WorldWideScience

Sample records for high health facility

  1. Health Facilities

    Science.gov (United States)

    Health facilities are places that provide health care. They include hospitals, clinics, outpatient care centers, and specialized care centers, ... psychiatric care centers. When you choose a health facility, you might want to consider How close it ...

  2. Lesotho - Health Facility Survey

    Data.gov (United States)

    Millennium Challenge Corporation — The main objective of the 2011 Health Facility Survey (HFS) was to establish a baseline for informing the Health Project performance indicators on health facilities,...

  3. High Throughput Facility

    Data.gov (United States)

    Federal Laboratory Consortium — Argonne?s high throughput facility provides highly automated and parallel approaches to material and materials chemistry development. The facility allows scientists...

  4. High Combustion Research Facility

    Data.gov (United States)

    Federal Laboratory Consortium — At NETL's High-Pressure Combustion Research Facility in Morgantown, WV, researchers can investigate new high-pressure, high-temperature hydrogen turbine combustion...

  5. High prevalence of workplace violence among nurses working at public health facilities in Southern Ethiopia.

    Science.gov (United States)

    Fute, Mathewos; Mengesha, Zelalem Birhanu; Wakgari, Negash; Tessema, Gizachew Assefa

    2015-01-01

    The rising rate of workplace violence in health care facilities has become a major problem for health care providers including nurses. However, evidences are lacking in Ethiopia particularly in the study area. The aim of this study is to assess the prevalence and associated factors of workplace violence among nurses working at health care facilities in Hawassa City Administration, Southern Ethiopia. An institution-based cross-sectional study was conducted on 660 randomly selected nurses working at public health facilities in Hawassa City Administration in April 2014. A pre-tested and structured questionnaire was used to collect the data. Data were entered using EPI-Info and exported to SPSS for further analysis. Descriptive statistics were done. Logistic regression analyses were used to see the association between different variables and the outcome variable. Odds ratios with 95% Confidence Interval (CI) were computed to determine the presence and strength of the association. In this study, the prevalence of workplace violence was 29.9% [95% CI: 26.5, 33.5)] of which physical violence accounted for 36 (18.22%), verbal abuse for 172 (89.58%) and sexual harassment for 25 (13.02%). Female sex [AOR=2.00, 95% CI: (1.28, 2.39)], short work experience [AOR=8.86, 95% CI: (3.47, 22.64)], age group of 22-25 [AOR=4.17, 95% CI: (2.46, 7.08)], age group of (26-35) [AOR=1.9, 95% CI (1.16, 3.1)], work in emergency [(AOR=4.28, 95% CI: (1.39, 4.34)] and work in the Inpatient Department [(AOR=2.11, 95% CI: (1.98, 2.64)] were the factors positively associated with workplace violence. A significant proportion of nurses faced violence while providing care at in public health facilities. Being female, younger age, short work experience, and assignment in emergency and inpatient departments were positively associated with workplace violence. Policy makers and stakeholders should focus on workplace violence prevention strategies.

  6. Health Facilities - Multiple Languages

    Science.gov (United States)

    ... Well-Being 10 - Medical Appointments - Amarɨñña / አማርኛ (Amharic) MP3 Siloam Family Health Center Arabic (العربية) Expand Section ... Well-Being 10 - Medical Appointments - myanma bhasa (Burmese) MP3 Siloam Family Health Center Dari (دری) Expand Section ...

  7. High-pressure water facility

    Science.gov (United States)

    2006-01-01

    NASA Test Operations Group employees, from left, Todd Pearson, Tim Delcuze and Rodney Wilkinson maintain a water pump in Stennis Space Center's high-pressure water facility. The three were part of a group of employees who rode out Hurricane Katrina at the facility and helped protect NASA's rocket engine test complex.

  8. High Pressure Industrial Water Facility

    Science.gov (United States)

    1992-01-01

    In conjunction with Space Shuttle Main Engine testing at Stennis, the Nordberg Water Pumps at the High Pressure Industrial Water Facility provide water for cooling the flame deflectors at the test stands during test firings.

  9. Spatial Distribution and Accessibility of Health Facilities in Akwa ...

    African Journals Online (AJOL)

    This paper therefore analyzed the spatial patterns of healthcare facilities in Akwa ... Data on six health indicator variables were obtained and analyzed to assess ... of healthcare facilities and thus hinders good access to high quality healthcare ...

  10. High heat flux facility GLADIS

    International Nuclear Information System (INIS)

    Greuner, H.; Boeswirth, B.; Boscary, J.; McNeely, P.

    2007-01-01

    The new ion beam facility GLADIS started the operation at IPP Garching. The facility is equipped with two individual 1.1 MW power ion sources for testing actively cooled plasma facing components under high heat fluxes. Each ion source generates heat loads between 3 and 55 MW/m 2 with a beam diameter of 70 mm at the target position. These parameters allow effective testing from probes to large components up to 2 m length. The high heat flux allows the target to be installed inclined to the beam and thus increases the heated surface length up to 200 mm for a heat flux of 15 MW/m 2 in the standard operating regime. Thus the facility has the potential capability for testing of full scale ITER divertor targets. Heat load tests on the WENDELSTEIN 7-X pre-series divertor targets have been successfully started. These tests will validate the design and manufacturing for the production of 950 elements

  11. High Exposure Facility Technical Description

    Energy Technology Data Exchange (ETDEWEB)

    Carter, Gregory L.; Stithem, Arthur R.; Murphy, Mark K.; Smith, Alex K.

    2008-02-12

    The High Exposure Facility is a collimated high-level gamma irradiator that is located in the basement of the 318 building. It was custom developed by PNNL back in 1982 to meet the needs for high range radiological instrument calibrations and dosimeter irradiations. At the time no commercially available product existed that could create exposure rates up to 20,000 R/h. This document is intended to pass on the design criteria that was employed to create this unique facility, while maintaining compliance with ANSI N543-1974, "General Safety Standard for Installations Using Non-Medical X-Ray and Sealed Gamma-Ray Sources, Energies up to 10 MeV."

  12. Are people at high risk for diabetes visiting health facility for confirmation of diagnosis? A population-based study from rural India.

    Science.gov (United States)

    Srinivasapura Venkateshmurthy, Nikhil; Soundappan, Kathirvel; Gummidi, Balaji; Bhaskara Rao, Malipeddi; Tandon, Nikhil; Reddy, K Srinath; Prabhakaran, Dorairaj; Mohan, Sailesh

    2018-01-01

    India is witnessing a rising burden of type 2 diabetes mellitus. India's National Programme for Prevention and Control of Diabetes, Cancer, Cardiovascular diseases and Stroke recommends population-based screening and referral to primary health centre for diagnosis confirmation and treatment initiation. However, little is known about uptake of confirmatory tests among screen positives. To estimate the uptake of confirmatory tests and identify the reasons for not undergoing confirmation by those at high risk for developing diabetes. We analysed data collected under project UDAY, a comprehensive diabetes and hypertension prevention and management programme, being implemented in rural Andhra Pradesh, India. Under UDAY, population-based screening for diabetes was carried out by project health workers using a diabetes risk score and capillary blood glucose test. Participants at high risk for diabetes were asked to undergo confirmatory tests. On follow-up visit, health workers assessed if the participant had undergone confirmation and ask for reasons if not so. Of the 35,475 eligible adults screened between April 2015 and August 2016, 10,960 (31%) were determined to be at high risk. Among those at high risk, 9670 (88%) were followed up, and of those, only 616 (6%) underwent confirmation. Of those who underwent confirmation, 'lack of symptoms of diabetes warranting visit to health facility' (52%) and 'being at high risk was not necessary enough to visit' (41%) were the most commonly reported reasons for non-confirmation. Inconvenient facility time (4.4%), no nearby facility (3.2%), un-affordability (2.2%) and long waiting time (1.6%) were the common health system-related factors that affected the uptake of the confirmatory test. Confirmation of diabetes was abysmally low in the study population. Low uptake of the confirmatory test might be due to low 'risk perception'. The uptake can be increased by improving the population risk perception through individual and

  13. Where do the rural poor deliver when high coverage of health facility delivery is achieved? Findings from a community and hospital survey in Tanzania.

    Directory of Open Access Journals (Sweden)

    Manuela Straneo

    Full Text Available As part of maternal mortality reducing strategies, coverage of delivery care among sub-Saharan African rural poor will improve, with a range of facilities providing services. Whether high coverage will benefit all socio-economic groups is unknown. Iringa rural District, Southern Tanzania, with high facility delivery coverage, offers a paradigm to address this question. Delivery services are available in first-line facilities (dispensaries, health centres and one hospital. We assessed whether all socio-economic groups access the only comprehensive emergency obstetric care facility equally, and surveyed existing delivery services.District population characteristics were obtained from a household community survey (n = 463. A Hospital survey collected data on women who delivered in this facility (n = 1072. Principal component analysis on household assets was used to assess socio-economic status. Hospital population socio-demographic characteristics were compared to District population using multivariable logistic regression. Deliveries' distribution in District facilities and staffing were analysed using routine data.Women from the hospital compared to the District population were more likely to be wealthier. Adjusted odds ratio of hospital delivery increased progressively across socio-economic groups, from 1.73 for the poorer (p = 0.0031 to 4.53 (p<0.0001 for the richest. Remarkable dispersion of deliveries and poor staffing were found. In 2012, 5505/7645 (72% institutional deliveries took place in 68 first-line facilities, the remaining in the hospital. 56/68 (67.6% first-line facilities reported ≤100 deliveries/year, attending 33% of deliveries. Insufficient numbers of skilled birth attendants were found in 42.9% of facilities.Poorer women remain disadvantaged in high coverage, as they access lower level facilities and are under-represented where life-saving transfusions and caesarean sections are available. Tackling the challenges

  14. WASH and gender in health care facilities: The uncharted territory.

    Science.gov (United States)

    Kohler, Petra; Renggli, Samuel; Lüthi, Christoph

    2017-11-08

    Health care facilities in low- and middle-income countries are high-risk settings, and face special challenges to achieving sustainable water, sanitation, and hygiene (WASH) services. Our applied interdisciplinary research conducted in India and Uganda analyzed six dimensions of WASH services in selected health care facilities, including menstrual hygiene management. To be effective, WASH monitoring strategies in health care facilities must include gender sensitive measures. We present a novel strategy, showing that applied gender sensitive multitool assessments are highly productive in assessments of WASH services and facilities from user and provider perspectives. We discuss its potential for applications at scale and as an area of future research.

  15. Health seeking behaviour and challenges in utilising health facilities ...

    African Journals Online (AJOL)

    ... and long distance to health facilities. Conclusions: There is potential to increase access to health care in rural areas by increasing the frequency of mobile clinic services and strengthening the community health worker strategy. Key words: Health seeking behaviour, Rural community, Health facilities, Challenges, Uganda ...

  16. communicable diseases at health facilities in Ethiopia

    African Journals Online (AJOL)

    user

    unsatisfactory and it varied between urban (34%) and rural (5%) health facilities. In general, cervical ... data for planning and monitoring scale-up intervention ... authority, Ethiopia, 2016. Regions. Number of facilities Percentage. Tigray. 42. 8. Afar. 38. 7. Amhara. 61. 11. Oromiya. 99. 18. Somali. 43. 8. Beni. Gumuz. 30. 5.

  17. 'High profile health facilities can add to your trouble': Women, stigma and un/safe abortion in Kenya.

    Science.gov (United States)

    Izugbara, Chimaraoke O; Egesa, Carolyne; Okelo, Rispah

    2015-09-01

    Public health discourses on safe abortion assume the term to be unambiguous. However, qualitative evidence elicited from Kenyan women treated for complications of unsafe abortion contrasted sharply with public health views of abortion safety. For these women, safe abortion implied pregnancy termination procedures and services that concealed their abortions, shielded them from the law, were cheap and identified through dependable social networks. Participants contested the notion that poor quality abortion procedures and providers are inherently dangerous, asserting them as key to women's preservation of a good self, management of stigma, and protection of their reputation, respect, social relationships, and livelihoods. Greater public health attention to the social dimensions of abortion safety is urgent. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. ART Attrition across Health Facilities Implementing Option B+ in Haiti.

    Science.gov (United States)

    Myrtil, Martine Pamphile; Puttkammer, Nancy; Gloyd, Stephen; Robinson, Julia; Yuhas, Krista; Domercant, Jean Wysler; Honoré, Jean Guy; Francois, Kesner

    2018-01-01

    Describing factors related to high attrition is important in order to improve the implementation of the Option B+ strategy in Haiti. We conducted a retrospective cohort study to describe the variability of antiretroviral therapy (ART) retention across health facilities among pregnant and lactating women and assess for differences in ART retention between Option B+ clients and other ART patients. There were 1989 Option B+ clients who initiated ART in 45 health facilities. The percentage of attrition varied from 9% to 81% across the facilities. The largest health facilities had 38% higher risk of attrition (relative risk [RR]: 1.38, 95% confidence interval [CI]: 1.08-1.77, P = .009). Private institutions had 18% less risk of attrition (RR: 0.82, 95% CI: 0.70-0.96, P = .020). Health facilities located in the West department and the South region had lower risk of attrition. Being on treatment in a large or public health facility or a facility located in the North region was a significant risk factor associated with high attrition among Option B+ clients. The implementation of the Option B+ strategy must be reevaluated in order to effectively eliminate mother-to-child HIV transmission.

  19. High Energy Solid State Laser Research Facility

    Data.gov (United States)

    Federal Laboratory Consortium — A suite of laboratories with advanced spectroscopic and laser equipment, this facility develops materials and techniques for advanced solid state high energy lasers....

  20. Gingin High Optical Power Test Facility

    International Nuclear Information System (INIS)

    Zhao, C; Blair, D G; Barrigo, P

    2006-01-01

    The Australian Consortium for Gravitational Wave Astronomy (ACIGA) in collaboration with LIGO is developing a high optical power research facility at the AIGO site, Gingin, Western Australia. Research at the facility will provide solutions to the problems that advanced gravitational wave detectors will encounter with extremely high optical power. The problems include thermal lensing and parametric instabilities. This article will present the status of the facility and the plan for the future experiments

  1. Legionnaires' Disease: a Problem for Health Care Facilities

    Science.gov (United States)

    ... Clips Legionnaires’ Disease A problem for health care facilities Language: English (US) Español (Spanish) Recommend on Facebook ... drinking. Many people being treated at health care facilities, including long-term care facilities and hospitals, have ...

  2. Decommissioning high-level waste surface facilities

    International Nuclear Information System (INIS)

    1978-04-01

    The protective storage, entombment and dismantlement options of decommissioning a High-Level Waste Surface Facility (HLWSF) was investigated. A reference conceptual design for the facility was developed based on the designs of similar facilities. State-of-the-art decommissioning technologies were identified. Program plans and cost estimates for decommissioning the reference conceptual designs were developed. Good engineering design concepts were on the basis of this work identified

  3. Health at risk in immigration detention facilities

    Directory of Open Access Journals (Sweden)

    Ioanna Kotsioni

    2013-09-01

    Full Text Available Since 2004 Médecins Sans Frontières (MSF has provided medical and psychosocial support for asylum seekers and migrants held in different immigration detention facilities across Europe (in Greece, Malta, Italy and Belgium where the life, health and human dignity of vulnerable people are being put at risk.

  4. 8. High power laser and ignition facilities

    International Nuclear Information System (INIS)

    Bayramian, A.J.; Beach, R.J.; Bibeau, C.

    2002-01-01

    This document gives a review of the various high power laser projects and ignition facilities in the world: the Mercury laser system and Electra (Usa), the krypton fluoride (KrF) laser and the HALNA (high average power laser for nuclear-fusion application) project (Japan), the Shenguang series, the Xingguang facility and the TIL (technical integration line) facility (China), the Vulcan peta-watt interaction facility (UK), the Megajoule project and its feasibility phase: the LIL (laser integration line) facility (France), the Asterix IV/PALS high power laser facility (Czech Republic), and the Phelix project (Germany). In Japan the 100 TW Petawatt Module Laser, constructed in 1997, is being upgraded to the world biggest peta-watt laser. Experiments have been performed with single-pulse large aperture e-beam-pumped Garpun (Russia) and with high-current-density El-1 KrF laser installation (Russia) to investigate Al-Be foil transmittance and stability to multiple e-beam irradiations. An article is dedicated to a comparison of debris shield impacts for 2 experiments at NIF (national ignition facility). (A.C.)

  5. A Pilot Health Information Technology-Based Effort to Increase the Quality of Transitions From Skilled Nursing Facility to Home: Compelling Evidence of High Rate of Adverse Outcomes.

    Science.gov (United States)

    Donovan, Jennifer L; Kanaan, Abir O; Gurwitz, Jerry H; Tjia, Jennifer; Cutrona, Sarah L; Garber, Lawrence; Preusse, Peggy; Field, Terry S

    2016-04-01

    Older adults are often transferred from hospitals to skilled nursing facilities (SNFs) for post-acute care. Patients may be at risk for adverse outcomes after SNF discharges, but little research has focused on this period. Assessment of the feasibility of a transitional care intervention based on a combination of manual information transmission and health information technology to provide automated alert messages to primary care physicians and staff; pre-post analysis to assess potential impact. A multispecialty group practice. Adults aged 65 and older, discharged from SNFs to home; comparison group drawn from SNF discharges during the previous 1.5 years, matched on facility, patient age, and sex. For the pre-post analysis, we tracked rehospitalization within 30 days after discharge and adverse drug events within 45 days. The intervention was developed and implemented with manual transmission of information between 8 SNFs and the group practice followed by entry into the electronic health record. The process required a 5-day delay during which a large portion of the adverse events occurred. Over a 1-year period, automated alert messages were delivered to physicians and staff for the 313 eligible patients discharged from the 8 SNFs to home. We compared outcomes to those of individually matched discharges from the previous 1.5 years and found similar percentages with 30-day rehospitalizations (31% vs 30%, adjusted HR 1.06, 95% CI 0.80-1.4). Within the adverse drug event (ADE) study, 30% of the discharges during the intervention period and 30% of matched discharges had ADEs within 45 days. Older adults discharged from SNFs are at high risk of adverse outcomes immediately following discharge. Simply providing alerts to outpatient physicians, especially if delivered multiple days after discharge, is unlikely to have any impact on reducing these rates. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All

  6. Health seeking behaviour and challenges in utilising health facilities in Wakiso district, Uganda.

    Science.gov (United States)

    Musoke, David; Boynton, Petra; Butler, Ceri; Musoke, Miph Boses

    2014-12-01

    The health seeking behaviour of a community determines how they use health services. Utilisation of health facilities can be influenced by the cost of services, distance to health facilities, cultural beliefs, level of education and health facility inadequacies such as stock-out of drugs. To assess the health seeking practices and challenges in utilising health facilities in a rural community in Wakiso district, Uganda. The study was a cross sectional survey that used a structured questionnaire to collect quantitative data among 234 participants. The sample size was obtained using the formula by Leslie Kish. While 89% of the participants were aware that mobile clinics existed in their community, only 28% had received such services in the past month. The majority of participants (84%) did not know whether community health workers existed in their community. The participants' health seeking behaviour the last time they were sick was associated with age (p = 0.028) and occupation (p = 0.009). The most significant challenges in utilising health services were regular stock-out of drugs, high cost of services and long distance to health facilities. There is potential to increase access to health care in rural areas by increasing the frequency of mobile clinic services and strengthening the community health worker strategy.

  7. Sultan - forced flow, high field test facility

    International Nuclear Information System (INIS)

    Horvath, I.; Vecsey, G.; Weymuth, P.; Zellweger, J.

    1981-01-01

    Three European laboratories: CNEN (Frascati, I) ECN (Petten, NL) and SIN (Villigen, CH) decided to coordinate their development efforts and to install a common high field forced flow test facility at Villigen Switzerland. The test facility SULTAN (Supraleiter Testanlage) is presently under construction. As a first step, an 8T/1m bore solenoid with cryogenic periphery will be ready in 1981. The cryogenic system, data acquisition system and power supplies which are contributed by SIN are described. Experimental feasibilities, including cooling, and instrumentation are reviewed. Progress of components and facility construction is described. Planned extension of the background field up to 12T by insert coils is outlined. 5 refs

  8. High-capacity neutron activation analysis facility

    International Nuclear Information System (INIS)

    Hochel, R.C.

    1979-01-01

    A high-capacity neutron activation analysis facility, the Reactor Activation Facility, was designed and built and has been in operation for about a year at one of the Savannah River Plant's production reactors. The facility determines uranium and about 19 other trace elements in hydrogeochemical samples collected in the National Uranium Resource Evaluation program. The facility has a demonstrated average analysis rate of over 10,000 samples per month, and a peak rate of over 16,000 samples per month. Uranium is determined by cyclic activation and delayed neutron counting of the U-235 fission products; other elements are determined from gamma-ray spectra recorded in subsequent irradiation, decay, and counting steps. The method relies on the absolute activation technique and is highly automated for round-the-clock unattended operation

  9. High-capacity neutron activation analysis facility

    International Nuclear Information System (INIS)

    Hochel, R.C.; Bowman, W.W.; Zeh, C.W.

    1980-01-01

    A high-capacity neutron activation analysis facility, the Reactor Activation Facility, was designed and built and has been in operation for about a year at one of the Savannah River Plant's production reactors. The facility determines uranium and about 19 other elements in hydrogeochemical samples collected in the National Uranium Resource Evaluation program, which is sponsored and funded by the United States Department of Energy, Grand Junction Office. The facility has a demonstrated average analysis rate of over 10,000 samples per month, and a peak rate of over 16,000 samples per month. Uranium is determined by cyclic activation and delayed neutron counting of the U-235 fission products; other elements are determined from gamma-ray spectra recorded in subsequent irradiation, decay, and counting steps. The method relies on the absolute activation technique and is highly automated for round-the-clock unattended operation

  10. High prevalence of cesarean section births in private sector health facilities- analysis of district level household survey-4 (DLHS-4) of India.

    Science.gov (United States)

    Singh, Priyanka; Hashmi, Gulfam; Swain, Prafulla Kumar

    2018-05-10

    Worldwide rising cesarean section (CS) births is an issue of concern. In India, with increase in institutional deliveries there has also been an increase in cesarean section births. Aim of the study is to quantify the prevalence of cesarean section births in public and private health facility, and also to determine the factors associated with cesarean section births. We analyzed data from district level household survey data 4 (DLHS-4) combined individual level dataset for 19 states/UTs of India comprising 24,398 deliveries resulting in 22,111 live births for year 2011. The percentages and Chi-square has been computed for the select variables viz. Socio demographic, maternal, antenatal care and delivery related based on type of births (CS Vs normal births). The multiple logistic regression model has been used to identify the potential risk factors associated with CS births. Of 22,111 live birth analyzed 49.2% were delivered at public sector, 31.9% at private sector and 18.9% were home deliveries. Prevalence of CS births were 13.7% (95% CI; 13.0- 14.3%) and 37.9% (95% CI; 36.7- 39.0%) in the public and private sectors, respectively. Higher odds of CS births were observed with- delivery at private health facility (OR 3.79; 95% C.I 3.06-4.72), urban residence (OR 1.15; 95% C.I 1.00- 1.35), first delivery after 35 years of maternal age (OR 5.5; 95% C.I 1.85- 16.4), hypertension in pregnancy (OR 1.32; 95% C.I 1.06- 1.65) and breach presentation (OR 2.37; 95% C.I. 1.63- 3.43). Our findings shows that CS births are nearly three times more in private as compared to public sector health facilities.The higher rates of CS births, especially in private sector, not only increase the cost of care but may pose unnecessary risks to women (when there is no indications for CS). The government of India need to take measures to strengthen existing public health facilities as well as ensure that cesarean sections are performed based upon medical indications in both public and private

  11. Geographic access to care is not a determinant of child mortality in a rural Kenyan setting with high health facility density

    Directory of Open Access Journals (Sweden)

    Williams Thomas N

    2010-03-01

    Full Text Available Abstract Background Policy-makers evaluating country progress towards the Millennium Development Goals also examine trends in health inequities. Distance to health facilities is a known determinant of health care utilization and may drive inequalities in health outcomes; we aimed to investigate its effects on childhood mortality. Methods The Epidemiological and Demographic Surveillance System in Kilifi District, Kenya, collects data on vital events and migrations in a population of 220,000 people. We used Geographic Information Systems to estimate pedestrian and vehicular travel times to hospitals and vaccine clinics and developed proportional-hazards models to evaluate the effects of travel time on mortality hazard in children less than 5 years of age, accounting for sex, ethnic group, maternal education, migrant status, rainfall and calendar time. Results In 2004-6, under-5 and under-1 mortality ratios were 65 and 46 per 1,000 live-births, respectively. Median pedestrian and vehicular travel times to hospital were 193 min (inter-quartile range: 125-267 and 49 min (32-72; analogous values for vaccine clinics were 47 (25-73 and 26 min (13-40. Infant and under-5 mortality varied two-fold across geographic locations, ranging from 34.5 to 61.9 per 1000 child-years and 8.8 to 18.1 per 1000, respectively. However, distance to health facilities was not associated with mortality. Hazard Ratios (HR were 0.99 (95% CI 0.95-1.04 per hour and 1.01 (95% CI 0.95-1.08 per half-hour of pedestrian and vehicular travel to hospital, respectively, and 1.00 (95% CI 0.99-1.04 and 0.97 (95% CI 0.92-1.05 per quarter-hour of pedestrian and vehicular travel to vaccine clinics in children Conclusions Significant spatial variations in mortality were observed across the area, but were not correlated with distance to health facilities. We conclude that given the present density of health facilities in Kenya, geographic access to curative services does not influence

  12. Effectiveness of counseling at primary health facilities: Level of ...

    African Journals Online (AJOL)

    Effectiveness of counseling at primary health facilities: Level of knowledge of antenatal attendee and their ... Objectives: To determine the effectiveness of counseling on HIV done in primary health facilities ... AJOL African Journals Online.

  13. MAPPING OF HEALTH FACILITIES IN JIMETA METROPOLIS: A ...

    African Journals Online (AJOL)

    PROF EKWUEME

    one of the major problems hindering the proper planning and monitoring of the various health facilities ... A digital map, showing the spatial distribution of health facilities in Jimeta metropolis .... mapping process to quicken map production.

  14. High temperature high vacuum creep testing facilities

    International Nuclear Information System (INIS)

    Matta, M.K.

    1985-01-01

    Creep is the term used to describe time-dependent plastic flow of metals under conditions of constant load or stress at constant high temperature. Creep has an important considerations for materials operating under stresses at high temperatures for long time such as cladding materials, pressure vessels, steam turbines, boilers,...etc. These two creep machines measures the creep of materials and alloys at high temperature under high vacuum at constant stress. By the two chart recorders attached to the system one could register time and temperature versus strain during the test . This report consists of three chapters, chapter I is the introduction, chapter II is the technical description of the creep machines while chapter III discuss some experimental data on the creep behaviour. Of helium implanted stainless steel. 13 fig., 3 tab

  15. High intensity neutrino oscillation facilities in Europe

    Directory of Open Access Journals (Sweden)

    T. R. Edgecock

    2013-02-01

    Full Text Available The EUROnu project has studied three possible options for future, high intensity neutrino oscillation facilities in Europe. The first is a Super Beam, in which the neutrinos come from the decay of pions created by bombarding targets with a 4 MW proton beam from the CERN High Power Superconducting Proton Linac. The far detector for this facility is the 500 kt MEMPHYS water Cherenkov, located in the Fréjus tunnel. The second facility is the Neutrino Factory, in which the neutrinos come from the decay of μ^{+} and μ^{-} beams in a storage ring. The far detector in this case is a 100 kt magnetized iron neutrino detector at a baseline of 2000 km. The third option is a Beta Beam, in which the neutrinos come from the decay of beta emitting isotopes, in particular ^{6}He and ^{18}Ne, also stored in a ring. The far detector is also the MEMPHYS detector in the Fréjus tunnel. EUROnu has undertaken conceptual designs of these facilities and studied the performance of the detectors. Based on this, it has determined the physics reach of each facility, in particular for the measurement of CP violation in the lepton sector, and estimated the cost of construction. These have demonstrated that the best facility to build is the Neutrino Factory. However, if a powerful proton driver is constructed for another purpose or if the MEMPHYS detector is built for astroparticle physics, the Super Beam also becomes very attractive.

  16. High intensity neutrino oscillation facilities in Europe

    CERN Document Server

    Edgecock, T.R.; Davenne, T.; Densham, C.; Fitton, M.; Kelliher, D.; Loveridge, P.; Machida, S.; Prior, C.; Rogers, C.; Rooney, M.; Thomason, J.; Wilcox, D.; Wildner, E.; Efthymiopoulos, I.; Garoby, R.; Gilardoni, S.; Hansen, C.; Benedetto, E.; Jensen, E.; Kosmicki, A.; Martini, M.; Osborne, J.; Prior, G.; Stora, T.; Melo-Mendonca, T.; Vlachoudis, V.; Waaijer, C.; Cupial, P.; Chancé, A.; Longhin, A.; Payet, J.; Zito, M.; Baussan, E.; Bobeth, C.; Bouquerel, E.; Dracos, M.; Gaudiot, G.; Lepers, B.; Osswald, F.; Poussot, P.; Vassilopoulos, N.; Wurtz, J.; Zeter, V.; Bielski, J.; Kozien, M.; Lacny, L.; Skoczen, B.; Szybinski, B.; Ustrzycka, A.; Wroblewski, A.; Marie-Jeanne, M.; Balint, P.; Fourel, C.; Giraud, J.; Jacob, J.; Lamy, T.; Latrasse, L.; Sortais, P.; Thuillier, T.; Mitrofanov, S.; Loiselet, M.; Keutgen, Th.; Delbar, Th.; Debray, F.; Trophine, C.; Veys, S.; Daversin, C.; Zorin, V.; Izotov, I.; Skalyga, V.; Burt, G.; Dexter, A.C.; Kravchuk, V.L.; Marchi, T.; Cinausero, M.; Gramegna, F.; De Angelis, G.; Prete, G.; Collazuol, G.; Laveder, M.; Mazzocco, M.; Mezzetto, M.; Signorini, C.; Vardaci, E.; Di Nitto, A.; Brondi, A.; La Rana, G.; Migliozzi, P.; Moro, R.; Palladino, V.; Gelli, N.; Berkovits, D.; Hass, M.; Hirsh, T.Y.; Schaumann, M.; Stahl, A.; Wehner, J.; Bross, A.; Kopp, J.; Neuffer, D.; Wands, R.; Bayes, R.; Laing, A.; Soler, P.; Agarwalla, S.K.; Cervera Villanueva, A.; Donini, A.; Ghosh, T.; Gómez Cadenas, J.J.; Hernández, P.; Martín-Albo, J.; Mena, O.; Burguet-Castell, J.; Agostino, L.; Buizza-Avanzini, M.; Marafini, M.; Patzak, T.; Tonazzo, A.; Duchesneau, D.; Mosca, L.; Bogomilov, M.; Karadzhov, Y.; Matev, R.; Tsenov, R.; Akhmedov, E.; Blennow, M.; Lindner, M.; Schwetz, T.; Fernández Martinez, E.; Maltoni, M.; Menéndez, J.; Giunti, C.; González García, M. C.; Salvado, J.; Coloma, P.; Huber, P.; Li, T.; López-Pavón, J.; Orme, C.; Pascoli, S.; Meloni, D.; Tang, J.; Winter, W.; Ohlsson, T.; Zhang, H.; Scotto-Lavina, L.; Terranova, F.; Bonesini, M.; Tortora, L.; Alekou, A.; Aslaninejad, M.; Bontoiu, C.; Kurup, A.; Jenner, L.J.; Long, K.; Pasternak, J.; Pozimski, J.; Back, J.J.; Harrison, P.; Beard, K.; Bogacz, A.; Berg, J.S.; Stratakis, D.; Witte, H.; Snopok, P.; Bliss, N.; Cordwell, M.; Moss, A.; Pattalwar, S.; Apollonio, M.

    2013-02-20

    The EUROnu project has studied three possible options for future, high intensity neutrino oscillation facilities in Europe. The first is a Super Beam, in which the neutrinos come from the decay of pions created by bombarding targets with a 4 MW proton beam from the CERN High Power Superconducting Proton Linac. The far detector for this facility is the 500 kt MEMPHYS water Cherenkov, located in the Fr\\'ejus tunnel. The second facility is the Neutrino Factory, in which the neutrinos come from the decay of {\\mu}+ and {\\mu}- beams in a storage ring. The far detector in this case is a 100 kt Magnetised Iron Neutrino Detector at a baseline of 2000 km. The third option is a Beta Beam, in which the neutrinos come from the decay of beta emitting isotopes, in particular 6He and 18Ne, also stored in a ring. The far detector is also the MEMPHYS detector in the Fr\\'ejus tunnel. EUROnu has undertaken conceptual designs of these facilities and studied the performance of the detectors. Based on this, it has determined the ph...

  17. Designing of High-Volume PET/CT Facility with Optimal Reduction of Radiation Exposure to the Staff: Implementation and Optimization in a Tertiary Health Care Facility in India

    International Nuclear Information System (INIS)

    Jha, Ashish Kumar; Singh, Abhijith Mohan; Mithun, Sneha; Shah, Sneha; Agrawal, Archi; Purandare, Nilendu C.; Shetye, Bhakti; Rangarajan, Venkatesh

    2015-01-01

    Positron emission tomography (PET) has been in use for a few decades but with its fusion with computed tomography (CT) in 2001, the new PET/CT integrated system has become very popular and is now a key influential modality for patient management in oncology. However, along with its growing popularity, a growing concern of radiation safety among the radiation professionals has become evident. We have judiciously developed a PET/CT facility with optimal shielding, along with an efficient workflow to perform high volume procedures and minimize the radiation exposure to the staff and the general public by reducing unnecessary patient proximity to the staff and general public

  18. High-risk facilities. Emergency management in nuclear, chemical and hazardous waste facilities

    International Nuclear Information System (INIS)

    Kloepfer, Michael

    2012-01-01

    The book on emergency management in high-risk facilities covers the following topics: Change in the nuclear policy, risk management of high-risk facilities as a constitutional problem - emergency management in nuclear facilities, operational mechanisms of risk control in nuclear facilities, regulatory surveillance responsibilities for nuclear facilities, operational mechanism of the risk control in chemical plants, regulatory surveillance responsibilities for chemical facilities, operational mechanisms of the risk control in hazardous waste facilities, regulatory surveillance responsibilities for hazardous waste facilities, civil law consequences in case of accidents in high-risk facilities, criminal prosecution in case of accidents in high-risk facilities, safety margins as site risk for emission protection facilities, national emergency management - strategic emergency management structures, warning and self-protection of the public in case of CBRN hazards including aspects of the psych-social emergency management.

  19. ACIGA's high optical power test facility

    International Nuclear Information System (INIS)

    Ju, L; Aoun, M; Barriga, P

    2004-01-01

    Advanced laser interferometer detectors utilizing more than 100 W of laser power and with ∼10 6 W circulating laser power present many technological problems. The Australian Consortium for Interferometric Gravitational Astronomy (ACIGA) is developing a high power research facility in Gingin, north of Perth, Western Australia, which will test techniques for the next generation interferometers. In particular it will test thermal lensing compensation and control strategies for optical cavities in which optical spring effects and parametric instabilities may present major difficulties

  20. Distribution and Utilization of Health Facilities in Calabar Metropolis ...

    African Journals Online (AJOL)

    The level of accessibility increases with increasing utilization. Distance was a barrier to the utilization of health facilities due to the uneven distribution of health facilities and the inability of patients to overcome economic distance. Greater investment by government in the health sector would guarantee more equitable access ...

  1. Elimination of mercury in health care facilities.

    Science.gov (United States)

    2000-03-01

    Mercury is a persistent, bioaccumulative toxin that has been linked to numerous health effects in humans and wildlife. It is a potent neurotoxin that may also harm the brain, kidneys, and lungs. Unborn children and young infants are at particular risk for brain damage from mercury exposure. Hospitals' use of mercury in chemical solutions, thermometers, blood pressure gauges, batteries, and fluorescent lamps makes these facilities large contributors to the overall emission of mercury into the environment. Most hospitals recognize the dangers of mercury. In a recent survey, four out of five hospitals stated that they have policies in place to eliminate the use of mercury-containing products. Sixty-two percent of them require vendors to disclose the presence of mercury in chemicals that the hospitals purchase. Only 12 percent distribute mercury-containing thermometers to new parents. Ninety-two percent teach their employees about the health and environmental effects of mercury, and 46 percent teach all employees how to clean up mercury spills. However, the same study showed that many hospitals have not implemented their policies. Forty-two percent were not aware whether they still purchased items containing mercury. In addition, 49 percent still purchase mercury thermometers, 44 percent purchase mercury gastrointestinal diagnostic equipment, and 64 percent still purchase mercury lab thermometers.

  2. Versatile high current metal ion implantation facility

    International Nuclear Information System (INIS)

    Brown, I.G.; Dickinson, M.R.; Galvin, J.E.; Godechot, X.; MacGill, R.A.

    1992-01-01

    A metal ion implantation facility has been developed with which high current beams of practically all the solid metals of the periodic table can be produced. A multicathode, broad-beam, metal vapor vacuum arc ion source is used to produce repetitively pulsed metal ion beams at an extraction voltage of up to 100 kV, corresponding to an ion energy of up to several hundred kiloelectronvolts because of the ion charge state multiplicity, and with a beam current of up to several amps peak pulsed and several tens of milliamps time averaged delivered onto a downstream target. Implantation is done in a broad-beam mode, with a direct line of sight from ion source to target. Here we summarize some of the features of the ion source and the implantation facility that has been built up around it. (orig)

  3. Rapid assessment of infrastructure of primary health care facilities - a relevant instrument for health care systems management.

    Science.gov (United States)

    Scholz, Stefan; Ngoli, Baltazar; Flessa, Steffen

    2015-05-01

    Health care infrastructure constitutes a major component of the structural quality of a health system. Infrastructural deficiencies of health services are reported in literature and research. A number of instruments exist for the assessment of infrastructure. However, no easy-to-use instruments to assess health facility infrastructure in developing countries are available. Present tools are not applicable for a rapid assessment by health facility staff. Therefore, health information systems lack data on facility infrastructure. A rapid assessment tool for the infrastructure of primary health care facilities was developed by the authors and pilot-tested in Tanzania. The tool measures the quality of all infrastructural components comprehensively and with high standardization. Ratings use a 2-1-0 scheme which is frequently used in Tanzanian health care services. Infrastructural indicators and indices are obtained from the assessment and serve for reporting and tracing of interventions. The tool was pilot-tested in Tanga Region (Tanzania). The pilot test covered seven primary care facilities in the range between dispensary and district hospital. The assessment encompassed the facilities as entities as well as 42 facility buildings and 80 pieces of technical medical equipment. A full assessment of facility infrastructure was undertaken by health care professionals while the rapid assessment was performed by facility staff. Serious infrastructural deficiencies were revealed. The rapid assessment tool proved a reliable instrument of routine data collection by health facility staff. The authors recommend integrating the rapid assessment tool in the health information systems of developing countries. Health authorities in a decentralized health system are thus enabled to detect infrastructural deficiencies and trace the effects of interventions. The tool can lay the data foundation for district facility infrastructure management.

  4. Integrated approach to oral health in aged care facilities using oral health practitioners and teledentistry in rural Queensland.

    Science.gov (United States)

    Tynan, Anna; Deeth, Lisa; McKenzie, Debra; Bourke, Carolyn; Stenhouse, Shayne; Pitt, Jacinta; Linneman, Helen

    2018-04-16

    Residents of residential aged care facilities are at very high risk of developing complex oral diseases and dental problems. Key barriers exist in delivering oral health services to residential aged care facilities, particularly in regional and rural areas. A quality improvement study incorporating pre- and post chart audits and pre- and post consultation with key stakeholders, including staff and residents, expert opinion on cost estimates and field notes were used. One regional and three rural residential aged care facilities situated in a non-metropolitan hospital and health service in Queensland. Number of appointments avoided at an oral health facility Feedback on program experience by staff and residents Compliance with oral health care plan implementation Observations of costs involved to deliver new service. The model developed incorporated a visit by an oral health therapist for screening, education, simple intervention and referral for a teledentistry session if required. Results showed an improvement in implementation of oral health care plans and a minimisation of need for residents to attend an oral health care facility. Potential financial and social cost savings for residents and the facilities were also noted. Screening via the oral health therapist and teledentistry appointment minimises the need for a visit to an oral health facility and subsequent disruption to residents in residential aged care facilities. © 2018 National Rural Health Alliance Ltd.

  5. High temperature aircraft research furnace facilities

    Science.gov (United States)

    Smith, James E., Jr.; Cashon, John L.

    1992-01-01

    Focus is on the design, fabrication, and development of the High Temperature Aircraft Research Furnace Facilities (HTARFF). The HTARFF was developed to process electrically conductive materials with high melting points in a low gravity environment. The basic principle of operation is to accurately translate a high temperature arc-plasma gas front as it orbits around a cylindrical sample, thereby making it possible to precisely traverse the entire surface of a sample. The furnace utilizes the gas-tungsten-arc-welding (GTAW) process, also commonly referred to as Tungsten-Inert-Gas (TIG). The HTARFF was developed to further research efforts in the areas of directional solidification, float-zone processing, welding in a low-gravity environment, and segregation effects in metals. The furnace is intended for use aboard the NASA-JSC Reduced Gravity Program KC-135A Aircraft.

  6. A spatial national health facility database for public health sector planning in Kenya in 2008

    Directory of Open Access Journals (Sweden)

    Gething Peter W

    2009-03-01

    Full Text Available Abstract Background Efforts to tackle the enormous burden of ill-health in low-income countries are hampered by weak health information infrastructures that do not support appropriate planning and resource allocation. For health information systems to function well, a reliable inventory of health service providers is critical. The spatial referencing of service providers to allow their representation in a geographic information system is vital if the full planning potential of such data is to be realized. Methods A disparate series of contemporary lists of health service providers were used to update a public health facility database of Kenya last compiled in 2003. These new lists were derived primarily through the national distribution of antimalarial and antiretroviral commodities since 2006. A combination of methods, including global positioning systems, was used to map service providers. These spatially-referenced data were combined with high-resolution population maps to analyze disparity in geographic access to public health care. Findings The updated 2008 database contained 5,334 public health facilities (67% ministry of health; 28% mission and nongovernmental organizations; 2% local authorities; and 3% employers and other ministries. This represented an overall increase of 1,862 facilities compared to 2003. Most of the additional facilities belonged to the ministry of health (79% and the majority were dispensaries (91%. 93% of the health facilities were spatially referenced, 38% using global positioning systems compared to 21% in 2003. 89% of the population was within 5 km Euclidean distance to a public health facility in 2008 compared to 71% in 2003. Over 80% of the population outside 5 km of public health service providers was in the sparsely settled pastoralist areas of the country. Conclusion We have shown that, with concerted effort, a relatively complete inventory of mapped health services is possible with enormous potential for

  7. A spatial national health facility database for public health sector planning in Kenya in 2008.

    Science.gov (United States)

    Noor, Abdisalan M; Alegana, Victor A; Gething, Peter W; Snow, Robert W

    2009-03-06

    Efforts to tackle the enormous burden of ill-health in low-income countries are hampered by weak health information infrastructures that do not support appropriate planning and resource allocation. For health information systems to function well, a reliable inventory of health service providers is critical. The spatial referencing of service providers to allow their representation in a geographic information system is vital if the full planning potential of such data is to be realized. A disparate series of contemporary lists of health service providers were used to update a public health facility database of Kenya last compiled in 2003. These new lists were derived primarily through the national distribution of antimalarial and antiretroviral commodities since 2006. A combination of methods, including global positioning systems, was used to map service providers. These spatially-referenced data were combined with high-resolution population maps to analyze disparity in geographic access to public health care. The updated 2008 database contained 5,334 public health facilities (67% ministry of health; 28% mission and nongovernmental organizations; 2% local authorities; and 3% employers and other ministries). This represented an overall increase of 1,862 facilities compared to 2003. Most of the additional facilities belonged to the ministry of health (79%) and the majority were dispensaries (91%). 93% of the health facilities were spatially referenced, 38% using global positioning systems compared to 21% in 2003. 89% of the population was within 5 km Euclidean distance to a public health facility in 2008 compared to 71% in 2003. Over 80% of the population outside 5 km of public health service providers was in the sparsely settled pastoralist areas of the country. We have shown that, with concerted effort, a relatively complete inventory of mapped health services is possible with enormous potential for improving planning. Expansion in public health care in Kenya has

  8. Laser safety at high profile laser facilities

    International Nuclear Information System (INIS)

    Barat, K.

    2010-01-01

    Complete text of publication follows. Laser safety has been an active concern of laser users since the invention of the laser. Formal standards were developed in the early 1970's and still continue to be developed and refined. The goal of these standards is to give users guidance on the use of laser and consistent safety guidance and requirements for laser manufacturers. Laser safety in the typical research setting (government laboratory or university) is the greatest challenge to the laser user and laser safety officer. This is due to two factors. First, the very nature of research can put the user at risk; consider active manipulation of laser optics and beam paths, and user work with energized systems. Second, a laser safety culture that seems to accept laser injuries as part of the graduate student educational process. The fact is, laser safety at research settings, laboratories and universities still has long way to go. Major laser facilities have taken a more rigid and serious view of laser safety, its controls and procedures. Part of the rationale for this is that these facilities draw users from all around the world presenting the facility with a work force of users coming from a wide mix of laser safety cultures. Another factor is funding sources do not like bad publicity which can come from laser accidents and a poor safety record. The fact is that injuries, equipment damage and lost staff time slow down progress. Hence high profile/large laser projects need to adapt a higher safety regimen both from an engineering and administrative point of view. This presentation will discuss all these points and present examples. Acknowledgement. This work has been supported by the University of California, Director, Office of Science.

  9. Regulatory measures for occupational health monitoring in BARC facilities

    International Nuclear Information System (INIS)

    Rajdeep; Chattopadhyay, S.

    2017-01-01

    Bhabha Atomic Research Centre (BARC) is the premier organization actively engaged in the research and developmental activities related to nuclear science and technology for the benefit of society and the nation. BARC has various facilities like nuclear fuel fabrication facilities, research reactors, spent fuel storage facilities, nuclear fuel re-cycling facilities, radioactive waste management facilities, machining workshops and various Physics, Chemistry and Biological laboratories. In BARC, aspects related to Occupational Safety and Health (OSH) are given paramount importance. The issues related OSH are subjected to multi-tier review process. BARC Safety Council (BSC) is the apex committee in the three-tier safety and security review framework of BARC. BSC functions as regulatory body for BARC facilities. BSC is responsible for occupational safety and health of employees in BARC facilities

  10. Quality along the continuum: a health facility assessment of intrapartum and postnatal care in Ghana.

    Directory of Open Access Journals (Sweden)

    Robin C Nesbitt

    Full Text Available To evaluate quality of routine and emergency intrapartum and postnatal care using a health facility assessment, and to estimate "effective coverage" of skilled attendance in Brong Ahafo, Ghana.We conducted an assessment of all 86 health facilities in seven districts in Brong Ahafo. Using performance of key signal functions and the availability of relevant drugs, equipment and trained health professionals, we created composite quality categories in four dimensions: routine delivery care, emergency obstetric care (EmOC, emergency newborn care (EmNC and non-medical quality. Linking the health facility assessment to surveillance data we estimated "effective coverage" of skilled attendance as the proportion of births in facilities of high quality.Delivery care was offered in 64/86 facilities; only 3-13% fulfilled our requirements for the highest quality category in any dimension. Quality was lowest in the emergency care dimensions, with 63% and 58% of facilities categorized as "low" or "substandard" for EmOC and EmNC, respectively. This implies performing less than four EmOC or three EmNC signal functions, and/or employing less than two skilled health professionals, and/or that no health professionals were present during our visit. Routine delivery care was "low" or "substandard" in 39% of facilities, meaning 25/64 facilities performed less than six routine signal functions and/or had less than two skilled health professionals and/or less than one midwife. While 68% of births were in health facilities, only 18% were in facilities with "high" or "highest" quality in all dimensions.Our comprehensive facility assessment showed that quality of routine and emergency intrapartum and postnatal care was generally low in the study region. While coverage with facility delivery was 68%, we estimated "effective coverage" of skilled attendance at 18%, thus revealing a large "quality gap." Effective coverage could be a meaningful indicator of progress towards

  11. High resolution VUV facility at INDUS-1

    International Nuclear Information System (INIS)

    Krishnamurty, G.; Saraswathy, P.; Rao, P.M.R.; Mishra, A.P.; Kartha, V.B.

    1993-01-01

    Synchrotron radiation (SR) generated in the electron storage rings is an unique source for the study of atomic and molecular spectroscopy especially in the vacuum ultra violet region. Realizing the potential of this light source, efforts are in progress to develop a beamline facility at INDUS-1 to carry out high resolution atomic and molecular spectroscopy. This beam line consists of a fore-optic which is a combination of three cylindrical mirrors. The mirrors are so chosen that SR beam having a 60 mrad (horizontal) x 6 mrad (vertical) divergence is focussed onto a slit of a 6.65 metre off-plane spectrometer in Eagle Mount equipped with horizontal slit and vertical dispersion. The design of the various components of the beam line is completed. It is decided to build the spectrometer as per the requirements of the user community. Details of the various aspects of the beam line will be presented. (author). 3 figs

  12. A High Intensity Hadron Facility, AGS II

    International Nuclear Information System (INIS)

    Lee, Y.Y.; Lowenstein, D.I.

    1988-01-01

    We have present one of several possibilities for the evolution of the AGS complex into a high intensity hadron facility. One could consider other alternatives, such as using the AGS as the Collector and constructing a new 9-30 GeV machine. We believe the most responsible scenario must minimize the cost and downtime to the ongoing physics program. With a stepwise approach, starting with the Booster, the physics program can evolve without a single major commitment in funds. At each step an evaluation of the funds versus physics merit can be made. As a final aside, each upgrade at the AGS and Booster is presently being implemented to support an interleaved operation of both protons and ions. 1 fig., 6 tabs

  13. Experimental Facilities at the High Energy Frontier

    CERN Document Server

    Jenni, P.

    2016-01-01

    The main theme of the lectures covered the experimental work at hadron colliders, with a clear focus on the Large Hadron Collider (LHC) and on the roadmap that led finally to the discovery of the Higgs boson. The lectures were not a systematic course on machine and detector technologies, but rather tried to give a physics-motivated overview of many experimental aspects that were all relevant for making the discovery. The actual lectures covered a much broader scope than what is documented here in this write- up. The successful concepts for the experiments at the LHC have benefitted from the experience gained with previous generations of detectors at lower- energy machines. The lectures included also an outlook to the future experimental programme at the LHC, with its machine and experiments upgrades, as well as a short discussion of possible facilities at the high energy frontier beyond LHC.

  14. High-temperature helium-loop facility

    International Nuclear Information System (INIS)

    Tokarz, R.D.

    1981-09-01

    The high-temperature helium loop is a facility for materials testing in ultrapure helium gas at high temperatures. The closed loop system is capable of recirculating high-purity helium or helium with controlled impurities. The gas loop maximum operating conditions are as follows: 300 psi pressure, 500 lb/h flow rate, and 2100 0 F temperature. The two test sections can accept samples up to 3.5 in. diameter and 5 ft long. The gas loop is fully instrumented to continuously monitor all parameters of loop operation as well as helium impurities. The loop is fully automated to operate continuously and requires only a daily servicing by a qualified operator to replenish recorder charts and helium makeup gas. Because of its versatility and high degree of parameter control, the helium loop is applicable to many types of materials research. This report describes the test apparatus, operating parameters, peripheral systems, and instrumentation system. The experimental capabilities and test conand presents the results that have been obtained. The study has been conducted using a four-phase approach. The first phase develops the solution to the steady-state radon-diffusion equation in one-dimensieered barriers; disposal charge analysis; analysis of spent fuel policy implementation; spent f water. Field measurements and observations are reported for each site. Analytical data and field measurements are presented in tables and maps. Uranium concentrations in the sediments which were above detection limits ranged from 0.10 t 51.2 ppM. The mean of the logarithms of the uranium concentrations was 0.53. A group of high uranium concentrations occurs near the junctions of quadrangles AB, AC, BB, a 200 mK. In case 2), x-ray studies of isotopic phase separation in 3 He-- 4 He bcc solids were carried out by B. A. Fraass

  15. Health Care Facilities Resilient to Climate Change Impacts

    Directory of Open Access Journals (Sweden)

    Jaclyn Paterson

    2014-12-01

    Full Text Available Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator’s guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change.

  16. 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.

  17. 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

    , particularly hypertensive disease case management and syphilis detection and treatment. There was fairly good concordance between our estimates of high likelihood of appropriate care and DHS estimates of coverage for iron supplementation, IPTp, and tetanus toxoid vaccination. Linking household surveys to health facility assessments revealed marked gaps in population-level coverage of quality ANC interventions and underscored the need for a double-pronged approach to increase ANC utilization and improve the quality of ANC services.

  18. [Organization of workplace first aid in health care facilities].

    Science.gov (United States)

    Ciavarella, M; Sacco, A; Bosco, Maria Giuseppina; Chinni, V; De Santis, A; Pagnanelli, A

    2007-01-01

    Laws D.Lgs. 626/94 and D.I. 388/03 attach particular importance to the organization of first aid in the workplace. Like every other enterprise, also hospitals and health care facilities have the obligation, as foreseen by the relevant legislation, to organize and manage first aid in the workplace. To discuss the topic in the light of the guidelines contained in the literature. We used the references contained in the relevant literature and in the regulations concerning organization of first aid in health care facilities. The regulations require the general manager of health care facilities to organize the primary intervention in case of emergencies in all health care facilities (health care or administrative, territorial and hospitals). In health care facilities the particular occupational risks, the general access of the public and the presence of patients who are already assumed to have altered states of health, should be the reason for particular care in guaranteeing the best possible management of a health emergency in the shortest time possible.

  19. History of health studies around nuclear facilities: a methodologival consideration

    International Nuclear Information System (INIS)

    Tokuhata, G.K.; Smith, M.W.

    1981-01-01

    A brief historical review was made of low-level radiation studies for general populations living around nuclear facilities. In addition, technical and methodological problems were identified and discussed which often arise in all epidemiological studies designed to determine the possible health effects of low-level radiation released from nuclear facilities. Need for extremely large populations for prospective cancer studies was discussed, but accompanying ascertainment difficulties were also emphasized. More epidemiological studies are needed to provide adequate assessment of the potential health hazards of nuclear facilities

  20. prevalence and correlates of utilization of health facilities in ...

    African Journals Online (AJOL)

    Musumali

    2007-10-11

    Oct 11, 2007 ... of the expectant women did not deliver at a health facility ... health service utilization for childbirth such as education5-8, maternal age 3,6, parity6,8, economic status7, cultural factors and beliefs, lack of skilled staff at primary.

  1. 42 CFR 476.78 - Responsibilities of health care facilities.

    Science.gov (United States)

    2010-10-01

    ... SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) General Provisions... 42 Public Health 4 2010-10-01 2010-10-01 false Responsibilities of health care facilities. 476.78...

  2. 42 CFR 476.76 - Cooperation with health care facilities.

    Science.gov (United States)

    2010-10-01

    ... SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) General Provisions... 42 Public Health 4 2010-10-01 2010-10-01 false Cooperation with health care facilities. 476.76...

  3. The role of civil society in strengthening intercultural maternal health care in local health facilities: Puno, Peru

    Directory of Open Access Journals (Sweden)

    Jeannie Samuel

    2016-12-01

    Full Text Available Background and objective: Peru's Ministry of Health has made efforts to increase the cultural inclusiveness of maternal health services. In 2005, the Ministry adopted an intercultural birthing policy (IBP that authorizes and encourages the use of culturally acceptable birthing practices in government-run health facilities. However, studies suggest that indigenous women may receive inconsistent benefits from these kinds of policies. This article examines whether a grassroots accountability initiative based on citizen monitoring of local health facilities by indigenous women can help to promote the objectives of the IBP and improve intercultural maternal health care. Design: Findings are drawn from a larger qualitative research study completed in 2015 that included fieldwork done between 2010 and 2011. Semi-structured interviews were conducted with 23 women working as citizen monitors in local health facilities in Puno and 30 key informants, including frontline health workers, health officials, and civil society actors in Puno and Lima, and human rights lawyers from the Defensoría del Pueblo Office in Puno. Results: Monitors confirmed from their own personal experiences in the 1990s and early 2000s that respect for intercultural aspects of maternal health care, including traditional indigenous birthing practices, were not readily accepted in publicly funded health facilities. It was also common for indigenous women to face discrimination when seeking health service provided by the state. Although the government's adoption of the IBP in 2005 was a positive step, considerable efforts are still needed to ensure high-quality, culturally appropriate maternal health care is consistently available in local health facilities. Conclusions: Despite important progress in the past two decades, policies aimed at improving intercultural maternal health care are unevenly implemented in local health facilities. Civil society, in particular indigenous women

  4. The role of civil society in strengthening intercultural maternal health care in local health facilities: Puno, Peru

    Science.gov (United States)

    Samuel, Jeannie

    2016-01-01

    Background and objective Peru's Ministry of Health has made efforts to increase the cultural inclusiveness of maternal health services. In 2005, the Ministry adopted an intercultural birthing policy (IBP) that authorizes and encourages the use of culturally acceptable birthing practices in government-run health facilities. However, studies suggest that indigenous women may receive inconsistent benefits from these kinds of policies. This article examines whether a grassroots accountability initiative based on citizen monitoring of local health facilities by indigenous women can help to promote the objectives of the IBP and improve intercultural maternal health care. Design Findings are drawn from a larger qualitative research study completed in 2015 that included fieldwork done between 2010 and 2011. Semi-structured interviews were conducted with 23 women working as citizen monitors in local health facilities in Puno and 30 key informants, including frontline health workers, health officials, and civil society actors in Puno and Lima, and human rights lawyers from the Defensoría del Pueblo Office in Puno. Results Monitors confirmed from their own personal experiences in the 1990s and early 2000s that respect for intercultural aspects of maternal health care, including traditional indigenous birthing practices, were not readily accepted in publicly funded health facilities. It was also common for indigenous women to face discrimination when seeking health service provided by the state. Although the government's adoption of the IBP in 2005 was a positive step, considerable efforts are still needed to ensure high-quality, culturally appropriate maternal health care is consistently available in local health facilities. Conclusions Despite important progress in the past two decades, policies aimed at improving intercultural maternal health care are unevenly implemented in local health facilities. Civil society, in particular indigenous women themselves, can play an

  5. Guidelines for Management Information Systems in Canadian Health Care Facilities

    Science.gov (United States)

    Thompson, Larry E.

    1987-01-01

    The MIS Guidelines are a comprehensive set of standards for health care facilities for the recording of staffing, financial, workload, patient care and other management information. The Guidelines enable health care facilities to develop management information systems which identify resources, costs and products to more effectively forecast and control costs and utilize resources to their maximum potential as well as provide improved comparability of operations. The MIS Guidelines were produced by the Management Information Systems (MIS) Project, a cooperative effort of the federal and provincial governments, provincial hospital/health associations, under the authority of the Canadian Federal/Provincial Advisory Committee on Institutional and Medical Services. The Guidelines are currently being implemented on a “test” basis in ten health care facilities across Canada and portions integrated in government reporting as finalized.

  6. Sound & Vibration 20 Design Guidelines for Health Care Facilities

    CERN Document Server

    Tocci, Gregory; Cavanaugh, William

    2013-01-01

    Sound, vibration, noise and privacy have significant impacts on health and performance. As a result, they are recognized as essential components of effective health care environments. However, acoustics has only recently become a prominent consideration in the design, construction, and operation of healthcare facilities owing to the absence, prior to 2010, of clear and objective guidance based on research and best practices. Sound & Vibration 2.0 is the first publication to comprehensively address this need. Sound & Vibration 2.0 is the sole reference standard for acoustics in health care facilities and is recognized by: the 2010 FGI Guidelines for the Design and Construction of Health Care Facilities (used in 60 countries); the US Green Building Council’s LEED for Health Care (used in 87 countries); The Green Guide for Health Care V2.2; and the International Code Council (2011). Sound & Vibration 2.0 was commissioned by the Facility Guidelines Institute in 2005, written by the Health Care Acous...

  7. Computerized health physics record system at a Canadian fabrication facility

    International Nuclear Information System (INIS)

    Thind, K.S.

    1984-01-01

    This poster session will describe the types of Health Physics data input into a Hewlett-Packard 3000 computer. The Health Physics data base at this facility includes the following: employee hours data, airborne uranium concentrations, external dosemetry (badge readings), internal dosemetry (bioassay) and environmental health physics (stack sample results) data. It will describe the types of outputs achievable in the form of various reports, such as: individual employee health physics report for a given period, a general health physics summary report for a given period, individual urinalysis report, local air concentration report and graphs. The use of this computerized health physics record system in the overall radiation protection program at this facility is discussed

  8. Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria: Successes and Challenges.

    Science.gov (United States)

    Ugo, Okoli; Ezinne, Eze-Ajoku; Modupe, Oludipe; Nicole, Spieker; Winifred, Ekezie; Kelechi, Ohiri

    2016-01-01

    Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. A total of 6 states were selected across the 6 geopolitical zones of the country. However, assessments were carried out in 40 facilities in only 5 states. Selection was based on location, coverage, and minimum services offered. The facilities were divided randomly into 2 groups. The treatment group received quality-of-care assessment, continuous feedback, and improvement support, whereas the control group received quality assessment and no other support. Data were collected using the SafeCare Healthcare Standards and managed on the SafeCare Data Management System-AfriDB. Eight core areas were assessed at baseline and end line, and compliance to quality health-care standards was compared. Outcomes from 40 facilities were accepted and analyzed. Overall scores increased in the treatment facilities compared to the control facilities, with strong evidence of improvement ( t = 5.28, P = .0004) and 11% average improvement, but no clear pattern of improvement emerged in the control group. The study demonstrated governance support and active community involvement offered potential for quality improvement in primary health-care facilities.

  9. An outline of research facilities of high intensity proton accelerator

    International Nuclear Information System (INIS)

    Tanaka, Shun-ichi

    1995-01-01

    A plan called PROTON ENGINEERING CENTER has been proposed in JAERI. The center is a complex composed of research facilities and a beam shape and storage ring based on a proton linac with an energy of 1.5 GeV and an average current of 10 mA. The research facilities planned are OMEGA·Nuclear Energy Development Facility, Neutron Facility for Material Irradiation, Nuclear Data Experiment Facility, Neutron Factory, Meson Factory, spallation Radioisotope Beam Facility, and Medium Energy Experiment Facility, where high intensity proton beam and secondary particle beams such as neutrons, π-mesons, muons, and unstable isotopes originated from the protons are available for promoting the innovative research of nuclear energy and basic science and technology. (author)

  10. [Anesthesia practice in Catalan hospitals and other health care facilities].

    Science.gov (United States)

    Villalonga, Antonio; Sabaté, Sergi; Campos, Juan Manuel; Fornaguera, Joan; Hernández, Carmen; Sistac, José María

    2006-05-24

    The aim of this arm of the ANESCAT study was to characterize anesthesia practice in the various types of health care facilities of Catalonia, Spain, in 2003. We analyzed data from the survey according to a) source of a facility's funding: public hospitals financed by the Catalan Public Health Authority (ICS), the network of subsidized hospitals for public use (XHUP), or private hospitals; b) size: facilities without hospital beds, hospitals with fewer than 250 beds, those with 251 to 500, and those with over 500; and c) training accreditation status: whether or not a facility gave medical resident training. A total of 131 facilities participated (11 under the ICS, 47 from the XHUP, and 73 private hospitals). Twenty-six clinics had no hospital beds, 78 facilities had fewer than 250, 21 had 251 to 500, and 6 had more than 500. Seventeen hospitals trained medical residents. XHUP hospitals performed 44.3% of all anesthetic procedures, private hospitals 36.7%, and ICS facilities 18.5%. Five percent of procedures were performed in clinics without beds, 42.9% in facilities with fewer than 250 beds, 35% in hospitals with 251 to 500, and 17.1% in hospitals with over 500. Anesthetists in teaching hospitals performed 35.5% of all procedures. The mean age of patients was lower in private hospitals, facilities with fewer than 250 beds, and hospitals that did not train medical residents. The physical status of patients was worse in ICS hospitals, in facilities with over 500 beds, and in teaching hospitals. It was noteworthy that 25% of anesthetic procedures were performed on an emergency basis in XHUP and ICS hospitals, in facilities with more than 250 beds, and in teaching hospitals. Anesthesia for outpatient procedures accounted for 40% of the total in private hospitals and 31% of the practice in ICS and XHUP hospitals. The duration of anesthesia and postanesthetic recovery was longer in ICS hospitals, in facilities with over 500 beds, and in those with medical resident

  11. Video Surveillance in Mental Health Facilities: Is it Ethical?

    Science.gov (United States)

    Stolovy, Tali; Melamed, Yuval; Afek, Arnon

    2015-05-01

    Video surveillance is a tool for managing safety and security within public spaces. In mental health facilities, the major benefit of video surveillance is that it enables 24 hour monitoring of patients, which has the potential to reduce violent and aggressive behavior. The major disadvantage is that such observation is by nature intrusive. It diminishes privacy, a factor of huge importance for psychiatric inpatients. Thus, an ongoing debate has developed following the increasing use of cameras in this setting. This article presents the experience of a medium-large academic state hospital that uses video surveillance, and explores the various ethical and administrative aspects of video surveillance in mental health facilities.

  12. Occupational Safety Review of High Technology Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Lee Cadwallader

    2005-01-31

    This report contains reviews of operating experiences, selected accident events, and industrial safety performance indicators that document the performance of the major US DOE magnetic fusion experiments and particle accelerators. These data are useful to form a basis for the occupational safety level at matured research facilities with known sets of safety rules and regulations. Some of the issues discussed are radiation safety, electromagnetic energy exposure events, and some of the more widespread issues of working at height, equipment fires, confined space work, electrical work, and other industrial hazards. Nuclear power plant industrial safety data are also included for comparison.

  13. Design issues for a laboratory high gain fusion facility

    International Nuclear Information System (INIS)

    Hogan, W.J.

    1987-01-01

    In an inertial fusion laboratory high gain facility, experiments will be carried out with up to 1000 MJ of thermonuclear yield. The experiment area of such a facility will include many systems and structures that will have to operate successfully in the difficult environment created by the sudden large energy release. This paper estimates many of the nuclear effects that will occur, discusses the implied design issues and suggests possible solutions so that a useful experimental facility can be built. 4 figs

  14. An Application of Business Process Management to Health Care Facilities.

    Science.gov (United States)

    Hassan, Mohsen M D

    The purpose of this article is to help health care facility managers and personnel identify significant elements of their facilities to address, and steps and actions to follow, when applying business process management to them. The ABPMP (Association of Business Process Management Professionals) life-cycle model of business process management is adopted, and steps from Lean, business process reengineering, and Six Sigma, and actions from operations management are presented to implement it. Managers of health care facilities can find in business process management a more comprehensive approach to improving their facilities than Lean, Six Sigma, business process reengineering, and ad hoc approaches that does not conflict with them because many of their elements can be included under its umbrella. Furthermore, the suggested application of business process management can guide and relieve them from selecting among these approaches, as well as provide them with specific steps and actions that they can follow. This article fills a gap in the literature by presenting a much needed comprehensive application of business process management to health care facilities that has specific steps and actions for implementation.

  15. High energy laser facilities at Lawrence Livermore National Laboratory

    International Nuclear Information System (INIS)

    Holmes, N.C.

    1981-06-01

    High energy laser facilities at Lawrence Livermore National Laboratory are described, with special emphasis on their use for equation of state investigations using laser-generated shockwaves. Shock wave diagnostics now in use are described. Future Laboratory facilities are also discussed

  16. Prospects for high-power radioactive beam facilities worldwide

    CERN Document Server

    Nolen, Jerry A

    2003-01-01

    Advances in accelerators, targets, ion sources, and experimental instrumentation are making possible ever more powerful facilities for basic and applied research with short-lived radioactive isotopes. There are several current generation facilities, based on a variety of technologies, operating worldwide. These include, for example, those based on the in-flight method such as the recently upgraded National Superconducting Cyclotron Laboratory at Michigan State University, the facility at RIKEN in Japan, GANIL in Caen, France, and GSI in Darmstadt, Germany. Present facilities based on the Isotope-Separator On-Line method include, for example, the ISOLDE laboratory at CERN, HRIBF at Oak Ridge, and the new high-power facility ISAC at TRIUMF in Vancouver. Next-generation facilities include the Radioactive-Ion Factory upgrade of RIKEN to higher energy and intensity and the upgrade of ISAC to a higher energy secondary beam; both of these projects are in progress. A new project, LINAG, to upgrade the capabilities at...

  17. Mapping of health facilities in Jimeta Metropolis: a digital approach ...

    African Journals Online (AJOL)

    In planning for any suitable development in any field, the primary requirement is the relevant data and maps. This is one of the major problems hindering the proper planning and monitoring of the various health facilities located in Jimeta metropolis. Survey techniques -were employed for the acquisition of data, GPS was ...

  18. A spatial decision support system for special health facility location ...

    African Journals Online (AJOL)

    Access to healthcare is a determinant of the wellbeing of the people. Planning the location and distribution of health facilities to ensure efficiency and equity in the face of limited resources can be challenging, especially where the type of care requires expensive equipments and specialists. This study attempts to provide a ...

  19. Ectopic pregnancy experience in a tertiary health facility in South ...

    African Journals Online (AJOL)

    Background: Ectopic pregnancy is a life-threatening gynecological emergency, and a significant cause of maternal morbidity and mortality in Nigeria. Objective: To determine the incidence, clinical presentation, risk factors and management outcomes of ectopic pregnancies in a tertiary health facility. Methods: A retrospective ...

  20. Missed vaccination opportunities at a secondary health facility in ...

    African Journals Online (AJOL)

    The study aimed to identify missed vaccination visits and the associated factors in children presenting at the general out-patient clinic of a secondary health facility in Ilorin, Nigeria. Method: Through a descriptive cross-sectional study, the vaccination data of all children seen at the out-patient clinic were critically reviewed ...

  1. 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

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

    Science.gov (United States)

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

    2018-05-03

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

  3. Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study.

    Science.gov (United States)

    Muinga, Naomi; Magare, Steve; Monda, Jonathan; Kamau, Onesmus; Houston, Stuart; Fraser, Hamish; Powell, John; English, Mike; Paton, Chris

    2018-04-18

    complex mix of sociotechnical and administrative issues. Learning from these early challenges, the system is now being redesigned and prepared for deployment in 6 new counties across Kenya. Implementing electronic health record systems is a challenging process in high-income settings. In low-income settings, such as Kenya, open source software may offer some respite from the high costs of software licensing, but the familiar challenges of clinical and administration buy-in, the need to adequately train users, and the need for the provision of ongoing technical support are common across the North-South divide. Strategies such as creating local support teams, using local development resources, ensuring end user buy-in, and rolling out in smaller facilities before larger hospitals are being incorporated into the project. These are positive developments to help maintain momentum as the project continues. Further integration with existing open source communities could help ongoing development and implementations of the project. We hope this case study will provide some lessons and guidance for other challenging implementations of electronic health record systems as they continue across Africa. ©Naomi Muinga, Steve Magare, Jonathan Monda, Onesmus Kamau, Stuart Houston, Hamish Fraser, John Powell, Mike English, Chris Paton. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 18.04.2018.

  4. [Quality Indicators of Primary Health Care Facilities in Austria].

    Science.gov (United States)

    Semlitsch, Thomas; Abuzahra, Muna; Stigler, Florian; Jeitler, Klaus; Posch, Nicole; Siebenhofer, Andrea

    2017-07-11

    Background The strengthening of primary health care is one major goal of the current national health reform in Austria. In this context, a new interdisciplinary concept was developed in 2014 that defines structures and requirements for future primary health care facilities. Objective The aim of this project was the development of quality indicators for the evaluation of the scheduled primary health care facilities in Austria, which are in accordance with the new Austrian concept. Methods We used the RAND/NPCRDC method for the development and selection of the quality indicators. We conducted systematic literature searches for existing measures in international databases for quality indicators as well as in bibliographic databases. All retrieved measures were evaluated and rated by an expert panel in a 2-step process regarding relevance and feasibility. Results Overall, the literature searches yielded 281 potentially relevant quality indicators, which were summarized to 65 different quality measures for primary health care. Out of these, the panel rated and accepted 30 measures as relevant and feasible for use in Austria. Five of these indicators were structure measures, 14 were process measures and the remaining 11 were outcome measures. Based on the Austrian primary health care concept, the final set of quality indicators was grouped in the 5 following domains: Access to primary health care (5), quality of care (15), continuity of care (5), coordination of care (4), and safety (1). Conclusion This set of quality measures largely covers the four defined functions of primary health care. It enables standardized evaluation of primary health care facilities in Austria regarding the implementation of the Austrian primary health care concept as well as improvement in healthcare of the population. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria

    OpenAIRE

    Ugo, Okoli; Ezinne, Eze-Ajoku; Modupe, Oludipe; Nicole, Spieker; Winifred, Ekezie; Kelechi, Ohiri

    2016-01-01

    Background: Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. Objective: To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. Method: A total of 6 states were selected...

  6. High Explosives Research and Development (HERD) Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The purpose is to provide high explosive formulation, chemical analysis, safety and performance testing, processing, X-ray, quality control and loading support for...

  7. Factors influencing deliveries at health facilities in a rural Maasai Community in Magadi sub-County, Kenya.

    Science.gov (United States)

    Karanja, Sarah; Gichuki, Richard; Igunza, Patrick; Muhula, Samuel; Ofware, Peter; Lesiamon, Josephine; Leshore, Lepantas; Kyomuhangi-Igbodipe, Lenny Bazira; Nyagero, Josephat; Binkin, Nancy; Ojakaa, David

    2018-01-03

    In response to poor maternal, newborn, and child health indicators in Magadi sub-county, the "Boma" model was launched to promote health facility delivery by establishing community health units and training community health volunteers (CHVs) and traditional birth attendants (TBAs) as safe motherhood promoters. As a result, health facility delivery increased from 14% to 24%, still considerably below the national average (61%). We therefore conducted this study to determine factors influencing health facility delivery and describe barriers and motivators to the same. A mixed methods cross-sectional study involving a survey with 200 women who had delivered in the last 24 months, 3 focus group discussions with health providers, chiefs and CHVs and 26 in-depth interviews with mothers, key decision influencers and TBAs. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) using logistic regression were calculated to identify predictive factors for health facility delivery. Thematic analysis was done to describe barriers and motivators to the same. Of the women interviewed, 39% delivered at the health facility. Factors positively associated with health facility deliveries included belonging to the highest wealth quintiles [aOR 4.9 (95%CI 1.5-16.5)], currently not married [aOR 2.4 (95%CI 1.1-5.4)] and living near the health facility [aOR 2.2 (95%CI 1.1 = 4.4)]. High parity [aOR 0.7 (95%CI 0.5-0.9)] was negatively associated with health facility delivery. Barriers to health facility delivery included women not being final decision makers on place of birth, lack of a birth plan, gender of health provider, unfamiliar birthing position, disrespect and/or abuse, distance, attitude of health providers and lack of essential drugs and supplies. Motivators included proximity to health facility, mother's health condition, integration of TBAs into the health system, and health education/advice received. Belonging to the highest wealth quintile, currently not married and

  8. Assessment of health facility capacity to provide newborn care in Bangladesh, Haiti, Malawi, Senegal, and Tanzania.

    Science.gov (United States)

    Winter, Rebecca; Yourkavitch, Jennifer; Wang, Wenjuan; Mallick, Lindsay

    2017-12-01

    Despite the importance of health facility capacity to provide comprehensive care, the most widely used indicators for global monitoring of maternal and child health remain contact measures which assess women's use of services only and not the capacity of health facilities to provide those services; there is a gap in monitoring health facilities' capacity to provide newborn care services in low and middle income countries. In this study we demonstrate a measurable framework for assessing health facility capacity to provide newborn care using open access, nationally-representative Service Provision Assessment (SPA) data from the Demographic Health Surveys Program. In particular, we examine whether key newborn-related services are available at the facility (ie, service availability, measured by the availability of basic emergency obstetric care (BEmOC) signal functions, newborn signal functions, and routine perinatal services), and whether the facility has the equipment, medications, training and knowledge necessary to provide those services (ie, service readiness, measured by general facility requirements, equipment, medicines and commodities, and guidelines and staffing) in five countries with high levels of neonatal mortality and recent SPA data: Bangladesh, Haiti, Malawi, Senegal, and Tanzania. In each country, we find that key services and commodities needed for comprehensive delivery and newborn care are missing from a large percentage of facilities with delivery services. Of three domains of service availability examined, scores for routine care availability are highest, while scores for newborn signal function availability are lowest. Of four domains of service readiness examined, scores for general requirements and equipment are highest, while scores for guidelines and staffing are lowest. Both service availability and readiness tend to be highest in hospitals and facilities in urban areas, pointing to substantial equity gaps in the availability of essential

  9. Cost recovery of NGO primary health care facilities: a case study in Bangladesh

    OpenAIRE

    Alam, Khurshid; Ahmed, Shakil

    2010-01-01

    Abstract Background Little is known about the cost recovery of primary health care facilities in Bangladesh. This study estimated the cost recovery of a primary health care facility run by Building Resources Across Community (BRAC), a large NGO in Bangladesh, for the period of July 2004 - June 2005. This health facility is one of the seven upgraded BRAC facilities providing emergency obstetric care and is typical of the government and private primary health care facilities in Bangladesh. Give...

  10. Regulatory role and approach of BARC Safety Council in safety and occupational health in BARC facilities

    International Nuclear Information System (INIS)

    Rajdeep; Jayarajan, K.; Taly, Y.K.

    2016-01-01

    Bhabha Atomic Research Centre is involved in multidisciplinary research and developmental activities, related to peaceful use of nuclear energy and its societal benefits. In order to achieve high level of performance of these facilities, the best efforts are made to maintain good health of the plant personnel and good working conditions. BARC Safety Council (BSC), which is the regulatory body for BARC facilities, regulates radiation safety, industrial safety and surveillance of occupational health, by implementing various rules and guidelines in BARC facilities. BARC Safety framework consists of various committees in a 3-tier system. The first tier is BSC, which is the apex body authorized for issuing directives, permissions, consents and authorizations. It is having responsibility of ensuring protection and safety of public, environment, personnel and facilities of BARC through enforcement of radiation protection and industrial safety programmes. Besides the 18 committees in 2"n"d tier, there are 6 other expert committees which assist in functioning of BSC. (author)

  11. Facility Configuration Study of the High Temperature Gas-Cooled Reactor Component Test Facility

    Energy Technology Data Exchange (ETDEWEB)

    S. L. Austad; L. E. Guillen; D. S. Ferguson; B. L. Blakely; D. M. Pace; D. Lopez; J. D. Zolynski; B. L. Cowley; V. J. Balls; E.A. Harvego, P.E.; C.W. McKnight, P.E.; R.S. Stewart; B.D. Christensen

    2008-04-01

    A test facility, referred to as the High Temperature Gas-Cooled Reactor Component Test Facility or CTF, will be sited at Idaho National Laboratory for the purposes of supporting development of high temperature gas thermal-hydraulic technologies (helium, helium-Nitrogen, CO2, etc.) as applied in heat transport and heat transfer applications in High Temperature Gas-Cooled Reactors. Such applications include, but are not limited to: primary coolant; secondary coolant; intermediate, secondary, and tertiary heat transfer; and demonstration of processes requiring high temperatures such as hydrogen production. The facility will initially support completion of the Next Generation Nuclear Plant. It will secondarily be open for use by the full range of suppliers, end-users, facilitators, government laboratories, and others in the domestic and international community supporting the development and application of High Temperature Gas-Cooled Reactor technology. This pre-conceptual facility configuration study, which forms the basis for a cost estimate to support CTF scoping and planning, accomplishes the following objectives: • Identifies pre-conceptual design requirements • Develops test loop equipment schematics and layout • Identifies space allocations for each of the facility functions, as required • Develops a pre-conceptual site layout including transportation, parking and support structures, and railway systems • Identifies pre-conceptual utility and support system needs • Establishes pre-conceptual electrical one-line drawings and schedule for development of power needs.

  12. Facility Configuration Study of the High Temperature Gas-Cooled Reactor Component Test Facility

    International Nuclear Information System (INIS)

    S. L. Austad; L. E. Guillen; D. S. Ferguson; B. L. Blakely; D. M. Pace; D. Lopez; J. D. Zolynski; B. L. Cowley; V. J. Balls; E.A. Harvego, P.E.; C.W. McKnight, P.E.; R.S. Stewart; B.D. Christensen

    2008-01-01

    A test facility, referred to as the High Temperature Gas-Cooled Reactor Component Test Facility or CTF, will be sited at Idaho National Laboratory for the purposes of supporting development of high temperature gas thermal-hydraulic technologies (helium, helium-Nitrogen, CO2, etc.) as applied in heat transport and heat transfer applications in High Temperature Gas-Cooled Reactors. Such applications include, but are not limited to: primary coolant; secondary coolant; intermediate, secondary, and tertiary heat transfer; and demonstration of processes requiring high temperatures such as hydrogen production. The facility will initially support completion of the Next Generation Nuclear Plant. It will secondarily be open for use by the full range of suppliers, end-users, facilitators, government laboratories, and others in the domestic and international community supporting the development and application of High Temperature Gas-Cooled Reactor technology. This pre-conceptual facility configuration study, which forms the basis for a cost estimate to support CTF scoping and planning, accomplishes the following objectives: (1) Identifies pre-conceptual design requirements; (2) Develops test loop equipment schematics and layout; (3) Identifies space allocations for each of the facility functions, as required; (4) Develops a pre-conceptual site layout including transportation, parking and support structures, and railway systems; (5) Identifies pre-conceptual utility and support system needs; and (6) Establishes pre-conceptual electrical one-line drawings and schedule for development of power needs

  13. Biosecurity measures in 48 isolation facilities managing highly infectious diseases.

    Science.gov (United States)

    Puro, Vincenzo; Fusco, Francesco M; Schilling, Stefan; Thomson, Gail; De Iaco, Giuseppina; Brouqui, Philippe; Maltezou, Helena C; Bannister, Barbara; Gottschalk, René; Brodt, Hans-Rheinhard; Ippolito, Giuseppe

    2012-06-01

    Biosecurity measures are traditionally applied to laboratories, but they may also be usefully applied in highly specialized clinical settings, such as the isolation facilities for the management of patients with highly infectious diseases (eg, viral hemorrhagic fevers, SARS, smallpox, potentially severe pandemic flu, and MDR- and XDR-tuberculosis). In 2009 the European Network for Highly Infectious Diseases conducted a survey in 48 isolation facilities in 16 European countries to determine biosecurity measures for access control to the facility. Security personnel are present in 39 facilities (81%). In 35 facilities (73%), entrance to the isolation area is restricted; control methods include electronic keys, a PIN system, closed-circuit TV, and guards at the doors. In 25 facilities (52%), identification and registration of all staff entering and exiting the isolation area are required. Access control is used in most surveyed centers, but specific lacks exist in some facilities. Further data are needed to assess other biosecurity aspects, such as the security measures during the transportation of potentially contaminated materials and measures to address the risk of an "insider attack."

  14. Community health facility preparedness for a cholera surge in Haiti.

    Science.gov (United States)

    Mobula, Linda Meta; Jacquet, Gabrielle A; Weinhauer, Kristin; Alcidas, Gladys; Thomas, Hans-Muller; Burnham, Gilbert

    2013-01-01

    With increasing population displacement and worsening water insecurity after the 2010 earthquake, Haiti experienced a large cholera outbreak. Our goal was to evaluate the strengths and weaknesses of seven community health facilities' ability to respond to a surge in cholera cases. Since 2010, Catholic Relief Services (CRS) with a number of public and private donors has been working with seven health facilities in an effort to reduce morbidity and mortality from cholera infection. In November 2012, CRS through the Centers for Disease Control and Prevention (CDC)'s support, asked the Johns Hopkins Center for Refugee and Disaster Response to conduct a cholera surge simulation tabletop exercise at these health facilities to improve each facility's response in the event of a cholera surge. Using simulation development guidelines from the Pan American Health Organization and others, a simulation scenario script was produced that included situations of differing severity, supply chain, as well as a surge of patients. A total of 119 hospital staff from seven sites participated in the simulation exercise including community health workers, clinicians, managers, pharmacists, cleaners, and security guards. Clinics that had challenges during the simulated clinical care of patients were those that did not appropriately treat all cholera patients according to protocol, particularly those that were vulnerable, those that would need additional staff to properly treat patients during a surge of cholera, and those that required a better inventory of supplies. Simulation-based activities have the potential to identify healthcare delivery system vulnerabilities that are amenable to intervention prior to a cholera surge.

  15. Storage facility for highly radioactive solid waste

    International Nuclear Information System (INIS)

    Kitano, Shozo

    1996-01-01

    A heat insulation plate is disposed at an intermediate portion between a ceiling wall of a storage chamber and an upper plate of a storage pit in parallel with them. A large number of highly radioactive solid wastes contained in canisters are contained in the storage pit. Cooling air is introduced from an air suction port, passes a channel on the upper side of the heat insulation plate formed by the ceiling of the storage chamber and the heat insulation plate, and flows from a flow channel on the side of the wall of the storage chamber to the lower portion of the storage pit. Afterheat is removed by the air flown from the lower portion to ventilation tubes at the outer side of container tubes. The air heated to a high temperature through the flow channel on the lower side of the heat insulation plate between the heat insulation plate and the upper plate of the storage pit, and is exhausted to an exhaustion port. Further, a portion of a heat insulation plate as a boundary between the cooling air and a high temperature air formed on the upper portion of the storage pit is formed as a heat transfer plate, so that the heat of the high temperature air is removed by the cooling air flowing the upper flow channel. This can prevent heating of the ceiling wall of the storage chamber. (I.N.)

  16. Identifying health facilities outside the enterprise: challenges and strategies for supporting health reform and meaningful use.

    Science.gov (United States)

    Dixon, Brian E; Colvard, Cyril; Tierney, William M

    2014-06-24

    Objective: To support collation of data for disability determination, we sought to accurately identify facilities where care was delivered across multiple, independent hospitals and clinics. Methods: Data from various institutions' electronic health records were merged and delivered as continuity of care documents to the United States Social Security Administration (SSA). Results: Electronic records for nearly 8000 disability claimants were exchanged with SSA. Due to the lack of standard nomenclature for identifying the facilities in which patients received the care documented in the electronic records, SSA could not match the information received with information provided by disability claimants. Facility identifiers were generated arbitrarily by health care systems and therefore could not be mapped to the existing international standards. Discussion: We propose strategies for improving facility identification in electronic health records to support improved tracking of a patient's care between providers to better serve clinical care delivery, disability determination, health reform and meaningful use. Conclusion: Accurately identifying the facilities where health care is delivered to patients is important to a number of major health reform and improvement efforts underway in many nations. A standardized nomenclature for identifying health care facilities is needed to improve tracking of care and linking of electronic health records.

  17. Radiation monitoring in high energy research facility

    International Nuclear Information System (INIS)

    Miyajima, Mitsuhiro

    1975-01-01

    In High Energy Physics Research Laboratory, construction of high energy proton accelerator is in progress. The accelerator is a cascaded machine comprising Cockcroft type (50 keV), linac (20 MeV), booster synchrotron (500 MeV), and synchrotron (8-12 GeV). Its proton beam intensity is 1x10 13 photons/pulse, and acceleration is carried out at the rate of every 2 minutes. The essential problems of radiation control in high energy accelerators are those of various radiations generated secondarily by proton beam and a number of induced radiations simultaneously originated with such secondary particles. In the Laboratory, controlled areas are divided into color-coded four regions, red, orange, yellow and green, based on each dose-rate. BF 3 counters covered with thick paraffin are used as neutron detectors, and side-window GM tubes, NaI (Tl) scintillators and ionization chambers as γ-detectors. In red region, however, ionization chambers are applied to induced radiation detection, and neutrons are not monitored. NIM standards are adopted for the circuits of all above monitors considering easy maintenance, economy and interchangeability. Notwithstanding the above described systems, these monitors are not sufficient to complete the measurement of whole radiations over wide energy region radiated from the accelerators. Hence separate radiation field measurement is required periodically. An example of the monitoring systems in National Accelerator Laboratory (U.S.) is referred at the last section. (Wakatsuki, Y.)

  18. Strengthening health facilities for maternal and newborn care: experiences from rural eastern Uganda

    Directory of Open Access Journals (Sweden)

    Gertrude Namazzi

    2015-03-01

    Full Text Available Background: In Uganda maternal and neonatal mortality remains high due to a number of factors, including poor quality of care at health facilities. Objective: This paper describes the experience of building capacity for maternal and newborn care at a district hospital and lower-level health facilities in eastern Uganda within the existing system parameters and a robust community outreach programme. Design: This health system strengthening study, part of the Uganda Newborn Study (UNEST, aimed to increase frontline health worker capacity through district-led training, support supervision, and mentoring at one district hospital and 19 lower-level facilities. A once-off supply of essential medicines and equipment was provided to address immediate critical gaps. Health workers were empowered to requisition subsequent supplies through use of district resources. Minimal infrastructure adjustments were provided. Quantitative data collection was done within routine process monitoring and qualitative data were collected during support supervision visits. We use the World Health Organization Health System Building Blocks to describe the process of district-led health facility strengthening. Results: Seventy two per cent of eligible health workers were trained. The mean post-training knowledge score was 68% compared to 32% in the pre-training test, and 80% 1 year later. Health worker skills and competencies in care of high-risk babies improved following support supervision and mentoring. Health facility deliveries increased from 3,151 to 4,115 (a 30% increase in 2 years. Of 547 preterm babies admitted to the newly introduced kangaroo mother care (KMC unit, 85% were discharged alive to continue KMC at home. There was a non-significant declining trend for in-hospital neonatal deaths across the 2-year study period. While equipment levels remained high after initial improvement efforts, maintaining supply of even the most basic medications was a challenge, with

  19. Review of occupational exposure patterns in Indian Health Care Facilities

    International Nuclear Information System (INIS)

    Senthilkumar, M.; Nehru, R.M.; Sonawane, A.U.

    2016-01-01

    Monitoring of individual radiation is a prime part of the radiation protection programme. The primary justification for monitoring helps achieve and demonstrate an appropriate level of protection and can demonstrate compliance with regulatory requirements, contribute to the control of operations and design of installations. Atomic Energy (Radiation Protection) Rules 2004 advocates that radiation surveillance is mandatory for all radiation workers. The largest group of individuals exposed occupationally to artificial radiation sources is that employed in health care facilities such as Diagnostic Radiology, Radiation Therapy and Nuclear Medicine. In this work, a comprehensive analysis was carried out on occupational exposure data for the period 2000 to 2014 to bring a measure of radiation protection infrastructure quality in health care facilities

  20. Quality of malaria case management in Malawi: results from a nationally representative health facility survey.

    Science.gov (United States)

    Steinhardt, Laura C; Chinkhumba, Jobiba; Wolkon, Adam; Luka, Madalitso; Luhanga, Misheck; Sande, John; Oyugi, Jessica; Ali, Doreen; Mathanga, Don; Skarbinski, Jacek

    2014-01-01

    Malaria is endemic throughout Malawi, but little is known about quality of malaria case management at publicly-funded health facilities, which are the major source of care for febrile patients. In April-May 2011, we conducted a nationwide, geographically-stratified health facility survey to assess the quality of outpatient malaria diagnosis and treatment. We enrolled patients presenting for care and conducted exit interviews and re-examinations, including reference blood smears. Moreover, we assessed health worker readiness (e.g., training, supervision) and health facility capacity (e.g. availability of diagnostics and antimalarials) to provide malaria case management. All analyses accounted for clustering and unequal selection probabilities. We also used survey weights to produce estimates of national caseloads. At the 107 facilities surveyed, most of the 136 health workers interviewed (83%) had received training on malaria case management. However, only 24% of facilities had functional microscopy, 15% lacked a thermometer, and 19% did not have the first-line artemisinin-based combination therapy (ACT), artemether-lumefantrine, in stock. Of 2,019 participating patients, 34% had clinical malaria (measured fever or self-reported history of fever plus a positive reference blood smear). Only 67% (95% confidence interval (CI): 59%, 76%) of patients with malaria were correctly prescribed an ACT, primarily due to missed malaria diagnosis. Among patients without clinical malaria, 31% (95% CI: 24%, 39%) were prescribed an ACT. By our estimates, 1.5 million of the 4.4 million malaria patients seen in public facilities annually did not receive correct treatment, and 2.7 million patients without clinical malaria were inappropriately given an ACT. Malawi has a high burden of uncomplicated malaria but nearly one-third of all patients receive incorrect malaria treatment, including under- and over-treatment. To improve malaria case management, facilities must at minimum have

  1. Health and environmental aspects of nuclear fuel cycle facilities

    International Nuclear Information System (INIS)

    1996-11-01

    The purpose of the present publication is to give a generic description of health and environmental aspects of nuclear fuel cycle facilities. Primarily the report is meant to stand alone; however, because of the content of the publication and in the context of the DECADES project, it may serve as a means of introducing specialists in other fuel cycles to the nuclear fuel cycle. Refs, figs, tabs

  2. Health facility committees and facility management - exploring the nature and depth of their roles in Coast Province, Kenya

    Directory of Open Access Journals (Sweden)

    Kabare Margaret

    2011-09-01

    Full Text Available Abstract Background Community participation has been emphasized internationally as a way of enhancing accountability, as well as a means to enhance health goals in terms of coverage, access and effective utilization. In rural health facilities in Kenya, initiatives to increase community accountability have focused on Health Facility Committees (HFCs. In Coast Province the role of HFCs has been expanded with the introduction of direct funding of rural facilities. We explored the nature and depth of managerial engagement of HFCs at the facility level in two rural districts in this Coastal setting, and how this has contributed to community accountability Methods We conducted structured interviews with the health worker in-charge and with patients in 30 health centres and dispensaries. These data were supplemented with in-depth interviews with district managers, and with health workers and HFC members in 12 health centres and dispensaries. In-depth interviews with health workers and HFC members included a participatory exercise to stimulate discussion of the nature and depth of their roles in facility management. Results HFCs were generally functioning well and played an important role in facility operations. The breadth and depth of engagement had reportedly increased after the introduction of direct funding of health facilities which allowed HFCs to manage their own budgets. Although relations with facility staff were generally good, some mistrust was expressed between HFC members and health workers, and between HFC members and the broader community, partially reflecting a lack of clarity in HFC roles. Moreover, over half of exit interviewees were not aware of the HFC's existence. Women and less well-educated respondents were particularly unlikely to know about the HFC. Conclusions There is potential for HFCs to play an active and important role in health facility management, particularly where they have control over some facility level resources

  3. Health facility committees and facility management - exploring the nature and depth of their roles in Coast Province, Kenya.

    Science.gov (United States)

    Goodman, Catherine; Opwora, Antony; Kabare, Margaret; Molyneux, Sassy

    2011-09-22

    Community participation has been emphasized internationally as a way of enhancing accountability, as well as a means to enhance health goals in terms of coverage, access and effective utilization. In rural health facilities in Kenya, initiatives to increase community accountability have focused on Health Facility Committees (HFCs). In Coast Province the role of HFCs has been expanded with the introduction of direct funding of rural facilities. We explored the nature and depth of managerial engagement of HFCs at the facility level in two rural districts in this Coastal setting, and how this has contributed to community accountability We conducted structured interviews with the health worker in-charge and with patients in 30 health centres and dispensaries. These data were supplemented with in-depth interviews with district managers, and with health workers and HFC members in 12 health centres and dispensaries. In-depth interviews with health workers and HFC members included a participatory exercise to stimulate discussion of the nature and depth of their roles in facility management. HFCs were generally functioning well and played an important role in facility operations. The breadth and depth of engagement had reportedly increased after the introduction of direct funding of health facilities which allowed HFCs to manage their own budgets. Although relations with facility staff were generally good, some mistrust was expressed between HFC members and health workers, and between HFC members and the broader community, partially reflecting a lack of clarity in HFC roles. Moreover, over half of exit interviewees were not aware of the HFC's existence. Women and less well-educated respondents were particularly unlikely to know about the HFC. There is potential for HFCs to play an active and important role in health facility management, particularly where they have control over some facility level resources. However, to optimise their contribution, efforts are needed to

  4. Measuring the preparedness of health facilities to deliver emergency obstetric care in a South African district.

    Science.gov (United States)

    Thwala, Siphiwe Bridget Pearl; Blaauw, Duane; Ssengooba, Freddie

    2018-01-01

    Improving the delivery of emergency obstetric care (EmNOC) remains critical in addressing direct causes of maternal mortality. United Nations (UN) agencies have promoted standard methods for evaluating the availability of EmNOC facilities although modifications have been proposed by others. This study presents an assessment of the preparedness of public health facilities to provide EmNOC using these methods in one South African district with a persistently high maternal mortality ratio. Data collection took place in the final quarter of 2014. Cross-sectional surveys were conducted to classify the 7 hospitals and 8 community health centres (CHCs) in the district as either basic EmNOC (BEmNOC) or comprehensive EmNOC (CEmNOC) facilities using UN EmNOC signal functions. The required density of EmNOC facilities was calculated using UN norms. We also assessed the availability of EmNOC personnel, resuscitation equipment, drugs, fluids, and protocols at each facility. The workload of skilled EmNOC providers at hospitals and CHCs was compared. All 7 hospitals in the district were classified as CEmNOC facilities, but none of the 8 CHCs performed all required signal functions to be classified as BEmNOC facilities. UN norms indicated that 25 EmNOC facilities were required for the district population, 5 of which should be CEmNOCs. None of the facilities had 100% of items on the EmNOC checklists. Hospital midwives delivered an average of 36.4±14.3 deliveries each per month compared to only 7.9±3.2 for CHC midwives (pfacilities in the district. Full EmNOC services were centralised to hospitals to assure patient safety even though national policy guidelines sanction more decentralisation to CHCs. Studies measuring EmNOC availability need to consider facility opening hours, capacity and staffing in addition to the demonstrated performance of signal functions.

  5. The Behavioral Health Role in Nursing Facility Social Work.

    Science.gov (United States)

    Myers, Dennis R; Rogers, Robin K; LeCrone, Harold H; Kelley, Katherine

    2017-09-01

    Types of compromised resident behaviors licensed nursing facility social workers encounter, the behavioral health role they enact, and effective practices they apply have not been the subject of systematic investigation. Analyses of 20 in-depth interviews with Bachelor of Social Work (BSW)/Master of Social Work (MSW) social workers averaging 8.8 years of experience identified frequently occurring resident behaviors: physical and verbal aggression/disruption, passive disruption, socially and sexually inappropriateness. Six functions of the behavioral health role were care management, educating, investigating, preventing, mediating, and advocating. Skills most frequently applied were attention/affirmation/active listening, assessment, behavior management, building relationship, teamwork, and redirection. Narratives revealed role rewards as well as knowledge deficits, organizational barriers, personal maltreatment, and frustrations. Respondents offered perspectives and prescriptions for behavioral health practice in this setting. The findings expand understanding of the behavioral health role and provide an empirical basis for more research in this area. Recommendations, including educational competencies, are offered.

  6. High-Level Waste Vitrification Facility Feasibility Study

    International Nuclear Information System (INIS)

    D. A. Lopez

    1999-01-01

    A ''Settlement Agreement'' between the Department of Energy and the State of Idaho mandates that all radioactive high-level waste now stored at the Idaho Nuclear Technology and Engineering Center will be treated so that it is ready to be moved out of Idaho for disposal by a compliance date of 2035. This report investigates vitrification treatment of the high-level waste in a High-Level Waste Vitrification Facility based on the assumption that no more New Waste Calcining Facility campaigns will be conducted after June 2000. Under this option, the sodium-bearing waste remaining in the Idaho Nuclear Technology and Engineering Center Tank Farm, and newly generated liquid waste produced between now and the start of 2013, will be processed using a different option, such as a Cesium Ion Exchange Facility. The cesium-saturated waste from this other option will be sent to the Calcine Solids Storage Facilities to be mixed with existing calcine. The calcine and cesium-saturated waste will be processed in the High-Level Waste Vitrification Facility by the end of calendar year 2035. In addition, the High-Level Waste Vitrification Facility will process all newly-generated liquid waste produced between 2013 and the end of 2035. Vitrification of this waste is an acceptable treatment method for complying with the Settlement Agreement. This method involves vitrifying the waste and pouring it into stainless-steel canisters that will be ready for shipment out of Idaho to a disposal facility by 2035. These canisters will be stored at the Idaho National Engineering and Environmental Laboratory until they are sent to a national geologic repository. The operating period for vitrification treatment will be from the end of 2015 through 2035

  7. High-Level Waste Vitrification Facility Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    D. A. Lopez

    1999-08-01

    A ''Settlement Agreement'' between the Department of Energy and the State of Idaho mandates that all radioactive high-level waste now stored at the Idaho Nuclear Technology and Engineering Center will be treated so that it is ready to be moved out of Idaho for disposal by a compliance date of 2035. This report investigates vitrification treatment of the high-level waste in a High-Level Waste Vitrification Facility based on the assumption that no more New Waste Calcining Facility campaigns will be conducted after June 2000. Under this option, the sodium-bearing waste remaining in the Idaho Nuclear Technology and Engineering Center Tank Farm, and newly generated liquid waste produced between now and the start of 2013, will be processed using a different option, such as a Cesium Ion Exchange Facility. The cesium-saturated waste from this other option will be sent to the Calcine Solids Storage Facilities to be mixed with existing calcine. The calcine and cesium-saturated waste will be processed in the High-Level Waste Vitrification Facility by the end of calendar year 2035. In addition, the High-Level Waste Vitrification Facility will process all newly-generated liquid waste produced between 2013 and the end of 2035. Vitrification of this waste is an acceptable treatment method for complying with the Settlement Agreement. This method involves vitrifying the waste and pouring it into stainless-steel canisters that will be ready for shipment out of Idaho to a disposal facility by 2035. These canisters will be stored at the Idaho National Engineering and Environmental Laboratory until they are sent to a national geologic repository. The operating period for vitrification treatment will be from the end of 2015 through 2035.

  8. Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria

    Science.gov (United States)

    Ugo, Okoli; Ezinne, Eze-Ajoku; Modupe, Oludipe; Nicole, Spieker; Kelechi, Ohiri

    2016-01-01

    Background: Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. Objective: To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. Method: A total of 6 states were selected across the 6 geopolitical zones of the country. However, assessments were carried out in 40 facilities in only 5 states. Selection was based on location, coverage, and minimum services offered. The facilities were divided randomly into 2 groups. The treatment group received quality-of-care assessment, continuous feedback, and improvement support, whereas the control group received quality assessment and no other support. Data were collected using the SafeCare Healthcare Standards and managed on the SafeCare Data Management System—AfriDB. Eight core areas were assessed at baseline and end line, and compliance to quality health-care standards was compared. Result: Outcomes from 40 facilities were accepted and analyzed. Overall scores increased in the treatment facilities compared to the control facilities, with strong evidence of improvement (t = 5.28, P = .0004) and 11% average improvement, but no clear pattern of improvement emerged in the control group. Conclusion: The study demonstrated governance support and active community involvement offered potential for quality improvement in primary health-care facilities. PMID:28462280

  9. Health facility and skilled birth deliveries among poor women with Jamkesmas health insurance in Indonesia: a mixed-methods study.

    Science.gov (United States)

    Brooks, Mohamad I; Thabrany, Hasbullah; Fox, Matthew P; Wirtz, Veronika J; Feeley, Frank G; Sabin, Lora L

    2017-02-02

    The growing momentum for quality and affordable health care for all has given rise to the recent global universal health coverage (UHC) movement. As part of Indonesia's strategy to achieve the goal of UHC, large investments have been made to increase health access for the poor, resulting in the implementation of various health insurance schemes targeted towards the poor and near-poor, including the Jamkesmas program. In the backdrop of Indonesia's aspiration to reach UHC is the high rate of maternal mortality that disproportionally affects poor women. The objective of this study was to evaluate the association of health facility and skilled birth deliveries among poor women with and without Jamkesmas and explore perceived barriers to health insurance membership and maternal health service utilization. We used a mixed-methods design. Utilizing data from the 2012 Indonesian Demographic and Health Survey (n = 45,607), secondary analysis using propensity score matching was performed on key outcomes of interest: health facility delivery (HFD) and skilled birth delivery (SBD). In-depth interviews (n = 51) were conducted in the provinces of Jakarta and Banten among poor women, midwives, and government representatives. Thematic framework analysis was performed on qualitative data to explore perceived barriers. In 2012, 63.0% of women did not have health insurance; 19.1% had Jamkesmas. Poor women with Jamkesmas were 19% (OR = 1.19 [1.03-1.37]) more likely to have HFD and 17% (OR = 1.17 [1.01-1.35]) more likely to have SBD compared to poor women without insurance. Qualitative interviews highlighted key issues, including: lack of proper documentation for health insurance registration; the preference of pregnant women to deliver in their parents' village; the use of traditional birth attendants; distance to health facilities; shortage of qualified health providers; overcrowded health facilities; and lack of health facility accreditation. Poor women with

  10. The high-temperature helium test facility (HHV)

    International Nuclear Information System (INIS)

    Noack, G.; Weiskopf, H.

    1977-03-01

    The report describes the high-temperature helium test facility (HHV). Construction of this plant was started in 1972 by Messrs. BBC, Mannheim, on behalf of the Kernforschungsanlage Juelich. By the end of 1976, the construction work is in its last stage, so that the plant may start operation early in 1977. First of all, the cycle system and the arrangement of components are dealt with, followed by a discussion of individual components. Here, emphasis is laid on components typical for HHT systems, while conventional components are mentioned without further structural detail. The projected test programme for the HHV facility in phase IB of the HHT project is shortly dealt with. After this, the potential of this test facility with regard to the possible use of test components and to fluid- and thermodynamic boundary conditions is pointed out. With the unique potential the facility offers here, aspects of shortened service life at higher cycle temperatures do not remain disregarded. (orig./UA) [de

  11. Development of a web based GIS for health facilities mapping ...

    African Journals Online (AJOL)

    Around the world health professionals and authorities, in many cases, do not have the ability to visualize health related spatial information to make timely decisions. The high cost of deploying a desktop Geographical Information System (GIS) for Public Health management coupled with the need for specialised training in ...

  12. Cervical cancer screening through human papillomavirus testing in community health campaigns versus health facilities in rural western Kenya.

    Science.gov (United States)

    Huchko, Megan J; Ibrahim, Saduma; Blat, Cinthia; Cohen, Craig R; Smith, Jennifer S; Hiatt, Robert A; Bukusi, Elizabeth

    2018-04-01

    To determine the effectiveness of community health campaigns (CHCs) as a strategy for human papillomavirus (HPV)-based cervical cancer screening in rural western Kenya. Between January and November 2016, a cluster-randomized trial was carried out in 12 communities in western Kenya to investigate high-risk HPV testing offered via self-collection to women aged 25-65 years in CHCs versus government health facilities. Outcome measures were the total number of women accessing cervical cancer screening and the proportion of HPV-positive women accessing treatment. In total, 4944 women underwent HPV-based cervical cancer screening in CHCs (n=2898) or health facilities (n=2046). Screening uptake as a proportion of total eligible women in the population was greater in communities assigned to CHCs (60.0% vs 37.0%, P<0.001). Rates of treatment acquisition were low in both arms (CHCs 39.2%; health facilities 31.5%; P=0.408). Cervical cancer screening using HPV testing of self-collected samples reached a larger proportion of women when offered through periodic CHCs compared with health facilities. The community-based model is a promising strategy for cervical cancer prevention. Lessons learned from this trial can be used to identify ways of maximizing the impact of such strategies through greater community participation and improved linkage to treatment. ClinicalTrials.gov registration: NCT02124252. © 2017 International Federation of Gynecology and Obstetrics.

  13. High level radioactive waste management facility design criteria

    International Nuclear Information System (INIS)

    Sheikh, N.A.; Salaymeh, S.R.

    1993-01-01

    This paper discusses the engineering systems for the structural design of the Defense Waste Processing Facility (DWPF) at the Savannah River Site (SRS). At the DWPF, high level radioactive liquids will be mixed with glass particles and heated in a melter. This molten glass will then be poured into stainless steel canisters where it will harden. This process will transform the high level waste into a more stable, manageable substance. This paper discuss the structural design requirements for this unique one of a kind facility. A special emphasis will be concentrated on the design criteria pertaining to earthquake, wind and tornado, and flooding

  14. Implementation of high-dose chemical dosimetry for industrial facilities

    International Nuclear Information System (INIS)

    Conceicao, Cirilo Cezar Sant'Anna da

    2006-01-01

    The purpose of this work is the implementation of methodology for high dose measurements using chemical dosimeters in liquid phase, traceable to the international metrology system, and make available in the country, the standard of high-dose to industrial irradiation facilities and research irradiators, trough the quality program with comparative measurements and direct use of the standard dosimeters in routine. The use of these low cost dosimetry systems in industrial irradiation facilities, assists to the certification requirements and it can reduce the costs with dosimetry for approximately 20% of the total dosimetry costs, using these systems in routine measurements and validation process, largely substituting the imported PMMA dosimeters, among others. (author)

  15. Thermo-aeraulics of high level waste storage facilities

    International Nuclear Information System (INIS)

    Lagrave, Herve; Gaillard, Jean-Philippe; Laurent, Franck; Ranc, Guillaume; Duret, Bernard

    2006-01-01

    This paper discusses the research undertaken in response to axis 3 of the 1991 radioactive waste management act, and possible solutions concerning the processes under consideration for conditioning and long-term interim storage of long-lived radioactive waste. The notion of 'long-term' is evaluated with respect to the usual operating lifetime of a basic nuclear installation, about 50 years. In this context, 'long-term' is defined on a secular time scale: the lifetime of the facility could be as long as 300 years. The waste package taken into account is characterized notably by its high thermal power release. Studies were carried out in dedicated facilities for vitrified waste and for spent UOX and MOX fuel. The latter are not considered as wastes, owing to the value of the reusable material they contain. Three primary objectives have guided the design of these long-term interim storage facilities: - ensure radionuclide containment at all times; - permit retrieval of the containers at any time; - minimize surveillance; - maintenance costs. The CEA has also investigated surface and subsurface facilities. It was decided to work on generic sites with a reasonable set of parameters values that should be applicable at most sites in France. All the studies and demonstrations to date lead to the conclusion that long-term interim storage is technically feasible. The paper addresses the following items: - Long-term interim storage concepts for high-level waste; - Design principles and options for the interim storage facilities; - General architecture; - Research topics, Storage facility ventilation, Dimensioning of the facility; - Thermo-aeraulics of a surface interim storage facility; - VALIDA surface loop, VALIDA single container test campaign, Continuation of the VALIDA program; - Thermo-aeraulics of a network of subsurface interim storage galleries; - SIGAL subsurface loop; - PROMETHEE subsurface loop; - Temperature behaviour of the concrete structures; - GALATEE

  16. Thermo-aeraulics of high level waste storage facilities

    Energy Technology Data Exchange (ETDEWEB)

    Lagrave, Herve; Gaillard, Jean-Philippe; Laurent, Franck; Ranc, Guillaume [CEA/Valrho, B.P. 17171, F-30207 Bagnols-sur-Ceze (France); Duret, Bernard [CEA Grenoble, 17 rue des Martyrs, 38054 Grenoble cedex 9 (France)

    2006-07-01

    This paper discusses the research undertaken in response to axis 3 of the 1991 radioactive waste management act, and possible solutions concerning the processes under consideration for conditioning and long-term interim storage of long-lived radioactive waste. The notion of 'long-term' is evaluated with respect to the usual operating lifetime of a basic nuclear installation, about 50 years. In this context, 'long-term' is defined on a secular time scale: the lifetime of the facility could be as long as 300 years. The waste package taken into account is characterized notably by its high thermal power release. Studies were carried out in dedicated facilities for vitrified waste and for spent UOX and MOX fuel. The latter are not considered as wastes, owing to the value of the reusable material they contain. Three primary objectives have guided the design of these long-term interim storage facilities: - ensure radionuclide containment at all times; - permit retrieval of the containers at any time; - minimize surveillance; - maintenance costs. The CEA has also investigated surface and subsurface facilities. It was decided to work on generic sites with a reasonable set of parameters values that should be applicable at most sites in France. All the studies and demonstrations to date lead to the conclusion that long-term interim storage is technically feasible. The paper addresses the following items: - Long-term interim storage concepts for high-level waste; - Design principles and options for the interim storage facilities; - General architecture; - Research topics, Storage facility ventilation, Dimensioning of the facility; - Thermo-aeraulics of a surface interim storage facility; - VALIDA surface loop, VALIDA single container test campaign, Continuation of the VALIDA program; - Thermo-aeraulics of a network of subsurface interim storage galleries; - SIGAL subsurface loop; - PROMETHEE subsurface loop; - Temperature behaviour of the concrete

  17. Hypervelocity Expansion Facility for Fundamental High-Enthalpy Research

    Science.gov (United States)

    2017-02-27

    ii Final Technical Report of Contract ONR N00014-15-1-2260 Entitled: HYPERVELOCITY EXPANSION FACILITY FOR FUNDAMENTAL HIGH-ENTHALPY...previous DoD investments in high-energy pulsed laser diagnostics for instantaneous planar velocimetry and thermometry to perform scientific studies of...capability for fundamental and applied studies of hypervelocity high enthalpy flows. In this document, we report on the progress over the 18-month

  18. Evaluating malaria case management at public health facilities in two provinces in Angola.

    Science.gov (United States)

    Plucinski, Mateusz M; Ferreira, Manzambi; Ferreira, Carolina Miguel; Burns, Jordan; Gaparayi, Patrick; João, Lubaki; da Costa, Olinda; Gill, Parambir; Samutondo, Claudete; Quivinja, Joltim; Mbounga, Eliane; de León, Gabriel Ponce; Halsey, Eric S; Dimbu, Pedro Rafael; Fortes, Filomeno

    2017-05-03

    Malaria accounts for the largest portion of healthcare demand in Angola. A pillar of malaria control in Angola is the appropriate management of malaria illness, including testing of suspect cases with rapid diagnostic tests (RDTs) and treatment of confirmed cases with artemisinin-based combination therapy (ACT). Periodic systematic evaluations of malaria case management are recommended to measure health facility readiness and adherence to national case management guidelines. Cross-sectional health facility surveys were performed in low-transmission Huambo and high-transmission Uíge Provinces in early 2016. In each province, 45 health facilities were randomly selected from among all public health facilities stratified by level of care. Survey teams performed inventories of malaria commodities and conducted exit interviews and re-examinations, including RDT testing, of a random selection of all patients completing outpatient consultations. Key health facility readiness and case management indicators were calculated adjusting for the cluster sampling design and utilization. Availability of RDTs or microscopy on the day of the survey was 71% (54-83) in Huambo and 85% (67-94) in Uíge. At least one unit dose pack of one formulation of an ACT (usually artemether-lumefantrine) was available in 83% (66-92) of health facilities in Huambo and 79% (61-90) of health facilities in Uíge. Testing rates of suspect malaria cases in Huambo were 30% (23-38) versus 69% (53-81) in Uíge. Overall, 28% (13-49) of patients with uncomplicated malaria, as determined during the re-examination, were appropriately treated with an ACT with the correct dose in Huambo, compared to 60% (42-75) in Uíge. Incorrect case management of suspect malaria cases was associated with lack of healthcare worker training in Huambo and ACT stock-outs in Uíge. The results reveal important differences between provinces. Despite similar availability of testing and ACT, testing and treatment rates were lower in

  19. 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

  20. Health physics considerations at a neutron therapy facility cyclotron

    International Nuclear Information System (INIS)

    Kleck, J.H.; Krueger, D.J.; Mc Laughlin, J.E.; Smathers, J.B.

    1987-01-01

    The U.C.L.A. Neutron Therapy Facility (NTF) is one of four such facilities in the United States currently involved in NCI sponsored trials of neutron therapy and reflects the present interest in the use of high energy neutron beams for treating certain types of human cancers. The NTF houses a CP-45 negative ion cyclotron which accelerates a 46 MeV proton beam for production of neutrons from a beryllium target. In addition to patient treatment, the NTF is involved in the production of positron emitting radioisotopes for diagnostic use in Positron Emission Tomography (PET). The activation of therapy treatment collimators, positron and neutron target systems, and a high and rapidly varying external radiation environment in a clinical setting have contributed to the need for a comprehensive radiation control program in which patient care is balanced with the maintenance of occupational exposures to ALARA levels

  1. High Power RF Test Facility at the SNS

    CERN Document Server

    Kang, Yoon W; Campisi, Isidoro E; Champion, Mark; Crofford, Mark; Davis, Kirk; Drury, Michael A; Fuja, Ray E; Gurd, Pamela; Kasemir, Kay-Uwe; McCarthy, Michael P; Powers, Tom; Shajedul Hasan, S M; Stirbet, Mircea; Stout, Daniel; Tang, Johnny Y; Vassioutchenko, Alexandre V; Wezensky, Mark

    2005-01-01

    RF Test Facility has been completed in the SNS project at ORNL to support test and conditioning operation of RF subsystems and components. The system consists of two transmitters for two klystrons powered by a common high voltage pulsed converter modulator that can provide power to two independent RF systems. The waveguides are configured with WR2100 and WR1150 sizes for presently used frequencies: 402.5 MHz and 805 MHz. Both 402.5 MHz and 805 MHz systems have circulator protected klystrons that can be powered by the modulator capable of delivering 11 MW peak and 1 MW average power. The facility has been equipped with computer control for various RF processing and complete dual frequency operation. More than forty 805 MHz fundamental power couplers for the SNS superconducting linac (SCL) cavitites have been RF conditioned in this facility. The facility provides more than 1000 ft2 floor area for various test setups. The facility also has a shielded cave area that can support high power tests of normal conducti...

  2. Predictors for health facility delivery in Busia district of Uganda: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Anyait Agnes

    2012-11-01

    Full Text Available Abstract Background Among the factors contributing to the high maternal morbidity and mortality in Uganda is the high proportion of pregnant women who do not deliver under supervision in health facilities. This study aimed to identify the independent predictors of health facility delivery in Busia a rural district in Uganda with a view of suggesting measures for remedial action. Methods In a cross sectional survey, 500 women who had a delivery in the past two years (from November 16 2005 to November 15 2007 were interviewed regarding place of delivery, demographic characteristics, reproductive history, attendance for antenatal care, accessibility of health services, preferred delivery positions, preference for disposal of placenta and mother’s autonomy in decision making. In addition the household socio economic status was assessed. The independent predictors of health facility delivery were identified by comparing women who delivered in health facilities to those who did not, using bivariate and binary logistic regression analysis. Results Eight independent predictors that favoured delivery in a health facility include: being of high socio-economic status (adjusted odds ratio [AOR] 2.8 95% Confidence interval [95% CI]1.2–6.3, previous difficult delivery (AOR 4.2, 95% CI 3.0–8.0, parity less than four (AOR 2.9, 95% CI 1.6–5.6, preference of supine position for second stage of labour (AOR 5.9, 95% CI 3.5–11.1 preferring health workers to dispose the placenta (AOR 12.1, 95% CI 4.3–34.1, not having difficulty with transport (AOR 2.0, 95% CI 1.2–3.5, being autonomous in decision to attend antenatal care (AOR 1.9, 95% CI 1.1–3.4 and depending on other people (e.g. spouse in making a decision of where to deliver from (AOR 2.4, 95% CI 1.4–4.6. A model with these 8 variables had an overall correct classification of 81.4% (chi square = 230.3, P  Conclusions These data suggest that in order to increase health facility deliveries

  3. NIF conventional facilities construction health and safety plan

    International Nuclear Information System (INIS)

    Benjamin, D W

    1998-01-01

    The purpose of this Plan is to outline the minimum health and safety requirements to which all participating Lawrence Livermore National Laboratory (LLNL) and non-LLNL employees (excluding National Ignition Facility [NIF] specific contractors and subcontractors covered under the construction subcontract packages (e.g., CSP-9)-see Construction Safety Program for the National Ignition Facility [CSP] Section I.B. ''NIF Construction Contractors and Subcontractors'' for specifics) shall adhere to for preventing job-related injuries and illnesses during Conventional Facilities construction activities at the NIF Project. For the purpose of this Plan, the term ''LLNL and non-LLNL employees'' includes LLNL employees, LLNL Plant Operations staff and their contractors, supplemental labor, contract labor, labor-only contractors, vendors, DOE representatives, personnel matrixed/assigned from other National Laboratories, participating guests, and others such as visitors, students, consultants etc., performing on-site work or services in support of the NIF Project. Based upon an activity level determination explained in Section 1.2.18, in this document, these organizations or individuals may be required by site management to prepare their own NIF site-specific safety plan. LLNL employees will normally not be expected to prepare a site-specific safety plan. This Plan also outlines job-specific exposures and construction site safety activities with which LLNL and non-LLNL employees shall comply

  4. Physics at high luminosity muon colliders and a facility overview

    International Nuclear Information System (INIS)

    Parsa, Z.

    2001-01-01

    Physics potentials at future colliders including high luminosity μ + μ - colliders are discussed. Luminosity requirement, estimates for Muon collider energies of interest (0.1 TeV to 100 TeV) are calculated. Schematics and an overview of Muon Collider facility concept are also included

  5. A high pressure sample facility for neutron scattering

    International Nuclear Information System (INIS)

    Carlile, C.J.; Glossop, B.H.

    1981-06-01

    Commissioning tests involving deformation studies and tests to destruction as well as neutron diffraction measurements of a standard sample have been carried out on the SERC high pressure sample facility for neutron scattering studies. A detailed description of the pressurising equipment is given. (author)

  6. Creation of a small high-throughput screening facility.

    Science.gov (United States)

    Flak, Tod

    2009-01-01

    The creation of a high-throughput screening facility within an organization is a difficult task, requiring a substantial investment of time, money, and organizational effort. Major issues to consider include the selection of equipment, the establishment of data analysis methodologies, and the formation of a group having the necessary competencies. If done properly, it is possible to build a screening system in incremental steps, adding new pieces of equipment and data analysis modules as the need grows. Based upon our experience with the creation of a small screening service, we present some guidelines to consider in planning a screening facility.

  7. Overview of high intensity proton accelerator facility, J-PARC

    International Nuclear Information System (INIS)

    Ikeda, Y.

    2010-01-01

    The J-PARC project of high intensity proton accelerator research complex, conducted jointly by JAERI and KEK, has been completed with demonstration of all beam productions in 2009 as the facility construction phase, and the operation started to offer the secondary beams of neutron, muon, kaon, and neutrino, to the advanced scientific experimental research aiming at making breakthroughs in materials and life science, nuclear and elementary physics, etc. This text describes the overview of the J-PARC present status with emphasis of a performance toward to 1MW power as user facilities. (author)

  8. Family planning and reproductive health supply stockouts: problems and remedies for faith-based health facilities in Africa

    Directory of Open Access Journals (Sweden)

    Amy M. Metzger

    2017-01-01

    Full Text Available Background and aims: Faith-based organizations (FBOs provide a substantial portion of the health care services in many African countries. FBO facilities do consider family planning and reproductive health services as essential to reducing maternal and child mortality, and to the growth of healthy families. Many health facilities, however, struggle to maintain adequate stocks of reproductive health (RH supplies because of the various RH supply chains and funding sources, which often operate separately from other medicines and supplies. The purpose of this study is to identify the types of supply chain systems used by African faith-based health facilities to acquire reproductive health products (clotrimazole, combined oral contraceptive pills, contraceptive implants, CycleBeads®, emergency contraception, Erythromycin, female condoms, injectable contraceptives, intra-uterine contraceptive devices, magnesium sulfate, male condoms, Methyldopa, Misoprostol, Nifedpine, Oxytocin, and Progestin-only pills, to describe their problems and challenges, and to identify possible corrective actions. Methods: Through email surveys, phone interviews, and on-site visits, we studied the supply chains of 46 faith-based health facilities in 13 African countries. Sixteen RH commodities, including contraceptives, were selected as indicators. Results: Of the 46 facilities surveyed, 55 percent faced stockouts of one or more products in the three months prior to the survey. Stockouts were less common for contraceptives than for other RH products. Significant strengths of the FBO supply chain included creativity in finding other sources of commodities in the face of stockouts, staff designated to monitor quality of the commodities, high capacity for storage, low incidence of expired products, few instances of poor quality, and strong financial sustainability mechanisms, often including patient fees. Weaknesses included unreliable commodity sources and power supplies, long

  9. Liberia_WADC00004_OHDR_Health_Facilities2010

    Data.gov (United States)

    United Nations Cartographic Section — This data is based on the survey questionnaire, which are included in the table belowWhat county is this facility in?What is the facility name?Is this facility a...

  10. Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study

    Science.gov (United States)

    2012-01-01

    Background Violence at work is one of the major concerns in health care activities. The aim of this study was to identify the prevalence of physical and non-physical violence in a general health care facility in Italy and to assess the relationship between violence and psychosocial factors, thereby providing a basis for appropriate intervention. Methods All health care workers from a public health care facility were invited to complete a questionnaire containing questions on workplace violence. Three questionnaire-based cross-sectional surveys were conducted. The response rate was 75 % in 2005, 71 % in 2007, and 94 % in 2009. The 2009 questionnaire contained the VIF (Violent Incident Form) for reporting violent incidents, the DCS (demand/control/support) model for job strain, the Colquitt 20 item questionnaire for perceived organizational justice, and the GHQ-12 General Health Questionnaire for the assessment of mental health. Results One out of ten workers reported physical assault, and one out of three exposure to non-physical violence in the workplace in the previous year. Nurses and physicians were the most exposed occupational categories, whereas the psychiatric and emergency departments were the services at greatest risk of violence. Workers exposed to non-physical violence were subject to high job strain, low support, low perceived organizational justice, and high psychological distress. Conclusion Our study shows that health care workers in an Italian local health care facility are exposed to violence. Workplace violence was associated with high demand and psychological disorders, while job control, social support and organizational justice were protective factors. PMID:22551645

  11. Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study

    Directory of Open Access Journals (Sweden)

    Magnavita Nicola

    2012-05-01

    Full Text Available Abstract Background Violence at work is one of the major concerns in health care activities. The aim of this study was to identify the prevalence of physical and non-physical violence in a general health care facility in Italy and to assess the relationship between violence and psychosocial factors, thereby providing a basis for appropriate intervention. Methods All health care workers from a public health care facility were invited to complete a questionnaire containing questions on workplace violence. Three questionnaire-based cross-sectional surveys were conducted. The response rate was 75 % in 2005, 71 % in 2007, and 94 % in 2009. The 2009 questionnaire contained the VIF (Violent Incident Form for reporting violent incidents, the DCS (demand/control/support model for job strain, the Colquitt 20 item questionnaire for perceived organizational justice, and the GHQ-12 General Health Questionnaire for the assessment of mental health. Results One out of ten workers reported physical assault, and one out of three exposure to non-physical violence in the workplace in the previous year. Nurses and physicians were the most exposed occupational categories, whereas the psychiatric and emergency departments were the services at greatest risk of violence. Workers exposed to non-physical violence were subject to high job strain, low support, low perceived organizational justice, and high psychological distress. Conclusion Our study shows that health care workers in an Italian local health care facility are exposed to violence. Workplace violence was associated with high demand and psychological disorders, while job control, social support and organizational justice were protective factors.

  12. Review of attacks on health care facilities in six conflicts of the past three decades.

    Science.gov (United States)

    Briody, Carolyn; Rubenstein, Leonard; Roberts, Les; Penney, Eamon; Keenan, William; Horbar, Jeffrey

    2018-01-01

    In the ongoing conflicts of Syria and Yemen, there have been widespread reports of attacks on health care facilities and personnel. Tabulated evidence does suggest hospital bombings in Syria and Yemen are far higher than reported in other conflicts but it is unclear if this is a reporting artefact. This article examines attacks on health care facilities in conflicts in six middle- to high- income countries that have occurred over the past three decades to try and determine if attacks have become more common, and to assess the different methods used to collect data on attacks. The six conflicts reviewed are Yemen (2015-Present), Syria (2011- Present), Iraq (2003-2011), Chechnya (1999-2000), Kosovo (1998-1999), and Bosnia and Herzegovina (1992-1995). We attempted to get the highest quality source(s) with summary data of the number of facilities attacked for each of the conflicts. The only conflict that did not have summary data was the conflict in Iraq. In this case, we tallied individual reported events of attacks on health care. Physicians for Human Rights (PHR) reported attacks on 315 facilities (4.38 per month) in Syria over a 7-year period, while the Monitoring Violence against Health Care (MVH) tool launched later by the World Health Organization (WHO) Turkey Health Cluster reported attacks on 135 facilities (9.64 per month) over a 14-month period. Yemen had a reported 93 attacks (4.65 per month), Iraq 12 (0.12 per month), Chechnya > 24 (2.4 per month), Kosovo > 100 (6.67 per month), and Bosnia 21 (0.41 per month). Methodologies to collect data, and definitions of both facilities and attacks varied widely across sources. The number of reported facilities attacked is by far the greatest in Syria, suggesting that this phenomenon has increased compared to earlier conflicts. However, data on attacks of facilities was incomplete for all of the conflicts examined, methodologies varied widely, and in some cases, attacks were not defined at all. A global

  13. 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

  14. 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

  15. High energy-density science on the National Ignition Facility

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, E.M.; Cauble, R.; Remington, B.A.

    1997-08-01

    The National Ignition Facility, as well as its French counterpart Le Laser Megajoule, have been designed to confront one of the most difficult and compelling problem in shock physics - the creation of a hot, compassed DT plasma surrounded and confined by cold, nearly degenerate DT fuel. At the same time, these laser facilities will present the shock physics community with unique tools for the study of high energy density matter at states unreachable by any other laboratory technique. Here we describe how these lasers can contribute to investigations of high energy density in the area of material properties and equations of state, extend present laboratory shock techniques such as high-speed jets to new regimes, and allow study of extreme conditions found in astrophysical phenomena.

  16. 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...

  17. Health Resources Statistics; Health Manpower and Health Facilities, 1968. Public Health Service Publication No. 1509.

    Science.gov (United States)

    National Center for Health Statistics (DHEW/PHS), Hyattsville, MD.

    This report is a part of the program of the National Center for Health Statistics to provide current statistics as baseline data for the evaluation, planning, and administration of health programs. Part I presents data concerning the occupational fields: (1) administration, (2) anthropology and sociology, (3) data processing, (4) basic sciences,…

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

    Science.gov (United States)

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

    2017-10-18

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

  19. Mental Health Facilities, This file contains the name, address, contact and some licensing information for the Mental Health facilities in Maryland., Published in 2010, Smaller than 1:100000 scale, Maryland Department of Health and Mental Hygiene.

    Data.gov (United States)

    NSGIC State | GIS Inventory — Mental Health Facilities dataset current as of 2010. This file contains the name, address, contact and some licensing information for the Mental Health facilities in...

  20. A STUDY ON STATUS OF CLIENT SATISFACTION IN PATIENTS ATTENDING GOVERNMENT HEALTH FACILITIES IN AGRA DISTRICT

    Directory of Open Access Journals (Sweden)

    D Anand

    2012-09-01

    Full Text Available Background: It is easier to evaluate the patient’s satisfaction towards the service than evaluate the quality of medical services that they receive. Patient satisfaction indicators remain stable over time as oppose to clinical indicators which will be changed with technology and pace of medical progress. Objectives: 1 To assess the level of satisfaction of patients attending government health facilities.2 To identify the area of low satisfaction at Government health facility. Methodology: Multistage sampling technique was used for selecting primary and secondary level health facilities. Patients were interviewed, when they were leaving health facility by using pretested, predesigned, semi-structured schedule. Results: A total of 600 clients were interviewed in this study and it was found that there was high level of satisfaction with signboard/display, courtesy and respect given by doctor, overall time duration given by doctor, skills of doctor, effectiveness of health services in solving problem, cost incurred on health services, and behavior of paramedical staff. Whereas comparatively low level of satisfaction was found regarding timings of OPD, registration procedure, waiting time, Cleanliness and comfort of waiting area and examination room, privacy measures and behavior of other non medical staff member.Major causes of dissatisfaction at primary level were Comfort and cleanliness of waiting area and service area, privacy measures, overall time duration given by doctor and behavior of supporting staff. However at higher i.e. secondary and tertiary level major causes found were inadequate OPD timing, mismanaged registration procedure and long waiting time to seek doctor. Conclusion: To raise level of patients satisfaction there should be capacity building,training and orientation programmes for health professonals.

  1. Quality assurance system for sitting high risk facilities

    International Nuclear Information System (INIS)

    Rodriguez, Aymee; Peralta, Jose L.; Fernandez, Manuel

    1999-01-01

    The paper shows how we have conceived and designed the quality assurance system for the site selection process of an area for sitting the facility of high risk in correspondence with the approved methodology. The results obtained in the implementation of the system have permitted the satisfactory performance of each one the expected stage, defining the most favorable sectors in order to continue the studies of the repository site for the disposal of low and intermedium. (author)

  2. ACIGA's high optical power test facility

    Energy Technology Data Exchange (ETDEWEB)

    Ju, L [School of Physics, University of Western Australia, Perth (Australia); Aoun, M [Computer and Information Science, Edith Cowan University, Perth (Australia); Barriga, P [School of Physics, University of Western Australia, Perth (Australia)] [and others

    2004-03-07

    Advanced laser interferometer detectors utilizing more than 100 W of laser power and with {approx}10{sup 6} W circulating laser power present many technological problems. The Australian Consortium for Interferometric Gravitational Astronomy (ACIGA) is developing a high power research facility in Gingin, north of Perth, Western Australia, which will test techniques for the next generation interferometers. In particular it will test thermal lensing compensation and control strategies for optical cavities in which optical spring effects and parametric instabilities may present major difficulties.

  3. Ion beams from high-current PF facilities

    Energy Technology Data Exchange (ETDEWEB)

    Sadowski, M [Soltan Inst. for Nuclear Studies, Otwock-Swierk (Poland)

    1997-12-31

    Pulsed beams of fast deuterons and impurity or admixture ions emitted from high-current PF-type facilities operated in different laboratories are dealt with. A short comparative analysis of time-integrated and time-resolved studies is presented. Particular attention is paid to the microstructure of such ion beams, and to the verification of some theoretical models. (author). 5 figs., 19 refs.

  4. Evaluating health risks in communities near nuclear facilities

    International Nuclear Information System (INIS)

    Ruttenber, A.J.

    1992-01-01

    Over the past 10 years, epidemiologic studies have been the most popular approach to examining health risks to populations near nuclear facilities. A review of these studies has identified a number of methodologic problems, particularly with regard to establishing causal relations between radiation exposure and disease. Recently, in the United States, dose reconstruction and risk assessment projects have been conducted as alternatives to epidemiologic studies. This paper reviews the problems associated with epidemiologic studies and discusses how dose reconstruction and risk assessment can serve as alternatives to epidemiologic studies. Examples are also provided to demonstrate how these techniques can be used to explore the feasibility of epidemiologic studies, and how dose reconstruction data can improve the quality of epidemiologic studies

  5. National ignition facility environment, safety, and health management plan

    International Nuclear Information System (INIS)

    1995-11-01

    The ES ampersand H Management Plan describes all of the environmental, safety, and health evaluations and reviews that must be carried out in support of the implementation of the National Ignition Facility (NIF) Project. It describes the policy, organizational responsibilities and interfaces, activities, and ES ampersand H documents that will be prepared by the Laboratory Project Office for the DOE. The only activity not described is the preparation of the NIF Project Specific Assessment (PSA), which is to be incorporated into the Programmatic Environmental Impact Statement for Stockpile Stewardship and Management (PEIS). This PSA is being prepared by Argonne National Laboratory (ANL) with input from the Laboratory participants. As the independent NEPA document preparers ANL is directly contracted by the DOE, and its deliverables and schedule are agreed to separately with DOE/OAK

  6. Strategic planning and marketing research for older, inner-city health care facilities: a case study.

    Science.gov (United States)

    Wood, V R; Robertson, K R

    1992-01-01

    Numerous health care facilities, located in downtown metropolitan areas, now find themselves surrounded by a decaying inner-city environment. Consumers may perceive these facilities as "old," and catering to an "urban poor" consumer. These same consumers may, therefore, prefer to patronize more modern facilities located in suburban areas. This paper presents a case study of such a health care facility and how strategic planning and marketing research were conducted in order to identify market opportunities and new strategic directions.

  7. 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.

  8. Keeping health facilities safe: one way of strengthening the interaction between disease-specific programmes and health systems.

    Science.gov (United States)

    Harries, Anthony D; Zachariah, Rony; Tayler-Smith, Katie; Schouten, Erik J; Chimbwandira, Frank; Van Damme, Wim; El-Sadr, Wafaa M

    2010-12-01

    The debate on the interaction between disease-specific programmes and health system strengthening in the last few years has intensified as experts seek to tease out common ground and find solutions and synergies to bridge the divide. Unfortunately, the debate continues to be largely academic and devoid of specificity, resulting in the issues being irrelevant to health care workers on the ground. Taking the theme 'What would entice HIV- and tuberculosis (TB)-programme managers to sit around the table on a Monday morning with health system experts', this viewpoint focuses on infection control and health facility safety as an important and highly relevant practical topic for both disease-specific programmes and health system strengthening. Our attentions, and the examples and lessons we draw on, are largely aimed at sub-Saharan Africa where the great burden of TB and HIV ⁄ AIDS resides, although the principles we outline would apply to other parts of the world as well. Health care infections, caused for example by poor hand hygiene, inadequate testing of donated blood, unsafe disposal of needles and syringes, poorly sterilized medical and surgical equipment and lack of adequate airborne infection control procedures, are responsible for a considerable burden of illness amongst patients and health care personnel, especially in resource-poor countries. Effective infection control in a district hospital requires that all the components of a health system function well: governance and stewardship, financing,infrastructure, procurement and supply chain management, human resources, health information systems, service delivery and finally supervision. We argue in this article that proper attention to infection control and an emphasis on safe health facilities is a concrete first step towards strengthening the interaction between disease-specific programmes and health systems where it really matters – for patients who are sick and for the health care workforce who provide

  9. Health physics manual of good practices for accelerator facilities

    International Nuclear Information System (INIS)

    Casey, W.R.; Miller, A.J.; McCaslin, J.B.; Coulson, L.V.

    1988-04-01

    It is hoped that this manual will serve both as a teaching aid as well as a useful adjunct for program development. In the context of application, this manual addresses good practices that should be observed by management, staff, and designers since the achievement of a good radiation program indeed involves a combined effort. Ultimately, radiation safety and good work practices become the personal responsibility of the individual. The practices presented in this manual are not to be construed as mandatory rather they are to be used as appropriate for the specific case in the interest of radiation safety. As experience is accrued and new data obtained in the application of this document, ONS will update the guidance to assure that at any given time the guidance reflects optimum performance consistent with current technology and practice.The intent of this guide therefore is to: define common health physics problems at accelerators; recommend suitable methods of identifying, evaluating, and managing accelerator health physics problems; set out the established safety practices at DOE accelerators that have been arrived at by consensus and, where consensus has not yet been reached, give examples of safe practices; introduce the technical literature in the accelerator health physics field; and supplement the regulatory documents listed in Appendix D. Many accelerator health physics problems are no different than those at other kinds of facilities, e.g., ALARA philosophy, instrument calibration, etc. These problems are touched on very lightly or not at all. Similarly, this document does not cover other hazards such as electrical shock, toxic materials, etc. This does not in any way imply that these problems are not serious. 160 refs

  10. HITRAP: A Facility for Experiments with Trapped Highly Charged Ions

    International Nuclear Information System (INIS)

    Quint, W.; Dilling, J.; Djekic, S.; Haeffner, H.; Hermanspahn, N.; Kluge, H.-J.; Marx, G.; Moore, R.; Rodriguez, D.; Schoenfelder, J.; Sikler, G.; Valenzuela, T.; Verdu, J.; Weber, C.; Werth, G.

    2001-01-01

    HITRAP is a planned ion trap facility for capturing and cooling of highly charged ions produced at GSI in the heavy-ion complex of the UNILAC-SIS accelerators and the ESR storage ring. In this facility heavy highly charged ions up to uranium will be available as bare nuclei, hydrogen-like ions or few-electron systems at low temperatures. The trap for receiving and studying these ions is designed for operation at extremely high vacuum by cooling to cryogenic temperatures. The stored highly charged ions can be investigated in the trap itself or can be extracted from the trap at energies up to about 10 keV/q. The proposed physics experiments are collision studies with highly charged ions at well-defined low energies (eV/u), high-accuracy measurements to determine the g-factor of the electron bound in a hydrogen-like heavy ion and the atomic binding energies of few-electron systems, laser spectroscopy of HFS transitions and X-ray spectroscopy

  11. Broad-beam, high current, metal ion implantation facility

    International Nuclear Information System (INIS)

    Brown, I.G.; Dickinson, M.R.; Galvin, J.E.; Godechot, X.; MacGill, R.A.

    1990-07-01

    We have developed a high current metal ion implantation facility with which high current beams of virtually all the solid metals of the Periodic Table can be produced. The facility makes use of a metal vapor vacuum arc ion source which is operated in a pulsed mode, with pulse width 0.25 ms and repetition rate up to 100 pps. Beam extraction voltage is up to 100 kV, corresponding to an ion energy of up to several hundred keV because of the ion charge state multiplicity; beam current is up to several Amperes peak and around 10 mA time averaged delivered onto target. Implantation is done in a broad-beam mode, with a direct line-of-sight from ion source to target. Here we describe the facility and some of the implants that have been carried out using it, including the 'seeding' of silicon wafers prior to CVD with titanium, palladium or tungsten, the formation of buried iridium silicide layers, and actinide (uranium and thorium) doping of III-V compounds. 16 refs., 6 figs

  12. Reasons rural Laotians choose home deliveries over delivery at health facilities: a qualitative study

    Directory of Open Access Journals (Sweden)

    Sychareun Vanphanom

    2012-08-01

    Full Text Available Abstract Background Maternal mortality among poor rural women in the Lao People’s Democratic Republic (Lao PDR is among the highest in Southeast Asia, in part because only 15% give birth at health facilities. This study explored why women and their families prefer home deliveries to deliveries at health facilities. Methods A qualitative study was conducted from December 2008 to February 2009 in two provinces of Lao PDR. Data was collected through eight focus group discussions (FGD as well as through in-depth interviews with 12 mothers who delivered at home during the last year, eight husbands and eight grandmothers, involving a total of 71 respondents. Content analysis was used to analyze the FGD and interview transcripts. Results Obstacles to giving birth at health facilities included: (1 Distance to the health facilities and difficulties and costs of getting there; (2 Attitudes, quality of care, and care practices at the health facilities, including a horizontal birth position, episiotomies, lack of privacy, and the presence of male staff; (3 The wish to have family members nearby and the need for women to be close to their other children and the housework; and (4 The wish to follow traditional birth practices such as giving birth in a squatting position and lying on a “hot bed” after delivery. The decision about where to give birth was commonly made by the woman’s husband, mother, mother-in-law or other relatives in consultation with the woman herself. Conclusion This study suggests that the preference in rural Laos for giving birth at home is due to convenience, cost, comfort and tradition. In order to assure safer births and reduce rural Lao PDR’s high maternal mortality rate, health centers could consider accommodating the wishes and traditional practices of many rural Laotians: allowing family in the birthing rooms; allowing traditional practices; and improving attitudes among staff. Traditional birth attendants, women, and

  13. Reasons rural Laotians choose home deliveries over delivery at health facilities: a qualitative study

    Science.gov (United States)

    2012-01-01

    Background Maternal mortality among poor rural women in the Lao People’s Democratic Republic (Lao PDR) is among the highest in Southeast Asia, in part because only 15% give birth at health facilities. This study explored why women and their families prefer home deliveries to deliveries at health facilities. Methods A qualitative study was conducted from December 2008 to February 2009 in two provinces of Lao PDR. Data was collected through eight focus group discussions (FGD) as well as through in-depth interviews with 12 mothers who delivered at home during the last year, eight husbands and eight grandmothers, involving a total of 71 respondents. Content analysis was used to analyze the FGD and interview transcripts. Results Obstacles to giving birth at health facilities included: (1) Distance to the health facilities and difficulties and costs of getting there; (2) Attitudes, quality of care, and care practices at the health facilities, including a horizontal birth position, episiotomies, lack of privacy, and the presence of male staff; (3) The wish to have family members nearby and the need for women to be close to their other children and the housework; and (4) The wish to follow traditional birth practices such as giving birth in a squatting position and lying on a “hot bed” after delivery. The decision about where to give birth was commonly made by the woman’s husband, mother, mother-in-law or other relatives in consultation with the woman herself. Conclusion This study suggests that the preference in rural Laos for giving birth at home is due to convenience, cost, comfort and tradition. In order to assure safer births and reduce rural Lao PDR’s high maternal mortality rate, health centers could consider accommodating the wishes and traditional practices of many rural Laotians: allowing family in the birthing rooms; allowing traditional practices; and improving attitudes among staff. Traditional birth attendants, women, and their families could be

  14. Heat stress and inadequate sanitary facilities at workplaces – an occupational health concern for women?

    Science.gov (United States)

    Venugopal, Vidhya; Rekha, Shanmugam; Manikandan, Krishnamoorthy; Latha, Perumal Kamalakkannan; Vennila, Viswanathan; Ganesan, Nalini; Kumaravel, Perumal; Chinnadurai, Stephen Jeremiah

    2016-01-01

    Background Health concerns unique to women are growing with the large number of women venturing into different trades that expose them to hot working environments and inadequate sanitation facilities, common in many Indian workplaces. Objective The study was carried out to investigate the health implications of exposures to hot work environments and inadequate sanitation facilities at their workplaces for women workers. Design A cross-sectional study was conducted with 312 women workers in three occupational sectors in 2014–2015. Quantitative data on heat exposures and physiological heat strain indicators such as core body temperature (CBT), sweat rate (SwR), and urine specific gravity (USG) were collected. A structured questionnaire captured workers perceptions about health impacts of heat stress and inadequate sanitary facilities at the workplace. Results Workplace heat exposures exceeded the threshold limit value for safe manual work for 71% women (Avg. wet bulb globe temperature=30°C±2.3°C) during the study period. Eighty-seven percent of the 200 women who had inadequate/no toilets at their workplaces reported experiencing genitourinary problems periodically. Above normal CBT, SwR, and USG in about 10% women workers indicated heat strain and moderate dehydration that corroborated well with their perceptions. Observed significant associations between high-heat exposures and SwR (t=−2.3879, p=0.0192), inadequate toilet facilities and self-reported adverse heat-related health symptoms (χ2=4.03, p=0.0444), and prevalence of genitourinary issues (χ2=42.92, p=0.0005×10−7) reemphasize that heat is a risk and lack of sanitation facilities is a major health concern for women workers. Conclusions The preliminary evidence suggests that health of women workers is at risk due to occupational heat exposures and inadequate sanitation facilities at many Indian workplaces. Intervention through strong labor policies with gender sensitivity is the need of the hour to

  15. Heat stress and inadequate sanitary facilities at workplaces – an occupational health concern for women?

    Directory of Open Access Journals (Sweden)

    Vidhya Venugopal

    2016-09-01

    Full Text Available Background: Health concerns unique to women are growing with the large number of women venturing into different trades that expose them to hot working environments and inadequate sanitation facilities, common in many Indian workplaces. Objective: The study was carried out to investigate the health implications of exposures to hot work environments and inadequate sanitation facilities at their workplaces for women workers. Design: A cross-sectional study was conducted with 312 women workers in three occupational sectors in 2014–2015. Quantitative data on heat exposures and physiological heat strain indicators such as core body temperature (CBT, sweat rate (SwR, and urine specific gravity (USG were collected. A structured questionnaire captured workers perceptions about health impacts of heat stress and inadequate sanitary facilities at the workplace. Results: Workplace heat exposures exceeded the threshold limit value for safe manual work for 71% women (Avg. wet bulb globe temperature=30°C±2.3°C during the study period. Eighty-seven percent of the 200 women who had inadequate/no toilets at their workplaces reported experiencing genitourinary problems periodically. Above normal CBT, SwR, and USG in about 10% women workers indicated heat strain and moderate dehydration that corroborated well with their perceptions. Observed significant associations between high-heat exposures and SwR (t=−2.3879, p=0.0192, inadequate toilet facilities and self-reported adverse heat-related health symptoms (χ2=4.03, p=0.0444, and prevalence of genitourinary issues (χ2=42.92, p=0.0005×10−7 reemphasize that heat is a risk and lack of sanitation facilities is a major health concern for women workers. Conclusions: The preliminary evidence suggests that health of women workers is at risk due to occupational heat exposures and inadequate sanitation facilities at many Indian workplaces. Intervention through strong labor policies with gender sensitivity is the

  16. Heat stress and inadequate sanitary facilities at workplaces - an occupational health concern for women?

    Science.gov (United States)

    Venugopal, Vidhya; Rekha, Shanmugam; Manikandan, Krishnamoorthy; Latha, Perumal Kamalakkannan; Vennila, Viswanathan; Ganesan, Nalini; Kumaravel, Perumal; Chinnadurai, Stephen Jeremiah

    2016-01-01

    Health concerns unique to women are growing with the large number of women venturing into different trades that expose them to hot working environments and inadequate sanitation facilities, common in many Indian workplaces. The study was carried out to investigate the health implications of exposures to hot work environments and inadequate sanitation facilities at their workplaces for women workers. A cross-sectional study was conducted with 312 women workers in three occupational sectors in 2014-2015. Quantitative data on heat exposures and physiological heat strain indicators such as core body temperature (CBT), sweat rate (SwR), and urine specific gravity (USG) were collected. A structured questionnaire captured workers perceptions about health impacts of heat stress and inadequate sanitary facilities at the workplace. Workplace heat exposures exceeded the threshold limit value for safe manual work for 71% women (Avg. wet bulb globe temperature=30°C±2.3°C) during the study period. Eighty-seven percent of the 200 women who had inadequate/no toilets at their workplaces reported experiencing genitourinary problems periodically. Above normal CBT, SwR, and USG in about 10% women workers indicated heat strain and moderate dehydration that corroborated well with their perceptions. Observed significant associations between high-heat exposures and SwR (t=-2.3879, p=0.0192), inadequate toilet facilities and self-reported adverse heat-related health symptoms (χ (2)=4.03, p=0.0444), and prevalence of genitourinary issues (χ (2)=42.92, p=0.0005×10(-7)) reemphasize that heat is a risk and lack of sanitation facilities is a major health concern for women workers. The preliminary evidence suggests that health of women workers is at risk due to occupational heat exposures and inadequate sanitation facilities at many Indian workplaces. Intervention through strong labor policies with gender sensitivity is the need of the hour to empower women, avert further health risks, and

  17. High temperature combustion facility: present capabilities and future prospects

    International Nuclear Information System (INIS)

    Boccio, J.L.; Ginsberg, T.; Ciccarelli, G.

    1995-01-01

    The high-temperature combustion facility constructed and operated by the Department of Advanced Technology of Brookhaven National Laboratory to support and promote research in the area of hydrogen combustion phenomena in mixtures prototypical to light-water reactor containment atmospheres under potential severe accident conditions is reported. The facility can accommodate combustion research activities encompassing the fields of detonation physics, flame acceleration, and low-speed deflagration in a wide range of combustible gas mixtures at initial temperatures up to 700 K and post-combustion pressures up to 100 atmospheres. Some preliminary test results are presented that provide further evidence that the effect of temperature is to increase the sensitivity of hydrogen-air-steam mixtures to undergo detonation [ru

  18. The high-energy dual-beam facility

    International Nuclear Information System (INIS)

    Kaletta, D.

    1984-07-01

    This proposal presents a new experimental facility at the Kernforschungszentrum Karlsruhe (KfK) to study the effects of irradiation on the first wall and blanket materials of a fusion reactor. A special effort is made to demonstrate the advantages of the Dual Beam Technique (DBT) as a future research tool for materials development within the European Fusion Technology Programme. The Dual-Beam-Technique allows the production both of helium and of damage in thick metal and ceramic specimens by simultaneous irradiation with high energy alpha particles and protons produced by the two KfK cyclotrons. The proposal describes the Dual Beam Technique the planned experimental activities and the design features of the Dual Beam Facility presently under construction. (orig.) [de

  19. Calibration of high-dose radiation facilities (Handbook)

    International Nuclear Information System (INIS)

    Gupta, B.L.; Bhat, R.M.

    1986-01-01

    In India at present several high intensity radiation sources are used. There are 135 teletheraphy machines and 65 high intensity cobalt-60 sources in the form of gamma chambers (2.5 Ci) and PANBIT (50 Ci). Several food irradiation facilities and a medical sterilization plant ISOMED are also in operation. The application of these high intensity sources involve a wide variation of dose from 10 Gy to 100 kGy. Accurate and reproducible radiation dosimetry is essential in the use of these sources. This handbook is especially compiled for calibration of high-dose radiation facilities. The first few chapters discuss such topics as interaction of radiation with matter, radiation chemistry, radiation processing, commonly used high intensity radiation sources and their special features, radiation units and dosimetry principles. In the chapters which follow, chemical dosimeters are discussed in detail. This discussion covers Fricke dosimeter, FBX dosimeter, ceric sulphate dosimeter, free radical dosimetry, coloured indicators for irrdiation verification. A final chapter is devoted to practical hints to be followed in calibration work. (author)

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

    Science.gov (United States)

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

    2015-01-01

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

  1. Infrastructural challenges to better health in maternity facilities in rural Kenya: community and healthworker perceptions.

    Science.gov (United States)

    Essendi, Hildah; Johnson, Fiifi Amoako; Madise, Nyovani; Matthews, Zoe; Falkingham, Jane; Bahaj, Abubakr S; James, Patrick; Blunden, Luke

    2015-11-09

    The efforts and commitments to accelerate progress towards the Millennium Development Goals for maternal and newborn health (MDGs 4 and 5) in low and middle income countries have focused primarily on providing key medical interventions at maternity facilities to save the lives of women at the time of childbirth, as well as their babies. However, in most rural communities in sub-Saharan, access to maternal and newborn care services is still limited and even where services are available they often lack the infrastructural prerequisites to function at the very basic level in providing essential routine health care services, let alone emergency care. Lists of essential interventions for normal and complicated childbirth, do not take into account these prerequisites, thus the needs of most health facilities in rural communities are ignored, although there is enough evidence that maternal and newborn deaths continue to remain unacceptably high in these areas. This study uses data gathered through qualitative interviews in Kitonyoni and Mwania sub-locations of Makueni County in Eastern Kenya to understand community and provider perceptions of the obstacles faced in providing and accessing maternal and newborn care at health facilities in their localities. The study finds that the community perceives various challenges, most of which are infrastructural, including lack of electricity, water and poor roads that adversely impact the provision and access to essential life-saving maternal and newborn care services in the two sub-locations. The findings and recommendations from this study are important for the attention of policy makers and programme managers in order to improve the state of lower-tier health facilities serving rural communities and to strengthen infrastructure with the aim of making basic routine and emergency obstetric and newborn care services more accessible.

  2. Awareness of Racial Disparities in Kidney Transplantation among Health Care Providers in Dialysis Facilities.

    Science.gov (United States)

    Kim, Joyce J; Basu, Mohua; Plantinga, Laura; Pastan, Stephen O; Mohan, Sumit; Smith, Kayla; Melanson, Taylor; Escoffery, Cam; Patzer, Rachel E

    2018-05-07

    Despite the important role that health care providers at dialysis facilities have in reducing racial disparities in access to kidney transplantation in the United States, little is known about provider awareness of these disparities. We aimed to evaluate health care providers' awareness of racial disparities in kidney transplant waitlisting and identify factors associated with awareness. We conducted a cross-sectional analysis of a survey of providers from low-waitlisting dialysis facilities ( n =655) across all 18 ESRD networks administered in 2016 in the United States merged with 2014 US Renal Data System and 2014 US Census data. Awareness of national racial disparity in waitlisting was defined as responding "yes" to the question: "Nationally, do you think that African Americans currently have lower waitlisting rates than white patients on average?" The secondary outcome was providers' perceptions of racial difference in waitlisting at their own facilities. Among 655 providers surveyed, 19% were aware of the national racial disparity in waitlisting: 50% (57 of 113) of medical directors, 11% (35 of 327) of nurse managers, and 16% (35 of 215) of other providers. In analyses adjusted for provider and facility characteristics, nurse managers (versus medical directors; odds ratio, 7.33; 95% confidence interval, 3.35 to 16.0) and white providers (versus black providers; odds ratio, 2.64; 95% confidence interval, 1.39 to 5.02) were more likely to be unaware of a national racial disparity in waitlisting. Facilities in the South (versus the Northeast; odds ratio, 3.05; 95% confidence interval, 1.04 to 8.94) and facilities with a low percentage of blacks (versus a high percentage of blacks; odds ratio, 1.86; 95% confidence interval, 1.02 to 3.39) were more likely to be unaware. One quarter of facilities had >5% racial difference in waitlisting within their own facilities, but only 5% were aware of the disparity. Among a limited sample of dialysis facilities with low

  3. Laser programs facility management plan for environment, safety, and health

    International Nuclear Information System (INIS)

    Cruz, G.E.

    1996-01-01

    The Lawrence Livermore National Laboratory's (LLNL) Laser Programs ES ampersand H policy is established by the Associate Director for Laser Programs. This FMP is one component of that policy. Laser Programs personnel design, construct and operate research and development equipment located in various Livermore and Site 300 buildings. The Programs include a variety of activities, primarily laser research and development, inertial confinement fusion, isotope separation, and an increasing emphasis on materials processing, imaging systems, and signal analysis. This FMP is a formal statement of responsibilities and controls to assure operational activities are conducted without harm to employees, the general public, or the environment. This plan identifies the hazards associated with operating a large research and development facility and is a vehicle to control and mitigate those hazards. Hazards include, but are not limited to: laser beams, hazardous and radioactive materials, criticality, ionizing radiation or x rays, high-voltage electrical equipment, chemicals, and powered machinery

  4. Intervention to promote physical health in staff within mental health facilities and the impact on patients' physical health

    DEFF Research Database (Denmark)

    Hjorth, Peter; Davidsen, Annette S; Kilian, Reinhold

    2016-01-01

    of an intervention programme for improving physical health in staff working in longtermpsychiatric treatment facilities. Furthermore, the paper measured the association betweenstaff’s changes in physical health and the patients’ changes in physical health. Methods: Thestudy was a cluster randomized controlled 12......-month intervention study, and the interventionwas active awareness on physical health. Results: In the intervention group the staff reducedtheir waist circumference by 2.3 cm (95% CI: 0.3–4.4) when controlling for gender, age andcigarette consumption. In the control group, the staff changed their waist...... blood pressure was seen. Indications that staff acted aspositive role models for the patients’ physical health were seen....

  5. High temperature engineering research facilities and experiments in Russia

    International Nuclear Information System (INIS)

    Kodochigov, N.G.; Kuzavkov, N.G.; Sukharev, Y.P.; Chudin, A.G.

    1998-01-01

    An overview is given of the characteristics of the experimental facilities and experiments in the Russian Federation: the HTGR neutron-physical investigation facilities ASTRA and GROG; facilities for fuel, graphite and other elements irradiation; and thermal hydraulics experimental facilities. The overview is presented in the form of copies of overhead sheets

  6. OPEN AIR DEMOLITION OF FACILITIES HIGHLY CONTAMINATED WITH PLUTONIUM

    International Nuclear Information System (INIS)

    LLOYD, E.R.

    2007-01-01

    The demolition of highly contaminated plutonium buildings usually is a long and expensive process that involves decontaminating the building to near free- release standards and then using conventional methods to remove the structure. It doesn't, however, have to be that way. Fluor has torn down buildings highly contaminated with plutonium without excessive decontamination. By removing the select source term and fixing the remaining contamination on the walls, ceilings, floors, and equipment surfaces; open-air demolition is not only feasible, but it can be done cheaper, better (safer), and faster. Open-air demolition techniques were used to demolish two highly contaminated buildings to slab-on-grade. These facilities on the Department of Energy's Hanford Site were located in, or very near, compounds of operating nuclear facilities that housed hundreds of people working on a daily basis. To keep the facilities operating and the personnel safe, the projects had to be creative in demolishing the structures. Several key techniques were used to control contamination and keep it within the confines of the demolition area: spraying fixatives before demolition; applying fixative and misting with a fine spray of water as the buildings were being taken down; and demolishing the buildings in a controlled and methodical manner. In addition, detailed air-dispersion modeling was done to establish necessary building and meteorological conditions and to confirm the adequacy of the proposed methods. Both demolition projects were accomplished without any spread of contamination outside the modest buffer areas established for contamination control. Furthermore, personnel exposure to radiological and physical hazards was significantly reduced by using heavy equipment rather than ''hands on'' techniques

  7. Highly durable and low permeable concrete for LLW facilities

    International Nuclear Information System (INIS)

    Yanagibashi, Kunio; Saito, Toshio; Odagawa, Masaro.

    1997-01-01

    Concrete used for LLW facilities is required to be highly durable. The authors evaluated concrete containing glycol ether derivatives and silica fume as admixtures. Compressive strength, diffusion coefficient of water, depth of accelerated carbonation, drying shrinkage, depth of chlorides penetration and resistance to freezing and thawing were investigated using concrete specimens. Compressive strength, depth of accelerated carbonation, diffusion coefficient of 137 Cs were investigated using mortar specimens before and after irradiation of gamma rays. Results showed that using glycol ether derivatives and silica fume was effective in improving the durability. (author)

  8. Shielding technology for high energy radiation production facility

    International Nuclear Information System (INIS)

    Lee, Byung Chul; Kim, Heon Il

    2004-06-01

    In order to develop shielding technology for high energy radiation production facility, references and data for high energy neutron shielding are searched and collected, and calculations to obtain the characteristics of neutron shield materials are performed. For the evaluation of characteristics of neutron shield material, it is chosen not only general shield materials such as concrete, polyethylene, etc., but also KAERI developed neutron shields of High Density PolyEthylene (HDPE) mixed with boron compound (B 2 O 3 , H 2 BO 3 , Borax). Neutron attenuation coefficients for these materials are obtained for later use in shielding design. The effect of source shape and source angular distribution on the shielding characteristics for several shield materials is examined. This effect can contribute to create shielding concept in case of no detail source information. It is also evaluated the effect of the arrangement of shield materials using current shield materials. With these results, conceptual shielding design for PET cyclotron is performed. The shielding composite using HDPE and concrete is selected to meet the target dose rate outside the composite, and the dose evaluation is performed by configuring the facility room conceptually. From the result, the proper shield configuration for this PET cyclotron is proposed

  9. A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana

    DEFF Research Database (Denmark)

    Ahiabu, Mary-Anne; Tersbøl, Britt Pinkowski; Biritwum, Richard

    2016-01-01

    with the national average estimated in 2008. Interventions that reduce diagnostic uncertainty in illness management should be considered. The National Health Insurance Scheme, as the main purchaser of health services in Ghana, offers an opportunity that should be exploited to introduce policies in support......Resistance to antibiotics is increasing globally and is a threat to public health. Research has demonstrated a correlation between antibiotic use and resistance development. Developing countries are the most affected by resistance because of high infectious disease burden, limited access to quality...... assured antibiotics and more optimal drugs and poor antibiotic use practices. The appropriate use of antibiotics to slow the pace of resistance development is crucial. The study retrospectively assessed antibiotic prescription practices in four public and private primary health-care facilities in Eastern...

  10. Regional health care planning: a methodology to cluster facilities using community utilization patterns.

    Science.gov (United States)

    Delamater, Paul L; Shortridge, Ashton M; Messina, Joseph P

    2013-08-22

    Community-based health care planning and regulation necessitates grouping facilities and areal units into regions of similar health care use. Limited research has explored the methodologies used in creating these regions. We offer a new methodology that clusters facilities based on similarities in patient utilization patterns and geographic location. Our case study focused on Hospital Groups in Michigan, the allocation units used for predicting future inpatient hospital bed demand in the state's Bed Need Methodology. The scientific, practical, and political concerns that were considered throughout the formulation and development of the methodology are detailed. The clustering methodology employs a 2-step K-means + Ward's clustering algorithm to group hospitals. The final number of clusters is selected using a heuristic that integrates both a statistical-based measure of cluster fit and characteristics of the resulting Hospital Groups. Using recent hospital utilization data, the clustering methodology identified 33 Hospital Groups in Michigan. Despite being developed within the politically charged climate of Certificate of Need regulation, we have provided an objective, replicable, and sustainable methodology to create Hospital Groups. Because the methodology is built upon theoretically sound principles of clustering analysis and health care service utilization, it is highly transferable across applications and suitable for grouping facilities or areal units.

  11. Physical Exposure to Seismic Hazards of Health Facilities in Mexico City, Mexico

    Science.gov (United States)

    Rodriguez, S. M.; Novelo Casanova, D.

    2010-12-01

    Although health facilities are essential infrastructure during disasters and emergencies, they are also usually highly vulnerable installations in the case of the occurrence of large and major earthquakes. Hospitals are one of the most complex critical facilities in modern cities and they are used as first response in emergency situations. The operability of a hospital must be maintained after the occurrence of a local strong earthquake in order to satisfy the need for medical care of the affected population. If a health facility is seriously damaged, it cannot fulfill its function when most is needed. In this case, hospitals become a casualty of the disaster. To identify the level of physical exposure of hospitals to seismic hazards in Mexico City, we analyzed their geographic location with respect to the seismic response of the different type of soils of the city from past earthquakes, mainly from the events that occurred on September 1985 (Ms= 8.0) and April 1989 (Ms= 6.9). Seismic wave amplification in this city is the result of the interaction of the incoming seismic waves with the soft and water saturated clay soils, on which a large part of Mexico City is built. The clay soils are remnants of the lake that existed in the Valley of Mexico and which has been drained gradually to accommodate the growing urban sprawl. Hospital facilities were converted from a simple database of names and locations into a map layer of resources. This resource layer was combined with other map layers showing areas of seismic microzonation in Mexico City. This overlay was then used to identify those hospitals that may be threatened by the occurrence of a large or major seismic event. We analyzed the public and private hospitals considered as main health facilities. Our results indicate that more than 50% of the hospitals are highly exposed to seismic hazards. Besides, in most of these health facilities we identified the lack of preventive measures and preparedness to reduce their

  12. Management of the high-level nuclear power facilities

    International Nuclear Information System (INIS)

    Preda, Marin

    2003-05-01

    This thesis approaches current issues in the management of the high power nuclear facilities and as such it appears to be important particularly for nuclear power plant operation topics. Of special interest are the failure events entailing possible catastrophic situations. The contents is structured onto ten chapters. The first chapter describes the operation regimes of the nuclear high power facilities. Highlighted here are the thesis scope and the original features of the work. The second chapter deals with operational policies developed in order to ensure the preventive maintenance of the nuclear installations. Also managing structures are described devoted to practical warranting the equipment safety function of non-classical power stations. In the third chapter cases of nuclear accidents are analyzed especially stressing the probabilistic risk and the operation regimes having in view the elimination of catastrophic events. In the fourth and fifth chapters the control of nuclear radiation emission is treated focusing the quality issue of nuclear installations required to avoid hazardous effects at level of nuclear reactor operation stage. At the same time set of operational measures is given here for preventing risks, catastrophes and chaotic situations. The chapter five presents both theoretical and practical approaches of the nuclear reactor core management concerning particularly the fuel testing, the water primary system and the quality of the involved equipment. In the sixth and seventh chapters issues of risk-quality correlations are approached as well as the structure of expert systems for monitoring the operational regimes of nuclear facilities. The efficiency of the power systems with nuclear injection is discussed and some original ideas developed in this work are evidenced in the eighth and ninth chapters. Presented are here both the operational principles and models of raising the efficiency of the interconnected nuclear stations and prices' policy

  13. Implementation of tuberculosis infection control in health facilities in Mukono and Wakiso districts, Uganda.

    Science.gov (United States)

    Buregyeya, Esther; Nuwaha, Fred; Verver, Suzanne; Criel, Bart; Colebunders, Robert; Wanyenze, Rhoda; Kalyango, Joan N; Katamba, Achilles; Mitchell, Ellen Mh

    2013-08-01

    Tuberculosis infection control (TBIC) is rarely implemented in the health facilities in resource limited settings. Understanding the reasons for low level of implementation is critical. The study aim was to assess TBIC practices and barriers to implementation in two districts in Uganda. We conducted a cross-sectional study in 51 health facilities in districts of Mukono and Wakiso. The study included: a facility survey, observations of practices and eight focus group discussions with health workers. Quantitative: Only 16 facilities (31%) had a TBIC plan. Five facilities (10%) were screening patients for cough. Two facilities (4%) reported providing masks to patients with cough. Ventilation in the waiting areas was inadequate for TBIC in 43% (22/51) of the facilities. No facility possessed N95 particulate respirators. Qualitative: Barriers that hamper implementation of TBIC elicited included: under-staffing, lack of space for patient separation, lack of funds to purchase masks, and health workers not appreciating the importance of TBIC. TBIC measures were not implemented in health facilities in the two Ugandan districts where the survey was done. Health system factors like lack of staff, space and funds are barriers to implement TBIC. Effective implementation of TBIC measures occurs when the fundamental health system building blocks--governance and stewardship, financing, infrastructure, procurement and supply chain management are in place and functioning appropriately.

  14. The effect of user fee exemption on the utilization of maternal health care at mission health facilities in Malawi.

    Science.gov (United States)

    Manthalu, Gerald; Yi, Deokhee; Farrar, Shelley; Nkhoma, Dominic

    2016-11-01

    The Government of Malawi has signed contracts called service level agreements (SLAs) with mission health facilities in order to exempt their catchment populations from paying user fees. Government in turn reimburses the facilities for the services that they provide. SLAs started in 2006 with 28 out of 165 mission health facilities and increased to 74 in 2015. Most SLAs cover only maternal, neonatal and in some cases child health services due to limited resources. This study evaluated the effect of user fee exemption on the utilization of maternal health services. The difference-in-differences approach was combined with propensity score matching to evaluate the causal effect of user fee exemption. The gradual uptake of the policy provided a natural experiment with treated and control health facilities. A second control group, patients seeking non-maternal health care at CHAM health facilities with SLAs, was used to check the robustness of the results obtained using the primary control group. Health facility level panel data for 142 mission health facilities from 2003 to 2010 were used. User fee exemption led to a 15% (P fee exemption is an important policy for increasing maternal health care utilization. For certain maternal services, however, other determinants may be more important. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  15. Radiation safety program in a high dose rate brachytherapy facility

    International Nuclear Information System (INIS)

    Rodriguez, L.V.; Hermoso, T.M.; Solis, R.C.

    2001-01-01

    The use of remote afterloading equipment has been developed to improve radiation safety in the delivery of treatment in brachytherapy. Several accidents, however, have been reported involving high dose-rate brachytherapy system. These events, together with the desire to address the concerns of radiation workers, and the anticipated adoption of the International Basic Safety Standards for Protection Against Ionizing Radiation (IAEA, 1996), led to the development of the radiation safety program at the Department of Radiotherapy, Jose R. Reyes Memorial Medical Center and at the Division of Radiation Oncology, St. Luke's Medical Center. The radiation safety program covers five major aspects: quality control/quality assurance, radiation monitoring, preventive maintenance, administrative measures and quality audit. Measures for evaluation of effectiveness of the program include decreased unnecessary exposures of patients and staff, improved accuracy in treatment delivery and increased department efficiency due to the development of staff vigilance and decreased anxiety. The success in the implementation required the participation and cooperation of all the personnel involved in the procedures and strong management support. This paper will discuss the radiation safety program for a high dose rate brachytherapy facility developed at these two institutes which may serve as a guideline for other hospitals intending to install a similar facility. (author)

  16. Background field coils for the High Field Test Facility

    International Nuclear Information System (INIS)

    Zbasnik, J.P.; Cornish, D.N.; Scanlan, R.M.; Jewell, A.M.; Leber, R.L.; Rosdahl, A.R.; Chaplin, M.R.

    1980-01-01

    The High Field Test Facility (HFTF), presently under construction at LLNL, is a set of superconducting coils that will be used to test 1-m-o.d. coils of prototype conductors for fusion magnets in fields up to 12 T. The facility consists of two concentric sets of coils; the outer set is a stack of Nb-Ti solenoids, and the inner set is a pair of solenoids made of cryogenically-stabilized, multifilamentary Nb 3 Sn superconductor, developed for use in mirror-fusion magnets. The HFTF system is designed to be parted along the midplane to allow high-field conductors, under development for Tokamak fusion machines, to be inserted and tested. The background field coils were wound pancake-fashion, with cold-welded joints at both the inner and outer diameters. Turn-to-turn insulation was fabricated at LLNL from epoxy-fiberglass strip. The coils were assembled and tested in our 2-m-diam cryostat to verify their operation

  17. Superconducting magnet development capability of the LLNL [Lawrence Livermore National Laboratory] High Field Test Facility

    International Nuclear Information System (INIS)

    Miller, J.R.; Shen, S.; Summers, L.T.

    1990-02-01

    This paper discusses the following topics: High-Field Test Facility Equipment at LLNL; FENIX Magnet Facility; High-Field Test Facility (HFTF) 2-m Solenoid; Cryogenic Mechanical Test Facility; Electro-Mechanical Conductor Test Apparatus; Electro-Mechanical Wire Test Apparatus; FENIX/HFTF Data System and Network Topology; Helium Gas Management System (HGMS); Airco Helium Liquefier/Refrigerator; CTI 2800 Helium Liquefier; and MFTF-B/ITER Magnet Test Facility

  18. Hospital-acquired infections in a Nigerian tertiary health facility: An ...

    African Journals Online (AJOL)

    Hospital-acquired infections in a Nigerian tertiary health facility: An audit of surveillance reports. ... This study evaluated the occurrence of HAI in a foremost tertiary health facility over a 5-year period for the purpose of reinforcing control efforts. Materials and Methods: A retrospective survey of records from the infection control ...

  19. Induced abortion and associated factors in health facilities of Guraghe zone, southern Ethiopia.

    Science.gov (United States)

    Tesfaye, Gezahegn; Hambisa, Mitiku Teshome; Semahegn, Agumasie

    2014-01-01

    Unsafe abortion is one of the major medical and public health problems in developing countries including Ethiopia. However, there is a lack of up-to-date and reliable information on induced abortion distribution and its determinant factors in the country. This study was intended to assess induced abortion and associated factors in health facilities of Guraghe zone, Southern Ethiopia. Institution based cross-sectional study was conducted in eight health facilities in Guraghe zone. Client exit interview was conducted on 400 patients using a structured questionnaire. Bivariate and multivariate logistic regression analysis was performed to identify factors associated with induced abortion. Out of 400 women, 75.5% responded that the current pregnancy that ended in abortion is unwanted. However, only 12.3% of the respondents have admitted interference to the current pregnancy. Having more than four pregnancies (AOR = 4.28, CI: (1.24-14.71)), age of 30-34 years (AOR = 0.15, CI: (0.04-0.55)), primary education (AOR = 0.26, CI: (0.13-0.88)), and wanted pregnancy (AOR = 0.44, CI: (0.14-0.65)) were found to have association with induced abortion. The study revealed high level of induced abortion which is underpinned by high magnitude of unwanted pregnancy. There is requirement for widespread expansion of increased access to high quality family planning service and post-abortion care.

  20. Improving water, sanitation and hygiene in health-care facilities, Liberia.

    Science.gov (United States)

    Abrampah, Nana Mensah; Montgomery, Maggie; Baller, April; Ndivo, Francis; Gasasira, Alex; Cooper, Catherine; Frescas, Ruben; Gordon, Bruce; Syed, Shamsuzzoha Babar

    2017-07-01

    The lack of proper water and sanitation infrastructures and poor hygiene practices in health-care facilities reduces facilities' preparedness and response to disease outbreaks and decreases the communities' trust in the health services provided. To improve water and sanitation infrastructures and hygiene practices, the Liberian health ministry held multistakeholder meetings to develop a national water, sanitation and hygiene and environmental health package. A national train-the-trainer course was held for county environmental health technicians, which included infection prevention and control focal persons; the focal persons acted as change agents. In Liberia, only 45% of 701 surveyed health-care facilities had an improved water source in 2015, and only 27% of these health-care facilities had proper disposal for infectious waste. Local ownership, through engagement of local health workers, was introduced to ensure development and refinement of the package. In-county collaborations between health-care facilities, along with multisectoral collaboration, informed national level direction, which led to increased focus on water and sanitation infrastructures and uptake of hygiene practices to improve the overall quality of service delivery. National level leadership was important to identify a vision and create an enabling environment for changing the perception of water, sanitation and hygiene in health-care provision. The involvement of health workers was central to address basic infrastructure and hygiene practices in health-care facilities and they also worked as stimulators for sustainable change. Further, developing a long-term implementation plan for national level initiatives is important to ensure sustainability.

  1. Managing highly flexible facilities: an essential complementary asset at risk

    NARCIS (Netherlands)

    Tierney, Robert; Tierney, R.; Groen, Arend J.; Harms, Rainer; Luizink, M.; Hetherington, D.; Steward, H.; Walsh, Steven Thomas; Linton, Jonathan; Linton, J.D.

    2012-01-01

    Purpose: Twenty first century problems are increasingly being addressed by multi technology solutions developed by regional entrepreneurial and intreprepreneurial innovators. However, they require an expensive new type of fabrication facility. Multiple technology production facilities (MTPF) have

  2. Evaluation of a high-level waste radiological maintenance facility

    International Nuclear Information System (INIS)

    Collins, K.J.

    1998-01-01

    The Savannah River Site''s (SRS) Defense Waste Processing Facility (DWPF) near Aiken, SC is the nation''s first and world''s largest high level waste vitrification facility. DWPF began, operations in March 1996 to process radioactive waste, consisting of a matrixed predominantly 137 Cs precipitate and a predominately 90 Sr and alpha emitting sludge, into boro-silicate glass for long term storage. Presently, DWPF is processing only sludge waste and is preparing to process a combination of sludge and precipitate waste. During precipitate operations, canister dose rates are expected to exceed 10 Sv hr -1 (1000 rem hr -1 ). In sludge-only operations, canister contact gamma dose rates are approximately 15 mSv hr -1 (1500 mrem hr -1 ). Transferable contamination levels have been greater than 10 mSv hr -1 (100 cm 2 ) -1 for beta-gamma emitters and into the millions of Bq (100 cm 2 ) -1 for the alpha emitting radionuclides. This paper presents an evaluation of the radiological maintenance areas and their ability to support radiological work

  3. 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.

  4. High level waste facilities - Continuing operation or orderly shutdown

    International Nuclear Information System (INIS)

    Decker, L.A.

    1998-04-01

    Two options for Environmental Impact Statement No action alternatives describe operation of the radioactive liquid waste facilities at the Idaho Chemical Processing Plant at the Idaho National Engineering and Environmental Laboratory. The first alternative describes continued operation of all facilities as planned and budgeted through 2020. Institutional control for 100 years would follow shutdown of operational facilities. Alternatively, the facilities would be shut down in an orderly fashion without completing planned activities. The facilities and associated operations are described. Remaining sodium bearing liquid waste will be converted to solid calcine in the New Waste Calcining Facility (NWCF) or will be left in the waste tanks. The calcine solids will be stored in the existing Calcine Solids Storage Facilities (CSSF). Regulatory and cost impacts are discussed

  5. Are Health Facility Management Committees in Kenya ready to implement financial management tasks: findings from a nationally representative survey.

    Science.gov (United States)

    Waweru, Evelyn; Opwora, Antony; Toda, Mitsuru; Fegan, Greg; Edwards, Tansy; Goodman, Catherine; Molyneux, Sassy

    2013-10-10

    Community participation in peripheral public health facilities has in many countries focused on including community representatives in Health Facility Management Committees (HFMCs). In Kenya, HFMC roles are being expanded with the phased implementation of the Health Sector Services Fund (HSSF). Under HSSF, HFMCs manage facility funds which are dispersed directly from central level into facility bank accounts. We assessed how prepared HFMCs were to undertake this new role in advance of HSSF roll out, and considered the implications for Kenya and other similar settings. Data were collected through a nationally representative sample of 248 public health centres and dispensaries in 24 districts in 2010. Data collection included surveys with in-charges (n = 248), HFMC members (n = 464) and facility users (n = 698), and record reviews. These data were supplemented by semi-structured interviews with district health managers in each district. Some findings supported preparedness of HFMCs to take on their new roles. Most facilities had bank accounts and HFMCs which met regularly. HFMC members and in-charges generally reported positive relationships, and HFMC members expressed high levels of motivation and job satisfaction. Challenges included users' low awareness of HFMCs, lack of training and clarity in roles among HFMCs, and some indications of strained relations with in-charges. Such challenges are likely to be common to many similar settings, and are therefore important considerations for any health facility based initiatives involving HFMCs. Most HFMCs have the basic requirements to operate. However to manage their own budgets effectively and meet their allocated roles in HSSF implementation, greater emphasis is needed on financial management training, targeted supportive supervision, and greater community awareness and participation. Once new budget management roles are fully established, qualitative and quantitative research on how HFMCs are adapting to

  6. Social and cultural dimensions of hygiene in Cambodian health care facilities

    Directory of Open Access Journals (Sweden)

    Faurand-Tournaire Anne-Laure

    2011-02-01

    Full Text Available Abstract Background The frequency of bloodborne pathogen healthcare-associated infections is thought to be high in developing Southeast Asian Countries. The underlying social-cultural logics contributing to the risks of transmission are rarely studied. This report provides some insights on the social and cultural factors that shape hygiene practices in Cambodian health care settings. Methods We conducted qualitative surveys in various public and private health facilities in Phnom Penh, the capital city and in provinces. We observed and interviewed 319 participants, health care workers and patients, regarding hygiene practices and social relationships amongst the health care staff and with patients. We also examined the local perceptions of hygiene, their impact on the relationships between the health care staff and patients, and perceptions of transmission risks. Data collection stem from face to face semi-structured and open-ended interviews and focus group discussions with various health care staffs (i.e. cleaners, nurses, midwives and medical doctors and with patients who attended the study health facilities. Results Overall responses and observations indicated that hygiene practices were burdened by the lack of adequate materials and equipements. In addition, many other factors were identified to influence and distort hygiene practices which include (1 informal and formal social rapports in hospitals, (2 major infection control roles played by the cleaners in absence of professional acknowledgment. Moreover, hygiene practices are commonly seen as an unessential matter to be devoted to low-ranking staff. Conclusion Our anthropological findings illustrate the importance of comprehensive understanding of hygiene practices; they need to be considered when designing interventions to improve infection control practices in a Cambodian medical setting.

  7. Why some women fail to give birth at health facilities: A comparative study between Ethiopia and Nigeria.

    Directory of Open Access Journals (Sweden)

    Sanni Yaya

    Full Text Available Obstetric complications and maternal deaths can be prevented through safe delivery process. Facility based delivery significantly reduces maternal mortality by increasing women's access to skilled personnel attendance. However, in sub-Saharan Africa, most deliveries take place without skilled attendants and outside health facilities. Utilization of facility-based delivery is affected by socio-cultural norms and several other factors including cost, long distance, accessibility and availability of quality services. This study examined country-level variations of the self-reported causes of not choosing to deliver at a health facility.Cross-sectional data on 37,086 community dwelling women aged between 15-49 years were collected from DHS surveys in Ethiopia (n = 13,053 and Nigeria (n = 24,033. Outcome variables were the self-reported causes of not delivering at health facilities which were regressed against selected sociodemographic and community level determinants. In total eight items complaints were identified for non-use of facility delivery: 1 Cost too much 2 Facility not open, 3 Too far/no transport, 4 don't trust facility/poor service, 5 No female provider, 6 Husband/family didn't allow, 7 Not necessary, 8 Not customary. Multivariable regression methods were used for measuring the associations.In both countries a large proportion of the women mentioned facility delivery as not necessary, 54.9% (52.3-57.9 in Nigeria and 45.4% (42.0-47.5 in Ethiopia. Significant urban-rural variations were observed in the prevalence of the self-reported causes of non-utilisation. Women in the rural areas are more likely to report delivering at health facility as not customary/not necessary and healthy facility too far/no transport. However, urban women were more likely to complain that husband/family did not allow and that the costs were too high.Women in the rural were more likely to regard facility delivery as unnecessary and complain about transportation

  8. Why some women fail to give birth at health facilities: A comparative study between Ethiopia and Nigeria.

    Science.gov (United States)

    Yaya, Sanni; Bishwajit, Ghose; Uthman, Olalekan A; Amouzou, Agbessi

    2018-01-01

    Obstetric complications and maternal deaths can be prevented through safe delivery process. Facility based delivery significantly reduces maternal mortality by increasing women's access to skilled personnel attendance. However, in sub-Saharan Africa, most deliveries take place without skilled attendants and outside health facilities. Utilization of facility-based delivery is affected by socio-cultural norms and several other factors including cost, long distance, accessibility and availability of quality services. This study examined country-level variations of the self-reported causes of not choosing to deliver at a health facility. Cross-sectional data on 37,086 community dwelling women aged between 15-49 years were collected from DHS surveys in Ethiopia (n = 13,053) and Nigeria (n = 24,033). Outcome variables were the self-reported causes of not delivering at health facilities which were regressed against selected sociodemographic and community level determinants. In total eight items complaints were identified for non-use of facility delivery: 1) Cost too much 2) Facility not open, 3) Too far/no transport, 4) don't trust facility/poor service, 5) No female provider, 6) Husband/family didn't allow, 7) Not necessary, 8) Not customary. Multivariable regression methods were used for measuring the associations. In both countries a large proportion of the women mentioned facility delivery as not necessary, 54.9% (52.3-57.9) in Nigeria and 45.4% (42.0-47.5) in Ethiopia. Significant urban-rural variations were observed in the prevalence of the self-reported causes of non-utilisation. Women in the rural areas are more likely to report delivering at health facility as not customary/not necessary and healthy facility too far/no transport. However, urban women were more likely to complain that husband/family did not allow and that the costs were too high. Women in the rural were more likely to regard facility delivery as unnecessary and complain about transportation and

  9. 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

    Leprosy is a chronic infectious disease of public health importance and one of the leading causes of permanent physical disability. Nevertheless, the drop in prevalence following multidrug therapy has resulted in the neglect of leprosy. The annual incidence of leprosy has remained the same in Ethiopia since decades with more than 76% of the reported new cases coming from Oromia and Amhara Regional States. This study was aimed to assess the knowledge, attitude and skill of general health workers in leprosy control activities at public health facilities in Oromia and Amhara Regional States. A cross-sectional study was conducted from September 2011 to February 2012 at different public health facilities in selected eight zones in Oromia and Amhara Regional States. A multistage sampling method was used to obtain representative samples. High and low endemic zones for leprosy were included in the study in both regional states. Data were collected from general health workers through a structured self-administered questionnaire and at on-site assessment of their performance. Baseline socio-demographic data, health workers' attitude towards leprosy and their knowledge and skill in the management of leprosy were assessed. Bloom's cut off point was used to describe the knowledge and practical skills of the respondents while Likert's scale was used for attitude assessment. A total of 601 general health workers responsible for leprosy control activities at public health facilities were included in knowledge and attitude assessment and 83 of them were subjected to practical evaluation, with on-site observation of how they handle leprosy patients. These included medical doctors (4%), health officers and nurses with Bachelor degree in Science (27%), clinical nurses with diploma (66%) and health assistants (2.8%). The median age of the respondents was 26.0 years and females made up of 45%. Generally the knowledge and skills of the respondents were found to be poor while attitude

  10. 203: THE RELATIONSHIP BETWEEN LEADERSHIP STYLES AND HEALTH WORKER MOTIVATION, TEAMWORK AND JOB SATISFACTION IN HEALTH FACILITIES IN UGANDA

    Science.gov (United States)

    Musinguzi, Conrad; Rutebemberwa, Elizeus; Namale, Leticia; Dahal, Aruna

    2017-01-01

    Background and aims Some studies have shown that poor leadership is associated with lack of effective teamwork and a demotivated workforce leading to poor service delivery. There is scanty data in Uganda on how leadership styles relate to service delivery. This study was done to identify the leadership style in health facilities in Uganda and their relationship with health workers' motivation, job satisfaction and teamwork. Methods A cross-sectional study was conducted in eastern, Rwenzori and west Nile regions of Uganda in November 2015 using self-administered questionnaires distributed and picked the same day from 564 health workers in 270 health facilities. These questionnaires collected information on the health workers' perception of leadership styles of their facility in-charges, their level of motivation and job satisfaction; and the level of team work. Factor analysis was used to identify and confirm latent variables for constructs on leadership styles, motivation, job satisfaction and team work. Relationships were assessed using Pearson correlation. Results A total of 368/564 (64.3%) health workers indicated that transformational leadership was frequent or fairly often, while for transactional leadership it was 304/564 (54.4%) and laissez faire, it was 64/564 (11.4%). There was high correlation between transformational leadership with job satisfaction (r=0.31) and team work (r=0.47) and less correlation with motivation (r=0.18). Transactional leadership was highly correlated with teamwork (r=0.45) but low correlation with motivation (r=0.20) and job satisfaction (r=0.25). Laissez was negatively correlated with motivation at (r=−0.0002), job satisfaction (r=−0.21) and team work (r=−0.19). Conclusion Health workers who perceived their leaders to display transformational leadership had a strong likelihood of being satisfied with their jobs and working in teams. However, those who perceived their in-charges as having a laissez faire leadership style were

  11. Development and use of a master health facility list: Haiti's experience during the 2010 earthquake response.

    Science.gov (United States)

    Rose-Wood, Alyson; Heard, Nathan; Thermidor, Roody; Chan, Jessica; Joseph, Fanor; Lerebours, Gerald; Zugaldia, Antonio; Konkel, Kimberly; Edwards, Michael; Lang, Bill; Torres, Carmen-Rosa

    2014-08-01

    Master health facility lists (MHFLs) are gaining attention as a standards-based means to uniquely identify health facilities and to link facility-level data. The ability to reliably communicate information about specific health facilities can support an array of health system functions, such as routine reporting and emergency response operations. MHFLs support the alignment of donor-supported health information systems with county-owned systems. Recent World Health Organization draft guidance promotes the utility of MHFLs and outlines a process for list development and governance. Although the potential benefits of MHFLs are numerous and may seem obvious, there are few documented cases of MHFL construction and use. The international response to the 2010 Haiti earthquake provides an example of how governments, nongovernmental organizations, and others can collaborate within a framework of standards to build a more complete and accurate list of health facilities. Prior to the earthquake, the Haitian Ministry of Health (Ministère de la Santé Publique et de la Population [MSPP]) maintained a list of public-sector health facilities but lacked information on privately managed facilities. Following the earthquake, the MSPP worked with a multinational group to expand the completeness and accuracy of the list of health facilities, including information on post-quake operational status. This list later proved useful in the response to the cholera epidemic and is now incorporated into the MSPP's routine health information system. Haiti's experience demonstrates the utility of MHFL formation and use in crisis as well as in the routine function of the health information system.

  12. High efficiency combined heat and power facilities - benefits and barriers

    International Nuclear Information System (INIS)

    Klein, M.

    2001-01-01

    There are important linkages between the economy, energy production, the environment and our health. Where thermal energy is needed, distributed Combined Heat and Power facilities, using gas turbines, reciprocating engines and future fuel cells can provide significant improvements to our long term mix of energy production. Local generation can also have benefits in security of energy supply and economic savings. This paper is intended to discuss the relevant air pollution and greenhouse gas emissions from modem CHP plants, the emission prevention and reduction methods available, and their operating experience and cost-effectiveness. Mention is made of recently constructed industrial and commercial plants, and institutional barriers to further development. Solutions described for these barriers include the need for more awareness of opportunities, improved access to the electricity grid, the proper design balance between thermal and electric for CHP systems rather than large combined cycles, improved corporate taxation incentives, and the assessment of all environmental and economic benefits when considering such cleaner sources in a restructured energy market. (author)

  13. American Health Information Management Association. Position statement. Issue: managing health information in facility mergers and acquisitions.

    Science.gov (United States)

    1994-04-01

    Healthcare facility mergers and acquisitions are becoming more common as the industry consolidates. Many critical issues must be considered in mergers and acquisitions, including the management of patient health information. In addition to operational issues, licensure, regulatory, and accreditation requirements must be addressed. To ensure availability of health information to all legitimate users, patient records should be consolidated or linked in the master patient index. A record retention policy should be developed and implemented to meet user needs and assure compliance with legal, regulatory, and accreditation requirements. If health information from closed facilities will be stored for a period of time, its integrity and confidentiality must be preserved, and it must be readily accessible for patient care. The compatibility and functionality of existing information systems should be assessed, and a plan should be formulated for integration of the systems to the extent possible. Such integration may be essential for the organization to successfully meet the demands of integrated delivery systems. Existing databases should be maintained in an accessible form to meet anticipated future needs.

  14. High Performance Computing Facility Operational Assessment 2015: Oak Ridge Leadership Computing Facility

    Energy Technology Data Exchange (ETDEWEB)

    Barker, Ashley D. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility; Bernholdt, David E. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility; Bland, Arthur S. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility; Gary, Jeff D. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility; Hack, James J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility; McNally, Stephen T. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility; Rogers, James H. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility; Smith, Brian E. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility; Straatsma, T. P. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility; Sukumar, Sreenivas Rangan [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility; Thach, Kevin G. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility; Tichenor, Suzy [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility; Vazhkudai, Sudharshan S. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility; Wells, Jack C. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility

    2016-03-01

    Oak Ridge National Laboratory’s (ORNL’s) Leadership Computing Facility (OLCF) continues to surpass its operational target goals: supporting users; delivering fast, reliable systems; creating innovative solutions for high-performance computing (HPC) needs; and managing risks, safety, and security aspects associated with operating one of the most powerful computers in the world. The results can be seen in the cutting-edge science delivered by users and the praise from the research community. Calendar year (CY) 2015 was filled with outstanding operational results and accomplishments: a very high rating from users on overall satisfaction that ties the highest-ever mark set in CY 2014; the greatest number of core-hours delivered to research projects; the largest percentage of capability usage since the OLCF began tracking the metric in 2009; and success in delivering on the allocation of 60, 30, and 10% of core hours offered for the INCITE (Innovative and Novel Computational Impact on Theory and Experiment), ALCC (Advanced Scientific Computing Research Leadership Computing Challenge), and Director’s Discretionary programs, respectively. These accomplishments, coupled with the extremely high utilization rate, represent the fulfillment of the promise of Titan: maximum use by maximum-size simulations. The impact of all of these successes and more is reflected in the accomplishments of OLCF users, with publications this year in notable journals Nature, Nature Materials, Nature Chemistry, Nature Physics, Nature Climate Change, ACS Nano, Journal of the American Chemical Society, and Physical Review Letters, as well as many others. The achievements included in the 2015 OLCF Operational Assessment Report reflect first-ever or largest simulations in their communities; for example Titan enabled engineers in Los Angeles and the surrounding region to design and begin building improved critical infrastructure by enabling the highest-resolution Cybershake map for Southern

  15. High Performance Computing Facility Operational Assessment, FY 2010 Oak Ridge Leadership Computing Facility

    Energy Technology Data Exchange (ETDEWEB)

    Bland, Arthur S Buddy [ORNL; Hack, James J [ORNL; Baker, Ann E [ORNL; Barker, Ashley D [ORNL; Boudwin, Kathlyn J. [ORNL; Kendall, Ricky A [ORNL; Messer, Bronson [ORNL; Rogers, James H [ORNL; Shipman, Galen M [ORNL; White, Julia C [ORNL

    2010-08-01

    Oak Ridge National Laboratory's (ORNL's) Cray XT5 supercomputer, Jaguar, kicked off the era of petascale scientific computing in 2008 with applications that sustained more than a thousand trillion floating point calculations per second - or 1 petaflop. Jaguar continues to grow even more powerful as it helps researchers broaden the boundaries of knowledge in virtually every domain of computational science, including weather and climate, nuclear energy, geosciences, combustion, bioenergy, fusion, and materials science. Their insights promise to broaden our knowledge in areas that are vitally important to the Department of Energy (DOE) and the nation as a whole, particularly energy assurance and climate change. The science of the 21st century, however, will demand further revolutions in computing, supercomputers capable of a million trillion calculations a second - 1 exaflop - and beyond. These systems will allow investigators to continue attacking global challenges through modeling and simulation and to unravel longstanding scientific questions. Creating such systems will also require new approaches to daunting challenges. High-performance systems of the future will need to be codesigned for scientific and engineering applications with best-in-class communications networks and data-management infrastructures and teams of skilled researchers able to take full advantage of these new resources. The Oak Ridge Leadership Computing Facility (OLCF) provides the nation's most powerful open resource for capability computing, with a sustainable path that will maintain and extend national leadership for DOE's Office of Science (SC). The OLCF has engaged a world-class team to support petascale science and to take a dramatic step forward, fielding new capabilities for high-end science. This report highlights the successful delivery and operation of a petascale system and shows how the OLCF fosters application development teams, developing cutting-edge tools

  16. Atlas Pulsed Power Facility for High Energy Density Physics Experiments

    International Nuclear Information System (INIS)

    Miller, R.B.; Ballard, E.O.; Barr, G.W.; Bowman, D.W.; Chochrane, J.C.; Davis, H.A.; Elizondo, J.M.; Gribble, R.F.; Griego, J.R.; Hicks, R.D.; Hinckley, W.B.; Hosack, K.W.; Nielsen, K.E.; Parker, J.V.; Parsons, M.O.; Rickets, R.L.; Salazar, H.R.; Sanchez, P.G.; Scudder, D.W.; Shapiro, C.; Thompson, M.C.; Trainor, R.J.; Valdez, G.A.; Vigil, B.N.; Watt, R.G.; Wysock, F.J.

    1999-01-01

    The Atlas facility, now under construction at Los Alamos National Laboratory (LANL), will provide a unique capability for performing high-energy-density experiments in support of weapon-physics and basic-research programs. It is intended to be an international user facility, providing opportunities for researchers from national laboratories and academic institutions around the world. Emphasizing institutions around the world. Emphasizing hydrodynamic experiments, Atlas will provide the capability for achieving steady shock pressures exceeding 10-Mbar in a volume of several cubic centimeters. In addition, the kinetic energy associated with solid liner implosion velocities exceeding 12 km/s is sufficient to drive dense, hydrodynamic targets into the ionized regime, permitting the study of complex issues associated with strongly-coupled plasmas. The primary element of Atlas is a 23-MJ capacitor bank, comprised of 96 separate Marx generators housed in 12 separate oil-filled tanks, surrounding a central target chamber. Each tank will house two, independently-removable maintenance units, with each maintenance unit consisting of four Marx modules. Each Marx module has four capacitors that can each be charged to a maximum of 60 kilovolts. When railgap switches are triggered, the marx modules erect to a maximum of 240 kV. The parallel discharge of these 96 Marx modules will deliver a 30-MA current pulse with a 4-5-micros risetime to a cylindrical, imploding liner via 24 vertical, tri-plate, oil-insulated transmission lines. An experimental program for testing and certifying all Marx and transmission line components has been completed. A complete maintenance module and its associated transmission line (the First Article) are now under construction and testing. The current Atlas schedule calls for construction of the machine to be complete by August, 2000. Acceptance testing is scheduled to begin in November, 2000, leading to initial operations in January, 2001

  17. Patient-, health worker-, and health facility-level determinants of correct malaria case management at publicly funded health facilities in Malawi: results from a nationally representative health facility survey.

    Science.gov (United States)

    Steinhardt, Laura C; Chinkhumba, Jobiba; Wolkon, Adam; Luka, Madalitso; Luhanga, Misheck; Sande, John; Oyugi, Jessica; Ali, Doreen; Mathanga, Don; Skarbinski, Jacek

    2014-02-20

    Prompt and effective case management is needed to reduce malaria morbidity and mortality. However, malaria diagnosis and treatment is a multistep process that remains problematic in many settings, resulting in missed opportunities for effective treatment as well as overtreatment of patients without malaria. Prior to the widespread roll-out of malaria rapid diagnostic tests (RDTs) in late 2011, a national, cross-sectional, complex-sample, health facility survey was conducted in Malawi to assess patient-, health worker-, and health facility-level factors associated with malaria case management quality using multivariate Poisson regression models. Among the 2,019 patients surveyed, 34% had confirmed malaria defined as presence of fever and parasitaemia on a reference blood smear. Sixty-seven per cent of patients with confirmed malaria were correctly prescribed the first-line anti-malarial, with most cases of incorrect treatment due to missed diagnosis; 31% of patients without confirmed malaria were overtreated with an anti-malarial. More than one-quarter of patients were not assessed for fever or history of fever by health workers. The most important determinants of correct malaria case management were patient-level clinical symptoms, such as spontaneous complaint of fever to health workers, which increased both correct treatment and overtreatment by 72 and 210%, respectively (pfacility-level factors were significantly associated with case management quality. Introduction of RDTs holds potential to improve malaria case management in Malawi, but health workers must systematically assess all patients for fever, and then test and treat accordingly, otherwise, malaria control programmes might miss an opportunity to dramatically improve malaria case management, despite better diagnostic tools.

  18. Isolation facilities for highly infectious diseases in Europe--a cross-sectional analysis in 16 countries.

    Directory of Open Access Journals (Sweden)

    Stefan Schilling

    Full Text Available BACKGROUND: Highly Infectious Diseases (HIDs are (i easily transmissible form person to person; (ii cause a life-threatening illness with no or few treatment options; and (iii pose a threat for both personnel and the public. Hence, even suspected HID cases should be managed in specialised facilities minimizing infection risks but allowing state-of-the-art critical care. Consensus statements on the operational management of isolation facilities have been published recently. The study presented was set up to compare the operational management, resources, and technical equipment among European isolation facilities. Due to differences in geography, population density, and national response plans it was hypothesized that adherence to recommendations will vary. METHODS AND FINDINGS: Until mid of 2010 the European Network for Highly Infectious Diseases conducted a cross-sectional analysis of isolation facilities in Europe, recruiting 48 isolation facilities in 16 countries. Three checklists were disseminated, assessing 44 items and 148 specific questions. The median feedback rate for specific questions was 97.9% (n = 47/48 (range: n = 7/48 (14.6% to n = 48/48 (100%. Although all facilities enrolled were nominated specialised facilities' serving countries or regions, their design, equipment and personnel management varied. Eighteen facilities fulfilled the definition of a High Level Isolation Unit'. In contrast, 24 facilities could not operate independently from their co-located hospital, and five could not ensure access to equipment essential for infection control. Data presented are not representative for the EU in general, as only 16/27 (59.3% of all Member States agreed to participate. Another limitation of this study is the time elapsed between data collection and publication; e.g. in Germany one additional facility opened in the meantime. CONCLUSION: There are disparities both within and between European countries regarding the design

  19. Health and Safety Management for Small-scale Methane Fermentation Facilities

    Science.gov (United States)

    Yamaoka, Masaru; Yuyama, Yoshito; Nakamura, Masato; Oritate, Fumiko

    In this study, we considered health and safety management for small-scale methane fermentation facilities that treat 2-5 ton of biomass daily based on several years operation experience with an approximate capacity of 5 t·d-1. We also took account of existing knowledge, related laws and regulations. There are no qualifications or licenses required for management and operation of small-scale methane fermentation facilities, even though rural sewerage facilities with a relative similar function are required to obtain a legitimate license. Therefore, there are wide variations in health and safety consciousness of the operators of small-scale methane fermentation facilities. The industrial safety and health laws are not applied to the operation of small-scale methane fermentation facilities. However, in order to safely operate a small-scale methane fermentation facility, the occupational safety and health management system that the law recommends should be applied. The aims of this paper are to clarify the risk factors in small-scale methane fermentation facilities and encourage planning, design and operation of facilities based on health and safety management.

  20. Referral of children seeking care at private health facilities in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K.; Buregyeya, Esther; Rutebemberwa, Elizeus

    2017-01-01

    Background In Uganda, referral of sick children seeking care at public health facilities is poor and widely reported. However, studies focusing on the private health sector are scanty. The main objective of this study was to assess referral practices for sick children seeking care at private health...... facilities in order to explore ways of improving treatment and referral of sick children in this sector. Methods A survey was conducted from August to October 2014 in Mukono district, central Uganda. Data was collected using a structured questionnaire supplemented by Focus Group Discussions and Key Informant...... interviews with private providers and community members. Results A total of 241 private health facilities were surveyed; 170 (70.5%) were registered drug shops, 59 (24.5%) private clinics and 12 (5.0%) pharmacies. Overall, 104/241 (43.2%) of the private health facilities reported that they had referred sick...

  1. Direct facility funding as a response to user fee reduction: implementation and perceived impact among Kenyan health centres and dispensaries.

    Science.gov (United States)

    Opwora, Antony; Kabare, Margaret; Molyneux, Sassy; Goodman, Catherine

    2010-09-01

    There is increasing pressure for reduction of user fees, but this can have adverse effects by decreasing facility-level funds. To address this, direct facility funding (DFF) was piloted in Coast Province, Kenya, with health facility committees (HFCs) responsible for managing the funds. We evaluated the implementation and perceived impact 2.5 years after DFF introduction. Quantitative data collection at 30 public health centres and dispensaries included a structured interview with the in-charge, record reviews and exit interviews. In addition, in-depth interviews were conducted with the in-charge and HFC members at 12 facilities, and with district staff and other stakeholders. DFF procedures were well established: HFCs met regularly and accounting procedures were broadly followed. DFF made an important contribution to facility cash income, accounting for 47% in health centres and 62% in dispensaries. The main items of expenditure were wages for support staff (32%), travel (21%), and construction and maintenance (18%). DFF was perceived to have a highly positive impact through funding support staff such as cleaners and patient attendants, outreach activities, renovations, patient referrals and increasing HFC activity. This was perceived to have improved health worker motivation, utilization and quality of care. A number of problems were identified. HFC training was reportedly inadequate, and no DFF documentation was available at facility level, leading to confusion. Charging user fees above those specified in the national policy remained common, and understanding of DFF among the broader community was very limited. Finally, relationships between HFCs and health workers were sometimes characterized by mistrust and resentment. Relatively small increases in funding may significantly affect facility performance when the funds are managed at the periphery. Kenya plans to scale up DFF nationwide. Our findings indicate this is warranted, but should include improved training

  2. High resolution muon computed tomography at neutrino beam facilities

    International Nuclear Information System (INIS)

    Suerfu, B.; Tully, C.G.

    2016-01-01

    X-ray computed tomography (CT) has an indispensable role in constructing 3D images of objects made from light materials. However, limited by absorption coefficients, X-rays cannot deeply penetrate materials such as copper and lead. Here we show via simulation that muon beams can provide high resolution tomographic images of dense objects and of structures within the interior of dense objects. The effects of resolution broadening from multiple scattering diminish with increasing muon momentum. As the momentum of the muon increases, the contrast of the image goes down and therefore requires higher resolution in the muon spectrometer to resolve the image. The variance of the measured muon momentum reaches a minimum and then increases with increasing muon momentum. The impact of the increase in variance is to require a higher integrated muon flux to reduce fluctuations. The flux requirements and level of contrast needed for high resolution muon computed tomography are well matched to the muons produced in the pion decay pipe at a neutrino beam facility and what can be achieved for momentum resolution in a muon spectrometer. Such an imaging system can be applied in archaeology, art history, engineering, material identification and whenever there is a need to image inside a transportable object constructed of dense materials

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

    Directory of Open Access Journals (Sweden)

    Peter Waiswa

    2015-03-01

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

  4. Health physics manual of good practices for tritium facilities

    International Nuclear Information System (INIS)

    Blauvelt, R.K.; Deaton, M.R.; Gill, J.T.

    1991-12-01

    The purpose of this document is to provide written guidance defining the generally accepted good practices in use at Department of Energy (DOE) tritium facilities. A open-quotes good practiceclose quotes is an action, policy, or procedure that enhances the radiation protection program at a DOE site. The information selected for inclusion in this document should help readers achieve an understanding of the key radiation protection issues at tritium facilities and provide guidance as to what characterizes excellence from a radiation protection point of view. The ALARA (As Low as Reasonable Achievable) program at DOE sites should be based, in part, on following the good practices that apply to their operations

  5. Approaches to the management of waste from health care facilities in Czech Republic and Kazakhstan

    OpenAIRE

    Kaireshev, Ruslan

    2015-01-01

    Waste from healthcare facilities or similar facilities includes components of various physical, chemical and biological character that require special approaches during the handling, specifically with regard to possible risks to human health and the environment. Nowadays a challenge for waste management system becomes waste produced in healthcare facilities and contributes too many reasons, such as population growth and rising life expectancy. The rate of waste production from healthcare faci...

  6. Accounting for variations in ART program sustainability outcomes in health facilities in Uganda: a comparative case study analysis.

    Science.gov (United States)

    Zakumumpa, Henry; Bennett, Sara; Ssengooba, Freddie

    2016-10-18

    Uganda implemented a national ART scale-up program at public and private health facilities between 2004 and 2009. Little is known about how and why some health facilities have sustained ART programs and why others have not sustained these interventions. The objective of the study was to identify facilitators and barriers to the long-term sustainability of ART programs at six health facilities in Uganda which received donor support to commence ART between 2004 and 2009. A case-study approach was adopted. Six health facilities were purposively selected for in-depth study from a national sample of 195 health facilities across Uganda which participated in an earlier study phase. The six health facilities were placed in three categories of sustainability; High Sustainers (2), Low Sustainers (2) and Non- Sustainers (2). Semi-structured interviews with ART Clinic managers (N = 18) were conducted. Questionnaire data were analyzed (N = 12). Document review augmented respondent data. Based on the data generated, across-case comparative analyses were performed. Data were collected between February and June 2015. Several distinguishing features were found between High Sustainers, and Low and Non-Sustainers' ART program characteristics. High Sustainers had larger ART programs with higher staffing and patient volumes, a broader 'menu' of ART services and more stable program leadership compared to the other cases. High Sustainers associated sustained ART programs with multiple funding streams, robust ART program evaluation systems and having internal and external program champions. Low and Non Sustainers reported similar barriers of shortage and attrition of ART-proficient staff, low capacity for ART program reporting, irregular and insufficient supply of ARV drugs and a lack of alignment between ART scale-up and their for-profit orientation in three of the cases. We found that ART program sustainability was embedded in a complex system involving dynamic interactions

  7. Improving primary health care facility performance in Ghana: efficiency analysis and fiscal space implications.

    Science.gov (United States)

    Novignon, Jacob; Nonvignon, Justice

    2017-06-12

    Health centers in Ghana play an important role in health care delivery especially in deprived communities. They usually serve as the first line of service and meet basic health care needs. Unfortunately, these facilities are faced with inadequate resources. While health policy makers seek to increase resources committed to primary healthcare, it is important to understand the nature of inefficiencies that exist in these facilities. Therefore, the objectives of this study are threefold; (i) estimate efficiency among primary health facilities (health centers), (ii) examine the potential fiscal space from improved efficiency and (iii) investigate the efficiency disparities in public and private facilities. Data was from the 2015 Access Bottlenecks, Cost and Equity (ABCE) project conducted by the Institute for Health Metrics and Evaluation. The Stochastic Frontier Analysis (SFA) was used to estimate efficiency of health facilities. Efficiency scores were then used to compute potential savings from improved efficiency. Outpatient visits was used as output while number of personnel, hospital beds, expenditure on other capital items and administration were used as inputs. Disparities in efficiency between public and private facilities was estimated using the Nopo matching decomposition procedure. Average efficiency score across all health centers included in the sample was estimated to be 0.51. Also, average efficiency was estimated to be about 0.65 and 0.50 for private and public facilities, respectively. Significant disparities in efficiency were identified across the various administrative regions. With regards to potential fiscal space, we found that, on average, facilities could save about GH₵11,450.70 (US$7633.80) if efficiency was improved. We also found that fiscal space from efficiency gains varies across rural/urban as well as private/public facilities, if best practices are followed. The matching decomposition showed an efficiency gap of 0.29 between private

  8. Determinants of use of health facility for childbirth in rural Hadiya zone, Southern Ethiopia.

    Science.gov (United States)

    Asseffa, Netsanet Abera; Bukola, Fawole; Ayodele, Arowojolu

    2016-11-16

    Maternal mortality remains a major global public health concern despite many international efforts. Facility-based childbirth increases access to appropriate skilled attendance and emergency obstetric care services as the vast majority of obstetric complications occur during delivery. The purpose of the study was to determine the proportion of facility delivery and assess factors influencing utilization of health facility for childbirth. A cross-sectional study was conducted in two rural districts of Hadiya zone, southern Ethiopia. Participants who delivered within three years of the survey were selected by stratified random sampling. Trained interviewers administered a pre-tested semi-structured questionnaire. We employed bivariate analysis and logistic regression to identify determinants of facility-based delivery. Data from 751 participants showed that 26.9% of deliveries were attended in health facilities. In bivariate analysis, maternal age, education, husband's level of education, possession of radio, antenatal care, place of recent ANC attended, planned pregnancy, wealth quintile, parity, birth preparedness and complication readiness, being a model family and distance from the nearest health facility were associated with facility delivery. On multiple logistic regression, age, educational status, antenatal care, distance from the nearest health facility, wealth quintile, being a model family, planned pregnancy and place of recent ANC attended were the determinants of facility-based childbirth. Efforts to improve institutional deliveries in the region must strengthen initiatives that promote female education, opportunities for wealth creation, female empowerment and increased uptake of family planning among others. Service related barriers and cultural influences on the use of health facility for childbirth require further evaluation.

  9. 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.

  10. The influence of facility design and human resource management on health care professionals.

    Science.gov (United States)

    Sadatsafavi, Hessam; Walewski, John; Shepley, Mardelle M

    2015-01-01

    Cost control of health care services is a strategic concern for organizations. To lower costs, some organizations reduce staffing levels. However, this may not be worth the trade-off, as the quality of services will likely be reduced, morale among health care providers tends to suffer, and patient satisfaction is likely to decline. The potential synergy between human resource management and facility design and operation was investigated to achieve the goal of providing cost containment strategies without sacrificing the quality of services and the commitment of employees. About 700 health care professionals from 10 acute-care hospitals participated in this cross-sectional study. The authors used structural equation modeling to test whether employees' evaluations of their physical work environment and human resource practices were significantly associated with lower job-related anxiety, higher job satisfaction, and higher organizational commitment. The analysis found that employees' evaluations of their physical work environment and human resource practices influenced their job-related feelings and attitudes. Perceived organizational support mediated this relationship. The study also found a small but positive interaction effect between the physical work environment and human resource practices. The influence of physical work environment was small, mainly because of the high predictive value of human resource practices and strong confounding variables included in the analysis. This study specifically showed the role of facility design in reducing job-related anxiety among caregivers. Preliminary evidence is provided that facility design can be used as a managerial tool for improving job-related attitudes and feelings of employees and earning their commitment. Providing a healthy and safe work environment can be perceived by employees as an indication that the organization respects them and cares about their well-being, which might be reciprocated with higher levels

  11. Determinants Of Poor Utilization Of Orthodox Health Facilities In A ...

    African Journals Online (AJOL)

    Large volume of work was disliked by 93.2w% and being addressed by fist name was cherished by 89.8% of the respondents. Lack of guidance in moving round some was of the facilities was highlighted by 58.9%, while financial difficulty was experienced by 50.6% of respondents. Conclusion: Development of community ...

  12. Older Adult Participation in Health Promotion Programs: Perspectives of Facility Administrators

    Science.gov (United States)

    Wright, Tim; Hyner, Gerald C.

    2011-01-01

    Administrators of older adult-centered facilities must identify barriers to the planning and implementation of health promotion programs. In this qualitative research those barriers were identified through in-depth interviews with administrators of older adult-centered facilities. As identified by administrators, the predominant barriers to the…

  13. 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

  14. High Performance Computing Facility Operational Assessment, FY 2011 Oak Ridge Leadership Computing Facility

    Energy Technology Data Exchange (ETDEWEB)

    Baker, Ann E [ORNL; Bland, Arthur S Buddy [ORNL; Hack, James J [ORNL; Barker, Ashley D [ORNL; Boudwin, Kathlyn J. [ORNL; Kendall, Ricky A [ORNL; Messer, Bronson [ORNL; Rogers, James H [ORNL; Shipman, Galen M [ORNL; Wells, Jack C [ORNL; White, Julia C [ORNL

    2011-08-01

    Oak Ridge National Laboratory's Leadership Computing Facility (OLCF) continues to deliver the most powerful resources in the U.S. for open science. At 2.33 petaflops peak performance, the Cray XT Jaguar delivered more than 1.5 billion core hours in calendar year (CY) 2010 to researchers around the world for computational simulations relevant to national and energy security; advancing the frontiers of knowledge in physical sciences and areas of biological, medical, environmental, and computer sciences; and providing world-class research facilities for the nation's science enterprise. Scientific achievements by OLCF users range from collaboration with university experimentalists to produce a working supercapacitor that uses atom-thick sheets of carbon materials to finely determining the resolution requirements for simulations of coal gasifiers and their components, thus laying the foundation for development of commercial-scale gasifiers. OLCF users are pushing the boundaries with software applications sustaining more than one petaflop of performance in the quest to illuminate the fundamental nature of electronic devices. Other teams of researchers are working to resolve predictive capabilities of climate models, to refine and validate genome sequencing, and to explore the most fundamental materials in nature - quarks and gluons - and their unique properties. Details of these scientific endeavors - not possible without access to leadership-class computing resources - are detailed in Section 4 of this report and in the INCITE in Review. Effective operations of the OLCF play a key role in the scientific missions and accomplishments of its users. This Operational Assessment Report (OAR) will delineate the policies, procedures, and innovations implemented by the OLCF to continue delivering a petaflop-scale resource for cutting-edge research. The 2010 operational assessment of the OLCF yielded recommendations that have been addressed (Reference Section 1) and

  15. Pathways to high and low performance: factors differentiating primary care facilities under performance-based financing in Nigeria

    Science.gov (United States)

    Mabuchi, Shunsuke; Sesan, Temilade; Bennett, Sara C

    2018-01-01

    Abstract The determinants of primary health facility performance in developing countries have not been well studied. One of the most under-researched areas is health facility management. This study investigated health facilities under the pilot performance-based financing (PBF) scheme in Nigeria, and aimed to understand which factors differentiated primary health care centres (PHCCs) which had performed well, vs those which had not, with a focus on health facility management practices. We used a multiple case study where we compared two high-performing PHCCs and two low-performing PHCCs for each of the two PBF target states. Two teams of two trained local researchers spent 1 week at each PHCC and collected semi-structured interview, observation and documentary data. Data from interviews were transcribed, translated and coded using a framework approach. The data for each PHCC were synthesized to understand dynamic interactions of different elements in each case. We then compared the characteristics of high and low performers. The areas in which critical differences between high and low-performers emerged were: community engagement and support; and performance and staff management. We also found that (i) contextual and health system factors particularly staffing, access and competition with other providers; (ii) health centre management including community engagement, performance management and staff management; and (iii) community leader support interacted and drove performance improvement among the PHCCs. Among them, we found that good health centre management can overcome some contextual and health system barriers and enhance community leader support. This study findings suggest a strong need to select capable and motivated health centre managers, provide long-term coaching in managerial skills, and motivate them to improve their practices. The study also highlights the need to position engagement with community leaders as a key management practice and a central

  16. Development of a web based GIS for health facilities mapping ...

    African Journals Online (AJOL)

    Hilary Mushonga

    Key Words: Spatial Decision Support System, Web GIS, Mapping, Health geography. 1. Introduction ... Health geography is an area of medical research that incorporates geographic techniques into the study of ... street water pump. Once the ...

  17. Implementation phase – Strengthening community to health facility ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Home · What we do ... Access to quality sexual and reproductive health information, services, prenatal services, and delivery services is ... should contribute to strengthening and improving the quality of provincial maternal health services.

  18. 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

  19. APSIC guidelines for disinfection and sterilization of instruments in health care facilities

    Directory of Open Access Journals (Sweden)

    Moi Lin Ling

    2018-02-01

    Full Text Available Abstract Background The Asia Pacific Society of Infection Control launched its revised Guidelines for Disinfection and Sterilization of Instruments in Health Care Facilities in February 2017. This document describes the guidelines and recommendations for the reprocessing of instruments in healthcare setting. It aims to highlight practical recommendations in a concise format designed to assist healthcare facilities at Asia Pacific region in achieving high standards in sterilization and disinfection. Method The guidelines were revised by an appointed workgroup comprising experts in the Asia Pacific region, following reviews of previously published guidelines and recommendations relevant to each section. Results It recommends the centralization of reprocessing, training of all staff with annual competency assessment, verification of cleaning, continual monitoring of reprocessing procedures to ensure their quality and a corporate strategy for dealing with single-use and single-patient use medical equipment/devices. Detailed recommendations are also given with respect to reprocessing of endoscopes. Close working with the Infection Prevention & Control department is also recommended where decisions related to reprocessing medical equipment/devices are to be made. Conclusions Sterilization facilities should aim for excellence in practices as this is part of patient safety. The guidelines that come with a checklist help service providers identify gaps for improvement to reach this goal.

  20. Structural Health Monitoring of Nuclear Spent Fuel Storage Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Lingyu

    2018-04-10

    Interim storage of spent nuclear fuel from reactor sites has gained additional importance and urgency for resolving waste-management-related technical issues. To ensure that nuclear power remains clean energy, monitoring has been identified by DOE as a high priority cross-cutting need, necessary to determine and predict the degradation state of the systems, structures, and components (SSCs) important to safety (ITS). Therefore, nondestructive structural condition monitoring becomes a need to be installed on existing or to be integrated into future storage system to quantify the state of health or to guarantee the safe operation of nuclear power plants (NPPs) during their extended life span. In this project, the lead university and the collaborating national laboratory teamed to develop a nuclear structural health monitoring (n-SHM) system based on in-situ piezoelectric sensing technologies that can monitor structural degradation and aging for nuclear spent fuel DCSS and similar structures. We also aimed to identify and quantify possible influences of nuclear spent fuel environment (temperature and radiation) to the piezoelectric sensor system and come up with adequate solutions and guidelines therefore. We have therefore developed analytical model for piezoelectric based n-SHM methods, with considerations of temperature and irradiation influence on the model of sensing and algorithms in acoustic emission (AE), guided ultrasonic waves (GUW), and electromechanical impedance spectroscopy (EMIS). On the other side, experimentally the temperature and irradiation influence on the piezoelectric sensors and sensing capabilities were investigated. Both short-term and long-term irradiation investigation with our collaborating national laboratory were performed. Moreover, we developed multi-modal sensing, validated in laboratory setup, and conducted the testing on the We performed multi-modal sensing development, verification and validation tests on very complex structures

  1. pattern of anti diabetic drug prescription at a health facility in jos

    African Journals Online (AJOL)

    Administrator

    Jos Journal of Medicine, Volume 9 No. 1. PATTERN OF ANTI ... diabetic drug prescription at a private health facility in North Central Nigeria. Methodology: this was a ... Figure gender distribution of subjects ( 0 = males 1. = females ). Regimen.

  2. 34 CFR 75.683 - Health or safety standards for facilities.

    Science.gov (United States)

    2010-07-01

    ... Conditions Must Be Met by a Grantee? Other Requirements for Certain Projects § 75.683 Health or safety... to the facilities that the grantee uses for the project. (Authority: 20 U.S.C. 1221e-3 and 3474) ...

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

    Science.gov (United States)

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

    2014-12-01

    Tuberculosis (TB) is a major public health problem in the world and Africa has approximately one quarter of the world's cases. One of the greatest challenges facing most TB programmes is the non-compliance to TB treatment among TB patients. This study aimed at determining the challenges of management of tuberculosis (TB) across selected Osun State health facilities. The study employed a descriptive cross-sectional design. A semi-structured questionnaire was used to collect data from 102 TB patients in the health facilities. The instrument measured socio-demographic variables, patient related factors, socio-economic variables, health care system related factors to TB disease and treatment. Data were analysed and summarized using descriptive and inferential statistics. Statistical significance was placed at p facilities (χ2 = 21.761, p facility and patient-related factors were largely responsible.

  4. Health facility-based data on women receiving sulphadoxine-pyrimethamine during pregnancy in Tanzania

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey M.; Byskov, Jens; Magnussen, Pascal

    2014-01-01

    A study of health facility (HF) data on women receiving sulphadoxine-pyrimethamine (SP) for intermittent preventive treatment of malaria during pregnancy (IPTp) was carried out at antenatal care (ANC) clinics in Mkuranga and Mufindi districts.......A study of health facility (HF) data on women receiving sulphadoxine-pyrimethamine (SP) for intermittent preventive treatment of malaria during pregnancy (IPTp) was carried out at antenatal care (ANC) clinics in Mkuranga and Mufindi districts....

  5. Health physics manual of good practices for tritium facilities

    Energy Technology Data Exchange (ETDEWEB)

    Blauvelt, R.K.; Deaton, M.R.; Gill, J.T. [and others

    1991-12-01

    The purpose of this document is to provide written guidance defining the generally accepted good practices in use at Department of Energy (DOE) tritium facilities. A {open_quotes}good practice{close_quotes} is an action, policy, or procedure that enhances the radiation protection program at a DOE site. The information selected for inclusion in this document should help readers achieve an understanding of the key radiation protection issues at tritium facilities and provide guidance as to what characterizes excellence from a radiation protection point of view. The ALARA (As Low as Reasonable Achievable) program at DOE sites should be based, in part, on following the good practices that apply to their operations.

  6. The forced flow high field test facility SULTAN

    International Nuclear Information System (INIS)

    Horvath, I.; Vecsey, G.; Weymuth, P.

    1984-01-01

    The construction of the 8 Tesla, 1 m bore Test Facility SULTAN - I, a common action of ENEA (I-Frascati), ECN (NL-Petten) and SIN (CH-Villigen), is completed. Results on assembly, cooldown and the first operation of the whole system are presented. The SULTAN facility provides a wide range of capability of parameter variations (field, current, cooling) for the investigation of steady state performance and stability of technical superconductors unders nominal and limiting conditions

  7. Does High School Facility Quality Affect Student Achievement? A Two-Level Hierarchical Linear Model

    Science.gov (United States)

    Bowers, Alex J.; Urick, Angela

    2011-01-01

    The purpose of this study is to isolate the independent effects of high school facility quality on student achievement using a large, nationally representative U.S. database of student achievement and school facility quality. Prior research on linking school facility quality to student achievement has been mixed. Studies that relate overall…

  8. 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

    Full Text Available Abstract Background Maternal mortality in Sub-Saharan Africa remains a challenge with estimates exceeding 1,000 maternal deaths per 100,000 live births in some countries. Successful prevention of maternal deaths hinges on adequate and quality emergency obstetric care. In addition to skilled personnel, there is need for a supportive environment in terms of essential drugs and supplies, equipment, and a referral system. Many household surveys report a reasonably high proportion of women delivering in health facilities. However, the quality and adequacy of facilities and personnel are often not assessed. The three delay model; 1 delay in making the decision to seek care; 2 delay in reaching an appropriate obstetric facility; and 3 delay in receiving appropriate care once at the facility guided this project. This paper examines aspects of the third delay by assessing quality of emergency obstetric care in terms of staffing, skills equipment and supplies. Methods We used data from a survey of 25 maternity health facilities within or near two slums in Nairobi that were mentioned by women in a household survey as places that they delivered. Ethical clearance was obtained from the Kenya Medical Research Institute. Permission was also sought from the Ministry of Health and the Medical Officer of Health. Data collection included interviews with the staff in-charge of maternity wards using structured questionnaires. We collected information on staffing levels, obstetric procedures performed, availability of equipment and supplies, referral system and health management information system. Results Out of the 25 health facilities, only two met the criteria for comprehensive emergency obstetric care (both located outside the two slums while the others provided less than basic emergency obstetric care. Lack of obstetric skills, equipment, and supplies hamper many facilities from providing lifesaving emergency obstetric procedures. Accurate estimation of burden

  9. Distribution of Trauma Care Facilities in Oman in Relation to High-Incidence Road Traffic Injury Sites: Pilot study.

    Science.gov (United States)

    Al-Kindi, Sara M; Naiem, Ahmed A; Taqi, Kadhim M; Al-Gheiti, Najla M; Al-Toobi, Ikhtiyar S; Al-Busaidi, Nasra Q; Al-Harthy, Ahmed Z; Taqi, Alaa M; Ba-Alawi, Sharif A; Al-Qadhi, Hani A

    2017-11-01

    Road traffic injuries (RTIs) are considered a major public health problem worldwide. In Oman, high numbers of RTIs and RTI-related deaths are frequently registered. This study aimed to evaluate the distribution of trauma care facilities in Oman with regards to their proximity to RTI-prevalent areas. This descriptive pilot study analysed RTI data recorded in the national Royal Oman Police registry from January to December 2014. The distribution of trauma care facilities was analysed by calculating distances between areas of peak RTI incidence and the closest trauma centre using Google Earth and Google Maps software (Google Inc., Googleplex, Mountain View, California, USA). A total of 32 trauma care facilities were identified. Four facilities (12.5%) were categorised as class V trauma centres. Of the facilities in Muscat, 42.9% were ranked as class IV or V. There were no class IV or V facilities in Musandam, Al-Wusta or Al-Buraimi. General surgery, orthopaedic surgery and neurosurgery services were available in 68.8%, 59.3% and 12.5% of the centres, respectively. Emergency services were available in 75.0% of the facilities. Intensive care units were available in 11 facilities, with four located in Muscat. The mean distance between a RTI hotspot and the nearest trauma care facility was 34.7 km; however, the mean distance to the nearest class IV or V facility was 83.3 km. The distribution and quality of trauma care facilities in Oman needs modification. It is recommended that certain centres upgrade their levels of trauma care in order to reduce RTI-associated morbidity and mortality in Oman.

  10. Health physics experience with nondestructive X-radiation facilities in the US Air Force

    International Nuclear Information System (INIS)

    Stencel, J.R.; Piltingsrud, H.V.

    1976-01-01

    Radiation safety experience in the construction and use of enclosed nondestructive inspection (NDI) facilities in the US Air Force, has reaffirmed the constant need for the health physicist to continually monitor and assit in upgrading these facilities. Health physics contributions include evaluation of initial shielding requirements, proper selection of construction material, insuring that adequate safety devices are installed and adequate personnel dosimetry devices are available, surveying the facility, and assisting in the safety education program. There is a need to better define NDI warning/safety devices, using the National Bureau of Standards, (NBS) Handbook 107 as the most applicable guide

  11. Patient-driven resource planning of a health care facility evacuation.

    Science.gov (United States)

    Petinaux, Bruno; Yadav, Kabir

    2013-04-01

    The evacuation of a health care facility is a complex undertaking, especially if done in an immediate fashion, ie, within minutes. Patient factors, such as continuous medical care needs, mobility, and comprehension, will affect the efficiency of the evacuation and translate into evacuation resource needs. Prior evacuation resource estimates are 30 years old. Utilizing a cross-sectional survey of charge nurses of the clinical units in an urban, academic, adult trauma health care facility (HCF), the evacuation needs of hospitalized patients were assessed periodically over a two-year period. Survey data were collected on 2,050 patients. Units with patients having low continuous medical care needs during an emergency evacuation were the postpartum, psychiatry, rehabilitation medicine, surgical, and preoperative anesthesia care units, the Emergency Department, and Labor and Delivery Department (with the exception of patients in Stage II labor). Units with patients having high continuous medical care needs during an evacuation included the neonatal and adult intensive care units, special procedures unit, and operating and post-anesthesia care units. With the exception of the neonate group, 908 (47%) of the patients would be able to walk out of the facility, 492 (25.5%) would require a wheelchair, and 530 (27.5%) would require a stretcher to exit the HCF. A total of 1,639 patients (84.9%) were deemed able to comprehend the need to evacuate and to follow directions; the remainder were sedated, blind, or deaf. The charge nurses also determined that 17 (6.9%) of the 248 adult intensive care unit patients were too ill to survive an evacuation, and that in 10 (16.4%) of the 61 ongoing surgery cases, stopping the case was not considered to be safe. Heath care facilities can utilize the results of this study to model their anticipated resource requirements for an emergency evacuation. This will permit the Incident Management Team to mobilize the necessary resources both within

  12. Facilities for High Resolution Imaging of the Sun

    Science.gov (United States)

    von der Lühe, Oskar

    2018-04-01

    The Sun is the only star where physical processes can be observed at their intrinsic spatial scales. Even though the Sun in a mere 150 million km from Earth, it is difficult to resolve fundamental processes in the solar atmosphere, because they occur at scales of the order of the kilometer. They can be observed only with telescopes which have apertures of several meters. The current state-of-the-art are solar telescopes with apertures of 1.5 m which resolve 50 km on the solar surface, soon to be superseded by telescopes with 4 m apertures with 20 km resolution. The US American 4 m DSI Solar Telescope is currently constructed on Maui, Hawaii, and is expected to have first light in 2020. The European solar community collaborates intensively to pursue the 4 m European Solar Telescope with a construction start in the Canaries early in the next decade. Solar telescopes with slightly smaller are also in the planning by the Russian, Indian and Chinese communities. In order to achieve a resolution which approaches the diffraction limit, all modern solar telescopes use adaptive optics which compensates virtually any scene on the solar disk. Multi-conjugate adaptive optics designed to compensate fields of the order on one minute of arc have been demonstrated and will become a facility feature of the new telescopes. The requirements for high precision spectro-polarimetry – about one part in 104 – makes continuous monitoring of (MC)AO performance and post-processing image reconstruction methods a necessity.

  13. Health workers' knowledge of and attitudes towards computer applications in rural African health facilities.

    Science.gov (United States)

    Sukums, Felix; Mensah, Nathan; Mpembeni, Rose; Kaltschmidt, Jens; Haefeli, Walter E; Blank, Antje

    2014-01-01

    The QUALMAT (Quality of Maternal and Prenatal Care: Bridging the Know-do Gap) project has introduced an electronic clinical decision support system (CDSS) for pre-natal and maternal care services in rural primary health facilities in Burkina Faso, Ghana, and Tanzania. To report an assessment of health providers' computer knowledge, experience, and attitudes prior to the implementation of the QUALMAT electronic CDSS. A cross-sectional study was conducted with providers in 24 QUALMAT project sites. Information was collected using structured questionnaires. Chi-squared tests and one-way ANOVA describe the association between computer knowledge, attitudes, and other factors. Semi-structured interviews and focus groups were conducted to gain further insights. A total of 108 providers responded, 63% were from Tanzania and 37% from Ghana. The mean age was 37.6 years, and 79% were female. Only 40% had ever used computers, and 29% had prior computer training. About 80% were computer illiterate or beginners. Educational level, age, and years of work experience were significantly associated with computer knowledge (pworkplace. Given the low levels of computer knowledge among rural health workers in Africa, it is important to provide adequate training and support to ensure the successful uptake of electronic CDSSs in these settings. The positive attitudes to computers found in this study underscore that also rural care providers are ready to use such technology.

  14. Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania

    Directory of Open Access Journals (Sweden)

    Kizito Kuchibanda

    2015-01-01

    Full Text Available The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interview, and observation checklist. The results revealed that healthcare wastes are not quantified or segregated in all the three hospitals. Healthcare wastes at the Shinyanga Regional Referral Hospital are disposed of by on-site incineration and burning and some wastes are disposed off-site. At Kolandoto DDH only on-site burning and land disposal are practiced, while at Kambarage UHC healthcare solid wastes are incinerated, disposed of on land disposal, and burned. Waste management workers do not have formal training in waste management techniques and the hospital administrations pay very little attention to appropriate management of healthcare wastes. In light of this, it is evident that management of healthcare solid wastes is not practiced in accordance with the national and WHO’s recommended standards.

  15. Cost-of-illness of cholera to households and health facilities in rural Malawi.

    Directory of Open Access Journals (Sweden)

    Patrick G Ilboudo

    Full Text Available Cholera remains an important public health problem in many low- and middle-income countries. Vaccination has been recommended as a possible intervention for the prevention and control of cholera. Evidence, especially data on disease burden, cost-of-illness, delivery costs and cost-effectiveness to support a wider use of vaccine is still weak. This study aims at estimating the cost-of-illness of cholera to households and health facilities in Machinga and Zomba Districts, Malawi. A cross-sectional study using retrospectively collected cost data was undertaken in this investigation. One hundred patients were purposefully selected for the assessment of the household cost-of-illness and four cholera treatment centres and one health facility were selected for the assessment conducted in health facilities. Data collected for the assessment in households included direct and indirect costs borne by cholera patients and their families while only direct costs were considered for the assessment conducted in health facilities. Whenever possible, descriptive and regression analysis were used to assess difference in mean costs between groups of patients. The average costs to patients' households and health facilities for treating an episode of cholera amounted to US$65.6 and US$59.7 in 2016 for households and health facilities, respectively equivalent to international dollars (I$ 249.9 and 227.5 the same year. Costs incurred in treating a cholera episode were proportional to duration of hospital stay. Moreover, 52% of households used coping strategies to compensate for direct and indirect costs imposed by the disease. Both households and health facilities could avert significant treatment expenditures through a broader use of pre-emptive cholera vaccination. These findings have direct policy implications regarding priority investments for the prevention and control of cholera.

  16. Cost-of-illness of cholera to households and health facilities in rural Malawi.

    Science.gov (United States)

    Ilboudo, Patrick G; Huang, Xiao Xian; Ngwira, Bagrey; Mwanyungwe, Abel; Mogasale, Vittal; Mengel, Martin A; Cavailler, Philippe; Gessner, Bradford D; Le Gargasson, Jean-Bernard

    2017-01-01

    Cholera remains an important public health problem in many low- and middle-income countries. Vaccination has been recommended as a possible intervention for the prevention and control of cholera. Evidence, especially data on disease burden, cost-of-illness, delivery costs and cost-effectiveness to support a wider use of vaccine is still weak. This study aims at estimating the cost-of-illness of cholera to households and health facilities in Machinga and Zomba Districts, Malawi. A cross-sectional study using retrospectively collected cost data was undertaken in this investigation. One hundred patients were purposefully selected for the assessment of the household cost-of-illness and four cholera treatment centres and one health facility were selected for the assessment conducted in health facilities. Data collected for the assessment in households included direct and indirect costs borne by cholera patients and their families while only direct costs were considered for the assessment conducted in health facilities. Whenever possible, descriptive and regression analysis were used to assess difference in mean costs between groups of patients. The average costs to patients' households and health facilities for treating an episode of cholera amounted to US$65.6 and US$59.7 in 2016 for households and health facilities, respectively equivalent to international dollars (I$) 249.9 and 227.5 the same year. Costs incurred in treating a cholera episode were proportional to duration of hospital stay. Moreover, 52% of households used coping strategies to compensate for direct and indirect costs imposed by the disease. Both households and health facilities could avert significant treatment expenditures through a broader use of pre-emptive cholera vaccination. These findings have direct policy implications regarding priority investments for the prevention and control of cholera.

  17. Using classification tree modelling to investigate drug prescription practices at health facilities in rural Tanzania

    Directory of Open Access Journals (Sweden)

    Kajungu Dan K

    2012-09-01

    Full Text Available Abstract Background Drug prescription practices depend on several factors related to the patient, health worker and health facilities. A better understanding of the factors influencing prescription patterns is essential to develop strategies to mitigate the negative consequences associated with poor practices in both the public and private sectors. Methods A cross-sectional study was conducted in rural Tanzania among patients attending health facilities, and health workers. Patients, health workers and health facilities-related factors with the potential to influence drug prescription patterns were used to build a model of key predictors. Standard data mining methodology of classification tree analysis was used to define the importance of the different factors on prescription patterns. Results This analysis included 1,470 patients and 71 health workers practicing in 30 health facilities. Patients were mostly treated in dispensaries. Twenty two variables were used to construct two classification tree models: one for polypharmacy (prescription of ≥3 drugs on a single clinic visit and one for co-prescription of artemether-lumefantrine (AL with antibiotics. The most important predictor of polypharmacy was the diagnosis of several illnesses. Polypharmacy was also associated with little or no supervision of the health workers, administration of AL and private facilities. Co-prescription of AL with antibiotics was more frequent in children under five years of age and the other important predictors were transmission season, mode of diagnosis and the location of the health facility. Conclusion Standard data mining methodology is an easy-to-implement analytical approach that can be useful for decision-making. Polypharmacy is mainly due to the diagnosis of multiple illnesses.

  18. Prevalence and predictors of giving birth in health facilities in Bugesera District, Rwanda

    Directory of Open Access Journals (Sweden)

    Joharifard Shahrzad

    2012-12-01

    Full Text Available Abstract Background The proportion of births attended by skilled health personnel is one of two indicators used to measure progress towards Millennium Development Goal 5, which aims for a 75% reduction in global maternal mortality ratios by 2015. Rwanda has one of the highest maternal mortality ratios in the world, estimated between 249–584 maternal deaths per 100,000 live births. The objectives of this study were to quantify secular trends in health facility delivery and to identify factors that affect the uptake of intrapartum healthcare services among women living in rural villages in Bugesera District, Eastern Province, Rwanda. Methods Using census data and probability proportional to size cluster sampling methodology, 30 villages were selected for community-based, cross-sectional surveys of women aged 18–50 who had given birth in the previous three years. Complete obstetric histories and detailed demographic data were elicited from respondents using iPad technology. Geospatial coordinates were used to calculate the path distances between each village and its designated health center and district hospital. Bivariate and multivariate logistic regressions were used to identify factors associated with delivery in health facilities. Results Analysis of 3106 lifetime deliveries from 859 respondents shows a sharp increase in the percentage of health facility deliveries in recent years. Delivering a penultimate baby at a health facility (OR = 4.681 [3.204 - 6.839], possessing health insurance (OR = 3.812 [1.795 - 8.097], managing household finances (OR = 1.897 [1.046 - 3.439], attending more antenatal care visits (OR = 1.567 [1.163 - 2.112], delivering more recently (OR = 1.438 [1.120 - 1.847] annually, and living closer to a health center (OR = 0.909 [0.846 - 0.976] per km were independently associated with facility delivery. Conclusions The strongest correlates of facility-based delivery in Bugesera District include previous delivery at a

  19. Quality of drug prescription in primary health care facilities in ...

    African Journals Online (AJOL)

    DR Marwa

    north-western Tanzania. GIVENESS ... Background: Drug therapy can improve a patient's quality of life and health outcomes if only used properly. .... Irrational use of drugs occurs in all countries and causes harm to people (El Mahalli 2012).

  20. factors influencing the choice of health care providing facility among

    African Journals Online (AJOL)

    In the public sector ... Objectives: This study aimed to assess the factors influencing choice and satisfaction with health service providers among local ... the consumer of healthcare services cannot control. ..... Acquisition of Stable Food.

  1. 9. Staff competencies at health facilities implementing an outpatient ...

    African Journals Online (AJOL)

    Esem

    2006-09-26

    Sep 26, 2006 ... an Outpatient Therapeutic Programme for Severely ... ¹Department of Public Health, School of Medicine, University of Zambia, Lusaka, Zambia. ²National Food and ...... professional practices of a three-day course on.

  2. Identifying Factors for Worker Motivation in Zambia's Rural Health Facilities.

    Science.gov (United States)

    Cross, Samuel S; Baernholdt, Dr Marianne

    2017-01-01

    Within Zambia there is a shortage of health workers in rural areas. This study aims to identify motivating factors for retaining rural health workers. Sixty rural health workers completed surveys and 46 were interviewed. They rated the importance of six motivating factors and discussed these and other factors in interviews. An interview was conducted with a Government Human Resources Manager (HR Manager) to elicit contextual information. All six factors were identified as being very important motivators, as were two additional factors. Additional career training was identified by many as the most important factor. Comparison of results and the HR Manager interview revealed that workers lacked knowledge about opportunities and that the HR manager was aware of barriers to career development. The Zambian government might better motivate and retain rural health workers by offering them any combination of identified factors, and by addressing the barriers to career development.

  3. Tuberculosis knowledge, attitudes and practices of patients at primary health care facilities in a South African metropolitan: research towards improved health education.

    Science.gov (United States)

    Kigozi, N Gladys; Heunis, J Christo; Engelbrecht, Michelle C; Janse van Rensburg, André P; van Rensburg, H C J Dingie

    2017-10-10

    Health education is important to empower patients and encourage their contribution towards tuberculosis (TB) control. In South Africa, health education activities are integrated into services provided at the primary health care (PHC) level. This study was conducted in a high TB burden metropolitan area in South Africa. The objective was to assess TB-related knowledge, attitudes and infection control practices of patients attending PHC facilities. In September and October 2015, a cross-sectional survey using fieldworker-administered questionnaires was conducted among patients older than 17 years attending 40 PHC facilities in the Mangaung Metropolitan. Convenience sampling was used to select patients. Participation in the study was voluntary. Descriptive, inferential and multivariate logistic regression analyses were performed. Statistical significance was considered at alpha data were included in the analysis. Most of the patients knew that TB transmission is facilitated by crowded conditions (84.6%) and that pulmonary TB is contagious (73.0%). Surprisingly, the majority of patients also believed that one can get TB from sharing toothbrushes (85.0%) or kissing (65.0%). An overwhelming majority of patients perceived TB to be serious (89.7%), and concurred that taking treatment (97.2%) and opening windows to prevent transmission in PHC facilities (97.0%) are important. Being employed (AOR: 11.5; CI: 4.8-27.6), having received TB infection control information from a PHC facility (AOR: 2.2; CI: 1.5-3.4), and being a TB patient (AOR: 1.6; CI: 1.02-2.46) increased the likelihood of adopting good infection control practices. These findings highlight the need for health education efforts to strengthen accurate information dissemination to promote sound TB knowledge and attitudes among patients attending PHC facilities. Health education efforts should also capitalise on the positive finding of this study that information dissemination at PHC facilities increases good

  4. The defense waste processing facility: the final processing step for defense high-level waste disposal

    International Nuclear Information System (INIS)

    Cowan, S.P.; Sprecher, W.M.; Walton, R.D.

    1983-01-01

    The policy of the U.S. Department of Energy is to pursue an aggressive and credible waste management program that advocates final disposal of government generated (defense) high-level nuclear wastes in a manner consistent with environmental, health, and safety responsibilities and requirements. The Defense Waste Processing Facility (DWPF) is an essential component of the Department's program. It is the first project undertaken in the United States to immobilize government generated high-level nuclear wastes for geologic disposal. The DWPF will be built at the Department's Savannah River Plant near Aiken, South Carolina. When construction is complete in 1989, the DWPF will begin processing the high-level waste at the Savannah River Plant into a borosilicate glass form, a highly insoluble and non-dispersable product, in easily handled canisters. The immobilized waste will be stored on site followed by transportation to and disposal in a Federal repository. The focus of this paper is on the DWPF. The paper discusses issues which justify the project, summarizes its technical attributes, analyzes relevant environmental and insitutional factors, describes the management approach followed in transforming technical and other concepts into concrete and steel, and concludes with observations about the future role of the facility

  5. From home deliveries to health care facilities: establishing a traditional birth attendant referral program in Kenya.

    Science.gov (United States)

    Tomedi, Angelo; Stroud, Sophia R; Maya, Tania Ruiz; Plaman, Christopher R; Mwanthi, Mutuku A

    2015-07-16

    To assess the effectiveness of a traditional birth attendant (TBA) referral program on increasing the number of deliveries overseen by skilled birth attendants (SBA) in rural Kenyan health facilities before and after the implementation of a free maternity care policy. In a rural region of Kenya, TBAs were recruited to educate pregnant women about the importance of delivering in healthcare facilities and were offered a stipend for every pregnant woman whom they brought to the healthcare facility. We evaluated the percentage of prenatal care (PNC) patients who delivered at the intervention site compared with the percentage of PNC patients who delivered at rural control facilities, before and after the referral program was implemented, and before and after the Kenya government implemented a policy of free maternity care. The window period of the study was from July of 2011 through September 2013, with a TBA referral intervention conducted from March to September 2013. The absolute increases from the pre-intervention period to the TBA referral intervention period in SBA deliveries were 5.7 and 24.0% in the control and intervention groups, respectively (p facility significantly increased compared to control health facilities when TBAs educated women about the need to deliver with a SBA and when TBAs received a stipend for bringing women to local health facilities to deliver. Furthermore, this TBA referral program proved to be far more effective in the target region of Kenya than a policy change to provide free obstetric care.

  6. Healthy firms: constraints to growth among private health sector facilities in Ghana and Kenya.

    Science.gov (United States)

    Burger, Nicholas E; Kopf, Daniel; Spreng, Connor P; Yoong, Joanne; Sood, Neeraj

    2012-01-01

    Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa), but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent) report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent). Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent), accounting (Ghana: 45 percent; Kenya: 27 percent), and inventory control (Ghana: 41 percent; Kenya: 24 percent). A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to finance when they have the business processes in place for operating a successful business

  7. Healthy firms: constraints to growth among private health sector facilities in Ghana and Kenya.

    Directory of Open Access Journals (Sweden)

    Nicholas E Burger

    Full Text Available BACKGROUND: Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa, but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. METHODOLOGY/PRINCIPAL FINDINGS: We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent. Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent, accounting (Ghana: 45 percent; Kenya: 27 percent, and inventory control (Ghana: 41 percent; Kenya: 24 percent. A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. CONCLUSIONS/SIGNIFICANCE: The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to

  8. Cost recovery of NGO primary health care facilities: a case study in Bangladesh

    Directory of Open Access Journals (Sweden)

    Alam Khurshid

    2010-06-01

    Full Text Available Abstract Background Little is known about the cost recovery of primary health care facilities in Bangladesh. This study estimated the cost recovery of a primary health care facility run by Building Resources Across Community (BRAC, a large NGO in Bangladesh, for the period of July 2004 - June 2005. This health facility is one of the seven upgraded BRAC facilities providing emergency obstetric care and is typical of the government and private primary health care facilities in Bangladesh. Given the current maternal and child mortality in Bangladesh and the challenges to addressing health-related Millennium Development Goal (MDG targets the financial sustainability of such facilities is crucial. Methods The study was designed as a case study covering a single facility. The methodology was based on the 'ingredient approach' using the allocation techniques by inpatient and outpatient services. Cost recovery of the facility was estimated from the provider's perspective. The value of capital items was annualized using 5% discount rate and its market price of 2004 (replacement value. Sensitivity analysis was done using 3% discount rate. Results The cost recovery ratio of the BRAC primary care facility was 59%, and if excluding all capital costs, it increased to 72%. Of the total costs, 32% was for personnel while drugs absorbed 18%. Capital items were17% of total costs while operational cost absorbed 12%. Three-quarters of the total cost was variable costs. Inpatient services contributed 74% of total revenue in exchange of 10% of total utilization. An average cost per patient was US$ 10 while it was US$ 67 for inpatient and US$ 4 for outpatient. Conclusion The cost recovery of this NGO primary care facility is important for increasing its financial sustainability and decreasing donor dependency, and achieving universal health coverage in a developing country setting. However, for improving the cost recovery of the health facility, it needs to increase

  9. Los Alamos High-Brightness Accelerator FEL (HIBAF) facility

    Energy Technology Data Exchange (ETDEWEB)

    Cornelius, W.D.; Bender, S.; Meier, K.; Thode, L.E.; Watson, J.M.

    1989-01-01

    The 10-/mu/m Los Alamos free-electron laser (FEL) facility is being upgraded. The conventional electron gun and bunchers have been replaced with a much more compact 6-MeV photoinjector accelerator. By adding existing parts from previous experiments, the primary beam energy will be doubled to 40 MeV. With the existing 1-m wiggler (/lambda//sub w/ = 2.7 cm) and resonator, the facility can produce photons with wavelengths from 3 to 100 /mu/m when lasing on the fundamental mode and produce photons in the visible spectrum with short-period wigglers or harmonic operation. After installation of a 150/degree/ bend, a second wiggler will be added as an amplifier. The installation of laser transport tubes between the accelerator vault and an upstairs laboratory will provide experimenters with a radiation-free environment for experiments. Although the initial experimental program of the upgraded facility will be to test the single accelerator-master oscillator/power amplifier configuration, some portion of the operational time of the facility can be dedicated to user experiments. 13 refs., 5 figs., 6 tabs.

  10. Drug availability and health facility usage in a Bamako Initiative and ...

    African Journals Online (AJOL)

    Background: The availability of drugs on a continuous basis is paramount to the success of any health care system. The Bamako Initiative (BI) had provision of essential drugs as one of its key thrusts in order to improve the utilization of health facilities. This study compared the perceived availability of essential drugs and ...

  11. 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 ...

  12. 42 CFR 475.105 - Prohibition against contracting with health care facilities.

    Science.gov (United States)

    2010-10-01

    ... facilities. 475.105 Section 475.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS QUALITY IMPROVEMENT ORGANIZATIONS Utilization and Quality Control Quality Improvement Organizations § 475.105 Prohibition against contracting...

  13. Pattern of Eclampsia in a Tertiary Health Facility Situated in a Semi ...

    African Journals Online (AJOL)

    ANNALS

    Annals of African Medicine. Vol. 6, No.4; 2007:164 – 167. Pattern of Eclampsia in a Tertiary Health Facility Situated in a Semi-Rural ... In Kano State (which is in the same zone as the place where this study was conducted), eclampsia .... eclampsia. RHL commentary. The WHO. Reproductive Health Library No 8. Update Soft.

  14. Quality of newborn care: a health facility assessment in rural Ghana using survey, vignette and surveillance data

    NARCIS (Netherlands)

    Vesel, Linda; Manu, Alexander; Lohela, Terhi J.; Gabrysch, Sabine; Okyere, Eunice; ten Asbroek, Augustinus H. A.; Hill, Zelee; Agyemang, Charlotte Tawiah; Owusu-Agyei, Seth; Kirkwood, Betty R.

    2013-01-01

    To assess the structural capacity for, and quality of, immediate and essential newborn care (ENC) in health facilities in rural Ghana, and to link this with demand for facility deliveries and admissions. Health facility assessment survey and population-based surveillance data. Seven districts in

  15. Development and manufacture of a Nb3Sn superconductor for the high-field test facility

    International Nuclear Information System (INIS)

    Scanlan, R.M.; Cornish, D.N.; Spencer, C.R.; Gregory, E.; Adam, E.

    1981-01-01

    The High-Field Test Facility (HFTF) project has two primary goals. The first is to establish manufacturing capability for a Nb 3 Sn conductor suitable for use in a mirror fusion coil. The second is to provide a test facility for evaluating other fusion conductor designs at high fields. This paper describes some of the problems encountered and the solutions devised in working toward the first goal. Construction of the test facility coils will be described in a subsequent paper

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

    Science.gov (United States)

    Kanyangarara, Mufaro; Walker, Neff; Boerma, Ties

    2018-01-01

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

  17. Comparison of a Commonwealth-initiated regional radiation oncology facility in Toowoomba with a Queensland Health facility

    International Nuclear Information System (INIS)

    Poulsen, M.; Ramsay, R.; Gogna, K.; Middleton, M.; Martin, J.; Khoo, E.; Wong, W.; McQuitty, S.; Walpole, E.; Fairweather, R.

    2010-01-01

    The aim was to compare a private Commonwealth-initiated regional radiation oncology facility in Toowoomba with a Queensland Health facility (QHF) in Brisbane. The comparison concentrated on staffing, case mix and operational budgets, but was not able to look at changes in access to services. Data were collected from the two facilities from January 2008 to June 2008 inclusive. A number of factors were compared, including case mix, staffing levels, delay times for treatment, research, training and treatment costs. The case mix between the two areas was similar with curative treatments making up just over half the work load in both centres and two-thirds the work being made up of cancers of breast and prostate. Staffing levels were leaner in Toowoomba, especially in the areas of nursing, administration and trial coordinators. Research activity was slightly higher in Toowoomba. The average medicare cost per treatment course was similar in both centres ($5000 per course). Total costs of an average treatment including patient, State and Commonwealth costs, showed a 30% difference in costing favouring Toowoomba. This regional radiation oncology centre has provided state-of-the-art cancer care that is close to home for patients living in the Darling Downs region. Both public and private patients have been treated with modest costs to the patient and significant savings to QH. The case mix is similar to the QHF, and there has been significant activity in clinical research. A paperless working environment is one factor that has allowed staffing levels to be reduced. Ongoing support from Governments are required if private facilities are to participate in important ongoing staff training.

  18. Leadership of public health facilities in different climes | Nigerian ...

    African Journals Online (AJOL)

    In view of perceived marginalization of allied health professionals (AHPs) by the medical doctors, there are agitations by them for appointment to the position of the Medical Directors of hospitals. There are however unanswered questions. This article appraises the current situation and compares what is being done in ...

  19. Perception and prevalence of work-related health hazards among health care workers in public health facilities in southern India.

    Science.gov (United States)

    Senthil, Arasi; Anandh, Balasubramanian; Jayachandran, Palsamy; Thangavel, Gurusamy; Josephin, Diana; Yamini, Ravindran; Kalpana, Balakrishnan

    2015-01-01

    Health care workers (HCWs) are exposed to occupational related health hazards. Measuring worker perception and the prevalence of these hazards can help facilitate better risk management for HCWs, as these workers are envisaged to be the first point of contact, especially in resource poor settings. To describe the perception of occupational health hazards and self-reported exposure prevalence among HCWs in Southern India. We used cross sectional design with stratified random sampling of HCWs from different levels of health facilities and categories in a randomly selected district in Southern India. Data on perception and exposure prevalence were collected using a structured interview schedule developed by occupational health experts and administered by trained investigators. A total of 482 HCWs participated. Thirty nine percent did not recognize work-related health hazards, but reported exposure to at least one hazard upon further probing. Among the 81·5% who reported exposure to biological hazard, 93·9% had direct skin contact with infectious materials. Among HCWs reporting needle stick injury, 70·5% had at least one in the previous three months. Ergonomic hazards included lifting heavy objects (42%) and standing for long hours (37%). Psychological hazards included negative feelings (20·3%) and verbal or physical abuse during work (20·5%). More than a third of HCWs failed to recognize work-related health hazards. Despite training in handling infectious materials, HCWs reported direct skin contact with infectious materials and needle stick injuries. RESULTS indicate the need for training oriented toward behavioral change and provision of occupational health services.

  20. Use of a spatial scan statistic to identify clusters of births occurring outside Ghanaian health facilities for targeted intervention.

    Science.gov (United States)

    Bosomprah, Samuel; Dotse-Gborgbortsi, Winfred; Aboagye, Patrick; Matthews, Zoe

    2016-11-01

    To identify and evaluate clusters of births that occurred outside health facilities in Ghana for targeted intervention. A retrospective study was conducted using a convenience sample of live births registered in Ghanaian health facilities from January 1 to December 31, 2014. Data were extracted from the district health information system. A spatial scan statistic was used to investigate clusters of home births through a discrete Poisson probability model. Scanning with a circular spatial window was conducted only for clusters with high rates of such deliveries. The district was used as the geographic unit of analysis. The likelihood P value was estimated using Monte Carlo simulations. Ten statistically significant clusters with a high rate of home birth were identified. The relative risks ranged from 1.43 ("least likely" cluster; P=0.001) to 1.95 ("most likely" cluster; P=0.001). The relative risks of the top five "most likely" clusters ranged from 1.68 to 1.95; these clusters were located in Ashanti, Brong Ahafo, and the Western, Eastern, and Greater regions of Accra. Health facility records, geospatial techniques, and geographic information systems provided locally relevant information to assist policy makers in delivering targeted interventions to small geographic areas. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  1. High Performance Computing Facility Operational Assessment, CY 2011 Oak Ridge Leadership Computing Facility

    Energy Technology Data Exchange (ETDEWEB)

    Baker, Ann E [ORNL; Barker, Ashley D [ORNL; Bland, Arthur S Buddy [ORNL; Boudwin, Kathlyn J. [ORNL; Hack, James J [ORNL; Kendall, Ricky A [ORNL; Messer, Bronson [ORNL; Rogers, James H [ORNL; Shipman, Galen M [ORNL; Wells, Jack C [ORNL; White, Julia C [ORNL; Hudson, Douglas L [ORNL

    2012-02-01

    Oak Ridge National Laboratory's Leadership Computing Facility (OLCF) continues to deliver the most powerful resources in the U.S. for open science. At 2.33 petaflops peak performance, the Cray XT Jaguar delivered more than 1.4 billion core hours in calendar year (CY) 2011 to researchers around the world for computational simulations relevant to national and energy security; advancing the frontiers of knowledge in physical sciences and areas of biological, medical, environmental, and computer sciences; and providing world-class research facilities for the nation's science enterprise. Users reported more than 670 publications this year arising from their use of OLCF resources. Of these we report the 300 in this review that are consistent with guidance provided. Scientific achievements by OLCF users cut across all range scales from atomic to molecular to large-scale structures. At the atomic scale, researchers discovered that the anomalously long half-life of Carbon-14 can be explained by calculating, for the first time, the very complex three-body interactions between all the neutrons and protons in the nucleus. At the molecular scale, researchers combined experimental results from LBL's light source and simulations on Jaguar to discover how DNA replication continues past a damaged site so a mutation can be repaired later. Other researchers combined experimental results from ORNL's Spallation Neutron Source and simulations on Jaguar to reveal the molecular structure of ligno-cellulosic material used in bioethanol production. This year, Jaguar has been used to do billion-cell CFD calculations to develop shock wave compression turbo machinery as a means to meet DOE goals for reducing carbon sequestration costs. General Electric used Jaguar to calculate the unsteady flow through turbo machinery to learn what efficiencies the traditional steady flow assumption is hiding from designers. Even a 1% improvement in turbine design can save the nation

  2. The SWARF high energy flash X-ray facility

    International Nuclear Information System (INIS)

    Gilbert, J.F.; Dove, E.W.D.

    1976-06-01

    A description is presented of the SWARF flash radiography facility at AWRE Foulness, which is stated to be the most powerful flash x-ray system available, in the U.K. The machine consists essentially of a Marx generator, a coaxial Blumlein system and an x-ray tube. The voltage output from the Marx generator (about 2.5 MV from an 80 kV input) is applied to a large re-entrant Blumlein pulse-forming line. Near maximum voltage, an adjustable oil switch short-circuits one end of the Blumlein generator and so applies a square voltage pulse of 65 ns duration to the x-ray tube. The x-rays are produced from a tantalum target which forms the anode of a vacuum field emission diode. The facility consists of two field machines positioned so that radiographs can be obtained from different angles. The description is given under the following heads: modus operandi; constructional details; oil installation; electrical details; commissioning, calibration and electrical data; flash radiography in explosives research; operational control of facility, film packs; radiographic results; further developments; overall performance. (U.K.)

  3. Delivering at home or in a health facility? health-seeking behaviour of women and the role of traditional birth attendants in Tanzania.

    Science.gov (United States)

    Pfeiffer, Constanze; Mwaipopo, Rosemarie

    2013-02-28

    Traditional birth attendants retain an important role in reproductive and maternal health in Tanzania. The Tanzanian Government promotes TBAs in order to provide maternal and neonatal health counselling and initiating timely referral, however, their role officially does not include delivery attendance. Yet, experience illustrates that most TBAs still often handle complicated deliveries. Therefore, the objectives of this research were to describe (1) women's health-seeking behaviour and experiences regarding their use of antenatal (ANC) and postnatal care (PNC); (2) their rationale behind the choice of place and delivery; and to learn (3) about the use of traditional practices and resources applied by traditional birth attendants (TBAs) and how they can be linked to the bio-medical health system. Qualitative and quantitative interviews were conducted with over 270 individuals in Masasi District, Mtwara Region and Ilala Municipality, Dar es Salaam, Tanzania. The results from the urban site show that significant achievements have been made in terms of promoting pregnancy- and delivery-related services through skilled health workers. Pregnant women have a high level of awareness and clearly prefer to deliver at a health facility. The scenario is different in the rural site (Masasi District), where an adequately trained health workforce and well-equipped health facilities are not yet a reality, resulting in home deliveries with the assistance of either a TBA or a relative. Instead of focusing on the traditional sector, it is argued that more attention should be paid towards (1) improving access to as well as strengthening the health system to guarantee delivery by skilled health personnel; and (2) bridging the gaps between communities and the formal health sector through community-based counselling and health education, which is provided by well-trained and supervised village health workers who inform villagers about promotive and preventive health services, including

  4. Facility Design and Health Management Program at the Sinnhuber Aquatic Research Laboratory.

    Science.gov (United States)

    Barton, Carrie L; Johnson, Eric W; Tanguay, Robert L

    2016-07-01

    The number of researchers and institutions moving to the utilization of zebrafish for biomedical research continues to increase because of the recognized advantages of this model. Numerous factors should be considered before building a new or retooling an existing facility. Design decisions will directly impact the management and maintenance costs. We and others have advocated for more rigorous approaches to zebrafish health management to support and protect an increasingly diverse portfolio of important research. The Sinnhuber Aquatic Research Laboratory (SARL) is located ∼3 miles from the main Oregon State University campus in Corvallis, Oregon. This facility supports several research programs that depend heavily on the use of adult, larval, and embryonic zebrafish. The new zebrafish facility of the SARL began operation in 2007 with a commitment to build and manage an efficient facility that diligently protects human and fish health. An important goal was to ensure that the facility was free of Pseudoloma neurophilia (Microsporidia), which is very common in zebrafish research facilities. We recognize that there are certain limitations in space, resources, and financial support that are institution dependent, but in this article, we describe the steps taken to build and manage an efficient specific pathogen-free facility.

  5. Health physics and quality control management of a cyclotron-based PET facility

    International Nuclear Information System (INIS)

    Jerabek, P.A.

    1995-01-01

    This paper provides an overview of the operation and management of a Positron Emission Tomography (PET) facility at the University of Texas. The facility components are discussed from an operations perspective with an emphasis on devices, and on practices and procedures which are implemented to ensure that personnel exposures are as low as reasonably achievable. The cyclotron-based PET facility uses in-house production of PET radioisotopes for preparation of radiopharmaceuticals. A combination of specially designed cyclotron equipped devices, radiopharmaceutical preparation devices, and shielded devices along with health physics practices have helped to make PET operations become routine

  6. Factors influencing women's preference for health facility deliveries in Jharkhand state, India: a cross sectional analysis.

    Science.gov (United States)

    Bhattacharyya, Sanghita; Srivastava, Aradhana; Roy, Reetabrata; Avan, Bilal I

    2016-03-07

    Expanding institutional deliveries is a policy priority to achieve MDG5. India adopted a policy to encourage facility births through a conditional cash incentive scheme, yet 28% of deliveries still occur at home. In this context, it is important to understand the care experience of women who have delivered at home, and also at health facilities, analyzing any differences, so that services can be improved to promote facility births. This study aims to understand women's experience of delivery care during home and facility births, and the factors that influence women's decisions regarding their next place of delivery. A community-based cross-sectional survey was undertaken in a district of Jharkhand state in India. Interviews with 500 recently delivered women (210 delivered at facility and 290 delivered at home) included socio-demographic characteristics, experience of their recent delivery, and preference of future delivery site. Data analysis included frequencies, binary and multiple logistic regressions. There is no major difference in the experience of care between home and facility births, the only difference in care being with regard to pain relief through massage, injection and low cost of delivery for those having home births. 75% women wanted to deliver their next child at a facility, main reasons being availability of medicine (29.4%) and perceived health benefits for mother and baby (15%). Women with higher education (AOR = 1.67, 95% CI = 1.04-3.07), women who were above 25 years (AOR = 2.14, 95% CI = 1.26-3.64), who currently delivered at facility (AOR = 5.19, 95% CI = 2.97-9.08) and had health problem post-delivery (AOR = 1.85, 95% CI = 1.08-3.19) were significant predictors of future facility-based delivery. The predictors for facility deliveries include, availability of medicines and supplies, potential health benefits for the mother and newborn and the perception of good care from the providers. There is a growing

  7. [Engineering aspects of seismic behavior of health-care facilities: lessons from California earthquakes].

    Science.gov (United States)

    Rutenberg, A

    1995-03-15

    The construction of health-care facilities is similar to that of other buildings. Yet the need to function immediately after an earthquake, the helplessness of the many patients and the high and continuous occupancy of these buildings, require that special attention be paid to their seismic performance. Here the lessons from the California experience are invaluable. In this paper the behavior of California hospitals during destructive earthquakes is briefly described. Adequate structural design and execution, and securing of nonstructural elements are required to ensure both safety of occupants, and practically uninterrupted functioning of equipment, mechanical and electrical services and other vital systems. Criteria for post-earthquake functioning are listed. In view of the hazards to Israeli hospitals, in particular those located along the Jordan Valley and the Arava, a program for the seismic evaluation of medical facilities should be initiated. This evaluation should consider the hazards from nonstructural elements, the safety of equipment and systems, and their ability to function after a severe earthquake. It should not merely concentrate on safety-related structural behavior.

  8. THORS: a high-temperature sodium test facility rated at 2.0 MW

    International Nuclear Information System (INIS)

    Gnadt, P.A.; Anderson, A.H.; Clapp, N.E.; Montgomery, B.H.; Collins, C.W.; Stulting, R.D.

    1979-01-01

    The Thermal--Hydraulic Out-of-Reactor Safety (THORS) facility at Oak Ridge Naitonal Laboratory (ORNL) is a high-temperature sodium test facility operated for the United States Breeder Reactor Safety Program. The facility is primarily used for testing large simulated Liquid-Metal Fast Breeder Reactor (LMFBR) fuel subassemblies. The facility has recently been upgraded to provide a 2.0-MW test bundle power input and heat removal capability. A new test section, which will be capable of operating at 980 0 C and which will accommodate a 217-pin bundle, has also been added. A 61-pin bundle is currently under test in the facility. A description of the test facility is presented, along with a brief summary of the 8-year operating history of this safety-related test facility

  9. Medical equipment in government health facilities: Missed opportunities

    OpenAIRE

    Pardeshi Geeta

    2005-01-01

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

  10. Design concept of radiation control system for the high intensity proton accelerator facility

    Energy Technology Data Exchange (ETDEWEB)

    Miyamoto, Yukihiro; Ikeno, Koichi; Akiyama, Shigenori; Harada, Yasunori [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    2002-11-01

    Description is given for the characteristic radiation environment for the High Intensity Proton Accelerator Facility and the design concept of the radiation control system of it. The facility is a large scale accelerator complex consisting of high energy proton accelerators carrying the highest beam intensity in the world and the related experimental facilities and therefore provides various issues relevant to the radiation environment. The present report describes the specifications for the radiation control system for the facility, determined in consideration of these characteristics. (author)

  11. The CERN-EU high-energy Reference Field (CERF) facility: applications and latest developments

    Science.gov (United States)

    Silari, Marco; Pozzi, Fabio

    2017-09-01

    The CERF facility at CERN provides an almost unique high-energy workplace reference radiation field for the calibration and test of radiation protection instrumentation employed at high-energy accelerator facilities and for aircraft and space dosimetry. This paper describes the main features of the facility and supplies a non-exhaustive list of recent (as of 2005) applications for which CERF is used. Upgrade work started in 2015 to provide the scientific and industrial communities with a state-of-the-art reference facility is also discussed.

  12. Assisted Living Facilities - CARE_LONG_TERM_FACILITIES_ISDH_IN: Residential Care Facilities, Nursing Homes, and Hospices in Indiana in 2007 (Indiana State Department of Health, Point Shapefile)

    Data.gov (United States)

    NSGIC State | GIS Inventory — CARE_LONG_TERM_FACILITIES_ISDH_IN is a point shapefile showing the locations of 86 residential care facilities, 525 long-term care facilities (nursing homes), and 81...

  13. Factors associated with health facility childbirth in districts of Kenya, Tanzania and Zambia

    DEFF Research Database (Denmark)

    Phiri, Selia Ng'anjo; Kiserud, Torvid; Kvåle, Gunnar

    2014-01-01

    of delivery. Socioeconomic position was measured by employing a construct of educational attainment and wealth index. All analyses were stratified by district and urban-rural residence. RESULTS: There were substantial inter-district differences in proportion of health facility childbirth. Facility childbirth......BACKGROUND: Maternal mortality continues to be a heavy burden in low and middle income countries where half of all deliveries take place in homes without skilled attendance. The study aimed to investigate the underlying and proximate determinants of health facility childbirth in rural and urban...... areas of three districts in Kenya, Tanzania and Zambia. METHODS: A population-based survey was conducted in 2007 as part of the 'REsponse to ACcountable priority setting for Trust in health systems' (REACT) project. Stratified random cluster sampling was used and the data included information on place...

  14. Preventing Airborne Disease Transmission: Review of Methods for Ventilation Design in Health Care Facilities

    Science.gov (United States)

    Aliabadi, Amir A.; Rogak, Steven N.; Bartlett, Karen H.; Green, Sheldon I.

    2011-01-01

    Health care facility ventilation design greatly affects disease transmission by aerosols. The desire to control infection in hospitals and at the same time to reduce their carbon footprint motivates the use of unconventional solutions for building design and associated control measures. This paper considers indoor sources and types of infectious aerosols, and pathogen viability and infectivity behaviors in response to environmental conditions. Aerosol dispersion, heat and mass transfer, deposition in the respiratory tract, and infection mechanisms are discussed, with an emphasis on experimental and modeling approaches. Key building design parameters are described that include types of ventilation systems (mixing, displacement, natural and hybrid), air exchange rate, temperature and relative humidity, air flow distribution structure, occupancy, engineered disinfection of air (filtration and UV radiation), and architectural programming (source and activity management) for health care facilities. The paper describes major findings and suggests future research needs in methods for ventilation design of health care facilities to prevent airborne infection risk. PMID:22162813

  15. Use of a Balanced Scorecard in strengthening health systems in developing countries: an analysis based on nationally representative Bangladesh Health Facility Survey.

    Science.gov (United States)

    Khan, M Mahmud; Hotchkiss, David R; Dmytraczenko, Tania; Zunaid Ahsan, Karar

    2013-01-01

    This paper illustrates the importance of collecting facility-based data through regular surveys to supplement the administrative data, especially for developing countries of the world. In Bangladesh, measures based on facility survey indicate that only 70% of very basic medical instruments and 35% of essential drugs were available in health facilities. Less than 2% of officially designated obstetric care facilities actually had required drugs, injections and personnel on-site. Majority of (80%) referral hospitals at the district level were not ready to provide comprehensive emergency obstetric care. Even though the Management Information System reports availability of diagnostic machines in all district-level and sub-district-level facilities, it fails to indicate that 50% of these machines are not functional. In terms of human resources, both physicians and nurses are in short supply at all levels of the healthcare system. The physician-nurse ratio also remains lower than the desirable level of 3.0. Overall job satisfaction index was less than 50 for physicians and 66 for nurses. Patient satisfaction score, however, was high (86) despite the fact that process indicators of service quality were poor. Facility surveys can help strengthen not only the management decision-making process but also the quality of administrative data. Copyright © 2012 John Wiley & Sons, Ltd.

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

    Science.gov (United States)

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

    2018-03-15

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

  17. Process Evaluation of Communitisation Programme in Public Sector Health Facilities, Mokokchung District, Nagaland, 2015.

    Science.gov (United States)

    Tushi, Aonungdok; Kaur, Prabhdeep

    2017-01-01

    Public sector health facilities were poorly managed due to a history of conflict in Nagaland, India. Government of Nagaland introduced "Nagaland Communitisation of Public Institutions and Services Act" in 2002. Main objectives of the evaluation were to review the functioning of Health Center Managing Committees (HCMCs), deliver health services in the institutions managed by HCMC, identify strengths as well as challenges perceived by HCMC members in the rural areas of Mokokchung district, Nagaland. The evaluation was made using input, process and output indicators. A doctor, the HCMC Chairman and one member from each of the three community health centers (CHC) and four primary health centers (PHC) were surveyed using a semi-structured questionnaire and an in-depth interview guide. Proportions for quantitative data were computed and key themes from the same were identified. Overall; the infrastructure, equipment and outpatient/inpatient service availability was satisfactory. There was a lack of funds and shortage of doctors, drugs as well as laboratory facilities. HCMCs were in place and carried out administrative activities. HCMCs felt ownership, mobilized community contributions and managed human resources. HCMC members had inadequate funds for their transport and training. They faced challenges in service delivery due to political interference and lack of adequate human, material, financial resources. Communitisation program was operational in the district. HCMC members felt the ownership of health facilities. Administrative, political support and adequate funds from the government are needed for effective functioning of HCMCs and optimal service delivery in public sector facilities.

  18. Selecting and Effectively Using a Health/Fitness Facility

    Science.gov (United States)

    ... live longer, healthier lives. Research shows that moderate physical activity – such as 30 minutes a day of brisk walking – significantly contributes to longevity. Even a person with risk factors like high ...

  19. Referral of children seeking care at private health facilities in Uganda.

    Science.gov (United States)

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

    2017-02-14

    In Uganda, referral of sick children seeking care at public health facilities is poor and widely reported. However, studies focusing on the private health sector are scanty. The main objective of this study was to assess referral practices for sick children seeking care at private health facilities in order to explore ways of improving treatment and referral of sick children in this sector. A survey was conducted from August to October 2014 in Mukono district, central Uganda. Data was collected using a structured questionnaire supplemented by Focus Group Discussions and Key Informant interviews with private providers and community members. A total of 241 private health facilities were surveyed; 170 (70.5%) were registered drug shops, 59 (24.5%) private clinics and 12 (5.0%) pharmacies. Overall, 104/241 (43.2%) of the private health facilities reported that they had referred sick children to higher levels of care in the two weeks prior to the survey. The main constraints to follow referral advice as perceived by caretakers were: not appreciating the importance of referral, gender-related decision-making and negotiations at household level, poor quality of care at referral facilities, inadequate finances at household level; while the perception that referral leads to loss of prestige and profit was a major constraint to private providers. In conclusion, the results show that referral of sick children at private health facilities faces many challenges at provider, caretaker, household and community levels. Thus, interventions to address constraints to referral of sick children are urgently needed.

  20. European network for promoting the physical health of residents in psychiatric and social care facilities (HELPS)

    DEFF Research Database (Denmark)

    Weiser, Prisca; Becker, Thomas; Losert, Carolin

    2009-01-01

    of defined health promoting interventions. The key methods are (a) stakeholder analysis, (b) international literature reviews, (c) Delphi rounds with experts from participating centres, and (d) focus groups with staff and residents of mental health care facilities.Meanwhile a multi-disciplinary network...... by promoting behaviour-based and/or environment-based interventions. METHODS AND DESIGN: HELPS is an interdisciplinary European network that aims at (i) gathering relevant knowledge on physical illness in people with mental illness, (ii) identifying health promotion initiatives in European countries that meet...... consisting of 15 European countries has been established and took up the work. As one main result of the project they expect that a widespread use of the HELPS toolkit could have a significant positive effect on the physical health status of residents of mental health and social care facilities, as well...

  1. Pattern of skin diseases in patients visiting a tertiary care health facility at hyderabad, pakistan

    International Nuclear Information System (INIS)

    Memon, K.N.; Soomro, R.A.

    2011-01-01

    Background: The morbidity associated with skin diseases makes them an important public health problem. Very scanty literature is found on the problem which is either disease-based, community based or a specified population group-based. objective of this study was to assess the pattern of skin diseases in patients and to determine their relation with demographic characteristics. Methods: This descriptive study was conducted at dermatology out-patient department of liaquat university hospital, jamshoro, pakistan for the period from 10th january to 10th february 2008. Four hundred and eleven patients were enrolled during the study period. The study population comprised of newly diagnosed cases as well as relapsing cases presenting at the facility. The criterion for registering the patients was clinical diagnosis although few cases were supported by investigations, too. The data was collected through a pre-designed questionnaire and analysed through spss-12. Result: Skin problems are fairly common among children and women. in children of less than 10 years age, 82.5% visiting the facility suffer from infectious skin diseases. among the infectious diseases, scabies is highly prevalent disease (45.5%). the majority of the patients belong to rural or slum areas (77.2%), low socio-economic strata (68.9%), and living in overcrowded families (82%). a strong association between skin infections and water inadequacy (p=0.016) was found, and scabies shows a strong statistical association with overcrowding (p=0.025). Conclusion: The skin diseases involve every age strata of our population but it is fairly common in younger age group, women, and people who do not practice hygiene. Out-reach services for the rural and slum communities and health education will give good results on prevention of skin diseases. (author)

  2. Recreational facilities: a guide to recreational facilities in the East Coast Area Health Board

    LENUS (Irish Health Repository)

    2012-02-01

    OBJECTIVE: To determine whether persons with generalized joint hypermobility have an increased risk of lower limb joint injury during sport. DATA SOURCES: PubMed, CINAHL, EMBASE, and SportDiscus were searched through February 2009, without language restrictions, using terms related to risk; hip, ankle, and knee injuries; and joint instability. Reference lists of included studies and relevant reviews were searched by hand. STUDY SELECTION: Selection criteria were peer-reviewed studies with a prospective design that used an objective scale to measure generalized joint hypermobility; the participants were engaged in sport activity, and the injury data were quantitative and based on diagnosis by a health professional, were self-reported, or resulted in time lost to athletic participation. The studies were screened by 1 researcher and checked by a second. Study methods were independently assessed by 2 investigators using the 6-point scale for prognostic studies developed by Pengel. Disagreements were resolved through discussion. Of 4841 studies identified, 18 met inclusion criteria. Of these, 8 were included in random-effects meta-analyses. DATA EXTRACTION: The data extracted by 2 reviewers included participant and sport characteristics and details of joint hypermobility and injury measurements. More detailed data for 4 investigations were obtained from the study authors. Where possible, hypermobility was defined as >\\/=4 of 9 points on the British Society of Rheumatology Scale (BSRS). MAIN RESULTS: Lower limb joint injuries (3 studies, 1047 participants) occurred in 14% of participants. Using the BSRS of joint hypermobility, any lower limb injury was not associated with hypermobility [odds ratio (OR), 1.43; 95% confidence interval (CI), 0.56-3.67]. Using the original authors\\' definitions, hypermobility was associated with risk of knee joint injuries (OR, 2.62; 95% CI, 1.04-6.58) in 5 studies. In 4 studies in which the BSRS could be used (1167 participants; incidence

  3. Impact of infection prevention and control training on health facilities during the Ebola virus disease outbreak in Guinea.

    Science.gov (United States)

    Keïta, Mory; Camara, Ansoumane Yassima; Traoré, Falaye; Camara, Mohamed ElMady; Kpanamou, André; Camara, Sékou; Tolno, Aminata; Houndjo, Bienvenu; Diallo, Fatimatou; Conté, Fatoumata; Subissi, Lorenzo

    2018-04-24

    In 2014-2016, West Africa faced the most deadly Ebola Virus Disease (EVD) outbreak in history. A key strategy to overcome this outbreak was continual staff training in Infection Prevention and Control (IPC), with a focus on Ebola. This research aimed to evaluate the impact of IPC training and the quality of IPC performance in health care facilities of one municipality of Conakry, Guinea. This study was conducted in February 2016. All health facilities within Ratoma municipality, Conakry, Guinea, were evaluated based on IPC performance standards developed by the Guinean Ministry of Health. The IPC performance of healthcare facilities was categorised into high or low IPC scores based on the median IPC score of the sample. The Mantel-Haenzsel method and logistic regression were used for statistical analysis. Twenty-five percent of health centres had one IPC-trained worker, 53% had at least two IPC-trained workers, and 22% of health centres had no IPC-trained workers. An IPC score above median was positively associated with the number of trained staff; health centres with two or more IPC-trained workers were eight times as likely to have an IPC score above median, while those with one IPC-trained worker were four times as likely, compared to centres with no trained workers. Health centres that implemented IPC cascade training to untrained medical staff were five times as likely to have an IPC score above median. This research highlights the importance of training healthcare staff in IPC and organising regular cascade trainings. IPC strategies implemented during the outbreak should continue to be reinforced for the better health of patients and medical staff, and be considered a key factor in any outbreak response.

  4. Health facility-based survey of poliovirus antibody prevalence ...

    African Journals Online (AJOL)

    Background: High level of Poliovirus protective antibodies, must at all times be sustained in a community if poliomyelitis eradication is to be achieved. For some time now children have been vaccinated against poliomyelitis through various means in Northern Nigeria without authorities taking steps to evaluate the ...

  5. An audit of some health facilities and equipment for neonatal ...

    African Journals Online (AJOL)

    Background: Neonatal Mortality rates continue to be high in spite of the general decline in under-5 mortality rates in Nigeria. Available evidence has shown that the availability of a skilled birth attendant and equipment for basic neonatal resuscitation is necessary for the prevention of early neonatal death which accounts for ...

  6. Building capacity in health facility management: guiding principles for skills transfer in Liberia.

    Science.gov (United States)

    Rowe, Laura A; Brillant, Sister Barbara; Cleveland, Emily; Dahn, Bernice T; Ramanadhan, Shoba; Podesta, Mae; Bradley, Elizabeth H

    2010-03-18

    Management training is fundamental to developing human resources for health. Particularly as Liberia revives its health delivery system, facility and county health team managers are central to progress. Nevertheless, such management skills are rarely prioritized in health training, and sustained capacity building in this area is limited. We describe a health management delivery program in which a north and south institution collaborated to integrate classroom and field-based training in health management and to transfer the capacity for sustained management development in Liberia. We developed and implemented a 6-month training program in health management skills (i.e. strategic problem solving, financial management, human resource management and leadership) delivered by Yale University and Mother Patern College from Liberia, with support from the Clinton HIV/AIDS Initiative. Over three 6-month cycles, responsibility for course instruction was transferred from the north institution to the south institution. A self-administered survey was conducted of all participants completing the course to measure changes in self-rated management skills, the degree to which the course was helpful and met its stated objectives, and faculty members' responsiveness to participant needs as the transfer process occurred. Respondents (n=93, response rate 95.9%) reported substantial improvement in self-reported management skills, and rated the helpfulness of the course and the degree to which the course met its objectives highly. Levels of improvement and course ratings were similar over the three cohorts as the course was transferred to the south institution. We suggest a framework of five elements for implementing successful management training programs that can be transferred and sustained in resource-limited settings, including: 1) use a short-course format focusing on four key skill areas with practical tools; 2) include didactic training, on-site projects, and on-site mentoring; 3

  7. Building capacity in health facility management: guiding principles for skills transfer in Liberia

    Directory of Open Access Journals (Sweden)

    Dahn Bernice T

    2010-03-01

    Full Text Available Abstract Background Management training is fundamental to developing human resources for health. Particularly as Liberia revives its health delivery system, facility and county health team managers are central to progress. Nevertheless, such management skills are rarely prioritized in health training, and sustained capacity building in this area is limited. We describe a health management delivery program in which a north and south institution collaborated to integrate classroom and field-based training in health management and to transfer the capacity for sustained management development in Liberia. Methods We developed and implemented a 6-month training program in health management skills (i.e. strategic problem solving, financial management, human resource management and leadership delivered by Yale University and Mother Patern College from Liberia, with support from the Clinton HIV/AIDS Initiative. Over three 6-month cycles, responsibility for course instruction was transferred from the north institution to the south institution. A self-administered survey was conducted of all participants completing the course to measure changes in self-rated management skills, the degree to which the course was helpful and met its stated objectives, and faculty members' responsiveness to participant needs as the transfer process occurred. Results Respondents (n = 93, response rate 95.9% reported substantial improvement in self-reported management skills, and rated the helpfulness of the course and the degree to which the course met its objectives highly. Levels of improvement and course ratings were similar over the three cohorts as the course was transferred to the south institution. We suggest a framework of five elements for implementing successful management training programs that can be transferred and sustained in resource-limited settings, including: 1 use a short-course format focusing on four key skill areas with practical tools; 2 include

  8. The effect of health facility delivery on neonatal mortality: systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Tura Gurmesa

    2013-01-01

    Full Text Available Abstract Background Though promising progress has been made towards achieving the Millennium Development Goal four through substantial reduction in under-five mortality, the decline in neonatal mortality remains stagnant, mainly in the middle and low-income countries. As an option, health facility delivery is assumed to reduce this problem significantly. However, the existing evidences show contradicting conclusions about this fact, particularly in areas where enabling environments are constraint. Thus, this review was conducted with the aim of determining the pooled effect of health facility delivery on neonatal mortality. Methods The reviewed studies were accessed through electronic web-based search strategy from PUBMED, Cochrane Library and Advanced Google Scholar by using combination key terms. The analysis was done by using STATA-11. I2 test statistic was used to assess heterogeneity. Funnel plot, Begg’s test and Egger’s test were used to check for publication bias. Pooled effect size was determined in the form of relative risk in the random-effects model using DerSimonian and Laird's estimator. Results A total of 2,216 studies conducted on the review topic were identified. During screening, 37 studies found to be relevant for data abstraction. From these, only 19 studies fulfilled the preset criteria and included in the analysis. In 10 of the 19 studies included in the analysis, facility delivery had significant association with neonatal mortality; while in 9 studies the association was not significant. Based on the random effects model, the final pooled effect size in the form of relative risk was 0.71 (95% CI: 0.54, 0.87 for health facility delivery as compared to home delivery. Conclusion Health facility delivery is found to reduce the risk of neonatal mortality by 29% in low and middle income countries. Expansion of health facilities, fulfilling the enabling environments and promoting their utilization during childbirth are

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

    Science.gov (United States)

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

    2018-02-06

    Behavioral health conditions are a significant concern for the U.S. military and the Military Health System (MHS) because of decreased military readiness and increased health care utilization. Although MHS beneficiaries receive direct care in military treatment facilities, a disproportionate majority of behavioral health treatment is purchased care received in civilian facilities. Yet, limited evidence exists about purchased behavioral health care received by MHS beneficiaries. This longitudinal study (1) estimated the prevalence of purchased behavioral health care and (2) identified patient and visit characteristics predicting receipt of purchased behavioral health care in acute care facilities from 2000 to 2014. Medical claims with Major Diagnostic Code 19 (mental disorders/diseases) or 20 (alcohol/drug disorders) as primary diagnoses and TRICARE as the primary/secondary payer were analyzed for MHS beneficiaries (n = 17,943) receiving behavioral health care in civilian acute care facilities from January 1, 2000, to December 31, 2014. The primary dependent variable, receipt of purchased behavioral health care, was modeled for select mental health and substance use disorders from 2000 to 2014 using generalized estimating equations. Patient characteristics included time, age, sex, and race/ethnicity. Visit types included inpatient hospitalization and emergency department (ED). Time was measured in days and visits were assumed to be correlated over time. Behavioral health care was described by both frequency of patients and visit type. The University of South Carolina Institutional Review Board approved this study. From 2000 to 2014, purchased care visits increased significantly for post-traumatic stress disorder, adjustment, anxiety, mood, bipolar, tobacco use, opioid/combination opioid dependence, nondependent cocaine abuse, psychosocial problems, and suicidal ideation among MHS beneficiaries. The majority of care was received for mental health disorders (78

  10. Evaluation of a quality improvement intervention for obstetric and neonatal care in selected public health facilities across six states of India.

    Science.gov (United States)

    Sarin, Enisha; Kole, Subir K; Patel, Rachana; Sooden, Ankur; Kharwal, Sanchit; Singh, Rashmi; Rahimzai, Mirwais; Livesley, Nigel

    2017-05-02

    While increase in the number of women delivering in health facilities has been rapid, the quality of obstetric and neonatal care continues to be poor in India, contributing to high maternal and neonatal mortality. The USAID ASSIST Project supported health workers in 125 public health facilities (delivering approximately 180,000 babies per year) across six states to use quality improvement (QI) approaches to provide better care to women and babies before, during and immediately after delivery. As part of this intervention, each month, health workers recorded data related to nine elements of routine care alongside data on perinatal mortality. We aggregated facility level data and conducted segmented regression to analyse the effect of the intervention over time. Care improved to 90-99% significantly (p improving provision of routine care, yet these approaches are underused in the Indian health system. We discuss the implications of this for policy makers.

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

    Science.gov (United States)

    Pardeshi, Geeta S

    2005-01-01

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

  12. Scaling Studies for High Temperature Test Facility and Modular High Temperature Gas-Cooled Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Richard R. Schult; Paul D. Bayless; Richard W. Johnson; James R. Wolf; Brian Woods

    2012-02-01

    The Oregon State University (OSU) High Temperature Test Facility (HTTF) is an integral experimental facility that will be constructed on the OSU campus in Corvallis, Oregon. The HTTF project was initiated, by the U.S. Nuclear Regulatory Commission (NRC), on September 5, 2008 as Task 4 of the 5-year High Temperature Gas Reactor Cooperative Agreement via NRC Contract 04-08-138. Until August, 2010, when a DOE contract was initiated to fund additional capabilities for the HTTF project, all of the funding support for the HTTF was provided by the NRC via their cooperative agreement. The U.S. Department of Energy (DOE) began their involvement with the HTTF project in late 2009 via the Next Generation Nuclear Plant (NGNP) project. Because the NRC's interests in HTTF experiments were only centered on the depressurized conduction cooldown (DCC) scenario, NGNP involvement focused on expanding the experimental envelope of the HTTF to include steady-state operations and also the pressurized conduction cooldown (PCC).

  13. Gender equality and childbirth in a health facility: Nigeria and MDG5.

    Science.gov (United States)

    Singh, Kavita; Bloom, Shelah; Haney, Erica; Olorunsaiye, Comfort; Brodish, Paul

    2012-09-01

    This paper examined how addressing gender equality can lead to reductions in maternal mortality in Nigeria through an increased use of facility delivery. Because the majority of maternal complications cannot be predicted and often arise suddenly during labor, delivery and the immediate postpartum period, childbirth in a health facility is key to reducing maternal mortality. This paper used data from the 2008 Nigeria Demographic and Health Survey (DHS) to examine associations of gender measures on the utilization of facility delivery after controlling for socio-demographic factors. Four gender equality measures were studied: household decision-making, financial decision-making, attitudes towards wife beating, and attitudes regarding a wife's ability to refuse sex. Results found older, more educated, wealthier, urban, and working women were more likely to have a facility delivery than their counterparts. In addition ethnicity was a significant variable indicating the importance of cultural and regional diversity. Notably, after controlling for the socioeconomic variables, two of the gender equality variables were significant: household decision-making and attitudes regarding a wife's ability to refuse sex. In resource-poor settings such as Nigeria, women with more decision-making autonomy are likely better able to advocate for and access a health facility for childbirth. Thus programs and policies that focus on gender in addition to focusing on education and poverty have the potential to reduce maternal mortality even further.

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

    Directory of Open Access Journals (Sweden)

    Tinne Gils

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

  15. Sodium and cover gas chemistry in the high temperature sodium facility

    International Nuclear Information System (INIS)

    McCown, J.J.; Duncan, H.C.

    1976-01-01

    The equipment and procedures used in following sodium and cover gas chemistry changes in the High Temperature Sodium Facility are presented. The methods of analysis and results obtained are given. Impurity trends which have been measured during the facility operations are discussed

  16. ORNL shielded facilities capable of remote handling of highly radioactive beta--gamma emitting materials

    International Nuclear Information System (INIS)

    Whitson, W.R.

    1977-09-01

    A survey of ORNL facilities having adequate shielding and containment for the remote handling of experimental quantities of highly radioactive beta-gamma emitting materials is summarized. Portions of the detailed descriptions of these facilities previously published in ORNL/TM-1268 are still valid and are repeated

  17. Environmental Assessment for the Health Protection Instrument Calibration Facility at the Savannah River Site

    Energy Technology Data Exchange (ETDEWEB)

    1993-08-01

    The purpose of this Environmental Assessment (EA) is to review the possible environmental consequences associated with the construction and operation of a Health Protection Instrument Calibration Facility on the Savannah River Site (SRS). The proposed replacement calibration facility would be located in B Area of SRS and would replace an inadequate existing facility currently located within A Area of SRS (Building 736-A). The new facility would provide laboratories, offices, test equipment and the support space necessary for the SRS Radiation Monitoring Instrument Calibration Program to comply with DOE Orders 5480.4 (Environmental Protection, Safety and Health Protection Standards) and 5480.11 (Radiation Protection for Occupational Workers). The proposed facility would serve as the central site source for the evaluation, selection, inspection, testing, calibration, and maintenance of all SRS radiation monitoring instrumentation. The proposed facility would be constructed on a currently undeveloped portion in B Area of SRS. The exact plot associated with the proposed action is a 1.2 hectare (3 acre) tract of land located on the west side of SRS Road No. 2. The proposed facility would lie approximately 4.4 km (2.75 mi) from the nearest SRS site boundary. The proposed facility would also lie within the confines of the existing B Area, and SRS safeguards and security systems. Archaeological, ecological, and land use reviews have been conducted in connection with the use of this proposed plot of land, and a detailed discussion of these reviews is contained herein. Socioeconomic, operational, and accident analyses were also examined in relation to the proposed project and the findings from these reviews are also contained in this EA.

  18. Environmental Assessment for the Health Protection Instrument Calibration Facility at the Savannah River Site

    International Nuclear Information System (INIS)

    1993-08-01

    The purpose of this Environmental Assessment (EA) is to review the possible environmental consequences associated with the construction and operation of a Health Protection Instrument Calibration Facility on the Savannah River Site (SRS). The proposed replacement calibration facility would be located in B Area of SRS and would replace an inadequate existing facility currently located within A Area of SRS (Building 736-A). The new facility would provide laboratories, offices, test equipment and the support space necessary for the SRS Radiation Monitoring Instrument Calibration Program to comply with DOE Orders 5480.4 (Environmental Protection, Safety and Health Protection Standards) and 5480.11 (Radiation Protection for Occupational Workers). The proposed facility would serve as the central site source for the evaluation, selection, inspection, testing, calibration, and maintenance of all SRS radiation monitoring instrumentation. The proposed facility would be constructed on a currently undeveloped portion in B Area of SRS. The exact plot associated with the proposed action is a 1.2 hectare (3 acre) tract of land located on the west side of SRS Road No. 2. The proposed facility would lie approximately 4.4 km (2.75 mi) from the nearest SRS site boundary. The proposed facility would also lie within the confines of the existing B Area, and SRS safeguards and security systems. Archaeological, ecological, and land use reviews have been conducted in connection with the use of this proposed plot of land, and a detailed discussion of these reviews is contained herein. Socioeconomic, operational, and accident analyses were also examined in relation to the proposed project and the findings from these reviews are also contained in this EA

  19. Universal opt-out screening for hepatitis C virus (HCV) within correctional facilities is an effective intervention to improve public health.

    Science.gov (United States)

    Morris, Meghan D; Brown, Brandon; Allen, Scott A

    2017-09-11

    Purpose Worldwide efforts to identify individuals infected with the hepatitis C virus (HCV) focus almost exclusively on community healthcare systems, thereby failing to reach high-risk populations and those with poor access to primary care. In the USA, community-based HCV testing policies and guidelines overlook correctional facilities, where HCV rates are believed to be as high as 40 percent. This is a missed opportunity: more than ten million Americans move through correctional facilities each year. Herein, the purpose of this paper is to examine HCV testing practices in the US correctional system, California and describe how universal opt-out HCV testing could expand early HCV detection, improve public health in correctional facilities and communities, and prove cost-effective over time. Design/methodology/approach A commentary on the value of standardizing screening programs across facilities by mandating all facilities (universal) to implement opt-out testing policies for all prisoners upon entry to the correctional facilities. Findings Current variability in facility-level testing programs results in inconsistent testing levels across correctional facilities, and therefore makes estimating the actual number of HCV-infected adults in the USA difficult. The authors argue that universal opt-out testing policies ensure earlier diagnosis of HCV among a population most affected by the disease and is more cost-effective than selective testing policies. Originality/value The commentary explores the current limitations of selective testing policies in correctional systems and provides recommendations and implications for public health and correctional organizations.

  20. Geomatic techniques for assessing ecological and health risk at U.S. Department of Energy facilities

    International Nuclear Information System (INIS)

    Regens, J.L.; White, L.; Albers, B.J.; Purdy, C.

    1994-01-01

    Hazardous substances, including radionuclides, heavy metals, and chlorinated hydrocarbons, pose unique challenges in terms of environmental restoration and waste management, especially in aquatic environments. When stored, used or disposed of improperly, hazardous materials including transuranic wastes, high level wastes, low level wastes, greater than class C wastes, mixed wastes or chemical wastes can contaminate an array of environmental receptors ranging from soils, sediments, groundwater to surface water. Depending on the specific hazardous substance and site attributes, assessing ecological and health risk as a basis for environmental restoration and waste management can be a complex, problematic activity. This is basis for environmental restoration and waste management can be a complex, problematic activity. This is particularly true for the major Defense Programs facilities managed by the U.S. Department of Energy (DOE). The Environmental Restoration (ER) program of DOE was initiated in 1987 to consolidate and coordinate those regulatory activities designed to identify and remediate sites at installations contaminated with radioactive, chemical or mixed wastes. To supply the tools necessary for defining, describing, and characterizing the nature of contaminants within the DOE complex and identifying alternative post-remediation land use options, DOE has implemented a program for the research and development of spatial data technologies to aid in assessing ecological and health risk

  1. Determinants of Quality of Work Life among Nurses Working in Hawassa Town Public Health Facilities, South Ethiopia: A Cross-Sectional Study.

    Science.gov (United States)

    Kelbiso, Lolemo; Belay, Admasu; Woldie, Mirkuzie

    2017-01-01

    A high quality of work life (QWL) is a crucial issue for health care facilities to have qualified, dedicated, and inspired employees. Among different specialties in health care settings, nurses have a major share among other health care providers. So, they should experience a better QWL to deliver high-quality holistic care to those who need help. To assess the level of quality of work life and its predictors among nurses working in Hawassa town public health facilities, South Ethiopia. A facility based cross-sectional study was conducted on 253 nurses of two hospitals and nine health centers. The total sample size was allocated to each facility based on the number of nurses in each facility. Data were collected using a structured questionnaire. The interitem consistency of the scale used to measure QWL had Cronbach's alpha value of 0.86. A multinomial logistic regression model was fitted to identify significant predictors of quality of work life using SPSS version 20. The study showed that 67.2% of the nurses were dissatisfied with the quality of their work life. We found that educational status, monthly income, working unit, and work environment were strong predictors of quality of work life among nurses ( p quality of their work life. The findings in this study and studies reported from elsewhere pinpoint that perception of nurses about the quality of their work life can be modified if health care managers are considerate of the key issues surrounding QWL.

  2. Health Care Facility Choice and User Fee Abolition: Regression Discontinuity in a Multinomial Choice Setting

    OpenAIRE

    Steven F. Koch; Jeffrey S. Racine

    2013-01-01

    We apply parametric and nonparametric regression discontinuity methodology within a multinomial choice setting to examine the impact of public health care user fee abolition on health facility choice using data from South Africa. The nonparametric model is found to outperform the parametric model both in- and out-of-sample, while also delivering more plausible estimates of the impact of user fee abolition (i.e. the 'treatment effect'). In the parametric framework, treatment effects were relat...

  3. [3D printing in health care facilities: What legislation in France?].

    Science.gov (United States)

    Montmartin, M; Meyer, C; Euvrard, E; Pazart, L; Weber, E; Benassarou, M

    2015-11-01

    Health care facilities more and more use 3D printing, including making their own medical devices (MDs). However, production and marketing of MDs are regulated. The goal of our work was to clarify what is the current French regulation that should be applied concerning the production of custom-made MDs produced by 3D printing in a health care facility. MDs consist of all devices used for diagnosis, prevention, or treatment of diseases in patients. Prototypes and anatomic models are not considered as MDs and no specific laws apply to them. Cutting guides, splints, osteosynthesis plates or prosthesis are MDs. In order to become a MD manufacturer in France, a health care facility has to follow the requirements of the 93/42/CEE directive. In addition, custom-made 3D-printed MDs must follow the annex VIII of the directive. This needs the writing of a declaration of conformity and the respect of the essential requirements (proving that a MD is secure and conform to what is expected), the procedure has to be qualified, a risk analysis and a control of the biocompatibility of the material have to be fulfilled. The documents proving that these rules have been respected have to be available. Becoming a regulatory manufacturer of MD in France is possible for a health care facility but the specifications have to be respected. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  4. Comparison of patient referral processes between rural and urban health facilities in Liberia

    Directory of Open Access Journals (Sweden)

    J. Kim*

    2013-12-01

    Conclusions: Patient referral systems in Liberia are relatively unsystematic. While formal and informal mechanisms for referrals exist at both rural and urban health facilities, establishing guidelines for referral care practices and transportation strategies tailored to each of these settings will help to strengthen the healthcare system as a whole.

  5. How to Investigate Drug Use in Health Facilities. Selected Drug Use ...

    African Journals Online (AJOL)

    This short WHO manual outlines methods for evaluating drug use indicators in health facilities. The broad areas of ... Washington: American Psychiatric Press, Inc. 1991. ISBN 0-88048-114-5. This book is ... discussion of different symptom categories using the DSM. (Diagnostic Statistical Manual) as a base. The definition of.

  6. Developing a user-perception assessment tool for health facilities in South Africa

    CSIR Research Space (South Africa)

    Saidi, M

    2007-06-01

    Full Text Available . The broader tool is envisaged to assess the performance of health facilities in areas of functionality, impact, and building durability and quality. The process will involve developing and testing the tool at a pilot hospital in the country...

  7. Safety in Elevators and Grain Handling Facilities. Module SH-27. Safety and Health.

    Science.gov (United States)

    Center for Occupational Research and Development, Inc., Waco, TX.

    This student module on safety in elevators and grain handling facilities is one of 50 modules concerned with job safety and health. Following the introduction, 15 objectives (each keyed to a page in the text) the student is expected to accomplish are listed (e.g., Explain how explosion suppression works). Then each objective is taught in detail,…

  8. 77 FR 21580 - Changes in Certain Multifamily Housing and Health Care Facility Mortgage Insurance Premiums for...

    Science.gov (United States)

    2012-04-10

    ... Multifamily Housing and Health Care Facility Mortgage Insurance Premiums for Fiscal Year (FY) 2013 AGENCY...: In accordance with HUD regulations, this notice announces changes of the mortgage insurance premiums... mortgage. The mortgage insurance premiums to be in effect for FHA firm commitments issued or reissued in FY...

  9. A simultaneous facility location and vehicle routing problem arising in health care logistics in the Netherlands

    NARCIS (Netherlands)

    Veenstra, Marjolein; Roodbergen, Kees Jan; Coelho, Leandro C.; Zhu, Stuart X.

    2018-01-01

    This paper introduces a simultaneous facility location and vehicle routing problem that arises in health care logistics in the Netherlands. In this problem, the delivery of medication from a local pharmacy can occur via lockers, from where patients that are within the coverage distance of a locker

  10. The consequences of nuclear waste disposal facilities on public health and environment

    International Nuclear Information System (INIS)

    Rivasi, M.

    2000-01-01

    This report, from the French parliament office for the evaluation of scientifical and technological choices, makes a status of the effluents and waste stocks from different types of nuclear facilities and analyzes the consequences of these effluents and wastes on the public health and on the environment. Finally, it examines the necessary scientifical, technical and legal improvements. (J.S.)

  11. High temperature facility for atomic physics studies. Final report

    International Nuclear Information System (INIS)

    1978-01-01

    The results of a program designed to develop a laser heated plasma sample for atomic physics studies in the 30 to 100 eV range of electron temperature and the 3 x 10 17 to 10 18 cm -3 range in electron density are presented. The approach used was discussed in detail in Mathematical Sciences Northwest, Inc., (MSNW) Proposal 1660, that is, the laser breakdown mode of heating in a slow solenoid. An extensive rework of the plasma sample facility was done in order to use this mode of heating. Specifically, a new solenoid magnet was constructed to allow higher field operation and the plasma chamber was modified to allow the use of puff filling orifices and small bore tube liners. The vacuum system and focussing optics were changed to allow the use of an on-axis Cassagranian system capable of focussing the laser radiation to a nearly diffraction limited spot as is necessary when heating through a small aperture. The 10 liter CO 2 laser optics were charged to an unstable oscillator configuration and additional windows were provided into the optical cavity for alignment purposes

  12. Recovery of spent high intensity neutron sources in Atalante Facility

    International Nuclear Information System (INIS)

    Bros, P.; Boyer Deslys, V.; Millet, A.; Solinhac, I.; Donnet, L.; Maillard, C.; Paillard, S.; Ranchoux, M.

    2005-01-01

    The Atalante facility is required by law to recover both neutron and gamma sources with activity levels exceeding 300 mCi. Most of the neutron sources consist of mixtures of alpha-emitters (238Pu, 239Pu, 241Am or 244Cm) and beryllium. Several processes now under consideration are based on routine chemical separation techniques (selective precipitation, extraction chromatography, ion exchange). The treatment produces an actinide oxide (which is used later for R and D studies) and solid beryllium nitrate, which is considered as a waste and transferred to a surface interim storage site if the overall activity of the package after 300 years is less than 50 MBq (ANDRA specifications). The Material Analysis and Metrology Laboratory of Atalante validate the residual alpha activity in the waste. The techniques used include alpha spectrometry and L-line X-ray fluorescence for alpha emitters, and plasma torch measurements (ICP-AES and ICP-MS) for beryllium analysis. Specific equipment for transport (B type cask), storage and treatment (hot shielded cells) are used for this activity. (Author)

  13. Impact of Electronic Health Records on Long-Term Care Facilities: Systematic Review.

    Science.gov (United States)

    Kruse, Clemens Scott; Mileski, Michael; Vijaykumar, Alekhya Ganta; Viswanathan, Sneha Vishnampet; Suskandla, Ujwala; Chidambaram, Yazhini

    2017-09-29

    Long-term care (LTC) facilities are an important part of the health care industry, providing care to the fastest-growing group of the population. However, the adoption of electronic health records (EHRs) in LTC facilities lags behind other areas of the health care industry. One of the reasons for the lack of widespread adoption in the United States is that LTC facilities are not eligible for incentives under the Meaningful Use program. Implementation of an EHR system in an LTC facility can potentially enhance the quality of care, provided it is appropriately implemented, used, and maintained. Unfortunately, the lag in adoption of the EHR in LTC creates a paucity of literature on the benefits of EHR implementation in LTC facilities. The objective of this systematic review was to identify the potential benefits of implementing an EHR system in LTC facilities. The study also aims to identify the common conditions and EHR features that received favorable remarks from providers and the discrepancies that needed improvement to build up momentum across LTC settings in adopting this technology. The authors conducted a systematic search of PubMed, Cumulative Index of Nursing and Allied Health (CINAHL), and MEDLINE databases. Papers were analyzed by multiple referees to filter out studies not germane to our research objective. A final sample of 28 papers was selected to be included in the systematic review. Results of this systematic review conclude that EHRs show significant improvement in the management of documentation in LTC facilities and enhanced quality outcomes. Approximately 43% (12/28) of the papers reported a mixed impact of EHRs on the management of documentation, and 33% (9/28) of papers reported positive quality outcomes using EHRs. Surprisingly, very few papers demonstrated an impact on patient satisfaction, physician satisfaction, the length of stay, and productivity using EHRs. Overall, implementation of EHRs has been found to be effective in the few LTC

  14. Development of High-Level Safety Requirements for a Pyroprocessing Facility

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Seok Jun; Jo, Woo Jin; You, Gil Sung; Choung, Won Myung; Lee, Ho Hee; Kim, Hyun Min; Jeon, Hong Rae; Ku, Jeong Hoe; Lee, Hyo Jik [KAERI, Daejeon (Korea, Republic of)

    2016-05-15

    Korea Atomic Energy Research Institute (KAERI) has been developing a pyroproceesing technology to reduce the waste volume and recycle some elements. The pyroprocessing includes several treatment processes which are related with not only radiological and physical but also chemical and electrochemical properties. Thus, it is of importance to establish safety design requirements considering all the aspects of those properties for a reliable pyroprocessing facility. In this study, high-level requirements are presented in terms of not only radiation protection, nuclear criticality, fire protection, and seismic safety but also confinement and chemical safety for the unique characteristics of a pyroprocessing facility. Several high-level safety design requirements such as radiation protection, nuclear criticality, fire protection, seismic, confinement, and chemical processing were presented for a pyroprocessing facility. The requirements must fulfill domestic and international safety technology standards for a nuclear facility. Furthermore, additional requirements should be considered for the unique electrochemical treatments in a pyroprocessing facility.

  15. High-adiabat high-foot inertial confinement fusion implosion experiments on the national ignition facility.

    Science.gov (United States)

    Park, H-S; Hurricane, O A; Callahan, D A; Casey, D T; Dewald, E L; Dittrich, T R; Döppner, T; Hinkel, D E; Berzak Hopkins, L F; Le Pape, S; Ma, T; Patel, P K; Remington, B A; Robey, H F; Salmonson, J D; Kline, J L

    2014-02-07

    This Letter reports on a series of high-adiabat implosions of cryogenic layered deuterium-tritium (DT) capsules indirectly driven by a "high-foot" laser drive pulse at the National Ignition Facility. High-foot implosions have high ablation velocities and large density gradient scale lengths and are more resistant to ablation-front Rayleigh-Taylor instability induced mixing of ablator material into the DT hot spot. Indeed, the observed hot spot mix in these implosions was low and the measured neutron yields were typically 50% (or higher) of the yields predicted by simulation. On one high performing shot (N130812), 1.7 MJ of laser energy at a peak power of 350 TW was used to obtain a peak hohlraum radiation temperature of ∼300  eV. The resulting experimental neutron yield was (2.4±0.05)×10(15) DT, the fuel ρR was (0.86±0.063)  g/cm2, and the measured Tion was (4.2±0.16)  keV, corresponding to 8 kJ of fusion yield, with ∼1/3 of the yield caused by self-heating of the fuel by α particles emitted in the initial reactions. The generalized Lawson criteria, an ignition metric, was 0.43 and the neutron yield was ∼70% of the value predicted by simulations that include α-particle self-heating.

  16. 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

  17. Spatial Analysis of the Level of Exposure to Seismic Hazards of Health Facilities in Mexico City, Mexico

    Science.gov (United States)

    Moran, S.; Novelo-Casanova, D. A.

    2011-12-01

    Although health facilities are essential infrastructure during disasters and emergencies, they are also usually highly vulnerable installations in the case of the occurrence of large and major earthquakes. Hospitals are one of the most complex critical facilities in modern cities and they are used as first response in emergency situations. The operability of a hospital must be maintained after the occurrence of a local strong earthquake in order to satisfy the need for medical care of the affected population. If a health facility is seriously damaged, it cannot fulfill its function when most is needed. In this case, hospitals become a casualty of the disaster. To identify the level of physical exposure of hospitals to seismic hazards in Mexico City, we analyzed their geographic location with respect to the seismic response of the different type of soils of the city from past earthquakes, mainly from the events that occurred on September 1985 (Ms= 8.0) and April 1989 (Ms= 6.9). Seismic wave amplification in this city is the result of the interaction of the incoming seismic waves with the soft and water saturated clay soils, on which a large part of Mexico City is built. The clay soils are remnants of the lake that existed in the Valley of Mexico and which has been drained gradually to accommodate the growing urban sprawl. Hospital facilities were converted from a simple database of names and locations into a map layer of resources. This resource layer was combined with other map layers showing areas of seismic microzonation in Mexico City. This overlay was then used to identify those hospitals that may be threatened by the occurrence of a large or major seismic event. We analyzed the public and private hospitals considered as main health facilities. Our results indicate that more than 50% of the hospitals are highly exposed to seismic hazards. Besides, in most of these health facilities we identified the lack of preventive measures and preparedness to reduce their

  18. Assessing the Contributions of Private Health Facilities in a Pioneer Private-Public Partnership in Childhood Immunization in Nigeria

    Science.gov (United States)

    Oluoha, Chukwuemeka; Ahaneku, Hycienth

    2014-01-01

    The vision of Nigeria’s immunization program is to reach and sustain routine immunization coverage of greater than 90% for all vaccines by 2020. In order to achieve this, Abia state embarked on a unique private-public partnership (PPP) between private health facilities and the Abia state ministry of health. The aim of this partnership was to collaborate with private health facilities to provide free childhood immunization services in the state - the first of its kind in Nigeria. This is a retrospective study of the 2011 Abia state, Nigeria monthly immunization data. In the 4 local governments operating the PPP, 45% (79/175) of the health facilities that offered immunization services in 2011 were private health facilities and 55% (96/175) were public health facilities. However, 21% of the immunization services took place in private health facilities while 79% took place in public health facilities. Private health facilities were shown to have a modest contribution to immunization in the 4 local governments involved in the PPP. Efforts should be made to expand PPP in immunization nationally to improve immunization services in Nigeria. PMID:28299112

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

    Science.gov (United States)

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

    2012-03-01

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

  20. 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

  1. Birth in a health facility--inequalities among the Ethiopian women: results from repeated national surveys.

    Directory of Open Access Journals (Sweden)

    Elias Ali Yesuf

    Full Text Available BACKGROUND: Uptake of health facilities for delivery care in Ethiopia has not been examined in the light of equality. We investigated differences in institutional deliveries by urbanity, administrative region, economic status and maternal education. METHODS: This study was based on nation-wide repeated surveys undertaken in the years 2000, 2005, and 2011. The surveys used a cluster sampling design. Women of reproductive age were interviewed on the place of their last delivery. Data was analyzed using logistic regressions to estimate the weighted association between birth in a health facility and study's predictors. RESULTS: Utilization of health institutions for deliveries has improved throughout the study period, however, rates remain low (5.4%,2000 and 11.8%,2011. Compared with women from rural places, women from urban areas had independent OR of a health facility delivery of 4.9 (95% CI: 3.4, 7.0, 5.0 (95% CI: 3.6, 6.9, and 4.6 (95% CI: 3.5, 6.0 in 2000, 2005, and 2011, respectively. Women with secondary/higher education had more deliveries in a healthcare facility than women with no education, and these gaps widened over the years (OR: 35.1, 45.0 and 53.6 in 2000, 2005, and 2011, respectively. Women of the upper economic quintile had 3.0-7.2 times the odds of healthcare facility deliveries, compared with the lowest quintile, with no clear trend over the years. While Addis-Ababa and Dire Dawa remained with the highest OR for deliveries in a health facility compared with Amhara, other regions displayed shifts in their relative ranking with Oromiya, SNNPR, Afar, Harari, and Somali getting relatively worse over time. CONCLUSIONS: The disparity related to urbanity or education in the use of health facility for birth in Ethiopia is staggering. There is a small inequality between most regions except Addis Ababa/Dire Dawa and sign of abating inequity between economic strata except for the richest households.

  2. Material-related issues at high-power and high-energy ion beam facilities

    CERN Document Server

    Bender, M.; Tomut, M.; Trautmann, C.

    2015-01-01

    When solids are exposed to energetic ions (MeV-GeV), their physical and chemical structure can be severely modified. The change is governed by ultrafast dynamical processes starting from the deposition of large energy densities, electronic excitation and ionization processes, and finally damage creation in the atomic lattice system. In many materials, each projectile creates a cylindrical track with a few nanometers in diameter and up to many μm in length. To study and monitor the creation of damage, the GSI irradiation facility dedicated to materials science provides different in-situ and on-line techniques such as high resolution microscopy, X-ray diffraction, optical absorption spectroscopy, thermal imaging and residual gas analysis. The irradiation experiments can be performed under various gas atmospheres and under cryogenic or elevated temperature.

  3. Availability of medicines in public sector health facilities of two North Indian States.

    Science.gov (United States)

    Prinja, Shankar; Bahuguna, Pankaj; Tripathy, Jaya Prasad; Kumar, Rajesh

    2015-12-23

    Access to free essential medicines is a critical component of universal health coverage. However availability of essential medicines is poor in India with more than two-third of the people having limited or no access. This has pushed up private out-of-pocket expenditure due to medicines. The states of Punjab and Haryana are in the process of institutionalizing drug procurement models to provide uninterrupted access to essential medicines free of cost in all public hospitals and health centres. We undertook this study to assess the availability of medicines in public sector health facilities in the 2 states. Secondly, we also ascertained the quality of storage and inventory management systems in health facilities. The present study was carried out in 80 public health facilities across 12 districts in Haryana and Punjab states. Overall, within each state 1 MC, 6 DHs, 11 CHCs and 22 PHCs were selected for the study. Drug procurement mechanisms in both the states were studied through document reviews and in-depth interviews with key stakeholders. Stock registers were reviewed to collect data on availability of a basket of essential medicines -92 at Primary Health Centre (PHC) level, 132 at Community Health Centre (CHC) level and 160 at tertiary care (District Hospital/Medical College) level. These essential medicines were selected based on the Essential Medicine List (EML) of the Department of Health (DOH). Overall availability of medicines was 45.2% and 51.1% in Punjab and Haryana respectively. Availability of anti-hypertensives was around 60% in both the states whereas for anti-diabetics it was 44% and 47% in Punjab and Haryana respectively. Atleast one drug in each of the categories including analgesic/antipyretic, anti-helminthic, anti-spasmodic, anti-emetic, anti-hypertensive and uterotonics were nearly universally available in public sector facilities. On the contrary, medicines such as thrombolytics, anti-cancer and endocrine medicines were available in less

  4. 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

  5. HIGH ENERGY, HIGH BRIGHTNESS X-RAYS PRODUCED BY COMPTON BACKSCATTERING AT THE LIVERMORE PLEIADES FACILITY

    International Nuclear Information System (INIS)

    Tremaine, A M; Anderson, S G; Betts, S; Crane, J; Gibson, D J; Hartemann, F V; Jacob, J S; Frigola, P; Lim, J; Rosenzweig, J; Travish, G

    2005-01-01

    PLEIADES (Picosecond Laser Electron Interaction for the Dynamic Evaluation of Structures) produces tunable 30-140 keV x-rays with 0.3-5 ps pulse lengths and up to 10 7 photons/pulse by colliding a high brightness electron beam with a high power laser. The electron beam is created by an rf photo-injector system, accelerated by a 120 MeV linac, and focused to 20 (micro)m with novel permanent magnet quadrupoles. To produce Compton back scattered x-rays, the electron bunch is overlapped with a Ti:Sapphire laser that delivers 500 mJ, 100 fs, pulses to the interaction point. K-edge radiography at 115 keV on Uranium has verified the angle correlated energy spectrum inherent in Compton scattering and high-energy tunability of the Livermore source. Current upgrades to the facility will allow laser pumping of targets synchronized to the x-ray source enabling dynamic diffraction and time-resolved studies of high Z materials. Near future plans include extending the radiation energies to >400 keV, allowing for nuclear fluorescence studies of materials

  6. Herbal medicine use among hypertensive patients attending public and private health facilities in Freetown Sierra Leone.

    Science.gov (United States)

    James, Peter Bai; Kamara, Halimatu; Bah, Abdulai Jawo; Steel, Amie; Wardle, Jon

    2018-05-01

    This study aimed to determine the prevalence, determinants and pattern of herbal medicine use among hypertensive patients in Freetown. We conducted a cross-sectional study among hypertensive patients attending public and private health facilities in Freetown, Sierra Leone between August and October 2016. We analyzed the data using SPSS version 24. We used Chi-square, Fisher exact two-tailed test and regression analysis for data analysis. A p-value less than 0.05 was considered statistically significant. Out of 260 study participants, over half (n = 148, 56.9%) reported using herbal medicine for the treatment of hypertension alone or together with comorbid condition(s). The most commonly used herbal medicine among users were honey (n = 89, 33.3%), moringa (n = 80, 30.0%) and garlic (n = 73, 27.3%). No significant difference existed between users and non-users of herbal medicine with regards to socio-demographic and health-related factors. The majority (n = 241, 92.7%) of respondents considered herbal medicine beneficial if it was recommended by a healthcare provider yet 85.1% (n = 126) did not disclose their herbal medicine use to their health care provider. There is a high use of herbal medicines among hypertensive patients in Freetown, Sierra Leone. It is essential for healthcare providers to take heed of the findings of this study and routinely ask their patients about their herbal medicine use status. Such practice will provide the opportunity to discuss the benefits and risks of herbal medicine use with the aim of maximizing patient desired therapeutic outcomes. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. The National Ignition Facility (NIF) and High Energy Density Science Research at LLNL (Briefing Charts)

    Science.gov (United States)

    2013-06-21

    The National Ignition Facility ( NIF ) and High Energy Density Science Research at LLNL Presentation to: IEEE Pulsed Power and Plasma Science...Conference C. J. Keane Director, NIF User Office June 21, 2013 1491978-1-4673-5168-3/13/$31.00 ©2013 IEEE Report Documentation Page Form ApprovedOMB No...4. TITLE AND SUBTITLE The National Ignition Facility ( NIF ) and High Energy Density Science Research at LLNL 5a. CONTRACT NUMBER 5b. GRANT

  8. Thermocouple calibration facility for 2900 deg C high temperature and its applications

    International Nuclear Information System (INIS)

    Chen Daolong

    1991-01-01

    The construction and the performance characteristic of a 2900 deg C high temperature thermocouple calibration facility are described. The calibration error analysis is made. The test results of the calibration characteristics of high temperature thermocouples Mo/Nb, W-3Re/W-25Re, and W-1Mo/W-25Mo are given. The test result of temperature dependent resistivity of BeO made by this facility is given

  9. The high pressure gas Cerenkov counter at the Omega Facility.

    CERN Multimedia

    1975-01-01

    The high-pressure gas Cerenkov was used to measure reactions as pion (or kaon)- hydrogen --> forward proton - X. It was built by the Ecole Polytechnique (Palaiseu). Here Peter Sonderegger and Patrick Fleury,

  10. 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.

  11. Health facilities safety in natural disasters: experiences and challenges from South East Europe.

    Science.gov (United States)

    Radovic, Vesela; Vitale, Ksenija; Tchounwou, Paul B

    2012-05-01

    The United Nations named 2010 as a year of natural disasters, and launched a worldwide campaign to improve the safety of schools and hospitals from natural disasters. In the region of South East Europe, Croatia and Serbia have suffered the greatest impacts of natural disasters on their communities and health facilities. In this paper the disaster management approaches of the two countries are compared, with a special emphasis on the existing technological and legislative systems for safety and protection of health facilities and people. Strategic measures that should be taken in future to provide better safety for health facilities and populations, based on the best practices and positive experiences in other countries are recommended. Due to the expected consequences of global climate change in the region and the increased different environmental risks both countries need to refine their disaster preparedness strategies. Also, in the South East Europe, the effects of a natural disaster are amplified in the health sector due to its critical medical infrastructure. Therefore, the principles of environmental security should be implemented in public health policies in the described region, along with principles of disaster management through regional collaborations.

  12. Health Facilities Safety in Natural Disasters: Experiences and Challenges from South East Europe

    Directory of Open Access Journals (Sweden)

    Vesela Radovic

    2012-05-01

    Full Text Available The United Nations named 2010 as a year of natural disasters, and launched a worldwide campaign to improve the safety of schools and hospitals from natural disasters. In the region of South East Europe, Croatia and Serbia have suffered the greatest impacts of natural disasters on their communities and health facilities. In this paper the disaster management approaches of the two countries are compared, with a special emphasis on the existing technological and legislative systems for safety and protection of health facilities and people. Strategic measures that should be taken in future to provide better safety for health facilities and populations, based on the best practices and positive experiences in other countries are recommended. Due to the expected consequences of global climate change in the region and the increased different environmental risks both countries need to refine their disaster preparedness strategies. Also, in the South East Europe, the effects of a natural disaster are amplified in the health sector due to its critical medical infrastructure. Therefore, the principles of environmental security should be implemented in public health policies in the described region, along with principles of disaster management through regional collaborations.

  13. 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.

  14. Women's use of private and government health facilities for childbirth in Nairobi's informal settlements.

    Science.gov (United States)

    Bazant, Eva S; Koenig, Michael A; Fotso, Jean-Christophe; Mills, Samuel

    2009-03-01

    The private sector's role in increasing the use of maternal health care for the poor in developing countries has received increasing attention, yet few data exist for urban slums. Using household-survey data from 1,926 mothers in two informal settlements in Nairobi, Kenya, collected in 2006, we describe and examine the factors associated with women's use of private and government health facilities for childbirth. More women gave birth at private facilities located in the settlements than at government facilities, and one-third of the women gave birth at home or with the assistance of a traditional birth attendant. In multivariate models, women's education, ethnic group, and household wealth were associated with institutional deliveries, especially in government hospitals. Residents in the more disadvantaged settlement were more likely than those in the better-off settlement to give birth in private facilities. In urban areas, maternal health services in both the government and private sectors should be strengthened, and efforts made to reach out to women who give birth at home.

  15. Process evaluation of communitisation programme in public sector health facilities, Mokokchung district, Nagaland, 2015

    Directory of Open Access Journals (Sweden)

    Aonungdok Tushi

    2017-01-01

    Full Text Available Background: Public sector health facilities were poorly managed due to a history of conflict in Nagaland, India. Government of Nagaland introduced “Nagaland Communitisation of Public Institutions and Services Act” in 2002. Main objectives of the evaluation were to review the functioning of Health Center Managing Committees (HCMCs, deliver health services in the institutions managed by HCMC, identify strengths as well as challenges perceived by HCMC members in the rural areas of Mokokchung district, Nagaland. Materials and Methods: The evaluation was made using input, process and output indicators. A doctor, the HCMC Chairman and one member from each of the three community health centers (CHC and four primary health centers (PHC were surveyed using a semi-structured questionnaire and an in-depth interview guide. Proportions for quantitative data were computed and key themes from the same were identified. Results: Overall; the infrastructure, equipment and outpatient/inpatient service availability was satisfactory. There was a lack of funds and shortage of doctors, drugs as well as laboratory facilities. HCMCs were in place and carried out administrative activities. HCMCs felt ownership, mobilized community contributions and managed human resources. HCMC members had inadequate funds for their transport and training. They faced challenges in service delivery due to political interference and lack of adequate human, material, financial resources. Conclusions: Communitisation program was operational in the district. HCMC members felt the ownership of health facilities. Administrative, political support and adequate funds from the government are needed for effective functioning of HCMCs and optimal service delivery in public sector facilities.

  16. mHealth: Knowledge and use among doctors and nurses in public secondary health-care facilities of Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Bukola Samuel Owolabi

    2018-01-01

    Full Text Available Objectives: Mobile health (mHealth is gaining importance worldwide, changing and improving the way healthcare and services are provided, but its role is just emerging in Nigeria. This study aimed to assess the knowledge and use of mHealth among health workers and the provisions for its use in public secondary health-care facilities of Lagos State, Nigeria. Methods: The study was a descriptive cross-sectional study carried out among 65 doctors and 135 nurses selected using a two-staged sampling method. Data were collected with pretested self-administered questionnaires and analyzed with EpiInfo™ 7. Results: Majority (doctors 84.6%, nurses 91.1% had not heard of the term “mHealth,” but most (doctors 96.9%, nurses 87.4% were aware of the use of mobile phones in health-care delivery. Only three (27.3% (health call centers/health-care telephone helpline, appointment reminders, and mobile telemedicine out of 11 mHealth components listed were mostly known. Most doctors simply used patient monitoring/surveillance and mobile telemedicine, while nurses mainly used treatment compliance and appointment reminder services. Majority were willing to use more mHealth services if available in their hospital. All the doctors and 97% of nurses had mobile phones. However, only about one-quarter (27.5% had smartphones with applications used for mHealth purposes. Conclusions: Knowledge, awareness, and use of mHealth services were low. Doctors and nurses should be enlightened and trained on ways to use mHealth services to improve health-care delivery, mHealth services should be made available in the hospitals, and use of smartphones encouraged as they portend better adaptability for mHealth use.

  17. External quality assessment of malaria microscopy diagnosis in selected health facilities in Western Oromia, Ethiopia.

    Science.gov (United States)

    Sori, Getachew; Zewdie, Olifan; Tadele, Geletta; Samuel, Abdi

    2018-06-18

    Accurate early diagnosis and prompt treatment are one of the key strategies to control and prevent malaria disease. External quality assessment is the most effective method for evaluation of the quality of malaria microscopy diagnosis. The aim of this study was to assess the quality of malaria microscopy diagnosis and its associated factors in selected public health facility laboratories in East Wollega Zone, Western Ethiopia. Facility-based cross-sectional study design was conducted in 30 randomly selected public health facility laboratories from November 2014 to January 2015 in East Wollega Zone, Western Ethiopia. Ten validated stained malaria panel slides with known Plasmodium species, developmental stage and parasite density were distributed. Data were captured; cleaned and analyzed using SPSS version 20 statistical software-multivariate logistic regressions and the agreement in reading between the peripheral diagnostic centers and the reference laboratory were done using kappa statistics. A total of 30 health facility laboratories were involved in the study and the overall quality of malaria microscopy diagnosis was poor (62.3%). The associated predictors of quality in this diagnosis were in-service training [(AOR = 16, 95% CI (1.3, 1.96)], smearing quality [(AOR = 24, 95% CI (1.8, 3.13)], staining quality [(AOR = 15, 95% CI (2.35, 8.61), parasite detection [(AOR = 9, 95% CI (1.1, 8.52)] and identification skills [(AOR = 8.6, 95% CI (1.21, 1.63)]. Eighteen (60%) of health facility laboratories had in-service trained laboratory professionals on malaria microscopy diagnosis. Overall quality of malaria microscopy diagnosis was poor and a significant gap in this service was observed that could impact on its diagnostic services.

  18. High-current Rhodotron for X-ray facility

    International Nuclear Information System (INIS)

    Umezu, Toru; Tsujiura, Yuichiro; Bol, Jean Louis

    2009-01-01

    The Rhodotron is a widely employed high-power industrial accelerator developed and exclusively distributed by IBA. Most early examples of the accelerator were optimized to operate at 10 MeV. A new Rhodotron configuration recently advanced produces a lower-energy higher-current beam dedicated with x-ray to sterilize and enhancement materials. Core elements of this system's evolution include a higher performance RF electron gun (operating range, response control, and cathode lifetime). This operational machine is now producing 100 mA at 7 MeV (700 kW of beam) and treat medical devices, thick cable and pipes with a high efficiency. (author)

  19. A New High-intensity Proton Irradiation Facility at the CERN PS East Area

    CERN Document Server

    Gkotse, B; Lima, P; Matli, E; Moll, M; Ravotti, F

    2014-01-01

    and IRRAD2), were heavily and successfully used for irradiation of particle detectors, electronic components and materials since 1992. These facilities operated with particle bursts - protons with momentum of 24GeV/c - delivered from the PS accelerator in “spills” of about 400ms (slow extraction). With the increasing demand of irradiation experiments, these facilities suffered from a number of restrictions such as the space availability, the maximum achievable particle flux and several access constraints. In the framework of the AIDA project, an upgrade of these facilities has been realized during the CERN long shutdown (LS1). While the new proton facility (IRRAD) will continue to be mainly devoted to the radiation hardness studies for the High Energy Physics (HEP) experimental community, the new mixed-field facility (CHARM) will mainly host irradiation experiments for the validation of electronic systems used in a...

  20. [Food and beverages available in automatic food dispensers in health care facilities of the Portugal North Health Region].

    Science.gov (United States)

    Rodrigues, Filipa Gomes; Ramos, Elisabete; Freitas, Mário; Neto, Maria

    2010-01-01

    Patients and health staff frequently need to stay in health care facilities for quite a long time. Therefore, it's necessary to create the conditions that allow the ingestion of food during those periods, namely through the existence of automatic food dispensers. However, the available food and beverages might not always be compatible with a healthy diet. The aim of this work was to evaluate if the food and beverages available in automatic food dispensers in public Ambulatory Care Facilities (ACF) and Hospitals of the Portugal North Health Region were contributing to a healthy diet, during the year of 2007. A questionnaire was elaborated and sent to the Coordinators of the Health Sub-Regions and to the Hospital Administrators. The questionnaire requested information about the existence of automatic food dispensers in the several departments of each health care facility, as well as which food and beverages were available and most sold. Afterwards, the pre-processing of the results involved the classification of the food and beverages in three categories: recommended, sometimes recommended and not recommended. The questionnaire reply ratio was 71% in ACF and 83% in Hospitals. Automatic food dispensers were available in all the Hospitals and 86.5% of ACF. It wasn't possible to acquire food in 37% of the health facility departments. These departments were all located in ACF. The more frequently available beverages in departments with automatic food dispensers were coffee, still water, tea, juices and nectars and soft drinks. Still water, coffee, yogurt, juices and nectars and soft drinks were reported as the most sold. The more frequently avaliable food items were chocolate, recommended cookies, not recommended cakes, recommended sandwiches and sometimes recommended croissants. The food items reported as being the most sold were recommended sandwiches, chocolate, recommended cookies, sometimes recommended croissants and not recommended cookies. The beverages in the

  1. Bringing the war back home: mental health disorders among 103,788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities.

    Science.gov (United States)

    Seal, Karen H; Bertenthal, Daniel; Miner, Christian R; Sen, Saunak; Marmar, Charles

    2007-03-12

    Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) have endured high combat stress and are eligible for 2 years of free military service-related health care through the Department of Veterans Affairs (VA) health care system, yet little is known about the burden and clinical circumstances of mental health diagnoses among OEF/OIF veterans seen at VA facilities. US veterans separated from OEF/OIF military service and first seen at VA health care facilities between September 30, 2001 (US invasion of Afghanistan), and September 30, 2005, were included. Mental health diagnoses and psychosocial problems were assessed using International Classification of Diseases, Ninth Revision, Clinical Modification codes. The prevalence and clinical circumstances of and subgroups at greatest risk for mental health disorders are described herein. Of 103 788 OEF/OIF veterans seen at VA health care facilities, 25 658 (25%) received mental health diagnosis(es); 56% of whom had 2 or more distinct mental health diagnoses. Overall, 32 010 (31%) received mental health and/or psychosocial diagnoses. Mental health diagnoses were detected soon after the first VA clinic visit (median of 13 days), and most initial mental health diagnoses (60%) were made in nonmental health clinics, mostly primary care settings. The youngest group of OEF/OIF veterans (age, 18-24 years) were at greatest risk for receiving mental health or posttraumatic stress disorder diagnoses compared with veterans 40 years or older. Co-occurring mental health diagnoses and psychosocial problems were detected early and in primary care medical settings in a substantial proportion of OEF/OIF veterans seen at VA facilities. Targeted early detection and intervention beginning in primary care settings are needed to prevent chronic mental illness and disability.

  2. Facile fabrication of highly flexible graphene paper for photocatalytic ...

    Indian Academy of Sciences (India)

    Administrator

    potential as a carbon-based catalyst in high-performance flexible catalytic ... resultant GOs/PAA/Au composite paper was applied as a catalytic material ... Graphene, as closely packed into two-dimensional (2D) ... only display the properties of metal nanoparticles and ... the morphology and the size of AuNPs, respectively.

  3. Challenges that Hinder Parturients to Deliver in Health Facilities: A Qualitative Analysis in Two Districts of Indonesia

    Directory of Open Access Journals (Sweden)

    Sudirman Nasir

    2016-12-01

    Full Text Available Background: There are many challenges women face to be able to give birth in health facilities in many parts of Indonesia. This study explores the roles and observations of close-to-community maternal health providers and other community members on potential barriers faced by women to deliver in health facilities in two districts within The Archipelago. Methods: Employing an explorative qualitative approach, 110 semi-structured interviews and 7 focus group discussions were conducted in 8 villages in Southwest Sumba, in the East Nusa Tenggara province, and in 8 villages in Cianjur, in the West Java province. The participants included village midwives, Posyandu kader (village health volunteers, traditional birth attendants (TBAs, mothers, men, village heads and district health officials. Results: The main findings were mostly similar in the two study areas. However, there were some key differences. Preference for TBA care, traditional beliefs, a lack of responsiveness of health providers to local traditions, distance, cost of travel and indirect costs of accompanying family members were all barriers to patients attending health facilities for the birth of their child. TBAs were the preferred health providers in most cases due to their close proximity at the time of childbirth and their adherence to traditional practices during pregnancy and delivery. Conclusions: Improving collaborations between midwives and TBAs, and responsiveness to traditional practices within health facilities and effective health promotion campaigns about the benefits of giving birth in health facilities may increase the use of health facilities in both study areas.

  4. High-intensity, subkilovolt x-ray calibration facility

    International Nuclear Information System (INIS)

    Kuckuck, R.W.; Gaines, J.L.; Ernst, R.D.

    1976-01-01

    A high-intensity subkilovolt x-ray calibration source utilizing proton-induced inner-shell atomic fluorescence of low-Z elements is described. The high photon yields and low bremsstrahlung background associated with this phenomenon are ideally suited to provide intense, nearly monoenergetic x-ray beams. The proton accelerator is a 3 mA, 300 kV Cockroft-Walton using a conventional rf hydrogen ion source. Seven remotely-selectable targets capable of heat dissipation of 5 kW/cm 2 are used to provide characteristic x-rays with energies between 100 and 1000 eV. Source strengths are of the order of 10 13 to 10 14 photons/sec. Methods of reducing spectral contamination due to hydrocarbon build-up on the target are discussed. Typical x-ray spectra (Cu-L, C-K and B-K) are shown

  5. Health facility challenges to the provision of Option B+ in western Kenya: a qualitative study.

    Science.gov (United States)

    Helova, Anna; Akama, Eliud; Bukusi, Elizabeth A; Musoke, Pamela; Nalwa, Wafula Z; Odeny, Thomas A; Onono, Maricianah; Spangler, Sydney A; Turan, Janet M; Wanga, Iris; Abuogi, Lisa L

    2017-03-01

    Current WHO guidelines recommend lifelong antiretroviral therapy (ART) for all HIV-positive individuals, including pregnant and breastfeeding women (Option B+) in settings with generalized HIV epidemics. While Option B+ is scaled-up in Kenya, insufficient adherence and retention to care could undermine the expected positive impact of Option B+. To explore challenges to the provision of Option B+ at the health facility level, we conducted forty individual gender-matched in-depth interviews with HIV-positive pregnant/postpartum women and their male partners, and four focus groups with thirty health care providers at four health facilities in western Kenya between September-November 2014. Transcripts were coded with the Dedoose software using a coding framework based on the literature, topics from interview guides, and emerging themes from transcripts. Excerpts from broad codes were then fine-coded using an inductive approach. Three major themes emerged: 1) Option B+ specific challenges (same-day initiation into treatment, health care providers unconvinced of the benefits of Option B+, insufficient training); 2) facility resource constraints (staff and drug shortages, long queues, space limitations); and 3) lack of client-friendly services (scolding of patients, inconvenient operating hours, lack of integration of services, administrative requirements). This study highlights important challenges at the health facility level related to Option B+ rollout in western Kenya. Addressing these specific challenges may increase linkage, retention and adherence to life-long ART treatment for pregnant HIV-positive women in Kenya, contribute towards elimination of mother-to-child HIV transmission, and improve maternal and child outcomes.

  6. Assessing the quality of care in a new nation: South Sudan's first national health facility assessment.

    Science.gov (United States)

    Berendes, Sima; Lako, Richard L; Whitson, Donald; Gould, Simon; Valadez, Joseph J

    2014-10-01

    We adapted a rapid quality of care monitoring method to a fragile state with two aims: to assess the delivery of child health services in South Sudan at the time of independence and to strengthen local capacity to perform regular rapid health facility assessments. Using a two-stage lot quality assurance sampling (LQAS) design, we conducted a national cross-sectional survey among 156 randomly selected health facilities in 10 states. In each of these facilities, we obtained information on a range of access, input, process and performance indicators during structured interviews and observations. Quality of care was poor with all states failing to achieve the 80% target for 14 of 19 indicators. For example, only 12% of facilities were classified as acceptable for their adequate utilisation by the population for sick-child consultations, 16% for staffing, 3% for having infection control supplies available and 0% for having all child care guidelines. Health worker performance was categorised as acceptable in only 6% of cases related to sick-child assessments, 38% related to medical treatment for the given diagnosis and 33% related to patient counselling on how to administer the prescribed drugs. Best performance was recorded for availability of in-service training and supervision, for seven and ten states, respectively. Despite ongoing instability, the Ministry of Health developed capacity to use LQAS for measuring quality of care nationally and state-by-state, which will support efficient and equitable resource allocation. Overall, our data revealed a desperate need for improving the quality of care in all states. © 2014 John Wiley & Sons Ltd.

  7. Hazardous medical waste generation rates of different categories of health-care facilities

    International Nuclear Information System (INIS)

    Komilis, Dimitrios; Fouki, Anastassia; Papadopoulos, Dimitrios

    2012-01-01

    Highlights: ► We calculated hazardous medical waste generation rates (HMWGR) from 132 hospitals. ► Based on a 22-month study period, HMWGR were highly skewed to the right. ► The HMWGR varied from 0.00124 to 0.718 kg bed −1 d −1 . ► A positive correlation existed between the HMWGR and the number of hospital beds. ► We used non-parametric statistics to compare rates among hospital categories. - Abstract: Goal of this work was to calculate the hazardous medical waste unit generation rates (HMWUGR), in kg bed −1 d −1 , using data from 132 health-care facilities in Greece. The calculations were based on the weights of the hazardous medical wastes that were regularly transferred to the sole medical waste incinerator in Athens over a 22-month period during years 2009 and 2010. The 132 health-care facilities were grouped into public and private ones, and, also, into seven sub-categories, namely: birth, cancer treatment, general, military, pediatric, psychiatric and university hospitals. Results showed that there is a large variability in the HMWUGR, even among hospitals of the same category. Average total HMWUGR varied from 0.012 kg bed −1 d −1 , for the public psychiatric hospitals, to up to 0.72 kg bed −1 d −1 , for the public university hospitals. Within the private hospitals, average HMWUGR ranged from 0.0012 kg bed −1 d −1 , for the psychiatric clinics, to up to 0.49 kg bed −1 d −1 , for the birth clinics. Based on non-parametric statistics, HMWUGR were statistically similar for the birth and general hospitals, in both the public and private sector. The private birth and general hospitals generated statistically more wastes compared to the corresponding public hospitals. The infectious/toxic and toxic medical wastes appear to be 10% and 50% of the total hazardous medical wastes generated by the public cancer treatment and university hospitals, respectively.

  8. Webinar Presentation: Environmental Exposures and Health Risks in California Child Care Facilities: First Steps to Improve Environmental Health where Children Spend Time

    Science.gov (United States)

    This presentation, Environmental Exposures and Health Risks in California Child Care Facilities: First Steps to Improve Environmental Health where Children Spend Time, was given at the NIEHS/EPA Children's Centers 2016 Webinar Series: Exposome.

  9. Present status of high quality beam facility at Waseda University

    International Nuclear Information System (INIS)

    Washio, M.; Kawai, H.; Hama, Y.; Kudo, N.; Kobayashi, M.; Kuribayasi, T.; Kawaguchi, M.; Kuroda, R.; Maeda, K.; Nagasawa, F.; Ueyama, D.; Hizume, K.; Wang, X.J.; Hayano, H.; Urakawa, J.; Kashiwagi, S.

    2004-01-01

    A research project named High-Tech Research Center Project has been conducted at Waseda University. In this project, an RF gun system has been used for production of low emittance and short bunched electron beam. The experiments for the electron beam quality measurement have been carried out by slit scan techniques, etc. Short pulsed x-ray with the energy range of so-called water window has been generation by the inverse compton scattering. Further, the pulse radiolysis system has been constructed, and the stroboscopic pulse radiolysis has been applied for the detection of hydrated electron in picosecond time region. (author)

  10. 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

  11. The Role of Health Extension Workers in Linking Pregnant Women With Health Facilities for Delivery in Rural and Pastoralist Areas of Ethiopia.

    Science.gov (United States)

    Jackson, Ruth; Hailemariam, Assefa

    2016-09-01

    Women's preference to give birth at home is deeply embedded in Ethiopian culture. Many women only go to health facilities if they have complications during birth. Health Extension Workers (HEWs) have been deployed to improve the utilization of maternal health services by bridging the gap between communities and health facilities. This study examined the barriers and facilitators for HEWs as they refer women to mid-level health facilities for birth. A qualitative study was conducted in three regions: Afar Region, Southern Nations Nationalities and People's Region and Tigray Region between March to December 2014. Interviews and focus group discussions were conducted with 45 HEWs, 14 women extension workers (employed by Afar Pastoralist Development Association, Afar Region) and 11 other health workers from health centers, hospitals or health offices. Data analysis was done based on collating the data and identifying key themes. Barriers to health facilities included distance, lack of transportation, sociocultural factors and disrespectful care. Facilitators for facility-based deliveries included liaising with Health Development Army (HDA) leaders to refer women before their expected due date or if labour starts at home; the introduction of ambulance services; and, provision of health services that are culturally more acceptable for women. HEWs can effectively refer more women to give birth in health facilities when the HDA is well established, when health staff provide respectful care, and when ambulance is available at any time.

  12. TB/HIV Co-Infection Care in Conflict-Affected Settings: A Mapping of Health Facilities in the Goma Area, Democratic Republic of Congo.

    Science.gov (United States)

    Kaboru, Berthollet Bwira; Ogwang, Brenda A; Namegabe, Edmond Ntabe; Mbasa, Ndemo; Kabunga, Deka Kambale; Karafuli, Kambale

    2013-09-01

    HIV/AIDS and Tuberculosis (TB) are major contributors to the burden of disease in sub-Saharan Africa. The two diseases have been described as a harmful synergy as they are biologically and epidemiologically linked. Control of TB/HIV co-infection is an integral and most challenging part of both national TB and national HIV control programmes, especially in contexts of instability where health systems are suffering from political and social strife. This study aimed at assessing the provision of HIV/TB co-infection services in health facilities in the conflict-ridden region of Goma in Democratic Republic of Congo. A cross-sectional survey of health facilities that provide either HIV or TB services or both was carried out. A semi-structured questionnaire was used to collect the data which was analysed using descriptive statistics. Eighty facilities were identified, of which 64 facilities were publicly owned. TB care was more available than HIV care (in 61% vs. 9% of facilities). Twenty-three facilities (29%) offered services to co-infected patients. TB/HIV co-infection rates among patients were unknown in 82% of the facilities. Only 19 facilities (24%) reported some coordination with and support from concerned diseases' control programmes. HIV and TB services are largely fragmented, indicating imbalances and poor coordination by disease control programmes. HIV and TB control appear not to be the focus of health interventions in this crisis affected region, despite the high risks of TB and HIV infection in the setting. Comprehensive public health response to this setting calls for reforms that promote joint TB/HIV co-infection control, including improved leadership by the HIV programmes that accuse weaknesses in this conflict-ridden region.

  13. TB/HIV Co-Infection Care in Conflict-Affected Settings: A Mapping of Health Facilities in the Goma Area, Democratic Republic of Congo

    Directory of Open Access Journals (Sweden)

    Berthollet Bwira Kaboru

    2013-01-01

    Full Text Available Background HIV/AIDS and Tuberculosis (TB are major contributors to the burden of disease in sub-Saharan Africa. The two diseases have been described as a harmful synergy as they are biologically and epidemiologically linked. Control of TB/HIV co-infection is an integral and most challenging part of both national TB and national HIV control programmes, especially in contexts of instability where health systems are suffering from political and social strife. This study aimed at assessing the provision of HIV/TB co-infection services in health facilities in the conflict-ridden region of Goma in Democratic Republic of Congo. Methods A cross-sectional survey of health facilities that provide either HIV or TB services or both was carried out. A semi-structured questionnaire was used to collect the data which was analysed using descriptive statistics. Results Eighty facilities were identified, of which 64 facilities were publicly owned. TB care was more available than HIV care (in 61% vs. 9% of facilities. Twenty-three facilities (29% offered services to co-infected patients. TB/HIV co-infection rates among patients were unknown in 82% of the facilities. Only 19 facilities (24% reported some coordination with and support from concerned diseases’ control programmes. HIV and TB services are largely fragmented, indicating imbalances and poor coordination by disease control programmes. Conclusion HIV and TB control appear not to be the focus of health interventions in this crisis affected region, despite the high risks of TB and HIV infection in the setting. Comprehensive public health response to this setting calls for reforms that promote joint TB/HIV co-infection control, including improved leadership by the HIV programmes that accuse weaknesses in this conflict-ridden region.

  14. High-Gain Shock Ignition on the National Ignition Facility

    Science.gov (United States)

    Perkins, L. J.; Lafortune, K.; Bailey, D.; Lambert, M.; MacKinnon, A.; Blackfield, D.; Comley, A.; Schurtz, G.; Ribeyre, X.; Lebel, E.; Casner, A.; Craxton, R. S.; Betti, R.; McKenty, P.; Anderson, K.; Theobald, W.; Schmitt, A.; Atzeni, S.; Schiavi, A.

    2010-11-01

    Shock ignition offers the possibility for a near-term test of high-gain ICF on the NIF at less than 1MJ drive energy and with day-1 laser hardware. We will summarize the status of target performance simulations, delineate the critical issues and describe the R&D program to be performed in order to test the potential of a shock-ignited target on NIF. In shock ignition, compressed fuel is separately ignited by a late-time laser-driven shock and, because capsule implosion velocities are significantly lower than those required for conventional hotpot ignition, simulations indicate that fusion energy gains of 60 may be achievable at laser energies around 0.5MJ. Like fast ignition, shock ignition offers high gain but requires only a single laser with less demanding timing and focusing requirements. Conventional symmetry and stability constraints apply, thus a key immediate step towards attempting shock ignition on NIF is to demonstrate adequacy of low-mode uniformity and shock symmetry under polar drive

  15. Conceptual design of a 6-10 MJ driver for a high gain target development facility

    International Nuclear Information System (INIS)

    Olson, R.E.

    1986-01-01

    Commercial application of inertial confinement fusion would require low yield (≅200-500 MJ), high gain (≥80) fusion targets. It is thought that the development off such targets would reqiure a 5-10 year research program utilizing one or more dedicated nuclear facilities with drivers capable of delivering on-target pulses of 6-10 MJ at the rate of several shots per day. The ''Target Development Facility'' (TDF) is the light ion driven version of such a facility. A TDF driver concept based upon reasonable extrapolation from present-day technology is described in this paper

  16. Conceptual design of a 10-MJ driver for a high gain target development facility

    International Nuclear Information System (INIS)

    Olson, R.E.

    1987-01-01

    Commercial application of inertial confinement fusion (ICF) will require inexpensive, high gain (>80) fusion targets. It is thought that the development of such targets will require a 5 to 10 year search effort utilizing a dedicated nuclear research facility with a driver capable of providing a 10 MJ, 300 to 1000 TW pulse of on-target energy. The Terget Development Facility (TDF) is a light ion driven concept for such a facility. A TDF driver based upon extrapolations from present-day pulsed power technology is described in the present paper

  17. Role of information and communication technology in promoting oral health at residential aged care facilities.

    Science.gov (United States)

    Adebayo, Bola; Durey, Angela; Slack-Smith, Linda M

    2017-07-01

    Information and communication technology (ICT) can provide knowledge and clinical support to those working in residential aged care facilities (RACFs). This paper aims to: (1) review literature on ICT targeted at residents, staff and external providers in RACFs including general practitioners, dental and allied health professionals on improving residents' oral health; (2) identify barriers and enablers to using ICT in promoting oral health at RACFs; and (3) investigate evidence of effectiveness of these approaches in promoting oral health. Findings from this narrative literature review indicate that ICT is not widely used in RACFs, with barriers to usage identified as limited training for staff, difficulties accessing the Internet, limited computer literacy particularly in older staff, cost and competing work demands. Residents also faced barriers including impaired cognitive and psychosocial functioning, limited computer literacy and Internet use. Findings suggest that more education and training in ICT to upskill staff and residents is needed to effectively promote oral health through this medium.

  18. Bechtel Hanford, Inc./ERC team health and safety plan Environmental Restoration Disposal Facility operations

    International Nuclear Information System (INIS)

    Turney, S.R.

    1996-02-01

    A comprehensive safety and health program is essential for reducing work-related injuries and illnesses while maintaining a safe and health work environment. This document establishes Bechtel Hanford, Inc. (BHI)/Environmental Restoration Contractor (ERC) team requirements, policies, and procedures and provides preliminary guidance to the Environmental Restoration Disposal Facility (ERDF) subcontractor for use in preparing essential safety and health documents. This health and safety plan (HASP) defines potential safety and health issues associated with operating and maintaining the ERDF. A site-specific HASP shall be developed by the ERDF subcontractor and shall be implemented before operations and maintenance work can proceed. An activity hazard analysis (AHA) shall also be developed to provide procedures to identify, assess, and control hazards or potential incidents associated with specific operations and maintenance activities

  19. Experiences of Fast Queue health care users in primary health care facilities in eThekwini district, South AfricaExperiences of Fast Queue health care users in primary health care facilities in eThekwini district, South Africa

    Directory of Open Access Journals (Sweden)

    Dudu G. Sokhela

    2013-07-01

    Full Text Available Background: Comprehensive Primary Health Care (PHC, based on the principles of accessibility, availability, affordability, equity and acceptability, was introduced in South Africa to address inequalities in health service provision. Whilst the Fast Queue was instrumental in the promotion of access to health care, a major goal of the PHC approach, facilities were not prepared for the sudden influx of clients. Increased access resulted in long waiting times and queues contributing to dissatisfaction with the service which could lead to missed appointments and non-compliance with established treatment plans.Objectives: Firstly to describe the experiences of clients using the Fast Queue strategy to access routine healthcare services and secondly, to determine how the clients’ experiences led to satisfaction or dissatisfaction with the Fast Queue service.Method: A descriptive qualitative survey using content analysis explored the experiences of the Fast Queue users in a PHC setting. Setting was first identified based on greatest number using the Fast Queue and geographic diversity and then a convenience sample of health care users of the Fast Queue were sampled individually along with one focus group of users who accessed the Queue monthly for medication refills. The same interview guide questions were used for both individual interviews and the one focus group discussion. Five clinics with the highest number of attendees during a three month period and a total of 83 health care users of the Fast Queue were interviewed. The average participant was female, 31 years old, single and unemployed.Results: Two themes with sub-themes emerged: health care user flow and communication, which highlights both satisfaction and dissatisfaction with the fast queue and queue marshals, could assist in directing users to the respective queues, reduce waiting time and keep users satisfied with the use of sign posts where there is a lack of human resources

  20. Involvement of the Public Health Authority in emergency planning and preparedness for nuclear facilities in Hungary

    International Nuclear Information System (INIS)

    Sztanyik, L.B.

    1986-01-01

    It is required by the Hungarian Atomic Energy Act and its enacting clause of 1980 that facilities established for the application of atomic energy be designed, constructed and operated in such a manner that abnormal operational occurrences can be avoided and unplanned exposures to radiation and radioactive substances can be prevented. The primary responsibility for planning and implementing emergency actions rests with the management of the operating organization. Thus one of the prerequisites of licensing the first nuclear power plant in Hungary was the preparation and submission for approval of an emergency plan by the operating organization. In addition to this, the council of the county where the power plant is located has also been obliged to prepare a complementary emergency plan, in co-operation with other regional and national authorities, for the prevention of consequences from an emergency that may extend beyond the site boundary of the plant. In preparing the complementary plan, the emergency plan of the facility had to be taken into account. Unlike most national authorities involved in nuclear matters, the Public Health Authority is involved in the preparation of plans for every kind of emergency in a nuclear facility, including even those whose consequences can probably be confined to the plant site. The paper discusses in detail the role and responsibility of the Public Health Authority in emergency planning and preparedness for nuclear facilities. (author)

  1. Wheelchair cleaning and disinfection in Canadian health care facilities: "That's wheelie gross!".

    Science.gov (United States)

    Gardner, Paula; Muller, Matthew P; Prior, Betty; So, Ken; Tooze, Jane; Eum, Linda; Kachur, Oksana

    2014-11-01

    Wheelchairs are complex equipment that come in close contact with individuals at increased risk of transmitting and acquiring antibiotic-resistant organisms and health care-associated infection. The purpose of this study was to determine the status of wheelchair cleaning and disinfection in Canadian health care facilities. Acute care hospitals (ACHs), chronic care hospitals (CCHs), and long-term care facilities (LTCFs) were contacted and the individual responsible for oversight of wheelchair cleaning and disinfection was identified. A structured interview was conducted that focused on current practices and concerns, barriers to effective wheelchair cleaning and disinfection, and potential solutions. Interviews were completed at 48 of the 54 facilities contacted (89%), including 18 ACHs, 16 CCHs, and 14 LTCFs. Most (n = 24) facilities had 50-200 in-house wheelchairs. Respondents were very concerned about wheelchair cleaning as an infection control issue. Specific concerns included the lack of reliable systems for tracking and identifying dirty and clean wheelchairs (71%, 34/48), failure to clean and disinfect wheelchairs between patients (52%, 25/48), difficulty cleaning cushions (42%, 20/48), lack of guidelines (35%, 27/48), continued use of visibly soiled wheelchairs (29%, 14/48) and lack of resources (25%, 12/48). Our results suggest that wheelchair cleaning and disinfection is not optimally performed at many Canadian hospitals and LTCFs. Specific guidance on wheelchair cleaning and disinfection is necessary. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  2. Field test of radioactive high efficiency filter and filter exchange techniques of fuel cycle examination facility

    International Nuclear Information System (INIS)

    Hwang, Yong Hwa; Lee, Hyung Kwon; Chun, Young Bum; Park, Dae Gyu; Ahn, Sang Bok; Chu, Yong Sun; Kim, Eun Ka.

    1997-12-01

    The development of high efficiency filter was started to protect human beings from the contamination of radioactive particles, toxic gases and bacillus, and its gradual performance increment led to the fabrication of Ultra Low Penetration Air Filter (ULPA) today. The application field of ULPA has been spread not only to the air conditioning of nuclear power facilities, semiconductor industries, life science, optics, medical care and general facilities but also to the core of ultra-precision facilities. Periodic performance test on the filters is essential to extend its life-time through effective maintenance. Especially, the bank test on HEPA filter of nuclear facilities handling radioactive materials is required for environmental safety. Nowadays, the bank test technology has been reached to the utilization of a minimized portable detecting instruments and the evaluation techniques can provide high confidence in the area of particle distribution and leakage test efficiency. (author). 16 refs., 13 tabs., 14 figs

  3. 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

  4. Facility type and primary care performance in sub-district health promotion hospitals in Northern Thailand.

    Directory of Open Access Journals (Sweden)

    Nithra Kitreerawutiwong

    Full Text Available Poor and middle-income Thai people rely heavily on primary care health services. These are staffed by a range of professionals. However, it is unknown whether the performance of primary care varies according to the staffing and organization of local service delivery units. Tambon (sub-district health promotion hospitals (THPHs were introduced in 2009 to upgrade the services offered by the previous health centres, but were faced with continuing shortages of doctors and nurses. The Ministry of Public Health (MoPH designated three categories of THPH, defined according to whether they were regularly staffed by a medical practitioner, a qualified nurse or non-clinical public health officers. This study aimed to compare the performance of primary care offered by the three different types of primary care facilities in one public health region of Northern Thailand (Public Health Region 2.A cross-sectional survey was undertaken in 2013. Data were collected on accessibility, continuity, comprehensiveness, co-ordination and community orientation of care from 825 patients attending 23 primary care facilities. These were selected to include the three officially-designated types of Tambon (sub-district health promotion hospitals (THPHs led by medical, nursing or public health personnel. Survey scores were compared in unadjusted and adjusted analyses.THPHs staffed only by public health officers achieved the highest performance score (Mean = 85.14, SD. = 7.30, followed by THPHs staffed by qualified nurses (Mean = 82.86, SD. = 7.06. THPHs staffed by a doctor on rotation returned the lowest scores (Mean = 81.63, SD. = 7.22.Differences in overall scores resulted mainly from differences in reported accessibility, continuity, and comprehensiveness of care, rather than staff skill-mix per se. Policy on quality improvement should therefore focus on improving performance in these areas.

  5. Intimate partner violence in pregnancy among antenatal attendees at health facilities in West Pokot county, Kenya.

    Science.gov (United States)

    Owaka, Isaac Ogweno; Nyanchoka, Margaret Keraka; Atieli, Harryson Etemesi

    2017-01-01

    The objective of this study was to investigate factors contributing to intimate partner violence in pregnancy among antenatal attendees at the health facilities in West Pokot Sub-County. The study was done in West Pokot Sub-County. Using cross sectional study design, a total of 238 antenatal attendees were systematically sampled for the study. Four focused group discussions and 20 key informant interviews were conducted for qualitative data collection. Qualitative data was consolidated into various themes while bivariate and logistic regression analysis was done to determine factors associated with experience of IPV in the index of pregnancy with P ≤ 0.05 being considered significant. The study found prevalence of overall, physical, psychological and sexual IPV in pregnancy to be 66.9%, 29.9%, 55.8% and 39.2% respectively. After adjusting for confounders, Overall IPV in pregnancy was significantly associated with Alcohol intake by partner (OR 2.116, 95% CI 1.950-2.260, P 0.000) and partner's level of education (OR 1.265, 95% CI 1.079-1.487, P 0.031), while psychological and sexual IPV was significantly associated with age of partner (OR 2.292, 95% CI 2.123-2.722, P 0.007) and age of pregnant women (OR 1.174, 95% CI 1.001-1.397 P 0.049) respectively. The care offered to antenatal attendees experiencing IPV was not in line with WHO guidelines and standard on handling gender based violence cases. The study finding indicates that IPV in pregnancy among antenatal attendees in West Pokot is very high. This unearths the gaps on gender based violence interventions in the maternal and child health programs.

  6. Knowledge and attitude toward vasectomy among antenatal clinic attendees in a tertiary health facility in Nigeria

    Directory of Open Access Journals (Sweden)

    Nyengidiki Kennedy Tamunomie

    2016-01-01

    Full Text Available Background: Nigeria is the most populous nation in Africa and has a high fertility rate and low contraceptive prevalence. Various strategies have been developed to reduce the fertility rates, all aimed toward increasing contraceptive prevalence. Male sterilization is a safe, cheap, and effective method of contraception, but female perception and awareness of vasectomy may greatly affect its utilization. Objective: To determine the knowledge and attitude of antenatal patients in a Nigerian tertiary health facility toward vasectomy. Subjects and Methods: A cross-sectional study was conducted among antenatal clinic attendees. The participants were selected via systematic random sampling technique and a structured pretested questionnaire was used to assess their knowledge and attitude toward vasectomy. Data analysis was done using SPSS version 17 statistical software for windows XP and results were expressed in percentages. Results: One hundred and fifty respondents participated in the study, 83 (55.3% were aware of vasectomy, 59 (71.08% accepted it as a method of male contraception, and only 23 (38.98% approved its use for their spouse. The main source of information on vasectomy was from health workers 53 (63.86%. Almost half of the women (47.8% who accepted vasectomy did so because they felt men should also participate in family planning. Most of the women who disapproved of vasectomy cited it as an unpopular method. Conclusion: The approval of use of vasectomy by female partners is poor. Majority of these patients would not recommend it to their spouse as they have wrong perception of the procedure. Re-education of medical workers and wider public education through mass media may improve the approval of vasectomy by women for their spouses.

  7. [EVALUATION OF THE EFFECTIVENESS OF ADDITIONAL PROFESSIONAL EDUCATION ON THE BASIS OF HEALTH CARE FACILITY].

    Science.gov (United States)

    Bohomaz, V M; Rymarenko, P V

    2014-01-01

    In this study we tested methods of facility learning of health care workers as part of a modern model of quality management of medical services. The statistical and qualitative analysis of the effectiveness of additional training in emergency medical care at the health facility using an adapted curriculum and special mannequins. Under the guidance of a certified instructor focus group of 53 doctors and junior medical specialists studied 22 hours. According to a survey of employees trained their level of selfassessment of knowledge and skills sigificantly increased. Also significantly increased the proportion of correct answers in a formalized testing both categories of workers. Using androgological learning model, mannequins simulators and training in small groups at work create the most favorable conditions for effective individual and group practical skills of emergency medicine.

  8. 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.

  9. The effectiveness of introducing Group Prenatal Care (GPC) in selected health facilities in a district of Bangladesh: study protocol.

    Science.gov (United States)

    Sultana, Marufa; Mahumud, Rashidul Alam; Ali, Nausad; Ahmed, Sayem; Islam, Ziaul; Khan, Jahangir A M; Sarker, Abdur Razzaque

    2017-01-31

    Despite high rates of antenatal care and relatively good access to health facilities, maternal and neonatal mortality remain high in Bangladesh. There is an immediate need for implementation of evidence-based, cost-effective interventions to improve maternal and neonatal health outcomes. The aim of the study is to assess the effect of the intervention namely Group Prenatal Care (GPC) on utilization of standard number of antenatal care, post natal care including skilled birth attendance and institutional deliveries instead of usual care. The study is quasi-experimental in design. We aim to recruit 576 pregnant women (288 interventions and 288 comparisons) less than 20 weeks of gestational age. The intervention will be delivered over around 6 months. The outcome measure is the difference in maternal service coverage including ANC and PNC coverage, skilled birth attendance and institutional deliveries between the intervention and comparison group. Findings from the research will contribute to improve maternal and newborn outcome in our existing health system. Findings of the research can be used for planning a new strategy and improving the health outcome for Bangladeshi women. Finally addressing the maternal health goal, this study is able to contribute to strengthening health system.

  10. High temperature engineering research facilities and experiments in China

    International Nuclear Information System (INIS)

    Xu, Yuanhui; Liu, Meisheng; Yao, Huizhong; Ju, Huaiming

    1998-01-01

    June 14, 1995, the construction of a pebble bed type high temperature gas-cooled reactor (HTGR) started in China. It is a test reactor with 10 MW thermal power output (termed HTR- 10). The test reactor is located on the site of Institute of Nuclear Energy Technology (INET) of Tsinghua University in the northwest suburb of Beijing, about 40 km away from the city. Design of the HTR-10 test reactor represents the features of HTR-Modular design: 'side-by-side' arrangement, spherical fuel elements with 'multi-pass' loading scheme, completely passive decay heat removal, reactor shutdown systems in the side reflector, etc. However, in the HTR-10 design some modifications from the HTR-Module were made to satisfy Chinese conditions. For example, the steam generator is composed of a number of modular helical tubes with small diameter, pulse pneumatic discharging apparatus are used in the fuel handling system and step motor driving control rods are designed. These modifications would cause some uncertainty in our design. It is necessary to do engineering experiments to prove these new or modified ideas. Therefore, a program of engineering experiments for HTR-10 key technologies is being conducted at INET. The main aims of these engineering experiments are to verify the designed characteristics and performance of the components and systems, to feedback on design and to obtain operational experiences. Those engineering experiments are depressurization test of the hot gas duct at room temperature and operating pressure, performance test of the hot gas duct at operating helium temperature and pressure, performance test of the pulse pneumatic fuel handling system, test of the control rods driving apparatus, two phase flow stability test for the once through steam generator and cross mixture test at the bottom of the reactor core

  11. Rotordynamic Analysis and Feasibility Study of a Disk Spin Test Facility for Rotor Health Monitoring

    Science.gov (United States)

    Sawicki, Jerzy T.

    2005-01-01

    Recently, National Aeronautics and Space Administration (NASA) initiated a program to achieve the significant improvement in aviation safety. One of the technical challenges is the design and development of accelerated experiments that mimic critical damage cases encountered in engine components. The Nondestructive Evaluation (NDE) Group at the NASA Glenn Research Center (GRC) is currently addressing the goal concerning propulsion health management and the development of propulsion system specific technologies intended to detect potential failures prior to catastrophe. For this goal the unique disk spin simulation system was assembled at NASA GRC, which allows testing of rotors with the spinning speeds up to 10K RPM, and at the elevated temperature environment reaching 540 C (1000 F). It is anticipated that the facility can be employed for detection of Low Cycle Fatigue disk cracking and further High Cycle Fatigue blade vibration. The controlled crack growth studies at room and elevated temperatures can be conducted on the turbine wheels, and various NDE techniques can be integrated and assessed as in-situ damage monitoring tools. Critical rotating parts in advanced gas turbine engines such as turbine disks frequently operate at high temperature and stress for long periods of time. The integrity of these parts must be proven by non-destructive evaluation (NDE) during various machining steps ranging from forging blank to finished shape, and also during the systematic overhaul inspections. Conventional NDE methods, however, have unacceptable limits. Some of these techniques are time-consuming and inconvenient for service aircraft testing. Almost all of these techniques require that the vicinity of the damage is known in advance. These experimental techniques can provide only local information and no indication of the structural strength at a component and/or system level. The shortcomings of currently available NDE methods lead to the requirement of new damage

  12. Job Satisfactions of Nurses and Physicians Working in the Same Health Care Facility in Turkey

    OpenAIRE

    Züleyha Alper; Đlker Ercan; Güven Özkaya; Neriman Akansel

    2011-01-01

    Background: Job satisfaction is defined as the degree to which employees like or enjoy their jobs and the degreeof satisfaction is based on the importance placed upon this reward and benefit.Objective: Aim of this study was to determine the job satisfaction levels of nurses and physicians working in thesame health care facility, analyze the factors that may affect job satisfaction levels. This study was conducted asa descriptive study and was carried out in one Medical Care Center Northwester...

  13. Efficient handling of high-level radioactive cell waste in a vitrification facility analytical laboratory

    International Nuclear Information System (INIS)

    Roberts, D.W.; Collins, K.J.

    1998-01-01

    The Savannah River Site''s (SRS) Defense Waste Processing Facility (DWPF) near Aiken, South Carolina, is the world''s largest and the United State''s first high level waste vitrification facility. For the past 1.5 years, DWPF has been vitrifying high level radioactive liquid waste left over from the Cold War. The vitrification process involves the stabilization of high level radioactive liquid waste into borosilicate glass. The glass is contained in stainless steel canisters. DWPF has filled more than 200 canisters 3.05 meters (10 feet) long and 0.61 meters (2 foot) diameter. Since operations began at DWPF in March of 1996, high level radioactive solid waste continues to be generated due to operating the facility''s analytical laboratory. The waste is referred to as cell waste and is routinely removed from the analytical laboratories. Through facility design, engineering controls, and administrative controls, DWPF has established efficient methods of handling the high level waste generated in its laboratory facility. These methods have resulted in the prevention of undue radiation exposure, wasted man-hours, expenses due to waste disposal, and the spread of contamination. This level of efficiency was not reached overnight, but it involved the collaboration of Radiological Control Operations and Laboratory personnel working together to devise methods that best benefited the facility. This paper discusses the methods that have been incorporated at DWPF for the handling of cell waste. The objective of this paper is to provide insight to good radiological and safety practices that were incorporated to handle high level radioactive waste in a laboratory setting

  14. Features of the design for highly hazardous facilities

    Directory of Open Access Journals (Sweden)

    Telichenko Valeriy Ivanovich

    2015-03-01

    Full Text Available In the part 1 of the article 48.1 of the town planning code of the Russian Federation we can find a list of objects that are especially dangerous. Article 2 paragraph 59 of the contract system establishes the responsibility of the customer to conduct electronic auction, provided that the purchase of goods, works, services is included in the list established by the Government of the Russian Federation, or in an additional list approved by the highest body of the Executive power of the subject of the Russian Federation. By order of the Government of the Russian Federation dated 31.10.2013 no. 2019-r there was approved a list of goods and services, in case of procurement of which the customer is obligated to conduct an auction in electronic form. The list included "Building works", related to the code 45 (excluding code 45.12 according to the all-Russian classifier of products by economic activity (OKPD OK 034-2007. The exception is the construction, reconstruction, overhaul of high-risk, technically complex objects of capital construction, provided that the cost of the purchase contract for the State needs is more than 150 million rubles; to provide municipal - 50 million rubles. Thus, the customer is obliged to conduct electronic auction in the case of procurement of construction works (code 45 OKPD OK 034-20071, besides the works relating to the code of 45.12 (drilling, if the initial (maximal cost of purchase for State needs does not exeed 150 million rubles, for municipal needs - 50 million rubles. Here is an example. In St. Petersburg, three competitions were announced by the customer on the site for the construction of four underground stations with total value of 940 million rubles. How to place an order-public audition with limited participation? The results of the audit conducted by the OFAS around St. Petersburg, led to the cancellation of the tender. In particular, due to an incorrect choice of customer ways to purchase. According to

  15. Measuring the quality of child health care at first-level facilities.

    Science.gov (United States)

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

    2005-08-01

    Sound policy and program decisions require timely information based on valid and relevant measures. Recent findings suggest that despite the availability of effective and affordable guidelines for the management of sick children in first-level health facilities in developing countries, the quality and coverage of these services remains low. We report on the development and evaluation of a set of summary indices reflecting the quality of care received by sick children in first-level facilities. The indices were first developed through a consultative process to achieve face validity by involving technical experts and policymakers. The definition of evaluation measures for many public health programs stops at this point. We added a second phase in which standard statistical techniques were used to evaluate the content and construct validity of the indices and their reliability, drawing on data sets from the multi-country evaluation of integrated management of childhood illness (MCE) in Brazil, Tanzania and Uganda. The statistical evaluation identified important conceptual errors in the indices arising from the theory-driven expert review. The experts had combined items into inappropriate indicators resulting in summary indices that were difficult to interpret and had limited validity for program decision making. We propose a revised set of summary indices for the measurement of child health care in developing countries that is supported by both expert and statistical reviews and that led to similar programmatic insights across the three countries. We advocate increased cross-disciplinary research within public health to improve measurement approaches. Child survival policymakers, program planners and implementers can use these tools to improve their monitoring and so increase the health impact of investments in health facility care.

  16. Promoting oral health care among people living in residential aged care facilities: Perceptions of care staff.

    Science.gov (United States)

    Villarosa, Amy R; Clark, Sally; Villarosa, Ariana C; Patterson Norrie, Tiffany; Macdonald, Susan; Anlezark, Jennifer; Srinivas, Ravi; George, Ajesh

    2018-04-23

    This study aimed to look at the practices and perspectives of residential aged care facility (RACF) care staff regarding the provision of oral health care in RACFs. Emphasis has been placed on the provision of adequate oral health care in RACFs through the Better Oral Health in Residential Aged Care programme. Endorsed by the Australian government, this programme provided oral health education and training for aged care staff. However, recent evidence suggests that nearly five years after the implementation of this programme, the provision of oral care in RACFs in NSW remains inadequate. This project utilised an exploratory qualitative design which involved a focus group with 12 RACF care staff. Participants were asked to discuss the current oral health practices in their facility, and their perceived barriers to providing oral health care. The key findings demonstrated current oral health practices and challenges among care staff. Most care staff had received oral health training and demonstrated positive attitudes towards providing dental care. However, some participants identified that ongoing and regular training was necessary to inform practice and raise awareness among residents. Organisational constraints and access to dental services also limited provision of dental care while a lack of standardised guidelines created confusion in defining their role as oral healthcare providers in the RACF. This study highlighted the need for research and strategies that focus on capacity building care staff in oral health care and improving access of aged care residents to dental services. © 2018 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  17. Baseline results of the first malaria indicator survey in Iran at the health facility level

    Directory of Open Access Journals (Sweden)

    Taghizadeh-Asl Rahim

    2011-10-01

    Full Text Available Abstract Background Malaria continues to be a global public health challenge, particularly in developing countries. Delivery of prompt and effective diagnosis and treatment of malaria cases, detection of malaria epidemics within one week of onset and control them in less than a month, regular disease monitoring and operational classification of malaria are among the major responsibilities of the national malaria programme. The study was conducted to determine these indicators at the different level of primary health care facilities in malaria-affected provinces of Iran Methods In this survey, data was collected from 223 health facilities including health centres, malaria posts, health houses and hospitals as well as the profile of all 5, 836 recorded malaria cases in these facilities during the year preceding the survey. Descriptive statistics (i.e. frequencies, percentages were used to summarize the results and Chi square test was used to analyse data. Results All but one percent of uncomplicated cases took appropriate and correctly-dosed of anti-malarial drugs in accordance to the national treatment guideline. A larger proportion of patients [85.8%; 95% CI: 84.8 - 86.8] were also given complete treatment including anti-relapse course, in line with national guidelines. About one third [35.0%; 95% CI: 33.6 - 36.4] of uncomplicated malaria cases were treated more than 48 hours after first symptoms onset. Correspondingly, half of severe malaria cases took recommended anti-malarial drugs for severe or complicated disease more than 48 hours of onset of first symptoms. The latter cases had given regular anti-malarial drugs promptly. The majority of malaria epidemics [97%; 95% CI: 90.6 - 100] in study areas were detected within one week of onset, but only half of epidemics were controlled within four weeks of detection. Just half of target districts had at least one health facility/emergency site with adequate supply and equipment stocks. Nevertheless

  18. 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.

  19. 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

  20. Experiences of Fast Queue health care users in primary health care facilities in eThekwini district, South Africa.

    Science.gov (United States)

    Sokhela, Dudu G; Makhanya, Nonhlanhla J; Sibiya, Nokuthula M; Nokes, Kathleen M

    2013-07-05

    Comprehensive Primary Health Care (PHC), based on the principles of accessibility, availability, affordability, equity and acceptability, was introduced in South Africa to address inequalities in health service provision. Whilst the Fast Queue was instrumental in the promotion of access to health care, a major goal of the PHC approach, facilities were not prepared for the sudden influx of clients. Increased access resulted in long waiting times and queues contributing to dissatisfaction with the service which could lead to missed appointments and non-compliance with established treatment plans. Firstly to describe the experiences of clients using the Fast Queue strategy to access routine healthcare services and secondly, to determine how the clients' experiences led to satisfaction or dissatisfaction with the Fast Queue service. A descriptive qualitative survey using content analysis explored the experiences of the Fast Queue users in a PHC setting. Setting was first identified based on greatest number using the Fast Queue and geographic diversity and then a convenience sample of health care users of the Fast Queue were sampled individually along with one focus group of users who accessed the Queue monthly for medication refills. The same interview guide questions were used for both individual interviews and the one focus group discussion. Five clinics with the highest number of attendees during a three month period and a total of 83 health care users of the Fast Queue were interviewed. The average participant was female, 31 years old, single and unemployed. Two themes with sub-themes emerged: health care user flow and communication, which highlights both satisfaction and dissatisfaction with the fast queue and queue marshals, could assist in directing users to the respective queues, reduce waiting time and keep users satisfied with the use of sign posts where there is a lack of human resources. Effective health communication strategies contribute to positive

  1. Experiences of Fast Queue health care users in primary health care facilities in eThekwini district, South Africa

    Directory of Open Access Journals (Sweden)

    Dudu G. Sokhela

    2013-07-01

    Full Text Available Background: Comprehensive Primary Health Care (PHC, based on the principles of accessibility, availability, affordability, equity and acceptability, was introduced in South Africa to address inequalities in health service provision. Whilst the Fast Queue was instrumental in the promotion of access to health care, a major goal of the PHC approach, facilities were not prepared for the sudden influx of clients. Increased access resulted in long waiting times and queues contributing to dissatisfaction with the service which could lead to missed appointments and non-compliance with established treatment plans. Objectives: Firstly to describe the experiences of clients using the Fast Queue strategy to access routine healthcare services and secondly, to determine how the clients’ experiences led to satisfaction or dissatisfaction with the Fast Queue service. Method: A descriptive qualitative survey using content analysis explored the experiences of the Fast Queue users in a PHC setting. Setting was first identified based on greatest number using the Fast Queue and geographic diversity and then a convenience sample of health care users of the Fast Queue were sampled individually along with one focus group of users who accessed the Queue monthly for medication refills. The same interview guide questions were used for both individual interviews and the one focus group discussion. Five clinics with the highest number of attendees during a three month period and a total of 83 health care users of the Fast Queue were interviewed. The average participant was female, 31 years old, single and unemployed. Results: Two themes with sub-themes emerged: health care user flow and communication, which highlights both satisfaction and dissatisfaction with the fast queue and queue marshals, could assist in directing users to the respective queues, reduce waiting time and keep users satisfied with the use of sign posts where there is a lack of human resources

  2. High contrast high intensity petawatt J-KAREN-P laser facility at QST

    Science.gov (United States)

    Nishiuchi, Mamiko; Kiriyama, Hiromitsu; Sakaki, Hironao; Dover, Nicholas P.; Kondo, Kotaro; Pirozhkov, Alexander S.; Sagisaka, Akito; Fukuda, Yuji; Nishitani, Keita; Miyahara, Takumi; Ogura, Koichi; Alkhimova, Mariya A.; Pikuz, Tatiana A.; Faenov, Anatoly Y.; Watanabe, Yukinobu; Koga, James; Bulanov, Sergei V.; Kando, Masaki; Kondo, Kiminori

    2017-05-01

    We report on the J-KAREN-P laser facility at QST, which can provide PW peak power at 0.1 Hz on target. The system can deliver short pulses with an energy of 30 J and pulse duration of 30 fs after compression with a contrast level of better than 1012. Such performance in high field science will give rise to the birth of new applications and breakthroughs, which include relativistic particle acceleration, bright x-ray source generation, and nuclear activation. The current achieved laser intensity on target is up to > 9x1021 Wcm-2 with an energy of 9 J on target. The interaction with a 3 to 5- μm stainless steel tape target provides us electrons with a typical temperature of more than 10 MeV and energetic proton beams with typical maximum energies of > 40 MeV with good reproducibility. The protons are accelerated in the Target Normal Sheath Acceleration regime, which is suitable for many applications including as an injector into a beamline for medical use, which is one of our objectives.

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

    Science.gov (United States)

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

    2017-12-01

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

  4. Electron beam irradiation facility for low to high dose irradiation applications

    International Nuclear Information System (INIS)

    Petwal, V.C.; Wanmode, Yashwant; Verma, Vijay Pal; Bhisikar, Abhay; Dwivedi, Jishnu; Shrivastava, P.; Gupta, P.D.

    2013-01-01

    Electron beam based irradiation facilities are becoming more and more popular over the conventional irradiator facilities due to many inherent advantages such as tunability of beam energy, availability of radiation both in electron mode and X-ray mode, wide range of the dose rate, control of radiation from a ON-OFF switch and other safety related merits. A prototype experimental facility based on electron accelerator has been set-up at RRCAT to meet the low-dose, medium dose and high-dose requirements for radiation processing of food, agricultural and medical products. The facility can be operated in the energy range from 7-10 MeV at variable power level from 0.05-3 kW to meet the dose rate requirement of 100 Gy to kGy. The facility is also equipped with a Bremsstrahlung converter optimized for X-ray irradiation at 7.5 MV. Availability of dose delivery in wide range with precision control and measurement has made the facility an excellent tool for researchers interested in electron/X-ray beam irradiation. A precision dosimetry lab based on alanine EPR and radiochromic film dosimetry system have been established to characterize the radiation field and precise dose measurements. Electron beam scattering technique has been developed to achieve low dose requirement for EB irradiation of various seeds such as groundnut, wheat, soybeans, moong beans, black gram etc. for mutation related studies. This paper describes various features of the facility together with the dosimetric measurements carried out for qualification of the facility and recent irradiation experiments carried out using this facility. (author)

  5. [Evaluation auditing of the quality of health care in accreditation of health facilities].

    Science.gov (United States)

    Paim, Chennyfer da Rosa Paino; Zucchi, Paola

    2011-01-01

    This article shows how many health insurance companies operating in the Greater São Paulo have been performing auditing of the quality of their health care services, professionals, and which criteria are being employed to do so. Because of the legislation decreeing that health insurance companies have legal co-responsibility for the health care services and National Health Agency control the health services National Health Agency, auditing evaluations have been implemented since then. The survey was based on electronic forms e-mailed to all health insurance companies operating in the Greater São Paulo. The sample consisted of 125 health insurance companies; 29 confirmed that had monitoring and evaluation processes; 26 performed auditing of their services regularly; from those, 20 used some type of form or protocol for technical visits; all evaluation physical and administrative structure and 22 included functional structure. Regarding the professionals audited 21 were nurses, 13 administrative assistants; 04 managers and 02 doctors. Regarding criteria for accreditation the following were highlighted: region analysis (96%), localization (88.88%) and cost (36%). We conclude that this type of auditing evaluation is rather innovative and is being gradually implemented by the health insurance companies, but is not a systematic process.

  6. 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.

  7. High Energy Ion Bombardment Simulation Facility at the University of Pittsburgh

    International Nuclear Information System (INIS)

    McGruer, J.N.; Choyke, W.J.; Doyle, N.J.; Spitznagel, J.A.

    1975-01-01

    The High Energy Ion Bombardment Simulation (HEIBS) Facility located at the University of Pittsburgh is now operational. The E-22 tandem accelerator of the Nuclear Physics Laboratory, fitted with a UNIS source, provides the heavy high energy ions. An auxiliary Van de Graaff accelerator is used for the simultaneous production of He ions. Special features of the simulation laboratory are reported

  8. High Solids Consolidated Incinerator Facility (CIF) Wastes Stabilization with Ceramicrete and Super Cement

    International Nuclear Information System (INIS)

    Walker, B.W.

    1999-01-01

    High Solids ash and scrubber solution waste streams were generated at the incinerator facility at SRS by burning radioactive diatomaceous filter rolls which contained small amounts of uranium, and listed solvents (F and U). This report details solidification activities using selected Mixed Waste Focus Area (MWFA) technologies with the High Solids waste streams

  9. Facile Synthesis of Gold Nanorice Enclosed by High- Index Facets and Its Application for CO Oxidation

    International Nuclear Information System (INIS)

    Zheng, Y.; Tao, J.; Liu, H.; Zeng, J.; Yu, T.; Ma, Y.; Moran, C.; Wu, L.; Zhu, Y.; Liu, J.; Xia, Y.

    2011-01-01

    A facile method for generating Au nanorice enclosed by high-index facets in high purity. The nanorice shows much higher catalytic activity for CO oxidation than multiply twinned particles of Au enclosed by {111} facets at temperatures below 300 C.

  10. Overview of new, upgraded, or proposed high energy physics facilities in the United States and Canada

    International Nuclear Information System (INIS)

    Gabriel, T.A.

    1994-01-01

    This article reviews six new, proposed, or upgraded accelerator facilities in the United States and Canada. All of the accelerators that are presented here in one form or fashion challenge the validity of the Standard Model of high energy physics which ''currently explains'' all experimentally know phenomena. These facilities include the Continuous Electron Beam Accelerator Facility (CEBAF) at Newport News, Virginia, the Kaon Factory at TRIUMF in Vancouver, British Columbia, Canada, the Asymmetric B Factory at the Stanford Linear Accelerator Center (SLAC) in Palo Alto, California, the Relativistic Heavy Ion Collider (RHIC) facility at Brookhaven National Laboratory in Upton, New York, the injector upgrade project at the Fermi National Accelerator Laboratory (FNAL) in Batavia, Illinois, and the Superconducting Super Collider Laboratory (SSCL) in Waxachachie, Texas

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

    Science.gov (United States)

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

    2013-01-01

    Background While bacterial sexually transmitted infections (STIs) are important cofactors for HIV transmission, STI control has received little attention in recent years. The aim of this study was to assess STI treatment and HIV testing referral practices among health providers in Kenya. Methods In 2011 we assessed quality of case management for male urethritis at pharmacies, private clinics and government health facilities in coastal Kenya using simulated visits at pharmacies and interviews at pharmacies and health facilities. Quality was assessed using Ministry of Health guidelines. Results Twenty (77%) of 26 pharmacies, 20 (91%) of 22 private clinics and all four government facilities in the study area took part. The median (IQR) number of adult urethritis cases per week was 5 (2–10) at pharmacies, 3 (1–3) at private clinics and 5 (2–17) at government facilities. During simulated visits, 10% of pharmacies prescribed recommended antibiotics at recommended dosages and durations and, during interviews, 28% of pharmacies and 27% of health facilities prescribed recommended antibiotics at recommended dosages and durations. Most regimens were quinolone-based. HIV testing was recommended during 10% of simulated visits, 20% of pharmacy interviews and 25% of health facility interviews. Conclusions In an area of high STI burden, most men with urethritis seek care at pharmacies and private clinics. Most providers do not comply with national guidelines and very few recommend HIV testing. In order to reduce the STI burden and mitigate HIV transmission, there is an urgent need for innovative dissemination of up-to-date guidelines and inclusion of all health providers in HIV/STI programmes. PMID:23698510

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

    Science.gov (United States)

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

    2013-11-01

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

  13. Review of emergency obstetric care interventions in health facilities in the Upper East Region of Ghana: a questionnaire survey.

    Science.gov (United States)

    Kyei-Onanjiri, Minerva; Carolan-Olah, Mary; Awoonor-Williams, John Koku; McCann, Terence V

    2018-03-15

    Maternal morbidity and mortality is most prevalent in resource-poor settings such as sub-Saharan Africa and southern Asia. In sub-Saharan Africa, Ghana is one of the countries still facing particular challenges in reducing its maternal morbidity and mortality. Access to emergency obstetric care (EmOC) interventions has been identified as a means of improving maternal health outcomes. Assessing the range of interventions provided in health facilities is, therefore, important in determining capacity to treat obstetric emergencies. The aim of this study was to examine the availability of emergency obstetric care interventions in the Upper East Region of Ghana. A cross-sectional survey of 120 health facilities was undertaken. Status of emergency obstetric care was assessed through an interviewer administered questionnaire to directors/in-charge officers of maternity care units in selected facilities. Data were analysed using descriptive statistics. Eighty per cent of health facilities did not meet the criteria for provision of emergency obstetric care. Comparatively, private health facilities generally provided EmOC interventions less frequently than public health facilities. Other challenges identified include inadequate skill mix of maternity health personnel, poor referral processes, a lack of reliable communication systems and poor emergency transport systems. Multiple factors combine to limit women's access to a range of essential maternal health services. The availability of EmOC interventions was found to be low across the region; however, EmOC facilities could be increased by nearly one-third through modest investments in some existing facilities. Also, the key challenges identified in this study can be improved by enhancing pre-existing health system structures such as Community-based Health Planning and Services (CHPS), training more midwifery personnel, strengthening in-service training and implementation of referral audits as part of health service

  14. Radiation protection of the operation of accelerator facilities. On high energy proton and electron accelerators

    International Nuclear Information System (INIS)

    Kondo, Kenjiro

    1997-01-01

    Problems in the radiation protection raised by accelerated particles with energy higher than several hundreds MeV in strong accelerator facilities were discussed in comparison with those with lower energy in middle- and small-scale facilities. The characteristics in the protection in such strong accelerator facilities are derived from the qualitative changes in the interaction between the high energy particles and materials and from quantitative one due to the beam strength. In the former which is dependent on the emitting mechanism of the radiation, neutron with broad energy spectrum and muon are important in the protection, and in the latter, levels of radiation and radioactivity which are proportional to the beam strength are important. The author described details of the interaction between high energy particles and materials: leading to the conclusion that in the electron accelerator facilities, shielding against high energy-blemsstrahlung radiation and -neutron is important and in the proton acceleration, shielding against neutron is important. The characteristics of the radiation field in the strong accelerator facilities: among neutron, ionized particles and electromagnetic wave, neutron is most important in shielding since it has small cross sections relative to other two. Considerations for neutron are necessary in the management of exposure. Multiplicity of radionuclides produced: which is a result of nuclear spallation reaction due to high energy particles, especially to proton. Radioactivation of the accelerator equipment is a serious problem. Other problems: the interlock systems, radiation protection for experimenters and maintenance of the equipment by remote systems. (K.H.). 11 refs

  15. Health workers' perceptions of private-not-for-profit health facilities' organizational culture and its influence on retention in Uganda.

    Science.gov (United States)

    Shumba, Constance Sibongile; Kielmann, Karina; Witter, Sophie

    2017-12-06

    An in-depth understanding of how organizational culture is experienced by health workers (HWs), and influences their decisions to leave their jobs is a fundamental, yet under-examined, basis for forming effective retention strategies. This research examined HWs' working experiences and perceptions of organisational culture within private-not-for-profit, largely mission-based hospitals, and how this influenced retention. Thirty-two HWs, including managers, in 19 health facilities in Uganda were interviewed using a semi-structured topic guide. Interview transcripts were analysed using thematic content analysis. Interviews showed that the organizational culture was predominantly hierarchical, with non-participative management styles which emphasized control and efficiency. HWs and managers held different perceptions of the organizational culture. While the managers valued results and performance, HWs valued team work, recognition and participative management. The findings of this study indicate that organizational culture influences retention of HWs in health facilities and provide a useful context to inform health care managers in the PNFP sub-sector in Uganda and similar contexts. To improve retention of HWs, a gradual shift in organizational culture will be necessary, focussing on the values, beliefs and perceptions which have the greatest influence on observable behaviour.

  16. Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana

    NARCIS (Netherlands)

    Alhassan, R.K.; Duku, S.O.; Janssens, W.; Nketiah-Amponsah, E.; Spieker, N.; Van Ostenberg, P.; Arhinful, D.K.; Pradhan, M.P.; Rinke de Wit, T.F.

    2015-01-01

    Background: Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients' decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will

  17. Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana

    NARCIS (Netherlands)

    Alhassan, Robert Kaba; Duku, Stephen Opoku; Janssens, Wendy; Nketiah-Amponsah, Edward; Spieker, Nicole; van Ostenberg, Paul; Arhinful, Daniel Kojo; Pradhan, Menno; Rinke de Wit, Tobias F.

    2015-01-01

    Background Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients' decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will

  18. Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana

    NARCIS (Netherlands)

    Alhassan, R.K.; Duku, S.O.; Janssens, W.; Nketiah-Amponsah, E.; Spieker, N.; van Ostenberg, P.; Arhinful, D.K.; Pradhan, M.; Rinke de Wit, T.F.

    2015-01-01

    Background Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients’ decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will

  19. Beam Test for Evaluating Applicabillity of High - Strength Reinforcement in Structure of Nuclear Facility

    International Nuclear Information System (INIS)

    Yim, Sangjun; Lee, Byungsoo; Bang, Changjoon

    2014-01-01

    The high-strength rebar which has high yield strength can reduce the amount of rebar in concrete and widen its spacing so that it has better workability and higher economic benefits for the structure. However, the maximum yield strength of rebar is limited to 420MPa in the design criteria for structure of nuclear facility in Korea and USA. Korea Hydro and Nuclear Power is progressing research to revise the limitation in the yield strength of rebar, which is suggested in the criteria of KEPIC and ACI, in order to apply 550 MPa high-strength rebar for the construction of a nuclear facility. This study is to review the applicability of high strength rebar in structure of a nuclear facility through a model beam test. After reviewing the shear capacity and reinforcement yield to assess the applicability of high-strength reinforcement in the structure of a nuclear facility, we make the following conclusions. When using high shear reinforcement with wider spacing, it has a similar shear capacity to normal reinforcement with narrower spacing. This means better workability and economic benefits can be achieved by widening the rebar spacing without brittle fracture in the elements. For future plans, the results of this test and supplementary test will be submitted to ACI349 committee as backup data to revise the standard for yield strength of high-strength rebar

  20. Beam Test for Evaluating Applicabillity of High - Strength Reinforcement in Structure of Nuclear Facility

    Energy Technology Data Exchange (ETDEWEB)

    Yim, Sangjun; Lee, Byungsoo; Bang, Changjoon [Korea Hydro and Nuclear Power Co., Ltd., Daejeon (Korea, Republic of)

    2014-05-15

    The high-strength rebar which has high yield strength can reduce the amount of rebar in concrete and widen its spacing so that it has better workability and higher economic benefits for the structure. However, the maximum yield strength of rebar is limited to 420MPa in the design criteria for structure of nuclear facility in Korea and USA. Korea Hydro and Nuclear Power is progressing research to revise the limitation in the yield strength of rebar, which is suggested in the criteria of KEPIC and ACI, in order to apply 550 MPa high-strength rebar for the construction of a nuclear facility. This study is to review the applicability of high strength rebar in structure of a nuclear facility through a model beam test. After reviewing the shear capacity and reinforcement yield to assess the applicability of high-strength reinforcement in the structure of a nuclear facility, we make the following conclusions. When using high shear reinforcement with wider spacing, it has a similar shear capacity to normal reinforcement with narrower spacing. This means better workability and economic benefits can be achieved by widening the rebar spacing without brittle fracture in the elements. For future plans, the results of this test and supplementary test will be submitted to ACI349 committee as backup data to revise the standard for yield strength of high-strength rebar.

  1. DOE standard: Integration of environment, safety, and health into facility disposition activities. Volume 2: Appendices

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-05-01

    This volume contains the appendices that provide additional environment, safety, and health (ES and H) information to complement Volume 1 of this Standard. Appendix A provides a set of candidate DOE ES and H directives and external regulations, organized by hazard types that may be used to identify potentially applicable directives to a specific facility disposition activity. Appendix B offers examples and lessons learned that illustrate implementation of ES and H approaches discussed in Section 3 of Volume 1. Appendix C contains ISMS performance expectations to guide a project team in developing and implementing an effective ISMS and in developing specific performance criteria for use in facility disposition. Appendix D provides guidance for identifying potential Applicable or Relevant and Appropriate Requirements (ARARs) when decommissioning facilities fall under the Comprehensive Environmental Response, Compensation, Liability Act (CERCLA) process. Appendix E discusses ES and H considerations for dispositioning facilities by privatization. Appendix F is an overview of the WSS process. Appendix G provides a copy of two DOE Office of Nuclear Safety Policy and Standards memoranda that form the bases for some of the guidance discussed within the Standard. Appendix H gives information on available hazard analysis techniques and references. Appendix I provides a supplemental discussion to Sections 3.3.4, Hazard Baseline Documentation, and 3.3.6, Environmental Permits. Appendix J presents a sample readiness evaluation checklist.

  2. DOE standard: Integration of environment, safety, and health into facility disposition activities. Volume 2: Appendices

    International Nuclear Information System (INIS)

    1998-05-01

    This volume contains the appendices that provide additional environment, safety, and health (ES and H) information to complement Volume 1 of this Standard. Appendix A provides a set of candidate DOE ES and H directives and external regulations, organized by hazard types that may be used to identify potentially applicable directives to a specific facility disposition activity. Appendix B offers examples and lessons learned that illustrate implementation of ES and H approaches discussed in Section 3 of Volume 1. Appendix C contains ISMS performance expectations to guide a project team in developing and implementing an effective ISMS and in developing specific performance criteria for use in facility disposition. Appendix D provides guidance for identifying potential Applicable or Relevant and Appropriate Requirements (ARARs) when decommissioning facilities fall under the Comprehensive Environmental Response, Compensation, Liability Act (CERCLA) process. Appendix E discusses ES and H considerations for dispositioning facilities by privatization. Appendix F is an overview of the WSS process. Appendix G provides a copy of two DOE Office of Nuclear Safety Policy and Standards memoranda that form the bases for some of the guidance discussed within the Standard. Appendix H gives information on available hazard analysis techniques and references. Appendix I provides a supplemental discussion to Sections 3.3.4, Hazard Baseline Documentation, and 3.3.6, Environmental Permits. Appendix J presents a sample readiness evaluation checklist

  3. Effectiveness of professional oral health care intervention on the oral health of residents with dementia in residential aged care facilities: a systematic review protocol.

    Science.gov (United States)

    Yi Mohammadi, Joanna Jin; Franks, Kay; Hines, Sonia

    2015-10-01

    The objective of this review is to critically appraise and synthesize evidence on the effectiveness of professional oral health care intervention on the oral health of aged care residents with dementia.More specifically the objectives are to identify the efficacy of professional oral health care interventions on general oral health, the presence of plaque and the number of decayed or missing teeth. Dementia poses a significant challenge for health and social policy in Australia. The quality of life of individuals, their families and friends is impacted by dementia. Older people with dementia often have other health comorbidities resulting in the need for a higher level of care. From 2009 to 2010, 53% of permanent residents in Residential Aged Care Facilities (RACFs) had dementia on admission. Older Australians are retaining more of their natural teeth, therefore residents entering RACFs will have more of their natural teeth and require complex dental work than they did in previous generations. Data from the Australian Institute of Health and Welfare showed that more than half the residents in RACFs are now partially dentate with an average of 12 teeth each. Furthermore, coronal and root caries are significant problems, especially in older Australians who are cognitively impaired.Residents in aged care facilities frequently have poor oral health and hygiene with moderate to high levels of oral disease and overall dental neglect. This is reinforced by aged care staff who acknowledge that the demands of feeding, toileting and behavioral issues amongst residents often take precedence over oral health care regimens. Current literature shows that there is a general reluctance on the part of aged care staff to prioritize oral care due to limited knowledge as well as existing psychological barriers to working on another person's mouth. Although staff routinely deal with residents' urinary and faecal incontinence, deep psychological barriers exist when working on someone

  4. Public health facility resource availability and provider adherence to first antenatal guidelines in a low resource setting in Accra, Ghana.

    Science.gov (United States)

    Amoakoh-Coleman, Mary; Agyepong, Irene Akua; Kayode, Gbenga A; Grobbee, Diederick E; Klipstein-Grobusch, Kerstin; Ansah, Evelyn K

    2016-09-21

    Lack of resources has been identified as a reason for non-adherence to clinical guidelines. Our aim was to describe public health facility resource availability in relation to provider adherence to first antenatal visit guidelines. A cross-sectional analysis of the baseline data of a prospective cohort study on adherence to first antenatal care visit guidelines was carried out in 11 facilities in the Greater Accra Region of Ghana. Provider adherence was studied in relation to health facility resource availability such as antenatal workload for clinical staffs, routine antenatal drugs, laboratory testing, protocols, ambulance and equipment. Eleven facilities comprising 6 hospitals (54.5 %), 4 polyclinics (36.4 %) and 1 health center were randomly sampled. Complete provider adherence to first antenatal guidelines for all the 946 participants was 48.1 % (95 % CI: 41.8-54.2 %), varying significantly amongst the types of facilities, with highest rate in the polyclinics. Average antenatal workload per month per clinical staff member was higher in polyclinics compared to the hospitals. All facility laboratories were able to conduct routine antenatal tests. Most routine antenatal drugs were available in all facilities except magnesium sulphate and sulphadoxine-pyrimethamine which were lacking in some. Antenatal service protocols and equipment were also available in all facilities. Although antenatal workload varies across different facility types in the Greater Accra region, other health facility resources that support implementation of first antenatal care guidelines are equally available in all the facilities. These factors therefore do not adequately account for the low and varying proportions of complete adherence to guidelines across facility types. Providers should be continually engaged for a better understanding of the barriers to their adherence to these guidelines.

  5. 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

  6. 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

  7. Multilevel examination of facility characteristics, social integration, and health for older adults living in nursing homes.

    Science.gov (United States)

    Leedahl, Skye N; Chapin, Rosemary K; Little, Todd D

    2015-01-01

    Testing a model based on past research and theory, this study assessed relationships between facility characteristics (i.e., culture change efforts, social workers) and residents' social networks and social support across nursing homes; and examined relationships between multiple aspects of social integration (i.e., social networks, social capital, social engagement, social support) and mental and functional health for older adults in nursing homes. Data were collected at nursing homes using a planned missing data design with random sampling techniques. Data collection occurred at the individual-level through in-person structured interviews with older adult nursing home residents (N = 140) and at the facility-level (N = 30) with nursing home staff. The best fitting multilevel structural equation model indicated that the culture change subscale for relationships significantly predicted differences in residents' social networks. Additionally, social networks had a positive indirect relationship with mental and functional health among residents primarily via social engagement. Social capital had a positive direct relationship with both health outcomes. To predict better social integration and mental and functional health outcomes for nursing homes residents, study findings support prioritizing that close relationships exist among staff, residents, and the community as well as increased resident social engagement and social trust. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Newborn Care in the Home and Health Facility: Formative Findings for Intervention Research in Cambodia

    Directory of Open Access Journals (Sweden)

    Alessandra N. Bazzano

    2016-12-01

    Full Text Available Global coverage and scale up of interventions to reduce newborn mortality remains low, though progress has been achieved in improving newborn survival in many low-income settings. An important factor in the success of newborn health interventions, and moving to scale, is appropriate design of community-based programs and strategies for local implementation. We report the results of formative research undertaken to inform the design of a newborn health intervention in Cambodia. Information was gathered on newborn care practices over a period of three months using multiple qualitative methods of data collection in the primary health facility and home setting. Analysis of the data indicated important gaps, both at home and facility level, between recommended newborn care practices and those typical in the study area. The results of this formative research have informed strategies for behavior change and improving referral of sick infants in the subsequent implementation study. Collection and dissemination of data on newborn care practices from settings such as these can contribute to efforts to advance survival, growth and development of newborns for intervention research, and for future newborn health programming.

  9. Nursing Administrators' Views on Oral Health in Long-Term Care Facilities: An exploratory study.

    Science.gov (United States)

    Urata, Janelle Y; Couch, Elizabeth T; Walsh, Margaret M; Rowe, Dorothy J

    2018-04-01

    Purpose: To explore the knowledge, attitudes, and practices of supervising nurse administrators (SNAs) regarding the oral care provided to long-term care facility (LTCF) residents and the role of dental professionals in those facilities. Methods: The investigators of this study partnered with the National Association of Nursing Administrators to send this cross-sectional study consisting of a 35-item electronic survey to its members whose email addresses were in their database. Online software tabulated responses and calculated frequencies (percentages) of responses for each survey item. Results: Of the 2,359 potential participants, 171 (n=171) completed the survey for a 7% response rate. Only 25% of the respondents were familiar with the expertise of dental hygienists (DHs), however once informed, the majority were interested in having DHs perform oral health staff trainings, oral screenings, and dental referrals and initiate fluoride varnish programs. Most respondents correctly answered the oral health-related knowledge items, understood that oral health is important to general health, but reported that the LTCF residents' oral health was only "good" or "fair." Fewer than half, (48%) of the SNAs were "very satisfied" with the quality of oral care provided to the residents. While more than half reported that they had no dentist on staff or on-site dental equipment, 77% reported that they would consider on-site mobile oral care services. Oral health training for staff was provided primarily by registered nurses, however only 32% reported including identification of dental caries as part of the in-service training. Conclusion: This exploratory study lays the foundation for more extensive research investigating various strategies to improve the oral health of LTCF residents, including increased collaboration between DHs and SNAs. Copyright © 2018 The American Dental Hygienists’ Association.

  10. Evidence-based practices to increase hand hygiene compliance in health care facilities: An integrated review.

    Science.gov (United States)

    Neo, Jun Rong Jeffrey; Sagha-Zadeh, Rana; Vielemeyer, Ole; Franklin, Ella

    2016-06-01

    Hand hygiene (HH) in health care facilities is a key component to reduce pathogen transmission and nosocomial infections. However, most HH interventions (HHI) have not been sustainable. This review aims to provide a comprehensive summary of recently published evidence-based HHI designed to improve HH compliance (HHC) that will enable health care providers to make informed choices when allocating limited resources to improve HHC and patient safety. The Medline electronic database (using PubMed) was used to identify relevant studies. English language articles that included hand hygiene interventions and related terms combined with health care environments or related terms were included. Seventy-three studies that met the inclusion criteria were summarized. Interventions were categorized as improving awareness with education, facility design, and planning, unit-level protocols and procedures, hospital-wide programs, and multimodal interventions. Past successful HHIs may not be as effective when applied to other health care environments. HH education should be interactive and engaging. Electronic monitoring and reminders should be implemented in phases to ensure cost-effectiveness. To create hospitalwide programs that engage end users, policy makers should draw expertise from interdisciplinary fields. Before implementing the various components of multimodal interventions, health care practitioners should identify and examine HH difficulties unique to their organizations. Future research should seek to achieve the following: replicate successful HHI in other health care environments, develop reliable HHC monitoring tools, understand caregiver-patient-family interactions, examine ways (eg, hospital leadership, financial support, and strategies from public health and infection prevention initiatives) to sustain HHC, and use simulated lab environments to refine study designs. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc

  11. Technology developments for ACIGA high power test facility for advanced interferometry

    Energy Technology Data Exchange (ETDEWEB)

    Barriga, P [School of Physics, University of Western Australia, Perth, WA 6009 (Australia); Barton, M [California Institute of Technology, LIGO Project, Pasadena, CA 91125 (United States); Blair, D G [School of Physics, University of Western Australia, Perth, WA 6009 (Australia)] [and others

    2005-05-21

    The High Optical Power Test Facility for Advanced Interferometry has been built by the Australian Consortium for Interferometric Gravitational Astronomy north of Perth in Western Australia. An 80 m suspended cavity has been prepared in collaboration with LIGO, where a set of experiments to test suspension control and thermal compensation will soon take place. Future experiments will investigate radiation pressure instabilities and optical spring effects in a high power optical cavity with {approx}200 kW circulating power. The facility combines research and development undertaken by all consortium members, whose latest results are presented.

  12. Technology developments for ACIGA high power test facility for advanced interferometry

    International Nuclear Information System (INIS)

    Barriga, P; Barton, M; Blair, D G

    2005-01-01

    The High Optical Power Test Facility for Advanced Interferometry has been built by the Australian Consortium for Interferometric Gravitational Astronomy north of Perth in Western Australia. An 80 m suspended cavity has been prepared in collaboration with LIGO, where a set of experiments to test suspension control and thermal compensation will soon take place. Future experiments will investigate radiation pressure instabilities and optical spring effects in a high power optical cavity with ∼200 kW circulating power. The facility combines research and development undertaken by all consortium members, whose latest results are presented

  13. Design of a high-flux test assembly for the Fusion Materials Irradiation Test Facility

    International Nuclear Information System (INIS)

    Opperman, E.K.; Vogel, M.A.

    1982-01-01

    The Fusion Material Test Facility (FMIT) will provide a high flux fusion-like neutron environment in which a variety of structural and non-structural materials irradiations can be conducted. The FMIT experiments, called test assemblies, that are subjected to the highest neutron flux magnitudes and associated heating rates will require forced convection liquid metal cooling systems to remove the neutron deposited power and maintain test specimens at uniform temperatures. A brief description of the FMIT facility and experimental areas is given with emphasis on the design, capabilities and handling of the high flux test assembly

  14. Summary of informal meeting on ''facilities for atomic physics research with highly ionized atoms''

    International Nuclear Information System (INIS)

    Cocke, C.L.; Jones, K.W.

    1984-01-01

    An informal meeting to discuss ''Facilities for Atomic Physics Research with Highly Ionized Atoms'' was held during the APS DEAP meeting at the University of Connecticut on May 30, 1984. The meeting was motivated by the realization that the status of facilities for studies of highly ionized atoms is unsettled and that it might be desirable to take action to ensure adequate resources for research over the whole range of charge states and energies of interest. It was assumed that the science to be done with these beams has been amply documented in the literature

  15. The Oral Health Care Manager in a Patient-Centered Health Facility.

    Science.gov (United States)

    Theile, Cheryl Westphal; Strauss, Shiela M; Northridge, Mary Evelyn; Birenz, Shirley

    2016-06-01

    The dental hygienist team member has an opportunity to coordinate care within an interprofessional practice as an oral health care manager. Although dental hygienists are currently practicing within interprofessional teams in settings such as pediatric offices, hospitals, nursing homes, schools, and federally qualified health centers, they often still assume traditional responsibilities rather than practicing to the full extent of their training and licenses. This article explains the opportunity for the dental hygiene professional to embrace patient-centered care as an oral health care manager who can facilitate integration of oral and primary care in a variety of health care settings. Based on an innovative model of collaboration between a college of dentistry and a college of nursing, an idea emerged among several faculty members for a new management method for realizing continuity and coordination of comprehensive patient care. Involved faculty members began working on the development of an approach to interprofessional practice with the dental hygienist serving as an oral health care manager who would address both oral health care and a patient's related primary care issues through appropriate referrals and follow-up. This approach is explained in this article, along with the results of several pilot studies that begin to evaluate the feasibility of a dental hygienist as an oral health care manager. A health care provider with management skills and leadership qualities is required to coordinate the interprofessional provision of comprehensive health care. The dental hygienist has the opportunity to lead closer integration of oral and primary care as an oral health care manager, by coordinating the team of providers needed to implement comprehensive, patient-centered care. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Final report of the HFIR [High Flux Isotope Reactor] irradiation facilities improvement project

    International Nuclear Information System (INIS)

    Montgomery, B.H.; Thoms, K.R.; West, C.D.

    1987-09-01

    The High-Flux Isotope Reactor (HFIR) has outstanding neutronics characteristics for materials irradiation, but some relatively minor aspects of its mechanical design severely limited its usefulness for that purpose. In particular, though the flux trap region in the center of the annular fuel elements has a very high neutron flux, it had no provision for instrumentation access to irradiation capsules. The irradiation positions in the beryllium reflector outside the fuel elements also have a high flux; however, although instrumented, they were too small and too few to replace the facilities of a materials testing reactor. To address these drawbacks, the HFIR Irradiation Facilities Improvement Project consisted of modifications to the reactor vessel cover, internal structures, and reflector. Two instrumented facilities were provided in the flux trap region, and the number of materials irradiation positions in the removable beryllium (RB) was increased from four to eight, each with almost twice the available experimental space of the previous ones. The instrumented target facilities were completed in August 1986, and the RB facilities were completed in June 1987

  17. Exploring the Demands on Nurses Working in Health Care Facilities During a Large-Scale Natural Disaster

    Directory of Open Access Journals (Sweden)

    Gillian C. Scrymgeour

    2016-06-01

    Full Text Available Nurses are pivotal to an effective societal response to a range of critical events, including disasters. This presents nurses with many significant and complex challenges that require them to function effectively under highly challenging and stressful circumstances and often for prolonged periods of time. The exponential growth in the number of disasters means that knowledge of disaster preparedness and how this knowledge can be implemented to facilitate the development of resilient and adaptive nurses and health care organizations represents an important adjunct to nurse education, policy development, and research considerations. Although this topic has and continues to attract attention in the literature, a lack of systematic understanding of the contingencies makes it difficult to clearly differentiate what is known and what gaps remain in this literature. Providing a sound footing for future research can be facilitated by first systematically reviewing the relevant literature. Focused themes were identified and analyzed using an ecological and interactive systems framework. Ten of the 12 retained studies included evacuation, revealing that evacuation is more likely to occur in an aged care facility than a hospital. The unpredictability of an event also highlighted organizational, functional, and competency issues in regard to the complexity of decision making and overall preparedness. The integrative review also identified that the unique roles, competencies, and demands on nurses working in hospitals and residential health care facilities during a natural disaster appear invisible within the highly visible event.

  18. Simplified static method for determining seismic loads on equipment in moderate and high hazard facilities

    International Nuclear Information System (INIS)

    Scott, M.A.; Holmes, P.A.

    1991-01-01

    A simplified static analysis methodology is presented for qualifying equipment in moderate and high-hazard facility-use category structures, where the facility use is defined in Design and Evaluation Guidelines for Department of Energy Facilities Subjected to Natural Phenomena Hazards, UCRL-15910. Currently there are no equivalent simplified static methods for determining seismic loads on equipment in these facility use categories without completing dynamic analysis of the facility to obtain local floor accelerations or spectra. The requirements of UCRL-15910 specify the use of open-quotes dynamicclose quotes analysis methods, consistent with Seismic Design Guidelines for Essential Buildings, Chapter 6, open-quotes Nonstructural Elements,close quotes TM5-809-10-1, be used for determining seismic loads on mechanical equipment and components. Chapter 6 assumes that the dynamic analysis of the facility has generated either floor response spectra or model floor accelerations. These in turn are utilized with the dynamic modification factor and the actual demand and capacity ratios to determine equipment loading. This complex methodology may be necessary to determine more exacting loads for hard to qualify equipment but does not provide a simple conservative loading methodology for equipment with ample structural capacity

  19. Screensaver: an open source lab information management system (LIMS for high throughput screening facilities

    Directory of Open Access Journals (Sweden)

    Nale Jennifer

    2010-05-01

    Full Text Available Abstract Background Shared-usage high throughput screening (HTS facilities are becoming more common in academe as large-scale small molecule and genome-scale RNAi screening strategies are adopted for basic research purposes. These shared facilities require a unique informatics infrastructure that must not only provide access to and analysis of screening data, but must also manage the administrative and technical challenges associated with conducting numerous, interleaved screening efforts run by multiple independent research groups. Results We have developed Screensaver, a free, open source, web-based lab information management system (LIMS, to address the informatics needs of our small molecule and RNAi screening facility. Screensaver supports the storage and comparison of screening data sets, as well as the management of information about screens, screeners, libraries, and laboratory work requests. To our knowledge, Screensaver is one of the first applications to support the storage and analysis of data from both genome-scale RNAi screening projects and small molecule screening projects. Conclusions The informatics and administrative needs of an HTS facility may be best managed by a single, integrated, web-accessible application such as Screensaver. Screensaver has proven useful in meeting the requirements of the ICCB-Longwood/NSRB Screening Facility at Harvard Medical School, and has provided similar benefits to other HTS facilities.

  20. Screensaver: an open source lab information management system (LIMS) for high throughput screening facilities.

    Science.gov (United States)

    Tolopko, Andrew N; Sullivan, John P; Erickson, Sean D; Wrobel, David; Chiang, Su L; Rudnicki, Katrina; Rudnicki, Stewart; Nale, Jennifer; Selfors, Laura M; Greenhouse, Dara; Muhlich, Jeremy L; Shamu, Caroline E

    2010-05-18

    Shared-usage high throughput screening (HTS) facilities are becoming more common in academe as large-scale small molecule and genome-scale RNAi screening strategies are adopted for basic research purposes. These shared facilities require a unique informatics infrastructure that must not only provide access to and analysis of screening data, but must also manage the administrative and technical challenges associated with conducting numerous, interleaved screening efforts run by multiple independent research groups. We have developed Screensaver, a free, open source, web-based lab information management system (LIMS), to address the informatics needs of our small molecule and RNAi screening facility. Screensaver supports the storage and comparison of screening data sets, as well as the management of information about screens, screeners, libraries, and laboratory work requests. To our knowledge, Screensaver is one of the first applications to support the storage and analysis of data from both genome-scale RNAi screening projects and small molecule screening projects. The informatics and administrative needs of an HTS facility may be best managed by a single, integrated, web-accessible application such as Screensaver. Screensaver has proven useful in meeting the requirements of the ICCB-Longwood/NSRB Screening Facility at Harvard Medical School, and has provided similar benefits to other HTS facilities.

  1. Use of Savannah River Site facilities for blend down of highly enriched uranium

    International Nuclear Information System (INIS)

    Bickford, W.E.; McKibben, J.M.

    1994-02-01

    Westinghouse Savannah River Company was asked to assess the use of existing Savannah River Site (SRS) facilities for the conversion of highly enriched uranium (HEU) to low enriched uranium (LEU). The purpose was to eliminate the weapons potential for such material. Blending HEU with existing supplies of depleted uranium (DU) would produce material with less than 5% U-235 content for use in commercial nuclear reactors. The request indicated that as much as 500 to 1,000 MT of HEU would be available for conversion over a 20-year period. Existing facilities at the SRS are capable of producing LEU in the form of uranium trioxide (UO 3 ) powder, uranyl nitrate [UO 2 (NO 3 ) 2 ] solution, or metal. Additional processing, and additional facilities, would be required to convert the LEU to uranium dioxide (UO 2 ) or uranium hexafluoride (UF 3 ), the normal inputs for commercial fuel fabrication. This study's scope does not include the cost for new conversion facilities. However, the low estimated cost per kilogram of blending HEU to LEU in SRS facilities indicates that even with fees for any additional conversion to UO 2 or UF 6 , blend-down would still provide a product significantly below the spot market price for LEU from traditional enrichment services. The body of the report develops a number of possible facility/process combinations for SRS. The primary conclusion of this study is that SRS has facilities available that are capable of satisfying the goals of a national program to blend HEU to below 5% U-235. This preliminary assessment concludes that several facility/process options appear cost-effective. Finally, SRS is a secure DOE site with all requisite security and safeguard programs, personnel skills, nuclear criticality safety controls, accountability programs, and supporting infrastructure to handle large quantities of special nuclear materials (SNM)

  2. Adherence to evidence based care practices for childbirth before and after a quality improvement intervention in health facilities of Rajasthan, India.

    Science.gov (United States)

    Iyengar, Kirti; Jain, Motilal; Thomas, Sunil; Dashora, Kalpana; Liu, William; Saini, Paramsukh; Dattatreya, Rajesh; Parker, Indrani; Iyengar, Sharad

    2014-08-13

    After the launch of Janani Suraksha Yojana, a conditional cash transfer scheme in India, the proportion of women giving birth in institutions has rapidly increased. However, there are important gaps in quality of childbirth services during institutional deliveries. The aim of this intervention was to improve the quality of childbirth services in selected high caseload public health facilities of 10 districts of Rajasthan. This intervention titled "Parijaat" was designed by Action Research & Training for Health, in partnership with the state government and United Nations Population Fund. The intervention was carried out in 44 public health facilities in 10 districts of Rajasthan, India. These included district hospitals (9), community health centres (32) and primary health centres (3). The main intervention was orientation training of doctors and program managers and regular visits to facilities involving assessment, feedback, training and action. The adherence to evidence based practices before, during and after this intervention were measured using structured checklists and scoring sheets. Main outcome measures included changes in practices during labour, delivery or immediate postpartum period. Use of several unnecessary or harmful practices reduced significantly. Most importantly, proportion of facilities using routine augmentation of labour reduced (p = 0), episiotomy for primigravidas (p = 0.0003), fundal pressure (p = 0.0003), and routine suction of newborns (0 = 0.0005). Among the beneficial practices, use of oxytocin after delivery increased (p = 0.0001) and the practice of listening foetal heart sounds during labour (p = 0.0001). Some practices did not show any improvements, such as dorsal position for delivery, use of partograph, and hand-washing. An intervention based on repeated facility visits combined with actions at the level of decision makers can lead to substantial improvements in quality of childbirth practices at health facilities.

  3. Social accountability in primary health care in West and Central Africa: exploring the role of health facility committees.

    Science.gov (United States)

    Lodenstein, Elsbet; Mafuta, Eric; Kpatchavi, Adolphe C; Servais, Jean; Dieleman, Marjolein; Broerse, Jacqueline E W; Barry, Alpha Amadou Bano; Mambu, Thérèse M N; Toonen, Jurrien

    2017-06-13

    Social accountability has been emphasised as an important strategy to increase the quality, equity, and responsiveness of health services. In many countries, health facility committees (HFCs) provide the accountability interface between health providers and citizens or users of health services. This article explores the social accountability practices facilitated by HFCs in Benin, Guinea and the Democratic Republic of Congo. The paper is based on a cross-case comparison of 11 HFCs across the three countries. The HFCs were purposefully selected based on the (past) presence of community participation support programs. The cases were derived from qualitative research involving document analysis as well as interviews and focus group discussions with health workers, citizens, committee members, and local authorities. Most HFCs facilitate social accountability by engaging with health providers in person or through meetings to discuss service failures, leading to changes in the quality of services, such as improved health worker presence, the availability of night shifts, the display of drug prices and replacement of poorly functioning health workers. Social accountability practices are however often individualised and not systematic, and their success depends on HFC leadership and synergy with other community structures. The absence of remuneration for HFC members does not seem to affect HFC engagement in social accountability. Most HFCs in this study offer a social accountability forum, but the informal and non-systematic character and limited community consultation leave opportunities for the exclusion of voices of marginalised groups. More inclusive, coherent and authoritative social accountability practices can be developed by making explicit the mandate of HFC in the planning, monitoring, and supervision of health services; providing instruments for organising local accountability processes; strengthening opportunities for community input and feedback; and

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

    Directory of Open Access Journals (Sweden)

    Dev Priya

    2015-10-01

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

  5. Specialized, multi-user computer facility for the high-speed, interactive processing of experimental data

    International Nuclear Information System (INIS)

    Maples, C.C.

    1979-01-01

    A proposal has been made to develop a specialized computer facility specifically designed to deal with the problems associated with the reduction and analysis of experimental data. Such a facility would provide a highly interactive, graphics-oriented, multi-user environment capable of handling relatively large data bases for each user. By conceptually separating the general problem of data analysis into two parts, cyclic batch calculations and real-time interaction, a multi-level, parallel processing framework may be used to achieve high-speed data processing. In principle such a system should be able to process a mag tape equivalent of data, through typical transformations and correlations, in under 30 sec. The throughput for such a facility, assuming five users simultaneously reducing data, is estimated to be 2 to 3 times greater than is possible, for example, on a CDC7600

  6. Specialized, multi-user computer facility for the high-speed, interactive processing of experimental data

    International Nuclear Information System (INIS)

    Maples, C.C.

    1979-05-01

    A proposal has been made at LBL to develop a specialized computer facility specifically designed to deal with the problems associated with the reduction and analysis of experimental data. Such a facility would provide a highly interactive, graphics-oriented, multi-user environment capable of handling relatively large data bases for each user. By conceptually separating the general problem of data analysis into two parts, cyclic batch calculations and real-time interaction, a multilevel, parallel processing framework may be used to achieve high-speed data processing. In principle such a system should be able to process a mag tape equivalent of data through typical transformations and correlations in under 30 s. The throughput for such a facility, for five users simultaneously reducing data, is estimated to be 2 to 3 times greater than is possible, for example, on a CDC7600. 3 figures

  7. When More is Less: The Case of Disconnected Information Systems in Indonesian Public Health Facilities

    Science.gov (United States)

    Wahid, Fathul; Teduh Dirgahayu, Raden; Hamzah, Almed; Setiaji, Hari

    2018-03-01

    The clear majority of previous studies have found that the absence of information systems to properly manage data is one of the main challenges in improving public health management. The present study offers an alternate perspective, revealing other emerging problems in cases where there are many information systems in place but without sufficient orchestration. The national government of Indonesia has been coercive in its implementation of various information systems without involving users at public health facilities, which has created many problems on the ground. The problems identified relate to the quality of the disconnected information systems currently in use, the lack of human resource development, unclear procedures, uncoordinated reports and the absence of an incentive scheme. The present study also highlights some practical implications, including the use of a more holistic perspective in designing and developing an integrated public health information infrastructure.

  8. Adopting and implementing nutrition guidelines in recreational facilities: tensions between public health and corporate profitability.

    Science.gov (United States)

    Olstad, Dana Lee; Raine, Kim D; McCargar, Linda J

    2013-05-01

    Little is known about how public entities can partner with industry to achieve public health goals. We investigated industry's perspective of factors that influenced their adoption and implementation of voluntary, government-issued nutrition guidelines (Alberta Nutrition Guidelines for Children and Youth, ANGCY) in recreational facilities. In-depth semi-structured interviews were conducted. Data were analysed using directed content analysis. Food services in recreational facilities. Seven managers from industry participated; five from companies that had adopted and implemented the ANGCY (adopters) in recreational facilities and two from companies that had not (non-adopters). Industry views nutrition guidelines through the lens of profitability. Non-adopters were unwilling to implement the ANGCY for fear of sacrificing short-term profitability, whereas adopters adhered to them in an attempt to position themselves for long-term profitability. Adopters faced barriers including few resources, no training, complex guidelines, low availability of and demand for ANGCY-compliant products, competitive pressures and substantial declines in revenue. Managers believed widespread voluntary adoption of the ANGCY was unlikely without government incentives and/or a mandate, as the environmental context for voluntary action was poor. All managers supported government-mandated implementation of the ANGCY to level the playing field upon which companies compete. Public-private partnerships in recreational facilities can embrace public health goals in the short term, provided industry perceives potential for long-term financial gain. Widespread uptake of voluntary nutrition guidelines in this setting is unlikely, however, as market mechanisms do not encourage industry to sell and promote healthier options. Government legislation may therefore be warranted.

  9. Newborn care practices at home and in health facilities in 4 regions of Ethiopia.

    Science.gov (United States)

    Callaghan-Koru, Jennifer A; Seifu, Abiy; Tholandi, Maya; de Graft-Johnson, Joseph; Daniel, Ephrem; Rawlins, Barbara; Worku, Bogale; Baqui, Abdullah H

    2013-12-01

    Ethiopia is one of the ten countries with the highest number of neonatal deaths globally, and only 1 in 10 women deliver with a skilled attendant. Promotion of essential newborn care practices is one strategy for improving newborn health outcomes that can be delivered in communities as well as facilities. This article describes newborn care practices reported by recently-delivered women (RDWs) in four regions of Ethiopia. We conducted a household survey with two-stage cluster sampling to assess newborn care practices among women who delivered a live baby in the period 1 to 7 months prior to data collection. The majority of women made one antenatal care (ANC) visit to a health facility, although less than half made four or more visits and women were most likely to deliver their babies at home. About one-fifth of RDWs in this survey had contact with Health Extension Workers (HEWS) during ANC, but nurse/midwives were the most common providers, and few women had postnatal contact with any health provider. Common beneficial newborn care practices included exclusive breastfeeding (87.6%), wrapping the baby before delivery of the placenta (82.3%), and dry cord care (65.2%). Practices contrary to WHO recommendations that were reported in this population of recent mothers include bathing during the first 24 hours of life (74.7%), application of butter and other substances to the cord (19.9%), and discarding of colostrum milk (44.5%). The results suggest that there are not large differences for most essential newborn care indicators between facility and home deliveries, with the exception of delayed bathing and skin-to-skin care. Improving newborn care and newborn health outcomes in Ethiopia will likely require a multifaceted approach. Given low facility delivery rates, community-based promotion of preventive newborn care practices, which has been effective in other settings, is an important strategy. For this strategy to be successful, the coverage of counseling delivered

  10. Experimental facility for development of high-temperature reactor technology: instrumentation needs and challenges

    Directory of Open Access Journals (Sweden)

    Sabharwall Piyush

    2015-01-01

    Full Text Available A high-temperature, multi-fluid, multi-loop test facility is under development at the Idaho National Laboratory for support of thermal hydraulic materials, and system integration research for high-temperature reactors. The experimental facility includes a high-temperature helium loop, a liquid salt loop, and a hot water/steam loop. The three loops will be thermally coupled through an intermediate heat exchanger (IHX and a secondary heat exchanger (SHX. Research topics to be addressed include the characterization and performance evaluation of candidate compact heat exchangers such as printed circuit heat exchangers (PCHEs at prototypical operating conditions. Each loop will also include an interchangeable high-temperature test section that can be customized to address specific research issues associated with each working fluid. This paper also discusses needs and challenges associated with advanced instrumentation for the multi-loop facility, which could be further applied to advanced high-temperature reactors. Based on its relevance to advanced reactor systems, the new facility has been named the Advanced Reactor Technology Integral System Test (ARTIST facility. A preliminary design configuration of the ARTIST facility will be presented with the required design and operating characteristics of the various components. The initial configuration will include a high-temperature (750 °C, high-pressure (7 MPa helium loop thermally integrated with a molten fluoride salt (KF-ZrF4 flow loop operating at low pressure (0.2 MPa, at a temperature of ∼450 °C. The salt loop will be thermally integrated with the steam/water loop operating at PWR conditions. Experiment design challenges include identifying suitable materials and components that will withstand the required loop operating conditions. The instrumentation needs to be highly accurate (negligible drift in measuring operational data for extended periods of times, as data collected will be

  11. Experimental facility for development of high-temperature reactor technology: instrumentation needs and challenges - 15066

    International Nuclear Information System (INIS)

    Sabharwall, P.; O'Brien, J.E.; Yoon, S.J.; Sun, X.

    2015-01-01

    A high-temperature, multi-fluid, multi-loop test facility is under development at the Idaho National Laboratory for support of thermal hydraulic, materials, and system integration research for high-temperature reactors. The experimental facility includes a high-temperature helium loop, a liquid salt loop, and a hot water/steam loop. The 3 loops will be thermally coupled through an intermediate heat exchanger (IHX) and a secondary heat exchanger (SHX). Research topics to be addressed include the characterization and performance evaluation of candidate compact heat exchangers such as printed circuits heat exchangers (PCHEs) at prototypical operating conditions. Each loop will also include an interchangeable high-temperature test section that can be customized to address specific research issues associated with each working fluid. This paper also discusses needs and challenges associated with advanced instrumentation for the multi-loop facility, which could be further applied to advanced high-temperature reactors. Based on its relevance to advanced reactor systems, the new facility has been named the Advanced Reactor Technology Integrated System Test (ARTIST) facility. A preliminary design configuration of the ARTIST facility will be presented with the required design and operating characteristics of the various components. The initial configuration will include a high-temperature (750 C. degrees), high-pressure (7 MPa) helium loop thermally integrated with a molten fluoride salt (KF-ZrF 4 ) flow loop operating at low pressure (0.2 MPa), at a temperature of ∼ 450 C. degrees. The salt loop will be thermally integrated with the steam/water loop operating at PWR conditions. Experiment design challenges include identifying suitable materials and components that will withstand the required loop operating conditions. The instrumentation needs to be highly accurate (negligible drift) in measuring operational data for extended periods of times, as data collected will be

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

    Directory of Open Access Journals (Sweden)

    Mokgobadibe V. Ntsiea

    2017-06-01

    Conclusion: The Wits physiotherapy curriculum covers all medical conditions treated by physiotherapists within the Gauteng state health facilities, and overall, the curriculum prepares the students to practise in a variety of situations.

  13. Design and operation of off-gas cleaning systems at high level liquid waste conditioning facilities

    International Nuclear Information System (INIS)

    1988-01-01

    The immobilization of high level liquid wastes from the reprocessing of irradiated nuclear fuels is of great interest and serious efforts are being undertaken to find a satisfactory technical solution. Volatilization of fission product elements during immobilization poses the potential for the release of radioactive substances to the environment and necessitates effective off-gas cleaning systems. This report describes typical off-gas cleaning systems used in the most advanced high level liquid waste immobilization plants and considers most of the equipment and components which can be used for the efficient retention of the aerosols and volatile contaminants. In the case of a nuclear facility consisting of several different facilities, release limits are generally prescribed for the nuclear facility as a whole. Since high level liquid waste conditioning (calcination, vitrification, etc.) facilities are usually located at fuel reprocessing sites (where the majority of the high level liquid wastes originates), the off-gas cleaning system should be designed so that the airborne radioactivity discharge of the whole site, including the emission of the waste conditioning facility, can be kept below the permitted limits. This report deals with the sources and composition of different kinds of high level liquid wastes and describes briefly the main high level liquid waste solidification processes examining the sources and characteristics of the off-gas contaminants to be retained by the off-gas cleaning system. The equipment and components of typical off-gas systems used in the most advanced (large pilot or industrial scale) high level liquid waste solidification plants are described. Safety considerations for the design and safe operation of the off-gas systems are discussed. 60 refs, 31 figs, 17 tabs

  14. Qualification test for ITER HCCR-TBS mockups with high heat flux test facility

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Suk-Kwon, E-mail: skkim93@kaeri.re.kr [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Park, Seong Dae; Jin, Hyung Gon; Lee, Eo Hwak; Yoon, Jae-Sung; Lee, Dong Won [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Cho, Seungyon [National Fusion Research Institute, Daejeon (Korea, Republic of)

    2016-11-01

    Highlights: • The test mockups for ITER HCCR (Helium Cooled Ceramic Reflector) TBS (Test Blanket System) in Korea were designed and fabricated. • A thermo-hydraulic analysis was performed using a high heat flux test facility by using electron beam. • The plan for qualification tests was developed to evaluate the thermo-hydraulic efficiency in accordance with the requirements of the ITER Organization. - Abstract: The test mockups for ITER HCCR (Helium Cooled Ceramic Reflector) TBS (Test Blanket System) in Korea were designed and fabricated, and an integrity and thermo-hydraulic performance test should be completed under the same or similar operation conditions of ITER. The test plan for a thermo-hydraulic analysis was developed by using a high heat flux test facility, called the Korean heat load test facility by using electron beam (KoHLT-EB). This facility is utilized for a qualification test of the plasma facing component (PFC) for the ITER first wall and DEMO divertor, and for the thermo-hydraulic experiments. In this work, KoHLT-EB will be used for the plan of the performance qualification test of the ITER HCCR-TBS mockups. This qualification tests should be performed to evaluate the thermo-hydraulic efficiency in accordance with the requirements of the ITER Organization (IO), which describe the specifications and qualifications of the heat flux test facility and test procedure for ITER PFC.

  15. Accelerator technical design report for high-intensity proton accelerator facility project, J-PARC

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-03-01

    This report presents the detail of the technical design of the accelerators for the High-Intensity Proton Accelerator Facility Project, J-PARC. The accelerator complex comprises a 400-MeV room-temperature linac (600-MeV superconducting linac), 3-GeV rapid-cycling synchrotron (RCS), and a 50-GeV synchrotron (MR). The 400-MeV beam is injected to the RCS, being accelerated to 3 GEV. The 1-MW beam thus produced is guided to the Materials Life Science Experimental Facility, with both the pulsed spallation neutron source and muon source. A part of the beam is transported to the MR, which provides the 0.75-MW beam to either the Nuclear and Fundamental Particle Experimental Facility or the Neutrino Production Target. On the other hand, the beam accelerated to 600 MeV by the superconducting linac is used for the Nuclear Waster Transmutation Experiment. In this way, this facility is unique, being multipurpose one, including many new inventions and Research and Development Results. This report is based upon the accomplishments made by the Accelerator Group and others of the Project Team, which is organized on the basis of the Agreement between JAERI and KEK on the Construction and Research and Development of the High-Intensity Proton Accelerator Facility. (author)

  16. Utilisation of a community-based health facility in a low-income urban community in Ibadan, Nigeria

    Directory of Open Access Journals (Sweden)

    Ayodeji M. Adebayo

    2015-05-01

    Full Text Available Background: Primary healthcare is established to ensure that people have access to health services through facilities located in their community. However, utilisation of health facilities in Nigeria remains low in many communities. Aim: To assess the utilisation of community-based health facility (CBHF amongst adults in Ibadan, Nigeria. Settings: A low-income community in Ibadan North West Local Government Area of Oyo State.Methods:A cross-sectional survey was conducted using a simple random sampling technique to select one adult per household in all 586 houses in the community. A semi-structured interviewer-administered questionnaire was used to collect information on respondents’ sociodemographic characteristics, knowledge and utilisation of the CBHF. Data analysis included descriptive statistics and association testing using the Chi-square test at p = 0.05. Results: The mean age of the respondents was 46.5 ± 16.0 years; 46.0% were men and 81.0% married; 26% had no formal education and 38.0% had secondary-level education and above; traders constituted 52.0% of the sample; and 85.2% were of low socioeconomic standing; 90%had patronised the CBHF. The main reasons for non-utilisation were preference for general hospitals (13.8% and self-medication (12.1%. Respondents who had secondary education and above, were in a higher socioeconomic class, who had good knowledge of the facility and were satisfied with care, utilised the CBHF three months significantly more than their counterparts prior to the study (p < 0.05. However, only satisfaction with care was found to be a significant predictor of utilisation of the CBHF. Conclusion: The utilisation of the CBHF amongst adults in the study setting is high, driven mostly by satisfaction with the care received previously. Self-medication, promoted by uncontrolled access to drugs through pharmacies and patent medicine stores, threatens this high utilisation.

  17. Operating manual for the High Flux Isotope Reactor. Description of the facility

    Energy Technology Data Exchange (ETDEWEB)

    None

    1965-06-01

    This report contains a comprehensive description of the High Flux Isotope Reactor facility. Its primary purpose is to supplement the detailed operating procedures, providing the reactor operators with background information on the various HFIR systems. The detailed operating procedures are presented in another report.

  18. Operating manual for the High Flux Isotope Reactor. Volume I. Description of the facility

    International Nuclear Information System (INIS)

    1982-09-01

    This volume contains a comprehensive description of the High Flux Isotope Reactor Facility. Its primary purpose is to supplement the detailed operating procedures, providing the reactor operators with background information on the various HFIR systems. The detailed operating procdures are presented in another report

  19. Operating manual for the High Flux Isotope Reactor. Volume I. Description of the facility

    Energy Technology Data Exchange (ETDEWEB)

    1982-09-01

    This volume contains a comprehensive description of the High Flux Isotope Reactor Facility. Its primary purpose is to supplement the detailed operating procedures, providing the reactor operators with background information on the various HFIR systems. The detailed operating procdures are presented in another report.

  20. The high current test facility injector operation to 40 mA dc

    International Nuclear Information System (INIS)

    Ungrin, J.; Ormrod, J.H.; Michel, W.L.

    1976-01-01

    The high current test facility injector is a 750 keV proton accelerator designed to investigate the problems involved in the acceleration of intense dc proton beams. The performance of the injector and the experience gained in operation with dc beams up to 40 mA are described. (author)

  1. High Temperature Test Facility Preliminary RELAP5-3D Input Model Description

    Energy Technology Data Exchange (ETDEWEB)

    Bayless, Paul David [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-12-01

    A RELAP5-3D input model is being developed for the High Temperature Test Facility at Oregon State University. The current model is described in detail. Further refinements will be made to the model as final as-built drawings are released and when system characterization data are available for benchmarking the input model.

  2. Complex workplace radiation fields at European high-energy accelerators and thermonuclear fusion facilities

    CERN Document Server

    Bilski, P; D'Errico, F; Esposito, A; Fehrenbacher, G; Fernàndez, F; Fuchs, A; Golnik, N; Lacoste, V; Leuschner, A; Sandri, S; Silari, M; Spurny, F; Wiegel, B; Wright, P

    2006-01-01

    This report outlines the research needs and research activities within Europe to develop new and improved methods and techniques for the characterization of complex radiation fields at workplaces around high-energy accelerators and the next generation of thermonuclear fusion facilities under the auspices of the COordinated Network for RAdiation Dosimetry (CONRAD) project funded by the European Commission.

  3. A High-Throughput Biological Calorimetry Core: Steps to Startup, Run, and Maintain a Multiuser Facility.

    Science.gov (United States)

    Yennawar, Neela H; Fecko, Julia A; Showalter, Scott A; Bevilacqua, Philip C

    2016-01-01

    Many labs have conventional calorimeters where denaturation and binding experiments are setup and run one at a time. While these systems are highly informative to biopolymer folding and ligand interaction, they require considerable manual intervention for cleaning and setup. As such, the throughput for such setups is limited typically to a few runs a day. With a large number of experimental parameters to explore including different buffers, macromolecule concentrations, temperatures, ligands, mutants, controls, replicates, and instrument tests, the need for high-throughput automated calorimeters is on the rise. Lower sample volume requirements and reduced user intervention time compared to the manual instruments have improved turnover of calorimetry experiments in a high-throughput format where 25 or more runs can be conducted per day. The cost and efforts to maintain high-throughput equipment typically demands that these instruments be housed in a multiuser core facility. We describe here the steps taken to successfully start and run an automated biological calorimetry facility at Pennsylvania State University. Scientists from various departments at Penn State including Chemistry, Biochemistry and Molecular Biology, Bioengineering, Biology, Food Science, and Chemical Engineering are benefiting from this core facility. Samples studied include proteins, nucleic acids, sugars, lipids, synthetic polymers, small molecules, natural products, and virus capsids. This facility has led to higher throughput of data, which has been leveraged into grant support, attracting new faculty hire and has led to some exciting publications. © 2016 Elsevier Inc. All rights reserved.

  4. Utility of health facility-based malaria data for malaria surveillance.

    Directory of Open Access Journals (Sweden)

    Yaw A Afrane

    Full Text Available Currently, intensive malaria control programs are being implemented in Africa to reduce the malaria burden. Clinical malaria data from hospitals are valuable for monitoring trends in malaria morbidity and for evaluating the impacts of these interventions. However, the reliability of hospital-based data for true malaria incidence is often questioned because of diagnosis accuracy issues and variation in access to healthcare facilities among sub-groups of the population. This study investigated how diagnosis and treatment practices of malaria cases in hospitals affect reliability of hospital malaria data.The study was undertaken in health facilities in western Kenya. A total of 3,569 blood smears were analyzed after being collected from patients who were requested by clinicians to go to the hospital's laboratory for malaria testing. We applied several quality control measures for clinical malaria diagnosis. We compared our slide reading results with those from the hospital technicians. Among the 3,390 patients whose diagnoses were analyzed, only 36% had clinical malaria defined as presence of any level of parasitaemia and fever. Sensitivity and specificity of clinicians' diagnoses were 60.1% (95% CI: 61.1-67.5 and 75.0% (95% CI: 30.8-35.7, respectively. Among the 980 patients presumptively treated with an anti-malarial by the clinicians without laboratory diagnosis, only 47% had clinical malaria.These findings revealed substantial over-prescription of anti-malarials and misdiagnosis of clinical malaria. More than half of the febrile cases were not truly clinical malaria, but were wrongly diagnosed and treated as such. Deficiency in malaria diagnosis makes health facility data unreliable for monitoring trends in malaria morbidity and for evaluating impacts of malaria interventions. Improving malaria diagnosis should be a top priority in rural African health centers.

  5. Money for Research, Not for Energy Bills: Finding Energy and Cost Savings in High Performance Computer Facility Designs

    Energy Technology Data Exchange (ETDEWEB)

    Drewmark Communications; Sartor, Dale; Wilson, Mark

    2010-07-01

    High-performance computing facilities in the United States consume an enormous amount of electricity, cutting into research budgets and challenging public- and private-sector efforts to reduce energy consumption and meet environmental goals. However, these facilities can greatly reduce their energy demand through energy-efficient design of the facility itself. Using a case study of a facility under design, this article discusses strategies and technologies that can be used to help achieve energy reductions.

  6. Barriers to obstetric care at health facilities in sub-Saharan Africa--a systematic review protocol.

    Science.gov (United States)

    Kyei-Nimakoh, Minerva; Carolan-Olah, Mary; McCann, Terence V

    2015-04-23

    Since the launch of the Millennium Development Goals (MDGs) by the United Nations in 2000, the global community has intensified efforts to reduce adverse maternal health outcomes, especially, in sub-Saharan Africa. Despite these efforts, there is an increasing concern that the decline in maternal deaths has been less than optimal, even for women who receive birthing care in health facilities. High maternal deaths have been attributed to a variety of issues such as poor quality of care, inadequate resources, poor infrastructure, and inaccessibility to healthcare services. In other words, even in settings where they are available, many women do not receive life-saving obstetric care, when needed, despite the fact that basic and comprehensive obstetric care is widely recognized as a key to meeting maternal health goals. It is important to understand the common challenges that this developing region is facing in order to ensure a more rapid decline in adverse maternal health outcomes. The aim of this review is to synthesize literature on barriers to obstetric care at health institutions which focuses on sub-Saharan Africa, the region that is most affected by severe maternal morbidity and mortality. This review follows guidelines by the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist. An electronic search of published literature will be conducted to identify studies which examined barriers to health facility-based obstetric care in sub-Saharan Africa. PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus databases will be searched. Published articles in English, dated between 2000 and 2014, will be included. Combinations of search terms such as obstetric care, access, barriers, developing countries, and sub-Saharan Africa will be used to locate related articles, and eligible ones retained for data abstraction. A narrative synthesis approach will be employed to synthesize the evidence and explore

  7. LDS hospital, a facility of Intermountain Health Care, Salt Lake City, Utah.

    Science.gov (United States)

    Peck, M; Nelson, N; Buxton, R; Bushnell, J; Dahle, M; Rosebrock, B; Ashton, C A

    1997-01-01

    On-line documentation by nurses and a comprehensive text management system are functional in several facilities of intermountain Health Care (IHC). The following articles detail factors in the design and implementation of this computerized network as experienced at LDS Hospital, part of the IHC system. Areas discussed are the system's applications for medical decision support, communication, patient classification, nurse staffing versus cost, emergency department usage, patient problem/event recording, clinical outcomes, and text publication. Users express satisfaction with the time saving, consistency of reporting, and cohesiveness of these applications.

  8. Animal-assisted interventions: A national survey of health and safety policies in hospitals, eldercare facilities, and therapy animal organizations.

    Science.gov (United States)

    Linder, Deborah E; Siebens, Hannah C; Mueller, Megan K; Gibbs, Debra M; Freeman, Lisa M

    2017-08-01

    Animal-assisted intervention (AAI) programs are increasing in popularity, but it is unknown to what extent therapy animal organizations that provide AAI and the hospitals and eldercare facilities they work with implement effective animal health and safety policies to ensure safety of both animals and humans. Our study objective was to survey hospitals, eldercare facilities, and therapy animal organizations on their AAI policies and procedures. A survey of United States hospitals, eldercare facilities, and therapy animal organizations was administered to assess existing health and safety policies related to AAI programs. Forty-five eldercare facilities, 45 hospitals, and 27 therapy animal organizations were surveyed. Health and safety policies varied widely and potentially compromised human and animal safety. For example, 70% of therapy animal organizations potentially put patients at risk by allowing therapy animals eating raw meat diets to visit facilities. In general, hospitals had stricter requirements than eldercare facilities. This information suggests that there are gaps between the policies of facilities and therapy animal organizations compared with recent guidelines for animal visitation in hospitals. Facilities with AAI programs need to review their policies to address recent AAI guidelines to ensure the safety of animals and humans involved. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  9. Revolving drug funds at front-line health facilities in Vientiane, Lao PDR.

    Science.gov (United States)

    Murakami, H; Phommasack, B; Oula, R; Sinxomphou, S

    2001-03-01

    Pharmaceutical cost recovery programmes, which have been mainly implemented in Africa, are gradually spreading to Southeast Asian countries that formerly belonged to the socialist bloc. This report describes the economic and operational realities of revolving drug funds (RDFs) at district hospitals and health centres in the capital of the Lao PDR by reviewing research conducted by the implementing department. People in the municipality spent an average of US$11 on drugs in 1996. The RDFs comprised only 3% of the total yearly drug sales in the municipality, whereas private pharmacies accounted for 75%. The RDFs were forced to operate in conjunction with the remaining government drug endowment and the thriving private pharmacies. This scheme has provided a stable supply of essential drugs. The assurance of drug availability at the front-line health facilities has resulted in increased utilization of the facilities despite the introduction of a drug fee. The cost recovery rate was 107% at health centres and 108% at district hospitals in two monitored districts during the 10 months from November 1997. Decentralized financial management was essential for cost recovery, allowing timely adjustment of selling prices as purchase prices rapidly inflated after the Asian economic crisis. The health staff observed that the people perceived drugs as everyday commodities that they should buy and take based on self-diagnosis and personal preference. Adaptation of the public health authorities to market-oriented thinking along with the establishment of pharmaceutical cost recovery occurred with few problems. However, both financial and operational management capacity at the municipal level pose a major challenge to policy clarification and scheme setting, especially in procurement, control of prescribing practices and the integration of drug dispensing with other components of quality clinical care.

  10. Shielding analysis of high level waste water storage facilities using MCNP code

    Energy Technology Data Exchange (ETDEWEB)

    Yabuta, Naohiro [Mitsubishi Research Inst., Inc., Tokyo (Japan)

    2001-01-01

    The neutron and gamma-ray transport analysis for the facility as a reprocessing facility with large buildings having thick shielding was made. Radiation shielding analysis consists of a deep transmission calculation for the concrete wall and a skyshine calculation for the space out of the buildings. An efficient analysis with a short running time and high accuracy needs a variance reduction technique suitable for all the calculation regions and structures. In this report, the shielding analysis using MCNP and a discrete ordinate transport code is explained and the idea and procedure of decision of variance reduction parameter is completed. (J.P.N.)

  11. Systems engineering applied to integrated safety management for high consequence facilities

    International Nuclear Information System (INIS)

    Barter, R; Morais, B.

    1998-01-01

    Integrated Safety Management is a concept that is being actively promoted by the U.S. Department of Energy as a means of assuring safe operation of its facilities. The concept involves the integration of safety precepts into work planning rather than adjusting for safe operations after defining the work activity. The system engineering techniques used to design an integrated safety management system for a high consequence research facility are described. An example is given to show how the concepts evolved with the system design

  12. Technical quality of delivery care in private- and public-sector health facilities in Enugu and Lagos States, Nigeria.

    Science.gov (United States)

    Hirose, Atsumi; Yisa, Ibrahim O; Aminu, Amina; Afolabi, Nathanael; Olasunmbo, Makinde; Oluka, George; Muhammad, Khalilu; Hussein, Julia

    2018-06-01

    Private-sector providers are increasingly being recognized as important contributors to the delivery of healthcare. Countries with high disease burdens and limited public-sector resources are considering using the private sector to achieve universal health coverage. However, evidence for the technical quality of private-sector care is lacking. This study assesses the technical quality of maternal healthcare during delivery in public- and private-sector facilities in resource-limited settings, from a systems and programmatic perspective. A summary index (the skilled attendance index, SAI), was used. Two-staged cluster sampling with stratification was used to select representative samples of case records in public- and private-sector facilities in Enugu and Lagos States, Nigeria. Information to assess criteria was extracted, and the SAI calculated. Linear regression models examined the relationship between SAI and the private and public sectors, controlling for confounders. The median SAI was 54.8% in Enugu and 85.7% in Lagos. The private for-profit sector's SAI was lower than and the private not-for-profit sector's SAI was higher than the public sector in Enugu [coefficient = -3.6 (P = 0.018) and 12.6 (P private for-profit sector's SAI was higher and the private not-for-profit sector's SAI was lower than the public sector [3.71 (P = 0.005) and -3.92 (P private for-profit providers' care was poorer than public providers where the public provision of care was weak, while private for-profit facilities provided better technical quality care than public facilities where the public sector was strong and there was a relatively strong regulatory body. Our findings raise important considerations relating to the quality of maternity care, the public-private mix and needs for regulation in global efforts to achieve universal healthcare.

  13. 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.

  14. High temperature superconducting current lead test facility with heat pipe intercepts

    International Nuclear Information System (INIS)

    Blumenfeld, P.E.; Prenger, C.; Roth, E.W.; Stewart, J.A.

    1998-01-01

    A high temperature superconducting (HTS) current lead test facility using heat pipe thermal intercepts is under development at the Superconducting Technology Center at Los Alamos National Laboratory. The facility can be configured for tests at currents up to 1,000 A. Mechanical cryocoolers provide refrigeration to the leads. Electrical isolation is maintained by intercepting thermal energy from the leads through cryogenic heat pipes. HST lead warm end temperature is variable from 65 K to over 90 K by controlling heat pipe evaporator temperature. Cold end temperature is variable up to 30 K. Performance predictions in terms of heat pipe evaporator temperature as a function of lead current are presented for the initial facility configuration, which supports testing up to 200 A. Measurements are to include temperature and voltage gradient in the conventional and HTS lead sections, temperature and heat transfer rate in the heat pipes. as well as optimum and off-optimum performance of the conventional lead sections

  15. Examination of Beryllium Under Intense High Energy Proton Beam at CERN's HiRadMat Facility

    CERN Document Server

    Ammigan, K.; Hurh, P.; Zwaska, R.; Atherton, A.; Caretta, O.; Davenne,T.; Densham, C.; Fitton, M.; Loveridge, P.; O'Dell, J.; Roberts, S.; Kuksenko, V.; Butcher, M.; Calviani, M.; Guinchard, M.; Losito, R.

    2017-01-01

    Beryllium is extensively used in various accelerator beam lines and target facilities as material for beam win- dows, and to a lesser extent, as secondary particle produc- tion targets. With increasing beam intensities of future ac- celerator facilities, it is critical to understand the response of beryllium under extreme conditions to avoid compro- mising particle production efficiency by limiting beam pa- rameters. As a result, the planned experiment at CERN’s HiRadMat facility will take advantage of the test facility’s tunable high intensity proton beam to probe and investigate the damage mechanisms of several grades of beryllium. The test matrix will consist of multiple arrays of thin discs of varying thicknesses as well as cylinders, each exposed to increasing beam intensities. Online instrumentations will acquire real time temperature, strain, and vibration data of the cylinders, while Post-Irradiation-Examination (PIE) of the discs will exploit advanced microstructural characteri- zation and imagin...

  16. Examination of Beryllium Under Intense High Energy Proton Beam at CERN's HiRadMat Facility

    CERN Document Server

    Ammigan, K; Hurh, P; Zwaska, R; Atherton, A; Caretta, O; Davenne, t; Densham, C; Fitton, M; Loveridge, P; O'Dell, J; Roberts, S; Kuksenko, v; Butcher, M; Calviani, M; Guinchard, M; Losito, R

    2015-01-01

    Beryllium is extensively used in various accelerator beam lines and target facilities as material for beam win- dows, and to a lesser extent, as secondary particle produc- tion targets. With increasing beam intensities of future ac- celerator facilities, it is critical to understand the response of beryllium under extreme conditions to avoid compro- mising particle production efficiency by limiting beam pa- rameters. As a result, the planned experiment at CERN’s HiRadMat facility will take advantage of the test facility’s tunable high intensity proton beam to probe and investigate the damage mechanisms of several grades of beryllium. The test matrix will consist of multiple arrays of thin discs of varying thicknesses as well as cylinders, each exposed to increasing beam intensities. Online instrumentations will acquire real time temperature, strain, and vibration data of the cylinders, while Post-Irradiation-Examination (PIE) of the discs will exploit advanced microstructural characteri- zation and imagin...

  17. A conceptual subsurface facility design for a high-level nuclear waste repository at Yucca Mountain

    International Nuclear Information System (INIS)

    McKenzie, D.G., III; Bhattacharyya, K.K.; Segrest, A.M.

    1996-01-01

    The US Department of Energy is responsible for the design, construction, operation and closure of a repository in which to permanently dispose of the nation's high level nuclear waste. In addition to the objective of safely isolating the waste inventory, the repository must provide a safe working environment for its workforce, and protect the public. The conceptual design for this facility is currently being developed. Tunnel Boring Machine will be used to excavate 228 kilometers of tunneling to construct the facility over a 30 year period. The excavation operations will be physically separated from the waste emplacement operations, and each operation will have its own dedicated ventilation system. The facility is being designed to remain open for 150 years

  18. Protection of High Ceiling Nuclear Facilities Using Photoelectric Sensors and Infrared Fire Detectors

    International Nuclear Information System (INIS)

    Wadoud, A.A.; El Eissawi, H.M.; Saleh, A.A.

    2017-01-01

    A variety of different security systems and components are commercially available and widely used. Before implementing a security system, it is important to understand the characteristics and requirements of the facility area to be protected. Technology and manufacturers of security devices are rapidly changing. It is necessary to use optimal security equipment suitable for the surrounding environment of the facility to be protected. Several security sensors can be used to protect the nuclear facilities, such as passive infrared detectors and glass breakage sensors, vibration detectors, and microwave sensors. This work introduces technical specifications, operation and method of installation for these detectors in nuclear facilities. Also a comparative study of different security sensors or equipment is provided. The photoelectric detectors and infrared fire beam smoke detectors are reliable, suitable and advanced security equipment. They can be used in special cases because of their advantages, this includes their long ranges and accuracy in performance. This paper presents a new concept for adapting the use infrared optical fire beam smoke detector as intrusion detection equipment in high ceiling buildings or towering height facilities. This is in addition to their main function, namely fire detection.The paper also provides a study for their types and installation method. Focus is made on the installation and operation method for two advanced security systems, and wireless control circuit for the overall system operation

  19. Design Optimisation of a High Intensity Beam Facility and Feasibility Experiment of a Solid Fragmented Target

    CERN Document Server

    Charitonidis, Nikolaos; Rivkin, Leonid

    2014-06-13

    The present PhD thesis describes the design, execution and results of the HRMT-10 experiment performed at the HiRadMat facility of the CERN/SPS complex. The first part of the thesis covers the design optimization studies of the HiRadMat facility, focusing in particular on the radiation protection issues. A detailed Monte-Carlo model of the facility has been developed and validated through comparison with measurements. A very satisfactory agreement between the simulation and the experimental data is observed. In the second part of this thesis, a novel feasibility experiment of a fragmented solid target for a future Neutrino Factory or a Super Beam facility, able to support high beam powers ( 1 MW) is presented in detail. A solid granular target has been proposed as an interesting alternative to an open Hg jet target, presently considered as the baseline for such facilities, but posing considerable technical challenges. The HRMT-10 experiment seeks to address the lack of experimental data of the feasibility of...

  20. Very high temperature gas-cooled reactor critical facility for Japan Atomic Energy Research Institute

    International Nuclear Information System (INIS)

    Ishihara, Noriyuki

    1985-01-01

    The outline of the critical facility, its construction, the results of the basic studies and experiments on the graphite material, and the results obtained from the test conducted on the overall functions of the critical facility were reported. With the completion of the critical facility, it has been made possible to demonstrate the establishment of the manufacturing techniques and product-quality guarantee for extremely pure isotropic graphite in addition to the reliability of the structural design and analytical techniques for the main unit of the critical facility. It is expected that the present facility will prove instrumental in the verification of the nuclear safety of the very high temperature gas-cooled nuclear reactor and in the acquisition of experimental data on the reactor physics pertaining to the improvement of the reactor characteristics. The tasks which remain to be accomplished hereafter are the improvements of the performance and quality features with regard to the oxidization of graphite, the heat-resisting structural materials, and the welded structures. (Kubozono, M.)

  1. High-energy, twelve-channel laser facility (DEFIN) for spherical irradiation of thermonuclear targets

    International Nuclear Information System (INIS)

    Basov, N.G.; Danilov, A.E.; Krokhin, O.N.; Kruglov, B.V.; Mikhailov, Yu.A.; Sklizkov, G.V.; Fedotov, S.I.; Fedorov, A.N.

    This paper describes a high-energy, twelve-channel laser facility (DELFIN) intended for high-temperature heating of thermonuclear targets with spherical symmetry. The facility includes a neodymium-glass laser with the ultimate radiation energy of 10 kJ, a pulse length of approximately 10 -10 to 10 -9 s, beam divergence of 5 x 10 -4 radians, a vacuum chamber in which laser radiation interacts with the plasma, and a system of diagnostic instrumentation for the observation of laser beam and plasma parameters. Described are the optical scheme and construction details of the laser facility. Presented is an analysis of focusing schemes for target irradiation and described is the focusing scheme of the DELFIN facility, which is capable of attaining a high degree of spherical symmetry in irradiating targets with maximum beam intensity at the target surface of approximately 10 15 W/cm 2 . This paper examines the most important problems connected with the physical investigations of thermonuclear laser plasma and the basic diagnostic problems involved in their solution

  2. Tracking implementation and (un)intended consequences: a process evaluation of an innovative peripheral health facility financing mechanism in Kenya.

    Science.gov (United States)

    Waweru, Evelyn; Goodman, Catherine; Kedenge, Sarah; Tsofa, Benjamin; Molyneux, Sassy

    2016-03-01

    In many African countries, user fees have failed to achieve intended access and quality of care improvements. Subsequent user fee reduction or elimination policies have often been poorly planned, without alternative sources of income for facilities. We describe early implementation of an innovative national health financing intervention in Kenya; the health sector services fund (HSSF). In HSSF, central funds are credited directly into a facility's bank account quarterly, and facility funds are managed by health facility management committees (HFMCs) including community representatives. HSSF is therefore a finance mechanism with potential to increase access to funds for peripheral facilities, support user