WorldWideScience

Sample records for facility general service

  1. General service and child immunization-specific readiness assessment of healthcare facilities in two selected divisions in Bangladesh.

    Science.gov (United States)

    Shawon, Md Shajedur Rahman; Adhikary, Gourab; Ali, Md Wazed; Shamsuzzaman, Md; Ahmed, Shahabuddin; Alam, Nurul; Shackelford, Katya A; Woldeab, Alexander; Lim, Stephen S; Levine, Aubrey; Gakidou, Emmanuela; Uddin, Md Jasim

    2018-01-25

    Service readiness of health facilities is an integral part of providing comprehensive quality healthcare to the community. Comprehensive assessment of general and service-specific (i.e. child immunization) readiness will help to identify the bottlenecks in healthcare service delivery and gaps in equitable service provision. Assessing healthcare facilities readiness also helps in optimal policymaking and resource allocation. A health facility survey was conducted between March 2015 and December 2015 in two purposively selected divisions in Bangladesh; i.e. Rajshahi division (high performing) and Sylhet division (low performing). A total of 123 health facilities were randomly selected from different levels of service, both public and private, with variation in sizes and patient loads from the list of facilities. Data on various aspects of healthcare facility were collected by interviewing key personnel. General service and child immunization specific service readiness were assessed using the Service Availability and Readiness Assessment (SARA) manual developed by World Health Organization (WHO). The analyses were stratified by division and level of healthcare facilities. The general service readiness index for pharmacies, community clinics, primary care facilities and higher care facilities were 40.6%, 60.5%, 59.8% and 69.5%, respectively in Rajshahi division and 44.3%, 57.8%, 57.5% and 73.4%, respectively in Sylhet division. Facilities at all levels had the highest scores for basic equipment (ranged between 51.7% and 93.7%) and the lowest scores for diagnostic capacity (ranged between 0.0% and 53.7%). Though facilities with vaccine storage capacity had very high levels of service readiness for child immunization, facilities without vaccine storage capacity lacked availability of many tracer items. Regarding readiness for newly introduced pneumococcal conjugate vaccine (PCV) and inactivated polio vaccine (IPV), most of the surveyed facilities reported lack of

  2. Facility Registry Service (FRS)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Facility Registry Service (FRS) provides an integrated source of comprehensive (air, water, and waste) environmental information about facilities across EPA,...

  3. Savannah River Plant engineering and design history. Volume 4: 300/700 Areas & general services and facilities

    Energy Technology Data Exchange (ETDEWEB)

    1957-01-01

    The primary function of the 300 Area is the production and preparation of the fuel and target elements required for the 100 Area production reactors. Uranium slugs and lithium-aluminium alloy control and blanket rods are prepared in separate structures. Other facilities include a test pile, a physics assembly laboratory, an office and change house, an electrical substation, and various service facilities such as rail lines, roads, sewers, steam and water distribution lines, etc. The 700 Area contains housing and facilities for plant management, general plant services, and certain technical activities. The technical buildings include the Main Technical Laboratory, the Waste Concentration Building, the Health Physics Headquarters, and the Health Physics Calibration building. Sections of this report describe the following: development of the 300-M Area; selection and description of process; design of main facilities of the 300 Area; development of the 700-A Area; design of the main facilities of the 700 Area; and general services and facilities, including transportation, plant protection, waste disposal and drainage, site work, pilot plants, storage, and furniture and fixtures.

  4. Service quality in contracted facilities.

    Science.gov (United States)

    Rabbani, Fauziah; Pradhan, Nousheen Akber; Zaidi, Shehla; Azam, Syed Iqbal; Yousuf, Farheen

    2015-01-01

    The purpose of this paper is to explore the readiness of contracted and non-contracted first-level healthcare facilities in Pakistan to deliver quality maternal and neonatal health (MNH) care. A balanced scorecard (BSC) was used as the assessment framework. Using a cross-sectional study design, two rural health centers (RHCs) contracted out to Aga Khan Health Service, Pakistan were compared with four government managed RHCs. A BSC was designed to assess RHC readiness to deliver good quality MNH care. In total 20 indicators were developed, representing five BSC domains: health facility functionality, service provision, staff capacity, staff and patient satisfaction. Validated data collection tools were used to collect information. Pearson χ2, Fisher's Exact and the Mann-Whitney tests were applied as appropriate to detect significant service quality differences among the two facilities. Contracted facilities were generally found to be better than non-contracted facilities in all five BSC domains. Patients' inclination for facility-based delivery at contracted facilities was, however, significantly higher than non-contracted facilities (80 percent contracted vs 43 percent non-contracted, p=0.006). The study shows that contracting out initiatives have the potential to improve MNH care. This is the first study to compare MNH service delivery quality across contracted and non-contracted facilities using BSC as the assessment framework.

  5. Generalized plotting facility

    Energy Technology Data Exchange (ETDEWEB)

    Burris, R.D.; Gray, W.H.

    1978-01-01

    A command which causes the translation of any supported graphics file format to a format acceptable to any supported device was implemented on two linked DECsystem-10s. The processing of the command is divided into parsing and translating phases. In the parsing phase, information is extracted from the command and augmented by default data. The results of this phase are saved on disk, and the appropriate translating routine is invoked. Twenty-eight translating programs were implemented in this system. They support four different graphics file formats, including the DISSPLA and Calcomp formats, and seven different types of plotters, including Tektronix, Calcomp, and Versatec devices. Some of the plotters are devices linked to the DECsystem-10s, and some are driven by IBM System/360 computers linked via a communications network to the DECsystem-10s. The user of this facility can use any of the supported packages to create a file of graphics data, preview the file on an on-line scope, and, when satisfied, cause the same data to be plotted on a hard-copy device. All of the actions utilize a single simple command format. 2 figures.

  6. 9 CFR 3.125 - Facilities, general.

    Science.gov (United States)

    2010-01-01

    ... Warmblooded Animals Other Than Dogs, Cats, Rabbits, Hamsters, Guinea Pigs, Nonhuman Primates, and Marine... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Facilities, general. 3.125 Section 3.125 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE...

  7. Hydroelectric Generating Facilities General Permit ...

    Science.gov (United States)

    2017-08-28

    The Notice of Availability of the Final NPDES General Permits (HYDROGP) for Discharges at Hydroelectric Generating Facilities in Massachusetts (MAG360000) and New Hampshire (NHG360000) and Tribal Lands in the State of Massachusetts was published in the Federal Register on December 7, 2009 (see 74 Fed. Reg. No. 233, pages 64074 - 64075).

  8. Facility Focus: Food Service.

    Science.gov (United States)

    College Planning & Management, 2002

    2002-01-01

    Describes the Hawthorn Court Community Center at Iowa State University, Ames, and the HUB-Robeson Center at Pennsylvania State University. Focuses on the food service offered in these new student-life buildings. Includes photographs. (EV)

  9. EPA Facility Registry Service (FRS): RADINFO

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  10. EPA Facility Registry Service (FRS): NEI

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  11. EPA Facility Registry Service (FRS): BIA

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  12. EPA Facility Registry Service (FRS): BRAC

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  13. EPA Facility Registry Service (FRS): NCDB

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  14. EPA Facility Registry Service (FRS): TRI

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  15. EPA Facility Registry Service (FRS): ICIS

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  16. EPA Facility Registry Service (FRS): RBLC

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  17. EPA Facility Registry Service (FRS): CAMDBS

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  18. EPA Facility Registry Service (FRS): SDWIS

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  19. EPA Facility Registry Service (FRS): RMP

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  20. 9 CFR 3.25 - Facilities, general.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Facilities, general. 3.25 Section 3.25... Pigs and Hamsters Facilities and Operating Standards § 3.25 Facilities, general. (a) Structural strength. Indoor and outdoor housing facilities for guinea pigs or hamsters shall be structurally sound and...

  1. EPA Facility Registry Service (FRS): Facility Interests Dataset - Intranet

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service consists of location and facility identification information from EPA's Facility Registry Service (FRS) for all sites that are available in...

  2. EPA Facility Registry Service (FRS): Facility Interests Dataset

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service consists of location and facility identification information from EPA's Facility Registry Service (FRS) for all sites that are available in...

  3. EPA Facility Registry Service (FRS): Facility Interests Dataset - Intranet Download

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service consists of location and facility identification information from EPA's Facility Registry Service (FRS) for all sites that are available in...

  4. EPA Facility Registry Service (FRS): OIL

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link to the Oil...

  5. EPA Facility Registry Service (FRS): ACRES

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service consists of location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of sites that link to...

  6. EPA Facility Registry Service (FRS): LANDFILL

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of non-hazardous waste...

  7. EPA Facility Registry Service (FRS): RCRA

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of hazardous waste...

  8. Advanced satellite servicing facility studies

    Science.gov (United States)

    Qualls, Garry D.; Ferebee, Melvin J., Jr.

    1988-01-01

    A NASA-sponsored systems analysis designed to identify and recommend advanced subsystems and technologies specifically for a manned Sun-synchronous platform for satellite management is discussed. An overview of system design, manned and unmanned servicing facilities, and representative mission scenarios are given. Mission areas discussed include facility based satellite assembly, checkout, deployment, refueling, repair, and systems upgrade. The ferrying of materials and consumables to and from manufacturing platforms, deorbit, removal, repositioning, or salvage of satellites and debris, and crew rescue of any other manned vehicles are also examined. Impacted subsytems discussed include guidance navigation and control, propulsion, data management, power, thermal control, structures, life support, and radiation management. In addition, technology issues which would have significant impacts on the system design are discussed.

  9. EPA Facility Registry Service (FRS): Facility Interests Dataset - Intranet Download

    Data.gov (United States)

    U.S. Environmental Protection Agency — This downloadable data package consists of location and facility identification information from EPA's Facility Registry Service (FRS) for all sites that are...

  10. EPA Facility Registry Service (FRS): Facility Interests Dataset Download

    Data.gov (United States)

    U.S. Environmental Protection Agency — This downloadable data package consists of location and facility identification information from EPA's Facility Registry Service (FRS) for all sites that are...

  11. Planning the School Food Service Facilities. Revised 1967.

    Science.gov (United States)

    Utah State Board of Education, Salt Lake City.

    Evaluations of food service equipment, kitchen design and food service facilities are comprehensively reviewed for those concerned with the planning and equipping of new school lunchrooms or the remodeling of existing facilities. Information is presented in the form of general guides adaptable to specific local situations and needs, and is…

  12. EPA Linked Open Data: Facility Registry Service

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Facility Registry Service (FRS) identifies facilities, sites, or places subject to environmental regulation or of environmental interest to EPA programs or...

  13. Space Physics Data Facility Web Services

    Science.gov (United States)

    Candey, Robert M.; Harris, Bernard T.; Chimiak, Reine A.

    2005-01-01

    The Space Physics Data Facility (SPDF) Web services provides a distributed programming interface to a portion of the SPDF software. (A general description of Web services is available at http://www.w3.org/ and in many current software-engineering texts and articles focused on distributed programming.) The SPDF Web services distributed programming interface enables additional collaboration and integration of the SPDF software system with other software systems, in furtherance of the SPDF mission to lead collaborative efforts in the collection and utilization of space physics data and mathematical models. This programming interface conforms to all applicable Web services specifications of the World Wide Web Consortium. The interface is specified by a Web Services Description Language (WSDL) file. The SPDF Web services software consists of the following components: 1) A server program for implementation of the Web services; and 2) A software developer s kit that consists of a WSDL file, a less formal description of the interface, a Java class library (which further eases development of Java-based client software), and Java source code for an example client program that illustrates the use of the interface.

  14. Service quality for facilities management in hospitals

    CERN Document Server

    Sui Pheng, Low

    2016-01-01

    This book examines the Facilities Management (FM) of hospitals and healthcare facilities, which are among the most complex, costly and challenging kind of buildings to manage. It presents and evaluates the FM service quality standards in Singapore’s hospitals from the patient’s perspective, and provides recommendations on how to successfully improve FM service quality and achieve higher patient satisfaction. The book also features valuable supplementary materials, including a checklist of 32 key factors for successful facilities management and another checklist of 24 service attributes for hospitals to achieve desirable service quality in connection with facilities management. The book adopts a unique approach of combining service quality and quality theory to provide a more holistic view of how FM service quality can be achieved in hospitals. It also integrates three instruments, namely the SERVQUAL model, the Kano model and the QFD model to yield empirical results from surveys for implementation in hosp...

  15. Design Criteria: School Food Service Facilities.

    Science.gov (United States)

    Florida State Dept. of Education, Tallahassee.

    This guide is intended for architects, district superintendents, and food service directors whose responsibility it is to plan food service facilities. It first discusses the factors to be considered in food service planning, presents cost studies, and lists the responsibilities of those involved in the planning. Other sections concern selection,…

  16. Site and facility transportation services planning documents

    Energy Technology Data Exchange (ETDEWEB)

    Ratledge, J.E. (Oak Ridge National Lab., TN (USA)); Danese, L.; Schmid, S. (Science Applications International Corp., Oak Ridge, TN (USA))

    1990-01-01

    The Office of Civilian Radioactive Waste Management (OCRWM) will eventually ship Purchasers' (10 CFR 961.3) spent nuclear fuel from approximately 122 commercial nuclear facilities. The preparation and processing of Site and Facility Specific Transportation Services Planning Documents (SPDs) and Site Specific Servicing Plans (SSSPs) provides a focus for advanced planning and the actual shipping of waste, as well as the overall development of transportation requirements for the waste transportation system. SPDs will be prepared for each of the affected nuclear waste facilities over the next 2 years with initial emphasis on facilities likely to be served during the earliest years of the Federal Waste Management System (FWMS) operations. 3 figs., 1 tab.

  17. Site and facility transportation services planning documents

    International Nuclear Information System (INIS)

    Ratledge, J.E.; Danese, L.; Schmid, S.

    1990-01-01

    The Office of Civilian Radioactive Waste Management (OCRWM) will eventually ship Purchasers' (10 CFR 961.3) spent nuclear fuel from approximately 122 commercial nuclear facilities. The preparation and processing of Site and Facility Specific Transportation Services Planning Documents (SPDs) and Site Specific Servicing Plans (SSSPs) provides a focus for advanced planning and the actual shipping of waste, as well as the overall development of transportation requirements for the waste transportation system. SPDs will be prepared for each of the affected nuclear waste facilities over the next 2 years with initial emphasis on facilities likely to be served during the earliest years of the Federal Waste Management System (FWMS) operations. 3 figs., 1 tab

  18. EPA Facility Registry Service (FRS): AIRS_AQS

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  19. EPA Facility Registry Service (FRS): RCRA_LQG

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  20. EPA Facility Registry Service (FRS): AIRS_AFS

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  1. EPA Facility Registry Service (FRS): RCRA_TRANS

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  2. EPA Facility Registry Service (FRS): CERCLIS_NPL

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that are...

  3. EPA Facility Registry Service (FRS): PCS_NPDES_MAJOR

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that are...

  4. EPA Facility Registry Service (FRS): PCS_NPDES

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  5. EPA Facility Registry Service (FRS): AIRS_AFS_MAJOR

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  6. EPA Facility Registry Service (FRS): ER_EPLAN

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link...

  7. EPA Facility Registry Service (FRS): ER_TRI

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link...

  8. EPA Facility Registry Service (FRS): ER_TSCA

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link...

  9. EPA Facility Registry Service (FRS): ER_CERCLIS

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link...

  10. EPA Facility Registry Service (FRS): ER_RMP

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link...

  11. EPA Facility Registry Service (FRS): ER_RCRATSD

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link...

  12. EPA Facility Registry Service (FRS): RCRA_INACTIVE

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of hazardous waste...

  13. EPA Facility Registry Service (FRS): ALL FRS INTERESTS LAYER

    Data.gov (United States)

    U.S. Environmental Protection Agency — This data provides location and attribute information on all facilities in EPA's Facility Registry Service (FRS) for a internet web feature service . The FRS is an...

  14. EPA Facility Registry Service (FRS): RCRA_ACTIVE

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of active hazardous...

  15. EPA Facility Registry Service (FRS): RCRA_TSD

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of Hazardous Waste...

  16. In-service diagnostics of pumping facilities

    International Nuclear Information System (INIS)

    Jaros, I.

    1987-01-01

    The potential is discussed of technical diagnostics in increasing operating reliability of pumping facilities of conventional and nuclear power plants, and in rationalizing the system of their maintenance. Attention is focused on the selection of diagnostic parameters in which the so-called subjective expert methodology is applied, and on the diagnostic system design. At this stage, the construction of the respective facility and the analysis of the failure rate of its individual assemblies should be considered. The selection of diagnostic means directly depends on the selection of diagnostic parameters and is conditional on other factors, such as availability, cost, technical service, and operator's training. Briefly characterized are Czechoslovak standards assessing the mechanical condition of rotary machines from the measurement of the effective value of the rate of their oscillations. (Z.M.)

  17. Storm Water General Permit 1 for Industrial Facilities

    Data.gov (United States)

    Iowa State University GIS Support and Research FacilityGeneral permit #1 for storm water discharges associated with industrial facilities in Iowa for the National Pollutant Discharge Elimination System (NPDES) program.

  18. 16 CFR 240.7 - Services or facilities.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Services or facilities. 240.7 Section 240.7 Commercial Practices FEDERAL TRADE COMMISSION GUIDES AND TRADE PRACTICE RULES GUIDES FOR ADVERTISING ALLOWANCES AND OTHER MERCHANDISING PAYMENTS AND SERVICES § 240.7 Services or facilities. The terms services...

  19. EPA Facility Registry Service (FRS): AIRS_AFS Sub Facilities

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Air Facility System (AFS) contains compliance and permit data for stationary sources regulated by EPA, state and local air pollution agencies. The sub facility...

  20. Facilities for in-service control

    International Nuclear Information System (INIS)

    Werner, H.

    1980-01-01

    Up to now the efficiency of in-service control had been limited and dependent on special qualifications of the super-intending personnel and was thus neither exact nor transferable. In the meantime a great number of testing and measuring facilities for special application have been developed. Even novel types of testing methods do not grant absolutely precise statements. In most cases, however, there is a possibility of planning repairs by trend control and of avoiding failures of operation with aggravating consequences. Technical designers from all subject fields should be made familiar with the continually increasing spectrum of in-service inspection techniques so that a better application of modern and well-tried testing methods can be planned. Systematic in-service inspections complete the Rules of Technology which are safety-oriented with regard to the nonlinear wear between regular dates of control which has been ignored so far and its implied risks. Components which are not liable to control can be checked much better by novel type methods. (orig./RW) [de

  1. Consumer satisfaction with the services of prosthetics and orthotics facilities

    NARCIS (Netherlands)

    Bosmans, Joline; Geertzen, Jan; Dijkstra, Pieter U.

    2009-01-01

    Consumer satisfaction with the services provided in a prosthetics and orthotics (PO) facility has seldom been studied. The aim of this study was to analyze consumer satisfaction regarding the services provided by 15 PO facilities in The Netherlands. Consumers (n=1,364) of these PO facilities who

  2. General dental practitioner's views on dental general anaesthesia services.

    Science.gov (United States)

    Threlfall, A G; King, D; Milsom, K M; Blinkhom, A S; Tickle, M

    2007-06-01

    Policy has recently changed on provision of dental general anaesthetic services in England. The aim of this study was to investigate general dental practitioners' views about dental general anaesthetics, the reduction in its availability and the impact on care of children with toothache. Qualitative study using semi-structured interviews and clinical case scenarios. General dental practitioners providing NHS services in the North West of England. 93 general dental practitioners were interviewed and 91 answered a clinical case scenario about the care they would provide for a 7-year-old child with multiple decayed teeth presenting with toothache. Scenario responses showed variation; 8% would immediately refer for general anaesthesia, 25% would initially prescribe antibiotics, but the majority would attempt to either restore or extract the tooth causing pain. Interview responses also demonstrated variation in care, however most dentists agree general anaesthesia has a role for nervous children but only refer as a last resort. The responses indicated an increase in inequalities, and that access to services did not match population needs, leaving some children waiting in pain. Most general dental practitioners support moving dental general anaesthesia into hospitals but some believe that it has widened health inequalities and there is also a problem associated with variation in treatment provision. Additional general anaesthetic services in some areas with high levels of tooth decay are needed and evidence based guidelines about caring for children with toothache are required.

  3. EPA Facility Registry Service (FRS): ER_WWTP_NPDES

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of Waste Water Treatment...

  4. Healthcare facility commissioning – the transition of clinical services

    CSIR Research Space (South Africa)

    Van der Watt, R

    2016-07-01

    Full Text Available structure of bricks and mortar into a functional facility with staff, equipment, medication, supplies, etc. ready to eventually receive patients who need care and cure. Beyond these tangible elements, there are also many intangibles which are required, e... in order for the new facility to deliver the intended clinical services. These include links to the emergency services which brings patients in need of emergency care to the facility, links to other healthcare facilities for more specialized care...

  5. Congestion Service Facilities Location Problem with Promise of Response Time

    Directory of Open Access Journals (Sweden)

    Dandan Hu

    2013-01-01

    Full Text Available In many services, promise of specific response time is advertised as a commitment by the service providers for the customer satisfaction. Congestion on service facilities could delay the delivery of the services and hurts the overall satisfaction. In this paper, congestion service facilities location problem with promise of response time is studied, and a mixed integer nonlinear programming model is presented with budget constrained. The facilities are modeled as M/M/c queues. The decision variables of the model are the locations of the service facilities and the number of servers at each facility. The objective function is to maximize the demands served within specific response time promised by the service provider. To solve this problem, we propose an algorithm that combines greedy and genetic algorithms. In order to verify the proposed algorithm, a lot of computational experiments are tested. And the results demonstrate that response time has a significant impact on location decision.

  6. Institute for Communication, General Services, Administration

    International Nuclear Information System (INIS)

    Legrain, C.

    2007-01-01

    The article describes the key activities of the Institute for Communication, General Services and Administration (CSA) of the Belgian Nuclear Research Centre SCK-CEN. CSA deals with communication and knowledge management and co-ordinates courses on the fundamentals and applications of nuclear research. CSA also comprises the administrative, financial, logistic and central technical services, as well as human resources and ICT

  7. Analysis of Student Satisfaction Toward Quality of Service Facility

    Science.gov (United States)

    Napitupulu, D.; Rahim, R.; Abdullah, D.; Setiawan, MI; Abdillah, LA; Ahmar, AS; Simarmata, J.; Hidayat, R.; Nurdiyanto, H.; Pranolo, A.

    2018-01-01

    The development of higher education is very rapid rise to the tight competition both public universities and private colleges. XYZ University realized to win the competition, required continuous quality improvement, including the quality of existing service facilities. Amenities quality services is believed to support the success of the learning activities and improve user satisfaction. This study aims to determine the extent to which the quality of the services effect on user satisfaction. The research method used is survey-based questionnaire that measure perception and expectation. The results showed a gap between perception and expectations of the respondents have a negative value for each item. This means XYZ service facility at the university is not currently meet the expectations of society members. Three service facility that has the lowest index is based on the perception of respondents is a laboratory (2.56), computer and multimedia (2.63) as well as wifi network (2.99). The magnitude of the correlation between satisfaction with the quality of service facilities is 0.725 which means a strong and positive relationship. The influence of the quality of service facilities to the satisfaction of the students is 0.525 meaning that the variable quality of the services facility can explain 52.5% of the variable satisfaction. The study provided recommendations for improvements to enhance the quality of services facility at the XYZ university facilities.

  8. Hydroelectric Generating Facilities General Permit (HYDROGP) for Massachusetts & New Hampshire

    Science.gov (United States)

    Documents, links & contacts for the Notice of Availability of the Final NPDES General Permits (HYDROGP) for Discharges at Hydroelectric Generating Facilities in Massachusetts (MAG360000) and New Hampshire (NHG360000) and Tribal Lands in the State of MA.

  9. EPA Facility Registry Service (FRS): CERCLIS

    Data.gov (United States)

    U.S. Environmental Protection Agency — This data provides location and attribute information on Facilities regulated under the Comprehensive Environmental Responsibility Compensation and Liability...

  10. Consumer preferences for general practitioner services.

    Science.gov (United States)

    Morrison, Mark; Murphy, Tom; Nalder, Craig

    2003-01-01

    This study focuses on segmenting the market for General Practitioner services in a regional setting. Using factor analysis, five main service attributes are identified. These are clear communication, ongoing doctor-patient relationship, same gender as the patient, provides advice to the patient, and empowers the patient to make his/her own decisions. These service attributes are used as a basis for market segmentation, using both socio-demographic variables and cluster analysis. Four distinct market segments are identified, with varying degrees of viability in terms of target marketing.

  11. EPA Facility Registry Service (FRS): Power Plants

    Data.gov (United States)

    U.S. Environmental Protection Agency — This GIS dataset contains data on power plants, based on the Energy Information Administration's EIA-860 dataset and supplemented with data from EPA's Facility...

  12. Site and facility waste transportation services planning documents

    International Nuclear Information System (INIS)

    Ratledge, J.E.; Schmid, S.; Danese, L.

    1991-01-01

    The Office of Civilian Radioactive Waste Management (OCRWM) will eventually ship Purchasers' (10 CFR 961.3) spent nuclear fuel from approximately 122 commercial nuclear facilities. The preparation and maintenance of Site- and Facility-Specific Transportation Services Planning Documents (SPDs) and Site-Specific Servicing Plans (SSSPs) provides a focus for advanced planning and the actual shipping of waste, as well as the overall development of transportation requirements for the waste transportation system. SPDs will be prepared for each of the affected nuclear waste facilities, with initial emphasis on facilities likely to be served during the earliest years of the Federal Waste Management System (FWMS) operations

  13. Consumer satisfaction with the services of prosthetics and orthotics facilities.

    Science.gov (United States)

    Bosmans, Joline; Geertzen, Jan; Dijkstra, Pieter U

    2009-03-01

    Consumer satisfaction with the services provided in a prosthetics and orthotics (P&O) facility has seldom been studied. The aim of this study was to analyze consumer satisfaction regarding the services provided by 15 P&O facilities in The Netherlands. Consumers (n = 1,364) of these P&O facilities who were fitted with a prosthesis, orthopaedic shoes, an orthosis, or another device, were asked to rate the overall services provided and whether they were satisfied with the device provided and its delivery time. Additionally, they filled in a modified SERVQUAL questionnaire (see Appendix). Consumers gave the service provided by P&O facilities a mean overall rating of 8.1. The highest ratings were given by consumers fitted with a prosthesis (mean overall rating of services: 8.4). In total, 78% of the consumers were satisfied with the device provided and 93% with the delivery time. The results of our study showed that, on the SERVQUAL, 50% of the statements fulfilled the criteria for a satisfactory quality of the services. The overall consumer rating of the service provided by P&O facilities is high and depends on the device provided. The outcomes on the SERVQUAL were moderate. In future, it is important to study consumer satisfaction more extensively in order to improve the quality of P&O services in daily practice. Additionally, specific questionnaires need to be developed to measure all aspects of prosthetic and orthotic care, with the aim to improve the services.

  14. Facility Service Market an European Overview based on EU Statistics

    Directory of Open Access Journals (Sweden)

    Alexander Redlein

    2017-01-01

    Full Text Available The macro-economic impact of facility management and facility services in special was not scientifically analysed by now. Some studies analysed single countries but were mainly lacking solid data. Especially a Pan European comparison is lacking. This paper presents the results of an in depth analysis of the Eurostat figures. It compares the facility service industry with other industries in particular the construction industry. It also compares the largest European economies (Germany, France and Italy. The study concentrates on the outsourced services only, as these are listed in the European Statistics. The results show big differences between the European countries. It also highlights that the facility service industry is the third largest regarding number of employees and the fourth largest regarding value added.

  15. EPA Facility Registry Service (FRS): FRS_ESF10

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web service contains the following layers: RMP, TRI, FRP, RCRATSD, CERCLIS, TSCA, and E-PLAN facilities and their associated CONTACTS, CHEMICALS, NAIP, SIC, and...

  16. EPA Facility Registry Service (FRS): Wastewater Treatment Plants

    Data.gov (United States)

    U.S. Environmental Protection Agency — This GIS dataset contains data on wastewater treatment plants, based on EPA's Facility Registry Service (FRS), EPA's Integrated Compliance Information System (ICIS)...

  17. Environmental Protection Agency (EPA) Facility Registry Service (FRS) Power Plants

    Data.gov (United States)

    Department of Homeland Security — This GIS dataset contains data on wastewater treatment plants, based on EPA's Facility Registry Service (FRS) and NPDES, along with Clean Watersheds Needs Survey...

  18. Study on Customer Satisfaction with Facilities Management Services in Lithuania

    Science.gov (United States)

    Lepkova, Natalija; Žūkaitė-Jefimovienė, Giedrė

    2012-12-01

    The article introduces the concept and content of facilities management (FM) services. The paper presents the concept of customer satisfaction and discusses the key factors which influence the opinions of customers and their satisfaction or dissatisfaction with the services provided. The article presents two studies: a brief survey of several FM service providers and a survey of customer satisfaction with FM services in Lithuania. The conclusions are given at the end of the article.

  19. Primary health care facility infrastructure and services and the ...

    African Journals Online (AJOL)

    ... Research Council ae Currently from Cape Peninsula University of Technology ... Keywords: primary health care facilities; nutritional status; children; caregivers' rural; South Africa ... underlying causes of malnutrition in children, while poor food quality, .... Information on PHC facility infrastructure and services was obtained.

  20. Anesthetic equipment, facilities and services available for pediatric ...

    African Journals Online (AJOL)

    Background: Facilities and equipment are known to contribute to improved patient care and outcome. Hospitals for sub‑specialized pediatric anesthetic service are routinely available worldwide. In Nigeria, such hospitals now exist. It is therefore relevant to study the facilities and equipment available for pediatric anesthetic ...

  1. Environmental Control Plan for the Industrial Hygiene Field Services Facility

    International Nuclear Information System (INIS)

    Donnelly, J.W.

    2000-01-01

    This environmental control plan is for the Hanford Site's Industrial Hygiene Field Services Facility, located in the 100-N Area. This facility is used for the maintenance and storage of respirators, respiratory equipment and testing, calibration and testing of industrial hygiene equipment, and asbestos fiber counting

  2. A Study on an appropriate operating system of environmental basic facility service industry

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Hyun Joo [Korea Environment Institute, Seoul (Korea)

    1998-12-01

    The environmental basic facility service industry is designed to have a structural reorganization of general operating system and the efficient and effective participation of private industry and regulation of industry in connection with the general system. 35 refs., 9 figs., 20 tabs.

  3. General Services Administration: FY 1998 Congressional Justification.

    Science.gov (United States)

    1997-03-20

    APPROPRIATIONS: Consumer Information Center CIC GSA InSite STATEMENT OF DAVID J. BARRAM ACTING ADMINISTRATOR, GENERAL SERVICES ADMINISTRATION BEFORE THE...When I tell people about change at GSA, they sometimes give me a strange look, perhaps thinking that "this poor guy from California believes that a...in every area in which we operate. I think three impulses drive us toward change. First, we believe the customer is king. We’re learning what that

  4. User involvement and supporting tools in business-to-business service innovations: Insights from Facility Management services

    DEFF Research Database (Denmark)

    Nardelli, Giulia

    is the generalizability of the findings to other business-to-business service sectors. More research conducted both in FM services and other service sectors would help to shed light on the generalizability of these findings. Originality/value – The study contributes with new and detailed insights into the complexity......Purpose – This article investigates and conceptualizes user involvement in business-to-business service innovations as well as the tools that are used to support interactions in such a service innovation process. Design/methodology/approach – The paper uses a qualitative research approach to answer...... the research question. By following Miles and Huberman (1984)’s this study started with a literature review of studies investigating service innovation, service innovations models, user roles and tools in service innovation in general, to conduct an empirical investigation in facility management (FM) services...

  5. Innovation Sources and Role of ICT in Facilities Services

    DEFF Research Database (Denmark)

    Scupola, Ada; Holzweber, Markus; Tuunainen, VK.

    2010-01-01

    structured interviews with main actors in the facilities management market. Our main finding is that facilities services innovation is mainly driven by management. However, employees also contribute to innovation. Customers have also a role in co-creation and as customer pull, even though these roles seem......In this paper, we investigate innovation sources in facilities services and the role that ICT has in supporting such innovation processes. Based on literature review, we propose a conceptual framework, which is then used to analyze empirical data. The empirical data was collected through seven semi...

  6. Radiation processing facilities and services in Malaysia

    International Nuclear Information System (INIS)

    Zulkafli Ghazali

    2007-01-01

    It is envisaged that radiation processing will continue to play an important role towards the progress and development of industry in Malaysia. Malaysian Government will continue to play an active role to support R and D in this field by providing the necessary infrastructure, facility, trained manpower and research funds. Additional e-beam accelerator is planned to be installed at Nuclear Malaysia in 2007. The medium energy electron beam accelerator (1 MeV, 50 mA) will be mainly use to evaluate the commercial viability for treating aqueous products such as wastewater. (author)

  7. Hanford facility dangerous waste permit application, general information portion

    International Nuclear Information System (INIS)

    Hays, C.B.

    1998-01-01

    The Hanford Facility Dangerous Waste Permit Application is considered to be a single application organized into a General Information Portion (document number DOE/RL-91-28) and a Unit-Specific Portion. Both the General Information and Unit-Specific portions of the Hanford Facility Dangerous Waste Permit Application address the content of the Part B permit application guidance prepared by the Washington State Department of Ecology (Ecology 1996) and the U.S. Environmental Protection Agency (40 Code of Federal Regulations 270), with additional information needed by the Hazardous and Solid Waste Amendments and revisions of Washington Administrative Code 173-303. Documentation contained in the General Information Portion is broader in nature and could be used by multiple treatment, storage, and/or disposal units (e.g., the glossary provided in this report)

  8. General fire protection guidelines for egyptian nuclear facilities. Vol. 4

    Energy Technology Data Exchange (ETDEWEB)

    Radhad, S; Hussien, A Z; Hammad, F H [National Center for Nuclear Safety and Radiation Control, Atomic Energy Authority, Cairo (Egypt)

    1996-03-01

    The purpose of this paper is to establish the regulatory requirements of that will provide and ensure fire protection of egyptian nuclear facilities. Those facilities that use, handle and store low and/or medium radioactive substances are included. Two or more classes of occupancy are considered to occur in the same building or structure. Fir protection measures and systems were reviewed for three of the egyptian Nuclear facilities. These are egypt first nuclear reactor (ETRR-1) building and systems, hot laboratories buildings and facilities, and the building including the AECL type Is-6500 industrial cobalt-60 gamma irradiator {sup E}gypt`s mega gamma I{sup .} The study includes the outlines of the various aspects of fire protection with a view to define the relevant highlights and scope of egyptian guideline for nuclear installations. The study considers fire protection aspects including the following items: 1- Site selection. 2- General facility design. 3- Fire alarm, detection and suppression systems. (4- Protection for specific areas/control room, cable spreading room, computer room) 5- Fire emergency response planning. 6- Fire water supply. 7- Emergency lighting and communication. 8- Rescue and escape routes. 9- Explosion protection. 10-Manual fire fighting. 11- Security consideration in the interest of fire protection. 12- quality assurance programme. Therefore, first of all the design stage, then during the construction stage, and later during the operation stage, measures must be taken to forestall the risks associated with the outbreak of fire and to ensure that consequences of fire accidents remain limited.

  9. Analysis of general specifications for nuclear facilities environmental monitoring vehicles

    International Nuclear Information System (INIS)

    Xu Xiaowei

    2014-01-01

    At present, with the nuclear energy more increasingly extensive application, the continuous stable radiation monitoring has become the focus of the public attention. The main purpose of the environmental monitoring vehicle for the continuous monitoring of the environmental radiation dose rate and the radionuclides concentration in the medium around nuclear facilities is that the environmental radiation level and the radioactive nuclides activity in the environment medium are measured. The radioactive pollution levels, the scope contaminated and the trends of the pollution accumulation are found out. The change trends for the pollution are observed and the monitoring results are explained. The domestic demand of the environmental monitoring for the nuclear facilities is shown in this report. The changes and demands of the routine environmental monitoring and the nuclear emergency monitoring are researched. The revision opinions for EJ/T 981-1995 General specifications for nuclear facilities environmental monitoring vehicles are put forward. The purpose is to regulate domestic environmental monitoring vehicle technical criterion. The criterion makes it better able to adapt and serve the environmental monitoring for nuclear facilities. The technical guarantee is provided for the environmental monitoring of the nuclear facilities. (authors)

  10. General fire protection guidelines for egyptian nuclear facilities. Vol. 4

    International Nuclear Information System (INIS)

    Radhad, S.; Hussien, A.Z.; Hammad, F.H.

    1996-01-01

    The purpose of this paper is to establish the regulatory requirements of that will provide and ensure fire protection of egyptian nuclear facilities. Those facilities that use, handle and store low and/or medium radioactive substances are included. Two or more classes of occupancy are considered to occur in the same building or structure. Fir protection measures and systems were reviewed for three of the egyptian Nuclear facilities. These are egypt first nuclear reactor (ETRR-1) building and systems, hot laboratories buildings and facilities, and the building including the AECL type Is-6500 industrial cobalt-60 gamma irradiator E gypt's mega gamma I . The study includes the outlines of the various aspects of fire protection with a view to define the relevant highlights and scope of egyptian guideline for nuclear installations. The study considers fire protection aspects including the following items: 1- Site selection. 2- General facility design. 3- Fire alarm, detection and suppression systems. 4- Protection for specific areas/control room, cable spreading room, computer room) 5- Fire emergency response planning. 6- Fire water supply. 7- Emergency lighting and communication. 8- Rescue and escape routes. 9- Explosion protection. 10-Manual fire fighting. 11- Security consideration in the interest of fire protection. 12- quality assurance programme. Therefore, first of all the design stage, then during the construction stage, and later during the operation stage, measures must be taken to forestall the risks associated with the outbreak of fire and to ensure that consequences of fire accidents remain limited

  11. Fleet servicing facilities for testing and maintaining rail and truck radioactive waste transport systems

    International Nuclear Information System (INIS)

    Watson, C.D.; Hudson, B.J.; Preston, M.K.; Keith, D.A.; McCreery, P.N.; Knox, W.; Easterling, E.M.; Lamprey, A.S.; Wiedemann, G.

    1980-01-01

    This paper examines feasibility design concepts and feasibility studies of Fleet Servicing Facilities (FSF). Such facilities are intended to be used for routine servicing, preventive maintenance, and for performing requalification license compliance tests and inspections, minor repairs, and decontamination of both the transportation casks and their associated rail cars or tractor-trailers. None of the waste handling plants in the United States presently receiving radioactive wastes have an onsite FSF, nor is there an existing third party facility providing all of these services. This situation has caused the General Accounting Office to express concern regarding the quality of waste transport system maintenance once the transport system is placed into service. Thus a need is indicated for FSFs or their equivalent at various radioactive materials receiving sites. This paper also compares the respective capital costs and operating characteristics of the following three concepts of a spent fuel cask transportation FSF; integrated FSF, colocated FSF, and independent FSF

  12. Hanford Facility dangerous waste permit application, general information

    International Nuclear Information System (INIS)

    1993-05-01

    The current Hanford Facility Dangerous Waste Permit Application is considered to be a single application organized into a General Information Portion (this document, number DOE/RL-91-28) and a treatment, storage, and/or disposal Unit-Specific Portion, which includes documentation for individual TSD units (e.g., document numbers DOE/RL-89-03 and DOE/RL-90-01). Both portions consist of a Part A division and a Part B division. The Part B division consists of 15 chapters that address the content of the Part B checklists prepared by the Washington State Department of Ecology (Ecology 1987) and the US Environmental Protection Agency (40 Code of Federal Regulations 270), with additional information requirements mandated by the Hazardous and Solid Waste Amendments of 1984 and revisions of Washington Administrative Code 173-303. For ease of reference, the Washington State Department of Ecology checklist section numbers, in brackets, follow the chapter headings and subheadings. Documentation contained in the General Information Portion (i.e., this document, number DOE/RL-91-28) is broader in nature and applies to all treatment, storage, and/or disposal units for which final status is sought. Because of its broad nature, the Part A division of the General Information Portion references the Hanford Facility Dangerous Waste Part A Permit Application (document number DOE/RL-88-21), a compilation of all Part A documentation for the Hanford Facility

  13. LAFD: TA-55 General Facility Familiarization Tour, Course #55261

    Energy Technology Data Exchange (ETDEWEB)

    Rutherford, Victor Stephen [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Miller, Joshua [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Mason, Robert Clifford [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2018-01-10

    Los Alamos National Laboratory (LANL) will conduct familiarization tours for personnel of the Los Alamos County Fire Department (LAFD) at the TA-55 General Facility. These familiarization tours are official LANL business; the purpose of these tours is to orient LAFD firefighters to the facility so that they can respond efficiently and quickly to a variety of emergency situations. This orientation includes, among other topics, ingress and egress of the area and buildings, layout and organization of the facility, evacuation procedures and assembly points, and areas of concern within the various buildings at the facility. LAFD firefighters have the skills and abilities to perform firefighting operations and other emergency response tasks that cannot be provided by LANL personnel who have the required clearance level. This handout provides details of the information, along with maps and diagrams, to be presented during the familiarization tours. The handout will be distributed to the trainees at the time of the tour. A corresponding checklist will also be used as guidance during the familiarization tours to ensure that all required information is presented to LAFD personnel.

  14. Advanced light microscopy core facilities: Balancing service, science and career

    Science.gov (United States)

    Hartmann, Hella; Reymann, Jürgen; Ansari, Nariman; Utz, Nadine; Fried, Hans‐Ulrich; Kukat, Christian; Peychl, Jan; Liebig, Christian; Terjung, Stefan; Laketa, Vibor; Sporbert, Anje; Weidtkamp‐Peters, Stefanie; Schauss, Astrid; Zuschratter, Werner; Avilov, Sergiy

    2016-01-01

    ABSTRACT Core Facilities (CF) for advanced light microscopy (ALM) have become indispensable support units for research in the life sciences. Their organizational structure and technical characteristics are quite diverse, although the tasks they pursue and the services they offer are similar. Therefore, throughout Europe, scientists from ALM‐CFs are forming networks to promote interactions and discuss best practice models. Here, we present recommendations for ALM‐CF operations elaborated by the workgroups of the German network of ALM‐CFs, German Bio‐Imaging (GerBI). We address technical aspects of CF planning and instrument maintainance, give advice on the organization and management of an ALM‐CF, propose a scheme for the training of CF users, and provide an overview of current resources for image processing and analysis. Further, we elaborate on the new challenges and opportunities for professional development and careers created by CFs. While some information specifically refers to the German academic system, most of the content of this article is of general interest for CFs in the life sciences. Microsc. Res. Tech. 79:463–479, 2016. © 2016 THE AUTHORS MICROSCOPY RESEARCH AND TECHNIQUE PUBLISHED BY WILEY PERIODICALS, INC. PMID:27040755

  15. 78 FR 10174 - Public Availability of General Services Administration FY 2012 Service Contract Inventory

    Science.gov (United States)

    2013-02-13

    ... GENERAL SERVICES ADMINISTRATION [Notice-MV-2013-02; Docket No. 2013-0002; Sequence 3] Public Availability of General Services Administration FY 2012 Service Contract Inventory AGENCY: General Services Administration (GSA). ACTION: Notice of Public Availability of FY 2012 Service Contract Inventories. SUMMARY: In...

  16. Use of health services by residents at a seniors-only living facility

    Directory of Open Access Journals (Sweden)

    Elen Ferraz Teston

    2013-10-01

    Full Text Available The objective of the study was to compare the use of medical and dental services by seniors residing at a seniors-only living facility and in the general community. It was a quantitative study, among 50 residents of the living facility and 173 in the general community. The data were collected between November 2011 and February 2012 through a questionnaire, and subjected to statistical analysis. Performance of clinical exams and satisfaction with health services was greater among seniors living in the general community; however, physical therapy treatment was more common among those living in the facility. The use of medical and dental services showed a statistically significant difference. The seniors in both groups need oral health monitoring and those living in the facility also require coverage by the Family Health Strategy. The presence of professionals with the right profile to adequately serve residents and the network of available services are determining factors for the success of this new housing policy.

  17. The nature of innovation processes in Facility Management services

    DEFF Research Database (Denmark)

    Nardelli, Giulia

    Purpose: This work investigates the dynamics of interaction between stakeholders of Facilities Management (FM) innovation and improvement processes. The aim is to understand how the complex value chain of FM services influences innovation processes within this field. Theory: This study combines...... theories on innovation in services with research focused on the empirical field of FM. More specifically, the analytical framework for this study applies the differentiation between reactive and proactive innovation processes by Toivonen and Tuominen (2009) to the value chain identified by Coenen...... has a threefold impact on the nature of innovation processes within this field. Firstly, end-users of FM services are usually not involved in innovation processes, although they might sometimes play a role as initial drivers. Secondly, FM services are intangible but more easily reproducible than other...

  18. 77 FR 5253 - Public Availability of General Services Administration FY 2011 Service Contract Inventory

    Science.gov (United States)

    2012-02-02

    ... GENERAL SERVICES ADMINISTRATION [Notice-MV-2012-01; Docket 2012-0002; Sequence 3] Public Availability of General Services Administration FY 2011 Service Contract Inventory AGENCY: Office of Acquisition Policy (MV); General Services Administration (GSA). ACTION: Notice of public availability of FY...

  19. 76 FR 5375 - Public Availability of General Services Administration FY 2010 Service Contract Inventory

    Science.gov (United States)

    2011-01-31

    ... GENERAL SERVICES ADMINISTRATION [2011-MV-1; Docket No. 2011-0006; Sequence 4] Public Availability of General Services Administration FY 2010 Service Contract Inventory AGENCY: Office of Acquisition Policy; General Services Administration (GSA). ACTION: Notice. SUMMARY: This notice announces that GSA is...

  20. Acquisition Services Reorganization at the General Services Administration

    National Research Council Canada - National Science Library

    Smith, Stephanie

    2005-01-01

    Congress enacted the Federal Property and Administrative Services Act in 1949 to provide for an "economical and efficient system" for the Federal Government's management of real property, procurement...

  1. Characteristics of U.S. Mental Health Facilities That Offer Suicide Prevention Services.

    Science.gov (United States)

    Kuramoto-Crawford, S Janet; Smith, Kelley E; McKeon, Richard

    2016-01-01

    This study characterized mental health facilities that offer suicide prevention services or outcome follow-up after discharge. The study analyzed data from 8,459 U.S. mental health facilities that participated in the 2010 National Mental Health Services Survey. Logistic regression analyses were used to compare facilities that offered neither of the prevention services with those that offered both or either service. About one-fifth of mental health facilities reported offering neither suicide prevention services nor outcome follow-up. Approximately one-third offered both, 25% offered suicide prevention services only, and 21% offered only outcome follow-up after discharge. Facilities that offered neither service were less likely than facilities that offered either to offer comprehensive support services or special programs for veterans; to offer substance abuse services; and to be accredited, licensed, or certified. Further examination of facilitators and barriers in implementing suicide prevention services in mental health facilities is warranted.

  2. Hanford Facility resource conservation and recovery act permit general inspection plan

    International Nuclear Information System (INIS)

    Beagles, D.B.

    1995-12-01

    The Hanford Facility Resource Conservation and Recovery Act Permit, General Inspection Requirements, includes a requirement that general facility inspections be conducted of the 100, 200 East, 200 West, 300, 400, and 1100 Areas and the banks of the Columbia River. This inspection plan describes the activities that shall be conducted for a general inspection of the Hanford Facility

  3. Service quality and patient experiences of ambulatory care in a specialized clinic vs. a general hospital.

    Science.gov (United States)

    De Regge, Melissa; De Groote, Hélène; Trybou, Jeroen; Gemmel, Paul; Brugada, Pedro

    2017-04-01

    Health care organizations are constantly looking for ways to establish a differential advantage to attract customers. To this end, service quality has become an important differentiator in the strategy of health care organizations. In this study, we compared the service quality and patient experience in an ambulatory care setting of a physician-owned specialized facility with that of a general hospital. A comparative case study with a mixed method design was employed. Data were gathered through a survey on health service quality and patient experience, completed with observations, walkthroughs, and photographic material. Service quality and patient experiences are high in both the investigated health care facilities. A significant distinction can be made between the two facilities in terms of interpersonal quality (p = 0.001) and environmental quality (P ≤ 0.001), in favor of the medical center. The difference in environmental quality is also indicated by the scores given by participants who had been in both facilities. Qualitative analysis showed higher administrative quality in the medical center. Environmental quality and patient experience can predict the interpersonal quality; for environmental quality, interpersonal quality and age are significant predictors. Service quality and patient experiences are high in both facilities. The medical center has higher service quality for interpersonal and environmental service quality and is more process-centered.

  4. 40 CFR 279.52 - General facility standards.

    Science.gov (United States)

    2010-07-01

    ... familiar with all aspects of the facility's contingency plan, all operations and activities at the facility... response roles if their help is needed. (ii) Whenever there is a release, fire, or explosion, the emergency...

  5. General considerations for neutron capture therapy at a reactor facility

    International Nuclear Information System (INIS)

    Binney, S.E.

    2001-01-01

    In addition to neutron beam intensity and quality, there are also a number of other significant criteria related to a nuclear reactor that contribute to a successful neutron capture therapy (NCT) facility. These criteria are classified into four main categories: Nuclear design factors, facility management and operations factors, facility resources, and non-technical factors. Important factors to consider are given for each of these categories. In addition to an adequate neutron beam intensity and quality, key requirements for a successful neutron capture therapy facility include necessary finances to construct or convert a facility for NCT, a capable medical staff to perform the NCT, and the administrative support for the facility. The absence of any one of these four factors seriously jeopardizes the overall probability of success of the facility. Thus nuclear reactor facility management considering becoming involved in neutron capture therapy, should it be proven clinically successful, should take all these factors into consideration. (author)

  6. 46 CFR 13.127 - Service: General.

    Science.gov (United States)

    2010-10-01

    ... restricted endorsement, a specific product) handled while the applicant accumulated the service; (2) The... discharged at the same time, a person may receive credit for only one transfer, one loading, and one discharge a watch. (5) Credit for a transfer during a watch of less than four hours accrues only if the...

  7. The General Agreement on Trade in Services

    Directory of Open Access Journals (Sweden)

    Francina Esteve García

    1995-07-01

    Full Text Available The conclusion of GATS and its inclusion as an annex in the constitutive Agreement of the World Trade Organization (WTO responds to the need for disposing of a stable juridical instrument which, given the current economic interdependence between States, can be applied to the international trade in services.One of the main new features of this agreement is its field of application given that it includes all service sectors (except those provided for in the name of governmental authorities and the four forms of carrying out trade in services and, as regards the principle of market access and that of national treatment, will be regulated according to those respective obligations which the Members have assumed.In exchange for not accepting the exclusion of any service sector, the negotiations concerning some fundamental sectors could not be totally closed and deadlines were extended in order to unblock the most controversial themes.One of the fundamental principles of the GATS is the most favoured nation clause of inconditional character but its consecration has been attenuated by the possibility of maintaining important exceptions in its application. The principle of transparency is also essential in the field of services, given that this sector is characterised by large public interventionism in access regulation and the exercise of the different economic activities which form it.The balance of the GATS is globally positive given that it includes a multilateral framework of principles and disciplines which is administered in the headquarters of the WTO, which have been accepted by a great majority of States within the international community and which remain subject to the WTO’s mechanism for the solution of differences.However, the opening of the market and the suppression of restrictions which derive from internal regulations have not been achieved given that, orientating itself around the objectives of national politics, liberalization is

  8. Algebraic Generalization Strategies Used by Kuwaiti Pre-Service Teachers

    Science.gov (United States)

    Alajmi, Amal Hussain

    2016-01-01

    This study reports on the algebraic generalization strategies used by elementary and middle/high school pre-service mathematics teachers in Kuwait. They were presented with 9 tasks that involved linear, exponential, and quadratic situations. The results showed that these pre-service teachers had difficulty in generalizing algebraic rules in all 3…

  9. Development and Assessment of Service Learning Projects in General Biology

    Science.gov (United States)

    Felzien, Lisa; Salem, Laura

    2008-01-01

    Service learning involves providing service to the community while requiring students to meet learning goals in a specific course. A service learning project was implemented in a general biology course at Rockhurst University to involve students in promoting scientific education in conjunction with community partner educators. Students were…

  10. Service profiles of general practitioners in Europe.

    NARCIS (Netherlands)

    Boerma, W.G.W.; Zee, J. van der; Fleming, D.M.

    1997-01-01

    Background. General practice is the focal point of primary care. There are national differences in the structure and organization of practice, the relationship with secondary care is being redefined, and in some countries major changes are taking place. Aim. To describe and examine differences in

  11. EPA Facility Registry Service (FRS): ER_FRP

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link to Facility...

  12. Evaluating Commercial and Private Cloud Services for Facility-Scale Geodetic Data Access, Analysis, and Services

    Science.gov (United States)

    Meertens, C. M.; Boler, F. M.; Ertz, D. J.; Mencin, D.; Phillips, D.; Baker, S.

    2017-12-01

    UNAVCO, in its role as a NSF facility for geodetic infrastructure and data, has succeeded for over two decades using on-premises infrastructure, and while the promise of cloud-based infrastructure is well-established, significant questions about suitability of such infrastructure for facility-scale services remain. Primarily through the GeoSciCloud award from NSF EarthCube, UNAVCO is investigating the costs, advantages, and disadvantages of providing its geodetic data and services in the cloud versus using UNAVCO's on-premises infrastructure. (IRIS is a collaborator on the project and is performing its own suite of investigations). In contrast to the 2-3 year time scale for the research cycle, the time scale of operation and planning for NSF facilities is for a minimum of five years and for some services extends to a decade or more. Planning for on-premises infrastructure is deliberate, and migrations typically take months to years to fully implement. Migrations to a cloud environment can only go forward with similar deliberate planning and understanding of all costs and benefits. The EarthCube GeoSciCloud project is intended to address the uncertainties of facility-level operations in the cloud. Investigations are being performed in a commercial cloud environment (Amazon AWS) during the first year of the project and in a private cloud environment (NSF XSEDE resource at the Texas Advanced Computing Center) during the second year. These investigations are expected to illuminate the potential as well as the limitations of running facility scale production services in the cloud. The work includes running parallel equivalent cloud-based services to on premises services and includes: data serving via ftp from a large data store, operation of a metadata database, production scale processing of multiple months of geodetic data, web services delivery of quality checked data and products, large-scale compute services for event post-processing, and serving real time data

  13. Decommissioning of Facilities. General Safety Requirements. Pt. 6

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2014-07-15

    Decommissioning is the last step in the lifetime management of a facility. It must also be considered during the design, construction, commissioning and operation of facilities. This publication establishes requirements for the safe decommissioning of a broad range of facilities: nuclear power plants, research reactors, nuclear fuel cycle facilities, facilities for processing naturally occurring radioactive material, former military sites, and relevant medical, industrial and research facilities. It addresses all the aspects of decommissioning that are required to ensure safety, aspects such as roles and responsibilities, strategy and planning for decommissioning, conduct of decommissioning actions and termination of the authorization for decommissioning. It is intended for use by those involved in policy development, regulatory control and implementation of decommissioning.

  14. Decommissioning of Facilities. General Safety Requirements. Pt. 6 (Spanish Edition)

    International Nuclear Information System (INIS)

    2017-01-01

    Decommissioning is the last step in the lifetime management of a facility. It must also be considered during the design, construction, commissioning and operation of facilities. This publication establishes requirements for the safe decommissioning of a broad range of facilities: nuclear power plants, research reactors, nuclear fuel cycle facilities, facilities for processing naturally occurring radioactive material, former military sites, and relevant medical, industrial and research facilities. It addresses all the aspects of decommissioning that are required to ensure safety, aspects such as roles and responsibilities, strategy and planning for decommissioning, conduct of decommissioning actions and termination of the authorization for decommissioning. It is intended for use by those involved in policy development, regulatory control and implementation of decommissioning.

  15. Decommissioning of Facilities. General Safety Requirements. Pt. 6 (Russian Edition)

    International Nuclear Information System (INIS)

    2015-01-01

    Decommissioning is the last step in the lifetime management of a facility. It must also be considered during the design, construction, commissioning and operation of facilities. This publication establishes requirements for the safe decommissioning of a broad range of facilities: nuclear power plants, research reactors, nuclear fuel cycle facilities, facilities for processing naturally occurring radioactive material, former military sites, and relevant medical, industrial and research facilities. It addresses all the aspects of decommissioning that are required to ensure safety, aspects such as roles and responsibilities, strategy and planning for decommissioning, conduct of decommissioning actions and termination of the authorization for decommissioning. It is intended for use by those involved in policy development, regulatory control and implementation of decommissioning

  16. Quick-Reaction Report on the Audit of ReCoupment Actions on Medicine Payments to Uniformed Services Treatment Facilities.

    Science.gov (United States)

    1993-07-21

    OFFICE OF THE INSPECTOR GENERAL QUICK-REACTION REPORT ON THE AUDIT OF RECOUPMENT ACTIONS ON MEDICARE PAYMENTS TO UNIFORMED SERVICES TREATMENT...Quick-Reaction Report on the Audit of Recoupment Actions on Medicare Payments to Uniformed Services Treatment Facilities (Report No. 93-150) We are...Inspectors General will provide a joint report to the congressional committees that requested the audit . The courtesies extended to the audit staff

  17. General Models for Assessing Hazards Aircraft Pose to Surface Facilities

    International Nuclear Information System (INIS)

    Ragan, G.E.

    2002-01-01

    This paper derives formulas for estimating the frequency of accidental aircraft crashes into surface facilities. Objects unintentionally dropped from aircraft are also considered. The approach allows the facility to be well within the flight area; inside the flight area, but close to the edge; or completely outside the flight area

  18. 33 CFR 158.310 - Reception facilities: General.

    Science.gov (United States)

    2010-07-01

    ... order to pass the inspection under § 158.160, must— (1) Be a reception facility as defined under § 158... residue; (5) Be capable of receiving NLS residue from an oceangoing ship within 24 hours after notice by that ship of the need for reception facilities; and (6) Be capable of completing the transfer of NLS...

  19. General problems specific to hot nuclear materials research facilities

    International Nuclear Information System (INIS)

    Bart, G.

    1996-01-01

    During the sixties, governments have installed hot nuclear materials research facilities to characterize highly radioactive materials, to describe their in-pile behaviour, to develop and test new reactor core components, and to provide the industry with radioisotopes. Since then, the attitude towards the nuclear option has drastically changed and resources have become very tight. Within the changed political environment, the national research centres have defined new objectives. Given budgetary constraints, nuclear facilities have to co-operate internationally and to look for third party research assignments. The paper discusses the problems and needs within experimental nuclear research facilities as well as industrial requirements. Special emphasis is on cultural topics (definition of the scope of nuclear research facilities, the search for competitive advantages, and operational requirements), social aspects (overageing of personnel, recruitment, and training of new staff), safety related administrative and technical issues, and research needs for expertise and state of the art analytical infrastructure

  20. 77 FR 18272 - Uranium Enrichment Fuel Cycle Facility Inspection Reports Regarding Louisiana Energy Services LLC...

    Science.gov (United States)

    2012-03-27

    ... NUCLEAR REGULATORY COMMISSION [Docket No. 70-3103; NRC-2010-0264] Uranium Enrichment Fuel Cycle Facility Inspection Reports Regarding Louisiana Energy Services LLC, National Enrichment Facility, Eunice... Louisiana Energy Services (LES), LLC, National enrichment Facility in Eunice, New Mexico, and has verified...

  1. 77 FR 65729 - Uranium Enrichment Fuel Cycle Facility Inspection Reports Regarding Louisiana Energy Services LLC...

    Science.gov (United States)

    2012-10-30

    ... NUCLEAR REGULATORY COMMISSION [Docket No. 70-3103; NRC-2010-0264] Uranium Enrichment Fuel Cycle Facility Inspection Reports Regarding Louisiana Energy Services LLC, National Enrichment Facility, Eunice... Services (LES), LLC, National Enrichment Facility in Eunice, New Mexico, and has verified that cascades...

  2. 42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

    Science.gov (United States)

    2010-10-01

    ... under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... Services of Inpatient Psychiatric Facilities § 412.405 Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. The prospective payment system...

  3. Optimal pricing policies for services with consideration of facility maintenance costs

    Science.gov (United States)

    Yeh, Ruey Huei; Lin, Yi-Fang

    2012-06-01

    For survival and success, pricing is an essential issue for service firms. This article deals with the pricing strategies for services with substantial facility maintenance costs. For this purpose, a mathematical framework that incorporates service demand and facility deterioration is proposed to address the problem. The facility and customers constitute a service system driven by Poisson arrivals and exponential service times. A service demand with increasing price elasticity and a facility lifetime with strictly increasing failure rate are also adopted in modelling. By examining the bidirectional relationship between customer demand and facility deterioration in the profit model, the pricing policies of the service are investigated. Then analytical conditions of customer demand and facility lifetime are derived to achieve a unique optimal pricing policy. The comparative statics properties of the optimal policy are also explored. Finally, numerical examples are presented to illustrate the effects of parameter variations on the optimal pricing policy.

  4. 42 CFR 440.40 - Nursing facility services for individuals age 21 or older (other than services in an institution...

    Science.gov (United States)

    2010-10-01

    ... older (other than services in an institution for mental disease), EPSDT, and family planning services... institution for mental disease), EPSDT, and family planning services and supplies. (a) Nursing facility... institution for mental diseases”, means services that are— (i) Needed on a daily basis and required to be...

  5. Provision of family planning services in Tanzania: a comparative analysis of public and private facilities

    NARCIS (Netherlands)

    Kakoko, D.C.; Ketting, E.; Kamazima, S.R.; Ruben, R.

    2012-01-01

    Adherence to the policy guidelines and standards is necessary for family planning services. We compared public and private facilities in terms of provision of family planning services. We analyzed data from health facility questionnaire of the 2006 Tanzania Service Provision Assessment survey, based

  6. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Science.gov (United States)

    2010-10-01

    ... Services of Residents § 415.204 Services of residents in skilled nursing facilities and home health... 42 Public Health 3 2010-10-01 2010-10-01 false Services of residents in skilled nursing facilities and home health agencies. 415.204 Section 415.204 Public Health CENTERS FOR MEDICARE & MEDICAID...

  7. 42 CFR 440.155 - Nursing facility services, other than in institutions for mental diseases.

    Science.gov (United States)

    2010-10-01

    ... institutions for mental diseases. 440.155 Section 440.155 Public Health CENTERS FOR MEDICARE & MEDICAID... PROVISIONS Definitions § 440.155 Nursing facility services, other than in institutions for mental diseases. (a) “Nursing facility services, other than in an institution for mental diseases” means services...

  8. [Provision of building maintenance services in healthcare facilities].

    Science.gov (United States)

    Amorim, Gláucia Maria; Quintão, Eliana Cardoso Vieira; Martelli Júnior, Hercílio; Bonan, Paulo Rogério Ferreti

    2013-01-01

    The scope of this paper was to evaluate the provision of building maintenance services in health units, by means of a descriptive, quantitative and cross-sectional study, considering the five types of facilities (Primary Health, Emergency, Specialty, Hospital and Mental Health Units). The research was approved by the Research Ethics Comittee of FHEMIG with the Terms of Agreement signed with the Unified Health System of Betim. Comparative analysis was conducted by checking the requirements of "Physical-Functional Structure Management" of the "Brazilian Hospital Accreditation Manual" of the National Accreditation Organization. Nonconformities were noted in the physical-functional management of the health centers, especially the primary health units. The assessment was important, considering that compliance with formal, technical and structural requirements, welfare activities, according to the service organization and appropriate to the profile and complexity, can collaborate to minimize the risks of users. To improve the quality of health care establishments, it is essential that managers, backed by "top management," prioritize financial, human and material resources in planning to ensure compliance with security requirements of users in buildings.

  9. Gaps in perceived quality of facility services between stakeholders in the built learning environment

    NARCIS (Netherlands)

    Kok, Herman; Mobach, Mark P.; Omta, Onno; Alexander, K.

    2013-01-01

    Purpose - This paper aims to identify perception gaps on the quality of facility services among different users of educational buildings, and provide possible explanations for these perception gaps, and discussing the consequences regarding Facility Management (FM) governance.

  10. Potable Water Treatment Facility General Permit (PWTF GP) ...

    Science.gov (United States)

    2017-08-28

    The Final PWTF GP establishes permit eligibility conditions, Notice of Intent (NOI) requirements, effluent limitations, standards, prohibitions, and best management practices for facilities that discharge to waters in the Commonwealth of Massachusetts (including both Commonwealth and Indian country lands) and the State of New Hampshire.

  11. 9 CFR 3.1 - Housing facilities, general.

    Science.gov (United States)

    2010-01-01

    ... and areas used for storing animal food or bedding must be free of any accumulation of trash, waste material, junk, weeds, and other discarded materials. Animal areas inside of housing facilities must be.... (e) Storage. Supplies of food and bedding must be stored in a manner that protects the supplies from...

  12. 9 CFR 3.75 - Housing facilities, general.

    Science.gov (United States)

    2010-01-01

    .... Housing facilities and areas used for storing animal food or bedding must be free of any accumulation of trash, waste material, junk, weeds, and other discarded materials. Animal areas inside of housing... carrying out other husbandry requirements. (e) Storage. Supplies of food and bedding must be stored in a...

  13. Seismic risk analysis for General Electric Plutonium Facility, Pleasanton, California

    International Nuclear Information System (INIS)

    1978-01-01

    This report presents the results of a seismic risk analysis that focuses on all possible sources of seismic activity, with the exception of the postulated Verona Fault. The best estimate curve indicates that the Vallecitos facility will experience 30% g with a return period of roughly 130 years and 60% g with a return period of roughly 700 years

  14. perception and utilization of oral histopathology services by general ...

    African Journals Online (AJOL)

    GENERAL PRACTICE DENTIST IN SOUTHWEST NIGERIA pathology ... Keywords: Oral; Histopathology; General dental practice; Southwest Nigeria. Ann Ibd. Pg. Med .... Table 3: Distribution of responses indicating barriers and utilization of oral histopathology services. Perception of respondents χ2 p value. Poor. Good.

  15. A generalized Web Service response time metric to support collaborative and corroborative Web Service monitoring

    CSIR Research Space (South Africa)

    Makitla, I

    2015-12-01

    Full Text Available In this paper, we describe the development of a generalized metric for computing response time of a web service. Such a generalized metric would help to develop consensus with regards to the meanings of contracted Quality of Service (QoS) parameters...

  16. 78 FR 8589 - Verizon Services Corporation, Customer Services Clerk, General Clerk, Clarksburg, WV; Notice of...

    Science.gov (United States)

    2013-02-06

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-82,095] Verizon Services Corporation, Customer Services Clerk, General Clerk, Clarksburg, WV; Notice of Affirmative Determination... Department of Labor (Department) on January 4, 2013, workers of Verizon Services Corporation, Customer...

  17. General framework and basis of decommissioning of nuclear facilities

    International Nuclear Information System (INIS)

    Santiago, J. L.; Martin, N.; Correa, C.

    2013-01-01

    This article summarizes the legal framework defining the strategies, the main activities and the basic responsibilities and roles of the various agents involved in the decommissioning of nuclear facilities in Spain. It also describes briefly the most relevant projects and activities already developed and/or ongoing nowadays, which have positioned Spain within the small group of countries having an integrated and proved experience and know how in this particular field. (Author)

  18. West Valley Demonstration Project facilities utilization plan for the existing facilities at the Western New York Nuclear Service Center

    International Nuclear Information System (INIS)

    Skillern, C.G.

    1986-05-01

    In 1980, Congress passed Public Law 96-368, the West Valley Demonstration Project (WVDP) Act. As a primary objective, the Act authorized the US Department of Energy (DOE) to solidify the high-level waste (HLW) stored at the Western New York Nuclear Service Center (WNYNSC) into a form suitable for transportation and disposal in a federal repository. This report will describe how WVDP proposes to use the existing WNYNSC Facilities in an efficient and technically effective manner to comply with Public Law 96-368. In support of the above cited law, the DOE has entered into a ''Cooperative agreement between the United States Department of Energy and the New York State Energy Research and Development Authority on the Western New York Nuclear Service Center at West Valley, New York.'' The state-owned areas turned over to the DOE for use are as follows: Process Plant, Waste Storage, Low-Level Waste Treatment Facility, Service Facilities, Plant Security, and Additional Facilities. The Facilities Utilization Plan (FUP) describes how the state-owned facilities will be utilized to complete the Project; it is divided into five sections as follows: Executive Summary - an overview; Introduction - the WVDP approach to utilizing the WNYNSC Facilities; WVDP Systems - a brief functional description of the system, list of equipment and components to be used and decontamination and decommissioning (D and D) support; WVDP Support Facilities; and Caveats that could effect or change the potential usage of a particular area

  19. Fleet servicing facilities for servicing, maintaining, and testing rail and truck radioactive waste transport systems: functional requirements, technical design concepts and options cost estimates and comparisons

    International Nuclear Information System (INIS)

    Watson, C.D.; Hudson, B.J.; Keith, D.A.; Preston, M.K. Jr.; McCreery, P.N.; Knox, W.; Easterling, E.M.; Lamprey, A.S.; Wiedemann, G.

    1980-05-01

    This is a resource document which examines feasibility design concepts and feasibility studies of a Fleet Servicing Facility (FSF). Such a facility is intended to be used for routine servicing, preventive maintenance, and for performing requalification license compliance tests and inspections, minor repairs, and decontamination of both the transportation casks and their associated rail cars or tractor-trailers. None of the United States' waste handling plants presently receiving radioactive wastes have an on-site FSF, nor is there an existing third party facility providing these services. This situation has caused the General Accounting Office to express concern regarding the quality of waste transport system maintenance once the system is placed into service. Thus, a need is indicated for FSF's, or their equivalent, at various radioactive materials receiving sites. In this report, three forms of FSF's solely for spent fuel transport systems were examined: independent, integrated, and colocated. The independent concept was already the subject of a detailed report and is extensively referenced in this document so that capital cost comparisons of the three concepts could be made. These facilities probably could service high-level, intermediate-level, low-level, or other waste transportation systems with minor modification, but this study did not include any system other than spent fuel. Both the Integrated and Colocated concepts were assumed to be associated with some radioactive materials handling facility such as an AFR repository

  20. Car drivers’ knowledge and preferences regarding additional services at parking facilities

    NARCIS (Netherlands)

    van der Waerden, P.J.H.J.; de Bruin - Verhoeven, M.; Rodrigues da Silva, A.N.

    2017-01-01

    The paper presents a study on car drivers’ knowledge and preferences regarding additional services at parking facilities. The following eight services are investigated the presence of public toilets, parking spaces for challenged people, lockers, refreshment machines, elevators, charging points for

  1. Preoperational Subsurface Conditions at the Idaho Nuclear Technology and Engineering Center Service Waste Disposal Facility

    Energy Technology Data Exchange (ETDEWEB)

    Ansley, Shannon Leigh

    2002-02-01

    The Idaho Nuclear Technology and Engineering Center (INTEC) Service Wastewater Discharge Facility replaces the existing percolation ponds as a disposal facility for the INTEC Service Waste Stream. A preferred alternative for helping decrease water content in the subsurface near INTEC, closure of the existing ponds is required by the INTEC Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Record of Decision (ROD) for Waste Area Group 3 Operable Unit 3-13 (DOE-ID 1999a). By August 2002, the replacement facility was constructed approximately 2 miles southwest of INTEC, near the Big Lost River channel. Because groundwater beneath the Idaho National Engineering and Environmental Laboratory (INEEL) is protected under Federal and State of Idaho regulations from degradation due to INEEL activities, preoperational data required by U.S. Department of Energy (DOE) Order 5400.1 were collected. These data include preexisting physical, chemical, and biological conditions that could be affected by the discharge; background levels of radioactive and chemical components; pertinent environmental and ecological parameters; and potential pathways for human exposure or environmental impact. This document presents specific data collected in support of DOE Order 5400.1, including: four quarters of groundwater sampling and analysis of chemical and radiological parameters; general facility description; site specific geology, stratigraphy, soils, and hydrology; perched water discussions; and general regulatory requirements. However, in order to avoid duplication of previous information, the reader is directed to other referenced publications for more detailed information. Documents that are not readily available are compiled in this publication as appendices. These documents include well and borehole completion reports, a perched water evaluation letter report, the draft INEEL Wellhead Protection Program Plan, and the Environmental Checklist.

  2. Preoperational Subsurface Conditions at the Idaho Nuclear Technology and Engineering Center Service Wastewater Discharge Facility; TOPICAL

    International Nuclear Information System (INIS)

    Ansley, Shannon L.

    2002-01-01

    The Idaho Nuclear Technology and Engineering Center (INTEC) Service Wastewater Discharge Facility replaces the existing percolation ponds as a disposal facility for the INTEC Service Waste Stream. A preferred alternative for helping decrease water content in the subsurface near INTEC, closure of the existing ponds is required by the INTEC Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Record of Decision (ROD) for Waste Area Group 3 Operable Unit 3-13 (DOE-ID 1999a). By August 2002, the replacement facility was constructed approximately 2 miles southwest of INTEC, near the Big Lost River channel. Because groundwater beneath the Idaho National Engineering and Environmental Laboratory (INEEL) is protected under Federal and State of Idaho regulations from degradation due to INEEL activities, preoperational data required by U.S. Department of Energy (DOE) Order 5400.1 were collected. These data include preexisting physical, chemical, and biological conditions that could be affected by the discharge; background levels of radioactive and chemical components; pertinent environmental and ecological parameters; and potential pathways for human exposure or environmental impact. This document presents specific data collected in support of DOE Order 5400.1, including: four quarters of groundwater sampling and analysis of chemical and radiological parameters; general facility description; site specific geology, stratigraphy, soils, and hydrology; perched water discussions; and general regulatory requirements. However, in order to avoid duplication of previous information, the reader is directed to other referenced publications for more detailed information. Documents that are not readily available are compiled in this publication as appendices. These documents include well and borehole completion reports, a perched water evaluation letter report, the draft INEEL Wellhead Protection Program Plan, and the Environmental Checklist

  3. Preoperational Subsurface Conditions at the Idaho Nuclear Technology and Engineering Center Service Wastewater Discharge Facility

    International Nuclear Information System (INIS)

    Ansley, Shannon L.

    2002-01-01

    The Idaho Nuclear Technology and Engineering Center (INTEC) Service Wastewater Discharge Facility replaces the existing percolation ponds as a disposal facility for the INTEC Service Waste Stream. A preferred alternative for helping decrease water content in the subsurface near INTEC, closure of the existing ponds is required by the INTEC Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Record of Decision (ROD) for Waste Area Group 3 Operable Unit 3-13 (DOE-ID 1999a). By August 2002, the replacement facility was constructed approximately 2 miles southwest of INTEC, near the Big Lost River channel. Because groundwater beneath the Idaho National Engineering and Environmental Laboratory (INEEL) is protected under Federal and State of Idaho regulations from degradation due to INEEL activities, preoperational data required by U.S. Department of Energy (DOE) Order 5400.1 were collected. These data include preexisting physical, chemical, and biological conditions that could be affected by the discharge; background levels of radioactive and chemical components; pertinent environmental and ecological parameters; and potential pathways for human exposure or environmental impact. This document presents specific data collected in support of DOE Order 5400.1, including: four quarters of groundwater sampling and analysis of chemical and radiological parameters; general facility description; site specific geology, stratigraphy, soils, and hydrology; perched water discussions; and general regulatory requirements. However, in order to avoid duplication of previous information, the reader is directed to other referenced publications for more detailed information. Documents that are not readily available are compiled in this publication as appendices. These documents include well and borehole completion reports, a perched water evaluation letter report, the draft INEEL Wellhead Protection Program Plan, and the Environmental Checklist

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

    Science.gov (United States)

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

    2017-12-01

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

  5. Hanford Facility Resource Conservation and Recovery Act Permit General Inspection Plan

    International Nuclear Information System (INIS)

    Beagles, D.S.

    1995-02-01

    This inspection plan describes the activities that shall be conducted for a general inspection of the Hanford Facility. RCRA includes a requirement that general facility inspections be conducted of the 100, 200 East, 200 West, 300, 400, and 1100 areas and the banks of the Columbia River. This plan meets the RCRA requirements and also provides for scheduling of inspections and defines general and specific items to be noted during the inspections

  6. 78 FR 38594 - Medicare and Medicaid Programs; Requirements for Long Term Care Facilities; Hospice Services

    Science.gov (United States)

    2013-06-27

    .... The LTC facility regulations clearly specify what services the facility is required to provide to... professional caregivers and are often paid by third-party payers, such as Medicaid. These facilities are... benefit. In regulations at 42 CFR 418.112(c), we specify what must be included in a written agreement...

  7. General practitioners' perceptions of pharmacists' new services in New Zealand.

    Science.gov (United States)

    Hatah, Ernieda; Braund, Rhiannon; Duffull, Stephen; Tordoff, June

    2012-04-01

    In recent years, the pharmacy profession has moved towards more patient-oriented services. Some examples are medication review, screening and monitoring for disease, and prescribing. The new services are intended to be in close collaboration with general practitioners (GPs) yet little is known of how GPs in New Zealand perceive these new services. Objective To examine GPs' perceptions of pharmacists' new services. Study was undertaken at GPs' practices in two localities in New Zealand. Qualitative, face to face, semi-structured interviews were undertaken of 18 GPs. The cohort included GPs with less/more than 20 years of practice, and GPs who had experience of working in localities where some patients had undergone a medication review (Medicines Use Review, MUR) by community pharmacists. GPs were asked to share their perceptions about pharmacists providing some new services. Data were thematically analysed with constant comparison using NVivo 8 software. Using a business strategic planning approach, themes were further analysed and interpreted as the services' potential Strengths, Weaknesses, Opportunities and Threats (SWOTs). GPs' perceptions of pharmacists' new services. GPs were more supportive of pharmacists' playing active roles in medication review and less supportive of pharmacists practising screening-monitoring and prescribing. Discussions Pharmacists' knowledge and skills in medication use and the perceived benefits of the services to patients were considered the potential strengths of the services. Weaknesses centred around potential patient confusion and harm, conflict and irritation to GPs' practice, and the potential to fragment patient-care. Opportunities were the possibilities of improving communication, and having a close collaboration and integration with GPs' practice. Apparent threats were the GPs' perceptions of a related, and not renumerated, increase in their workloads, and the perception of limited benefit to patients. Pharmacists should

  8. 49 CFR 1242.25 - Locomotive servicing facilities (account XX-19-27).

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Locomotive servicing facilities (account XX-19-27... Structures § 1242.25 Locomotive servicing facilities (account XX-19-27). Separate common expenses according to distribution of common expenses in the following accounts: Locomotive Fuel (XX-51-67 and XX-52-67...

  9. 76 FR 11523 - Atomic Safety and Licensing Board; AREVA Enrichment Services, LLC (Eagle Rock Enrichment Facility...

    Science.gov (United States)

    2011-03-02

    ... and Licensing Board; AREVA Enrichment Services, LLC (Eagle Rock Enrichment Facility); Notice of... Governmental Entities Regarding Environmental Portion of Enrichment Facility Licensing Proceeding February 24.... White. In this 10 CFR part 70 proceeding regarding the request of applicant AREVA Enrichment Services...

  10. 77 FR 55843 - Office of Facilities Management and Program Services; Submission for OMB Review; Background...

    Science.gov (United States)

    2012-09-11

    ... of Facilities Management and Program Services; Submission for OMB Review; Background Investigations for Child Care Workers AGENCY: Office of Facilities Management and Program Services, Public Building... Act, the Regulatory Secretariat will be submitting to the Office of Management and Budget (OMB) a...

  11. Stakeholder experiences with general practice pharmacist services: a qualitative study.

    Science.gov (United States)

    Tan, Edwin C K; Stewart, Kay; Elliott, Rohan A; George, Johnson

    2013-09-11

    To explore general practice staff, pharmacist and patient experiences with pharmacist services in Australian general practice clinics within the Pharmacists in Practice Study. Qualitative study. Two general practice clinics in Melbourne, Australia, in which pharmacists provided medication reviews, patient and staff education, medicines information and quality assurance services over a 6-month period. Patients, practice staff and pharmacists. Semi-structured telephone interviews with patients, focus groups with practice staff and semi-structured interviews and periodic narrative reports with practice pharmacists. Data were analysed thematically and theoretical frameworks used to explain the findings. 34 participants were recruited: 18 patients, 14 practice staff (9 general practitioners, 4 practice nurses, 1 practice manager) and 2 practice pharmacists. Five main themes emerged: environment; professional relationships and integration; pharmacist attributes; staff and patient benefits and logistical challenges. Participants reported that colocation and the interdisciplinary environment of general practice enabled better communication and collaboration compared to traditional community and consultant pharmacy services. Participants felt that pharmacists needed to possess certain attributes to ensure successful integration, including being personable and proactive. Attitudinal, professional and logistical barriers were identified but were able to be overcome. The findings were explained using D'Amour's structuration model of collaboration and Roger's diffusion of innovation theory. This is the first qualitative study to explore the experiences of general practice staff, pharmacists and patients on their interactions within the Australian general practice environment. Participants were receptive of colocated pharmacist services, and various barriers and facilitators to integration were identified. Future research should investigate the feasibility and sustainability of

  12. General principles underlying the decommissioning of nuclear facilities

    International Nuclear Information System (INIS)

    1988-03-01

    Previous statements on the use of the term 'decommissioning' by the International Atomic Energy Agency, the Atomic Energy Control Board, and the Advisory Committee on Nuclear Safety are reviewed, culminating in a particular definition for its use in this paper. Three decommissioning phases are identified and discussed, leading to eight general principles governing decommissioning including one related to financing

  13. EPA Facility Registry Service (FRS): ER_STATE_ID

    Data.gov (United States)

    U.S. Environmental Protection Agency — To improve public health and the environment, the United States Environmental Protection Agency (USEPA) collects information about facilities, sites, or places...

  14. EPA Facility Registry Service (FRS): ER_WTP

    Data.gov (United States)

    U.S. Environmental Protection Agency — To improve public health and the environment, the United States Environmental Protection Agency (USEPA) collects information about facilities, sites, or places...

  15. EPA Facility Registry Service (FRS): ER_SIC

    Data.gov (United States)

    U.S. Environmental Protection Agency — To improve public health and the environment, the United States Environmental Protection Agency (USEPA) collects information about facilities, sites, or places...

  16. EPA Facility Registry Service (FRS): ER_NAICS

    Data.gov (United States)

    U.S. Environmental Protection Agency — To improve public health and the environment, the United States Environmental Protection Agency (USEPA) collects information about facilities, sites, or places...

  17. EPA Facility Registry Service (FRS): ER_CONTACTS

    Data.gov (United States)

    U.S. Environmental Protection Agency — To improve public health and the environment, the United States Environmental Protection Agency (USEPA) collects information about facilities, sites, or places...

  18. GANDALF - a generally applicable numerical data aquisition laboratory facility

    International Nuclear Information System (INIS)

    Lynov, J.P.; Michelsen, P.

    1983-01-01

    This report contains a description of an interactive computer program, GANDALF, for general purpose data handling. GANDALF is designed for different types of data input, it has flexible data processing possibilities, and it can produce various kinds of data output. The program is written for an HP-9825 desk-top computer in HPL-language. However, the fundamental program structure can also be applied to other computer systems with other computer languages. (author)

  19. Evaluation of a radioisotope service in a general hospital

    International Nuclear Information System (INIS)

    Mateil, P.-Y.

    1978-12-01

    The value of radioisotopes in medicine has become increasingly apparent over the last few years. Nuclear medicine however recent, has nevertheless reached adult hood and doctors appreciate its substantial contribution in the field of diagnosis especially. So far nuclear medicine has been confined to University Hospital Centres, mainly for legal reasons. However the considerable help offered by this discipline is now taken for granted in the medical world and the wholly experimental stage is long past. While this aspect of nuclar medicine still exists, and is still dealt with by the services of University Hospital Centres, radioisotopes are now used to a large extend and on a day-to-day basis in pathology. Owing to pressure of work it is difficult for UH Centres to meet all request for examinations, so would the presence of nuclear medicine Service be justified in general Hospitals. The existence of one such service at the Bayonne HC might help to answer this question. For this reason the activity of the Bayonne HC Nuclear Medicine Service during its first year of practice is examined here. For a better understanding of the position this report first presents the Bayonne Hospital and the place occupied by a nuclear Medicine service in such an establishment. The activity of this service during its first year is then studied and the situation weighed up generally [fr

  20. Anesthetic equipment, facilities and services available for pediatric ...

    African Journals Online (AJOL)

    2011-04-09

    Apr 9, 2011 ... standards and increased use of disposable anesthetic equipment. An audit of equipment and facilities for anesthetic care in pediatric patients is important and should be carried out periodically to appraise the situation for upgrading of essential anesthetic facilities and equipment. Appendix A. 18th March, ...

  1. Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo

    Directory of Open Access Journals (Sweden)

    Aveledi Blandine

    2009-12-01

    Full Text Available Abstract Background Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC. Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC and family planning (FP. Methods Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. Results None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive. Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Conclusions Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1 providing necessary equipment and renovations to health facilities; 2 improving supply management systems; 3 providing comprehensive competency

  2. Maintaining Department of Energy facilities general design criteria

    International Nuclear Information System (INIS)

    Metzler, J.F.

    1985-01-01

    A General Design Criteria (GDC) Planning Board has been established in the Department of Energy to streamline the improvement and maintenance of the GDC Manual. This Planning Board, composed of a membership from field organizations and Headquarters programmatic offices, started work on 15 enhancements to the GDC Manual. One of those enhancements details natural phenomena hazards criteria. In the past year the Planning Board submitted a major recommendation which has been implemented into what is known as the GDC Improvements project. The result of this project pledges to dramatically increase the GDC Manual's utilization and effectiveness

  3. Provision of general paediatric surgical services in a regional hospital.

    LENUS (Irish Health Repository)

    Zgraj, O

    2012-01-31

    BACKGROUND: In Ireland, specialist paediatric surgery is carried out in paediatric hospitals in Dublin. General surgeons\\/consultants in other surgical specialities provide paediatric surgical care in regional centres. There has been a failure to train general surgeons with paediatric skills to replace these surgeons upon retirement. AIM: To assess paediatric surgical workload in one regional centre to focus the debate regarding the future provision of general paediatric surgery in Ireland. METHODS: Hospital in-patient enquiry (HIPE) system was used to identify total number of paediatric surgical admissions and procedures. Cases assessed requiring hospital transfer. RESULTS: Of 17,478 surgical patients treated, 2,584 (14.8%) were under 14 years. A total of 2,154 procedures were performed. CONCLUSION: Regional centres without dedicated paediatric surgeons deliver care to large numbers of paediatric patients. The demand for care highlights the need for formal paediatric services\\/appropriate surgical training for general surgical trainees.

  4. Wound center facility billing: A retrospective analysis of time, wound size, and acuity scoring for determining facility level of service.

    Science.gov (United States)

    Fife, Caroline E; Walker, David; Farrow, Wade; Otto, Gordon

    2007-01-01

    Outpatient wound center facility reimbursement for Medicare beneficiaries can be a challenge to determine and obtain. To compare methods of calculating facility service levels for outpatient wound centers and to demonstrate the advantages of an acuity-based billing system (one that incorporates components of facility work that is non-reimbursable by procedure codes and that represents an activity-based costing approach to medical billing), a retrospective study of 5,098 patient encounters contained in a wound care-specific electronic medical record database was conducted. Approximately 500 patient visits to the outpatient wound center of a Texas regional hospital between April 2003 and November 2004 were categorized by service level in documentation and facility management software. Visits previously billed using a time-based system were compared to the Centers for Medicare and Medicaid Services' proposed three-tiered wound size-based system. The time-based system also was compared to an acuity-based scoring system. The Pearson correlation coefficient between billed level of service by time and estimated level of service by acuity was 0.442 and the majority of follow-up visits were billed as Level 3 and above (on a time level of 1 to 5) , confirming that time is not a surrogate for actual work performed. Wound size also was found to be unrelated to service level (Pearson correlation = 0.017) and 97% of wound areas were billings than extremes; no other method produced this distribution. Hospital-based outpatient wound centers should develop, review, and refine acuity score-based models on which to determine billed level of service.

  5. Final Environmental Planning Technical Report. Public Services and Facilities

    Science.gov (United States)

    1984-06-01

    Start, coordinates the federal commodities food distribution program for low-income people, and maintains an updated human service resource manual for...organization also publishes a comprehensive resource manual on social services in Laramie County. One-to-One Tutoring provides volunteers to tutor...services by other organizacions . eoresent the total OOr-lati:n. Rate of volunteer ans •" ;rowth is forecast as follcs..: 1983 z 70.467, half tine green

  6. Tools for Stakeholder Involvement in Facility Management Service Design

    DEFF Research Database (Denmark)

    Nardelli, Giulia; Scupola, Ada

    that are more in line with the stakeholder needs and expectations, and may thus result in increased customer satisfaction, better services and, at the very end, an increased competitive advantage for the organization. Background: The background of this study lies in user involvement in service design...... in the design process as well as FM service provision processes. Research limitations: The major limitation of the study consists of the relatively small amount of interviews conducted, which is the basis for finding the tools in FM service design processes....

  7. Creation of the quality control service in radio diagnosis facilities

    International Nuclear Information System (INIS)

    Martinez, A.; Morales, J.A.; Jova, L.

    1998-01-01

    This paper shows tests and tolerance criteria employed by LSCD in delivering this service as well as all documents supporting it. Besides it also offers some results attained during the execution of this service in different hospital in the capital of the country

  8. Environmental Protection Agency (EPA) Facility Registry Service (FRS) Emergency Response (ER) Toxic Substances Control Act (TSCA) Facilities - Oil and Hazardous Materials

    Data.gov (United States)

    Department of Homeland Security — The purpose of this web feature service is to provide users with access to integrated facility information from FRS, limited to the subset of facilities that link to...

  9. Innovation in Services and Stakeholder Interactions: Cases from Facilities Management

    DEFF Research Database (Denmark)

    Nardelli, Giulia

    Services are increasingly becoming a crucial driver of the economies of developed countries. At the same time, innovation is not only recommended, but also required, to ensure survival and growth of organisations, within the manufacturing as well as the service sectors. Given globalisation...... and the development of information and communication technologies, more and more heterogeneous parties are and might be involved in innovation processes; meaning that both manufacturers and service providers shall take into consideration a more diverse set of needs and expectations when developing new offerings....... Within the service context, specifically, empirical evidence and existing research suggest that interactions between stakeholders are an important element of innovation processes. Therefore, when managing and studying innovation in the service context, interactions between stakeholders should be taken...

  10. Consumer Response to Gastrointestinal Illness Perceived To Originate from Food Service Facilities.

    Science.gov (United States)

    Garnett, Erin S; Gretsch, Stephanie R; Null, Clair; Moe, Christine L

    2016-10-01

    Consumer responses to food product recalls have been documented, but there is little information on how consumers respond to illnesses or outbreaks associated with food service facilities. This study uses an on-line survey of 885 adults conducted in 2012 to determine how respondents changed their dining behavior following personal experiences with and secondhand reports of gastrointestinal illness believed to be associated with food service facilities. In response to personally experiencing gastrointestinal illness that they attributed to a food service facility, 90% of survey participants reported that they avoided the implicated facility for a time following the incident; almost one-half decided to never return to the facility they believed had made them ill. In response to a secondhand report of gastrointestinal illness, 86% of respondents reported they would avoid the implicated facility for a time, and 22% said they would never return to the facility. After both personal experiences of illness and secondhand reports of illness, consumer responses were significantly more severe toward the implicated facility than toward all other food service facilities. Frequent diners avoided facilities for shorter periods of time and were less likely to never go back to a facility than were infrequent diners. The survey results indicate that 24 to 97 fewer meals were purchased per respondent, or a 11 to 20% reduction in meals purchased outside the home, in the year following respondents' illness. Future estimates of the economic burden of foodborne illnesses, including those caused by noroviruses, should consider the impacts on the food service industry attributable to changes in consumer behavior, in addition to health care costs and loss of productivity.

  11. Environmental Protection Agency (EPA) Facility Registry Service (FRS) Wastewater Treatment Plants

    Data.gov (United States)

    Department of Homeland Security — This GIS dataset contains data on wastewater treatment plants, based on EPA's Facility Registry Service (FRS) and NPDES, along with Clean Watersheds Needs Survey...

  12. Hospitality and Facility Care Services. Ohio's Competency Analysis Profile.

    Science.gov (United States)

    Ohio State Univ., Columbus. Vocational Instructional Materials Lab.

    Developed through a modified DACUM (Developing a Curriculum) process involving business, industry, labor, and community agency representatives in Ohio, this document is a comprehensive and verified employer competency profile for hospitality and facility care occupations. The list contains units (with and without subunits), competencies, and…

  13. The effect of the National Health Insurance Scheme (NHIS) on health service delivery in mission facilities in Ghana: a retrospective study.

    Science.gov (United States)

    Aryeetey, Genevieve Cecilia; Nonvignon, Justice; Amissah, Caroline; Buckle, Gilbert; Aikins, Moses

    2016-06-07

    In 2004, Ghana began implementation of a National Health Insurance Scheme (NHIS) to minimize out-of-pocket expenditure at the point of use of service. The implementation of the scheme was accompanied by increased access and use of health care services. Evidence suggests most health facilities are faced with management challenges in the delivery of services. The study aimed to assess the effect of the introduction of the NHIS on health service delivery in mission health facilities in Ghana. We conceptualised the effect of NHIS on facilities using service delivery indicators such as outpatient and inpatient turn out, estimation of general service readiness, revenue and expenditure, claims processing and availability of essential medicines. We collected data from 38 mission facilities, grouped into the three ecological zones; southern, middle and northern. Structured questionnaires and exit interviews were used to collect data for the periods 2003 and 2010. The data was analysed in SPSS and MS Excel. The facilities displayed high readiness to deliver services. There were significant increases in outpatient and inpatient attendance, revenue, expenditure and improved access to medicines. Generally, facilities reported increased readiness to deliver services. However, challenging issues around high rates of non-reimbursement of NHIS claims due to errors in claims processing, lack of feedback regarding errors, and lack of clarity on claims reporting procedures were reported. The implementation of the NHIS saw improvement and expansion of services resulting in benefits to the facilities as well as constraints. The constraints could be minimized if claims processing is improved at the facility level and delays in reimbursements also reduced.

  14. Environmental Control Plan for the Industrial Hygiene Field Services Facility; TOPICAL

    International Nuclear Information System (INIS)

    J. W. Donnelly

    2001-01-01

    This environmental control plan is for the Hanford Site's industrial hygiene field services facility, located in the 100-N Area. The facility is used for the maintenance and storage of respirators, respiratory equipment and testing, calibration and testing of industrial hygiene equipment, and asbestos fiber counting

  15. 76 FR 387 - Atomic Safety and Licensing Board; AREVA Enrichment Services, LLC (Eagle Rock Enrichment Facility)

    Science.gov (United States)

    2011-01-04

    ... and Licensing Board; AREVA Enrichment Services, LLC (Eagle Rock Enrichment Facility) December 17, 2010... construction and operation of a gas centrifuge uranium enrichment facility--denoted as the Eagle Rock... site at http://www.nrc.gov/materials/fuel-cycle-fac/arevanc.html . These and other documents relating...

  16. 7 CFR 1735.13 - Location of facilities and service for nonrural subscribers.

    Science.gov (United States)

    2010-01-01

    ...-TELECOMMUNICATIONS PROGRAM Loan Purposes and Basic Policies § 1735.13 Location of facilities and service for nonrural... times be necessary to provide loan funds to finance telephone facilities which (1) will also serve nonrural subscribers, or (2) are located in nonrural areas. Loans may be approved to finance such...

  17. Perception of quality of maternal healthcare services among women utilising antenatal services in selected primary health facilities in Anambra State, Southeast Nigeria

    Science.gov (United States)

    Emelumadu, Obiageli F.; Onyeonoro, Ugochukwu Uchenna; Ukegbu, Andrew Ugwunna; Ezeama, Nkiru N.; Ifeadike, Chigozie Ozoemena; Okezie, Obasi Kanu

    2014-01-01

    Background: This is a cross-sectional descriptive study aimed at assessing antenatal care service attendees’ perception of quality of maternal healthcare (MHC) services in Anambra State, southeast Nigeria. Materials and Methods: A total of 310 pregnant women utilising antenatal care (ANC) services in three purposively selected primary health centres (PHCs) in rural communities in Anambra State were studied. Reponses were elicited from the participants selected consecutively over a 4-month period, using a pre-tested, semi-structured interviewer-administered questionnaire on socio-demographic characteristics, utilisation and perception of MHC services. Data collected were analysed using SPSS version 17. Results: Findings showed that utilisation of facility for both antenatal (97.0%; 95% CI, 94.4–98.4%) and natal services (92.7%; 95% CI 89.2–95.2%) were quite high. Generally, most of the women were satisfied with MHC services (89.7%). Most of them were satisfied with the staff attitude (85.1%), waiting time (84.1%) and cost of services (79.5%). Being ≥30 years (X2 = 4.61, P = 0.032), married (X2 = 9.70, P = 0.008) and multiparous (X2 = 9.14, P = 0.028), as well as utilisation of formal health facility for antenatal (X2 = 26.94, P = 0.000) and natal (X2 = 33.42, P = 0.000) services were associated with satisfaction with maternal health services. Conclusions: The study showed high level of satisfaction with quality of maternal health services among antenatal attendees and highlights the need to strengthen interventions that increase uptake of formal MHC services. PMID:24791050

  18. Quality management standards for facility services in the Italian health care sector.

    Science.gov (United States)

    Cesarotti, Vittorio; Di Silvio, Bruna

    2006-01-01

    Health care, one of the most dynamic sectors in Italy, is studied with a particular focus on outsourcing non-core activities such as facility management (FM) services. The project's goals are to define national standards to balance and control facility service evolution, and to drive FM services towards organisational excellence. The authors, in cooperation with a pool of facility service providers and hospitals managers, studied cleaning services--one of the most critical areas. This article describes the research steps and findings following definition and publication of the Italian standard and its application to an international benchmarking process. The method chosen for developing the Italian standard was to merge technical, strategic and organisational aspects with the goal of standardising the contracting system, giving service providers the chance to improve efficiency and quality, while helping healthcare organisations gain from a better, more reliable and less expensive service. The Italian standard not only improved services but also provided adequate control systems for outsourcing organisations. In this win-win context, it is hoped to continually drive FM services towards organisational excellence. This study is specific to the Italian national healthcare system. However, the strategic dynamics described are common to many other contexts. A systematic method for improving hospital FM services is presented. The authors believe that lessons learned from their Italian case study can be used to better understand and drive similar services in other countries or in other FM service outsourcing sectors.

  19. Integrated social facility location planning for decision support: Accessibility studies provide support to facility location and integration of social service provision

    CSIR Research Space (South Africa)

    Green, Cheri A

    2012-09-01

    Full Text Available for two or more facilities to create an integrated plan for development Step 6 Costing of development plan Case Study Access norms and thresholds guidelines in accessibility analysis Appropriate norms/provision guidelines facilitate both service... access norms and threshold standards ?Test the relationship between service demand and the supply (service capacity) of the facility provision points within a defined catchment area ?Promote the ?right?sizing? of facilities relative to the demand...

  20. EPA Facility Registry Service (FRS): FRS_ESF3

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web service contains the following layers: WWTP -NPDES and WTP. The WWTP-NPDES facilties have associated CONTACTS, NAIP, SIC, and STATE IDs information. Layers...

  1. UFISA: electric facility engineering for the service of emergy market

    International Nuclear Information System (INIS)

    Gutierrez Zapico, A.

    1997-01-01

    UFISA is the engineering company with the experience of UNION ELECTRICA FENOSA S.A. It activity began in 1990. This company offers to national and international markets the services for energy consumers and for the electricity costumers. (Author)

  2. Quality of the delivery services in health facilities in Northern Ethiopia.

    Science.gov (United States)

    Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen

    2017-03-09

    Substantial improvements have been observed in the coverage of and access to maternal health service, especially in skilled birth attendants, in Ethiopia. However, the quality of care has been lagging behind. Therefore, this study investigated the status of the quality of delivery services in Northern Ethiopia. A facility based survey was conducted from December 2014 to February 2015 in Northern Ethiopia. The quality of delivery service was assessed in 32 health facilities using a facility audit checklist, by reviewing delivery, by conducting in-depth interview and observation, and by conducting exit interviews with eligible mothers. Facilities were considered as 'good quality' if they scored positively on 75% of the quality indicators set in the national guidelines for all the three components; input (materials, infrastructure, and human resource), process (adherence to standard care procedures during intrapartum and immediate postpartum periods) and output (the mothers' satisfaction and utilization of lifesaving procedures). Overall 2 of 32 (6.3%) of the study facilities fulfilled all the three quality components; input, process and output. Two of the three components were assessed as good in 11 of the 32 (34.4%) health facilities. The input quality was the better of the other quality components; which was good in 21 out of the 32 (65.6%) health facilities. The process and output quality was good in only 10 of the 32 (31.3%) facilities. Only 6.3% of the studied health facilities had good quality in all three dimensions of quality measures that was done in accordance to the national delivery service guidelines. The most compromised quality component was the process. Systematic and sustained efforts need to be strengthened to improve all dimensions of quality in order to achieve the desired quality of delivery services and increase the proportion of births occurring in health facilities.

  3. The benefits of Outsourcing facility services when selecting right service provider for a hotel:Case Kämp Group Oy

    OpenAIRE

    Paudyal, Manoj; Acharya, Saroj

    2015-01-01

    This research paper examines about the outsourcing of facility services in the Kämp group of hotels. The scope of the study includes Facility Management, outsourcing facilities services, and the selection process of the service providers for a hotel. The research was carried at the hotels of Kämp group Oy in the Metropolitan Area of Helsinki. Facility management includes wide ranges of non-core functions such as Property management, real estates, design and technology. Activities such as secu...

  4. What Is a Service of General Economic Interest?

    DEFF Research Database (Denmark)

    Ølykke, Grith Skovgaard; Møllgaard, Peter

    2016-01-01

    is subject only to a test for manifest error of assessment by the Commission. To increase legal certainty, ensure effective intervention in markets and prevent their use in industrial policy, it is highly relevant to clarify what SGEIs are. The various definitions published by the Commission......The definition of the concept a “service of general economic interest” (SGEI) known from Article 106(2) treaty of the functioning of the European Union is clarified. When a service is determined to be an SGEI, Member States may enact measures and undertakings entrusted with the provision...... of the SGEI may engage in behaviour which would otherwise be contrary to the rules of the Treaties, notably the competition rules. Member States retain a wide discretion to define, provide and finance SGEIs; i.e. to use the entrustment of an SGEI as a tool to intervene in the market. This discretion...

  5. Using a cognitive architecture for general purpose service robot control

    Science.gov (United States)

    Puigbo, Jordi-Ysard; Pumarola, Albert; Angulo, Cecilio; Tellez, Ricardo

    2015-04-01

    A humanoid service robot equipped with a set of simple action skills including navigating, grasping, recognising objects or people, among others, is considered in this paper. By using those skills the robot should complete a voice command expressed in natural language encoding a complex task (defined as the concatenation of a number of those basic skills). As a main feature, no traditional planner has been used to decide skills to be activated, as well as in which sequence. Instead, the SOAR cognitive architecture acts as the reasoner by selecting which action the robot should complete, addressing it towards the goal. Our proposal allows to include new goals for the robot just by adding new skills (without the need to encode new plans). The proposed architecture has been tested on a human-sized humanoid robot, REEM, acting as a general purpose service robot.

  6. [The importance of chronic migraine in a general neurology service].

    Science.gov (United States)

    Gracia-Naya, M; Alarcia-Alejos, R; Modrego-Pardo, P J

    Chronic migraine is a primary headache that is difficult to treat and has an important impact on the patient's quality of life. The international headache classification recently modified the criteria for chronic migraine and therefore few studies have been conducted that analyse groups according to these new criteria. AIM. To analyse a group of patients with chronic migraine who were referred to a general neurology service. The first 100 patients with migraine were selected. Researchers established and analysed a number of subgroups of patients with episodic, chronic or chronic migraine with probable headache due to medication abuse, in accordance with the International Headache Society (IHS) headache classification and its revised version from 2006. Of the total sample of 738 new patients, 100 (13.5%) suffered from migraines and of these 100 new patients with migraine 42 (5.6% of the total series) satisfied criteria for chronic migraine and 15 patients with chronic migraine met the criteria for probable headache due to medication abuse. Before visiting the neurology service, only 41% had been diagnosed as suffering from migraine, 38% had received no information about this condition, only 17% took triptans for symptomatic relief and 23% had followed some kind of preventive treatment. One notable finding was the importance of episodic and chronic migraine in a general neurology service, on applying the recent IHS criteria. A high percentage of patients with chronic migraine who were referred to the neurology service have not been diagnosed or given any information or proper treatment; an elevated degree of self-medication and medication abuse also exists. Preventive treatment and triptans in cases of intense migraines are still not commonly used in primary care.

  7. Readiness of health facilities to deliver safe male circumcision services in Tanzania: a descriptive study

    Directory of Open Access Journals (Sweden)

    Frank Felix Mosha

    2013-03-01

    Full Text Available Assessing the readiness of health facilities to deliver safe male circumcision services is more important in sub-Saharan Africa because of the inadequacy state of health facilities in many ways. The World Health Organization recommends that only facilities equipped with available trained staff, capable to perform at least minor surgery, able to offer minimum MC package and appropriate equipment for resuscitation, and compliant with requirements for sterilization and infection control should be allowed to deliver safe circumcision services. A cross-sectional study using quantitative data collection technique was conducted to assess the readiness of the health facilities to deliver safe circumcision services in selected districts of Tanzania. All hospitals, health centres and 30% of all dispensaries in these districts were selected to participate in the study. Face-toface questionnaires were administered to the heads of the health facilities and to health practitioners. Overall, 49/69 (59% of the facilities visited provided circumcision services and only 46/203 (24% of the health practitioners performed circumcision procedures. These were mainly assistant medical officers and clinical officers. The vast majority – 190/203 (95% – of the health practitioners require additional training prior to providing circumcision services. Most facilities – 63/69 (91% – had all basic supplies (gloves, basin, chlorine and waste disposal necessary for infection prevention, 44/69 (65% provided condoms, HIV counselling and testing, and sexuallytransmitted infections services, while 62/69 (90% had the capability to perform at least minor surgery. However, only 25/69 (36% and 15/69 (22% of the facilities had functioning sterilization equipment and appropriate resuscitation equipment, respectively. There is readiness for roll out of circumcision services; however, more practitioners need to be trained on circumcision procedures, demand forecasting

  8. REKAYASA KOMPONEN WEB SERVICE GENERAL LEDGER BERBASIS MICROSOFT .NET

    Directory of Open Access Journals (Sweden)

    Suhadi Lili

    2004-01-01

    Full Text Available Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} Kebutuhan akan akuntansi menjadi suatu kebutuhan yang begitu mendasar bagi perusahaan baik yang skala kecil, menengah sampai yang besar. Tak pernah terlepas sedikitpun kegiatan ekonomi di suatu perusahaan dari akuntansi dan bagian-bagian yang ada di dalamnya. Salah satu bagian dari akuntansi itu adalah General Ledger atau Buku Besar. General Ledger atau Buku Besar menjadi inti dan pokok dari akuntansi. Pada penelitian ini dikembangkan sebuah komponen yang dapat digunakan untuk membangun web service General Ledger, dimana fungsinya adalah untuk melakukan proses penjurnalan sehingga dapat secara otomatis menghasilkan laporan-laporan keuangan. Tahapan untuk membuatnya adalah dengan waterfall development model dimulai dari pencarian masalah, membuat model class, pengaturan layer hingga aplikasi dapat diimplementasikan. Dalam ujicoba yang dilakukan, komponen telah dapat berfungsi dengan baik pada saat diimplementasikan, dengan melakukan pengisian data master, pengisian jurnal dan pembuatan laporan-laporan akuntansi. Kata kunci : Komponen, Web Service, General Ledger, Akuntansi, Microsoft .NET

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

    Science.gov (United States)

    Cohn, Amy; Najavits, Lisa M

    2014-04-01

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

  10. Quality assurance requirements for control of procurement items and services for nuclear fuel reprocessing facilities

    International Nuclear Information System (INIS)

    Anon.

    1979-01-01

    Requirements and guidelines are provided for the control of activities to be exercised during procurement of items and services which affect the quality of nuclear facilities. These requirements and guidelines apply to procurement activities for items and services such as designing, purchasing, fabricating, handling, shipping, storing, cleaning, constructing, erecting, installing, inspecting, texting, maintaining and modifying

  11. 45 CFR 234.130 - Assistance in the form of institutional services in intermediate care facilities.

    Science.gov (United States)

    2010-10-01

    ... facilities as management services, building maintenance and laundry, with other units. (iv) Transfers between... in bathing, dressing, grooming, and management of personal affairs such as shopping. (c) Continuous... properly carried out and recorded; (d) Arrangements for services of a physician in the event of an...

  12. Energy efficiency in U.S. Forest Service facilities: a multiregion review

    Science.gov (United States)

    Rachelle S. Meyer; David L. Nicholls; Trista M. Patterson; Rachel E. White

    2013-01-01

    We reviewed energy efficiency measures in facilities across the U.S. Department of Agriculture Forest Service, examining opportunities and obstacles, and identifying factors of project success. The adoption of energy efficiency measures at Forest Service sites was seen to be most likely when decision control was local to the site and when budget timing and structures...

  13. 77 FR 31017 - Office of Facilities Management and Program Services; Information Collection; Background...

    Science.gov (United States)

    2012-05-24

    ... 3090-0287, Background Investigations for Child Care Workers. Instructions: Please submit comments only... request for review and approval for background check investigations of child care workers, form GSA 176C... Child Care Workers AGENCY: Office of Facilities Management and Program Services, Public Building Service...

  14. Stochastic inventory management at a service facility with a set of ...

    African Journals Online (AJOL)

    We consider a continuous review perishable inventory system at a service facility with a finite waiting capacity. The maximum inventory level is fixed and the customers arrive according to a Markov arrival process. The life time of each item and the service time are assumed to have independent exponential distributions.

  15. 42 CFR 424.14 - Requirements for inpatient services of inpatient psychiatric facilities.

    Science.gov (United States)

    2010-10-01

    ... psychiatric facilities. 424.14 Section 424.14 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Certification and Plan Requirements § 424.14 Requirements for inpatient services of inpatient psychiatric... requirements differ from those for other hospitals because the care furnished in psychiatric hospitals is often...

  16. Review of paediatric cardiology services in district general hospitals in the United Kingdom.

    Science.gov (United States)

    Andrews, Hannah; Singh, Yogen

    2016-03-01

    Following the Safe and Sustainable review of Paediatric Services in 2012/2013, National Health Service England recommended that local paediatric cardiology services should be provided by specially trained paediatricians with expertise in cardiology in all non-specialist hospitals. To understand the variation in local paediatric cardiology services provided across district general hospitals in the United Kingdom. An internet-based questionnaire was sent out via the Paediatrician with Expertise in Cardiology Special Interest Group and the Neonatologists with Interest in Cardiology and Haemodynamics contact databases and the National Health Service directory. Non-responders were followed-up via telephone. The response rate was 80% (141 of 177 hospitals), and paediatricians with expertise in cardiology were available in 68% of those. Local cardiology clinics led by paediatricians with expertise in cardiology were provided in 96 hospitals (68%), whereas specialist outreach clinics were held in 123 centres (87%). A total of 11 hospitals provided neither specialist outreach clinics nor any local cardiology clinics led by paediatricians with expertise in cardiology. Paediatric echocardiography services were provided in 83% of the hospitals, 12-lead electrocardiogram in 96%, Holter electrocardiogram in 91%, and exercise testing in only 47% of the responding hospitals. Telemedicine facilities were established in only 52% of the centres, where sharing echocardiogram images via picture archiving and communication system was used most commonly. There has been a substantial increase in the availability of paediatricians with expertise in cardiology since 2008. Most of the hospitals are well-supported by specialist cardiology centres via outreach clinics; however, there remains significant variation in the local paediatric cardiology services provided across district general hospitals in the United Kingdom.

  17. The ITER neutral beam test facility: Designs of the general infrastructure, cryosystem and cooling plant

    International Nuclear Information System (INIS)

    Cordier, J.J.; Hemsworth, R.; Chantant, M.; Gravil, B.; Henry, D.; Sabathier, F.; Doceul, L.; Thomas, E.; Houtte, D. van; Zaccaria, P.; Antoni, V.; Bello, S. Dal; Marcuzzi, D.; Antipenkov, A.; Day, C.; Dremel, M.; Mondino, P.L.

    2005-01-01

    The CEA Association is involved, in close collaboration with ENEA, FZK, IPP and UKAEA European Associations, in the first ITER neutral beam (NB) injector and the ITER neutral beam test facility design (EFDA task ref. TW3-THHN-IITF1). A total power of about 50 MW will have to be removed in steady state on the neutral beam test facility (NBTF). The main purpose of this task is to make progress with the detailed design of the first ITER NB injector and to start the conceptual design of the ITER NBTF. The general infrastructure layout of a generic site for the NBTF includes the test facility itself equipped with a dedicated beamline vessel [P.L. Zaccaria, et al., Maintenance schemes for the ITER neutral beam test facility, this conference] and integration studies of associated auxiliaries such as cooling plant, cryoplant and forepumping system

  18. The Impact of a Customer Service Intervention and Facility Design on Firm Performance

    OpenAIRE

    Joanne M. Sulek; Mary R. Lind; Ann S. Marucheck

    1995-01-01

    The purpose of this research was to investigate the impact of a customer service intervention and store design on store performance within a regional food retailing chain. A longitudinal study examines the organization's implementation of a customer service intervention which utilized new service standards and customer feedback mechanisms. Moreover, the chain provided a natural experiment, since the forty-six stores in this chain represented three levels of facility design ranging from the tr...

  19. The effect of facility-based antiretroviral therapy programs on outpatient services in Kenya and Uganda.

    Science.gov (United States)

    Wollum, Alexandra; Dansereau, Emily; Fullman, Nancy; Achan, Jane; Bannon, Kelsey A; Burstein, Roy; Conner, Ruben O; DeCenso, Brendan; Gasasira, Anne; Haakenstad, Annie; Hanlon, Michael; Ikilezi, Gloria; Kisia, Caroline; Levine, Aubrey J; Masters, Samuel H; Njuguna, Pamela; Okiro, Emelda A; Odeny, Thomas A; Allen Roberts, D; Gakidou, Emmanuela; Duber, Herbert C

    2017-08-16

    Considerable debate exists concerning the effects of antiretroviral therapy (ART) service scale-up on non-HIV services and overall health system performance in sub-Saharan Africa. In this study, we examined whether ART services affected trends in non-ART outpatient department (OPD) visits in Kenya and Uganda. Using a nationally representative sample of health facilities in Kenya and Uganda, we estimated the effect of ART programs on OPD visits from 2007 to 2012. We modeled the annual percent change in non-ART OPD visits using hierarchical mixed-effects linear regressions, controlling for a range of facility characteristics. We used four different constructs of ART services to capture the different ways in which the presence, growth, overall, and relative size of ART programs may affect non-ART OPD services. Our final sample included 321 health facilities (140 in Kenya and 181 in Uganda). On average, OPD and ART visits increased steadily in Kenya and Uganda between 2007 and 2012. For facilities where ART services were not offered, the average annual increase in OPD visits was 4·2% in Kenya and 13·5% in Uganda. Among facilities that provided ART services, we found average annual OPD volume increases of 7·2% in Kenya and 5·6% in Uganda, with simultaneous annual increases of 13·7% and 12·5% in ART volumes. We did not find a statistically significant relationship between annual changes in OPD services and the presence, growth, overall, or relative size of ART services. However, in a subgroup analysis, we found that Ugandan hospitals that offered ART services had statistically significantly less growth in OPD visits than Ugandan hospitals that did not provide ART services. Our findings suggest that ART services in Kenya and Uganda did not have a statistically significant deleterious effects on OPD services between 2007 and 2012, although subgroup analyses indicate variation by facility type. Our findings are encouraging, particularly given recent recommendations

  20. Strategic sourcing and procurement of facilities management services

    DEFF Research Database (Denmark)

    Jensen, Per Anker

    2017-01-01

    /methodology/approach: The paper investigates a strategic sourcing and procurement process in a large public organisation in Denmark based on participating in internal meetings, a workshop, document studies and interviews. The process is compared to a new ISO standard with guidance on strategic sourcing and development of FM......Purpose: The purpose it to provide insights into strategic sourcing concerning Facilities Management (FM) and how it can contribute to a sourcing decision that combines the benefits of internal and external provision with consideration of business risk and cost. Design...... agreements. Findings: A problem in the new ISO standard is that it is based on sequential model starting with detailing the demand and needs before investigating sourcing option. The case shows that the way needs are specified are depending on the chosen sourcing models. Based on a thorough analysis...

  1. Inspector General, DOD, Oversight of the Naval Audit Service Audit of the Navy General Fund Financial Statements for FY 1998

    National Research Council Canada - National Science Library

    1999-01-01

    .... This report provides our endorsement of the Naval Audit Service disclaimer of opinion on the Navy General Fund Financial Statements for FY 1998, along with the Naval Audit Service report, "Department...

  2. The time-resolved and extreme conditions XAS (TEXAS) facility at the European Synchrotron Radiation Facility: the general-purpose EXAFS bending-magnet beamline BM23.

    Science.gov (United States)

    Mathon, O; Beteva, A; Borrel, J; Bugnazet, D; Gatla, S; Hino, R; Kantor, I; Mairs, T; Munoz, M; Pasternak, S; Perrin, F; Pascarelli, S

    2015-11-01

    BM23 is the general-purpose EXAFS bending-magnet beamline at the ESRF, replacing the former BM29 beamline in the framework of the ESRF upgrade. Its mission is to serve the whole XAS user community by providing access to a basic service in addition to the many specialized instruments available at the ESRF. BM23 offers high signal-to-noise ratio EXAFS in a large energy range (5-75 keV), continuous energy scanning for quick-EXAFS on the second timescale and a micro-XAS station delivering a spot size of 4 µm × 4 µm FWHM. It is a user-friendly facility featuring a high degree of automation, online EXAFS data reduction and a flexible sample environment.

  3. 76 FR 34103 - In the Matter of Areva Enrichment Services, LLC (Eagle Rock Enrichment Facility); Notice of...

    Science.gov (United States)

    2011-06-10

    .... 10-899-02-ML-BD01] In the Matter of Areva Enrichment Services, LLC (Eagle Rock Enrichment Facility...'' portion of this proceeding regarding the December 2008 application by AREVA Enrichment Services, LLC (AES... gas centrifuge uranium enrichment facility--denoted as the Eagle Rock Enrichment Facility (EREF)--in...

  4. The time-resolved and extreme conditions XAS (TEXAS) facility at the European Synchrotron Radiation Facility: the general-purpose EXAFS bending-magnet beamline BM23

    Energy Technology Data Exchange (ETDEWEB)

    Mathon, O., E-mail: mathon@esrf.fr; Beteva, A.; Borrel, J.; Bugnazet, D.; Gatla, S.; Hino, R.; Kantor, I.; Mairs, T. [European Synchrotron Radiation Facility, CS 40220, 38043 Grenoble Cedex 9 (France); Munoz, M. [European Synchrotron Radiation Facility, CS 40220, 38043 Grenoble Cedex 9 (France); Université Joseph Fourier, 1381 rue de la Piscine, BP 53, 38041 Grenoble Cedex 9 (France); Pasternak, S.; Perrin, F.; Pascarelli, S. [European Synchrotron Radiation Facility, CS 40220, 38043 Grenoble Cedex 9 (France)

    2015-10-17

    BM23 is the general-purpose EXAFS bending-magnet beamline at the ESRF, replacing the former BM29 beamline in the framework of the ESRF upgrade. Its mission is to serve the whole XAS user community by providing access to a basic service in addition to the many specialized instruments available at the ESRF. BM23 offers high-signal-to-noise ratio EXAFS in a large energy range (5–75 keV), continuous energy scanning for quick-EXAFS on the second timescale and a micro-XAS station delivering a spot size of 4 µm × 4 µm FWHM. BM23 is the general-purpose EXAFS bending-magnet beamline at the ESRF, replacing the former BM29 beamline in the framework of the ESRF upgrade. Its mission is to serve the whole XAS user community by providing access to a basic service in addition to the many specialized instruments available at the ESRF. BM23 offers high signal-to-noise ratio EXAFS in a large energy range (5–75 keV), continuous energy scanning for quick-EXAFS on the second timescale and a micro-XAS station delivering a spot size of 4 µm × 4 µm FWHM. It is a user-friendly facility featuring a high degree of automation, online EXAFS data reduction and a flexible sample environment.

  5. Customer satisfaction in medical service encounters -- a comparison between obstetrics and gynecology patients and general medical patients.

    Science.gov (United States)

    Chang, Ching-Sheng; Weng, Hui-Ching; Chang, Hsin-Hsin; Hsu, Tsuen-Ho

    2006-03-01

    This study is concerned with the "service encounter", and seeks to describe, by use of the Service Encounter Evaluation Model, how the processes involved in the service encounter affect customer satisfaction. Its findings have implications for management practice and research directions, and recommendations are made. With the implementation of a national health insurance scheme, an ever-prospering economy and continually improving educational levels in Taiwan, demand among citizens for good health and medical care is ever increasing. Obstetrics and gynecology patients often differ greatly from general patients, in terms of their moods and emotions. This research involved an empirical study, whose subjects were 590 customers of general clinics and 339 customers of gynecology clinics, in various medical centers in southern Taiwan. By factor analysis, the study established four influencing factors, which were "Medical professionals", "Nursing professionals", "Service personnel" and "Space and facilities". Using the Linear Structural Relation Model (LISREL), it found that medical professionals, nursing professionals, service personnel and space and facilities were effective predictors of medical treatment satisfaction. We also found that the greatest positive impact on overall medical treatment satisfaction resulted from rises in satisfaction with medical professionals, but that the least impact was achieved in relation to service personnel in the general and gynecology clinics.

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

    OpenAIRE

    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 u...

  7. Regulating food service in North Carolina's long-term care facilities.

    Science.gov (United States)

    DePorter, Cindy H

    2005-01-01

    Other commentaries in this issue of the North Carolina Medical Journal describe innovative food and dining practices in some of our state's long-term care facilities. Federal and state regulations do not prohibit these innovations, and DFS supports the concept of "enhancements" of the dining experience in these facilities. The Division of Facilities Services, therefore, encourages facilities to assess and operationalize various dining methods, allowing residents to select their foods, dining times, dining partners, and other preferences. The regulations allow facilities to utilize innovative dining approaches, such as buffet lines, or family-style serving options, which allow residents to order at the table as they would in a restaurant. The regulations do not dictate whether facilities should serve food to residents on trays, in buffet lines, or in a family style. While there are many regulations, they leave room for innovative new ideas as long as these ideas do not compromise resident health or safety.. Food consumption and the dining experience are an integral part of the resident's life in a nursing facility. It is important that resident preferences are being honored, and the dining experience is as pleasant and home-like as possible. The facility's responsibility is to provide adequate nutrition and hydration that assures the resident is at his/her highest level of functioning emotionally, functionally, and physically. Meeting the unique needs of each resident in a facility can be a daunting task, but one of immense importance to the quality long-term care.

  8. Comparison of the socioeconomic impacts of international fuel service centers versus dispersed nuclear facilities

    International Nuclear Information System (INIS)

    Braid, R.B. Jr.

    1979-01-01

    The paper investigates a variety of community impacts including: public services, fiscal issues, economic matters, land and water use, political and social cohesion, and legal considerations. Comparisons of socioeconomic impacts of colocated versus dispersed sites are made on the basis of the size of the impacted communities, the size and type of nuclear facility, and the facility's construction time frame. The paper concludes that, under similar circumstances, most of the socioeconomic impacts of colocated nuclear facilities would be somewhat less than the sum of the impacts associated with equivalent dispersed sites. While empirical data is non-existent, the paper contends, however, that because the socioeconomic impacts of colocated facilities are so great and readily identifiable to a public unskilled in making comparisons with the dispersed alternative, the facilities will likely generate so much public opposition that IFSCs will probably prove infeasible

  9. Assessing the performance of mental health service facilities for meeting patient priorities and health service responsiveness.

    Science.gov (United States)

    Bramesfeld, A; Stegbauer, C

    2016-10-01

    The World Health Organisation has defined health service responsiveness as one of the key-objectives of health systems. Health service responsiveness relates to the ability to respond to service users' legitimate expectations on non-medical issues when coming into contact with the services of a healthcare system. It is defined by the areas showing respect for persons and patient orientation. Health service responsiveness is particularly relevant to mental health services, due to the specific vulnerability of mental health patients but also because it matches what mental health patients consider as good quality of care as well as their priorities when seeking healthcare. As (mental) health service responsiveness applies equally to all concerned services it would be suitable as a universal indicator for the quality of services' performance. However, performance monitoring programs in mental healthcare rarely assess health service performance with respect to meeting patient priorities. This is in part due of patient priorities as an outcome being underrepresented in studies that evaluate service provision. The lack of studies using patient priorities as outcomes transmits into evidence based guidelines and subsequently, into underrepresentation of patient priorities in performance monitoring. Possible ways out of this situation include more intervention studies using patient priorities as outcome, considering evidence from qualitative studies in guideline development and developing performance monitoring programs along the patient pathway and on key-points of relevance for service quality from a patient perspective.

  10. Management in general practice: the challenge of the new General Medical Services contract.

    Science.gov (United States)

    Checkland, Kath

    2004-10-01

    Managers in general practice perform a variety of roles, from purely administrative to higher-level strategic planning. There has been little research investigating in detail how they perform these roles and the problems that they encounter. The new General Medical Services (GMS) contract contains new management challenges and it is not clear how practices will meet these. To improve understanding of the roles performed by managers in general practice and to consider the implications of this for the implementation of the new GMS contract. In-depth qualitative case studies covering the period before and immediately after the vote in favour of the new GMS contract. Three general practices in England, chosen using purposeful sampling. Semi-structured interviews with all clinical and managerial personnel in each practice, participant and non-participant observation, and examination of documents. Understanding about what constitutes the legitimate role of managers in general practice varies both within and between practices. Those practices in the study that employed a manager to work at a strategic level with input into the direction of the organisation demonstrated significant problems with this in practice. These included lack of clarity about what the legitimate role of the manager involved, problems relating to the authority of managers in the context of a partnership, and lack of time available to them to do higher-level work. In addition, general practitioners (GPs) were not confident about their ability to manage their managers' performance. The new GMS contract will place significant demands on practice management. These results suggest that it cannot be assumed that simply employing a manager with high-level skills will enable these demands to be met; there must first be clarity about what the manager should be doing, and attention must be directed at questions about the legitimacy enjoyed by such a manager, the limits of his or her authority, and the

  11. Quality Assessment of Family Planning Sterilization Services at Health Care Facilities: Case Record Audit.

    Science.gov (United States)

    Mathur, Medha; Goyal, Ram Chandra; Mathur, Navgeet

    2017-05-01

    Quality of sterilization services is a matter of concern in India because population control is a necessity. Family Planning Sterilization (FPS) services provided at public health care facilities need to be as per Standard Operating Procedures. To assess the quality of FPS services by audit of case records at selected health care facilities. This cross-sectional study was conducted for two and a half year duration at selected public health care facilities of central India by simple random sampling where FPS services were provided. As per the standards of Government of India, case records were audited and compliance was calculated to assess the quality of services. Results of record audit were satisfactory but important criteria like previous contraceptive history and postoperative counselling were found to be deviated from standards. At Primary Health Centres (PHCs) only 89.5% and at Community Health Centres (CHCs) 58.7% of records were having details of previous contraceptive history. Other criteria like mental illness (only 70% at CHCs) assessment were also inadequate. Although informed consent was found to be having 100% compliance in all records. Quality of care in FPS services is the matter of concern in present scenario for better quality of services. This study may enlighten the policy makers regarding improvements needed for providing quality care.

  12. Status of safety in nuclear facilities - 2012. AREVA General Inspectorate Annual report

    International Nuclear Information System (INIS)

    2013-05-01

    After a message from the Areva's Chief Executive Officer and a message from the senior Vice President of safety, health, security, sustainable development, a text by the inspector general comments the key safety results (events, dose levels, radiological impacts), the inspection findings, the areas of vigilance (relationship with the ASN, the management of the criticality risk, and facility compliance), some significant topics after the Fukushima accident. Then this report addresses the status of nuclear safety and radiation protection in the group's facilities and operations. It more specifically addresses the context and findings (lessons learned from the inspections, operating experience from event, employee radiation monitoring, environmental monitoring), crosscutting processes (safety management, controlling facility compliance, subcontractor guidance and management, crisis management), specific risks (criticality risk, fire hazards, transportation safety, radioactive waste management, pollution prevention, liability mitigation and dismantling), and areas for improvement and outlook

  13. 77 FR 54917 - Public Availability of General Services Administration FY 2012 Federal Activities Inventory...

    Science.gov (United States)

    2012-09-06

    ... GENERAL SERVICES ADMINISTRATION [Notice-MV-2012-02; Docket No. 2012-0002; Sequence 14] Public Availability of General Services Administration FY 2012 Federal Activities Inventory Reform (FAIR) Act Inventory AGENCY: General Services Administration (GSA). ACTION: Notice of Public Availability of Fiscal...

  14. 78 FR 73863 - Public Availability of General Services Administration FY 2013 Federal Activities Inventory...

    Science.gov (United States)

    2013-12-09

    ... GENERAL SERVICES ADMINISTRATION [Notice-MV-2013-03; Docket No. 2013-0002; Sequence 37] Public... Inventory AGENCY: General Services Administration (GSA). ACTION: Notice of public availability of FY 2013...) Circular A-76, General Services Administration (GSA) is publishing this notice to advise the public of the...

  15. The Role of Distance and Quality on Facility Selection for Maternal and Child Health Services in Urban Kenya.

    Science.gov (United States)

    Escamilla, Veronica; Calhoun, Lisa; Winston, Jennifer; Speizer, Ilene S

    2018-02-01

    Universal access to health care requires service availability and accessibility for those most in need of maternal and child health services. Women often bypass facilities closest to home due to poor quality. Few studies have directly linked individuals to facilities where they sought maternal and child health services and examined the role of distance and quality on this facility choice. Using endline data from a longitudinal survey from a sample of women in five cities in Kenya, we examine the role of distance and quality on facility selection for women using delivery, facility-based contraceptives, and child health services. A survey of public and private facilities offering reproductive health services was also conducted. Distances were measured between household cluster location and both the nearest facility and facility where women sought care. A quality index score representing facility infrastructure, staff, and supply characteristics was assigned to each facility. We use descriptive statistics to compare distance and quality between the nearest available facility and visited facility among women who bypassed the nearest facility. Facility distance and quality comparisons were also stratified by poverty status. Logistic regression models were used to measure associations between the quality and distance to the nearest facility and bypassing for each outcome. The majority of women bypassed the nearest facility regardless of service sought. Women bypassing for delivery traveled the furthest and had the fewest facility options near their residential cluster. Poor women bypassing for delivery traveled 4.5 km further than non-poor women. Among women who bypassed, two thirds seeking delivery and approximately 46% seeking facility-based contraception or child health services bypassed to a public hospital. Both poor and non-poor women bypassed to higher quality facilities. Our findings suggest that women in five cities in Kenya prefer public hospitals and are

  16. Economic assessment of the general thoracic surgery outpatient service.

    Science.gov (United States)

    Jones, David R; Vaughters, Ann B R; Smith, Philip W; Daniel, Thomas M; Shen, K Robert; Heinzmann, Janet L

    2006-09-01

    One aspect of the definition of institutional value for any program is based on the return on investment (ROI) for that program. Program requests for future resource allocations depend, in part, on that information. The purpose of this project was to determine the ROI for initial outpatient visits only for our General Thoracic Surgery (GTS) program. The number of GTS outpatient visits, studies, and requested consultations ordered by GTS surgeons only was determined after review of the hospital database and office records for the calendar year 2003. Only charges associated with the initial outpatient visits (no inpatient or physician charges) were included. Charges were based on hospital finance department data. The ROI for GTS outpatient services was calculated using total hospital costs and hospital collections. There were 689 initial outpatient GTS visits. The majority were for lung cancer (48%), benign lung diseases (21%), and esophageal diseases (14%). Total outpatient charges were 1.25M dollars and by disease process were lung cancer (644,000 dollars), benign lung disease (90,000 dollars), esophageal disease (159,000 dollars), and other (357,000 dollars). The most significant hospital charges were the following: radiology (850,000 dollars), laboratory studies (82,000 dollars), gastrointestinal medicine studies (59,000 dollars), and cardiology (42,000 dollars). Total operational costs for the GTS clinic were 415,000 dollars and hospital collections were 513,000 dollars, yielding an ROI of 98,000 dollars or an operating margin of 19%. An operating margin of 19% for GTS outpatient services is better than most Fortune 500 companies. Acquisition of this type of information by GTS surgeons may be helpful for future program development and institutional resource allocation.

  17. Standards and general criteria for the planning and certification of need of megavoltage radiation oncology units in health care facilities

    International Nuclear Information System (INIS)

    1977-01-01

    Minimum standards and guidelines to be applied by State agencies and New Jersey health systems agencies in the examination of certificate-of-need applications and in the development of planning activities for radiation oncology units in health care facilities are presented. Radiation oncology is a medical discipline devoted to education and research in the use of ionizing radiation for the treatment of neoplastic disease. The proper application of radiation can be directed at either curative or palliative intent. It is an important and effective technique for the management of cancer. Radiotherapy equipment in clinical use is divided into four main categories: superficial, orthovoltage, megavoltage, and treatment planning facilities. Particular attention is given to megavoltage equipment which emits or generates rays over 1,000 kilovolts. These high energy rays effect better penetration of human tissue and are skin-sparing in nature, thus allowing for better tumor-to- skin dose ratios. The regionalization of megavoltage therapy services is discussed. Data on hospital megavoltage facilities in New Jersey for 1974, 1975, and 1976 are provided. The standards and guidelines pertain to utilization, personnel, and general criteria. A form for use by megavoltage radiation therapy units is appended

  18. Safety Assessment for Facilities and Activities. General Safety Requirements. Pt. 4

    International Nuclear Information System (INIS)

    2009-01-01

    The Safety Fundamentals publication, Fundamental Safety Principles, establishes principles for ensuring the protection of workers, the public and the environment, now and in the future, from harmful effects of ionizing radiation. The objective of this Safety Requirements publication is to establish the generally applicable requirements to be fulfilled in safety assessment for facilities and activities, with special attention paid to defence in depth, quantitative analyses and the application of a graded approach to the ranges of facilities and of activities that are addressed. The publication also addresses the independent verification of the safety assessment that needs to be carried out by the originators and users of the safety assessment. This publication is intended to provide a consistent and coherent basis for safety assessment across all facilities and activities, which will facilitate the transfer of good practices between organizations conducting safety assessments and will assist in enhancing the confidence of all interested parties that an adequate level of safety has been achieved for facilities and activities. The requirements, which are derived from the Fundamental Safety Principles, relate to any human activity that may cause people to be exposed to radiation risks arising from facilities and activities, as follows: Facilities includes: (a) Nuclear power plants; (b) Other reactors (such as research reactors and critical assemblies); (c) Enrichment facilities and fuel fabrication facilities; (d) Conversion facilities used to generate UF6; (e) Storage and reprocessing plants for irradiated fuel; (f) Facilities for radioactive waste management where radioactive waste is treated, conditioned, stored or disposed of; (g) Any other places where radioactive materials are produced, processed, used, handled or stored; (h) Irradiation facilities for medical, industrial, research and other purposes, and any places where radiation generators are installed; (i

  19. Safety assessment for facilities and activities. General safety requirements. Pt. 4

    International Nuclear Information System (INIS)

    2009-01-01

    The Safety Fundamentals publication, Fundamental Safety Principles, establishes principles for ensuring the protection of workers, the public and the environment, now and in the future, from harmful effects of ionizing radiation. The objective of this Safety Requirements publication is to establish the generally applicable requirements to be fulfilled in safety assessment for facilities and activities, with special attention paid to defence in depth, quantitative analyses and the application of a graded approach to the ranges of facilities and of activities that are addressed. The publication also addresses the independent verification of the safety assessment that needs to be carried out by the originators and users of the safety assessment. This publication is intended to provide a consistent and coherent basis for safety assessment across all facilities and activities, which will facilitate the transfer of good practices between organizations conducting safety assessments and will assist in enhancing the confidence of all interested parties that an adequate level of safety has been achieved for facilities and activities. The requirements, which are derived from the Fundamental Safety Principles, relate to any human activity that may cause people to be exposed to radiation risks arising from facilities and activities, as follows: Facilities includes: (a) Nuclear power plants; (b) Other reactors (such as research reactors and critical assemblies); (c) Enrichment facilities and fuel fabrication facilities; (d) Conversion facilities used to generate UF 6 ; (e) Storage and reprocessing plants for irradiated fuel; (f) Facilities for radioactive waste management where radioactive waste is treated, conditioned, stored or disposed of; (g) Any other places where radioactive materials are produced, processed, used, handled or stored; (h) Irradiation facilities for medical, industrial, research and other purposes, and any places where radiation generators are installed; (i

  20. Safety Assessment for Facilities and Activities. General Safety Requirements. Pt. 4

    International Nuclear Information System (INIS)

    2010-01-01

    The Safety Fundamentals publication, Fundamental Safety Principles, establishes principles for ensuring the protection of workers, the public and the environment, now and in the future, from harmful effects of ionizing radiation. The objective of this Safety Requirements publication is to establish the generally applicable requirements to be fulfilled in safety assessment for facilities and activities, with special attention paid to defence in depth, quantitative analyses and the application of a graded approach to the ranges of facilities and of activities that are addressed. The publication also addresses the independent verification of the safety assessment that needs to be carried out by the originators and users of the safety assessment. This publication is intended to provide a consistent and coherent basis for safety assessment across all facilities and activities, which will facilitate the transfer of good practices between organizations conducting safety assessments and will assist in enhancing the confidence of all interested parties that an adequate level of safety has been achieved for facilities and activities. The requirements, which are derived from the Fundamental Safety Principles, relate to any human activity that may cause people to be exposed to radiation risks arising from facilities and activities, as follows: Facilities includes: (a) Nuclear power plants; (b) Other reactors (such as research reactors and critical assemblies); (c) Enrichment facilities and fuel fabrication facilities; (d) Conversion facilities used to generate UF6; (e) Storage and reprocessing plants for irradiated fuel; (f) Facilities for radioactive waste management where radioactive waste is treated, conditioned, stored or disposed of; (g) Any other places where radioactive materials are produced, processed, used, handled or stored; (h) Irradiation facilities for medical, industrial, research and other purposes, and any places where radiation generators are installed; (i

  1. Safety Assessment for Facilities and Activities. General Safety Requirements. Pt. 4

    International Nuclear Information System (INIS)

    2009-01-01

    The Safety Fundamentals publication, Fundamental Safety Principles, establishes principles for ensuring the protection of workers, the public and the environment, now and in the future, from harmful effects of ionizing radiation.? read more The objective of this Safety Requirements publication is to establish the generally applicable requirements to be fulfilled in safety assessment for facilities and activities, with special attention paid to defence in depth, quantitative analyses and the application of a graded approach to the ranges of facilities and of activities that are addressed. The publication also addresses the independent verification of the safety assessment that needs to be carried out by the originators and users of the safety assessment. This publication is intended to provide a consistent and coherent basis for safety assessment across all facilities and activities, which will facilitate the transfer of good practices between organizations conducting safety assessments and will assist in enhancing the confidence of all interested parties that an adequate level of safety has been achieved for facilities and activities. The requirements, which are derived from the Fundamental Safety Principles, relate to any human activity that may cause people to be exposed to radiation risks arising from facilities and activities, as follows: Facilities includes: (a) Nuclear power plants; (b) Other reactors (such as research reactors and critical assemblies); (c) Enrichment facilities and fuel fabrication facilities; (d) Conversion facilities used to generate UF6; (e) Storage and reprocessing plants for irradiated fuel; (f) Facilities for radioactive waste management where radioactive waste is treated, conditioned, stored or disposed of; (g) Any other places where radioactive materials are produced, processed, used, handled or stored; (h) Irradiation facilities for medical, industrial, research and other purposes, and any places where radiation generators are

  2. International VLBI Service for Geodesy and Astrometry: General Meeting Proceedings

    Science.gov (United States)

    Vandenberg, Nancy R. (Editor); Baver, Karen D. (Editor)

    2002-01-01

    This volume contains the proceedings of the second General Meeting of the International VLBI Service for Geodesy and Astrometry (IVS), held in Tsukuba, Japan, February 4-7, 2002. The contents of this volume also appear on the IVS Web site at http://ivscc.gsfc.nasa.gov/publications/gm2002. The key-note of the second GM was prospectives for the future, in keeping with the re-organization of the IAG around the motivation of geodesy as 'an old science with a dynamic future' and noting that providing reference frames for Earth system science that are consistent over decades on the highest accuracy level will provide a challenging role for IVS. The goal of the meeting was to provide an interesting and informative program for a wide cross section of IVS members, including station operators, program managers, and analysts. This volume contains 72 papers and five abstracts of papers presented at the GM. The volume also includes reports about three splinter meetings held in conjunction with the GM: a mini-TOW (Technical Operations Workshop), the third IVS Analysis Workshop and a meeting of the analysis working group on geophysical modeling.

  3. 76 FR 37853 - Arizona Public Service Company; Notice of Consideration of Issuance of Amendment to Facility...

    Science.gov (United States)

    2011-06-28

    ...] Arizona Public Service Company; Notice of Consideration of Issuance of Amendment to Facility Operating License, Proposed No Significant Hazards Consideration Determination, and Opportunity for a Hearing AGENCY... consideration. Under the Commission's regulations in Title 10 of the Code of Federal Regulations (10 CFR...

  4. A study on the service radii and accessibility to health facilities in ...

    African Journals Online (AJOL)

    Government policies over the years has centered on the provision and delivery of healthcare to all. Spatial distribution of health facilities is subject to a number of social and commercial influences and healthcare needs of the population. The objective of this paper analyzed the service radii and accessibility of health ...

  5. Value Adding Management of buildings and facility services in four steps

    DEFF Research Database (Denmark)

    van der Voordt, Theo; Jensen, Per Anker; Hoendervanger, Jan Gerard

    2016-01-01

    This paper presents a new Value Adding Management (VAM) model that aims to support decision makers in identifying appropriate interventions in buildings, other facilities and services that add value to the organisation, to manage its implementation, and to measure the output and outcomes. The pap...

  6. Value Adding Management (VAM) of buildings and facility services in four steps

    NARCIS (Netherlands)

    van der Voordt, Theo; Hoendervanger, Jan Gerard; Jensen, Per Anker; Bergsma, Feike

    2016-01-01

    This paper presents a new Value Adding Management (VAM) model that aims to support decision makers in identifying appropriate interventions in buildings, other facilities and services that add value to the organisation, to manage its implementation, and to measure the output and outcomes. The paper

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

    Science.gov (United States)

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

    2010-01-01

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

  8. Students' Perceived Quality of Library Facilities and Services in Nigerian Private Universities

    Science.gov (United States)

    Oluwunmi, A. O.; Durodola, O. D.; Ajayi, C. A.

    2016-01-01

    In a highly competitive academic environment, students are becoming more selective and demanding in their choice of University. Hence, it is essential for educational institutions, particularly privately-owned institutions, to be interested in getting feedback on the quality of their facilities and services. With a focus on four private…

  9. Long term assurance of supply of back end of fuel cycle facilities and services

    International Nuclear Information System (INIS)

    1978-01-01

    The paper deals with the long-term assurance of supply of the back end of fuel cycle facilities and services. 11 fundamental questions are posed and commented on by representatives of 7 countries. Non-proliferation aspects are not considered as they will be discussed elsewhere

  10. 18 CFR 157.18 - Applications to abandon facilities or service; exhibits.

    Science.gov (United States)

    2010-04-01

    ... and terminus of all remaining facilities. (d) Exhibit W—Impact on customers whose service will be.... Applicant may use pro forma accounting entries based on estimated amounts, provided that upon consummation... the amount of federal and state income taxes to be allocated to the gain. If no allocation is to be...

  11. 7 CFR 1951.220 - General servicing actions.

    Science.gov (United States)

    2010-01-01

    ... relatively large portion of the total value of the security property. The approval official will require a... Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS...) PROGRAM REGULATIONS (CONTINUED) SERVICING AND COLLECTIONS Servicing of Community and Direct Business...

  12. A hybrid algorithm for stochastic single-source capacitated facility location problem with service level requirements

    Directory of Open Access Journals (Sweden)

    Hosseinali Salemi

    2016-04-01

    Full Text Available Facility location models are observed in many diverse areas such as communication networks, transportation, and distribution systems planning. They play significant role in supply chain and operations management and are one of the main well-known topics in strategic agenda of contemporary manufacturing and service companies accompanied by long-lasting effects. We define a new approach for solving stochastic single source capacitated facility location problem (SSSCFLP. Customers with stochastic demand are assigned to set of capacitated facilities that are selected to serve them. It is demonstrated that problem can be transformed to deterministic Single Source Capacitated Facility Location Problem (SSCFLP for Poisson demand distribution. A hybrid algorithm which combines Lagrangian heuristic with adjusted mixture of Ant colony and Genetic optimization is proposed to find lower and upper bounds for this problem. Computational results of various instances with distinct properties indicate that proposed solving approach is efficient.

  13. 38 CFR 59.130 - General requirements for all State home facilities.

    Science.gov (United States)

    2010-07-01

    ... design and construct the project to provide sufficient space and equipment in dining, health services... safety of participants, personnel and the public. (b) A State home must meet the general conditions of..., including the Uniform Federal Accessibility Standards (UFAS) (24 CFR part 40, appendix A), during the design...

  14. The Relative Patient Costs and Availability of Dental Services, Materials and Equipment in Public Oral Care Facilities in Tanzania.

    OpenAIRE

    Nyamuryekung'e, Kasusu K; Lahti, Satu M; Tuominen, Risto J

    2015-01-01

    Background Patient charges and availability of dental services influence utilization of dental services. There is little available information on the cost of dental services and availability of materials and equipment in public dental facilities in Africa. This study aimed to determine the relative cost and availability of dental services, materials and equipment in public oral care facilities in Tanzania. The local factors affecting availability were also studied. Methods A survey of all dis...

  15. E-government Facilities Analysis for Public Services in Higher Education

    Science.gov (United States)

    Astawa, I. P. M.; Dewi, K. C.

    2018-01-01

    E-Government in higher education can be utilized in order to provide public services to stakeholders both internal and external. The research objectives is to analyze the e-government facilities for public services in higher education. The research began by reviewing the concept of public services and e-government, then continued by analysing e-government facilities based on the E-Government Maturity Level developed by Wirtz and Piehler. The research subject was the e-government website of three universities that ranked the top three of webometrics version (Indonesia country rank), while the research object was e-government facilities for public services. Data collection was done by observing e-government sites via online browsing. The research’s results indicated that all three e-government sites have met four e-government business model and provided e-government services in line with the fourth stage on the e-government development stage. It can concluded that the three universities have achieved e-government maturity at the fourth level.

  16. Spatial variation in general medical services income in dublin general practitioners.

    Science.gov (United States)

    Teljeur, Conor; Kelly, Alan; O'Dowd, Tom

    2011-01-01

    The general medical services (GMS) scheme provides care free at the point of use for the 30% most economically deprived section of the population and the elderly. Almost all people of over-70-year olds are eligible for the GMS scheme potentially directing resources away from those most in need. The aim of this study is to analyse the relationship between practice GMS income and deprivation amongst Dublin-based general practitioners (GPs). The practice GMS income in Dublin was analysed in relation to practice characteristics including the number of GPs, catchment area population, proportion of over-70-year olds in the catchment area, catchment deprivation, number of GMS GPs within 2 km, and average GMS practice income within 2 km. Practice GMS income was highest in deprived areas but is also a valuable source of income in the least deprived areas. The capitation rate for over-70-year olds provides an incentive for GPs to locate in affluent areas and potentially directs resources away from those in greater need.

  17. Service facilities

    International Nuclear Information System (INIS)

    Lestyan, Ernoe

    1988-01-01

    Major structural features of the supplementary buildings where among others the cloack-rooms, laundries, the dosimetric and radiochemical laboratories are situated are given. Additional buildings, not in close connection with the technology such as the central office, chemical water pretreatment, boiler, heat centre, transducer station, kitchen, canteen etc. are listed. Ground plans and photos are presented. (V.N.) 11 figs

  18. An evaluation of the benefits and challenges of video consulting between general practitioners and residential aged care facilities.

    Science.gov (United States)

    Wade, Victoria; Whittaker, Frank; Hamlyn, Jeremy

    2015-12-01

    This research evaluated a project that provided video consultations between general practitioners (GPs) and residential aged care facilities (RACFs), with the aim of enabling faster access to medical care and avoidance of unnecessary hospital transfers. GPs were paid for video consultations at a rate equivalent to existing insurance reimbursement for supporting telehealth services. Evaluation data were gathered by direct observation at the project sites, semi-structured interviews and video call data from the technical network. Three pairs of general practices and RACFs were recruited to the project. 40 video consultations eligible for payment occurred over a 6 month period, three of which were judged to have avoided hospital attendance. The process development and change management aspects of the project required substantially more effort than was anticipated. This was due to problems with RACF technical infrastructure, the need for repeated training and awareness raising in RACFs, the challenge of establishing new clinical procedures, the short length of the project and broader difficulties in the relationships between GPs and RACFs. Video consulting between GPs and RACFs was clinically useful and avoided hospital attendance on a small scale, but further focus on process development is needed to embed this as a routine method of service delivery. © The Author(s) 2015.

  19. Performance of general health workers in leprosy control activities at public health facilities in Amhara and Oromia States, Ethiopia.

    Science.gov (United States)

    Abeje, Tadiye; Negera, Edessa; Kebede, Eshetu; Hailu, Tsegaye; Hassen, Ismaile; Lema, Tsehainesh; Yamuah, Lawrence; Shiguti, Birru; Fenta, Melkamu; Negasa, Megersa; Beyene, Demissew; Bobosha, Kidist; Aseffa, Abraham

    2016-04-07

    towards leprosy was positive for the majority of the respondents. The result showed that 519 (86.3%) had poor knowledge. Overall 155 (25.8%) of the respondents had positive attitude towards leprosy while 205 (34.1%) had intermediate (mixed) attitude and 241 (40.1%) had negative attitude to the disease. Among 83 respondents assessed for diagnosis of leprosy only 15(18.0%) diagnosed leprosy correctly. Variation in knowledge and attitude indicated a significant difference (p leprosy control activities are integrated to the general health services in the country, the knowledge and skills of leprosy diagnosis, treatment and management by health workers was unsatisfactory. Hence, attention should be given to develop training strategies that can improve health worker knowledge and promote better leprosy management at public health facilities. This could be achieved through pre-service and in-service training and giving adequate emphasis to leprosy related practical work and continuous follow- up.

  20. General overview and a review of storage rings, research facilities, and insertion devices

    International Nuclear Information System (INIS)

    Winick, H.

    1989-01-01

    Synchrotron radiation, the electromagnetic radiation given off by electrons in circular motion, is revolutionizing many branches of science and technology by offering beams of vacuum ultraviolet light and x rays of immense flux and brightness. In the past decade there has been an explosion of interest in these applications leading to increased exploitation of existing rings and activity to construct new research facilities based on advanced storage rings and insertion device sources. Applications include basic and applied research in biology, chemistry, medicine, and physics plus many areas of technology. In this article they present a general overview of the field of synchrotron radiation research, its history, the present status and future prospects of storage rings and research facilities, and the development of wiggler and undulator insertion devices as sources of synchrotron radiation. 66 references, 20 figures, 1 table

  1. IAEA Director General visits purification facility at Polish thermal power station

    International Nuclear Information System (INIS)

    2001-01-01

    On the occasion of his first visit to Poland, the Director General of the IAEA visited an industrial scale Electron Beam Demonstration facility constructed with IAEA assistance at the Pomorzany Electric Power Station near Szczecin. The facility uses an electron beam device to purify gas effluents from coal burning. By the addition of ammonia, the process permits the production of fertilizer as a by-product. This is an excellent example of how nuclear techniques can be used to reduce the emissions from conventional power plants. Experience gained will help to demonstrate the environmental effectiveness and economic competitiveness of this technology and serve to illustrate how the IAEA in cooperation with Member States can provide advanced nuclear technique to industrial companies

  2. Synchrotron radiation A general overview and a review of storage rings, research facilities, and insertion devices

    International Nuclear Information System (INIS)

    Winick, H.

    1989-01-01

    Synchrotron radiation, the electromagnetic radiation given off by electrons in circular motion, is revolutionizing many branches of science and technology by offering beams of vacuum ultraviolet light and x rays of immense flux and brightness. In the past decade there has been an explosion of interest in these applications leading activity to construct new research facilities based on advanced storage rings and insertion device sources. Applications include basic and applied research in biology, chemistry, medicine, and physics plus many areas of technology. In this article we present a general overview of the field of synchrotron radiation research, its history, the present status and future prospects of storage rings and research facilities, and the development of wiggler and undulator insertion devices as sources of synchrotron radiation

  3. Potential criticality accident at the General Electric Nuclear Fuel and Component Manufacturing Facility, May 29, 1991

    International Nuclear Information System (INIS)

    1991-08-01

    At the General Electric Nuclear Fuel and Component Manufacturing facility, located near Wilmington, North Carolina, on May 28 and 29, 1991, approximately 150 kilograms of uranium were inadvertently transferred from safe process tanks to an unsafe tank located at the waste treatment facility, thus creating the potential for a localized criticality safety problem. The excess uranium was ultimately safely recovered when the tank contents were centrifuged to remove the uranium-bearing material. Subsequently, the US Nuclear Regulatory Commission dispatched an Incident Investigation Team to determine what happened, to identify probable causes, and to make appropriate findings and conclusions. This report describes the incident, the methodology used by the team in its investigation, and presents the team's findings and conclusions. 48 figs., 8 tabs

  4. Hanford facility dangerous waste permit application, general information portion. Revision 3

    International Nuclear Information System (INIS)

    Sonnichsen, J.C.

    1997-01-01

    For purposes of the Hanford facility dangerous waste permit application, the US Department of Energy's contractors are identified as ''co-operators'' and sign in that capacity (refer to Condition I.A.2. of the Dangerous Waste Portion of the Hanford Facility Resource Conservation and Recovery Act Permit). Any identification of these contractors as an ''operator'' elsewhere in the application is not meant to conflict with the contractors' designation as co-operators but rather is based on the contractors' contractual status with the U.S. Department of Energy, Richland Operations Office. The Dangerous Waste Portion of the initial Hanford Facility Resource Conservation and Recovery Act Permit, which incorporated five treatment, storage, and/or disposal units, was based on information submitted in the Hanford Facility Dangerous Waste Permit Application and in closure plan and closure/postclosure plan documentation. During 1995, the Dangerous Waste Portion was modified twice to incorporate another eight treatment, storage, and/or disposal units; during 1996, the Dangerous Waste Portion was modified once to incorporate another five treatment, storage, and/or disposal units. The permit modification process will be used at least annually to incorporate additional treatment, storage, and/or disposal units as permitting documentation for these units is finalized. The units to be included in annual modifications are specified in a schedule contained in the Dangerous Waste Portion of the Hanford Facility Resource Conservation and Recovery Act Permit. Treatment, storage, and/or disposal units will remain in interim status until incorporated into the Permit. The Hanford Facility Dangerous Waste Permit Application is considered to be a single application organized into a General Information Portion (this document, DOE/RL-91-28) and a Unit-Specific Portion. The scope of the Unit-Specific Portion is limited to individual operating treatment, storage, and/or disposal units for which

  5. Hanford facility dangerous waste permit application, general information portion. Revision 3

    Energy Technology Data Exchange (ETDEWEB)

    Sonnichsen, J.C.

    1997-08-21

    For purposes of the Hanford facility dangerous waste permit application, the US Department of Energy`s contractors are identified as ``co-operators`` and sign in that capacity (refer to Condition I.A.2. of the Dangerous Waste Portion of the Hanford Facility Resource Conservation and Recovery Act Permit). Any identification of these contractors as an ``operator`` elsewhere in the application is not meant to conflict with the contractors` designation as co-operators but rather is based on the contractors` contractual status with the U.S. Department of Energy, Richland Operations Office. The Dangerous Waste Portion of the initial Hanford Facility Resource Conservation and Recovery Act Permit, which incorporated five treatment, storage, and/or disposal units, was based on information submitted in the Hanford Facility Dangerous Waste Permit Application and in closure plan and closure/postclosure plan documentation. During 1995, the Dangerous Waste Portion was modified twice to incorporate another eight treatment, storage, and/or disposal units; during 1996, the Dangerous Waste Portion was modified once to incorporate another five treatment, storage, and/or disposal units. The permit modification process will be used at least annually to incorporate additional treatment, storage, and/or disposal units as permitting documentation for these units is finalized. The units to be included in annual modifications are specified in a schedule contained in the Dangerous Waste Portion of the Hanford Facility Resource Conservation and Recovery Act Permit. Treatment, storage, and/or disposal units will remain in interim status until incorporated into the Permit. The Hanford Facility Dangerous Waste Permit Application is considered to be a single application organized into a General Information Portion (this document, DOE/RL-91-28) and a Unit-Specific Portion. The scope of the Unit-Specific Portion is limited to individual operating treatment, storage, and/or disposal units for which

  6. Does courtesy bias affect how clients report on objective and subjective measures of family planning service quality? A comparison between facility- and home-based interviews

    Directory of Open Access Journals (Sweden)

    Hameed W

    2018-05-01

    Full Text Available Waqas Hameed, Muhammad Ishaque, Xaher Gul, Junaid-ur-Rehman Siddiqui, Sharmeen Hussain, Wajahat Hussain, Aftab Ahmed, Asma Balal Strategy Department, Marie Stopes Society, Karachi, Sindh, Pakistan Purpose: Despite a general understanding that exit interviews being conducted at service providers’ facilities may influence clients’ responses favorably to health professionals, there is very little evidence available that demonstrates the extent to which this problem exists. This study aimed at assessing and comparing clients’ perceptions of the quality of family planning services and their satisfaction levels between facility- and home-based interviews. Methods: A cross-sectional survey was conducted among clients receiving family planning services across three service delivery channels – nongovernmental organization (NGO clinics, social franchise (SF centers, and outreach camps. The survey took place from December 2015 to January 2016 in 70 districts across all four provinces of Pakistan. A total of 2,807 clients were interviewed, of whom 1,404 clients were interviewed at health facilities after receiving services and 1,403 were interviewed at their homes within 3 days of method uptake. Results: Overall, we found no significant differences between the characteristics of study participants interviewed at health facilities or at home. The findings suggested that experiences reported in exit surveys at facilities were strongly biased positively. This was true for both experiential (service quality and perception-based (satisfaction questions in the context of SF centers, while at NGO clinics the interview location only affected clients’ responses regarding service quality. However, in outreach settings, clients are more likely to share bad experiences in exit interviews than in home-based interviews on objectively asked questions (service quality. Conclusion: Our study indicates signs of courtesy bias and possibly the Hawthorne effect in

  7. Does courtesy bias affect how clients report on objective and subjective measures of family planning service quality? A comparison between facility- and home-based interviews.

    Science.gov (United States)

    Hameed, Waqas; Ishaque, Muhammad; Gul, Xaher; Siddiqui, Junaid-Ur-Rehman; Hussain, Sharmeen; Hussain, Wajahat; Ahmed, Aftab; Balal, Asma

    2017-01-01

    Despite a general understanding that exit interviews being conducted at service providers' facilities may influence clients' responses favorably to health professionals, there is very little evidence available that demonstrates the extent to which this problem exists. This study aimed at assessing and comparing clients' perceptions of the quality of family planning services and their satisfaction levels between facility- and home-based interviews. A cross-sectional survey was conducted among clients receiving family planning services across three service delivery channels - nongovernmental organization (NGO) clinics, social franchise (SF) centers, and outreach camps. The survey took place from December 2015 to January 2016 in 70 districts across all four provinces of Pakistan. A total of 2,807 clients were interviewed, of whom 1,404 clients were interviewed at health facilities after receiving services and 1,403 were interviewed at their homes within 3 days of method uptake. Overall, we found no significant differences between the characteristics of study participants interviewed at health facilities or at home. The findings suggested that experiences reported in exit surveys at facilities were strongly biased positively. This was true for both experiential (service quality) and perception-based (satisfaction) questions in the context of SF centers, while at NGO clinics the interview location only affected clients' responses regarding service quality. However, in outreach settings, clients are more likely to share bad experiences in exit interviews than in home-based interviews on objectively asked questions (service quality). Our study indicates signs of courtesy bias and possibly the Hawthorne effect in exit interviews. Program implementers could opt for home-based interviews for women receiving services at NGO clinics or SF center, whereas exit interviews could be used in outreach settings.

  8. Does courtesy bias affect how clients report on objective and subjective measures of family planning service quality? A comparison between facility- and home-based interviews

    Science.gov (United States)

    Hameed, Waqas; Ishaque, Muhammad; Gul, Xaher; Siddiqui, Junaid-ur-Rehman; Hussain, Sharmeen; Hussain, Wajahat; Ahmed, Aftab; Balal, Asma

    2017-01-01

    Purpose Despite a general understanding that exit interviews being conducted at service providers’ facilities may influence clients’ responses favorably to health professionals, there is very little evidence available that demonstrates the extent to which this problem exists. This study aimed at assessing and comparing clients’ perceptions of the quality of family planning services and their satisfaction levels between facility- and home-based interviews. Methods A cross-sectional survey was conducted among clients receiving family planning services across three service delivery channels – nongovernmental organization (NGO) clinics, social franchise (SF) centers, and outreach camps. The survey took place from December 2015 to January 2016 in 70 districts across all four provinces of Pakistan. A total of 2,807 clients were interviewed, of whom 1,404 clients were interviewed at health facilities after receiving services and 1,403 were interviewed at their homes within 3 days of method uptake. Results Overall, we found no significant differences between the characteristics of study participants interviewed at health facilities or at home. The findings suggested that experiences reported in exit surveys at facilities were strongly biased positively. This was true for both experiential (service quality) and perception-based (satisfaction) questions in the context of SF centers, while at NGO clinics the interview location only affected clients’ responses regarding service quality. However, in outreach settings, clients are more likely to share bad experiences in exit interviews than in home-based interviews on objectively asked questions (service quality). Conclusion Our study indicates signs of courtesy bias and possibly the Hawthorne effect in exit interviews. Program implementers could opt for home-based interviews for women receiving services at NGO clinics or SF center, whereas exit interviews could be used in outreach settings. PMID:29760573

  9. Inspector General, DOD, Oversight of the Naval Audit Service Audit of the Navy General Fund Financial Statements for FY 1998

    National Research Council Canada - National Science Library

    1999-01-01

    .... The audit objective was to determine the accuracy and completeness of the Naval Audit Service audit of the Navy General Fund Financial Statements for Fiscal Year 1998. See Appendix A for a discussion of the audit Process.

  10. 77 FR 28390 - General Services Administration Acquisition Regulation; Submission for OMB Review; GSA Form 527...

    Science.gov (United States)

    2012-05-14

    .... Purpose The General Services Administration will be requesting the Office of Management and Budget to... GENERAL SERVICES ADMINISTRATION [OMB Control No. 3090-0007; Docket 2011-0016; Sequence 12] General... Qualifications and Financial Information AGENCY: Office of the Chief Finance Officer, GSA. ACTION: Notice of...

  11. 77 FR 5020 - General Services Administration Acquisition Regulation; Information Collection; GSA Form 527...

    Science.gov (United States)

    2012-02-01

    ... INFORMATION: A. Purpose The General Services Administration will be requesting the Office of Management and... GENERAL SERVICES ADMINISTRATION [OMB Control No. 3090-0007; Docket 2011-0001; Sequence 12] General... Qualifications and Financial Information AGENCY: Office of the Chief Finance Officer, GSA. ACTION: Notice of...

  12. Assessment Of The Location And Availability Of Public Facilities And Services In Port Harcourt Metropolis In Rivers State Nigeria

    Directory of Open Access Journals (Sweden)

    Eyenghe Tari

    2015-06-01

    Full Text Available ABSTRACT The continues increase in both urban and rural population has birthed the problem of inadequate availability of facilities and social services thus giving rise to social disparity and unequal access to basic facilities and services by people of the same population spectrum. Consequently the problem of social disparity inequality is on the increase and is gaining global and local attention. Despite the efforts of government to combat this social problem it is still raising its head in form of unequal access to educational facilities heath care good roads emergency services and etcetera. Hence the study was intended to ascertain whether or not there is disparity in distribution and access to facilities and services by assessing facilities and services in Port Harcourt City. The study adopted the simple random technique for data collection. Also primary and secondary data were the major data collected with the use of closed ended structured questionnaire. However the result of the study showed that income formed a major determining factor in the distribution of facilities and services in Port Harcourt while population threshold was not considered significantly in the study area. However the study revealed that there is gap in the distribution of facilities and services in Port Harcourt City. The recommendations included the involvement of the citizens at grass root in decision making facilities and services should be provided with respect to actual population on ground income level should not determine facilities and service distribution. The study concluded that there is disparity and unequal access in the distribution of social services and facilities.

  13. Can contracted out health facilities improve access, equity, and quality of maternal and newborn health services? Evidence from Pakistan.

    Science.gov (United States)

    Zaidi, Shehla; Riaz, Atif; Rabbani, Fauziah; Azam, Syed Iqbal; Imran, Syeda Nida; Pradhan, Nouhseen Akber; Khan, Gul Nawaz

    2015-11-25

    The case of contracting out government health services to non-governmental organizations (NGOs) has been weak for maternal, newborn, and child health (MNCH) services, with documented gains being mainly in curative services. We present an in-depth assessment of the comparative advantages of contracting out on MNCH access, quality, and equity, using a case study from Pakistan. An end-line, cross-sectional assessment was conducted of government facilities contracted out to a large national NGO and government-managed centres serving as controls, in two remote rural districts of Pakistan. Contracting out was specific for augmenting MNCH services but without contractual performance incentives. A household survey, a health facility survey, and focus group discussions with client and spouses were used for assessment. Contracted out facilities had a significantly higher utilization as compared to control facilities for antenatal care, delivery, postnatal care, emergency obstetric care, and neonatal illness. Contracted facilities had comparatively better quality of MNCH services but not in all aspects. Better household practices were also seen in the district where contracting involved administrative control over outreach programs. Contracting was also faced with certain drawbacks. Facility utilization was inequitably higher amongst more educated and affluent clients. Contracted out catchments had higher out-of-pocket expenses on MNCH services, driven by steeper transport costs and user charges for additional diagnostics. Contracting out did not influence higher MNCH service coverage rates across the catchment. Physical distances, inadequate transport, and low demand for facility-based care in non-emergency settings were key client-reported barriers. Contracting out MNCH services at government health facilities can improve facility utilization and bring some improvement in  quality of services. However, contracting out of health facilities is insufficient to increase

  14. [Diabetes care and incidence of severe hypoglycemia in nursing home facilities and nursing services: The Heidelberg Diabetes Study].

    Science.gov (United States)

    Bahrmann, A; Wörz, E; Specht-Leible, N; Oster, P; Bahrmann, P

    2015-04-01

    The goal of this study was to perform a structured analysis of the treatment quality and acute complications of geriatric patients with diabetes mellitus (DM) cared for by nursing services and nursing home facilities. Secondly, structural problems and potentials for improvement in the care of multimorbid older people with DM treated by nursing homes and nursing services were analysed from the viewpoint of geriatric nurses, managers of nursing homes and general practitioners. In all, 77 older persons with DM from 13 nursing homes and 3 nursing services were included in the analysis (76.6% female, HbA1c 6.9 ± 1.4%, age 81.6 ± 9.9 years). Structural problems and potentials for improvement were collected from 95 geriatric nurses, 9 managers of nursing homes and 6 general practitioners using semistandardized questionnaires. Metabolic control was too strict in care-dependent older people with DM (mean HbA1c value: 6.9 ± 1.4 %; recommended by guidelines: 7-8%). The measurement of HbA1c was performed in 16 of 77 people (20.8%) within the last year despite a high visitation frequency of the general practitioners (12.7 ± 7.7 within the last 6 months). The incidence of severe hypoglycemia was 7.8%/patient/year. Regarding the management in case of diabetes-related acute complications 33 geriatric nurses (34.7%) stated not having any written standard (nursing home 39%, geriatric services 16.7%). Complex insulin therapies are still used in older people with DM with the consequence of a high incidence of severe hypoglycemia. Concrete management standards in the case of diabetes-related acute complications for geriatric nurses are lacking for more than one third of the nursing services.

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

    International Nuclear Information System (INIS)

    1980-01-01

    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

  16. Cost of delivering health care services at primary health facilities in Ghana

    Directory of Open Access Journals (Sweden)

    Maxwell Ayindenaba Dalaba

    2017-11-01

    Full Text Available Abstract Background There is limited knowledge on the cost of delivering health services at primary health care facilities in Ghana which is posing a challenge in resource allocations. This study therefore estimated the cost of providing health care in primary health care facilities such as Health Centres (HCs and Community-based Health Planning and Services (CHPS in Ghana. Methods The study was cross-sectional and quantitative data was collected from the health provider perspective. Data was collected between July and August, 2016 at nine primary health facilities (six CHPS and three HCs from the Upper West region of Ghana. All health related costs for the year 2015 and revenue generated for the period were collected. Data were captured and analysed using Microsoft excel. Costs of delivery health services were estimated. In addition, unit costs such as cost per Outpatient Department (OPD attendance were estimated. Results The average annual cost of delivering health services through CHPS and HCs was US$10,923 and US$44,638 respectively. Personnel cost accounted for the largest proportion of cost (61% for CHPS and 59% for HC. The cost per OPD attendance was higher at CHPS (US$8.79 than at HCs (US$5.16. The average Internally Generated Funds (IGF recorded for the period at CHPS and HCs were US$2327 and US$ 15,795 respectively. At all the facilities, IGFs were greatly lower than costs of running the health facilities. Also, at both the CHPS and HCs, the National Health Insurance Scheme (NHIS reimbursement was the main source of revenue accounting for over 90% total IGF. Conclusions The average annual cost of delivering primary health services through CHPS and HCs is US$10,923 and US$44,638 respectively and personnel cost accounts for the major cost. The government should be guided by these findings in their financial planning, decision making and resource allocation in order to improve primary health care in the country. However, more similar

  17. AECL hot-cell facilities and post-irradiation examination services

    International Nuclear Information System (INIS)

    Schankula, M.H.; Plaice, E.L.; Woodworth, L.G.

    1995-01-01

    This paper presents an overview of the post-irradiation examination (PIE) services available at AECL's hot-cell facilities (HCF). The HCFs are used primarily to provide PIE support for operating CANDU power reactors in Canada and abroad, and for the examination of experimental fuel bundles and core components irradiated in research reactors at the Chalk River Laboratories (CRL) and off-shore. A variety of examinations and analysis are performed ranging from non-destructive visual and dimensional inspections to detailed optical and scanning electron microscopic examinations. Several hot cells are dedicated to mechanical property testing of structural materials and to determine the fitness-for-service of reactor core components. Facility upgrades and the development of innovative examination techniques continue to improve AECL's PIE capabilities. (author)

  18. AECL hot-cell facilities and post-irradiation examination services

    International Nuclear Information System (INIS)

    Schankula, M.H.; Plaice, E.L.; Woodworth, L.G.

    1998-04-01

    This paper presents an overview of the post-irradiation examination (PIE) services available at AECL's hot-cell facilities (HCF). The HCFs are used primarily to provide PIE support for operating CANDU power reactors in Canada and abroad, and for the examination of experimental fuel bundles and core components irradiated in research reactors at the Chalk River Laboratories (CRL) and off-shore. A variety of examinations and analyses are performed ranging from non-destructive visual and dimensional inspections to detailed optical and scanning electron microscopic examinations. Several hot cells are dedicated to mechanical property testing of structural materials and to determine the fitness-for-service of reactor core components. Facility upgrades and the development of innovative examination techniques continue to improve AECL's PIE capabilities. (author)

  19. Electron Microscopy Facility for Research and Services in the Malaysian Nuclear Agency towards TSO

    International Nuclear Information System (INIS)

    Nadira Kamarudin; Mohd Bin Harun; Zaiton Selamat

    2011-01-01

    Scanning Electron Microscope FEI-Quanta 400 (SEM) made in the USA was commissioned in late 2003. This equipment is used in many areas of materials science, metallurgy, engineering, electronics, medicine, agriculture, biology and so on. This facility has helped the researchers in conducting research in their respective fields as well have been providing services to agencies, institutions, industries and local industry. Since 2004, there were 81 projects and 5000 samples analyzed using this facility in Malaysian Nuclear Agency, while 23 companies and 900 samples were from various agencies. In addition, revenue derived from these services has able to provide for the maintenance of this equipment. SEM is an important step in the nuclear material testing process. Nuclear material can be inspected for its performance by getting information from its morphology micrograph by using SEM. It opens up a whole new world that is unseen by the naked eye. (author)

  20. Evaluating Fidelity to a Modified NIATx Process Improvement Strategy for Improving HIV Services in Correctional Facilities.

    Science.gov (United States)

    Pankow, Jennifer; Willett, Jennifer; Yang, Yang; Swan, Holly; Dembo, Richard; Burdon, William M; Patterson, Yvonne; Pearson, Frank S; Belenko, Steven; Frisman, Linda K

    2018-04-01

    In a study aimed at improving the quality of HIV services for inmates, an organizational process improvement strategy using change teams was tested in 14 correctional facilities in 8 US states and Puerto Rico. Data to examine fidelity to the process improvement strategy consisted of quantitative ratings of the structural and process components of the strategy and qualitative notes that explicate challenges in maintaining fidelity to the strategy. Fidelity challenges included (1) lack of communication and leadership within change teams, (2) instability in team membership, and (3) issues with data utilization in decision-making to implement improvements to services delivery.

  1. Variation in Hospice Services by Location of Care: Nursing Home Versus Assisted Living Facility Versus Home.

    Science.gov (United States)

    Unroe, Kathleen T; Bernard, Brittany; Stump, Timothy E; Tu, Wanzhu; Callahan, Christopher M

    2017-07-01

    To describe differences in hospice services for patients living at home, in nursing homes or in assisted living facilities, including the overall number and duration of visits by different hospice care providers across varying lengths of stay. Retrospective cohort study using hospice patient electronic medical record data. Large, national hospice provider. Data from 32,605 hospice patients who received routine hospice care from 2009 to 2014 were analyzed. Descriptive statistics were calculated for utilization measures for each type of provider and by location of care. Frequency and duration of service contacts were standardized to a 1 week period and pairwise comparisons were used to detect differences in care provided between the three settings. Minimal differences were found in overall intensity of service contacts across settings, however, the mix of services were different for patients living at home versus nursing home versus assisted living facility. Overall, more nurse care was provided at the beginning and end of the hospice episode; intensity of aide care services was higher in the middle portion of the hospice episode. Nearly 43% of the sample had hospice stays less than 2 weeks and up to 20% had stays greater than 6 months. There are significant differences between characteristics of hospice patients in different settings, as well as the mix of services they receive. Medicare hospice payment methodology was revised starting in 2016. While the new payment structure is in greater alignment with the U shape distribution of services, it will be important to evaluate the impact of the new payment methodology on length of stay and mix of services by different providers across settings of care. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  2. 77 FR 14016 - General Services Administration Acquisition Regulation; Preparation, Submission, and Negotiation...

    Science.gov (United States)

    2012-03-08

    ..., Submission, and Negotiation of Subcontracting Plans; Correction AGENCY: General Services Administration (GSA..., Preparation, Submission, and Negotiation of Subcontracting Plans; Correction. Correction In the information...

  3. Numeric data services and sources for the general reference librarian

    CERN Document Server

    Kellam, Lynda

    2011-01-01

    The proliferation of online access to social science statistical and numeric data sources, such as the U.S. Census Bureau's American Fact Finder, has lead to an increased interest in supporting these sources in academic libraries. Many large libraries have been able to devote staff to data services for years, and recently smaller academic libraries have recognized the need to provide numeric data services and support. This guidebook serves as a primer to developing and supporting social science statistical and numerical data sources in the academic library. It provides strategies for the estab

  4. The Influence of Brand Image, Price, Service Quality and Facilities on Customer Satisfaction at Aston Hotel Manado

    OpenAIRE

    Taroreh, Rita N.; Mananeke, Lisbeth; Suwandi, Monica M.

    2015-01-01

    The economic condition of a country will change the mindset of people, so what happened in Indonesia it determines the public goods and services, in accordance with ability of business players and their business oriented towards the consumer. Consumers free use of money and free compare products or services and factors associated with services like the brand image, price, service quality and facilities. These days, service business in this case of hotel, have a thighter competition. As the ne...

  5. Quality of antenatal care service provision in health facilities across sub-Saharan Africa: Evidence from nationally representative health facility assessments.

    Science.gov (United States)

    Kanyangarara, Mufaro; Munos, Melinda K; Walker, Neff

    2017-12-01

    Utilization of antenatal care (ANC) services has increased over the past two decades. Continued gains in maternal and newborn health will require an understanding of both access and quality of ANC services. We linked health facility and household survey data to examine the quality of service provision for five ANC interventions across health facilities in sub-Saharan Africa. Using data from 20 nationally representative health facility assessments - the Service Provision Assessment (SPA) and the Service Availability and Readiness Assessment (SARA), we estimated facility level readiness to deliver five ANC interventions: tetanus toxoid vaccine for pregnant women, intermittent preventive treatment for malaria in pregnancy (IPTp), syphilis detection and treatment in pregnancy, iron supplementation and hypertensive disease case management. Facility level indicators were stratified by health facility type, managing authority and location, then linked to estimates of ANC utilization in that stratum from the corresponding Demographic and Health Surveys (DHS) to generate population level estimates of the 'likelihood of appropriate care'. Finally, the association between estimates of the 'likelihood of appropriate care' from the linking approach and estimates of coverage levels from the DHS were assessed. A total of 10 534 health facilities were surveyed in the 20 health facility assessments, of which 8742 reported offering ANC services and were included in the analysis. Health facility readiness to deliver IPTp, iron supplementation, and tetanus toxoid vaccination was higher (median: 84.1%, 84.9% and 82.8% respectively) than readiness to deliver hypertensive disease case management and syphilis detection and treatment (median: 23.0% and 19.9% respectively). Coverage of at least 4 ANC visits ranged from 24.8% to 75.8%. Estimates of the likelihood of appropriate care derived from linking health facility and household survey data showed marked gaps for all interventions

  6. 7 CFR 762.140 - General servicing responsibilities.

    Science.gov (United States)

    2010-01-01

    ... manner, protecting and accounting for the collateral, and remaining the mortgagee or secured party of...) Receiving all payments of principal and interest on the loan as they fall due and promptly disbursing to any... lender's servicing fee. (5) Performing an annual analysis of the borrower's financial condition to...

  7. 47 CFR 76.1602 - Customer service-general information.

    Science.gov (United States)

    2010-10-01

    ... cable franchise authority may enforce the customer service standards set forth in paragraph (b) of this section against cable operators. The franchise authority must provide affected cable operators 90 days... procedures, including the address and telephone number of the local franchise authority's cable office. (c...

  8. Audit of availability and distribution of paediatric cardiology services and facilities in Nigeria.

    Science.gov (United States)

    Ekure, Ekanem N; Sadoh, Wilson E; Bode-Thomas, Fidelia; Orogade, Adeola A; Animasahun, Adeola B; Ogunkunle, Oluwatoyin O; Babaniyi, Iretiola; Anah, Maxwell U; Otaigbe, Barbara E; Olowu, Adebiyi; Okpokowuruk, Frances; Omokhodion, Samuel I; Maduka, Ogechi C; Onakpoya, Uvie U; Adiele, Daberechi K; Sani, Usman M; Asani, Mustapha; Yilgwan, Christopher S; Daniels, Queennette; Uzodimma, Chinyere C; Duru, Chika O; Abdulkadir, Mohammad B; Afolabi, Joseph K; Okeniyi, John A

    Paediatric cardiac services in Nigeria have been perceived to be inadequate but no formal documentation of availability and distribution of facilities and services has been done. To evaluate and document the currently available paediatric cardiac services in Nigeria. In this questionnaire-based, cross-sectional descriptive study, an audit was undertaken from January 2010 to December 2014, of the personnel and infrastructure, with their distributions according to geopolitical zones of Nigeria. Forty-eight centres participated in the study, with 33 paediatric cardiologists and 31 cardiac surgeons. Echocardiography, electrocardiography and pulse oximetry were available in 45 (93.8%) centres while paediatric intensive care units were in 23 (47.9%). Open-heart surgery was performed in six (12.5%) centres. South-West zone had the majority of centres (20; 41.7%). Available paediatric cardiac services in Nigeria are grossly inadequate and poorly distributed. Efforts should be intensified to upgrade existing facilities, establish new and functional centres, and train personnel.

  9. Applied research and service activities at the University of Missouri Research Reactor Facility (MURR)

    International Nuclear Information System (INIS)

    Alger, D.M.

    1987-01-01

    The University Of Missouri operates MURR to provide an intense source of neutron and gamma radiation for research and applications by experimenters from its four campuses and by experimenters from other universities, government and industry. The 10 MW reactor, which has been operating an average of 155 hours per week for the past eight years, produces thermal neutron fluxes up to 6-7x10 14 n/cm 2 -s in the central flux trap and beamport source fluxes of up to 1.2x10 14 n/cm 2 -s. The mission of the reactor facility, to promote research, education and service, is the same as the overall mission of the university and therefore, applied research and service supported by industrial firms have been welcomed. The university recognized after a few years of reactor operation that in order to build utilization, it would be necessary to develop in-house research programs including people, equipment and activity so that potential users could more easily and quickly obtain the results needed. Nine research areas have been developed to create a broadly based program to support the level of activity needed to justify the cost of operating the facility. Applied research and service generate financial support for about one-half of the annual budget. The applied and service programs provide strong motivation for university/industry association in addition to the income generated. (author)

  10. The role of service readiness and health care facility factors in attrition from Option B+ in Haiti: a joint examination of electronic medical records and service provision assessment survey data.

    Science.gov (United States)

    Lipira, Lauren; Kemp, Christopher; Domercant, Jean Wysler; Honoré, Jean Guy; Francois, Kesner; Puttkammer, Nancy

    2018-01-01

    Option B+ is a strategy wherein pregnant or breastfeeding women with HIV are enrolled in lifelong antiretroviral therapy (ART) for prevention of mother-to-child transmission (PMTCT) of HIV. In Haiti, attrition from Option B+ is problematic and variable across health care facilities. This study explores service readiness and other facility factors as predictors of Option B+ attrition in Haiti. This analysis used longitudinal data from 2012 to 2014 from the iSanté electronic medical record system and cross-sectional data from Haiti's 2013 Service Provision Assessment. Predictors included Service Availability and Readiness Assessment (SARA) measures for antenatal care (ANC), PMTCT, HIV care services and ART services; general facility characteristics and patient-level factors. Multivariable Cox proportional hazards models modelled the time to first attrition. Analysis of data from 3147 women at 63 health care facilities showed no significant relationships between SARA measures and attrition. Having integrated ANC/PMTCT care and HIV-related training were significant protective factors. Being a public-sector facility, having a greater number of quality improvement activities and training in ANC were significant risk factors. Several facility-level factors were associated with Option B+ attrition. Future research is needed to explore unmeasured facility factors, clarify causal relationships, and incorporate community-level factors into the analysis of Option B+ attrition. © The Author(s) 2018. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. AREVA General Inspectorate Annual Report 2013 - Status of safety in nuclear facilities

    International Nuclear Information System (INIS)

    Oursel, Luc; Riou, Jean

    2014-06-01

    This annual report by AREVA's General Inspectorate deals with the status of nuclear safety and radiation protection in the group's facilities and operations over the course of 2013. Based on the findings made during implementation of the annual inspection program, this annual report also includes the results of the analysis of significant events and the observations and assessments of specialists in the Safety Health Security Sustainable Development Department (SHSSDD), supplemented by regular interaction with the safety regulators, different government agencies, stakeholders and other nuclear operators. Additionally, this report presents the action plans put into motion and the directions taken for continuous improvement in risk prevention for operations conducted in France and internationally. In 2013, the level of safety in the group's nuclear facilities and operations remained satisfactory, although improvements are necessary in some domains. This report is based on established indicators, analyses of reported events, responses to commitments made to the regulators, and the results of different improvement actions reported on in the inspected and supported entities. In 2013, no level 2 event on the International Nuclear and Radiological Event Scale (INES) was reported, the bottom-up reporting of weak signals was confirmed, dose levels were low and there were no radiological impacts on the environment. The General Inspectorate conducted 45 inspections in 30 of the group's entities in 2013. Of these, 10 concerned sites outside France and 7 were conducted following events or particular situations. These inspections gave rise to 176 recommendations, which the inspected entities have translated into action plans. Verification of these different action plans according to planned procedures and announced schedules gave rise to 16 follow-up inspections. The major lessons learned from these inspections relate to project management, facility compliance and operational

  12. Experts stress both wellness and amenity aspects of food and nutrition services in assisted living facilities for older adults.

    Science.gov (United States)

    Chao, Shirley Y; Dwyer, Johanna T; Houser, Robert F; Jacques, Paul; Tennstedt, Sharon

    2008-10-01

    There has been no consensus on best practices in food and nutrition services in assisted living facilities for older adults. We documented experts' views on optimal food and nutrition services emphases in assisted living facilities, and factors affecting their views. One hundred thirty-five national experts specializing in health, aging, nutrition and assisted living facilities completed a survey consisting four scenarios (ie, home-style, restaurant/hotel, and health/medical, and a combination of these three) in six food and nutrition services areas: dining room environment, meal services, meal quality, nutrition services, employees' qualifications, and therapeutic nutrition services. Sixty-three percent of experts favored the combination scenario. Dietetics education and experts' beliefs that assisted living facilities should be health promotion and maintenance facilities were significant predictors of emphases, including wellness considerations. Experts' personal views exerted a powerful influence. Experts chose food and nutrition service quality indicators that emphasized a focus on both wellness and amenities as their ideal scenarios for optimal food and nutrition services in assisted living facilities.

  13. Validated Competency Task Lists for General Merchandise Retailing, Food Service Management, and Business and Personal Services Marketing.

    Science.gov (United States)

    Faught, Suzanne G.

    This publication contains competency task lists that address principal entry-level and career-sustaining jobs in the occupational categories of general merchandise retailing, food service management, and business and personal services marketing. Section I, Development of the Competency Task Lists, provides details on how the competencies were…

  14. The Views of the Teachers Related to the Problems the Nursery Class Teachers Encounter in Personnel Services and General Services

    Science.gov (United States)

    Ertör, Eren; Akan, Durdagi

    2016-01-01

    In this study, it was aimed to analyze the problems that the nursery school teachers, who worked in primary schools of Ministry of National Education in Agri city center in 2014-2015 academic years, experience in personnel services and general services according to the views of the teachers. In the direction of this purpose, phenomenology design,…

  15. Remote Internet access to advanced analytical facilities: a new approach with Web-based services.

    Science.gov (United States)

    Sherry, N; Qin, J; Fuller, M Suominen; Xie, Y; Mola, O; Bauer, M; McIntyre, N S; Maxwell, D; Liu, D; Matias, E; Armstrong, C

    2012-09-04

    Over the past decade, the increasing availability of the World Wide Web has held out the possibility that the efficiency of scientific measurements could be enhanced in cases where experiments were being conducted at distant facilities. Examples of early successes have included X-ray diffraction (XRD) experimental measurements of protein crystal structures at synchrotrons and access to scanning electron microscopy (SEM) and NMR facilities by users from institutions that do not possess such advanced capabilities. Experimental control, visual contact, and receipt of results has used some form of X forwarding and/or VNC (virtual network computing) software that transfers the screen image of a server at the experimental site to that of the users' home site. A more recent development is a web services platform called Science Studio that provides teams of scientists with secure links to experiments at one or more advanced research facilities. The software provides a widely distributed team with a set of controls and screens to operate, observe, and record essential parts of the experiment. As well, Science Studio provides high speed network access to computing resources to process the large data sets that are often involved in complex experiments. The simple web browser and the rapid transfer of experimental data to a processing site allow efficient use of the facility and assist decision making during the acquisition of the experimental results. The software provides users with a comprehensive overview and record of all parts of the experimental process. A prototype network is described involving X-ray beamlines at two different synchrotrons and an SEM facility. An online parallel processing facility has been developed that analyzes the data in near-real time using stream processing. Science Studio and can be expanded to include many other analytical applications, providing teams of users with rapid access to processed results along with the means for detailed

  16. 76 FR 79221 - Penske Logistics, LLC, Customer Service Department General Motors and Tier Finished Goods...

    Science.gov (United States)

    2011-12-21

    ..., Customer Service Department General Motors and Tier Finished Goods/Finished Goods Division; a Subsidiary of... Manpower El Paso, TX; Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance... should read Penske Logistics, LLC, Customer Service Department, General Motors and Tier Finished Goods...

  17. 41 CFR 105-1.101 - General Services Administration Property Management Regulations.

    Science.gov (United States)

    2010-07-01

    ...-INTRODUCTION 1.1-Regulations System § 105-1.101 General Services Administration Property Management Regulations... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false General Services Administration Property Management Regulations. 105-1.101 Section 105-1.101 Public Contracts and Property...

  18. On the relation between cost and service models for general inventory systems

    NARCIS (Netherlands)

    Houtum, van G.J.J.A.N.; Zijm, W.H.M.

    2000-01-01

    In this paper, we present a systematic overview of possible relations between cost and service models for fairly general single- and multi-stage inventory systems. In particular, we relate various types of penalty costs in pure cost models to equivalent types of service measures in service models.

  19. 42 CFR 412.87 - Additional payment for new medical services and technologies: General provisions.

    Science.gov (United States)

    2010-10-01

    ... payment for new medical services and technologies: General provisions. (a) Basis. Sections 412.87 and 412... establish a mechanism to recognize the costs of new medical services and technologies under the hospital... that are new medical services and technologies, if the following conditions are met: (1) A new medical...

  20. A general theory to explain the relatively high cost of environmental restoration at DOE facilities

    International Nuclear Information System (INIS)

    Sullivan, W.H.

    1995-01-01

    Environmental Restoration costs for Department of Energy (DOE) facilities have been the subject of much scrutiny and concern for several years. General opinion is that DOE clean-up costs are as much as three times higher than costs for similar clean-up projects in the private sector. Consequently, DOE Environmental Restoration professionals are continually under pressure to do more with less, which, ironically, can lead to additional inefficiencies in the system. This paper proposes a general theory as to why DOE costs are higher, explains the reasons why current conditions will make it difficult to realize any pervasive or significant decreases in clean-up costs, and presents some general changes that need to take place in the DOE system in order to bring about conditions that will allow more efficient clean-up to occur. The theory is based on a simple economic model that describes the balance between the resources spent for risk avoidance and the corresponding changes in overall productivity as a function of risk. The elementary concepts illustrated with the economic model, when refined and specifically applied, have the potential to become the catalyst for significant change-change that is absolutely necessary if we truly intend to conduct environmental clean-up with the same efficiencies as private industry

  1. Evaluation of an aged care nurse practitioner service: quality of care within a residential aged care facility hospital avoidance service.

    Science.gov (United States)

    Dwyer, Trudy; Craswell, Alison; Rossi, Dolene; Holzberger, Darren

    2017-01-13

    Reducing avoidable hospitialisation of aged care facility (ACF) residents can improve the resident experience and their health outcomes. Consequently many variations of hospital avoidance (HA) programs continue to evolve. Nurse practitioners (NP) with expertise in aged care have the potential to make a unique contribution to hospital avoidance programs. However, little attention has been dedicated to service evaluation of this model and the quality of care provided. The purpose of this study was to evaluate the quality of an aged care NP model of care situated within a HA service in a regional area of Australia. Donabedian's structure, process and outcome framework was applied to evaluate the quality of the NP model of care. The Australian Nurse Practitioner Study standardised interview schedules for evaluating NP models of care guided the semi-structured interviews of nine health professionals (including ACF nurses, medical doctors and allied health professionals), four ACF residents and their families and two NPs. Theory driven coding consistent with the Donabedian framework guided analysis of interview data and presentation of findings. Structural dimensions identified included the 'in-reach' nature of the HA service, distance, limitations of professional regulation and the residential care model. These dimensions influenced the process of referring the resident to the NP, the NPs timely response and interactions with other professionals. The processes where the NPs take time connecting with residents, initiating collaborative care plans, up-skilling aged care staff and function as intra and interprofessional boundary spanners all contributed to quality outcomes. Quality outcomes in this study were about timely intervention, HA, timely return home, partnering with residents and family (knowing what they want) and resident and health professional satisfaction. This study provides valuable insights into the contribution of the NP model of care within an aged care

  2. Professional Human Service Occupation Biases Represented in General Psychology Textbooks

    Science.gov (United States)

    Firmin, Michael W.; Johnson, Erica J.; Wikler, Jeremiah

    2009-01-01

    We examined the coverage given by General Psychology textbooks, representing 8 major commercial publishers, regarding the professions of psychology, counseling, marriage & family therapy, and social workers. Of the 24 textbooks assessed, we found substantial bias favoring the coverage of psychology. While 25% of the texts mentioned social workers,…

  3. Preparedness of Lithuanian general practitioners to provide mental healthcare services

    DEFF Research Database (Denmark)

    Jaruseviciene, Lina; Sauliune, Skirmante; Jarusevicius, Gediminas

    2014-01-01

    BACKGROUND: A large unmet need for mental healthcare in Lithuania is partially attributable to a lack of primary care providers with skills in this area. The aim of this study was to assess general practitioners' (GPs) experience in mental healthcare and their perceptions about how to increase th...

  4. General principles governing sampling and measurement techniques for monitoring radioactive effluents from nuclear facilities

    International Nuclear Information System (INIS)

    Fitoussi, L.

    1978-01-01

    An explanation is given of the need to monitor the release of radioactive gases and liquid effluents from nuclear facilities, with particular emphasis on the ICRP recommendations and on the interest in this problem shown by the larger international organizations. This is followed by a description of the classes of radionuclides that are normally monitored in this way. The characteristics of monitoring 'in line' and 'by sample taking' are described; the disadvantages of in line monitoring and the problem of sample representativity are discussed. There follows an account of the general principles for measuring gaseous and liquid effluents that are applied in the techniques normally employed at nuclear facilities. Standards relating to the specifications for monitoring instruments are at present being devised by the International Electrotechnical Commission, and there are still major differences in national practices, at least as far as measurement thresholds are concerned. In conclusion, it is shown that harmonization of practices and standardization of equipment would probably help to make international relations in the field more productive. (author)

  5. Protection of facilities against sabotage general approaches and studies in France

    International Nuclear Information System (INIS)

    Venot, R.; Loiseau, O.; Cheval, K.

    2004-01-01

    In addition to the measures taken in the frame of the nuclear safety demonstration, the French nuclear facilities are subjected to a specific verification approach concerning the risk resulting from a malevolent action that may cause a release of radioactive materials in the environment. This approach aims at determining the protection level for facilities, based on predefined threats and the provisions to be set, if necessary, to ensure a satisfactory protection. The approach presented in this paper basically consists of a sensitivity analysis followed by a vulnerability analysis. In the French national control system also shortly described in the paper, the competent authority asks the operator to present a demonstration based on the approach and IRSN is charged with the technical assessment of the dossier. Because these analyses are generally based on specific tools, particularly in the case of vulnerability assessment, IRSN has raised a program to collect a set of methods and data on this subject, presented in the second part of this paper. It must be pointed out that no quantitative results or detailed examples will be given in the paper due to the sensitivity of the subject and the confidentiality measures applying. (orig.)

  6. Medicare Advantage Members' Expected Out-Of-Pocket Spending For Inpatient And Skilled Nursing Facility Services.

    Science.gov (United States)

    Keohane, Laura M; Grebla, Regina C; Mor, Vincent; Trivedi, Amal N

    2015-06-01

    Inpatient and skilled nursing facility (SNF) cost sharing in Medicare Advantage (MA) plans may reduce unnecessary use of these services. However, large out-of-pocket expenses potentially limit access to care and encourage beneficiaries at high risk of needing inpatient and postacute care to avoid or leave MA plans. In 2011 new federal regulations restricted inpatient and skilled nursing facility cost sharing and mandated limits on out-of-pocket spending in MA plans. After these regulations, MA members in plans with low premiums averaged $1,758 in expected out-of-pocket spending for an episode of seven hospital days and twenty skilled nursing facility days. Among members with the same low-premium plan in 2010 and 2011, 36 percent of members belonged to plans that added an out-of-pocket spending limit in 2011. However, these members also had a $293 increase in average cost sharing for an inpatient and skilled nursing facility episode, possibly to offset plans' expenses in financing out-of-pocket limits. Some MA beneficiaries may still have difficulty affording acute and postacute care despite greater regulation of cost sharing. Project HOPE—The People-to-People Health Foundation, Inc.

  7. Medicare Advantage Members’ Expected Out-Of-Pocket Spending For Inpatient And Skilled Nursing Facility Services

    Science.gov (United States)

    Keohane, Laura M.; Grebla, Regina C.; Mor, Vincent; Trivedi, Amal N.

    2015-01-01

    Inpatient and skilled nursing facility (SNF) cost sharing in Medicare Advantage (MA) plans may reduce unnecessary use of these services. However, large out-of-pocket expenses potentially limit access to care and encourage beneficiaries at high risk of needing inpatient and postacute care to avoid or leave MA plans. In 2011 new federal regulations restricted inpatient and skilled nursing facility cost sharing and mandated limits on out-of-pocket spending in MA plans. After these regulations, MA members in plans with low premiums averaged $1,758 in expected out-of-pocket spending for an episode of seven hospital days and twenty skilled nursing facility days. Among members with the same low-premium plan in 2010 and 2011, 36 percent of members belonged to plans that added an out-of-pocket spending limit in 2011. However, these members also had a $293 increase in average cost sharing for an inpatient and skilled nursing facility episode, possibly to offset plans’ expenses in financing out-of-pocket limits. Some MA beneficiaries may still have difficulty affording acute and postacute care despite greater regulation of cost sharing. PMID:26056208

  8. Community Extreme Tonnage User Service (CETUS): A 5000 Ton Open Research Facility in the United States

    Science.gov (United States)

    Danielson, L. R.; Righter, K.; Vander Kaaden, K. E.; Rowland, R. L., II; Draper, D. S.; McCubbin, F. M.

    2017-12-01

    Large sample volume 5000 ton multi-anvil presses have contributed to the exploration of deep Earth and planetary interiors, synthesis of ultra-hard and other novel materials, and serve as a sample complement to pressure and temperature regimes already attainable by diamond anvil cell experiments. However, no such facility exists in the Western Hemisphere. We are establishing an open user facility for the entire research community, with the unique capability of a 5000 ton multi-anvil and deformation press, HERA (High pressure Experimental Research Apparatus), supported by a host of extant co-located experimental and analytical laboratories and research staff. We offer wide range of complementary and/or preparatory experimental options. Any required synthesis of materials or follow up experiments can be carried out controlled atmosphere furnaces, piston cylinders, multi-anvil, or experimental impact apparatus. Additionally, our division houses two machine shops that would facilitate any modification or custom work necessary for development of CETUS, one for general fabrication and one located specifically within our experimental facilities. We also have a general sample preparation laboratory, specifically for experimental samples, that allows users to quickly and easily prepare samples for ebeam analyses and more. Our focus as contract staff is on serving the scientific needs of our users and collaborators. We are seeking community expert input on multiple aspects of this facility, such as experimental assembly design, module modifications, immediate projects, and future innovation initiatives. We've built a cooperative network of 12 (and growing) collaborating institutions, including COMPRES. CETUS is a coordinated effort leveraging HERA with our extant experimental, analytical, and planetary process modelling instrumentation and expertise in order to create a comprehensive model of the origin and evolution of our solar system and beyond. We are looking to engage

  9. Health facility characteristics and their relationship to coverage of PMTCT of HIV services across four African countries: the PEARL study.

    Directory of Open Access Journals (Sweden)

    Didier K Ekouevi

    Full Text Available Health facility characteristics associated with effective prevention of mother-to-child transmission of HIV (PMTCT coverage in sub-Saharan are poorly understood.We conducted surveys in health facilities with active PMTCT services in Cameroon, Cote d'Ivoire, South Africa, and Zambia. Data was compiled via direct observation and exit interviews. We constructed composite scores to describe provision of PMTCT services across seven topical areas: antenatal quality, PMTCT quality, supplies available, patient satisfaction, patient understanding of medication, and infrastructure quality. Pearson correlations and Generalized Estimating Equations (GEE to account for clustering of facilities within countries were used to evaluate the relationship between the composite scores, total time of visit and select individual variables with PMTCT coverage among women delivering. Between July 2008 and May 2009, we collected data from 32 facilities; 78% were managed by the government health system. An opt-out approach for HIV testing was used in 100% of facilities in Zambia, 63% in Cameroon, and none in Côte d'Ivoire or South Africa. Using Pearson correlations, PMTCT coverage (median of 55%, (IQR: 33-68 was correlated with PMTCT quality score (rho = 0.51; p = 0.003; infrastructure quality score (rho = 0.43; p = 0.017; time spent at clinic (rho = 0.47; p = 0.013; patient understanding of medications score (rho = 0.51; p = 0.006; and patient satisfaction quality score (rho = 0.38; p = 0.031. PMTCT coverage was marginally correlated with the antenatal quality score (rho = 0.304; p = 0.091. Using GEE adjustment for clustering, the, antenatal quality score became more strongly associated with PMTCT coverage (p<0.001 and the PMTCT quality score and patient understanding of medications remained marginally significant.We observed a positive relationship between an antenatal quality score and PMTCT coverage but did not identify

  10. Procedure for the training of workers of facilities of service of the trade retailer.

    Directory of Open Access Journals (Sweden)

    Tania Ivón Sosa Ibarra

    2011-09-01

    Full Text Available The benefit of the services transforms quickly. To improve this activity is vital to reach the excellence and a fundamental element is the human factor that should be motivated and highly qualified to satisfy the necessities of the clients, of there the importance of its superación. In this investigation a training procedure is designed for workers of facilities of service of the trade that it facilitates, starting from an appropriate detection of the training necessities, to execute actions to achieve an improvement in the benefit of the services. These transformations in the superación of the workers impact significantly in their conceptions, in order to achieve the formation of a professional of the sector from the much more competent and adjusted services to the demands that it demands the current moment. The procedure is feasible of applying in all the establishments of the commercial net and it contemplates four moments: diagnostic, projection, execution and the control. It constitutes a novel experience, to the being a proposal of change and innovation in the environment of the training and the benefit of the services in the sector of the trade and it can favor the development of work values.

  11. 9 CFR 203.12 - Statement with respect to providing services and facilities at stockyards on a reasonable and...

    Science.gov (United States)

    2010-01-01

    ..., marketing, buying, or selling on a commission basis or otherwise, feeding, watering, holding, delivery..., buying, or selling on a commission basis or otherwise, marketing, feeding, watering, holding, delivery... facilities. Such services and facilities include, but are not limited to, the restaurant, restrooms, drinking...

  12. KNOWLEDGE IS REFERENCE FACILITIES OF SUPPORT OF PROCESSES OF INFORMATIVE ACCOMPANIMENT OF MEDICAL SERVICE OF POPULATION (first report

    Directory of Open Access Journals (Sweden)

    O. P. Mintser

    2012-11-01

    Full Text Available Described approaches, models and facilities of forming of the systems of knowledges, by the s purpose of support of grant informatively consultative services at medical practice of doctor. Ontological models, facilities of linguistic analysis and visualization of reflection of objects of medical industry, are determined.

  13. 75 FR 10525 - In the Matter of: AREVA Enrichment Services, LLC (Eagle Rock Enrichment Facility) and All Other...

    Science.gov (United States)

    2010-03-08

    ...: AREVA Enrichment Services, LLC (Eagle Rock Enrichment Facility) and All Other Persons Who Seek or Obtain... for the Implementation of a Safeguards Information Program (Effective Immediately) I AREVA Enrichment... it to construct and operate a uranium enrichment facility in Bonneville County, Idaho. AES submitted...

  14. Statistical near-real-time accountancy procedures applied to AGNS [Allied General Nuclear Services] minirun data using PROSA

    International Nuclear Information System (INIS)

    Beedgen, R.

    1988-03-01

    The computer program PROSA (PROgram for Statistical Analysis of near-real-time accountancy data) was developed as a tool to apply statistical test procedures to a sequence of materials balance results for detecting losses of material. First applications of PROSA to model facility data and real plant data showed that PROSA is also usable as a tool for process or measurement control. To deepen the experience for the application of PROSA to real data of bulk-handling facilities, we applied it to uranium data of the Allied General Nuclear Services miniruns, where accountancy data were collected on a near-real-time basis. Minirun 6 especially was considered, and the pulsed columns were chosen as materials balance area. The structure of the measurement models for flow sheet data and actual operation data are compared, and methods are studied to reduce the error for inventory measurements of the columns

  15. [Dementia friendly care services in general hospitals : Representative results of the general hospital study (GHoSt)].

    Science.gov (United States)

    Hendlmeier, Ingrid; Bickel, Horst; Hessler, Johannes Baltasar; Weber, Joshua; Junge, Magdalena Nora; Leonhardt, Sarah; Schäufele, Martina

    2017-11-06

    Mostly model projects report on special care services and procedures for general hospital patients with cognitive impairment. The objective of this study was to determine the frequency of special care services and procedures in general hospitals on the basis of a representative cross-sectional study. From a list of all general hospitals in southern Germany we randomly selected a specified number of hospitals und somatic wards. The hospitals were visited and all older patients on the selected wards on that day were included in the study. Information about care services and their utilization was collected with standardized instruments. A total of 33 general hospitals and 172 wards participated in the study. The patient sample included 1469 persons over 65 (mean age 78.6 years) and 40% of the patients showed cognitive impairments. The staff reported that the most frequent measures for patients with cognitive impairments concerned patients with wandering behavior (63.1%), efforts to involve the patients' relatives to help with their daily care (60.1%), conducting nonintrusive interviews to identify cognitive impairments (59.9%), allocation to other rooms (58%) and visual aids for place orientation of patients (50.6%). In accordance with earlier studies our results show that other dementia friendly services implemented in pilot projects were rare. The existing special services for patients with cognitive impairment were rarely used by the patients or their relatives. The results demonstrate the urgent need to improve special care services and routines for identification of elderly patients with cognitive impairment and risk of delirium in general hospitals.

  16. Is the case-mix of patients who self-present to ED similar to general practice and other acute-care facilities?

    Science.gov (United States)

    Harris, Tim; McDonald, Keith

    2014-12-01

    To benchmark walk-in presentations to emergency departments (ED) with those presenting to other local acute healthcare facilities. A large teaching hospital with an annual ED census of 140, 000 adult patients and surrounding associated acute healthcare providers. A random sample of 384 patients who self-presented to the ED was obtained. Benchmarking data were drawn from two general practices; the Tower Hamlets Community Services walk-in centre (co-located on-site with the ED) and the GP-run out-of-hours service. The case-mix presenting to the ED was characterised by a higher proportion of injuries and chest pain, but fewer simple infections and non-traumatic musculoskeletal conditions as compared to other acute care facilities in our region. Patients with injuries and possible cardiac chest pain were more likely to attend the ED, and those with infection or musculoskeletal problems less likely, as compared with other acute healthcare facilities. The population presenting to the ED is distinct from that presenting to general practice, out-of-hours clinics, or walk-in centres. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Protection of consumer rights in the field of economic services of general economic interest

    Directory of Open Access Journals (Sweden)

    Vasile Dinu

    2013-06-01

    Full Text Available Over the years, the demand for services of general interest and the manner they are provided have evolved significantly. Services that the state would traditionally provide in a direct form have been increasingly outsourced by national, regional and local authorities, and are now often provided by the private sector (with or without profit. This changed approach is driven by the processes of deregulation, the changes in government policies and the changing needs and expectations of users According to its European definition, a general interest service is a service that "public authorities classify as being general interest, and is subject to specific public service obligations". These services were identified as having a central role in the European model of society that the European Union has been built on, because they meet people’s basic needs.

  18. How to Measure Quality of Service Using Unstructured Data Analysis: A General Method Design

    Directory of Open Access Journals (Sweden)

    Lucie Sperková,

    2015-10-01

    Full Text Available The aim of the paper is to design a general method usable for measuring the quality of the service from the customer’s point of view with the help of content analytics. Large amount of unstructured data is created by customers of the service. This data can provide a valuable feedback from the service usage. Customers talk among themselves about their experiences and feelings from consumption of the service. The design of the method is based on a systematic literature review in the area of the service quality and unstructured data analysis. Analytics and quality measurement models are collected and critically evaluated regarding their potential use for measuring IT service quality. The method can be used by IT service provider to measure and monitor service quality based on World-of-Mouth in order to continual service improvement.

  19. Telemental health technology in deaf and general mental-health services: access and use.

    Science.gov (United States)

    Austen, Sally; McGrath, Melissa

    2006-01-01

    Long-distance travel to provide mental health services for deaf people has implications for efficiency, safety, and equality of service. However, uptake of Telemental Health (TMH) has been slow in both deaf and general mental health services. A quantitative study was used to investigate access to TMH and whether staff confidence, experience, or demographics affect TMH use. It was concluded that staff in neither deaf mental health services nor general mental health services had adequate knowledge of or access to TMH. Staff expressed concerns over TMH's appropriateness in their work. Previous use of videoconferencing was assosciated significantly with confidence, but previous use of videophones was not. Neither staff in deaf services nor deaf staff were more experienced with or more confident about videoconferencing, whereas, within deaf services, deaf staff were significantly more confident about videophone use. Training implications are discussed.

  20. Course: general radiodiagnostics. Qualification to hand x-ray facilities with diagnostics purposes

    International Nuclear Information System (INIS)

    CIEMAT. Instituto de Estudios de la Energia.

    1993-01-01

    This book contains 13 lectures in order to teach personnel of x-ray facilities. The topics are: 1) Interaction photon-matter. 2) Characteristics of x-ray equipments. 3) Ionizing radiation detection. 4) Quality control of x-ray facilities. 5) Radiation effects of ionizing radiations. 6) Radiation protection. 7) Quality control of radiodiagnostic facilities. 81) Spanish legislation

  1. 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...

  2. Policy implementation in practice: the case of national service frameworks in general practice.

    Science.gov (United States)

    Checkland, Kath; Harrison, Stephen

    2004-10-01

    National Service Frameworks are an integral part of the government's drive to 'modernise' the NHS, intended to standardise both clinical care and the design of the services used to deliver that clinical care. This article uses evidence from qualitative case studies in three general practices to illustrate the difficulties associated with the implementation of such top-down guidelines and models of service. In these studies it was found that, while there had been little explicit activity directed at implementation overall, the National Service Framework for coronary heart disease had in general fared better than that for older people. Gunn's notion of 'perfect implementation' is used to make sense of the findings.

  3. Healthcare service providers' and facility administrators' perspectives of the free maternal healthcare services policy in Malindi District, Kenya: a qualitative study.

    Science.gov (United States)

    Lang'at, Evaline; Mwanri, Lillian

    2015-06-27

    Globally, there are increasing efforts to improve maternal health outcomes including the reduction in maternal mortality rates. Improved access to skilled care utilisation during pregnancy and delivery has been one of the strategies employed to improve maternal health outcomes. In Kenya, more than half of the women deliver without the assistance of a skilled attendant and this has contributed to high maternal mortality rates. The free maternal healthcare services policy in all public facilities was initiated as a strategy to improve access to skilled care and reduce poor maternal health outcomes. This study aimed to explore the perspectives of the service providers and facility administrators of the free maternal health care service policy that was introduced in Kenya in 2013. A qualitative inquiry using semi-structured one-on-one interviews was conducted in Malindi District, Kenya. The participants included maternal health service providers and facility administrators recruited from five different healthcare facilities. Data were analysed using a thematic framework analysis. Free maternal healthcare service provision was perceived to boost skilled care utilisation during pregnancy and delivery. However, challenges including; delays in the reimbursement of funds by the government to the facilities, stock outs of essential commodities in the facilities to facilitate service provision, increased workload amidst staff shortage and lack of consultation and sensitisation of key stakeholders were perceived as barriers to effective implementation of this policy. Free maternal healthcare services can be one of the strategies to improve a range of maternal health outcomes. However, the implementation of this policy would be more effective if; the healthcare facilities were upgraded, equipped with adequate supplies, funds and staff; the community are continually sensitized on the importance of seeking skilled care during pregnancy and delivery; and inclusivity and

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

    Science.gov (United States)

    Cohn, Amy; Elmasry, Hoda; Niaura, Ray

    2017-06-01

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

  5. Experts stress both wellness and amenity aspects of food and nutrition services in assisted living facilities for older adults

    Science.gov (United States)

    There has been no consensus on best practices in food and nutrition services in assisted living facilities (ALFs) for older adults. We documented experts’ views on optimal food and nutrition services emphases in ALFs, and factors affecting their views. One hundred thirty-five national experts speci...

  6. What services are public? What aspects of performance are to be ranked? The case of “services of general interest”

    NARCIS (Netherlands)

    S.G.J. Van de Walle (Steven)

    2008-01-01

    textabstractIn this article, we focus on the difficulties in evaluating the performance of so-called services of general interest. These services generally include such services as water and electricity supply, telephony, postal services, and public transport, where providers are subjected to

  7. A Facile and General Approach to Recoverable High-Strain Multishape Shape Memory Polymers.

    Science.gov (United States)

    Li, Xingjian; Pan, Yi; Zheng, Zhaohui; Ding, Xiaobin

    2018-03-01

    Fabricating a single polymer network with no need to design complex structures to achieve an ideal combination of tunable high-strain multiple-shape memory effects and highly recoverable shape memory property is a great challenge for the real applications of advanced shape memory devices. Here, a facile and general approach to recoverable high-strain multishape shape memory polymers is presented via a random copolymerization of acrylate monomers and a chain-extended multiblock copolymer crosslinker. As-prepared shape memory networks show a large width at the half-peak height of the glass transition, far wider than current classical multishape shape memory polymers. A combination of tunable high-strain multishape memory effect and as high as 1000% recoverable strain in a single chemical-crosslinking network can be obtained. To the best of our knowledge, this is the first thermosetting material with a combination of highly recoverable strain and tunable high-strain multiple-shape memory effects. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  8. Determinants of facility readiness for integration of family planning with HIV testing and counseling services: evidence from the Tanzania service provision assessment survey, 2014-2015.

    Science.gov (United States)

    Bintabara, Deogratius; Nakamura, Keiko; Seino, Kaoruko

    2017-12-22

    Global policy reports, national frameworks, and programmatic tools and guidance emphasize the integration of family planning and HIV testing and counseling services to ensure universal access to reproductive health care and HIV prevention. However, the status of integration between these two services in Tanzanian health facilities is unclear. This study examined determinants of facility readiness for integration of family planning with HIV testing and counseling services in Tanzania. Data from the 2014-2015 Tanzania Service Provision Assessment Survey were analyzed. Facilities were considered ready for integration of family planning with HIV testing and counseling services if they scored ≥ 50% on both family planning and HIV testing and counseling service readiness indices as identified by the World Health Organization. All analyses were adjusted for clustering effects, and estimates were weighted to correct for non-responses and disproportionate sampling. Descriptive, bivariate, and multivariate logistic regression analyses were performed. A total of 1188 health facilities were included in the study. Of all of the health facilities, 915 (77%) reported offering both family planning and HIV testing and counseling services, while only 536 (45%) were considered ready to integrate these two services. Significant determinants of facility readiness for integrating these two services were being government owned [AOR = 3.2; 95%CI, 1.9-5.6], having routine management meetings [AOR = 1.9; 95%CI, 1.1-3.3], availability of guidelines [AOR = 3.8; 95%CI, 2.4-5.8], in-service training of staff [AOR = 2.6; 95%CI, 1.3-5.2], and availability of laboratories for HIV testing [AOR = 17.1; 95%CI, 8.2-35.6]. The proportion of facility readiness for the integration of family planning with HIV testing and counseling in Tanzania is unsatisfactory. The Ministry of Health should distribute and ensure constant availability of guidelines, availability of rapid diagnostic

  9. Audit of HIV counselling and testing services among primary healthcare facilities in Cameroon: a protocol for a multicentre national cross-sectional study.

    Science.gov (United States)

    Tianyi, Frank-Leonel; Tochie, Joel Noutakdie; Agbor, Valirie Ndip; Kadia, Benjamin Momo

    2018-03-01

    HIV testing is an invaluable entry point to prevention, care and treatment services for people living with HIV and AIDS. Poor adherence to recommended protocols and guidelines reduces the performance of rapid diagnostic tests, leading to misdiagnosis and poor estimation of HIV seroprevalence. This study seeks to evaluate the adherence of primary healthcare facilities in Cameroon to recommended HIV counselling and testing (HCT) procedures and the impact this may have on the reliability of HIV test results. This will be an analytical cross-sectional study involving primary healthcare facilities from all the 10 regions of Cameroon, selected by a multistaged random sampling of primary care facilities in each region. The study will last for 9 months. A structured questionnaire will be used to collect general information concerning the health facility, laboratory and other departments involved in the HCT process. The investigators will directly observe at least 10 HIV testing processes in each facility and fill out the checklist accordingly. Clearance has been obtained from the National Ethical Committee to carry out the study. Informed consent will be sought from the patients to observe the HIV testing process. The final study will be published in a peer-reviewed journal and the findings presented to health policy-makers and the general public. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Print Advertising of Educational Services: an investigation on the impact of the pictures facilities and testimonial about attitudes

    OpenAIRE

    Ayrosa, Eduardo André Teixeira; Facó, Marcos Henrique

    2010-01-01

    Just like other services organizations, some higher education institutions have invested in printed advertising to attract applicants. The services management literature suggests that using stimuli such as pictures of the facilities and alumni testimonials may help to turn tangible the offer of services so strongly intangible as higher education. In the present work, the impact of two different types of cue on prospects' attitudes is investigated. The cue paradigm (Olson & Jacoby 1972) has be...

  11. Service Quality and Consumer Perception on Retail Banking Facilities and Employees' Courtesy in Malaysia and New Zealand

    OpenAIRE

    Moha Asri Abdullah; Noor Hazilah Abd Manaf; Kamru Ahsan; Ferdous Azam

    2014-01-01

    Service quality and consumer perception are the issues being focused solicitously by the business community today. With the expansion of the banking sector and extensive market formation, scopes of different acuity and satisfaction level for consumers seem to impose a mingle game of their perception on service quality especially in retail banking. However, this study is focused on the service quality and consumer perception on retail banking facilities and employees' courtesy in Malaysia and ...

  12. In-Course Instructor-Guided Service Learning in a Community College General Psychology Class

    Science.gov (United States)

    Goomas, David T.; Weston, Melissa B.

    2012-01-01

    Students enrolled in two general psychology classes at El Centro College (ECC) of the Dallas County Community College District (DCCCD) were offered the opportunity to earn extra credit by performing up to 20 hours of service learning. Benefits of service learning were observed in student development, including exploration of career possibilities,…

  13. 77 FR 9659 - General Services Administration Acquisition Regulation; Information Collection; GSA Mentor...

    Science.gov (United States)

    2012-02-17

    ... Services Administration Acquisition Regulation; Information Collection; GSA Mentor-Prot[eacute]g[eacute... collection concerning the GSA Mentor-Prot[eacute]g[eacute] Program, General Service Administration...- 0286, GSA Mentor-Prot[eacute]g[eacute] Program by any of the following methods: Regulations.gov : http...

  14. 77 FR 31016 - General Services Administration Acquisition Regulation; Submission for OMB Review; GSA Mentor...

    Science.gov (United States)

    2012-05-24

    ... Services Administration Acquisition Regulation; Submission for OMB Review; GSA Mentor-Prot[eacute]g[eacute... collection concerning the GSA Mentor-Prot[eacute]g[eacute] Program, General Service Administration... Collection 3090- 0286, GSA Mentor-Prot[eacute]g[eacute] Program by any of the following methods: Regulations...

  15. Examining physicians’ preparedness for tobacco cessation services in India: Findings from primary care public health facilities in two Indian states

    Directory of Open Access Journals (Sweden)

    Rajmohan Panda

    2013-03-01

    Full Text Available BackgroundA total of 275 million tobacco users live throughout India and are in need of tobacco cessation services. However, the preparation of physicians to deliver this service at primary care health facilities remains unknown.AimsThe study aimed to examine the primary care physicians’ preparedness to deliver tobacco cessation services in two Indian states.MethodResearchers surveyed physicians working in primary care public health facilities, primarily in rural areas using a semistructured interview schedule. Physicians’ preparedness was defined in the study as those possessing knowledge of tobacco cessation methods and exhibiting a positive attitude towards the benefits of tobacco cessation counselling as well as being willing to be part of tobacco prevention or cessation program.ResultsOverall only 17% of physicians demonstrated adequate preparation to provide tobacco cessation services at primary care health facilities in both the States. The findings revealed minimal tobacco cessation training during formal medical education (21.3% and on-the-job training (18.9%. Factors, like sex and age of service provider, type of health facility, location of health facility and number of patients attended by the service provider, failed to show significance during bivariate and regression analysis. Preparedness was significantly predicted by state health system.ConclusionThe study highlights a lack of preparedness of primary care physicians to deliver tobacco cessation services. Both the curriculum in medical school and on-the-job training require an addition of a learning component on tobacco cessation. The addition of this component will enable existing primary care facilities to deliver tobacco cessation services.

  16. [Comprehensive study on the prevention of food poisoning through the investigation of an affected hospital food service facility].

    Science.gov (United States)

    Kubota, Satoshi; Kawai, Hiromi

    2015-01-01

    In Japan, more than 20,000 people suffer from various types of food poisoning annually. In this paper, we discuss the prevention of food poisoning in hospital food service facilities from the perspective of hygiene management and organizational behavior. We inspected the kitchen environment and the meal preparation process in a hospital food service facility in Japan that had been the site of a food poisoning incident. To clarify the present state of hygiene management, interviews were conducted with both the head of the nutrition and food service section and the administrative manager. In addition, questionnaires were distributed to the food service staff to assess their level of satisfaction with the working environment. The facility had been built about 10 years previously and was well maintained. Meal preparations were performed according to the operation manual, and education and training for the food service staff were carried out daily. No problems were evident regarding hygiene management. However, concerning organizational behavior, the satisfaction level of the staff was found to be relatively low, which may have led to a reduction in their organizational commitment and a decrease in their performance. To aid in the prevention of food poisoning incidents in hospital food service facilities, it is essential not only to conduct standard hygiene management and training, but also to consider the organizational behavior of the food service staff.

  17. General Plan Environmental Assessment for Joint Base Andrews-Naval Air Facility, Washington, Maryland

    Science.gov (United States)

    2011-04-01

    new facility, Building 1535 would be demolished. The new administrative campus would be anchored by the BRAC/NCR facility and will include future...squadron operations facility, Building 1658, provides the anchor to further development of operations-related facilities in this area. The...A!l’ltndm<:r.l b &pp<QVN. Th.it a.:tiGn romplttes MOE’s n:litw of the ()cle, u r~uind by S«tion 9-507 of the E’.nvironmtnt Ankle of !he Annolai.t<l

  18. A standards-based approach to quality improvement for HIV services at Zambia Defence Force facilities: results and lessons learned.

    Science.gov (United States)

    Kols, Adrienne; Kim, Young-Mi; Bazant, Eva; Necochea, Edgar; Banda, Joseph; Stender, Stacie

    2015-07-01

    The Zambia Defence Force adopted the Standards-Based Management and Recognition approach to improve the quality of the HIV-related services at its health facilities. This quality improvement intervention relies on comprehensive, detailed assessment tools to communicate and verify adherence to national standards of care, and to test and implement changes to improve performance. A quasi-experimental evaluation of the intervention was conducted at eight Zambia Defence Force primary health facilities (four facilities implemented the intervention and four did not). Data from three previous analyses are combined to assess the effect of Standards-Based Management and Recognition on three domains: facility readiness to provide services; observed provider performance during antiretroviral therapy (ART) and antenatal care consultations; and provider perceptions of the work environment. Facility readiness scores for ART improved on four of the eight standards at intervention sites, and one standard at comparison sites. Facility readiness scores for prevention of mother-to-child transmission (PMTCT) of HIV increased by 15 percentage points at intervention sites and 7 percentage points at comparison sites. Provider performance improved significantly at intervention sites for both ART services (from 58 to 84%; P improved at intervention sites and declined at comparison sites; differences in trends between study groups were significant for eight items. A standards-based approach to quality improvement proved effective in supporting healthcare managers and providers to deliver ART and PMTCT services in accordance with evidence-based standards in a health system suffering from staff shortages.

  19. The relative patient costs and availability of dental services, materials and equipment in public oral care facilities in Tanzania.

    Science.gov (United States)

    Nyamuryekung'e, Kasusu K; Lahti, Satu M; Tuominen, Risto J

    2015-07-01

    Patient charges and availability of dental services influence utilization of dental services. There is little available information on the cost of dental services and availability of materials and equipment in public dental facilities in Africa. This study aimed to determine the relative cost and availability of dental services, materials and equipment in public oral care facilities in Tanzania. The local factors affecting availability were also studied. A survey of all district and regional dental clinics in selected regions was conducted in 2014. A total of 28/30 facilities participated in the study. A structured interview was undertaken amongst practitioners and clinic managers within the facilities. Daily resources for consumption (DRC) were used for estimation of patients' relative cost. DRC are the quantified average financial resources required for an adult Tanzanian's overall consumption per day. Tooth extractions were found to cost four times the DRC whereas restorations were 9-10 times the DRC. Studied facilities provided tooth extractions (100%), scaling (86%), fillings (79%), root canal treatment (46%) and fabrication of removable partial dentures (32%). The ratio of tooth fillings to extractions in the facilities was 1:16. Less than 50% of the facilities had any of the investigated dental materials consistently available throughout the year, and just three facilities had all the investigated equipment functional and in use. Dental materials and equipment availability, skills of the practitioners and the cost of services all play major roles in provision and utilization of comprehensive oral care. These factors are likely to be interlinked and should be taken into consideration when studying any of the factors individually.

  20. 78 FR 32461 - Verizon Services Corporation, Customer Service Clerk, General Clerk, Clarksburg, West Virginia...

    Science.gov (United States)

    2013-05-30

    ... only Mexico but also the Philippines and India; that the worker group at Clarksburg, West Virginia are... the company for internet issues, we spoke with Verizon workers in India.'' During the reconsideration... Determination Regarding Application for Reconsideration for the workers and former workers of Verizon Services...

  1. 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...

  2. Polycyclic aromatic hydrocarbon levels and risk assessment for food from service facilities in Korea.

    Science.gov (United States)

    Park, Shin-Woong; Jeong, Jun-Hyun; Her, Jae-Young; Kim, Mina K; Lee, Kwang-Geun

    2017-06-01

    In this study, levels of benzo[a]anthracene, chrysene, benzo[b]fluoranthene, benzo[k]fluoranthene, benzo[a]pyrene (BaP), dibenzo[a,h]anthracene, benzo[g,h,i]perylene and indeno[1,2,3-c,d]pyrene in 412 food items collected from food service facilities in Korea were analysed. The concentrations of the eight polycyclic aromatic hydrocarbons (PAHs) ranged 0.13-0.48 μg/kg. The concentrations of benzo[a]pyrene in all food samples were foods regulated by European Union legislation. PAH contents were employed to conduct exposure and risk assessment. The chronic daily intake of PAHs from 412 food samples was 5.48 × 10 -6 -4.70 ×x 10 -4  µg-TEQ BaP /kg/day with margins of exposure of 1.04 × 10 9 -1.16 × 10 11 .

  3. HEPCloud, a New Paradigm for HEP Facilities: CMS Amazon Web Services Investigation

    Energy Technology Data Exchange (ETDEWEB)

    Holzman, Burt [Fermilab; Bauerdick, Lothar A.T. [Fermilab; Bockelman, Brian [Nebraska U.; Dykstra, Dave [Fermilab; Fisk, Ian [New York U.; Fuess, Stuart [Fermilab; Garzoglio, Gabriele [Fermilab; Girone, Maria [CERN; Gutsche, Oliver [Fermilab; Hufnagel, Dirk [Fermilab; Kim, Hyunwoo [Fermilab; Kennedy, Robert [Fermilab; Magini, Nicolo [Fermilab; Mason, David [Fermilab; Spentzouris, Panagiotis [Fermilab; Tiradani, Anthony [Fermilab; Timm, Steve [Fermilab; Vaandering, Eric W. [Fermilab

    2017-09-29

    Historically, high energy physics computing has been performed on large purpose-built computing systems. These began as single-site compute facilities, but have evolved into the distributed computing grids used today. Recently, there has been an exponential increase in the capacity and capability of commercial clouds. Cloud resources are highly virtualized and intended to be able to be flexibly deployed for a variety of computing tasks. There is a growing nterest among the cloud providers to demonstrate the capability to perform large-scale scientific computing. In this paper, we discuss results from the CMS experiment using the Fermilab HEPCloud facility, which utilized both local Fermilab resources and virtual machines in the Amazon Web Services Elastic Compute Cloud. We discuss the planning, technical challenges, and lessons learned involved in performing physics workflows on a large-scale set of virtualized resources. In addition, we will discuss the economics and operational efficiencies when executing workflows both in the cloud and on dedicated resources.

  4. 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.

  5. 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.

  6. HIV treatment and care services for adolescents: a situational analysis of 218 facilities in 23 sub-Saharan African countries.

    Science.gov (United States)

    Mark, Daniella; Armstrong, Alice; Andrade, Catarina; Penazzato, Martina; Hatane, Luann; Taing, Lina; Runciman, Toby; Ferguson, Jane

    2017-05-16

    In 2013, an estimated 2.1 million adolescents (age 10-19 years) were living with HIV globally. The extent to which health facilities provide appropriate treatment and care was unknown. To support understanding of service availability in 2014, Paediatric-Adolescent Treatment Africa (PATA), a non-governmental organisation (NGO) supporting a network of health facilities across sub-Saharan Africa, undertook a facility-level situational analysis of adolescent HIV treatment and care services in 23 countries. Two hundred and eighteen facilities, responsible for an estimated 80,072 HIV-infected adolescents in care, were surveyed. Sixty per cent of the sample were from PATA's network, with the remaining gathered via local NGO partners and snowball sampling. Data were analysed using descriptive statistics and coding to describe central tendencies and identify themes. Respondents represented three subregions: West and Central Africa ( n  = 59; 27%), East Africa ( n  = 77, 35%) and southern Africa ( n  = 82, 38%). Half (50%) of the facilities were in urban areas, 17% peri-urban and 33% rural settings. Insufficient data disaggregation and outcomes monitoring were critical issues. A quarter of facilities did not have a working definition of adolescence. Facilities reported non-adherence as their key challenge in adolescent service provision, but had insufficient protocols for determining and managing poor adherence and loss to follow-up. Adherence counselling focused on implications of non-adherence rather than its drivers. Facilities recommended peer support as an effective adherence and retention intervention, yet not all offered these services. Almost two-thirds reported attending to adolescents with adults and/or children, and half had no transitioning protocols. Of those with transitioning protocols, 21% moved pregnant adolescents into adult services earlier than their peers. There was limited sexual and reproductive health integration, with 63% of facilities

  7. Service readiness, health facility management practices, and delivery care utilization in five states of Nigeria: a cross-sectional analysis.

    Science.gov (United States)

    Gage, Anastasia J; Ilombu, Onyebuchi; Akinyemi, Akanni Ibukun

    2016-10-06

    Existing studies of delivery care in Nigeria have identified socioeconomic and cultural factors as the primary determinants of health facility delivery. However, no study has investigated the association between supply-side factors and health facility delivery. Our study analyzed the role of supply-side factors, particularly health facility readiness and management practices for provision of quality maternal health services. Using linked data from the 2005 and 2009 health facility and household surveys in the five states in which the Community Participation for Action in the Social Sector (COMPASS) project was implemented, indices of health service readiness and management were developed based on World Health Organization guidelines. Multilevel logistic regression models were run to determine the association between these indices and health facility delivery among 2710 women aged 15-49 years whose last child was born within the five years preceding the surveys and who lived in 51 COMPASS LGAs. The health facility delivery rate increased from 25.4 % in 2005 to 44.1 % in 2009. Basic amenities for antenatal care provision, readiness to deliver basic emergency obstetric and newborn care, and management practices supportive of quality maternal health services were suboptimal in health facilities surveyed and did not change significantly between 2005 and 2009. The LGA mean index of basic amenities for antenatal care provision was more positively associated with the odds of health facility delivery in 2009 than in 2005, and in rural than in urban areas. The LGA mean index of management practices was associated with significantly lower odds of health facility delivery in rural than in urban areas. The LGA mean index of facility readiness to deliver basic emergency obstetric and neonatal care declined slightly from 5.16 in 2005 to 3.98 in 2009 and was unrelated to the odds of health facility delivery. Supply-side factors appeared to play a role in health facility delivery

  8. AREVA General Inspectorate 2010 Annual Report. Status of safety in nuclear facilities

    International Nuclear Information System (INIS)

    2010-01-01

    After messages by different managers, this report proposes a description of the context for nuclear safety: group's policy in matters of nuclear safety and radiation protection, regulatory changes (in France, with respect to information, changes in administrative organization, overhaul of general technical regulations, international context). It describes the organizational changes which occurred within the company. It reports actions regarding transparency, briefly describes actions and principles aimed at improving safety, indicates and comments noteworthy nuclear events, discusses their assessment from a HOF (human and organizational factors) perspective, comments lessons learned from inspections, comments data regarding radiation protection and actions aimed at improving radiation protection. It discusses environmental impact issues. It addresses the different processes and factors which transversely appear in nuclear safety: safety management, human and organizational factors, safety in design, project management, and emergency management. Several specific risks are discussed: criticality control, nuclear materials safeguards, fire, spill prevention, transportation, radioactive waste, shutdown and dismantling, service operations, mining, and environmental liabilities. Document in French and in English

  9. A method for studying the development pattern of urban commercial service facilities based on customer reviews from social media

    Science.gov (United States)

    Wang, Y. D.; Jiang, B. T.; Ye, X. Y.

    2016-06-01

    Urbanization is one of the most important human social activities in the 21st century (Chaolin et al., 2012). With an increasing number of people visiting cities, the provision of adequate urban service facilities, including public and commercial service facilities, in locations where people live has become an important guarantee of the success of urbanization. Exploring the commercial service facilities in a specific area of a city can help us understand the progress and trends of urban renewal in the area, provide a quantitative basis for evaluating the rationality of planning implementation, and facilitate an analysis of the effects of different factors on the regional development of a city (Schor et al. 2003). In this paper, we proposed a data processing and analysis method for studying the distribution and development pattern of urban commercial facilities based on customer reviews. In addition, based on road network constraints, we explored the patterns contained in customer reviews data, including patterns for the spatial distribution and spatial-temporal evolution of facilities as well as the number of facilities and degree of satisfaction.

  10. A method for studying the development pattern of urban commercial service facilities based on customer reviews from social media

    Directory of Open Access Journals (Sweden)

    Y. D. Wang

    2016-06-01

    Full Text Available Urbanization is one of the most important human social activities in the 21st century (Chaolin et al., 2012. With an increasing number of people visiting cities, the provision of adequate urban service facilities, including public and commercial service facilities, in locations where people live has become an important guarantee of the success of urbanization. Exploring the commercial service facilities in a specific area of a city can help us understand the progress and trends of urban renewal in the area, provide a quantitative basis for evaluating the rationality of planning implementation, and facilitate an analysis of the effects of different factors on the regional development of a city (Schor et al. 2003. In this paper, we proposed a data processing and analysis method for studying the distribution and development pattern of urban commercial facilities based on customer reviews. In addition, based on road network constraints, we explored the patterns contained in customer reviews data, including patterns for the spatial distribution and spatial-temporal evolution of facilities as well as the number of facilities and degree of satisfaction.

  11. Health Care Expenditures After Initiating Long-term Services and Supports in the Community Versus in a Nursing Facility.

    Science.gov (United States)

    Newcomer, Robert J; Ko, Michelle; Kang, Taewoon; Harrington, Charlene; Hulett, Denis; Bindman, Andrew B

    2016-03-01

    Individuals who receive long-term services and supports (LTSS) are among the most costly participants in the Medicare and Medicaid programs. To compare health care expenditures among users of Medicaid home and community-based services (HCBS) versus those using extended nursing facility care. Retrospective cohort analysis of California dually eligible adult Medicaid and Medicare beneficiaries who initiated Medicaid LTSS, identified as HCBS or extended nursing facility care, in 2006 or 2007. Propensity score matching for demographic, health, and functional characteristics resulted in a subsample of 34,660 users who initiated Medicaid HCBS versus extended nursing facility use. Those with developmental disabilities or in managed care plans were excluded. Average monthly adjusted acute, postacute, long-term, and total Medicare and Medicaid expenditures for the 12 months following initiation of either HCBS or extended nursing facility care. Those initiating extended nursing facility care had, on average, $2919 higher adjusted total health care expenditures per month compared with those who initiated HCBS. The difference was primarily attributable to spending on LTSS $2855. On average, the monthly LTSS expenditures were higher for Medicare $1501 and for Medicaid $1344 when LTSS was provided in a nursing facility rather than in the community. The higher cost of delivering LTSS in a nursing facility rather than in the community was not offset by lower acute and postacute spending. Medicare and Medicaid contribute similar amounts to the LTSS cost difference and both could benefit financially by redirecting care from institutions to the community.

  12. Integration of leprosy services into the General Health Service in Sri Lanka: overcoming challenges to implementation in a remote district.

    Science.gov (United States)

    Wijesinghe, Thushanthi S; Wijesinghe, Pushpa Ranjan

    2013-01-01

    Sri Lanka took a policy decision to integrate leprosy services into the general health services (GHS) in 1999. This paper aims to summarize the emergence of new, specific challenges and how they were overcome during the integration of leprosy services to the GHS in a remote, leprosy endemic district in Sri Lanka. In this article, the regional epidemiologist as the team leader describes the principles used for transition to an effective integrated model of leprosy services from a centralized leprosy control model in the district. In addition, rationale for integration is viewed from the epidemiological and operational perspectives. National and district leprosy epidemiological data from secondary sources are also reviewed for corroborating the effectiveness of integration. Challenges surfaced were mainly related to the transfer of ownership of the programme, selection of appropriate service providing institutions easily accessible to clients, sustainability of leprosy services at the GHS, ensuring participation of all stakeholders in capacity building programmes and co-ordination of patient care in the absence of a dermatologist in the district. An empowered district team leader with specified roles and responsibilities, his sound technical and managerial know how and ability to translate 'team work' concept to practice were found to be essential for successful implementation of integration. Decision-making powers at the district level and flexibility to introduce new, area-specific changes to the centrally prepared core activities of integration were also vital to overcome locally surfaced challenges.

  13. Operational experience in the non-destructive assay of fissile material in General Electric's nuclear fuel fabrication facility

    International Nuclear Information System (INIS)

    Stewart, J.P.

    1976-01-01

    Operational experience in the non-destructive assay of fissile material in a variety of forms and containers and incorporation of the assay devices into the accountability measurement system for General Electric's Wilmington Fuel Fabrication Facility measurement control programme is detailed. Description of the purpose and related operational requirements of each non-destructive assay system is also included. In addition, the accountability data acquisition and processing system is described in relation to its interaction with the various non-destructive assay devices and scales used for accountability purposes within the facility. (author)

  14. An integrated model to measure service management and physical constraints' effect on food consumption in assisted-living facilities.

    Science.gov (United States)

    Huang, Hui-Chun; Shanklin, Carol W

    2008-05-01

    The United States is experiencing remarkable growth in the elderly population, which provides both opportunities and challenges for assisted-living facilities. The objective of this study was to explore how service management influences residents' actual food consumption in assisted-living facilities. Physical factors influencing residents' service evaluation and food consumption also were investigated. A total of 394 questionnaires were distributed to assisted-living residents in seven randomly selected facilities. The questionnaire was developed based on an in-depth literature review and pilot study. Residents' perceived quality evaluations, satisfaction, and physical constraints were measured. Residents' actual food consumption was measured using a plate waste technique. A total of 118 residents in five facilities completed both questionnaires and food consumption assessments. Descriptive, multivariate analyses and structural equation modeling techniques were employed. Service management, including food and service quality and customer satisfaction, was found to significantly influence residents' food consumption. Physical constraints associated with aging, including a decline in health status, chewing problems, sensory loss, and functional disability, also significantly influenced residents' food consumption. A significant relationship was found between physical constraints and customer satisfaction. Foodservice that provides good food and service quality increases customer satisfaction and affects residents' actual food consumption. Physical constraints also influence residents' food consumption directly, or indirectly through satisfaction. The findings suggest that food and nutrition professionals in assisted-living should consider the physical profiles of their residents to enhance residents' satisfaction and nutrient intake. Recommendations for exploring residents' perspectives are discussed.

  15. A Customer’s Possibilities to Increase the Performance of a Service Provider by Adding Value and Deepening the Partnership in Facility Management Service

    Directory of Open Access Journals (Sweden)

    Sillanpää Elina

    2016-06-01

    Full Text Available Reliable and good suppliers are an important competitive advantage for a customer and that is why the development of suppliers, improvement of performance and enhancement of customership are also in the interest of the customer. The purpose of this study is to clarify a customer’s possibilities to increase the performance of a service provider and to develop the service process in FM services and thus help to improve partnership development. This research is a qualitative research. The research complements the existing generic model of supplier development towards partnership development by customer and clarifies the special features that facility management services bring to this model. The data has been gathered from interviews of customers and service providers in the facility management service sector. The result is a model of customers’ possibilities to develop the performance of service providers from the viewpoint of value addition and relationship development and in that way ensure added value to the customer and the development of a long-term relationship. The results can be beneficial to customers when they develop the cooperation between the customer and the service provider toward being more strategic and more partnership focused.

  16. Current experiences and educational preferences of general practitioners and staff caring for people with dementia living in residential facilities.

    Science.gov (United States)

    Beer, Christopher; Horner, Barbara; Almeida, Osvaldo P; Scherer, Samuel; Lautenschlager, Nicola T; Bretland, Nick; Flett, Penelope; Schaper, Frank; Flicker, Leon

    2009-08-12

    Residential care is important for older adults, particularly for those with advanced dementia and their families. Education interventions that achieve sustainable improvement in the care of older adults are critical to quality care. There are few systematic data available regarding the educational needs of Residential Care Facility (RCF) staff and General Practitioners (GPs) relating to dementia, or the sustainability of educational interventions. We sought to determine participation in dementia education, perceived levels of current knowledge regarding dementia, perceived unmet educational needs, current barriers, facilitators and preferences for dementia education. A mixed methods study design was utilised. A survey was distributed to a convenience sample of general practitioners, and staff in 223 consecutive residential care facilities in Perth, Western Australia. Responses were received from 102 RCF staff working in 10 facilities (out of 33 facilities who agreed to distribute the survey) and 202 GPs (19% of metropolitan GPs). Quantitative survey data were summarised descriptively and chi squared statistics were used to analyse the distribution of categorical variables. Qualitative data were collected from general practitioners, staff in residential care facilities and family carers of people with dementia utilizing individual interviews, surveys and focus groups. Qualitative data were analysed thematically. Among RCF staff and GPs attending RCF, participation in dementia education was high, and knowledge levels generally perceived as good. The individual experiences and needs of people with dementia and their families were emphasised. Participants identified the need for a person centred philosophy to underpin educational interventions. Limited time was a frequently mentioned barrier, especially in relation to attending dementia care education. Perceived educational needs relating to behaviours of concern, communication, knowledge regarding dementia, aspects of

  17. Views of the Scottish general public on community pharmacy weight management services: international implications.

    Science.gov (United States)

    Weidmann, Anita Elaine; Cunningham, Scott; Gray, Gwen; Hansford, Denise; Bermano, Giovanna; Stewart, Derek

    2012-04-01

    Obesity has reached pandemic levels, with more than 1.5 billion adults being affected worldwide. In Scotland two-thirds of men and more than half of women are either overweight or obese, placing Scotland overall third behind the United States of America and Mexico. All community pharmacies in Scotland are contracted to provide public health services such as smoking cessation and there is increasing interest in their contribution to weight management. Researching this area in Scotland may provide valuable information to facilitate the development of community pharmacy services in other parts of the UK and internationally. To describe the views of the Scottish general public on the provision of weight management services via community pharmacies. General public in Scotland. A cross-sectional postal questionnaire survey of 6,000 randomly selected members of the Scottish general public aged 18 years and over. Views on community pharmacy led weight management services. Questionnaires were returned by 20.6% (n = 1,236). Over half 60.1% (n = 751) agreed or strongly agreed that they had easy access to pharmacy services in general and around one-third agreed (35%; n = 438) that it was more convenient to obtain weight management advice from a pharmacist than it is to make an appointment with a GP. Most respondents however lacked awareness of the types of health services available through community pharmacy (13.2%; n = 162) and would not feel comfortable speaking to a pharmacist or medicines counter assistant about weight related issues (25%; n = 320). Concerns over privacy (47.3%; n = 592) and perceived lack of pharmacists' specialist knowledge (open comments) were identified as potential barriers to service uptake by the general public. Overall, respondents appear to be receptive to the idea of accessing weight management services through community pharmacy but a perceived lack of privacy, poor knowledge of pharmacists' skill level and of public health services available to

  18. An audit of non-urgent general adult referrals to Stikland State Psychiatric Facility

    Directory of Open Access Journals (Sweden)

    J Ras

    2011-12-01

    Full Text Available Objectives. The national Department of Health strongly advocates the strengthening of primary health care systems, and recommendations for appropriate level of care referrals exist. Very few published data on the scope of current ambulatory specialised psychiatric hospital services in South Africa are currently available, making it difficult to assess whether these recommendations are being followed. As a starting point, an audit was conducted to obtain a profile of new non-urgent general adult patients seen at Stikland Hospital with a view to evaluating system needs and demands. Methods. The folders of 103 consecutively seen patients were selected for retrospective review. Patient demographic, referral and assessment information was entered into a single database. Descriptive statistics were compiled with reference to the above variables using SPSS. Results. Overall 58.3% of referrals were from the private sector. More than a third (36.7% of referral letters stated no clear reason for referral and 41.7% no psychiatric diagnosis, and 29.1% of patients were referred without psychotropic medication being started. On assessment 62.1% of patients were found to have a single Axis I diagnosis. Despite virtually no referral letters making any mention of them, substance use disorders (30.1%, personality traits/disorders (35.9% and co-morbid medical illness (36.7% were commonly found on assessment. Conclusions. A significant portion of the patients in our sample could have been managed at primary care level and were referred prematurely. The overall quality of referral letters was poor, and they lacked vital information required for appropriate pre-assessment decision making. Undergraduate training focusing on these skills should be intensified, and consideration should be given to incorporating aspects of our findings into primary health care updates.

  19. Gaps in monitoring systems for Implanon NXT services in South Africa: An assessment of 12 facilities in two districts

    Directory of Open Access Journals (Sweden)

    D Pillay

    2017-10-01

    Full Text Available Background. Implanon NXT, a long-acting subdermal contraceptive implant, was introduced in South Africa (SA in early 2014 as part of an expanded contraceptive method mix. After initial high levels of uptake, reports emerged of frequent early removals and declines in use. Monitoring of progress and challenges in implant service delivery could identify aspects of the programme that require strengthening. Objectives. To assess data management and record keeping within implant services at primary care facilities. Methods. We developed a checklist to assess the tools used for monitoring implant services and data reporting to district offices. The checklist was piloted in seven facilities. An additional six high-volume and six low-volume implant insertion clinics in the City of Johannesburg (CoJ, Gauteng Province, and the Dr Kenneth Kaunda District, North West Province, were selected for assessment. Results. All 12 facilities completed a Daily Head Count Register, which tallied the number of clients attending the clinic, but not information about implant use. A more detailed Tick Register recorded services that clinic attendees received, with nine documenting number of implant insertions and six implant removals. A more specific tool, an Insertion Checklist, collected data on insertion procedures and client characteristics, but was only used in CoJ (five of six facilities. Other registers, which were developed de novo by staff at individual facilities, captured more detailed information about insertions and removals, including reasons. Five of six low-volume insertion facilities used these registers, but only three of six high-volume facilities. No facilities used the form specifically developed by the National Department of Health for implant pharmacovigilance. Nine of 12 clinics reported data on numbers of insertions to the district office, six reported removals and none provided data on reasons for removals. Conclusion. For data to inform effective

  20. Gaps in monitoring systems for Implanon NXT services in South Africa: An assessment of 12 facilities in two districts

    Science.gov (United States)

    Pillay, D; Morroni, C; Pleaner, M; Adeogba, O; Chersich, M; Naidoo, N; Mullick, S; Rees, H

    2017-10-01

    Background. Implanon NXT, a long-acting subdermal contraceptive implant, was introduced in South Africa (SA) in early 2014 as part of an expanded contraceptive method mix. After initial high levels of uptake, reports emerged of frequent early removals and declines in use. Monitoring of progress and challenges in implant service delivery could identify aspects of the programme that require strengthening. Objectives. To assess data management and record keeping within implant services at primary care facilities. Methods. We developed a checklist to assess the tools used for monitoring implant services and data reporting to district offices. The checklist was piloted in seven facilities. An additional six high-volume and six low-volume implant insertion clinics in the City of Johannesburg (CoJ), Gauteng Province, and the Dr Kenneth Kaunda District, North West Province, were selected for assessment. Results. All 12 facilities completed a Daily Head Count Register, which tallied the number of clients attending the clinic, but not information about implant use. A more detailed Tick Register recorded services that clinic attendees received, with nine documenting number of implant insertions and six implant removals. A more specific tool, an Insertion Checklist, collected data on insertion procedures and client characteristics, but was only used in CoJ (five of six facilities). Other registers, which were developed de novo by staff at individual facilities, captured more detailed information about insertions and removals, including reasons. Five of six low-volume insertion facilities used these registers, but only three of six high-volume facilities. No facilities used the form specifically developed by the National Department of Health for implant pharmacovigilance. Nine of 12 clinics reported data on numbers of insertions to the district office, six reported removals and none provided data on reasons for removals. Conclusion. For data to inform effective decision

  1. General practice, primary care, and health service psychology: concepts, competencies, and the Combined-Integrated model.

    Science.gov (United States)

    Schulte, Timothy J; Isley, Elayne; Link, Nancy; Shealy, Craig N; Winfrey, LaPearl Logan

    2004-10-01

    The profession of psychology is being impacted profoundly by broader changes within the national system of health care, as mental and behavioral health services are being recognized as essential components of a comprehensive, preventive, and cost-efficient primary care system. To fully define and embrace this role, the discipline of professional psychology must develop a shared disciplinary identity of health service psychology and a generalized competency-based model for doctoral education and training. This very framework has been adopted by Combined-Integrated (C-I) doctoral programs in professional psychology, which train across the practice areas (clinical, counseling, and school psychology) to provide a general and integrative foundation for their students. Because C-I programs produce general practitioners who are competent to function within a variety of health service settings, this innovative training approach has great potential to educate and train psychologists for a changing health care marketplace. Copyright 2004 Wiley Periodicals, Inc.

  2. Interprofessional collaboration between general physicians and emergency department services in Belgium: a qualitative study

    OpenAIRE

    Karam, Marlène; Tricas, Sandra Maria; Darras, Elisabeth; Macq, Jean

    2016-01-01

    Introduction: The use of emergency department (ED) services has known a significant rise in the past decade. Organizational factors, such as the models of after-hours primary medical care services, and the shortage of general practitioners (GPs) could explain this phenomena. But also demographic and societal elements combined with the problem of patient’s ‘inappropriate visits to the ED. In order to ensure continuity of care for patients, collaboration between GPs and EDs becomes increasingly...

  3. Analysis on the Implementation of Nutrition Services in Tugurejo General Hospital Semarang

    OpenAIRE

    Dewi, Emy Shinta; Kartasurya, Martha Irene; Sriatmi, Ayun

    2015-01-01

    Nutrition was an important factor for patient care and cure. Results of an evaluation by nutritionalresearch and development unit of Tugurejo district general hospital (RSUD) in 2011 indicated thatfood remains of patient were still below the minimal standard of service. Objective of this study wasto analyze the implementation of nutritional service in the RSUD Tugurejo Semarang.This was a qualitative study with 4 nutritionists, 8 cook assistants, and 8 waitresses as maininformants. Triangulat...

  4. General practice integration in Australia. Primary health services provider and consumer perceptions of barriers and solutions.

    Science.gov (United States)

    Appleby, N J; Dunt, D; Southern, D M; Young, D

    1999-08-01

    To identify practical examples of barriers and possible solutions to improve general practice integration with other health service providers. Twelve focus groups, including one conducted by teleconference, were held across Australia with GPs and non GP primary health service providers between May and September, 1996. Focus groups were embedded within concept mapping sessions, which were used to conceptually explore the meaning of integration in general practice. Data coding, organising and analysis were based on the techniques documented by Huberman and Miles. Barriers to integration were perceived to be principally due to the role and territory disputes between the different levels of government and their services, the manner in which the GP's role is currently defined, and the system of GP remuneration. Suggestions on ways to improve integration involved two types of strategies. The first involves initiatives implemented 'top down' through major government reform to service structures, including the expansion of the role of divisions of general practice, and structural changes to the GP remuneration systems. The second type of strategy suggested involves initiatives implemented from the 'bottom up' involving services such as hospitals (e.g. additional GP liaison positions) and the use of information technology to link services and share appropriate patient data. The findings support the need for further research and evaluation of initiatives aimed at achieving general practice integration at a systems level. There is little evidence to suggest which types of initiatives improve integration. However, general practice has been placed in the centre of the health care debate and is likely to remain central to the success of such initiatives. Clarification of the future role and authority of general practice will therefore be required if such integrative strategies are to be successful at a wider health system level.

  5. Physiotherapists and General Practitioners attitudes towards 'Physio Direct' phone based musculoskeletal Physiotherapy services: a national survey.

    Science.gov (United States)

    Harland, Nicholas; Blacklidge, Brian

    2017-06-01

    Physiotherapy phone based, "Physio Direct" (PD) musculoskeletal triage and treat services are a relatively new phenomena. This study explored Physiotherapist and GP attitudes towards PD services. Online national survey via cascade e-mail initiated by study leads. 488 Physiotherapists and 68 GPs completed the survey. The survey asked three negatively worded and three positively worded Likert scale questions regarding PD services. It also collected demographic data and more global attitudes including a version of the friends and family test. Overall both Physiotherapists and GP's have positive attitudes towards PD services. There was global agreement that PD triage was a good idea but in both groups the majority of respondents who expressed a definite opinion thought that patients would still eventually need to be seen face to face. The vast majority of all respondents also thought patients should be given a choice about first accessing PD services. Physiotherapists with experience of PD services had more positive and less negative attitudes than those without experience. More detailed results are discussed. Relevant clinical stakeholders have generally positive attitudes towards PD services, but more so when they have experience of them. Counter to research findings significant proportions of respondents believe patients accessing PD services will still need to be seen face to face. The significant majority of respondents believe patients should be given a choice whether they access PD services in the first instance or not. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  6. Relocation consequences on an ophthalmology consultation service from an inpatient to outpatient facility

    Directory of Open Access Journals (Sweden)

    Singh JS

    2015-10-01

    Full Text Available Jorawer S Singh,1 Vincent M Imbrogno,2 Mary K Howard,3 Amandip S Cheema,3 Ausra D Selvadurai,4 Surbhi Bansal5 1Department of Ophthalmology, George Washington University, Washington, DC, 2Contemporary Ophthalmology of Erie, Erie, PA, 3Department of Ophthalmology, University at Buffalo, Buffalo, NY, 4OcuSight Eye Care Center, Rochester, NY, 5Department of Ophthalmology, Virginia Commonwealth University, Richmond, VA, USA Importance: This study shows that relocation of an academic ophthalmology residency program from an inpatient to an outpatient setting in western New York does not affect the consult volume but affects management patterns and follow-up rates.Objective: To investigate the effects on the ophthalmology consultation service of an academic program with relocation from a Regional Level-1 Trauma center to an outpatient facility.Design: Consultation notes from 3 years before and 3 years after the University at Buffalo’s (UB Department of Ophthalmology relocation from a Regional Level-1 Trauma center (Erie County Medical Center to an outpatient facility (Ross Eye Institute were obtained from hospital electronic medical records and analyzed.Setting: Hospitalized care and institutional practice.Participants: All inpatient or Emergency Room Ophthalmology consultation patients from the Department of Ophthalmology at UB from 2004 to 2010 (1,379 patients.Exposures: None, this was a retrospective chart review.Main outcome measures: Patient demographics, reason for consult, diagnoses, and ophthalmic procedures performed by the UB Department of Ophthalmology before and after its relocation.Results: Relocation to the outpatient facility did not affect consult volume (P=0.15. The number of consults focusing on ophthalmic conditions, as a percentage of the yearly total, rose 460% (P=0.0001, while systemic condition consults with ocular manifestations fell 83% (P=0.0001. Consults for ocular trauma decreased 65% (P=0.0034. Consults ending with a

  7. A review of governance of maternity services at South Tipperary general hospital

    LENUS (Irish Health Repository)

    Flory, David

    2015-09-01

    This review of the governance of maternity services at South Tipperary General Hospital has focussed on the systems and processes for assurance of service quality, risk management and patient safety primarily inside the hospital but also in the Hospital Group structure within which it operates. The effectiveness of the governance arrangements is largely determined by the quality of the leadership and management – both clinical and general – which designs, implements, and oversees those systems and processes and is ultimately responsible and accountable.\\r\

  8. Factors associated with utilization of dental services in a long-term care facility: a descriptive cross-sectional study.

    Science.gov (United States)

    Scannapieco, Frank A; Amin, Summar; Salme, Marc; Tezal, Mine

    2017-03-01

    To describe factors associated with the utilization of dental services in a long-term care facility (LTCF) in Western New York. A descriptive cross-sectional study reviewed the dental and medical records of residents of an LTCF discharged between January 1, 2008 and December 30, 2012. Information on demographic and health variables at admission was extracted from electronic health records. Information on oral health variables was extracted from patient charts. A total of 2,516 residents were discharged between 2008 and 2012. From those, 259 (10.3%) utilized dental services at least once during their stay. Those who utilized dental services were significantly older at admission (78.5 vs. 82.0 years, p dental services. Dental services appear to be underutilized by residents of LTCF. Significant differences exist in demographic and health variables between residents who utilize these services compared to those who do not. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

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

    International Nuclear Information System (INIS)

    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 ampersand 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

  10. 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.

  11. Diagnostic delay amongst tuberculosis patients in Jogjakarta Province, Indonesia is related to the quality of services in DOTS facilities.

    Science.gov (United States)

    Ahmad, Riris Andono; Mahendradhata, Yodi; Utarini, Adi; de Vlas, Sake J

    2011-04-01

    To understand determinants of care-seeking patterns and diagnostic delay amongst tuberculosis (TB) patients diagnosed at direct observed treatment short course (DOTS) facilities in Jogjakarta, Indonesia. Cross-sectional survey amongst newly diagnosed TB patients in 89 DOTS facilities whose history of care-seeking was reconstructed through retrospective interviews gathering data on socio-demographic determinants, onset of TB symptoms, type of health facilities visited, duration of each care-seeking action were recorded. Two hundred and fifty-three TB patients were included in the study whose median duration of patients' delay was 1 week and whose total duration of diagnostic delay was 5.4 weeks. The median number of visits was 4. Many of the patients' socio-demographic determinants were not associated with the care-seeking patterns, and no socio-demographic determinants were associated with the duration of diagnostic delay. More than 60% of TB patients started their care-seeking processes outside DOTS facilities, but the number of visits in DOTS facilities was greater during the overall care-seeking process. Surprisingly, patient's immediate visits to a DOTS facility did not correspond to shorter diagnostic delay. Diagnostic delay in Jogjakarta province was not associated with patients' socio demographic factors, but rather with the health system providing DOTS services. This suggests that strengthening the health system and improving diagnostic quality within DOTS services is now a more rational strategy than expanding the TB programme to engage more providers. © 2010 Blackwell Publishing Ltd.

  12. General Practitioners' Attitudes Toward a Web-Based Mental Health Service for Adolescents: Implications for Service Design and Delivery.

    Science.gov (United States)

    Subotic-Kerry, Mirjana; King, Catherine; O'Moore, Kathleen; Achilles, Melinda; O'Dea, Bridianne

    2018-03-23

    Anxiety disorders and depression are prevalent among youth. General practitioners (GPs) are often the first point of professional contact for treating health problems in young people. A Web-based mental health service delivered in partnership with schools may facilitate increased access to psychological care among adolescents. However, for such a model to be implemented successfully, GPs' views need to be measured. This study aimed to examine the needs and attitudes of GPs toward a Web-based mental health service for adolescents, and to identify the factors that may affect the provision of this type of service and likelihood of integration. Findings will inform the content and overall service design. GPs were interviewed individually about the proposed Web-based service. Qualitative analysis of transcripts was performed using thematic coding. A short follow-up questionnaire was delivered to assess background characteristics, level of acceptability, and likelihood of integration of the Web-based mental health service. A total of 13 GPs participated in the interview and 11 completed a follow-up online questionnaire. Findings suggest strong support for the proposed Web-based mental health service. A wide range of factors were found to influence the likelihood of GPs integrating a Web-based service into their clinical practice. Coordinated collaboration with parents, students, school counselors, and other mental health care professionals were considered important by nearly all GPs. Confidence in Web-based care, noncompliance of adolescents and GPs, accessibility, privacy, and confidentiality were identified as potential barriers to adopting the proposed Web-based service. GPs were open to a proposed Web-based service for the monitoring and management of anxiety and depression in adolescents, provided that a collaborative approach to care is used, the feedback regarding the client is clear, and privacy and security provisions are assured. ©Mirjana Subotic

  13. 18 CFR 260.9 - Reports by natural gas pipeline companies on service interruptions and damage to facilities.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Reports by natural gas..., NATURAL GAS ACT STATEMENTS AND REPORTS (SCHEDULES) § 260.9 Reports by natural gas pipeline companies on service interruptions and damage to facilities. (a)(1) Every natural gas company must report to the...

  14. Benefits and Barriers of Information and Communication Technologies Adoption in Facilities Management Services Supply Chain

    DEFF Research Database (Denmark)

    Scupola, Ada

      This paper presents the results of a study of factors impacting information and communication technology (ICT) adoption in the supply chain of facilities management services. The research questions addressed in this study are: What are the key factors that influence adoption and assimilation of...

  15. Distance from health facility and mothers' perception of quality related to skilled delivery service utilization in northern Ethiopia.

    Science.gov (United States)

    Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen

    2017-01-01

    Poor maternal health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia. A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia. Multistage sampling technique was used to select mothers from the identified clusters. Households within a 10 km radius of the health facility were taken as a cluster for a community survey. Data were collected using face-to-face interview at the household level. We compared the mothers who reported giving birth to the index child in a health facility and those who reported delivering at home, in order to identify the predictors of skilled delivery utilization. Multivariable logistic regression model was used to determine the predictors of skilled delivery service utilization. The results are presented with odds ratio (OR) and 95% confidence interval (CI). A total of 1,796 mothers participated in the study, with a 100% response rate. Distance to health facilities (adjusted odds ratio [AOR] =0.53 [95% CI: 0.39, 0.71]), perception of mothers to the availability of adequate equipment in the delivery service in their catchment area (AOR =1.5 [95% CI: 1.11, 2.13]), experiencing any complication during childbirth, using antenatal care, lower birth order and having an educated partner were the significant predictors of skilled delivery service utilization. Implementing community-based intervention programs that will address the physical accessibility of delivery services, such as the ambulance service, road issues and waiting rooms, and improving quality maternity service will likely reduce the current problem.

  16. Distance from health facility and mothers’ perception of quality related to skilled delivery service utilization in northern Ethiopia

    Science.gov (United States)

    Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen

    2017-01-01

    Background Poor maternal health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia. Subjects and methods A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia. Multistage sampling technique was used to select mothers from the identified clusters. Households within a 10 km radius of the health facility were taken as a cluster for a community survey. Data were collected using face-to-face interview at the household level. We compared the mothers who reported giving birth to the index child in a health facility and those who reported delivering at home, in order to identify the predictors of skilled delivery utilization. Multivariable logistic regression model was used to determine the predictors of skilled delivery service utilization. The results are presented with odds ratio (OR) and 95% confidence interval (CI). Results A total of 1,796 mothers participated in the study, with a 100% response rate. Distance to health facilities (adjusted odds ratio [AOR] =0.53 [95% CI: 0.39, 0.71]), perception of mothers to the availability of adequate equipment in the delivery service in their catchment area (AOR =1.5 [95% CI: 1.11, 2.13]), experiencing any complication during childbirth, using antenatal care, lower birth order and having an educated partner were the significant predictors of skilled delivery service utilization. Conclusion Implementing community-based intervention programs that will address the physical accessibility of delivery services, such as the ambulance service, road issues and waiting rooms, and improving quality maternity service will likely reduce the current

  17. Veterans Affairs general surgery service: the last bastion of integrated specialty care.

    Science.gov (United States)

    Poteet, Stephen; Tarpley, Margaret; Tarpley, John L; Pearson, A Scott

    2011-11-01

    In a time of increasing specialization, academic training institutions provide a compartmentalized learning environment that often does not reflect the broad clinical experience of general surgery practice. This study aimed to evaluate the contribution of the Veterans Affairs (VA) general surgery surgical experience to both index Accreditation Council for Graduate Medical Education (ACGME) requirements and as a unique integrated model in which residents provide concurrent care of multiple specialty patients. Institutional review board approval was obtained for retrospective analysis of electronic medical records involving all surgical cases performed by the general surgery service from 2005 to 2009 at the Nashville VA. Over a 5-year span general surgery residents spent an average of 5 months on the VA general surgery service, which includes a postgraduate year (PGY)-5, PGY-3, and 2 PGY-1 residents. Surgeries involved the following specialties: surgical oncology, endocrine, colorectal, hepatobiliary, transplant, gastrointestinal laparoscopy, and elective and emergency general surgery. The surgeries were categorized according to ACGME index requirements. A total of 2,956 surgeries were performed during the 5-year period from 2005 through 2009. Residents participated in an average of 246 surgeries during their experience at the VA; approximately 50 cases are completed during the chief year. On the VA surgery service alone, 100% of the ACGME requirement was met for the following categories: endocrine (8 cases); skin, soft tissue, and breast (33 cases); alimentary tract (78 cases); and abdominal (88 cases). Approximately 50% of the ACGME requirement was met for liver, pancreas, and basic laparoscopic categories. The VA hospital provides an authentic, broad-based, general surgery training experience that integrates complex surgical patients simultaneously. Opportunities for this level of comprehensive care are decreasing or absent in many general surgery training

  18. 78 FR 57156 - General Services Administration Acquisition Regulation; Submission for OMB Review; Modifications...

    Science.gov (United States)

    2013-09-17

    ... GENERAL SERVICES ADMINISTRATION [OMB Control No. 3090-0302; Docket No. 2013-0001; Sequence 9... (GSAR) to add clause 552.243-81 Modifications (Federal Supply Schedule) and an Alternate I version of..., Modifications (Federal Supply Schedule). The alternate version of the clause implements and mandates electronic...

  19. Questioning territorial cohesion: (Un)equal access to services of general interest

    Czech Academy of Sciences Publication Activity Database

    Malý, Jiří

    -, August 2016 (2016), s. 1-21 ISSN 1056-8190 Institutional support: RVO:68145535 Keywords : territorial cohesion * services of general interest * accessibility * spatial justice * Czech Republic Subject RIV: DE - Earth Magnetism, Geodesy, Geography Impact factor: 1.272, year: 2016 http://onlinelibrary.wiley.com/doi/10.1111/pirs.12250/full

  20. 77 FR 58380 - General Services Administration Acquisition Regulation; Submission for OMB Review; Price...

    Science.gov (United States)

    2012-09-20

    ...] General Services Administration Acquisition Regulation; Submission for OMB Review; Price Reductions Clause... requirement regarding the GSAR Price Reductions Clause. A notice was published in the Federal Register at 76... identified by Information Collection 3090- 0235, Price Reduction Clause, by any of the following methods...

  1. A general equilibrium model of ecosystem services in a river basin

    Science.gov (United States)

    Travis Warziniack

    2014-01-01

    This study builds a general equilibrium model of ecosystem services, with sectors of the economy competing for use of the environment. The model recognizes that production processes in the real world require a combination of natural and human inputs, and understanding the value of these inputs and their competing uses is necessary when considering policies of resource...

  2. 76 FR 78010 - General Services Administration Acquisition Regulation; Information Collection; Contract...

    Science.gov (United States)

    2011-12-15

    ... collection of information is accurate and based on valid assumptions and methodology; and ways to enhance the...: February 13, 2012. FOR FURTHER INFORMATION CONTACT: Ms. Dana Munson, Procurement Analyst, General Services.../or business confidential information provided. SUPPLEMENTARY INFORMATION: A. Purpose Under certain...

  3. 77 FR 59790 - General Services Administration Acquisition Regulation (GSAR); Rewrite of Part 504...

    Science.gov (United States)

    2012-10-01

    ... and Forms. This final rule is part of the General Services Administration Acquisition Manual (GSAM... the prescription for inclusion of the clause at 552.204-9, Personal Identity Verification Requirements... the ``National Industrial Security Program Operating Manual (NISPOM)'', and link to the web address...

  4. Equilibrium arrival times to queues with general service times and non-linear utility functions

    DEFF Research Database (Denmark)

    Breinbjerg, Jesper

    2017-01-01

    by a general utility function which is decreasing in the waiting time and service completion time of each customer. Applications of such queueing games range from people choosing when to arrive at a grand opening sale to travellers choosing when to line up at the gate when boarding an airplane. We develop...

  5. 78 FR 29245 - U.S. General Services Administration Federal Property Management Regulations; Administrative Wage...

    Science.gov (United States)

    2013-05-20

    ... Federal Property Management Regulations; Administrative Wage Garnishment AGENCY: Office of the Chief... the U.S. General Services Administration Property Management Regulation (GSPMR) to remove information... Administrative Wage Garnishment Code of Federal Regulations (CFR) Parts affected are as follows: 41 CFR part 105...

  6. Pre-Service Teachers' Attitudes toward Use of Vee Diagrams in General Physics Laboratory

    Science.gov (United States)

    Keles, Özgül; Özsoy, Sibel

    2009-01-01

    The purpose of this study is to determine pre-service teachers' attitudes toward use of Vee diagrams in general physics laboratory. The sample of the study consists of 29 (16 girls and 13 boys) freshmen students enrolling to elementary school science education program at one of the universities in Turkey. To gather the data of the study…

  7. Inequalities in utilisation of general practitioner and specialist services in 9 European countries

    NARCIS (Netherlands)

    Stirbu, Irina; Kunst, Anton E.; Mielck, Andreas; Mackenbach, Johan P.

    2011-01-01

    The aim of this study is to describe the magnitude of educational inequalities in utilisation of general practitioner (GP) and specialist services in 9 European countries. In addition to West European countries, we have included 3 Eastern European countries: Hungary, Estonia and Latvia. To cover the

  8. Inequalities in utilisation of general practitioner and specialist services in 9 European countries

    NARCIS (Netherlands)

    Stirbu, I.; Kunst, A.E.; Mielck, A.; Mackenbach, J.P.

    2011-01-01

    ABSTRACT: BACKGROUND: The aim of this study is to describe the magnitude of educational inequalities in utilisation of general practitioner (GP) and specialist services in 9 European countries. In addition to West European countries, we have included 3 Eastern European countries: Hungary, Estonia

  9. Clients' perception of service quality of care in health facilities in ...

    African Journals Online (AJOL)

    Introduction: Clients perception of service quality is important for utilization of health services. Clients with positive perception are more likely to comply with treatment and to continue to use health care services. Assessing clients' perception of services offered is crucial for improving delivery and organization of the services.

  10. Generalized economic model for evaluating disposal costs at a low-level waste disposal facility

    International Nuclear Information System (INIS)

    Baird, R.D.; Rogers, V.C.

    1985-01-01

    An economic model is developed which can be used to evaluate cash flows associated with the development, operations, closure, and long-term maintenance of a proposed Low-Level Radioactive Waste disposal facility and to determine the unit disposal charges and unit surcharges which might result. The model includes the effects of nominal interest rate (rate of return on investment, or cost of capital), inflation rate, waste volume growth rate, site capacity, duration of various phases of the facility history, and the cash flows associated with each phase. The model uses standard discounted cash flow techniques on an after-tax basis to determine that unit disposal charge which is necessary to cover all costs and expenses and to generate an adequate rate of return on investment. It separately considers cash flows associated with post-operational activities to determine the required unit surcharge. The model is applied to three reference facilities to determine the respective unit disposal charges and unit surcharges, with various values of parameters. The sensitivity of the model results are evaluated for the unit disposal charge

  11. Quality of nutrition services in primary health care facilities: Implications for integrating nutrition into the health system in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Sk Masum Billah

    Full Text Available In 2011, the Bangladesh Government introduced the National Nutrition Services (NNS by leveraging the existing health infrastructure to deliver nutrition services to pregnant woman and children. This study examined the quality of nutrition services provided during antenatal care (ANC and management of sick children younger than five years.Service delivery quality was assessed across three dimensions; structural readiness, process and outcome. Structural readiness was assessed by observing the presence of equipment, guidelines and register/reporting forms in ANC rooms and consulting areas for sick children at 37 primary healthcare facilities in 12 sub-districts. In addition, the training and knowledge relevant to nutrition service delivery of 95 healthcare providers was determined. The process of nutrition service delivery was assessed by observing 381 ANC visits and 826 sick children consultations. Satisfaction with the service was the outcome and was determined by interviewing 541 mothers/caregivers of sick children.Structural readiness to provide nutrition services was higher for ANC compared to management of sick children; 73% of ANC rooms had >5 of the 13 essential items while only 13% of the designated areas for management of sick children had >5 of the 13 essential items. One in five (19% healthcare providers had received nutrition training through the NNS. Delivery of the nutrition services was poor: <30% of women received all four key antenatal nutrition services, 25% of sick children had their weight checked against a growth-chart and <1% had their height measured. Nevertheless, most mothers/caregivers rated their satisfaction of the service above average.Strengthening the provision of equipment and increasing the coverage of training are imperative to improve nutrition services. Inherent barriers to implementing nutrition services in primary health care, especially high caseloads during the management of sick under-five children, should

  12. Health facility service availability and readiness for intrapartum and immediate postpartum care in Malawi: A cross-sectional survey.

    Directory of Open Access Journals (Sweden)

    Naoko Kozuki

    Full Text Available This analysis seeks to identify strengths and gaps in the existing facility capacity for intrapartum and immediate postpartum fetal and neonatal care, using data collected as a part of Malawi's Helping Babies Breath program evaluation. From August to September 2012, the Maternal and Child Health Integrated Program (MCHIP conducted a cross-sectional survey in 84 Malawian health facilities to capture current health facility service availability and readiness and health worker capacity and practice pertaining to labor, delivery, and immediate postpartum care. The survey collected data on availability of equipment, supplies, and medications, and health worker knowledge and performance scores on intrapartum care simulation and actual management of real clients at a subset of facilities. We ran linear regression models to identify predictors of high simulation performance of routine delivery care and management of asphyxiated newborns across all facilities surveyed. Key supplies for infection prevention and thermal care of the newborn were found to be missing in many of the surveyed facilities. At the health center level, 75% had no clinician trained in basic emergency obstetric care or newborn care and 39% had no midwife trained in the same. We observed that there were no proportional increases in available transport and staff at a facility as catchment population increased. In simulations of management of newborns with breathing problems, health workers were able to complete a median of 10 out of 16 tasks for a full-term birth case scenario and 20 out of 30 tasks for a preterm birth case scenario. Health workers who had more years of experience appeared to perform worse. Our study provides a benchmark and highlights gaps for future evaluations and studies as Malawi continues to make strides in improving facility-based care. Further progress in reducing the burden of neonatal and fetal death in Malawi will be partly predicated on guaranteeing

  13. Health facility service availability and readiness for intrapartum and immediate postpartum care in Malawi: A cross-sectional survey.

    Science.gov (United States)

    Kozuki, Naoko; Oseni, Lolade; Mtimuni, Angella; Sethi, Reena; Rashidi, Tambudzai; Kachale, Fannie; Rawlins, Barbara; Gupta, Shivam

    2017-01-01

    This analysis seeks to identify strengths and gaps in the existing facility capacity for intrapartum and immediate postpartum fetal and neonatal care, using data collected as a part of Malawi's Helping Babies Breath program evaluation. From August to September 2012, the Maternal and Child Health Integrated Program (MCHIP) conducted a cross-sectional survey in 84 Malawian health facilities to capture current health facility service availability and readiness and health worker capacity and practice pertaining to labor, delivery, and immediate postpartum care. The survey collected data on availability of equipment, supplies, and medications, and health worker knowledge and performance scores on intrapartum care simulation and actual management of real clients at a subset of facilities. We ran linear regression models to identify predictors of high simulation performance of routine delivery care and management of asphyxiated newborns across all facilities surveyed. Key supplies for infection prevention and thermal care of the newborn were found to be missing in many of the surveyed facilities. At the health center level, 75% had no clinician trained in basic emergency obstetric care or newborn care and 39% had no midwife trained in the same. We observed that there were no proportional increases in available transport and staff at a facility as catchment population increased. In simulations of management of newborns with breathing problems, health workers were able to complete a median of 10 out of 16 tasks for a full-term birth case scenario and 20 out of 30 tasks for a preterm birth case scenario. Health workers who had more years of experience appeared to perform worse. Our study provides a benchmark and highlights gaps for future evaluations and studies as Malawi continues to make strides in improving facility-based care. Further progress in reducing the burden of neonatal and fetal death in Malawi will be partly predicated on guaranteeing properly equipped and

  14. Client perception of service quality at the outpatient clinics of a General hospital in Lagos, Nigeria.

    Science.gov (United States)

    Ogunnowo, Babatunde Enitan; Olufunlayo, Tolulope Florence; Sule, Salami Suberu

    2015-01-01

    Service quality assessments have assumed increasing importance in the last two decades. They are useful in identifying gaps in services been provided with the ultimate aim of guaranteeing quality assurance. The objective of this study was to assess the client perception of service quality at the outpatient clinics of Randle General hospital, Lagos. A descriptive cross sectional study was conducted from March to May 2013. A multistage sampling technique was used to select respondents and data was collected with the aid of modified SERVQUAL questionnaires. The data was analysed with aid of EPI-INFO 2002 and statistical significance was set at a P value 0.05 for statistical significance. Total of 400 respondents were interviewed. The mean age was 40 years with a standard deviation of 15.2 yrs. The highest mean score of 4.35 out of a possible maximum of 5 was recorded in assurance domain while the lowest mean score of 4.00 was recorded in the responsiveness domain. The overall mean score of all the domains was 4.20 with standard deviation of 0.51. Overall majority (80.8%) of respondents rated the overall service quality as good/ very good. After linear regression, the assurance domain was the most important predictor of the overall perceived service quality (pservice quality was good. The major deficiencies were in the responsiveness domain and especially the waiting time. The hospital management should implement measures to improve the responsiveness of services by ensuring prompt delivery of services.

  15. PTSD and Use of Outpatient General Medical Services Among Veterans of the Vietnam War.

    Science.gov (United States)

    Schlenger, William E; Mulvaney-Day, Norah; Williams, Christianna S; Kulka, Richard A; Corry, Nida H; Mauch, Danna; Nagler, Caryn F; Ho, Chia-Lin; Marmar, Charles R

    2016-05-01

    The primary goal of this analysis was to assess whether recent use of outpatient services for general medical concerns by Vietnam veterans varies according to level of posttraumatic stress disorder (PTSD) symptomatology over time. Another goal was to determine whether PTSD symptomatology was associated with veterans' reports of discussing behavioral health issues as part of a general medical visit. Self-reported service use data and measures of PTSD were from a nationally representative sample of 848 male and female Vietnam theater veterans (individuals who were deployed to the Vietnam theater of operations) who participated in the National Vietnam Veterans Longitudinal Study, a 25-year follow-up of a cohort of veterans originally interviewed from 1984-1988 as part of the National Vietnam Veterans Readjustment Study. Four categories of PTSD symptomatology course over 25 years were defined, and logistic regression models were used to assess their relationship with recent use of outpatient general medical services. Male and female theater veterans with high or increasing PTSD symptomatology over the period were more likely than those with low symptomatology to report recent VA outpatient visits. Males in the increasing and high categories were also more likely to discuss behavioral health issues at general medical visits. Vietnam veterans with high and increasing PTSD symptomatology over time were likely to use VA outpatient general health services. Attention to stressors of the aging process and to persistence of PTSD symptoms is important for Vietnam veterans, as is addressing PTSD with other psychiatric and medical comorbidities within the context of outpatient general medical care.

  16. Distance from health facility and mothers’ perception of quality related to skilled delivery service utilization in northern Ethiopia

    Directory of Open Access Journals (Sweden)

    Fisseha G

    2017-10-01

    Full Text Available Girmatsion Fisseha,1 Yemane Berhane,2 Alemayehu Worku,2,3 Wondwossen Terefe1 1Mekelle University, College of Health Science, School of Public Health, Mekelle, Ethiopia; 2Addis Continental Institute of Public Health, Epidemiology Department, Addis Ababa, Ethiopia; 3Addis Ababa University, School of Public Health, Biostatistics Department, Addis Ababa, Ethiopia Background: Poor maternal health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia.Subjects and methods: A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia. Multistage sampling technique was used to select mothers from the identified clusters. Households within a 10 km radius of the health facility were taken as a cluster for a community survey. Data were collected using face-to-face interview at the household level. We compared the mothers who reported giving birth to the index child in a health facility and those who reported delivering at home, in order to identify the predictors of skilled delivery utilization. Multivariable logistic regression model was used to determine the predictors of skilled delivery service utilization. The results are presented with odds ratio (OR and 95% confidence interval (CI.Results: A total of 1,796 mothers participated in the study, with a 100% response rate. Distance to health facilities (adjusted odds ratio [AOR] =0.53 [95% CI: 0.39, 0.71], perception of mothers to the availability of adequate equipment in the delivery service in their catchment area (AOR =1.5 [95% CI: 1.11, 2.13], experiencing any complication during childbirth, using antenatal care, lower

  17. Mapping of pedestrian characteristics and level of service for facilities at Universitas Negeri Malang using geographic information system

    Science.gov (United States)

    Rahayuningsih, Titi; Pranoto, Nindyawati, Umniati, B. Sri; Mardhika, Moch Aqfa Syabahid

    2017-09-01

    Universitas Negeri Malang (UM) is a university with the second largest academic community in Malang. The activities of the academic community should be supported by adequate facilities, such as pedestrian facilities—crucial yet much neglected matters, so pedestrians to walk along the roadway. As a result, conflicts between pedestrians with motor vehicle users and accidents might occur at any time. This research aimed at: 1) investigating the geometric conditions of pedestrian facilities at UM; 2) identifying the characteristics of pedestrians and the pedestrian facilities at UM; and 3) determining the level of service for pedestrian facilities at UM using Geographic Information System (GIS). The research was conducted through survey of location, survey of geometric conditions, estimation of the number of pedestrians using sidewalk (data were recorded every 15 minutes), measurement of pedestrian speed, and questionnaire about pedestrians' identity, destination, as well as travel time and distance. Data analysis was carried out to identify the pedestrian characteristics, pedestrian flow characteristics, and pedestrian level of service. The research result showed that the percentage of road segments in campus without sidewalks was 52%. The average width of sidewalk was 1.33 m, which was less than the minimum standard of i.e. 2 m. In terms of pedestrian characteristics, the pedestrians consisted of more female (51%) who were mostly students of the Faculty of Letters whose destination was classroom building. The maximum pedestrian flow was at 10.00-13.30 i.e. 4.2018 p/m/min. The average speed of pedestrian was 63.49 m/min. The highest pedestrian density of 0.0609 p/m2 occurred at 10.00-13.30. The largest walking space was 28.0348 m2/p and occurred in the afternoon at 13.30-17.00. The level of service for pedestrian facilities belonged to category A in the morning and afternoon. The level of service at 10.00-13.30 decreased to category B.

  18. National Service Frameworks and UK general practitioners: street-level bureaucrats at work?

    Science.gov (United States)

    Checkland, Kath

    2004-11-01

    This paper argues that the past decade has seen significant changes in the nature of medical work in general practice in the UK. Increasing pressure to use normative clinical guidelines and the move towards explicit quantitative measures of performance together have the potential to alter the way in which health care is delivered to patients. Whilst it is possible to view these developments from the well-established sociological perspectives of deprofessionalisation and proletarianisation, this paper takes a view of general practice as work, and uses the ideas of Lipsky to analyse practice-level responses to some of these changes. In addition to evidence-based clinical guidelines, National Service Frameworks, introduced by the UK government in 1997, also specify detailed models of service provision that health care providers are expected to follow. As part of a larger study examining the impact of National Service Frameworks in general practice, the response of three practices to the first four NSFs were explored. The failure of NSFs to make a significant impact is compared to the practices' positive responses to purely clinical guidelines such as those developed by the British Hypertension Society. Lipsky's concept of public service workers as 'street-level bureaucrats' is discussed and used as a framework within which to view these findings.

  19. Living large: the experiences of large-bodied women when accessing general practice services

    Directory of Open Access Journals (Sweden)

    Russell N

    2013-09-01

    Full Text Available INTRODUCTION: Numerous studies report high levels of stigma and discrimination experienced by obese/overweight women within the health care system and society at large. Despite general practice being the most utilised point of access for health care services, there is very little international or national exploration of the experiences of large-bodied women (LBW accessing these services. The aim of this study was to explore LBW's experiences of accessing general practice services in New Zealand. METHODS: This is a qualitative, descriptive, feminist study. Local advertising for participants resulted in eight self-identified, large-bodied women being interviewed. A post-structural feminist lens was applied to the data during thematic analysis. FINDINGS: The women in this study provided examples of verbal insults, inappropriate humour, negative body language, unmet health care needs and breaches of dignity from health care providers in general practice. Seven themes were identified: early experiences of body perception, confronting social stereotypes, contending with feminine beauty ideals, perceptions of health, pursuing health, respecting the whole person, and feeling safe to access care. CONCLUSION: Pressure for body size vigilance has, in effect, excluded the women in this study from the very locations of health that they are 'encouraged' to attend-including socialising and exercising in public, screening opportunities that require bodily exposure, and accessing first point of care health services.

  20. Current experiences and educational preferences of general practitioners and staff caring for people with dementia living in residential facilities

    Directory of Open Access Journals (Sweden)

    Scherer Samuel

    2009-08-01

    Full Text Available Abstract Background Residential care is important for older adults, particularly for those with advanced dementia and their families. Education interventions that achieve sustainable improvement in the care of older adults are critical to quality care. There are few systematic data available regarding the educational needs of Residential Care Facility (RCF staff and General Practitioners (GPs relating to dementia, or the sustainability of educational interventions. We sought to determine participation in dementia education, perceived levels of current knowledge regarding dementia, perceived unmet educational needs, current barriers, facilitators and preferences for dementia education. Methods A mixed methods study design was utilised. A survey was distributed to a convenience sample of general practitioners, and staff in 223 consecutive residential care facilities in Perth, Western Australia. Responses were received from 102 RCF staff working in 10 facilities (out of 33 facilities who agreed to distribute the survey and 202 GPs (19% of metropolitan GPs. Quantitative survey data were summarised descriptively and chi squared statistics were used to analyse the distribution of categorical variables. Qualitative data were collected from general practitioners, staff in residential care facilities and family carers of people with dementia utilizing individual interviews, surveys and focus groups. Qualitative data were analysed thematically. Results Among RCF staff and GPs attending RCF, participation in dementia education was high, and knowledge levels generally perceived as good. The individual experiences and needs of people with dementia and their families were emphasised. Participants identified the need for a person centred philosophy to underpin educational interventions. Limited time was a frequently mentioned barrier, especially in relation to attending dementia care education. Perceived educational needs relating to behaviours of concern

  1. Lambdastation: a forwarding and admission control service to interface production network facilities with advanced research network paths

    Energy Technology Data Exchange (ETDEWEB)

    DeMar, Philip; Petravick, Don; /Fermilab

    2004-12-01

    Over the past several years, there has been a great deal of research effort and funding put into the deployment of optical-based, advanced technology wide-area networks. Fermilab and CalTech have initiated a project to enable our production network facilities to exploit these advanced research network facilities. Our objective is to forward designated data transfers across these advanced wide area networks on a per-flow basis, making use our capacious production-use storage systems connected to the local campus network. To accomplish this, we intend to develop a dynamically provisioned forwarding service that would provide alternate path forwarding onto available wide area advanced research networks. The service would dynamically reconfigure forwarding of specific flows within our local production-use network facilities, as well as provide an interface to enable applications to utilize the service. We call this service LambdaStation. If one envisions wide area optical network paths as high bandwidth data railways, then LambdaStation would functionally be the railroad terminal that regulates which flows at the local site get directed onto the high bandwidth data railways. LambdaStation is a DOE-funded SciDac research project in its very early stage of development.

  2. Linking household and health facility surveys to assess obstetric service availability, readiness and coverage: evidence from 17 low- and middle-income countries.

    Science.gov (United States)

    Kanyangarara, Mufaro; Chou, Victoria B; Creanga, Andreea A; Walker, Neff

    2018-06-01

    Improving access and quality of obstetric service has the potential to avert preventable maternal, neonatal and stillborn deaths, yet little is known about the quality of care received. This study sought to assess obstetric service availability, readiness and coverage within and between 17 low- and middle-income countries. We linked health facility data from the Service Provision Assessments and Service Availability and Readiness Assessments, with corresponding household survey data obtained from the Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Based on performance of obstetric signal functions, we defined four levels of facility emergency obstetric care (EmOC) functionality: comprehensive (CEmOC), basic (BEmOC), BEmOC-2, and low/substandard. Facility readiness was evaluated based on the direct observation of 23 essential items; facilities "ready to provide obstetric services" had ≥20 of 23 items available. Across countries, we used medians to characterize service availability and readiness, overall and by urban-rural location; analyses also adjusted for care-seeking patterns to estimate population-level coverage of obstetric services. Of the 111 500 health facilities surveyed, 7545 offered obstetric services and were included in the analysis. The median percentages of facilities offering EmOC and "ready to provide obstetric services" were 19% and 10%, respectively. There were considerable urban-rural differences, with absolute differences of 19% and 29% in the availability of facilities offering EmOC and "ready to provide obstetric services", respectively. Adjusting for care-seeking patterns, results from the linking approach indicated that among women delivering in a facility, a median of 40% delivered in facilities offering EmOC, and 28% delivered in facilities "ready to provide obstetric services". Relatively higher coverage of facility deliveries (≥65%) and coverage of deliveries in facilities "ready to provide obstetric

  3. Political economy of decentralising HIV and AIDS treatment services to primary healthcare facilities in three Nigerian states.

    Science.gov (United States)

    Mbachu, Chinyere; Onwujekwe, Obinna; Ezumah, Nkoli; Ajayi, Olayinka; Sanwo, Olusola; Uzochukwu, Benjamin

    2016-09-01

    Decentralisation is defined as the dispersion, distribution or transfer of resources, functions and decision-making power from a central authority to regional and local authorities. It is usually accompanied by assignment of accountability and responsibility for results. Fundamental to understanding decentralisation is learning what motivates central governments to give up power and resources to local governments, and the practical significance of this on their positions regarding decentralisation. This study examined key political and institutional influences on role-players' capacity to support decentralisation of HIV and AIDS treatment services to primary healthcare facilities, and implications for sustainability. In-depth interviews were conducted with 55 purposively selected key informants, drawn from three Nigerian states that were at different stages of decentralising HIV and AIDS treatment services to primary care facilities. Key informants represented different categories of role-players involved in HIV and AIDS control programmes. Thematic framework analysis of data was done. Support for decentralisation of HIV and AIDS treatment services to primary healthcare facilities was substantial among different categories of actors. Political factors such as the local and global agenda for health, political tenure and party affiliations, and institutional factors such as consolidation of decision-making power and improvements in career trajectories, influenced role-players support for decentralisation of HIV and AIDS treatment services. It is feasible and acceptable to decentralise HIV and AIDS treatment services to primary healthcare facilities, to help improve coverage. However, role-players' support largely depends on how well the reform aligns with political structures and current institutional practices.

  4. Increased ICU resource needs for an academic emergency general surgery service*.

    Science.gov (United States)

    Lissauer, Matthew E; Galvagno, Samuel M; Rock, Peter; Narayan, Mayur; Shah, Paulesh; Spencer, Heather; Hong, Caron; Diaz, Jose J

    2014-04-01

    ICU needs of nontrauma emergency general surgery patients are poorly described. This study was designed to compare ICU utilization of emergency general surgery patients admitted to an acute care emergency surgery service with other general surgery patients. Our hypothesis is that tertiary care emergency general surgery patients utilize more ICU resources than other general surgical patients. Retrospective database review. Academic, tertiary care, nontrauma surgical ICU. All patients admitted to the surgical ICU over age 18 between March 2004 and June 2012. None. Six thousand ninety-eight patients were evaluated: 1,053 acute care emergency surgery, 1,964 general surgery, 1,491 transplant surgery, 995 facial surgery/otolaryngology, and 595 neurosurgery. Acute care emergency surgery patients had statistically significantly longer ICU lengths of stay than other groups: acute care emergency surgery (13.5 ± 17.4 d) versus general surgery (8.7 ± 12.9), transplant (7.8 ± 11.6), oral-maxillofacial surgery (5.5 ± 4.2), and neurosurgery (4.47 ± 9.8) (all psurgery patients: acute care emergency surgery 73.4% versus general surgery 64.9%, transplant 63.3%, oral-maxillofacial surgery 58.4%, and neurosurgery 53.1% (all p surgery patients: acute care emergency surgery 10.8% versus general surgery 4.3%, transplant 6.6%, oral-maxillofacial surgery 0%, and neurosurgery 0.5% (all p surgery patients were more likely interhospital transfers for tertiary care services than general surgery or transplant (24.5% vs 15.5% and 8.3% respectively, p surgery (13.7% vs 6.7% and 3.5%, all p surgery and general surgery, whereas transplant had fewer. Emergency general surgery patients have increased ICU needs in terms of length of stay, ventilator usage, and continuous renal replacement therapy usage compared with other services, perhaps due to the higher percentage of transfers and emergent surgery required. These patients represent a distinct population. Understanding their resource needs

  5. Effects of Caps on Cost Sharing for Skilled Nursing Facility Services in Medicare Advantage Plans.

    Science.gov (United States)

    Keohane, Laura M; Rahman, Momotazur; Thomas, Kali S; Trivedi, Amal N

    2018-03-12

    To evaluate a federal regulation effective in 2011 that limited how much that Medicare Advantage (MA) plans could charge for the first 20 days of care in a skilled nursing facility (SNF). Difference-in-differences retrospective analysis comparing SNF utilization trends from 2008-2012. Select MA plans. Members of 27 plans with mandatory cost sharing reductions (n=132,000) and members of 21 plans without such reductions (n=138,846). Mean monthly number of SNF admissions and days per 1,000 members; annual proportion of MA enrollees exiting the plan. In plans with mandated cost sharing reductions, cost sharing for the first 20 days of SNF care decreased from an average of $2,039 in 2010 to $992 in 2011. In adjusted analyses, plans with mandated cost-sharing reductions averaged 158.1 SNF days (95% confidence interval (CI)=153.2-163.1 days) per 1,000 members per month before the cost sharing cap. This measure increased by 14.3 days (95% CI=3.8-24.8 days, p=0.009) in the 2 years after cap implementation. However, increases in SNF utilization did not significantly differ between plans with and without mandated cost-sharing reductions (adjusted between-group difference: 7.1 days per 1,000 members, 95% CI=-6.5-20.8, p=.30). Disenrollment patterns did not change after the cap took effect. When a federal regulation designed to protect MA members from high out-of-pocket costs for postacute care took effect, the use of SNF services did not change. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  6. Analysis of an M/G/1 Queue with Multiple Vacations, N-policy, Unreliable Service Station and Repair Facility Failures

    Directory of Open Access Journals (Sweden)

    Wenqing Wu

    2014-05-01

    Full Text Available This paper studies an M/G/1 repairable queueing system with multiple vacations and N-policy, in which the service station is subject to occasional random breakdowns. When the service station breaks down, it is repaired by a repair facility. Moreover, the repair facility may fail during the repair period of the service station. The failed repair facility resumes repair after completion of its replacement. Under these assumptions, applying a simple method, the probability that the service station is broken, the rate of occurrence of breakdowns of the service station, the probability that the repair facility is being replaced and the rate of occurrence of failures of the repair facility along with other performance measures are obtained. Following the construction of the long-run expected cost function per unit time, the direct search method is implemented for determining the optimum threshold N* that minimises the cost function.

  7. Office of Inspector General audit report on aircraft and air service management programs

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-01-01

    The Department of Energy`s (DOE) Albuquerque Operations Office (Albuquerque) owns seven aircraft that support defense programs, research and development efforts, emergency response programs, and official travel of Government and contractor employees. An Office of Inspector General (OIG) report, issued in 1994, identified concerns with Albuquerque`s cost for air service. Since that report, there have been reductions in cost and personnel indicating changes in air service requirements. This audit was conducted to determine (1) whether costs to operate Albuquerque`s aircraft were excessive and (2) if individual aircraft in the fleet were justified.

  8. Conceptual design of disposal facility below the generally used depth. Document prepared by other institute, based on the trust contract

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Wataru; Nakagawa, Tatsuo; Mukunoki, Atsushi; Goto, Kikuji [JGC Corp., Tokyo (Japan)

    2002-02-01

    Radioisotope, nuclear fuel materials, and so on have been used in the various fields such as the research activities of universities and research institutes or the treatment and diagnosis of the medical institutes. It is necessary to treat and dispose of radioactive wastes safety and economically. However, as for radioactive wastes disposal below the generally used depth, a concrete disposal concept isn't examined, and the safety of disposal isn't evaluated, either. This report contains building of the database for the radioactive wastes applicable for disposal below the generally used depth, and preliminary safety evaluation was enforced on the setup of condition presumed in the present. Finally subjects for the conceptual design of the disposal facility below the generally used depth were extracted. (author)

  9. Consultation performance of general practitioners when supported by an asthma/COPDC-service

    Directory of Open Access Journals (Sweden)

    Annelies Lucas EM

    2012-07-01

    Full Text Available Abstract Background General practitioners (GPs can refer patients to an asthma/COPD service (AC-service for diagnostic assessment of spirometry and medical history and for asthma or COPD monitoring. The AC-service reports diagnostic results and additional information about disease burden (BORG-score for complaints, MRC-dyspnoea score, exacerbation rate, life style, medication and compliance, to the patient’s GP. This study explores how GPs use this additional information when discussing the patient’s disease burden and how this influences GPs’ information and education provision during consultations with asthma/COPD patients. Method Patients with (a suspicion of asthma or COPD were referred to an AC-service and consulted their GPs after they had received a report from the AC-service. Retrospectively patients answered questions about their GPs’ performance during these consultations. Performances were compared with performances of the same GPs during consultations without support of the AC-service (usual care, earlier that year. Results Of consultations not initiated by an AC-service check-up, 91% focussed on complaints, the initial reason for the consultation. In AC-service supported follow-up consultations, GPs explored disease burden when the (BORG-score for complaints was high - as reported by the AC-service - even when patients themselves thought it was irrelevant. GPs put significantly less effort in exploring disease burden when the Borg-score was low (BORG 3–4: 69%; BORG1-2: 51%, p = 0,01. GPs mostly ignored MRC-dyspnoea scores: attention to dyspnoea was 18% for MRC-score p = 0,63. GPs encouraged physical fitness in 13% of patients. Smoking behaviour was discussed with 66% of the actual smokers but only 14% remembered a stop smoking advice. Furthermore, pharmacotherapeutic management education in AC-service supported consultations did not differ from performance in usual care according to patient evaluations. Conclusion

  10. Evaluation of alternatives for the future of facilities at the Western New York Nuclear Service Center

    International Nuclear Information System (INIS)

    1978-08-01

    Regulatory considerations are discussed. Alternatives for the continued operation or decommissioning of the state-licensed burial area, the low-level waste treatment facilities, and the NRC licensed burial area are evaluated. Radiological impact analyses were also performed for alternatives on other facilities

  11. Academic Computing Facilities and Services in Higher Education--A Survey.

    Science.gov (United States)

    Warlick, Charles H.

    1986-01-01

    Presents statistics about academic computing facilities based on data collected over the past six years from 1,753 institutions in the United States, Canada, Mexico, and Puerto Rico for the "Directory of Computing Facilities in Higher Education." Organizational, functional, and financial characteristics are examined as well as types of…

  12. Barriers to Accessing Detox Facilities, Substance Use Treatment, and Residential Services among Women Impacted by Commercial Sexual Exploitation & Trafficking.

    Science.gov (United States)

    Gerassi, Lara B

    2017-10-06

    More than 50% of women entering substance use treatment in the U.S. reported having traded sex for money or drugs. Women's participation in addiction treatment and related services is essential to their recovery and increased safety, stabilization, and quality of life. This paper's aim is to explore the barriers related to accessing detox facilities and essential services including substance use treatment and residential services for women impacted by commercial sexual exploitation (CSE). Data are drawn from a larger, community-based, grounded theory study. In-depth interview data were collected from 30 adult women who traded sex as adults (through maximum variation and snowball sampling), as well as 20 service providers who come into contact with adult women who trade sex (through nominations and purposive sampling). Finding suggest that women often encountered sobriety requirements, which created barriers to accessing addiction treatment or residential services. Some organizations' policies required evicting women if they were caught using, which created additional challenges for women who relapsed. Women wanted to avoid becoming "dopesick" on the streets or at home, which partially contributed to them needing to maintain their addiction. Consequently, some returned to sex trading, thus increasing their risk of trafficking. Some women engaged in creative strategies, such as claiming they were suicidal, in order to access the detox facilities in hospitals. Some women indicated they were only able to detox when they were forced to do so in jail or prison, often without medical assistance. Implications to improve health care delivery for this population are discussed.

  13. Factors determining the concentration and chemical composition of particulate matter in the air of selected service facilities

    Science.gov (United States)

    Rogula-Kopiec, Patrycja; Pastuszka, Józef; Mathews, Barbara; Widziewicz, Kamila

    2018-01-01

    The link between increased morbidity and mortality and increasing concentrations of particulate matter (PM) resulted in great attention being paid to the presence and physicochemical properties of PM in closed rooms, where people spends most of their time. The least recognized group of such indoor environments are small service facilities. The aim of this study was to identify factors which determine the concentration, chemical composition and sources of PM in the air of different service facilities: restaurant kitchen, printing office and beauty salon. The average PM concentration measured in the kitchen was 5-fold (PM4, particle fraction ≥ 4 μm) and 5.3-fold (TSP, total PM) greater than the average concentration of these PM fractions over the same period. During the same measurement period in the printing office and in the beauty salon, the mean PM concentration was 10- and 4-fold (PM4) and 8- and 3-fold (TSP) respectively greater than the mean concentration of these PM fractions in outdoor air. In both facilities the main source of PM macro-components, especially organic carbon, were chemicals, which are normally used in such places - solvents, varnishes, paints, etc. The influence of some metals inflow from the outdoor air into indoor environment of those facilities was also recognized.

  14. Invisible Thread: Pre-Service Success Indicators Among Marine General Officers

    Science.gov (United States)

    2017-12-01

    30 Table 12. Self -Perception About Pre-Service Success Indicators .............................34...then reviewed by an Officer Review Board, which according to Marine Corps Order is “used to determine which company grade officers will be offered the...Status 91 Place of Birth State 83 Quarter of Birth 64 Religion 91 Sex 91 9 1. Accession Type Accession type defines which program each general

  15. Hospital discharge summary scorecard: a quality improvement tool used in a tertiary hospital general medicine service.

    Science.gov (United States)

    Singh, G; Harvey, R; Dyne, A; Said, A; Scott, I

    2015-12-01

    We assessed the impact of completion and feedback of discharge summary scorecards on the quality of discharge summaries written by interns in a general medicine service of a tertiary hospital. The scorecards significantly improved summary quality in the first three rotations of the intern year and could be readily adopted by other units as a quality improvement intervention for optimizing clinical handover to primary care providers. © 2015 Royal Australasian College of Physicians.

  16. Invisible thread: pre-service success indicators among Marine general officers

    OpenAIRE

    Munoz, Valerie; Common, Joseph; Lue, Kendra

    2017-01-01

    Approved for public release; distribution is unlimited The purpose of this study is to identify commonalities that may exist among general officers within the Unites States Marine Corps. This exploratory analysis focuses on pre-service indicators of success and assesses the existence of any competitive advantages. The data used in this analysis includes pre- and post-accession information obtained from the United States Marine Corps' Total Force Data Warehouse (TFDW), as well as semi-struc...

  17. Inequalities in utilisation of general practitioner and specialist services in 9 European countries

    Directory of Open Access Journals (Sweden)

    Mielck Andreas

    2011-10-01

    Full Text Available Abstract Background The aim of this study is to describe the magnitude of educational inequalities in utilisation of general practitioner (GP and specialist services in 9 European countries. In addition to West European countries, we have included 3 Eastern European countries: Hungary, Estonia and Latvia. To cover the gap in knowledge we pay a special attention to the magnitude of inequalities among patients with chronic conditions. Methods Data on the use of GP and specialist services were derived from national health surveys of Belgium, Estonia, France, Germany, Hungary, Ireland, Latvia, the Netherlands and Norway. For each country and education level we calculated the absolute prevalence and relative inequalities in utilisation of GP and specialist services. In order to account for the need for care, the results were adjusted by the measure of self-assessed health. Results People with lower education used GP services equally often in most countries (except Belgium and Germany compared with those with a higher level of education. At the same time people with a higher education used specialist care services significantly more often in all countries, except in the Netherlands. The general pattern of educational inequalities in utilisation of specialist care was similar for both men and women. Inequalities in utilisation of specialist care were equally large in Eastern European and in Western European countries, except for Latvia where the inequalities were somewhat larger. Similarly, large inequalities were found in the utilisation of specialist care among patients with chronic diseases, diabetes, and hypertension. Conclusions We found large inequalities in the utilisation of specialist care. These inequalities were not compensated by utilisation of GP services. Of particular concern is the presence of inequalities among patients with a high need for specialist care, such as those with chronic diseases.

  18. Inequalities in utilisation of general practitioner and specialist services in 9 European countries.

    Science.gov (United States)

    Stirbu, Irina; Kunst, Anton E; Mielck, Andreas; Mackenbach, Johan P

    2011-10-31

    The aim of this study is to describe the magnitude of educational inequalities in utilisation of general practitioner (GP) and specialist services in 9 European countries. In addition to West European countries, we have included 3 Eastern European countries: Hungary, Estonia and Latvia. To cover the gap in knowledge we pay a special attention to the magnitude of inequalities among patients with chronic conditions. Data on the use of GP and specialist services were derived from national health surveys of Belgium, Estonia, France, Germany, Hungary, Ireland, Latvia, the Netherlands and Norway. For each country and education level we calculated the absolute prevalence and relative inequalities in utilisation of GP and specialist services. In order to account for the need for care, the results were adjusted by the measure of self-assessed health. People with lower education used GP services equally often in most countries (except Belgium and Germany) compared with those with a higher level of education. At the same time people with a higher education used specialist care services significantly more often in all countries, except in the Netherlands. The general pattern of educational inequalities in utilisation of specialist care was similar for both men and women. Inequalities in utilisation of specialist care were equally large in Eastern European and in Western European countries, except for Latvia where the inequalities were somewhat larger. Similarly, large inequalities were found in the utilisation of specialist care among patients with chronic diseases, diabetes, and hypertension. We found large inequalities in the utilisation of specialist care. These inequalities were not compensated by utilisation of GP services. Of particular concern is the presence of inequalities among patients with a high need for specialist care, such as those with chronic diseases. © 2011 Stirbu et al; licensee BioMed Central Ltd.

  19. STAR - Research Experiences at National Laboratory Facilities for Pre-Service and Early Career Teachers

    Science.gov (United States)

    Keller, J. M.; Rebar, B.; Buxner, S.

    2012-12-01

    The STEM Teacher and Researcher (STAR) Program provides pre-service and beginning teachers the opportunity to develop identity as both teachers and researchers early in their careers. Founded and implemented by the Center for Excellence in Science and Mathematics Education (CESaME) at California Polytechnic State University on behalf of the California State University (CSU) system, STAR provides cutting edge research experiences and career development for students affiliated with the CSU system. Over the past three summers, STAR has also partnered with the NSF Robert Noyce Teacher Scholarship Program to include Noyce Scholars from across the country. Key experiences are one to three summers of paid research experience at federal research facilities associated with the Department of Energy (DOE), National Aeronautics and Space Administration (NASA), National Oceanic and Atmospheric Association (NOAA), and the National Optical Astronomy Observatory (NOAO). Anchoring beginning teachers in the research community enhances participant understanding of what it means to be both researchers and effective teachers. Since its inception in 2007, the STAR Program has partnered with 15 national lab facilities to provide 290 research experiences to 230 participants. Several of the 68 STAR Fellows participating in the program during Summer 2012 have submitted abstracts to the Fall AGU Meeting. Through continued partnership with the Noyce Scholar Program and contributions from outside funding sources, the CSU is committed to sustaining the STAR Program in its efforts to significantly impact teacher preparation. Evaluation results from the program continue to indicate program effectiveness in recruiting high quality science and math majors into the teaching profession and impacting their attitudes and beliefs towards the nature of science and teaching through inquiry. Additionally, surveys and interviews are being conducted of participants who are now teaching in the classroom as

  20. Acoustic assessment report for Toronto Hydro Energy Services Inc. Ashbridge's Bay power generation facility

    International Nuclear Information System (INIS)

    Bernard, F.; Shinbin, N.

    2010-04-01

    This acoustic assessment report was conducted to determine the potential noise impacts of a biogas cogeneration plant that will be located on a street in a primarily industrial area of Toronto, Ontario. The facility will be comprised of seven 1.416 MW biogas-fired reciprocating engine generators and a single flare. The report presented results obtained from noise level calculations and noise modelling studies of the on-site equipment at the planned facility. The cogeneration plant will utilize biogas produced in existing digesters to generate electricity and hot water. The biogas will be produced by anaerobic digestion from municipal sewage waste at an adjacent facility. It is expected that the facility will generate 9.912 MW of electricity from the generators. Heat resulting from the biogas combustion process is recovered from engine and exhaust flue gases by heat exchangers. The facility will operate continuously. Significant noise sources at the facility include generator exhaust gas stacks; air intake points; building ventilation fans; and roof-top heat dump radiators. Sound power levels determined for each of the noise sources were based upon worst-case operating scenarios. Results of the assessment indicated that the facility is in compliance with all Ministry of the Environment (MOE) requirements. 5 refs., 10 tabs., 4 figs.

  1. Uranium Production Safety Assessment Team. UPSAT. An international peer review service for uranium production facilities

    International Nuclear Information System (INIS)

    1996-01-01

    The IAEA Uranium Production Safety Assessment Team (UPSAT) programme is designed to assist Member States to improve the safe operation of uranium production facilities. This programme facilitates the exchange of knowledge and experience between team members and industry personnel. An UPSAT mission is an international expert review, conducted outside of any regulatory framework. The programme is implemented in the spirit of voluntary co-operation to contribute to the enhancement of operational safety and practices where it is most effective, at the facility itself. An UPSAT review supplements other facility and regulatory efforts which may have the same objective

  2. The impact of the prospective payment system for skilled nursing facilities on therapy service provision: a transaction cost approach.

    Science.gov (United States)

    Zinn, Jacqueline S; Mor, Vincent; Intrator, Orna; Feng, Zhanlian; Angelelli, Joseph; Davis, Jullet A

    2003-12-01

    To examine skilled nursing facilities (SNFs) "make-or-buy" decisions with respect to rehabilitation therapy service provision in the 1990s, both before and after implementation of Medicare's Prospective Payment System (PPS) for SNFs. Longitudinal On-line Survey Certification and Reporting (OSCAR) data (1992-2001) on a sample of 10,241 freestanding urban SNFs. We estimated a longitudinal multinomial logistic regression model derived from transaction cost economic theory to predict the probability of the outcome in each of four service provision categories (all employed staff, all contract, mixed, and no services provided). Transaction frequency, uncertainty, and complexity result in greater control over therapy services through employment as opposed to outside contracting. For-profit status and chain affiliation were associated with greater control over therapy services. Following PPS, nursing homes acted to limit transaction costs by either exiting the rehabilitation market or exerting greater control over therapy services by managing rehabilitation services in-house. The financial incentives associated with changes in reimbursement methodology have implications that extend beyond the boundaries of the health care industry segment directly affected. Unintended quality and access consequences need to be carefully monitored by the Medicare program.

  3. The User Community and a Multi-Mission Data Project: Services, Experiences and Directions of the Space Physics Data Facility

    Science.gov (United States)

    Fung, Shing F.; Bilitza, D.; Candey, R.; Chimiak, R.; Cooper, John; Fung, Shing; Harris, B.; Johnson R.; King, J.; Kovalick, T.; hide

    2008-01-01

    From a user's perspective, the multi-mission data and orbit services of NASA's Space Physics Data Facility (SPDF) project offer a unique range of important data and services highly complementary to other services presently available or now evolving in the international heliophysics data environment. The VSP (Virtual Space Physics Observatory) service is an active portal to a wide range of distributed data sources. CDAWeb (Coordinate Data Analysis Web) enables plots, listings and file downloads for current data cross the boundaries of missions and instrument types (and now including data from THEMIS and STEREO). SSCWeb, Helioweb and our 3D Animated Orbit Viewer (TIPSOD) provide position data and query logic for most missions currently important to heliophysics science. OMNIWeb with its new extension to 1- and 5-minute resolution provides interplanetary parameters at the Earth's bow shock as a unique value-added data product. SPDF also maintains NASA's CDF (common Data Format) standard and a range of associated tools including translation services. These capabilities are all now available through webservices-based APIs as well as through our direct user interfaces. In this paper, we will demonstrate the latest data and capabilities now supported in these multi-mission services, review the lessons we continue to learn in what science users need and value in this class of services, and discuss out current thinking to the future role and appropriate focus of the SPDF effort in the evolving and increasingly distributed heliophysics data environment.

  4. A 'mystery client' evaluation of adolescent sexual and reproductive health services in health facilities from two regions in Tanzania.

    Directory of Open Access Journals (Sweden)

    Zaina Mchome

    Full Text Available Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people's access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning. The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers' mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people's efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed.

  5. In a niche of time: do specialty hospitals outperform general services hospitals?

    Science.gov (United States)

    Poole, LeJon; Davis, Jullet A; Gunby, Norris W

    2013-01-01

    Niche hospitals represent a growing segment in the health care industry. Niche facilities are primarily engaged in the treatment of cardiac or orthopedic conditions. The effectiveness of this strategy is of interest because niche hospitals focus on only the most profitable services. The purpose of this research was to assess the financial effectiveness of the niche strategy. We theorize that firm and market-level factors concomitantly with the strategy of the hospital-niche versus traditional-are associated with financial performance. This research used 2 data sources, the 2003 Medicare Cost Report and the 2003 Area Resource File. The sample was limited to only for-profit, urban, nongovernmental hospitals (n = 995). The data were analyzed using hierarchical least squares regression. Financial performance was operationalized using the hospital's return on assets. The principal finding of this project is that niche hospitals had significantly higher performance than traditional facilities. From the organizational perspective, the niche strategy leads to better financial performance. From a societal perspective, the niche strategy provides increased focus and efficiencies through repetition. Despite the limited focus of this strategy, patients who can access these providers may experience better outcomes than patients in more traditional hospitals.

  6. 41 CFR 102-118.420 - Can the Administrator of General Services waive the postpayment auditing provisions of this subpart?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Can the Administrator of General Services waive the postpayment auditing provisions of this subpart? 102-118.420 Section 102-118... Transportation Audits § 102-118.420 Can the Administrator of General Services waive the postpayment auditing...

  7. Access to general health care services by a New Zealand population with serious mental illness.

    Directory of Open Access Journals (Sweden)

    Wheeler A

    2014-03-01

    Full Text Available INTRODUCTION: Literature suggests that good quality health care access can have a positive impact on the health of people with serious mental illness (SMI, but literature relating to patterns of access by this group is equivocal. AIM: This study was designed to explore health care access patterns in a group of people with SMI and to compare them with a general New Zealand population group, in order for health providers to understand how they might contribute to positive health outcomes for this group. METHODS: The study surveyed 404 mental health consumers aged 18-65 years receiving care from one district health board in Auckland about their patterns of health care access. Results were compared with those from the New Zealand Health Survey of the general population. RESULTS: Findings suggest that the SMI consumer respondents had poorer physical health than the general population respondents, accessed health care services in more complex ways and were more particular about who they accessed for their care than the general population respondents. There was some concern from SMI consumers around discrimination from health care providers. The study also suggested that some proactive management with SMI consumers for conditions such as metabolic syndrome was occurring within the health care community. DISCUSSION: The first point of access for SMI consumers with general health problems is not always the family general practitioner and so other health professionals may sometimes need to consider the mental and physical health of such consumers in a wider context than their own specialism.

  8. Operation and maintenance experience at the General Atomic Company's TRIGA reactor facility at San Diego, California

    International Nuclear Information System (INIS)

    Whittemore, W.L.; Stout, W.A.; Shoptaugh, J.R.; Chesworth, R.H.

    1982-01-01

    Since the startup of the original 250 kW TRIGA Mark I reactor in 1958, General Atomic Company has accumulated nearly 24 years of operation and maintenance experience with this type of reactor. In addition to the nearly 24 years of experience gained on the Mark I, GA has operated the 1.5 MW Advanced Prototype Test Reactor (Mark F) for 22 years and operated a 2 MW below-ground TRIGA Mark III for five years. Information obtained from normal and abnormal operation are presented. (author)

  9. Utilization of outpatient services in refugee settlement health facilities: a comparison by age, gender, and refugee versus host national status

    Directory of Open Access Journals (Sweden)

    Meyer Sarah

    2011-09-01

    Full Text Available Abstract Background Comparisons between refugees receiving health care in settlement-based facilities and persons living in host communities have found that refugees have better health outcomes. However, data that compares utilization of health services between refugees and the host population, and across refugee settlements, countries and regions is limited. The paper will address this information gap. The analysis in this paper uses data from the United Nations High Commissioner of Refugees (UNHCR Health Information System (HIS. Methods Data about settlement populations and the use of outpatient health services were exported from the UNHCR health information system database. Tableau Desktop was used to explore the data. STATA was used for data cleaning and statistical analysis. Differences in various indicators of the use of health services by region, gender, age groups, and status (host national vs. refugee population were analyzed for statistical significance using generalized estimating equation models that adjusted for correlated data within refugee settlements over time. Results Eighty-one refugee settlements were included in this study and an average population of 1.53 million refugees was receiving outpatient health services between 2008 and 2009. The crude utilization rate among refugees is 2.2 visits per person per year across all settlements. The refugee utilization rate in Asia (3.5 was higher than in Africa on average (1.8. Among refugees, females have a statistically significant higher utilization rate than males (2.4 visits per person per year vs. 2.1. The proportion of new outpatient attributable to refugees is higher than that attributable to host nationals. In the Asian settlements, only 2% outpatient visits, on average, were attributable to host community members. By contrast, in Africa, the proportion of new outpatient (OPD visits by host nationals was 21% on average; in many Ugandan settlements, the proportion of outpatient

  10. Utilization of outpatient services in refugee settlement health facilities: a comparison by age, gender, and refugee versus host national status.

    Science.gov (United States)

    Weiss, William M; Vu, Alexander; Tappis, Hannah; Meyer, Sarah; Haskew, Christopher; Spiegel, Paul

    2011-09-21

    Comparisons between refugees receiving health care in settlement-based facilities and persons living in host communities have found that refugees have better health outcomes. However, data that compares utilization of health services between refugees and the host population, and across refugee settlements, countries and regions is limited. The paper will address this information gap. The analysis in this paper uses data from the United Nations High Commissioner of Refugees (UNHCR) Health Information System (HIS). Data about settlement populations and the use of outpatient health services were exported from the UNHCR health information system database. Tableau Desktop was used to explore the data. STATA was used for data cleaning and statistical analysis. Differences in various indicators of the use of health services by region, gender, age groups, and status (host national vs. refugee population) were analyzed for statistical significance using generalized estimating equation models that adjusted for correlated data within refugee settlements over time. Eighty-one refugee settlements were included in this study and an average population of 1.53 million refugees was receiving outpatient health services between 2008 and 2009. The crude utilization rate among refugees is 2.2 visits per person per year across all settlements. The refugee utilization rate in Asia (3.5) was higher than in Africa on average (1.8). Among refugees, females have a statistically significant higher utilization rate than males (2.4 visits per person per year vs. 2.1). The proportion of new outpatient attributable to refugees is higher than that attributable to host nationals. In the Asian settlements, only 2% outpatient visits, on average, were attributable to host community members. By contrast, in Africa, the proportion of new outpatient (OPD) visits by host nationals was 21% on average; in many Ugandan settlements, the proportion of outpatient visits attributable to host community members

  11. Utilization of outpatient services in refugee settlement health facilities: a comparison by age, gender, and refugee versus host national status

    Science.gov (United States)

    2011-01-01

    Background Comparisons between refugees receiving health care in settlement-based facilities and persons living in host communities have found that refugees have better health outcomes. However, data that compares utilization of health services between refugees and the host population, and across refugee settlements, countries and regions is limited. The paper will address this information gap. The analysis in this paper uses data from the United Nations High Commissioner of Refugees (UNHCR) Health Information System (HIS). Methods Data about settlement populations and the use of outpatient health services were exported from the UNHCR health information system database. Tableau Desktop was used to explore the data. STATA was used for data cleaning and statistical analysis. Differences in various indicators of the use of health services by region, gender, age groups, and status (host national vs. refugee population) were analyzed for statistical significance using generalized estimating equation models that adjusted for correlated data within refugee settlements over time. Results Eighty-one refugee settlements were included in this study and an average population of 1.53 million refugees was receiving outpatient health services between 2008 and 2009. The crude utilization rate among refugees is 2.2 visits per person per year across all settlements. The refugee utilization rate in Asia (3.5) was higher than in Africa on average (1.8). Among refugees, females have a statistically significant higher utilization rate than males (2.4 visits per person per year vs. 2.1). The proportion of new outpatient attributable to refugees is higher than that attributable to host nationals. In the Asian settlements, only 2% outpatient visits, on average, were attributable to host community members. By contrast, in Africa, the proportion of new outpatient (OPD) visits by host nationals was 21% on average; in many Ugandan settlements, the proportion of outpatient visits attributable

  12. Development of a Quality of Meals and Meal Service Set of Indicators for Residential Facilities for Elderly.

    Science.gov (United States)

    Van Damme, N; Buijck, B; Van Hecke, A; Verhaeghe, S; Goossens, E; Beeckman, D

    2016-01-01

    To develop a content validated set of indicators to evaluate the quality of meals and meal service in residential facilities for elderly. Inadequate food intake is an important risk factor for malnutrition in residential facilities for elderly. Through better meeting the needs and preferences of residents and optimization of meals and meal service, residents' food intake can improve. No indicators were available which could help to guide strategies to improve the quality of meals and meal service. The indicator set was developed according to the Indicator Development Manual of the Dutch Institute for Health Care Improvement (CBO). The working group consisted of three nurse researchers and one expert in gastrology and had expertise in elderly care, malnutrition, indicator development, and food quality. A preliminary list of potential indicators was compiled using the literature and the working group's expertise. Criteria necessary to measure the indicator in practice were developed for each potential indicator. In a double Delphi procedure, the list of potential indicators and respective criteria were analyzed for content validity, using a multidisciplinary expert panel of 11 experts in elderly meal care. A preliminary list of 20 quality indicators, including 45 criteria, was submitted to the expert panel in a double Delphi procedure. After the second Delphi round, 13 indicators and 25 criteria were accepted as having content validity. The content validity index (CVI) ranged from 0.83 to 1. The indicator set consisted of six structural, four result, and three outcome indicators covering the quality domains food, service and choice, as well as nutritional screening. The criteria measure diverse aspects of meal care which are part of the responsibility of kitchen staff and health care professionals. The 'quality of meals and meal service' set of indicators is a resource to map meal quality in residential facilities for elderly. As soon as feasibility tests in practice

  13. Qualitative Study of correspondence between Patient Perception of Service Advertisement and Service Provided from Traditional Health Facilities

    Directory of Open Access Journals (Sweden)

    Lusi Kristiana

    2015-01-01

    Full Text Available background: Attractive adses of traditional health services often promises such as certainty of healing, treatment without side effect, experience personnel, exclusive recipes, and testimony of patients who recovered. Ads that this unsubstantiated allegedly played a role in the tendency of people turn to traditional medicine. The aim of the study is to describe the perception of patients about the correspondence between the advertisement and the services provided qualitatively. Methods: The study was conducted in Surabaya for 5 months in 2012. Informants were selected purposively. results: The result shows that most of the information about traditional health services obtained from either advertisement local and national television. Health complaints predominanly degenerative diseases, and most have been treated to modern medicine but because they do not heal, switch to traditional medicine. conclusion: Informants judge ad featuring attractive because advanced equipment, herbal remedies as well as testimonials of patients who have recovered. Much of the promise of the ads is not evident when patients seek treatment, so they seek other traditional treatments. Most of them are less satisfied, but there is a fraction that satisfied because being cured. Traditional health services responsiveness associated with the non-medical aspects assessed either by informants. recomendation:Competent authorities should enforce and socialize media literacy to encourage community.

  14. The Influence of Facility and Service Quality towards Customer Satisfaction and its Impact on Customer Loyalty in Borobudur Hotel in Jakarta

    Directory of Open Access Journals (Sweden)

    Rianto Nurtjahjo

    2017-05-01

    Full Text Available Hotel developments currently grow very rapidly. The emergence of new hotels increases the competition in the hospitality industry. This research aimed to determine the influence of the facilities, the quality of service to customer satisfaction and its impact on customer loyalty in Borobudur Hotel in Jakarta. Data collection was done by distributing questionnaires directly to 360 customers in Borobudur Hotel in Jakarta. The analysis technique used path analysis. The results of this research indicate that the variables of facilities, service quality and customer satisfaction significantly affect customer loyalty variables simultaneously or partially. In addition, facilities and quality of service variable have a significant effect on customer satisfaction variables.

  15. Problems of development and putting into education process an electronic textbook on special discipline 'General theory and construction of heat-and-power engineering facilities'

    International Nuclear Information System (INIS)

    Karitskaya, S.G.; Ruzanov, K.A.; Davletov, V.S.

    2005-01-01

    The results of work of making the electronic textbook of special discipline ('General theory and construction of heat-and-power engineering facilities' are brought. The principles and requirements, presented towards literature of such type, are outlined. (author)

  16. Using paradox theory to understand responses to tensions between service and training in general surgery.

    Science.gov (United States)

    Cleland, Jennifer; Roberts, Ruby; Kitto, Simon; Strand, Pia; Johnston, Peter

    2018-03-01

    The tension between service and training in pressured health care environments can have a detrimental impact on training quality and job satisfaction. Yet the management literature proposes that competing demands are inherent in organisational settings: it is not the demands as such that lead to negative outcomes but how people and organisations react to opposing tensions. We explored how key stakeholders responded to competing service-training demands in a surgical setting that had recently gone through a highly-publicised organisational crisis. This was an explanatory case study of a general surgery unit. Public documents informed the research questions and the data were triangulated with semi-structured interviews (n = 14) with key stakeholders. Data coding and analysis were initially inductive but, after the themes emerged, we used a paradox lens to group themes into four contextual dimensions: performing, organising, belonging and learning. Tensions were apparent in the data, with managers, surgeons and trainees or residents in conflict with each other because of different goals or priorities and divergent perspectives on the same issue of balancing service and training (performing). This adversely impacted on relationships across and within groups (belonging, learning) and led to individuals prioritising their own goals rather than working for the 'greater good' (performing, belonging). Yet although relationships and communication improved, the approach to getting a better balance maintained the 'compartmentalisation' of training (organising) rather than acknowledging that training and service cannot be separated. Stakeholder responses to the tensions provided temporary relief but were unlikely to lead to real change if the tension between service and training was considered to be an interdependent and persistent paradox. Reframing the service-training paradox in this way may encourage adjusting responses to create effective working partnerships. Our findings

  17. Geothermal source heat pumps under energy services companies finance scheme to increase energy efficiency and production in stockbreeding facilities

    International Nuclear Information System (INIS)

    Borge-Diez, David; Colmenar-Santos, Antonio; Pérez-Molina, Clara; López-Rey, África

    2015-01-01

    In Europe energy services are underutilized in terms of their potential to improve energy efficiency and reduce external energy dependence. Agricultural and stockbreeding sectors have high potential to improve their energy efficiency. This paper presents an energy model for geothermal source heat pumps in stockbreeding facilities and an analysis of an energy services business case. The proposed solution combines both energy cost reduction and productivity increases and improves energy services company financing scheme. CO 2 emissions drop by 89%, reducing carbon footprint and improving added value for the product. For the two different evaluated scenarios, one including winter heating and one including heating and cooling, high IRR (internal return rate) values are obtained. A sensitivity analysis reveals that the IRR ranges from 10.25% to 22.02%, making the investment attractive. To make the research highly extensible, a sensitivity analysis for different locations and climatic conditions is presented, showing a direct relationship between financial parameters and climatic conditions. A Monte Carlo simulation is performed showing that initial fuel cost and initial investment are the most decisive in the financial results. This work proves that energy services based on geothermal energy can be profitable in these sectors and can increase sustainability, reduce CO 2 emissions and improve carbon footprint. - Highlights: • Geothermal heat pumps are studied to promote industrial energy services. • Geothermal energy in farming facilities improves global competitiveness. • Research shows profitability of low enthalpy geothermal energy services. • Climatic conditions sensitivity analysis reveals IRR ranges from 10.25% to 22.02%. • Added market value for the product as carbon footprint reduction, are achieved

  18. The state of emergency obstetric care services in Nairobi informal settlements and environs: Results from a maternity health facility survey

    Directory of Open Access Journals (Sweden)

    Saliku Teresa

    2009-03-01

    of morbidity and mortality was a challenge due to poor and incomplete medical records. Conclusion The quality of emergency obstetric care services in Nairobi slums is poor and needs improvement. Specific areas that require attention include supervision, regulation of maternity facilities; and ensuring that basic equipment, supplies, and trained personnel are available in order to handle obstetric complications in both public and private facilities.

  19. Psychopathology of adolescents with an intellectual disability who present to general hospital services.

    Science.gov (United States)

    Theodoratos, Oreste; McPherson, Lyn; Franklin, Catherine; Tonge, Bruce; Einfeld, Stewart; Lennox, Nicholas; Ware, Robert S

    2017-10-01

    Adolescents with intellectual disability have increased rates of psychopathology compared with their typically developing peers and present to hospital more frequently for ambulant conditions. The aim of this study is to describe the psychopathology and related characteristics of a sample of adolescents with intellectual disability who presented to general hospital services. We investigated a cohort of adolescents with intellectual disability in South East Queensland, Australia between January 2006 and June 2010. Demographic and clinical data were obtained via mailed questionnaires and from general practice notes. Psychopathology was measured with the Short Form of the Developmental Behaviour Checklist. Of 98 individuals presenting to hospital, 71 (72.5%) had significant levels of psychopathology. Unknown aetiology for the intellectual disability was associated with presence of problem behaviours. Adolescents with more severe intellectual disability were more likely to have major problem behaviours. Co-morbid physical health issues were not associated with psychopathology. Only 12 (12.1%) adolescents had undergone specialized mental health intervention. The general hospital environment may offer opportunities for liaison psychiatry services to screen and provide management expertise for adolescent individuals with intellectual disability presenting for physical health issues.

  20. Experiences of military CRNAs with service personnel who are emerging from general anesthesia.

    Science.gov (United States)

    Wilson, John Tyler; Pokorny, Marie E

    2012-08-01

    We conducted this qualitative study to understand the experiences of military Certified Registered Nurse Anesthetists (CRNAs) working with service personnel who have traumatic brain injury (TBI) and/or posttraumatic stress disorder (PTSD) and are emerging from general anesthesia. This study is important because there are no studies in the literature that describe the experiences of anesthetists working with patients with these specific problems. The leading questions were: "Out of all the anesthesia cases both abroad and stateside (post 9/11/2001), have you noticed service members wake from general anesthesia (not utilizing total intravenous anesthesia (TIVA), in a state of delirium? If so, can you tell me your experiences and thought processes as to why it was occurring?" Five themes emerged: (1) Emergence delirium (ED) exists and to a much higher degree in the military than in the general population. (2) ED was much more prevalent in the younger military population. (3) TIVA was a superior anesthetic for patients thought to have TBI and/or PTSD. (4) Talking to all patients suspected of having TBI and/or PTSD before surgery and on emergence was vital for a smooth emergence. (5) There is something profound happening in regard to ketamine and PTSD and TBI.

  1. Military Construction of the Defense Finance and Accounting Service Operations Facility, Columbus, Ohio

    National Research Council Canada - National Science Library

    Granetto, Paul

    1995-01-01

    The audit objectives were to determine whether the Defense Finance and Accounting Service Columbus Center properly planned and programmed the FY 1996 proposed military construction project and whether...

  2. Can sonographers offer an accurate upper abdominal ultrasound service in a district general hospital?

    International Nuclear Information System (INIS)

    Dongola, N.A.; Guy, R.L.; Giles, J.A.; Ward, S.

    2003-01-01

    Purpose: This study was performed to evaluate the accuracy of upper abdominal ultrasound (US) scanning performed by sonographers in a district general hospital, to identify potential areas of weakness and to make recommendations to improve the service. Materials and methods: Upper abdominal US examinations performed and reported by sonographers over a 4-week period were retrospectively reviewed. The accuracy of the imaging findings and reports were assessed against other imaging, surgical, histological or laboratory findings and against clinical outcome. Results: A heterogenous group of 104 patients were included in the study, 62 of whom had an US abnormality. Errors of scanning or interpretation were identified in 10 patients (9.6%) of whom five (4.8%) were felt to be potentially significant. Conclusions: The sonographers' accuracy in reporting upper abdominal US scans was 90%. However, on the basis of this study we have implemented specific recommendations to improve the quality of the service

  3. Exploring barriers to accessing physiotherapy services for stroke patients at Tema general hospital, Ghana.

    Science.gov (United States)

    Nketia-Kyere, Mercy; Aryeetey, Genevieve Cecilia; Nonvignon, Justice; Aikins, Moses

    2017-01-01

    Physiotherapy has been shown to reduce the risk of disability among stroke patients. Poor adherence to physiotherapy can negatively affect outcomes and healthcare cost. However, very little is known about barriers especially to physiotherapy services in Ghana. The objective of this study was to assess the barriers to physiotherapy services for stroke patients at Tema General Hospital (TGH). The individual/personal and health system barriers to physiotherapy services at TGH were determined. A cross-sectional study design was employed. A simple random sampling technique was used to recruit 207 respondents for a face-to-face interview. Interviewer-administered questionnaires were used to collect data on individual/personal barriers of respondents to physiotherapy services and were described using the Likert's scale. Health system barriers were assessed using a self-structured questionnaire which had section under the following heading: human factors, physiotherapy modalities, physical barriers and material/equipment factors. The time spent waiting for physiotherapy and attitude of physiotherapist towards patients; physiotherapy modality such as electrotherapy, exercise therapy and massage therapy among others were some of the indices measured. Respondents' adherence to Medication was assessed with the Morisky 8-item medication adherence questionnaire. Data were entered and analysed using Epi info 7 and STATA 12.0. Associations between the variables were determined using a chi-square test and logistic regression model was used to test the strength of associations between the independent and the dependent variables. The level of statistical significance was set at p  Tema General Hospital.

  4. Views of West Valley area residents concerning the Nuclear Fuel Services facility at West Valley, New York

    International Nuclear Information System (INIS)

    Kamieniecki, S.; Milbrath, L.W.

    1978-06-01

    A number of major findings have emerged from this analysis. Although most people have heard or read about the Nuclear Fuel Services plant at West Valley, few exhibit a high level of knowledge about the issue area. A clear majority of residents living in the region are concerned about the presence of the facility. Many are particularly concerned about the health dangers that can result from radioactive contamination of the environment. People want to see something done about the facility, but do not know exactly what. When forced to choose one out of three possible alternatives, twice as many people preferred to ''completely remove the plant and restore the area'' than either of the two remaining alternatives. People who are concerned about the facility tend to favor removal of the plant and restoration of the area. Nearly three-fourths of West Valley area residents who believe that the plant did not employ enough people to significantly help the economy of the region favor removal of the facility and restoration of the area. The results of this study may help policymakers choose the most acceptable course of action

  5. Autonomous underwater handling system for service, measurement and cutting tasks for the decommissioning of nuclear facilities

    International Nuclear Information System (INIS)

    Hahn, M.; Haferkamp, H.; Bach, W.; Rose, N.

    1992-01-01

    For about 10 years the Institute for Material Science at the Hanover University has worked on projects of underwater cutting and welding. Increasing tasks to be done in nuclear facilities led to the development of special handling systems to support and handle the cutting tools. Also sensors and computers for extensive and complex tasks were integrated. A small sized freediving handling system, equipped with 2 video cameras, ultrasonic and radiation sensors and a plasma cutting torch for inspection and decommissioning tasks in nuclear facilities is described in this paper. (Author)

  6. Facilities Management Service Delivery in Public and Private High Rise Residential Buildings in Nigeria: A case study of Eko Court Complex and Niger Towers

    Directory of Open Access Journals (Sweden)

    Olanrele O. O.

    2014-01-01

    Full Text Available This study assessed and compared the delivery of Facilities Management (FM services in public and private high rise residential buildings in Lagos, Nigeria. While some facilities or services may not be available in some public estates, the efficiency of the available ones is inadequate in comparison with the adequacy and efficiency of services provided in private estates. The objectives set for the study include identification of services that are provided in the case studies, service delivery method, and an assessment of the residents’ satisfaction of the services. This study adopted questionnaire survey for collection of data. 127 questionnaires were distributed to the residents of the case studies and 93 were returned. Three of which were discarded for incompleteness, thus 90 were analysed. The study found that most but not all of the facilities services expected in high rise buildings are available in the case studies and the services are outsourced under a standard Service Level Agreement. The service delivery in private high rise residential building is better than the public residential high rise buildings as revealed by the study. The study recommends improved standardization of services, customized services and meeting customer’s expectation for improved service delivery.

  7. International VLBI Service for Geodesy and Astrometry 2004 General Meeting Proceedings

    Science.gov (United States)

    Vandenberg, Nancy R. (Editor); Baver, Karen D. (Editor)

    2004-01-01

    This volume is the proceedings of the third General Meeting of the International VLBI Service for Geodesy and Astromctry IVS), held in Otlawa, Canada, February 9-11,2004. The keynote of the third GM was visions for the next decade following the main theme of "Today's Results and Tomorrow's Vision". with a recognition that the outstanding VLBI results available today are the foundation and motivation for the next generation VLBI system requirements. The goal of the meeting was to provide an interesting and informative program for a wide cross section of IVS members, including station operators, program managers, and analysts.

  8. Quality of caesarean delivery services and documentation in first-line referral facilities in Afghanistan: a chart review

    Directory of Open Access Journals (Sweden)

    Kim Young-Mi

    2012-03-01

    Full Text Available Abstract Background Increasing appropriate use and documentation of caesarean section (CS has the potential to decrease maternal and perinatal mortality in settings with low CS rates. We analyzed data collected as part of a comprehensive needs assessment of emergency obstetric and newborn care (EmONC facilities in Afghanistan to gain a greater understanding of the clinical indications, timeliness, and outcomes of CS deliveries. Methods Records were reviewed at 78 government health facilities expected to function as EmONC providers that were located in secure areas of the country. Information was collected on the three most recent CS deliveries in the preceding 12 months at facilities with at least one CS delivery in the preceding three months. After excluding 16 facilities with no recent CS deliveries, the sample includes 173 CS deliveries at 62 facilities. Results No CS deliveries were performed in the previous three months at 21% of facilities surveyed; all of these were lower-level facilities. Most CS deliveries (88% were classified as emergencies, and only 12% were referrals from another facility. General anesthesia was used in 62% of cases, and spinal or epidural anesthesia in 34%. Only 28% of cases were managed with a partograph. Surgery began less than one hour after the decision for a CS delivery in just 30% of emergency cases. Among the 173 cases, 27 maternal deaths, 28 stillbirths, and 3 early neonatal deaths were documented. In cases of maternal and fetal death, the most common indications for CS delivery were placenta praevia or abruption and malpresentation. In 62% of maternal deaths, the fetus was stillborn or died shortly after birth. In 48% of stillbirths, the fetus had a normal heart rate at the last check. Information on partograph use was missing in 38% of cases, information on parity missing in 23% of cases and indications for cesareans missing in 9%. Conclusions Timely referral within and to EmONC facilities would decrease

  9. International VLBI Service for Geodesy and Astrometry: 2000 General Meeting Proceedings

    Science.gov (United States)

    Vandenberg, Nancy R. (Editor); Baver, Karen D. (Editor)

    2000-01-01

    This volume is the proceedings of the first General Meeting of the International Very Long Base Interferometry (VLBI) Service for Geodesy and Astrometry (IVS), held in Koetzting, Germany, February 21-24, 2000. The content of this volume also appears on the IVS web site at: http://ivscc.gsfc.nasa.gov/publications/gm2000. The goal of the program committee for the General Meeting was to provide an interesting and informative program for a wide cross section of IVS members, including station operators, program managers, and analysts. The program included reports, tutorials, invited and contributed papers, and poster presentations. The tutorial papers should be particularly useful references because each one provides an overview and introduction to a topic relevant to VLBI.

  10. Weighted log-linear models for service delivery points in Ethiopia: a case of modern contraceptive users at health facilities.

    Science.gov (United States)

    Workie, Demeke Lakew; Zike, Dereje Tesfaye; Fenta, Haile Mekonnen; Mekonnen, Mulusew Admasu

    2018-05-10

    Ethiopia is among countries with low contraceptive usage prevalence rate and resulted in high total fertility rate and unwanted pregnancy which intern affects the maternal and child health status. This study aimed to investigate the major factors that affect the number of modern contraceptive users at service delivery point in Ethiopia. The Performance Monitoring and Accountability2020/Ethiopia data collected between March and April 2016 at round-4 from 461 eligible service delivery points were in this study. The weighted log-linear negative binomial model applied to analyze the service delivery point's data. Fifty percent of service delivery points in Ethiopia given service for 61 modern contraceptive users with the interquartile range of 0.62. The expected log number of modern contraceptive users at rural was 1.05 (95% Wald CI: - 1.42 to - 0.68) lower than the expected log number of modern contraceptive users at urban. In addition, the expected log count of modern contraceptive users at others facility type was 0.58 lower than the expected log count of modern contraceptive users at the health center. The numbers of nurses/midwives were affecting the number of modern contraceptive users. Since, the incidence rate of modern contraceptive users increased by one due to an additional nurse in the delivery point. Among different factors considered in this study, residence, region, facility type, the number of days per week family planning offered, the number of nurses/midwives and number of medical assistants were to be associated with the number of modern contraceptive users. Thus, the Government of Ethiopia would take immediate steps to address causes of the number of modern contraceptive users in Ethiopia.

  11. 75 FR 65282 - Medicare and Medicaid Programs; Requirements for Long Term Care Facilities; Hospice Services

    Science.gov (United States)

    2010-10-22

    .... Palliative care in an LTC facility involves addressing physical, intellectual, emotional, social, and... Disability, Aging and Long-Term Care Policy and the Urban Institute; ``Synthesis and Analysis of Medicare..., mental, social, or emotional status; clinical complications that suggested a need to alter the care plan...

  12. DOE Coal Gasification Multi-Test Facility: fossil fuel processing technical/professional services

    Energy Technology Data Exchange (ETDEWEB)

    Hefferan, J.K.; Lee, G.Y.; Boesch, L.P.; James, R.B.; Rode, R.R.; Walters, A.B.

    1979-07-13

    A conceptual design, including process descriptions, heat and material balances, process flow diagrams, utility requirements, schedule, capital and operating cost estimate, and alternative design considerations, is presented for the DOE Coal Gasification Multi-Test Facility (GMTF). The GMTF, an engineering scale facility, is to provide a complete plant into which different types of gasifiers and conversion/synthesis equipment can be readily integrated for testing in an operational environment at relatively low cost. The design allows for operation of several gasifiers simultaneously at a total coal throughput of 2500 tons/day; individual gasifiers operate at up to 1200 tons/day and 600 psig using air or oxygen. Ten different test gasifiers can be in place at the facility, but only three can be operated at one time. The GMTF can produce a spectrum of saleable products, including low Btu, synthesis and pipeline gases, hydrogen (for fuel cells or hydrogasification), methanol, gasoline, diesel and fuel oils, organic chemicals, and electrical power (potentially). In 1979 dollars, the base facility requires a $288 million capital investment for common-use units, $193 million for four gasification units and four synthesis units, and $305 million for six years of operation. Critical reviews of detailed vendor designs are appended for a methanol synthesis unit, three entrained flow gasifiers, a fluidized bed gasifier, and a hydrogasifier/slag-bath gasifier.

  13. Requirements analysis of information services for patients on a general practitioner's website--patient and general practitioner's perspectives

    NARCIS (Netherlands)

    Prins, A. H.; Abu-Hanna, A.

    2007-01-01

    OBJECTIVE: To elicit and analyze information needs of patients and primary care physicians (GPs) regarding the information services (static and functional) that a GP's practice website should provide. METHODS: To find candidate information services, we conducted a literature search and examined

  14. [Hardy personality, self-efficacy, and general health in nursing professionals of intensive and emergency services].

    Science.gov (United States)

    Ríos Rísquez, María Isabel; Sánchez Meca, Julio; Godoy Fernández, Carmen

    2010-11-01

    In this study, the predictive power of hardy personality and generalized self-efficacy on general health perception was investigated in a sample of nursing personnel working in emergency and intensive care services. A cross-sectional retrospective design was used, and the following measurement instruments were applied: a sociodemographic and work questionnaire, Goldberg's GHQ-28 Health Questionnaire, the Baessler and Schwarzer General Self-efficacy Questionnaire, and the Hardy Personality Subscale of Moreno's Nursing Burnout Questionnaire (CDPE). The results revealed a positive and statistically significant relationship between the individual variables of generalized self-efficacy and hardy personality. A canonical correlation analysis carried out on the psychological distress symptoms with self-efficacy and hardy personality as predictor variables, led us to emphasize the relevance of the construct total hardy personality as a predictor and, consequently, as a protective factor against the onset of psychological distress symptoms in the sample of professionals studied. Lastly, the implications of the results for clinical practice are discussed.

  15. Preparedness of County Referral Health Facilities in Implementing Adolescent Friendly Health Services: A Case Study of Mama Lucy Kibaki Hosptal

    Science.gov (United States)

    Owuondo, Pacific Akinyi; Mwaura-Tenembergen, Wanja; Adoyo, Maureen; Kiilu, Elizabeth M.

    2015-01-01

    Health service delivery is a key pillar of the health system management .The World Health Organization recently emphasized the need to develop adolescent -friendly health services to improve the care provided to young people throughout the world. However, there is limited peer reviewed literature on this subject therefore necessitating assessment of whether the existing health facilities are prepared to implement the adolescent friendly health services. Adolescent friendly health services remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. After International Conference on Population and Development in 1994, countries started implementing adolescent friendly health services. The Government of Kenya together with partners in an attempt to address the health challenges came up with the Adolescent package of care (APOC) in 2013 whose guidelines were finalized in November 2014 and released for use by service providers . Despite this package of care, there is still ineffective staff capacity in relation to skills and knowledge gap of health professionals, training needs, health resources as well as health system factors that can affect implementation of AFHS. The study explored ways of mitigating or addressing the barriers to implementation of these services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 348 health care providers and 472 adolescents in Mam Lucy Kibaki Hospital from 3rd May 2014 to 16 June 2014 .The key informants were mainly nurses, clinical officers and Medical doctors who were working at the health service delivery area at the time of study and were interviewed using an interview guide. The managers at the hospital were interviewed using an in-depth interview guide while the adolescents were interviewed through interview guide and focused

  16. Preparedness of County Referral Health Facilities in Implementing Adolescent Friendly Health Services: A Case Study of Mama Lucy Kibaki Hospital.

    Science.gov (United States)

    Owuondo, Pacific Akinyi; Mwaura-Tenembergen, Wanja; Adoyo, Maureen; Kiilu, Elizabeth M

    2015-03-25

    Health service delivery is a key pillar of the health system management. The World Health Organization recently emphasized the need to develop adolescent -friendly health services to improve the care provided to young people throughout the world. However, there is limited peer reviewed literature on this subject therefore necessitating assessment of whether the existing health facilities are prepared to implement the adolescent friendly health services. Adolescent friendly health services remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. After International Conference on Population and Development in 1994, countries started implementing adolescent friendly health services. The Government of Kenya together with partners in an attempt to address the health challenges came up with the Adolescent package of care (APOC) in 2013 whose guidelines were finalized in November 2014 and released for use by service providers . Despite this package of care, there is still ineffective staff capacity in relation to skills and knowledge gap of health professionals, training needs, health resources as well as health system factors that can affect implementation of AFHS. The study explored ways of mitigating or addressing the barriers to implementation of these services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 348 health care providers and 472 adolescents in Mam Lucy Kibaki Hospital from 3rd May 2014 to 16 June 2014. The key informants were mainly nurses, clinical officers and Medical doctors who were working at the health service delivery area at the time of study and were interviewed using an interview guide. The managers at the hospital were interviewed using an in-depth interview guide while the adolescents were interviewed through interview guide and focused

  17. Dental care and treatments provided under general anaesthesia in the Helsinki Public Dental Service

    Directory of Open Access Journals (Sweden)

    Savanheimo Nora

    2012-10-01

    Full Text Available Abstract Background Dental general anaesthesia (DGA is a very efficient treatment modality, but is considered only in the last resort because of the risks posed by general anaesthesia to patients’ overall health. Health services and their treatment policies regarding DGA vary from country to country. The aims of this work were to determine the reasons for DGA in the Helsinki Public Dental Service (PDS and to assess the role of patient characteristics in the variation in reasons and in the treatments given with special focus on preventive care. Methods The data covered all DGA patients treated in the PDS in Helsinki in 2010. The data were collected from patient documents and included personal background: age ( Results The DGA patients (n=349 were aged 2.3 to 67.2 years. Immigrants predominated in the youngest age group (p Conclusions Extreme non-cooperation, dental fear and an excessive need for treatment were the main reasons for the use of comprehensive, conservative DGA in the Helsinki PDS. The reasons for the use of DGA and the treatments provided varied according to personal and medical background, and immigration status with no gender-differences. Preventive measures formed only a minor part of the dental care given under DGA.

  18. Communication problems between dementia carers and general practitioners: effect on access to community support services.

    Science.gov (United States)

    Bruce, David G; Paley, Glenys A; Underwood, Peter J; Roberts, David; Steed, Duncan

    2002-08-19

    To investigate the circumstances that led general practitioners to refer dementia sufferers and their carers to community support services. Qualitative study using semi-structured interviews, carried out between 1 September 1999 and 30 April 2000. 21 live-in carers of patients with dementia referred for the first time to a Western Australian metropolitan Aged Care Assessment Team, and 19 of their referring general practitioners. Most referrals occurred after the carers had been experiencing carer stress, and were precipitated by crisis situations. Carers failed to discuss their difficulties with the referring GP for a variety of reasons, including the belief that they should cope because it was their duty. The doctors found it difficult to know how the carers were coping or when to intervene, and some carers tended to resist their attempts to help. Time constraints were a significant problem for both groups. Attitudinal barriers in both carers of patients with dementia and GPs, combined with time constraints, often lead to inadequate assessment of carer problems. While it is important that strategies to improve communication between carers and GPs are developed, it would be sensible for GPs to assume that dementia carers are at risk of carer stress and should be encouraged to use community care services.

  19. Unplanned 30-Day Readmissions in a General Internal Medicine Hospitalist Service at a Comprehensive Cancer Center.

    Science.gov (United States)

    Manzano, Joanna-Grace M; Gadiraju, Sahitya; Hiremath, Adarsh; Lin, Heather Yan; Farroni, Jeff; Halm, Josiah

    2015-09-01

    Hospital readmissions are considered by the Centers for Medicare and Medicaid as a metric for quality of health care delivery. Robust data on the readmission profile of patients with cancer are currently insufficient to determine whether this measure is applicable to cancer hospitals as well. To address this knowledge gap, we estimated the unplanned readmission rate and identified factors influencing unplanned readmissions in a hospitalist service at a comprehensive cancer center. We retrospectively analyzed unplanned 30-day readmission of patients discharged from the General Internal Medicine Hospitalist Service at a comprehensive cancer center between April 1, 2012, and September 30, 2012. Multiple independent variables were studied using univariable and multivariable logistic regression models, with generalized estimating equations to identify risk factors associated with readmissions. We observed a readmission rate of 22.6% in our cohort. The median time to unplanned readmission was 10 days. Unplanned readmission was more likely in patients with metastatic cancer and those with three or more comorbidities. Patients discharged to hospice were less likely to be readmitted (all P values quality measures in cancer hospitals. Copyright © 2015 by American Society of Clinical Oncology.

  20. General practitioners' attitude to sport and exercise medicine services: a questionnaire-based survey.

    Science.gov (United States)

    Kassam, H; Tzortziou Brown, V; O'Halloran, P; Wheeler, P; Fairclough, J; Maffulli, N; Morrissey, D

    2014-12-01

    Sport and exercise medicine (SEM) aims to manage sporting injuries and promote physical activity. This study explores general practitioners' (GPs) awareness, understanding and utilisation of their local SEM services. A questionnaire survey, including patient case scenarios, was administered between February and May 2011. 693 GPs working in Cardiff and Vale, Leicester and Tower Hamlets were invited to participate. 244 GPs responded to the questionnaire (35.2% response rate). Less than half (46%; 112/244) were aware of their nearest SEM service and only 38% (92/244) had a clear understanding on referral indications. The majority (82%; 199/244) felt confident advising less active patients about exercise. There were divergent management opinions about the case scenarios of patients who were SEM referral candidates. Overall, GPs were significantly more likely to refer younger patients and patients with sport-related problems rather than patients who would benefit from increasing their activity levels in order to prevent or manage chronic conditions (pHealth Service which may be resulting in suboptimal utilisation especially for patients who could benefit from increasing their activity levels. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Acceptability of general practice services for Afghan refugees in south-eastern Melbourne.

    Science.gov (United States)

    Manchikanti, Prashanti; Cheng, I-Hao; Advocat, Jenny; Russell, Grant

    2017-04-01

    Over 750000 refugees have resettled in Australia since 1945. Despite complex health needs related to prior traumatic experiences and the challenges of resettlement in a foreign country, refugees experience poor access to primary care. Health and settlement service providers describe numerous cultural, communication, financial and health literacy barriers. This study aimed to investigate the acceptability of general practitioner (GP) services and understand what aspects of acceptability are relevant for Afghan refugees in south-eastern Melbourne. Semi-structured interviews were conducted with two Afghan community leaders and 16 Dari- or English-speaking Afghan refugees who accessed GP services. Two distinct narratives emerged - those of recently arrived refugees and established refugees (living in Australia for 3 years or longer). Transecting these narratives, participants indicated the importance of: (1) a preference for detailed clinical assessments, diagnostic investigations and the provision of prescriptions at the first consultation; (2) 'refugee-friendly' staff; and (3) integrated, 'one-stop-shop' GP clinic features. The value of acceptable personal characteristics evolved over time - GP acceptability was less a consideration for recently arrived, compared with more, established refugees. The findings reinforce the importance of tailoring healthcare delivery to the evolving needs and healthcare expectations of newly arrived and established refugees respectively.

  2. Differences in medical services in Nordic general practice: a comparative survey from the QUALICOPC study.

    Science.gov (United States)

    Eide, Torunn Bjerve; Straand, Jørund; Björkelund, Cecilia; Kosunen, Elise; Thorgeirsson, Ofeigur; Vedsted, Peter; Rosvold, Elin Olaug

    2017-06-01

    We aim to describe medical services provided by Nordic general practitioners (GPs), and to explore possible differences between the countries. We did a comparative analysis of selected data from the Nordic part of the study Quality and Costs of Primary Care in Europe (QUALICOPC). A total of 875 Nordic GPs (198 Norwegian, 80 Icelandic, 97 Swedish, 212 Danish and 288 Finnish) answered identical questionnaires regarding their practices. The GPs indicated which equipment they used in practice, which procedures that were carried out, and to what extent they were involved in treatment/follow-up of a selection of diagnoses. The Danish GPs performed minor surgical procedures significantly less frequent than GPs in all other countries, although they inserted IUDs significantly more often than GPs in Iceland, Sweden and Finland. Finnish GPs performed a majority of the medical procedures more frequently than GPs in the other countries. The GPs in Iceland reported involvement in a more narrow selection of conditions than the GPs in the other countries. The Finnish GPs had more advanced technical equipment than GPs in all other Nordic countries. GPs in all Nordic countries are well equipped and offer a wide range of medical services, yet with a substantial variation between countries. There was no clear pattern of GPs in one country doing consistently more procedures, having consistently more equipment and treating a larger diversity of medical conditions than GPs in the other countries. However, structural factors seemed to affect the services offered.

  3. GIS-based evaluation of public facility provision to achieve improved governance and equitable service delivery

    CSIR Research Space (South Africa)

    Green, Cheri A

    2009-04-01

    Full Text Available .0 – smart, sustainable, integrative. Strategies, concepts and technologies for planning the urban future The South African constitution requires that every citizen be granted access to basic services. It is therefore a legal requirement that all... eradication 8 REAL CORP 2009: Cities 3.0 – smart, sustainable, integrative. Strategies, concepts and technologies for planning the urban future 6 EVALUATION OF THE SERVICE ACCESS PLANNING APPLICATION 6.1 Usefulness of the results...

  4. Measuring factors that influence the utilisation of preventive care services provided by general practitioners in Australia

    Directory of Open Access Journals (Sweden)

    Oldenburg Brian

    2009-12-01

    Full Text Available Abstract Background Relatively little research attention has been given to the development of standardised and psychometrically sound scales for measuring influences relevant to the utilisation of health services. This study aims to describe the development, validation and internal reliability of some existing and new scales to measure factors that are likely to influence utilisation of preventive care services provided by general practitioners in Australia. Methods Relevant domains of influence were first identified from a literature review and formative research. Items were then generated by using and adapting previously developed scales and published findings from these. The new items and scales were pre-tested and qualitative feedback was obtained from a convenience sample of citizens from the community and a panel of experts. Principal Components Analyses (PCA and internal reliability testing (Cronbach's alpha were then conducted for all of the newly adapted or developed scales utilising data collected from a self-administered mailed survey sent to a randomly selected population-based sample of 381 individuals (response rate 65.6 per cent. Results The PCA identified five scales with acceptable levels of internal consistency were: (1 social support (ten items, alpha 0.86; (2 perceived interpersonal care (five items, alpha 0.87, (3 concerns about availability of health care and accessibility to health care (eight items, alpha 0.80, (4 value of good health (five items, alpha 0.79, and (5 attitudes towards health care (three items, alpha 0.75. Conclusion The five scales are suitable for further development and more widespread use in research aimed at understanding the determinants of preventive health services utilisation among adults in the general population.

  5. Creation of an emergency surgery service concentrates resident training in general surgical procedures.

    Science.gov (United States)

    Ahmed, Hesham M; Gale, Stephen C; Tinti, Meredith S; Shiroff, Adam M; Macias, Aitor C; Rhodes, Stancie C; Defreese, Marissa A; Gracias, Vicente H

    2012-09-01

    Emergency general surgery (EGS) is increasingly being provided by academic trauma surgeons in an acute care surgery model. Our tertiary care hospital recently changed from a model where all staff surgeons (private, subspecialty academic, and trauma academic) were assigned EGS call to one in which an emergency surgery service (ESS), staffed by academic trauma faculty, cares for all EGS patients. In the previous model, many surgeries were "not covered" by residents because of work-hour restrictions, conflicting needs, or private surgeon preference. The ESS was separate from the trauma service. We hypothesize that by creating a separate ESS, residents can accumulate needed and concentrated operative experience in a well-supervised academic environment. A prospectively accrued EGS database was retrospectively queried for the 18-month period: July 2010 to June 2011. The Accreditation Council for Graduate Medical Education (ACGME) databases were queried for operative numbers for our residency program and for national resident data for 2 years before and after creating the ESS. The ACGME operative requirements were tabulated from online sources. ACGME requirements were compared with surgical cases performed. During the 18-month period, 816 ESS operations were performed. Of these, 307 (38%) were laparoscopy. Laparoscopic cholecystectomy and appendectomy were most common (138 and 145, respectively) plus 24 additional laparoscopic surgeries. Each resident performed, on average, 34 basic laparoscopic cases during their 2-month rotation, which is 56% of their ACGME basic laparoscopic requirement. A diverse mixture of 70 other general surgical operations was recorded for the remaining 509 surgical cases, including reoperative surgery, complex laparoscopy, multispecialty procedures, and seldom-performed operations such as surgery for perforated ulcer disease. Before the ESS, the classes of 2008 and 2009 reported that only 48% and 50% of cases were performed at the main academic

  6. Compilation of the FY 1997 Navy General Fund Financial Statements at the Defense Finance and Accounting Service Cleveland Center

    National Research Council Canada - National Science Library

    1998-01-01

    Audit Report on tile Compilation of the FY 1997 Navy General Fund Financial Statements at the Defense Finance and Accounting Service Cleveland Center Our objective was to determine whether the DFAS...

  7. Min-max optimization and the radial approach to the public service system design with generalized utility

    Directory of Open Access Journals (Sweden)

    Jaroslav Janáček

    2016-04-01

    Full Text Available The paper deals with the min-max public service system design, where the generalized utility is considered. In contrast to the formulations presented in the literature, the generalized utility defined for a public service system assumes that the user’s utility comes generally from more than one located service center and the individual contributions from relevant centers are weighted by reduction coefficients depending on a center order. Given that commercial IP-solvers often fail due to enormous computational times or extreme memory demands when resolving this issue, we suggested and compared several approaches based on a bisection process with the purpose of developing an effective max-min approach to the public service system design with a generalized utility.

  8. Factors Affecting Quality of Laboratory Services in Public and Private Health Facilities in Addis Ababa, Ethiopia.

    Science.gov (United States)

    Mesfin, Eyob Abera; Taye, Binyam; Belay, Getachew; Ashenafi, Aytenew; Girma, Veronica

    2017-10-01

    Quality laboratory service is an essential component of health care system but in Sub-Saharan Africa such as Ethiopia, laboratories quality system remains weak due to several factors and it needs more attention to strengthen its capacity and quality system. A cross sectional study was conducted using a questionnaire to assess factors affecting the quality of laboratory service at private and public health institutions in Addis Ababa. A total of 213 laboratory professionals participated in the study and 131 (61.5%) participants had bachelor degree. Majority, 133 (62.4%), of the professionals did not attend any work related training. Seventy five (35.2%) respondents believed that their laboratories did not provide quality laboratory services and the major reported factors affecting provision of quality services were shortage of resources (64.3%), poor management support (57.3%), poor equipment quality (53.4%), high workload (41.1%), lack of equipment calibration (38.3%) and lack of knowledge (23.3%). Moreover logistic regression analysis showed that provision of quality laboratory service was significantly associated with result verification (AOR=9.21, 95% CI=2.26, 37.48), internal quality control (AOR= 6.11, 95% CI=2.11, 17.70), turnaround time (AOR=5.11, 95% CI=1.94, 13.46), shortage of equipment (AOR=7.76, 95% CI=2.55, 23.66), communication with clinicians (AOR=3.24, 95% CI=1.25, 8.41) and lack of job description (AOR=3.67, 95% CI=1.319, 10.22). In conclusion, the major factors that affecting the quality of laboratory service were associated with poor human resource management, poor resources provision, poor management commitment, ineffective communication system and lack of well-established quality management system.

  9. Utilisation of health services and the poor: deconstructing wealth-based differences in facility-based delivery in the Philippines.

    Science.gov (United States)

    Hodge, Andrew; Firth, Sonja; Bermejo, Raoul; Zeck, Willibald; Jimenez-Soto, Eliana

    2016-07-06

    Despite achieving some success, wealth-related disparities in the utilisation of maternal and child health services persist in the Philippines. The aim of this study is to decompose the principal factors driving the wealth-based utilisation gap. Using national representative data from the 2013 Philippines Demographic and Health Survey, we examine the extent overall differences in the utilisation of maternal health services can be explained by observable factors. We apply nonlinear Blinder-Oaxaca-type decomposition methods to quantify the effect of differences in measurable characteristics on the wealth-based coverage gap in facility-based delivery. The mean coverage of facility-based deliveries was respectively 41.1 % and 74.6 % for poor and non-poor households. Between 67 and 69 % of the wealth-based coverage gap was explained by differences in observed characteristics. After controlling for factors characterising the socioeconomic status of the household (i.e. the mothers' and her partners' education and occupation), the birth order of the child was the major factor contributing to the disparity. Mothers' religion and the subjective distance to the health facility were also noteworthy. This study has found moderate wealth-based disparities in the utilisation of institutional delivery in the Philippines. The results confirm the importance of recent efforts made by the Philippine government to implement equitable, pro-poor focused health programs in the most deprived geographic areas of the country. The importance of addressing the social determinants of health, particularly education, as well as developing and implementing effective strategies to encourage institutional delivery for higher order births, should be prioritised.

  10. 24 CFR 100.65 - Discrimination in terms, conditions and privileges and in services and facilities.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Discrimination in terms, conditions... Discriminatory Housing Practices § 100.65 Discrimination in terms, conditions and privileges and in services and... rental of a dwelling, because a person failed or refused to provide sexual favors. ...

  11. LISTENing to healthcare students: the impact of new library facilities on the quality of services.

    Science.gov (United States)

    Haldane, Graham C

    2003-06-01

    Following a low assessment of 'Learning resources' provision by the Quality Assurance Agency, the librarian of Homerton College, School of Health Studies commenced the LISTEN Project, a long-term study to monitor the effects of planned interventions on the quality of library provision. Surveys of entry-to-register student nurses & midwives were conducted in 1999 and 2001 by extensive questionnaires, inviting Likert-scaled and free text responses. Following a college relocation, students made greater than expected use of a new health studies library in Cambridge, and significantly less use of the local teaching hospital library. Using both a satisfaction index and a non-parametric test of mean scores, student evaluation of library services in Cambridge significantly improved following relocation. The physical accommodation and location of library services remain important to healthcare students. Identifiable improvements to the quality of services, however, will overcome initial resistance to change. Education providers must ensure the best mix of physical and electronic services for students who spend much of their time on clinical placement.

  12. End-of-Life Care and Discussions in Japanese Geriatric Health Service Facilities: A Nationwide Survey of Managing Directors' Viewpoints.

    Science.gov (United States)

    Kanoh, Asako; Kizawa, Yoshiyuki; Tsuneto, Satoru; Yokoya, Shoji

    2018-01-01

    Geriatric health service facilities (GHSFs) play important roles as intermediate care facilities for elderly individuals temporarily when they need rehabilitation before returning home. However, the number of residents spending their end-of-life (EOL) period in such facilities is increasing. To improve the quality of EOL care, end-of-life discussions (EOLDs) are recommended by some guidelines and studies. This study aimed to clarify the current practice of EOL care and EOLDs in GHSFs in Japan. We conducted a nationwide cross-sectional survey by mailing questionnaires about EOL care and EOLDs to 3437 GHSF managing directors. The questionnaire was developed through a literature review and discussion among the researchers and experts. Descriptive statistics summarized the data. We also analyzed the factors related to GHSFs conducting EOLDs using Fisher exact tests. The response rate was 20.7% (713 of 3437). Among the respondents, 75.2% (536 of 713) of GHSFs provided EOL care and 73.1% (521 of 713) conducted EOLDs. The most common reasons for difficulties in providing EOL care included the lack of EOL education for nurses and care workers, and their fear about caring for dying residents. End-of-life discussions were mostly initiated after the deterioration of a resident's condition and were conducted with families by physicians. Statistically significant factors of GHSFs conducting EOLDs included providing EOL education for nurses and care workers, availability of private room for critically ill residents, emergency on-call doctors, and EOL care. Adequate practical staff education programs for EOL care including EOLDs may be crucial for quality of end-of-life care in aged care facilities.

  13. The impact of market and organizational characteristics on nursing care facility service innovation: a resource dependency perspective.

    Science.gov (United States)

    Banaszak-Holl, J; Zinn, J S; Mor, V

    1996-04-01

    Using resource dependency theory as a conceptual framework, this study investigates both the organizational and environmental factors associated with an emerging health care service delivery innovation, the provision of specialty care in designated units in nursing care facilities. We consider two types of specialty units, Alzheimer's Disease and subacute care. The Medicare/Medicaid Automated Certification Survey (MMACS) data file was merged with local market area data obtained from the 1992 Area Resource File and with state level regulatory data. The likelihood of providing Alzheimer's Disease or subacute care in dedicated units was estimated by separate logistic regressions. Results indicate that facilities with fewer Medicare patients are more likely to operate a dedicated Alzheimer's care unit, while facilities located in markets with a large HMO population and greater hospital supply are more likely to operate a subacute care unit. While competition among nursing homes, for the most part, is an incentive to innovate, greater regulatory stringency appears to constrain the development of specialty care units of both types. Finally, organizational characteristics (e.g., size and proprietary status) appear to be important enabling factors influencing the propensity to provide specialty care in dedicated units. Nursing care facilities are moving toward providing specialty care units partly as a response to a growing demand by resource providers and to maintain a competitive edge in tighter markets. Loosening regulation directed at cost containment would further encourage the development of specialty care but should be preceded by some evaluation of population needs for specialty care and the effectiveness of specialty care units.

  14. Non-western immigrants' satisfaction with the general practitioners' services in Oslo, Norway.

    Science.gov (United States)

    Lien, Else; Nafstad, Per; Rosvold, Elin O

    2008-02-27

    Over the last few years the number of immigrants from the non-western parts of the world living in Oslo, has increased considerably. We need to know if these immigrants are satisfied with the health services they are offered. The aim of this study was to assess whether the immigrants' level of satisfaction with visits to general practitioners was comparable with that for ethnic Norwegians. Two population-based surveys, the Oslo Health Study and the Oslo Immigrant Health Study, were performed on selected groups of Oslo citizens in 2000 and 2002. The response rates were 46% and 33%, respectively. In all, 11936 Norwegians and 1102 non-western immigrants from the Oslo Health Study, and 1774 people from the Oslo Immigrant Health Study, were included in this analysis. Non-western immigrants' and ethnic Norwegians' level of satisfaction with visits to general practitioners were analysed with respect to age, gender, health, working status, and use of translators. Bivariate (Chi square) and multivariate analyses (logistic regression) were performed. Most participants were either moderately or very satisfied with their last visit to a general practitioner. Non-western immigrants were less satisfied than Norwegians. Dissatisfaction among the immigrants was associated with young age, a feeling of not having good health, and coming from Turkey, Iran, Pakistan, or Vietnam as compared to Sri Lanka. The attendance rates in the surveys were rather low and lowest among the non-western immigrants. Although the degree of satisfaction with the primary health care was relatively high among the participants in these surveys, the non-western immigrants in this study were less satisfied than ethnic Norwegians with their last visit to a general practitioner. The rather low response rates opens for the possibility that the degree of satisfaction may not be representative for all immigrants.

  15. Proceedings of the Sixth General Meeting of the International VLBI Service for Geodesy and Astrometry

    Science.gov (United States)

    Behrend, Dirk (Editor); Baver, Karen D. (Editor)

    2010-01-01

    This volume is the proceedings of the sixth General Meeting of the International VLBI Service for Geodesy and Astrometry (IVS), held in Hobart, Tasmania, Australia, February 7-13, 2010. The contents of this volume also appear on the IVS Web site at http://ivscc.gsfc.nasa.gov/publications/gm2010. The keynote of the sixth GM was the new perspectives of the next generation VLBI system under the theme "VLBI2010: From Vision to Reality". The goal of the meeting was to provide an interesting and informative program for a wide cross-section of IVS members, including station operators, program managers, and analysts. This volume contains 88 papers. All papers were edited by the editors for usage of the English language, form, and minor content-related issues.

  16. The twinning of Scottish general practices and Malawian clinics: the provision of email and internet services

    Directory of Open Access Journals (Sweden)

    Ron Neville

    2007-01-01

    Full Text Available Many patients and health care professionals in the developed world are uncomfortable about doing nothing in the face of the glaring inequities in health care between their own environment and that of Africa. In an effort to 'think global, act local' a Scottish GP practice used personal contacts to build a twinning link with a clinic serving a township in Malawi. This article describes the experience of establishing e-mail and internet services for Malawian health care staff to afford them the same level of access as developed world staff enjoy in accessing educational materials and professional supports. Using our twin link as an exemplar we are now matching other Scottish General Practices to Malawian Clinics around a common theme of modern communication media.

  17. Process control through the incorporation of PLC networks in service radiation facilities

    International Nuclear Information System (INIS)

    Moehlmann, J.H.F.

    1990-01-01

    In order to ensure the smooth and safe running and operation of an irradiation facility, several regulations must be complied with, most of which are prescribed by the authorities. However, internal working regulations, based on years of practical experience, are of equal importance. The application of computers, micro-processors and PLCs, in combination with semi-conductor electronics, has improved process control considerably. Not only can every step in the process and even each detailed function be controlled, but also the combination of the different functions. By using PLC-systems in combination with computers, important data can be stored, recorded and presented in such a way that the technical staff can be warned in advance of breakdowns or undesirable deviations in the process parameters. Keeping a log of these data will help guarantee the correct functioning of the irradiation facility. It is even possible with these modern PLC techniques to monitor the control-console, so that each operation is recorded and accessible. (author)

  18. Dental care and treatments provided under general anaesthesia in the Helsinki Public Dental Service

    Science.gov (United States)

    2012-01-01

    Background Dental general anaesthesia (DGA) is a very efficient treatment modality, but is considered only in the last resort because of the risks posed by general anaesthesia to patients’ overall health. Health services and their treatment policies regarding DGA vary from country to country. The aims of this work were to determine the reasons for DGA in the Helsinki Public Dental Service (PDS) and to assess the role of patient characteristics in the variation in reasons and in the treatments given with special focus on preventive care. Methods The data covered all DGA patients treated in the PDS in Helsinki in 2010. The data were collected from patient documents and included personal background: age (periodontics, surgical procedures and miscellaneous. The reasons for DGA and the treatments provided varied according to age, immigration, previous sedation and DGA and medical background. The logistic regression model showed that previous sedation (OR 2.3; 95%CI 1.3-4.1; p=0.005) and extreme non-cooperation (OR 1.7; 95%CI 0.9-3.2; p=0.103) were most indicative of preventive measures given. Conclusions Extreme non-cooperation, dental fear and an excessive need for treatment were the main reasons for the use of comprehensive, conservative DGA in the Helsinki PDS. The reasons for the use of DGA and the treatments provided varied according to personal and medical background, and immigration status with no gender-differences. Preventive measures formed only a minor part of the dental care given under DGA. PMID:23102205

  19. Social phobia in Finnish general adolescent population: prevalence, comorbidity, individual and family correlates, and service use.

    Science.gov (United States)

    Ranta, Klaus; Kaltiala-Heino, Riittakerttu; Rantanen, Päivi; Marttunen, Mauri

    2009-01-01

    Few studies have investigated the epidemiology of social phobia (SP) among early to middle adolescents, at the time of suggested mean onset of the disorder. The objective of this study was to investigate the prevalence, comorbidity, individual and familial correlates, and service use associated with SP among Finnish 12-17-year-old adolescents in general population. A sample of 784 adolescents was screened with the Social Phobia Inventory, and a sub-sample (n=350) was interviewed with a semi-structured clinical interview to identify SP, sub-clinical SP (SSP), and a range of other axis I DSM-IV disorders. Individual and familial correlates, and service use associated with SP were also inquired. We found a 12-month prevalence of 3.2% for SP, and 4.6% for SSP. The prevalence rose and the gender ratio shifted to female preponderance as age increased. SP was frequently comorbid with other anxiety disorders (41%) and depressive disorders (41%). Adolescents with SP/SSP were impaired in their academic and global functioning, and reported more parental psychiatric treatment contacts. Two thirds (68%) of adolescents with SP reported having been bullied by peers. Only one fifth of adolescents with non-comorbid SP had been in contact with a mental health professional. We conclude that adolescent SP is a relatively frequent, undertreated and highly comorbid condition, associated with educational impairment, depression and anxiety in parents, and peer victimization. (c) 2009 Wiley-Liss, Inc.

  20. Development of restaurant serviceology based on the methodology of general theory of service

    OpenAIRE

    Glushchenko V.; Glushchenko I.; Katz S.; Olshevskaya K.; Pryazhnikova A.; Stashkova E.

    2018-01-01

    The positions of restaurant service (service in restaurant business — restaurantology) are formed as a scientific basis for designing a business and assessing the quality of services in restaurant business, developing the service sector in restaurant business, exploring and forming theoretical bases for the development of economy and management in the restaurant business in the globalization of the market for such a kind of services, development of service and information technologies and com...

  1. Collaboration, facilities and communities in day care services for older people.

    Science.gov (United States)

    Adams, John

    2001-05-01

    Similarities and differences between day hospitals, run by the NHS, and day centres, run by local authorities or charitable organisations, have been widely discussed in the literature of gerontology for many years. The authors of this paper have undertaken a single blind, randomised-controlled trial to compare rehabilitation outcomes in the two settings, which was published in 1999. This research project involved augmenting the staff of day centres by visiting therapists. In addition to quantitative findings, their project also generated much qualitative data from interviews with health service and social service staff which provides the thought-provoking content. The themes identified included the reluctance of some patients to accept referral to a day centre, and the difficulties associated with discharging patients. Positive aspects included the opportunity to share skills, knowledge and resources. 29 references.

  2. The morphological /settlement pattern classification of South African settlements based on a settlement catchment approach, to inform facility allocation and service delivery

    CSIR Research Space (South Africa)

    Sogoni, Z

    2016-07-01

    Full Text Available / settlement pattern classification of South African settlements based on a settlement catchment approach, to inform facility allocation and service delivery Zukisa Sogoni Planning Africa Conference 2016 4 July 2Project Focus and Background • CSIR... services. • Purpose is to support application & planning for new investment & prevent “unsustainable” investments / White elephants. 3Outputs • National set of service delivery catchments • Profile information per individual catchment • Ranking...

  3. Inspector General, DOD, Oversight of the Naval Audit Service Audit of the Navy General Fund Financial Statements for FY 1998

    National Research Council Canada - National Science Library

    1999-01-01

    Introduction. An audit of the Navy General Fund Financial Statements is requited by Public Law 101-576, the "Chief Financial Officers Act of 1990," November 15, 1990, as amended by Public Law 103-356, the "Federal...

  4. 41 CFR 102-71.5 - What is the scope and philosophy of the General Services Administration's (GSA) real property...

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What is the scope and philosophy of the General Services Administration's (GSA) real property policies? 102-71.5 Section 102-71.5...) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 71-GENERAL § 102-71.5 What is the scope and philosophy of the...

  5. A blueprint-based case study analysis of nutrition services provided in a midterm care facility for the elderly.

    Science.gov (United States)

    Paquet, Catherine; St-Arnaud-Mckenzie, Danielle; Ferland, Guylaine; Dubé, Laurette

    2003-03-01

    Ensuring nutritionally adequate food intake in institutions is a complex and important challenge for dietitians. To tackle this problem, we argue that dietitians need to adopt a systematic, integrative, and patient-centered approach to identify and manage more effectively organizational determinants of the quality of food intake under their control. In this study, we introduce such an approach, the blueprint-based case study, that we applied in the context of a midterm care facility for elderly patients. Data gathered through interviews and field observations were used to develop, from the perspective of key patient encounters, detailed representations of the food, nutrition, and nursing activities necessary to ensure adequate food intake. These service "blueprints" were developed to illustrate all activities that might potentially impact on the nutritional, sensory, functional, and social quality of patients' meals. They were also used as roadmaps to develop a case study analysis in which critical areas were identified and opportunities for improvement put forth, while considering services' resources and priorities. By providing a precise, objective, yet comprehensive mapping of the service operations and management, the blueprint-based case study approach represents a valuable tool to determine the optimal allocation of resources to insure nutritionally adequate food intake to patients.

  6. Delivery Practices and Associated Factors among Mothers Seeking Child Welfare Services in Selected Health Facilities in Nyandarua South District, Kenya

    Directory of Open Access Journals (Sweden)

    Wanjira Carol

    2011-05-01

    Full Text Available Abstract Background A measure of the proportion of deliveries assisted by skilled attendants is one of the indicators of progress towards achieving Millennium Development Goal (MDG 5, which aims at improving maternal health. This study aimed at establishing delivery practices and associated factors among mothers seeking child welfare services at selected health facilities in Nyandarua South district, Kenya to determine whether mothers were receiving appropriate delivery care. Methods A hospital-based cross-sectional survey among women who had recently delivered while in the study area was carried out between August and October 2009. Binary Logistic regression was used to identify factors that predicted mothers' delivery practice. Results Among the 409 mothers who participated in the study, 1170 deliveries were reported. Of all the deliveries reported, 51.8% were attended by unskilled birth attendants. Among the deliveries attended by unskilled birth attendants, 38.6% (452/1170 were by neighbors and/or relatives. Traditional Birth Attendants attended 1.5% (17/1170 of the deliveries while in 11.7% (137/1170 of the deliveries were self administered. Mothers who had unskilled birth attendance were more likely to have Conclusion Among the mothers interviewed, utilization of skilled delivery attendance services was still low with a high number of deliveries being attended by unqualified lay persons. There is need to implement cost effective and sustainable measures to improve the quality of maternal health services with an aim of promoting safe delivery and hence reducing maternal mortality.

  7. Berkeley Low Background Facility

    International Nuclear Information System (INIS)

    Thomas, K. J.; Norman, E. B.; Smith, A. R.; Poon, A. W. P.; Chan, Y. D.; Lesko, K. T.

    2015-01-01

    The Berkeley Low Background Facility (BLBF) at Lawrence Berkeley National Laboratory (LBNL) in Berkeley, California provides low background gamma spectroscopy services to a wide array of experiments and projects. The analysis of samples takes place within two unique facilities; locally within a carefully-constructed, low background laboratory on the surface at LBNL and at the Sanford Underground Research Facility (SURF) in Lead, SD. These facilities provide a variety of gamma spectroscopy services to low background experiments primarily in the form of passive material screening for primordial radioisotopes (U, Th, K) or common cosmogenic/anthropogenic products; active screening via neutron activation analysis for U,Th, and K as well as a variety of stable isotopes; and neutron flux/beam characterization measurements through the use of monitors. A general overview of the facilities, services, and sensitivities will be presented. Recent activities and upgrades will also be described including an overview of the recently installed counting system at SURF (recently relocated from Oroville, CA in 2014), the installation of a second underground counting station at SURF in 2015, and future plans. The BLBF is open to any users for counting services or collaboration on a wide variety of experiments and projects

  8. General practitioners' satisfaction with and attitudes to out-of-hours services

    Directory of Open Access Journals (Sweden)

    Wesseling Geertjan

    2005-03-01

    Full Text Available Abstract Background In recent years, Dutch general practitioner (GP out-of-hours service has been reorganised into large-scale GP cooperatives. Until now little is known about GPs' experiences with working at these cooperatives for out-of-hours care. The purpose of this study is to gain insight into GPs' satisfaction with working at GP cooperatives for out-of-hours care in separated and integrated cooperatives. Methods A GP cooperative separate from the hospital Accident and Emergency (A&E department, and a GP cooperative integrated within the A&E department of another hospital. Both cooperatives are situated in adjacent geographic regions in the South of the Netherlands. One hundred GPs were interviewed by telephone; fifty GPs working at the separated GP cooperative and fifty GPs from the integrated GP cooperative. Opinions on different aspects of GP cooperatives for out-of-hours care were measured, and regression analysis was performed to investigate if these could be related to GP satisfaction with out-of-hours care organisation. Results GPs from the separated model were more satisfied with the organisation of out-of-hours care than GPs from the integrated model (70 vs. 60 on a scale score from 0 to 100; P = 0.020. Satisfaction about out-of-hours care organisation was related to opinions on workload, guarantee of gatekeeper function, and attitude towards out-of-hours care as being an essential part of general practice. Cooperation with medical specialists was much more appreciated at the integrated model (77 vs. 48; P Conclusion GPs in this study appear to be generally satisfied with the organisation of GP cooperatives for out-of-hours care. Furthermore, GPs working at the separated cooperative seem to be more satisfied compared to GPs working at the integrated cooperative.

  9. Clients’ satisfaction with quality of childbirth services: A comparative study between public and private facilities in Limuru Sub-County, Kiambu, Kenya

    Science.gov (United States)

    2018-01-01

    Background This study intended to compare the clients’ satisfaction with the quality of childbirth services in a private and public facility amongst mothers who have delivered within the last twenty four to seventy hours. Methods This was a cross-sectional comparative research design with both quantitative and qualitative data collection and analysis methods. Data were collected through a focused group discussion guide and structured questionnaire collecting information on clients’ satisfaction with quality of childbirth services. The study was conducted amongst women of reproductive age (WRA) between 15–49 years in Tigoni District hospital (public hospital) and Limuru Nursing home (private hospital). For quantitative data we conducted descriptive analysis and Mann-Whitney test using SPSS version 20.0 while qualitative data was manually analyzed manually using thematic analysis. Results A higher proportion of clients from private facility 98.1% were attended within 0–30 minutes of arrival to the facility as compared to 87% from public facility. The overall mean score showed that the respondents in public facility gave to satisfaction with the services was 4.46 out of a maximum of 5.00 score while private facility gave 4.60. The level of satisfaction amongst respondents in the public facility on pain relief after delivery was statistically significantly higher than the respondents in private facilities (U = 8132.50, psatisfaction amongst respondents in the public facility on functional equipment was statistically significantly higher than the respondents in private facilities (U = 9206.50, p = 0.001). Moreover, level of satisfaction with the way staff responded to questions and concerns during labour and delivery was statistically significantly higher than the respondents in private facilities (U = 9964.50, p = 0.022). Conclusion In overall, majority of clients from both public and private facilities expressed satisfaction with quality of services from

  10. Clients' satisfaction with quality of childbirth services: A comparative study between public and private facilities in Limuru Sub-County, Kiambu, Kenya.

    Directory of Open Access Journals (Sweden)

    Clarice Okumu

    Full Text Available This study intended to compare the clients' satisfaction with the quality of childbirth services in a private and public facility amongst mothers who have delivered within the last twenty four to seventy hours.This was a cross-sectional comparative research design with both quantitative and qualitative data collection and analysis methods. Data were collected through a focused group discussion guide and structured questionnaire collecting information on clients' satisfaction with quality of childbirth services. The study was conducted amongst women of reproductive age (WRA between 15-49 years in Tigoni District hospital (public hospital and Limuru Nursing home (private hospital. For quantitative data we conducted descriptive analysis and Mann-Whitney test using SPSS version 20.0 while qualitative data was manually analyzed manually using thematic analysis.A higher proportion of clients from private facility 98.1% were attended within 0-30 minutes of arrival to the facility as compared to 87% from public facility. The overall mean score showed that the respondents in public facility gave to satisfaction with the services was 4.46 out of a maximum of 5.00 score while private facility gave 4.60. The level of satisfaction amongst respondents in the public facility on pain relief after delivery was statistically significantly higher than the respondents in private facilities (U = 8132.50, p<0.001 while the level of satisfaction amongst respondents in the public facility on functional equipment was statistically significantly higher than the respondents in private facilities (U = 9206.50, p = 0.001. Moreover, level of satisfaction with the way staff responded to questions and concerns during labour and delivery was statistically significantly higher than the respondents in private facilities (U = 9964.50, p = 0.022.In overall, majority of clients from both public and private facilities expressed satisfaction with quality of services from admission

  11. The Willingness-to-Pay for General Practitioners in Contractual Service and Influencing Factors among Empty Nesters in Chongqing, China

    Directory of Open Access Journals (Sweden)

    Fei Chen

    2015-08-01

    Full Text Available Background: In 2012, a pilot health policy of contractual service relations between general practitioners and patients was implemented in China. Due to the decline in body and cognitive function, as well as the lack of family care and narrow social support networks, the demand of health services among the elderly is much higher than that among the general population. This study aims to probe into the empty nesters’ willingness-to-pay for general practitioners using a contractual service policy, investigating empty nesters’ payment levels for the service, and analyze the main factors affecting the willingness of empty-nesters’ general practitioners using contractual service supply cost. Methods: This cross-sectional study adopted a multistage stratified sampling method to survey 865, city empty nesters (six communities in three districts of one city aged 60–85 years. A condition value method was used to infer the distribution of the willingness-to-pay; Cox’s proportional hazards regression model was used to analyze the influencing factors of willingness-to-pay. Results: More than seventy percent (76.6% of the empty nesters in this city were willing to pay general practitioners using contract service in Chongqing. The level of willingness-to-pay for the surveyed empty nesters was 34.1 yuan per year. The median value was 22.1 yuan per year, which was below the Chongqing urban and rural cooperative medical insurance individual funding level (60 yuan per year in 2013. Cox’s proportional hazards regression model analysis showed that the higher the education level was, the worse the self-reported health status would be, accompanied by higher family per capita income, higher satisfaction of community health service, and higher willingness-to-pay empty nesters using a contract service. Women had a higher willingness-to-pay than men. Conclusions: The willingness-to-pay for general practitioners by contractual service is high among city empty

  12. The Willingness-to-Pay for General Practitioners in Contractual Service and Influencing Factors among Empty Nesters in Chongqing, China.

    Science.gov (United States)

    Chen, Fei; Xu, Xiang-Long; Yang, Zhan; Tan, Hua-Wei; Zhang, Liang

    2015-08-10

    In 2012, a pilot health policy of contractual service relations between general practitioners and patients was implemented in China. Due to the decline in body and cognitive function, as well as the lack of family care and narrow social support networks, the demand of health services among the elderly is much higher than that among the general population. This study aims to probe into the empty nesters' willingness-to-pay for general practitioners using a contractual service policy, investigating empty nesters' payment levels for the service, and analyze the main factors affecting the willingness of empty-nesters' general practitioners using contractual service supply cost. This cross-sectional study adopted a multistage stratified sampling method to survey 865, city empty nesters (six communities in three districts of one city) aged 60-85 years. A condition value method was used to infer the distribution of the willingness-to-pay; Cox's proportional hazards regression model was used to analyze the influencing factors of willingness-to-pay. More than seventy percent (76.6%) of the empty nesters in this city were willing to pay general practitioners using contract service in Chongqing. The level of willingness-to-pay for the surveyed empty nesters was 34.1 yuan per year. The median value was 22.1 yuan per year, which was below the Chongqing urban and rural cooperative medical insurance individual funding level (60 yuan per year) in 2013. Cox's proportional hazards regression model analysis showed that the higher the education level was, the worse the self-reported health status would be, accompanied by higher family per capita income, higher satisfaction of community health service, and higher willingness-to-pay empty nesters using a contract service. Women had a higher willingness-to-pay than men. The willingness-to-pay for general practitioners by contractual service is high among city empty nesters in Chongqing, thus, individual financing is feasible. However

  13. Differences in the structure of outpatient diabetes care between endocrinologist-led and general physician-led services.

    LENUS (Irish Health Repository)

    O Donnell, Máire

    2013-11-25

    Despite a shift in diabetes care internationally from secondary to primary care, diabetes care in the Republic of Ireland remains very hospital-based. Significant variation in the facilities and resources available to hospitals providing outpatient diabetes care have been reported in the UK. The aim of this study was to ascertain the structure of outpatient diabetes care in public hospitals in the Republic of Ireland and whether differences existed in services provided across hospitals.

  14. Do service innovations influence the adoption of electronic health records in long-term care organizations? Results from the U.S. National Survey of Residential Care Facilities.

    Science.gov (United States)

    Bhuyan, Soumitra S; Zhu, He; Chandak, Aastha; Kim, Jungyoon; Stimpson, Jim P

    2014-12-01

    Healthcare organizations including residential care facilities (RCFs) are diversifying their services to meet market demands. Service innovations have been linked to the changes in the way that healthcare organizations organize their work. The objective of this study is to explore the relationship between organizational service innovations and Electronic Health Record (EHR) adoption in the RCFs. We used the data from the 2010 National Survey of Residential Care Facilities conducted by the Centers for Disease Control and Prevention. The outcome was whether an RCF adopted EHR or not, and the predictors were the organizational service innovations including provision of skilled nursing care and medication review. We also added facility characteristics as control variables. Weighted multivariate logistic regressions were used to estimate the relationship between service innovation factors and EHR adoption in the RCFs. In 2010, about 17.4% of the RCFs were estimated to use EHR. Multivariate analysis showed that RCFs employing service innovations were more likely to adopt EHR. The residential care facilities that provide skilled nursing services to their residents are more likely (OR: 1.42; 95% CI: 1.09-1.87) to adopt EHR. Similarly, RCFs with a provision of medication review were also more likely to adopt EHR (OR: 1.40; 95% CI: 1.00-1.95). Among the control variables, facility size, chain affiliation, ownership type, and Medicaid certification were significantly associated with EHR adoption. Our findings suggest that service innovations may drive EHR adoption in the RCFs in the United States. This can be viewed as a strategic attempt by RCFs to engage in a new business arrangement with hospitals and other health care organizations, where quality of care and interoperability of patients' records might play a vital role under the current healthcare reform. Future research could examine the relationship between service innovations and use of different EHR functionality in

  15. Discharge Processes and 30-Day Readmission Rates of Patients Hospitalized for Heart Failure on General Medicine and Cardiology Services.

    Science.gov (United States)

    Salata, Brian M; Sterling, Madeline R; Beecy, Ashley N; Ullal, Ajayram V; Jones, Erica C; Horn, Evelyn M; Goyal, Parag

    2018-05-01

    Given high rates of heart failure (HF) hospitalizations and widespread adoption of the hospitalist model, patients with HF are often cared for on General Medicine (GM) services. Differences in discharge processes and 30-day readmission rates between patients on GM and those on Cardiology during the contemporary hospitalist era are unknown. The present study compared discharge processes and 30-day readmission rates of patients with HF admitted on GM services and those on Cardiology services. We retrospectively studied 926 patients discharged home after HF hospitalization. The primary outcome was 30-day all-cause readmission after discharge from index hospitalization. Although 60% of patients with HF were admitted to Cardiology services, 40% were admitted to GM services. Prevalence of cardiovascular and noncardiovascular co-morbidities were similar between patients admitted to GM services and Cardiology services. Discharge summaries for patients on GM services were less likely to have reassessments of ejection fraction, new study results, weights, discharge vital signs, discharge physical examinations, and scheduled follow-up cardiologist appointments. In a multivariable regression analysis, patients on GM services were more likely to experience 30-day readmissions compared with those on Cardiology services (odds ratio 1.43 95% confidence interval [1.05 to 1.96], p = 0.02). In conclusion, outcomes are better among those admitted to Cardiology services, signaling the need for studies and interventions focusing on noncardiology hospital providers that care for patients with HF. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. The Facilities of British Intelligence Service in Trabzon at the Beginning of National Struggle

    Directory of Open Access Journals (Sweden)

    Resul YAVUZ

    2017-12-01

    Full Text Available Trabzon and its surrounding has always been one of the places where the states want to expand to inner parts through North want to control in almost every period of the history. The closest attempts to realize this aim were undoubtly to be carried out by Russians in the First World War and by the British in the Turkish Independence War which began after the war. The strategic position of it was in the interest of foreign intelligence services, especially in the national struggle years, due to its sophisticated socio-economic structure compared to the region and its geographical closeness to Bolshevik Russia. During these years, the British intelligence service reported to the centers about the connection and hidden points of the city and the sketches of possible landing and pathways in order to send troops to eastern Anatolia in the event of a possible occupation. Besides, the British attempted to control all activities of the city, especially the control of arm delivery under the name of implementing the conditions of the armistice by increasing the pressure on Trabzon during the years of national struggle that started in Anatolia.

  17. Implementation and operational experience of an integrated fuel information service at the BNFL THORP facility

    International Nuclear Information System (INIS)

    Robson, D.N.; Ramsden, P.N.

    1995-01-01

    BNFL's THORP Plant, which started active operations early in 1994, has contracts to reprocess 7000t(U) of fuel belonging to 33 customers in 9 countries in the UK, Europe and Japan during its first 10 years of operation. Contracts are in place or being negotiated, and further business sought after, with the expectation of extending THORP's operations well beyond the initial 10 years. An integrated data management service, for the fuel storage areas of BNFL's THORP Division, is being implemented to replace several, independent, systems. This Fuel Information Service (FIS) will bring the Nuclear Materials Accountancy and Safeguards Records together with the Operating Records into one database from which all Safeguards Reports will be made. BNFL's contractual and commercial data and technical data on the stored fuel, required to support the reprocessing business, will also be brought into the common database. FIS is the first stage in a project to integrate the Materials Management systems throughout the THORP nuclear recycling business including irradiated fuel receipt and storage, reprocessing and storage of products, mixed oxide fuel manufacture and the conditioning and storage of wastes

  18. Demonstration of anticoagulation patient self-testing feasibility at an Indian Health Service facility: A case series analysis

    Directory of Open Access Journals (Sweden)

    Schupbach RR

    2013-03-01

    Full Text Available Background: Anticoagulation patient self-testing (PST represents an alternative approach to warfarin monitoring by enabling patients to use coagulometers to test their international normalized ratio (INR values. PST offers several advantages that potentially improve warfarin management. Objective: To describe implementation and associated performance of a PST demonstration program at an Indian Health Service (IHS facility. Methods: A non-consecutive case series analysis of patients from a pharmacy-managed PST demonstration program was performed at an IHS facility in Oklahoma between July 2008 and February 2009.Results: Mean time in therapeutic range (TTR for the seven patients showed a small, absolute increase during the twelve weeks of PST compared to the twelve weeks prior to PST. Four of the seven patients had an increase in TTR during the twelve week course of PST compared to their baseline TTR. Three of four patients with increased TTR in the final eight week period of PST achieved a TTR of 100%. Of the three patients who experienced a decrease in TTR after initiating self-testing, two initially presented with a TTR of 100% prior to PST and one patient had a TTR of 100% for the final eight weeks of PST. The two patients not achieving a TTR of 100% during the twelve week PST period demonstrated an increase in TTR following the first four weeks of PST. Conclusion: Although anticoagulation guidelines now emphasize patient self-management (PSM only, optimal PST remains an integral process in PSM delivery. In the patients studied, the results of this analysis suggest that PST at the IHS facility provided a convenient, alternative method for management of chronic warfarin therapy for qualified patients. More than half of the patients demonstrated improvement in TTR. Although there is a learning curve immediately following PST initiation, the mean TTR for the entire PST period increased modestly when compared to the time period prior to PST.

  19. Emergency department boarding and adverse hospitalization outcomes among patients admitted to a general medical service.

    Science.gov (United States)

    Lord, Kito; Parwani, Vivek; Ulrich, Andrew; Finn, Emily B; Rothenberg, Craig; Emerson, Beth; Rosenberg, Alana; Venkatesh, Arjun K

    2018-03-20

    Overcrowding in the emergency department (ED) has been associated with patient harm, yet little is known about the association between ED boarding and adverse hospitalization outcomes. We sought to examine the association between ED boarding and three common adverse hospitalization outcomes: rapid response team activation (RRT), escalation in care, and mortality. We conducted an observational analysis of consecutive patient encounters admitted from the ED to the general medical service between February 2013 and June 2015. This study was conducted in an urban, academic hospital with an annual adult ED census over 90,000. We defined boarding as patients with greater than 4h from ED bed order to ED departure to hospital ward. The primary outcome was a composite of adverse outcomes in the first 24h of admission, including RRT activation, care escalation to intensive care, or in-hospital mortality. A total of 31,426 patient encounters were included of which 3978 (12.7%) boarded in the ED for 4h or more. Adverse outcomes occurred in 1.92% of all encounters. Comparing boarded vs. non-boarded patients, 41 (1.03%) vs. 244 (0.90%) patients experienced a RRT activation, 53 (1.33%) vs. 387 (1.42%) experienced a care escalation, and 1 (0.03%) vs.12 (0.04%) experienced unanticipated in-hospital death, within 24h of ED admission. In unadjusted analysis, there was no difference in the composite outcome between boarding and non-boarding patients (1.91% vs. 1.91%, p=0.994). Regression analysis adjusted for patient demographics, acuity, and comorbidities also showed no association between boarding and the primary outcome. A sensitivity analysis showed an association between ED boarding and the composite outcome inclusive of the entire inpatient hospital stay (5.8% vs. 4.7%, p=0.003). Within the first 24h of hospital admission to a general medicine service, adverse hospitalization outcomes are rare and not associated with ED boarding. Copyright © 2018 Elsevier Inc. All rights

  20. Evaluating health services with point of service feedback: perspectives and experiences of patients, staff and community volunteers in an inpatient rehabilitation facility.

    Science.gov (United States)

    Gill, Stephen D; Dolley, Pamela J; Dunning, Trisha L; Hughes, Andrew J

    2015-01-01

    To determine patient, staff and community volunteer opinions and experiences of point of service feedback (POSF) in an inpatient rehabilitation facility. Participants were recruited by purposeful sampling. Two researchers conducted in-depth semi-scripted interviews with patients, staff or volunteers until no new issues emerged. Manually transcribed interview data underwent thematic analysis that grouped information into categories of related information. Twenty patients, 26 staff from 10 different professional groups, and 2 community volunteers were interviewed. Patient and volunteer data were grouped into five main categories: patients wanted their voice heard and acted on; patients could be positively and negatively affected by POSF; patients could be reluctant to evaluate staff; patients preferred POSF to post-discharge mailed questionnaires; and patients' feedback was influenced by the data collector. Staff wanted: feedback to help them improve the patient experience; and feedback that was trustworthy, usable and used. Staff believed that the feedback-collector influenced patients' feedback and affected how feedback could be used. Patients, staff and community volunteers identified issues that determine the appropriateness and usefulness of POSF. Policy and practise should address the preferences, needs and experiences of health service users and providers so that POSF produces maximum benefits for both patients and health services. Implications for Rehabilitation POSF can enhance patients' experiences of inpatient rehabilitation by providing a mechanism to be heard and communicating that patients are valued; care must be exercised with patients who find giving feedback stressful. Collecting POSF is most beneficial when coupled with methods to efficiently and effectively respond to feedback. POSF requires interpretation in light of its limitations including patients' ability to accurately and unreservedly communicate their experiences. Who collects POSF

  1. MINIMUM AREAS FOR ELEMENTARY SCHOOL BUILDING FACILITIES.

    Science.gov (United States)

    Pennsylvania State Dept. of Public Instruction, Harrisburg.

    MINIMUM AREA SPACE REQUIREMENTS IN SQUARE FOOTAGE FOR ELEMENTARY SCHOOL BUILDING FACILITIES ARE PRESENTED, INCLUDING FACILITIES FOR INSTRUCTIONAL USE, GENERAL USE, AND SERVICE USE. LIBRARY, CAFETERIA, KITCHEN, STORAGE, AND MULTIPURPOSE ROOMS SHOULD BE SIZED FOR THE PROJECTED ENROLLMENT OF THE BUILDING IN ACCORDANCE WITH THE PROJECTION UNDER THE…

  2. [Accident prevention in agriculture in the ASL1 Abruzzo Local Health Service: protection facilities for tractors].

    Science.gov (United States)

    Pompei, Domenico; Rossi, Roberta; Vecchiola, Rita; Angelone, Anna Maria; Fabiani, Leila

    2015-07-08

    The ASL1 workplace prevention and safety service in Abruzzo has been conducting workplace inspections on agricultural and livestock farms in the province of L'Aquila since 2011, mainly in the areas of Avezzano, Sulmona and L'Aquila. The agricultural sector in Abruzzo is characterized by high rates of accidents and the ratio of fatal injuries/total injuries is higher than the industry and services sector. To evaluate the presence or absence of safety devices , i.e. compliance or otherwise with regulations for tractors, and of any variable factor that could be associated with the safety of the vehicle. Between 2011 and 2013, 98 farms in the province of L'Aquila were inspected. The data resulting from the inspections was collected by the use of a checklist. An univariate logistic regression analysis was conducted in which the vehicles that complied with regulations were considered as the dependant variable, and the age of the tractor owner, the acres of worked land and the type of farm were considered as explanatory variables. Statistical elaboration was carried out using the Stata 12 programme. Out of a total of 298 tractors that were checked, 64.8% did not comply with regulations due to absence or unsuitability of one or more safety devices such as: a protective device in case of overturning; retention system of the driver; mounting and dismounting from the vehicle; protection of moving parts and hot parts; PTO (Power Take Off) protection device. A significant association between non-compliance of vehicles and the age of the owner and acres worked was observed, whereas no statistical significance was observed for the association with the farm type variable. Our study showed that farms where the owner's age is between 50 and 64 years and where more acres of land are worked are those where the agricultural or forestry tractors had lower levels of compliance with regulations.

  3. New graduates’ perceptions of preparedness to provide speech-language therapy services in general and dysphagia services in particular

    Science.gov (United States)

    Booth, Alannah; Choto, Fadziso; Gotlieb, Jessica; Robertson, Rebecca; Morris, Gabriella; Stockley, Nicola; Mauff, Katya

    2015-01-01

    Background Upon graduation, newly qualified speech-language therapists are expected to provide services independently. This study describes new graduates’ perceptions of their preparedness to provide services across the scope of the profession and explores associations between perceptions of dysphagia theory and clinical learning curricula with preparedness for adult and paediatric dysphagia service delivery. Methods New graduates of six South African universities were recruited to participate in a survey by completing an electronic questionnaire exploring their perceptions of the dysphagia curricula and their preparedness to practise across the scope of the profession of speech-language therapy. Results Eighty graduates participated in the study yielding a response rate of 63.49%. Participants perceived themselves to be well prepared in some areas (e.g. child language: 100%; articulation and phonology: 97.26%), but less prepared in other areas (e.g. adult dysphagia: 50.70%; paediatric dysarthria: 46.58%; paediatric dysphagia: 38.36%) and most unprepared to provide services requiring sign language (23.61%) and African languages (20.55%). There was a significant relationship between perceptions of adequate theory and clinical learning opportunities with assessment and management of dysphagia and perceptions of preparedness to provide dysphagia services. Conclusion There is a need for review of existing curricula and consideration of developing a standard speech-language therapy curriculum across universities, particularly in service provision to a multilingual population, and in both the theory and clinical learning of the assessment and management of adult and paediatric dysphagia, to better equip graduates for practice. PMID:26304217

  4. Measuring client satisfaction and the quality of family planning services: a comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana.

    Science.gov (United States)

    Hutchinson, Paul L; Do, Mai; Agha, Sohail

    2011-08-24

    Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory

  5. 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...

  6. Mobile task management tool that improves workflow of an acute general surgical service.

    Science.gov (United States)

    Foo, Elizabeth; McDonald, Rod; Savage, Earle; Floyd, Richard; Butler, Anthony; Rumball-Smith, Alistair; Connor, Saxon

    2015-10-01

    Understanding and being able to measure constraints within a health system is crucial if outcomes are to be improved. Current systems lack the ability to capture decision making with regard to tasks performed within a patient journey. The aim of this study was to assess the impact of a mobile task management tool on clinical workflow within an acute general surgical service by analysing data capture and usability of the application tool. The Cortex iOS application was developed to digitize patient flow and provide real-time visibility over clinical decision making and task performance. Study outcomes measured were workflow data capture for patient and staff events. Usability was assessed using an electronic survey. There were 449 unique patient journeys tracked with a total of 3072 patient events recorded. The results repository was accessed 7792 times. The participants reported that the application sped up decision making, reduced redundancy of work and improved team communication. The mode of the estimated time the application saved participants was 5-9 min/h of work. Of the 14 respondents, nine discarded their analogue methods of tracking tasks by the end of the study period. The introduction of a mobile task management system improved the working efficiency of junior clinical staff. The application allowed capture of data not previously available to hospital systems. In the future, such data will contribute to the accurate mapping of patient journeys through the health system. © 2015 Royal Australasian College of Surgeons.

  7. Perceived barriers to utilizing maternal and neonatal health services in contracted-out versus government-managed health facilities in the rural districts of Pakistan.

    Science.gov (United States)

    Riaz, Atif; Zaidi, Shehla; Khowaja, Asif Raza

    2015-03-06

    A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs) in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users' perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH) services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted). A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs) conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong community-based behavior change strategies. © 2015 by Kerman University of Medical Sciences.

  8. Perceived Barriers to Utilizing Maternal and Neonatal Health Services in Contracted-Out Versus Government-Managed Health Facilities in the Rural Districts of Pakistan

    Directory of Open Access Journals (Sweden)

    Atif Riaz

    2015-05-01

    Full Text Available Background A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users’ perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted. Methods A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Results Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Conclusion Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong communitybased behavior change strategies.

  9. Upgrade of general control system employed for Materials and Life Science Experimental Facility of J-PARC

    International Nuclear Information System (INIS)

    Watanabe, Akihiko; Sakai, Kenji; Ooi, Motoki; Meigo, Shin-ichiro; Takada, Hiroshi

    2013-11-01

    The General Control System (GCS) of the Materials and Life Science Experimental Facility (MLF) of J-PARC controls various devices of a pulsed spallation neutron source and a muon target which are driven by proton beams with energy of 3 GeV and a power of 1 MW, neutron instruments of 23 neutron beam lines and muon instruments of 4 secondary muon beam lines under a network of the control system of accelerators. The current GCS has performed its function as designed since operating MLF was started in 2008. However, it has a weakness that it costs very much in the maintenance because of its poor flexibility on Operating System (OS) and software versions. For example, all computers composed of the GCS must be replaced when the OS is upgraded. For improving the potential flexibility of the GCS in maintenance in view of sustainable long-term operation, therefore, we have re-examined the framework software and those employed for individual functions of GCS under the condition of current functions so as to control all local control panels by plural exclusive PCs, and acquire, store and distribute operation data over 7000 items in the suitable data format. Furthermore, we have made a prototype of an upgraded GCS and evaluated its concrete performances with true data/information such as data transmission speed from PLCs, control functions from operating windows, storage capability of data server and long-term stability/reliability of the system. In conclusion, we decided to adopt following softwares for the upgraded GCS: Experimental Physics and Industrial Control System (EPICS) as framework software, Takebishi-made OPC server as data input/output module, Control System Studio (CSS) as user interface window and PostgreSQL as the data storage server. (author)

  10. 76 FR 34886 - General Services Administration Acquisition Regulation; Implementation of Information Technology...

    Science.gov (United States)

    2011-06-15

    ... Acquisition Regulation; Implementation of Information Technology Security Provision AGENCY: Office of... information technology (IT) supplies, services and systems with security requirements. DATES: Effective Date... effective date that include information technology (IT) supplies, services and systems with security...

  11. 77 FR 749 - General Services Administration Acquisition Regulation; Implementation of Information Technology...

    Science.gov (United States)

    2012-01-06

    ... Acquisition Regulation; Implementation of Information Technology Security Provision AGENCY: Office of... orders that include information technology (IT) supplies, services and systems. DATES: Effective Date... 6, 2012 that include information technology (IT) supplies, services and systems with security...

  12. Effective antimicrobial stewardship in a long-term care facility through an infectious disease consultation service: keeping a LID on antibiotic use.

    Science.gov (United States)

    Jump, Robin L P; Olds, Danielle M; Seifi, Nasim; Kypriotakis, Georgios; Jury, Lucy A; Peron, Emily P; Hirsch, Amy A; Drawz, Paul E; Watts, Brook; Bonomo, Robert A; Donskey, Curtis J

    2012-12-01

    We introduced a long-term care facility (LTCF) infectious disease (ID) consultation service (LID service) that provides on-site consultations to residents of a Veterans Affairs (VA) LTCF. We determined the impact of the LID service on antimicrobial use and Clostridium difficile infections at the LTCF. A 160-bed VA LTCF. Systemic antimicrobial use and positive C. difficile tests at the LTCF were compared for the 36 months before and the 18 months after the initiation of the ID consultation service through segmented regression analysis of an interrupted time series. Relative to that in the preintervention period, total systemic antibiotic administration decreased by 30% (Peffective means to achieve antimicrobial stewardship.

  13. Service quality in low-voltage systems. General principles. [EDF, France

    Energy Technology Data Exchange (ETDEWEB)

    Heisch, J. (Electricite de France, 75 - Paris)

    1984-01-01

    Voltage quality and service continuity are two components of service quality, as limited to the technical aspect of the concept. After reviewing the current situation, the actions undertaken to improve said situation are enumerated, actions essentially directed towards MV systems, taking into account system structures. With service quality still of an industrial character, certain users might be led to install additional equipment.

  14. The effect of facility characteristics on patient safety, patient experience, and service availability for procedures in non-hospital-affiliated outpatient settings: A systematic review.

    Science.gov (United States)

    Berglas, Nancy F; Battistelli, Molly F; Nicholson, Wanda K; Sobota, Mindy; Urman, Richard D; Roberts, Sarah C M

    2018-01-01

    Over recent decades, numerous medical procedures have migrated out of hospitals and into freestanding ambulatory surgery centers (ASCs) and physician offices, with possible implications for patient outcomes. In response, states have passed regulations for office-based surgeries, private organizations have established standards for facility accreditation, and professional associations have developed clinical guidelines. While abortions have been performed in office setting for decades, states have also enacted laws requiring that facilities that perform abortions meet specific requirements. The extent to which facility requirements have an impact on patient outcomes-for any procedure-is unclear. We conducted a systematic review to examine the effect of outpatient facility type (ASC vs. office) and specific facility characteristics (e.g., facility accreditation, emergency response protocols, clinician qualifications, physical plant characteristics, other policies) on patient safety, patient experience and service availability in non-hospital-affiliated outpatient settings. To identify relevant research, we searched databases of the published academic literature (PubMed, EMBASE, Web of Science) and websites of governmental and non-governmental organizations. Two investigators reviewed 3049 abstracts and full-text articles against inclusion/exclusion criteria and assessed the quality of 22 identified articles. Most studies were hampered by methodological challenges, with 12 of 22 not meeting minimum quality criteria. Of 10 studies included in the review, most (6) examined the effect of facility type on patient safety. Existing research appears to indicate no difference in patient safety for outpatient procedures performed in ASCs vs. physician offices. Research about specific facility characteristics is insufficient to draw conclusions. More and higher quality research is needed to determine if there is a public health problem to be addressed through facility

  15. Dialysis Facility Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Dialysis Facility Compare helps you find detailed information about Medicare-certified dialysis facilities. You can compare the services and the quality of care that...

  16. New graduates’ perceptions of preparedness to provide speech-language therapy services in general and dysphagia services in particular

    Directory of Open Access Journals (Sweden)

    Shajila Singh

    2015-06-01

    Methods: New graduates of six South African universities were recruited to participate in a survey by completing an electronic questionnaire exploring their perceptions of the dysphagia curricula and their preparedness to practise across the scope of the profession of speechlanguage therapy. Results: Eighty graduates participated in the study yielding a response rate of 63.49%. Participants perceived themselves to be well prepared in some areas (e.g. child language: 100%; articulation and phonology: 97.26%, but less prepared in other areas (e.g. adult dysphagia: 50.70%; paediatric dysarthria: 46.58%; paediatric dysphagia: 38.36% and most unprepared to provide services requiring sign language (23.61% and African languages (20.55%. There was a significant relationship between perceptions of adequate theory and clinical learning opportunities with assessment and management of dysphagia and perceptions of preparedness to provide dysphagia services. Conclusion: There is a need for review of existing curricula and consideration of developing a standard speech-language therapy curriculum across universities, particularly in service provision to a multilingual population, and in both the theory and clinical learning of the assessment and management of adult and paediatric dysphagia, to better equip graduates for practice.

  17. Provision of hormonal and long-acting reversible contraceptive services by general practices in Scotland, UK (2004-2009).

    Science.gov (United States)

    Reddy, Anusha; Watson, Margaret; Hannaford, Philip; Lefevre, Karen; Ayansina, Dolapo

    2014-01-01

    In the UK, a large proportion of contraceptive services are provided from general practice. However, little is known about which contraceptive services are provided and to whom. Descriptive serial cross-sectional study of women aged 12-55 years, registered with 191 general practices in Scotland, UK between 2004 and 2009. Annual incidence of provision of hormonal and long-acting reversible contraceptives (LARCs) increased from 27.7% in 2004 to 30.1% in 2009. Amongst those women registered with a general practice for the full 5-year period the provision of LARCs increased from 8.8% to 12.5% (pemergency hormonal contraception (EHC) decreased from 5.2% to 2.6% (pcontraceptives and LARCs from general practices. It is important that a full range of contraceptive options remains easily available to women.

  18. A research program to reduce interior noise in general aviation airplanes. Design of an acoustic panel test facility

    Science.gov (United States)

    Roskam, J.; Muirhead, V. U.; Smith, H. W.; Henderson, T. D.

    1977-01-01

    The design, construction, and costs of a test facility for determining the sound transmission loss characteristics of various panels and panel treatments are described. The pressurization system and electronic equipment used in experimental testing are discussed as well as the reliability of the facility and the data gathered. Tests results are compared to pertinent acoustical theories for panel behavior and minor anomalies in the data are examined. A method for predicting panel behavior in the stiffness region is also presented.

  19. The effects of citizenship status on service utilization and general satisfaction with healthcare: a cross-cultural study

    OpenAIRE

    Khaled, Salama M.; Shockley, Bethany; Abdul Rahim, Hanan F.

    2016-01-01

    Objective: To explore the role of citizenship status as a predictor of general satisfaction with healthcare services in Qatar, including potential interaction with utilization and health insurance coverage type. Design: A cross-sectional survey conducted in 2012. Setting: A household survey in the State of Qatar in the Arab Gulf. Participants: A nationally representative sample of 2750 citizens and noncitizens aged 18 years and older. Main Outcome: General satisfaction st...

  20. Clinical and economic benefit of general practitioner integration to a symptomatic breast service.

    Science.gov (United States)

    Beecher, S M; Donlan, C; O'Leary, D P; Kerin, M J; McLaughlin, R

    2016-11-01

    Integration of general practitioners (GPs) into a tertiary care team is a model used internationally to assist with provision of patient care. Symptomatic breast clinics have seen significant increases in attendances and consequential staffing issues. We wished to analyze the integration of GPs into a tertiary breast care team and establish whether their inclusion is a cost-effective approach. A prospectively maintained database was used to identify 1614 new and 1453 review patients seen in the clinic between September and December 2013. The triple assessment clinical, radiological, and biopsy scores of patients assessed by GPs were compared to those assessed by registrars and to the overall number of patients seen. A cost analysis was performed based on the hourly rates of GPs and registrars. 1614 new patients seen over the 4-month period. GPs reviewed a mean of 153.6 new patients and registrars reviewed a mean of 97.8. Registrars reviewed patients who were allocated higher 'S' scores, with 46 % of patients allocated an S4 and 21 % of patients allocated an S5 score. GPs reviewed a mean of 115.6 return patients and registrars reviewed a mean of 110.1 return patients. The weekly cost of employing 3 GPs for 15 h was €835. This compares favorably to the cost of employing a full-time registrar. This study demonstrates that GPs can play a substantial role in the provision of a symptomatic breast service. In addition, the incorporation of GPs in this setting can prove cost-effective.