 such patients. Oral opioids, subcutaneous opioids, and subcutaneous haloperidol were available in more than 90% of district nursing services, whereas 35% of GPs reported that oral opioids were unavailable and 50% reported that subcutaneous opioids or haloperidol were unavailable. Sixty-seven percent of GPs and 93% of district nursing services were willing to use palliative care consultation services. Frequent reasons for admission were family burden of caregiving, unexpected change in physical condition, uncontrolled physical symptoms, and delirium. Japanese GPs have little experience in caring for cancer patients dying at home, whereas DNs have more experience. To achieve quality palliative care programs for cancer patients at the regional level, educating GPs about opioids and psychiatric medications, easily available palliative care consultation services, systems to support home care technology, and coordinated systems to alleviate family burden is of importance. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Carey, L; Desouza, C; Moorcroft, A; Elgalib, A
The aim of this study was to describe the obstetrical and virological outcomes in HIV-infected pregnant women who delivered at a district general hospital in south London in the period from 2008 to 2014. Our review identified 137 pregnancies; most (60%, 63/105) of them were unplanned. The commonest mode of delivery was spontaneous vaginal delivery (SVD) (42%, 48/114) followed by emergency Caesarean section (32%, 36/114). Gestational age at delivery was ≥37 weeks in most (84%, 91/106) of the cases. Maternal HIV VL at or closest to delivery was undetectable (1000 copies/mL in 73% (94/129), 90% (116/129) and 6% (8/129) of the pregnancies, respectively. None of the infants were infected with HIV making the rate of MTCT of HIV 0% (zero). Our study shows that favourable virological and obstetrical outcomes of HIV-infected pregnant women are achievable in non-tertiary HIV treatment centres. Impact Statement What is already known on this subject: Prevention of mother-to-child transmission (MTCT) of HIV has been one of the major public health successes in the last decades. This success was evident by the reduction of MTCT of HIV in the UK from 25.6% in the 1993 to only 0.46% in 2011. Furthermore, many reports from individual providers, mainly from tertiary centres, of HIV care in the UK also showed very low rates MTCT of HIV. What the results of this study add: Our study shows that favourable virological and obstetrical outcomes of HIV-infected pregnant women are achievable in non-tertiary HIV treatment centres. The MTCT of HIV rate in our hospital was zero in the period from 2008 to 2014. What the implications are of these findings for clinical practice and/or further research: Staff caring for pregnant HIV positive women in general hospitals and small-to-medium HIV clinics should liaise closely with each other and utilise the skill-mix within their hospital in order to provide a quality care that is similar to what is achieved in large teaching centres; however, a
Swarnkar, K; Stamatakis, J D; Young, W T
Endoscopic retrograde cholangiopancreaticography (ERCP) is available in many district general hospitals in the UK. Most of the published literature on ERCP in cases with Billroth II gastrectomy reflects teaching hospital experience. The aim of this study was to evaluate this procedure in the district general hospital setting, over a 10-year period. Details of 41 consecutive patients, whom had previously undergone Billroth II gastrectomy and were referred for ERCP were analysed for presenting symptoms and outcome of their ERCP. All procedures were carried out by a single radiologist using a conventional Olympus side-viewing duodenoscope. 48 examinations and 44 therapeutic procedures were carried out in 41 cases. Afferent loop intubation and cannulation of ampulla was successful in 87.5% and 98%, respectively. Two episodes of minor bleeding occurred after sphincterotomy, not requiring blood transfusion. One case of afferent loop perforation (2%) was repaired surgically. There were no cases of pancreatitis or death in this series. The results show that ERCP after a Bilroth II gastrectomy can be safe and successful in the majority of cases when carried out by clinicians with a special interest, including those in a district general hospital However, experience with this procedure will diminish due to fewer indications for Billroth II gastrectomy and emergence of magnetic resonance cholangiopancreatography. It may be advisable to concentrate this technique in a few designated centres with skill and expertise.
Full Text Available Abstract Background Over recent years increased emphasis has been given to performance monitoring of NHS hospitals, including overall number of hospital readmissions, which however are often sub-optimally adjusted for case-mix. We therefore conducted a study to examine the effect of various patient and disease factors on the risk of emergency medical readmission. Methods The study setting was a District General Hospital in Greater Manchester and the study period was 4.5-years. All index emergency medical admission during the study period leading to a live discharge were included in the study (n = 20,209. A multivariable proportional hazards modelling was used, based on Hospital Episodes Statistics data, to examine the influence of various baseline factors on readmission risk. Deprivation status was measured with the Townsend deprivation index score. Hazard ratios (HR and associated 95% confidence intervals (CI of unplanned emergency medical admission by sex, age group, admission method, diagnostic group, number of coded co-morbidities, length of stay and patient's deprivation status quartile, were calculated. Results Significant independent predictors of readmission risk at 12 months were male sex (HR 1.13, CI: 1.07–1.2, age (age >75 (HR 1.57, CI 1.45–1.7, number of coded co-morbidities (HR for >4 coded co-morbidities: 1.49 CI: 1.26–1.76, admission via GP referral (HR 0.93, CI 0.88–0.99 and primary diagnosis of heart failure (HR 1.33, CI: 1.16–1.53 and chronic obstructive pulmonary disease/asthma (HR 1.34, CI: 1.21–1.48. Higher level of deprivation was also significantly and independently associated and with increased emergency medical readmission risk at three (HR for the most deprived quartile 1.21, CI: 1.08–1.35, six (HR 1.21, CI: 1.1–1.33 and twelve months (HR 1.25, CI: 1.16–1.36. Conclusions There is a potential for improving health and reducing demand for emergency medical admissions with more effective management of
Keat, R M; Thomas, M; McKechnie, A
Sedentary behaviour is widely associated with deleterious health outcomes that in modern medicine have similar connotations to smoking tobacco and alcohol misuse. The integration of e-portfolio, e-logbook, British National Formulary (BNF) and encrypted emails has made smartphones a necessity for trainees. Smartphones also have the ability to record the amount of exercise taken, which allows activity at work to be monitored. The aim of this study to compare the activity of the same group of dental core trainees when they worked within a large multisite teaching hospital and a smaller district general hospital, to find out if supplementary activity was needed outside work. Data were collected from smartphones. To ensure continuity, data were collected only from those who had calibrated iPhones (n=10). At the teaching hospital six of the trainees walked over 10 000 steps a day while working (mean (SD) 10 004 (639)). At the district hospital none of the trainees walked 10 000 steps. The mean (SD) number of steps completed by all trainees was 6265 (119). Walking at work provides the full quota of recommended daily exercise most of the time for those working in the teaching hospital, but additional exercise is occasionally required. While working at the district hospital they walk less, meaning that they should try to increase their activity outside work. Trainees working in the teaching hospital walk significantly more steps than in the district hospital. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Tao, Lin; Ning, Hong-Jian; Nie, Hai-Ming; Guo, Xiao-Yun; Qin, Shan-Yu; Jiang, Hai-Xing
The diagnosis of tuberculosis (TB) ascites using standard diagnostic tools is difficult. The aim of the present meta-analysis was to establish the overall diagnostic accuracy of adenosine deaminase (ADA) levels in ascites for diagnosing TB ascites. A systematic review was performed of English language publications prior to April 2013. Sensitivity, specificity, and other measures of the accuracy of ADA for the diagnosis of TB ascites using ascites fluid were summarized using a random-effects model or a fixed-effects model. Receiver operating characteristic curves were used to summarize overall test performance. Seventeen studies involving 1797 subjects were eligible for the analysis. The summary estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and the area under cure of overall analysis were: 0.93, 0.94, 13.55, 0.11, 169.83, and 0.976, respectively; the results of sensitivity analysis of studies that used Giusti method were 0.94, 0.94, 12.99, 0.08, 183.18, and 0.977, respectively. Our results suggest that ADA in the ascites can be a sensitive and specific target and a critical criterion for the diagnosis of TB ascites. Copyright © 2014 Elsevier Inc. All rights reserved.
Full Text Available Abstract Background Hypertension prevalence is high in China, while patients’ levels of hypertension awareness, treatment and control are low. General practitioners’ knowledge and training relating to hypertension prevention may be an important related factor. We aimed to investigate general practitioners’ knowledge of hypertension prevention and potential training needs. Methods A questionnaire survey was conducted among all general practitioners at five community health service centers selected by convenience sampling. A total of 160 questionnaires were distributed and 147 were returned (response rate 91.9% The questionnaire included general information; 12 subjective questions on health promotion, education and training needs; and 19 objective questions in 5 domains (epidemiology, diagnosis, treatment, referral and community management measuring knowledge of hypertension prevention and treatment. Results The major difficulties in health education practice for general practitioners were poor patient compliance (77.6% and lack of medical consultation time (49.0%. The average accuracy rate of hypertension prevention knowledge was 49.2%, ranging from 10.5% to 94.7%. The factors associated with accuracy rate were physician’s education level (medical university vs. professional school, β = 13.3, P = 0.003, and type of center (training base vs. community healthcare center, β = 12.3, P Conclusions The knowledge level of hypertension prevention is low among general practitioners in urban settings. Physicians working in community clinics where they participate in a series of teaching, assessing and evaluating systems for hypertension prevention perform better than those in general healthcare centers who lack specific training. Continuing hypertension education is urgently needed to ensure that physicians in general practice are aware of and adhere to the national hypertension prevention guidelines.
Irfan, Muhammad; Caldas de Almeida, Jose Miguel; Irfan, Uma Maheswari; Raza, Usman Ahmad; Farooq, Saeed
To assess the knowledge and practices of general practitioners about diagnosis and treatment of schizophrenia and determine their association with clinical exposure to such cases in practice. The cross-sectional study was conducted in Peshawar from August 2009 to December 2011 at the clinics of general practitioners enrolled with the provincial Health Regulation Authority. All the listed GPs were contacted and those consenting to participate were included. A semi-structured questionnaire was used to assess their knowledge and practices related to diagnosis and treatment of schizophrenia. They were categorised as having Good Knowledge/Practice, in this regard, when they responded to >60% of the questions correctly. Of the 135 general practitioners contacted, 114(84.5%) agreed to participate and represented the study sample. Of them, 61(53.5%) physicians did not treat any diagnosed case while 15(13.2%) treated more than 10(8.8%) annually. Only 6(5.3%) practitioners spent more than 30 minutes, while 22(19.3%) spent less than 10 minutes per patient. Besides, 14(12.3%) practitioners had good knowledge about schizophrenia diagnosis and treatment, while 100(87.7%) had poor or no knowledge. Similarly, 32(28.1%) practitioners had good practice skills regarding schizophrenia compared to 82(71.9%) having poor practice skills or no practice regarding schizophrenia. General practitioners who were not treating any patients with schizophrenia had lower knowledge and practice scores compared to those who were treating one or more patients with schizophrenia annually (pschizophrenia diagnosis and treatment.
Kamour, A; Yardley, R; Longshaw, M; Stuart, J
To assess the impact of the Parklife annual music festival on the local hospital, North Manchester General. Data was obtained retrospectively by analysis of emergency department records during the weekend of Parklife 2015. 32 patients were identified, 56% reported taking drugs. 34% were admitted for overnight observation. 4 patients presented with methaemoglobinaemia following oral ingestion of amyl nitrate. One patient had a methaemoglobin fraction of 90.6%, which is amongst the most extreme recorded in literature. Music festivals can impose a burden on local health services. Organisers should operate an efficient surveillance system in order to prevent the sale and use of recreational drugs, providing adequate on-site health services and working in collaboration with local emergency services.
Juarez, M; Price, E; Collins, D; Williamson, L
Foot problems are highly prevalent in inflammatory arthritis (IA), especially rheumatoid arthritis (RA). Chronic inflammation can lead to permanent structural changes, deformity and disability. Early podiatry intervention in RA improves long term outcomes. National guidelines recommend that patients should be treated by a multidisciplinary team with dedicated podiatry services. In clinical practice funding constraints limit availability of these services. To assess prevalence of foot problems and quality and availability of foot care services at a UK district general hospital. 1200 IA patients in Swindon (Wiltshire, UK) were invited to complete an anonymised questionnaire regarding access to foot care services and education/information on foot problems. 448 patients. Prevalence of foot problems: 68%. Only 31% of patients had access to appropriate foot specialist. 24% had received foot assessment within 3 months of diagnosis of IA and 17% yearly review thereafter. Despite high prevalence of foot problems in our population we identified significant deficiencies in provision of integrated multidisciplinary podiatry care. The data we present could be used by others to support business cases to obtain funding to improve the links between rheumatology and podiatry services. Copyright 2010 Elsevier Ltd. All rights reserved.
El Ashry, Saad R; El Gamal, Tarek A; Challagundla, Sudhakar R; Ntala, Chara A; Nagy, Ahmed M; Crane, Evan O
We wanted to assess the number of unnecessary radiographs done for acute knee injury patients and the accuracy of the Pittsburgh decision rules. A retrospective observational study was done to look at the acute knee injury patients presented to a district general hospital Accident and Emergency Department from August 2011 till August 2013. We assessed the following parameters: sex, age, mechanism of injury, weight-bearing status and incidence of fractures in patients subjected to plain radiograph. A prospective study was then done from April 2014- August 2014 following implementation of the Pittsburgh decision rules. 24% of the patients had knee X-ray, compared to 72.12% in the first cycle. 36.8% had fracture, compared to 6.1% first cycle, with 66.7 % reduction in x-rays. Pittsburgh decision rules sensitivity was 100% and specificity 85.3%, positive predictive value 45.8% and accuracy 87%. 1. The Pittsburgh decision rules is highly sensitive, specific and accurate in determining the need of X-ray in acute knee Injuries. 2. We found that the Pittsburgh decision rules performs well in our hospital, which coincides with previously published literature.
Medford, Andrew Rl; Pepperell, Justin Ct
In 1993, the British Thoracic Society (BTS) issued guidelines for the management of spontaneous pneumothorax (SP). These were refined in 2003. To determine adherence to the 2003 BTS SP guidelines in a district general hospital. An initial retrospective audit of 52 episodes of acute SP was performed. Subsequent intervention involved a junior doctor educational update on both the 2003 BTS guidelines and the initial audit results, and the setting up of an online guideline hyperlink. After the educational intervention a further prospective re-audit of 28 SP episodes was performed. Management of SP deviated considerably from the 2003 BTS guidelines in the initial audit - deviation rate 26.9%. After the intervention, a number of clinical management deviations persisted (32.1% deviation rate); these included failure to insert a chest drain despite unsuccessful aspiration, and attempting aspiration of symptomatic secondary SPs. Specific tools to improve standards might include a pneumothorax proforma to improve record keeping and a pneumothorax care pathway to reduce management deviations compared to BTS guidelines. Successful change also requires identification of the total target audience for any educational intervention.
Full Text Available Abstract Background The definition of primary care varies between countries. Swedish primary care has developed from a philosophic viewpoint based on quality, accessibility, continuity, co-operation and a holistic view. The meaning of holism in international literature differs between medicine and nursing. The question is, if the difference is due to different educational traditions. Due to the uncertainties in defining holism and a holistic view we wished to study, in depth, how holism is perceived by doctors and nurses in their clinical work. Thus, the aim was to explore the perceived meaning of a holistic view among general practitioners (GPs and district nurses (DNs. Methods Seven focus group interviews with a purposive sample of 22 GPs and 20 nurses working in primary care in two Swedish county councils were conducted. The interviews were transcribed verbatim and analysed using qualitative content analysis. Results The analysis resulted in three categories, attitude, knowledge, and circumstances, with two, two and four subcategories respectively. A professional attitude involves recognising the whole person; not only fragments of a person with a disease. Factual knowledge is acquired through special training and long professional experience. Tacit knowledge is about feelings and social competence. Circumstances can either be barriers or facilitators. A holistic view is a strong motivator and as such it is a facilitator. The way primary care is organised can be either a barrier or a facilitator and could influence the use of a holistic approach. Defined geographical districts and care teams facilitate a holistic view with house calls being essential, particularly for nurses. In preventive work and palliative care, a holistic view was stated to be specifically important. Consultations and communication with the patient were seen as important tools. Conclusion 'Holistic view' is multidimensional, well implemented and very much alive among both
Is the Current Management of Patients Presenting With Spinal Trauma to District General Hospitals Fit for Purpose? Our Experience of Delivering a Spinal Service Using an Electronic Referral Platform in a Large District General Teaching Hospital Without Onsite Spinal Services.
Hill, Daniel S; Marynissen, Hans
A retrospective cross-sectional analysis. To describe the provision of a spinal service using an electronic platform to direct management from an external spinal unit, and quantify time taken to obtain definitive management plans whilst under prescribed spinal immobilization. Most attending district general hospitals following spinal trauma will have stable injuries and normal neurology, with only a small proportion requiring urgent transfer to a specialist centre. A retrospective review of 104 patients admitted following vertebral during a 12-month period. The British Orthopaedic Association Standards for Trauma consensus that "spinal immobilisation is not recommended for more than 48 hours" was the standard of care measured against. 100 patients occupied a total of 975 hospital inpatient bed days. 117 radiological investigations were requested after the point of external referral (47 CT-scans, 37 MRI-scans, and 33 weight bearing radiographs). The period between initial referral to the regional spinal service and then receiving a definitive final management had a median value of 72 hours and a range of 0 - 33 days. Patients will have been under some form of prescribed spinal immobilisation until the definitive management plan was communicated. 34 patients (34% of the overall cohort) had a definitive management plan in place within 48 hours. 80 patients had vertebral injuries (73 stable, 6 unstable), 3 patients had prolapsed intervertebral disks, 1 had metastatic disease, and 17 had not evidence of an acute injury following evaluation. Patients are being placed under prescribed immobilisation for longer than is recommended. Delays in obtaining radiological imaging were an important factor, together with the time taken to receive a definitive management plan. Limitations in social care provision and delays in arranging this were additional barriers to hospital discharge following the final management plan. 4.
The papers presented at this meeting dealt with an international comparison of district heating, the Swiss district heating network, political aspects of nuclear district heating, nuclear and non-nuclear sources for district heating. 17 figs., 6 tabs
Vermont Center for Geographic Information — The following Overlay Districts are included in the data:General Development Four Commercial DistrictGeneral Development Four Openspace DistrictShoreland...
Squires, Seth Ian; Boal, Allan John; Naismith, Graham Douglas
It has become increasingly recognised that outpatient management is more cost-effective in inflammatory bowel disease (IBD). IBD Standards (Revised 2013) recommend telephone advice for patients with regard to symptoms and medication management. This report attempts to quantify the net financial impact of this service at our hospital since it was introduced in August 2013. The Royal Alexandra Hospital in Paisley (National Health Service, Greater Glasgow and Clyde) is a district general hospital with a catchment population of 200 000 with approximately 2500 patients with IBD. Data relating to the use of the IBD telemedicine service were prospectively recorded on a daily basis for a period of 5 months. We documented reasons for calling and the likely action taken by the patient had the telephone advice line not been available. Cost savings based on alternative outcomes were made in accordance with the Department of Health figures (Department of Health reference costs 2011-2012). The mean number of calls per month was 88 (IQR 24)-(the mean number of calls which were deemed non-IBD issues was 30 calls per month (IQR 8.0)) The mean cost of staffing the IBD advice line with an IBD clinical nurse specialist was £482.00 per month (IQR 195.5). The mean time spent on calls per month was 28.5 h (IQR 11.5). Cost savings over 5 months for avoidance of general practitioner (GP) consultation was £3408.00. Savings for avoidance of a consultant appointment made over the 5-month period was £27 454.00. Savings made from patients avoiding either an accident and emergency (A&E) or a hospital admission were £540.00 and £11 488.00, respectively, over the 5-month period. The net saving was £42 890.00. A nurse-led telephone advice line appears to be a cost-effective intervention. It may prevent patients from unnecessary hospital attendance. Savings can be made to both primary care and secondary care. Overall, it appears that the advice line is providing a highly valuable
McGreevy, A; Millar, L; Murphy, B; Davison, G W; Brown, R; O'Donnell, M E
Previous studies have reported a conflicting relationship between the effect of live and televised sporting events on attendance rates to emergency departments (ED). The objectives of this study were to investigate the relationship of major sporting events on emergency department attendance rates and to determine the potential effects of such events on service provision. A retrospective analysis of ED attendances to a district general hospital (DGH) and subsequent admissions over a 24-h period following live and televised sporting activities was performed over a 5-year period. Data were compiled from the hospital's emergency record books including the number of attendances, patient demographics, clinical complaint and outcome. Review patients were excluded. Analysis of sporting events was compiled for live local, regional and national events as well as world-wide televised sporting broadcasts. A total of 137,668 (80,445 men) patients attended from April 2002 to July 2007. Mean attendance rate per day was 80 patients (men = 47). Mean admission rate was 13.6 patients per day. Major sporting events during the study period included; Soccer: 4 FA Cup and 1 World Cup (WC) finals; Rugby: 47 Six Nations, 25 Six nations games involving Ireland, 1 WC final, 2 WC semi-finals, 2 WC quarter-finals and 4 WC games involving Ireland; and Gaelic Football [Gaelic Athletic Association (GAA)]: 5 All-Ireland finals, 11 semi-finals, 11 quarter-finals and 5 provincial finals. There was a significantly higher patient admission rate during the soccer FA Cup final, Rugby Six Nations and games involving Ireland and for GAA semi- and quarter-final games (p = 0.001-0.01). There was no difference identified in total attendance or non-admission rates for sporting events throughout the study period. Although there was no correlation identified between any of these sporting events and total emergency department attendances (r 0.07), multinomial logistic regression demonstrated that FA Cup final (p
In fall 2002 staff of the Los Rios Community College District (LRCCD) Office of Institutional Research collaborated with occupational deans, academic deans, and faculty to develop and administer a survey of former business students. The survey was designed to determine how well courses had met the needs of former business students in the areas of…
Lombardo, F; Salzano, G; Di Bella, C; Aversa, T; Pugliatti, F; Cara, S; Valenzise, M; De Luca, F; Rigoli, L
Since the original description, there have been only few epidemiological studies of Wolfram syndrome (WS). Aims of the present paper are to ascertain WS prevalence and expression in a district of North-eastern Sicily, i.e. a geographic area where consanguineous unions are not very unusual. Prevalence rates of WS in the Messina district were calculated by taking into consideration both the total population (653,737) and the populations included within the 0-30 year age range (202,681). We estimated the relative prevalence of WS among patients with youth-onset insulin-dependent diabetes mellitus (DM) who are currently aged under 30 years (256). Global WS prevalence in our district is 1:54,478, whereas prevalence among individuals under 30 is 1:16,890 and relative prevalence among patients with juvenile-onset insulin-dependent DM is 1:22.3. When compared with the patients with insulin-dependent DM of Messina district, WS patients did not exhibit significant differences in terms of biochemical features at DM onset, whereas age at DM diagnosis was significantly earlier in WS group. (a) WS prevalence is not so infrequent as generally expected; (b) in our series, DM presented before 10 years in 11/12 patients and ten cases have already developed all the four peculiar manifestations of WS by 26 years; (c) 9/12 patients exhibited a homozygous frameshift/truncation mutation (Y454_L459del_fsX454), which is the one most frequently found also in patients from other Italian regions; (d) age at DM diagnosis was significantly earlier in WS group than in the patients with insulin-dependent DM of Messina district.
Sofía Estela Ares
Full Text Available Recognizing the space transformations related to the residential behaviors and the mobility of the population requires taking into consideration all the mobility habits, whatever the distance and duration. The purpose of this work is to put into evidence the prevailing motivations in the processes of observed mobility of the population in a set of minor cities next to provincial routes 11th south and 226th of General Pueyrredon District (Buenos Aires Province. Primary data were collected through ninety eight semi-structured surveys carried out in the space units that comprise the study area. The selection of the sampling units was accomplished through a non probabilistic method. The results show a set of non similarities among distinctive settlement lines, and even within them, and point to processes of consolidation of the social-territorial fragmentation beyond the main district urban area.
Town of Cary, North Carolina — View the location of the Town of Cary’s four Town Council districts.Please note that one district, District A, is split into two geo-spatial areas. One area is in...
Kumar, P; Kumar, P; Dixit, A; Gupta, V; Singh, HP; Sargaiyan, V
Background: Oral diseases are largely preventable and it is hoped that with the early exposure to oral health-care activities, the prevalence of oral diseases will be reduced in children and they would be more receptive to dental services. Aim: The present study evaluated the awareness of prevention of dental caries among pediatricians in Ghaziabad district, India. Subjects and Methods: A cross-sectional survey was undertaken among the pediatricians in Ghaziabad district, India. Total subjects including in the survey were 88 pediatricians, through systemic random sampling. Both the gender was including Male-37.8% (35/88) and Female-62.2% (53/88). Pre-tested, structured and self administered questionnaire was used in the survey and data analysis was done by using ‘SPSS’ software version 16.0 (IBM, United States). Results: Our study indicated that most of the pediatricians in Ghaziabad district had moderate knowledge 39.7% (35/88), followed by good knowledge 36.5% (32/88) and poor knowledge 23.8% (21/88) about dental caries. Practice guidelines and opinions of pediatricians in the survey were moderate 64.7% (57/88) in about more than half, followed by poor 23.8% (21/88) and followed by good 11.5% (10/88). The attitude for prevention of dental caries was positive in almost everybody 81.8% (72/88). Conclusion: The present survey concluded that pediatricians in Ghaziabad district, India had a good attitude and practices, but had moderate knowledge and lacked proper awareness about dental caries. PMID:25364606
Shet, RGK; Jain, Gaurvi; Maroli, Sohani; Srivastava, Kirti Jajoo; Kasina, Sitaram Prasad; Shwetha, GS
Background: To associate oral health related quality of life with dental anxiety and depression along with general health among people of Bhopal district, Madhya Pradesh. Materials & Methods: A cross sectional questionnaires based survey was conducted among the subjects of Bhopal district, Madhya Pradesh. The survey was carried among 101 subjects aging from 20-40 years. Subjects under investigation were belonging to various occupations. They were assigned a questionnaire. Questionnaire consisted of four parts, first part consists of socio-demographic data along with dental visiting habits, second part has OHqOL-questionnaire, third part has general health (sf-12) and fourth part has hospital anxiety and depression questionnaire. Questionnaire was used for assessment of OHqOL. It consists of 16 questions which takes into account both effect and impact of oral health on quality of life. Dental anxiety and depression was measured by Hospital Anxiety and Depression Scale. Each question was provided with four options and numbering ranging from 0-3. For general health consideration sf-12 v2 was being used, which calculates two values PCS and MCS giving result in percentage. Results: A large proportion of respondent perceived oral health as having an enhanced effect on their quality of life in all three aspects that is general health, social and psychological. This is in stark contrast to other studies, where only physical aspects of oral health were more frequently considered to have the greatest overall impact of life quality compared with items relating to social, psychological and general health aspects. Conclusion: Gender variations were not apparent in the study. Both genders were likely to perceive oral health as it is impacting strongly on their quality of life. No significant gender variations are seen. But both have specific oral health needs and are most likely to utilize dental services which may be the key in understanding oral health behavior, including
Shet, Rgk; Jain, Gaurvi; Maroli, Sohani; Srivastava, Kirti Jajoo; Kasina, Sitaram Prasad; Shwetha, Gs
To associate oral health related quality of life with dental anxiety and depression along with general health among people of Bhopal district, Madhya Pradesh. A cross sectional questionnaires based survey was conducted among the subjects of Bhopal district, Madhya Pradesh. The survey was carried among 101 subjects aging from 20-40 years. Subjects under investigation were belonging to various occupations. They were assigned a questionnaire. Questionnaire consisted of four parts, first part consists of socio-demographic data along with dental visiting habits, second part has OHqOL-questionnaire, third part has general health (sf-12) and fourth part has hospital anxiety and depression questionnaire. Questionnaire was used for assessment of OHqOL. It consists of 16 questions which takes into account both effect and impact of oral health on quality of life. Dental anxiety and depression was measured by Hospital Anxiety and Depression Scale. Each question was provided with four options and numbering ranging from 0-3. For general health consideration sf-12 v2 was being used, which calculates two values PCS and MCS giving result in percentage. A large proportion of respondent perceived oral health as having an enhanced effect on their quality of life in all three aspects that is general health, social and psychological. This is in stark contrast to other studies, where only physical aspects of oral health were more frequently considered to have the greatest overall impact of life quality compared with items relating to social, psychological and general health aspects. Gender variations were not apparent in the study. Both genders were likely to perceive oral health as it is impacting strongly on their quality of life. No significant gender variations are seen. But both have specific oral health needs and are most likely to utilize dental services which may be the key in understanding oral health behavior, including dental attendance patterns. How to cite this article: Shet
Ogundipe, O A; Cordina, J; Norris, C A
The Scottish Intercollegiate Guidelines Network (SIGN) guideline 95 on the management of chronic heart failure (CHF) was published in February 2007, superseding SIGN guideline 35 of February 1999. The guideline promotes evidence based management of CHE. To describe an existing service model and to review our level of concordance with SIGN guidelines. We describe a model of a CHF service based in a district general hospital (DGH) in Scotland. We conducted a retrospective review on consecutive new referrals between August and November 2002, and a prospective review of new attendances between September 2005 and January 2006. In 2002 and 2005/6, 49 and 45 patients were reviewed respectively, with 26 and 28 patients showing left ventricular systolic dysfunction on echocardiography. Median ages of patients were 81 and 79 years respectively. Angiotensin Converting Enzyme Inhibitor (ACEI) or Angiotensin II Receptor Blocker (AIIRB) therapy was in use in 23 (88.5%) and 24 (85.7%) patients respectively. The use of beta-blockers, digoxin and spironolactone was shown to have improved between both reviews. We have been able to demonstrate an improving level of concordance with SIGN guidelines in a district general hospital (DGH) heart failure service model run by care of the elderly physicians and supported by specialist nurses.
By request of the Dutch Lower House the Netherlands Court of Audit examined the profitability or loss-making of district heating projects between 2001 and 2003. District heating supplies heat to consumers for heating their houses and providing warm tap water. The heat is supplied via warm water that runs through a network of pipes. In the Netherlands, about 250,000 households use district heating. The request by the Dutch Lower House to conduct research on district heating coheres with the initiative District Heating Bill. The bill aims to legally guarantee the supply and affordability of heat for consumers of district heating. [mk] [nl
Kastner, C; Tagg, A
To assess the current practice of emergency management of renal colic in a district hospital, review literature, implement new guidelines, and assess them. Data were collected about the use of analgesia, waiting time for intravenous urography (IVU), and admission status of patients presenting to the hospital with symptoms of renal colic over the period of three months. A literature search into the use of analgesia, imaging, and treatment was performed. Members of the involved departments were consulted and new guidelines developed and implemented. This was followed by further data collection over three months. Seven of 14 patients were admitted. Five to wait for their IVU. Their average waiting time was 12.3 (SD 2.2) hours. Mainly intramuscular opioid analgesia was used. Literature recommended the use of diclofenac. Although computed tomography was favoured it was decided to continue to use IVU because of circumstances within the hospital. The literature recommended a cut off between conservative and surgical treatment at a calculus size of >4 mm. Existing policies of the relevant departments were obeyed and a training system for the junior doctors was introduced. Emergency department staff were encouraged to perform 3-film IVUs. After this, of 5 of 19 patients were admitted, only one of those to wait for an IVU. The average waiting time for an IVU was 4.1 (SD 0.96) hours. Rectal diclofenac was noted to be the drug of choice. Coordination of efforts, interdepartmental communication, and a practical application of available literature has resulted in a significant improvement of effectiveness without affecting medical standards, workload, or resources. Accident and emergency senior house officers felt highly satisfied at being able to complete management from presentation to diagnosis and treatment. Interdisciplinary communication has to be continued to maintain smooth operation of the guidelines.
Joensson, Mats; Olsson, Nils
This thesis describes the conditions for district heating in the Republic of Korea at the turn of the year 1994-95. It is based on a study made in Seoul at Korea District Heating Corporation, which is the largest district heating utility in Korea. The substations were particularly studied. District heating was introduced in Korea in the 80s because of the environmental advantages. KHDC was established in 1985 and in 1994 they provided 340 000 households with district heating. By the year of 2001 KDHC plans to supply 45% of the heating in Seoul with its 12 million inhabitants. KDHC receives most of its thermal energy from combined heat and power plants that use natural gas as fuel. In 1991 KDHC initiated a collaboration with Ekono of Finland to develop more advanced technology in Korea. Therefore the Finnish standard, which is similar to Swedish standard, has left it`s mark on the Korean district heating technology. Typical for the Korean substation is that the heat exchangers are connected in parallel in only one step. KDHC:s expansion will, within a couple of years, help to make Korea one of the leading countries in modern district heating. 9 refs, 3 figs, 2 tabs
Kerr, Hui-Ling; Jackson, Rosalyn; Kothari, Paresh
This study assessed the radiological measurements, American Orthopaedic Foot and Ankle Society (AOFAS) scores, and patient satisfaction associated with performance of the scarf osteotomy, combined with an Akin osteotomy, for the treatment of hallux valgus in patients at a general hospital. Thirty-five patients were assessed before surgery, and at 6 months following performance of the scarf first metatarsal osteotomy plus Akin osteotomy. The mean first intermetatarsal and hallux abductus angles reduced from 14.1 degrees +/- 3.5 degrees to 10.0 degrees +/- 3.2 degrees and 32.1 degrees +/- 9.9 degrees to 16.4 degrees +/- 7.9 degrees , respectively, and these differences were statistically significant (P .05). The mean global AOFAS Hallux Metatarsophalangeal-Interphalangeal score increased from 58.8 +/- 11.6 to 86.4 +/- 11.6, and this difference was statistically significant (P surgery. Based on these results, we concluded that the improved radiographic angles and AOFAS scores observed in this study were comparable to previously reported results, and our findings indicated that, in the setting of a general hospital, the scarf osteotomy combined with the Akin osteotomy is a safe, versatile and useful procedure for the treatment of hallux valgus. Copyright 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
Is Knowledge Regarding Tuberculosis Associated with Stigmatising and Discriminating Attitudes of General Population towards Tuberculosis Patients? Findings from a Community Based Survey in 30 Districts of India.
Sagili, Karuna D; Satyanarayana, Srinath; Chadha, Sarabjit S
Stigmatising and discriminating attitudes may discourage tuberculosis (TB) patients from actively seeking medical care, hide their disease status, and discontinue treatment. It is expected that appropriate knowledge regarding TB should remove stigmatising and discriminating attitudes. In this study we assessed the prevalence of stigmatising and discriminating attitudes towards TB patients among general population and their association with knowledge regarding TB. A cross-sectional knowledge, attitude and practice survey was conducted in 30 districts of India in January-March 2011. A total of 4562 respondents from general population were interviewed using semi-structured questionnaires which contained items to measure stigma, discrimination and knowledge on TB. Of the 4562 interviewed, 3823 were eligible for the current analysis. Of these, 73% (95% CI 71.4-74.2) had stigmatising and 98% (95% CI 97.4-98.3) had discriminating attitude towards TB patients. Only 17% (95% CI 15.6-18.0) of the respondents had appropriate knowledge regarding TB with even lower levels observed amongst females, rural areas and respondents from low income groups. Surprisingly stigmatising (adjusted OR 1.31 (0.78-2.18) and discriminating (adjusted OR 0.79 (0.43-1.44) attitudes were independent of knowledge regarding TB. Stigmatising and discriminating attitudes towards TB patients remain high among the general population in India. Since these attitudes were independent of the knowledge regarding TB, it is possible that the current disseminated knowledge regarding TB which is mainly from a medical perspective may not be adequately addressing the factors that lead to stigma and discrimination towards TB patients. Therefore, there is an urgent need to review the messages and strategies currently used for disseminating knowledge regarding TB among general population and revise them appropriately. The disseminated knowledge should include medical, psycho-social and economic aspects of TB that not
Full Text Available Abstract Introduction Sildenafil (Viagra® is one of the drugs used in the first line therapy of male erectile dysfunction (MED. We have recorded outcomes, adverse events and acceptability of Sildenafil (Viagra therapy in an unselected group of men presenting with ED to a British district general hospital. Methods In this prospective observational study, 147 men with ED were seen since Oct 1999. Study patients were reviewed at 4, 12 and 52 weeks. All the patients filled the International Index of Erectile Function (IIEF questionnaire and were asked about their willingness to pay (WTP for treatment. Results All suitable men accepted Viagra as first line therapy. 91% of our patients found sildenafil treatment successful. 80% of these patients were willing to continue with sildenafil therapy. Side effect profile of sildenafil was different in this study with much higher incidence of headache, dyspepsia, flushing and abnormal vision. 92% of men with ED expect to be treated by the NHS. Of those men eligible for treatment in the NHS, 30% qualify under the clinical categories and 18% under the 'distress' category. Only 55% of those with cardiovascular risk factors qualify for NHS treatment. Conclusions Sildenafil is widely accepted as first line therapy among British men with ED and has a success rate of 91%. Nearly half of men with ED qualify for NHS treatment. Nearly half of those with vascular risk factors do not qualify for NHS treatment. Most men with ED could possibly be managed in primary care.
Spencer, Jonathan; Smith, Andrew; Woods, David
To determine whether a time delay of greater than 6 h from injury to surgical debridement affected the infection rate in open long-bone fractures in a typical district general hospital in the UK. Prospective audit over 5 years. 142 open long-bone fractures in 130 patients were seen over a 5-year period between 1996 and 2001 in our hospital. 115 fractures in 103 patients were available for study. The data were collected prospectively in weekly audit meetings. Patients were followed until clinical or radiological union occurred or until a secondary procedure for non-union or infection was carried out. Surgical debridement was carried out in less than 6 h from injury in 60% of cases and in greater than 6 h from injury in 40% of cases. Infection rates were 10.1% and 10.8%, respectively. We could not demonstrate a significantly increased infection rate in patients in whom surgical debridement occurred greater than 6 h after injury.
Strandberg, Eva Lena; Ovhed, Ingvar; Borgquist, Lars; Wilhelmsson, Susan
Background The definition of primary care varies between countries. Swedish primary care has developed from a philosophic viewpoint based on quality, accessibility, continuity, co-operation and a holistic view. The meaning of holism in international literature differs between medicine and nursing. The question is, if the difference is due to different educational traditions. Due to the uncertainties in defining holism and a holistic view we wished to study, in depth, how holism is perceived by doctors and nurses in their clinical work. Thus, the aim was to explore the perceived meaning of a holistic view among general practitioners (GPs) and district nurses (DNs). Methods Seven focus group interviews with a purposive sample of 22 GPs and 20 nurses working in primary care in two Swedish county councils were conducted. The interviews were transcribed verbatim and analysed using qualitative content analysis. Results The analysis resulted in three categories, attitude, knowledge, and circumstances, with two, two and four subcategories respectively. A professional attitude involves recognising the whole person; not only fragments of a person with a disease. Factual knowledge is acquired through special training and long professional experience. Tacit knowledge is about feelings and social competence. Circumstances can either be barriers or facilitators. A holistic view is a strong motivator and as such it is a facilitator. The way primary care is organised can be either a barrier or a facilitator and could influence the use of a holistic approach. Defined geographical districts and care teams facilitate a holistic view with house calls being essential, particularly for nurses. In preventive work and palliative care, a holistic view was stated to be specifically important. Consultations and communication with the patient were seen as important tools. Conclusion 'Holistic view' is multidimensional, well implemented and very much alive among both GPs and DNs. The word
Full Text Available Background: Evidence should drive public health initiatives to better address the most important health issues. Chronic diseases represent the main burden of healthcare expenditure in Western countries and are determined by risk factors related to behaviour. Population-based surveys should lead to well informed decision making in this field. Methods: A cross-sectional survey was carried out among the general population aged between 18 and 69 in the district of Monza-Brianza in Northern Italy through phone interviews. A validated questionnaire investigating health-related lifestyles and behaviours was used. The questionnaire was divided into the following parts: general health status, physical activity, smoking habit, nutrition, alcohol consumption, driving safety, cardiovascular risk, cancer screening, mental health, domestic safety and socio-economic status. Results: In total, 308 interviews were carried out (response rate=76%. Almost 40% reported a body mass index >25, 64.9% had high school or university degrees, 60.4% worked full-time, 26.2% were assessed as physically inactive, and 13.3% were on a weight –loss diet. In addition, 19.7% had an “at risk” alcohol consumption , especially among younger age groups. Symptoms of depression were identified in 4.9% of the study subjects, particularly in women. Conclusions: Age, body mass index, education, and occupation were significantly associated with the likelihood of reporting poor health status. Young subjects were more likely to be smokers and drinkers at risk. Psychological health and appropriate prescription of anti-cholesterol and anti-hypertensive drugs areì areas deserving further investigations. Nutrition, physical activity, driving safety and youth health, especially concerning drinking
Background: Evidence should drive public health initiatives to better address the most important health issues. Chronic diseases represent the main burden of healthcare expenditure in Western countries and are determined by risk factors related to behaviour. Population-based surveys should lead to well informed decision making in this field.
Methods: A cross-sectional survey was carried out among the general population aged between 18 and 69 in the district of Monza-Brianza in Northern Italy through phone interviews. A validated questionnaire investigating health-related lifestyles and behaviours was used. The questionnaire was divided into the following parts: general health status, physical activity, smoking habit, nutrition, alcohol consumption, driving safety, cardiovascular risk, cancer screening, mental health, domestic safety and socio-economic status.
Results: In total, 308 interviews were carried out (response rate=76%. Almost 40% reported a body mass index >25, 64.9% had high school or university degrees, 60.4% worked full-time, 26.2% were assessed as physically inactive, and 13.3% were on a weight –loss diet. In addition, 19.7% had an “at risk” alcohol consumption , especially among younger age groups. Symptoms of depression were identified in 4.9% of the study subjects, particularly in women.
Conclusions: Age, body mass index, education, and occupation were significantly associated with the likelihood of reporting poor health status. Young subjects were more likely to be smokers and drinkers at risk. Psychological health and appropriate prescription of anti-cholesterol and anti-hypertensive drugs areì areas deserving further investigations. Nutrition, physical activity, driving safety and youth health, especially concerning drinking
Herath, H M M; Weerasinghe, N P; Dias, H; Weerarathna, T P
Type 2 diabetes mellitus (DM) has become a global epidemic with significant disability and premature death. Identification of the level of knowledge, attitude and practice (KAP) related to diabetes among the general public is important in strategies for prevention of diabetes mellitus. This study was conducted as a community based cross sectional study in three Medical Officers of Health (MOH) areas in Galle district. Previously healthy literate individuals who have not attended any diabetes education program in the last two years were selected for this study. A total of 277 participants were included in the study. The majority (77%) had either moderate (39%) or above moderate knowledge (38%) on diabetes mellitus. Even though, level of education was significantly and positively associated with knowledge (p = 0.001), the association of gender and age with knowledge was not significant. Unlike knowledge, the attitude towards diabetes was poor in majority (90%) and level of education had no significant effect on attitude. With regards to practices, more than half of study subjects never had their blood sugar checked and, about 65% used to take refined sugar liberally and a large majority (80%) had no regular exercise activity. Even though the majority (77%) had moderate or above moderate knowledge on diabetes, their attitudes towards diabetes was poor (88%). It appears that the higher knowledge on diabetes did not translate into good practices as over 50% of study subjects did not involve with any preventive measures. Therefore, more emphasis should be given to address the issue of poor attitude and practices towards diabetes mellitus among general public in Sri Lanka.
H. M. M Herath
Full Text Available Abstract Background Type 2 diabetes mellitus (DM has become a global epidemic with significant disability and premature death. Identification of the level of knowledge, attitude and practice (KAP related to diabetes among the general public is important in strategies for prevention of diabetes mellitus. Methods This study was conducted as a community based cross sectional study in three Medical Officers of Health (MOH areas in Galle district. Previously healthy literate individuals who have not attended any diabetes education program in the last two years were selected for this study. Results A total of 277 participants were included in the study. The majority (77% had either moderate (39% or above moderate knowledge (38% on diabetes mellitus. Even though, level of education was significantly and positively associated with knowledge (p = 0.001, the association of gender and age with knowledge was not significant. Unlike knowledge, the attitude towards diabetes was poor in majority (90% and level of education had no significant effect on attitude. With regards to practices, more than half of study subjects never had their blood sugar checked and, about 65% used to take refined sugar liberally and a large majority (80% had no regular exercise activity. Conclusions Even though the majority (77% had moderate or above moderate knowledge on diabetes, their attitudes towards diabetes was poor (88%. It appears that the higher knowledge on diabetes did not translate into good practices as over 50% of study subjects did not involve with any preventive measures. Therefore, more emphasis should be given to address the issue of poor attitude and practices towards diabetes mellitus among general public in Sri Lanka.
Vermont Center for Geographic Information — The Forestry Districts layer is part of a dataset that contains administrative boundaries for Vermont's Agency of Natural Resources. This is a layer file which...
Vermont Center for Geographic Information — This dataset is a representation overlay of warden (areas of responsibility). The Vermont Warden Districts layer is part of a dataset that contains administrative...
Vermont Center for Geographic Information — The Wildlife Districts layer is part of a larger dataset contains administrative boundaries for Vermont's Agency of Natural Resources. The dataset includes feature...
Vermont Center for Geographic Information — The Wastewater districts layer is part of a larger dataset that contains administrative boundaries for Vermont's Agency of Natural Resources. The dataset includes...
Vermont Center for Geographic Information — The Parks Districts layer is part of a dataset contains administrative boundaries for Vermont's Agency of Natural Resources. The dataset includes feature classes for...
Vermont Center for Geographic Information — The Fisheries districts data layer is part of a larger dataset that contains administrative boundaries for Vermont's Agency of Natural Resources. The dataset...
This paper describes an approach to school district planning that examines overall objectives, ongoing operations, values, performance criteria, performance outcomes, and costs. The method utilizes seven general data files to assess school district activities in terms of educational and economic criteria. These files consist of: three structural…
In this paper, we look at the inner workings of a school district through the lens of the "district operating system (DOS)," a set of interlocking mutually-reinforcing modules that includes functions like procurement, contracting, data and IT policy, the general counsel's office, human resources, and the systems for employee and family…
Derias, Mina; Subramanian, Ashok; Allan, Simon; Shah, Elizabeth; Teraifi, Hassan El; Howlett, David
Invasive lobular carcinoma (ILC) accounts for 5-15% of breast cancers. In comparison to other types of breast cancer, ILC is more likely to be associated with multifocal and contralateral breast involvement as well as a tendency to a diffuse infiltrative growth pattern which can represent a diagnostic challenge. The National Institute of Clinical Excellence guidelines in 2009 recommended the use of magnetic resonance imaging (MRI) in the preoperative assessment of ILC. This study aims to assess compliance with the guidelines in two District General Hospitals and the utility of MRI in the investigation of ILC. All cases of ILC between 2011 and 2013 were retrospectively identified from the pathology database and their breast imaging findings, pathology report, and operative intervention were reviewed. A total of 126 patients were identified with ILC, of these 46 had MRI preoperatively (36.5%). MRI upgraded mammography/ultrasound diagnoses in 10 patients (21.7%). MRI showed multicentric unilateral disease in 17 patients (37.0%) occult on ultrasound/mammogram, with these patients undergoing mastectomy and 16/17 (94.1%) confirmed multifocality on pathology. MRI showed a contralateral lesion in 9 patients (19.6%), four (8.7%) of which were malignant and had bilateral surgery, and five (10.9%) were benign on further imaging/biopsy. MRI also downgraded three patients (6.5%) to unifocal disease with reported multifocal appearances on mammography/ultrasound, and these patients underwent breast-conserving surgery. MRI adds significant additional information to mammograms/ultrasound in ILC and should be undertaken in all such cases preoperatively assuming no contraindication. © 2016 Wiley Periodicals, Inc.
Page S20: NMR compound 4i. Page S22: NMR compound 4j. General: Chemicals were purchased from Fluka, Merck and Aldrich Chemical Companies. All the products were characterized by comparison of their IR, 1H NMR and 13C NMR spectroscopic data and their melting points with reported values. General procedure ...
This document describes the Boise geothermal district heating project from preliminary feasibility studies completed in 1979 to a fully operational system by 1983. The report includes information about the two local governments that participated in the project - the City of Boise, Idaho and the Boise Warm Springs Water District. It also discusses the federal funding sources; the financial studies; the feasibility studies conducted; the general system planning and design; design of detailed system components; the legal issues involved in production; geological analysis of the resource area; distribution and disposal; the program to market system services; and the methods of retrofitting buildings to use geothermal hot water for space heating. Technically this report describes the Boise City district heating system based on 170/sup 0/F water, a 4000 gpm production system, a 41,000 foot pipeline system, and system economies. Comparable data are also provided for the Boise Warm Springs Water District. 62 figs., 31 tabs.
In Greater Stockholm more than ten municipalities operate more or less extensive district heating networks, whereas a couple of municipalities have still not decided in principle what form of heating will be employed in the future. About 1,2 million people live and work in these municipalities, which together occupy an area of about 1500 km 2 . In this general survey the planning of the extensive work in the municipalities and the alternatives of heat systems in Greater Stockholm, including large integrated district heating systems based on nuclear dual-purpose plants as well as systems based on fossil fuels and several combined plants are discussed. (M.S.)
District heating has been used in Switzerland for more than 50 years. Its share of the heat market is less than 3% today. An analysis of the use of district heating in various European countries shows that a high share of district heating in the heat market is always dependent on ideal conditions for its use. Market prospects and possible future developments in the use of district heating in Switzerland are described in this paper. The main Swiss producers and distributors of district heating are members of the Association of District Heating Producers and Distributors. This association supports the installation of district heating facilities where ecological, energetical and economic aspects indicate that district heating would be a good solution. (author) 2 tabs., 6 refs
California Natural Resource Agency — State Water Project District boundaries are areas where state contracts provide water to the district in California. This database is designed as a regions polygon...
California Natural Resource Agency — Private Water District boundaries are areas where private contracts provide water to the district in California. This database is designed as a regions polygon...
Vermont Center for Geographic Information — This dataset is a representation overlay of Lieutenant Chief Warden Districts (areas of responsibility). The Vermont Lieutenant Chief Warden Districts layer is part...
California Department of Resources — State Water Project District boundaries are areas where state contracts provide water to the district in California. This database is designed as a regions polygon...
California Department of Resources — This is a series of district layers pertaining to California'spolitical districts, that are derived from the California State Senateand State Assembly information....
Vermont Center for Geographic Information — (Link to Metadata) Vermont School Districts and one Interstate School District. Part of data sets which model Vermont's education system governance boudaries for...
California Natural Resource Agency — This is a series of district layers pertaining to California'spolitical districts, that are derived from the California State Senateand State Assembly information....
Iowa State University GIS Support and Research Facility — The National Register Historic District layer is a shape file showing the boundaries of Historic Districts that are listed on the National Register of Historic Places.
Kansas Data Access and Support Center — Each coverage contains a COVER-ID field that defines the House or Senate district number. Kansas House and Senate districts were created by the Legislative Research...
California Department of Resources — Private Water District boundaries are areas where private contracts provide water to the district in California. This database is designed as a regions polygon...
Kolkman, PME; Luteijn, AJ; Nasiiro, RS; Bruney, [No Value; Smith, RJA; Meyboom-de Jong, B
District nurses constitute the basis of the primary health care services in Dominica. All encounters of three district nurses were registered using the international classification of primary care. Information on other aspects of district nursing was collected by participating observation and the
Department of Surgery, University of Cape Town Health Sciences Faculty, Groote Schuur Hospital, Observatory, Cape Town,. South Africa ... included all district, regional and tertiary hospitals in the nine provinces. Clinics and so-called ..... large contingency of senior general surgeons from countries such as Cuba, who have ...
Cauda equina syndrome: is the current management of patients presenting to district general hospitals fit for purpose? A personal view based on a review of the literature and a medicolegal experience.
Todd, N V
There is no universally agreed definition of cauda equina syndrome (CES). Clinical signs of CES including direct rectal examination (DRE) do not reliably correlate with cauda equina (CE) compression on MRI. Clinical assessment only becomes reliable if there are symptoms/signs of late, often irreversible, CES. The only reliable way of including or excluding CES is to perform MRI on all patients with suspected CES. If the diagnosis is being considered, MRI should ideally be performed locally in the District General Hospitals within one hour of the question being raised irrespective of the hour or the day. Patients with symptoms and signs of CES and MRI confirmed CE compression should be referred to the local spinal service for emergency surgery. CES can be subdivided by the degree of neurological deficit (bilateral radiculopathy, incomplete CES or CES with retention of urine) and also by time to surgical treatment (12, 24, 48 or 72 hour). There is increasing understanding that damage to the cauda equina nerve roots occurs in a continuous and progressive fashion which implies that there are no safe time or deficit thresholds. Neurological deterioration can occur rapidly and is often associated with longterm poor outcomes. It is not possible to predict which patients with a large central disc prolapse compressing the CE nerve roots are going to deteriorate neurologically nor how rapidly. Consensus guidelines from the Society of British Neurological Surgeons and British Association of Spinal Surgeons recommend decompressive surgery as soon as practically possible which for many patients will be urgent/emergency surgery at any hour of the day or night. ©2015 The British Editorial Society of Bone & Joint Surgery.
Elementary Assessment Handbook; a self-assessment handbook for compliance with the laws relating to elementary school boards of trustees and the state board of education policies for the general operation of a school district.
Arizona State Dept. of Education, Phoenix.
As an alternative to assessments conducted by the State Department of Education, Arizona school districts can use this handbook for self evaluation of their compliance with school law, which is basically controlled by Arizona Revised Statute (ARS) Title 15 and State Board of Education policy. This handbook is divided into seven parts which…
Earth Data Analysis Center, University of New Mexico — This layer represents boundaries for New Mexico tax district "OUT" categories and incorporated/municipal "IN" categories as identified on the "Certificate of Tax...
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset portrays the boundaries of the County Council Districts in Allegheny County. The dataset is based on municipal boundaries and City of Pittsburgh ward...
Vermont Center for Geographic Information — The Solid waste management districts layer is part of a dataset that contains administrative boundaries for Vermont's Agency of Natural Resources. This dataset...
Earth Data Analysis Center, University of New Mexico — The dataset represents the boundaries of all public school districts in the state of New Mexico. The source for the data layer is the New Mexico Public Education...
Vermont Center for Geographic Information — The ACT 250 Districts layer is part of a larger dataset that contains administrative boundaries for Vermont's Agency of Natural Resources. The dataset includes...
National Oceanic and Atmospheric Administration, Department of Commerce — This layer depicts the 115th Congressional Districts for the United States, with attributes listing the elected officials for the 115th Congress. Elected to a...
Montgomery County of Maryland — The purpose of a Floodplain District Permit (FPDP) is to control floodplain development in order to protect persons and property from danger and destruction and to...
Kansas Data Access and Support Center — This dataset outlines the location of the five Groundwater Management Districts in Kansas. GMDs are locally formed and elected boards for regional groundwater...
Persson, Urban; Werner, Sven
Highlights: ► European excess heat recovery and utilisation by district heat distribution. ► Heat recovery in district heating systems – a structural energy efficiency measure. ► Introduction of new theoretical concepts to express excess heat recovery. ► Fourfold potential for excess heat utilisation in EU27 compared to current levels. ► Large scale excess heat recovery – a collaborative challenge for future Europe. -- Abstract: Increased recovery of excess heat from thermal power generation and industrial processes has great potential to reduce primary energy demands in EU27. In this study, current excess heat utilisation levels by means of district heat distribution are assessed and expressed by concepts such as recovery efficiency, heat recovery rate, and heat utilisation rate. For two chosen excess heat activities, current average EU27 heat recovery levels are compared to currently best Member State practices, whereby future potentials of European excess heat recovery and utilisation are estimated. The principle of sequential energy supply is elaborated to capture the conceptual idea of excess heat recovery in district heating systems as a structural and organisational energy efficiency measure. The general conditions discussed concerning expansion of heat recovery into district heating systems include infrastructure investments in district heating networks, collaboration agreements, maintained value chains, policy support, world market energy prices, allocation of synergy benefits, and local initiatives. The main conclusion from this study is that a future fourfold increase of current EU27 excess heat utilisation by means of district heat distribution to residential and service sectors is conceived as plausible if applying best Member State practice. This estimation is higher than the threefold increase with respect to direct feasible distribution costs estimated by the same authors in a previous study. Hence, no direct barriers appear with
Samina Yasmin; Suleman; Hanif Ullah, et al.
Scabies is a contagious disorder of skin caused by a mite called human itch mite, Sarcoptes scabiei. An epidemiological study of scabies was conducted from district Haripur to evaluate the prevalence and the important risk factors responsible for the spread of scabies. The study was conducted in General population from (February - April 2013).Surveys were carried out in general population comprising 200 families of district Haripur. Out of two hundred families in general population, 81 were s...
Bliss, J; While, A
Much has been written regarding the challenges facing district nursing in light of the constant change and development of the NHS. This paper follows the chronological development of district nursing up to the reorganization of the NHS in 1974. The paper commences with a brief outline of the origins of district nursing as a charitable activity before the inception of the NHS and moves on to consider the relationship between district nurses and general practitioners. A review of policy and legislation identifies that district nurses, in the early days of the NHS, were working for the GP, no longer an autonomous practitioner of a charitable organization. Other challenges experienced by district nurses included being employed by the Local Health Authority, a separate organization to the NHS. By exploring the clinical practice of district nurses, alongside the management and organization of district nursing it is possible to critically discuss the challenges facing district nurses in the current health care climate of teamwork and collaboration.
Full Text Available Yinbing Wu,1,2 Mingxin Pan,1 Shuzhong Cui,2 Mingchen Ba,2 Zulong Chen,2 Qiang Ruan2 1Second Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, 2Treatment Center of Body Cavitary Thermo-Perfusion, Cancer Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China Background: This study aimed to evaluate the efficacy and safety of ultrasound-guided continuous hyperthermic intraperitoneal perfusion chemotherapy (CHIPC for the treatment of malignant ascites (MA. Methods: Between July 2011 and June 2013, 36 MA patients were prospectively and consecutively hospitalized for three cycles of elective CHIPC under ultrasound guidance, maintained at a constant flow rate of 400–600 mL/min normal saline containing 5-fluorouracil plus mitomycin or carboplatin and at a constant temperature of 43°C±0.2°C, for 90 minutes. Main outcome measures were ascites resolution, Karnofsky performance status (KPS, and serum tumor biomarkers at 2 weeks after the last cycle of CHIPC. All the patients underwent uneventful CHIPC as scheduled, and vital signs remained stable over CHIPC. Results: At 2 weeks after the last cycle of CHIPC, MA completely and partially resolved in 26 (72.2% patients and eight (22.2% patients, respectively; mean KPS score increased from pretreatment 61±9 to posttreatment 76±9 (P<0.001, and serum carcinoembryonic antigen and carbohydrate antigens 12-5 and 19-9 significantly decreased (all P<0.01. Conclusion: The current study indicated that ultrasound-guided CHIPC is an effective and safe palliative treatment modality for MA with respect to MA resolution, patient’s general well-being, and systemic disease control. The long-term benefit of CHIPC on overall survival remains to be investigated in MA patients. Keywords: continuous hyperthermic intraperitoneal perfusion chemotherapy, malignant ascites, peritoneal carcinomatosis, ultrasound guidance, safety
Goldschmidt, Dorthe; Groenvold, Mogens; Johnsen, Anna Thit
BACKGROUND: Palliative home-care teams often cooperate with general practitioners (GPs) and district nurses. Our aim was to evaluate a palliative home-care team from the viewpoint of GPs and district nurses. METHODS: GPs and district nurses received questionnaires at the start of home-care and on...
... Energy Regulatory Commission Public Utility District No. 1 of Klickitat County, Washington; Notice of... Competing Applications On May 1, 2012, the Public Utility District No. 1 of Klickitat County, Washington...: Mr. John Smith, General Manager, Public Utility District No. 1 of Klickitat County, 1313 S. Columbus...
NSGIC Local Govt | GIS Inventory — Community Development Districts (CDDs) are special taxing districts or local units of special-purpose government. A CDD may charge separate non-ad valorem special...
Larson, Nicole; Davey, Cynthia; Hoffman, Pamela; Kubik, Martha Y.; Nanney, Marilyn S.
Objective To compare the strength of district wellness policies with corresponding school-level practices reported by principals and teachers. Design District-level wellness policy data was collected from school district websites and, if not available online, by requests made to district administrators in the fall of 2013. The strength of district policies was scored using the Wellness School Assessment Tool. School-level data were drawn from the 2012 Minnesota School Health Profiles principal and teacher surveys and National Center for Education Statistics Common Core Data. Generalized estimating equations which accounted for school-level demographics and the nesting of up to two schools within some districts were used to examine 10 district policy items and 14 school-level practices of relevance to nutrition standards, nutrition education and wellness promotion, and physical activity promotion. Setting/Subjects Statewide sample of 180 districts and 212 public schools in Minnesota. Results The mean number of energy-dense, nutrient-poor snack foods and beverages available for students to purchase at school was inversely related to the strength of district wellness policies regulating vending machines and school stores (p=0.01). The proportion of schools having a joint use agreement for shared use of physical activity facilities was inversely related to the strength of district policies addressing community use of school facilities (p=0.03). No associations were found between the strength of other district policies and school-level practices. Conclusions Nutrition educators and other health professionals should assist schools in periodically assessing their wellness practices to ensure compliance with district wellness policies and environments supportive of healthy behaviors. PMID:25990324
Fearnley, R.; Susak, W. [City of Vancouver, BC (Canada); Johnstone, I. [BCG Services Inc., Vancouver, BC (Canada)
The concept of district energy was introduced in the City of North Vancouver, a city of 45,000, in 1997. A preliminary study was completed in 1997, followed by a tour of some district energy facilities in Finland in the same year. In 1999 a large district energy study was completed by a consultant. The study indicated the need for an investment of $15 million to implement district heating in the City. Lack of sufficient financial resources and immediately connectable heat load, the project was considered a non-starter. Some of the other factors leading to shelving the project included no current significant pricing advantages over competing energy sources and no current opportunity for cogeneration, given the low price that BC Hydro is willing to pay for independently produced power. The project, although shelved for the moment, has not been discarded. Planning and exploration are continuing, aided by the City's commitment to energy efficiency and conservation, its long term planning horizon and its significant influence over the development of some prime real estate.
School districts have resorted to hiring debt collectors, employing constables, and swapping out standard meals for scaled-back versions to try to coerce parents to pay off school lunch debt that, in recent years, appears to have surged as the result of a faltering economy and better record-keeping. While the average school lunch costs just about…
Minnesota State Office of the Legislative Auditor, St. Paul. Program Evaluation Div.
Minnesota spends more for education than most states and has increased its financial commitment steadily over the past 15 years. Because of the state's dominant role in education funding, legislators have enacted measures requiring all local school districts to follow uniform financial accounting and reporting standards (UFARS). Since 1980, the…
Earth Data Analysis Center, University of New Mexico — This data represents the NM Department of Transportation District boundaries as legislatively defined (i.e. these are not maintenance defined districts).
Earth Data Analysis Center, University of New Mexico — This dataset contains boundaries of the New Mexico Forestry Districts, plus the names of the district offices. It is in a vector digital structure digitized from a...
McLoone, Eugene P.
All school districts are affected by the stagnant economy, the growing needs of the public sector, the increased burden of transfer payments, and the limited growth of public revenues. Retrenchment is common to all school districts, but it may be more severe in affluent districts. By 1969-70, suburban school systems were the clear-cut expenditure…
The proceedings of the 7th International District Heating Conference contain the full texts of the 89 presented papers of which 11 fall under the INIS Subject Scope. The conference met in seven sessions and dealt with the following problem areas: design and optimization of systems of district heating, integration of the power system and the district heating systems, cooperation of nuclear and fossil burning sources in district heating systems, the use of specific nuclear power plants for heating purposes, questions of the control of systems of district heating, the development of components of heating networks, the reliability and design of heat supply pipes. (Z.M.)
Damecour, R.; Andersson, B. [Kattner/FVB District Energy Inc., Toronto, ON (Canada)
An overview of the development of district energy systems throughout the world is provided. Significant district energy data is provided for Canada, the United States, East Asia, Korea, Japan, China, Eastern Europe and Russia, Estonia, and Sweden. The overall conclusion is that district energy systems are here to stay and have a good chance of succeeding provided that the concept has the support of business, municipalities and national governments. The 40 years old district heating system in Vasteras, Sweden, the oldest and most successful district energy system in the world, was highlighted.
in a district heating system based on combined heat and power plants (CHP). A theoretical comparison of trigeneration (cooling, heating and electricity) systems, a traditional system and a recovery system is carried out. The comparison is based on the systems overall exergy efficiency. The traditional system......, R22 and R143a) are chosen to be representative for current refrigeration plants of the traditional and recovery system. Also different refrigeration cycle, one and two stage cycle is considered. The CHP plants considered is back-pressure and extraction plant. In general heat recovery is more...... beneficial if the district heating system is based on back-pressure rather than on extraction CHP plant. Heat recovery with extraction CHP plant is in general questionable. If heat recovery is considered it is recommendable to use two stage cycle rather than one stage cycle heat pump. Apportioning the costs...
described and analysed for their chemical, physical and mineralogical characteristics. Based on these data, general fertility is ... Key words: Pedological characteristics, fertility, soil classification, benchmark soils, Morogoro. District, Tanzania. INTRODUCTION .... under Eucalyptus spp . and Hyperrhenia spp . ustic. 6.
The aim of this Final Report, prepared for the project `Procedures for Selecting and Buying DistRict Heating Equipment - Sofia District Heating Company`, is to establish an overview of the activities accomplished, the outputs delivered and the general experience gained as a result of the project. The main objective of the project is to enable Sofia District Heating Company to prepare specifications and tender documents, identify possible suppliers, evaluate offers, etc. in connection with purchase of district heating equipment. This objective has been reached by using rehabilitation of sub-stations as an example requested by Sofia DH. The project was originally planned to be finalized end of 1995, but due to the extensions of the scope of work, the project has been prolonged until end 1997. The following main activities were accomplished: Preparation of a detailed work plan; Collection of background information; Discussion and advice about technical specifications and tender documents for sub-station rehabilitation; Input to terms of reference for a master plan study; Input to technical specification for heat meters; Collection of ideas for topics and examples related to dissemination of information to consumers about matters related to district heating consumption. (EG)
This paper describes the geology of the Streltsovskoye uranium district located in south-eastern Zabaikalie region, Chita Province, Siberia, Russia. This district hosts Russia's only currently active uranium production centre. The uranium ore was discovered from 1963 to 1967 by drilling below fluorite veins which had minor associated uranium mineralization and radioactive anomalies. The uranium occurs as large scale vein stockwork deposits of hydrothermal origin within a volcano-tectonic caldera formed by continental volcanism of Late Mesozoic age. Rocks occurring in the caldera include basalt and trachydacite, overlain by rhyolite, and with associated interbedded sediments. The ore bodies occur in steeply dipping faults, with the greatest concentrations located where faults along the margins of the caldera intersect steeply dipping, cross cutting, northeasterly and northwesterly striking faults. The Streltsovskoye caldera extends over an area of 150 km 2 and is underlain by a large batholith. The 19 identified uranium deposits occurred in structural features that cut through the caldera sequence and extend into the basement rocks. The caldera has a maximum thickness of 1400 metres. Details of several deposits are given, including descriptions of mineralization and associated alteration. (author). 10 figs
Estimation of prevalence of periodontal disease and oral lesions and their relation to CD4 counts in HIV seropositive patients on antiretroviral therapy regimen reporting at District General Hospital, Raichur.
Ravi, Jagganatha Rao; Rao, Tuthipat Ramachandra Gururaja
Acquired Immuno Deficiency Syndrome (AIDS) is a condition in which the body becomes susceptible to a host of opportunistic infections. This syndrome is a culmination of infection with a lenti virus called Human Immunodeficiency Virus (HIV) particularly HIV 1. A cross section of the population including adults and children are affected by HIV infection with estimate of 36.1 million affected by the end of 2014. HIV infection affects the T lymphocytes especially cluster of differentiation 4 (CD4) count reducing it drastically jeopardizing the acquired immunity. The advent of Anti Retroviral Therapy (ART) has proved as a ray of hope, at least reducing the misery and suffering although not permanently. This study attempts to understand the prevalence of periodontal disease and other oral lesions, further examining their relationship with CD4 counts in the HIV seropositive patients on ART. A total of 72 HIV positive patients on ART reporting at ART centre at Raichur District hospital were screened in the study for periodontal status, oral manifestations. The latest CD4 count values were obtained from the hospital records. The study showed a 36.11% of prevalence of periodontal disease; however no statistically significant association was seen with its relation to CD4 counts. Other oral manifestations were seen in 46% of patients with a high prevalence of Oral Candidiasis lesions and a positive association with CD 4 counts was seen. Under the limitations of this study no significant association was seen between CD4 counts and prevalence of periodontal disease however candiasis showed a stronger association. As HIV infection gradually becomes a chronic disease the features and course of chronic periodontal disease and other oral manifestations in HIV infected patients require more careful and extensive investigation.
Richter, S.; Hilbert, Lisbeth Rischel; Thorarinsdottir, R.I.
General corrosion rates in the geothermal district heating systems in Iceland are generally low, of the magnitude 1 lm/y. The reason is high pH (9.5), low-conductivity (200 lm/y) and negligible dissolved oxygen. The geothermal hot water is either used directly from source or to heat up cold ground...
This qualitative case study used General Systems Theory and social network analysis to explore the relationships between the members of a district central office and principals of elementary schools within an urban school district in the Midwest. Findings revealed sparse relationships between members of the district central office and principals,…
... Energy Regulatory Commission Public Utility District No. 1 of Snohomish County; Notice of Intent To File.... Submitted By: Public Utility District No. 1 of Snohomish County (Snohomish PUD). e. Name of Project: Sunset..., Assistant General Manager of Generation, Water and Corporate Services, Public Utility District No. 1 of...
This book provides guidelines for conducting internal audits of school districts. The first five chapters provide an overview of internal auditing and describe techniques that can be used to improve or implement internal audits in school districts. They offer information on the definition and benefits of internal auditing, the role of internal…
An economic study of nuclear district heating is concerned with: heat production, its transmission towards the area to be served and the distribution management towards the consumers. Foreign and French assessments show that the high cost of now existing techniques of hot water transport defines the competing limit distance between the site and township to be below some fifty kilometers for the most important townships (provided that the fuel price remain stationary). All studies converge towards the choice of a high transport temperature as soon as the distance is of some twenty kilometers. As for fossile energy saving, some new possibilities appear with process heat reactors; either PWR of about 1000MWth for large townships, or pool-type reactors of about 100MWth when a combination with an industrial steam supply occurs [fr
Di Nardo, Armando; Di Mauro, Anna
The management of a water supply network can be substantially improved defining permanent sectors or districts that enhances simpler water loss detection and pressure management. However, the water network partitioning may compromise water system performance, since some pipes are usually closed to delimit districts in order not to have too many metering stations, to decrease costs and simplify water balance. This may reduce the reliability of the whole system and not guarantee the delivery of water at the different network nodes. In practical applications, the design of districts or sectors is generally based on empirical approaches or on limited field experiences. The book proposes a design support methodology, based on graph theory principles and tested on real case study. The described methodology can help water utilities, professionals and researchers to define the optimal districts or sectors of a water supply network.
Vermont Center for Geographic Information — Historical Preservation overlay district, Westminster, Vermont. Other overlay overlay districts (Agricultural Land and Ridgeline Protection), and base zoning...
Vermont Center for Geographic Information — Cartographic version of overlay district (surface water buffer), Marlboro, Vermont. Base zoning districts are in a separate shapefile. Data were originally created...
NSGIC Local Govt | GIS Inventory — Polygons designating boundaries for state Senate Districts within Volusia County according to Senate Joint Resolution 2B State Senate Plan S016S9030 approved on...
Full Text Available The District of Codru – District or Land? The main objective of this paper is to demonstrate why the ethnographic Codru is a “district” (ținut and not a “land” (țară – the term used by most people. To achieve this goal, we analyzed the significance of the two concepts, as well as their characteristic elements. Following the first part of the paper we presented connotations that have known “district and land” over time, and in the second part we presented the differences between the two concepts, with application to the District of Codru. Presentation and analysis of the situation eventually led to support the fact that the ethnographic Codru is a “district” – a unique mental space.
National Oceanic and Atmospheric Administration, Department of Commerce — This data set is one component of a digital terrain model (DTM) for the Southwest Florida Water Management District's FY2006 Digital Orthophoto (B089) and LiDAR...
Cavell, I.W.; Peabody, C.O.
This report describes the District Gamma Survey carried out around the A.E.E., Winfrith since June, 1959. Its organisation, equipment and techniques are described, and the results obtained up to the 31st December, 1960 are given. (author)
Earth Data Analysis Center, University of New Mexico — This layer represents boundaries for New Mexico tax district "OUT" categories and incorporated/municipal "IN" categories as identified on the "Certificate of Tax...
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset demarcates the school district boundaries within Allegheny County If viewing this description on the Western Pennsylvania Regional Data Center’s open...
Vermont Center for Geographic Information — (Link to Metadata) Vermont General Assembly is periodically re-apportioned to reflect the state's changing population patterns. The current apportionment process is...
So, an attempt has been made to classify TC hazard proneness of districts by adopting a hazard criteria based on frequency and intensity of cyclone, wind strength, probable maximum precipitation, and probable maximum storm surge. Ninety-six districts including 72 districts touching the coast and 24 districts not touching ...
... Energy Regulatory Commission Public Utility District No. 1 of Snohomish County; Notice of Preliminary... by the Snohomish PUD. Applicant Contact: Steven J. Klein, General Manager, Public Utility District No... Applications May 14, 2010. On March 2, 2010, and supplemented on April 29, 2010, and May 4, 2010, Public...
... Irrigation District and Modesto Irrigation District; Notice of Intent To File License Application, Filing of...: Turlock Irrigation District and Modesto Irrigation District. e. Name of Project: Don Pedro Hydroelectric... Irrigation District, P.O. Box 949, Turlock, California 95381, 209-883-8241 and Greg Dias, Project Manager...
... Irrigation District, Modesto Irrigation District; Notice of Proposed Restricted Service List for a... any Order issuing a license. Turlock Irrigation District and Modesto Irrigation District, as the..., Sacramento, CA 95816. Robert Nees, or Representative, Turlock Irrigation District, P.O. Box 949, Turlock, CA...
... Irrigation District; Modesto Irrigation District; Notice of Proposed Restricted Service List for a... any Order issuing a license. Turlock Irrigation District and Modesto Irrigation District, as the..., Turlock Irrigation District, P.O. Box 949, Turlock, CA 95381. Greg Dias or Representative, Modesto...
Bordin, Chiara; Gordini, Angelo; Vigo, Daniele
District heating systems provide the heat generated in a centralized location to a set of users for their residential and commercial heating requirements. Heat distribution is generally obtained by using hot water or steam flowing through a closed network of insulated pipes and heat exchange
Data on illegal immigration from Mexico into Texas provide accurate information on the impact of this immigration on the generally underfunded and understaffed border school districts in the state. Immigration and Naturalization Service statistics show 20 million illegal immigrants in the United States. A more scientific estimate is 4 million, 2.7…
Association of School Business Officials International, Reston, VA.
Statement 34 is the most significant change in the history of governmental accounting. It is a dramatic change in the way school districts report and present financial information. This new reporting model affects every public-school organization that issues financial statements in conformity with generally accepted accounting principles (GAAP).…
Mead, Dean Michael
In March 2009, the Governmental Accounting Standards Board (GASB) issued Statement No. 54, "Fund Balance Reporting and Governmental Fund Type Definitions." School districts that prepare financial reports based on generally accepted accounting principles are required to implement this standard no later than the first fiscal year that starts after…
Reza MOHAMMADY GARFAMY
Full Text Available This paper provides a comparison study of industrial districts in two European countries, Spain and Sweden, using the conceptual framework of corporation. The relevance of this approach is based on the specific qualities that the industrial districts have, including the preexisting conditions, local traditions, products and production characteristics, marketing strategies, local policies and present challenges. The findings indicate the ways in which different patterns of inter-firm relationships, organization of production and dynamics of local alliances have shaped divergent regional responses to the industrial construction.
Chou, Chung-I.; Li, Sai-Ping
The Political Districting Problem is to partition a zone into several electoral districts subject to some constraints such as contiguity, population equality, etc. In this paper, we apply statistical physics methods to Political Districting Problem. This political problem is mapped to a q-state Potts model system, and the political constraints are written in the form of an energy function with the interactions between sites or external fields acting on the system. Districting into q voter districts is equivalent to finding the ground state of this q-state Potts model. We illustrate this problem by districting Taipei city and compare it to a computer-generated artificial system.
Full Text Available The underlying assumption of this study is that in order to retain the competitiveness while reaching for the EU targets regarding low-energy construction, district heating companies need to develop new business and service models. How district heating companies could broaden their perspective and switch to a more service-oriented way of thinking is a key interest of our research. The used methods in our study are house builder interviews and a questionnaire. With the help of these methods we discussed the potential interest in heating related services acquiring a comprehensive understanding of the customer needs. The results indicate the importance of certain criteria when choosing the heating system in households: easiness, comfort and affordability seem to dominate the house builders’ preferences. Also environmental awareness seems to be for many an important factor when making a decision about the heating of the house. Altogether, based on the results of this study, we suggest that the prospects of district heating could benefit from highlighting certain aspects and strengths in the future. District heating companies need to increase flexibility, readiness to adopt new services, to invest in new marketing strategies and improving the communication skills.
The first phase of research (100662) explored the dynamics of manganese in the ecosystem and its neurological effects on the adult population. A significant association was found between air exposure and the risk of neuromotor impairment. The project resulted in an ecosystem-based management plan to reduce ...
Clostridium difficileis one of the most important causes of diarrhoea especially following antibiotic course. Elderly population is more susceptible and results in significant mortality and morbidity. We audited twenty four cases of Clostridium difficile in our hospital over duration of three months. We looked into the demographic
Larson, Nicole; Davey, Cynthia; Hoffman, Pamela; Kubik, Martha Y; Nanney, Marilyn S
To compare the strength of district wellness policies with corresponding school-level practices reported by principals and teachers. District-level wellness policy data were collected from school district websites and, if not available online, by requests made to district administrators in the autumn of 2013. The strength of district policies was scored using the Wellness School Assessment Tool. School-level data were drawn from the 2012 Minnesota School Health Profiles principal and teacher surveys and the National Center for Education Statistics Common Core Data. Generalized estimating equations which accounted for school-level demographics and the nesting of up to two schools within some districts were used to examine ten district policy items and fourteen school-level practices of relevance to nutrition standards, nutrition education and wellness promotion, and physical activity promotion. State-wide sample of 180 districts and 212 public schools in Minnesota, USA. The mean number of energy-dense, nutrient-poor snack foods and beverages available for students to purchase at school was inversely related to the strength of district wellness policies regulating vending machines and school stores (P=0·01). The proportion of schools having a joint use agreement for shared use of physical activity facilities was inversely related to the strength of district policies addressing community use of school facilities (P=0·03). No associations were found between the strength of other district policies and school-level practices. Nutrition educators and other health professionals should assist schools in periodically assessing their wellness practices to ensure compliance with district wellness policies and environments supportive of healthy behaviours.
Zhang, J.; Zhang, J.; Huo, X.; Zheng, W.; Zheng, X.; Zhang, M.
Historic districts are a special type of cultural heritage, as living cultural heritage, the utilization and development of historical districts is an inevitable issue. How to accurately position the protection and utilization of districts and achieve its healthy and sustainable development is the key work in the protection of districts. In this paper, the Internet data including Tencent's location big data are employed to study some Chinese historic and cultural streets, establish protection and development index system for historic and cultural streets, carry out in-depth study of ten core indicators, and sum up the positioning and development direction for the protection and use of districts. Historic district, as a special type of cultural heritage, is the birthplace and supporting zone of urban context, and also the place for the daily life of the general public. It boasts profound historic and humanistic background and the characteristics of a living form. As the living cultural heritage, its use and development are necessary, and attention shall also be paid to static protection and dynamic comprehensive management. But judging from the current practice, protection and use of historic districts face a host of challenges. Some districts are devoid of popularity and vitality and become cold galleries. Some districts suffer excessive development for tourism and commercialism, and lose its "original" cultural characteristics. In addition, throngs of tourists exert a negative impact on the life of the local people and the protection of immovable cultural relics. Disorderly business format and increasingly similar landscape go against the presentation of local characteristics. We should regard historic district as a dynamic urban heritage, and achieve dynamic development and protection in accordance with its inherent development laws and the principle of "step by step" through the "organic update" mode, with emphasis on the continuous comprehensive management of
Agribotix GCS 077
information from Assembly members to community members and inadequate financial resources for the District ..... situations where multiple groups share a common resource that is fixed in nature, the chance that each will .... the Navrongo Health Research Centre (NHRC), a lottery method was used to select houses from.
President Barack Obama's announcement last week of a wide-ranging anti-violence plan in response to the Newtown, Connecticut, school shootings comes as many districts are adopting new and sometimes dramatic measures--including arming teachers and volunteers--intended to prevent similar tragedies in their own schools. School safety experts warn…
Lane, John J., Ed.
Development of marketing plans can assist not only public school districts in meeting recent competition but will also improve educational processes, increase revenue, and restore confidence in schools. This collection of articles describes a new role for school administrators--particulary for business managers: administrators as "entrepreneurs."…
Atwood, E. Barrett, Jr.
Advises careful analysis and improvement of existing school district accounting systems prior to investment in new ones. Emphasizes the importance of attracting and maintaining quality financial staffs, developing an accounting policies and procedures manual, and designing a good core accounting system before purchasing computer hardware and…
Full Text Available Implementation of security and peace, order and protection of the people especially those who are within the settlement is the duty and responsibility of member units of community protection (Satlinmas, and what happens when members Satlinmas in carrying out its duties and functions not supported by the human resources of adequate quality and quantity , so the expectations and desires of the community to get security and peace, order and public protection are not met in full and result in (Satlinmas presence cannot be felt by the community. The method used in this study using qualitative research with descriptive analysis, the data obtained through documentation, observation, and interviews, sample locations were selected based on purposive sample of Cilacap, Cilacap is a district that has accommodated the institutional Linmas the organizational structure of Civil Service Police Unit and a barometer for other regions in the implementation of the enforcement of local regulations. The purpose of the study wanted to know how far Satlinmas can act in accordance with its duties and functions. Research results that Satlinmas role in organizing disaster management, the handling of security, peace and order, protection of the public at the district level are generally already be implemented, but at the neighbourhood level and harmonious citizens tasks and functions are yet to be implemented optimally.
Army Corps of Engineers, Department of the Army, Department of Defense — St. Paul District - US Army Corps of Engineers Managed Facility locations. District headquarters, Natural Resource, Recreation, Lock and Dam, and Regulatory offices...
Vermont Center for Geographic Information — The following overlay districts are included in the data:Shoreline Protection OverlayFlood Hazard OverlayDetails about these overlay districts, as well as zoning...
Department of Homeland Security — This layer is a polygonal dataset that represents land and maritime boundaries for each representative United States Coast Guard district, which includes district 1,...
Schaupp, Frederick W.; Maust, Robert S.
A school district audit committee has the capacity to unearth pertinent information about the operating efficiency and effectiveness of a school district, as well as providing a more professional audit. (Author/WM)
Persson, Urban; Werner, Sven [School of Business and Engineering, Halmstad University, PO Box 823, SE-30118 Halmstad (Sweden)
competitiveness in low heat density areas. Hence, reduced heat demands in high heat density areas are not a general barrier for district heating in the future. (author)
... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 12745-002] Modesto Irrigation District and Turlock Irrigation District; Notice of Preliminary Permit Application Accepted for... February 1, 2010, Modesto Irrigation District and Turlock Irrigation District filed an application for a...
Cline, David S.
The vast majority of U.S. school districts are considered independent and have taxing authority; the remaining districts rely on revenue and budgetary approval from their local government. In the latter case, localities often use some form of negotiated process to determine the amount of revenue their school districts will receive. Typically, a…
... 7 Agriculture 8 2010-01-01 2010-01-01 false Grower districts. 982.31 Section 982.31 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... importance of production in each district and the number of growers in each district; (2) the geographic...
... 7 Agriculture 8 2010-01-01 2010-01-01 false District. 920.12 Section 920.12 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Definitions § 920.12 District. District means the applicable one of the following described subdivisions of...
Mounts, R.; Frazier, A.; Wood, E.; Pyles, O.
This report describes how several cities use groundwater and geothermal energy in district heating systems. It begins with groundwater, introducing the basic technology and techniques of development, and describing two case studies of cities with groundwater-based district heating systems. The second half of the report consists of three case studies of cities with district heating systems using higher temperature geothermal resources.
Florian, Judy; Hange, Jane; Copeland, Glenda
Nearly every state focuses on implementing standards-based systems but supports educational reform in as many different ways as there are states. An examination of 15 districts located in 13 states suggests, however, that some states and districts have policies and practices in common that support a district's capacity for reform, whether there is…
... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements..., ARIZONA, AND NEW MEXICO Definitions § 983.11 Districts. (a) Districts shall consist of the following: (1... States of Arizona and New Mexico. (b) With the approval of the Secretary, the boundaries of any district...
Caskey, John; Kuperberg, Mark
This article describes the budget crisis that the School District of Philadelphia has faced for the past few years. Three specific events triggered the 2012 crisis: an abrupt reduction in federal and state funding, the inability of the district to cut many of its costs, and political pressures on the district to spend available revenues in a given…
Full Text Available This paper focuses on new trends in district heating a cooling (DHC area and algorithms allowing incorporating new technologies and performing optimal control. Classical district heating usually means huge source (as heating plant and set of pipes which transfer heat energy through a medium, mostly water, across whole town and chilled water is returning back to the plant. Let’s imagine a modern city where buildings are consuming only a fraction of the energy contrary to what buildings required in the past. And especially during sunny or windy days, they have energy to spare. Around of such modern city is not only the one big heating plant, but perhaps solar and wind farms, waste incinerators, industrial companies with energy surpluses. Simply in this modern city are dozens, perhaps hundreds of small energy producers that share pipe network or at least part of it. In such a district energy system, production planning is more difficult. And not only production, modern houses with minimal heat loss and data connections also allow to plan consumption more effectively. The aim is to achieve the best solution evaluated by the objective function, usually determined by minimizing the production and distribution costs and providing meets the needs of energy consumers. The method presented in this paper is based on a simulation using the proposed holonic distributed model. This model also introduces the idea of general prosumers strategy, where all active elements within the modern DHC system are represented by prosumer objects. The prosumers are perceived as objects able to actively participate in the planning and realization of the production and consumption of energy. It is assumed that the general behaviour of the object in DHC is the same, no matter how they differ in size and design. Thus, all the objects are defined by two characteristics - the ability to produce and consume. The model based on this basic principle, of course, with the most
Full Text Available Purpose of the article: Regional development includes qualitative changes in economy (e.g. in production, investments, employment as well as qualitative changes (regarding the structure of economy and society, changes in the environment. The research of regional development is important and necessary in order to make appropriate decisions at the regional and local level. The main purpose of the article is comparative analysis of districts in the Lesser Poland Voivodship in the area of economic, social and ecological development. Scientific aim: The scientific aims of paper are verifying the hypothesis concerning eco-development and forecasting the level of regional development in districts of Lesser Poland Voivodship. Methodology/methods: In the research of regional development the quality index of economic, social and ecological development has been proposed which has been calculated on the basis of a certain aggregation of the results of the Principal Component Analysis made on the correlation matrix of standardised variables being the components of the index. Forecasts of the regional development level in districts were calculated with the use of different econometric models as linear model, exponential model, or power model. Findings: The findings prove that the Lesser Poland Voivodship is characterised by considerable disproportions in regional development. The most favourable conditions for economic and social development are in the districts with large city agglomerations as well as extensive municipality infrastructure and transport infrastructure. The presented results demonstrate that the majority of districts have not exhibited a constant tendency to changes in the positions in successive ranking lists in terms of the economic, social and ecological development. The positions occupied by most districts are generally stable and have not changed considerably in the examined period. Conclusions: The research has confirmed the negative
Haglund Stignor, Caroline [Swedish National Testing and Research Inst., Boraas (Sweden)
Cooling of the chiller condensers in supermarkets can be performed in different ways. To start with, the condensers can be cooled by use of outdoor air in dry coolers, but the ventilation air can also perform the cooling, totally or partially. In such a way the total or a part of the heating demand of the supermarket might be covered. A third alternative for condenser cooling is use of district cooling. However, in such a case the possibility to heat the supermarket by heat recovery is lost. The purpose of this study is to outline when district cooling offers the most advantageous alternative for condenser cooling in comparison to the other alternatives. This assessment is to be performed taking costs, electricity use and environmental impact into consideration separately. The results from calculations for a case supermarket show that the price for district cooling is generally to high for making it profitable for a supermarket to cool the condensers by district cooling. However, cooling the condensers by district cooling might lead to savings for the supermarket, both in terms of investments and use of electricity. This leads to the fact that cooling the condensers by district cooling could offer a profitable alternative for the supermarket, if the prices are adapted to this type of costumer. Hopefully, such a business could be profitable for the producers of district cooling as well. In addition, there are other advantages associated with condenser cooling by district cooling, which are hard to evaluate in economic terms. When it comes to the comparison of electricity use, it is shown that condenser cooling by district cooling is the alternative that uses least electricity in a national point of view, if the district cooling is produced by a deep-water source. In this comparison, the electricity used for production of district cooling and district heating is included as well. If district cooling is co-produced with district heating in heat pumps, the result is
Lyon, R.B.; Sochaski, R.O.
Current district heating trends are towards an increasing use of electricity. This report concerns the evaluation of an alternative means of energy supply - the direct use of thermal energy from CANDU nuclear stations. The energy would be transmitted via a hot fluid in a pipeline over distances of up to 40 km. Advantages of this approach include a high utilization of primary energy, with a consequent reduction in installed capacity, and load flattening due to inherent energy storage capacity and transport delays. Disadvantages include the low load factors for district heating, the high cost of the distribution systems and the necessity for large-scale operation for economic viability. This requirement for large-scale operation from the beginning could cause difficulty in the implementation of the first system. Various approaches have been analysed and costed for a specific application - the supply of energy to a district heating load centre in Toronto from the location of the Pickering reactor station about 40 km away. (author)
Steven, Thomas A.
horablendite, massive chlorite, or serpentinite where these masses are near or are cut by pegmatite bodies. Some of the deposits may be potential producers of commercial-grade vermiculite, but most are small and erratic in shape or grade.Fluorspar is the main mineral commodity that has been produced from the Northgate district. It was deposited during two distinct periods of mineralization, but only the younger deposits have been productive. Small bodies of silicified breccia containing minor coarsely crystalline fluorite occur along the Independence Mountain fault, and in a few places along other Laramide faults. The fluorspar is an integral part of the fault breccia and apparently was deposited while the enclosing fault was still active. The largest deposits of fluorspar in the Northgate district occur along the late Tertiary (?) faults on Pinkham Mountain. The fluorspar consists typically of botryoidal layers that formed as successive encrustations along open fractures, or as finely granular aggregates replacing and cementing fault gouge and White River formation. Many incompletely filled cavities, called water courses, still exist. Fluorite is the principal vein material; fragments of country rock constitute the chief impurity although finely granular quartz or chalcedony is common locally. Soft powdery manganese oxide coats many fractures and in places is associated with a fine white clay. Fluorspar was deposited in or adjacent to open spaces along the late Tertiary (?) faults. Fractures in hard granitic rocks tended to remain open after faulting and were the favored sites for fluorspar deposition; fractures in the less competent hornblende and hornblende-biotite gneiss and schist generally were tight and little fluorspar was deposited. The White River rocks, although soft, were permeable and were widely impregnated or replaced by fluorspar. Both of the main vein zones are along faults that have predominant rightlateral strike-slip displacement. As they theoretically
The relationships between student achievement, school district economies of scale, school district size and student socioeconomic status were measured for 131 school districts in the state of Oregon. Data for school districts ranging in size from districts with around 300 students to districts with more than 40,000 students were collected for…
Hodkin, Katherine Story
Duties of the staff of media centers in the Salt Lake City School District and an analysis of task performances by position are listed. Positions included are: (1) head of the school media center/school media specialist, (2) school media center technician, (3) school media center aide, and (4) student aides. Twenty general district operational…
Dujardin B, Haelterman E, Van Damme W, Kegels G. The adequacy of one sputum smear for diagnosing pulmonary tuberculosis. Am J Pubi Hlth 1997; 87: 1234-1235. 16. Narain R, Nair SS, Naganna К, Chandrasekhar P, Ramanatha Rao G, Lai P. Problems in defining a "case" of pulmonary tuberculosis in prevalence ...
Ottosson, Peter [AaF-Energikonsult Syd AB (Sweden)
Often the choice is between reparation or exchange of a damaged section of the network. If the exchange is based on the wrong assumptions, large sections of undamaged pipelines could be removed. Most important for the district heating company is to decide which strategy to use for the future exchange of the pipelines. Whichever strategy used, it has to based on an assessment of the network and/or assumptions based on that assessment. The question if it is possible extend the life span of the pipelines arises. What is the most economical choice, the exchange or the renovation. (au)
... to the Turlock Irrigation District's Tuolumne Substation; (2) 23-mile-long, 69-kV Don Pedro-Hawkins Line extending from the Don Pedro switchyard to the Turlock Irrigation District's Hawkins Substation...
Lund, Henrik; Werner, Sven; Wiltshire, Robin
This paper defines the concept of 4th Generation District Heating (4GDH) including the relations to District Cooling and the concepts of smart energy and smart thermal grids. The motive is to identify the future challenges of reaching a future renewable non-fossil heat supply as part...... of the implementation of overall sustainable energy systems. The basic assumption is that district heating and cooling has an important role to play in future sustainable energy systems – including 100 percent renewable energy systems – but the present generation of district heating and cooling technologies will have...
Full Text Available Ahlat district has suitable topography for growing of agricultural products. Almost half of Ahlat district is suitable for agricultural. Today, 32.7% of the land use in Ahlat is agricultural area. 90% of agricultural area is dry farming area. 10% of agricultural area is irrigated. 60.3%of land use in Ahlat district is pasturage area. The economy of Ahlat is based on agricultural and animal husbandry. Today, agricultural products such as wheat, potato and sugar beet are grown in agricultural areas. Ahlat district has some problems like unplanned production, irrigation and marketing.
Gary G. Huang
Full Text Available School restructuring raises questions about the role of school districts in improving student learning. Centralization by state governments and decentralization to individual schools as proposed in systemic reform leave districts' role unsettled. Empirical research on the district role in the context of ongoing reform is inadequate. This analysis of combined data from the NAEP and the Common Core of Data (CCD was intended to address the issue. We analyzed 1990, 1992, and 1996 NAEP 8th grade mathematics national assessment data in combination with CCD data of corresponding years to examine the extent to which student achievement was related to districts' control over instructional expenditure, adjusting for relevant key factors at both district and student levels. Upon sample modification, we used hierarchical linear modeling (HLM to estimate the relationships of student achievement to two district fiscal policy indictors, current expenditure per pupil (CEPP and districts' discretionary rates for instructional expenditure (DDR. Net of relevant district factors, DDR was found unrelated to districts' average 8th grade math performance. The null effect was consistent in the analysis of the combined NAEP-CCD data for 1990, 1992, and 1996. In contrast, CEPP was found related to higher math performance in a modest yet fairly consistent way. Future research may be productive to separately study individual states and integrate the findings onto the national level.
As policy directives gather pace for service provision to be delivered in primary care, district nursing has not been recognised as a valuable asset to facilitate this agenda. Investment in district nursing and specialist district nursing education has fallen. This is concurrent with an ageing district nursing workforce, a lack of recruitment and growing caseloads, as district nursing adapts to meet the challenges of the complexities of contemporary healthcare in the community. The district nurse role is complex and multifaceted and includes working collaboratively and creatively to coordinate care. Redressing the shortages of specialist district nurse practitioners with increased numbers of health care support workers will not replace the skill, knowledge, experience required to meet the complex care needs of today's society. District nursing needs to be reinstated as the valuable asset it is, through renewed investment in the service, research development and in specialist practice education. To prevent extinction district nurses need to be able to demonstrate and articulate the complexities and dynamisms of the role to reinstate themselves to their commissioners as a valuable asset for contemporary practice that can meet current health and social care needs effectively. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.
Armour-Brown, A.; Tukiainen, T.; Wallin, B.
A short review is given of reconnaissance work in South Greenland. The work has demonstrated that there are areas in the Motzfeldt centre of at least 1 km 2 with continuously high radioactivity. If the uranium content of these radioactive zones are sufficiently high, then potential ore tonnages could prove to be substantial. The reconnaissance exploration has proved that uranium mineralization is widely distributed in the Narssaq-Narssarssuaq district. It is, no doubt, responsible for the high uranium values in the exploration geochemical samples. Although the size of the pitchblende occurences which have been found so far are small, the high grade of the mineralisation, the great frequency of the fracturing and the evidence for an all pervasive mineralising event over a wide area indicate that there is a good possibility of finding economic mineralisation within the Narssaq-Narssarssuaq area. The area as a whole may, perhaps, be termed a ''uranium mineral district''. As the potential targets are small, only detailed follow-up exploration will establish this. At the same time more detailed work on individual showings, and geological mapping to demonstrate the relative ages of the various petrological and mineralising events, will establish the possible origin of this uranium mineralisation. (author)
Espinosa, Ruben W.
The educational community and the courts continue to struggle with the challenges of intra-district resource inequality revealed by the California Supreme Court landmark case "Rodriguez v. Los Angeles Unified School District" (1992). Intra-district school resource inequality is one of the remaining bastions of major inequalities in the…
Reinagel, Tyler P.
School districts across the United States are often forced into situations where limited public funds must be distributed among multiple districts. These are often reliant on distribution rates negotiated by district leadership and elected officials. An example of this is Georgia's 1% Education Local Option Sales Tax (ELOST). The tax is collected…
Full Text Available District health systems (DHS are central to the global efforts to improve health outcomes but many remain ineffective. In many lowresource settings, despite the generally weak DHS there is evidence that some districts consistently perform well against the odds, and this is often attributed to the calibre of managers leading such districts and their management and leadership (M&L skills. This paper examines the M&L practices of district health managers in high and low performing districts in Indonesia in an attempt to understand whether the differences in the performance of DHS can be explained, at least in part, by the differences in the performance of their health managers. We employed a mixed methods case study design focusing on two purposefully selected districts. Data were collected in 2011 using questionnaires and in-depth interviews. The preliminary results suggest that M&L practices of managers in the high and low performing districts are similar and provide little explanation for the differences in the performance of the two DHS. Contextual and health system factors offered a much better explanation for the variations in DHS performance.
A first document addresses the nuclear risk with some generalities (definition, occurrence, consequences for people and for the environment with an indication of exposure thresholds, presentation of individual safety directives), a discussion of the nuclear risk level in the district (history, contamination threats, preventive actions for the Cattenom nuclear plant, existence of a triple barrier for radioactive product containment, other factors aimed at nuclear safety, urban development control, control of nuclear activities, information, rescue organisation, map of concerned communes). The second document addresses the risk related to radioactive material transport with some generalities (definition, occurrence, consequences for persons and goods, individual safety directive in case of road or railway accident), a more detailed analysis of the risk in the district (situation of the radioactive material transport in the district, risk history, human and environmental stakes, preventive actions, radiation protection safety challenges, safety factors, control of transports, rescue organisation)
Determinants of perinatal mortality in Marondera district, Mashonaland East Province of Zimbabwe, 2009: a case control study. ... Health worker training in emergency management of obstetric and neonatal care was initiated. Marondera District started holding perinatal mortality meetings. Key words: Perinatal mortality, ...
More districts realize that communicating in a clear and engaging way with stakeholders about everything from the district's overall education vision to scholastic and extracurricular success stories can go a long way toward enlisting broad community support. And although face-to-face communications are still important, technology provides a…
Albuquerque Public Schools, NM.
This study compares salaries as well as benefits of school district personnel in the nine metropolitan school districts that include Albuquerque, New Mexico; Denver, Colorado; El Paso, Texas; Memphis, Tennessee; Phoenix and Tucson, Arizona; Wichita, Kansas; and Mobile, Alabama. The tables aggregate all the elements in the total compensation…
... line from the northeast corner of Solano County to the town of Rio Vista. (d) El Dorado District... County, Shasta County, Tehama County, Modoc County, Siskiyou County, Lassen County, Plumas County, and Colusa County. (b) Central Sacramento Valley District includes and consists of Sutter County, Butte...
This paper considers a basic question that many schools districts face in attempting to develop affordable, expandable district-wide computer networks that are resistant to obsolescence: Should these wide area networks (WANs) employ wireless technology, stick to venerable hard-wired solutions, or combine both. This publication explores the…
Background/Context: Partnering across districts, schools, and other community organizations has become ubiquitous as a policy for promoting change. Despite growing attention to and scholarship on district-community partnerships, there is little examination of the organizational mechanisms involved in sustaining them. Purpose/Objectives: This study…
Owens, Ann; Reardon, Sean F.; Jencks, Christopher
Although trends in the racial segregation of schools are well documented, less is known about trends in income segregation. We use multiple data sources to document trends in income segregation between schools and school districts. Between-district income segregation of families with children enrolled in public school increased by over 15% from…
Pincus, John: Williams, Richard C.
Reports on what researchers discovered in their study of five urban school districts that were labeled "innovative." Provides a conceptual framework that takes into account five factors that seemed critical to a district's success or failure in implementing change. (Author/IRT)
Introduction: Uganda is vulnerable to several natural, man-made and a hybrid of disasters including drought, famine, floods, warfare, and disease outbreaks. We assessed the district disaster team's performance, roles and experiences following the training. Findings: The disasters most commonly experienced by the district ...
School librarians in the Mesquite Independent School District (ISD) have been operating solo on their campuses since the 1970s. Campus clerical assistance in the school libraries was a luxury that they couldn't afford. Since the district's vision was of a teaching librarian, a Library Processing Department was established in 1972. As years passed,…
Home; Journals; Journal of Earth System Science; Volume 124; Issue 3. Cyclone hazard proneness of districts of India ... Thus classification of TC hazard proneness of the coastal districts is very essential for planning and preparedness aspects of management of TCs. So, an attempt has been made to classify TC hazard ...
Woulfin, Sarah L.; Donaldson, Morgaen L.; Gonzales, Richard
Purpose: Educator evaluation systems have recently undergone scrutiny and reform, and district and school leaders play a key role in interpreting and enacting these systems. This article uses framing theory to understand district leaders' interpretation and advancement of a state's new educator evaluation policy. Research Methods: The article…
Sometimes all it takes is a little fate to accomplish something great, or in this case, something green. The Broward County Public School (BCPS) District shows how a natural disaster (Hurricane Wilma) inspired a green revolution. This article presents the five steps that the Broward County School District followed in implementing an Environmental…
This article analyses the process of creating districts. It ..... The process of the creation of districts was assessed as follows in a recent report: 46 Section 181 (1) of the Constitution. 47 Section 181 (2) of the Constitution. 48 Section .... The report notes, among other things, the concealment of cash transactions from scrutiny ...
Perez-Mora, Nicolas; Bava, Federico; Andersen, Martin
Both district heating and solar collector systems have been known and implemented for many years. However, the combination of the two, with solar collectors supplying heat to the district heating network, is relatively new, and no comprehensive review of scientific publications on this topic coul...
Chou, C.-I [Department of Physics, Chinese Culture University, Taipei, Taiwan 111 (China)]. E-mail: firstname.lastname@example.org; Li, S.-P. [Institute of Physics, Academia Sinica, Taipei, Taiwan 115 (China)
The aim of the Political Districting Problem is to partition a territory into electoral districts subject to some constraints such as contiguity, population equality, etc. In this paper, we apply statistical physics methods to Political Districting Problem. We will show how to transform the political problem to a spin system, and how to write down a q-state Potts model-like energy function in which the political constraints can be written as interactions between sites or external fields acting on the system. Districting into q voter districts is equivalent to finding the ground state of this q-state Potts model. Searching for the ground state becomes an optimization problem, where optimization algorithms such as the simulated annealing method and Genetic Algorithm can be employed here.
Chou, Chung-I.; Li, Sai-Ping
The aim of the Political Districting Problem is to partition a territory into electoral districts subject to some constraints such as contiguity, population equality, etc. In this paper, we apply statistical physics methods to Political Districting Problem. We will show how to transform the political problem to a spin system, and how to write down a q-state Potts model-like energy function in which the political constraints can be written as interactions between sites or external fields acting on the system. Districting into q voter districts is equivalent to finding the ground state of this q-state Potts model. Searching for the ground state becomes an optimization problem, where optimization algorithms such as the simulated annealing method and Genetic Algorithm can be employed here.
Chen, Yuche [National Renewable Energy Laboratory (NREL), Golden, CO (United States)
Automated vehicles (AVs) are increasingly being discussed as the basis for on-demand mobility services, introducing a new paradigm in which a fleet of AVs displace private automobiles for day-to-day travel in dense activity districts. This project examines such a concept to displace privately owned automobiles within a region containing dense activity generators (jobs, retail, entertainment, etc.), referred to as an automated mobility district (AMDs). The project reviews several such districts including airport, college campuses, business parks, downtown urban cores, and military bases, with examples of previous attempts to meet the mobility needs apart from private automobiles, some with automated technology and others with more traditional transit based solutions. The issues and benefits of AMDs are framed within the perspective of intra-district, inter-district, and border issues, and the requirements for a modeling framework are identified to adequately reflect the breadth of mobility, energy, and emissions impact anticipated with AMDs.
Goldschmidt, Dorthe; Groenvold, Mogens; Johnsen, Anna Thit
BACKGROUND: Palliative home-care teams often cooperate with general practitioners (GPs) and district nurses. Our aim was to evaluate a palliative home-care team from the viewpoint of GPs and district nurses. METHODS: GPs and district nurses received questionnaires at the start of home-care and one...... month later. Questions focussed on benefits to patients, training issues for professionals and cooperation between the home-care team and the GP/ district nurse. A combination of closed- and open-ended questions was used. RESULTS: Response rate was 84% (467/553). Benefits to patients were experienced...... by 91 %, mainly due to improvement in symptom management, 'security', and accessibility of specialists in palliative care. After one month, 57% of the participants reported to have learnt aspects of palliative care, primarily symptom control, and 89% of them found cooperation satisfactory...
Nilsson, Stefan Forsaeus [SP Technical Research Institute of Sweden, Building Technology and Mechanics, P.O. Box 24036, SE-400 22 Goeteborg (Sweden); Reidhav, Charlotte [Chalmers University of Technology, Department of Civil and Environmental Engineering, SE-412 96 Goeteborg (Sweden); Lygnerud, Kristina [Goeteborg University, School of Business, Economics and Law, Department of Business Administration, P.O. Box 610, SE-405 30 Goeteborg (Sweden); Werner, Sven [Chalmers University of Technology, Department of Energy and Environment, SE-412 96 Goeteborg (Sweden)
This paper presents a review of the sparse district-heating research programme undertaken in Sweden between 2002 and 2006. The goal of the programme was to increase the future competitiveness for district heat in low heat density areas, e.g., suburban single-family houses and small villages. Such areas are unfavourable, since revenues from heat sold are low compared with the investment cost for the local distribution network. In Sweden, district heat has a dominant position in the heat market for residential and service-sector buildings. In order for the business to grow, it is necessary to increase the rate of expansion in the detached-house segment. This is why the programme was initiated. The extent of the programme was set at EUR 3.6 million with equal financing from the Swedish District-Heating Association and the Swedish Energy-Agency. The research was carried out in three phases: a state of the art survey; a development phase focused on productivity gains where new research on both technology and customer interaction was performed; and finally a demonstration phase where new methods were tested in full-scale field operation. The programme has shown that the Swedish district-heating industry needs to adjust in order to reach a higher profitability for sparse district-heating investments. Tradition from large-scale high-density district heating is hard to scale to fit sparse district-heating systems. For example, the construction becomes very labour intensive and the industry is weak when it comes to market-oriented business logic, sales and private customer interaction. Innovation seems to be a way forward and active management of innovations is a way to create increased value of the investments. Other keys to improving the profitability of sparse district-heating investments are more efficient working routines (resulting in higher productivity) and revised ways of customer communications. These seem more important than increasing efficiency in district
Full Text Available BACKGROUND: Following the 1971 ban of DDT in Bangladesh, malaria cases have increased steadily. Malaria persists as a major health problem in the thirteen south-eastern and north-eastern districts of Bangladesh. At present the national malaria control program, largely supported by the Global Fund for AIDS, Tuberculosis and Malaria (GFATM, provides interventions including advocacy at community level, Insecticide Treated Net (ITN distribution, introduction of Rapid Diagnostic Tests (RDT and combination therapy with Coartem. It is imperative, therefore, that baseline data on malaria prevalence and other malaria indicators are collected to assess the effectiveness of the interventions and rationalize the prevention and control efforts. The objective of this study was to obtain this baseline on the prevalence of malaria and bed net use in the thirteen malaria endemic districts of Bangladesh. METHODS AND PRINCIPAL FINDINGS: In 2007, BRAC and ICDDR,B carried out a malaria prevalence survey in thirteen malaria endemic districts of Bangladesh. A multi-stage cluster sampling technique was used and 9750 blood samples were collected. Rapid Diagnostic Tests (RDT were used for the diagnosis of malaria. The weighted average malaria prevalence in the thirteen endemic districts was 3.97%. In five south-eastern districts weighted average malaria prevalence rate was 6.00% and in the eight north-eastern districts weighted average malaria prevalence rate was (0.40%. The highest malaria prevalence was observed in Khagrachari district. The majority of the cases (90.18% were P. falciparum infections. Malaria morbidity rates in five south-eastern districts was 2.94%. In eight north-eastern districts, morbidity was 0.07%. CONCLUSION AND SIGNIFICANCE: Bangladesh has hypoendemic malaria with P. falciparum the dominant parasite species. The malaria situation in the five north-eastern districts of Bangladesh in particular warrants urgent attention. Detailed maps of the
Đorđević Jadranka Đ.
Full Text Available Kinship terminology includes a variety of terms used to identify and address kinsmen. This paper deals with nominal kinship categories, used for blood or fictive kinsmen in the district of Vranje during the second half of the 20th century. In addition, some old-fashioned, long-used kinship terms were also noted down. In addition to the similarities with the kinship terminology used among Serbs in general, the terminology used in the area of Vranje has a couple of specifics of its own. These specifics originated in the particular cultural and social environment of Vranje. The appellations of (paternal uncle, wife of father's brother, uncle, father-in-law and mother-in-law are just a few of the specific terms used in the area examined. A kinship relation as well as the maintenance of the bond is based on emotional attachment and life-interest similarities. This is illustrated in the usage of personal names in direct communications instead of kinship terms. On the other hand, some archaic kin appellations are still in use which indicates that the formation of the new terms does not imply the disappearance of the old ones. The concurrent usage of the old and new terms characterizes the kinship terminology, where changes act in a less visible manner. In sum, kinship terminology is a complex subject that offers a number of possibilities for understanding various aspects of the kinship system and segments of a given society.
Vermont Center for Geographic Information — Conservation and Recreatioal Protection overaly districts for the Town of Winhall, Vermont. Other overlay districts (Transfer of Development Rights, and Scenic...
This paper presented an analysis of the technical and economic characteristics of district energy in Ontario. The market context for district energy was evaluated, and institutional issues that may influence the future development and operation of district energy systems in Ontario were explored. Technical, economic, and environmental analyses of district energy based on different neighbourhood sizes, types, and district energy systems were presented. Three case studies were included to demonstrate real world district energy applications. A set of interviews conducted with representatives of the province's district energy supply chain was also provided in order to provide a framework for district energy opportunities and challenges within the province. 22 tabs., 16 figs.
... BY PUBLIC ACCOMMODATIONS AND IN COMMERCIAL FACILITIES Enforcement § 36.503 Suit by the Attorney... discretion, the Attorney General may commence a civil action in any appropriate United States district court...
Olga Valeryevna Dyomina
Full Text Available The article explores ways of state regulation of natural monopolies, shows their generalized classification. Two main ways of direct regulation are described: costs-based and stimulating. It is shown that there is an overwhelming trend of changing ways of regulation to less state-controlled. On the example of the district heating market of Russia the article shows the failing of the acting costs-based type of regulation. It is concluded that the main task of changing regulation is destroying the connection between tariffs and heat producer’s costs. The alternative way for district heating reform is a stimulating type of regulation based on price limits (the price of ‘heat-only boilers’. The author made estimates of gains received as a result of the reform for participants of three largest district heating markets of the Far East. It is shown that annual increase rates of tariffs for consumers will be: Vladivostok – 5.0%, Khabarovsk – 8.8%, Blagoveshchensk – 11.1%. The estimates do not support the estimates of Russian Ministry of Energy specialists according to which the annual increase rate is expected to be about 0.6%
Full Text Available Historic districts are a special type of cultural heritage, as living cultural heritage, the utilization and development of historical districts is an inevitable issue. How to accurately position the protection and utilization of districts and achieve its healthy and sustainable development is the key work in the protection of districts. In this paper, the Internet data including Tencent’s location big data are employed to study some Chinese historic and cultural streets, establish protection and development index system for historic and cultural streets, carry out in-depth study of ten core indicators, and sum up the positioning and development direction for the protection and use of districts. Historic district, as a special type of cultural heritage, is the birthplace and supporting zone of urban context, and also the place for the daily life of the general public. It boasts profound historic and humanistic background and the characteristics of a living form. As the living cultural heritage, its use and development are necessary, and attention shall also be paid to static protection and dynamic comprehensive management. But judging from the current practice, protection and use of historic districts face a host of challenges. Some districts are devoid of popularity and vitality and become cold galleries. Some districts suffer excessive development for tourism and commercialism, and lose its “original” cultural characteristics. In addition, throngs of tourists exert a negative impact on the life of the local people and the protection of immovable cultural relics. Disorderly business format and increasingly similar landscape go against the presentation of local characteristics. We should regard historic district as a dynamic urban heritage, and achieve dynamic development and protection in accordance with its inherent development laws and the principle of “step by step” through the “organic update” mode, with emphasis on the
Away from petroleum, is the slogan used by all politicians. And the sellers of power energies keep repeating this and interpret it as they like. But none ofthose responsible tells the public with what to heat if not with petroleum. Those offering district heating consider themselves to have the biggest chances for the area after fuel oil. Although the costs of district heating are enormously high. The people should be suspicious if district heating projects are given new economical weight under the perspective of creating new places of employment.
Full Text Available General understanding of the law indicates that the product areas that are made bythe local government, in no way can be separated from the system perundamginvitationnationally. Local regulations made by independent government units(autonomous and Environment Authority an independent anyway. Therefore, doneagainst higher level legislation should not be solely based on pertingkatan, but ratheron the environment authority. in Indonesia is beside as further the elaboration oflegislation on it which produces district regulation delegasian, as well as the specialconditions in passenger areas that generate self-contained district regulation.
Sakamoto, A; Matsuo, K; Kawai, K; Yoshida, K; Fukuda, K; Nakano, M; Nakatani, A; Tsuchiyama, H; Tagawa, H
Three rare autopsy cases of fetal ascites were presented and the etiology of each case was described. Case 1 was a male neonate, delivered by cesarean section at 32 weeks' gestation, and died of respiratory failure. The abdomen was remarkably distended with 1020 ml of ascites. The etiology of Case 1 remained unknown even after macroscopic and microscopic examinations. We considered this as "idiopathic" fetal ascites. Case 2 was a female neonate, delivered at 31 weeks' gestation, with marked abdominal distension and cyanosis. Autopsy revealed 435 ml of ascites, and she was considered to have had "polysplenia syndrome" with cardiovascular malformations. Intrauterine heart failure due to cardiac anomalies was thought to be the cause of this ascites. In case 3 embryotomy was carried out under the diagnosis of fetal ascites by ultrasound examination at 22 weeks' gestation. An urachal cyst connected to the dilated urinary bladder and deficiency of musculature of the abdominal wall composed of loose connective tissue with calcification were observed. The abdominal wall was ruptured and 1,960 ml of ascites was measured. Polycystic kidney with renal dysplasia was also found. Case 3 showed "Prune-Berry syndrome" and fetal ascites may have arisen from these anomalies.
Background: The abdomen is the sixth most common site of extra-pulmonary tuberculosis. The clinical manifestations of abdominal tuberculosis are varied and non-specific. It is known to mimic a variety of abdominal disorders and may be missed, leading to delay in appropriate management and poor prognosis.
... Patient Education & Resource Center GI Health and Disease Recursos en Español What is a Gastroenterologist Video and ... Education & Resource Center Home GI Health and Disease Recursos en Español What is a Gastroenterologist? Podcasts and ...
Cerebrospinal fluid ascites is one complication of ventriculoperitoneal shunt surgery. This case reports a 7year old child with abdominal distention five years after ventriculoperitoneal shunt insertion for hydrocephalus secondary to aqueductal stenosis. The child had a history of multiple shunt revisions. Liver, cardiac and ...
Raed M Alsulaiman
Full Text Available Eosinophilic gastroenteritis is a rare gastrointestinal (GI disorder characterized by nonspecific GI symptoms, peripheral eosinophilia, and eosinophilic infiltration of the intestinal wall. The disorder is classified into mucosal, muscular, and sub-serosal types, depending on the clinical picture and the depth of eosinophilic infiltration within the GI wall. Sub-serosal disease, which is complicated by ascites, usually results in the most severe clinical form of eosinophilic gastroenteritis and requires early corticosteroid therapy. In such cases, a favorable outcome can be achieved after a short course of corticosteroids. We present the case of a 28-year-old female with diffuse abdominal pain and distention for 2 weeks. Her physical examination was significant for moderate ascites. Initial work-up demonstrated severe peripheral blood eosinophilia, normal liver function tests, and elevated serum immunoglobulin E (IgE. Upper endoscopy, colonoscopy showed a thickening of the stomach and colon, and biopsies showed marked eosinophilic infiltration of the mucosa. Ascitic fluid analysis showed significant eosinophilia. Subsequent treatment with oral prednisone resulted in the normalization of laboratory and radiologic abnormalities 45 days after the start of the treatment. Despite its rarity, eosinophilic gastroenteritis needs to be recognized by the clinician because the disease is treatable, and timely diagnosis and initiation of treatment could be of major importance.
Nilsson; Hannus, M.
The role foreseen for the SECURE (Safe Environmentally Clean Urban REactor) nuclear district heating plant is to provide the baseload heating needs of primarily the larger and medium size urban centers that are outside the range of waste heat supply from conventional nuclear power stations. The rationale of the SECURE concept is that the simplicity in design and the inherent safety advantages due to the use of low temperatures and pressures should make such reactors economically feasible in much smaller unit sizes than nuclear power reactors and should make their urban location possible. It is felt that the present design should be safe enough to make urban underground location possible without restriction according to any criteria based on actual risk evaluation. From the environmental point of view, this is a municipal heat supply plant with negligible pollution. Waste heat is negligible, gaseous radioactivity release is negligible, and there is no liquid radwaste release. Economic comparisons show that the SECURE plant is competitive with current fossil-fueled alternatives. Expected future increase in energy raw material prices will lead to additional energy cost advantages to the SECURE plant
Sato, K. (Hot Springs Research Center, Japan)
In the Hokuriku district including Toyama, Ishikawa, and Fukui Prefectures, hot springs of more than 25/sup 0/C were investigated. In the Toyama Prefecture, there are 14 hot springs which are located in an area from the Kurobe River to the Tateyama volcano and in the mountainous area in the southwest. In Ishikawa Prefecture there are 16 hot springs scattered in Hakusan and its vicinity, the Kaga mountains, and in the Noto peninsula. In northern Fukui Prefecture there are seven hot springs. The hot springs in Shirakawa in Gifu Prefecture are characterized as acid springs producing exhalations and H/sub 2/S. These are attributed to the Quaternary volcanoes. The hot springs of Wakura, Katayamazu, and Awara in Ishikawa Prefecture are characterized by a high Cl content which is related to Tertiary andesite. The hot springs of Daishoji, Yamanaka, Yamashiro, Kuritsu, Tatsunokuchi, Yuwaku, and Yunotani are characterized by a low HCO/sub 3/ content. The Ca and SO/sub 4/ content decreases from east to west, and the Na and Cl content increases from west to east. These fluctuations are related to the Tertiary tuff and rhyolite. The hot springs of Kuronagi, Kinshu, and Babadani, located along the Kurobe River are characterized by low levels of dissolved components and high CO/sub 2/ and HCO/sub 3/ content. These trends are related to late Paleozoic granite. Hot springs resources are considered to be connected to geothermal resources. Ten tables, graphs, and maps are provided.
Full Text Available Scabies is a contagious disorder of skin caused by a mite called human itch mite, Sarcoptes scabiei. An epidemiological study of scabies was conducted from district Haripur to evaluate the prevalence and the important risk factors responsible for the spread of scabies. The study was conducted in General population from (February - April 2013.Surveys were carried out in general population comprising 200 families of district Haripur. Out of two hundred families in general population, 81 were scabetic showing a prevalence rate of 40.5%.Considering an individual as a unit, 109cases were detected, out of these total samples of 1193 individuals, exhibiting a prevalence rate of 9.13%.The disease was significantly more common in females (10.4%than males(7.9%,in lower socio-economic classes (13.8% than the upper and middle classes (5.22%,7.16%, in those living in uncemented houses (23.6% than those living in cemented houses (7.5%,and in those having domestic animals at home(13.4%than those without domestic animals(8.08%. Family size was of no significance but prevalence was positively co-related with the level of crowding (average number of person per room in a house. No clear trend was indicated in the prevalence rate of scabies changing with educational level. The distribution of the number of cases per family followed a Poisson distribution, demonstrating that all the families surveyed were equally exposed to the risk of scabies.
Jensen, Jesper Ole
model for sustainability profiles for districts in Copenhagen that includes environmental, social and environmental indicators. The work is strongly inspired by the Dutch model 'DPL' (Dutch acronym for Duurzaamheid Prestatie voor een Locatie, ‘Sustainability-Profile for Districts'), which has been quite...... The paper concerns the development of sustainability profiles for districts in Copenhagen. This work is currently being carried out by the Danish Building Research Institute, the Technical University of Copenhagen, and the municipality of Copenhagen. The aim of the project is to develop a first...... successful in the Netherlands. The developer of DPL, IVAM Environmental Research, is consultant for the project. The concept of DPL is that the tool ".. assesses in a clear and transparent way the spatial plan for a district on sustainability, based on the information from the urban plan. It so helps...
Earth Data Analysis Center, University of New Mexico — This layer represents boundaries for New Mexico tax district "OUT" categories and incorporated/municipal "IN" categories as identified on the "Certificate of Tax...
The Author surveys the trend that has been established over the last two decades in the use of district heating in Italy. Comparison with the European situation reveals that Italy is lagging behind. The reason for this the Author states is the Italian public's aversion to unknown risks involved in the utilization of innovative technologies associated with cogeneration/district heating (current preference is given to autonomous methane fuelled building space heating systems), and the current opinion of some misinformed public administrations that cogeneration/district heating plants are too costly. Citing the successful campaign by the natural gas industry to promote the public acceptance of methane as a safe, readily available and competitively priced energy source, he suggests that similar efforts be made to have the public also accept cogeneration (with methane fired gas turbines)/district heating as being safe and environmentally, as well as, economically beneficial
Vermont Center for Geographic Information — Tax Increment Financing (TIF) Districts is established by a municipality around an area that requires public infrastructure to encourage public and private real...
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset demarcates the Pennsylvania Senate district boundaries within Allegheny County. If viewing this description on the Western Pennsylvania Regional Data...
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This webmap demarcates municipal voting districts in Allegheny County. If viewing this description on the Western Pennsylvania Regional Data Center’s open data...
Minnesota Department of Natural Resources — District boundaries for wild, scenic, and recreational rivers designated under the Minnesota State Wild and Scenic Rivers Act. Includes portions of the Minnesota...
Vermont Center for Geographic Information — The following Overlay District Data is included:Design Review OverlayInstitutional Core Campus OverlayRH Density Bonus OverlayNatural Resource Protection OverlayRL...
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset shows the magisterial districts in Allegheny County. If viewing this description on the Western Pennsylvania Regional Data Center’s open data portal...
Department of Education — School District Finance Survey, 2013–14 (F-33 2013–14) is a study that is part of the Common Core of Data (CCD) program; program data is available since 1989–90 at ....
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This webmap demarcates municipal voting districts in Allegheny County. If viewing this description on the Western Pennsylvania Regional Data Center’s open data...
Mikulandric, Robert; Krajačić, Goran; Khavin, Gennadii
more extensively used in district heating systems either separately or as a supplement to traditional fossil fuels in order to achieve national energy policy objectives. However, they are still facing problems such as high intermittences, high energy production costs and low load factors as well...... could reach up to 20% with utilisation of solar energy as supplement energy source in traditional fossil fuel based district heating systems. In this work, the performance of hybrid district energy system for a particular location will be analysed. For performance analysis, mathematical model......District heating system could contribute to more efficient heat generation through cogeneration power plants or waste heat utilization facilities and to increase of renewable energy sources share in total energy consumption. In the most developed EU countries, renewable energy sources have been...
Hilbert, Lisbeth Rischel; Thorarinsdottir, R.I.; Andersen, A.
A three-year project - financially supported by the Nordic Industrial Fund - on monitoring of corrosion in district heating systems has been initiated with participation of researchers and industrial partners in Denmark, Finland, Iceland, Norway and Sweden. The primary objective of the project...... is to improve the quality control in district heating systems by corrosion monitoring. In Danish systems electrochemical impedance spectroscopy (EIS), linear polarisation resistance (LPR), high-sensitive electrical resistance (ER) technology, crevice corrosion probes, as well as weight loss coupons...
Laurent, Michel; Collignon, Albert; Bara, Simona; Degre, Delphine; Mouchel, Dominique; Poncet, Jean-Marc; Troussard, Xavier
This document proposed a summarized version and a full version of a study on cancer epidemiology in the Manche district in which are located four nuclear sites of different nature and with different potential risks: the Flamanville nuclear plant (with the EPR under construction), the La Hague Areva nuclear fuel processing plant, the Manche storage site, and the Cherbourg arsenal. It describes the missions of the two cancer registries regarding the Manche region population (the general cancer registry for the Manche district, and the specialized registry of hematologic malignancies for the Basse-Normandie region), discusses the post-accidental management of a nuclear accident, presents the levels of the various basic indicators of cancer epidemiology survey (share of cancers in global mortality and factors of risk cancer, radio-induced cancers), compares cancer occurrence in the Manche district and in France and outlines some peculiarities of cancer occurrence in the Manche district, comments the cartography of cancer occurrence in the Manche district over the 1999-2010 period (solid cancers, hematologic malignancies)
The current status of and problems facing district heating systems operated by electric utilities were identified. The technical and economic factors which can affect the present and future success of district heating systems in the United States were evaluated. A survey of 59 district heating electric utilities was conducted to determine the current status of the industry. Questions developed to obtain data on technical, economic, regulator, and marketing factors were included in the survey. Literature on district heating in the U.S. and abroad was collected from governments, industry and foreign sources and reviewed to aid in evaluating the current and future potential of the industry. Interviews were held with executives of 16 utilities that operate district heating systems in order to determine corporate attitudes. A summary of the literature obtained is provided. Survey results are tabulated and described. The interviews and survey data were used to compile 10 case studies of utilities operating district heating systems under a braod range of circumstances.
Volume 19 Issue 1 January 2014 pp 1-2 General Editorial. General Editorial on Publication Ethics · R Ramaswamy · More Details Fulltext PDF. Volume 19 Issue 1 January 2014 pp 3-3 General Editorial. Academy Policy on Plagiarism · More Details Fulltext PDF. Volume 22 Issue 1 January 2017 pp 1-3 General Editorial.
Partington, Gordon Geoffrey
Discusses controversies concerning the use of generalizations in history. Generalizations lead to national stereotypes and confusion over definitions. Concludes, however, that historical understanding requires criteria to determine what in general may be of importance to the human condition. Classificatory or labeling generalizations are…
... to have negative effects on school improvement. The paper ends with recommendations for more empirical work that would uncover district leadership approaches that influence the success of the districts and support school improvement. Keywords: district leadership; education reform; leadership styles; school district; ...
aries. Close attention needs to be given to district- level health management, the complementary roles of district and regional health authorities, working relationships and accountability among professional staff from different disciplines, involvement of the community in a district health authority and the district health system ...
Soltero, Victor Manuel; Rodríguez-Artacho, Salvador; Velázquez, Ramón; Chacartegui, Ricardo
In mild climate regions Directive 27/2012 EU application for developing sustainable district heating networks in consolidated urban nucleus is a challenge. In Spain most of the municipalities above 5,000 inhabitants have a reliable natural gas network and individual heating systems at homes. In this work a new heating network paradigm is proposed, the biomass universal heating network in rural areas. This model involves all the economic, legal and technical aspects and interactions between the different agents of the systems: provider company, individual and collective end-users and local and regional administration. The continental region in Spain has 588 municipalities with a population above 1,500 inhabitants close to forest biomass with renewable use. In many of these cases the regulation identifies the ownership of the forest resources use. The universal heating networks are a great opportunity for energy saving of 2,000 GWh, avoiding 2.7 million tons of CO2 emissions and with a global annual savings for end users of 61.8 million of euros. The presented model is easily extrapolated to other small municipalities in Europe. The real application of the model is presented for three municipalities in different locations of Spain where Universal Heating Networks are under development. The analysis show the interest of the integrated model for the three cases with different structural agents and relationships between them. The use of sustainable forest resources, extracted and managed by local companies, strengths circular economy in the region with a potential global economic impact above 200 M€.
Nordling, Magnus [Swedish Corrosion Inst., Stockholm (Sweden)
results point out the risk of only analysing the water instead of also neglecting to expose coupons and analysing the presence of biofilms on the coupons. Also made clear when using exposure containers is the advantage of having the possibility of withdrawal of coupons at different occasions, thereby being able to investigate the increase with time in concentration of micro-organisms in the biofilm. The Swedish Corrosion Institute has developed such an exposure container, and used it during phase two. It has proved to be both easy to handle and in good working order, at service for supervision of microbial activity in district cooling nets in general. Finally, recommendations for reducing the risk for biofilm formation and microbial corrosion can be stated as follows: Only water of DH quality should be used, both as basic water and feed water; Avoid additives, especially if organic; Only connect district cooling tubes which are clean on the inside; Watch over the system regarding micro-organism related problems, preferably by using exposure containers.
Menéndez Granados, Nicolás; Vaquero Abellán, Manuel; Toledano Estepa, Manuel; Pérez Díaz, Manuel Modesto; Redondo Pedraza, Rosa
To describe the distribution of frequent attenders (FA) through the different primary care practices in Cordoba-Guadalquivir Health District (Córdoba, Spain). An ecological study was performed, including data from 2011 to 2015. Defining FA as those subjects who made12 or more appointments per year; independently analysed for nursing, general practice and paediatrics. Prevalence of frequent attendance and FA/professional ratio were used as dependent variables. Demographic characteristics from district population, number of health professionals and use of general facilities were also examinated. Aiming to understand FA distribution, primary health settings were classified according to facility size and environmental location (urban, suburban and rural). The mean prevalence for FA was 10.86% (0.5 SE) for nursing; general practice 21.70% (0.7 SE) and for paediatrics 16.96% (0.7 SE). FA/professional ratios for the different professional categories were: 101.07 (5.0 SE) for nursing, 239.74 (9.0 SE) for general practice and 159.54 (9.8 SE) for paediatrics. A major part of primary health care users make a high number of consultations. From this group, women overuse nursing and general practitioner services more compared to men. A higher prevalence of FAs was observed in smaller settings, in rural areas. Although taking the FAs:professional ratio as the bar, medium-size practices are more highly overused. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Lunghofer, Daniel S.
This manual provides principles that are an integral part of the accounting requirements for educational service districts (ESDs) in the state of Washington. They are in conformance with generally accepted accounting principles, except where referenced in the ESD principles that follow. This manual provides guidance on the following topics:(1)…
... Attainment dates for national standards. Section 52.2523 states that The New Manchester and Grant Magisterial... 33364), EPA redesignated the New Manchester-Grant Magisterial District in part 81 as ``Better than... includes a copy of the rule, to each House of the Congress and to the Comptroller General of the United...
Wawire, Nelson H. W.; Nafukho, Fredrick M.
Purpose: The purpose of this study is to highlight the main factors that affect the management of the WGs' Micro and Small Enterprises (MSEs) in Kakamega District and Africa in general. Design/methodology/approach: The study adopted a descriptive research design. This is because the study was concerned about a univariate question in which the…
Drinking alcohol in pregnancy is a serious public health concern worldwide. This study sought to determine the magnitude and socio-demograhic characteristics of pregnant women attending Antenatal clinic in the Bosomtwe district, Ghana who drank alcohol and to assess their general knowledge about the effects of ...
Hrabak, R. A.; Kron, Jr., N. F.; Pferdehirt, W. P.
The US Department of Housing and Urban Development (HUD) and the US Department of Energy (DOE) cosponsor a program aimed at increasing the number of district heating and cooling systems. Twenty-eight communities have received HUD cooperative agreements to aid in a national feasibility assessment of district heating and cooling systems. The HUD/DOE program includes technical assistance provided by Argonne National Laboratory and Oak Ridge National Laboratory. Part of this assistance is a computer program, called the district heating strategy model, that performs preliminary calculations to analyze potential district heating and cooling systems. The model uses information about a community's physical characteristics, current electricity-supply systems, and local economic conditions to calculate heat demands, heat supplies from existing power plants and a new boiler, system construction costs, basic financial forecasts, and changes in air-pollutant emissions resulting from installation of a district heating and cooling system. This report explains the operation of the district heating strategy model, provides simplified forms for organizing the input data required, and describes and illustrates the model's output data. The report is written for three groups of people: (1) those in the HUD/DOE-sponsored communities who will be collecting input data, and studying output data, to assess the potential for district heating and cooling applications in their communiites; (2) those in any other communities who may wish to use the model for the same purpose; and (3) technical-support people assigned by the national laboratories to explain to community personnel how the model is used.
... Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE HANDBOOK Acquisition Acquisition of Rights-Of-Entry § 644.155 General. Sections 644.155 through 644.157 describe the... procedures are applicable to all Division and district Engineers having real estate responsibilities. ...
... Project Planning Civil Works § 644.2 General. (a) Purpose. Sections 644.2 through 644.8 describe the authorities and procedures of the Corps of Engineers relating to real estate planning and project...) Applicability. These sections are applicable to all Division and District Engineers having civil works real...
... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 2299-075] Don Pedro Hydroelectric Project: Turlock Irrigation District; Modesto Irrigation District; Supplement to Notice of Study... Pedro Hydroelectric Project, Dispute Resolution Panel Chair, (202) 505-6861, [email protected] . d...
Ralston, Nicole; Weitzel, Bruce; Waggoner, Jacqueline; Naegele, Zulema; Smith, Rebecca
There has been a recent shift in university-district partnership models from traditional transactional partnerships, which lack a shared purpose, to transformational partnerships that are mutually beneficial to both universities and school districts. These transformational research-practice partnerships have gained popularity in the United States…
Syafruddin, D.; Asih, P.B.; Coutrier, F.N.; Trianty, L.; Noviyanti, R.; Luase, Y.; Sumarto, W.; Caley, M.; Ven, A.J.A.M. van der; Sauerwein, R.W.
Malaria has long been known as one of the major public health problems in West Sumba District, East Nusa Tenggara Province, Indonesia. To obtain baseline data for establishment of a suitable malaria control program in the area, malariometric surveys were conducted in two sub-districts, Wanokaka and
Hornung, Katie; Yoder, Nick
In the wake of the Common Core State Standards and teacher evaluation reform, school leaders increasingly look to district leaders for support, coaching, and leadership. District leaders--superintendents, assistant or area superintendents, specialists, principal supervisors, and school business administrators--can hold varying and multiple roles…
... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. UL11-1-000; Project No. 2299-078] Turlock Irrigation District and Modesto Irrigation District; Notice Clarifying Party Status On... respect to the La Grange Project. In its December 19, 2012 Order Finding Licensing of Hydroelectric...
... generally safe because of modern equipment, medicines, and safety standards. Most people recover completely and do not have any complications. Alternative Names Surgery - general anesthesia Patient Instructions Anesthesia - what to ask your doctor - adult ...
Li, Hongwei; Svendsen, Svend; Dalla Rosa, Alessandro
In many countries, district heating (DH) has a key role in the national strategic energy planning. However, tighter legislation on new and future buildings requires much less heating demand which subsequently causes relative high network heat loss. This will make current DH system uneconomical...... comparing with other local heat generation units. The design and operation of DH systems therefore needs to be re-examined, part of the solution being low operational temperature. The 3-years IEA DHC Annex X project ‘Towards 4th Generation District Heating: Experience and Potential of Low......-Temperature District Heating (LTDH)’ aims to document experiences gained in mature DH countries with low temperature systems serving highly energyefficient new buildings and existing buildings. The potential to supply DHW at temperature close to 50oC without the risk of Legionella was investigated. Information...
District nurse (DN) care delivery has undergone substantial change in recent years due to changing demographics and service delivery demands that have called for a move of care delivery from secondary to primary care. The title District Nurse is recorded with the Nursing and Midwifery Council (NMC) on completion of the Specialist Practice Qualification in District Nursing (SPQ DN), which purports to be a 'transformational' course that prepares future caseload holders to manage their team and prioritise care delivery effectively. This article explores the need for assertiveness skills in this role in response to Australian research, and outlines the pedagogic interventions implemented during the SPQ DN course to enhance this skill. Assertiveness scores were monitored for the duration of the course and demonstrated a significant increase-a topic that is now the subject of a future, funded study.
Carol S. Parke
Full Text Available This paper describes how districts can better use their extensive student databases and other existing data to explore questions of interest. School districts are required to maintain a wealth of student information in electronic data systems and other formats. The meaningfulness of the data depends to a large degree on whether they can understand the information and use it to guide their efforts. The considerations and guidelines presented here are organized into six components which include identifying the broad area, creating specific questions, roles and trust, sample and methodology, presentation of results, and outcomes and further directions. Two examples are used throughout the paper to illustrate each component. One is from a study of high school mathematics in an urban school district, the other is from a teacher-initiated effort to better understand students' perceptions of their middle school. Recommendations are offered throughout for encouraging effective data use in decision-making.
.... Public Law 106-554 requires the inspector general of each Federal agency that receives water and sewer services from the District of Columbia to report to the Congressional Appropriations Committees...
Griffith, Richard; Tengnah, Cassam
The Government wants to see a large rise in the use of adoption as a means of giving children a secure, loving and permanent home. Guidance coming into effect from April calls for a more pragmatic approach to adoption placements, and calls for the active promotion of the adoption process by health and social care professionals. District nurses will encounter people interested in becoming prospective adopters, but who are unsure if their background or lifestyle makes them eligible. It is essential that district nurses have a working understanding of the guidance and provisions of the Adoption and Children Act 2002 to confidently advise others about adoption and clarify any issues raised.
Bowers, Ben; Pellett, Candice
This paper helps district nurses to understand how and why existing quality measurement tools can be used as part of everyday practice to demonstrate clinical effectiveness. We consider how productivity has historically been used to crudely indicate district nurses' clinical effectiveness and why this is now being balanced alongside a range of more robust clinical effectiveness measurement tools. Evaluating clinical effectiveness and improving future care involves examining a number of indicators alongside each other. These include patient safety indicators, patient satisfaction, productivity measurement tools, and how effective clinicians are in supporting people to achieve their best clinical outcomes.
Stričević, Ljiljana; Radivojević, Aleksandar; Golubović, Ninoslav; Miletić, Jelena; Milić, Jana
Rasina District is faced with serious demographic problems at the beginning of the twenty-first century which are the consequence of long-term economic and social changes both in this area and the country as a whole. The basic problem is insufficient population regeneration, which further leads to other negative processes. One of the most important problems of Rasina District is the ageing of population, i.e., a drop in young population and a significant rise in old population. Therefore, the...
M. Suhirtha Muhil
Full Text Available Odonates were surveyed in Coimbatore District from September 2012 to January 2016. The survey sites covered three major rivers—the Noyyal, Bhavani and Aliyar. Aquatic habitats such as forest streams, riverine sites, irrigational tanks and paddy fields were surveyed in the study. A total of 70 species of odonates were recorded in the survey, which brings the list of odonates in Coimbatore to 87 species. Eighteen species are first time records to the district. In this paper, we catalogue odonates and their distribution from the present survey and pre-existing records.
Maahn, Ernst Emanuel
Three candidate materials for construction of buffer tanks for district heating water have been tested for corrosion fatigue properties in a district heating water environment. The investigation included Slow Strain Rate Testing of plain tensile specimens, crack initiation testing by corrosion...... fatigue of plain tensile specimens and crack growth rate determination for Compact Tensile Specimens under corrosion fatigue conditions. The three materials are equal with respect to stress corrosion sensibility and crack initiation. Crack growth rate is increased with a factor of 4-6 relative to an inert...
Increased demand will cause the price of district heating to increase, but not to the level of the price of electricity. The cheapest heating alternative in Denmark, Norway and Sweden is district heating. In Norway, district heating is developed primarily for commercial buildings and housing cooperatives. Thirty per cent of all buildings under construction are prepared for district heating and the percentage will increase strongly in the coming time. The total net production of district heating in Norway in 2001 was 2000 GWh, which is only a small part of the total potential for district heating
Full Text Available The phenomenon of unemployment and exacerbating demographic situation can be seen as major social problem of nowadays in Poland. The paper is an attempt to compare districts of the Małopolskie voivodeship with respect to chosen features characterizing these phenomena. On the basis of the data from the Central Statistical Offi ce and with the help of taxonomic methods, grouping of districts has been carried out with respect to the level of features under investigation. The procedure allowed for distinguishing 5 groups of signifi - cant inter-group diff erentiation. The application of taxonomic methods resulted in obtaining a general and, at the same time, accurate picture of diff erentiation of the Małopolskie voivodeship with respect to social problems being analysed and distinction of districts with the most diffi cult situation in this area.
Grohnheit, Poul Erik; Mortensen, Bent Ole Gram
for increased energy efficiency. Additional technologies suitable for small-scale networks are heat pumps, solar panels and local biomass in the form of straw or biogas. For large-scale urban networks, incineration of urban waste and geothermal heat are key technologies. With heat storages district heating...... and cogeneration but limited support for the development and expansion of the district heating infrastructure. It was partly based on a contribution to the Shared Analysis Project for the European Commission Directorate-General for Energy, concerning the penetration of combined heat and power (CHP), energy saving......, such as the legal and institutional framework. This includes the experience with market places for electricity trade on an hourly basis over the last two decades. Improved modelling tools and modelling experience will add to the development and performance of district heating systems. Finally, we summarise...
Greco, Salvatore; Mesiar, Radko; Rindone, Fabio
Aggregation functions on [0,1] with annihilator 0 can be seen as a generalized product on [0,1]. We study the generalized product on the bipolar scale [–1,1], stressing the axiomatic point of view. Based on newly introduced bipolar properties, such as the bipolar increasingness, bipolar unit element, bipolar idempotent element, several kinds of generalized bipolar product are introduced and studied. A special stress is put on bipolar semicopulas, bipolar quasi-copulas and bipolar copulas.
Kirillov, A.P.; Anbriashivili, Y.K.; Suvilova, A.V.
The measures of security assurance against the effect of radioactive contamination has become more and more complex due to the construction of nuclear power stations of diverse types. The aseismatic measures for the nuclear power stations built in the districts where earthquakes of different intensity occur are important problems. All main machinery and equipments and emergency systems in power stations must be protected from earthquakes, and this makes the solution of problems difficult. At present in USSR, the provisional standard concerning the design of atomic energy facilities built in earthquake-prone districts is completed. The basic philosophy of the standard is to decide the general requirements as the conditions for the design of nuclear power stations built in earthquake-prone districts. The lowest earthquake activity in the construction districts is considered as magnitude 4, and in the districts where earthquake activity is magnitude 9 or more, the construction of nuclear power stations is prohibited. Two levels of earthquake action are specified for the design: design earthquake and the largest design earthquake. The construction sites of nuclear power stations must be 15 to 150 km distant from the potential sources of earthquakes. Nuclear power stations are regarded as the aseismatically guaranteed type when the safety of reactors is secured under the application of the standard. The buildings and installations are classified into three classes regarding the aseismatic properties. (Kako, I.)
Dhiany. Faila Sophia Hartatri
Full Text Available Arabica coffee has a unique flavour and very potential market. The purpose of this study was to analyse Arabica coffee farming and to investigate its performance of marketing chains in Manggarai and East Manggarai Districts, Flores, East Nusa Tenggara Province. This research was conducted in 2008-2010 by interviewing coffee farmers and coffee buyers; using open and close questions. The number of respondents were 100 people in each district. The result showed that land holding per household farmer in Manggarai and East Manggarai were 0.84 ha and 0.92 ha, respectively. Farmers in both districts were within the range of productive age, the farmers who were members of farmer groups in both study sites was £ 50%. Arabica coffee cultivation was still done in a traditional way. Fertilizing and controlling of pest and diseases had not been carried out inten sively. Arabica coffee farming in both district was feasible. BCR, NPV and IRR values in Manggarai were 4.2, Rp8,530,105, and 70.76% respectively, while BCR, NPV, and IRR value in East Manggarai district were 8.1, Rp2,465,833, and 27%, respectively. BEP production and coffee price in Manggarai were 94.2 kg/ha/th and Rp15,913/kg respectively, whereas BEP production and coffee price in East Manggarai were 78,2 kg/ha/th and Rp10,134/kg, respectively. In general, farmers sold their coffee in green bean form. In general, the marketing chains of Arabica coffee in both districts was farmer – collector - trader - exporter.Key words: Arabica coffee, potential market, farming analysis, feasible, marketing chains.
..., sanitary district, utility district, drainage district, or similar entity, or an integrated waste..., association, partnership, corporation, municipality, State or Federal agency, or an agent or employee thereof...
Kramer, Daniëlle; Jongeneel-Grimen, Birthe; Stronks, Karien; Droomers, Mariël; Kunst, Anton E
Numerous area-based initiatives have been implemented in deprived areas across Western-Europe with the aim to improve the socio-economic and environmental conditions in these areas. Only few of these initiatives have been scientifically evaluated for their impact on key social determinants of health, like perceived area safety. Therefore, this study aimed to assess the impact of a Dutch area-based initiative called the District Approach on trends in perceived area safety and underlying problems in deprived target districts. A quasi-experimental design was used. Repeated cross-sectional data on perceived area safety and underlying problems were obtained from the National Safety Monitor (2005-2008) and its successor the Integrated Safety Monitor (2008-2011). Study population consisted of 133,522 Dutch adults, including 3,595 adults from target districts. Multilevel logistic regression analyses were performed to assess trends in self-reported general safety, physical order, social order, and non-victimization before and after the start of the District Approach mid-2008. Trends in target districts were compared with trends in various control groups. Residents of target districts felt less safe, perceived less physical and social order, and were victimized more often than adults elsewhere in the Netherlands. For non-victimization, target districts showed a somewhat more positive change in trend after the start of the District Approach than the rest of the Netherlands or other deprived districts. Differences were only statistically significant in women, older adults, and lower educated adults. For general safety, physical order, and social order, there were no differences in trend change between target districts and control groups. Results suggest that the District Approach has been unable to improve perceptions of area safety and disorder in deprived areas, but that it did result in declining victimization rates.
Kirby, Charlotte O.
The Tri-District Arts Consortium in South Carolina was formed to serve artistically gifted students in grades six-nine. The consortium developed a summer program offering music, dance, theatre, and visual arts instruction through a curriculum of intense training, performing, and hands-on experiences with faculty members and guest artists. (JDD)
Greater involvement of farmers in development and dissemination of agricultural technology is a key component in current reforms of ... its members to engage in demand-driven agricultural services in Soroti district and thereby contributed to the success of .... long training in integrated production and pest management.
McPhail, Jay; Paredes, Judi
Planning and implementing major innovations in large urban districts can be a daunting and overwhelming idea--particularly when it comes to technology--due to real and perceived obstacles. Added to this challenge is the reality of the worst budget crisis in California history. When students are empowered by full access to technology, learning…
Moving from a traditional desktop computing environment to a virtualized solution is a daunting task. In this article, the author presents case histories of three districts that have made the conversion to virtual computing to learn about their experiences: What prompted them to make the move, and what were their objectives? Which obstacles prove…
Big, Oovidiu; Li, Hongwei; Svendsen, Svend
between 25% and 35%. By making the light renovation, the heating system needs a minimum supply water temperature of 58ºC in order to cover the thermal comfort. Through extensive renovation, the supply water temperature could be reduced to 50ºC which makes it possible to transform the District Heating...
... 7 Agriculture 8 2010-01-01 2010-01-01 false Districts. 947.32 Section 947.32 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... consideration to (1) the relative importance of new areas of production, (2) changes in the relative position of...
... 7 Agriculture 8 2010-01-01 2010-01-01 false Districts. 958.27 Section 958.27 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... representation, the committee shall give consideration to: (1) The relative importance of new producing sections...
Lawton, Sally; Stewart, Fiona
Being assertive is not the same as being aggressive. Assertiveness is a tool for expressing ourselves confidently, and a way of saying 'yes' and 'no' in an appropriate way. This article explores issues concerned with assertiveness in district nurse settings. It outlines helpful techniques to develop assertiveness, such as the broken record, fogging, negative assertion and negative inquiry.
School districts should have a records management system through which student, employee, and related documents are maintained. Explains the meaning of records management, the implications of choosing not to establish an ongoing program, and how to be a leader in the program. (eight references) (MLF)
Shooting instructor Johnny Price looked at the teachers lined up in front of him. Mr. Price, the owner of Big Iron Concealed Handgun Training in Waco, Texas, spent two days this month training teachers and staff members from the Clifton school district in all they need to know to earn licenses to carry weapons out of sight. There is no indication…
Roos, A.; Bohlin, F.; Hektor, B.; Hillring, B.
Woodfuel use in the Swedish district heating sector increased significantly from 1985 to 1999. This study analysed strategies and considerations concerning woodfuel procurement in district heating plants. Priorities and concerns in the industry involved an increased woodfuel share, ambitions to create an environmental image, cost minimisation, awareness about the role of energy policies for fuel choice, improvement of woodfuel quality and the ambition to maintain a competitive woodfuel market with several suppliers. Factor analysis yielded five dimensions in the woodfuel procurement strategies among the district heating companies: (1) increased woodfuel use; (2) import; (3) spot market woodfuel purchases; (4) focus on refined woodfuels; and (5) using price only when deciding whether to use woodfuels or other fuels. Five clusters were defined along the three strategy dimensions (1)-(3). The clusters differed concerning size, experiences from the introduction of woodfuels, perceptions about woodfuels and strategies employed to date. This paper describes different strategies that the district heating companies apply on the woodfuel market. The conclusion is that policies should consider this diversity in procurement strategies, mitigate their negative side-effects and assist to make them cost-effective. (author)
The Toronto District School Board (Ontario) established a department of environmental education to lighten the school board's impact on the environment and to increase ecological literacy among students. School programs have been developed in the areas of eco-literacy, energy conservation, waste management, and school yard greening. One program…
An old county town that has retained its individuality through all the changes of the last three centuries, and is expanding vigorously to meet the challenge of the next--that is Northampton. The health services of the district reflect the town, and draw strength, as they always have done, from close links with the community they serve.
The urban areas in the Netherlands can be considered as a separate flora district; the so-called “Urban district”. It consists of large stony areas, with a “steppe”-like environment and a deviant climate. Characteristic for urban areas are often disturbed and trampled communities of ruderals and
The 1992 Constitution of the Republic of Ghana and the various legislations on decentralisation articulate the explicit objectives of the policy which includes responsiveness to community needs. The rationale behind Ghana's decentralisation programme and the functions of the District Assemblies (DAs) therefore provide a ...
toral area, Yabello districts, to estimate the prevalence and to identify risk factors associated ... Three-hundred three (75.8%) of sheep and 858 (55.2%) goats were positive for strongyle eggs. Animal species and body condition inﬂuenced the prevalence of gastrointestinal parasite in sheep and ..... Seasonal evolution of fe-.
Kathleen L. Wolf
A multistudy research program has investigated how consumers respond to the urban forest in central business districts of cities of various sizes. Trees positively affect judgments of visual quality but, more significantly, may influence other consumer responses and behaviors. Survey respondents from all regions of the United States...
The process works with members of a real DHMT, and has the advantage of encouraging team building around real health problems. It does, however, have the disadvantage of depleting districts of the bulk of their managerial staff during the workshop periods. The programme should ideally be run by the Department of ...
A tried and tested formula for selecting the right telephone system includes the following elements: determining telephone system needs, considering future growth, using written proposals to make comparisons, and shopping for quality products with excellent references. Flagstaff (Arizona) Uified School District's experience is used to illustrate…
Rout, U R
This paper presents the results of a pilot study investigating stress among district nurses in the north-west of England. Nurses completed questionnaires covering job satisfaction, mental health, stress, Type A behaviour, health behavior, coping skills and demographic details. A specific measure of stress was developed following in-depth interviews with primary care professionals, including district nurses. A total of 79 district nurses took part in the study. The major sources of stress isolated by the district nurses related to: time pressure, administrative responsibility, having too much to do, factors not under their control, interruptions, keeping up with National Health Service (NHS) changes, and lack of resources. Factor analysis of stress questionnaire responses identified five major factors: demands of the job and lack of communication, working environment, problems with patients, work/home interface and social life, and career development. The highest levels of satisfaction were reported for the amount of variety in their job and the lowest level of job satisfaction was reported for chance of promotion. The results revealed that the mental wellbeing of the nurses was higher than that of the other population groups. Furthermore, multivariate analysis revealed three major stressors that were predictive of high levels of job dissatisfaction: demands of the job and lack of communication, working environment, and career development. The implications of the findings for further research are considered.
Objectives. To ascertain patient retention on ART after 5 years on treatment in one district of Gauteng Province, SA, establish the number of patients ... A retrospective cohort study of patients initiated on highly active antiretroviral therapy (HAART) between January and March .... ferred-out patients from the total of 381 leaves.
... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Seashore District. 27.3 Section 27.3 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR CAPE...' studio, for appropriate small scale home occupations as the making and selling of traditional Cape Cod...
Wrapping up a two-day conference in Denver designed to improve labor-management relations in school districts, sponsors and participants vowed to work at reforms that will be beneficial to teachers, students, and officials. Teams made up of a local superintendent, a school board representative, and the teachers' union leader descended on the Mile…
Back in the mid-2000s, in public and in the news media, Joseph P. Burke, then superintendent of the Springfield public schools, and Timothy T. Collins, president of the local teachers' union, often seemed to be at odds with each other. Out of the public eye, however, the two men had begun meeting regularly. When Burke left the district, the work…
Gerow, L.B.; Bernstein, H.
Despite the growing popularity in Europe of district heating as an alternative to conventional systems, a number of institutional barriers blocked the road to its successful implementation in Canada. These hurdles include questions of ownership, operation/administration, consumer accountability, financial arrangements, and general consumer acceptance of a new technology. In deciding on ownership, the major issues were legal. Provincial laws to be complied with included The Municipal Franchises Act, The Public Utilities Act, The Municipal Act and The Ontario Municipal Board Act. The operation and administration of the project were also beset with legal complications. The relevant laws were The Boilers and Pressure Vessels Act, and The Environmental Assessment Act. How to charge individual users (consumer accountability) raised a number of technical problems including metering and rate-setting for hot water distribution, and heat borrowing between units. The report recommends that groups planning to implement district heating are advised to allow plenty of lead time for obtaining approvals and franchising arrangements so as not to jeopardize construction schedules. 3 refs.
Diniz, Debora; Machado, Teresa Robichez de Carvalho; Penalva, Janaina
This paper seeks to analyze the Judiciary's approach with respect to demands for the judicialization of the right to health by means of a case study of civil lawsuits for access to health care in Brazil's Federal District. Judicialization of the right to health signifies the judicialization of various of the health services provided. This is a descriptive and exploratory case study that covers the Federal District and uses mixed techniques to gather and analyze data. This study analyzed 385 lawsuits (87% of the total number of cases of judicialization of health for the period from 2005 to 2010 that reached the Appellate court). The results indicate that the most judicialized service is access to intensive care unit, followed by drugs and health care. Almost all lawsuits are filed by public defenders, with medical prescriptions and recommendations from the public health service. The results of this study challenge some dominant themes in the national debate, particularly the claim that judicialization is a phenomenon of the elites and that the services judicialized are drugs. The study does not seek to make generalizations, but highlights the fact that the phenomenon of judicialization of health has different aspects encompassed under the same concept.
Griffiths, Jane; Ewing, Gail; Wilson, Charlotte; Connolly, Michael; Grande, Gunn
UK District Nurses have an important role in enabling a good death. Patients and families need to know the patient is approaching the dying phase, yet evidence suggests breaking bad news about the patient's transition to dying rarely happens. District Nurses spend a lot of time with patients and families during the dying phase and are ideally placed to recognise and discuss the transition to dying. To explore the role of District Nurses in breaking bad news of transition to dying. Qualitative focus groups. Primary care (District Nurse service); Four National Health Service Trusts, North West England. A total of 40 District Nurses across the Trusts, all Registered General Nurse qualified. Median number of years as a District Nurse was 12.5. All had palliative cancer patients on their caseloads. District Nurses' role in breaking bad news of transition to dying was challenging, but the conversation was described as essential preparation for a good death. Four main challenges with the conversations were patients' responses to the prognosis (unawareness, denial and anger), timing the conversation, complexities of the home environment and limited preparation in this aspect of their work. District Nurses are with patients during their last weeks of life. While other colleagues can avoid breaking bad news of transition to dying, District Nurses have no choice if they are to provide optimal end of life care. While ideally placed to carry out this work, it is complex and they are unprepared for it. They urgently need carefully tailored training in this aspect of their work, to enable them to provide optimal end of life care. © The Author(s) 2014.
Bliss, Julie; While, Alison E
General practitioners and district nurses have a long history of providing care outside the hospital setting. With health care increasingly moving out of the hospital setting, there are more opportunities for general practitioners and district nurses to work together to meet the health needs of the local population. However, the reduction in qualiﬁed specialist practitioner district nurses over the last decade is concerning. The need for an effective district nursing service has been recognised by the Department of Health in their own model - the nature of district nursing work, often over a long period, enables relationships to develop with the patient, family and informal carers as a basis for anticipatory care to manage long-term conditions. Communication and understanding of the role are central to enhance effective working between general practitioners and district nurses, which can be fostered by engagement in community-oriented integrated care and case management.
General relativity is discussed in this book at a level appropriate to undergraduate students of physics and astronomy. It describes concepts and experimental results, and provides a succinct account of the formalism. A brief review of special relativity is followed by a discussion of the equivalence principle and its implications. Other topics covered include the concepts of curvature and the Schwarzschild metric, test of the general theory, black holes and their properties, gravitational radiation and methods for its detection, the impact of general relativity on cosmology, and the continuing search for a quantum theory of gravity. (author)
Kiwanuka Henriksson, Dorcus; Fredriksson, Mio; Waiswa, Peter; Selling, Katarina; Swartling Peterson, Stefan
Poor quality of care and access to effective and affordable interventions have been attributed to constraints and bottlenecks within and outside the health system. However, there is limited understanding of health system barriers to utilization and delivery of appropriate, high-impact, and cost-effective interventions at the point of service delivery in districts and sub-districts in low-income countries. In this study we illustrate the use of the bottleneck analysis approach, which could be used to identify bottlenecks in service delivery within the district health system. A modified Tanahashi model with six determinants for effective coverage was used to determine bottlenecks in service provision for maternal and newborn care. The following interventions provided during antenatal care were used as tracer interventions: use of iron and folic acid, intermittent presumptive treatment for malaria, HIV counseling and testing, and syphilis testing. Data from cross-sectional household and health facility surveys in Mayuge and Namayingo districts in Uganda were used in this study. Effective coverage and human resource gaps were identified as the biggest bottlenecks in both districts, with coverage ranging from 0% to 66% for effective coverage and from 46% to 58% for availability of health facility staff. Our findings revealed a similar pattern in bottlenecks in both districts for particular interventions although the districts are functionally independent. The modified Tanahashi model is an analysis tool that can be used to identify bottlenecks to effective coverage within the district health system, for instance, the effective coverage for maternal and newborn care interventions. However, the analysis is highly dependent on the availability of data to populate all six determinants and could benefit from further validation analysis for the causes of bottlenecks identified.
Kiwanuka Henriksson, Dorcus; Fredriksson, Mio; Waiswa, Peter; Selling, Katarina; Swartling Peterson, Stefan
ABSTRACT Background: Poor quality of care and access to effective and affordable interventions have been attributed to constraints and bottlenecks within and outside the health system. However, there is limited understanding of health system barriers to utilization and delivery of appropriate, high-impact, and cost-effective interventions at the point of service delivery in districts and sub-districts in low-income countries. In this study we illustrate the use of the bottleneck analysis approach, which could be used to identify bottlenecks in service delivery within the district health system. Methods: A modified Tanahashi model with six determinants for effective coverage was used to determine bottlenecks in service provision for maternal and newborn care. The following interventions provided during antenatal care were used as tracer interventions: use of iron and folic acid, intermittent presumptive treatment for malaria, HIV counseling and testing, and syphilis testing. Data from cross-sectional household and health facility surveys in Mayuge and Namayingo districts in Uganda were used in this study. Results: Effective coverage and human resource gaps were identified as the biggest bottlenecks in both districts, with coverage ranging from 0% to 66% for effective coverage and from 46% to 58% for availability of health facility staff. Our findings revealed a similar pattern in bottlenecks in both districts for particular interventions although the districts are functionally independent. Conclusion: The modified Tanahashi model is an analysis tool that can be used to identify bottlenecks to effective coverage within the district health system, for instance, the effective coverage for maternal and newborn care interventions. However, the analysis is highly dependent on the availability of data to populate all six determinants and could benefit from further validation analysis for the causes of bottlenecks identified. PMID:28581379
The General Conformity requirements ensure that the actions taken by federal agencies in nonattainment and maintenance areas do not interfere with a state’s plans to meet national standards for air quality.
San Mateo Community Coll. District, CA.
In 1974, the San Mateo Community College District (SMCCD) organized a District Master Planning Committee (DMPC), which was charged with outlining a planning program for the District which would be responsive to individual and community needs. The DMPC was comprised of student, staff, and community representatives, and was aided by a District…
Ebell, Steven; Hughes, Holly; Bockart, Scott; Silva, Susan; McBride, Stephanie
In Texas--specifically in the greater Houston area--Clear Creek Independent School District is a destination district. Families with young children seek to move into the Clear Creek ISD district boundaries when looking for housing in the area. State accountability requirements, coupled with slow changes in student demographics, have caused Clear…
House, Jess E.
Ohio State Senate Bill 28 allows school districts, with voter approval, to impose a tax on the incomes of district residents. This paper examines the early response of school districts to the opportunity presented by the legislation. The paper explains the Ohio system for funding public schools, with a focus on revenue growth, describes features…
Spencer, Jennifer Dawn
This dissertation addresses the question of how suburban school district leaders in one large Midwestern school district respond to increasing student poverty. The purpose of this study was to determine how suburban school district leaders respond to increasing student poverty in their decision making and actions. Data for this study came from one…
Jun 21, 2011 ... study sub-districts while few houses were made of stone wall and iron roofs. In addition to indoor residual spraying (IRS) of houses with DDT or Malathion, ITNs have also been distributed to all malarious sub-districts by the district Health Bureau (Hailemariam Alemayehu, personal communication).
The math problem is common to most U.S. school districts, and education leaders are well aware that U.S. math achievement lags far behind many other countries in the world. University Place (Washington) School District Superintendent Patti Banks found the conspicuous income gap for math scores even more disturbing. In her school district, only 23%…
Close attention needs to be given to districtlevel health management, the complementary roles of district and regional health authorities, working relationships and accountability among professional staff from different disciplines, involvement of the community in a district health authority and the district health system as an ...
A major flood in year 1981 in Jaipur district resulted into huge erosion of the top fertile soil and leaving the land unproductive for agriculture production. The present study was carried in Jaipur district of Rajasthan state to measure physical characteristics of the soil samples from different districts of Jaipur. Soils samples were ...
Jensen, Paul E.
By July 1, 1966, each school district in New York State was required to install a system of property accounting. This pamphlet provides a suggested method of property accounting to assist school districts in meeting this requirement. In addition, suggestions are made to help the districts record the information needed for fire insurance purposes.…
Keugoung, Basile; Fotsing, Richard; Macq, Jean; Buve, Anne; Marchal, Bruno; Meli, Jean; Criel, Bart
The aim of this study was to investigate the effects of the national HIV/AIDS control programme on district hospitals in Cameroon. A multiple case study was conducted in two district hospitals- one public and one faith-based. Data were collected by document review, semi-structured interviews and observation of managerial processes and health care delivery. Programme interventions result in a series of positive and negative effects on the functioning of district hospitals and local health systems. High input and support of staff skills were observed for antiretroviral therapy and the management of opportunistic infections. However, the impact of the programme on the stewardship function is problematic. The low implication of district management teams in the implementation of HIV /AIDS activities reduces their structural capacity to run the local health systems. Programme and health system managers failed to take advantage of opportunities to develop synergies between the HIV/AIDS programme and local health systems. The HIV/AIDS programme weakens the systemic and structural capacity of local health systems. Managers of both programmes and general health systems should analyse and adapt their interventions in order to effective' strengthen health systems. One of the research questions is to understand why health system stakeholders do not seize opportunities to develop synergies between programmes and the general system and to strengthen health systems.
Nielsen, Susanne Balslev; Jensen, Jesper Ole
overviews on the current baselines as well as stages in a transition process. The Dutch tool DPL (Dutch acronym for Duurzaamheid Prestatie voor een Locatie, ‘Sustainability-Profile for locations’) is a tool for mapping sustainability profiles of urban districts through a set of environmental, social......Local authorities are seen as having a unique position to promote sustainable development because of their legal rights and obligations to steer society development at local level in connection with society level in general. However, to actually manage transition processes towards a (more......) sustainable build environment, there are numerous decision makers whose decision has an impact on the bigger whole, and which can promote or hinder a transition on city as well as society level. In a management perspective it seems useful for a local authority to generate holistic or at least multi sector...
Hilbert, Lisbeth Rischel; Nielsen, Lars Vendelbo; Thorarinsdottir, R.I.
Investigations aimed at evaluating monitoring techniques as a function of the specific water chemistry has been conducted as a part of a Nordic project focused on improving the quality of corrosion monitoring in municipal district heating. A combination of techniques has been selected to measure...... both general and localised corrosion. Electrochemical techniques (LPR, EIS) as well as direct techniques (high sensitive ER, weight loss, local crevice corrosion current) have been applied. The data show that the water quality in Danish systems is high resulting in low corrosion rates, but changes...... in the water quality induce localised corrosion. Useful monitoring results have been obtained with high sensitive ER technique (MetriCorr) and crevice corrosion measurements with the LOCORR cell (FORCE TECHNOLOGY)....
Full Text Available A total of 140 plants have been reported ethnobotanically from Tehsil Kabal, Swat District. These include the 133 plants (95% of angiosperms, 3 (2.14% of gymnosperms, and 2 (1.42% each of pteridophytes and fungi. The largest family is Lamiaceae represented by 11 species followed by Rosaceae represented by 9 species. Among angiosperms 76 (55.63% were herbs, 17 (12.78% were shrubs, and 40 (30.07% were trees; 127 plants (95.48% were dicot while 6 plants (4.51% were monocot. Most of the plants were used for more than one purpose. Generally the plants were used for medicinal, fuel, timber wood, food, and fodder for cattle purposes.
Jensen, Louise Overvad; Hallgreen, Christine Erikstrup; Larsen, Esben
The possibility of implementing geothermal heating in the Copenhagen district-heating system is assessed. This is done by building up general knowledge on the geological factors that influence the development of useable geothermal resources, factors concerning the exploration and utilization...... of geothermal energy in Denmark as well as the Danish potential, which, in former investigations, has been found to be around 100.000 PJ annually, and the economical potential is less, about 15 PJ/year. Since a considerable amount of the Danish power supply is tied to weather and the demand for heating......, an increasing demand for flexibility has been raised. Implementing geothermal heating would improve the flexibility in the Eastern Danish power system. Based on this information, as well as, on the hourly values of the expected production and consumption in 2010 and 2020, a model of the Copenhagen power...
Merlo, Caitlin L; Michael, Shannon; Brener, Nancy D; Coffield, Edward; Kingsley, Beverly S; Zytnick, Deena; Blanck, Heidi
Foods and beverages marketed in schools are typically of poor nutritional value. School districts may adopt policies and practices to restrict marketing of unhealthful foods and to promote healthful choices. Students' exposure to marketing practices differ by school demographics, but these differences have not yet been examined by district characteristics. We analyzed data from the 2012 School Health Policies and Practices Study to examine how food and beverage marketing and promotion policies and practices varied by district characteristics such as metropolitan status, size, and percentage of non-Hispanic white students. Most practices varied significantly by district size: a higher percentage of large districts than small or medium-sized districts restricted marketing of unhealthful foods and promoted healthful options. Compared with districts whose student populations were majority (>50%) non-Hispanic white, a higher percentage of districts whose student populations were minority non-Hispanic white (≤50% non-Hispanic white) prohibited advertising of soft drinks in school buildings and on school grounds, made school meal menus available to students, and provided families with information on school nutrition programs. Compared with suburban and rural districts, a higher percentage of urban districts prohibited the sale of soft drinks on school grounds and used several practices to promote healthful options. Preliminary findings showing significant associations between district demographics and marketing policies and practices can be used to help states direct resources, training, and technical assistance to address food and beverage marketing and promotion to districts most in need of improvement.
Van Maldeghem, Hendrik
Generalized Polygons is the first book to cover, in a coherent manner, the theory of polygons from scratch. In particular, it fills elementary gaps in the literature and gives an up-to-date account of current research in this area, including most proofs, which are often unified and streamlined in comparison to the versions generally known. Generalized Polygons will be welcomed both by the student seeking an introduction to the subject as well as the researcher who will value the work as a reference. In particular, it will be of great value for specialists working in the field of generalized polygons (which are, incidentally, the rank 2 Tits-buildings) or in fields directly related to Tits-buildings, incidence geometry and finite geometry. The approach taken in the book is of geometric nature, but algebraic results are included and proven (in a geometric way!). A noteworthy feature is that the book unifies and generalizes notions, definitions and results that exist for quadrangles, hexagons, octagons - in the ...
Lund, Rasmus; Persson, Urban
The ambitious policy in Denmark on having a 100% renewable energy supply in 2050 requires radical changes to the energy systems to avoid an extensive and unsustainable use of biomass resources. Currently, wind power is being expanded and the increasing supply of electricity is slowly pushing the CHP (combined heat and power) plants out of operation, reducing the energy efficiency of the DH (district heating) supply. Here, large heat pumps for district heating is a frequently mentioned solution as a flexible demand for electricity and an energy efficient heat producer. The idea is to make heat pump use a low temperature waste or ambient heat source, but it has so far been very unclear which heat sources are actually available for this purpose. In this study eight categories of heat sources are analysed for the case of Denmark and included in a detailed spatial analysis where the identified heat sources are put in relation to the district heating areas and the corresponding demands. The analysis shows that potential heat sources are present near almost all district heating areas and that sea water most likely will have to play a substantial role as a heat source in future energy systems in Denmark. - Highlights: • The availability of heat sources for heat pumps in Denmark are mapped and quantified. • A novel methodology for assessment of low temperature industrial excess heat is presented. • There are heat sources available for 99% of district heating networks in Denmark. • The concentration of heat sources is generally bigger around bigger cities than smaller. • Ambient temperature heat sources will be more needed in district heating of big cities.
Westrich, Lisa; Sanchez, Monika; Strobel, Karen; Duong, Nina
The Sequoia Healthcare District (SHD), in collaboration with four local school districts--Belmont-Redwood Shores School District (BRSSD), Redwood City School District (RCSD), San Carlos School District (SCSD), and Sequoia Union High School District (SUHSD)--launched the Healthy Schools Initiative (HSI) in August 2010. This three-year initiative is…
In conclusion, a general consensus of a number of points which the author endeavours to summarize in this article: -doctors are an excellent channel for passing on information to the public -doctors feel that they do not know enough about the subject and a training on radiobiology and radiation protection is a necessity for them -communication between doctors and the general public is poor in this field -research should be encouraged in numerous areas such as: carcinogenic effect of low doses of radiation, pedagogy and risk perception
Pakanen, J.; Hyvaerinen, J.; Kuismin, J.; Ahonen, M. [VTT Building Technology, Espoo (Finland). Building Physics, Building Services and Fire Technology
A district heating substation is a demanding process for fault diagnosis. The process is nonlinear, load conditions of the district heating network change unpredictably and standard instrumentation is designed only for control and local monitoring purposes, not for automated diagnosis. Extra instrumentation means additional cost, which is usually not acceptable to consumers. That is why all conventional methods are not applicable in this environment. The paper presents five different approaches to fault diagnosis. While developing the methods, various kinds of pragmatic aspects and robustness had to be considered in order to achieve practical solutions. The presented methods are: classification of faults using performance indexing, static and physical modelling of process equipment, energy balance of the process, interactive fault tree reasoning and statistical tests. The methods are applied to a control valve, a heat excharger, a mud separating device and the whole process. The developed methods are verified in practice using simulation, simulation or field tests. (orig.) (25 refs.)
Hilbert, Lisbeth Rischel; Nielsen, Lars Vendelbo; Andersen, A.
Quality control in district heating systems to keep uniform corrosion rates low and localized corrosion minimal is based on water quality control. Side-stream units equipped with carbon steel probes for online monitoring were mounted in district heating plants to investigate which techniques would...... be applicable, and if on-line monitoring could improve the quality control. Water quality monitoring was applied as well as corrosion rate monitoring with linear polarization resistance (LPR), electrochemical impedance spectroscopy (EIS), electrical resistance (ER) technique, mass loss and a crevice corrosion...... cell for localized corrosion risk estimation. Important variations in corrosion rate due to changes in make-up water quality were detected with the continuous monitoring provided by ER and crevice cell, while LPR gave unreliable corrosion rates. The acquisition time of two-three days for EIS...
Bressler, S.; Gardner, T.C.; King, D.; Nimmons, J.T.
The attributes of various institutional entities which might participate in various phases of geothermal heating applications are described. Public entities considered include cities, counties, and special districts. Private entities discussed include cooperative organizations and non-member-owned private enterprises. The powers, authority and manner of operation of each of the institutional entities are reviewed. Some of the public utility regulatory implications which may affect choices among available alternatives are considered. (MHR)
Marco-Lajara, Bartolomé; Claver Cortés, Enrique; Úbeda García, Mercedes; Zaragoza Sáez, Patrocinio del Carmen
This paper measures the impact on profitability of the geographical area where the vacation hotels of the Spanish Mediterranean are situated. It places a special emphasis on analysing the tourist districts existing in this coastal Spanish area and the extent to which the degree of business agglomeration at each destination affects hotel profit. Due to the characteristics of the service sector, and after a revision of the agglomeration literature, a ‘U’-shaped relationship is hypothesized betw...
Haque, Ubydul; Ahmed, Syed Masud; Hossain, Shahed; Huda, Mamun; Hossain, Awlad; Alam, Mohammad Shafiul; Mondal, Dinesh; Khan, Wasif Ali; Khalequzzaman, Mohammod; Haque, Rashidul
BACKGROUND: Following the 1971 ban of DDT in Bangladesh, malaria cases have increased steadily. Malaria persists as a major health problem in the thirteen south-eastern and north-eastern districts of Bangladesh. At present the national malaria control program, largely supported by the Global Fund for AIDS, Tuberculosis and Malaria (GFATM), provides interventions including advocacy at community level, Insecticide Treated Net (ITN) distribution, introduction of Rapid Diagnostic Tests (RDT) and ...
Full Text Available Rasina District is faced with serious demographic problems at the beginning of the twenty-first century which are the consequence of long-term economic and social changes both in this area and the country as a whole. The basic problem is insufficient population regeneration, which further leads to other negative processes. One of the most important problems of Rasina District is the ageing of population, i.e., a drop in young population and a significant rise in old population. Therefore, the population of Rasina District is already in the critical phase of demographic aging. Such age structure influences further economic development of this area at large. The decrease in young population, which is the carrier of future reproduction and regeneration of the population of this area, is evident. So as to stop or decelerate these processes, it is necessary to improve life conditions and ensure certain economic standard. Otherwise, these processes will not be stopped; they will be all the more intensified.
In part I of this study a survey has veen given of what Dutch authors have written since 1870, when capital punishment was abolished, on subjects concerning the general preventive effect of punishment. This historical survey ends where, during the years 1940-1945, under the stress of the occupation
5th April, 2016 – Ordinary General Assembly of the Staff Association! In the first semester of each year, the Staff Association (SA) invites its members to attend and participate in the Ordinary General Assembly (OGA). This year the OGA will be held on Tuesday, April 5th 2016 from 11:00 to 12:00 in BE Auditorium, Meyrin (6-2-024). During the Ordinary General Assembly, the activity and financial reports of the SA are presented and submitted for approval to the members. This is the occasion to get a global view on the activities of the SA, its financial management, and an opportunity to express one’s opinion, including taking part in the votes. Other points are listed on the agenda, as proposed by the Staff Council. Who can vote? Only “ordinary” members (MPE) of the SA can vote. Associated members (MPA) of the SA and/or affiliated pensioners have a right to vote on those topics that are of direct interest to them. Who can give his/her opinion? The Ordinary General Asse...
Leider, A S; Garbarino, V E
The case of an elderly female patient with a long-standing history of generalized hypercementosis is described. A thorough review of the literature indicates that this may be one of the most extensive cases of hypercementosis to be reported. Possible etiologic factors--including heredity, systemic disorders, chronic periapical infection, and abnormal occlusal trauma--are discussed.
Home; Journals; Resonance – Journal of Science Education; Volume 8; Issue 2. Supersymmetry. Akshay Kulkarni P Ramadevi. General Article Volume 8 Issue 2 February 2003 pp 28-41. Fulltext. Click here to view fulltext PDF. Permanent link: http://www.ias.ac.in/article/fulltext/reso/008/02/0028-0041. Keywords. Symmetry ...
This book provides a completely revised and expanded version of the previous classic edition ‘General Relativity and Relativistic Astrophysics’. In Part I the foundations of general relativity are thoroughly developed, while Part II is devoted to tests of general relativity and many of its applications. Binary pulsars – our best laboratories for general relativity – are studied in considerable detail. An introduction to gravitational lensing theory is included as well, so as to make the current literature on the subject accessible to readers. Considerable attention is devoted to the study of compact objects, especially to black holes. This includes a detailed derivation of the Kerr solution, Israel’s proof of his uniqueness theorem, and a derivation of the basic laws of black hole physics. Part II ends with Witten’s proof of the positive energy theorem, which is presented in detail, together with the required tools on spin structures and spinor analysis. In Part III, all of the differential geomet...
Home; Journals; Resonance – Journal of Science Education; Volume 8; Issue 2. Supersymmetry. Akshay Kulkarni P Ramadevi. General Article Volume 8 Issue 2 February 2003 pp 28-41 ... Author Affiliations. Akshay Kulkarni1 P Ramadevi1. Physics Department, Indian Institute of Technology, Mumbai 400 076, India.
. A q-ary necklace of length n is an equivalence class of q-coloured strings of length n under rota- tion. In this article, we study various generaliza- tions and derive analytical expressions to count the number of these generalized necklaces.
Full Text Available As a departing point, the paper presents the historical genesis of the concept of industrial district focusing on the scientific views of the pioneer of this field, Alfred Marshall. The concept has its origins in the observation of the current industrial reality, mainly of the British one. The purpose is to give an explanation to the difficulties of the classic theory and to study the challenges of the class conflicts. The economic conditions which launched British industrial districts were present, grosso modo, in Italy after the second World War. Some contributions have dealt with the little industrialisation of some Italian regions and using Marshallian thoughts have rediscovered the industrial districts phenomenon. This is the starting point of a high number of scientific contribution in Italy and abroad. Some of these international studies, particularly the ones made by Spanish experts, are quoted. The text analyses the link between districts-made in Italy with the competitive advantages of Italian products in many economic activities (i.e. clothing, shoes, furniture, etc.. Finally, in the third part the paper reviews some new contributions on the industrial district in Italy.
Knudsen, Torben; Trangbæk, Klaus; Kallesøe, Carsten Skovmose
The general ideas within plug and play process control (PTC) are to initialize and reconfigure control systems just by plug and play. In this paper these ideas are applied to a district heating pressure control problem. First of all this serves as a concrete example of PTC, secondly some of the f...... of the first techniques developed in the project to solve the problems in PTC are presented. These are in the area of incremental modelling and control and they make it possible to "plug'' in a new sensor and actuator and make it "play'' automatically.......The general ideas within plug and play process control (PTC) are to initialize and reconfigure control systems just by plug and play. In this paper these ideas are applied to a district heating pressure control problem. First of all this serves as a concrete example of PTC, secondly some...
Yaya, G; Kemata, B; Youfegan Baanam, M; Bobossi-Serengbe, G
Support of visual disabilities in terms of preventive and curative treatment, is a priority for public health in Central African Republic. The lack of recent and reliable data on ocular pathologies in general including trachoma particularly, has led health authorities, in collaboration with partners to undertake an epidemiological investigation to determine the mapping. This study was designed to assess the importance of endemicity in the most sensitive groups within population, including children of 1 to 9 years old. Eight from sixteen health districts in the country, were selected for this survey as a first step. The data collected will assess the real needs in medical and surgical care to develop an appropriate strategic plan of support for this condition on a large scale. This is a cross-sectional descriptive survey carried out in one month, from November 23 to December 26, 2011 in eight health prefectures of the country. The sampling frame was the population of eight health districts. The exhaustive list of villages and demographic data from the national census conducted in December 2003, adjusted by the rate of annual increase of 2.5%has been used. The administrative headquarters of the places of the visited districts leaders were excluded from the sampling frame. A random survey in clusters at two levels made from formed bases. Twenty villages (clusters) in each health district have been drawn according to the proportional probability to the size of the totals cumulative. 12,800 children of both sexes, aged 1 to 9 years have been identified in this investigation and 11,287 were actually examined, or 88.2 %, sex ratio is significantly 1.11. The proportion by age group of the children sampled is stackable to the general population. 26.9 % of TF and 5.9 % TI have been diagnosed. Six from eight districts surveyed are endemic. Three of them had respectively rates of 32.3 %, 47.1 % and 54.3 %.
General experiences in nuclear power are summarized using statistical data revealing the significance of nuclear power in comparison with traditional power sources. Some causes of problems associated with nuclear power are listed, including world recession, high innovation costs, oversupply of nuclear power plants, low availabilities, insufficient arguments for reactor safety to facilitate public acceptance, unsolved waste disposal problems. To assure the world's long-term energy supply, development of commercial fast breeder reactors are suggested. (V.N.)
Davis, H.; Grammel, S.; Kuzanek, J.; Levine, E.
A study, designed to aid in evaluating the feasibility of a district heating and cooling system that uses heat supplied by existing electric generating plants retrofitted for cogeneration, is presented. Based on thermal demands of a metropolitan area, the District Heating and Cooling System (DHCS) model estimates the cost of the retrofit. Environmental impact and the potential for scarce-fuel savings also are assessed by this model. The computer program used is the District Heating Strategy Model (DHSM). Section 2 identifies metropolitan demand sectors and describes the data acquisition method. Section 3 defines thermal energy supply sources and shows how each is located. Program output is summarized in terms of financial data, electrical and thermal loads, and a ranking of existing power plants. Section 4 assesses air pollutant emissions and DHCS fuel-use requirements. Finally, Sec. 5 considers the economics of the DHCS and its costs vs benefits.
This book is intended to be an introduction to the fascinating theory ofgeneralized polygons for both the graduate student and the specialized researcher in the field. It gathers together a lot of basic properties (some of which are usually referred to in research papers as belonging to folklore) and very recent and sometimes deep results. I have chosen a fairly strict geometrical approach, which requires some knowledge of basic projective geometry. Yet, it enables one to prove some typically group-theoretical results such as the determination of the automorphism groups of certain Moufang polygons. As such, some basic group-theoretical knowledge is required of the reader. The notion of a generalized polygon is a relatively recent one. But it is one of the most important concepts in incidence geometry. Generalized polygons are the building bricks of Tits buildings. They are the prototypes and precursors of more general geometries such as partial geometries, partial quadrangles, semi-partial ge ometries, near...
Mikhail Mikhailovich Panov
Full Text Available The article presents the research on the main directions and scale of migration in municipal districts of the Vologda Oblast and considers the main types of migration and the specifics of their statistical accounting. The data by Rosstat served as a basis upon which a general analysis of migration dynamics in the Vologda Oblast districts was carried out; and the article presents its periodization. Three main periods are defined: the “migration shock” of 1991–1999 after the collapse of the Soviet Union, the migration stability of 2000–2008 and the post-crisis rural out-migration that began in 2009 and is increasing year by year. At the same time, gross migration indicators have shown high sensitivity to significant socioeconomic change, in particular, to the economic crises of 1999 and 2008. The article describes the main age and gender characteristics of migrants, it has been determined that the most active migrants are girls aged 15–29, who move from rural to urban settlements. In general, it is the young people aged 15–34 who are most likely to migrate. The author has found out that most of the Vologda Oblast districts are characterized by a higher outflow of the population, which is in some places restrained by a relative migration attractiveness of a number of areas. The author has found out that most districts of the Oblast are characterized by a higher outflow of the population, which is sometimes restrained by relative migration attractiveness of some areas. The author highlights the region’s territories with the highest migration attraction; in the long run they can play the role of “growth points” in the region; these territories comprise Velikoustyugsky and Chagodoshchensky districts, as well as several districts of the central part of the Vologda Oblast – Ust-Kubinsky and Vologodsky. The author also points out the territories that suffered the most from out-migration: Kichmengsko-Gorodetsky, Vashkinsky
Reed, Frances M; Fitzgerald, Les; Rae, Melanie
To highlight philosophical and theoretical considerations for planning a mixed methods research design that can inform a practice model to guide rural district nursing end of life care. Conceptual models of nursing in the community are general and lack guidance for rural district nursing care. A combination of pragmatism and nurse agency theory can provide a framework for ethical considerations in mixed methods research in the private world of rural district end of life care. Reflection on experience gathered in a two-stage qualitative research phase, involving rural district nurses who use advocacy successfully, can inform a quantitative phase for testing and complementing the data. Ongoing data analysis and integration result in generalisable inferences to achieve the research objective. Mixed methods research that creatively combines philosophical and theoretical elements to guide design in the particular ethical situation of community end of life care can be used to explore an emerging field of interest and test the findings for evidence to guide quality nursing practice. Combining philosophy and nursing theory to guide mixed methods research design increases the opportunity for sound research outcomes that can inform a nursing model of care.
Thapa, M; Neopane, A K; Singh, U K; Aryal, N; Agrawal, K; Shrestha, B
Nutritional status is a prime indicator of health. Generally, three anthropometric indicators are often used to assess nutritional status during childhood and adolescence: underweight (weight-for-age), stunting (height- for-age) and thinness (BMI-for-age). Malnutrition in children is a major public health problem in many developing countries. This study was conducted to assess nutritional status among children attending health camps in two mountainous districts in Nepal. Five hundred and seventy five children below 15 years of age attending the medical camp in Humla and Mugu districts in October 2011 were assessed for nutritional status. For children less than five years, weight for age, weight for height and height for age as per WHO classification, and for children between five to 15 years age specific values of height, weight and Body Mass Index (BMI) were calculated. In Humla district, 28.2% children were undernourished, 8.8% wasted and 22.4% stunted in less than five years. In the same age group, 31.7% children were undernourished, 9.4% wasted and 29.4% stunted in Mugu district. In the age group five to 15 years, thinness was seen in 22.4% and 29.4% children in Humla and Mugu respectively. Malnutrition (underweight, stunting, wasting and thinness) still constitutes a major health problem among Nepalese children, particularly in mountainous regions.
Kapoor, A.; Channa, N.A.; Soomro, A.M.; Tunio, S.A.; Khand, T.U.; Memon, N.
Malnutrition and clinical manifestation in school going children of Tharparkar District Methodology: The study subjects were school going children of class VI to X from different boys and girls schools at Mithi, District Tharparkar. A total number of 300 children with age range of 12-17 years, were included, out of which 150 (50%) were girls and 150 (50%) were boys. General physical examination was carried out for all the subjects. Estimated nutrient intake of energy, carbohydrates, protein, fat and iron was calculated by one week recall method. Anthropometric measurements such as weight, and height, were taken by using the standard operating procedures. Results: General physical examination revealed generalized weakness, recurrent infection and anemia were the most commonly seen in the school going children at district Tharparkar. Nutritional status of children according to the age for height showed 32% girls and 34% boys were stunt whereas the of age for weight showed 34% girls and 39% boys were underweight. The body mass index for age showed 16% girls and 34% boys were thin. Only 2.6 % girls and boys were overweight, but we didn't find any obese children. Conclusion: It is concluded that energy (caloric) carbohydrates, protein, and iron are below recommended daily allowance, which reflects the malnutrition in children. Inadequate intake of nutrients has the effect on height, weight and body mass index. (author)
Studies on the various possibilities for the application of heat from nuclear reactors in the form of district heat or process steam for industrial purposes had been made long before the present energy crisis. Although these studies have indicated technical feasibility and economical justification of such utilization, the availability of relatively cheap oil and difficulties in locating a nuclear heat source inside industrial areas did not stimulate much further development. Since the increase of oil prices, the interest in nuclear heat application is reawakened, and a number of new potential areas have been identified. It now seems generally recognized that the heat from nuclear reactors should play an important role in primary energy supply, not only for electricity production but also as direct heat. At present three broad areas of nuclear heat application are identified: Direct heat utilization in industrial processing requiring a temperature above 800 deg. C; Process steam utilization in various industries, requiring a temperature mainly in the range of 200-300 deg. C; Low temperature and waste heat utilization from nuclear power plants for desalination of sea water and district heating. Such classification is mainly related to the type and characteristics of the heat source or nuclear reactor which could be used for a particular application. Modified high temperature reactor types (HTR) are the candidates for direct heat application, while the LWR reactors can satisfy most of the demands for process steam. Production of waste heat is a characteristic of all thermal power plants, and its utilization is a major challenge in the field of power production
The author proposes a course on general relativity. He first presents a geometrical framework by addressing, presenting and discussion the following notions: the relativistic space-time, the metric tensor, Universe lines, observers, principle of equivalence and geodesics. In the next part, he addresses gravitational fields with spherical symmetry: presentation of the Schwarzschild metrics, radial light geodesics, gravitational spectral shift (Einstein effect), orbitals of material objects, photon trajectories. The next parts address the Einstein equation, black holes, gravitational waves, and cosmological solutions. Appendices propose a discussion of the relationship between relativity and GPS, some problems and their solutions, and Sage codes
Skov Jensen, Christian; Lando, David; Heje Pedersen, Lasse
We characterize when physical probabilities, marginal utilities, and the discount rate can be recovered from observed state prices for several future time periods. Our characterization makes no assumptions of the probability distribution, thus generalizing the time-homogeneous stationary model...... of Ross (2015). Our characterization is simple and intuitive, linking recovery to the relation between the number of time periods and the number of states. When recovery is feasible, our model is easy to implement, allowing a closed-form linearized solution. We implement our model empirically, testing...
Jensen, Christian Skov; Lando, David; Pedersen, Lasse Heje
We characterize when physical probabilities, marginal utilities, and the discount rate can be recovered from observed state prices for several future time periods. Our characterization makes no assumptions of the probability distribution, thus generalizing the time-homogeneous stationary model...... of Ross (2015). Our characterization is simple and intuitive, linking recovery to the relation between the number of time periods on the number of states. When recovery is feasible, our model is easy to implement, allowing a closed-form linearized solution. We implement our model empirically, testing...
Jensen, Christian Skov; Lando, David; Pedersen, Lasse Heje
We characterize when physical probabilities, marginal utilities, and the discount rate can be recovered from observed state prices for several future time periods. We make no assumptions of the probability distribution, thus generalizing the time-homogeneous stationary model of Ross (2015......). Recovery is feasible when the number of maturities with observable prices is higher than the number of states of the economy (or the number of parameters characterizing the pricing kernel). When recovery is feasible, our model is easy to implement, allowing a closed-form linearized solution. We implement...... our model empirically, testing the predictive power of the recovered expected return and other recovered statistics....
Kwon, Yeong Sik; Lee, Dong Seop; Ryu, Haung Ryong; Jang, Cheol Hyeon; Choi, Bong Jong; Choi, Sang Won
The book concentrates on the latest general chemistry, which is divided int twenty-three chapters. It deals with basic conception and stoichiometry, nature of gas, structure of atoms, quantum mechanics, symbol and structure of an electron of ion and molecule, chemical thermodynamics, nature of solid, change of state and liquid, properties of solution, chemical equilibrium, solution and acid-base, equilibrium of aqueous solution, electrochemistry, chemical reaction speed, molecule spectroscopy, hydrogen, oxygen and water, metallic atom; 1A, IIA, IIIA, carbon and atom IVA, nonmetal atom and an inert gas, transition metals, lanthanons, and actinoids, nuclear properties and radioactivity, biochemistry and environment chemistry.
In order to expand the penetration of uranium in the national energy balance sheet, the C.E.A. has been studying nuclear reactors for several years now, that are capable of providing heat at favourable economic conditions. In this paper the THERMOS model is introduced. After showing the attraction of direct town heating by nuclear energy, the author describes the THERMOS project, defines the potential market, notably in France, and applies the lay-out study to the Grenoble Nuclear Study Centre site with district communal heating in mind. The economic aspects of the scheme are briefly mentioned [fr
Cardellicchio, N.; Dell'Atti, A.; Strisciullo, G.; Salamida, M.
This work represents the continuation of the study undertaken in June 1991 and addressed to characterize the quality of subterranean waters in district of Lecce. The results of the determination, both chemical-analytical and microbiological, handled on patterns of stratum water used to irrigated and taken from 39 wells in the reclaimed area of Ugento Li Foggi illustrated and discussed. The results show the high contents of salinity and chlorides of the water caused by a sea water intrusion in the stratum which limits the use of the water resources in agriculture
in the gas cooler, pinch temperature in the evaporator and effectiveness of the IHX. These results are complemented by the exergy analysis, where the exergy destruction ratio of the CO2 system’s component is found. Heat recovery from vapour compression heat pumps has been investigated. The heat is to be used...... based system is the investment cost for the pipes. To overcome this, a combined district heating and cooling system based on CO2 as refrigerant and transport fluid is proposed. Exergoeconomic analysis has been used to evaluate and optimize a CO2 based system for combined heating and cooling...
This report concerns: Kaliningrad Regional District Heating Network project which was implemented from 2004 to 2006. The task of the project was to establish and operate an association for district heating companies in the region in order to transfer and distribute district heating know-how to the sector and through activities strengthen the sector. The long term aim was to contribute to establishment of an association to continue as a real association for the heat supply companies in the region. (au)
Ianakiev, A; Cui, JM; Garbett, S; Filer, A
An innovative low temperature district heating (LTDH) local network is developed in Nottingham, supported by the REMOURBAN project, part of the H2020 Smart City and Community Lighthouse scheme. It was proposed that a branch emanating from the return pipe of the existing district heating system in Nottingham would be created to use low temperature heating for the first time on such scale in the UK. The development is aimed to extract unused heat from existing district heating system and to mak...
For a district heating company it is of importance to have an efficient and well performing system. A central part in the work to lower temperature levels in district heating networks is to acknowledge and improve cooling capability in substations. The aim of this thesis is to analyse substations in Polish district heating systems in order to identify reasons of poor cooling and to present suggestions of implementable measures. Furthermore, the economical saving potential from an improved coo...
Agyepong, I A
Many countries in sub-Saharan Africa face the problem of organizing health service delivery in a manner that provides adequate quality and coverage of health care to their populations against a background of economic recession and limited resources. In response to these challenges, different governments, including that of Ghana, have been considering or are in the process of implementing varying degrees of reform in the health sector. This paper examines aspects of health services delivery, and trends in utilization and coverage, using routine data over time in the Dangme West district of the Greater Accra region of Ghana, from the perspective of a district health manager. Specific interventions through which health services delivery and utilization at district level could be improved are suggested. Suggestions include raising awareness among care providers and health managers that increased resource availability is only a success in so far as it leads to improvements in coverage, utilization and quality; and developing indicators of performance which assess and reward use of resources at the local level to improve coverage, utilization and quality. Also needed are more flexibility in Central Government regulations for resource allocation and use; integration of service delivery at district level with more decentralized planning to make services better responsive to local needs; changes in basic and inservice training strategies; and exploration of how the public and private sectors can effectively collaborate to achieve maximum coverage and quality of care within available resources.
... 8--Salmon and Steelhead Full Life-Cycle Population Models; and Request 9--Effects of the Project and... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Don Pedro Hydroelectric Project Project... relicensing proceeding for the Don Pedro Hydroelectric Project No. 2299-075.\\1\\ Turlock Irrigation District...
Growing complexity of technical matter has meant that technical expertise is called upon in more and more legal proceedings. The technical expert is, in general terms, the mediator between technology and the law, he is also entrusted with the task of pointing up the differences in approach and in the nature of authority in these two areas and thus paving the way for mutual understanding. The evaluation of the technical expert's opinion is one of the cardinal problems bound up with the role of the expert in legal procedure. After the presentation of the expert's opinion, the judge is supposed to possess so much specialised knowledge that he can assess the opinion itself in scientific and technical respects and put his finger on any errors the expert may have made. This problem can only be solved via an assessment opinion. First of all, the opinion can be assessed indirectly via evaluation of the credentials and the neutrality and independence of the expert. In direct terms, the opinion can be subjected to a certain - albeit restricted - scrutiny, whether it is generally convincing, as far as the layman is competent to judge. This interpretation alone makes it possible to classify and integrate legally the technical standards and regulations represent expert statements on the scientific and technical theorems based on the knowledge and experience gained in a given area. They are designed to reflect prevailing opinion among leading representatives of the profession and can thus themselves be regarded as expert opinions. As a rule, these opinions will have such weight that - other than in exceptional cases - they will not be invalidated in procedure by deviating opinions from individual experts. (orig./HSCH) [de
Ringwalt, Chris; Vincus, Amy A; Ennett, Susan T; Hanley, Sean; Bowling, J Michael; Yacoubian, George S; Rohrbach, Louise A
We estimated the proportion of the nation's public school districts that have high school grades in which random drug testing is conducted. We collected data in spring 2005 from 1343 drug prevention coordinators in a nationally representative sample of school districts with schools that have high school grades; of these districts, 14% conducted random drug testing. Almost all districts randomly tested athletes, and 65% randomly tested other students engaged in extracurricular activities; 28% randomly tested all students, exceeding the current sanction of the US Supreme Court.
National Oceanic and Atmospheric Administration, Department of Commerce — Geographic Information System (GIS). Southwest Florida Water Management District (SWFWMD) regularly uses digital topographic information to support regulatory, land...
Lund, Henrik; Mathiesen, Brian Vad
District heating and cooling are here to stay, but the district heating technology has to change. It has to adjust to the requirements of a future smart energy development. Therefore, research is essential, but not only research in university laboratories. Demonstration projects and innovation an...... and collaboration between industry and universities are important, not only in terms of technical improvements, but also institutional and organizational aspects.......District heating and cooling are here to stay, but the district heating technology has to change. It has to adjust to the requirements of a future smart energy development. Therefore, research is essential, but not only research in university laboratories. Demonstration projects and innovation...
Bhattarai, Shandesh; Chaudhary, Ram P; Quave, Cassandra L; Taylor, Robin S L
This study documents the use of medicinal plants from the Mustang district of the north-central part of Nepal. Traditional botanical medicine is the primary mode of healthcare for most of the population of this district and traditional Tibetan doctors (Amchi) serve as the local medical experts. Field research was conducted in 27 communities of the Mustang district in Nepal from 2005-2007. We sampled 202 interviewees, using random and snowball sampling techniques. After obtaining prior informed consent, we collected data through semi-structured interviews and participant-observation techniques. Voucher specimens of all cited botanic species were deposited at TUCH in Nepal. We recorded the traditional uses of 121 medicinal plant species, belonging to 49 vascular plant and 2 fungal families encompassing 92 genera. These 121 species are employed to treat a total of 116 ailments. We present data on 58 plant species previously unknown for their medicinal uses in the Mustang district. Of the medicinal plants reported, the most common growth form was herbs (73%) followed by shrubs, trees, and climbers. We document that several parts of individual plant species are used as medicine. Plant parts were generally prepared using hot or cold water as the 'solvent', but occasionally remedies were prepared with milk, honey, jaggery, ghee and oil. Amchis recommended different types of medicine including paste, powder, decoction, tablet, pills, infusion, and others through oral, topical, nasal and others routes of administration. The traditional pharmacopoeia of the Mustang district incorporates a myriad of diverse botanical flora. Traditional knowledge of the remedies is passed down through oral traditions and dedicated apprenticeships under the tutelage of senior Amchi. Although medicinal plants still play a pivotal role in the primary healthcare of the local people of Mustang, efforts to ensure the conservation and sustainable use of medicinal species are necessary.
Chaudhary Ram P
Full Text Available Abstract Background This study documents the use of medicinal plants from the Mustang district of the north-central part of Nepal. Traditional botanical medicine is the primary mode of healthcare for most of the population of this district and traditional Tibetan doctors (Amchi serve as the local medical experts. Methods Field research was conducted in 27 communities of the Mustang district in Nepal from 2005-2007. We sampled 202 interviewees, using random and snowball sampling techniques. After obtaining prior informed consent, we collected data through semi-structured interviews and participant-observation techniques. Voucher specimens of all cited botanic species were deposited at TUCH in Nepal. Results We recorded the traditional uses of 121 medicinal plant species, belonging to 49 vascular plant and 2 fungal families encompassing 92 genera. These 121 species are employed to treat a total of 116 ailments. We present data on 58 plant species previously unknown for their medicinal uses in the Mustang district. Of the medicinal plants reported, the most common growth form was herbs (73% followed by shrubs, trees, and climbers. We document that several parts of individual plant species are used as medicine. Plant parts were generally prepared using hot or cold water as the 'solvent', but occasionally remedies were prepared with milk, honey, jaggery, ghee and oil. Amchis recommended different types of medicine including paste, powder, decoction, tablet, pills, infusion, and others through oral, topical, nasal and others routes of administration. Conclusions The traditional pharmacopoeia of the Mustang district incorporates a myriad of diverse botanical flora. Traditional knowledge of the remedies is passed down through oral traditions and dedicated apprenticeships under the tutelage of senior Amchi. Although medicinal plants still play a pivotal role in the primary healthcare of the local people of Mustang, efforts to ensure the conservation and
When the Institute of Plasma Physics, Nagoya University, expressed the hope to move into Toki district, the environmental problems accompanying the movement were discussed. The effect of the radioactivity leaking from the nuclear facility on human bodies must be far smaller than that of natural radiation, and for the purpose, the amount and fluctuation range of the natural radiation in the district must be known. The initial objectives of this cooperative research were to study on environmental radiation and to make a Geiger counter for the measurement. In 1981, a scintillation counter will be completed, and using a multi-channel pulse height analyzer, the nuclides which are the source of environmental radiation emission will be identified, and the tritium in natural water will be detected. Thus, the evaluation of environmental radiation can be carried out, and the situation before the movement of the research facility can be grasped. In this paper, the natural radioactivity in earth, atmosphere and water and cosmic ray, artificial radioactivity, and environmental radiation exposure dose are reported. Also, the manufacture of a GM counter measuring instrument and the measurements of cosmic ray background, typical earth samples and environmental radioactivity with the GM counter are reported. The related data are attached. (Kako, I.)
A district heating scheme is proposed which makes it possible to use the waste heat from power stations for the supply of households and industry. The heat is stored by evaporation of ammonia salts or liquids with dissolved salts. Both substances are transported on existing rail- or waterways to heating stations near the consumers, and the heat recovered by reaction of the two components. Then the product of reaction is transported back to the power stations, and reactivated by heat again. Based on a cost estimation, it can be shown that the proposed heat transport with heat trains or ships, at distances up to 100 km, results in heat costs which are to-day already below that of heat from fuel oil. The investment required for the heat transport system is unusually low due to the use of transport ways which already exist. The district heating system is not only favourable in respect of the environment, but actually reduces its present strain, both at the consumer and at the power stations. The technical advantages of the suggested concept, especially the possibility of introducing it in stages, are discussed. The consequences for the national economy regarding the safety of supply and the trade balance, as well as for the public transport undertakings, are obvious, and therefore not included in the paper. (orig.) [de
Vallios, Ioannis; Tsoutsos, Theocharis; Papadakis, George
The biomass exploitation takes advantage of the agricultural, forest, and manure residues and in extent, urban and industrial wastes, which under controlled burning conditions, can generate heat and electricity, with limited environmental impacts. Biomass can - significantly - contribute in the energy supplying system, if the engineers will adopt the necessary design changes to the traditional systems and become more familiar with the design details of the biomass heating systems. The aim of this paper is to present a methodology of the design of biomass district heating systems taking into consideration the optimum design of building structure and urban settlement around the plant. The essential energy parameters are presented for the size calculations of a biomass burning-district heating system, as well as for the environmental (i.e. Greenhouse Gas Emissions) and economic evaluation (i.e. selectivity and viability of the relevant investment). Emphasis has been placed upon the technical parameters of the biomass system, the economic details of the boiler, the heating distribution network, the heat exchanger and the Greenhouse Gas Emissions
Bancroft, A.R.; Fenton, N.
Global energy requirements are expected to double over the next 40 years. In the northern hemisphere, many countries consume in excess of 25 percent of their primary energy supply for building heating. Satisfying this need, within the constraints now being acknowledged for sustainable global development, provides an important opportunity for district heating. Fuel-use flexibility, energy and resource conservation, and reduced atmospheric pollution from acid gases and greenhouse gases, are important features offered by district heating systems. Among the major fuel options, only hydro-electricity and nuclear heat completely avoid emissions of combustion gases. To fill the need for an economical nuclear heat source, Atomic Energy of Canada Limited has designed a 10 MW plant that is suitable as a heat source within a network or as the main supply to large individual users. Producing hot water at temperatures below 100 degrees C, it incorporates a small pool-type reactor based on AECL's successful SLOWPOKE Research Reactor. A 2 MW prototype for the commercial unit is now being tested at the Whiteshell Nuclear Research Establishment in Manitoba. With capital costs of $7 million (Canadian), unit energy costs are projected to be $0.02/kWh for a 10 MW unit operating in a heating grid over a 30-year period. By keeping the reactor power low and the water temperature below 100 degrees C, much of the complexity of the large nuclear power plants can be avoided, thus allowing these small, safe nuclear heating systems to be economically viable
Kaburia Humphrey F
Full Text Available Abstract Background Ethnobotanical pharmacopoeia is confidently used in disease intervention and there is need for documentation and preservation of traditional medical knowledge to bolster the discovery of novel drugs. The objective of the present study was to document the indigenous medicinal plant utilization, management and their extinction threats in Samburu District, Kenya. Methods Field research was conducted in six divisions of Samburu District in Kenya. We randomly sampled 100 consented interviewees stratified by age, gender, occupation and level of education. We collected plant use data through semi-structured questionnaires; transect walks, oral interviews and focus groups discussions. Voucher specimens of all cited botanic species were collected and deposited at University of Nairobi's botany herbarium. Results Data on plant use from the informants yielded 990 citations on 56 medicinal plant species, which are used to treat 54 different animal and human diseases including; malaria, digestive disorders, respiratory syndromes and ectoparasites. Conclusion The ethnomedicinal use of plant species was documented in the study area for treatment of both human and veterinary diseases. The local population has high ethnobotanical knowledge and has adopted sound management conservation practices. The major threatening factors reported were anthropogenic and natural. Ethnomedical documentation and sustainable plant utilization can support drug discovery efforts in developing countries.
Vallios, Ioannis [Energy Applications Mgr., METRON Ltd Engineering Company (Greece); Tsoutsos, Theocharis [Department of Environmental Engineering, Technical University of Crete, GR-73100 Chania (Greece); Papadakis, George [Department of Natural Resources and Agricultural Engineering, Agricultural University of Athens (Greece)
The biomass exploitation takes advantage of the agricultural, forest, and manure residues and in extent, urban and industrial wastes, which under controlled burning conditions, can generate heat and electricity, with limited environmental impacts. Biomass can - significantly - contribute in the energy supplying system, if the engineers will adopt the necessary design changes to the traditional systems and become more familiar with the design details of the biomass heating systems. The aim of this paper is to present a methodology of the design of biomass district heating systems taking into consideration the optimum design of building structure and urban settlement around the plant. The essential energy parameters are presented for the size calculations of a biomass burning-district heating system, as well as for the environmental (i.e. Greenhouse Gas Emissions) and economic evaluation (i.e. selectivity and viability of the relevant investment). Emphasis has been placed upon the technical parameters of the biomass system, the economic details of the boiler, the heating distribution network, the heat exchanger and the Greenhouse Gas Emissions. (author)
Saleh, Muneer Aziz; Ramli, Ahmad Termizi; Alajerami, Yasser; Aliyu, Abubakar Sadiq; Bt Basri, Nor Afifah
A potential site has been selected for a nuclear power plant (NPP) in Mersing District of Malaysia. This study aims at providing the base line data of this district for the first time, in line with the International Atomic Energy Agency (IAEA) for NPP sitting criteria. The mean dose rate, mean population weighted dose rate and annual effective dose are found to be 140 nGy h-1, 0.836 mSv y-1 and 0.857 mSv, respectively. A hyper Purity Germanium Detector (HPGe) is used in determining the activity concentrations of 232Th, 226Ra and 40K. The activity concentration ranges from 16±1 to 410±15 Bq kg-1 for 232Th, 17±1 to 271±8 Bq kg-1 for 226Ra and 13±3 to 1434±57 Bq kg-1 for 40K. In addition, a Low Background Alpha Beta Series 5 XLB Automatic was used in the determination of gross alpha and gross beta activity. The result ranges from 202±50 to 2325±466 Bq kg-1 for gross alpha and 164±17 to 2447±103 Bq kg-1 for gross beta. Contour maps were produced for isodose, activity concentration of 232Th, 226Ra, 40K, gross alpha and gross beta for the study area. The results are compared with UNSCEAR (2000).
Matei, Magdalena; Enescu, Diana; Varjoghie, Elena; Radu, Florin; Matei, Lucian
District heating, DH, is an energy source which can provide a cost-effective, environmentally friendly source of heat and power for cities, but only in the case of well running systems, with reasonable technological losses. The benefits of DH system are well known: environmental friendly, energy security, economic and social advantages. DH already covers 60% of heating and hot water needs in transition economies. Today, 70 % of Russian, Latvian and Belarus homes use DH, and heating accounts for one-third of total Russian energy consumption. Yet a large number of DH systems in the region face serious financial, marketing or technical problems because of the policy framework. How can DH issues be best addressed in national and local policy? What can governments do to create the right conditions for the sustainable development of DH while improving service quality? What policies can help capture the economic, environmental and energy security benefits of co-generation and DH? To address these questions, the International Energy Agency (IEA) hosted in 2002 and 2004 conference focusing on the crucial importance of well-designed DH policies, for exchanging information on policy approaches. The conclusions of the conference have shown that 'DH systems can do much to save energy and boost energy security, but stronger policy measures are needed to encourage wise management and investment. With a stronger policy framework, DH systems in formerly socialist countries could save the equivalent of 80 billion cubic meters of natural gas a year through supply side efficiency improvements. This is greater than total annual natural gas consumption in Italy'. More efficient systems will also decrease costs, reducing household bills and making DH competitive on long-term. This paper presents the issues: -Theoretical benefits of the district heating and cooling systems; - Municipal heating in Romania; - Technical and economic problems of DH systems and social supportability; - How
Katahoire, Anne Ruhweza; Henriksson, Dorcus Kiwanuka; Ssegujja, Eric; Waiswa, Peter; Ayebare, Florence; Bagenda, Danstan; Mbonye, Anthony K; Peterson, Stefan Swartling
find solutions. The dialogues however are more likely to be sustainable if embedded in existing community structures and conducted by district based facilitators. U report as a community feedback mechanism registered a low response rate. The UNICEF tools were adopted at district level and generally well perceived by the DHTs. The limited resources and fiscal decision space however can hinder implementation of prioritized activities. Community dialogues based on CRCs can bring service providers and the community together but need to be embedded in existing community structures for sustainability.
Anokbonggo, W W; Ogwal-Okeng, J W; Ross-Degnan, D; Aupont, O
In Uganda, the decentralization of administrative functions, management, and responsibility for health care to districts, which began in 1994, resulted in fundamental changes in health care delivery. Since the introduction of the policy in Uganda, little information has been available on stakeholders' perceptions about the benefits of the policy and how decentralization affected health care delivery. To identify the perceptions and beliefs of key stakeholders on the impact and process of decentralization and on the operations of health services in two districts in Uganda, and to report their suggestions to improve future implementation of similar policies. We used qualitative research methods that included focus group discussions with 90 stakeholders from both study districts. The sample population comprised of 12 health workers from the two hospitals, 11 district health administrators, and 67 Local Council Leaders. Perceptions and concerns of stakeholders on the impact of decentralization on district health services. There was a general consensus that decentralization empowered local administrative and political decision-making. Among stakeholders, the policy was perceived to have created a sense of ownership and responsibility. Major problems that were said to be associated with decentralization included political harassment of civil servants, increased nepotism, inadequate financial resources, and mismanagement of resources. This study elicited perceptions about critical factors upon which successful implementation of the decentralization policy depended. These included: appreciation of the role of all stakeholders by district politicians; adequate availability and efficient utilization of resources; reasonably developed infrastructure prior to the policy change; appropriate sensitisation and training of those implementing policies; and the good will and active involvement of the local community. In the absence of these factors, implementation of
Pinkster, Fenne M; Boterman, Willem R
Expansion of urban tourism in historic districts in European cities is putting increasing pressure on these areas as places to live. In Amsterdam, an ever-growing number of tourists visit the famous canal district, which also forms the home of a group of long-term, upper-middle-class residents. While such residents are generally depicted as instigators of urban transformation, in this case, they are on the receiving end. Bringing together the literature on the socio-spatial impact of tourism, belonging and the lived experience of place, this article explores the changing relationship between these established residents and their neighbourhood and provides insight into their growing sense of discontent and even powerlessness in the face of neighbourhood change.
Pinkster, Fenne M; Boterman, Willem R
Expansion of urban tourism in historic districts in European cities is putting increasing pressure on these areas as places to live. In Amsterdam, an ever-growing number of tourists visit the famous canal district, which also forms the home of a group of long-term, upper-middle-class residents. While such residents are generally depicted as instigators of urban transformation, in this case, they are on the receiving end. Bringing together the literature on the socio-spatial impact of tourism, belonging and the lived experience of place, this article explores the changing relationship between these established residents and their neighbourhood and provides insight into their growing sense of discontent and even powerlessness in the face of neighbourhood change. PMID:29278248
Fricke, Norman [Jena Univ. (Germany)
By means of licensing agreements municipalities grant the right to the district heating suppliers to use their properties with or without fees for the construction of district heating pipelines. Contrary to the power industry or gas industry, this type of contract is not regulated by special legal and price-legal regulations. Often an uncertainty exists whether and in which amount the municipalities may require a return for the right of utilization. In particular, this is valid if municipalities make the extension of discontinued licensing agreements dependent on the agreement of higher license fees. The general review under consideration reports on any legal limits of the amount of the licence fees. At the same time, a reference to licence fees in the power sector and gas sector is performed. In addition, the author reports on the law historical and law political background of license fees.
Duval, Valentin; Lemarie, Christophe; Geneau De Lamarliere, Laurent; Hubert, Cecile; Le Guen, Gaelle
The first objective of this study is to determine the quantity of fermentable wastes produced by agricultural exploitations, agri-food industries and communities at the district scale, and to identify the main agricultural, industrial and community-based consumers of agricultural heat in order to ensure project profitability. A second objective, based on previous assessments, is to highlight possible methanization projects on the whole district territory, and to determine needed surfaces in relationship with the spreading of the digestate produced by these methanization projects. As far as the second objective is concerned, the report propose some generalities (project typologies, development criteria, produced energy, other potential wastes), presents different types of liquid phase or dry methanization (methodology, technology, costs), alternative scenarios, spreading potentials, and an environmental assessment (greenhouse emissions, impact on the natural and human environment). Several appendices are provided which contain data tables, maps of production assessments and of location distributions of installations
Graczyk, Sandra L.
An introduction to general systems theory and an overview of vocabulary and concepts are presented to introduce school business officials to systems thinking and to foster its use as an analytical tool. The theory is then used to analyze a sample problem: planning changes to a district's administrative computer system. (eight references) (MLF)
ABSTRACT. There is no consensus among scholars as to whether competitive partisan elections at Ghana's district assembly level can help deepen the country's decentralization system. It remains unclear whether a non-partisan district Assembly can work in Ghana. To address this issue, extensive qualitative interviews ...
Oregon Department of Education, 2012
The school and district report cards were created by the 1999 Oregon Legislature. The legislation requires that the Oregon Department of Education (ODE) produce and issue a report card to all public schools and districts in the state. The report cards are designed to: (1) Communicate the many good things occurring in Oregon's public schools; (2)…
Persons identified with disability in this study from three districts in Rwanda have various activity limitations. The findings provide a useful resource for planning rehabilitation services and to direct future enquiry into the epidemiology of disability in other districts of Rwanda. Keywords: disability, prevalence, ICF, Rwanda ...
This article describes an effort to create a coherent teacher recruitment, preparation and induction program in a large urban school district, based in part on the medical residency model. The article argues for several core principles in the creation of such a program: a) the program serves the school district, b) the program is structured to…
Palsson, Olafur Petur; Madsen, Henrik; Søgaard, Henning Tangen
In district heating systems, and in particular if the heat production cakes place at a combined heat and power (CHP) plant, a reasonable control strategy is to keep the supply temperature from the district heating plant as low as possible. However, the control is subject to some restrictions...
... SMALL BUSINESS ADMINISTRATION Houston District Office Advisory Committee AGENCY: U.S. Small... Houston District Office Advisory committee. The meeting will be open to the public. DATES: The meeting...; located at 8701 South Gessner, Houston, TX 77074. SUPPLEMENTARY INFORMATION: Pursuant to section 10(a)(2...
... SMALL BUSINESS ADMINISTRATION Houston District Office Advisory Committee AGENCY: U.S. Small... Houston District Office Advisory committee. The meeting will be open to the public. DATES: The meeting...; located at 8701 South Gessner, Houston, TX. 77074. SUPPLEMENTARY INFORMATION: Pursuant to section 10(a)(2...
Rogers, John D.; Glesner, Talia J.; Meyers, Herman W.
This article describes the implementation of an initiative to encourage voluntary school district mergers in Vermont. The law was intended to increase educational opportunities for Vermont students while reducing costs. Three research activities were conducted to understand how districts and supervisory unions around the state responded to the new…
A cross-sectional survey of bovine trypanosomosis was carried out in Wemberma district of west Gojjam zone, North West Ethiopia. From three peasant associations in the district (one from the midland and two from lowland), 384 cattle were randomly selected and examined for trypanosomosis. The prevalence of the.
The creation of administrative districts and parliamentary constituencies constitute major aspects of the internal organisation of states. The Ghanaian Constitution of 1992 invests the creation of districts and constituencies in the Presidency and the independent Electoral Commission respectively. This arrangement has ...
Schroeder, G.; Barnert, H.; Wischnewski, R.
From the demand viewpoint, the connection of an installed nuclear thermal capacity of 290 MJ/s for district heating purposes would be possible in the central Ruhr District by 1982-1983. The nuclear district heating system is made up of several subsystems, for instance, a smaller size high-temperature reactor [500 MW(thermal)] as a nuclear heat-and-power plant and an interconnected district heating system with a feed temperature of 453 K (180 0 C). The expenditure for additional investments, additional fuel costs, and costs for substitute power capacity are charged to the thermal energy generation costs of the nuclear heat-and-power plant. For the nuclear district heating system, the district heating costs to the consumer will vary over wide limits, depending on local conditions, between 7.8 and 12.2 $/GJ at the commissioning date in 1983, assuming that all subsystems have to be newly installed. These costs can be lower than district heating costs in a conventional district heating system with fossil-fired heating stations
Moving from a traditional school district to one that embraces a community schools model requires fundamental shifts in organizational structure and practices. Evansville Vanderburgh School Corporation in southern Indiana and Vancouver Public Schools in Vancouver, Wash., are two districts that have navigated this change. Leaders from those…
Managing Plan Implementation in the Asante Akyem South District Assembly: Capacity Issues and Challenges. ... This paper uses a case study approach to appraise the capacity of the Asante Akyem South District Assembly (AASDA) in managing the implementation of its development plans. Using questionnaires and ...
ABSTRACT. Background: In 2003, the Government of Zambia in collaboration with implementing partners in immunisation introduced the Reaching Every District. (RED) strategy to improve immunization coverage. The aim of this study is to evaluate the implementation of the. RED strategy in Lusaka district. Methods: A ...
The threat of terrorism is a concern in public facilities including schools. This study focused on school districts in a southwestern state. Terrorism emergency preparedness policies are well-documented as measures to protect students and staff in school districts from terrorism threats and vulnerabilities. However, those threats and…
An outbreak of human anthrax occurred in Maragua district between December 2005 and January 2006 and an investigation was undertaken through visits and interviews with the District Veterinary (DVO) and Public Health Officers, owners of cattle that had died, people who had butchered or eaten the meat from dead ...
Abstract. The creation of administrative districts and parliamentary constituencies constitute major aspects of the internal organisation of states. The Ghanaian. Constitution of 1992 invests the creation of districts and constituencies in the. Presidency and the independent Electoral Commission respectively. This arrangement ...
Tuttle, Christina; McCullough, Moira; Richman, Scott; Booker, Kevin; Burnett, Alyson; Keating, Betsy; Cavanaugh, Michael
In November 2012, the Bill & Melinda Gates Foundation invested in seven innovative district-charter partnerships with "the potential capacity and commitment to accelerate student college ready rates through deep collaboration and sharing of best practices" (District-Charter Collaboration Grant Request for Proposal [RFP]). These…
Maxwell, Lesli A.
It took a while for four-time finalist Aldine, Texas, to win the Broad Prize for Urban Education. But it took even longer to craft the system that ultimately put the district over the top. Educators in Aldine district have been working for more than a decade to refine their "managed instruction" system. Reviewers examined how the school…
Albuquerque Public Schools, NM.
This study compares salaries as well as benefits of school district personnel in the seven metropolitan school districts that include Albuquerque, New Mexico; Denver, Colorado; Phoenix and Tucson, Arizona; Wichita, Kansas; and Mobile, Alabama. The tables aggregate all the elements in the total compensation package for each category of employee and…
Albuquerque Public Schools, NM.
This study compares salaries as well as benefits of school district personnel in the eight metropolitan school districts that include Albuquerque, New Mexico; Denver, Colorado; El Paso, Texas; Phoenix and Tuscon, Arizona; Wichita, Kansas; and Mobile, Alabama. The tables aggregate all the elements in the total compensation package for each category…
B. K. Kortatsi
Abstract. Reconnaissance hydrochemical survey of 56 wells was conducted in the Wassa West District with the objective of providing baseline data for the establishment of groundwater quality monitoring stations. The data acquired is used in this paper to assess the quality of groundwater in the District. Groundwaters are ...
House, Jess E.
Exit polling of school district election returns is a form of environmental scanning that can provide information needed for strategic planning and be used to increase the effectiveness of school election campaigns. This technique is recommended for all school districts dependent on voter approval to meet revenue needs. (11 references) (MLH)
Chisesi, Lawrence J.
I study how competition played out between elementary schools in a Colorado school district. When the school board approved new schools without catchments, schools faced with declining catchment populations responded. Some schools adapted by altering programming away from the standard district curriculum. I model a school's success in recruiting…
However, the frequency of hunting was higher in Serengeti District than in Ngorongoro District and dogs were significantly more used for hunting than were other means of hunting. Some small mammals, such as rodents, were a nuisance in raiding crop fields and food stores. In attempting to protect their crops and other ...
Woodburn Public Schools, OR.
Year-round schooling is a positive alternative for the Woodburn School District, a district experiencing an overcrowding problem. The year-round education system has not yet been implemented in Woodburn, but the proposal is getting serious attention by administrators, teachers, and parents. The Utah Foundation Research Report identifies 10…
The bird's-eye perspective: how do district health managers experience the impact of family physicians within the South African district health system? A qualitative study. K.B. Von Pressentin, R.J. Mash, L Baldwin-Ragaven, R.P.G. Botha, I Govender, W.J. Steinberg ...
... DEPARTMENT OF EDUCATION Race to the Top--District AGENCY: Office of the Deputy Secretary, Department of Education. ACTION: Notice reopening the Race to the Top--District competition. Catalog of Federal Domestic Assistance (CFDA) Number: 84.416. SUMMARY: The Secretary reopens the Race to the Top...
The present article considers human- small mammal interactions in six villages adjacent to the protected areas. Data were obtained through questionnaire administration to the local people in the districts. Small mammals were hunted in the two districts for food purposes and some villagers declared that they were earning.
Hammett, Kathleen M; Katz, Brian G; McPherson, Benjamin F; Patino, Eduardo; Schiffer, Donna M; Wedderburn, Leslie; Yobbi, Dann K
This Science Plan has been prepared by the Florida District of the U.S. Geological Survey (USGS) as a tool to provide direction for the scientific work to be accomplished in the District during the next 5-10 years...
... WHISKEYTOWN-SHASTA-TRINITY NATIONAL RECREATION AREA: ZONING STANDARDS FOR WHISKEYTOWN UNIT § 30.3 Recreation District I. (a) Definition. This district shall comprise all those portions of the Whiskeytown Unit of the... deviation from these prescribed limitations and requirements would subject the property to acquisition...
Short, Deborah J.; Cloud, Nancy; Morris, Patricia; Motta, Julie
Secondary English as a second language (ESL) curricula that address four levels of ESL proficiency and prepare students for the English language arts (ELA) curricula and state-mandated ELA tests are not common. A curriculum jointly developed by two districts is even rarer. Yet two urban districts in Rhode Island undertook such a curriculum…
Objective: To describe the surgical experience of typhoid perforations at a rural district hospital in Kenya. Patient and Methods: This was a retrospective chart review of patients who underwent laparotomies for peritonitis at the Kapenguria District Hospital in Kenya between April 2007 and October 2009. Data abstracted from ...
DOWNLOAD FULL TEXT Open Access DOWNLOAD FULL TEXT Subscription or Fee Access. Status of Indigenous Chicken Farming in Dhemaji District of Assam, India. H Chutia, N Kalita, N Barua, P Hazarika. Abstract. A survey was conducted in Dhemaji district of Assam, India comprising 15 villages and 300 households.
DeMoulin, Donald F.; Guyton, John W.
In the quest for excellence, school districts have a variety of indicators or attributes available by which to gauge their progress. This model, used By the Equity and Excellence Research school districts in Mississippi, monitors achievement in relation to educational excellence. Team members established a list of attributes and various means of…
Hansen, Leif Gjesing; Lise Drewes, Nielsen
The paper presents results of the logistical flows and logistical organisation used in a district logistics analysis in Viborg county, Denmark.......The paper presents results of the logistical flows and logistical organisation used in a district logistics analysis in Viborg county, Denmark....
Reconnaissance hydrochemical survey of 56 wells was conducted in the Wassa West District with the objective of providing baseline data for the establishment of groundwater quality monitoring stations. The data acquired is used in this paper to assess the quality of groundwater in the District. Groundwaters are mainly ...
Hyndman, June; Cleveland, Roger; Huffman, Tyler
From 1945 to 1980, school districts across the United States decreased the number of schools through consolidation. With the advent of geographic software, it is possible to map schools across time and analyze patterns of school openings, closings, and consolidation. In this study, one Southeastern Kentucky district was selected as a pilot for…
Curley, John R.
Describes New York State's experience with school district tax limits in urban districts serving less than 125,000. Originally designed to protect taxpayers, these tax limits have spawned a costly state aid system that raises serious equity issues. Recent legislation removed tax limits and made state aid more equitable. (32 references) (MLH)
Deal, Terrence E.; Nutt, Samuel C.
Compiled for school administrators who must initiate or respond to external mandate for change, this guide draws on the experiences of 10 rural school districts that participated in the federally funded Experimental Schools (ES) program for perspectives that can be used in the successful management of change efforts in school districts. Organized…
...: I have determined that the emergency conditions in the District of Columbia resulting from Hurricane... District of Columbia to have been adversely affected by this declared emergency: Emergency protective....046, Fire Management Assistance Grant; 97.048, Disaster Housing Assistance to Individuals and...
Ommen, Torben Schmidt; Markussen, Wiebke Brix; Elmegaard, Brian
In the current Danish energy system, the majority of electricity and heat is produced in combined heat and power plants. With increasing shares of intermittent renewable power production, it becomes a challenging task to match power and heat production, as heat demand and production capacity...... constraints limit the power plants. Efficient heat pumps can be used to decouple the constraints of electricity and heat production, while maintaining the high energy efficiency needed to match the politically agreed carbon emission goals. The requirements in terms of COP, location, capacity and economy...... are calculated using an energy system model which includes power plants, heat pumps and district heating consumption profiles. The model is developed with focus on accurate representation of the performance of the units in different locations and operating modes. The model can assist in investment decisions...
Al-Mohareb, F; Al-Sadoon, M
Eighty-two patients with snakebites were seen at King Fahad Hospital (KFH) in Al Baha during the period from 1983G to 1989G and were retrospectively reviewed. Most common symptoms were pain (80.5%) and swelling (77%). Hemostatic abnormalities were found in 36 patients (44%) and were usually present on admission but may be delayed up to 20 hours after snakebite. All of these patients had local swellings, 17 had low hemoglobin and 29 had leukocytosis, suggesting systemic envenomation. Five patients had local skin necrosis, and three had to have fasciotomy for compartment syndrome. All patients, except one death, responded to treatment (antivenin, plasma products, or both). These data emphasize that hemostatic abnormality is the major complication of snakebite in the Al Baha District of Saudi Arabia.
Over 25% of the primary energy consumption in most of the countries of the northern Pacific Basin is used to heat buildings. This represents an important opportunity for nuclear energy to significantly reduce the dependence on fossil fuels in an end-use application that is readily amenable to substitution. In a major departure from traditional nuclear power technology, Atomic Energy of Canada Limited has developed the SLOWPOKE Energy System - a 10 MWt nuclear heat source specially designed to satisfy the needs of local heating systems used by buildings and institutions. A prototype reactor has been constructed to verify in a very demonstrative way that the technical, economic and safety criteria for nuclear district heating systems can in fact be met
Over 25% of the primary energy consumption in most of the countries of the northern Pacific Basin is used to heat buildings. This represents an important opportunity for nuclear energy to significantly reduce the dependence on fossil fuels in an end-use application that is readily amenable to substitution. In a major departure from traditional nuclear power technology, Atomic Energy of Canada Limited has developed the SLOWPOKE Energy System-a 10 MWt nuclear heat source specially designed to satisfy the needs of local heating systems used by buildings andinstitutions. A prototype reactor has been constructed to verify in a very demonstrative way that the technical, economic and safety criteria for nuclear district heating systems can in fact be met. (author)
Audunson, T.; Dahl, F.-E.; Jacobson, P.; Land, J.
The hydrophysical investigations made in order to evaluate the suitability of the waters adjacent to three prospective nuclear power plant sites in the Oslofjord district are summarised. In the evaluation for the Brenntangen site special consideration is given to the effect of cooling water discharge on the temperature conditions in the inner Oslofjord. The renewed evaluation of the Hurum site has been made at the request of Norges Vassdrags- og Elektrisitetsvesen, on the understanding that it would not delay the Brenntangen investigations, and is therefore madeon a sparse data basis. A one-dimensional numerical model has been developed which, together with hydrophysical calculations, allows the warming of the inner Oslofjord to be evaluated. (JIW)
Hakala, L.; Pesola, A.; Vanhanen, J.
Local district heating business, outside large urban centers, is a profitable business in Finland, which can be practiced with several different business models. In addition to the traditional, local district heating business, local district heat production can be also based on franchising business model, on integrated service model or on different types of cooperation models, either between a local district heat producer and industrial site providing surplus heat or between a local district heat producer and a larger district heating company. Locally available wood energy is currently utilized effectively in the traditional district heating business model, in which a local entrepreneur produces heat to consumers in the local area. The franchising model is a more advanced version of the traditional district heating entrepreneurship. In this model, franchisor funds part of the investments, as well as offers centralized maintenance and fuel supply, for example. In the integrated service model, the local district heat producer offers also energy efficiency services and other value-added services, which are based on either the local district heat suppliers or his partner's expertise. In the cooperation model with industrial site, the local district heating business is based on the utilization of the surplus heat from the industrial site. In some cases, profitable operating model approach may be a district heating company outsourcing operations of one or more heating plants to a local entrepreneur. It can be concluded that all business models for district heat production (traditional district heat business model, franchising, integrated service model, cooperative model) discussed in this report can be profitable in Finnish conditions, as well for the local heat producer as for the municipality - and, above all, they produce cost-competitive heat for the end-user. All the models were seen as viable and interesting and having possibilities for expansion Finland
Full Text Available Drought is one of natural disaster occurrences that affect many life aspects such as agricultural and economy. Drought is one of hazard that affected by extreme condition due to climate change. Wonogiri is one of districts in Indonesia that has a high risk of meteorological drought. This area tends to have less rainfall than other areas that make the condition drier. This study is aimed to provide some information required in determining the drought disaster mitigation through analysis of the drought characteristics, for both historical and future condition. For the historical condition analysis, the input is 12 years of daily rainfall recorded data from 1990 to 2001 in 15 rain gauges. In case of the future assessment, the meteorological drought was analyzed by using Effective Drought Index (EDI and Standardized Precipitation Index (SPI methods. Input data for the future assessment is 90 years of daily rainfall which was generated by using climate model HadCM3 scenario A2 and B2. The future data prediction was done by using Automated Statistical Downscaling software. Statistical criteria i.e. Root Mean Square Error (RMSE, regression coefficient and standard deviation were used for testing the model accuracy. The drought coefficient obtained from the analysis using EDI and SPI then was applied to draw drought risk map using GIS software in Wonogiri District for historical and future condition. The results show that for the historical condition, the most severe drought occurred in 1997-1998. This extreme condition related to ENSO phenomenon that happened in this area. Compared with the historical condition, the number of future drought event in 2080 period is less than the historical one. This result agree with the rainfall prediction. The generated rainfall for both scenarios are increase from existing period to 2080’s.
Möller, Bernd; Lund, Henrik
energy production. The present paper describes a geographical study of the potential to expand district heating into areas supplied with natural gas. The study uses a highly detailed spatial database of the built environment, its current and potential future energy demand, its supply technologies and its....... The analyses suggest to expand district heating from present 46% to somewhere in between 50% and 70%. The most attractive potential is located around towns and cities. The study also suggests that CO2-emissions, fuel consumption and socioeconomic costs can be reduced by expanding district heating, while...... location relative to energy infrastructure. First, using a spatially explicit economic model, the study calculates the potentials and costs of connection to expanded district heating networks by supply technology. Then a comprehensive energy systems analysis is carried out to model how the new district...
This Final Report (Volume 2) of Phase 1 of District Heating for Communities Through Power Plant Retrofit Distribution Network contains 3 tasks: (1) Demonstration Team; (2) Identify Thermal Energy Sources and Potential Service Areas; and (3) Energy Market Analysis. Task 2 consists of estimating the thermal load within 5 and 10 miles of Public Service Electric and Gas Company steam power plants, Newark, New Jersey; estimating the costs of supplying thermal services to thermal loads of varying densities; a best case economic analysis of district heating for single-family homes; and some general comments on district-heating system design and development. Task 3 established the potential market for district heating that exists within a 5-mile radius of the selected generating stations; a sample of the questionnaire sent to the customers are shown. (MCW)
... the California State Implementation Plan, Mojave Desert Air Quality Management District AGENCY... limited disapproval of revisions to the Mojave Desert Air Quality Management District (MDAQMD) portion of.... * * * * * (c) * * * (379) * * * (i) * * * (E) Mojave Desert Air Quality Management District. (1) Rule 1159...
... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State... Quality Management District--SCAQMD) (1) Rule 1143, ``Consumer Paint Thinners & Multi-purpose Solvents...
Fire and EMS Districts, Fire District boundaries within Sedgwick County. Cover is programmatically derived from taxing unit districts. Used for Public Safety map rolls. Primary attribute is fire district name. Published to scfiredia.shp., Published in 2008, 1:1200 (1in=100ft) scale, Sedgwick County Government.
NSGIC Local Govt | GIS Inventory — Fire and EMS Districts dataset current as of 2008. Fire District boundaries within Sedgwick County. Cover is programmatically derived from taxing unit districts....
Syafruddin, Din; Asih, Puji B S; Coutrier, Farah N; Trianty, Leily; Noviyanti, Rintis; Luase, Yaveth; Sumarto, Wajiyo; Caley, Marten; van der Ven, Andre J A M; Sauerwein, Robert W
Malaria has long been known as one of the major public health problems in West Sumba District, East Nusa Tenggara Province, Indonesia. To obtain baseline data for establishment of a suitable malaria control program in the area, malariometric surveys were conducted in two sub-districts, Wanokaka and Loli, during the periods of January, May, and August 2005. The survey included three selected villages in each sub-district, and blood smear analyses of 701, 921, and 894 randomly selected subjects in January, May, and August revealed 30.5%, 25.3%, and 28.2% malaria positives, respectively, consisting mainly of Plasmodium falciparum and P. vivax, and in a few cases, P. malariae. Analysis of malaria prevalence at different age groups clearly reflected the common phenomenon that younger individuals are more vulnerable by infection of either P. falciparum or P. vivax. In falciparum malaria, the frequency of cases carrying gametocytes was also relatively high involving all age groups. The findings indicate that the malaria incidence and transmission in the area are relatively high and that further exploration is warranted to establish a precise malaria control program.
Martins, Meghan G.
This research developed a survey that measures the degree to which challenges are experienced by school and district leaders, and teachers, when attempting to implement legislatively required District Improvement Plans (DIPs). The data indicate that there are certainly challenges when implementing DIPs and that teachers report experiencing a…
In 2011, the Center of American Progress (CAP) released the first-ever attempt to evaluate the productivity of almost every major school district in the country. That project developed a set of relatively simple productivity metrics in order to measure the achievement that a school district produces relative to its spending, while controlling for…
Dickens, Kimberly Rae
School districts across the country make many decisions that impact teachers' satisfaction both positively and negatively. With statistics reporting a significant number of teachers leaving the profession in the first 5 years of experience, determining the reasons for teacher dissatisfaction are important in shaping district practices to be more…
Anderson, Kevin John Boyett
Current literature shows that many science teachers view policies of standards-based and test-based accountability as conflicting with research-based instruction in science education. With societal goals of improving scientific literacy and using science to spur economic growth, improving science education policy becomes especially important. To understand perceived influences of science education policy, this study looked at three questions: 1) How do teachers perceive state science standards and assessment and their influence on curriculum and instruction? 2) How do these policy perspectives vary by district and teacher level demographic and contextual differences? 3) How do district leaders' interpretations of and efforts within these policy realms relate to teachers' perceptions of the policies? To answer these questions, this study used a stratified sample of 53 districts across Wisconsin, with 343 middle school science teachers responding to an online survey; science instructional leaders from each district were also interviewed. Survey results were analyzed using multiple regression modeling, with models generally predicting 8-14% of variance in teacher perceptions. Open-ended survey and interview responses were analyzed using a constant comparative approach. Results suggested that many teachers saw state testing as limiting use of hands-on pedagogy, while standards were seen more positively. Teachers generally held similar views of the degree of influence of standards and testing regardless of their experience, background in science, credentials, or grade level taught. District SES, size and past WKCE scores had some limited correlations to teachers' views of policy, but teachers' perceptions of district policies and leadership consistently had the largest correlation to their views. District leadership views of these state policies correlated with teachers' views. Implications and future research directions are provided. Keywords: science education, policy
Ruoyan, Gai; Lingzhong, Xu; Huijuan, Li; Chengchao, Zhou; Jiangjiang, He; Yoshihisa, Shirayama; Wei, Tang; Chushi, Kuroiwa
In China, national regulations and standards for health care waste management were implemented in 2003. To investigate the current status of health care waste management at different levels of health care facilities (HCF) after the implementation of these regulations, one tertiary hospital, one secondary hospital, and four primary health care centers from Binzhou District were visited and 145 medical staff members and 24 cleaning personnel were interviewed. Generated medical waste totaled 1.22, 0.77, and 1.17 kg/bed/day in tertiary, secondary, and primary HCF, respectively. The amount of medical waste generated in primary health care centers was much higher than that in secondary hospitals, which may be attributed to general waste being mixed with medical waste. This study found that the level of the HCF, responsibility for medical waste management in departments and wards, educational background and training experience can be factors that determine medical staff members' knowledge of health care waste management policy. Regular training programs and sufficient provision of protective measures are urgently needed to improve occupational safety for cleaning personnel. Financing and administrative monitoring by local authorities is needed to improve handling practices and the implementation of off-site centralized disposal in primary health care centers.
Ruoyan, Gai; Xu Lingzhong; Li Huijuan; Zhou Chengchao; He Jiangjiang; Yoshihisa, Shirayama; Tang Wei; Chushi, Kuroiwa
In China, national regulations and standards for health care waste management were implemented in 2003. To investigate the current status of health care waste management at different levels of health care facilities (HCF) after the implementation of these regulations, one tertiary hospital, one secondary hospital, and four primary health care centers from Binzhou District were visited and 145 medical staff members and 24 cleaning personnel were interviewed. Generated medical waste totaled 1.22, 0.77, and 1.17 kg/bed/day in tertiary, secondary, and primary HCF, respectively. The amount of medical waste generated in primary health care centers was much higher than that in secondary hospitals, which may be attributed to general waste being mixed with medical waste. This study found that the level of the HCF, responsibility for medical waste management in departments and wards, educational background and training experience can be factors that determine medical staff members' knowledge of health care waste management policy. Regular training programs and sufficient provision of protective measures are urgently needed to improve occupational safety for cleaning personnel. Financing and administrative monitoring by local authorities is needed to improve handling practices and the implementation of off-site centralized disposal in primary health care centers.
Government Districts, Other, Sedgwick County Board of County Commissioner district boundaries. Derived from countywide Elections coverage. Primary attributes include District number and respresentative name. Includes district number annotation. Published to scbocc_a.shp., Published in 2008, 1:1200 (1in=100ft) scale, Sedgwick County Government.
NSGIC Local Govt | GIS Inventory — Government Districts, Other dataset current as of 2008. Sedgwick County Board of County Commissioner district boundaries. Derived from countywide Elections coverage....
Saellberg, Sven-Erik; Nilsson, Stefan [Swedish National Testing and Research Inst., Goeteborg (Sweden)
Previous studies have shown that polyurethane insulation (PUR foam) on district heating pipes acts as protection against water if it is of good quality, i.e. free from cracks, cavities and other defects. On the other hand water vapour easily diffuses through PUR foam. However this is not a problem as long as the steel pipe is warmer than the surface layer, since the high temperature will prevent the vapour from condensating. What will happen with the insulation of a casing free district heating pipe where the ground water level occasionally reaches above the pipe has not been studied in detail. The current project has studied to what extent moisture enters the PUR foam insulation of two approximately one meter long district heating pipes without casing which have been in the ground for four years. Occasionally, the ground-water has entirely covered the pipes. In addition, the foam has been studied with respect to damage from the surrounding backfill material. Test specimens were taken out of the casing free pipes and were analysed with respect to moisture content. Additional measurements were done with a moisture indicator, and the electric resistance between the steel pipes and the four surveillance wires in each pipe was measured. The results from the various measurement techniques were the compared. The results show that the PUR foam remains dry as long as the service pipe is hot if no defects, such as crack and cavities, are present. Close to the service pipe, the foam actually dries out over time. The moisture content of the middle layer remains more or less constant. Only the colder parts on the outside exhibit an increase in moisture content. It was also seen that defects may lead to water ingress with subsequent humidification of the foam. However, the damaged foam area is limited. This is not the case for a regular pipe with a vapour tight casing, where experience show that moisture tend to spread along the pipe. The pipes were buried in sand and no
Full Text Available Urban floods are linked to patterns of land use, specifically urban sprawl. Since the 1980s, government-led new districts are sweeping across China, which account for many of the floods events. Focuses of urbanization impact on floods are extending gradually from hydraulic channels, to imperviousness ratio, to imperviousness pattern in urban areas or urbanized basins. Thus, the paper aims to explore how urban land pattern can affect floods in urban areas to provide decision makers with guidance on land use and stormwater management. Imperviousness was generally correlated with spatial variations in land use, with lower imperviousness in less dense, new districts, and higher imperviousness in more dense, uniform/clustered development in local areas adjacent to hot nodes. The way imperviousness and channel are organized, and the location of imperviousness within a catchment, can influence floods. Local government’s approach to new district planning, in terms of zoning provisions, has only considered some development aspects and has not adequately integrated flood management. A key issue for the planning should been done to adequately cater for flooding, particularly considering the benefits of keeping natural conveyance systems (rivers and their floodplains to manage flood waters.
Orach, Christopher Garimol; Mayega, Roy William; Woboya, Vincent; William, Bazeyo
Uganda is vulnerable to several natural, man-made and a hybrid of disasters including drought, famine, floods, warfare, and disease outbreaks. We assessed the district disaster team's performance, roles and experiences following the training. The disasters most commonly experienced by the district teams were epidemics of diseases in humans (7 of 12), animals (epizoonotics) (3 of 12) and crops (3 of 12); hailstorms and floods (3 of 12). The capabilities viewed most useful for management of disasters were provision of health care services (9/12) and response management (8 of 12). The capability domains most often consulted during the disasters were general response management (31%), health services (29%) and water and sanitation (17%). The skills areas perceived to be vital following the training were response to epidemics 10/12, disaster management planning 8/12, hazards and vulnerability analysis 7/12 and principles of disaster planning 7/12 respectively. Main challenges mentioned by district teams were inadequacy of finance and logistics, lack of commitment by key partners towards disaster preparedness and response. The most common disaster experienced disasters related to outbreaks of diseases in man, animals and crops. The most frequently applied capabilities were response management and provision of emergency health services. The activities most frequently implemented following disaster management teams training were conducting planning meetings, refinement of plans and dissemination of skills gained. The main challenges were related to limited budget allocations and legal frameworks for disaster management that should be addressed by both central and local governments.
Ronanki, Venkata Ramana; Sheeladevi, Sethu; Ramachandran, Brinda P; Jalbert, Isabelle
There is a huge need for the availability of transplantable donor corneas worldwide to reduce the burden of corneal blindness due to corneal opacity. Voluntary eye donation depends on the awareness levels of various stakeholders in the community. This study aimed to assess the awareness level regarding eye donation among various stakeholders in Srikakulam district in the state of Andhra Pradesh, India. 355 subjects were selected from the district using multi stage random sampling. A pre tested semi structured questionnaire was used to collect information regarding each individual's awareness, knowledge, and perception regarding eye donation. Each response was scored individually and a total score was calculated. Univariate and multivariate regression analysis was used to determine the factors associated with willingness towards eye donation and increased awareness levels. Of the 355 subjects interviewed, 192 (54%) were male and 163 (46%) were female. The mean age of the stakeholders was 35.9 years (SD ±16.1) and all the study subjects were literate. Ninety-three percent of subjects were aware of the concept of eye donation. Knowledge levels were similar among the teaching community and persons engaged in social service, but lower among students (p stakeholders, there was considerable ambiguity regarding whether persons currently wearing spectacles or suffering from a chronic illnesses could donate their eyes. Older age group (p stakeholders in Srikakulam district in India. The services of stakeholders could be utilized, in conjunction with other community based eye donation counselors, to promote awareness regarding eye donation among the general population.
Li, Hongwei; Svendsen, Svend
Low temperature district heating with reduced network supply and return temperature provides better match of the low quality building heating demand and the low quality heating supply from waste heat or renewable energy. In this paper, a hypothetical low temperature district heating network is designed to supply heating for 30 low energy detached residential houses. The network operational supply/return temperature is set as 55 °C/25 °C, which is in line with a pilot project carried out in Denmark. Two types of in-house substations are analyzed to supply the consumer domestic hot water demand. The space heating demand is supplied through floor heating in the bathroom and low temperature radiators in the rest of rooms. The network thermal and hydraulic conditions are simulated under steady state. A district heating network design and simulation code is developed to incorporate the network optimization procedure and the network simultaneous factor. Through the simulation, the overall system energy and exergy efficiencies are calculated and the exergy losses for the major district heating system components are identified. Based on the results, suggestions are given to further reduce the system energy/exergy losses and increase the quality match between the consumer heating demand and the district heating supply. -- Highlights: ► Exergy and energy analysis for low and medium temperature district heating systems. ► Different district heating network dimensioning methods are analyzed. ► Major exergy losses are identified in the district heating network and the in-house substations. ► Advantages to apply low temperature district heating are highlighted through exergy analysis. ► The influence of thermal by-pass on system exergy/energy performance is analyzed.
Pavelek, J; Hudáková, G
From death certificates assemble in the Zilina district in three years (1968-1970) the authors prepared and coded questionnaires with 29 criteria. In the present article they submit some results obtained by automatic computing and biometric evaluation of these data. In the introduction they draw attention to and explain the rising trend of mortality in the Zilina district as well as in the Slovak Socialist Republic. Significant differences were revealed in the marital status of men and women with a predominance of married man and widows. The investigated variations of the number of deceased per day or week is not statistically significant; they were significant only in the course of the year with the maximum of deaths in March and the minimum in August. The specific mortality by decades revealed that men have from birth throughout life a higher death rate than women. As regards causes of death according to the 17 classes of the International Classification four classes dominate similarly an in the entire Slovak Socialist Republic, i. e. cardiovascular diseases 40.8%, tumours 17.8%, respiratory diseases 17.2% and accidents 7.5% all diagnoses. The order of diseases is the same for men and women only in the five most numerous classes and even there is a significant difference in the mortality level in three. Trichotomic classification of communities throws some light on the problem of causes of death of the rural and urban population. The last doctor attending the patient before death was in 48,3% the health community doctor, in 39,1% the hospital, in 8,9% (accidents and acute attacks) nobody whereby the percentage structure of men and women differs significantly also in this indicator. Finally the authors draw attention to the fact that the number of post mortem examinations (31,8%) is highest, as compared with the Central Slovak region (19,9%), the Slovak Socialist Republic (21,1%), the Czech Socialist Republic (29,8%) and the CSSR (27,6%).
The recommended approach to solving Panama's, or Latin America's, housing problem was to use an integrated program of services which considered not just housing, but also sanitation, roads, clean water supply, accessibility, educational and health services, financial resources, and human, legal, and administrative resources. Rapid population growth in cities from migration has created the "witches' district." Living conditions in "witches' districts" are characterized by poverty, crowded sleeping and living conditions, filth, lack of sanitary services, naked children, and files that hover around food, children, and garbage. Limited resources creates a mentality of partial solutions, rationing, and a closed attitude toward an integrated solution. Housing means more than a roof over one's head. There is planning, design, finance, administration, housing construction, and services. A shelter exists in a larger framework of a human habitat. The priority should be in order of importance: the physical structure of housing in a socially organized form, basic services including health and education, and availability of resources. Housing lobbyists have prevented integrated solutions because of their emphasis on the lack of housing units, and the identification of substandard housing. There is a narrow focus that deliberately reduces both the availability of housing and necessary services, whether at the local or community, regional, or national level. Housing is an urban problem, caused by urban population's high growth rates between 2.5% and 3.5%. There has been constant migration which has led to growth rates of 10% annually in large cities. Confounding the issue is the expectation from migrants that there will be dwelling space better than prior housing, drinkable water, electricity, rapid transit, and free services. Educational and health services which were adequate in rural life are unsuitable for urban living. Cars and trucks require paved roads. Living requires
Ford, Rufus; Pietruschka, Dirk; Sipilä, Kari
This report titled “Case studies and demonstrations” is the subtask D report of the IEA DHC|CHP Annex TS1 project “Low Temperature District Heating for Future Energy Systems” carried out between 2013 and 2016. The project was led by Fraunhofer Institute for Building Physics (IBP) with the other...... include examples on low temperature district heating systems, solar heating in a district heating system, heat pump based heat supply and energy storages for both peak load management and for seasonal heat storage. Some demonstrations have been implemented while others are at planning phase...
Li, Hongwei; Wang, Stephen Jia
Previous research and development shows that low temperature district heating (LTDH) system is economic feasible for low energy buildings and buildings at sparse areas. Coupling with reduced network temperature and well-designed district heating (DH) networks, LTDH can reduce network heat loss...... by up to 75% comparing with the current medium temperature district heating system. Further system efficiency improvement can be achieved through a holistic approach which includes measures such as reduced system design margin, enhanced demand side management and improved operation of decentralized heat...
Lund, Henrik; Duic, Neven; Østergaard, Poul Alberg
This editorial gives an introduction to the important relationship between Smart Energy Systems and 4th Generation District Heating and presents a number of selected papers from the 1st International Conference on the topic. All of the papers elaborate on or otherwise contribute to the theoretical...... for the active inclusion of the heating and cooling sectors. The concept of 4th Generation District Heating emphasizes that district heating and cooling are both important elements but also technologies that have to be developed further into a 4th generation version to be able to fulfil their roles in future...
There has been growing concern about the increase in teenage pregnancies in relation to the teenagers’ knowledge of human sexuality and the impact sex education has on these teenagers in both the urban and rural areas. The aim of the study was to assess the knowledge of sex education and the health beliefs of teenagers with regard to teenage pregnancy.
Full Text Available National Health Service Quality Improvement Scotland (NHS QIS published a health technology scoping report in 2006 acknowledging that there are serious concerns within Scotland in relation to Developmental Dysplasia of Hip (DDH as there is no formal screening program in place and there are significant variations between NHS boards leading to confusion for staff and parents. NHS QIS identified need for audit work to improve hip screening in Scotland. The aim of this study is to review of current practice of selective screening for DDH. All newborns who had their first hip scan during one year period (2014 were included in this retrospective study and followed up until June 2015 to include any surgical intervention for dysplastic hip. Out of 428 babies (856 hip scans, abnormality was seen in 119 babies/147 hips (134 Graf 2a/2b, 10 hips were 2c and 3 hips were Graf grade 3. Average age when first scan was performed was 5 weeks (range 3 weeks to 22 weeks. Analysis of risk factors in 119 babies with abnormal scan was consistent with literature (83 breech, 12 family history, 12 HBW, 10 instability and 2 twins of breech. Twelve babies (16 hips required treatment and were successfully treated in Pavlik harness. There was one case of missed/late dislocation, which lived in outside catchment area for 3 years since birth. During this study period there was no case of avascular necrosis or femoral nerve palsy as a result of treatment. In our experience, selective hip screening by ultrasound scan is useful in avoiding overtreatment and minimizing late presentations.
Materials and methods: A total of 552 patients who visited Outpatient Department of Jaipur Dental College, Jaipur, were studied. Complete information regarding presence of smoking and other forms of tobacco was recorded in case history proforma and any of tobacco-related oral lesions among these patients were examined. Results: In age group of 0.05 in 12.84% subjects, oral cancer was reported in 33 patients (p-value = 0.001 whereas smoker′s palate in 25 patients and OSMF being the most common. Awareness level about ill effects of tobacco was 51.10 %. Conclusion: High incidence of tobacco usage in smokeless form is seen in Jaipur population especially in adolescents. There were no significant findings found between males and females. Of all lesion examined, OSMF was found to be more prevalent. Therefore, it is important to take immediate steps to curb the habit.
Full Text Available There has been growing concern about the increase in teenage pregnancies in relation to the teenagers’ knowledge of human sexuality and the impact sex education has on these teenagers in both the urban and rural areas. The aim of the study was to assess the knowledge of sex education and the health beliefs of teenagers with regard to teenage pregnancy.
The acutely painful scrotum is a common urologic emergency. The primary objective of management is to avoid testicular loss. This requires a high index of clinical suspicion and prompt surgical intervention. In our series conducted between January 1996 and December 2005, 119 patients (age range: 4-62 years) underwent emergency operative exploration for acute scrotal pain. The most common finding was torted cyst of Morgagni (63\\/119, 52.9%), followed by testicular torsion (41\\/119, 34.4%). The majority of testicular torsions occurred in the pubertal group (22\\/41, 53.6%). Only one patient in this group had an unsalvageable testis necessitating orchidectomy, a testicular loss rate in torsion of 2.4%. There were no postoperative wound infections or scrotal haematomas. Testicular salvage depends critically on early surgical intervention, so the delay incurred in diagnostic imaging may extend the period of ischaemia. Furthermore, all radiological investigations have a certain false-negative rate. We advocate immediate surgical exploration of the acute scrotum. We report a low orchidectomy rate (2.4%) in testicular torsion.
Comer, D M
Aim The burden of referrals to investigate sleep disorders has escalated considerably. In order to address this, the feasibility of a nurse-led sleep disorder clinic was investigated. Methods Sleep referrals were stratified on the basis of information contained within the primary care referral, and appropriate home-based sleep studies arranged if obstructive sleep apnoea was considered the most likely working diagnosis. Selected patients were started on continuous positive airway pressure treatment if deemed appropriate. Education was almost exclusively provided by specialist nursing staff or by means of validated information by the British Lung Foundation. Results Eighty patients were included in the respiratory nurse-led sleep service. Feedback from the patient questionnaire was positive and 59 patients were managed without requirement to attend consultant-led outpatient services. Non-sleep breathing disorders as the reason for daytime somnolence, and patients requiring referral to tertiary services, were identified. Conclusion Developing a respiratory nurse-led sleep service is adequate to identify non-sleep breathing disorders, is fit for purpose, functions broadly in accordance with American Sleep Society guidelines, and is well received by patients.
Imamura, Mitsuru; Sato, Kotaro; Narabayashi, Tadashi; Shimazu, Yoichiro; Tsuji, Masashi
We have studied nuclear power plant for district heating. Already some towns and villages in Hokkaido have requested small reactor for district heating. Using existing technology allows us to shorten development period and to keep a lid on development cost. We decided to develop new reactor based on 'MUTSU' reactor technology because 'MUTSU' had already proved its safety. And this reactor was boron free reactor. It allows plant system to reduce the chemical control system. And moderator temperature coefficient is deeply negative. It means to improve its operability and leads to dependability enhancement. We calculated burn-up calculation of erbium addition fuel. In the result, the core life became about 10 years. And we adapt the cassette type refueling during outagein in order to maintain nonproliferation. In the district heating system, a double heat exchanger system enables to response to load change in season. To obtain the acceptance of public, this system has a leak prevention system of radioactive materials to public. And road heating system of low grade heat utilization from turbine condenser leads to improve the heat utilization efficiency. We carried out performance evaluation test of district heating pipeline. Then the heat loss of pipeline is estimated at about 0.440degC/km. This result meets general condition, which is about 1degC/km. This small plant has passive safety system. It is natural cooling of containment vessel. In case of loss of coolant accident, decay heat can remove by natural convection air cooling after 6 hours. Decay heat within 6 hours can remove by evaporative heat transfer of pool on containment vessel. (author)
Full Text Available Artisanal small-scale mining (ASM has devastating impacts on the environment, such as deforestation, over-stripping of overburden, burning of bushes and use of harmful chemicals like mercury. These environmental impacts are a result of destructive mining, wasteful mineral extraction and processing practices and techniques used by the artisanal small-scale miners. This paper explores the ecological problems caused by ASM in Mzingwane District, Zimbabwe. It seeks to determine the nature and extent to which the environment has been damaged by the ASM from a community perspective. Interviews, questionnaires and observations were used to collect qualitative data. Results indicated that the nature of the mining activities undertaken by unskilled and under-equipped gold panners in Mzingwane District is characterised by massive stripping of overburden and burning of bushes, leading to destruction of large tracts of land and river systems and general ecosystem disturbance. The research concluded that ASM in Mzingwane District is an ecological time bomb, stressing the need for appropriate modifications of the legal and institutional frameworks for promoting sustainable use of natural resources and mining development in Zimbabwe. Government, through the Ministry of Small Scale and Medium Enterprises, need to regularise and formalise all gold mining activities through licensing, giving permanent claims and operating permits to panners in order to recoup some of the added costs in the form of taxes. At the local level, the Mzingwane Rural District Council (MRDC together with the Environmental Management Agency (EMA need to design appropriate environmental education and awareness programmes targeting the local community and gold panners.
Through the analysis of energy supply choices, this article explores the way in which energy priorities and their climate-related features are incorporated into urban public policy. These choices must take account of different factors, as is the case with district heating, which is justified as a vehicle of renewable energy while subject to pressure in eco-districts because its techno-economic balances are destabilised by falls in demand. Our study focuses particularly on the city of Metz (France), which has chosen district heating as the primary source for provision for the municipal area and for its first eco-district. We analyse the tensions within these choices, with particular attention to the way in which they are negotiated inside municipal departments and with the local energy operator. This enables us to explore the tensions in defining the scale that governs decisions and the linkages between energy-related and urban priorities. - Highlights: • Analyses of tensions in the choice of energy supplies for eco-districts. •District heating networks can be vehicles of renewable energy. • District heating networks are threatened by drops in energy consumption. • Energy supply issues oppose urban planning and energy policy in municipal departments. • Technical and financial adjustments can be made by the municipality to justify its energy choices
Full Text Available The article assesses available historical and cultural heritage of Lubny district, Poltava region. Among the considered assessment methods of the historical and cultural heritage K. A. Polyvach’s method has been chosen for the study, as it allows to assess the security of an administrative district. According to this method, the provision of rural districts according to the following indicators was carried out: the number of objects and their division into types; concentration of objects calculated on the area of the territory; a modified concentration index. The latter takes into account not only the area, but also the population. The coefficient of objects’ localization, showing the largest number of cultural monuments and the smallest area of rural councils has also been indicated. In Lubensky district, archeological monuments dominate, namely, the fraternal graves and memorial plaques to the fallen heroes of warriors. The disadvantage of this area is the lack of fixed objects of science and technology that would act as a tourist resource. The largest number of historical and cultural heritage objects is concentrated in Vovchytsya, Kalaydenska, Mgarska and Mykhnivska village councils, and the smallest number is in Shershnevsky, Matskiv and Okipsky. In general, it can be said that there are 102 objects in Lubensky area - this is not enough, if you also take into account that their placement is not uniform. In addition to the lowest level of livelihood in Shershnivska, Okipa, Berezivka, Tyshkivska, Vyshchebulatka, Matskivska, Lytvyakivska and Novorikhivska settlement councils there are only monuments of one category, which diminishes their interest among tourists. In the area the most promising for the development of tourism are Mgarska, Vovchytska and Kalaydentsi rural councils, because within them there is an opportunity to build complex tourist routes and, in general, to develop tourist infrastructure, not only because of the large
Mwanakasale, Victor; Songolo, Peter; Daka, Victor
Human African Trypanosomiasis is one of the Neglected Tropical Diseases that is targeted for elimination by the World Health Organization. Strong health delivery system in endemic countries is required for a control program to eliminate this disease. In Zambia, Human African Trypanosomiasis is lowly endemic in the northeastern part of the country. We conducted a cross-sectional survey of health institutions in Mpika district in Northern Province of Zambia from 9th to 23rd November 2011. The aim of this study was to assess current health delivery system in the management of Human African Trypanosomiasis cases in Mpika district, Northern Province of Zambia. Ten health institutions were covered in the survey. Two structured questionnaires targeting health workers were used to collect the data on general knowledge on HAT and state of health care facilities in relation to HAT management from the surveyed health institution.Only 46% of the 28 respondents scored more than 50% from the questionnaire on general knowledge about Human African Trypanosomiasis disease. None of the respondents knew how to differentiate the two clinical stages of Human African Trypanosomiasis disease. There were only three medical doctors to attend to all Human African Trypanosomiasis cases and other diseases at the only diagnostic and treatment hospital in Mpika district. The supply of antitrypanosomal drugs to the only treatment centre was erratic. Only one refresher course on Human African Trypanosomiasis case diagnosis and management for health staff in the district had been organized by the Ministry of Health in conjunction with the World Health Organization in the district in 2009. The referral system for suspected Human African Trypanosomiasis cases from Rural Health Centres (RHCs) to the diagnostic/treatment centre was inefficient. There are a number of challenges that have been identified and need to be addressed if Human African Trypanosomiasis is to be eliminated in a lowly endemic
Tuberculosis is one of the leading causes of morbidity and mortality across the globe. Pakistan is one of the 22 high tuberculosis burden countries of the world sharing more than 80% of the global burden of tuberculosis. Methods: This study was a retrospective case-based study that analyzed secondary data obtained from TB-03 form at the office of the District Tuberculosis Control Officer (DTO), Mansehra. Data was entered into SPSS-20 and analyzed. Results: A total of 625 patients with a mean age of 32.1±19.1 years were registered at the DTO office during the year 2013. Most of the patients were female (57%) as compared to males (43%). The most common treatment outcome was treatment completed, recorded against 56% of the patients. The proportion of patients declared cured at the end of the treatment was 236 (37.8%). There were only 4 (0.64%) cases of treatment failure during 2013. Conclusion: Despite falling incidence of tuberculosis and mortality across the globe, tuberculosis is still a major determinant of disease in our society. Aggressive case detection and treatment is needed to manage this disease. (author)
Wei Bing; Wang Songling; Li Li
Selecting the optimal type of district heating (DH) system is of great importance because different heating systems have different levels of efficiency, which will impact the system economics, environment and energy use. In this study, seven DH systems were analysed and evaluated by the fuzzy comprehensive evaluation method. The dimensionless number-goodness was introduced into the calculation, the economics, environment and energy technology factors were considered synthetically, and the final goodness values were obtained. The results show that if only one of the economics, environment or energy technology factors are considered, different heating systems have different goodness values. When all three factors were taken into account, the final ranking of goodness values was: combined heating and power>gas-fired boiler>water-source heat pump>coal-fired boiler>ground-source heat pump>solar-energy heat pump>oil-fired boiler. The combined heating and power system is the best choice from all seven systems; the gas-fired boiler system is the best of the three boiler systems for heating purpose; and the water-source heat pump is the best of the three heat pump systems for heating and cooling.
Difs, Kristina; Trygg, Louise
A vital measure for industries when redirecting the energy systems towards sustainability is conversion from electricity to district heating (DH). This conversion can be achieved for example, by replacing electrical heating with DH and compression cooling with heat-driven absorption cooling. Conversion to DH must, however, always be an economically attractive choice for an industry. In this paper the effects for industries and the local DH supplier are analysed when pricing DH by marginal cost in combination with industrial energy efficiency measures. Energy audits have shown that the analysed industries can reduce their annual electricity use by 30% and increase the use of DH by 56%. When marginal costs are applied as DH tariffs and the industrial energy efficiency measures are implemented, the industrial energy costs can be reduced by 17%. When implementing the industrial energy efficiency measures and also considering a utility investment in the local energy system, the local DH supplier has a potential to reduce the total energy system cost by 1.6 million EUR. Global carbon dioxide emissions can be reduced by 25,000 tonnes if the industrial energy efficiency measures are implemented and when coal-condensing power is assumed to be the marginal electricity source. (author)
Siddique, M.; Shahzadi, I.; Yousaf, S.
In District Abbottabad, area cover under forests is 76148 ha, which is 5.4% of the forest resources of the province. The study areas have sufficient natural resources but these natural resources are depleting very rapidly. The present study showed that most of the population living especially near the mountain range is poor, illiterate and having no other means of income generation. Therefore they cut forests trees for the fuel and timber not only to fulfill their domestic needs but also on commercial scale. There are no other alternatives of fuel wood in the area. They mostly depend of forest for fuel wood. People of the area get timber mainly from the nearby forests for construction. Agriculture is the backbone of local economy in the area. The forest trees near the agriculture area are cut down to extend their agricultural land. Soil erosion and flooding is increased because of clearing of land for agriculture. People of the area graze their livestock freely in the rangelands and forests without taking care of their carrying capacity. The political administration and forest department cannot take any step to prevent overgrazing and deforestation activities in the area. Some times the local people damage the plants by cutting or putting them in fire, which causes severe damage to the plants. Lack of awareness among local communities about the importance of natural resources i.e. forest and wildlife. The people considered the wildlife, as free gift of nature there is no restriction on hunting from government or other agency. (author)
Brudnik, J.; Ryska, V. (Obvodni Bansky Urad, Ostrava (Czech Republic))
Comparatively evaluates ventilation of 14 underground coal mines in the Ostrava-Karvina coal district (8 in the Karvina area and 6 in the Ostrava area). The following aspects are analyzed: number of ventilation shafts, flow rate of fresh air forced by the main blower systems, depression, efficiency, flow rate forced by exhaust ventilation blowers, their efficiency, general efficiency of the ventilation systems, pressure losses, temperature, humidity and velocity of the air used for face ventilation, types of air conditioning systems, emission of methane in the mines, use of local ventilation systems, degassing efficiency. Statistical data that characterize operation of the ventilation systems, coal seam degassing and air conditioning are analyzed.
General planning considerations which affect nearly every community are reviewed, and alternative operating structures which are available to communities are reviewed, including local governments, nonprofit cooperatives, private enterprises, and joint ventures. The financing options available to publicly-owned and privately-owned district heating systems are then summarized. The geothermal production and distribution activities most appropriate to each type of operating structure are reviewed, along with typical equity and debt funding sources. The tax advantages for private developers are described, as are the issures of customer contracts and service prices, and customer retrofit financing. The treatment is limited to an introductory overview. (LEW)
Full Text Available This paper presents a synthesis of the ethnobotanical prospection performed in the Ripollès district between 2004 and 2013. Through semistructured interviews with 163 informants born between 1915 and 1988, we obtained information on popular names and uses of 457 taxa (including species, subspecies and varieties, 15 of which have only been determined at the genus level. About these plants, the informants have produced 7192 use reports. In this article we provide general comments on the different uses (medicinal, food and others and we present, in two appendices, the complete catalogue of the district’s ethnoflora.
General planning considerations which affect nearly every community are reviewed, and alternative operating structures which are available to communities are reviewed, including local governments, nonprofit cooperatives, private enterprises, and joint ventures. The financing options available to publicly-owned and privately-owned district heating systems are then summarized. The geothermal production and distribution activities most appropriate to each type of operating structure are reviewed, along with typical equity and debt funding sources. The tax advantages for private developers are described, as are the issues of customer contracts and service prices, and customer retrofit financing. The treatment is limited to an introductory overview.
Full Text Available The difficulty of finding land for farming activities in Indonesia caused some communities began to switch utilizing peat land for agricultural areas such as oil palm. Oil palm plantation is a commodity that has been developed in Indonesia.Oil palm planted area has increased rapidly.Since 1967 extensive oil palm plantations has increased 35times to 5.6 million ha in 2005 and about 7.8 million ha in 2009. The biggest expansion of oil palm plantations occur in 6 province,one of them is Riau.Most people take a practical way to open agricultural areas by burning peat.Riau Province in Indonesia is one of the major hotspots for peat fires during the dry season. Peat fire at smouldering phaseemits a lot of compounds that are not completely oxidized (e.g. CO, VOCs, PAHs that more dangerous than the emissions released during combustion at flaming fires. Particulate Matter (PM 2.5 is one of the emissions from peat fires too.However, existing data on VOCs and PM 2.5 of smoke from peat fires Indonesia is still limited.The aim of this study was to analyze the concentration of VOCs and PM 2.5 on emissions from peat fires in the Langkai Village Siak District and RimboPanjang Village Kampar District Riau Province when compared with background site and the permissible exposure limit and provide recommendations based on the results of this research.VOCs measurement method is based on NIOSH 1500 and EPA TO-17 while the PM 2.5 based on IMPROVE A method. The average concentration of PM 2.5 is 996.72 ± 531.01μg/m3. PM2.5 concentrations increased (compared with the background site was very high at 4,838%.This condition causes a decrease in air quality and serious health problems. While the results of the maximum TVOCs concentration obtained in Siak District was 391,880 g/m3, while in Kampar Districtwas 195,940 g/m3. TVOCs concentration atSiak Districtwas 130.63 times greater than the existing quality standards, while at Kampar District regency was 65.31 times
Based on the basic act for disaster countermeasures, this plan aimes at establishing the necessary system concerning the countermeasures for preventing the disaster due to the release of a large quantity of radioactive substances from the Hamaoka Nuclear Power Station, Chubu Electric Power Co., Inc., determining the measures to be taken for disaster prevention, and striving for the safety of inhabitants by executing the deskworks and services of the disaster prevention related to nuclear power synthetically and purposefully. The general matters concerning the disaster prevention in the district of Shizuoka Prefecture are determined in the ''Plan of disaster prevention in the district of Shizuoka Prefecture (General countermeasures)'', but in view of the peculiarity of nuclear power disaster, the peculiar matters are to be determined in this plan. The general rules on the works of respective disaster prevention organizations, the countermeasures for preventing nuclear power disaster, the emergency countermeasures to nuclear power disaster, the countermeasures to Tokai earthquakes and the countermeasures for restoration after nuclear power disaster are stipulated. (Kako, I.)
NSGIC Local Govt | GIS Inventory — A polygon feature class of Miami-Dade County Fire Rescue (MDFR) Fire District Station Territories clipped to the extent of inhabited areas. This layer is intended...
Mikulandric, Robert; Krajačić, Goran; Duic, Neven
, the performance of a hybrid district energy system for a small town in Croatia has been analysed. Mathematical model for process analysis and optimisation algorithm for optimal system configuration has been developed and described. The main goal of the system optimisation is to reduce heat production costs....... Several energy sources for heat production have been considered in 8 different simulation cases. Simulation results show that the heat production costs could be reduced with introduction of different energy systems into an existing district heating system. Renewable energy based district heating systems...... could contribute to heat production costs decrease in district heating systems up to 30% in comparison with highly efficient heat production technologies based on conventional fuels....
Schmitz, John P; Shafer, Linda
The San Antonio District Dental Society serves approximately 850 dentists in a diverse, 14-county region of southwest Texas. San Antonio is a large metropolitan area, with a major medical center and dental school. The city is also a popular convention destination, regularly hosting the Texas Dental Association and more recently hosting the American Dental Association and the American Association of Dental Schools meetings. The rural and poor areas of the district have prompted the district to sponsor a full offering of outreach and community oral health services programs. The district is especially proud of its relationships with young dentists, including them in the society's monthly meetings and governance structure and maintaining an active mentoring program.
Li, Hongwei; Svendsen, Svend
Low temperature district heating (LTDH) with reduced network supply and return temperature provides better match of the low quality building thermal demand and the low quality waste heat supply. In this paper, an exemplary LTDH network was designed for 30 low energy demand residential houses, which...... is in line with a pilot project that is carrying out in Denmark with network supply/return temperature at 55oC/25 oC. The consumer domestic hot water (DHW) demand is supplied with a special designed district heating (DH) storage tank. The space heating (SH) demand is supplied with a low temperature radiator....... The network thermal and hydraulic conditions were simulated under steady state with an in-house district heating network design and simulation code. Through simulation, the overall system energetic and exergetic efficiencies were calculated and the exergy losses for the major district heating system...
. This is because they are major stakeholders in the development process. This study investigates youth involvement in rural development activities in Ogba district of Rivers state, Nigeria. Data was collected from 120 randomly selected youths ...
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset demarcates the U.S. Legislative Congressional district boundaries within Allegheny County. If viewing this description on the Western Pennsylvania...
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset demarcates municipal voting districts in Allegheny County. If viewing this description on the Western Pennsylvania Regional Data Center’s open data...
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset demarcates the Pennsylvania House of Representatives district boundaries within Allegheny County. If viewing this description on the Western...
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset demarcates municipal voting districts in Allegheny County. If viewing this description on the Western Pennsylvania Regional Data Center’s open data...
Hentschke, Guilbert C.
Discusses the value for school districts of a program cost accounting system and examines different approaches to generating program cost data, with particular emphasis on the "cost allocation to program system" (CAPS) and the traditional "transaction-based system." (JG)
Dominkovic, Dominik Franjo; Bačeković, I.; Sveinbjörnsson, Dadi Þorsteinn
was reduced by 1.76 %. For the year 2029, in which intermittent renewable energy sources are dominating the energy generation, total socio-economic costs were reduced by 5.9 %, CO2 emissions by 7.1 % and primary energy supply by 8.4 % after the adjacent district heating systems were connected. Hence......Although liberalization of the electricity day-ahead markets has gained pace throughout the Europe, district heating markets are often dominated by lack of competition between suppliers, which curbs the potential of having cheaper systems in terms of socio-economic costs, and technically better...... system in terms of CO2 emissions. In order to assess the financial and technical outcome of connecting five adjacent district heating systems, a linear continuous optimization model that minimizes total socio-economic costs was developed. Geographical distribution of different district heating systems...
Minnesota Department of Natural Resources — This data shows the DNR Division of Parks and Trails District Boundaries as of May 2010. The boundaries were created by the Division Leadership Team. Boundaries are...
The primary objective of this quantitative research is to provide information : for more effective decision making regarding the level of investment in various : transportation systems in District 8. : This objective was accomplished by establishing ...
. Until 1990 all governmental health authorities and. NGOs functioned independently of each other with little co-ordination, co-operation or communication. Since then, a few steps forward on the road to a district health service have been taken.
I. V. Morozov
Full Text Available The article reveals the possibility of the Southern Federal District to form regional network structures. The prospects for the formation of networks in the region in relation to the Olympic Winter Games Sochi 2014.
Louisiana Geographic Information Center — This is a graphical polygon dataset depicting the polygon boundaries of the twelve (12) Metropolitan Council Districts within the Parish of East Baton Rouge. The...
Debates the federal court decision in the case of "Kuhlmeier v. Hazelwood School District," which found that the school newspaper was an integral part of the school curriculum and was therefore subject to administrative control and censorship. (DF)
Staatz, Mortimer H.; Trites, A.F.
The Quartz Creek pegmatite district includes an area about 29 square miles in the vicinity of Quartz Creek in Gunnison County,. Colo. This area contains 1,803 pegmatites that are intruded into pre-Cambrian rocks.
Hough, Kimberly L.
This quantitative survey study was designed to determine whether superintendent accountability behaviors or agreement about accountability behaviors between superintendents and their subordinate central office administrators predicted district student achievement. Hierarchical multiple regression and analyses of covariance were employed,…
SPRING Project, this research set out to explore district leaders' perceptions of the nutrition situation, programs and opportunities for integration. Qualitative data were collected through key-informant interviews and focus group discussions.
Earth Data Analysis Center, University of New Mexico — The New Mexico Soil and Water Conservation District (SWCD) shapefile includes forty-seven boudaries which cover each SWCD throughout the State.
U.S. Environmental Protection Agency — This SEGS web service contains the following map layers: 114th Congressional district boundaries. Layers are drawn at scales of 1:30 million and greater. Data used...
Louisiana Geographic Information Center — This is a graphical polygon dataset depicting the polygon boundaries of the 16 Planning Districts of the East Baton Rouge Parish of the State of Louisiana. The...
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset demarcates municipal voting districts in Allegheny County.If viewing this description on the Western Pennsylvania Regional Data Center’s open data...
National Oceanic and Atmospheric Administration, Department of Commerce — USGS - Suwannee River Water Management District Contract No.G10PC00093, Task Order No.G12PD00242 Prime Contractor: Digital Aerial Solutions (DAS) Sub-Contractor:...
The waste disposal facility in the Aube district is the second surface waste disposal facility built in France. It is located in the Aube district, and has been operated by Andra since 1992. With a footprint of 95 hectares, it is licensed for the disposal of 1 million cubic meters of low- and intermediate-level, short-lived waste packages. The CSA is located a few kilometers away another Andra facility, currently in operation for very-low-level waste, and collection and storage of non-nuclear power waste (the Cires). Contents: Andra in the Aube district, an exemplary industrial operator - The waste disposal facility in the Aube district (CSA); Low- and intermediate-level, short-lived radioactive waste (LILW-SL); The LILW-SL circuit; Protecting present and future generations
Francisco Javier Ortega-Colomer
Full Text Available The significance and popularity of the cluster and industrial district concepts claim for a deeper reflection. The analysis of one of the European Commission’s (EC policy documents shows inconsistencies that do not impede the formulation of normative statements. That way we answer the question of why and how cluster ideas have substituted industrial district principles and the consequences derived from that phenomenon.
Marco-Lajara, Bartolomé; Claver Cortés, Enrique; Úbeda García, Mercedes
Purpose – The present paper aims to analyze how the performance of hotels located on the Spanish Mediterranean coast (peninsular and Balearic) and Canary coast is affected by the degree of business agglomeration in tourist districts. If agglomeration affects hotels positively, then the externalities generated in tourist districts will be relevant when locating an establishment. Otherwise, the reason why hotels group together geographically would be more related to the suitability of beaches a...
Taber, Daniel R; Chriqui, Jamie F; Chaloupka, Frank J
States and school districts nationwide have enacted policies targeting youth obesity, but many policies lack specific requirements or enforcement language. Geographic disparities in youth obesity could worsen if policies are weaker in areas with higher obesity prevalence. To determine if state or district policy strength varies with youth obesity prevalence across Census divisions. Policies in five domains related to nutrition and physical activity in schools were obtained from all states and nationally representative samples of 578 and 592 public school districts in the 2006-2007 and 2008-2009 school years, respectively. Policy language strength was rated on a 0-100 scale on both the state and district level. Regression models were used to determine if mean 2006-2007 strength scores, and changes in mean scores from 2006-2007 to 2008-2009, were associated with youth obesity prevalence across Census divisions. Analyses were conducted in 2010. State and district policies governing foods sold outside of school meal programs ("competitive foods") were stronger in 2006-2007 in the two divisions with the highest youth obesity prevalence (East South Central, West South Central). Furthermore, mean competitive food policy strength increased the most from 2006-2007 to 2008-2009 in these divisions. The West South Central had the weakest district physical education policies in 2006-2007, however, and was the only division in which average strength of district school meal policies decreased. State and districts in Census divisions with the highest youth obesity prevalence are taking steps to restrict competitive foods in schools, but many have not targeted other policy domains as aggressively. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Raeisi, Ahmad Reza; Saghaeiannejad, Sakineh; Karimi, Saeed; Ehteshami, Asghar; Kasaei, Mahtab
Health care managers and personnel should be aware and literate of health information system in order to increase the efficiency and effectiveness in their organization. Since accurate, appropriate, precise, timely, valid information and interpretation of information is required and is the basis for policy planning and decision making in various levels of the organization. This study was conducted to assess the district health information system evolution in Iran according to WHO framework. This research is an applied, descriptive cross sectional study, in which a total of twelve urban and eight rural facilities, and the district health center at Falavarjan region were surveyed by using a questionnaire with 334 items. Content and constructive validity and reliability of the questionnaire were confirmed with correlation coefficient of 0.99. Obtained data were analyzed with SPSS 16 software and descriptive statistics were used to examine measures of WHO compliance. The analysis of data revealed that the mean score of compliance of district health information system framework was 35.75 percent. The maximum score of compliance with district health information system belonged to the data collection process (70 percent). The minimum score of compliance with district health information system belonged to information based decision making process with a score of 10 percent. District Health Information System Criteria in Isfahan province do not completely comply with WHO framework. Consequently, it seems that health system managers engaged with underlying policy and decision making processes at district health level should try to restructure and decentralize district health information system and develop training management programs for their managers.
Olga Mikhailovna Prokapalo; Artyom Gennadyevich Isaev; Marina Gamilovna Mazitova
Based on current statistical information the article analyzes conditions and trends of socio-economic development of the Far Eastern Federal District in 2016. The situation is compared with national average trends. The paper shows that socio-economic situation in the Far Eastern Federal District remains unstable and is characterized by the following trends: falling growth potential of industrial production with continued weak positive growth resulting from the growth in extractive industries;...
Graham, M.W.; Delate, K.; Burras, C.L.; Mazur, R.E.; Brenner, D.M.; Tenywa, M.M.; Nakimbugwe, D.N.; Kabahuma, M.; Abili, A.
Metadata only record Grain amaranths (Amaranthus spp.) are high protein content and protein quality pseudo-cereal crops whose favorable nutritional profile belies their potential to alleviate nutrition and food insecurity in developing countries. Grain amaranth was introduced as a nutrient dense food into the Kamuli District, eastern Uganda, in 2006. However, initial analysis of protein content of amaranth grain pooled from farms in the Kamuli District indicated that protein levels ranged ...
District energy systems are a major part of the energy use and delivery infrastructure of the United States. With nearly 6,000 operating systems currently in place, district energy represents approximately 800 billion BTU per hour of installed thermal production capacity, and provides over 1.1 quadrillion BTU of energy annually -- about 1.3% of all energy used in the US each year. Delivered through more that 20,000 miles of pipe, this energy is used to heat and cool almost 12 billion square feet of enclosed space in buildings that serve a diverse range of office, education, health care, military, industrial and residential needs. This Census is intended to provide a better understanding of the character and extent of district heating, cooling and cogeneration in the United States. It defines a district energy system as: Any system that provides thermal energy (steam, hot water, or chilled water) for space heating, space cooling, or process uses from a central plant, and that distributes the energy to two or more buildings through a network of pipes. If electricity is produced, the system is a cogenerating facility. The Census was conducted through surveys administered to the memberships of eleven national associations and agencies that collectively represent the great majority of the nation`s district energy system operators. Responses received from these surveys account for about 11% of all district systems in the United States. Data in this report is organized and presented within six user sectors selected to illustrate the significance of district energy in institutional, community and utility settings. Projections estimate the full extent of district energy systems in each sector.
Wickramasinghe, Kanchana; Steele, Paul; Dawson, Andrew
States dollars (US$), using 2005 figures, was derived from hospital accounts. FINDINGS: The average total cost of treating a self-poisoned patient at the general hospital was US$ 31.83, with ward staff input and drugs being the highest expenditure category and only US$ 0.19 of this sum related to capital......OBJECTIVE: To estimate the direct financial costs to the Sri Lanka Ministry of Health of treating patients after self-poisoning, particularly from pesticides, in a single district. METHODS: Data on staff, drug, laboratory and other inputs for each patient admitted for self-poisoning were...... prospectively collected over a one-month period from one general hospital (2005) and five peripheral hospitals (2006) in the Anuradhapura district. Data on transfers to secondary- and tertiary-level facilities were obtained for a 6-month period from 30 peripheral hospitals. The cost of the inputs in United...
The issue of public/private partnership as it relates to the Sudbury District Energy Project was discussed. When completed, it will be the first cogeneration-based district heating and cooling project involving private sector/public sector partnership in Canada. The equal partners include Toromont Energy and Sudbury Hydro. Sudbury Hydro is a community owned energy and communications utility. It was the first electric utility in Ontario to retail natural gas in the new competitive market place. The Sudbury District Energy Project began in 1996, when the utility began the development of a community district energy system in partnership with the City of Sudbury. At the time, the downtown district heating/cooling system supplied cold and hot water to Sudbury's Wellness Centre. In 1998, Toromont Energy accepted a 50/50 partnership arrangement between themselves and the public sector partners to form the Sudbury District Energy Corporation. Sudbury Hydro will benefit from the project because it will reduce their peak loads and it will also be an alternate source of revenue. It is expected that the project will displace 39,600 tons of carbon dioxide, a greenhouse gas which contributes to global warming