Floors: Care and Maintenance.

Science.gov (United States)

Post Office Dept., Washington, DC.

Guidelines, methods and policies regarding the care and maintenance of post office building floors are overviewed in this handbook. Procedures outlined are concerned with maintaining a required level of appearance without wasting manpower. Flooring types and characteristics and the particular cleaning requirements of each type are given along with…

Maintenance program decision-making utilizing crash data.

Science.gov (United States)

2013-07-01

This document describes methods that may be used by UDOT Maintenance personnel to improve highway safety. Four programs have been recommended using crash data to make more informed decisions concerning maintenance programs as follows: : Snow & Ic...

Maintenance philosophy and program at Cernavoda NPP

International Nuclear Information System (INIS)

Bobos, M.; Enciu, G.

1994-01-01

Maintenance plays a key role in ensuring safe and reliable operation. An effective maintenance program should ensure that installed equipment operates when needed and the equipment malfunctions or deficiencies are corrected in time and rarely recur. Maintenance includes not only the activities traditionally associated with identifying or correcting current or potential equipment deficiencies but also extends to supporting technical functions for the conduct of these activities (for example, engineering, technical support, chemistry control, radiological protection, industrial safety and training). The maintenance management program should clearly define the relationship among these supporting groups as it is related to overall plant maintenance and promotes the concept of a successful integrated team effort. (Author)

25 CFR 170.804 - How is BIA's Road Maintenance Program related to the IRR Program?

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false How is BIA's Road Maintenance Program related to the IRR... WATER INDIAN RESERVATION ROADS PROGRAM BIA Road Maintenance § 170.804 How is BIA's Road Maintenance Program related to the IRR Program? The following chart illustrates how BIA's Road Maintenance Program is...

RCM [reliability-centered maintenance] at Ginna: Preventive maintenance program optimization at year 20

International Nuclear Information System (INIS)

Edgar, E.C.

1989-01-01

The reliability-centered maintenance (RCM) program at Rochester Gas ampersand Electric Company's Ginna station is entering its second year. Of the 20 systems originally selected for evaluation, 10 are in various stages of completion, and recommendations resulting from the earliest systems studied are now being implemented. As expected, few major discoveries have been made in terms of preventive maintenance program failings or excesses. The performance of the now 20-yr-old plant has been excellent in recent years, and objectives focus more on ensuring continued high standards of safety, reliability, and economy than on maintenance program cost reduction

Planning factors for developing an enterprise-wide picture archiving and communication system maintenance program.

Science.gov (United States)

Staley, S; Romlein, J; Chacko, A K; Wider, R

2000-05-01

Picture archiving and communication system (PACS) maintenance on an individual site basis has historically been a complex and costly challenge. With the advent of enterprise-wide PACS projects such as the Virtual Radiology Environment (VRE) project, the challenge of a maintenance program with even more complexities has presented itself. The approach of the project management team for the VRE project is not one of reactive maintenance, but one of highly proactive planning and negotiations, in hopes of capitalizing on the economies of scale of an enterprise-wide PACS maintenance program. A proactive maintenance program is one aspect of life-cycle management. As with any capital acquisition, life-cycle management may be used to manage the specific project aspects related to PACS. The purpose of an enterprise-wide warranty and maintenance life-cycle management approach is to maintain PACS at its maximum operational efficiency and utilization levels through a flexible, shared, yet symbiotic relationship between local, regional, and vendor resources. These goals include providing maximum operational performance levels on a local, regional, and enterprise basis, while maintaining acceptable costs and resource utilization levels. This goal must be achieved without negatively impacting point of care activities, regardless of changes to the clinical business environment.

Adherence to a maintenance exercise program 1 year after pulmonary rehabilitation: what are the predictors of dropout?

Science.gov (United States)

Heerema-Poelman, Ankie; Stuive, Ilse; Wempe, Johan B

2013-01-01

To evaluate adherence to a maintenance exercise program in patients with chronic obstructive pulmonary disease (COPD) and explore predictors for adherence. Seventy patients with COPD were referred to a home-care maintenance exercise program after completing pulmonary rehabilitation (PR) in the rehabilitation center. Adherence (yes/no) to the maintenance program was assessed by a self-reported questionnaire, where adherence was defined as attending the maintenance program 1 year after PR. Early dropouts received a self-reported questionnaire after 6 months and the remaining patients after 12 months. Lung function, exercise capacity, exercise self-efficacy, illness perceptions, health-related quality of life, levels of anxiety and depression, duration of PR, and the number of exacerbations were studied as possible predictors of adherence. Ten patients died or were lost to followup. Of the remaining 60 patients, 73.3% and 63.3% were adherent to the maintenance exercise program after 6 and 12 months, respectively. Forced expiratory volume in 1 second (FEV1) (P = .021), Hospital Anxiety and Depression Scale depression score (P = .025), and duration of PR (P = .018) were significant predictors of adherence to the maintenance program. Adherence to the maintenance exercise program included a 36.7% drop-out rate during the first year after completing PR. Experiencing exacerbations was the most reported reason for dropout. Poorer lung function, shorter initial PR course measured by reviewing patient records, and higher level of depressive symptoms were predictive of drop-out to the maintenance program. Adherence to the maintenance program needs to be improved for patients with lower FEV1, with signs of depression, or with a shorter initial PR course.

After reliability centred maintenance. Preventive maintenance living program implementation at Bruce Power

International Nuclear Information System (INIS)

Harazim, Michael L.; Ferguson, Brian J.

2003-01-01

Industrial preventive maintenance (PM) programs represent a large part of plant O and M costs. PM Optimization (PMO) projects represent an effective mechanism for identifying unnecessary PM, extending PM intervals and infusing predictive maintenance (PdM) methods. However, once optimized, what process prevents the PM program from returning to a state of disarray? This is the function of a PM living program (PMLP). In 1997, an independent performance assessment identified concerns with the applicability and effectiveness of all Ontario Power Generation, Inc. (OPGI) PM programs. In response, OPGI instituted an Integrated Maintenance Program (IMP) including Reliability Centred Maintenance (RCM) and a PMLP. It should be noted that the PMLP was developed for the 3 OPGI nuclear Sites (i.e. Bruce, Pickering, and Darlington). Effective 1 May 2001, the Bruce Site has been leased to a group of investors lead by British Energy. This paper is written in historical context and therefore refers to the Bruce Site as part of OPGI. The PMLP is made up of five elements: 1) process control, 2) change control, 3) worker feedback, 4) program performance metrics, and 5) deferral module. A PMLP software tool, originally applied to Duke Energy nuclear plants, was enhanced and customized specifically for the OPGI PMLP, and then implemented at all three of OPGI's nuclear sites. The objective of the OPGI PMLP was to: Provide processes/procedures for continual optimization of all site PM tasks, Ensure effective and timely revision of PM tasks in the work management system, Ensure PM tasks remain applicable/effective at all times, Maintain and enhance PM consistency on a component, system and Site basis, Ensure that new predictive maintenance techniques are applied and integrated with the PM program, Ensure that mandated PM tasks are identified and executed, Provide a mechanism for craft feedback, Meet regulatory requirements for PM program effectiveness, and Provide PM task deferral

Reliability-based maintenance evaluations and standard preventive maintenance programs

International Nuclear Information System (INIS)

Varno, M.; McKinley, M.

1993-01-01

Due to recent issuance of 10CFR50.65, the U.S. Nuclear Regulatory Commission maintenance rule (Rule), and the open-quotes Industry Guideline for Monitoring the Effectiveness of Maintenance at Nuclear Power Plantsclose quotes prepared by the Nuclear Management and Resources Council, many utilities are undertaking review or evaluation of current preventive maintenance (PM) programs. Although PM optimization and documentation are not specifically required by the Rule, an appropriate and effective PM program (PMP) will be the cornerstone of the successful and cost-effective implementation of the Rule. Currently, a project is being conducted at the Vermont Yankee Nuclear Power Station (VYNPS) in conjunction with Quadrex Energy Services to evaluate, optimize, and document the PMP. The project began in March 1993 and is scheduled for completion in mid-1995. The initial scope for the project is the evaluation of those structures, systems, and components that are within the scope of the Rule. Because of the number of systems to be evaluated (∼50), the desired completion schedule, and cost considerations, a streamlined approach to PM optimization and documentation is being utilized

Reliability centered Maintenance (RCM) program for Chashma NPP (CHASNUPP)

International Nuclear Information System (INIS)

Khalid, S.; Khan, S.A.

2000-01-01

This paper describes the proposed Reliability Centered Maintenance (RCM) program for Chashma Nuclear Power Plant (CHASNUPP). Major steps are the identification of risk critical components and the implementation of RCM procedures. Identification of risk critical components is based upon the CHASNUPP level 1 PSA results (performed under IAEA TC Project PAK/9/019) which is near completion. The other requirements for implementation of RCM program is the qualitative analysis to be performed for identifying the dominant potential failure modes of each risk critical component and determination of the necessary maintenance activities, required to ensure reliable operation of the identified risk critical components. Implementation of RCM program for these components will lead to improvement in plant availability and safety together with reduction in the maintenance cost. Development - implementation of RCM program at this stage will help the CHASNUPP Maintenance department who is now developing the maintenance program - procedures for CHASNUPP. (author)

25 CFR 170.801 - What is the BIA Road Maintenance Program?

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false What is the BIA Road Maintenance Program? 170.801 Section... ROADS PROGRAM BIA Road Maintenance § 170.801 What is the BIA Road Maintenance Program? The BIA Road... subpart contains a list of activities that are eligible for funding under the BIA road maintenance program. ...

25 CFR 170.2 - What is the IRR Program and BIA Road Maintenance Program policy?

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false What is the IRR Program and BIA Road Maintenance Program... and BIA Road Maintenance Program policy? (a) It is the policy of the Secretary of the Interior and the... designed to enable Indian tribes to participate in all contractible IRR and BIA Road Maintenance programs...

Building Maintenance. Florida Vocational Program Guide.

Science.gov (United States)

University of South Florida, Tampa. Dept. of Adult and Vocational Education.

This program guide identifies primary concerns in the organization, operation, and evaluation of a building maintenance program. It is designed for local school district and community college administrators, instructors, program advisory committees, and regional coordinating councils. The guide begins with the Dictionary of Occupational Titles…

Using systematic aging assessments to improve effectiveness of plant maintenance programs

International Nuclear Information System (INIS)

Watson, P.; Yang, J.X.; Dam, R.F.; Nickerson, J.H.

2003-01-01

Nuclear plant equipment aging assessment studies provided by AECL include life assessments, condition assessments or systematic assessments of maintenance. AECL has developed several tools to apply the results of aging assessment studies to improve the effectiveness of actual plant maintenance programs. The Systematic Assessment of Maintenance and the SYSTMS tool generate maintenance tasks for a system. The System Maintenance Datastore tool assesses the maintenance resources on a system basis, and can thus quantify the savings realized by optimizing the maintenance program. Long term trends in condition-based maintenance due to component aging can be predicted, and resource savings due to optimum timing of component replacement or general plant refurbishment can be quantified. The System based Adaptive Maintenance Process ensures the maintenance program is continually updated to reflect the latest plant equipment condition and maintenance strategy information. (author)

[Maintenance care for dental implant].

Science.gov (United States)

Kamoi, K

1989-10-01

Dental implant has tried at the early stage in 19th century recovering an oral function and esthetics. Technological revolutions in biochemical and new materials have developed on the remarkable change in the dental implants, nowadays we call the three generation therapy for dental implantology. There are many kinds of methods and techniques in dental implants, however a lot of troublesome complication on the process of surgical phase, construction of prothodontics and prognosis of maintenance care. In the proceedings of this symposium, I would like to propose you how to manage the maintenance care for various kind of dental implants through the methodology and case presentations. Tendenay and future for dental implants The current outlook of dental implant has increasing supply and demand not only dentists but also patients. According to Japanese Welfare Ministry's report in 1987, average missing teeth over sixty years old generations are approximately 42% in accordance with NIDR (U.S.A.) research. They are missed on ten over teeth in full 28th teeth dentitions owing to dental caries and periodontal diseases. Generally speaking, latent implant patients are occupied on the same possibility of needs for dental implants both Japan and U.S.A. Management of maintenance care The patients hardly recognized the importance of plaque control for the maintenance care in the intraoral condition after implantation. Dentists and dental staffs must be instruct patients for importance of plaque removal and control, because they already had forgotten the habit of teeth cleaning, especially in the edenturous conditions. 1) Concept of establishment in oral hygiene. Motivation and instruction for patients include very important factors in dental implants as well as in periodontal diseases. Patients who could not achieve on good oral hygiene levels obtained no good results in the long term observations. To establish good oral hygiene are how to control supra plaque surrounding tissues

Long-period maintenance program of JRR-3M

International Nuclear Information System (INIS)

Murayama, Yoji; Onozaki, Michio; Kakefuda, Kazuhiro

1999-01-01

The JRR-3M is a swimming pool type research reactor with maximum thermal output of 20 MW, classed in a large-scale research reactor and composed of numerous facilities. An operation cycle consists of 4 weeks of continuously reactor operation and 1 week of shutdown work such as fuel exchange and irradiation sample handling. The temporary and small-scale maintenance is also carried out during the shutdown period. Systematic maintenance period through a year usually follows 2 stages. The former stage of about 4 weeks is prepared to maintain the general facilities related to the overall reactor system such as computer system. The latter stage of about 9 weeks is prepared to maintain the other individual facilities such as cooling facilities and control facilities that are to be inspected by the regulatory body. Since preventive maintenance is required in order to achieve an improvement of safety, reliability and availability throughout the life cycle of the reactor, a long-period maintenance program should be prepared properly in consideration of an ageing degradation of the facilities. The long-period maintenance program of JRR-3M, which determines not only the replacement frequency but also the maintenance frequency of the facilities, is made on the basis of an ageing degradation of the facilities, irradiation effects of the materials, recommendations from the manufacturer and JRR-3M maintenance records. The replacement frequency recommended by the manufacturer is examined from the viewpoint of the safety significance of the facilities and availability of the components. The program is arranged so that it may not concentrate the replacement of the facilities in the specific fiscal year and smooth the budget and maintenance period throughout the life cycle of the reactor. There have been two unanticipated failures of the facilities, which required rearranging the program. (author)

Program strategies for maintenance management, organization and planning

International Nuclear Information System (INIS)

Czegeny, J.I.

2003-01-01

In this paper we look respectively at three specific examples showing program strategies for maintenance management, organization and planning. Starting with preventive maintenance optimization, we will look at one Bruce B Predefined task on the Reactor Regulating System to illustrate reduced maintenance requirement, a maintenance management strategy. Next discussed is the organizational strategy at Darlington to have an engineering program meet the jurisdictional requirements for maintaining certification for TSSA registered pressure vessels. The last look-see will show the earned value of the planning for the first Pickering A unit to be returned to service. Finally all the above is tied together in a compare and contrast of what works and what could be improved upon. (author)

32 CFR 644.368 - Procedures and responsibilities for care, custody, accountability, and maintenance.

Science.gov (United States)

2010-07-01

..., accountability, and maintenance. 644.368 Section 644.368 National Defense Department of Defense (Continued... Surplus Property § 644.368 Procedures and responsibilities for care, custody, accountability, and maintenance. (a) Department of the Army military property. Care, custody, accountability, and maintenance of...

The Nordic maintenance care program – case management of chiropractic patients with low back pain: A survey of Swedish chiropractors

Directory of Open Access Journals (Sweden)

Jørgensen Kristian

2008-06-01

Full Text Available Abstract Background Chiropractic treatment for low back pain (LBP can often be divided into two phases: Initial treatment of the problem to attempt to remove pain and bring it back into its pre-clinical or maximum improvement status, and "maintenance care", during which it is attempted to maintain this status. Although the use of chiropractic maintenance care has been described and discussed in the literature, there is no information as to its precise indications. The objective of this study is to investigate if there is agreement among Swedish chiropractors on the overall patient management for various types of LBP-scenarios, with a special emphasis on maintenance care. Method The design was a mailed questionnaire survey. Members of the Swedish Chiropractors' Association, who were participants in previous practice-based research, were sent a closed-end questionnaire consisting of nine case scenarios and six clinical management alternatives and the possibility to create one's own alternative, resulting in a "nine-by-seven" table. The research team defined its own pre hoc choice of "clinically logical" answers based on the team's clinical experience. The frequency of findings was compared to the suggestions of the research team. Results Replies were received from 59 (60% of the 99 persons who were invited to take part in the study. A pattern of self-reported clinical management strategies emerged, largely corresponding to the "clinically logical" answers suggested by the research team. In general, patients of concern would be referred out for a second opinion, cases with early recovery and without a history of previous low back pain would be quickly closed, and cases with quick recovery and a history of recurring events would be considered for maintenance care. However, also other management patterns were noted, in particular in the direction of maintenance care. Conclusion To a reasonable extent, Swedish chiropractors participating in this

Preventive maintenance program of motorized operated valves (MOV) at Cernavoda NPP

International Nuclear Information System (INIS)

Groza, M.; Moldoveanu, Edy

2001-01-01

This is a Power Point presentation. The following objectives are addressed: A. Determine the target of MOV program; B. Define the strategy for MOV; C. Establish the MOV program execution phases; D. Identification of key parameters; E. Examples. The target of MOV program is to improve the safety by ensuring the adequacy of safety valves and the reliability of safety equipment and, subsequently, to ensure the economic operation of the plant. Consequences of MV malfunction are indicated. The strategy for MOV program development is both general, namely, to define the minimal requirements of preventive /corrective maintenance activities for all MOV's according to design/ manufacture specification and particular, namely to identify MV's specific problems and the need for increasing/decreasing the preventing maintenance tasks or frequency established in 'general' MOV program. Strategy for MOV program development implies: - Establish MOV program applicability; - Develop diagnostic strategy (define key parameters ); - Perform program for engineering review; - Establish program for preventive maintenance; - Revise procedures for operating and maintenance tests; - Dynamic evaluation of MOV. The program execution phases are listed as follows: 1. Perform risk assessment of the MOV's to determine criticality level (program applicability); 2. Collect data to fill in MOV Application Data Sheet; 3. Perform engineering review to determine functional parameters acceptable range and determine key parameters; 4. Analysis for maintenance tasks / frequencies selection and determination of implementing actions (engineer review); 5. Prepare work packages for availability confirmation; 6. Schedule and plan corrective actions or provide input to other programs; 7. Schedule and plan implementing actions in preparation for program field execution; 8. Program field implementation; 9. Program monitoring, evaluation and optimization. The criteria defining the key operational and maintenance

Establishing a predictive maintenance program at the Hanford Site

International Nuclear Information System (INIS)

Winslow, R.W.

1994-05-01

This document contains information about a new Predictive Maintenance Program being developed and implemented at the Hanford Reservation. Details of the document include: background on persons developing the program, history of predictive maintenance, implementation of new program, engineering task analysis, network development and new software, issues to be resolved, benefits expected, and appendix gives information about the symposium from which this paper is based

A study on maintenance rule program and its application at Korean NPPs

International Nuclear Information System (INIS)

Hwang, Mee Jeong; Kim, Kil Yoo; Kang, Dae Il; Yang, Joon Eon; Ha, Jae Joo

2000-11-01

The objective of the Maintenance Rule is to require monitoring of the overall continuing effectiveness of licensee maintenance programs to ensure that safety related and certain nonsafety-related SSCs are capable of performing their intended functions and, for nonsafety-related equipment failures will not occur that prevent the fulfillment of safety-related functions, and failures resulting in scrams and unnecessary actuations of safety-related systems are minimized. That is, proper maintenance is essential to plant safety. U.S. Maintenance Rule, which was effective July 1996 in USA., was not officially adopted in Korea by Korean regulatory body. However, since many PSA and IPE have been performed for NPPs, the philosophy and usefulness of the Maintenance Rule as well as performance-based regulation are being acceptable. We survey the Maintenance Rule program and applications in the USA, and also developed the Maintenance Rule program to apply to Korean NPPs. In addition, we applied the Maintenance Rule Program apply to Ulchin 3,4 Units roughly with the Maintenance Rule Program developed in this project

A study on maintenance rule program and its application at Korean NPPs

Energy Technology Data Exchange (ETDEWEB)

Hwang, Mee Jeong; Kim, Kil Yoo; Kang, Dae Il; Yang, Joon Eon; Ha, Jae Joo

2000-11-01

The objective of the Maintenance Rule is to require monitoring of the overall continuing effectiveness of licensee maintenance programs to ensure that safety related and certain nonsafety-related SSCs are capable of performing their intended functions and, for nonsafety-related equipment failures will not occur that prevent the fulfillment of safety-related functions, and failures resulting in scrams and unnecessary actuations of safety-related systems are minimized. That is, proper maintenance is essential to plant safety. U.S. Maintenance Rule, which was effective July 1996 in USA., was not officially adopted in Korea by Korean regulatory body. However, since many PSA and IPE have been performed for NPPs, the philosophy and usefulness of the Maintenance Rule as well as performance-based regulation are being acceptable. We survey the Maintenance Rule program and applications in the USA, and also developed the Maintenance Rule program to apply to Korean NPPs. In addition, we applied the Maintenance Rule Program apply to Ulchin 3,4 Units roughly with the Maintenance Rule Program developed in this project.

14 CFR 129.113 - Fuel tank system maintenance program.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Fuel tank system maintenance program. 129... Continued Airworthiness and Safety Improvements § 129.113 Fuel tank system maintenance program. (a) Except... on which an auxiliary fuel tank is installed under a field approval, before June 16, 2008, the...

14 CFR 121.1113 - Fuel tank system maintenance program.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Fuel tank system maintenance program. 121... Improvements § 121.1113 Fuel tank system maintenance program. (a) Except as provided in paragraph (g) of this... capacity of 7500 pounds or more. (b) For each airplane on which an auxiliary fuel tank is installed under a...

A comprehensive approach to RCM-based preventive maintenance program development

International Nuclear Information System (INIS)

Hall, B.E.; Davis, T.; Pennington, A.J.

1988-01-01

In late 1986, Public Service Electric and Gas Company (PSE ampersand G) concluded that to support its vision and strategic planning it would be necessary to develop a consistent approach to maintenance for all nuclear units at the artificial island. General Physics Corporation was selected to lead a consultant team to support full-scale development of a preventive maintenance (PM) program for Salem and Hope Creek generating stations based on a reliability-centered maintenance (RCM) approach. RCM was selected because it represents a systematic approach to developing a PM program that provides a logical, consistent, and traceable methodology and produces a well-documented engineering basis for the program. Early in 1987, primary objectives for the PM program were defined. The Phase I tasks addressed key programmatic areas such as maintenance philosophy, procedures, condition monitoring, performance trending, equipment failure data base, ogranization, PM program effectiveness evaluation, RCM process, reliability/availability modeling, information management, training, spare parts, software/hardware, and commitments. Phase I of the PM program development project was completed in January 1988. Highlights of the Phase I work and the PM program manual are described

Method and computer program product for maintenance and modernization backlogging

Science.gov (United States)

Mattimore, Bernard G; Reynolds, Paul E; Farrell, Jill M

2013-02-19

According to one embodiment, a computer program product for determining future facility conditions includes a computer readable medium having computer readable program code stored therein. The computer readable program code includes computer readable program code for calculating a time period specific maintenance cost, for calculating a time period specific modernization factor, and for calculating a time period specific backlog factor. Future facility conditions equal the time period specific maintenance cost plus the time period specific modernization factor plus the time period specific backlog factor. In another embodiment, a computer-implemented method for calculating future facility conditions includes calculating a time period specific maintenance cost, calculating a time period specific modernization factor, and calculating a time period specific backlog factor. Future facility conditions equal the time period specific maintenance cost plus the time period specific modernization factor plus the time period specific backlog factor. Other embodiments are also presented.

The International Coal Statistics Data Base program maintenance guide

International Nuclear Information System (INIS)

1991-06-01

The International Coal Statistics Data Base (ICSD) is a microcomputer-based system which contains information related to international coal trade. This includes coal production, consumption, imports and exports information. The ICSD is a secondary data base, meaning that information contained therein is derived entirely from other primary sources. It uses dBase III+ and Lotus 1-2-3 to locate, report and display data. The system is used for analysis in preparing the Annual Prospects for World Coal Trade (DOE/EIA-0363) publication. The ICSD system is menu driven and also permits the user who is familiar with dBase and Lotus operations to leave the menu structure to perform independent queries. Documentation for the ICSD consists of three manuals -- the User's Guide, the Operations Manual, and the Program Maintenance Manual. This Program Maintenance Manual provides the information necessary to maintain and update the ICSD system. Two major types of program maintenance documentation are presented in this manual. The first is the source code for the dBase III+ routines and related non-dBase programs used in operating the ICSD. The second is listings of the major component database field structures. A third important consideration for dBase programming, the structure of index files, is presented in the listing of source code for the index maintenance program. 1 fig

Cost effectiveness of the MDOT preventive maintenance program.

Science.gov (United States)

2013-04-01

The Michigan Department of Transportations (MDOT) pavement preservation program dates back to 1992. MDOTs pavement preservation strategy is primarily implemented through its capital preventive maintenance (CPM) program, in which preventive main...

Laboratory services series: a master-slave manipulator maintenance program

International Nuclear Information System (INIS)

Jenness, R.G.; Hicks, R.E.; Wicker, C.D.

1976-12-01

The volume of master slave manipulator maintenance at Oak Ridge National Laboratory has necessitated the establishment of a repair facility and organization of a specially trained group of craftsmen. Emphasis on cell containment requires the use of manipulator boots and development of precise procedures for accomplishing the maintenance of 287 installed units. A very satisfactory computer programmed maintenance system has been established at the Laboratory to provide an economical approach to preventive maintenance

Population-Level Density Dependence Influences the Origin and Maintenance of Parental Care.

Science.gov (United States)

Reyes, Elijah; Thrasher, Patsy; Bonsall, Michael B; Klug, Hope

2016-01-01

Parental care is a defining feature of animal breeding systems. We now know that both basic life-history characteristics and ecological factors influence the evolution of care. However, relatively little is known about how these factors interact to influence the origin and maintenance of care. Here, we expand upon previous work and explore the relationship between basic life-history characteristics (stage-specific rates of mortality and maturation) and the fitness benefits associated with the origin and the maintenance of parental care for two broad ecological scenarios: the scenario in which egg survival is density dependent and the case in which adult survival is density dependent. Our findings suggest that high offspring need is likely critical in driving the origin, but not the maintenance, of parental care regardless of whether density dependence acts on egg or adult survival. In general, parental care is more likely to result in greater fitness benefits when baseline adult mortality is low if 1) egg survival is density dependent or 2) adult mortality is density dependent and mutant density is relatively high. When density dependence acts on egg mortality, low rates of egg maturation and high egg densities are less likely to lead to strong fitness benefits of care. However, when density dependence acts on adult mortality, high levels of egg maturation and increasing adult densities are less likely to maintain care. Juvenile survival has relatively little, if any, effect on the origin and maintenance of egg-only care. More generally, our results suggest that the evolution of parental care will be influenced by an organism's entire life history characteristics, the stage at which density dependence acts, and whether care is originating or being maintained.

25 CFR 170.803 - What facilities are eligible under the BIA Road Maintenance Program?

Science.gov (United States)

2010-04-01

... AND WATER INDIAN RESERVATION ROADS PROGRAM BIA Road Maintenance § 170.803 What facilities are eligible under the BIA Road Maintenance Program? (a) The following public transportation facilities are eligible for maintenance under the BIA Road Maintenance Program: (1) BIA transportation facilities listed in...

National Synchrotron Light Source Facility Manual Maintenance Management Program. Revision 1

Energy Technology Data Exchange (ETDEWEB)

Fewell, N.

1993-12-01

The purpose of this program s to meet the policy and objectives for the management and performance of cost-effective maintenance and repair of the National Synchrotron Light Source, as required by the US Department of Energy order DOE 433O.4A. It is the DOE`s policy that: The maintenance management program for the NSLS be consistent with this Order and that NSLS property is maintained in a manner which promotes operational safety, worker health, environmental protection and compliance, property preservation, and cost-effectiveness while meeting the NSLS`s programmatic mission. Structures, components and systems (active and passive) that are imporant to safe operation of the NSLS shall be subject to a maintenance program to ensure that they meet or exceed their design requirements throughout the life of the NSLS. Periodic examination of structures, systems components and equipment be performed to determine deterioration or technical obsolescence which may threaten performance and/or safety. Primary responsibility, authority, and accountability for the direction and management of the maintenance program at the NSLS reside with the line management assigned direct programmatic responsibility. Budgeting and accounting for maintenance programs are consistent with DOE Orders guidance.

Population-Level Density Dependence Influences the Origin and Maintenance of Parental Care.

Directory of Open Access Journals (Sweden)

Elijah Reyes

Full Text Available Parental care is a defining feature of animal breeding systems. We now know that both basic life-history characteristics and ecological factors influence the evolution of care. However, relatively little is known about how these factors interact to influence the origin and maintenance of care. Here, we expand upon previous work and explore the relationship between basic life-history characteristics (stage-specific rates of mortality and maturation and the fitness benefits associated with the origin and the maintenance of parental care for two broad ecological scenarios: the scenario in which egg survival is density dependent and the case in which adult survival is density dependent. Our findings suggest that high offspring need is likely critical in driving the origin, but not the maintenance, of parental care regardless of whether density dependence acts on egg or adult survival. In general, parental care is more likely to result in greater fitness benefits when baseline adult mortality is low if 1 egg survival is density dependent or 2 adult mortality is density dependent and mutant density is relatively high. When density dependence acts on egg mortality, low rates of egg maturation and high egg densities are less likely to lead to strong fitness benefits of care. However, when density dependence acts on adult mortality, high levels of egg maturation and increasing adult densities are less likely to maintain care. Juvenile survival has relatively little, if any, effect on the origin and maintenance of egg-only care. More generally, our results suggest that the evolution of parental care will be influenced by an organism's entire life history characteristics, the stage at which density dependence acts, and whether care is originating or being maintained.

[Effectiveness of a mindfulness program in primary care professionals].

Science.gov (United States)

Martín Asuero, Andrés; Rodríguez Blanco, Teresa; Pujol-Ribera, Enriqueta; Berenguera, Anna; Moix Queraltó, Jenny

2013-01-01

To determine the long-term effects of a mindfulness program on burnout, mood states, empathy, and mindfulness in primary care professionals. A repeated measures before-after study was performed in 87 participants working in primary care. The variables evaluated were scores of the Burnout Inventory (Maslach), mood states (Profile of Mood States [POMS]), empathy (Jefferson Scale of Physician Empathy [JSPE]) and mindfulness (Five Facet Mindfulness Questionnaire [FFMQ]), adherence to the intervention, and changes in attitudes. Evaluations were performed at baseline, at 8 weeks, and at 6 and 12 months. The intervention lasted for 1 year and consisted of two training phases, an intensive first phase lasting 28 hours, spread over 8 weeks, and a second, maintenance phase of 25 hours spread over 10 months. The effect of the intervention was assessed through observed change, standardized response mean (SRM), and linear mixed-effects models on repeated measures. The scores of all the scales improved significantly during the follow-up compared with baseline scores. The greatest differences were obtained at 12 months, especially in the the FFMQ (SRM: 1.4), followed by the POMS (SRM: 0,8). The greatest improvement in the maintenance phase was found in the difference between consecutive scores. The only scale that showed major changes in all phases was the FFMQ scale. At the end of the intervention, 89% of participants practiced the exercises of the program on their own and 94% reported improvements in self-care and greater professionalism. A psychoeducational program based on mindfulness reduces burnout and improves mood states, empathy, and mindfulness, while encouraging better self-care. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

Long-Term Weight Maintenance after a 17-Week Weight Loss Intervention with or without a One-Year Maintenance Program: A Randomized Controlled Trial

Directory of Open Access Journals (Sweden)

Tuula Pekkarinen

2015-01-01

Full Text Available Background. Weight lost by obese patients is almost always regained over time. Extended treatment may improve maintenance, but solid evidence is lacking. Purpose. We determined effectiveness of maintenance therapy after a weight loss program. Methods. Together 201 patients (mean age 47 years and BMI 42 kg/m2, 71% women were randomly assigned to either a 17-week weight loss program followed by a one-year maintenance program or to a weight loss program without subsequent maintenance intervention. The weight loss program included behavior modification and a very-low-calorie diet, and maintenance program behavior modification. The primary outcome measure was percentage of patients with 5% or more weight loss at the end of maintenance (week 69 and one year later (week 121. Secondary outcomes were weight related changes in lifestyle and quality of life. Results. At week 69, 52% of the patients with and 44% of those without maintenance program had lost weight ≥5%, P=0.40, and, at week 121, 33% and 34%, P=0.77, respectively. At week 121 secondary outcomes did not differ between the groups among those successfully followed up. Conclusions. This one-year maintenance program was not effective in preventing weight regain in severely obese patients. Trial Registration. This trial is registered under clinicaltrials.gov Identifier: NCT00590655.

Implementing a Reliability Centered Maintenance Program at NASA's Kennedy Space Center

National Research Council Canada - National Science Library

Tuttle, Raymond

1998-01-01

.... A reliability centered maintenance (RCM) program seeks to offer equal or greater reliability at decreased cost by insuring only applicable, effective maintenance is performed and by in large part replacing time based maintenance...

14 CFR 91.1411 - Continuous airworthiness maintenance program use by fractional ownership program manager.

Science.gov (United States)

2010-01-01

... program use by fractional ownership program manager. 91.1411 Section 91.1411 Aeronautics and Space FEDERAL... airworthiness maintenance program use by fractional ownership program manager. Fractional ownership program... through 91.1443. Any program manager who elects to maintain the program aircraft using a continuous...

A study on maintenance rule program and its application to Korean NPP - Rev.1

International Nuclear Information System (INIS)

Hwang, Mee Jeong; Kim, Kil Yoo; Yang, Joon Eon; Ha, Jae Joo

2001-03-01

The objective of the Maintenance Rule is to require monitoring of the overall continuing effectiveness of licensee maintenance programs to ensure that safety related and certain nonsafety-related SSCs are capable of performing their intended functions and, for nonsafety-related equipment failures will not occur that prevent the fulfillment of safety-related functions, and failures resulting in scrams and unnecessary actuations of safety-related systems are minimized. That is, proper maintenance is essential to plant safety. U.S. Maintenance Rule, which was effective July 1996 in USA., was not officially adopted in Korea by Korean regulatory body. However, since many PSA and IPE have been performed for NPPs, the philosophy and usefulness of the Maintenance Rule as well as performance-based regulation are being acceptable. We survey the Maintenance Rule program and applications in the USA, and also developed the Maintenance Rule program to apply to Korean NPPs. In addition, we applied the Maintenance Rule Program apply to Ulchin 3,4 Units roughly with the Maintenance Rule Program developed in this project

Tandem mirror next step: remote maintenance

International Nuclear Information System (INIS)

Doggett, J.N.; Damm, C.C.; Hanson, C.L.

1980-01-01

This study of the next proposed experiment in the Mirror Fusion Program, the Tandem Mirror Next Step (TMNS), has included serious consideration of the maintenance requirements of such a large source of high energy neutrons with its attendant throughput of tritium. Although maintenance will be costly in time and money, our conclusion is that with careful attention to a design for maintenance plan such a device can be reliably operated

A Planned Preventive Maintenance Program. A Handbook for Chief Business Officers and Supervisors of Maintenance with Suggestions on Maintenance for Consideration by Presidents of Higher Institutions.

Science.gov (United States)

Daniel, Clarence H.

This handbook explains planned preventive maintenance program, which is an operational system of maintenance designed to increase the effectiveness of the maintenance staff and the use of maintenance funds through efficient scheduling of inspections and follow-through of work to be performed. Sections are included for the chief administrative…

Enhanced human performance of utility maintenance programs

International Nuclear Information System (INIS)

Fresco, A.; Haber, S.; O'Brien, J.

1993-01-01

Assuring the safe operation of a nuclear power plant depends, to a large extent, on how effectively one understands and manages the aging-related degradation that occurs in structures, systems, and components (SSCs). Aging-related degradation is typically managed through a nuclear plant's maintenance program. A review of 44 Maintenance Team Inspection (MTI) Reports indicated that while some plant organizations appeared to assume a proactive mode in preventing aging-related failures of their SSCs important to safety, others seemed to be taking a passive or reactive mode. Across all plants, what is clearly needed, is a strong recognition of the importance of aging-related degradation and the use of existing organizational assets to effectively detect and mitigate those effects. Many of those assets can be enhanced by the consideration of organizational and management factors necessary for the implementation of an effective aging management program. This report provides a discussion of this program

21 CFR 1271.160 - Establishment and maintenance of a quality program.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Establishment and maintenance of a quality program... Establishment and maintenance of a quality program. (a) General. If you are an establishment that performs any... corrective actions relating to core CGTP requirements, including reaudits of deficiencies, are taken and...

Status of the reliability centered maintenance program at Ontario Hydro's Bruce 'A' Nuclear Division

International Nuclear Information System (INIS)

Khan, I.

1995-01-01

Bruce A started a preventive maintenance (PM) quality improvement program in August of 1991. This initiative was taken to address the concerns expressed by the AECB and the Peer Audits finding. The concerns were on the quality of the Bruce A PM Program and its execution in the field. Reliability Centered Maintenance (RCM) analysis was selected as the PM program quality improvement and optimization technique. Therefore, RCM became a key component of Bruce A's Integrated PM program and maintenance strategy. As a result of RCM implementation, and improvements in the work planning and scheduling process, Bruce A is seeing downward trends in the corrective maintenance work load, maintenance preventable forced outages, overdue/missed PM tasks and corrective maintenance backlog. Control Room Operators have reported observing an improvement in systems and equipment response to transients. Other benefits include a documented, controlled and traceable PM program. In addition, the team approach required by RCM has started to improve staff confidence in the PM program which, in turn, is improving the compliance with the PM program. (author)

Florida maintenance rating program (MRP) assessment and enhancement : final report, May 28, 2008 [summary].

Science.gov (United States)

2008-01-01

The Florida Department of Transportation : (FDOT) has used its maintenance rating : program (MRP) to evaluate the states : highway maintenance conditions and : determine asset maintenance needs since : 1985. Periodic evaluation of the program is :...

Building Maintenance and Utilities Management. Florida Vocational Program Guide.

Science.gov (United States)

University of South Florida, Tampa. Dept. of Adult and Vocational Education.

This program guide identifies primary concerns in the organization, operation, and evaluation of a building maintenance and utilities management program. It is designed for local school district and community college administrators, instructors, program advisory committees, and regional coordinating councils. The guide begins with the Dictionary…

Florida maintenance rating program (MRP) assessment and enhancement : final report, May 28, 2008.

Science.gov (United States)

2008-05-28

The Maintenance Rating Program (MRP), developed in 1985 by FDOT, is a statewide maintenance system aimed : at evaluating the State highway maintenance conditions, and determining FDOT asset maintenance needs. In the : quest for continuous improvement...

A study of adopting maintenance rule under the periodic safety review and reliability centered maintenance program

International Nuclear Information System (INIS)

Kilyoo, Kim

2001-01-01

U.S Maintenance Rule (MR) has three main functions. One is to monitor the performance changes of SSCs (Structure, System, and Component) caused by risk informed applications. Periodic Safety Review (PSR) program is widely adopted in Europe while it is not adopted in U. S. A where MR and new oversight program are instead used. Recently, in Korea, it was determined to adopt PSR, and the first PSR program has started this year for Kori unit 1 as a pilot plant. Also, a traditional Reliability Centered Maintenance (RCM) has been performed for 4 systems of YGN unit 1 and 2 and it will be applied to the other nuclear power plants in Korea. However, since MR is adopting many useful concept of RCM, traditional RCM could not be further performed without being associated with MR. Thus, MR, RCM and PSR have recently become hot issue policies which should be well associated each other in Korea, and this paper suggests a desirable new maintenance process which would embrace the concepts of the three policies, and also discusses whether U.S. MR is necessary even though a PSR program is already adopted, and if necessary, then how cost-effectively it can be introduced to. (author)

Development of Simulator Maintenance Engineer Qualification Program Draft

International Nuclear Information System (INIS)

Chung, Kyung Hun

2010-01-01

As of 2009, KHNP has currently seven full scope simulators that are used for training of Nuclear Power Plant (NPP) Operators. Well-trained Simulator Maintenance Engineers (SME) are required to support these simulators. These SMEs will maintain and address any issues identified or any changes required for keep up the simulator with their respective plant sites. These issues will be identified as Simulator Discrepancy Reports (DR) or Work Order (WO) by the simulator operation personnel in KHNP. The simulator maintenance is a very complex. The simulator consists of many areas of process and requires experts in software modeling for different processes such as Neutronics, thermohydraulics, Logics, control, Electrical systems and computer systems as well as hardware subjects such as I and C, I/O, computers, etc. All these areas need experts the subject expertise need to be divided among SME's. In other word the SME's need to be trained for different expertise as well as having different level of SME's. KHNP has seen the need to outsource the maintenance work for these complex simulators. To have one company concentrating on this work will have many benefits such as: · Provides proper and well trained experts · Maintains consistent support personnel · Maintains the maintenance history for the simulator · Coordinates and Maintains the knowledge in house · The simulator maintenance will be consistent In order to accomplish the goals, KEPCO RI has recognized that there is a need for a program to adequately train and qualify the SME's. KEPCO RI and GSE, which has provided 6 simulators among 7 NPP simulators in Korea, have jointly developed this Simulator Maintenance Engineer Qualification Program (SMEQP). After issue of this plan, KEPCO RI will maintain and modify as needed periodically to meet the goals and purpose of the plan

Improved Navy Maintenance Through Corrosion-Fatigue Assessment Program

National Research Council Canada - National Science Library

Hoppe, Wally

2008-01-01

... to evaluate issues relevant to corrosion-fatigue of aircraft components. In this multi-year, multi-contract program, tools have been developed to assist in the establishment of maintenance options for corroded components...

Preventive maintenance and reliability-centered maintenance

International Nuclear Information System (INIS)

Anderson, J.G.

1989-01-01

In the recent past, the primary function of the preventive maintenance program at a nuclear power plant was to maintain the operability and reliability of the plant. Reducing overall maintenance costs by performing effective preventive maintenance, instead of more costly and disruptive corrective maintenance, instead of more costly and disruptive corrective maintenance, was a secondary consideration. In today's operating environment, the preventive maintenance program must meet the test of cost-effectiveness as well as many new standards for performance that are being required by rate regulators. The preventive maintenance program must be able to withstand the challenge of independent audit to a new standard of technical adequacy and compliance with recommendations from component vendors. In this new environment, the standard that is being applied at the San Onofre nuclear generating station (SONGS) is that the preventive maintenance program must meet the test of cost-effectiveness, improve equipment performance, support increased plant availability, and (a) literally implement the recommendations of the vendor, (b) provide other compensation for the vendor recommendation, or (c) provide technical justification for the deviation. The subject of this paper is the way that reliability-centered maintenance (RCM) is helping SONGS meet these challenges

Status of maintenance in the US nuclear power industry 1985. Volume 2. Description of programs and practices

International Nuclear Information System (INIS)

1986-06-01

This report documents a review of the status of maintenance programs and practices in the US commercial nuclear power industry. The purpose of this review is to establish a baselines reference for evaluating the effectiveness of future industry activities in maintenance. Two methods used to collect progammatic data. First, a Maintenance Review Protocol was used during site visits to eight selected power plants to collect in-depth maintenance program information. Second, a Maintenance Questionnaire was filled out by NRC Resident Inspectors regarding maintenance programs at their plant. The protocol and questionnaire contained items regarding five broad categories of maintenance: (1) organization and administration, (2) facilities and equipment, (3) procedures, (4) personnel, and (5) work control. The study found that there is wide variability in industry maintenance programs. However, the industry is currently undergoing changes in maintenance practices, and adherence to INPO and NUMARC guidance in maintenance may bring about more systematically developed program practices

Standards for maintenance documentation of COSMOS programs

International Nuclear Information System (INIS)

Burstall, R.F.; Rickets, T.M.; Butland, A.T.D.

1982-06-01

The Compatible Open Shop Modular Operating Scheme (COSMOS) is used for fast reactor neutronics and subassembly distortion calculations in the UK. It provides database and databank facilities for this purpose. A large number of applications programs use these facilities. This report sets down the standards agreed for use in the preparation of maintenance documents for these programs. These standards have been developed as the result of experience with earlier more complicated standards. Some of the terminology used in this report is particular to COSMOS, but the general features of the standard may be useful to those responsible for other computer programs. (author)

A Compromise Programming Model for Highway Maintenance Resources Allocation Problem

Directory of Open Access Journals (Sweden)

Hui Xiong

2012-01-01

Full Text Available This paper formulates a bilevel compromise programming model for allocating resources between pavement and bridge deck maintenances. The first level of the model aims to solve the resource allocation problems for pavement management and bridge deck maintenance, without considering resource sharing between them. At the second level, the model uses the results from the first step as an input and generates the final solution to the resource-sharing problem. To solve the model, the paper applies genetic algorithms to search for the optimal solution. We use a combination of two digits to represent different maintenance types. Results of numerical examples show that the conditions of both pavements and bridge decks are improved significantly by applying compromise programming, rather than conventional methods. Resources are also utilized more efficiently when the proposed method is applied.

Maintenance pharmacotherapy for recurrent major depressive disorder in primary care: A 5-year follow-up study.

Science.gov (United States)

Riihimäki, K; Vuorilehto, M; Isometsä, E

2017-03-01

Most practice guidelines recommend maintenance antidepressant treatment for recurrent major depressive disorder. However, the degree to which such guidance is actually followed in primary health care has remained obscure. We investigated the provision of maintenance antidepressant treatment within a representative primary care five-year cohort study. In the Vantaa Primary Care Depression Study, a stratified random sample of 1119 adult patients was screened for depression using the Prime-MD. Depressive and comorbid psychiatric disorders were diagnosed using SCID-I/P and SCID-II interviews. Of the 137 patients with depressive disorders, 82% completed the prospective five-year follow-up. A graphic life chart enabling evaluation of the longitudinal course of episodes plus duration of pharmacotherapies was used. In accordance with national guidelines, an indication for maintenance treatment was defined to exist after three or more lifetime major depressive episodes (MDEs); maintenance treatment was to commence four months after onset of full remission. Of the cohort patients, 34% (46/137) had three or more lifetime MDEs, thus indicating the requirement for maintenance pharmacotherapy. Of these, half (54%, 25/46) received maintenance treatment, for only 29% (489/1670) of the months indicated. In this cohort of depressed primary care patients, half of patients with indications for maintenance treatment actually received it, and only for a fraction of the time indicated. Antidepressant maintenance treatment for the prevention of recurrences is unlikely to be subject to large-scale actualization as recommended, which may significantly undermine the potential public health benefits of treatment. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

An optimal maintenance policy for machine replacement problem using dynamic programming

OpenAIRE

Mohsen Sadegh Amalnik; Morteza Pourgharibshahi

2017-01-01

In this article, we present an acceptance sampling plan for machine replacement problem based on the backward dynamic programming model. Discount dynamic programming is used to solve a two-state machine replacement problem. We plan to design a model for maintenance by consid-ering the quality of the item produced. The purpose of the proposed model is to determine the optimal threshold policy for maintenance in a finite time horizon. We create a decision tree based on a sequential sampling inc...

2003 Long-Term Surveillance and Maintenance Program Report

International Nuclear Information System (INIS)

2004-01-01

are part of long-term site management. In response to post-closure care requirements set forth in UMTRCA, DOE Headquarters established the Long-Term Surveillance and Maintenance (LTS&M) Program in 1988 at the DOE office in Grand Junction, Colorado. The program assumed long-term management responsibility for sites remediated under UMTRCA and other programs. Since its inception, the LTS&M Program has evolved in response to changing stakeholder needs, improvements in technology, and the addition of more DOE sites as remediation is completed. The mission of the LTS&M Program was to fulfill DOE's responsibility to implement all activities necessary to ensure regulatory compliance and to protect the public and the environment from long-lived wastes associated with the nation's nuclear energy, weapons, and research activities. Key components of the LTS&M Program included stakeholder participation, site monitoring and maintenance, records and information management, and research and technology transfer. This report presents summaries of activities conducted in 2003 in fulfillment of the LTS&M Program mission. On December 15, 2003, DOE established the Office of Legacy Management (LM) to allow for optimum management of DOE's legacy responsibilities. Offices are located in Washington, DC, Grand Junction, Colorado, Morgantown, West Virginia, and Pittsburgh, Pennsylvania, to perform long-term site management, land management, site transition support, records management, and other related tasks. All activities formerly conducted under the LTS&M Program have been incorporated into the Office of Land and Site Management (LM-50), as well as management of remedies involving ground water and surface water contaminated by former processing activities

2003 Long-Term Surveillance and Maintenance Program Report

Energy Technology Data Exchange (ETDEWEB)

None

2004-07-01

are part of long-term site management. In response to post-closure care requirements set forth in UMTRCA, DOE Headquarters established the Long-Term Surveillance and Maintenance (LTS&M) Program in 1988 at the DOE office in Grand Junction, Colorado. The program assumed long-term management responsibility for sites remediated under UMTRCA and other programs. Since its inception, the LTS&M Program has evolved in response to changing stakeholder needs, improvements in technology, and the addition of more DOE sites as remediation is completed. The mission of the LTS&M Program was to fulfill DOE’s responsibility to implement all activities necessary to ensure regulatory compliance and to protect the public and the environment from long-lived wastes associated with the nation’s nuclear energy, weapons, and research activities. Key components of the LTS&M Program included stakeholder participation, site monitoring and maintenance, records and information management, and research and technology transfer. This report presents summaries of activities conducted in 2003 in fulfillment of the LTS&M Program mission. On December 15, 2003, DOE established the Office of Legacy Management (LM) to allow for optimum management of DOE’s legacy responsibilities. Offices are located in Washington, DC, Grand Junction, Colorado, Morgantown, West Virginia, and Pittsburgh, Pennsylvania, to perform long-term site management, land management, site transition support, records management, and other related tasks. All activities formerly conducted under the LTS&M Program have been incorporated into the Office of Land and Site Management (LM–50), as well as management of remedies involving ground water and surface water contaminated by former processing activities.

Optimizing preventive maintenance with maintenance templates

International Nuclear Information System (INIS)

Dozier, I.J.

1996-01-01

Rising operating costs has caused maintenance professionals to rethink their strategy for preventive maintenance (PM) programs. Maintenance Templates are pre-engineered PM task recommendations for a component type based on application of the component. Development of the maintenance template considers the dominant failure cause of the component and the type of preventive maintenance that can predict or prevent the failure from occurring. Maintenance template development also attempts to replace fixed frequency tasks with condition monitoring tasks such as vibration analysis or thermography. For those components that have fixed frequency PM intervals, consideration is given to the maintenance drivers such as criticality, environment and usage. This helps to maximize the PM frequency intervals and maximize the component availability. Maintenance Templates have been used at PECO Energy's Limerick Generating Station during the Reliability Centered Maintenance (RCM) Process to optimize their PM program. This paper describes the development and uses of the maintenance templates

A Long-Term Leisure Program for Individuals with Intellectual Disability in Residential Care Settings: Research to Practice

Science.gov (United States)

Fox, Robert A.; Burke, Amie M.; Fung, Michael P.

2013-01-01

We studied the effectiveness of an individually-tailored leisure program implemented by direct care staff in a residential program for 28 adults with severe to profound intellectual disability using a multiple baseline design across two homes over a 1.5 year baseline and treatment period followed by another nearly 1.5 year maintenance phase. The…

The Nordic Maintenance Care Program - Time intervals between treatments of patients with low back pain: how close and who decides?

Directory of Open Access Journals (Sweden)

Leboeuf-Yde Charlotte

2010-03-01

Full Text Available Abstract Background The management of chiropractic patients with acute and chronic/persistent conditions probably differs. However, little is known on this subject. There is, for example, a dearth of information on maintenance care (MC. Thus it is not known if patients on MC are coerced to partake in a program of frequent treatments over a long period of time, or if they are actively involved in designing their own individualized treatment program. Objectives It was the purpose of this study to investigate how chiropractic patients with low back pain were scheduled for treatment, with special emphasis on MC. The specific research questions were: 1. How many patients are on maintenance care? 2 Are there specific patterns of intervals between treatments for patients and, if so, do they differ between MC patients and non-MC patients? 3. Who decides on the next treatment, the patient, the chiropractor or both, and are there any differences between MC patients and non-MC patients? Methods Chiropractic students, who during their summer holidays were observers in chiropractic clinics in Norway and Denmark, recorded whether patients were classified by the treating chiropractor as a MC-patient or not, dates for last and subsequent visits, and made a judgement on whether the patient or the chiropractor decided on the next appointment. Results Observers in the study were 16 out of 30 available students. They collected data on 868 patients from 15 Danish and 13 Norwegian chiropractors. Twenty-two percent and 26%, respectively, were classified as MC patients. Non-MC patients were most frequently seen within 1 week. For MC patients, the previous visit was most often 2-4 weeks prior to the actual visit, and the next appointment between 1 and 3 months. This indicates a gradual increase in intervals. The decision of the next visit was mainly made by the chiropractor, also for MC patients. However, the study samples of chiropractors appear not to be

An evaluation of the Browns Ferry Nuclear Plant preventive maintenance program based on reliability centered maintenance analysis

International Nuclear Information System (INIS)

McCullough, C.L.; McCullough, C.A.

1989-01-01

Reliability centered maintenance (RCM) techniques were used to support a preventative maintenance (PM) upgrade program (PMUP) performed at TVA Browns Ferry Nuclear Plant (BFNP). The purpose of the RCM analysis was to identify critical equipment based on risk and economic importance and to evaluate the PM activities applicable to that equipment. The analysis may be conveniently divided into three steps, which will be outlined in the Approach section of this paper. The net benefit of the RCM approach was a prioritization of the focus of the PM upgrade program so that plant components receive attention proportional to their importance, and assurance that PM activities properly address the most likely component failure causes

25 CFR 170.808 - Can BIA Road Maintenance Program funds be used to improve IRR transportation facilities?

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Can BIA Road Maintenance Program funds be used to improve... THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM BIA Road Maintenance § 170.808 Can BIA Road Maintenance Program funds be used to improve IRR transportation facilities? No. BIA Road...

Long-Term Weight-Loss Maintenance by a Meal Replacement Based Weight Management Program in Primary Care

Directory of Open Access Journals (Sweden)

Renate Kruschitz

2017-04-01

Full Text Available Objective: Structured obesity treatment programs at primary care level are becoming increasingly important. However, evidence from current treatment approaches in the long term is lacking. In view of this fact we evaluated a standardized, meal replacement-based weight loss program (myLINE®; AENGUS, Graz, Austria according to the currently applicable guidelines. Methods: Data of overweight and obese individuals (n = 70 who participated at least 36 months in the program were analyzed. Data were collected at baseline (T0 as well as after 1, 3, 6, 12, 24, and 36 (T1-T36 months. Body composition was measured by conventional anthropometry and bioelectrical impedance analysis. Results: Compared to T0, a maximum weight, BMI, fat mass, absolute body cell mass (BCM reduction and an increase of relative BCM could be seen at T6. Subsequently, the findings reveal a significant reduction of body weight and body fat and a satisfying development of body cell mass during the observation period of 36 months. Conclusion: The evaluated program complies with national and international guidelines for the therapy of obesity in adults and is efficient and meaningful for a long-term therapeutic use in primary care..

Guide for monitoring effectiveness of utility Reliability Centered Maintenance (RCM) programs

International Nuclear Information System (INIS)

Midgett, W.D.; Wilson, J.F.; Krochmal, D.F.; Owsenek, L.W.

1991-02-01

Reliability centered maintenance (RCM) programs help utilities optimize preventive maintenance efforts while improving plant safety and economy through increased dependability of plant components. The project team developed this guide and accompanying methodology based on status updates from the Ginna and San Onofre demonstration projects. These updates addressed areas ranging from system selection to the effectiveness of RCM program implementation. In addition, the team incorporated information from a 12-utility survey soliciting opinions on the need for a methodology to monitor RCM cost-effectiveness. An analysis of the 12-utility survey showed that no techniques had been developed to measure RCM program cost-effectiveness. Thus, this guide addresses two key areas: Pros and cons of various monitoring techniques available to assess the overall effectiveness of RCM and a methodology for specifically evaluating the cost-effectiveness of RCM programs. 1 fig

Population-Level Density Dependence Influences the Origin and Maintenance of Parental Care

OpenAIRE

Reyes, Elijah; Thrasher, Patsy; Bonsall, Michael B.; Klug, Hope

2016-01-01

Parental care is a defining feature of animal breeding systems. We now know that both basic life-history characteristics and ecological factors influence the evolution of care. However, relatively little is known about how these factors interact to influence the origin and maintenance of care. Here, we expand upon previous work and explore the relationship between basic life-history characteristics (stage-specific rates of mortality and maturation) and the fitness benefits associated with the...

Improving maintenance of lost weight following a commercial liquid meal replacement program: a preliminary study.

Science.gov (United States)

Ames, Gretchen E; Patel, Roshni H; McMullen, Jillian S; Thomas, Colleen S; Crook, Julia E; Lynch, Scott A; Lutes, Lesley D

2014-01-01

Clinic-based liquid meal replacement (800kcals/day) programs produce substantial weight loss. Nevertheless, long-term maintenance remains a challenge. A limitation of maintenance programs is that they continue to promote large behavior changes that are initially required to induce weight loss which may be unsustainable long-term. The study aims were to conduct a preliminary assessment of the feasibility, acceptability, and effectiveness of a small changes maintenance intervention (SCM) for 30 patients who completed liquid meal replacement program (LMR). The 20-session SCM delivered over 52 weeks offered no preset goals for maintenance behaviors and all changes in behavior were self-selected. Participants had a median BMI of 40.9 kg/m(2) and weight of 111 kg at the start of LMR. At LMR completion, they lost 18% (21 kg) of body weight. The SCM was completed by 22 patients (73%); 19 completers (86%) attended ≥ 17 of 20 sessions with a median satisfaction rating of 9 (on a scale of 1 to 9). Completers were asked to record self-selected maintenance behaviors daily (median 351 days recorded). The most commonly reported daily behaviors were self-weighing, use of meal replacements and step counting. Median percent regain at week 52 was 14% (2.8 kg) of lost weight (range, -42 to 74%), significantly less than a median of 56% (11 kg) percent regain of lost weight (range, -78 to 110%) in a demographically similar historical control group with no maintenance intervention after LMR completion (P<0.001). Thus, SCM holds promise for improving weight maintenance. Future research should compare SCM to standard maintenance programs that promote large program-directed changes. © 2013.

Fuzzy Goal Programming Approach in Selective Maintenance Reliability Model

Directory of Open Access Journals (Sweden)

Neha Gupta

2013-12-01

Full Text Available 800x600 In the present paper, we have considered the allocation problem of repairable components for a parallel-series system as a multi-objective optimization problem and have discussed two different models. In first model the reliability of subsystems are considered as different objectives. In second model the cost and time spent on repairing the components are considered as two different objectives. These two models is formulated as multi-objective Nonlinear Programming Problem (MONLPP and a Fuzzy goal programming method is used to work out the compromise allocation in multi-objective selective maintenance reliability model in which we define the membership functions of each objective function and then transform membership functions into equivalent linear membership functions by first order Taylor series and finally by forming a fuzzy goal programming model obtain a desired compromise allocation of maintenance components. A numerical example is also worked out to illustrate the computational details of the method.  Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4

Canada's MMP (Maintenance Management Professional) education and certification program

International Nuclear Information System (INIS)

Clegg, N.; Rae, V.

2010-01-01

'Full text:' Plant Engineering and Maintenance Association of Canada (PEMAC) is a national not-for-profit association providing global leadership, education and certification in world class maintenance, reliability and physical asset management practices. This presentation will introduce the MMP (Maintenance Management Professional) education and certification program and its 8 Modules. You will see the learning elements and learning outcomes of each of the 8 Modules which are delivered through selected colleges, institutes and universities across Canada using in-class, on-site and live, on-line formats in both official languages. (author)

Comparing Costs of Telephone versus Face-to-Face Extended Care Programs for the Management of Obesity in Rural Settings

Science.gov (United States)

Radcliff, Tiffany A.; Bobroff, Linda B.; Lutes, Lesley D.; Durning, Patricia E.; Daniels, Michael J.; Limacher, Marian C.; Janicke, David M.; Martin, A. Daniel; Perri, Michael G.

2012-01-01

Background A major challenge following successful weight loss is continuing the behaviors required for long-term weight maintenance. This challenge may be exacerbated in rural areas with limited local support resources. Objective This study describes and compares program costs and cost-effectiveness for 12-month extended care lifestyle maintenance programs following an initial 6-month weight loss program. Design A 1-year prospective controlled randomized clinical trial. Participants/Setting The study included 215 female participants age 50 or older from rural areas who completed an initial 6-month lifestyle program for weight loss. The study was conducted from June 1, 2003, to May 31, 2007. Intervention The intervention was delivered through local Cooperative Extension Service offices in rural Florida. Participants were randomly-assigned to a 12-month extended care program using either individual telephone counseling (n=67), group face-to-face counseling (n=74), or a mail/control group (n=74). Main Outcome Measures Program delivery costs, weight loss, and self-reported health status were directly assessed through questionnaires and program activity logs. Costs were estimated across a range of enrollment sizes to allow inferences beyond the study sample. Statistical Analyses Performed Non-parametric and parametric tests of differences across groups for program outcomes were combined with direct program cost estimates and expected value calculations to determine which scales of operation favored alternative formats for lifestyle maintenance. Results Median weight regain during the intervention year was 1.7 kg for participants in the face-to-face format, 2.1 kg for the telephone format, and 3.1 kg for the mail/control format. For a typical group size of 13 participants, the face-to-face format had higher fixed costs, which translated into higher overall program costs ($420 per participant) when compared to individual telephone counseling ($268 per participant) and

Advancements in nuclear plant maintenance programs

International Nuclear Information System (INIS)

Meligi, A.E.; Maras, M.C.

1993-01-01

The viability of the nuclear option as a technology choice for present and future electricity generation will be decided primarily on the basis of operating cost to achieve plant performance objectives. In a nuclear plant, performance is judged not only on availability and output rate but also on safety risk and radiation exposure. Operating, cost is essentially made up of the fuel cost and operation and maintenance (O and M) cost. Over the past decade, the industry average nuclear plant performance has improved significantly; however, this improvement was accompanied by rising O and M cost. The net result was that the nuclear option lost its long-standing economic advantage over the coal option, based on the industry average comparison, around 1987 - with the gap narrowing slightly in the last 2 years. In recent times, gas-fired plants have also become a basis for comparison. The electric generation cost comparisons of various fuel options has led to even greater scrutiny of nuclear plant performance, with the poorer performing plants facing the risk of shutdown. While effective O and M programs improve plant performance, present industry data show that there is no direct correlation between the cost of a plant O and M program and its associated performance. There is a significant number of existing tools and techniques in the O and M area that have proved to be successful and have resulted in significant benefits and payback. This paper presents an overview of the nuclear industry efforts to improve the conduct of O and M activities, describes the basic elements of an effective O and M program, and addresses some of the state-of-the-art tools and techniques to enhance maintenance work planning, training, and procedures

Hardware and software maintenance strategies for upgrading vintage computers

International Nuclear Information System (INIS)

Wang, B.C.; Buijs, W.J.; Banting, R.D.

1992-01-01

The paper focuses on the maintenance of the computer hardware and software for digital control computers (DCC). Specific design and problems related to various maintenance strategies are reviewed. A foundation was required for a reliable computer maintenance and upgrading program to provide operation of the DCC with high availability and reliability for 40 years. This involved a carefully planned and executed maintenance and upgrading program, involving complementary hardware and software strategies. The computer system was designed on a modular basis, with large sections easily replaceable, to facilitate maintenance and improve availability of the system. Advances in computer hardware have made it possible to replace DCC peripheral devices with reliable, inexpensive, and widely available components from PC-based systems (PC = personal computer). By providing a high speed link from the DCC to a PC, it is now possible to use many commercial software packages to process data from the plant. 1 fig

Long-Term Weight-Loss Maintenance by a Meal Replacement Based Weight Management Program in Primary Care.

Science.gov (United States)

Kruschitz, Renate; Wallner-Liebmann, Sandra; Lothaller, Harald; Luger, Maria; Ludvik, Bernhard

2017-01-01

Structured obesity treatment programs at primary care level are becoming increasingly important. However, evidence from current treatment approaches in the long term is lacking. In view of this fact we evaluated a standardized, meal replacement-based weight loss program (myLINE®; AENGUS, Graz, Austria) according to the currently applicable guidelines. Data of overweight and obese individuals (n = 70) who participated at least 36 months in the program were analyzed. Data were collected at baseline (T0) as well as after 1, 3, 6, 12, 24, and 36 (T1-T36) months. Body composition was measured by conventional anthropometry and bioelectrical impedance analysis. Compared to T0, a maximum weight, BMI, fat mass, absolute body cell mass (BCM) reduction and an increase of relative BCM could be seen at T6. Subsequently, the findings reveal a significant reduction of body weight and body fat and a satisfying development of body cell mass during the observation period of 36 months. The evaluated program complies with national and international guidelines for the therapy of obesity in adults and is efficient and meaningful for a long-term therapeutic use in primary care.. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Health Care Delivery.

Science.gov (United States)

Starfield, Barbara

1987-01-01

The article reviews emerging health care delivery options for handicapped children. Cost structures, quality of care, and future prospects are considered for Health Maintenance Organizations, Preferred Provider Organizations, Tax Supported Direct Service Programs, Hospital-Based Services, and Ambulatory Care Organizations. (Author/DB)

"Business Continuity and Information Security Maintenance" Masters’ Training Program

OpenAIRE

Miloslavskaya , Natalia; Senatorov , Mikhail; Tolstoy , Alexandr; Zapechnikov , Sergei

2013-01-01

Part 1: WISE 8; International audience; The experience of preparing for the "Business Continuity and Information Security Maintenance" (BC&ISM) Masters’ program implementation and realization at the "Information Security of Banking Systems" Department of the National Research Nuclear University MEPhI (NRNU MEPhI, Moscow, Russia) is presented. Justification of the educational direction choice for BC&ISM professionals is given. The model of IS Master being trained on this program is described. ...

The right maintenance on the right components, at the right time, with the right parts: maintaining high plant reliability through an effective maintenance program

International Nuclear Information System (INIS)

Von Hatten, P.

2008-01-01

The objective of the maintenance program at a Nuclear Power Plant is to be proactive and prevent unexpected failures of equipment that can impact on Nuclear or Conventional Safety and Plant Production. This does not mean that all equipment failures will be prevented; in a number of cases the most cost effective solution is to allow equipment to run to failure. Deciding what components are critical to the plant is the first step. The industry uses guidance from INPO Advanced Process, AP913, to classify components as Critical, Non Critical or Run to Failure based on the consequence of the failure. Once this is complete, then the right maintenance program needs to be specified. This is done through utilization of experience from the industry based on the type of component. Maintenance strategies and templates have been produced for most power plant components. Each station or fleet needs then to apply the criteria, with exceptions as required, to determine the maintenance requirements and frequency for their components. This includes predictive and preventative maintenance. The more critical the component is the more rigorous the maintenance requirements. Once the maintenance program is defined it can be implemented. This requires that the Preventative Maintenance (PM's) are updated to ensure the correct tasks are in place and the frequency is correct. Work Management will group the PM's so they can scheduled efficiently and to minimize equipment down time. The last element is to ensure that the required parts are specified and are stocked or readily available for the maintenance when it is scheduled. This is an ongoing effort since components become obsolete or suppliers go out of business or change hands. (author)

Program plan for future regulatory activity in nuclear-power-plant maintenance

International Nuclear Information System (INIS)

Badalamente, R.V.

1982-10-01

The intent of this paper is to describe the results of a study of nuclear power plant (NPP) maintenance conducted by Battelle's Pacific Northwest Laboratories (PNL) for the Nuclear Regulatory Commission (NRC). The purpose of the study for the NRC was to determine problems affecting human performance in NPP maintenance, pinpoint those which adversely affect public health and safety, review strategies for overcoming the problems, and suggest the direction that regulatory activities should take. Results of the study were presented to the NRC (Division of Human Factors Safety) in the form of a recommended program plan for future regulatory activity in NPP maintenance

ORNL Surplus Facilities Management Program maintenance and surveillance plan for fiscal year 1984

International Nuclear Information System (INIS)

Coobs, J.H.; Myrick, T.E.

1986-10-01

The Surplus Facilities Management Program (SFMP) at Oak Ridge National Laboratory (ORNL) is part of the Department of Energy's (DOE) National SFMP, administered by the Richland Operations Office. The purpose and objectives of the national program are set forth in the current SFMP Program Plan and include (1) the maintenance and surveillance of facilities awaiting decommissioning, (2) planning for the orderly decommissioning of these facilities, and (3) implementation of a program to accomplish the facility disposition in a safe, cost-effective, and timely manner. As outlined in the national program plan, participating SFMP contractors are required to prepare a formal plan that documents the maintenance and surveillance (M and S) programs established for each site. This report has been prepared to provide this documentation for those facilties included in the ORNL SFMP

25 CFR Appendix A to Subpart G - List of Activities Eligible for Funding Under BIA Transportation Facility Maintenance Program

Science.gov (United States)

2010-04-01

... Transportation Facility Maintenance Program A Appendix A to Subpart G Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM BIA Road Maintenance Pt. 170... Transportation Facility Maintenance Program The following activities are eligible for BIA Transportation Facility...

Implementing a customer focused continual business improvement program to improve the maintenance process

International Nuclear Information System (INIS)

Kharshafdjian, G.; Fisher, C.; Beres, T.; Brooks, S.; Forbes, S.; Krause, M.; McAuley, K.; Wendorf, M.

2006-01-01

Global market pressures and increasing competition demands that successful companies establish a continual business improvement program as part of implementing its business strategy. Such programs must be driven by the definition of quality from the customer's perspective. This customer quality focus often requires a change in all aspects of the business including products, services, processes and culture. This paper will describe how Atomic Energy of Canada Limited implemented a Continual Business Improvement Program in their Nuclear Laboratories Business Unit. In particular, to review how the techniques were applied to improve the maintenance process and the status of the project. Customer (internal users of the processes at CRL) feedback has shown repeatedly there is dissatisfaction of the maintenance process. Customers complain about jobs not getting done to schedule or being deferred. A project has been launched with the following goals: to improve the maintenance process customer satisfaction and increase trades wrench time by 30 minutes / trade / day. DMAIC (Define-Measure-Analyze-Improve-Control) methodology was applied to find out the Root Cause(s) of the problem, provide solutions, and implement improvements. The expected Operational Benefits include: Executing work efficiently to quality standards and business performance of the site, improve maintenance efficiencies, reduce cycle time for maintenance process and improve process yield, and improve customer and employee satisfaction. (author)

Implementing a customer focused continual business improvement program to improve the maintenance process

Energy Technology Data Exchange (ETDEWEB)

Kharshafdjian, G.; Fisher, C.; Beres, T.; Brooks, S.; Forbes, S.; Krause, M.; McAuley, K.; Wendorf, M. [Atomic Energy of Canada Limited, Chalk River, Ontario (Canada)

2006-07-01

Global market pressures and increasing competition demands that successful companies establish a continual business improvement program as part of implementing its business strategy. Such programs must be driven by the definition of quality from the customer's perspective. This customer quality focus often requires a change in all aspects of the business including products, services, processes and culture. This paper will describe how Atomic Energy of Canada Limited implemented a Continual Business Improvement Program in their Nuclear Laboratories Business Unit. In particular, to review how the techniques were applied to improve the maintenance process and the status of the project. Customer (internal users of the processes at CRL) feedback has shown repeatedly there is dissatisfaction of the maintenance process. Customers complain about jobs not getting done to schedule or being deferred. A project has been launched with the following goals: to improve the maintenance process customer satisfaction and increase trades wrench time by 30 minutes / trade / day. DMAIC (Define-Measure-Analyze-Improve-Control) methodology was applied to find out the Root Cause(s) of the problem, provide solutions, and implement improvements. The expected Operational Benefits include: Executing work efficiently to quality standards and business performance of the site, improve maintenance efficiencies, reduce cycle time for maintenance process and improve process yield, and improve customer and employee satisfaction. (author)

A "small-changes" workplace weight loss and maintenance program: examination of weight and health outcomes.

Science.gov (United States)

Zinn, Caryn; Schofield, Grant M; Hopkins, Will G

2012-10-01

To compare the effect of "small-changes" and "usual care" workplace interventions on weight loss and to investigate the effect of small changes with or without maintenance on weight and health outcomes. Overweight/obese employees at two New Zealand worksites received a 12-month usual-care intervention (n = 53), followed by a 12-month small-changes intervention (n = 102). Small changes comprised a 12-week component, followed by 9 months of maintenance, implemented at only one worksite. Magnitudes of effects were assessed via a threshold of -5% (weight loss) and standardization (health outcomes). Small changes showed beneficial weight loss relative to usual care in both worksites. For small-changes interventions, worksites reduced weight (12 weeks) and maintained lost weight (12 months). One in every three participants lost 5% or more weight. Some improvements in health outcomes were shown. Regardless of maintenance, the small-changes intervention was successful in sustaining weight loss.

Integrated predictive maintenance program vibration and lube oil analysis: Part I - history and the vibration program

Energy Technology Data Exchange (ETDEWEB)

Maxwell, H.

1996-12-01

This paper is the first of two papers which describe the Predictive Maintenance Program for rotating machines at the Palo Verde Nuclear Generating Station. The organization has recently been restructured and significant benefits have been realized by the interaction, or {open_quotes}synergy{close_quotes} between the Vibration Program and the Lube Oil Analysis Program. This paper starts with the oldest part of the program - the Vibration Program and discusses the evolution of the program to its current state. The {open_quotes}Vibration{close_quotes} view of the combined program is then presented.

Integrated predictive maintenance program vibration and lube oil analysis: Part I - history and the vibration program

International Nuclear Information System (INIS)

Maxwell, H.

1996-01-01

This paper is the first of two papers which describe the Predictive Maintenance Program for rotating machines at the Palo Verde Nuclear Generating Station. The organization has recently been restructured and significant benefits have been realized by the interaction, or open-quotes synergyclose quotes between the Vibration Program and the Lube Oil Analysis Program. This paper starts with the oldest part of the program - the Vibration Program and discusses the evolution of the program to its current state. The open-quotes Vibrationclose quotes view of the combined program is then presented

A blended learning approach to teaching CVAD care and maintenance.

Science.gov (United States)

Hainey, Karen; Kelly, Linda J; Green, Audrey

2017-01-26

Nurses working within both acute and primary care settings are required to care for and maintain central venous access devices (CVADs). To support these nurses in practice, a higher education institution and local health board developed and delivered CVAD workshops, which were supported by a workbook and competency portfolio. Following positive evaluation of the workshops, an electronic learning (e-learning) package was also introduced to further support this clinical skill in practice. To ascertain whether this blended learning approach to teaching CVAD care and maintenance prepared nurses for practice, the learning package was evaluated through the use of electronic questionnaires. Results highlighted that the introduction of the e-learning package supported nurses' practice, and increased their confidence around correct clinical procedures.

Standard Review Plan Maintenance Program implementing procedures document

International Nuclear Information System (INIS)

1996-11-01

The implementing Procedures Document (IPD) was developed by the Inspection Program Projects Branch, Office of Nuclear Reactor Regulation, with assistance from Pacific Northwest National Laboratory, for the Standard Review Plan Maintenance Program (SRP-MP). The SRP-MP was established to maintain the Standard Review Plan (SRP) on an on-going basis. The IPD provides guidance, including an overall approach and procedures, for SRP-MP tasks. The objective of the IPD is to ensure that modifications to SRP need to reflect current NRC requirements and guidance are identified and that a consistent methodology is used to develop and revise SRP sections

Buprenorphine/Naloxone Maintenance Therapy: an Observational Retrospective Report on the Effect of Dose on 18 months Retention in an Office-Based Treatment Program

Directory of Open Access Journals (Sweden)

Theodore V Parran

2017-10-01

Full Text Available Context and objective: Buprenorphine has been available with few reports of the dose range necessary to adequately maintain patients. We report on the effect of 8 mg/d versus 16 mg/d of buprenorphine on long-term patient retention in office-based opioid maintenance (OBOMT. Design, setting, and participants: Case series, at an urban hospital-based primary care clinic providing OBOMT to 157 opiate-dependent, low socioeconomic status, uninsured, nonhomeless patients. Intervention: The OBOMT program operated by a comprehensive sobriety treatment program experienced State funding cuts. Thus, after 2 years, the program was required by the State funder to decrease the buprenorphine maintenance dose from 16 to 8 mg/d for all new admissions. We report on patient retention before and after dose reduction. Main outcome measures: The primary outcomes of this study were to measure and compare patient retention in the 2 cohorts at each point of treatment transition over the 18 months following OBOMT initiation. Results: No significant differences in patient retention were observed between the 16 and 8 mg/d patient cohorts. Lower dose buprenorphine maintenance (8 mg/d in uninsured patients enrolled in publicly funded long-term OBOMT combined with comprehensive sobriety counseling was as effective as higher dose therapy (16 mg/d in promoting patient retention throughout the study period. This lower dose resulted in a substantial saving to the public funding agency. Conclusions: In an observational retrospective report, retention in treatment of opiate-addicted patients was the same at 8 and 16 mg/d buprenorphine doses after 18 months. These data have implications for public and managed care funding of OBOMT, for the general prescribing of buprenorphine in outpatient care, and may be instructive in the ongoing debate about the relationship between buprenorphine dose.

Surveying the elements of successful infrared predictive maintenance programs

Science.gov (United States)

Snell, John R., Jr.; Spring, Robert W.

1991-03-01

This paper summarizes the results of a survey of over three hundred maintenance personnel who use imaging equipment within their company or organization. All had previously participated in one or more of our training programs. The companies took in a broad range of industry, including, among other, power generation, pulp and paper, metals, mining, petrochemical, automotive and general manufacturing. The organizations were mainly quite large, either commercial or public, and included governmental agencies, military, colleges and universities, municipalities, and utilities. Although we had a very tight time line for the survey, we were pleased to have a 15% response rate. The results show that some of the causes of success and failure in infrared programs are not unlike those associated with any type of program in an organizational structure, i.e. the need for accurate and timely communications; justification requirements; etc. Another set of problems was shared more closely with other startup maintenance technologies (for example, vibration monitoring), such as the need for trending data; providing appropriate technical training; achieving reproducible results; etc. Finally, some of the driving mechanisms are more specific to this technology, such as re-designing equipment so that it can be thermally inspected; establishing effective documentation strategies; etc.

Using the system maintenance datastore to characterize lifetime maintenance for PLiM

International Nuclear Information System (INIS)

Watson, P.; Dam, R.; Nickerson, J.

2004-01-01

A comprehensive Plant Life Management (PLiM) program involves evaluating a large amount of information. For any plant, there are numerous maintenance, surveillance and inspection programs for the important systems, structures and components. There is extensive industry experience on component failure modes, degradation mechanisms and recommended maintenance practices. This information forms the basis of the aging assessment work, through which improvements to these plant programs are identified. AECL has developed several tools to manage the quantities of information required in aging assessment studies, such as the SYSTMS (SYtematic approach for the development of STrategy for Maintenance and Surveillance) tool and the System Maintenance Datastore (SMD). The SMD has been developed to serve as a hub to a Systematic based Adaptive Maintenance Program (SAMP), by storing maintenance resource requirements for recommended maintenance tasks for use by the other processes in a SAMP. The SMD can be used to (a) quantify the savings or cost of optimising a maintenance program, (b) characterize and understand long term trends in condition-based maintenance due to component aging, (c) quantify the resource savings due to optimum timing of component replacement or general plant refurbishment, and (d) provide aging assessment cost information for input to plant asset evaluation. The SMD contains data for regular maintenance program tasks, plant condition assessment recommendations, and equipment refurbishment costs. A prototype SMD has been developed with data tables populated with information from operating CANDU stations. The SMD is now available to be used either with a SYSTMS evaluation or with a plant's database of maintenance tasks. (author)

Investigating the Optimal Management Strategy for a Healthcare Facility Maintenance Program

National Research Council Canada - National Science Library

Gaillard, Daria

2004-01-01

...: strategic partnering with an equipment management firm. The objective of this study is to create a decision-model for selecting the optimal management strategy for a healthcare organization's facility maintenance program...

Managed maintenance, the next step in power plant maintenance

International Nuclear Information System (INIS)

Butterworth, G.; Anderson, T.M.

1984-01-01

The Westinghouse Nuclear Services Integration Division managed maintenance services are described. Essential to the management and control of a total plant maintenance programme is the development of a comprehensive maintenance specification. During recent years Westinghouse has jointly developed total plant engineering-based maintenance specifications with a number of utilities. The process employed and the experience to date are described. To efficiently implement the maintenance programme Westinghouse has developed a computer software program specifically designed for day to day use at the power plant by maintenance personnel. This program retains an equipment maintenance history, schedules maintenance activities, issues work orders and performs a number of sophisticated analyses of the maintenance backlog and forecast, equipment failure rates, etc. The functions of this software program are described and details of Westinghouse efforts to support the utilities in reducing outage times through development of predefined outage plans for critical report maintenance activities are given. Also described is the experience gained in the training of specialized maintenance personnel, employing competency-based training techniques and equipment mock-ups, and the benefits experienced, in terms of improved quality and productivity of maintenance performed. The success experienced with these methods has caused Westinghouse to expand the use of these training techniques to the more routine skill areas of power plant maintenance. A significant reduction in the operating costs of nuclear power plants will only be brought about by a significant improvement in the quality of maintenance. Westinghouse intends to effect this change by expanding its international service capabilities and to make major investments in order to promote technological developments in the area of power plant maintenance. (author)

User Delay Cost Model and Facilities Maintenance Cost Model for a Terminal Control Area : Volume 3. User's Manual and Program Documentation for the Facilities Maintenance Cost Model

Science.gov (United States)

1978-05-01

The Facilities Maintenance Cost Model (FMCM) is an analytic model designed to calculate expected annual labor costs of maintenance within a given FAA maintenance sector. The model is programmed in FORTRAN IV and has been demonstrated on the CDC Krono...

Providing Our Fellows in Training with Education on Inflammatory Bowel Disease Health Maintenance to Improve the Quality of Care in Our Health Care System.

Science.gov (United States)

Lee, Ann Joo; Kraemer, Dale F; Smotherman, Carmen; Eid, Emely

2016-01-01

Inflammatory bowel disease (IBD) quality measures were established in an effort to standardize IBD health care. Despite effort to improve clinical performance, considerable variations in practice still exist. To further improve IBD health care, we propose incorporating an in-service educational session on IBD health maintenance to provide trainees with increasing awareness and knowledge on IBD management. Fifty electronic medical charts were randomly selected, and the level of quality documentation was assessed for 15 core IBD quality measures. Data were reported as the percentage of charts meeting audit criteria (compliance score). Fellows then attended an in-service educational session to review IBD quality measures and reinforce practice expectations. A second audit was then performed on an additional 50 patient charts to determine whether documentation practices improved after the educational session. We found a positive correlation between an in-service educational session and fellows' compliance with IBD health maintenance. Overall, the fellows' compliance score increased by 18% (before intervention, 65%; after intervention, 83%; P bases for IBD health maintenance. Incorporating a standard curriculum on IBD health maintenance provides fellows in training with increased awareness and guidance on managing the unique preventive care needs of patients with IBD.

World-wide developments in motor vehicle inspection/maintenance (I/M) programs

Energy Technology Data Exchange (ETDEWEB)

Klausmeier, R. [Consulting Inc., Austin, TX (United States); Kishan, S. [Radian Corporation, Austin, TX (United States)

1995-12-31

Motor vehicles contribute much to urban air pollution. As a result, most governments have enacted emission standards that significantly lower pollutant emission levels from new motor vehicles. For example, vehicles built in the United States emit 95 % fewer pollutants than uncontrolled vehicles when they are new. However, studies indicate that proper maintenance is needed to obtain the full benefit of vehicle emission controls. Furthermore, there is evidence that a significant percentage of the vehicle fleet is not properly maintained. This has led to the creation of motor vehicle Inspection/Maintenance (I/M) Programs. I/M programs inspect vehicles for indications that they are emitting excessive quantities of pollutants. Vehicles that fail the inspection must be repaired in order to comply with program requirements. The first I/M programs were implemented in the United States in the early 1970s. With substantial urging from the federal government, most of the U.S. states with severe air pollution problems have implemented I/M programs. Recently, with the passage of the U.S. Clean Air Act Amendments of 1990, many states have been required to significantly upgrade the performance and coverage of their I/M programs. I/M programs also have been implemented in Europe and recently in Asia. This presentation reviews developments in I/M programs for light-duty gasoline powered vehicles. Developments in I/M programs for diesel powered vehicles are briefly described. (author)

World-wide developments in motor vehicle inspection/maintenance (I/M) programs

Energy Technology Data Exchange (ETDEWEB)

Klausmeier, R [Consulting Inc., Austin, TX (United States); Kishan, S [Radian Corporation, Austin, TX (United States)

1996-12-31

Motor vehicles contribute much to urban air pollution. As a result, most governments have enacted emission standards that significantly lower pollutant emission levels from new motor vehicles. For example, vehicles built in the United States emit 95 % fewer pollutants than uncontrolled vehicles when they are new. However, studies indicate that proper maintenance is needed to obtain the full benefit of vehicle emission controls. Furthermore, there is evidence that a significant percentage of the vehicle fleet is not properly maintained. This has led to the creation of motor vehicle Inspection/Maintenance (I/M) Programs. I/M programs inspect vehicles for indications that they are emitting excessive quantities of pollutants. Vehicles that fail the inspection must be repaired in order to comply with program requirements. The first I/M programs were implemented in the United States in the early 1970s. With substantial urging from the federal government, most of the U.S. states with severe air pollution problems have implemented I/M programs. Recently, with the passage of the U.S. Clean Air Act Amendments of 1990, many states have been required to significantly upgrade the performance and coverage of their I/M programs. I/M programs also have been implemented in Europe and recently in Asia. This presentation reviews developments in I/M programs for light-duty gasoline powered vehicles. Developments in I/M programs for diesel powered vehicles are briefly described. (author)

AUTOMOTIVE DIESEL MAINTENANCE 1. UNIT IV, MAINTAINING THE COOLING SYSTEM--DETROIT DIESEL ENGINES.

Science.gov (United States)

Human Engineering Inst., Cleveland, OH.

THIS MODULE OF A 30-MODULE COURSE IS DESIGNED TO DEVELOP AN UNDERSTANDING OF THE OPERATION AND MAINTENANCE OF THE DIESEL ENGINE COOLING SYSTEM. TOPICS ARE PURPOSE OF THE COOLING SYSTEM, CARE MAINTENANCE OF THE COOLING SYSTEM, COOLING SYSTEM COMPONENTS, AND TROUBLESHOOTING TIPS. THE MODULE CONSISTS OF A SELF-INSTRUCTIONAL BRANCH PROGRAMED TRAINING…

Development of inspection and maintenance program for reactor and reactivity control units in HANARO

International Nuclear Information System (INIS)

Cho, Yeong-Garp

1998-01-01

This paper summarizes the overall program for inspection and maintenance of reactor structure and Reactivity Control Units (RCU) of HANARO during lifetime. The long-term plan for in-service inspection is introduced in the viewpoint of the structural integrity of reactor and RCU, and the operability of RCU mechanism. This program includes the list of components to be inspected, the schedule of inspection and maintenance, and the development of special tools and test rig that are required for the remote inspection and maintenance of reactor and RCU components. Preliminary results of the evaluation on the lifetime of RCU components are summarized based on the operation history since the installation of reactor. A test rig will be designed and constructed for the purposes of verifying the prolonged lifetime of RCU components being used, the performance of special tools, and the rehearsal of maintenance work as well. (author)

Development of a Preventive Maintenance Program for Tooling Used in Powder Slush Molding

Energy Technology Data Exchange (ETDEWEB)

Lara-Curzio, Edgar [ORNL; Rios, Orlando [ORNL; Marquez Rossy, Andres E [ORNL

2016-07-19

ORNL collaborated with Faurecia Interior Systems to investigate the feasibility of developing a thermomagnetic preventive maintenance program for nickel tooling used in powder slush molding. It was found that thermal treatments at temperatures greater than 500°C can anneal strain hardening in nickel tooling and a range of temperatures and times for effective thermal annealing were identified. It was also observed that magnetic fields applied during thermal annealing do not alter the kinetics of strain hardening annealing. The results obtained in this investigation provide a foundation for establishing a preventive maintenance program for nickel tooling.

Maintenance of Certification®, Maintenance of Public Trust

Science.gov (United States)

Chung, Kevin C.; Clapham, Philip J.; Lalonde, Donald H.

2010-01-01

The Maintenance of Certification® (MOC) program has been well received by many physicians, but faced significant opposition from others, who complain that it is overly tedious, costly, and irrelevant to their practice. This article offers a consolidated and concise history of the MOC program and a summary of what plastic surgeons need to know to successfully complete the American Board of Plastic Surgery’s (ABPS) own MOC requirements. The authors have justified each step of the ABPS’s MOC process in terms of how it improves the quality of care delivered to Plastic Surgery patients. Finally, a summary of research is presented that demonstrates both that the public supports the MOC process for all physicians and that continuing education and formal assessment and improvement initiatives have been linked in multiple studies to a better and more evidence-based medical practice. PMID:21285803

SCI Hospital in Home Program: Bringing Hospital Care Home for Veterans With Spinal Cord Injury.

Science.gov (United States)

Madaris, Linda L; Onyebueke, Mirian; Liebman, Janet; Martin, Allyson

2016-01-01

The complex nature of spinal cord injury (SCI) and the level of care required for health maintenance frequently result in repeated hospital admissions for recurrent medical complications. Prolonged hospitalizations of persons with SCI have been linked to the increased risk of hospital-acquired infections and development or worsening pressure ulcers. An evidence-based alternative for providing hospital-level care to patients with specific diagnoses who are willing to receive that level of care in the comfort of their home is being implemented in a Department of Veterans Affairs SCI Home Care Program. The SCI Hospital in Home (HiH) model is similar to a patient-centered interdisciplinary care model that was first introduced in Europe and later tested as part of a National Demonstration and Evaluation Study through Johns Hopkins School of Medicine and School of Public Health. This was funded by the John A. Hartford Foundation and the Department of Veterans Affairs. The objectives of the program are to support veterans' choice and access to patient-centered care, reduce the reliance on inpatient medical care, allow for early discharge, and decrease medical costs. Veterans with SCI who are admitted to the HiH program receive daily oversight by a physician, daily visits by a registered nurse, access to laboratory services, oxygen, intravenous medications, and nursing care in the home setting. In this model, patients may typically access HiH services either as an "early discharge" from the hospital or as a direct admit to the program from the emergency department or SCI clinic. Similar programs providing acute hospital-equivalent care in the home have been previously implemented and are successfully demonstrating decreased length of stay, improved patient access, and increased patient satisfaction.

Laboratory equipment maintenance contracts.

Science.gov (United States)

Boudreau, D A; Scheer, W D; Catrou, P G

1985-12-01

The increasing level of technical sophistication and complexity found in clinical laboratory instrumentation today more than ever demands careful attention to maintenance service needs. The time-worn caution for careful definition of requirements for acquisition of a system should also carry over to acquisition of maintenance service. Guidelines are presented for specifications of terms and conditions for maintenance service from the perspective of the laboratorian in the automated clinical laboratory.

Preventive maintenance program for a research and production reactor

International Nuclear Information System (INIS)

Rico, N.A.

1990-01-01

This program proposes a simple, rapid and efficient methodology for the task of developing a really preventive maintenance discipline. Moreover, the lower cost of its application -since it must satisfy the plant's budget-. To this purpose, an extremely economical and easily obtainable infrastructure is proposed. The following stage is referred to the commissioning system, subsequent supervision and follow-up. The experience gained from the two reactors as RA-6 (Bariloche Atomic Center) and NUR (RAE) of Argelia. Finally, the interacting characteristic of this program, since it may be rapidly adapted to different dimensions of plants, laboratories, etc., must be pointed out. (Author) [es

Code Maintenance and Design for a Visual Programming Language Graphical User Interface

National Research Council Canada - National Science Library

Pierson, Graham

2004-01-01

This work adds new functionality to an existing visual programming environment. It applies software maintenance techniques for use with the Java Language in a Microsoft Windows operating system environment...

Systematic maintenance analysis with decision support method and tool for optimizing maintenance programme

International Nuclear Information System (INIS)

Laakso, K.; Simola, K.; Dorrepaal, J.; Skogberg, P.

1999-01-01

This report describes an approach to evaluate the effectiveness of test and maintenance programs of technical systems used during several years. The method combines an analysis of the historical data on faults and repairs with an analysis of the history of periodic testing and preventive maintenance action programs. The application of the maintenance analysis from the methodological point of view in the reliability centered maintenance (RCM) project for Barsebaeck nuclear power plant is described. In order to limit the analysis resources, a method for ranking of objects for maintenance analysis is needed. Preliminary suggestions for changes in maintenance action programs are based on signals from simple maintenance indicators and qualitative analysis of underlying data on failures and maintenance. To facilitate generation of maintenance indicators, and make the maintenance analysis more efficient, a powerful and suitable data treatment tool is needed for analysis of the work order history. In the final maintenance decisions, additional decision criteria must be taken into account, and thus a more formal decision analysis is often needed for decision support. (au)

The American Board of Radiology Maintenance of Certification (MOC) Program in Radiologic Physics

International Nuclear Information System (INIS)

Thomas, Stephen R.; Hendee, William R.; Paliwal, Bhudatt R.

2005-01-01

Maintenance of Certification (MOC) recognizes that in addition to medical knowledge, several essential elements involved in delivering quality care must be developed and maintained throughout one's career. The MOC process is designed to facilitate and document the professional development of each diplomate of The American Board of Radiology (ABR) through its focus on the essential elements of quality care in Diagnostic Radiology and its subspecialties, and in the specialties of Radiation Oncology and Radiologic Physics. The initial elements of the ABR-MOC have been developed in accord with guidelines of The American Board of Medical Specialties. All diplomates with a ten-year, time-limited primary certificate in Diagnostic Radiologic Physics, Therapeutic Radiologic Physics, or Medical Nuclear Physics who wish to maintain certification must successfully complete the requirements of the appropriate ABR-MOC program for their specialty. Holders of multiple certificates must meet ABR-MOC requirements specific to the certificates held. Diplomates with lifelong certificates are not required to participate in the MOC, but are strongly encouraged to do so. MOC is based on documentation of individual participation in the four components of MOC: (1) professional standing, (2) lifelong learning and self-assessment, (3) cognitive expertise, and (4) performance in practice. Within these components, MOC addresses six competencies: medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice

Determinants of Heart Failure Self-Care Maintenance and Management in Patients and Caregivers: A Dyadic Analysis.

Science.gov (United States)

Bidwell, Julie T; Vellone, Ercole; Lyons, Karen S; D'Agostino, Fabio; Riegel, Barbara; Juárez-Vela, Raúl; Hiatt, Shirin O; Alvaro, Rosaria; Lee, Christopher S

2015-10-01

Disease self-management is a critical component of maintaining clinical stability for patients with chronic illness. This is particularly evident in the context of heart failure (HF), which is the leading cause of hospitalization for older adults. HF self-management, commonly known as HF self-care, is often performed with the support of informal caregivers. However, little is known about how a HF dyad manages the patient's care together. The purpose of this study was to identify determinants of patient and caregiver contributions to HF self-care maintenance (daily adherence and symptom monitoring) and management (appropriate recognition and response to symptoms), utilizing an approach that controls for dyadic interdependence. This was a secondary analysis of cross-sectional data from 364 dyads of Italian HF patients and caregivers. Multilevel modeling was used to identify determinants of HF self-care within patient-caregiver dyads. Patients averaged 76.2 (SD = 10.7) years old, and a slight majority (56.9%) was male, whereas caregivers averaged 57.4 (SD = 14.6) years old, and about half (48.1%) were male. Most caregivers were adult children (48.4%) or spouses (32.7%) of patients. Both patients and caregivers reported low levels of HF maintenance and management behaviors. Significant individual and dyadic determinants of self-care maintenance and self-care management included gender, quality of life, comorbid burden, impaired ADLs, cognition, hospitalizations, HF duration, relationship type, relationship quality, and social support. These comprehensive dyadic models assist in elucidating the complex nature of patient-caregiver relationships and their influence on HF self-care, leading to more effective ways to intervene and optimize outcomes. © 2015 Wiley Periodicals, Inc.

Long-Term Body Weight Maintenance among StrongWomen–Healthy Hearts Program Participants

Directory of Open Access Journals (Sweden)

Rebecca A. Seguin

2017-01-01

Full Text Available Background. The repeated loss and regain of body weight, referred to as weight cycling, may be associated with negative health complications. Given today’s obesity epidemic and related interventions to address obesity, it is increasingly important to understand contexts and factors associated with weight loss maintenance. This study examined BMI among individuals who had previously participated in a 12-week, evidence-based, nationally disseminated nutrition and physical activity program designed for overweight and obese middle-aged and older women. Methods. Data were collected using follow-up surveys. Complete height and weight data were available for baseline, 12-week program completion (post-program and follow-up (approximately 3 years later for 154 women (response rate = 27.5%; BMI characteristics did not differ between responders and nonresponders. Results. Mean BMI decreased significantly from baseline to post-program (−0.5, P<0.001 and post-program to follow-up (−0.7, P<0.001. Seventy-five percent of survey respondents maintained or decreased BMI post-program to follow-up. Self-efficacy and social support for healthy eating behaviors (but not physical activity were associated with BMI maintenance or additional weight loss. Conclusions. These findings support the durability of weight loss following participation in a relatively short-term intervention.

49 CFR 180.416 - Discharge system inspection and maintenance program for cargo tanks transporting liquefied...

Science.gov (United States)

2010-10-01

... section. (v) Stainless steel flexible connectors with damaged reinforcement braid. (vi) Internal self... program for cargo tanks transporting liquefied compressed gases. 180.416 Section 180.416 Transportation... PACKAGINGS Qualification and Maintenance of Cargo Tanks § 180.416 Discharge system inspection and maintenance...

Community Building Services Training Program: A Model Training Program to Provide Technical Training for Minority Adults in Construction, Building Maintenance,and Property Management. Final Report.

Science.gov (United States)

Community Building Maintenance Corp., Chicago, IL.

A demonstration program, administered by a community based building maintenance, management, and construction corporation, was developed to provide technical training for minority adults in construction, building maintenance, and property management in the Chicago area. The program was concerned with seeking solutions to the lack of housing, job…

Successfully integrating aged care services: A review of the evidence and tools emerging from a long-term care program

Directory of Open Access Journals (Sweden)

Michael J. Stewart

2013-02-01

Full Text Available Background: Providing efficient and effective aged care services is one of the greatest public policy concerns currently facing governments. Increasing the integration of care services has the potential to provide many benefits including increased access, promoting greater efficiency, and improving care outcomes. There is little research, however, investigating how integrated aged care can be successfully achieved. The PRISMA (Program of Research to Integrate Services for the Maintenance of Autonomy project, from Quebec, Canada, is one of the most systematic and sustained bodies of research investigating the translation and outcomes of an integrated care policy into practice.  The PRISMA research program has run since 1988, yet there has been no independent systematic review of this work to draw out the lessons learnt. Methods: Narrative review of all literature emanating from the PRISMA project between 1988 and 2012. Researchers accessed an online list of all published papers from the program website. The reference lists of papers were hand searched to identify additional literature. Finally, Medline, Pubmed, EMBASE and Google Scholar indexing databases were searched using key terms and author names. Results were extracted into specially designed spread sheets for analysis. Results: 45 journal articles and two books authored or co-authored by the PRISMA team were identified. Research was primarily concerned with: the design, development and validation of screening and assessment tools; and results generated from their application. Both quasi-experimental and cross sectional analytic designs were used extensively. Contextually appropriate expert opinion was obtained using variations on the Delphi Method. Literature analysis revealed the structures, processes and outcomes which underpinned the implementation. PRISMA provides evidence that integrating care for older persons is beneficial to individuals through reducing incidence of functional

Successfully integrating aged care services: A review of the evidence and tools emerging from a long-term care program

Directory of Open Access Journals (Sweden)

Michael J. Stewart

2013-02-01

Full Text Available Background: Providing efficient and effective aged care services is one of the greatest public policy concerns currently facing governments. Increasing the integration of care services has the potential to provide many benefits including increased access, promoting greater efficiency, and improving care outcomes. There is little research, however, investigating how integrated aged care can be successfully achieved. The PRISMA (Program of Research to Integrate Services for the Maintenance of Autonomy project, from Quebec, Canada, is one of the most systematic and sustained bodies of research investigating the translation and outcomes of an integrated care policy into practice.  The PRISMA research program has run since 1988, yet there has been no independent systematic review of this work to draw out the lessons learnt.Methods: Narrative review of all literature emanating from the PRISMA project between 1988 and 2012. Researchers accessed an online list of all published papers from the program website. The reference lists of papers were hand searched to identify additional literature. Finally, Medline, Pubmed, EMBASE and Google Scholar indexing databases were searched using key terms and author names. Results were extracted into specially designed spread sheets for analysis.Results: 45 journal articles and two books authored or co-authored by the PRISMA team were identified. Research was primarily concerned with: the design, development and validation of screening and assessment tools; and results generated from their application. Both quasi-experimental and cross sectional analytic designs were used extensively. Contextually appropriate expert opinion was obtained using variations on the Delphi Method. Literature analysis revealed the structures, processes and outcomes which underpinned the implementation. PRISMA provides evidence that integrating care for older persons is beneficial to individuals through reducing incidence of functional

An optimal maintenance policy for machine replacement problem using dynamic programming

Directory of Open Access Journals (Sweden)

Mohsen Sadegh Amalnik

2017-06-01

Full Text Available In this article, we present an acceptance sampling plan for machine replacement problem based on the backward dynamic programming model. Discount dynamic programming is used to solve a two-state machine replacement problem. We plan to design a model for maintenance by consid-ering the quality of the item produced. The purpose of the proposed model is to determine the optimal threshold policy for maintenance in a finite time horizon. We create a decision tree based on a sequential sampling including renew, repair and do nothing and wish to achieve an optimal threshold for making decisions including renew, repair and continue the production in order to minimize the expected cost. Results show that the optimal policy is sensitive to the data, for the probability of defective machines and parameters defined in the model. This can be clearly demonstrated by a sensitivity analysis technique.

EVALUATION OF THE IMPLEMENTATION OF OPERATIONS AND MAINTENANCE PROGRAMS IN NEW JERSEY SCHOOLS

Science.gov (United States)

The Asbestos Hazard Emergency Response Act (AHERA) required all schools to develop and implement an asbestos management plan (AMP). The key component of the AMP is the operations and maintenance (O&M) program. A study was conducted to evaluate the implementation of O&M programs a...

Maintenance planning and performance software for valve packing programs at nuclear power stations (ValvePro Version 2.5)

International Nuclear Information System (INIS)

Hutcheson, N.D.

1994-01-01

ValvePro Version 2.5 for Windows was developed to help power plant maintenance personnel improve maintenance productivity and quality through a simple, attractive software program, which can be installed on personal computer systems in use at many utilities today. This paper explains the functions of this software and how it can be used by a maintenance organization as a foundation for a consistent, effective valve packing program utilizing sound packing principles

Hotline Allegations Involving Contracts for Programmed Depot Maintenance of KC-135 Aircraft

National Research Council Canada - National Science Library

1998-01-01

Introduction. We performed the audit in response to 15 allegations made to the Defense Hotline involving two contracts on the Programmed Depot Maintenance of the KC-135 Aircraft, which Oklahoma City Air logistics...

The Prenatal Care at School Program

Science.gov (United States)

Griswold, Carol H.; Nasso, Jacqueline T.; Swider, Susan; Ellison, Brenda R.; Griswold, Daniel L.; Brooks, Marilyn

2013-01-01

School absenteeism and poor compliance with prenatal appointments are concerns for pregnant teens. The Prenatal Care at School (PAS) program is a new model of prenatal care involving local health care providers and school personnel to reduce the need for students to leave school for prenatal care. The program combines prenatal care and education…

Building Maintenance, Management, and Budgeting.

Science.gov (United States)

Pawsey, M. R.

1982-01-01

Australian methods and formulas for funding building maintenance and management are outlined and found to be haphazard. Discussed are: ultimate costs of deferred maintenance, major plant replacements, life cycle costing, types of maintenance programs (including full preventive maintenance), use of computer programs for planning, and organization…

Comprehensive low-cost reliability centered maintenance. Final report

International Nuclear Information System (INIS)

Rotton, S.J.; Dozier, I.J.; Thow, R.

1995-09-01

Reliability Centered Maintenance (RCM) is a maintenance optimization approach that all electric utilities can apply to power plant systems. The Electric Power Research Institute and PECO Energy Company jointly sponsored this Comprehensive Low-Cost Reliability Centered Maintenance project to demonstrate that the standard RCM methodology could be streamlined to reduce the cost of analysis while maintaining a high quality product. EPRI's previous investigation of streamlined RCM methods being pioneered in the nuclear industry indicated that PECO Energy could expect to optimize its maintenance program at reduced cost by carefully controlling the scope without sacrificing documentation or technical quality. Using the insights obtained from these previous studies, three methods were defined in this project and were demonstrated in a large scale application to 60 systems at both the Limerick Generating Station and the Peach Bottom Atomic Power Station

Predictors of Weight Loss Maintenance following an Insurance-Sponsored Weight Management Program

OpenAIRE

Christiaan G. Abildso; Olivier Schmid; Megan Byrd; Sam Zizzi; Alessandro Quartiroli; Sean J. Fitzpatrick

2014-01-01

Intentional weight loss among overweight and obese adults (body mass index ≥ 25 kg/m2) is associated with numerous health benefits, but weight loss maintenance (WLM) following participation in weight management programming has proven to be elusive. Many individuals attempting to lose weight join formal programs, especially women, but these programs vary widely in focus, as do postprogram weight regain results. We surveyed 2,106 former participants in a community-based, insurance-sponsored wei...

A Model for Community-Based Pediatric Oral Heath: Implementation of an Infant Oral Care Program

Directory of Open Access Journals (Sweden)

Francisco J. Ramos-Gomez

2014-01-01

Full Text Available The Affordable Care Act (ACA mandates risk assessments, preventive care, and evaluations based on outcomes. ACA compliance will require easily accessible, cost-effective care models that are flexible and simple to establish. UCLA has developed an Infant Oral Care Program (IOCP in partnership with community-based organizations that is an intervention model providing culturally competent perinatal and infant oral care for underserved, low-income, and/or minority children aged 0–5 and their caregivers. In collaboration with the Venice Family Clinic's Simms/Mann Health and Wellness Center, UCLA Pediatrics, Women, Infants, and Children (WIC, and Early Head Start and Head Start programs, the IOCP increases family-centered care access and promotes early utilization of dental services in nontraditional, primary care settings. Emphasizing disease prevention, management, and care that is sensitive to cultural, language, and oral health literacy challenges, IOCP patients achieve better oral health maintenance “in health” not in “disease modality”. IOCP uses interprofessional education to promote pediatric oral health across multiple disciplines and highlights the necessity for the “age-one visit”. This innovative clinical model facilitates early intervention and disease management. It sets a new standard of minimally invasive dental care that is widely available and prevention focused, with high retention rates due to strong collaborations with the community-based organizations serving these vulnerable, high-risk children.

A model for community-based pediatric oral heath: implementation of an infant oral care program.

Science.gov (United States)

Ramos-Gomez, Francisco J

2014-01-01

The Affordable Care Act (ACA) mandates risk assessments, preventive care, and evaluations based on outcomes. ACA compliance will require easily accessible, cost-effective care models that are flexible and simple to establish. UCLA has developed an Infant Oral Care Program (IOCP) in partnership with community-based organizations that is an intervention model providing culturally competent perinatal and infant oral care for underserved, low-income, and/or minority children aged 0-5 and their caregivers. In collaboration with the Venice Family Clinic's Simms/Mann Health and Wellness Center, UCLA Pediatrics, Women, Infants, and Children (WIC), and Early Head Start and Head Start programs, the IOCP increases family-centered care access and promotes early utilization of dental services in nontraditional, primary care settings. Emphasizing disease prevention, management, and care that is sensitive to cultural, language, and oral health literacy challenges, IOCP patients achieve better oral health maintenance "in health" not in "disease modality". IOCP uses interprofessional education to promote pediatric oral health across multiple disciplines and highlights the necessity for the "age-one visit". This innovative clinical model facilitates early intervention and disease management. It sets a new standard of minimally invasive dental care that is widely available and prevention focused, with high retention rates due to strong collaborations with the community-based organizations serving these vulnerable, high-risk children.

Institutional Control Program: Long Term Care and Control of Decommissioned Mine/Mill Sites Located on Crown Land

International Nuclear Information System (INIS)

Cunningham, K.

2014-01-01

Institutional Control Program: • Establishes an endpoint for mining company activities on sites located on Crown land; • Establishes funding for the long-term care and control of the closed sites; • Company responsibilities for sites under the Environmental Management and Protection Act remain; • Establishes an Institutional Control Registry; • Establishes an Institutional Control Monitoring and Maintenance Fund and an Institutional Control Unforeseen Events Fund

Managing NASA's International Space Station Logistics and Maintenance program

Science.gov (United States)

Butina, Anthony J.

2001-02-01

The International Space Station will be a permanently manned orbiting vehicle that has no landing gear, no international borders, and no organizational lines-it is one Station that must be supported by one crew, 24 hours a day, 7 days a week, 365 days a year. It flies partially assembled for a number of years before it is finally complete in April of 2006. Space logistics is a new concept that will have wide reaching consequences for both space travel and life on Earth. What is it like to do something that no one has done before? What challenges do you face? What kind of organization do you put together to perform this type of task? How do you optimize your resources to procure what you need? How do you change a paradigm within a space agency? How do you coordinate and manage a one of a kind system with approximately 5,700 Orbital Replaceable Units (ORUs)? How do you plan for preventive and corrective maintenance, when you need to procure spare parts which number into the hundreds of thousands, from 127 major US vendors and 70 major international vendors? How do you transport large sections of ISS hardware around the country? These are some of the topics discussed in this paper. From conception to operation, the ISS requires a unique approach in all aspects of development and operation. Today the dream is coming true; hardware is flying and hardware is failing. The system has been put into place to support the Station and only time will tell if we did it right. This paper discusses some of the experiences of the author after working 12 years on the International Space Station's integrated logistics & maintenance program. From his early days as a contractor supportability engineer and manager, to the NASA manager responsible for the entire ISS Logistics and Maintenance program. .

PRISMA: Program of Research to Integrate the Services for the Maintenance of Autonomy. A system-level integration model in Quebec

Directory of Open Access Journals (Sweden)

Margaret MacAdam

2015-09-01

Full Text Available The Program of Research to Integrate the Services for the Maintenance of Autonomy (PRISMA began in Quebec in 1999. Evaluation results indicated that the PRISMA Project improved the system of care for the frail elderly at no additional cost. In 2001, the Quebec Ministry of Health and Social Services made implementing the six features of the PRISMA approach a province-wide goal in the programme now known as RSIPA (French acronym. Extensive Province-wide progress has been made since then, but ongoing challenges include reducing unmet need for case management and home care services, creating incentives for increased physician participation in care planning and improving the computerized client chart, among others. PRISMA is the only evaluated international model of a coordination approach to integration and one of the few, if not the only, integration model to have been adopted at the system level by policy-makers.

75 FR 67751 - Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting

Science.gov (United States)

2010-11-03

...] Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting AGENCY: Centers for Medicare... guidance and ask questions about the upcoming Community-based Care Transitions Program. The meeting is open... conference will also provide an overview of the Community-based Care Transitions Program (CCTP) and provide...

Effects of a 14-month low-cost maintenance training program in patients with chronic systolic heart failure

DEFF Research Database (Denmark)

Prescott, Eva; Hjardem-Hansen, Rasmus; Ørkild, Bodil

2009-01-01

Exercise training is known to be beneficial in chronic heart failure (CHF) patients but there is a lack of studies following patient groups for longer duration with maintenance training programs to defer deconditioning.......Exercise training is known to be beneficial in chronic heart failure (CHF) patients but there is a lack of studies following patient groups for longer duration with maintenance training programs to defer deconditioning....

Results of calendar year 1995 Well Inspection and Maintenance Program Y-12 Plant, Oak Ridge, Tennessee

International Nuclear Information System (INIS)

McMaster, B.W.

1996-07-01

This document is a compendium of results of the 1995 Monitor Well Inspection and Maintenance Program at the US Department of Energy's Oak Ridge Y-12 Plant. This report documents the work relating to well inspections and maintenance requests. Inspections are implemented in order to better assess the condition and maintenance needs of wells that are actively being monitored. Currently this approach calls for inspecting all wells on a routine (annual or triennial) basis which are: (1) in an active sampling program; (2) included in a hydrologic study; or (3) not in service, but not scheduled for plugging and abandonment. Routine inspections help to ensure that representative groundwater samples and hydrologic data are being collected, and contribute to the effective longevity of each well. This report formally presents well inspection and maintenance activities that were conducted at the Y-12 Plant from August through December 1995

Two fuzzy possibilistic bi-objective zero-one programming models for outsourcing the equipment maintenance problem

Science.gov (United States)

Vahdani, Behnam; Jolai, Fariborz; Tavakkoli-Moghaddam, Reza; Meysam Mousavi, S.

2012-07-01

Maintenance outsourcing can be regarded as a strategic weapon to increase productivity and customer satisfaction in many companies, and this critical activity can be performed in a more efficient and effective way. This article presents two novel fuzzy possibilistic bi-objective zero-one programming (FPBOZOP) models for outsourcing of the equipment maintenance. In these models, cost parameters, including outsourcing cost, risk cost, time operations for performing the equipment maintenance and reliability level, as well as other influential parameters are considered through the outsourcing process. Moreover, the presented models can measure the capability of the company in doing different activities, unlike previous studies, in order to see the possibility of maintenance in-house, and can lead to make a best decision on the basis of the models' results. Both models are developed under uncertainty, which bring top managers the possibility of assigning more than one equipment or project to the supplier so that the profit is maximized, and the cost is minimized by considering bi-objectives concurrently. Then, a new fuzzy mathematical programming based possibilistic approach is introduced as a solution methodology from the recent literature to solve the proposed bi-objective zero-one programming (BOZOP) models and to reach a preferred compromise solution. Furthermore, a real-case study is utilized to demonstrate and to validate the effectiveness of the presented models. The computational results revealed that the models can be implemented in variety of problems in the domain of the equipment maintenance outsourcing and project outsourcing either from theory or application perspectives.

Y-12 Groundwater Protection Program CY2012 Triennial Report Of The Monitoring Well Inspection And Maintenance Program Y-12 National Security Complex, Oak Ridge, Tennessee

Energy Technology Data Exchange (ETDEWEB)

None

2013-09-01

This document is the triennial report for the Well Inspection and Maintenance Program of the Y- 12 Groundwater Protection Program (GWPP), at the U.S. Department of Energy (DOE) Y-12 National Security Complex (Y-12). This report formally documents well inspections completed by the GWPP on active and inactive wells at Y-12 during calendar years (CY) 2010 through 2012. In addition, this report also documents well inspections performed under the Y-12 Water Resources Restoration Program, which is administered by URS|CH2M Oak Ridge (UCOR). This report documents well maintenance activities completed since the last triennial inspection event (CY 2009); and provides summary tables of well inspections and well maintenance activities during the reference time period.

South Blackwater Coal`s maintenance program

Energy Technology Data Exchange (ETDEWEB)

Nash, J. [South Blackwater Coal Limited, Blackwater, Qld. (Australia)

1998-09-01

The South Blackwater operation consists of two opencut mining areas and two underground mines (Laleham and Kenmure) near Blackwater in central Queensland, all of which supply coal to a central coal preparation plant. South Blackwater Coal Ltd. recently developed a maintenance improvement programme, described in this article. The programme involved implementation systems of key performance indicators (KPIs), benchmaking, condition monitoring, work planning and control, failure analysis and maintenance audit. Some improvements became almost immediately apparent, others were quite gradual. Major results included: improved availability (and reliability) of all opencast fleets, improvements in rear dump availability; reduced maintenance man-hours for opencast fleets; and increased availability of the coal handling and preparation plant. The paper is an edited version of that presented at the `Maintenance in mining conference` 16-19 March 1998, held in Bali, Indonesia. 4 figs., 2 photos.

Programas de continuidad de cuidados: el ejemplo del distrito de Chamartín de Madrid Continuity of care programs: the example of Madrid Chamartin district

Directory of Open Access Journals (Sweden)

Ana González Rodríguez

2011-12-01

Full Text Available Se presenta el programa de continuidad de cuidados del Centro de Salud Mental de Chamartín en Madrid, para ilustrar con una experiencia fuera del ámbito anglosajón donde surgen estos programas, la teoría expuesta en la primera parte acerca del surgimiento, desarrollo y filosofía de los programas de continuidad de cuidados. Se describen los recursos sanitarios, sociales y personales de los que dispone la población a la que va dirigido y la forma de intervención, con el tipo de actuaciones que se realizan. Por último, se señalan algunos riesgos en el desarrollo y mantenimiento de los programas de continuidad de cuidados.The case management program of Chamartin Mental Health Center in Madrid is presented to illustrate with an experience outside the Anglo-Saxon context, where such programs arise, the theory advanced in the first part about the emergence, development and philosophy of continuity of care programs. Finally, some risks in the development and maintenance of continuity of care programs are pointed out. The health, social and staff resources are described, and also the population to be targeted, the form of intervention and the type of actions that are performed. Finally, we point out some risks in the development and maintenance of continuity of care programs.

Y-12 Groundwater Protection Program CY 2009 Triennial Report Of The Monitoring Well Inspection And Maintenance Program, Y-12 National Security Complex, Oak Ridge, Tennessee

Energy Technology Data Exchange (ETDEWEB)

None

2013-06-01

This document is the triennial report for the Well Inspection and Maintenance Program of the Y- 12 Groundwater Protection Program (GWPP), at the U.S. Department of Energy (DOE) Y-12 National Security Complex (Y-12). This report formally documents well inspection events conducted on active and inactive wells at Y-12 during calendar years (CY) 2007 through 2009; it documents well maintenance and plugging and abandonment activities completed since the last triennial inspection event (CY 2006); and provides summary tables of well inspection events, well maintenance events, and well plugging and abandonment events during the reference time period.

The Effectiveness of Stress Management Program on Quality of Life among Methadone Maintenance Treatment Members

Directory of Open Access Journals (Sweden)

s Zarei

2014-11-01

Full Text Available Objective: The aim of present study was to investigate the effectiveness of stress management program on quality of life among methadone maintenance treatment members. Method: In this pre-test, post-test experimental study, 30 individual who referred to Saba MMT center in Pakdasht were randomly divided into experimental group (n=15 participants and control group (n=15 participants. The experimental group was undergone ten 90 minutes sessions of stress management program and the control group didn’t receive any treatment program. Quality of life questionnaire (SF-36 was administered. Result: The results showed that the mean sf-36 score in the experimental group had significant higher increased in comparison of control group. Conclusion: It can be concluded stress management program is effective on increasing of quality of life among methadone maintenance treatment members.

Creation of an instrument maintenance program at W. M. Keck Observatory

Science.gov (United States)

Hill, G. M.; Kwok, S. H.; Mader, J. A.; Wirth, G. D.; Dahm, S. E.; Goodrich, R. W.

2014-08-01

Until a few years ago, the W. M. Keck Observatory (WMKO) did not have a systematic program of instrument maintenance at a level appropriate for a world-leading observatory. We describe the creation of such a program within the context of WMKO's lean operations model which posed challenges but also guided the design of the system and resulted in some unique and notable capabilities. These capabilities and the flexibility of the system have led to its adoption across the Observatory for virtually all PM's. The success of the Observatory in implementing the program and its impact on instrument reliability are presented. Lessons learned are reviewed and strategic implications discussed.

Four Generations of Maintenance Resource Management Programs in the United States: An Analysis of the Past, Present, and Future

Science.gov (United States)

Taylor, James C.; Patankar, Manoj S.

2001-01-01

This paper analyzes four generations of Maintenance Resource Management (MRM) programs implemented by aviation maintenance organizations in the United States. Data collected from over ten years of survey research and field observations are used for this analysis; they are presented in a case-study format. The first three generations of MRM programs were episodic efforts to increase safety through teamwork, focus group discussions, and awareness courses, respectively. Now, the fourth generation programs, characterized by a commitment to long-term communication and behavioral changes in maintenance, are set to build on those earlier generations, toward a culture of mutual trust between mechanics, their managers, and regulators.

Annual summary report of the Decontamination and Decommissioning Surveillance and Maintenance Program at Oak Ridge National Laboratory for period ending September 30, 1994

International Nuclear Information System (INIS)

Anderson, L.A.; Burwinkle, T.W.; Ford, M.K.; Gaddis, H.R.; Holder, L. Jr.; Mandry, G.J.; Nelson, T.R.; Patton, B.D.

1995-03-01

The Surplus Facilities Management Program (SFMP) was established at Oak Ridge National Laboratory (ORNL) in 1976 to provide collective management of all surplus sites under ORNL's control on the Oak Ridge Reservation. Presently, over 50 facilities, grouped into projects, are currently managed by the Decontamination and Decommissioning Program, the successor program to the SFMP. Support includes (1) surveillance and maintenance planning; (2) routine surveillance and maintenance; and (3) special maintenance projects. This report documents routine surveillance and maintenance, special projects, and special maintenance performed on these facilities for the period of October 1993 through September 1994

Child Care Program Office

Science.gov (United States)

Information Medicaid Public Health Centers Temporary "Cash" Assistance Senior Benefits Program the proposed regulation changes, including the potential costs to private persons of complying with Heating Assistance Medicaid Senior Benefits Temporary Assistance Get Help Food Health Care Cash Child Care

Maintenance for the Millennium: Another Approach

International Nuclear Information System (INIS)

Sculthorpe, Barruy R.

2002-01-01

Nuclear units nationwide are struggling to increase plant reliability and availability while at the same time reduce their operating and maintenance costs. Some very costly investments have been made in programs such as Reliability Centered Maintenance [RCM]. Florida Power and Light's approach at the St. Lucie Nuclear Plant has taken a slightly different approach. Building on our knowledge of the RCM process and an already existing 'World Class' Predictive Maintenance Program, a 'Condition-Based' Maintenance Program that takes advantage of the RCM philosophy and our toolbox full of advanced and highly successful predictive maintenance technologies. These tools currently consist of vibration analysis, lubricant analysis (both physical property and wear metals analysis, thermographic analysis, motor current signature analysis, tribology and process parameter trending. All employed with the intent to evaluate a machines health. This machine health check allows the forecasting of future preventative maintenance [PM's] tasks and the revision of existing PM's to maximize machine performance and eliminate 'no-value-added' maintenance activities/costs. Within the last year, the Condition-Based Maintenance Program has produced a cost saving of approximately $1.5 million dollars. As the program matures, these cost savings will accumulate well into the millennium. (authors)

Two Different Maintenance Strategies in the Hospital Environment: Preventive Maintenance for Older Technology Devices and Predictive Maintenance for Newer High-Tech Devices

OpenAIRE

Sezdi, Mana

2016-01-01

A maintenance program generated through the consideration of characteristics and failures of medical equipment is an important component of technology management. However, older technology devices and newer high-tech devices cannot be efficiently managed using the same strategies because of their different characteristics. This study aimed to generate a maintenance program comprising two different strategies to increase the efficiency of device management: preventive maintenance for older tec...

Design, Development, and Maintenance of the GLOBE Program Website and Database

Science.gov (United States)

Brummer, Renate; Matsumoto, Clifford

2004-01-01

This is a 1-year (Fy 03) proposal to design and develop enhancements, implement improved efficiency and reliability, and provide responsive maintenance for the operational GLOBE (Global Learning and Observations to Benefit the Environment) Program website and database. This proposal is renewable, with a 5% annual inflation factor providing an approximate cost for the out years.

Two Different Maintenance Strategies in the Hospital Environment: Preventive Maintenance for Older Technology Devices and Predictive Maintenance for Newer High-Tech Devices.

Science.gov (United States)

Sezdi, Mana

2016-01-01

A maintenance program generated through the consideration of characteristics and failures of medical equipment is an important component of technology management. However, older technology devices and newer high-tech devices cannot be efficiently managed using the same strategies because of their different characteristics. This study aimed to generate a maintenance program comprising two different strategies to increase the efficiency of device management: preventive maintenance for older technology devices and predictive maintenance for newer high-tech devices. For preventive maintenance development, 589 older technology devices were subjected to performance verification and safety testing (PVST). For predictive maintenance development, the manufacturers' recommendations were used for 134 high-tech devices. These strategies were evaluated in terms of device reliability. This study recommends the use of two different maintenance strategies for old and new devices at hospitals in developing countries. Thus, older technology devices that applied only corrective maintenance will be included in maintenance like high-tech devices.

Turbine maintenance and modernization

Energy Technology Data Exchange (ETDEWEB)

Unga, E [Teollisuuden Voima Oy, Olkiluoto (Finland)

1999-12-31

The disturbance-free operation of the turbine plant plays an important role in reaching good production results. In the turbine maintenance of the Olkiluoto nuclear power plant the lifetime and efficiency of turbine components and the lifetime costs are taken into account in determining the turbine maintenance and modernization/improvement program. The turbine maintenance program and improvement/modernization measures taken in the plant units are described in this presentation. (orig.)

Turbine maintenance and modernization

Energy Technology Data Exchange (ETDEWEB)

Unga, E. [Teollisuuden Voima Oy, Olkiluoto (Finland)

1998-12-31

The disturbance-free operation of the turbine plant plays an important role in reaching good production results. In the turbine maintenance of the Olkiluoto nuclear power plant the lifetime and efficiency of turbine components and the lifetime costs are taken into account in determining the turbine maintenance and modernization/improvement program. The turbine maintenance program and improvement/modernization measures taken in the plant units are described in this presentation. (orig.)

Portsmouth Gaseous Diffusion Plant Decontamination and Decommissioning Program surveillance and maintenance plan, FY 1993--2002

International Nuclear Information System (INIS)

Schloesslin, W.

1992-11-01

The Decontamination and Decommissioning (D ampersand D) Program at the Portsmouth Gaseous Diffusion Plant (PORTS) is part of the Environmental Restoration (ER) and Waste Management (WM) Programs (ERWM). The objective of the ER Program is to provide PORTS the capability to meet applicable environmental regulations through facility development activities and site remedial actions. The WM Program supports the ER Program. The D ampersand D Program provides collective management of the sites within the plant which require decontamination and decommissioning, prioritizes those areas in terms of health, safety and environmental concerns, and implements the appropriate level of remedial action. The D ampersand D Program provides support to facilities which formerly served one or more of the many Plant functions. Program activities include (1) surveillance and maintenance of facilities awaiting decommissioning; (2) planning safe and orderly facility decommissioning; and (3) implementing a program to accomplish facility disposition in a safe, cost effective, and timely manner. In order to achieve the first objective, a formal plan which documents the surveillance and maintenance needs for each inactive facility has been prepared. This report provides this documentation for the PORTS facilities currently included in the D ampersand D Program and includes projected resource requirements for the planning period of FY 1993 through FY 2002

Attitude toward the out-patient cardiac rehabilitation program and facilitators for maintenance of exercise behavior.

Science.gov (United States)

Wong, Eliza M L; Zhong, Xue Bing; Sit, Janet W H; Chair, Sek Ying; Leung, Doris Y P; Leung, Carmen; Leung, K C

2016-09-01

This study examined the attitudes of Chinese patients with coronary heart disease (CHD) toward the outpatient cardiac rehabilitation program (OCRP), as well as their exercise behavior, intention, maintenance and related factors. A qualitative descriptive study design was used, and 22 CHD patients were recruited in Hong Kong in 2014. In-depth interviews and content analyses were conducted. The tripartite model of attitudes was adopted as research framework. Two themes were identified: (1) informant attitude (perception, affection, and practice) toward the OCRP and (2) Exercise Behavior - intention, maintenance and its related factors. Most informants showed positive perception and affection regarding the outpatient rehabilitation program, leading to regular practice of exercise in the program and at home. Peer, group dynamic, social support and Chinese culture influences on exercise behavior may serve as major facilitators to maintain exercise behavior. Positive attitude toward the OCRP enhanced the participation rate, whereas peer and social support from the family and workplace were useful to improve the maintenance of exercise behavior. Overall, this study provides insights into strategic planning for the OCRP and continual support for CHD patients in the community.

Maintenance of Certification for Radiation Oncology

International Nuclear Information System (INIS)

Kun, Larry E.; Ang, Kian; Erickson, Beth; Harris, Jay; Hoppe, Richard; Leibel, Steve; Davis, Larry; Hattery, Robert

2005-01-01

Maintenance of Certification (MOC) recognizes that in addition to medical knowledge, several essential elements involved in delivering quality care must be developed and maintained throughout one's career. The MOC process is designed to facilitate and document professional development of American Board of Radiology (ABR) diplomates in the essential elements of quality care in Radiation Oncology and Radiologic Physics. ABR MOC has been developed in accord with guidelines of the American Board of Medical Specialties. All Radiation Oncology certificates issued since 1995 are 10-year, time-limited certificates; diplomates with time-limited certificates who wish to maintain specialty certification must complete specific requirements of the American Board of Radiology MOC program. Diplomates with lifelong certificates are not required to participate but are strongly encouraged to do so. Maintenance of Certification is based on documentation of participation in the four components of MOC: (1) professional standing, (2) lifelong learning and self-assessment, (3) cognitive expertise, and (4) performance in practice. Through these components, MOC addresses six competencies-medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice. Details of requirements for components 1, 2, and 3 of MOC are outlined along with aspects of the fourth component currently under development

GunderKids: Design of a Clinical Care Management Program for Parents With Substance Abuse and Their Newborn Children with a Focus on Preventing Child Abuse.

Science.gov (United States)

Budzak-Garza, Ann E; Allmon Dixson, Allison L; Holzer, Renee A; Lillard-Pierce, Kaitlin E; Devine, Carolynn J

2018-03-01

In response to an increased need to care for babies born to mothers with substance abuse issues, we developed GunderKids, a care management program that provides integrated medical care beyond standard-of-care, well-child appointments for these socially complex families. The program incorporates frequent visits to the pediatrician and the care team, which includes pediatric nurses, a pediatric social worker, and a child psychologist. Enrollment is voluntary. Each visit addresses parenting challenges, home environment, basic needs, safety issues, and maintenance of sobriety, as well as child development and health issues. We found that mothers and fathers (or parents) welcome intense support following delivery, appreciate the relationship that is built with the care team, and prefer frequent visits at the medical center over in-home visits, which they perceive as potentially intrusive. We describe here the planning and implementation of the program, as well as insights gained in our first year. Copyright© Wisconsin Medical Society.

Human factors interventions to reduce human errors and improve productivity in maintenance tasks

International Nuclear Information System (INIS)

Isoda, Hachiro; Yasutake, J.Y.

1992-01-01

This paper describes work in progress to develop interventions to reduce human errors and increase maintenance productivity in nuclear power plants. The effort is part of a two-phased Human Factors research program being conducted jointly by the Central Research Institute of Electric Power Industry (CRIEPI) in Japan and the Electric Power Research Institute (EPRI) in the United States. The overall objective of this joint research program is to identify critical maintenance tasks and to develop, implement and evaluate interventions which have high potential for reducing human errors or increasing maintenance productivity. As a result of the Phase 1 effort, ten critical maintenance tasks were identified. For these tasks, over 25 candidate interventions were identified for potential development. After careful analysis, seven interventions were selected for development during Phase 2. This paper describes the methodology used to analyze and identify the most critical tasks, the process of identifying and developing selected interventions and some of the initial results. (author)

A Vocational Program for Recreational Vehicle Maintenance/Repair. A Report, 1977-78.

Science.gov (United States)

1978

This report contains a secondary school curriculum guide designed to be used by vocational teachers in a one- or two-year recreational vehicle maintenance/repair program. In the preliminary pages, a description is given of the project that developed the curriculum, outlining its objectives and procedures in formulating the model interdisciplinary…

EPR design for maintenance

International Nuclear Information System (INIS)

Krugmann, U.

1998-01-01

Preventive maintenance is very important in achieving high plant availability. For the European Pressurized Reactor (EPR) preventive maintenance has been carefully addressed in the design stage. This is particularly necessary because of the traditionally different maintenance strategies employed in France and Germany. This paper emphasizes the following features introduced in the ERP design to minimize the duration of the refueling outage: (1) containment accessibility during power operation; (2) overall plant layout to facilitate inspections and maintenances within the containment; and (3) safety system design for enabling preventive maintenance during power operation. (author)

Results of calendar year 1994 monitor well inspection and maintenance program, Y-12 Plant, Oak Ridge, Tennessee

International Nuclear Information System (INIS)

McMaster, B.W.; Jones, S.B.; Sitzler, J.L.

1995-06-01

This document is a compendium of results of the calendar year 1994 Monitor Well Inspection and Maintenance Program at the Department of Energy Y-12 Plant in Oak Ridge, Tennessee. This report documents the work relating to well inspections and maintenance requests. Inspections are implemented in order to better assess the condition and maintenance needs of wells that are actively being monitored. Currently this approach calls for inspecting all wells on a routine (annual or triennial) basis which are: (1) in an active sampling program; (2) included in a hydrologic study; or (3) not in service, but not scheduled for plugging and abandonment. Routine inspections help to ensure that representative groundwater samples and hydrologic data are being collected, and contribute to the life expectancy of each well. This report formally presents well inspection and maintenance activities that were conducted at the Y-12 Plant during 1994. All inspections were conducted between April and December

Results of calendar year 1994 monitor well inspection and maintenance program, Y-12 Plant, Oak Ridge, Tennessee

Energy Technology Data Exchange (ETDEWEB)

McMaster, B.W. [Univ. of Tennessee, Knoxville, TN (United States); Jones, S.B.; Sitzler, J.L. [Oak Ridge National Lab., TN (United States)

1995-06-01

This document is a compendium of results of the calendar year 1994 Monitor Well Inspection and Maintenance Program at the Department of Energy Y-12 Plant in Oak Ridge, Tennessee. This report documents the work relating to well inspections and maintenance requests. Inspections are implemented in order to better assess the condition and maintenance needs of wells that are actively being monitored. Currently this approach calls for inspecting all wells on a routine (annual or triennial) basis which are: (1) in an active sampling program; (2) included in a hydrologic study; or (3) not in service, but not scheduled for plugging and abandonment. Routine inspections help to ensure that representative groundwater samples and hydrologic data are being collected, and contribute to the life expectancy of each well. This report formally presents well inspection and maintenance activities that were conducted at the Y-12 Plant during 1994. All inspections were conducted between April and December.

Preventative Maintenance.

Science.gov (United States)

Migliorino, James

Boards of education must be convinced that spending money up front for preventive maintenance will, in the long run, save districts' tax dollars. A good program of preventive maintenance can minimize disruption of service; reduce repair costs, energy consumption, and overtime; improve labor productivity and system equipment reliability; handle…

Home-based intermediate care program vs hospitalization

Science.gov (United States)

Armstrong, Catherine Deri; Hogg, William E.; Lemelin, Jacques; Dahrouge, Simone; Martin, Carmel; Viner, Gary S.; Saginur, Raphael

2008-01-01

OBJECTIVE To explore whether a home-based intermediate care program in a large Canadian city lowers the cost of care and to look at whether such home-based programs could be a solution to the increasing demands on Canadian hospitals. DESIGN Single-arm study with historical controls. SETTING Department of Family Medicine at the Ottawa Hospital (Civic campus) in Ontario. PARTICIPANTS Patients requiring hospitalization for acute care. Participants were matched with historical controls based on case-mix, most responsible diagnosis, and level of complexity. INTERVENTIONS Placement in the home-based intermediate care program. Daily home visits from the nurse practitioner and 24-hour access to care by telephone. MAIN OUTCOME MEASURES Multivariate regression models were used to estimate the effect of the program on 5 outcomes: length of stay in hospital, cost of care substituted for hospitalization (Canadian dollars), readmission for a related diagnosis, readmission for any diagnosis, and costs incurred by community home-care services for patients following discharge from hospital. RESULTS The outcomes of 43 hospital admissions were matched with those of 363 controls. Patients enrolled in the program stayed longer in hospital (coefficient 3.3 days, P costs of home-based care were not significantly different from the costs of hospitalization (coefficient -$501, P = .11). CONCLUSION While estimated cost savings were not statistically significant, the limitations of our study suggest that we underestimated these savings. In particular, the economic inefficiencies of a small immature program and the inability to control for certain factors when selecting historical controls affected our results. Further research is needed to determine the economic effect of mature home-based programs. PMID:18208958

Pacific Northwest Laboratory Maintenance Implementation plan

International Nuclear Information System (INIS)

Bright, J.D.

1992-06-01

This Maintenance Implementation plan has been developed for Pacific Northwest Laboratory's (PNL) Nuclear Facilities: 306W, 324, 325, 327 and 329NMF. It is based on a graded approach, self-assessment of the existing maintenance program(s) per the requirements specified by US Department of Energy (DOE) Order 4330.4A, Chapter II, Change number-sign 3. The results of this assessment were evaluated to determine needed improvements in PNL Craft Services' current maintenance program. The objective of this implementation plan is to provide baseline information for compliance to the DOE 4330.4A, and for needed improvements. The prime consideration in applying a graded approach to the Order has been to maintain safe and reliable operations, environmental compliance, safeguards and security, programmatic mission, facility preservation, and/or other facility-specific requirements. Using the results of the self-assessment, PNL has selected nine of the 18 elements of the Maintenance Program defined by DOE Order 4330.4A for improvement. The elements selected for improvement are Training and Qualification of Maintenance Personnel; Maintenance Procedures; Planning, Scheduling, and Coordination of Maintenance; Control of Maintenance Activities; Post-Maintenance Testing; Facility Condition Inspection; Management Involvement; Maintenance History; and Additional Maintenance Requirements. Based upon graded approach and current funding, those elements considered most important have been selected as goals for earliest compliance. Commitment dates for these elements have been established for compliance. The remaining elements of noncompliance will be targeted for implementation during later budget periods

Cost-effectiveness analysis of implementing an antimicrobial stewardship program in critical care units.

Science.gov (United States)

Ruiz-Ramos, Jesus; Frasquet, Juan; Romá, Eva; Poveda-Andres, Jose Luis; Salavert-Leti, Miguel; Castellanos, Alvaro; Ramirez, Paula

2017-06-01

To evaluate the cost-effectiveness of antimicrobial stewardship (AS) program implementation focused on critical care units based on assumptions for the Spanish setting. A decision model comparing costs and outcomes of sepsis, community-acquired pneumonia, and nosocomial infections (including catheter-related bacteremia, urinary tract infection, and ventilator-associated pneumonia) in critical care units with or without an AS was designed. Model variables and costs, along with their distributions, were obtained from the literature. The study was performed from the Spanish National Health System (NHS) perspective, including only direct costs. The Incremental Cost-Effectiveness Ratio (ICER) was analysed regarding the ability of the program to reduce multi-drug resistant bacteria. Uncertainty in ICERs was evaluated with probabilistic sensitivity analyses. In the short-term, implementing an AS reduces the consumption of antimicrobials with a net benefit of €71,738. In the long-term, the maintenance of the program involves an additional cost to the system of €107,569. Cost per avoided resistance was €7,342, and cost-per-life-years gained (LYG) was €9,788. Results from the probabilistic sensitivity analysis showed that there was a more than 90% likelihood that an AS would be cost-effective at a level of €8,000 per LYG. Wide variability of economic results obtained from the implementation of this type of AS program and short information on their impact on patient evolution and any resistance avoided. Implementing an AS focusing on critical care patients is a long-term cost-effective tool. Implementation costs are amortized by reducing antimicrobial consumption to prevent infection by multidrug-resistant pathogens.

Weight maintenance through behaviour modification with a cooking course or neurolinguistic programming.

Science.gov (United States)

Sørensen, Lone Brinkmann; Greve, Tine; Kreutzer, Martin; Pedersen, Ulla; Nielsen, Claus Meyer; Toubro, Søren; Astrup, Arne

2011-01-01

We compared the effect on weight regain of behaviour modification consisting of either a gourmet cooking course or neurolinguistic programming (NLP) therapy. Fifty-six overweight and obese subjects participated. The first step was a 12-week weight loss program. Participants achieving at least 8% weight loss were randomized to five months of either NLP therapy or a course in gourmet cooking. Follow-up occurred after two and three years. Forty-nine participants lost at least 8% of their initial body weight and were randomized to the next step. The NLP group lost an additional 1.8 kg and the cooking group lost 0.2 kg during the five months of weight maintenance (NS). The dropout rate in the cooking group was 4%, compared with 26% in the NLP group (p=0.04). There was no difference in weight maintenance after two and three years of follow-up. In conclusion, weight loss in overweight and obese participants was maintained equally efficiently with a healthy cooking course or NLP therapy, but the dropout rate was lower during the active cooking treatment.

76 FR 34541 - Child and Adult Care Food Program Improving Management and Program Integrity

Science.gov (United States)

2011-06-13

... 7 CFR Parts 210, 215, 220 et al. Child and Adult Care Food Program Improving Management and Program..., 220, 225, and 226 RIN 0584-AC24 Child and Adult Care Food Program Improving Management and Program... management and integrity in the Child and Adult Care Food Program (CACFP), at 67 FR 43447 (June 27, 2002) and...

Annual summary report on the surveillance and maintenance activities for the Oak Rige National Laboratory Environmental Restoration Program for fiscal year 1995

International Nuclear Information System (INIS)

1995-11-01

This Annual Summary Report on the Surveillance and Maintenance Activities for the Oak Ridge National Laboratory Environmental Restoration Program for Fiscal Year 1995 was prepared to communicate the accomplishments of the Program during fiscal year 1995. This work was performed under work breakdown structure element 1.4.12.6.1.14.20 (activity data sheet 3314, ''Remedial Action Surveillance and Maintenance''). Publication of this document meets the Life Cycle Baseline milestone date of November 30, 1995. This document provides the accomplishments for both the Remedial Action and Decontamination and Decommissioning Surveillance and Maintenance programs

Maintenance management systems

International Nuclear Information System (INIS)

Rohan, M. de

1989-01-01

This paper is concerned principally with Maintenance Management systems and their effective introduction into organisations. Maintenance improvement is basically a problem of managing the maintenance department in the broadest sense. Improvement does not only lie in the area of special techniques, systems or procedures; although they are valuable tools, but rather in a balanced attack, carefully guided by management. Over recent years, maintenance systems have received the major emphasis and in many instances the selection of the system has become a pre-occupation, whereas the importance of each maintenance function must be recognised and good management practices applied to all maintenance activities. The ingredients for success in the implementation of maintenance management systems are summarised as: having a management committee, clear objectives, project approach using project management techniques and an enthusiastic leader, user managed and data processing supported project, realistic budget and an understanding of the financial audit requirements. (author)

340 Facility maintenance implementation plan

International Nuclear Information System (INIS)

1995-03-01

This Maintenance Implementation Plan (MIP) has been developed for maintenance functions associated with the 340 Facility. This plan is developed from the guidelines presented by Department of Energy (DOE) Order 4330.4B, Maintenance Management Program (DOE 1994), Chapter II. The objective of this plan is to provide baseline information for establishing and identifying Westinghouse Hanford Company (WHC) conformance programs and policies applicable to implementation of DOE order 4330.4B guidelines. In addition, this maintenance plan identifies the actions necessary to develop a cost-effective and efficient maintenance program at the 340 Facility. Primary responsibility for the performance and oversight of maintenance activities at the 340 Facility resides with Westinghouse Hanford Company (WHC). Maintenance at the 340 Facility is performed by ICF-Kaiser Hanford (ICF-KH) South Programmatic Services crafts persons. This 340 Facility MIP provides interface requirements and responsibilities as they apply specifically to the 340 Facility. This document provides an implementation schedule which has been developed for items considered to be deficient or in need of improvement. The discussion sections, as applied to implementation at the 340 Facility, have been developed from a review of programs and practices utilizing the graded approach. Biennial review and additional reviews are conducted as significant programmatic and mission changes are made. This document is revised as necessary to maintain compliance with DOE requirements

340 Facility maintenance implementation plan

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-03-01

This Maintenance Implementation Plan (MIP) has been developed for maintenance functions associated with the 340 Facility. This plan is developed from the guidelines presented by Department of Energy (DOE) Order 4330.4B, Maintenance Management Program (DOE 1994), Chapter II. The objective of this plan is to provide baseline information for establishing and identifying Westinghouse Hanford Company (WHC) conformance programs and policies applicable to implementation of DOE order 4330.4B guidelines. In addition, this maintenance plan identifies the actions necessary to develop a cost-effective and efficient maintenance program at the 340 Facility. Primary responsibility for the performance and oversight of maintenance activities at the 340 Facility resides with Westinghouse Hanford Company (WHC). Maintenance at the 340 Facility is performed by ICF-Kaiser Hanford (ICF-KH) South Programmatic Services crafts persons. This 340 Facility MIP provides interface requirements and responsibilities as they apply specifically to the 340 Facility. This document provides an implementation schedule which has been developed for items considered to be deficient or in need of improvement. The discussion sections, as applied to implementation at the 340 Facility, have been developed from a review of programs and practices utilizing the graded approach. Biennial review and additional reviews are conducted as significant programmatic and mission changes are made. This document is revised as necessary to maintain compliance with DOE requirements.

Reliability centered maintenance streamlining through lessons learned

International Nuclear Information System (INIS)

Strong, D.K.

1991-01-01

In late 1986, PSE and G concluded that the Nuclear Department would develop a consistent approach to maintenance at Artificial Island (Salem and Hope Creak nuclear units). Preventive maintenance (PM) would be the heart of this approach. In the last six months of 1987 departments affected by the maintenance program participated on working groups that developed the Artificial Island maintenance philosophy. The central theme of the maintenance philosophy is the RCM (reliability centered maintenance) process. A pilot project tested the process in 1988. In 1989 the Central PM Group formed and in 1990 was given responsibility and authority to analyze, approve, implement, and control PM program changes. RCM is the central theme of the PM improvement effort but not the whole effort. Other important pieces included in this paper are: development of a common PM program, improvement of work instructions, development of predictive maintenance techniques into programs, development of a PM basis database, development of PM feedback from failure trends, root cause analysis, maintenance performance indicators, technicians, and engineers

Maintenance program, organization and procedures

International Nuclear Information System (INIS)

Schegk, J.R.R.

1986-01-01

The Rheinisch-Westfaelisches Elektrizitaetswerk AG (RWE) operates two pressurized water reactors (PWR) with 1.200 MW and 1.300 MW and two boiling water reactors (BWR) with an electrical output of 1.300 MW each. The PWR were commissioned in 1975 and 1977 respectively and have so far achieved a cumulative availability of 72%. The BWR started operating in 1984 and 1985. Since than they have been generating with a cumulative availability of 88%. The reliability of the nuclear power stations resulted in a trouble-free operation. For the last two years, the unscheduled non-availability amounted to 3,7% and 6,5% for the PWR and the BWR respectively. These favourable operating results derive inter alia from systematic preventive maintenance and consistent outage management. Apart from the personnel structure in the power stations the functional sequence of planning, control, performance as well as evaluation of maintenance results constitute a closed cycle. In order to ensure and support an effective cooperation of the above mentioned four functional sequences of a cycle, uniform and computer-assisted information and planning aids have been introduced such as task lists, job ordering, time scheduling and materials management. As a result of this preventive maintenance system the average refueling outage period is 35 to 42 days. (orig.)

A new pulmonary rehabilitation maintenance strategy through home-visiting and phone contact in COPD

Directory of Open Access Journals (Sweden)

Li Y

2018-01-01

Full Text Available Yi Li,1,2 Jing Feng,3,4 Yuechuan Li,2 Wei Jia,2 Hongyu Qian2 1Graduate School, Tianjin Medical University, 2Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital, 3Respiratory Department, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China; 4Neuropharmacology Section, Laboratory of Toxicology and Pharmacology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA Background: The benefit of pulmonary rehabilitation (PR for patients with COPD diminishes over time. We investigated a new strategy involving home-visit and phone contact and compared this to usual care in maintenance of PR benefits.Methods: A total of 172 stable COPD patients receiving 8-week PR program were recruited for this prospective study. Patients were allocated into usual care group (UC and PR maintenance group (PRMG randomly. Patients in PRMG participated in maintenance strategy at home under supervision through home-visit and phone contact. The 6-minute walking test (6MWT, COPD assessment test (CAT, and modified Medical Research Council scale (mMRC scores were evaluated every 3 months.Results: Of the total, 151 patients completed 8-week PR program with satisfactory PR results (p<0.001, and 104 patients finished the follow-up. The clinical improvements in 6MWT, CAT, and mMRC scores were maintained (p<0.001 in PRMG. In comparison, the benefit of PR diminished gradually in UC. The differences in 6MWT, CAT, and mMRC scores between groups were observed 6, 9, and 6 months after PR, respectively (p<0.05. Total frequency of exacerbations in PRMG was lower than UC (p=0.021.Conclusion: Maintenance strategy involving home-visit and phone contact is superior to usual care to preserve PR benefits, and reduces the acute COPD exacerbation rate. Keywords: COPD, pulmonary rehabilitation, 6-minute walking test, COPD assessment test, maintenance 

Management of maintenance activities at Cernavoda NPP

International Nuclear Information System (INIS)

Riedel, M.; Urjan, R.; Marinescu, S.; Corlan, L.

2000-01-01

After the Construction and Commissioning phases are over, the safety and economic performances of each nuclear unit are determined by the quality of its operation as well as by the combination of reliability and availability of the systems consisting the whole unit. Therefore, the value of a good maintenance program in making a safe and profitable operation is now widely recognized; all stations operating with excellent performance have well-defined policies and effectively administered programs to govern maintenance activities. The Cernavoda maintenance optimization initiative is derived from good practices suggested by such recognized bodies as the IAEA, INPO and EPRI. It should be noted that the program is evolving at this time and that this paper is an attempt to summarize the myriad of activities and plans required to finally implement the maintenance program. Although many of the elements of the program are in place, many are in various stages of completion. The main components of the program (policy's objectives, strategies used, specific subprograms, maintenance plans and their integration) are presented in brief along with the performance indicators used to assess the effectiveness of the program and maintenance activities. The new programs intended to be developed are also specified, as well as the main comments and recommendations received from IAEA experts. (author)

Disease Management, Case Management, Care Management, and Care Coordination: A Framework and a Brief Manual for Care Programs and Staff.

Science.gov (United States)

Ahmed, Osman I

2016-01-01

With the changing landscape of health care delivery in the United States since the passage of the Patient Protection and Affordable Care Act in 2010, health care organizations have struggled to keep pace with the evolving paradigm, particularly as it pertains to population health management. New nomenclature emerged to describe components of the new environment, and familiar words were put to use in an entirely different context. This article proposes a working framework for activities performed in case management, disease management, care management, and care coordination. The author offers standard working definitions for some of the most frequently used words in the health care industry with the goal of increasing consistency for their use, especially in the backdrop of the Centers for Medicaid & Medicare Services offering a "chronic case management fee" to primary care providers for managing the sickest, high-cost Medicare patients. Health care organizations performing case management, care management, disease management, and care coordination. Road map for consistency among users, in reporting, comparison, and for success of care management/coordination programs. This article offers a working framework for disease managers, case and care managers, and care coordinators. It suggests standard definitions to use for disease management, case management, care management, and care coordination. Moreover, the use of clear terminology will facilitate comparing, contrasting, and evaluating all care programs and increase consistency. The article can improve understanding of care program components and success factors, estimate program value and effectiveness, heighten awareness of consumer engagement tools, recognize current state and challenges for care programs, understand the role of health information technology solutions in care programs, and use information and knowledge gained to assess and improve care programs to design the "next generation" of programs.

The Development and Maintenance of Exemplary Formal Mentoring Programs in Fortune 500 Companies

Science.gov (United States)

Hegstad, Christine D.; Wentling, Rose Mary

2004-01-01

This study sought to advance current mentoring research by examining the development and maintenance of exemplary formal mentoring programs in the nation's top performing companies. The ADDIE model of instructional systems design, which incorporates five steps from needs analysis to evaluation, formed the conceptual framework guiding the study.…

Regulatory approach of the monitoring the effectiveness of maintenance at nuclear power plants program

International Nuclear Information System (INIS)

Vajgel, Stefan

2009-03-01

The electrical power generation using nuclear power plants requires this installation being safety, reliable and available for the working periods. For this purpose, an adequate, effective and well conducted maintenance program makes an essential and useful tool to the owner of the plant. However, it is necessary to follow the regulatory requirements for this program implementation which monitories this maintenance effectiveness. There are Brazilian norms requirements which must be followed. The international regulatory guides establish these requirements in good details but it is necessary to verify if this methodology for implementing can be totally applied here in Brazil. Then, the american guide NUMARC 93-01 which details how can be implemented a program for this monitoring, shows some methods for using. In this thesis, the Delphi and Probabilistic Safety Analysis were briefly included because they were preferred for implementing this monitoring.in a Brazilian plant. The results which are being obtained show that, looking the regulatory aspects, the NUMARC 93-01 follows our regulations and gives good results for the plant management. (author)

38 CFR 1.478 - Disclosures to prevent multiple enrollments in detoxification and maintenance treatment programs...

Science.gov (United States)

2010-07-01

... psychological effects incident to withdrawal from the sustained use of a narcotic drug. (3) Maintenance... heroin or other morphine-like drugs. (4) Member program means a non-VA detoxification treatment or...

The Effect of a Multiple Treatment Program and Maintenance Procedures on Smoking Cessation.

Science.gov (United States)

Powell, Don R.

The efficacy of a multiple treatment smoking cessation program and three maintenance strategies was evaluated. Phases I and II of the study involved 51 subjects who participated in a five-day smoking cessation project consisting of lectures, demonstrations, practice exercises, negative smoking, and the teaching of self-control procedures. At the…

Surveillance and Maintenance Plan for the ORNL Decontamination and Decommissioning Program FY 1993--2002

International Nuclear Information System (INIS)

Ford, M.K.; Holder, L. Jr.

1992-07-01

The Decontamination and Decommissioning (D ampersand D) Program at the Oak Ridge National Laboratory (ORNL) is part of the Department of Energy (DOE) Environmental Restoration D ampersand D program. The purpose and objectivesof this program include: (1) surveillance and maintenance (S ampersand M) of facilities awaiting decommissioning; (2) planning for the orderly decommissioning of these facilities; and (3) implementation of a program to accomplish facility disposition in a safe, cost-effective, and timely manner. Participating D ampersand D contractors are required to prepare formal plans that document the S ampersand M programs established for each site. This report has been prepared to provide this documentation for those facilities included in the ORNL D ampersand D Program

Maintenance analysis method and operational feedback: a comprehensive maintenance management

International Nuclear Information System (INIS)

Mathieu Riou; Victor Planchon

2006-01-01

Full text of publication follows: Current periodic inspections program carried out on the COGEMA LOGISTICS casks is required by regulations and approved by the competent Authority. Thus, Safety and casks conformity to the according certificate of approval are guaranteed. Nonetheless, based on experience it appeared that some maintenance operations did not seem relevant or were redundant. Then, it was decided to rethink completely our maintenance program to reach the following objectives: - Set up the 'a minima' required inspection operations required to guarantee Safety and conformity to the certificate of approval, - Optimize criteria and periodicities of inspections taking into account: operational feedback, routine inspections carried out for each transport, regulations, environmental impact (ALARA, waste reduction,...), cost-effectiveness (reduction of cask's immobilization period,...). - Set up a maintenance program in Safety Analysis Reports that: stands alone (no need to check the specification or the certificate of approval to have the complete list of inspections mandatory to guarantee Safety), gives objectives instead of means of controls. This approach needs then to be re-evaluated by the competent Authority. Study's scope has been limited to the TN TM 12 cask family which is intensely used. COGEMA LOGISTICS has a high operational feedback on these casks. After Authority agreement, and in accordance with its requirements, study will then be extended to the other casks belonging to the COGEMA LOGISTICS cask fleet. Actually, the term 'maintenance' is linked to 'Base maintenance' and 'Main maintenance' and implicitly means that the cask is immobilized for a given period. To emphasize the modifications, the term 'maintenance' is no longer used and is substituted by 'periodic upkeep'. By changing the name, COGEMA LOGISTICS wants to emphasize that: some operations can for instance be realized while the cask is unloaded, periodicities are thought in terms of

Facility Decontamination and Decommissioning Program Surveillance and Maintenance Plan, Revision 2

Energy Technology Data Exchange (ETDEWEB)

Poderis, Reed J. [NSTec; King, Rebecca A. [NSTec

2013-09-30

This Surveillance and Maintenance (S&M) Plan describes the activities performed between deactivation and final decommissioning of the following facilities located on the Nevada National Security Site, as documented in the Federal Facility Agreement and Consent Order under the Industrial Sites program as decontamination and decommissioning sites: ? Engine Maintenance, Assembly, and Disassembly (EMAD) Facility: o EMAD Building (Building 25-3900) o Locomotive Storage Shed (Building 25-3901) ? Test Cell C (TCC) Facility: o Equipment Building (Building 25-3220) o Motor Drive Building (Building 25-3230) o Pump Shop (Building 25-3231) o Cryogenic Lab (Building 25-3232) o Ancillary Structures (e.g., dewars, water tower, piping, tanks) These facilities have been declared excess and are in various stages of deactivation (low-risk, long-term stewardship disposition state). This S&M Plan establishes and implements a solid, cost-effective, and balanced S&M program consistent with federal, state, and regulatory requirements. A graded approach is used to plan and conduct S&M activities. The goal is to maintain the facilities in a safe condition in a cost-effective manner until their final end state is achieved. This plan accomplishes the following: ? Establishes S&M objectives and framework ? Identifies programmatic guidance for S&M activities to be conducted by National Security Technologies, LLC, for the U.S. Department of Energy, National Nuclear Security Administration Nevada Field Office (NNSA/NFO) ? Provides present facility condition information and identifies hazards ? Identifies facility-specific S&M activities to be performed and their frequency ? Identifies regulatory drivers, NNSA/NFO policies and procedures, and best management practices that necessitate implementation of S&M activities ? Provides criteria and frequencies for revisions and updates ? Establishes the process for identifying and dispositioning a condition that has not been previously identified or

Maintenance implementation plan for fuel supply shutdown

International Nuclear Information System (INIS)

Stephenson, R.L.

1995-06-01

This Maintenance Implementation Plan is written to satisfy the requirements of DOE Order 4330.4B, ''MAINTENANCE MANAGEMENT PROGRAM'', that specifies the general policy and objectives for the establishment of DOE controlled maintenance programs. These Programs provide for the management and performance of cost-effective maintenance and repair of Department of Energy (DOE) property, which includes facilities. A review of DOE Order 4330.4B, particularly Chapter II the nuclear portion, against existing WHC site programs and policies has provided assurance that most requirements of this order have already been implemented by existing WHC programs. Applicable requirements and guidelines of 4330.4B that are deficient or not implemented are presently being developed and implemented through WHC site policies and programs. Where no program is presently identified or being developed for 4330.4B requirements, responsibility for implementation has been assigned within this plan

Multiobjective Optimization of Aircraft Maintenance in Thailand Using Goal Programming: A Decision-Support Model

Directory of Open Access Journals (Sweden)

Yuttapong Pleumpirom

2012-01-01

Full Text Available The purpose of this paper is to develop the multiobjective optimization model in order to evaluate suppliers for aircraft maintenance tasks, using goal programming. The authors have developed a two-step process. The model will firstly be used as a decision-support tool for managing demand, by using aircraft and flight schedules to evaluate and generate aircraft-maintenance requirements, including spare-part lists. Secondly, they develop a multiobjective optimization model by minimizing cost, minimizing lead time, and maximizing the quality under various constraints in the model. Finally, the model is implemented in the actual airline's case.

Remote maintenance in nuclear fuel reprocessing

International Nuclear Information System (INIS)

Herndon, J.N.

1985-01-01

Remote maintenance techniques applied in large-scale nuclear fuel reprocessing plants are reviewed with particular attention to the three major maintenance philosophy groupings: contact, remote crane canyon, and remote/contact. Examples are given, and the relative success of each type is discussed. Probable future directions for large-scale reprocessing plant maintenance are described along with advanced manipulation systems for application in the plants. The remote maintenance development program within the Consolidated Fuel Reprocessing Program at the Oak Ridge National Laboratory is also described. 19 refs., 19 figs

What influences success in family medicine maternity care education programs?

Science.gov (United States)

Biringer, Anne; Forte, Milena; Tobin, Anastasia; Shaw, Elizabeth; Tannenbaum, David

2018-01-01

Abstract Objective To ascertain how program leaders in family medicine characterize success in family medicine maternity care education and determine which factors influence the success of training programs. Design Qualitative research using semistructured telephone interviews. Setting Purposive sample of 6 family medicine programs from 5 Canadian provinces. Participants Eighteen departmental leaders and program directors. METHODS Semistructured telephone interviews were conducted with program leaders in family medicine maternity care. Departmental leaders identified maternity care programs deemed to be “successful.” Interviews were audiorecorded and transcribed verbatim. Team members conducted thematic analysis. Main findings Participants considered their education programs to be successful in family medicine maternity care if residents achieved competency in intrapartum care, if graduates planned to include intrapartum care in their practices, and if their education programs were able to recruit and retain family medicine maternity care faculty. Five key factors were deemed to be critical to a program’s success in family medicine maternity care: adequate clinical exposure, the presence of strong family medicine role models, a family medicine–friendly hospital environment, support for the education program from multiple sources, and a dedicated and supportive community of family medicine maternity care providers. Conclusion Training programs wishing to achieve greater success in family medicine maternity care education should employ a multifaceted strategy that considers all 5 of the interdependent factors uncovered in our research. By paying particular attention to the informal processes that connect these factors, program leaders can preserve the possibility that family medicine residents will graduate with the competence and confidence to practise full-scope maternity care. PMID:29760273

Site Maintenance Plan: Part 2, Site Maintenance Action Plan for FY 1994

Energy Technology Data Exchange (ETDEWEB)

Fisk, E.L.

1994-06-01

This Fiscal Year (FY) 1994 Site Maintenance Action Plan (SMAP) is Part II of the Site Maintenance Plan, and has been written by Westinghouse Hanford Company (WHC) to outline the requirements stated in DOE Order 4330.4B, Maintenance Management Program, Chapter 1, Paragraph 3.3.1. The SMAP provides an annual status of maintenance initiatives completed and planned, a summary of performance indicators, a summary of maintenance backlog, a listing of real property and capital equipment maintenance cost estimates that were used to create the FY 1996 infrastructure and maintenance budget input, and a listing of proposed line item and general plant projects. Additionally, assumptions for various Site programs are listed to bring the Site Maintenance Plan into focus with overall Site activities. The primary mission at Hanford is to clean up the Site. In this cleanup process WHC will provide scientific and technological expertise to meet global needs, and partnership with stakeholders in the region to develop regional economic diversification. Other missions at the Hanford Site include energy research and development, and waste management and disposal activities. Their primary mission has a 30-year projected life span and will direct the shutting down and cleanup of defense production facilities and the Fast Flux Test Facility. This long-term mission requires continuous maintenance and in many instances, replacement of existing basic infrastructure, support facilities, and utilities. Without adequate maintenance and capital funding these infrastructure, support facilities, and utilities will continue to deteriorate causing an increase in backlogged work.

Site Maintenance Plan: Part 2, Site Maintenance Action Plan for FY 1994

International Nuclear Information System (INIS)

Fisk, E.L.

1994-06-01

This Fiscal Year (FY) 1994 Site Maintenance Action Plan (SMAP) is Part II of the Site Maintenance Plan, and has been written by Westinghouse Hanford Company (WHC) to outline the requirements stated in DOE Order 4330.4B, Maintenance Management Program, Chapter 1, Paragraph 3.3.1. The SMAP provides an annual status of maintenance initiatives completed and planned, a summary of performance indicators, a summary of maintenance backlog, a listing of real property and capital equipment maintenance cost estimates that were used to create the FY 1996 infrastructure and maintenance budget input, and a listing of proposed line item and general plant projects. Additionally, assumptions for various Site programs are listed to bring the Site Maintenance Plan into focus with overall Site activities. The primary mission at Hanford is to clean up the Site. In this cleanup process WHC will provide scientific and technological expertise to meet global needs, and partnership with stakeholders in the region to develop regional economic diversification. Other missions at the Hanford Site include energy research and development, and waste management and disposal activities. Their primary mission has a 30-year projected life span and will direct the shutting down and cleanup of defense production facilities and the Fast Flux Test Facility. This long-term mission requires continuous maintenance and in many instances, replacement of existing basic infrastructure, support facilities, and utilities. Without adequate maintenance and capital funding these infrastructure, support facilities, and utilities will continue to deteriorate causing an increase in backlogged work

Electric motor predictive and preventive maintenance guide

International Nuclear Information System (INIS)

Oliver, J.A.

1992-07-01

Electric motor performance is vital to the reliable and efficient operation of power plants. The failure of one or more critical motors could cause lost capacity and excessive repair and maintenance cost. However, existing maintenance recommendations proposed by vendors for electric motors have sometimes encouraged many overly conservative maintenance practices. These practices have lead to excessive maintenance activities and costs which have provided no extra margin of operability. EPRI has sponsored RP2814-35 to develop a guide which provides power plants with information and guidance for establishing an effective maintenance program which will aid in preventing unexpected motor failures and assist in planning motor maintenance efforts. The guide includes a technical description which summarizes technical data relative to the four basic types of motors and their components in general use in power plants. The significant causes of motor failures are investigated and described in detail and methods to optimize service life and minimize maintenance cost through appropriate preventive maintenance and conditioning program are presented. This guide provides a foundation for an effective electric motor maintenance program and simplifies the selection of predictive and preventive maintenance tasks. Its use will enable maintenance personnel in nuclear and fossil plants to plan motor repairs during scheduled outages and avoid costly unexpected failures

[Effect of the frequency of maintenance therapy on patients treated for gingivitis and incipient marginal periodontitis].

Science.gov (United States)

Rojas, I F; Zepeda, M S; Zúñiga, H P

1990-11-01

The effectiveness of maintenance care program applied at different period of time was evaluate in patients treated for gingivitis and incipiente marginal periodontitis. Fifty six patients were divided in three groups, each one controlled three times (each 2, 4 and 6 months respectively), to evaluate periodontal health. At each control, gingival index and plaque index was registered and patients had profilaxis and reinforcement of dental care instructions. All patients knew and practiced a control plaque control during active treatment. Results demonstrated that maintenance care program applied each 2 months, could get better clinical healthy periodontal conditions, without influence of patient's control plaque. Those patients with good hygiene could provide for an acceptable level of periodontal health even in patients controlled each 4 and 6 months. Positive correlations between controls in each index are indicative for that. Age seemingly do not have influence like etiological factor of recurrence inflammation. High correlation between plaque index and gingival index was found in every control mainly in the groups controlled each 4 and 6 months.

Second Line of Defense: Electronic Maintenance Reports, Local Maintenance Provider User Guide, Rev. 3

Energy Technology Data Exchange (ETDEWEB)

Leigh, Richard J.

2012-09-01

The Electronic Maintenance Report forms allow Local Maintenance Providers (LMP) and other program staff to enter maintenance information into a simple and secure system. This document describes the features and information required to complete the Maintenance Report forms. It is expected that all Corrective Maintenance Reports from LMPs will be submitted electronically into the SLD Portal. As an exception (e.g., when access to the SLD Portal is unavailable), Maintenance Reports can be submitted via a secure Adobe PDF form available through the Sustainability Manager assigned to each country.

Environmental Restoration Program pollution prevention checklist guide for the surveillance and maintenance project phase

International Nuclear Information System (INIS)

1993-09-01

DOE Order 5820.2 mandates that a surveillance and maintenance program be established in all shut-down facilities to ensure adequate containment of contamination, provide physical safety and security, and reduce potential public and environmental hazards. A key consideration in this process is the prevention of any waste to be generated from these activities. The purpose of this checklist guide is to assist the user with incorporating pollution prevention/waste minimization (PP/WM) in all Surveillance and Maintenance (S ampersand M) phase projects of the Environmental Restoration (ER) Program. This guide will help users document their PP/WM activities for technology transfer and reporting requirements. Automated computer screens will be created from the checklist data to assist users with implementing and evaluating waste reduction. Users can then establish numerical performance measures to measure progress in planning, training, self-assessments, field implementation, documentation, and technology transfer. Cost savings result as users train and assess themselves and perform preliminary waste assessments

CANDU plant maintenance: Recent developments

International Nuclear Information System (INIS)

Charlebois, P.

2000-01-01

CANDU units have long been recognized for their exceptional safety and reliability. Continuing development in the maintenance area has played a key role in achieving this performance level. For over two decades, safety system availability has been monitored closely and system maintenance programs adjusted accordingly to maintain high levels of performance. But as the plants approach mid life in a more competitive environment and component aging becomes a concern, new methods and techniques are necessary. As a result, recent developments are moving the maintenance program largely from a corrective and preventive approach to predictive and condition based maintenance. The application of these techniques is also being extended to safety related systems. These recent developments include use of reliability centred methods to define system maintenance requirements and strategies. This approach has been implemented on a number of systems at Canadian CANDU plants with positive results. The pilot projects demonstrated that the overall maintenance effort remained relatively constant while the system performance improved. It was also possible to schedule some of the redundant component maintenance during plant operation without adverse impact on system availability. The probabilistic safety assessment was found to be useful in determining the safety implications of component outages. These new maintenance strategies are now making use of predictive and condition based maintenance techniques to anticipate equipment breakdown and schedule preventive maintenance as the need arises rather than time based. Some of these techniques include valve diagnostics, vibration monitoring, oil analysis, thermography. Of course, these tools and techniques must form part of an overall maintenance management system to ensure that maintenance becomes a living program. To facilitate this process and contain costs, new information technology tools are being introduced to provide system engineers

Optimization of surface maintenance

International Nuclear Information System (INIS)

Oeverland, E.

1990-01-01

The present conference paper deals with methods of optimizing the surface maintenance of steel-made offshore installations. The paper aims at identifying important approaches to the problems regarding the long-range planning of an economical and cost effective maintenance program. The methods of optimization are based on the obtained experiences from the maintenance of installations on the Norwegian continental shelf. 3 figs

TRUPACT-II Container Maintenance Program Plan

International Nuclear Information System (INIS)

1991-05-01

This document details the maintenance, repair, and replacement of components, as well as the documentation required and the procedures to be followed to maintain the integrity of the TRUPACT-II container in accordance with OM-134, TRUPACT-II Container Operations and Maintenance Manual; and the TRUPACT-II Container Certificate of Compliance (Number 9218). The routine shipping and receiving inspections required by the Department of Transportation (DOT), Department of Energy (DOE), Nuclear Regulatory Commission (NRC) and other regulations are not addressed in this document. This document applies to all DOE shipping and receiving sites that use the TRUPACT-II containers

FAMILY BEHAVIOR IN MAINTENANCE STATUS HB CHRONIC RENAL FAILURE PATIENTS THROUGH FAMILY CENTERED CARE APPROACH OF DIET FE MANAGEMENT

Directory of Open Access Journals (Sweden)

Anggia Fajar Hardianti

2017-04-01

Full Text Available Introduction: Erythropoietic agent as standard practice for anemia treatment, which has a function to increase the value of hemoglobin (Hb to 12 g/dl in patients with chronic renal failure (CRF, who receiving dialysis treatment. The use of erythropoietin has to keep of the iron/Fe amount in the body. Family who have a duty of care should have knowledge, attitude, and behavior to maintain patient’s Hb by giving support to the patient to obey the Fe diet. The aimed of this study was to investigate the effect of family centered care approach in management Fe diet toward family’s behaviour in maintenance Hb level of CRF patients in hemodialysis ward, Gambiran Hospital, Kediri. Method: This study was used a pre experimental design. Total sample were 10 respondents, who met to inclusion criteria. The independent variables were knowledge, attitude, and psychomotor of family in maintenance of Hb level in CRF’s patients. The dependent variable was Fe diet management with family centered care approach. Data was collected by using a structured questionnaire and home visit observation. Result: Data was analyzed by using Wilcoxon Sign Rank Test with significance level α≤0.05. Results showed that Fe diet management with family centered care approach took effect to family’s knowledge (p=0.011, family’s attitude (p=0.005 and family’s psychomotor (p=0.005 in maintenance Hb level of CRF patients. Discussion: Family’s knowledge, attitude, and psychomotor were effected by experiences during the care of a patient, not affordable to access information and patient’s own decision. The strengths and weaknesses in the family to got a better plan of care can be made by discuss and sharing among researcher, patient and his family. It can be concluded that Fe diet management with family centered care approach took effect to family’s behaviour. Further studies should involve larger respondents and better measurement tools to obtain more accurate results.

Integer 1/0 Knapsack Problem Dynamic Programming Approach in Building Maintenance Optimization

Directory of Open Access Journals (Sweden)

Viska Dewi Fawzy

2017-12-01

Full Text Available The most common problem in urban areas is the high public demand and the limited provision of housing. In meeting the needs of affordable housing for low income communities, the Government of Indonesia implements Rusunawa Project. Object of this research is Pandanarang Rusunawa. Rusunawa Pandanarang is one of the vertical housing in Cilacap that is facing deterioration issue and needs good maintenance management. This study aims at insetting priority and optimizing maintenance plan due to limited funds (limited budget and the amount of damage that must be repaired.This study uses one of the optimization methods of Dynamic Programing on the application of Integer 1/0 Knapsack Problem, to determine an schedule the maintenance activities. The Criteria that are used such as: the level of building components damage and the level of occupants participation. In the first criterion, the benefit (p is the percentage of damage that is fixed with the cost (w. While on the second criterion, the benefit (p is the percentage of occupant participation rate on the maintenance activities with the cost (w. For the budget of Rp 125.000.000, 00, it was obtained from the simulation that the value of the optimum solution on the first criterion at the 7th stage of 71.88% with total cost Rp 106.000.000, 00. At the second criterion, the value of the optimum solution at the 7th stage of 89.29% with total cost Rp 124.000.000, 00.

Condition based maintenance pilot projects at Pickering ND

International Nuclear Information System (INIS)

Zemdegs, R.T.

1995-01-01

Ontario Hydro has recognized that the approaches to maintenance have undergone significant changes to the past decades. The traditional break down maintenance approach has been replaced by preventative maintenance and more recently, by condition based maintenance. The nuclear plants of Ontario Hydro have evaluated on a number of alternative programs to improve their maintenance effectiveness and to reduce costs, including Reliability Centred Maintenance (RCM), call-up review, component-based PM programs, analysis of failure history and so on. Pickering ND (nuclear division) and Ontario Hydro's Nuclear Technologies Services Division, have embarked on a Condition Based Maintenance pilot project to address the above issues as a breakthrough solution for smarter maintenance. The Condition Based Maintenance pilot project will demonstrate an end-to-end process utilizing a Reliability Centred Maintenance structured approach to re-engineer and redefine the existing maintenance programs. The project emphasizes on-condition maintenance where justified, and utilizes an information management tool to provide the required records keeping and analysis infrastructure. This paper briefly describes the planned maintenance model at Pickering ND used to guide the CBM pilot, and an overview of the methodology used to develop on-condition equipment indicators as part of a re-engineered maintenance plan

Successful factors to a better maintenance effectiveness in Cernavoda NPP 's Unit 1

International Nuclear Information System (INIS)

Riedel, M.; Bigu, D.

2001-01-01

Two tables are presented titled 'Existing maintenance-specific and maintenance-related plant programs' and 'New programs intended to be developed', respectively. In the first table the following items are indicated and commented: 1. Corrective maintenance program; 2. EQ Program; 3. Equipment maintenance history program; 4. In service inspection program; 5. Lube oil analysis program; 6. MOVs program; 7. Operational test procedures; 8. Performance evaluation program; 9. Preventive maintenance program; 10. Spares management program; 11. Vibration monitoring program. In table 2 the following items are indicated and commented: 1. Check Valves program; 2. Electrical Cable Diagnostics; 3. Erosion-corrosion; 4. Temperature monitoring (infra red thermography; noncontact thermometer); 5. Airborne Ultrasound Detection program; 6. PdM Program. A flowchart is presented in figure 1 showing the maintenance strategies' selection. In figure 2 there is presented a flowchart showing the plants maintenance current approach. Finally, in figure 3 the station maintenance program is presented in a diagram structured on the following fields: concepts, requirements, strategies, specific programs and plans

Maintenance and Outage Management Assessment (MOMA)

International Nuclear Information System (INIS)

2005-01-01

The competitive environment has significant implications for nuclear power plant (NPP) operations, which include, inter alia, the need for efficient use of resources and effective management of plant activities of maintenance and outages. The purpose of NPP maintenance and outages is to allow NPPs to use all those functions necessary for safe and reliable power production by keeping them available and adequate maintenance programme is essential. The maintenance programme covers all preventive and remedial measures, both administrative and technical, necessary to identify and mitigate degradation of a functioning system, structure or component, or restore the design functions of a failed system, structure or component to an acceptable level. In response to the needs of MSs, NPES (Nuclear Power Section, Division of Nuclear Power, IAEA) plans to strengthen its services. NPES services will not only continue to provide its 'traditional' products of publications of nuclear industrial best practices and technical implementation of TC projects on plant maintenance and outage management, but also be expanded to deliver, in a timely manner, technical support missions as requested by MSs for NPPs. One of many services is Maintenance and Outage Management Assessment (MOMA). The NPP can obtain support and assistance in assessment and optimisation of its maintenance program and/or outage management. It aims to help the NPP improve its performance of maintenance and outage in a competitive nuclear power business environment. The specific benefits of the assessment are as follows: a) disseminate nuclear industrial best practices on maintenance program and outage management in the world, b) benchmark, evaluate and optimise the approach of maintenance program and outage management and c) identify solutions to known problems at nuclear power plants, if any. MOMA is conducted at the request of NPPs of any IAEA Member States. MOMA consists in a technical mission/visit for 1-3 weeks by

Maintenance of scientific instruments

International Nuclear Information System (INIS)

Lucero, E.

1986-01-01

During the last years Colombia has increased the use of nuclear techniques, instruments and equipment in ambitious health programs, as well as in research centers, industry and education; this has resulted in numerous maintenance problems. As an alternative solution IAN has established a Central Maintenance Laboratory for nuclear instruments within an International Atomic Energy Agency program for eight Latin American and nine Asian Countries. Established strategies and some results are detailed in this writing

PROMSYS, Plant Equipment Maintenance and Inspection Scheduling

International Nuclear Information System (INIS)

Morgan, D.L.; Srite, B.E.

1986-01-01

1 - Description of problem or function: PROMSYS is a computer system designed to automate the scheduling of routine maintenance and inspection of plant equipment. This 'programmed maintenance' provides the detailed planning and accomplishment of lubrication, inspection, and similar repetitive maintenance activities which can be scheduled at specified predetermined intervals throughout the year. The equipment items included are the typical pumps, blowers, motors, compressors, automotive equipment, refrigeration units, filtering systems, machine shop equipment, cranes, elevators, motor-generator sets, and electrical switchgear found throughout industry, as well as cell ventilation, shielding, containment, and material handling equipment unique to nuclear research and development facilities. Four related programs are used to produce sorted schedule lists, delinquent work lists, and optional master lists. Five additional programs are used to create and maintain records of all scheduled and unscheduled maintenance history. 2 - Method of solution: Service specifications and frequency are established and stored. The computer program reviews schedules weekly and prints, on schedule cards, instructions for service that is due the following week. The basic output from the computer program comes in two forms: programmed-maintenance schedule cards and programmed-maintenance data sheets. The data sheets can be issued in numerical building, route, and location number sequence as equipment lists, grouped for work assigned to a particular foreman as the foreman's equipment list, or grouped by work charged to a particular work order as the work-order list. Data sheets grouped by equipment classification are called the equipment classification list

Annual summary report of the decontamination and decommissioning surveillance and maintenance program at Oak Ridge National Laboratory for period ending September 30, 1991

International Nuclear Information System (INIS)

Ford, M.K.; Holder, L. Jr.

1991-09-01

The Surplus Facilities Management Program and Defense Facilities Decommissioning Program were established at Oak Ridge National Laboratory (ORNL) in 1976 in order to provide collective management of all surplus sites under ORNL control on the Oak Ridge Reservation. Some 34 facilities, classified into 3 civilian-related and 8 defense-related projects, are currently managed by the recently integrated Decontamination and Decommissioning Program. Support includes (1) surveillance and maintenance (S ampersand M) planning, (2) routine S ampersand M, and (3) special maintenance projects. This report documents routine S ampersand M, special projects, and special maintenance performed on these facilities for the period of October 1990 through September 1991

Predictive maintenance primer

International Nuclear Information System (INIS)

Flude, J.W.; Nicholas, J.R.

1991-04-01

This Predictive Maintenance Primer provides utility plant personnel with a single-source reference to predictive maintenance analysis methods and technologies used successfully by utilities and other industries. It is intended to be a ready reference to personnel considering starting, expanding or improving a predictive maintenance program. This Primer includes a discussion of various analysis methods and how they overlap and interrelate. Additionally, eighteen predictive maintenance technologies are discussed in sufficient detail for the user to evaluate the potential of each technology for specific applications. This document is designed to allow inclusion of additional technologies in the future. To gather the information necessary to create this initial Primer the Nuclear Maintenance Applications Center (NMAC) collected experience data from eighteen utilities plus other industry and government sources. NMAC also contacted equipment manufacturers for information pertaining to equipment utilization, maintenance, and technical specifications. The Primer includes a discussion of six methods used by analysts to study predictive maintenance data. These are: trend analysis; pattern recognition; correlation; test against limits or ranges; relative comparison data; and statistical process analysis. Following the analysis methods discussions are detailed descriptions for eighteen technologies analysts have found useful for predictive maintenance programs at power plants and other industrial facilities. Each technology subchapter has a description of the operating principles involved in the technology, a listing of plant equipment where the technology can be applied, and a general description of the monitoring equipment. Additionally, these descriptions include a discussion of results obtained from actual equipment users and preferred analysis techniques to be used on data obtained from the technology. 5 refs., 30 figs

Nuclear adaptor Ldb1 regulates a transcriptional program essential for the maintenance of hematopoietic stem cells.

Science.gov (United States)

Li, LiQi; Jothi, Raja; Cui, Kairong; Lee, Jan Y; Cohen, Tsadok; Gorivodsky, Marat; Tzchori, Itai; Zhao, Yangu; Hayes, Sandra M; Bresnick, Emery H; Zhao, Keji; Westphal, Heiner; Love, Paul E

2011-02-01

The nuclear adaptor Ldb1 functions as a core component of multiprotein transcription complexes that regulate differentiation in diverse cell types. In the hematopoietic lineage, Ldb1 forms a complex with the non-DNA-binding adaptor Lmo2 and the transcription factors E2A, Scl and GATA-1 (or GATA-2). Here we demonstrate a critical and continuous requirement for Ldb1 in the maintenance of both fetal and adult mouse hematopoietic stem cells (HSCs). Deletion of Ldb1 in hematopoietic progenitors resulted in the downregulation of many transcripts required for HSC maintenance. Genome-wide profiling by chromatin immunoprecipitation followed by sequencing (ChIP-Seq) identified Ldb1 complex-binding sites at highly conserved regions in the promoters of genes involved in HSC maintenance. Our results identify a central role for Ldb1 in regulating the transcriptional program responsible for the maintenance of HSCs.

TRUPACT-II container maintenance program plan

International Nuclear Information System (INIS)

1990-11-01

This document details the maintenance/repair and replacement of components, as well as the documentation required and the procedures to be followed to maintain the integrity of the TRUPACT-II container, in accordance with requirements of the TRUPACT-II Container Operations and Maintenance Manual, OM-134, the TRUPACT-II Container Safety Analysis Report (SARP), and the TRUPACT-II Container Certificate of Compliance (Number 9218). The routine shipping and receiving inspections required by the Department of Transportation (DOT), Department of Energy (DOE), Nuclear Regulatory Commission (NRC) and other regulations are not addressed in this document. This document applies to all DOE shipping and receiving sites that use the TRUPACT-II containers

Maintenance: Two Views.

Science.gov (United States)

Ballard, J. Barry; Burdette, Clarence E.

1987-01-01

Presents two viewpoints on the question of using funding from the Vocational Education Act to maintain ongoing vocational programs. Ballard argues that programs have improved qualitatively because of additional program improvement monies, whereas Burdette argues that the ban on using funds for maintenance treats some states unfairly. (CH)

Analysis of maintenance strategies

International Nuclear Information System (INIS)

Laakso, K.; Simola, K.

1998-01-01

The main topics of the presentation include: (1) an analysis model and methods to evaluate maintenance action programs and the support decision to make changes in them and (2) to understand the maintenance strategies in a systems perspective as a basis for future developments. The subproject showed how systematic models for maintenance analysis and decision support, utilising computerised and statistical tool packages, can be taken into use for evaluation and optimisation of maintenance of active systems from the safety and economic point of view

Implementation of laparoscopic hysterectomy: maintenance of skills after a mentorship program.

Science.gov (United States)

Twijnstra, A R H; Blikkendaal, M D; Kolkman, W; Smeets, M J G H; Rhemrev, J P T; Jansen, F W

2010-01-01

To evaluate the implementation and maintenance of advanced laparoscopic skills after a structured mentorship program in laparoscopic hysterectomy (LH). Cohort retrospective analysis of 104 successive LHs performed by two gynecologists during and after a mentorship program. LHs were compared for indication, patient characteristics and intraoperative characteristics. As a frame of reference, 94 LHs performed by the mentor were analyzed. With regard to indication, blood loss and adverse outcomes, both trainees performed LHs during their mentorship program comparable with the LHs performed by the mentor. The difference in mean operating time between trainees and mentor was not clinically significant. Both trainees progressed along a learning curve, while operating time remained statistically constant and comparable to that of the mentor. After completing the mentorship program, both gynecologists maintained their acquired skills as blood loss, adverse outcome rates and operating time were comparable with the results during their traineeship. A mentorship program is an effective and durable tool for implementing a new surgical procedure in a teaching hospital with respect to patient safety aspects, as indications, operating time and adverse outcome rates are comparable to those of the mentor in his own hospital during and after completing the mentorship program. Copyright © 2010 S. Karger AG, Basel.

Participation in preventive care programs: individual determinants, social interactions and program design.

OpenAIRE

Bouckaert, Nicolas

2014-01-01

This doctoral research focuses on existing medical preventive care programs. Because of externalities (e.g. in the prevention of communicable diseases) or the program cost-benefit ratio, preventive care programs require high participation rates. In the United States, the Centers for Disease Control and Prevention have set clear participation objectives – next to quality targets – which are measured and evaluated over time (National Center for Health Statistics, 2012). For example, the 2010 pa...

Asbestos exposure of building maintenance personnel.

Science.gov (United States)

Mlynarek, S; Corn, M; Blake, C

1996-06-01

The exposures of building maintenance personnel and occupants to airborne asbestos fibers, and the effects of operations and maintenance programs on those exposures, continue to be an important public health issue. The subject of this investigation was a large metropolitan county with numerous public buildings which routinely conducted air sampling for asbestos. A total of 302 personal air samples in nine task categories collected during maintenance worker activities in proximity to asbestos-containing materials were analyzed; 102 environmental air samples in four task categories were also analyzed. The arithmetic means of the 8-hr time weighted average exposures for personal sampling for each task category were all below the Occupational Safety and Health Administration permissible exposure level of 0.1 fibers (f)/cc > 5 microm. The highest mean 8-hr time weighted average exposure was 0.030 f/cc > 5 microm for ceiling tile replacement. The maximum asbestos concentration during sample collection for environmental samples was 0.027 f/cc > 5 microm. All asbestos-related maintenance work was done within the framework of an Operations and Maintenance Program (OMP) which utilized both personal protective equipment and controls against fiber release/dispersion. Results are presented in association with specific OMP procedures or controls. These results support the effectiveness of using Operations and Maintenance Programs to manage asbestos in buildings without incurring unacceptable risk to maintenance workers performing maintenance tasks.

AUTOMOTIVE DIESEL MAINTENANCE 1. UNIT XX, CUMMINS DIESEL ENGINE, MAINTENANCE SUMMARY.

Science.gov (United States)

Minnesota State Dept. of Education, St. Paul. Div. of Vocational and Technical Education.

THIS MODULE OF A 30-MODULE COURSE IS DESIGNED TO PROVIDE A SUMMARY OF THE REASONS AND PROCEDURES FOR DIESEL ENGINE MAINTENANCE. TOPICS ARE WHAT ENGINE BREAK-IN MEANS, ENGINE BREAK-IN, TORQUING BEARINGS (TEMPLATE METHOD), AND THE NEED FOR MAINTENANCE. THE MODULE CONSISTS OF A SELF-INSTRUCTIONAL BRANCH PROGRAMED TRAINING FILM "CUMMINS DIESEL ENGINE…

Reliability Centered Maintenance - Methodologies

Science.gov (United States)

Kammerer, Catherine C.

2009-01-01

Journal article about Reliability Centered Maintenance (RCM) methodologies used by United Space Alliance, LLC (USA) in support of the Space Shuttle Program at Kennedy Space Center. The USA Reliability Centered Maintenance program differs from traditional RCM programs because various methodologies are utilized to take advantage of their respective strengths for each application. Based on operational experience, USA has customized the traditional RCM methodology into a streamlined lean logic path and has implemented the use of statistical tools to drive the process. USA RCM has integrated many of the L6S tools into both RCM methodologies. The tools utilized in the Measure, Analyze, and Improve phases of a Lean Six Sigma project lend themselves to application in the RCM process. All USA RCM methodologies meet the requirements defined in SAE JA 1011, Evaluation Criteria for Reliability-Centered Maintenance (RCM) Processes. The proposed article explores these methodologies.

Industry assessment of human factors in aviation maintenance and inspection research program : an assessment of industry awareness and use of the Federal Aviation Administration Office of Aviation Medicine Human Factors in Aviation Maintenance and Inspect

Science.gov (United States)

1998-03-01

Ten years ago the Federal Aviation Administration (FAA) Office of Aviation Medicine embarked on a research and development program dedicated to human factors in aviation maintenance and inspection. Since 1989 FAA has invested over $12M in maintenance...

Competition and rural primary care programs.

Science.gov (United States)

Ricketts, T C

1990-04-01

Rural primary care programs were established in areas where there was thought to be no competition for patients. However, evidence from site visits and surveys of a national sample of subsidized programs revealed a pattern of competitive responses by the clinics. In this study of 193 rural primary care programs, mail and telephone surveys produced uniform data on the organization, operation, finances, and utilization of a representative sample of clinics. The programs were found to compete in terms of: (1) price, (2) service mix, (3) staff availability, (4) structural accessibility, (5) outreach, and (6) targeting a segment of the market. The competitive strategies employed by the clinics had consequences that affected their productivity and financial stability. The strategies were related to the perceived missions of the programs, and depended heavily upon the degree of isolation of the program and the targeting of the services. The competitive strategy chosen by a particular program could not be predicted based on service area population and apparent competitors in the service area. The goals and objectives of the programs had more to do with their competitive responses than with market characteristics. Moreover, the chosen strategies may not meet the demands of those markets.

Development of a computational program to planning and control of the IEA-R1 reactor maintenance

International Nuclear Information System (INIS)

Martins, Mauro Onofre; Madi Filho, Tufic

2013-01-01

Maintenance is an essential activity in nuclear reactors. The components of safety systems of an industrial plant should have a low probability of failure, especially if there is a high risk of accidents that may cause environmental damage. In nuclear facilities, the presence of security systems is a technical specification and a requirement for their license and operation. In order to manage the entire information flow from the maintenance of the IEA-R1, a computational program (software) was developed, which not only plans and control all the maintenance, but also updates the documents and records to safeguard the quality, ensuring the safe operation of the reactor. The software has access levels and provides detailed reports of all maintenance planned and implemented, together with an individual history of the equipment during its lifetime in the facility. This work presents all the stages of the software development, description, compatibility, application, advantages and results obtained experimentally. (author)

North American nuclear maintenance best practices compared to Japanese utility maintenance practices

International Nuclear Information System (INIS)

Harazim, M.L.; Ferguson, B.J.

2003-01-01

The purpose of this paper is to compare the best practices in North America concerning Preventive Maintenance, Predictive Maintenance and Reliability Centered Maintenance (RCM) or Preventive Maintenance Optimization (PMO) with the time-directed maintenance philosophies utilized by Japanese utilities, and how the Japanese utilities are considering (and some have begun) adopting North American ways of doing business. Preventive Maintenance Living Programs are also discussed, along with the Institute of Nuclear Power Operations AP-913 process, Equipment Reliability Process. Also, a cost benefit analysis will be demonstrated showing how major cost savings can be achieved by shifting from a predominantly time-directed maintenance philosophy to a predominantly predictive strategy utilizing vibration analysis, lubricating oil analysis, thermography and other predictive technologies to better utilize resources, reduce spare part consumption and to minimize maintenance induced errors. As a result of the strides made while incorporating these new philosophies, we no longer advocate tearing apart perfectly good equipment. (author)

A hybrid Constraint Programming/Mixed Integer Programming framework for the preventive signaling maintenance crew scheduling problem

DEFF Research Database (Denmark)

Pour, Shahrzad M.; Drake, John H.; Ejlertsen, Lena Secher

2017-01-01

A railway signaling system is a complex and interdependent system which should ensure the safe operation of trains. We introduce and address a mixed integer optimisation model for the preventive signal maintenance crew scheduling problem in the Danish railway system. The problem contains many...... to feed as ‘warm start’ solutions to a Mixed Integer Programming (MIP) solver for further optimisation. We apply the CP/MIP framework to a section of the Danish rail network and benchmark our results against both direct application of a MIP solver and modelling the problem as a Constraint Optimisation...

Characteristics of national and statewide health care-associated infection surveillance programs: A qualitative study.

Science.gov (United States)

Russo, Philip L; Havers, Sally M; Cheng, Allen C; Richards, Michael; Graves, Nicholas; Hall, Lisa

2016-12-01

There are many well-established national health care-associated infection surveillance programs (HAISPs). Although validation studies have described data quality, there is little research describing important characteristics of large HAISPs. The aim of this study was to broaden our understanding and identify key characteristics of large HAISPs. Semi-structured interviews were conducted with purposively selected leaders from national and state-based HAISPs. Interview data were analyzed following an interpretive description process. Seven semi-structured interviews were conducted over a 6-month period during 2014-2015. Analysis of the data generated 5 distinct characteristics of large HAISPs: (1) triggers: surveillance was initiated by government or a cooperative of like-minded people, (2) purpose: a clear purpose is needed and determines other surveillance mechanisms, (3) data measures: consistency is more important than accuracy, (4) processes: a balance exists between the volume of data collected and resources, and (5) implementation and maintenance: a central coordinating body is crucial for uniformity and support. National HAISPs are complex and affect a broad range of stakeholders. Although the overall goal of health care-associated infection surveillance is to reduce the incidence of health care-associated infection, there are many crucial factors to be considered in attaining this goal. The findings from this study will assist the development of new HAISPs and could be used as an adjunct to evaluate existing programs. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Darlington Station outage - a maintenance perspective

International Nuclear Information System (INIS)

Plourde, J.; Marczak, J.; Stone, M.; Myers, R.; Sutton, K.

1997-01-01

Ontario Hydro's Darlington Nuclear Generating Station (4x881MW(e)net) has carried out its first station outage since full commercial operation. The outage presented challenges to the organization in terms of outage planning, support, management, and safe execution within the constraints of schedule, budget and resources. This paper will focus on the success of the outage maintenance program, identifying the major work programs - a vacuum structure and containment outage, an emergency service water system outage, an emergency coolant injection system outage, intake channel inspections, low pressure service water inspections, and significant outage maintenance work on each of the four reactor units. Planning for the outage was initiated early in anticipation of this important milestone in the station's life. Detailed safety reviews - nuclear, radiation, and conventional - were conducted in support of the planned maintenance program. System lineup and work protection were provided by the Station Operator work group. Work protection permitry was initiated well in advance of the outage. Station maintenance staff resources were bolstered in support of the outage to ensure program execution could be maintained within the schedule. Training programs were in place to ensure that expectations were clear and that high standards would be maintained. Materials management issues in support of maintenance activities were given high priority to ensure no delays to the planned work. Station management review and monitoring in preparation for and during the outage ensured that staff priorities remained focused. Lessons learned from the outage execution are being formalized in maintenance procedures and outage management procedures, and shared with the nuclear community. (author)

Maintenance viewpoint of a successful reactor program

International Nuclear Information System (INIS)

Moffitt, W.C.; Grygiel, M.L.

1984-05-01

As the Operating and Support staffs of the FFTF organization have gained experience, the plant reliability and capacity factors have shown a steadily improving trend. The plant capacity factor for Cycle 4 was 99.5%. It is the purpose of this report to describe the evolution of the maintenance organization at the FFTF site from a general support organization to a technically proficient organization playing a major role in planning and performance of plant maintenance evolutions

Adaptation and Implementation of Predictive Maintenance Technique with Nondestructive Testing for Power Plants

International Nuclear Information System (INIS)

Jung, Gye Jo; Jung, Nam Gun

2010-01-01

Many forces are pressuring utilities to reduce operating and maintenance costs without cutting back on reliability or availability. Many utility managers are re-evaluating maintenance strategies to meet these demands. To utilities how to reduce maintenance costs and extent the effective operating life of equipment, predictive maintenance technique can be adapted. Predictive maintenance had three types program which are in-house program, engineering company program and mixed program. We can approach successful predictive maintenance program with 'smart trust' concept

Operation and maintenance requirements of system design bases

International Nuclear Information System (INIS)

Banerjee, A.K.; Hanley, N.E.

1989-01-01

All system designs make assumptions about system operation testing, inspection, and maintenance. Existing industry codes and standards explicitly address design requirements of new systems, while issues related to system and plant reliability, life, design margins, effects of service conditions, operation, maintenance, etc., usually are implicit. However, system/component design documents of existing power plants often address the code requirements without considering the operation, maintenance, inspection, and testing (OMIT) requirements. The nuclear industry is expending major efforts at most nuclear power plants to reassemble and/or reconstitute system design bases. Stone ampersand Webster Engineering Corporation (SWEC) recently addressed the OMIT requirements of system/component design as an integral part of a utility's preventive maintenance program. For each component, SWEC reviewed vendor recommendations, NPRDS data/industry experience, the existing maintenance program, component service conditions, and actual plant experience. A maintenance program that considers component service conditions and plant experience ensures a connection between maintenance and design basis. Root cause analysis of failure and engineering evaluation of service condition are part of the program. System/component OMIT requirements also are compared against system design, service condition, degradation mechanism, etc., through system/component life-cycle evaluation

Budesonide/formoterol maintenance and reliever therapy in primary care asthma management : effects on bronchial hyperresponsiveness and asthma control

NARCIS (Netherlands)

Riemersma, Roland A.; Postma, Dirkje; van der Molen, Thys

Background: The management of asthma has changed since the introduction of budesonide/formoterol (Symbicort (R)) as both maintenance and reliever therapy (SMART). SMART and its effects on bronchial hyperresponsiveness (BHR) have not been studied in primary care. Aims: To compare the effects of SMART

Waste sampling and characterization facility (WSCF) maintenance implementation plan

International Nuclear Information System (INIS)

Heinemann, J.L.; Millard, G.E.

1997-08-01

This Maintenance Implementation Plan (MIP) is written to satisfy the requirements of the US Department of Energy (DOE) Order 4330.4B, Maintenance Management Program that specifies the general policy and objectives for the establishment of the DOE controlled maintenance programs. These programs provide for the management and performance of cost effective maintenance and repair of the DOE property, which includes facilities. This document outlines maintenance activities associated with the facilities operated by Waste Management Hanford, Inc. (WMH). The objective of this MIP is to provide baseline information for the control and execution of WMH Facility Maintenance activities relative to the requirements of Order 4330.4B, assessment of the WMH maintenance programs, and actions necessary to maintain compliance with the Order. Section 2.0 summarizes the history, mission and description of the WMH facilities. Section 3.0 describes maintenance scope and requirements, and outlines the overall strategy for implementing the maintenance program. Specific elements of DOE Order 4330.4B are addressed in Section 4.0, listing the objective of each element, a discussion of the WMH compliance methodology, and current implementation requirements with references to WMH and HNF policies and procedures. Section 5.0 addresses deviations from policy requirements, and Section 6.0 is a schedule for specific improvements in support of this MIP

Maintenance Staffing Standards for Zero-Based Budgeting.

Science.gov (United States)

Adams, Matthew C.; And Others

1998-01-01

Discusses school preventive maintenance and the variables associated with maintenance staffing standards that address a zero-based budgeting environment. Explores preventive-maintenance measurement for staffing requirements, defines staffing levels and job descriptions, and outlines the factors to consider when creating a maintenance program and…

Does progressive resistance and balance exercise reduce falls in residential aged care? Randomized controlled trial protocol for the SUNBEAM program.

Science.gov (United States)

Hewitt, Jennifer; Refshauge, Kathryn M; Goodall, Stephen; Henwood, Timothy; Clemson, Lindy

2014-01-01

Falls are common among older adults. It is reported that approximately 60% of residents of aged care facilities fall each year. This is a major cause of morbidity and mortality, and a significant burden for health care providers and the health system. Among community dwelling older adults, exercise appears to be an effective countermeasure, but data are limited and inconsistent among studies in residents of aged care communities. This trial has been designed to evaluate whether the SUNBEAM program (Strength and Balance Exercise in Aged Care) reduces falls in residents of aged care facilities. Is the program more effective and cost-effective than usual care for the prevention of falls? Single-blinded, two group, cluster randomized trial. 300 residents, living in 20 aged care facilities. Progressive resistance and balance training under the guidance of a physiotherapist for 6 months, then facility-guided maintenance training for 6 months. Usual care. Number of falls, number of fallers, quality of life, mobility, balance, fear of falling, cognitive well-being, resource use, and cost-effectiveness. Measurements will be taken at baseline, 6 months, and 12 months. The number of falls will be analyzed using a Poisson mixed model. A logistic mixed model will be used to analyze the number of residents who fall during the study period. Intention-to-treat analysis will be used. This study addresses a significant shortcoming in aged care research, and has potential to impact upon a substantial health care problem. Outcomes will be used to inform care providers, and guide health care policies.

Effective maintenance practices to manage system aging

International Nuclear Information System (INIS)

Chockie, A.; Bjorkelo, K.

1992-01-01

For a variety of economic and technical reasons, there has been a growing concern with the aging of complex systems and components and the role that maintenance can play in reducing this degradation. A study for the Nuclear Regulatory Commission was recently undertaken to identify effective maintenance practices that could be adapted by the nuclear industry in the United States to assist in managing the aging degradation of plant systems and components. Four organizations were examined to assess the influence that their maintenance programs have on their ability to address the systems and component aging degradation issues. An effective maintenance program was found to be essential to the management of system and component aging. The four key elements of an effective maintenance program that are important to an aging management program were identified. These are: the selection of critical systems and components; the development of an understanding of aging through the collection and analysis of equipment performance information; the development of appropriate preventive and predictive maintenance tasks to manage equipment and system aging degradation; the use of feedback mechanisms to continuously improve the management of aging systems and components. These elements were found to be common to all four organizations. In examining how the four organizations have structured their maintenance programs to include these key elements provides valuable lessons not only for the nuclear power industry, but also for any industrial organization that is concerned with the management of system and component aging degradation. This document provides detail, of these studies

TRUPACT-II container maintenance program plan

International Nuclear Information System (INIS)

1990-01-01

This document details the maintenance/repair and replacement of components, as well as the documentation required and the procedures to be followed to maintain the integrity of the TRUPACT-II container

Costs of Development and Maintenance of an Internet Program for Teens with Type 1 Diabetes

Science.gov (United States)

Grey, Margaret; Liberti, Lauren; Whittemore, Robin

2015-01-01

Many adolescents with type 1 diabetes (T1D) have difficulty completing self-management tasks within the context of their social environments. Group-based approaches to psycho-educational support have been shown to prevent declines in glucose control, but are challenging to implement due to youths’ many activities and costs. A novel solution is providing psycho-educational support via the internet. The purpose of this study is to describe the cost of developing and maintaining two internet psycho-educational programs, both of which have been shown to improve health outcomes in adolescents with T1D. We calculated actual costs of personnel and programming in the development of TEENCOPE™ and Managing Diabetes, two highly interactive programs that were evaluated in a multi-site clinical trial (n=320). Cost calculations were set at U.S. dollars and converted to value for 2013 as expenses were incurred over 6 years. Development costs over 1.5 years totaled $324,609, with the majority of costs being for personnel to develop and write content in a creative and engaging format, to get feedback from teens on content and a prototype, and IT programming. Maintenance of the program, including IT support, a part-time moderator to assure safety of the discussion board (0.5–1 hour/week), and yearly update of content was $43,845/year, or $137.00 per youth over 4.5 years. Overall, program and site development were relatively expensive, but the program reach was high, including non-white youth from 4 geographically distinct regions. Once developed, maintenance was minimal. With greater dissemination, cost-per-youth would decrease markedly, beginning to offset the high development expense. PMID:26213677

A COMPUTER BASED MAINTENANCE MANAGEMENT SYSTEM ...

African Journals Online (AJOL)

... programs to schedule for maintenance or replacement of machines has been designed such that it enables the maintenance department control all jobs associated with plant maintenance and breakdown. It predicts the time to failure of designated plants and caters for the replacement analysis of some capital equipment.

Development of a hospital-based care coordination program for children with special health care needs.

Science.gov (United States)

Petitgout, Janine M; Pelzer, Daniel E; McConkey, Stacy A; Hanrahan, Kirsten

2013-01-01

A hospital-based Continuity of Care program for children with special health care needs is described. A family-centered team approach provides care coordination and a medical home. The program has grown during the past 10 years to include inpatients and outpatients from multiple services and outreach clinics. Improved outcomes, including decreased length of stay, decreased cost, and high family satisfaction, are demonstrated by participants in the program. Pediatric nurse practitioners play an important role in the medical home, collaborating with primary care providers, hospital-based specialists, community services, and social workers to provide services to children with special health care needs. Copyright © 2013 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

Multiple Learning Strategies Project. Building Maintenance & Engineering. Visually Impaired.

Science.gov (United States)

Smith, Dwight; And Others

This instructional package is designed for visually impaired students in the vocational area of building maintenance and engineering. The twenty-eight learning modules are organized into six units: floor care, general maintenance tasks; restrooms; carpet care; power and hand tools; and cabinet construction. Each module, printed in large block…

CHILD MAINTENANCE IN TURKISH LAW

Directory of Open Access Journals (Sweden)

Banu Bilge Sarihan

2017-12-01

Full Text Available The concept of alimony; the dictionary defines as, the whole of what is needed to make a living; as the legal sense is defined as connected with one month to one court decision that obliged to provide for. Family members of a moral rule, first of all to help each other. This moral without often any coercion parties in the framework adapts to this rule, but in this case the legislator for the processing always smoothly, has made it a statutory duty by going to road regulations to help each other for certain family members. Assistance in the form of alimony and child support maintenance can be divided into two main groups. Support resulting from family law, commonly referred to as maintenance support. Maintenance alimony; temporary alimony, child maintenance and poverty alimony. The care and upbringing of children in the marital union is entitled to custody of the mother and father in the framework. Mother and father use custody together. Custody of minors and adult children must sometimes restricted to persons, about paying attention to both the goods and to represent them as a whole of the rights and obligations of the law have been installed on the parents. Common life of the spouses or by court order issued at the end of separation has occurred judge may give custody to one of the spouses. side with custody of children have been left to him is obliged to look after and educate them. However, not given custody of his side, must participate in their child's care and education expenses amount to be determined by the judge according to financial strength. Associates alimony, separation or nullity or divorce, child custody as a result of which he had left his wife, child care and the financial strength to participate in the rate training expenses. Associates alimony, not a liability connected to custody, is a natural consequence of being parents. Because spouses are obliged to take care of children's care and upbringing. Child maintenance is

Evaluation of a Research Mentorship Program in Community Care

Science.gov (United States)

Ploeg, Jenny; de Witt, Lorna; Hutchison, Brian; Hayward, Lynda; Grayson, Kim

2008-01-01

This article describes the results of a qualitative case study evaluating a research mentorship program in community care settings in Ontario, Canada. The purpose of the program was to build evaluation and research capacity among staff of community care agencies through a mentorship program. Data were collected through in-depth, semi-structured…

A human factors approach to effective maintenance

International Nuclear Information System (INIS)

Penington, J.; Shakeri, S.

2006-01-01

Traditionally in the field of Human Factors within the nuclear industry, the focus has been to identify the potential for human errors in operating tasks, and develop strategies to prevent their occurrence, provide recovery mechanisms, and mitigate the consequences of error as appropriate. Past experience has demonstrated however a significant number of human errors within the nuclear industry occur during maintenance tasks. It is for this reason, and the fact that our nuclear power plants are ageing and increasingly in need of maintenance, that the industry must pay more attention to maintenance tasks. The purpose of this paper is to present a framework for effective maintenance programs, and based upon this framework discuss an approach (an audit tool) that can be used to both design such a program, and to assess existing programs. In addition, this tool can form the basis of cost benefit decisions relating to priorities for improvements to existing programs. (author)

What influences success in family medicine maternity care education programs? Qualitative exploration.

Science.gov (United States)

Biringer, Anne; Forte, Milena; Tobin, Anastasia; Shaw, Elizabeth; Tannenbaum, David

2018-05-01

To ascertain how program leaders in family medicine characterize success in family medicine maternity care education and determine which factors influence the success of training programs. Qualitative research using semistructured telephone interviews. Purposive sample of 6 family medicine programs from 5 Canadian provinces. Eighteen departmental leaders and program directors. Semistructured telephone interviews were conducted with program leaders in family medicine maternity care. Departmental leaders identified maternity care programs deemed to be "successful." Interviews were audiorecorded and transcribed verbatim. Team members conducted thematic analysis. Participants considered their education programs to be successful in family medicine maternity care if residents achieved competency in intrapartum care, if graduates planned to include intrapartum care in their practices, and if their education programs were able to recruit and retain family medicine maternity care faculty. Five key factors were deemed to be critical to a program's success in family medicine maternity care: adequate clinical exposure, the presence of strong family medicine role models, a family medicine-friendly hospital environment, support for the education program from multiple sources, and a dedicated and supportive community of family medicine maternity care providers. Training programs wishing to achieve greater success in family medicine maternity care education should employ a multifaceted strategy that considers all 5 of the interdependent factors uncovered in our research. By paying particular attention to the informal processes that connect these factors, program leaders can preserve the possibility that family medicine residents will graduate with the competence and confidence to practise full-scope maternity care. Copyright© the College of Family Physicians of Canada.

Susquehanna SES maintenance supervisor training and certification

International Nuclear Information System (INIS)

Deckman, M.

1991-01-01

Susquehanna's program targets all Supervisors, Supervisor Candidates, and Temporary Supervisors that are responsible for in-plant maintenance or maintenance support activities, including: mechanical maintenance; electrical maintenance; maintenance support (labor support, radwaste, etc.); mobile construction support (mechanical and electrical); chemistry; health physics; maintenance planning; and instrument and controls. The program integrates the three major areas of direct Supervisory responsibilities: (1) Leadership and Management - Skills that require interpersonal activities that are typically humanistic and subjective; such as coaching, motivating, communications, etc. (2) Technical and Administrative - Knowledge that is directly related to the job of Supervising from the production, regulatory, accountability perspective. These topics are very objective and include training on topics such as workpackages, plant chemistry parameters, radiological concerns, etc. (3) Technical Skills - Ensure each Supervisor is technically competent in the plant systems, components, or equipment he/she is tasked with maintaining or overseeing. Typical skills found in this area are, circuit breaker maintenance, primary system sampling, or overhauling pumps

Cost to primary care practices of responding to payer requests for quality and performance data.

Science.gov (United States)

Halladay, Jacqueline R; Stearns, Sally C; Wroth, Thomas; Spragens, Lynn; Hofstetter, Sara; Zimmerman, Sheryl; Sloane, Philip D

2009-01-01

We wanted to determine how much it costs primary care practices to participate in programs that require them to gather and report data on care quality indicators. Using mixed quantitative-qualitative methods, we gathered data from 8 practices in North Carolina that were selected purposively to be diverse by size, ownership, type, location, and medical records. Formal practice visits occurred between January 2008 and May 2008. Four quality-reporting programs were studied: Medicare's Physician Quality Reporting Initiative (PQRI), Community Care of North Carolina (CCNC), Bridges to Excellence (BTE), and Improving Performance in Practice (IPIP). We estimated direct costs to the practice and on-site costs to the quality organization for implementation and maintenance phases of program participation. Major expenses included personnel time for planning, training, registry maintenance, visit coding, data gathering and entry, and modification of electronic systems. Costs per full-time equivalent clinician ranged from less than $1,000 to $11,100 during program implementation phases and ranged from less than $100 to $4,300 annually during maintenance phases. Main sources of variation included program characteristics, amount of on-site assistance provided, experience and expertise of practice personnel, and the extent of data system problems encountered. The costs of a quality-reporting program vary greatly by program and are important to anticipate and understand when undertaking quality improvement work. Incentives that would likely improve practice participation include financial payment, quality improvement skills training, and technical assistance with electronic system troubleshooting.

Maintenance and environmental qualification

International Nuclear Information System (INIS)

Martin, R.S.; Austin, D.G.

1995-01-01

The design of today's nuclear generating plants involves many detailed design considerations. This includes comprehensive look at aging effects on plant components over their expected lifetimes. This is important to ensuring that the plant operates safely throughout its life. The effects of aging are required to be documented in detail in today's designs. This documentation provides assurance that safe operating conditions are maintained throughout the station life cycle. This requirement is analogous to the longer standing requirement to ensure pressure boundary integrity. The pressure boundary integrity requirement has existed in the industry since its inception. The subject of plant aging effects and the maintenance of functionality is known as Environmental Qualification (EQ). This paper will attempt to explain the wisdom of EQ and the potential for optimizing maintenance activities (to move from reactive to proactive activities), within the context of the overall maintenance program. It is the author's intent to encourage the active involvement of maintenance professionals in the effective implementation of the ongoing EQ program so that the benefits are maximized

Implementing Internet-Based Self-Care Programs in Primary Care: Qualitative Analysis of Determinants of Practice for Patients and Providers.

Science.gov (United States)

Hermes, Eric; Burrone, Laura; Perez, Elliottnell; Martino, Steve; Rowe, Michael

2018-05-18

Access to evidence-based interventions for common mental health conditions is limited due to geographic distance, scheduling, stigma, and provider availability. Internet-based self-care programs may mitigate these barriers. However, little is known about internet-based self-care program implementation in US health care systems. The objective of this study was to identify determinants of practice for internet-based self-care program use in primary care by eliciting provider and administrator perspectives on internet-based self-care program implementation. The objective was explored through qualitative analysis of semistructured interviews with primary care providers and administrators from the Veterans Health Administration. Participants were identified using a reputation-based snowball design. Interviews focused on identifying determinants of practice for the use of internet-based self-care programs at the point of care in Veterans Health Administration primary care. Qualitative analysis of transcripts was performed using thematic coding. A total of 20 physicians, psychologists, social workers, and nurses participated in interviews. Among this group, internet-based self-care program use was relatively low, but support for the platform was assessed as relatively high. Themes were organized into determinants active at patient and provider levels. Perceived patient-level determinants included literacy, age, internet access, patient expectations, internet-based self-care program fit with patient experiences, interest and motivation, and face-to-face human contact. Perceived provider-level determinants included familiarity with internet-based self-care programs, changes to traditional care delivery, face-to-face human contact, competing demands, and age. This exploration of perspectives on internet-based self-care program implementation among Veterans Health Administration providers and administrators revealed key determinants of practice, which can be used to develop

Proactive maintenance initiatives at Argonne National Laboratory-West

International Nuclear Information System (INIS)

Duckwitz, N.R.; Duncan, L.W.; Whipple, J.J.

1995-01-01

In the late 1980's, ANL-W Management foresaw a need to provide dedicated technical support for maintenance supervisors. Maintenance supervisors were facing increased challenges to ensure all environmental, safety, and waste management regulations were followed in daily maintenance activities. This increased burden was diverting supervisory time away from on-the-job supervision. Supervisors were finding less time for their ''mentor'' roles to ensure maintenance focused on finding and correcting root causes. Additionally the traditional maintenance organization could not keep up with the explosion in predictive maintenance technologies. As a result, engineers were tasked to provide direct technical support to the maintenance organization. Today the maintenance technical support group consists of two mechanical engineers, two electrical engineers and an I ampersand C engineer. The group provides a readily available, quick response resource for crafts people and their supervisors. They can and frequently do ask the support group for help to determine the root cause and to effect permanent fixes. Crafts and engineers work together informally to make an effective maintenance team. In addition to day-to-day problem solving, the technical support group has established several maintenance improvement programs for the site. This includes vibration analysis of rotating machinery, testing of fuel for emergency diesel generators, improving techniques for testing of high efficiency particulate air (HEPA) filters, and capacity testing of UPS and emergency diesel starting batteries. These programs have increased equipment reliability, reduced conventional routine maintenance, reduced unexpected maintenance, and improved testing accuracy. This paper will discuss the interaction of the technical support group within the maintenance department. Additionally the maintenance improvement programs will be presented along with actual cases encountered, the resolutions and lessons learned

Maintenance Process Strategic Analysis

Science.gov (United States)

Jasiulewicz-Kaczmarek, M.; Stachowiak, A.

2016-08-01

The performance and competitiveness of manufacturing companies is dependent on the availability, reliability and productivity of their production facilities. Low productivity, downtime, and poor machine performance is often linked to inadequate plant maintenance, which in turn can lead to reduced production levels, increasing costs, lost market opportunities, and lower profits. These pressures have given firms worldwide the motivation to explore and embrace proactive maintenance strategies over the traditional reactive firefighting methods. The traditional view of maintenance has shifted into one of an overall view that encompasses Overall Equipment Efficiency, Stakeholders Management and Life Cycle assessment. From practical point of view it requires changes in approach to maintenance represented by managers and changes in actions performed within maintenance area. Managers have to understand that maintenance is not only about repairs and conservations of machines and devices, but also actions striving for more efficient resources management and care for safety and health of employees. The purpose of the work is to present strategic analysis based on SWOT analysis to identify the opportunities and strengths of maintenance process, to benefit from them as much as possible, as well as to identify weaknesses and threats, so that they could be eliminated or minimized.

Maintenance cost optimization in condition based maintenance: a case study for critical facilities

OpenAIRE

Filippo De Carlo; Maria Antonietta Arleo

2013-01-01

The increasing availability required to industrial plants and the limited budget often existing to assure it, require a careful formulation of maintenance optimization models. This need is primary for process plants, for which minimization of stops and maximization of their availability, are essential for ensuring targeted production and, therefore, profitability. In this context, the choice of the maintenance strategy is hence fundamental, depending on the system features and then on the eff...

Maintenance Implementation Plan for the 222-S Laboratory

International Nuclear Information System (INIS)

Stark, T.E.

1992-10-01

This Maintenance Implementation Plan (MIP) has been developed for the 222-S Laboratory at Hanford. It is based on assessments of the existing maintenance program to the requirements specified by US Department of Energy (DOE) Order 4330.4A, Maintenance Management Program (DOE 1990), Chapter II, Change 3. The results of these assessments were evaluated to determine corrective actions required. The 222-S Laboratory is currently supporting the waste management, chemical processing, and environmental monitoring programs presently under Westinghouse Hanford Company (Westinghouse Hanford) responsibility. This is done through quality analytical and process chemistry services

Demonstration of Sensor Data Integration Across Naval Aviation Maintenance

Science.gov (United States)

2018-02-01

Concepts, Programs and Processes; Maintenance Unit Department, Division Organization; Manpower Management ; and Aviation Officers.” http...Naval Aviation Maintenance Alejandra Jolodosky and Adi Zolotov February 2018 This work was performed under Federal Government Contract...underutilized sensor data. CNA proposed a pilot program that integrated sensor data across maintenance levels to expedite repairs of aviation parts

Maintenance planning for nuclear power plants

International Nuclear Information System (INIS)

Mattu, R.K.; Cooper, S.E.; Lauderdale, J.R.

2004-01-01

Maintenance planning for nuclear power plants is similar to that in other industrial plants but it is heavily influenced by regulatory rules, with consequent costs of compliance. Steps by the nuclear industry and the Nuclear Regulatory Commission to address that problem include development of guidelines for maintenance of risk-critical equipment, using PRA-based techniques to select a set of equipment that requires maintenance and reliability-centered maintenance (RCM) approaches for determining what maintenance is required. The result of the process is a program designed to ensure effective maintenance of the equipment most critical to plant safety. (author)

Remote maintenance development for ITER

International Nuclear Information System (INIS)

Tada, Eisuke; Shibanuma, Kiyoshi

1998-01-01

This paper describes the overall ITER remote maintenance design concept developed mainly for in-vessel components such as diverters and blankets, and outlines the ITER R and D program to develop remote handling equipment and radiation hard components. Reactor structures inside the ITER cryostat must be maintained remotely due to DT operation, making remote handling technology basic to reactor design. The overall maintenance scenario and design concepts have been developed, and maintenance design feasibility, including fabrication and testing of full-scale in-vessel remote maintenance handling equipment and tool, is being verified. (author)

Remote maintenance development for ITER

Energy Technology Data Exchange (ETDEWEB)

Tada, Eisuke [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Shibanuma, Kiyoshi

1998-04-01

This paper describes the overall ITER remote maintenance design concept developed mainly for in-vessel components such as diverters and blankets, and outlines the ITER R and D program to develop remote handling equipment and radiation hard components. Reactor structures inside the ITER cryostat must be maintained remotely due to DT operation, making remote handling technology basic to reactor design. The overall maintenance scenario and design concepts have been developed, and maintenance design feasibility, including fabrication and testing of full-scale in-vessel remote maintenance handling equipment and tool, is being verified. (author)

Evaluating Behaviorally Oriented Aviation Maintenance Resource Management (MRM) Training and Programs: Methods, Results, and Conclusions

Science.gov (United States)

Taylor, James C.; Thomas, Robert L., III

2003-01-01

Assessment of the impact of Aviation Resource Management Programs on aviation culture and performance has compelled a considerable body of research (Taylor & Robertson, 1995; Taylor, 1998; Taylor & Patankar, 2001). In recent years new methods have been applied to the problem of maintenance error precipitated by factors such as the need for self-assessment of communication and trust. The present study - 2002 -- is an extension of that past work. This research project was designed as the conclusion of a larger effort to help understand, evaluate and validate the impact of Maintenance Resource Management (MRM) training programs, and other MRM interventions on participant attitudes, opinions, behaviors, and ultimately on enhanced safety performance. It includes research and development of evaluation methodology as well as examination of psychological constructs and correlates of maintainer performance. In particular, during 2002, three issues were addressed. First, the evaluation of two (independent & different) MRM programs for changing behaviors was undertaken. In one case we were able to further apply the approach to measuring written communication developed during 2001 (Taylor, 2002; Taylor & Thomas, 2003). Second, the MRM/TOQ surveys were made available for completion on the internet. The responses from these on-line surveys were automatically linked to a results calculator (like the one developed and described in Taylor, 2002) to aid industry users in analyzing and evaluating their local survey data on the internet. Third, the main trends and themes from our research about MRM programs over the past dozen years were reviewed.

Medication safety programs in primary care: a scoping review.

Science.gov (United States)

Khalil, Hanan; Shahid, Monica; Roughead, Libby

2017-10-01

Medication safety plays an essential role in all healthcare organizations; improving this area is paramount to quality and safety of any wider healthcare program. While several medication safety programs in the hospital setting have been described and the associated impact on patient safety evaluated, no systematic reviews have described the impact of medication safety programs in the primary care setting. A preliminary search of the literature demonstrated that no systematic reviews, meta-analysis or scoping reviews have reported on medication safety programs in primary care; instead they have focused on specific interventions such as medication reconciliation or computerized physician order entry. This scoping review sought to map the current medication safety programs used in primary care. The current scoping review sought to examine the characteristics of medication safety programs in the primary care setting and to map evidence on the outcome measures used to assess the effectiveness of medication safety programs in improving patient safety. The current review considered participants of any age and any condition using care obtained from any primary care services. We considered studies that focussed on the characteristics of medication safety programs and the outcome measures used to measure the effectiveness of these programs on patient safety in the primary care setting. The context of this review was primary care settings, primary healthcare organizations, general practitioner clinics, outpatient clinics and any other clinics that do not classify patients as inpatients. We considered all quantitative studied published in English. A three-step search strategy was utilized in this review. Data were extracted from the included studies to address the review question. The data extracted included type of medication safety program, author, country of origin, aims and purpose of the study, study population, method, comparator, context, main findings and outcome

Suncor maintenance and reliability

Energy Technology Data Exchange (ETDEWEB)

Little, S. [Suncor Energy, Calgary, AB (Canada)

2006-07-01

Fleet maintenance and reliability at Suncor Energy was discussed in this presentation, with reference to Suncor Energy's primary and support equipment fleets. This paper also discussed Suncor Energy's maintenance and reliability standard involving people, processes and technology. An organizational maturity chart that graphed organizational learning against organizational performance was illustrated. The presentation also reviewed the maintenance and reliability framework; maintenance reliability model; the process overview of the maintenance and reliability standard; a process flow chart of maintenance strategies and programs; and an asset reliability improvement process flow chart. An example of an improvement initiative was included, with reference to a shovel reliability review; a dipper trip reliability investigation; bucket related failures by type and frequency; root cause analysis of the reliability process; and additional actions taken. Last, the presentation provided a graph of the results of the improvement initiative and presented the key lessons learned. tabs., figs.

Application of reliability centered maintenance to Embalse NPP

International Nuclear Information System (INIS)

Torres, Antonio; Perdomo, Manuel; Fornero, Damian; Corchera, Roberto

2010-01-01

One of the most recent applications of Probabilistic Safety Analysis to Embalse NPP is the Safety Oriented Maintenance Program developed through the Reliability Centered Maintenance (RCM) methodology. Such an application was carried out by a cooperated effort between the staff of nuclear safety department of NPP and experts from Instituto Superior de Tecnologias y Ciencias Aplicadas of Cuba. So far 6 technological systems have been analyzed with important results regarding the optimization of preventive and predictive maintenance program of those systems. Any tasks of RCM were automated via MOSEG code. The results of this study were focused on the elaboration and modification of the Preventive Program, prioritization of stocks, reorientation of predictive techniques and modification in the time parameters of maintenance. (author)

Wellness Programs: Preventive Medicine to Reduce Health Care Costs.

Science.gov (United States)

Martini, Gilbert R., Jr.

1991-01-01

A wellness program is a formalized approach to preventive health care that can positively affect employee lifestyle and reduce future health-care costs. Describes programs for health education, smoking cessation, early detection, employee assistance, and fitness, citing industry success figures. (eight references) (MLF)

Optimum Maintenance Strategies for Highway Bridges

DEFF Research Database (Denmark)

Frangopol, Dan M.; Thoft-Christensen, Palle; Das, Parag C.

As bridges become older and maintenance costs become higher, transportation agencies are facing challenges related to implementation of optimal bridge management programs based on life cycle cost considerations. A reliability-based approach is necessary to find optimal solutions based on minimum...... expected life-cycle costs or maximum life-cycle benefits. This is because many maintenance activities can be associated with significant costs, but their effects on bridge safety can be minor. In this paper, the program of an investigation on optimum maintenance strategies for different bridge types...... is described. The end result of this investigation will be a general reliability-based framework to be used by the UK Highways Agency in order to plan optimal strategies for the maintenance of its bridge network so as to optimize whole-life costs....

Integrated Pest Management: A Curriculum for Early Care and Education Programs

Science.gov (United States)

California Childcare Health Program, 2011

2011-01-01

This "Integrated Pest Management Toolkit for Early Care and Education Programs" presents practical information about using integrated pest management (IPM) to prevent and manage pest problems in early care and education programs. This curriculum will help people in early care and education programs learn how to keep pests out of early…

A knowledge-based assistant for valve maintenance planning

International Nuclear Information System (INIS)

Winter, M.J.; Danofsky, R.A.; Spinrad, B.I.; Howard, K.

1987-01-01

A knowledge-based program is being developed to assist engineers in maintenance planning for safety related, motor-operated valves at a boiling water reactor. The purpose of this project is to develop the general framework for a prototype system that demonstrates the capabilities for diagnosing valve symptoms and prescribing corrective maintenance, completing a portion of the Corrective Maintenance Action Request (CMAR) form which must be prepared for each job, and managing an interactive valve data base. Minimizing user input and providing output in a form that is familiar to the maintenance planning engineer are important goals for the program. This paper describes the present features of the valve maintenance advisory system which is currently being tested

Maintenance Of The EPS 3000 Electron Beam Machine As Part Of Quality Assurance Program For Irradiation Service At ALURTRON, Nuclear Malaysia

International Nuclear Information System (INIS)

Siti Aiasah Hashim; Shari Jahar; Ayub Muhammad; Azmi Ali; Abdul Basit Shafiei; Sarada Idris

2012-01-01

The EPS 3000 electron beam machine is the first of its kind in the country and was installed in Nuclear Malaysia in 1991. It was manufactured by Nissin High Voltage having variable energies from 0.5 to 3.0 MeV and maximum power of 90 kW. The machine is currently used for commercial irradiation that serves local industries. The Alurtron facility where the EPS is housed is an ISO 9000 certified plant. Maintenance program for the EPS is an essential part of Alurtron's Quality Assurance program. This is to ensure that the machine is in good condition and can serve the customer as the demand requires. Preventive maintenance is carried out at scheduled period based on recommendation of the machine's manufacturer. Corrective maintenance and repairs are carried out in-house by Alurtron's technical staff. Assistance may be sought from the manufacturer if necessary. Over the years, Alurtron had built its own capabilities in term of operation and maintenance of Cockcroft Walton type electron beam machine. (author)

Equipment Maintenance management support system based on statistical analysis of maintenance history data

International Nuclear Information System (INIS)

Shimizu, S.; Ando, Y.; Morioka, T.

1990-01-01

Plant maintenance is recently becoming important with the increase in the number of nuclear power stations and in plant operating time. Various kinds of requirements for plant maintenance, such as countermeasures for equipment degradation and saving maintenance costs while keeping up plant reliability and productivity, are proposed. For this purpose, plant maintenance programs should be improved based on equipment reliability estimated by field data. In order to meet these requirements, it is planned to develop an equipment maintenance management support system for nuclear power plants based on statistical analysis of equipment maintenance history data. The large difference between this proposed new method and current similar methods is to evaluate not only failure data but maintenance data, which includes normal termination data and some degree of degradation or functional disorder data for equipment and parts. So, it is possible to utilize these field data for improving maintenance schedules and to evaluate actual equipment and parts reliability under the current maintenance schedule. In the present paper, the authors show the objectives of this system, an outline of this system and its functions, and the basic technique for collecting and managing of maintenance history data on statistical analysis. It is shown, from the results of feasibility tests using simulation data of maintenance history, that this system has the ability to provide useful information for maintenance and the design enhancement

Machine and lubricant condition monitoring for extended equipment lifetimes and predictive maintenance

Energy Technology Data Exchange (ETDEWEB)

Lukas, M; Anderson, D P [Spectro Incorporated, Littleton, Massachusetts (United States)

1998-12-31

Predictive maintenance has gained wide acceptance as a cost cutting strategy in modern industry. Condition monitoring by lubricant analysis is one of the basic tools of a predictive maintenance program along with vibration monitoring, performance monitoring and thermography. In today`s modern power generation, manufacturing, refinery, transportation, mining, and military operations, the cost of equipment maintenance, service, and lubricants are ever increasing. Parts, labor, equipment downtime and lubricant prices and disposal costs are a primary concern in a well run maintenance management program. Machine condition monitoring based on oil analysis has become a prerequisite in most maintenance programs. Few operations can afford not to implement a program if they wish to remain competitive, and in some cases, profitable. This presentation describes a comprehensive Machine Condition Monitoring Program based on oil analysis. Actual operational condition monitoring programs will be used to review basic components and analytical requirements. Case histories will be cited as examples of cost savings, reduced equipment downtime and increased efficiencies of maintenance programs through a well managed oil analysis program. (orig.)

Machine and lubricant condition monitoring for extended equipment lifetimes and predictive maintenance

Energy Technology Data Exchange (ETDEWEB)

Lukas, M.; Anderson, D.P. [Spectro Incorporated, Littleton, Massachusetts (United States)

1997-12-31

Predictive maintenance has gained wide acceptance as a cost cutting strategy in modern industry. Condition monitoring by lubricant analysis is one of the basic tools of a predictive maintenance program along with vibration monitoring, performance monitoring and thermography. In today`s modern power generation, manufacturing, refinery, transportation, mining, and military operations, the cost of equipment maintenance, service, and lubricants are ever increasing. Parts, labor, equipment downtime and lubricant prices and disposal costs are a primary concern in a well run maintenance management program. Machine condition monitoring based on oil analysis has become a prerequisite in most maintenance programs. Few operations can afford not to implement a program if they wish to remain competitive, and in some cases, profitable. This presentation describes a comprehensive Machine Condition Monitoring Program based on oil analysis. Actual operational condition monitoring programs will be used to review basic components and analytical requirements. Case histories will be cited as examples of cost savings, reduced equipment downtime and increased efficiencies of maintenance programs through a well managed oil analysis program. (orig.)

Gentilly 2 maintenance in a total quality environment

Energy Technology Data Exchange (ETDEWEB)

Ross, M H; Marois, H [Hydro-Quebec, Gentilly (Canada). Gentilly Generating Station

1993-12-31

Comprehensive preventive maintenance programs at Gentilly-2 Nuclear Generating Station are based on a policy that seeks to balance requirements against resources. A commitment to total quality aims at performance improvement and total customer satisfaction. To improve overall performance to an annual availability factor of 90%, planned outages must be limited to 21 days per year, and the preventive maintenance program must be upgraded. A quality improvement team is involved in supporting this initiative. This team will seek to bring a new balance to the program, and eventually optimize it, using reliability-centred maintenance techniques. 24 figs.

The critical care air transport program.

Science.gov (United States)

Beninati, William; Meyer, Michael T; Carter, Todd E

2008-07-01

The critical care air transport team program is a component of the U.S. Air Force Aeromedical Evacuation system. A critical care air transport team consists of a critical care physician, critical care nurse, and respiratory therapist along with the supplies and equipment to operate a portable intensive care unit within a cargo aircraft. This capability was developed to support rapidly mobile surgical teams with high capability for damage control resuscitation and limited capacity for postresuscitation care. The critical care air transport team permits rapid evacuation of stabilizing casualties to a higher level of care. The aeromedical environment presents important challenges for the delivery of critical care. All equipment must be tested for safety and effectiveness in this environment before use in flight. The team members must integrate the current standards of care with the limitation imposed by stresses of flight on their patient. The critical care air transport team capability has been used successfully in a range of settings from transport within the United States, to disaster response, to support of casualties in combat.

Development of a chronic care ostomy self-management program.

Science.gov (United States)

Grant, Marcia; McCorkle, Ruth; Hornbrook, Mark C; Wendel, Christopher S; Krouse, Robert

2013-03-01

Each year a percentage of the 1.2 million men and women in the United States with a new diagnosis of colorectal cancer join the 700,000 people who have an ostomy. Education targeting the long-term, chronic care of this population is lacking. This report describes the development of a Chronic Care Ostomy Self-Management Program, which was informed by (1) evidence on published quality-of-life changes for cancer patients with ostomies, (2) educational suggestions from patients with ostomies, and (3) examination of the usual care of new ostomates to illustrate areas for continued educational emphases and areas for needed education and support. Using these materials, the Chronic Care Ostomy Self-Management Program was developed by a team of multi-disciplinary researchers accompanied by experienced ostomy nurses. Testing of the program is in process. Pilot study participants reported high satisfaction with the program syllabus, ostomy nurse leaders, and ostomate peer buddies.

Development of a Chronic Care Ostomy Self Management Program

Science.gov (United States)

Grant, Marcia; McCorkle, Ruth; Hornbrook, Mark C.; Wendel, Christopher S.; Krouse, Robert

2012-01-01

Each year a percentage of the 1.2 million men and women in the United States with a new diagnosis of colorectal cancer join the 700,000 people who have an ostomy. Education targeting the long term, chronic care of this population is lacking. This report describes the development of a Chronic Care Ostomy Self Management Program, which was informed by (1) evidence on published quality of life changes for cancer patients with ostomies, (2) educational suggestions from patients with ostomies, and (3) examination of the usual care of new ostomates to illustrate areas for continued educational emphases and areas for needed education and support. Using these materials, the Chronic Care Ostomy Self Management Program was developed by a team of multi-disciplinary researchers accompanied by experienced ostomy nurses. Testing of the program is in process. Pilot study participants reported high satisfaction with the program syllabus, ostomy nurse leaders, and ostomate peer buddies. PMID:23104143

Systems Sustainability: Implementation of Enhanced Maintenance Programs at the Kurchatov Institute, the All-Russian Research Institute of Experimental physics (VNIIEF) and the All-Russian Scientific Institute for Technical Physics (VNIITF)

International Nuclear Information System (INIS)

Coppinger, M.; Pikula, M.; Randolph, J.D.; Windham, M.

1999-01-01

Implementation of quality maintenance programs is essential to enhancing sustainable continuous operations of United States funded Materials Protection, Control and Accountability (MPC and A) equipment/systems upgrades at various Russian nuclear facilities. An effective maintenance program is expected to provide assurances to both parties for achieving maximum continuous systems operations with minimum down time. To be effective, the program developed must focus on minimum down time for any part of a system. Minimum down time is realized through the implementation of a quality maintenance program that includes preventative maintenance, necessary diagnostic tools, properly trained technical staff, and an in-house inventory of required spare parts for repairing the impacted component of the system. A centralized maintenance management program is logistically essential for the success of this effort because of the large volume of MPC and A equipment/systems installed at those sites. This paper will discuss current programs and conditions at the Russian Research Center-Kurchatov Institute, the All-Russian Scientific Institute for Technical Physics and the All-Russian Research Institute of Experimental Physics and will address those steps necessary to implement an upgraded program at those sites

40 CFR 68.56 - Maintenance.

Science.gov (United States)

2010-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 2 Prevention Program § 68.56 Maintenance. (a) The owner or operator shall prepare and implement procedures to maintain the on-going mechanical integrity of the process...

25 CFR 170.812 - What is emergency maintenance?

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false What is emergency maintenance? 170.812 Section 170.812 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM BIA Road Maintenance § 170.812 What is emergency maintenance? Emergency maintenance is work that...

Systematization of Angra-1 operation attendance - Maintenance and periodic testings

International Nuclear Information System (INIS)

Furieri, E.B.; Carvalho Bruno, N. de; Salaverry, N.A.

1988-01-01

A maintenance analysis, their types and their functions for the safety of nuclear power plants is done. Programs and present trends in the reactor maintenance, as well as the maintenance program and periodic tests of Angra I, are analysed. The necessities of safety analysis and a systematization for maintenance attendance are discussed and the periodic testing as well as the attendance of international experience. (M.C.K.) [pt

49 CFR 214.341 - Roadway maintenance machines.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Roadway maintenance machines. 214.341 Section 214... Roadway maintenance machines. (a) Each employer shall include in its on-track safety program specific provisions for the safety of roadway workers who operate or work near roadway maintenance machines. Those...

Identifying potentially cost effective chronic care programs for people with COPD

Directory of Open Access Journals (Sweden)

L M G Steuten

2008-12-01

Full Text Available L M G Steuten1, K M M Lemmens2, A P Nieboer2, H JM Vrijhoef31Maastricht University Medical Centre, School for Care and Public Health Research, Department of Health, Organisation, Policy and Economics, Maastricht, The Netherlands; 2Erasmus University Medical Centre, Institute of Health Policy and Management, Rotterdam, The Netherlands; 3Maastricht University Medical Centre, School for Care and Public Health Research, Department of Integrated Care, Maastricht, The NetherlandsObjective: To review published evidence regarding the cost effectiveness of multi-component COPD programs and to illustrate how potentially cost effective programs can be identified.Methods: Systematic search of Medline and Cochrane databases for evaluations of multi-component disease management or chronic care programs for adults with COPD, describing process, intermediate, and end results of care. Data were independently extracted by two reviewers and descriptively summarized.Results: Twenty articles describing 17 unique COPD programs were included. There is little evidence for significant improvements in process and intermediate outcomes, except for increased provision of patient self-management education and improved disease-specific knowledge. Overall, the COPD programs generate end results equivalent to usual care, but programs containing ≥3 components show lower relative risks for hospitalization. There is limited scope for programs to break-even or save money.Conclusion: Identifying cost effective multi-component COPD programs remains a challenge due to scarce methodologically sound studies that demonstrate significant improvements on process, intermediate and end results of care. Estimations of potential cost effectiveness of specific programs illustrated in this paper can, in the absence of ‘perfect data’, support timely decision-making regarding these programs. Nevertheless, well-designed health economic studies are needed to decrease the current decision

Control maintenance training program for special safety systems at Bruce B

International Nuclear Information System (INIS)

Reinwald, G.

1997-01-01

It was recognized from the early days of commissioning of Bruce B that Control Maintenance staff would require a level of expertise to be able to maintain Special Safety Systems in proper running order. In the early 80's this was achieved through hands on experience during the original commissioning, troubleshooting and placing of the various systems in service. Control maintenance procedures were developed and implemented as the new systems came available for commissioning, as were operating manuals,training manuals etc. Under the development of the Maintenance Manager, a Conduct of Maintenance section was organized. One of the responsibilities of this section was to develop a series of Maintenance Administrative Procedures (MAPs) that set the standards for maintenance activities including training

Road Maintenance and Rehabilitation Program Using Functional and Structural Assessment

Science.gov (United States)

Setianingsih, A. I.; Sangaji, S.; Setyawan, A.

2017-02-01

Road sector development policy in Bangka Belitung emphasis on equitable development, which is opening up new areas for industrial development zones of potential marine and coastal tourism, so that having an impact on the budget priority to build a new road. This led to a minimal budget provided for the maintenance of the existing road. This study aimed to evaluate the condition of the pavement both functionally and structurally, the growth of traffic density and the availability of existing road maintenance costs. Then, to analyze the influence of existing road conditions, traffic density and road maintenance costs to the type of road maintenance management. The results are compared with the results of the existing maintenance conducted by the Public Works Department of Bangka Belitung province. Evaluation of pavement conditions consists of visual assessment of pavement condition using IRI, pavement condition assessment functionally with deflection method using test data tool Benkelman Beam (BB) and the actual traffic load. IRI value, deflections and traffic growth gained from years 2011-2015 subsequently created regression models to obtain the relationship and the correlation coefficient. The analysis showed that using the same relative magnitude of the budget from 2011 to 2015, giving priority to the maintenance of the road with good conditions capable of providing the road with a steady state of 100%. Recommendations can be given that maintain the road with good conditions reflecting that preservation provide maximum results with the more efficient maintenance cost.

Comparing Weight Loss-Maintenance Outcomes of a Worksite-Based Lifestyle Program Delivered via DVD and Face-to-Face: A Randomized Trial.

Science.gov (United States)

Ing, Claire Townsend; Miyamoto, Robin E S; Fang, Rui; Antonio, Mapuana; Paloma, Diane; Braun, Kathryn L; Kaholokula, Joseph Keawe'aimoku

2018-03-01

Native Hawaiians and other Pacific Islanders have high rates of overweight and obesity compared with other ethnic groups in Hawai'i. Effective weight loss and weight loss-maintenance programs are needed to address obesity and obesity-related health inequities for this group. Compare the effectiveness of a 9-month, worksite-based, weight loss-maintenance intervention delivered via DVD versus face-to-face in continued weight reduction and weight loss maintenance beyond the initial weight loss phase. We tested DVD versus face-to-face delivery of the PILI@Work Program's 9-month, weight loss-maintenance phase in Native Hawaiian-serving organizations. After completing the 3-month weight loss phase, participants ( n = 217) were randomized to receive the weight loss-maintenance phase delivered via trained peer facilitators or DVDs. Participant assessments at randomization and postintervention included weight, height, blood pressure, physical functioning, exercise frequency, and fat intake. Eighty-three face-to-face participants were retained at 12 months (74.1%) compared with 73 DVD participants (69.5%). There was no significant difference between groups in weight loss or weight loss maintenance. The number of lessons attended in Phase 1 of the intervention (β = 0.358, p = .022) and baseline systolic blood pressure (β = -0.038, p = .048) predicted percent weight loss at 12 months. Weight loss maintenance was similar across groups. This suggests that low-cost delivery methods for worksite-based interventions targeting at-risk populations can help address obesity and obesity-related disparities. Additionally, attendance during the weight loss phase and lower baseline systolic blood pressure predicted greater percent weight loss during the weight loss-maintenance phase, suggesting that early engagement and initial physical functioning improve long-term weight loss outcomes.

Critical Care Nurses' Reasons for Poor Attendance at a Continuous Professional Development Program.

Science.gov (United States)

Viljoen, Myra; Coetzee, Isabel; Heyns, Tanya

2016-12-01

Society demands competent and safe health care, which obligates professionals to deliver quality patient care using current knowledge and skills. Participation in continuous professional development programs is a way to ensure quality nursing care. Despite the importance of continuous professional development, however, critical care nurse practitioners' attendance rates at these programs is low. To explore critical care nurses' reasons for their unsatisfactory attendance at a continuous professional development program. A nominal group technique was used as a consensus method to involve the critical care nurses and provide them the opportunity to reflect on their experiences and challenges related to the current continuous professional development program for the critical care units. Participants were 14 critical care nurses from 3 critical care units in 1 private hospital. The consensus was that the central theme relating to the unsatisfactory attendance at the continuous professional development program was attitude. In order of importance, the 4 contributing priorities influencing attitude were communication, continuous professional development, time constraints, and financial implications. Attitude relating to attending a continuous professional development program can be changed if critical care nurses are aware of the program's importance and are involved in the planning and implementation of a program that focuses on the nurses' individual learning needs. ©2016 American Association of Critical-Care Nurses.

Methadone maintenance treatment program in prisons from the perspective of medical and non-medical prison staff: a qualitative study in Iran.

Science.gov (United States)

Moradi, Ghobad; Farnia, Marzieh; Shokoohi, Mostafa; Shahbazi, Mohammad; Moazen, Babak; Rahmani, Khaled

2015-03-12

As one of the most important components of harm reduction strategy for high-risk groups, following the HIV epidemics, Methadone Maintenance Treatment (MMT) has been initiated in prisoners since 2003. In this paper, we aimed to assess the advantages and shortcomings of the MMT program from the perspective of people who were involved with the delivery of prison healthcare in Iran. On the basis of grounded theory and through conducting 14 Focus Group Discussions (FGDs), 7 FGDs among physicians, consultants, experts, and 7 FGDs among directors and managers of prisons (n= 140) have been performed. The respondents were asked about positive and negative elements of the MMT program in Iranian prisons. This study included a total of 48 themes, of which 22 themes were related to advantages and the other 26 were about shortcomings of MMT programs in the prisons. According to participants' views "reduction of illegal drug use and high-risk injection", "reduction of potentially high-risk behaviors" and "making positive attitudes" were the main advantages of MMT in prisons, while issues such as "inaccurate implementation", "lack of skilled manpower" and "poor care after release from prison" were among the main shortcomings of MMT program. MMT program in Iran's prisons has achieved remarkable success in the field of harm reduction, but to obtain much more significant results, its shortcomings and weaknesses must be also taken into account by policy-makers. © 2015 by Kerman University of Medical Sciences.

Development of a methodology for maintenance optimization at Kozloduy NPP

International Nuclear Information System (INIS)

Kitchev, E.

1997-01-01

The paper presents the overview of a project for development of an applicable strategy and methods for Kozloduy NPP (KNPP) to optimize its maintenance program in order to meet the current risk based maintenance requirements. The strategy in a format of Integrated Maintenance Program (IMP) manual will define the targets of the optimization process, the major stages and elements of this process and their relationships. IMP embodies the aspects of the US NRC Maintenance Rule compliance and facilitates the integration of KNPP programs and processes which impact the plant maintenance and safety. The methods in a format of IMP Instructions (IM-PI) will define how the different IMP stages can be implemented and the IMP targets can be achieved at KNPP environment. (author). 8 refs

Employer Child Care Resources: A Guide to Developing Effective Child Care Programs and Policies.

Science.gov (United States)

Women's Bureau (DOL), Washington, DC.

Increasing numbers of employers are responding to employee child care needs by revising their benefit packages, work schedules, and recruitment plans to include child care options. This guide details ways to develop effective child care programs and policies. Section 1 of the guide describes employees' growing child care needs and employers'…

Development of a Proactive Care Program (U-CARE) to Preserve Physical Functioning of Frail Older People in Primary Care

NARCIS (Netherlands)

Bleijenberg, N.; Ten Dam, V.H.; Drubbel, I.; Numans, M.E.; De Wit, N.J.; Schuurmans, M.J.

2013-01-01

Purpose: Care for older patients in primary care is currently reactive, fragmented, and time consuming. An innovative structured and proactive primary care program (U-CARE) has been developed to preserve physical functioning and enhance quality of life of frail older people. This study describes in

The association of affective temperaments with smoking initiation and maintenance in adult primary care patients.

Science.gov (United States)

Eory, Ajandek; Rozsa, Sandor; Gonda, Xenia; Dome, Peter; Torzsa, Peter; Simavorian, Tatevik; Fountoulakis, Konstantinos N; Pompili, Maurizio; Serafini, Gianluca; Akiskal, Knarig K; Akiskal, Hagop S; Rihmer, Zoltan; Kalabay, Laszlo

2015-02-01

Smoking behaviour and its course is influenced by personality factors. Affective temperaments could allow a more specific framework of the role trait affectivity plays in this seriously harmful health-behaviour. The aim of our study was to investigate if such an association exists in an ageing population with a special emphasis on gender differences. 459 primary care patients completed the TEMPS-A, Beck Depression Inventory (BDI) and Hamilton Anxiety Rating Scale (HAM-A). Subjects were characterized according to their smoking behaviour as current, former or never smokers. Univariate analysis ANOVA and logistic regression were performed to analyse differences in the three smoking subgroups to predict smoking initiation and maintenance. Current smokers were younger and less educated than former or never smokers. Males were more likely to try tobacco during their lifetime and were more successful in cessation. Depressive, cyclothymic and irritable temperament scores showed significant differences between the three smoking subgroups. Irritable temperament was a predictor of smoking initiation in females whereas depressive temperament predicted smoking maintenance in males with a small, opposite effect of HAM-A scores independent of age, education, lifetime depression and BDI scores. Whereas smoking initiation was exclusively predicted by a higher BDI score in males, smoking maintenance was predicted by younger age and lower education in females. The cross-sectional nature of the study design may lead to selective survival bias and hinder drawing causal relationships. Affective temperaments contribute to smoking initiation and maintenance independently of age, education, and depression. The significant contribution of depressive temperament in males and irritable temperament in females may highlight the role of gender-discordant temperaments in vulnerable subgroups. Copyright © 2014 Elsevier B.V. All rights reserved.

26 CFR 1.528-2 - Organized and operated to provide for the acquisition, construction, management, maintenance and...

Science.gov (United States)

2010-04-01

... acquisition, construction, management, maintenance and care of association property. 1.528-2 Section 1.528-2... acquisition, construction, management, maintenance and care of association property. (a) Organized and... association are the acquisition, construction, management, maintenance, and care of association property. In...

FY 1994 annual summary report of the surveillance and maintenance activities for the Oak Ridge National Laboratory Environmental Restoration Program

International Nuclear Information System (INIS)

1994-11-01

The Oak Ridge National Laboratory (ORNL) Environmental Restoration (ER) Surveillance and Maintenance (S and M) Program was initiated to manage former waste management and environmental research sites contaminated with radioactive materials and/or hazardous chemicals. The S and M Program is responsible for managing designated sites/facilities from the end of their operating lives until final disposition or site stabilization. To effectively manage and perform the various S and M Program responsibilities, five summary-level work breakdown structure (WBS) elements have been established: S and M Preliminary Investigations, Special Projects, Routine S and M, Inactive Groundwater Wells, and Project Management. Routine S and M activities were conducted as scheduled throughout fiscal years (FY) 1994 at applicable inactive waste management (WM) and other contaminated areas. Overall, the ER S and M Program maintains 47 facilities, performs vegetation maintenance on approximately 230 acres, maintains 54 inactive tanks, and provides overall site management on over 700 acres. In addition to the routine S and M activities, detailed site inspections were conducted at established frequencies on appropriate sites in the ER S and M Program. This document provides a summary of the FY 1994 ORNL ER S and M Program accomplishments

Establishing a predictive maintenance (PdM) program at the Hanford Site

International Nuclear Information System (INIS)

Murray, W.A.; Winslow, R.G.

1994-02-01

The production reactors have been shut down for some time. But for the rest of the site, there is currently about 16,000 people engaged in a multi-billion dollar effort to safely process wastes which have been stored at the site since the 1940's. This effort also includes demolition of some older facilities and environmental restoration of much of the site. This is expected to take approximately 30 to 40 years. The concept of a site-wide predictive maintenance (PdM) program began to form in early 1993. Several informal studies showed that the stand alone predictive maintenance groups which had prevailed on site to date were less than 15% effective at trending equipment conditions and predicting failures. To improve the effectiveness of PdM within the company, an engineering analysis by Rick Winslow confirmed that utilization of software networking technology which was now available would significantly overcome many of these built in handicaps. A site-wide predictive maintenance network would make PdM technology accessible to all of the areas and facilities at the site regardless of geographical distances and company division lines. Site resident vibration experts can easily be located and provide consultations on the network. However, it was recognized that strong leadership and management skills would be required within each of the two organizations for effective implementation. To start this process, a letter of understanding and agreement between the facilities and Tank Farm divisions was drafted and endorsed by company management. The agreement assigned the primary responsibility of acquiring the network software and licensee to the Tank Farms division. The acquisition and installation of the network server would be the responsibility of the facilities division. This paper describes the rest of the network development and implementation process

Computer Programming Languages for Health Care

Science.gov (United States)

O'Neill, Joseph T.

1979-01-01

This paper advocates the use of standard high level programming languages for medical computing. It recommends that U.S. Government agencies having health care missions implement coordinated policies that encourage the use of existing standard languages and the development of new ones, thereby enabling them and the medical computing community at large to share state-of-the-art application programs. Examples are based on a model that characterizes language and language translator influence upon the specification, development, test, evaluation, and transfer of application programs.

Effect of tailored educational intervention to improve self-care maintenance and quality of life in postmenopausal osteoporotic women after a fragility fracture: the Guardian Angel® study.

Science.gov (United States)

Basilici Zannetti, Emanuela; D'Agostino, Fabio; Cittadini, Noemi; Feola, Maurizio; Pennini, Annalisa; Rao, Cecilia; Vellone, Ercole; Tarantino, Umberto; Alvaro, Rosaria

2017-01-01

Osteoporosis has a significant impact on affected patients. Healthcare providers should encourage postmenopausal women to improve self-care maintenance behaviors and quality of life following a fragility fracture. The aims of this study were to a) develop two new instruments for measuring, respectively, self-care maintenance and quality of life, in postmenopausal women with osteoporosis; b) evaluate the effectiveness of a tailored educational intervention to improve self-care maintenance and quality of life after a fragility fracture in postmenopausal women. For the first aim, a cross-sectional study will be performed; for the second aim, a multicenter, quasi-experimental, interventional design will be used. A convenience sample of postmenopausal women admitted to 44 hospitals in Italy with a diagnosis of bone fragility fracture will be enrolled and surveyed at 7, 30, 60 and 180 days after discharge. Trained nurses will conduct the educational intervention. The new instruments will allow the measurement of self-care and quality of life in postmenopausal women following a fragility fracture. Through tailored educational interventions, women can be helped to take their medications correctly, adopt a healthy lifestyle, reduce the occurrence of bone fractures, and have a better quality of life.

Time providing care outside visits in a home-based primary care program.

Science.gov (United States)

Pedowitz, Elizabeth J; Ornstein, Katherine A; Farber, Jeffrey; DeCherrie, Linda V

2014-06-01

To assess how much time physicians in a large home-based primary care (HBPC) program spend providing care outside of home visits. Unreimbursed time and patient and provider-related factors that may contribute to that time were considered. Mount Sinai Visiting Doctors (MSVD) providers filled out research forms for every interaction involving care provision outside of home visits. Data collected included length of interaction, mode, nature, and with whom the interaction was for 3 weeks. MSVD, an academic home-visit program in Manhattan, New York. All primary care physicians (PCPs) in MSVD (n = 14) agreed to participate. Time data were analyzed using a comprehensive estimate and conservative estimates to quantify unbillable time. Data on 1,151 interactions for 537 patients were collected. An average 8.2 h/wk was spent providing nonhome visit care for a full-time provider. Using the most conservative estimates, 3.6 h/wk was estimated to be unreimbursed per full-time provider. No significant differences in interaction times were found between patients with and without dementia, new and established patients, and primary-panel and covered patients. Home-based primary care providers spend substantial time providing care outside home visits, much of which goes unrecognized in the current reimbursement system. These findings may help guide practice development and creation of new payment systems for HBPC and similar models of care. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Development of blanket remote maintenance system

International Nuclear Information System (INIS)

Kakudate, Satoshi; Nakahira, Masataka; Oka, Kiyoshi; Taguchi, Kou

1998-01-01

ITER in-vessel components such as blankets are scheduled maintenance components, including complete shield blanket replacement for breeding blankets. In-vessel components are activated by 14 MeV neutrons, so blanket maintenance requires remote handling equipment and tools able to handle heavy payloads of about 4 tons within a positioning accuracy of 2 mm under intense gamma radiation. To facilitate remote maintenance, blankets are segmented into 730 modules and rail-mounted vehicle remote maintenance was developed. According to the ITER R and D program, critical technology related to blanket maintenance was developed extensively through joint efforts of the Japan, EU, and U.S. home teams. This paper summarizes current blanket maintenance technology conducted by the Japan Home Team, including development of full-scale remote handling equipment and tools for blanket maintenance. (author)

Development of blanket remote maintenance system

Energy Technology Data Exchange (ETDEWEB)

Kakudate, Satoshi; Nakahira, Masataka; Oka, Kiyoshi; Taguchi, Kou [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

1998-04-01

ITER in-vessel components such as blankets are scheduled maintenance components, including complete shield blanket replacement for breeding blankets. In-vessel components are activated by 14 MeV neutrons, so blanket maintenance requires remote handling equipment and tools able to handle heavy payloads of about 4 tons within a positioning accuracy of 2 mm under intense gamma radiation. To facilitate remote maintenance, blankets are segmented into 730 modules and rail-mounted vehicle remote maintenance was developed. According to the ITER R and D program, critical technology related to blanket maintenance was developed extensively through joint efforts of the Japan, EU, and U.S. home teams. This paper summarizes current blanket maintenance technology conducted by the Japan Home Team, including development of full-scale remote handling equipment and tools for blanket maintenance. (author)

Aging based maintenance and reinvestment scheduling of electric distribution

Energy Technology Data Exchange (ETDEWEB)

Korpijarvi, J.

2012-07-01

The maintenance of electric distribution network is a topical question for distribution system operators because of increasing significance of failure costs. In this dissertation the maintenance practices of the distribution system operators are analyzed and a theory for scheduling maintenance activities and reinvestment of distribution components is created. The scheduling is based on the deterioration of components and the increasing failure rates due to aging. The dynamic programming algorithm is used as a solving method to maintenance problem which is caused by the increasing failure rates of the network. The other impacts of network maintenance like environmental and regulation reasons are not included to the scope of this thesis. Further the tree trimming of the corridors and the major disturbance of the network are not included to the problem optimized in this thesis. For optimizing, four dynamic programming models are presented and the models are tested. Programming is made in VBA-language to the computer. For testing two different kinds of test networks are used. Because electric distribution system operators want to operate with bigger component groups, optimal timing for component groups is also analyzed. A maintenance software package is created to apply the presented theories in practice. An overview of the program is presented (orig.)

32 CFR 199.16 - Supplemental Health Care Program for active duty members.

Science.gov (United States)

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Supplemental Health Care Program for active duty... (CHAMPUS) § 199.16 Supplemental Health Care Program for active duty members. (a) Purpose and applicability... the supplemental health care program for active duty members of the uniformed services, the provision...

[Nutritional care in the cardiac rehabilitation program].

Science.gov (United States)

da Vico, Letizia; Biffi, Barbara; Masini, Maria Luisa; Fattirolli, Francesco

2007-06-01

There is some evidence of the efficacy of nutritional care in modifying eating habits and behavior in patients undergoing cardiac rehabilitation: nutritional care has a relevant role in the secondary prevention of cardiovascular disease. The dietitian is the qualified sanitary professional for nutritional care. The aim of this study was to define the role of dietitians within a health care team in programs of cardiac rehabilitation. In this setting, nutritional care starts with a dietary assessment, which includes a measurement of the anthropometric parameters, and a survey of the patient knowledge and eating habits. If there is no need for change in the patient lifestyle, the patient is addressed to the normal cardiac rehabilitation program with no further nutritional intervention except one session of counseling. When lifestyle changes are needed, the dietitian defines, together with the patient, therapeutic aims and expected results. The following phase is represented by group session with patients and their relatives during which nutritional topics are discussed and nutritional education is provided Afterwards, self-monitoring sheets of eating habits are individually discussed in one visit; a last individual visit is used for a final assessment of nutritional knowledge, dietary habits, and anthropometric parameters. In case of unsatisfactory results, patients are invited to participate to three group session to be held biweekly, during which they interact with the dietitian and take part to exercises and group discussions. When the established targets are reached, the nutritional program includes individual follow up visits at six and twelve months for further assessment of medium term results.

Maintenance Issues in Long Term Operation of Nuclear Power Plant

International Nuclear Information System (INIS)

Contri, P.; Bieth, M.; Rieg, C.

2006-01-01

Due to current social and economical framework, in last years many nuclear power plant owners started a program for the Long Term Operation (LTO)/PLEX (Plant Life Extension) of their older nuclear facilities. This process has many nuclear safety implications, other than strategic and political ones. The need for tailoring the available safety assessment tools to such applications has become urgent in recent years and triggered many research actions. The review of regular maintenance and ageing management programs are tools widely used in LTO/PLEX context in many Countries. However, most of these tools are rather general and in many cases they need reshaping in an LTO/PLEX framework before application, with focus to the safety implications of the LTO/PLEX. Many Countries and plants radically modified their maintenance rules towards a condition based approach as a precondition for the implementation of LTO/PLEX programs. In 2004 a network of European Organisations operating Nuclear Power Plants, SENUF, under the coordination of the JRC-IE, carried out an extensive questionnaire on maintenance practice in their facilities aiming at capturing the aspects of the maintenance programs where research is mostly needed. This paper uses some results of the questionnaire, which was not oriented to LTO/PLEX, to draw some conclusions on how the current maintenance programs could support a potential LTO/PLEX, among the other programs running at NPPs. In this sense, it is spin-off of the SENUF WG on maintenance. The paper aims at identifying the technical attributes of the maintenance programs more directly affecting the decision for a long-term safe operation of a nuclear facility, the issues related to their implementation and safety review. The paper includes an analysis of the questionnaire circulated among the SENUF participants and a discussion on the implications of optimised maintenance programs in existing plants. Some examples at WWER plants taken by sources other than

Day Care: A Program in Search of a Policy.

Science.gov (United States)

Bikales, Gerda

This report examines current issues relating to day care and challenges many of the policy assumptions that underlie a major public program of subsidized day care for children. A historical perspective of day care is presented and various types of day care are described. The costs and benefits of day care are examined and the relation of day care…

Optimization of maintenance programme at Daya Bay Nuclear Power Station based on RCM analysis results

International Nuclear Information System (INIS)

Liu Min

2003-01-01

This paper begins with an introduction to Guangdong Daya Bay Nuclear Power Station (GNPS) and gives a simple introduction to the operations and maintenance documentation system at GNPS. It then will review the maintenance program guidelines base and the associated problems prior to the application of reliability centered maintenance (RCM). How RCM was implemented at GNPS, how the results of RCM analysis were used to optimize the maintenance program and test program, and what is the interface between RCM and the existing maintenance program will be shown. Next, it will show the successful implementation of RCM at GNPS resulted in the following changes: A new understanding of equipment failure challenges operations and maintenance beliefs, maintenance concepts undergo a large change, maintenance program and periodic testing program are continuously modified and optimized, new on-condition maintenance technologies are introduced, non-productive scheduled overhauls are discarded, maintenance costs are effectively controlled, maintenance appropriateness has improved, management of hidden failures is more effective and timely. It will show the benefit of greater equipment reliability brought about by all of these changes, which in turn increases the reliability and safety of the entire power station. (author)

Maintenance of nuclear power plants

International Nuclear Information System (INIS)

Migaud, D.; Hutin, J.P.; Jouette, I.; Eymond, P.; Devie, P.; Cudelou, C.; Magnier, S.; Frydman, M.

2016-01-01

This document gathers different articles concerning the maintenance of the French nuclear power plants. The first article analyses the impact of the recent law on the energetic transition that sets the share of nuclear power at 50% of the electricity produced by 2025. A consequence may be the decommissioning of 17 to 20 reactors by 2025 and the huge maintenance program called 'Grand Carenage' whose aim is to extend operating life over 40 years will have to be re-considered in order to avoid useless expenses. The second article shows that in 2015 the French nuclear reactor fleet got very good results in terms of availability and safety. There were 49 scheduled outages and among them some ended ahead of time. The third article describes the specificities of the maintenance of a nuclear power plant, for instance the redundancy of some systems implies that maintenance has to deal with systems that have never functioned but must be ready to operate at any moment. Another specificity is the complexity of a nuclear power plant that implies an essential phase of preparation for maintenance operations. Because of safety requirements any maintenance operation has to be controlled, checked and may provide feedback. The fourth article presents the 'Grand Carenage' maintenance program that involves the following operations: the replacement of steam generators, the re-tubing of condensers, the replacement of the filtering drums used for cooling water, the testing of the reactor building, the hydraulic test of the primary circuit and the inspection of the reactor vessel. The fifth article focuses on the organization of the work-site for maintenance operations and the example of the Belleville-sur-Loire is described in the sixth article. Important maintenance operations like 'Grand Carenage' requires a strong collaboration with a network of specialized enterprises and as no reactor (except Flamanville EPR) is being built in France, maintenance

Proceedings of the third international conference on CANDU maintenance

International Nuclear Information System (INIS)

1995-01-01

The third international conference on Candu maintenance included sessions on the following topics: predictive maintenance, reliability improvements, steam generator monitoring, tools and instrumentation, valve performance, fuel channel inspection and maintenance, steam generator maintenance, environmental qualification, predictive maintenance, instrumentation and control, steam generator cleaning, decontamination and radiation protection, inspection techniques, maintenance program strategies and valve packing experience, remote tooling/ robotics and fuel handling. The individual papers have been abstracted separately

Proceedings of the third international conference on CANDU maintenance

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-12-31

The third international conference on Candu maintenance included sessions on the following topics: predictive maintenance, reliability improvements, steam generator monitoring, tools and instrumentation, valve performance, fuel channel inspection and maintenance, steam generator maintenance, environmental qualification, predictive maintenance, instrumentation and control, steam generator cleaning, decontamination and radiation protection, inspection techniques, maintenance program strategies and valve packing experience, remote tooling/ robotics and fuel handling. The individual papers have been abstracted separately.

The Long-term Outcomes of Sibutramine Effectiveness on Weight (LOSE Weight) study: evaluating the role of drug therapy within a weight management program in a group-model health maintenance organization.

Science.gov (United States)

Porter, Julie A; Raebel, Marsha A; Conner, Douglas A; Lanty, Frances A; Vogel, Erin A; Gay, Elizabeth C; Merenich, John A

2004-06-01

To assess the benefit of sibutramine hydrochloride monohydrate within a weight management program. Prospective randomized controlled trial in a health maintenance organization. Obese patients (n = 588) starting a weight management program were enrolled. Patients were randomly assigned to participate in the program alone or to participate in the program and receive sibutramine for 12 months. Outcome measures were change in weight, body mass index (BMI), percentage body fat, serum lipids, serum glucose, and blood pressure. At baseline, there was a younger age and higher weight, BMI, and waist circumference in the drug group. There was more degenerative joint disease in the nondrug group. The mean weight loss at 6 months was 6.8 kg (95% confidence interval [CI], -7.4 to -6.1 kg) in the drug group vs 3.1 kg (95% CI, -3.8 to -2.4 kg) (P managed care setting, the effectiveness and safety of sibutramine were similar to those observed in randomized, double-blind clinical efficacy trials.

76 FR 61103 - Medicare Program; Comprehensive Primary Care Initiative

Science.gov (United States)

2011-10-03

...] Medicare Program; Comprehensive Primary Care Initiative AGENCY: Centers for Medicare & Medicaid Services... organizations to participate in the Comprehensive Primary Care initiative (CPC), a multipayer model designed to... the Comprehensive Primary Care initiative or the application process. SUPPLEMENTARY INFORMATION: I...

Equipment reliability process improvement and preventive maintenance optimization

International Nuclear Information System (INIS)

Darragi, M.; Georges, A.; Vaillancourt, R.; Komljenovic, D.; Croteau, M.

2004-01-01

The Gentilly-2 Nuclear Power Plant wants to optimize its preventive maintenance program through an Integrated Equipment Reliability Process. All equipment reliability related activities should be reviewed and optimized in a systematic approach especially for aging plants such as G2. This new approach has to be founded on best practices methods with the purpose of the rationalization of the preventive maintenance program and the performance monitoring of on-site systems, structures and components (SSC). A rational preventive maintenance strategy is based on optimized task scopes and frequencies depending on their applicability, critical effects on system safety and plant availability as well as cost-effectiveness. Preventive maintenance strategy efficiency is systematically monitored through degradation indicators. (author)

Selecting, adapting, and sustaining programs in health care systems

Directory of Open Access Journals (Sweden)

Zullig LL

2015-04-01

Full Text Available Leah L Zullig,1,2 Hayden B Bosworth1–4 1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; 2Department of Medicine, Duke University Medical Center, Durham, NC, USA; 3School of Nursing, 4Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA Abstract: Practitioners and researchers often design behavioral programs that are effective for a specific population or problem. Despite their success in a controlled setting, relatively few programs are scaled up and implemented in health care systems. Planning for scale-up is a critical, yet often overlooked, element in the process of program design. Equally as important is understanding how to select a program that has already been developed, and adapt and implement the program to meet specific organizational goals. This adaptation and implementation requires attention to organizational goals, available resources, and program cost. We assert that translational behavioral medicine necessitates expanding successful programs beyond a stand-alone research study. This paper describes key factors to consider when selecting, adapting, and sustaining programs for scale-up in large health care systems and applies the Knowledge to Action (KTA Framework to a case study, illustrating knowledge creation and an action cycle of implementation and evaluation activities. Keywords: program sustainability, diffusion of innovation, information dissemination, health services research, intervention studies 

Public dental health care program for persons with disability

DEFF Research Database (Denmark)

Christensen, Lisa Bøge; Hede, Børge; Petersen, Poul Erik

2005-01-01

The objectives of the study were (1) to describe the organization and content of the Danish public oral health care program for persons with disability, and (2) to analyse possible variations in relation to the goals and requirements set by the health authorities. Data were collected by means......) payment of service, (4) providers of oral health care, (5) special training of staff, 6) dental services delivered, (7) ethical issues, and (8) patient rights. Less than one-third of persons estimated by the health authorities were enrolled in the program. On average, 0.4% of the municipal population...... of knowledge of oral health and oral health care for persons with disability were barriers to equal access to the program. Preventive dental services were the most frequent services delivered, although relatively few oral hygienists were involved in the program. Special training was most frequent in large...

Proceedings of the fourth international conference on CANDU maintenance

International Nuclear Information System (INIS)

1997-01-01

These proceedings record the information presented at the 4th International Conference on CANDU Maintenance held November 16-18,1997 in Toronto, Canada. The papers for these proceedings were prepared on component maintenance, human performance, steam generator leak detection, fuel channel inspections, rotating equipment maintenance, surveillance programs, inspection techniques, valve maintenance, steam generator repairs and performance, reactor aging management and preventative maintenance

Proceedings of the fourth international conference on CANDU maintenance

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-07-01

These proceedings record the information presented at the 4th International Conference on CANDU Maintenance held November 16-18,1997 in Toronto, Canada. The papers for these proceedings were prepared on component maintenance, human performance, steam generator leak detection, fuel channel inspections, rotating equipment maintenance, surveillance programs, inspection techniques, valve maintenance, steam generator repairs and performance, reactor aging management and preventative maintenance.

Airline experience with reliability-centered maintenance

International Nuclear Information System (INIS)

Matteson, T.D.

1985-01-01

Reliability-Centered Maintenance is a process for developing preventive maintenance programs. Its concepts evolved from the post WWII experience of the airline community. Its genesis was in a paper by F. Stanley Nowlan and Thomas D. Matteson of United Airlines for the American Institute of Aeronautics and Astronautics in 1967. Its first application was to the Boeing 747. It has subsequently been adopted by the FAA and the Department of Defense and applied to many new transport and military aircraft. Its objective is applicable and effective preventive maintenance and it has proven to be a highly effective replacement for the prior intuitive processes for selective preventive maintenance tasks. It focuses on system functions, functional failures, then dominant failure modes and effects. It then uses a decision tree to classify failure criticality and identify applicable and effective tasks. The result is a program focused on maintaining inherent safety and reliability at minimum cost. (orig.)

Airline experience with reliability-centered maintenance

Energy Technology Data Exchange (ETDEWEB)

Matteson, T.D.

1985-11-01

Reliability-Centered Maintenance is a process for developing preventive maintenance programs. Its concepts evolved from the post WWII experience of the airline community. Its genesis was in a paper by F. Stanley Nowlan and Thomas D. Matteson of United Airlines for the American Institute of Aeronautics and Astronautics in 1967. Its first application was to the Boeing 747. It has subsequently been adopted by the FAA and the Department of Defense and applied to many new transport and military aircraft. Its objective is applicable and effective preventive maintenance and it has proven to be a highly effective replacement for the prior intuitive processes for selective preventive maintenance tasks. It focuses on system functions, functional failures, then dominant failure modes and effects. It then uses a decision tree to classify failure criticality and identify applicable and effective tasks. The result is a program focused on maintaining inherent safety and reliability at minimum cost. (orig.).

Scheduling and recording of reactor maintenance and testing by computer

International Nuclear Information System (INIS)

Gray, P.L.

1975-01-01

The use of a computer program, Maintenance Information and Control (MIAC), at the Savannah River Laboratory (SRL) assists a small operating staff in maintaining three research reactors and a subcritical facility. The program schedules and defines preventive maintenance, schedules required periodic tests, logs repair and cost information, specifies custodial and service responsibilities, and provides equipment maintenance history, all with a minimum of record-keeping

A randomized controlled trial of interim methadone maintenance.

Science.gov (United States)

Schwartz, Robert P; Highfield, David A; Jaffe, Jerome H; Brady, Joseph V; Butler, Carol B; Rouse, Charles O; Callaman, Jason M; O'Grady, Kevin E; Battjes, Robert J

2006-01-01

Effective alternatives to long waiting lists for entry into methadone hydrochloride maintenance treatment are needed to reduce the complications of continuing heroin dependence and to increase methadone treatment entry. To compare the effectiveness of interim methadone maintenance with that of the usual waiting list condition in facilitating methadone treatment entry and reducing heroin and cocaine use and criminal behavior. Randomized, controlled, clinical trial using 2 conditions, with treatment assignment on a 3:2 basis to interim maintenance-waiting list control. A methadone treatment program in Baltimore. A total of 319 individuals meeting the criteria for current heroin dependence and methadone maintenance treatment. Participants were randomly assigned to either interim methadone maintenance, consisting of an individually determined methadone dose and emergency counseling only for up to 120 days, or referral to community-based methadone treatment programs. Entry into comprehensive methadone maintenance therapy at 4 months from baseline; self-reported days of heroin use, cocaine use, and criminal behavior; and number of urine drug test results positive for heroin and cocaine at the follow-up interview conducted at time of entry into comprehensive methadone treatment (or at 4 months from baseline for participants who did not enter regular treatment). Significantly more participants assigned to the interim methadone maintenance condition entered comprehensive methadone maintenance treatment by the 120th day from baseline (75.9%) than those assigned to the waiting list control condition (20.8%) (Pmethadone maintenance results in a substantial increase in the likelihood of entry into comprehensive treatment, and is an effective means of reducing heroin use and criminal behavior among opioid-dependent individuals awaiting entry into a comprehensive methadone treatment program.

Reliability Centered Maintenance for Savannah River Site's interim waste management facilities

International Nuclear Information System (INIS)

Hauer, K.A.; Wilson, J.F.

1992-01-01

The application of Reliability Centered Maintenance (RCM) has been shown to be an effective means to optimize maintenance programs or to establish new programs. The key to success of any RCM program is to customize the methodology to meet the specific needs of the implementing organization. This paper discusses how RCM is being used to establish the preventive maintenance program and how the resulting system data is being used to support the Technical Baseline reconstitution effort for the interim Waste Management Division of Westinghouse Savannah River Company (WSRC)

Good practices for effective maintenance to manage aging at NPPs

International Nuclear Information System (INIS)

Scott, W.B.; Enderlin, W.I.; Levy, I.S.

1989-01-01

The Nuclear Regulatory Commission's Office of Nuclear Regulatory Research is sponsoring this effort to study maintenance as it relates to aging, under the Nuclear Plant Aging Research (NPAR). Maintenance is the primary means of combating and correcting the effects of aging degradation at nuclear power plants. Maintenance effectiveness directly affects the safety of nuclear power plants. Several recent plant events have shown that improper maintenance or a lack of maintenance can be a significant contributory cause of plant incidents (e.g., transients at Rancho Seco and Davis Besse, and the Salem anticipated transient without scram event). In these, and other events, safety related plant equipment functions have been impaired by poor maintenance practices or a lack of maintenance on the specific equipment or in ancillary equipment that affects the ability of the safety related equipment to function. In some cases, the ancillary equipment has been nonsafety-related equipment, or balance-of-plant equipment that has not received adequate maintenance attention. In addition to the potential for causing safety significant plant transients, poor or lacking maintenance may allow the licensing basis of the plant to be eroded without detection. In some cases, time-related aging degradation of equipment that has not been detected, corrected or managed by the maintenance program has been a significant contributory factor. The NPAR program has developed significant information on aging degradation, detection, mitigation, and correction practices for safety-significant structures, systems and components that can be factored into maintenance programs and their effectiveness

TOTAL PRODUCTIVE MAINTENANCE, A CENTRAL PREOCCUPATION OF THE MANAGERS

OpenAIRE

Daniela POPESCU; Adriana SCRIOŞTEANU; ANDREI POPESCU

2013-01-01

This present study demonstrates that the role of the mangers in the productive maintenance is currently becoming more important. This assessment is formulated starting from the daily realities regarding the growth of the proportions of productions and along with these the growth of the volume of equipments which need a better care and maintenance for a proper operation. The productive maintenance has developed and emerged out of this necessity. Therefore, the productive maintenance in the eco...

Critical Care Pharmacist Market Perceptions: Comparison of Critical Care Program Directors and Directors of Pharmacy.

Science.gov (United States)

Hager, David R; Persaud, Rosemary A; Naseman, Ryan W; Choudhary, Kavish; Carter, Kristen E; Hansen, Amanda

2017-05-01

Background: While hospital beds continue to decline as patients previously treated as inpatients are stabilized in ambulatory settings, the number of critical care beds available in the United States continues to rise. Growth in pharmacy student graduation, postgraduate year 2 critical care (PGY2 CC) residency programs, and positions has also increased. There is a perception that the critical care trained pharmacist market is saturated, yet this has not been evaluated since the rise in pharmacy graduates and residency programs. Purpose: To describe the current perception of critical care residency program directors (CC RPDs) and directors of pharmacy (DOPs) on the critical care pharmacist job market and to evaluate critical care postresidency placement and anticipated changes in PGY2 CC programs. Methods: Two electronic surveys were distributed from October 2015 to November 2015 through Vizient/University HealthSystem Consortium, American Society of Health-System Pharmacists (ASHP), Society of Critical Care Medicine, and American College of Clinical Pharmacy listservs to target 2 groups of respondents: CC RPDs and DOPs. Questions were based on the ASHP Pharmacy Forecast and the Pharmacy Workforce Center's Aggregate Demand Index and were intended to identify perceptions of the critical care market of the 2 groups. Results: Of 116 CC RPDs, there were 66 respondents (56.9% response rate). Respondents have observed an increase in applicants; however, they do not anticipate increasing the number of positions in the next 5 years. The overall perception is that there is a balance in supply and demand in the critical care trained pharmacist market. A total of 82 DOPs responded to the survey. Turnover of critical care pharmacists within respondent organizations is expected to be low. Although a majority of DOPs plan to expand residency training positions, only 9% expect to increase positions in critical care PGY2 training. Overall, DOP respondents indicated a balance of

Does progressive resistance and balance exercise reduce falls in residential aged care? Randomized controlled trial protocol for the SUNBEAM program

Directory of Open Access Journals (Sweden)

Hewitt J

2014-02-01

Full Text Available Jennifer Hewitt,1 Kathryn M Refshauge,1 Stephen Goodall,2 Timothy Henwood,3 Lindy Clemson1 1Faculty of Health Sciences, University of Sydney, 2Centre for Health Economic Research and Evaluation, University of Technology, Sydney, NSW, 3University of Queensland/Blue Care Research and Practice Development Centre, The University of Queensland, Brisbane, QLD, Australia Introduction: Falls are common among older adults. It is reported that approximately 60% of residents of aged care facilities fall each year. This is a major cause of morbidity and mortality, and a significant burden for health care providers and the health system. Among community dwelling older adults, exercise appears to be an effective countermeasure, but data are limited and inconsistent among studies in residents of aged care communities. This trial has been designed to evaluate whether the SUNBEAM program (Strength and Balance Exercise in Aged Care reduces falls in residents of aged care facilities. Research question: Is the program more effective and cost-effective than usual care for the prevention of falls? Design: Single-blinded, two group, cluster randomized trial. Participants and setting: 300 residents, living in 20 aged care facilities. Intervention: Progressive resistance and balance training under the guidance of a physiotherapist for 6 months, then facility-guided maintenance training for 6 months. Control: Usual care. Measurements: Number of falls, number of fallers, quality of life, mobility, balance, fear of falling, cognitive well-being, resource use, and cost-effectiveness. Measurements will be taken at baseline, 6 months, and 12 months. Analysis: The number of falls will be analyzed using a Poisson mixed model. A logistic mixed model will be used to analyze the number of residents who fall during the study period. Intention-to-treat analysis will be used. Discussion: This study addresses a significant shortcoming in aged care research, and has potential to impact

Early Careerist Interest and Participation in Health Care Leadership Development Programs.

Science.gov (United States)

Thompson, Jon M; Temple, April

2015-01-01

Health care organizations are increasingly embracing leadership development programs. These programs include a variety of specific activities, such as formally structured leadership development, as well as mentoring, personal development and coaching, 360-degree feedback, and job enlargement, in order to increase the leadership skills of managers and high-potential staff. However, there is a lack of information on how early careerists in health care management view these programs and the degree to which they participate. This article reports on a study undertaken to determine how early careerists working in health care organizations view leadership development programs and their participation in such programs offered by their employers. Study findings are based on a survey of 126 early careerists who are graduates of an undergraduate health services administration program. We found varying levels of interest and participation in specific leadership development activities. In addition, we found that respondents with graduate degrees and those with higher compensation were more likely to participate in selected leadership development program activities. Implications of study findings for health care organizations and early careerists in the offering of, and participation in, leadership development programs are discussed.

The Nordic maintenance care program: what are the indications for maintenance care in patients with low back pain? A survey of the members of the Danish Chiropractors' Association

Directory of Open Access Journals (Sweden)

Hansen Signe F

2010-09-01

Full Text Available Abstract Background Maintenance care (MC is relatively commonly used among chiropractors. However, factual information is needed on its indications for use. Objectives This study had two objectives: 1 to describe which role patients' past history and treatment outcome play in chiropractors' decision to use MC in patients with low back pain, 2 to investigate if the chiropractors' clinical/educational background has an effect on the frequency of using MC and their indications for use of MC. Method An anonymous questionnaire was sent to all 413 chiropractors practising in Denmark. Its main part consisted of 3 sets of 4 questions relating to one basic case of low back pain. For each case, the chiropractors were asked if they would use MC as they self-defined the term (no/perhaps/yes. There were questions also on gender, age, educational and clinical background, and on the number of MC patients seen by these chiropractors. Their decision to recommend MC was reported. Associations between the demographic variables and 1 the frequency of MC-use and 2 their indications for use of MC were tested through multivariate analysis. Results The response rate was 72%. Non-indications for MC were: 1 a good outcome combined with no previous events, or 2 a past history of LBP and gradual worsening with treatment. Indications for MC were a good outcome combined with a previous history of low back pain between once a month and once a year. The mean proportion of MC patients per week were 22% (SD 19, ranging from 0% to 100%. The use of MC was highest among experienced chiropractors, those who were educated in North America, and clinic owners. However, in Denmark most chiropractors graduated before 1999, are educated abroad, whereas most chiropractors thereafter are educated in Denmark. Therefore, we cannot conclude whether this difference relates to education or years of experience. There were no associations detected between demographic variables and the indications

Critical Care Organizations: Building and Integrating Academic Programs.

Science.gov (United States)

Moore, Jason E; Oropello, John M; Stoltzfus, Daniel; Masur, Henry; Coopersmith, Craig M; Nates, Joseph; Doig, Christopher; Christman, John; Hite, R Duncan; Angus, Derek C; Pastores, Stephen M; Kvetan, Vladimir

2018-04-01

Academic medical centers in North America are expanding their missions from the traditional triad of patient care, research, and education to include the broader issue of healthcare delivery improvement. In recent years, integrated Critical Care Organizations have developed within academic centers to better meet the challenges of this broadening mission. The goal of this article was to provide interested administrators and intensivists with the proper resources, lines of communication, and organizational approach to accomplish integration and Critical Care Organization formation effectively. The Academic Critical Care Organization Building section workgroup of the taskforce established regular monthly conference calls to reach consensus on the development of a toolkit utilizing methods proven to advance the development of their own academic Critical Care Organizations. Relevant medical literature was reviewed by literature search. Materials from federal agencies and other national organizations were accessed through the Internet. The Society of Critical Care Medicine convened a taskforce entitled "Academic Leaders in Critical Care Medicine" on February 22, 2016 at the 45th Critical Care Congress using the expertise of successful leaders of advanced governance Critical Care Organizations in North America to develop a toolkit for advancing Critical Care Organizations. Key elements of an academic Critical Care Organization are outlined. The vital missions of multidisciplinary patient care, safety, and quality are linked to the research, education, and professional development missions that enhance the value of such organizations. Core features, benefits, barriers, and recommendations for integration of academic programs within Critical Care Organizations are described. Selected readings and resources to successfully implement the recommendations are provided. Communication with medical school and hospital leadership is discussed. We present the rationale for critical

Effects of a 14-month low-cost maintenance training program in patients with chronic systolic heart failure: a randomized study

DEFF Research Database (Denmark)

Prescott, Eva; Hjardem-Hansen, Rasmus; Dela, Flemming

2009-01-01

% CI: 3.0-13.0, P=0.002). No effect of maintenance intervention was observed for 6-min walk test, incremental shuttle walk test, sit-to-stand test, or quality of life. After 14 months changes in most markers of inflammation, endothelial damage, and glycemic control were more beneficial...... was maximum workload; secondary endpoints were 6-min walk test, incremental shuttle walk test, sit-to-stand test, quality of life, and serological markers. RESULTS: Six patients died and 43 completed the study. The initial 8-week training was associated with small but significant improvement in all...... in the intervention group. CONCLUSION: A low-cost maintenance intervention in CHF patients reduced the decline in the maximum workload compared with usual care but not in other measures of physical function. Results suggest beneficial effects of long-term maintenance training on glycemic control, inflammation...

Remote maintenance development for ITER

International Nuclear Information System (INIS)

Tada, Eisuke; Shibanuma, Kiyoshi

1997-01-01

This paper both describes the overall design concept of the ITER remote maintenance system, which has been developed mainly for use with in-vessel components such as divertor and blanket, and outlines of the ITER R and D program, which has been established to develop remote handling equipment/tools and radiation hard components. In ITER, the reactor structures inside cryostat have to be maintained remotely because of activation due to DT operation. Therefore, remote-handling technology is fundamental, and the reactor-structure design must be made consistent with remote maintainability. The overall maintenance scenario and design concepts of the required remote handling equipment/tools have been developed according to their maintenance classification. Technologies are also being developed to verify the feasibility of the maintenance design and include fabrication and testing of a fullscale remote-handling equipment/tools for in-vessel maintenance. (author)

Guide for generic application of Reliability Centered Maintenance (RCM) recommendations

International Nuclear Information System (INIS)

Schwan, C.A.; Toomey, G.E.; Morgan, T.A.; Darling, S.S.

1991-02-01

Previously completed reliability centered maintenance (RCM) studies form the basis for developing or refining a preventive maintenance program. This report describes a generic methodology that will help utilities optimize nuclear plant maintenance programs using RCM techniques. This guide addresses the following areas: history of the generic methodology development process, and use of the generic methodology for conducting system-to-system and component-to-component evaluations. 2 refs., 2 figs., 5 tabs

Development of divertor remote maintenance system

Energy Technology Data Exchange (ETDEWEB)

Takeda, Nobukazu; Oka, Kiyoshi; Akou, Kentaro; Takiguchi, Yuji [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

1998-04-01

The ITER divertor is categorized as a scheduled maintenance component because of extreme heat and particle loads it is exposed to by plasma. It is also highly activated by 14 MeV neutrons. Reliable remote handling equipment and tools are required for divertor maintenance under intense gamma radiation. To facilitate remote maintenance, the divertor is segmented into 60 cassettes, and each cassette weighing about 25 tons and maintained and replaced through four maintenance ports each 90 degrees. Divertor cassettes must be transported toroidally and radially for replacement through maintenance ports. Remote handling involving cassette movers and carriers for toroidal and radial transport has been developed. Under the ITER R and D program, technology critical to divertor cassette maintenance is being developed jointly by Japan, E.U., and U.S. home teams. This paper summarizes divertor remote maintenance design and the status of technology development by the Japan Home Team. (author)

Development of divertor remote maintenance system

International Nuclear Information System (INIS)

Takeda, Nobukazu; Oka, Kiyoshi; Akou, Kentaro; Takiguchi, Yuji

1998-01-01

The ITER divertor is categorized as a scheduled maintenance component because of extreme heat and particle loads it is exposed to by plasma. It is also highly activated by 14 MeV neutrons. Reliable remote handling equipment and tools are required for divertor maintenance under intense gamma radiation. To facilitate remote maintenance, the divertor is segmented into 60 cassettes, and each cassette weighing about 25 tons and maintained and replaced through four maintenance ports each 90 degrees. Divertor cassettes must be transported toroidally and radially for replacement through maintenance ports. Remote handling involving cassette movers and carriers for toroidal and radial transport has been developed. Under the ITER R and D program, technology critical to divertor cassette maintenance is being developed jointly by Japan, E.U., and U.S. home teams. This paper summarizes divertor remote maintenance design and the status of technology development by the Japan Home Team. (author)

ATTENTION MAINTENANCE IN NOVICE DRIVERS: ASSESSMENT AND TRAINING

OpenAIRE

Pradhan, Anuj; Masserang, Kathleen M.; Divekar, Gautam; Reagan, Ian; Thomas, F. Dennis; Blomberg, Richard; Pollatsek, Alexander; Fisher, Donald

2009-01-01

All programs assessing attention maintenance inside the vehicle have required eye trackers and either a driving simulator or a specially equipped field vehicle. Ideally, one would like a way to assess attention maintenance that could be implemented on a desktop PC. Additionally, one would like to have a program that could be used to train novice drivers to maintain their attention more safely on the forward roadway. An experiment was run (a) to determine whether a program FOCAL (Focused Conce...

40 CFR 160.63 - Maintenance and calibration of equipment.

Science.gov (United States)

2010-07-01

...) PESTICIDE PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Equipment § 160.63 Maintenance and calibration of..., maintenance, testing, calibration, and/ or standardization of equipment, and shall specify, when appropriate... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Maintenance and calibration of...

Nuclear instrument maintenance - problems, solutions, and obstacles

International Nuclear Information System (INIS)

Vuister, P.H.

1983-01-01

In 200 laboratories of South-East Asia, Latin America and Africa a survey was made of the state of instrumentation for nuclear medicine. The principal cause of failures and defects was inadequate quality control and preventive maintenance. On the basis of the survey coordinated research programs were compiled for the maintenance of nuclear instruments. The four principal points of the programs are: to safeguard quality and stable electric power supplies for the instruments, to safeguard permanent temperature and humidity in the environment in which the equipment is operated, effective maintenance, and training of personnel. In the years 1981 and 1982, 14 local training courses were run in which emphasis was put on practicals and tests in mechanics and electronics

A multicriteria decision making approach applied to improving maintenance policies in healthcare organizations.

Science.gov (United States)

Carnero, María Carmen; Gómez, Andrés

2016-04-23

Healthcare organizations have far greater maintenance needs for their medical equipment than other organization, as many are used directly with patients. However, the literature on asset management in healthcare organizations is very limited. The aim of this research is to provide more rational application of maintenance policies, leading to an increase in quality of care. This article describes a multicriteria decision-making approach which integrates Markov chains with the multicriteria Measuring Attractiveness by a Categorical Based Evaluation Technique (MACBETH), to facilitate the best choice of combination of maintenance policies by using the judgements of a multi-disciplinary decision group. The proposed approach takes into account the level of acceptance that a given alternative would have among professionals. It also takes into account criteria related to cost, quality of care and impact of care cover. This multicriteria approach is applied to four dialysis subsystems: patients infected with hepatitis C, infected with hepatitis B, acute and chronic; in all cases, the maintenance strategy obtained consists of applying corrective and preventive maintenance plus two reserve machines. The added value in decision-making practices from this research comes from: (i) integrating the use of Markov chains to obtain the alternatives to be assessed by a multicriteria methodology; (ii) proposing the use of MACBETH to make rational decisions on asset management in healthcare organizations; (iii) applying the multicriteria approach to select a set or combination of maintenance policies in four dialysis subsystems of a health care organization. In the multicriteria decision making approach proposed, economic criteria have been used, related to the quality of care which is desired for patients (availability), and the acceptance that each alternative would have considering the maintenance and healthcare resources which exist in the organization, with the inclusion of a

What Do High-Risk Patients Value? Perspectives on a Care Management Program.

Science.gov (United States)

Ganguli, Ishani; Orav, E John; Weil, Eric; Ferris, Timothy G; Vogeli, Christine

2018-01-01

There is growing interest in coordinating care for high-risk patients through care management programs despite inconsistent results on cost reduction. Early evidence suggests patient-centered benefits, but we know little about how participants engage with the programs and what aspects they value. To explore care management program participants' awareness and perceived utility of program offerings. Cross-sectional telephone survey administered December 2015-January 2016. Patients enrolled in a Boston-area primary care-based care management program. Our main outcome was the number of topics in which patients reported having "very helpful" interactions with their care team in the past year. We analyzed awareness of one's care manager as an intermediate outcome, and then as a primary predictor of the main outcome, along with patient demographics, years in the program, attitudes, and worries as secondary predictors. The survey response rate was 45.8% (n = 1220); non-respondents were similar to respondents. More respondents reported worrying about family (72.8%) or financial issues (52.5%) than about their own health (41.6%). Seventy-four percent reported care manager awareness, particularly women (OR 1.33, 95% CI 1.01-1.77) and those with more years in the program (OR 1.16, 95% CI 1.03-1.30). While interaction rates ranged from 19.8% to 72.4% across topics, 81.3% rated at least one interaction as very helpful. Those who were aware of their care manager reported very helpful interactions on more topics (OR 2.77, 95% CI 2.15-3.56), as did women (OR 1.25, 95% CI 1.00-1.55), younger respondents (OR 0.98 for older age, 95% CI 0.97-0.99), and those with higher risk scores (OR 1.04, 95% CI 1.02-1.06), preference for deferring treatment decisions to doctors (OR 2.00, 95% CI 1.60-2.50), and reported control over their health (OR 1.67, 95% CI 1.33-2.10). High-risk patients reported helpful interactions with their care team around medical and social determinants of health

Day Care Legal Handbook: Legal Aspects of Organizing and Operating Day Care Programs.

Science.gov (United States)

Aikman, William F.

This guide for providers of day care services presents information on business regulations and other legal considerations affecting for-profit and not-for-profit day care programs. Three basic topics covered are: (1) choosing the type of organization (sole proprietorship, partnership or corporation), (2) forming the organization, and (3) operating…

TPM and autonomous maintenance: case study in a metal mechanic company

Directory of Open Access Journals (Sweden)

Norberto Carvalho Biehl

2015-12-01

Full Text Available The purpose of this article was to describe a case of autonomous maintenance implementation in a pilot area of a metal mechanical industry company. The TPM – Total Productive Maintenance is a managerial technology that can help companies to reduce failures and breakages of machines. One of the most important issues of TPM is autonomous maintenance. The method of research was the case study. A program of twelve points was structured and adopted as stand-alone maintenance deployment guide. The program began in a pilot area, including three machining centers. The main results of the pilot program were: increasing by more than 700% the Mean Time between Failure, reducing by more than 40% in the Mean Time to Repair, as well as the consequent increase of more than five percentage points on the availability of the three machines and almost 60% reduction in the cost of maintenance materials. The main conclusion was that the TPM, and in particular the autonomous maintenance, can increase the efficiency of maintenance as strategic factor, which enhances the competitiveness of manufacturing in industrial companies.

Methadone Maintenance as Last Resort

DEFF Research Database (Denmark)

Järvinen, Margaretha; Miller, Gale

2010-01-01

Drawing on qualitative interviews with drug addicts in Copenhagen, Denmark, this article offers a phenomenological reading of a methadone maintenance program. The program is set within the principles of harm reduction, meaning that its aim is not to cure the participants’ addiction but to keep them...

Clinical usefulness and economic implications of continuation/maintenance electroconvulsive therapy in a Spanish National Health System public hospital: A case series.

Science.gov (United States)

Rodriguez-Jimenez, Roberto; Bagney, Alexandra; Torio, Iosune; Caballero, Montserrat; Ruiz, Pedro; Rivas, Francisco de Paula Jose; Jimenez-Arriero, Miguel Angel

2015-01-01

Continuation/maintenance electroconvulsive therapy has been shown to be effective for prevention of relapse in affective and psychotic disorders. However, there is a limited nubber of studies that investigate clinical management, associated costs, and perceived quality variables. A series of 8 cases included during the first 18 months of the Continuation/Maintenance Electroconvulsive Therapy Program of the Psychiatry Department at 12 de Octubre University Hospital is presented. Clinical variables (Clinical Global Impression-Improvement Scale, length of hospitalization, number of Emergency Department visits, number of urgent admissions) before and after inclusion in the continuation/maintenance electroconvulsive therapy program were compared for each patient, as well as associated costs and perceived quality. After inclusion in the program, 50.0% of patients reported feeling « much better » and 37.5% « moderately better » in the Clinical Global Impression-Improvement Scale. In addition, after inclusion in the continuation/maintenance electroconvulsive therapy program, patients were hospitalized for a total of 349 days, visited the Emergency Department on 3 occasions, and had 2 urgent admissions, compared to 690 days of hospitalization (P = .012), 26 Emergency Department visits (P = .011) and 22 urgent admissions (P = .010) during the same period before inclusion in the program. Associated direct costs per day of admission were reduced to 50.6% of the previous costs, and costs associated with Emergency Department visits were reduced to 11.5% of the previous costs. As regards perceived quality, 87.5% of patients assessed the care and treatment received as being « very satisfactory », and 12.5% as « satisfactory ». This continuation/maintenance electroconvulsive therapy program has shown to be clinically useful and to have a favourable economic impact, as well as high perceived quality. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights

National Structural Survey of Veterans Affairs Home-Based Primary Care Programs.

Science.gov (United States)

Karuza, Jurgis; Gillespie, Suzanne M; Olsan, Tobie; Cai, Xeuya; Dang, Stuti; Intrator, Orna; Li, Jiejin; Gao, Shan; Kinosian, Bruce; Edes, Thomas

2017-12-01

To describe the current structural and practice characteristics of the Department of Veterans Affairs (VA) Home-Based Primary Care (HBPC) program. We designed a national survey and surveyed HBPC program directors on-line using REDCap. We received 236 surveys from 394 identified HBPC sites (60% response rate). HBPC site characteristics were quantified using closed-ended formats. HBPC program directors were most often registered nurses, and HBPC programs primarily served veterans with complex chronic illnesses that were at high risk of hospitalization and nursing home care. Primary care was delivered using interdisciplinary teams, with nurses, social workers, and registered dietitians as team members in more than 90% of the sites. Most often, nurse practitioners were the principal primary care providers (PCPs), typically working with nurse case managers. Nearly 60% of the sites reported dual PCPs involving VA and community-based physicians. Nearly all sites provided access to a core set of comprehensive services and programs (e.g., case management, supportive home health care). At the same time, there were variations according to site (e.g., size, location (urban, rural), use of non-VA hospitals, primary care models used). HBPC sites reflected the rationale and mission of HBPC by focusing on complex chronic illness of home-based veterans and providing comprehensive primary care using interdisciplinary teams. Our next series of studies will examine how HBPC site structural characteristics and care models are related to the processes and outcomes of care to determine whether there are best practice standards that define an optimal HBPC structure and care model or whether multiple approaches to HBPC better serve the needs of veterans. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Excellence through maintenance mastering

International Nuclear Information System (INIS)

Lamarche, M.; Guillot, M.; Monier, M.

1987-01-01

To improve the overall availability factor of nuclear power plants you have to cut either the forced outage role and the planned outage time or you need to reduce simultaneously the failures and the efforts devoted to avoiding them. Among other results, this goal leads to a decrease in the number of real or anticipated problems. Electricite de France policy, in this matter, is to focus on decreasing the compoents' maintenance needs through a comprehensive modification program, targeted to eliminating the weak points as revealed by the operation. Thereby one may reach, for simple equipment, a nearly maintenance-free condition in which the only maintenance needed is surveillance, which provides assurance that everything is operating properly. A good example of this type of equipment is the family of static components, drums, and pipes whose corrective maintenance is almost nil when their initial condition is good

German diabetes management programs improve quality of care and curb costs.

Science.gov (United States)

Stock, Stephanie; Drabik, Anna; Büscher, Guido; Graf, Christian; Ullrich, Walter; Gerber, Andreas; Lauterbach, Karl W; Lüngen, Markus

2010-12-01

This paper reports the results of a large-scale analysis of a nationwide disease management program in Germany for patients with diabetes mellitus. The German program differs markedly from "classic" disease management in the United States. Although it combines important hallmarks of vendor-based disease management and the Chronic Care Model, the German program is based in primary care practices and carried out by physicians, and it draws on their personal relationships with patients to promote adherence to treatment goals and self-management. After four years of follow-up, overall mortality for patients and drug and hospital costs were all significantly lower for patients who participated in the program compared to other insured patients with similar health profiles who were not in the program. These results suggest that the German disease management program is a successful strategy for improving chronic illness care.

Pilot Study for Maintenance Rule at KSNP

International Nuclear Information System (INIS)

Choi, Kwang Hee; Jeong, Hyeon Jong; Jee, Moon Hak; Hong, Sung Yull

2005-01-01

Maintenance Rule (MR), which was developed to monitor the effectiveness of maintenance in a nuclear power plant (NPP), has been received as highly successful program by and large since its implementation in 1996 in the United States. Korea has initiated two pilot programs to implement the Maintenance Rule program in 2003. Selected plants for the pilot implementation are Kori 3 and 4 units and Ulchin 3 and 4 units, where Kori 3 and 4 units are Westinghouse units and Ulchin 3 and 4 units are Korean Standardized Nuclear Power (KSNP) Plant units. This paper describes the results of each key tasks completed to date and insights gained from pilot study on the KSNP units. Currently, Scoping of the functions of maintenance rule and determination of safety significance level have been completed during first year. As first task, total 607 functions were identified and defined by detailed function analysis on 135 systems that cover all plant systems. About 55% of total functions are selected as within the scope of maintenance rule. Among these inscoped functions, 56% of scoped functions are safety related and 44% are non-safety related functions. Evaluation of safety significance for each function was determined by expert panel consist of eight experts in field of plant maintenance, operation, PSA, work schedule and system engineers. As a result, about 46% of functions were determined to be high safety significant functions and rest of the functions were classified as low safety significant. The remaining tasks that are included determination of performance criteria and preparation of implementing guideline will be performed in following years

Floors: Selection and Maintenance.

Science.gov (United States)

Berkeley, Bernard

Flooring for institutional, commercial, and industrial use is described with regard to its selection, care, and maintenance. The following flooring and subflooring material categories are discussed--(1) resilient floor coverings, (2) carpeting, (3) masonry floors, (4) wood floors, and (5) "formed-in-place floors". The properties, problems,…

Variation in the Viral Hepatitis and HIV Policies and Practices of Methadone Maintenance Programs.

Science.gov (United States)

Jessop, Amy B; Hom, Jeffrey K; Burke, Monika

Patients prescribed methadone maintenance treatment (MMT) demonstrate elevated prevalence of hepatitis B virus (HBV), hepatitis C virus, and HIV. Government agencies recommend testing for these infections in MMT programs, but uptake is limited. We audited infection-related policies and practices of all 14 MMT programs in Philadelphia, Pennsylvania, in 2015. Results were tabulated and compared with the results from a 2010 audit of 10 of 12 MMT programs. The audit focused on which patients are tested, timing and frequency, specific tests ordered, vaccination, and communication of test results. Written policies were nonspecific, offering little guidance on appropriate testing. The principal change in policy between 2010 and 2015 involved adding clearer guidance for communication of results to patients. In 2010 and 2015, all MMT programs tested new patients for hepatitis C virus antibodies, although retesting of existing patients varied. HBV testing increased from 2010 to 2015, though it was not uniform, with 5 programs testing for HBV surface antibodies and 10 programs testing for HBV surface antigens. Six programs assessed hepatitis vaccination status, but only 1 administered vaccines. In 2010, city-sponsored HIV antibody testing was available at all MMT programs. Without this program in 2015, few MMT programs conducted HIV testing. Despite limited hepatitis and HIV screening in MMT programs nationally, this study shows that testing can be incorporated into routine procedures. MMT programs are positioned to play an integral role in the identification of patients with chronic infections, but additional guidance and resources are required to maximize their impact.

Working Together to Connect Care: a metropolitan tertiary emergency department and community care program.

Science.gov (United States)

Harcourt, Debra; McDonald, Clancy; Cartlidge-Gann, Leonie; Burke, John

2017-03-02

Objective Frequent attendance by people to an emergency department (ED) is a global concern. A collaborative partnership between an ED and the primary and community healthcare sectors has the potential to improve care for the person who frequently attends the ED. The aims of the Working Together to Connect Care program are to decrease the number of presentations by providing focused community support and to integrate all healthcare services with the goal of achieving positive, patient-centred and directed outcomes. Methods A retrospective analysis of ED data for 2014 and 2015 was used to ascertain the characteristics of the potential program cohort. The definition used to identify a 'frequent attendee' was more than four presentations to an ED in 1 month. This analysis was used to develop the processes now known as the Working Together to Connect Care program. This program includes participant identification by applying the definition, flagging of potential participants in the ED IT system, case review and referral to community services by ED staff, case conferencing facilitated within the ED and individualised, patient centred case management provided by government and non-government community services. Results Two months after the date of commencement of the Working Together to Connect Care program there are 31 active participants in the program: 10 are on the Mental Health pathway, and one is on the No Consent pathway. On average there are three people recruited to the program every week. The establishment of a new program for supporting frequent attendees of an ED has had its challenges. Identifying systems that support people in their community has been an early positive outcome of this project. Conclusion It is expected that data regarding the number of ED presentations, potential fiscal savings and client outcomes will be available in 2017. What is known about the topic? Frequent attendance at EDs is a global issue and although the number of 'super users' is

Creating a successful culturally sensitive home care program.

Science.gov (United States)

Blanter, R; Page, P M

1995-12-01

Providing quality home care services to immigrants requires an integrated, holistic approach that genuinely addresses language and cultural differences. One home care agency in Massachusetts developed a team-oriented, culturally sensitive outreach program that ensures non-English-speaking patients the same level of service that the general population receives.

End-of-life care in the United States: policy issues and model programs of integrated care

Directory of Open Access Journals (Sweden)

Joshua M. Wiener

2003-05-01

Full Text Available Background: End-of-life care financing and delivery in the United States is fragmented and uncoordinated, with little integration of acute and long-term care services. Objective: To assess policy issues involving end-of-life care, especially involving the hospice benefit, and to analyse model programs of integrated care for people who are dying. Methods: The study conducted structured interviews with stakeholders and experts in end-of-life care and with administrators of model programs in the United States, which were nominated by the experts. Results: The two major public insurance programs—Medicare and Medicaid—finance the vast majority of end-of-life care. Both programs offer a hospice benefit, which has several shortcomings, including requiring physicians to make a prognosis of a six month life expectancy and insisting that patients give up curative treatment—two steps which are difficult for doctors and patients to make—and payment levels that may be too low. In addition, quality of care initiatives for nursing homes and hospice sometimes conflict. Four innovative health systems have overcome these barriers to provide palliative services to beneficiaries in their last year of life. Three of these health systems are managed care plans which receive capitated payments. These providers integrate health, long-term and palliative care using an interdisciplinary team approach to management of services. The fourth provider is a hospice that provides palliative services to beneficiaries of all ages, including those who have not elected hospice care. Conclusions: End-of-life care is deficient in the United States. Public payers could use their market power to improve care through a number of strategies.

Does diabetes disease management save money and improve outcomes? A report of simultaneous short-term savings and quality improvement associated with a health maintenance organization-sponsored disease management program among patients fulfilling health employer data and information set criteria.

Science.gov (United States)

Sidorov, Jaan; Shull, Robert; Tomcavage, Janet; Girolami, Sabrina; Lawton, Nadine; Harris, Ronald

2002-04-01

Little is known about the impact of disease management programs on medical costs for patients with diabetes. This study compared health care costs for patients who fulfilled health employer data and information set (HEDIS) criteria for diabetes and were in a health maintenance organization (HMO)-sponsored disease management program with costs for those not in disease management. We retrospectively examined paid health care claims and other measures of health care use over 2 years among 6,799 continuously enrolled Geisinger Health Plan patients who fulfilled HEDIS criteria for diabetes. Two groups were compared: those who were enrolled in an opt-in disease management program and those who were not enrolled. We also compared HEDIS data on HbA(1c) testing, percent not in control, lipid testing, diabetic eye screening, and kidney disease screening. All HEDIS measures were based on a hybrid method of claims and chart audits, except for percent not in control, which was based on chart audits only. Of 6,799 patients fulfilling HEDIS criteria for the diagnosis of diabetes, 3,118 (45.9%) patients were enrolled in a disease management program (program), and 3,681 (54.1%) were not enrolled (nonprogram). Both groups had similar male-to-female ratios, and the program patients were 1.4 years younger than the nonprogram patients. Per member per month paid claims averaged 394.62 dollars for program patients compared with 502.48 dollars for nonprogram patients (P 9.5%, as compared with 79 of 548 (14.4%) nonprogram patients. In this HMO, an opt-in disease management program appeared to be associated with a significant reduction in health care costs and other measures of health care use. There was also a simultaneous improvement in HEDIS measures of quality care. These data suggest that disease management may result in savings for sponsored managed care organizations and that improvements in HEDIS measures are not necessarily associated with increased medical costs.

Preventive maintenance basis: Volume 31 -- Relays -- timing. Final report

International Nuclear Information System (INIS)

Worledge, D.; Hinchcliffe, G.

1998-07-01

US nuclear power plants are implementing preventive maintenance (PM) tasks with little documented basis beyond fundamental vendor information to support the tasks or their intervals. The Preventive Maintenance Basis project provides utilities with the technical basis for PM tasks and task intervals associated with 40 specific components such as valves, electric motors, pumps, and HVAC equipment. This document provides a program of preventive maintenance tasks suitable for application to timing relays. The PM tasks that are recommended provide a cost-effective way to intercept the causes and mechanisms that lead to degradation and failure. They can be used in conjunction with material from other sources, to develop a complete PM program or to improve an existing program

Preventive maintenance basis: Volume 30 -- Relays -- control. Final report

International Nuclear Information System (INIS)

Worledge, D.; Hinchcliffe, G.

1998-07-01

US nuclear power plants are implementing preventive maintenance (PM) tasks with little documented basis beyond fundamental vendor information to support the tasks or their intervals. The Preventive Maintenance Basis project provides utilities with the technical basis for PM tasks and task intervals associated with 40 specific components such as valves, electric motors, pumps, and HVAC equipment. This document provides a program of preventive maintenance tasks suitable for application to control relays. The PM tasks that are recommended provide a cost-effective way to intercept the causes and mechanisms that lead to degradation and failure. They can be used in conjunction with material from other sources, to develop a complete PM program or to improve an existing program

Maintenance quality assurance peer exchange 2.

Science.gov (United States)

2009-04-01

This report documents a comprehensive study of twenty three maintenance quality assurance : (MQA) programs throughout the United States and Canada. The policies and standards of : each program were synthesized to create a general assessment on the co...

Risk-based maintenance-Techniques and applications

International Nuclear Information System (INIS)

Arunraj, N.S.; Maiti, J.

2007-01-01

Plant and equipment, however well designed, will not remain safe or reliable if it is not maintained. The general objective of the maintenance process is to make use of the knowledge of failures and accidents to achieve the possible safety with the lowest possible cost. The concept of risk-based maintenance was developed to inspect the high-risk components usually with greater frequency and thoroughness and to maintain in a greater manner, to achieve tolerable risk criteria. Risk-based maintenance methodology provides a tool for maintenance planning and decision making to reduce the probability of failure of equipment and the consequences of failure. In this paper, the risk analysis and risk-based maintenance methodologies were identified and classified into suitable classes. The factors affecting the quality of risk analysis were identified and analyzed. The applications, input data and output data were studied to understand their functioning and efficiency. The review showed that there is no unique way to perform risk analysis and risk-based maintenance. The use of suitable techniques and methodologies, careful investigation during the risk analysis phase, and its detailed and structured results are necessary to make proper risk-based maintenance decisions

Autonomous and professional maintenance in metallurgical enterprise as activities within total productive maintenance

Directory of Open Access Journals (Sweden)

B. Gajdzik

2014-04-01

Full Text Available The content of this publication consists of notions connected with Total Productive Maintenance (TPM in metallurgical enterprise. The basic areas of devices condition management through Autonomous and Professional Maintenance are described here. Mentioned areas of activities are performed in metallurgical enterprise ArcelorMittal Poland within pillars of World Class Manufacturing (WCM. The aims of UR programs are to maintain the basic functionality of the devices and decrease the number of failures in order to reach improvement of production efficiency.

State-of-the-art Model M-2 Maintenance System

International Nuclear Information System (INIS)

Herndon, J.N.; Martin, H.L.; Satterlee, P.E. Jr.; Jelatis, D.G.; Jennrich, C.E.

1984-04-01

The Model M-2 Maintenance System is part of an ongoing program within the Consolidated Fuel Reprocessing Program (CFRP) at Oak Ridge National Laboratory (ORNL) to improve remote manipulation technology for future nuclear fuel reprocessing and other remote applications. Techniques, equipment, and guidelines which can improve the efficiency of remote maintenance are being developed. The Model M-2 Maintenance System, installed in the Integrated Equipment Test (IET) Facility at ORNL, provides a complete, integrated remote maintenance system for the demonstration and development of remote maintenance techniques. The system comprises a pair of force-reflecting servomanipulator arms, television viewing, lighting, and auxiliary lifting capabilities, thereby allowing manlike maintenance operations to be executed remotely within the remote cell mockup area in the IET. The Model M-2 Maintenance System incorporates an upgraded version of the proven Central Research Laboratories' Model M servomanipulator. Included are state-of-the-art brushless dc servomotors for improved performance, remotely removable wrist assemblies, geared azimuth drive, and a distributed microprocessor-based digital control system. 5 references, 8 figures

Implementation of a comprehensive pharmaceutical care program for an underserved population.

Science.gov (United States)

Mascardo, Lisa A; Spading, Kimberly A; Abramowitz, Paul W

2012-07-15

The implementation of a prescription benefit program for low-income patients emphasizing clinical pharmacist services and strict formulary control is described, with a review of program expenditures and cost avoidance. In 2006, University of Iowa Hospitals and Clinics (UIHC) launched a program to provide a limited prescription benefit to indigent patients under the IowaCare Medicaid demonstration waiver. Sudden dramatic growth in IowaCare enrollment, combined with sharp budget cuts, forced UIHC pharmacy leaders to implement creative cost-control strategies: (1) the establishment of an ambulatory care clinic staffed by a clinical pharmacy specialist, (2) increased reliance on an almost exclusively generic formulary, (3) collaboration with social services staff to help secure medication assistance for patients requiring brand-name drugs, (4) optimized purchasing through the federal 340B Drug Pricing Program, and (5) the imposition of medication copayments and mailing fees for prescription refills. Now in its seventh year, the UIHC pharmacy program has expanded indigent patients' access to pharmaceutical care services while reducing their use of hospital and emergency room services and lowering program medication costs by an estimated 50% (from $2.6 million in fiscal year 2009 to $1.3 million in fiscal year 2010). The UIHC ambulatory care pharmacy implemented a prescription program in collaboration with social service workers to address the medication needs of the state's low-income and uninsured patients in a fiscally responsible manner by managing purchasing contracts, revising a generic formulary, implementing copayments and mailing fees, and reviewing medication profiles.

Empirical analysis of selected nuclear power plant maintenance factors and plant safety

International Nuclear Information System (INIS)

Olson, J.; Osborn, R.N.; Thurber, J.A.; Sommers, P.E.; Jackson, D.H.

1985-07-01

This report contains a statistical analysis of the relationship between selected aspects of nuclear power plant maintenance programs and safety related performance. The report identifies a large number of maintenance resources which can be expected to influence maintenance performance and subsequent plant safety performance. The resources for which data were readily available were related statistically to two sets of performance indicators: maintenance intermediate safety indicators and final safety performance indicators. The results show that the administrative structure of the plant maintenance program is a significant predictor of performance on both sets of indicators

Low-level waste management in the South. Task 4.2 - long-term care requirements

International Nuclear Information System (INIS)

1983-01-01

This paper provides an analysis of the long-term care requirements of low-level radioactive waste disposal facilities. Among the topics considered are the technical requirements for long-term care, the experiences of the three inactive and three active commercial disposal facilities concerning perpetual care and maintenance, and the financial management of a perpetual care fund. In addition, certain recommendations for the establishment of a perpetual care fund are provided. The predominant method of disposing of low-level radioactive wastes is shallow land burial. After studying alternative methods of disposal, the U.S Nuclear Regulatory Commission (NRC) concluded that there are no compelling reasons for abandoning this disposal method. Of the 22 shallow land burial facilities in the U.S., the federal government maintains 14 active and two inactive disposal sites. There are three active (Barnwell, South Carolina; Hanford, Washington; and Beatty, Nevada) and three inactive commercial disposal facilities (Maxey Flats, Kentucky; Sheffield, Illinois; and West Valley, New York). The life of a typical facility can be broken into five phases: preoperational, operational, closure, postclosure observation and maintenance, and institutional control. Long-term care of a shallow land burial facility will begin with the disposal site closure phase and continue through the postclosure observation and maintenance and institutional control phases. Since the postclosure observation and maintenance phase will last about five years and the institutional control phase 100 years, the importance of a well planned long-term care program is apparent. 26 references, 1 table

Preventive Maintenance Optimization in Healthcare Domain: Status of Research and Perspective

OpenAIRE

Mahfoud, H.; El Barkany, A.; El Biyaali, A.

2016-01-01

Although medical equipment maintenance has been carefully managed for years, very few in-depth studies have been conducted to evaluate the effectiveness and efficiency of these implemented preventive maintenance strategies, especially after the debate about the credibility of manufacturer’s recommendations has increased in the clinical engineering community. Facing the dilemma of merely following manufactures maintenance manual or establishing an evidence-based maintenance, medical equipment ...

Implementing the Namaste Care Program for residents with advanced dementia: exploring the perceptions of families and staff in UK care homes.

Science.gov (United States)

Stacpoole, Min; Hockley, Jo; Thompsell, Amanda; Simard, Joyce; Volicer, Ladislav

2017-10-01

Increasing numbers of older people with advanced dementia are cared for in care homes. No cure is available, so research focused on improving quality of life and quality of care for people with dementia is needed to support them to live and die well. The Namaste Care programme is a multi-dimensional care program with sensory, psycho-social and spiritual components intended to enhance quality of life and quality of care for people with advanced dementia. The aim of the study was to establish whether the Namaste Care program can be implemented in UK care homes; and what effect Namaste Care has on the quality of life of residents with advanced dementia, their families and staff. This article explores the qualitative findings of the study, reporting the effect of the programme on the families of people with advanced dementia and care home staff, and presenting their perceptions of change in care. An organisational action research methodology was used. Focus groups and interviews were undertaken pre/post implementation of the Namaste Care program. The researcher kept a reflective diary recording data on the process of change. A comments book was available to staff and relatives in each care home. Data was analysed thematically within each care home and then across all care homes. Six care homes were recruited in south London: one withdrew before the study was underway. Of the five remaining care homes, four achieved a full Namaste Care program. One care home did not achieve the full program during the study, and another discontinued Namaste Care when the study ended. Every home experienced management disruption during the study. Namaste Care challenged normal routinised care for older people with advanced dementia. The characteristics of care uncovered before Namaste was implemented were: chaos and confusion, rushing around, lack of trust, and rewarding care. After the programme was implemented these perceptions were transformed, and themes of calmness, reaching out to

Developing a CANDU industry maintenance guide. A 'community of practice' compendium

International Nuclear Information System (INIS)

Von Hatten, P.; Hoye, D.S.

2011-01-01

The CANDU Owners Group (COG) has initiated a joint utility project to create an Industry Maintenance Guide. The primary goal of the guide is to provide a structured template of activities to implement the maintenance program, based on industry best practices, and with consideration for new regulatory requirements identified in the Canadian Nuclear Safety Commission document S210. The guide will be prepared with a macro view of the maintenance program, which includes core maintenance activities as well as supporting activities and programs in Engineering, Supply Chain and Work Management. Currently there is no such document that solidly links all the requirements to develop, support and execute a maintenance program. Some elements are captured in various industry documents such as INPO documents AP928, Work Management, AP913, Equipment Reliability and AP908, Materials and Services. The guide will not replicate these good practices, but will focus on how they are linked and interrelate to create an optimum program. It is expected that utilities will be able to utilize the guide to take the next incremental step in performance based on cross functional alignment and efficiency.

40 CFR 57.109 - Maintenance of pay.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 5 2010-07-01 2010-07-01 false Maintenance of pay. 57.109 Section 57.109 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PRIMARY NONFERROUS SMELTER ORDERS General § 57.109 Maintenance of pay. The Administrator will not approve...

Development and validation of an online interactive, multimedia wound care algorithms program.

Science.gov (United States)

Beitz, Janice M; van Rijswijk, Lia

2012-01-01

To provide education based on evidence-based and validated wound care algorithms we designed and implemented an interactive, Web-based learning program for teaching wound care. A mixed methods quantitative pilot study design with qualitative components was used to test and ascertain the ease of use, validity, and reliability of the online program. A convenience sample of 56 RN wound experts (formally educated, certified in wound care, or both) participated. The interactive, online program consists of a user introduction, interactive assessment of 15 acute and chronic wound photos, user feedback about the percentage correct, partially correct, or incorrect algorithm and dressing choices and a user survey. After giving consent, participants accessed the online program, provided answers to the demographic survey, and completed the assessment module and photographic test, along with a posttest survey. The construct validity of the online interactive program was strong. Eighty-five percent (85%) of algorithm and 87% of dressing choices were fully correct even though some programming design issues were identified. Online study results were consistently better than previously conducted comparable paper-pencil study results. Using a 5-point Likert-type scale, participants rated the program's value and ease of use as 3.88 (valuable to very valuable) and 3.97 (easy to very easy), respectively. Similarly the research process was described qualitatively as "enjoyable" and "exciting." This digital program was well received indicating its "perceived benefits" for nonexpert users, which may help reduce barriers to implementing safe, evidence-based care. Ongoing research using larger sample sizes may help refine the program or algorithms while identifying clinician educational needs. Initial design imperfections and programming problems identified also underscored the importance of testing all paper and Web-based programs designed to educate health care professionals or guide

MANAJEMEN SARANA PRASARANA DI DAY CARE BABY’S HOME SALATIGA

Directory of Open Access Journals (Sweden)

Desi Kusumawati

2017-01-01

Full Text Available Day Care is one form of early childhood education in non formal education program that organize nurturing and social welfare of children from birth up to the age of 6 years. This study aimed to identify the suitability of existing infrastructure in Baby's Home day care with the ACT of Minister of Education and Culture No. 137 of 2014 Article 32 Paragraph 3; and to provide an overview why the planning, maintenance and inventory in Baby's Home day care were not optimal. This study was qualitative research. The subject was Baby's Home day care Salatiga. Technique of collecting data using interviews, observation and documents. Data were analyzed using Miles and Huberman Model. Data validation using triangulation technique of data. Facilities and infrastructure in Baby's Home day care which conform with ACT of Minister of Education and Culture No. 137 of 2014 Article 32 Paragraph 3 of were the area of land, space of activities inside and outside, hand washing facilities, showers and latrines, and access to health facilities. While things were not conform included the bedroom, dining room, and covered trash. The cause of the planning, maintenance and inventory of facilities and infrastructure have not optimally done because the plan was not carried out continuously, the lack of personnel to assist in the maintenance, and did not have the administrative staff specifically for inventory. Advice can be given to Baby's Home day care is to conduct procurement planning infrastructure on sleeping room, dining room and trash. In addition, the maintenance to existing infrastructure must be made as well as the inventory of infrastructure in order to facilitate the planning purchasing.

The state-of-the-art Model M-2 Maintenance System

International Nuclear Information System (INIS)

Herndon, J.N.; Martin, H.L.; Satterlee, P.E. Jr.; Jelatis, D.G.; Jennrich, C.E.

1984-01-01

The Model M-2 Maintenance System is part of an ongoing program within the Consolidated Fuel Reprocessing Program (CFRP) at Oak Ridge National Laboratory (ORNL) to improve remote manipulation technology for future nuclear fuel reprocessing and other remote applications. Techniques, equipment, and guidelines which can improve the efficiency of remote maintenance are being developed. The Model M-2 Maintenance System, installed in the Integrated Equipment Test (IET) Facility at ORNL, provides a complete, integrated remote maintenance system for the demonstration and development of remote maintenance techniques. The system comprises a pair of force-reflecting servomanipulator arms, television viewing, lighting, and auxiliary lifting capabilities, thereby allowing manlike maintenance operations to be executed remotely within the remote cell mockup area in the IET. The Model M-2 Maintenance System incorporates an upgraded version of the proven Central Research Laboratories' Model M servomanipulator. Included are state-of-the-art brushless dc servomotors for improved performance, remotely removable wrist assemblies, geared azimuth drive, and a distributed microprocessor-based digital control system

Cost Analysis and Policy Implications of a Pediatric Palliative Care Program.

Science.gov (United States)

Gans, Daphna; Hadler, Max W; Chen, Xiao; Wu, Shang-Hua; Dimand, Robert; Abramson, Jill M; Ferrell, Betty; Diamant, Allison L; Kominski, Gerald F

2016-09-01

In 2010, California launched Partners for Children (PFC), a pediatric palliative care pilot program offering hospice-like services for children eligible for full-scope Medicaid delivered concurrently with curative care, regardless of the child's life expectancy. We assessed the change from before PFC enrollment to the enrolled period in 1) health care costs per enrollee per month (PEPM), 2) costs by service type and diagnosis category, and 3) health care utilization (days of inpatient care and length of hospital stay). A pre-post analysis compared enrollees' health care costs and utilization up to 24 months before enrollment with their costs during participation in the pilot, from January 2010 through December 2012. Analyses were conducted using paid Medicaid claims and program enrollment data. The average PEPM health care costs of program enrollees decreased by $3331 from before their participation in PFC to the enrolled period, driven by a reduction in inpatient costs of $4897 PEPM. PFC enrollees experienced a nearly 50% reduction in the average number of inpatient days per month, from 4.2 to 2.3. Average length of stay per hospitalization dropped from an average of 16.7 days before enrollment to 6.5 days while in the program. Through the provision of home-based therapeutic services, 24/7 access to medical advice, and enhanced, personally tailored care coordination, PFC demonstrated an effective way to reduce costs for children with life-limiting conditions by moving from costly inpatient care to more coordinated and less expensive outpatient care. PFC's home-based care strategy is a cost-effective model for pediatric palliative care elsewhere. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Stepped care for depression and anxiety: from primary care to specialized mental health care: a randomised controlled trial testing the effectiveness of a stepped care program among primary care patients with mood or anxiety disorders

Directory of Open Access Journals (Sweden)

Seekles Wike

2009-06-01

Full Text Available Abstract Background Mood and anxiety disorders are highly prevalent and have a large impact on the lives of the affected individuals. Therefore, optimal treatment of these disorders is highly important. In this study we will examine the effectiveness of a stepped care program for primary care patients with mood and anxiety disorders. A stepped care program is characterized by different treatment steps that are arranged in order of increasing intensity. Methods This study is a randomised controlled trial with two conditions: stepped care and care as usual, whereby the latter forms the control group. The stepped care program consists of four evidence based interventions: (1 Watchful waiting, (2 Guided self-help, (3 Problem Solving Treatment and (4 Medication and/or specialized mental health care. The study population consists of primary care attendees aged 18–65 years. Screeners are sent to all patients of the participating general practitioners. Individuals with a Diagnostic and Statistical Manual of mental disorders (DSM diagnosis of major depression, dysthymia, panic disorder (with or without agoraphobia, generalized anxiety disorder, or social phobia are included as well as individuals with minor depression and anxiety disorders. Primary focus is the reduction of depressive and anxiety symptoms. Both conditions are monitored at 8, 16 and 24 weeks. Discussion This study evaluates the effectiveness of a stepped care program for patients with depressive and anxiety disorder. If effective, a stepped care program can form a worthwhile alternative for care as usual. Strengths and limitations of this study are discussed. Trial Registration Current Controlled Trails: ISRCTN17831610.

Neurocritical care education during neurology residency: AAN survey of US program directors.

Science.gov (United States)

Sheth, K N; Drogan, O; Manno, E; Geocadin, R G; Ziai, W

2012-05-29

Limited information is available regarding the current state of neurocritical care education for neurology residents. The goal of our survey was to assess the need and current state of neurocritical care training for neurology residents. A survey instrument was developed and, with the support of the American Academy of Neurology, distributed to residency program directors of 132 accredited neurology programs in the United States in 2011. A response rate of 74% (98 of 132) was achieved. A dedicated neuroscience intensive care unit (neuro-ICU) existed in 64%. Fifty-six percent of residency programs offer a dedicated rotation in the neuro-ICU, lasting 4 weeks on average. Where available, the neuro-ICU rotation was required in the vast majority (91%) of programs. Neurology residents' exposure to the fundamental principles of neurocritical care was obtained through a variety of mechanisms. Of program directors, 37% indicated that residents would be interested in performing away rotations in a neuro-ICU. From 2005 to 2010, the number of programs sending at least one resident into a neuro-ICU fellowship increased from 14% to 35%. Despite the expansion of neurocritical care, large proportions of US neurology residents have limited exposure to a neuro-ICU and neurointensivists. Formal training in the principles of neurocritical care may be highly variable. The results of this survey suggest a charge to address the variability of resident education and to develop standardized curricula in neurocritical care for neurology residents.

Establishing an In-House Wind Maintenance Program

Energy Technology Data Exchange (ETDEWEB)

None

2011-12-01

Update to the 2008 guidebook titled “Establishing an In-house Wind Maintenance Program”, which was developed to support utilities in developing O&M strategies. This update includes significant contributions from utilities and other stakeholders around the country, representing all perspectives and regardless of whether or not they own wind turbines or projects.

The meteorological monitoring audit, preventative maintenance and quality assurance programs at a former nuclear weapons facility

International Nuclear Information System (INIS)

Maxwell, D.R.

1995-01-01

The purposes of the meteorological monitoring audit, preventative maintenance, and quality assurance programs at the Rocky Flats Environmental Technology Site (Site), are to (1) support Emergency Preparedness (EP) programs at the Site in assessing the transport, dispersion, and deposition of effluents actually or potentially released into the atmosphere by Site operations; and (2) provide information for onsite and offsite projects concerned with the design of environmental monitoring networks for impact assessments, environmental surveillance activities, and remediation activities. The risk from the Site includes chemical and radioactive emissions historically related to nuclear weapons component production activities that are currently associated with storage of large quantities of radionuclides (plutonium) and radioactive waste forms. The meteorological monitoring program provides information for site-specific weather forecasting, which supports Site operations, employee safety, and Emergency Preparedness operations

Impact of a New Palliative Care Program on Health System Finances: An Analysis of the Palliative Care Program Inpatient Unit and Consultations at Johns Hopkins Medical Institutions.

Science.gov (United States)

Isenberg, Sarina R; Lu, Chunhua; McQuade, John; Chan, Kelvin K W; Gill, Natasha; Cardamone, Michael; Torto, Deirdre; Langbaum, Terry; Razzak, Rab; Smith, Thomas J

2017-05-01

Palliative care inpatient units (PCUs) can improve symptoms, family perception of care, and lower per-diem costs compared with usual care. In March 2013, Johns Hopkins Medical Institutions (JHMI) added a PCU to the palliative care (PC) program. We studied the financial impact of the PC program on JHMI from March 2013 to March 2014. This study considered three components of the PC program: PCU, PC consultations, and professional fees. Using 13 months of admissions data, the team calculated the per-day variable cost pre-PCU (ie, in another hospital unit) and after transfer to the PCU. These fees were multiplied by the number of patients transferred to the PCU and by the average length of stay in the PCU. Consultation savings were estimated using established methods. Professional fees assumed a collection rate of 50%. The total positive financial impact of the PC program was $3,488,863.17. There were 153 transfers to the PCU, 60% with cancer, and an average length of stay of 5.11 days. The daily loss pretransfer to the PCU of $1,797.67 was reduced to $1,345.34 in the PCU (-25%). The PCU saved JHMI $353,645.17 in variable costs, or $452.33 per transfer. Cost savings for PC consultations in the hospital, 60% with cancer, were estimated at $2,765,218. $370,000 was collected in professional fees savings. The PCU and PC program had a favorable impact on JHMI while providing expert patient-centered care. As JHMI moves to an accountable care organization model, value-based patient-centered care and increased intensive care unit availability are desirable.

Field maintenance of radiation-shielding windows at HFEF

International Nuclear Information System (INIS)

Tobias, D.A.

1983-01-01

The achievement of excellent viewing through hot-cell shielding windows does not occur by chance. Instead, it requires a well planned and executed program of field maintenance. The lack of such a program is a major factor when a hot-cell facility has poor window viewing. At HFEF, all preventive maintenance is performed by one group of trained technical-support personnel under the immediate direction of a Systems Engineer, who has responsibility for the shielding windows. Window maintenance is prescheduled and recorded by being incorporated into the computerized Maintenance Data System (MDS). Measurements of window light transmission are scheduled annually to determine glass browning or oil cloudiness conditions within the window tank. The tank oil is sampled and chemically analyzed annually to determine the moisture content, the acidity, and the probable deterioration rate caused by irradiation

Innovation in Rehabilitation Services and Clinical Programs for Health Care

Directory of Open Access Journals (Sweden)

Asghar Dadkhah

2014-06-01

Full Text Available Rehabilitation program is a critical piece of clinical care strategy in order to accelerate healing and improve quality of life to the fullest extent possible. An innovated program should have 3 inspiring concepts: Seek inspire and Advance. Seeking and evaluating is a breakthrough technology, innovative methodology and emerging trend in the healthcare industry. The program should inspire clinicians to critically evaluate and implement the highest standards of care. Also an innovated program should advance clinical program development to maximize opportunities for first to market positioning and community partnerships. The scope of program can be from psycho-rehabilitation to predictor in addiction (1-3, Cognitive and motor rehabilitation researchers are quite concerned about system wide biases that may impair development of innovative rehabilitation techniques. In this issue ....

The Impact of a Primary Care Education Program Regarding Cancer Survivorship Care Plans: Results from an Engineering, Primary Care, and Oncology Collaborative for Survivorship Health.

Science.gov (United States)

Donohue, SarahMaria; Haine, James E; Li, Zhanhai; Trowbridge, Elizabeth R; Kamnetz, Sandra A; Feldstein, David A; Sosman, James M; Wilke, Lee G; Sesto, Mary E; Tevaarwerk, Amye J

2017-09-20

Survivorship care plans (SCPs) have been recommended as tools to improve care coordination and outcomes for cancer survivors. SCPs are increasingly being provided to survivors and their primary care providers. However, most primary care providers remain unaware of SCPs, limiting their potential benefit. Best practices for educating primary care providers regarding SCP existence and content are needed. We developed an education program to inform primary care providers of the existence, content, and potential uses for SCPs. The education program consisted of a 15-min presentation highlighting SCP basics presented at mandatory primary care faculty meetings. An anonymous survey was electronically administered via email (n = 287 addresses) to evaluate experience with and basic knowledge of SCPs pre- and post-education. A total of 101 primary care advanced practice providers (APPs) and physicians (35% response rate) completed the baseline survey with only 23% reporting prior receipt of a SCP. Only 9% could identify the SCP location within the electronic health record (EHR). Following the education program, primary care physicians and APPs demonstrated a significant improvement in SCP knowledge, including improvement in their ability to locate one within the EHR (9 vs 59%, p educational program containing information about SCP existence, content, and location in the EHR increased primary care physician and APP knowledge in these areas, which are prerequisites for using SCP in clinical practice.

Elimination of maintenance outage and cost reduction by development of outage-free maintenance techniques

International Nuclear Information System (INIS)

Jakabe, Hideo; Maruyama, Yoshinaga

1996-01-01

The development program of KEPCO on outage-free maintenance techniques for distribution line work since 1984 is overviewed. It has succeeded in eliminating maintenance outages since 1989. The original aim was to improve customer satisfaction. However, in all, four benefits were realised through the development. These are cost reduction, securing of worker safety, improvement of customer service, and advancement of distribution techniques and morale in KEPCO. The introduction of robotic techniques for maintenance work and manipulator techniques for repair work is planned for further modernization. These new techniques are helping in both work safety and work efficiency improvement. Cost reduction and advancement of distribution line work techniques is also considered. (R.P.)

NPP component maintenance and life management in Russia

International Nuclear Information System (INIS)

Tutnov, I.; Lyssakov, V.

2002-01-01

This report represents the conceptual strategies (ideas) on life management programs for nuclear power plants. Use of the optimum programs for NPP's NDE, maintenance service, operation and service life can provide the best economic benefit for the utilities. The paper presents general approaches to life management, maintenance service, and risks of operating and service life of NPPs in Russia. The report offers some optimized ways for the solution of these important tasks

A Strength Training Program for Primary Care Patients, Central Pennsylvania, 2012

Science.gov (United States)

Patel, Vijay A.; Kraschnewski, Jennifer L.; Rovniak, Liza S.; Messina, Dino A.; Stuckey, Heather L.; Curry, William J.; Chuang, Cynthia H.; Sherwood, Lisa L.; Hess, Stacy L.

2014-01-01

Introduction Primary care providers can recommend strength training programs to use “Exercise as Medicine,” yet few studies have examined the interest of primary care patients in these programs. Methods We conducted a cross-sectional survey of primary care patients in central Pennsylvania. Interest in participating in free group-based strength training and weight control programs was assessed, in addition to patient demographics, medical history, and quality of life. Results Among 414 patients, most (61.0%) were aged 54 or older, and 64.0% were female. More patients were interested in a strength training program (55.3%) than in a weight control program (45.4%). Nearly three-quarters (72.8%) of those reporting 10 or more days of poor physical health were interested in a strength training program compared with 49.5% of those reporting no days of poor physical health. After adjusting for potential confounders, those reporting poorer physical health had 2.7 greater odds (95% confidence interval, 1.4–5.1) of being interested in a strength training program compared with those reporting better physical health. Patients with hypertension, diabetes, or high cholesterol were not more interested in a strength training program than those without these conditions. Conclusion Primary care practices may consider offering or referring patients to community-based strength training programs. This study observed high levels of interest in these widely available programs. Practices may also consider screening and referring those with poorer physical health, as they may be the most interested and have the most to gain from participating. PMID:24967829

A new measure of the impact of managed care on healthcare markets.

Science.gov (United States)

Pawlson, L G; Moy, E M; Kim, J I; Griner, P F

2001-11-01

Most studies of managed care impact have used health maintenance organization (HMO) penetration or index of competition as the marker of managed care impact. However, little empirical evidence has been found to support the validity of these or other measures in current use. In addition, as managed care evolves to forms other than HMOs and managed care penetration in large metropolitan areas approaches 100% of commercially insured patients, the utility of the most commonly used measure, HMO penetration, will decrease still further. To provide a preliminary analysis of the use of premiums as a measure of market impact of managed care. Retrospective analysis (quartile, correlation, multiple-variable linear regression) of publicly available datasets. Labor market-adjusted HMO premiums from 3 publicly available sources, for the 56 largest metropolitan areas in the United States, were compared with penetration and index of competition as predictors of the dependent market variable, hospital bed-days per 1000 population. Health maintenance organization premiums in the Federal Employees Health Benefits Program emerged as the best predictor of HMO market impact. Average HMO premiums reported in the Interstudy database and for the Medicare+Choice program also outperformed penetration or index of competition in relating to several commonly available markers of competition such as bed-days per 1000. Premiums charged by HMOs are a useful measure of the impact of managed care on healthcare markets in large metropolitan areas.

Optimizing preventive maintenance

International Nuclear Information System (INIS)

DiCola, F.E.

1988-01-01

The traditional approach to preventive maintenance (PM) is based on adherence to manufacturers's requirements and recommended frequencies. When equipment fails, either new procedures are established or the frequency is increased. This leads to an increase in the number of PM activities, overloading not only maintenance resources, but support as well. There is no correlation between more PM and an increase in equipment reliability. More PM may actually induce failures. Reliability-centered maintenance, a new concept in utility maintenance, is based on identifying system/subsystem functions, failures, and dominant failure modes to develop or revise PM tasks. The activities described in this paper are based on actual implementation of this concept on an ongoing project to upgrade the PM program at one of the largest electric utilities in the country. Optimum PM activities are those that, when implemented, will minimize factors that c cause equipment to fail. One technique described illustrates how equipment performance, failure modes, and causes can be related to minimize the occurrence of failures. Operating history and service life of a component are key factors in determining the most effective PM activities, provided that the factors are related to failure modes and causes