WorldWideScience

Sample records for facility final medical

  1. Management of radioactive material safety programs at medical facilities. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Camper, L.W.; Schlueter, J.; Woods, S. [and others

    1997-05-01

    A Task Force, comprising eight US Nuclear Regulatory Commission and two Agreement State program staff members, developed the guidance contained in this report. This report describes a systematic approach for effectively managing radiation safety programs at medical facilities. This is accomplished by defining and emphasizing the roles of an institution`s executive management, radiation safety committee, and radiation safety officer. Various aspects of program management are discussed and guidance is offered on selecting the radiation safety officer, determining adequate resources for the program, using such contractual services as consultants and service companies, conducting audits, and establishing the roles of authorized users and supervised individuals; NRC`s reporting and notification requirements are discussed, and a general description is given of how NRC`s licensing, inspection and enforcement programs work.

  2. Accidental nuclear excursion recuplex operation 234-5 facility: Final medical report

    Energy Technology Data Exchange (ETDEWEB)

    Fuqua, P. A.

    1962-04-07

    The April 7, 1962 criticality accident involving human exposures was the first to have occurred in any production facility at Hanford. The accidental nuclear excursion did not result in any mechanical damage or spread of contamination. Three employees received over-exposure to gamma and neutron radiation. None were fatally exposed and in each case the over-exposure was recognized promptly. Following an initial period of medical observation and testing, the men were released to work. They continued to be followed clinically. Clinical studies performed were hematological procedures including leukocyte chromosome aberrations, morphologically aberrant blood cells, bone marrow evaluations, blood chemistry determinations, amino acid excretion studies, seminal fluid, urinary gonadotropins and estrogen excretion studies, testicular biopsies and crystalline lens examinations. These studies, along with a brief description of the accident and of the dosimetry, are summarized in this report by those participating in the studies. In view of the dose ranges received in these cases, both the negative and positive findings are considered to be of unusual interest due to the lack of knowledge of effects following human exposures at these levels.

  3. Medical Image Analysis Facility

    Science.gov (United States)

    1978-01-01

    To improve the quality of photos sent to Earth by unmanned spacecraft. NASA's Jet Propulsion Laboratory (JPL) developed a computerized image enhancement process that brings out detail not visible in the basic photo. JPL is now applying this technology to biomedical research in its Medical lrnage Analysis Facility, which employs computer enhancement techniques to analyze x-ray films of internal organs, such as the heart and lung. A major objective is study of the effects of I stress on persons with heart disease. In animal tests, computerized image processing is being used to study coronary artery lesions and the degree to which they reduce arterial blood flow when stress is applied. The photos illustrate the enhancement process. The upper picture is an x-ray photo in which the artery (dotted line) is barely discernible; in the post-enhancement photo at right, the whole artery and the lesions along its wall are clearly visible. The Medical lrnage Analysis Facility offers a faster means of studying the effects of complex coronary lesions in humans, and the research now being conducted on animals is expected to have important application to diagnosis and treatment of human coronary disease. Other uses of the facility's image processing capability include analysis of muscle biopsy and pap smear specimens, and study of the microscopic structure of fibroprotein in the human lung. Working with JPL on experiments are NASA's Ames Research Center, the University of Southern California School of Medicine, and Rancho Los Amigos Hospital, Downey, California.

  4. Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)/TRICARE: Refills of Maintenance Medications Through Military Treatment Facility Pharmacies or National Mail Order Pharmacy Program. Final rule.

    Science.gov (United States)

    2016-11-02

    This final rule implements section 702 (c) of the Carl Levin and Howard P. "Buck" McKeon National Defense Authorization Act for Fiscal Year 2015 which states that beginning October 1, 2015, the pharmacy benefits program shall require eligible covered beneficiaries generally to refill non-generic prescription maintenance medications through military treatment facility pharmacies or the national mail-order pharmacy program. An interim final rule is in effect. Section 702(c) of the National Defense Authorization Act for Fiscal Year 2015 also terminates the TRICARE For Life Pilot Program on September 30, 2015. The TRICARE For Life Pilot Program described in section 716(f) of the National Defense Authorization Act for Fiscal Year 2013, was a pilot program which began in March 2014 requiring TRICARE For Life beneficiaries to refill non-generic prescription maintenance medications through military treatment facility pharmacies or the national mail-order pharmacy program. TRICARE for Life beneficiaries are those enrolled in the Medicare wraparound coverage option of the TRICARE program. This rule includes procedures to assist beneficiaries in transferring covered prescriptions to the mail order pharmacy program.

  5. Medical response to effects of ionising radiation. [Nuclear facilities

    Energy Technology Data Exchange (ETDEWEB)

    Crosbie, W.A.; Gittus, J.H. (UKAEA Headquarters, London (UK))

    1989-01-01

    The proceedings of a conference on 'Medical Response to Effects of Ionising Radiation' in 1989 in the form of nineteen papers published as a book. Topics discussed include radiation accidents at nuclear facilities, the medical management of radiation casualties, the responsibilities, plans and resources for coping with a nuclear accident and finally the long term effects of radiation, including leukaemia epidemiology studies. All papers were selected and indexed separately. (UK).

  6. Instrumentation of the ESRF medical imaging facility

    CERN Document Server

    Elleaume, H; Berkvens, P; Berruyer, G; Brochard, T; Dabin, Y; Domínguez, M C; Draperi, A; Fiedler, S; Goujon, G; Le Duc, G; Mattenet, M; Nemoz, C; Pérez, M; Renier, M; Schulze, C; Spanne, P; Suortti, P; Thomlinson, W; Estève, F; Bertrand, B; Le Bas, J F

    1999-01-01

    At the European Synchrotron Radiation Facility (ESRF) a beamport has been instrumented for medical research programs. Two facilities have been constructed for alternative operation. The first one is devoted to medical imaging and is focused on intravenous coronary angiography and computed tomography (CT). The second facility is dedicated to pre-clinical microbeam radiotherapy (MRT). This paper describes the instrumentation for the imaging facility. Two monochromators have been designed, both are based on bent silicon crystals in the Laue geometry. A versatile scanning device has been built for pre-alignment and scanning of the patient through the X-ray beam in radiography or CT modes. An intrinsic germanium detector is used together with large dynamic range electronics (16 bits) to acquire the data. The beamline is now at the end of its commissioning phase; intravenous coronary angiography is intended to start in 1999 with patients and the CT pre-clinical program is underway on small animals. The first in viv...

  7. Copayments for medication in 2014. Final rule.

    Science.gov (United States)

    2014-05-27

    This document adopts as a final rule, without change, an interim final rule amending the Department of Veterans Affairs (VA) medical regulations to freeze the copayments required for certain medications provided by VA until December 31, 2014. Under that rule, the copayment amounts for all veterans were maintained at the same rates as they were in 2013, which were $8 for veterans in priority groups 2-6 and $9 for veterans in priority groups 7 and 8. On January 1, 2015, the copayment amounts may increase based on the prescription drug component of the Medical Consumer Price Index (CPI-P).

  8. Geothermal Loop Experimental Facility. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1980-04-01

    Research at the Geothermal Loop Experimental Facility was successfully concluded in September 1979. In 13,000 hours of operation over a three and one half year period, the nominal 10 megawatt electrical equivalent GLEF provided the opportunity to identify problems in working with highly saline geothermal fluids and to develop solutions that could be applied to a commercial geothermal power plant producing electricity. A seven and one half year period beginning in April 1972, with early well flow testing and ending in September 1979, with the completion of extensive facility and reservoir operations is covered. During this period, the facility was designed, constructed and operated in several configurations. A comprehensive reference document, addressing or referencing documentation of all the key areas investigated is presented.

  9. Massachusetts Large Blade Test Facility Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Rahul Yarala; Rob Priore

    2011-09-02

    Project Objective: The Massachusetts Clean Energy Center (CEC) will design, construct, and ultimately have responsibility for the operation of the Large Wind Turbine Blade Test Facility, which is an advanced blade testing facility capable of testing wind turbine blades up to at least 90 meters in length on three test stands. Background: Wind turbine blade testing is required to meet international design standards, and is a critical factor in maintaining high levels of reliability and mitigating the technical and financial risk of deploying massproduced wind turbine models. Testing is also needed to identify specific blade design issues that may contribute to reduced wind turbine reliability and performance. Testing is also required to optimize aerodynamics, structural performance, encourage new technologies and materials development making wind even more competitive. The objective of this project is to accelerate the design and construction of a large wind blade testing facility capable of testing blades with minimum queue times at a reasonable cost. This testing facility will encourage and provide the opportunity for the U.S wind industry to conduct more rigorous testing of blades to improve wind turbine reliability.

  10. Gasification Product Improvement Facility (GPIF). Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    The gasifier selected for development under this contract is an innovative and patented hybrid technology which combines the best features of both fixed-bed and fluidized-bed types. PyGas{trademark}, meaning Pyrolysis Gasification, is well suited for integration into advanced power cycles such as IGCC. It is also well matched to hot gas clean-up technologies currently in development. Unlike other gasification technologies, PyGas can be designed into both large and small scale systems. It is expected that partial repowering with PyGas could be done at a cost of electricity of only 2.78 cents/kWh, more economical than natural gas repowering. It is extremely unfortunate that Government funding for such a noble cause is becoming reduced to the point where current contracts must be canceled. The Gasification Product Improvement Facility (GPIF) project was initiated to provide a test facility to support early commercialization of advanced fixed-bed coal gasification technology at a cost approaching $1,000 per kilowatt for electric power generation applications. The project was to include an innovative, advanced, air-blown, pressurized, fixed-bed, dry-bottom gasifier and a follow-on hot metal oxide gas desulfurization sub-system. To help defray the cost of testing materials, the facility was to be located at a nearby utility coal fired generating site. The patented PyGas{trademark} technology was selected via a competitive bidding process as the candidate which best fit overall DOE objectives. The paper describes the accomplishments to date.

  11. The medical director and quality requirements in the dialysis facility.

    Science.gov (United States)

    Schiller, Brigitte

    2015-03-06

    Four decades after the successful implementation of the ESRD program currently providing life-saving dialysis therapy to >430,000 patients, the definitions of and demands for a high-quality program have evolved and increased at the same time. Through substantial technological advances ESRD care improved, with a predominant focus on the technical aspects of care and the introduction of medications such as erythropoiesis-stimulating agents and active vitamin D for anemia and bone disease management. Despite many advances, the size of the program and the increasingly older and multimorbid patient population have contributed to continuing challenges for providing consistently high-quality care. Medicare's Final Rule of the Conditions for Coverage (April 2008) define the medical director of the dialysis center as the leader of the interdisciplinary team and the person ultimately accountable for quality, safety, and care provided in the center. Knowledge and active leadership with a hands-on approach in the quality assessment and performance improvement process (QAPI) is essential for the achievement of high-quality outcomes in dialysis centers. A collaborative approach between the dialysis provider and medical director is required to optimize outcomes and deliver evidence-based quality care. In 2011 the Centers for Medicare & Medicaid Services introduced a pay-for-performance program-the ESRD quality incentive program (QIP)- with yearly varying quality metrics that result in payment reductions in subsequent years when targets are not achieved during the performance period. Success with the QIP requires a clear understanding of the structure, metrics, and scoring methods. Information on achievement and nonachievement is publicly available, both in facilities (through the facility performance score card) and on public websites (including Medicare's Dialysis Facility Compare). By assuming the leadership role in the quality program of dialysis facilities, the medical

  12. Performance specifications for proton medical facility

    Energy Technology Data Exchange (ETDEWEB)

    Chu, W.T.; Staples, J.W.; Ludewigt, B.A.; Renner, T.R.; Singh, R.P.; Nyman, M.A.; Collier, J.M.; Daftari, I.K.; Petti, P.L.; Alonso, J.R. [Lawrence Berkeley Lab., CA (United States); Kubo, H.; Verhey, L.J. [University of California Davis Medical Center, Sacramento, CA (United States). Cancer Center]|[California Univ., San Francisco, CA (United States). School of Medicine; Castro, J.R. [Lawrence Berkeley Lab., CA (United States)]|[University of California Davis Medical Center, Sacramento, CA (United States). Cancer Center]|[California Univ., San Francisco, CA (United States). School of Medicine

    1993-03-01

    Performance specifications of technical components of a modern proton radiotherapy facility are presented. The technical items specified include: the accelerator; the beam transport system including rotating gantry; the treatment beamline systems including beam scattering, beam scanning, and dosimetric instrumentation; and an integrated treatment and accelerator control system. Also included are treatment ancillary facilities such as diagnostic tools, patient positioning and alignment devices, and treatment planning systems. The facility specified will accommodate beam scanning enabling the three-dimensional conformal therapy deliver .

  13. Fuel Storage Facility Final Safety Analysis Report. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Linderoth, C.E.

    1984-03-01

    The Fuel Storage Facility (FSF) is an integral part of the Fast Flux Test Facility. Its purpose is to provide long-term storage (20-year design life) for spent fuel core elements used to provide the fast flux environment in FFTF, and for test fuel pins, components and subassemblies that have been irradiated in the fast flux environment. This Final Safety Analysis Report (FSAR) and its supporting documentation provides a complete description and safety evaluation of the site, the plant design, operations, and potential accidents.

  14. Hospitals - MEDICAL_CARE_FACILITIES_MHMP_IN: Medical Care Facilities in Indiana, derived from Essential Facilities Data of the Multi-Hazard Mitigation Planning Data (The Polis Center, Point Shapefile)

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — MEDICAL_CARE_FACILITIES_MHMP_IN.SHP is a point shapefile that shows medical care facilities in Indiana. MEDICAL_CARE_FACILITIES_MHMP_IN.SHP was derived from the...

  15. Attitude of final year medical students towards community medicine ...

    African Journals Online (AJOL)

    Attitude of final year medical students towards community medicine in Ahmadu Bello University, Zaria, Nigeria. ... A total of 94 graduating medical students during the 2006/2007 academic session were invited to participate in ... Article Metrics.

  16. Abortion Services and Military Medical Facilities

    Science.gov (United States)

    2010-12-16

    Contraceptive ; Plan B,” National Journal Group, Inc., September 6, 2005 54 Harris, Gardiner, F.D.A. Approves Broader Access t Next-Day Pill , New York...Management For Contraceptives (Updated 26 Jan 07). 57 Stein, Rob, “Pentagon to stock health facilities with morning-after pill ,” The Washington Post...emergency contraceptive used to prevent pregnancy following a known or suspected contraceptive failure (e.g., broken condom) or when a pregnancy may result

  17. Radiological Characterization and Final Facility Status Report Tritium Research Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Garcia, T.B.; Gorman, T.P.

    1996-08-01

    This document contains the specific radiological characterization information on Building 968, the Tritium Research Laboratory (TRL) Complex and Facility. We performed the characterization as outlined in its Radiological Characterization Plan. The Radiological Characterization and Final Facility Status Report (RC&FFSR) provides historic background information on each laboratory within the TRL complex as related to its original and present radiological condition. Along with the work outlined in the Radiological Characterization Plan (RCP), we performed a Radiological Soils Characterization, Radiological and Chemical Characterization of the Waste Water Hold-up System including all drains, and a Radiological Characterization of the Building 968 roof ventilation system. These characterizations will provide the basis for the Sandia National Laboratory, California (SNL/CA) Site Termination Survey .Plan, when appropriate.

  18. Fast Flux Test Facility final safety analysis report. Amendment 73

    Energy Technology Data Exchange (ETDEWEB)

    Gantt, D.A.

    1993-08-01

    This report provides Final Safety Analysis Report (FSAR) Amendment 73 for incorporation into the Fast Flux Test Facility (FFTR) FSAR set. This page change incorporates Engineering Change Notices (ECNs) issued subsequent to Amendment 72 and approved for incorparoration before May 6, 1993. These changes include: Chapter 3, design criteria structures, equipment, and systems; chapter 5B, reactor coolant system; chapter 7, instrumentation and control systems; chapter 9, auxiliary systems; chapter 11, reactor refueling system; chapter 12, radiation protection and waste management; chapter 13, conduct of operations; chapter 17, technical specifications; chapter 20, FFTF criticality specifications; appendix C, local fuel failure events; and appendix Fl, operation at 680{degrees}F inlet temperature.

  19. Fast Flux Test Facility final safety analysis report. Amendment 73

    Energy Technology Data Exchange (ETDEWEB)

    Gantt, D.A.

    1993-08-01

    This report provides Final Safety Analysis Report (FSAR) Amendment 73 for incorporation into the Fast Flux Test Facility (FFTR) FSAR set. This page change incorporates Engineering Change Notices (ECNs) issued subsequent to Amendment 72 and approved for incorparoration before May 6, 1993. These changes include: Chapter 3, design criteria structures, equipment, and systems; chapter 5B, reactor coolant system; chapter 7, instrumentation and control systems; chapter 9, auxiliary systems; chapter 11, reactor refueling system; chapter 12, radiation protection and waste management; chapter 13, conduct of operations; chapter 17, technical specifications; chapter 20, FFTF criticality specifications; appendix C, local fuel failure events; and appendix Fl, operation at 680{degrees}F inlet temperature.

  20. Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities.

    Science.gov (United States)

    Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

    2014-01-01

    Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs' decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: "degree of perceived risk in EMS staffs and their patients." This theme consisted of two main categories: (1) patient's condition' and (2) the context of the EMS mission'. The patent's condition category emerged from "physical health statuses," "socioeconomic statuses," and "cultural background" subcategories. The context of the EMS mission also emerged from two subcategories of "characteristics of the mission" and EMS staffs characteristics'. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients' needs for transportation in a prehospital situation.

  1. Exploring Factors Affecting Emergency Medical Services Staffs’ Decision about Transporting Medical Patients to Medical Facilities

    Directory of Open Access Journals (Sweden)

    Abbasali Ebrahimian

    2014-01-01

    Full Text Available Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS staffs. So this study was performed to explore affecting factors in EMS staffs’ decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: “degree of perceived risk in EMS staffs and their patients.” This theme consisted of two main categories: (1 patient’s condition’ and (2 the context of the EMS mission’. The patent’s condition category emerged from “physical health statuses,” “socioeconomic statuses,” and “cultural background” subcategories. The context of the EMS mission also emerged from two subcategories of “characteristics of the mission” and EMS staffs characteristics’. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients’ needs for transportation in a prehospital situation.

  2. Medical Isotope Production Analyses In KIPT Neutron Source Facility

    Energy Technology Data Exchange (ETDEWEB)

    Talamo, Alberto [Argonne National Lab. (ANL), Argonne, IL (United States); Gohar, Yousry [Argonne National Lab. (ANL), Argonne, IL (United States)

    2016-01-01

    Medical isotope production analyses in Kharkov Institute of Physics and Technology (KIPT) neutron source facility were performed to include the details of the irradiation cassette and the self-shielding effect. An updated detailed model of the facility was used for the analyses. The facility consists of an accelerator-driven system (ADS), which has a subcritical assembly using low-enriched uranium fuel elements with a beryllium-graphite reflector. The beryllium assemblies of the reflector have the same outer geometry as the fuel elements, which permits loading the subcritical assembly with different number of fuel elements without impacting the reflector performance. The subcritical assembly is driven by an external neutron source generated from the interaction of 100-kW electron beam with a tungsten target. The facility construction was completed at the end of 2015, and it is planned to start the operation during the year of 2016. It is the first ADS in the world, which has a coolant system for removing the generated fission power. Argonne National Laboratory has developed the design concept and performed extensive design analyses for the facility including its utilization for the production of different radioactive medical isotopes. 99Mo is the parent isotope of 99mTc, which is the most commonly used medical radioactive isotope. Detailed analyses were performed to define the optimal sample irradiation location and the generated activity, for several radioactive medical isotopes, as a function of the irradiation time.

  3. Medical students' experience and perceptions of their final rotation ...

    African Journals Online (AJOL)

    led by consultants, and sessions devoted to interpersonal and microcommunication ... Objective. To evaluate medical students' perceptions of their final psychiatry rotation of 7 weeks. Methods. .... relationships between factors and individual.

  4. Final Design Report for the RH LLW Disposal Facility (RDF) Project

    Energy Technology Data Exchange (ETDEWEB)

    Austad, S. L. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-05-01

    The RH LLW Disposal Facility (RDF) Project was designed by AREVA Federal Services (AFS) and the design process was managed by Battelle Energy Alliance (BEA) for the Department of Energy (DOE). The final design report for the RH LLW Disposal Facility Project is a compilation of the documents and deliverables included in the facility final design.

  5. Final Design Report for the RH LLW Disposal Facility (RDF) Project

    Energy Technology Data Exchange (ETDEWEB)

    Austad, Stephanie Lee [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-09-01

    The RH LLW Disposal Facility (RDF) Project was designed by AREVA Federal Services (AFS) and the design process was managed by Battelle Energy Alliance (BEA) for the Department of Energy (DOE). The final design report for the RH LLW Disposal Facility Project is a compilation of the documents and deliverables included in the facility final design.

  6. Final Design Report for the RH LLW Disposal Facility (RDF) Project

    Energy Technology Data Exchange (ETDEWEB)

    Austad, Stephanie Lee [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-09-01

    The RH LLW Disposal Facility (RDF) Project was designed by AREVA Federal Services (AFS) and the design process was managed by Battelle Energy Alliance (BEA) for the Department of Energy (DOE). The final design report for the RH LLW Disposal Facility Project is a compilation of the documents and deliverables included in the facility final design.

  7. Residents' perspectives on the final year of medical school.

    Science.gov (United States)

    O'Brien, Bridget C; Niehaus, Brian; Teherani, Arianne; Young, John Q

    2012-08-07

    To characterize junior residents' perspectives on the purpose, value, and potential improvement of the final year of medical school. Eighteen interviews were conducted with junior residents who graduated from nine different medical schools and who were in internal medicine, surgery, and psychiatry programs at one institution in the United States. Interview transcripts were coded and analyzed inductively for themes. Participants' descriptions of the purpose of their recently completed final year of medical school contained three primary themes: residency-related purposes, interest- or need-based purposes, and transitional purposes. Participants commented on the most valued aspects of the final year. Themes included opportunities to: prepare for residency; assume a higher level of responsibility in patient care; pursue experiences of interest that added breadth of knowledge, skills and perspective; develop and/or clarify career plans; and enjoy a period of respite. Suggestions for improvement included enhancing the learning value of clinical electives, augmenting specific curricular content, and making the final year more purposeful and better aligned with career goals. The final year of medical school is a critical part of medical education for most learners, but careful attention is needed to ensure that the year is developmentally robust. Medical educators can facilitate this by creating structures to help students define personal and professional goals, identify opportunities to work toward these goals, and monitor progress so that the value of the final year is optimized and not exclusively focused on residency preparation.

  8. Facilities and regionalization--emergency medical services systems.

    Science.gov (United States)

    Stewart, R D

    1990-02-01

    Advanced life support and the modern EMS system were born out of the hope that by extending hospital emergency facilities outside the bounds of the hospital, earlier and more intensive care could be provided to those patients requiring it. EMS systems have since left the nest and only recently, following a turbulent adolescence, is prehospital care returning as a partner with the medical facilities and physicians that presided over their modern origins. The next decade will see the continuing trend toward hospitals and practitioners regaining some influence in the design and direction of prehospital care.

  9. Fast Flux Test Facility final safety analysis report. Amendment 72

    Energy Technology Data Exchange (ETDEWEB)

    Gantt, D. A.

    1992-08-01

    This document provides the Final Safety Analysis Report (FSAR) Amendment 72 for incorporation into the Fast Flux Test Facility (FFTF) FSAR set. This amendment change incorporates Engineering Change Notices issued subsequent to Amendment 71 and approved for incorporation before June 24, 1992. These include changes in: Chapter 2, Site Characteristics; Chapter 3, Design Criteria Structures, Equipment, and Systems; Chapter 5B, Reactor Coolant System; Chapter 7, Instrumentation and Control Systems; Chapter 8, Electrical Systems - The description of the Class 1E, 125 Vdc systems is updated for the higher capacity of the newly installed, replacement batteries; Chapter 9, Auxiliary Systems - The description of the inert cell NASA systems is corrected to list the correct number of spare sample points; Chapter 11, Reactor Refueling System; Chapter 12, Radiation Protection and Waste Management; Chapter 13, Conduct of Operations; Chapter 16, Quality Assurance; Chapter 17, Technical Specifications; Chapter 19, FFTF Fire Specifications for Fire Detection, Alarm, and Protection Systems; Chapter 20, FFTF Criticality Specifications; and Appendix B, Primary Piping Integrity Evaluation.

  10. [Marketing in the system of military-medical facilities].

    Science.gov (United States)

    Kostiuchenko, O M; Sviridova, T B

    2014-02-01

    Military medical facilities of the Ministry of Defence of the Russian, have received the right to provide additional services and have been involved in the sphere of market relations. The strong influence of market relations - an objective reality that must be used for the development of military medical institutions and improving quality of care.Effective commercial activity can improve capabilities of the military medical institutions. This requires constant study of market mechanisms to implement and develop their competitive advantage. The paper substantiates the need for the participation of military medical institutions in the provision of health services to the public on the terms of compensation incurred by financial institutions costs (paid medical services, medical assistance program of compulsory and voluntary health insurance). Taking into account the specifics of military medical institutions set out basic principles and recommendations have been implementing marketing approach in their management, the practical application of which will not only increase efficiency, but also create conditions to improve the financial and economic indicators. This knowledge will help the mechanism of functioning health care market and the rules of interaction of market counterparties.

  11. National facilities survey. Water treatment technology report No. 12 (Final)

    Energy Technology Data Exchange (ETDEWEB)

    Furukawa, D.H.

    1994-09-01

    This report is a survey of publicly and privately owned laboratories, facilities, and pilot plant equipment in the United States capable of undertaking water research and technology development. The survey was initiated by the National Water Research Institute and the Bureau of Reclamation as its first step in the development of the National Centers for Separation and Thermal Systems Research (Centers). The Centers concepts will facilitate water purification research through optimization of use of research resources, including facilities, making existing resources, facilities, and equipment available for investigators to conduct research. The survey contains information on 66 facilities in the United States.

  12. New Pump and Treat Facility Remedial Action Work Plan for Test Area North (TAN) Final Groundwater Remediation, Operable Unit 1-07B

    Energy Technology Data Exchange (ETDEWEB)

    L. O. Nelson

    2003-09-01

    This operations and maintenance plan supports the New Pump and Treat Facility (NPTF) remedial action work plan and identifies the approach and requirements for the operations and maintenance activities specific to the final medical zone treatment remedy. The NPTF provides the treatment system necessary to remediate the medical zone portion of the OU 1-07B contaminated groundwater plume. Design and construction of the New Pump and Treat Facility is addressed in the NPTF remedial action work plan. The scope of this operation and maintenance plan includes facility operations and maintenance, remedy five-year reviews, and the final operations and maintenance report for the NPTF.

  13. Radioactive isotope production for medical applications using Kharkov electron driven subcritical assembly facility.

    Energy Technology Data Exchange (ETDEWEB)

    Talamo, A.; Gohar, Y.; Nuclear Engineering Division

    2007-05-15

    Kharkov Institute of Physics and Technology (KIPT) of Ukraine has a plan to construct an accelerator driven subcritical assembly. The main functions of the subcritical assembly are the medical isotope production, neutron thereby, and the support of the Ukraine nuclear industry. Reactor physics experiments and material research will be carried out using the capabilities of this facility. The United States of America and Ukraine have started collaboration activity for developing a conceptual design for this facility with low enrichment uranium (LEU) fuel. Different conceptual designs are being developed based on the facility mission and the engineering requirements including nuclear physics, neutronics, heat transfer, thermal hydraulics, structure, and material issues. Different fuel designs with LEU and reflector materials are considered in the design process. Safety, reliability, and environmental considerations are included in the facility conceptual design. The facility is configured to accommodate future design improvements and upgrades. This report is a part of the Argonne National Laboratory Activity within this collaboration for developing and characterizing the subcritical assembly conceptual design. In this study, the medical isotope production function of the Kharkov facility is defined. First, a review was carried out to identify the medical isotopes and its medical use. Then a preliminary assessment was performed without including the self-shielding effect of the irradiated samples. Finally, more detailed investigation was carried out including the self-shielding effect, which defined the sample size and irradiation location for producing each medical isotope. In the first part, the reaction rates were calculated as the multiplication of the cross section with the unperturbed neutron flux of the facility. Over fifty isotopes were considered and all transmutation channels are used including (n,{gamma}), (n,2n), (n,p), and ({gamma},n). In the second part

  14. Crowder College MARET Center Facility Final Scientific/Technical Report

    Energy Technology Data Exchange (ETDEWEB)

    Rand, Amy

    2013-08-20

    This project was a research facility construction project and did not include actual research. The new facility will benefit the public by providing training opportunities for students, as well as incubator and laboratory space for entrepreneurs in the areas of alternative and renewable energies. The 9,216 -square-foot Missouri Alternative and Renewable Energy Technology (MARET) Center was completed in late 2011. Classes in the MARET Center began in the spring 2012 semester. Crowder College takes pride in the MARET Center, a focal point of the campus, as the cutting edge in education, applied research and commercial development in the growing field of green technology.

  15. Staging and storage facility feasibility study. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Swenson, C.E. [Westinghouse Hanford Co., Richland, WA (United States)

    1995-02-01

    This study was performed to investigate the feasibility of adapting the design of the HWVP Canister Storage Building (CSB) to meet the needs of the WHC Spent Nuclear Fuel Project for Staging and Storage Facility (SSF), and to develop Rough Order of Magnitude (ROM) cost and schedule estimates.

  16. Final year medical students’ understanding of family medicine

    Directory of Open Access Journals (Sweden)

    Marija Petek Šter

    2013-05-01

    Full Text Available Objective. The European Academy of Teachers in General Practice / Family Medicine (EURACT has developed an educational agenda, the key document for teaching family medicine in Europe. The aim of our study was to find out how final year medical students at the beginning of their family medicine clerkship understand the discipline of family medicine. Methods. The attitudes toward family medicine were paraphrased and developed into a 164-item questionnaire, which was administered to 335 final-year medical students at the beginning of their clerkship. Using combinatorial optimization with genetic algorithms we selected 30 items which yielded the highest Cronbach alpha reliability coefficient. Finally, we performed a factor analysis to find which dimensions of family medicine were recognised by the students and compared them with the domains defined in the EURACT definition. Results. The 30-item questionnaire had a Cronbach alpha reliability coefficient of 0.919. The differences between male and female students were not very significant (p=0.061. With the factor analysis we recognised seven factors, belonging to three out of six domains of the EURACT educational agenda: primary care management, personcenteredness and comprehensive approach. Conclusion. Final-year medical students at the beginning of their family medicine clerkship understand some of the dimensions of family medicine rather well, but they are not aware of some important competences of family doctors. There is a necessity to teach students about specific problem solving skills and the importance of balance between the health needs of an individual patient and the community.

  17. East Mesa geothermal pump test facility (EMPTF). Final report

    Energy Technology Data Exchange (ETDEWEB)

    Olander, R.G.; Roberts, G.K.

    1984-11-28

    The design, fabrication and installation of a geothermal pump test facility (EMPFT) at the DOE geothermal site at East Mesa, California which is capable of testing 70 to 750 horsepower downwell pumps in a controlled geothermal environment were completed. The facility consists of a skid-mounted brine control module, a 160 foot below test well section, a hydraulic turbine for power recovery, a gantry-mounted hoist for pump handling and a 3-phase, 480 VAC, 1200 amp power supply to handle pump electric requirements. Geothermal brine is supplied to the EMPTF from one of the facility wells at East Mesa. The EMPTF is designed with a great amount of flexibility. The 20-inch diameter test well can accommodate a wide variety of pumps. The controls are interactive and can be adjusted to obtain a full complement of pump operation data, or set to maintain constant conditions to allow long-term testing with a minimum of operator support. The hydraulic turbine allows the EMPTF user to recover approximately 46% of the input pump power to help defray the operating cost of the unit. The hoist is provided for material handling and pump servicing and reduces the equipment that the user must supply for pump installation, inspection and removal.

  18. East Mesa geothermal pump test facility (EMPTF). Final report

    Energy Technology Data Exchange (ETDEWEB)

    Olander, R.G.; Roberts, G.K.

    1984-11-28

    Barber-Nichols has completed the design, fabrication and installation of a geothermal pump test facility at the DOE geothermal site at East Mesa, California which is capable of testing 70 to 750 horsepower downwell pumps in a controlled geothermal environment. The facility consists of a skid-mounted brine control module, a 160 foot below ground test well section, a hydraulic turbine for power recovery, a gantry-mounted hoist for pump handling and a 3-phase, 480 VAC, 1200 amp power supply to handle pump electric requirements. Geothermal brine is supplied to the EMPTF from one of the facility wells at East Mesa. The EMPTF is designed with a great amount of flexibility to attract the largest number of potential users. The 20-inch diameter test well can accommodate a wide variety of pumps. The controls are interactive and can be adjusted to obtain a full complement of pump operation data, or set to maintain constant conditions to allow long-term testing with a minimum of operator support. The hydraulic turbine allows the EMPTF user to recover approximately 46% of the input pump power to help defray the operating cost of the unit. The hoist is provided for material handling and pump servicing and reduces the equipment that the user must supply for pump installation, inspection and removal.

  19. Consolidated Incineration Facility waste burn test. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Burns, D.B.

    1995-01-11

    The Savannah River Technology Center (SRTC) is Providing technical support for start-up and operation of the Consolidated Incineration Facility. This support program includes a series of pilot incineration tests performed at the Environmental Protection Agency`s (EPA`s) Incineration Research Facility (MF) using surrogate CIF mixed wastes. The objectives for this test program included measuring incinerator offgas particulate loading and size distributions as a function of several operating variables, characterizing kiln bottom ash and offgas particulates, determining heavy metal partition between the kiln bottom ash and incinerator stack gas, and measuring kiln organics emissions (particularly polychlorinated dioxins and furans). These tests were designed to investigate the effect of the following operating parameters: Incineration Temperature; Waste Feed Rate; Waste Density; Kiln Solids Residence Time; and Waste Composition. Tests were conducted at three kiln operating temperatures. Three solid waste simulants were burned, two waste mixtures (paper, plastic, latex, and PVC) with one containing spiked toxic organic and metal compounds, and one waste type containing only paper. Secondary Combustion Chamber (SCC) offgases were sampled for particulate loading and size distribution, organic compounds, polychlorinated dibenzo[p]dioxins and polychlorinated dibenzofurans (PCDD/PCDF), metals, and combustion products. Kiln bottom ash and offgas particulates were characterized to determine the principal elements and compounds comprising these secondary wastes.

  20. Why Veterinary Medical Educators Should Embrace Cumulative Final Exams.

    Science.gov (United States)

    Royal, Kenneth D

    2017-01-03

    The topic of cumulative final examinations often elicits polarizing opinions from veterinary medical educators. While some faculty prefer cumulative finals, there are many who perceive these types of examinations as problematic. Specifically, faculty often cite cumulative examinations are more likely to cause students' greater stress, which may in turn result in negative student evaluations of teaching. Cumulative finals also restrict the number of items one may present to students on most recent material. While these cited disadvantages may have some merit, the advantages of cumulative examinations far exceed the disadvantages. The purpose of this article is to discuss the advantages of cumulative examinations with respect to learning evidence, grade/score validity, fairness issues, and implications for academic policy.

  1. Competence for internship: perceptions of final-year medical students.

    Science.gov (United States)

    Draper, C E; Louw, G J

    2012-07-01

    A 'new', problem-based medical curriculum was introduced at the University of Cape Town (UCT) in 2002. The objective of this study was to assess the perceptions of competence for internship and the factors influencing competence of final-year medical students. Eighteen focus groups were conducted (six per year) with UCT final-year medical students in 2007 (n =27), 2008 (n =27), and 2009 (n =30). Guide questions covered student's expectations of internship, perceptions of competence, priorities regarding competence, and factors influencing competence. Participants felt generally positive about and competent to enter internship, and the transition into internship was characterized as having both personal and professional components. Participants identified interpersonal skills, theoretical grounding, and intellectual ability as strengths, and lack of basic science knowledge and certain procedural skills as weaknesses. Factors influencing competence included personal initiative, motivation, and clinical exposure. Curriculum strengths identified were teaching of interpersonal skills and development of students as lifelong learners. The main weaknesses identified were teaching and assessment of basic sciences, and problem-based learning (PBL). Overall, the participants felt generally positive about internship and the 'new' curriculum, and felt generally competent to enter internship. Their responses highlight the role of confidence in the development of competence. These findings highlight the complexities surrounding perceptions of students about competence and views about the content and methodology of the learning. Perceptions of students regarding competence are an important indicator of the attainment of intended curriculum outcomes, and provide valuable information for the improvement of curriculum.

  2. Hazardous medical waste generation in Greece: case studies from medical facilities in Attica and from a small insular hospital.

    Science.gov (United States)

    Komilis, Dimitrios; Katsafaros, Nikolaos; Vassilopoulos, Panagiotis

    2011-08-01

    The accurate calculation of the unit generation rates and composition of medical waste generated from medical facilities is necessary in order to design medical waste treatment systems. In this work, the unit medical waste generation rates of 95 public and private medical facilities in the Attica region were calculated based on daily weight records from a central medical waste incineration facility. The calculated medical waste generation rates (in kg bed(-1) day( -1)) varied widely with average values at 0.27 ± 113% and 0.24 ± 121%, for public and private medical facilities, respectively. The hazardous medical waste generation was measured, at the source, in the 40 bed hospital of the island of Ikaria for a period of 42 days during a 6 month period. The average hazardous medical waste generation rate was 1.204 kg occupied bed(-1) day(-1) or 0.33 kg (official) bed( -1) day(-1). From the above amounts, 54% resulted from the patients' room (solid and liquid wastes combined), 24% from the emergency department (solid waste), 17% from the clinical pathology lab and 6% from the X-ray lab. In average, 17% of the total hazardous medical waste was solely infectious. Conclusively, no correlation among the number of beds and the unit medical waste generation rate could be established. Each hospital should be studied separately, since medical waste generation and composition depends on the number and type of departments/laboratories at each hospital, number of external patients and number of occupied beds.

  3. Activation of air and concrete in medical isotope production facilities

    Science.gov (United States)

    Dodd, Adam C.; Shackelton, R. J.; Carr, D. A.; Ismail, A.

    2017-05-01

    Medical isotope facilities operating in the 10 to 25 MeV proton energy range have long been used to generate radioisotopes for medical diagnostic imaging. In the last few years the beam currents available in commercially available cyclotrons have increased dramatically, and so the activation of the materials within cyclotron vaults may now pose more serious radiological hazards. This will impact the regulatory oversight of cyclotron operations, cyclotron servicing and future decommissioning activities. Air activation could pose a hazard to cyclotron staff. With the increased cyclotron beam currents it was necessary to examine the issue more carefully. Therefore the ways in which radioactivity may be induced in air by neutron reactions and neutron captures were considered and it was found that the dominant mechanism is neutron capture on Ar-40. A study of the activation of the air by neutron capture on Ar-40 within a cyclotron vault was performed using the MCNP Monte Carlo code. The neutron source energy spectrum used was from the production of the widely used F-18 PET isotope. The results showed that the activation of the air within a cyclotron vault does not pose a significant radiological hazard at the beam intensities currently in use and shows how ventilation affects the results. A second MCNP study on the activation of ordinary concrete in cyclotron vaults by neutron capture was made with a view to determining the optimum thickness of borated polyethylene to reduce neutron activation on both the inner surfaces of the vault and around production targets. This is of importance in decommissioning cyclotrons and therefore in the design of new cyclotron vaults. The distribution of activation on the walls as a function of the source position was also studied. Results are presented for both borated and regular polyethylene, and F-18 and Tc-99 neutron spectra.

  4. X-Ray facilities for medical diagnosis in Spain; Las instalaciones de rayos X con fines de diagnostico medico en Espana

    Energy Technology Data Exchange (ETDEWEB)

    Alvarez, C.

    2002-07-01

    This report is concerned with existing X-rays facilities for medical diagnosis in Spain and describes the legalization process of these facilities. Likewise, it indicators the measures for radiation protection applicable to equipment manufacture, design, distribution and proper facilities security during operation. Finally, data of the evolution of average worker dose in this sector, corresponding to the last seven years, are collected from The National Dosimetry Bank. (Author) 9 refs.

  5. Absenteeism and under-achievement in final year medical students.

    Science.gov (United States)

    Dhaliwal, Upreet

    2003-01-01

    Absenteeism among medical students has received little attention in the literature. The aim of this study was to determine the causes of absenteeism from didactic lectures in ophthalmology and its correlation with performance in formative assessment. The attendance of 101 final year medical students for lectures in ophthalmology was studied in three parts: terms 1, 2 and 3. Based on the attendance in all three terms, students were divided into groups I to V, where group I students had good attendance in all three terms down to group V, with very poor attendance in one or more terms. The marks scored in the first, second and third terminal theory tests were tabulated separately. Results of the second and final professional examinations were assessed for the five groups of students. Students were asked to list the causes of absenteeism in a proforma. Data were analysed by regression analysis and Chi-square test. Significance was obtained at 5% level. In each formative assessment, higher attendance was associated with better marks (p absenteeism in 62.6% of instances. Six of the 10 students who failed the ophthalmology professional examination were in groups IV and V and had failed the second professional examination as well. They were designated low achievers, as were 3 students who made several attempts to pass the second professional examination and failed in ophthalmology despite a fair-good attendance. Learner absenteeism may contribute to low achievement. However, absenteeism may be symptomatic of low achievers. Low achievers or students with learning handicaps must be identified before admission or early in the medical course and encouraged to improve their performance and thereby enhance their self-esteem. A support group of family, peers, faculty and psychologists could help.

  6. Study on patient-induced radioactivity during proton treatment in hengjian proton medical facility.

    Science.gov (United States)

    Wu, Qingbiao; Wang, Qingbin; Liang, Tianjiao; Zhang, Gang; Ma, Yinglin; Chen, Yu; Ye, Rong; Liu, Qiongyao; Wang, Yufei; Wang, Huaibao

    2016-09-01

    At present, increasingly more proton medical facilities have been established globally for better curative effect and less side effect in tumor treatment. Compared with electron and photon, proton delivers more energy and dose at its end of range (Bragg peak), and has less lateral scattering for its much larger mass. However, proton is much easier to produce neutron and induced radioactivity, which makes radiation protection for proton accelerators more difficult than for electron accelerators. This study focuses on the problem of patient-induced radioactivity during proton treatment, which has been ignored for years. However, we confirmed it is a vital factor for radiation protection to both patient escort and positioning technician, by FLUKA's simulation and activation formula calculation of Hengjian Proton Medical Facility (HJPMF), whose energy ranges from 130 to 230MeV. Furthermore, new formulas for calculating the activity buildup process of periodic irradiation were derived and used to study the relationship between saturation degree and half-life of nuclides. Finally, suggestions are put forward to lessen the radiation hazard from patient-induced radioactivity.

  7. Western Regional Final Supplemental Environmental Impact Statement: Rulemaking for Small Power Production and Cogeneration Facilities - Exemptions for Geothermal Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Heinemann, Jack M.; Nalder, Nan; Berger, Glen

    1981-02-01

    Section 643 of the Energy Security Act of 1980 directed the Federal Energy Regulatory Commission to develop rules to further encourage geothermal development by Small Power Production Facilities. This rule amends rules previously established in Dockets No. RM79-54 and 55 under Section 201 and 210 of the Public Utility Regulatory Policies Act of 1978 (PURPA). The analysis shows that the rules are expected to stimulate the development of up to 1,200 MW of capacity for electrical generation from geothermal facilities by 1995--1,110 MW more than predicted in the original PURPA EIS. This Final Supplemental EIS to the DEIS, issued by FERC in June 1980, forecasts likely near term development and analyzes environmental effects anticipated to occur due to development of geothermal resources in the Western United States as a result of this additional rulemaking.

  8. Utilizing field medical equipment to support fixed facilities during major renovation projects.

    Science.gov (United States)

    Call, C A; Maloney, J P

    1993-05-01

    When a fixed facility plans for renovation, the ultimate goal is to provide continuous, cost-effective medical operations. One alternative is to utilize field medical equipment. The Deployable Medical Systems (DEPMEDS), even though designed for battlefield medicine, has been successfully used for six fixed facility renovation projects. As a direct result of various studies, several improvements have been implemented and recommended for the DEPMEDS equipment when used to support fixed facilities. These projects have provided a rich learning experience and have significantly improved the readiness posture of the AMEDD.

  9. Medicare program; inpatient rehabilitation facility prospective payment system for federal fiscal year 2014. Final rule.

    Science.gov (United States)

    2013-08-01

    This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for federal fiscal year (FY) 2014 (for discharges occurring on or after October 1, 2013 and on or before September 30, 2014) as required by the statute. This final rule also revised the list of diagnosis codes that may be counted toward an IRF's "60 percent rule'' compliance calculation to determine "presumptive compliance,'' update the IRF facility-level adjustment factors using an enhanced estimation methodology, revise sections of the Inpatient Rehabilitation Facility-Patient Assessment Instrument, revise requirements for acute care hospitals that have IRF units, clarify the IRF regulation text regarding limitation of review, update references to previously changed sections in the regulations text, and revise and update quality measures and reporting requirements under the IRF quality reporting program.

  10. Ultraviolet Light Generation and Transport in the Final Optics Assembly of the National Ignition Facility

    Energy Technology Data Exchange (ETDEWEB)

    Wegner, P. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Hackel, L. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Feit, M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Parham, T. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Kozlowski, M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Whitman, P. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2015-02-12

    The design of the National Ignition Facility (NIF) includes a Final Optics Assembly (FOA) subsystem for ultraviolet (UV) light generation and transport for each of the 192 beamlines. Analytical and experimental work has been done to help understand and predict the performance of FOA.

  11. Experimental and Theoretical Progress of Linear Collider Final Focus Design and ATF2 Facility

    CERN Document Server

    Seryi, Andrei; Zimmermann, Frank; Kubo, Kiyoshi; Kuroda, Shigeru; Okugi, Toshiyuki; Tauchi, Toshiaki; Terunuma, Nobuhiro; Urakawa, Junji; White, Glen; Woodley, Mark; Angal-Kalinin, Deepa

    2014-01-01

    In this brief overview we will reflect on the process of the design of the linear collider (LC) final focus (FF) optics, and will also describe the theoretical and experimental efforts on design and practical realisation of a prototype of the LC FF optics implemented in the ATF2 facility at KEK, Japan, presently being commissioned and operated.

  12. Reactivation of the Shock-Tunnel Facility at Fort Cronkhite. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1982-05-01

    This final report describes the results of work undertaken to reactivate the Shock Tunnel Facility at Battery Townsley, Fort Cronkhite, Marin County, California. The facility has been reactivated and can not be utilized for blast testing. The major emphasis will be testing of concepts pertaining to programs of interest to the Federal Emergency Management Agency (FEMA) and in particular to civil defense oriented research. However, a wide variety of testing requirements can be accommodated. For example, past programs at the facility have included: tests of debris from trees subjected to blast for Bell Telephone Laboratories; tests of the response of aluminum hull panels to blast loading and of the response of a model surface effects ship for the Naval Ship Research and Development center, and tests of the response of a radome prototype to blast loading conducted for ANCOM (the radome manufacturer). The Shock Tunnel Facility is located in a former coastal defense 16-inch gun emplacement constructed by the US Army beginning in 1938. It was converted in 1967 to serve as a facility for full-scale testing of the loading and response of structural elements and civil defense equipment. It remained in operation until November 1976 when Battery Townsley was turned over to the National Park Service. Work under the present purchase order consisted of the following major tasks: (I) cleanup and secure the facility, (II) reactivate the shock tunnel, and (III) design permanent facility improvements. (WHK)

  13. "Megatrends" driving healthcare facility design: a look at the major trends that will shape medical facility design.

    Science.gov (United States)

    Mann, George J; Okamoto, Kazuhiko

    2010-01-01

    Changes in medical construction and design are accelerating exponentially, and anyone who can anticipate where these changes are going to happen will be at an advantage. Knowing the "Megatrends" defining and driving the future of healthcare delivery and healthcare facility design will help decision makers anticipate the future.

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

    Science.gov (United States)

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

    2007-01-01

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

  15. Medical equipment in government health facilities: Missed opportunities

    OpenAIRE

    Pardeshi Geeta

    2005-01-01

    BACKGROUND: The availability and optimal utilization of medical equipment is important for improving the quality of health services. Significant investments are made for the purchase, maintenance and repair of medical equipment. Inadequate management of these equipment will result in financial losses and deprive the public of the intended benefits. This analysis is based on the conceptual framework drawn from the WHO recommended- lifecycle of medical equipment. AIMS: (1) To identify the probl...

  16. Medical equipment in government health facilities: Missed opportunities

    OpenAIRE

    Pardeshi Geeta

    2005-01-01

    BACKGROUND: The availability and optimal utilization of medical equipment is important for improving the quality of health services. Significant investments are made for the purchase, maintenance and repair of medical equipment. Inadequate management of these equipment will result in financial losses and deprive the public of the intended benefits. This analysis is based on the conceptual framework drawn from the WHO recommended- lifecycle of medical equipment. AIMS: (1) To identify the probl...

  17. Pitfalls and Security Measures for the Mobile EMR System in Medical Facilities

    OpenAIRE

    Yeo, Kiho; Lee, Keehyuck; Kim, Jong-Min; Kim, Tae-Hun; Choi, Yong-Hoon; Jeong, Woo-Jin; Hwang, Hee; Baek, Rong Min; Yoo, Sooyoung

    2012-01-01

    Objectives The goal of this paper is to examine the security measures that should be reviewed by medical facilities that are trying to implement mobile Electronic Medical Record (EMR) systems designed for hospitals. Methods The study of the security requirements for a mobile EMR system is divided into legal considerations and sectional security investigations. Legal considerations were examined with regard to remote medical services, patients' personal information and EMR, medical devices, th...

  18. [The historical experience of medical service in cooperation with state healthcare facilities during the Great Patriotic War 1941-1945].

    Science.gov (United States)

    Budko, A A; Gribovskaia, G A; Zhuravlev, D A

    2014-05-01

    Cooperation issues between military-medical service and civil healthcare in the field of delivery of medical aid to patients in the rear of country are considered in the artic. The rear is a final stage of the care by echelon and the main medical reserve force for front and army areas. Wide hospital network in the rear consisted mainly of evacuation hospitals of the People's Commissariat of the USSR healthcare. Cooperation between military-medical service and civil healthcare facilities was required. Sometimes necessary cooperation failed and made mutual helming of evacuation hospitals difficult. But despite the problems the main problem - return of maximum wounded soldiers to active duty was solved during the Great Patriotic War.

  19. Safety Analysis Report: X17B2 beamline Synchrotron Medical Research Facility

    Energy Technology Data Exchange (ETDEWEB)

    Gmuer, N.F.; Thomlinson, W.

    1990-02-01

    This report contains a safety analysis for the X17B2 beamline synchrotron medical research facility. Health hazards, risk assessment and building systems are discussed. Reference is made to transvenous coronary angiography. (LSP)

  20. Managing Disruptive Behavior by Patients and Physicians: A Responsibility of the Dialysis Facility Medical Director.

    Science.gov (United States)

    Jones, Edward R; Goldman, Richard S

    2015-08-07

    The Centers for Medicare & Medicaid Services' Conditions for Coverage make the medical director of an ESRD facility responsible for all aspects of care, including high-quality health care delivery (e.g., safe, effective, timely, efficient, and patient centered). Because of the high-pressure environment of the dialysis facility, conflicts are common. Conflict frequently occurs when aberrant behaviors disrupt the dialysis facility. Patients, family members, friends, and, less commonly appreciated, nephrology clinicians (i.e., nephrologists and advanced care practitioners) may manifest disruptive behavior. Disruptive behavior in the dialysis facility impairs the ability to deliver high-quality care. Furthermore, disruptive behavior is the leading cause for involuntary discharge (IVD) or involuntary transfer (IVT) of a patient from a facility. IVD usually results in loss of continuity of care, increased emergency department visits, and increased unscheduled, acute dialysis treatments. A sufficient number of IVDs and IVTs also trigger an extensive review of the facility by the regional ESRD Networks, exposing the facility to possible Medicare-imposed sanctions. Medical directors must be equipped to recognize and correct disruptive behavior. Nephrology-based literature and tools exist to help dialysis facility medical directors successfully address and resolve disruptive behavior before medical directors must involuntarily discharge a patient or terminate an attending clinician.

  1. Transuranic-contaminated solid waste Treatment Development Facility. Final safety analysis report

    Energy Technology Data Exchange (ETDEWEB)

    Warner, C.L. (comp.)

    1979-07-01

    The Final Safety Analysis Report (FSAR) for the Transuranic-Contaminated Solid-Waste Treatment Facility has been prepared in compliance with the Department of Energy (DOE) Manual Chapter 0531, Safety of Nonreactor Nuclear Facilities. The Treatment Development Facility (TDF) at the Los Alamos Scientific Laboratory is a research and development facility dedicated to the study of radioactive-waste-management processes. This analysis addresses site assessment, facility design and construction, and the design and operating characteristics of the first study process, controlled air incineration and aqueous scrub off-gas treatment with respect to both normal and accident conditions. The credible accidents having potentially serious consequences relative to the operation of the facility and the first process have been analyzed and the consequences of each postulated credible accident are presented. Descriptions of the control systems, engineered safeguards, and administrative and operational features designed to prevent or mitigate the consequences of such accidents are presented. The essential features of the operating and emergency procedures, environmental protection and monitoring programs, as well as the health and safety, quality assurance, and employee training programs are described.

  2. Electronic Medical Record and Quality Ratings of Long Term Care Facilities Long-Term Care Facility Characteristics and Reasons and Barriers for Adoption of Electronic Medical Record

    Science.gov (United States)

    Daniels, Cheryl Andrea

    2013-01-01

    With the growing elderly population, compounded by the retirement of the babyboomers, the need for long-term care (LTC) facilities is expected to grow. An area of great concern for those that are seeking a home for their family member is the quality of care provided by the nursing home to the residents. Electronic medical records (EMR) are often…

  3. CERN-MEDICIS (Medical Isotopes Collected from ISOLDE: A New Facility

    Directory of Open Access Journals (Sweden)

    Ricardo Manuel dos Santos Augusto

    2014-05-01

    Full Text Available About 50% of the 1.4 GeV CERN (European Organization for Nuclear Research, www.cern.ch protons are sent onto targets to produce radioactive beams by online mass separation at the Isotope Separator Online Device (ISOLDE facility, for a wide range of studies in fundamental and applied physics. CERN-MEDICIS is a spin-off dedicated to R&D in life sciences and medical applications. It is located in an extension of the Class A building presently under construction. It will comprise laboratories to receive the irradiated targets from a new station located at the dump position behind the ISOLDE production targets. An increasing range of innovative isotopes will thus progressively become accessible from the start-up of the facility in 2015 onward; for fundamental studies in cancer research, for new imaging and therapy protocols in cell and animal models and for pre-clinical trials, possibly extended to specific early phase clinical studies up to Phase I trials. Five hundred megabecquerel isotope batches purified by electromagnetic mass separation combined with chemical methods will be collected on a weekly basis. A possible future upgrade with gigabecquerel pharmaceutical-grade i.e., current good manufacturing practices (cGMP batch production capabilities is finally presented.

  4. Optimizing proton therapy at the LBL medical accelerator. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Alonso, J.

    1992-03-01

    This Grant has marked the beginning of a multi-year study process expected to lead to design and construction of at least one, possibly several hospital-based proton therapy facilities in the United States.

  5. Sterilization validation for medical compresses at IRASM multipurpose irradiation facility

    Energy Technology Data Exchange (ETDEWEB)

    Alexandru, Mioara [Horia Hulubei National Institute of Physics and Nuclear Engineering, IRASM Radiation Processing Centre (Romania)]. E-mail: m_alexandru@irasm.ro; Ene, Mihaela [Horia Hulubei National Institute of Physics and Nuclear Engineering, IRASM Radiation Processing Centre (Romania)

    2007-08-15

    In Romania, IRASM Radiation Processing Center is the unique supplier of radiation sterilization services-industrial scale (ISO 9001:2000 and ISO 13485:2003 certified). Its Laboratory of Microbiological Testing is the sole third party competent laboratory (GLPractice License, ISO 17025 certification in progress) for pharmaceutics and medical devices as well. We here refer to medical compresses as a distinct category of sterile products, made from different kind of hydrophilic materials (cotton, non-woven, polyurethane foam) with or without an impregnated ointment base (paraffin, plant extracts). These products are included in the class of medical devices, but for the sterilization validation, from microbiological point of view, there are important differences in testing method compared to the common medical devices (syringes, catheters, etc). In this paper, we present some results and practical solutions chosen to perform a sterilization validation, compliant with ISO 11137: 2006.

  6. Sterilization validation for medical compresses at IRASM multipurpose irradiation facility

    Science.gov (United States)

    Alexandru, Mioara; Ene, Mihaela

    2007-08-01

    In Romania, IRASM Radiation Processing Center is the unique supplier of radiation sterilization services—industrial scale (ISO 9001:2000 and ISO 13485:2003 certified). Its Laboratory of Microbiological Testing is the sole third party competent laboratory (GLPractice License, ISO 17025 certification in progress) for pharmaceutics and medical devices as well. We here refer to medical compresses as a distinct category of sterile products, made from different kind of hydrophilic materials (cotton, non-woven, polyurethane foam) with or without an impregnated ointment base (paraffin, plant extracts). These products are included in the class of medical devices, but for the sterilization validation, from microbiological point of view, there are important differences in testing method compared to the common medical devices (syringes, catheters, etc). In this paper, we present some results and practical solutions chosen to perform a sterilization validation, compliant with ISO 11137: 2006.

  7. 42 CFR 431.105 - Consultation to medical facilities.

    Science.gov (United States)

    2010-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION... State agencies furnish consultative services to hospitals, nursing homes, home health agencies, clinics... and child health and crippled children's program (title V of the Act), Medicaid or Medicare;...

  8. Medical Examination of Aliens--Revisions to Medical Screening Process. Final rule.

    Science.gov (United States)

    2016-01-26

    The Centers for Disease Control and Prevention (CDC), within the Department of Health and Human Services (HHS), is issuing this final rule (FR) to amend its regulations governing medical examinations that aliens must undergo before they may be admitted to the United States. Based on public comment received, HHS/CDC did not make changes from the NPRM published on June 23, 2015. Accordingly, this FR will: Revise the definition of communicable disease of public health significance by removing chancroid, granuloma inguinale, and lymphogranuloma venereum as inadmissible health-related conditions for aliens seeking admission to the United States; update the notification of the health-related grounds of inadmissibility to include proof of vaccinations to align with existing requirements established by the Immigration and Nationality Act (INA); revise the definitions and evaluation criteria for mental disorders, drug abuse and drug addiction; clarify and revise the evaluation requirements for tuberculosis; clarify and revise the process for the HHS/CDC-appointed medical review board that convenes to reexamine the determination of a Class A medical condition based on an appeal; and update the titles and designations of federal agencies within the text of the regulation.

  9. Request for modification of 200 Area effluent treatment facility final delisting

    Energy Technology Data Exchange (ETDEWEB)

    BOWMAN, R.C.

    1998-11-19

    A Delisting Petition submitted to the U.S. Environmental Protection Agency in August 1993 addressed effluent to be generated at the 200 Area Effluent Treatment Facility from treating Hanford Facility waste streams. This Delisting Petition requested that 71.9 million liters per year of treated effluent, bearing the designation 'F001' through 'F005', and/or 'F039' that is derived from 'F001' through 'F005' waste, be delisted. On June 13, 1995, the U.S. Environmental Protection Agency published the final rule (Final Delisting), which formally excluded 71.9 million liters per year of 200 Area Effluent Treatment Facility effluent from ''being listed as hazardous wastes'' (60 FR 31115 now promulgated in 40 CFR 261). Given the limited scope, it is necessary to request a modification of the Final Delisting to address the management of a more diverse multi-source leachate (F039) at the 200 Area Effluent Treatment Facility. From past operations and current cleanup activities on the Hanford Facility, a considerable amount of both liquid and solid Resource Conservation and Recovery Act of 1976 regulated mixed waste has been and continues to be generated. Ultimately this waste will be treated as necessary to meet the Resource Conservation and Recovery Act Land Disposal Restrictions. The disposal of this waste will be in Resource Conservation and Recovery Act--compliant permitted lined trenches equipped with leachate collection systems. These operations will result in the generation of what is referred to as multi-source leachate. This newly generated waste will receive the listed waste designation of F039. This waste also must be managed in compliance with the provisions of the Resource Conservation and Recovery Act.

  10. 75 FR 1615 - Amended Record of Decision: Idaho High-Level Waste and Facilities Disposition Final Environmental...

    Science.gov (United States)

    2010-01-12

    ... Record of Decision: Idaho High-Level Waste and Facilities Disposition Final Environmental Impact..., announcing an amended Record of Decision (ROD) for the Idaho High-Level Waste and Facilities Disposition Final Environmental Impact Statement. This document corrects an error in that notice. FOR FURTHER...

  11. Reed Reactor Facility final report, September 1, 1995--August 31, 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-09-01

    This report covers the period from September 1, 1995 to August 31, 1996. This report is intended to fulfill several purposes including the reporting requirements of the US Nuclear Regulatory Commission, the US Department of Energy, and the Oregon Department of Energy. Highlights of the last year include: student participation in the program is very high; the facility continues its success in obtaining donated equipment from the Portland General Electric, US Department of Energy, and other sources; the facility is developing more paid work; progress is being made in a collaborative project with Pacific Northwest National Laboratory on isotope production for medical purposes. There were over 1,500 individual visits to the Reactor Facility during the year. Most were students in classes at Reed College or area universities, colleges, and high schools. Including tours and research conducted at the facility, the Reed Reactor Facility contributed to the educational programs of six colleges and universities in addition to eighteen pre-college groups. During the year, the reactor was operated almost three hundred separate times. The total energy production was over 23 MW-hours. The reactor staff consists of a Director, an Associated Director, a contract Health Physicist, and approximately twenty Reed College undergraduate students as hourly employees. All radiation exposures to individuals during this year were well below 5% of the federal limits.

  12. Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2017. Final rule.

    Science.gov (United States)

    2016-08-05

    This final rule will update the prospective payment rates for inpatient rehabilitation facilities (IRFs) for federal fiscal year (FY) 2017 as required by the statute. As required by section 1886(j)(5) of the Act, this rule includes the classification and weighting factors for the IRF prospective payment system's (IRF PPS's) case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2017. This final rule also revises and updates quality measures and reporting requirements under the IRF quality reporting program (QRP).

  13. Measuring the Efficient Utilization of Medical Personnel at Navy Military Treatment Facilities

    Science.gov (United States)

    1990-06-01

    Subject Terms (continue on reverse if necessary and Identify by block number) Field Group Subgroup effectiveness,efficiency,health,hospital,medical, NIHSS ...the study.v, xi I. INTRODUCTION A. PROBLEM Managers of medical treatment facilities (MTFs) lack reliable performance measures that capture, in a...Value Engineering b. Product diversification c. Product simplification d. Research and development e. Product standardization f. Reliability

  14. Prevalence of inappropriate medication using Beers criteria in Japanese long-term care facilities

    DEFF Research Database (Denmark)

    Niwata, Satoko; Yamada, Yukari; Ikegami, Naoki

    2006-01-01

    conducted a retrospective cross-sectional study in 17 Japanese long-term care (LTC) facilities by collecting data from the comprehensive MDS assessment forms for 1669 patients aged 65 years and over who were assessed between January and July of 2002. Potentially inappropriate medications were identified...... on the basis of the 2003 Beers criteria. Results The patients in the sample were similar in terms of demographic characteristics to those in the national survey. Our study revealed that 356 (21.1%) of the patients were treated with potentially inappropriate medication independent of disease or condition...... medication use independent of disease or condition. Neither patient characteristics nor facility characteristics emerged as predictors of inappropriate prescription. Conclusion The prevalence and predictors of inappropriate medication use in Japanese LTC facilities were similar to those in other countries....

  15. Medical equipment in government health facilities: missed opportunities.

    Science.gov (United States)

    Pardeshi, Geeta S

    2005-01-01

    The availability and optimal utilization of medical equipment is important for improving the quality of health services. Significant investments are made for the purchase, maintenance and repair of medical equipment. Inadequate management of these equipment will result in financial losses and deprive the public of the intended benefits. This analysis is based on the conceptual framework drawn from the WHO recommended- lifecycle of medical equipment. (1) To identify the problems in different stages of the life cycle. (2) To assess its financial implications and effect on service delivery. Analysis of secondary data from the latest Comptroller and Auditor General (CAG) Reports for the states in India. The study variables were category of equipment, financial implications and problems in the stages of life cycle. Calculation of proportions. A total of forty instances mentioning problems in the first phase of the life cycle of medical equipment were noted in 12 state reports. The equipment from the radiology department (15), equipment in the wards (5), laboratory (3) and operation theatres (4) were the ones most frequently implicated. In a majority of cases the financial implications amounted to twenty-five lakhs. The financial implications were in the form of extra expenditure, unfruitful expenditure or locking of funds. In 25 cases the equipment could not be put to use because of non-availability of trained staff and inadequate infrastructural support. Careful procurement, incoming inspection, successful installation and synchronization of qualified trained staff and infrastructural support will ensure timely onset of use of the equipment.

  16. Trauma treatment in a role 1 medical facility in Afghanistan

    DEFF Research Database (Denmark)

    Vedel, Pernille Nygaard; Helsø, I; Jørgensen, H L

    2013-01-01

    Most of the emergency care delivered in Afghanistan is currently provided by the military sector and non-governmental organisations. Main Operating Base (MOB) Price in Helmand Province has a small medical centre and due to its location provides critical care to civilians and military casualties a...

  17. Health incarcerated the use of medical services within correctional facilities.

    NARCIS (Netherlands)

    Brake, J.H.M. te; Jongh, D.M. de; Bakker, D.H. de; Devillé, W.L.J.M.

    2005-01-01

    Background: In order to adequately staff correctional medical teams it is important to collect objective data on their work load, especially given the increasing call for cut-backs in the overall treatment of inmates. Moreover, inmates typically constitute a vulnerable patient group, characterized b

  18. Health incarcerated the use of medical services within correctional facilities.

    NARCIS (Netherlands)

    Brake, J.H.M. te; Jongh, D.M. de; Bakker, D.H. de; Devillé, W.L.J.M.

    2005-01-01

    Background: In order to adequately staff correctional medical teams it is important to collect objective data on their work load, especially given the increasing call for cut-backs in the overall treatment of inmates. Moreover, inmates typically constitute a vulnerable patient group, characterized b

  19. DOE Center of Excellence in Medical Laser Applications. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Jacques, S.L. (Oregon Medical Laser Center, Portland, OR (United States))

    1998-01-01

    An engineering network of collaborating medical laser laboratories are developing laser and optical technologies for medical diagnosis and therapy and are translating the engineering into medical centers in Portland, OR, Houston, TX, and Galveston, TX. The Center includes the University of Texas M.D. Anderson Cancer Center, the University of Texas-Austin, Texas A and M University, Rice University, the University Texas Medical Branch-Galveston, Oregon Medical Laser Center (Providence St. Vincent Medical Center, Oregon Health Sciences University, and Oregon Graduate Institute, Portland, OR), and the University of Oregon. Diagnostics include reflectance, fluorescence, Raman IR, laser photoacoustics, optical coherence tomography, and several new video techniques for spectroscopy and imaging. Therapies include photocoagulation therapy, laser welding, pulsed laser ablation, and light-activated chemotherapy of cancer (photodynamic therapy, or PDT). Medical applications reaching the clinic include optical monitoring of hyperbilirubinemia in newborns, fluorescence detection of cervical dysplasia, laser thrombolysis of blood clots in heart attack and brain stroke, photothermal coagulation of benign prostate hyperplasia, and PDT for both veterinary and human cancer. New technologies include laser optoacoustic imaging of breast tumors and hemorrhage in head trauma and brain stroke, quality control monitoring of dosimetry during PDT for esophageal and lung cancer, polarization video reflectometry of skin cancer, laser welding of artificial tissue replacements, and feedback control of laser welding.

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

    Science.gov (United States)

    1998-07-01

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

  1. Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2016. Final rule.

    Science.gov (United States)

    2015-08-01

    This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for federal fiscal year (FY) 2016 as required by the statute. As required by section 1886(j)(5) of the Act, this rule includes the classification and weighting factors for the IRF PPS's case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2016. This final rule also finalizes policy changes, including the adoption of an IRF-specific market basket that reflects the cost structures of only IRF providers, a 1-year phase-in of the revised wage index changes, a 3-year phase-out of the rural adjustment for certain IRFs, and revisions and updates to the quality reporting program (QRP).

  2. Medical equipment in government health facilities: Missed opportunities

    Directory of Open Access Journals (Sweden)

    Pardeshi Geeta

    2005-01-01

    Full Text Available BACKGROUND: The availability and optimal utilization of medical equipment is important for improving the quality of health services. Significant investments are made for the purchase, maintenance and repair of medical equipment. Inadequate management of these equipment will result in financial losses and deprive the public of the intended benefits. This analysis is based on the conceptual framework drawn from the WHO recommended- lifecycle of medical equipment. AIMS: (1 To identify the problems in different stages of the life cycle. (2 To assess its financial implications and effect on service delivery. SETTINGS AND DESIGN: Analysis of secondary data from the latest Comptroller and Auditor General (CAG Reports for the states in India. The study variables were category of equipment, financial implications and problems in the stages of life cycle. STATISTICAL ANALYSIS: Calculation of proportions. RESULTS AND CONCLUSIONS: A total of forty instances mentioning problems in the first phase of the life cycle of medical equipment were noted in 12 state reports. The equipment from the radiology department (15, equipment in the wards (5, laboratory (3 and operation theatres (4 were the ones most frequently implicated. In a majority of cases the financial implications amounted to twenty-five lakhs. The financial implications were in the form of extra expenditure, unfruitful expenditure or locking of funds. In 25 cases the equipment could not be put to use because of non-availability of trained staff and inadequate infrastructural support. Careful procurement, incoming inspection, successful installation and synchronization of qualified trained staff and infrastructural support will ensure timely onset of use of the equipment.

  3. Medicare Program; termination of non-random prepayment complex medical review. Final rule.

    Science.gov (United States)

    2008-09-26

    This final rule implements requirements regarding the termination of non-random prepayment complex medical review as required under the Medicare Prescription Drug, Improvement and Modernization Act of 2003. This final rule sets forth the criteria CMS contractors will use for terminating a provider or supplier from non-random prepayment complex medical review.

  4. Neutron medical treatment of tumours — a survey of facilities

    Science.gov (United States)

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

    2012-03-01

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

  5. Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2018. Final rule.

    Science.gov (United States)

    2017-08-03

    This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for federal fiscal year (FY) 2018 as required by the statute. As required by section 1886(j)(5) of the Social Security Act (the Act), this rule includes the classification and weighting factors for the IRF prospective payment system's (IRF PPS) case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2018. This final rule also revises the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) diagnosis codes that are used to determine presumptive compliance under the "60 percent rule," removes the 25 percent payment penalty for inpatient rehabilitation facility patient assessment instrument (IRF-PAI) late transmissions, removes the voluntary swallowing status item (Item 27) from the IRF-PAI, summarizes comments regarding the criteria used to classify facilities for payment under the IRF PPS, provides for a subregulatory process for certain annual updates to the presumptive methodology diagnosis code lists, adopts the use of height/weight items on the IRF-PAI to determine patient body mass index (BMI) greater than 50 for cases of single-joint replacement under the presumptive methodology, and revises and updates measures and reporting requirements under the IRF quality reporting program (QRP).

  6. Final report of the radiological release survey of Building 19 at the Grand Junction Office Facility

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, R.K.; Corle, S.G.

    1997-09-01

    The U.S. Department of Energy (DOE) Grand Junction Office (GJO) occupies a 61.7-acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore concentrates and mill tailings during vanadium refining activities of the Manhattan Engineer District, and during sampling, assaying, pilot milling, storage, and brokerage activities conducted for the U.S. Atomic Energy Commission`s domestic uranium procurement program. The DOE Defense Decontamination and Decommissioning Program established the GJO Remedial Action Project (GJORAP) to clean up and restore the facility lands, improvements, and underlying aquifer. WASTREN-Grand Junction is the site contractor for the facility and the remedial action contractor for GJORAP. Building 19 and the underlying soil were found not to be radiologically contaminated; therefore, the building can be released for unrestricted use. Placards have been placed at the building entrances indicating the completion of the radiological release survey and prohibiting the introduction of any radioactive materials within the building without written approvals from the GJO Facilities Operations Manager. This document was prepared in response to a DOE-GJO request for an individual final release report for each GJO building.

  7. Final report of the radiological release survey of Building 11 at the Grand Junction Office Facility

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, R.K.; Corle, S.G.

    1997-09-01

    The U.S. Department of Energy (DOE) Grand Junction Office (GJO) occupies a 61.7-acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore concentrates and mill tailings during vanadium refining activities of the Manhattan Engineer District, and during sampling, assaying, pilot milling, storage, and brokerage activities conducted for the U.S. Atomic Energy Commission`s domestic uranium procurement program. The DOE Defense Decontamination and Decommissioning Program established the GJO Remedial Action Project (GJORAP) to clean up and restore the facility lands, improvements, and underlying aquifer. WASTREN-Grand Junction is the site contractor for the facility and the remedial action contractor for GJORAP. Building 11 and the underlying soil were found not to be radiologically contaminated; therefore, the building can be released for unrestricted use. Placards have been placed at the building entrances indicating the completion of the radiological release survey and prohibiting the introduction of any radioactive materials within the building without written approvals from the GJO Facilities Operations Manager. This document was prepared in response to a DOE-GJO request for an individual final release report for each GJO building.

  8. Final report of the radiological release survey of Building 29 at the Grand Junction Office Facility

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, R.K.; Corle, S.G.

    1997-09-01

    The U.S. Department of Energy (DOE) Grand Junction Office (GJO) occupies a 61.7-acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore concentrates and mill tailing during vanadium refining activities of the Manhattan Engineer District, and during sampling, assaying, pilot milling, storage, and brokerage activities conducted for the U.S. Atomic Energy Commission`s domestic uranium procurement program. The DOE Defense Decontamination and Decommissioning Program established the GJO Remedial Action Project (GJORAP) to clean up and restore the facility lands, improvements, and underlying aquifer. WASTREN-Grand Junction is the site contractor for the facility and the remedial action contractor for GJORAP. Building 29 and the underlying soil were found not to be radiologically contaminated; therefore, the building can be released for unrestricted use. Placards have been placed at the building entrances indicating the completion of the radiological release survey and prohibiting the introduction of any radioactive materials within the building without written approvals from the GJO Facilities Operations Manager. This document was prepared in response to a DOE-GJO request for an individual final release report for each GJO building.

  9. A Health Facility Planning Methodology for Army Troop Medical Clinics.

    Science.gov (United States)

    1981-04-01

    Herbert H. Hyman, Basic Health Planning Methods, (Germantown, Md: Aspen Systems Corp., 1978), p.14 . 16 17 1 3James A. Rice, " Interinstitutional Planning...another for collaboration throughout the developmental process in order for that project to come to fruition. In the final analysis, the planning...Space Needs." Hospitals 54 (December 16, 1980): 109-112. Rice, James A. " Interinstitutional Planning Process, Part 1. Free Standing Hospitals." Hospitals

  10. Medical gamma processing facility in Riyadh, Saudi Arabia, and radiation applications

    Energy Technology Data Exchange (ETDEWEB)

    Grecz, N.; Hahn, E.W.; Jouris, W.E.

    1985-09-01

    A medical cobalt-60 facility was opened at King Faisal Specialist Hospital and Research Center in 1984. Features of the facility are that it can be heated to 120-190F during irradiation and has an on-line 30 kw microwave oven. It can be used for small scale batch irradiation or large scale conveyor irradiation. Programs under development are the sterilization of hospital supplies, radiation processing of Saudi foods and radiation of infectious hospital wastes.

  11. Lessons from managing an injured suspected pirate onboard a Role 1 medical facility.

    Science.gov (United States)

    Millar, J

    2012-01-01

    The embarkation of detainees is complex and medical requirements and ethical considerations can collide with operational requirements. Morally and ethically the correct route of action is always to disembark the patient at the earliest opportunity to a first rate medical facility; however this is not always possible for a variety of geographical, operational, financial and political reasons. It is ultimately a command decision utilising the best advice that the Medical Officer can provide. It is important that Commanding Officers and Medical Officers have a strong working relationship and understand each other's responsibilities and constraints.

  12. A study on the necessity of medical facilities safety design adoption.

    Science.gov (United States)

    Park, Bora; Yang, Yeongae; Yang, Dongjoo; Shin, Joong-Il; Park, Sujong; Park, Soohee; Park, Yunhee

    2013-07-01

    [Purpose] The purpose of this study was to investigate the requirements of the introduction of a safety design and certification system for medical facilities. [Subjects] A survey was carried out of one hundred nurses, physical therapists, occupational therapists, speech and language therapists from May to August in 2012. [Methods] The survey was conducted after giving subjects some information about safety design. [Results] The participants were aware of the need for establishing a safety design certification system. Total responses to services, facilities and space were analyzed in order to evaluate the priorities of safety, user characteristics, functionality, convenience and aesthetics. Regarding the application of a safety design certification system to services, items were prioritized in the order of children's items, household supplies and hospital supplies. For facilities, the priorities were, living space, social welfare and medical facilities; space, they were public and transportation-related places. The requirements for operating a safety design system were in order development of: highly skilled manpower, the legal system, educational promotion and qualifying facilities. [Conclusion] In conclusion, in order to implement safety design in medical facilities, a safety design certification system should be introduced first, and to do this a systematic and comprehensive study is needed.

  13. Real-time Stack Monitoring at the BaTek Medical Isotope Production Facility

    Energy Technology Data Exchange (ETDEWEB)

    McIntyre, Justin I.; Agusbudiman, A.; Cameron, Ian M.; Dumais, Johannes R.; Eslinger, Paul W.; Gheddou, A.; Khrustalev, Kirill; Marsoem, Pujadi; Miley, Harry S.; Nikkinen, Mika; Prinke, Amanda M.; Ripplinger, Mike D.; Schrom, Brian T.; Sliger, William A.; Stoehlker, Ulrich; Suhariyono, G.; Warren, Glen A.; Widodo, Susilo; Woods, Vincent T.

    2016-04-01

    Radioxenon emissions from radiopharmaceutical production are a major source of background concentrations affecting the radioxenon detection systems of the International Monitoring System (IMS). Collection of real-time emissions data from production facilities makes it possible to screen out some medical isotope signatures from the IMS radioxenon data sets. This paper describes an effort to obtain and analyze real-time stack emissions data with the design, construction and installation of a small stack monitoring system developed by a joint CTBTO-IDC, BATAN, and PNNL team at the BaTek medical isotope production facility near Jakarta, Indonesia.

  14. Smoke-Free Medical Facility Campus Legislation: Support, Resistance, Difficulties and Cost

    Directory of Open Access Journals (Sweden)

    J. Gary Wheeler

    2009-01-01

    Full Text Available Although medical facilities restrict smoking inside, many people continue to smoke outside, creating problems with second-hand smoke, litter, fire risks, and negative role modeling. In 2005, Arkansas passed legislation prohibiting smoking on medical facility campuses. Hospital administrators (N=113 were surveyed pre- and post-implementation. Administrators reported more support and less difficulty than anticipated. Actual cost was 10-50% of anticipated cost. Few negative effects and numerous positive effects on employee performance and retention were reported. The results may be of interest to hospital administrators and demonstrate that state legislation can play a positive role in facilitating broad health-related policy change.

  15. Prevalence of inappropriate medication using Beers criteria in Japanese long-term care facilities

    Directory of Open Access Journals (Sweden)

    Yamada Yukari

    2006-01-01

    Full Text Available Abstract Background The prevalence and risk factors of potentially inappropriate medication use among the elderly patients have been studied in various countries, but because of the difficulty of obtaining data on patient characteristics and medications they have not been studied in Japan. Methods We conducted a retrospective cross-sectional study in 17 Japanese long-term care (LTC facilities by collecting data from the comprehensive MDS assessment forms for 1669 patients aged 65 years and over who were assessed between January and July of 2002. Potentially inappropriate medications were identified on the basis of the 2003 Beers criteria. Results The patients in the sample were similar in terms of demographic characteristics to those in the national survey. Our study revealed that 356 (21.1% of the patients were treated with potentially inappropriate medication independent of disease or condition. The most commonly inappropriately prescribed medication was ticlopidine, which had been prescribed for 107 patients (6.3%. There were 300 (18.0% patients treated with at least 1 inappropriate medication dependent on the disease or condition. The highest prevalence of inappropriate medication use dependent on the disease or condition was found in patients with chronic constipation. Multiple logistic regression analysis revealed psychotropic drug use (OR = 1.511, medication cost of per day (OR = 1.173, number of medications (OR = 1.140, and age (OR = 0.981 as factors related to inappropriate medication use independent of disease or condition. Neither patient characteristics nor facility characteristics emerged as predictors of inappropriate prescription. Conclusion The prevalence and predictors of inappropriate medication use in Japanese LTC facilities were similar to those in other countries.

  16. Easing the transition: the final year of medical education at Maastricht University.

    Science.gov (United States)

    van den Akker, Marjan; Dornan, Tim; Scherpbier, Albert J J A; oude Egbrink, Mirjam G A; Snoeckx, Luc H E H

    2012-01-01

    This manuscript describes the final year of medical education at Maastricht University as it has been operating since 2006. At the time external drivers for the development of a new structure of the final year were: the desire to prepare medical students for lifelong learning, the CanMEDs that were increasingly acknowledged to state the final attainment level of medical education and an increasing recognition of the importance of learning by participating actively and by taking more responsibility. Internal drivers were students' evaluations and our wish to improve instructional design and quality control. The main aim of this new final year is to better prepare students for the transition from the medical master programme to one of the postgraduate training programmes to become a medical specialist. The final year of the medical master programme consists of two 18-weeks participation electives, one in health care and one in research. Students have a higher level of autonomy and responsibility during this final year compared to the preceding medical clerkships to enhance the transition. Portfolios are the key element in examination of SCIP and HELP. Student evaluations of the final year show high scores on coaching and instructiveness. Despite some differences between departments overall scores are very high. Suggestions to improve include the availability of work places and time for education and coaching.

  17. Seismic risk analysis for General Electric Plutonium Facility, Pleasanton, California. Final report, part II

    Energy Technology Data Exchange (ETDEWEB)

    1980-06-27

    This report is the second of a two part study addressing the seismic risk or hazard of the special nuclear materials (SNM) facility of the General Electric Vallecitos Nuclear Center at Pleasanton, California. The Part I companion to this report, dated July 31, 1978, presented the seismic hazard at the site that resulted from exposure to earthquakes on the Calaveras, Hayward, San Andreas and, additionally, from smaller unassociated earthquakes that could not be attributed to these specific faults. However, while this study was in progress, certain additional geologic information became available that could be interpreted in terms of the existance of a nearby fault. Although substantial geologic investigations were subsequently deployed, the existance of this postulated fault, called the Verona Fault, remained very controversial. The purpose of the Part II study was to assume the existance of such a capable fault and, under this assumption, to examine the loads that the fault could impose on the SNM facility. This report first reviews the geologic setting with a focus on specifying sufficient geologic parameters to characterize the postulated fault. The report next presents the methodology used to calculate the vibratory ground motion hazard. Because of the complexity of the fault geometry, a slightly different methodology is used here compared to the Part I report. This section ends with the results of the calculation applied to the SNM facility. Finally, the report presents the methodology and results of the rupture hazard calculation.

  18. Family and Medical Leave Act; Definition of Spouse. Final rule.

    Science.gov (United States)

    2016-04-08

    The U.S. Office of Personnel Management (OPM) is revising the definition of spouse in its regulations on the Family and Medical Leave Act (FMLA) as a result of the decision by the United States Supreme Court holding section 3 of the Defense of Marriage Act (DOMA) unconstitutional. The new definition replaces the existing definition, which contains language from DOMA that refers to "a legal union between one man and one woman.'' The new definition permits Federal employees with same-sex spouses to use FMLA leave in the same manner as Federal employees with opposite-sex spouses.

  19. Scoping assessment on medical isotope production at the Fast Flux Test Facility

    Energy Technology Data Exchange (ETDEWEB)

    Scott, S.W.

    1997-08-29

    The Scoping Assessment addresses the need for medical isotope production and the capability of the Fast Flux Test Facility to provide such isotopes. Included in the discussion are types of isotopes used in radiopharmaceuticals, which types of cancers are targets, and in what way isotopes provide treatment and/or pain relief for patients.

  20. Workplace Violence and Safety Issues in Long-Term Medical Care Facilities: Nurses' Perspectives

    Directory of Open Access Journals (Sweden)

    Bankole K. Fasanya

    2016-06-01

    Conclusion: WPV is an epidemic problem that affects all health-care professionals. The findings of this study could help long-term medical care facilities' management identify the areas to focus on mitigating, controlling, and/or eliminating incidents of WPV.

  1. Military Personnel: Enhanced Collaboration and Process Improvements Needed for Determining Military Treatment Facility Medical Personnel Requirements

    Science.gov (United States)

    2010-07-01

    dentists, medical service corps, and veterinarians , to name a few, at the work center level across Army fixed military treatment facilities. The model uses...1072 - 896 903 Hematology /Oncology 41 40 43 - 12 17 - 18 14 Infectious Disease 63 59 62 - 29 34 - 16 17 Internal Medicine 315 e 254 e 277 e

  2. Radiation dosimetry for NCT facilities at the Brookhaven Medical Research Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Holden, N.E.; Hu, J.P.; Greenberg, D.D.; Reciniello, R.N.

    1998-12-31

    Brookhaven Medical Research Reactor (BMRR) is a 3 mega-watt (MW) heterogeneous, tank-type, light water cooled and moderated, graphite reflected reactor, which was designed for medical and biological studies and became operational in 1959. Over time, the BMRR was modified to provide thermal and epithermal neutron beams suitable for research studies. NCT studies have been performed at both the epithermal neutron irradiation facility (ENIF) on the east side of the BMRR reactor core and the thermal neutron irradiation facility (TNIF) on the west side of the core. Neutron and gamma-ray dosimetry performed from 1994 to the present in both facilities are described and the results are presented and discussed.

  3. [MANAGEMENT STANDARDS FOR QUALIFIED PHYSICIANS AND MEDICAL FACILITIES FOR ENDOVENOUS ABLATION OF VARICOSE VEINS].

    Science.gov (United States)

    Ogawa, Tomohiro

    2015-05-01

    Endovenous ablation of saphenous veins using laser energy was approved by the Japanese Ministry of Health, Labor and Welfare in 2011 as a more effective, less-invasive method than classical treatment for varicose veins. New medical laser and radiofrequency devices for this purpose were also approved in 2014. A requirement for the treatment of varicose veins with health insurance reimbursement using these devices is a physician with sufficient knowledge of endovenous ablation. The management standards for endovenous ablation set by varicose vein specialist medical societies are used to accredit qualified physicians who have basic clinical experience in the treatment of varicose veins, qualified instructors, and safe, effective medical facilities.

  4. An Air MEDEVAC Asset Dispatching and Prioritized Casualty Transporting Model for Military Medical Evacuation Systems with Distinguishable Medical Treatment Facilities and Errors in Triage

    Science.gov (United States)

    2014-02-13

    distinguishable medical treatment facilities and errors in triage The views, opinions and/or findings contained in this report are those of the author(s) and...facilities and errors in triage Report Title Decision making in military medical evacuation (MEDEVAC) of casualties consists of identifying which...treatment facilities. The model accounts for errors made during triage of casualties to investigate the revelation of information over time and

  5. Effect of Repeated/Spaced Formative Assessments on Medical School Final Exam Performance

    Directory of Open Access Journals (Sweden)

    Edward K. Chang

    2017-06-01

    Discussion: Performance on weekly formative assessments was predictive of final exam scores. Struggling medical students will benefit from extra cumulative practice exams while students who are excelling do not need extra practice.

  6. Test facility for advanced electric adjustable frequency drives and generators of typical industrial ratings. Final technical report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-01

    A test facility has been developed, for electric adjustable-speed motors and variable-speed generators, that is unique in US universities in terms of its range (5 to 300 hp currently with 0.1 to 1,000 hp final capability) and flexibility (standard NEMA frame and novel geometry machines can be accommodated). The basic facility was constructed with funding from the Electric Power Research Institute. The instrumentation obtained under this DOE grant has been integrated into the facility which was completed in Fall 1997. The facility has already provided useful studies for DOE, EPRI, as well as several West Coast industries and electric energy utilities.

  7. A near-peer teaching program designed, developed and delivered exclusively by recent medical graduates for final year medical students sitting the final objective structured clinical examination (OSCE

    Directory of Open Access Journals (Sweden)

    Sobowale Oluwaseun

    2011-03-01

    Full Text Available Abstract Background The General Medical Council states that teaching doctors and students is important for the care of patients. Our aim was to deliver a structured teaching program to final year medical students, evaluate the efficacy of teaching given by junior doctors and review the pertinent literature. Methods We developed a revision package for final year medical students sitting the Objective Structured Clinical Examination (OSCE. The package was created and delivered exclusively by recent medical graduates and consisted of lectures and small group seminars covering the core areas of medicine and surgery, with a focus on specific OSCE station examples. Students were asked to complete a feedback questionnaire during and immediately after the program. Results One hundred and eighteen completed feedback questionnaires were analysed. All participants stated that the content covered was relevant to their revision. 73.2% stated that junior doctors delivered teaching that is comparable to that of consultant - led teaching. 97.9% stated the revision course had a positive influence on their learning. Conclusions Our study showed that recent medical graduates are able to create and deliver a structured, formal revision program and provide a unique perspective to exam preparation that was very well received by our student cohort. The role of junior doctors teaching medical students in a formal structured environment is very valuable and should be encouraged.

  8. The forgotten foot - an assessment of foot and ankle radiograph pathology in final year medical students.

    LENUS (Irish Health Repository)

    Groarke, P J

    2014-04-27

    It has been shown that doctors in Emergency Departments (EDs) have inconsistent knowledge of musculoskeletal anatomy. This is most likely due to a deficiency in focused musculoskeletal modules at undergraduate level in medical school. The aims of this study were to evaluate the knowledge of final year medical students on foot anatomy and common foot and ankle pathology as seen on radiographs.

  9. Attitudes toward Psychiatry among Final-Year Medical Students in Kumasi, Ghana

    Science.gov (United States)

    Laugharne, Richard; Appiah-Poku, John; Laugharne, Jon; Shankar, Rohit

    2009-01-01

    Objective: Most sub-Saharan African countries have fewer psychiatrists than one per one million people. One possible reason could be that medical students have a negative attitude toward the specialty. The authors evaluated the attitudes toward a career in psychiatry of final-year medical students in Kumasi, Ghana, and compare these with attitudes…

  10. 78 FR 72581 - Direct Final Approval of Hospital/Medical/Infectious Waste Incinerator Negative Declaration for...

    Science.gov (United States)

    2013-12-03

    ... AGENCY 40 CFR Part 62 Direct Final Approval of Hospital/Medical/Infectious Waste Incinerator Negative... negative declarations from Michigan and Wisconsin regarding Hospital/Medical/ Infectious Waste Incinerator...) requirements to existing solid waste combustors, including HMIWIs, and provide that EPA should include, as...

  11. Assessment of workplace air concentrations of formaldehyde during and before working hours in medical facilities.

    Science.gov (United States)

    Higashikubo, Ichiro; Miyauchi, Hiroyuki; Yoshida, Satoru; Tanaka, Shinsuke; Matsuoka, Mitsunori; Arito, Heihachiro; Araki, Akihiro; Shimizu, Hidesuke; Sakurai, Haruhiko

    2017-04-07

    Workplace air concentrations of formaldehyde (FA) in medical facilities where FA and FA-treated organs were stored and handled were measured before and during working hours and assessed by the official method specified by Work Environment Measurement Law. Sixty-percent of the total facilities examined were judged as inappropriately controlled work environment. The concentrations of FA before working hours by spot sampling were found to exceed 0.1 ppm in some facilities, and tended to increase with increasing volume of containers storing FA and FA-treated materials. Regression analysis revealed that logarithmic concentrations of FA during working hours by the Law-specified analytical method were highly correlated with those before working hours by spot sampling, suggesting the importance for appropriate storing methods of FA and FA-treated materials. The concentrations of FA during working hours are considered to be lowered by effective ventilation of FA-contaminated workplace air and appropriate storage of FA and FA-treated materials in plastic containers in the medical facilities. In particular, such improvement by a local exhaust ventilation system and tightly-sealed containment of FA-treated material were urgently needed for the dissecting room where FA-treated cadavers were prepared and handled for a gross anatomy course in a medical school.

  12. New Pump and Treat Facility Remedial Action Work Plan for Test Area North (TAN) Final Groundwater Remediation, Operable Unit 1-07B

    Energy Technology Data Exchange (ETDEWEB)

    D. Vandel

    2003-09-01

    This remedial action work plan identifies the approach and requirements for implementing the medical zone remedial action for Test Area North, Operable Unit 1-07B, at the Idaho National Engineering and Environmental Laboratory (INEEL). This plan details management approach for the construction and operation of the New Pump and Treat Facility. As identified in the remedial design/remedial action scope of work, a separate remedial design/remedial action work plan will be prepared for each remedial component of the Operable Unit 1-07B remedial action. This work plan was originally prepared as an early implementation of the final Phase C remediation. At that time, The Phase C implementation strategy was to use this document as the overall Phase C Work Plan and was to be revised to include the remedial actions for the other remedial zones (hotspot and distal zones). After the completion of Record of Decision Amendment: Technical Support Facility Injection Well (TSF-05) and Surrounding Groundwater Contamination (TSF-23) and Miscellaneous No Action Sites, Final Remedial Action, it was determined that each remedial zone would have it own stand-alone remedial action work plan. Revision 1 of this document converts this document to a stand-alone remedial action plan specific to the implementation of the New Pump and Treat Facility used for plume remediation within the medical zone of the OU 1-07B contaminated plume.

  13. Testing and evaluation of an alcohol production facility utilizing potatoes as a feedstock. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Kuby, W.; Nackord, S.; Wyss, W.

    1984-05-01

    This study presents the sampling and analysis results for the characterization of liquid effluents and solid residuals from a culled potato feedstock process for the production of ethanol for use as fuel. The facility tested produces approximately 1 million gallons per year of ethanol and is located in eastern Idaho. Liquid and solid samples were taken throughout the process from the following locations: sluice/flume water, chopper product, makeup water, cooker product, fermenter product, beer tank, stillage, interim and final product, washwater, fuel oil, bath and 'Sparkle' bath. Analytical results for the ethanol plant effluents include: ethanol and sugar content, conventional parameters, metals, cyanide, phenols, nutrients, oil and grease, priority pollutant organics, and selected pesticides. The most significant characteristics of concern were the BOD and COD levels.

  14. Towards the final BSA modeling for the accelerator-driven BNCT facility at INFN LNL

    Energy Technology Data Exchange (ETDEWEB)

    Ceballos, C. [Centro de Aplicaciones Tecnlogicas y Desarrollo Nuclear, 5ta y30, Miramar, Playa, Ciudad Habana (Cuba); Esposito, J., E-mail: juan.esposito@lnl.infn.it [INFN, Laboratori Nazionali di Legnaro (LNL), via dell' Universita, 2, I-35020 Legnaro (PD) (Italy); Agosteo, S. [Politecnico di Milano, Dipartimento di Energia, Piazza Leonardo da Vinci 32, 20133 Milano (Italy)] [INFN, Sezione di Milano, via Celoria 16, 20133 Milano (Italy); Colautti, P.; Conte, V.; Moro, D. [INFN, Laboratori Nazionali di Legnaro (LNL), via dell' Universita, 2, I-35020 Legnaro (PD) (Italy); Pola, A. [Politecnico di Milano, Dipartimento di Energia, Piazza Leonardo da Vinci 32, 20133 Milano (Italy)] [INFN, Sezione di Milano, via Celoria 16, 20133 Milano (Italy)

    2011-12-15

    Some remarkable advances have been made in the last years on the SPES-BNCT project of the Istituto Nazionale di Fisica Nucleare (INFN) towards the development of the accelerator-driven thermal neutron beam facility at the Legnaro National Laboratories (LNL), aimed at the BNCT experimental treatment of extended skin melanoma. The compact neutron source will be produced via the {sup 9}Be(p,xn) reactions using the 5 MeV, 30 mA beam driven by the RFQ accelerator, whose modules construction has been recently completed, into a thick beryllium target prototype already available. The Beam Shaping Assembly (BSA) final modeling, using both neutron converter and the new, detailed, Be(p,xn) neutron yield spectra at 5 MeV energy recently measured at the CN Van de Graaff accelerator at LNL, is summarized here.

  15. Towards the final BSA modeling for the accelerator-driven BNCT facility at INFN LNL.

    Science.gov (United States)

    Ceballos, C; Esposito, J; Agosteo, S; Colautti, P; Conte, V; Moro, D; Pola, A

    2011-12-01

    Some remarkable advances have been made in the last years on the SPES-BNCT project of the Istituto Nazionale di Fisica Nucleare (INFN) towards the development of the accelerator-driven thermal neutron beam facility at the Legnaro National Laboratories (LNL), aimed at the BNCT experimental treatment of extended skin melanoma. The compact neutron source will be produced via the (9)Be(p,xn) reactions using the 5 MeV, 30 mA beam driven by the RFQ accelerator, whose modules construction has been recently completed, into a thick beryllium target prototype already available. The Beam Shaping Assembly (BSA) final modeling, using both neutron converter and the new, detailed, Be(p,xn) neutron yield spectra at 5 MeV energy recently measured at the CN Van de Graaff accelerator at LNL, is summarized here. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Experimental geothermal research facilities study (Phase O). Final report No. 26405-6001-RU-00

    Energy Technology Data Exchange (ETDEWEB)

    1974-12-31

    This study focuses on identification of a representative liquid-dominated geothermal reservoir of moderate temperature and salinity, preliminary design of an appropriate energy conversion system, identification of critical technology and planning for the implementation of experimental facilities. Results of Phase O of the project are reported in two volumes. Volume II presents detailed results of studies and analyses arranged in nine appendices including the final report by a subcontractor on the study. The specific appendices are: Appendix A: Geothermal Resources of the Western United States; Appendix B: Site Selection Process and the East Mesa Geothermal Field; Appendix C: East Mesa Geothermal Field Reservoir Characteristics; Appendix D: Advisor's Views and Comments; Appendix E: Thermodynamic Analyses; Appendix F: Material and Corrosion Factors; Appendix G: Preliminary Reliability/Maintainability Analyses; Appendix H: Environmental Impact Analysis Guidelines; and Appendix I: Report to the National Science Foundation/TRW Systems Group by Rogers Engineering Company, Inc., San Francisco, California.

  17. Production of medical radioactive isotopes using KIPT electron driven subcritical facility

    Energy Technology Data Exchange (ETDEWEB)

    Talamo, Alberto [Nuclear Engineering Division, Argonne National Laboratory, 9700 South Cass Avenue, Argonne, IL 60439 (United States)], E-mail: alby@anl.gov; Gohar, Yousry [Nuclear Engineering Division, Argonne National Laboratory, 9700 South Cass Avenue, Argonne, IL 60439 (United States)

    2008-05-15

    Kharkov Institute of Physics and Technology (KIPT) of Ukraine in collaboration with Argonne National Laboratory (ANL) has a plan to construct an electron accelerator driven subcritical assembly. One of the facility objectives is the production of medical radioactive isotopes. This paper presents the ANL collaborative work performed for characterizing the facility performance for producing medical radioactive isotopes. First, a preliminary assessment was performed without including the self-shielding effect of the irradiated samples. Then, more detailed investigation was carried out including the self-shielding effect, which defined the sample size and location for producing each medical isotope. In the first part, the reaction rates were calculated as the multiplication of the cross section with the unperturbed neutron flux of the facility. Over fifty isotopes have been considered and all transmutation channels are used including (n, {gamma}), (n, 2n), (n, p), and ({gamma}, n). In the second part, the parent isotopes with high reaction rate were explicitly modeled in the calculations. Four irradiation locations were considered in the analyses to study the medical isotope production rate. The results show the self-shielding effect not only reduces the specific activity but it also changes the irradiation location that maximizes the specific activity. The axial and radial distributions of the parent capture rates have been examined to define the irradiation sample size of each parent isotope.

  18. What Medical Directors Need to Know about Dialysis Facility Water Management.

    Science.gov (United States)

    Kasparek, Ted; Rodriguez, Oscar E

    2015-06-05

    The medical directors of dialysis facilities have many operational clinic responsibilities, which on first glance, may seem outside the realm of excellence in patient care. However, a smoothly running clinic is integral to positive patient outcomes. Of the conditions for coverage outlined by the Centers for Medicare and Medicaid Services, one most critical to quality dialysis treatment is the provision of safe purified dialysis water, because there are many published instances where clinic failure in this regard has resulted in patient harm. As the clinical leader of the facility, the medical director is obliged to have knowledge of his/her facility's water treatment system to reliably ensure that the purified water used in dialysis will meet the standards for quality set by the Association for the Advancement of Medical Instrumentation and used by the Centers for Medicare and Medicaid Services for conditions for coverage. The methods used to both achieve and maintain these quality standards should be a part of quality assessment and performance improvement program meetings. The steps for water treatment, which include pretreatment, purification, and distribution, are largely the same, regardless of the system used. Each water treatment system component has a specific role in the process and requires individualized maintenance and monitoring. The medical director should provide leadership by being engaged with the process, knowing the facility's source water, and understanding water treatment system operation as well as the clinical significance of system failure. Successful provision of quality water will be achieved by those medical directors who learn, know, and embrace the requirements of dialysis water purification and system maintenance.

  19. Dual axis radiographic hydrodynamic test facility. Final environmental impact statement, Volume 2: Public comments and responses

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-01

    On May 12, 1995, the U.S. Department of Energy (DOE) issued the draft Dual Axis Radiographic Hydrodynamic Test Facility Environmental Impact Statement (DARHT EIS) for review by the State of New Mexico, Indian Tribes, local governments, other Federal agencies, and the general public. DOE invited comments on the accuracy and adequacy of the draft EIS and any other matters pertaining to their environmental reviews. The formal comment period ran for 45 days, to June 26, 1995, although DOE indicated that late comments would be considered to the extent possible. As part of the public comment process, DOE held two public hearings in Los Alamos and Santa Fe, New Mexico, on May 31 and June 1, 1995. In addition, DOE made the draft classified supplement to the DARHT EIS available for review by appropriately cleared individuals with a need to know the classified information. Reviewers of the classified material included the State of New Mexico, the U.S. Environmental Protection Agency, the Department of Defense, and certain Indian Tribes. Volume 2 of the final DARHT EIS contains three chapters. Chapter 1 includes a collective summary of the comments received and DOE`s response. Chapter 2 contains the full text of the public comments on the draft DARHT EIS received by DOE. Chapter 3 contains DOE`s responses to the public comments and an indication as to how the comments were considered in the final EIS.

  20. Mapping medical careers: Questionnaire assessment of career preferences in medical school applicants and final-year students

    Directory of Open Access Journals (Sweden)

    McManus IC

    2004-10-01

    Full Text Available Abstract Background The medical specialities chosen by doctors for their careers play an important part in the workforce planning of health-care services. However, there is little theoretical understanding of how different medical specialities are perceived or how choices are made, despite there being much work in general on this topic in occupational psychology, which is influenced by Holland's RIASEC (Realistic-Investigative-Artistic-Social-Enterprising-Conventional typology of careers, and Gottfredson's model of circumscription and compromise. In this study, we use three large-scale cohorts of medical students to produce maps of medical careers. Methods Information on between 24 and 28 specialities was collected in three UK cohorts of medical students (1981, 1986 and 1991 entry, in applicants (1981 and 1986 cohorts, N = 1135 and 2032 or entrants (1991 cohort, N = 2973 and in final-year students (N = 330, 376, and 1437. Mapping used Individual Differences Scaling (INDSCAL on sub-groups broken down by age and sex. The method was validated in a population sample using a full range of careers, and demonstrating that the RIASEC structure could be extracted. Results Medical specialities in each cohort, at application and in the final-year, were well represented by a two-dimensional space. The representations showed a close similarity to Holland's RIASEC typology, with the main orthogonal dimensions appearing similar to Prediger's derived orthogonal dimensions of 'Things-People' and 'Data-Ideas'. Conclusions There are close parallels between Holland's general typology of careers, and the structure we have found in medical careers. Medical specialities typical of Holland's six RIASEC categories are Surgery (Realistic, Hospital Medicine (Investigative, Psychiatry (Artistic, Public Health (Social, Administrative Medicine (Enterprising, and Laboratory Medicine (Conventional. The homology between medical careers and RIASEC may mean that the map can be

  1. Mapping medical careers: questionnaire assessment of career preferences in medical school applicants and final-year students.

    Science.gov (United States)

    Petrides, K V; McManus, I C

    2004-10-01

    The medical specialities chosen by doctors for their careers play an important part in the workforce planning of health-care services. However, there is little theoretical understanding of how different medical specialities are perceived or how choices are made, despite there being much work in general on this topic in occupational psychology, which is influenced by Holland's RIASEC (Realistic-Investigative-Artistic-Social-Enterprising-Conventional) typology of careers, and Gottfredson's model of circumscription and compromise. In this study, we use three large-scale cohorts of medical students to produce maps of medical careers. Information on between 24 and 28 specialities was collected in three UK cohorts of medical students (1981, 1986 and 1991 entry), in applicants (1981 and 1986 cohorts, N = 1135 and 2032) or entrants (1991 cohort, N = 2973) and in final-year students (N = 330, 376, and 1437). Mapping used Individual Differences Scaling (INDSCAL) on sub-groups broken down by age and sex. The method was validated in a population sample using a full range of careers, and demonstrating that the RIASEC structure could be extracted. Medical specialities in each cohort, at application and in the final-year, were well represented by a two-dimensional space. The representations showed a close similarity to Holland's RIASEC typology, with the main orthogonal dimensions appearing similar to Prediger's derived orthogonal dimensions of 'Things-People' and 'Data-Ideas'. There are close parallels between Holland's general typology of careers, and the structure we have found in medical careers. Medical specialities typical of Holland's six RIASEC categories are Surgery (Realistic), Hospital Medicine (Investigative), Psychiatry (Artistic), Public Health (Social), Administrative Medicine (Enterprising), and Laboratory Medicine (Conventional). The homology between medical careers and RIASEC may mean that the map can be used as the basis for understanding career choice, and for

  2. Prototype interface facility for intelligent handling and processing of medical image and data

    Science.gov (United States)

    Lymberopoulos, Dimitris C.; Garantziotis, Giannis; Spiropoulos, Kostas V.; Kotsopoulos, Stavros A.; Goutis, Costas E.

    1993-06-01

    This paper introduces an interface facility (IF) developed within the overall framework of RACE research project. Due to the nature of the project which it has been focused in the Remote Medical Expert Consultation, the involvement of distances, the versatile user advocation and familiarity with newly introduced methods of medical diagnosis, considerable deficiencies can arise. The aim was to intelligently assist the user/physician by providing an ergonomic environment which would contain operational and functional deficiencies to the lowest possible levels. IF, energizes and activates system and application level commands and procedures along with the necessary exemplified and instructional help facilities, in order to concisely allow the user to interact with the system safely and easily at all levels.

  3. STRESSFUL SITUATIONS IN THE WORK OF A MULTIPROFILE PEDIATRIC MEDICAL FACILITY'S CALL CENTER

    Directory of Open Access Journals (Sweden)

    I. M. Spivak

    2015-01-01

    Full Text Available Stressful situations in the work of a pediatric medical facility's call center are associated with patients' violation of social communication norms and aggressive behavior, as well as the operator's professional/maternal conflict. The following psychological resources facilitate better stress resistance of operators: self-confidence, mature and rational attitude, personal activity, inner satisfaction, optimism, emotional breadth and emotional colleague support. 

  4. Imaging the risks - risking the image: Social impact assessment of the final disposal facility

    Energy Technology Data Exchange (ETDEWEB)

    Avolahti, J.; Vira, J. [Posiva Oy, Helsinki (Finland)

    1999-12-01

    Preparations for the final disposal of spent nuclear fuel in Finland started about twenty years ago. At present the work is carried out by Posiva Oy, which in 1996 took over the programme managed earlier by Teollisuuden Voima Oy, one of the country's nuclear power companies. From 1996 on the preparations have been made for all the spent fuel from Finnish nuclear power stations. The site for the final disposal facility will be selected among four alternatives by the end of 2000 and - assuming that the technical approach proposed by Posiva is accepted by the Government and the Parliament - the construction of the repository will start in the 2010s. The disposal operations are planned to be started in 2020. The alternative four sites have gone through a systematic site selection process based on geologic siting criteria and on environmental and cultural considerations. One of the objectives of the process was to avoid inhabited areas, agricultural fields, valuable groundwater or preservation areas as well as areas which might draw interest as regards the potential for ore deposits. The idea was that the field investigations and later the possible disposal facility should not cause any harm to local people. Two of the candidate sites are at present nuclear power plant sites situated at the coast, the two other candidates are inland sites with no nuclear activities. The geologic siting investigations were started in 1987. Interim assessments of the results so far have been made in 1992 and 1996 and a final report of all the investigations will be published before the end of 2000. The present view is that all four candidates are geologically suitable for siting the repository. Posiva's EIA for the final disposal of spent fuel in Finland is nearing completion. A considerable effort was made to involve local groups and individuals in the assessment process. Yet the participation remained limited and consisted mainly of active opponents of the project and of those

  5. Using Tools of Strategic Management in Medical Facilities of Lublin Region

    Directory of Open Access Journals (Sweden)

    Jaworzynska Magdalena

    2017-06-01

    Full Text Available The purpose of this article is to evaluate the use of tools of strategic management in hospitals in Lublin region. The study was conducted among 14 medical entities from the area of Lublin Voivodeship. The survey was addressed to economic directors or chief accountants of health care facilities and sent by post. The questionnaire was also helpful in conducting an in-depth interview as it provided a required structure. As part of the interviews with managers of health care facilities, information beyond the questionnaire was acquired, e.g. about the mission. According to studies, most health care facilities develop strategic plans (71.4%. For 21.4% of the studied facilities, the strategic plan is known mainly to management. In contrast, 28.6% of entities do not have a strategic plan. The presented results of the research can increase the effectiveness of activities in each area of the health care facility, continuous process improvement and rapid response to changes in the environment.

  6. Estimates of Radioxenon Released from Southern Hemisphere Medical isotope Production Facilities Using Measured Air Concentrations and Atmospheric Transport Modeling

    Energy Technology Data Exchange (ETDEWEB)

    Eslinger, Paul W.; Friese, Judah I.; Lowrey, Justin D.; McIntyre, Justin I.; Miley, Harry S.; Schrom, Brian T.

    2014-09-01

    Abstract The International Monitoring System (IMS) of the Comprehensive-Nuclear-Test-Ban-Treaty monitors the atmosphere for radioactive xenon leaking from underground nuclear explosions. Emissions from medical isotope production represent a challenging background signal when determining whether measured radioxenon in the atmosphere is associated with a nuclear explosion prohibited by the treaty. The Australian Nuclear Science and Technology Organisation (ANSTO) operates a reactor and medical isotope production facility in Lucas Heights, Australia. This study uses two years of release data from the ANSTO medical isotope production facility and Xe-133 data from three IMS sampling locations to estimate the annual releases of Xe-133 from medical isotope production facilities in Argentina, South Africa, and Indonesia. Atmospheric dilution factors derived from a global atmospheric transport model were used in an optimization scheme to estimate annual release values by facility. The annual releases of about 6.8×1014 Bq from the ANSTO medical isotope production facility are in good agreement with the sampled concentrations at these three IMS sampling locations. Annual release estimates for the facility in South Africa vary from 1.2×1016 to 2.5×1016 Bq and estimates for the facility in Indonesia vary from 6.1×1013 to 3.6×1014 Bq. Although some releases from the facility in Argentina may reach these IMS sampling locations, the solution to the objective function is insensitive to the magnitude of those releases.

  7. Estimates of radioxenon released from Southern Hemisphere medical isotope production facilities using measured air concentrations and atmospheric transport modeling.

    Science.gov (United States)

    Eslinger, Paul W; Friese, Judah I; Lowrey, Justin D; McIntyre, Justin I; Miley, Harry S; Schrom, Brian T

    2014-09-01

    The International Monitoring System (IMS) of the Comprehensive-Nuclear-Test-Ban-Treaty monitors the atmosphere for radioactive xenon leaking from underground nuclear explosions. Emissions from medical isotope production represent a challenging background signal when determining whether measured radioxenon in the atmosphere is associated with a nuclear explosion prohibited by the treaty. The Australian Nuclear Science and Technology Organisation (ANSTO) operates a reactor and medical isotope production facility in Lucas Heights, Australia. This study uses two years of release data from the ANSTO medical isotope production facility and (133)Xe data from three IMS sampling locations to estimate the annual releases of (133)Xe from medical isotope production facilities in Argentina, South Africa, and Indonesia. Atmospheric dilution factors derived from a global atmospheric transport model were used in an optimization scheme to estimate annual release values by facility. The annual releases of about 6.8 × 10(14) Bq from the ANSTO medical isotope production facility are in good agreement with the sampled concentrations at these three IMS sampling locations. Annual release estimates for the facility in South Africa vary from 2.2 × 10(16) to 2.4 × 10(16) Bq, estimates for the facility in Indonesia vary from 9.2 × 10(13) to 3.7 × 10(14) Bq and estimates for the facility in Argentina range from 4.5 × 10(12) to 9.5 × 10(12) Bq.

  8. The NASA Heliophysics Active Final Archive at the Space Physics Data Facility

    Science.gov (United States)

    McGuire, Robert E.

    2012-01-01

    The 2009 NASA Heliophysics Science Data Management Policy re-defined and extended the responsibilities of the Space Physics Data Facility (SPDF) project. Building on SPDF's established capabilities, the new policy assigned the role of active "Final Archive" for non-solar NASA Heliophysics data to SPDF. The policy also recognized and formalized the responsibilities of SPDF as a source for critical infrastructure services such as VSPO to the overall Heliophysics Data Environment (HpDE) and as a Center of Excellence for existing SPDF science-enabling services and software including CDAWeb, SSCWeb/4D Orbit Viewer, OMNIweb and CDF. We will focus this talk to the principles, strategies and planned SPDF architecture to effectively and efficiently perform these roles, with special emphasis on how SPDF will ensure the long-term preservation and ongoing online community access to all the data entrusted to SPDF. We will layout our archival philosophy and what we are advocating in our work with NASA missions both current and future, with potential providers of NASA and NASA-relevant archival data, and to make the data and metadata held by SPDF accessible to other systems and services within the overall HpOE. We will also briefly review our current services, their metrics and our current plans and priorities for their evolution.

  9. TRIGA Mark II nuclear reactor facility. Final report, 1 July 1980--30 June 1995

    Energy Technology Data Exchange (ETDEWEB)

    Ryan, B.C.

    1997-05-01

    This report is a final culmination of activities funded through the Department of Energy`s (DOE) University Reactor Sharing Program, Grant DE-FG02-80ER10273, during the period 1 July 1980 through 30 June 1995. Progress reports have been periodically issued to the DOE, namely the Reactor Facility Annual Reports C00-2082/2219-7 through C00-2082/10723-21, which are contained as an appendix to this report. Due to the extent of time covered by this grant, summary tables are presented. Table 1 lists the fiscal year financial obligations of the grant. As listed in the original grant proposals, the DOE grant financed 70% of project costs, namely the total amount spent of these projects minus materials costs and technical support. Thus the bulk of funds was spent directly on reactor operations. With the exception of a few years, spending was in excess of the grant amount. As shown in Tables 2 and 3, the Reactor Sharing grant funded a immense number of research projects in nuclear engineering, geology, animal science, chemistry, anthropology, veterinary medicine, and many other fields. A list of these users is provided. Out of the average 3000 visitors per year, some groups participated in classes involving the reactor such as Boy Scout Merit Badge classes, teacher`s workshops, and summer internships. A large number of these projects met the requirements for the Reactor Sharing grant, but were funded by the University instead.

  10. Final report on the public involvement process phase 1, Monitored Retrievable Storage Facility Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Moore, L.; Shanteau, C.

    1992-12-01

    This report summarizes the pubic involvement component of Phase 1 of the Monitored Retrievable Storage Facility (NM) Feasibility Study in San Juan County, Utah. Part of this summary includes background information on the federal effort to locate a voluntary site for temporary storage of nuclear waste, how San Juan County came to be involved, and a profile of the county. The heart of the report, however, summarizes the activities within the public involvement process, and the issues raised in those various forums. The authors have made every effort to reflect accurately and thoroughly all the concerns and suggestions expressed to us during the five month process. We hope that this report itself is a successful model of partnership with the citizens of the county -- the same kind of partnership the county is seeking to develop with its constituents. Finally, this report offers some suggestions to both county officials and residents alike. These suggestions concern how decision-making about the county`s future can be done by a partnership of informed citizens and listening decision-makers. In the Appendix are materials relating to the public involvement process in San Juan County.

  11. Final report on the public involvement process phase 1, Monitored Retrievable Storage Facility Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Moore, L.; Shanteau, C.

    1992-12-01

    This report summarizes the pubic involvement component of Phase 1 of the Monitored Retrievable Storage Facility (NM) Feasibility Study in San Juan County, Utah. Part of this summary includes background information on the federal effort to locate a voluntary site for temporary storage of nuclear waste, how San Juan County came to be involved, and a profile of the county. The heart of the report, however, summarizes the activities within the public involvement process, and the issues raised in those various forums. The authors have made every effort to reflect accurately and thoroughly all the concerns and suggestions expressed to us during the five month process. We hope that this report itself is a successful model of partnership with the citizens of the county -- the same kind of partnership the county is seeking to develop with its constituents. Finally, this report offers some suggestions to both county officials and residents alike. These suggestions concern how decision-making about the county's future can be done by a partnership of informed citizens and listening decision-makers. In the Appendix are materials relating to the public involvement process in San Juan County.

  12. Present and future sources of protons and heavy ions. [Medical facilities

    Energy Technology Data Exchange (ETDEWEB)

    Grunder, H.A.; Leemann, C.W.

    1976-09-13

    A brief outline of existing medical heavy-ion facilities is given. The beam specifications for future dedicated medical ion accelerators are discussed. Machines capable of delivering dose rates of approximately 1 krad/min in volumes of a few liters are shown to represent existing technology. A cost and performance analysis shows the synchrotrons to be the most economical source for the heavier ions while conventional cyclotrons seem optimal for an exclusive proton facility. It is seen that the incorporation of additional capabilities such as neutron generation or radioisotope production can be achieved at modest incremental costs. In addition to the accelerators, feasible layouts of hypothetical facilities are discussed, and three-dimensional beam scanning is shown to allow the irradiation of large volumes without sacrificing the precise dose localization capabilities of heavy-ion beams. Concepts of quality-controlled engineering and modern computer technology are introduced as a means to obtain the desired high degree of reliability and ease of operation and maintenance.

  13. 77 FR 8855 - Final Reissuance of the NPDES General Permit for Facilities Related to Oil and Gas Extraction in...

    Science.gov (United States)

    2012-02-15

    ... exploration, development, and production facilities located in and discharging to the territorial seas off... the Territorial Seas of Texas AGENCY: Environmental Protection Agency. ACTION: Notice of Final NPDES... the Territorial Seas of Texas (No. TXG260000) for discharges from existing and new dischargers and...

  14. Specialty preferences among final year medical students in medical schools of southeast Nigeria: need for career guidance.

    Science.gov (United States)

    Ossai, Edmund Ndudi; Uwakwe, Kenechi Anderson; Anyanwagu, Uchenna Chidi; Ibiok, Ntat Charles; Azuogu, Benedict Ndubueze; Ekeke, Ngozi

    2016-10-04

    In resource-poor settings with low doctor-population ratio, there is need for equitable distribution of healthcare workforce. The specialty preferences of medical students determine the future composition of physician workforce hence its relevance in career guidance, healthcare planning and policy formulation. This study was aimed at determining the specialty preferences of final year medical students in medical schools of southeast Nigeria, the gender differences in choice of specialty and the availability of career guidance to the students during the period of training. A descriptive cross-sectional study was conducted among final year medical students in the six accredited medical schools in southeast Nigeria using self-administered semi-structured questionnaire. Information on reason for studying Medicine, specialty preference and career guidance were obtained. Chi-square test of statistical significance was used in the analysis. A total of 457 students participated in the study with a response rate of 86.7 %. The mean age was 25.5 ± 2.9 years and 57.1 % were male. Majority (51 %) opted to study Medicine in-order to save lives while 89.5 % intended to pursue postgraduate medical training. A higher proportion (51.8 %) made the decision during the period of clinical rotation. The five most preferred specialties among the students were Surgery (24.0 %); Paediatrics (18.8 %); Obstetrics and Gynaecology (15.6 %); Internal Medicine (11.0 %) and Community Medicine (6.8 %) while Pathology (2.0 %); Anaesthesia (0.7 %) and Ear, Nose and Throat (0.2 %), were the least preferred. Compared to females, a higher proportion of male students intended to specialise in Surgery (32.3 % vs 13.0 %, p career guidance during their stay in medical school and 11.2 % were undecided on choice of specialty. In spite of the high proportion of students willing to pursue specialist medical training after graduation, most opted for the four core clinical specialities of

  15. Maximum reasonable radioxenon releases from medical isotope production facilities and their effect on monitoring nuclear explosions.

    Science.gov (United States)

    Bowyer, Theodore W; Kephart, Rosara; Eslinger, Paul W; Friese, Judah I; Miley, Harry S; Saey, Paul R J

    2013-01-01

    Fission gases such as (133)Xe are used extensively for monitoring the world for signs of nuclear testing in systems such as the International Monitoring System (IMS). These gases are also produced by nuclear reactors and by fission production of (99)Mo for medical use. Recently, medical isotope production facilities have been identified as the major contributor to the background of radioactive xenon isotopes (radioxenon) in the atmosphere (Stocki et al., 2005; Saey, 2009). These releases pose a potential future problem for monitoring nuclear explosions if not addressed. As a starting point, a maximum acceptable daily xenon emission rate was calculated, that is both scientifically defendable as not adversely affecting the IMS, but also consistent with what is possible to achieve in an operational environment. This study concludes that an emission of 5 × 10(9) Bq/day from a medical isotope production facility would be both an acceptable upper limit from the perspective of minimal impact to monitoring stations, but also appears to be an achievable limit for large isotope producers.

  16. First operation of the medical research facility at the NSLS for coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Thomlinson, W.; Gmuer, N.; Chapman, D.; Garrett, R.; Lazarz, N.; Moulin, H. (Brookhaven National Lab., Upton, NY (United States)); Thompson, A.C. (Lawrence Berkeley Lab., CA (United States)); Zeman, H.D. (Dept. of Biomedical Engineering, University of Tennessee, Memphis, Tennessee, 38163 (US)); Brown, G.S. (Stanford Univ., CA (United States). Stanford Synchrotron Radiation Lab.); Morrison, J.; Reiser, P

    1991-01-01

    The Synchrotron Medical Research Facility (SMERF) at the National Synchrotron Light Source has been completed and is operational for human coronary angiography experiments. The imaging system and hardware have been brought to SMERF from the Stanford Synchrotron Radiation Laboratory where prior studies were carried out. SMERF consists of a suite of rooms at the end of the high field superconducting wiggler X17 beamline and is classified as an Ambulatory health Care Facility. Since October of 1990 the coronary arteries of five patients have been imaged. Continuously improving image quality has shown that a large part of both the right coronary artery and the left anterior descending coronary artery can be imaged following a venous injection of contrast agent. 16 refs., 4 figs.

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

    Directory of Open Access Journals (Sweden)

    Oleson Megan

    2006-01-01

    Full Text Available Abstract There is growing evidence of the public health and community harms associated with crack cocaine smoking, particularly the risk of blood-borne transmission through non-parenteral routes. In response, community advocates and policy makers in Vancouver, Canada are calling for an exemption from Health Canada to pilot a medically supervised safer smoking facility (SSF for non-injection drug users (NIDU. Current reluctance on the part of health authorities is likely due to the lack of existing evidence surrounding the extent of related harm and potential uptake of such a facility among NIDUs in this setting. In November 2004, a feasibility study was conducted among 437 crack cocaine smokers. Univariate analyses were conducted to determine associations with willingness to use a SSF and logistic regression was used to adjust for potentially confounding variables (p

  18. Mailability of sharps and other medical devices--Postal Service. Amendment to final rule.

    Science.gov (United States)

    1992-09-21

    In response to further comments, and to ensure that parcels covered by this rule will be in complete compliance with Department of Transportation regulations on shipping papers and marking of hazardous materials, and to preclude parcels of this type from being rejected by the airlines, we are amending the final rule titled Mailability of Sharps and Other Medical Devices, dated June 30, 1992.

  19. Communication Skills in Standardized-Patient Assessment of Final-Year Medical Students: A Psychometric Study

    Science.gov (United States)

    Guiton, Gretchen; Hodgson, Carol S.; Delandshere, Ginett; Wilkerson, Luann

    2004-01-01

    The purpose of this study is to investigate the content-specificity of communication skills. It investigates the reliability and dimensionality of standardized patient (SP) ratings of communication skills in an Objective Structured Clinical Examination(OSCE) for final year medical students. An OSCE consisting of seven standardized patient(SP)…

  20. How well do final year undergraduate medical students master practical clinical skills?

    Science.gov (United States)

    Störmann, Sylvère; Stankiewicz, Melanie; Raes, Patricia; Berchtold, Christina; Kosanke, Yvonne; Illes, Gabrielle; Loose, Peter; Angstwurm, Matthias W.

    2016-01-01

    Introduction: The clinical examination and other practical clinical skills are fundamental to guide diagnosis and therapy. The teaching of such practical skills has gained significance through legislative changes and adjustments of the curricula of medical schools in Germany. We sought to find out how well final year undergraduate medical students master practical clinical skills. Methods: We conducted a formative 4-station objective structured clinical examination (OSCE) focused on practical clinical skills during the final year of undergraduate medical education. Participation was voluntary. Besides the examination of heart, lungs, abdomen, vascular system, lymphatic system as well as the neurological, endocrinological or orthopaedic examination we assessed other basic clinical skills (e.g. interpretation of an ECG, reading a chest X-ray). Participants filled-out a questionnaire prior to the exam, inter alia to give an estimate of their performance. Results: 214 final year students participated in our study and achieved a mean score of 72.8% of the total score obtainable. 9.3% of participants (n=20) scored insufficiently (clinical skills in the context of a formative assessment. Half of the students over-estimate their own performance. We recommend an institutionalised and frequent assessment of practical clinical skills during undergraduate medical education, especially in the final year. PMID:27579358

  1. Computation of, and rules relating to, medical loss ratio. Final regulations.

    Science.gov (United States)

    2014-01-01

    This document contains final regulations that provide guidance to Blue Cross and Blue Shield organizations, and certain other qualifying health care organizations, on computing and applying the medical loss ratio added to the Internal Revenue Code by the Patient Protection and Affordable Care Act.

  2. An assisted living facility curriculum to introduce geriatrics to first-year medical students.

    Science.gov (United States)

    Tong, Iris L; Dodd, Kimberly A; Warrier, Sarita S; Pugliese, Louis J; McMackin, Naomi Y; Taylor, Julie Scott

    2015-01-01

    Many U.S. medical schools have developed curricula in geriatric medicine to address the growing older adult population. At our university, the authors have integrated an assisted living facility (ALF) program into a required first-year clinical skills course. During the 2011 to 2012 academic year, an electronic survey was distributed to 109 first-year medical students prior to and after the program. Eighty-eight percent and 85% of students completed the pre- and postintervention survey, respectively. Students reported a positive attitude toward caring for older adults (92.5% post- vs. 80.2% preintervention), an understanding of the medical and social needs of older adults (89.2% post- vs. 38.5% preintervention), an acquisition of the skills to assess the health of older adults (71% post- vs. 14.5% preintervention), and an understanding of ALFs as nonmedical supportive housing (92.5% post- vs. 70.8% preintervention). The authors' curriculum offers an innovative method to integrate geriatrics education early in medical education and to involve medical students in their community.

  3. Use of mobile learning technology among final year medical students in Kenya.

    Science.gov (United States)

    Masika, Moses Muia; Omondi, Gregory Barnabas; Natembeya, Dennis Simiyu; Mugane, Ephraim Mwatha; Bosire, Kefa Ogonyo; Kibwage, Isaac Ongubo

    2015-01-01

    Mobile phone penetration has increased exponentially over the last decade as has its application in nearly all spheres of life including health and medical education. This study aimed at assessing the use of mobile learning technology and its challenges among final year undergraduate students in the College of Health sciences, University of Nairobi. This was a cross-sectional descriptive study conducted among final year undergraduate students at the University of Nairobi, College of Health Sciences. Self-administered, anonymous questionnaires were issued to all final year students in their lecture rooms after obtaining informed consent. Data on demographics, mobile device ownership and mobile learning technology use and its challenges was collected. Data entry and analysis was done using SPSS(®). Chi-square and t-test were used for bivariate analysis. We had 292 respondents; 62% were medical students, 16% were nursing students, 13% were pharmacy students and 9% were dental surgery students. The majority were female (59%) and the average age was 24 years. Eighty eight percent (88%) of the respondents owned a smart device and nearly all of them used it for learning. 64% of the respondents used medical mobile applications. The main challenges were lack of a smart device, lack of technical know-how in accessing or using apps, sub-optimal internet access, cost of acquiring apps and limited device memory. Mobile learning is increasingly popular among medical students and should be leveraged in promoting access and quality of medical education.

  4. Framework for Certification of Fish Propagation, Protection and Monitoring Facilities. Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Carlson, Thomas J.; Costello, Ronald J.

    1997-06-01

    A conceptual framework for certification of fish production and monitoring facilities including software templates to expedite implementation of the framework are presented. The framework is based on well established and widely utilized project management techniques. The implementation templates are overlays for Microsoft Professional Office software products: Excel, Word, and Project. Use of the software templates requires Microsoft Professional Office. The certification framework integrates two classical project management processes with a third process for facility certification. These processes are: (1) organization and definition of the project, (2) acquisition and organization of project documentation, and (3) facility certification. The certification process consists of systematic review of the production processes and the characteristics of the produced product. The criteria for certification review are the plans and specifications for the products and production processes that guided development of the facility. The facility is certified when the production processes are operating as designed and the product produced meets specifications. Within this framework, certification is a performance based process, not dissimilar from that practiced in many professions and required for many process, or a product meets professional/industry standards of performance. In the case of fish production facilities, the certifying authority may be diffuse, consisting of many entities acting through a process such as NEPA. A cornerstone of certification is accountability, over the long term, for the operation and products of a facility. This is particularly important for fish production facilities where the overall goal of the facility may require decades to accomplish.

  5. Syphilis test availability and uptake at medical facilities in southern China

    Science.gov (United States)

    Tucker, Joseph D; Wang, Cheng; Shen, Song-Ying; Chen, Xiang-Sheng; Yang, Bin; Peeling, Rosanna

    2011-01-01

    Abstract Objective To examine syphilis testing capacity, screening coverage rates and types of syphilis tests used in medical facilities in southern China. Methods Eleven of the 14 municipalities in Guangdong province participated. Data on syphilis testing capacity, screening coverage and types of syphilis tests used were collected from all types of public medical facilities offering prenatal care (n = 109). A total of 494 680 women who delivered during 2004–2008 were studied. Findings In 2008, 54 196 pregnant women (43.1%) were not screened for syphilis. Among such women, 32 863 (60.6%) attended clinics without any syphilis testing capacity and 21 333 (39.4%) attended clinics that performed testing but were not screened. The likelihood of not having syphilis test capacity was much higher for hygiene stations (odds ratio, OR: 10; 95% confidence interval, CI: 4–25), services at the township level (OR: 33; 95% CI: 10–100) and services with ≤ 1000 deliveries per year (OR: 1.002; 95% CI: 1.001–1.003). These same service characteristics correlated with lower screening coverage rates (P < 0.01). Only one antenatal clinic had the capacity to conduct both treponemal and non-treponemal tests for diagnosing syphilis. Conclusion Syphilis screening is available in very few of the basic medical facilities offering prenatal care where most neonates in southern China are delivered. In light of this and of the increasing incidence of syphilis in the area, expanding point-of-care rapid syphilis testing is a priority. PMID:22084525

  6. Influences on final year medical students’ attitudes to general practice as a career

    Directory of Open Access Journals (Sweden)

    Parker JE

    2014-03-01

    Full Text Available INTRODUCTION: General practice is under-represented in student career choices. This study aimed to identify and explore factors that influence the attitudes of final year medical students to general practice as a career. METHODS: This qualitative study used semi-structured interviews of focus groups of final year undergraduate medical students at the University of Otago, Christchurch, New Zealand. Thematic analysis and grounded theory were used to interpret the data. FINDINGS: General practitioners (GPs play a key role in influencing medical students’ attitudes to general practice as a career. Students identified their general practice placement during medical school training and personal contact with their own GP as principal factors. The media portrayal of general practice and the attitudes of friends and family were also influential. Students were positively influenced when they were made to feel part of the team, involved with consultations, allowed to carry out practical procedures under supervision, and witnessed what they perceived as good medical practice during clinical placements. Positive experiences often occurred later in training, when students felt more confident of their clinical abilities. While students reported occasional negative comments about general practice by some hospital doctors, these had a lesser role in influencing their perceptions of general practice compared with their own experiences, both as students and patients. CONCLUSION: GPs have a strong influence, positively and negatively, on the attitudes of medical students to general practice as a career. Effective influences include being made to feel welcome, involved, valued, and given legitimate roles during clinical placements.

  7. How well do final year undergraduate medical students master practical clinical skills?

    Directory of Open Access Journals (Sweden)

    Störmann, Sylvère

    2016-08-01

    Full Text Available Introduction: The clinical examination and other practical clinical skills are fundamental to guide diagnosis and therapy. The teaching of such practical skills has gained significance through legislative changes and adjustments of the curricula of medical schools in Germany. We sought to find out how well final year undergraduate medical students master practical clinical skills.Methods: We conducted a formative 4-station objective structured clinical examination (OSCE focused on practical clinical skills during the final year of undergraduate medical education. Participation was voluntary. Besides the examination of heart, lungs, abdomen, vascular system, lymphatic system as well as the neurological, endocrinological or orthopaedic examination we assessed other basic clinical skills (e.g. interpretation of an ECG, reading a chest X-ray. Participants filled-out a questionnaire prior to the exam, inter alia to give an estimate of their performance.Results: 214 final year students participated in our study and achieved a mean score of 72.8% of the total score obtainable. 9.3% of participants (n=20 scored insufficiently (<60%. We found no influence of sex, prior training in healthcare or place of study on performance. Only one third of the students correctly estimated their performance (35.3%, whereas 30.0% and 18.8% over-estimated their performance by 10% and 20% respectively.Discussion: Final year undergraduate medical students demonstrate considerable deficits performing practical clinical skills in the context of a formative assessment. Half of the students over-estimate their own performance. We recommend an institutionalised and frequent assessment of practical clinical skills during undergraduate medical education, especially in the final year.

  8. CERN-MEDICIS (Medical Isotopes Collected from ISOLDE): A New Facility

    OpenAIRE

    Ricardo Manuel dos Santos Augusto; Leo Buehler; Zoe Lawson; Stefano Marzari; Monika Stachura; Thierry Stora; CERN-MEDICIS collaboration

    2014-01-01

    About 50% of the 1.4 GeV CERN (European Organization for Nuclear Research, www.cern.ch) protons are sent onto targets to produce radioactive beams by online mass separation at the Isotope Separator Online Device (ISOLDE) facility, for a wide range of studies in fundamental and applied physics. CERN-MEDICIS is a spin-off dedicated to R&D in life sciences and medical applications. It is located in an extension of the Class A building presently under construction. It will comprise laboratori...

  9. The Development of a Quality Management Framework for Evaluating Medical Device Reprocessing Practice in Healthcare Facilities.

    Science.gov (United States)

    Lorv, Bailey; Horodyski, Robin; Welton, Cynthia; Vail, John; Simonetto, Luca; Jokanovic, Danilo; Sharma, Richa; Mahoney, Angela Rea; Savoy-Bird, Shay; Bains, Shalu

    2017-01-01

    There is increasing awareness of the importance of medical device reprocessing (MDR) for the provision of safe patient care. Although industry service standards are available to guide MDR practices, there remains a lack of published key performance indicators (KPIs) and targets that are necessary to evaluate MDR quality for feedback and improvement. This article outlines the development of an initial framework that builds on established guidelines and includes service standards, KPIs and targets for evaluating MDR operations. This framework can support healthcare facilities in strengthening existing practices and enables a platform for collaboration towards better MDR performance management.

  10. Intake risk and dose evaluation methods for workers in radiochemistry labs of a medical cyclotron facility.

    Science.gov (United States)

    Calandrino, Riccardo; del Vecchio, Antonella; Savi, Annarita; Todde, Sergio; Belloli, Sara

    2009-10-01

    The aim of this paper is to evaluate the risks and doses for the internal contamination of the radiochemistry staff in a high workload medical cyclotron facility. The doses from internal contamination derive from the inhalation of radioactive gas leakage from the cells by personnel involved in the synthesis processes and are calculated from urine sample measurements. Various models are considered for the calculation of the effective committed dose from the analysis of these urine samples, and the results are compared with data obtained from local environmental measurement of the radioactivity released inside the lab.

  11. A human factors engineering evaluation of the Multi-Function Waste Tank Facility. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Donohoo, D.T. [Pacific Northwest Lab., Richland, WA (United States); Sarver, T.L. [ARES Corp., San Francisco, CA (United States)

    1995-06-05

    This report documents the methods and results of a human factors engineering (HFE) review conducted on the Multi-Function Waste Tank Facility (MWTF), Westinghouse Hanford Company (WHC) Project 236A, to be constructed at the U.S. Department of Energy (DOE) facility at Hanford, Washington. This HFE analysis of the MWTF was initiated by WHC to assess how well the current facility and equipment design satisfies the needs of its operations and maintenance staff and other potential occupants, and to identify areas of the design that could benefit from improving the human interfaces at the facility. Safe and effective operations, including maintenance, is a primary goal for the MWTF. Realization of this goal requires that the MWTF facility, equipment, and operations be designed in a manner that is consistent with the abilities and limitations of its operating personnel. As a consequence, HFE principles should be applied to the MWTF design, construction, its operating procedures, and its training. The HFE review was focused on the 200-West Area facility as the design is further along than that of the 200-East Area. The review captured, to the greatest extent feasible at this stage of design, all aspects of the facility activities and included the major topics generally associated with HFE (e.g., communication, working environment). Lessons learned from the review of the 200 West facility will be extrapolated to the 200-East Area, as well as generalized to the Hanford Site.

  12. 77 FR 15794 - Final Environmental Impact Statement for the Proposed KRoad Moapa Solar Generation Facility...

    Science.gov (United States)

    2012-03-16

    ... Generation Facility, Clark County, NV AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Availability. SUMMARY: This notice advises the public that the Bureau of Indian Affairs (BIA) as the lead... Generation Facility on the Moapa River Indian Reservation (Reservation) in Clark County, Nevada. This...

  13. Secure Internet video conferencing for assessing acute medical problems in a nursing facility.

    Science.gov (United States)

    Weiner, M; Schadow, G; Lindbergh, D; Warvel, J; Abernathy, G; Dexter, P; McDonald, C J

    2001-01-01

    Although video-based teleconferencing is becoming more widespread in the medical profession, especially for scheduled consultations, applications for rapid assessment of acute medical problems are rare. Use of such a video system in a nursing facility may be especially beneficial, because physicians are often not immediately available to evaluate patients. We have assembled and tested a portable, wireless conferencing system to prepare for a randomized trial of the system s influence on resource utilization and satisfaction. The system includes a rolling cart with video conferencing hardware and software, a remotely controllable digital camera, light, wireless network, and battery. A semi-automated paging system informs physicians of patient s study status and indications for conferencing. Data transmission occurs wirelessly in the nursing home and then through Internet cables to the physician s home. This provides sufficient bandwidth to support quality motion images. IPsec secures communications. Despite human and technical challenges, this system is affordable and functional.

  14. Knowledge of primary health care and career choice at primary health care settings among final year medical students - challenges to human resources for health in Vietnam.

    Science.gov (United States)

    Giang, Kim Bao; Minh, Hoang Van; Hien, Nguyen Van; Ngoc, Nguyen Minh; Hinh, Nguyen Duc

    2015-01-01

    There is a shortage of medical doctors in primary health care (PHC) settings in Vietnam. Evidence about the knowledge medical students have about PHC and their career decision-making is important for making policy in human resources for health. The objective of this study was to analyse knowledge and attitudes about PHC among medical students in their final year and their choice to work in PHC after graduation. A cross-sectional study was conducted among 400 final year general medical students from Hanoi Medical University. Self-administered interviews were conducted. Key variables were knowledge, awareness of the importance of PHC and PHC career choices. Descriptive and analytic statistics were performed. Students had essential knowledge of the concept and elements of PHC and were well aware of its importance. However, only one-third to one half of them valued PHC with regard to their professional development or management opportunities. Less than 1% of students would work at commune or district health facilities after graduation. This study evidences challenges related to increasing the number of medical doctors working in PHC settings. Immediate and effective interventions are needed to make PHC settings more attractive and to encourage medical graduates to start and continue a career in PHC.

  15. Evaluation of the contribution of radiological imaging to the final diagnosis in medical case reports.

    Science.gov (United States)

    Wiesinger, Isabel; Scharf, Gregor; Platz, Natascha; Dendl, Lena M; Pawlik, Michael T; Stroszczynski, Christian; Schreyer, Andreas G

    2015-05-01

    To evaluate the clinical value and impact of radiological imaging in published medial case reports. We analysed 671 consecutively published case reports of a peer-reviewed medical journal for case reports. The general use of radiological imaging as well as the specific imaging modality used in each case (ultrasound, x-ray, fluoroscopy, CT, MRI) was documented, and most importantly the 'final problem solver', i.e. the diagnostic modality giving the final clue to the patient's diagnosis, was identified. In 511 of 671 (76.1 %) analysed case reports at least one radiological modality was used in the diagnostic cascade. In 28.6% of all cases the final diagnosis was achieved by radiological imaging. All other cases were solved by the patient's history and physical examination (15.2%), histology (12.4%), and blood analysis (9.6%). When radiology was the 'final problem solver', it was mainly CT (51.6%) and MRI (30.6%). In 52.2% of the case reports the radiological image was included in the article. In case reports published in a prominent general medical journal radiological imaging is an important key player in the diagnostic process. In many cases, it is also the diagnostic tool which ultimately leads to determining the final diagnosis. • Radiology was the most important specialty for finding the final diagnosis. • CT was the most successful problem-solving imaging modality followed by MRI. • MRI and CT had the best solution rates of more than 30%.

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

    Science.gov (United States)

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

    2017-01-01

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

  17. From Cure to Care: Assessing the Ethical and Professional Learning Needs of Medical Learners in a Care-Based Facility

    Science.gov (United States)

    Hall, Pippa; O'Reilly, Jane; Dojeiji, Sue; Blair, Richard; Harley, Anne

    2009-01-01

    The purpose of this study was to assess the ethical and professional learning needs of medical trainees on clinical placements at a care-based facility, as they shifted from acute care to care-based philosophy. Using qualitative data analysis and grounded theory techniques, 12 medical learners and five clinical supervisors were interviewed. Five…

  18. From Cure to Care: Assessing the Ethical and Professional Learning Needs of Medical Learners in a Care-Based Facility

    Science.gov (United States)

    Hall, Pippa; O'Reilly, Jane; Dojeiji, Sue; Blair, Richard; Harley, Anne

    2009-01-01

    The purpose of this study was to assess the ethical and professional learning needs of medical trainees on clinical placements at a care-based facility, as they shifted from acute care to care-based philosophy. Using qualitative data analysis and grounded theory techniques, 12 medical learners and five clinical supervisors were interviewed. Five…

  19. Future use of BI-GAS facility. Final report, Part II. [Other possible uses

    Energy Technology Data Exchange (ETDEWEB)

    1981-09-01

    The 120 tpd BI-GAS pilot plant, intended to produce SNG at high pressure, was completed in 1976. For the next three and a half years, the operator, Stearns-Roger Inc., was engaged in operating the plant while overcoming a series of mechanical problems that have prevented the plant from running at design capacity and pressure. Since July 1980, these problems have apparently been corrected and considerable progress was made. In late 1979, the Yates Congressional Committee directed DOE to investigate the possibility of establishing an entrained-bed gasifier test facility at the site. In January 1981, the DOE established a study group composed of DOE and UOP/SDC personnel to determine how best to use the BI-GAS facility. The group considered four possibilities: Continue operation of the facility in accordance with the technical program plan developed by DOE and Stearns-Roger; modify the plant into an entrained-bed facility for testing components and processes; mothball the facility, or dismantle the facility. The group took the view that modifying the plant into a test facility would increase substantially the amount of engineering data available to the designers of commercial gasification plants. Since it appears that syngas plants will be of commercial interest sooner than SNG plants will, it was decided that the facility should test syngas production components and processes at high pressure. Consequently, it was recommended that: Operation of the plant be continued, both to collect data and to prove the BI-GAS process, as long as the schedule of the technical program plan is met; Begin at once to prepare a detailed design for modifying the BI-GAS plant to a high-pressure, entrained flow syngas test facility; and Implement the modification plan as soon as the BI-GAS process is proven or it becomes apparent that progress is unsatisfactory.

  20. 78 FR 40015 - Approval and Promulgation of State Air Quality Plans for Designated Facilities and Pollutants...

    Science.gov (United States)

    2013-07-03

    ... Pollutants; District of Columbia; Control of Emissions From Existing Hospital/Medical/Infectious Waste... taking direct final action to approve a negative declaration for hospital/medical/infectious waste... pollutants) at existing solid waste combustor facilities (designated facilities) whenever standards...

  1. The effects of the final disposal facility for spent nuclear fuel on regional economy; Kaeytetyn ydinpolttoaineen loppusijoituslaitoksen aluetaloudelliset vaikutukset

    Energy Technology Data Exchange (ETDEWEB)

    Laakso, S. [Seppo Laakso Urban Research (Finland)

    1999-03-01

    The study deals with the economic effects of the final disposal facility for spent nuclear fuel on the alternative location municipalities - Eurajoki, Kuhmo, Loviisa and Aeaenekoski - and their neighbouring areas (in Finland). The economic influence of the facility on industrials, employment, population, property markets, community structure and local public economics are analysed applying the approach of regional economics. The evaluation of the facility`s effects on employment is based on the input-output analysis. Both the direct and indirect effects of the construction and the functioning of the facility are taken into account in the analysis. According to the results the total increase in employment caused by the construction of the facility is about 350 persons annually, at national level. Some 150 persons of this are estimated to live in the wider region and 100-150 persons in the facility`s influence area consisting of the location municipality and neighbouring municipalities. This amount is reached at the top stage of construction (around the year 2018). At the production stage - after the year 2020 - the facility`s effects on employment will be concentrated significantly more on the location municipality and the rest of the influence area than on the rest of the country, compared with the construction stage. The estimated employment growth in the production stage is approximately 160 persons at national level of which 100-120 persons live in the candidate municipality and in the rest of the influence area. There is a direct link between local employment and population development. The growth of jobs attracts immigrants affecting the development of both the number and the structure of population. The facility`s effects on population development in the alternative location municipalities are analysed using comparative population forecasts based on demographic population projection methods. According to the results the job growth caused by the facility will

  2. Technical assistance for Meharry Medical College Energy Efficiency Project. Final project status and technical report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-05-08

    This report presents the results of a program to provide technical assistance to Meharry Medical College. The purpose of the program is to facilitate Meharry`s effort to finance a campus-wide facility retrofit. The US Department of Energy (USDOE) funded the program through a grant to the Tennessee Department of Economic and Community Development (TECD). The University of Memphis-Technology and Energy Services (UM-TES), under contract to TECD, performed program services. The report has three sections: (1) introduction; (2) project definition, financing, and participants; and (3) opportunities for federal participation.

  3. Evaluation of the contribution of radiological imaging to the final diagnosis in medical case reports

    Energy Technology Data Exchange (ETDEWEB)

    Wiesinger, Isabel; Scharf, Gregor; Platz, Natascha; Dendl, Lena M.; Stroszczynski, Christian; Schreyer, Andreas G. [University Hospital Regensburg, Institute of Radiology, Regensburg (Germany); Pawlik, Michael T. [Intensive Care and Emergency Medicine, Institute of Anaesthesiology, Regensburg (Germany)

    2015-05-01

    To evaluate the clinical value and impact of radiological imaging in published medial case reports. We analysed 671 consecutively published case reports of a peer-reviewed medical journal for case reports. The general use of radiological imaging as well as the specific imaging modality used in each case (ultrasound, x-ray, fluoroscopy, CT, MRI) was documented, and most importantly the 'final problem solver', i.e. the diagnostic modality giving the final clue to the patient's diagnosis, was identified. In 511 of 671 (76.1 %) analysed case reports at least one radiological modality was used in the diagnostic cascade. In 28.6 % of all cases the final diagnosis was achieved by radiological imaging. All other cases were solved by the patient's history and physical examination (15.2 %), histology (12.4 %), and blood analysis (9.6 %). When radiology was the 'final problem solver', it was mainly CT (51.6 %) and MRI (30.6 %). In 52.2 % of the case reports the radiological image was included in the article. In case reports published in a prominent general medical journal radiological imaging is an important key player in the diagnostic process. In many cases, it is also the diagnostic tool which ultimately leads to determining the final diagnosis. (orig.)

  4. Improving the regulation of safety at DOE nuclear facilities. Final report: Appendices

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    The report strongly recommends that, with the end of the Cold War, safety and health at DOE facilities should be regulated by outside agencies rather than by any regulatory scheme, DOE must maintain a strong internal safety management system; essentially all aspects of safety at DOE`s nuclear facilities should be externally regulated; and existing agencies rather than a new one should be responsible for external regulation.

  5. Improving the regulation of safety at DOE nuclear facilities. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    The report strongly recommends that, with the end of the Cold War, safety and health at DOE facilities should be regulated by outside agencies rather than by DOE itself. The three major recommendations are: under any regulatory scheme, DOE must maintain a strong internal safety management system; essentially all aspects of safety at DOE`s nuclear facilities should be externally regulated; and existing agencies rather than a new one should be responsible for external regulation.

  6. Ocean Thermal Energy Conversion (OTEC) test facilities study program. Final report. Volume II. Part A

    Energy Technology Data Exchange (ETDEWEB)

    1977-01-17

    Results are presented of an 8-month study to develop alternative non-site-specific OTEC facilities/platform requirements for an integrated OTEC Test Program which may include land and floating test facilities. The document, Volume II - Appendixes is bound in three parts (A, B, and C) which together comprise a compendium of the most significant detailed data developed during the study. Part A contains definitions, baseline revisions, test plans, and energy utilization sections.

  7. [Utilization of radionuclide therapy facility and assembly-temporary type therapeutic facility for medical treatment of radioactivity contaminated patients in nuclear emergency].

    Science.gov (United States)

    Watanabe, Naoyuki; Satro, Hiroyuki; Kawahara, Hiroshi; Sasaki, Yasuhito

    2011-05-01

    Medical management of patients internally contaminated in nuclear emergency needs, in addition to general medical treatment, to evaluate doses due to intakes of radioactive materials, to conduct effective treatment with stable isotopes and chelating agents and to keep public away from radioactive materials in and excreted from patients. The idea of medical treatment for internal contamination is demonstrated in the general principles on medical management of victims in nuclear emergency issued by the Cabinet Office in Japan. However, if impressive number patients with internal contamination are generated, the current medical management scheme in nuclear emergency is not able to admit them. The utilization of radionuclide therapy facilities where patients with thyroid diseases are treated with radioisotope and assembly-temporary housing type treatment facilities dedicated for internal contaminated patients may be expected to complement the medical management scheme in nuclear emergency. The effect or more medical management system for patients internally contaminated may become one of the safety nets in the contemporary society that inclines to use nuclear energy on account of accessibility.

  8. Assisted Living Facilities, Locations of Assisted Living Facilities identifed visually and placed on the Medical Multi-Hazard Mitigation layer., Published in 2006, 1:1200 (1in=100ft) scale, Noble County Government.

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — Assisted Living Facilities dataset current as of 2006. Locations of Assisted Living Facilities identifed visually and placed on the Medical Multi-Hazard Mitigation...

  9. Community-level football injury epidemiology: traumatic injuries treated at Swedish emergency medical facilities.

    Science.gov (United States)

    Timpka, Toomas; Schyllander, Jan; Stark Ekman, Diana; Ekman, Robert; Dahlström, Örjan; Hägglund, Martin; Kristenson, Karolina; Jacobsson, Jenny

    2017-05-16

    Despite the popularity of the sport, few studies have investigated community-level football injury patterns. This study examines football injuries treated at emergency medical facilities using data from three Swedish counties. An open-cohort design was used based on residents aged 0-59 years in three Swedish counties (pop. 645 520). Data were collected from emergency medical facilities in the study counties between 1 January 2007 and 31 December 2010. Injury frequencies and proportions for age groups stratified by sex were calculated with 95% confidence intervals (95% CIs) and displayed per diagnostic group and body location. Each year, more than 1/200 person aged 0-59 years sustained at least one injury during football play that required emergency medical care. The highest injury incidence was observed among adolescent boys [2009 injuries per 100 000 population years (95% CI 1914-2108)] and adolescent girls [1413 injuries per 100 000 population years (95% CI 1333-1498)]. For female adolescents and adults, knee joint/ligament injury was the outstanding injury type (20% in ages 13-17 years and 34% in ages 18-29 years). For children aged 7-12 years, more than half of the treated injuries involved the upper extremity; fractures constituted about one-third of these injuries. One of every 200 residents aged 0-59 years in typical Swedish counties each year sustained a traumatic football injury that required treatment in emergency healthcare. Further research on community-level patterns of overuse syndromes sustained by participation in football play is warranted.

  10. Engineering Evaluation/Cost Analysis for Power Burst Facility (PER-620) Final End State and PBF Vessel Disposal

    Energy Technology Data Exchange (ETDEWEB)

    B. C. Culp

    2007-05-01

    Preparation of this engineering evaluation/cost analysis is consistent with the joint U.S. Department of Energy and U.S. Environmental Protection Agency Policy on Decommissioning of Department of Energy Facilities Under the Comprehensive Environmental Response, Compensation, and Liability Act, (DOE and EPA 1995) which establishes the Comprehensive Environmental, Response, Compensation, and Liability Act non-time critical removal action process as an approach for decommissioning. The scope of this engineering evaluation/cost analysis is to evaluate alternatives and recommend a preferred alternative for the final end state of the PBF and the final disposal location for the PBF vessel.

  11. 'Reactive' nano-complex coated medical cotton: a facile avenue for tailored release of small molecules.

    Science.gov (United States)

    Rather, Adil Majeed; Mahato, Sulendar; Maji, Kousik; Gogoi, Neeha; Manna, Uttam

    2017-08-15

    Controlled and sustained release of drug-like small molecules in an aqueous medium still remains a challenging problem due to rapid infiltration of liquid water in most reported drug release systems. However, internal-superhydrophobicity with an antifouling property extending beyond the surface of a material recently has been recognized as a potential avenue for sustained and extended release of drug-like small molecules. Sluggish removal of metastable trapped air in a superhyrophobic material provides a basis to achieve extended release of encapsulated small molecules. In this article, naturally abundant medical-cotton-extensively used in wound management including control of bleeding, absorbance of secretions and protecting wounds from contamination-is strategically exploited in tailoring (from rapid to extended) the release of small molecules by appropriate modulation of liquid water wettability. Modulation included bio-mimicked adhesive and non-adhesive superhydrophobicity of the medical cotton without erosion of any polymeric material. In this process, amine 'reactive' nano-complexes (RNC) were prepared by just mixing branched poly(ethylenimine) (BPEI) with dipentaerythritol pentaacrylate (5Acl) in ethanol with appropriate compositions. Then they were covalently immobilized on fibrous medical-cotton through a facile and robust 1,4-conjugated addition reaction. Residual acrylate moieties in the immobilized RNC provide an opportunity to tailor water wettability through strategic and appropriate post-chemical modification of RNC-coated medical cotton with a primary amine containing various small molecules. This medical-cotton with tunable wettability was exploited further to control the release rate of small molecules from rapid (100 days) times. A volatile solvent induced transient and reversible switching of anti-fouling properties which allowed further varying the amount of post-loading small molecules into the medical cotton up to 2.36 wt% without

  12. Perceptions of acne vulgaris in final year medical student written examination answers.

    Science.gov (United States)

    Green, J; Sinclair, R D

    2001-05-01

    Misconceptions exist in the community regarding factors that exacerbate acne vulgaris. In particular stress, diet, lifestyle and personal hygiene are often erroneously claimed to be important factors. In order to investigate whether these common misconceptions persist in medical graduates, we analysed the answers of 215 sixth year medical students, who all subsequently graduated from The University of Melbourne, to a short-answer question on acne management and exacerbating factors in one of their final year examination papers. With respect to exacerbating factors, 67% of students identified stress, 10% identified lifestyle factors (smoking and alcohol consumption), and 25% claimed poor facial hygiene exacerbated acne. Diet was stated to be an important factor by 41% of students, of whom 12% specifically mentioned chocolate. Persistence of these misconceptions among medical graduates is likely to perpetuate misinformation in the community.

  13. 77 FR 24403 - Direct Final Approval of Hospital/Medical/Infectious Waste Incinerators State Plan for Designated...

    Science.gov (United States)

    2012-04-24

    ... AGENCY 40 CFR Part 62 Direct Final Approval of Hospital/Medical/Infectious Waste Incinerators State Plan...). ACTION: Direct final rule. SUMMARY: EPA is approving Illinois' revised State Plan to control air pollutants from ``Hazardous/Medical/Infectious Waste Incinerators'' (HMIWI). The Illinois Environmental...

  14. 77 FR 24451 - Direct Final Approval of Hospital/Medical/Infectious Waste Incinerators State Plan for Designated...

    Science.gov (United States)

    2012-04-24

    ... AGENCY 40 CFR Part 62 Direct Final Approval of Hospital/Medical/Infectious Waste Incinerators State Plan...). ACTION: Proposed rule. SUMMARY: EPA is proposing to approve, through direct final rulemaking, Illinois' revised State Plan to control air pollutants from Hazardous/ Medical/Infectious Waste Incinerators (HMIWI...

  15. 77 FR 24405 - Direct Final Approval of Hospital/Medical/Infectious Waste Incinerators State Plan for Designated...

    Science.gov (United States)

    2012-04-24

    ... AGENCY 40 CFR Part 62 Direct Final Approval of Hospital/Medical/Infectious Waste Incinerators State Plan...). ACTION: Direct final rule. SUMMARY: EPA is approving Indiana's revised State Plan to control air pollutants from ``Hazardous/Medical/Infectious Waste Incinerators'' (HMIWI). The Indiana Department of...

  16. Thermal and fluid mixing in a 1/2-scale test facility. Volume 1. Facility and test design report. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Dolan, F.X.; Valenzuela, J.A.

    1985-07-01

    This report describes the test facility and program designed to measure fluid mixing and heat transfer in a 1/2-scale model of the cold leg downcomer and lower plenum of a pressurized water reactor under conditions of interest to the issue of pressurized thermal shock. Several cold leg assemblies are modeled and the downcomer arrangement can be altered to match vendor-specific configurations. The facility can be operated to model flow rates based on Froude number of the injected flow in the cold leg and with steady or transient inlet boundary conditions. Extensive instrumentation is provided to measure flow rates, temperatures and pressure at the facility boundaries and for detailed measurements of temperature, velocity and heat transfer data in the cold leg and downcomer models. The test data are monitored and recorded by a computer data acquisition system that is also used for post-test data reduction and plotting. The planned test matrix includes 75 tests with variations in cold leg and downcomer geometries, loop and HPI flow rates, cold leg Froude number and loop to HPI density difference. Test results will be reported in a series of quick look and final report.

  17. Waste Receiving and Processing (WRAP) Facility Final Safety Analysis Report (FSAR)

    Energy Technology Data Exchange (ETDEWEB)

    TOMASZEWSKI, T.A.

    2000-04-25

    The Waste Receiving and Processing Facility (WRAP), 2336W Building, on the Hanford Site is designed to receive, confirm, repackage, certify, treat, store, and ship contact-handled transuranic and low-level radioactive waste from past and present U.S. Department of Energy activities. The WRAP facility is comprised of three buildings: 2336W, the main processing facility (also referred to generically as WRAP); 2740W, an administrative support building; and 2620W, a maintenance support building. The support buildings are subject to the normal hazards associated with industrial buildings (no radiological materials are handled) and are not part of this analysis except as they are impacted by operations in the processing building, 2336W. WRAP is designed to provide safer, more efficient methods of handling the waste than currently exist on the Hanford Site and contributes to the achievement of as low as reasonably achievable goals for Hanford Site waste management.

  18. Disposition of PUREX facility tanks D5 and E6 uranium and plutonium solutions. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Harty, D.P.

    1993-12-01

    Approximately 9 kilograms of plutonium and 5 metric tons of uranium in a 1 molar nitric acid solution are being stored in two PUREX facility vessels, tanks D5 and E6. The plutonium was accumulated during cleanup activities of the plutonium product area of the PUREX facility. Personnel at PUREX recently completed a formal presentation to the Surplus Materials Peer Panel (SMPP) regarding disposition of the material currently in these tanks. The peer panel is a group of complex-wide experts who have been chartered by EM-64 (Office of Site and Facility Transfer) to provide a third party independent review of disposition decisions. The information presented to the peer panel is provided in the first section of this report. The panel was generally receptive to the information provided at that time and the recommendations which were identified.

  19. Wildlife Protection, Mitigation, and Enhancement Plans, Anderson Ranch and Black Canyon Facilities: Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Meuleman, G. Allyn

    1987-06-01

    Under direction of the Pacific Northwest Electric Power Planning and Conservation Act of 1980, and the subsequent Northwest Power Planning Council's Columbia River Basin Fish and Wildlife Program, projects have been developed in Idaho to mitigate the impacts to wildlife habitat and production due to the development and operation of the Anderson Ranch and Black Canyon Facilities (i.e., dam, power plant, and reservoir areas). The Anderson Ranch Facility covered about 4812 acres of wildlife habitat while the Black Canyon Facility covered about 1115 acres. These acreages include dam and power plant staging areas. A separate mitigation plan has been developed for each facility. A modified Habitat Evaluation Procedure (HEP) was used to assess the benefits of the mitigation plans to wildlife. The interagency work group used the target species Habitat Units (HU's) lost at each facility as a guideline during the mitigation planning process, while considering the needs of wildlife in the areas. Totals of 9619 and 2238 target species HU's were estimated to be lost in the Anderson Ranch and Black Canyon Facility areas, respectively. Through a series of projects, the mitigation plans will provide benefits of 9620 target species HU's to replace Anderson Ranch wildlife impacts and benefits of 2195 target species HU's to replace Black Canyon wildlife impacts. Target species to be benefited by the Anderson Ranch and/or Black Canyon mitigation plans include the mallard, Canada goose, mink, yellow warbler, black-capped chickadee, ruffed grouse, mule deer, blue grouse, sharp-tailed grouse, ring-necked pheasant, and peregrine falcon.

  20. Ocean Thermal Energy Conversion (OTEC) test facilities study program. Final report. Volume I

    Energy Technology Data Exchange (ETDEWEB)

    None

    1977-01-17

    A comprehensive test program has been envisioned by ERDA to accomplish the OTEC program objectives of developing an industrial and technological base that will lead to the commercial capability to successfully construct and economically operate OTEC plants. This study was performed to develop alternative non-site specific OTEC test facilities/platform requirements for an integrated OTEC test program including both land and floating test facilities. A progression of tests was established in which OTEC power cycle component designs proceed through advanced research and technology, component, and systems test phases. This progression leads to the first OTEC pilot plant and provides support for following developments which potentially reduce the cost of OTEC energy. It also includes provisions for feedback of results from all test phases to enhance modifications to existing designs or development of new concepts. The tests described should be considered as representative of generic types since specifics can be expected to change as the OTEC plant design evolves. Emphasis is placed on defining the test facility which is capable of supporting the spectrum of tests envisioned. All test support facilities and equipment have been identified and included in terms of space, utilities, cost, schedule, and constraints or risks. A highly integrated data acquisition and control system has been included to improve test operations and facility effectiveness through a centralized computer system capable of automatic test control, real-time data analysis, engineering analyses, and selected facility control including safety alarms. Electrical power, hydrogen, and ammonia are shown to be technically feasible as means for transmitting OTEC power to a land-based distribution point. (WHK)

  1. Development and perceived effects of an educational programme on quality and safety in medication handling in residential facilities.

    Science.gov (United States)

    Mygind, Anna; El-Souri, Mira; Rossing, Charlotte; Thomsen, Linda Aagaard

    2017-03-27

    To develop and test an educational programme on quality and safety in medication handling for staff in residential facilities for the disabled. The continuing pharmacy education instructional design model was used to develop the programme with 22 learning objectives on disease and medicines, quality and safety, communication and coordination. The programme was a flexible, modular seven + two days' course addressing quality and safety in medication handling, disease and medicines, and medication supervision and reconciliation. The programme was tested in five Danish municipalities. Municipalities were selected based on their application for participation; each independently selected a facility for residents with mental and intellectual disabilities, and a facility for residents with severe mental illnesses. Perceived effects were measured based on a questionnaire completed by participants before and after the programme. Effects on motivation and confidence as well as perceived effects on knowledge, skills and competences related to medication handling, patient empowerment, communication, role clarification and safety culture were analysed conducting bivariate, stratified analyses and test for independence. Of the 114 participants completing the programme, 75 participants returned both questionnaires (response rate = 66%). Motivation and confidence regarding quality and safety in medication handling significantly improved, as did perceived knowledge, skills and competences on 20 learning objectives on role clarification, safety culture, medication handling, patient empowerment and communication. The programme improved staffs' motivation and confidence and their perceived ability to handle residents' medication safely through improved role clarification, safety culture, medication handling and patient empowerment and communication skills. © 2017 Royal Pharmaceutical Society.

  2. Environmental Assessment for decontaminating and decommissioning the General Atomics Hot Cell Facility. Final [report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-01

    This EA evaluates the proposed action to decontaminate and decommission GA`s hot cell facility in northern San Diego, CA. This facility has been used for DOE and commercial nuclear R&D for > 30 years. About 30,000 cubic feet of decontamination debris and up to 50,000 cubic feet of contaminated soil are to be removed. Low-level radioactive waste would be shipped for disposal. It was determined that the proposal does not constitute a major federal action significantly affecting the human environment according to NEPA; therefore, a finding of no significant impact is made, and an environmental impact statement is not required.

  3. Final Corrective Action Study for the Former CCC/USDA Facility in Hanover, Kansas

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, Lorraine M. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2013-11-01

    Low concentrations of carbon tetrachloride in groundwater and vapor intrusion into a limited number of residences (attributable to the contaminant concentrations in groundwater) have been identified in Hanover, Kansas, at and near a grain storage facility formerly leased and operated by the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA). At the request of the Kansas Department of Health and Environment (KDHE 2009h), the CCC/USDA has prepared this Corrective Action Study (CAS) for the facility. The CAS examines corrective actions to address the contamination in groundwater and soil vapor.

  4. Medication incident reporting in residential aged care facilities: Limitations and risks to residents’ safety

    Directory of Open Access Journals (Sweden)

    Tariq Amina

    2012-11-01

    Full Text Available Abstract Background Medication incident reporting (MIR is a key safety critical care process in residential aged care facilities (RACFs. Retrospective studies of medication incident reports in aged care have identified the inability of existing MIR processes to generate information that can be used to enhance residents’ safety. However, there is little existing research that investigates the limitations of the existing information exchange process that underpins MIR, despite the considerable resources that RACFs’ devote to the MIR process. The aim of this study was to undertake an in-depth exploration of the information exchange process involved in MIR and identify factors that inhibit the collection of meaningful information in RACFs. Methods The study was undertaken in three RACFs (part of a large non-profit organisation in NSW, Australia. A total of 23 semi-structured interviews and 62 hours of observation sessions were conducted between May to July 2011. The qualitative data was iteratively analysed using a grounded theory approach. Results The findings highlight significant gaps in the design of the MIR artefacts as well as information exchange issues in MIR process execution. Study results emphasized the need to: a design MIR artefacts that facilitate identification of the root causes of medication incidents, b integrate the MIR process within existing information systems to overcome key gaps in information exchange execution, and c support exchange of information that can facilitate a multi-disciplinary approach to medication incident management in RACFs. Conclusions This study highlights the advantages of viewing MIR process holistically rather than as segregated tasks, as a means to identify gaps in information exchange that need to be addressed in practice to improve safety critical processes.

  5. Evaluation of Antidiabetic Prescriptions from Medical Reimbursement Applications at Banaras Hindu University Health Care Facility

    Directory of Open Access Journals (Sweden)

    Dev Priya

    2015-10-01

    Full Text Available Background: Diabetes is on rapid increase in third world countries undergoing rapid transition in terms of development particularly in India, which is often being referred as Diabetic capital. It is a disease more prevalent at latter part of life of human beings when finances dwindle and social care gets neglected. The medication continues till the whole life on a regular basis. In present study, the objective has been to provide pharmacoeconomic medication to the diabetic pensioners in the backdrop as mentioned in above background.Methods: The data was collected at the medical reimbursement section of pensioners of the University. The data was examined to answer issues of therapeutic decisions in the light of the pharmacoeconomic considerations. In this paper essentially data on choice of prescriptions with the angle of pharmacoeconomic prudence were included. The dichotomy of specialist versus non specialist prescribers at the tertiary center (i.e. medical college hospital was compared. Effort was made to define merit of the prescription based on comprehensive considerations of patient profile, disease profile and therapeutic choice.Results: Total 72 prescriptions were analyzed for the study in which 475 drugs were prescribed to the patients.  Total antidiabetic drugs prescribed to the patients were 169. Out of 72 cases 39 were males and 33 were females with mean age 66.04 ± 5.80 (Mean ± SEM. The average number of drugs per prescription was 6.59 which was very high as per guidelines. Most commonly prescribed antidiabetic drug was Metformin (63.89% followed by Glimepiride (31.95%.Conclusion: This study reflects that there is need to make available the standard therapeutic optionat University Health Care Facility based upon pharmacoeconomic considerations.

  6. [CERN-MEDICIS (Medical Isotopes Collected from ISOLDE): a new facility].

    Science.gov (United States)

    Viertl, David; Buchegger, Franz; Prior, John O; Forni, Michel; Morel, Philippe; Ratib, Osman; Bühler Léo H; Stora, Thierry

    2015-06-17

    CERN-MEDICIS is a facility dedicated to research and development in life science and medical applications. The research platform was inaugurated in October 2014 and will produce an increasing range of innovative isotopes using the proton beam of ISOLDE for fundamental studies in cancer research, for new imaging and therapy protocols in cell and animal models and for preclinical trials, possibly extended to specific early phase clinical studies (phase 0) up to phase I trials. CERN, the University Hospital of Geneva (HUG), the University Hospital of Lausanne (CHUV), the Swiss Institute for Experimental Cancer (ISREC) at Swiss Federal Institutes of Technology (EPFL) that currently support the project will benefit of the initial production that will then be extended to other centers.

  7. Evaluation of RayXpert® for shielding design of medical facilities

    Science.gov (United States)

    Derreumaux, Sylvie; Vecchiola, Sophie; Geoffray, Thomas; Etard, Cécile

    2017-09-01

    In a context of growing demands for expert evaluation concerning medical, industrial and research facilities, the French Institute for radiation protection and nuclear safety (IRSN) considered necessary to acquire new software for efficient dimensioning calculations. The selected software is RayXpert®. Before using this software in routine, exposure and transmission calculations for some basic configurations were validated. The validation was performed by the calculation of gamma dose constants and tenth value layers (TVL) for usual shielding materials and for radioisotopes most used in therapy (Ir-192, Co-60 and I-131). Calculated values were compared with results obtained using MCNPX as a reference code and with published values. The impact of different calculation parameters, such as the source emission rays considered for calculation and the use of biasing techniques, was evaluated.

  8. Dental emergency rates at two expeditionary medical support facilities supporting operations enduring and Iraqi Freedom.

    Science.gov (United States)

    Dunn, William J; Langsten, Robert E; Flores, Salvador; Fandell, Jay E

    2004-07-01

    This study reports dental emergency rates and distribution of causes of dental emergencies at two expeditionary medical support facilities supporting operations Enduring Freedom/ Iraqi Freedom. A retrospective cohort analysis of 9948 soldiers deployed to Prince Sultan Air Base, Kingdom of Saudi Arabia, and 1467 soldiers at Baghdad International Airport, Iraq, was accomplished from a phased deployment from January 2003 to September 2003. Procedures were divided into 11 categories: endodontic, extraction of teeth other than third molars, extraction of third molar teeth, restoration of teeth (caries), restoration of broken teeth (not caries), orthodontic bracket/wire problem, sensitive teeth, temperomandibular pain, periodontal, oral pathology, and prosthodontic. The dental emergency rates for Prince Sultan Air Base and Baghdad International Airport were 153 and 145 dental emergencies per 1000 soldiers per year, respectively. Most of the emergencies were because of dental caries. Pain from third molars was the second most common reason for visiting the dental clinic.

  9. Reed Reactor Facility final report, September 1, 1994--August 31, 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-09-01

    This report covers the period from September 1, 1994 to August 31, 1995. Information contained in this report is intended to fulfill several purposes including the reporting requirements of the US Nuclear Regulatory Commission (USNRC), the US Department of Energy (USDOE), and the Oregon Department of Energy (ODOE). Highlights of the last year include: student participation in the program is very high; the facility has been extraordinarily successful in obtaining donated equipment from Portland General Electric, US Department of Energy, Precision Castparts, Tektronix, and other sources; the facility is developing more paid work. There were 1,115 visits of the Reactor Facility by individuals during the year. Most of these visitors were students in classes at Reed College or area universities, colleges, and high schools. During the year, the reactor was operated 225 separate times on 116 days. The total energy production was 24.6 MW-hours. The reactor staff consists of a Director, an Associate Director, a contract Health Physicist, and approximately fifteen Reed College undergraduate students as hourly employees. All radiation exposures to individuals during this year were well below 1% of the federal limits. There were no releases of liquid radioactive material from the facility and airborne releases (primarily {sup 41}Ar) were well within regulatory limits.

  10. Final report of the radiological release survey of Building 54 at the Grand Junction Office Facility

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, R.K.; Corle, S.G.

    1997-09-01

    The U.S. Department of Energy (DOE) Grand Junction Office (GJO) occupies a 61.7-acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore concentrates and mill tailings during vanadium refining activities of the Manhattan Engineer District, and during sampling, assaying, pilot milling, storage, and brokerage activities conducted for the U.S. Atomic Energy Commission`s domestic uranium procurement program. The DOE Defense Decontamination and Decommissioning Program established the GJO Remedial Action Project (GJORAP) to clean up and restore the facility lands, improvements, and underlying aquifer. WASTREN-Grand Junction is the site contractor for the facility and the remedial action contractor for GJORAP. Building 54 and the underlying soil were found not to be radiologically contaminated, and can be released for unrestricted use. Placards have been placed at the building entrances indicating the completion of the radiological release survey and prohibiting the introduction of any radioactive materials within the building without written approvals from the GJO Facilities Operations Manager. This document was prepared in response to a DOE-GJO request for an individual release report for each GJO building.

  11. Status Review of Wildlife Mitigation, Columbia Basin Hydroelectric Projects, Columbia River Mainstem Facilities, 1984 Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Howerton, Jack; Hwang, Diana

    1984-11-01

    This report reviews the status of past, present, and proposed future wildlife planning and mitigation programs at existing hydroelectric projects in the Columbia River Basin. The project evaluations will form the basis for determining any needed remedial measures or additional project analysis. Each hydropower facility report is abstracted separately for inclusion in the Energy Data Base.

  12. Pima Community College Facilities Specification for a Library/Student Center Prototype. Final [Report].

    Science.gov (United States)

    Paulien, Daniel K.; Thibodeau, Yvonne

    This document is a description of a prototype Library/Student Center designed to serve approximately 10,000 students at a comprehensive campus. Prepared by the firm Paulien & Associates, Inc., of Denver, Colorado, this prototype will serve a design basis for facilities at all Pima Community College (PCC) campuses. The prototype will not be…

  13. Implementation of the Credit Enhancement for Charter School Facilities Program. Final Report

    Science.gov (United States)

    Temkin, Kenneth; Hong, Grace; Davis, Laurel; Bavin, William

    2008-01-01

    The number of charter schools has grown rapidly from 250 in 1995 to about 4,000 by 2007, now enrolling more than 1.1 million students in the United States. Charter schools face many challenges when they attempt to purchase or lease permanent facilities and frequently operate in temporary space that is poorly suited for delivering educational…

  14. Gamma Irradiation Facility at Sandia National Laboratories, Albuquerque, New Mexico. Final environmental assessment

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-11-01

    The US Department of Energy (DOE) has prepared an environmental assessment (EA) on the proposed construction and operation of a new Gamma Irradiation Facility (GIF) at Sandia National Laboratories/New Mexico (SNL/NM). This facility is needed to: enhance capabilities to assure technical excellence in nuclear weapon radiation environments testing, component development, and certification; comply with all applicable ES and H safeguards, standards, policies, and regulations; reduce personnel radiological exposure to comply with ALARA limits in accordance with DOE orders and standards; consolidate major gamma ray sources into a central, secured area; and reduce operational risks associated with operation of the GIF and LICA in their present locations. This proposed action provides for the design, construction, and operation of a new GIF located within TA V and the removal of the existing GIF and Low Intensity Cobalt Array (LICA). The proposed action includes potential demolition of the gamma shield walls and removal of equipment in the existing GIF and LICA. The shielding pool used by the existing GIF will remain as part of the ACRR facility. Transportation of the existing {sup 60}Co sources from the existing LICA and GIF to the new facility is also included in the proposed action. Relocation of the gamma sources to the new GIF will be accomplished by similar techniques to those used to install the sources originally.

  15. 78 FR 16279 - HUD Healthcare Facility Documents: Notice Announcing Final Approved Documents and Assignment of...

    Science.gov (United States)

    2013-03-14

    ... kind of transfer, with HUD's consent. HUD notes, however, that according to the Financial Accounting... varied their references to specific provisions in the documents; sometimes the commenters referred to the provision in the healthcare facility document as sections, subsections, and paragraphs. Efforts have...

  16. Status Review of Wildlife Mitigation at Columbia Basin Hydroelectric Projects, Oregon Facilities, Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Bedrossian, Karen L.

    1984-08-01

    The report presents a review and documentation of existing information on wildlife resources at Columbia River Basin hydroelectric facilities within Oregon. Effects of hydroelectric development and operation; existing agreements; and past, current and proposed wildlife mitigation, enhancement, and protection activities were considered. (ACR)

  17. Drug prescription based on WHO indicators: Tehran university of medical sciences facilities with pharmacy

    Directory of Open Access Journals (Sweden)

    Mosleh A.

    2007-11-01

    Full Text Available Background: Rationalize of drug use in societies is one of the main responsibilities of health policy makers. In our country irrational use of dugs has increased in the recent years, for example one study in 1998 has shown that average number of medicines per prescription was 3.6, percentage of prescriptions containing antibiotics was 43% and percentage of prescriptions containing Injections was 39%. One of the best tools for evaluation of drug use is the WHO guideline for calculating prescribing indicators. In this study, we had an assessment about prescribing patterns in South of Tehran, Islamshahr and Rey Health Centers.Methods: In order to evaluating prescribing indicators in Tehran University of Medical Sciences region 35 facilities which had pharmacy were selected according to WHO gridline and 4190 prescription from these facilities were studied. Indicators were calculated according to formulas has explained in article. Results: The average number of drug per prescription was 2.58, percentage of drug prescribed by generic name: 99.8%, percentage of encounters prescribed Antibiotics: 62.39% percentage of encounters prescribed Injection: 28.96% & the percentage of drugs prescribed from PHC formulary 99.46%. These findings were almost similar in the three Health Centers.Conclusions: Health facilities are one of the most important bases to improve rational use of Drugs and general practitioners are the major chain in RUD cycle. Results show that we need to design intervention especially educational interventions to improve two WHO prescribing indicators, percentage of encounters prescribed Antibiotics & Injections in this region. For reaching this goals we need to design educational programs for physicians, pharmacists and people too. These educations can be as workshops, seminars, conferences or printed materials such as books, leaflets and etc.

  18. Introducing DartMouse: The Mouse Speed Congenic Facility at Dartmouth Medical School

    Science.gov (United States)

    Trask, H.; Tomlinson, C.; Fiering, S.; Gorham, J.D.; Muirhead, K.

    2010-01-01

    CF-9 DartMouse™ is the Mouse Speed Congenic Facility at Dartmouth Medical School. Use of DartMouse allows for the rapid introgression of modified genes onto any inbred strain of mouse. Speed congenic strains of mice are achievable in 5 generations (1 to 1.5 years), versus 10 generations (∼3 years) required by conventional back-crossing. The application of DartMouse services saves both money and time for researchers using the laboratory mouse for any number of pre-clinical disease models. DartMouse is a complete service facility that works closely with clients at and outside of Dartmouth, helping to design appropriate breeding schemes to optimize back-crossing speed and efficiency. Clients supply mouse tail snips. DartMouse isolates genomic DNA, performs and analyzes complete genome-wide scans, and returns data in graphical and spreadsheet formats. DartMouse discusses results with clients and makes specific recommendations on breeder selection. DartMouse uses “SNP-Chip” technology on an Illumina BeadStation 500 Platform. Chips use a 377 SNP array covering the mouse genome with an average interval density of <7 cM. Turnaround time from receipt of tails to results is typically <2 weeks. One of DartMouse's most popular services is the “background check” in which the genetic background of supposedly fully back-crossed mice can be thoroughly assessed across all chromosomes. DartMouse was inaugurated in the summer of 2008, and received ARRA-funding in the fall of 2009. Our plans are to make DartMouse a regional and national core facility for the generation of speed congenic mice and for the verification of genetic background for conventionally back-crossed mice.

  19. Woodbridge research facility remedial investigation/feasibility study. Health and safety plan. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, P.; McKown, G.; Waugh, J.; Houser, W.; Joy, G.

    1995-09-01

    The requirements set forth in 29 CFR 1910.120(f), shall be met for all employees performing or supervising hazardous waste operations. Medical exams shall be conducted as soon as possible upon notification by an employee that he/she has developed signs or symptoms indicating possible health hazards or overexposure to hazardous substances. Subcontractor personnel shall provide documentation of current status of participation in a medical surveillance program as required by 29 CFR 1910.120(f). Subcontractors unable to provide such documentation shall have successfully completed a medical examination as described in the above referenced OSHA standard prior to beginning work in a contaminated zone. Specific protocols for medical examinations are designed by an occupational physician. Common components include: (a) medical history and physical examination; (b) dipstick urinalysis, vision screen and vital signs; (c) spirometry ;(d) audiometry; (e) blood chemistry (complete blood count, liver function, kidney function, lipid metabolism, carbohydrate metabolism); (f) resting EkG (with approval); (g) chest radiograph (P/A). No project-specific medical examinations, or biological monitoring is required for this project.

  20. Final report of the radiological release survey of Building 30B at the Grand Junction Office Facility

    Energy Technology Data Exchange (ETDEWEB)

    Krauland, P.A.; Corle, S.G.

    1997-09-01

    The U.S. Department of Energy (DOE) Grand Junction Office (GJO) occupies a 61.7-acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore concentrates and mill tailings during vanadium refining activities of the Manhattan Engineer District, and during sampling, assaying, pilot milling, storage, and brokerage activities conducted for the U.S. Atomic Energy Commission`s domestic uranium procurement program. The DOE Defense Decontamination and Decommissioning Program established the GJO Remedial Action Project (GJORAP) to clean up and restore the facility lands, improvements, and underlying aquifer. WASTREN-Grand Junction is the site contractor for the facility and the remedial action contractor for GJORAP. Building 30B and the underlying soil were found not to be radiologically contaminated; therefore, the building can be released for unrestricted use. Placards have been placed at the building entrances indicating the completion of the radiological release survey and prohibiting the introduction of any radioactive materials within the building without written approvals from the GJO Facilities Operations Manager. This document was prepared in response to a DOE-GJO request for an individual final release report for each GJO building.

  1. Dental emergency rates at an expeditionary medical support facility supporting Operation Enduring Freedom.

    Science.gov (United States)

    Dunn, William Jackson

    2004-05-01

    The purpose of this study was to report the dental emergency rate and the distribution of cause of dental emergencies at an Expeditionary Medical Support +25 medical facility during a 6-month deployment in support of Operation Enduring Freedom. A retrospective cohort analysis of 1,972 soldiers stationed at Seeb Air Base, Sultanate of Oman, was accomplished from a phased deployment from March to September 2002. Procedures were divided into 11 categories: endodontic, extraction of teeth other than third molars, extraction of third molar teeth, restoration of teeth (caries), restoration of broken teeth (not caries), orthodontic bracket/wire problem, sensitive teeth, temperomandibular pain, periodontal, oral pathology, and prosthodontic. One hundred thirty-five dental emergency visits were recorded, corresponding to a rate of 137 dental emergencies per 1,000 soldiers per year. Most of the emergencies (34.8%) were due to caries. Pain from third molars was the second most common reason for visiting the dental clinic (19.3%).

  2. Diagnostic development and support of MHD test facilities. Final progress report, March 1980--March 1994

    Energy Technology Data Exchange (ETDEWEB)

    1995-02-01

    The Diagnostic Instrumentation and Analysis Laboratory (DIAL) at Mississippi State University (MSU), under U.S. Department of Energy (DOE) Contract No. DE-AC02-80ET-15601, Diagnostic Development and Support of MHD Test Facilities, developed diagnostic instruments for magnetohydrodynamic (MHD) power train data acquisition and for support of MHD component development test facilities. Microprocessor-controlled optical instruments, initially developed for Heat Recovery/Seed Recovery (HRSR) support, were refined, and new systems to measure temperatures and gas-seed-slag stream characteristics were developed. To further data acquisition and analysis capabilities, the diagnostic systems were interfaced with DIAL`s computers. Technical support was provided for the diagnostic needs of the national MHD research effort. DIAL personnel also cooperated with government agencies and private industries to improve the transformation of research and development results into processes, products and services applicable to their needs. The initial contract, Testing and Evaluation of Heat Recovery/Seed Recovery, established a data base on heat transfer, slagging effects on heat transfer surfaces, metal durability, secondary combustor performance, secondary combustor design requirements, and other information pertinent to the design of HR/SR components at the Coal-Fired Flow Facility (CFFF). To accomplish these objectives, a combustion test stand was constructed that simulated MHD environments, and mathematical models were developed and evaluated for the heat transfer in hot-wall test sections. Two transitions occurred during the span of this contract. In May 1983, the objectives and title of the contract changed from Testing and Evaluation of Heat Recovery/Seed Recovery to Diagnostic Development and Support of MHD Test Facilities. In July 1988, the research laboratory`s name changed from the MHD Energy Center to the Diagnostic Instrumentation and Analysis Laboratory.

  3. Premier`s Task Force on NAFTA wind turbine manufacturing facility and windpower plants : final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-03-01

    The proposal for a 700 MW wind farm and associated manufacturing facility at Pincher Creek, Alberta was discussed. York WindPower and ENERCON submitted the joint proposal in the spring of 1996 and requested a financial arrangement to guarantee a sale price of 5.4 cents per kWh (escalated) over 25 years. This was later revised in February, 1997 to 350 MW, 4.9 cents per kWh (escalated) over 15 years. A Task Force was established to assess this proposal and any other prospects for development of renewables in general. The two inseparable elements of the proposed project would be a manufacturing facility which would produce approximately 400 wind turbines a year, and a 700 MW wind farm, phased in over 10 years. The size of the wind farm would be based on a calculation of the minimal annual production required for the manufacturing facility to be viable. Pincher Creek residents are supportive of renewable energy and have been promoting wind energy long before the York/ENERCON proposal. They view this project as a support for regional economic development. The Task Force was pleased that York/ENERCON is pursuing the Alberta Advantage and is considering setting up a manufacturing facility. The Task Force did not seek to make a finding with respect to the business viability of the project, instead, the Task Force concluded that the commercial test for the project should be provided by competition in the marketplace. Nevertheless, the Task Force is supportive of the project, provided it proceeds on a voluntary, market-driven basis, and there are no conflicts with the existing government policy framework. 4 tabs., 2 appendices.

  4. Purdue University National Biomedical Tracer Facility: Project definition phase. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Green, M.A.

    1995-02-15

    The proposed National Biomedical Tracer Facility (NBTF) will house a high-current accelerator dedicated to production of short-lived radionuclides for biomedical and scientific research. The NBTF will play a vital role in repairing and maintaining the United States` research infrastructure for generation of essential accelerator-based radioisotopes. If properly designed and managed, the NBTF should also achieve international recognition as a Center-of-Excellence for research on radioisotope production methods and for associated education and training. The current report documents the results of a DOE-funded NBTF Project Definition Phase study carried out to better define the technical feasibility and projected costs of establishing and operating the NBTF. This report provides an overview of recommended Facility Design and Specifications, including Accelerator Design, Building Design, and the associated Construction Cost Estimates and Schedule. It is recommended that the NBTF be established as an integrated, comprehensive facility for meeting the diverse production, research, and educational missions set forth in previous documents. Based on an analysis of the projected production demands that will be placed on the NBTF, it appears that a 70 MeV, 1 mA, negative ion cyclotron will offer a good balance between production capabilities and the costs of accelerator purchase and operation. A preliminary architectural plan is presented for a facility designed specifically to fulfill the functions of the NBTF in a cost-effective manner. This report also presents a detailed analysis of the Required Federal State, and Local Permits that may be needed to establish the NBTF, along with schedules and cost estimates for obtaining these permits. The Handling, Storage, and Disposal of Radioactive Waste will pose some significant challenges in the operation of the NBTF, but at this stage of planning the associated problems do not appear to be prohibitive.

  5. Surrogate Final Technical Report for "Solar: A Photovoltaic Manufacturing Development Facility"

    Energy Technology Data Exchange (ETDEWEB)

    Farrar, Paul [State University of New York Research Foundation, Albany, NY (United States)

    2014-06-27

    The project goal to create a first-of-a-kind crystalline Silicon (c-Si) photovoltaic (PV) Manufacturing & Technology Development Facility (MDF) that will support the growth and maturation of a strong domestic PV manufacturing industry, based on innovative and differentiated technology, by ensuring industry participants can, in a timely and cost-effective manner, access cutting-edge manufacturing equipment and production expertise needed to accelerate the transition of innovative technologies from R&D into manufacturing.

  6. Final turbine and test facility design report Alden/NREC fish friendly turbine

    Energy Technology Data Exchange (ETDEWEB)

    Cook, Thomas C. [Alden Research Lab., Holden, MA (United States); Cain, Stuart A. [Alden Research Lab., Holden, MA (United States); Fetfatsidis, Paul [Alden Research Lab., Holden, MA (United States); Hecker, George E. [Alden Research Lab., Holden, MA (United States); Stacy, Philip S. [Alden Research Lab., Holden, MA (United States)

    2000-09-01

    The final report provides an overview of the Alden/NREC Fish Friendly turbine design phase, turbine test plan, preliminary test results, costs, schedule, and a hypothetical application at a real world project.

  7. Environmental assessment for device assembly facility operations, Nevada Test Site, Nye County, Nevada. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-05-01

    The U.S. Department of Energy, Nevada Operations Office (DOE/NV), has prepared an environmental assessment (EA), (DOE/EA-0971), to evaluate the impacts of consolidating all nuclear explosive operations at the newly constructed Device Assembly Facility (DAF) in Area 6 of the Nevada Test Site. These operations generally include assembly, disassembly or modification, staging, transportation, testing, maintenance, repair, retrofit, and surveillance. Such operations have previously been conducted at the Nevada Test Site in older facilities located in Area 27. The DAF will provide enhanced capabilities in a state-of-the-art facility for the safe, secure, and efficient handling of high explosives in combination with special nuclear materials (plutonium and highly enriched uranium). Based on the information and analyses in the EA, DOE has determined that the proposed action would not constitute a major federal action significantly affecting the quality of the human environment within the meaning of the National Environmental Policy Act of 1969 (42 U.S.C. 4321 et seq.). Therefore, an environmental impact statement is not required, and DOE is issuing this finding of no significant impact.

  8. DOE final report, phase one startup, Waste Receiving and Processing Facility (WRAP)

    Energy Technology Data Exchange (ETDEWEB)

    Jasen, W.G.

    1998-01-07

    This document is to validate that the WRAP facility is physically ready to start up phase 1, and that the managers and operators are prepared to safely manage and operate the facility when all pre-start findings have been satisfactorily corrected. The DOE Readiness Assessment (RA) team spent a week on-site at Waste Receiving and Processing Module 1 (WRAP-1) to validate the readiness for phase 1 start up of facility. The Contractor and DOE staff were exceptionally cooperative and contributed significantly to the overall success of the RA. The procedures and Conduct of Operations areas had significant discrepancies, many of which should have been found by the contractor review team. In addition the findings of the contractor review team should have led the WRAP-1 management team to correcting the root causes of the findings prior to the DOE RA team review. The findings and observations include many issues that the team believes should have been found by the contractor review and corrective actions taken. A significantly improved Operational Readiness Review (ORR) process and corrective actions of root causes must be fully implemented by the contractor prior to the performance of the contractor ORR for phase 2 operations. The pre-start findings as a result of this independent DOE Readiness Assessment are presented.

  9. Final work plan : investigation of potential contamination at the former USDA facility in Powhattan, Kansas.

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, L. M.; Environmental Science Division

    2007-02-02

    This Work Plan outlines the scope of work to be conducted to investigate the subsurface contaminant conditions at the property formerly leased by the Commodity Credit Corporation (CCC) in Powhattan, Kansas (Figure 1.1). Data obtained during this event will be used to (1) evaluate potential contaminant source areas on the property; (2) determine the vertical and horizontal extent of potential contamination; and (3) provide recommendations for future action, with the ultimate goal of assigning this site No Further Action status. The planned investigation includes groundwater monitoring requested by the Kansas Department of Health and Environment (KDHE), in accordance with Section V of the Intergovernmental Agreement between the KDHE and the Farm Service Agency of the U.S. Department of Agriculture (USDA). The work is being performed on behalf of the CCC/USDA by the Environmental Science Division of Argonne National Laboratory. A nonprofit, multidisciplinary research center operated by the University of Chicago for the U.S. Department of Energy, Argonne provides technical assistance to the CCC/USDA with environmental site characterization and remediation at former CCC/USDA grain storage facilities. Argonne issued a Master Work Plan (Argonne 2002) that has been approved by the KDHE. The Master Work Plan describes the general scope of all investigations at former CCC/USDA facilities in Kansas and provides guidance for these investigations. It should be consulted for the complete details of plans for work associated with the former CCC/USDA facility at Powhattan.

  10. The Photovoltaic Higher Education National Exemplar Facility (PHENEF). Final report, [August 1, 1980--September 30, 1991

    Energy Technology Data Exchange (ETDEWEB)

    Podbielski, V.; Shaff, D.

    1994-04-01

    In August 1980, the US Department of Energy awarded the proposed grant to Georgetown University. The grant covered the following tasks: Task 1, The Department of Energy would participate in the building of an academic facility that would facilitate the integration of flat plate photovoltaic roof modules with an optimally oriented solar architecture. The completion of the facility to be built on the Georgetown University Campus and known as the Georgetown University Intercultural Center was to be a jointly funded endeavor with the Department of Education funding $9.2M through a grant and a loan, Department of Energy funding a maximum of $4M and Georgetown University funding the residual costs. Task II, Georgetown University would provide the necessary skills, services, materials, equipment and facilities to design, furnish, install and make operational the Georgetown University Intercultural Center Photovoltaic System. The specific objective of this effort would be to build an exemplar flat plate electrical grid connected photovoltaic (PV) system which would demonstrate integration of PV modules into a watertight roofing surface. The system capability, measured at the input to the inverter, would be a 300 kilowatt peak power system as measured at the normal cell operating temperature and an isolation of 100 milliwatts per square centimeter at the collector surface. DOE funding under the grant for the PV system would be limited to a system cost of $20.00 per peak watt up to maximum of six million dollars.

  11. Final closure cover for a Hanford radioactive mixed waste disposal facility

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, K.D.

    1996-02-06

    This study provides a preliminary design for a RCRA mixed waste landfill final closure cover. The cover design was developed by a senior class design team from Seattle University. The design incorporates a layered design of indigenous soils and geosynthetics in a layered system to meet final closure cover requirements for a landfill as imposed by the Washington Administrative Code WAC-173-303 implementation of the Resource Conservation and Recovery Act.

  12. Perceived stress at transition to workplace: a qualitative interview study exploring final-year medical students’ needs

    Directory of Open Access Journals (Sweden)

    Moczko TR

    2016-01-01

    Full Text Available Tobias R Moczko,1,2,* Till J Bugaj,1,* Wolfgang Herzog,1 Christoph Nikendei1 1Department for General Internal and Psychosomatic Medicine, University Hospital of Heidelberg, Heidelberg, 2School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany *These authors contributed equally to this work Objectives: This study was designed to explore final-year medical students’ stressors and coping strategies at the transition to the clinical workplace. Methods: In this qualitative study, semi-standardized interviews with eight final-year medical students (five male, three female; aged 25.9±1.4 years were conducted during their internal medicine rotation. After verbatim transcription, a qualitative content analysis of students’ impressions of stress provoking and easing factors during final-year education was performed. Results: Students’ statements regarding burdens and dealing with stress were classified into four main categories: A perceived stressors and provoking factors, B stress-induced consequences, C personal and external resources for preventing and dealing with stress, and D final-year students’ suggestions for workplace improvement. Conclusion: Final-year medical students perceived different types of stress during their transition to medical wards, and reported both negative consequences and coping resources concerning perceived stress. As supervision, feedback, and coping strategies played an important role in the students’ perception of stress, final-year medical education curricula development should focus on these specifically. Keywords: undergraduate medical education, stress prevention, final-year medical education, workplace learning, qualitative research

  13. Reflective writing by final year medical students: lessons for curricular change.

    Science.gov (United States)

    Ganesh, Alka; Ganesh, Gayatri

    2010-01-01

    Reflective writinghas been used in undergraduate medical curricula to inculcate empathetic attitudes in medical students. Journal writing has been used to enhance reflection in a confidential space. We aimed to introduce our medical students to reflective writing of their daily experiences, both to enhance empathetic attitudes as well as to use the entries to Inform curricular changes. We invited 16 final year medical students posted in the Department of Medicine to record their emotional experiences during a 6-week posting. Freedom to abstain without prejudice was emphasized, yet all 16 students complied. According to the principle of grounded theory, the entries were grouped into 8 themes: (i) doctor-patient relationship; (ii) personal inadequacy; (iii) empathy; (iv) communication skills; (v) doctor's competence; (vi) patient behaviour; (vii) hospital practices; and (viii) personal feelings. There were 179 entries which were evaluable under the above categories, with no significant gender differences. Based on the entries, the following curricular suggestions were made: (i) use of diaries by medical students to express their emotional reactions and make value judgements, followed by guided discussion by experienced facilitators; (ii) introduction of communication skills courses at appropriate points to enhance Interview skills, empathetic listening, conflict resolution and breaking bad news; (iii) encourage reflection on healthcare delivery and its inequities and suggest methods of dealing with individual patients; and (iv) use of positive feedback and encouragement by faculty. Conclusions. Reflective journal writing by medical students in India gives valuable insights into improving communication skills and professionalism. Appropriate curricular changes should be made to meet the challenges posed by the existing healthcare system.

  14. Smartphones and professionalism: A cross-sectional study on interns and final-year medical students

    Directory of Open Access Journals (Sweden)

    Saleh Alqaryan

    2016-09-01

    Full Text Available The smartphone is a powerful tool that can be used to improve the health care system as long as certain checks and balances are implemented. It is commonly used by health care providers and medical students. A cross-sectional study conducted at Qassim University, Saudi Arabia. Final-year medical students and interns were included. A survey was distributed and divided into three sections: personal technology, experiences of using smartphones during clinical rotations, and attitudes about the usage of smartphones for clinical work. A total of 156 interns and students participated in the study. All of them owned a smartphone. Three-quarters of the respondents used their mobile for personal purposes, while 71.2% used them to look up medical references and resources. Respondents also used personal mobiles to keep in contact with team members regarding patient- (29.5% and non-patientrelated issues (26.3%. Some 16% of participants did not have any security features on their smartphones. Over half the participants did not get proper instructions about using their smartphones from either their medical college or senior residents or consultants. There is a lot to be done in this area, as certain regulations need to be carried out to lead toward a world that is pro-technology, health centered, and safe.

  15. A survey of interventional radiology awareness among final-year medical students in a European country.

    LENUS (Irish Health Repository)

    Leong, Sum

    2009-07-01

    Interventional radiology (IR) is a rapidly expanding specialty that is facing the challenges of turf wars and personnel shortages. Appropriate exposure of medical students to this field can be vital to recruitment of potential future trainees or referring physicians. The aim of this study was to determine the knowledge and views of final-year medical students in a single EU country regarding various aspects of IR. An electronic survey was sent via e-mail to all final-year medical students in a European country. The students were given a month to respond to the questionnaire. A total of 234 students of 675 (34.5%) replied to the survey. Of the respondents, 35% had previously completed an attachment to the radiology department. The majority of students (63%) thought their knowledge in radiology in general was poor. The percentage of students who correctly identified procedures performed by interventional radiologists was 69% for Hickman line insertion, 79% for fibroid embolization, and 67.5% for lower limb angioplasty. Sixty percent, 30%, and 47% thought that interventional radiologists perform cardiac angioplasties, perform arterial bypasses, and create AV fistulas, respectively. Forty-nine percent felt that interventional radiologists are surgically trained. Eighty-three percent of students were first made aware of angioplasty by a cardiologist. Thirty-one percent thought that interventional radiologists do ward rounds, 24% thought that interventional radiologists have admitting rights, and 26% felt that interventional radiologists run an outpatient practice. A significant number of students (76%) thought that the job prospects in IR are good or excellent but only 40.5% were willing to consider a career in IR. In conclusion, this study indicates that IR remains a nascent but attractive specialty to the majority of medical students. Further development of the existing informal undergraduate curriculum to address shortcomings will ensure that IR continues to attract

  16. Medicare Program; Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies. Final rule.

    Science.gov (United States)

    2015-12-30

    This final rule establishes a prior authorization program for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items that are frequently subject to unnecessary utilization. This rule defines unnecessary utilization and creates a new requirement that claims for certain DMEPOS items must have an associated provisional affirmed prior authorization decision as a condition of payment. This rule also adds the review contractor's decision regarding prior authorization of coverage of DMEPOS items to the list of actions that are not initial determinations and therefore not appealable.

  17. Final work plan : investigation of potential contamination at the former USDA facility in Ramona, Kansas.

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, L. M.

    2006-01-27

    This Work Plan outlines the scope of work that will be conducted to investigate the subsurface contaminant conditions at the property formerly leased by the Commodity Credit Corporation (CCC) in Ramona, Kansas (Figure 1.1). Data obtained during this event will be used to (1) evaluate potential source areas on the property, (2) determine the vertical and horizontal extent of potential contamination, and (3) provide recommendations for future actions, with the ultimate goal of assigning this site No Further Action status. The planned investigation includes groundwater monitoring requested by the Kansas Department of Health and Environment (KDHE), in accordance with Section V of the Intergovernmental Agreement between the KDHE and the Farm Service Agency of the United States Department of Agriculture (USDA). The work is being performed on behalf of the CCC/USDA by the Environmental Research Division of Argonne National Laboratory. Argonne is a nonprofit, multidisciplinary research center operated by the University of Chicago for the U.S. Department of Energy. Under the Intergovernmental Agreement, Argonne provides technical assistance to the CCC/USDA with environmental site characterization and remediation at former CCC/USDA grain storage facilities. Argonne has issued a Master Work Plan (Argonne 2002) that describes the general scope of all investigations at former CCC/USDA facilities in Kansas and provides guidance for these investigations. The Master Work Plan was approved by the KDHE. It contains materials common to investigations at locations in Kansas and should be consulted for the complete details of plans for work associated with the former CCC/USDA facility at Ramona.

  18. Advanced accelerator test facility-Final report for the period 9/1/2010 - 8/31/2013

    Energy Technology Data Exchange (ETDEWEB)

    Hirshfield, Jay [Yale Univ., New Haven, CT (United States)

    2014-10-27

    This final report summarizes results achieved in the Beam Physics Laboratory at Yale University during the period 9/1/2010 – 8/31//2013, under DoE grant DE-FG02-07 ER 41504. During the period covered by this report, notable progress in technical consolidation of facilities in the Yale Beam Physics Laboratory has occurred; and theory, design, and fabrication for future experiments have been carried out. In the period covered by this grant, 29 scientific publications based on this work and related topics have appeared in the archival literature. Titles, authors, and citations are listed in Section V of this report.

  19. IFMIF : International Fusion Materials Irradiation Facility Conceptual Design Activity: Final report

    Energy Technology Data Exchange (ETDEWEB)

    Martone, M. [ENEA, Centro Ricerche Frascati, Rome (Italy)

    1997-01-01

    This report documents the results of the Conceptual Design Activity (CDA) on the International Fusion Materials Irradiation Facility (IFMIF), conducted during 1995 and 1996. The activity is under the auspices of the International Energy Agency (IEA) Implementing Agreement for a Programme of Research and Development on Fusion Materials. An IEA Fusion Materials Executive Subcommittee was charged with overseeing the IFMIF-CDA work. Participants in the CDA are the European Union, Japan, and the United States, with the Russian Federation as an associate member.

  20. Hydrazine Blending and Storage Facility, Interim Response Action, Final Implementation Document for Decommissioning, Phase 1

    Science.gov (United States)

    1991-03-18

    PRIMARY OBJECTIVES OF THE IRA 2. SITE INVENTORY - TANKS, PIPING, BUILDINGS, ASBEST , DEBRIS, DRUMS 3. PLAN OF ACTION - TRANSFER OF UNTREATED WASTEWATER...Response Action (IRA) H at thte Hydrazine Blending and Storage Facility (HBSF) located at Rocky Mountain Arsenal (RMA) in Commerce City , Colorado. It was...LOCATION MAP Commerce CIty , Colorado 1A U) Cl)) zr LU .i I 0< 9< z (’ICM ..w co ai >. r 0) IC., Z C’) ________________0 W jl cor cliB destruction of

  1. SUNY beamline facilities at the National Synchrotron Light Source (Final Report)

    Energy Technology Data Exchange (ETDEWEB)

    Coppens, Philip

    2003-06-22

    The DOE sponsored SUNY synchrotron project has involved close cooperation among faculty at several SUNY campuses. A large number of students and postdoctoral associates have participated in its operation which was centered at the X3 beamline of the National Synchrotron Light Source at Brookhaven National Laboratory. Four stations with capabilities for Small Angle Scattering, Single Crystal and Powder and Surface diffraction and EXAFS were designed and operated with capability to perform experiments at very low as well as elevated temperatures and under high vacuum. A large amount of cutting-edge science was performed at the facility, which in addition provided excellent training for students and postdoctoral scientists in the field.

  2. Operational readiness review for the Waste Experimental Reduction Facility. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1993-11-01

    An Operational Readiness Review (ORR) at the Idaho National Engineering Laboratory`s (INEL`s) Waste Experimental Reduction Facility (WERF) was conducted by EG&G Idaho, Inc., to verify the readiness of WERF to resume operations following a shutdown and modification period of more than two years. It is the conclusion of the ORR Team that, pending satisfactory resolution of all pre-startup findings, WERF has achieved readiness to resume unrestricted operations within the approved safety basis. ORR appraisal forms are included in this report.

  3. Final corrective action study for the former CCC/USDA facility in Ramona, Kansas.

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, L. M. (Environmental Science Division)

    2011-04-20

    Past operations at a grain storage facility formerly leased and operated by the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) in Ramona, Kansas, resulted in low concentrations of carbon tetrachloride in groundwater that slightly exceed the regulatory standard in only one location. As requested by the Kansas Department of Health and Environment, the CCC/USDA has prepared a Corrective Action Study (CAS) for the facility. The CAS examines corrective actions to address groundwater impacted by the former CCC/USDA facility but not releases caused by other potential groundwater contamination sources in Ramona. Four remedial alternatives were considered in the CAS. The recommended remedial alternative in the CAS consists of Environmental Use Control to prevent the inadvertent use of groundwater as a water supply source, coupled with groundwater monitoring to verify the continued natural improvement in groundwater quality. The Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) has directed Argonne National Laboratory to prepare a Corrective Action Study (CAS), consistent with guidance from the Kansas Department of Health and Environment (KDHE 2001a), for the CCC/USDA grain storage facility formerly located in Ramona, Kansas. This effort is pursuant to a KDHE (2007a) request. Although carbon tetrachloride levels at the Ramona site are low, they remain above the Kansas Tier 2 risk-based screening level (RBSL) and the U.S. Environmental Protection Agency (EPA) maximum contaminant level (MCL) of 5 {micro}g/L (Kansas 2003, 2004). In its request for the CAS, the KDHE (2007a) stated that, because of these levels, risk is associated with potential future exposure to contaminated groundwater. The KDHE therefore determined that additional measures are warranted to limit future use of the property and/or exposure to contaminated media as part of site closure. The KDHE further requested comparison of at least two corrective

  4. End-of-life attitudes in the Intensive Care Unit (ICU) amongst final year medical students at International Medical University, Malaysia

    OpenAIRE

    Sangeetha Poovaneswaran; Anuradha Poovaneswaran; hiruselvi Subramaniam

    2014-01-01

    With recent medical advances and the availability of newer sophisticated technologies, critically ill patients tend to survive longer.1 Thus, decisions to forgo life-sustaining medical treatment generate challenging issues that all doctors must face. The aim of this pilot study was to assess attitudes towards end-of-life care in ICU which included futile therapy (withholding and withdrawing therapy) among final year medical students who had received the same degr...

  5. Activities to support the liquefied gaseous fuels spill test facility program. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Sheesley, D.; King, S.B.; Routh, T.

    1997-03-01

    Approximately a hundred years ago the petrochemical industry was in its infancy, while the chemical industry was already well established. Today, both of these industries, which are almost indistinguishable, are a substantial part of the makeup of the U.S. economy and the lifestyle we enjoy. It is difficult to identify a single segment of our daily lives that isn`t affected by these industries and the products or services they make available for our use. Their survival and continued function in a competitive world market are necessary to maintain our current standard of living. The occurrence of accidents in these industries has two obvious effects: (1) the loss of product during the accident and future productivity because of loss of a portion of a facility or transport medium, and (2) the potential loss of life or injury to individuals, whether workers, emergency responders, or members of the general public. A great deal of work has been conducted at the Liquefied Gaseous Fuels Spill test Facility (LGFSTF) on hazardous spills. WRI has conducted accident investigations as well as provided information on the research results via the internet and bibliographies.

  6. Status of stack gas control technology. Final report. Part I. [Comparative evaluation of 19 facilities

    Energy Technology Data Exchange (ETDEWEB)

    Rosenberg, H.S.; Ball, D.A.; Engdahl, R.B.; Bloom, S.G.; Anastas, M.Y.; Genco, J.M.; Slack, A.V.; Oxley, J.H.

    1975-08-01

    During 1974, Battelle's Columbus Laboratories (BCL) established a Stack Gas Pollution Control Coordination Center under the sponsorship of the Electric Power Research Institute (EPRI), the American Petroleum Institute (API), and a number of individual companies. One of the specific tasks funded by EPRI was a survey of full-scale operating SO/sub 2/ scrubbing installations in the United States. BCL's experienced chemical and mechanical engineers visited as many of these installations as possible within the constraints of budgetary limitations and of gaining the required permission to inspect the facilities. In fact, all but one or two of the currently operating full-scale SO/sub 2/ scrubbing facilities were visited during 1974, as well as several pilot plants. BCL engineers also visited several power plants which are practicing new methods of particulate control including wet scrubbers, baghouses, and hot electrostatic precipitators. A comprehensive trip report in a standardized format was prepared for each visit. This volume is a compendium of the trip reports.

  7. Healy Clean Coal Project: Healy coal firing at TRW Cleveland Test Facility. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Koyama, T.; Petrill, E.; Sheppard, D.

    1991-08-01

    A test burn of two Alaskan coals was conducted at TRW`s Cleveland test facility in support of the Healy Clean Coal Project, as part of Clean Coal Technology III Program in which a new power plant will be constructed using a TRW Coal Combustion System. This system features ash slagging technology combined with NO{sub x} and SO{sub x} control. The tests, funded by the Alaska Industrial Development and Export Authority (AIDEA) and TRW, were conducted to verify that the candidate Healy station coals could be successfully fired in the TRW coal combustor, to provide data required for scale-up to the utility project size requirements, and to produce sufficient flash-calcined material (FCM) for spray dryer tests to be conducted by Joy/NIRO. The tests demonstrated that both coals are viable candidates for the project, provided the data required for scale-up, and produced the FCM material. This report describes the modifications to the test facility which were required for the test burn, the tests run, and the results of the tests.

  8. Mirror Fusion Test Facility-B (MFTF-B) axicell configuration: NbTi magnet system. Manufacturing/producibility final report. Volume 2

    Energy Technology Data Exchange (ETDEWEB)

    Ritschel, A.J.; White, W.L.

    1985-05-01

    This Final MFTF-B Manufacturing/Producibility Report covers facilities, tooling plan, manufacturing sequence, schedule and performance, producibility, and lessons learned for the solenoid, axicell, and transition coils, as well as a deactivation plan, conclusions, references, and appendices.

  9. Career intentions of final year medical students in Uganda after graduating: the burden of brain drain.

    Science.gov (United States)

    Kizito, Samuel; Mukunya, David; Nakitende, Joyce; Nambasa, Stella; Nampogo, Adrian; Kalyesubula, Robert; Katamba, Achilles; Sewankambo, Nelson

    2015-08-01

    Uganda has severe shortage of human resources for health despite the heavy disease burden. The country has one of the highest fertility, and population growth rates in the world and is in dire need of trained health workers. The current doctor: patient ratio of 1:15000 is inadequate and this is further constrained by trained health workers leaving the country while others abandon the health sector. The aim of the study was to determine the career intentions of the final year medical students to leave the county and health field after graduating and the associated factors. We conducted a cross-sectional study among 251 final year medical students from Makerere, Mbarara, Gulu and Kampala International Universities. We enrolled all the eligible final year medical students. The study was conducted using face-to-face questionnaires in each university. We determined the demographics, reasons for leaving the country and health sector and the intended destinations of medical students who planned to leave the country. Data was entered in Epidata then exported and analyzed in stata 12. Of the 251 students enrolled in the study, 28(11.2 %) wanted to leave the health sector, with Mbarara University of Science and Technology (MUST) having the highest percentage, 16.7 % and Kampala International University (KIU) the least, 7.7 %. Of the 28 who intended to leave the health sector, 82.1 % wanted to join the business sector, 10.7 % agriculture, and 7.1 % politics. Reasons given for the intent to leave were; lack of equipment and supplies in hospitals, over whelming patient numbers, very risky working environment, low payment to doctors, and political reasons. Overall, 112 (44.6 %) of the participants wanted to leave the country with 30.3 % intending to migrate to United States of America (USA), 11.9 % to United Kingdom (UK), 11.0 % to South Africa among others. Some of the reasons given were; doctors are paid a high salary abroad, safe working environment, and desire to continue

  10. Medicare program; establishing additional Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) supplier enrollment safeguards. Final rule.

    Science.gov (United States)

    2010-08-27

    This final rule will clarify, expand, and add to the existing enrollment requirements that Durable Medical Equipment and Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers must meet to establish and maintain billing privileges in the Medicare program.

  11. Final report of the decontamination and decommissioning of Building 44 at the Grand Junction Projects Office Facility

    Energy Technology Data Exchange (ETDEWEB)

    Widdop, M.R.

    1996-07-01

    The U.S. Department of Energy (DOE) Junction Projects Office (GJPO) occupies a 61.7 acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore and mill tailings during uranium refining activities of the Manhattan Engineer District and during pilot milling experiments conducted for the U.S. Atomic Energy Commission`s domestic uranium procurement program. The DOE Defense Decontamination and Decommissioning Program established the Grand Junction Projects Office Remedial Action Project to clean up and restore the facility lands, improvements, and the underlying aquifer. The site contractor for the facility, Rust Geotech, is also the remedial action contractor. Building 44 was radiologically contaminated and the building was demolished in 1994. The soil area within the footprint of the building was not contaminated; it complies with the identified standards and the area can be released for unlimited exposure and unrestricted use. This document was prepared in response to a DOE request for an individual final report for each contaminated GJPO building.

  12. Final report of the decontamination and decommissioning of Building 1 at the Grand Junction Projects Office Facility

    Energy Technology Data Exchange (ETDEWEB)

    Widdop, M.R.

    1996-08-01

    The U.S. Department of Energy (DOE) Grand Junction Projects Office (GJPO) occupies a 61.7-acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore and mill tailings during uranium refining activities of the Manhattan Engineer District and during pilot milling experiments conducted for the U.S. Atomic Energy Commission`s domestic uranium procurement program. The DOE Defense Decontamination and Decommissioning Program established the GJPO Remedial Action Project to clean up and restore the facility lands, improvements, and the underlying aquifer. The site contractor for the facility, Rust Geotech, also is the remedial action contractor. Building 1 was found to be radiologically contaminated and was demolished in 1996. The soil beneath and adjacent to the building was remediated in accordance with identified standards and can be released for unlimited exposure and unrestricted use. This document was prepared in response to a DOE request for an individual final report for each contaminated GJPO building.

  13. Final report of the decontamination and decommissioning of Building 18 at the Grand Junction Projects Office Facility

    Energy Technology Data Exchange (ETDEWEB)

    Widdop, M.R.

    1996-08-01

    The U.S. Department of Energy (DOE) Grand Junction Projects Office (GJPO) occupies a 61.7-acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore and mill tailings during uranium refining activities of the Manhattan Engineer District and during pilot milling experiments conducted for the U.S. Atomic Energy Commission`s domestic uranium procurement program. The DOE Defense Decontamination and Decommissioning Program established the GJPO Remedial Action Project to clean up and restore the facility lands, improvements, and the underlying aquifer. The site contractor for the facility, Rust Geotech, also is the remedial action contractor. The soil beneath Building 18 was found to be radiologically contaminated; the building was not contaminated. The soil was remediated in accordance with identified standards. Building 18 and the underlying soil can be released for unlimited exposure and unrestricted use. This document was prepared in response to a DOE request for an individual final report for each contaminated GJPO building.

  14. Methodology for evaluating Insite: Canada's first medically supervised safer injection facility for injection drug users

    Directory of Open Access Journals (Sweden)

    Wood Evan

    2004-11-01

    Full Text Available Abstract Many Canadian cities are experiencing ongoing infectious disease and overdose epidemics among injection drug users (IDUs. In particular, Human Immunodeficiency Virus (HIV and hepatitis C Virus (HCV have become endemic in many settings and bacterial and viral infections, such as endocarditis and cellulitis, have become extremely common among this population. In an effort to reduce these public health concerns and the public order problems associated with public injection drug use, in September 2003, Vancouver, Canada opened a pilot medically supervised safer injecting facility (SIF, where IDUs can inject pre-obtained illicit drugs under the supervision of medical staff. The SIF was granted a legal exemption to operate on the condition that its impacts be rigorously evaluated. In order to ensure that the evaluation is appropriately open to scrutiny among the public health community, the present article was prepared to outline the methodology for evaluating the SIF and report on some preliminary observations. The evaluation is primarily structured around a prospective cohort of SIF users, that will examine risk behavior, blood-borne infection transmission, overdose, and health service use. These analyses will be augmented with process data from within the SIF, as well as survey's of local residents and qualitative interviews with users, staff, and key stakeholders, and standardised evaluations of public order changes. Preliminary observations suggest that the site has been successful in attracting IDUs into its programs and in turn helped to reduce public drug use. However, each of the indicators described above is the subject of a rigorous scientific evaluation that is attempting to quantify the overall impacts of the site and identify both benefits and potentially harmful consequences and it will take several years before the SIF's impacts can be appropriately examined.

  15. Testing and evaluation of on-farm alcohol production facilities. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Kuby, W.; Markoja, R.; Nackord, S.

    1984-07-01

    Ethanol is the most important of biomass derived fuels in the short term. The bulk of the production will come from large (20 to 600M gallons/year) units with the remainder being produced on-farm in small (less than 6,000 gallons/year) units. The on-farm production of alcohol presents a unique problem in that the Environmental Protection Agency (EPA) had no data available by which it could evaluate the possible impacts of a very large number of these facilities. This report gives the results of a sampling and analysis program conducted to characterize the air emissions, water effluents, and solid residuals from two on-farm ethanol production processes sampled in June 1980. Several recommendations, including acid neutralization and effluent ponding, are recommended to minimize the impacts.

  16. The National Ignition Facility (NIF) and the issue of nonproliferation. Final study

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-19

    NIF, the next step proposed by DOE in a progression of Inertial Confinement Fusion (ICF) facilities, is expected to reach the goal of ICF capsule ignition in the laboratory. This report is in response to a request of a Congressman that DOE resolve the question of whether NIF will aid or hinder U.S. nonproliferation efforts. Both technical and policy aspects are addressed, and public participation was part of the decision process. Since the technical proliferation concerns at NIF are manageable and can be made acceptable, and NIF can contribute positively to U.S. arms control and nonproliferation policy goals, it is concluded that NIF supports the nuclear nonproliferation objectives of the United States.

  17. Aquifer thermal energy storage at Mid-Island postal facility: Phase 1 final report

    Energy Technology Data Exchange (ETDEWEB)

    Marseille, T.J.; Armstrong, P.R.; Brown, D.R.; Vail, L.W.; Kannberg, L.D.

    1993-05-01

    The successful widespread commercialization of aquifer thermal energy storage (ATES) in the United States will depend on how experiences gained from early full-scale projects are used as guides in the design, installation, and operation of future projects. One early system, built in the mid-1980s, is the US Postal Service (USPS) Mid-Island Mail Processing Facility (MPF), in Melville, New York. The heating, ventilation, and air conditioning (HVAC) of the MPF`s workroom is provided by an ATES system, which is operated year-round to provide a source for both heating and cooling, in combination with a triethylene glycol (TEG) liquid-desiccant system for humidity control. Because the facility affords a unique opportunity to study this innovative system, the US Department of Energy`s (DOE) Pacific Northwest Laboratory (PNL) entered into agreements with the USPS, the US Geological Survey (USGS), and the New York State Energy Research and Development Authority (the Energy Authority) to assess the operation and performance of the system. Two essentially independent questions were to be addressed by the project. The first question was: ``How does the MPF ATES/TEG technology compare to conventional technologies?`` The second was: ``What can be done to make operation of the USPS MPF more economical?`` Modelling of the MPF ATES/TEG HVAC system and its loads helped to address both of these questions by showing how much energy is used by the different system components. This report is divided into six sections. Section 1 is an introduction. Section 2 provides system background. Section 3 describes PNL`s technical performance assessment of the system. Section 4 discusses the life-cycle cost assessment. An operational assessment of the liquid-desiccant system is discussed in Section 5. Section 6 contains conclusions of this study.

  18. Aquifer thermal energy storage at Mid-Island postal facility: Phase 1 final report

    Energy Technology Data Exchange (ETDEWEB)

    Marseille, T.J.; Armstrong, P.R.; Brown, D.R.; Vail, L.W.; Kannberg, L.D.

    1993-05-01

    The successful widespread commercialization of aquifer thermal energy storage (ATES) in the United States will depend on how experiences gained from early full-scale projects are used as guides in the design, installation, and operation of future projects. One early system, built in the mid-1980s, is the US Postal Service (USPS) Mid-Island Mail Processing Facility (MPF), in Melville, New York. The heating, ventilation, and air conditioning (HVAC) of the MPF's workroom is provided by an ATES system, which is operated year-round to provide a source for both heating and cooling, in combination with a triethylene glycol (TEG) liquid-desiccant system for humidity control. Because the facility affords a unique opportunity to study this innovative system, the US Department of Energy's (DOE) Pacific Northwest Laboratory (PNL) entered into agreements with the USPS, the US Geological Survey (USGS), and the New York State Energy Research and Development Authority (the Energy Authority) to assess the operation and performance of the system. Two essentially independent questions were to be addressed by the project. The first question was: How does the MPF ATES/TEG technology compare to conventional technologies '' The second was: What can be done to make operation of the USPS MPF more economical '' Modelling of the MPF ATES/TEG HVAC system and its loads helped to address both of these questions by showing how much energy is used by the different system components. This report is divided into six sections. Section 1 is an introduction. Section 2 provides system background. Section 3 describes PNL's technical performance assessment of the system. Section 4 discusses the life-cycle cost assessment. An operational assessment of the liquid-desiccant system is discussed in Section 5. Section 6 contains conclusions of this study.

  19. City of Raleigh, Wilders Grove Service Center, Solid Waste Services Facility. Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Cox, Robert [Jacobs Engineering, NC (United States); Black, Bill [City of Raleigh, NC (United States); Battle, Fred [City of Raleigh, NC (United States)

    2015-07-22

    Final Report for DOE Grant EE0002808. Grant award was for technology demonstration of geothermal energy systems. One of the major objectives identified for the demonstration portion of the grant was to prove the viability of Ground Source Heat Pump (GSHP) systems in significantly reducing energy usage of HVAC and domestic water heating systems compared to traditional systems. Data were monitored and conclusions drawn, including estimating payback timeframes and documenting lessons learned.

  20. Efficiency in reducing lost-time injuries of a nurse-based and a first-aid-based on-site medical facility.

    Science.gov (United States)

    Spangenberg, Søren; Mikkelsen, Kim L; Kines, Pete; Dyreborg, Johnny

    2005-01-01

    The purpose of the study was to evaluate the efficiency of two standards for on-site medical facilities in reducing lost-time injuries during the construction of the link across the Oresund sound between Sweden and Denmark. One medical facility employed licensed nurses, who had advanced medical assistance at their disposal. The other medical facility utilized first-aid-trained watchmen. The on-site medical facilities aimed both at providing immediate medical assistance to workers subjected to occupational injuries and at reducing lost worktime. The distributions of injuries treated on-site (the worker resumed work after treatment) and injuries sent to hospitals or to specialists were compared for each type of injury and for each category of injured body part. The on-site medical facilities dealt, in particular, with the treatment of ocular injuries (21%), wounds (21%), and sprains or strains (15%). The study showed a statistically significant on-site treatment (and resume work) rate ratio of 3.3 between the nurse-based (76%) and the first-aid-based (23%) medical facility. The construction of the Oresund Link shows a need for on-site medical facilities, particularly at remote construction sites, and that it is essential that the medical personnel have both the qualifications and authorization to treat site-specific workplace injuries effectively in order to obtain high on-site treatment rates.

  1. CERN-MEDICIS (MEDical Isotopes Collected from ISOLDE): A new facility

    CERN Document Server

    Augusto, Ricardo Manuel dos Santos; Lawson, Zoe; Marzari, Stefano; Stachura, Monika; Stora, Thierry; CERN. Geneva. ATS Department

    2014-01-01

    About 50% of the 1.4GeV CERN’s protons are sent onto targets to produce radioactive beams by online mass separation at ISOLDE, for a wide range of studies in fundamental and applied physics. CERN-MEDICIS is a spin-off dedicated to R&D in life sciences and medical applications. It is located in an extension of the Class A building presently under construction. It will comprise laboratories to receive the irradiated targets from a new station located at the dump position behind the ISOLDE production targets. An increasing range of innovative isotopes will thus progressively become accessible from the start-up of the facility in 2015 onward; for fundamental studies in cancer research, for new imaging and therapy protocols in cell and animal models and for pre-clinical trials, possibly extended to specific early phase clinical studies up to phase I trials. 500 MBq isotope batches purified by electromagnetic mass separation combined with chemical methods will be collected on a weekly basis. Possible future u...

  2. Impact of sensitization workshop on knowledge regarding tuberculosis among final year medical students

    Directory of Open Access Journals (Sweden)

    Purushottam A Giri

    2013-04-01

    Full Text Available Background: India is the highest TB burden country in the world and accounts for nearly one fifth (20% of global burden of tuberculosis. Every year, approximately 1.8 million persons develop tuberculosis, of which about 8,00,000 are infectious and until recently, 3,70,000 cases died of it annually. In India, today, two deaths occur every three minutes from tuberculosis, but these deaths can be prevented with proper care and treatment. Materials and Methods: An interventional study was conducted from January to March 2009 by interviewing 86 final year medical students studying at Rural Medical College, Loni, India. A pre-designed and pre-tested questionnaire was used to collect the pre-workshop and post-workshop data. Questions were based on the knowledge regarding tuberculosis. Results were analyzed statistically using percentage, proportions, and Chi-square test. Results: In this study, about 55 (63.9% participants correctly specified RNTCP objectives in pre-test, while in post-test, 80 (93.1% participants could state correct response ( P < 0.0001. In pre-test, 57 (66.3% participants thought that family member can be a DOTS provider, while during post-test, 80 (93.1% participants realized that DOTS should not be given by family member ( P < 0.0001. Similarly, highly significant difference in pre- and post-test was observed for DOTS components. Conclusion: Sensitization workshops increase the knowledge of tuberculosis amongst the medical students. RNTCP training should be a part of regular activity of all medical colleges.

  3. Final master work plan : environmental investigations at former CCC/USDA facilities in Kansas, 2002 revision.

    Energy Technology Data Exchange (ETDEWEB)

    Burton, J. C.; Environmental Research

    2003-01-23

    The Commodity Credit Corporation (CCC) of the U.S. Department of Agriculture (USDA) has entered into an interagency agreement with the U.S. Department of Energy (DOE) under which Argonne National Laboratory provides technical assistance for hazardous waste site characterization and remediation for the CCC/USDA. Carbon tetrachloride is the contaminant of primary concern at sites in Kansas where former CCC/USDA grain storage facilities were located. Argonne applies its QuickSite(reg sign) Expedited Site Characterization (ESC) approach to these former facilities. The QuickSite environmental site characterization methodology is Argonne's proprietary implementation of the ESC process (ASTM 1998). Argonne has used this approach at several former CCC/USDA facilities in Kansas, including Agenda, Agra, Everest, and Frankfort. The Argonne ESC approach revolves around a multidisciplinary, team-oriented approach to problem solving. The basic features and steps of the QuickSite methodology are as follows: (1) A team of scientists with diverse expertise and strong field experience is required to make the process work. The Argonne team is composed of geologists, geochemists, geophysicists, hydrogeologists, chemists, biologists, engineers, computer scientists, health and safety personnel, and regulatory staff, as well as technical support staff. Most of the staff scientists are at the Ph.D. level; each has on average, more than 15 years of experience. The technical team works together throughout the process. In other words, the team that plans the program also implements the program in the field and writes the reports. More experienced scientists do not remain in the office while individuals with lesser degrees or experience carry out the field work. (2) The technical team reviews, evaluates, and interprets existing data for the site and the contaminants there to determine which data sets are technically valid and can be used in initially designing the field program. A basic

  4. Final master work plan : environmental investigations at former CCC/USDA facilities in Kansas, 2002 revision.

    Energy Technology Data Exchange (ETDEWEB)

    Burton, J. C.; Environmental Research

    2003-01-23

    The Commodity Credit Corporation (CCC) of the U.S. Department of Agriculture (USDA) has entered into an interagency agreement with the U.S. Department of Energy (DOE) under which Argonne National Laboratory provides technical assistance for hazardous waste site characterization and remediation for the CCC/USDA. Carbon tetrachloride is the contaminant of primary concern at sites in Kansas where former CCC/USDA grain storage facilities were located. Argonne applies its QuickSite(reg sign) Expedited Site Characterization (ESC) approach to these former facilities. The QuickSite environmental site characterization methodology is Argonne's proprietary implementation of the ESC process (ASTM 1998). Argonne has used this approach at several former CCC/USDA facilities in Kansas, including Agenda, Agra, Everest, and Frankfort. The Argonne ESC approach revolves around a multidisciplinary, team-oriented approach to problem solving. The basic features and steps of the QuickSite methodology are as follows: (1) A team of scientists with diverse expertise and strong field experience is required to make the process work. The Argonne team is composed of geologists, geochemists, geophysicists, hydrogeologists, chemists, biologists, engineers, computer scientists, health and safety personnel, and regulatory staff, as well as technical support staff. Most of the staff scientists are at the Ph.D. level; each has on average, more than 15 years of experience. The technical team works together throughout the process. In other words, the team that plans the program also implements the program in the field and writes the reports. More experienced scientists do not remain in the office while individuals with lesser degrees or experience carry out the field work. (2) The technical team reviews, evaluates, and interprets existing data for the site and the contaminants there to determine which data sets are technically valid and can be used in initially designing the field program. A basic

  5. Medicaid program; clarification of outpatient hospital facility (including outpatient hospital clinic) services definition. Final rule.

    Science.gov (United States)

    2008-11-07

    Outpatient hospital services are a mandatory part of the standard Medicaid benefit package. This final rule aligns the Medicaid definition of outpatient hospital services more closely to the Medicare definition in order to: Improve the functionality of the applicable upper payment limits (which are based on a comparison to Medicare payments for the same services), provide more transparency in determining available hospital coverage in any State, and generally clarify the scope of services for which Federal financial participation (FFP) is available under the outpatient hospital services benefit category.

  6. Grout for closure of the demonstration vault at the US DOE Hanford Facility. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Wakeley, L.D.; Ernzen, J.J.

    1992-08-01

    The Waterways Experiment Station (WES) developed a grout to be used as a cold- (nonradioactive) cap or void-fill grout between the solidified low-level waste and the cover blocks of a demonstration vault for disposal of phosphate-sulfate waste (PSW) at the US Department of Energy (DOE) Hanford Facility. The project consisted of formulation and evaluation of candidate grouts and selection of the best candidate grout, followed by a physical scale-model test to verify grout performance under project-specific conditions. Further, the project provided data to verify numerical models (accomplished elsewhere) of stresses and isotherms inside the Hanford demonstration vault. Evaluation of unhardened grout included obtaining data on segregation, bleeding, flow, and working time. For hardened grout, strength, volume stability, temperature rise, and chemical compatibility with surrogate wasteform grout were examined. The grout was formulated to accommodate unique environmental boundary conditions (vault temperature = 45 C) and exacting regulatory requirements (mandating less than 0.1% shrinkage with no expansion and no bleeding); and to remain pumpable for a minimum of 2 hr. A grout consisting of API Class H oil-well cement, an ASTM C 618 Class F fly ash, sodium bentonite clay, and a natural sand from the Hanford area met performance requirements in laboratory studies. It is recommended for use in the DOE Hanford demonstration PSW vault.

  7. Storage fee analysis for a nuclear waste terminal storage facility. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1976-09-01

    A model was developed for determining a pricing schedule designed to recover federal government costs incurred in the development, design, construction, operation, decommissioning, and surveillance of a federal repository for high-level waste generated by the commercial nuclear power industry. As currently constructed, the model computes current dollar prices on a yearly basis for a single unit charge or a split fee based upon two user-provided quantity flows. Over the period of facility operation, the computed-cost schedule shows variability on a year-to-year basis only within specified ranges. The model uses as basic input data: cost schedule for the federal repository; quantity flow schedule for each factor to be charged; schedule for escalation rate, discount rate, and interest rate; and fraction of costs to be recovered on each quantity flow if the split-fee option is used. The model allows testing of these variables in order to determine the relative significance of each component with regard to cost to, and impact on, the nuclear power industry. Another feature of the model is its versatility. Not only is the user able to specify the percent of total costs to be covered by each method of fee assessment listed above but also the user can specify a revenue-cost ratio, an option that would prove useful in trying to assess the general uncertainty involved when dealing in the future. In addition, the model accepts either current-dollar or constant-dollar cost measures, and in the case of the latter escalates the costs with user-provided assumptions.

  8. Final Report, University Research Program in Robotics (URPR), Nuclear Facilities Clean-up

    Energy Technology Data Exchange (ETDEWEB)

    Tesar, Delbert; Kapoor, Chetan; Pryor, Mitch

    2005-03-31

    This final report describes the research activity at the University of Texas at Austin with application to EM needs at DOE. This research activity is divided in to two major thrusts and contributes to the overall University Research Program in Robotics (URPR) thrust by providing mechanically oriented robotic solutions based on modularity and generalized software. These thrusts are also the core strengths of the UTA program that has a 40-year history in machine development, 30 years specifically devoted to robotics. Since 1975, much of this effort has been to establish the general analytical and design infrastructure for an open (modular) architecture of systems with many degrees of freedom that are able to satisfy a broad range of applications for future production machines. This work has coalesced from two principal areas: standardized actuators and generalized software.

  9. Preparation courses for medical clerkships and the final clinical internship in medical education – The Magdeburg Curriculum for Healthcare Competence

    Directory of Open Access Journals (Sweden)

    Spura, Anke

    2016-05-01

    Full Text Available Background/Goals: Supporting medical students entering their internships – the clinical clerkship and the internship “final clinical year” (Praktisches Jahr, PJ – the seminars “Ready for Clerkship” and “Ready for PJ” were held for the first time in 2014 and continued successfully in 2015. These seminars are part of the “Magdeburg Curriculum for Healthcare Competence” (Magdeburger Curriculum zur Versorgungskompetenz, MCV. The concept comprises three main issues: “Understanding interdisciplinary clinical procedures”, “Interprofessional collaboration”, and “Individual cases and their reference to the system.” The aim of the seminar series is to prepare students as medical trainees for their role in the practice-oriented clinical clerkship and PJ, respectively.Methods: Quality assurance evaluations and didactic research are integral parts of the seminars. In preparation for the “Ready for PJ” seminar a needs assessment was conducted. The seminars were rated by the participants using an anonymized questionnaire consisting of a 5-choice Likert scale (ranging from 1=fully agree to 5=fully disagree and spaces for comments that was generated by the evaluation software Evasys.Results: The results are presented for the preparatory seminars “Ready for Clerkship” and “Fit für PJ” held in 2014 and 2015. Overall, the students regarded the facultative courses as very good preparation for the clerkship as well as for the PJ. The three-dimensional main curricular concept of the MCV was recognized in the evaluation as a valuable educational approach. Interprofessional collaboration, taught by instructors focussing in teamwork between disciplines, was scored positively and highly valued.Conclusions: The “Magdeburg Curriculum for Healthcare Competence” (MCV integrates clerkship and PJ in a framing educational concept and allows students a better appreciation of their role in patient care and the tasks that they will

  10. Perceived stress at transition to workplace: a qualitative interview study exploring final-year medical students’ needs

    Science.gov (United States)

    Moczko, Tobias R; Bugaj, Till J; Herzog, Wolfgang; Nikendei, Christoph

    2016-01-01

    Objectives This study was designed to explore final-year medical students’ stressors and coping strategies at the transition to the clinical workplace. Methods In this qualitative study, semi-standardized interviews with eight final-year medical students (five male, three female; aged 25.9±1.4 years) were conducted during their internal medicine rotation. After verbatim transcription, a qualitative content analysis of students’ impressions of stress provoking and easing factors during final-year education was performed. Results Students’ statements regarding burdens and dealing with stress were classified into four main categories: A) perceived stressors and provoking factors, B) stress-induced consequences, C) personal and external resources for preventing and dealing with stress, and D) final-year students’ suggestions for workplace improvement. Conclusion Final-year medical students perceived different types of stress during their transition to medical wards, and reported both negative consequences and coping resources concerning perceived stress. As supervision, feedback, and coping strategies played an important role in the students’ perception of stress, final-year medical education curricula development should focus on these specifically. PMID:26834503

  11. 50% Failure Rate in Final Year Medical Exams – Whose Fault is it?

    Directory of Open Access Journals (Sweden)

    Omran Bakoush

    2007-01-01

    their working life amongst more modern teaching systems and approaches in the west. So it is logical to conclude that should the methods of teaching and teaching skills improve, the success rate among final year medical students will undoubtedly follow suit.It is our recommendation that in order to improve the success rate amongst students, a more modern way of teaching is urgently required [3]. Teachers first need to recognise that problems exist, and then act proactively to address them [4]. One way is the provision of ‘Train The Trainer’ and other similar courses to increase teaching skills, coupled with more discussion groups, clinical clerks, case presentations, increased student involvement during medical rounds and within lectures, and increased attendance at common procedures. All of the above will surely result in increasing the success rate beyond the current 50% passing rate for final year students.

  12. Effects of the Emergency Trauma Training Course on the confidence of final-year medical students dealing with trauma patients.

    Science.gov (United States)

    Lin, Hsing-Lin; Chen, Chao-Wen; Lee, Wei-Che; Kuo, Liang-Chi; Cheng, Yuan-Chia; Lin, Yen-Ko; Lin, Jiun-Nong; Chan, Hon-Man

    2009-01-01

    Trauma is an important issue that has been neglected in the training of medical students. This study evaluated the effects of the Emergency Trauma Training Course (ETTC), after completion of standard medical training, on seventh-year medical students. The ETTC was designed in Taiwan by the Taiwan Society of Emergency Medicine to train physicians and registered nurses who care for trauma patients in the emergency department (ED). We implemented the course for our medical students' internship. One hundred and fifty-one participants were divided into three groups: Group A included 36 medical students before they entered their internship in hospital; Group B included 41 medical students who had received 6 months of internship training in hospital; and Group C included 74 ED nurses. Group C was used to test Cronbach's alpha coefficient of the questionnaire. After the training course, the participants had a final examination and filled out a questionnaire about the training course and their levels of self-confidence. There were no differences in scores between the medical students in Groups A and B (p = 0.064). Using repeated measures analysis of variance, we found that confidence before training was low, with no difference between Groups A and B. Confidence improved after training, but there was still no significant difference between the groups (p = 0.875). However, there were significant differences between confidence levels before and after the training course (p confidence, the confidence of final year medical students after completion of their training was improved by the ETTC. This indicates that the ETTC could increase the confidence of participants. This is the first evaluation of the implementation of the ETTC for final-year medical students in Taiwan. Based on our results, we highly recommend that this training course be taught to final-year medical students before they practice in hospital.

  13. Turkish Final Year Medical Students’ Exposure to and Attitudes Concerning Drug Company Interactions: A Perspective from a Minimally Regulated Environment for Medical Students

    Science.gov (United States)

    Beyhun, Nazim Ercument; Kolayli, Cevriye Ceyda; Can, Gamze; Topbas, Murat

    2016-01-01

    Interactions between drug companies and medical students may affect evidence-based medical practice and patient safety. The aim of this study was to assess drug company–medical student interactions in a medical faculty where limited specific national or institutional regulations apply between drug companies and medical students. The objectives of the study were to determine the exposure and attitudes of final year medical students in terms of drug company–medical student and physician interactions, to identify factors affecting those attitudes and to provide data for policymakers working on the regulation of interactions between drug companies and medical students. This anonymous questionnaire-based study of 154 medical final year medical students at the Karadeniz Technical University Medical Faculty, Trabzon, Turkey, in April and May 2015 attracted a response rate of 92.2% (n/N, 154/164). Exposure to interaction with a pharmaceutical representative was reported by 90.3% (139/154) of students, and 68.8% (106/154) reported experiencing such interaction alongside a resident. In addition, 83.7% (128/153) of students reported an interaction during internship. Furthermore, 69.9% (107/153) of students agreed that interactions influence physicians’ prescription preferences, while 33.1% (51/154) thought that a medical student should never accept a gift from a drug company and 24.7% (38/154) agreed with the proposition that “drug companies should not hold activities in medical faculties”. Students with rational prescription training expressed greater agreement with the statement “I am skeptical concerning the information provided by drug companies during interactions” than those who had not received such training, and this finding was supported by logistic regression [O.R.(C.I), p -3.7(1.2–11.5), p = 0.022]. Acceptance of advertisement brochures was found to significantly reduce the level of agreement with the proposition that “A physician should not

  14. Final design and progress of WEAVE: the next generation wide-field spectroscopy facility for the William Herschel Telescope

    Science.gov (United States)

    Dalton, Gavin; Trager, Scott; Abrams, Don Carlos; Bonifacio, Piercarlo; Aguerri, J. Alfonso L.; Middleton, Kevin; Benn, Chris; Dee, Kevin; Sayède, Frédéric; Lewis, Ian; Pragt, Johannes; Pico, Sergio; Walton, Nic; Rey, Jeurg; Allende Prieto, Carlos; Peñate, José; Lhome, Emilie; Agócs, Tibor; Alonso, José; Terrett, David; Brock, Matthew; Gilbert, James; Schallig, Ellen; Ridings, Andy; Guinouard, Isabelle; Verheijen, Marc; Tosh, Ian; Rogers, Kevin; Lee, Martin; Steele, Iain; Stuik, Remko; Tromp, Niels; Jaskó, Attila; Carrasco, Esperanza; Farcas, Szigfrid; Kragt, Jan; Lesman, Dirk; Kroes, Gabby; Mottram, Chris; Bates, Stuart; Rodriguez, Luis Fernando; Gribbin, Frank; Delgado, José Miguel; Herreros, José Miguel; Martin, Carlos; Cano, Diego; Navarro, Ramon; Irwin, Mike; Lewis, Jim; Gonzalez Solares, Eduardo; Murphy, David; Worley, Clare; Bassom, Richard; O'Mahoney, Neil; Bianco, Andrea; Zurita, Christina; ter Horst, Rik; Molinari, Emilio; Lodi, Marcello; Guerra, José; Martin, Adrian; Vallenari, Antonella; Salasnich, Bernardo; Baruffolo, Andrea; Jin, Shoko; Hill, Vanessa; Smith, Dan; Drew, Janet; Poggianti, Bianca; Pieri, Mat; Dominquez Palmero, Lillian; Farina, Cecilia

    2016-08-01

    We present the Final Design of the WEAVE next-generation spectroscopy facility for the William Herschel Telescope (WHT), together with a status update on the details of manufacturing, integration and the overall project schedule now that all the major fabrication contracts are in place. We also present a summary of the current planning behind the 5-year initial phase of survey operations. WEAVE will provide optical ground-based follow up of ground-based (LOFAR) and space-based (Gaia) surveys. WEAVE is a multi-object and multi-IFU facility utilizing a new 2-degree prime focus field of view at the WHT, with a buffered pick-and-place positioner system hosting 1000 multi-object (MOS) fibres, 20 integral field units, or a single large IFU for each observation. The fibres are fed to a single (dual-beam) spectrograph, with total of 16k spectral pixels, located within the WHT GHRIL enclosure on the telescope Nasmyth platform, supporting observations at R 5000 over the full 370-1000nm wavelength range in a single exposure, or a high resolution mode with limited coverage in each arm at R 20000. The project is now in the manufacturing and integration phase with first light expected for early of 2018.

  15. Final-year medical students′ perceptions regarding the curriculum in public health

    Directory of Open Access Journals (Sweden)

    Mitrakrishnan Rayno Navinan

    2011-01-01

    Full Text Available Background: The Faculty of Medicine, University of Colombo, has an integrated curriculum in which teaching of public health takes place through a series of modules which span the full five-year study programme. Aim: To assess final year medical student perceptions regarding the public health curriculum and to identify factors which influence this. Materials and Methods: The study was cross sectional. Convenience sampling was utilized on final-year students of the Faculty of Medicine, University of Colombo, Sri Lanka. A self-administered 4-point Likert scale questionnaire covered general opinion on public healthcare and perceptions about the curriculum. Data were analyzed using descriptive statistics and Chi-square tests. Results: One hundred and eighty four students (94% participated in the study. Eighty-two percent (148 viewed public health as an important field. Only 9% (16 were interested in a career in public health. A significant association was found between choosing public health as career and the following: perception of public health as an important field; holding a good opinion about public health prior to commencement of the course; having found the field-based experience enjoyable and beneficial to the community; and feeling competent to work in the community at the end of the course (P < 0.01. With regard to teaching methods, group activities and discussion-centered activities were identified positively (153, 83% and 125, 68% respectively. The majority of students indicated that they were not stimulated to read more on the subject or regularly revise what they have learnt, both during the introductory public health programme and during the final year. Conclusions: The curriculum has been able to create a positive opinion about public health. However, students lack enthusiasm to learn independently. Experiential, group-centered teaching activities and a constructivist approach may be more effective in promoting independent learning

  16. A real-time positron monitor for the estimation of stack effluent releases from PET medical cyclotron facilities.

    Science.gov (United States)

    Mukherjee, Bhaskar

    2002-12-01

    Large activities of short-lived positron emitting radiopharmaceuticals are routinely manufactured by modern Medical Cyclotron facilities for positron emission tomography (PET) applications. During radiochemical processing, a substantial fraction of the volatile positron emitting radiopharmaceuticals are released into the atmosphere. An inexpensive, fast response positron detector using a simple positron-annihilation chamber has been developed for real-time assessment of the stack release of positron emitting effluents at the Australian National Medical Cyclotron. The positron detector was calibrated by using a 3.0 ml (1.50 MBq) aliquot of 18FDG and interfaced to an industrial standard datalogger for the real-time acquisition of stack release data.

  17. Final report : phase I investigation at the former CCC/USDA grain storage facility in Savannah, Missouri.

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, L. M.; Environmental Science Division

    2010-08-05

    Agency of the USDA and the MoDNR, to address carbon tetrachloride contamination potentially associated with a number of former CCC/USDA grain storage facilities in Missouri. The site characterization at Savannah is being conducted on behalf of the CCC/USDA by the Environmental Science Division of Argonne National Laboratory. A phased approach is being employed by the CCC/USDA and Argonne, with the approval of the MoDNR, so that information obtained and interpretations developed during each incremental stage of the study can be used most effectively to guide subsequent aspects of the program. This report presents the technical findings of Phase I of Argonne's studies. The Phase I investigation was undertaken in accord with the final site-specific Phase I Work Plan for Savannah (Argonne 2007), as well as with the Master Work Plan (MWPK) for CCC/USDAArgonne operations in the state of Kansas (Argonne 2002), which the MoDNR reviewed and approved (with minor revisions) for temporary use in Missouri to facilitate the start-up of the CCC/USDA's activities at Savannah. (Argonne is developing a similar Master Work Plan for operations in Missouri that is based on the existing MWPK, with the approval of the MoDNR. The Missouri document has not been finalized, however, at this time.) The site-specific Savannah Work Plan (Argonne 2007; approved by the MoDNR [2007a]) (1) summarized the pre-existing knowledge base for the Savannah investigation site compiled by Argonne and (2) described the site-specific technical objectives and the intended scope of work developed for this phase of the investigation. Four primary technical objectives were identified for the Phase I studies, as follows: (1) Update the previous (MoDNR 2000a,b) inventory and status of private wells in the immediate vicinity of the former CCC/USDA grain storage facility, and sample the identified wells for analyses for volatile organic compounds (VOCs) and geochemical constituents. (2) Investigate for possible

  18. An audit of basic practical skills acquisition of final year medical ...

    African Journals Online (AJOL)

    year medical students of a Nigerian medical school to basic practical skills. ... Keywords: Acquisition, basic practical skills, medical students .... structured learning and feedback. ... role of practical experience in undergraduate and general.

  19. Final Status Survey Report for Corrective Action Unit 117 - Pluto Disassembly Facility, Building 2201, Nevada National Security Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    Jeremy Gwin and Douglas Frenette

    2010-09-30

    This document contains the process knowledge, radiological data and subsequent statistical methodology and analysis to support approval for the radiological release of Corrective Action Unit (CAU) 117 – Pluto Disassembly Facility, Building 2201 located in Area 26 of the Nevada National Security Site (NNSS). Preparations for release of the building began in 2009 and followed the methodology described in the Multi-Agency Radiation Survey and Site Investigation Manual (MARSSIM). MARSSIM is the DOE approved process for release of Real Property (buildings and landmasses) to a set of established criteria or authorized limits. The pre-approved authorized limits for surface contamination values and corresponding assumptions were established by DOE O 5400.5. The release criteria coincide with the acceptance criteria of the U10C landfill permit. The U10C landfill is the proposed location to dispose of the radiologically non-impacted, or “clean,” building rubble following demolition. However, other disposition options that include the building and/or waste remaining at the NNSS may be considered providing that the same release limits apply. The Final Status Survey was designed following MARSSIM guidance by reviewing historical documentation and radiological survey data. Following this review a formal radiological characterization survey was performed in two phases. The characterization revealed multiple areas of residual radioactivity above the release criteria. These locations were remediated (decontaminated) and then the surface activity was verified to be less than the release criteria. Once remediation efforts had been successfully completed, a Final Status Survey Plan (10-015, “Final Status Survey Plan for Corrective Action Unit 117 – Pluto Disassembly Facility, Building 2201”) was developed and implemented to complete the final step in the MARSSIM process, the Final Status Survey. The Final Status Survey Plan consisted of categorizing each individual room

  20. The prevalence of mental disorders in adults in different level general medical facilities in Kenya: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Kuria Mary W

    2009-01-01

    Full Text Available Abstract Background The possibility that a significant proportion of the patients attending a general health facility may have a mental disorder means that psychiatric conditions must be recognised and managed appropriately. This study sought to determine the prevalence of common psychiatric disorders in adult (aged 18 years and over inpatients and outpatients seen in public, private and faith-based general hospitals, health centres and specialised clinics and units of general hospitals. Methods This was a descriptive cross-sectional study conducted in 10 health facilities. All the patients in psychiatric wards and clinics were excluded. Stratified and systematic sampling methods were used. Informed consent was obtained from all study participants. Data were collected over a 4-week period in November 2005 using various psychiatric instruments for adults. Descriptive statistics were generated using SPSS V. 11.5. Results A total of 2,770 male and female inpatients and outpatients participated in the study. In all, 42% of the subjects had symptoms of mild and severe depression. Only 114 (4.1% subjects had a file or working diagnosis of a psychiatric condition, which included bipolar mood disorder, schizophrenia, psychosis and depression. Conclusion The 4.1% clinician detection rate for mental disorders means that most psychiatric disorders in general medical facilities remain undiagnosed and thus, unmanaged. This calls for improved diagnostic practices in general medical facilities in Kenya and in other similar countries.

  1. General Hospital and Personal Use Devices: Renaming of Pediatric Hospital Bed Classification and Designation of Special Controls for Pediatric Medical Crib; Classification of Medical Bassinet. Final rule.

    Science.gov (United States)

    2016-12-19

    The Food and Drug Administration (FDA) is issuing a final rule to rename pediatric hospital beds as pediatric medical cribs and establish special controls for these devices. FDA is also establishing a separate classification regulation for medical bassinets, previously under the pediatric hospital bed classification regulation, as a class II (special controls) device. In addition, this rule continues to allow both devices to be exempt from premarket notification and use of the device in traditional health care settings and permits prescription use of pediatric medical cribs and bassinets outside of traditional health care settings.

  2. Siting a municipal solid waste disposal facility, part II: the effects of external criteria on the final decision.

    Science.gov (United States)

    Korucu, M Kemal; Karademir, Aykan

    2014-02-01

    The procedure of a multi-criteria decision analysis supported by the geographic information systems was applied to the site selection process of a planning municipal solid waste management practice based on twelve different scenarios. The scenarios included two different decision tree modes and two different weighting models for three different area requirements. The suitability rankings of the suitable sites obtained from the application of the decision procedure for the scenarios were assessed by a factorial experimental design concerning the effect of some external criteria on the final decision of the site selection process. The external criteria used in the factorial experimental design were defined as "Risk perception and approval of stakeholders" and "Visibility". The effects of the presence of these criteria in the decision trees were evaluated in detail. For a quantitative expression of the differentiations observed in the suitability rankings, the ranking data were subjected to ANOVA test after a normalization process. Then the results of these tests were evaluated by Tukey test to measure the effects of external criteria on the final decision. The results of Tukey tests indicated that the involvement of the external criteria into the decision trees produced statistically meaningful differentiations in the suitability rankings. Since the external criteria could cause considerable external costs during the operation of the disposal facilities, the presence of these criteria in the decision tree in addition to the other criteria related to environmental and legislative requisites could prevent subsequent external costs in the first place.

  3. Observation on the Joint Service Military Medical Facility What Does the Future Hold

    Science.gov (United States)

    2007-03-30

    base hospitals at Mather and McClellan , Sacramento , CA; March AFB hospital, CA; Fitzsimmons Medical Center, Aurora, CO, among others.20 Unlike...Medical Center, San Diego, CA and David Grant Medical Center, Travis AFB , CA for Army RC units, such as the 921st Field Hospital (FH) from Sacramento ...with Malcolm Grow Medical Center at Andrews AFB , Dewitt Army Community Hospital at Ft. Belvoir, and associated area clinics.14 But the Office of

  4. 38 CFR 17.52 - Hospital care and medical services in non-VA facilities.

    Science.gov (United States)

    2010-07-01

    ... or equipped to perform, and transfer to a public or private hospital which has the necessary staff or... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Hospital care and medical... VETERANS AFFAIRS MEDICAL Use of Public Or Private Hospitals § 17.52 Hospital care and medical services in...

  5. Final report : phase I investigation at the former CCC/USDA grain storage facility in Savannah, Missouri.

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, L. M.; Environmental Science Division

    2010-08-05

    Agency of the USDA and the MoDNR, to address carbon tetrachloride contamination potentially associated with a number of former CCC/USDA grain storage facilities in Missouri. The site characterization at Savannah is being conducted on behalf of the CCC/USDA by the Environmental Science Division of Argonne National Laboratory. A phased approach is being employed by the CCC/USDA and Argonne, with the approval of the MoDNR, so that information obtained and interpretations developed during each incremental stage of the study can be used most effectively to guide subsequent aspects of the program. This report presents the technical findings of Phase I of Argonne's studies. The Phase I investigation was undertaken in accord with the final site-specific Phase I Work Plan for Savannah (Argonne 2007), as well as with the Master Work Plan (MWPK) for CCC/USDAArgonne operations in the state of Kansas (Argonne 2002), which the MoDNR reviewed and approved (with minor revisions) for temporary use in Missouri to facilitate the start-up of the CCC/USDA's activities at Savannah. (Argonne is developing a similar Master Work Plan for operations in Missouri that is based on the existing MWPK, with the approval of the MoDNR. The Missouri document has not been finalized, however, at this time.) The site-specific Savannah Work Plan (Argonne 2007; approved by the MoDNR [2007a]) (1) summarized the pre-existing knowledge base for the Savannah investigation site compiled by Argonne and (2) described the site-specific technical objectives and the intended scope of work developed for this phase of the investigation. Four primary technical objectives were identified for the Phase I studies, as follows: (1) Update the previous (MoDNR 2000a,b) inventory and status of private wells in the immediate vicinity of the former CCC/USDA grain storage facility, and sample the identified wells for analyses for volatile organic compounds (VOCs) and geochemical constituents. (2) Investigate for possible

  6. Information literacy: are final-year medical radiation science students on the pathway to success?

    Science.gov (United States)

    Thompson, Nadine; Lewis, Sarah; Brennan, Patrick; Robinson, John

    2010-01-01

    It is necessary for Medical Radiation Science (MRS) students to become information literate in order to interact with and thrive in the professional health care arena. All health care professionals require information literacy (IL) skills to be independent learners and critical thinkers. To achieve this, effective search and evaluation methods must be cultivated in students. Twenty-eight final year MRS students participated in a 30-minute digitally recorded interview regarding their knowledge of information sources, where they locate information, and how they evaluate these sources. Constant comparative analysis via grounded theory was used to thematise the data. A conceptual framework was developed demonstrating the link between the key concepts of convenience, confidence and competence. The impact of the internet on the IL skills of students has been profound, due mainly to convenience. Most students had little confidence in their IL skills, however there were still some students who were confident with their skills and were competent who still preferred to access information sources that were convenient because there was nothing preventing them from doing so. By identifying problem areas, educators can redesign curricula around the strengths and weaknesses of students' IL skills, thus promoting lifelong learning and using electronic based learning to its full potential.

  7. University of Nebraska Medical Center Mass Spectrometry and Proteomics Core Facility

    OpenAIRE

    Ciborowski, P.; Wojtkiewicz, M.

    2011-01-01

    The UNMC Mass Spectrometry and Proteomics Core Facility offers a broad range of services, such as ESI and MALDI protein identification using Mascot and Sequest Algorithms, iTRAQ-based quantitative proteomics, MRM protein quantitation, phosphoproteomics profiling and molecular weight determination for proteins, peptides and small molecules. The facility is equipped with LTQ Orbitrap ETD, LTQ Velos, 4800 MALDI TOF-TOF, 4000 Q TRAP, all with supporting nano-LC systems. Although the majority of u...

  8. Accidental nuclear excursion Recuplex operation 234-5 facility. Final report: Date of incident: April 7, 1962

    Energy Technology Data Exchange (ETDEWEB)

    1962-08-01

    On Saturday morning, April 7, 1962, at about 1059 Armed Forces time, an accidental nuclear excursion occurred in the plutonium waste recovery facility (Recuplex) of the 234-5 Building. This excursion did not result in any mechanical damage or spread of contamination. Three employees of the General Electric Company received overexposures to gamma and neutron radiation. None were fatally exposed; in each case the overexposure was recognized promptly, and following medical observation and testing the men were released to return to work. In compliance with AEC Manual Chapter 0703, an AEC-HAPO committee composed of two AEC employees and five General Electric employees was appointed by the Manger, HOO, with the concurrence of the General Manager, HAPO, to conduct an investigation of the incident. The committee`s purpose was to determine the cause, nature, and extent of the incident, and recommend action to be taken by others to minimize or preclude future incidents of this magnitude. A study of operating practices and operating conditions that appeared to exist prior to, during, and subsequent to the accident was made by the committee. The committee believes that this report provides sufficient information to answer questions which may arise as a result of the criticality incident except those relating to its cause.

  9. A Feasibility Study on the Implementation of Teleophthalmology in the Medical Treatment Facilities in the Great Plains Regional Medical Command

    Science.gov (United States)

    2004-06-01

    noted that the prevalence of eye complications is directly related to the duration of the disease. “3.6% of younger-onset patients (aged ណ years...and older At time of diagnosis Yearly Prior to pregnancy Prior to conception or early first trimester 3 months Source: American College of...1520. Massachusetts Medical Society (2000). Retinopathy and nephropathy in patients with Type 1 diabetes four years after a trial of intensive

  10. Material control in nuclear fuel fabrication facilities. Part II. Accountability, instrumntation, and measurement techniques in fuel fabrication facilities, P. O. 1236909. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Borgonovi, G.M.; McCartin, T.J.; McDaniel, T.; Miller, C.L.; Nguyen, T.

    1978-12-01

    This report describes the measurement techniques, the instrumentation, and the procedures used in accountability and control of nuclear materials, as they apply to fuel fabrication facilities. Some of the material included has appeared elswhere and it has been summarized. An extensive bibliography is included. A spcific example of application of the accountability methods to a model fuel fabrication facility which is based on the Westinghouse Anderson design.

  11. Interactive radiopharmaceutical facility between Yale Medical Center and Brookhaven National Laboratory. Progress report, October 1976-June 1979

    Energy Technology Data Exchange (ETDEWEB)

    Gottschalk, A.

    1979-01-01

    DOE Contract No. EY-76-S-02-4078 was started in October 1976 to set up an investigative radiochemical facility at the Yale Medical Center which would bridge the gap between current investigation with radionuclides at the Yale School of Medicine and the facilities in the Chemistry Department at the Brookhaven National Laboratory. To facilitate these goals, Dr. Mathew L. Thakur was recruited who joined the Yale University faculty in March of 1977. This report briefly summarizes our research accomplishments through the end of June 1979. These can be broadly classified into three categories: (1) research using indium-111 labelled cellular blood components; (2) development of new radiopharmaceuticals; and (3) interaction with Dr. Alfred Wolf and colleagues in the Chemistry Department of Brookhaven National Laboratory.

  12. [Implementation of quality management in medical rehabilitation--current challenges for rehabilitation facilities].

    Science.gov (United States)

    Enge, M; Koch, A; Müller, T; Vorländer, T

    2010-12-01

    The legal responsibilities imposed upon rehabilitation facilities under section 20 (2a) SGB IX, necessitate fundamental decisions to be taken regarding the development of quality management systems over and above the existing framework. This article is intended to provide ideas and suggestions to assist rehabilitation facilities in implementing a quality management system, which is required in addition to participation in the quality assurance programmes stipulated by the rehabilitation carriers. In this context, the additional internal benefit a functioning quality management system can provide for ensuring a high level of quality and for maintaining the competitiveness of the rehabilitation facility should be taken into account. The core element of these observations, hence, is a list of requirements which enables assessment of the quality of consultants' performance in setting up a quality management system.

  13. New irradiation facilities for development of production methods of medical radionuclides at cyclotrons at Forschungszentrum Jülich

    Science.gov (United States)

    Spellerberg, S.; Scholten, B.; Spahn, I.; Felden, O.; Gebel, R.; Qaim, S. M.; Bai, M.; Neumaier, B.

    2017-05-01

    An essential basis for research and development work on radiopharmaceuticals is the efficient production of radionuclides of high quality. In this process research-oriented studies aiming for elucidation of biochemical processes require novel products. The radionuclide development at INM-5 entails basic research, e.g. the determination of nuclear reaction data, as well as technical aspects of practical production, such as high-current targetry, chemical separation, formulation and quality control. In this work developments, adaptation and optimization of irradiation facilities at the BC 1710, JULIC as Injector of COSY and COSY itself are summarized, which shall allow the extension of radionuclide production possibilities, aiming at innovations in medical applications.

  14. Source Term Estimates of Radioxenon Released from the BaTek Medical Isotope Production Facility Using External Measured Air Concentrations

    Energy Technology Data Exchange (ETDEWEB)

    Eslinger, Paul W.; Cameron, Ian M.; Dumais, Johannes R.; Imardjoko, Yudi; Marsoem, Pujadi; McIntyre, Justin I.; Miley, Harry S.; Stoehlker, Ulrich; Widodo, Susilo; Woods, Vincent T.

    2015-10-01

    Abstract Batan Teknologi (BaTek) operates an isotope production facility in Serpong, Indonesia that supplies 99mTc for use in medical procedures. Atmospheric releases of Xe-133 in the production process at BaTek are known to influence the measurements taken at the closest stations of the International Monitoring System (IMS). The purpose of the IMS is to detect evidence of nuclear explosions, including atmospheric releases of radionuclides. The xenon isotopes released from BaTek are the same as those produced in a nuclear explosion, but the isotopic ratios are different. Knowledge of the magnitude of releases from the isotope production facility helps inform analysts trying to decide whether a specific measurement result came from a nuclear explosion. A stack monitor deployed at BaTek in 2013 measured releases to the atmosphere for several isotopes. The facility operates on a weekly cycle, and the stack data for June 15-21, 2013 show a release of 1.84E13 Bq of Xe-133. Concentrations of Xe-133 in the air are available at the same time from a xenon sampler located 14 km from BaTek. An optimization process using atmospheric transport modeling and the sampler air concentrations produced a release estimate of 1.88E13 Bq. The same optimization process yielded a release estimate of 1.70E13 Bq for a different week in 2012. The stack release value and the two optimized estimates are all within 10 percent of each other. Weekly release estimates of 1.8E13 Bq and a 40 percent facility operation rate yields a rough annual release estimate of 3.7E13 Bq of Xe-133. This value is consistent with previously published estimates of annual releases for this facility, which are based on measurements at three IMS stations. These multiple lines of evidence cross-validate the stack release estimates and the release estimates from atmospheric samplers.

  15. An Assessment of the Electric Power Quality and Electrical Installation Impacts on Medical Electrical Equipment Operations at Health Care Facilities

    Directory of Open Access Journals (Sweden)

    Mário C.G. Ramos

    2009-01-01

    Full Text Available Problem statement: Medical electrical equipments at health care facilities presented malfunction and wrong medical information due to poor electric power quality and to inadequate electrical Installations. Some equipment such as X-ray, computerized axial tomography and magnetic resonance imaging are considered as polluting ones due to their high amount of harmonics and voltage transients produced on the electrical power supply when in operation, while other equipments, connected to the same power supply, are considered sensitive or victim ones, presenting failure or producing wrong. Approach: The effects on some sensitive medical electrical equipment were verified in a controlled environment at energy quality technological center of the technical school of the University of Sao Paulo. A heart monitor, pulmonary ventilator and pulse oxymeter equipment types were submitted to a controlled voltage supply with high harmonic content and voltage sags. The test methodology used simulated conditions based on Brazilian NBR standards, ANSI/IEEE Std. 519, IEC 60601 and IEC 61000-4-11 standards. Results: The results of the polluting equipment current consumption measurements as well as the three sensitive equipments tested were presented and discussed. The pulmonary ventilator presented problems that range from stoppage to expiratory valve blockage and alarm system failures. The pulse oxymeter presented display malfunctions and it was extremely sensitive to voltage sags. The heart monitor maintained steady operation in all test cases. Conclusion/Recommendations: In spite of several existing recommendations and standards for testing medical electrical equipments, there is a lack of standard related to test cases considering the effects of high harmonic and voltage sags. The quality of electrical installation in health care facilities needs to be improved to reduce risks to the patients and to provide better health treatment.

  16. The impact of critical event checklists on medical management and teamwork during simulated crises in a surgical daycare facility.

    Science.gov (United States)

    Everett, T C; Morgan, P J; Brydges, R; Kurrek, M; Tregunno, D; Cunningham, L; Chan, A; Forde, D; Tarshis, J

    2017-03-01

    Although the incidence of major adverse events in surgical daycare centres is low, these critical events may not be managed optimally due to the absence of resources that exist in larger hospitals. We aimed to study the impact of operating theatre critical event checklists on medical management and teamwork during whole-team operating theatre crisis simulations staged in a surgical daycare facility. We studied 56 simulation encounters (without and with a checklist available) divided between an initial session and then a retention session several months later. Medical management and teamwork were quantified via percentage adherence to key processes and the Team Emergency Assessment Measure, respectively. In the initial session, medical management was not improved by the presence of a checklist (56% without checklist vs. 62% with checklist; p = 0.50). In the retention session, teams performed significantly worse without the checklists (36% without checklist vs. 60% with checklist; p = 0.04). We did not observe a change in non-technical skills in the presence of a checklist in either the initial or retention sessions (68% without checklist vs. 69% with checklist (p = 0.94) and 69% without checklist vs. 65% with checklist (p = 0.36), respectively). Critical events checklists do not improve medical management or teamwork during simulated operating theatre crises in an ambulatory surgical daycare setting.

  17. Knowledge of tuberculosis management using directly observed treatment short course therapy among final year medical students in South Western Nigeria.

    Science.gov (United States)

    Olakunle, Olarewaju Sunday; Oladimeji, Olanrewaju; Olalekan, Adebimpe Wasiu; Olugbenga-Bello, Adenike; Akinleye, Callistus; Oluwatoyin, Olarewaju Abiodun

    2014-01-01

    Equipping medical graduates with the competence to manage tuberculosis is not just imperative but also urgent as the diseases have been consistently listed as one of the major causes of morbidity and mortality in Nigeria. However, there were no baseline studies done on knowledge of final year medical students on various aspects of TB diagnosis and management under directly observed treatment short course therapy (DOTS) which forms the basis of this study. A total of 241 final year medical students from three medical colleges in Nigeria were interviewed. The questions assessed their knowledge about various modes of transmission, symptoms and management of tuberculosis under DOTS. More than half of the respondents (i.e. 69%) had poor knowledge on TB disease. Only 33.6% mentioned sputum smear as the best tool of diagnosing TB according to guideline. Poor knowledge was also exhibited when asked of various categories under DOTS treatment regimen, as 46.1% correctly mentioned cat 1 and 2. Minority 18.7% and 6.7% had complete knowledge of 6 months duration for new TB cases and 8 months for re-treatment cases respectively. Less than one tenth, i.e. 4.6% and 2.9% could correctly defined what is called a new TB case and re-treatment cases according to standard guideline. The study reveals gross inadequacies in TB knowledge and management practices among Nigerian final year medical students. There is urgent need for incorporation of National TB guideline into existing undergraduate medical education curriculum as well as students rotation through activities in DOTS clinic.

  18. Career Choices of the 1976 Graduates of U.S. Medical Schools. Final Report.

    Science.gov (United States)

    Cuca, Janet Melei

    The interactions and influences of various sociodemographic, experiential, and other factors on the career decisions of medical students are described. Special emphasis is on students' characteristics and career preferences at application, their medical schools, their first graduate year programs, and the hospitals of their first graduate year…

  19. Designing Medical Facilities to Care for Patients with Highly Hazardous Communicable Diseases

    Science.gov (United States)

    2017-07-14

    lengthy period. “Hard-wired” features [TABLE 1] that were unique to the Slammer included negative pressure air handling, with HEPA- filtered intake air...and double HEPA- filtered exhaust air. Liquid waste drained into the laboratory sewer system that was steam sterilized prior to its release into the...PHN], [REF: Beam-Am JInfect Control] Positioning the isolation area a short distance from the entry point into the facility and laboratory assets

  20. Regional PIXE facility at Chandigarh (India) and Trace Element Analysis of Aerosol and Bio-medical Samples

    Science.gov (United States)

    Govil, I. M.

    2009-03-01

    A regional Proton induced X-ray Emission (PIXE) facility is newly developed using 3 Mev Proton beam from Variable Energy Cyclotron, Panjab University, Chandigarh (India). A new target chamber has been designed to cater for Proton Induced Gamma Emission (PIGE) and Rutherford Back Scattering (RBS) along with PIXE measurements. The HPGe x-ray detector, the Ge (Li) gamma-ray detector and a silicon surface barrier (SSB) detector can be mounted simultaneously in the chamber for this purpose. A remotely controlled stepper motor is provided to move the target wheel holding 12/24 samples at a time. This facility is now routinely used for the detection of trace elements in the aerosol, medical and forensic science samples. The paper presents the analysis of Aerosol samples collected from highly polluted steel city of Mandi Govindgarh in Punjab state and relatively clean city of Jammu in Jammu & Kashmir region. The results from the analysis of these samples show some basic differences in the trace element profile of the two cities. The paper also describes the trace element analysis of fly ash in the vicinity of Ropar Thermal Power plant in Punjab. The scope of this study was to determine the concentration and composition of atmospheric particulate matter (PM) in the vicinity of coal-fired thermal power plants in India. The data taken for the Bio-medical samples are also discussed.

  1. Education to reduce potentially harmful medication use among residents of assisted living facilities: a randomized controlled trial.

    Science.gov (United States)

    Pitkälä, Kaisu H; Juola, Anna-Liisa; Kautiainen, Hannu; Soini, Helena; Finne-Soveri, U Harriet; Bell, J Simon; Björkman, Mikko

    2014-12-01

    The objectives of this study were (1) to investigate the effect of nurse training on the use of potentially harmful medications; and (2) to explore the effect of nurse training on residents' health-related quality of life (HRQoL), health service utilization, and mortality. A randomized controlled trial. In total, 227 residents in 20 wards of assisted living facilities in Helsinki were recruited. The 20 wards were randomized into those in which (1) staff received two 4-hour training sessions on appropriate medication treatment (intervention group), and (2) staff received no additional training and continued to provide routine care (control group). Two 4-hour interactive training sessions for nursing staff based on constructive learning theory to recognize potentially harmful medications and corresponding adverse drug events. Use of potentially harmful medications, HRQoL assessed using the 15 dimensional instrument of health-related quality of life, health service utilization, and mortality assessed at baseline, and 6 and 12 months. During the 12-month follow-up, the mean number of potentially harmful medications decreased in the intervention wards [-0.43, 95% confidence interval (CI) -0.71 to -0.15] but remained constant in the control wards (+0.11, 95% CI -0.09 to +0.31) (P = .004, adjusted for age, sex, and comorbidities). HRQoL declined more slowly in the intervention wards (-0.038 (95% CI -0.054 to -0.022) than in the control wards (-0.072 (95% CI -0.089 to -0.055) (P = .005, adjusted for age, sex, and comorbidities). Residents of the intervention wards had significantly less hospital days (1.4 days/person/year, 95% CI 1.2-1.6) than in the control wards (2.3 days/person/year; 95% CI 2.1-2.7) (relative risk 0.60, 95% CI 0.49-0.75, P < .001, adjusted for age, sex, and comorbidities). Activating learning methods directed at nurses in charge of comprehensive care can reduce the use of harmful medications, maintain HRQoL, and reduce hospitalization in residents of

  2. Natural History of Multi-Drug Resistant Organisms in a New Military Medical Facility

    Science.gov (United States)

    2012-10-01

    Shigella flexneri  Pediatric Ward  06.248  COMPOSITE 1  Rhizobium  radiobacter  Medical Telemetry  07.334  Sink top  Staphyloccus saprophyticus  Medical...chair  Pseudomonas putida  Surgical Ward  06.342  Sink top  Aerococcous viridans  Surgical Ward  06.342  Call box  Rhizobium  radiobacter  Surgical Ward

  3. University of the Witwatersrand physiotherapy undergraduate curriculum alignment to medical conditions of patients within Gauteng state health facilities

    Directory of Open Access Journals (Sweden)

    Mokgobadibe V. Ntsiea

    2017-02-01

    Full Text Available Background: The healthcare sector requires graduates with the ability to confidently assess and manage the majority of the medical conditions seen in hospitals.Objective: To establish whether the most prevalent medical conditions treated by physiotherapists in Gauteng (South Africa state health facilities align with the University of the Witwatersrand (Wits physiotherapy curriculum.Methods: This was a retrospective review of condition-related statistics from physiotherapy departments within the Gauteng province state health facilities. Data from all Gauteng government hospitals that had submitted at least 75% of their physiotherapy condition–related statistics to the provincial statistics coordinator from January 2012 to December 2014 were considered and compared to medical conditions covered in the Wits 2015 physiotherapy curriculum to check if all conditions listed in the Gauteng statistics appeared within the Wits curriculum document. The number of teaching hours for the common conditions was noted to check the emphasis given to these conditions in the curriculum.Results: Eighty-three per cent of the hospitals submitted 75% of their monthly statistics. Overall, the most common conditions treated were lower limb fractures (13% followed by stroke (7.6% (n = 705 597. Within the neuro-musculoskeletal category, the most common conditions after lower limb fractures were soft tissue injuries (15.1% (n = 330 511. The most common cardiopulmonary conditions were tuberculosis (24.9%, followed by pneumonia (13.8% (n = 94 895. The most common neurological conditions were stroke (30.9% followed by cerebral palsy (17% (n = 174 024. Within the non-specified categories, the number of intensive care unit (ICU patients was the highest (23%, followed by sputum induction (21% (n = 138 187. The most common conditions that were emphasised within the Wits curriculum as indicated by the teaching hours: fractures, 14.5 (66% of 22 third-year orthopaedics hours

  4. DOE Center of Excellence in Medical Laser Applications. Final report, December 1, 1994--November 30, 1997

    Energy Technology Data Exchange (ETDEWEB)

    Jacques, S.L.

    1998-01-01

    An engineering network of collaborating medical laser laboratories are developing laser and optical technologies for medical diagnosis and therapy and are translating the engineering into medical centers in Portland OR, Houston TX, and Galveston TX. The Center includes the University of Texas M.D. Anderson Cancer Center, the University of Texas-Austin, Texas A and M University, Rice University, the University Texas Medical Branch-Galveston, Oregon Medical Laser Center (Providence St. Vincent Medical Center, Oregon Health Sciences University, and Oregon Graduate Institute, Portland, OR), and the University of Oregon. Diagnostics include reflectance, fluorescence, Raman IR, laser photoacoustics, optical coherence tomography, and several new video techniques for spectroscopy and imaging. Therapies include photocoagulation therapy, laser welding, pulsed laser ablation, and light-activated chemotherapy of cancer (photodynamic therapy, or PDT). Medical applications reaching the clinic include optical monitoring of hyperbilirubinemia in newborns, fluorescence detection of cervical dysplasia, laser thrombolysis of blood clots in heart attack and brain stroke, photothermal coagulant of benign prostate hyperplasia, and PDT for both veterinary and human cancer. New technologies include laser optoacoustic imaging of breast tumors and hemorrhage in head trauma and brain stroke, quality control monitoring of dosimetry during PDT for esophageal and lung cancer, polarization video reflectometry of skin cancer, laser welding of artificial tissue replacements, and feedback control of laser welding.

  5. Final Deactivation Project report on the Alpha Powder Facility, Building 3028, at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-04-01

    This report documents the condition of the Alpha Powder Facility (APF), Building 3028, after completion of deactivation activities. Activities conducted to place the facility in a safe and environmentally sound condition for transfer to the U.S. Department of Energy (DOE) Office of Environmental Restoration (EM-40) program are outlined. A history and profile of the facility prior to commencing deactivation activities and a profile of the building after completion of deactivation activities are provided. Turnover items, such as the post-deactivation surveillance and maintenance (S&M) plan, remaining hazardous materials, radiological controls, safeguards and security, quality assurance, facility operations, and supporting documentation provided for in the DOE Nuclear Materials and Facility Stabilization Program (EM-60) turnover package are discussed.

  6. Screening study for waste biomass to ethanol production facility using the Amoco process in New York State. Appendices to the final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-01

    The final report evaluates the economic feasibility of locating biomass-to-ethanol waste conversion facilities in New York State. Part 1 of the study evaluates 74 potential sites in New York City and identifies two preferred sites on Staten Island, the Proctor and Gamble and the Arthur Kill sites for further consideration. Part 2 evaluates upstate New York and determines that four regions surrounding the urban centers of Albany, Buffalo, Rochester, and Syracuse provide suitable areas from which to select specific sites for further consideration. A conceptual design and economic viability evaluation were developed for a minimum-size facility capable of processing 500 tons per day (tpd) of biomass consisting of wood or paper, or a combination of the two for upstate regions. The facility would use Amoco`s biomass conversion technology and produce 49,000 gallons per day of ethanol and approximately 300 tpd of lignin solid by-product. For New York City, a 1,000-tpd processing facility was also evaluated to examine effects of economies of scale. The reports evaluate the feasibility of building a biomass conversion facility in terms of city and state economic, environmental, and community factors. Given the data obtained to date, including changing costs for feedstock and ethanol, the project is marginally attractive. A facility should be as large as possible and located in a New York State Economic Development Zone to take advantage of economic incentives. The facility should have on-site oxidation capabilities, which will make it more financially viable given the high cost of energy. This appendix to the final report provides supplemental material supporting the evaluations.

  7. 77 FR 56817 - Notice of Public Hearings for the Draft Environmental Impact Statement for Medical Facilities...

    Science.gov (United States)

    2012-09-14

    ... actions and alternatives were evaluated within several environmental resource areas: Geology, topography... Department of the Navy Notice of Public Hearings for the Draft Environmental Impact Statement for Medical... Environmental Policy Act (NEPA) and the Council on Environmental Quality Regulations for implementing the...

  8. The Contribution of Social and Emotional Factors to the Utilization of Navy Outpatient Medical Facilities.

    Science.gov (United States)

    1982-01-01

    found a significantly higher proportion of social/emotional problemA identified in university-base’d clinics than in non- university based clinics...1965, 1, 371-375. Jones, V.R., & Vischi, T.R. Impact of alcohol , drue abuse and mental health treatment on mediral care utilization. Medical Care

  9. Computer Simulation of an Anesthesia Service at a U.S. Army Medical Treatment Facility

    Science.gov (United States)

    1999-08-01

    Anesthesia Simulation Study 1 Running head : ANESTHESIA SIMULATION Computer Simulation of an Anesthesia Service at a U.S. Army Medical Treatment...bettering marketing efforts). There are several articles that address staffing from the perspective of what type of provider is the most cost

  10. The final days of Edgar Allan Poe: clues to an old mystery using 21st century medical science.

    Science.gov (United States)

    Francis, Roger A

    This study examines all documented information regarding the final days and death of Edgar Allan Poe (1809-1849), in an attempt to determine the most likely cause of death of the American poet, short story writer, and literary critic. Information was gathered from letters, newspaper accounts, and magazine articles written during the period after Poe's death, and also from biographies and medical journal articles written up until the present. A chronology of Poe's final days was constructed, and this was used to form a differential diagnosis of possible causes of death. Death theories over the last 160 years were analyzed using this information. This analysis, along with a review of Poe's past medical history, would seem to support an alcohol-related cause of death.

  11. Searching for the Final Answer: Factors Contributing to Medication Administration Errors.

    Science.gov (United States)

    Pape, Tess M.

    2001-01-01

    Causal factors contributing to errors in medication administration should be thoroughly investigated, focusing on systems rather than individual nurses. Unless systemic causes are addressed, many errors will go unreported for fear of reprisal. (Contains 42 references.) (SK)

  12. Interns' Day in Surgery: improving intern performance through a simulation-based course for final year medical students.

    Science.gov (United States)

    Sinha, Sankar N; Page, Wendy

    2015-01-01

    The transition from final year medical student into the first year of clinical practice is known to be associated with anxiety and stress that ultimately affects job performance. Studies have shown that much of this stress and anxiety results from a junior doctor's lack of confidence in performing a number of basic tasks. We investigated if implementation of a half-day simulation-based course in the final year medical students results in increased confidence in performing these tasks. Final year medical students of the University of Tasmania's School of Medicine posted at the Royal Hobart Hospital participated in a half-day simulation course, comprised of multiple simulation stations, which required students to perform the basic tasks a competent surgical intern would be expected to complete. Students completed a survey which investigated their confidence with each task before and after the course. Overall, the majority of students thought that the Interns' Day in Surgery course was useful. The most significant improvements perceived were in case presentation (57.5% to 94.6%; P = 0.02) and communication with patients and other professional colleagues (55.5% to 75.5%; P = 0.01). A follow-up survey of doctors who attended this course reinforced its benefits. Simulation-based courses in clinical practice provide good learning opportunities for final year medical students within the curriculum. This study confirms significant gains in all skills categories practised during the course with perceived benefits subsequently identified by interns. This should lead to a less stressful and more successful transition from student to doctor and ultimately, better patient care. © 2014 Royal Australasian College of Surgeons.

  13. Evaluation of Occupational Health Teaching Sessions for Final Year Medical Students

    Directory of Open Access Journals (Sweden)

    Ali Naci Yildiz

    2012-06-01

    Conclusion: There was a greater increase in students’ knowledge on technical precautions than their knowledge on issues related to medical practice in the workplace. Visiting a workplace was found to contribute to the overall aim of knowledge and attitude change on occupational health issues. The scope of undergraduate medical education should be extended by improving occupational health education with respect to educational content, duration, and methods.

  14. Essential competencies in prescribing: A first european cross-sectional study among 895 final-year medical students.

    Science.gov (United States)

    Brinkman, D J; Tichelaar, J; Schutte, T; Benemei, S; Böttiger, Y; Chamontin, B; Christiaens, T; Likic, R; Maˇiulaitis, R; Marandi, T; Monteiro, E C; Papaioannidou, P; Pers, Y M; Pontes, C; Raskovic, A; Regenthal, R; Sanz, E J; Tamba, B I; Wilson, K; Vries, Tp de; Richir, M C; Agtmael, Ma van

    2017-02-01

    European medical students should have acquired adequate prescribing competencies before graduation, but it is not known whether this is the case. In this international multicenter study, we evaluated the essential knowledge, skills, and attitudes in clinical pharmacology and therapeutics (CPT) of final-year medical students across Europe. In a cross-sectional design, 26 medical schools from 17 European countries were asked to administer a standardized assessment and questionnaire to 50 final-year students. Although there were differences between schools, our results show an overall lack of essential prescribing competencies among final-year students in Europe. Students had a poor knowledge of drug interactions and contraindications, and chose inappropriate therapies for common diseases or made prescribing errors. Our results suggest that undergraduate teaching in CPT is inadequate in many European schools, leading to incompetent prescribers and potentially unsafe patient care. A European core curriculum with clear learning outcomes and assessments should be urgently developed. © 2016 The Authors. Clinical Pharmacology & Therapeutics published by Wiley Periodicals, Inc. on behalf of The American Society for Clinical Pharmacology and Therapeutics.

  15. Final Report for the Restart of the Waste Characterization, Reduction and Repackaging Facility (WCRRF) Contractor Readiness Assessment (CRA)

    Energy Technology Data Exchange (ETDEWEB)

    Stephens, Gregory Mark [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-02-22

    The Los Alamos National Laboratory (LANL or Laboratory) Contractor Readiness Assessment (CRA) required for restart of the Technical Area (TA) 50 Waste Characterization, Reduction, and Repackaging Facility (WCRRF) for remediated nitrate salt (RNS) waste operations was performed in compliance with the requirements of Department of Energy (DOE) Order (O) 425.1D, Verification of Readiness to Start Up or Restart Nuclear Facilities, and LANL procedure FSD-115-001, Verification of Readiness to Start Up or Restart LANL Nuclear Facilities, Activities, and Operations.

  16. An approach to radiation safety department benchmarking in academic and medical facilities.

    Science.gov (United States)

    Harvey, Richard P

    2015-02-01

    Based on anecdotal evidence and networking with colleagues at other facilities, it has become evident that some radiation safety departments are not adequately staffed and radiation safety professionals need to increase their staffing levels. Discussions with management regarding radiation safety department staffing often lead to similar conclusions. Management acknowledges the Radiation Safety Officer (RSO) or Director of Radiation Safety's concern but asks the RSO to provide benchmarking and justification for additional full-time equivalents (FTEs). The RSO must determine a method to benchmark and justify additional staffing needs while struggling to maintain a safe and compliant radiation safety program. Benchmarking and justification are extremely important tools that are commonly used to demonstrate the need for increased staffing in other disciplines and are tools that can be used by radiation safety professionals. Parameters that most RSOs would expect to be positive predictors of radiation safety staff size generally are and can be emphasized in benchmarking and justification report summaries. Facilities with large radiation safety departments tend to have large numbers of authorized users, be broad-scope programs, be subject to increased controls regulations, have large clinical operations, have significant numbers of academic radiation-producing machines, and have laser safety responsibilities.

  17. Evaluation of self-perception of mechanical ventilation knowledge among Brazilian final-year medical students, residents and emergency physicians

    Science.gov (United States)

    Tallo, Fernando Sabia; de Campos Vieira Abib, Simone; de Andrade Negri, Alexandre Jorgi; Filho, Paulo Cesar; Lopes, Renato Delascio; Lopes, Antônio Carlos

    2017-01-01

    OBJECTIVE: To present self-assessments of knowledge about mechanical ventilation made by final-year medical students, residents, and physicians taking qualifying courses at the Brazilian Society of Internal Medicine who work in urgent and emergency settings. METHODS: A 34-item questionnaire comprising different areas of knowledge and training in mechanical ventilation was given to 806 medical students, residents, and participants in qualifying courses at 11 medical schools in Brazil. The questionnaire’s self-assessment items for knowledge were transformed into scores. RESULTS: The average score among all participants was 21% (0-100%). Of the total, 85% respondents felt they did not receive sufficient information about mechanical ventilation during medical training. Additionally, 77% of the group reported that they would not know when to start noninvasive ventilation in a patient, and 81%, 81%, and 89% would not know how to start volume control, pressure control and pressure support ventilation modes, respectively. Furthermore, 86.4% and 94% of the participants believed they would not identify the basic principles of mechanical ventilation in patients with obstructive pulmonary disease and acute respiratory distress syndrome, respectively, and would feel insecure beginning ventilation. Finally, 77% said they would fear for the safety of a patient requiring invasive mechanical ventilation under their care. CONCLUSION: Self-assessment of knowledge and self-perception of safety for managing mechanical ventilation were deficient among residents, students and emergency physicians from a sample in Brazil.

  18. US Department of Energy Grand Junction Projects Office Remedial Action Project, final report of the decontamination and decommissioning of Building 36 at the Grand Junction Projects Office Facility

    Energy Technology Data Exchange (ETDEWEB)

    Widdop, M.R.

    1996-08-01

    The U.S. Department of Energy (DOE) Grand Junction Projects Office (GJPO) occupies a 61.7-acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore and mill tailings during uranium refining activities of the Manhattan Engineer District and during pilot milling experiments conducted for the U.S. Atomic Energy Commission`s domestic uranium procurement program. The DOE Defense Decontamination and Decommissioning Program established the GJPO Remedial Action Project to clean up and restore the facility lands, improvements, and the underlying aquifer. The site contractor for the facility, Rust Geotech, also is the remedial action contractor. Building 36 was found to be radiologically contaminated and was demolished in 1996. The soil beneath the building was remediated in accordance with identified standards and can be released for unlimited exposure and unrestricted use. This document was prepared in response to a DOE request for an individual final report for each contaminated GJPO building.

  19. Are medical students satisfied with rural community posting? A survey among final year students in medical schools of south-east Nigeria.

    Science.gov (United States)

    Ossai, Edmund N; Azuogu, Benedict N; Uwakwe, Kenechi A; Anyanwagu, Uchenna C; Ibiok, Ntat C; Ekeke, Ngozi

    2016-01-01

    The aim of the study was to determine whether final year medical students in medical schools of south-east Nigeria were satisfied with rural community posting. A cross-sectional descriptive study design was used. All final year medical students in the six medical schools in south-east Nigeria who had completed their rural community posting and were willing to participate were included in the study. The students were interviewed using a pretested, self-administered questionnaire. A total of 457 medical students participated in the study, representing a response rate of 86.7%. Only a minor proportion of the students (22.5%) were satisfied with rural community posting. The most common reason for dissatisfaction among the students was lack of interest in rural communities. Most students (68.7%) were of the opinion that a good rural community posting could influence the students to practise in a rural area after graduation. Factors associated with satisfaction with rural community posting included being a student in a federal institution (adjusted odds ratio (AOR)=0.6, 95% confidence interval (CI)=0.4-0.9), being a male student (AOR=2.4, 95%CI=1.5-3.9) and intention to specialize in community medicine after graduation (AOR=2.7, 95%CI=1.2-6.0). Most students were dissatisfied with rural community postings and the major reason for dissatisfaction was lack of interest in rural communities. A properly organized rural community posting is capable of changing the negative attitude of the students towards life and medical practice in the rural area. Adequate orientation of the students on the relevance of the posting, good community exposure and enhanced student lecturer interactions during the posting period could ensure satisfaction of the students. There should be a targeted evaluation of the rural community posting at the various medical schools in the country with the aim of strengthening and modifying the posting where necessary so as to ensure its purpose is realized.

  20. Recognition of Autism Spectrum Disorder (ASD) symptoms and knowledge about some other aspects of ASD among final year medical students in Nigeria, Sub-Saharan Africa.

    Science.gov (United States)

    Bakare, M O; Tunde-Ayinmode, M F; Adewuya, A O; Bello-Mojeed, M A; Sale, S; James, B O; Yunusa, M A; Obindo, J T; Igwe, M N; Odinka, P C; Okafor, C J; Oshodi, Y O; Okonoda, K M; Munir, K M; Orovwigho, A O

    2015-09-18

    Earlier studies suggest that knowledge about Autism Spectrum Disorder (ASD) among healthcare workers in Nigeria is low. This present study assessed the knowledge of Nigerian final year medical students about symptoms of ASD and some other aspects of ASD. This is a cross sectional descriptive study that drew a total of seven hundred and fifty-seven (757) final year medical students from ten (10) randomly selected fully accredited medical schools out of a total of twenty-seven (27) fully accredited medical schools in Nigeria. Sociodemographic and Knowledge about Childhood Autism among Health Workers (KCAHW) questionnaires were used to assess knowledge of final year medical students about ASD and obtain demographic information. Only few, 218 (28.8 %) of the 757 final year medical students had seen and participated in evaluation and management of at least a child with ASD during their clinical postings in pediatrics and psychiatry. Knowledge and recognition of symptoms of ASD is observed to be better among this group of final year medical students as shown by higher mean scores in the four domains of KCAHW questionnaire. Knowledge about ASD varies across gender and regions. Misconceptions about ASD were also observed among the final year medical students. More focus needs to be given to ASD in the curriculum of Nigerian undergraduate medical students, especially during their psychiatry and pediatric clinical postings.

  1. Performance evaluation of non-incineration treatment facilities for disinfection of medical infectious and sharps wastes in educational hospitals of Shahid Beheshti University of Medical Sciences in 2013

    Directory of Open Access Journals (Sweden)

    Anooshiravan Mohseni Band-pay

    2015-06-01

    Full Text Available Background: In 2007, a rule prohibiting the use of incinerators was ratified by the Iranian Islamic Parliament. Based on this rule, the Ministry of Health emphasized the sterilization of infectious waste at its production source by means of non-incineration equipment and methods. This research examined the performance of non-incineration technologies in treating medical infectious and sharps wastes at educational hospitals affiliated with Shahid Beheshti University of Medical Sciences. Methods: This cross-sectional descriptive study was conducted in 12 educational hospitals of Shahid Beheshti University of Medical Sciences. First, a questionnaire was designed and its validity approved. Then the required data was gathered during visits to participating hospitals. Finally, the collected data were analyzed using Microsoft Excel and SPSS version 16. Results: Findings showed that the daily production of infectious and sharps wastes in the studied hospitals generally equaled 3387 kg. All hospitals were equipped with non-incineration systems; however, only 83.3% of them were active. Some infectious waste was disposed of along with urban wastes without being sterilized. Monthly biological assessments of treatment equipment were implemented for only 41.7% of the equipment. Conclusion: The failures of the non-incineration systems demand that appropriate investigations be conducted prior to the purchase of these devices. Monthly biological assessments are essential to ensure the accuracy of the systems’ performance in hospitals.

  2. Conducting a study of Internet-based video conferencing for assessing acute medical problems in a nursing facility.

    Science.gov (United States)

    Weiner, Michael; Schadow, Gunther; Lindbergh, Donald; Warvel, Jill; Abernathy, Greg; Perkins, Susan M; Dexter, Paul R; McDonald, Clement J

    2002-01-01

    We expect the use of real-time, interactive video conferencing to grow, due to more affordable technology and new health policies. Building and implementing portable systems to enable conferencing between physicians and patients requires durable equipment, committed staff, reliable service, and adequate protection and capture of data. We are studying the use of Internet-based conferencing between on-call physicians and patients residing in a nursing facility. We describe the challenges we experienced in constructing the study. Initiating and orchestrating unscheduled conferences needs to be easy, and requirements for training staff in using equipment should be minimal. Studies of health outcomes should include identification of medical conditions most amenable to benefit from conferencing, and outcomes should include positive as well as negative effects.

  3. Screening study for waste biomass to ethanol production facility using the Amoco process in New York State. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-01

    This report evaluates the economic feasibility of locating biomass-to-ethanol waste conversion facilities in New York State. Part 1 of the study evaluates 74 potential sites in New York City and identifies two preferred sites on Staten, the Proctor Gamble and the Arthur Kill sites, for further consideration. Part 2 evaluates upstate New York and determines that four regions surrounding the urban centers of Albany, Buffalo, Rochester, and Syracuse provide suitable areas from which to select specific sites for further consideration. A separate Appendix provides supplemental material supporting the evaluations. A conceptual design and economic viability evaluation were developed for a minimum-size facility capable of processing 500 tons per day (tpd) of biomass consisting of wood or paper, or a combination of the two for upstate regions. The facility would use Amoco`s biomass conversion technology and produce 49,000 gallons per day of ethanol and approximately 300 tpd of lignin solid by-product. For New York City, a 1,000-tpd processing facility was also evaluated to examine effects of economies of scale. The reports evaluate the feasibility of building a biomass conversion facility in terms of city and state economic, environmental, and community factors. Given the data obtained to date, including changing costs for feedstock and ethanol, the project is marginally attractive. A facility should be as large as possible and located in a New York State Economic Development Zone to take advantage of economic incentives. The facility should have on-site oxidation capabilities, which will make it more financially viable given the high cost of energy. 26 figs., 121 tabs.

  4. Definition of spouse under the Family and Medical Leave Act. Final rule.

    Science.gov (United States)

    2015-02-25

    The Department of Labor's (Department) Wage and Hour Division (WHD) revises the regulation defining "spouse" under the Family and Medical Leave Act of 1993 (FMLA or the Act) in light of the United States Supreme Court's decision in United States v. Windsor, which found section 3 of the Defense of Marriage Act (DOMA) to be unconstitutional.

  5. Factors influencing choice of site for rural clinical placements by final year medical students in a South African university

    Directory of Open Access Journals (Sweden)

    Nontsikelelo O. Mapukata

    2017-01-01

    Full Text Available Background: Most of South Africa’s citizens who live in rural or underserved communities rely on the public health care sector to access quality health care. The value of rural exposure through clinical placements is well documented. Medical schools in South Africa have a responsibility to provide solutions that address the prevailing human resources challenges. Despite this commitment, medical students do not necessarily appreciate their role in resolving South Africa’s human resources challenges. This study aimed to assess the factors that influenced the choice of clinical learning sites in a self-selection process undertaken by Wits final year medical students for the compulsory 6-week integrated primary care block rotation.Methods: Qualitative data related to reasons for choice of service learning site were gathered from 524 pre-placement questionnaires completed by final year medical students entering the rotation over a 3-year period (2012–2014. Thematic analysis was performed using the MAXQDA software.Results: Eight themes emerged from the study indicating that the majority of participants were in favour of local urban underserved placement. Contextual factors, such as work commitments or family responsibilities, being compromised socially and losing academic standing were the main reasons for seeking urban placement. Good supervision, opportunistic learning, skills development and moral support were reasons for seeking rural placements. Previous voluntary exposure to rural practice or being of rural origin was a strong indicator for uptake of rural placement.Conclusion: This study has demonstrated the challenges faced by coordinators in balancing personal and institutional needs with country needs and the contextual factors that must be considered when implementing medical education programmes that respond to social challenges.

  6. Final work plan : investigation of potential contamination at the former CCC/USDA grain storage facility in Hanover, Kansas.

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, L. M.; Environmental Science Division

    2008-11-19

    The Commodity Credit Corporation (CCC), an agency of the U.S. Department of Agriculture (USDA), operated a grain storage facility at the northeastern edge of the city of Hanover, Kansas, from 1950 until the early 1970s. During this time, commercial grain fumigants containing carbon tetrachloride were in common use by the grain storage industry to preserve grain in their facilities. In February 1998, trace to low levels of carbon tetrachloride (below the maximum contaminant level [MCL] of 5.0 {micro}g/L) were detected in two private wells near the former grain storage facility at Hanover, as part of a statewide USDA private well sampling program that was implemented by the Kansas Department of Health and Environment (KDHE) near former CCC/USDA facilities. In April 2007, the CCC/USDA collected near-surface soil samples at 1.8-2 ft BGL (below ground level) at 61 locations across the former CCC/USDA facility. All soil samples were analyzed by the rigorous gas chromatograph-mass spectrometer analytical method (purge-and-trap method). No contamination was found in soil samples above the reporting limit of 10 {micro}g/kg. In July 2007, the CCC/USDA sampled indoor air at nine residences on or adjacent to its former facility to address the residents concerns regarding vapor intrusion. Low levels of carbon tetrachloride were detected at four of the nine homes. Because carbon tetrachloride found in private wells and indoor air at the site might be linked to historical use of fumigants containing carbon tetrachloride at its former grain storage facility, the CCC/USDA is proposing to conduct an investigation to determine the source and extent of the carbon tetrachloride contamination associated with the former facility. This investigation will be conducted in accordance with the intergovernmental agreement between the KDHE and the Farm Service Agency (FSA) of the USDA. The investigation at Hanover will be performed, on behalf of the CCC/USDA, by the Environmental Science

  7. Decontamination and dismantlement of the building 594 waste ion exchange facility at Argonne National Laboratory-East project final report.

    Energy Technology Data Exchange (ETDEWEB)

    Wiese, E. C.

    1998-11-23

    The Building 594 D&D Project was directed toward the following goals: Removal of any radioactive and hazardous materials associated with the Waste Ion Exchange Facility; Decontamination of the Waste Ion Exchange Facility to unrestricted use levels; Demolition of Building 594; and Documentation of all project activities affecting quality (i.e., waste packaging, instrument calibration, audit results, and personnel exposure) These goals had been set in order to eliminate the radiological and hazardous safety concerns inherent in the Waste Ion Exchange Facility and to allow, upon completion of the project, unescorted and unmonitored access to the area. The ion exchange system and the resin contained in the system were the primary areas of concern, while the condition of the building which housed the system was of secondary concern. ANL-E health physics technicians characterized the Building 594 Waste Ion Exchange Facility in September 1996. The characterization identified a total of three radionuclides present in the Waste Ion Exchange Facility with a total activity of less than 5 {micro}Ci (175 kBq). The radionuclides of concern were Co{sup 60}, Cs{sup 137}, and Am{sup 241}. The highest dose rates observed during the project were associated with the resin in the exchange vessels. DOE Order 5480.2A establishes the maximum whole body exposure for occupational workers at 5 rem (50 mSv)/yr; the administrative limit at ANL-E is 1 rem/yr (10 mSv/yr).

  8. Influence of a non-hospital medical care facility on antimicrobial resistance in wastewater.

    Directory of Open Access Journals (Sweden)

    Mathias Bäumlisberger

    Full Text Available The global widespread use of antimicrobials and accompanying increase in resistant bacterial strains is of major public health concern. Wastewater systems and wastewater treatment plants are considered a niche for antibiotic resistance genes (ARGs, with diverse microbial communities facilitating ARG transfer via mobile genetic element (MGE. In contrast to hospital sewage, wastewater from other health care facilities is still poorly investigated. At the instance of a nursing home located in south-west Germany, in the present study, shotgun metagenomics was used to investigate the impact on wastewater of samples collected up- and down-stream in different seasons. Microbial composition, ARGs and MGEs were analyzed using different annotation approaches with various databases, including Antibiotic Resistance Ontologies (ARO, integrons and plasmids. Our analysis identified seasonal differences in microbial communities and abundance of ARG and MGE between samples from different seasons. However, no obvious differences were detected between up- and downstream samples. The results suggest that, in contrast to hospitals, sewage from the nursing home does not have a major impact on ARG or MGE in wastewater, presumably due to much less intense antimicrobial usage. Possible limitations of metagenomic studies using high-throughput sequencing for detection of genes that seemingly confer antibiotic resistance are discussed.

  9. Assessment of Present Anadromous Fish Production Facilities in the Columbia River Basin, Washington Department of Wildlife Hatcheries, Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Delarm, Michael R.; Smith, Robert Z.

    1990-07-01

    The goal of this report is to document current production practices for hatcheries which rear anadromous fish in the Columbia River Basin and to identify those facilities where production can be increased. A total of 85 hatchery and satellite facilities operated by the Idaho Department of Fish and Game, Oregon Department of Fish and Game, US Fish and Wildlife Service, Washington Department of Wildlife, Washington Department of Wildlife, and Washington Department of Fisheries were evaluated. The years 1985 to 1987 were used in this evaluation. During those years, releases averaged 143,306,596 smolts weighing 7,693,589 pounds. A total of 48 hatchery or satellite facilities were identified as having expansion capability. They were estimated to have the potential for increasing production by an 84,448,000 smolts weighing 4,853,306 pounds. 2 refs., 25 tabs.

  10. Assessment of Present Anadromous Fish Production Facilities in the Columbia River Basin, US Fish and Wildlife Hatcheries, Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Delarm, Michael R.; Smith, Robert Z.

    1990-07-01

    The goal of this report is to document current production practices for hatcheries which rear anadromous fish in the Columbia River Basin and to identify those facilities where production can be increased. A total of 85 hatchery and satellite facilities operated by the Idaho Department of Fish and Game, Oregon Department of Fish and Game, US Fish and Wildlife Service, Washington Department of Wildlife, and Washington Department of Fisheries were evaluated. The years 1985 to 1987 were used in this evaluation. During those years, releases averaged 143,306,596 smolts weighing 7,693,589 pounds. A total of 48 hatchery or satellite facilities were identified as having expansion capability. They were estimated to have the potential for increasing production by an 84,448,000 smolts weighing 4,853,306 pounds. 2 refs., 25 tabs.

  11. FINAL REPORT FORMER RADIATION WORKER MEDICAL SURVEILLANCE PROGRAM AT ROCKY FLATS For Department of Energy Programs

    Energy Technology Data Exchange (ETDEWEB)

    Joe M. Aldrich

    2004-11-01

    The Former Radiation Worker Medical Surveillance Program at Rocky Flats was conducted in Arvada, CO, by Oak Ridge Associated Universities through the Oak Ridge Institute for Science and Education under DOE Contract DE-AC05-00OR22750. Objectives of the program were to obtain information on the value of medical surveillance among at-risk former radiation workers and to provide long-term internal radiation dosimetry information to the scientific community. This program provided the former radiation workers of the Rocky Flats Environmental Technology Site (formerly Rocky Flats Plant) an opportunity to receive follow-up medical monitoring and a re-evaluation of their internal radiation dose. The former Rocky Flats radiation worker population is distinctive because it was a reasonably stable work force that received occupational exposures, at times substantial, over several decades. This report reflects the summation of health outcomes, statistical analyses, and dose assessment information on former Rocky Flats radiation workers to the date of study termination as of March 2004.

  12. Prevalence of skin diseases among infants in a tertiary medical facility in Uttarakhand

    Directory of Open Access Journals (Sweden)

    Jitendra Singh Bist

    2015-05-01

    Full Text Available Background: Skin diseases are common in infancy. This study aimed to determine to prevalence of various dermatoses in infancy in Uttarakhand. Objectives: To determine the prevalence of different dermatologic diseases in infant in Uttarakhand. Methods: A prospective study was carried out for one year from 06 Sep 2013 to 05 Sep 2014, to study prevalence and patterns of dermatological lesions in infants, a tertiary care health facility in Uttarakhand. A total of 234 infants of both sexes were seen during this period. Results: Of 234 patients 58.9% were males. Noninfectious dermatitis was the largest group of skin disorders in infancy, constituting 35.89% of total cases. Seborrheic dermatitis was commonest type of non-infectious dermatitis in infancy (42.85% followed by atopic dermatitis (19.04%, Ptyriasis alba (14.28 %, contact and diaper dermatitis (7.14% each. Seborrheic dermatitis did not display any gender or seasonal bias. Infectious/ parasitic infestations formed second largest group of dermatoses in infants (26.92% with commonest being fungal infections (49% cases of infectious group followed by parasitic infestations (26.98%. Bacterial and viral infections were formed only 12.69% and 11.11% of infectious group cases. Nonfungal and nonparasitic infections showed higher incidence in summers. Conclusion: Out of 234 infants who attended paediatric dermatology clinic, major dermatoses were of noninfectious origin with seborrheic dermatitis forming largest group. Infectious etiology dermatoses constituted second major group with fungal and parasitic etiology. Nonfungal and non-parasitic dermatoses showed higher prevalence in summer months. [Int J Res Med Sci 2015; 3(5.000: 1172-1176

  13. Actinide Partitioning-Transmutation Program Final Report. V. Preconceptual designs and costs of partitioning facilities and shipping casks (appendix 3)

    Energy Technology Data Exchange (ETDEWEB)

    1980-06-01

    This Appendix contains cost estimate documents for the Fuels Reprocessing Plant Waste Treatment Facility. Plant costs are summarized by Code of Accounts and by Process Function. Costs contribution to each account are detailed. Process equipment costs are detailed for each Waste Treatment Process. Service utility costs are also summarized and detailed.

  14. Material control in nuclear fuel fabrication facilities. Part I. Fuel descriptions and fabrication processes, P. O. 1236909 Final report

    Energy Technology Data Exchange (ETDEWEB)

    Borgonovi, G.M.; McCartin, T.J.; Miller, C.L.

    1978-12-01

    The report presents information on foreign nuclear fuel fabrication facilities. Fuel descriptions and fuel fabrication information for three basic reactor types are presented: The information presented for LWRs assumes that Pu--U Mixed Oxide Fuel (MOX) will be used as fuel.

  15. Medical weather forecast as the risk management facilities of meteopathia with population

    Science.gov (United States)

    Efimenko, Natalya; Chalaya, Elena; Povolotskaia, Nina; Senik, Irina; Topuriya, David

    2013-04-01

    Frequent cases of extreme deviations of weather conditions and anthropogenic press on the Earth atmosphere are external stressors and provoke the development of meteopathic reactions (DMR) with people suffering from dysadaptation (DA). [EGU2011-6740-3; EGU2012-6103]. The influence of weather factors on the person is multivariate which complicates the search of physiological indicators of this exposure. The results of long-term researches of meteodependence and risks development of weather-conditional pathologic reactions with people suffering from DA (1640 observed people) in various systems and human body subsystems (thermal control, cardiovascular, respiratory, vegetative and central nervous systems) were taken as a principle of calculation methodology of estimation of weather pathogenicity (EWP). This estimation is used in the system of medical weather forecast (MWF) in the resorts of Caucasian Mineral Waters and is marked as an organized structure in prevention of DMR risks. Nowadays MWF efficiency is from 78% to 95% as it depends not only on the performance of models of dynamic, synoptic, heliogeophysical forecasts, but also on the underestimation of environmental factors which often act as dominating stressors. The program of atmospheric global system monitoring and real-time forecasts doesn`t include atmospheric electricity factors, ionization factors, range and chemistry factors of aerosol particles and organic volatile plant matters in atmospheric boundary layer. New fractality researches of control mechanisms processes providing adaptation to external and internal environmental conditions with patients suffering from DA allowed us to understand the meaning of the phenomenon of structural similarity and similarity of physiological response processes to the influence of weather types with similar dominating environmental factors. Particularly, atmospheric conditions should be regarded as stressor natural factors that create deionization conditions of the

  16. Increase in medical knowledge during the final year of undergraduate medical education in Germany [Wissenszuwachs im Praktischen Jahr des Medizinstudiums in Deutschland

    Directory of Open Access Journals (Sweden)

    Harendza, Sigrid

    2013-08-01

    Full Text Available [english] Aims: In Germany, the final year of undergraduate medical education (‘practice year’ consists of three 16-week clinical attachments, two of which are internal medicine and surgery. Students can choose a specific specialty for their third 16-week attachment. Practice year students do not receive specific teaching to prepare them for the National Licensing Examination. It is unknown whether knowledge levels increase during this year. This study aimed at assessing knowledge at the beginning and the end of the final year of medical school. Methods: Three hundred pre-selected United States Medical Licensing Examination type items from ten medical disciplines were reviewed by ten recent medical graduates from the Netherlands and Germany. The resulting test included 150 items and was taken by 77 and 79 final year medical students from Göttingen and Hamburg at the beginning and the end of their practice year, respectively. Results: Cronbach’s α of the pre- and post-test was 0.75 and 0.68, respectively. Mean percent scores in the pre- and post-test were 63.9±6.9 and 69.4±5.7, respectively (p[german] Zielsetzung: In Deutschland besteht das letzte Jahr des Studiums der Humanmedizin ("Praktisches Jahr", PJ aus drei Tertialen von je 16 Wochen, von denen eines in der Inneren Medizin und eines in der Chirurgie abzuleisten ist. Die Fachrichtung des dritten Tertials von 16 Wochen kann von den Studierenden frei gewählt werden. Während des Praktischen Jahres findet keine gezielte Vorbereitung auf den schriftlichen Teil des Staatsexamens statt. Es ist unklar, inwieweit die Studierenden während des Praktischen Jahres auch neue Wissensinhalte erlernen. Ziel dieser Studie war es, zu Beginn und am Ende des Praktischen Jahres Wissensinhalte zu überprüfen. Methodik: Zehn Absolventen des Medizinstudiums in Deutschland und den Niederlanden trafen eine Auswahl aus 300 vorselektierten Fragen der US-amerikanischen Abschlussprüfung (USMLE, die zehn

  17. 150 kWe solar-powered deep well irrigation facility. Volume II. Main report. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1977-08-30

    The screening, selection, and detailed optimized design of a 150 kW solar-powered irrigation facility for construction on a farm in Arizona are described. The heliostat/central receiver collector system was selected, and a steam Rankine cycle power system using molten salt heat transfer fluid was chosen. Systems analyses and detailed designs of the subsystems are presented. Cost estimates are included, and the Phase II program plan is detailed. (WHK)

  18. Assessment of the feasibility of recommissioning the French Landing Hydroelectric Facility in Van Buren Township, Michigan. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1979-02-01

    The results of a study of the feasibility of recommissioning a small, low-head hydroelectric facility in southeastern Michigan are presented. The study concludes that there are several cost-effective designs for recommissioning the site, based on the use of vertical turbines and the sale of power to nearby industrial markets. In terms of the bulk sale of power to the local electric utility, no cost-effective alternatives were found to exist. A major burden on project cost-effectiveness was found to be the relatively large costs for structural repairs to the dam and powerhouse needed to insure safe operation and on adequate service life. From an engineering standpoint it was found that the items of equipment needed to recommission the site are readily available from both US and foreign manufacturers. A variety of hydraulic turbine designs could be successfully adapted to the existing powerhouse, without extensive new construction. It was determined that the production capacity of the facility had an important influence on the cost-effectiveness of the project. A detailed benefit/cost analysis was conducted to identify the optimum facility size in terms of incremental costs and revenues. A detailed environmental assessment using an impact matrix methodology concluded that the development of the facility for hydroelectric generation would have important positive environmental consequences related to improved impoundment and flow management techniques as well as enhanced public safety due to structural repairs to the dam. The institutional and regulatory implications of developing the site for hydroelectric generation were found to be significant but manageable.

  19. Final Environmental Assessment: For Immediate Storm Surge Protection for Santa Rosa Island Facilities, Eglin Air Force Base, FL

    Science.gov (United States)

    2006-06-01

    allowable atmospheric concentration that may occur and still protect public health and welfare with a reasonable margin of safety. The NAAQS...federal agencies to make every effort to reduce the risk of flood loss, minimize the impact of floods on human health, safety, and welfare , and preserve...Protection for Santa Rosa Island Facilities, Eglin Air Force Base, FL Davis et al., 2000 Davis, R. W., W. E. Evans, B. Würsig (eds), 2000. Cetaceans

  20. Final report of the decontamination and decommissioning of Building 34 at the Grand Junction Projects Office Facility

    Energy Technology Data Exchange (ETDEWEB)

    Widdop, M.R.

    1996-08-01

    The U.S. Department of Energy (DOE) Grand Junction Projects Office (GJPO) occupies a 61.7 acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore and mill tailings during uranium refining activities of the Manhattan Engineer District and during pilot milling experiments conducted for the U.S. Atomic Energy Commission`s domestic uranium procurement program. The DOE Defense Decontamination and Decommissioning Program established the Grand Junction Projects Office Remedial Action Project to clean up and restore the facility lands, improvements, and the underlying aquifer. The site contractor for the facility, Rust Geotech, was also the remedial action contractor. Building 34 was radiologically contaminated and the building was demolished in 1996. The soil area within the footprint of the building was analyzed and found to be not contaminated. The area can be released for unlimited exposure and unrestricted use. This document was prepared in response to a DOE request for an individual closeout report for each contaminated GJPO building.

  1. Maximum dose angle for oblique incidence on primary beam protective barriers in the design of medical radiation therapy facilities.

    Science.gov (United States)

    Fondevila, Damián; Arbiser, Silvio; Sansogne, Rosana; Brunetto, Mónica; Dosoretz, Bernardo

    2008-05-01

    Primary barrier determinations for the shielding of medical radiation therapy facilities are generally made assuming normal beam incidence on the barrier, since this is geometrically the most unfavorable condition for that shielding barrier whenever the occupation line is allowed to run along the barrier. However, when the occupation line (for example, the wall of an adjacent building) runs perpendicular to the barrier (especially roof barrier), then two opposing factors come in to play: increasing obliquity angle with respect to the barrier increases the attenuation, while the distance to the calculation point decreases, hence, increasing the dose. As a result, there exists an angle (alpha(max)) for which the equivalent dose results in a maximum, constituting the most unfavorable geometric condition for that shielding barrier. Based on the usual NCRP Report No. 151 model, this article presents a simple formula for obtaining alpha(max), which is a function of the thickness of the barrier (t(E)) and the equilibrium tenth-value layer (TVL(e)) of the shielding material for the nominal energy of the beam. It can be seen that alpha(max) increases for increasing TVL(e) (hence, beam energy) and decreases for increasing t(E), with a range of variation that goes from 13 to 40 deg for concrete barriers thicknesses in the range of 50-300 cm and most commercially available teletherapy machines. This parameter has not been calculated in the existing literature for radiotherapy facilities design and has practical applications, as in calculating the required unoccupied roof shielding for the protection of a nearby building located in the plane of the primary beam rotation.

  2. The impact of a final disposal facility for spent nuclear fuel on a municipality`s image; Tutkimus loppusijoituslaitoksen vaikutuksista kuntien imagoon

    Energy Technology Data Exchange (ETDEWEB)

    Kankaanpaeae, H.; Haapavaara, L.; Lampinen, T

    1999-02-01

    The study comprised on one hand a nationwide telephone interview (totally 800 interviews) aimed at mapping out the current image of possible host municipalities to a final disposal facility for spent nuclear fuel, and on the other hand some group interviews of people of another parish but of interest from the municipalities` point of view. The purpose of these group interviews was the same as that of the telephone interview, i.e. to find out what kind of an impact locating a final disposal facility of spent nuclear fuel in a certain municipality would have on the host municipality`s image. Because the groups interviewed were selected on different grounds the results of the interviews are not fully comparable. The most important result of the study is that the current attitude towards a final disposal facility for spent nuclear fuel is calm and collected and that the matter is often considered from the standpoint of an outsider. The issue is easily ignored, classified as a matter `which does not concern me`, provided that the facility will not be placed too near one`s own home. Among those interviewed the subject seemed not to be of any `great interest and did not arouse spontaneous feelings for or against`. There are, however, deeply rooted beliefs concerning the facility and quite strong negative and positive attitudes towards it. The facility itself and the associated decision-making procedure arouse many questions, which at present to a large extent are still unexpressed because the subject is considered so remote. It is, however, necessary to give concrete answers to the questions because this makes it possible for people to relate the issue to daily life. It is further important that things arousing fear and doubts also can be discussed because a silence in this respect only emphasizes their importance. The attitude towards the facility is varying. On one hand there are economic and technical factors: the probable economic benefit from it, the obligation to

  3. Final work plan : supplemental upward vapor intrusion investigation at the former CCC/USDA grain storage facility in Hanover, Kansas.

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, L. M.; Environmental Science Division

    2008-12-15

    The Commodity Credit Corporation (CCC), an agency of the U.S. Department of Agriculture (USDA), operated a grain storage facility at the northeastern edge of the city of Hanover, Kansas, from 1950 until the early 1970s. During this time, commercial grain fumigants containing carbon tetrachloride were in common use by the grain storage industry to preserve grain in their facilities. In February 1998, trace to low levels of carbon tetrachloride (below the maximum contaminant level [MCL] of 5.0 {micro}g/L) were detected in two private wells near the former grain storage facility at Hanover, as part of a statewide USDA private well sampling program that was implemented by the Kansas Department of Health and Environment (KDHE) near former CCC/USDA facilities. In 2007, the CCC/USDA conducted near-surface soil sampling at 61 locations and also sampled indoor air at nine residences on or adjacent to its former Hanover facility to address the residents concerns regarding vapor intrusion. Low levels of carbon tetrachloride were detected at four of the nine homes. The results were submitted to the KDHE in October 2007 (Argonne 2007). On the basis of the results, the KDHE requested sub-slab sampling and/or indoor air sampling (KDHE 2007). This Work Plan describes, in detail, the proposed additional scope of work requested by the KDHE and has been developed as a supplement to the comprehensive site investigation work plan that is pending (Argonne 2008). Indoor air samples collected previously from four homes at Hanover were shown to contain the carbon tetrachloride at low concentrations (Table 2.1). It cannot be concluded from these previous data that the source of the detected carbon tetrachloride is vapor intrusion attributable to former grain storage operations of the CCC/USDA at Hanover. The technical objective of the vapor intrusion investigation described here is to assess the risk to human health due to the potential for upward migration of carbon tetrachloride and

  4. Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2017, SNF Value-Based Purchasing Program, SNF Quality Reporting Program, and SNF Payment Models Research. Final rule.

    Science.gov (United States)

    2016-08-01

    This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2017. In addition, it specifies a potentially preventable readmission measure for the Skilled Nursing Facility Value-Based Purchasing Program (SNF VBP), and implements requirements for that program, including performance standards, a scoring methodology, and a review and correction process for performance information to be made public, aimed at implementing value-based purchasing for SNFs. Additionally, this final rule includes additional polices and measures in the Skilled Nursing Facility Quality Reporting Program (SNF QRP). This final rule also responds to comments on the SNF Payment Models Research (PMR) project.

  5. Modern Chemistry Techniques Applied to Metal Behavior and Chelation in Medical and Environmental Systems ? Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Sutton, M; Andresen, B; Burastero, S R; Chiarappa-Zucca, M L; Chinn, S C; Coronado, P R; Gash, A E; Perkins, J; Sawvel, A M; Szechenyi, S C

    2005-02-03

    This report details the research and findings generated over the course of a 3-year research project funded by Lawrence Livermore National Laboratory (LLNL) Laboratory Directed Research and Development (LDRD). Originally tasked with studying beryllium chemistry and chelation for the treatment of Chronic Beryllium Disease and environmental remediation of beryllium-contaminated environments, this work has yielded results in beryllium and uranium solubility and speciation associated with toxicology; specific and effective chelation agents for beryllium, capable of lowering beryllium tissue burden and increasing urinary excretion in mice, and dissolution of beryllium contamination at LLNL Site 300; {sup 9}Be NMR studies previously unstudied at LLNL; secondary ionization mass spec (SIMS) imaging of beryllium in spleen and lung tissue; beryllium interactions with aerogel/GAC material for environmental cleanup. The results show that chelator development using modern chemical techniques such as chemical thermodynamic modeling, was successful in identifying and utilizing tried and tested beryllium chelators for use in medical and environmental scenarios. Additionally, a study of uranium speciation in simulated biological fluids identified uranium species present in urine, gastric juice, pancreatic fluid, airway surface fluid, simulated lung fluid, bile, saliva, plasma, interstitial fluid and intracellular fluid.

  6. Energy Engineering Analysis. Cutler Army Community Hospital and Associated Facilities, Fort Devens, Massachusetts. Volume 1 - executive summary. Final Submittal report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1985-10-01

    In February 1980, the Corps of Engineers, Norfolk District, initiated Contract No. DACA65-80-C-0003 with Reynolds, Smith and Hills, Architects-Engineers-Planners, Inc. of Jacksonville, Florida. This contract called for the performance of Energy Engineering Analysis Programs (EEAP) at three U.S. Army installations: Fort Devens, Massachusetts; Letterkenny Army Depot, Pennsylvania; and Seneca Army Depot, New York. The objective of these programs was the identification, evaluation and development of programming documents for energy conservation projects which meet the criteria of the Army`s Energy Conservation Investment Program (ECIP) and other funding mechanisms. The basic contract was modified by the Corps of Engineers several times to include additional increments of energy-related studies at each of the three installations. Work performed thus far for Fort Devens has included the following increments: A - ECIP`s for buildings and processes; B - ECIP`s for utilities and energy distribution systems and EMCS; C - Solar and renewable energy systems; D - Wood-Fired Steam Generation Plant; E - Coal conversion; and G - Projects identified in Increments A B that did not meet ECIP criteria In order to fulfill expanded requirements of the Army Facilities Energy Plan, the Corps of Engineers extended the contract with RSH to include a detailed energy audit of the Cutler Army Community Hospital and Associated Facilities at Fort Devens, Massachusetts. The Associated Facilities are the Vail Dental Clinic and the Oral Health Center. The energy audit consists of a field survey, analysis of energy conservation opportunities, and development of 1391`s and other programming documents for qualifying projects.

  7. Comprehensive computerized medical imaging at Victoria General Hospital: final implementation plan

    Science.gov (United States)

    Fisher, Paul D.; Brauer, Gerhard W.; Nosil, Josip; Scobie, Duncan L.; Clark, R. P.; Ritchie, Gordon W.; Weigl, Wilhelm J.

    1990-08-01

    A plan for the installation and implementation of a comprehensive computer-based system for the management and communication of digital radiographic images and diagnostic information is described. The paper is based on the authors' experience with, and evaluation of, prototype equipment and systems over the past 5 years. The final configuration will be realized in 1992 at the completion of a 3-phase installation plan. The system will address the clinical, data management, and administrative needs of the different types of users within the department, as well as the requirement to distribute radiographic information and images to locations outside of the department. In order to be considered successful, the system described herein will need to bring about a 90% reduction in both paper- and film-based communication of images and information. The British Columbia Ministry of Health is funding this phase of the project in order to obtain information on which to base decisions regarding installation of similar systems at other sites within the Province and predict with some confidence the cost effectiveness of such decisions.

  8. Outpatient evaluation, recognition, and initial management of pediatric overweight and obesity in U.S. military medical treatment facilities.

    Science.gov (United States)

    Dickey, Wayne; Arday, David R; Kelly, Joseph; Carnahan, Col David

    2017-02-01

    As childhood obesity is a concern in many communities, this study investigated outpatient evaluation and initial management of overweight and obese pediatric patients in U.S. military medical treatment facilities (MTFs). Samples of 579 overweight and 341 obese patients (as determined by body mass index [BMI]) aged 3-17 years were drawn from MTFs. All available FY2011 outpatient records were searched for documentation of BMI assessment, overweight/obesity diagnosis, and counseling. Administrative data for these patients were merged to assess coded diagnostic and counseling rates and receipt of recommended laboratory screenings. Generic BMI documentation was high, but BMI percentile assessments were found among fewer than half the patients. Diagnostic recording or recognition totaled 10.9% of overweight and 32.0% of obese. Counseling rates were higher, with 46.4% and 61.0% of overweight and obese patients, respectively, receiving weight related counseling. Among patients 10 years of age or older, rates of recommended lab screenings for diabetes, liver abnormality, and dyslipidemia were not greater than 33%. BMI percentile recording was strongly associated with diagnostic recording, and diagnostic recording was strongly associated with counseling. Improvements to electronic health records or implementation of local procedures to facilitate better diagnostic recording would likely improve adherence to clinical practice guidelines. ©2016 American Association of Nurse Practitioners.

  9. US Department of Energy Grand Junction Projects Office Remedial Action Project. Final report of the decontamination and decommissioning of Building 52 at the Grand Junction Projects Office Facility

    Energy Technology Data Exchange (ETDEWEB)

    Krabacher, J.E.

    1996-08-01

    The U.S. Department of Energy (DOE) Grand Junction Projects Office (GJPO) occupies a 61.7-acre facility along the Gunnison River near Grand Junction, Colorado. This site was contaminated with uranium ore and mill tailings during uranium refining activities of the Manhattan Engineer District and during pilot milling experiments conducted for the U.S. Atomic Energy Commission`s domestic uranium procurement program. The DOE Defense Decontamination and Decommissioning Program established the GJPO Remedial Action Project to clean up and restore the facility lands, improvements, and the underlying aquifer. The site contractor for the facility, Rust Geotech, also was the remedial action contractor. Building 52 was found to be radiologically contaminated and was demolished in 1994. The soil area within the footprint of the building has been remediated in accordance with the identified standards and the area can be released for unlimited exposure and unrestricted use. This document was prepared in response to a DOE request for an individual final report for each contaminated GJPO building.

  10. Thermal and fluid mixing in a 1/2-scale test facility. Volume 2. Data report. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Dolan, F.X.; Valenzuela, J.A.

    1985-07-01

    This report presents data from an experimental study of fluid mixing in a 1/2-scale model of the cold leg, downcomer, lower plenum, pump simulator, and loop seal typical of a Westinghouse Pressurized Water Reactor. The tests were transient cooldown tests in that they simulated an extreme condition of Small Break Loss of Coolant Accident (SBLOCA) during which cold High Pressure Injection (HPI) fluid is injected into stagnant, hot primary fluid with complete loss of natural circulation in the loop. Extensive temperature, velocity, and heat transfer coefficient data are presented at two cold leg Froude numbers: 0.052 and 0.076. The 1/2-scale data are compared with earlier data from a 1/5-scale, geometrically similar facility to assess scaling principles.

  11. MANAGEMENT PRE-START REVIEW FINAL REPORT FOR THE BIOSAFETY LEVEL 3 (BSL-3) FACILITY (B368) LAWRENCE LIVERMORE NATIONAL LABORATORY

    Energy Technology Data Exchange (ETDEWEB)

    Hull, R; O' brien, J; Owens, T; Salvo, V; Sassone, D; Tuholski, S J; Tsan, S

    2006-07-25

    A Lawrence Livermore National Laboratory (LLNL) Management Pre-Start Review (MPR) Team was formed to independently verify the operational readiness of Building 368 (B368) Biosafety Level III (BSL-3) Facility to conduct research with biological pathogens and toxins including those considered Select Agents. Review objectives and criteria were developed from the DOE/NNSA and LLNL requirements. These were provided in the Implementation Plan for the Biosafety Level III (BSL-3) Facility Management Pre-Start Review (BSL-3 MPR) at Lawrence Livermore National Laboratory that was reviewed and approved by DOE/NNSA-LSO. The formal part of the LLNL MPR for the BSL-3 Facility was begun in August of 2005 but work on the MPR was stopped in October of 2005 due to the need for LLNL to reassess organizational and operational controls and respond to Centers for Disease Control and Prevention inquiries related to a shipping incident involving select agents. The MPR was restarted in mid-June of 2006. Preliminary facility tours and familiarization with project documents took place in June of 2005. The Independent Management Review Team consists of seven members led by a Team Leader with expertise in management, operations, and safety basis experience with biosafety laboratories. Other team members have expertise in electrical engineering, security, environmental/waste management/regulatory compliance, biosafety/industrial hygiene/medical, structural engineering, and mechanical engineering. The MPR Team reviewed various documents, including authorization basis, safety, emergency preparedness, and various operations, configuration, and management plans. They also reviewed building plans, equipment repair/maintenance documents, training records, and many standard operating procedures. The MPR resulted in three Pre-Start Findings, one Post-Start/Critical Finding, and four observations which are shown on Tables 1, 2, and 3, respectively. Based upon this review the Team feels that the B368

  12. Present Status And First Results of the Final Focus Beam Line at the KEK Accelerator Test Facility

    Energy Technology Data Exchange (ETDEWEB)

    Bambade, P.; /Orsay /KEK, Tsukuba; Alabau Pons, M.; /Valencia U., IFIC; Amann, J.; /SLAC; Angal-Kalinin, D.; /Daresbury; Apsimon, R.; /Oxford U., JAI; Araki, S.; Aryshev, A.; /KEK, Tsukuba; Bai, S.; /Beijing, Inst. High Energy Phys.; Bellomo, P.; /SLAC; Bett, D.; /Oxford U., JAI; Blair, G.; /Royal Holloway, U. of London; Bolzon, B.; /Savoie U.; Boogert, S.; Boorman, G.; /Royal Holloway, U. of London; Burrows, P.N.; Christian, G.; Coe, P.; Constance, B.; /Oxford U., JAI; Delahaye, Jean-Pierre; /CERN; Deacon, L.; /Royal Holloway, U. of London; Elsen, E.; /DESY /Valencia U., IFIC /KEK, Tsukuba /Beijing, Inst. High Energy Phys. /Savoie U. /Fermilab /Ecole Polytechnique /KEK, Tsukuba /Kyungpook Natl. U. /KEK, Tsukuba /Pohang Accelerator Lab. /Kyoto U., Inst. Chem. Res. /Savoie U. /Daresbury /Tokyo U. /Royal Holloway, U. of London /Kyungpook Natl. U. /Pohang Accelerator Lab. /Tokyo U. /KEK, Tsukuba /SLAC /University Coll. London /KEK, Tsukuba /SLAC /Royal Holloway, U. of London /KEK, Tsukuba /Tokyo U. /SLAC /Tohoku U. /KEK, Tsukuba /Tokyo U. /Pohang Accelerator Lab. /Brookhaven /SLAC /Oxford U., JAI /SLAC /Orsay /KEK, Tsukuba /Oxford U., JAI /Orsay /Fermilab /Tohoku U. /Manchester U. /CERN /SLAC /Tokyo U. /KEK, Tsukuba /Oxford U., JAI /Hiroshima U. /KEK, Tsukuba /CERN /KEK, Tsukuba /Oxford U., JAI /Ecole Polytechnique /SLAC /Oxford U., JAI /Fermilab /SLAC /Liverpool U. /SLAC /Tokyo U. /SLAC /Tokyo U. /KEK, Tsukuba /SLAC /CERN

    2011-11-11

    ATF2 is a final-focus test beam line which aims to focus the low emittance beam from the ATF damping ring to a vertical size of about 37 nm and to demonstrate nanometer level beam stability. Several advanced beam diagnostics and feedback tools are used. In December 2008, construction and installation were completed and beam commissioning started, supported by an international team of Asian, European, and U.S. scientists. The present status and first results are described.

  13. Present status and first results of the final focus beam line at the KEK Accelerator Test Facility

    CERN Document Server

    Bambade, P; Amann, J; Angal-Kalinin, D; Apsimon, R; Araki, S; Aryshev, A; Bai, S; Bellomo, P; Bett, D; Blair, G; Bolzon, B; Boogert, S; Boorman, G; Burrows, P N; Christian, G; Coe, P; Constance, B; Delahaye, Jean-Pierre; Deacon, L; Elsen, E; Faus-Golfe, A; Fukuda, M; Gao, J; Geffroy, N; Gianfelice-Wendt, E; Guler, H; Hayano, H; Heo, A -Y; Honda, Y; Huang, J Y; Hwang, W H; Iwashita, Y; Jeremie, A; Jones, J; Kamiya, Y; Karataev, P; Kim, E -S; Kim, H -S; Kim, S H; Komamiya, S; Kubo, K; Kume, T; Kuroda, S; Lam, B; Lyapin, A; Masuzawa, M; McCormick, D; Molloy, S; Naito, T; Nakamura, T; Nelson, J; Okamoto, D; Okugi, T; Oroku, M; Park, Y J; Parker, B; Paterson, E; Perry, C; Pivi, M; Raubenheimer, T; Renier, Y; Resta-Lopez, J; Rimbault, C; Ross, M; Sanuki, T; Scarfe, A; Schulte, D; Seryi, A; Spencer, C; Suehara, T; Sugahara, R; Swinson, C; Takahashi, T; Tauchi, T; Terunuma, N; Tomas, R; Urakawa, J; Urner, D; Verderi, M; Wang, M -H; Warden, M; Wendt, M; White, G; Wittmer, W; Wolski, A; Woodley, M; Yamaguchi, Y; Yamanaka, T; Yan, Y; Yoda, H; Yokoya, K; Zhou, F; Zimmermann, F

    2010-01-01

    ATF2 is a final-focus test beam line which aims to focus the low emittance beam from the ATF damping ring to a vertical size of about 37 nm and to demonstrate nanometer level beam stability. Several advanced beam diagnostics and feedback tools are used. In December 2008, construction and installation were completed and beam commissioning started, supported by an international team of Asian, European, and U.S. scientists. The present status and first results are described.

  14. Present status and first results of the final focus beam line at the KEK Accelerator Test Facility

    CERN Document Server

    Bambade, P; Amann, J; Angal-Kalinin, D; Apsimon, R; Araki, S; Aryshev, A; Bai, S; Bellomo, P; Bett, D; Blair, G; Bolzon, B; Boogert, S; Boorman, G; Burrows, P N; Christian, G; Coe, P; Constance, B; Delahaye, J P; Deacon, L; Elsen, E; Faus-Golfe, A; Fukuda, M; Gao, J; Geffroy, N; Gianfelice-Wendt, E; Guler, H; Hayano, H; Heo, A Y; Honda, Y; Huang, J Y; Hwang, W H; Iwashita, Y; Jeremie, A; Jones, J; Kamiya, Y; Karataev, P; Kim, E S; Kim, H S; Kim, S H; Komamiya, S; Kubo, K; Kume, T; Kuroda, S; Lam, B; Lyapin, A; Masuzawa, M; McCormick, D; Molloy, S; Naito, T; Nakamura, T; Nelson, J; Okamoto, D; Okugi, T; Oroku, M; Park, Y J; Parker, B; Paterson, E; Perry, C; Pivi, M; Raubenheimer, T; Renier, Y; Resta-Lopez, J; Rimbault, C; Ross, M; Sanuki, T; Scarfe, A; Schulte, D; Seryi, A; Spencer, C; Suehara, T; Sugahara, R; Swinson, C; Takahashi, T; Tauchi, T; Terunuma, N; Tomas, R; Urakawa, J; Urner, D; Verderi, M; Wang, M H; Warden, M; Wendt, M; White, G; Wittmer, W; Wolski, A; Woodley, M; Yamaguchi, Y; Yamanaka, T; Yan, Y; Yoda, H; Yokoya, K; Zhou, F; Zimmermann, F; 10.1103/PhysRevSTAB.13.042801

    2010-01-01

    ATF2 is a final-focus test beam line which aims to focus the low emittance beam from the ATF damping ring to a vertical size of about 37 nm and to demonstrate nanometer level beam stability. Several advanced beam diagnostics and feedback tools are used. In December 2008, construction and installation were completed and beam commissioning started, supported by an international team of Asian, European, and U.S. scientists. The present status and first results are described.

  15. Current trends in use of intracanal medications in dental care facilities: questionnaire-based survey on training dental hygienists at educational institutions.

    Science.gov (United States)

    Furusawa, Masahiro; Yoshida, Takashi; Hosokawa, Souhei; Ariizumi, Yuugo

    2013-01-01

    The success of root canal therapy is dependent not only on removal of infected pulp (pulpectomy) followed by root canal enlargement, but also on the pharmacological effects of intracanal medications. Various intracanal medications are used. Formaldehyde preparations such as formocresol were common in the past, but these are no longer used in Europe or the US due to the biological toxicity of formaldehyde. In this study, a questionnaire was used to determine current trends in the use of intracanal medications at dental care facilities where dental hygiene students undergo practical training. The questionnaire comprised questions regarding the types of frequently used intracanal medications and their methods of application at dental care facilities in Saitama and Shizuoka prefectures. The results indicated that calcium hydroxide preparations were more commonly used in Europe or the US. However, these results also revealed that formaldehyde preparations were frequently used, which slightly differs from the scenario in Europe and the US. This study revealed that multiple intracanal medications were used for root canal therapy. Furthermore, it was also observed that cotton plugs were generally used as applicator tips for intracanal medications, whereas the use of absorbent paper points was relatively uncommon. The results suggest that the cost of absorbent paper points needs to be reduced.

  16. The NIAID Integrated Research Facility at Frederick, Maryland: a unique international resource to facilitate medical countermeasure development for BSL-4 pathogens.

    Science.gov (United States)

    Jahrling, Peter B; Keith, Lauren; St Claire, Marisa; Johnson, Reed F; Bollinger, Laura; Lackemeyer, Matthew G; Hensley, Lisa E; Kindrachuk, Jason; Kuhn, Jens H

    2014-07-01

    Scientists at the National Institute of Allergy and Infectious Diseases Integrated Research Facility at Fort Detrick, Frederick, Maryland, coordinate and facilitate preclinical research on infectious diseases to develop medical countermeasures for high-consequence pathogens. This facility is unique in that it is the only maximum containment laboratory in the world where conventional and molecular medical imaging equipments are incorporated into the design of the facility. This capability provides investigators with unique tools to dissect disease pathogenesis, evaluate the ability of animal models to recapitulate human disease, and test candidate countermeasures. Importantly, advanced molecular imaging has the potential to provide alternative endpoints to lethality. Using these alternative endpoints, investigators can reduce the number of animals used in experiments and evaluate countermeasures in sublethal models. With the incorporation of medical imaging modalities, a clinical laboratory modeled after those existing in hospitals, and a highly trained veterinary medicine team, IRF-Frederick is uniquely suited to advance our understanding of emerging infectious diseases and to facilitate the development of medical countermeasures and clinical care paradigms previously considered impossible.

  17. Availability of drugs and medical supplies for emergency obstetric care: experience of health facility managers in a rural District of Tanzania.

    Science.gov (United States)

    Mkoka, Dickson Ally; Goicolea, Isabel; Kiwara, Angwara; Mwangu, Mughwira; Hurtig, Anna-Karin

    2014-03-19

    Provision of quality emergency obstetric care relies upon the presence of skilled health attendants working in an environment where drugs and medical supplies are available when needed and in adequate quantity and of assured quality. This study aimed to describe the experience of rural health facility managers in ensuring the timely availability of drugs and medical supplies for emergency obstetric care (EmOC). In-depth interviews were conducted with a total of 17 health facility managers: 14 from dispensaries and three from health centers. Two members of the Council Health Management Team and one member of the Council Health Service Board were also interviewed. A survey of health facilities was conducted to supplement the data. All the materials were analysed using a qualitative thematic analysis approach. Participants reported on the unreliability of obtaining drugs and medical supplies for EmOC; this was supported by the absence of essential items observed during the facility survey. The unreliability of obtaining drugs and medical supplies was reported to result in the provision of untimely and suboptimal EmOC services. An insufficient budget for drugs from central government, lack of accountability within the supply system and a bureaucratic process of accessing the locally mobilized drug fund were reported to contribute to the current situation. The unreliability of obtaining drugs and medical supplies compromises the timely provision of quality EmOC. Multiple approaches should be used to address challenges within the health system that prevent access to essential drugs and supplies for maternal health. There should be a special focus on improving the governance of the drug delivery system so that it promotes the accountability of key players, transparency in the handling of information and drug funds, and the participation of key stakeholders in decision making over the allocation of locally collected drug funds.

  18. [Medical function in case of death: a final service to the patient and a key factor in legal safeguard].

    Science.gov (United States)

    Zollinger, U; Wyler, D

    1997-05-01

    The final service a doctor gives to his patients is to confirm death and to comfort the relatives. The unequivocal confirmation of death can, with complete justification, be considered the most important diagnosis so that it must be reached with every precaution. Apart from special conditions in intensive care units, where the guidelines of the Swiss Academy of Medical Sciences have to be followed with a view to using organs for transplantation, for example, the presence of reliable signs of death must absolutely be confirmed. The doctor who confirms death plays a key role in detecting so-called unusual deaths which require notification even in "clear", non-suspicious circumstances. This also applies to late deaths in hospital after an accident or other violence, where the clarification of the causal connection between this event and death is of decisive relevance. The detection or unequivocal exclusion of an outside influence in the death thus depend on the quality of the medical post-mortem examination and compliance with the duty of notification. The additional tasks falling to a doctor when he undertakes a legal inspection at the request of the examining authority in the case of an unusual death are discussed here only in passing. These tasks presuppose that the doctor has appropriate experience, which is why only official or district physicians from named institutions are accepted from the legal and forensic points of view in some Cantons.

  19. Association of the pre-internship objective structured clinical examination in final year medical students with comprehensive written examinations.

    Science.gov (United States)

    Eftekhar, Hasan; Labaf, Ali; Anvari, Pasha; Jamali, Arsia; Sheybaee-Moghaddam, Farshad

    2012-01-01

    The purpose of this study is to evaluate the association of the pre-internship Objective Structured Clinical Examination (OSCE) in final year medical students with comprehensive written examinations. SUBJECTS AND MATERIAL: All medical students of October 2004 admission who took part in the October 2010 National Comprehensive Pre-internship Examination (NCPE) and pre-internship OSCE were included in the study (n = 130). OSCE and NCPE scores and medical grade point average (GPA) were collected. GPA was highly correlated with NCPE (r = 0.76 and P<0.001) and moderately with OSCE (r = 0.68 and P < 0.001). Similarly a moderate correlation was observed between NCPE and OSCE scores(r = 0.6 and P < 0.001).Linear stepwise regression shows r(2) of a model applying GPA as predictor of OSCE score is 0.46 (β = 0.68 and P < 0.001), while addition of gender to the model increases r(2) to 0.59 (β = 0.61 and 0.36, for GPA and male gender, respectively and P < 0.001). Logistic forward regression models shows male gender and GPA are the only dependent predictors of high score in OSCE. OR of GPA and male gender for high OSCE score are 4.89 (95% CI = 2.37-10.06) and 6.95 (95% CI = 2.00-24.21), respectively (P < 0.001). Our findings indicate OSCE and examination which mainly evaluate knowledge, judged by GPA and NCPE are moderately to highly correlated. Our results illustrate the interwoven nature of knowledge and clinical skills. In other words, certain level of knowledge is crucial for appropriate clinical performance. Our findings suggest neither OSCE nor written forms of assessments can replace each other. They are complimentary and should also be combined by other evaluations to cover all attributes of clinical competence efficiently.

  20. Testicular Cancer and Testicular Self-Examination; Knowledge, Attitudes and Practice in Final Year Medical Students in Nigeria

    Science.gov (United States)

    Ugwumba, Fred O; Ekwueme, Osa Eloka C; Okoh, Agharighom D

    2016-11-01

    The testicular cancer (TCa) incidence is increasing in many countries, with age-standardized incidence rates up to 7.8/100,000 men in the Western world, although reductions in mortality and increasingly high cure rates are being witnessed at the same time. In Africa, where rates are lower, presentation is often late and morbidity and mortality high. Given this scenario, awareness of testicular cancer and practice of testicular self-examination among future first response doctors is very important. This study was conducted to determine knowledge and attitude to testicular cancer, and practice of testicular self-examination (TSE) among final (6th) year medical students. In addition, the effect of an intervention in the form of a single PowerPoint® lecture, lasting 40 minutes with image content on testicular cancer and testicular self examination was assessed. Pre and post intervention administration of a self-administered structured pre tested questionnaire was performed on 151 medical students, 101 of whom returned answers (response rate of 66.8%). In the TC domain, there was a high level of awareness of testicular cancer, but poor knowledge of the age group most affected, with significant improvement post intervention (ptesticular self-examination pre-intervention was found considering the nature of the study group..Respondents had surprisingly weak/poor responses to the question “How important to men’s health is regular testicular self-examination?” Answers to the questions “Do you think it is worthwhile to examine your testis regularly?” and “Would you be interested in more information on testicular cancer and testicular self-examination?” were also suboptimal, but improved post intervention ptesticular cancer in the curricula of medical schools and other training institutions for health care personnel.

  1. Present status and first results of the final focus beam line at the KEK Accelerator Test Facility

    Directory of Open Access Journals (Sweden)

    2010-04-01

    Full Text Available ATF2 is a final-focus test beam line which aims to focus the low emittance beam from the ATF damping ring to a vertical size of about 37 nm and to demonstrate nanometer level beam stability. Several advanced beam diagnostics and feedback tools are used. In December 2008, construction and installation were completed and beam commissioning started, supported by an international team of Asian, European, and U.S. scientists. The present status and first results are described.

  2. Solar powered hydrogen generating facility and hydrogen powered vehicle fleet. Final technical report, August 11, 1994--January 6, 1997

    Energy Technology Data Exchange (ETDEWEB)

    Provenzano, J.J.

    1997-04-01

    This final report describes activities carried out in support of a demonstration of a hydrogen powered vehicle fleet and construction of a solar powered hydrogen generation system. The hydrogen generation system was permitted for construction, constructed, and permitted for operation. It is not connected to the utility grid, either for electrolytic generation of hydrogen or for compression of the gas. Operation results from ideal and cloudy days are presented. The report also describes the achievement of licensing permits for their hydrogen powered trucks in California, safety assessments of the trucks, performance data, and information on emissions measurements which demonstrate performance better than the Ultra-Low Emission Vehicle levels.

  3. Review of project definition studies of possible on-site uses of superconducting super collider assets and facilities. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-12-01

    This document reports on the results of a peer review and evaluation of studies made of potential uses of assets from the terminated Superconducting Super Collider (SSC) project. These project definition studies focused on nine areas of use of major assets and facilities at the SSC site near Waxahachie, Texas. The studies were undertaken as part of the effort to maximize the value of the investment made in the SSC and were supported by two sets of grants, one to the Texas National Research Laboratory Commission (TNRLC) and the second to various universities and other institutions for studies of ideas raised by a public call for expressions of interest. The Settlement Agreement, recently signed by the Department of Energy (DOE) and TNRLC, provides for a division of SSC property. As part of the goal of maximizing the value of the SSC investment, the findings contained in this report are thus addressed to officials in both the Department and TNRLC. In addition, this review had several other goals: to provide constructive feedback to those doing the studies; to judge the benefits and feasibility (including funding prospects) of the projects studied; and to help worthy projects become reality by matching projects with possible funding sources.

  4. The development of coal-based technologies for Department of Defense facilities: Phase 1 final report. Volume 1: Technical report

    Energy Technology Data Exchange (ETDEWEB)

    Miller, B.G.; Morrison, J.L.; Pisupati, S.V. [Pennsylvania State Univ., University Park, PA (United States). Energy and Fuels Research Center] [and others

    1997-01-31

    The first phase of a three-phase project investigating the development of coal-based technologies for Department of Defense facilities has been completed. The objectives of the project are to: decrease DOD`s dependence on foreign oil and increase its use of coal; promote public and private sector deployment of technologies for utilizing coal-based fuels in oil-designed combustion equipment; and provide a continuing environment for research and development of coal-based fuel technologies for small-scale applications at a time when market conditions in the US are not favorable for the introduction of coal-fired equipment in the commercial and industrial capacity ranges. The Phase 1 activities were focused on developing clean, coal-based combustion technologies for the utilization of both micronized coal-water mixtures (MCWMs) and dry, micronized coal (DMC) in fuel oil-designed industrial boilers. The specific objective in Phase 1 was to deliver fully engineered retrofit options for a fuel oil-designed watertube boiler located on a DOD installation to fire either MCWM or DMC. This was achieved through a project consisting of fundamental, pilot-sale, and demonstration-scale activities investigating coal beneficiation and preparation, and MCWM and DMC combustion performance. In addition, detailed engineering designs and an economic analysis were conducted for a boiler located at the Naval Surface Warfare Center, near Crane, Indiana. Results are reported on MCWM and DMC combustion performance evaluation; engineering design; and cost/economic analysis.

  5. Analysis of radionuclide concentration in air released through the stack of a radiopharmaceutical production facility based on a medical cyclotron

    Science.gov (United States)

    Giardina, M.; Tomarchio, E.; Greco, D.

    2015-11-01

    Positron emitting radionuclides are increasingly used in medical diagnostics and the number of radiopharmaceutical production facilities have been estimated to be growing worldwide. During the process of production and/or patient administration of radiopharmaceuticals, an amount of these radionuclides might become airborne and escape into the environment. Therefore, the analysis of radionuclide concentration in the air released to the stack is a very important issue to evaluate the dose to the population living around the plant. To this end, sampling and measurement of radionuclide concentration in air released through the stack of a Nuclear Medicine Center (NMC), provided with a cyclotron for radiopharmaceuticals production, must be routinely carried out with an automatic measurement system. In this work is presented the air monitoring system realized at "San Gaetano" NMC at Bagheria (Italy) besides the analysis of the recorded stack relesead air concentration data. Sampling of air was carried out continuously and gamma-ray spectrometric measurement are made on-line and for a short time by using a shielded Marinelli beaker filled with sampled air and a gamma detector. The use of this system allows to have 1440 values of air concentration per day from 2002, year of the start of operation with the cyclotron. Therefore, the concentration values are very many and an analysis software is needed to determine the dose to the population. A comparison with the results of a simulation code based on a Gaussian Plume air dispersion modelling allow us to confirm the no-radiological significance of the stack effluent releases in terms of dose to population and to evaluate possible improvements in the plant devices to reduce the air concentration at stack.

  6. Wildlife and Wildlife Habitat Loss Assessment Summary at Federal Hydroelectric Facilities; Willamette River Basin, 1985 Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Noyes, J.H.

    1986-02-01

    Habitat based assessments were conducted of the US Army Corps of Engineers' hydroelectric projects in the Willamette River Basin, Oregon, to determine losses or gains to wildlife and/or wildlife habitat resulting from the development and operation of the hydroelectric-related components of the facilities. Preconstruction, postconstruction, and recent vegetation cover types at the project sites were mapped based on aerial photographs. Vegetation cover types were identified within the affected areas and acreages of each type at each period were determined. Wildlife target species were selected to represent a cross-section of species groups affected by the projects. An interagency team evaluated the suitability of the habitat to support the target species at each project for each time period. An evaluation procedure which accounted for both the quantity and quality of habitat was used to aid in assessing impacts resulting from the projects. The Willamette projects extensively altered or affected 33,407 acres of land and river in the McKenzie, Middle Fork Willamette, and Santiam river drainages. Impacts to wildlife centered around the loss of 5184 acres of old-growth conifer forest, and 2850 acres of riparian hardwood and shrub cover types. Impacts resulting from the Willamette projects included the loss of critical winter range for black-tailed deer and Roosevelt elk, and the loss of year-round habitat for deer, upland game birds, furbearers, spotted owls, pileated woodpeckers, and many other wildlife species. Bald eagles and ospreys were benefited by an increase in foraging habitat. The potential of the affected areas to support wildlife was greatly altered as a result of the Willamette projects. Losses or gains in the potential of the habitat to support wildlife will exist over the lives of the projects. Cumulative or system-wide impacts of the Willamette projects were not quantitatively assessed.

  7. Economic impacts of oil spills: Spill unit costs for tankers, pipelines, refineries, and offshore facilities. [Task 1, Final report

    Energy Technology Data Exchange (ETDEWEB)

    1993-10-15

    The impacts of oil spills -- ranging from the large, widely publicized Exxon Valdez tanker incident to smaller pipeline and refinery spills -- have been costly to both the oil industry and the public. For example, the estimated costs to Exxon of the Valdez tanker spill are on the order of $4 billion, including $2.8 billion (in 1993 dollars) for direct cleanup costs and $1.125 billion (in 1992 dollars) for settlement of damages claims caused by the spill. Application of contingent valuation costs and civil lawsuits pending in the State of Alaska could raise these costs appreciably. Even the costs of the much smaller 1991 oil spill at Texaco`s refinery near Anacortes, Washington led to costs of $8 to 9 million. As a result, inexpensive waming, response and remediation technologies could lower oil spin costs, helping both the oil industry, the associated marine industries, and the environment. One means for reducing the impact and costs of oil spills is to undertake research and development on key aspects of the oil spill prevention, warming, and response and remediation systems. To target these funds to their best use, it is important to have sound data on the nature and size of spills, their likely occurrence and their unit costs. This information could then allow scarce R&D dollars to be spent on areas and activities having the largest impact. This report is intended to provide the ``unit cost`` portion of this crucial information. The report examines the three key components of the US oil supply system, namely, tankers and barges; pipelines and refineries; and offshore production facilities. The specific purpose of the study was to establish the unit costs of oil spills. By manipulating this key information into a larger matrix that includes the size and frequency of occurrence of oil spills, it will be possible` to estimate the likely future impacts, costs, and sources of oil spills.

  8. Final report : results of the 2006 investigation of potential contamination at the former CCC/USDA facility in Ramona, Kansas.

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, L. M.; Environmental Science Division

    2007-10-18

    The investigation reported here was conducted by the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) in 2006. The investigation addressed carbon tetrachloride contamination on the former CCC/USDA grain storage facility at Ramona, Kansas. The results clearly demonstrate that only minimal contamination is associated with the past use of carbon tetrachloride on the former CCC/USDA property. No soil contamination was detected at concentrations above Kansas Department of Health and Environment (KDHE) risk-based screening level (RBSL) Tier 2 standard of 200 {micro}g/kg for the soil-to-groundwater protection pathway. Carbon tetrachloride concentrations in groundwater above the RBSL and maximum contaminant level (MCL) value of 5.0 {micro}g/L were detected in only two samples, collected at adjacent locations on the southeast part of the property. The relatively low concentrations detected and the limited areal extent of the contamination demonstrate that no imminent threat exists on the former CCC/USDA property to warrant remediation. The soil and groundwater contamination detected on the former CCC/USDA property is clearly separate from contamination detected at off-site locations. The carbon tetrachloride and chloroform contamination in groundwater (at concentrations above the RBSL and MCL value) associated with past activities on the former CCC/USDA property is contained within the property boundaries. Data collected independently by the KDHE in 2006 validate these findings and, furthermore, provide additional evidence that the sources identified on the Co-op property (west of the former CCC/USDA property) are separate from the comparatively minor results of past activities on the former CCC/USDA property. The KDHE concluded in its 2006 report that the sources are separate and that the Co-op is the principally responsible party for the carbon tetrachloride contamination detected during its 2006 investigation.

  9. Final report on passive and active low-frequency electromagnetic spectroscopy for airborne detection of underground facilities

    Energy Technology Data Exchange (ETDEWEB)

    SanFilipo, Bill

    2000-04-01

    The objective of this program is to perform research to advance the science in the application of both passive and active electromagnetic measurement techniques for the detection and spatial delineation of underground facilities. Passive techniques exploit the electromagnetic fields generated by electrical apparatus within the structure, including generators, motors, power distribution circuitry, as well as communications hardware and similar electronics equipment. Frequencies monitored are generally in the audio range (60-20,000 Hz), anticipating strong sources associated with normal AC power (i.e., 50 or 60 Hz and associated harmonics), and low frequency power from broad-band sources such as switching circuits. Measurements are made using receiver induction coils wired to electronics that digitize and record the voltage induced by the time varying magnetic fields. Active techniques employ electromagnetic field transmitters in the form of AC current carrying loops also in the audio frequency range, and receiving coils that measure the resultant time varying magnetic fields. These fields are perturbed from those expected in free space by any conductive material in the vicinity of the coils, including the ground, so that the total measured field is comprised of the primary free-space component and the secondary scattered component. The latter can be further delineated into an average background field (uniform conductive half-space earth) and anomalous field associated with heterogeneous zones in the earth, including both highly conductive objects such as metallic structures as well as highly resistive structures such as empty voids corresponding to rooms or tunnels. Work performed during Phase I included the development of the prototype GEM-2H instrumentation, collection of data at several test sites in the passive mode and a single site in the active mode, development of processing and interpretation software. The technical objectives of Phase II were to: (1

  10. [Supply and demand of medical specialists in the health facilities of the Ministry of Health: national, regional and by type of specialty gaps].

    Science.gov (United States)

    Zevallos, Leslie; Pastor, Reyna; Moscoso, Betsy

    2011-06-01

    To characterize the supply, demand and the gap of medical specialists in facilities of the Ministry of Health of Peru (MINSA) at the national, regional and specialty type levels. Observational, descriptive study through which we calculated the supply of medical specialists using secondary sources of MINSA. The analysis of the demand for medical specialists was based on two methodologies: the need for specialists according to the guidelines of classification of the health facilities and according to the epidemiological and demographic profile. The arithmetic difference between the estimated demand and the supply was the procedure used to calculate the gap of medical specialists. The Ministry of Health has a total supply at the national level of 6,074 medical specialists of which 61.5% belong to the clinical specialties, 33.2% to the surgical specialties, 4.9% specialities related to aid to diagnosis and treatment and 0.4% to public health specialties. According to the categorization guideline there is a total demand of 11,176 medical specialists and according to the epidemiological and demographic profile of 11,738. The national estimated gaps found are similar in both methods, although they differ widely across regions and by type of specialty. At the regional level, the gaps are greater in Loreto, Piura, Puno and Madre de Dios when estimating the defficit in relation to the supply. Regarding the speciality, the gap is greater in the four basic specialties: gynecology and obstetrics, pediatrics, internal medicine and general surgery. There is a waid gap between supply and demand of medical specialists at the national and regional levels, as a whole representing approximately 45% of the current offer, regardless of the estimation method.

  11. Post-cold war United Nations peacekeeping operations: a review of the case for a hybrid level 2+ medical treatment facility.

    Science.gov (United States)

    Johnson, Ralph Jay

    2015-01-01

    Post-Cold War, UN peacekeeping operations (UN PKOs) have become larger, more mobile, multi-faceted and conducted over vast areas of remote, rugged, and harsh geography. They have been increasingly involved in dangerous areas with ill-defined boundaries, simmering internecine armed conflict, and disregard on the part of some local parties for peacekeepers' security and role. Yet progressively there have been expectations of financial restraint and austerity. Additionally, UN PKOs have become more "robust," that is, engaged in preemptive, assertive operations. A statistically positive and significant relationship exists between missions' size, complexity, remoteness, and aggressive tenor and a higher probability of trauma or death, especially as a result of hostile actions or disease. Therefore, in the interest of "force protection" and optimizing operations, a key component of UN PKOs is health care and medical treatment. The expectation is that UN PKO medical support must conform to the general intent and structure of current UN PKOs to become more streamlined, portable, mobile, compartmentalized, and specialized, but also more varied and complex to address the medical aspects of these missions cost-efficiently. This article contends that establishing a hybrid level 2-a level 2 with level 3 modules and components (i.e., level 2+)-is a viable course of action when considering trends in the medical aspects of Post-Cold War UN PKOs. A level 2 medical treatment facility has the potential to provide needed forward mobile medical treatment, especially trauma care, for extended, complex, large-scale, and comprehensive UN PKOs. This is particularly the case for missions that include humanitarian outreach, preventive medicine, and psychiatry. The level 2 treatment facility is flexible enough to expand into a hybrid level 2+ with augmentation of modules based on changes in mission requirements and variation in medical aspects.

  12. Operation of beam line facilities for real-time x-ray studies at Sector 7 of the advanced photon source. Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Clarke, Roy

    2003-09-10

    This Final Report documents the research accomplishments achieved in the first phase of operations of a new Advanced Photon Source beam line (7-ID MHATT-CAT) dedicated to real-time x-ray studies. The period covered by this report covers the establishment of a world-class facility for time-dependent x-ray studies of materials. During this period many new and innovative research programs were initiated at Sector 7 with support of this grant, most notably using a combination of ultrafast lasers and pulsed synchrotron radiation. This work initiated a new frontier of materials research: namely, the study of the dynamics of materials under extreme conditions of high intensity impulsive laser irradiation.

  13. Perceptions of final-year medical students towards the impact of gender on their training and future practice

    Directory of Open Access Journals (Sweden)

    Van Wyk JM

    2016-09-01

    Full Text Available Jacqueline M Van Wyk,1 Soornarain S Naidoo,2 Kogie Moodley,1 Susan B Higgins-Opitz3 1Nelson R. Mandela School of Medicine, University of KwaZulu‑Natal, 2Faculty of Health Sciences, Durban University of Technology, 3School of Health Sciences, University of KwaZulu‑Natal, Durban, South Africa Introduction: Following policy implementations to redress previous racial and gender discrepancies, this study explored how gender impacted on the clinical experiences of final-year medical students during their undergraduate training. It also gathered their perceptions and expectations for the future.Methods: This cross-sectional, mixed-method study used a purposive sampling method to collect data from the participants (n=94. Each respondent was interviewed by two members of the research team. The quantitative data were entered into Excel and analyzed descriptively. The qualitative data were transcribed and thematically analyzed.Results: The majority of the respondents still perceived clinical practice as male dominated. All respondents agreed that females faced more obstacles in clinical practice than males. This included resistance from some patients, poor mentoring in some disciplines, and less support from hostile nurses. They feared for their personal safety and experienced gender-based stereotyping regarding their competency. Males thought that feminization of the profession may limit their residency choices, and they reported obstacles when conducting intimate examinations and consultations on female patients. Both males and females expressed desire for more normalized work hours to maintain personal relationships.Conclusion: Social redress policies have done much to increase equal access for females to medical schools. Cultural values and attitudes from mentors, peers, and patients still impact on the quality of their clinical experiences and therefore also their decisions regarding future clinical practice. More mentoring and education may help

  14. Development of biological and chemical methods for environmental monitoring of DOE waste disposal and storage facilities. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1989-04-01

    Hazardous chemicals in the environment have received ever increasing attention in recent years. In response to ongoing problems with hazardous waste management, Congress enacted the Resource Conservation and Recovery Act (RCRA) in 1976. In 1980, Congress adopted the Comprehensive Environmental Response Compensation, and Liability Act (CERCLA), commonly called Superfund to provide for emergency spill response and to clean up closed or inactive hazardous waste sites. Scientists and engineers have begun to respond to the hazardous waste challenge with research and development on treatment of waste streams as well as cleanup of polluted areas. The magnitude of the problem is just now beginning to be understood. The U.S. Environmental Protection Agency (USEPA) National Priorities List as of September 13 1985, contained 318 proposed sites and 541 final sites (USEPA, 1985). Estimates of up to 30,000 sites containing hazardous wastes (1,200 to 2,000 of which present a serious threat to public health) have been made (Public Law 96-150). In addition to the large number of sites, the costs of cleanup using available technology are phenomenal. For example, a 10-acre toxic waste site in Ohio is to be cleaned up by removing chemicals from the site and treating the contaminated groundwater. The federal government has already spent more than $7 million to remove the most hazardous wastes and the groundwater decontamination alone is expected to take at least 10 years and cost $12 million. Another example of cleanup costs comes from the State of California Commission for Economic Development which predicts a bright economic future for the state except for the potential outlay of $40 billion for hazardous waste cleanup mandated by federal and state laws.

  15. [Medication administration practices in elderly residential facilities in Ile de France Region in 2014: findings and room for improvement].

    Science.gov (United States)

    de Saunière, Anne; Bonneau, Laetitia; Donio, Valérie; Godinot, Valérie; Flouzat, Jean-Philippe; Bensasson, Géraldine; Code, Christelle; Galay, Guillaume; Pige, Dominique

    2016-11-25

    The institutions expressed great interest in medication administration systems and tools designed to monitor all stages of medication administration. A dozen simple and pragmatic improvement actions were identified and listed in the Ile-de-France Regional Health Agency action plan to improve medication administration management of in EHPAD..

  16. Attributes and perspectives of public providers related to provision of medical abortion at public health facilities in Vietnam: a cross-sectional study in three provinces

    Directory of Open Access Journals (Sweden)

    Ngo TD

    2014-08-01

    Full Text Available Thoai D Ngo,1,2 Caroline Free,1 Hoan T Le,3 Phil Edwards,1 Kiet HT Pham,4 Yen BT Nguyen,4 Thang H Nguyen5 1Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK; 2Research, Monitoring and Evaluation Team, Health System Department, Marie Stopes International, London, UK; 3Department of Environmental Health, 4Department of Health Economics, Hanoi Medical University, 5Research and Metrics Team, Marie Stopes International Vietnam, Hanoi, Vietnam Background: The purpose of this study was to investigate attributes of public service providers associated with the provision of medical abortion in Vietnam. Methods: We conducted a cross-sectional study via interviewer-administered questionnaire among abortion providers from public health facilities in Hanoi, Khanh Hoa, and Ho Chi Minh City in Vietnam between August 2011 and January 2012. We recruited abortion providers at all levels of Vietnam's public health service delivery system. Participants were questioned about their medical abortion provision practices and perspectives regarding abortion methods. Results: A total of 905 providers from 62 health facilities were included, comprising 525 (58.0% from Hanoi, 122 (13.5% from Khanh Hoa, and 258 (28.5% from Ho Chi Minh City. The majority of providers were female (96.7%, aged ≥25 years (94%, married (84.4%, and had at least one child (89%; 68.9% of providers offered only manual vacuum aspiration and 31.1% performed both medical abortion and manual vacuum aspiration. Those performing both methods included physicians (74.5%, midwives (21.7%, and nurses (3.9%. Unadjusted analyses showed that female providers (odds ratio 0.1; 95% confidence interval 0.01–0.30 and providers in rural settings (odds ratio 0.3; 95% confidence interval 0.08–0.79 were less likely to provide medical abortion than their counterparts. Obstetricians and gynecologists were more likely to provide medical abortion than providers with

  17. Study on an advanced treatment system for medical waste drainage containing radioactive iodine (II). In-place test using drainage in a medical facility

    Energy Technology Data Exchange (ETDEWEB)

    Takuwa, Tomoya; Hio, Akihiro [Chiyoda Technol Corp., Ibaraki (Japan). Oarai Research Center; Tatenuma, Katsuyoshi; Hanamoto, Yukio [Kaken Corp., Mito (Japan); Konishi, Junji; Kasagi, Kanji [Kyoto Univ. (Japan). Graduate School of Medicine

    2002-08-01

    Recently, {sup 131}I has become to be used for treatment by the increment of its dose. Treatment doses for thyroid cancer amount to GBq order. The regulations with regard to the discharge of the waste drainage containing {sup 131}I are very strict, and it burdens the drainage treatment facilities. When usage of {sup 131}I for treatment becomes popular, the drainage treatment facilities may groan under the heavy burden. We made an equipment with activated carbon impregnated with per-bromine ion which efficiently adsorbs {sup 131}I in drainage by halogen substitution reaction and tested it at the drainage facility in a hospital. The removal efficiency of {sup 131}I was more than 99% using only a single impregnated carbon column (diameter 100 mm, length 220 mm) under 4 L/min flow rate. For a practical application, it will be important to improve the performance and the ability for a long term use. (author)

  18. Assisted Living Facilities, Medical, Published in 2006, 1:1200 (1in=100ft) scale, Steuben County Government.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Assisted Living Facilities dataset, published at 1:1200 (1in=100ft) scale, was produced all or in part from Field Observation information as of 2006. It is...

  19. 2011年某院终末病案质量统计分析%Statistic analysis on final medical records quality in a hospital in 2011

    Institute of Scientific and Technical Information of China (English)

    范玉荣

    2012-01-01

    Objective To investigate the problems existing and emerging in the writing of hospitalization medical records, and to improve the quality of medical records by the final quality control. Methods A total of 9435 final medical records were checked and deficiencies in the writing were analyzed according to the evaluation criterion of medical records and the basic writing rules issued by Ministry of Health. Results There were 8663 grade A medical records, 569 grade B medical records and 203 grade C medical records. The major reason for defect was a lack of medical record information, and the quality of medical records in surgery was worse than the others. Conclusion It is necessary to enhance health professional's responsibility towards law and give more skills training to strengthen the writing rule on medical records.%目的 了解某院终末病案缺陷情况,以提高病案质量.方法 对照2010 年3 月卫生部新颁布的和对某二甲医院2011 年出院的全部9 435 份终末病案进行质量检查,分析缺陷情况.结果 甲级病案8 663 份,乙级病案569 份,丙级病案203 份.病历资料缺失是造成病案质量重要缺陷的主要原因.外科系统病案质量较差.结论 加强培训、实时监控、增强各级医师的责任心是改变目前病案质量的惟一途径.

  20. Developing personal attributes of professionalism during clinical rotations: views of final year bachelor of clinical medical practice students.

    Science.gov (United States)

    Mapukata-Sondzaba, Nontsikelelo; Dhai, Ames; Tsotsi, Norma; Ross, Eleanor

    2014-07-16

    Medical professionalism as a set of behaviours that transcends personal values, beliefs and attitudes to incorporate ethical and moral principles is considered a covenant between society and the practice of medicine. The Bachelor of Clinical Medical Practice (BCMP) a three year professional degree was launched at the University of the Witwatersrand in January 2009 in response to a documented shortage of doctors especially in the rural areas of South Africa. The BCMP programme is unique in its offering as it requires a teaching approach that meets the needs of an integrated curriculum, providing for an accelerated transition from the classroom to the patient's bedside. Following five week attachments in designated District Education Campuses, 25 final year BCMP students were required to reflect individually on the covenant that exists between society and the practice of medicine based on their daily interactions with health care workers and patients for three of the five rotations in a one page document. A retrospective, descriptive case study employed qualitative methods to group emerging themes from 71 portfolios. Ethical clearance was obtained from the Human Research Ethics Committee at the University of the Witwatersrand. As an outcome of an ethical analysis, the majority of BCMP students reflected on the determinants of accountable and responsible practice (N=54). The commitment to the Oath became significant with a personalised reference to patients 'as my patients'. Students acknowledged professional health care workers (HCWs) who demonstrated commitment to core values of good practice as they recognised the value of constantly reflecting as a skill (n=51). As the students reflected on feeling like 'guinea pigs' (n=25) migrating through periods of uncertainity to become 'teachable learners', they made ethical judgements that demonstrated the development of their moral integrity. A few students felt vulnerable in instances where they were pressured into

  1. Implementation of ‘Goals of Patient Care’ medical treatment orders in residential aged care facilities: protocol for a randomised controlled trial

    Science.gov (United States)

    Martin, Ruth S; Hayes, Barbara J; Hutchinson, Anastasia; Yates, Paul; Lim, Wen Kwang

    2017-01-01

    Introduction Systematic reviews demonstrate that advance care planning (ACP) has many positive effects for residents of aged care facilities, including decreased hospitalisation. The proposed Residential Aged Care Facility (RACF) ‘Goals of Patient Care’ (GOPC) form incorporates a resident's prior advance care plan into medical treatment orders. Where none exists, it captures residents' preferences. This documentation helps guide healthcare decisions made at times of acute clinical deterioration. Methods and analysis This is a mixed methods study. An unblinded cluster randomised controlled trial is proposed in three pairs of RACFs. In the intervention arm, GOPC forms will be completed by a doctor incorporating advance care plans or wishes. In the control arm, residents will have usual care which may include an advance care plan. The primary hypothesis is that the GOPC form is superior to standard ACP alone and will lead to decreased hospitalisation due to clearer documentation of residents' medical treatment plans. The primary outcome will be an analysis of the effect of the GOPC medical treatment orders on emergency department attendances and hospital admissions at 6 months. Secondary outcome measurements will include change in hospitalisation rates at 3 and 12 months, length of stay and external mortality rates among others. Qualitative interviews, 12 months post GOPC implementation, will be used for process evaluation of the GOPC and to evaluate staff perceptions of the form's usefulness for improving communication and medical decision-making at a time of deterioration. Dissemination The results will be disseminated in peer review journals and research conferences. This robust randomised controlled trial will provide high-quality data about the influence of medical treatment orders that incorporate ACP or preferences adding to the current gap in knowledge and evidence in this area. Trial registration number ACTRN12615000298516, Results. PMID:28283490

  2. [The urgency of the application of the medical sanitary passport in the system for chemical safety in the areas of location of high-risk chemical facilities in the Russian Federation].

    Science.gov (United States)

    Kombarova, M Iu; Radilov, A S; Dulov, S A

    2012-01-01

    The main provisions concerning the need for a creation of medical and sanitary passport for territories in the protective measures zones (PMZ) of storage facilities and facilities for the destruction of chemical weapons (FDCW) are presented in the article. The assessment of results of certification of the territory of PMZ and FDCW in "Maradykovsky" in the Kirov region has been done.

  3. Assessment of radiation doses due to normal operation, incidents and accidents of the final disposal facility; Kaeytetyn ydinpolttoaineen loppusijoituslaitoksen normaalikaeytoen, kaeyttoehaeirioeiden ja onnettomuustilanteiden aiheuttamien saeteilyannosten arviointi

    Energy Technology Data Exchange (ETDEWEB)

    Rossi, J.; Raiko, H.; Suolanen, V.; Ilvonen, M. [VTT Energy, Espoo (Finland)

    1999-03-01

    Radiation doses for workers of the encapsulation and disposal facility and for inhabitants in the environment caused by the facility during its operation were considered. The study covers both the normal operation of the plant and some hypothetical incidents and accidents. Occupational radiation doses inside the plant during normal operation are based on the design basis, assuming that highest permitted dose levels are prevailing in control rooms during fuel transfer and encapsulation processes. Release through the ventilation stack is assumed to be filtered both in normal operation and in hypothetical incident and accident cases. Calculation of the offsite doses from normal operation is based on the hypothesis that one fuel pin per 100 fuel bundles for all batches of spent fuel transported to the encapsulation facility is leaking. The release magnitude in incidents and accidents is based on the event chains, which lead to loss of fuel pin tightness followed by a discharge of radionuclides into the handling chamber and to some degree through the ventilation stack into atmosphere. The weather data measured at the Olkiluoto meteorological mast was employed for calculating of offsite doses. Therefore doses could be calculated in a large amount of different dispersion conditions, the statistical frequencies of which have, been measured. Finally doses were combined into cumulative distributions, from which a dose value representing the 99.5 % confidence level, is presented. The dose values represent the exposure of a critical group, which is assumed to live at the distance of 200 meters from the encapsulation and disposal plant and thus it will receive the largest doses in most dispersion conditions. Exposure pathways considered were: cloudsnine, inhalation, groundshine and nutrition (milk of cow, meat of cow, green vegetables, grain and root vegetables). Nordic seasonal variation is included in ingestion dose models. The results obtained indicate that offsite doses

  4. Knowledge of Staff Members of Residential Care Facilities for Individuals with Intellectual Disability on Medication Administration via Enteral Feeding Tube

    Science.gov (United States)

    Joos, E.; Mehuys, E.; Van Bocxlaer, J.; Remon, J. P.; Van Winckel, M.; Boussery, K.

    2016-01-01

    Background: Guidelines for the safe administration of drugs through enteral feeding tube (EFT) are an important tool to minimise the risk of errors. This study aimed to investigate knowledge of these guidelines among staff of residential care facilities (RCF) for people with ID. Method: Knowledge was assessed using a 13-item self-administered…

  5. Medical screening reference manual for security force personnel at fuel cycle facilities possessing formula quantities of special nuclear materials

    Energy Technology Data Exchange (ETDEWEB)

    Arzino, P.A.; Brown, C.H. (California State Univ., Hayward, CA (United States). Foundation)

    1991-09-01

    The recommendations contained throughout this NUREG were provided to the Nuclear Regulatory Commission (NRC) as medical screening information that could be used by physicians who are evaluating the parameters of the safe participation of guards, Tactical Response Team members (TRTs), and all other armed response personnel in physical fitness training and in physical performance standards testing. The information provided in this NUREG will help licensees to determine if guards, TRTs, and other armed response personnel can effectively perform their normal and emergency duties without undue hazard to themselves, to fellow employees, to the plant site, and to the general public. The medical recommendations in this NUREG are similar in content to the medical standards contained in 10 CFR Part 1046 which, in part, specifies medical standards for the protective force personnel regulated by the Department of Energy. The guidelines contained in this NUREG are not requirements, and compliance is not required. 3 refs.

  6. Coping with information silos: an examination of the medication management process in residential aged care facilities (RACFs).

    Science.gov (United States)

    Tariq, Amina; Georgiou, Andrew; Westbrook, Johanna

    2014-01-01

    The aim of this study was to examine the actions of geographically dispersed process stakeholders (doctors, community pharmacists and RACFs) in order to cope with the information silos that exist within and across different settings. The study setting involved three metropolitan RACFs in Sydney, Australia and employed a qualitative approach using semi-structured interviews, non-participant observations and artefact analysis. Findings showed that medication information was stored in silos which required specific actions by each setting to translate this information to fit their local requirements. A salient example of this was the way in which community pharmacists used the RACF medication charts to prepare residents' pharmaceutical records. This translation of medication information across settings was often accompanied by telephone or face-to-face conversations to cross-check, validate or obtain new information. Findings highlighted that technological interventions that work in silos can negatively impact the quality of medication management processes in RACF settings. The implementation of commercial software applications like electronic medication charts need to be appropriately integrated to satisfy the collaborative information requirements of the RACF medication process.

  7. Solar production of industrial process hot water: operation and evaluation of the Campbell Soup hot water solar facility. Final report, September 1, 1979-December 10, 1980

    Energy Technology Data Exchange (ETDEWEB)

    Kull, J. I.; Niemeyer, W. N.; Youngblood, S. B.

    1980-12-01

    The operation and evaluation of a solar hot water facility designed by Acurex Corporation and installed (November 1977) at the Campbell Soup Company Sacramento, California canning plant is summarized. The period of evaluation was for 12 months from October 1979 through September 1980. The objective of the work was to obtain additional, long term data on the operation and performance of the facility. Minor modifications to the facility were completed. The system was operated for 15 months, and 12 months of detailed data were evaluated. The facility was available for operation 99% of the time during the last 8 months of evaluation. A detailed description of the solar facility and of the operating experience is given, and a summary of system performance for the 12 month operation/evaluation period is presented. Recommendations for large-scale solar facilities based on this project's experience are given, and an environmental impact assessment for the Campbell Soup solar facility is provided. (WHK)

  8. An Analysis of the Admission Process to U.S. Medical Schools, 1973 and 1976. Final Report.

    Science.gov (United States)

    Cuca, Janet Melei

    The medical school admission process is a major determinant of various attributes and characteristics of the American physician manpower pool. This analysis investigated the criteria of national and institutional consequence in selecting students for medical school, the changes in the relative importance of these criteria from 1973 to 1976, the…

  9. How we implemented an integrated professionalism curriculum to 2nd year medical students at the National University of Ireland Galway Medical School, with examples from students' final output.

    Science.gov (United States)

    McNair, Antonia; Moran, Conor; McGrath, Erinn; Naqvi, Syed; Connolly, Claire; McKenna, Verna; Kropmans, Thomas

    2011-01-01

    Since the introduction of professionalism in medical curricula worldwide, little evidence has been published to exemplify good educational practice. The Medical school at the National University of Ireland Galway teaches professionalism in an interdisciplinary manner, integrating the learning objectives of health informatics, understanding health & illness in society, medical law and ethics. Students work in small groups on clinical cases. Enquiry-based learning is used as the teaching method following a few introductory lectures on specific objectives. Students present their work in the format of a scientific essay. The latter is assessed by a board of reviewers. The purpose of this article is to demonstrate evidence of excellent professional output and illustrate the benefits to a fully integrated professionalism curriculum.

  10. Guidance for the design and management of a maintenance plan to assure safety and improve the predictability of a DOE nuclear irradiation facility. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Booth, R.S.; Kryter, R.C.; Shepard, R.L.; Smith, O.L. [Oak Ridge National Lab., TN (United States); Upadhyaya, B.R. [Univ. of Tennessee, Knoxville, TN (United States). Dept. of Nuclear Engineering; Rowan, W.J.

    1994-10-01

    A program is recommended for planning the maintenance of DOE nuclear facilities that will help safety and enhance availability throughout a facility`s life cycle. While investigating the requirements for maintenance activities, a major difference was identified between the strategy suitable for a conventional power reactor and one for a research reactor facility: the latter should provide a high degree of predicted availability (referred to hereafter as ``predictability``) to its users, whereas the former should maximize total energy production. These differing operating goals necessitate different maintenance strategies. A strategy for scheduling research reactor facility operation and shutdown for maintenance must balance safety, reliability,and predicted availability. The approach developed here is based on three major elements: (1) a probabilistic risk analysis of the balance between assured reliability and predictability (presented in Appendix C), (2) an assessment of the safety and operational impact of maintenance activities applied to various components of the facility, and (3) a data base of historical and operational information on the performance and requirements for maintenance of various components. These factors are integrated into a set of guidelines for designing a new highly maintainable facility, for preparing flexible schedules for improved maintenance of existing facilities, and for anticipating the maintenance required to extend the life of an aging facility. Although tailored to research reactor facilities, the methodology has broader applicability and may therefore be used to improved the maintenance of power reactors, particularly in anticipation of peak load demands.

  11. Why Medical Schools Should Embrace Wikipedia: Final-Year Medical Student Contributions to Wikipedia Articles for Academic Credit at One School.

    Science.gov (United States)

    Azzam, Amin; Bresler, David; Leon, Armando; Maggio, Lauren; Whitaker, Evans; Heilman, James; Orlowitz, Jake; Swisher, Valerie; Rasberry, Lane; Otoide, Kingsley; Trotter, Fred; Ross, Will; McCue, Jack D

    2017-02-01

    Most medical students use Wikipedia as an information source, yet medical schools do not train students to improve Wikipedia or use it critically. Between November 2013 and November 2015, the authors offered fourth-year medical students a credit-bearing course to edit Wikipedia. The course was designed, delivered, and evaluated by faculty, medical librarians, and personnel from WikiProject Medicine, Wikipedia Education Foundation, and Translators Without Borders. The authors assessed the effect of the students' edits on Wikipedia's content, the effect of the course on student participants, and readership of students' chosen articles. Forty-three enrolled students made 1,528 edits (average 36/student), contributing 493,994 content bytes (average 11,488/student). They added higher-quality and removed lower-quality sources for a net addition of 274 references (average 6/student). As of July 2016, none of the contributions of the first 28 students (2013, 2014) have been reversed or vandalized. Students discovered a tension between comprehensiveness and readability/translatability, yet readability of most articles increased. Students felt they improved their articles, enjoyed giving back "specifically to Wikipedia," and broadened their sense of physician responsibilities in the socially networked information era. During only the "active editing months," Wikipedia traffic statistics indicate that the 43 articles were collectively viewed 1,116,065 times. Subsequent to students' efforts, these articles have been viewed nearly 22 million times. If other schools replicate and improve on this initiative, future multi-institution studies could more accurately measure the effect of medical students on Wikipedia, and vice versa.

  12. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Nursing and related services, medical social... Inpatient Hospital Services and Inpatient Critical Access Hospital Services § 409.12 Nursing and related... (b) of this section, Medicare pays for nursing and related services, use of hospital or...

  13. Recovery of cost of hospital and medical care and treatment furnished by the United States; delegation of authority. Final rule.

    Science.gov (United States)

    2010-03-01

    This rule amends Department of Justice regulations to increase the settlement and waiver authority delegated to heads of departments and agencies of the United States responsible for the furnishing of hospital, medical, surgical, or dental care. This change responds to the increase in medical costs since 1992, when the current level of delegated settlement and waiver authority was established, and will further the efficient operation of the government.

  14. Developing personal attributes of professionalism during clinical rotations: views of final year bachelor of clinical medical practice students

    OpenAIRE

    2014-01-01

    Background Medical professionalism as a set of behaviours that transcends personal values, beliefs and attitudes to incorporate ethical and moral principles is considered a covenant between society and the practice of medicine. The Bachelor of Clinical Medical Practice (BCMP) a three year professional degree was launched at the University of the Witwatersrand in January 2009 in response to a documented shortage of doctors especially in the rural areas of South Africa. The BCMP programme is un...

  15. Fatal and Non-Fatal Electrocution Injuries at U.S. Marine Corps Forward Medical Facilities During Operation Enduring Freedom and Operation Iraqi Freedom.

    Science.gov (United States)

    Williams, Bradley; Deaton, Travis; Galarneau, Mike; Dye, Judy; Zieber, Tara; Auten, Jonathan

    2017-09-01

    Death from electrocution is rare and generally an accidental occurrence. In contrast to civilian patterns of electrocution injury, the military work environment suffers from a greater percentage of fatal high-voltage electrocutions. This study compared U.S. and international electrocution case fatality rates to rates among deployed military personnel presenting for care at expeditionary medical care facilities. We also sought to identify potential risk factors for fatal electrocution injury among deployed military personnel. A retrospective analysis was performed on electrocution injuries presenting to U.S. Marine Corps forward deployed medical facilities in Iraq and Afghanistan between January 2004 and December 2012. Descriptive statistics were used to describe the study population and compare fatal and nonfatal electrocutions. Fatality rates were reported in cases per 1,000,000 people per year. A total of 38 patients were identified; all were males with a mean (SD) age of 25.3 (5.3) years. Most electrocutions occurred on base (68%), whereas a smaller number (21%) occurred while conducting operations outside of the base. A majority of fatal cases (80%) occurred while outside of base on foot or vehicle mounted patrol. The rate of fatal electrocutions among U.S. Marine Corps personnel during this period was 37 per 1,000,000 people per year, 7-fold higher than the international electrocution fatality rate of 5.4 per 1,000,000 people per year and nearly three-fold above the U.S. utility and construction worker's fatality rate of 14 per 1,000,000 people per year. Electrocution injuries occurring during foot or vehicle mounted patrols seem to account for findings of higher case fatality rates among deployed military personnel than those found in international or high risk civilian occupational settings. Basic life support training for medical and nonmedical military personnel is critical to optimizing care delivered at the scene of these injuries. Reprint & Copyright

  16. CENER/NREL Collaboration in Testing Facility and Code Development: Cooperative Research and Development Final Report, CRADA Number CRD-06-207

    Energy Technology Data Exchange (ETDEWEB)

    Moriarty, P.

    2014-11-01

    Under the funds-in CRADA agreement, NREL and CENER will collaborate in the areas of blade and drivetrain testing facility development and code development. The project shall include NREL assisting in the review and instruction necessary to assist in commissioning the new CENER blade test and drivetrain test facilities. In addition, training will be provided by allowing CENER testing staff to observe testing and operating procedures at the NREL blade test and drivetrain test facilities. CENER and NREL will exchange blade and drivetrain facility and equipment design and performance information. The project shall also include exchanging expertise in code development and data to validate numerous computational codes.

  17. Consumption of woody biomass in industry, commercial, and public facilities in Serbia: Present state and possible contribution to the share of renewable sources in final energy consumption

    Directory of Open Access Journals (Sweden)

    Glavonjić Branko D.

    2012-01-01

    Full Text Available This paper is the continuation of the presentation of results obtained in comprehensive researches of woody biomass consumption in Serbia conducted as a part of the TCP/FAO project “Wood energy for sustainable rural development”. The previous paper (No. 3, 2011 showed results of wood fuels consumption for households heating and this paper shows their consumption for the needs of industry, commercial and public facilities. Research results show that total consumption of woody biomass in Serbia in 2010 was 7.41 million m3, out of which 7.03 million m3 was in the form of roundwood and 0.38 million m3 was in the form of wood residue from industry. The biggest consumers of woody biomass (roundwood, chips, residues are households with the participation of 86.54%, followed by the production of wood-based panels with 4.47% and energy production for own purposes of wood processing companies with 2.96%. Compared to the officially registered consumption in energy balance in the amount of 0.281 Mtoe, actual consumption of wood energy in Serbia in 2010 was 1.37 Mtoe or 4.9 times higher. Participation of wood energy in final energy consumption in Serbia was 57,300 TJ or 13.6% in 2010. Current use of wood energy substitutes imports of light heating oil in the value of 1.3 billion € or 650 million € in the case of natural gas substituting. Use of wood fuel prevented emissions of about 7 million tonnes of CO2 from fossil fuels.

  18. Polypharmacy and medication regimen complexity as factors associated with staff informant rated quality of life in residents of aged care facilities: a cross-sectional study.

    Science.gov (United States)

    Lalic, Samanta; Jamsen, Kris M; Wimmer, Barbara C; Tan, Edwin C K; Hilmer, Sarah N; Robson, Leonie; Emery, Tina; Bell, J Simon

    2016-09-01

    The purpose of this study is to investigate the association between polypharmacy with health-related quality of life (HRQoL) and medication regimen complexity with HRQoL in residential aged care facilities (RACFs). A cross-sectional study of 383 residents from six Australian RACFs was conducted. The primary exposures were polypharmacy (≥9 regular medications) and the validated Medication Regimen Complexity Index (MRCI). The outcome measure was staff informant rated quality of life assessed using the Quality of Life Alzheimer's disease (QoL-AD) scale. Covariates included age, sex, Charlson's comorbidity index, activities of daily living, and dementia severity. Logistic quantile regression was used to characterize the association between polypharmacy and QoL-AD (model 1) and MRCI and QoL-AD (model 2). The median age of the 383 residents was 88 years and 297 (78 %) residents were female. In total, 63 % of residents were exposed to polypharmacy and the median MRCI score (range) was 43.5 (4-113). After adjusting for the covariates, polypharmacy was not associated with either higher or lower QoL-AD scores (estimate -0.02; 95 % confidence interval (CI) -0.165, 0.124; p = 0.78). Similarly, after adjusting for the covariates, MRCI was not associated with either higher or lower QoL-AD scores (estimate -0.0009, 95 % CI -0.005, 0.003; p = 0.63). These findings suggest that polypharmacy and medication regimen complexity are not associated with staff informant rated HRQoL. Further research is needed to investigate how specific medication classes may impact change in quality of life over time.

  19. Studies and research concerning BNFP: life of project operating expenses for away-from-reactor (AFR) spent fuel storage facility. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Shallo, F. A.

    1979-09-01

    Life of Project operating expenses for a licensed Away-From-Reactor (AFR) Spent Fuel Storage Facility are developed in this report. A comprehensive business management structure is established and the functions and responsibilities for the facility organization are described. Contractual provisions for spent fuel storage services are evaluated.

  20. Final Report for The University of Texas at Arlington Optical Medical Imaging Section of Advanced Imaging Research Center

    Energy Technology Data Exchange (ETDEWEB)

    Khosrow Behbehani

    2013-02-26

    The goal of this project was to create state-of-the-art optical medical imaging laboratories for the Biomedical Engineering faculty and student researchers of the University of Texas at Arlington (UTA) on the campus of the University of Texas Southwestern Medical Center (UTSW). This has been successfully achieved. These laboratories provide an unprecedented opportunity for the bioengineers (from UTA) to bring about new breakthroughs in medical imaging using optics. Specifically, three major laboratories have been successfully established and state-of-the-art scientific instruments have been placed in the labs. As a result of this grant, numerous journal and conference publications have been generated, patents for new inventions have been filed and received, and many additional grants for the continuation of the research has been received.

  1. Use of North America's first medically supervised safer injecting facility among HIV-positive injection drug users.

    Science.gov (United States)

    Reddon, Hudson; Wood, Evan; Tyndall, Mark; Lai, Calvin; Hogg, Robert; Montaner, Julio; Kerr, Thomas

    2011-10-01

    The objective of this study was to examine supervised injecting facility (SIF) use among a cohort of 395 HIV-positive injection drug users (IDUs) in Vancouver, Canada. The correlates of SIF use were identified using generalized estimating equation analyses. In multivariate analyses, frequent SIF use was associated with homelessness (adjusted odds ratio [AOR] = 1.90), daily heroin injection (AOR = 1.56), and daily cocaine injection (AOR = 1.59). The reasons given for not using the SIF included a preference for injecting at home and already having a safe place to inject. The SIF services most commonly used were needle exchange and nursing services. The SIF appears to have attracted a high-risk subpopulation of HIV-positive IDUs; this coverage perhaps could be extended with the addition of HIV-specific services such as disease monitoring and the provision of antiretroviral therapy.

  2. Development of an Industry Dynamometer/Spin Test Facility--Equipment Only: Cooperative Research and Development Final Report, CRADA Number CRD-05-164

    Energy Technology Data Exchange (ETDEWEB)

    McDade, Mark [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-12-01

    The Department of Energy/National Renewable Energy Laboratory (DOE/NREL) owns and operates a megawatt-scale dynamometer used for testing wind turbine drive trains up to 1.5 megawatt (MW) in rated capacity. At this time, this unit is the only unit of its type in the United States, available for use by the American Wind Industry. Currently this dynamometer is heavily backlogged and unavailable to provide testing needed by various wind industry members. DOE/NREL is in possession of two critical pieces of equipment that may be used to develop an alternative Dynamometer facility, but does not have the funds or other resources necessary to develop such a facility. The Participant possesses complimentary facilities and infrastructure that when combined with the NREL equipment can create such a test facility. The Participant is also committed to expending funds to develop and operate such a facility to the subsequent benefit of the Wind Industry and DOE Wind Energy program. In exchange for DOE/NREL providing the critical equipment, the Participant will grant DOE/NREL a minimum of 90 days of testing time per year in the new facility while incurring no facilities fees.

  3. ORNL necessary and sufficient standards for environment, safety, and health. Final report of the Identification Team for other industrial, radiological, and non-radiological hazard facilities

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-07-01

    This Necessary and Sufficient (N and S) set of standards is for Other Industrial, Radiological, and Non-Radiological Hazard Facilities at Oak Ridge National Laboratory (ORNL). These facility classifications are based on a laboratory-wide approach to classify facilities by hazard category. An analysis of the hazards associated with the facilities at ORNL was conducted in 1993. To identify standards appropriate for these Other Industrial, Radiological, and Non-Radiological Hazard Facilities, the activities conducted in these facilities were assessed, and the hazards associated with the activities were identified. A preliminary hazards list was distributed to all ORNL organizations. The hazards identified in prior hazard analyses are contained in the list, and a category of other was provided in each general hazard area. A workshop to assist organizations in properly completing the list was held. Completed hazard screening lists were compiled for each ORNL division, and a master list was compiled for all Other Industrial, Radiological Hazard, and Non-Radiological facilities and activities. The master list was compared against the results of prior hazard analyses by research and development and environment, safety, and health personnel to ensure completeness. This list, which served as a basis for identifying applicable environment, safety, and health standards, appears in Appendix A.

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

    Science.gov (United States)

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

    2016-06-01

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

  5. Child Murder in Nazi Germany: The Memory of Nazi Medical Crimes and Commemoration of “Children’s Euthanasia” Victims at Two Facilities (Eichberg, Kalmenhof

    Directory of Open Access Journals (Sweden)

    Lutz Kaelber

    2012-09-01

    Full Text Available Nazi Germany’s “children’s euthanasia” was a unique program in the history of mankind, seeking to realize a social Darwinist vision of a society by means of the systematic murder of disabled children and youths. Perpetrators extinguished “unworthy life” during childhood and adolescence by establishing killing stations, misleadingly labeled Kinderfachabteilungen (“special children’s wards”, in existing medical or other care facilities. Part of a research project on Nazi “euthanasia” crimes and their victims, this paper uses a comparative historical perspective to trace memories of the crimes and the memorialization of their victims at the sites of two of these wards (Eichberg and Kalmenhof in Hesse, Germany. It also discusses the implications of the findings for theorizing mnemonic practices and analyzing ways in which memorials and other sites of memory deal with past trauma and atrocity.

  6. THE INVESTIGATION OF APPLYING MULTIPLE-CHOICE QUESTION MAKING RULES IN FINAL EXAMS OF THE FACULTY MEMBERS OF YAZD MEDICAL SHAHID SADOUGHI UNIVERSITY

    Directory of Open Access Journals (Sweden)

    A.A Vaezi

    2007-07-01

    Full Text Available Introduction and the goal : Exam with Multiple-choice question is one of the most objective tests applied in medical science. This type of exam is considered as one of the best existing methods of testing because of several reasons such as homogeneity of the questions, low susceptibility for blind guess, and easiness of the scoring. The goal of this study is to find out the extent which the members of scientific board and the professors of Yazd Medical University of Shahid Sadoughi follow the multiple-choice test-making rules while preparing the questions for final exams. Methods : This is a descriptive study one which was administered on the questions of 187 of the members of scientific board and the university professors who had evaluated their students by multiple-choice questions. The data was gathered using the check list designed by the members of medical education center including demographic information of the scientific board member and the items on how to adapt multiple-choice questions to making rules of these questions. Finally the gathered data was analyzed by SPSS software. Results : The results showed that 79.1% (148 persons of the 187 subjects were males and the rest were females. The highest number of the subjects was from Medical University (clinical (41.2% or 77 persons and the lowest was from public health (8% or 15 persons. The distribution of the scores by ordinal scale included 24.6(46 persons as good, 66.8% (125 persons as intermediate and 8.6 (16 persons as poor. The highest percentage of good scores belonged to nursery and midwifery faculty (30.4% and the lowest belonged to paramedical faculty (5.6%. Besides paramedical faculty (83.3% possessed the highest intermediate score (83.3% and the faculty of dentistry possessed the lowest one. Finally, the highest low score belonged to dentistry faculty (16% and the lowest was for Medical faculty (5.2%(clinical. Discussion : Due to the significant role of evaluation in the

  7. Medicare program; revisions to the durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) supplier safeguards. Final rule.

    Science.gov (United States)

    2012-03-14

    This final rule removes the definition of "direct solicitation'' and allows DMEPOS suppliers, including DMEPOS competitive bidding program contract suppliers, to contract with licensed agents to provide DMEPOS supplies, unless prohibited by State law. It also removes the requirement for compliance with local zoning laws and modifies certain State licensure requirement exceptions.

  8. West Angeles Community Development Corporation final technical report on export market feasibility planning and research for the solar medical autoclave

    Energy Technology Data Exchange (ETDEWEB)

    Power, G.D.

    1998-04-20

    This report summarizes core findings from an investigation performed by the staff of West Angeles Community Development Corporation (CDC) regarding the feasibility of marketing the Solar Medical Autoclave (``autoclave``) in South Africa. The investigation was completed during 1997, the period prescribed by the Grant Award made by the U.S. Department of Energy on January 1, 1997, and was monitored by the National Renewable Energy Laboratory.

  9. Evaluation of emergency medical technicians intermediate prediction about their transported patients final disposition in emergency department of Imam Khomeini Hospital.

    Science.gov (United States)

    Afzalimoghadam, Mohammad; Mozafari, Javad; Talebian, Mohammad Taghi; Mohammadnejad, Esmaeil; Kasaeian, Amir

    2013-08-07

    This was a prospective cross-sectional study of consecutive transported patients by emergency medical service (EMS) to a referral hospital. The goal of this study was the evaluation of emergency medical technician intermediate prediction about their transported patients disposition in Emergency Department of Imam Khomeini Hospital. 2950 patients were transported to this hospital, Questionnaires were submitted in 300 of consecutive patient transports and completed data were obtained and available upon arrival at hospital for 267 of these cases. Emergency medical technicians intermediate (EMT-I) were asked to predict whether the transported patient would require admission to the hospital, and if so, what will be their prediction of patient actual disposition. Their predictions were compared with emergency specialist physicians. EMT-I predicted that 208 (78%) transports would lead to admission to the hospital, after actual disposition, 232 (%87) patients became admitted. The sensitivity of predicting any admission was 65%, with positive predictive value (PPV) of 39% and specificity of 86% with negative predictive value (NPV) of 94%. The sensitivity of predicting trauma patients (56.2% of total patients) was 55% with PPV of 38%, specificity of 86% and for Non-trauma patients' sensitivity was 80% with PPV of 40% and specificity of 82%. EMT-I in our emergency medical system have very limited ability in prediction of admission and disposition in transported patients and their prediction were better in Non-trauma patients. So in our EMS, the pre-hospital diversion and necessity of transporting policies should not be based on EMS personnel disposition.

  10. Evaluation of emergency medical technicians intermediate prediction about their transported patients final disposition in emergency department of Imam Khomeini Hospital.

    Directory of Open Access Journals (Sweden)

    Mohammad Afzalimoghadam

    2013-07-01

    Full Text Available This was a prospective cross-sectional study of consecutive transported patients by emergency medical service (EMS to a referral hospital. The goal of this study was the evaluation of emergency medical technician intermediate prediction about their transported patients disposition in Emergency Department of Imam Khomeini Hospital. 2950 patients were transported to this hospital, Questionnaires were submitted in 300 of consecutive patient transports and completed data were obtained and available upon arrival at hospital for 267 of these cases. Emergency medical technicians intermediate (EMT-I were asked to predict whether the transported patient would require admission to the hospital, and if so, what will be their prediction of patient actual disposition. Their predictions were compared with emergency specialist physicians. EMT-I predicted that 208 (78% transports would lead to admission to the hospital, after actual disposition, 232 (%87 patients became admitted. The sensitivity of predicting any admission was 65%, with positive predictive value (PPV of 39% and specificity of 86% with negative predictive value (NPV of 94%. The sensitivity of predicting trauma patients (56.2% of total patients was 55% with PPV of 38%, specificity of 86% and for Non-trauma patients' sensitivity was 80% with PPV of 40% and specificity of 82%. EMT-I in our emergency medical system have very limited ability in prediction of admission and disposition in transported patients and their prediction were better in Non-trauma patients. So in our EMS, the pre-hospital diversion and necessity of transporting policies should not be based on EMS personnel disposition.

  11. Juvenile Salmonid Pit-Tag Studies at Prosser Dam and the Chandler Canal Fish Collection Facility, Yakima River, 1991 and 1992 Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Ruehle, Thomas E.; Sandford, Benjamin P.

    1996-01-01

    In 1991 and 1992, the National Marine Fisheries Service completed the second and third years of a 3-year study to estimate juvenile salmonid (Oncorhynchus spp.) timing and survival characteristics related to passage through the Prosser Dam complex, including the Chandler Canal and the Chandler fish collection facility, on the Yakima River. Yearling chinook (O. tshawyacha) and coho salmon (O. kisutch) were collected at the Chandler facility, PIT tagged, and released at various locations in the Yakima River, Chandler Canal, and the Chandler facility. Individual fish were subsequently detected at PIT-tag detection monitors at the Chandler facility and/or McNary Dam on the Columbia River. Survival through various reaches, PIT-tag detection efficiency, and Chandler Canal fish entrainment proportion parameters were estimated using maximum likelihood techniques. The research objectives in 1991 and 1992 were to: (1) assess the effects of passage through the Chandler Canal and the Chandler facility on the survival of juvenile salmonids, (2) determine the entrainment rate of juvenile salmonids into the Chandler Canal as a function of river flow, and (3) determine the efficiency and reliability of the PIT-tag monitoring system at the Chandler facility. The initial 1990 research plan was expanded in 1991 and 1992 to include several more release locations and many more release days.

  12. Safety, efficacy and acceptability of outpatient mifepristone-misoprostol medical abortion through 70 days since last menstrual period in public sector facilities in Mexico City.

    Science.gov (United States)

    Sanhueza Smith, Patricio; Peña, Melanie; Dzuba, Ilana G; García Martinez, María Laura; Aranguré Peraza, Ana Gabriela; Bousiéguez, Manuel; Shochet, Tara; Winikoff, Beverly

    2015-02-01

    Extensive evidence exists regarding the efficacy and acceptability of medical abortion through 63 days since last menstrual period (LMP). In Mexico City's Secretariat of Health (SSDF) outpatient facilities, mifepristone-misoprostol medical abortion is the first-line approach for abortion care in this pregnancy range. Recent research demonstrates continued high rates of complete abortion through 70 days LMP. To expand access to legal abortion services in Mexico City (where abortion is legal through 12 weeks LMP), this study sought to assess the efficacy and acceptability of the standard outpatient approach through 70 days in two SSDF points of service. One thousand and one women seeking pregnancy termination were enrolled and given 200 mg mifepristone followed by 800 μg misoprostol 24-48 hours later. Women were asked to return to the clinic one week later for evaluation. The great majority of women (93.3%; 95% CI: 91.6-94.8) had complete abortions. Women with pregnancies ≤ 8 weeks LMP had significantly higher success rates than women in the 9th or 10th weeks (94.9% vs. 90.5%; p = 0.01). The difference in success rates between the 9th and 10th weeks was not significant (90.0% vs. 91.2%; p = 0.71). The majority of women found the side effects (82.9%) and the use of misoprostol (84.4%) to be very acceptable or acceptable. This study provides additional evidence supporting an extended outpatient medical abortion regimen through 10 weeks LMP. Copyright © 2015 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  13. Behavioral and clinical characteristics of people receiving medical care for HIV infection in an outpatient facility in Sicily, Italy

    Directory of Open Access Journals (Sweden)

    Di Carlo P

    2016-05-01

    Full Text Available Paola Di Carlo,1 Giuliana Guadagnino,1 Palmira Immordino,1 Giovanni Mazzola,2 Pietro Colletti,2 Ilenia Alongi,1 Lucia Adamoli,1 Francesco Vitale,1 Alessandra Casuccio1 1Department of Sciences for Health Promotion and Mother-Child Care “G D’Alessandro”, University of Palermo, 2Department of Medicinal Clinics and Emerging Diseases, “Paolo Giaccone” Polyclinic University Hospital, Palermo, Italy Aim: The authors examined a cohort of HIV-positive outpatients at the AIDS Center of Palermo University in Italy in order to identify factors related to the frequency of their visits to the outpatient facility for health care services.Methods: Two hundred and twenty-four HIV-infected subjects were enrolled in the study. Demographic and HIV disease characteristics were recorded and assessed with the number of days accessed to our outpatients unit in univariate and multivariate analyses. The potential relationship with immunological status was also analyzed stratifying the patients into groups according to their CD4+ T-cell counts (≥500 vs <500/mm3, and ≥200 vs <200/mm3.Results: Both univariate and multivariate analyses showed that duration of antiretroviral therapy <5 years and hypertension were significantly associated with a CD4+ T-cell count of <500/mm3, whereas geographic origin (Africa was associated with a CD4+ T-cell count of <200/mm3. Mean number of days the patients sought access to day-care services for laboratory tests was negatively associated with CD4+ T-cell count.Conclusion: Patients with low CD4+ T-cell counts showed higher use of health care services, demonstrating how early HIV diagnosis can help to reduce health care costs. The CD4+ T-cell cut-off of 200 cells emphasizes the importance of identifying and managing HIV infection among hard-to-reach groups like vulnerable migrants. In our sample, the illegal status of immigrants does not influence the management of their HIV/AIDS condition, but the lack of European health card

  14. Assessment of Present Anadromous Fish Production Facilities in the Columbia River Basin, Oregon Department of Fish and Wildlife Hatcheries, Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Delarm, Michael R.; Smith, Robert Z.

    1990-07-01

    The goal of this report is to document current production practices for hatcheries which rear anadromous fish in the Columbia River Basin and to identify those facilities where production can be increased. A total of 85 hatchery and satellite facilities operated by the Idaho Department of Fish and Game, Oregon Department of Fish and Game, US Fish and Wildlife Service, Washington Department of Wildlife, and Washington Department of Fisheries were evaluated. The years 1985 to 1987 were used in this evaluation. During those years, releases averaged 143,306,596 smolts weighing 7,693,589 pounds. A total of 48 hatchery or satellite facilities were identified as having expansion capability. They were estimated to have the potential for increasing production by an 84,448,000 smolts weighing 4,853,306 pounds. 2 refs, 25 figs.

  15. Assessment of Present Anadromous Fish Production Facilities in the Columbia River Basin, Idaho Department of Fish and Game Hatcheries, Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Delarm, Michael R.; Smith, Robert Z.

    1990-07-01

    The goal of this report is to document current production practices for hatcheries which rear anadromous fish in the Columbia River Basin and to identify those facilities where production can be increased. A total of 85 hatchery and satellite facilities operated by the Idaho Department of Fish and Game, Oregon Department of Fish and Game, US Fish and Wildlife Service, Washington Department of Wildlife, and Washington Department of Fisheries were evaluated. The years 1985 to 1987 were used in this evaluation. During those years, releases averaged 143,306,596 smolts weighing 7,693,589 pounds. A total of 48 hatchery or satellite facilities were identified as having expansion capability. They were estimated to have the potential for increasing production by an 84,448,000 smolts weighting 4,853,306 pounds. 2 refs., 25 figs.

  16. NaREC Offshore and Drivetrain Test Facility Collaboration: Cooperative Research and Development Final Report, CRADA Number CRD-04-140

    Energy Technology Data Exchange (ETDEWEB)

    Musial, W.

    2014-08-01

    The National Renewable Energy Laboratory (NREL) and the National Renewable Energy Centre (NaREC) in the United Kingdom (UK) have a mutual interest in collaborating in the development of full-scale offshore wind energy and drivetrain testing facilities. NREL and NaREC will work together to share resources and experiences in the development of future wind energy test facilities. This Cooperative Research and Development Agreement (CRADA) includes sharing of test protocols, infrastructure cost data, test plans, pro forma contracting instruments, and safe operating strategies. Furthermore, NREL and NaREC will exchange staff for training and development purposes.

  17. Knowledge, perceptions and attitudes of final year medical, occupational therapy and sport science students regarding physiotherapy, in KwaZulu Natal.

    Directory of Open Access Journals (Sweden)

    T. Puckree

    2011-02-01

    Full Text Available Knowledge, perceptions and attitudes about physiotherapy  has affected its status. In a developing profession whose patient base is still significantly dependent on referral from medical practitioners, certain stereo-typic attitudes about it require attention. This study investigated the knowledge, perceptions and attitudes of the 2009 final year medical, occupational therapy and sport science students at one university in KwaZulu natal, regarding  physio therapy. A saturation sample of 292 students from the selected groups was  invited  to  participate  in  the study. The  cross  sectional  survey  used a questionnaire  with  open  and  closed ended  questions.  The  data  was  reduced to percentages and analysed using chi square tests at p< 0, 05. The overall response rate was 51% with 95% occupational therapy, 71% sport science and only 31% medical students responding. About 74% of the respondents had adequate knowledge about physiotherapy. Seventy five percent of medical and 50% of oT students knew that physiotherapists were first contact practitioners. over 50% of the respondents who had experienced physiotherapy displayed positive attitudes and felt that physio-therapy was a good career choice. Massage was the best known (95% and electrotherapy the least known (44% modality. orthopedics (88%, sports physio therapy (84% and rehabilitation (78% were better known. we conclude that the response rate to the study especially by medical students is of concern despite the overall positive attitudes displayed by the participants.

  18. Study of medical isotope production facility stack emissions and noble gas isotopic signature using automatic gamma-spectra analysis platform

    Science.gov (United States)

    Zhang, Weihua; Hoffmann, Emmy; Ungar, Kurt; Dolinar, George; Miley, Harry; Mekarski, Pawel; Schrom, Brian; Hoffman, Ian; Lawrie, Ryan; Loosz, Tom

    2013-04-01

    The nuclear industry emissions of the four CTBT (Comprehensive Nuclear-Test-Ban Treaty) relevant radioxenon isotopes are unavoidably detected by the IMS along with possible treaty violations. Another civil source of radioxenon emissions which contributes to the global background is radiopharmaceutical production companies. To better understand the source terms of these background emissions, a joint project between HC, ANSTO, PNNL and CRL was formed to install real-time detection systems to support 135Xe, 133Xe, 131mXe and 133mXe measurements at the ANSTO and CRL 99Mo production facility stacks as well as the CANDU (CANada Deuterium Uranium) primary coolant monitoring system at CRL. At each site, high resolution gamma spectra were collected every 15 minutes using a HPGe detector to continuously monitor a bypass feed from the stack or CANDU primary coolant system as it passed through a sampling cell. HC also conducted atmospheric monitoring for radioxenon at approximately 200 km distant from CRL. A program was written to transfer each spectrum into a text file format suitable for the automatic gamma-spectra analysis platform and then email the file to a server. Once the email was received by the server, it was automatically analysed with the gamma-spectrum software UniSampo/Shaman to perform radionuclide identification and activity calculation for a large number of gamma-spectra in a short period of time (less than 10 seconds per spectrum). The results of nuclide activity together with other spectrum parameters were saved into the Linssi database. This database contains a large amount of radionuclide information which is a valuable resource for the analysis of radionuclide distribution within the noble gas fission product emissions. The results could be useful to identify the specific mechanisms of the activity release. The isotopic signatures of the various radioxenon species can be determined as a function of release time. Comparison of 133mXe and 133Xe activity

  19. Beyond "medical tourism": Canadian companies marketing medical travel

    Directory of Open Access Journals (Sweden)

    Turner Leigh

    2012-06-01

    companies. Seven other businesses market regional, cross-border health services available in the United States and intranational travel to clinics in Canada. In contrast to medical tourism companies, they do not market holiday tours in addition to medical care. Two companies occupy a narrow market niche and promote testing for CCSVI and “Liberation therapy” for multiple sclerosis. Three additional companies offer bariatric surgery and cosmetic surgery at facilities in Mexico. Four businesses offer health insurance products intended to cover the cost of obtaining privately financed health care in the U.S. These businesses also help their clients arrange treatment beyond Canada’s borders. Finally, one medical travel company based in Canada markets health services primarily to U.S. citizens. Conclusions This article uses content analysis of websites of Canadian companies marketing medical travel to provide insight into Canada’s medical travel industry. The article reveals a complex marketplace with different types of companies taking distinct approaches to marketing medical travel.

  20. Beyond "medical tourism": Canadian companies marketing medical travel.

    Science.gov (United States)

    Turner, Leigh

    2012-06-15

    -border health services available in the United States and intranational travel to clinics in Canada. In contrast to medical tourism companies, they do not market holiday tours in addition to medical care. Two companies occupy a narrow market niche and promote testing for CCSVI and "Liberation therapy" for multiple sclerosis. Three additional companies offer bariatric surgery and cosmetic surgery at facilities in Mexico. Four businesses offer health insurance products intended to cover the cost of obtaining privately financed health care in the U.S. These businesses also help their clients arrange treatment beyond Canada's borders. Finally, one medical travel company based in Canada markets health services primarily to U.S. citizens. This article uses content analysis of websites of Canadian companies marketing medical travel to provide insight into Canada's medical travel industry. The article reveals a complex marketplace with different types of companies taking distinct approaches to marketing medical travel.

  1. Beyond "medical tourism": Canadian companies marketing medical travel

    Science.gov (United States)

    2012-01-01

    businesses market regional, cross-border health services available in the United States and intranational travel to clinics in Canada. In contrast to medical tourism companies, they do not market holiday tours in addition to medical care. Two companies occupy a narrow market niche and promote testing for CCSVI and “Liberation therapy” for multiple sclerosis. Three additional companies offer bariatric surgery and cosmetic surgery at facilities in Mexico. Four businesses offer health insurance products intended to cover the cost of obtaining privately financed health care in the U.S. These businesses also help their clients arrange treatment beyond Canada’s borders. Finally, one medical travel company based in Canada markets health services primarily to U.S. citizens. Conclusions This article uses content analysis of websites of Canadian companies marketing medical travel to provide insight into Canada’s medical travel industry. The article reveals a complex marketplace with different types of companies taking distinct approaches to marketing medical travel. PMID:22703873

  2. Factors influencing knowledge about childhood autism among final year undergraduate Medical, Nursing and Psychology students of University of Nigeria, Enugu State, Nigeria.

    Science.gov (United States)

    Igwe, Monday N; Bakare, Muideen O; Agomoh, Ahamefule O; Onyeama, Gabriel M; Okonkwo, Kevin O

    2010-06-13

    Knowledge and awareness about childhood autism is low among health care workers and the general populace in Nigeria. Poor knowledge about childhood autism among final year medical, nursing and psychology students who would form tomorrow's child health care professionals can compromise early recognition and interventions that are known to improve prognosis in childhood autism. Educational factors that could be influencing knowledge about childhood autism among these future health care professionals are unknown. This study assessed knowledge about childhood autism among final year undergraduate medical, nursing and psychology students in south-eastern Nigeria and determined the factors that could be influencing such knowledge. One hundred final year undergraduate students were randomly selected from each of the Departments of Medicine, Nursing Science and Psychology respectively of University of Nigeria, Enugu State, Nigeria making a sample size of three hundred. A socio-demographic questionnaire and knowledge about childhood autism among health workers (KCAHW) questionnaire were administered to the students. The total mean score for the three groups of students on the KCAHW questionnaire was 10.67+/-3.73 out of a possible total score of 19, with medical, nursing and psychology students having total mean scores of 12.24+/-3.24, 10.76+/-3.50 and 9.01+/-3.76 respectively. The mean scores for the three groups showed statistically significant difference for domain 1 (p=0.000), domain 3 (p=0.029), domain 4 (p=0.000) and total score (p=0.000), with medical students more likely to recognise symptoms and signs of autism compared to nursing and psychology students. The mean score in domain 2 did not show statistically significant difference among the three groups (p=0.769). The total score on the KCAHW questionnaire is positively correlated with the number of weeks of posting in psychiatry (r=0.319, p=0.000) and the number of weeks of posting in paediatrics (r=0.372, p=0

  3. The Optimizing Patient Transfers, Impacting Medical Quality, andImproving Symptoms:Transforming Institutional Care approach: preliminary data from the implementation of a Centers for Medicare and Medicaid Services nursing facility demonstration project.

    Science.gov (United States)

    Unroe, Kathleen T; Nazir, Arif; Holtz, Laura R; Maurer, Helen; Miller, Ellen; Hickman, Susan E; La Mantia, Michael A; Bennett, Merih; Arling, Greg; Sachs, Greg A

    2015-01-01

    The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project aims to reduce avoidable hospitalizations of long-stay residents enrolled in 19 central Indiana nursing facilities. This clinical demonstration project, funded by the Centers for Medicare and Medicaid Services Innovations Center, places a registered nurse in each nursing facility to implement an evidence-based quality improvement program with clinical support from nurse practitioners. A description of the model is presented, and early implementation experiences during the first year of the project are reported. Important elements include better medical care through implementation of Interventions to Reduce Acute Care Transfers tools and chronic care management, enhanced transitional care, and better palliative care with a focus on systematic advance care planning. There were 4,035 long-stay residents in 19 facilities enrolled in OPTIMISTIC between February 2013 and January 2014. Root-cause analyses were performed for all 910 acute transfers of these long stay residents. Of these transfers, the project RN evaluated 29% as avoidable (57% were not avoidable and 15% were missing), and opportunities for quality improvement were identified in 54% of transfers. Lessons learned in early implementation included defining new clinical roles, integrating into nursing facility culture, managing competing facility priorities, communicating with multiple stakeholders, and developing a system for collecting and managing data. The success of the overall initiative will be measured primarily according to reduction in avoidable hospitalizations of long-stay nursing facility residents.

  4. On the road to becoming a responsible leader: A simulation-based training approach for final year medical students

    Directory of Open Access Journals (Sweden)

    Schmidt-Huber, Marion

    2017-08-01

    Full Text Available Background and objective: There is a need for young physicians to take a responsible role in clinical teams, comparable to a leadership role. However, today’s medical curricula barely consider the development of leadership competencies. Acquisition of leadership skills are currently a by-product of medical education, even though it seems to be a competency relevant for physicians’ success. Therefore, an innovative leadership training program for young physicians was developed and validated. Training conceptualisation were based upon Method: The training consists of four sessions (3-4 hours each and provided evidence-based lectures of leadership theory and effective leader behaviors, interactive training elements and a simulation-based approach with professional role players focusing on interprofessional collaboration with care staff. Training evaluation was assessed twice after completion of the program (=37. Assessments included items from validated and approved evaluation instruments regarding diverse learning outcomes (satisfaction/reaction, learning, self-efficacy, and application/transfer and transfer indicators. Furthermore, training success predictors were assessed based on stepwise regression analysis. In addition, long-term trainings effects and behavioral changes were analysed. Results: Various learning outcomes are achieved (self-reported training satisfaction, usefulness of the content and learning effects and results show substantial transfer effects of the training contents and a strengthened awareness for the leadership role (e.g. self-confidence, ideas dealing with work-related problems in a role as responsible physician. We identified competence of trainer, training of applied tools, awareness of job expectations, and the opportunity to learn from experiences of other participants as predictors of training success. Additionally, we found long-term training effects and participants reported an increase in specific

  5. Medical examination of aliens--removal of human immunodeficiency virus (HIV) infection from definition of communicable disease of public health significance. Final rule.

    Science.gov (United States)

    2009-11-02

    Through this final rule, the Centers for Disease Control and Prevention (CDC), within the U.S. Department of Health and Human Services (HHS), is amending its regulations to remove "Human Immunodeficiency Virus (HIV) infection" from the definition of communicable disease of public health significance and remove references to "HIV" from the scope of examinations for aliens. Prior to this final rule, aliens with HIV infection were considered to have a communicable disease of public health significance and were thus inadmissible to the United States per the Immigration and Nationality Act (INA). While HIV infection is a serious health condition, it is not a communicable disease that is a significant public health risk for introduction, transmission, and spread to the U.S. population through casual contact. As a result of this final rule, aliens will no longer be inadmissible into the United States based solely on the ground they are infected with HIV, and they will not be required to undergo HIV testing as part of the required medical examination for U.S. immigration.

  6. Medicare program; End-Stage Renal Disease prospective payment system, quality incentive program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies. Final rule.

    Science.gov (United States)

    2014-11-06

    This final rule will update and make revisions to the End-Stage Renal Disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2015. This rule also finalizes requirements for the ESRD quality incentive program (QIP), including for payment years (PYs) 2017 and 2018. This rule will also make a technical correction to remove outdated terms and definitions. In addition, this final rule sets forth the methodology for adjusting Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) fee schedule payment amounts using information from the Medicare DMEPOS Competitive Bidding Program (CBP); makes alternative payment rules for certain DME under the Medicare DMEPOS CBP; clarifies the statutory Medicare hearing aid coverage exclusion and specifies devices not subject to the hearing aid exclusion; will not update the definition of minimal self-adjustment; clarifies the Change of Ownership (CHOW) and provides for an exception to the current requirements; revises the appeal provisions for termination of a CBP contract, including the beneficiary notification requirement under the Medicare DMEPOS CBP, and makes a technical change to the regulation related to the conditions for awarding contracts for furnishing infusion drugs under the Medicare DMEPOS CBP.

  7. Structured Pharmaceutical Analysis of the Systematic Tool to Reduce Inappropriate Prescribing Is an Effective Method for Final-Year Medical Students to Improve Polypharmacy Skills : A Randomized Controlled Trial

    NARCIS (Netherlands)

    Keijsers, Carolina J. P. W.; van Doorn, Adriaan B. D.; van Kalles, Anouk; de Wildt, Dick J.; Brouwers, Jacobus R. B. J.; Van de Kamp, Henrieke J.; Jansen, Paul A. F.

    Medical students may not be adequately trained to prescribe appropriately to older adults with polypharmacy. This study addressed how to teach students to minimize inappropriate polypharmacy. Final-year medical students (N = 106) from two Dutch schools of medicine participated in this randomized

  8. Structured pharmaceutical analysis of the Systematic Tool to Reduce Inappropriate Prescribing is an effective method for final-year medical students to improve polypharmacy skills : a randomized controlled trial

    NARCIS (Netherlands)

    Keijsers, Carolina J P W; van Doorn, Adriaan B D; van Kalles, Anouk; de Wildt, Dick J; Brouwers, Jacobus R B J; van de Kamp, Henrieke J; Jansen, Paul A F

    Medical students may not be adequately trained to prescribe appropriately to older adults with polypharmacy. This study addressed how to teach students to minimize inappropriate polypharmacy. Final-year medical students (N = 106) from two Dutch schools of medicine participated in this randomized

  9. Final Assessment: U.S. Virgin Islands Industrial Development Park and Adjacent Facilities Energy-Efficiency and Micro-Grid Infrastructure

    Energy Technology Data Exchange (ETDEWEB)

    Petersen, Joseph M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Boyd, Paul A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Dahowski, Robert T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Parker, Graham B. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-12-31

    The purpose of this assessment was to undertake an assessment and analysis of cost-effective options for energy-efficiency improvements and the deployment of a micro-grid to increase the energy resilience at the U.S. Virgin Islands Industrial Development Park (IDP) and adjacent facilities in St. Croix, Virgin Islands. The Economic Development Authority sought assistance from the U.S. Department of Energy to undertake this assessment undertaken by Pacific Northwest National Laboratory. The assessment included 18 buildings plus the perimeter security lighting at the Virgin Islands Bureau of Correctional Facility, four buildings plus exterior lighting at the IDP, and five buildings (one of which is to be constructed) at the Virgin Islands Police Department for a total of 27 buildings with a total of nearly 323,000 square feet.

  10. Cost and schedule estimate to construct the tunnel and shaft remedial shielding concept, Los Alamos Meson Physics Facility, Los Alamos National Laboratory, Los Alamos, New Mexico. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-11-30

    The report provides an estimate of the cost and associated schedule to construct the tunnel and shaft remedial shielding concept. The cost and schedule estimate is based on a preliminary concept intended to address the potential radiation effects on Line D and Line Facilities in event of a beam spill. The construction approach utilizes careful tunneling methods based on available excavation and ground support technology. The tunneling rates and overall productivity on which the cost and project schedule are estimated are based on conservative assumptions with appropriate contingencies to address the uncertainty associated with geological conditions. The report is intended to provide supplemental information which will assist in assessing the feasibility of the tunnel and shaft concept and justification for future development of this particular aspect of remedial shielding for Line D and Line D Facilities.

  11. Final Environmental Assessment: For Construction at the Colorado Army National Guard Army Aviation Support Facility Complex, Buckley Air Force Base, Colorado

    Science.gov (United States)

    2005-01-01

    energy resource efficient design (e.g., a southeast orientation to the building would allow for solar exposure to the hangar doors and apron area, which... solar effects into the design. Communications. Buckley AFB is well served by fiber-optic lines and other communication facilities. There would be a...Box 737 Ignacio , CO 8113 7 From: Colorado Army National Guard 6846 S. Revere Pkwy. Centennial, CO 80112 Dear Mr. Frazier, 12 May2004 The Colorado

  12. FINAL REPORT FOR THE REDUCTION OF CHROME (VI) TO CHROME (III) IN THE SECONDARY WASTE STREAM OF THE EFFLUENT TREATMENT FACILITY

    Energy Technology Data Exchange (ETDEWEB)

    DUNCAN JB; GUTHRIE MD

    2008-08-29

    This report documents the laboratory results of RPP-PLAN-35958, Test Plan for the Effluent Treatment Facility to Reduce Chrome (VI) to Chrome (III) in the Secondary Waste Stream With the exception of the electrochemical corrosion scans, all work was carried out at the Center for Laboratory Science (CLS) located at the Columbia Basin College. This document summarizes the work carried out at CLS and includes the electrochemical scans and associated corrosion rates for 304 and 316L stainless steel.

  13. Role of Human Health Care Providers and Medical Treatment Facilities in Military Working Dog Care and Accessibility Difficulties with Military Working Dog Blood Products.

    Science.gov (United States)

    Giles Iii, James T

    2016-01-01

    The use of military working dogs (MWDs) in support of military operations has increased dramatically over recent years, as they have proven to be our most reliable deterrent to improvised explosive devices. Healthcare delivery for MWDs in combat presents unique challenges and requires extensive collaboration between veterinarians and human health care providers (HCPs). A successful example is the incorporation of MWD emergency care for nonveterinary HCPs into the Joint Trauma System Clinical Practice Guidelines, which has proven to be a helpful product. Additional challenges that need further solutions include MWDs as patients in human medical treatment facilities (MTFs) and the procurement of appropriate canine blood components in an operational environment. It is often necessary for MWDs to be treated as patients in human MTFs, however, there is no Department of Defense guidance to support this activity. Access to MWD blood products is limited to collection of fresh whole blood in the operational setting. Similar to humans, specific blood component therapy, such as fresh frozen plasma, is often indicated for sick or injured MWDs. Currently there is no formal system in place to deliver any blood products for MWDs or to facilitate collection in theater.

  14. Final closure plan for the high-explosives open burn treatment facility at Lawrence Livermore National Laboratory Experimental Test Site 300

    Energy Technology Data Exchange (ETDEWEB)

    Mathews, S.

    1997-04-01

    This document addresses the interim status closure of the HE Open Bum Treatment Facility, as detailed by Title 22, Division 4.5, Chapter 15, Article 7 of the Califonia Code of Regulations (CCR) and by Title 40, Code of Federal Regulations (CFR) Part 265, Subpart G, ``Closure and Post Closure.`` The Closure Plan (Chapter 1) and the Post- Closure Plan (Chapter 2) address the concept of long-term hazard elimination. The Closure Plan provides for capping and grading the HE Open Bum Treatment Facility and revegetating the immediate area in accordance with applicable requirements. The Closure Plan also reflects careful consideration of site location and topography, geologic and hydrologic factors, climate, cover characteristics, type and amount of wastes, and the potential for contaminant migration. The Post-Closure Plan is designed to allow LLNL to monitor the movement, if any, of pollutants from the treatment area. In addition, quarterly inspections will ensure that all surfaces of the closed facility, including the cover and diversion ditches, remain in good repair, thus precluding the potential for contaminant migration.

  15. Intended Career Choice in Family Medicine in Slovenia: An Issue of Gender, Family Background or Empathic Attitudes in Final Year Medical Students?

    Science.gov (United States)

    Ster, Marija Petek; Selic, Polona

    2017-01-01

    Background: Among a variety of complex factors affecting a decision to take family medicine as a future specialisation, this study focused on demographic characteristics and assessed empathic attitudes in final year medical students. Methods: A convenience sampling method was employed in two consecutive academic years of final year medical students at the Faculty of Medicine in Ljubljana, Slovenia, in May 2014 and May 2015. A modified version of the 16-item Jefferson Scale of Empathy – Student Version (JSE-S) was administered to examine self-reported empathic attitudes. An intended career in family medicine was reported using a five-point Likert scale. Results: Of the 175 medical school seniors in study year 2013/14, there were 64 (36.6%) men and 111 (63.4%) women, while in the second group (study year 2014/5), there were 68 (40.5%) men and 100 (59.5%) women; 168 students in total. They were 24.9±1.6 (generation 2013/4) and 24.9±1.7 (generation 2014/15) years old. Thirty-six percent of the students in the academic year 2013/14 intended to choose family medicine as a future career, and a similar proportion in academic year 2014/15 (31.7%). Gender (χ2=6.763, p=0.034) and empathic attitudes (c2=14.914; p=0.001) had a bivariate association with an intended career choice of family medicine in the 2014/15 generation. When logistic regression was applied to this group of students, an intended career choice in family medicine was associated with empathic attitudes (OR 1.102, 95% CI 1.040-1.167, p=0.001), being single (OR 3.659, 95% CI 1.150-11.628, p=0.028) and the father having only primary school education (OR 142.857 95% CI 1.868, p=0.025), but not with gender (OR 1.117, 95% CI 0.854-1.621, p=0.320). Conclusion: The level of students’ father’s education, and not living in an intimate partnership, increased the odds on senior medical students to choose family medicine, yet we expected higher JSE-S scores to be associated with interest in this speciality. To

  16. Final work plan : phase II investigation of potential contamination at the former CCC/USDA grain storage facility in Savannah, Missouri.

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, L. M.; Environmental Science Division

    2010-08-16

    From approximately 1949 until 1970, the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) operated a grain storage facility on federally owned property approximately 0.25 mi northwest of Savannah, Missouri (Figure 1.1). During this time, commercial grain fumigants containing carbon tetrachloride were commonly used by the CCC/USDA and the private grain storage industry to preserve grain in their facilities. In November 1998, carbon tetrachloride was detected in a private well (Morgan) roughly 50 ft south of the former CCC/USDA facility, as a result of statewide screening of private wells near former CCC/USDA facilities, conducted in Missouri by the U.S. Environmental Protection Agency (EPA 1999). The 1998 and subsequent investigations by the EPA and the Missouri Department of Natural Resources (MoDNR) confirmed the presence of carbon tetrachloride in the Morgan well, as well as in a second well (on property currently occupied by the Missouri Department of Transportation [MoDOT]) described as being approximately 400 ft east of the former CCC/USDA facility. The identified concentrations in these two wells were above the EPA maximum contaminant level (MCL) and the Missouri risk-based corrective action default target level (MRBCA DTL) values of 5.0 {micro}g/L for carbon tetrachloride in water used for domestic purposes (EPA 1999; MoDNR 2000a,b, 2006). Because the observed contamination in the Morgan and MoDOT wells might be linked to the past use of carbon tetrachloride-based fumigants at its former grain storage facility, the CCC/USDA is conducting an investigation to (1) characterize the source(s), extent, and factors controlling the subsurface distribution and movement of carbon tetrachloride at Savannah and (2) evaluate the potential risks to human health, public welfare, and the environment posed by the contamination. This work is being performed in accord with the Intergovernmental Agreement established between the Farm Service Agency

  17. Final work plan : Phase I investigation of potential contamination at the former CCC/USDA grain storage facility in Savannah, Missouri.

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, L. M.; Environmental Science Division

    2007-10-12

    From approximately 1949 until 1970, the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) operated a grain storage facility on federally owned property approximately 0.25 mi northwest of Savannah, Missouri. During this time, commercial grain fumigants containing carbon tetrachloride were commonly used by the CCC/USDA and the private grain storage industry to preserve grain in their facilities. In November 1998, carbon tetrachloride was detected in a private well (Morgan) roughly 50 ft south of the former CCC/USDA facility, as a result of state-wide screening of private wells near former CCC/USDA facilities, conducted in Missouri by the U.S. Environmental Protection Agency (EPA 1999). The 1998 and subsequent investigations by the EPA and the Missouri Department of Natural Resources (MoDNR) confirmed the presence of carbon tetrachloride in the Morgan well, as well as in a second well (on property currently occupied by the Missouri Department of Transportation [MoDOT]), approximately 400 ft east of the former CCC/USDA facility. Carbon tetrachloride concentrations in the Morgan well have ranged from the initial value of 29 {micro}g/L in 1998, up to a maximum of 61 {micro}g/L in 1999, and back down to 22 {micro}g/L in 2005. The carbon tetrachloride concentration in the MoDOT well in 2000 (the only time it was sampled) was 321 {micro}g/L. The concentrations for the two wells are above the EPA maximum contaminant level (MCL) of 5 {micro}g/L for carbon tetrachloride (EPA 1999; MoDNR 2000a,b). Because the observed contamination in the Morgan and MoDOT wells might be linked to the past use of carbon tetrachloride-based grain fumigants at its former grain storage facility, the CCC/USDA will conduct investigations to (1) characterize the source(s), extent, and factors controlling the subsurface distribution and movement of carbon tetrachloride at Savannah and (2) evaluate the health and environmental threats potentially posed by the contamination

  18. Final work plan : phase I investigation of potential contamination at the former CCC/USDA grain storage facility in Montgomery City, Missouri.

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, L. M.; Environmental Science Division

    2010-08-16

    From September 1949 until September 1966, the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) leased property at the southeastern end of Montgomery City, Missouri, for the operation of a grain storage facility. During this time, commercial grain fumigants containing carbon tetrachloride were commonly used by the CCC/USDA and the private grain storage industry to preserve grain in their facilities. In January 2000, carbon tetrachloride was detected in a soil sample (220 {micro}g/kg) and two soil gas samples (58 {micro}g/m{sup 3} and 550 {micro}g/m{sup 3}) collected at the former CCC/USDA facility, as a result of a pre-CERCLIS site screening investigation (SSI) performed by TN & Associates, Inc., on behalf of the U.S. Environmental Protection Agency (EPA), Region VII (MoDNR 2001). In June 2001, the Missouri Department of Natural Resources (MoDNR) conducted further sampling of the soils and groundwater at the former CCC/USDA facility as part of a preliminary assessment/site inspection (PA/SI). The MoDNR confirmed the presence of carbon tetrachloride (at a maximum identified concentration of 2,810 {micro}g/kg) and chloroform (maximum 82 {micro}g/kg) in the soils and also detected carbon tetrachloride and chloroform (42.2 {micro}g/L and 58.4 {micro}g/L, respectively) in a groundwater sample collected at the former facility (MoDNR 2001). The carbon tetrachloride levels identified in the soils and groundwater are above the default target level (DTL) values established by the MoDNR for this contaminant in soils of all types (79.6 {micro}g/kg) and in groundwater (5.0 {micro}g/L), as outlined in Missouri Risk-Based Corrective Action (MRBCA): Departmental Technical Guidance (MoDNR 2006a). The corresponding MRBCA DTL values for chloroform are 76.6 {micro}g/kg in soils of all types and 80 {micro}g/L in groundwater. Because the observed contamination at Montgomery City might be linked to the past use of carbon tetrachloride-based fumigants at its

  19. Final Report: Detection and Characterization of Underground Facilities by Stochastic Inversion and Modeling of Data from the New Generation of Synthetic Aperture Satellites

    Energy Technology Data Exchange (ETDEWEB)

    Foxall, W; Cunningham, C; Mellors, R; Templeton, D; Dyer, K; White, J

    2012-02-27

    Many clandestine development and production activities can be conducted underground to evade surveillance. The purpose of the study reported here was to develop a technique to detect underground facilities by broad-area search and then to characterize the facilities by inversion of the collected data. This would enable constraints to be placed on the types of activities that would be feasible at each underground site, providing a basis the design of targeted surveillance and analysis for more complete characterization. Excavation of underground cavities causes deformation in the host material and overburden that produces displacements at the ground surface. Such displacements are often measurable by a variety of surveying or geodetic techniques. One measurement technique, Interferometric Synthetic Aperture Radar (InSAR), uses data from satellite-borne (or airborne) synthetic aperture radars (SARs) and so is ideal for detecting and measuring surface displacements in denied access regions. Depending on the radar frequency and the acquisition mode and the surface conditions, displacement maps derived from SAR interferograms can provide millimeter- to centimeter-level measurement accuracy on regional and local scales at spatial resolution of {approx}1-10 m. Relatively low-resolution ({approx}20 m, say) maps covering large regions can be used for broad-area detection, while finer resolutions ({approx}1 m) can be used to image details of displacement fields over targeted small areas. Surface displacements are generally expected to be largest during or a relatively short time after active excavation, but, depending on the material properties, measurable displacement may continue at a decreasing rate for a considerable time after completion. For a given excavated volume in a given geological setting, the amplitude of the surface displacements decreases as the depth of excavation increases, while the area of the discernable displacement pattern increases. Therefore, the

  20. Final work plan : indoor air and ambient air sampling near the former CCC/USDA grain storage facility in Everest, Kansas.

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, L. M. (Environmental Science Division)

    2010-05-24

    The Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) operated a grain storage facility at the western edge of Everest, Kansas, from the early 1950s to the early 1970s. Sampling by the Kansas Department of Health and Environment (KDHE) in 1997 resulted in the detection of carbon tetrachloride in one domestic well (the Nigh well) northwest of the former facility. On behalf of the CCC/USDA, Argonne National Laboratory subsequently conducted a series of investigations to characterize the contamination (Argonne 2003, 2006a,b,c). Automatic, continuous monitoring of groundwater levels began in 2002 and is ongoing at six locations. The results have consistently indicated groundwater flow toward the north-northwest from the former CCC/USDA property to the Nigh property, then west-southwest from the Nigh property to the intermittent creek. Sitewide periodic groundwater and surface water sampling with analysis for volatile organic compounds (VOCs) began in 2008. Argonne's combined data indicate no significant downgradient extension of contamination since 2000. At present, the sampling is annual, as approved by the KDHE (2009) in response to a plan developed for the CCC/USDA (Argonne 2009). This document presents a plan for collecting indoor air samples in homes located along and adjacent to the defined extent of the carbon tetrachloride contamination. The plan was requested by the KDHE. Ambient air samples to represent the conditions along this pathway will also be taken. The purpose of the proposed work is to satisfy KDHE requirements and to collect additional data for assessing the risk to human health due to the potential upward migration of carbon tetrachloride and its primary degradation product (chloroform) into homes located in close proximity to the former grain storage facility, as well as along and within 100 ft laterally from the currently defined plume emanating from the former Everest facility. Investigation of the indoor air

  1. Final report : results of the 2006-2007 investigation of potential contamination at the former CCC/USDA facility in Barnes, Kansas.

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, L. M.; Environmental Science Division

    2008-08-28

    The 2006-2007 investigation of carbon tetrachloride and chloroform contamination at Barnes, Kansas, was conducted at the request of the Kansas Department of Health and Environment (KDHE). The Environmental Science Division of Argonne National Laboratory implemented the investigation on behalf of the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA). The overall goal of the investigation was to establish criteria for monitoring leading to potential site reclassification. The investigation objectives were to (1) determine the hydraulic gradient near the former CCC/USDA facility, (2) delineate the downgradient carbon tetrachloride plume, and (3) design and implement an expanded monitoring network at Barnes (Argonne 2006a).

  2. New Pump and Treat Facility Remedial Action Work Plan For Test Area North Final Groundwater Remediation, Operable Unit 1-07B

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, L. O.

    2007-06-12

    This remedial action work plan identifies the approach and requirements for implementing the medial zone remedial action for Test Area North, Operable Unit 1-07B, at the Idaho National Laboratory. This plan details the management approach for the construction and operation of the New Pump and Treat Facility (NPTF). As identified in the remediatial design/remedial action scope of work, a separate remedial design/remedial action work plan will be prepared for each remedial component of the Operable Unit 1-07B remedial action.

  3. Development of manufacturing capability for the fabrication of the Nb/sub 3/Sn superconductor for the High Field Test Facility. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Spencer, C R

    1981-01-01

    Construction of High Field Test Facility (HFTF) at Lawrence Livermore Laboratory (LLNL) requires an extended surface Nb/sub 3/Sn superconductor cable of carrying currents in excess of 7500 amperes in a 12 Tesla magnetic field. This conductor consists of a 5.4 mm x 11.0 mm superconducting core onto whose broad surfaces are soldered embossed oxygen free copper strips. Two different core designs have been developed and the feasibility of each design evaluated. Equipment necessary to produce the conductor were developed and techniques of production were explored.

  4. Well-being and help-seeking: an exploratory study among final-year medical students Bem-estar e busca de ajuda: um estudo exploratório entre alunos de medicina ao final curso

    Directory of Open Access Journals (Sweden)

    Paula Bertozzi de Oliveira e Sousa Leão

    2011-08-01

    Full Text Available OBJECTIVE: Doubts, competitiveness and preparation for the residency examination increase stress and insecurity at the end of medical course. Well-being is very important at this point, but it is known that medical students are reluctant to seek help, particularly for emotional problems. This study investigated the relationship among well-being, perceived needs and help-seeking in final-year students. METHODS: Well-being was assessed using Beck's Inventories of Anxiety (BAI and Depression (BDI and the WHOQOL-brief (quality of life. A questionnaire was used to assess perceived needs and medical school support resources. RESULTS: The students reported good quality of life (68% but presented anxiety (27%, depression (20% and impaired social functioning. Fifty-one percent of the students acknowledged academic needs and 25% psychological needs. Only a portion of the students with anxiety and depression or bad quality of life used the institutional support. Female gender, perceived psychological needs and anxiety symptoms were associated to the use of the Mental Health Service. Satisfaction with mentoring relationships and positive changes were associated to Mentoring attendance. CONCLUSION: There are different factors involved in help-seeking and identifying specificities in the use of institutional support resources can help to develop strategies to sensitize students about help-seeking during the medical courseOBJETIVO: Dúvidas, competição e o exame de residência aumentam o estresse e a insegurança ao final do curso; entretanto, sabe-se que alunos de Medicina são resistentes a procurar ajuda, especialmente para problemas emocionais. Este estudo investigou a relação entre bem-estar, percepção de necessidades e busca de ajuda entre alunos do último ano do curso médico. MÉTODOS: Utilizou-se os Inventários Beck (ansiedade e depressão, o WHOQOL-breve (qualidade de vida e um questionário para avaliar necessidades e o uso dos recursos de

  5. Final work plan : phase I investigation of potential contamination at the former CCC/USDA grain storage facility in Montgomery City, Missouri.

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, L. M.; Environmental Science Division

    2010-08-16

    From September 1949 until September 1966, the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) leased property at the southeastern end of Montgomery City, Missouri, for the operation of a grain storage facility. During this time, commercial grain fumigants containing carbon tetrachloride were commonly used by the CCC/USDA and the private grain storage industry to preserve grain in their facilities. In January 2000, carbon tetrachloride was detected in a soil sample (220 {micro}g/kg) and two soil gas samples (58 {micro}g/m{sup 3} and 550 {micro}g/m{sup 3}) collected at the former CCC/USDA facility, as a result of a pre-CERCLIS site screening investigation (SSI) performed by TN & Associates, Inc., on behalf of the U.S. Environmental Protection Agency (EPA), Region VII (MoDNR 2001). In June 2001, the Missouri Department of Natural Resources (MoDNR) conducted further sampling of the soils and groundwater at the former CCC/USDA facility as part of a preliminary assessment/site inspection (PA/SI). The MoDNR confirmed the presence of carbon tetrachloride (at a maximum identified concentration of 2,810 {micro}g/kg) and chloroform (maximum 82 {micro}g/kg) in the soils and also detected carbon tetrachloride and chloroform (42.2 {micro}g/L and 58.4 {micro}g/L, respectively) in a groundwater sample collected at the former facility (MoDNR 2001). The carbon tetrachloride levels identified in the soils and groundwater are above the default target level (DTL) values established by the MoDNR for this contaminant in soils of all types (79.6 {micro}g/kg) and in groundwater (5.0 {micro}g/L), as outlined in Missouri Risk-Based Corrective Action (MRBCA): Departmental Technical Guidance (MoDNR 2006a). The corresponding MRBCA DTL values for chloroform are 76.6 {micro}g/kg in soils of all types and 80 {micro}g/L in groundwater. Because the observed contamination at Montgomery City might be linked to the past use of carbon tetrachloride-based fumigants at its

  6. Final Report - Independent Verification Survey Report for the Waste Loading Area, Former Hazardous Waste Management Facility, Brookhaven National Laboratory, Upton, New York

    Energy Technology Data Exchange (ETDEWEB)

    P.C. Weaver

    2008-08-19

    The objective of the verification survey was to obtain evidence by means of measurements and sampling to confirm that the final radiological conditions were less than the established release criteria. This objective was achieved via multiple verification components including document reviews to determine the accuracy and adequacy of FSS documentation.

  7. Atención médica al final de la vida: Conceptos Medical care at the end of life: Concepts

    Directory of Open Access Journals (Sweden)

    M. Gómez-Sancho

    2010-04-01

    Full Text Available Hay una gran confusión terminológica en cuanto se refiere al final de la vida de los pacientes. Como quiera que es un asunto de un permanente debate, con mucha frecuencia la discusión se ve entorpecida por la interpretación que los diversos interlocutores hacen de algunos conceptos. Por este motivo, desde la Organización Médica Colegial se ha elaborado un pequeño documento en el que se clarifica el significado de las palabras que aluden a situaciones relacionadas con el final de la vida.There is great confusion as regards the therm "end of life" of patients. The subject is continuosly under debate, with the arguments often being obstructed by how various interlocutors interpret some concepts. For this reason the Medical Colleges Organisation has prepared a short document in which it clarifies the significance of these words that allude to situations associated with the end of life.

  8. Control of antibiotic resistance in China must not be delayed: The current state of resistance and policy suggestions for the government, medical facilities, and patients.

    Science.gov (United States)

    Tang, Qi; Song, Peipei; Li, Jiajia; Kong, Fanlei; Sun, Long; Xu, Lingzhong

    2016-02-01

    Antibiotics are medicines used to prevent and treat bacterial infections. Antibiotic resistance occurs when bacteria change in response to the use of these medicines. Antibiotic resistance is rising to dangerously high levels in all parts of the world, leading to higher medical costs, prolonged hospital stays, and increased mortality. In the European Union alone, drug-resistant bacteria are estimated to cause 25,000 deaths and cost more than US$1.5 billion every year in healthcare expenses and productivity losses. The problems of antibiotic misuse and antibiotic resistance are quite serious in China. In 2015, results of a study by the State Key Laboratory of Organic Geochemistry, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences indicated that the total antibiotic usage in China in 2013 was approximately 162,000 tons, including human use (48%) and use in animals (52%). This amount accounted for about half of the antibiotic usage worldwide. The per-capita use of antibiotics in China is more than 5 times that in Europe and the United States. These data mean that China is one of the world's leading countries with serious problems in terms of antibiotic misuse and antibiotic resistance. The current article analyzes the current state and harms of antibiotic misuse and causes of antibiotic resistance in China. The Government needs to pay close attention to the issue of antibiotic resistance in China and formulate a strategy at the national level. Thus, the following suggestions are offered: i) The Chinese Government should implement policies that promote antibiotic research and development; ii) Medical facilities in China should create multidisciplinary teams (MDTs) and encourage early action by MDTs to control the spread of multi-drug-resistant bacteria (MDRB); iii) An intervention in the form of health education should target patients and accompanying family members (AFM) in China. In other words, antibiotic resistance is not a personal problem but an

  9. Final Report: Detection and Characterization of Underground Facilities by Stochastic Inversion and Modeling of Data from the New Generation of Synthetic Aperture Satellites

    Energy Technology Data Exchange (ETDEWEB)

    Foxall, W; Cunningham, C; Mellors, R; Templeton, D; Dyer, K; White, J

    2012-02-27

    Many clandestine development and production activities can be conducted underground to evade surveillance. The purpose of the study reported here was to develop a technique to detect underground facilities by broad-area search and then to characterize the facilities by inversion of the collected data. This would enable constraints to be placed on the types of activities that would be feasible at each underground site, providing a basis the design of targeted surveillance and analysis for more complete characterization. Excavation of underground cavities causes deformation in the host material and overburden that produces displacements at the ground surface. Such displacements are often measurable by a variety of surveying or geodetic techniques. One measurement technique, Interferometric Synthetic Aperture Radar (InSAR), uses data from satellite-borne (or airborne) synthetic aperture radars (SARs) and so is ideal for detecting and measuring surface displacements in denied access regions. Depending on the radar frequency and the acquisition mode and the surface conditions, displacement maps derived from SAR interferograms can provide millimeter- to centimeter-level measurement accuracy on regional and local scales at spatial resolution of {approx}1-10 m. Relatively low-resolution ({approx}20 m, say) maps covering large regions can be used for broad-area detection, while finer resolutions ({approx}1 m) can be used to image details of displacement fields over targeted small areas. Surface displacements are generally expected to be largest during or a relatively short time after active excavation, but, depending on the material properties, measurable displacement may continue at a decreasing rate for a considerable time after completion. For a given excavated volume in a given geological setting, the amplitude of the surface displacements decreases as the depth of excavation increases, while the area of the discernable displacement pattern increases. Therefore, the

  10. Factors influencing knowledge about childhood autism among final year undergraduate Medical, Nursing and Psychology students of University of Nigeria, Enugu State, Nigeria

    Directory of Open Access Journals (Sweden)

    Igwe Monday N

    2010-06-01

    Full Text Available Abstract Background Knowledge and awareness about childhood autism is low among health care workers and the general populace in Nigeria. Poor knowledge about childhood autism among final year medical, nursing and psychology students who would form tomorrow's child health care professionals can compromise early recognition and interventions that are known to improve prognosis in childhood autism. Educational factors that could be influencing knowledge about childhood autism among these future health care professionals are unknown. This study assessed knowledge about childhood autism among final year undergraduate medical, nursing and psychology students in south-eastern Nigeria and determined the factors that could be influencing such knowledge. Methods One hundred final year undergraduate students were randomly selected from each of the Departments of Medicine, Nursing Science and Psychology respectively of University of Nigeria, Enugu State, Nigeria making a sample size of three hundred. A socio-demographic questionnaire and knowledge about childhood autism among health workers (KCAHW questionnaire were administered to the students. Results The total mean score for the three groups of students on the KCAHW questionnaire was 10.67 ± 3.73 out of a possible total score of 19, with medical, nursing and psychology students having total mean scores of 12.24 ± 3.24, 10.76 ± 3.50 and 9.01 ± 3.76 respectively. The mean scores for the three groups showed statistically significant difference for domain 1 (p = 0.000, domain 3 (p = 0.029, domain 4 (p = 0.000 and total score (p = 0.000, with medical students more likely to recognise symptoms and signs of autism compared to nursing and psychology students. The mean score in domain 2 did not show statistically significant difference among the three groups (p = 0.769. The total score on the KCAHW questionnaire is positively correlated with the number of weeks of posting in psychiatry (r = 0.319, p = 0

  11. The views of doctors in their first year of medical practice on the lasting impact of a preparation for house officer course they undertook as final year medical students

    Directory of Open Access Journals (Sweden)

    Saunders John H

    2010-06-01

    Full Text Available Abstract Background The UK General Medical Council recommends that medical students have the opportunity of shadowing the outgoing new doctor whose post they will soon undertake. At the University of Nottingham the two-week shadowing period was preceded by two weeks of lectures/seminars wherein students followed sessions on topics such as common medical/surgical emergencies, contracts, time management, surviving the first two years of clinical practice, careers advice and so on. The present study aimed to gain a better knowledge and understanding of the lasting impact of a four-week preparation course for new Foundation Year 1 doctors [F1 s - interns]. The objectives chosen to achieve this aim were: 1/ to determine the extent to which the lecture/seminar course and shadowing period achieved their stated aim of smoothing the transition from life as a medical student to work as a new doctor; 2/ to evaluate perceptions of the importance of various forms of knowledge in easing the transition between medical student and new doctor Method In the spring of 2007, 90 graduates from Nottingham were randomly selected and then emailed a link to a short, online survey of quantitative and qualitative questions. Of these 76 responded. Analysis of quantitative data was carried out using SPSS 16.0 and employed McNemar's test. Analysis of the qualitative data was carried out using the constant comparative method. Results Only 31% of respondents strongly agreed or agreed that the lecture/seminar part of the course prepared them well for their first FY1 post; 14% agreed that during their first job they drew on the knowledge gained during the lecture/seminar course; 94% strongly agreed or agreed that the shadowing part of the course was more useful than the lecture/seminar part. Experiential knowledge gained in the shadowing was the most highly valued, followed by procedural knowledge with propositional knowledge coming far behind. Conclusions Our study shows that

  12. Discourse of Requirement for Facility&Environment in Medical Device Quality System%浅析医疗器械质量管理体系对厂房设施和环境的要求

    Institute of Scientific and Technical Information of China (English)

    吕宏光

    2012-01-01

      本文简单介绍了中国医疗器械质量管理体系规范、欧盟医疗器械指令、ISO13485标准和美国FDA对厂房设施和环境的要求,并进行了简单的比较,目的是为医疗器械制造商在理解相关法规时,提供借鉴。%  In this paper, it simply introduce requirement for facility and environment separate in China medical device Quality System Regulation, Europe medical device Directive, ISO13485 standard and FDA medical device Quality system regulation. The comparison is made to help medical device industry understand the regulation requirement.

  13. Construction of. gamma pi. /sup 0/ spectrometer and photon tagging facility at Bates Linear Accelerator. Final report, July 31, 1979-July 31, 1980

    Energy Technology Data Exchange (ETDEWEB)

    Booth, E.C.

    1981-08-01

    The funds provided under Contract No. DE-AC02-79ER10486 were totally expended for hardware and supplies required by two related devices at the Bates Linear Accelerator. These were a photon tagging facility and a ..gamma pi../sup 0/ spectrometer in Beam Line C of the new South Experimental Hall. Construction was begun in November of 1979 and both systems became fully operational in the summer of 1981. Preliminary data was taken in 1980 with a prototype ..gamma pi../sup 0/ spectrometer will be carried out in the fall of 1981 and spring of 1982. The photon tagging system has been used successfully to calibrate the ..gamma pi../sup 0/ spectrometer for the BU - MIT collaboration and to test a lead glass detector system for Brandeis University.

  14. Using Sound to Modify Fish Behavior at Power-Production and Water-Control Facilities: A Workshop December 12-13, 1995. Phase II: Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Carlson, Thomas J. [ed.] [Pacific Northwest National Lab., Richland, WA (United States); Popper, Arthur N. [ed.] [Univ. of Maryland, College Park, MD (United States)

    1997-06-01

    A workshop on ``Use of Sound for Fish Protection at Power-Production and Water-Control Facilities`` was held in Portland, Oregon on December 12--13, 1995. This workshop convened a 22-member panel of international experts from universities, industry, and government to share knowledge, questions, and ideas about using sound for fish guidance. Discussions involved in a broad range of indigenous migratory and resident fish species and fish-protection issues in river systems, with particular focus on the Columbia River Basin. Because the use of sound behavioral barriers for fish is very much in its infancy, the workshop was designed to address the many questions being asked by fishery managers and researchers about the feasibility and potential benefits of using sound to augment physical barriers for fish protection in the Columbia River system.

  15. Final Report

    Energy Technology Data Exchange (ETDEWEB)

    R Paul Drake

    2004-01-12

    OAK-B135 This is the final report from the project Hydrodynamics by High-Energy-Density Plasma Flow and Hydrodynamics and Radiation Hydrodynamics with Astrophysical Applications. This project supported a group at the University of Michigan in the invention, design, performance, and analysis of experiments using high-energy-density research facilities. The experiments explored compressible nonlinear hydrodynamics, in particular at decelerating interfaces, and the radiation hydrodynamics of strong shock waves. It has application to supernovae, astrophysical jets, shock-cloud interactions, and radiative shock waves.

  16. Assisted Living Facilities, Locations of Assisted Living Facilities identifed visually and placed on the Medical Multi-Hazard Mitigation layer., Published in 2006, 1:1200 (1in=100ft) scale, Noble County Government.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Assisted Living Facilities dataset, published at 1:1200 (1in=100ft) scale, was produced all or in part from Field Observation information as of 2006. It is...

  17. Assisted Living Facilities, Listing of medical facilities as identifed by Emergency Management director within Noble County., Published in 2006, 1:1200 (1in=100ft) scale, Noble County Government.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Assisted Living Facilities dataset, published at 1:1200 (1in=100ft) scale, was produced all or in part from Other information as of 2006. It is described as...

  18. Use of Sound for Fish Protection at Power Facilities : A Historical Perspective of the State of the Art : Phase 1 Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Carlson, Thomas J.

    1994-11-01

    This paper summarizes the current state of the knowledge of fish hearing, i.e., what is known about fish response to sound, and provides a starting place for investigation into the use of sonic behavior modification to help solve pressing problems in the maintenance and recovery of anadromous and resident fish stocks of the Columbia River Basin. The challenge for scientists and engineers is to understand (1) how and what fish hear, and (2) how to use this knowledge to influence fish behavior or to factor fish sensory systems and behavior into the design of fish protection devices at power-production and water-control facilities. The sections that follow are a studied response to this challenge. In many respects, the search for effective and economical ways to modify fish behavior without physical intervention is one of the grails of fish management, particularly (although not exclusively), relative to electric power production. Within the Columbia River Basin and elsewhere, water is put to many uses not conducive to the health of indigenous fish. Irrigation, impoundment, and hydropower production frequently modify the riverine environment to the detriment of indigenous stocks while creating productive environments for competing or predatory species. The mechanisms of impact are numerous. Water project managers, when faced with the need to reduce impacts of their operations on fish health, generally attempt to divert fish from high-risk to lower-risk regions or manage the environment in such a way as to increase the survival prospects of impacted species. Almost without exception, risk reduction is accomplished by using physical barriers of one form or another. Unfortunately, physical barriers at water projects have several drawbacks, e.g., reducing available water flow for energy production and incurring high maintenance costs. In addition, recent studies (Sale et al. 1991) have documented that once these barriers are installed, they are rarely evaluated for

  19. Facilities & Leadership

    Data.gov (United States)

    Department of Veterans Affairs — The facilities web service provides VA facility information. The VA facilities locator is a feature that is available across the enterprise, on any webpage, for the...

  20. Compressed air energy storage: preliminary design and site development program in an aquifer. Final draft, Task 1: establish facility design criteria and utility benefits

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-10-01

    Compressed air energy storage (CAES) has been identified as one of the principal new energy storage technologies worthy of further research and development. The CAES system stores mechanical energy in the form of compressed air during off-peak hours, using power supplied by a large, high-efficiency baseload power plant. At times of high electrical demand, the compressed air is drawn from storage and is heated in a combustor by the burning of fuel oil, after which the air is expanded in a turbine. In this manner, essentially all of the turbine output can be applied to the generation of electricity, unlike a conventional gas turbine which expends approximately two-thirds of the turbine shaft power in driving the air compressor. The separation of the compression and generation modes in the CAES system results in increased net generation and greater premium fuel economy. The use of CAES systems to meet the utilities' high electrical demand requirements is particularly attractive in view of the reduced availability of premium fuels such as oil and natural gas. This volume documents the Task 1 work performed in establishing facility design criteria for a CAES system with aquifer storage. Information is included on: determination of initial design bases; preliminary analysis of the CAES system; development of data for site-specific analysis of the CAES system; detailed analysis of the CAES system for three selected heat cycles; CAES power plant design; and an economic analysis of CAES.

  1. Characterization of the neutron spectra at the final of the installations labyrinth with medical accelerators; Caracterizacion del espectro de neutrones al final del laberinto de instalaciones con aceleradores medicos

    Energy Technology Data Exchange (ETDEWEB)

    Carelli, J.; Cruzate, J.A.; Gregori, B.; Papadopulos, S.; Discacciatti, A. [Autoridad Reguladora Nuclear, Av. del Libertador 8250, Buenos Aires (Argentina)]. e-mail: jcarelli@cae.arn.gov.ar

    2006-07-01

    A linear electron accelerator for medical use is an equipment dedicated to the production of collimated beams of electrons and/or photons. In an accelerator of a bigger potential or equal to 6 MV, are produced neutrons starting from the reaction (gamma, n) due to the interaction of the photons with the materials that compose the headset and the target. In this work the theoretical and experimental studies carried out to characterize the neutron spectra to the exit of the labyrinth of three bunkers of different geometry with accelerators of 15 MV, with the purpose of evaluating the effective dose of the occupationally exposure personnel are presented. It was carried out the simulation of the neutron transport with the MCNPX code and the ENDF/B - VI library. With the objective of analyzing the variables that affect the spectral distribution the bunkers of two existent facilities in Argentina were modeled. It was considered a isotropic punctual source located in the supposed position of the target. The spectra of {sup 252} Cf and of Watt of 1.8 MeV of half energy were simulated. The election of the sources was based on published works that suppose initial neutron sources with half energy between 1.8 and 2.3 MeV for accelerators of 15 at 25 MV. Its were considered headsets of different dimensions, with and without phantom of water disperser in the patient's position and several field dimensions in the isocenter. The spectral distribution doesn't present significant differences in the different modeling situations. Its were carried out measurements, with the multisphere spectrometric system based on twelve polyethylene spheres and a spherical detector of {sup 3} He, to the exit of each one of the bunkers. It was carried out the convolution of the spectrum using the MXD{sub F}C33 code (of the UMG33 set), considering as initial spectrum that of the fission type (inverse of the energy). The obtained spectra and the environmental equivalent dose rate in each case

  2. Confidence level in performing endodontic treatment among final year undergraduate dental students from the University of Medical Science and Technology, Sudan (2014

    Directory of Open Access Journals (Sweden)

    Elhadi Mohieldin Awooda

    2016-01-01

    Full Text Available Aim: This study is aimed to evaluate the confidence level of undergraduate final year dental students in performing root canal treatment (RCT and how it may affect their performance and perception regarding endodontics. Materials and Methods: A self-administered questionnaire was distributed to the final year dental students, at the University of Medical Sciences and Technology, Khartoum, Sudan (2013–2014. A total of 21 students were requested to participate voluntary and were asked to score their level of confidence using a 5-point Likert's scale. Results: Response rate was 100%, all the students (100% stated that the requirements set were enough, and 66.7% rated endodontic as average in terms of difficulty. When rating the mean of self-confidence for performing RCT in the dentition, maxillary teeth (2.43 ± 0.51 followed by mandibular teeth (2.71 ± 0.64 were higher, whereas the molars were the least. Higher scores of self-confidence were in administrating local anesthesia (4.24 ± 0.70, followed by root canal shaping by hand instrument (3.76 ± 0.54. No association was found between overall confidence level and the number of performed RCT (P = 0.721. No association was found between overall confidence level of students who were subjected to instrument fracture and their frequency of fracture (P = 0.507, supervisor' reaction (P = 0.587, and willingness to specialize in endodontics (P = 0.530. Conclusion: Students displayed high confidence in performing basic endodontic and treating single-rooted teeth. More exposure is recommended to enhance the students' self-confidence.

  3. Biochemistry Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Biochemistry Facility provides expert services and consultation in biochemical enzyme assays and protein purification. The facility currently features 1) Liquid...

  4. Final report on the effects of ECM furnace motors on electricity and gas use : results from the CCHT research facility and projections

    Energy Technology Data Exchange (ETDEWEB)

    Gusdorf, J.; Hayden, S.; Enchev, E. [Natural Resources Canada, Ottawa, ON (Canada). CANMET Energy Technology Centre; Swinton, M. [National Research Council of Canada, Ottawa, ON (Canada); Simpson, C. [Craig J. Simpson Technical Services, Ottawa, ON (Canada); Castellan, B. [Enbridge Gas Distribution, Toronto, ON (Canada)

    2003-12-01

    Electronically commutated motors (ECM) are brushless, permanent magnet DC motors with integrated controls. At low speeds, ECMs can save over 60 per cent of the electricity used by permanent split capacitor motors currently used in residential furnaces. A study was conducted at the Canadian Centre for Housing Technology in which the impact of ECM on electricity and gas consumption in 2 identical test houses was evaluated. Located in Ottawa, Ontario, the twin energy efficient houses represent a typical Canadian winter heating season. The study demonstrated the ability of the high efficiency ECM motor technology to significantly reduce electricity needed to move air in forced air heating and cooling systems. The amount of extra natural gas that would be needed during the heating season was quantified along with the extra electricity that would be saved in the cooling season. The HOT2000 energy simulation model was used to summarize the results to an entire year for mid-and high-efficiency furnaces in a variety of house types in 4 Canadian cities, Winnipeg, Toronto, Ottawa and Moncton. Results indicate that electricity savings resulting from the use of ECM are in the order of 1,500 kWh/per year or as high 18 per cent without air conditioning, and 25 per cent with air conditioning. The increased use of natural gas is more than 150 cubic metres per year. In the case of electricity being supplied from coal-fired power plants, the net reduction in greenhouse gas (GHG) emissions can be as high as 1,675 kg of carbon dioxide per year without air conditioners and 2,964 kg of carbon dioxide per year with air conditioners. In Winnipeg, where most electricity is produced at hydroelectric facilities, GHG emissions decreased by 312 kg of carbon dioxide per year. It was concluded that ECMs provide a unique and efficient fuel switching opportunity for natural gas to displace electricity. 12 refs., 7 tabs., 14 figs., 6 appendices.

  5. Improving medication information transfer between hospitals, skilled-nursing facilities, and long-term-care pharmacies for hospital discharge transitions of care: A targeted needs assessment using the Intervention Mapping framework.

    Science.gov (United States)

    Kerstenetzky, Luiza; Birschbach, Matthew J; Beach, Katherine F; Hager, David R; Kennelty, Korey A

    2017-04-07

    Patients transitioning from the hospital to a skilled nursing home (SNF) are susceptible to medication-related errors resulting from fragmented communication between facilities. Through continuous process improvement efforts at the hospital, a targeted needs assessment was performed to understand the extent of medication-related issues when patients transition from the hospital into a SNF, and the gaps between the hospital's discharge process, and the needs of the SNF and long-term care (LTC) pharmacy. We report on the development of a logic model that will be used to explore methods for minimizing patient care medication delays and errors while further improving handoff communication to SNF and LTC pharmacy staff. Applying the Intervention Mapping (IM) framework, a targeted needs assessment was performed using quantitative and qualitative methods. Using the hospital discharge medication list as reference, medication discrepancies in the SNF and LTC pharmacy lists were identified. SNF and LTC pharmacy staffs were also interviewed regarding the continuity of medication information post-discharge from the hospital. At least one medication discrepancy was discovered in 77.6% (n = 45/58) of SNF and 76.0% (n = 19/25) of LTC pharmacy medication lists. A total of 191 medication discrepancies were identified across all SNF and LTC pharmacy records. Of the 69 SNF staff interviewed, 20.3% (n = 14) reported patient care delays due to omitted documents during the hospital-to-SNF transition. During interviews, communication between the SNF/LTC pharmacy and the discharging hospital was described by facility staff as unidirectional with little opportunity for feedback on patient care concerns. The targeted needs assessment guided by the IM framework has lent to several planned process improvements initiatives to help reduce medication discrepancies during the hospital-to-SNF transition as well as improve communication between healthcare entities. Opening lines of

  6. Discourse of Requirement for Facility & Environment in Medical Device Quality System%浅析医疗器械质量体系对厂房设施和环境的要求

    Institute of Scientific and Technical Information of China (English)

    吕宏光

    2012-01-01

    Requirement for facility and environment of FDA, regulation of China medical device Quality System, Europe medical device Directive and ISO13485 standard are introduced. The comparison is made to help domestic medical device industry understand the regulation requirement.%介绍了中国医疗器械质量体系规范、欧盟医疗器械指令、ISO13485 标准和美国FDA 对厂房设施和环境的要求,并进行了简单的比较,为我国医疗器械制造商在理解相关法规时提供借鉴.

  7. Understanding the information dynamics of medication administration in residential aged care facilities (RACFs): a prerequisite for design of effective ICT systems.

    Science.gov (United States)

    Tariq, Amina; Georgiou, Andrew; Westbrook, Johanna

    2013-01-01

    Medication information is a critical part of the information required to ensure residents' safety in the highly collaborative care context of RACFs. Studies report poor medication information as a barrier to improve medication management in RACFs. Research exploring medication work practices in aged care settings remains limited. This study aimed to identify contextual and work practice factors contributing to breakdowns in medication information exchange in RACFs in relation to the medication administration process. We employed non-participant observations and semi-structured interviews to explore information practices in three Australian RACFs. Findings identified inefficiencies due to lack of information timeliness, manual stock management, multiple data transcriptions, inadequate design of essential documents such as administration sheets and a reliance on manual auditing procedures. Technological solutions such as electronic medication administration records offer opportunities to overcome some of the identified problems. However these interventions need to be designed to align with the collaborative team based processes they intend to support.

  8. Final Environmental Impact Statement to construct and operate a facility to receive, store, and dispose of 11e.(2) byproduct material near Clive, Utah (Docket No. 40-8989)

    Energy Technology Data Exchange (ETDEWEB)

    1993-08-01

    A Final Environmental Impact Statement (FEIS) related to the licensing of Envirocare of Utah, Inc.`s proposed disposal facility in Tooele county, Utah (Docket No. 40-8989) for byproduct material as defined in Section 11e.(2) of the Atomic Energy Act, as amended, has been prepared by the Office of Nuclear Material Safety and Safeguards. This statement describes and evaluates the purpose of and need for the proposed action, the alternatives considered, and the environmental consequences of the proposed action. The NRC has concluded that the proposed action evaluated under the National Environmental Policy Act of 1969 (NEPA) and 10 CFR Part 51, is to permit the applicant to proceed with the project as described in this Statement.

  9. Medical Applications

    CERN Document Server

    Biscari, C.

    2014-12-19

    The use of accelerators for medical applications has evolved from initial experimentation to turn-key devices commonly operating in hospitals. New applications are continuously being developed around the world, and the hadrontherapy facilities of the newest generation are placed at the frontier between industrial production and advanced R&D. An introduction to the different medical application accelerators is followed by a description of the hadrontherapy facilities, with special emphasis on CNAO, and the report closes with a brief outlook on the future of this field.

  10. Determinants of Noncompliance to Clinic Appointments and Medications among Nigerian Children with Epilepsy: Experience in a Tertiary Health Facility in Enugu, Nigeria

    Science.gov (United States)

    Ibekwe, Roland Chidi; Ndukuba, Appolos Chidi; Aronu, Ann Ebele; Eke, Christopher Bismarck; Ibekwe, MaryAnn Ugochi; Ojinnaka, Ngozi Chinyelu

    2016-01-01

    Purpose. To determine the frequency and determinants of noncompliance to clinic appointment and medication among Nigerian children with epilepsy. Method. This is a cross-sectional survey of noncompliance to clinic appointments and medication among 113 consecutive children with epilepsy attending the Paediatric Neurology Clinic of University of Nigeria Teaching Hospital, Enugu, southeastern Nigeria. Results. Noncompliance to clinic appointment and medication was 23% and 15.3%, respectively. The major reasons given were lack of finance, clashing with school time, and forgetting to take the drugs. Children whose mothers were less educated and unemployed were more likely to miss clinic appointments. Noncompliance to medication was associated with poor seizure control. Children that were on phenobarbitone were more likely to be noncompliant with medication than those on sodium valproate and/or carbamazepine. Conclusion. Missed clinic appointment and medication noncompliance are common among Nigerian children with epilepsy and financial constraint is the most common reason. PMID:26997756

  11. Determinants of Noncompliance to Clinic Appointments and Medications among Nigerian Children with Epilepsy: Experience in a Tertiary Health Facility in Enugu, Nigeria

    Directory of Open Access Journals (Sweden)

    Roland Chidi Ibekwe

    2016-01-01

    Full Text Available Purpose. To determine the frequency and determinants of noncompliance to clinic appointment and medication among Nigerian children with epilepsy. Method. This is a cross-sectional survey of noncompliance to clinic appointments and medication among 113 consecutive children with epilepsy attending the Paediatric Neurology Clinic of University of Nigeria Teaching Hospital, Enugu, southeastern Nigeria. Results. Noncompliance to clinic appointment and medication was 23% and 15.3%, respectively. The major reasons given were lack of finance, clashing with school time, and forgetting to take the drugs. Children whose mothers were less educated and unemployed were more likely to miss clinic appointments. Noncompliance to medication was associated with poor seizure control. Children that were on phenobarbitone were more likely to be noncompliant with medication than those on sodium valproate and/or carbamazepine. Conclusion. Missed clinic appointment and medication noncompliance are common among Nigerian children with epilepsy and financial constraint is the most common reason.

  12. Medicare Program; End-Stage Renal Disease Prospective Payment System, Coverage and Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, End-Stage Renal Disease Quality Incentive Program, Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program Bid Surety Bonds, State Licensure and Appeals Process for Breach of Contract Actions, Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program and Fee Schedule Adjustments, Access to Care Issues for Durable Medical Equipment; and the Comprehensive End-Stage Renal Disease Care Model. Final rule.

    Science.gov (United States)

    2016-11-04

    This rule updates and makes revisions to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2017. It also finalizes policies for coverage and payment for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury. This rule also sets forth requirements for the ESRD Quality Incentive Program, including the inclusion of new quality measures beginning with payment year (PY) 2020 and provides updates to programmatic policies for the PY 2018 and PY 2019 ESRD QIP. This rule also implements statutory requirements for bid surety bonds and state licensure for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). This rule also expands suppliers' appeal rights in the event of a breach of contract action taken by CMS, by revising the appeals regulation to extend the appeals process to all types of actions taken by CMS for a supplier's breach of contract, rather than limit an appeal for the termination of a competitive bidding contract. The rule also finalizes changes to the methodologies for adjusting fee schedule amounts for DMEPOS using information from CBPs and for submitting bids and establishing single payment amounts under the CBPs for certain groupings of similar items with different features to address price inversions. Final changes also are made to the method for establishing bid limits for items under the DMEPOS CBPs. In addition, this rule summarizes comments on the impacts of coordinating Medicare and Medicaid Durable Medical Equipment for dually eligible beneficiaries. Finally, this rule also summarizes comments received in response to a request for information related to the Comprehensive ESRD Care Model and future payment models affecting renal care.

  13. Recognizing and preventing medication administration errors.

    Science.gov (United States)

    Martin, Caren McHenry; Bryan, Gianna

    2013-05-01

    Proper medication administration in the long-term care facility is vitally important, as many medications have specific administration parameters that are essential to their optimal efficacy. Pharmacists servicing long-term care facilities play an integral role in observing medication administration in the facility and educating facility staff on proper administration techniques. By being vigilant to potential problems, pharmacists can help ensure that facility residents receive their medications appropriately.

  14. [PRIORITY TECHNOLOGIES OF THE MEDICAL WASTE DISPOSAL SYSTEM].

    Science.gov (United States)

    Samutin, N M; Butorina, N N; Starodubova, N Yu; Korneychuk, S S; Ustinov, A K

    2015-01-01

    The annual production of waste in health care institutions (HCI) tends to increase because of the growth of health care provision for population. Among the many criteria for selecting the optimal treatment technologies HCI is important to provide epidemiological and chemical safety of the final products. Environmentally friendly method of thermal disinfection of medical waste may be sterilizators of medical wastes intended for hospitals, medical centers, laboratories and other health care facilities that have small and medium volume of processing of all types of waste Class B and C. The most optimal method of centralized disposal of medical waste is a thermal processing method of the collected material.

  15. Fabrication Facilities

    Data.gov (United States)

    Federal Laboratory Consortium — The Fabrication Facilities are a direct result of years of testing support. Through years of experience, the three fabrication facilities (Fort Hood, Fort Lewis, and...

  16. Facility Microgrids

    Energy Technology Data Exchange (ETDEWEB)

    Ye, Z.; Walling, R.; Miller, N.; Du, P.; Nelson, K.

    2005-05-01

    Microgrids are receiving a considerable interest from the power industry, partly because their business and technical structure shows promise as a means of taking full advantage of distributed generation. This report investigates three issues associated with facility microgrids: (1) Multiple-distributed generation facility microgrids' unintentional islanding protection, (2) Facility microgrids' response to bulk grid disturbances, and (3) Facility microgrids' intentional islanding.

  17. Performance assessment through pre- and post-training evaluation of continuing medical education courses in prevention and management of cardio-vascular diseases in primary health care facilities of Armenia.

    Science.gov (United States)

    Khachatryan, Lilit; Balalian, Arin

    2013-12-01

    To assess the difference of pre- and post-training performance evaluation of continuing medical education (CME) courses in cardio-vascular diseases (CVD) management among physicians at primary health care facilities of Armenian regions we conducted an evaluation survey. 212 medical records were surveyed on assessment of performance before and after the training courses through a self-employed structured questionnaire. Analysis of survey revealed statistically significant differences (p evaluation of performance assessment may be explained by improved and interactive training modes, more advanced methods of demonstration of modeling. Current findings may serve a basis for future planning of CME courses for physicians of remote areas facing challenges in upgrading their knowledge, as well as expand the experience of performance assessment along with evaluation of knowledge scores.

  18. Hospitals, Listing of medical facilities as identifed by Emergency Management director within Noble County., Published in 2006, 1:1200 (1in=100ft) scale, Noble County Government.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Hospitals dataset, published at 1:1200 (1in=100ft) scale, was produced all or in part from Other information as of 2006. It is described as 'Listing of medical...

  19. Clinicians' and patients' experiences and satisfaction with unscheduled, nighttime, Internet-based video conferencing for assessing acute medical problems in a nursing facility.

    Science.gov (United States)

    Weiner, Michael; Schadow, Gunther; Lindbergh, Donald; Warvel, Jill; Abernathy, Greg; Perkins, Susan M; Fyffe, Joanne; Dexter, Paul R; McDonald, Clement J

    2003-01-01

    Videoconferencing between patients and their physicians can increase patients' access to healthcare. Unscheduled videoconferencing can benefit patients with acute medical problems but has not been studied extensively. We conducted a clinical trial of unscheduled, nighttime videoconferencing in a nursing home, where on-call physicians usually provide care by telephone from remote locations. Although most calls for medical problems did not lead to videoconferencing, physicians and nursing-home residents were satisfied with videoconferencing when it did occur, and physicians reported that making medical decisions was easier with videoconferencing. Videoconferencing was most often conducted to assess residents with changes in mental status, abnormal laboratory values, or falls. Physicians often lacked immediate access to videoconferencing equipment when medical problems with residents occurred. This application could benefit from improved access and portability of equipment.

  20. Cost of the medical management and prescription pattern for primary open angle glaucoma (POAG) in Ghana–a retrospective cross-sectional study from three referral facilities

    OpenAIRE

    Ocansey, Stephen; Kyei, Samuel; Diafo, Ama; Darfor, Kwabena Nkansah; Boadi-Kusi, Samuel Bert; Aglobitse, Peter B.

    2016-01-01

    Background Glaucoma is the leading cause of irreversible blindness globally, and treatment involves considerable cost to stakeholders in healthcare. However, there is infrequent availability of cost information and patterns of management, especially in developing countries. This study determined the cost of the medical management of POAG, adherence, and pattern of medication prescription in Ghana. Methods A retrospective cross-sectional study involving 891 Primary Open Angle Glaucoma (POAG) c...

  1. Society of U.S. Air Force Surgeons’ 2010 State of the Flight Surgeon Survey: The Medical Treatment Facility Commander’s Perspective

    Science.gov (United States)

    2010-08-01

    filling an active billet as a flight surgeon may be very short (i.e., immediate), as in the case of a general medical officer ( GMO ), or very long...Inexperience (9/19) • The two assigned flight surgeons are general medical officers ( GMOs ). It is difficult to complete the necessary training at a...other two are newly assigned GMOs , who are motivated but are still in the learning phase. I have no doubt they will eventually grow into outstanding

  2. The Birmingham Irradiation Facility

    Science.gov (United States)

    Dervan, P.; French, R.; Hodgson, P.; Marin-Reyes, H.; Wilson, J.

    2013-12-01

    At the end of 2012 the proton irradiation facility at the CERN PS [1] will shut down for two years. With this in mind, we have been developing a new ATLAS scanning facility at the University of Birmingham Medical Physics cyclotron. With proton beams of energy approximately 30 MeV, fluences corresponding to those of the upgraded Large Hadron Collider (HL-LHC) can be reached conveniently. The facility can be used to irradiate silicon sensors, optical components and mechanical structures (e.g. carbon fibre sandwiches) for the LHC upgrade programme. Irradiations of silicon sensors can be carried out in a temperature controlled cold box that can be scanned through the beam. The facility is described in detail along with the first tests carried out with mini (1×1 cm2) silicon sensors.

  3. The Birmingham Irradiation Facility

    CERN Document Server

    Dervan, P; Hodgson, P; Marin-Reyes, H; Wilson, J

    2013-01-01

    At the end of 2012 the proton irradiation facility at the CERN PS [1] will shut down for two years. With this in mind, we have been developing a new ATLAS scanning facility at the University of Birmingham Medical Physics cyclotron. With proton beams of energy approximately 30 MeV, fluences corresponding to those of the upgraded Large Hadron Collider (HL-LHC) can be reached conveniently. The facility can be used to irradiate silicon sensors, optical components and mechanical structures (e.g. carbon fibre sandwiches) for the LHC upgrade programme. Irradiations of silicon sensors can be carried out in a temperature controlled cold box that can be scanned through the beam. The facility is described in detail along with the first tests carried out with mini (1 x 1 cm^2 ) silicon sensors.

  4. A Description of the Practice Pattern Characteristics of Anesthesia Care in Small, Medium and Large Teaching and Non-Teaching Medical Treatment Facilities in the Air Force

    Science.gov (United States)

    1999-05-20

    percentages of cesarean sections ; however, small facilities do twice as many intrathecal narcotic procedures as labor * epidurals. The majority of medium...military health care delivery systems as well. Virtually all health care providers will feel the effects of change be it in technological updates or...data obtained will be presented in relation to the major research questions outlined in Chapter 1. The first section provides demographic and

  5. Toroid magnet test facility

    CERN Multimedia

    2002-01-01

    Because of its exceptional size, it was not feasible to assemble and test the Barrel Toroid - made of eight coils - as an integrated toroid on the surface, prior to its final installation underground in LHC interaction point 1. It was therefore decided to test these eight coils individually in a dedicated test facility.

  6. Comparative cross-sectional study of empathy among first year and final year medical students in Jimma University, Ethiopia: steady state of the heart and opening of the eyes.

    Science.gov (United States)

    Dehning, Sandra; Girma, Eshetu; Gasperi, Sarah; Meyer, Sebastian; Tesfaye, Markos; Siebeck, Matthias

    2012-05-24

    There is general consent that empathy is crucial for the physician-patient relationship and thus an important issue in medical education. This comparative study was designed to examine the differences in empathy between first year and final year medical students in Jimma University, Ethiopia. A comparative cross-sectional study among 131 first year and 106 final year medical students was conducted in Jimma University, Ethiopia on academic year 2010/11. The study subjects were selected using simple random sampling technique from the list of the students. Study participation was voluntary. The Balanced Emotional Empathy Scale (BEES) was used for the detection of "heart-reading", i.e. emotional empathy and the Reading the Mind in the Eyes test (RME-R test) to evaluate "mind-reading", i.e. cognitive empathy. We performed t-test to compare the mean difference in empathy and RME-R scores between the two groups of students. A linear regression was computed to identify potential factors influencing the BEES and RME-R. Out of the total 237 students, 207 (87.3%) were males. The mean age of first year and final year students was 19.3 ± 1.1 and 24.0 ± 1.4 years respectively. First year students have scored 40.6 ± 23.8 while final year students scored 41.5 ± 20.8 mean in the BEES measuring emotional empathy score. However, this difference was not statistically significant (t = -0.30, df = 231, P-value >0.05). Final year students had significantly higher mean cognitive empathy score (17.8 ± 4.5) than first year students (14.4 ± 4.8) [β = 2.7, 95%CI (1.20, 4.13)]. Males had scored lower cognitive [β = -2.5, 95%CI (-4.37, -0.66)] and emotional empathy [β = -12.0, 95%CI (-21.66, -5.46)]. Low emotional (BEES) and cognitive empathy sores were found in first year and final year students of Jimma University could have implications on the medical education curricula. Medical education targeted at enhancing emotional empathy and

  7. Comparative cross-sectional study of empathy among first year and final year medical students in Jimma University, Ethiopia: Steady state of the heart and opening of the eyes

    Directory of Open Access Journals (Sweden)

    Dehning Sandra

    2012-05-01

    Full Text Available Abstract Background There is general consent that empathy is crucial for the physician-patient relationship and thus an important issue in medical education. This comparative study was designed to examine the differences in empathy between first year and final year medical students in Jimma University, Ethiopia. Methods A comparative cross-sectional study among 131 first year and 106 final year medical students was conducted in Jimma University, Ethiopia on academic year 2010/11. The study subjects were selected using simple random sampling technique from the list of the students. Study participation was voluntary. The Balanced Emotional Empathy Scale (BEES was used for the detection of “heart-reading”, i.e. emotional empathy and the Reading the Mind in the Eyes test (RME-R test to evaluate “mind-reading”, i.e. cognitive empathy. We performed t-test to compare the mean difference in empathy and RME-R scores between the two groups of students. A linear regression was computed to identify potential factors influencing the BEES and RME-R. Results Out of the total 237 students, 207 (87.3% were males. The mean age of first year and final year students was 19.3 ± 1.1 and 24.0 ± 1.4 years respectively. First year students have scored 40.6 ± 23.8 while final year students scored 41.5 ± 20.8 mean in the BEES measuring emotional empathy score. However, this difference was not statistically significant (t = −0.30, df = 231, P-value >0.05. Final year students had significantly higher mean cognitive empathy score (17.8 ± 4.5 than first year students (14.4 ± 4.8 [β = 2.7, 95%CI (1.20, 4.13]. Males had scored lower cognitive [β = −2.5, 95%CI (−4.37, −0.66] and emotional empathy [β = −12.0, 95%CI (−21.66, −5.46]. Conclusions Low emotional (BEES and cognitive empathy sores were found in first year and final year students of Jimma University could have implications on the medical

  8. A cryogenic test facility

    Science.gov (United States)

    Veenendaal, Ian

    The next generation, space-borne instruments for far infrared spectroscopy will utilize large diameter, cryogenically cooled telescopes in order to achieve unprecedented sensitivities. Low background, ground-based cryogenic facilities are required for the cryogenic testing of materials, components and subsystems. The Test Facility Cryostat (TFC) at the University of Lethbridge is a large volume, closed cycle, 4K cryogenic facility, developed for this purpose. This thesis discusses the design and performance of the facility and associated external instrumentation. An apparatus for measuring the thermal properties of materials is presented, and measurements of the thermal expansion and conductivity of carbon fibre reinforced polymers (CFRPs) at cryogenic temperatures are reported. Finally, I discuss the progress towards the design and fabrication of a demonstrator cryogenic, far infrared Fourier transform spectrometer.

  9. Initial assessment of the benefits of implementing pharmacogenetics into the medical management of patients in a long-term care facility.

    Science.gov (United States)

    Saldivar, Juan-Sebastian; Taylor, David; Sugarman, Elaine A; Cullors, Ali; Garces, Jorge A; Oades, Kahuku; Centeno, Joel

    2016-01-01

    The health care costs associated with prescription drugs are enormous, particularly in patients with polypharmacy (taking more than five prescription medications), and they continue to grow annually. The evolution of pharmacogenetics has provided clinicians with a valuable tool that allows for a smarter, more fine-tuned approach to treating patients for a number of clinical conditions. Applying a pharmacogenetics approach to the medical management of patients can provide a significant improvement to their care, result in cost savings by reducing the use of ineffective drugs, and decrease overall health care utilization. AltheaDx has begun a study to look at the benefits associated with incorporating pharmacogenetics into the medical management of patients who are on five or more medications. Applying pharmacogenetic guided PharmD recommendations across this patient population resulted in the elimination and/or replacement of one to three drugs, for 50% of the polypharmacy patient population tested, and an estimated US$621 in annual savings per patient. The initial assessment of this study shows that there is a clear opportunity for concrete health care savings solely from prescription drug management when incorporating pharmacogenetic testing.

  10. Medical research and evaluation facility and studies supporting the Medical Chemical Defense Program. Time and dose response characterization of the prevention of HD-induced NAD+ depletion and HD-induced cytotoxicity by niacinamide and niacin. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Olson, C.T.; Johnson, J.B.; Blank, J.A.; Menton, R.G.; Starner, R.A.

    1997-01-01

    Studies were conducted under this task to Assess the time and concentration dependent nature of niacinamide (NM) protection against HD-induced NAD+ depletion and cytotoxicity. The HD concentrations used assess the time dependent nature of cytotoxicity and NAD+ depletion, and the impact of NM and niacin (NI) treatment were 13,62, 101, and 171 mu-M HD. Three concentrations of NM and NI were (0.01,0.1 and 1 mM) selected by USAMRICD for evaluation at 2, 4,8, 12, 16,20,24,48, and 72 hours after exposure to HD. Cytotoxicity and total culture NAD+ content were assessed. NAD+ concentrations following the addition of 1 mM NM frequently were significantly greater than those observed for the HD-exposed controls especially at 171mu-M HD. Multiple addition of NM had little protective effect relative to that by provided by pretreatment alone. At the 171mu-M HD concentration, the single addition of NM provided marginal but statistically significant (p<=0.05) protection. Comparisons of the different NM addition modes yielded mixed results, but usually the number of viable cells was greater with multiple additions of NM. NI did not provide protection against HD-induced NAD+ depletion or cytotoxicity.

  11. Cost - utility analysis of parenteral antibiotics prescribed in medical wards in a tertiary care health facility in southern province of Sri Lanka

    Directory of Open Access Journals (Sweden)

    Lukshmy Menik Hettihewa

    2012-10-01

    Full Text Available Introduction: Parenteral antibiotic (PA prescription pattern in a hospital will directly influence the annual budget allocation, development of bacterial resistance and occurrence of unnecessary adverse drug reactions if it is done with poor adherence to the standard guidelines of prescription. As specialist in the field we understand the need of conducting economic studies in relation to the cost and utility of PA prescription pattern. It will be helpful to predict the drug procurement plan for the next year and also to prevent unnecessary complications mentioned above. Objective: Our main objective was to analyze the cost/utility relationship of PA drugs which were used in medical wards in this hospital according to the top ten of the cost (TTTC and the top ten of the consumption (TTCS. Materials and method : Aggregate data from the pharmacy record books were collected for year 2010 from indoor pharmacy. Unit prize was obtained from medical supplies division. Total quantity consumed by each medical ward was considered for analysis of the cost /utility relationship. Two top ten lists were prepared according to the cost and the consumption respectively for medical wards and the correlation was analyzed using non parametric testing with spearman test. Results: Regarding PA drugs used in this hospital, 7/10 PA drugs in TTTC are not included in the TTCS. Out of the total cost for TTTC, 82.6% of the cost had been spent for the PA drugs which are not in the TTCS and 17.5% of the cost of TTTC was used to purchase only three drugs from the TTCS. But these three drugs had contributed only 28% of top ten consumption. 72% of the PA drugs in TTCS were not costly drugs and highly consumed in medical wards. Correlation was significantly positive between cost and utility of PA drugs. ( r=-0.91,p<0.001 Conclusion: Majority of the consumed PA drugs are non-costly and it indicates the prescriptions had been done according to the rational guidelines including

  12. The medical-irradiation characteristics for neutron capture therapy at the Heavy Water Neutron Irradiation Facility of Kyoto University Research Reactor.

    Science.gov (United States)

    Sakurai, Yoshinori; Kobayashi, Tooru

    2002-10-01

    At the Heavy Water Neutron Irradiation Facility of the Kyoto University Research Reactor, the mix irradiation of thermal and epi-thermal neutrons, and the solo irradiation of epi-thermal neutrons are available additionally to the thermal neutron irradiation, and then the neutron capture therapy (NCT) at this facility became more flexible, after the update in 1996. The estimation of the depth dose distributions in NCT clinical irradiation, were performed for the standard irradiation modes of thermal, mixed and epi-thermal neutrons, from the both sides of experiment and calculation. On the assumption that the 10B concentration in tumor part was 40 ppm and the ratio of tumor to normal tissue was 3.5, the advantage depth were estimated to 5.4, 6.0, and 8.0, for the respective standard irradiation modes. It was confirmed that the various irradiation conditions can be selected according to the target-volume conditions, such as size, depth, etc. Besides, in the viewpoint of the radiation shielding for patient, it was confirmed that the whole-body exposure is effectively reduced by the new clinical collimators, compared with the old one.

  13. The Majority of US Combat Casualty Soft-Tissue Wounds are not Infected or Colonized Upon Arrival or during Treatment at a Continental US Military Medical Facility

    Science.gov (United States)

    2010-01-01

    2%, 0.8% ), Staphylococcus haemolyticus (2%, 0.8%), Citrobacter freuntlii (2%, 0.8%), A/loicoccus otitis ( 1%, 0.4% ), and Bacillus cereus (1...multiple operating rooms, blood products surgi- cal teams, and subspccialists. Within this modem US military medical paradigm, the emphasis in the combat...Homogenized tissue spec- imens (1 J.LL and 10 J.CL) were inoculated on sheep’s blood agar and MacConkey plates in triplicate. Plates were incu- bated

  14. Revised Medical Criteria for Evaluating Human Immunodeficiency Virus (HIV) Infection and for Evaluating Functional Limitations in Immune System Disorders. Final rule.

    Science.gov (United States)

    2016-12-02

    We are revising the criteria in the Listing of Impairments (listings) that we use to evaluate claims involving human immunodeficiency virus (HIV) infection in adults and children under titles II and XVI of the Social Security Act (Act). We also are revising the introductory text of the listings that we use to evaluate functional limitations resulting from immune system disorders. The revisions reflect our program experience, advances in medical knowledge, our adjudicative experience, recommendations from a commissioned report, and comments from medical experts and the public.

  15. Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and fiscal year 2013 rates; hospitals' resident caps for graduate medical education payment purposes; quality reporting requirements for specific providers and for ambulatory surgical centers. final rule.

    Science.gov (United States)

    2012-08-31

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems. Some of the changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act) and other legislation. These changes will be applicable to discharges occurring on or after October 1, 2012, unless otherwise specified in this final rule. We also are updating the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The updated rate-of-increase limits will be effective for cost reporting periods beginning on or after October 1, 2012. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and implementing certain statutory changes made by the Affordable Care Act. Generally, these changes will be applicable to discharges occurring on or after October 1, 2012, unless otherwise specified in this final rule. In addition, we are implementing changes relating to determining a hospital's full-time equivalent (FTE) resident cap for the purpose of graduate medical education (GME) and indirect medical education (IME) payments. We are establishing new requirements or revised requirements for quality reporting by specific providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities (IPFs)) that are participating in Medicare. We also are establishing new administrative, data completeness, and extraordinary circumstance waivers or extension requests requirements, as well as a reconsideration process, for quality reporting by ambulatory surgical centers

  16. Medical tourism in Iran: Issues and challenges.

    Science.gov (United States)

    Jabbari, Alireza; Delgoshaei, Bahram; Mardani, Raja; Tabibi, Seid Jamaledin

    2012-01-01

    Medical tourism is rapidly becoming a worldwide, multibillion-dollar industry. Iran has a high potential for this industry. The purpose of this study was to examine the medical tourism cluster, using Diamond Analysis tool. This study is a descriptive, analytical and qualitative one. Thirty professionals and researchers in this field were interviewed and official documents belonging to the Health ministry as well as tourism organization and finally related literature were examined. The data was analyzed using content analysis method. Positive and negative parts of the medical tourism industry of Iran were determined according to diamond of advantage. The strategic issues were identified and a number of possible solutions for addressing them were recommended. More and effective public-private participations, aggressive marketing, improving infrastructures, and international accreditation of health care facilities and human resources development could improve medical tourism industry in the country.

  17. Final Focus Test Stand final report

    CERN Document Server

    Jeremie, A; Burrows, P

    2013-01-01

    Future Linear colliders will need particle beam sizes in the nanometre range. The beam also needs to be stable all along the beam line and especially at the Final Focus section. A dedicated Final Focus test stand has been used for this study and is comprised of several sub-parts. First there is the Stabilisation/Isolation system with sensors and actuators stabilizing down to sub-nanometre level. Then the Magnet itself needs to comply with very specific design constraints. In addition to the mechanical items, the beam can be stabilized acting on the trajectory directly and Beam-based controls have been developed and tested on different accelerator facilities.

  18. Linkage between Graduate Medical Education Training Practice Profiles in Psychiatry, Obstetrics/Gynecology, and Family Practice. Deliverable No. 5. Final Report.

    Science.gov (United States)

    Moynihan, Christy; And Others

    This study examined the relationship between graduate medical education (GME) and practice profiles in three specialties: family practice, psychiatry, and obstetrics/gynecology. Two analyses were performed, the first assessing the relationship between GME and current practice patterns and the second assessing the relationship between GME and…

  19. Final Technical Report

    Energy Technology Data Exchange (ETDEWEB)

    Gilbert, Chris [Altamont Environmental, Inc.

    2014-11-13

    The project, Capital Investment to Fund Equipment Purchases and Facility Modifications to Create a Sustainable Future for EnergyXchange served to replace landfill gas energy with alternative energy resources, primarily solar and wood waste. This is the final project closeout report.

  20. Medical Malpractice

    DEFF Research Database (Denmark)

    Grembi, Veronica

    2014-01-01

    MM first came to the attention of policy makers primarily in the USA where, from the 1970s, healthcare providers denounced problems in getting insurance for medical liability, pointing out to a crisis in the MM insurance market (Sage WM (2003) Understanding the first malpractice crisis of the 21th...... in the last decades also among European countries (Hospitals of the European Union (HOPE) (2004) Insurance and malpractice, final report. Brussels, www.hope.be; OECD (2006) Medical malpractice, insurance and coverage options, policy issues in insurance n.11; EC (European Commission, D.G. Sanco) (2006) Special...... eurobarometer medical errors)...

  1. Proton beam therapy facility

    Energy Technology Data Exchange (ETDEWEB)

    1984-10-09

    It is proposed to build a regional outpatient medical clinic at the Fermi National Accelerator Laboratory (Fermilab), Batavia, Illinois, to exploit the unique therapeutic characteristics of high energy proton beams. The Fermilab location for a proton therapy facility (PTF) is being chosen for reasons ranging from lower total construction and operating costs and the availability of sophisticated technical support to a location with good access to patients from the Chicago area and from the entire nation. 9 refs., 4 figs., 26 tabs.

  2. Two-year seizure reduction in adults with medically intractable partial onset epilepsy treated with responsive neurostimulation: final results of the RNS System Pivotal trial.

    Science.gov (United States)

    Heck, Christianne N; King-Stephens, David; Massey, Andrew D; Nair, Dileep R; Jobst, Barbara C; Barkley, Gregory L; Salanova, Vicenta; Cole, Andrew J; Smith, Michael C; Gwinn, Ryder P; Skidmore, Christopher; Van Ness, Paul C; Bergey, Gregory K; Park, Yong D; Miller, Ian; Geller, Eric; Rutecki, Paul A; Zimmerman, Richard; Spencer, David C; Goldman, Alica; Edwards, Jonathan C; Leiphart, James W; Wharen, Robert E; Fessler, James; Fountain, Nathan B; Worrell, Gregory A; Gross, Robert E; Eisenschenk, Stephan; Duckrow, Robert B; Hirsch, Lawrence J; Bazil, Carl; O'Donovan, Cormac A; Sun, Felice T; Courtney, Tracy A; Seale, Cairn G; Morrell, Martha J

    2014-03-01

    To demonstrate the safety and effectiveness of responsive stimulation at the seizure focus as an adjunctive therapy to reduce the frequency of seizures in adults with medically intractable partial onset seizures arising from one or two seizure foci. Randomized multicenter double-blinded controlled trial of responsive focal cortical stimulation (RNS System). Subjects with medically intractable partial onset seizures from one or two foci were implanted, and 1 month postimplant were randomized 1:1 to active or sham stimulation. After the fifth postimplant month, all subjects received responsive stimulation in an open label period (OLP) to complete 2 years of postimplant follow-up. All 191 subjects were randomized. The percent change in seizures at the end of the blinded period was -37.9% in the active and -17.3% in the sham stimulation group (p = 0.012, Generalized Estimating Equations). The median percent reduction in seizures in the OLP was 44% at 1 year and 53% at 2 years, which represents a progressive and significant improvement with time (p < 0.0001). The serious adverse event rate was not different between subjects receiving active and sham stimulation. Adverse events were consistent with the known risks of an implanted medical device, seizures, and of other epilepsy treatments. There were no adverse effects on neuropsychological function or mood. Responsive stimulation to the seizure focus reduced the frequency of partial-onset seizures acutely, showed improving seizure reduction over time, was well tolerated, and was acceptably safe. The RNS System provides an additional treatment option for patients with medically intractable partial-onset seizures. © 2014 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International League Against Epilepsy.

  3. The Final Oral/Practical State Examination at Freiburg Medical Faculty in 2012 – Analysis of grading to test quality assurance

    Directory of Open Access Journals (Sweden)

    Schickler, Angela

    2015-10-01

    Full Text Available Aim: The aim of this study is to analyze the grades given for the oral/practical part of the German State Examination at the Medical Faculty of Freiburg. We examined whether or not the grades given for the written and the oral/practical examinations correlated and if differences in grading between the Freiburg University Medical Center (UMC and the other teaching hospitals could be found.In order to improve the quality of the state examination, the medical school has been offering standardized training for examiners for several years. We evaluated whether or not trained and untrained examiners differed in their grading of the exam and how these differences have changed over time.Methods: The results of the 2012 spring and fall exams were analyzed (N=315. The relevant data set was made available to us by the Baden-Württemberg Examination Office (. The data were analyzed by means of descriptive and inferential statistics.Results: We observed a correlation of ρ=0.460** between the grades for the written and the oral/practical exams. The UMC and the teaching hospitals did not differ significantly in their grade distributions. Compared to untrained examiners, trained ones assigned the grade of “very good” less often. Furthermore, they displayed a significantly higher variance in the grades given (p=0.007, phi=0.165. This effect is stronger when concentrating specifically on those examiners who took part in the training less than a year before.Conclusion: The results of this study suggest that the standardized training for examiners at the Medical Faculty of Freiburg is effective for quality assurance. As a consequence, more examiners should be motivated to take part in the training.

  4. Mammography Facilities

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Mammography Facility Database is updated periodically based on information received from the four FDA-approved accreditation bodies: the American College of...

  5. Health Facilities

    Science.gov (United States)

    Health facilities are places that provide health care. They include hospitals, clinics, outpatient care centers, and specialized care centers, such as birthing centers and psychiatric care centers. When you ...

  6. Canyon Facilities

    Data.gov (United States)

    Federal Laboratory Consortium — B Plant, T Plant, U Plant, PUREX, and REDOX (see their links) are the five facilities at Hanford where the original objective was plutonium removal from the uranium...

  7. A Case of Bordetella brochiseptica at a Military Medical Facility in Hawai‘i: Phenotypic and Molecular Testing of an Uncommon Human Pathogen

    Science.gov (United States)

    Agee, Willie A; Kajiura, Lauren; Hawley-Molloy, Joshua S; Staege, Catherine M; Barnhill, Jason C

    2015-01-01

    Bordetella bronchiseptica (B. bronchiseptica) is rarely implicated in human disease. Human infections typically occur in the context of immunosuppression and while human infection has been sporadically reported in the literature, the majority of these reports are largely descriptive and do not explore the molecular and phenotypic properties of the isolates in question. Here we report the isolation and characterization of a B. bronchiseptica isolate derived from an HIV positive patient at Tripler Army Medical Center on O‘ahu. This case represents the first published report of human infection of B. bronchiseptica in the state of Hawai‘i and the most detailed description of the biochemical and molecular features of a Hawaiian isolate to date. PMID:26225268

  8. A Case of Bordetella brochiseptica at a Military Medical Facility in Hawai'i: Phenotypic and Molecular Testing of an Uncommon Human Pathogen.

    Science.gov (United States)

    Washington, Michael A; Agee, Willie A; Kajiura, Lauren; Hawley-Molloy, Joshua S; Staege, Catherine M; Barnhill, Jason C

    2015-07-01

    Bordetella bronchiseptica (B. bronchiseptica) is rarely implicated in human disease. Human infections typically occur in the context of immunosuppression and while human infection has been sporadically reported in the literature, the majority of these reports are largely descriptive and do not explore the molecular and phenotypic properties of the isolates in question. Here we report the isolation and characterization of a B. bronchiseptica isolate derived from an HIV positive patient at Tripler Army Medical Center on O'ahu. This case represents the first published report of human infection of B. bronchiseptica in the state of Hawai'i and the most detailed description of the biochemical and molecular features of a Hawaiian isolate to date.

  9. Ground of maintenance of model of health of saving technologies of students of the special medical educational separation of physical education facilities

    Directory of Open Access Journals (Sweden)

    Prysjazhnuk S.I.

    2013-01-01

    Full Text Available The psychological pedagogical problems of physical development of students are considered with a rejection in a state of health. Experience of physical education of students of task medical force is studied. The structural functional model of process of physical education of students is developed with the use of health of saving technologies. Over 5000 students took part in researches. It is set that morphometric indexes are most closely associate. Intercommunications of indexes of level of development of physical qualities specify on insufficient differentiation in mechanisms which determine the structure of physical preparedness of students. Recommendations of model physical possibilities of students are resulted. Models are instrumental in an estimation individual potential possibility of organism. Models allow to utillize information for planning and leadthrough of a health educational educate process on physical education. Possibilities of determination of volume of the physical loading are shown taking into account a floor, nosology of diseases and state of physical preparedness of students.

  10. ESO adaptive optics facility

    Science.gov (United States)

    Arsenault, R.; Madec, P.-Y.; Hubin, N.; Paufique, J.; Stroebele, S.; Soenke, C.; Donaldson, R.; Fedrigo, E.; Oberti, S.; Tordo, S.; Downing, M.; Kiekebusch, M.; Conzelmann, R.; Duchateau, M.; Jost, A.; Hackenberg, W.; Bonaccini Calia, D.; Delabre, B.; Stuik, R.; Biasi, R.; Gallieni, D.; Lazzarini, P.; Lelouarn, M.; Glindeman, A.

    2008-07-01

    ESO has initiated in June 2004 a concept of Adaptive Optics Facility. One unit 8m telescope of the VLT is upgraded with a 1.1 m convex Deformable Secondary Mirror and an optimized instrument park. The AO modules GALACSI and GRAAL will provide GLAO and LTAO corrections forHawk-I and MUSE. A natural guide star mode is provided for commissioning and maintenance at the telescope. The facility is completed by a Laser Guide Star Facility launching 4 LGS from the telescope centerpiece used for the GLAO and LTAO wavefront sensing. A sophisticated test bench called ASSIST is being designed to allow an extensive testing and characterization phase of the DSM and its AO modules in Europe. Most sub-projects have entered the final design phase and the DSM has entered Manufacturing phase. First light is planned in the course of 2012 and the commissioning phases should be completed by 2013.

  11. Influence of the training experience of Makerere University medical and nursing graduates on willingness and competence to work in rural health facilities.

    Science.gov (United States)

    Kaye, Dan K; Mwanika, Andrew; Sewankambo, Nelson

    2010-01-01

    The global human resources crisis in the rural health sector is characterized by an unwillingness or inability of health workers to locate to a rural area, and/or function effectively there. To assist in addressing this issue in Uganda, Makerere University Faculty of Medicine designed and implemented a problem-based learning (PBL) curriculum in which health students underwent experiential training on community placements. This study sought to assess the influence of this training experience on students' willingness, readiness and competence to work in rural health facilities by surveying 60 recent graduates of Makerere University Faculty of Medicine, who completed their studies during the transition from traditional to PBL curriculum. During a comprehensive evaluation of the PBL curriculum conducted from 19 to 31 October 2008, 60 graduates were assessed. Their distribution between the traditional and PBL curricula was equal. Using a participatory approach and open-ended questionnaires, the 2 groups were compared for the effect of their training on willingness and readiness to work in a rural location. Influential training experience factors were compared according to whether the students were educated in the PBL curriculum or the traditional curriculum (with or without PBL influence). The community based training experience of graduates significantly influenced their choice to work in a rural and underserved area of Uganda, compared with their counterparts from the traditional curriculum. In addition, PBL/community based curriculum graduates showed greater motivation to take up employment in a rural area, and confidence about practicing there effectively. While personal values may impact on a decision to work in a rural area, training experience also shapes these personal values and choices.

  12. Emergency Medical Services

    Science.gov (United States)

    ... and need help right away, you should use emergency medical services. These services use specially trained people and specially equipped facilities. You may need care in the hospital emergency room (ER). Doctors and nurses there treat emergencies, ...

  13. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2017 Rates; Quality Reporting Requirements for Specific Providers; Graduate Medical Education; Hospital Notification Procedures Applicable to Beneficiaries Receiving Observation Services; Technical Changes Relating to Costs to Organizations and Medicare Cost Reports; Finalization of Interim Final Rules With Comment Period on LTCH PPS Payments for Severe Wounds, Modifications of Limitations on Redesignation by the Medicare Geographic Classification Review Board, and Extensions of Payments to MDHs and Low-Volume Hospitals. Final rule.

    Science.gov (United States)

    2016-08-22

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2017. Some of these changes will implement certain statutory provisions contained in the Pathway for Sustainable Growth Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Notice of Observation Treatment and Implications for Care Eligibility Act of 2015, and other legislation. We also are providing the estimated market basket update to apply to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2017. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2017. In addition, we are making changes relating to direct graduate medical education (GME) and indirect medical education payments; establishing new requirements or revising existing requirements for quality reporting by specific Medicare providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities), including related provisions for eligible hospitals and critical access hospitals (CAHs) participating in the Electronic Health Record Incentive Program; updating policies relating to the Hospital Value-Based Purchasing Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition Reduction Program; implementing statutory provisions that require hospitals and CAHs to furnish notification to Medicare beneficiaries, including Medicare Advantage enrollees, when the beneficiaries receive outpatient observation services for more than 24 hours; announcing the implementation of the Frontier Community Health Integration Project Demonstration; and

  14. Comparison of continuing medical education (CME priorities of midwives employed at health facilities and treatment centers of Kashan and Aran & Bidgol - 2010

    Directory of Open Access Journals (Sweden)

    S Behrouzifar

    2012-06-01

    Full Text Available Introduction: In Continuing Medical Education (CME, paying attention to professional empowerment on the basis of community needs and learners’ institutional requirements is necessary. This study was conducted to determine continuing CME priorities of midwifery graduates employed in health and treatment centers of Kashan and Aran & Bidgol cities located in central Iran (2010. Methods: This cross-sectional study was conducted on 71 midwives. A questionnaire including 87 educational items in 6 subjects was designed. Every item was scored on a Likert scale ranging from zero to ten. Data were extracted, classified and analyzed by SPSS software using descriptive and inferential statistics. Results: Of the six subjects raised, gynecology (7.89±1.54 had the highest score and fundamentals of nursing (6.05±2.35 had the lowest score. Among different disease the topics of abnormal genital tract bleeding (9.32±1.3, diabetes mellitus during pregnancy (9.26±1.27, breast cancer (9±1.97, anemia (8.87±1.71, preventing the birth of premature infants (8.44±2.34 and infection control in special units (7.36±3.06, had the highest means, respectively. There was a statistically significant difference between two groups of midwives employed in health centers and treatment centers regarding the need for learning some subjects. Conclusion: The need for CME priorities varied according to functional domains. This is essential to be considered by decision makers.

  15. "Getting the water-carrier to light the lamps": Discrepant role perceptions of traditional, complementary, and alternative medical practitioners in government health facilities in India.

    Science.gov (United States)

    Josyula, K Lakshmi; Sheikh, Kabir; Nambiar, Devaki; Narayan, Venkatesh V; Sathyanarayana, T N; Porter, John D H

    2016-10-01

    The government of India has, over the past decade, implemented the "integration" of traditional, complementary and alternative medical (TCAM) practitioners, specifically practitioners of Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-rigpa, and Homoeopathy (collectively known by the acronym AYUSH), in government health services. A range of operational and ethical challenges has manifested during this process of large health system reform. We explored the practices and perceptions of health system actors, in relation to AYUSH providers' roles in government health services in three Indian states - Kerala, Meghalaya, and Delhi. Research methods included 196 in-depth interviews with a range of health policy and system actors and beneficiaries, between February and October 2012, and review of national, state, and district-level policy documents relating to AYUSH integration. The thematic 'framework' approach was applied to analyze data from the interviews, and systematic content analysis performed on policy documents. We found that the roles of AYUSH providers are frequently ambiguously stated and variably interpreted, in relation to various aspects of their practice, such as outpatient care, prescribing rights, emergency duties, obstetric services, night duties, and referrals across systems of medicine. Work sharing is variously interpreted by different health system actors as complementing allopathic practice with AYUSH practice, or allopathic practice, by AYUSH providers to supplement the work of allopathic practitioners. Interactions among AYUSH practitioners and their health system colleagues frequently take place in a context of partial information, preconceived notions, power imbalances, and mistrust. In some notable instances, collegial relationships and apt divisions of responsibilities are observed. Widespread normative ambivalence around the roles of AYUSH providers, complicated by the logistical constraints prevalent in poorly resourced systems, has the

  16. Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Reserve Select; TRICARE Dental Program; Early Eligibility for TRICARE for Certain Reserve Component Members. Final rule.

    Science.gov (United States)

    2015-09-15

    TRICARE Reserve Select (TRS) is a premium-based TRICARE health plan available for purchase worldwide by qualified members of the Ready Reserve and by qualified survivors of TRS members. TRICARE Dental Program (TDP) is a premium-based TRICARE dental plan available for purchase worldwide by qualified Service members. This final rule revises requirements and procedures for the TRS program to specify the appropriate actuarial basis for calculating premiums in addition to making other minor clarifying administrative changes. For a member who is involuntarily separated from the Selected Reserve under other than adverse conditions this final rule provides a time-limited exception that allows TRS coverage in effect to continue for up to 180 days after the date on which the member is separated from the Selected Reserve and TDP coverage in effect to continue for no less than 180 days after the separation date. It also expands early TRICARE eligibility for certain Reserve Component members from a maximum of 90 days to a maximum of 180 days prior to activation in support of a contingency operation for more than 30 days.

  17. Medical Student Dissection of CadaversImproves Performance on Practical Exams, but not Dissection-Relevant Questions in the NBME Gross Anatomy and Embryology Final Exam

    Directory of Open Access Journals (Sweden)

    Leslie Sargent Jones

    2001-03-01

    Full Text Available We have examined whether cadaver dissection by first year medical students (MIs affected their performance in two test measures: the NBME Gross Anatomy and Embryology Subject Exam (dissection-relevant questions only, and practical exams given at the end of each major section within the course. The dissections for the entire course were divided into 18 regional dissection units and each student was assigned to dissect one third of the regional units; the other two-thirds of the material was learned from the partner-prosected cadavers. Performance for each student on the exams was then assessed as a function of the regions those students actually dissected. While the results indicated a small performance advantage for MIs answering questions on material they had dissected on the NBME Subject Exam questions relevant to dissection (78-88% of total exam, the results were not statistically significant. However, a similar, small performance advantage on the course practical exams was highly significant.

  18. Malawi; Sixth and Final Review Under the Three-Year Arrangement Under the Poverty Reduction and Growth Facility, and Request for Waiver of Nonobservance of Performance Criteria and Augmentation Access: Staff Report; Press Release on the Executive Board Discussion; and Statement by the Executive Director for Malawi

    OpenAIRE

    International Monetary Fund

    2008-01-01

    This paper discusses key findings of the Sixth and Final Review for Malawi Under the Poverty Reduction and Growth Facility (PRGF). Performance remained generally strong in the period under review. The authorities met most program targets for end-December 2007, and domestic debt fell as a share of GDP, but the domestic borrowing performance criterion was missed. The government aims to meet the 2007/08 domestic borrowing target. Higher fuel and fertilizer prices are putting pressure on internat...

  19. Final year nursing students in Nigeria; How knowledgeable and prepared are they to offer medical care to patients with chronic kidney disease?

    Science.gov (United States)

    Okwuonu, Chimezie Godswill; Kanu, Hannah Sylvanus; Odigie, Ojeh-Oziegbe

    2017-01-01

    Nurses play an important role in the management of chronic kidney disease (CKD) patients at primary, secondary, and tertiary levels of care. In other to perform their functions, it is pertinent that they have a good understanding of kidney functions and CKD. We do not know if the current educational curriculum prepares them adequately for this role. To assess the knowledge level of kidney functions and diseases among final year nursing students in Abia State Nigeria. This was a cross sectional study involving final year diploma and Bachelor of nursing (B.Nursing) students who were randomly chosen. Structured, self-administered questionnaire containing 18 items was the tool for data collection. A score of one was given for each correctly answered question on functions of the kidney, symptoms, signs, causes, and complications of CKD. A score of 50% and above was regarded as good knowledge. Two hundred questionnaires were distributed, but 186 were returned (response rate of 93%). Male:female ratio was 1:14.5. One hundred and seventeen (62.9%) knew the correct definition of CKD, but only 69 (37.1%) knew the normal range of glomerular filtration rate. Eighty-one percent had good knowledge of kidney functions while 39 (21%) had good knowledge of CKD. Overall, 42 (22.6%) had good knowledge of kidney functions and CKD. Students who rotated through the dialysis unit during their clinical posting had higher mean knowledge score than others (P = 0.03). There was no significant difference in the mean knowledge scores of the diploma and B.Nursing students (P = 0.76). The majority of the final year students had poor knowledge of CKD. There is need to expand the current teaching curriculum so as to increase the knowledge of these future nurses on the basic concepts of CKD to improve outcomes of patient management. Résumé Contexte: Les infirmiers jouent un rôle important dans le suivi des personnes souffrant de la maladie rénale chronique (MRC) aux premiers, deuxièmes et

  20. Asian Facilities

    Science.gov (United States)

    Nakahata, M.

    2011-04-01

    Asian underground facilities are reviewed. The YangYang underground Laboratory in Korea and the Kamioka observatory in Japan are operational and several astrophysical experiments are running. Indian Neutrino Observatory(INO) and China JinPing Underground Laboratory (CJPL) are under construction and underground experiments are being prepared. Current activities and future prospects at those underground sites are described.