Bureaucratic Blockages : Water, Civil Servants, and Community in Tanzania

OpenAIRE

Bailey, Juli

2017-01-01

How do civil servants in district water and sanitation departments address problems of water access in rural communities in Tanzania? What are the bureaucratic procedures they follow? How do the bureaucratic procedures around formulating budgets, managing money, and interacting with communities impede or enhance their ability to manage water projects? This report addresses these and related ...

The Relationship between Bureaucratic School Structures and Teacher Self-Efficacy

Science.gov (United States)

Kilinç, Ali Çagatay; Kosar, Serkan; Er, Emre; Ögdem, Zeki

2016-01-01

The purpose of this study was to examine the relationship between bureaucratic school structures and teachers' self-efficacy. Participants included 252 teachers from 15 primary schools in Ankara, Turkey. Mean, standard deviation, correlation, and regression analyses were conducted. Results indicated that bureaucratic school structures and teacher…

Parkinson's Law quantified: three investigations on bureaucratic inefficiency

Science.gov (United States)

Klimek, Peter; Hanel, Rudolf; Thurner, Stefan

2009-03-01

We formulate three famous, descriptive essays of Parkinson on bureaucratic inefficiency in a quantifiable and dynamical socio-physical framework. In the first model we show how the use of recent opinion formation models for small groups can be used to understand Parkinson's observation that decision-making bodies such as cabinets or boards become highly inefficient once their size exceeds a critical 'Coefficient of Inefficiency', typically around 20. A second observation of Parkinson—which is sometimes referred to as Parkinson's Law—is that the growth of bureaucratic or administrative bodies usually goes hand in hand with a drastic decrease of its overall efficiency. In our second model we view a bureaucratic body as a system of a flow of workers, who enter, become promoted to various internal levels within the system over time, and leave the system after having served for a certain time. Promotion usually is associated with an increase of subordinates. Within the proposed model it becomes possible to work out the phase diagram under which conditions of bureaucratic growth can be confined. In our last model we assign individual efficiency curves to workers throughout their life in administration, and compute the optimum time to give them the old age pension, in order to ensure a maximum of efficiency within the body—in Parkinson's words we compute the 'Pension Point'.

Bribe-Taking by Bureaucrats: Personal and Circumstantial Determinants

OpenAIRE

Chi, Wei; Wang, Yijiang

2008-01-01

We argue that personal (e.g., age, gender and education) and circumstantial (e.g., bureaucratic rank and sector of employment) factors affect the cost and the benefit of bribe-taking by the bureaucrats. The bureaucrat’s bribe-taking decision is modeled. A unique data set is used to test the predictions of the model. The empirical findings include that education reduces, but power (measured by rank and sector of work) increases, the magnitude of bribe-taking. Age affects bribe-taking in a ...

Bureaucratic oppression: its causes and cures

Directory of Open Access Journals (Sweden)

Edward L. Rubin

2017-12-01

Full Text Available Objective to consider and study the legal procedures aimed at deterring bureaucratic oppression. Methods dialectic approach to cognition of social phenomena enabling to analyze them in historical development and functioning in the context of the totality of objective and subjective factors that determined the choice of the following research methods analysis synthesis comparison systematic formallegal comparativelegal methods. Results the auricle views legal procedures aimed at deterring bureaucratic oppression. The author comes to the conclusion that these legal procedures are one of the multiple mechanisms which allow regulation of interaction between a state and private persons. As the problem extends to an extremely broad range of interactions the paper analyzes and reveals the features of only certain types of potentially oppressing interactions between a state and citizens the treatment of business enterprises by regulatory agencies the treatment of government grantees by funding agencies the treatment of individuals by protective services and the treatment of individuals in government institutions. Scientific novelty Part I of the Article discusses the sources of bureaucratic oppression and identifies four such sources status differences stranger relations institutional pathologies and divergent incentives. Part II explores four solutions to the problem of bureaucratic oppression that have been proposed and in some cases implemented. The first two ndash the judicial solution of due process and the legislative solution of ombudspersons involve actors external to the administrative system. The second two ndash the management theory solution of clientcentered administration and the microeconomic solution of market simulating mechanisms ndash are internal to that system. Because of the limitations of these various solutions Part III proposes an additional solution described as a collaborative monitor. This monitor would be an agency of the

Legal-sounding bureaucratic re-centralisation of community forestry in Nepal

DEFF Research Database (Denmark)

Basnyat, Bijendra; Treue, Thorsten; Pokharel, Ridish Kumar

2018-01-01

, forest officials, and donor project employees in Nepal, we document the mechanisms of legal-sounding re-centralisation. The central tenet is that bureaucratically established procedures, which are not required by law but treated as if they were, are used to impose regular revisions of community forest...... management plans. Meagre government or more generous donor budgets financed the revisions. Forest bureaucrats and/or consultants did the work and benefitted financially. None of the approaches, however, lived up to technical, scientific standards or followed stipulated participatory processes. The revised...... of plan revisions appears to be strengthening or re-establishing the forest bureaucracy's control over community forest resources which allows forest bureaucrats to tap into donor project and forest product value chains....

Why Does Bureaucratic Corruption Occur in the EU?

DEFF Research Database (Denmark)

Brandt, Urs Steiner; Svendsen, Gert Tinggaard

2013-01-01

Why does bureaucratic corruption occur in the EU system? Several examples suggest that bureaucratic corruption exists and that the Commission’s anti-fraud agency, OLAF, is not a fully independent authority. We thus develop a novel interpretation of the principalsupervisor-agent model to cope...... with non-independent anti-fraud units. This model shows that corruption is likely to occur when the expected value to the client from bribing the agent is larger than the expected value to the principal of truth-telling by the supervisor. Overall, this analysis points to the risks of flawed incentives...

The Relationship of Student Teachers' Bureaucratic Orientation to Verbal Classroom Behavior.

Science.gov (United States)

Sturm, Dieter W. F.

1979-01-01

Determines the relationship of student teachers' commitment to values, attitudes, and behaviors characteristically fostered by bureaucratic organizations and their verbal classroom behavior while teaching. Findings reveal no difference in verbal classroom behavior of student teachers high and low in bureaucratic orientation, and no difference in…

Professional Performance and Bureaucratic Benchmarking Information

DEFF Research Database (Denmark)

Schneider, Melanie L.; Mahlendorf, Matthias D.; Schäffer, Utz

controls because of organizational-professional conflicts. We therefore analyze the association between bureaucratic benchmarking information provision and professional performance and suggest that the association is more positive if prior professional performance was low. We test our hypotheses based...

Disability and Bureaucratic Forms of Life

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Thomas Abrams

2015-06-01

Full Text Available This paper employs a hybrid actor-network theory/phenomenological approach to a frequent bother in the lives of disabled persons: bureaucratic forms. I argue that these forms are key sites where disabled personhood emerges, something I examine through the lens of what philosopher Annemarie Mol calls ‘ontological politics’. To be disabled is to be entered into the bureaucratic form of life. These forms translate human existence into a categorize-able, transportable and combinable object, to be administered through ‘centers of calculation’. Combining Heidegger’s fundamental ontology with Latour’s theory of paperwork, I suggest that these forms represent disability in terms of ‘objective presence’, as a mere pre-existing thing, rather than a human way of being. I conclude with suggestions for further phenomenological research that takes embodied difference as its point of departure.

The Will to Bureaucratic Control.

Science.gov (United States)

McMurtry, John

1992-01-01

Addresses the problem of bureaucratic control over what is taught and how in the classroom. Suggests that only by allowing classroom teachers to be part of curriculum decisions will public schools promote the growth of academic freedom and creative thinking. Argues that quality teaching is more important than political safety or obedient teachers.…

Initial treatment of severe malaria in children is inadequate – a study ...

African Journals Online (AJOL)

-medicated at home. Initial consultations are at primary local health facilities where less effective drugs are prescribed at inadequate dosages. Recommended ACTs were also often prescribed at inadequate dosages. Education in the use of ...

Politicians, Managers, and Street-Level Bureaucrats

DEFF Research Database (Denmark)

J. May, Peter; Winter, Søren

This article addresses the influence of politicians, managers, and the dispositions of street-level bureaucrats in shaping actions at the frontlines of policy implementation. We investigate these for the implementation of employment policy reforms in Denmark. Our findings show a large percentage ...

Domesticating Uncertainty - Reflections on electoral and bureaucratic practices in a election office

DEFF Research Database (Denmark)

Vadgård, Anne Kathrine Pihl

Election Day is often considered a celebration of democracy in which politicians and voters alike partake in the festivities. They vote, campaign discuss, and engage. Election Day is, however, also the culmination of months and months of preparation behind the scene. In the bureaucratic engine ro...... discussions of accountability and control with remote bureaucratic sites.......Election Day is often considered a celebration of democracy in which politicians and voters alike partake in the festivities. They vote, campaign discuss, and engage. Election Day is, however, also the culmination of months and months of preparation behind the scene. In the bureaucratic engine room...... – the election office – every little step towards this celebratory day and the subsequent counting of the ballots are planned meticulously. By following these often mundane and ordinary practices at a Danish election office this paper discusses the bureaucratic infrastructures, in which electoral and democratic...

The organization of political parties and the politics of bureaucratic reform

OpenAIRE

Cruz, Cesi; Keefer, Philip

2013-01-01

Bureaucratic reform is a priority of donor organizations, including the World Bank, but is notoriously difficult to implement. In many countries, politicians have little interest in the basic financial and personnel management systems that are essential to political oversight of bureaucratic performance. To explain this, this paper presents a new perspective on the political economy of bur...

The Conflict of Professionals in Bureaucratic Organizations

Science.gov (United States)

Sorensen, James E.; Sorensen, Thomas L.

1974-01-01

A study of 264 certified public accountants in large public accounting firms showed that when professionals work in a professional-bureaucratic organization, conflict and deprivation result with predictable consequences such as job dissatisfaction and job migration. (Author)

The Humanities Amidst the Bureaucratic Realities.

Science.gov (United States)

Terrey, John

1983-01-01

Examines the prospects for the humanities within the bureaucratic structure which determines resource allocations. Suggests that higher education be viewed as big business to help clarify ways in which change, policy, and individuals interact within complex settings. Concludes that leadership is needed to sustain the role of the humanities within…

The Professional-Bureaucratic Conflict: Origins, Implications, Resolution.

Science.gov (United States)

Angona, Judith; Williams, Leonard B.

1981-01-01

Examines the literature on the inevitable conflict in modern organizations between the professional's training for self-administration and bureaucratic denial of individual initiative and draws implications for administrative techniques that can help win the loyalty of a professional staff. (Author/WD)

School Bureaucratization and Alienation from High School

Science.gov (United States)

Anderson, Barry D.

1973-01-01

The major goals of this study are to identify dimensions of bureaucracy and alienation, to determine the relationship of these dimensions to second-order, or integrating, factors, and to determine the relationships between the integrating factors of bureaucratic structure and alienation. (Author)

Managers as consultants:The hybridity and tensions of neo-bureaucratic management

OpenAIRE

Sturdy, Andrew J; Wright, Christopher; Wylie, Nick

2016-01-01

The nature and extent of changes in management remain subject to debate, especially around the notion of post-bureaucracy. Most research concedes that, partly in response to critiques of bureaucracy, some change has occurred, but towards hybrid or neo-bureaucratic practices which retain core elements of bureaucratic organisation. However, both the mechanisms through which these changes have occurred and their outcomes have received less attention. This paper addresses these issues by focusing...

Analyzing Red Tape: The Performative vs Informative Roles of Bureaucratic Documents

OpenAIRE

Lee, R.M.

1980-01-01

The preparation and transfer of documents bureaucratic procedures are generally viewed solely as a means of transferring information within the organization. When taken as the basis for analyzing and improving bureaucratic systems, this view is too narrow. Another, performative aspect of these documents also needs to be considered in the analysis. This paper elaborates on this additional function of organizational documents and points out the need for a broader framework for analyzing bu...

Bureaucratization and Adaptive Behavior in the Higher Education

Directory of Open Access Journals (Sweden)

Vyacheslav V. Volchik

2016-12-01

Full Text Available The paper is devoted to researching the economic behavior of individuals in the higher education in the term of increasing bureaucratization. Reasons of bureaucracy and inefficiencies generated by it are considered on the example of the higher education sector. Constant changes in the bureaucratic system requirements need to be adapted in the behavior of actors. The authors highlight approaches to adaptation within the framework of the Austrian school of economics. Austrian approaches to adapt and the adaptive rationality concept in institutional economics are compared. The role of rationality in the process of adaptation is shown in the research. The empirical basis of the study is represented by the transcripts of 50 in-depth interviews conducted in 2015 with students, lecturers and heads of higher education institutions of the Rostov region. The main objective of the interview is the allocation of institutional change in higher education. Bureaucratization was named by respondents as one of the most important changes. The paper systematizes the respondents' answers on the impact of bureaucracy and carries out typology of adapting ways to the formal innovations. Imitating practices as a form of adaptation to the growth of the formal requirements are considered clearly. The authors display the negative impact of this adaptation form to the quality of educational activities and organizational culture.

The bureaucratization of war: moral challenges exemplified by the covert lethal drone

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Richard Adams

2013-12-01

Full Text Available This article interrogates the bureaucratization of war, incarnate in the covert lethal drone. Bureaucracies are criticized typically for their complexity, inefficiency, and inflexibility. This article is concerned with their moral indifference. It explores killing, which is so highly administered, so morally remote, and of such scale, that we acknowledge a covert lethal program. This is a bureaucratized program of assassination in contravention of critical human rights. In this article, this program is seen to compromise the advance of global justice. Moreover, the bureaucratization of lethal force is seen to dissolve democratic ideals from within. The bureaucracy isolates the citizens from lethal force applied in their name. People are killed, in the name of the State, but without conspicuous justification, or judicial review, and without informed public debate. This article gives an account of the risk associated with the bureaucratization of the State's lethal power. Exemplified by the covert drone, this is power with formidable reach. It is power as well, which requires great moral sensitivity. Considering the drone program, this article identifies challenges, which will become more prominent and pressing, as technology advances.

Who Are the Post-Bureaucrats?

OpenAIRE

Johnsen, Christian Garmann

2015-01-01

This thesis undertakes a philosophical examination of three figures at the heart of post-bureaucratic thought – the figures of the creative manager, the authentic leader and the entrepreneur. While the figures of the creative manager, the authentic leader and the entrepreneur share the aim of resolving the crisis of Taylorism, this thesis argues that they produce their own internal crises. They do so because the figures of the creative manager, the authentic leader and the e...

Bureaucratic Corruption, MNEs and FDI

OpenAIRE

Dahlström, Tobias; Johnson, Andreas

2007-01-01

This paper adds to the limited number of studies analysing the relationship between host country corruption and FDI inflows. A model describes the incentives foreign MNEs and host country bureaucrats have for engaging in corruption and shows how corruption increases the MNE costs of operations in the host country. The model predicts that the costs caused by corruption reduce FDI inflows. Regression analysis using panel data finds that host country corruption has a significant negative effect ...

Bureaucratic (?) Failures: Causes and Cures

OpenAIRE

Fiorina, Morris P.

1982-01-01

Bureaucracy is a traditional object of disparaging commentary, but in recent years it has received more than a proportionate share of popular and political criticism. Perceived problems of wasteful, unresponsive, power-hungry, and out-of-control bureaucracy have generated calls for across the board cut-backs in bureaucratic size and authority, as well as for various structural reforms designed to limit the activities of what is left after the pruning. This paper argues that much criticism of ...

Using Literature to Teach about Bureaucratic Structure.

Science.gov (United States)

Carroll, Virginia Schaefer; Gailey, Joan D.

1992-01-01

An interdisciplinary business administration course taught at Kent State University (Ohio) uses literature to teach bureaucratic structure, based on the idea that, for business students, studying literature is an opportunity to develop alternative methods of perceiving and managing human resources. The curriculum is described and the reading list…

Socio-phenomenological perspective of the bureaucratic organizational structure

Directory of Open Access Journals (Sweden)

Jairo E. Cuenú Cabezas

2011-12-01

Full Text Available To accomplish their purposes in carrying out their activities, organizations need a structure. The word structure is used by different disciplines, which - in general terms - conceive it as an order-relation. In organizational theory, the word structure essentially defines the relationships amongst individuals to reach a given end. The organizational structure is a product of the interaction of human beings and it is they, from their experiences, rationalities, and expectations, who determine how the purposes should be accomplished. Different forms exist, in terms of structure, to accomplish organizational purposes; one of the most representative forms is the bureaucratic approach. Bureaucracy is a method to use special abilities. This cannot be denied, but it is also a form, from Alfred Schütz’ phenomenological sociology, of establishing settings of intimacy and anonymity in organizational relations. The objective of this article is to show how the bureaucratic structure generates intimacy or anonymity in the organization. In the first place, the article presents the concept of structure from which the organizational structure is explained, especially the bureaucratic structure. The second part presents Alfred Schütz’ phenomenological sociology, emphasizing on the concept he raised of the world of everyday life and the relations of otherness. With the aforementioned, intimacy and anonymity in the organization is developed or explained. In conclusion, among other aspects, we address the need for the organizational theory or for organizational theorists to approach everyday life in organizations

THE BUREAUCRATIC PHENOMENON: CLASSICAL CONCEPTS

OpenAIRE

Дама Ибрагима

2013-01-01

Aim of this article - to analyze Hegel and Karl Marx’s classic bureaucracy theories and also Max Weber’s concept of rational bureaucracy and its development in the works of Herbert Simon, Robert Merton, Peter Blau and Michel Crozier. It shows that the above listed researchers only undertook a change of terminology within the same theoretical tradition. The article describes different approaches to the bureaucratic system of administrative schools of the late 1950s and early 1980s. Major concl...

How politicians and bureaucrats network

DEFF Research Database (Denmark)

Alexander, Damon; Lewis, Jenny; Considine, Mark

2011-01-01

Effective public administration relies on the passage of information through interpersonal communication networks. While we have a vast research literature concerning formal structures and roles in organizations, including public agencies and government institutions, we know far less about the flow...... of information through semiformal, voluntary interactions. In this paper we use a large survey to explore the networking patterns of politicians and bureaucrats and to compare these with the more formal structural attributes of hierarchy and functional specialization. Social network analysis and standard...

Bureaucratic Corruption and Profit Tax Evasion

OpenAIRE

Laszlo Goerke

2006-01-01

Firms may evade taxes on profits and can also avoid fulfilling legal restrictions on production activities by bribing bureaucrats. It is shown that the existence of tax evasion does not affect corruption activities at the firm level, while the budgetary repercussions of tax evasion induce less corruption. Policy measures which alter the gains or losses from corruption have a non-systematic impact on tax evasion behaviour.

Bureaucratic oppression: its causes and cures

OpenAIRE

Edward L. Rubin

2017-01-01

Objective to consider and study the legal procedures aimed at deterring bureaucratic oppression. Methods dialectic approach to cognition of social phenomena enabling to analyze them in historical development and functioning in the context of the totality of objective and subjective factors that determined the choice of the following research methods analysis synthesis comparison systematic formallegal comparativelegal methods. Results the auricle views legal procedures aimed at...

Techno-Bureaucratic Governance and Public Service Delivery: Indonesia and Nigeria in Perspectives

Directory of Open Access Journals (Sweden)

Jacob Olufemi Fatile

2015-09-01

Full Text Available Techno-bureaucratic governance is fundamental to contemporary public service. This is because the roles of the bureaucrats and technocrats become more relevant in policy formulation and implementation when the government had to (reinvent its institutions to move from routine administration to that of development planning and management. Utilizing a qualitative approach, the paper notes that techno-bureaucratic ideology values technical expertise itself and its technical experts, efficiency, economic development and effective public service delivery. Adopting comparative perspective, the paper examines techno-bureaucratic governance and public service delivery in Indonesia and Nigeria. The paper takes a cursory look at the similarities and differences between the two countries. The paper notes that the technocracy nurtured by the New Order in Indonesia was cohesive and effective because of its technical expertise and has helped Indonesia to turn oil income into productive investments,whereas in Nigeria the oil income was used for prestigious projects to the detriment of productive investments. The paper therefore recommend among others that developing societies need a new strategy in delivery services in their public service, and this can be achieved through skilled professionals, technocrats and knowledge based actors. It concludes that for public service to deliver effective services, an efficient bureaucracy and technocracy remain invaluable.

The Policy Choices of Bureaucrats: an institutional analysis

NARCIS (Netherlands)

S. Naseer (Shaheen)

2018-01-01

textabstractThis dissertation analyzes the over-arching question of how the institutional and social context of public bureaucracy impact the choices of bureaucrats. These choices are introduced in the form of inertial-preferences and identity-driven preferences in the decision-making of

What Is Political about Bureaucratic-Collegial Decision-Making?

Science.gov (United States)

Childers, Marie E.

1981-01-01

A fundamental assumption that bureaucratic, collegial, and political models of administration are independent and distinct is challenged, and process and structure within higher education institutions are differentiated as they describe role and power relationships and lines of authority. Survey results are cited as evidence and implications are…

Effective emergency management: reconsidering the bureaucratic approach.

Science.gov (United States)

Neal, D M; Phillips, B D

1995-12-01

The command and control approach is compared with the Emergent Human Resources Model (EHRM) approach to emergency management. Four decades of systematic research shows that a rigid, bureaucratic command and control approach to emergency management generally leads to an ineffective emergency response. Previous studies and our own research suggest that flexible, malleable, loosely coupled, organizational configurations can create a more effective disaster response.

Bureaucratic power in note-writing: authoritative expertise within the state.

Science.gov (United States)

Mangset, Marte; Asdal, Kristin

2018-02-24

What produces the power of senior civil servants at ministries of finance, positioned at the top of the bureaucratic hierarchy? Max Weber has claimed that a hierarchical organization, meritocratic recruitment and procedural work provide bureaucracies with legitimacy. In particular he insisted on the role of Fachwissen (disciplinary knowledge) obtained through formal education. However, he also argued for the role of Dienstwissen, forms of knowledge and skills stemming from the experience of service in itself. Weber did not elaborate on this concept in detail, and few analysts of governmental expertise have examined this notion. We draw on the practice-turn in sociology, combining the study of governmental expertise with micro-sociological studies of administrative practices. By analysing interviews with 48 senior civil servants at the British, French and Norwegian ministries of finance about their daily practices, this article demonstrates that bureaucratic note-writing and the procedural evaluation of such notes constitute a key form of expertise that yields authority. The study provides an analytical framework for understanding what administrative expertise consists of, how it is integral to procedural work, the forms bureaucratic hierarchies take in practice and how these three dimensions provide authority. © London School of Economics and Political Science 2018.

Street-level bureaucrats help clients, even in difficult circumstances

NARCIS (Netherlands)

Tummers, L.G.

2015-01-01

This policy brief presents the main findings of the Marie Curie Project “COPING: Policy implementation in stressful times: Analyzing coping strategies of civil servants”. The project combines insights from public administration and psychology to study how street-level bureaucrats (also termed

Street-level bureaucrats help clients, even in difficult circumstances

NARCIS (Netherlands)

L.G. Tummers (Lars)

2015-01-01

textabstractThis policy brief presents the main findings of the Marie Curie Project “COPING: Policy implementation in stressful times: Analyzing coping strategies of civil servants”. The project combines insights from public administration and psychology to study how street-level bureaucrats (also

Politicians, Managers, and Street-Level Bureaucrats

DEFF Research Database (Denmark)

May, Peter J.; Winter, Søren

2010-01-01

This article addresses the influence of politicians, managers, and the dispositions of street-level bureaucrats in shaping actions at the frontlines of policy implementation. We investigate these for the implementation of employment policy reforms in Denmark. Our findings show a large percentage...... of caseworkers emphasizing actions that are consistent with the national employment reform goal of getting clients into jobs quickly. The influence of politicians and managers in bringing this about is relatively limited in comparison to the influences of caseworkers’ understanding of policy goals...

Politicians, Managers, and Street-Level Bureaucrats

DEFF Research Database (Denmark)

J. May, Peter; Winter, Søren

2009-01-01

This article addresses the influence of politicians, managers, and the dispositions of street-level bureaucrats in shaping actions at the frontlines of policy implementation. We investigate these for the implementation of employment policy reforms in Denmark. Our findings show a large percentage...... of caseworkers emphasizing actions that are consistent with the national employment reform goal of getting clients into jobs quickly. The influence of politicians and managers in bringing this about is relatively limited in comparison to the influences of caseworkers’ understanding of policy goals...

Bureaucrats Versus the Ballot Box in Foreign Policy Decision Making: An Experimental Analysis of the Bureaucratic Politics Model and the Poliheuristic Theory

Science.gov (United States)

Christensen, Eben J.; Redd, Steven B.

2004-01-01

The bureaucratic politics model and the poliheuristic theory are used to examine how political advice presented in various contexts influences choice. Organizational advisers who offer endogenous political advice are compared with situations in which the decision maker is offered advice by a separate, or exogenous, political adviser. Results show…

Managerial use of performance data by bureaucrats and politicians

DEFF Research Database (Denmark)

Moynihan, Donald P.; Nielsen, Poul Aaes; Kroll, Alexander

2017-01-01

This chapter examines experimental evidence on performance informa- tion use by public officials – including both bureaucrats and politi- cians – charged with managing public services. Unlike topics covered in many of the chapters in this book, the topic is relatively new, and while observational...

When Politics Matters: The Impact of Politicians' and Bureaucrats' Policy Preferences on Salient and Nonsalient Policy Areas

DEFF Research Database (Denmark)

Bækgaard, Martin; Blom-Hansen, Jens; Serritzlew, Søren

2015-01-01

whether politics still matters when bureaucratic preferences are taken into account. We do this in a simultaneous test of political and bureaucratic influences on public budgets, a policy measure often studied in the ‘politics matters’ literature. We find that political preferences trump bureaucratic ones...... in policy areas salient to the public, but not in less salient areas. This might be comforting news from a democratic perspective. However, since public budgets represent an easy case for political influence, it is food for thought that political preferences do not always prevail....

Bureaucratic corruption and anti-corruption strategies in Nigeria: an ...

African Journals Online (AJOL)

This paper derives from the contemporary concern facing good governance and the sustainability of democratic government in Nigeria. The phenomenon of corruption i.e. bureaucratic corruption has negative implications on the nation and therefore capable of terminating our nascent democracy, hence, the need to curb or ...

Bureaucratic accountability in the education action zones of South ...

African Journals Online (AJOL)

The Education Action Zone program me in Gauteng p rovince, South A frica, has been w idely seen as a very successful school improvement initiative, with particular significance as it represents a unique model of top-down, bureaucratic accountability as a vehicle for turning- around dysfunctional secondary schools. In this ...

Organizing Special Operations Forces: Navigating the Paradoxical Requirements of Institutional-Bureaucratic and operational Environments

DEFF Research Database (Denmark)

Dalgaard-Nielsen, Anja

2017-01-01

Increased focus on the potential of special operations has lead several countries to establish dedicated special operations organizations. Analysts have warned against bureaucratization, yet little research has explored the effect of organizational formalization or asked how best to organize....... This article draws from research into high-reliability organizations and interviews in Denmark’s Special Operations Command. It contrasts the demands of the command’s institutional-bureaucratic and operational environments and argues that the ability to straddle them is key to success. The high...

Bureaucratic Corruption: Efficiency Virtue or Distributive Vice?

OpenAIRE

Kulshreshtha Pravin

2003-01-01

Governments frequently allocate resources at low prices and on a first-come-first-served basis because of reasons of equity and a concern for the poor. However, bureaucrats who distribute these resources often take bribes. This paper develops a rigorous model to analyze the distributional, efficiency and public policy implications of bribery in such situations. It is shown that at low prices, the poor would choose to wait while the rich would pay the bribe to obtain the rationed commodity. If...

Bureaucratic Structure in Schools: A Refinement and Synthesis in Measurement.

Science.gov (United States)

Sousa, David A.; Hoy, Wayne K.

1981-01-01

Compares two methods of measuring bureaucratic structure, Hall's organizational inventory and the University of Aston (England) approach, and tests them using data from 55 public high schools in New Jersey. Factor analysis reveals four underlying dimensions of school structure, including organizational control, rational specialization, system…

Soviet Education Policy 1917-1935: From Ideology to Bureaucratic Control.

Science.gov (United States)

Lauglo, Jon

1988-01-01

Examining early Soviet educational policy, Lauglo analyzes the initial expression of Marxist humanist values, popular participation, and the value of productive work for general education. Discusses the routinization into a Stalinist pattern of bureaucratically controlled utilitarianism and comments briefly on recent indications of change in…

Bureaucratic Complexity and Impacts of Corruption in Utilities

OpenAIRE

Tøndel, Line; Søreide, Tina

2008-01-01

This paper explores how the relationship between bureaucratic complexity and corruption affects the performance in utilities. We observe considerable variation in the performance of the utilities across countries, also across countries which appear to be relatively similar in terms of GDP per capita. Our hypothesis is that corruption is an important explanatory factor. In particular, corruption coupled with a complex regulatory structure can have negative effects on performance in this sector...

Bureaucratic Tax-Seeking: The Danish Waste Tax

DEFF Research Database (Denmark)

Christoffersen, Henrik; Svendsen, Gert Tinggaard

2002-01-01

model. These suggestions are confirmed by the case of the Danish waste tax with its fixed price approach and perverse incentives compared to that of achieving environmental target levels in a cost-minimising way. Thus, we recommend that bureaucratic institutions should coordinate their tax......-seeking efforts to maximise budgets in the long run and that the ministries that collect green tax revenues should not be allowed to control these revenues. Furthermore, our results dictate that postulated effects from green tax intervention need to be demonstrated....

Bureaucratic Reform in Irrigation: A Review of Four Case Studies

Directory of Open Access Journals (Sweden)

Diana Suhardiman

2014-10-01

Full Text Available Poor performance of government-managed irrigation systems persists globally. This paper argues that addressing performance requires not simply more investment or different policy approaches, but reform of the bureaucracies responsible for irrigation management. Based on reform experiences in The Philippines, Mexico, Indonesia, and Uzbekistan, we argue that irrigation (policy reform cannot be treated in isolation from the overall functioning of government bureaucracies and the wider political structure of the states. Understanding of how and why government bureaucracies shape reform processes and outcomes is crucial to increase the actual significance of reforms. To demonstrate this, the paper links reform processes in the irrigation sector with the wider discourse of bureaucratic reform in the political science, public administration, and organisational science literature. Doing so brings to light the need for systematic comparative research on the organisational characteristic of the irrigation bureaucracies, their bureaucratic identities, and how these are shaped by various segments within the bureaucracies to provide the insights needed to improve irrigation systems performance.

Indecopi’s bureaucratic barriers control and economic fundamental rights guardianship

Directory of Open Access Journals (Sweden)

César Ochoa Cardich

2013-12-01

Full Text Available This study analyzes the guardianship role on entrepreneurial freedom fundamental rights, non- discrimination in economic and property aspects exerted by the Elimination of Bureaucratic Barriers Commission from the National Institute for the Defense of Competition and IntellectualProperty (Indecopi developed throughout resolutions and administrative cases set up by the Defense of Competition Chamber #1. This role is particularly relevant in our legal system, due to their special functions the Elimination of Bureaucratic Barriers Commission is entitled by legal mandate to establish the non- application of rules in specific cases exercising legal control. This administrative function- initially misunderstood-has proved to be an efficient tool for the guardianship of economic rights due to our judicial system ineffectiveness in contentious administrative matters. The author considers the possibility of making a constitutional reform in order to provide specialized administrative bodies, such as INDECOPI, with the quality of “primary administrative jurisdiction” whose resolutions will only be reviewed by the State Council jurisdiction.

Bureaucrats, Budgets, and the BIA: Segmentary Opposition in a Residential School

Science.gov (United States)

Colfer, Carol J. Pierce

1975-01-01

The article describes the political system which operates in an American Indian school and discusses the striking analogy between the school's bureaucratic structure and operation and the structure and operation of a segmentary lineage system. (AUTHOR/NQ)

Combating political and bureaucratic corruption in Uganda: Colossal challenges for the church and the citizens

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Wilson B. Asea

2018-05-01

Full Text Available This article formulates a new approach to combating corruption in Uganda. In pursuit of this research, the author highlights the chronicity of corruption in Uganda, which is uniformly political and bureaucratic. Bureaucratic corruption takes place in service delivery and rule enforcement. It has two sides: demand-induced and supply-induced. Political corruption occurs at high levels of politics. There are ‘political untouchables’ and businessmen who are above the law and above institutional control mechanisms. The established institutions of checks and balances in Uganda have assiduously continued to have a limited bearing on corruption. Neither coherent anti-corruption norms nor severe formal sanctions are able to dishearten certain politicians and civil servants in Uganda from the deviant behaviour of structural corruption. Corruption is a spiritual departure from the law and standard of God. It is an action conceived in the human mind and carried out by the corrupt. Therefore, corruption deterrence not only lies in sound public financial management systems but depends to a large extent on having people with positive human character in all aspects of national life. This article thus provides the framework of corruption and discusses the manifestation of political and bureaucratic corruption in Uganda. It also exegetes the biblical stance regarding corruption. Finally, it proposes a panacea for combating political and bureaucratic corruption.

Multilevel Governance and Organizational Performance: Investigating the Political-Bureaucratic Labyrinth

Science.gov (United States)

Meier, Kenneth J.; O'Toole, Laurence J., Jr.; Nicholson-Crotty, Sean

2004-01-01

Research on governance has extensively explored the complex interactions of governmental, nongovernmental, and for-profit entities in the execution of public policy. It has consistently failed, however, to model empirically the joint effects of political and bureaucratic actors in governance systems. To address this issue, a theory of multilevel…

Parkinson's Law Quantified: Three Investigations on Bureaucratic Inefficiency

OpenAIRE

Klimek, Peter; Hanel, Rudolf; Thurner, Stefan

2008-01-01

We formulate three famous, descriptive essays of C.N. Parkinson on bureaucratic inefficiency in a quantifiable and dynamical socio-physical framework. In the first model we show how the use of recent opinion formation models for small groups can be used to understand Parkinson's observation that decision making bodies such as cabinets or boards become highly inefficient once their size exceeds a critical 'Coefficient of Inefficiency', typically around 20. A second observation of Parkinson - w...

Bureaucratism as a phenomenon of rational bureaucracy: the reasons of appearance and the ways of overcoming

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V. D. Bodnarchuk

2016-03-01

Full Text Available The essence and contents of the concepts «bureaucracy» and «bureaucratism» in domestic and foreign science are researched. Generalized definitions of these concepts from a position of public administration are proposed. It is proved that the bureaucracy is a necessary condition for the existence of public administration, without that it cannot perform its functions. As for the bureaucratism, it is negative and even destructive phenomenon, that destroys laws and social rules, limits public participation in making public and administrative decisions, slows reforms in the country. The reasons of the bureaucratism’s appearance in the system of public administration are analyzed, namely: the low professional and moral level of civil servants, the excessive politicization of public and administrative apparatus, the insufficient development of civil society institutions, including independent media, and the general low level of public consciousness and activity. It was demonstrated that the objective gap between the Max Weber’s bureaucracy ideal model and real public administration system is always a place for the signs of bureaucratism, such as formalism, individualism, automatism, that reduce the public administration effectiveness. Therefore the de-bureaucratization ways finding should not behave to full eradication of bureaucratism’s phenomenon that is a priori impossible, and to creating the conditions that makes it impossible the bureaucratism’s most threatening for the society forms - careerism, protectionism, bribery. The ways to bureaucratism’s overcoming, in particular through the institutionalization of civil society, the system auditing of public activities and the implementation of market processes in public administration, are suggested. The complex of these measures will contribute to rationalization and de-bureaucratization of public administration activity.

Critical Experience Amidst Bureaucratic Structures: Interdisciplinary Dialogue on Educational Futures.

Science.gov (United States)

Herman, Robin; Crawford, Jeffrey

The public schools of today are pictured as rigid bureaucratic structures, unresponsive to dynamic change, and stultifying to individual initiative and growth. A discussion is presented on the future needs of education that will meet expanding demands for greater freedom for the individual in a democracy to make intelligent decisions. Proposals…

The Impact of New Information Technology on Bureaucratic Organizational Culture

Science.gov (United States)

Givens, Mark A.

2011-01-01

Virtual work environments (VWEs) have been used in the private sector for more than a decade, but the United States Marine Corps (USMC), as a whole, has not yet taken advantage of associated benefits. The USMC construct parallels the bureaucratic organizational culture and uses an antiquated information technology (IT) infrastructure. During an…

Effect of Corrupt Behavior of the Forestry Bureaucrats on the Forest Sustainability

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Sudarsono Soedomo

2012-11-01

Full Text Available 800x600 This article show that corrupt bureaucrats do not always result in a negative effect on the forest sustainability. Even under a certain condition, a corrupt behavior may result in a positive effect on the forest sustainability. An inappropriate policy is more important a cause of the forest sustainability than a corrupt behavior. Therefore, fixing this structural mistake needs to be prioritized in combating the forest destruction, for this structural mistake is the real primary cause of the forest destruction in Indonesia. Fixing this structural mistake is much more effective in combating the forest destruction than finding honest bureaucrats. Keywords:     Birokrat, Distortionary, Nondistortionary, Kelestarian, Korup. Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4

[Red tape in psychiatry: on bureaucracy, bureaucratism, and our secret fondness for procedures].

Science.gov (United States)

Blom, J D; Smink, F R E; Kwidama, E V; Vladár Rivero, V M

2016-01-01

A frequent complaint in psychiatry is that the psychiatrist-patient relationship and the quality of care are hampered by bureaucratic processes. To provide an analysis of various types of bureaucracy in psychiatry that can serve as a starting-point for the improvement of care and the performance of qualitative studies. We conducted an exploratory study using PubMed, Google, and various Dutch medical journals. Contemporary psychiatry is characterised by a bureaucratic organization structure. Mental, somatic, and social problems are translated in a standardised manner into medical jargon which gives rise to a DSM diagnosis, a cost-price, and outcome measures. This medical-bureaucratic system has important virtues, provided it is applied efficiently and the patient-psychiatrist relationship remains intact. In the Netherlands, however, this balance has been disturbed. Future research can be facilitated if distinctions are made between various types of bureaucracy (referred to here as Hippocratic, Weberian, and Kafkaesque bureaucracy). In addition, we discuss various national initiatives which aim to counter bureaucracy, including initiatives of the Dutch government. If the patient-psychiatrist relationship is to regain its central role, bureaucracy needs to be countered constantly. The government can facilitate this process, but healthcare providers can also play a key role and meanwhile help to bring about a substantial reduction in the costs of care.

Supervisor Expertise: Resolving the Dilemma between Bureaucratic Control and Teacher Autonomy.

Science.gov (United States)

Street, Mary Sue; Licata, Joseph W.

1989-01-01

Ideally, teacher confidence in the principal's instructional or supervisory expertise can overcome concerns about professional autonomy and bureaucratic control. This study focuses on elementary teachers' perceptions of the relationships among the principal's supervisory expertise, teacher sense of autonomy, and the robustness of school climate.…

Bureaucratic Control or Professional Autonomy? Performance Management in New Zealand Schools.

Science.gov (United States)

Fitzgerald, Tanya; Youngs, Howard; Grootenboer, Peter

2003-01-01

Investigates New Zealand teachers' perceptions of the bureaucratic and professional approaches to performance management in their schools. In climate of increasing control of teachers' work and professional activities by the state, results indicate that school managers have adopted a professional approach to staff appraisal. (Contains 41…

Using Bureaucratic and Cultural Linkages to Improve Instruction: The Principal's Contribution.

Science.gov (United States)

Firestone, William A.; Wilson, Bruce L.

1985-01-01

Principals can influence teachers and instructional behavior by working through linkage mechanisms within the organizational structure of the school. Two types of linkages are identified: bureaucratic and cultural. Principals have access to linkages of both kinds; using linkages effectively, they can generate a common purpose in their schools. (MD)

Bureaucracy Versus Environment: The Environmental Costs of Bureaucratic Governance

Science.gov (United States)

Singer, S. Fred

The 15 contributors to this volume have an important message. They are convinced that both environmental and economic costs of bureaucratic management of natural resources are too high, and unnecessarily so. The main reason is an institutional one: Authority is given to those who do not bear responsibility for the consequences o f their actions.A classic case is the set of specific numerical emission standards for automobiles in the Clean Air Act Amendments of 1970. Congress arrived at these standards without a scientific basis, without technical analysis, and certainly without any consideration of costs and benefits. Only 3 years later did Senator Muskie ask the National Academy of Sciences to conduct a cost-benefit analysis. The NAS results were presented in a fashion that seemed to support the action of Congress; yet, the statutory emissions standards yielded marginal costs well beyond their marginal benefits. They had a major impact on Detroit during the 1970's, and very likely damaged, perhaps irreversibly, the competitive standing of the American automobile industry, a major segment of the U.S. economy. But the economic costs of these actions were never considered, least of all by the responsible bureaucrats. They were completely buffered from any consequences flowing from the exercise of their authority.

Politicians, Managers, and Street-Level Bureaucrats

DEFF Research Database (Denmark)

May, Peter J.; Winter, Søren

2012-01-01

This article addresses the influence of politicians, managers, and the dispositions of street level bureaucrats in shaping actions at the frontlines of policy implementation. We investigate these for the implementation of employment policy reforms in Denmark. Our findings show a large percentage...... of caseworkers emphasizing actions that are consistent with thenational employment reform goal of getting clients into jobs quickly. The influence of politicians and managers in bringing this about is relatively limited in comparison to the influences of caseworkers’ understanding of policy goals......, their professional knowledge, and their policy predispositions. Our main contribution is an unpacking of the political and managerial influences on caseworkers’ policy emphases. We find direct effects and, more notably, indirect effects that operate on the influence of caseworkers’ perceptions of policy goals...

The overprotective parent - Bureaucratic agencies and natural hazard management

OpenAIRE

Paul Raschky

2007-01-01

Due to the public good character of protective measures against natural disasters events, their allocation is very often in the realm of bureaucratic and expert agencies. Based on the economic theory of bureaucracy the behaviour of a bureau providing the good "protection against natural hazards" is analysed. The existing model is extended by further institutional constraints accounting for societal control mechanisms. The main proposition is that the allocation of protective measures through ...

25 CFR 170.811 - What happens if lack of funds results in inadequate maintenance?

Science.gov (United States)

2010-04-01

... maintenance? 170.811 Section 170.811 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM BIA Road Maintenance § 170.811 What happens if lack of funds results in inadequate maintenance? If BIA determines that an IRR transportation facility is not being...

The association between inadequate prenatal care and future healthcare use among offspring in the Bedouin population.

Science.gov (United States)

Estis-Deaton, Asia; Sheiner, Eyal; Wainstock, Tamar; Landau, Daniella; Walfisch, Asnat

2017-12-01

To evaluate the impact of inadequate prenatal care on long-term morbidity among the offspring of an ethnic minority population. A retrospective population-based cohort analysis was performed among all Bedouin women with singleton pregnancies who delivered in a tertiary medical center in Israel between January 1, 1991, and January 1, 2014. Morbidity was defined as pediatric hospitalization across six distinct disease categories before 18 years of age. The cumulative morbidity rates were compared for offspring born following pregnancies with either inadequate (prenatal care facility) or adequate prenatal care. Overall, 127 396 neonates were included; 19 173 (15.0%) were born following inadequate prenatal care. Pediatric hospitalizations for all morbidities other than cardiovascular ones were less frequent among the inadequate prenatal care group than the adequate prenatal care group (Pprenatal care group, with the exception of cardiovascular disease. Inadequate prenatal care correlated with reduced pediatric hospitalization rates among offspring, possibly owing to a lack of child healthcare service utilization within the Bedouin population. © 2017 International Federation of Gynecology and Obstetrics.

Nurse managers and budgeting: professional/bureaucratic conflict?

Science.gov (United States)

Abernethy, M A; Stoelwinder, J U

1988-01-01

Professional/bureaucratic conflict theory suggests that the extent to which nurse managers use management control systems will depend on whether their goal orientation is to system rather than output or derived goals. This article examines the use of budgeting as a management control strategy, in relation to the goal orientation of nurse managers, in four large teaching hospitals. The goal orientations and use of budgeting by nurse managers is also compared with those of physician managers and other sub-unit managers. The results indicate that nurse managers appear to be developing their goals of professionalization without a diminution of their organizational focus or their orientation towards providing a high standard of patient care.

The costs and benefits of 'red tape': anti-bureaucratic structure and gender inequity in a science research organization.

Science.gov (United States)

Roth, Wendy D; Sonnert, Gerhard

2011-06-01

This paper explicates a central conflict that can affect science research organizations, the conflict between the anti-bureaucratic stance believed to advance science and concerns for gender equity rooted in the universalist ethos of science. We present a case study of a science research organization, using employment and publication records, a survey of 308 employees, and qualitative interviews with 60 employees. We show how anti-bureaucratic organizational structures perpetuate gender inequities for both female scientists and non-scientists.

Manager’s decision-making in organizations –empirical analysis of bureaucratic vs. learning approach

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Jana Frenová

2010-06-01

Full Text Available The paper is focused on the study of manager’s decision-making with respect to the basic model of learning organization, presented by P. Senge as a system model of management. On one hand, the empirical research was conducted in connection with key dimensions of organizational learning such as: 1. system thinking, 2. personal mastery, 3. mental models, 4. team learning, 5. building shared vision and 6. dynamics causes. On the other hand, the research was connected with the analysis of the bureaucratic logic of decision-making process, characterized by non-functional stability, inflexibility, individualism, power, authority and hierarchy, centralization, vagueness, fragmentariness. The objective of the research was to analyse to what extent manager’s decision–making is based on bureaucratic tools or organizational learning in either complex problem-solving or non-problemsolving decision-making. (MANOVA, method of the repeated measure, intersubject factor – situation: 1. non problematic, 2. problematic. The conclusion of analysis is that there are significant differences in character of solving of problem situation and non-problem situation decision-making: the bureaucratic attributes of decision-making are more intensive in problematic situations while learning approach is more actual in non-problematic situations. The results of our analysis have shown that managers who apply the learning organization attributes in their decision-making. are more successful in problem-solving.

APPLICABILITY OF THE BUREAUCRATIC MODEL TO THE ORGANIZATIONAL STRUCTURE OF THE SCHOOL.

Science.gov (United States)

ANDERSON, JAMES G.

THE STUDY OBJECTIVES WERE (1) TO EXAMINE THE DEVELOPMENT AND FUNCTIONING OF RULES WITHIN THE SCHOOL, (2) TO DETERMINE WHETHER CERTAIN LATENT BUREAUCRATIC CHARACTERISTICS EXIST IN THE SCHOOL AND THEIR RELATION TO RULES, AND (3) TO DEVELOP LIKERT SCALES, TO MEASURE CERTAIN STRUCTURAL CHARACTERISTICS OF THE SCHOOL AND LATENT CHARACTERISTICS OF…

Electoral Proximity and the Political Involvement of Bureaucrats: A Natural Experiment in Argentina, 1904

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Valentín Figueroa

2016-01-01

Full Text Available In this paper, I use a slightly modified version of the Becker–Stigler model of corrupt behavior to explain bureaucratic political involvement. Since bureaucrats prefer higher rewards and not to support losing candidates, we expect them to become politically involved near elections – when rewards are expected to be higher, and information more abundant. Taking advantage of a natural experiment, I employ differences-in-means and differences-in-differences techniques to esti-mate the effect of electoral proximity on the political involvement of justices of the peace in the city of Buenos Aires in 1904. I find a large, positive, and highly local effect of electoral proximity on their political involvement, with no appreciable impact in the months before or after elections.

Beyond the Call of Duty? Essays on motivation and self-selection of bureaucrats

NARCIS (Netherlands)

M.W.J.M. Buurman (Margaretha)

2011-01-01

textabstractThe existence and effects of public service motivation (PSM), or altruism, among bureaucrats, is a well-debated topic among economists and administrative scientists (see e.g. Perry and Hondeghem 2008a, Besley and Ghatak 2005, Francois 2000 and 2007). However, the debate about motivation

Romanticizing Bureaucratic Leadership? The Politics of How Elected Officials Attribute Responsibility for Performance

DEFF Research Database (Denmark)

Nielsen, Poul A.; Moynihan, Donald P.

2017-01-01

A core task for elected officials is to hold bureaucratic leaders responsible, but how do they determine if public managers actually influence outcomes? We propose that partisan and leadership heuristics affect how politicians apply a logic of individualized responsibility, i.e. focus on individu...

THE BUREAUCRATIC PHENOMENON: CLASSICAL CONCEPTS

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Дама Ибрагима

2013-09-01

Full Text Available Aim of this article - to analyze Hegel and Karl Marx’s classic bureaucracy theories and also Max Weber’s concept of rational bureaucracy and its development in the works of Herbert Simon, Robert Merton, Peter Blau and Michel Crozier. It shows that the above listed researchers only undertook a change of terminology within the same theoretical tradition. The article describes different approaches to the bureaucratic system of administrative schools of the late 1950s and early 1980s. Major conclusions in the article include the following: administering the state apparatus consists in the organization of government on the basis of regulated rights, mandatory procedures that are invoked to ensure balance in the interest of man and society; bad effectiveness of government, infringement of the rights and freedoms of the individual is the result of dysfunction in the state apparatus; the struggle against it can be carried out with the help of administrative, economical and legal methods.DOI: http://dx.doi.org/10.12731/2218-7405-2013-6-45

The influence of bureaucrats on the policy-making process in the former Soviet Union: The case of Chernobyl

Science.gov (United States)

Kerner, Lucy Alexandra

The events that started to unfurl in the former Soviet Union in the beginning of the 1990s and that ended with the disintegration of the USSR caught many sovietologists, and specialists on former communist and socialist regimes by surprise. Major theories and analyses developed and successfully used in such areas as Comparative Politics, International Relations, and Comparative Socialism turned out to be impotent to foresee the approach of the dramatic changes. Noticing the growing significance of and influence on the policy making process of numerous bureaucracies, this study has applied alternative approaches that were developed in such fields as Organizational Theory, Bureaucratic Behavior, and Public Policy. The issue of bureaucratic performance in the former USSR became the central focal point of the study. Methods suggested by specialists in these fields permitted measurement of the performance of different bureaucratic medical institutions during and after the Chernobyl crisis. Utilization of performance measurements helped uncover several important phenomena. One, that performance of the Soviet medical institutions/organizations and bureaucracies that they housed reached an ultimate dysfunctional stage. It became counterproductive to the point that we can brand it pathological. The characteristic feature of pathological performance is that its outcomes (final results) have a totally counterproductive effect on the external environment and on the community which uses its services and/or products. In the case of Chernobyl it was medical services that were either very poorly provided to the victims of the accident or totally withheld from them The result was a manifold increase in different illnesses and deaths among the population affected by the accident. Second, behavior and performance of the medical bureaucracies in comparison with the behavior and performance of other Soviet bureaucracies has shown that it was not unique. This counterproductive behavior

CONSEQUENCES OF INADEQUATE ENGAGEMENT OF EXPERTS FOR BUILDING SPORT FACILITIES IN BAR

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Miodrag Banović

2010-09-01

Full Text Available In Bar we still do not have experiance that for investments in sport facilities, sport experts are consulted. Such an approach to this problem put in question racional reasons for an investment? Consequences: Such facilities were not built in accordance with the sport rules and could not be registrated to the Sports Associations for performance of official sport competitions. 1. Hotel „Topolica“, 1980. year (open swimming pool, 2. OŠ „Anto Đedović“, 1983. year (asfaltfloor playground, 3. Sportsko-rekreativni centar Bar, 1986. year (tartan track i asfaltfloor playground, 4. OŠ „Meksiko“, 1987. year ( gim, 5. Sportsko-rekreativni centar Bar, 1987. year (stadium dressing room, 6. Sportsko-rekreativni centar Bar, 2004. year (tartan track i asfaltfloor playground, i cross-country track 7. Rekreativni parak „Oaza“, 2005. godine ( trim track reconstruction and artificial light instalement at „Oaza“, 8. Sportsko-rekreativni centar Bar, 2009. year (football – tennis pitch, Distorical and descriptive methods were used. Subject of inquiery were sport facilities where sport rules were not followed.Vanity of certain persons has been fulfilled, but not the needs of sport population. If there is a wish that sport facilities should be in the function of sport in its full capacity, it is necessary that during construction, reconstruction and adaptation of such facilities expers are to be engaged.

Bureaucratic limits of firm size: Empirical analysis using transaction cost economics

OpenAIRE

Canbäck, Staffan

2002-01-01

This thesis was submitted for the degree of Doctor of Business Administration and awarded by Brunel University on behalf of Henley Management College This thesis tests Oliver Williamson’s proposition that transaction cost economics can explain the limits of firm size. Williamson suggests that diseconomies of scale are manifested through four interrelated factors: atmospheric consequences due to specialisation, bureaucratic insularity, incentive limits of the employment relation and communi...

Bureaucratic Tax-Seeking: The Danish Waste Tax

DEFF Research Database (Denmark)

Christoffersen, Henrik; Svendsen, Gert Tinggaard

2000-01-01

Two main results in traditional tax theory states the following. First, general taxes minimize the welfare loss from changed relative prices. Second, because the total public budget tends to exceed the optimal size, a leader (here named 'troop leader') is needed in the budget process to prevent...... over-taxation. Nevertheless, differentiated taxes initiated by individual ministries generate a still larger proportion of total tax revenue, in particular under cover of taxing externalities such as environmental pollution. We suggest that this situation leads to over-taxation for two reasons. First......, the absence of a strong and fully informed troop leader prevents rational coordination of collective action. Second, budget maximization leads to overwhelming fiscal pressure because bureaucracies are competing about resources just like fishermen or hunters (here named 'bureaucratic tax-seeking'). Taxing...

Private Practice Teachers in Public Schools: Reexamining Tensions between Professionalism and Bureaucratic Control.

Science.gov (United States)

Goldring, Ellen B.; Ogwa, Rodney

This paper examines the phenomenon of private-practice teachers in public schools. It helps frame the debates surrounding market-driven reforms that are aimed at freeing schools from bureaucratic control and raises several questions about the potential impact of private-practice teachers. It asks whether market-driven reforms within public schools…

Case Managers for High-Risk, High-Cost Patients as Agents and Street-Level Bureaucrats.

Science.gov (United States)

Swanson, Jeffrey; Weissert, William G

2017-08-01

Case management programs often designate a nurse or social worker to take responsibility for guiding care when patients are expected to be expensive or risk a major decline. We hypothesized that though an intuitively appealing idea, careful program design and faithful implementation are essential if case management programs are to succeed. We employed two theory perspectives, principal-agent framework and street-level bureaucratic theory to describe the relationship between program designers (principals) and case managers (agents/street-level bureaucrats) to review 65 case management studies. Most programs were successful in limited program-specific process and outcome goals. But there was much less success in cost-saving or cost-effectiveness-the original and overarching goal of case management. Cost results might be improved if additional ideas of agency and street-level theory were adopted, specifically, incentives, as well as "green tape," clear rules, guidelines, and algorithms relating to resource allocation among patients.

Does Introduction of Bureaucratic Competition Reduce Corruption in Public Service Delivery?

OpenAIRE

Banerjee, Panchali; Mukherjee, Vivekananda

2015-01-01

The paper theoretically explores the impact of introducing bureaucratic competition on corruption. For this purpose it considers three different measures of corruption such as corruption incidence (CI), relative corruption incidence (CRI) and corruption rents (CR) in two different types of economies namely corruption-tolerant economies and corruption-reliant economies. As it compares both intensive margin (i.e. the magnitude of bribe) and extensive margin (i.e. the number of bribe incident) o...

BUREAUCRATISM AS AN INDICATOR OF SYSTEMIC CONTRADICTIONS IN THE EDUCATION SYSTEM

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A. P. Usol'tsev

2018-01-01

Full Text Available Introduction. The problem of a sharp increase in paperwork done by experts of an education system, educators and teachers has been repeatedly brought up by the pedagogical community. The teachers have to draw up endless reports, plans, schedules, references; as a consequence, teachers have less time and energy to perform direct professional duties – training and education of younger generation. Nevertheless, continuous appeals of “masses” and recurrent promises of “heads” to reduce the unreasonable bureaucratic reporting have not led even to the minimum positive changes. The aim of the publication is the identification and discussion of the causes of bureaucratism in education; comparison of the tendencies of development of the world pedagogical system with the processes of development of the Russian system of education.Methodology and methods of research. The methodological framework is based on the holistic approach, the complex systems theory, and the synergetics foundations. The study is made up of the comparative, structural and functional analysis of educational systems with the methods of modeling and forecasting application.Results and scientific novelty. It is proved that bureaucratism has objective nature; it is an indicator of a crisis situation, which in turn, is a consequence of systemic contradictions not only within the framework of the existing education system but also in the whole pedagogical system as an ideal foundation of the education institutions functioning. Having reflected own practice and analysed pedagogical publications, the author has systematized the crises of education according to the singled out levels of the contradictions which differ with degree of “globality”. The groups of contradictions of each of the levels that determine the depth of the crisis are formulated and described: contradictions between the existing global pedagogical system and the social, technical, natural world surrounding

Inadequate housing in Ghana

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Franklin Obeng-Odoom

2011-01-01

Full Text Available Two themes are evident in housing research in Ghana. One involves the study of how to increase the number of dwellings to correct the overall housing deficit, and the other focuses on how to improve housing for slum dwellers. Between these two extremes, there is relatively little research on why the existing buildings are poorly maintained. This paper is based on a review of existing studies on inadequate housing. It synthesises the evidence on the possible reasons for this neglect, makes a case for better maintenance and analyses possible ways of reversing the problem of inadequate housing.

Relationship between Professional Learning Community, Bureaucratic Structure and Organisational Trust in Primary Education Schools

Science.gov (United States)

Kalkan, Fatma

2016-01-01

This research uses relational survey method to determine the relationship between professional learning community, bureaucratic structure and organisational trust according to the perceptions of teachers who work in primary education schools. Data were collected from 805 teachers who work in primary education schools in the districts (Altindag,…

Radiologists' responses to inadequate referrals

International Nuclear Information System (INIS)

Lysdahl, Kristin Bakke; Hofmann, Bjoern Morten; Espeland, Ansgar

2010-01-01

To investigate radiologists' responses to inadequate imaging referrals. A survey was mailed to Norwegian radiologists; 69% responded. They graded the frequencies of actions related to referrals with ambiguous indications or inappropriate examination choices and the contribution of factors preventing and not preventing an examination of doubtful usefulness from being performed as requested. Ninety-five percent (344/361) reported daily or weekly actions related to inadequate referrals. Actions differed among subspecialties. The most frequent were contacting the referrer to clarify the clinical problem and checking test results/information in the medical records. Both actions were more frequent among registrars than specialists and among hospital radiologists than institute radiologists. Institute radiologists were more likely to ask the patient for additional information and to examine the patient clinically. Factors rated as contributing most to prevent doubtful examinations were high risk of serious complications/side effects, high radiation dose and low patient age. Factors facilitating doubtful examinations included respect for the referrer's judgment, patient/next-of-kin wants the examination, patient has arrived, unreachable referrer, and time pressure. In summary, radiologists facing inadequate referrals considered patient safety and sought more information. Vetting referrals on arrival, easier access to referring clinicians, and time for radiologists to handle inadequate referrals may contribute to improved use of imaging. (orig.)

Missing Areas in the Bureaucratic Reputation Framework

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Moshe Maor

2016-06-01

Full Text Available Drawing on insights from social networks, social cognition and the study of emotions, this conceptual article offers a set of ideas and a series of predictions on how systematic variation in two sets of relationships may bear on agency behavior. The first is the agency-audience relationship which revolves around how and what multiple audiences think about public agencies, how these thoughts impact upon agency behavior, how information regarding this behavior is transformed within multiple audiences and how it influences audience memory and behavior regarding that agency. The second is the relationship between the reputation of an agency head and the reputation of that agency. The article identifies six broad areas that offer the most promising possibilities for future research on bureaucratic reputation, calling on researchers to incorporate insights from the aforementioned literatures, to dimensionalize these sets of relationships and to assess the generalizability of reputation’s effects.

Dealing with Law in migration control: The Powers of Street-level bureaucrats at French Consulates

NARCIS (Netherlands)

Alpes, M.J.; Spire, A.

2014-01-01

This article examines how street-level bureaucrats within migration control use their scope for discretionary powers. On the basis of two ethnographic studies of French consulates in Yaoundé and Tunis, we argue that state agents' practices are significantly shaped by organizational constraints such

Ethical decision making within the bureaucratic context: a case study.

Science.gov (United States)

Desai, Kathryn

2003-01-01

Balancing the polarized notions of quality and quantity of service and care is a challenge for the 21st century health and social service system. The expectation of transparent decision making at both the policy and the practice level of case management has forced practitioners to seek guidance in ethical decision making. Case management, as a system, has potential to lead this new practice approach by incorporating the principles of ethical decision making in planning and coordinating care. A recent case study of ethical decision making within the bureaucratic context offers some insight and learning and may help inform future practice.

Neutralized Politics by Bureaucratic Power in Turkey from 1923 to 2002

OpenAIRE

Erdal Gişi

2014-01-01

Although the Republic of Turkey is recognized as a country figured in opposition to the heritage of and in contrast with the Ottoman Empire, it is obvious that this viewpoint does not fully comply with realities. In this regard, it is possible to claim that the attempt of a bureaucratic group to control the whole social and political area, which also revealed itself for centuries in the Ottoman Period and became more evident in its last periods, has passed to the Republic. Center-periphery re...

Bureaucrats as Innovators? Statistical Analysis on Innovative Capacity within the Hungarian Central Civil Service

Directory of Open Access Journals (Sweden)

Marton GELLÉN

2016-12-01

Full Text Available What makes a public administration innovative if it is strongly legalistic and profoundly bureaucratic? Are there innovators in such a setting who would be able to elaborate strategies in accordance with public demands? If yes, who are the innovators and what are they like? Are they among the leaders? The article offers an answer to these questions based on an empirical research conducted in Hungary where public administration is not only legalistic but has a strong culture of topdown domination. The current study targets the key element of innovativeness namely: managerial and cultural prerequisites of innovation within central public administration. The empirical research was carried out in the Hungarian central civil service. The article also discusses whether such an environment would have an impact on innovations. According to the fi ndings of the article, certain prerequisites of an innovative environment exist in the given strictly hierarchic, traditionally stiff setting; however, traits of innovativeness can be identifi ed in innovators who are genuine bureaucrats at the same time.

An Essay on the History of the Russian and Soviet Bureaucratic Nomenclature

OpenAIRE

Alexander Obolonsky

2015-01-01

The topic of the paper is the history of Russian nomenclature bureaucratic system from the beginning of the 19-th century to the contemporary time. As the Soviet period is the main subject of attention, the earlier times are considered rather briefly, with the accent being made on the 19-th century attempts to modernize bureaucracy, particularly on M. Speranskys initiative to introduce an education criterion instead of the domineering then length of service, and also on periodical unsuccessfu...

96/5000 Other literature Bureaucratic records and traces of disappearances in Argentina

OpenAIRE

Emilio Crenzel

2014-01-01

In this article I examine a series of bureaucratic records produced during the military dictatorship by workers in two state agencies, a morgue and a public hospital, located in two different provinces of Argentina, Córdoba and Buenos Aires. In these public documents, these workers left evidence, for several and different reasons, on the existence of practices that integrated phases or moments of the system of forced disappearance of persons, a crime which distinguished the last military dict...

Trust in Management under Post-bureaucratic Conditions: The Case of Finnish Civil Servants

OpenAIRE

Jaakko Koivumäki; Pasi Pyöriä

2013-01-01

The Finnish state administration has recently undergone a wave of reforms towards decentralized decision-making and increased flexibility in organizing work. Traditional bureaucracy, however, has its virtues. Based on a survey and qualitative interview material, the results presented in this paper indicate that many characteristics of bureaucracy, such as well-defined work roles and hierarchical control, facilitate trust among employees. In contrast, the current post-bureaucratic model of org...

Implications of system usability on intermodal facility design.

Science.gov (United States)

2010-08-01

Ensuring good design of intermodal transportation facilities is critical for effective and : satisfactory operation. Passenger use of the facilities is often hindered by inadequate space, a poor : layout, or lack of signage. This project aims to impr...

The Relationship of Bureaucratic Structure to School Climate: An Exploratory Factor Analysis of Construct Validity

Science.gov (United States)

Lennon, Patricia A.

2010-01-01

This researcher examined the relationship of bureaucratic structure to school climate by means of an exploratory factor analysis of a measure of bureaucracy developed by Hoy and Sweetland (2000) and the four dimensional measure of climate developed by Hoy, Smith, and Sweetland (2002). Since there had been no other empirical studies whose authors…

Provision and financing of assistive technology devices in Germany: a bureaucratic odyssey? The case of amyotrophic lateral sclerosis and Duchenne muscular dystrophy.

Science.gov (United States)

Henschke, Cornelia

2012-05-01

The regulations for financing assistive technology devices (ATDs) are complex and fragmented and, thus, might influence adequate provision of these devices to people who need multiple ATDs. This study aims to explore and analyze patients' problems with the provision and financing of ATDs for the following two rare diseases: amyotrophic lateral sclerosis (ALS) and Duchenne muscular dystrophy (DMD). A survey was conducted by means of semi-standardized questionnaires addressing the issues of coverage decisions for ATDs and problems with provision of ATDs. Information was retrieved from ALS (n=19) and DMD (n=14) patients. Conducted interviews were transcribed verbatim and analyzed using qualitative content analysis. Respondents experienced difficulties with the provision and financing of ATDs. They underlined problems such as long approval processes and a serious bureaucratic burden, which induced inadequate provision of ATDs. Experiences of ALS and DMD respondents frequently were similar, especially regarding financing decisions and the process of decision making by sickness funds. The results suggest that difficulties in receiving and financing ATDs are common problems among ALS and DMD patients. There is a need for an interdisciplinary approach in the provision of ATDs and their financing, which should be coordinated by case managers. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Characteristics of the large corporation-based, bureaucratic model among oecd countries - an foi model analysis

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Bartha Zoltán

2014-03-01

Full Text Available Deciding on the development path of the economy has been a delicate question in economic policy, not least because of the trade-off effects which immediately worsen certain economic indicators as steps are taken to improve others. The aim of the paper is to present a framework that helps decide on such policy dilemmas. This framework is based on an analysis conducted among OECD countries with the FOI model (focusing on future, outside and inside potentials. Several development models can be deduced by this method, out of which only the large corporation-based, bureaucratic model is discussed in detail. The large corporation-based, bureaucratic model implies a development strategy focused on the creation of domestic safe havens. Based on country studies, it is concluded that well-performing safe havens require the active participation of the state. We find that, in countries adhering to this model, business competitiveness is sustained through intensive public support, and an active role taken by the government in education, research and development, in detecting and exploiting special market niches, and in encouraging sectorial cooperation.

Radiologists' responses to inadequate referrals

Energy Technology Data Exchange (ETDEWEB)

Lysdahl, Kristin Bakke [Oslo University College, Faculty of Health Sciences, Oslo (Norway); University of Oslo, Section for Medical Ethics, Faculty of Medicine, P.O. Box 1130, Blindern, Oslo (Norway); Hofmann, Bjoern Morten [University of Oslo, Section for Medical Ethics, Faculty of Medicine, P.O. Box 1130, Blindern, Oslo (Norway); Gjoevik University College, Faculty of Health Care and Nursing, Gjoevik (Norway); Espeland, Ansgar [Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Section for Radiology, Department of Surgical Sciences, Bergen (Norway)

2010-05-15

To investigate radiologists' responses to inadequate imaging referrals. A survey was mailed to Norwegian radiologists; 69% responded. They graded the frequencies of actions related to referrals with ambiguous indications or inappropriate examination choices and the contribution of factors preventing and not preventing an examination of doubtful usefulness from being performed as requested. Ninety-five percent (344/361) reported daily or weekly actions related to inadequate referrals. Actions differed among subspecialties. The most frequent were contacting the referrer to clarify the clinical problem and checking test results/information in the medical records. Both actions were more frequent among registrars than specialists and among hospital radiologists than institute radiologists. Institute radiologists were more likely to ask the patient for additional information and to examine the patient clinically. Factors rated as contributing most to prevent doubtful examinations were high risk of serious complications/side effects, high radiation dose and low patient age. Factors facilitating doubtful examinations included respect for the referrer's judgment, patient/next-of-kin wants the examination, patient has arrived, unreachable referrer, and time pressure. In summary, radiologists facing inadequate referrals considered patient safety and sought more information. Vetting referrals on arrival, easier access to referring clinicians, and time for radiologists to handle inadequate referrals may contribute to improved use of imaging. (orig.)

9 CFR 417.6 - Inadequate HACCP Systems.

Science.gov (United States)

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Inadequate HACCP Systems. 417.6 Section 417.6 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS § 417.6 Inadequate HACCP Systems. A HACCP system may be...

Trust in Management under Post-bureaucratic Conditions: The Case of Finnish Civil Servants

Directory of Open Access Journals (Sweden)

Jaakko Koivumäki

2013-12-01

Full Text Available The Finnish state administration has recently undergone a wave of reforms towards decentralized decision-making and increased flexibility in organizing work. Traditional bureaucracy, however, has its virtues. Based on a survey and qualitative interview material, the results presented in this paper indicate that many characteristics of bureaucracy, such as well-defined work roles and hierarchical control, facilitate trust among employees. In contrast, the current post-bureaucratic model of organizing work may increase insecurity and decrease trust.

Bureaucratic Behavior: A Review of the Theory and its Application to Serbian Public Administration

OpenAIRE

Jelena Žarković-Rakić

2007-01-01

A professional and competent public administration is necessary for successful transition from a socialist, centrally planned economy to a functioning market democracy. The difficulty lies in building an organized and effective civil service sector. This paper gives a brief overview of formal bureaucratic reasoning, beginning with Niskanen’s theory, followed by the principal-agent model. The "Weberian state hypothesis", which provides an alternative view of bureaucracies in less developed cou...

Factors associated with inadequate receipt of components and use of antenatal care services in Nigeria: a population-based study.

Science.gov (United States)

Agho, Kingsley E; Ezeh, Osita K; Ogbo, Felix A; Enoma, Anthony I; Raynes-Greenow, Camille

2018-05-01

Antenatal care (ANC) is an essential intervention to improve maternal and child health. In Nigeria, no population-based studies have investigated predictors of poor receipt of components and uptake of ANC at the national level to inform targeted maternal health initiatives. This study aimed to examine factors associated with inadequate receipt of components and use of ANC in Nigeria. The study used information on 20 405 singleton live-born infants of the mothers from the 2013 Nigeria Demographic and Health Survey. Multivariable logistic regression analyses that adjusted for cluster and survey weights were used to determine potential factors associated with inadequate receipt of components and use of ANC. The prevalence of underutilization and inadequate components of ANC were 47.5% (95% CI: 45.2 to 49.9) and 92.6% (95% CI: 91.8 to 93.2), respectively. Common risk factors for underutilization and inadequate components of ANC in Nigeria included residence in rural areas, no maternal education, maternal unemployment, long distance to health facilities and less maternal exposure to the media. Other risk factors for underutilization of ANC were home births and low household wealth. The study suggests that underutilization and inadequate receipt of the components of ANC were associated with amenable factors in Nigeria. Subsidized maternal services and well-guided health educational messages or financial support from the government will help to improve uptake of ANC services.

Applying Bureaucratic Caring Theory and the Chronic Care Model to Improve Staff and Patient Self-Efficacy.

Science.gov (United States)

Potter, Marcia A; Wilson, Candy

Patient activation and engagement can be powerful enablers for health outcomes that are just as important as staff engagement and satisfaction. The authors applied the Bureaucratic Caring Theory and the Chronic Care Model to a process improvement project designed to link activation, engagement, satisfaction, and health outcomes. Twenty-two adults with diabetes and 7 staff members caring for them participated in a 12-week process improvement project that incorporated a time-based element of longitudinal care with skill-based competencies to provide collaborative, team-based care to patients with type 2 diabetes. Patients completed satisfaction surveys at the end of their clinical encounters. Staff members completed satisfaction surveys pre- and postimplementation. The authors analyzed hemoglobin A1C levels pre- and postimplementation. As engagement and activation increased for both staff and patients, hemoglobin A1C levels decreased. The clinical implication is that the use of Bureaucratic Caring Theory may foster caring while broad application of the Chronic Care Model may improve self-efficacy, create healthier populations, and reduce health care costs.

Professional responses to post bureaucratic hospital reforms and their impact on care provision.

Science.gov (United States)

Johnsen, Helle

2015-06-01

Post bureaucracy is increasingly shaping how health care professionals work. Within hospital settings, post bureaucracy is frequently connected to loss of professional autonomy and protocol-based care. However, this development also affects relationships between care providers and care receivers. To explore experiences of post bureaucratic hospital reforms and their impact on care provision. Data builds on nine mini group interviews with midwives (n=three), nurses (n=three) and physiotherapists (n=three), in all thirty participants. Data was analysed using existing theories of professionalism and post bureaucracy. Two overarching themes were identified: 'Time, tasks and institutional duties' which referred to transformations in care practices, increased use of screening procedures, efficiency requirements and matching linear time to the psychosocial needs of patients. 'Managerial control of work' which described rising administrative demands, engaging in protective measures, younger professionals pressured by documentation obligations and fear of disciplinary procedures. The institutional context appears to play a key role shaping care practices. Although midwives, nurses and physiotherapists share similar experiences of post bureaucratic hospital reforms, changes in care provision can impact these professions in different ways. As a discipline, midwifery is founded on relationships between women and midwives. Standardised clinical care, performativity demands, litigation risks and rising administrative obligations are liable to challenge the provision of woman centred care. These changes may also result in increased inequity in maternity care by affecting some groups of women more than others. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

The Bureaucratization of Social Policies. The Management of Rural Food Programs in Argentina

Directory of Open Access Journals (Sweden)

Lorena Poblete

2008-01-01

Full Text Available Between 1995 and 1999 the reform of the wine production sector caused significant social changes in Mendoza (Argentina. The restructuring of the paternalistic model which had been the core of the old system of productivity made the rural workers to experience a complete lack of references. They went from a well—known and controlled poverty to a system of social instability in which even the basic resources were missing. The State, unable to satisfy the claims made by the rural workers, created a bureaucratic mechanism for the allocation of social aid.

The theory of bureaucratic caring for nursing practice in the organizational culture.

Science.gov (United States)

Ray, M A

1989-01-01

Changes in the health care environment have raised many questions related to patient care. How are political, economic, legal, and technological caring decisions made? How is spiritual caring fostered? How can ethical caring be the grounds on which moral decisions are made? What new policies must be designed to enhance the human perspective in corporate policy, and how will these principles and policies guide actions? The impact of the Theory of Bureaucratic Caring on the corporate enterprise will necessitate a system shift from a narrow to a broad focus where management and caring views can exist side by side and realistically represent the transformation of health care organizations to benefit humankind.

How Do Politicians Attribute Bureaucratic Responsibility for Performance? Negativity Bias and Interest Group Advocacy

DEFF Research Database (Denmark)

Nielsen, Poul A.; Moynihan, Donald P.

2017-01-01

Voters reward or punish politicians by deeming them responsible for positive and negative outcomes, but how, in turn, do politicians attribute responsibility to those who actually deliver public services? Inattention to this question renders incomplete current perspectives on democratic processes...... to attribute causal responsibility to bureaucratic leaders, but only in cases of low performance, suggesting a negativity bias in public sector responsibility attribution processes. Additionally, we offer evidence that interest group advocates influence how elected officials use performance information...... to attribute responsibility, but contingent on ideological alignment....

Transformational leadership and change readiness and a moderating role of perceived bureaucratic structure: an empirical investigation

OpenAIRE

Badri Abbasi

2017-01-01

The purpose of this study was to examine the relationship between transformational leadership and change readiness through perceived bureaucratic structure among government employees in Rasht. As a methodology, descriptive method was applied using questionnaire to collect data. The studied population consisted of 600 employees from three state organizations including Municipality, Gilan Tax Department and Gilan Justice Court. According to Morgan table, the sample size was estimated at 234. Th...

Unruly clients : a study of how bureaucrats try and fail to transform gatekeepers, communists and preachers into ideal beneficiaries

NARCIS (Netherlands)

Vries, de P.

1992-01-01

State-peasant relations in this book are studied by focussing on the strategies which farmers and bureaucrats deploy in a colonisation area of the Atlantic zone of Costa Rica in order to deal with forms of state intervention which include programmes, projects and other instruments of state

Toward an Integration of Organization Research and Practice: A Contingency Study of Bureaucratic Control and Performance in Scientific Settings.

Science.gov (United States)

Cheng, Joseph L. C.; McKinley, William

1983-01-01

A study of 288 research units in 66 universities in Austria, Belgium, Finland, and Sweden found that bureaucratic control, through national science policy influence on research themes, affected organizational performance positively in physics and chemistry (where paradigms are highly developed), and negatively in biology and geology (with less…

Clinical significance of inadequate endometrial biopsies prior to hysterectomy.

Science.gov (United States)

Turney, Emily H; Farghaly, Hanan; Eskew, Ashley M; Parker, Lynn P; Milam, Michael R

2012-01-01

To evaluate preoperative clinical risk factors associated with significant uterine histopathologic abnormalities in final hysterectomy specimens in patients with inadequate preoperative endometrial biopsies. This is an institutional review board-approved, retrospective cohort analysis of 469 consecutive patients who underwent preoperative endometrial biopsies with subsequent hysterectomy from January 1, 2005, to December 31, 2009, at the University of Louisville Medical Center. We analyzed risk factors for inadequate biopsy and for final diagnosis of endometrial pathology (defined as endometrial hyperplasia or uterine cancer). Of the 469 preoperative endometrial biopsies reviewed, 26.2% (123/469) were inadequate (IBx) and 73.8% (346/469) were adequate and benign. IBx on endometrial biopsies was associated with a greater risk of having significant uterine histopathologic abnormalities on final hysterectomy specimens (6.5% vs. 2.3%, RR 2.8 [95% CI 1.1-7.3], p = 0.04). Although inadequate endometrial biopsies are a common finding, they can be associated with significant uterine histopathologic abnormalities on final hysterectomy specimens.

Chiropractic physicians: toward a select conceptual understanding of bureaucratic structures and functions in the health care institution

Science.gov (United States)

Fredericks, Marcel; Kondellas, Bill; Hang, Lam; Fredericks, Janet; Ross, Michael WV

2011-01-01

Objective The purpose of this article is to present select concepts and theories of bureaucratic structures and functions so that chiropractic physicians and other health care professionals can use them in their respective practices. The society-culture-personality model can be applied as an organizational instrument for assisting chiropractors in the diagnosis and treatment of their patients irrespective of locality. Discussion Society-culture-personality and social meaningful interaction are examined in relationship to the structural and functional aspects of bureaucracy within the health care institution of a society. Implicit in the examination of the health care bureaucratic structures and functions of a society is the focus that chiropractic physicians and chiropractic students learn how to integrate, synthesize, and actualize values and virtues such as empathy, integrity, excellence, diversity, compassion, caring, and understanding with a deep commitment to self-reflection. Conclusion It is essential that future and current chiropractic physicians be aware of the structural and functional aspects of an organization so that chiropractic and other health care professionals are able to deliver care that involves the ingredients of quality, affordability, availability, accessibility, and continuity for their patients. PMID:22693481

Chiropractic physicians: toward a select conceptual understanding of bureaucratic structures and functions in the health care institution.

Science.gov (United States)

Fredericks, Marcel; Kondellas, Bill; Hang, Lam; Fredericks, Janet; Ross, Michael Wv

2011-12-01

The purpose of this article is to present select concepts and theories of bureaucratic structures and functions so that chiropractic physicians and other health care professionals can use them in their respective practices. The society-culture-personality model can be applied as an organizational instrument for assisting chiropractors in the diagnosis and treatment of their patients irrespective of locality. Society-culture-personality and social meaningful interaction are examined in relationship to the structural and functional aspects of bureaucracy within the health care institution of a society. Implicit in the examination of the health care bureaucratic structures and functions of a society is the focus that chiropractic physicians and chiropractic students learn how to integrate, synthesize, and actualize values and virtues such as empathy, integrity, excellence, diversity, compassion, caring, and understanding with a deep commitment to self-reflection. It is essential that future and current chiropractic physicians be aware of the structural and functional aspects of an organization so that chiropractic and other health care professionals are able to deliver care that involves the ingredients of quality, affordability, availability, accessibility, and continuity for their patients.

Consequences of Inadequate Physical Activity

Centers for Disease Control (CDC) Podcasts

2018-03-27

Listen as CDC Epidemiologist Susan Carlson, PhD, talks about her research, which estimates the percentage of US deaths attributed to inadequate levels of physical activity.  Created: 3/27/2018 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 3/27/2018.

Rights, Regulation and Bureaucratic Impact: The Impact of Human Rights Litigation on the Regulation of Informal Trade in Johannesburg

Directory of Open Access Journals (Sweden)

Marius Pieterse

2017-01-01

Full Text Available In contemplating the extent to which rights-based litigation is conducive to positive social change, attention ought to be paid to the bureaucratic impact of court judgments that vindicate rights against the State. As a case study of such impact, this article considers the effects of human rights litigation on the regulation of informal trade in the City of Johannesburg, where a 2013 attempt by local government to clamp down on informal trade in the central business district (CBD led to high-profile court action. After describing and problematising the City's general approach to managing informal trade, the article focuses on "Operation Clean Sweep", which aimed to rid much of the CBD of informal traders and became the focal point of rights-based resistance. It then briefly describes the constitutional and jurisprudential framework within which the legal challenge to "Operation Clean Sweep" was to be decided, before critically discussing the judgment of the Constitutional Court in South African Informal Traders Forum v City of Johannesburg 2014 4 SA 371 (CC, which effectively halted "Operation Clean Sweep" by interdicting the City from removing traders from their places of business. The article then proceeds to consider the aftermath of the judgment, and assesses its impact on the City's informal trade policy and urban management practices, as well as on the broader regulatory and political environment around street trade in South African cities. The article shows that the bureaucratic impact of the judgment has, at best, been mixed, and that the judgment has not been entirely successful in disrupting the legal and bureaucratic mindsets, frameworks and processes that simultaneously create, exacerbate and unsuccessfully attempt to address the "unmanageability" of street trade in Johannesburg.

Management of Decommissioning on a Multi-Facility Site

International Nuclear Information System (INIS)

Laraia, Michele; McIntyre, Peter; Visagie, Abrie

2008-01-01

The management of the decommissioning of multi-facility sites may be inadequate or inappropriate if based on approaches and strategies developed for sites consisting of only a single facility. The varied nature of activities undertaken, their interfaces and their interdependencies are likely to complicate the management of decommissioning. These issues can be exacerbated where some facilities are entering the decommissioning phase while others are still operational or even new facilities are being built. Multi-facility sites are not uncommon worldwide but perhaps insufficient attention has been paid to optimizing the overall site decommissioning in the context of the entire life cycle of facilities. Decommissioning management arrangements need to be established taking a view across the whole site. A site-wide decommissioning management system is required. This should include a project evaluation and approval process and specific arrangements to manage identified interfaces and interdependencies. A group should be created to manage decommissioning across the site, ensuring adequate and consistent practices in accordance with the management system. Decommissioning management should be aimed at the entire life cycle of facilities. In the case of multi facility sites, the process becomes more complex and decommissioning management arrangements need to be established with a view to the whole site. A site decommissioning management system, a group that is responsible for decommissioning on site, a site project evaluation and approval process and specific arrangements to manage the identified interfaces are key areas of a site decommissioning management structure that need to be addressed to ensure adequate and consistent decommissioning practices. A decommissioning strategy based on single facilities in a sequential manner is deemed inadequate

From a Bureaucratic to a Critical-Sociocultural Model of Policymaking in Colombia

Directory of Open Access Journals (Sweden)

Doris Correa

2013-10-01

Full Text Available In the context of the National Bilingual Program 2004-2019, currently called “Program for Strengthening the Development of Competencies in a Foreign Language,” the Colombian government has implemented a series of actions to raise the level of English proficiency of teachers and students and insert the country into globalization processes. The purpose of this article, which is the result of a project conducted by the authors in Antioquia (Colombia about the stakeholders’ views of the program, is to show how these actions fit a bureaucratic policymaking model which has been highly questioned by policy experts and to propose a new model which can be used to make deep changes in the program with the participation of all stakeholders.

Bureaucratic behavior: A review of the theory and its application to Serbian public administration

Directory of Open Access Journals (Sweden)

Žarković-Rakić Jelena

2007-01-01

Full Text Available A professional and competent public administration is necessary for successful transition from a socialist, centrally planned economy to a functioning market democracy. The difficulty lies in building an organized and effective civil service sector. This paper gives a brief overview of formal bureaucratic reasoning, beginning with Niskanen’s theory, followed by the principal-agent model. The "Weberian state hypothesis", which provides an alternative view of bureaucracies in less developed countries, is subsequently explored. Finally, the currant state of Serbian public administration is described, along with a discussion of challenges to be addressed in the future.

The research imperative and bureaucratic control: the case of clinical research.

Science.gov (United States)

Hall, D

1991-01-01

This paper examines the development of Research Ethics Committees and explores some of the conflicts of value and role which surround the practice of medical research. The case of medical research on children is discussed as one which raises in an acute form concerns about consent and risk/benefit analysis. The paper draws on a survey of Research Ethics Committees to illustrate their variety of structure and functioning, and to relate current practice to a model of bureaucratic control. Bureaucracy is considered both in its common-sense understanding of officious rule-making and delay, and in its theoretical formulation in terms of specialisation, standardisation, formalization and centralisation of procedures. It is argued that the concept of bureaucracy can aid an understanding of the problems of control over research, as well as providing a model for more informed, consistent and open decision making.

Off to the Courts? Or the Agency? Public Attitudes on Bureaucratic and Legal Approaches to Policy Enforcement

Directory of Open Access Journals (Sweden)

Quinn Mulroy

2018-04-01

Full Text Available A key curiosity in the operation of the American regulatory state lies with its hybrid structure, defined by centralized, bureaucratic approaches but also more decentralized actions such as lawsuits brought by private citizens in the courts. While current research on these two pathways focuses at the elite level—exploring how and why political actors and institutions opt for legal or administrative strategies for implementing different public policies—there is little research that examines public attitudes toward how policy is enforced in the U.S. Given that the public is a key partner in this process, this paper integrates public attitudes into the discussion, tapping into conceptions of “big government,” privatization, and the tort reform movement. Using original data from a series of vignette-based experiments included in the 2014 Cooperative Congressional Election Survey, we examine public preferences about how policy is regulated—by private citizens in the courts or by government officials in agencies—across a broad number of policy areas. We offer one of the first studies that adjudicates the boundaries of public attitudes on litigation and bureaucratic regulation in the U.S., offering implications for how elites might approach the design of policy implementation for different issue areas.

African Research Review

African Journals Online (AJOL)

Prof

Bureaucratic Dictatorship in Tax Management in the Rat Race ... budget. This definition however in sub Saharan Africa appear inadequate due to the ..... instruments, including an option to make direct transfer of cash to households, that.

Evidence Report: Risk Factor of Inadequate Nutrition

Science.gov (United States)

Smith, Scott M.; Zwart, Sara R.; Heer, Martina

2015-01-01

The importance of nutrition in exploration has been documented repeatedly throughout history, where, for example, in the period between Columbus' voyage in 1492 and the invention of the steam engine, scurvy resulted in more sailor deaths than all other causes of death combined. Because nutrients are required for the structure and function of every cell and every system in the body, defining the nutrient requirements for spaceflight and ensuring provision and intake of those nutrients are primary issues for crew health and mission success. Unique aspects of nutrition during space travel include the overarching physiological adaptation to weightlessness, psychological adaptation to extreme and remote environments, and the ability of nutrition and nutrients to serve as countermeasures to ameliorate the negative effects of spaceflight on the human body. Key areas of clinical concern for long-duration spaceflight include loss of body mass (general inadequate food intake), bone and muscle loss, cardiovascular and immune system decrements, increased radiation exposure and oxidative stress, vision and ophthalmic changes, behavior and performance, nutrient supply during extravehicular activity, and general depletion of body nutrient stores because of inadequate food supply, inadequate food intake, increased metabolism, and/or irreversible loss of nutrients. These topics are reviewed herein, based on the current gap structure.

The Link Between Inadequate Sleep and Obesity in Young Adults.

Science.gov (United States)

Vargas, Perla A

2016-03-01

The prevalence of obesity has increased dramatically over the past decade. Although an imbalance between caloric intake and physical activity is considered a key factor responsible for the increase, there is emerging evidence suggesting that other factors may be important contributors to weight gain, including inadequate sleep. Overall research evidence suggests that inadequate sleep is associated with obesity. Importantly, the strength and trajectory of the association seem to be influenced by multiple factors including age. Although limited, the emerging evidence suggests young adults might be at the center of a "perfect health storm," exposing them to the highest risk for obesity and inadequate sleep. Unfortunately, the methods necessary for elucidating the complex relationship between sleep and obesity are lacking. Uncovering the underlying factors and trajectories between inadequate sleep and weight gain in different populations may help to identify the windows of susceptibility and to design targeted interventions to prevent the negative impact of obesity and related diseases.

Change Vocational Funding to Acquire Qualified Math/Science Teachers.

Science.gov (United States)

Heron, Bill

1985-01-01

Gives a brief overview of the problems occurring at the high school level due to inadequately paid personnel in the math and science areas, summarizes the current bureaucratic structure surrounding vocational funding, and suggests an alternative. (FL)

When and How do Bureaucratic Conflicts Matter in Trade Policy? Evidence from the US Trade Policymaking Process during the Clinton Administration (1993–2001

Directory of Open Access Journals (Sweden)

Rodrigo Fagundes Cézar

Full Text Available Abstract The study of the role played by bureaucracies contributed substantively to the analysis of the domestic determinants of foreign policy outcomes, particularly by softening the premise of the state as a unitary-rational actor. However, the potential of focusing on bureaucracies to analyse US trade policy outcomes has been severely underestimated by the most recent IPE scholarship, which tends to focus on the Congress and interest groups, and to consider the Executive a unitary actor. Based on elements of the bureaucratic politics model, this article uses evidence from the US trade policy during Clinton’s administration (1993–2001 in order to present arguments regarding how and when bureaucratic conflicts matter the most, and highlight the relevance of these conflicts in the trade decision-making process.

Wind energy: Overcoming inadequate wind and modeling uncertainties

Energy Technology Data Exchange (ETDEWEB)

Kane, Vivek

2010-09-15

'Green Energy' is the call of the day, and significance of Wind Energy can never be overemphasized. But the key question here is - What if the wind resources are inadequate? Studies reveal that the probability of finding favorable wind at a given place on land is only 15%. Moreover, there are inherent uncertainties associated with wind business. Can we overcome inadequate wind resources? Can we scientifically quantify uncertainty and model it to make business sense? This paper proposes a solution, by way of break-through Wind Technologies, combined with advanced tools for Financial Modeling, enabling vital business decisions.

Inadequate exercise as a risk factor for sepsis mortality.

Science.gov (United States)

Williams, Paul T

2013-01-01

Test whether inadequate exercise is related to sepsis mortality. Mortality surveillance of an epidemiological cohort of 155,484 National Walkers' and Runners' Health Study participants residing in the United States. Deaths were monitored for an average of 11.6-years using the National Death index through December 31, 2008. Cox proportional hazard analyses were used to compare sepsis mortality (ICD-10 A40-41) to inadequate exercise (<1.07 METh/d run or walked) as measured on their baseline questionnaires. Deaths occurring within one year of the baseline survey were excluded. Sepsis was the underlying cause in 54 deaths (sepsis(underlying)) and a contributing cause in 184 deaths (sepsis(contributing)), or 238 total sepsis-related deaths (sepsis(total)). Inadequate exercise was associated with 2.24-fold increased risk for sepsis(underlying) (95%CI: 1.21 to 4.07-fold, P = 0.01), 2.11-fold increased risk for sepsis(contributing) (95%CI: 1.51- to 2.92-fold, P<10(-4)), and 2.13-fold increased risk for sepsis(total) (95%CI: 1.59- to 2.84-fold, P<10(-6)) when adjusted for age, sex, race, and cohort. The risk increase did not differ significantly between runners and walkers, by sex, or by age. Sepsis(total) risk was greater in diabetics (P = 10(-5)), cancer survivors (P = 0.0001), and heart attack survivors (P = 0.003) and increased with waist circumference (P = 0.0004). The sepsis(total) risk associated with inadequate exercise persisted when further adjusted for diabetes, prior cancer, prior heart attack and waist circumference, and when excluding deaths with cancer, or cardiovascular, respiratory, or genitourinary disease as the underlying cause. Inadequate exercise also increased sepsis(total) risk in 2163 baseline diabetics (4.78-fold, 95%CI: 2.1- to 13.8-fold, P = 0.0001) when adjusted, which was significantly greater (P = 0.03) than the adjusted risk increase in non-diabetics (1.80-fold, 95%CI: 1.30- to 2.46-fold, P = 0

[The conflict of tomatoes and olive oil within a bureaucratic machinery].

Science.gov (United States)

Gil García, E

2000-03-01

In this short article, the author relates, by means of a case report, a type of conflict which occurs as a result of the paradoxes derived from the current managerial model practiced in the Andalucian public hospitals. The limitations and the incompetence of a bureaucracy, rigid in compliance with its functions, and which is incapable of attending to the demands that belong to the hard core of the organization, place the supposed most important and most immediate objectives of an efficient managerial system in "danger". The basic hypothesis lies in the need to bear in mind, at the time of designing a hospital's organizational system, the "structures of the invisible interests", with their corresponding paradoxes and perversions, of each of the distinct component parts of this system. And how these invisible bureaucratic interests can hinder and pervert managerial and organizational designs which appear to be ideal and optimal in their objectives and principles.

Motivation and Retention of Physicians in Primary Healthcare Facilities: A Qualitative Study From Abbottabad, Pakistan

Directory of Open Access Journals (Sweden)

Sayed Masoom Shah

2016-08-01

Full Text Available Background: Workforce motivation and retention is important for the functionality and quality of service delivery in health systems of developing countries. Despite huge primary healthcare (PHC infrastructure, Pakistan’s health indicators are not impressive; mainly because of under-utilization of facilities and low patient satisfaction. One of the major underlying issues is staff absenteeism. The study aimed to identify factors affecting retention and motivation of doctors working in PHC facilities of Pakistan. Methods: An exploratory study was conducted in a rural district in Khyber Puktunkhwa (KP province, in Pakistan. A conceptual framework was developed comprising of three organizational, individual, and external environmental factors. Qualitative research methods comprising of semi-structured interviews with doctors working in basic health units (BHUs and in-depth interviews with district and provincial government health managers were used. Document review of postings, rules of business and policy actions was also conducted. Triangulation of findings was carried out to arrive at the final synthesis. Results: Inadequate remuneration, unreasonable facilities at residence, poor work environment, political interference, inadequate supplies and medical facilities contributed to lack of motivation among both male and female doctors. The physicians accepted government jobs in BHUs with a belief that these jobs were more secure, with convenient working hours. Male physicians seemed to be more motivated because they faced less challenges than their female counterparts in BHUs especially during relocations. Overall, the organizational factors emerged as the most significant whereby human resource policy, career growth structure, performance appraisal and monetary benefits played an important role. Gender and marital status of female doctors was regarded as most important individual factor affecting retention and motivation of female doctors in BHUs

Motivation and Retention of Physicians in Primary Healthcare Facilities: A Qualitative Study From Abbottabad, Pakistan.

Science.gov (United States)

Shah, Sayed Masoom; Zaidi, Shehla; Ahmed, Jamil; Rehman, Shafiq Ur

2016-04-09

Workforce motivation and retention is important for the functionality and quality of service delivery in health systems of developing countries. Despite huge primary healthcare (PHC) infrastructure, Pakistan's health indicators are not impressive; mainly because of under-utilization of facilities and low patient satisfaction. One of the major underlying issues is staff absenteeism. The study aimed to identify factors affecting retention and motivation of doctors working in PHC facilities of Pakistan. An exploratory study was conducted in a rural district in Khyber Puktunkhwa (KP) province, in Pakistan. A conceptual framework was developed comprising of three organizational, individual, and external environmental factors. Qualitative research methods comprising of semi-structured interviews with doctors working in basic health units (BHUs) and in-depth interviews with district and provincial government health managers were used. Document review of postings, rules of business and policy actions was also conducted. Triangulation of findings was carried out to arrive at the final synthesis. Inadequate remuneration, unreasonable facilities at residence, poor work environment, political interference, inadequate supplies and medical facilities contributed to lack of motivation among both male and female doctors. The physicians accepted government jobs in BHUs with a belief that these jobs were more secure, with convenient working hours. Male physicians seemed to be more motivated because they faced less challenges than their female counterparts in BHUs especially during relocations. Overall, the organizational factors emerged as the most significant whereby human resource policy, career growth structure, performance appraisal and monetary benefits played an important role. Gender and marital status of female doctors was regarded as most important individual factor affecting retention and motivation of female doctors in BHUs. Inadequate remuneration, unreasonable

Impact of Facilities on Academic Performance of Students with Special Needs in Mainstreamed Public Schools in Southwestern Nigeria

Science.gov (United States)

Fareo, Dorcas Oluremi; Ojo, Olakunbi Olubukola

2013-01-01

Facilities have a great impact on academic performances of students, and inadequate facilities translate to poor performance. The study examined the availability and convenience of the facilities that were provided to students with special educational needs in mainstreamed schools. It ascertained the qualifications of teachers teaching in…

land use changes and its effects on the provision of social facilities

African Journals Online (AJOL)

Osondu

2013-05-07

May 7, 2013 ... inadequate compared to the existing population. Residents ... Keywords: Ghana, Land, Land Use Changes, Social Facilities, Traditional Authorities, Kumasi Metropolis. ..... interviewed had the belief that once they own the.

Application of information and communication technology facilities in ...

African Journals Online (AJOL)

Information Impact | Jorunal of Information and Knowledge Management

Findings also revealed that inadequate training of staff on ICT application to technical services; poor electricity supply and insufficient fund were some of the challenges plaguing the application of ICT facilities to technical unit of the library. The study recommends that there should be adequate straining of staff, provision of ...

Bureaucratic Itineraries in Colombia. A theoretical and methodological tool to assess managed-care health care systems.

Science.gov (United States)

Abadia, Cesar Ernesto; Oviedo, Diana G

2009-03-01

Steady increases in the number of Colombians insured by the health care system contrasts with the hundreds of thousands of legal actions interposed to warrant citizen's right to health. This study aims to analyze the relationships among patients' experiences of denials by the system, the country's legal mechanisms, and the functioning of insurance companies and service providing institutions. We conducted a mixed-methods case study in Bogotá and present a quantitative description of 458 cases, along with semi-structured interviews and an in-depth illness history. We found that Colombians' denials of care most commonly include appointments, laboratory tests or treatments. Either insurance companies or service providing institutions use the system's legal structure to justify the different kinds of denials. To warrant their right to health care, citizens are forced to interpose legal mechanisms, which are largely ruled in favor, but delays result in a progressive and cumulative pattern of harmful consequences, as follows: prolongation of suffering, medical complications of health status, permanent harmful consequences, permanent disability, and death. We diagram the path that Colombians need to follow to have their health care claims attended by the system in a matrix called Bureaucratic Itineraries. Bureaucratic Itineraries is a theoretical and methodological construct that links the personal experience of illness with the system's structure and could be an important tool for understanding, evaluating and comparing different systems' performances. In this case, it allowed us to conclude that managed care in Colombia has created complex bureaucracies that delay and limit care through cost-containment mechanisms, which has resulted in harmful consequences for people's lives.

The significance of inadequate transcranial Doppler studies in children with sickle cell disease.

Directory of Open Access Journals (Sweden)

Simon Greenwood

Full Text Available Sickle cell disease (SCD is a common cause of cerebrovascular disease in childhood. Primary stroke prevention is effective using transcranial Doppler (TCD scans to measure intracranial blood velocities, and regular blood transfusions or hydroxycarbamide when these are abnormal. Inadequate TCD scans occur when it is not possible to measure velocities in all the main arteries. We have investigated the prevalence and significance of this in a retrospective audit of 3915 TCD scans in 1191 children, performed between 2008 and 2015. 79% scans were normal, 6.4% conditional, 2.8% abnormal and 12% inadequate. 21.6% of 1191 patients had an inadequate scan at least once. The median age of first inadequate scan was 3.3 years (0.7-19.4, with a U-shaped frequency distribution with age: 28% aged 2-3 years, 3.5% age 10 years, 25% age 16 years. In young children reduced compliance was the main reason for inadequate TCDs, whereas in older children it was due to a poor temporal ultrasound window. The prevalence of inadequate TCD was 8% in the main Vascular Laboratory at King's College Hospital and significantly higher at 16% in the outreach clinics (P<0.0001, probably due to the use of a portable ultrasound machine. Inadequate TCD scans were not associated with underlying cerebrovascular disease.

Family Life and Racial and Ethnic Diversity: An Assessment of Communitarianism, Liberalism, and Conservatism.

Science.gov (United States)

Sjoberg, Gideon; And Others

1995-01-01

Examines the debates among communitarians, liberals, and conservatives regarding contemporary family issues and critically evaluates these perspectives. Current orientations inadequately address the impact of large-scale bureaucratic organizations on family life and do not confront problems relating to ethnic and racial discrimination. Education…

Inadequate humidification of respiratory gases during mechanical ventilation of the newborn.

Science.gov (United States)

Tarnow-Mordi, W O; Sutton, P; Wilkinson, A R

1986-01-01

Proximal airway humidity was measured during mechanical ventilation in 14 infants using an electronic hygrometer. Values below recommended minimum humidity of adult inspired gas were recorded on 251 of 396 occasions. Inadequate humidification, largely due to inadequate proximal airway temperature, is commoner than recognised in infants receiving mechanical ventilation. PMID:3740912

[Resolutions of the Health Council: instrument of social control or bureaucratic document].

Science.gov (United States)

Landerdhal, Maria Celeste; Unfer, Beatriz; Braun, Katia; Skupien, Jovito Adiel

2010-08-01

The present study has a documentary character and analyzes the resolutions registered in minutes of meetings of a Health Council, as a form to characterize the social control in health carried through for this instance. The majority of the resolutions were referred to the approval of Programs and Projects, arising from the Secretariat of Health, regarding the reform, material and equipment acquisition for units of health, the qualification of existing services or the creation of new services. The study suggests that the practical one of this council seems to be bureaucratic, without any proposal of politics of health for the council is visualized. The way the resolutions have being legalized does not characterize its guiding not even the visibility of the actions for the population in general. In the studied case, it is signaled that the mere regular functioning of this council does not guarantee that exist effective social control.

Determinants of inadequate fruit and vegetable consumption amongst Portuguese adults.

Science.gov (United States)

Oliveira, A; Maia, B; Lopes, C

2014-04-01

A low consumption of fruit and vegetables (F&V) represents a high burden on health. The present study evaluates sociodemographic, lifestyle and anthropometric determinants of an inadequate consumption of F&V (Diet was assessed by a validated food frequency questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by logistic regression, after sex stratification and controlling for age, education, marital status, smoking, regular physical exercise and total energy intake. Older women and men had 37% and 67%, respectively, lower odds of inadequate F&V consumption (≥65 versus 12 versus excessive alcohol (women: ≥15 g day(-1) ; men: ≥30 g day(-1) ) presented a two- and four-fold higher probability of having inadequate F&V consumption compared to nondrinkers (OR = 1.95, 95% CI = 1.38-2.77 in women; OR = 4.40, 95% CI = 2.70-7.18 in men). In both sexes, an inadequate consumption of F&V was more frequently found in younger, less educated and less physically active subjects with smoking and drinking habits. Strategies aiming to increase F&V consumption should consider these target groups that present a clustering of unhealthy lifestyles. © 2013 The British Dietetic Association Ltd.

Assessment Of Market Facilities And Locational Effects On Adjoining Neighborhoods In Nigerian Urban Centers Empirical Evidence From Akure Nigeria

Directory of Open Access Journals (Sweden)

Adeyinka S. A.

2015-08-01

Full Text Available There is the need for people to buy and sell and transact their businesses in a way that life can go on normally. This study examined the markets facilities level and locational effects on adjoining neighbourhoods in Akure Township. Both primary and secondary data types were employed in the study primary data were collected through the administration of questionnaire on traders and patronsbuyers in the markets and residents of adjoining neighbourhoods and personal observation. Secondary data were collected from government publications. Data collected were analysed using descriptive statistical methods which included frequency counts and Likerts scale to analyse the satisfaction of traders and patrons on the facilities in the markets and severity of locational effects on residents of adjoining neighbourhoods. Findings from the study showed that facilities such as parking spaces fire extinguishers circulation spaces within the markets trading spaces safe area for children perimeter fencing and loading and off-loading bay were inadequately provided. While on-street display of goods traffic congestion air pollution on-street parking due to inadequate parking spaces were the severely perceived locational effects. The study concluded that facilities in the markets were inadequate and that markets constitute nuisances to the adjoining areas. It hereby recommends that markets in the study area be provided with the required level of facilities to prevent future urban problems.

Barriers to Mammography among Inadequately Screened Women

Science.gov (United States)

Stoll, Carolyn R. T.; Roberts, Summer; Cheng, Meng-Ru; Crayton, Eloise V.; Jackson, Sherrill; Politi, Mary C.

2015-01-01

Mammography use has increased over the past 20 years, yet more than 30% of women remain inadequately screened. Structural barriers can deter individuals from screening, however, cognitive, emotional, and communication barriers may also prevent mammography use. This study sought to identify the impact of number and type of barriers on mammography…

Relationship between health services, socioeconomic variables and inadequate weight gain among Brazilian children.

Science.gov (United States)

de Souza, A C; Peterson, K E; Cufino, E; Gardner, J; Craveiro, M V; Ascherio, A

1999-01-01

This ecological analysis assessed the relative contribution of behavioural, health services and socioeconomic variables to inadequate weight gain in infants (0-11 months) and children (12-23 months) in 140 municipalities in the State of Ceara, north-east Brazil. To assess the total effect of selected variables, we fitted three unique sets of multivariate linear regression models to the prevalence of inadequate weight gain in infants and in children. The final predictive models included variables from the three sets. Findings showed that participation in growth monitoring and urbanization were inversely and significantly associated with the prevalence of inadequate weight gain in infants, accounting for 38.3% of the variation. Female illiteracy rate, participation in growth monitoring and degree of urbanization were all positively associated with prevalence of inadequate weight gain in children. Together, these factors explained 25.6% of the variation. Our results suggest that efforts to reduce the average municipality-specific female illiteracy rate, in combination with participation in growth monitoring, may be effective in reducing municipality-level prevalence of inadequate weight gain in infants and children in Ceara.

Challenges in the management of decommission waste of nuclear facilities in Ghana

International Nuclear Information System (INIS)

Glover, E.T.; Fletcher, J.J.

2002-01-01

It is inevitable that every nuclear facility must one day be safely decommissioned. When considering decommissioning, large amounts of radioactive and non-radioactive waste have to be taken into account. Disposal of such materials can have large economic impact on the overall decommissioning cost. In developing countries like Ghana, the perception of environmental protection through waste management, is often not very high as compared to many other pressing needs. Therefore limited resources are allocated for environmental problems. Ghana operates a tank-in- pool type research reactor, 30kW output for research in neutron activation analysis, radioisotope preparation, education and training, a radiotherapy unit that utilizes a 185TBq Co-60 radioactive sources for the treatment of cancer and a gamma irradiation facility which utilizes 1.85PBq Co-60 radioactive source for the irradiation of various materials. All these facilities are operating without designed decommissioning in mind, an inadequate waste management infrastructure as well as a lack of a repository to handling the resulting waste. It is today's beneficials of the nuclear facility that has to deal with the legacies of the future decommissioning activities. The paper outlines some of the challenges and issues to be expected in the management of waste from future decommissioning of nuclear facilities in Ghana with the absence of a waste management infrastructure and inadequate financial resources. The paper puts forth a concept to perform meaningful and significant plans whilst the facilities are still operating. (author)

Bureaucratic politics and national preference formation in EU constitutional politics – is the state merely a transmission belt?

DEFF Research Database (Denmark)

Beach, Derek

  In a perfect representative democracy, there is a democratic chain of delegation that links voters with their elected representatives and then onwards to the executive branch and finally to civil servants in the bureaucracy (Strøm 2000). But is this an accurate picture of foreign policy making ...... that bureaucratic politics do matter, and that how positions are coordinated did have some independent impact upon national positions. But in the majority of issues, it does appear that the state was merely a transmission belt for executive priorities....

Italian retail gasoline activities: inadequate distribution network

International Nuclear Information System (INIS)

Verde, Stefano

2005-01-01

It is common belief that competition in the Italian retail gasoline activities is hindered by oil companies' collusive behaviour. However, when developing a broader analysis of the sector, low efficiency and scarce competition could results as the consequences coming from an inadequate distribution network and from the recognition of international markets and focal point [it

Evaluation of the improvement suggestion system in a nuclear facility

International Nuclear Information System (INIS)

Carnaval, Joao Paulo Rodrigues; Moraes, Geice Almeida

2017-01-01

This work evaluated methods for processing improvement suggestions of a nuclear factory, with the intention to verify those which best fits to the company purposes. Two methods for processing improvement suggestions were applied in the studied organization. The first one was guided to the processing suggestions by specific independent sectors of the company and the second one was conducted to the processing of suggestions by a multidisciplinary team. It has been concluded that a multidisciplinary team focused on research and development would be the best option to the implementation of improvement suggestions and technological innovation on this facility, instead of multi sector processing which revealed to be excessive bureaucratic before the expected goals. This study can be used by nuclear facilities to optimize an existing system of improvements analysis or even guide them for the implantation of a new one. It is more significant for the companies certified on ISO and OHSAS standards for the quality management, environmental and safety and occupational health systems which requires that the continuous improvement must exist and to be demonstrated. But it is also relevant for nuclear plants aiming to implement an Integrated Management System certified on ISO Standards. (author)

Evaluation of the improvement suggestion system in a nuclear facility

Energy Technology Data Exchange (ETDEWEB)

Carnaval, Joao Paulo Rodrigues; Moraes, Geice Almeida, E-mail: joaocarnaval@inb.gov.br, E-mail: geice@inb.gov.br [Industrias Nucleares do Brasil S.A (INB), Resende, RJ (Brazil)

2017-11-01

This work evaluated methods for processing improvement suggestions of a nuclear factory, with the intention to verify those which best fits to the company purposes. Two methods for processing improvement suggestions were applied in the studied organization. The first one was guided to the processing suggestions by specific independent sectors of the company and the second one was conducted to the processing of suggestions by a multidisciplinary team. It has been concluded that a multidisciplinary team focused on research and development would be the best option to the implementation of improvement suggestions and technological innovation on this facility, instead of multi sector processing which revealed to be excessive bureaucratic before the expected goals. This study can be used by nuclear facilities to optimize an existing system of improvements analysis or even guide them for the implantation of a new one. It is more significant for the companies certified on ISO and OHSAS standards for the quality management, environmental and safety and occupational health systems which requires that the continuous improvement must exist and to be demonstrated. But it is also relevant for nuclear plants aiming to implement an Integrated Management System certified on ISO Standards. (author)

96/5000 Other literature Bureaucratic records and traces of disappearances in Argentina

Directory of Open Access Journals (Sweden)

Emilio Crenzel

2014-08-01

Full Text Available In this article I examine a series of bureaucratic records produced during the military dictatorship by workers in two state agencies, a morgue and a public hospital, located in two different provinces of Argentina, Córdoba and Buenos Aires. In these public documents, these workers left evidence, for several and different reasons, on the existence of practices that integrated phases or moments of the system of forced disappearance of persons, a crime which distinguished the last military dictatorship (1976-1983 of their predecessors. The analysis of these administrative records is an exploratory approach that aims to contribute to the understanding of the logic / s operation of state bureaucracies during the last military dictatorship, try to establish and understand the variety of relationships that a portion of its members established with the practice of forced disappearance of persons and other repressive practices unwrapped during this period and try to document the variety of ideas and emotions that, contemporary to the facts, were put into play in relation to the perpetrators of these crimes and their victims.

The challenge of inadequate achievement in mathematics: Focus on a meta-approach

Directory of Open Access Journals (Sweden)

Kobus Maree

2009-09-01

Full Text Available As is the case elsewhere in the world, all stakeholders in South Africa are deeply concerned about the level and scope of underachievement in mathematics, not only at Grade 12 level, but, indeed, at University, University of Technology and Further Education and Training levels. These concerns assume a deeper dimension in light of the fact that inadequate achievement in mathematics inevitably will have a ripple effect on the academic situation in any country: inadequate achievement in mathematics precludes learners from applying for admission to sought-after fi elds of study, which, in turn, prevents numerous learners from realising their true potential and, eventually, from being happy and successful in careers that they might otherwise have been able to execute successfully. It goes without saying that inadequate achievement in mathematics will impact negatively on the overall economic situation in any country (even more so in a developing country such as South Africa. Truth being, achievement in mathematics amounts to equipping oneself with survival skills. In this article, the spotlight shifts from a narrow and outdated focus on problems that are associated with inadequate achievement in mathematics to possible solutions for this disconcerting situation and the implied challenge it raises. The focus is thus on three levels that collectively underpin and impact on achievement in mathematics, viz. the macro level, the meso level and the micro level. The macro level refers mainly to the input by the national government (and, by default, the National Department of Education. In the fi rst instance, it is the responsibility of the state to provide adequate schooling facilities for all learners, irrespective of where they fi nd themselves. Furthermore, it is the duty of the state to ensure that every learner has access to basic facilities, including food, water, sanitation and housing. The state (via the National Department of Education is also

Cognitive Attributes of Adequate and Inadequate Responders to Reading Intervention in Middle School

Science.gov (United States)

Miciak, Jeremy; Stuebing, Karla K.; Vaughn, Sharon; Roberts, Greg; Barth, Amy E.; Fletcher, Jack M.

2014-01-01

No studies have investigated the cognitive attributes of middle school students who are adequate and inadequate responders to Tier 2 reading intervention. We compared students in Grades 6 and 7 representing groups of adequate responders (n = 77) and inadequate responders who fell below criteria in (a) comprehension (n = 54); (b) fluency (n = 45);…

University multi-user facility survey-2010.

Science.gov (United States)

Riley, Melissa B

2011-12-01

Multi-user facilities serve as a resource for many universities. In 2010, a survey was conducted investigating possible changes and successful characteristics of multi-user facilities, as well as identifying problems in facilities. Over 300 surveys were e-mailed to persons identified from university websites as being involved with multi-user facilities. Complete responses were received from 36 facilities with an average of 20 years of operation. Facilities were associated with specific departments (22%), colleges (22%), and university research centers (8.3%) or were not affiliated with any department or college within the university (47%). The five most important factors to succeed as a multi-user facility were: 1) maintaining an experienced, professional staff in an open atmosphere; 2) university-level support providing partial funding; 3) broad client base; 4) instrument training programs; and 5) an effective leader and engaged strategic advisory group. The most significant problems were: 1) inadequate university financial support and commitment; 2) problems recovering full service costs from university subsidies and user fees; 3) availability of funds to repair and upgrade equipment; 4) inability to retain highly qualified staff; and 5) unqualified users dirtying/damaging equipment. Further information related to these issues and to fee structure was solicited. Overall, there appeared to be a decline in university support for facilities and more emphasis on securing income by serving clients outside of the institution and by obtaining grants from entities outside of the university.

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

Science.gov (United States)

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

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

The impact of an inadequate municipal water system on the residents of Chinhoyi town, Zimbabwe.

Science.gov (United States)

Schwartz, U; Siziya, S; Tshimanga, M; Barduagni, P; Chauke, T L

1999-06-01

To assess the use and impact of the water reticulation system in Chinhoyi on its residents. Cross sectional and case series studies. Chinhoyi town. 600 Chinhoyi residents. Practices and perceptions of Chinhoyi residents on the water system, and distribution of water-related diseases per area of residence. Out of 600 respondents, 565 (99.3%) had access to piped water and 558 (98.0%) to flush toilets. Breakdowns of water supply and functioning of toilet facility were reported by 308 (77.0%) and 110 (28.0%) respondents in the previous six months, respectively. Main complaints of Chinhoyi residents were about low water quality (36.2%), inadequate sewage system (31.3%) and environmental pollution (26.5%). Cases of water-related diseases were not associated with natural water bodies. Chinhoyi residents have good access to the municipal water and an adequate sanitation system. However, low quality of the water, frequent system breakdowns and the degradation and loss of amenity of the environment impair their quality of life.

Factors associated with inadequate work ability among women in the clothing industry.

Science.gov (United States)

Augusto, Viviane Gontijo; Sampaio, Rosana Ferreira; Ferreira, Fabiane Ribeiro; Kirkwood, Renata Noce; César, Cibele Comini

2015-01-01

Work ability depends on a balance between individual resources and work demands. This study evaluated factors that are associated with inadequate work ability among workers in the clothing industry. We conducted a cross-sectional observational study of 306 workers in 40 small and medium-sized enterprises. We assessed work ability, individual resources, physical and psychosocial demands, and aspects of life outside work using a binary logistic regression model with hierarchical data entry. The mean work ability was 42.5 (SD=3.5); when adjusted for age, only 11% of the workers showed inadequate work ability. The final model revealed that smoking, high isometric physical load, and poor physical environmental conditions were the most significant predictors of inadequate work ability. Good working conditions and worker education must be implemented to eliminate factors that can be changed and that have a negative impact on work ability. These initiatives include anti-smoking measures, improved postures at work, and better physical environmental conditions.

Prevalence of Inadequate Immunity to Measles, Mumps, Rubella, and Varicella in MLB and NBA Athletes.

Science.gov (United States)

Conway, Justin J; Toresdahl, Brett G; Ling, Daphne I; Boniquit, Nicole T; Callahan, Lisa R; Kinderknecht, James J

2018-05-01

Multiple outbreaks of vaccine-preventable viral diseases have occurred in professional sports in recent years. Currently, there is no established protocol for vaccination or immunity screening for professional athletes. There are significant differences in the prevalence of inadequate immunity dependent on age, sport, country of birth, and participation in collegiate sports. Cross-sectional cohort study. Level 4. A sample of Major League Baseball (MLB) and National Basketball Association (NBA) players were screened for serologic evidence of immunity to measles, mumps, rubella, and varicella prior to the 2015 and 2016 seasons. The results were designated as adequate (immune) or inadequate (equivocal or nonimmune) based on laboratory criteria. Comparison with an age-matched control group was performed using data from the National Health and Nutrition Examination Survey (NHANES). A total of 98 athletes (62 MLB, 36 NBA) were screened. The prevalence of inadequate immunity for any virus was 35.5% in MLB players and 33.3% in NBA players. There was a significantly greater risk of inadequate immunity to rubella (risk ratio, 6.38; P < 0.01) and varicella (risk ratio, 4.21; P < 0.01) in athletes compared with the age-matched NHANES population. Our analysis did not reveal differences in rates of immunity based on sport, country of birth (US born vs international), or participation in college athletics. There was a lower rate of inadequate immunity to varicella with increasing age (odds ratio, 0.72; P = 0.05). One-third of athletes studied had inadequate immunity to 1 of the 4 viruses tested. Younger players had a significantly greater risk of inadequate immunity to varicella. Birth outside the US and lack of participation in college athletics were not found to influence immunity rates. These results can inform the development of future screening programs to prevent outbreaks of viral infections in professional athletes.

Lifesaving emergency obstetric services are inadequate in south-west Ethiopia: a formidable challenge to reducing maternal mortality in Ethiopia.

Science.gov (United States)

Girma, Meseret; Yaya, Yaliso; Gebrehanna, Ewenat; Berhane, Yemane; Lindtjørn, Bernt

2013-11-04

population which is below the UN's minimum recommendation. The utilization of the existing facilities for delivery was also low, which is clearly inadequate to reduce maternal deaths to the MDG target.

Inadequate pre-season preparation of schoolboy rugby players - a ...

African Journals Online (AJOL)

... in prospective studies at the same schools. The players' knowledge of techniques known to prevent rugby injuries was inadequate and too little attention was paid at the start of the rugby season to training and coaching techniques to reduce injury risk. Coaching errors may therefore have predisposed players to injury.

Cognitive Attributes of Adequate and Inadequate Responders to Reading Intervention in Middle School

OpenAIRE

Miciak, Jeremy; Stuebing, Karla K.; Vaughn, Sharon; Roberts, Greg; Barth, Amy Elizabeth; Fletcher, Jack M.

2014-01-01

No studies have investigated the cognitive attributes of middle school students who are adequate and inadequate responders to Tier 2 reading intervention. We compared students in Grades 6 and 7 representing groups of adequate responders (n = 77) and inadequate responders who fell below criteria in (a) comprehension (n = 54); (b) fluency (n = 45); and (c) decoding, fluency, and comprehension (DFC; n = 45). These students received measures of phonological awareness, listening comprehension, rap...

Self-esteem, social support, and satisfaction differences in women with adequate and inadequate prenatal care.

Science.gov (United States)

Higgins, P; Murray, M L; Williams, E M

1994-03-01

This descriptive, retrospective study examined levels of self-esteem, social support, and satisfaction with prenatal care in 193 low-risk postpartal women who obtained adequate and inadequate care. The participants were drawn from a regional medical center and university teaching hospital in New Mexico. A demographic questionnaire, the Coopersmith self-esteem inventory, the personal resource questionnaire part 2, and the prenatal care satisfaction inventory were used for data collection. Significant differences were found in the level of education, income, insurance, and ethnicity between women who received adequate prenatal care and those who received inadequate care. Women who were likely to seek either adequate or inadequate prenatal care were those whose total family income was $10,000 to $19,999 per year and high school graduates. Statistically significant differences were found in self-esteem, social support, and satisfaction between the two groups of women. Strategies to enhance self-esteem and social support have to be developed to reach women at risk for receiving inadequate prenatal care.

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

Science.gov (United States)

Checkland, Kath

2004-11-01

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

Skull-base Osteomyelitis: a Dreaded Complication after Trivial Fall and Inadequate Management

Directory of Open Access Journals (Sweden)

Kundan Mittal

2015-10-01

Full Text Available Introduction: Skull-based osteomyelitis is bony infection which generally originates from inadequately treated chronic infection, adjoining tissue infection or after trauma.Case: 11 month female child had a trivial fall while standing near a bucket. The child developed fracture of right clavicle and left orbital swelling which was inadequately treated. This resulted in in spread of infection to adjoining tissues, skull bones, sinuses and brain.Conclusion: Cranial base osteomyelitis is rare but dreaded condition which requires early diagnosis and prompt treatment to avoid mortality and morbidity in form of neurological deficits and permanent disability

Do infants with cow's milk protein allergy have inadequate levels of vitamin D?

Science.gov (United States)

Silva, Cristiane M; Silva, Silvia A da; Antunes, Margarida M de C; Silva, Gisélia Alves Pontes da; Sarinho, Emanuel Sávio Cavalcanti; Brandt, Katia G

To verify whether infants with cow's milk protein allergy have inadequate vitamin D levels. This cross-sectional study included 120 children aged 2 years or younger, one group with cow's milk protein allergy and a control group. The children were recruited at the pediatric gastroenterology, allergology, and pediatric outpatient clinics of a university hospital in the Northeast of Brazil. A questionnaire was administered to the caregiver and blood samples were collected for vitamin D quantification. Vitamin D levels <30ng/mL were considered inadequate. Vitamin D level was expressed as mean and standard deviation, and the frequency of the degrees of sufficiency and other variables, as proportions. Infants with cow's milk protein allergy had lower mean vitamin D levels (30.93 vs.35.29ng/mL; p=0.041) and higher deficiency frequency (20.3% vs.8.2; p=0.049) than the healthy controls. Exclusively or predominantly breastfed infants with cow's milk protein allergy had higher frequency of inadequate vitamin D levels (p=0.002). Regardless of sun exposure time, the groups had similar frequencies of inadequate vitamin D levels (p=0.972). Lower vitamin D levels were found in infants with CMPA, especially those who were exclusively or predominantly breastfed, making these infants a possible risk group for vitamin D deficiency. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Do infants with cow's milk protein allergy have inadequate levels of vitamin D?

Directory of Open Access Journals (Sweden)

Cristiane M. Silva

Full Text Available Abstract Objective: To verify whether infants with cow's milk protein allergy have inadequate vitamin D levels. Methods: This cross-sectional study included 120 children aged 2 years or younger, one group with cow's milk protein allergy and a control group. The children were recruited at the pediatric gastroenterology, allergology, and pediatric outpatient clinics of a university hospital in the Northeast of Brazil. A questionnaire was administered to the caregiver and blood samples were collected for vitamin D quantification. Vitamin D levels <30 ng/mL were considered inadequate. Vitamin D level was expressed as mean and standard deviation, and the frequency of the degrees of sufficiency and other variables, as proportions. Results: Infants with cow's milk protein allergy had lower mean vitamin D levels (30.93 vs.35.29 ng/mL; p = 0.041 and higher deficiency frequency (20.3% vs.8.2; p = 0.049 than the healthy controls. Exclusively or predominantly breastfed infants with cow's milk protein allergy had higher frequency of inadequate vitamin D levels (p = 0.002. Regardless of sun exposure time, the groups had similar frequencies of inadequate vitamin D levels (p = 0.972. Conclusions: Lower vitamin D levels were found in infants with CMPA, especially those who were exclusively or predominantly breastfed, making these infants a possible risk group for vitamin D deficiency.

Magnitude and determinants of inadequate third-trimester weight gain in rural Bangladesh

Science.gov (United States)

Hasan, S. M. Tafsir; Rahman, Sabuktagin; Locks, Lindsey Mina; Rahman, Mizanur; Hore, Samar Kumar; Saqeeb, Kazi Nazmus; Khan, Md. Alfazal

2018-01-01

Objectives The objective of this study was to estimate the magnitude and determinants of inadequate weight gain in the third-trimester among rural women in Matlab, Bangladesh. Methods The study analyzed data on weight gain in the third trimester in 1,883 pregnant women in Matlab, Bangladesh. All these women were admitted to Matlab hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) for childbirth during 2012–2014, and they had singleton live births at term. Data were retrieved from the electronic databases of Matlab Health and Demographic Surveillance System and Matlab hospital. A multivariable logistic regression for inadequate weight gain in the third trimester (≤4 kg) was built with sociodemographic, environmental and maternal factors as predictors. Results One thousand and twenty-six (54%) pregnant women had inadequate weight gain in the third trimester. In the multivariable model, short stature turned out to be the most robust risk factor for inadequate weight gain in the third trimester (OR = 2.5; 95% CI 1.8, 3.5 for short compared to tall women). Pre-third-trimester BMI was inversely associated with insufficient weight gain (OR = 0.96; 95% CI 0.93, 0.99 for 1 unit increase in BMI). Other risk factors for inadequate weight gain in the third trimester were advanced age (OR = 1.9; 95% CI 1.2, 3.1 for ≥35 years compared to ≤19 years), parity (OR = 1.5; 95% CI 1.2, 1.9 for multipara compared to nulliparous women), low socioeconomic status (OR = 1.7; 95% CI 1.2, 2.3 for women in the lowest compared to women in the highest wealth quintile), low level of education (OR = 1.6; 95% CI 1.2, 2.1 for ≤5 years compared to ≥10 years of education), belonging to the Hindu religious community (OR = 1.8; 95% CI 1.3, 2.5), consuming arsenic-contaminated water (OR = 1.4; 95% CI 1.1, 1.9), and conceiving during monsoon or dry season compared to summer (OR = 1.4; 95% CI 1.1, 1.8). Conclusions Among rural Bangladeshi women in Matlab

Magnitude and determinants of inadequate third-trimester weight gain in rural Bangladesh.

Science.gov (United States)

Hasan, S M Tafsir; Rahman, Sabuktagin; Locks, Lindsey Mina; Rahman, Mizanur; Hore, Samar Kumar; Saqeeb, Kazi Nazmus; Khan, Md Alfazal; Ahmed, Tahmeed

2018-01-01

The objective of this study was to estimate the magnitude and determinants of inadequate weight gain in the third-trimester among rural women in Matlab, Bangladesh. The study analyzed data on weight gain in the third trimester in 1,883 pregnant women in Matlab, Bangladesh. All these women were admitted to Matlab hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) for childbirth during 2012-2014, and they had singleton live births at term. Data were retrieved from the electronic databases of Matlab Health and Demographic Surveillance System and Matlab hospital. A multivariable logistic regression for inadequate weight gain in the third trimester (≤4 kg) was built with sociodemographic, environmental and maternal factors as predictors. One thousand and twenty-six (54%) pregnant women had inadequate weight gain in the third trimester. In the multivariable model, short stature turned out to be the most robust risk factor for inadequate weight gain in the third trimester (OR = 2.5; 95% CI 1.8, 3.5 for short compared to tall women). Pre-third-trimester BMI was inversely associated with insufficient weight gain (OR = 0.96; 95% CI 0.93, 0.99 for 1 unit increase in BMI). Other risk factors for inadequate weight gain in the third trimester were advanced age (OR = 1.9; 95% CI 1.2, 3.1 for ≥35 years compared to ≤19 years), parity (OR = 1.5; 95% CI 1.2, 1.9 for multipara compared to nulliparous women), low socioeconomic status (OR = 1.7; 95% CI 1.2, 2.3 for women in the lowest compared to women in the highest wealth quintile), low level of education (OR = 1.6; 95% CI 1.2, 2.1 for ≤5 years compared to ≥10 years of education), belonging to the Hindu religious community (OR = 1.8; 95% CI 1.3, 2.5), consuming arsenic-contaminated water (OR = 1.4; 95% CI 1.1, 1.9), and conceiving during monsoon or dry season compared to summer (OR = 1.4; 95% CI 1.1, 1.8). Among rural Bangladeshi women in Matlab, third-trimester weight gain was in

Secondary containment systems for bulk oil storage facilities

International Nuclear Information System (INIS)

Carr, B.A.

1996-01-01

The United States Environmental Protection Agency has conducted site inspections at several onshore bulk oil above ground storage facilities, to ensure that owners follow the spill prevention, control and countermeasure regulations. The four violations which were most frequently cited at these facilities were: (1) lack of a spill prevention plan, (2) lack of appropriate containment equipment to prevent discharged oil from reaching a navigable water course, (3) inadequate secondary containment structures, and (4) lack of an adequate quick drainage system in the facility tank loading/unloading area. Suggestions for feasible designs which would improve the impermeability of secondary containment for above ground storage tanks (AST) included the addition of a liner, retrofitting the bottom of an AST with a second steel plate, using a geosynthetic liner on top of the original bottom, installing a leak detection system in the interstitial space between the steel plates, or installing an under-tank liner with a leak detection system during construction of a new AST. 2 refs

How many medical requests for US, body CT, and musculoskeletal MR exams in outpatients are inadequate?

International Nuclear Information System (INIS)

Sardanelli, Francesco; Aliprandi, Alberto; Fausto, Alfonso

2005-01-01

Purpose: Our aim was to evaluate how many medical requests for US, CT and MR outpatients exams are inadequate. Materials and methods: We evaluated three series of consecutive requests for outpatients exams, distinguishing firstly the adequate from the inadequate requests. The inadequate requests were classified as: (A) absence of real indication; (B) lacking or vague clinical query; (C) absence of important information on patient's status. US requests concerned 282 patients for 300 body segments, as follows: neck (n=50); upper abdomen (n=95); lower abdomen (n=12); upper and lower abdomen (n=84); musculoskeletal (n=32); other body segments (n=27). CT requests concerned 280 patients for 300 body segments, as follows: chest (n=67); abdomen (n=77); musculoskeletal (n=94); other body segments (n=62). MR musculoskeletal requests concerned 138 patients for 150 body segments, as follows: knee (n=87); ankle (n=13); shoulder (n=28); other body segments (n=22). Results: A total of 228/300 US requests (76%) were inadequate, ranging from 66% (musculoskeletal) to 86% (neck) classified as: A, 21/228 (9%); B, 130/228 (57%); C, 77/228 (34%). A total of 231/300 (77%) body CT request were inadequate, ranging from 72% (chest) to 86% (musculoskeletal), classified as: A, 22/231 (10%); B, 88/231 (38%); C, 121/231 (52%). A total of 124/150 (83%) MR musculoskeletal requests were inadequate, ranging from 69% (ankle) to 89% (knee), classified as: A, 12/124 (10%); B, 50/124 (40%); C, 62/124 (50%). No significant difference was found among the levels of inadequacy for the three techniques and among the body segments for each of the three techniques. Conclusions: The majority of the medical requests for outpatients exams turned out to be inadequate. A large communication gap between referring physicians and radiologists needs to be filled [it

Design criteria tank farm storage and staging facility. Revision 1

International Nuclear Information System (INIS)

Lott, D.T.

1994-01-01

Tank Farms Operations must store/stage material and equipment until work packages are ready to work. Consumable materials are also required to be stored for routine and emergency work. Connex boxes and open storage is currently used for much of the storage because of the limited space at 272AW and 272WA. Safety issues based on poor housekeeping and material deteriorating due to weather damage has resulted from this inadequate storage space. It has been determined that a storage building in close proximity to the Tank Farm work force would be cost effective. Project W-402 and W-413 will provide a storage/staging area in 200 East and West Areas by the construction of two new storage facilities. The new facilities will be used by Operations, Maintenance and Materials groups to adequately store material and equipment. These projects will also furnish electrical services to the facilities for lighting and HVAC. Fire Protection shall be extended to the 200 East facility from 272AW if necessary

Consequences of Inadequate Staffing Include Missed Care, Potential Failure to Rescue, and Job Stress and Dissatisfaction.

Science.gov (United States)

Simpson, Kathleen Rice; Lyndon, Audrey; Ruhl, Catherine

2016-01-01

To evaluate responses of registered nurse members of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) to a survey that sought their recommendations for staffing guidelines and their perceptions of the consequences of inadequate nurse staffing. The goal was to use these member data to inform the work of the AWHONN nurse staffing research team. Secondary analysis of responses to the 2010 AWHONN nurse staffing survey. Online. AWHONN members (N = 884). Review of data from an online survey of AWHONN members through the use of thematic analysis for descriptions of the consequences of inadequate nurse staffing during the childbirth process. Three main themes emerged as consequences of inadequate staffing or being short-staffed: Missed Care, Potential for Failure to Rescue, and Job-Related Stress and Dissatisfaction. These themes are consistent with those previously identified in the literature related to inadequate nurse staffing. Based on the responses from participants in the 2010 AWHONN nurse staffing survey, consequences of inadequate staffing can be quite serious and may put patients at risk for preventable harm. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

CHALLENGES IN SETTING UP QUALITY CONTROL IN DIAGNOSTIC RADIOLOGY FACILITIES IN NIGERIA.

Science.gov (United States)

Inyang, S O; Egbe, N O; Ekpo, E

2015-01-01

The Nigerian Nuclear Regulatory Authority (NNRA) was established to regulate and control the use of radioactive and radiation emitting sources in Nigeria. Quality control (QC) on diagnostic radiology equipment form part of the fundamental requirements for the authorization of diagnostic radiology facilities in the Country. Some quality control tests (output, exposure linearity and reproducibility) were measured on the x-ray machines in the facilities that took part in the study. Questionnaire was developed to evaluate the frequencies at which QC tests were conducted in the facilities and the challenges in setting up QC. Results show great variation in the values of the QC parameters measured. Inadequate cooperation by facilities management, lack of QC equipment and insufficient staff form the major challenges in setting up QC in the facilities under study. The responses on the frequencies at which QC tests should be conducted did not correspond to the recommended standards; indicating that personnel were not familiar with QC implementation and may require further training on QC.

Comparison of the geometric accuracy of radiotherapy facilities by various manufacturers, performed within the programme of quality audits

International Nuclear Information System (INIS)

Pridal, I.; Klaclova, T.; Gremlica, D.; Zackova, H.; Snobr, J.

1998-01-01

The evaluation of geometric parameters of radiotherapy facilities is discussed, these parameters being of importance for focusing the target volume and for achieving the required standard of treatment. During quality audits at radiotherapy systems various shortcomings were found as regards the accuracy of irradiation. A part of the shortcomings was due to inadequate setting of the facility parameters; another, however, was related to the mechanical design of the treatment units. The latter problems cannot be easily eliminated and have to be taken into account when using the respective facilities

Factors associated with an inadequate hypoglycemia in the insulin tolerance test in Japanese patients with suspected or proven hypopituitarism.

Science.gov (United States)

Takahashi, Kiyohiko; Nakamura, Akinobu; Miyoshi, Hideaki; Nomoto, Hiroshi; Kameda, Hiraku; Cho, Kyu Yong; Nagai, So; Shimizu, Chikara; Taguri, Masataka; Terauchi, Yasuo; Atsumi, Tatsuya

2017-04-29

We attempted to identify the predictors of an inadequate hypoglycemia in insulin tolerance test (ITT), defined as a blood glucose level higher than 2.8 mmol/L after insulin injection, in Japanese patients with suspected or proven hypopituitarism. A total of 78 patients who had undergone ITT were divided into adequate and inadequate hypoglycemia groups. The relationships between the subjects' clinical parameters and inadequate hypoglycemia in ITT were analyzed. Stepwise logistic regression analysis identified high systolic blood pressure (SBP) and high homeostasis model assessment of insulin resistance (HOMA-IR) as being independent factors associated with inadequate hypoglycemia in ITT. Receiver operating characteristic (ROC) curve analysis revealed the cutoff value for inadequate hypoglycemia was 109 mmHg for SBP and 1.4 for HOMA-IR. The areas under ROC curve for SBP and HOMA-IR were 0.72 and 0.86, respectively. We confirmed that high values of SBP and HOMA-IR were associated with inadequate hypoglycemia in ITT, regardless of the degree of reduction of pituitary hormone levels. Furthermore, the strongest predictor of inadequate hypoglycemia was obtained by using the cutoff value of HOMA-IR. Our results suggest that HOMA-IR is a useful pre-screening tool for ITT in these populations.

DE-Sovietizing educational systems, learning from past policy and practice

Science.gov (United States)

Kaufman, Cathy C.

1994-03-01

All 21st century societies face the dilemma of reforming educational systems to meet changing social demands. In order to enable new beginnings to be made, this article examines the ending of reform efforts in the former Soviet Union immediately prior to the establishment of the Commonwealth of Independent States. Educational policy had followed a shifting course under changing Soviet leadership, much supposed reform consisting of little more than reworked statements of intent. In the second half of the 1980's, more serious attempts were made to raise enrollment of six-year olds, to upgrade instructional materials and teaching quality, and to redesign vocational education. Inadequate facilities and resources, lack of trained personnel, promotion on non-educational grounds, economic hardship and bureaucratic resistance hindered these reforms. As successor states to the Soviet Union — and others — face structural change, knowledge of why certain reforms were previously resisted will help future planning.

The inadequate liability and compensation regime for damage caused by nuclear activities

International Nuclear Information System (INIS)

Dyke, Jon M. Van

2010-09-01

The specific obligation to provide restitution and compensation when nuclear activities cause injuries has been recognized repeatedly and is now certainly part of customary international law. But problems remain regarding how to measure damages, how to implement the duty to repair the injuries, and what specific obligations exist to protect neighboring states from transboundary pollution. Although some treaties exist governing liability for harm resulting from nuclear accidents, they are not adequate to protect victims and have not been widely ratified. The failure to require nuclear operators to prepare for damage that may result from accidents constitutes a subsidy to the nuclear industry and makes it difficult to compare the real costs of nuclear energy with the costs of other energy sources. This survey of settled norms and unresolved issues demonstrates that further work is needed to develop a comprehensive and authoritative regime to govern harm from nuclear activities. Although it is clear that both the operators of nuclear facilities and the states that have jurisdiction over them would be responsible to provide restitution and compensation for such harm under a strict liability regime, the types of injuries that must be compensated and the range of damages that must be covered remain subjects of controversy. Although the underlying customary international law principles (the no-harm principle and the polluter-pays principle) are clear, the actual treaties that have been drafted are inadequate and they have not been widely ratified. Victims of damage from nuclear activities would have difficulty finding a neutral tribunal in which to bring their claims and would face procedural obstacles including caps on liabilities and inappropriately short statutes of limitations as well as difficulties regarding proof of damages. The failure to develop a proper regime that would ensure full restitution and compensation for harm resulting from nuclear facilities

Racial and Social Class Differences in How Parents Respond to Inadequate Achievement: Consequences for Children's Future Achievement.

Science.gov (United States)

Robinson, Keith; Harris, Angel L

2013-12-01

Despite numerous studies on parental involvement in children's academic schooling, there is a dearth of knowledge on how parents respond specifically to inadequate academic performance. This study examines whether 1) racial differences exist in parenting philosophy for addressing inadequate achievement, 2) social class has implications for parenting philosophy, and 3) parents' philosophies are consequential for children's academic achievement. Using data from the Child Development Supplement (N=1041) to the Panel Study of Income Dynamics, we sort parents into two categories-those whose parenting repertoires for addressing poor achievement include punitive responses and those whose repertoires do not. We then determine whether racial differences exist between these categories and how various responses within the aforementioned categories are related to students' academic achievement. The findings show that white and black parents have markedly different philosophies on how to respond to inadequate performance, and these differences appear to impact children's achievement in dramatically different ways. Educators and policy makers should pay particular attention to how parents respond to inadequate achievement as imploring parents of inadequately performing students to be more involved without providing them with some guidance might exacerbate the problem.

Bureaucratic discretion and alternative teacher certification: understanding program variation in Missouri.

Directory of Open Access Journals (Sweden)

Ethan B. Heinen

2007-06-01

Full Text Available Alternative teacher certification literature has contributed significantly to our understanding of this approach to teacher preparation. However, this literature has more often than not treated alternative teacher certification programs (ATCPs as a black box, thus ignoring program heterogeneity. The present study examines how and why five ATCPs in Missouri have evolved in different ways. To understand this variation and its potential significance for researchers and practitioners, we use political science literature on bureaucratic discretion to understand programs' varied responses within the same state policy context. Using a multiple case study design, we present two key findings. First, external factors such as the state's regulatory approach, programs' relationships with school districts, and programs' relationship with external partners shape program coordinators' perceptions of their discretionary authority. Second, within an environment of limited regulation, programs responded to these external factors in ways that shaped programs in dramatically different ways. These approaches ranged from formal partnerships with large urban school districts and philanthropic funders to alternative certification programs that were at least partially blended with existing undergraduate and post baccalaureate teacher preparation programs. In our discussion, we explore how state attempts to widen the discretionary space between the rules may have allowed external interests (e.g., school districts, and external funders to backfill that space in ways that limit the potential for programs to provide high quality preparation experiences. This study explores these consequences and trade offs in order to inform policy makers and practitioners who are concerned with fostering innovative and creative ways to prepare high quality teachers.

Predicting Patients with Inadequate 24- or 48-Hour Urine Collections at Time of Metabolic Stone Evaluation.

Science.gov (United States)

McGuire, Barry B; Bhanji, Yasin; Sharma, Vidit; Frainey, Brendan T; McClean, Megan; Dong, Caroline; Rimar, Kalen; Perry, Kent T; Nadler, Robert B

2015-06-01

We aimed to understand the characteristics of patients who are less likely to submit adequate urine collections at metabolic stone evaluation. Inadequate urine collection was defined using two definitions: (1) Reference ranges for 24-hour creatinine/kilogram (Cr/24) and (2) discrepancy in total 24-hour urine Cr between 24-hour urine collections. There were 1502 patients with ≥1 kidney stone between 1998 and 2014 who performed a 24- or 48-hour urine collection at Northwestern Memorial Hospital and who were identified retrospectively. Multivariate analysis was performed to analyze predictor variables for adequate urine collection. A total of 2852 urine collections were analyzed. Mean age for males was 54.4 years (range 17-86), and for females was 50.2 years (range 8-90). One patient in the study was younger than 17 years old. (1) Analysis based on the Cr 24/kg definition: There were 50.7% of patients who supplied an inadequate sample. Females were nearly 50% less likely to supply an adequate sample compared with men, Pcollections were achieved in 82.8%, 66.9%, 51.7%, 38.5%, and 26.4% of patients, respectively. Statistical significance was observed based on differences of ≥40%, and this was defined as the threshold for an inadequate sample. Female sex (OR 0.73 [0.54-0.98], P=0.037) predicted supplying inadequate samples. Adequate collections were more likely to be received on a Sunday (OR 1.6 [1.03-2.58], P=0.038) and by sedentary workers (OR 2.3 [1.12-4.72], P=0.023). Urine collections from patients during metabolic evaluation for nephrolithiasis may be considered inadequate based on two commonly used clinical definitions. This may have therapeutic or economic ramifications and the propensity for females to supply inadequate samples should be investigated further.

Inadequate cerebral oxygen delivery and central fatigue during strenuous exercise

DEFF Research Database (Denmark)

Nybo, Lars; Rasmussen, Peter

2007-01-01

Under resting conditions, the brain is protected against hypoxia because cerebral blood flow increases when the arterial oxygen tension becomes low. However, during strenuous exercise, hyperventilation lowers the arterial carbon dioxide tension and blunts the increase in cerebral blood flow, which...... can lead to an inadequate oxygen delivery to the brain and contribute to the development of fatigue....

Inadequate Evidence for Multiple Intelligences, Mozart Effect, and Emotional Intelligence Theories

Science.gov (United States)

Waterhouse, Lynn

2006-01-01

I (Waterhouse, 2006) argued that, because multiple intelligences, the Mozart effect, and emotional intelligence theories have inadequate empirical support and are not consistent with cognitive neuroscience findings, these theories should not be applied in education. Proponents countered that their theories had sufficient empirical support, were…

The politics and anti-politics of the global fund experiment: understanding partnership and bureaucratic expansion in Uganda.

Science.gov (United States)

Taylor, E Michelle; Harper, Ian

2014-01-01

After a decade of operations, the Global Fund is an institutional form in flux. Forced to cancel its eleventh round of funding due to a shortfall in donor pledges, the Fund is currently in firefighting mode, overhauling its leadership, governance structures, and operations. Drawing on a case study of Uganda, we look at how the original Global Fund vision to be a simple financial instrument has played out at the country level. Even prior to the cancellation of round 11, the proliferation of partners required to sustain the Global Fund to Fight AIDS, Tuberculosis and Malaria experiment led to increasing bureaucratization and an undermining of the Fund's own intentions to award life-saving grants according to need. Understanding these effects through the ethnographic material presented here may be one way of reflecting on the Fund's structure and practices as it struggles to reinvent itself in the face of criticism that it has impeded resource distribution.

Predictors of Inadequate Prenatal Care in Methamphetamine-Using Mothers in New Zealand and the United States

Science.gov (United States)

LaGasse, Linda L.; Wouldes, Trecia A.; Arria, Amelia M.; Wilcox, Tara; Derauf, Chris; Newman, Elana; Shah, Rizwan; Smith, Lynne M.; Neal, Charles R.; Huestis, Marilyn A.; DellaGrotta, Sheri; Lester, Barry M.

2013-01-01

This study compared patterns of prenatal care among mothers who used methamphetamine (MA) during pregnancy and non-using mothers in the US and New Zealand (NZ), and evaluated associations among maternal drug use, child protective services (CPS) referral, and inadequate prenatal care in both countries. The sample consisted of 182 mothers in the MA-Exposed and 196 in the Comparison groups in the US, and 107 mothers in the MA-Exposed and 112 in the Comparison groups in NZ. Positive toxicology results and/or maternal report of MA use during pregnancy were used to identify MA use. Information about sociodemographics, prenatal care and prenatal substance use was collected by maternal interview. MA-use during pregnancy is associated with lower socio-economic status, single marital status, and CPS referral in both NZ and the US. Compared to their non-using counterparts, MA-using mothers in the US had significantly higher rates of inadequate prenatal care. No association was found between inadequate care and MA-use in NZ. In the US, inadequate prenatal care was associated with CPS referral, but not in NZ. Referral to CPS for drug use only composed 40 % of all referrals in the US, but only 15 % of referrals in NZ. In our study population, prenatal MA-use and CPS referral eclipse maternal sociodemographics in explanatory power for inadequate prenatal care. The predominant effect of CPS referral in the US is especially interesting, and should encourage further research on whether the US policy of mandatory reporting discourages drug-using mothers from seeking antenatal care. PMID:22588827

Inadequate pelvic radiographs: implications of not getting it right the first time.

Science.gov (United States)

Parker, S; Nagra, N S; Kulkarni, K; Pegrum, J; Barry, S; Hughes, R; Ghani, Y

2017-09-01

Introduction Pelvic radiography is a frequent investigation. European guidelines aim to ensure appropriate use and adequate quality. When initial images are inadequate, repeat radiographs are often required, which may have significant patient safety and economic implications. Objectives The study aimed to assess the adequacy of pelvic imaging across three orthopaedic centres, to identify causes for inadequate imaging and to establish the cost of inadequate imaging from financial and patient safety perspectives. Methods Pelvic radiographs were identified on Picture Archiving and Communication System software at three UK hospitals. Radiographs were assessed against European guidelines and indications for repeat imaging were analysed. Results A total of 1,531 sequential pelvic radiographs were reviewed. The mean age of patients was 60 years (range 5 months to 101 years). Of this total, 51.9% of images were suboptimal, with no significant difference across the three hospitals (P > 0.05). Hospital 3 repeated radiographs in 6.3% of cases, compare with 18.1% and 19.7% at hospitals 1 and 2, respectively (P > 0.05). Hospital 3 identified pathology missed on the initial radiograph in 1% of cases, compared with 5.4% and 5.5% at hospitals 1 and 2, respectively (P > 0.05). Out-of-hours imaging is associated with a higher rate of suboptimal quality (69.1%) compared with normal working hours (51.3%; P = 0.006). Adequacy rates vary with age (χ 2 = 43.62, P hours imaging.

Estimating the global prevalence of inadequate zinc intake from national food balance sheets: effects of methodological assumptions.

Directory of Open Access Journals (Sweden)

K Ryan Wessells

Full Text Available The prevalence of inadequate zinc intake in a population can be estimated by comparing the zinc content of the food supply with the population's theoretical requirement for zinc. However, assumptions regarding the nutrient composition of foods, zinc requirements, and zinc absorption may affect prevalence estimates. These analyses were conducted to: (1 evaluate the effect of varying methodological assumptions on country-specific estimates of the prevalence of dietary zinc inadequacy and (2 generate a model considered to provide the best estimates.National food balance data were obtained from the Food and Agriculture Organization of the United Nations. Zinc and phytate contents of these foods were estimated from three nutrient composition databases. Zinc absorption was predicted using a mathematical model (Miller equation. Theoretical mean daily per capita physiological and dietary requirements for zinc were calculated using recommendations from the Food and Nutrition Board of the Institute of Medicine and the International Zinc Nutrition Consultative Group. The estimated global prevalence of inadequate zinc intake varied between 12-66%, depending on which methodological assumptions were applied. However, country-specific rank order of the estimated prevalence of inadequate intake was conserved across all models (r = 0.57-0.99, P<0.01. A "best-estimate" model, comprised of zinc and phytate data from a composite nutrient database and IZiNCG physiological requirements for absorbed zinc, estimated the global prevalence of inadequate zinc intake to be 17.3%.Given the multiple sources of uncertainty in this method, caution must be taken in the interpretation of the estimated prevalence figures. However, the results of all models indicate that inadequate zinc intake may be fairly common globally. Inferences regarding the relative likelihood of zinc deficiency as a public health problem in different countries can be drawn based on the country

Influenza preparedness and the bureaucratic reflex: anticipating and generating the 2009 H1N1 event.

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Barker, Kezia

2012-07-01

This paper draws together work on the event to problematise the generative implications of anticipatory governance in the management of emerging infectious disease. Through concerns for preparedness, the need to anticipate outbreaks of disease has taken on a new urgency. With the identification of the H1N1 virus circulating amongst human populations in 2009, public health measures and security practices at regional, national and international levels were rapidly put into play. However, as the ensuing event demonstrated, the social, political and economic disruptions of emerging infectious diseases can be matched by those of anticipatory actions. I argue that the event-making potential of surveillance practices and the pre-determined arrangements of influenza preparedness planning, when triggered by the H1N1 virus, caused an event acceleration through the hyper-sensitised global health security architecture. In the UK, this led to a bureaucratic reflex, a security response event that overtook the present actualities of the disease. This raises questions about the production of forms of insecurity by the security apparatus itself. Copyright © 2012. Published by Elsevier Ltd.

Evidence Report: Risk of Inadequate Human-Computer Interaction

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Holden, Kritina; Ezer, Neta; Vos, Gordon

2013-01-01

Human-computer interaction (HCI) encompasses all the methods by which humans and computer-based systems communicate, share information, and accomplish tasks. When HCI is poorly designed, crews have difficulty entering, navigating, accessing, and understanding information. HCI has rarely been studied in an operational spaceflight context, and detailed performance data that would support evaluation of HCI have not been collected; thus, we draw much of our evidence from post-spaceflight crew comments, and from other safety-critical domains like ground-based power plants, and aviation. Additionally, there is a concern that any potential or real issues to date may have been masked by the fact that crews have near constant access to ground controllers, who monitor for errors, correct mistakes, and provide additional information needed to complete tasks. We do not know what types of HCI issues might arise without this "safety net". Exploration missions will test this concern, as crews may be operating autonomously due to communication delays and blackouts. Crew survival will be heavily dependent on available electronic information for just-in-time training, procedure execution, and vehicle or system maintenance; hence, the criticality of the Risk of Inadequate HCI. Future work must focus on identifying the most important contributing risk factors, evaluating their contribution to the overall risk, and developing appropriate mitigations. The Risk of Inadequate HCI includes eight core contributing factors based on the Human Factors Analysis and Classification System (HFACS): (1) Requirements, policies, and design processes, (2) Information resources and support, (3) Allocation of attention, (4) Cognitive overload, (5) Environmentally induced perceptual changes, (6) Misperception and misinterpretation of displayed information, (7) Spatial disorientation, and (8) Displays and controls.

The Bureaucratic Muse: On Thomas Bernhard's Exempel, Adalbert Stifter's Der Kuss von Sentze, Franz Kafka's In der Strafkolonie, and Oswald Wieners die verbesserung von mitteleuropa, roman

OpenAIRE

Hughes, Helen

1994-01-01

The thesis, as its title suggests, works through examples: it looks at the way in which four literary works have responded to the spirit of bureaucracy. It also looks at the way in which each text, by thematizing bureaucracy, questions itself as a literary text. By working through examples the thesis also thematizes the bureaucratization of literature in that each example is an individual case, selected in order to become one of a group. In the introduction it is argued that the essence o...

More energy wood from forestry operations through integrated harvesting and multi-products processing

International Nuclear Information System (INIS)

Lambert, M.B.

1991-01-01

Abundant supplies of forest biomass that could potentially be used for energy wood are not being accessed because of marginal economics, inadequate harvest methods, and restrictive land management practices. Future forestry objectives may impose even more restrictive conditions. Improvements in efficiency and effectiveness of harvest methods, marketing, and bureaucratic processes may, however, render more energy wood while meeting new post-harvest stand conditions. Some improvements have been achieved while others lie on the horizon

Capacity of Health Facilities to Manage Hypertension in Mukono and Buikwe Districts in Uganda: Challenges and Recommendations.

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Musinguzi, Geofrey; Bastiaens, Hilde; Wanyenze, Rhoda K; Mukose, Aggrey; Van Geertruyden, Jean-Pierre; Nuwaha, Fred

2015-01-01

The burden of chronic diseases is increasing in both low- and middle-income countries. However, healthcare systems in low-income countries are inadequately equipped to deal with the growing disease burden, which requires chronic care for patients. The aim of this study was to assess the capacity of health facilities to manage hypertension in two districts in Uganda. In a cross-sectional study conducted between June and October 2012, we surveyed 126 health facilities (6 hospitals, 4 Health Center IV (HCIV), 23 Health Center III (HCIII), 41 Health Center II (HCII) and 52 private clinics/dispensaries) in Mukono and Buikwe districts in Uganda. We assessed records, conducted structured interviews with heads of facilities, and administered questionnaires to 271 health workers. The study assessed service provision for hypertension, availability of supplies such as medicines, guidelines and equipment, in-service training for hypertension, knowledge of hypertension management, challenges and recommendations. Of the 126 health facilities, 92.9% reported managing (diagnosing/treating) patients with hypertension, and most (80.2%) were run by non-medical doctors or non-physician health workers (NPHW). Less than half (46%) of the facilities had guidelines for managing hypertension. A 10th of the facilities lacked functioning blood pressure devices and 28% did not have stethoscopes. No facilities ever calibrated their BP devices except one. About a half of the facilities had anti-hypertensive medicines in stock; mainly thiazide diuretics (46%), beta blockers (56%) and calcium channel blockers (48.4%). Alpha blockers, mixed alpha & beta blockers and angiotensin II receptor antagonists were only stocked by private clinics/dispensaries. Most HCIIs lacked anti-hypertensive medicines, including the first line thiazide diuretics. Significant knowledge gaps in classification of patients as hypertensive were noted among respondents. All health workers (except 5, 1.9%) indicated that they

Management challenges faced by managers of New Zealand long-term care facilities.

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Madas, E; North, N

2000-01-01

This article reports on a postal survey of 78 long-term care managers in one region of New Zealand, of whom 45 (58%) responded. Most long-term care managers (73.2%) were middle-aged females holding nursing but not management qualifications. Most long-term care facilities (69%) tended to be stand-alone facilities providing a single type of care (rest home or continuing care hospital). The most prominent issues facing managers were considered to be inadequate funding to match the growing costs of providing long-term care and occupancy levels. Managers believed that political/regulatory, economic and social factors influenced these issues. Despite a turbulent health care environment and the challenges facing managers, long-term care managers reported they were coping well and valued networking.

High Prevalence of Inadequate Calcium and Iron Intakes by Mexican Population Groups as Assessed by 24-Hour Recalls.

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Sánchez-Pimienta, Tania G; López-Olmedo, Nancy; Rodríguez-Ramírez, Sonia; García-Guerra, Armando; Rivera, Juan A; Carriquiry, Alicia L; Villalpando, Salvador

2016-09-01

A National Health and Nutrition Survey (ENSANUT) conducted in Mexico in 1999 identified a high prevalence of inadequate mineral intakes in the population by using 24-h recall questionnaires. However, the 1999 survey did not adjust for within-person variance. The 2012 ENSANUT implemented a more up-to-date 24-h recall methodology to estimate usual intake distributions and prevalence of inadequate intakes. We examined the distribution of usual intakes and prevalences of inadequate intakes of calcium, iron, magnesium, and zinc in the Mexican population in groups defined according to sex, rural or urban area, geographic region of residence, and socioeconomic status (SES). We used dietary intake data obtained through the 24-h recall automated multiple-pass method for 10,886 subjects as part of ENSANUT 2012. A second measurement on a nonconsecutive day was obtained for 9% of the sample. Distributions of usual intakes of the 4 minerals were obtained by using the Iowa State University method, and the prevalence of inadequacy was estimated by using the Institute of Medicine's Estimated Average Requirement cutoff. Calcium inadequacy was 25.6% in children aged 1-4 y and 54.5-88.1% in subjects >5 y old. More than 45% of subjects >5 y old had an inadequate intake of iron. Less than 5% of children aged 12 y had inadequate intakes of magnesium, whereas zinc inadequacy ranged from <10% in children aged <12 y to 21.6% in men aged ≥20 y. Few differences were found between rural and urban areas, regions, and tertiles of SES. Intakes of calcium, iron, magnesium, and zinc are inadequate in the Mexican population, especially among adolescents and adults. These results suggest a public health concern that must be addressed. © 2016 American Society for Nutrition.

[Electrical field exposure and human health. Risk assessment and problems relative to bureaucratic procedures and to the role of instituitional organizations in control and prevention].

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Grappasonni, I; Petrelli, F; Pellegrini, M G; Nacciarriti, L; Bernardini, C; Cocchioni, M

2000-01-01

After closely analyzing the phenomenon regarding the immense increase and diffusion of equipment which generates low- and high-frequency electromagnetic fields, the AA emphasize both the methodological and interpretive difficulties of assessing the effects produced on public health. They maintain the need to exercise caution in determining the tolerable limits of exposure, and in particular long-term ones. Finally, after analyzing the bureaucratic procedure which led to the formulation of Decree No. 381 of 1998, they express the hope that the various Regions will set themselves high-quality objectives when promulgating the necessary legislation, so as to minimize the risk factor.

Determinants of Integrated Management of Childhood Illness (IMCI) non-severe pneumonia classification and care in Malawi health facilities: Analysis of a national facility census.

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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

Inadequate Gestational Weight Gain Predicts Adverse Pregnancy Outcomes in Mothers with Inflammatory Bowel Disease: Results from a Prospective US Pregnancy Cohort.

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Bengtson, May-Bente; Martin, Christopher F; Aamodt, Geir; Vatn, Morten H; Mahadevan, Uma

2017-08-01

Malnutrition and weight loss are common features of patients with inflammatory bowel disease (IBD). To explore the impact of inadequate gestational weight gain (GWG) on adverse outcomes among IBD mothers in the prospective US pregnancy in Inflammatory Bowel Disease and Neonatal Outcomes (PIANO) cohort. The PIANO cohort comprises 559 and 363 pregnant mothers with Crohn's disease (CD) and ulcerative colitis (UC), respectively, enrolled between 2006 and 2014. The mothers were followed during and after pregnancy to ascertain medication, measurement of disease activity and complications during pregnancy and at delivery. Inadequate GWG was based on US Institute of Medicine recommendations. The associations between inadequate GWG and adverse pregnancy outcomes in maternal IBD were analyzed, adjusted for diabetes, hypertension, smoking, maternal age, education, and disease activity. Maternal CD and UC with inadequate GWG had a 2.5-fold increased risk of preterm birth (OR 2.5, CI 1.3, 4.9 and OR 2.5, CI 1.2, 5.6). Furthermore, an increased risk of intrauterine growth restriction and a trend for small for gestational age were demonstrated in CD but not in UC (OR 3.3, CI 1.1, 10.0, OR 4.5, CI 0.8, 24.3, p = 0.08). Flares increased risk of inadequate GWG (OR 1.6, CI 1.2, 2.3, p = 0.002) but did not change the associations between inadequate GWG and adverse pregnancy outcomes in our models. The US PIANO cohort demonstrated that inadequate GWG was a strong independent predictor of adverse pregnancy outcomes in IBD mothers.

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

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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.

Inadequate management of pregnancy-associated listeriosis: lessons from four case reports.

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Charlier, C; Goffinet, F; Azria, E; Leclercq, A; Lecuit, M

2014-03-01

Listeria monocytogenes infection during pregnancy can lead to dramatic fetal or neonatal outcomes. No clinical trial has evaluated treatment options, and retrospective studies of cases are therefore important to define optimal regimens. We report four cases of materno-neonatal listeriosis illustrating inadequate antimicrobial therapy management and discuss recommended treatment options. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

Bureaucratic logic in new social movement clothing: the limits of health promotion research.

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Stevenson, H M; Burke, M

1992-01-01

This paper discusses theoretical, methodological and political problems in the field of health promotion research. It argues that these problems result from a partial and contradictory appropriation of the discourse of new social movements. Politically, the health promotion movement is largely confined within the state, rather than the expression of a social movement against the state. The direction of health promotion research and policy is, therefore, caught in the bureaucratic logic of "trapped administrators", and results in contradictory emphases on problems like the development of "health promotion indicators", which show little result in informing a broader but coherent conceptualization of health, let alone in effecting change in health policy and outcomes. Such political problems reflect parallel confusions about theory and methodology. Theoretically, the field relies heavily on a critique of bio-medical science, but fails to move beyond a rhetorical outline of an alternative to systematic arguments about what promotes health. In this regard, the literature on health promotion remains unaware of important conceptual developments in the social sciences, relies on imprecise specifications of major constructs like community empowerment, and has no conception of the state. Methodologically, the literature is influenced by contradictory epistemological tendencies which reflect a positivist inspiration (as in the search for indicators) and an anti-positivist emphasis on agency and social change through the collective action and the discursive reconstitution of social identity, value and meaning. In regard to these questions, this paper is critical of observers who suggest that the way ahead is to embrace post-modern research strategies.(ABSTRACT TRUNCATED AT 250 WORDS)

OCCUPATIONAL ACCIDENTS AS INDICATORS OF INADEQUATE WORK CONDITIONS AND WORK ENVIRONMENT

OpenAIRE

Petar Babović

2009-01-01

Occupational accidents due to inadequate working conditions and work environment present a major problem in highly industrialised countries, as well as in developing ones. Occupational accidents are a regular and accompanying phenomenon in all human activities and one of the main health related and economic problems in modern societies.The aim of this study is the analysis of the connections of unfavourable working conditions and working environment on occupational accidents. Occurrence of oc...

Hanford Site waste tank farm facilities design reconstitution program plan

International Nuclear Information System (INIS)

Vollert, F.R.

1994-01-01

Throughout the commercial nuclear industry the lack of design reconstitution programs prior to the mid 1980's has resulted in inadequate documentation to support operating facilities configuration changes or safety evaluations. As a result, many utilities have completed or have ongoing design reconstitution programs and have discovered that without sufficient pre-planning their program can be potentially very expensive and may result in end-products inconsistent with the facility needs or expectations. A design reconstitution program plan is developed here for the Hanford waste tank farms facility as a consequence of the DOE Standard on operational configuration management. This design reconstitution plan provides for the recovery or regeneration of design requirements and basis, the compilation of Design Information Summaries, and a methodology to disposition items open for regeneration that were discovered during the development of Design Information Summaries. Implementation of this plan will culminate in an end-product of about 30 Design Information Summary documents. These documents will be developed to identify tank farms facility design requirements and design bases and thereby capture the technical baselines of the facility. This plan identifies the methodology necessary to systematically recover documents that are sources of design input information, and to evaluate and disposition open items or regeneration items discovered during the development of the Design Information Summaries or during the verification and validation processes. These development activities will be governed and implemented by three procedures and a guide that are to be developed as an outgrowth of this plan

Managing inadequate responses to frontline treatment of chronic myeloid leukemia: a case-based review.

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Bixby, Dale L

2013-05-01

The tyrosine kinase inhibitors (TKIs) imatinib, nilotinib, and dasatinib are the standard of care for treating patients with newly diagnosed chronic-phase chronic myeloid leukemia (CML). Compared with interferon-based treatment, the previous standard of care, imatinib is associated with significantly higher cytogenetic response rates and prolonged overall survival. Nilotinib and dasatinib, both newer and more potent TKIs, significantly improve cytogenetic and molecular response rates compared with imatinib. Despite significant advances in CML treatment enabled by the TKIs, a fraction of patients who receive frontline treatment with a TKI demonstrate inadequate response. The reasons for this vary, but in many cases, inadequate response can be attributed to non-adherence to the treatment regimen, intolerance to the drug, intrinsic or acquired resistance to the drug, or a combination of reasons. More often than not, strategies to improve response necessitate a change in treatment plan, either a dose adjustment or a switch to an alternate drug, particularly in the case of drug intolerance or drug resistance. Improved physician-patient communication and patient education are effective strategies to address issues relating to adherence and intolerance. Because inadequate response to TKI treatment correlates with poor long-term outcomes, it is imperative that patients who experience intolerance or who fail to achieve appropriate responses are carefully evaluated so that appropriate treatment modifications can be made to maximize the likelihood of positive long-term outcome. Copyright © 2012. Published by Elsevier Ltd.

Educational Needs of Health Care Providers Working in Long-Term Care Facilities with Regard to Pain Management

Directory of Open Access Journals (Sweden)

Yannick Tousignant-Laflamme

2012-01-01

Full Text Available BACKGROUND: The prevalence of chronic pain ranges from 40% to 80% in long-term care facilities (LTCF, with the highest proportion being found among older adults and residents with dementia. Unfortunately, pain in older adults is underdiagnosed, undertreated, inadequately treated or not treated at all. A solution to this problem would be to provide effective and innovative interdisciplinary continuing education to health care providers (HCPs.

Randomized Trial of Once-Daily Fluticasone Furoate in Children with Inadequately Controlled Asthma

DEFF Research Database (Denmark)

Oliver, Amanda J.; Covar, Ronina A.; Goldfrad, Caroline H.

2016-01-01

Objective To evaluate the dose-response, efficacy, and safety of fluticasone furoate (FF; 25 µg, 50 µg, and 100 µg), administered once daily in the evening during a 12-week treatment period to children with inadequately controlled asthma. Study design This was a Phase IIb, multicenter, stratified...

Application of demography to energy facility development projects. Working Paper No. 39

International Nuclear Information System (INIS)

Krannich, R.S.; Stanfield, G.G.

1977-01-01

The emergence of concern regarding socioeconomic consequences of large-scale development projects has resulted in a growing literature directed as estimating the types and levels of various impact dimensions which can be expected to result in human communities experiencing such development. Among these dimensions, a focus on population change has been prevalent. Accurate demographic predictions may be viewed as critical for the adequate comprehension of and preparation for impacts deriving from projects such as energy facility developments. Unfortunately, the state of the art in projecting demographic consequences of energy projects has been generally inadequate. Several of the more influential prior methods for estimating local demographic effects of developing energy facilities are critiqued, although their specific prediction figures are not summarized. The studies reviewed were found to be of dubious practical utility, probably due in part to the failure of basic demography to provide a base of support for applied demographic research. This report sets forth recommendations for the development of a theoretical perspective which would more adequately serve the needs of practitioners attempting to predict local demographic effects of energy facility development

Inadequate ventilation for nosocomial tuberculosis prevention in public hospitals in Central Thailand.

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Jiamjarasrangsi, W; Bualert, S; Chongthaleong, A; Chaindamporn, A; Udomsantisuk, N; Euasamarnjit, W

2009-04-01

Forty-two community and general hospitals in central Thailand. To examine the adequacy of indoor ventilation for nosocomial tuberculosis (TB) prevention in public hospitals in central Thailand. A cross-sectional survey was conducted among 323 patient care and ancillary areas in the target hospitals. Data on indoor ventilation rate were collected by the tracer gas method and reported as air changes per hour (ACH). The adequacy of the measured ventilation rates were then determined by comparison with the international recommended standard values. Indoor ventilation rates were inadequate in almost half of the studied areas (144/323, 44.6%). The inadequacy was particularly serious in the emergency rooms (ERs) and radiological areas, where 73.8% (31/42 each) of the rooms had ACH below the recommended standards. Detailed analysis showed that most of the rooms with natural ventilation had air exchange rates that exceeded the recommended standards, while the opposite was the case for rooms with air-conditioning, particularly the window or wall-mount type. Indoor ventilation in high-risk nosocomial TB areas in public hospitals in Thailand was inadequate due to the installation of air-conditioning systems in modern buildings.

Household Response to Inadequate Sewerage and Garbage Collection Services in Abuja, Nigeria.

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Abubakar, Ismaila Rimi

2017-01-01

Provision of sanitation and garbage collection services is an important and yet challenging issue in the rapidly growing cities of developing countries, with significant human health and environmental sustainability implications. Although a growing number of studies have investigated the consequences of inadequate delivery of basic urban services in developing countries, few studies have examined how households cope with the problems. Using the Exit, Voice, Loyalty, and Neglect (EVLN) model, this article explores how households respond to inadequate sewerage and garbage collection services in Abuja, Nigeria. Based on a qualitative study, data were gathered from in-depth interviews with sixty households, complemented with personal observation. The findings from grounded analysis indicated that majority (62%) and about half (55%) of the respondents have utilized the informal sector for sewerage services and garbage collection, respectively, to supplement the services provided by the city. While 68% of the respondents reported investing their personal resources to improve the delivery of existing sewerage services, half (53%) have collectively complained to the utility agency and few (22%) have neglected the problems. The paper concludes by discussing the public health and environmental sustainability implications of the findings.

Facility-Based Maternal Death in Western Africa: A Systematic Review

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Nathali Gunawardena

2018-02-01

Full Text Available BackgroundFor exploring maternal death, supply and demand-side factors can be characterized by the three delays model developed by Thaddeus and Maine (1994. The model comprises delay in deciding to seek care (delay 1, delay in reaching the health facility (delay 2, and delay in receiving quality care once at the health facility (delay 3. Few studies have comprehensively dealt with the health systems delays that prevent the receipt of timely and appropriate obstetric care once a woman reaches a health facility (phase III delays. The objective of the present study was to identify facility-level barriers in West African health facilities.MethodsElectronic databases (Medline, cumulative index to nursing and allied health literature, Centre for Agriculture and Biosciences International Global Health, EMBASE were searched to identify original research articles from 1996 to 2016. Search terms (and synonyms related to (1 maternal health care (e.g., obstetric care, perinatal care, maternal health services; (2 facility level (e.g., maternity unit, health facility, phase III, hospital; and (3 Western Africa (e.g., Nigeria, Burkina Faso were combined. This review followed the preferred reporting items for systematic reviews and meta-analyses.ResultsOf the 2103 citations identified, 13 studies were eligible. Studies were conducted in Nigeria, Burkina Faso, Gambia, Guinea, Senegal, and Sierra Leone. 30 facility-level barriers were identified and grouped into 6 themes (human resources, supply and equipment, referral-related, infrastructure, cost-related, patient-related. The most obvious barriers included staff shortages, lack of maternal health services and procedures offered to patients, and lack of necessary medical equipment and supplies in the health-care facilities.ConclusionThis review emphasizes that phase I and phase II barriers are not the only factors preventing women from accessing proper emergency obstetric care. Health-care facilities in Western

Lower Socio-economic Status and Cardiovascular Disease: Role of Healthcare Facility and Policy in India

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Arti Singh

2016-09-01

Full Text Available Background: Cardio-vascular disease (CVD is one of the main cause of mortality Worldwide and India is no exception. Unlike developed countries, where both CVD prevalence and mortality has been established to affect lower socio-economic status (SES, in India there is no consensus among researchers over socio-economic patterning of CVD prevalence but the mortality rate has been reported to disproportionately affect the economically weaker sections. Aims & Objectives: This article, focuses at the issue of how lack of good healthcare facilities and non-supportive health policies are affecting CVD mortality positively among lower SES of India. Challenges of the Indian healthcare system in context of lower SES can be described in terms of the issue of availability, accessibility and affordability. Inadequate policy and public healthcare system either leads to the problem of high Out-of-Pocket Payments (OPP or opting out of the treatment, which further increases poverty and mortality among them. Moreover, limited insurance coverage and inadequate regulatory policies for alcohol and tobacco-leading CVD risk factors among lower SES groups – do little to discourage its use among them. Conclusion: Since, lower SES people in India are already under the burden of communicable diseases, government should take immediate steps to control the mortality among them by creating a supportive environment through pro-poor health policies and healthcare facilities.

Effect of inadequate ferrule segment location on fracture resistance of endodontically treated teeth

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Satheesh B Haralur

2018-01-01

Full Text Available Introduction: The circumferential 2 mm ferrule during the fabrication of the crown is strongly advocated for the long-term clinical success. During the routine clinical practice, the dentist encounters the endodontically treated tooth (ETT with inadequacy of the ferrule in some segment due to caries, abrasion, and erosions. The aim of this in vitro study was to investigate the consequence of inadequate segmental ferrule location on fracture strength of the root canal-treated anterior and posterior teeth. Materials and Methods: Fifty each maxillary canine and mandibular premolar intact human teeth were root canal treated and sectioned at 2 mm above the cementum-enamel junction. The teeth samples were divided into 5 groups of 10 each. The G-I and G-V samples had the 360° ferrule and complete absence of the ferrule, respectively. The G-II had the inadequate ferrule on the palatal surface, while G-III and G-IV had inadequate ferrule at buccal and proximal area. Teeth samples were subsequently restored with glass-reinforced fiber post, composite core, and full veneer metal crown. The samples were tested with universal testing machine under static load to record the fracture resistance. The acquired data were subjected to ANOVA and Tukey's post hoc statistical analysis. Results: The G-I with circumferential ferrule showed the higher fracture resistance. The teeth samples with lack of the ferrule had the least fracture resistance. Among the segmental absence of ferrule, teeth samples with lack of the proximal ferrule were least affected. Deficiency of a ferrule on the lingual wall significantly affected the fracture strength in both anterior and posterior ETT. Conclusions: The ETT with sectional inadequacy of the ferrule is significantly more effective in resisting the fracture in comparison to the complete absence of the ferrule.

Risk factors for and consequences of inadequate surgical margins in oral squamous cell carcinoma

DEFF Research Database (Denmark)

Lawaetz, Mads; Homøe, Preben

2014-01-01

OBJECTIVE: The purpose of this study was to examine which factors are associated with inadequate surgical margins and to assess the postoperative consequences. STUDY DESIGN: A retrospective cohort of 110 patients with oral squamous cell carcinoma treated with surgery during a 2-year period...

76 FR 33780 - Assessments for Mismatched Payments or Inadequate Payment Information for Geothermal, Solid...

Science.gov (United States)

2011-06-09

...] Assessments for Mismatched Payments or Inadequate Payment Information for Geothermal, Solid Minerals, and...: Regulations for geothermal, solid minerals, and Indian oil and gas leases authorize the Office of Natural..., Office of Natural Resources Revenue, P.O. Box 25165, MS 61211B, Denver, Colorado 80225-0165...

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

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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.

Performance of the lot quality assurance sampling method compared to surveillance for identifying inadequately-performing areas in Matlab, Bangladesh.

Science.gov (United States)

Bhuiya, Abbas; Hanifi, S M A; Roy, Nikhil; Streatfield, P Kim

2007-03-01

This paper compared the performance of the lot quality assurance sampling (LQAS) method in identifying inadequately-performing health work-areas with that of using health and demographic surveillance system (HDSS) data and examined the feasibility of applying the method by field-level programme supervisors. The study was carried out in Matlab, the field site of ICDDR,B, where a HDSS has been in place for over 30 years. The LQAS method was applied in 57 work-areas of community health workers in ICDDR,B-served areas in Matlab during July-September 2002. The performance of the LQAS method in identifying work-areas with adequate and inadequate coverage of various health services was compared with those of the HDSS. The health service-coverage indicators included coverage of DPT, measles, BCG vaccination, and contraceptive use. It was observed that the difference in the proportion of work-areas identified to be inadequately performing using the LQAS method with less than 30 respondents, and the HDSS was not statistically significant. The consistency between the LQAS method and the HDSS in identifying work-areas was greater for adequately-performing areas than inadequately-performing areas. It was also observed that the field managers could be trained to apply the LQAS method in monitoring their performance in reaching the target population.

Cognitive Dissonance, Confirmatory Bias and Inadequate Information Processing: Evidence from Experimental Auctions

OpenAIRE

Cao, Ying; Just, David R.; Wansink, Brian

2014-01-01

Using psychological terms such as cognitive dissonance and confirmation bias, this study reveals how individual consumers inadequately process (food safety) information, pay limited attention to signals, and make purchase decisions that are bias towards their initial choices. While it is expected that reading extra information about potential risk associated with the food decreases consumers' willingness to pay (WTP), the magnitude of the impact varies across individuals. In general, consumer...

A successful effort to involve stakeholders in a facility siting decision using LIPS with stakeholder involvement

International Nuclear Information System (INIS)

Merkhofer, L.; Conway, R.; Anderson, B.

1995-01-01

Local public opposition to federal bureaucratic decisions has resulted in public agencies rethinking the role of stakeholders in decision making. Efforts to include stakeholders directly in the decision-making process are on the increase. Unfortunately, many attempts to involve members of the public in decisions involving complex technical issues have failed. A key problem has been defining a meaningful role for the public in the process of arriving at a technical decision. This paper describes a successful effort by Sandia National Laboratories (SNL) in New Mexico to involve stakeholders in an important technical decision associated with its Environmental Restoration (ER) Project. The decision was where to locate a Corrective Action Management Unit (CAMU), a facility intended to consolidate and store wastes generated from the cleanup of hazardous waste sites. A formal priority setting process known as the Laboratory Integration Prioritization System (LIPS) was adapted to provide an approach for involving the public. Although rarely applied to stakeholder participation, the LIPS process proved surprisingly effective. It produced a consensus over a selected site and enhanced public trust and understanding of Project activities

Role of Sex and the Environment in Moderating Weight Gain Due to Inadequate Sleep.

Science.gov (United States)

Coborn, Jamie E; Houser, Monica M; Perez-Leighton, Claudio E; Teske, Jennifer A

2017-12-01

The growing prevalence of obesity, inadequate sleep and sleep disorders together with the negative impact of lack of sleep on overall health highlights the need for therapies targeted towards weight gain due to sleep loss. Sex disparities in obesity and sleep disorders are present; yet, the role of sex is inadequately addressed and thus it is unclear whether sensitivity to sleep disruption differs between men and women. Like sex, environmental factors contribute to the development of obesity and poor sleep. The obesogenic environment is characterized by easy access to palatable foods and a low demand for energy expenditure in daily activities. These and other environmental factors are discussed, as they drive altered sleep or their interaction with food choice and intake can promote obesity. We discuss data that suggest differences in sleep patterns and responses to sleep disruption influence sex disparities in weight gain, and that enviromental disturbances alter sleep and interact with features of the obesogenic environment that together promote obesity.

Inadequate Sleep and Exercise Associated with Burnout and Depression Among Medical Students.

Science.gov (United States)

Wolf, Megan R; Rosenstock, Jason B

2017-04-01

The authors studied whether low levels of exercise or inadequate sleep correlated with higher levels of burnout and depression in medical students. Medical students of all years at the University of Pittsburgh School of Medicine, Pittsburgh, PA, USA, were invited to participate in an anonymous online survey in Fall 2012 and Winter 2013. Validated measures were used to assess exercise, sleep, burnout, and depression. Response rates were 28.7 % at the beginning of the school year and 22.6 % at the middle of the school year. Burnout rates overall were 22.4 % at the beginning of the year and 19.2 % in the middle of the year. Eight percent of students screened positive for depression at the beginning of the year and 9.3 % in the middle of the year. Decreased exercise frequency was significantly correlated with lower professional efficacy. Pathological sleepiness was significantly associated with a higher prevalence of burnout. Inadequate sleep correlated with significantly lower professional efficacy and higher exhaustion scores. Burnout was associated with a positive depression screen. Positive depression screening, pathological sleepiness, and sleeping less than 7 h a night were independent predictors of burnout. Sleep habits, exercise, and a positive depression screen were associated with burnout risk within the medical student population.

IE Information Notice No. 85-75: Improperly installed instrumentation, inadequate quality control and inadequate postmodification testing

International Nuclear Information System (INIS)

Jordan, E.L.

1992-01-01

On June 10, 1985, the licensee informed the NRC Resident Inspector that for approximately 5 days LaSalle Unit 2 had been without the capability of automatic actuation of emergency core cooling (ECCS) and that for approximately 3 days during this period the plant had been without secondary containment integrity. The major cause of this condition was improper installation (the variable and reference legs were reversed) of the two reactor vessel level actuation switches which control Division 1 automatic depressurization system (ADS), low pressure core spray (LPCS), and reactor core isolation cooling (RCIC). On July 20, 1985, the Trojan Nuclear Power Plant tripped from 100% power because of a turbine trip that was caused by the loss of the unit auxiliary transformer. All systems functioned normally except that low suction pressure caused one auxiliary feedwater pump to trip and then the other auxiliary feedwater pump to trip after restart of the first auxiliary feedwater pump. The cause of the trips of the auxiliary feedwater pumps can be traced back to improper postmodification adjustment and inadequate postmodification testing following retrofit of environmentally qualified controllers for the auxiliary feedwater system. The auxiliary feedwater pump trips on low suction pressure were caused by excessive combined flow from the two auxiliary feedwater pumps that draw from a single header from the condensate storage tank. The flow control valves were open farther than required after new environmentally qualified controllers had been installed during a recent refueling outage

Healthcare professionals' perceptions on the emotional impact of having an inadequate response to antidepressant medications: survey and prospective patient audit.

Science.gov (United States)

Mago, Rajnish; Fagiolini, Andrea; Weiller, Emmanuelle; Weiss, Catherine

2018-01-01

Despite the availability of effective antidepressants, about half of patients with major depressive disorder (MDD) display an inadequate response to their initial treatment. A large patient survey recently reported that 29.8% of MDD patients experiencing an inadequate treatment response felt frustrated about their medication and 19.2% were frustrated with their healthcare provider. This survey and chart audit evaluated healthcare professionals' (HCP) views on the emotional impact of having an inadequate response to antidepressant medication. HCPs who frequently treat patients with MDD completed a survey and chart audit of their MDD patients currently experiencing an inadequate response to antidepressant treatment. 287 HCPs completed 1336 chart audits. HCPs reported that 38% of their patients were trusting/accepting of their MDD medications and 41% of their patients trusted/felt confident with their healthcare provision. Conversely, HCPs reported that 11% of their patients were frustrated with their medication and 5% with their healthcare benefits. HCPs cited impact on daily life (53%) and treatment issues (lack of efficacy and side effects; 50%) as the main drivers for their patients' feelings of frustration. When HCPs recognized patients' feelings of frustration, the top concerns of the HCPs were worsening of symptoms (43%) and non-compliance (41%). This survey and chart audit highlights the emotional burden associated with inadequate responses to MDD treatment in addition to persistent symptoms. Differences between the views of the HCPs and patients are highlighted and suggest that HCPs may underestimate the full impact that having to try numerous medications has on their patients.

Examining the Relationship Between Children's ADHD Symptomatology and Inadequate Parenting: The Role of Household Chaos.

Science.gov (United States)

Wirth, Andrea; Reinelt, Tilman; Gawrilow, Caterina; Schwenck, Christina; Freitag, Christine M; Rauch, Wolfgang A

2017-02-01

This study examines the interrelations of parenting practices, emotional climate, and household chaos in families with children with and without ADHD. In particular, indirect pathways from children's ADHD symptomatology to inadequate parenting and negative emotional climate via household chaos were investigated. Parenting, emotional climate, and household chaos were assessed using questionnaires and a speech sample of parents of 31 children with and 53 without ADHD, aged 7 to 13 years. Group differences were found for certain parenting dimensions, the parent-child relationship, critical comments, and household chaos. While we found significant indirect effects between children's ADHD and certain parenting dimensions through household chaos, no effects were found for any aspect of emotional climate. Children's ADHD symptoms translate into inadequate parenting through household chaos, which underlines the need for interventions to improve household organization skills in parents of children with ADHD.

Inadequate emergence after anesthesia: emergence delirium and hypoactive emergence in the Postanesthesia Care Unit.

Science.gov (United States)

Xará, Daniela; Silva, Acácio; Mendonça, Júlia; Abelha, Fernando

2013-09-01

To evaluate the frequency, determinants, and outcome of inadequate emergence after elective surgery in the Postanesthesia Care Unit (PACU). Prospective observational study. 12-bed PACU of a tertiary-care hospital in a major metropolitan area. 266 adult patients admitted to the PACU. To evaluate inadequate emergence, the Richmond Agitation and Sedation Scale (RASS) was administered to patients 10 minutes after their admission to the PACU. Demographic data, perioperative variables, and postoperative length of stay (LOS) in the PACU and the hospital were recorded. 40 (15%) patients showed symptoms of inadequate emergence: 17 patients (6.4%) screened positive for emergence delirium and 23 patients (8.6%) showed hypoactive emergence. Determinants of emergence delirium were longer duration of preoperative fasting (P = 0.001), higher visual analog scale (VAS) scores for pain (P = 0.002), and major surgical risk (P = 0.001); these patients had a higher frequency of postoperative delirium (P = 0.017) and had higher nausea VAS score 6 hours after surgery (P = 0.001). Determinants of hypoactive emergence were duration of surgery (P = 0.003), amount of crystalloids administered during surgery (P = 0.002), residual neuromuscular block (P < 0.001), high-risk surgery (P = 0.002), and lower core temperature on PACU admission (P = 0.028); these patients also had more frequent residual neuromuscular block (P < 0.001) postoperative delirium (P < 0.001), and more frequent adverse respiratory events (P = 0.02). Patients with hypoactive emergence had longer PACU and hospital LOS. Preventable determinants for emergence delirium were higher postoperative pain scores and longer fasting times. Hypoactive emergence was associated with longer postoperative PACU and hospital LOSs. © 2013 Elsevier Inc. All rights reserved.

Facilities for technology testing of ITER divertor concepts, models, and prototypes in a plasma environment

International Nuclear Information System (INIS)

Cohen, S.A.

1991-12-01

The exhaust of power and fusion-reaction products from ITER plasma are critical physics and technology issues from performance, safety, and reliability perspectives. Because of inadequate pulse length, fluence, flux, scrape-off layer plasma temperature and density, and other parameters, the present generation of tokamaks, linear plasma devices, or energetic beam facilities are unable to perform adequate technology testing of divertor components, though they are essential contributors to many physics issues such as edge-plasma transport and disruption effects and control. This Technical Requirements Documents presents a description of the capabilities and parameters divertor test facilities should have to perform accelerated life testing on predominantly technological divertor issues such as basic divertor concepts, heat load limits, thermal fatigue, tritium inventory and erosion/redeposition. The cost effectiveness of such divertor technology testing is also discussed

Internet addiction: reappraisal of an increasingly inadequate concept.

Science.gov (United States)

Starcevic, Vladan; Aboujaoude, Elias

2017-02-01

This article re-examines the popular concept of Internet addiction, discusses the key problems associated with it, and proposes possible alternatives. The concept of Internet addiction is inadequate for several reasons. Addiction may be a correct designation only for the minority of individuals who meet the general criteria for addiction, and it needs to be better demarcated from various patterns of excessive or abnormal use. Addiction to the Internet as a medium does not exist, although the Internet as a medium may play an important role in making some behaviors addictive. The Internet can no longer be separated from other potentially overused media, such as text messaging and gaming platforms. Internet addiction is conceptually too heterogeneous because it pertains to a variety of very different behaviors. Internet addiction should be replaced by terms that refer to the specific behaviors (eg, gaming, gambling, or sexual activity), regardless of whether these are performed online or offline.

Post-implementation review of inadequate core cooling instrumentation

International Nuclear Information System (INIS)

Anderson, J.L.; Anderson, R.L.; Hagen, E.W.; Morelock, T.C.; Huang, T.L.; Phillips, L.E.

1988-01-01

Studies of Three Mile Island (TMI) accident identified the need for additional instrumentation to detect inadequate core cooling (ICC) in nuclear power plants. Industry studies by plant owners and reactor vendors supported the conclusion that improvements were needed to help operators diagnose the approach to or existence of ICC and to provide more complete information for operator control of safety injection, flow to minimize the consequences of such an accident. In 1980, the US Nuclear Regulatory Commission (NRC) required further studies by the industry and described ICC instrumentation design requirements that included human factors and environmental considerations. On December 10, 1982, NRC issued to Babcock and Wilcox (BandW) licensees' orders for Modification of License and transmitted to all pressurized water reactor (PWR) licensees Generic Letter 82-28 to inform them of the revised NRC requirements. The instrumentation requirements for detection of ICC include upgraded subcooling margin monitors (SMMs), upgraded core exit thermocouples (CETs), and installation of a reactor coolant inventory tracking system (RCITS)

Good ergonomic practices in a terminal facility

Energy Technology Data Exchange (ETDEWEB)

Anjos, Luciana Mattos dos; Curty, Adriana Favacho [CHEMTECH, Rio de Janeiro, RJ (Brazil); Franca, Guilherme Foerster do Monte; Jardino, Alessandro Neto [Petroleo Brasileiro S.A. (PETROBRAS), Rio de Janeiro, RJ (Brazil)

2009-07-01

Ergonomics is the technological design of the interplay between men, machines and environment in order to make labor activities more pleasant, profitable and functional. This article analyses the importance of ergonomic issues in process terminal plants and facilities, since the conceptual design stage until the detail engineering design. The ergonomic solutions are compared with practices that are current in engineering design plants nowadays. It will be shown how an inadequate ergonomic design often leads to accessibility problems and non-effectiveness during plant operation and dangers in emergency situations. The way perform an ergonomic design is to integrate the various disciplines that are involved in all stages of the design plant. The earlier the ergonomic design is implemented the better are the results in cost reduction, since later design modifications are more time-consuming and expensive. (author)

Risk factors for inadequate TB case finding in Rural Western Kenya: a comparison of actively and passively identified TB patients.

Directory of Open Access Journals (Sweden)

Anna H Van't Hoog

Full Text Available The findings of a prevalence survey conducted in western Kenya, in a population with 14.9% HIV prevalence suggested inadequate case finding. We found a high burden of infectious and largely undiagnosed pulmonary tuberculosis (PTB, that a quarter of the prevalent cases had not yet sought care, and a low case detection rate.We aimed to identify factors associated with inadequate case finding among adults with PTB in this population by comparing characteristics of 194 PTB patients diagnosed in a health facility after self-report, i.e., through passive case detection, with 88 patients identified through active case detection during the prevalence survey. We examined associations between method of case detection and patient characteristics, including HIV-status, socio-demographic variables and disease severity in univariable and multivariable logistic regression analyses.HIV-infection was associated with faster passive case detection in univariable analysis (crude OR 3.5, 95% confidence interval (CI 2.0-5.9, but in multivariable logistic regression this was largely explained by the presence of cough, illness and clinically diagnosed smear-negative TB (adjusted OR (aOR HIV 1.8, 95% CI 0.85-3.7. Among the HIV-uninfected passive case detection was less successful in older patients aOR 0.76, 95%CI 0.60-0.97 per 10 years increase, and women (aOR 0.27, 95%CI 0.10-0.73. Reported current or past alcohol use reduced passive case detection in both groups (0.42, 95% CI 0.23-0.79. Among smear-positive patients median durations of cough were 4.0 and 6.9 months in HIV-infected and uninfected patients, respectively.HIV-uninfected patients with infectious TB who were older, female, relatively less ill, or had a cough of a shorter duration were less likely found through passive case detection. In addition to intensified case finding in HIV-infected persons, increasing the suspicion of TB among HIV-uninfected women and the elderly are needed to improve TB case

Assessment of radiological protection systems among diagnostic radiology facilities in North East India.

Science.gov (United States)

Singh, Thokchom Dewan; Jayaraman, T; Arunkumar Sharma, B

2017-03-01

This study aims to assess the adequacy level of radiological protection systems available in the diagnostic radiology facilities located in three capital cities of North East (NE) India. It further attempts to understand, using a multi-disciplinary approach, how the safety codes/standards in diagnostic radiology framed by the Atomic Energy Regulatory Board (AERB) and the International Atomic Energy Agency (IAEA) to achieve adequate radiological protection in facilities, have been perceived, conceptualized, and applied accordingly in these facilities. About 30 diagnostic radiology facilities were randomly selected from three capitals of states in NE India; namely Imphal (Manipur), Shillong (Meghalaya) and Guwahati (Assam). A semi-structured questionnaire developed based on a multi-disciplinary approach was used for this study. It was observed that radiological practices undertaken in these facilities were not exactly in line with safety codes/standards in diagnostic radiology of the AERB and the IAEA. About 50% of the facilities had registered/licensed x-ray equipment with the AERB. More than 80% of the workers did not use radiation protective devices, although these devices were available in the facilities. About 85% of facilities had no institutional risk management system. About 70% of the facilities did not carry out periodic quality assurance testing of their x-ray equipment or surveys of radiation leakage around the x-ray room, and did not display radiation safety indicators in the x-ray rooms. Workers in these facilities exhibited low risk perception about the risks associated with these practices. The majority of diagnostic radiology facilities in NE India did not comply with the radiological safety codes/standards framed by the AERB and IAEA. The study found inadequate levels of radiological protection systems in the majority of facilities. This study suggests a need to establish firm measures that comply with the radiological safety codes/standards of the

Inadequate calcium intake is highly prevalent in Korean children and adolescents: the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2010.

Science.gov (United States)

Im, Jong Geun; Kim, Shin Hye; Lee, Gyeong-Yoon; Joung, Hyojee; Park, Mi-Jung

2014-11-01

The present study aimed to assess the adequacy of Ca intake and major food sources of Ca in Korean children and adolescents. A cross-sectional study. Data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2007-2010. We analysed the daily Ca intake, major food sources of Ca and the prevalence of inadequate Ca intake in the study population. Ca intake was categorized as inadequate when the participant's daily Ca intake was less than the Estimated Average Requirement. Subject The study population consisted of 7233 children and adolescents (3973 boys, 3260 girls; aged 1-18 years). Mean Ca intake was 510·2 mg/d in boys and 431·7 mg/d in girls. Overall, 75·0 % of adolescents (boys 71·6 %, girls 79·1 %) had inadequate Ca intake. The prevalence of inadequate Ca intake increased significantly from toddlers (45-55 %) to adolescents (78-86 %) in both genders. The highest ranked food sources for Ca were dairy products (35·0 %), followed by vegetables (17·3 %), grains (11·3 %) and seafood (9·9 %). Ca intake from dairy products decreased significantly from 57 % in toddlers to 30 % in adolescents, while Ca intakes from other foods increased with age. Inadequate Ca intake is highly prevalent and increased with age in Korean children and adolescents. It should be emphasized to encourage children and adolescents to eat more Ca-rich products to meet their Ca needs.

Delayed ultraviolet light-induced cessation of respiration by inadequate aeration of Escherichia coli

International Nuclear Information System (INIS)

Joshi, J.G.; Swenson, P.A.; Schenley, R.L.

1977-01-01

Inadequately aerated Escherichia coli B/r cultures did not shut their respiration off 60 min after ultraviolet light (52 J/m 2 at 254 nm) as they did when well supplied with oxygen. Since cessation of respiration is associated with cell death, the result suggested that oxygen toxicity by superoxide radicals generated by cell metabolism might be responsible for cell death. The specific activity of superoxide dismutase, which scavenges O 2 - radicals, increased twofold after 90 min of adequate aeration, but the specific activity of catalase remained constant. Respiration and viability of irradiated cells were affected not at all by the presence of superoxide dismutase and only slightly by the presence of catalase. Metal ions such as Mn 2+ and Fe 2+ , inducers of superoxide dismutase, had no effect on respiration and viability. When irradiated cells were incubated under N 2 for 90 min, the respiration, growth, and viability time-course responses were the same as for cells not exposed to anaerobiosis. We conclude that superoxide anions generated at the time of irradiation play no part in cessation of respiration and cell death and that inadequate aeration or anaerobiosis delays the ultraviolet light-induced synthesis of proteins responsible for the irreversible cessation of respiration

The relations between inadequate parent-child boundaries and borderline personality disorder in adolescence.

Science.gov (United States)

Vanwoerden, Salome; Kalpakci, Allison; Sharp, Carla

2017-11-01

Borderline Personality Disorder (BPD) is a severe mental illness that onsets in adolescence. Research has demonstrated the central role of parent-child relationships for the development and maintenance of BPD although more research is necessary to clarify the specific dynamics that relate to BPD during adolescence. Based on preliminary research establishing the importance of parent-child boundaries for adolescent BPD, this study sought to evaluate the relations between different forms of inadequate boundaries and BPD in adolescence using a multi-method approach. To that end, 301 adolescents (65.1% female; ages 12-17) inpatients were recruited; parents and adolescents completed questionnaire- and interview-based measures of BPD features in adolescent children and a questionnaire-based measure of parent-child boundaries. Relations were found between parental guilt induction and psychological control with children's BPD features above and beyond relations with psychiatric severity and gender. Relations between parent reports of triangulation (when children are recruited to mediate parental marital conflict) and children's BPD were contingent on the level of children's perceptions of triangulation. Findings confirm previous research suggesting the relevance of inadequate parent-child boundaries to children's BPD features and have important implications for understanding the dynamics in families with adolescents with BPD, representing a relevant treatment target. Copyright © 2017 Elsevier B.V. All rights reserved.

The Influence of Inadequate Teacher-to-Student Social Support on Amotivation of Physical Education Students

Science.gov (United States)

Shen, Bo; Li, Weidong; Sun, Haichun; Rukavina, Paul Bernard

2010-01-01

Guided by Green-Demers, Leagult, Pelletier, and Pelletier's (2008) assumption that amotivation (absence of motivation) is a multidimensional construct, we designed this study to investigate the influence of inadequate teacher-to-student social support on amotivation of high-school physical education students. Five hundred and sixty-six ninth…

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.

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

Cross-sectional Survey of Long-Term Care Facilities in the Rockaway Peninsula: Preparedness and Response During Hurricane Sandy.

Science.gov (United States)

Jiang, Lynn; Tedeschi, Christopher; Subaiya, Saleena

2018-04-01

Few studies have described the challenges experienced by long-term care facilities (LTCFs) following Hurricane Sandy. This study examined LTCF preparedness and experiences during and after the storm. A cross-sectional survey was conducted 2 years after Hurricane Sandy to assess LTCF demographics, preparation, and post-storm resources. Surveys were conducted at LTCFs located on the Rockaway Peninsula of New York City. All LTCFs located in a heavily affected area were approached. Of 29 facilities, 1 had closed, 5 did not respond, 9 declined to participate, and 14 participated, yielding a response rate of 50% for open facilities. Twenty-one percent of the facilities had preparations specifically for hurricanes. More than 70% of the facilities had lost electricity, heat, and telephone service, and one-half had evacuated. Twenty-one percent of the facilities reported not receiving any assistance and over one-half reported that relief resources did not meet their needs. Many LTCFs lacked plans specific to such a large-scale event. Since nearly all of the LTCFs in the region were affected, preexisting transportation and housing plans may have been inadequate. Future preparation could include hazard-specific planning and reliance on resources from a wider geographic area. Access to electricity emerged as a top priority. (Disaster Med Public Health Preparedness. 2018;12:194-200).

Mercury regulation, fate, transport, transformation, and abatement within cement manufacturing facilities: review.

Science.gov (United States)

Sikkema, Joel K; Alleman, James E; Ong, Say Kee; Wheelock, Thomas D

2011-09-15

The USEPA's 2010 mercury rule, which would reduce emissions from non-hazardous waste burning cement manufacturing facilities by an estimated 94%, represents a substantial regulatory challenge for the industry. These regulations, based on the performance of facilities that benefit from low concentrations of mercury in their feedstock and fuel inputs (e.g., limestone concentration was less than 25 ppb at each facility), will require non-compliant facilities to develop innovative controls. Control development is difficult because each facility's emissions must be assessed and simple correlation to mercury concentrations in limestone or an assumption of 'typically observed' mercury concentrations in inputs are unsupported by available data. Furthermore, atmospheric emissions are highly variable due to an internal control mechanism that captures and loops mercury between the high-temperature kiln and low-temperature raw materials mill. Two models have been reported to predict emissions; however, they have not been benchmarked against data from the internal components that capture mercury and do not distinguish between mercury species, which have different sorption and desorption properties. Control strategies include technologies applied from other industries and technologies developed specifically for cement facilities. Reported technologies, listed from highest to lowest anticipated mercury removal, include purge of collected dust or raw meal, changes in feedstocks and fuels, wet scrubbing, cleaning of mercury enriched dust, dry sorbent injection, and dry and semi-dry scrubbing. The effectiveness of these technologies is limited by an inadequate understanding of sorption, desorption, and mercury species involved in internal loop mercury control. To comply with the mercury rule and to improve current mercury control technologies and practices, research is needed to advance fundamental knowledge regarding mercury species sorption and desorption dynamics on materials

Development of a short sample test facility for evaluating superconducting wires

International Nuclear Information System (INIS)

Singh, M.R.; Kulkarni, D.G.; Sahni, V.C.; Ravikumar, G.; Patel, K.L.

2002-01-01

In this paper we describe a short sample test facility we have set up at Bhabha Atomic Research Centre (BARC). This facility has been used to measure critical currents of NbTi/Cu composite superconducting wires by recording V versus I data at 4.2 K. It offers sample current as large as 1500 A and a transverse magnetic field up to 7.4 T. A power law, V ∼I n( H) is fitted to the resistive transition region to estimate the exponent n, which is a measure of the uniformity of superconducting filaments in composite wires. It is observed that inadequate thermal stabilization of sample wire results in thermal runaway, which limits the V-I data to∼ 2μ V . This in turn affects the reliability of estimated filament uniformity. To mitigate this problem, we have used a sample holder made of OFHC-Cu which enhances thermal stabilization of the sample. With this sample holder, the results of measurements carried out on wires developed by the Atomic Fuel Division, BARC show a high filament uniformity (n ∼ 58). (author)

The theory-practice gap: impact of professional-bureaucratic work conflict on newly-qualified nurses.

Science.gov (United States)

Maben, Jill; Latter, Sue; Clark, Jill Macleod

2006-08-01

resources and reduce the professional-bureaucratic work conflict are discussed.

Inadequate Gestational Weight Gain, the Hidden Link Between Maternal IBD and Adverse Pregnancy Outcomes: Results from the Norwegian Mother and Child Cohort Study.

Science.gov (United States)

Bengtson, May-Bente; Aamodt, Geir; Mahadevan, Uma; Vatn, Morten H

2017-07-01

Patients with inflammatory bowel disease (IBD) are in general prone to weight loss. We explored the risk of inadequate gestational weight gain (GWG), and the impact of GWG on adverse pregnancy outcomes, among mothers with IBD in the Norwegian Mother and Child Cohort Study (MoBa). The MoBa with 95,200 mothers enrolled from 1999 to 2008, comprised 217 mothers with ulcerative colitis and 166 with Crohn's disease. Demographics were ascertained through a basic questionnaire before the first ultrasound visit and an IBD history and disease activity during pregnancy through a questionnaire mailed out in 2013. Inadequate GWG was based on the US Institute of Medicine recommendations. The associations between IBD and inadequate GWG or adverse pregnancy outcomes were explored, adjusted for diabetes, hypertension, smoking, maternal age, education, and disease activity. Mothers with Crohn's disease (34.3%) and ulcerative colitis (26.7%) were more frequently exposed to inadequate GWG compared with non-IBD mothers (19.4%) (adjusted odds ratio [aOR] = 2.02, 95% confidence interval [CI], 1.42-2.86 and aOR = 1.46, 95% CI, 1.04-2.05, respectively). Mothers with IBD with inadequate GWG (exposed) had a 2-fold risk of small for gestational age infants compared with exposed non-IBD mothers (aOR = 1.93, 95% CI, 1.13-3.29). Exposed mothers with Crohn's disease and ulcerative colitis had a several-fold increased risk of small for gestational age compared with nonexposed IBD mothers (aOR = 4.5, 95% CI, 1.3-16.2, aOR = 5.5, 95% CI, 1.6-18.5). Disease activity was associated with reduced GWG (17.5 kg) (aOR = 3.34, 95% CI, 1.33-8.38). Inadequate GWG should be considered as a risk factor for adverse pregnancy outcomes or as a marker of disease activity.

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

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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

Psychological distress is associated with inadequate dietary intake in Vietnamese marriage immigrant women in Korea.

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Hwang, Ji-Yun; Lee, Sang Eun; Kim, Sun Hye; Chung, Hye Won; Kim, Wha Young

2010-05-01

Previous studies have reported that the nutritional status of Vietnamese female marriage immigrants in Korea is inadequate. And the mediation of acculturation stress can contribute to problems in their eating practices and dietary intakes. This study examines an association between psychological distress and inadequate dietary intake in Vietnamese female marriage immigrants living in Korea. A cross-sectional study analyzed baseline data (n=570) from the Cohort of Intermarried Women in Korea. Daily nutrient intakes were compared according to the quartiles of distress scores assessed by the Psychological Well-Being Index-Short Form. One-way analysis of variance and chi(2) tests were used to compare eating practices and nutrient intake across quartiles of psychological distress. Subjects in the highest stress scores were more likely to skip breakfast and to change their dietary habits after living in Korea than those in groups with low stress scores. Analyses of the subjects' Mini Dietary Assessments revealed that those with the highest stress scores were less likely to consume milk or dairy products, eat regular meals, or have balanced diets than those with the lowest stress scores. Nutrient intakes were found to be inadequate in the subjects, and those with the highest stress scores showed lower consumptions of energy, carbohydrate, protein, fat, calcium, zinc, thiamin, riboflavin, and folate compared to those with the lowest scores. The prevalence of underweight (body mass index [calculated as kg/m(2)] Korea was negatively associated with dietary intake. These findings can assist dietetics practitioners working with minority immigrants because such information is important in designing appropriate strategies for dietary counseling. A follow-up study should address the underlying mechanisms of the observed diet-distress association in Vietnamese marriage immigrant women in Korea, as well as other various ethnic minority immigrants in Korea. Copyright 2010 American

Racial disparities in travel time to radiotherapy facilities in the Atlanta metropolitan area.

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Peipins, Lucy A; Graham, Shannon; Young, Randall; Lewis, Brian; Flanagan, Barry

2013-07-01

Low-income women with breast cancer who rely on public transportation may have difficulty in completing recommended radiation therapy due to inadequate access to radiation facilities. Using a geographic information system (GIS) and network analysis we quantified spatial accessibility to radiation treatment facilities in the Atlanta, Georgia metropolitan area. We built a transportation network model that included all bus and rail routes and stops, system transfers and walk and wait times experienced by public transportation system travelers. We also built a private transportation network to model travel times by automobile. We calculated travel times to radiation therapy facilities via public and private transportation from a population-weighted center of each census tract located within the study area. We broadly grouped the tracts by low, medium and high household access to a private vehicle and by race. Facility service areas were created using the network model to map the extent of areal coverage at specified travel times (30, 45 and 60 min) for both public and private modes of transportation. The median public transportation travel time to the nearest radiotherapy facility was 56 min vs. approximately 8 min by private vehicle. We found that majority black census tracts had longer public transportation travel times than white tracts across all categories of vehicle access and that 39% of women in the study area had longer than 1 h of public transportation travel time to the nearest facility. In addition, service area analyses identified locations where the travel time barriers are the greatest. Spatial inaccessibility, especially for women who must use public transportation, is one of the barriers they face in receiving optimal treatment. Published by Elsevier Ltd.

Democracy leadership (study approach of bureaucrats leadership at sub bagian tata usaha badan perencanaan pembangunan daerah, East Java province)

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Lestari, Y.; Rosdiana, W.; Noviyanti

2018-01-01

The main key to organizational success depends on the success of a leadership. Each organization’s progress will require the ability of a leader to transformed the organization. The emergence of the democratic-leadership is one of the most humane style of leadership. Democratic leadership positioned people as the most important factor in the leadership exercised by the orientation and emphasis on relationships with members of the organization. This study raised that the democratic-leadership in government agencies to study the leadership approach of bureaucrats at Sub Bagian Tata Usaha Badan Perencanaan Pembangunan Daerah East Java Province. The data collection techniques used descriptive research with qualitative approach, then the techniques were interviews, observation and documentation. While, the research data analysis used interactive analysis model approach of Miles and Huberman, which includes: (1) data reduction; (2) the presentation of the data; and (3) conclusion. Based on Nawawi theory’s [1], this study showed that (1) Leaders are very obedient to the rules/procedures work, (2) Leaders look more autocratic, (3) leaders make familiarity with subordinates, (4) leaders develop kinship situation and teamwork, (5) the leaders seem monotonous work and do not like a modification, (6) Leaders seem slow in decision making, and (7) leaders are accustomed to low-risk jobs with less survival trends.

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

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Eyenghe Tari

2015-06-01

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

Promoting universal financial protection: contracting faith-based health facilities to expand access--lessons learned from Malawi.

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Chirwa, Maureen L; Kazanga, Isabel; Faedo, Giulia; Thomas, Stephen

2013-08-19

Public-private collaborations are increasingly being utilized to universalize health care. In Malawi, the Ministry of Health contracts selected health facilities owned by the main faith-based provider, the Christian Health Association of Malawi (CHAM), to deliver care at no fee to the most vulnerable and underserved populations in the country through Service Level Agreements (SLAs). This study examined the features of SLAs and their effectiveness in expanding universal coverage. The study involved a policy analysis focusing on key stakeholders around SLAs as well as a case study approach to analyse how design and implementation of SLAs affect efficiency, equity and sustainability of services delivered by SLAs. The study employed both qualitative and quantitative research methods to address the research questions and was conducted in five CHAM health facilities: Mulanje Mission, Holy Family, and Mtengowanthenga Hospitals, and Mabiri and Nkope Health Centres. National and district level decision makers were interviewed while providers and clients associated with the health facilities were surveyed on their experiences. A total of 155 clients from an expected 175 were recruited in the study. The study findings revealed key aspects of how SLAs were operating, the extent to which their objectives were being attained and why. In general, the findings demonstrated that SLAs had the potential to improve health and universal health care coverage, particularly for the vulnerable and underserved populations. However, the findings show that the performance of SLAs in Malawi were affected by various factors including lack of clear guidelines, non-revised prices, late payment of bills, lack of transparency, poor communication, inadequate human and material resources, and lack of systems to monitor performance of SLAs, amongst others. There was strong consensus and shared interest between the government and CHAM regarding SLAs. It was clear that free services provided by SLAs had

Inadequate-1D and dynamic NMR of mesoion 3-phenyl-1-thio-2,3,4-triazole-5-methylides; INADEQUATE-1D i dynamiczny NMR mezojonowych 3-fenylo-1-tio-2,3,4-triazolo-5-metylidow

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Bocian, W.; Stefaniak, L. [Inst. Chemii Organicznej, Polska Akademia Nauk, Warsaw (Poland)

1994-12-31

The chemical shifts and coupling constants have been measured in series of mesoionic triazoles by means of inadequate atoms and dynamic NMR techniques. The electronic structure and other parameters of C5-C6 chemical bond in different derivatives of mesoionic 3-phenyl-1-thio-2,3,4-triazole-5 methyls have been determined. 14 refs, 3 figs, 2 tabs.

Associations between Inadequate Parenting Practices and Behavioral Problems in Children and Adolescents with Attention Deficit Hyperactivity Disorder

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Maria Cristina Triguero Veloz Teixeira

2015-01-01

Full Text Available Children and adolescents with ADHD present behaviors such as impulsiveness, inattention, and difficulties with personal organization that represent an overload for parents. Moreover, it also increases their level of stress and leads them to resort to inadequate educational strategies. The present study verifies associations between inadequate parenting practices and behavioral profiles of children and adolescents with ADHD. The sample was composed of 22 children with ADHD (age range 6–16 years and their mothers. Spearman correlation analyses were made with the scores of Parenting Style Inventory (PSI and Child Behavior Checklist for ages 6–18 (CBCL/6–18. Results indicate statistically significant associations between behavioral problems and the use of punishment practices and negligence. When assessing a child with ADHD, it is important to verify the predominant types of parenting practices that can influence both immediate interventions and the prognosis of the disorder.

Comparison of Dynamic Contrast-Enhanced MRI and PET/CT in the Evaluation of Laryngeal Cancer After Inadequate CT Results

International Nuclear Information System (INIS)

Citil, Serdal; Dogan, Serap; Atilgan, Hasan Ikbal; Menzilcioglu, Mehmet Sait; Sahin, Tuna; Abdulrezzak, Ummuhan; Duymus, Mahmut; Ozturk, Mustafa

2015-01-01

To investigate the diagnostic value of dynamic magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) for laryngeal cancers after inadequate CT results. The study comprised 45 patients investigated for primary laryngeal cancer or recurrence-residue in which CT was considered inadequate. A mass was found in 20 patients. Dynamic MRI and PET/CT were compared for diagnosis of mass, lymph node involvement, recurrence and residue. The dynamic curves formed in dynamic MRI were investigated for diagnostic contributions. The sensitivity and specificity of the dynamic MRI, for supraglottic, glottic and subglottic location, was 100%, 80%, and 92%; 100%, 85%, and 100%, respectively. In PET/CT the sensitivity and specificity were 100% for all of those localizations. For lymph node involvement, the sensitivity of dynamic MRI and PET/CT was 100%, the specificity was 100% and 93%, respectively. For recurrence-residue, the sensitivity and specificity of dynamic MRI were 86% and 67%, respectively, with 100% sensitivity and specificity in PET/CT. The sensitivity of type A curve for detection of malignancy was 40%, and specificity was 100%. When type A and B curves were included, the sensitivity was 100%. For patients investigated for laryngeal cancer in which CT is considered inadequate, dynamic MRI or PET/CT is useful

Comparison of Dynamic Contrast-Enhanced MRI and PET/CT in the Evaluation of Laryngeal Cancer After Inadequate CT Results.

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Citil, Serdal; Dogan, Serap; Atilgan, Hasan Ikbal; Menzilcioglu, Mehmet Sait; Sahin, Tuna; Abdulrezzak, Ummuhan; Duymus, Mahmut; Ozturk, Mustafa

2015-01-01

To investigate the diagnostic value of dynamic magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) for laryngeal cancers after inadequate CT results. The study comprised 45 patients investigated for primary laryngeal cancer or recurrence-residue in which CT was considered inadequate. A mass was found in 20 patients. Dynamic MRI and PET/CT were compared for diagnosis of mass, lymph node involvement, recurrence and residue. The dynamic curves formed in dynamic MRI were investigated for diagnostic contributions. The sensitivity and specificity of the dynamic MRI, for supraglottic, glottic and subglottic location, was 100%, 80%, and 92%; 100%, 85%, and 100%, respectively. In PET/CT the sensitivity and specificity were 100% for all of those localizations. For lymph node involvement, the sensitivity of dynamic MRI and PET/CT was 100%, the specificity was 100% and 93%, respectively. For recurrence-residue, the sensitivity and specificity of dynamic MRI were 86% and 67%, respectively, with 100% sensitivity and specificity in PET/CT. The sensitivity of type A curve for detection of malignancy was 40%, and specificity was 100%. When type A and B curves were included, the sensitivity was 100%. For patients investigated for laryngeal cancer in which CT is considered inadequate, dynamic MRI or PET/CT is useful.

Evaluation of inadequate, indeterminate, false-negative and false-positive cases in cytological examination for breast cancer according to histological type

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2012-01-01

Background We previously investigated the current status of breast cytology cancer screening at seven institutes in our area of southern Fukuoka Prefecture, and found some differences in diagnostic accuracy among the institutions. In the present study, we evaluated the cases involved and noted possible reasons for their original cytological classification as inadequate, indeterminate, false-negative and false-positive according to histological type. Methods We evaluated the histological findings in 5693 individuals who underwent cytological examination for breast cancer (including inadequate, indeterminate, false-negative and false-positive cases), to determine the most common histological types and/or features in these settings and the usefulness/limitations of cytological examination for the diagnosis of breast cancer. Results Among 1152 cytologically inadequate cases, histology revealed that 75/173 (43.6%) cases were benign, including mastopathy (fibrocystic disease) in 38.6%, fibroadenoma in 24.0% and papilloma in 5.3%. Ninety-five of 173 (54.9%) cases were histologically malignant, with scirrhous growing type, invasive ductal carcinoma (SIDC) being significantly more frequent (49.5%) than papillotubular growing type (Papi-tub) (P breast disease. In particular, several inadequate, indeterminate and false-negative cases with samples collected by aspiration were diagnosed as SIDC. These findings should encourage the use of needle biopsy rather than aspiration when this histological type is identified on imaging. Namely, good communication between clinicians and pathological staff, and triple assessment (i.e., clinical, pathological and radiological assessment), are important for accurate diagnosis of aspiration samples. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/7349809170055423 PMID:22607447

Factors explaining inadequate prenatal care utilization by first and second generation non-western women in The Netherlands.

NARCIS (Netherlands)

Boerleider, A.W.; Manniën, J.; Wiegers, T.A.; Francke, A.L.; Devillé, W.L.J.M.

2013-01-01

Background: In many industrialized western countries non-western women constitute a substantial part of the prenatal care client population. In The Netherlands, these women have also been shown to be more likely to make inadequate use of prenatal care. Explanatory factors for this include, among

Safety and efficacy of twice-daily exenatide in Taiwanese patients with inadequately controlled type 2 diabetes mellitus

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Chieh-Hsiang Lu

2013-03-01

Conclusion: This subgroup analysis of Taiwanese patients was consistent with the overall study results, which showed that exenatide BID is superior to placebo for improving glycemic control in Asian patients with type 2 diabetes who experienced inadequate glycemic control when using oral antidiabetic therapy.

Cautious Citizenship: The Deterring Effect of Immigration Issue Salience on Health Care Use and Bureaucratic Interactions among Latino US Citizens.

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Pedraza, Franciso I; Nichols, Vanessa Cruz; LeBrón, Alana M W

2017-10-01

Research shows that health care use among Latino immigrants is adversely affected by restrictive immigration policy. A core concern is that immigrants shy away from sharing personal information in response to policies that expand bureaucratic monitoring of citizenship status across service-providing organizations. This investigation addresses the concern that immigration politics also negatively influences health care utilization among Latino US citizens. One implication is that health insurance expansions may not reduce health care inequities among Latinos due to concern about exposure to immigration law enforcement authorities. Using data from the 2015 Latino National Health and Immigration Survey, we examine the extent to which the politics of immigration deters individuals from going to health care providers and service-providing institutions. Results indicate that Latino US citizens are less likely to make an appointment to see a health care provider when the issue of immigration is mentioned. Additionally, Latino US citizens who know someone who has been deported are more inclined to perceive that information shared with health care providers is not secure. We discuss how cautious citizenship, or risk-avoidance behaviors toward public institutions in order to avoid scrutiny of citizenship status, informs debates about reducing health care inequities. Copyright © 2017 by Duke University Press.

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

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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.

Inadequate Nutritional Status of Hospitalized Cancer Patients

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Ali Alkan

2017-03-01

Full Text Available Objective: In oncology practice, nutrition and also metabolic activity are essential to support the nutritional status and prevent malignant cachexia. It is important to evaluate the patients and plan the maneuvers at the start of the therapy. The primary objective of the study is to define the nutritional status of hospitalized patients and the factors affecting it in order to define the most susceptible patients and maneuvers for better nutritional support. Methods: Patients hospitalized in oncology clinic for therapy were evaluated for food intake and nutritional status through structured interviews. The clinical properties, medical therapies, elements of nutritional support were noted and predictors of inadequate nutritional status (INS were analyzed. Results: Four hundred twenty three patients, between 16-82 years old (median: 52 were evaluated. Nearly half of the patients (185, 43% reported a better appetite at home than in hospital and declared that hospitalization is an important cause of loss of appetite (140/185, 75.6%. Presence of nausea/vomiting (N/V, depression, age less than 65 and use of non-steroidal anti-inflammatory drugs (NSAIDs were associated with increased risk of INS in hospitalized cancer patients. On the contrary, steroid medication showed a positive impact on nutritional status of cancer patients. Conclusion: N/V, younger age, presence of depression and NSAIDs medication were associated with INS in hospitalized cancer patients. Clinicians should pay more attention to this group of patients. In addition, unnecessary hospitalizations and medications that may disturb oral intake must be avoided. Corticosteroids are important tools for managing anorexia and INS.

Dialysis Hypotension : A Role for Inadequate Increase in Arginine Vasopressin Levels? A Systematic Literature Review and Meta-Analysis

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Ettema, Esmee M.; Zittema, Debbie; Kuipers, Johanna; Gansevoort, Ron T.; Vart, Priya; de Jong, Paul E.; Westerhuis, Ralf; Franssen, Casper F. M.

2014-01-01

Background: Intradialytic hypotension is a common complication of hemodialysis (HD). Some studies have suggested that inadequate arginine vasopressin (AVP) increase could play a role in the pathogenesis of intradialytic hypotension. However, AVP levels during HD and its relation to hypotension has

Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries

Science.gov (United States)

Prüss-Ustün, Annette; Bartram, Jamie; Clasen, Thomas; Colford, John M; Cumming, Oliver; Curtis, Valerie; Bonjour, Sophie; Dangour, Alan D; De France, Jennifer; Fewtrell, Lorna; Freeman, Matthew C; Gordon, Bruce; Hunter, Paul R; Johnston, Richard B; Mathers, Colin; Mäusezahl, Daniel; Medlicott, Kate; Neira, Maria; Stocks, Meredith; Wolf, Jennyfer; Cairncross, Sandy

2014-01-01

Objective To estimate the burden of diarrhoeal diseases from exposure to inadequate water, sanitation and hand hygiene in low- and middle-income settings and provide an overview of the impact on other diseases. Methods For estimating the impact of water, sanitation and hygiene on diarrhoea, we selected exposure levels with both sufficient global exposure data and a matching exposure-risk relationship. Global exposure data were estimated for the year 2012, and risk estimates were taken from the most recent systematic analyses. We estimated attributable deaths and disability-adjusted life years (DALYs) by country, age and sex for inadequate water, sanitation and hand hygiene separately, and as a cluster of risk factors. Uncertainty estimates were computed on the basis of uncertainty surrounding exposure estimates and relative risks. Results In 2012, 502 000 diarrhoea deaths were estimated to be caused by inadequate drinking water and 280 000 deaths by inadequate sanitation. The most likely estimate of disease burden from inadequate hand hygiene amounts to 297 000 deaths. In total, 842 000 diarrhoea deaths are estimated to be caused by this cluster of risk factors, which amounts to 1.5% of the total disease burden and 58% of diarrhoeal diseases. In children under 5 years old, 361 000 deaths could be prevented, representing 5.5% of deaths in that age group. Conclusions This estimate confirms the importance of improving water and sanitation in low- and middle-income settings for the prevention of diarrhoeal disease burden. It also underscores the need for better data on exposure and risk reductions that can be achieved with provision of reliable piped water, community sewage with treatment and hand hygiene. PMID:24779548

Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries.

Science.gov (United States)

Prüss-Ustün, Annette; Bartram, Jamie; Clasen, Thomas; Colford, John M; Cumming, Oliver; Curtis, Valerie; Bonjour, Sophie; Dangour, Alan D; De France, Jennifer; Fewtrell, Lorna; Freeman, Matthew C; Gordon, Bruce; Hunter, Paul R; Johnston, Richard B; Mathers, Colin; Mäusezahl, Daniel; Medlicott, Kate; Neira, Maria; Stocks, Meredith; Wolf, Jennyfer; Cairncross, Sandy

2014-08-01

To estimate the burden of diarrhoeal diseases from exposure to inadequate water, sanitation and hand hygiene in low- and middle-income settings and provide an overview of the impact on other diseases. For estimating the impact of water, sanitation and hygiene on diarrhoea, we selected exposure levels with both sufficient global exposure data and a matching exposure-risk relationship. Global exposure data were estimated for the year 2012, and risk estimates were taken from the most recent systematic analyses. We estimated attributable deaths and disability-adjusted life years (DALYs) by country, age and sex for inadequate water, sanitation and hand hygiene separately, and as a cluster of risk factors. Uncertainty estimates were computed on the basis of uncertainty surrounding exposure estimates and relative risks. In 2012, 502,000 diarrhoea deaths were estimated to be caused by inadequate drinking water and 280,000 deaths by inadequate sanitation. The most likely estimate of disease burden from inadequate hand hygiene amounts to 297,000 deaths. In total, 842,000 diarrhoea deaths are estimated to be caused by this cluster of risk factors, which amounts to 1.5% of the total disease burden and 58% of diarrhoeal diseases. In children under 5 years old, 361,000 deaths could be prevented, representing 5.5% of deaths in that age group. This estimate confirms the importance of improving water and sanitation in low- and middle-income settings for the prevention of diarrhoeal disease burden. It also underscores the need for better data on exposure and risk reductions that can be achieved with provision of reliable piped water, community sewage with treatment and hand hygiene. © 2014 The Authors. Tropical Medicine and International Health published by John Wiley & Sons Ltd.

Microbiological changes after periodontal therapy in diabetic patients with inadequate metabolic control

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Carina Maciel Silva-Boghossian

2014-05-01

Full Text Available The present study investigated the effect of non-surgical periodontal treatment (SRP on the composition of the subgingival microbiota of chronic periodontitis (CP in individuals with type 2 diabetes (DM2 with inadequate metabolic control and in systemically healthy (SH individuals. Forty individuals (20 DM2 and 20 SH with CP underwent full-mouth periodontal examination. Subgingival plaque was sampled from 4 deep sites of each individual and tested for mean prevalence and counts of 45 bacterial taxa by the checkerboard method. Clinical and microbiological assessments were performed before and 3 months after SRP. At baseline, those in the DM2 group presented a significantly higher percentage of sites with visible plaque and bleeding on probing compared with those in the SH group (p < 0.01. Those in the DM2 group presented significantly higher levels of C. rectus and P. gingivalis, and lower prevalence of P. micra and S. anginosus, compared with those in the SH group (p ≤ 0.001. At the 3-month visit, both groups showed a significant improvement in all clinical parameters (p < 0.01. Those in the DM2 group showed significantly higher prevalence and/or levels of A. gerencseriae, A. naeslundii I, A. oris, A. odontolyticus, C. sputigena, F. periodonticum, and G. morbillorum compared with those in the SH group (p ≤ 0.001. However, those in the DM2 group showed a significant reduction in the levels of P. intermedia, P. gingivalis, T. forsythia, and T. denticola (p ≤ 0.001 over time. Those in the SRP group showed improved periodontal status and reduced levels of putative periodontal pathogens at 3 months’ evaluation compared with those in the DM2 group with inadequate metabolic control.

Lack of access to chemotherapy for colon cancer: multiplicative disadvantage of being extremely poor, inadequately insured and African American.

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Gorey, Kevin M; Haji-Jama, Sundus; Bartfay, Emma; Luginaah, Isaac N; Wright, Frances C; Kanjeekal, Sindu M

2014-03-22

Despite evidence of chemotherapy's ability to cure or comfort those with colon cancer, nearly half of such Americans do not receive it. African Americans (AA) seem particularly disadvantaged. An ethnicity by poverty by health insurance interaction was hypothesized such that the multiplicative disadvantage of being extremely poor and inadequately insured is worse for AAs than for non-Hispanic white Americans (NHWA). California registry data were analyzed for 459 AAs and 3,001 NHWAs diagnosed with stage II to IV colon cancer between 1996 and 2000 and followed until 2011. Socioeconomic data from the 2000 census categorized neighborhoods: extremely poor (≥ 30% of households poor), middle (5-29% poor) and low poverty (Primary health insurers were Medicaid, Medicare, private or none. Chemotherapy rates were age and stage-adjusted and comparisons used standardized rate ratios (RR). Logistic and Cox regressions, respectively, modeled chemotherapy receipt and long term survival. A significant 3-way ethnicity by poverty by health insurance interaction effect on chemotherapy receipt was observed. Among those who did not live in extremely poor neighborhoods and were adequately insured privately or by Medicare, chemotherapy rates did not differ significantly between AAs (37.7%) and NHWAs (39.5%). Among those who lived in extremely poor neighborhoods and were inadequately insured by Medicaid or uninsured, AAs (14.6%) were nearly 60% less likely to receive chemotherapy than were NHWAs (25.5%, RR = 0.41). When the 3-way interaction effect as well as the main effects of poverty, health insurance and chemotherapy was accounted for, survival rates of AAs and NHWAs were the same. The multiplicative barrier to colon cancer care that results from being extremely poor and inadequately insured is worse for AAs than it is for NHWAs. AAs are more prevalently poor, inadequately insured, and have fewer assets so they are probably less able to absorb the indirect and direct, but uncovered

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

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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.

The Constitution, waste facility performance standards, and radioactive waste classification: Is equal protection possible?

Energy Technology Data Exchange (ETDEWEB)

Eye, R.V. [Kansas Dept. of Health and Environment, Topeka, KS (United States)

1993-03-01

The process for disposal of so-called low-level radioactive waste is deadlocked at present. Supporters of the proposed near-surface facilities assert that their designs will meet minimum legal and regulatory standards currently in effect. Among opponents there is an overarching concern that the proposed waste management facilities will not isolate radiation from the biosphere for an adequate length of time. This clash between legal acceptability and a perceived need to protect the environment and public health by requiring more than the law demand sis one of the underlying reasons why the process is deadlocked. Perhaps the most exhaustive public hearing yet conducted on low-level radioactive waste management has recently concluded in Illinois. The Illinois Low-Level Radioactive Waste Disposal Facility Sitting Commission conducted 71 days of fact-finding hearings on the safety and suitability of a site near Martinsville, Illinois, to serve as a location for disposition of low-level radioactive waste. Ultimately, the siting commission rejected the proposed facility site for several reasons. However, almost all the reasons were related, to the prospect that, as currently conceived, the concrete barrier/shallow-land burial method will not isolate radioactive waste from the biosphere. This paper reviews the relevant legal framework of the radioactive waste classification system and will argue that it is inadequate for long-lived radionuclides. Next, the paper will present a case for altering the classification system based on high-level waste regulatory considerations.

Improving the Effectiveness of Speaker Verification Domain Adaptation With Inadequate In-Domain Data

Science.gov (United States)

2017-08-20

M speakers. We seek a probabilistic solution to domain adap- tation, and so we encode knowledge of the out-of-domain data in prior distributions...the VB solution from (16)-(21) becomes: µ =αȳ + (1− α)µout, (24) Σa =α ( 1 NT NT∑ n=1 〈ynyTn 〉 − ȳȳT ) + (1− α) Σouta (25) + α (1− α) ( ȳ − µout...non- English languages and from unseen channels. An inadequate in-domain set was provided, which consisted of 2272 samples from 1164 speakers, and

Loss of integrity of thyroid morphology and function in children born to mothers with inadequately treated Graves' disease

NARCIS (Netherlands)

Kempers, Marlies J. E.; van Trotsenburg, A. S. Paul; van Rijn, Rick R.; Smets, Anne M. J. B.; Smit, Bert J.; de Vijlder, Jan J. M.; Vulsma, Thomas

2007-01-01

Context: Central congenital hypothyroidism (CH-C) in neonates born to mothers with inadequately treated Graves' disease usually needs T-4 supplementation. The thyroid and its regulatory system have not yet been extensively studied after T-4 withdrawal, until we observed disintegrated thyroid glands

Evaluation of inadequate, indeterminate, false-negative and false-positive cases in cytological examination for breast cancer according to histological type

Directory of Open Access Journals (Sweden)

Yamaguchi Rin

2012-05-01

Full Text Available Abstract Background We previously investigated the current status of breast cytology cancer screening at seven institutes in our area of southern Fukuoka Prefecture, and found some differences in diagnostic accuracy among the institutions. In the present study, we evaluated the cases involved and noted possible reasons for their original cytological classification as inadequate, indeterminate, false-negative and false-positive according to histological type. Methods We evaluated the histological findings in 5693 individuals who underwent cytological examination for breast cancer (including inadequate, indeterminate, false-negative and false-positive cases, to determine the most common histological types and/or features in these settings and the usefulness/limitations of cytological examination for the diagnosis of breast cancer. Results Among 1152 cytologically inadequate cases, histology revealed that 75/173 (43.6% cases were benign, including mastopathy (fibrocystic disease in 38.6%, fibroadenoma in 24.0% and papilloma in 5.3%. Ninety-five of 173 (54.9% cases were histologically malignant, with scirrhous growing type, invasive ductal carcinoma (SIDC being significantly more frequent (49.5% than papillotubular growing type (Papi-tub (P P = 0.0001 and ductal carcinoma in situ (DCIS (P = 0.0001. Among 458 indeterminate cases, 54/139 (38.8% were histologically benign (mastopathy, 30.0%; fibroadenoma, 27.8%; papilloma, 26.0% and 73/139 (52.5% were malignant, with SIDC being the most frequent malignant tumor (37.0%. Among 52 false-negative cases, SIDC was significantly more frequent (42.3% than DCIS (P = 0.0049 and Papi-tub (P = 0.001. There were three false-positive cases, with one each of fibroadenoma, epidermal cyst and papilloma. Conclusions The inadequate, indeterminate, false-negative and false-positive cases showed similar histological types, notably SIDC for malignant tumors, and mastopathy, fibroadenoma and papilloma for

Hospital to Post-Acute Care Facility Transfers: Identifying Targets for Information Exchange Quality Improvement.

Science.gov (United States)

Jones, Christine D; Cumbler, Ethan; Honigman, Benjamin; Burke, Robert E; Boxer, Rebecca S; Levy, Cari; Coleman, Eric A; Wald, Heidi L

2017-01-01

Information exchange is critical to high-quality care transitions from hospitals to post-acute care (PAC) facilities. We conducted a survey to evaluate the completeness and timeliness of information transfer and communication between a tertiary-care academic hospital and its related PAC facilities. This was a cross-sectional Web-based 36-question survey of 110 PAC clinicians and staff representing 31 PAC facilities conducted between October and December 2013. We received responses from 71 of 110 individuals representing 29 of 31 facilities (65% and 94% response rates). We collapsed 4-point Likert responses into dichotomous variables to reflect completeness (sufficient vs insufficient) and timeliness (timely vs not timely) for information transfer and communication. Among respondents, 32% reported insufficient information about discharge medical conditions and management plan, and 83% reported at least occasionally encountering problems directly related to inadequate information from the hospital. Hospital clinician contact information was the most common insufficient domain. With respect to timeliness, 86% of respondents desired receipt of a discharge summary on or before the day of discharge, but only 58% reported receiving the summary within this time frame. Through free-text responses, several participants expressed the need for paper prescriptions for controlled pain medications to be sent with patients at the time of transfer. Staff and clinicians at PAC facilities perceive substantial deficits in content and timeliness of information exchange between the hospital and facilities. Such deficits are particularly relevant in the context of the increasing prevalence of bundled payments for care across settings as well as forthcoming readmissions penalties for PAC facilities. Targets identified for quality improvement include structuring discharge summary information to include information identified as deficient by respondents, completion of discharge summaries

A test of the cerebellar hypothesis of dyslexia in adequate and inadequate responders to reading intervention.

Science.gov (United States)

Barth, Amy E; Denton, Carolyn A; Stuebing, Karla K; Fletcher, Jack M; Cirino, Paul T; Francis, David J; Vaughn, Sharon

2010-05-01

The cerebellar hypothesis of dyslexia posits that cerebellar deficits are associated with reading disabilities and may explain why some individuals with reading disabilities fail to respond to reading interventions. We tested these hypotheses in a sample of children who participated in a grade 1 reading intervention study (n = 174) and a group of typically achieving children (n = 62). At posttest, children were classified as adequately responding to the intervention (n = 82), inadequately responding with decoding and fluency deficits (n = 36), or inadequately responding with only fluency deficits (n = 56). Based on the Bead Threading and Postural Stability subtests from the Dyslexia Screening Test-Junior, we found little evidence that assessments of cerebellar functions were associated with academic performance or responder status. In addition, we did not find evidence supporting the hypothesis that cerebellar deficits are more prominent for poor readers with "specific" reading disabilities (i.e., with discrepancies relative to IQ) than for poor readers with reading scores consistent with IQ. In contrast, measures of phonological awareness, rapid naming, and vocabulary were strongly associated with responder status and academic outcomes. These results add to accumulating evidence that fails to associate cerebellar functions with reading difficulties.

Safety culture in industrial radiography facility

International Nuclear Information System (INIS)

Vincent-Furo, Evelyn

2015-02-01

This project reviewed published IAEA materials and other documents on safety culture with specific references to industrial radiography. Safety culture requires all duties important to safety to be carried out correctly, with alertness, due thought and full knowledge, sound judgment and a proper sense of accountability. The development and maintenance of safety culture in an operating organization has to cover management systems, policies, responsibilities, procedures and organizational arrangements. The essence is to control radiation hazard, optimize radiation protection to prevent or reduce exposures and mitigate the consequences of accidents and incidents. To achieve a high degree of safety culture appropriate national and international infrastructure should exist to ensure effective training of workers and management system that supports commitment to safety culture at all level of the organization; management, managers and workforce. The result of the review revealed that all accidents in industrial radiography facilities were due to poor safety culture practices including inadequate regulatory control oversight. Some recommendations are provided and if implemented could improve safety culture leading to good safety performance which will significantly reduce accidents and their consequences in industrial radiography. These examples call for a review of safety culture in Industrial radiography. (au)

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

Construction of a Solid State Research Facility, Building 3150

International Nuclear Information System (INIS)

1993-07-01

The Department of Energy (DOE) proposes to construct a new facility to house the Materials Synthesis Group (MSG) and the Semiconductor Physics Group (SPG) of the Solid State Division, Oak Ridge National Laboratory (ORNL). The location of the proposed action is Roane County, Tennessee. MSG is involved in the study of crystal growth and the preparation and characterization of advanced materials, such as high-temperature superconductors, while SPG is involved in semiconductor physics research. All MSG and a major pardon of SPG research activities are now conducted in Building 2000, a deteriorating structure constructed in the 1940. The physical deterioration of the roof; the heating, ventilation, and air conditioning (HVAC) system; and the plumbing make this building inadequate for supporting research activities. The proposed project is needed to provide laboratory and office space for MSG and SPG and to ensure that research activities can continue without interruption due to deficiencies in the building and its associated utility systems

Methodologies for and Results of Planning later Decommissioning of Nuclear Facilities

International Nuclear Information System (INIS)

Auler, I.; Paul, R.; Petrasch, P.

1996-01-01

Cost and success of decommissioning and dismantling nuclear power plants or other nuclear facilities are very much related to the chosen strategy and their implementation in practice. The strategy to be developed depends on the specific boundary conditions in a certain country and plant. Inadequate planning and equipment considered too late cause delays in the project performance and improvisations with financial and radiological consequences. For the development of a decommissioning strategy for a nuclear power plant broad experience from past D and D-projects is very important. That experience is very helpful in assessing the importance of the many factors which determine the success or failure of strategic decisions Tools for the systematic recording and investigation of the needed measures and expenditures are available, eg. the decommissioning cost program STILLKO-2, which has been established as standard tool. (author)

Response to baricitinib therapy in patients with rheumatoid arthritis with inadequate response to csDMARDs as a function of baseline characteristics.

Science.gov (United States)

Kremer, Joel M; Schiff, Michael; Muram, David; Zhong, Jinglin; Alam, Jahangir; Genovese, Mark C

2018-01-01

We analysed the effects of baseline characteristics on the safety and efficacy of baricitinib in patients with rheumatoid arthritis (RA) with inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) from two phase III trials. In RA-BEAM (NCT01710358), patients with inadequate response to methotrexate were randomised to placebo, baricitinib 4 mg or adalimumab 40 mg. RA-BUILD (NCT01721057) patients had inadequate response to ≥1 csDMARDs and were randomised to either placebo or once-daily baricitinib (2 or 4 mg). Both study populations were naïve to biologic DMARDs (bDMARDs). Primary end point for both studies was American College of Rheumatology 20% improvement (ACR20) response at week 12. Pooled data from the two trials were analysed post hoc based on select subgroups defined by age, previous csDMARD use, baseline RA disease activity, etc, with assessment of clinical and safety outcomes at week 12 and radiographic outcomes at week 24 for the baricitinib 4 mg and placebo-treated patients. Efficacy was observed with baricitinib 4 mg treatment irrespective of patient demographics and baseline disease characteristics. ORs primarily favoured baricitinib over placebo in the ACR20 response. In other outcomes such as Disease Activity Score for 28 joints based on high-sensitivity C reactive protein levels, Simplified Disease Activity Index score ≤11 and radiographic progression, baricitinib 4 mg showed better responses than placebo regardless of baseline characteristics. Safety events were more common in patients over 65 years, but similar between baricitinib 4 mg and placebo patients. Baseline characteristics did not substantially affect clinical response to baricitinib 4 mg in patients with RA with inadequate response to csDMARDs.

Violations of Law in the Bureaucrats Community and Their Perception by the Ukrainian and Russian People in the Late XVIII – First Half of XIX Centuries

Directory of Open Access Journals (Sweden)

Sergey I. Degtyarev

2014-06-01

Full Text Available Studies the problem of service violations and abuses, which were extremely common in the bureaucratic environment of the Russian Empire in the late XVIII – early XIX centuries. The author attempts to answer the question of how these negative phenomena were perceived various population groups in different regions of the empire? It was concluded, that range of offenses, which were committed officials, was extremely broad. In doing so they affected the interests of society regardless of ethnic, social or professional affiliation of its members. This contributed to occurrence of a negative image of officials at all levels of society and in all regions of the empire. Inability and unwillingness of the government fight the offense in the environment of bureaucracy during many decades has led to the creation a negative image of the official. It was display in numerous literary works and poetry of Ukrainian and Russian authors, the memoirs of contemporaries, official documents.

Nonoclusive thrombosis of mechanical mitral valve prosthesis caused by inadequate treatment of anticoagulant therapy resistance

Directory of Open Access Journals (Sweden)

Ivanović Branislava

2008-01-01

Full Text Available Background. Oral anticoagulants have been used in the prevention of thromboembolic complications for over six decades. A rare, but possible problem in the application of these medications could be resistance to them. Case report. We presented a patient with nonocclusive thrombosis of the mechanical mitral prosthesis due to inadequately treated resistance to peroral anticoagulant therapy. Resistance to oral anticoagulant medications was proven by an increased dosage of warfarin up to 20 mg and, after that, acenokumarol to 15 mg over ten days which did not lead to an increase in the international normalized ratio (INR value over 1.2. On the basis of information that she did not take food rich in vitamin K or medications which could reduce effects of oral anticoagulants, and that she did not have additional illnesses and conditions that could cause an inadequate response to anticoagulant therapy, it was circumstantially concluded that this was a hereditary form of resistance. Because of the existing mechanical prosthetics on the mitral position, low molecular heparin has been introduced into the therapy. The patient reduced it on her own initiative, leading to nonocclusive valvular thrombosis. Conclusion. When associated complications like absolute arrhithmia does not exist, the finding of resistance to oral anticoagulant agents is an indication for the replacement of a mechanical prosthetic with a biological one which has been done in this patients.

Explanatory factors for first and second-generation non-western women's inadequate prenatal care utilisation: a prospective cohort study.

Science.gov (United States)

Boerleider, Agatha W; Manniën, Judith; van Stenus, Cherelle M V; Wiegers, Therese A; Feijen-de Jong, Esther I; Spelten, Evelien R; Devillé, Walter L J M

2015-04-21

Little research into non-western women's prenatal care utilisation in industrialised western countries has taken generational differences into account. In this study we examined non-western women's prenatal care utilisation and its explanatory factors according to generational status. Data from 3300 women participating in a prospective cohort of primary midwifery care clients (i.e. women with no complications or no increased risk for complications during pregnancy, childbirth and the puerperium who receive maternity care by autonomous midwives) in the Netherlands (the DELIVER study) was used. Gestational age at entry and the total number of prenatal visits were aggregated into an index. The extent to which potential factors explained non-western women's prenatal care utilisation was assessed by means of blockwise logistic regression analyses and percentage changes in odds ratios. The unadjusted odds of first and second-generation non-western women making inadequate use of prenatal care were 3.26 and 1.96 times greater than for native Dutch women. For the first generation, sociocultural factors explained 43% of inadequate prenatal care utilisation, socioeconomic factors explained 33% and demographic and pregnancy factors explained 29%. For the second generation, sociocultural factors explained 66% of inadequate prenatal care utilisation. Irrespective of generation, strategies to improve utilisation should focus on those with the following sociocultural characteristics (not speaking Dutch at home, no partner or a first-generation non-Dutch partner). For the first generation, strategies should also focus on those with the following demographic, pregnancy and socioeconomic characteristics (aged ≤ 19 or ≥ 36, unplanned pregnancies, poor obstetric histories (extra-uterine pregnancy, molar pregnancy or abortion), a low educational level, below average net household income and no supplementary insurance.

The impact of empathy-explaining diversity in street-level decision-making

DEFF Research Database (Denmark)

Jensen, Didde Cramer; Pedersen, Line Bjørnskov

2017-01-01

in correctional facilities in Denmark, with a 67.5% response rate. The findings confirm that discretionary decision-making is affected by the empathic abilities of bureaucrats. However, the impact of empathy depends on the severity of inmates' infringement against the rules. In essence, the findings demonstrate......This article investigates whether the empathic abilities of street-level bureaucrats have an impact on their discretionary decision-making. The impact of empathic abilities on decision-making is considered an important research question, as our knowledge remains limited as to the importance...... of personal ability on decisions. The article further contributes to the field of street-level bureaucracy by conducting a discrete choice experiment, an approach highly suitable for examining discretionary decision-making. The article draws on nationally representative survey data from 268 employees...

Rationing access to care to the medically uninsured: the role of bureaucratic front-line discretion at large healthcare institutions.

Science.gov (United States)

Weiner, Saul J; Laporte, Margaret; Abrams, Richard I; Moswin, Arthur; Warnecke, Richard

2004-04-01

Medically uninsured patients seeking nonemergency care are not guaranteed access to services at most healthcare institutions. They must first register with a clerk who could require a deposit and/or payment on an outstanding debt. This study examines the factors that influence whether nonmedical bureaucratic staff sign in or turn away uninsured patients who cannot meet prepayment requirements. The study was conducted at a for-profit, a not-for-profit, and a public healthcare institution in a metropolitan area. The authors explored the relevant policy environment through interviews with senior administrators and a review of documents pertaining to the management of self-pay patients. Then they examined how policies affecting access were implemented through in-depth, semistructured, audiotaped interviews with 55 front-line clerical personnel. At all 3 institutions, policies were ambiguous about what to do when uninsured patients cannot afford required prepayments. Seventy-one percent of staff reported they do not turn patients away; the remainder stated that on occasion they do. A variety of rationales were provided for how decisions are made. Those with the lowest-level positions were significantly more likely to be sympathetic to indigent patients and less likely to report turning patients away. Consistent with other studies of front-line bureaucracies indicating that low-level personnel who interface with clients make discretionary decisions, particularly when organizations pursue potentially conflicting priorities, this preliminary investigation found that nonmedical personnel play a significant role in decisions affecting access to care for medically indigent patients.

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.

Case-mix and quality indicators in Chinese elder care homes: are there differences between government-owned and private-sector facilities?

Science.gov (United States)

Liu, Chang; Feng, Zhanlian; Mor, Vincent

2014-02-01

To assess the association between ownership of Chinese elder care facilities and their performance quality and to compare the case-mix profile of residents and facility characteristics in government-owned and private-sector homes. Cross-sectional study. Census of elder care homes surveyed in Nanjing (2009) and Tianjin (2010). Elder care facilities located in urban Nanjing (n = 140, 95% of all) and urban Tianjin (n = 157, 97% of all). A summary case-mix index based on activity of daily living (ADL) limitations and cognitive impairment was created to measure levels of care needs of residents in each facility. Structure, process, and outcome measures were selected to assess facility-level quality of care. A structural quality measure, understaffing relative to resident levels of care needs, which indicates potentially inadequate staffing given resident case-mix, was also developed. Government-owned homes had significantly higher occupancy rates, presumably reflecting popular demand for publicly subsidized beds, but served residents who, on average, have fewer ADL and cognitive functioning limitations than those in private-sector facilities. Across a range of structure, process, and outcome measures of quality, there is no clear evidence suggesting advantages or disadvantages of either ownership type, although when staffing-to-resident ratio is gauged relative to resident case-mix, private-sector facilities were more likely to be understaffed than government-owned facilities. In Nanjing and Tianjin, private-sector homes were more likely to be understaffed, although their residents were sicker and frailer on average than those in government facilities. It is likely that the case-mix differences are the result of selective admission policies that favor healthier residents in government facilities than in private-sector homes. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

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climatic conditions, soil degradation, land tenure system, inadequate storage and processing facilities, inadequate credit facilities and market price of agricultural activities. Extension ... levels to devise appropriate response strategies to tackle the problem. These have ... Although there is increase in demand for them, the ...

Emission Facilities - Erosion & Sediment Control Facilities

Data.gov (United States)

NSGIC Education | GIS Inventory — An Erosion and Sediment Control Facility is a DEP primary facility type related to the Water Pollution Control program. The following sub-facility types related to...

Inadequate knowledge of neonatal danger signs among recently delivered women in southwestern rural Uganda: a community survey.

Directory of Open Access Journals (Sweden)

Jacob Sandberg

Full Text Available BACKGROUND: Early detection of neonatal illness is an important step towards improving newborn survival. Every year an estimated 3.07 million children die during their first month of life and about one-third of these deaths occur during the first 24 hours. Ninety-eight percent of all neonatal deaths occur in low- and middle-income countries like Uganda. Inadequate progress has been made globally to reduce the amount of neonatal deaths that would be required to meet Millennium Development Goal 4. Poor knowledge of newborn danger signs delays care seeking. The aim of this study was to explore the knowledge of key newborn danger signs among mothers in southwestern Uganda. METHODS: Results from a community survey of 765 recently delivered women were analyzed using univariate and multivariate logistic regressions. Six key danger signs were identified, and spontaneous responses were categorized, tabulated, and analyzed. RESULTS: Knowledge of at least one key danger sign was significantly associated with being birth prepared (adjusted OR 1.7, 95% CI 1.2-2.3. Birth preparedness consisted of saving money, identifying transportation, identifying a skilled birth attendant and buying a delivery kit or materials. Overall, respondents had a poor knowledge of key newborn danger signs: 58.2% could identify one and 14.8% could identify two. We found no association between women attending the recommended number of antenatal care visits and their knowledge of danger signs (adjusted OR 1.0, 95% CI 0.8-1.4, or between women using a skilled birth attendant at delivery and their knowledge of danger signs (adjusted OR 1.2, 95% CI 0.9-1.7. CONCLUSIONS: Our findings indicate the need to enhance education of mothers in antenatal care as well as those discharged from health facilities after delivery. Further promotion of birth preparedness is encouraged as part of the continuum of maternal care.

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

Fire hazards analysis for W-413, West Area Tank Farm Storage and Staging Facility

International Nuclear Information System (INIS)

Huckfeldt, R.A.; Lott, D.T.

1994-01-01

In accordance with DOE Order 5480.7A, a Fire Hazards Analysis must be performed for all new facilities. The purpose of the analysis is to comprehensively assess the risk from fire within individual fire areas in relation to proposed fire protection so as to ascertain whether the fire protection objectives of the Order are met. The Order acknowledges a graded approach commensurate with the hazards involved. Tank Farms Operations must sore/stage material and equipment such as pipes, fittings, conduit, instrumentation and others related items until work packages are ready to work. Consumable materials, such as nut, bolts and welding rod, are also requires to be stored for routine and emergency work. Connex boxes and open storage is currently used for much of the storage because of the limited space at and 272WA. Safety issues based on poor housekeeping and material deteriorating due to weather damage has resulted from this inadequate storage space. It has been determined that a storage building in close proximity to the Tank Farm work force would be cost effective. This facility is classified as a safety class 4 building

Predicting inadequate bowel preparation for colonoscopy in participants receiving split-dose bowel preparation: development and validation of a prediction score

NARCIS (Netherlands)

Dik, V.K.; Moons, L.M.; Huyuk, M.; Schaar, P. van der; Cappel, W.H. de Vos Tot Nede; Borg, P.C. ter; Meijssen, M.A.; Ouwendijk, R.J.; Fevre, D.M. Le; Stouten, M.; Galien, O. van der; Hiemstra, T.J.; Monkelbaan, J.F.; Oijen, M.G. van; Siersema, P.D.

2015-01-01

BACKGROUND: Adequate bowel preparation is important for optimal colonoscopy. It is important to identify patients at risk for inadequate bowel preparation because this allows taking precautions in this specific group. OBJECTIVE: To develop a prediction score to identify patients at risk for

Predicting inadequate bowel preparation for colonoscopy in participants receiving split-dose bowel preparation : Development and validation of a prediction score

NARCIS (Netherlands)

Dik, Vincent K.; Moons, Leon M G; Hüyük, Melek; Van Der Schaar, Peter; De Vos Tot Nederveen Cappel, Wouter H.; Ter Borg, Pieter C J; Meijssen, Maarten A C; Ouwendijk, Rob J T H; Le Fèvre, Doris M.; Stouten, Merijn; Van Der Galiën, Onno; Hiemstra, Theo J.; Monkelbaan, Jan F.; van Oijen, Martijn G. H.; Siersema, Peter D.; Tang, Thjon J.; Ter Borg, Frank; Kuipers, Ernst J.

2015-01-01

Background: Adequate bowel preparation is important for optimal colonoscopy. It is important to identify patients at risk for inadequate bowel preparation because this allows taking precautions in this specific group. Objective: To develop a prediction score to identify patients at risk for

The Security Environment in Southeast Asia and Australia, 1995-2010.

Science.gov (United States)

1996-03-01

bottlenecks still frustrate eager foreign investors. The government is attempting to establish a "one- stop" facility where foreign entrepreneurs can get...and entrepreneurs will increasingly supplement traditional sources of politicians—bureaucrats, retired military officers, and rural landowning...confidence. Prime Minister Mahathir has made a deliber- ate public effort to dispel the image of China as a threat. Vietnam’s millennial history of

Results of salvage radiotherapy after inadequate surgery in invasive cervical carcinoma patients: A retrospective analysis

International Nuclear Information System (INIS)

Saibishkumar, Elantholi P.; Patel, Firuza D.; Ghoshal, Sushmita; Kumar, Vinay; Karunanidhi, Gunaseelan; Sharma, Suresh C.

2005-01-01

Purpose: To evaluate the results of salvage radiotherapy (RT) after inadequate surgery in patients with invasive carcinoma of the cervix. Methods and Materials: Between 1996 and 2001, 105 invasive cervical carcinoma patients were treated at our center with external beam RT with or without intracavitary RT after having undergone total/subtotal hysterectomy at outside institutions. Results: The median follow-up was 34 months. The gap between surgery and RT was 23-198 days (median, 80). Clinically visible residual disease was present in 81 patients (77.1%). Total hysterectomy had been done in 82 patients (78%) and subtotal hysterectomy in 23 patients (22%). The 5-year overall survival, disease-free survival, and pelvic control rates of all patients were 55.2%, 53.3%, and 72.4%, respectively. On univariate analysis, older age, total hysterectomy, hemoglobin level >10 g% before RT, nonsquamous histologic type, use of intracavitary RT, a shorter gap between surgery and RT, and the absence of, or a small volume of, residual disease favorably affected the outcome. The 5-year actuarial rate of late toxicity (Radiation Therapy Oncology Group Criteria) was 19% in the rectum, 4.8% in the bladder, 24.8% in the skin, and 14.3% in the small intestine. Conclusions: Inadequate and inappropriate surgery in invasive cervical cancer with resulting gross residual disease is common in India. Factors such as the use of intracavitary RT, the correction of anemia, and a shorter gap between surgery and RT will enable postoperative RT to achieve acceptable results with minimal morbidity

Mixed Waste Working Group report

International Nuclear Information System (INIS)

1993-01-01

The treatment of mixed waste remains one of this country's most vexing environmental problems. Mixed waste is the combination of radioactive waste and hazardous waste, as defined by the Resource Conservation and Recovery Act (RCRA). The Department of Energy (DOE), as the country's largest mixed waste generator, responsible for 95 percent of the Nation's mixed waste volume, is now required to address a strict set of milestones under the Federal Facility Compliance Act of 1992. DOE's earlier failure to adequately address the storage and treatment issues associated with mixed waste has led to a significant backlog of temporarily stored waste, significant quantities of buried waste, limited permanent disposal options, and inadequate treatment solutions. Between May and November of 1993, the Mixed Waste Working Group brought together stakeholders from around the Nation. Scientists, citizens, entrepreneurs, and bureaucrats convened in a series of forums to chart a course for accelerated testing of innovative mixed waste technologies. For the first time, a wide range of stakeholders were asked to examine new technologies that, if given the chance to be tested and evaluated, offer the prospect for better, safer, cheaper, and faster solutions to the mixed waste problem. In a matter of months, the Working Group has managed to bridge a gap between science and perception, engineer and citizen, and has developed a shared program for testing new technologies

Inadequate Riboflavin Intake and Anemia Risk in a Chinese Population: Five-Year Follow Up of the Jiangsu Nutrition Study

Science.gov (United States)

Shi, Zumin; Zhen, Shiqi; Wittert, Gary A.; Yuan, Baojun; Zuo, Hui; Taylor, Anne W.

2014-01-01

Objectives Riboflavin (vitamin B2) has been shown in animal studies to affect the absorption and metabolism of iron. Cross-sectional population studies show a relationship between riboflavin intake and anemia but prospective population studies are limited. The aim of the study was to determine the relationship between riboflavin intake and the risk of anemia in a Chinese cohort. Method The study used data from 1253 Chinese men and women who participated in two waves of the Jiangsu Nutrition Study (JIN), five years apart, in 2002 and 2007. Riboflavin intake and hemoglobin (Hb) were quantitatively assessed together with dietary patterns, lifestyle, socio-demographic and health-related factors. Results At baseline, 97.2% of participants had inadequate riboflavin intake (below the estimate average requirement). Riboflavin intake was positively associated with anemia at baseline, but low riboflavin intake was associated with an increased risk of anemia at follow-up among those anemic at baseline. In the multivariate model, adjusting for demographic and lifestyle factors and dietary patterns, the relative risk and 95% confidence interval for anemia at follow-up, across quartiles of riboflavin intake were: 1, 0.82(0.54–1.23), 0.56(0.34–0.93), 0.52(0.28–0.98) (p for trend 0.021). There was a significant interaction between riboflavin and iron intake; when riboflavin intake was low, a high iron intake was associated with a lower probability of anemia at follow-up. This association disappeared when riboflavin intake was high. Conclusion Inadequate riboflavin intake is common and increases the risk of anemia in Chinese adults. Given the interaction with iron intake correcting inadequate riboflavin intake may be a priority in the prevention of anemia, and population based measurement and intervention trials are required. PMID:24533156

Bürokrasi-Demokrasi İlişkisi ve Bürokratların Seçilmişlerce Kontrolü Sorunu(Relation Between Bureaucracy and Democracy and The Problem of Bureaucratic Control by The Elected

Directory of Open Access Journals (Sweden)

Fatih DEMİR

2011-01-01

Full Text Available In this paper the discussions made on political/democratic control of bureaucracy in international literature, as well as the theories proposed and models developed. The paper aims at focusing on the theoretical aspects of the issue avoiding the patterns of supervising administration such as parliamentary investigations or ombudsman which are envisaged in administrative or constitutional law. The manner with which democratic control of bureaucracy will be ensured is a long-discussed phenomenon; principal-agent theory, representative bureaucracy approach, administrative procedures and politicization of bureaucracy can be recommended as solutions to this problem. Each of these methods carry the risk of divergence from ideal bureaucratic type, but this is an acceptable price if public sovereignty is to be reflected on administration.

Facility effluent monitoring plan determinations for the 400 Area facilities

International Nuclear Information System (INIS)

Nickels, J.M.

1991-09-01

This Facility Effluent Monitoring Plan determination resulted from an evaluation conducted for the Westinghouse Hanford Company 400 Area facilities on the Hanford Site. The Facility Effluent Monitoring Plan determinations have been prepared in accordance with A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans. Two major Westinghouse Hanford Company facilities in the 400 Area were evaluated: the Fast Flux Test Facility and the Fuels Manufacturing and examination Facility. The determinations were prepared by Westinghouse Hanford Company. Of these two facilities, only the Fast Flux Test Facility will require a Facility Effluent Monitoring Plan. 7 refs., 5 figs., 4 tabs

Bureaucratic Structure and Bureaucratic Performance in Less Developed Countries

OpenAIRE

Rauch, James E; Evans, Peter B.

1999-01-01

Recent cross-country empirical analysis has found that privately produced ratings of the performance of the central government bureaucracy in areas such as corruption and red tape are significant predictors of economic performance. We argue that several relatively simple, easily identifiable structural features constitute the key ingredients of effective state bureaucracies and should help to predict these ratings: competitive salaries, internal promotion and career stability, and meritocrati...

Where there is no toilet: water and sanitation environments of domestic and facility births in Tanzania.

Directory of Open Access Journals (Sweden)

Lenka Benova

Full Text Available Inadequate water and sanitation during childbirth are likely to lead to poor maternal and newborn outcomes. This paper uses existing data sources to assess the water and sanitation (WATSAN environment surrounding births in Tanzania in order to interrogate whether such estimates could be useful for guiding research, policy and monitoring initiatives.We used the most recent Tanzania Demographic and Health Survey (DHS to characterise the delivery location of births occurring between 2005 and 2010. Births occurring in domestic environments were characterised as WATSAN-safe if the home fulfilled international definitions of improved water and improved sanitation access. We used the 2006 Service Provision Assessment survey to characterise the WATSAN environment of facilities that conduct deliveries. We combined estimates from both surveys to describe the proportion of all births occurring in WATSAN-safe environments and conducted an equity analysis based on DHS wealth quintiles and eight geographic zones.42.9% (95% confidence interval: 41.6%-44.2% of all births occurred in the woman's home. Among these, only 1.5% (95% confidence interval: 1.2%-2.0% were estimated to have taken place in WATSAN-safe conditions. 74% of all health facilities conducted deliveries. Among these, only 44% of facilities overall and 24% of facility delivery rooms were WATSAN-safe. Combining the estimates, we showed that 30.5% of all births in Tanzania took place in a WATSAN-safe environment (range of uncertainty 25%-42%. Large wealth-based inequalities existed in the proportion of births occurring in domestic environments based on wealth quintile and geographical zone.Existing data sources can be useful in national monitoring and prioritisation of interventions to improve poor WATSAN environments during childbirth. However, a better conceptual understanding of potentially harmful exposures and better data are needed in order to devise and apply more empirical definitions of

Where there is no toilet: water and sanitation environments of domestic and facility births in Tanzania.

Science.gov (United States)

Benova, Lenka; Cumming, Oliver; Gordon, Bruce A; Magoma, Moke; Campbell, Oona M R

2014-01-01

Inadequate water and sanitation during childbirth are likely to lead to poor maternal and newborn outcomes. This paper uses existing data sources to assess the water and sanitation (WATSAN) environment surrounding births in Tanzania in order to interrogate whether such estimates could be useful for guiding research, policy and monitoring initiatives. We used the most recent Tanzania Demographic and Health Survey (DHS) to characterise the delivery location of births occurring between 2005 and 2010. Births occurring in domestic environments were characterised as WATSAN-safe if the home fulfilled international definitions of improved water and improved sanitation access. We used the 2006 Service Provision Assessment survey to characterise the WATSAN environment of facilities that conduct deliveries. We combined estimates from both surveys to describe the proportion of all births occurring in WATSAN-safe environments and conducted an equity analysis based on DHS wealth quintiles and eight geographic zones. 42.9% (95% confidence interval: 41.6%-44.2%) of all births occurred in the woman's home. Among these, only 1.5% (95% confidence interval: 1.2%-2.0%) were estimated to have taken place in WATSAN-safe conditions. 74% of all health facilities conducted deliveries. Among these, only 44% of facilities overall and 24% of facility delivery rooms were WATSAN-safe. Combining the estimates, we showed that 30.5% of all births in Tanzania took place in a WATSAN-safe environment (range of uncertainty 25%-42%). Large wealth-based inequalities existed in the proportion of births occurring in domestic environments based on wealth quintile and geographical zone. Existing data sources can be useful in national monitoring and prioritisation of interventions to improve poor WATSAN environments during childbirth. However, a better conceptual understanding of potentially harmful exposures and better data are needed in order to devise and apply more empirical definitions of WATSAN

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

Development of a Commonwealth Radioactive Waste Management Facility in Australia

International Nuclear Information System (INIS)

Hesterman, R.

2006-01-01

Full text: The Australian Government has commenced a process to build a Commonwealth Radioactive Waste Management Facility in the Northern Territory for management of radioactive wastes produced by Australian Government agencies. The Government is committed to safely managing its relatively small volume of low level radioactive waste (approximately 3800 cubic metres) and even smaller volume of intermediate level waste (around 400 cubic metres) that have been generated since the early 1950s from the research, medical and industrial use of radioactive materials. Australia has no high level radioactive waste as it does not have any nuclear power reactors. Australian states and territories are responsible for the safe and secure management of low level and intermediate level waste generated within their jurisdictions. They have jointly generated approximately 200 cubic metres of low level radioactive waste and under 100 cubic metres of intermediate level for the same period. In July 2004, the Prime Minister announced that the Australian Government would examine the suitability of Commonwealth land holdings, both onshore and offshore, for establishing the Facility. An initial assessment of offshore territories by the Department of Education, Science and Training (DEST) did not find any sufficiently suitable sites for hosting the Facility. This was due to the low elevation of most territories, inadequate infrastructure and incompatibility with existing land uses. In July 2005, Dr Nelson, then the Minister for Education, Science and Training, announced that three Department of Defence properties in the Northern Territory would be investigated for siting the Facility. The three properties are Fishers Ridge, about 43 kilometres southeast of Katherine; Harts Range, 100 kilometres directly northeast of Alice Springs; and Mt Everard, about 27 kilometres directly northwest of Alice Springs. In addition, the Commonwealth Radioactive Waste Management Act 2005, enacted in December

Non-western women in maternity care in the Netherlands: Exploring 'inadequate' use of prenatal care and the experiences of care professionals

NARCIS (Netherlands)

Boerleider, A.W.

2015-01-01

Non-western women in the Netherlands are more likely to make inadequate use of prenatal care than native Dutch women. Furthermore, non-western women are diverse in origin which implies diversity in their needs and expectations for maternity care. This thesis examines the factors and reasons

Rethinking clinical trials of transcranial direct current stimulation: participant and assessor blinding is inadequate at intensities of 2mA.

Directory of Open Access Journals (Sweden)

Neil E O'Connell

Full Text Available BACKGROUND: Many double-blind clinical trials of transcranial direct current stimulation (tDCS use stimulus intensities of 2 mA despite the fact that blinding has not been formally validated under these conditions. The aim of this study was to test the assumption that sham 2 mA tDCS achieves effective blinding. METHODS: A randomised double blind crossover trial. 100 tDCS-naïve healthy volunteers were incorrectly advised that they there were taking part in a trial of tDCS on word memory. Participants attended for two separate sessions. In each session, they completed a word memory task, then received active or sham tDCS (order randomised at 2 mA stimulation intensity for 20 minutes and then repeated the word memory task. They then judged whether they believed they had received active stimulation and rated their confidence in that judgement. The blinded assessor noted when red marks were observed at the electrode sites post-stimulation. RESULTS: tDCS at 2 mA was not effectively blinded. That is, participants correctly judged the stimulation condition greater than would be expected to by chance at both the first session (kappa level of agreement (κ 0.28, 95% confidence interval (CI 0.09 to 0.47 p=0.005 and the second session (κ=0.77, 95%CI 0.64 to 0.90, p=<0.001 indicating inadequate participant blinding. Redness at the reference electrode site was noticeable following active stimulation more than sham stimulation (session one, κ=0.512, 95%CI 0.363 to 0.66, p<0.001; session two, κ=0.677, 95%CI 0.534 to 0.82 indicating inadequate assessor blinding. CONCLUSIONS: Our results suggest that blinding in studies using tDCS at intensities of 2 mA is inadequate. Positive results from such studies should be interpreted with caution.

Inadequate functional health literacy in Spanish as a barrier to cervical cancer screening among immigrant Latinas in New York City.

Science.gov (United States)

Garbers, Samantha; Chiasson, Mary Ann

2004-10-01

The objective of this study was to examine the association between inadequate functional health literacy in Spanish among low-income Latinas aged 40 and older and cervical cancer screening knowledge and behavior. Spanish-speaking Latinas aged 40-78 of various nationalities (n = 205) participated in a study that included a survey on cervical cancer knowledge and behavior administered in Spanish and the Spanish version of the Test of Functional Health Literacy in Adults. Compared to those with adequate and marginal health literacy, women with inadequate functional health literacy in Spanish were significantly less likely to have ever had a Papanicolaou (Pap) test (odds ratio, 0.12; 95% confidence interval [CI], 0.04-0.37) or in the last three years (odds ratio, 0.35; 95% CI, 0.18-0.68) and were significantly more likely to have had their last Pap test at a local public hospital (odds ratio, 2.43; 95% CI, 1.18-4.97). Even when controlling for other factors, women with inadequate health literacy were 16.7 times less likely (adjusted odds ratio, 0.06; 95% CI, 0.01-0.55) to have ever had a Pap test. Almost half of the population we studied will have difficulty interpreting written medical materials, even in Spanish. When developing efforts to reach women who have not been screened, programs and service providers need to be aware that the women most in need of information about screening may be more likely to be unable to read any written materials provided to them, regardless of the language or level of simplicity of the materials. Programs and strategies need to be implemented to increase screening prevalence and to minimize the identified gaps in regular screening for Latinas who have low health literacy.

Service providers' perception of the quality of emergency obsteric ...

African Journals Online (AJOL)

Facility/staff themes which emerged as contributing to the poor care were; inadequate resources, inadequate staffing, poor teamwork, and inadequate knowledge/supervision. Conclusion The findings of this study reveal that health care workers rate the quality of emergency obstetric care they provide as poor. They were ...

Dance Facilities.

Science.gov (United States)

Ashton, Dudley, Ed.; Irey, Charlotte, Ed.

This booklet represents an effort to assist teachers and administrators in the professional planning of dance facilities and equipment. Three chapters present the history of dance facilities, provide recommended dance facilities and equipment, and offer some adaptations of dance facilities and equipment, for elementary, secondary and college level…

Facilities inventory protection for nuclear facilities

International Nuclear Information System (INIS)

Schmitt, F.J.

1989-01-01

The fact that shut-down applications have been filed for nuclear power plants, suggests to have a scrutinizing look at the scopes of assessment and decision available to administrations and courts for the protection of facilities inventories relative to legal and constitutional requirements. The paper outlines the legal bases which need to be observed if purposeful calculation is to be ensured. Based on the different actual conditions and legal consequences, the author distinguishes between 1) the legal situation of facilities licenced already and 2) the legal situation of facilities under planning during the licencing stage. As indicated by the contents and restrictions of the pertinent provisions of the Atomic Energy Act and by the corresponding compensatory regulation, the object of the protection of facilities inventor in the legal position of the facility owner within the purview of the Atomic Energy Act, and the licensing proper. Art. 17 of the Atomic Energy Act indicates the legislators intent that, once issued, the licence will be the pivotal point for regulations aiming at protection and intervention. (orig./HSCH) [de

Healthcare waste management status in Lagos State, Nigeria: a case study from selected healthcare facilities in Ikorodu and Lagos metropolis.

Science.gov (United States)

Longe, Ezechiel O

2012-06-01

A survey of healthcare waste management practices and their implications for health and the environment was carried out. The study assessed waste management practices in 20 healthcare facilities ranging in capacity from 40 to 600 beds in Ikorodu and metropolitan Lagos, Lagos State, Nigeria. The prevailing healthcare waste management status was analysed. Management issues on quantities and proportion of different constituents of waste, segregation, collection, handling, transportation, treatment and disposal methods were assessed. The waste generation averaged 0.631 kg bed(-1) day(-1) over the survey area. The waste stream from the healthcare facilities consisted of general waste (59.0%), infectious waste (29.7%), sharps and pathological (8.9%), chemical (1.45%) and others (0.95%). Sharps/pathological waste includes disposable syringes. In general, the waste materials were collected in a mixed form, transported and disposed of along with municipal solid waste with attendant risks to health and safety. Most facilities lacked appropriate treatment systems for a variety of reasons that included inadequate funding and little or no priority for healthcare waste management as well as a lack of professionally competent waste managers among healthcare providers. Hazards associated with healthcare waste management and shortcomings in the existing system were identified.

Cost calculations for decommissioning and dismantling of nuclear research facilities, Phase 1

International Nuclear Information System (INIS)

Andersson, Inga; Backe, S.; Iversen, Klaus; Lindskog, S; Salmenhaara, S.; Sjoeblom, R.

2006-11-01

Today, it is recommended that planning of decommission should form an integral part of the activities over the life cycle of a nuclear facility. However, no actual international guideline on cost calculations exists at present. Intuitively, it might be tempting to regard costs for decommissioning of a nuclear facility as similar to those of any other plant. However, the presence of radionuclide contamination may imply that the cost is one or more orders of magnitude higher as compared to a corresponding inactive situation, the actual ratio being highly dependent on the level of contamination as well as design features and use of the facility in question. Moreover, the variations in such prerequisites are much larger than for nuclear power plants. This implies that cost calculations cannot be performed with any accuracy or credibility without a relatively detailed consideration of the radiological and other prerequisites. Application of inadequate methodologies especially at early stages has often lead to large underestimations. The goals of the project and the achievements described in the report are as follows: 1) Advice on good practice with regard to: 1a) Strategy and planning; 1b) Methodology selection; 1c) Radiological surveying; 1d) Uncertainty analysis; 2) Techniques for assessment of costs: 2a) Cost structuring; 2b) Cost estimation methodologies; 3) Compilation of data for plants, state of planning, organisations, etc.; 3a) General descriptions of relevant features of the nuclear research facilities; 3b) General plant specific data; 3c) Example of the decommissioning of the R1 research reactor in Sweden; 3d) Example of the decommissioning of the DR1 research reactor in Denmark. In addition, but not described in the present report, is the establishment of a Nordic network in the area including an internet based expert system. It should be noted that the project is planned to exist for at least three years and that the present report is an interim one

Cost calculations for decommissioning and dismantling of nuclear research facilities, Phase 1

Energy Technology Data Exchange (ETDEWEB)

Andersson, Inga [StudsvikNuclear AB (Sweden); Backe, S. [Institute for Energy Technology (Norway); Iversen, Klaus [Danish Decommissioning (Denmark); Lindskog, S [Swedish Nuclear Power Inspectorate (Sweden); Salmenhaara, S. [VTT Technical Research Centre of Finland (Finland); Sjoeblom, R. [Tekedo AB (Sweden)

2006-11-15

Today, it is recommended that planning of decommission should form an integral part of the activities over the life cycle of a nuclear facility. However, no actual international guideline on cost calculations exists at present. Intuitively, it might be tempting to regard costs for decommissioning of a nuclear facility as similar to those of any other plant. However, the presence of radionuclide contamination may imply that the cost is one or more orders of magnitude higher as compared to a corresponding inactive situation, the actual ratio being highly dependent on the level of contamination as well as design features and use of the facility in question. Moreover, the variations in such prerequisites are much larger than for nuclear power plants. This implies that cost calculations cannot be performed with any accuracy or credibility without a relatively detailed consideration of the radiological and other prerequisites. Application of inadequate methodologies especially at early stages has often lead to large underestimations. The goals of the project and the achievements described in the report are as follows: 1) Advice on good practice with regard to: 1a) Strategy and planning; 1b) Methodology selection; 1c) Radiological surveying; 1d) Uncertainty analysis; 2) Techniques for assessment of costs: 2a) Cost structuring; 2b) Cost estimation methodologies; 3) Compilation of data for plants, state of planning, organisations, etc.; 3a) General descriptions of relevant features of the nuclear research facilities; 3b) General plant specific data; 3c) Example of the decommissioning of the R1 research reactor in Sweden; 3d) Example of the decommissioning of the DR1 research reactor in Denmark. In addition, but not described in the present report, is the establishment of a Nordic network in the area including an internet based expert system. It should be noted that the project is planned to exist for at least three years and that the present report is an interim one

Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach.

Science.gov (United States)

Patel, Rachana; Ladusingh, Laishram

2015-01-01

This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007-08) data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM) and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women's residing in more urbanized districts increased the utilization. "Inter-district" variation was 14 percent whereas "between-villages" variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and inaccessible considering

Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach.

Directory of Open Access Journals (Sweden)

Rachana Patel

Full Text Available This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007-08 data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women's residing in more urbanized districts increased the utilization. "Inter-district" variation was 14 percent whereas "between-villages" variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and

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.

Tofacitinib for Psoriatic Arthritis in Patients with an Inadequate Response to TNF Inhibitors.

Science.gov (United States)

Gladman, Dafna; Rigby, William; Azevedo, Valderilio F; Behrens, Frank; Blanco, Ricardo; Kaszuba, Andrzej; Kudlacz, Elizabeth; Wang, Cunshan; Menon, Sujatha; Hendrikx, Thijs; Kanik, Keith S

2017-10-19

Tofacitinib is an oral Janus kinase inhibitor that is under investigation for the treatment of psoriatic arthritis. We evaluated tofacitinib in patients with active psoriatic arthritis who had previously had an inadequate response to tumor necrosis factor (TNF) inhibitors. In this 6-month randomized, placebo-controlled, double-blind, phase 3 trial, we randomly assigned 395 patients, in a 2:2:1:1 ratio, to four regimens: 5 mg of tofacitinib administered orally twice daily (132 patients); 10 mg of tofacitinib twice daily (132 patients); placebo, with a switch to 5 mg of tofacitinib twice daily at 3 months (66 patients); or placebo, with a switch to 10 mg of tofacitinib twice daily at 3 months (65 patients). Data from the patients who received placebo during the first 3 months of the trial were pooled. The primary end points were the percentage of patients who had at least 20% improvement according to the criteria of the American College of Rheumatology (ACR20 response) and the change from baseline score on the Health Assessment Questionnaire-Disability Index (HAQ-DI; scores range from 0 to 3, with higher scores indicating greater disability) at the month 3 analysis. At 3 months, the rates of ACR20 response were 50% with the 5-mg dose of tofacitinib and 47% with the 10-mg dose, as compared with 24% with placebo (Ptofacitinib continuously and in 6% who received the 10-mg dose continuously. Over the course of 6 months, there were four serious infections, three herpes zoster infections, one myocardial infarction, and one ischemic stroke among the patients who received tofacitinib continuously. Elevations of aspartate and alanine aminotransferase concentrations of three or more times the upper limit of the normal range occurred in more patients who received tofacitinib continuously than in patients who received placebo followed by tofacitinib. In this trial involving patients with active psoriatic arthritis who had had an inadequate response to TNF inhibitors, tofacitinib

Patient information regarding medical radiation exposure is inadequate: Patients' experience in a university hospital

International Nuclear Information System (INIS)

Ukkola, L.; Oikarinen, H.; Henner, A.; Haapea, M.; Tervonen, O.

2017-01-01

Introduction: It is suspected that little or no information is provided to patients regarding radiological examinations. The purpose was to evaluate the coverage, content and source of this information in a university hospital. Methods: Altogether 147 patients (18–85 years) were interviewed after different examinations using a questionnaire. The patients had undergone 35 low (<1 mSv), 66 medium (1–10), and 46 high (>10) dose examinations. They were asked if they were informed about radiation use, the course or indication of the examination, the consequences of not having the examination, other options, the dose and risks of radiation, the source for the information and if any consent was enquired. Results: 52 (35%) patients did not receive any information while 95 (65%) obtained some information. Fifty-six (38%) patients received an information letter, and 75 (51%) obtained oral information, mainly from the referrer or the radiographer. The information was mostly about indication, course or radiation use, very seldom about radiation risks and the other areas. Those with a nuclear medicine examination received information more often than those with other medium- or high-dose examinations (p = 0.004). The patients scored the received information as 2.2 (mean, SD 1.3) on a Likert scale from 1 (poor) to 5 (good). Conclusion: Patients obtained inadequate information regarding radiological examinations in a university hospital. The information was provided non-systematically from various sources. The results help to set up practical guidelines for systematic information and to follow up their efficiency. The mode of operation might be helpful elsewhere in the future. - Highlights: • Patients obtained inadequate information regarding medical radiation exposure. • The information was provided non-systematically from various sources. • Patients with nuclear examinations were informed better than with other modalities. • In addition to general guidelines

"You should go so that others can come"; the role of facilities in determining an early departure after childbirth in Morogoro Region, Tanzania.

Science.gov (United States)

McMahon, Shannon A; Mohan, Diwakar; LeFevre, Amnesty E; Mosha, Idda; Mpembeni, Rose; Chase, Rachel P; Baqui, Abdullah H; Winch, Peter J

2015-12-09

Tanzania is among ten countries that account for a majority of the world's newborn deaths. However, data on time-to-discharge after facility delivery, receipt of postpartum messaging by time to discharge and women's experiences in the time preceding discharge from a facility after childbirth are limited. Household survey of 1267 women who delivered in the preceding 2-14 months; in-depth interviews with 24 women, 12 husbands, and 5 community elders. Two-thirds of women with vaginal, uncomplicated births departed within 12 h; 90 % within 24 h, and 95 % within 48 h. Median departure times varied significantly across facilities (hospital: 23 h, health center: 10 h, dispensary: 7 h, p discharge. In multiple logistic regression, level of facility (hospital, health center, dispensary) was the only significant predictor of early discharge (p = 0.001). However across all types of facilities a majority of women depart before 24 h ranging from hospitals (54 %) to health centers (64 %) to dispensaries (74 %). Most women who experienced a delivery complication (56 %), gave birth by caesarean section (90 %), or gave birth to a pre-term baby (70 %) stayed longer than 24 h. Reasons for early discharge include: facility practices including discharge routines and working hours and facility-based discomforts for women and those who accompany them to facilities. Provision of postpartum counseling was inadequate regardless of time to discharge and regardless of type of facility where delivery occurred. Our quantitative and qualitative findings indicate that the level of facility care and comforts existing or lacking in a facility have the greatest effect on time to discharge. This suggests that individual or interpersonal characteristics play a limited role in deciding whether a woman would stay for shorter or longer periods. Implementation of a policy of longer stay must incorporate enhanced postpartum counseling and should be sensitive to women's perceptions

Facility effluent monitoring plan determinations for the 200 Area facilities

International Nuclear Information System (INIS)

Nickels, J.M.

1991-11-01

The following facility effluent monitoring plan determinations document the evaluations conducted for the Westinghouse Hanford Company 200 Area facilities (chemical processing, waste management, 222-S Laboratory, and laundry) on the Hanford Site in south central Washington State. These evaluations determined the need for facility effluent monitoring plans for the 200 Area facilities. The facility effluent monitoring plan determinations have been prepared in accordance with A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438 (WHC 1991). The Plutonium/Uranium Extraction Plant and UO 3 facility effluent monitoring plan determinations were prepared by Los Alamos Technical Associates, Richland, Washington. The Plutonium Finishing Plant, Transuranic Waste Storage and Assay Facility, T Plant, Tank Farms, Low Level Burial Grounds, and 222-S Laboratory determinations were prepared by Science Applications International Corporation of Richland, Washington. The B Plant Facility Effluent Monitoring Plan Determination was prepared by ERCE Environmental Services of Richland, Washington

Facilities & Leadership

Data.gov (United States)

Department of Veterans Affairs — The facilities web service provides VA facility information. The VA facilities locator is a feature that is available across the enterprise, on any webpage, for the...

Facility model for the Los Alamos Plutonium Facility

International Nuclear Information System (INIS)

Coulter, C.A.; Thomas, K.E.; Sohn, C.L.; Yarbro, T.F.; Hench, K.W.

1986-01-01

The Los Alamos Plutonium Facility contains more than sixty unit processes and handles a large variety of nuclear materials, including many forms of plutonium-bearing scrap. The management of the Plutonium Facility is supporting the development of a computer model of the facility as a means of effectively integrating the large amount of information required for material control, process planning, and facility development. The model is designed to provide a flexible, easily maintainable facility description that allows the faciltiy to be represented at any desired level of detail within a single modeling framework, and to do this using a model program and data files that can be read and understood by a technically qualified person without modeling experience. These characteristics were achieved by structuring the model so that all facility data is contained in data files, formulating the model in a simulation language that provides a flexible set of data structures and permits a near-English-language syntax, and using a description for unit processes that can represent either a true unit process or a major subsection of the facility. Use of the model is illustrated by applying it to two configurations of a fictitious nuclear material processing line

Determinants of inadequate parental sun protection behaviour in their children--results of a cross-sectional study in Germany.

Science.gov (United States)

Klostermann, Swaantje; Bolte, Gabriele

2014-03-01

Unprotected sun exposure especially during childhood is a risk factor for skin cancer. A combined use of sun protection measures is recommended to protect children. However, the prevalence and determinants for combined use have been scarcely studied in children. The objective of this study was to identify determinants of parental sun protection behaviour. A cross-sectional survey was performed in five regions in Bavaria (Germany) during school entrance health examination (2010/2011). Parents of 4579 children (47% female, aged 5-6 years) completed a self-administered questionnaire (response 61%). Most children were regularly protected with single measures (shade (69%), clothes (80%), hat (83%), sunscreen (89%), sunglasses (20%)). However, regarding regular and combined use, >50% of children were inadequately protected. Larger family size, lower household equivalent income, darker skin and sunburn history were associated with inadequate use of different sun protection measures. The less frequent use of one sun protection measure was associated with less frequent use of the others. Child's sex, migration background, parental education and sun exposure showed inconsistent results regarding the different sun protection outcomes. Based on our results a regular, combined and correct use of multiple sun protection for children should be promoted independent of sociodemographic characteristics. Priority of shade, clothes and hat before sunscreen should be clarified. Copyright © 2013 Elsevier GmbH. All rights reserved.

Animal facilities

International Nuclear Information System (INIS)

Fritz, T.E.; Angerman, J.M.; Keenan, W.G.; Linsley, J.G.; Poole, C.M.; Sallese, A.; Simkins, R.C.; Tolle, D.

1981-01-01

The animal facilities in the Division are described. They consist of kennels, animal rooms, service areas, and technical areas (examining rooms, operating rooms, pathology labs, x-ray rooms, and 60 Co exposure facilities). The computer support facility is also described. The advent of the Conversational Monitor System at Argonne has launched a new effort to set up conversational computing and graphics software for users. The existing LS-11 data acquisition systems have been further enhanced and expanded. The divisional radiation facilities include a number of gamma, neutron, and x-ray radiation sources with accompanying areas for related equipment. There are five 60 Co irradiation facilities; a research reactor, Janus, is a source for fission-spectrum neutrons; two other neutron sources in the Chicago area are also available to the staff for cell biology studies. The electron microscope facilities are also described

Facilities Performance Indicators Report 2013-14: Tracking Your Facilities Vital Signs

Science.gov (United States)

APPA: Association of Higher Education Facilities Officers, 2015

2015-01-01

This paper features an expanded Web-based "Facilities Performance Indicators (FPI) Report." The purpose of APPA: Association of Higher Education Facilities Officers (APPA's) Facilities Performance Indicators is to provide a representative set of statistics about facilities in educational institutions. "The Facilities Performance…

LOW LEVEL LIQUID RADIOACTIVE WASTE TREATMENT AT MURMANSK, RUSSIA: FACILITY UPGRADE AND EXPANSION

International Nuclear Information System (INIS)

BOWERMAN, B.; CZAJKOWSKI, C.; DYER, R.S.; SORLIE, A.

2000-01-01

Today there exist many almost overfilled storage tanks with liquid radioactive waste in the Russian Federation. This waste was generated over several years by the civil and military utilization of nuclear power. The current waste treatment capacity is either not available or inadequate. Following the London Convention, dumping of the waste in the Arctic seas is no longer an alternative. Waste is being generated from today's operations, and large volumes are expected to be generated from the dismantling of decommissioned nuclear submarines. The US and Norway have an ongoing co-operation project with the Russian Federation to upgrade and expand the capacity of a treatment facility for low level liquid waste at the RTP Atomflot site in Murmansk. The capacity will be increased from 1,200 m 3 /year to 5,000 m 3 /year. The facility will also be able to treat high saline waste. The construction phase will be completed the first half of 1998. This will be followed by a start-up and a one year post-construction phase, with US and Norwegian involvement for the entire project. The new facility will consist of 9 units containing various electrochemical, filtration, and sorbent-based treatment systems. The units will be housed in two existing buildings, and must meet more stringent radiation protection requirements that were not enacted when the facility was originally designed. The US and Norwegian technical teams have evaluated the Russian design and associated documentation. The Russian partners send monthly progress reports to US and Norway. Not only technical issues must be overcome but also cultural differences resulting from different methods of management techniques. Six to eight hour time differentials between the partners make real time decisions difficult and relying on electronic age tools becomes extremely important. Language difficulties is another challenge that must be solved. Finding a common vocabulary, and working through interpreters make the process very

Communication grounding facility

International Nuclear Information System (INIS)

Lee, Gye Seong

1998-06-01

It is about communication grounding facility, which is made up twelve chapters. It includes general grounding with purpose, materials thermal insulating material, construction of grounding, super strength grounding method, grounding facility with grounding way and building of insulating, switched grounding with No. 1A and LCR, grounding facility of transmission line, wireless facility grounding, grounding facility in wireless base station, grounding of power facility, grounding low-tenton interior power wire, communication facility of railroad, install of arrester in apartment and house, install of arrester on introduction and earth conductivity and measurement with introduction and grounding resistance.

Reforming Management of Behavior Symptoms and Psychiatric Conditions in Long-Term Care Facilities: A Different Perspective.

Science.gov (United States)

Levenson, Steven A; Desai, Abhilash K

2017-04-01

Despite much attention including national initiatives, concerns remain about the approaches to managing behavior symptoms and psychiatric conditions across all settings, including in long-term care settings such as nursing homes and assisted living facilities. One key reason why problems persist is because most efforts to "reform" and "correct" the situation have failed to explore or address root causes and instead have promoted inadequate piecemeal "solutions." Further improvement requires jumping off the bandwagon and rethinking the entire issue, including recognizing and applying key concepts of clinical reasoning and the care delivery process to every situation. The huge negative impact of cognitive biases and rote approaches on related clinical problem solving and decision making and patient outcomes also must be addressed. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Facility effluent monitoring plan for the 327 Facility

International Nuclear Information System (INIS)

1994-11-01

The 327 Facility [Post-Irradiation Testing Laboratory] provides office and laboratory space for Pacific Northwest Laboratory (PNL) scientific and engineering staff conducting multidisciplinary research in the areas of post-irradiated fuels and structural materials. The facility is designed to accommodate the use of radioactive and hazardous materials in the conduct of these activities. This report summarizes the airborne emissions and liquid effluents and the results of the Facility Effluent Monitoring Plan (FEMP) determination for the facility. The complete monitoring plan includes characterization of effluent streams, monitoring/sampling design criteria, a description of the monitoring systems and sample analysis, and quality assurance requirements

2013 Nutrition Risk Evidence Review Panel. Evidence Review for: The Risk Factor of Inadequate Nutrition

Science.gov (United States)

2014-01-01

The 2013 Nutrition Risk Standing Review Panel (from here on referred to as the SRP) met for a site visit in Houston, TX on November 20 - 21, 2013. The SRP reviewed the new Evidence Report for the Risk Factor of Inadequate Nutrition (from here on referred to as the 2013 Nutrition Evidence Report), as well as the Research Plan for this Risk. Overall, the SRP thinks the well-qualified research team has compiled an excellent summary of background information in the 2013 Nutrition Evidence Report. The SRP would like to commend the authors in general and particularly note that while the 2013 Nutrition Evidence Report has been written using a single nutrient approach, the research plan takes a much more integrated and physiologically based approach.

Facility effluent monitoring plan for the 325 Facility

International Nuclear Information System (INIS)

1998-01-01

The Applied Chemistry Laboratory (325 Facility) houses radiochemistry research, radioanalytical service, radiochemical process development, and hazardous and mixed hazardous waste treatment activities. The laboratories and specialized facilities enable work ranging from that with nonradioactive materials to work with picogram to kilogram quantities of fissionable materials and up to megacurie quantities of other radionuclides. The special facilities include two shielded hot-cell areas that provide for process development or analytical chemistry work with highly radioactive materials, and a waste treatment facility for processing hazardous, mixed, low-level, and transuranic wastes generated by Pacific Northwest Laboratory. Radioactive material storage and usage occur throughout the facility and include a large number of isotopes. This material is in several forms, including solid, liquid, particulate, and gas. Some of these materials are also heated during testing which can produce vapors. The research activities have been assigned to the following activity designations: High-Level Hot Cell, Hazardous Waste Treatment Unit, Waste Form Development, Special Testing Projects, Chemical Process Development, Analytical Hot Cell, and Analytical Chemistry. The following summarizes the airborne and liquid effluents and the results of the Facility Effluent Monitoring Plan (FEMP) determination for the facility. The complete monitoring plan includes characterization of effluent streams, monitoring/sampling design criteria, a description of the monitoring systems and sample analysis, and quality assurance requirements

Distinguishing the Impacts of Inadequate Prey and Vessel Traffic on an Endangered Killer Whale (Orcinus orca) Population

Science.gov (United States)

Ayres, Katherine L.; Booth, Rebecca K.; Hempelmann, Jennifer A.; Koski, Kari L.; Emmons, Candice K.; Baird, Robin W.; Balcomb-Bartok, Kelley; Hanson, M. Bradley; Ford, Michael J.; Wasser, Samuel K.

2012-01-01

Managing endangered species often involves evaluating the relative impacts of multiple anthropogenic and ecological pressures. This challenge is particularly formidable for cetaceans, which spend the majority of their time underwater. Noninvasive physiological approaches can be especially informative in this regard. We used a combination of fecal thyroid (T3) and glucocorticoid (GC) hormone measures to assess two threats influencing the endangered southern resident killer whales (SRKW; Orcinus orca) that frequent the inland waters of British Columbia, Canada and Washington, U.S.A. Glucocorticoids increase in response to nutritional and psychological stress, whereas thyroid hormone declines in response to nutritional stress but is unaffected by psychological stress. The inadequate prey hypothesis argues that the killer whales have become prey limited due to reductions of their dominant prey, Chinook salmon (Oncorhynchus tshawytscha). The vessel impact hypothesis argues that high numbers of vessels in close proximity to the whales cause disturbance via psychological stress and/or impaired foraging ability. The GC and T3 measures supported the inadequate prey hypothesis. In particular, GC concentrations were negatively correlated with short-term changes in prey availability. Whereas, T3 concentrations varied by date and year in a manner that corresponded with more long-term prey availability. Physiological correlations with prey overshadowed any impacts of vessels since GCs were lowest during the peak in vessel abundance, which also coincided with the peak in salmon availability. Our results suggest that identification and recovery of strategic salmon populations in the SRKW diet are important to effectively promote SRKW recovery. PMID:22701560

Research in artificial intelligence for nuclear facilities

International Nuclear Information System (INIS)

Uhrig, R.E.

1990-01-01

The application of artificial intelligence, in the form of expert systems and neural networks, to the control room activities in a nuclear power plant has the potential to reduce operator error and increase plant safety, reliability, and efficiency. Furthermore, artificial intelligence can increase efficiency and effectiveness in a large number of nonoperating activities (testing, routine maintenance, outage planning, equipment diagnostics, and fuel management) and in research facility experiments. Recent work at the University of Tennessee has demonstrated the feasibility of using neural networks to identify six different transients introduced into the simulation of a steam generator of a nuclear power plant. This work is now being extended to utilize data from a nuclear power plant training simulator. In one configuration, the inputs to the neural network are a subset of the quantities that are typical of those available from the safety parameter display system. The outputs of the network represent the various states of the plant (e.g., normal operation, coolant leakage, inadequate core flow, excessive peak fuel temperature, etc.). Training of the neural network is performed by introducing various faults or conditions to be diagnosed into the simulator. The goal of this work is to demonstrate a neural network diagnostic system that could provide advice to the operators in accordance with the emergency operating procedures

Air Quality Facilities

Data.gov (United States)

Iowa State University GIS Support and Research Facility — Facilities with operating permits for Title V of the Federal Clean Air Act, as well as facilities required to submit an air emissions inventory, and other facilities...

Facilities Performance Indicators Report, 2004-05. Facilities Core Data Survey

Science.gov (United States)

Glazner, Steve, Ed.

2006-01-01

The purpose of "Facilities Performance Indicators" is to provide a representative set of statistics about facilities in educational institutions. The second iteration of the web-based Facilities Core Data Survey was posted and available to facilities professionals at more than 3,000 institutions in the Fall of 2005. The website offered a printed…

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.

Where There Is No Toilet: Water and Sanitation Environments of Domestic and Facility Births in Tanzania

Science.gov (United States)

Benova, Lenka; Cumming, Oliver; Gordon, Bruce A.; Magoma, Moke; Campbell, Oona M. R.

2014-01-01

Background Inadequate water and sanitation during childbirth are likely to lead to poor maternal and newborn outcomes. This paper uses existing data sources to assess the water and sanitation (WATSAN) environment surrounding births in Tanzania in order to interrogate whether such estimates could be useful for guiding research, policy and monitoring initiatives. Methods We used the most recent Tanzania Demographic and Health Survey (DHS) to characterise the delivery location of births occurring between 2005 and 2010. Births occurring in domestic environments were characterised as WATSAN-safe if the home fulfilled international definitions of improved water and improved sanitation access. We used the 2006 Service Provision Assessment survey to characterise the WATSAN environment of facilities that conduct deliveries. We combined estimates from both surveys to describe the proportion of all births occurring in WATSAN-safe environments and conducted an equity analysis based on DHS wealth quintiles and eight geographic zones. Results 42.9% (95% confidence interval: 41.6%–44.2%) of all births occurred in the woman's home. Among these, only 1.5% (95% confidence interval: 1.2%–2.0%) were estimated to have taken place in WATSAN-safe conditions. 74% of all health facilities conducted deliveries. Among these, only 44% of facilities overall and 24% of facility delivery rooms were WATSAN-safe. Combining the estimates, we showed that 30.5% of all births in Tanzania took place in a WATSAN-safe environment (range of uncertainty 25%–42%). Large wealth-based inequalities existed in the proportion of births occurring in domestic environments based on wealth quintile and geographical zone. Conclusion Existing data sources can be useful in national monitoring and prioritisation of interventions to improve poor WATSAN environments during childbirth. However, a better conceptual understanding of potentially harmful exposures and better data are needed in order to devise and apply

Risk of Performance Decrement and Crew Illness Due to an Inadequate Food System

Science.gov (United States)

Douglas, Grace L.; Cooper, Maya; Bermudez-Aguirre, Daniela; Sirmons, Takiyah

2016-01-01

NASA is preparing for long duration manned missions beyond low-Earth orbit that will be challenged in several ways, including long-term exposure to the space environment, impacts to crew physiological and psychological health, limited resources, and no resupply. The food system is one of the most significant daily factors that can be altered to improve human health, and performance during space exploration. Therefore, the paramount importance of determining the methods, technologies, and requirements to provide a safe, nutritious, and acceptable food system that promotes crew health and performance cannot be underestimated. The processed and prepackaged food system is the main source of nutrition to the crew, therefore significant losses in nutrition, either through degradation of nutrients during processing and storage or inadequate food intake due to low acceptability, variety, or usability, may significantly compromise the crew's health and performance. Shelf life studies indicate that key nutrients and quality factors in many space foods degrade to concerning levels within three years, suggesting that food system will not meet the nutrition and acceptability requirements of a long duration mission beyond low-Earth orbit. Likewise, mass and volume evaluations indicate that the current food system is a significant resource burden. Alternative provisioning strategies, such as inclusion of bioregenerative foods, are challenged with resource requirements, and food safety and scarcity concerns. Ensuring provisioning of an adequate food system relies not only upon determining technologies, and requirements for nutrition, quality, and safety, but upon establishing a food system that will support nutritional adequacy, even with individual crew preference and self-selection. In short, the space food system is challenged to maintain safety, nutrition, and acceptability for all phases of an exploration mission within resource constraints. This document presents the

Nuclear facilities

International Nuclear Information System (INIS)

Anon.

2000-01-01

Here is given the decree (2000-1065) of the 25. of October 2000 reporting the publication of the convention between the Government of the French Republic and the CERN concerning the safety of the LHC (Large Hadron Collider) and the SPS (Proton Supersynchrotron) facilities, signed in Geneva on July 11, 2000. By this convention, the CERN undertakes to ensure the safety of the LHC and SPS facilities and those of the operations of the LEP decommissioning. The French legislation and regulations on basic nuclear facilities (concerning more particularly the protection against ionizing radiations, the protection of the environment and the safety of facilities) and those which could be decided later on apply to the LHC, SPS and auxiliary facilities. (O.M.)

Facility effluent monitoring plan for 242-A Evaporator facility

International Nuclear Information System (INIS)

Crummel, G.M.; Gustavson, R.D.

1993-03-01

A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1* for any operations that involve hazardous materials and radioactive substances that could affect employee or public safety or the environment. A facility effluent monitoring plan determination was performed during Calendar Year 1991 and the evaluation showed the need for a facility effluent monitoring plan. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility effluent Monitoring Plans, WHC-EP-0438-1**. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements

North Slope, Alaska ESI: FACILITY (Facility Points)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains data for oil field facilities for the North Slope of Alaska. Vector points in this data set represent oil field facility locations. This data...

Professional burnout syndrome among correctional facility officers.

Science.gov (United States)

Harizanova, Stanislava N; Tarnovska, Tanya H

2013-01-01

Correctional facilities present unique work places--the employees there work in tough, demanding and hazardous working conditions, in real life-threatening environment, subjected to physical and mental fatigue, risk of infectious diseases, work in shifts, with inadequate pay, etc. The aim of this study was to find the prevalence and level of burnout syndrome among employees working in the District Prison of the town of Plovdiv. The study included all employees that had direct contact with the inmates in the prison. We recruited 106 employees that participated in the study anonymously and voluntarily. The main instrument we used was the questionnaire designed according to the methods developed by V. Boiko, which allows identification of professional burnout syndrome in its three phases with four symptoms in each of the phases. We found a high prevalence of burnout syndrome among the staff in the District Prison in Plovdiv (74.53%). All three phases of burnout were found to have a high prevalence rate--the stress phase: 48.11%, the resistance phase: 66.98%, the exhaustion phase: 41.51%. The rank in the service hierarchy was found to be a predictor in the stress phase, B = 0.701, p = 0.048, Exp(B) = 2.106, 95%CI [1.00; 4.04]. The single officers (83.33% of the divorced and 55.56% of the single employees) and those of the staff that were more highly educated (78.72%) had elevated levels of burnout syndrome, and these manifested during the first 5 years of their service in the prison (77.78%). In Bulgaria at present the burnout syndrome has not been studied among employees working in correctional facilities. We found a high prevalence of the syndrome among the employees of the District Prison - Plovdiv. The younger, the single and the more educated employees had greater levels of burnout syndrome, which manifest during the first 5 years of their service. The results suggest that there is a need to develop and implement effective strategies to reduce and prevent

26 CFR 1.142(a)(5)-1 - Exempt facility bonds: Sewage facilities.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Exempt facility bonds: Sewage facilities. 1.142... Bonds § 1.142(a)(5)-1 Exempt facility bonds: Sewage facilities. (a) In general. Under section 103(a), a... in section 142(a) is a sewage facility. This section defines the term sewage facility for purposes of...

Fossil fuel subsidy removal and inadequate public power supply: Implications for businesses

International Nuclear Information System (INIS)

Bazilian, Morgan; Onyeji, Ijeoma

2012-01-01

We briefly consider the impact of fossil fuel subsidy removal policies in the context of inadequate power supply, with a focus on the implications for businesses. In doing so, we utilize the case of the early 2012 fuel subsidy removal in Nigeria. The rationale for such subsidy-removal policies is typically informed by analysis showing that they lead to an economically inefficient allocation of resources and market distortions, while often failing to meet intended objectives. However, often the realities of infrastructural and institutional deficiencies are not appropriately factored into the decision-making process. Businesses in many developing countries, already impaired by the high cost of power supply deficiencies, become even less competitive on an unsubsidized basis. We find that justifications for removal often do not adequately reflect the specific environments of developing country economies, resulting in poor recommendations – or ineffective policy. - Highlights: ► We consider the impact of fuel subsidy removal in the context of energy poverty. ► Calls for subsidy removal often do not reflect the developing country realities. ► Businesses impaired by power supply deficiencies, become even less competitive.

Facility transition instruction

International Nuclear Information System (INIS)

Morton, M.R.

1997-01-01

The Bechtel Hanford, Inc. facility transition instruction was initiated in response to the need for a common, streamlined process for facility transitions and to capture the knowledge and experience that has accumulated over the last few years. The instruction serves as an educational resource and defines the process for transitioning facilities to long-term surveillance and maintenance (S and M). Generally, these facilities do not have identified operations missions and must be transitioned from operational status to a safe and stable configuration for long-term S and M. The instruction can be applied to a wide range of facilities--from process canyon complexes like the Plutonium Uranium Extraction Facility or B Plant, to stand-alone, lower hazard facilities like the 242B/BL facility. The facility transition process is implemented (under the direction of the US Department of Energy, Richland Operations Office [RL] Assistant Manager-Environmental) by Bechtel Hanford, Inc. management, with input and interaction with the appropriate RL division and Hanford site contractors as noted in the instruction. The application of the steps identified herein and the early participation of all organizations involved are expected to provide a cost-effective, safe, and smooth transition from operational status to deactivation and S and M for a wide range of Hanford Site facilities

Facilities Performance Indicators Report 2012-13: Tracking Your Facilities Vital Signs

Science.gov (United States)

APPA: Association of Higher Education Facilities Officers, 2014

2014-01-01

This paper features an expanded Web-based "Facilities Performance Indicators (FPI) Report." The purpose of APPA's Facilities Performance Indicators is to provide a representative set of statistics about facilities in educational institutions. "The Facilities Performance Indicators Report" is designed for survey…

Guide to research facilities

Energy Technology Data Exchange (ETDEWEB)

1993-06-01

This Guide provides information on facilities at US Department of Energy (DOE) and other government laboratories that focus on research and development of energy efficiency and renewable energy technologies. These laboratories have opened these facilities to outside users within the scientific community to encourage cooperation between the laboratories and the private sector. The Guide features two types of facilities: designated user facilities and other research facilities. Designated user facilities are one-of-a-kind DOE facilities that are staffed by personnel with unparalleled expertise and that contain sophisticated equipment. Other research facilities are facilities at DOE and other government laboratories that provide sophisticated equipment, testing areas, or processes that may not be available at private facilities. Each facility listing includes the name and phone number of someone you can call for more information.

Experimental Fuels Facility Re-categorization Based on Facility Segmentation

Energy Technology Data Exchange (ETDEWEB)

Reiss, Troy P.; Andrus, Jason

2016-07-01

The Experimental Fuels Facility (EFF) (MFC-794) at the Materials and Fuels Complex (MFC) located on the Idaho National Laboratory (INL) Site was originally constructed to provide controlled-access, indoor storage for radiological contaminated equipment. Use of the facility was expanded to provide a controlled environment for repairing contaminated equipment and characterizing, repackaging, and treating waste. The EFF facility is also used for research and development services, including fuel fabrication. EFF was originally categorized as a LTHC-3 radiological facility based on facility operations and facility radiological inventories. Newly planned program activities identified the need to receive quantities of fissionable materials in excess of the single parameter subcritical limit in ANSI/ANS-8.1, “Nuclear Criticality Safety in Operations with Fissionable Materials Outside Reactors” (identified as “criticality list” quantities in DOE-STD-1027-92, “Hazard Categorization and Accident Analysis Techniques for Compliance with DOE Order 5480.23, Nuclear Safety Analysis Reports,” Attachment 1, Table A.1). Since the proposed inventory of fissionable materials inside EFF may be greater than the single parameter sub-critical limit of 700 g of U-235 equivalent, the initial re-categorization is Hazard Category (HC) 2 based upon a potential criticality hazard. This paper details the facility hazard categorization performed for the EFF. The categorization was necessary to determine (a) the need for further safety analysis in accordance with LWP-10802, “INL Facility Categorization,” and (b) compliance with 10 Code of Federal Regulations (CFR) 830, Subpart B, “Safety Basis Requirements.” Based on the segmentation argument presented in this paper, the final hazard categorization for the facility is LTHC-3. Department of Energy Idaho (DOE-ID) approval of the final hazard categorization determined by this hazard assessment document (HAD) was required per the

Nuclear security. Improving correction of security deficiencies at DOE's weapons facilities

International Nuclear Information System (INIS)

Wells, James E.; Cannon, Doris E.; Fenzel, William F.; Lightner, Kenneth E. Jr.; Curtis, Lois J.; DuBois, Julia A.; Brown, Gail W.; Trujillo, Charles S.; Tumler, Pamela K.

1992-11-01

The US nuclear weapons research, development, and production are conducted at 10 DOE nuclear weapons facilities by contractors under the guidance and oversight of 9 DOE field offices. Because these facilities house special nuclear materials used in making nuclear weapons and nuclear weapons components, DOE administers a security program to protect (1) against theft, sabotage, espionage, terrorism, or other risks to national security and (2) the safety and health of DOE employees and the public. DOE spends almost $1 billion a year on this security program. DOE administers the security program through periodic inspections that evaluate and monitor the effectiveness of facilities' safeguards and security. Security inspections identify deficiencies, instances of noncompliance with safeguards and security requirements or poor performance of the systems being evaluated, that must be corrected to maintain adequate security. The contractors and DOE share responsibility for correcting deficiencies. Contractors, in correcting deficiencies, must comply with several DOE orders. The contractors' performances were not adequate in conducting four of the eight procedures considered necessary in meeting DOE's deficiency correction requirements. For 19 of the 20 deficiency cases we reviewed, contractors could not demonstrate that they had conducted three critical deficiency analyses (root cause, risk assessment, and cost-benefit) required by DOE. Additionally, the contractors did not always adequately verify that corrective actions taken were appropriate, effective, and complete. The contractors performed the remaining four procedures (reviewing deficiencies for duplication, entering deficiencies into a data base, tracking the status of deficiencies, and preparing and implementing a corrective action plan) adequately in all 20 cases. DOE's oversight of the corrective action process could be improved in three areas. The computerized systems used to track the status of security

Inadequate control of world's radioactive sources

International Nuclear Information System (INIS)

2002-01-01

The radioactive materials needed to build a 'dirty bomb' can be found in almost any country in the world, and more than 100 countries may have inadequate control and monitoring programs necessary to prevent or even detect the theft of these materials. The IAEA points out that while radioactive sources number in the millions, only a small percentage have enough strength to cause serious radiological harm. It is these powerful sources that need to be focused on as a priority. In a significant recent development, the IAEA, working in collaboration with the United States Department of Energy (DOE) and the Russian Federation's Ministry for Atomic Energy (MINATOM), have established a tripartite working group on 'Securing and Managing Radioactive Sources'. Through its program to help countries improve their national infrastructures for radiation safety and security, the IAEA has found that more than 100 countries may have no minimum infrastructure in place to properly control radiation sources. However, many IAEA Member States - in Africa, Asia, Latin America, and Europe - are making progress through an IAEA project to strengthen their capabilities to control and regulate radioactive sources. The IAEA is also concerned about the over 50 countries that are not IAEA Member States (there are 134), as they do not benefit from IAEA assistance and are likely to have no regulatory infrastructure. The IAEA has been active in lending its expertise to search out and secure orphaned sources in several countries. More than 70 States have joined with the IAEA to collect and share information on trafficking incidents and other unauthorized movements of radioactive sources and other radioactive materials. The IAEA and its Member States are working hard to raise levels of radiation safety and security, especially focusing on countries known to have urgent needs. The IAEA has taken the leading role in the United Nations system in establishing standards of safety, the most significant of

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

International Nuclear Information System (INIS)

Coenenberg, J.G.

1997-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

Coenenberg, J.G.

1997-08-15

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

Death Associated with Inadequate Reassessment of Venous Thromboembolism Prophylaxis at and after Hospital Discharge.

Science.gov (United States)

2015-01-01

Venous thromboembolism (VTE) prophylaxis, also known as thromboprophylaxis, reduces the risk of deep vein thrombosis, pulmonary embolism, and associated complications, including death, in high-risk patients. VTE prophylaxis is recommended for acutely ill, hospitalized medical patients at risk of thrombosis. Anticoagulants, the pharmacologic agents of choice to prevent VTE, are considered high-alert medications. By definition, therefore, anticoagulants bear a hightened risk of causing significant patient harm when they are used in error. As part of ongoing collaboration with a provincial death investigation service, ISMP Canada received a report of a fatal incident that involved continuation of VTE prophylaxis with enoxaparin for a patient discharge to a long-term care (LTC) facility from an acute care setting. The findings and recommendations from this case are charged to highlight the need to build routine reassessment of VTE prophylaxis into the process for discharging patients from the acute care setting and upon transfer to another facility or to primary care. The incident described in this bulletin highlights the importance of continually reassessing the need for VTE prophylaxis, especially at transitions of care, such as discharge from an acute care setting. Evidence and guidelines confirm the benefits of VTE prophylaxis in certain patients during a hospital stay for an acute illness, but the balance of benefits and risks may become unfavourable once the patient is discharged. Clear documentation from the acute care facility can assist the receiving facility and health-care providers, as well as family caregivers, when determining whether thromboprophylaxis is still warranted. Until clear guidance to continue thromboprophylaxis after acute care is available, health-care organizations and practitioners across the spectrum of care are urged to share and consider the strategies presented in this bulletin to ensure the safe use of VTE prophylaxis and improved

Evolution of poor reporting and inadequate methods over time in 20 920 randomised controlled trials included in Cochrane reviews: research on research study.

Science.gov (United States)

Dechartres, Agnes; Trinquart, Ludovic; Atal, Ignacio; Moher, David; Dickersin, Kay; Boutron, Isabelle; Perrodeau, Elodie; Altman, Douglas G; Ravaud, Philippe

2017-06-08

Objective  To examine how poor reporting and inadequate methods for key methodological features in randomised controlled trials (RCTs) have changed over the past three decades. Design  Mapping of trials included in Cochrane reviews. Data sources  Data from RCTs included in all Cochrane reviews published between March 2011 and September 2014 reporting an evaluation of the Cochrane risk of bias items: sequence generation, allocation concealment, blinding, and incomplete outcome data. Data extraction  For each RCT, we extracted consensus on risk of bias made by the review authors and identified the primary reference to extract publication year and journal. We matched journal names with Journal Citation Reports to get 2014 impact factors. Main outcomes measures  We considered the proportions of trials rated by review authors at unclear and high risk of bias as surrogates for poor reporting and inadequate methods, respectively. Results  We analysed 20 920 RCTs (from 2001 reviews) published in 3136 journals. The proportion of trials with unclear risk of bias was 48.7% for sequence generation and 57.5% for allocation concealment; the proportion of those with high risk of bias was 4.0% and 7.2%, respectively. For blinding and incomplete outcome data, 30.6% and 24.7% of trials were at unclear risk and 33.1% and 17.1% were at high risk, respectively. Higher journal impact factor was associated with a lower proportion of trials at unclear or high risk of bias. The proportion of trials at unclear risk of bias decreased over time, especially for sequence generation, which fell from 69.1% in 1986-1990 to 31.2% in 2011-14 and for allocation concealment (70.1% to 44.6%). After excluding trials at unclear risk of bias, use of inadequate methods also decreased over time: from 14.8% to 4.6% for sequence generation and from 32.7% to 11.6% for allocation concealment. Conclusions  Poor reporting and inadequate methods have decreased over time, especially for sequence generation

Facility effluent monitoring plan for 242-A evaporator facility

International Nuclear Information System (INIS)

Crummel, G.M.; Gustavson, R.D.

1995-02-01

A facility effluent monitoring plan is required by the U.S. Department of Energy in DOE Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could affect employee or public safety or the environment. A facility effluent monitoring plan determination was performed during Calendar Year 1991 and the evaluation showed the need for a facility effluent monitoring plan. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438-1. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements. This facility effluent monitoring plan shall ensure long-range integrity of the effluent monitoring systems by requiring an update whenever a new process or operation introduces new hazardous materials or significant radioactive materials. This document must be reviewed annually even if there are no operational changes, and it must be updated, as a minimum, every three years

Performance of the Lot Quality Assurance Sampling Method Compared to Surveillance for Identifying Inadequately-performing Areas in Matlab, Bangladesh

OpenAIRE

Bhuiya, Abbas; Hanifi, S.M.A.; Roy, Nikhil; Streatfield, P. Kim

2007-01-01

This paper compared the performance of the lot quality assurance sampling (LQAS) method in identifying inadequately-performing health work-areas with that of using health and demographic surveillance system (HDSS) data and examined the feasibility of applying the method by field-level programme supervisors. The study was carried out in Matlab, the field site of ICDDR,B, where a HDSS has been in place for over 30 years. The LQAS method was applied in 57 work-areas of community health workers i...

EPA Facility Registry Service (FRS): Facility Interests Dataset

Data.gov (United States)

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

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.

Facilities Management Service Delivery in Public and Private High Rise Residential Buildings in Nigeria: A case study of Eko Court Complex and Niger Towers

Directory of Open Access Journals (Sweden)

Olanrele O. O.

2014-01-01

Full Text Available This study assessed and compared the delivery of Facilities Management (FM services in public and private high rise residential buildings in Lagos, Nigeria. While some facilities or services may not be available in some public estates, the efficiency of the available ones is inadequate in comparison with the adequacy and efficiency of services provided in private estates. The objectives set for the study include identification of services that are provided in the case studies, service delivery method, and an assessment of the residents’ satisfaction of the services. This study adopted questionnaire survey for collection of data. 127 questionnaires were distributed to the residents of the case studies and 93 were returned. Three of which were discarded for incompleteness, thus 90 were analysed. The study found that most but not all of the facilities services expected in high rise buildings are available in the case studies and the services are outsourced under a standard Service Level Agreement. The service delivery in private high rise residential building is better than the public residential high rise buildings as revealed by the study. The study recommends improved standardization of services, customized services and meeting customer’s expectation for improved service delivery.

Die hospitaal as ’n burokrasie

Directory of Open Access Journals (Sweden)

D.A. Du Toit

1983-09-01

Full Text Available The bureaucratic structure of the hospital is a factor the exerts great influence on the daily activities of various categories of workers in the hospital. How aware are these workers of bureaucratic influence and to what extent does bureaucratic influence strain the activities of hospital workers? The historical development of hospital bureaucratisation is reviewed in this article, and then several dimensions of the hospital as a bureaucracy are taken into account, for instance hospital goals, rationality and the division of labour in the hospital. authority in the hospital, the bureaucratic structure of the hospital, communication in the hospital, the human being in the hospital, as well as the development of the informal organisation out of the bureaucratic structure of the hospital. These various aspects of the bureaucratic structure of the hospital can have a negative influence on human beings in the hospital, including patients and personnel. Various negative influences as a direct result of the bureaucratic structure of the hospital are discussed. There is nothing we can do about the bureaucratic system. It has come to stay and, to a certain extent, promotes efficiency. There is, however, a lot that can be done to alleviate strains brought about by bureaucracy.

Biochemistry Facility

Data.gov (United States)

Federal Laboratory Consortium — The Biochemistry Facility provides expert services and consultation in biochemical enzyme assays and protein purification. The facility currently features 1) Liquid...

Facility effluent monitoring plan for the plutonium-uranium extraction facility

International Nuclear Information System (INIS)

Nickels, J.M.; Geiger, J.L.

1992-11-01

A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. A facility effluent monitoring plan determination was performed during Calendar Year 1991 and the evaluation requires the need for a facility effluent monitoring plan. This document is prepared using the specific guidelines identified. in. A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements

Jupiter Laser Facility

Data.gov (United States)

Federal Laboratory Consortium — The Jupiter Laser Facility is an institutional user facility in the Physical and Life Sciences Directorate at LLNL. The facility is designed to provide a high degree...

Liquid Effluent Retention Facility/Effluent Treatment Facility Hazards Assessment

International Nuclear Information System (INIS)

Simiele, G.A.

1994-01-01

This document establishes the technical basis in support of Emergency Planning activities for the Liquid Effluent Retention Facility and Effluent Treatment Facility the Hanford Site. The document represents an acceptable interpretation of the implementing guidance document for DOE ORDER 5500.3A. Through this document, the technical basis for the development of facility specific Emergency Action Levels and the Emergency Planning Zone is demonstrated

Towards Knowledge-Based Digital Libraries

NARCIS (Netherlands)

Feng, L.; Jeusfeld, M.A.; Hoppenbrouwers, J.

From the standpoint of satisfying human's information needs, the current digital library (DL) systems suffer from the following two shortcomings: (i) inadequate high-level cognition support; (ii) inadequate knowledge sharing facilities. In this article, we introduce a two-layered digital library

LOW LEVEL LIQUID RADIOACTIVE WASTE TREATMENT AT MURMANSK, RUSSIA: FACILITY UPGRADE AND EXPANSION

Energy Technology Data Exchange (ETDEWEB)

BOWERMAN,B.; CZAJKOWSKI,C.; DYER,R.S.; SORLIE,A.

2000-03-01

Today there exist many almost overfilled storage tanks with liquid radioactive waste in the Russian Federation. This waste was generated over several years by the civil and military utilization of nuclear power. The current waste treatment capacity is either not available or inadequate. Following the London Convention, dumping of the waste in the Arctic seas is no longer an alternative. Waste is being generated from today's operations, and large volumes are expected to be generated from the dismantling of decommissioned nuclear submarines. The US and Norway have an ongoing co-operation project with the Russian Federation to upgrade and expand the capacity of a treatment facility for low level liquid waste at the RTP Atomflot site in Murmansk. The capacity will be increased from 1,200 m{sup 3}/year to 5,000 m{sup 3} /year. The facility will also be able to treat high saline waste. The construction phase will be completed the first half of 1998. This will be followed by a start-up and a one year post-construction phase, with US and Norwegian involvement for the entire project. The new facility will consist of 9 units containing various electrochemical, filtration, and sorbent-based treatment systems. The units will be housed in two existing buildings, and must meet more stringent radiation protection requirements that were not enacted when the facility was originally designed. The US and Norwegian technical teams have evaluated the Russian design and associated documentation. The Russian partners send monthly progress reports to US and Norway. Not only technical issues must be overcome but also cultural differences resulting from different methods of management techniques. Six to eight hour time differentials between the partners make real time decisions difficult and relying on electronic age tools becomes extremely important. Language difficulties is another challenge that must be solved. Finding a common vocabulary, and working through interpreters make the

The psychological drivers of bureaucracy: protecting the societal goals of an organization

NARCIS (Netherlands)

Andringa, Tjeerd

2015-01-01

This chapter addresses the psychological enablers of bureaucracy and ways to protect bureaucrats and society from its adverse effects. All organizations benefit from formalization, but a bureaucracy is defined by the dominance of coercive formalization. Since bureaucrats are not bureaucratic among

Metabolic regulation during sport events: factual interpretations and inadequate allegations

Directory of Open Access Journals (Sweden)

Jacques Remy Poortmans

2013-09-01

Full Text Available Different fuels are available to generate ATP for muscle activities during sport events. Glycogen from striated muscles and liver stores may be converted to lactic acid or almost completely oxidized to carbon dioxide (CO2, triacylglycerol within the muscle itself and fatty acids from adipose tissue could be converted to CO2 in acting muscles, some free amino acids can be released within the muscle itself and from intestinal stores to sustain the amount of ATP generation indispensable for muscle contraction. All single biochemical reactions, but one, need one or several enzymes to activate the conversion of a substrate into a product. The energy transformation in biochemical reactions is led by application of so-called free energy. Reversible and non-reversible reactions within a metabolic pathway are dependent on specific enzymes near or far from equilibrium. Allosteric enzymes are regulatory enzymes that provide the direction in the pathway. A regulatory enzyme is either activated or inhibited by small regulators (ligands. A reversible substrate cycle between A and B is catalyzed by two enzymes with different fluxes. The need of ATP production for muscle contraction is under the leadership of regulatory enzymes and available substrate stores. The improvement of adapted metabolic reactions under sport training depends on the appropriate increase of regulatory enzymes within the glycolytic and oxidative pathways. The amount of some specific enzymes is increased by training in order to improve the maximum activity of the metabolic pathway. Unfortunately, several publications do not precisely implicate the appropriate enzyme(s to explain or reject the adaptation induced by the training schedule. A few examples will illustrate the factual interpretation and the inadequate allegation.

Research Facilities | Wind | NREL

Science.gov (United States)

Research Facilities Research Facilities NREL's state-of-the-art wind research facilities at the Research Facilities Photo of five men in hard hards observing the end of a turbine blade while it's being tested. Structural Research Facilities A photo of two people silhouetted against a computer simulation of

Waste Facilities

Data.gov (United States)

Vermont Center for Geographic Information — This dataset was developed from the Vermont DEC's list of certified solid waste facilities. It includes facility name, contact information, and the materials...

Fabrication Facilities

Data.gov (United States)

Federal Laboratory Consortium — The Fabrication Facilities are a direct result of years of testing support. Through years of experience, the three fabrication facilities (Fort Hood, Fort Lewis, and...

Challenges with implementing malaria rapid diagnostic tests at primary care facilities in a Ghanaian district: a qualitative study.

Science.gov (United States)

Boadu, Nana Yaa; Amuasi, John; Ansong, Daniel; Einsiedel, Edna; Menon, Devidas; Yanow, Stephanie K

2016-02-27

Rapid diagnostic Tests (RDTs) for malaria enable diagnostic testing at primary care facilities in resource-limited settings, where weak infrastructure limits the use of microscopy. In 2010, Ghana adopted a test-before-treat guideline for malaria, with RDT use promoted to facilitate diagnosis. Yet healthcare practitioners still treat febrile patients without testing, or despite negative malaria test results. Few studies have explored RDT implementation beyond the notions of provider or patient acceptability. The aim of this study was to identify the factors directly influencing malaria RDT implementation at primary care facilities in a Ghanaian district. Qualitative interviews, focus groups and direct observations were conducted with 50 providers at six purposively selected primary care facilities in the Atwima-Nwabiagya district. Data were analysed thematically. RDT implementation was hampered by: (1) healthcare delivery constraints (weak supply chain, limited quality assurance and control, inadequate guideline emphasis, staffing limitations); (2) provider perceptions (entrenched case-management paradigms, limited preparedness for change); (3) social dynamics of care delivery (expected norms of provider-patient interaction, test affordability); and (4) limited provider engagement in policy processes leading to fragmented implementation of health sector reform. Limited health system capacity, socio-economic, political, and historical factors hampered malaria RDT implementation at primary care facilities in the study district. For effective RDT implementation providers must be: (1) adequately enabled through efficient allocation and management of essential healthcare commodities; (2) appropriately empowered with the requisite knowledge and skill through ongoing, effective professional development; and (3) actively engaged in policy dialogue to demystify socio-political misconceptions that hinder health sector reform policies from improving care delivery. Clear

Evaluation of inadequate anti-retroviral treatment in patients with HIV/AIDS

Directory of Open Access Journals (Sweden)

Leonardo Carvalho da Fonseca

2012-04-01

Full Text Available INTRODUCTION: Since the emergence of antiretroviral therapy, the survival of patients infected with human immunodeficiency virus has increased. Non-adherence to this therapy is directly related to treatment failure, which allows the emergence of resistant viral strains. METHODS: A retrospective descriptive study of the antiretroviral dispensing records of 229 patients from the Center for Health Care, University Hospital, Federal University of Juiz de Fora, Brazil, was conducted between January and December 2009. RESULTS: The study aimed to evaluate patient compliance and determine if there was an association between non-adherence and the therapy. Among these patients, 63.8% were men with an average age of 44.0 ± 9.9 years. The most used treatment was a combination of 2 nucleoside reverse transcriptase inhibitors with 1 non-nucleoside reverse transcriptase inhibitor (55.5% or with 2 protease inhibitors (28.8%. It was found that patients taking lopinavir/ritonavir with zidovudine and lamivudine had a greater frequency of inadequate treatment than those taking atazanavir with zidovudine and lamivudine (85% and 83.3%, respectively. Moreover, when the combination of zidovudine/ lamivudine was used, the patients were less compliant (χ2 = 4.468, 1 degree of freedom, p = 0.035. CONCLUSIONS: The majority of patients failed to correctly adhere to their treatment; therefore, it is necessary to implement strategies that lead to improved compliance, thus ensuring therapeutic efficacy and increased patient survival.

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

Data.gov (United States)

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

Survey on Inadequate and Omitted Citations in Manuscripts: A Precursory Study in Identification of Tasks for a Literature Review and Manuscript Writing Assistive System

Science.gov (United States)

Raamkumar, Aravind Sesagiri; Foo, Schubert; Pang, Natalie

2016-01-01

Introduction: This paper looks at the issue of inadequate and omitted citations in manuscripts by collecting the experiential opinions of researchers from the dual perspectives of manuscript reviewers and authors. Method: An online survey was conducted with participation from 207 respondents who had experience of reviewing and authoring research…

Inadequate Iodine Intake in Population Groups Defined by Age, Life Stage and Vegetarian Dietary Practice in a Norwegian Convenience Sample.

Science.gov (United States)

Brantsæter, Anne Lise; Knutsen, Helle Katrine; Johansen, Nina Cathrine; Nyheim, Kristine Aastad; Erlund, Iris; Meltzer, Helle Margrete; Henjum, Sigrun

2018-02-17

Inadequate iodine intake has been identified in populations considered iodine replete for decades. The objective of the current study is to evaluate urinary iodine concentration (UIC) and the probability of adequate iodine intake in subgroups of the Norwegian population defined by age, life stage and vegetarian dietary practice. In a cross-sectional survey, we assessed the probability of adequate iodine intake by two 24-h food diaries and UIC from two fasting morning spot urine samples in 276 participants. The participants included children ( n = 47), adolescents ( n = 46), adults ( n = 71), the elderly ( n = 23), pregnant women ( n = 45), ovo-lacto vegetarians ( n = 25), and vegans ( n = 19). In all participants combined, the median (95% CI) UIC was 101 (90, 110) µg/L, median (25th, 75th percentile) calculated iodine intake was 112 (77, 175) µg/day and median (25th, 75th percentile) estimated usual iodine intake was 101 (75, 150) µg/day. According to WHOs criteria for evaluation of median UIC, iodine intake was inadequate in the elderly, pregnant women, vegans and non-pregnant women of childbearing age. Children had the highest (82%) and vegans the lowest (14%) probability of adequate iodine intake according to reported food and supplement intakes. This study confirms the need for monitoring iodine intake and status in nationally representative study samples in Norway.

Irradiation Facilities at CERN

CERN Document Server

Gkotse, Blerina; Carbonez, Pierre; Danzeca, Salvatore; Fabich, Adrian; Garcia, Alia, Ruben; Glaser, Maurice; Gorine, Georgi; Jaekel, Martin, Richard; Mateu,Suau, Isidre; Pezzullo, Giuseppe; Pozzi, Fabio; Ravotti, Federico; Silari, Marco; Tali, Maris

2017-01-01

CERN provides unique irradiation facilities for applications in many scientific fields. This paper summarizes the facilities currently operating for proton, gamma, mixed-field and electron irradiations, including their main usage, characteristics and information about their operation. The new CERN irradiation facilities database is also presented. This includes not only CERN facilities but also irradiation facilities available worldwide.

Inadequate recording of alcohol-drinking, tobacco-smoking and discharge diagnosis in medical in-patients: failure to recognize risks including drug interactions.

Science.gov (United States)

Bairstow, B M; Burke, V; Beilin, L J; Deutscher, C

1993-11-01

The records of 62 men and 43 women, 14-88 years old, admitted to general medical wards in a public teaching hospital during 1991 were examined for discharge medications and for the recording of alcohol-drinking, tobacco-smoking and discharge diagnosis. Drinking and smoking status was unrecorded in 22.9% and 21.9% of patients respectively. Twenty-four patients had 31 potential drug interactions which were related to the number of drugs prescribed and to drinking alcohol; 10.5% of the patients had interactions involving alcohol and 2.9% tobacco. Six patients received relatively or absolutely contraindicated drugs, including one asthmatic given two beta-blockers. The drugs prescribed indicated that some patients had conditions such as gastro-oesophageal disorders, diabetes and obstructive airways disease which had not been recorded. Inadequate recording of diagnoses, alcohol and smoking status creates risks to patients and may cause opportunities for preventive care to be missed. This study provides the basis for the development of undergraduate and postgraduate education programmes to address these issues and so decrease risks to patients which arise from inadequate recording practices. Incomplete diagnoses also adversely affect hospital funding where this depends on case-mix diagnostic groups. Quality assurance programmes and other strategies are being implemented to improve medical recording and prescribing habits.

Behavior Of Bureaucracy In Good Program Policy Implementation In District Bombana

Directory of Open Access Journals (Sweden)

Syafruddin

2015-04-01

Full Text Available Abstract The existence of the bureaucracy and the device has a very important role and vital in the life of modern man. This is because the bureaucracy is interpreted as an official institution that performs the functions of service to the public needs. Internal conditions bureaucratic organization itself does not stand alone but it has the internal and external sustainability. One of the most prominent aspect in the review of the bureaucratic organization is bureaucratic behavior. Good bureaucracy is based on bureaucratic behavior professional. Behavior embodiment bureaucracy itself can be grouped into four 4 main models ie models autocratic custodial models models of supportive and collegial models. One of the flagship program of work undertaken by the Building Movement Bombana is Bombana with Ridha Allah GLAD. In a way this program found some key problems in the realm of bureaucratic organization studies. Some issues such as village-level bureaucrats dependence greatly to the district government the low professionalism and competence of the bureaucratic apparatus and the difficulty of implementation of inter-agency coordination is still a topic interesting study. The problem of bureaucratic behavior is a complex element that can be influenced by factors that are subjectively individual and that associated with the condition in which the bureaucratic organization is located. Therefore the condition of the organization is divided into four 4 elements namely the organizational structure organizational culture policies and practices of human resources as well as the design work which are all expected to shape the behavior of bureaucracy Fun program.

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

Data.gov (United States)

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

Hanford Facility Dangerous Waste Permit Application, 200 Area Effluent Treatment Facility

International Nuclear Information System (INIS)

1993-08-01

The 200 Area Effluent Treatment Facility Dangerous Waste Permit Application documentation consists of both Part A and a Part B permit application documentation. An explanation of the Part A revisions associated with this treatment and storage unit, including the current revision, is provided at the beginning of the Part A section. Once the initial Hanford Facility Dangerous Waste Permit is issued, the following process will be used. As final, certified treatment, storage, and/or disposal unit-specific documents are developed, and completeness notifications are made by the US Environmental Protection Agency and the Washington State Department of Ecology, additional unit-specific permit conditions will be incorporated into the Hanford Facility Dangerous Waste Permit through the permit modification process. All treatment, storage, and/or disposal units that are included in the Hanford Facility Dangerous Waste Permit Application will operate under interim status until final status conditions for these units are incorporated into the Hanford Facility Dangerous Waste Permit. The Hanford Facility Dangerous Waste Permit Application, 200 Area Effluent Treatment Facility contains information current as of May 1, 1993

Hanford Facility Dangerous Waste Permit Application, 200 Area Effluent Treatment Facility

Energy Technology Data Exchange (ETDEWEB)

1993-08-01

The 200 Area Effluent Treatment Facility Dangerous Waste Permit Application documentation consists of both Part A and a Part B permit application documentation. An explanation of the Part A revisions associated with this treatment and storage unit, including the current revision, is provided at the beginning of the Part A section. Once the initial Hanford Facility Dangerous Waste Permit is issued, the following process will be used. As final, certified treatment, storage, and/or disposal unit-specific documents are developed, and completeness notifications are made by the US Environmental Protection Agency and the Washington State Department of Ecology, additional unit-specific permit conditions will be incorporated into the Hanford Facility Dangerous Waste Permit through the permit modification process. All treatment, storage, and/or disposal units that are included in the Hanford Facility Dangerous Waste Permit Application will operate under interim status until final status conditions for these units are incorporated into the Hanford Facility Dangerous Waste Permit. The Hanford Facility Dangerous Waste Permit Application, 200 Area Effluent Treatment Facility contains information current as of May 1, 1993.

EPA Facility Registry Service (FRS): AIRS_AFS Sub Facilities

Data.gov (United States)

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

Facility effluent monitoring plan for the fast flux test facility

International Nuclear Information System (INIS)

Nickels, J.M.; Dahl, N.R.

1992-11-01

A facility effluent monitoring plan is required by the US Department of Energy in US Department of Energy Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could affect employee or public safety or the environment. A Facility Effluent Monitoring Plan determination was performed during calendar year 1991 and the evaluation requires the need for a facility effluent monitoring plan. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements

Availability of essential drugs for managing HIV-related pain and symptoms within 120 PEPFAR-funded health facilities in East Africa: a cross-sectional survey with onsite verification.

Science.gov (United States)

Harding, Richard; Simms, Victoria; Penfold, Suzanne; Downing, Julia; Powell, Richard A; Mwangi-Powell, Faith; Namisango, Eve; Moreland, Scott; Gikaara, Nancy; Atieno, Mackuline; Kataike, Jennifer; Nsubuga, Clare; Munene, Grace; Banga, Geoffrey; Higginson, Irene J

2014-04-01

World Health Organization's essential drugs list can control the highly prevalent HIV-related pain and symptoms. Availability of essential medicines directly influences clinicians' ability to effectively manage distressing manifestations of HIV. To determine the availability of pain and symptom controlling drugs in East Africa within President's Emergency Plan for AIDS Relief-funded HIV health care facilities. Directly observed quantitative health facilities' pharmacy stock review. We measured availability, expiration and stock-outs of specified drugs required for routine HIV management, including the World Health Organization pain ladder. A stratified random sample in 120 President's Emergency Plan for AIDS Relief-funded HIV care facilities (referral and district hospitals, health posts/centres and home-based care providers) in Kenya and Uganda. Non-opioid analgesics (73%) and co-trimoxazole (64%) were the most commonly available drugs and morphine (7%) the least. Drug availability was higher in hospitals and lower in health centres, health posts and home-based care facilities. Facilities generally did not use minimum stock levels, and stock-outs were frequently reported. The most common drugs had each been out of stock in the past 6 months in 47% of facilities stocking them. When a minimum stock level was defined, probability of a stock-out in the previous 6 months was 32.6%, compared to 45.5% when there was no defined minimum stock level (χ (2) = 5.07, p = 0.024). The data demonstrate poor essential drug availability, particularly analgesia, limited by facility type. The lack of strong opioids, isoniazid and paediatric formulations is concerning. Inadequate drug availability prevents implementation of simple clinical pain and symptom control protocols, causing unnecessary distress. Research is needed to identify supply chain mechanisms that lead to these problems.

DUPIC facility engineering

Energy Technology Data Exchange (ETDEWEB)

Lee, J S; Choi, J W; Go, W I; Kim, H D; Song, K C; Jeong, I H; Park, H S; Im, C S; Lee, H M; Moon, K H; Hong, K P; Lee, K S; Suh, K S; Kim, E K; Min, D K; Lee, J C; Chun, Y B; Paik, S Y; Lee, E P; Yoo, G S; Kim, Y S; Park, J C

1997-09-01

In the early stage of the project, a comprehensive survey was conducted to identify the feasibility of using available facilities and of interface between those facilities. It was found out that the shielded cell M6 interface between those facilities. It was found out that the shielded cell M6 of IMEF could be used for the main process experiments of DUPIC fuel fabrication in regard to space adequacy, material flow, equipment layout, etc. Based on such examination, a suitable adapter system for material transfer around the M6 cell was engineered. Regarding the PIEF facility, where spent PWR fuel assemblies are stored in an annex pool, disassembly devices in the pool are retrofitted and spent fuel rod cutting and shipping system to the IMEF are designed and built. For acquisition of casks for radioactive material transport between the facilities, some adaptive refurbishment was applied to the available cask (Padirac) based on extensive analysis on safety requirements. A mockup test facility was newly acquired for remote test of DUPIC fuel fabrication process equipment prior to installation in the M6 cell of the IMEF facility. (author). 157 refs., 57 tabs., 65 figs.

DUPIC facility engineering

International Nuclear Information System (INIS)

Lee, J. S.; Choi, J. W.; Go, W. I.; Kim, H. D.; Song, K. C.; Jeong, I. H.; Park, H. S.; Im, C. S.; Lee, H. M.; Moon, K. H.; Hong, K. P.; Lee, K. S.; Suh, K. S.; Kim, E. K.; Min, D. K.; Lee, J. C.; Chun, Y. B.; Paik, S. Y.; Lee, E. P.; Yoo, G. S.; Kim, Y. S.; Park, J. C.

1997-09-01

In the early stage of the project, a comprehensive survey was conducted to identify the feasibility of using available facilities and of interface between those facilities. It was found out that the shielded cell M6 interface between those facilities. It was found out that the shielded cell M6 of IMEF could be used for the main process experiments of DUPIC fuel fabrication in regard to space adequacy, material flow, equipment layout, etc. Based on such examination, a suitable adapter system for material transfer around the M6 cell was engineered. Regarding the PIEF facility, where spent PWR fuel assemblies are stored in an annex pool, disassembly devices in the pool are retrofitted and spent fuel rod cutting and shipping system to the IMEF are designed and built. For acquisition of casks for radioactive material transport between the facilities, some adaptive refurbishment was applied to the available cask (Padirac) based on extensive analysis on safety requirements. A mockup test facility was newly acquired for remote test of DUPIC fuel fabrication process equipment prior to installation in the M6 cell of the IMEF facility. (author). 157 refs., 57 tabs., 65 figs

Follow-up of abnormal or inadequate test results in the Danish Cervical Cancer Screening Program

DEFF Research Database (Denmark)

Kristiansen, Bettina Kjær

2014-01-01

Denmark has a higher incidence of cervical cancer than other Nordic countries, although all Danish women (aged 23–65) are screened regularly to identify possible cervical dysplasia or asymptomatic invasive cancer. Annually 40 000 women receives an abnormal or inadequate test result and a follow......-up recommendation. However problems with delayed follow-up may threaten the effectiveness of the Danish Cervical Cancer Screening Program, as 20% of women are delayed and dysplasia potentially can progress into cancer. Delayed follow-up is found in situations where women either consciously or unconsciously postpone...... up will be sent to the women (RCT). The intention is to ensure that all women will be notified about the test result, quickly, homogenously and in layman’s written language, still with the opportunity to contact or be contacted by the GP, if there is special needs. Furthermore, it is assumed that GP...

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 ...

DUPIC facility engineering

Energy Technology Data Exchange (ETDEWEB)

Park, J. J.; Lee, H. H.; Kim, K. H. and others

2000-03-01

The objectives of this study are (1) the refurbishment for PIEF(Post Irradiation Examination Facility) and M6 hot-cell in IMEF(Irradiated Material Examination Facility), (2) the establishment of the compatible facility for DUPIC fuel fabrication experiments which is licensed by government organization, and (3) the establishment of the transportation system and transportation cask for nuclear material between facilities. The report for this project describes following contents, such as objectives, necessities, scope, contents, results of current step, R and D plan in future and etc.

5 year old girl with malignant lymphoblastic lymphoma: Challenges ...

African Journals Online (AJOL)

Socio-cultural, financial (cost implications for the patient for both investigative and therapeutic interventions), inadequate resources and facilities were identified as some of the constraints leading to inadequate management and poor outcome in patients with this condition. Conclusion: Given the limitations associated with ...

Education and innovativeness of the slovene hotel organisations staff

Directory of Open Access Journals (Sweden)

Metod Šuligoj

2010-03-01

Full Text Available The author’s purpose in this article is to ascertain the differences in the attitude to innovativeness between bureaucratic and non-bureaucratic hotel organisations. He defines as bureaucratic the organisations establishing standards. As a separate issue he wishes to find out whether bureaucratic organisations employ properly educated staff or not. For this purpose he defines basic terminology: hotel industry, innovativeness, bureaucracy and knowledge, general and knowledge of tourism and hotel trade. He points out that the government is aware of the importance of innovativeness in hotel industry and tourism, whence a number of measures. In the empirical part, using statistical methods, such as the descriptive analysis and the Bonferroni test, the author establishes that there are no statistically significant differences between bureaucratic and non-bureaucratic organisations either with regard to innovativeness or the level of staff education. In this way, by using scientific method, the author rejects the often misinterpreted opinion on the influence of bureaucracy on innovativeness.

Shielding of Medical Facilities. Shielding Design Considerations for PET-CT Facilities

International Nuclear Information System (INIS)

Cruzate, J.A.; Discacciatti, A.P.

2011-01-01

The radiological evaluation of a Positron Emission Tomography (PET) facility consists of the assessment of the annual effective dose both to workers occupationally exposed, and to members of the public. This assessment takes into account the radionuclides involved, the facility features, the working procedures, the expected number of patients per year, and so on. The evaluation embraces the distributions of rooms, the thickness and physical material of walls, floors and ceilings. This work detail the methodology used for making the assessment of a PET facility design taking into account only radioprotection aspects. The assessment results must be compared to the design requirements established by national regulations in order to determine whether or not, the facility complies with those requirements, both for workers and for members of the public. The analysis presented is useful for both, facility designers and regulators. In addition, some guidelines for improving the shielding design and working procedures are presented in order to help facility designer's job. (authors)

Pedagogical Red Tape: Difficulties in Teaching the Bureaucracy to Undergraduate Students

Science.gov (United States)

Miller, William J.; Kaltenthaler, Karl; Feuerstein, Derek

2010-01-01

Americans are often perceived as holding extremely negative views of governmental bureaucrats. Phrases like bureaucratic waste and unresponsive bureaucracy fill the mainstream media and taint the image of bureaucrats. Beginning in basic high school civics classes, students are taught to respect the lawmaking process, the executive power of the…

Nuclear weapons facilities. Hearing before the Subcommittee on Oversight and Investigations of the Committee on Energy and Commerce, House of Representatives, Ninety-Ninth Congress, Second Session, March 6, 1986

International Nuclear Information System (INIS)

Anon.

1987-01-01

A hearing to review evidence that security at DOE weapons facilities is not adequate to protect against a potential terrorist attack focused on incidents in which security personnel performances reveal weaknesses in the Inspection and Evaluation (I and E) program. Criticism of the program cited DOE credibility, personnel training and possible drug use by plant personnel, poor coordination, and inadequate protection for physical plants and classified information. Reduced budgeting for security contributed to the problem. The hearing record includes an exchange of correspondence between the Oversight Committee and government officials, the testimony of DOE officials responsible for defense programs, and other material submitted for the record

Iron deficiency is uncommon among lactating women in urban Nepal, despite a high risk of inadequate dietary iron intake.

Science.gov (United States)

Henjum, Sigrun; Manger, Mari; Skeie, Eli; Ulak, Manjeswori; Thorne-Lyman, Andrew L; Chandyo, Ram; Shrestha, Prakash S; Locks, Lindsey; Ulvik, Rune J; Fawzi, Wafaie W; Strand, Tor A

2014-07-14

The main objective of the present study was to examine the association between dietary Fe intake and dietary predictors of Fe status and Hb concentration among lactating women in Bhaktapur, Nepal. We included 500 randomly selected lactating women in a cross-sectional survey. Dietary information was obtained through three interactive 24 h recall interviews including personal recipes. Concentrations of Hb and plasma ferritin and soluble transferrin receptors were measured. The daily median Fe intake from food was 17·5 mg, and 70% of the women were found to be at the risk of inadequate dietary Fe intake. Approximately 90% of the women had taken Fe supplements in pregnancy. The prevalence of anaemia was 20% (Hb levels < 123 g/l) and that of Fe deficiency was 5% (plasma ferritin levels < 15 μg/l). In multiple regression analyses, there was a weak positive association between dietary Fe intake and body Fe (β 0·03, 95% CI 0·014, 0·045). Among the women with children aged < 6 months, but not those with older infants, intake of Fe supplements in pregnancy for at least 6 months was positively associated with body Fe (P for interaction < 0·01). Due to a relatively high dietary intake of non-haem Fe combined with low bioavailability, a high proportion of the women in the present study were at the risk of inadequate intake of Fe. The low prevalence of anaemia and Fe deficiency may be explained by the majority of the women consuming Fe supplements in pregnancy.

Energy Systems Integration Facility (ESIF) Facility Stewardship Plan: Revision 2.1

Energy Technology Data Exchange (ETDEWEB)

Torres, Juan [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Anderson, Art [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

2018-01-02

The U.S. Department of Energy (DOE), Office of Energy Efficiency and Renewable Energy (EERE), has established the Energy Systems Integration Facility (ESIF) on the campus of the National Renewable Energy Laboratory (NREL) and has designated it as a DOE user facility. This 182,500-ft2 research facility provides state-of-the-art laboratory and support infrastructure to optimize the design and performance of electrical, thermal, fuel, and information technologies and systems at scale. This Facility Stewardship Plan provides DOE and other decision makers with information about the existing and expected capabilities of the ESIF and the expected performance metrics to be applied to ESIF operations. This plan is a living document that will be updated and refined throughout the lifetime of the facility.

Overview of radiation protection programme in nuclear medicine facility for diagnostic procedures

International Nuclear Information System (INIS)

Ahmed, Ezzeldein Mohammed Nour Mohammed

2015-02-01

This project was conducted to review Radiation Protection Program in Nuclear Medicine facility for diagnostic procedures which will provide guide for meeting the standard and regulatory requirements in diagnostic nuclear medicine. The main objective of this project is to keep dose to staff, patient and public as low as reasonably achievable (ALARA). The specific objectives were to review the Radiation Protection Program (RPP) in diagnostic nuclear medicine and to make some recommendation for improving the level of radiation protection in diagnostic nuclear medicine that will help to control normal exposure and prevent or mitigate potential exposure. The methodology used is review of various documents. The review showed that if the Radiation Protection Program is inadequate it leads to unjustified exposure to radiation. Finally, this study stated some recommendations that if implemented could improve the level of radiation protection in nuclear medicine department. One of the most important recommendations is that a qualified Radiation Protection Officer (RPO) should be appointed to lay down and oversee a radiation protection in the nuclear medicine department. The RPO must be given the full authority and the adequate time to enable him to perform his duties effectively. (au)

Facilities Performance Indicators Report 2011-12: Tracking Your Facilities Vital Signs

Science.gov (United States)

APPA: Association of Higher Education Facilities Officers, 2013

2013-01-01

This paper provides an expanded Web-based "Facilities Performance Indicators (FPI) Report." The purpose of APPA's Facilities Performance Indicators is to provide a representative set of statistics about facilities in educational institutions. APPA's Information and Research Committee's goal for this year was to enhance the…

Facility effluent monitoring plan for the tank farm facility

Energy Technology Data Exchange (ETDEWEB)

Crummel, G.M.

1998-05-18

A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements.

CLEAR test facility

CERN Multimedia

Ordan, Julien Marius

2017-01-01

A new user facility for accelerator R&D, the CERN Linear Electron Accelerator for Research (CLEAR), started operation in August 2017. CLEAR evolved from the former CLIC Test Facility 3 (CTF3) used by the Compact Linear Collider (CLIC). The new facility is able to host and test a broad range of ideas in the accelerator field.

An Audit of Otorhinolaryngological Practice in a Tertiary Institution in ...

African Journals Online (AJOL)

DATONYE ALASIA

however; otolaryngology practice in developing. 4 countries has remained inadequate. In the Niger delta region of the country, there are no available published data however, there are even fewer ORL surgeons and residents in training with inadequate diagnostic and therapeutic facilities. Niger Delta University teaching ...

Facility Effluent Monitoring Plan for Pacific Northwest National Laboratory Balance-of-Plant Facilities

Energy Technology Data Exchange (ETDEWEB)

Ballinger, Marcel Y.; Gervais, Todd L.

2004-11-15

The Pacific Northwest National Laboratory (PNNL) operates a number of Research & Development (R&D) facilities for the U.S. Department of Energy (DOE) on the Hanford Site. Facility effluent monitoring plans (FEMPs) have been developed to document the facility effluent monitoring portion of the Environmental Monitoring Plan (DOE 2000) for the Hanford Site. Three of PNNL’s R&D facilities, the 325, 331, and 3720 Buildings, are considered major emission points for radionuclide air sampling, and individual FEMPs were developed for these facilities in the past. In addition, a balance-of-plant (BOP) FEMP was developed for all other DOE-owned, PNNL-operated facilities at the Hanford Site. Recent changes, including shutdown of buildings and transition of PNNL facilities to the Office of Science, have resulted in retiring the 3720 FEMP and combining the 331 FEMP into the BOP FEMP. This version of the BOP FEMP addresses all DOE-owned, PNNL-operated facilities at the Hanford Site, excepting the Radiochemical Processing Laboratory, which has its own FEMP because of the unique nature of the building and operations. Activities in the BOP facilities range from administrative to laboratory and pilot-scale R&D. R&D activities include both radioactive and chemical waste characterization, fluid dynamics research, mechanical property testing, dosimetry research, and molecular sciences. The mission and activities for individual buildings are described in Appendix A. Potential radioactive airborne emissions in the BOP facilities are estimated annually using a building inventory-based approach provided in federal regulations. Sampling at individual BOP facilities is based on a potential-to-emit assessment. Some of these facilities are considered minor emission points and thus are sampled routinely, but not continuously, to confirm the low emission potential. One facility, the 331 Life Sciences Laboratory, has a major emission point and is sampled continuously. Sampling systems are

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

Data.gov (United States)

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

Insight into implementation of facility-based integrated management of childhood illness strategy in a rural district of Sindh, Pakistan.

Science.gov (United States)

Pradhan, Nousheen Akber; Rizvi, Narjis; Sami, Neelofar; Gul, Xaher

2013-07-05

, while 4 out of 16 facilities had 56% of the required IMCI drug stock. The mean availability of supplies ranged from 36.6 to 66%, while the mean availability of drugs ranged from 45.8 to 56.7%. Our findings indicate that the Matiari district has sound implementation potential; however, bottlenecks at health care facility and at health care management level have badly constrained the implementation process. An interdependency exists among the constraining factors, such as lack of sound planning resulting in unclear understanding of the strategy; leading to ambiguous roles and responsibilities among stakeholders which manifest as inadequate availability of supplies and drugs at PHC facilities. Addressing these barriers is likely to have a cumulative effect on facilitating IMCI implementation. On the basis of these findings, we recommend that the provincial Ministry of Health (MoH) and provincial Maternal Neonatal and Child Health (MNCH) program jointly assess the situation and streamline IMCI implementation in the district through sound planning, training, supervision, and logistic support.

Novel Biocontrol Methods for Listeria monocytogenes Biofilms in Food Production Facilities.

Science.gov (United States)

Gray, Jessica A; Chandry, P Scott; Kaur, Mandeep; Kocharunchitt, Chawalit; Bowman, John P; Fox, Edward M

2018-01-01

High mortality and hospitalization rates have seen Listeria monocytogenes as a foodborne pathogen of public health importance for many years and of particular concern for high-risk population groups. Food manufactures face an ongoing challenge in preventing the entry of L. monocytogenes into food production environments (FPEs) due to its ubiquitous nature. In addition to this, the capacity of L. monocytogenes strains to colonize FPEs can lead to repeated identification of L. monocytogenes in FPE surveillance. The contamination of food products requiring product recall presents large economic burden to industry and is further exacerbated by damage to the brand. Poor equipment design, facility layout, and worn or damaged equipment can result in Listeria hotspots and biofilms where traditional cleaning and disinfecting procedures may be inadequate. Novel biocontrol methods may offer FPEs effective means to help improve control of L. monocytogenes and decrease cross contamination of food. Bacteriophages have been used as a medical treatment for many years for their ability to infect and lyse specific bacteria. Endolysins, the hydrolytic enzymes of bacteriophages responsible for breaking the cell wall of Gram-positive bacteria, are being explored as a biocontrol method for food preservation and in nanotechnology and medical applications. Antibacterial proteins known as bacteriocins have been used as alternatives to antibiotics for biopreservation and food product shelf life extension. Essential oils are natural antimicrobials formed by plants and have been used as food additives and preservatives for many years and more recently as a method to prevent food spoilage by microorganisms. Competitive exclusion occurs naturally among bacteria in the environment. However, intentionally selecting and applying bacteria to effect competitive exclusion of food borne pathogens has potential as a biocontrol application. This review discusses these novel biocontrol methods and their

Facility Effluent Monitoring Plan for the uranium trioxide facility

International Nuclear Information System (INIS)

Lohrasbi, J.; Johnson, D.L.; De Lorenzo, D.S.

1993-12-01

A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438-01. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements. This facility effluent monitoring plan shall ensure long-range integrity of the effluent monitoring systems by requiring an update whenever a new process or operation introduces new hazardous materials or significant radioactive materials. This document must be reviewed annually even if there are no operational changes, and it must be updated at a minimum of every three years

Glimepiride versus pioglitazone combination therapy in subjects with type 2 diabetes inadequately controlled on metformin monotherapy: results of a randomized clinical trial.

Science.gov (United States)

Umpierrez, Guillermo; Issa, Maher; Vlajnic, Aleksandra

2006-04-01

To compare the effect of add-on glimepiride or pioglitazone in subjects with type 2 diabetes inadequately controlled on metformin monotherapy. Multicenter, randomized, parallel-group, open-label, forcedtitration study involving 203 adults with poorly controlled type 2 diabetes (A1C 7.5-10%) on metformin monotherapy. Subjects were randomized to receive glimepiride or pioglitazone, titrated to the maximum dose for 26 weeks. Subjects were evaluated for A1C changes, fasting plasma glucose (FPG), insulin, C-peptide, and lipid levels. Safety outcomes and diabetes-related healthcare resource utilization were also evaluated. Both treatment groups achieved similar and significant mean decreases from baseline to endpoint (week 26) in A1C (p = 0.0001) and FPG (p use of fasting C-peptide concentration > or = 0.27 nmol/L in the inclusion criteria was a potential limitation as it may have included those patients with an improved probability for glimepiride or pioglitazone response. In addition, a larger patient population would have provided a greater degree of data applicability. In patients with type 2 diabetes inadequately controlled on metformin monotherapy, add-on glimepiride or pioglitazone results in similar overall improvements in glycemic control. Compared with pioglitazone, glimepiride is associated with faster glycemic control, lower total and LDL cholesterol levels and reduced short-term healthcare costs.

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

Data.gov (United States)

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

Basic Research Firing Facility

Data.gov (United States)

Federal Laboratory Consortium — The Basic Research Firing Facility is an indoor ballistic test facility that has recently transitioned from a customer-based facility to a dedicated basic research...

Facility effluent monitoring plan for the 300 Area Fuels Fabrication Facility

International Nuclear Information System (INIS)

Nickels, J.M.; Brendel, D.F.

1991-11-01

A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP- 0438. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements. This facility effluent monitoring plan is the first annual report. It shall ensure long-range integrity of the effluent monitoring system by requiring an update whenever a new process or operation introduces new hazardous materials or significant radioactive materials. This document must be reviewed annually even if there are no operational changes, and it must be updated as a minimum every three years. The Fuel Fabrication Facility in the Hanford 300 Area supported the production reactors from the 1940's until they were shut down in 1987. Prior to 1987 the Fuel Fabrication Facility released both airborne and liquid radioactive effluents. In January 1987 the emission of airborne radioactive effluents ceased with the shutdown of the fuels facility. The release of liquid radioactive effluents have continued although decreasing significantly from 1987 to 1990

Trauma facilities in Denmark

DEFF Research Database (Denmark)

Weile, Jesper; Nielsen, Klaus; Primdahl, Stine C

2018-01-01

Background: Trauma is a leading cause of death among adults aged challenge. Evidence supports the centralization of trauma facilities and the use multidisciplinary trauma teams. Because knowledge is sparse on the existing distribution of trauma facilities...... and the organisation of trauma care in Denmark, the aim of this study was to identify all Danish facilities that care for traumatized patients and to investigate the diversity in organization of trauma management. Methods: We conducted a systematic observational cross-sectional study. First, all hospitals in Denmark...... were identified via online services and clarifying phone calls to each facility. Second, all trauma care manuals on all facilities that receive traumatized patients were gathered. Third, anesthesiologists and orthopedic surgeons on call at all trauma facilities were contacted via telephone...

Facility Effluent Monitoring Plan for Pacific Northwest National Laboratory Balance-of-Plant Facilities

International Nuclear Information System (INIS)

Ballinger, M.Y.; Shields, K.D.

1999-01-01

The Pacific Northwest National Laboratory (PNNL) operates a number of research and development (R and D) facilities for the Department of Energy on the Hanford Site. According to DOE Order 5400.1, a Facility Effluent Monitoring Plan is required for each site, facility, or process that uses, generates, releases, or manages significant pollutants or hazardous materials. Three of the R and D facilities: the 325, 331, and 3720 Buildings, are considered major emission points for radionuclide air sampling and thus individual Facility Effluent Monitoring Plans (FEMPs) have been developed for them. Because no definition of ''significant'' is provided in DOE Order 5400.1 or the accompanying regulatory guide DOE/EH-0173T, this FEMP was developed to describe monitoring requirements in the DOE-owned, PNNL-operated facilities that do not have individual FEMPs. The remainder of the DOE-owned, PNNL-operated facilities are referred to as Balance-of-Plant (BOP) facilities. Activities in the BOP facilities range from administrative to laboratory and pilot-scale R and D. R and D activities include both radioactive and chemical waste characterization, fluid dynamics research, mechanical property testing, dosimetry research, and molecular sciences. The mission and activities for individual buildings are described in the FEMP

Facility Effluent Monitoring Plan for Pacific Northwest National Laboratory Balance-of-Plant Facilities

Energy Technology Data Exchange (ETDEWEB)

Ballinger, M.Y.; Shields, K.D.

1999-04-02

The Pacific Northwest National Laboratory (PNNL) operates a number of research and development (R and D) facilities for the Department of Energy on the Hanford Site. According to DOE Order 5400.1, a Facility Effluent Monitoring Plan is required for each site, facility, or process that uses, generates, releases, or manages significant pollutants or hazardous materials. Three of the R and D facilities: the 325, 331, and 3720 Buildings, are considered major emission points for radionuclide air sampling and thus individual Facility Effluent Monitoring Plans (FEMPs) have been developed for them. Because no definition of ''significant'' is provided in DOE Order 5400.1 or the accompanying regulatory guide DOE/EH-0173T, this FEMP was developed to describe monitoring requirements in the DOE-owned, PNNL-operated facilities that do not have individual FEMPs. The remainder of the DOE-owned, PNNL-operated facilities are referred to as Balance-of-Plant (BOP) facilities. Activities in the BOP facilities range from administrative to laboratory and pilot-scale R and D. R and D activities include both radioactive and chemical waste characterization, fluid dynamics research, mechanical property testing, dosimetry research, and molecular sciences. The mission and activities for individual buildings are described in the FEMP.

Facilities Programming.

Science.gov (United States)

Bullis, Robert V.

1992-01-01

A procedure for physical facilities management written 17 years ago is still worth following today. Each of the steps outlined for planning, organizing, directing, controlling, and evaluating must be accomplished if school facilities are to be properly planned and constructed. However, lessons have been learned about energy consumption and proper…

Facility effluent monitoring plan for the 2724-W Protective Equipment Decontamination Facility

International Nuclear Information System (INIS)

Nickels, J.M.; Lavey, G.H.

1992-12-01

A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1* for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. A facility effluent monitoring plan determination was performed during Calendar Year 1991 and the evaluation requires the need for a facility effluent monitoring plan. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438**. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements

Household trends in access to improved water sources and sanitation facilities in Vietnam and associated factors: findings from the Multiple Indicator Cluster Surveys, 2000-2011.

Science.gov (United States)

Tuyet-Hanh, Tran Thi; Lee, Jong-Koo; Oh, Juhwan; Van Minh, Hoang; Ou Lee, Chul; Hoan, Le Thi; Nam, You-Seon; Long, Tran Khanh

2016-01-01

both improved water and sanitation facilities in the Mekong River Delta, South East and Central Highlands regions of Vietnam. There is also a need to address socio-economic factors associated with inadequate access to improved sanitation facilities.

Research Opportunities in High Energy Density Laboratory Plasmas on the NDCX-II Facility

International Nuclear Information System (INIS)

Barnard, John; Cohen, Ron; Friedman, Alex; Grote, Dave; Lund, Steven; Sharp, Bill; Bieniosek, Frank; Ni, Pavel; Roy, Prabir; Henestroza, Enrique; Jung, Jin-Young; Kwan, Joe; Lee, Ed; Leitner, Matthaeus; Lidia, Steven; Logan, Grant; Seidl, Peter; Vay, Jean-Luc; Waldron, Will

2009-01-01

Intense beams of heavy ions offer a very attractive tool for fundamental research in high energy density physics and inertial fusion energy science. These applications build on the significant recent advances in the generation, compression and focusing of intense heavy ion beams in the presence of a neutralizing background plasma. Such beams can provide uniform volumetric heating of the target during a time-scale shorter than the hydrodynamic response time, thereby enabling a significant suite of experiments that will elucidate the underlying physics of dense, strongly-coupled plasma states, which have been heretofore poorly understood and inadequately diagnosed, particularly in the warm dense matter regime. The innovations, fundamental knowledge, and experimental capabilities developed in this basic research program is also expected to provide new research opportunities to study the physics of directly-driven ion targets, which can dramatically reduce the size of heavy ion beam drivers for inertial fusion energy applications. Experiments examining the behavior of thin target foils heated to the warm dense matter regime began at the Lawrence Berkeley National Laboratory in 2008, using the Neutralized Drift Compression Experiment - I (NDCX-I) facility, and its associated target chamber and diagnostics. The upgrade of this facility, called NDCX-II, will enable an exciting set of scientific experiments that require highly uniform heating of the target, using Li + ions which enter the target with kinetic energy in the range of 3 MeV, slightly above the Bragg peak for energy deposition, and exit with energies slightly below the Bragg peak. This document briefly summarizes the wide range of fundamental scientific experiments that can be carried out on the NDCX-II facility, pertaining to the two charges presented to the 2008 Fusion Energy Science Advisory Committee (FESAC) panel on High Energy Density Laboratory Plasmas (HEDLP). These charges include: (1) Identify the

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...

Educational intervention on physical restraint use in long-term care facilities - Systematic review and meta-analysis.

Science.gov (United States)

Lan, Shao-Huan; Lu, Li-Chin; Lan, Shou-Jen; Chen, Jong-Chen; Wu, Wen-Jun; Chang, Shen-Peng; Lin, Long-Yau

2017-08-01

"Physical restraint" formerly used as a measure of protection for psychiatric patients is now widely used. However, existing studies showed that physical restraint not only has inadequate effect of protection but also has negative effects on residents. To analyzes the impact of educational program on the physical restraint use in long-term care facilities. A systematic review with meta-analysis and meta-regression. Eight databases, including Cochrane Library, ProQuest, PubMed, EMBASE, EBSCO, Web of Science, Ovid Medline and Physiotherapy Evidence Database (PEDro), were searched up to January 2017. Eligible studies were classified by intervention and accessed for quality using the Quality Assessment Tool for quantitative studies. Sixteen research articles were eligible in the final review; 10 randomize control trail studies were included in the analysis. The meta-analysis revealed that the use of physical restraint was significantly less often in the experimental (education) group (OR = 0.55, 95% CI: 0.39 to 0.78, p education would have decreased the effect of the restraint educational program (β: 0.08, p = 0.002); instead, the longer education period and more times of education would have a stronger effect of reducing the use of physical restraint (β: -0.07, p educational program had an effect on the reduced use of physical restraint. The results of meta-regression suggest that long-term care facilities should provide a continuous education program of physical restraint for caregivers. Copyright © 2017. Published by Elsevier Taiwan.

Facility effluent monitoring plan for the tank farms facilities

International Nuclear Information System (INIS)

Crummel, G.M.; Gustavson, R.D.; Kenoyer, J.L.; Moeller, M.P.

1991-11-01

A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements. This facility effluent monitoring plan is the first annual report. It shall ensure long-range integrity of the effluent monitoring systems by requiring an update whenever a new process or operation introduces new hazardous materials or significant radioactive materials. This document must be reviewed annually even if there are no operational changes, and it must be updated as a minimum three years. A variety of liquid wastes are generated in processing treatment, and disposal operations throughout the Hanford Site. The Tank Farms Project serves a major role in Hanford Site waste management activities as the temporary repository for these wastes. Stored wastes include hazardous components regulated under the Resource Conservation and Recovery Act of 1976 (RCRA) and as by-product material regulated under the Atomic Energy Act of 1954. A total of 177 single- and double-shell tanks (SST and DST) have been constructed in the 200 East and 200 West Areas of the Hanford Site. These facilities were constructed to various designs from 1943 to 1986. The Tank Farms Project is comprised of these tanks along with various transfer, receiving, and treatment facilities

Test and User Facilities | NREL

Science.gov (United States)

Test and User Facilities Test and User Facilities Our test and user facilities are available to | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z B Battery Thermal and Life Test Facility Biochemical Conversion Pilot Plant C Controllable Grid Interface Test System D Dynamometer Test Facilities

Licensed Healthcare Facilities

Data.gov (United States)

California Natural Resource Agency — The Licensed Healthcare Facilities point layer represents the locations of all healthcare facilities licensed by the State of California, Department of Health...

Facility effluent monitoring plan for the 324 Facility

International Nuclear Information System (INIS)

1994-11-01

The 324 Facility [Waste Technology Engineering Laboratory] in the 300 Area primarily supports the research and development of radioactive and nonradioactive waste vitrification technologies, biological waste remediation technologies, spent nuclear fuel studies, waste mixing and transport studies, and tritium development programs. All of the above-mentioned programs deal with, and have the potential to, release hazardous and/or radioactive material. The potential for discharge would primarily result from (1) conducting research activities using the hazardous materials, (2) storing radionuclides and hazardous chemicals, and (3) waste accumulation and storage. This report summarizes the airborne and liquid effluents, and the results of the Facility Effluent Monitoring Plan (FEMP) determination for the facility. The complete monitoring plan includes characterizing effluent streams, monitoring/sampling design criteria, a description of the monitoring systems and sample analysis, and quality assurance requirements

Insight into implementation of facility-based integrated management of childhood illness strategy in a rural district of Sindh, Pakistan

Directory of Open Access Journals (Sweden)

Nousheen Akber Pradhan

2013-07-01

16 surveyed facilities had 75% of the total supplies, while 4 out of 16 facilities had 56% of the required IMCI drug stock. The mean availability of supplies ranged from 36.6 to 66%, while the mean availability of drugs ranged from 45.8 to 56.7%. Conclusion: Our findings indicate that the Matiari district has sound implementation potential; however, bottlenecks at health care facility and at health care management level have badly constrained the implementation process. An interdependency exists among the constraining factors, such as lack of sound planning resulting in unclear understanding of the strategy; leading to ambiguous roles and responsibilities among stakeholders which manifest as inadequate availability of supplies and drugs at PHC facilities. Addressing these barriers is likely to have a cumulative effect on facilitating IMCI implementation. On the basis of these findings, we recommend that the provincial Ministry of Health (MoH and provincial Maternal Neonatal and Child Health (MNCH program jointly assess the situation and streamline IMCI implementation in the district through sound planning, training, supervision, and logistic support.

Contribution of university farms to teaching and learning of ...

African Journals Online (AJOL)

Contribution of university farms to teaching and learning of agricultural science in Ghana. ... leaving the university. The main factors identified for this gap were the lack of supervision, lack of basic and modern facilities on the farms, lack of motivation, inadequate funds, and inadequate time allotted for practical on the farms.

An assessment of the forest regeneration potential of the taungya ...

African Journals Online (AJOL)

The study identified lack of credit facilities, inadequate funding and ignorance of the advantage of tree crops on tropical farmland as well as inadequate technical support as the major constraints of the taungya system. The taungya system is effective for forest regeneration albeit taking care of farmers' interest beyond the ...

Outline of NUCEF facility

International Nuclear Information System (INIS)

Takeshita, Isao

1996-01-01

NUCEF is a multipurpose research facility in the field of safety and advanced technology of nuclear fuel cycle back-end. Various experiment facilities and its supporting installations, in which nuclear fuel materials, radio isotopes and TRU elements can be handled, are arranged in more than one hundred rooms of two experiment buildings. Its construction was completed in middle of 1994 and hot experiments have been started since then. NUCEF is located on the site (30,000 m 2 ) of southeastern part in the Tokai Research Establishment of JAERI facing to the Pacific Ocean. The base of Experiment Buildings A and B was directly founded on the rock existing at 10-15 m below ground level taking the aseismatic design into consideration. Each building is almost same sized and composed of one basement and three floors of which area is 17,500 m 2 in total. In the basement, there are exhaust facilities of ventilation system, treatment system of solution fuel and radioactive waste solution and storage tanks of them. Major experiment facilities are located on the first or the second floors in each building. An air-inlet facility of ventilation system for each building is equipped on the third floor. Most of experiment facilities for criticality safety research including two critical facilities: Static Experiment Critical Facility (STACY) and Transient Experiment Critical Facility (TRACY) are installed in Experiment Building A. Experiment equipments for research on advanced fuel reprocessing process and on TRU waste management, which are named BECKY (Back End Fuel Cycle Key Elements Research Facility), are installed in laboratories and a-g cells in Experiment Building B. (J.P.N.)

Rocketball Test Facility

Data.gov (United States)

Federal Laboratory Consortium — This test facility offers the capability to emulate and measure guided missile radar cross-section without requiring flight tests of tactical missiles. This facility...

Facility Description 2012. Summary report of the encapsulation plant and disposal facility designs

International Nuclear Information System (INIS)

Palomaeki, J.; Ristimaeki, L.

2013-10-01

The purpose of the facility description is to be a specific summary report of the scope of Posiva's nuclear facilities (encapsulation plant and disposal facility) in Olkiluoto. This facility description is based on the 2012 designs and completing Posiva working reports. The facility description depicts the nuclear facilities and their operation as the disposal of spent nuclear fuel starts in Olkiluoto in about 2020. According to the decisions-in-principle of the government, the spent nuclear fuel from Loviisa and Olkiluoto nuclear power plants in operation and in future cumulative spent nuclear fuel from Loviisa 1 and 2, Olkiluoto 1, 2, 3 and 4 nuclear power plants, is permitted to be disposed of in Olkiluoto bedrock. The design of the disposal facility is based on the KBS-3V concept (vertical disposal). Long-term safety concept is based on the multi-barrier principle i.e. several release barriers, which ensure one another so that insufficiency in the performance of one barrier doesn't jeopardize long-term safety of the disposal. The release barriers are the following: canister, bentonite buffer and deposition tunnel backfill, and the host rock around the repository. The canisters are installed into the deposition holes, which are bored to the floor of the deposition tunnels. The canisters are enveloped with compacted bentonite blocks, which swell after absorbing water. The surrounding bedrock and the central and access tunnel backfill provide additional retardation, retention, and dilution. The nuclear facilities consist of an encapsulation plant and of underground final disposal facility including other aboveground buildings and surface structures serving the facility. The access tunnel and ventilation shafts to the underground disposal facility and some auxiliary rooms are constructed as a part of ONKALO underground rock characterization facility during years 2004-2014. The construction works needed for the repository start after obtaining the construction

340 Facility compliance assessment

International Nuclear Information System (INIS)

English, S.L.

1993-10-01

This study provides an environmental compliance evaluation of the RLWS and the RPS systems of the 340 Facility. The emphasis of the evaluation centers on compliance with WAC requirements for hazardous and mixed waste facilities, federal regulations, and Westinghouse Hanford Company (WHC) requirements pertinent to the operation of the 340 Facility. The 340 Facility is not covered under either an interim status Part A permit or a RCRA Part B permit. The detailed discussion of compliance deficiencies are summarized in Section 2.0. This includes items of significance that require action to ensure facility compliance with WAC, federal regulations, and WHC requirements. Outstanding issues exist for radioactive airborne effluent sampling and monitoring, radioactive liquid effluent sampling and monitoring, non-radioactive liquid effluent sampling and monitoring, less than 90 day waste storage tanks, and requirements for a permitted facility

Wastewater Treatment Facilities

Data.gov (United States)

Iowa State University GIS Support and Research Facility — Individual permits for municipal, industrial, and semi-public wastewater treatment facilities in Iowa for the National Pollutant Discharge Elimination System (NPDES)...

Energetics Conditioning Facility

Data.gov (United States)

Federal Laboratory Consortium — The Energetics Conditioning Facility is used for long term and short term aging studies of energetic materials. The facility has 10 conditioning chambers of which 2...

Suboptimal Iodine Concentration in Breastmilk and Inadequate Iodine Intake among Lactating Women in Norway.

Science.gov (United States)

Henjum, Sigrun; Lilleengen, Anne Marie; Aakre, Inger; Dudareva, Anna; Gjengedal, Elin Lovise Folven; Meltzer, Helle Margrete; Brantsæter, Anne Lise

2017-06-22

Breastfed infants depend on sufficient maternal iodine intake for optimal growth and neurological development. Despite this, few studies have assessed iodine concentrations in human milk and there is currently no published data on iodine status among lactating women in Norway. The aim of this study was to assess iodine concentrations in breast milk (BMIC) in lactating women and estimate iodine intake. Five Mother and Child Health Centres in Oslo were randomly selected during 2016, and 175 lactating women between 2nd and 28th weeks postpartum participated. Each of the women provided four breastmilk samples which were pooled and analysed for iodine concentrations. Participants also provided information on iodine intake from food and supplements covering the last 24 h and the habitual iodine intake (food frequency questionnaire). The median (p25, p75 percentiles) BMIC was 68 (45, 98) µg/L and 76% had BMIC food (p25, p75) was 121 (82, 162) µg/day and the total intake (food and supplements) was 134 (95, 222) µg/day. The majority of lactating women had suboptimal BMIC and inadequate intake of iodine from food and supplements.

Facilities projects performance measurement system

International Nuclear Information System (INIS)

Erben, J.F.

1979-01-01

The two DOE-owned facilities at Hanford, the Fuels and Materials Examination Facility (FMEF), and the Fusion Materials Irradiation Test Facility (FMIT), are described. The performance measurement systems used at these two facilities are next described

Household trends in access to improved water sources and sanitation facilities in Vietnam and associated factors: findings from the Multiple Indicator Cluster Surveys, 2000–2011

Science.gov (United States)

Tuyet-Hanh, Tran Thi; Lee, Jong-Koo; Oh, Juhwan; Van Minh, Hoang; Ou Lee, Chul; Hoan, Le Thi; Nam, You-Seon; Long, Tran Khanh

2016-01-01

efforts are required to increase household access to both improved water and sanitation facilities in the Mekong River Delta, South East and Central Highlands regions of Vietnam. There is also a need to address socio-economic factors associated with inadequate access to improved sanitation facilities. PMID:26950563

Household trends in access to improved water sources and sanitation facilities in Vietnam and associated factors: findings from the Multiple Indicator Cluster Surveys, 2000–2011

Directory of Open Access Journals (Sweden)

Tran Thi Tuyet-Hanh

2016-02-01

.0. Conclusions: More efforts are required to increase household access to both improved water and sanitation facilities in the Mekong River Delta, South East and Central Highlands regions of Vietnam. There is also a need to address socio-economic factors associated with inadequate access to improved sanitation facilities.

Explosive Components Facility

Data.gov (United States)

Federal Laboratory Consortium — The 98,000 square foot Explosive Components Facility (ECF) is a state-of-the-art facility that provides a full-range of chemical, material, and performance analysis...

Design of the PRIDE Facility

International Nuclear Information System (INIS)

You, Gil Sung; Choung, Won Myung; Lee, Eun Pyo; Cho, Il Je; Kwon, Kie Chan; Hong, Dong Hee; Lee, Won Kyung; Ku, Jeong Hoe

2009-01-01

From 2007, KAERI is developing a PyRoprocess Integrated inactive DEmonstration facility (the PRIDE facility). The maximum annual treatment capacity of this facility will be a 10 ton-HM. The process will use a natural uranium feed material or a natural uranium mixed with some surrogate material for a simulation of a spent fuel. KAERI has also another plan to construct a demonstration facility which can treat a real spent fuel by pyroprocessing. This facility is called by ESPF, Engineering Scale Pyroprocess Facility. The ESPF will have the same treatment capability of spent fuel with the PRIDE facility. The only difference between the PRIDE and the ESPF is a radiation shielding capability. From the PRIDE facility designing works and demonstration with a simulated spent fuel after construction, it will be able to obtain the basic facility requirements, remote operability, interrelation properties between process equipment for designing of the ESPF. The flow sheet of the PRIDE processes is composed of five main processes, such as a decladding and voloxidation, an electro-reduction, an electrorefining, an electro-winning, and a salt waste treatment. The final products from the PRIDE facility are a simulated TRU metal and U metal ingot

Comprehensive facilities plan

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-09-01

The Ernest Orlando Lawrence Berkeley National Laboratory`s Comprehensive Facilities Plan (CFP) document provides analysis and policy guidance for the effective use and orderly future development of land and capital assets at the Berkeley Lab site. The CFP directly supports Berkeley Lab`s role as a multiprogram national laboratory operated by the University of California (UC) for the Department of Energy (DOE). The CFP is revised annually on Berkeley Lab`s Facilities Planning Website. Major revisions are consistent with DOE policy and review guidance. Facilities planing is motivated by the need to develop facilities for DOE programmatic needs; to maintain, replace and rehabilitate existing obsolete facilities; to identify sites for anticipated programmatic growth; and to establish a planning framework in recognition of site amenities and the surrounding community. The CFP presents a concise expression of the policy for the future physical development of the Laboratory, based upon anticipated operational needs of research programs and the environmental setting. It is a product of the ongoing planning processes and is a dynamic information source.

Conceptual design report, Sodium Storage Facility, Fast Flux Test Facility, Project F-031

International Nuclear Information System (INIS)

Shank, D.R.

1995-01-01

The Sodium Storage Facility Conceptual Design Report provides conceptual design for construction of a new facility for storage of the 260,000 gallons of sodium presently in the FFTF plant. The facility will accept the molten sodium transferred from the FFTF sodium systems, and store the sodium in a solid state under an inert cover gas until such time as a Sodium Reaction Facility is available for final disposal of the sodium

Dialysis Facility Compare

Data.gov (United States)

U.S. Department of Health & Human Services — Dialysis Facility Compare helps you find detailed information about Medicare-certified dialysis facilities. You can compare the services and the quality of care that...

Projectile Demilitarization Facilities

Data.gov (United States)

Federal Laboratory Consortium — The Projectile Wash Out Facility is US Army Ammunition Peculiar Equipment (APE 1300). It is a pilot scale wash out facility that uses high pressure water and steam...

Facility design: introduction

International Nuclear Information System (INIS)

Unger, W.E.

1980-01-01

The design of shielded chemical processing facilities for handling plutonium is discussed. The TRU facility is considered in particular; its features for minimizing the escape of process materials are listed. 20 figures

Status of RIB facilities in Asia

International Nuclear Information System (INIS)

Tanihata, Isao

1998-01-01

Radioactive Ion Beam Facilities in Asia are presented. In China, in-flight separation type facilities are in operation at the Institute of Modern Physics in Lanzhou and the other at Tandem facility in China Institute of Atomic Energy in Beijing. The storage-ring facility is proposed and approved in Lanzhou. In India, the Variable Energy Cyclotron Facility in Calcutta start to construct an ISOL-type facility. In Japan, in-flight separation type facilities are working at Research Center for Nuclear Physics in Osaka, and at RIKEN. Also a separator start its operation in medical facility in Chiba. In RIKEN, the construction of RI Beam Factory has been started. An ISOL-type facility is proposed in the Japan Hadron Facility in KEK. Table I summarize these facilities

Facility effluent monitoring plan for the plutonium-uranium extraction facility

International Nuclear Information System (INIS)

Lohrasbi, J.; Johnson, D.L.; De Lorenzo, D.S.

1993-12-01

A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438-01. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements. This facility effluent monitoring plan shall ensure long-range integrity of the effluent monitoring systems by requiring an update whenever a new process or operation introduces new hazardous materials or significant radioactive materials. This document must be reviewed annually even if there are no operational changes, and it must be updated at a minimum of every three years

Facility effluent monitoring plan for the plutonium uranium extraction facility

Energy Technology Data Exchange (ETDEWEB)

Wiegand, D.L.

1994-09-01

A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438-01. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements. This facility effluent monitoring plan shall ensure long-range integrity of the effluent monitoring systems by requiring an update whenever a new process or operation introduces new hazardous materials or significant radioactive materials. This document must be reviewed annually even if there are no operational changes, and it must be updated at a minimum of every three years.

Facility effluent monitoring plan for the plutonium uranium extraction facility

International Nuclear Information System (INIS)

Wiegand, D.L.

1994-09-01

A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438-01. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements. This facility effluent monitoring plan shall ensure long-range integrity of the effluent monitoring systems by requiring an update whenever a new process or operation introduces new hazardous materials or significant radioactive materials. This document must be reviewed annually even if there are no operational changes, and it must be updated at a minimum of every three years

Facility effluent monitoring plan for the Plutonium Uranium Extraction Facility

International Nuclear Information System (INIS)

Greager, E.M.

1997-01-01

A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438-01. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether these systems are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements. This facility effluent monitoring plan will ensure long-range integrity of the effluent monitoring systems by requiring an update whenever a new process or operation introduces new hazardous materials or significant radioactive materials. This document must be reviewed annually even if there are no operational changes, and it must be updated, at a minimum, every 3 years

Facility effluent monitoring plan for the plutonium-uranium extraction facility

Energy Technology Data Exchange (ETDEWEB)

Lohrasbi, J.; Johnson, D.L. [Westinghouse Hanford Co., Richland, WA (United States); De Lorenzo, D.S. [Los Alamos Technical Associates, NM (United States)

1993-12-01

A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438-01. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements. This facility effluent monitoring plan shall ensure long-range integrity of the effluent monitoring systems by requiring an update whenever a new process or operation introduces new hazardous materials or significant radioactive materials. This document must be reviewed annually even if there are no operational changes, and it must be updated at a minimum of every three years.

Integrated Disposal Facility

Data.gov (United States)

Federal Laboratory Consortium — Located near the center of the 586-square-mile Hanford Site is the Integrated Disposal Facility, also known as the IDF.This facility is a landfill similar in concept...

STAR facility tritium accountancy

International Nuclear Information System (INIS)

Pawelko, R. J.; Sharpe, J. P.; Denny, B. J.

2008-01-01

The Safety and Tritium Applied Research (STAR) facility has been established to provide a laboratory infrastructure for the fusion community to study tritium science associated with the development of safe fusion energy and other technologies. STAR is a radiological facility with an administrative total tritium inventory limit of 1.5 g (14,429 Ci) [1]. Research studies with moderate tritium quantities and various radionuclides are performed in STAR. Successful operation of the STAR facility requires the ability to receive, inventory, store, dispense tritium to experiments, and to dispose of tritiated waste while accurately monitoring the tritium inventory in the facility. This paper describes tritium accountancy in the STAR facility. A primary accountancy instrument is the tritium Storage and Assay System (SAS): a system designed to receive, assay, store, and dispense tritium to experiments. Presented are the methods used to calibrate and operate the SAS. Accountancy processes utilizing the Tritium Cleanup System (TCS), and the Stack Tritium Monitoring System (STMS) are also discussed. Also presented are the equations used to quantify the amount of tritium being received into the facility, transferred to experiments, and removed from the facility. Finally, the STAR tritium accountability database is discussed. (authors)

Synchrotron radiation facilities

CERN Multimedia

1972-01-01

Particularly in the past few years, interest in using the synchrotron radiation emanating from high energy, circular electron machines has grown considerably. In our February issue we included an article on the synchrotron radiation facility at Frascati. This month we are spreading the net wider — saying something about the properties of the radiation, listing the centres where synchrotron radiation facilities exist, adding a brief description of three of them and mentioning areas of physics in which the facilities are used.

The CUTLASS database facilities

International Nuclear Information System (INIS)

Jervis, P.; Rutter, P.

1988-09-01

The enhancement of the CUTLASS database management system to provide improved facilities for data handling is seen as a prerequisite to its effective use for future power station data processing and control applications. This particularly applies to the larger projects such as AGR data processing system refurbishments, and the data processing systems required for the new Coal Fired Reference Design stations. In anticipation of the need for improved data handling facilities in CUTLASS, the CEGB established a User Sub-Group in the early 1980's to define the database facilities required by users. Following the endorsement of the resulting specification and a detailed design study, the database facilities have been implemented as an integral part of the CUTLASS system. This paper provides an introduction to the range of CUTLASS Database facilities, and emphasises the role of Database as the central facility around which future Kit 1 and (particularly) Kit 6 CUTLASS based data processing and control systems will be designed and implemented. (author)

The catastrophic collapse of morale among hospital physicians in Japan

Directory of Open Access Journals (Sweden)

Hideo Yasunaga

2008-11-01

Full Text Available Hideo YasunagaDepartment of Health Management and Policy, Graduate School of Medicine, University of Tokyo, Tokyo, JapanAbstract: The past few decades have witnessed bleak pictures of unhappy physicians worldwide. Japanese physicians working in hospitals are particularly distressed. Today, Japan’s healthcare system is near collapse because physicians are utterly demoralized. Their loss of morale is due to budget constraints, excessive demands, physician shortages, poor distribution, long working hours, hostile media, increasing lawsuits, and violence by patients. Severe cost-saving policies, inadequate distribution of healthcare resources, and the failure to communicate risks has damaged physicians’ morale and created conflicts between physicians and society. Physicians should communicate the uncertainty, limitations, and risks of modern medicine to all members of society. No resolution can be achieved unless trust exists between physicians, patients, the public, the media, bureaucrats, politicians and jurists.Keywords: physician’s morale, physician shortages, overwork, health policy

Materiel Evaluation Facility

Data.gov (United States)

Federal Laboratory Consortium — CRREL's Materiel Evaluation Facility (MEF) is a large cold-room facility that can be set up at temperatures ranging from −20°F to 120°F with a temperature change...

Chronic arthritis of the hip joint: an unusual complication of an inadequately treated fistula-in-ano

Science.gov (United States)

Raghunath, Rajat; Varghese, Gigi; Simon, Betty

2014-01-01

We report a case of chronic arthritis of the right hip joint in an otherwise healthy young male athlete as a complication of inadequately treated anal fistula. A young male athlete presented with symptoms of right hip pain and difficulty in walking and intermittent fever for 2 months. He had a history of perianal abscess drainage. On examination he was found to have a tender right hip joint with severe restriction of movements. He was also found to have a partially drained right ischiorectal abscess. X-ray and MRI of the hip joint revealed chronic arthritis of the right hip joint, which was communicating with a complex fistula-in-ano. He underwent a diversion sigmoid colostomy and right ischiorectal abscess drainage along with appropriate antibiotics with a plan for definitive hip joint procedure later. He was lost to follow-up and succumbed to severe perianal sepsis within a few months. PMID:25414226

Facility effluent monitoring plan for the plutonium-uranium extraction facility

International Nuclear Information System (INIS)

Thompson, R.J.; Sontage, S.

1991-11-01

A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements. This facility effluent monitoring plan is the first annual report. It shall ensure long-range integrity of the effluent monitoring systems by requiring an update whenever a new process or operation introduces new hazardous materials or significant radioactive materials. This document must be reviewed annually even if there are no operational changes, and it must be updated as a minimum every three years

Inadequately marketing our brand: Medical student awareness of acute care surgery.

Science.gov (United States)

Montgomery, Stephanie C; Privette, Alicia R; Ferguson, Pamela L; Mirdamadi, Meena; Fakhry, Samir M

2015-11-01

Despite focused national efforts to promote acute care surgery (ACS), little is known about medical student awareness of ACS as a career choice. The impending shortage of general surgeons emphasizes the need to increase interest in this comprehensive surgical specialty. The goal of this study was to determine whether students would be more likely to consider choosing ACS if they were aware of the specialty and its benefits. A survey was distributed electronically to medical students at our institution, a Level I trauma center with an active ACS service. The survey asked questions regarding specialty choice and factors that were used in making that decision. Also included were questions regarding their familiarity and affinity for ACS. The survey was returned by 518 students. Each medical school year was proportionately represented. Twenty-one percent of the students reported surgery as their career choice; however, women were half as likely to choose surgery as men. When asked to define ACS, 23% of all students gave the correct response. Only 8.9% of the students in the preclinical years correctly defined ACS. Even in the clinical years, 54% were unaware of ACS as a specialty. Students reported that the top factors that influenced their choice were controllable lifestyle, predictable schedule, and a positive medical school role model. When asked to identify what would make ACS appealing, a 50-hour work week was deemed most influential. When given the definition of ACS with approximate pay and on-call hours, 41.5% of the students and 75% of those interested in surgery would be likely to choose ACS as a career. This study highlights that awareness of ACS as a specialty is lacking. This may reflect inadequate marketing of our "brand" both locally and nationally. Focused efforts at familiarizing students with ACS and increased role modeling may increase interest in ACS.

AOV Facility Tool/Facility Safety Specifications -

Data.gov (United States)

Department of Transportation — Develop and maintain authorizing documents that are standards that facilities must follow. These standards are references of FAA regulations and are specific to the...

202-S Hexone Facility supplemental information to the Hanford Facility Contingency Plan

International Nuclear Information System (INIS)

Ingle, S.J.

1996-03-01

This document is a unit-specific contingency plan for the 202-S Hexone Facility and is intended to be used as a supplement to the Hanford Facility Contingency Plan. This unit-specific plan is to be used to demonstrate compliance with the contingency plan requirements of WAC 173-303 for certain Resource Conservation and Recovery Act of 1976 (RCRA) waste management units. The 202-S Hexone Facility is not used to process radioactive or nonradioactive hazardous material. Radioactive, dangerous waste material is contained in two underground storage tanks, 276-S-141 and 276-S-142. These tanks do not present a significant hazard to adjacent facilities, personnel, or the environment. Currently, dangerous waste management activities are not being applied at the tanks. It is unlikely that any incidents presenting hazards to public health or the environment would occur at the 202-S Hexone Facility

9 CFR 351.10 - Facilities.

Science.gov (United States)

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Facilities. 351.10 Section 351.10... CERTIFICATION CERTIFICATION OF TECHNICAL ANIMAL FATS FOR EXPORT Facilities and Operations § 351.10 Facilities. (a) Facilities for the preparation, identification, and storage of the technical animal fat to be...

Surplus Facilities Management Program

International Nuclear Information System (INIS)

Coobs, J.H.

1983-01-01

This is the second of two programs that are concerned with the management of surplus facilities. The facilities in this program are those related to commercial activities, which include the three surplus experimental and test reactors [(MSRE, HRE-2, and the Low Intensity Test Reactor (LITR)] and seven experimental loops at the ORR. The program is an integral part of the Surplus Facilities Management Program, which is a national program administered for DOE by the Richland Operations Office. Very briefly reported here are routine surveillance and maintenance of surplus radioactively contaminated DOE facilities awaiting decommissioning

The National Ignition Facility (NIF) as a User Facility

Science.gov (United States)

Keane, Christopher; NIF Team

2013-10-01

The National Ignition Facility (NIF) has made significant progress towards operation as a user facility. Through June 2013, NIF conducted over 1200 experiments in support of ICF, HED science, and development of facility capabilities. The NIF laser has met or achieved all specifications and a wide variety of diagnostic and target fabrication capabilities are in place. A NIF User Group and associated Executive Board have been formed. Two User Group meetings have been conducted since formation of the User Group. NIF experiments in fundamental science have provided important new results. NIF ramp compression experiments have been conducted using diamond and iron, with EOS results obtained at pressures up to approximately 50 Mbar and 8 Mbar, respectively. Initial experiments in supernova hydrodynamics, the fundamental physics of the Rayleigh-Taylor instability, and equation of state in the Gbar pressure regime have also been conducted. This presentation will discuss the fundamental science program at NIF, including the proposal solicitation and scientific review processes and other aspects of user facility operation. This work was performed under the auspices of the Lawrence Livermore National Security, LLC, (LLNS) under Contract No. DE-AC52-07NA27344.

Challenges for proteomics core facilities.

Science.gov (United States)

Lilley, Kathryn S; Deery, Michael J; Gatto, Laurent

2011-03-01

Many analytical techniques have been executed by core facilities established within academic, pharmaceutical and other industrial institutions. The centralization of such facilities ensures a level of expertise and hardware which often cannot be supported by individual laboratories. The establishment of a core facility thus makes the technology available for multiple researchers in the same institution. Often, the services within the core facility are also opened out to researchers from other institutions, frequently with a fee being levied for the service provided. In the 1990s, with the onset of the age of genomics, there was an abundance of DNA analysis facilities, many of which have since disappeared from institutions and are now available through commercial sources. Ten years on, as proteomics was beginning to be utilized by many researchers, this technology found itself an ideal candidate for being placed within a core facility. We discuss what in our view are the daily challenges of proteomics core facilities. We also examine the potential unmet needs of the proteomics core facility that may also be applicable to proteomics laboratories which do not function as core facilities. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

7 CFR 58.127 - Facilities.

Science.gov (United States)

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Facilities. 58.127 Section 58.127 Agriculture..., Facilities, Equipment and Utensils § 58.127 Facilities. (a) Water supply. There shall be an ample supply of both hot and cold water of safe and sanitary quality, with adequate facilities for its proper...

Sustainable Facilities Management

DEFF Research Database (Denmark)

Nielsen, Susanne Balslev; Elle, Morten; Hoffmann, Birgitte

2004-01-01

The Danish public housing sector has more than 20 years of experience with sustainable facilities management based on user involvement. The paper outlines this development in a historical perspective and gives an analysis of different approaches to sustainable facilities management. The focus...... is on the housing departments and strateies for the management of the use of resources. The research methods used are case studies based on interviews in addition to literature studies. The paper explores lessons to be learned about sustainable facilities management in general, and points to a need for new...

Wind Energy Facilities

Energy Technology Data Exchange (ETDEWEB)

Laurie, Carol

2017-02-01

This book takes readers inside the places where daily discoveries shape the next generation of wind power systems. Energy Department laboratory facilities span the United States and offer wind research capabilities to meet industry needs. The facilities described in this book make it possible for industry players to increase reliability, improve efficiency, and reduce the cost of wind energy -- one discovery at a time. Whether you require blade testing or resource characterization, grid integration or high-performance computing, Department of Energy laboratory facilities offer a variety of capabilities to meet your wind research needs.

Pengaruh Pemberdayaan Aparatur Birokrasi Terhadap Motivasi Kerja Dalam Rangka Meningkatkan Kualitas Pelayanan Izin Usaha Industri di Kota Medan Sumatera Utara

OpenAIRE

Revida, Erika

2007-01-01

The fundamental problems in this research were the less of quality of industrial permit services: inefficient, ineffective, irresponsive, and unfair. The costs of services were expensive, inappropriate with standard and also length bureaucratic apparatus and enhance work motivation The purpose of this research were to study and analyze the influence of : empowerment of bureaucratic apparatus on work motivation, empowerment of bureaucratic apparatus on the quality of industri...

Facility effluent monitoring plan for the uranium trioxide facility

International Nuclear Information System (INIS)

Thompson, R.J.; Sontag, S.

1991-11-01

A facility effluent monitoring plant is required by the US Department of Energy in DOE Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements. This facility effluent monitoring plan is the first annual report. It shall ensure long-range integrity of the effluent monitoring systems by requiring an update whenever a new process or operation introduces new hazardous materials or significant radioactive materials. This document must be reviewed annually even if there are no operational changes, and it must be updated as a minimum every three years. The UO 3 Plant is located in the south-central portion of the 200 West Area of the Hanford Site. The plant consists of two primary processing buildings and several ancillary facilities. The purpose of the UO 3 Plant is to receive uranyl nitrate hexahydrate (UNH) from the Plutonium-Uranium Extraction (PUREX) Plant, concentrate it, convert the UNH to uranium trioxide (UO 3 ) powder by calcination and package it for offsite shipment. The UO 3 Plant has been placed in a standby mode. There are two liquid discharges, and three gaseous exhaust stacks, and seven building exhausters that are active during standby conditions

Nuclear physics accelerator facilities

International Nuclear Information System (INIS)

1988-12-01

This paper describes many of the nuclear physics heavy-ion accelerator facilities in the US and the research programs being conducted. The accelerators described are: Argonne National Laboratory--ATLAS; Brookhaven National Laboratory--Tandem/AGS Heavy Ion Facility; Brookhaven National Laboratory--Relativistic Heavy Ion Collider (RHIC) (Proposed); Continuous Electron Beam Accelerator Facility; Lawrence Berkeley Laboratory--Bevalac; Lawrence Berkeley Laboratory--88-Inch Cyclotron; Los Alamos National Laboratory--Clinton P. Anderson Meson Physics Facility (LAMPF); Massachusetts Institute of Technology--Bates Linear Accelerator Center; Oak Ridge National Laboratory--Holifield Heavy Ion Research Facility; Oak Ridge National Laboratory--Oak Ridge Electron Linear Accelerator; Stanford Linear Accelerator Center--Nuclear Physics Injector; Texas AandM University--Texas AandM Cyclotron; Triangle Universities Nuclear Laboratory (TUNL); University of Washington--Tandem/Superconducting Booster; and Yale University--Tandem Van de Graaff

Haemodialysis and Transplantation Facilities in South Africa

African Journals Online (AJOL)

1974-04-13

Apr 13, 1974 ... The provIsion of services in South Africa for patients suffering from chronic renal failure is inadequate in terms· of nationai requirements. A survey of the available facili- ties made in July 1973 showed that 14 maintenance haemodialysis centres had a total of 39 dialysing stations capable of treating 143 ...

National Ignition Facility system design requirements conventional facilities SDR001

International Nuclear Information System (INIS)

Hands, J.

1996-01-01

This System Design Requirements (SDR) document specifies the functions to be performed and the minimum design requirements for the National Ignition Facility (NIF) site infrastructure and conventional facilities. These consist of the physical site and buildings necessary to house the laser, target chamber, target preparation areas, optics support and ancillary functions

Irradiation facilities in JRR-3M

International Nuclear Information System (INIS)

Ohtomo, Akitoshi; Sigemoto, Masamitsu; Takahashi, Hidetake

1992-01-01

Irradiation facilities have been installed in the upgraded JRR-3 (JRR-3M) in Japan Atomic Energy Research Institute (JAERI). There are hydraulic rabbit facilities (HR), pneumatic rabbit facilities (PN), neutron activation analysis facility (PN3), uniform irradiation facility (SI), rotating irradiation facility and capsule irradiation facilities to carry out the neutron irradiation in the JRR-3M. These facilities are operated using a process control computer system to centerize the process information. Some of the characteristics for the facilities were satisfactorily measured at the same time of reactor performance test in 1990. During reactor operation, some of the tests are continued to confirm the basic characteristics on facilities, for example, PN3 was confirmed to have enough performance for activation analysis. Measurement of neutron flux at all irradiation positions has been carried out for the equilibrium core. (author)

Evaluating the effectiveness of training for nuclear facility personnel. Proceedings of the specialists' meeting

Energy Technology Data Exchange (ETDEWEB)

NONE

2003-07-01

One of the essential requirements for safe and reliable nuclear power plant operation and maintenance is the availability of competent personnel. The systematic approach to training (SAT) is recognized world-wide as the international best practice for attaining and maintaining the qualification and competence of nuclear power plant personnel. Many countries have applied and are now implementing or enhancing the use of SAT in their training systems, as demonstrated by the results of the IAEA World Survey on Nuclear Power Plant Personnel Training published in the beginning of 1999. Among the major challenges of human resource professionals is the need to measure the effectiveness of their training programs. Most training programs in the nuclear industry are effective because they are meeting legitimate needs and are conducted by competent, professional staff. Unfortunately, the extent of the impact of teaming is usually unknown or vague at best. Measurement and evaluation processes and procedures are usually inadequate or need further development and refinement. The IAEA has already been addressing the NPP personnel teaming problem during the last several years. Nevertheless, the scope of the problem is widening and new solutions are being developed. Therefore, the IAEA has decided to invite teaming professionals to a Specialists' Meeting to learn about and discuss NPP personnel training trends. The topic of this meeting, evaluating the effectiveness of training for nuclear facility personnel, was selected by the IAEA International Working Group on Training and Qualification of Nuclear Power Plant Personnel. A Specialists' Meeting on Evaluating the Effectiveness of Training for Nuclear Facility Personnel, organized in co-operation with EXITECH Corporation, the US DOE was attended by participants from 12 countries presenting 21 papers.

Evaluating the effectiveness of training for nuclear facility personnel. Proceedings of the specialists' meeting

International Nuclear Information System (INIS)

2003-01-01

One of the essential requirements for safe and reliable nuclear power plant operation and maintenance is the availability of competent personnel. The systematic approach to training (SAT) is recognized world-wide as the international best practice for attaining and maintaining the qualification and competence of nuclear power plant personnel. Many countries have applied and are now implementing or enhancing the use of SAT in their training systems, as demonstrated by the results of the IAEA World Survey on Nuclear Power Plant Personnel Training published in the beginning of 1999. Among the major challenges of human resource professionals is the need to measure the effectiveness of their training programs. Most training programs in the nuclear industry are effective because they are meeting legitimate needs and are conducted by competent, professional staff. Unfortunately, the extent of the impact of teaming is usually unknown or vague at best. Measurement and evaluation processes and procedures are usually inadequate or need further development and refinement. The IAEA has already been addressing the NPP personnel teaming problem during the last several years. Nevertheless, the scope of the problem is widening and new solutions are being developed. Therefore, the IAEA has decided to invite teaming professionals to a Specialists' Meeting to learn about and discuss NPP personnel training trends. The topic of this meeting, evaluating the effectiveness of training for nuclear facility personnel, was selected by the IAEA International Working Group on Training and Qualification of Nuclear Power Plant Personnel. A Specialists' Meeting on Evaluating the Effectiveness of Training for Nuclear Facility Personnel, organized in co-operation with EXITECH Corporation, the US DOE was attended by participants from 12 countries presenting 21 papers

Facility effluent monitoring plan for the tank farms facilities

Energy Technology Data Exchange (ETDEWEB)

Bachand, D.D.; Crummel, G.M.

1995-05-01

A facility effluent monitoring plan is required by the US Department of Energy for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. This document is prepared using specific guidelines. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements. This facility effluent monitoring plan shall ensure long-range integrity of the effluent monitoring systems by requiring an update whenever a new process or operation introduces new hazardous materials or significant radioactive materials. This document must be reviewed annually even if there are no operational changes, and it must be updated as a minimum every three years.

21 CFR 606.40 - Facilities.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Facilities. 606.40 Section 606.40 Food and Drugs... GOOD MANUFACTURING PRACTICE FOR BLOOD AND BLOOD COMPONENTS Plant and Facilities § 606.40 Facilities. Facilities shall be maintained in a clean and orderly manner, and shall be of suitable size, construction and...

Hanford Surplus Facilities Program plan

International Nuclear Information System (INIS)

Hughes, M.C.; Wahlen, R.K.; Winship, R.A.

1989-09-01

The Hanford Surplus Facilities Program is responsible for the safe and cost-effective surveillance, maintenance, and decommissioning of surplus facilities at the Hanford Site. The management of these facilities requires a surveillance and maintenance program to keep them in a safe condition and development of a plan for ultimate disposition. Criteria used to evaluate each factor relative to decommissioning are based on the guidelines presented by the US Department of Energy-Richland Operations Office, Defense Facilities Decommissioning Program Office, and are consistent with the Westinghouse Hanford Company commitment to decommission the Hanford Site retired facilities in the safest and most cost-effective way achievable. This document outlines the plan for managing these facilities to the end of disposition

Green facility location

NARCIS (Netherlands)

Velázquez Martínez, J.C.; Fransoo, J.C.; Bouchery, Y.; Corbett, C.J.; Fransoo, J.C.; Tan, T.

2017-01-01

Transportation is one of the main contributing factors of global carbon emissions, and thus, when dealing with facility location models in a distribution context, transportation emissions may be substantially higher than the emissions due to production or storage. Because facility location models

Requirements of on-site facilities

International Nuclear Information System (INIS)

Burchardt, H.

1977-01-01

1) Requirements of on-site facilities: a) brief description of supplying the site with electricity and water; communication facilities, b) necessary facilities for containment and pipeline installation, c) necessary facilities for storage, safety, accommodation of personnel, housing; workshops; 2) Site management: a) Organisation schedules for 'turn-key-jobs' and 'single commission', b) Duties of the supervisory staff. (orig.) [de

304 Concretion facility closure plan

International Nuclear Information System (INIS)

1990-04-01

The Hanford Site, located northwest of Richland, Washington, houses reactors, chemical-separation systems, and related facilities used for the production of special nuclear materials. The 300 Area of the Hanford Site contains reactor fuel manufacturing facilities and several research and development laboratories. Recyclable scrap uranium Zircaloy-2 and copper silicon alloy, uranium-titanium alloy, beryllium/Zircaloy-2 alloy, and Zircaloy-2 chips and fines were secured in concrete billets in the 304 Concretion Facility, located in the 300 Area. The beryllium/Zircaloy-2 alloy and Zircaloy-2 chips and fines are designated as low-level radioactive mixed waste (LLRMW) with the characteristic of ignitability. The concretion process reduced the ignitability of the fines and chips for safe storage and shipment. This process has been discontinued and the 304 Concretion Facility is now undergoing closure as defined in the Resource Conservation and Recovery Act of 1976 (RCRA). This closure plan presents a description of the facility, the history of materials and wastes managed, and the procedures that will be followed to close the 304 Concretion Facility (304 Facility). Clean closure of the 304 Facility is the proposed method for closure of the facility. Justification for this proposal is presented. 15 refs., 22 figs., 4 tabs

Decommissioning nuclear facilities

International Nuclear Information System (INIS)

Harmon, K.M.; Jenkins, C.E.; Waite, D.A.; Brooksbank, R.E.; Lunis, B.C.; Nemec, J.F.

1976-01-01

This paper describes the currently accepted alternatives for decommissioning retired light water reactor fuel cycle facilities and the current state of decommissioning technology. Three alternatives are recognized: Protective Storage; Entombment; and Dismantling. Application of these alternatives to the following types of facilities is briefly described: light water reactors; fuel reprocessing plants, and mixed oxide fuel fabrication plants. Brief descriptions are given of decommissioning operations and results at a number of sites, and recent studies of the future decommissioning of prototype fuel cycle facilities are reviewed. An overview is provided of the types of operations performed and tools used in common decontamination and decommissioning techniques and needs for improved technology are suggested. Planning for decommissioning a nuclear facility is dependent upon the maximum permitted levels of residual radioactive contamination. Proposed guides and recently developed methodology for development of site release criteria are reviewed. 21 fig, 32 references

Shigellosis on Indian reserves in Manitoba, Canada: its relationship to crowded housing, lack of running water, and inadequate sewage disposal.

Science.gov (United States)

Rosenberg, T; Kendall, O; Blanchard, J; Martel, S; Wakelin, C; Fast, M

1997-09-01

This study compares incidence and hospitalization rates for shigellosis between Indians and the rest of the population in Manitoba, Canada. It examines the relationship between shigellosis and environmental conditions on reserves. Rates were calculated with surveillance data and a survey of environmental infrastructure was done. Indians had shigellosis incidence and hospitalization rates that were 29 and 12 times as high, respectively, as those of the rest of the population. Household crowding, lack of piped water, and inadequate sewage disposal were significantly associated with an increased incidence of shigellosis on reserves. Many cases of shigellosis may be prevented by improving living conditions on Indian reserves.

Efficacy and safety of vildagliptin in patients with type 2 diabetes mellitus inadequately controlled with dual combination of metformin and sulphonylurea.

Science.gov (United States)

Lukashevich, V; Del Prato, S; Araga, M; Kothny, W

2014-05-01

The broadly used combination of metformin and sulphonylurea (SU) often fails to bring patients to glycaemic goal. This study assessed the efficacy and safety of vildagliptin as add-on therapy to metformin plus glimepiride combination in patients with type 2 diabetes mellitus (T2DM) who had inadequate glycaemic control. A multicentre, double-blind, placebo-controlled study randomized patients to receive treatment with vildagliptin 50 mg bid (n = 158) or placebo (n = 160) for 24 weeks. After 24 weeks, the adjusted mean change in haemoglobin A1c (HbA1c) was -1.01% with vildagliptin (baseline 8.75%) and -0.25% with placebo (baseline 8.80%), with a between-treatment difference of -0.76% (p vildagliptin achieved the HbA1c target vildagliptin and placebo was -1.13 mmol/l (p vildagliptin reduced HbA1c by 0.74% from baseline 7.82% (between-treatment difference: -0.97%; p Vildagliptin was well tolerated with low incidence of hypoglycaemia, slightly higher than with placebo (5.1% vs. 1.9%) and no clinically relevant weight gain. Vildagliptin significantly improved glycaemic control in patients with T2DM inadequately controlled with metformin plus glimepiride combination. The addition of vildagliptin was well tolerated with low risk of hypoglycaemia and weight gain. This makes vildagliptin an attractive treatment option for patients failing on metformin plus SU particularly in patients with baseline HbA1c ≤8%. © 2013 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.