Association of public health initiatives with outcomes for out-of-hospital cardiac arrest at home and in public locations

DEFF Research Database (Denmark)

Christopher B., Fordyce; Carolina M., Hansen; Kragholm, Kristian

2017-01-01

Importance  Little is known about the influence of comprehensive public health initiatives according to out-of-hospital cardiac arrest (OHCA) location, particularly at home, where resuscitation efforts and outcomes have historically been poor.Objective  To describe temporal trends in bystander...... cardiopulmonary resuscitation (CPR) and first-responder defibrillation for OHCAs stratified by home vs public location and their association with survival and neurological outcomes.Design, Setting, and Participants  This observational study reviewed 8269 patients with OHCAs (5602 [67.7%] at home and 2667 [32.......3%] in public) for whom resuscitation was attempted using data from the Cardiac Arrest Registry to Enhance Survival (CARES) from January 1, 2010, through December 31, 2014. The setting was 16 counties in North Carolina.Exposures  Patients were stratified by home vs public OHCA. Public health initiatives...

Home, Office of Public Advocacy, Department of Administration, State of

Science.gov (United States)

Visiting Alaska State Employees State of Alaska Department of Administration Division of Office of Public Advocacy Alaska Department of Administration, Office of Public Advocacy Home Programs Sections Forms Vendor Support Search Office of Public Advocacy State of Alaska Administration > Office of Public Advocacy

The influences on women who choose publicly-funded home birth in Australia.

Science.gov (United States)

Catling, Christine; Dahlen, Hannah; Homer, Caroline S E

2014-07-01

to explore the influences on women who chose a publicly-funded home birth in one Australian state. a constructivist grounded theory methodology was used. a publicly-funded home birth service located within a tertiary referral hospital in the southern suburbs of Sydney, Australia. data were collected though semi-structured interviews of 17 women who chose to have a publicly-funded home birth. six main categories emerged from the data. These were feeling independent, strong and confident, doing it my way, protection from hospital related activities, having a safety net, selective listening and telling, and engaging support. The core category was having faith in normal. This linked all the categories and was an overriding attitude towards themselves as women and the process of childbirth. The basic social process was validating the decision to have a home birth. women reported similar influences to other studies when choosing home birth. However, the women in this study were reassured by the publicly-funded system׳s 'safety net' and apparent seamless links with the hospital system. The flexibility of the service to permit women to change their minds to give birth in hospital, and essentially choose their birthplace at any time during pregnancy or labour was also appreciated. women that choose a publicly-funded home birth service describe strong influences that led them to home birth within this model of care. Service managers and health professionals need to acknowledge the importance of place of birth choice for women. Copyright © 2014 Elsevier Ltd. All rights reserved.

Public interest in the private sphere: how far into the home can local policy-making reach?

Energy Technology Data Exchange (ETDEWEB)

Palm, Jenny (Linkoeping Univ., Dept. of Technology and Social Change, Linkoeping (Sweden))

2009-07-01

Environmental problems in the energy system largely originate from everyday activities and choices. The home is a 'node' of daily life and is often seen as our private sphere. However, the privacy of the home can be contested in relation to local policies in general and energy and environmental policies in particular. This paper discusses the private/public divide in energy policies and how this divide appears to Swedish municipal energy consultants. By analyzing the actions of several energy consultants and their efforts to influence households as well as how households perceive this guidance, we can gauge how far policy instruments have penetrated the private sphere. Municipal energy consultants are careful in providing advice to the households: they preserve a rather large 'no-trespassing' area to avoid interfering in peoples' private sphere. Households can accept information, even individually tailored information, but will not accept requests to do certain things. Authorities can inform but not tell people how to act: the decision is still the householders'. Looking at exactly how both households and consultants reason about energy efficiency and the public/private divide, we can discern tendencies for what were earlier considered private concerns to be increasingly perceived as common or public concerns. Energy consultants are trying to find ways to influence family lifestyle while householders are requesting individual inspections and want the consultants to keep individual records of family energy use, not regarding this information as too private. Swedish regulations, however, are hampering this development and delaying the urgent need for changes in both technologies used and energy-related behaviours.

Motivating Factors in Guidance Publications by Ibovespa Companies and Their Conformity to CODIM’s Guideline Statement 04/2008

Directory of Open Access Journals (Sweden)

Helio Macedo Neto

2014-04-01

Full Text Available As the demand for resources in the national capital market grows, there is a stronger necessity by companies to release result prospects in order to keep or attract new investors. The guidance, a publication of future results, appears in this scenario as a response to this trend. In this perspective, the research investigates probable motivating factors in the publication of guidance by Ibovespa companies, while assessing their response to CODIM’s 04/2008 statement. The investigation comprehended factors related to institutional environments (listing segment at BM&FBovespa and listing of actions in foreign stock exchanges and three groups of interest (suppliers, employees and investors. Qualitative in nature, this exploratory research has used the technique of content analysis. After analyzing the reference forms from 62 companies, it was possible to verify the disclosure of guidances, in 2010, of 26 of them, or 41.9% of the Ibovespa index. The results indicate that the factors analyzed were considered motivational in the evidencing of future result perspectives and the guidance publications, as recommended by the Institutional Theory and the Theory of Stakeholders. These results suggest that the surveyed companies provide information on future estimates to maintain or ensure its legitimacy in the market and towards its stakeholders. However, the content analysis showed that the guidance published by the companies do not meet in a satisfactory way the Statement 04/2008.

75 FR 21000 - Draft Guidance for the Public, Food and Drug Administration Advisory Committee Members, and Food...

Science.gov (United States)

2010-04-22

...] (formerly Docket No. 02D-0049) Draft Guidance for the Public, Food and Drug Administration Advisory Committee Members, and Food and Drug Administration Staff: Public Availability of Advisory Committee Members... and Drug Administration Amendments Act of 2007, Public Law No. 110-85), and section 701 (21 U.S.C. 371...

Teachers' Demographic Factors on Attitude towards Guidance and Counselling Services in Public Primary Schools of Kimilili Subcounty, Kenya

Science.gov (United States)

Nasilumbi, Wesonga Joanne; Jenniffer, Munyau K.; Prisca, Tarus

2016-01-01

The government of Kenya through the Ministry of education banned corporal punishment in schools. This necessitated strengthening of guidance and counseling (G&C) services in schools. This study aimed to: determine the teachers' attitude towards guidance and counseling services in public primary schools in Kimilili Sub-County and determine the…

The Effect of Publicized Quality Information on Home Health Agency Choice.

Science.gov (United States)

Jung, Jeah Kyoungrae; Wu, Bingxiao; Kim, Hyunjee; Polsky, Daniel

2016-12-01

We examine consumers' use of publicized quality information in Medicare home health care markets, where consumer cost sharing and travel costs are absent. We report two findings. First, agencies with high quality scores are more likely to be preferred by consumers after the introduction of a public reporting program than before. Second, consumers' use of publicized quality information differs by patient group. Community-based patients have slightly larger responses to public reporting than hospital-discharged patients. Patients with functional limitations at the start of their care, at least among hospital-discharged patients, have a larger response to the reported functional outcome measure than those without functional limitations. In all cases of significant marginal effects, magnitudes are small. We conclude that the current public reporting approach is unlikely to have critical impacts on home health agency choice. Identifying and releasing quality information that is meaningful to consumers may help increase consumers' use of public reports. © The Author(s) 2015.

Theoretical and hands-on guidance from dental hygienists promotes good oral health in elderly people living in nursing homes, a pilot study.

Science.gov (United States)

Seleskog, B; Lindqvist, L; Wårdh, I; Engström, A; von Bültzingslöwen, I

2018-04-12

Oral health in nursing homes for elderly is often unsatisfactory, and oral health education to nursing staff has not shown sufficient results why there is need for novel approaches. The aim of the study was to trial a new oral healthcare educational programme and to evaluate the effects on residents' oral health. In addition, attitudes among the nursing staff in the intervention nursing home were explored. In a controlled clinical trial, two comparable nursing homes were randomly assigned for intervention or control. Interventions included weekly theoretical and hands-on guidance from dental hygienists on oral hygiene procedures and discussions on oral care routines. The residents' oral health, measured by the Revised Oral Assessment Guide (ROAG), dental plaque and gingival bleeding were evaluated at baseline and after 3 months. Attitudes among the staff to oral health care were measured at the intervention nursing home. Revised Oral Assessment Guide gums and lips scores showed a tendency to decrease in the intervention group, but remained high in the control group. Plaque levels improved significantly after intervention, and a trend towards less gingival bleeding was observed. The intervention nursing staff seemed to be more aware of their own limitations concerning oral health care after intervention and valued more frequent contact with dental services to a greater extent. The oral healthcare situation for elderly people today is so complex that theoretical education at the group level regarding different aspects of oral health is not sufficient. Individual hands-on guidance by dental hygienists on a regular basis in everyday care may be a new approach. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Retrofitting Las Vegas. Implementing Energy Efficiency in Two Las Vegas Test Homes

Energy Technology Data Exchange (ETDEWEB)

Puttagunta, S. [Consortium for Advanced Residential Buildings, Norwalk, CT (United States)

2013-04-01

In 2009, the state of Nevada received nearly $40 million in Neighborhood Stabilization Funds from the Department of Housing and Urban Development to use to stabilize communities that have suffered from foreclosures and abandonment. In order to provide guidance to local officials and maximize how effectively this NSP funding is used in retrofitting homes, the CARB team provided design specifications, energy modeling, and technical support for the BARA team and its local partners—Better Building Performance, Nevada Energy Star Partners Green Alliance, and Home Free Nevada—for two retrofit test homes. One home demonstrated a modest retrofit and the other a deep energy retrofit. This report describes the retrofit packages, which were used as an educational experience for home performance professionals, building trades, remodelers, and the general public.

Potential travel cost saving in urban public-transport networks using smartphone guidance

Science.gov (United States)

2018-01-01

Public transport (PT) is a key element in most major cities around the world. With the development of smartphones, available journey planning information is becoming an integral part of the PT system. Each traveler has specific preferences when undertaking a trip, and these preferences can also be reflected on the smartphone. This paper considers transit assignment in urban public-transport networks in which the passengers receive smartphone-based information containing elements that might influence the travel decisions in relation to line loads, as well as passenger benefits, and the paper discusses the transition from the current widespread choosing approach to a personalized decision-making approach based on smartphone information. The approach associated with smartphone guidance that considers passengers’ preference on travel time, waiting time and transfer is proposed in the process of obtaining his/her preferred route from the potential travel routes generated by the Deep First Search (DFS) method. Two other approaches, based on the scenarios reflecting reality, include passengers with access to no real time information, and passengers that only have access to the arrival time at the platform are used as comparisons. For illustration, the same network proposed by Spiess and Florian is utilized on the experiments in an agent-based model. Two experiments are conducted respectively according to whether each passenger’s choosing method is consistent. As expected, the results in the first experiment showed that the travel for consistent passengers with smartphone guidance was clearly shorter and that it can reduce travel time exceeding 15% and weighted cost exceeding 20%, and the average saved time approximated 3.88 minutes per passenger. The second experiment presented that travel cost, as well as cost savings, gradually decreased by employing smartphone guidance, and the maximum cost savings accounted for 14.2% of the total weighted cost. PMID:29746528

Potential travel cost saving in urban public-transport networks using smartphone guidance.

Science.gov (United States)

Song, Cuiying; Guan, Wei; Ma, Jihui

2018-01-01

Public transport (PT) is a key element in most major cities around the world. With the development of smartphones, available journey planning information is becoming an integral part of the PT system. Each traveler has specific preferences when undertaking a trip, and these preferences can also be reflected on the smartphone. This paper considers transit assignment in urban public-transport networks in which the passengers receive smartphone-based information containing elements that might influence the travel decisions in relation to line loads, as well as passenger benefits, and the paper discusses the transition from the current widespread choosing approach to a personalized decision-making approach based on smartphone information. The approach associated with smartphone guidance that considers passengers' preference on travel time, waiting time and transfer is proposed in the process of obtaining his/her preferred route from the potential travel routes generated by the Deep First Search (DFS) method. Two other approaches, based on the scenarios reflecting reality, include passengers with access to no real time information, and passengers that only have access to the arrival time at the platform are used as comparisons. For illustration, the same network proposed by Spiess and Florian is utilized on the experiments in an agent-based model. Two experiments are conducted respectively according to whether each passenger's choosing method is consistent. As expected, the results in the first experiment showed that the travel for consistent passengers with smartphone guidance was clearly shorter and that it can reduce travel time exceeding 15% and weighted cost exceeding 20%, and the average saved time approximated 3.88 minutes per passenger. The second experiment presented that travel cost, as well as cost savings, gradually decreased by employing smartphone guidance, and the maximum cost savings accounted for 14.2% of the total weighted cost.

Problematising public and private work spaces: midwives' work in hospitals and in homes.

Science.gov (United States)

Bourgeault, Ivy Lynn; Sutherns, Rebecca; Macdonald, Margaret; Luce, Jacquelyne

2012-10-01

as the boundaries between public and private spaces become increasingly fluid, interest is growing in exploring how those spaces are used as work environments, how professionals both construct and convey themselves in those spaces, and how the lines dividing spaces traditionally along public and private lines are blurred. This paper draws on literature from critical geography, organisational studies, and feminist sociology to interpret the work experiences of midwives in Ontario, Canada who provide maternity care both in hospitals and in clients' homes. qualitative design involving in-depth semi-structured interviews content coded thematically. Ontario, Canada. community midwives who practice at home and in hospital. the accounts of practicing midwives illustrate the ways in which hospital and home work spaces are sites of both compromise and resistance. With the intention of making birthing women feel more `at home', midwives describe how they attempt to recreate the woman's home in the hospital. Similarly, midwives also reorient women's homes to a certain degree into a more standardised work space for home birth attendance. Many midwives also described how they like `guests' in both settings. there seems to be a conscious or unconscious convergence of midwifery work spaces to accommodate Ontario midwives' unique model of practice. we link these findings of midwives' place of work on their experiences as workers to professional work experiences in both public and private spaces and offer suggestions for further exploration of the concept of professionals as guests in their places of work. Copyright © 2012. Published by Elsevier Ltd.

ICRP guidance on radioactive waste disposal

International Nuclear Information System (INIS)

Cooper, J.R.

2002-01-01

The International Commission on Radiological Protection (ICRP) issued recommendations for a system of radiological protection in 1991 as the 1990 Recommendations. Guidance on the application of these recommendations in the general area of waste disposal was issued in 1997 as Publication 77 and guidance specific to disposal of solid long-lived radioactive waste was issued as Publication 81. This paper summarises ICRP guidance in radiological protection requirements for waste disposal concentrating on the ones of relevance to the geological disposal of solid radioactive waste. Suggestions are made for areas where further work is required to apply the ICRP guidance. (author)

Students' perception of guidance and counselling services offered in ...

African Journals Online (AJOL)

Many students of tertiary institutions including Colleges of Education are young adults who feel more concerned about getting a job, making a home and continuing higher education. These concerns require proper guidance The general purpose of this study therefore was to find out the perception of students on guidance ...

Do public nursing home care providers deliver higher quality than private providers? Evidence from Sweden.

Science.gov (United States)

Winblad, Ulrika; Blomqvist, Paula; Karlsson, Andreas

2017-07-14

Swedish nursing home care has undergone a transformation, where the previous virtual public monopoly on providing such services has been replaced by a system of mixed provision. This has led to a rapidly growing share of private actors, the majority of which are large, for-profit firms. In the wake of this development, concerns have been voiced regarding the implications for care quality. In this article, we investigate the relationship between ownership and care quality in nursing homes for the elderly by comparing quality levels between public, for-profit, and non-profit nursing home care providers. We also look at a special category of for-profit providers; private equity companies. The source of data is a national survey conducted by the Swedish National Board of Health and Welfare in 2011 at 2710 nursing homes. Data from 14 quality indicators are analyzed, including structure and process measures such as staff levels, staff competence, resident participation, and screening for pressure ulcers, nutrition status, and risk of falling. The main statistical method employed is multiple OLS regression analysis. We differentiate in the analysis between structural and processual quality measures. The results indicate that public nursing homes have higher quality than privately operated homes with regard to two structural quality measures: staffing levels and individual accommodation. Privately operated nursing homes, on the other hand, tend to score higher on process-based quality indicators such as medication review and screening for falls and malnutrition. No significant differences were found between different ownership categories of privately operated nursing homes. Ownership does appear to be related to quality outcomes in Swedish nursing home care, but the results are mixed and inconclusive. That staffing levels, which has been regarded as a key quality indicator in previous research, are higher in publicly operated homes than private is consistent with earlier

On the design of fuzzified trajectory shaping guidance law.

Science.gov (United States)

Lin, Chun-Liang; Lin, Yu-Ping; Chen, Kai-Ming

2009-04-01

Midcourse guidance is commonly designed to save as much energy as possible so that the missile's final speed can be maximized while entering the homing stage. For this purpose, a competitive guidance design should be able to generate an admissible flight trajectory as to bring the interceptor to a superior altitude for a favorable target engagement. In this paper, a new adaptive trajectory shaping guidance scheme based on the adaptive fuzzy inference system, which is capable of generating a variety of trajectories for efficient target interception, is presented. The guidance law is developed with the aim of saving the interceptor's energy conservation while improving performance robustness. Applications of the presented approach have included a variety of mission oriented guidance, such as cruise missile guidance, anti-ballistic missile guidance, etc.

One Chance to Get it Right: understanding the new guidance for care of the dying person.

Science.gov (United States)

Sykes, Nigel

2015-09-01

Following criticism of the Liverpool Care of the Dying Pathway (LCP), widely used to guide care of dying people in British health-care settings, the UK Government set up an independent review which in 2013 recommended that use of the LCP be discontinued. In response, the Leadership Alliance for the Care of Dying People, a coalition of a wide range of stakeholders, recently published guidance entitled One Chance to Get it Right. This guidance contains five Priorities of Care for the dying person that are intended to guide clinical staff and will inform Care Quality Commission inspections of health-care providers. This article summarizes the background to One Chance to Get it Right and the guidance it contains. One Chance to Get it Right, More Care, Less Pathway and related guidance documents. The need to improve the standard of end-of-life care in every clinical setting. The value of a pathway-based approach to end-of-life care in a context where well-implemented programmes of staff education in the subject are lacking. Public concern with, and scrutiny of, the quality of dying in the UK health-care system, particularly in hospitals but also the ability of patients to die well at home where that is their place of choice. Effective methods of teaching end of life care to all clinical staff; the effect upon families of caring for a dying relative at home; the optimum type, quantity and source of external support to informal carers that is perceived by them as adequate and enables the ill person to die well in in their own home; fuller understanding of the physiology of dying. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

76 FR 66925 - Guidance for 1-Hour SO2

Science.gov (United States)

2011-10-28

...The EPA is announcing an extension of the public comment period for its draft non-binding guidance titled, ``Guidance for 1-Hour SO2 SIP Submissions.'' The draft of the guidance document is currently on the EPA's Web site. The EPA is extending the comment period for an additional 30-day period and invites public comments on this guidance during this period. The EPA plans to issue an updated version of the guidance after reviewing timely submitted comments.

Hurricane Season Public Health Preparedness, Response, and Recovery Guidance for Health Care Providers, Response and Recovery Workers, and Affected Communities - CDC, 2017.

Science.gov (United States)

2017-09-22

CDC and the Agency for Toxic Substances and Disease Registry (ATSDR) have guidance and technical materials available in both English and Spanish to help communities prepare for hurricanes and floods (Table 1). To help protect the health and safety of the public, responders, and clean-up workers during response and recovery operations from hurricanes and floods, CDC and ATSDR have developed public health guidance and other resources; many are available in both English and Spanish (Table 2).

The Influence of Urinary Incontinence on Publicly Financed Home Care Services to Low-Income Elderly People.

Science.gov (United States)

Baker, Dorothy I.; Bice, Thomas W.

1995-01-01

A retrospective cohort design is used to estimate the effect of urinary incontinence (UI) on the public costs of home care services to elderly individuals. Multivariate analyses controlling for other individual, household, and supply characteristics demonstrate that those with UI generate significantly greater public costs for home care services.…

Comparing Public Quality Ratings for Accredited and Nonaccredited Nursing Homes.

Science.gov (United States)

Williams, Scott C; Morton, David J; Braun, Barbara I; Longo, Beth Ann; Baker, David W

2017-01-01

Compare quality ratings of accredited and nonaccredited nursing homes using the publicly available Centers for Medicare and Medicaid Services (CMS) Nursing Home Compare data set. This cross-sectional study compared the performance of 711 Joint Commission-accredited (TJC-accredited) nursing homes (81 of which also had Post-Acute Care Certification) to 14,926 non-Joint Commission-accredited (non-TJC-accredited) facilities using the Nursing Home Compare data set (as downloaded on April 2015). Measures included the overall Five-Star Quality Rating and its 4 components (health inspection, quality measures, staffing, and RN staffing), the 18 Nursing Home Compare quality measures (5 short-stay measures, 13 long-stay measures), as well as inspection deficiencies, fines, and payment denials. t tests were used to assess differences in rates for TJC-accredited nursing homes versus non-TJC-accredited nursing homes for quality measures, ratings, and fine amounts. Analysis of variance models were used to determine differences in rates using Joint Commission accreditation status, nursing home size based on number of beds, and ownership type. An additional model with an interaction term using Joint Commission accreditation status and Joint Commission Post-Acute Care Certification status was used to determine differences in rates for Post-Acute Care Certified nursing homes. Binary variables (eg, deficiency type, fines, and payment denials) were evaluated using a logistic regression model with the same covariates. After controlling for the influences of facility size and ownership type, TJC-accredited nursing homes had significantly higher star ratings than non-TJC-accredited nursing homes on each of the star rating component subscales (P homes with Post-Acute Care Certification performed statistically better on the overall star rating, as well as 3 of the 4 subscales (P homes had statistically fewer deficiencies than non-TJC-accredited nursing homes (P payment denials (P homes

Effective communication of public health guidance to emergency department clinicians in the setting of emerging incidents: a qualitative study and framework.

Science.gov (United States)

Khan, Yasmin; Sanford, Sarah; Sider, Doug; Moore, Kieran; Garber, Gary; de Villa, Eileen; Schwartz, Brian

2017-04-28

Evidence to inform communication between emergency department clinicians and public health agencies is limited. In the context of diverse, emerging public health incidents, communication is urgent, as emergency department clinicians must implement recommendations to protect themselves and the public. The objectives of this study were to: explore current practices, barriers and facilitators at the local level for communicating public health guidance to emergency department clinicians in emerging public health incidents; and develop a framework that promotes effective communication of public health guidance to clinicians during emerging incidents. A qualitative study was conducted using semi-structured interviews with 26 key informants from emergency departments and public health agencies in Ontario, Canada. Data were analyzed inductively and the analytic approach was guided by concepts of complexity theory. Emergent themes corresponded to challenges and strategies for effective communication of public health guidance. Important challenges related to the coordination of communication across institutions and jurisdictions, and differences in work environments across sectors. Strategies for effective communication were identified as the development of partnerships and collaboration, attention to specific methods of communication used, and the importance of roles and relationship-building prior to an emerging public health incident. Following descriptive analysis, a framework was developed that consists of the following elements: 1) Anticipate; 2) Invest in building relationships and networks; 3) Establish liaison roles and redundancy; 4) Active communication; 5) Consider and respond to the target audience; 6) Leverage networks for coordination; and 7) Acknowledge and address uncertainty. The qualities inherent in local relationships cut across framework elements. This research indicates that relationships are central to effective communication between public health

[Present Status and Problems of Management and Guidance for Visiting Pharmacy Service to In-home Patients by Hospital Pharmacists].

Science.gov (United States)

Nakamura, Masumi; Kishita, Yoshie; Asada, Miyako; Otsuka, Megumi; Takeshita, Sachiko; Hama, Norihisa; Hayashi, Seigo; Ito, Tomoki; Nishio, Masayuki; Nakamura, Masaki

2018-03-01

We conducted a survey of the background of 41 patients who received management and guidance from an in-home visiting pharmacy service and of the contents of support by the pharmacist, using patients' medical records from May 2016 to March 2017. Support comprised delivery of medicine to alleviate a burden to caregiver, suggesting medication, adjusting remaining medicines, and providing support during hospitalization. Out of 285 visits, there were 32 visits for which a medical fee could not be claimed. The main reasons for this were delivery of medicine on the day of visiting medical care, management of prescribed medicine at home, and delivery of temporal medicines. We used SWOT analysis to examine the problems and to consider improvements. The results showed that the different method for calculating medical fees is disadvantage for the hospital pharmacy, compared with the health insurance pharmacy. On the other hand, an advantage for the hospital pharmacist is that he or she can refer to the patient's medical records and support them during hospitalization.

Trajectory reshaping based guidance with impact time and angle constraints

Directory of Open Access Journals (Sweden)

Zhao Yao

2016-08-01

Full Text Available This study presents a novel impact time and angle constrained guidance law for homing missiles. The guidance law is first developed with the prior-assumption of a stationary target, which is followed by the practical extension to a maneuvering target scenario. To derive the closed-form guidance law, the trajectory reshaping technique is utilized and it results in defining a specific polynomial function with two unknown coefficients. These coefficients are determined to satisfy the impact time and angle constraints as well as the zero miss distance. Furthermore, the proposed guidance law has three additional guidance gains as design parameters which make it possible to adjust the guided trajectory according to the operational conditions and missile’s capability. Numerical simulations are presented to validate the effectiveness of the proposed guidance law.

Changes in clinical and hotel expenditures following publication of the nursing home compare report card.

Science.gov (United States)

Mukamel, Dana B; Spector, William D; Zinn, Jacqueline; Weimer, David L; Ahn, Richard

2010-10-01

Nursing Home Compare first published clinical quality measures at the end of 2002. It is a quality report card that for the first time offers consumers easily accessible information about the clinical quality of nursing homes. It led to changes in consumers' demand, increasing the relative importance of clinical versus hotel aspects of quality in their search and choice of a nursing home. To examine the hypothesis that nursing homes responding to these changes in demand shifted the balance of resources from hotel to clinical activities. The study included 10,022 free-standing nursing homes nationwide during 2001 to 2006. RESEARCH DESIGN AND DATA: A retrospective multivariate statistical analysis of trends in the ratio of clinical to hotel expenditures, using Medicare cost reports, Minimum Data Set and Online Survey, Certification and Reporting data, controlling for changes in residents' acuity and facility fixed effects. Inference is based on robust standard errors. The ratio of clinical to hotel expenditures averaged 1.78. It increased significantly (P hotel expenditures following publication of the report card suggests that nursing homes responded as expected to the changes in the elasticity of demand with respect to clinical quality brought about by the public reporting of clinical quality measures. The response was stronger among nursing homes facing stronger incentives.

Moisture Control Guidance for Commercial and Public ...

Science.gov (United States)

This document provides guidance to designers, construction mangers, and building operation/maintenance managers to improve IEQ and reduce risks of encountering IEQ problems due to insufficient moisture control. EPA will be producing a document entitled

Location, Location, Location: Characteristics and Services of Long-Stay Home Care Recipients in Retirement Homes Compared to Others in Private Homes and Long-Term Care Homes.

Science.gov (United States)

Poss, Jeffrey W; Sinn, Chi-Ling Joanna; Grinchenko, Galina; Blums, Jane; Peirce, Tom; Hirdes, John

2017-02-01

We examine recipients of publicly funded ongoing care in a single Ontario jurisdiction who reside in three different settings: long-stay home care patients in private homes and apartments, other patients in retirement homes and residents of long-term care homes, using interRAI assessment instruments. Among home care patients, those in retirement homes have higher proportions of dementia and moderate cognitive impairment, less supportive informal care systems as well as more personal care and nursing services above those provided by the public home care system, more frequent but shorter home support visits and lower than expected public home care expenditures. These lower expenditures may be because of efficiency of care delivery or by retirement homes providing some services otherwise provided by the public home care system. Although persons in each setting are mostly older adults with high degrees of frailty and medical complexity, long-term care home residents show distinctly higher needs. We estimate that 40% of retirement home residents are long-stay home care patients, and they comprise about one in six of this Community Care Access Centre's long-stay patients. Copyright © 2017 Longwoods Publishing.

Environmental guidance regulatory bulletin

International Nuclear Information System (INIS)

1997-01-01

This document describes the background on expanding public participation in the Resource Conservation and Recovery Act and DOE's response. The bulletin also describes the changes made by the final rule to existing regulations, guidance provided by EPA in the preamble and in the revised RCRA Public Participation Manual, the relationship between public participation and environmental justice, and DOE's recent public participation and environmental justice initiatives

HANDBOOK: HAZARDOUS WASTE INCINERATION MEASUREMENT GUIDANCE

Science.gov (United States)

This publication, Volume III of the Hazardous Waste Incineration Guidance Series, contains general guidance to permit writers in reviewing hazardous waste incineration permit applications and trial burn plans. he handbook is a how-to document dealing with how incineration measure...

'Tell us something we don't already know or do!' - The response of planning and transport professionals to public health guidance on the built environment and physical activity.

Science.gov (United States)

Allender, Steven; Cavill, Nick; Parker, Mike; Foster, Charles

2009-04-01

A large proportion of non-communicable disease can be attributed to modifiable risk factors such as poor nutrition and physical inactivity. We present data on planning and transport practitioners' perceptions and responses to government public health guidance aimed at modifying environmental factors to promote physical activity. This study was informed by questions on the role of evidence-based guidance, the views of professionals towards the guidance, the links between guidance and existing legislation and policy and the practicality of guidelines. A key informant 'snowball' sampling technique was used to recruit participants from the main professional planning organisations across England. Seventy-six people were interviewed in eight focus groups. We found that evidence-based public health guidance is a new voice in urban and town planning, although much of the advice is already reflected by the 'accepted wisdom' of these professions. Evidence-based health guidance could be a powerful driver affecting planning practice, but other legislated planning guidance may take priority for planning and transport professionals.

Changes in the relationship between nursing home financial performance and quality of care under public reporting.

Science.gov (United States)

Park, Jeongyoung; Werner, Rachel M

2011-07-01

The relationship between financial performance and quality of care in nursing homes is not well defined and prior work has been mixed. The recent focus on improving the quality of nursing homes through market-based incentives such as public reporting may have changed this relationship, as public reporting provides nursing homes with increased incentives to engage in quality-based competition. If quality improvement activities require substantial production costs, nursing home profitability may become a more important predictor of quality under public reporting. This study explores the relationship between financial performance and quality of care and test whether this relationship changes under public reporting. Using a 10-year (fiscal years 1997-2006) panel data set of 9444 skilled nursing facilities in the US, this study employs a facility fixed-effects with and without instrumental variables approach to test the effect of finances on quality improvement and correct for potential endogeneity. The results show that better financial performance, as reflected by the 1-year lagged total profit margin, is modestly associated with higher quality but only after public reporting is initiated. These findings have important policy implications as federal and state governments use market-based incentives to increase demand for high-quality care and induce providers to compete based on quality. Copyright © 2010 John Wiley & Sons, Ltd.

Nuclear power: Accidental releases - practical guidance for public health action

International Nuclear Information System (INIS)

1987-01-01

The disaster at Chernobyl, USSR, has caused a major crisis of confidence in nuclear safety, and highlighted the need for comprehensive contingency planning for - and emergency response to - such accidents. This report gives practical guidance on how the authorities should deal with an accident in any type of nuclear installation, whether it involves accidental releases to the air or into water. It is based on principles developed in a previous WHO report published in 1984. It summarizes the range of accidents for which plans need to be made to protect the public, the measures to be taken and the levels of dose at which they should be applied. It indicates how to measure the levels of exposure and what are the most likely routes of exposure. It then outlines the problems faced by public health authorities and medical practitioners, and the administrative arrangements that will have to be made. The example used is of a standard pressurized light water reactor of the type currently used for electricity generation, but many of the features will be common to other nuclear installations as well. This report is addressed to those organizations and individuals responsible for public health in the event of a nuclear accident. It will also be of use to those medical practitioners who are not administratively responsible in an accident, but who may need to be aware of the consequences and of the action to be taken in the aftermath of an accident. Coordination is vital between the public health administration and the organizations with direct responsibilities in the event of an accident, and this report is essential reading for them all. 29 refs, 2 figs, 7 tabs

Public health guidance on cardiovascular benefits and risks related to fish consumption

Directory of Open Access Journals (Sweden)

Stern Alan H

2007-10-01

Full Text Available Abstract Historically, concerns with fish consumption have addressed risks from contaminants (e.g., methylmercury (MeHg, and PCBs. More recently public health concerns have widened in appreciation of the specific benefits of fish consumption such as those arising from polyunsaturated fatty acids (PUFAs in fish oil. Fish contains varying levels of PUFAs and MeHg. Since both address the same health outcomes (in opposite directions and occur together in fish, great care must be exercised in providing public health guidance. Mozaffarian and Rimm in a recent article (JAMA. 2006, 296:1885–99 have made a strong case for the beneficial effects of PUFAs in reducing the risk of coronary heart disease, but at the same time, have also broadly discounted the increased risks of coronary heart disease posed by MeHg in fish, stating that "... among adults... the benefits of fish intake exceed the potential risks." This conclusion appears to be based on an inaccurate and insufficiently critical analysis of the literature. This literature is re-examined in light of their conclusions, and the available and appropriate public health options are considered.

Significant Guidance Issued by the Federal Transit Administration

Data.gov (United States)

Department of Transportation — A list of Significant Guidance documents, which include guidance document disseminated to regulated entities or the general public that may reasonably be anticipated...

Significant Guidance Issued by the Federal Aviation Administration

Data.gov (United States)

Department of Transportation — A list of Significant Guidance documents, which include guidance document disseminated to regulated entities or the general public that may reasonably be anticipated...

Significant Guidance Issued by the Federal Highway Administration

Data.gov (United States)

Department of Transportation — A list of Significant Guidance documents, which include guidance document disseminated to regulated entities or the general public that may reasonably be anticipated...

Teaching adolescents with severe disabilities to use the public telephone.

Science.gov (United States)

Test, D W; Spooner, F; Keul, P K; Grossi, T

1990-04-01

Two adolescents with severe disabilities served as participants in a study conducted to train in the use of the public telephone to call home. Participants were trained to complete a 17-step task analysis using a training package which consisted of total task presentation in conjunction with a four-level prompting procedure (i.e., independent, verbal, verbal + gesture, verbal + guidance). All instruction took place in a public setting (e.g., a shopping mall) with generalization probes taken in two alternative settings (e.g., a movie theater and a convenience store). A multiple probe across individuals design demonstrated the training package was successful in teaching participants to use the telephone to call home. In addition, newly acquired skills generalized to the two untrained settings. Implications for community-based training are discussed.

The Application of Multimedia Messaging Services via Mobile Phones to Support Outpatients:Home Nursing Guidance for Pediatric Intestinal Colostomy Complications

Institute of Scientific and Technical Information of China (English)

Qiao-Ling Yang; Qin Wei; Ying Huang; Yu-Xiu Jiang; Dai-Zhen Chen; Ping Huang; Li-Jun Liang

2015-01-01

Objective:To present a model of extended home nursing support provided through WeChat for pediatric colostomy patients between the first and second surgery to support parents and to assist them in nursing possible complications at home,to reduce colostomy complications caused by improper care,to improve the quality of life of patients at home and to ensure the success of the recovery and second surgery.Methods:A combination of relevant clinical information,health care guidelines,and training as well as the establishment of a specific monitoring protocol was provided to the parents during the patient’ s first hospitalization.A support system for nursing the colostomy was established with regular follow-up via WeChat after the patient’ s first discharge from the hospital using a predetermined protocol.During the 3 to 6 months of home care in-between the colostomy operations,the charge nurse initiated the phone follow-up and provided specific,individual guidance and feedback.If necessary,extended service at predetermined intervals was provided in the 1st week,the 1st month,the 2nd month and the 3rd month.Results:Extended assistance for the home care of patients with pediatric colostomy complications improved the quality of life of the patients and caregivers and was accepted by all parties involved upon introduction.The assistance provided support for the parents at all hours,efficiently reduced the level of complications for this type of patient and facilitated fast referrals to hospital care in cases of emergencies.Furthermore it paved the way to successful second stage surgeries,provided direct feedback to the charge nurse and improved the work satisfaction and sense of achievement of the nurses involved.Conclusions:All 80 cases supported by WeChat successfully underwent two-stage pediatric colostomy operations.The response of the parents and the medical staff involved was very positive.This method is easy to use,economical to operate and could be applied

The Application of Multimedia Messaging Services via Mobile Phones to Support Outpatients：Home Nursing Guidance for Pediatric Intestinal Colostomy Complications

Institute of Scientific and Technical Information of China (English)

Qiao-Ling Yang; Qin Wei; Ying Huang; Yu-Xiu Jiang; Dai-Zhen Chen; Ping Huang; Li-Jun Liang

2015-01-01

Objective: To present a model of extended home nursing support provided through WeChat for pediatric colostomy patients between the first and second surgery to support parents and to assist them in nursing possible complications at home, to reduce colostomy complications caused by improper care, to improve the quality of life of patients at home and to ensure the success of the recovery and second surgery. Methods: A combination of relevant clinical information, health care guidelines, and training as well as the establishment of a specific monitoring protocol was provided to the parents during the patient’ s first hospitalization. A support system for nursing the colostomy was established with regular follow-up via WeChat after the patient’ s first discharge from the hospital using a predetermined protocol. During the 3 to 6 months of home care in-between the colostomy operations, the charge nurse initiated the phone follow-up and provided specific, individual guidance and feedback. If necessary, extended serv-ice at predetermined intervals was provided in the 1st week, the 1st month, the 2nd month and the 3rd month. Results: Extended assistance for the home care of patients with pediatric colostomy complications im-proved the quality of life of the patients and caregivers and was accepted by all parties involved upon in-troduction. The assistance provided support for the parents at all hours, efficiently reduced the level of complications for this type of patient and facilitated fast referrals to hospital care in cases of emergen-cies. Furthermore it paved the way to successful second stage surgeries, provided direct feedback to the charge nurse and improved the work satisfaction and sense of achievement of the nurses involved. Conclusions: All 80 cases supported by WeChat successfully underwent two-stage pediatric colostomy operations. The response of the parents and the medical staff involved was very positive. This method is easy to use, economical to

Time-Varying Biased Proportional Guidance with Seeker’s Field-of-View Limit

OpenAIRE

Yang, Zhe; Wang, Hui; Lin, Defu

2016-01-01

Traditional guidance laws with range-to-go information or time-to-go estimation may not be implemented in passive homing missiles since passive seekers cannot measure relative range directly. A time-varying biased proportional guidance law, which only uses line-of-sight (LOS) rate and look angle information, is proposed to satisfy both impact angle constraint and seeker’s field-of-view (FOV) limit. In the proposed guidance law, two time-varying bias terms are applied to divide the trajectory ...

76 FR 61098 - Guidance for 1-Hour SO2

Science.gov (United States)

2011-10-03

...Notice is hereby given that the EPA has posted its draft non- binding guidance titled, ``Guidance for 1-Hour SO2 NAAQS SIP Submissions'' on its Web site. The EPA invites public comments on this guidance document during the comment period specified below, and plans to issue an updated version of the guidance after reviewing timely submitted comments.

Implementing Home Health Standards in Clinical Practice.

Science.gov (United States)

Gorski, Lisa A

2016-02-01

In 1986, the American Nurses Association (ANA) published the first Standards of Home Health Practice. Revised in 1992 and expanded in 1999 to become Home Health Nursing: Scope and Standards of Practice, it was revised in 2008 and again in 2014. In the 2014 edition, there are 6 standards of home healthcare nursing practice and 10 standards of professional performance for home healthcare nursing. The focus of this article is to describe the home healthcare standards and to provide guidance for implementation in clinical practice. It is strongly encouraged that home healthcare administrators, educators, and staff obtain a copy of the standards and fully read this essential home healthcare resource.

Reactions to smoke-free public policies and smoke-free home policies in the Republic of Georgia: results from a 2014 national survey.

Science.gov (United States)

Berg, Carla J; Topuridze, Marina; Maglakelidze, Nino; Starua, Lela; Shishniashvili, Maia; Kegler, Michelle C

2016-05-01

We examined receptivity to public smoke-free policies and smoke-free home status among adults in the Republic of Georgia. In Spring 2014, we conducted a national household survey of 1163 adults. Our sample was on average 42.4 years old, 51.1 % male, and 43.2 % urban. Current smoking prevalence was 54.2 % in men and 6.5 % in women. Notably, 42.2 % reported daily secondhand smoke exposure (SHSe). Past week SHSe was 29.9 % in indoor public places and 33.0 % in outdoor public places. The majority reported no opposition to public smoke-free policies. Correlates of greater receptivity to public policies included being older, female, and a nonsmoker. Past week SHSe in homes was 54.2 %; 38.8 % reported daily SHSe at home. Only 14.3 % reported complete smoke-free home policies; 39.0 % had partial policies. The only correlate of allowing smoking in the home was being a smoker. Among smokers, correlates of allowing smoking in the home were being male and lower confidence in quitting. SHSe is prevalent in various settings in Georgia, requiring efforts to promote support for public smoke-free policies and implementation of personal policies.

Assessment of radio frequency exposures in schools, homes, and public places in Belgium.

Science.gov (United States)

Verloock, Leen; Joseph, Wout; Goeminne, Francis; Martens, Luc; Verlaek, Mart; Constandt, Kim

2014-12-01

Characterization of exposure from emerging radio frequency (RF) technologies in areas where children are present is important. Exposure to RF electromagnetic fields (EMF) was assessed in three "sensitive" microenvironments; namely, schools, homes, and public places located in urban environments and compared to exposure in offices. In situ assessment was conducted by performing spatial broadband and accurate narrowband measurements, providing 6-min averaged electric-field strengths. A distinction between internal (transmitters that are located indoors) and external (outdoor sources from broadcasting and telecommunication) sources was made. Ninety-four percent of the broadband measurements were below 1 V m(-1). The average and maximal total electric-field values in schools, homes, and public places were 0.2 and 3.2 V m(-1) (WiFi), 0.1 and 1.1 V m(-1) (telecommunication), and 0.6 and 2.4 V m(-1) (telecommunication), respectively, while for offices, average and maximal exposure were 0.9 and 3.3 V m(-1) (telecommunication), satisfying the ICNIRP reference levels. In the schools considered, the highest maximal and average field values were due to internal signals (WiFi). In the homes, public places, and offices considered, the highest maximal and average field values originated from telecommunication signals. Lowest exposures were obtained in homes. Internal sources contributed on average more indoors (31.2%) than outdoors (2.3%), while the average contributions of external sources (broadcast and telecommunication sources) were higher outdoors (97.7%) than at indoor positions (68.8%). FM, GSM, and UMTS dominate the total downlink exposure in the outdoor measurements. In indoor measurements, FM, GSM, and WiFi dominate the total exposure. The average contribution of the emerging technology LTE was only 0.6%.

Decontamination of breast pump milk collection kits and related items at home and in hospital: guidance from a Joint Working Group of the Healthcare Infection Society and Infection Prevention Society.

Science.gov (United States)

Price, E; Weaver, G; Hoffman, P; Jones, M; Gilks, J; O'Brien, V; Ridgway, G

2016-03-01

A variety of methods are in use for decontaminating breast pump milk collection kits and related items associated with infant feeding. This paper aims to provide best practice guidance for decontamination of this equipment at home and in hospital. It has been compiled by a Joint Working Group of the Healthcare Infection Society and the Infection Prevention Society. The guidance has been informed by a search of the literature in Medline, the British Nursing Index, the Cumulative Index to Nursing and Allied Health Literature, Midwifery and Infant Care, and the results of two surveys of UK neonatal units in 2002/3 and 2006, and of members of the Infection Prevention Society in 2014. Since limited good quality evidence was available from these sources, much of the guidance represents good practice based on the consensus view of the Working Group. This guidance provides practical recommendations to support the safe decontamination of breast pump milk collection kits for healthcare professionals to use and communicate to other groups such as parents and carers. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Care satisfaction among older people receiving public care and service at home or in special accommodation.

Science.gov (United States)

Karlsson, Staffan; Edberg, Anna-Karin; Jakobsson, Ulf; Hallberg, Ingalill R

2013-02-01

To explore care satisfaction in relation to place of living, health-related quality of life, functional dependency and health complaints among people 65 years or older, receiving public care and service. The concept public care and service concerns formal care from the municipality, including home help, home nursing care, rehabilitation and a special accommodation. To be able to provide care and service of high quality to older people, knowledge about factors influencing their experience of satisfaction with the care is essential. Cross-sectional, including comparison and correlation. One-hundred sixty-six people receiving public care and service from the municipality were interviewed regarding demography, functional ability, perceived health complaints and care. Health-related quality of life was measured with SF-12, and self-rated care satisfaction was measured with a questionnaire. Low self-rated care satisfaction was associated with dependency in Instrumental Activities of Daily Living, blindness, faeces incontinence and anxiety, while high self-rated care satisfaction was associated with dependency in Personal Activities of Daily Living. Those at home rated an overall higher care satisfaction and were more satisfied with care continuity and personal relations; they thought that the staff had more time and were more respectful and quiet, than the ratings by those in a special accommodation (equivalent to a nursing home). Care satisfaction and health-related quality of life among older people was more associated with functional impairment and health complaints than to whether care and service was received at home or in a special accommodation. An approach using intervention focused on functional ability and health complaints is important for development of improved care satisfaction for older people receiving public care and service. © 2013 Blackwell Publishing Ltd.

The political economy of a public health case management program's transition into medical homes.

Science.gov (United States)

Wells, Rebecca; Cilenti, Dorothy; Issel, L Michele

2015-11-01

Throughout the United States, public health leaders are experimenting with how best to integrate services for individuals with complex needs. To that end, North Carolina implemented a policy incorporating both local public health departments and other providers into medical homes for low income pregnant women and young children at risk of developmental delays. To understand how this transition occurred within local communities, a pre-post comparative case study was conducted. A total of 42 people in four local health departments across the state were interviewed immediately before the 2011 policy change and six months later: 32 professionals (24 twice) and 10 pregnant women receiving case management at the time of the policy implementation. We used constant comparative analysis of interview and supplemental data to identify three key consequences of the policy implementation. One, having medical homes increased the centrality of other providers relative to local health departments. Two, a shift from focusing on personal relationships toward medical efficiency diverged in some respects from both case managers' and mothers' goals. Three, health department staff re-interpreted state policies to fit their public health values. Using a political economy perspective, these changes are interpreted as reflecting shifts in public health's broader ideological environment. To a large extent, the state successfully induced more connection between health department-based case managers and external providers. However, limited provider engagement may constrain the implementation of the envisioned medical homes. The increased focus on medical risk may also undermine health departments' role in supporting health over time by attenuating staff relationships with mothers. This study helps clarify how state public health policy innovations unfold at local levels, and why front line practice may in some respects diverge from policy intent. Published by Elsevier Ltd.

Revised guidance of the principles for establishing intervention levels for the protection of the public in the event of a nuclear accident or radiological emergency

International Nuclear Information System (INIS)

1988-07-01

An IAEA Advisory Group met in February 1987 to: i) review existing Agency guidance on intervention levels of dose and whether, and if so, what, revision is required; ii) consider whether, and if so, what additional guidance is required on limiting the stochastic risk and collective dose equivalent, and; iii) consider whether, and if so, what, additional guidance should be developed on derived intervention levels. The purpose of this Interim Report is to present to a broader audience the initial conclusions and recommendations of the Advisory Group in order that they may be used in conjunction with the guidance currently presented in Safety Series No. 72, pending publication of the revised Safety Series, scheduled for late 1989. 14 refs

Retrofitting Vegas: Implementing Energy Efficiency in Two Las Vegas Test Homes

Energy Technology Data Exchange (ETDEWEB)

Puttagunta, S.

2013-04-01

In 2009, the state of Nevada received nearly forty million dollars in Neighborhood Stabilization Funds from the Department of Housing and Urban Development. The purpose of this funding was to stabilize communities that have suffered from foreclosures and abandonment. In an effort to provide guidance to local officials and maximize how effectively this NSP funding is utilized in retrofitting homes, CARB provided design specifications, energy modeling, and technical support for the Building America Retrofit Alliance (BARA) team and its local partners - Better Building Performance, Nevada Energy Star Partners Green Alliance, and Home Free Nevada - for two retrofit test homes. One home was to demonstrate a modest retrofit and the other a deep energy retrofit. Through this project, CARB has provided two robust solution packages for retrofitting homes built in this region between the 1980s and early 1990s without substantially inconveniencing the occupants. The two test homes, the Carmen and Sierra Hills, demonstrate how cost-effectively energy efficient upgrades can be implemented in the hot, dry climate of the Southwest. In addition, the homes were used as an educational experience for home performance professionals, building trades, remodelers, and the general public. In-field trainings on air-sealing, HVAC upgrades, and insulating were provided to local contractors during the retrofit and BARA documented these retrofits through a series of video presentations, beginning with a site survey and concluding with the finished remodel and test out.

Significant Guidance Issued by the Federal Motor Carrier Safety Administration

Data.gov (United States)

Department of Transportation — A list of Significant Guidance documents, which include guidance document disseminated to regulated entities or the general public that may reasonably be anticipated...

Deep Energy Retrofit Guidance for the Building America Solutions Center

Energy Technology Data Exchange (ETDEWEB)

Less, Brennan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Walker, Iain [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2015-01-01

The U.S. DOE Building America program has established a research agenda targeting market-relevant strategies to achieve 40% reductions in existing home energy use by 2030. Deep Energy Retrofits (DERs) are part of the strategy to meet and exceed this goal. DERs are projects that create new, valuable assets from existing residences, by bringing homes into alignment with the expectations of the 21st century. Ideally, high energy using, dated homes that are failing to provide adequate modern services to their owners and occupants (e.g., comfortable temperatures, acceptable humidity, clean, healthy), are transformed through comprehensive upgrades to the building envelope, services and miscellaneous loads into next generation high performance homes. These guidance documents provide information to aid in the broader market adoption of DERs. They are intended for inclusion in the online resource the Building America Solutions Center (BASC). This document is an assemblage of multiple entries in the BASC, each of which addresses a specific aspect of Deep Energy Retrofit best practices for projects targeting at least 50% energy reductions. The contents are based upon a review of actual DERs in the U.S., as well as a mixture of engineering judgment, published guidance from DOE research in technologies and DERs, simulations of cost-optimal DERs, Energy Star and Consortium for Energy Efficiency (CEE) product criteria, and energy codes.

The nutritional status of 1081 elderly people residing in publicly funded shelter homes in Peninsular Malaysia.

Science.gov (United States)

Visvanathan, R; Zaiton, A; Sherina, M S; Muhamad, Y A

2005-03-01

The aim of this study was to determine the: (1) prevalence of undernutrition as determined by the 'DETERMINE Your Nutritional Health Checklist' (NHC) and (2) factors independently associated with undernutrition among the older residents of these publicly funded shelter homes in Peninsular Malaysia. A total of 1081 elderly people (59%M) over the age of 60 y were surveyed using questionnaires determining baseline demographics, nutritional and cognitive status, physical function and psychological well-being. Shelter homes, Peninsular Malaysia. In all, 41.4% (n = 447) were nourished (score 5) according to the NHC. A large proportion of subjects were underweight with 14.3% of subjects recording a low body mass index (BMI) or = 3). Using a BMI people residing in publicly funded shelter homes in Malaysia may be at-risk of undernutrition, and were underweight. The NHC is better used as an awareness tool rather than as a screening tool.

Deep Energy Retrofit Guidance for the Building America Solutions Center

Energy Technology Data Exchange (ETDEWEB)

Less, Brennan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Walker, Iain [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2015-01-01

The U.S. DOE Building America program has established a research agenda targeting market-relevant strategies to achieve 40% reductions in existing home energy use by 2030. Deep Energy Retrofits (DERs) are part of the strategy to meet and exceed this goal. DERs are projects that create new, valuable assets from existing residences, by bringing homes into alignment with the expectations of the 21st century. Ideally, high energy using, dated homes that are failing to provide adequate modern services to their owners and occupants (e.g., comfortable temperatures, acceptable humidity, clean, healthy), are transformed through comprehensive upgrades to the building envelope, services and miscellaneous loads into next generation high performance homes. These guidance documents provide information to aid in the broader market adoption of DERs.

Evaluating Home Day Care Mothers' Work with Young Children.

Science.gov (United States)

Seattle Community Coll., Washington.

This checklist was developed to determine the skills of day care home mothers before and after training as observed by a day care home educator. Areas evaluated are: Professional Attitude; Parent Relationships; Nutrition; Health and Safety; Baby Care; Preparing the Teaching Environment; Guidance; Teaching Techniques, Language and Literature; Art;…

Modeling school choice: A comparison of public, private-independent, private-religious and home-schooled students

Directory of Open Access Journals (Sweden)

Clive R. Belfield

2004-06-01

Full Text Available U.S. students now have four choices of schooling: public schooling, private–religious schooling, private–independent schooling, and home-schooling. Of these, home-schooling is the most novel: since legalization across the states in the last few decades, it has grown in importance and legitimacy as an alternative choice. Thus, it is now possible to investigate the motivation for home-schooling, relative to the other schooling options. Here, we use two recent large-scale datasets to assess the school enrollment decision: the first is the National Household Expenditure Survey (1999, and the second is micro-data on SAT test-takers in 2001. We find that, generally, families with home-schoolers have similar characteristics to those with children at other types of school, but mother’s characteristics – specifically, her employment status – have a strong influence on the decision to home-school. Plausibly, religious belief has an important influence on the schooling decision, not only for Catholic students, but also those of other faiths.

Best clinical practice guidance for management of early caries lesions in children and young adults

DEFF Research Database (Denmark)

Kühnisch, J; Ekstrand, K R; Pretty, I

2016-01-01

BACKGROUND: The European Academy of Paediatric Dentistry (EAPD) encourages prevention and arrest of active dental caries. Therefore, the present guidance provides evidence- and clinically-based recommendations for detecting and diagnosing early/non-cavitated caries lesions, risk assessment......-invasively in the majority of cases. The spectrum of measures includes a low cariogenicity tooth-friendly diet, daily and appropriate management of the biofilm, home and within the dental office/surgery usage of fluorides as well as sealing techniques. CONCLUSION: The detection and management of non-cavitated caries...... is an essential aspect of preventive dentistry. Therefore, the EAPD encourages oral health care providers and caregivers to implement preventive practices that can arrest early caries and improve individual and public dental health....

Technical and scale efficiency in public and private Irish nursing homes - a bootstrap DEA approach.

Science.gov (United States)

Ni Luasa, Shiovan; Dineen, Declan; Zieba, Marta

2016-10-27

This article provides methodological and empirical insights into the estimation of technical efficiency in the nursing home sector. Focusing on long-stay care and using primary data, we examine technical and scale efficiency in 39 public and 73 private Irish nursing homes by applying an input-oriented data envelopment analysis (DEA). We employ robust bootstrap methods to validate our nonparametric DEA scores and to integrate the effects of potential determinants in estimating the efficiencies. Both the homogenous and two-stage double bootstrap procedures are used to obtain confidence intervals for the bias-corrected DEA scores. Importantly, the application of the double bootstrap approach affords true DEA technical efficiency scores after adjusting for the effects of ownership, size, case-mix, and other determinants such as location, and quality. Based on our DEA results for variable returns to scale technology, the average technical efficiency score is 62 %, and the mean scale efficiency is 88 %, with nearly all units operating on the increasing returns to scale part of the production frontier. Moreover, based on the double bootstrap results, Irish nursing homes are less technically efficient, and more scale efficient than the conventional DEA estimates suggest. Regarding the efficiency determinants, in terms of ownership, we find that private facilities are less efficient than the public units. Furthermore, the size of the nursing home has a positive effect, and this reinforces our finding that Irish homes produce at increasing returns to scale. Also, notably, we find that a tendency towards quality improvements can lead to poorer technical efficiency performance.

Significant Guidance Issued by the Office of the Secretary of Transportation

Data.gov (United States)

Department of Transportation — A list of Significant Guidance documents, which include guidance document disseminated to regulated entities or the general public that may reasonably be anticipated...

Public, Private, and Home School Children's Views of Forgiveness and Retribution in "Cinderella."

Science.gov (United States)

Knafle, June D.; Wescott, Alice Legenza

Fifth Graders (N=626) from public, Catholic, Christian, and home schools reacted to values of forgiveness versus retribution in the two main versions of "Cinderella" by choosing which ending they preferred for themselves, for a 4-year old sister, and for a 4-year old brother. Girls preferred the forgiveness ending for themselves…

Health and thermal comfort: From WHO guidance to housing strategies

International Nuclear Information System (INIS)

Ormandy, David; Ezratty, Véronique

2012-01-01

There are many references to the WHO guidance on thermal comfort in housing, but not to the original source material. Based on archive material, this paper gives the evidential basis for the WHO guidance. It then reports on evidence that some groups may be more susceptible to high or low indoor temperatures than others. It examines different methods for measuring thermal comfort, such as air temperature measurement, assessing residents' perception, and predicting satisfaction. Resident's perception was used effectively in the WHO LARES project, showing that self-reported poor health was significantly associated with poor thermal comfort. Tools to inform strategies directed at dealing with cold homes and fuel poverty are considered, including Energy Performance Certificates, Fuel Poverty Indicators, and the English Housing Health and Safety Rating System. Conclusions from a WHO Workshop on Housing, Energy and Thermal Comfort are also summarised. The WHO view of thermal comfort, which is driven by protecting health from both high and low indoor temperatures, should be recognised in energy efficiency, fuel poverty and climate change strategies. While this is a major challenge, it could provide both health gains for individuals, and economic benefits for society. - Highlights: ► WHO guidance on thermal comfort is directed to protecting health in the home environment. ► In particular, the WHO guidance aims to protect the health of the most susceptible and fragile. ► Housing energy efficiency strategies protect health, and attack inequities. ► Housing energy efficiency strategies also have economic benefits for society.

75 FR 68784 - Healthy Indoor Environment Protocols for Home Energy Upgrades

Science.gov (United States)

2010-11-09

... carefully crafted to stimulate the growth of a vibrant, private sector- led market for residential energy... collaboration to help overcome barriers to these recommended healthy homes actions. Additional resources... assistance and other home energy retrofit program guidance and training materials, and collaboration to help...

Variations in levels of care between nursing home patients in a public health care system.

Science.gov (United States)

Døhl, Øystein; Garåsen, Helge; Kalseth, Jorid; Magnussen, Jon

2014-03-05

Within the setting of a public health service we analyse the distribution of resources between individuals in nursing homes funded by global budgets. Three questions are pursued. Firstly, whether there are systematic variations between nursing homes in the level of care given to patients. Secondly, whether such variations can be explained by nursing home characteristics. And thirdly, how individual need-related variables are associated with differences in the level of care given. The study included 1204 residents in 35 nursing homes and extra care sheltered housing facilities. Direct time spent with patients was recorded. In average each patient received 14.8 hours direct care each week. Multilevel regression analysis is used to analyse the relationship between individual characteristics, nursing home characteristics and time spent with patients in nursing homes. The study setting is the city of Trondheim, with a population of approximately 180 000. There are large variations between nursing homes in the total amount of individual care given to patients. As much as 24 percent of the variation of individual care between patients could be explained by variation between nursing homes. Adjusting for structural nursing home characteristics did not substantially reduce the variation between nursing homes. As expected a negative association was found between individual care and case-mix, implying that at nursing home level a more resource demanding case-mix is compensated by lowering the average amount of care. At individual level ADL-disability is the strongest predictor for use of resources in nursing homes. For the average user one point increase in ADL-disability increases the use of resources with 27 percent. In a financial reimbursement model for nursing homes with no adjustment for case-mix, the amount of care patients receive does not solely depend on the patients' own needs, but also on the needs of all the other residents.

Effectiveness of Home Visits in Pregnancy as a Public Health Measure to Improve Birth Outcomes.

Directory of Open Access Journals (Sweden)

Kayoko Ichikawa

Full Text Available Birth outcomes, such as preterm birth, low birth weight (LBW, and small for gestational age (SGA, are crucial indicators of child development and health.To evaluate whether home visits from public health nurses for high-risk pregnant women prevent adverse birth outcomes.In this quasi-experimental cohort study in Kyoto city, Japan, high-risk pregnant women were defined as teenage girls (range 14-19 years old, women with a twin pregnancy, women who registered their pregnancy late, had a physical or mental illness, were of single marital status, non-Japanese women who were not fluent in Japanese, or elderly primiparas. We collected data from all high-risk pregnant women at pregnancy registration interviews held at a public health centers between 1 July 2011 and 30 June 2012, as well as birth outcomes when delivered from the Maternal and Child Health Handbook (N = 964, which is a record of prenatal check-ups, delivery, child development and vaccinations. Of these women, 622 women were selected based on the home-visit program propensity score-matched sample (pair of N = 311 and included in the analysis. Data were analyzed between January and June 2014.In the propensity score-matched sample, women who received the home-visit program had lower odds of preterm birth (odds ratio [OR], 0.62; 95% confidence interval [CI], 0.39 to 0.98 and showed a 0.55-week difference in gestational age (95% CI: 0.18 to 0.92 compared to the matched controlled sample. Although the program did not prevent LBW and SGA, children born to mothers who received the program showed an increase in birth weight by 107.8 g (95% CI: 27.0 to 188.5.Home visits by public health nurses for high-risk pregnant women in Japan might be effective in preventing preterm birth, but not SGA.

Career Guidance and Social Exclusion: A Cautionary Tale.

Science.gov (United States)

Watts, A. G.

2001-01-01

Examines the relationship of career guidance to public-policy interventions designed to address social exclusion. Analyzes the nature and origin of the concept of social exclusion and reviews the roles of career guidance in response to it, particularly in relation to young people who have dropped out of formal education or are at high risk of…

The Need for a Functional Guidance and Counselling Programme in ...

African Journals Online (AJOL)

The paper examines the need for a functional guidance and counselling programme in Nigeria's primary school with particular reference to developmental guidance and vocational development. Primary school counselling naturally, must be concerned with consulting, appraisal, counselling, placement, public relation and ...

Information architecture. Volume 3: Guidance

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-04-01

The purpose of this document, as presented in Volume 1, The Foundations, is to assist the Department of Energy (DOE) in developing and promulgating information architecture guidance. This guidance is aimed at increasing the development of information architecture as a Departmentwide management best practice. This document describes departmental information architecture principles and minimum design characteristics for systems and infrastructures within the DOE Information Architecture Conceptual Model, and establishes a Departmentwide standards-based architecture program. The publication of this document fulfills the commitment to address guiding principles, promote standard architectural practices, and provide technical guidance. This document guides the transition from the baseline or defacto Departmental architecture through approved information management program plans and budgets to the future vision architecture. This document also represents another major step toward establishing a well-organized, logical foundation for the DOE information architecture.

The structure and organisation of home-based postnatal care in public hospitals in Victoria, Australia: A cross-sectional survey.

Science.gov (United States)

Forster, Della A; McKay, Heather; Powell, Rhonda; Wahlstedt, Emma; Farrell, Tanya; Ford, Rachel; McLachlan, Helen L

2016-04-01

There is limited evidence regarding the provision of home-based postnatal care, resulting in a weak evidence-base for policy formulation and the further development of home-based postnatal care services. To explore the structure and organisation of public hospital home-based postnatal care in Victoria, Australia. An online survey including mostly closed-ended questions was sent to representatives of all public maternity providers in July 2011. The response rate of 87% (67/77) included rural (70%; n=47), regional (15%; n=10) and metropolitan (15%; n=10) services. The majority (96%, 64/67) provided home-based postnatal care. The median number of visits for primiparous women was two and for multiparous women, one. The main reason for no visit was the woman declining. Two-thirds of services attempted to provide some continuity of carer for home-based postnatal care. Routine maternal and infant observations were broadly consistent across the services, and various systems were in place to protect the safety of staff members during home visits. Few services had a dedicated home-based postnatal care coordinator. This study demonstrates that the majority of women receive at least one home-based postnatal visit, and that service provision on the whole is similar across the state. Further work should explore the optimum number and timing of visits, what components of care are most valued by women, and what model best ensures the timely detection and prevention of postpartum complications, be they psychological or physiological. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

End-of-life expectations and experiences among nursing home patients and their relatives

DEFF Research Database (Denmark)

Fosse, Anette; Schaufel, Margrethe Aase; Ruths, Sabine

2014-01-01

. CONCLUSION: Nursing home patients and their relatives wanted doctors more involved in end-of-life care. They expected doctors to acknowledge their preferences and provide guidance and symptom relief. PRACTICE IMPLICATIONS: High-quality end-of-life care in nursing homes relies on organization, funding......OBJECTIVE: Synthesize research about patients' and relatives' expectations and experiences on how doctors can improve end-of-life care in nursing homes. METHODS: We systematically searched qualitative studies in English in seven databases (Medline, Embase, PsycINFO, CINAHL, Ageline, Cochrane...... decision-makers reported uncertainty and distress when guidance from health personnel was lacking. They worried about staff shortage and emphasized doctor availability. Relatives and health personnel seldom recognized patients' ability to consent, and patients' preferences were not always recognized...

Energy expenditure of three public and three home based active computer games in children.

NARCIS (Netherlands)

Simons, M.; de Vries, S.I.; Jongert, M.W.A.

2014-01-01

The purpose of this study was to assess the energy expenditure (EE) experienced by children when playing six active video games, which can be used in a home environment and in a public setting (e.g. game center), and to evaluate whether the intensity of playing these games can meet the threshold for

Energy expenditure of three public and three home-based active video games in children

NARCIS (Netherlands)

Simons, Monique|info:eu-repo/dai/nl/323255639; De Vries, Sanne I.|info:eu-repo/dai/nl/333758412; Jongert, Tinus; Verheijden, Marieke W.

2014-01-01

The purpose of this study was to assess the energy expenditure (EE) experienced by children when playing six active video games, which can be used in a home environment and in a public setting (e.g. game center), and to evaluate whether the intensity of playing these games can meet the threshold for

Dimensions of work-home culture and their relations with the use of work-home arrangements and work-home interaction

NARCIS (Netherlands)

Dikkers, J.S.E.; Geurts, S.A.E.; Dulk, L. den; Peper, A.B.; Taris, T.W.; Kompier, M.A.J.

2007-01-01

This study examined the associations of work–home culture with (a) demographic and organizational characteristics, (b) the use of work–home arrangements, and (c) negative and positive work–home interaction, among 1,179 employees from one public and two private organizations. Substantial support was

Dimensions of work-home culture and their relations with the use of work-home arrangements and work-home interaction

NARCIS (Netherlands)

Dikkers, J.S.E.; Geurts, S.A.E.; den Dulk, L.; Peper, B.; Taris, T.W.; Kompier, M.A.J.

2007-01-01

This study examined the associations of work-home culture with (a) demographic and organizational characteristics, (b) the use of work-home arrangements, and (c) negative and positive work-home interaction, among 1,179 employees from one public and two private organizations. Substantial support was

HOME CARE NURSES’ ROLES IN ENHANCING QUALITY OF NURSING CARE FOR PATIENTS AT HOME: A PHENOMENOLOGICAL STUDY

Directory of Open Access Journals (Sweden)

Titan Ligita

2017-08-01

Full Text Available Background: Provision of health care service at home is one of the advanced forms of care for patients being discharged from hospitalization. Little is known about the experience of nurses providing home care services through a nursing home-care model especially in Indonesian context. Objective: This study aims to explore the experience in order to increase understanding on the form of home care provision, and consequently the nurses may understand the form of home care globally. Methods: This study employed a phenomenological design and performed interview in the process of data collection. Data were analysed by using content analysis. Results: The main contexts of home care nurse experiences were generated. There were definition and role of home care nurses, the involvement of family members in the provision of care, the facilitating and hindering factors contributed to home care provision as well as manual on providing home care nursing. Conclusion: The implication from this study is that nursing care should be given to the patients continuously and consequently the need for family involvement is important. Additionally, in providing the home care, a proper manual is needed by home care nurses as the guidance to give best quality of care to patients.

Public Policies for Career Development. Case Studies And Emerging Issues For Designing Career Information And Guidance Systems In Developing And Transition Economies

Science.gov (United States)

Watts, A. G.; Fretwell, David H.

2004-01-01

The following pages summarize the findings of seven case-studies of public policy in career guidance carried out in Chile, the Philippines, Poland, Romania, Russia, South Africa and Turkey. The objectives of this World Bank study were: to identify and describe the distinctive issues faced by developing and transition economies in forming effective…

Manual for guided home exercises for osteoarthritis of the knee

Directory of Open Access Journals (Sweden)

Nilza Aparecida de Almeida Carvalho

2010-06-01

Full Text Available INTRODUCTION: Physiotherapy is one of the most important components of therapy for osteoarthritis of the knee. The objective of this prospective case series was to assess the efficiency of a guidance manual for patients with osteoarthritis of the knee in relation to pain, range of movement , muscle strength and function, active goniometry, manual strength test and function. METHODS: Thirty-eight adults with osteoarthritis of the knee (> 45 years old who were referred to the physiotherapy service at the university hospital (Santa Casa de Misericórdia de São Paulo were studied. Patients received guidance for the practice of specific physical exercises and a manual with instructions on how to perform the exercises at home. They were evaluated for pain, range of movement, muscle strength and function. These evaluations were performed before they received the manual and three months later. Patients were seen monthly regarding improvements in their exercising abilities. RESULTS: The program was effective for improving muscle strength, controlling pain, maintaining range of movement of the knee joint, and reducing functional incapacity. DISCUSSION: A review of the literature showed that there are numerous clinical benefits to the regular practice of physical therapy exercises by patients with osteoarthritis of the knee(s in a program with appropriate guidance. This study shows that this guidance can be attained at home with the use of a proper manual. CONCLUSIONS: Even when performed at home without constant supervision, the use of the printed manual for orientation makes the exercises for osteoarthritis of the knee beneficial.

Air pollution and public health: a guidance document for risk managers.

Science.gov (United States)

Craig, Lorraine; Brook, Jeffrey R; Chiotti, Quentin; Croes, Bart; Gower, Stephanie; Hedley, Anthony; Krewski, Daniel; Krupnick, Alan; Krzyzanowski, Michal; Moran, Michael D; Pennell, William; Samet, Jonathan M; Schneider, Jurgen; Shortreed, John; Williams, Martin

2008-01-01

This guidance document is a reference for air quality policymakers and managers providing state-of-the-art, evidence-based information on key determinants of air quality management decisions. The document reflects the findings of five annual meetings of the NERAM (Network for Environmental Risk Assessment and Management) International Colloquium Series on Air Quality Management (2001-2006), as well as the results of supporting international research. The topics covered in the guidance document reflect critical science and policy aspects of air quality risk management including i) health effects, ii) air quality emissions, measurement and modeling, iii) air quality management interventions, and iv) clean air policy challenges and opportunities.

Public authority over home care.

NARCIS (Netherlands)

Genet, N.A.; Boerma, W.G.W.; Kroneman, M.

2011-01-01

Background: The ageing society, decreasing resources and financial constraints are putting governments under pressure. Across Europe, division of responsibilities for long-term care are being reconsidered. Under these pressures, the role of governments in home care could be changing. This paper will

Ethics of clinician communication in a changing communication landscape: guidance from professional societies.

Science.gov (United States)

Gollust, Sarah E; Dwyer, Anne M

2013-12-01

Cancer experts engage in public communication whenever they promote their research or practice, respond to media inquiries, or use social media. In a changing communication landscape characterized by new technologies and heightened attention to cancer controversies, these activities may pose ethical challenges. This study was designed to evaluate existing resources to help clinicians navigate their public communication activities. We conducted a systematic, qualitative content analysis of codes of ethics, policy statements, and similar documents disseminated by professional medical and nursing societies for their members. We examined these documents for four types of content related to public communication: communication via traditional media; communication via social media; other communication to the public, policy, and legal spheres; and nonspecific language regarding public communication. We identified 46 documents from 23 professional societies for analysis. Five societies had language about traditional news media communication, five had guidance about social media, 11 had guidance about other communication domains, and 15 societies offered general language about public communication. The limited existing guidance focused on ethical issues related to patients (such as privacy violations) or clinicians (such as accuracy and professional boundaries), with less attention to population or policy impact of communication. Cancer-related professional societies might consider establishing more specific guidance for clinicians concerning their communication activities in light of changes to the communication landscape. Additional research is warranted to understand the extent to which clinicians face ethical challenges in public communication.

Identifying evidence for public health guidance: a comparison of citation searching with Web of Science and Google Scholar.

Science.gov (United States)

Levay, Paul; Ainsworth, Nicola; Kettle, Rachel; Morgan, Antony

2016-03-01

To examine how effectively forwards citation searching with Web of Science (WOS) or Google Scholar (GS) identified evidence to support public health guidance published by the National Institute for Health and Care Excellence. Forwards citation searching was performed using GS on a base set of 46 publications and replicated using WOS. WOS and GS were compared in terms of recall; precision; number needed to read (NNR); administrative time and costs; and screening time and costs. Outcomes for all publications were compared with those for a subset of highly important publications. The searches identified 43 relevant publications. The WOS process had 86.05% recall and 1.58% precision. The GS process had 90.7% recall and 1.62% precision. The NNR to identify one relevant publication was 63.3 with WOS and 61.72 with GS. There were nine highly important publications. WOS had 100% recall, 0.38% precision and NNR of 260.22. GS had 88.89% recall, 0.33% precision and NNR of 300.88. Administering the WOS results took 4 h and cost £88-£136, compared with 75 h and £1650-£2550 with GS. WOS is recommended over GS, as citation searching was more effective, while the administrative and screening times and costs were lower. Copyright © 2015 John Wiley & Sons, Ltd.

Integrated detection, estimation, and guidance in pursuit of a maneuvering target

Science.gov (United States)

Dionne, Dany

The thesis focuses on efficient solutions of non-cooperative pursuit-evasion games with imperfect information on the state of the system. This problem is important in the context of interception of future maneuverable ballistic missiles. However, the theoretical developments are expected to find application to a broad class of hybrid control and estimation problems in industry. The validity of the results is nevertheless confirmed using a benchmark problem in the area of terminal guidance. A specific interception scenario between an incoming target with no information and a single interceptor missile with noisy measurements is analyzed in the form of a linear hybrid system subject to additive abrupt changes. The general research is aimed to achieve improved homing accuracy by integrating ideas from detection theory, state estimation theory and guidance. The results achieved can be summarized as follows. (i) Two novel maneuver detectors are developed to diagnose abrupt changes in a class of hybrid systems (detection and isolation of evasive maneuvers): a new implementation of the GLR detector and the novel adaptive- H0 GLR detector. (ii) Two novel state estimators for target tracking are derived using the novel maneuver detectors. The state estimators employ parameterized family of functions to described possible evasive maneuvers. (iii) A novel adaptive Bayesian multiple model predictor of the ballistic miss is developed which employs semi-Markov models and ideas from detection theory. (iv) A novel integrated estimation and guidance scheme that significantly improves the homing accuracy is also presented. The integrated scheme employs banks of estimators and guidance laws, a maneuver detector, and an on-line governor; the scheme is adaptive with respect to the uncertainty affecting the probability density function of the filtered state. (v) A novel discretization technique for the family of continuous-time, game theoretic, bang-bang guidance laws is introduced. The

Strong Public Health Recommendations from Weak Evidence? Lessons Learned in Developing Guidance on the Public Health Management of Meningococcal Disease

Directory of Open Access Journals (Sweden)

Germaine Hanquet

2015-01-01

Full Text Available The evidence underpinning public health policy is often of low quality, leading to inconsistencies in recommended interventions. One example is the divergence in national policies across Europe for managing contacts of invasive meningococcal disease. Aiming to develop consistent guidance at the European level, a group of experts reviewed the literature and formulated recommendations. The group defined eight priority research questions, searched the literature, and formulated recommendations using GRADE methodology. Five of the research questions are discussed in this paper. After taking into account quality of evidence, benefit, harm, value, preference, burden on patient of the intervention, and resource implications, we made four strong recommendations and five weak recommendations for intervention. Strong recommendations related not only to one question with very low quality of evidence as well as to two questions with moderate to high quality of evidence. The weak recommendations related to two questions with low and very low quality of evidence but also to one question with moderate quality of evidence. GRADE methodology ensures a transparent process and explicit recognition of additional factors that should be considered when making recommendations for policy. This approach can be usefully applied to many areas of public health policy where evidence quality is often low.

78 FR 39284 - Technical Guidance for Assessing Environmental Justice in Regulatory Analysis

Science.gov (United States)

2013-07-01

... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OA-2013-0320; FRL-9830-1] Technical Guidance for Assessing Environmental Justice in Regulatory Analysis AGENCY: Environmental Protection Agency (EPA). ACTION: Notice... Environmental Protection Agency (EPA) issued for public comment a document entitled, ``Technical Guidance for...

Telemedicine in Neonatal Home Care: Identifying Parental Needs Through Participatory Design.

Science.gov (United States)

Garne, Kristina; Brødsgaard, Anne; Zachariassen, Gitte; Clemensen, Jane

2016-07-08

For the majority of preterm infants, the last weeks of hospital admission mainly concerns tube feeding and establishment of breastfeeding. Neonatal home care (NH) was developed to allow infants to remain at home for tube feeding and establishment of breastfeeding with regular home visits from neonatal nurses. For hospitals covering large regions, home visits may be challenging, time consuming, and expensive and alternative approaches must be explored. To identify parental needs when wanting to provide neonatal home care supported by telemedicine. The study used participatory design and qualitative methods. Data were collected from observational studies, individual interviews, and focus group interviews. Two neonatal units participated. One unit was experienced in providing neonatal home care with home visits, and the other planned to offer neonatal home care with telemedicine support. A total of 9 parents with preterm infants assigned to a neonatal home care program and 10 parents with preterm infants admitted to a neonatal unit participated in individual interviews and focus group interviews, respectively. Three overall themes were identified: being a family, parent self-efficacy, and nurse-provided security. Parents expressed desire for the following: (1) a telemedicine device to serve as a "bell cord" to the neonatal unit, giving 24-hour access to nurses, (2) video-conferencing to provide security at home, (3) timely written email communication with the neonatal unit, and (4) an online knowledge base on preterm infant care, breastfeeding, and nutrition. Our findings highlight the importance of neonatal home care. NH provides parents with a feeling of being a family, supports their self-efficacy, and gives them a feeling of security when combined with nursing guidance. Parents did not request hands-on support for infant care, but instead expressed a need for communication and guidance, which could be met using telemedicine.

Context-aware patient guidance during blood pressure self-measurement

DEFF Research Database (Denmark)

Sandager, Puk; Lindahl, Camilla; Schlütter, Jacob Mørup

2013-01-01

The importance of accurate measurement of blood pressure in the screening and management of hypertension during pregnancy is well established. Blood pressure levels can be measured manually by healthcare staff or by using a blood pressure self-measurement device, either at home or in the clinic...... the blood pressure self-measurement process. Preliminary results indicate that such active and context-aware guidance leads to more reliable measurements by inhibiting non-adherent patient behavior...

75 FR 49913 - Draft Guidance, “Federal Greenhouse Gas Accounting and Reporting”

Science.gov (United States)

2010-08-16

... provides this draft guidance for public review and comment to ensure accessibility of Federal accounting... COUNCIL ON ENVIRONMENTAL QUALITY Draft Guidance, ``Federal Greenhouse Gas Accounting and Reporting... recommended Federal GHG reporting and accounting procedures. On April 5, 2010, DOE-FEMP submitted the final...

Public involvement in research within care homes: benefits and challenges in the APPROACH study.

Science.gov (United States)

Froggatt, Katherine; Goodman, Claire; Morbey, Hazel; Davies, Sue L; Masey, Helen; Dickinson, Angela; Martin, Wendy; Victor, Christina

2016-12-01

Public involvement in research (PIR) can improve research design and recruitment. Less is known about how PIR enhances the experience of participation and enriches the data collection process. In a study to evaluate how UK care homes and primary health-care services achieve integrated working to promote older people's health, PIR was integrated throughout the research processes. This paper aims to present one way in which PIR has been integrated into the design and delivery of a multisite research study based in care homes. A prospective case study design, with an embedded qualitative evaluation of PIR activity. Data collection was undertaken in six care homes in three sites in England. Six PIR members participated: all had prior personal or work experience in care homes. Qualitative data collection involved discussion groups, and site-specific meetings to review experiences of participation, benefits and challenges, and completion of structured fieldwork notes after each care home visit. PIR members supported recruitment, resident and staff interviews and participated in data interpretation. Benefits of PIR work were resident engagement that minimized distress and made best use of limited research resources. Challenges concerned communication and scheduling. Researcher support for PIR involvement was resource intensive. Clearly defined roles with identified training and support facilitated involvement in different aspects of the data collection process. This can also ensure that vulnerable older people who participate in research have a positive experience that reinforces the value of their views. © 2015 The Authors Health Expectations Published by John Wiley & Sons Ltd.

The Utility of Home-Practice in Mindfulness-Based Group Interventions: A Systematic Review.

Science.gov (United States)

Lloyd, Annette; White, Ross; Eames, Catrin; Crane, Rebecca

2018-01-01

A growing body of research supports the efficacy of mindfulness-based interventions (MBIs). MBIs consider home-practice as essential to increasing the therapeutic effects of the treatment. To date however, the synthesis of the research conducted on the role of home-practice in controlled MBI studies has been a neglected area. This review aimed to conduct a narrative synthesis of published controlled studies, evaluating mindfulness-based group interventions, which have specifically measured home-practice. Empirical research literature published until June 2016 was searched using five databases. The search strategy focused on mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), and home-practice. Included studies met the following criteria: controlled trials, participants 18 years and above, evaluations of MBSR or MBCT, utilised standardised quantitative outcome measures and monitored home-practice using a self-reported measure. Fourteen studies met the criteria and were included in the review. Across all studies, there was heterogeneity in the guidance and resources provided to participants and the approaches used for monitoring home-practice. In addition, the guidance on the length of home-practice was variable across studies, which indicates that research studies and teachers are not adhering to the published protocols. Finally, only seven studies examined the relationship between home-practice and clinical outcomes, of which four found that home-practice predicted improvements on clinical outcome measures. Future research should adopt a standardised approach for monitoring home-practice across MBIs. Additionally, studies should assess whether the amount of home-practice recommended to participants is in line with MBSR/MBCT manualised protocols. Finally, research should utilise experimental methodologies to explicitly explore the relationship between home-practice and clinical outcomes.

75 FR 50801 - Reverse Mortgage Products: Guidance for Managing Compliance and Reputation Risks

Science.gov (United States)

2010-08-17

... recommended in this guidance when advertising reverse mortgages through certain forms of media, such as radio... organization commenter urged that loan originators should ensure that brokers do not advertise reverse... borrower was 73 years old, had a home valued at $261,500, and had financial assets of less than $33,000...

42 CFR 440.70 - Home health services.

Science.gov (United States)

2010-10-01

... an acute illness to avoid the recipient's transfer to a nursing facility. (d) “Home health agency... 42 Public Health 4 2010-10-01 2010-10-01 false Home health services. 440.70 Section 440.70 Public...) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services. (a...

PREPARING THE PUBLIC FOR COMMERCIALIZATION AND GUIDANCE OF STRUCTURAL MEDIA SPACE TOWARDS ITS FUSION WITH ADVERTISING SPACE

Directory of Open Access Journals (Sweden)

Marina Đukić

2015-07-01

Full Text Available Through genre structure analysis of the Television´s Zagreb First Channel schedule from the beginning of 1970´s till the end of the 1980´s accompanied by analysis of advertising in same period, the paper will examine the ways and intensity of commercialization entrance in Croatian media space dominated then by state media. Television schedule genre change and the broadcast of economic propaganda program will point out the different character of the television. It can be said that it will serve for preparing the public for commercialization entrance and guidance of structural media space towards its fusion with advertising one. The assumption is that in spite of the TV schedule change, which was in economic sense accompanied by economy reforms in order to establish market economy, the public wasn´t yet delivered to advertisers. One of the clarification lies in the role of the media, which then had revolutionary function with main purpose of not the voters’ generation but only to create patriots. The paper will reproduce a kind of public transformation genesis from latent status in state guided media system to same status of latent consumers in dual media model.

Research on the model of home networking

Science.gov (United States)

Yun, Xiang; Feng, Xiancheng

2007-11-01

It is the research hotspot of current broadband network to combine voice service, data service and broadband audio-video service by IP protocol to transport various real time and mutual services to terminal users (home). Home Networking is a new kind of network and application technology which can provide various services. Home networking is called as Digital Home Network. It means that PC, home entertainment equipment, home appliances, Home wirings, security, illumination system were communicated with each other by some composing network technology, constitute a networking internal home, and connect with WAN by home gateway. It is a new network technology and application technology, and can provide many kinds of services inside home or between homes. Currently, home networking can be divided into three kinds: Information equipment, Home appliances, Communication equipment. Equipment inside home networking can exchange information with outer networking by home gateway, this information communication is bidirectional, user can get information and service which provided by public networking by using home networking internal equipment through home gateway connecting public network, meantime, also can get information and resource to control the internal equipment which provided by home networking internal equipment. Based on the general network model of home networking, there are four functional entities inside home networking: HA, HB, HC, and HD. (1) HA (Home Access) - home networking connects function entity; (2) HB (Home Bridge) Home networking bridge connects function entity; (3) HC (Home Client) - Home networking client function entity; (4) HD (Home Device) - decoder function entity. There are many physical ways to implement four function entities. Based on theses four functional entities, there are reference model of physical layer, reference model of link layer, reference model of IP layer and application reference model of high layer. In the future home network

Approaches to quality improvement in nursing homes: Lessons learned from the six-state pilot of CMS's Nursing Home Quality Initiative

Directory of Open Access Journals (Sweden)

Palmer Laura

2003-05-01

Full Text Available Abstract Background In November 2002, the Centers for Medicare & Medicaid Services (CMS launched a Nursing Home Quality Initiative that included publicly reporting a set of Quality Measures for all nursing homes in the country, and providing quality improvement assistance to nursing homes nationwide. A pilot of this initiative occurred in six states for six months prior to the launch. Methods Review and analysis of the lessons learned from the six Quality Improvement Organizations (QIOs that led quality improvement efforts in nursing homes from the six pilot states. Results QIOs in the six pilot states found several key outcomes of the Nursing Home Quality Initiative that help to maximize the potential of public reporting to leverage effective improvement in nursing home quality of care. First, public reporting focuses the attention of all stakeholders in the nursing home industry on achieving good quality outcomes on a defined set of measures, and creates an incentive for partnership formation. Second, publicly reported quality measures motivate nursing home providers to improve in certain key clinical areas, and in particular to seek out new ways of changing processes of care, such as engaging physicians and the medical director more directly. Third, the lessons learned by QIOs in the pilot of this Initiative indicate that certain approaches to providing quality improvement assistance are key to guiding nursing home providers' desire and enthusiasm to improve towards a using a systematic approach to quality improvement. Conclusion The Nursing Home Quality Initiative has already demonstrated the potential of public reporting to foster collaboration and coordination among nursing home stakeholders and to heighten interest of nursing homes in quality improvement techniques. The lessons learned from this pilot project have implications for any organizations or individuals planning quality improvement projects in the nursing home setting.

Rights of patients required in a public service ombudsman

Directory of Open Access Journals (Sweden)

Maristela Santini Martins

2015-07-01

Full Text Available Objective: analyzing the rights of patients required in a public service ombudsmen. Methods: an exploratory, descriptive study of documentary research. 109 complaint forms coming from the basic network were analyzed, related to 12 Basic Health Units located within the Southern Health Technical Supervision. Results: grouped into four categories of required rights: access to goods and services (62.4% being, access to specialized exams (28.7%, access to consultations (16.6%, referral to a specialist (5.7%, referral for urgent/emergency cases (1.3%, monitoring through home visits (7.6%, guaranteed medications (2.5%. Quality of health services (36.9% divided into: decent, considerate and respectful care (26.8%, guidance/clarification (9.6%, and public disclosure of government programs (0.6% and adequate infrastructure (0.6%. Conclusion: the rights that patients required are related to access, quality, treatment and adequate infrastructure.

An Evaluation of Unemployment Reduction in Akwa Ibom State using Career Guidance and Counselling

OpenAIRE

Nsikak-Abasi Udofia; Eno Daniel Inyang

2013-01-01

This study was carried out to examine the possibility of reducing unemployment in Akwa Ibom State using career guidance and counselling interventions. To guide the study, four research questions and four null hypotheses were formulated. Variables such as educational guidance, vocational, personality trait guidance and sociological guidance were used in the investigation. A survey design was used in studying a population of 6509 senior secondary two students in 58 public secondary schools that...

Living and ageing in the technological landscapes of homes and public places - an international perspective

DEFF Research Database (Denmark)

Helle, Tina; Kottorp, Anders; Gudetti, Susanne

upon the use of new, innovative assessments and intervention strategies to address ET use and public places, and understand how these can support evidence-based intervention planning in practice. Methods: The teaching methods will be interactive sessions based upon open-space methodology, using: (1...... and participation in public places for people with functional impairments, while little is still known of the cognitive aspects of accessibility. In order to access and use homes and public spaces (including health care services, crucial challenges are associated with technology, both everyday technology (e.g. cell...... places for the target group of his/her practice, (2) Reflect upon challenges in access/use of public places and ET from a multicultural perspective , (3) Know about current international research in occupational therapy in this area, and how this can be implemented into his/her practice, and (4) Reflect...

Perilaku Agresif Siswa dari Keluarga Broken Home

Directory of Open Access Journals (Sweden)

Randi Pratama

2016-12-01

Full Text Available This research is based because of the aggressive behavior shown by the students, especially students who come from a broken home. The purpose of this study is to describe the aggressive behavior that is owned by a student who comes from a broken home in terms of attacking people physically, verbally, and damaging and destroying property and wealth of others. The results of this research shows that in general student’s aggressivebehavior are on average level. Implications of research in guidance and counseling is as the basis for programs to prevent and cope with aggressive behavior that is owned by the students, especially students who come from a broken home. Cooperation with the homeroom teacher mentors, teachers and other school personnel will also help identify students who have an aggressive behavior, especially students who come from a broken home to immediately provided services.

42 CFR 441.15 - Home health services.

Science.gov (United States)

2010-10-01

... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this subchapter, a State plan must provide that— (a) Home health services include, as a minimum— (1) Nursing services... 42 Public Health 4 2010-10-01 2010-10-01 false Home health services. 441.15 Section 441.15 Public...

Towards a new approach to model guidance laws

International Nuclear Information System (INIS)

Borne, P.; Duflos, E.; Vanheeghe, P.

1994-01-01

Proportional navigation laws have been widely used and studied. Nevertheless very few publications explain rigorously the origin of all these laws. For researchers who are starting to work on guidance laws, a feeling of confusion can result. For others, this lack of explanation can be, for example, the source of the difficulties to make the true proportional navigation become equivalent to the pure proportional navigation. The authors propose here a way to model guidance laws in order to fill this lack of explanation. The first consequence is a better exploration of the kinematic behaviors arising during the guidance process. The second consequence is the definition of a new 3D guidance law which can be seen as a generalization of the true proportional navigation. Moreover, this generalization allow this last law to become equivalent to the pure proportional navigation in terms of initial conditions which allow the object to reach its target

Technical Barriers, Gaps, and Opportunities Related to Home Energy Upgrade Market Delivery

Energy Technology Data Exchange (ETDEWEB)

Bianchi, M. V. A.

2011-11-01

This report outlines the technical barriers, gaps, and opportunities that arise in executing home energy upgrade market delivery approaches, as identified through research conducted by the U.S. Department of Energy's Building America program. The objective of this report is to outline the technical1 barriers, gaps, and opportunities that arise in executing home energy upgrade market delivery approaches, as identified through research conducted by the U.S. Department of Energy's (DOE) Building America program. This information will be used to provide guidance for new research necessary to enable the success of the approaches. Investigation for this report was conducted via publications related to home energy upgrade market delivery approaches, and a series of interviews with subject matter experts (contractors, consultants, program managers, manufacturers, trade organization representatives, and real estate agents). These experts specified technical barriers and gaps, and offered suggestions for how the technical community might address them. The potential benefits of home energy upgrades are many and varied: reduced energy use and costs; improved comfort, durability, and safety; increased property value; and job creation. Nevertheless, home energy upgrades do not comprise a large part of the overall home improvement market. Residential energy efficiency is the most complex climate intervention option to deliver because the market failures are many and transaction costs are high (Climate Change Capital 2009). The key reasons that energy efficiency investment is not being delivered are: (1) The opportunity is highly fragmented; and (2) The energy efficiency assets are nonstatus, low-visibility investments that are not properly valued. There are significant barriers to mobilizing the investment in home energy upgrades, including the 'hassle factor' (the time and effort required to identify and secure improvement works), access to financing, and the

77 FR 14507 - Revision to Guidance, “Federal Greenhouse Gas Accounting and Reporting”

Science.gov (United States)

2012-03-12

... accounting procedures. CEQ provides this draft revision of the guidance for public review and comment to... COUNCIL ON ENVIRONMENTAL QUALITY Revision to Guidance, ``Federal Greenhouse Gas Accounting and..., ``Federal Greenhouse Gas Accounting and Reporting''. SUMMARY: On October 5, 2009, President Obama signed...

Guidance on Port Biological Baseline Surveys (PBBS)

Digital Repository Service at National Institute of Oceanography (India)

Awad, A.; Haag, F.; Anil, A.C.; Abdulla, A.

This publication has been prepared by GBP, IOI, CSIR-NIO and IUCN in order to serve as guidance to those who are planning to carry out a port biological baseline survey, in particular in the context of Ballast Water Management. It has been drafted...

Dosimetric Significance of the ICRP's Updated Guidance and Models, 1989-2003, and Implications for U.S. Federal Guidance

Energy Technology Data Exchange (ETDEWEB)

Leggett, R.W.

2003-09-10

Over the past two decades the U.S. Environmental Protection Agency (EPA) has issued a series of Federal guidance documents for the purpose of providing the Federal and State agencies with technical information to assist their implementation of radiation protection programs. Currently recommended dose conversion factors, annual limits on intake, and derived air concentrations for intake of radionuclides are tabulated in Federal Guidance Report No. 11 (FGR 11), published in 1988. The tabulations in FGR 11 were based on dosimetric quantities and biokinetic and dosimetric models of the International Commission on Radiological Protection (ICRP) developed for application to occupational exposures. Since the publication of FGR 11 the ICRP has revised some of its dosimetric quantities and its models for workers and has also developed age-specific models and dose conversion factors for intake of radionuclides by members of the public. This report examines the extent of the changes in the inhalation and ingestion dose coefficients of FGR 11 implied by the updated recommendations of the ICRP, both for workers and members of the public.

Impact of NICE guidance on rates of haemorrhage after tonsillectomy: an evaluation of guidance issued during an ongoing national tonsillectomy audit.

Science.gov (United States)

Audit, National Prospective Tonsillectomy

2008-08-01

The National Institute for Health and Clinical Excellence (NICE) issued guidance on surgical techniques for tonsillectomy during a national audit of surgical practice and postoperative complications. To assess the impact of the guidance on tonsillectomy practice and outcomes. An interrupted time-series analysis of routinely collected Hospital Episodes Statistics data, and an analysis of longitudinal trends in surgical technique using data from the National Prospective Tonsillectomy Audit. Patients undergoing tonsillectomy in English NHS hospitals between January 2002 and December 2004. Postoperative haemorrhage within 28 days. The rate of haemorrhage increased by 0.5% per year from 2002, reaching 6.4% when the guidance was published. After publication, the rate of haemorrhage fell immediately to 5.7% (difference 0.7%: 95% CI -1.3% to 0.0%) and the rate of increase appeared to have stopped. Data from the National Prospective Tonsillectomy Audit showed that the fall coincided with a shift in surgical techniques, which was consistent with the guidance. NICE guidance influenced surgical tonsillectomy technique and in turn produced an immediate fall in postoperative haemorrhage. The ongoing national audit and strong support from the surgical specialist association may have aided its implementation.

77 FR 74195 - Draft Guidance for Industry and Food and Drug Administration Staff; Design Considerations for...

Science.gov (United States)

2012-12-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-D-1161] Draft Guidance for Industry and Food and Drug Administration Staff; Design Considerations for Devices Intended for Home Use; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The...

Emergency Medical Services Public Health Implications and Interim Guidance for the Ebola Virus in the United States

Directory of Open Access Journals (Sweden)

Christopher E. McCoy

2014-11-01

Full Text Available The 25th known outbreak of the Ebola Virus Disease (EVD is now a global public health emergency and the World Health Organization (WHO has declared the epidemic to be a Public Health Emergency of International Concern (PHEIC. Since the first cases of the West African epidemic were reported in March 2014, there has been an increase in infection rates of over 13,000% over a 6-month period. The Ebola virus has now arrived in the United States and public health professionals, doctors, hospitals, Emergency Medial Services Administrators, Medical Directors, and policy makers have been working with haste to develop strategies to prevent the disease from reaching epidemic proportions. Prehospital care providers (emergency medical technicians and paramedics and medical first responders (including but not limited to firefighters and law enforcement are the healthcare systems front lines when it comes to first medical contact with patients outside of the hospital setting. Risk of contracting Ebola can be particularly high in this population of first responders if the appropriate precautions are not implemented. This article provides a brief clinical overview of the Ebola Virus Disease and provides a comprehensive summary of the Center for Disease Control and Prevention’s Interim Guidance for Emergency Medical Services (EMS Systems and 9-1-1 Public Safety Answering Points (PSAPS for Management of Patients with Known of Suspected Ebola Virus Disease in the United States. [West J Emerg Med. 2014;15(7:-0.

Perception of quality of care among residents of public nursing-homes in Spain: a grounded theory study.

Science.gov (United States)

Rodríguez-Martín, Beatriz; Martínez-Andrés, María; Cervera-Monteagudo, Beatriz; Notario-Pacheco, Blanca; Martínez-Vizcaíno, Vicente

2013-06-28

The quality of care in nursing homes is weakly defined, and has traditionally focused on quantify nursing homes outputs and on comparison of nursing homes' resources. Rarely the point of view of clients has been taken into account. The aim of this study was to ascertain what means "quality of care" for residents of nursing homes. Grounded theory was used to design and analyze a qualitative study based on in-depth interviews with a theoretical sampling including 20 persons aged over 65 years with no cognitive impairment and eight proxy informants of residents with cognitive impairment, institutionalized at a public nursing home in Spain. Our analysis revealed that participants perceived the quality of care in two ways, as aspects related to the persons providing care and as institutional aspects of the care's process. All participants agreed that aspects related to the persons providing care was a pillar of quality, something that, in turn, embodied a series of emotional and technical professional competences. Regarding the institutional aspects of the care's process, participants laid emphasis on round-the-clock access to health care services and on professional's job stability. This paper includes perspectives of the nursing homes residents, which are largely absent. Incorporating residents' standpoints as a complement to traditional institutional criteria would furnish health providers and funding agencies with key information when it came to designing action plans and interventions aimed at achieving excellence in health care.

Can organisations learn without political leadership? The case of public sector reform among South African Home Affairs officials

NARCIS (Netherlands)

Segatti, A.; Hoag, C.; Vigneswaran, D.

2012-01-01

This paper deals with the transformation of "institutional culture" in bureaucratic agencies. This is explored in the context of post-Apartheid South African public sector reform, and more particularly that of migration management within the Department of Home Affairs (DHA). The paper assesses the

Enhancing the Public Image of School Counseling: A Marketing Approach.

Science.gov (United States)

Ritchie, Martin H.

1989-01-01

Suggests some basic marketing principles that might be applied to assist school counselors in selling their guidance programs to the public. Discusses assessing the needs and demands for guidance services, product development and defining the guidance program, pricing, distribution, and advertising and public relations. (NB)

Public health and English local government: historical perspectives on the impact of 'returning home'.

Science.gov (United States)

Gorsky, Martin; Lock, Karen; Hogarth, Sue

2014-12-01

This article uses history to stimulate reflection on the present opportunities and challenges for public health practice in English local government. Its motivation is the paradox that despite Department of Health policy-makers' allusions to 'a long and proud history' and 'returning public health home' there has been no serious discussion of that past local government experience and what we might learn from it. The article begins with a short resumé of the achievements of Victorian public health in its municipal location, and then considers the extensive responsibilities that it developed for environmental, preventive and health services by the mid-twentieth century. The main section discusses the early NHS, explaining why historians see the era as one of decline for the speciality of public health, leading to the reform of 1974, which saw the removal from local government and the abolition of the Medical Officer of Health role. Our discussion focuses on challenges faced before 1974 which raise organizational and political issues relevant to local councils today as they embed new public health teams. These include the themes of leadership, funding, integrated service delivery, communication and above all the need for a coherent vision and rationale for public health action in local authorities. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health.

EMP Attachment 3 DOE-SC PNNL Site Dose Assessment Guidance

Energy Technology Data Exchange (ETDEWEB)

Snyder, Sandra F.

2011-12-21

This Dose Assessment Guidance (DAG) describes methods to use to determine the Maximally-Exposed Individual (MEI) location and to estimate dose impact to that individual under the U.S. Department of Energy Office of Science (DOE-SC) Pacific Northwest National Laboratory (PNNL) Site Environmental Monitoring Plan (EMP). This guidance applies to public dose from radioactive material releases to the air from PNNL Site operations. This document is an attachment to the Pacific Northwest National Laboratory (PNNL) Environmental Monitoring Plan (EMP) and describes dose assessment guidance for radiological air emissions. The impact of radiological air emissions from the U.S. Department of Energy Office of Science (DOE-SC) PNNL Site is indicated by dose estimates to a maximally exposed member of the public, referred to as the maximally exposed individual (MEI). Reporting requirements associated with dose to members of the public from radiological air emissions are in 40 CFR Part 61.94, WAC 246-247-080, and DOE Order 458.1. The DOE Order and state standards for dose from radioactive air emissions are consistent with U.S. Environmental Protection Agency (EPA) dose standards in 40 CFR 61.92 (i.e., 10 mrem/yr to a MEI). Despite the fact that the current Contract Requirements Document (CRD) for the DOE-SC PNNL Site operations does not include the requirement to meet DOE CRD 458.1, paragraph 2.b, public dose limits, the DOE dose limits would be met when EPA limits are met.

HUMAN FACTORS GUIDANCE FOR CONTROL ROOM EVALUATION

International Nuclear Information System (INIS)

OHARA, J.; BROWN, W.; STUBLER, W.; HIGGINS, J.; WACHTEL, J.; PERSENSKY, J.J.

2000-01-01

The Human-System Interface Design Review Guideline (NUREG-0700, Revision 1) was developed by the US Nuclear Regulatory Commission (NRC) to provide human factors guidance as a basis for the review of advanced human-system interface technologies. The guidance consists of three components: design review procedures, human factors engineering guidelines, and a software application to provide design review support called the ''Design Review Guideline.'' Since it was published in June 1996, Rev. 1 to NUREG-0700 has been used successfully by NRC staff, contractors and nuclear industry organizations, as well as by interested organizations outside the nuclear industry. The NRC has committed to the periodic update and improvement of the guidance to ensure that it remains a state-of-the-art design evaluation tool in the face of emerging and rapidly changing technology. This paper addresses the current research to update of NUREG-0700 based on the substantial work that has taken place since the publication of Revision 1

Home | SREL Herpetology Program

Science.gov (United States)

Savannah River Ecology Laboratory Herpetology Program Herp Home Research Publications Herps of SC /GA P.A.R.C. Outreach SREL Home powered by Google Search Herpetology at SREL The University of SREL herpetology research programs have always included faculty of the University of Georgia, post

International guidance activities

International Nuclear Information System (INIS)

Richardson, Allan C.B.

1989-01-01

International principles for setting Protective Action Guides (PAGs) are contained in two key documents that contain identical statements. One is Publication Number 40 of the ICRP, which was issued in 1985. The title is 'Protection of the Public in the Event of Major Radiation Accidents, Principles for Planning'. The other is the IAEA's Safety Series Publication Number 72, also issued in 1985, written by many of the same authors and titled, 'Principles for Establishing Intervention Levels'. The principles that were set forth in these documents were identical, were incomplete, and they are, unfortunately, the only principles that are now in effect, while proposed revisions go through one draft after another. There are several such draft revisions that are of significance. The most important is that of the ICRP. The basic guidance that applies to most planned exposure to radiation is ICRP Publication 26. That document has been under revision by the Commission for a number of years, and the new version will, for the first time, include recommendations for emergency response. They are now getting close to closure, and I think it should be a very much improved and useful document. But it isn't finished yet. Such guidance doesn't get developed in a vacuum, and there have been a couple of parallel efforts which have provided significant input to the ICRP, which is essentially a behind-closed-doors effort. These other efforts are more open. One of these is being carried out within the IAEA, which has convened annual meetings of national experts for a number of years in Vienna, to generate a replacement for Safety Series No. 72, mentioned earlier. There is a meeting scheduled this December to complete this effort; and, hopefully, we will reach closure at that meeting on at least the basic principles. The Nuclear Energy Agency (NEA) has also been at work. It has convened a group of experts from member nations that have been developing recommendations. There is an overlap

The Technology Acceptance of a TV Platform for the Elderly Living Alone or in Public Nursing Homes.

Science.gov (United States)

Santana-Mancilla, Pedro C; Anido-Rifón, Luis E

2017-06-08

In Mexico, many seniors are alone for most of the day or live in public nursing homes. Simple interaction with computer systems is required for older people. This is why we propose the exploration of a medium well known by seniors, such as the television (TV). The primary objective of this study is to improve the quality of life of seniors through an easier reminder system, using the television set. A technological platform was designed based on interactive television, through which seniors and their caregivers can have a better way to track their daily activities. Finally, an evaluation of the technology adoption was performed with 50 seniors living in two public nursing homes. The evaluation found that the elderly perceived the system as useful, easy to use, and they had a positive attitude and good intention to use it. This helped to generate initial evidence that the system supported them in achieving a better quality of life, by reminding them to take their medications and increasing their rate of attendance to their medical appointments.

Guidance on future art commissioning.

Science.gov (United States)

2009-05-01

Delegates at Building Better Healthcare's recent "National Patient Environment and the Arts Conference 2009" in London heard how national public arts think tank ixia has appointed Bristol-based arts and wellbeing development agency Willis Newson to write "concise and convincing guidance" on commissioning art for new healthcare facilities. A key message, during a joint presentation, was that integrating artwork into hospitals and other healthcare premises requires the earliest possible consideration to reap the maximum rewards.

Can a publicly funded home care system successfully allocate service based on perceived need rather than socioeconomic status? A Canadian experience.

Science.gov (United States)

Laporte, Audrey; Croxford, Ruth; Coyte, Peter C

2007-03-01

The present quantitative study evaluates the degree to which socioeconomic status (SES), as opposed to perceived need, determines utilisation of publicly funded home care in Ontario, Canada. The Registered Persons Data Base of the Ontario Health Insurance Plan was used to identify the age, sex and place of residence for all Ontarians who had coverage for the complete calendar year 1998. Utilisation was characterised in two dimensions: (1) propensity - the probability that an individual received service, which was estimated using a multinomial logit equation; and (2) intensity - the amount of service received, conditional on receipt. Short- and long-term service intensity were modelled separately using ordinary least squares regression. Age, sex and co-morbidity were the best predictors (P funded home care as well as how much care was received, with sicker individuals having increased utilisation. The propensity and intensity of service receipt increased with lower SES (P funded home care service was primarily based on perceived need rather than ability to pay, barriers to utilisation for those from areas with a high proportion of recent immigrants were identified. Future research is needed to assess whether the current mix and level of publicly funded resources are indeed sufficient to offset the added costs associated with the provision of high-quality home care.

75 FR 3959 - Fifth Meeting-RTCA Special Committee 220: Automatic Flight Guidance and Control

Science.gov (United States)

2010-01-25

... 220: Automatic Flight Guidance and Control AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of RTCA Special Committee 220: Automatic Flight Guidance and Control meeting. SUMMARY: The FAA is issuing this notice to advise the public of a meeting of RTCA Special Committee 220: Automatic Flight...

76 FR 30175 - Draft Guidance for Clinical Investigators, Industry, and FDA Staff: Financial Disclosure by...

Science.gov (United States)

2011-05-24

... consider public release of financial disclosure information related to an approved marketing application...] (Formerly FDA-1999-D-0792) Draft Guidance for Clinical Investigators, Industry, and FDA Staff: Financial... entitled ``Guidance for Clinical Investigators, Industry, and FDA Staff: Financial Disclosure by Clinical...

Moisture Control Guidance for Commercial and Public Buildings (EPA 402-F-13053)

Science.gov (United States)

This document provides guidance to designers, construction mangers, and building operation/maintenance managers to improve IEQ and reduce risks of encountering IEQ problems due to insufficient moisture control. EPA will be producing a document entitled "Moisture Control Guida...

Security in the transport of radioactive material - interim guidance for comment

International Nuclear Information System (INIS)

Legoux, P.; Wangler, M.

2004-01-01

While the IAEA has provided specific guidance for physical protection in the transport of nuclear material, its previous publications have only provided some general guidelines for security of non-nuclear radioactive material in transport. Some basic practical advice has been provided in the requirements of the International Basic Safety Standards for Protection against Ionising Radiation and for the Safety of Radiation Sources (BSS) [1]. These guidelines were primarily directed toward such issues as unintentional exposure to radiation, negligence and inadvertent loss. Recently, the IAEA published a document on the security of sources, which included some general guidance on providing security during transport of the sources. However, it is clear that more guidance is needed for security during the transport of radioactive material in addition to those already existing for nuclear material. Member States have requested guidance on the type and nature of security measures that might be put in place for radioactive material in general during its transport and on the methodology to be used in choosing and implementing such measures. The purpose of the TECDOC on Security in the Transport of Radioactive Material being developed by the IAEA is to provide an initial response to that request. This interim guidance is being developed with a view to harmonizing the security guidance - as much as possible - with existing guidance from the IAEA for the transport of radioactive sources and nuclear material. It is also intended to harmonize with model requirements developed in 2002-2003 by the United Nations Economic and Social Council's Committee of Experts on the Transport of Dangerous Goods and on the Globally Harmonised System of Classification and Labelling of Chemicals which was issued as general security guidelines for all dangerous goods, including radioactive material, and that will shortly be implemented as binding regulations by the international modal authorities

Security in the transport of radioactive material - interim guidance for comment

Energy Technology Data Exchange (ETDEWEB)

Legoux, P.; Wangler, M. [International Atomic Energy Agency, Vienna (Austria)

2004-07-01

While the IAEA has provided specific guidance for physical protection in the transport of nuclear material, its previous publications have only provided some general guidelines for security of non-nuclear radioactive material in transport. Some basic practical advice has been provided in the requirements of the International Basic Safety Standards for Protection against Ionising Radiation and for the Safety of Radiation Sources (BSS) [1]. These guidelines were primarily directed toward such issues as unintentional exposure to radiation, negligence and inadvertent loss. Recently, the IAEA published a document on the security of sources, which included some general guidance on providing security during transport of the sources. However, it is clear that more guidance is needed for security during the transport of radioactive material in addition to those already existing for nuclear material. Member States have requested guidance on the type and nature of security measures that might be put in place for radioactive material in general during its transport and on the methodology to be used in choosing and implementing such measures. The purpose of the TECDOC on Security in the Transport of Radioactive Material being developed by the IAEA is to provide an initial response to that request. This interim guidance is being developed with a view to harmonizing the security guidance - as much as possible - with existing guidance from the IAEA for the transport of radioactive sources and nuclear material. It is also intended to harmonize with model requirements developed in 2002-2003 by the United Nations Economic and Social Council's Committee of Experts on the Transport of Dangerous Goods and on the Globally Harmonised System of Classification and Labelling of Chemicals which was issued as general security guidelines for all dangerous goods, including radioactive material, and that will shortly be implemented as binding regulations by the international modal

[Family caregivers' adjustment to nursing home placement of older relatives].

Science.gov (United States)

Wang, Szu-Yao; Davies, Elizabeth

2007-06-01

The literature on the impact of nursing home placement of older parents on family caregivers is still incomplete. Family caregivers experience stress, shock, anxiety, fear, resistance, and guilt in the process of decision making. The literature has demonstrated that family caregivers continue to experience stress and problems after placing older relatives into a long term care facility. Cultural values impact on people's attitudes, values and expectations. Culture will therefore affect the care-giving experience. Relatively little information is available from Asian and multicultural societies. Identifying family caregiver experiences after nursing home placement can alert professionals to the need for family guidance prior to nursing home placement and assist in early identification of potential problems. This article reviews the literature and discusses the impact on family caregivers of making a decision for nursing home placement and dealing with the stress and challenges that persist after nursing home admission.

Review of soil contamination guidance

International Nuclear Information System (INIS)

Mueller, M.A.; Kennedy, W.E. Jr.; Soldat, J.K.

1981-08-01

A review of existing and proposed radioactive soil contamination standards and guidance was conducted for United Nuclear Corporation (UNC), Office of Surplus Facilities Management. Information was obtained from both government agencies and other sources during a literature survey. The more applicable standards were reviewed, evaluated, and summarized. Information pertaining to soil contamination for both facility operation and facility decommissioning was obtained from a variety of sources. These sources included: the Code of Federal Regulations, regulatory guides, the Federal Register, topical reports written by various government agencies, topical reports written by national laboratories, and publications from the American National Standards Institute (ANSI). It was difficult to directly compare the standards and guidance obtained from these sources since each was intended for a specific situation and different units or bases were used. However, most of the information reviewed was consistent with the philosophy of maintaining exposures at levels as low as reasonably achievable

DOE Zero Energy Ready Home Case Study: Mandalay Homes, Phoenix, Arizona

Energy Technology Data Exchange (ETDEWEB)

none,

2013-09-01

This builder built fourteen homes in the Gordon Estates subdivision that achieved Challenge Home certification with HERS 38–58 on an affordable budget for homeowners. Every Mandalay home in the development also met the National Green Building Standard gold level. The Gordon Estates subdivision is also serving as a showcase of energy efficiency, and Mandalay is hosting education workshops for realtors, state and local officials, other builders, students, potential homeowners, and the public. The builder won a 2013 Housing Innovation Award in the affordable builder category.

41 CFR 102-33.75 - What other guidance is available to us in planning to acquire Government aircraft?

Science.gov (United States)

2010-07-01

... Parts Planning to Acquire Government Aircraft § 102-33.75 What other guidance is available to us in... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What other guidance is available to us in planning to acquire Government aircraft? 102-33.75 Section 102-33.75 Public Contracts and...

Interactive application of a virtual smart home

NARCIS (Netherlands)

Allameh, E.; Heidari Jozam, M.; Vries, de B.; Timmermans, H.J.P.

2014-01-01

Smart Homes confront many challenges trying to move from vision to reality. Poor understanding of the concept of Smart Homes by both designers and end users causes many challenges in accepting smart homes by public. To overcome this problem, user participation in Smart Home design is advocated. On

The Vocational Guidance Research Database: A Scientometric Approach

Science.gov (United States)

Flores-Buils, Raquel; Gil-Beltran, Jose Manuel; Caballer-Miedes, Antonio; Martinez-Martinez, Miguel Angel

2012-01-01

The scientometric study of scientific output through publications in specialized journals cannot be undertaken exclusively with the databases available today. For this reason, the objective of this article is to introduce the "Base de Datos de Investigacion en Orientacion Vocacional" [Vocational Guidance Research Database], based on the…

Implementation of NUREG-1318 guidance within the Yucca Mountain Project

International Nuclear Information System (INIS)

La Monica, L.B.; Waddell, J.D.; Hardin, E.L.

1990-01-01

The US Department of Energy's Yucca Mountain Project is implementing a quality assurance program that fulfills the requirements of the US Nuclear Regulatory Commission (NRC). Additional guidance for this program was provided in NUREG 1318, ''Technical Position on Items and Activities in the High-Level Waste Geologic Repository Program Subject to Quality Assurance Requirements'' for identification of items and activities important to public radiological safety and waste isolation. The process and organization for implementing this guidance is discussed. 3 refs., 2 figs

[Analysis of public quality reports for home care and long-term care with respect to their usefulness for the customer].

Science.gov (United States)

Sünderkamp, Susanne; Weiß, Christian; Rothgang, Heinz

2014-10-01

Public quality reports, based on new legislative regulations of 2008, were supposed to offer potential customers the possibility to make a well-informed choice of a care provider. This empirical study on marks for long-term care is based on the public quality reports of the Medical Service of the Health Insurance Companies (MDK), of 11 884 home care services and 10 310 nursing homes, which corresponds to a comprehensive survey of almost all care providers in Germany. Descriptive statistical methods and discussion of the results concerning the customer benefit. The analysis of transparency reports reveals a limited value for customers, which is particularly caused by very good quality results with low scattering. In addition, a high amount of missing data - especially in the area of home care providers - leads to a growing influence of service criteria on the final grade. Though deficits in nursing might be compensated by good marks in service criteria, it rarely occurs. At present, a more detailed look at risk criteria hardly improves the customer benefit. The marks for nursing need to be improved to increase their informative value for the customer.

Education and Public Outreach for Stardust@home: An Interactive Internet-based Search for Interstellar Dust

Science.gov (United States)

Mendez, Bryan J.; Westphal, A. J.; Butterworth, A. L.; Craig, N.

2006-12-01

On January 15, 2006, NASA’s Stardust mission returned to Earth after nearly seven years in interplanetary space. During its journey, Stardust encountered comet Wild 2, collecting dust particles from it in a special material called aerogel. At two other times in the mission, aerogel collectors were also opened to collect interstellar dust. The Stardust Interstellar Dust Collector is being scanned by an automated microscope at the Johnson Space Center. There are approximately 700,000 fields of view needed to cover the entire collector, but we expect only a few dozen total grains of interstellar dust were captured within it. Finding these particles is a daunting task. We have recruited many thousands of volunteers from the public to aid in the search for these precious pieces of space dust trapped in the collectors. We call the project Stardust@home. Through Stardust@home, volunteers from the public search fields of view from the Stardust aerogel collector using a web-based Virtual Microscope. Volunteers who discover interstellar dust particles have the privilege of naming them. The interest and response to this project has been extraordinary. Many people from all walks of life are very excited about space science and eager to volunteer their time to contribute to a real research project such as this. We will discuss the progress of the project and the education and outreach activities being carried out for it.

Guidance and Control Software Project Data - Volume 1: Planning Documents

Science.gov (United States)

Hayhurst, Kelly J. (Editor)

2008-01-01

The Guidance and Control Software (GCS) project was the last in a series of software reliability studies conducted at Langley Research Center between 1977 and 1994. The technical results of the GCS project were recorded after the experiment was completed. Some of the support documentation produced as part of the experiment, however, is serving an unexpected role far beyond its original project context. Some of the software used as part of the GCS project was developed to conform to the RTCA/DO-178B software standard, "Software Considerations in Airborne Systems and Equipment Certification," used in the civil aviation industry. That standard requires extensive documentation throughout the software development life cycle, including plans, software requirements, design and source code, verification cases and results, and configuration management and quality control data. The project documentation that includes this information is open for public scrutiny without the legal or safety implications associated with comparable data from an avionics manufacturer. This public availability has afforded an opportunity to use the GCS project documents for DO-178B training. This report provides a brief overview of the GCS project, describes the 4-volume set of documents and the role they are playing in training, and includes the planning documents from the GCS project. Volume 1 contains five appendices: A. Plan for Software Aspects of Certification for the Guidance and Control Software Project; B. Software Development Standards for the Guidance and Control Software Project; C. Software Verification Plan for the Guidance and Control Software Project; D. Software Configuration Management Plan for the Guidance and Control Software Project; and E. Software Quality Assurance Activities.

Guidance and Control Software Project Data - Volume 3: Verification Documents

Science.gov (United States)

Hayhurst, Kelly J. (Editor)

2008-01-01

The Guidance and Control Software (GCS) project was the last in a series of software reliability studies conducted at Langley Research Center between 1977 and 1994. The technical results of the GCS project were recorded after the experiment was completed. Some of the support documentation produced as part of the experiment, however, is serving an unexpected role far beyond its original project context. Some of the software used as part of the GCS project was developed to conform to the RTCA/DO-178B software standard, "Software Considerations in Airborne Systems and Equipment Certification," used in the civil aviation industry. That standard requires extensive documentation throughout the software development life cycle, including plans, software requirements, design and source code, verification cases and results, and configuration management and quality control data. The project documentation that includes this information is open for public scrutiny without the legal or safety implications associated with comparable data from an avionics manufacturer. This public availability has afforded an opportunity to use the GCS project documents for DO-178B training. This report provides a brief overview of the GCS project, describes the 4-volume set of documents and the role they are playing in training, and includes the verification documents from the GCS project. Volume 3 contains four appendices: A. Software Verification Cases and Procedures for the Guidance and Control Software Project; B. Software Verification Results for the Pluto Implementation of the Guidance and Control Software; C. Review Records for the Pluto Implementation of the Guidance and Control Software; and D. Test Results Logs for the Pluto Implementation of the Guidance and Control Software.

78 FR 38349 - Draft Guidance for Industry on Expedited Programs for Serious Conditions-Drugs and Biologics...

Science.gov (United States)

2013-06-26

... Therapy.'' This draft guidance is being issued consistent with FDA's good guidance practices regulation... all promotional materials including promotional labeling as well as advertisements intended for... the intended time of initial dissemination of the labeling or initial publication of the advertisement...

Social barriers to the adoption of smart homes

International Nuclear Information System (INIS)

Balta-Ozkan, Nazmiye; Davidson, Rosemary; Bicket, Martha; Whitmarsh, Lorraine

2013-01-01

The aim of this paper is to explore social barriers to the adoption of smart homes through the analysis of expert views and public attitudes. Smart home services aim to improve the comfort, convenience and safety of householders, as well as allowing them to use energy more efficiently and cope with increasing costs. Despite the existence of smart homes and smart home technologies for some time, their prevalence is not widespread, and thus their potential largely untapped. Using a combination of in-depth deliberative public workshops, expert interviews and a review of the existing literature, this paper explores social barriers to smart home diffusion, including how these vary by expertise, life-stage and location. The research highlights the importance of barriers such as control, security, and cost, providing insights for policymakers as well as smart-home designers and developers as to how these might be addressed. - Highlights: • Smart homes and related technologies can provide a variety of benefits. • Technologies need to be reliable and fit into householders’ lifestyles. • Public concerns relate to cost, control and privacy. • Trust in energy companies and government is important

Guidance and Control Software Project Data - Volume 2: Development Documents

Science.gov (United States)

Hayhurst, Kelly J. (Editor)

2008-01-01

The Guidance and Control Software (GCS) project was the last in a series of software reliability studies conducted at Langley Research Center between 1977 and 1994. The technical results of the GCS project were recorded after the experiment was completed. Some of the support documentation produced as part of the experiment, however, is serving an unexpected role far beyond its original project context. Some of the software used as part of the GCS project was developed to conform to the RTCA/DO-178B software standard, "Software Considerations in Airborne Systems and Equipment Certification," used in the civil aviation industry. That standard requires extensive documentation throughout the software development life cycle, including plans, software requirements, design and source code, verification cases and results, and configuration management and quality control data. The project documentation that includes this information is open for public scrutiny without the legal or safety implications associated with comparable data from an avionics manufacturer. This public availability has afforded an opportunity to use the GCS project documents for DO-178B training. This report provides a brief overview of the GCS project, describes the 4-volume set of documents and the role they are playing in training, and includes the development documents from the GCS project. Volume 2 contains three appendices: A. Guidance and Control Software Development Specification; B. Design Description for the Pluto Implementation of the Guidance and Control Software; and C. Source Code for the Pluto Implementation of the Guidance and Control Software

A Novel Guidance Law with Line-of-Sight Acceleration Feedback for Missiles against Maneuvering Targets

Directory of Open Access Journals (Sweden)

Kemao Ma

2014-01-01

Full Text Available Terminal guidance law design and its implementation are considered for homing missiles against maneuvering targets. The lateral acceleration dynamics are taken into account in the design. In the guidance law design, the line-of-sight acceleration signals are incorporated into the acceleration reference signals to compensate for the targets’ maneuvers. Then the commanded accelerations are designed and the convergent tracking of the lateral accelerations to these signals is proven theoretically. In the guidance implementation, a linear high-gain differentiator is used to estimate the line-of-sight rates and the line-of-sight acceleration signals. To avoid the magnifying effects of higher order differentiation, a practical design of commanded accelerations is given to realize approximate tracking of the lateral accelerations to the given reference signals. Simulation is conducted for both cases with and without measurement noises. The simulation results justify the feasibility of the design and the implementation.

Achieving Improvement Through Nursing Home Quality Measurement

OpenAIRE

Harris, Yael; Clauser, Steven B.

2002-01-01

CMS has initiated the Nursing Home Quality Initiative (NHQI) to improve the quality of nursing home care. Central to the NHQI is the public reporting of nursing home quality measures that serve as the basis for the Initiative's communication and quality improvement program. This article provides an overview of the NHQI, focusing on the role of nursing home quality measures in achieving improvements in nursing home care. We also describe the evolution of quality measurement in nursing homes, a...

Home Education and Law in China

Science.gov (United States)

Sheng, Xiaoming

2018-01-01

Home education is at an early stage for the public, researchers, media and educational authorities in China. Yet the research relating to the development of home education has been entirely ignored. In particular, the literature focusing on the legal status of home education is negligible in the educational context of China. There is no literature…

77 FR 8751 - Guidance for Decommissioning Planning During Operations

Science.gov (United States)

2012-02-15

..., 40, 50, 70, and 72 [NRC-2011-0286] Guidance for Decommissioning Planning During Operations AGENCY... Guide, DG-4014, ``Decommissioning Planning During Operations'' in the Federal Register with a public... Guide DG-4014, ``Decommissioning Planning During Operations.'' This DG refers to NUREG-1757 Volume 3...

Predictors of Home Care Expenditures and Death at Home for Cancer Patients in an Integrated Comprehensive Palliative Home Care Pilot Program

Science.gov (United States)

Howell, Doris M.; Abernathy, Tom; Cockerill, Rhonda; Brazil, Kevin; Wagner, Frank; Librach, Larry

2011-01-01

Purpose: Empirical understanding of predictors for home care service use and death at home is important for healthcare planning. Few studies have examined these predictors in the context of the publicly funded Canadian home care system. This study examined predictors for home care use and home death in the context of a “gold standard” comprehensive palliative home care program pilot in Ontario where patients had equal access to home care services. Methods: Secondary clinical and administrative data sources were linked using a unique identifier to examine multivariate factors (predisposing, enabling, need) on total home care expenditures and home death for a cohort of cancer patients enrolled in the HPCNet pilot. Results: Subjects with gastrointestinal symptoms (OR: 1.64; p=0.03) and those with higher income had increased odds of dying at home (OR: 1.14; phome care expenditures. Conclusions: Predictors of home death found in earlier studies appeared less important in this comprehensive palliative home care pilot. An income effect for home death observed in this study requires examination in future controlled studies. Relevance: Access to palliative home care that is adequately resourced and organized to address the multiple domains of issues that patients/families experience at the end of life has the potential to enable home death and shift care appropriately from limited acute care resources. PMID:22294993

Implementation of NUREG 1318 guidance within the Yucca Mountain Project

International Nuclear Information System (INIS)

La Monica, L.B.; Waddell, J.D.; Hardin, E.L.

1990-01-01

This paper discusses the implementation of a quality assurance program that fulfills the requirements of the U.S. Nuclear Regulatory Commission (NRC). Additional guidance for this program was provided in NUREG 1318, Technical Position on Items and Activities in the High-Level Waste Geologic Repository Program Subject to Quality Assurance Requirements for the identification of items and activities important to public radiological safety and waste isolation for placement on a Q-List and Quality Activities List and also for graded application of QA measures. The process and organization for implementing this guidance is discussed

Career guidance in communities

DEFF Research Database (Denmark)

Thomsen, Rie

for the development of a critically reflexive career guidance practice. The considerations are organised around seven elements. 1. Creating opportunity, structure and access 2. Entering a community and increasing visibility 3. Providing guidance in communities 4. Exploring potentials in guidance situations 5...... in career guidance practices as well as in the lives of the people in the communities. This paper falls into two parts: The first part considers the collective as the starting point for the development of meaningful career guidance activities. Based on previous research on career guidance in communities......The aim of this paper is to inspire practitioners and professionals to leave their offices to bring career guidance into communities that might not identify with career guidance in the first instance. By making the effort to engage with communities, practitioners may bring about a critical change...

78 FR 60015 - Proposed Policy Guidance on Metropolitan Planning Organization Representation

Science.gov (United States)

2013-09-30

... rulemaking, performance measures and standards to be used by States to assess the condition of the pavements... on MPO boards, this proposed guidance proposes flexible approaches for MPOs and providers of public...

Framing the evidence for health smart homes and home-based consumer health technologies as a public health intervention for independent aging: a systematic review.

Science.gov (United States)

Reeder, Blaine; Meyer, Ellen; Lazar, Amanda; Chaudhuri, Shomir; Thompson, Hilaire J; Demiris, George

2013-07-01

There is a critical need for public health interventions to support the independence of older adults as the world's population ages. Health smart homes (HSH) and home-based consumer health (HCH) technologies may play a role in these interventions. We conducted a systematic review of HSH and HCH literature from indexed repositories for health care and technology disciplines (e.g., MEDLINE, CINAHL, and IEEE Xplore) and classified included studies according to an evidence-based public health (EBPH) typology. One thousand, six hundred and thirty-nine candidate articles were identified. Thirty-one studies from the years 1998-2011 were included. Twenty-one included studies were classified as emerging, 10 as promising and 3 as effective (first tier). The majority of included studies were published in the period beginning in the year 2005. All 3 effective (first tier) studies and 9 of 10 of promising studies were published during this period. Almost all studies included an activity sensing component and most of them used passive infrared motion sensors. The three effective (first tier) studies all used a multicomponent technology approach that included activity sensing, reminders and other technologies tailored to individual preferences. Future research should explore the use of technology for self-management of health by older adults; social support; and self-reported health measures incorporated into personal health records, electronic medical records, and community health registries. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

78 FR 5185 - Guidance for Industry and Food and Drug Administration Staff; Humanitarian Use Device (HUD...

Science.gov (United States)

2013-01-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0847] Guidance for Industry and Food and Drug Administration Staff; Humanitarian Use Device (HUD) Designations... public comment ``Draft Guidance for Industry and Food and Drug Administration Staff on Humanitarian Use...

Planning required in the development of radiation protection guidance for underground engineering applications

Energy Technology Data Exchange (ETDEWEB)

Neill, R H [U.S. Public Health Service, Rockville, MD (United States)

1969-07-01

The potential variety of engineering applications from the peaceful uses of underground nuclear explosives indicates an increased need for applicable radiation protection guidance to protect the public health of potentially exposed populations. To insure the orderly development of such uses, additional operational data as well as bioeffects data will be required to develop appropriate criteria and guidance to inform health officials and the public of the significance of possible exposures. The required planning includes an evaluation of the potential benefits and risks as well as the size and age of population, multiplicity of sources, likely and unlikely future uses, and the total environmental impact. (author)

Planning required in the development of radiation protection guidance for underground engineering applications

International Nuclear Information System (INIS)

Neill, R.H.

1969-01-01

The potential variety of engineering applications from the peaceful uses of underground nuclear explosives indicates an increased need for applicable radiation protection guidance to protect the public health of potentially exposed populations. To insure the orderly development of such uses, additional operational data as well as bioeffects data will be required to develop appropriate criteria and guidance to inform health officials and the public of the significance of possible exposures. The required planning includes an evaluation of the potential benefits and risks as well as the size and age of population, multiplicity of sources, likely and unlikely future uses, and the total environmental impact. (author)

Guidance on accidents involving radioactivity

International Nuclear Information System (INIS)

1989-01-01

This annex contains advice to Health Authorities on their response to accidents involving radioactivity. The guidance is in six parts:-(1) planning the response required to nuclear accidents overseas, (2) planning the response required to UK nuclear accidents a) emergency plans for nuclear installations b) nuclear powered satellites, (3) the handling of casualties contaminated with radioactive substances, (4) background information for dealing with queries from the public in the event of an accident, (5) the national arrangements for incident involving radioactivity (NAIR), (6) administrative arrangements. (author)

Public Comment Period Open for the Draft Update to the Planning for Natural Disaster Debris Guidance and to Related Documents

Science.gov (United States)

EPA is requesting comment on the draft Planning for Natural Disaster Debris Guidance, and two other documents. The Guidance is an update of the Planning for Natural Disaster Debris guidance that EPA published in March 2008.

Home audit program: management manual

Energy Technology Data Exchange (ETDEWEB)

1980-09-01

Many public power systems have initiated home energy audit programs in response to the requests of their consumers. The manual provides smaller public power systems with the information and specific skills needed to design and develop a program of residential energy audits. The program is based on the following precepts: locally owned public systems are the best, and in many cases the only agencies available to organize and coordinate energy conservation programs in many smaller communities; consumers' rights to energy conservation information and assistance should not hinge on the size of the utility that serves them; in the short run, public power systems of all sizes should offer residential energy conservation assistance to their consumers, because such assistance is desirable, necessary, and in the public interest; and in the long run, such programs will complement national energy goals and will produce economic benefits for both consumers and the public power system. A detailed description of home audit program planning, organization, and management are given. (MCW)

Public Transparency

OpenAIRE

UNCTAD; World Bank

2018-01-01

This note provides guidance on the type of information about agricultural investments that investors and governments can make publicly available. Transparency about certain aspects of investments can improve relations between investors and communities, enable external stakeholders to hold investors to commitments, and improve investors’ public image. Although some information should be kep...

78 FR 71532 - Amendments to Material Control and Accounting Regulations and Proposed Guidance for Fuel Cycle...

Science.gov (United States)

2013-11-29

... Accounting Regulations and Proposed Guidance for Fuel Cycle Facility Material Control and Accounting Plans... material control and accounting (MC&A) of special nuclear material (SNM) and the proposed guidance... and how the NRC will review and inspect these plans. DATES: The public meeting will be held on...

Coordinated hospital-home care for kidney patients on hemodialysis from the perspective of nursing personnel

Directory of Open Access Journals (Sweden)

Luz María Tejada-Tayabas

2015-04-01

Full Text Available OBJECTIVE: To examine, from the nursing perspective, the needs and challenges of coordinated hospital-home care for renal patients on hemodialysis. METHODS: A qualitative analysis was conducted with an ethnographic approach in a hemodialysis unit in San Luis Potosi, Mexico. Semistructured interviews were conducted with nine nurses, selected by purposeful sampling. Structured content analysis was used. RESULTS: Nurses recounted the needs and challenges involved in caring for renal patients. They also identified barriers that limit coordinated patient care in the hospital and the home, mainly the work overload at the hemodialysis unit and the lack of a systematic strategy for education and lifelong guidance to patients, their families and caregivers. CONCLUSIONS: This study shows the importance and necessity of establishing a strategy that goes beyond conventional guidance provided to caregivers of renal patients, integrating them into the multidisciplinary group of health professionals that provide care for these patients in the hospital to establish coordinated hospital-home care that increases therapeutic adherence, treatment substitution effectiveness and patient quality of life.

42 CFR 494.100 - Condition: Care at home.

Science.gov (United States)

2010-10-01

... Patient Care § 494.100 Condition: Care at home. A dialysis facility that is certified to provide services to home patients must ensure through its interdisciplinary team, that home dialysis services are at... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Care at home. 494.100 Section 494.100...

45 CFR 1306.33 - Home-based program option.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Home-based program option. 1306.33 Section 1306.33... PROGRAM HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS Head Start Program Options § 1306.33 Home-based program option. (a) Grantees implementing a home-based program option must: (1) Provide one home...

78 FR 78822 - Draft Guidance for Assessing the Effects of Anthropogenic Sound on Marine Mammals-Acoustic...

Science.gov (United States)

2013-12-27

... Guidance for Assessing the Effects of Anthropogenic Sound on Marine Mammals--Acoustic Threshold Levels for... available in electronic form via the Internet at http://www.nmfs.noaa.gov/pr/acoustics/ . You may submit...: Acoustic Guidance. Instructions: All comments received are a part of the public record and will generally...

38 CFR 17.57 - Use of community nursing homes.

Science.gov (United States)

2010-07-01

... MEDICAL Use of Community Nursing Home Care Facilities § 17.57 Use of community nursing homes. (a) Nursing home care in a contract public or private nursing home facility may be authorized for the following... currently receiving VA hospital based home health services. (Authority: 38 U.S.C. 1720; sec. 108, Pub. L. 99...

Zika Virus and Pregnancy

Medline Plus

Full Text Available ... My ACOG ACOG Departments Donate Shop Career Connection Home Clinical Guidance & Publications Practice Management Education & Events Advocacy For Patients About ACOG Zika Virus and Pregnancy Home For Patients Zika Virus and Pregnancy Page Navigation ▼ ...

Effective public involvement in the HoST-D Programme for dementia home care support: From proposal and design to methods of data collection (innovative practice).

Science.gov (United States)

Giebel, Clarissa; Roe, Brenda; Hodgson, Anthony; Britt, David; Clarkson, Paul

2017-01-01

Public involvement is an important element in health and social care research. However, it is little evaluated in research. This paper discusses the utility and impact of public involvement of carers and people with dementia in a five-year programme on effective home support in dementia, from proposal and design to methods of data collection, and provides a useful guide for future research on how to effectively involve the public. The Home SupporT in Dementia (HoST-D) Programme comprises two elements of public involvement, a small reference group and a virtual lay advisory group. Involving carers and people with dementia is based on the six key values of involvement - respect, support, transparency, responsiveness, fairness of opportunity, and accountability. Carers and people with dementia gave opinions on study information, methods of data collection, an economic model, case vignettes, and a memory aid booklet, which were all taken into account. Public involvement has provided benefits to the programme whilst being considerate of the time constraints and geographical locations of members.

The Impact of Certificate-of-Need Laws on Nursing Home and Home Health Care Expenditures.

Science.gov (United States)

Rahman, Momotazur; Galarraga, Omar; Zinn, Jacqueline S; Grabowski, David C; Mor, Vincent

2016-02-01

Over the past two decades, nursing homes and home health care agencies have been influenced by several Medicare and Medicaid policy changes including the adoption of prospective payment for Medicare-paid postacute care and Medicaid-paid long-term home and community-based care reforms. This article examines how spending growth in these sectors was affected by state certificate-of-need (CON) laws, which were designed to limit the growth of providers and have remained unchanged for several decades. Compared with states without CON laws, Medicare and Medicaid spending in states with CON laws grew faster for nursing home care and more slowly for home health care. In particular, we observed the slowest growth in community-based care in states with CON for both the nursing home and home health industries. Thus, controlling for other factors, public postacute and long-term care expenditures in CON states have become dominated by nursing homes. © The Author(s) 2015.

Decontamination of breast pump milk collection kits and related items at home and in hospital: guidance from a Joint Working Group of the Healthcare Infection Society & Infection Prevention Society.

Science.gov (United States)

Price, E; Weaver, G; Hoffman, P; Jones, M; Gilks, J; O'Brien, V; Ridgway, G

2016-03-01

A variety of methods are in use for decontaminating breast pump milk collection kits and related items associated with infant feeding. This paper aims to provide best practice guidance for decontamination of this equipment at home and in hospital. It has been compiled by a joint Working Group of the Healthcare Infection Society and the Infection Prevention Society. The guidance has been informed by a search of the literature in Medline, the British Nursing Index, the Cumulative Index to Nursing & Allied Health Literature, Midwifery & Infant Care and the results of two surveys of UK neonatal units in 2002/3 and 2006, and of members of the Infection Prevention Society in 2014. Since limited good quality evidence was available from these sources much of the guidance represents good practice based on the consensus view of the Working Group. Breast pump milk collection kits should not be reused by different mothers unless they have been sterilized in a Sterile Services Department between these different users.When used by the same mother, a detergent wash followed by thorough rinsing and drying after each use gives acceptable decontamination for most circumstances, as long as it is performed correctly.Additional decontamination precautions to washing, rinsing and drying may be used if indicated by local risk assessments and on advice from the departmental clinicians and Infection Prevention and Control Teams. The microbiological quality of the rinse water is an important consideration, particularly for infants on neonatal units.If bottle brushes or breast/nipple shields are used, they should be for use by one mother only. Decontamination should be by the processes used for breast pump milk collection kits.Dummies (soothers, pacifiers or comforters) needed for non-nutritive sucking by infants on neonatal units, should be for single infant use. Manufacturers should provide these dummies ready-to-use and individually packaged. They must be discarded at least every 24 hours

Stroke and Nursing Home care: a national survey of nursing homes.

LENUS (Irish Health Repository)

Cowman, Seamus

2010-01-01

BACKGROUND: Although stroke is recognised as a major factor in admission to nursing home care, data is lacking on the extent and nature of the disabilities and dependency in nursing homes arising from stroke. A national study conducted in nursing homes can quantify the number of residents with stroke in nursing homes, their disability and levels of dependency. METHODS: A cross-sectional survey research design was used. A total of 572 public and private nursing homes were identified nationally and a stratified random selection of 60 nursing homes with 3,239 residents was made. In half of the nursing homes (n = 30) efforts were made to interview all residents with stroke Survey instruments were used to collect data from residents with stroke and nursing home managers on demography, patient disability, and treatment. RESULTS: Across all nursing homes (n = 60), 18% (n = 570) of the residents had previously had a stroke. In homes (n = 30), where interviews with residents with stroke (n = 257), only 7% (n = 18) residents were capable of answering for themselves and were interviewed. Data on the remaining 93% (n = 239) residents were provided by the nursing home manager. Nurse Managers reported that 73% of residents with stroke had a high level of dependency. One in two residents with stroke was prescribed antidepressants or sedative medication. Only 21% of stroke residents were prescribed anticoagulants, 42% antiplatelets, and 36% cholesterol lowering medications. Stroke rehabilitation guidelines were lacking and 68% reported that there was no formal review process in place. CONCLUSIONS: This study provides seminal findings on stroke and nursing home services in Ireland. We now know that one in six nursing home residents in a national survey are residents with a stroke, and have a wide range of disabilities. There is currently little or no structured care (beyond generic care) for stroke survivors who reside in nursing homes in Ireland.

Understanding sharps injuries in home healthcare: The Safe Home Care qualitative methods study to identify pathways for injury prevention.

Science.gov (United States)

Markkanen, Pia; Galligan, Catherine; Laramie, Angela; Fisher, June; Sama, Susan; Quinn, Margaret

2015-04-11

Home healthcare is one of the fastest growing sectors in the United States. Percutaneous injuries from sharp medical devices (sharps) are a source of bloodborne pathogen infections among home healthcare workers and community members. Sharps use and disposal practices in the home are highly variable and there is no comprehensive analysis of the system of sharps procurement, use and disposal in home healthcare. This gap is a barrier to effective public health interventions. The objectives of this study were to i) identify the full range of pathways by which sharps enter and exit the home, stakeholders involved, and barriers for using sharps with injury prevention features; and ii) assess the leverage points for preventive interventions. This study employed qualitative research methods to develop two systems maps of the use of sharps and prevention of sharps injuries in home healthcare. Twenty-six in-depth interview sessions were conducted including home healthcare agency clinicians, public health practitioners, sharps device manufacturers, injury prevention advocates, pharmacists and others. Interview transcripts were audio-recorded and analyzed thematically using NVIVO qualitative research analysis software. Analysis of supporting archival material also was conducted. All findings guided development of the two maps. Sharps enter the home via multiple complex pathways involving home healthcare providers and home users. The providers reported using sharps with injury prevention features. However, home users' sharps seldom had injury prevention features and sharps were commonly re-used for convenience and cost-savings. Improperly discarded sharps present hazards to caregivers, waste handlers, and community members. The most effective intervention potential exists at the beginning of the sharps systems maps where interventions can eliminate or minimize sharps injuries, in particular with needleless treatment methods and sharps with injury prevention features

Guidance and Control Software Project Data - Volume 4: Configuration Management and Quality Assurance Documents

Science.gov (United States)

Hayhurst, Kelly J. (Editor)

2008-01-01

The Guidance and Control Software (GCS) project was the last in a series of software reliability studies conducted at Langley Research Center between 1977 and 1994. The technical results of the GCS project were recorded after the experiment was completed. Some of the support documentation produced as part of the experiment, however, is serving an unexpected role far beyond its original project context. Some of the software used as part of the GCS project was developed to conform to the RTCA/DO-178B software standard, "Software Considerations in Airborne Systems and Equipment Certification," used in the civil aviation industry. That standard requires extensive documentation throughout the software development life cycle, including plans, software requirements, design and source code, verification cases and results, and configuration management and quality control data. The project documentation that includes this information is open for public scrutiny without the legal or safety implications associated with comparable data from an avionics manufacturer. This public availability has afforded an opportunity to use the GCS project documents for DO-178B training. This report provides a brief overview of the GCS project, describes the 4-volume set of documents and the role they are playing in training, and includes configuration management and quality assurance documents from the GCS project. Volume 4 contains six appendices: A. Software Accomplishment Summary for the Guidance and Control Software Project; B. Software Configuration Index for the Guidance and Control Software Project; C. Configuration Management Records for the Guidance and Control Software Project; D. Software Quality Assurance Records for the Guidance and Control Software Project; E. Problem Report for the Pluto Implementation of the Guidance and Control Software Project; and F. Support Documentation Change Reports for the Guidance and Control Software Project.

Nursing Home Compare

Data.gov (United States)

U.S. Department of Health & Human Services — The data that is used by the Nursing Home Compare tool can be downloaded for public use. This functionality is primarily used by health policy researchers and the...

Formal home help services and institutionalization

DEFF Research Database (Denmark)

Yamada, Yukari; Siersma, Volkert; Avlund, Kirsten

2012-01-01

The effect of home help services has been inconsistent. Raising the hypothesis that receiving small amounts of home help may postpone or prevent institutionalization, the aim of the present study is to analyze how light and heavy use of home help services was related to the risk...... for institutionalization. The study was a secondary analysis of a Danish intervention study on preventive home visits in 34 municipalities from 1999 to 2003, including 2642 home-dwelling older people who were nondisabled and did not receive public home help services at baseline in 1999 and who lived at home 18 months...... after baseline. Cox regression analysis showed that those who received home help services during the first 18 months after baseline were at higher risk of being institutionalized during the subsequent three years than those who did not receive such services. However, receiving home help for less than 1h...

Does investor-ownership of nursing homes compromise the quality of care?

Science.gov (United States)

Harrington, Charlene; Woolhandler, Steffie; Mullan, Joseph; Carrillo, Helen; Himmelstein, David U

2002-01-01

Quality problems have long plagued the nursing home industry. While two-thirds of U.S. nursing homes are investor-owned, few studies have examined the impact of investor-ownership on the quality of care. The authors analyzed 1998 data from inspections of 13,693 nursing facilities representing virtually all U.S. nursing homes. They grouped deficiency citations issued by inspectors into three categories ("quality of care," "quality of life," and "other") and compared deficiency rates in investor-owned, nonprofit, and public nursing homes. A multivariate model was used to control for case mix, percentage of residents covered by Medicaid, whether the facility was hospital-based, whether it was a skilled nursing facility for Medicare only, chain ownership, and location by state. The study also assessed nurse staffing. The authors found that investor-owned nursing homes provide worse care and less nursing care than nonprofit or public homes. Investor-owned facilities averaged 5.89 deficiencies per home, 46.5 percent higher than nonprofit and 43.0 percent higher than public facilities, and also had more of each category of deficiency. In the multivariate analysis, investor-ownership predicted 0.679 additional deficiencies per home; chain-ownership predicted an additional 0.633 deficiencies per home. Nurse staffing ratios were markedly lower at investor-owned homes.

Cyberspace’s Dynamic Duo: Forging a Cybersecurity Public-Private Partnership

Directory of Open Access Journals (Sweden)

Max Manley

2015-10-01

Full Text Available As of 2015, cyber threats have become more prevalent due to high-profile cases like the Target, JPMorgan Chase & Co., Home Depot, and Sony Entertainment breaches. In order to prevent what former Secretary of Defense Leon Panetta characterized as a “Cyber Pearl Harbor,” the US government has to engage the private sector in order to build a solid public-private partnership (PPP for cybersecurity. For there to be a successful cybersecurity PPP between the US government and the private sector, there must be a PPP founded on a model composed of four essential elements: a high level of trust between the public and private entities that corresponds to a mutual belief in the positive gains of both partners; clear baseline guidance imposed from legislation, which should be reinforced with government training and financial incentives; a bottom-up structural approach for efficient operations that allows for more autonomy at lower levels on local needs and resources; and, gaining influential community involvement in the formation of PPPs from all levels of the participating organizations, as well as civil leadership and the general public.

Talking about living and dying with the oldest old: public involvement in a study on end of life care in care homes

Directory of Open Access Journals (Sweden)

Goodman Claire

2011-11-01

Full Text Available Abstract Background Public involvement in research on sensitive subjects, such as death and dying, can help to ensure that questions are framed to reflect the interests of their peers, develop a shared understanding of issues raised, and moderate the often unequal power relationship between researcher and participant. This paper describes the contribution and impact of older members of a Public Involvement in Research group (PIRg to a study on living and dying in care homes. Methods A longitudinal study, with a mixed method approach, its aims were to capture key experiences, events and change over one year, of older people resident in participating care homes in the East of England. Residents were interviewed up to three times and their case notes were reviewed four times over the year. Interviews were semi structured, and recorded. Four members of a Public Involvement in Research group (PIRg contributed to preliminary discussions about the research and three were involved with many of the subsequent stages of the research process including the facilitation of discussion groups with residents. Results There were three areas where the involvement of the Public Involvement in Research group (PIRg positively influenced the study process. These were recruitment, governance and safeguarding, and in collaboration with the residents in the care homes, the discussion and interpretation of emergent findings. PIRg members were of similar age to the residents and their involvement provided different and often more reflective insights of the significance of the findings for the participants. There were examples where decision making about the range of PIRg participation was not always negotiable, and this raised issues about power relationships within the team. Nevertheless, PIRg members expressed personal benefit and satisfaction through participating in the research and a commitment to continue to support research with this older age group. Conclusions

Evaluation of school counseling and guidance services based on views of high school students

OpenAIRE

Fulya Yüksel-Şahin

2008-01-01

This study evaluated school psychological counseling services based on high school students’ views. Participants were 235 students. “Student Personal Information Form” and “the School Guidance Services Scale” were used for data analysis. MANOVA and multiple regression procedures were used for data analysis. Results showed that students listed the guidance services from the most utilized to the least as follows: consultation, placement, follow-up, public and famil...

Guidance for States Implementing Comprehensive Safeguards Agreements and Additional Protocols

International Nuclear Information System (INIS)

2016-01-01

This publication is aimed at enhancing States’ understanding of the safeguards obligations of both the State and the IAEA, and at improving the cooperation between States and the IAEA in safeguards implementation. It is principally intended for State or regional safeguards regulatory authorities and facility operators, and is a reference document that is supported by detailed guidance and examples in safeguards implementation practices presented in other publications in the series. (This version is the 2016 update.)

Achievement and Demographics of Home School Students: 1998

Directory of Open Access Journals (Sweden)

Lawrence M. Rudner

1999-03-01

Full Text Available This report presents the results of the largest survey and testing program for students in home schools to date. In Spring 1998, 20,760 K-12 home school students in 11,930 families were administered either the Iowa Tests of Basic Skills (ITBS or the Tests of Achievement and Proficiency (TAP, depending on their current grade. The parents responded to a questionnaire requesting background and demographic information. Major findings include: the achievement test scores of this group of home school students are exceptionally high--the median scores were typically in the 70th to 80th percentile; 25% of home school students are enrolled one or more grades above their age-level public and private school peers; this group of home school parents has more formal education than parents in the general population; the median income for home school families is significantly higher than that of all families with children in the United States; and almost all home school students are in married couple families. Because this was not a controlled experiment, the study does not demonstrate that home schooling is superior to public or private schools and the results must be interpreted with caution. The report clearly suggests, however, that home school students do quite well in that educational environment.

Estimating length of stay in publicly-funded residential and nursing care homes: a retrospective analysis using linked administrative data sets.

Science.gov (United States)

Steventon, Adam; Roberts, Adam

2012-10-31

Information about how long people stay in care homes is needed to plan services, as length of stay is a determinant of future demand for care. As length of stay is proportional to cost, estimates are also needed to inform analysis of the long-term cost effectiveness of interventions aimed at preventing admissions to care homes. But estimates are rarely available due to the cost of repeatedly surveying individuals. We used administrative data from three local authorities in England to estimate the length of publicly-funded care homes stays beginning in 2005 and 2006. Stays were classified into nursing home, permanent residential and temporary residential. We aggregated successive placements in different care home providers and, by linking to health data, across periods in hospital. The largest group of stays (38.9%) were those intended to be temporary, such as for rehabilitation, and typically lasted 4 weeks. For people admitted to permanent residential care, median length of stay was 17.9 months. Women stayed longer than men, while stays were shorter if preceded by other forms of social care. There was significant variation in length of stay between the three local authorities. The typical person admitted to a permanent residential care home will cost a local authority over £38,000, less payments due from individuals under the means test. These figures are not apparent from existing data sets. The large cost of care home placements suggests significant scope for preventive approaches. The administrative data revealed complexity in patterns of service use, which should be further explored as it may challenge the assumptions that are often made.

Estimating length of stay in publicly-funded residential and nursing care homes: a retrospective analysis using linked administrative data sets

Directory of Open Access Journals (Sweden)

Steventon Adam

2012-10-01

Full Text Available Abstract Background Information about how long people stay in care homes is needed to plan services, as length of stay is a determinant of future demand for care. As length of stay is proportional to cost, estimates are also needed to inform analysis of the long-term cost effectiveness of interventions aimed at preventing admissions to care homes. But estimates are rarely available due to the cost of repeatedly surveying individuals. Methods We used administrative data from three local authorities in England to estimate the length of publicly-funded care homes stays beginning in 2005 and 2006. Stays were classified into nursing home, permanent residential and temporary residential. We aggregated successive placements in different care home providers and, by linking to health data, across periods in hospital. Results The largest group of stays (38.9% were those intended to be temporary, such as for rehabilitation, and typically lasted 4 weeks. For people admitted to permanent residential care, median length of stay was 17.9 months. Women stayed longer than men, while stays were shorter if preceded by other forms of social care. There was significant variation in length of stay between the three local authorities. The typical person admitted to a permanent residential care home will cost a local authority over £38,000, less payments due from individuals under the means test. Conclusions These figures are not apparent from existing data sets. The large cost of care home placements suggests significant scope for preventive approaches. The administrative data revealed complexity in patterns of service use, which should be further explored as it may challenge the assumptions that are often made.

Graphic Turbulence Guidance

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Forecast turbulence hazards identified by the Graphical Turbulence Guidance algorithm. The Graphical Turbulence Guidance product depicts mid-level and upper-level...

The virtual dental home: a critique.

Science.gov (United States)

Friedman, Jay W; Nash, David A; Mathu-Muju, Kavita R

2017-09-01

The Virtual Dental Home is a concept of the Pacific Center for Special Care of the Arthur A. Dugoni School of Dentistry in San Francisco. It is designed to improve access to dental care for underserved populations, specifically children and institutionalized adults. This article describes the development and implementation of the Virtual Dental Home, subsequently critiquing the concept. The criteria for a dental home are not met by the program. It is the equivalent of a traditional public oral health prevention and screening program, with the additional dimension of allowing dental hygienists and assistants to place interim glass ionomer restorations in dental cavities. The critique questions the need to insert a "cloud" dentist into the process. The routine utilization of radiographs is also challenged. The VDH not only lacks the attributes of a dental home, it has not been shown to be as efficient and effective as traditional programs staffed by dental hygienists and dental therapists. The article concludes by describing how programs utilizing dental therapists could address the deficiencies of the Virtual Dental Home, effectively improving access to oral health care for underserved populations. © 2017 American Association of Public Health Dentistry.

Does investor ownership of nursing homes compromise the quality of care?

Science.gov (United States)

Harrington, C; Woolhandler, S; Mullan, J; Carrillo, H; Himmelstein, D U

2001-09-01

Two thirds of nursing homes are investor owned. This study examined whether investor ownership affects quality. We analyzed 1998 data from state inspections of 13,693 nursing facilities. We used a multivariate model and controlled for case mix, facility characteristics, and location. Investor-owned facilities averaged 5.89 deficiencies per home, 46.5% higher than nonprofit facilities and 43.0% higher than public facilities. In multivariate analysis, investor ownership predicted 0.679 additional deficiencies per home; chain ownership predicted an additional 0.633 deficiencies. Nurse staffing was lower at investor-owned nursing homes. Investor-owned nursing homes provide worse care and less nursing care than do not-for-profit or public homes.

Ethnic/racial disparities in adolescents' home food environments and linkages to dietary intake and weight status.

Science.gov (United States)

Larson, Nicole; Eisenberg, Marla E; Berge, Jerica M; Arcan, Chrisa; Neumark-Sztainer, Dianne

2015-01-01

Research is needed to confirm that public health recommendations for home/family food environments are equally relevant for diverse populations. This study examined ethnic/racial differences in the home/family environments of adolescents and associations with dietary intake and weight status. The sample included 2374 ethnically/racially diverse adolescents and their parents enrolled in coordinated studies, EAT 2010 (Eating and Activity in Teens) and Project F-EAT (Families and Eating and Activity in Teens), in the Minneapolis/St. Paul metropolitan area. Adolescents and parents completed surveys and adolescents completed anthropometric measurements in 2009-2010. Nearly all home/family environment variables (n=7 of 8 examined) were found to vary significantly across the ethnic/racial groups. Several of the home/family food environment variables were significantly associated with one or more adolescent outcome in expected directions. For example, parental modeling of healthy food choices was inversely associated with BMI z-score (p=0.03) and positively associated with fruit/vegetable consumption (peating was associated with lower intake of sugar-sweetened beverages only among youth representing the White, African American, Asian, and mixed/other ethnic/racial groups and was unrelated to intake among East African, Hispanic, and Native American youth. Food and nutrition professionals along with other providers of health programs and services for adolescents should encourage ethnically/racially diverse parents to follow existing recommendations to promote healthy eating such as modeling nutrient-dense food choices, but also recognize the need for cultural sensitivity in providing such guidance. Copyright © 2014 Elsevier Ltd. All rights reserved.

Home Care Reform in the Netherlands. Impacts on Unpaid Care

NARCIS (Netherlands)

I.P. van Staveren (Irene)

2009-01-01

textabstractIntroduction In the Netherlands, about half a million people make use of home care, that is, formally arranged, and publicly financed home care services. Until 1 January 2007, Dutch home care provisioning used to be supplied by relatively small, profit and non-profit home care

Fixing the broken image of care homes, could a 'care home innovation centre' be the answer?

OpenAIRE

Hockley, Jo; Harrison, Jennifer Kirsty; Watson, Julie; Randall, Marion; Murray, Scott

2016-01-01

The UK has many excellent care homes that provide high-quality care for their residents; however, across the care home sector, there is a significant need for improvement. Even though the majority of care homes receive a rating of 'good' from regulators, still significant numbers are identified as requiring 'improvement' or are 'inadequate'. Such findings resonate with the public perceptions of long-term care as a negative choice, to be avoided wherever possible-as well as impacting on the ca...

NASA LaRC Workshop on Guidance, Navigation, Controls, and Dynamics for Atmospheric Flight, 1993

Science.gov (United States)

Buttrill, Carey S. (Editor)

1993-01-01

This publication is a collection of materials presented at a NASA workshop on guidance, navigation, controls, and dynamics (GNC&D) for atmospheric flight. The workshop was held at the NASA Langley Research Center on March 18-19, 1993. The workshop presentations describe the status of current research in the GNC&D area at Langley over a broad spectrum of research branches. The workshop was organized in eight sessions: overviews, general, controls, military aircraft, dynamics, guidance, systems, and a panel discussion. A highlight of the workshop was the panel discussion which addressed the following issue: 'Direction of guidance, navigation, and controls research to ensure U.S. competitiveness and leadership in aerospace technologies.'

Zika Virus and Pregnancy

Medline Plus

Full Text Available ... Shop Career Connection Home Clinical Guidance & Publications Practice Management Education & Events Advocacy For Patients About ACOG Zika Virus ... Infographic Resources & Publications Committee Opinions Practice ... Coding Health Info Technology Professional Liability Managing Your ...

Non-cable vehicle guidance

Energy Technology Data Exchange (ETDEWEB)

Daugela, G.C.; Willott, A.M.; Chopiuk, R.G.; Thornton, S.E.

1988-06-01

The purpose is to determine the most promising driverless mine vehicle guidance systems that are not dependent on buried cables, and to plan their development. The project is presented in two phases: a preliminary study and literature review to determine whether suitable technologies exist to justify further work; and an in-depth assessment and selection of technologies for vehicle guidance. A large number of guidance elements are involved in a completely automated vehicle. The technologies that hold the best potential for development of guidance systems for mine vehicles are ultrasonics, radar, lasers, dead reckoning, and guidance algorithms. The best approach to adaptation of these technologies is on a step by step basis. Guidance modules that are complete in themselves and are designed to be integrated with other modules can provide short term benefits. Two modules are selected for development: the dragline operations monitor and automated machine control for optimized mining (AMCOM). 99 refs., 20 figs., 40 tabs.

Time to and predictors of dual incontinence in older nursing home admissions.

Science.gov (United States)

Bliss, Donna Z; Gurvich, Olga V; Eberly, Lynn E; Harms, Susan

2018-01-01

There are few studies of nursing home residents that have investigated the development of dual incontinence, perhaps the most severe type of incontinence as both urinary and fecal incontinence occur. To determine the time to and predictors of dual incontinence in older nursing home residents. Using a cohort design, records of older nursing home admissions who were continent or had only urinary or only fecal incontinence (n = 39,181) were followed forward for report of dual incontinence. Four national US datasets containing potential predictors at multiple levels describing characteristics of nursing home residents, nursing homes (n = 445), and socioeconomic and sociodemographic status of the community surrounding nursing homes were analyzed. A Cox proportional hazard regression with nursing home-specific random effect was used. At 6 months after admission, 28% of nursing home residents developed dual incontinence, at 1 year 42% did so, and at 2 years, 61% had dual incontinence. Significant predictors for time to developing dual incontinence were having urinary incontinence, greater functional or cognitive deficits, more comorbidities, older age, and lesser quality of nursing home care. The development of dual incontinence is a major problem among nursing home residents. Predictors in this study offer guidance in developing interventions to prevent and reduce the time to developing this problem which may improve the quality of life of nursing residents. © 2017 Wiley Periodicals, Inc.

Guidance Optimization for Tactical Homing Missiles and Air Defense Systems

Directory of Open Access Journals (Sweden)

Yunes Sh. ALQUDSI

2018-03-01

Full Text Available The aim of this paper is to develop a functional approach to optimize the engagement effectiveness of the tactical homing missiles and air defense systems by utilizing the differential geometric concepts. In this paper the engagement geometry of the interceptor and the target is developed and expressed in differential geometric terms in order to demonstrate the possibilities of the impact triangles and specify the earliest interception based on the direct intercept geometry. Optimizing the missile heading angle and suitable missile velocity against the target velocity is then examined to achieve minimum missile latax, minimum time-to-go (time-to-hit and minimum appropriate missile velocity that is guaranteed a quick and precise interception for the given target. The study terminates with different scenarios of engagement optimization with two-dimensional simulation to demonstrate the applicability of the DG approach and to show its properties.

Stroke and Nursing Home care: a national survey of nursing homes

Directory of Open Access Journals (Sweden)

McGee Hannah

2010-01-01

Full Text Available Abstract Background Although stroke is recognised as a major factor in admission to nursing home care, data is lacking on the extent and nature of the disabilities and dependency in nursing homes arising from stroke. A national study conducted in nursing homes can quantify the number of residents with stroke in nursing homes, their disability and levels of dependency. Methods A cross-sectional survey research design was used. A total of 572 public and private nursing homes were identified nationally and a stratified random selection of 60 nursing homes with 3,239 residents was made. In half of the nursing homes (n = 30 efforts were made to interview all residents with stroke Survey instruments were used to collect data from residents with stroke and nursing home managers on demography, patient disability, and treatment. Results Across all nursing homes (n = 60, 18% (n = 570 of the residents had previously had a stroke. In homes (n = 30, where interviews with residents with stroke (n = 257, only 7% (n = 18 residents were capable of answering for themselves and were interviewed. Data on the remaining 93% (n = 239 residents were provided by the nursing home manager. Nurse Managers reported that 73% of residents with stroke had a high level of dependency. One in two residents with stroke was prescribed antidepressants or sedative medication. Only 21% of stroke residents were prescribed anticoagulants, 42% antiplatelets, and 36% cholesterol lowering medications. Stroke rehabilitation guidelines were lacking and 68% reported that there was no formal review process in place. Conclusions This study provides seminal findings on stroke and nursing home services in Ireland. We now know that one in six nursing home residents in a national survey are residents with a stroke, and have a wide range of disabilities. There is currently little or no structured care (beyond generic care for stroke survivors who reside in nursing homes in Ireland.

75 FR 47494 - Implementation Guidance for Physical Protection of Byproduct Material; Category 1 and Category 2...

Science.gov (United States)

2010-08-06

... availability for the guidance was published July 14, 2010. The public comment period on the guidance ends... Doubletree Hotel in Austin, Texas. The second meeting will be held at the NRC in Rockville, Maryland. During..., 2010, from 8:30 a.m. to 5 p.m. in Austin, Texas and September 20, 2010, from 8:30 a.m. to 5 p.m. in...

Effect of prospective reimbursement on nursing home costs.

OpenAIRE

Coburn, A F; Fortinsky, R; McGuire, C; McDonald, T P

1993-01-01

OBJECTIVE. This study evaluates the effect of Maine's Medicaid nursing home prospective payment system on nursing home costs and access to care for public patients. DATA SOURCES/STUDY SETTING. The implementation of a facility-specific prospective payment system for nursing homes provided the opportunity for longitudinal study of the effect of that system. Data sources included audited Medicaid nursing home cost reports, quality-of-care data from state facility survey and licensure files, and ...

NRC ARDC Guidance Support Status Report

Energy Technology Data Exchange (ETDEWEB)

Holbrook, Mark R. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2017-07-01

This report provides a summary that reflects the progress and status of proposed regulatory design criteria for advanced non-light water reactor (LWR) designs in accordance with the Level 3 milestone M3AT-17IN2001013 in work package AT-17IN200101. These criteria have been designated as advanced reactor design criteria (ARDC) and they provide guidance to future applicants for addressing the general design criteria (GDC) that are currently applied specifically to LWR designs. This report provides a summary of Phase 2 activities related to the various tasks associated with ARDC development and the subsequent development of ARDC regulatory guidance for sodium fast reactor (SFR) and modular high-temperature gas-cooled reactor (HTGR) designs. Status Report Organization: Section 2 discusses the origin of the GDC and their application to LWRs. Section 3 addresses the objective of this initiative and how it benefits the advanced non-LWR reactor vendors. Section 4 discusses the scope and structure of the initiative. Section 5 provides background on the U.S. Department of Energy (DOE) ARDC team’s original development of the proposed ARDC that were submitted to the NRC for consideration. Section 6 provides a summary of recent ARDC Phase 2 activities. Appendices A through E document the DOE ARDC team’s public comments on various sections of the NRC’s draft regulatory guide DG–1330, “Guidance for Developing Principal Design Criteria for Non-Light Water Reactors.”

NRC ARDC Guidance Support Status Report

International Nuclear Information System (INIS)

Holbrook, Mark R.

2017-01-01

This report provides a summary that reflects the progress and status of proposed regulatory design criteria for advanced non-light water reactor (LWR) designs in accordance with the Level 3 milestone M3AT-17IN2001013 in work package AT-17IN200101. These criteria have been designated as advanced reactor design criteria (ARDC) and they provide guidance to future applicants for addressing the general design criteria (GDC) that are currently applied specifically to LWR designs. This report provides a summary of Phase 2 activities related to the various tasks associated with ARDC development and the subsequent development of ARDC regulatory guidance for sodium fast reactor (SFR) and modular high-temperature gas-cooled reactor (HTGR) designs. Status Report Organization: Section 2 discusses the origin of the GDC and their application to LWRs. Section 3 addresses the objective of this initiative and how it benefits the advanced non-LWR reactor vendors. Section 4 discusses the scope and structure of the initiative. Section 5 provides background on the U.S. Department of Energy (DOE) ARDC team’s original development of the proposed ARDC that were submitted to the NRC for consideration. Section 6 provides a summary of recent ARDC Phase 2 activities. Appendices A through E document the DOE ARDC team’s public comments on various sections of the NRC’s draft regulatory guide DG–1330, “Guidance for Developing Principal Design Criteria for Non-Light Water Reactors.”

Guidance: Demonstrating Compliance with the Land Disposal Restrictions (LDR) Alternative Soil Treatment Standards

Science.gov (United States)

This guidance provides suggestions and perspectives on how members of the regulated community, states, and the public can demonstrate compliance with the alternative treatment standards for certain contaminated soils that will be land disposed.

Client Involvement in Home Care Practice

DEFF Research Database (Denmark)

Glasdam, Stinne; Henriksen, Nina; Kjær, Lone

2013-01-01

Client involvement’ has been a mantra within health policies, education curricula and healthcare institutions over many years, yet very little is known about how ‘client involvement’ is practised in home-care services. The aim of this article is to analyse ‘client involvement’ in practise seen fr...... in public home-care practice remains limited...

Guidance, Navigation, and Control Techniques and Technologies for Active Satellite Removal

Science.gov (United States)

Ortega Hernando, Guillermo; Erb, Sven; Cropp, Alexander; Voirin, Thomas; Dubois-Matra, Olivier; Rinalducci, Antonio; Visentin, Gianfranco; Innocenti, Luisa; Raposo, Ana

2013-09-01

This paper shows an internal feasibility analysis to de- orbit a non-functional satellite of big dimensions by the Technical Directorate of the European Space Agency ESA. The paper focuses specifically on the design of the techniques and technologies for the Guidance, Navigation, and Control (GNC) system of the spacecraft mission that will capture the satellite and ultimately will de-orbit it on a controlled re-entry.The paper explains the guidance strategies to launch, rendezvous, close-approach, and capture the target satellite. The guidance strategy uses chaser manoeuvres, hold points, and collision avoidance trajectories to ensure a safe capture. It also details the guidance profile to de-orbit it in a controlled re-entry.The paper continues with an analysis of the required sensing suite and the navigation algorithms to allow the homing, fly-around, and capture of the target satellite. The emphasis is placed around the design of a system to allow the rendezvous with an un-cooperative target, including the autonomous acquisition of both the orbital elements and the attitude of the target satellite.Analysing the capture phase, the paper provides a trade- off between two selected capture systems: the net and the tentacles. Both are studied from the point of view of the GNC system.The paper analyses as well the advanced algorithms proposed to control the final compound after the capture that will allow the controlled de-orbiting of the assembly in a safe place in the Earth.The paper ends proposing the continuation of this work with the extension to the analysis of the destruction process of the compound in consecutive segments starting from the entry gate to the rupture and break up.

Zika Virus and Pregnancy

Medline Plus

Full Text Available ... Departments Donate Shop Career Connection Home Clinical Guidance & Publications Practice Management Education & Events Advocacy For Patients About ... pregnant. Related: Zika Virus and Pregnancy Infographic Resources & Publications Committee Opinions Practice Bulletins Patient Education Green Journal ...

Zika Virus and Pregnancy

Medline Plus

Full Text Available ... Donate Shop Career Connection Home Clinical Guidance & Publications Practice Management Education & Events Advocacy For Patients About ACOG ... Virus and Pregnancy Infographic Resources & Publications Committee Opinions Practice Bulletins Patient Education Green Journal Clinical Updates Practice ...

Guidance on the scientific requirements for health claims related to gut and immune function

DEFF Research Database (Denmark)

Tetens, Inge

2011-01-01

The European Food Safety Authority (EFSA) asked the Panel on Dietetic Products Nutrition and Allergies (NDA) to draft guidance on scientific requirements for health claims related to gut and immune function. This guidance has been drawn from scientific opinions of the NDA Panel on such health......, was subjected to public consultation (28 September 2010 to 22 October 2010), and was also discussed at a technical meeting with experts in the field on 2 December 2010 in Amsterdam....

Examining Racial and Ethnic Differences in Nursing Home Quality.

Science.gov (United States)

Hefele, Jennifer Gaudet; Ritter, Grant A; Bishop, Christine E; Acevedo, Andrea; Ramos, Candi; Nsiah-Jefferson, Laurie A; Katz, Gabrielle

2017-11-01

Identifying racial/ethnic differences in quality is central to identifying, monitoring, and reducing disparities. Although disparities across all individual nursing home residents and disparities associated with between-nursing home differences have been established, little is known about the degree to which quality of care varies by race//ethnicity within nursing homes. A study was conducted to measure within-facility differences for a range of publicly reported nursing home quality measures. Resident assessment data on approximately 15,000 nursing homes and approximately 3 million residents (2009) were used to assess eight commonly used and publicly reported long-stay quality measures: the proportion of residents with weight loss, with high-risk and low-risk pressure ulcers, with incontinence, with depressive symptoms, in restraints daily, and who experienced a urinary tract infection or functional decline. Each measure was stratified by resident race/ethnicity (non-Hispanic white, non-Hispanic black, and Hispanic), and within-facility differences were examined. Small but significant differences in care on average were found, often in an unexpected direction; in many cases, white residents were experiencing poorer outcomes than black and Hispanic residents in the same facility. However, a broad range of differences in care by race/ethnicity within nursing homes was also found. The results suggest that care is delivered equally across all racial/ethnic groups in the same nursing home, on average. The results support the call for publicly reporting stratified nursing home quality measures and suggest that nursing home providers should attempt to identify racial/ethnic within-facility differences in care. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

Protection of people living in long-term contaminated areas after a nuclear accident: the guidance of ICRP Publication 111

International Nuclear Information System (INIS)

Lochard, Jacques

2012-01-01

The International Commission on Radiological Protection provides guidance for the protection of people living in long-term contaminated areas after nuclear accidents or radiological emergencies in ICRP Publication 111 (Ann. ICRP 2009, 39(3)). The prolonged exposures resulting from such events are defined as existing exposure situations and the driving principle for managing exposure situations is the optimization of protection. In conjunction with optimization, the Commission recommends the use of reference levels to restrict individual doses. To be effective, protection strategies to maintain and reduce exposure as low as reasonably achievable should include actions implemented by public authorities and private businesses, but also by the affected population itself. The process through which inhabitants living in a contaminated environment identify problems and apply their own protective actions has been named 'self-help protection' by the Commission. Such a process supposes that affected individuals are fully aware of the situation and are well informed. It is the responsibility of the authorities to establish programmes for continuous radiation monitoring, information and education of the population. The involvement of local professionals and inhabitants in the definition and implementation of protection strategies is a key factor for the sustainability of long-term rehabilitation programmes. (note)

Public transit to public lands : the nature express.

Science.gov (United States)

2017-05-01

Access to leisure by public transportation has not been studied in great detail, at least in the United States. The Northeastern Illinois region with the City of Chicago (in Cook County) as the focal point is home to the third largest public transpor...

Career Guidance and Health Promotion with Adolescents: Keys for Intervention Programs

Science.gov (United States)

Aguiar, Fernando Henrique Rezende; Conceição, Maria Inês Gandolfo

2015-01-01

This qualitative study investigates underprivileged students' perceptions of their future, their health, and the relevance of a career counseling process. Interviews regarding career guidance were conducted during a workshop with nine eleventh-grade students from a public high school in Brazil's capital. The data were analyzed according to…

41 CFR 302-10.5 - May I transport a mobile home over water?

Science.gov (United States)

2010-07-01

... transport a mobile home over water? Yes, you may transport a mobile home over water when both the points of... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false May I transport a mobile home over water? 302-10.5 Section 302-10.5 Public Contracts and Property Management Federal Travel...

Healthy End of Life Project (HELP): a progress report on implementing community guidance on public health palliative care initiatives in Australia.

Science.gov (United States)

Grindrod, Andrea; Rumbold, Bruce

2018-04-01

Contemporary end of life care policies propose increasing community capacity by developing sustainable skills, policies, structures, and resources to support members of a community in caring for each other at the end of life. Public health approaches to palliative care provide strategies to bring this about. Practical implementation can however be ineffective, principally due to failures to grasp the systemic nature of public health interventions, or to ensure that programs are managed and owned by community members, not the professionals who may have introduced them. This article outlines a comprehensive community development project that identifies local end of life needs and meets them through the efficient use of community resources. The project is the product of a three-phase enquiry. The first phase, carried out in a local community, examined carers' experiences of home-based dying, the networks that supported them during care, and broader community networks with the potential to extend care. Data were collected through in-depth research interviews, focus groups and consultation with a community research reference group. Findings were key issues to be targeted by a local community development strategy. In the second phase, these local findings were compared with other practice accounts to identify themes common to many contexts. A public health palliative care framework was then used to produce an evidence-informed community development model for end of life care. The third phase involves implementing and evaluating this model in different Australian contexts. A major theme emerging in phase one of the enquiry was the reluctance of carers to ask for, or even accept, offers of help from family, friends and community networks despite their evident need for support while providing end of life care at home. Others' willingness to provide support was thus hindered by uncertainty about what to offer, and concern about infringing on people's privacy. To develop

Building Homes, Building Careers.

Science.gov (United States)

Cohn, Meredith

1987-01-01

The Construction Trades Foundation, a nonprofit corporation of business, industry, and school leaders, provides high school students in Montgomery County, Maryland, with unique hands-on experiences in construction, home design, marketing, public relations, and other fields. (SK)

Development of guidance on applications of regulatory requirements for low specific activity materials and surface contaminated objects

International Nuclear Information System (INIS)

Pope, R.B.; Easton, E.P.; Shankman, S.F.

1997-01-01

In 1985, the International Atomic Energy Agency issued revised regulations for the safe transport of radioactive material. Significant among the changes were major revisions to requirements for Low Specific Activity (LSA) material and Surface Contaminated Objects (SCOs). In preparation for the adoption of these requirements into regulations in the United States, it became apparent that guidance on how to apply these requirements, clarifying technical uncertainties and ensuring proper implementation, would be needed both by the regulators and those regulated. Thus, the US Department of Transportation and the US Nuclear Regulatory Commission, with the assistance of staff from Oak Ridge National Laboratory, are preparing regulatory guidance for LSA material and SCO transport. The guidance will present examples of acceptable methods for demonstrating compliance with the revised rules. Ideas being investigated for inclusion in the pending guidance are discussed in this paper. Under current plans, the guidance will be issued for public comment prior to final issuance of the guidance in 1997

Development of guidance on applications of regulatory requirements for low specific activity materials and surface contaminated objects

International Nuclear Information System (INIS)

Pope, R.B.; Easton, E.P.; Shankman, S.F.; Boyle, R.W.

1997-01-01

In 1985, the International Atomic Energy Agency issued revised regulations for the safe transport of radioactive material. Significant among the changes were major revisions to requirements for Low Specific Activity (LSA) material and Surface Contaminated Objects (SCOs). In preparation for the adoption of these requirements into regulations in the United States, it became apparent that guidance on how to apply these requirements, clarifying technical uncertainties and ensuring proper implementation, would be needed both by the regulators and those regulated. Thus, the US Department of Transportation and the U.S. Nuclear Regulatory Commission, with the assistance of staff from Oak Ridge National Laboratory, are preparing regulatory guidance for LSA material and SCO transport. The guidance will present examples of acceptable methods for demonstrating compliance with the revised rules. Ideas being investigated for inclusion in the pending guidance are discussed in this paper. Under current plans, the guidance will be issued for public comment prior to final issue of the guidance in 1997. (Author)

77 FR 14473 - Final Guidance on Improving the Process for Preparing Efficient and Timely Environmental Reviews...

Science.gov (United States)

2012-03-12

..., economic, and social aspirations and is a cornerstone of our Nation's efforts to protect the environment... direct interaction with the public. Earlier CEQ guidance has emphasized the importance of public... Federal involvement that trigger NEPA requirements). \\38\\ 40 CFR 1507.3(b)(1). All agencies are required...

Publications about Radon

Science.gov (United States)

There is no known safe level of exposure to radon. EPA strongly recommends that you fix your home if your test shows 4 picocuries (pCi/L) or more. These publications and resources will provide you with the information you need to fix your home.

Dissecting Attending Surgeons' Operating Room Guidance: Factors That Affect Guidance Decision Making.

Science.gov (United States)

Chen, Xiaodong Phoenix; Williams, Reed G; Smink, Douglas S

2015-01-01

The amount of guidance provided by the attending surgeon in the operating room (OR) is a key element in developing residents' autonomy. The purpose of this study is to explore factors that affect attending surgeons' decision making regarding OR guidance provided to the resident. We used video-stimulated recall interviews (VSRI) throughout this 2-phase study. In Phase 1, 3 attending surgeons were invited to review separately 30 to 45 minute video segments of their prerecorded surgical operations to explore factors that influenced their OR guidance decision making. In Phase 2, 3 attending surgeons were observed and documented in the OR (4 operations, 341min). Each operating surgeon reviewed their videotaped surgical performance within 5 days of the operation to reflect on factors that affected their decision making during the targeted guidance events. All VSRI were recorded. Thematic analysis and manual coding were used to synthesize and analyze data from VSRI transcripts, OR observation documents, and field notes. A total of 255 minutes of VSRI involving 6 surgeons and 7 surgical operations from 5 different procedures were conducted. A total of 13 guidance decision-making influence factors from 4 categories were identified (Cohen's κ = 0.674): Setting (case schedule and patient morbidity), content (procedure attributes and case progress), resident (current competency level, trustworthiness, self-confidence, and personal traits), and attending surgeon (level of experience, level of comfort, preferred surgical technique, OR training philosophy, and responsibility as surgeon). A total of 5 factors (case schedule, patient morbidity, procedure attributes, resident current competency level, and trustworthiness) influenced attending surgeons' pre-OR guidance plans. "OR training philosophy" and "responsibility as surgeon" were anchor factors that affected attending surgeons' OR guidance decision-making patterns. Surgeons' OR guidance decision making is a dynamic process

Law, Ethics, and Conversations between Physicians and Patients about Firearms in the Home.

Science.gov (United States)

McCourt, Alexander D; Vernick, Jon S

2018-01-01

Firearms in the home pose a risk to household members, including homicide, suicide, and unintentional deaths. Medical societies urge clinicians to counsel patients about those risks as part of sound medical practice. Depending on the circumstances, clinicians might recommend safe firearm storage, temporary removal of the firearm from the home, or other measures. Certain state firearm laws, however, might present legal and ethical challenges for physicians who counsel patients about guns in the home. Specifically, we discuss state background check laws for gun transfers, safe gun storage laws, and laws forbidding physicians from engaging in certain firearm-related conversations with their patients. Medical professionals should be aware of these and other state gun laws but should offer anticipatory guidance when clinically appropriate. © 2018 American Medical Association. All Rights Reserved.

The effect of early postpartum home visits by health visitors: a natural experiment

DEFF Research Database (Denmark)

Kronborg, Hanne; Væth, Michael; Kristensen, Ingeborg

2012-01-01

Objective: To assess if the absence of early home visits influenced the mothers’ breastfeeding duration and use of medical services. Design: Data from mothers who had given birth during a strike period were compared to data from a reference period with usual work practice. Sample: The study...... included 3834 newborn and 375 health visitors, 75 of whom worked during the strike period. Intervention: All families were offered non- standardized home visits after discharge in the reference period. During the strike, the service was based on individual risk assessment. Results: Overall, no difference....... The mothers’ needs for postnatal visits differed depending on parity: primiparae underlined uncertainty, multiparae underlined previous breastfeeding experience. Mothers had missed out on guidance on all areas of the health visitors’ service. Conclusion: Non-standardized home visits by health visitors were...

Guidance for Reviewing OCSPP 850.2100 Avian Oral Toxicity Studies Conducted with Passerine Birds

Science.gov (United States)

Guidance based on comparison of results from the TG223 validation studies to results from avian acute oral studies previously submitted to EPA for two test chemicals following EPA's 850.2100 (public draft) guidelines.

Early school leaving and lifelong guidance

DEFF Research Database (Denmark)

Plant, Peter; Oomen, Annemarie

Early school leaving (ESL) is costly for the individual, for society and for the economy. Not just in economic terms, but also in terms of low self esteem, and the risk of social exclusion. More, and, in particular, better education can lead to positive outcomes, in relation to employment, level...... of salaries, better health, less crime, higher social cohesion, lower public and social costs and higher productivity. This is why ESL is a policy focal point. In these terms, lifelong guidance has a key role to play in terms of both prevention, intervention, and of compensation strategies....

Configuration management: Phase II implementation guidance

Energy Technology Data Exchange (ETDEWEB)

1994-03-01

Configuration management (CM) is essential to maintaining an acceptable level of risk to the public, workers, environment, or mission success. It is a set of activities and techniques used to maintain consistency among physical and functional configuration, applicable requirements, and key documents. This document provides guidance for continuing the implementation of CM in a phased and graded manner. It describes a cost-effective approach to documented consistency with requirements, with early emphasis on items most important to safety and environmental protection. It is intended to help responsible line managers and configuration management staff personnel in meeting the Energy Systems configuration management policy standard.

Raising the Profile of Career Guidance: Educational and Vocational Guidance Practitioner

Science.gov (United States)

Hiebert, Bryan

2009-01-01

In 2007 the International Association for Educational and Vocational Guidance (IAEVG) launched the Educational and Vocational Guidance Practitioner credential (EVGP) as one means of formally acknowledging the knowledge, skills, and personal attributes that practitioners need in order to provide quality career development services to clients. This…

Public nursing home staff's experience of participating in an intervention aimed at enhancing their self-esteem.

Science.gov (United States)

Wadensten, Barbro; Engström, Maria; Häggström, Elisabeth

2009-11-01

The aim of the present study was to gain an understanding of how nursing staff experienced participating in a training programme aimed at strengthening their self-esteem and empowering them, to determine whether participation benefited them in any way, and to describe their opinions about possible benefits or disadvantages. Staff working in institutions such as nursing homes have a low status in society. A training programme was introduced to staff in a public nursing home. It focused on helping them understand factors in the work situation that influence them and on empowering them. The study was explorative and qualitative in design. The participants in the programme were generally satisfied with it. Their opinions about the benefits they received from the programme can be described using three themes: 'improved communication skills', 'enhanced self-esteem' and 'sees work in a different light'. The most important finding of the present study is that it was possible to strengthen and empower staff. Staff members were generally pleased and satisfied with the content/organization of the training programme. They felt the programme had been of value to them by improving their communication skills and increasing their self-esteem. The present result could be of value to managers and educators working in the area of nursing home care when planning education and development activities for staff. Learning to communicate better and understand the social structure at the workplace could improve staff members' self-esteem, thereby enhancing the work situation and atmosphere as well as empowering the individuals.

Nationwide study of factors associated with public's willingness to use home self-test kit for dengue fever in Malaysia.

Science.gov (United States)

Wong, Li Ping; Atefi, Narges; AbuBakar, Sazaly

2016-08-12

As there is no specific treatment for dengue, early detection and access to proper treatment may lower dengue fatality. Therefore, having new techniques for the early detection of dengue fever, such as the use of dengue test kit, is vitally important. The aims of the study were: 1) identify factors associated with acceptance of a home self-test kit for dengue fever if the dengue test is available to the public and 2) find out the characteristics of the test kits that influence the use of the dengue test kit. A national telephone survey was carried out with 2,512 individuals of the Malaysian public aged 18-60 years old. Individuals were contacted by random digit dialling covering the whole of Malaysia from February 2012 to June 2013. From 2,512 participants, 6.1 % reported to have heard of the availability of the dengue home test kit and of these, 44.8 % expressed their intention to use the test kit if it was available. Multivariate logistic regressions indicated that participants with primary (OR: 0.65; 95 % CI: 0.43-0.89; p = 0.02, vs. tertiary educational level) and secondary educational levels (OR: 0.73; 95 % CI: 0.57-0.90; p = 0.01, vs. tertiary educational level) were less likely than participants with a tertiary educational level to use a home self-testing dengue kit for dengue if the kit was available. Participants with lower perceived barriers to dengue prevention (level of barriers 0-5) were less likely (OR: 0.67, 95 % CI: 0.53-0.85, p dengue kit for dengue if the kit was available compared to those with higher perceived barriers to dengue prevention (level of barriers 6-10). Participants with a lower total dengue fever knowledge score (range 0-22) were also less likely to use a home self-testing dengue kit for dengue if the kit was available (OR: 0.75; 95 % CI: 0.61-0.91, p = 0.001, vs. higher total dengue fever knowledge score) compared to those with a higher total dengue fever knowledge score (range 23-44). With response to

Guidance For The Bioremediation Of Oil-Contaminated Wetlands, Marshes, And Marine Shorelines

Science.gov (United States)

Marine shorelines are important public and ecological resources that serve as a home to a variety of wildlife and provide public recreation. Marine oil spills, particularly large scale spill accidents, have posed great threats and cause extensive damage to the marine coastal env...

Guidance for regulation of underground repositories for disposal of radioactive wastes

International Nuclear Information System (INIS)

1989-01-01

Deep geological formations are favoured for disposal of high level and alpha bearing wastes from the nuclear fuel cycle: varying depths of emplacement, including shallow land disposal, with or without engineered barriers may be foreseen for low and intermediate level wastes. Most countries will regulate such disposal through licensing actions by a regulatory body whose purpose is to review and analyse the safety of all stages of the disposal programme. This regulatory function may be performed either by a single national authority or a system of authorities. It is the intent of the IAEA that this publication will be used as a guide to develop regulatory requirements for licensing waste disposal facilities. This report updates IAEA Safety Series No. 51. Development of the regulatory process is maturing rapidly in Member States, hence there is a clear need to revise the nearly ten year old text of that publication. The purpose of this report is to provide general guidance for the regulation of underground disposal of low, intermediate and high level radioactive wastes once a fundamental decision to pursue this option has been made. It is intended to reflect the experience of those countries with mature regulatory programmes and to provide some guidance to those countries that wish to develop regulatory programmes. Guidance is given on what issues should be addressed in the licensing review, what decision points are important, and what guidance should be given to the applicant by the regulatory system in the course of the licensing actions. The orientation of the report is on technical factors rather than the social and political aspects that need to be taken into account when regulating the underground disposal of radioactive wastes. The financing aspects are not discussed

76 FR 20595 - Guidance on Reporting Interest Paid to Nonresident Aliens; Hearing

Science.gov (United States)

2011-04-13

... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Parts 1 and 31 [REG-146097-09] RIN 1545-BJ01 Guidance on Reporting Interest Paid to Nonresident Aliens; Hearing AGENCY: Internal Revenue.... offices of certain financial institutions and paid to nonresident alien individuals. DATES: The public...

76 FR 22064 - Guidance on Reporting Interest Paid to Nonresident Aliens; Hearing

Science.gov (United States)

2011-04-20

... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Parts 1 and 31 [REG-146097-09] RIN 1545-BJ01 Guidance on Reporting Interest Paid to Nonresident Aliens; Hearing AGENCY: Internal Revenue... and paid to nonresident alien individuals. DATES: The public hearing is being rescheduled from Monday...

Guidance for evidence-informed policies about health systems: rationale for and challenges of guidance development.

Directory of Open Access Journals (Sweden)

Xavier Bosch-Capblanch

Full Text Available In the first paper in a three-part series on health systems guidance, Xavier Bosch-Capblanch and colleagues examine how guidance is currently formulated in low- and middle-income countries, and the challenges to developing such guidance.

Approaches to quality improvement in nursing homes: Lessons learned from the six-state pilot of CMS's Nursing Home Quality Initiative

OpenAIRE

Kissam, Stephanie; Gifford, David; Parks, Peggy; Patry, Gail; Palmer, Laura; Wilkes, Linda; Fitzgerald, Matthew; Petrulis, Alice Stollenwerk; Barnette, Leslie

2003-01-01

Abstract Background In November 2002, the Centers for Medicare & Medicaid Services (CMS) launched a Nursing Home Quality Initiative that included publicly reporting a set of Quality Measures for all nursing homes in the country, and providing quality improvement assistance to nursing homes nationwide. A pilot of this initiative occurred in six states for six months prior to the launch. Methods Review and analysis of the lessons learned from the six Quality Improvement Organizations (QIOs) tha...

Measuring Integrated Socioemotional Guidance at School: Factor Structure and Reliability of the Socioemotional Guidance Questionnaire (SEG-Q)

Science.gov (United States)

Jacobs, Karen; Struyf, Elke

2013-01-01

Socioemotional guidance of students has recently become an integral part of education, however no instrument exists to measure integrated socioemotional guidance. This study therefore examines the factor structure and reliability of the Socioemotional Guidance Questionnaire. Psychometric properties of the Socioemotional Guidance Questionnaire and…

Graphical Turbulence Guidance - Composite

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Forecast turbulence hazards identified by the Graphical Turbulence Guidance algorithm. The Graphical Turbulence Guidance product depicts mid-level and upper-level...

Second home tourism in the Algarve – The perception of public managers

Directory of Open Access Journals (Sweden)

Raphael dos Santos D’Emery Gomes

2017-04-01

Full Text Available Proposal: In the last year’s second home tourism has obtained a relevant attention in Portugal, and especially in the Algarve region. It has been identified by the national tourism plan as one of the strategic products. In the Algarve second home market important for the tourism dynamics. Objective: This study focuses on the perception of government agents in the Algarve about second home tourism, in particular the strengths, weaknesses, opportunities and threats that this product creates for regional development. Methodological Design: The study uses a descriptive and exploratory approach with an online survey applied to all  municipalities in the Algarve. Results: The results are helpful to understand second home tourism trajectories by presenting useful information to future strategies. Originality: It was observed that economic factors directly influence strengths and threats, the weakness are more related to social and environmental aspects, and the opportunities are linked to all dimensions, economic, social and environmental.

78 FR 48175 - Retrospective Review of Draft Guidance Documents Issued Before 2010; Withdrawal of Guidances

Science.gov (United States)

2013-08-07

... guidances (number 19 through 22), contact the Office of Pharmaceutical Science in CDER. 23. ``Qualifying for... to the pharmaceutical industry. In most cases, FDA has developed other guidances and resources to... guidances: 1. ``Manufacturing, Processing, or Holding Active Pharmaceutical Ingredients''--issued April 1998...

Fixing the broken image of care homes, could a 'care home innovation centre' be the answer?

Science.gov (United States)

Hockley, Jo; Harrison, Jennifer Kirsty; Watson, Julie; Randall, Marion; Murray, Scott

2017-03-01

The UK has many excellent care homes that provide high-quality care for their residents; however, across the care home sector, there is a significant need for improvement. Even though the majority of care homes receive a rating of 'good' from regulators, still significant numbers are identified as requiring 'improvement' or are 'inadequate'. Such findings resonate with the public perceptions of long-term care as a negative choice, to be avoided wherever possible-as well as impacting on the career choices of health and social care students. Projections of current demographics highlight that, within 10 years, the part of our population that will be growing the fastest will be those people older than 80 years old with the suggestion that spending on long-term care provision needs to rise from 0.6% of our Gross Domestic Product in 2002 to 0.96% by 2031. Teaching/research-based care homes have been developed in the USA, Canada, Norway, the Netherlands and Australia in response to scandals about care, and the shortage of trained geriatric healthcare staff. There is increasing evidence that such facilities help to reduce inappropriate hospital admissions, increase staff competency and bring increased enthusiasm about working in care homes and improve the quality of care. Is this something that the UK should think of developing? This commentary details the core goals of a Care Home Innovation Centre for training and research as a radical vision to change the culture and image of care homes, and help address this huge public health issue we face. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Contextual cueing improves attentional guidance, even when guidance is supposedly optimal.

Science.gov (United States)

Harris, Anthony M; Remington, Roger W

2017-05-01

Visual search through previously encountered contexts typically produces reduced reaction times compared with search through novel contexts. This contextual cueing benefit is well established, but there is debate regarding its underlying mechanisms. Eye-tracking studies have consistently shown reduced number of fixations with repetition, supporting improvements in attentional guidance as the source of contextual cueing. However, contextual cueing benefits have been shown in conditions in which attentional guidance should already be optimal-namely, when attention is captured to the target location by an abrupt onset, or under pop-out conditions. These results have been used to argue for a response-related account of contextual cueing. Here, we combine eye tracking with response time to examine the mechanisms behind contextual cueing in spatially cued and pop-out conditions. Three experiments find consistent response time benefits with repetition, which appear to be driven almost entirely by a reduction in number of fixations, supporting improved attentional guidance as the mechanism behind contextual cueing. No differences were observed in the time between fixating the target and responding-our proxy for response related processes. Furthermore, the correlation between contextual cueing magnitude and the reduction in number of fixations on repeated contexts approaches 1. These results argue strongly that attentional guidance is facilitated by familiar search contexts, even when guidance is near-optimal. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Knowledge, perceived skills and activities of nursing staff to support oral home care among older domiciliary care clients.

Science.gov (United States)

Salmi, Riikka; Tolvanen, Mimmi; Suhonen, Riitta; Lahti, Satu; Närhi, Timo

2018-04-25

Increasing number of older adults lives in their own homes, but needs help in many daily routines. Domiciliary care nursing staff (DCNS) is often needed to support oral home care. However, information of nursing staff's knowledge, skills and activity in this task is sparse. The study aimed to assess DCNS knowledge, perceived skills and activities to support oral home care of older domiciliary care clients. The study was conducted among DCNS in one of the largest cities in Finland. All DCNS members (n = 465) received a questionnaire with 14 multiple choice and open questions regarding the perceived skills, knowledge and activities of oral health guidance of older domiciliary care clients. In total, 115 (25%) DCNS members returned the questionnaires. Frequencies, percentages, means and standard deviations were used to describe the samples and study variables. DCNS was categorised according to age and working years for group comparisons, which were assessed with chi-squared test. Knowledge concerning oral health was mostly on a high level. Around 50% of DCNS considered their knowledge regarding dental prosthesis hygiene as sufficient. Of the DCNS, 67% informed that they had received education on oral health care. However, over 50% of the DCNS had a need for further education in issues related to oral home care. DCNS were active in supporting most oral and prosthesis hygiene means, yet less in guidance concerning toothbrushing. Activity to support cleaning the interdental spaces was the weakest, in which only 12% of the respondents considered having average or excellent skills. Younger DCNS had better knowledge on oral home care due to recent education, but older staff members were more skilful in performing oral hygiene measures. There is a need for structured instructions and training on oral home care for DCNS. Oral home care should be taken into account more often and regularly. © 2018 Nordic College of Caring Science.

ATLAS@Home looks for CERN volunteers

CERN Multimedia

Rosaria Marraffino

2014-01-01

ATLAS@Home is a CERN volunteer computing project that runs simulated ATLAS events. As the project ramps up, the project team is looking for CERN volunteers to test the system before planning a bigger promotion for the public.   The ATLAS@home outreach website. ATLAS@Home is a large-scale research project that runs ATLAS experiment simulation software inside virtual machines hosted by volunteer computers. “People from all over the world offer up their computers’ idle time to run simulation programmes to help physicists extract information from the large amount of data collected by the detector,” explains Claire Adam Bourdarios of the ATLAS@Home project. “The ATLAS@Home project aims to extrapolate the Standard Model at a higher energy and explore what new physics may look like. Everything we’re currently running is preparation for next year's run.” ATLAS@Home became an official BOINC (Berkeley Open Infrastructure for Network ...

The Socialization of Home-Schooled Children in Rural Utah

OpenAIRE

Mecham, Neil A.

2004-01-01

Concern over the social development of children who are home schooled has caused parents and educators to question the wisdom of this practice. A review of home-schooling research has not revealed whether a difference exists between the social skills of homeschooled children and children who attend public schools. This study explored the socialization of home-schooled children by comparing Social Skills Rating System scores of home-schooled children with the scores of their mothers and a comp...

75 FR 69089 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

Science.gov (United States)

2010-11-10

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-D-0514] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document... Administration (FDA) is announcing the availability of the guidance entitled ``Class II Special Controls Guidance...

76 FR 29251 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls; Guidance...

Science.gov (United States)

2011-05-20

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2006-D-0094] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls; Guidance Document... of the guidance entitled ``Guidance for Industry and Food and Drug Administration Staff; Class II...

77 FR 10535 - Final Guidances for Industry Describing Product-Specific Bioequivalence Recommendations...

Science.gov (United States)

2012-02-22

... recommendations provide product-specific guidance on the design of BE studies to support abbreviated new drug... the process that would be used to make product-specific BE recommendations available to the public on... ``Bioequivalence Recommendations for Specific Products,'' which explained the process that would be used to make...

77 FR 28519 - Test Procedure Guidance for Room Air Conditioners, Residential Dishwashers, and Residential...

Science.gov (United States)

2012-05-15

... Guidance for Room Air Conditioners, Residential Dishwashers, and Residential Clothes Washers: Public... procedures for room air conditioners, residential dishwashers, and residential clothes washers. DATES: DOE...'s existing test procedures for residential room air conditioners, residential dishwashers, and...

THE EVALUATION OF COUNSELING AND GUIDANCE SERVICES BASED ON TEACHER VIEWS AND THEIR PREDICTION BASED ON SOME VARIABLES

Directory of Open Access Journals (Sweden)

Fulya Yuksel-Sahin

2009-01-01

Full Text Available This study evaluated psychological counseling and guidance services based on elementary and secondary education teachers’ views. Participants were 204 teachers. “School Guidance Services Scale” and “Teacher Personal Information Form” were used for gathering the necessary information. Percentage calculations and multiple regression analysis were used for data analysis. The results showed that teachers listed the guidance services from the most utilized to the least as follows: consultation, counseling, information gathering and outreach, appraisal, orientation, placement, research and evaluation public and family relations and follow-up services. Results of this study showed that overall an approximately 46% of all counseling and guidance services were offered. Moreover, according to the results of the study, the grade being taught and holding the view that schools should definitely have a school counselor were significant predictors of teachers’ evaluation of counseling and guidance services. However, taking counseling and guidance lessons during undergraduate studies, the length of service and gender were not significant predictors of teachers’ evaluation of counseling and guidance services.

Study on the Reduced Traffic Congestion Method Based on Dynamic Guidance Information

Science.gov (United States)

Li, Shu-Bin; Wang, Guang-Min; Wang, Tao; Ren, Hua-Ling; Zhang, Lin

2018-05-01

This paper studies how to generate the reasonable information of travelers’ decision in real network. This problem is very complex because the travelers’ decision is constrained by different human behavior. The network conditions can be predicted by using the advanced dynamic OD (Origin-Destination, OD) estimation techniques. Based on the improved mesoscopic traffic model, the predictable dynamic traffic guidance information can be obtained accurately. A consistency algorithm is designed to investigate the travelers’ decision by simulating the dynamic response to guidance information. The simulation results show that the proposed method can provide the best guidance information. Further, a case study is conducted to verify the theoretical results and to draw managerial insights into the potential of dynamic guidance strategy in improving traffic performance. Supported by National Natural Science Foundation of China under Grant Nos. 71471104, 71771019, 71571109, and 71471167; The University Science and Technology Program Funding Projects of Shandong Province under Grant No. J17KA211; The Project of Public Security Department of Shandong Province under Grant No. GATHT2015-236; The Major Social and Livelihood Special Project of Jinan under Grant No. 20150905

Public Participation Plan

International Nuclear Information System (INIS)

1993-07-01

The purpose of this Public Participation Plan is to describe the US Department of Energy's (DOE) plan for involving the public in the decision-making process for the Uranium Mill Tailings Remedial Action (UMTRA) Project. The plan describes how the DOE will meet the public participation requirements of the Uranium Mill Tailings Radiation Control Act (UMTRCA) of 1978, as amended, and of the National Environmental Policy Act (NEPA) of 1969. It includes the UMTRA Project Office plans for complying with DOE Order 5440.1D and for implementing the DOE's Public Participation Policy for Environmental Restoration and Waste Management (1992) and Public Participation Guidance for Environmental Restoration and Waste Management (1993)

Exploring innovative solutions for quality of life and care of bed-ridden nursing home residents through codesign sessions

NARCIS (Netherlands)

Van Hoof, J.; Wetzels, Mart; Dooremalen, A.M.C.; Overdiep, R.A.; Nieboer, M.E.; Eyck, A.M.E.; Van Gorkom, P.J.L.M.; Zwerts-Verhelst, E.L.M.; Aarts, S.; Vissers-Luijcks, C.; Van Der Voort, C.S.; Moonen, M.J.G.A.; Van De Vrande, H.A.; Van Dijck-Heinen, C.J.M.L.; Wouters, E.J.M.

2015-01-01

Bed-ridden nursing home residents are in need of environments which are homelike and facilitate the provision of care. Design guidance for this group of older people is limited. This study concerned the exploration and generation of innovative environmental enrichment scenarios for bed-ridden

Can Organizations Learn without Political Leadership? The Case of Public Sector Reform among South African Home Affairs Officials

DEFF Research Database (Denmark)

Segatti, Aurelia; Hoag, Colin Brewster; Vigneswaran, Darshan

2012-01-01

This paper deals with the transformation of “institutional culture” in bureaucratic agencies. This is explored in the context of post-Apartheid South African public sector reform, and more particularly that of migration management within the Department of Home Affairs (DHA). The paper assesses...... the effects on staff’s perceptions and practices of a politically driven attempt at inculcating a new sense of “service delivery”. Structural factors are not found to have been prevalent determinants explaining the difficulties in implementing the reform. It is rather the failure of the political leadership...

76 FR 14405 - Agency Information Collection Activities; Proposed Collection; Comment Request; Guidance for...

Science.gov (United States)

2011-03-16

... cooperative manufacturing arrangements for licensed biologics. DATES: Submit either electronic or written... Public Health Service Act (42 U.S.C. 262). The guidance addresses several types of manufacturing... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No.FDA-2011-N-0085...

Equal employment opportunity plan development guidance

Energy Technology Data Exchange (ETDEWEB)

None

1978-09-01

The purpose of this publication is to provide instructions for the development of EEO Plans for Fiscal Year 1979. It supplements the National EEO Plan for the Department of Energy issued in August 1978 (DOE/S-0002). The material included should be used immediately as guidance to develop, document, and implement subordinate echelon commitments to EEO. A schedule for the development and submission of EEO Plans is included. Most of the continuing requirements will be published at a later date as part of the directives system. Any comments or helpful suggestions concerned with the program outlined would be appreciated by the Office of Equal Opportunity.

Effect of prospective reimbursement on nursing home costs.

Science.gov (United States)

Coburn, A F; Fortinsky, R; McGuire, C; McDonald, T P

1993-04-01

This study evaluates the effect of Maine's Medicaid nursing home prospective payment system on nursing home costs and access to care for public patients. The implementation of a facility-specific prospective payment system for nursing homes provided the opportunity for longitudinal study of the effect of that system. Data sources included audited Medicaid nursing home cost reports, quality-of-care data from state facility survey and licensure files, and facility case-mix information from random, stratified samples of homes and residents. Data were obtained for six years (1979-1985) covering the three-year period before and after implementation of the prospective payment system. This study used a pre-post, longitudinal analytical design in which interrupted, time-series regression models were estimated to test the effects of prospective payment and other factors, e.g., facility characteristics, nursing home market factors, facility case mix, and quality of care, on nursing home costs. Prospective payment contributed to an estimated $3.03 decrease in total variable costs in the third year from what would have been expected under the previous retrospective cost-based payment system. Responsiveness to payment system efficiency incentives declined over the study period, however, indicating a growing problem in achieving further cost reductions. Some evidence suggested that cost reductions might have reduced access for public patients. Study findings are consistent with the results of other studies that have demonstrated the effectiveness of prospective payment systems in restraining nursing home costs. Potential policy trade-offs among cost containment, access, and quality assurance deserve further consideration, particularly by researchers and policymakers designing the new generation of case mix-based and other nursing home payment systems.

Impacts of Pre-Retirement Guidance and Family Involvement on Retirement Adjustment of Retirees in Nigeria

Directory of Open Access Journals (Sweden)

O.O. Olatomide

2017-12-01

Full Text Available The study examined retirement adjustment of teacher-retirees in Osun State, and explored the interaction effects of pre-retirement guidance and family in-volvement on retirement adjustment. Exposit-facto design was used. The population comprised retirees from public, civil and private establishments from which 122 teacher-retirees were selected using a multi-stage sampling technique. An instrument: Family Involvement, Pre-retirement Guidance and Retirement Adjustment Questionnaire was used for data collection. Three research questions and three hypotheses guided the study. Data were analyzed using descriptive and inferential statistics. Results revealed that retirees in Osun State are not optimally adjusted, and positive significant interaction effect was found between family involvement and pre-retirement guidance on retirees adjustment, among others. Appropriate policy implications are outlined.

Zika Virus and Pregnancy

Medline Plus

Full Text Available ... Guidance & Publications Practice Management Education & Events Advocacy For Patients About ACOG Zika Virus and Pregnancy Home For Patients Zika Virus and Pregnancy Page Navigation ▼ ACOG Pregnancy ...

Home Range Characteristics and Habitat Selection by Daurian Hedgehogs ( Mesechinus dauuricus in Ikh Nart Nature Reserve, Mongolia

Directory of Open Access Journals (Sweden)

Mirka Zapletal

2012-12-01

Full Text Available We examined home range characteristics and habitat selection of Daurian hedgehogs in Ikh Nart Nature Reserve, Mongolia. Home ranges of hedgehogs varied from 113.15 ha to 2,171.97 ha, and were larger in early summer than late summer. Hedgehogs showed relative preference for rocky outcrops and low-density shrub habitats, and relative avoidance of high- density shrub areas. Habitat selection also changed between early and late summer, shifting to greater use of low-density shrub areas and decreased use of forb-dominated short grass. Our baseline data on home ranges and habitat selection expand understanding of hedgehog ecology and provide guidance for future management decisions in Ikh Nart Nature Reserve and elsewhere in Mongolia.

Marketing in home health care. A practical approach.

Science.gov (United States)

Freitag, E M

1988-06-01

Home health marketing brings special problems and opportunities. One cannot rely on physical factors such as the physical plant and food service of a hospital or on the durability of a consumer product to judge home health. Opportunities exist within home health to identify activities that carry marketing value. Applying marketing principles to activities such as intake, customer service and public relations allows the home health agency to build referrals by meeting the wants and needs of the market. The home health organization needs to consider different wants and needs of those involved in the home health transaction: the decision maker, the purchaser, and the user. The success of the marketing function in meeting the organization's objectives will be aided by the placement of marketing at the senior management level.

78 FR 12759 - Draft Guidance for Industry on Attachment to Guidance on Antiviral Product Development-Conducting...

Science.gov (United States)

2013-02-25

...; formerly 2005D-0183] Draft Guidance for Industry on Attachment to Guidance on Antiviral Product Development... guidance to the Division of Drug Information, Center for Drug Evaluation and Research, Food and Drug... 20852. FOR FURTHER INFORMATION CONTACT: Lisa K. Naeger, Center for Drug Evaluation and Research, Food...

[Infection control management and practice in home care - analysis of structure quality].

Science.gov (United States)

Spegel, H; Höller, C; Randzio, O; Liebl, B; Herr, C

2013-02-01

Surveillance of infection control management and practices in home care is an important task of the public health service. While infection control aspects in residential homes for the aged and nursing are increasingly being discussed this subject has been poorly recognised in home care. The aim of this study was to identify problems in hygiene regarding the transmission of infectious diseases as well as quality assessment in home care. Based on the results of this study implications for infection control in home care facilities for public health services should be developed. Statistical analyses were performed on the primary quality assessment data of home care facilities collected by the medical service of health insurances via computer-assisted personal interviews between March 2006 and March 2009. Structure quality in 194 home care facilities was analysed as well as human resources and organisational conditions. Analyses were also done in the context of the clients' risk factor load. All analyses were performed by stratifying for the size of the home care services. To assess how the involved characteristics vary according to the size of the home care services chi-square tests and non-parametric tests were calculated. About 80% of the assessed home care services disposed of an infection control management plan. Compared to larger services smaller home care services, especially services with less than 10 clients had a poor structure in infection control management and practice. They also carried a higher load of risk factors in clients. The larger services had significantly less human resources. Surveillance of infection control management and practices by the public health services should focus on the structure of the smaller home care services. At the same time smaller home care services should be supported by offering training for the staff or counselling regarding hygiene-related aspects. Furthermore, the outcome quality of the larger home care services with

Guidance for States Implementing Comprehensive Safeguards Agreements and Additional Protocols

International Nuclear Information System (INIS)

2012-01-01

This publication is aimed at enhancing States' understanding of the safeguards obligations of both the State and the IAEA, and at improving the cooperation between States and the IAEA in safeguards implementation. It is principally intended for State or regional safeguards regulatory authorities and facility operators, and is a reference document that will be supported by detailed guidance and examples in 'Safeguards Implementation Practices' (SIPs) to be published separately.

Make Yourself At Home! Adolescents in Search of the Queer Spaces of Home

Directory of Open Access Journals (Sweden)

Kokkola, Lydia

2014-09-01

Full Text Available Home is often assumed to be a safe place, a place to which children can return after their adventures Away. For many gay and lesbian teens, both fictional and in real life, however, the space they share with their family of origin is not a place where they can feel at home. The heterosexual family home is often so hostile to queerly desiring teens that they are forced to leave in search of a place where they can feel at home. The queer spaces they enter in their search are usually considered risky spaces – public spaces, urban spaces, the bar and the street – unhomely spaces. In these temporary, in-between spaces, the queerly desiring teens in the novels examined in this paper form new family structures. Although all the Anglophone novels discussed in this article end on moments of up-lift and hope for the future, the association of the queerly desiring youngster with risky spaces suggests that the queer teens are themselves unheimlich (uncanny..

Guidance for Organisational Strategy on Knowledge to Action from Conceptual Frameworks and Practice

Science.gov (United States)

Willis, Cameron; Riley, Barbara; Lewis, Mary; Stockton, Lisa; Yessis, Jennifer

2017-01-01

This paper aims to provide public health organisations involved in chronic disease prevention with conceptual and practical guidance for developing contextually sensitive knowledge-to-action (KTA) strategies. Methods involve an analysis of 13 relevant conceptual KTA frameworks, and a review of three case examples of organisations with active KTA…

Draft guidance notes for the protection of persons against ionising radiations arising from veterinary use

International Nuclear Information System (INIS)

1983-01-01

These guidance notes have been prepared for those who use ionising radiation for diagnostic purposes in veterinary practice, either in private practices or in larger institutions. Ancillary activities such as the testing and calibration of equipment are also covered by these notes so far as they are carried out on the same premises. The guidance notes indicate procedures for the protection of all persons who may be exposed as a result of these practices, that is to say all employed and self-employed persons, apprentices and students, and members of the public. (author)

The adoption of care robots in home care-A survey on the attitudes of Finnish home care personnel.

Science.gov (United States)

Rantanen, Teemu; Lehto, Paula; Vuorinen, Pertti; Coco, Kirsi

2018-05-01

This article examines the attitudes of Finnish home care registered nurses, licensed vocational nurses and other health and social care personnel towards the introduction and use of care robots in home care. The significance of care robotics has been highlighted in recent years. However, personnel-related social psychological barriers to the introduction of care robots have been given very little study. Cross-sectional study conducted by questionnaire. The theoretical framework of the study is based on Ajzen's theory of planned behaviour and the research discussion about attitudes towards robots. The research data were collected in five municipalities in different parts of Finland in 2016, and the questionnaire was answered by a total of 200 home care workers. The research data were analysed using exploratory factor analysis, Pearson product-moment correlation, one-way analysis of variance and linear regression analysis. The results are consistent with Ajzen's theory and previous studies on the acceptance of information systems in health care. Personnel behavioural intentions related to the introduction of robot applications in home care are influenced by their personal appreciation of the usefulness of robots, the expectations of their colleagues and supervisors, as well as by their own perceptions of their capacity to learn to use care robots. In particular, personnel emphasised the value of care robots in providing reminders and guidance, as well as promoting the safety of the older people. The study shows that an intimate human-robot relationship can pose a challenge from the perspective of the acceptance of care robots. From the perspective of the introduction of care robots in home care, personnel training and the construction of a positive working atmosphere play a key role. In addition, the introduction of robots requires further consideration of a number of ethical issues. © 2018 John Wiley & Sons Ltd.

Zika Virus and Pregnancy

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Full Text Available ... ACOG Join Pay Dues Follow us: Women's Health Care Physicians Contact Us My ACOG ACOG Departments Donate Shop Career Connection Home Clinical Guidance & Publications Practice Management Education & Events Advocacy ...

Zika Virus and Pregnancy

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Full Text Available Advertisement Member Login My ACOG Join Pay Dues Follow us: Women's Health Care Physicians Contact Us My ACOG ACOG Departments Donate Shop Career Connection Home Clinical Guidance & Publications Practice ...

Introducing a feedback training system for guided home rehabilitation

Directory of Open Access Journals (Sweden)

Disselhorst-Klug Catherine

2010-01-01

Full Text Available Abstract As the number of people requiring orthopaedic intervention is growing, individualized physiotherapeutic rehabilitation and adequate postoperative care becomes increasingly relevant. The chances of improvement in the patients condition is directly related to the performance and consistency of the physiotherapeutic exercises. In this paper a smart, cost-effective and easy to use Feedback Training System for home rehabilitation based on standard resistive elements is introduced. This ensures high accuracy of the exercises performed and offers guidance and control to the patient by offering direct feedback about the performance of the movements. 46 patients were recruited and performed standard physiotherapeutic training to evaluate the system. The results show a significant increase in the patient's ability to reproduce even simple physiotherapeutic exercises when being supported by the Feedback Training System. Thus physiotherapeutic training can be extended into the home environment whilst ensuring a high quality of training.

Introducing a feedback training system for guided home rehabilitation.

Science.gov (United States)

Kohler, Fabian; Schmitz-Rode, Thomas; Disselhorst-Klug, Catherine

2010-01-15

As the number of people requiring orthopaedic intervention is growing, individualized physiotherapeutic rehabilitation and adequate postoperative care becomes increasingly relevant. The chances of improvement in the patients condition is directly related to the performance and consistency of the physiotherapeutic exercises.In this paper a smart, cost-effective and easy to use Feedback Training System for home rehabilitation based on standard resistive elements is introduced. This ensures high accuracy of the exercises performed and offers guidance and control to the patient by offering direct feedback about the performance of the movements.46 patients were recruited and performed standard physiotherapeutic training to evaluate the system. The results show a significant increase in the patient's ability to reproduce even simple physiotherapeutic exercises when being supported by the Feedback Training System. Thus physiotherapeutic training can be extended into the home environment whilst ensuring a high quality of training.

The Factors Influencing the Sense of Home in Nursing Homes: A Systematic Review from the Perspective of Residents

Directory of Open Access Journals (Sweden)

M. D. Rijnaard

2016-01-01

Full Text Available Purpose. To provide an overview of factors influencing the sense of home of older adults residing in the nursing home. Methods. A systematic review was conducted. Inclusion criteria were (1 original and peer-reviewed research, (2 qualitative, quantitative, or mixed methods research, (3 research about nursing home residents (or similar type of housing, and (4 research on the sense of home, meaning of home, at-homeness, or homelikeness. Results. Seventeen mainly qualitative articles were included. The sense of home of nursing home residents is influenced by 15 factors, divided into three themes: (1 psychological factors (sense of acknowledgement, preservation of one’s habits and values, autonomy and control, and coping; (2 social factors (interaction and relationship with staff, residents, family and friends, and pets and activities; and (3 the built environment (private space and (quasi-public space, personal belongings, technology, look and feel, and the outdoors and location. Conclusions. The sense of home is influenced by numerous factors related to the psychology of the residents and the social and built environmental contexts. Further research is needed to determine if and how the identified factors are interrelated, if perspectives of various stakeholders involved differ, and how the factors can be improved in practice.

Higher prices, higher quality? Evidence from German nursing homes

OpenAIRE

Herr, Annika; Hottenrott, Hanna

2016-01-01

Objectives: This study investigates the relationship between prices and quality of 7,400 German nursing homes controlling for income, nursing home density, demographics, labour market characteristics, and infrastructure at the regional level. Method: We use a cross section of public quality reports for all German nursing homes, which had been evaluated between 2010 and 2013 by external institutions. Our analysis is based on multivariate regressions in a two stage least squares framework, wher...

Interim Consequence Management Guidance for a Wide-Area Biological Attack

Energy Technology Data Exchange (ETDEWEB)

Raber, Ellen [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Kirvel, Robert [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); MacQueen, Don [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Love, Adam [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Dombroski, Matthew [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); McGrann, Thomas [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Richards, John [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Melius, Carl [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Bunt, Thomas [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Hibbard, Wilthea [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Greenwalt, Robert [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Miles, Robin [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Dillon, Michael [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Mancieri, Sav [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Harris, Steve [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Michalik, Richard [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Wheeler, Richard [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Hoppes, Bill [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Tucker, Mark [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Krauter, Paula [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Knowlton, Robert [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Yang, Lynn [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Franco, Dave [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Einfeld, Wayne [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Brockman, John [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Betty, Rita [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2011-05-17

The Interagency Biological Restoration Demonstration (IBRD) program is a collaborative, interagency effort co-chaired by the Department of Homeland Security and Department of Defense aimed at improving the nation‘s ability to respond to and recover from a large-scale, wide-area, domestic attack involving the release of an environmentally persistent biological warfare agent. The program is focused on understanding interactions between the civilian and military sectors, and in building mutual support to carry out such remediations. This Interim Consequence Management Guidance document provides guidance for decisionmakers in executing activities required to respond to and recover from a biological incident affecting a wide urban area insofar as information is currently available. The spore-forming bacterium Bacillus anthracis is discussed as the biological agent of primary concern because it is the most difficult of known bioterrorism agents to inactivate and is considered to be one of the key threat agents. Most other biological threat agents are much easier to remediate, and in many cases, inactivation would occur naturally within days as a result of environmental exposure; however, the framework and operational questions that need to be addressed are expected to remain the same. The guidance in this document is applicable to (1) enclosed facilities, such as commercial, residential, and continental U.S. military facilities; (2) semi-enclosed facilities, such as subways and public transit facilities; (3) outdoor areas (both localized and wide area), such as building exteriors, streets, parks, and other open spaces; (4) drinking water facilities; and (5) drinking water sources. This document follows an interagency framework [Planning Guidance for Recovery Following Biological Incidents (DHS and EPA 2009)]—which considered Raber et al. (2002) in its development—but takes the framework to a more operational level and provides guidance at key action and decision

Guidance on risk analysis and safety implications of a large liquefied natural gas (LNG) spill over water.

Energy Technology Data Exchange (ETDEWEB)

Wellman, Gerald William; Melof, Brian Matthew; Luketa-Hanlin, Anay Josephine; Hightower, Marion Michael; Covan, John Morgan; Gritzo, Louis Alan; Irwin, Michael James; Kaneshige, Michael Jiro; Morrow, Charles W.

2004-12-01

While recognized standards exist for the systematic safety analysis of potential spills or releases from LNG (Liquefied Natural Gas) storage terminals and facilities on land, no equivalent set of standards or guidance exists for the evaluation of the safety or consequences from LNG spills over water. Heightened security awareness and energy surety issues have increased industry's and the public's attention to these activities. The report reviews several existing studies of LNG spills with respect to their assumptions, inputs, models, and experimental data. Based on this review and further analysis, the report provides guidance on the appropriateness of models, assumptions, and risk management to address public safety and property relative to a potential LNG spill over water.

Interim Guidance for the Sanitary Control and Surveillance of Field Water Supplies

Science.gov (United States)

2005-07-15

on field water site/area restoration , including the removal and disposal of waste (see chapter 11 and FM 4-02.17). CHAPTER 3 INTRODUCTION TO...chemical addition, coagulation, sedimentation, and various kinds of filtration including multimedia filtration, cartridge filtration, microfiltration ... microfiltration membrane-based pretreatment system. Interim Guidance Pending Publication of TBMED 577 15 July 2005 53 Figure 9-1

41 CFR 302-14.4 - Must my agency pay me a home marketing incentive?

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false Must my agency pay me a home marketing incentive? 302-14.4 Section 302-14.4 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES 14-HOME MARKETING...

Beat the Fear of Public Speaking: Mobile 360° Video Virtual Reality Exposure Training in Home Environment Reduces Public Speaking Anxiety.

Science.gov (United States)

Stupar-Rutenfrans, Snežana; Ketelaars, Loes E H; van Gisbergen, Marnix S

2017-10-01

With this article, we aim to increase our understanding of how mobile virtual reality exposure therapy (VRET) can help reduce speaking anxiety. Using the results of a longitudinal study, we examined the effect of a new VRET strategy (Public Speech Trainer, PST), that incorporates 360° live recorded VR environments, on the reduction of public speaking anxiety. The PST was developed as a 360° smartphone application for a VR head-mounted device that participants could use at home. Realistic anxiety experiences were created by means of live 360° video recordings of a lecture hall containing three training sessions based on graded exposure framework; empty classroom (a) and with a small (b) and large audience (c). Thirty-five students participated in all sessions using PST. Anxiety levels were measured before and after each session over a period of 4 weeks. As expected, speaking anxiety significantly decreased after the completion of all PST sessions, and the decrement was the strongest in participants with initially high speaking anxiety baseline levels. Results also revealed that participants with moderate and high speaking anxiety baseline level differ in the anxiety state pattern over time. Conclusively and in line with habituation theory, the results supported the notion that VRET is more effective when aimed at reducing high-state anxiety levels. Further implications for future research and improvement of current VRET strategies are discussed.

"No place like home": Gender, family, and the politics of home care in post-world war II Ontario.

Science.gov (United States)

Struthers, James

2003-01-01

Since the early 1990s home care increasingly has emerged as a favoured policy response to the growing costs which an aging population poses for our health care system. This paper explores the early history of home care for the elderly in Ontario during the first three decades after World War II. It demonstrates that policy debates over the merits of home versus institutional care for the elderly, and community-based over hospital-based approaches to home care are not recent phenomenon but have been on going since the 1940s within the public health and social services sector. The paper examines why home care failed for so long to develop beyond the margins of Ontario's highly institutionalized health care system. It also explores how earlier visions of community-based home care, designed to help the elderly age in place, increasingly were obscured by an exclusive preoccupation with home care's "cost effectiveness" as an alternative to hospital or residential care, a rationale which discounted home care's costs to unpaid and principally female care givers. The paper concludes that the Ontario health ministry's systematic devaluing of caregiving and home maker skills, the fear of undermining the family's willingness to provide care, as well as the failure to develop effective mechanisms for integrated regional health care planning, also impeded the progress of home care's development before the 1980s.

Quality in career guidance: The Danish case

DEFF Research Database (Denmark)

Plant, Peter

2011-01-01

Quality assurance systems are introduced in career guidance to monitor, control and develop guidance interventions. The Danish case represents at centrally driven, top-down approach......Quality assurance systems are introduced in career guidance to monitor, control and develop guidance interventions. The Danish case represents at centrally driven, top-down approach...

Home schooling as an open-learning educational challenge in ...

African Journals Online (AJOL)

Despite current legislation which makes provision for collaboration between the public school sector and home schooling, it appears that much can still be done to move towards a closer partnership. Consequently I investigated the possibilities of such a liaison. A literature review on the nature of home schooling in general ...

IAEA Guidance for Safeguards Implementation in Facility Design and Construction

International Nuclear Information System (INIS)

Sprinkle, J.; Hamilton, A.; Poirier, S.; Catton, A.; Ciuculescu, C.; Ingegneri, M.; Plenteda, R.

2015-01-01

One of the IAEA's statutory objectives is to seek to accelerate and enlarge the contribution of nuclear energy to peace, health and prosperity throughout the world. One way the IAEA works to achieve this objective is through the publication of technical series that can provide guidance to Member States. These series include the IAEA Services Series, the IAEA Safety Standard Series, the IAEA Nuclear Security Series and the IAEA Nuclear Energy Series. The Nuclear Energy Series is comprised of publications designed to encourage and assist research and development on, and practical application of, nuclear energy for peaceful purposes. This includes guidance to be used by owners and operators of utilities, academia, vendors and government officials. The IAEA has chosen the Nuclear Energy Series to publish guidance for States regarding the consideration of safeguards in nuclear facility design and construction. Historically, safeguards were often applied after a facility was designed or maybe even after it was built. However, many in the design and construction community would prefer to include consideration of these requirements from the conceptual design phase in order to reduce the need for retro-fits and modifications. One can then also take advantage of possible synergies between safeguards, security, safety and environmental protection and reduce the project risk against cost increments and schedule slippage. The IAEA is responding to this interest with a suite of publications in the IAEA Nuclear Energy Series, developed with the assistance of a number of Member State Support Programmes through a joint support programme task: · International Safeguards in Nuclear Facility Design and Construction (NP-T-2.8, 2013), · International Safeguards in the Design of Nuclear Reactors (NP-T-2.9, 2014), · International Safeguards in the Design of Spent Fuel Management (NF-T-3.1, tbd), · International Safeguards in the Design of Fuel Fabrication Plants (NF-T-4.7, tbd

77 FR 34390 - Draft Guidance for Industry: Amendment to “Guidance for Industry: Revised Preventive Measures To...

Science.gov (United States)

2012-06-11

... recommendations for plasma-derived products, including albumin and products containing plasma-derived albumin, in..., submit either electronic or written comments on the draft guidance by September 10, 2012. ADDRESSES... electronic access to the draft guidance document. Submit electronic comments on the draft guidance to http...

75 FR 54637 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

Science.gov (United States)

2010-09-08

... conferencing and electronic submissions, Mammography Matters, and other device-oriented information. The CDRH... approval) into class II (special controls). DATES: Submit written or electronic comments on this guidance... electronic access to the guidance. Submit electronic comments on the guidance to http://www.regulations.gov...

Lifelong guidance: How guidance and counselling support lifelong learning in the contrasting contexts of China and Denmark

Science.gov (United States)

Zhang, Zhixin

2016-10-01

Due to the effects of globalisation and rapid technological development, traditional linear life course patterns of the past are gradually disappearing, and this affects education and learning systems as well as labour markets. Individuals are forced to develop lifestyles and survival strategies to manage job insecurity and make their skills and interests meet labour market needs. In modern attempts to develop and implement institutional provision for lifelong learning, guidance and counselling play an important role. The current Danish guidance system is well-organised, highly structured and professionalised. By contrast, Chinese guidance is still fragmented and "sectorisational". This paper explores whether elements of the highly structured and professionalised Danish guidance system and practice might be applicable to the Chinese context. The author begins by outlining international and national factors which are affecting citizens' life and career planning. She then presents and discusses the evolution of guidance and the different elements of provision in each of the two countries. Next, She compares the concepts and goals of "lifelong guidance" in Denmark and China, pointing out their similarities and differences and their respective strengths and weaknesses. The paper concludes with some suggestions for the further development of guidance in China.

Video-Guidance Design for the DART Rendezvous Mission

Science.gov (United States)

Ruth, Michael; Tracy, Chisholm

2004-01-01

NASA's Demonstration of Autonomous Rendezvous Technology (DART) mission will validate a number of different guidance technologies, including state-differenced GPS transfers and close-approach video guidance. The video guidance for DART will employ NASA/Marshall s Advanced Video Guidance Sensor (AVGS). This paper focuses on the terminal phase of the DART mission that includes close-approach maneuvers under AVGS guidance. The closed-loop video guidance design for DART is driven by a number of competing requirements, including a need for maximizing tracking bandwidths while coping with measurement noise and the need to minimize RCS firings. A range of different strategies for attitude control and docking guidance have been considered for the DART mission, and design decisions are driven by a goal of minimizing both the design complexity and the effects of video guidance lags. The DART design employs an indirect docking approach, in which the guidance position targets are defined using relative attitude information. Flight simulation results have proven the effectiveness of the video guidance design.

Impact of revisions to the F-Tag 309 surveyors' interpretive guidelines on pain management among nursing home residents.

Science.gov (United States)

Lapane, Kate L; Quilliam, Brian J; Chow, Wing; Kim, Myoung S

2012-05-01

On 31 March 2009, the US Centers for Medicare & Medicaid Services (CMS) provided revised guidance for meeting compliance in the evaluation and management of pain in nursing home residents, known as F-Tag 309. The aim of the study was to estimate the extent to which implementation of revisions to the surveyors' interpretive guidelines for F-Tag 309 improved recognition and management of pain among nursing home residents. The impact of the revisions to guidance on F-Tag 309 on pain in nursing home residents was investigated. The study was quasi-experimental in design and included 174 for-profit nursing homes in 19 US states. Nursing home residents with ≥2 Minimum Data Set (MDS) assessments between 1 January 2007 and 30 March 2009 (before the revisions to the guidelines; n = 8449) and between 31 March 2009 and 31 December 2009 (after the revisions; n = 1400) were included. The MDS assessments provided information on pain, analgesic use and cognitive, functional and emotional status. Separate logistic regression models that adjusted for clustering effects of residents residing in nursing homes provided estimates of the relationship between the implementation of the revisions to F-Tag 309 and the prevalence of pain and its management. Pain was more likely to be documented in the period after the revisions were implemented. The odds of pain being documented on at least one of two consecutive MDS assessments increased after the revisions to the guidelines were implemented (adjusted odds ratio [OR] 1.15; 95% confidence interval [CI] 1.01, 1.31). Increases in scheduled analgesic prescription were observed in the post-revision era (adjusted OR 1.38; 95% CI 1.21,1.57). The implementation of revisions to the surveyors' interpretive guidelines for F-Tag 309 improved recognition and management of pain as well as analgesic use in nursing home residents with documented non-cancer pain. Use of directed language as part of the surveyors' interpretive guidelines may be a

Threshold guidance update

International Nuclear Information System (INIS)

Wickham, L.E.

1986-01-01

The Department of Energy (DOE) is developing the concept of threshold quantities for use in determining which waste materials must be handled as radioactive waste and which may be disposed of as nonradioactive waste at its sites. Waste above this concentration level would be managed as radioactive or mixed waste (if hazardous chemicals are present); waste below this level would be handled as sanitary waste. Last years' activities (1984) included the development of a threshold guidance dose, the development of threshold concentrations corresponding to the guidance dose, the development of supporting documentation, review by a technical peer review committee, and review by the DOE community. As a result of the comments, areas have been identified for more extensive analysis, including an alternative basis for selection of the guidance dose and the development of quality assurance guidelines. Development of quality assurance guidelines will provide a reasonable basis for determining that a given waste stream qualifies as a threshold waste stream and can then be the basis for a more extensive cost-benefit analysis. The threshold guidance and supporting documentation will be revised, based on the comments received. The revised documents will be provided to DOE by early November. DOE-HQ has indicated that the revised documents will be available for review by DOE field offices and their contractors

Regulatory guidance document

International Nuclear Information System (INIS)

1994-05-01

The Office of Civilian Radioactive Waste Management (OCRWM) Program Management System Manual requires preparation of the OCRWM Regulatory Guidance Document (RGD) that addresses licensing, environmental compliance, and safety and health compliance. The document provides: regulatory compliance policy; guidance to OCRWM organizational elements to ensure a consistent approach when complying with regulatory requirements; strategies to achieve policy objectives; organizational responsibilities for regulatory compliance; guidance with regard to Program compliance oversight; and guidance on the contents of a project-level Regulatory Compliance Plan. The scope of the RGD includes site suitability evaluation, licensing, environmental compliance, and safety and health compliance, in accordance with the direction provided by Section 4.6.3 of the PMS Manual. Site suitability evaluation and regulatory compliance during site characterization are significant activities, particularly with regard to the YW MSA. OCRWM's evaluation of whether the Yucca Mountain site is suitable for repository development must precede its submittal of a license application to the Nuclear Regulatory Commission (NRC). Accordingly, site suitability evaluation is discussed in Chapter 4, and the general statements of policy regarding site suitability evaluation are discussed in Section 2.1. Although much of the data and analyses may initially be similar, the licensing process is discussed separately in Chapter 5. Environmental compliance is discussed in Chapter 6. Safety and Health compliance is discussed in Chapter 7

Preventing Deep Vein Thrombosis

Science.gov (United States)

... Physicians Contact Us My ACOG ACOG Departments Donate Shop Career Connection Home Clinical Guidance & Publications Practice Management ... skin. A clot also can form if blood flow is too slow the lining of a vein ...

Zika Virus and Pregnancy

Medline Plus

Full Text Available ... Departments Donate Shop Career Connection Home Clinical Guidance & Publications Practice Management Education & Events Advocacy For Patients About ... pregnant. Related: Zika Virus and Pregnancy ... Committee Opinions Practice Bulletins Patient Education Green Journal ...

The quasi-market for adult residential care in the UK: Do for-profit, not-for-profit or public sector residential care and nursing homes provide better quality care?

Science.gov (United States)

Barron, David N; West, Elizabeth

2017-04-01

There has been a radical transformation in the provision of adult residential and nursing home care in England over the past four decades. Up to the 1980s, over 80% of adult residential care was provided by the public sector, but today public sector facilities account for only 8% of the available places, with the rest being provided by a mixture of for-profit firms (74%) and non-profit charities (18%). The public sector's role is often now that of purchaser (paying the fees of people unable to afford them) and regulator. While the idea that private companies may play a bigger role in the future provision of health care is highly contentious in the UK, the transformation of the residential and nursing home care has attracted little comment. Concerns about the quality of care do emerge from time to time, often stimulated by high profile media investigations, scandals or criminal prosecutions, but there is little or no evidence about whether or not the transformation of the sector from largely public to private provision has had a beneficial effect on those who need the service. This study asks whether there are differences in the quality of care provided by public, non-profit or for-profit facilities in England. We use data on care quality for over 15,000 homes that are provided by the industry regulator in England: the Care Quality Commission (CQC). These data are the results of inspections carried out between April 2011 and October 2015. Controlling for a range of facility characteristics such as age and size, proportional odds logistic regression showed that for-profit facilities have lower CQC quality ratings than public and non-profit providers over a range of measures, including safety, effectiveness, respect, meeting needs and leadership. We discuss the implications of these results for the ongoing debates about the role of for-profit providers of health and social care. Copyright © 2017 Elsevier Ltd. All rights reserved.

Public health interventions: evaluating the economic evaluations

Directory of Open Access Journals (Sweden)

Martin Forster

2013-10-01

Full Text Available Recent years have witnessed much progress in the incorporation of economic considerations into the evaluation of public health interventions. In England, the Centre for Public Health Excellence within the National Institute for Health and Care Excellence works to develop guidance for preventing illness and assessing which public health interventions are most effective and provide best value for money...

Transformation by stealth: the retargeting of home care services in Finland.

Science.gov (United States)

Kröger, Teppo; Leinonen, Anu

2012-05-01

This paper analyses the trends and changes that home care services for older people have undergone during the last two decades in Finland. The data used come from national social care statistics, covering the time period from 1990-2010. The results show that, in contrast to many other European nations that have expanded their home care provisions, the coverage levels in Finland have dropped dramatically during this period. Those with the highest needs do receive increased amounts of support, but others have become excluded from publicly funded home care provisions and often need to rely on family members. In most localities, public service provision is focused on personal care, and no longer covers household tasks. This major change of the character of the service is connected to three other recent trends that structure current provisions: the amalgamation of home-based social and healthcare services, the marketisation and emerging privatisation of care and the integration of informal family care into the formal care system. Overall, the changes represent weakening defamilisation, that is, decreasing public responsibility for the needs of many older people and, correspondingly, an increasing reliance on family carers. This full-scale transformation of home care has taken place without any real policy debate or major modification of legislation. No actual decision was ever made to thoroughly alter the character of home care in Finland: the transformation happened by stealth. © 2011 Blackwell Publishing Ltd.

A Formal Investigation of the Organization of Guidance Behavior: Implications for Humans and Autonomous Guidance

Science.gov (United States)

Kong, Zhaodan

Guidance behavior generated either by artificial agents or humans has been actively studied in the fields of both robotics and cognitive science. The goals of these two fields are different. The former is the automatic generation of appropriate or even optimal behavior, while the latter is the understanding of the underlying mechanism. Their challenges, though, are closely related, the most important one being the lack of a unified, formal and grounded framework where the guidance behavior can be modeled and studied. This dissertation presents such a framework. In this framework, guidance behavior is analyzed as the closed-loop dynamics of the whole agent-environment system. The resulting dynamics give rise to interaction patterns. The central points of this dissertation are that: first of all, these patterns, which can be explained in terms of symmetries that are inherent to the guidance behavior, provide building blocks for the organization of behavior; second, the existence of these patterns and humans' organization of their guidance behavior based on these patterns are the reasons that humans can generate successful behavior in spite of all the complexities involved in the planning and control. This dissertation first gives an overview of the challenges existing in both scientific endeavors, such as human and animal spatial behavior study, and engineering endeavors, such as autonomous guidance system design. It then lays out the foundation for our formal framework, which states that guidance behavior should be interpreted as the collection of the closed-loop dynamics resulting from the agent's interaction with the environment. The following, illustrated by examples of three different UAVs, shows that the study of the closed-loop dynamics should not be done without the consideration of vehicle dynamics, as is the common practice in some of the studies in both autonomous guidance and human behavior analysis. The framework, the core concepts of which are

Modeling of Target Tracking System for Homing Missiles and Air Defense Systems

Directory of Open Access Journals (Sweden)

Yunes Sh. ALQUDSI

2018-06-01

Full Text Available One reason of why the guidance and control systems are imperfect is due to the dynamics of both the tracker and the missile, which appears as an error in the alignment with the LOS and delay in the response of the missile to change its orientation. Other reasons are the bias and disturbances as well as the noise about and within the system such as the thermal noise. This paper deals with the tracking system used in the homing guidance and air defense systems. A realistic model for the tracking system model is developed including the receiver servo dynamics and the possible disturbance and noise that may affect the accuracy of the tracking signals measured by the seeker sensor. Modeling the parameters variability and uncertainty is also examined to determine the robustness margin of the tracking system.

32 CFR 651.36 - Public involvement.

Science.gov (United States)

2010-07-01

... to open decision-making and builds the necessary community trust that sustains the Army in the long... and agencies. (f) Further guidance on public participation requirements (to potentially be used for...

Quality Assurance in University Guidance Services

Science.gov (United States)

Simon, Alexandra

2014-01-01

In Europe there is no common quality assurance framework for the delivery of guidance in higher education. Using a case study approach in four university career guidance services in England, France and Spain, this article aims to study how quality is implemented in university career guidance services in terms of strategy, standards and models,…

STUDY OF HOME DEMONSTRATION UNITS IN A SAMPLE OF 27 COUNTIES IN NEW YORK STATE, NUMBER 3.

Science.gov (United States)

ALEXANDER, FRANK D.; HARSHAW, JEAN

AN EXPLORATORY STUDY EXAMINED CHARACTERISTICS OF 1,128 HOME DEMONSTRATION UNITS TO SUGGEST HYPOTHESES AND SCOPE FOR A MORE INTENSIVE STUDY OF A SMALL SAMPLE OF UNITS, AND TO PROVIDE GUIDANCE IN SAMPLING. DATA WERE OBTAINED FROM A SPECIALLY DESIGNED MEMBERSHIP CARD USED IN 1962. UNIT SIZE AVERAGED 23.6 MEMBERS BUT THE RANGE WAS FAIRLY GREAT. A NEED…

Zika Virus and Pregnancy

Medline Plus

Full Text Available ... Dues Follow us: Women's Health Care Physicians Contact Us My ACOG ACOG Departments Donate Shop Career Connection Home Clinical Guidance & Publications Practice Management Education & Events Advocacy For Patients About ACOG Zika Virus ...

78 FR 40199 - Draft Spent Fuel Storage and Transportation Interim Staff Guidance

Science.gov (United States)

2013-07-03

.... ML13056A516. NRC's PDR: You may examine and purchase copies of public documents at the NRC's PDR, Room O1-F21... current or future applicants The NRC staff has no intention to impose the draft ISG positions on existing... of the effective date of this guidance The NRC staff has no intention to impose the draft ISG...

Volunteer computers in homes to fight against Malaria in Africa

CERN Document Server

2006-01-01

"Africa@home, a project conceived and coordinated by CERN1, was launched publicly this week. It is recruiting volunteer computers in homes and offices to run a computer-intensive simulation program called MalariaControl.net, developed by researchers at the Swiss Tropical Institute (STI)" (1 page)

Providing Career Guidance for Young Women.

Science.gov (United States)

Colby, Pamela G.

This module is directed at personnel working or planning to work in the areas of guidance, counseling, placement and follow-through in junior and senior high school settings, grades 7-12. The module topic is career guidance for young women of junior and senior high school age, aand the focus will be on providing nonbiased career guidance which…

Relationship of the union and workers in home care

OpenAIRE

Zaenker, Anita

2012-01-01

This video clip comprises one of the 5 presentations of the PANEL SESSION: “The Front Line – Home Care Providers” held at the 21st Annual John K. Friesen Conference, "Innovations in Home Care: A Public Policy Perspective," MAY 16-17, 2012, Vancouver, BC. Presented by Anita Zaenker, Researcher, BC Government and Service Employees’ Union. It is well known that jurisdictions with more comprehensive and integrated home care delivery systems are able to extend independent living for older ...

Guidance at the educational marketplace

DEFF Research Database (Denmark)

Lystbæk, Christian Tang

in educational policies and institutions. As educational systems have expanded and, further, have been restructured with the expansion of choice opportunities since the 1980s, guidance has become prioritized as a form of counseling or coaching, which can support students. Thus, guidance has become an important...... `agent´ on the educational "market´, assisting (potential) students into and around the `marketplace´. Consequently, guidance is also an important `agent´ for educational institutions that increasingly use marketing strategies to promote themselves on the market to attract and hold on to their “customers......” in order for the institutions to increase their ´market value´, `sales” and “turnover”. Thus, the expansion of guidance is nurtured by the expansion of the logic of marketization and consumerism. Drawing on Foucauldian perspectives in educational research, which highlight the expansion of powerful...

Interventions to support people with dementia and their caregivers during the transition from home care to nursing home care: A systematic review.

Science.gov (United States)

Müller, Christian; Lautenschläger, Sindy; Meyer, Gabriele; Stephan, Astrid

2017-06-01

During the transition of people with dementia from home to nursing home family caregivers often feel burdened. We aimed to 1) identify interventions which support people with dementia and their caregivers in the transition from home care to nursing home care, 2) synthesize the evidence for efficacy of these interventions, and 3) examine whether the identified interventions have been systematically developed, evaluated and implemented according to the Medical Research Council guidance on complex interventions. A systematic review of randomised controlled trials was conducted according to the recommendations specified in the Cochrane Handbook for Intervention Reviews. The review protocol was registered in PROSPERO (2015: CRD42015019839). Reporting follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement. MEDLINE, CENTRAL, PsycINFO, CINAHL, OTseeker, and PEDro, were searched. Other sources included Google Scholar, and ALOIS. Two reviewers independently assessed the eligibility of the articles. Data extraction was performed by one reviewer and verified independently by another. The Cochrane Risk of Bias tool was used for critical appraisal. Development and evaluation of the identified interventions were assessed, taking the Medical Research Council guidance into account. Review findings were synthesized narratively. The search yielded 1278 records. Five studies were included, all conducted in the United States (4 RCTs and 1 cRCT with a total of 695 participants). The psychosocial interventions were individual and family counseling via telephone or ad hoc all of which addressed only informal caregivers. The intervention components, content and mode of delivery differed widely with inconsistent results. Significant intervention effects were found for the reduction of caregivers' depressive symptoms, burden, feeling of guilt, emotional distress, overload, and interactions with staff. Other outcomes, i.e. stress, placement

Home versus hospital birth--process and outcome.

Science.gov (United States)

Wax, Joseph R; Pinette, Michael G; Cartin, Angelina

2010-02-01

A constant small, but clinically important, number of American women choose to deliver at home. Contradictory professional and public policies reflect the polarization and politicization of the controversy surrounding this birth option. Women opting for home birth seek and often attain their goals of a nonmedicalized experience in comfortable, familiar surroundings wherein they maintain situational control. However, home deliveries in developed Western nations are often associated with excess perinatal and neonatal mortality, particularly among nonanomalous term infants. On the other hand, current home birth practices are, especially when birth attendants are highly trained and fully integrated into comprehensive health care delivery systems, associated with fewer cesareans, operative vaginal deliveries, episiotomies, infections, and third and fourth degree lacerations. Newborn benefits include less meconium staining, assisted ventilation, low birth weight, prematurity, and intensive care admissions. Existing data suggest areas of future research regarding the safety of home birth in the United States. Obstetricians & Gynecologists, Family Physicians. After completion of this educational activity, the participant should be better able to assess perinatal outcomes described in the reported literature associated with home births in developed countries, list potential advantages and disadvantages of planned home births, and identify confounders in current literature that impact our thorough knowledge of home birth outcomes.

Performing Home in Barcelona: A Practice-Based Photo Essay

Science.gov (United States)

Pons, Esther Belvis

2018-01-01

During the winter of 2016, I carried out an artistic project in Barcelona entitled 'Performing Home' that aimed to explore the affective and social challenges that artists in political asylum or refuge cope with. The project began with a simple question: "where in public spaces do artists in asylum feel 'at home'?" It explored how public…

Regulatory guidance for license renewal

International Nuclear Information System (INIS)

Thoma, John A.

1991-01-01

The proposed 10 CFR Part 54 rule proceduralizes the process for license renewal by identifying both the administrative and technical requirements for a renewal application. To amplify and support this regulation, written guidance has been provided in the form of a draft Regulatory Guide (DG 1009) and a draft Standard Review Plan for License Renewal (NUREG 1299). This guidance is scheduled to be finalized in 1992. Similar guidance will be provided for the proposed revisions to 10 CFR Part 51 concerning the environmental aspects of license renewal. (author)

Impact of an ABCDE team triage process combined with public guidance on the division of work in an emergency department.

Science.gov (United States)

Kantonen, Jarmo; Lloyd, Robert; Mattila, Juho; Kauppila, Timo; Menezes, Ricardo

2015-06-01

To study the effects of applying an emergency department (ED) triage system, combined with extensive publicity in local media about the "right" use of emergency services, on the division of work between ED nurses and general practitioners (GPs). An observational and quasi-experimental study based on before-after comparisons. Implementation of the ABCDE triage system in a Finnish combined ED where secondary care is adjacent, and in a traditional primary care ED where secondary care is located elsewhere. GPs and nurses from two different primary care EDs. Numbers of monthly visits to different professional groups before and after intervention in the studied primary care EDs and numbers of monthly visits to doctors in the local secondary care ED. The beginning of the triage process increased temporarily the number of independent consultations and patient record entries by ED nurses in both types of studied primary care EDs and reduced the number of patient visits to a doctor compared with previous years but had no effect on doctor visits in the adjacent secondary care ED. No further decrease in the number of nurse or GP visits was observed by inhibiting the entrance of non-urgent patients. The ABCDE triage system combined with public guidance may reduce non-urgent patient visits to doctors in different kinds of primary care EDs without increasing visits in the secondary care ED. However, the additional work to implement the ABCDE system is mainly directed to nurses, which may pose a challenge for staffing.

Issuance of Final Guidance: Ecological Risk Assessment and Risk Management Principles for Superfund Sites, October 7, 1999

Science.gov (United States)

This guidance is intended to help Superfund risk managers make ecological risk management decisions that are based on sound science, consistent across Regions, and present a characterization of site risks that is transparent to the public.

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

Science.gov (United States)

2010-10-01

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

41 CFR 302-14.2 - What is the purpose of a home marketing incentive payment?

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What is the purpose of a home marketing incentive payment? 302-14.2 Section 302-14.2 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES 14-HOME MARKETING...

Navigation errors encountered using weather-mapping radar for helicopter IFR guidance to oil rigs

Science.gov (United States)

Phillips, J. D.; Bull, J. S.; Hegarty, D. M.; Dugan, D. C.

1980-01-01

In 1978 a joint NASA-FAA helicopter flight test was conducted to examine the use of weather-mapping radar for IFR guidance during landing approaches to oil rig helipads. The following navigation errors were measured: total system error, radar-range error, radar-bearing error, and flight technical error. Three problem areas were identified: (1) operational problems leading to pilot blunders, (2) poor navigation to the downwind final approach point, and (3) pure homing on final approach. Analysis of these problem areas suggests improvement in the radar equipment, approach procedure, and pilot training, and gives valuable insight into the development of future navigation aids to serve the off-shore oil industry.

Constituent aspects of workplace guidance in secondary VET

NARCIS (Netherlands)

Swager, Robert; Klarus, Ruud; Van Merriënboer, Jeroen; Nieuwenhuis, Loek

2018-01-01

Purpose – This paper aims to present an integrated model of workplace guidance to enhance awareness of what constitutes good guidance, to improve workplace guidance practices in vocational education and training. Design/methodology/approach – To identify constituent aspects of workplace guidance,

General RMP Guidance - Appendix D: OSHA Guidance on PSM

Science.gov (United States)

OSHA's Process Safety Management (PSM) Guidance on providing complete and accurate written information concerning process chemicals, process technology, and process equipment; including process hazard analysis and material safety data sheets.

Amending the Characterization of Guidance in Visual Analytics

OpenAIRE

Ceneda, Davide; Gschwandtner, Theresia; May, Thorsten; Miksch, Silvia; Schulz, Hans-Jörg; Streit, Marc; Tominski, Christian

2017-01-01

At VAST 2016, a characterization of guidance has been presented. It includes a definition of guidance and a model of guidance based on van Wijk's model of visualization. This note amends the original characterization of guidance in two aspects. First, we provide a clarification of what guidance actually is (and is not). Second, we insert into the model a conceptually relevant link that was missing in the original version.

75 FR 61771 - Notice of Public Availability of Navigation and Vessel Inspection Circular (NVIC) 2-10, “Guidance...

Science.gov (United States)

2010-10-06

... voluntary guidance to vessel owners and operators, salvage and marine firefighting resource providers, and... marine firefighting resources to be identified, contracted for, and capable of responding to incidents up...

Zika Virus and Pregnancy

Medline Plus

Full Text Available ... Shop Career Connection Home Clinical Guidance & Publications Practice Management Education & Events Advocacy For Patients About ACOG Zika ... Bulletins Patient Education Green Journal Clinical Updates Practice Management Coding Health Info Technology Professional Liability Managing Your ...

Zika Virus and Pregnancy

Medline Plus

Full Text Available ... Shop Career Connection Home Clinical Guidance & Publications Practice Management Education & Events Advocacy For Patients About ACOG Zika Virus and ... Bulletins Patient Education Green Journal Clinical Updates ... Annual Meeting CME Overview CREOG Meetings Calendar Congressional ...

Guidance and control, 1993; Annual Rocky Mountain Guidance and Control Conference, 16th, Keystone, CO, Feb. 6-10, 1993

Science.gov (United States)

Culp, Robert D.; Bickley, George

Papers from the sixteenth annual American Astronautical Society Rocky Mountain Guidance and Control Conference are presented. The topics covered include the following: advances in guidance, navigation, and control; control system videos; guidance, navigation and control embedded flight control systems; recent experiences; guidance and control storyboard displays; and applications of modern control, featuring the Hubble Space Telescope (HST) performance enhancement study. For individual titles, see A95-80390 through A95-80436.

76 FR 67461 - Cosmetic Microbiological Safety Issues; Public Meeting

Science.gov (United States)

2011-11-01

...] Cosmetic Microbiological Safety Issues; Public Meeting AGENCY: Food and Drug Administration, HHS. ACTION... Administration (FDA) is announcing a public meeting entitled ``Cosmetic Microbiological Safety Issues.'' The... cosmetic microbiological safety and to suggest areas for the possible development of FDA guidance documents...

7 CFR Exhibit A to Subpart A of... - Memorandum of Understanding Between Commodity Credit Corporation and Farmers Home Administration...

Science.gov (United States)

2010-01-01

... Corporation and Farmers Home Administration or its successor agency under Public Law 103-354 A Exhibit A to... Understanding Between Commodity Credit Corporation and Farmers Home Administration or its successor agency under Public Law 103-354 IT IS HEREBY AGREED by and between the Farmers Home Administration or its successor...

Translation of the Care of Persons with Dementia in their Environments (COPE) intervention in a publicly-funded home care context: Rationale and research design.

Science.gov (United States)

Fortinsky, Richard H; Gitlin, Laura N; Pizzi, Laura T; Piersol, Catherine Verrier; Grady, James; Robison, Julie T; Molony, Sheila

2016-07-01

Dementia is the leading cause of loss of independence in older adults worldwide. In the U.S., approximately 15 million family members provide care to relatives with dementia. This paper presents the rationale and design for a translational study in which an evidence-based, non-pharmacologic intervention for older adults with dementia and family caregivers (CGs) is incorporated into a publicly-funded home care program for older adults at risk for nursing home admission. The 4-month Care of Persons with Dementia in their Environments (COPE) intervention is designed to optimize older adults' functional independence, and to improve CG dementia management skills and health-related outcomes. COPE features 10 in-home occupational therapy visits, and 1 in-home visit and 1 telephone contact by an advanced practice nurse. COPE was deemed efficacious in a published randomized clinical trial. In the present study, older adults with dementia enrolled in the Connecticut Home Care Program for Elders (CHCPE) and their CGs are randomly assigned to receive COPE plus their ongoing CHCPE services, or to continue receiving CHCPE services only. The primary outcome for older adults with dementia is functional independence; secondary outcomes are activity engagement, quality of life, and prevention or alleviation of neuropsychiatric symptoms. CG outcomes include perceived well-being and confidence in using activities to manage dementia symptoms. Translational outcomes include net financial benefit of COPE, and feasibility and acceptability of COPE implementation into the CHCPE. COPE has the potential to improve health-related outcomes while saving Medicaid waiver and state revenue-funded home care program costs nationwide. Copyright © 2016 Elsevier Inc. All rights reserved.

[Case Study - A Successful Outpatient Design of Cross-Professional Pharmaceutical Cooperation in Home Health Care - Reduction of Financial and Care-Related Burden by Shifting to R-Compound Enteral Semisolid Formulation].

Science.gov (United States)

Takeda, Namihiro; Hamana, Tomoko; Oka, Toyoka; Matsuyama, Narihisa; Hirohara, Masayoshi; Kushida, Kazuki

2015-12-01

Among patients who receive enteral nutrition through a gastric fistula, some are concomitantly administered viscosity modifiers to avoid aspiration pneumonitis caused by gastroesophageal reflux. These patients(and families)often bear the high economic and care burdens associated with enteral nutritional management. We developed an outpatient-based pharmacy service through multidisciplinary cooperation, facilitating a shift from enteral nutrition to semi-solid formula. This shift is expected to reduce the economic burden by approximately 120 thousand yen, and the hours of care by about 550 hours annually. Owing to family circumstances or economic conditions, some patients(and families)do not receive at-home guidance of pharmaceutical management by pharmacists. The family members of such patients visit the pharmacy to obtain the prescribed medications. Such patients and families could be supported within the outpatient-based pharmacy services, through proactively participating in home health care daily(collaborative relationship with the local community)and re-counting experiences of providing home guidance of pharmaceutical management.

Optimal guidance law in quantum mechanics

International Nuclear Information System (INIS)

Yang, Ciann-Dong; Cheng, Lieh-Lieh

2013-01-01

Following de Broglie’s idea of a pilot wave, this paper treats quantum mechanics as a problem of stochastic optimal guidance law design. The guidance scenario considered in the quantum world is that an electron is the flight vehicle to be guided and its accompanying pilot wave is the guidance law to be designed so as to guide the electron to a random target driven by the Wiener process, while minimizing a cost-to-go function. After solving the stochastic optimal guidance problem by differential dynamic programming, we point out that the optimal pilot wave guiding the particle’s motion is just the wavefunction Ψ(t,x), a solution to the Schrödinger equation; meanwhile, the closed-loop guidance system forms a complex state–space dynamics for Ψ(t,x), from which quantum operators emerge naturally. Quantum trajectories under the action of the optimal guidance law are solved and their statistical distribution is shown to coincide with the prediction of the probability density function Ψ ∗ Ψ. -- Highlights: •Treating quantum mechanics as a pursuit-evasion game. •Reveal an interesting analogy between guided flight motion and guided quantum motion. •Solve optimal quantum guidance problem by dynamic programming. •Gives a formal proof of de Broglie–Bohm’s idea of a pilot wave. •The optimal pilot wave is shown to be a wavefunction solved from Schrödinger equation

Optimal guidance law in quantum mechanics

Energy Technology Data Exchange (ETDEWEB)

Yang, Ciann-Dong, E-mail: cdyang@mail.ncku.edu.tw; Cheng, Lieh-Lieh, E-mail: leo8101@hotmail.com

2013-11-15

Following de Broglie’s idea of a pilot wave, this paper treats quantum mechanics as a problem of stochastic optimal guidance law design. The guidance scenario considered in the quantum world is that an electron is the flight vehicle to be guided and its accompanying pilot wave is the guidance law to be designed so as to guide the electron to a random target driven by the Wiener process, while minimizing a cost-to-go function. After solving the stochastic optimal guidance problem by differential dynamic programming, we point out that the optimal pilot wave guiding the particle’s motion is just the wavefunction Ψ(t,x), a solution to the Schrödinger equation; meanwhile, the closed-loop guidance system forms a complex state–space dynamics for Ψ(t,x), from which quantum operators emerge naturally. Quantum trajectories under the action of the optimal guidance law are solved and their statistical distribution is shown to coincide with the prediction of the probability density function Ψ{sup ∗}Ψ. -- Highlights: •Treating quantum mechanics as a pursuit-evasion game. •Reveal an interesting analogy between guided flight motion and guided quantum motion. •Solve optimal quantum guidance problem by dynamic programming. •Gives a formal proof of de Broglie–Bohm’s idea of a pilot wave. •The optimal pilot wave is shown to be a wavefunction solved from Schrödinger equation.

GUILD: GUidance for Information about Linking Data sets†

Science.gov (United States)

Gilbert, Ruth; Lafferty, Rosemary; Hagger-Johnson, Gareth; Zhang, Li-Chun; Smith, Peter; Dibben, Chris; Goldstein, Harvey

2018-01-01

Abstract Record linkage of administrative and survey data is increasingly used to generate evidence to inform policy and services. Although a powerful and efficient way of generating new information from existing data sets, errors related to data processing before, during and after linkage can bias results. However, researchers and users of linked data rarely have access to information that can be used to assess these biases or take them into account in analyses. As linked administrative data are increasingly used to provide evidence to guide policy and services, linkage error, which disproportionately affects disadvantaged groups, can undermine evidence for public health. We convened a group of researchers and experts from government data providers to develop guidance about the information that needs to be made available about the data linkage process, by data providers, data linkers, analysts and the researchers who write reports. The guidance goes beyond recommendations for information to be included in research reports. Our aim is to raise awareness of information that may be required at each step of the linkage pathway to improve the transparency, reproducibility, and accuracy of linkage processes, and the validity of analyses and interpretation of results. PMID:28369581

Home and workplace built environment supports for physical activity.

Science.gov (United States)

Adlakha, Deepti; Hipp, Aaron J; Marx, Christine; Yang, Lin; Tabak, Rachel; Dodson, Elizabeth A; Brownson, Ross C

2015-01-01

Physical inactivity has been associated with obesity and related chronic diseases. Understanding built environment (BE) influences on specific domains of physical activity (PA) around homes and workplaces is important for public health interventions to increase population PA. To examine the association of home and workplace BE features with PA occurring across specific life domains (work, leisure, and travel). Between 2012 and 2013, telephone interviews were conducted with participants in four Missouri metropolitan areas. Questions included sociodemographic characteristics, home and workplace supports for PA, and dietary behaviors. Data analysis was conducted in 2013; logistic regression was used to examine associations between BE features and domain-specific PA. In home neighborhoods, seven of 12 BE features (availability of fruits and vegetables, presence of shops and stores, bike facilities, recreation facilities, crime rate, seeing others active, and interesting things) were associated with leisure PA. The global average score of home neighborhood BE features was associated with greater odds of travel PA (AOR=1.99, 95% CI=1.46, 2.72); leisure PA (AOR=1.84, 95% CI=1.44, 2.34); and total PA (AOR=1.41, 95% CI=1.04, 1.92). Associations between workplace neighborhoods' BE features and workplace PA were small but in the expected direction. This study offers empirical evidence on BE supports for domain-specific PA. Findings suggest that diverse, attractive, and walkable neighborhoods around workplaces support walking, bicycling, and use of public transit. Public health practitioners, researchers, and worksite leaders could benefit by utilizing worksite domains and measures from this study for future BE assessments. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

77 FR 36273 - Public Meeting on Draft Permitting Guidance for Oil and Gas Hydraulic Fracturing Activities Using...

Science.gov (United States)

2012-06-18

... duration and well closure; area of review; information submitted with the permit application; and... Fracturing Activities Using Diesel Fuels--Draft: Underground Injection Control Program Guidance 84.'' The... permits under the Safe Drinking Water Act to ensure protection of underground sources of drinking water...

Changes in Consumer Demand Following Public Reporting of Summary Quality Ratings: An Evaluation in Nursing Homes.

Science.gov (United States)

Werner, Rachel M; Konetzka, R Tamara; Polsky, Daniel

2016-06-01

Limited consumer use of health care report cards may be due to the large amount of information presented in report cards, which can be difficult to understand. These limitations may be overcome with summary measures. Our objective was to evaluate consumer response to summary measures in the setting of nursing homes. 2005-2010 nursing home Minimum Data Set and Online Survey, Certification and Reporting (OSCAR) datasets. In December 2008, Medicare converted its nursing home report card to summary or star ratings. We test whether there was a change in consumer demand for nursing homes related to the nursing home's star rating after the information was released. The star rating system was associated with a significant change in consumer demand for low- and high-scoring facilities. After the star-based rating system was released, 1-star facilities typically lost 8 percent of their market share and 5-star facilities gained over 6 percent of their market share. The nursing home star rating system significantly affected consumer demand for high- and low-rated nursing homes. These results support the use of summary measures in report cards. © Health Research and Educational Trust.

78 FR 12761 - Guidance for Industry: Guidance on the Labeling of Certain Uses of Lecithin Derived From Soy...

Science.gov (United States)

2013-02-25

...] (formerly 2006D-0169) Guidance for Industry: Guidance on the Labeling of Certain Uses of Lecithin Derived... on the Labeling of Certain Uses of Lecithin Derived From Soy Under Section 403(w) of the Federal Food.... The guidance explained FDA's then current thinking on the labeling of certain uses of lecithin derived...

Reliability and energy efficiency of zero energy homes (Conference Presentation)

Science.gov (United States)

Dhere, Neelkanth G.

2016-09-01

Photovoltaic (PV) modules and systems are being installed increasingly on residential homes to increase the proportion of renewable energy in the energy mix. The ultimate goal is to attain sustainability without subsidy. The prices of PV modules and systems have declined substantially during the recent years. They will be reduced further to reach grid parity. Additionally the total consumed energy must be reduced by making the homes more energy efficient. FSEC/UCF Researchers have carried out research on development of PV cells and systems and on reducing the energy consumption in homes and by small businesses. Additionally, they have provided guidance on PV module and system installation and to make the homes energy efficient. The produced energy is fed into the utility grid and the consumed energy is obtained from the utility grid, thus the grid is assisting in the storage. Currently the State of Florida permits net metering leading to equal charge for the produced and consumed electricity. This paper describes the installation of 5.29 KW crystalline silicon PV system on a south-facing tilt at approximately latitude tilt on a single-story, three-bedroom house. It also describes the computer program on Building Energy Efficiency and the processes that were employed for reducing the energy consumption of the house by improving the insulation, air circulation and windows, etc. Finally it describes actual consumption and production of electricity and the installation of additional crystalline silicon PV modules and balance of system to make it a zero energy home.

Intimacy between care home residents with dementia: Findings from a review of the literature.

Science.gov (United States)

Wiskerke, Esther; Manthorpe, Jill

2016-07-13

There is limited research on what family members and frontline care home staff consider to be the best responses to the sexual expression of a person with dementia, whilst at the same time respecting relatives' feelings, managing their possible distress and conflict, and how good practice should be reflected in care home policy and practice guidance. This literature review explored what is known of the views of relatives and care workers of new relationships or sexual intimacy between care home residents with dementia, whilst still married to another person. It reports the findings of searches of three databases undertaken in August 2014 (Medline, Embase and PsychINFO). Nine papers were found relevant to the research question. The following themes emerged from a synthesis of the papers located: sexuality in old age, dementia and sexuality, hyper-sexuality, views regarding sexuality of older people living in care homes, the law, ethics and consent, relationships and communication between care home and relatives, and new relationships or intimacy between residents with dementia. While studies of residents' expression of sexuality and their engaging in sexual behaviour with other resident(s) may be challenging to manage in care home settings and can be emotionally painful or uncomfortable for families, the review found that studies are few in number and span emotional intimacy and distressing behaviour. © The Author(s) 2016.

Guidance for performing preliminary assessments under CERCLA

Energy Technology Data Exchange (ETDEWEB)

NONE

1991-09-01

EPA headquarters and a national site assessment workgroup produced this guidance for Regional, State, and contractor staff who manage or perform preliminary assessments (PAs). EPA has focused this guidance on the types of sites and site conditions most commonly encountered. The PA approach described in this guidance is generally applicable to a wide variety of sites. However, because of the variability among sites, the amount of information available, and the level of investigative effort required, it is not possible to provide guidance that is equally applicable to all sites. PA investigators should recognize this and be aware that variation from this guidance may be necessary for some sites, particularly for PAs performed at Federal facilities, PAs conducted under EPA`s Environmental Priorities Initiative (EPI), and PAs at sites that have previously been extensively investigated by EPA or others. The purpose of this guidance is to provide instructions for conducting a PA and reporting results. This guidance discusses the information required to evaluate a site and how to obtain it, how to score a site, and reporting requirements. This document also provides guidelines and instruction on PA evaluation, scoring, and the use of standard PA scoresheets. The overall goal of this guidance is to assist PA investigators in conducting high-quality assessments that result in correct site screening or further action recommendations on a nationally consistent basis.

76 FR 50433 - Regulatory Guidance: Applicability of the Federal Motor Carrier Safety Regulations to Operators...

Science.gov (United States)

2011-08-15

... operating under share-cropping agreements are common or contract carriers; and third, whether FMCSA should.... FMCSA is issuing guidance that farmers operating under share-cropping or similar arrangements are not... farmer, the Agency sought as much public involvement and comment as possible on these issues. It is worth...

Efficiency and quality of care in nursing homes: an Italian case study.

Science.gov (United States)

Garavaglia, Giulia; Lettieri, Emanuele; Agasisti, Tommaso; Lopez, Silvano

2011-03-01

This study investigates efficiency and quality of care in nursing homes. By means of Data Envelopment Analysis (DEA), the efficiency of 40 nursing homes that deliver their services in the north-western area of the Lombardy Region was assessed over a 3-year period (2005-2007). Lombardy is a very peculiar setting, since it is the only Region in Italy where the healthcare industry is organised as a quasi-market, in which the public authority buys health and nursing services from independent providers-establishing a reimbursement system for this purpose. The analysis is conducted by generating bootstrapped DEA efficiency scores for each nursing home (stage one), then regressing those scores on explanatory variables (stage two). Our DEA model employed two input (i.e. costs for health and nursing services and costs for residential services) and three output variables (case mix, extra nursing hours and residential charges). In the second-stage analysis, Tobit regressions and the Kruskall-Wallis tests of hypothesis to the efficiency scores were applied to define what are the factors that affect efficiency: (a) the ownership (private nursing houses outperform their public counterparts); and (b) the capability to implement strategies for labour cost and nursing costs containment, since the efficiency heavily depends upon the alignment of the costs to the public reimbursement system. Lastly, even though the public institutions are less efficient than the private ones, the results suggest that public nursing homes are moving towards their private counterparts, and thus competition is benefiting efficiency.

Non-Participation in Guidance: An Opportunity for Development?

Science.gov (United States)

Thomsen, Rie

2014-01-01

This article discusses how new opportunities for guidance can emerge from an analysis of the interplay between the participation (or lack of participation) of the individuals in career guidance, and the career guidance practitioner's response. The article suggests critical psychology as a framework for career guidance research and presents…

Constituent Aspects of Workplace Guidance in Secondary VET

Science.gov (United States)

Swager, Robert; Klarus, Ruud; van Merriënboer, Jeroen J. G.; Nieuwenhuis, Loek F. M.

2015-01-01

Purpose: This paper aims to present an integrated model of workplace guidance to enhance awareness of what constitutes good guidance, to improve workplace guidance practices in vocational education and training. Design/methodology/approach: To identify constituent aspects of workplace guidance, a systematic search of Web of Science was conducted,…

Guidance for the scientific requirements for health claims related to antioxidants, oxidative damage and cardiovascular health (Revision 1)

DEFF Research Database (Denmark)

Sjödin, Anders Mikael

2018-01-01

of additional health claim applications related to antioxidants, oxidative damage and cardiovascular health, and the information collected from a Grant launched in 2014. This guidance is intended to assist applicants in preparing applications for the authorisation of health claims related to the antioxidants......EFSA asked the Panel on Dietetic Products, Nutrition and Allergies (NDA) to update the guidance on the scientific requirements for health claims related to antioxidants, oxidative damage and cardiovascular health published in 2011. The update takes into accounts experiences gained with evaluation......, oxidative damage and cardiovascular health. The document was subject to public consultation (from 12 July to 3 September 2017). This document supersedes the guidance on the scientific requirements for health claims related to antioxidants, oxidative damage and cardiovascular health published in 2011...

Volunteer computing experience with ATLAS@Home

CERN Document Server

AUTHOR|(INSPIRE)INSPIRE-00068610; The ATLAS collaboration; Bianchi, Riccardo-Maria; Cameron, David; Filipčič, Andrej; Lançon, Eric; Wu, Wenjing

2016-01-01

ATLAS@Home is a volunteer computing project which allows the public to contribute to computing for the ATLAS experiment through their home or office computers. The project has grown continuously since its creation in mid-2014 and now counts almost 100,000 volunteers. The combined volunteers’ resources make up a sizeable fraction of overall resources for ATLAS simulation. This paper takes stock of the experience gained so far and describes the next steps in the evolution of the project. These improvements include running natively on Linux to ease the deployment on for example university clusters, using multiple cores inside one task to reduce the memory requirements and running different types of workload such as event generation. In addition to technical details the success of ATLAS@Home as an outreach tool is evaluated.

Volunteer Computing Experience with ATLAS@Home

CERN Document Server

Cameron, David; The ATLAS collaboration; Bourdarios, Claire; Lan\\c con, Eric

2016-01-01

ATLAS@Home is a volunteer computing project which allows the public to contribute to computing for the ATLAS experiment through their home or office computers. The project has grown continuously since its creation in mid-2014 and now counts almost 100,000 volunteers. The combined volunteers' resources make up a sizable fraction of overall resources for ATLAS simulation. This paper takes stock of the experience gained so far and describes the next steps in the evolution of the project. These improvements include running natively on Linux to ease the deployment on for example university clusters, using multiple cores inside one job to reduce the memory requirements and running different types of workload such as event generation. In addition to technical details the success of ATLAS@Home as an outreach tool is evaluated.

Volunteer Computing Experience with ATLAS@Home

Science.gov (United States)

Adam-Bourdarios, C.; Bianchi, R.; Cameron, D.; Filipčič, A.; Isacchini, G.; Lançon, E.; Wu, W.; ATLAS Collaboration

2017-10-01

ATLAS@Home is a volunteer computing project which allows the public to contribute to computing for the ATLAS experiment through their home or office computers. The project has grown continuously since its creation in mid-2014 and now counts almost 100,000 volunteers. The combined volunteers’ resources make up a sizeable fraction of overall resources for ATLAS simulation. This paper takes stock of the experience gained so far and describes the next steps in the evolution of the project. These improvements include running natively on Linux to ease the deployment on for example university clusters, using multiple cores inside one task to reduce the memory requirements and running different types of workload such as event generation. In addition to technical details the success of ATLAS@Home as an outreach tool is evaluated.

International guidance on the qualifications of nuclear power plant operations personnel

International Nuclear Information System (INIS)

Csik, B.J.

1984-01-01

Nuclear power plant operation and maintenance as well as training of operations personnel are activities where a large amount of experience is available. Though it would seem that the status of a well-established practice, requiring constant attention but no major efforts directed towards improvements, should have been reached, this is not the case. Currently, upgrading of the qualification requirements and training procedures of nuclear power plant operations personnel is a major issue and substantial efforts are being expended to this effect. The availability of international guidance in this field is perceived to be of benefit to all; therefore the Agency has undertaken to develop such guidance. In addition to earlier publications, a guidebook on this subject area is being prepared. Important problems and current issues have been identified and these are commented upon in the present paper. The specific topics referred to include: the role of the operating organization and the regulatory body; organizational aspects; staffing requirements; competence requirements for personnel; establishment and verification of competence; and personnel management. It is recognized that developing international guidance is a difficult and delicate task, especially when it is intended to go beyond stating the obvious and expressing generalities which are certain to meet a general consensus. (author)

Choosing care homes as the least preferred place to die: a cross-national survey of public preferences in seven European countries.

Science.gov (United States)

Calanzani, Natalia; Moens, Katrien; Cohen, Joachim; Higginson, Irene J; Harding, Richard; Deliens, Luc; Toscani, Franco; Ferreira, Pedro L; Bausewein, Claudia; Daveson, Barbara A; Gysels, Marjolein; Ceulemans, Lucas; Gomes, Barbara

2014-10-23

Care homes are increasingly becoming places where people spend the final stages of their lives and eventually die. This trend is expected to continue due to population ageing, yet little is known about public preferences regarding this setting. As part of a larger study examining preferences and priorities for end of life care, we investigated the extent to which care homes are chosen as the least preferred place of death, and the factors associated with this negative preference. We conducted a cross-sectional telephone survey among 9,344 adults from random private households in England, Flanders, Germany, Italy, the Netherlands, Portugal and Spain. We asked participants where they would least prefer to die in a situation of serious illness with less than one year to live. Multivariate binary logistic regressions were used to identify factors associated with choosing care homes as the least preferred place of death in each country. Care homes were the most frequently mentioned least preferred place of death in the Netherlands (41.5%), Italy and Spain (both 36.7%) and the second most frequent in England (28.0%), Portugal (25.8%), Germany (23.7%) and Flanders (18.9%). Only two factors had a similar and significant effect on the least preferred place of death in more than one country. In Germany and the Netherlands those doing housework were less likely to choose care homes as their least preferred place (AOR 0.72; 95% CI:0.54-0.96 and AOR 0.68; 95% CI:0.52-0.90 respectively), while those born in the country where the survey took place were more likely to choose care homes (AOR 1.77; 95% CI:1.05-2.99 and AOR 1.74; 95% CI:1.03-2.95 respectively). Experiences of serious illness, death and dying were not associated with the preference. Our results suggest it might be difficult to promote care homes as a good place to die. This is an urgent research area in order to meet needs and preferences of a growing number of older people with chronic, debilitating conditions across

Guidance and Counselling in the Universal Basic Education ...

African Journals Online (AJOL)

Quite a number of personnel has significant and diverse roles to play. The guidance counsellor whose role is to provide indispensable guidance services is the primary focus of this paper. The paper justifies the relevance of guidance services to the UBE scheme and also isolates a number of challenges facing the guidance ...

Machine learning in smart home control systems - Algorithms and new opportunities

Science.gov (United States)

Berg, Ivan A.; Khorev, Oleg E.; Matvevnina, Arina I.; Prisjazhnyj, Alexey V.

2017-11-01

Worldwide, more and more attention is paid to issues related to a smart home. If in 2000 Scopus registered 25 publications with about "smart house", in 2016 their number increased up to 1600. The top three countries with interest in smart home technologies include the United States, China and India. Corporations begin to offer their package solutions for automation of the intellectual home, dozens of start-ups around the creation of technology are established. Where is such interest from? What can offer intelligent home technologies? What can an end user receive?

U.S. Department of Energy Zero Energy Ready Home Implementation

Energy Technology Data Exchange (ETDEWEB)

Rothgeb, Stacey K [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Schirber, T. [Univ. of Minnesota, St. Paul, MN (United States). NorthernSTAR Building America Partnership; Mosiman, G. [Univ. of Minnesota, St. Paul, MN (United States). NorthernSTAR Building America Partnership; VonThoma, E. [Univ. of Minnesota, St. Paul, MN (United States). NorthernSTAR Building America Partnership

2017-07-25

The intention of this project is to assist home builders in the upper Midwest in achieving DOE Zero Energy Ready Home program certification, and to document the process and outcomes involved in meeting this rigorous standard. NorthernSTAR, in conjunction with our program partner Building Knowledge, Inc., provided technical support to the builders during the design and construction process. At the time of this publication, four qualifying homes have been completed and an additional three are currently under construction to be completed later this year. Three additional homes were excluded from certification due to the HVAC contractor not completing their required credentialing until after completion of the homes, though the energy performance would have otherwise qualified the homes for program certification. Both Amaris Homes and Cobblestone Homes note that participation in the ZERH program provides them with competitive advantage in the market place at reasonable construction costs that also result in extremely satisfied clients who are willing to recommend the builders to friends and family.

Zika Virus and Pregnancy

Medline Plus

Full Text Available ... Career Connection Home Clinical Guidance & Publications Practice Management Education & Events Advocacy For Patients About ACOG Zika Virus ... and Pregnancy Page Navigation ▼ ACOG Pregnancy Book Patient Education FAQs Patient Education Pamphlets - Spanish Share: PEV002, September ...

Zika Virus and Pregnancy

Medline Plus

Full Text Available ... Donate Shop Career Connection Home Clinical Guidance & Publications Practice Management Education & Events Advocacy For Patients About ACOG Zika ... Practice Bulletins Patient Education Green Journal Clinical Updates Practice Management Coding Health Info Technology Professional Liability Managing Your ...

The continuum of behavior guidance.

Science.gov (United States)

Nelson, Travis

2013-01-01

Behavior guidance is a continuum of techniques, basic and advanced, fundamental to the provision of quality dental care for pediatric patients. This practice must be individualized, pairing the correct method of behavior guidance with each child. To select the appropriate technique, the clinician must have a thorough understanding of each aspect of the continuum and anticipate parental expectations, child temperament, and the technical procedures necessary to complete care. By effectively using techniques within the continuum of behavior guidance, a healing relationship with the family is maintained while addressing dental disease and empowering the child to receive dental treatment throughout their lifetime. Copyright © 2013 Elsevier Inc. All rights reserved.

Guidance for States Implementing Comprehensive Safeguards Agreements and Additional Protocols (Spanish Edition)

International Nuclear Information System (INIS)

2015-01-01

This publication is aimed at enhancing States’ understanding of the safeguards obligations of both the State and the IAEA, and at improving the cooperation between States and the IAEA in safeguards implementation. It is principally intended for State or regional safeguards regulatory authorities and facility operators, and is a reference document that will be supported by detailed guidance and examples in ‘Safeguards Implementation Practices’ (SIPs) to be published separately

Guidance for States Implementing Comprehensive Safeguards Agreements and Additional Protocols (Arabic Edition)

International Nuclear Information System (INIS)

2017-01-01

This publication is aimed at enhancing States’ understanding of the safeguards obligations of both the State and the IAEA, and at improving the cooperation between States and the IAEA in safeguards implementation. It is principally intended for State or regional safeguards regulatory authorities and facility operators, and is a reference document that will be supported by detailed guidance and examples in ‘Safeguards Implementation Practices’ (SIPs) to be published separately.

Consolidated guidance about materials licenses: Program-specific guidance about portable gauge licenses. Final report; Volume 1

Energy Technology Data Exchange (ETDEWEB)

Vacca, P.C.; Whitten, J.E.; Pelchat, J.M.; Arredondo, S.A.; Matson, E.R.; Lewis, S.H.; Collins, D.J.; Santiago, P.A. [Nuclear Regulatory Commission, Washington, DC (United States). Div. of Industrial and Medical Nuclear Safety; Tingle, W. [Dept. of Environment, Health, and Natural Resources, Raleigh, NC (United States). Div. of Radiation Protection

1997-05-01

As part of its redesign of the materials licensing process, NRC is consolidating and updating numerous guidance documents into a single comprehensive repository as described in NUREG-1539 and draft NUREG-1541. NUREG-1556, Vol. 1, is the first program-specific guidance developed for the new process and will serve as a template for subsequent program-specific guidance. This document is intended for use by applicants, licensees, and NRC staff and will also be available to Agreement States. This document supersedes the guidance previously found in draft Regulatory Guide DG-0008, ``Applications for the Use of Sealed Sources in Portable Gauging Devices,`` and in NMSs Policy and guidance Directive 2-07, ``Standard Review Plan for Applications for Use of Sealed Sources in Portable Gauging Devices.`` This final report takes a more risk-informed, performance-based approach to licensing portable gauges, and reduces the information(amount and level of detail) needed to support an application to use these devices. It incorporates many suggests submitted during the comment period on draft NUREG-1556, Volume 1. When published, this final report should be used in preparing portable gauge license applications. NRC staff will use this final report in reviewing these applications.

Consolidated guidance about materials licenses: Program-specific guidance about portable gauge licenses. Final report; Volume 1

International Nuclear Information System (INIS)

Vacca, P.C.; Whitten, J.E.; Pelchat, J.M.; Arredondo, S.A.; Matson, E.R.; Lewis, S.H.; Collins, D.J.; Santiago, P.A.; Tingle, W.

1997-05-01

As part of its redesign of the materials licensing process, NRC is consolidating and updating numerous guidance documents into a single comprehensive repository as described in NUREG-1539 and draft NUREG-1541. NUREG-1556, Vol. 1, is the first program-specific guidance developed for the new process and will serve as a template for subsequent program-specific guidance. This document is intended for use by applicants, licensees, and NRC staff and will also be available to Agreement States. This document supersedes the guidance previously found in draft Regulatory Guide DG-0008, ''Applications for the Use of Sealed Sources in Portable Gauging Devices,'' and in NMSs Policy and guidance Directive 2-07, ''Standard Review Plan for Applications for Use of Sealed Sources in Portable Gauging Devices.'' This final report takes a more risk-informed, performance-based approach to licensing portable gauges, and reduces the information(amount and level of detail) needed to support an application to use these devices. It incorporates many suggests submitted during the comment period on draft NUREG-1556, Volume 1. When published, this final report should be used in preparing portable gauge license applications. NRC staff will use this final report in reviewing these applications

Becoming a guest in your own home: Home care in Sweden from the perspective of older people with multimorbidities.

Science.gov (United States)

Jarling, Aleksandra; Rydström, Ingela; Ernsth-Bravell, Marie; Nyström, Maria; Dalheim-Englund, Ann-Charlotte

2018-03-30

To describe the meaning of the phenomenon home care from the perspective of older persons who live alone with multimorbidity. In line with worldwide changing demographics, conditions for older people in need of home care are changing. In Sweden there is a stay-in-place policy and older people are expected to live and be cared for in their own home as long as possible. Home care, instituted by different laws, is a challenge affecting the older person when the private home becomes a workplace. This study uses a qualitative design with a lifeworld approach. The study having been conducted in Sweden in 2016, the researchers interviewed 12 older persons that live alone and receive home care. Data were analysed using qualitative content analysis. The findings illustrate four sub-themes: adapting to a caring culture, feeling exposed, unable to influence care and forced relations. The overall theme reveals that older people experience a life-changing situation when receiving home care and they become a guest in their own home. Becoming older with increased needs means to disrupt one's life when one's private home becomes a public arena. The gap between an older person's rights by law and the older person's experiences of receiving home care needs to be highlighted to meet the oncoming challenges in providing a home care that includes participation of the older themselves. Only then can care be offered that enables older people to have a sense of control and experience their home as their own. The findings emphasise the need to view older people as being self-determinant and independent. Older people receiving home care need to be seen as individuals, and their entire life situation should be considered by also acknowledging the important role played by relatives and caregivers. © 2018 John Wiley & Sons Ltd.

Image Guidance

Science.gov (United States)

Guidance that explains the process for getting images approved in One EPA Web microsites and resource directories. includes an appendix that shows examples of what makes some images better than others, how some images convey meaning more than others

Coastal nonpoint pollution control program: Program development and approval guidance

International Nuclear Information System (INIS)

1993-01-01

The document, developed by NOAA and EPA, contains guidance for states in developing and implementing their coastal nonpoint pollutant source programs. It describes the requirements that must be met, including: the geographic scope of the program; the pollutant sources to be addressed; the types of management measures used; the establishment of critical areas; technical assistance, public participation, and administrative coordination; and, the process for program submission and Federal approval. The document also contains the criteria by which NOAA and EPA will review the states' submissions

Safety of magnetic fusion facilities: Guidance

International Nuclear Information System (INIS)

1996-05-01

This document provides guidance for the implementation of the requirements identified in DOE-STD-6002-96, Safety of Magnetic Fusion Facilities: Requirements. This guidance is intended for the managers, designers, operators, and other personnel with safety responsibilities for facilities designated as magnetic fusion facilities. While the requirements in DOE-STD-6002-96 are generally applicable to a wide range of fusion facilities, this Standard, DOE-STD-6003-96, is concerned mainly with the implementation of those requirements in large facilities such as the International Thermonuclear Experimental Reactor (ITER). Using a risk-based prioritization, the concepts presented here may also be applied to other magnetic fusion facilities. This Standard is oriented toward regulation in the Department of Energy (DOE) environment as opposed to regulation by other regulatory agencies. As the need for guidance involving other types of fusion facilities or other regulatory environments emerges, additional guidance volumes should be prepared. The concepts, processes, and recommendations set forth here are for guidance only. They will contribute to safety at magnetic fusion facilities

A public governance look at CSR

DEFF Research Database (Denmark)

Buhmann, Karin

2014-01-01

interesting potential for public regulators to steer private/public-private resource exploitation towards increased contributions to public sustainability and welfare state objectives. The significance of CSR policies and practices as private governance modalities towards risk management and as competition...... parameters combine with normative guidance based on CSR norms (e.g. the UN Global Compact, OECD’s Guidelines for Multinational Enterprises, the UN Guidelines on Business and Human Rights). Focusing on debates concerning resource extraction operations in Greenland and the pertinent policy framework...

Zika Virus and Pregnancy

Medline Plus

Full Text Available ... Login My ACOG Join Pay Dues Follow us: Women's Health Care Physicians Contact Us My ACOG ACOG Departments Donate Shop Career Connection Home Clinical Guidance & Publications Practice Management Education & Events Advocacy For Patients About ACOG Zika Virus ...

Replacement Windows for Existing Homes Homes | Efficient Windows

Science.gov (United States)

Collaborative Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring

Home safe home: Evaluation of a childhood home safety program.

Science.gov (United States)

Stewart, Tanya Charyk; Clark, Andrew; Gilliland, Jason; Miller, Michael R; Edwards, Jane; Haidar, Tania; Batey, Brandon; Vogt, Kelly N; Parry, Neil G; Fraser, Douglas D; Merritt, Neil

2016-09-01

The London Health Sciences Centre Home Safety Program (HSP) provides safety devices, education, a safety video, and home safety checklist to all first-time parents for the reduction of childhood home injuries. The objective of this study was to evaluate the HSP for the prevention of home injuries in children up to 2 years of age. A program evaluation was performed with follow-up survey, along with an interrupted time series analysis of emergency department (ED) visits for home injuries 5 years before (2007-2013) and 2 years after (2013-2015) implementation. Spatial analysis of ED visits was undertaken to assess differences in home injury rates by dissemination areas controlling differences in socioeconomic status (i.e., income, education, and lone-parent status) at the neighborhood level. A total of 3,458 first-time parents participated in the HSP (a 74% compliance rate). Of these, 20% (n = 696) of parents responded to our questionnaire, with 94% reporting the program to be useful (median, 6; interquartile range, 2 on a 7-point Likert scale) and 81% learning new strategies for preventing home injuries. The median age of the respondent's babies were 12 months (interquartile range, 1). The home safety check list was used by 87% of respondents to identify hazards in their home, with 95% taking action to minimize the risk. The time series analysis demonstrated a significant decline in ED visits for home injuries in toddlers younger than2 years of age after HSP implementation. The declines in ED visits for home injuries remained significant over and above each socioeconomic status covariate. Removing hazards, supervision, and installing safety devices are key facilitators in the reduction of home injuries. Parents found the HSP useful to identify hazards, learn new strategies, build confidence, and provide safety products. Initial finding suggests that the program is effective in reducing home injuries in children up to 2 years of age. Therapeutic/care management study

Public participation in UMTRA Project Program Management

International Nuclear Information System (INIS)

Majors, M.J.; Ulland, L.M.

1993-01-01

The U.S. Department of Energy (DOE) is cleaning up radioactive soil and ore residue from 24 inactive uranium processing sites under the Uranium Mill Tailings Remedial Action (UMTRA) Project. In early 1993, the DOE adopted new guidelines strongly encouraging public participation. This guidance commits to providing the public with opportunities to participate in the decision-making process for program planning, design, and implementation. Rooted in the conviction that an effective public participation program will enable citizens to take part in policy decisions, the full adoption of the guidance by the UMTRA project can also help DOE make better decisions, provide a means to build consensus, and assist in building credibility. This transition to open communication parallels the climate of corporate America in which increases in productivity are often the result of workers and management teaming together to solve problems. While these guidelines have been embraced by public affairs staff from headquarters to the field offices, barriers still exist that inhibit substantive public involvement. The challenge for the UMTRA project is to overcome these barriers to ensure that public participation is an integral part of the way business is conducted. This paper discusses lessons learned by the UMTRA project in its efforts to address barriers to public participation and the project's plans for full compliance with the DOE guidelines

DOE Waste Treatability Group Guidance

International Nuclear Information System (INIS)

Kirkpatrick, T.D.

1995-01-01

This guidance presents a method and definitions for aggregating U.S. Department of Energy (DOE) waste into streams and treatability groups based on characteristic parameters that influence waste management technology needs. Adaptable to all DOE waste types (i.e., radioactive waste, hazardous waste, mixed waste, sanitary waste), the guidance establishes categories and definitions that reflect variations within the radiological, matrix (e.g., bulk physical/chemical form), and regulated contaminant characteristics of DOE waste. Beginning at the waste container level, the guidance presents a logical approach to implementing the characteristic parameter categories as part of the basis for defining waste streams and as the sole basis for assigning streams to treatability groups. Implementation of this guidance at each DOE site will facilitate the development of technically defined, site-specific waste stream data sets to support waste management planning and reporting activities. Consistent implementation at all of the sites will enable aggregation of the site-specific waste stream data sets into comparable national data sets to support these activities at a DOE complex-wide level

DOE Waste Treatability Group Guidance

Energy Technology Data Exchange (ETDEWEB)

Kirkpatrick, T.D.

1995-01-01

This guidance presents a method and definitions for aggregating U.S. Department of Energy (DOE) waste into streams and treatability groups based on characteristic parameters that influence waste management technology needs. Adaptable to all DOE waste types (i.e., radioactive waste, hazardous waste, mixed waste, sanitary waste), the guidance establishes categories and definitions that reflect variations within the radiological, matrix (e.g., bulk physical/chemical form), and regulated contaminant characteristics of DOE waste. Beginning at the waste container level, the guidance presents a logical approach to implementing the characteristic parameter categories as part of the basis for defining waste streams and as the sole basis for assigning streams to treatability groups. Implementation of this guidance at each DOE site will facilitate the development of technically defined, site-specific waste stream data sets to support waste management planning and reporting activities. Consistent implementation at all of the sites will enable aggregation of the site-specific waste stream data sets into comparable national data sets to support these activities at a DOE complex-wide level.

History of the CERN Web Software Public Releases

CERN Document Server

Fluckiger, Francois; CERN. Geneva. IT Department

2016-01-01

This note is an extended version of the article “Licencing the Web” (http://home.web.cern.ch/topics/birthweb/licensing-web) published by CERN, Nov 2013, in the “Birth of the Web” series of articles (http://home.cern/topics/birth-web). It describes the successive steps of the public release of the CERN Web software, from public domain to open source, and explains their rationale. It provides in annexes historical documents including release announcement and texts of the licences used by CERN and MIT in public software distributions.

Regulatory systems-based licensing guidance documentation

International Nuclear Information System (INIS)

Delligatti, M.S.

1991-01-01

The US Nuclear Regulatory Commission (NRC) has developed a series of licensing guidance documents based on the regulatory requirements in Part 60 of Title 10 of the Code of Federal Regulations (10 CFR Part 60). This regulatory systems-based approach to licensing guidance documentation relies on the definition of the high-level waste repository in 10 CFR Part 60. A document which is important for the frame-work it gives to other programmatic licensing guidance is the Draft Regulatory Guide open-quotes Format and Content for the License Application for the High-Level Waste Repositoryclose quotes (FCRG). The FCRG describes a format and content acceptable to NRC for a high-level waste repository license application pursuant to the requirements of 10 CFR Part 60. Other licensing guidance documents will be compatible with the FCRG

The Building Act 1984. The Building Regulations 1991; BR 211; Radon; guidance on protective measures for new dwellings, 1999 edition

International Nuclear Information System (INIS)

1999-01-01

This guidance is the 1999 edition of BR 211, Radon: guidance on protective measures for new dwellings, which was published on 11 November 1999. The guidance in the 1999 edition of BR 211 should be considered to apply to any building or building work for which a building notice, initial notice, amendment notice or public body's notice is given to a local authority, or full plans are deposited with a local authority on or after 14 February 2000. Where an amendment notice is given on or after 14 February 2000 relating to an initial notice given before that date, only new work added to the initial notice will be formally subject to the 1999 edition of BR 211

[Cleaning and disinfection in nursing homes. Data on quality of structure, process and outcome in nursing homes in Frankfurt am Main, Germany, 2011].

Science.gov (United States)

Heudorf, U; Gasteyer, S; Samoiski, Y; Voigt, K

2012-08-01

Due to the Infectious Disease Prevention Act, public health services in Germany are obliged to check the infection prevention in hospitals and other medical facilities as well as in nursing homes. In Frankfurt/Main, Germany, standardized control visits have been performed for many years. In 2011 focus was laid on cleaning and disinfection of surfaces. All 41 nursing homes were checked according to a standardized checklist covering quality of structure (i.e. staffing, hygiene concept), quality of process (observation of the cleaning processes in the homes) and quality of output, which was monitored by checking the cleaning of fluorescent marks which had been applied some days before and should have been removed via cleaning in the following days before the final check. In more than two thirds of the homes, cleaning personnel were salaried, in one third external personnel were hired. Of the homes 85% provided service clothing and all of them offered protective clothing. All homes had established hygiene and cleaning concepts, however, in 15% of the homes concepts for the handling of Norovirus and in 30% concepts for the handling of Clostridium difficile were missing. Regarding process quality only half of the processes observed, i.e. cleaning of hand contact surfaces, such as handrails, washing areas and bins, were correct. Only 44% of the cleaning controls were correct with enormous differences between the homes (0-100%). The correlation between quality of process and quality of output was significant. There was good quality of structure in the homes but regarding quality of process and outcome there was great need for improvement. This was especially due to faults in communication and coordination between cleaning personnel and nursing personnel. Quality outcome was neither associated with the number of the places for residents nor with staffing. Thus, not only quality of structure but also quality of process and outcome should be checked by the public health

Home health nursing care services in Greece during an economic crisis.

Science.gov (United States)

Adamakidou, T; Kalokerinou-Anagnostopoulou, A

2017-03-01

The purpose of this review was to describe public home healthcare nursing services in Greece. The effectiveness and the efficiency of home healthcare nursing are well documented in the international literature. In Greece, during the current financial crisis, the development of home healthcare nursing services is the focus and interest of policymakers and academics because of its contribution to the viability of the healthcare system. A review was conducted of the existing legislation, the printed and electronic bibliography related to the legal framework, the structures that provide home health care, the funding of the services, the human resources and the services provided. The review of the literature revealed the strengths and weaknesses of the existing system of home health care and its opportunities and threats, which are summarized in a SWOT analysis. There is no Greek nursing literature on this topic. The development of home health nursing care requires multidimensional concurrent and combined changes and adjustments that would support and strengthen healthcare professionals in their practices. Academic and nursing professionals should provide guidelines and regulations and develop special competencies for the best nursing practice in home health care. At present, in Greece, which is in an economic crisis and undergoing reforms in public administration, there is an undeniable effort being made to give primary health care the position it deserves within the health system. There is an urgent need at central and academic levels to develop home healthcare services to improve the quality and efficiency of the services provided. © 2016 International Council of Nurses.

Precarious Situations of Care Workers in Home-Based Elder Care in Slovenia.

Science.gov (United States)

Hrženjak, Majda

2018-02-01

Based on policy analysis and individual interviews, the author analyzes the care workers' precarious situations in home-based elder care in Slovenia, a post-socialist, European Union country characterized by a rapidly aging population and delays in adapting a long-term care system to this new social risk. Employment and quasi-employment positions which coexist in home-based care can be sorted along two continuums: between public and market service; between formal and informal work. The author argues that working conditions in home-based care differ according to the position of the care worker on these two continuums, that is, being employed in public services, being self-employed, working in informal care markets, holding a status of family assistant, or being an informal family caregiver. Although the working conditions in public services are deteriorating, the analysis shows that precarity is more severe in market and informal care, while formalization and socialization of care bring about less precarious conditions.

Newborn well-child visits in the home setting: a pilot study in a family medicine residency.

Science.gov (United States)

Lakin, Ashley; Sutter, Mary Beth; Magee, Susanna

2015-03-01

The purpose of our study was to pilot a home visit program targeting neonates conducted by family medicine residents. While the literature shows that home visit programs are successful at preventing adverse outcomes for young children, such as improving parenting practices and promoting breastfeeding, no data exist about newborn home visits conducted by resident physicians. Residents conducted newborn home visits precepted by a family medicine faculty member from June 2012--May 2013. Subjects were recruited from the residency continuity practice and randomized to receive two home visits (which replaced two office visits) or routine office-based newborn care. All participants were surveyed using the validated WHOQOL-BREF quality of life scale and a patient satisfaction instrument. Metrics were also obtained from the electronic medical record. Mothers and resident physicians completed an open-ended questionnaire about their experience. All patients, whether receiving office-based or home-based care, rated their care highly. Significant differences were seen in usage of acute care in the first 6 months of life, and mothers in the home visit group trended toward initiating breastfeeding at a higher rate. The home visit group ranked their quality of life higher across all domains when compared to the control group, approaching statistical significance in two domains. Residents providing home visits reported increased connectedness to patients and improved confidence in anticipatory guidance delivery. Home visits are valuable for families with newborns, in terms of minimizing acute care service usage, breastfeeding promotion, and perhaps increasing maternal perceptions of well-being. A home visit program has the potential to enhance resident education and the doctor-patient relationship.

41 CFR 302-14.100 - How should we administer our home marketing incentive payment program?

Science.gov (United States)

2010-07-01

... reduce your overall relocation costs. You must not make a home marketing incentive payment that exceeds... our home marketing incentive payment program? 302-14.100 Section 302-14.100 Public Contracts and... 14-HOME MARKETING INCENTIVE PAYMENTS Agency Responsibilities § 302-14.100 How should we administer...

Assessment of private homes as spaces for the dying elderly

Directory of Open Access Journals (Sweden)

Tulika Bhattacharyya

2017-01-01

Full Text Available Aim: This study makes an assessment of end-of-life care of the elderly in private homes in Kolkata, West Bengal, India. Participants and Methods: Primary data were collected from private homes which supported elder care through observation and semi-structured interviews with primary family caregivers of the elderly. Results: The study finds that the major factors preventing private homes from providing adequate care to the elderly were architecturally inadequate housing conditions, paucity of financial support, and scarcity of skilled caregivers. Besides, considerable neglect and domestic abuse of the elderly was also found in some private homes. In addition, the peripheral location of private homes within public health framework and inadequate state palliative policy, including stringent narcotic regulations, accentuated the problems of home care. Conclusion: The study concludes by questioning the rhetoric of private homes as spaces for the dying elderly in Kolkata and suggests remedial measures to improve their capacity to deliver care.

Addressing Kitchen Contaminants for Healthy, Low-Energy Homes

Energy Technology Data Exchange (ETDEWEB)

Stratton, J. Chris [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Singer, Brett C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2014-01-01

Cooking and cooking burners emit pollutants that can adversely affect indoor air quality in residences and significantly impact occupant health. Effective kitchen exhaust ventilation can reduce exposure to cooking-related air pollutants as an enabling step to healthier, low-energy homes. This report by Lawrence Berkeley National Laboratory identifies barriers to the widespread adoption of kitchen exhaust ventilation technologies and practice and proposes a suite of strategies to overcome these barriers. The recommendations have been vetted by a group of industry, regulatory, health, and research experts and stakeholders who convened for two meetings and provided input and feedback to early drafts of this document. The most fundamental barriers are (1) the common misconception, based on a sensory perception of risk, that kitchen exhaust when cooking is unnecessary and (2) the lack of a code requirement for kitchen ventilation in most U.S. locations. Highest priority objectives include the following: (1) Raise awareness among the public and the building industry of the need to install and routinely use kitchen ventilation; (2) Incorporate kitchen exhaust ventilation as a requirement of building codes and improve the mechanisms for code enforcement; (3) Provide best practice product and use-behavior guidance to ventilation equipment purchasers and installers, and; (4) Develop test methods and performance targets to advance development of high performance products. A specific, urgent need is the development of an over-the-range microwave that meets the airflow and sound requirements of ASHRAE Standard 62.2.

Addressing Kitchen Contaminants for Healthy, Low-Energy Homes

Energy Technology Data Exchange (ETDEWEB)

Stratton, J. Chris; Singer, Brett C.

2014-01-01

Cooking and cooking burners emit pollutants that can adversely affect indoor air quality in residences and significantly impact occupant health. Effective kitchen exhaust ventilation can reduce exposure to cooking-related air pollutants as an enabling step to healthier, low-energy homes. This report identifies barriers to the widespread adoption of kitchen exhaust ventilation technologies and practice and proposes a suite of strategies to overcome these barriers. The recommendations have been vetted by a group of industry, regulatory, health, and research experts and stakeholders who convened for two web-based meetings and provided input and feedback to early drafts of this document. The most fundamental barriers are (1) the common misconception, based on a sensory perception of risk, that kitchen exhaust when cooking is unnecessary and (2) the lack of a code requirement for kitchen ventilation in most US locations. Highest priority objectives include the following: (1) Raise awareness among the public and the building industry of the need to install and routinely use kitchen ventilation; (2) Incorporate kitchen exhaust ventilation as a requirement of building codes and improve the mechanisms for code enforcement; (3) Provide best practice product and use-behavior guidance to ventilation equipment purchasers and installers, and; (4) Develop test methods and performance targets to advance development of high performance products. A specific, urgent need is the development of an over-the-range microwave that meets the airflow and sound requirements of ASHRAE Standard 62.2.

Safety assessment guidance in the International Atomic Energy Agency RADWASS Program

Energy Technology Data Exchange (ETDEWEB)

Vovk, I.F.; Seitz, R.R.

1995-12-31

The IAEA RADWASS programme is aimed at establishing a coherent and comprehensive set of principles and standards for the safe management of waste and formulating the guidelines necessary for their application. A large portion of this programme has been devoted to safety assessments for various waste management activities. Five Safety Guides are planned to be developed to provide general guidance to enable operators and regulators to develop necessary framework for safety assessment process in accordance with international recommendations. They cover predisposal, near surface disposal, geological disposal, uranium/thorium mining and milling waste, and decommissioning and environmental restoration. The Guide on safety assessment for near surface disposal is at the most advanced stage of preparation. This draft Safety Guide contains guidance on description of the disposal system, development of a conceptual model, identification and description of relevant scenarios and pathways, consequence analysis, presentation of results and confidence building. The set of RADWASS publications is currently undergoing in-depth review to ensure a harmonized approach throughout the Safety Series.

Nursing home residents' views on dying and death: nursing home employee's perspective.

Science.gov (United States)

Dwyer, Lise-Lotte; Hansebo, Görel; Andershed, Birgitta; Ternestedt, Britt-Marie

2011-12-01

To reveal nursing home employees' views on dying and death among older people they cared for. Palliative care stakeholders recently included more groups in their definition of palliative care; older people constitute one such group. Consequently, palliative care systems, which will serve a large, aging cohort, will require new skills. The first stage in skills acquisition is to gather current views on dying and death. Qualitative descriptive study that uses focus group discussions for data collection; 20 employees in 4 Swedish nursing homes participated. Data were analysed using qualitative content analysis. The following categories were conceptualised: alleviating suffering and pain; finding meaning in everyday life; revealing thoughts and attitudes about death; taking care of the dead person's body; and coping with the gap between personal ideals and reality. A deeper understanding of the palliative care philosophy is needed to further develop and tailor care for the dying persons in nursing homes. To get public support for palliative care, the silence surrounding dying and death must be broken. Employees must receive education to prepare for all aspects of their work, and management must account for employees' situation when planning the care. © 2010 Blackwell Publishing Ltd.

Ultrasound Guidance for Botulinum Neurotoxin Chemodenervation Procedures

Directory of Open Access Journals (Sweden)

Katharine E. Alter

2017-12-01

Full Text Available Injections of botulinum neurotoxins (BoNTs are prescribed by clinicians for a variety of disorders that cause over-activity of muscles; glands; pain and other structures. Accurately targeting the structure for injection is one of the principle goals when performing BoNTs procedures. Traditionally; injections have been guided by anatomic landmarks; palpation; range of motion; electromyography or electrical stimulation. Ultrasound (US based imaging based guidance overcomes some of the limitations of traditional techniques. US and/or US combined with traditional guidance techniques is utilized and or recommended by many expert clinicians; authors and in practice guidelines by professional academies. This article reviews the advantages and disadvantages of available guidance techniques including US as well as technical aspects of US guidance and a focused literature review related to US guidance for chemodenervation procedures including BoNTs injection.

Trends in characteristics of women choosing contraindicated home births.

Science.gov (United States)

Zafman, Kelly B; Stone, Joanne L; Factor, Stephanie H

2018-04-12

To characterize the American College of Obstetricians and Gynecologists (ACOG) contraindicated home births and the women who are receiving these births in hopes of identifying venues for intervention. The National Center for Health Statistics (NCHS) birth certificate records from 1990 to 2015 were used. "Planned home births" were defined as those births in which birthplace was coded as "residence" and birth attendant was coded as "certified nurse midwife (CNM)" or "other midwife". Contraindicated home births were defined as "planned home births" from 1990 to 2015 that had one or more of the ACOG risk factors for home births, which include vaginal birth after prior cesarean delivery (VBAC), breech presentation and multiple gestations. A review of trends in contraindicated home births from 1990 to 2015 suggests that they are increasing in number (481-1396) and as a percentage of total births (0.01%-0.04%, P95%), which is most frequently initiated in the first trimester. The majority of home births were paid out-of-pocket (65%-69%). The increasing number of contraindicated home births in the United States requires public health action. Home births are likely a matter of choice rather than a lack of resources. It is unclear if women choose home births while knowing the risk or due to a lack of information. Prenatal education about contraindicated home births is possible, as almost all women receive prenatal care.

75 FR 5356 - Office of New Reactors; Final Interim Staff Guidance on Post-Combined License Commitments

Science.gov (United States)

2010-02-02

... the guidance provided to the NRC staff in Section 1.0, ``Introduction and Interfaces,'' of NUREG-0800, ``Standard Review Plan for the Review of Safety Analysis Reports for Nuclear Power Plants,'' concerning the... maintains ADAMS, which provides text and image files of NRC's public documents. These documents may be...

Home-based tele-assisted robotic rehabilitation of joint impairments in children with cerebral palsy.

Science.gov (United States)

Chen, Kai; Ren, Yupeng; Gaebler-Spira, Deborah; Zhang, Li-Qun

2014-01-01

A portable rehabilitation robot incorporating intelligent stretching, robot-guided voluntary movement training with motivating games and tele-rehabilitation was developed to provide convenient and cost-effective rehabilitation to children with cerebral palsy (CP) and extend rehabilitation care beyond hospital. Clinicians interact with the patients remotely for periodic evaluations and updated guidance. The tele-assisted stretching and active movement training was done over 6-week 18 sessions on the impaired ankle of 23 children with CP in their home setting. Treatment effectiveness was evaluated using biomechanical measures and clinical outcome measures. After the tele-assisted home robotic rehabilitation intervention, there were significant increases in the ankle passive and active range of motion, muscle strength, a decrease in spasticity, and increases in balance and selective control assessment of lower-extremity.

Surgery for constipation : systematic review and clinical guidance : Paper 1 : Introduction & Methods

OpenAIRE

Knowles, C. H.; Grossi, U.; Horrocks, E. J.; Pares, D.; Vollebregt, P. F.; Chapman, M.; Brown, S. R.; Mercer-Jones, M.; Williams, A. B.; Hooper, R. J.; Stevens, N.; Mason, James; HASH(0x55897e378178); HASH(0x55897e14a718)

2017-01-01

Aim\\ud \\ud This manuscript provides the introduction and detailed methodology used in subsequent reviews to assess the outcomes of surgical interventions with the primary intent of treating chronic constipation in adults and to develop recommendations for practice.\\ud \\ud Method\\ud \\ud PRISMA guidance was adhered to throughout. A literature search was performed in public databases between January 1960 and February 2016. Studies that fulfilled strictly-defined PICOS (patients, interventions, c...

Automated low-thrust guidance for the orbital maneuvering vehicle

Science.gov (United States)

Rose, Richard E.; Schmeichel, Harry; Shortwell, Charles P.; Werner, Ronald A.

1988-01-01

This paper describes the highly autonomous OMV Guidance Navigation and Control system. Emphasis is placed on a key feature of the design, the low thrust guidance algorithm. The two guidance modes, orbit change guidance and rendezvous guidance, are discussed in detail. It is shown how OMV will automatically transfer from its initial orbit to an arbitrary target orbit and reach a specified rendezvous position relative to the target vehicle.

Marketization in Long-Term Care: A Cross-Country Comparison of Large For-Profit Nursing Home Chains

Science.gov (United States)

Harrington, Charlene; Jacobsen, Frode F; Panos, Justin; Pollock, Allyson; Sutaria, Shailen; Szebehely, Marta

2017-01-01

This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership, corporate strategies, costs, and quality of the 5 largest for-profit chains in each country. The findings show that large for-profit nursing home chains are increasingly owned by private equity investors, have had many ownership changes over time, and have complex organizational structures. Large for-profit nursing home chains increasingly dominate the market and their strategies include the separation of property from operations, diversification, the expansion to many locations, and the use of tax havens. Generally, the chains have large revenues with high profit margins with some documented quality problems. The lack of adequate public information about the ownership, costs, and quality of services provided by nursing home chains is problematic in all the countries. The marketization of nursing home care poses new challenges to governments in collecting and reporting information to control costs as well as to ensure quality and public accountability. PMID:28634428

Which mothers receive a post partum home visit in Queensland, Australia? A cross-sectional retrospective study.

Science.gov (United States)

Brodribb, Wendy; Miller, Yvette

2015-06-01

Although home visiting in the early post partum period appears to have increased, there are limited data defining which women receive a visit and none that include Queensland. We aimed to investigate patterns of post partum home visiting in the public and private sectors in Queensland. Data were collected via a retrospective cross-sectional survey of women birthing in Queensland between 1 February and 31 May 2010 at 4 months post partum (n = 6948). Logistic regression was used to assess associations between receiving a home visit and sociodemographic, clinical and hospital variables. Analyses were stratified by public and private birthing sector because of significant differences between sectors. Public sector women were more likely to receive a visit from a nurse or midwife (from the hospital or child health sector) within 10 days of hospital discharge (67.2%) than private sector women (7.2%). Length of hospital stay was associated with home visiting in both sectors. Some vulnerable subpopulations in both sectors were more likely to be visited, whereas others were not. Home visiting in Queensland varies markedly between the public and private sector and is less common in some vulnerable populations. Further consideration to improving the equity of community post partum care in Queensland is needed.

75 FR 8412 - Office of New Reactors: Interim Staff Guidance on Assessing Ground Water Flow and Transport of...

Science.gov (United States)

2010-02-24

... NUCLEAR REGULATORY COMMISSION [NRC-2010-0047] Office of New Reactors: Interim Staff Guidance on Assessing Ground Water Flow and Transport of Accidental Radionuclide Releases; Solicitation of Public... ground water flow and transport of accidental radionuclide releases necessary to demonstrate compliance...

European Lifelong Guidance Policy Network Representatives' Conceptions of the Role of Information and Communication Technologies Related to National Guidance Policies

Science.gov (United States)

Kettunen, Jaana; Vuorinen, Raimo; Ruusuvirta, Outi

2016-01-01

This article reports findings from a phenomenographic investigation into European Lifelong Guidance Policy Network representatives' conceptions of the role of information and communication technologies (ICT) related to national lifelong guidance policies. The role of ICT in relation to national lifelong guidance policies was conceived as (1)…

Patterns of 'at-home' alcohol-related injury presentations to emergency departments.

Science.gov (United States)

Bunker, Naomi; Woods, Cindy; Conway, Jane; Barker, Ruth; Usher, Kim

2017-01-01

This study aimed to establish the scale of alcohol-related injuries originating in the home. Despite recent media and public attention on alcohol-related injuries occurring at licensed venues, many occur in other locations including the home. A retrospective observational study. Emergency department surveillance data sourced from the Queensland Injury Surveillance Unit were interrogated for alcohol-related emergency department presentations from 2003-2012 (n = 12,296). Descriptive analysis was undertaken to assess alcohol involvement in injury, and analysis of variance was used to determine the differences among group means and their associated presentations. The relationship between demographic variables and injury location was assessed using p value of domestic violence by spouse or partner (n = 510), 59·5% occurred 'at home'. This is the first study to investigate alcohol-related injuries occurring at home. The home accounts for a greater proportion of injuries than the frequently assessed licensed premises location. Further research is required to validate these findings in a wider setting. A public health campaign is required to minimise harm associated with alcohol-related injuries in the home, and nurses are positioned to inform health policy makers around this issue. Furthermore, emergency department nurses are in a unique position to provide brief interventions around safe alcohol consumption and injury prevention. © 2016 John Wiley & Sons Ltd.

Cost consideration in the clinical guidance documents of physician specialty societies in the United States.

Science.gov (United States)

Schwartz, Jennifer A T; Pearson, Steven D

2013-06-24

Despite increasing concerns regarding the cost of health care, the consideration of costs in the development of clinical guidance documents by physician specialty societies has received little analysis. To evaluate the approach to consideration of cost in publicly available clinical guidance documents and methodological statements produced between 2008 and 2012 by the 30 largest US physician specialty societies. Qualitative document review. Whether costs are considered in clinical guidance development, mechanism of cost consideration, and the way that cost issues were used in support of specific clinical practice recommendations. Methodological statements for clinical guidance documents indicated that 17 of 30 physician societies (57%) explicitly integrated costs, 4 (13%) implicitly considered costs, 3 (10%) intentionally excluded costs, and 6 (20%) made no mention. Of the 17 societies that explicitly integrated costs, 9 (53%) consistently used a formal system in which the strength of recommendation was influenced in part by costs, whereas 8 (47%) were inconsistent in their approach or failed to mention the exact mechanism for considering costs. Among the 138 specific recommendations in these guidance documents that included cost as part of the rationale, the most common form of recommendation (50 [36%]) encouraged the use of a specific medical service because of equal effectiveness and lower cost. Slightly more than half of the largest US physician societies explicitly consider costs in developing their clinical guidance documents; among these, approximately half use an explicit mechanism for integrating costs into the strength of recommendations. Many societies remain vague in their approach. Physician specialty societies should demonstrate greater transparency and rigor in their approach to cost consideration in documents meant to influence care decisions.

Online thesis guidance management information system

Science.gov (United States)

Nasution, T. H.; Pratama, F.; Tanjung, K.; Siregar, I.; Amalia, A.

2018-03-01

The development of internet technology in education is still not maximized, especially in the process of thesis guidance between students and lecturers. Difficulties met the lecturers to help students during thesis guidance is the limited communication time and the compatibility of schedule between students and lecturer. To solve this problem, we designed an online thesis guidance management information system that helps students and lecturers to do thesis tutoring process anytime, anywhere. The system consists of a web-based admin app for usage management and an android-based app for students and lecturers.

Guidance for research-practice partnerships (R-PPs) and collaborative research.

Science.gov (United States)

Ovretveit, John; Hempel, Susanne; Magnabosco, Jennifer L; Mittman, Brian S; Rubenstein, Lisa V; Ganz, David A

2014-01-01

The purpose of this paper is to provide evidence based guidance to researchers and practice personnel about forming and carrying out effective research partnerships. A review of the literature, interviews and discussions with colleagues in both research and practice roles, and a review of the authors' personal experiences as researchers in partnership research. Partnership research is, in some respects, a distinct "approach" to research, but there are many different versions. An analysis of research publications and of their research experience led the authors to develop a framework for planning and assessing the partnership research process, which includes defining expected outcomes for the partners, their roles, and steps in the research process. This review and analysis provides guidance that may reduce commonly-reported misunderstandings and help to plan more successful partnerships and projects. It also identifies future research which is needed to define more precisely the questions and purposes for which partnership research is most appropriate, and methods and designs for specific types of partnership research. As more research moves towards increased participation of practitioners and patients in the research process, more precise and differentiated understanding of the different partnership approaches is required, and when each is most suitable. This article describes research approaches that have the potential to reduce "the research-practice gap". It gives evidence- and experience-based guidance for choosing and establishing a partnership research process, so as to improve partnership relationship-building and more actionable research.

Our Lady of Fatima Home, Oakpark, Tralee, Kerry.

LENUS (Irish Health Repository)

Cowman, Seamus

2010-01-01

BACKGROUND: Although stroke is recognised as a major factor in admission to nursing home care, data is lacking on the extent and nature of the disabilities and dependency in nursing homes arising from stroke. A national study conducted in nursing homes can quantify the number of residents with stroke in nursing homes, their disability and levels of dependency. METHODS: A cross-sectional survey research design was used. A total of 572 public and private nursing homes were identified nationally and a stratified random selection of 60 nursing homes with 3,239 residents was made. In half of the nursing homes (n = 30) efforts were made to interview all residents with stroke Survey instruments were used to collect data from residents with stroke and nursing home managers on demography, patient disability, and treatment. RESULTS: Across all nursing homes (n = 60), 18% (n = 570) of the residents had previously had a stroke. In homes (n = 30), where interviews with residents with stroke (n = 257), only 7% (n = 18) residents were capable of answering for themselves and were interviewed. Data on the remaining 93% (n = 239) residents were provided by the nursing home manager. Nurse Managers reported that 73% of residents with stroke had a high level of dependency. One in two residents with stroke was prescribed antidepressants or sedative medication. Only 21% of stroke residents were prescribed anticoagulants, 42% antiplatelets, and 36% cholesterol lowering medications. Stroke rehabilitation guidelines were lacking and 68% reported that there was no formal review process in place. CONCLUSIONS: This study provides seminal findings on stroke and nursing home services in Ireland. We now know that one in six nursing home residents in a national survey are residents with a stroke, and have a wide range of disabilities. There is currently little or no structured care (beyond generic care) for stroke survivors who reside in nursing homes in Ireland.

Interim guidance for the safe transport of reprocessed uranium

International Nuclear Information System (INIS)

1994-06-01

Increasingly reprocessed uranium is being used for the fabrication of nuclear fuel elements. Different intermediate reprocessing steps are carried out at different locations. Therefore, transportation of uranium material is necessary. Due to the difference in isotope composition of reprocessed uranium then unirradiated uranium a doubt is casted on the presumption that packages used for the transport of unirradiated uranium are automatically suitable for reprocessed uranium compounds. The Standing Advisory Group on the Safe Transport of Radioactive Material (SAGSTRAM) recommended that the issue be reviewed by consultants and that a document be developed that would give guidance to users of the Regulations. This TECDOC is the result of the endeavors of the experts convened at two Consultants Services meetings. It contains guidance on the provisions in the current Regulations as well as proposals for changes to the new Revised Edition whose publication is planned for 1996. This document demonstrates that under the present Transport Regulations it is possible in most cases to ship reprocessed uranium compounds in the same packages as unirradiated uranium compounds. In few cases a more stringent package type is required. 8 refs, 22 figs, 19 tabs

Security of radioactive sources. Interim guidance for comment

International Nuclear Information System (INIS)

2003-06-01

In previous IAEA publications, there have been only rather general security requirements for non-nuclear radioactive material. These requirements were primarily directed to such issues as unintentional exposure to radiation, negligence and inadvertent loss. However, it is clear that more guidance is needed to not only try and prevent further events involving orphan sources, but also to prevent the deliberate attempt to acquire radioactive sources for malevolent purposes. Member States have requested guidance on the type and nature of security measures that might be put in place and on the methodology to be used in choosing such measures. These requests were also endorsed in the findings of the international conference on 'Security of Radioactive Sources' held in March 2003. Practical advice on assessing and implementing security measures complements the general commitments in the proposed Revised Code of Conduct on Safety and Security of radioactive Sources. A Safety Guide entitled 'Safety and Security of Radiation Sources' that, amongst other things, discusses these issues is being drafted. However, it is recognized that guidance material is required before this document will be finalized in order to allow Member States opportunity to put in place appropriate actions and planning to address current issues. Hence the purpose of the current document is to provide advice on security approaches and to allow comment on detailed recommendations for levels of security on radioactive sources that may be incorporated within the Safety Guide. This report is primarily addressed to Regulatory Authorities but it is also intended to provide guidance to manufacturers, suppliers and users of sources. Its objective is to assist Member States in deciding which security measures are needed to ensure consistency with the International Basic Safety Standards and the Revised Code of Conduct for the Safety and Security of Radioactive Sources. It is recognized that there must be a

Does Methodological Guidance Produce Consistency? A Review of Methodological Consistency in Breast Cancer Utility Value Measurement in NICE Single Technology Appraisals.

Science.gov (United States)

Rose, Micah; Rice, Stephen; Craig, Dawn

2017-07-05

Since 2004, National Institute for Health and Care Excellence (NICE) methodological guidance for technology appraisals has emphasised a strong preference for using the validated EuroQol 5-Dimensions (EQ-5D) quality-of-life instrument, measuring patient health status from patients or carers, and using the general public's preference-based valuation of different health states when assessing health benefits in economic evaluations. The aim of this study was to review all NICE single technology appraisals (STAs) for breast cancer treatments to explore consistency in the use of utility scores in light of NICE methodological guidance. A review of all published breast cancer STAs was undertaken using all publicly available STA documents for each included assessment. Utility scores were assessed for consistency with NICE-preferred methods and original data sources. Furthermore, academic assessment group work undertaken during the STA process was examined to evaluate the emphasis of NICE-preferred quality-of-life measurement methods. Twelve breast cancer STAs were identified, and many STAs used evidence that did not follow NICE's preferred utility score measurement methods. Recent STA submissions show companies using EQ-5D and mapping. Academic assessment groups rarely emphasized NICE-preferred methods, and queries about preferred methods were rare. While there appears to be a trend in recent STA submissions towards following NICE methodological guidance, historically STA guidance in breast cancer has generally not used NICE's preferred methods. Future STAs in breast cancer and reviews of older guidance should ensure that utility measurement methods are consistent with the NICE reference case to help produce consistent, equitable decision making.

Public regulators and CSR

DEFF Research Database (Denmark)

Buhmann, Karin

2016-01-01

The social licence to operate (SLO) concept is little developed in the academic literature so far. Deployment of the term was made by the United National (UN) Guiding Principles on Business and Human Rights and the UN ‘Protect, Respect and Remedy’ Framework, which apply SLO as an argument...... for responsible business conduct, connecting to social expectations and bridging to public regulation. This UN guidance has had a significant bearing on how public regulators seek to influence business conduct beyond Human Rights to broader Corporate Social Responsibility (CSR) concerns. Drawing on examples...

Feasibility of home management using ACT for childhood malaria episodes in an urban setting

Directory of Open Access Journals (Sweden)

Nsagha DS

2011-12-01

Full Text Available Dickson S Nsagha1,2, Jean-Bosco N Elat2,3, Proper AB Ndong2,4, Peter N Tata2,5, Maureen-Nill N Tayong2, Francios F Pokem2, Christian C Wankah61Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon; 2Public Health Research Group, Yaounde, Cameroon; 3National AIDS Control Committee, Ministry of Public Health, Cameroon; 4National Malaria Control Programme, Ministry of Public Health, Cameroon; 5Department of Anthropology, Faculty of Arts, Letters and Social Sciences, University of Yaounde 1, Yaounde, Cameroon; 6Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, CameroonBackground: Over 90% of malaria cases occur in Sub-Saharan Africa, where a child under the age of 5 years dies from this illness every 30 seconds. The majority of families in Sub-Saharan Africa treat malaria at home, but therapy is often incomplete, hence the World Health Organization has adopted the strategy of home management of malaria to solve the problem. The purpose of this study was to determine community perception and the treatment response to episodes of childhood malaria in an urban setting prior to implementation of home management using artemisinin-based combination therapy (ACT.Methods: This qualitative exploratory study on the home management of malaria in urban children under 5 years of age used 15 focus group discussions and 20 in-depth interviews in various categories of caregivers of children under 5 years. One hundred and eighteen people participated in the focus group discussions and 20 in the in-depth interviews. The study explored beliefs and knowledge about malaria, mothers' perception of home management of the disease, health-seeking behavior, prepackaged treatment of malaria using ACT and a rapid diagnostic test, preferred channels for home management of uncomplicated malaria, communication, the role of the community in home management of malaria, and

Opinions of Old Age According to Residents of Polish Public Nursing Homes and Members of the Universities of the Third Age.

Science.gov (United States)

Cybulski, Mateusz; Krajewska-Kułak, Elżbieta; Jamiołkowski, Jacek

2016-01-01

Statistical data from the turn of the 21st century shows a significant increase in the average human life span and, what follows, an extension of old age. The aim of this study was to become familiar with the opinions submitted by respondents regarding aging and old age, health problems connected with aging and preferred health behaviors. The research was conducted between January 3rd 2013 and February 15th 2014 on a group of 200 residents of public nursing homes and 200 members of the University of the Third Age using a questionnaire created by the authors. Forty-two point five per cent of the residents of PNHs and 58.0% of the members of UTAs were of the opinion that old age can be a successful period of life. Sixty-one percent of all participants stated that the elderly are needed in society. According to respondents, the factor which was most important in delaying aging was an active lifestyle (80.0% of residents of PNH vs. 90.0% of UTA members). Perceptions of elderly people by the seniors are different, complex and multidimensional. The perception of elderly people to society can variously affect (positively or negatively) quality of life in this age group. The results of the study showed small differences between the residents of public nursing homes and students of Universities of the Third Age in the perception of old age. There is a need to integrate seniors with younger generations in order to eliminate the stereotypes prevailing in society about older people.

75 FR 18500 - Guidance on Improving EPA Review of Appalachian Surface Coal Mining Operations under the Clean...

Science.gov (United States)

2010-04-12

..., Monday through Friday, excluding legal holidays. The telephone number for the Public Reading Room is (202... recognizes the importance of this guidance to its Federal and state partners, to the regulated community, and... of Appalachian Surface Coal Mining Operations under the Clean Water Act, National Environmental...

Science-based response planning guidance for the first 100 minutes of the response to a radiological dispersal device

International Nuclear Information System (INIS)

Musolino, S.V.; Harper, F.T.

2016-01-01

The first 100 minutes of a response to a radiological dispersal device are critical as this period will set the stage for how the overall response will be executed. First responders will be tasked with multiple activities such as confirming a radiological release, conducting lifesaving rescue operations, issuing protective actions, and beginning characterization of the scene. These activities need to take place as soon as the responders arrive on the scene (the first few minutes). The effectiveness of these early activities will define how well or how poorly the response will be in the emergency phase. The document which is under development provides guidance that can be used for planning an effective response to an RDD that will result in protection of the responders and the members of the public. The information is based on research and results of extensive experiments conducted by the Department of Energy National Laboratories. This guidance provides a realistic estimate of the possible consequences of an RDD detonation and delineates five missions and ten tactics that should be executed by the first responders and local response agencies in the first 100 minutes of a response. The guidance includes recommendations on how to execute the strategy, equipment requirements including personal protective equipment and public messaging

Optimal Aerocapture Guidance

Data.gov (United States)

National Aeronautics and Space Administration — The main goal of my research is to develop, implement, verify, and validate an optimal numerical predictor-corrector aerocapture guidance algorithm that is...

Home drinking in the UK: trends and causes.

Science.gov (United States)

Foster, John H; Ferguson, Colin S

2012-01-01

To explore the trend in the UK to consume alcohol at home rather than at licensed premises. A Medline search entering the terms 'home drinking', 'alcohol' and 'adult' covering the period 2000-2011 yielded 48 articles, of which 6 met the criteria to be included in the review. Grey literature including survey and market research data were reviewed. In the UK, since 1970 there has been trend for beer to be consumed at home more often than in licensed premises and that the overall trend towards greater home drinking has increased since 2000. The main reasons given are convenience, cost, safety, autonomy and stress relief. There has also been an increase in the practice known as 'pre-loading' (drinking before going out). Adults who drink mainly at home report that they are aware that they run a risk of higher overall alcohol consumption but tend to play down the possibility that increased consumption may lead to longer-term harm. Home drinking trends may have long-term public health consequences. Greater understanding of the drivers of this trend will help policy-makers to respond to these societal changes.

Landmarks or panoramas: what do navigating ants attend to for guidance?

Directory of Open Access Journals (Sweden)

Beugnon Guy

2011-08-01

Full Text Available Abstract Background Insects are known to rely on terrestrial landmarks for navigation. Landmarks are used to chart a route or pinpoint a goal. The distant panorama, however, is often thought not to guide navigation directly during a familiar journey, but to act as a contextual cue that primes the correct memory of the landmarks. Results We provided Melophorus bagoti ants with a huge artificial landmark located right near the nest entrance to find out whether navigating ants focus on such a prominent visual landmark for homing guidance. When the landmark was displaced by small or large distances, ant routes were affected differently. Certain behaviours appeared inconsistent with the hypothesis that guidance was based on the landmark only. Instead, comparisons of panoramic images recorded on the field, encompassing both landmark and distal panorama, could explain most aspects of the ant behaviours. Conclusion Ants navigating along a familiar route do not focus on obvious landmarks or filter out distal panoramic cues, but appear to be guided by cues covering a large area of their panoramic visual field, including both landmarks and distal panorama. Using panoramic views seems an appropriate strategy to cope with the complexity of natural scenes and the poor resolution of insects' eyes. The ability to isolate landmarks from the rest of a scene may be beyond the capacity of animals that do not possess a dedicated object-perception visual stream like primates.

The Development of a Lifelong Guidance System in Hungary

Science.gov (United States)

Watts, A. G.; Borbely-Pecze, Bors Tibor

2011-01-01

The development of a lifelong guidance system in Hungary Systematic work is currently being undertaken in Hungary to develop a lifelong guidance system, in line with principles outlined by leading international organisations. The origins of career guidance in Hungary, and the nature of the current career guidance system, are outlined. The main…

The second leg home advantage: evidence from European football cup competitions.

Science.gov (United States)

Page, Lionel; Page, Katie

2007-12-01

The home advantage is a widely acknowledged sporting phenomenon, especially in association football. Here, we examine the second leg home advantage, an effect that is discussed in the public domain but which has received very little scientific attention. The second leg home advantage effect occurs when on average teams are more likely to win a two-stage knock-out competition when they play at home in the second leg. That is, both teams have a home advantage but this advantage is significantly greater for the team that plays at home second. Examining data from three different European Cup football competitions spanning 51 years, we show that the second leg home advantage is a real phenomenon. The second leg home team has more than a 50% probability to qualify for the next round in the competition even after controlling for extra time and team ability as possible alternative explanations. The second leg home advantage appears, however, to have decreased significantly over the past decade. Possible reasons for its existence and subsequent decline are presented.

Alaska Public Offices Commission, Department of Administration, State of

Science.gov (United States)

Visiting Alaska State Employees State of Alaska Department of Administration Alaska Public Offices Commission Alaska Department of Administration, Alaska Public Offices Commission APOC Home Commission Filer ; AO's Contact Us Administration > Alaska Public Offices Commission Alaska Public Offices Commission

42 CFR 403.764 - Basis and purpose of religious nonmedical health care institutions providing home service.

Science.gov (United States)

2010-10-01

... care institutions providing home service. 403.764 Section 403.764 Public Health CENTERS FOR MEDICARE... Basis and purpose of religious nonmedical health care institutions providing home service. (a) Basis... and 1878 of the Act regarding Medicare payment for items and services provided in the home setting...

76 FR 43690 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

Science.gov (United States)

2011-07-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2007-D-0149] (Formerly 2007D-0309) Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document: Electrocardiograph Electrodes; Availability AGENCY: Food and Drug...

77 FR 14403 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

Science.gov (United States)

2012-03-09

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-D-0167] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document: Norovirus Serological Reagents; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice...

Adapting haptic guidance authority based on user grip

NARCIS (Netherlands)

Smisek, J.; Mugge, W.; Smeets, J.B.J.; Van Paassen, M.M.; Schiele, A

2014-01-01

Haptic guidance systems support the operator in task execution using additional forces on the input device. Scaling of the guidance forces determines the control authority of the support system. As task complexity may vary, one level of the guidance scaling may be insufficient, and adaptation of the

Establishing Design Strategies and an Assessment Tool of Home Appliances to Promote Sustainable Behavior for the New Poor

Directory of Open Access Journals (Sweden)

Jui-Che Tu

2018-05-01

Full Text Available Environmental benefits related to home appliance life cycles depend on how these products are used. Designing home appliances that promote sustainable behavior is an effective way to reduce environmental impacts. This study aimed to increase relevant opportunities for promoting sustainable behavior practices on the new poor through home appliances, which is rarely discussed in the fields of design for sustainable behavior (DfSB and product design. In particular, relevant assessment tools or indicators are lacking in DfSB, and people’s use of home appliances is generally unsustainable. Therefore, repertory grid technology was used to understand the perceptions of the new poor, develop an assessment tool, and construct design strategies for home appliances that promote sustainable behavior. Data were collected from the new poor and from designers. Through cluster and principal component analyses, three strategy types were proposed that corresponded to different product features, suggestions, and guidance. In addition, the effectiveness and potential of an assessment tool were demonstrated using the Wilcoxon rank test. The findings could be used by designers, retailers, and green marketers to propose effective product design programs that promote sustainable behavior of the new poor during product use.

Resource file: practical publications for energy management, edition III

Energy Technology Data Exchange (ETDEWEB)

1980-03-01

The Resource File is an in-depth bibliography of 166 practical and action-oriented energy conservation publications and materials. It is a reference tool, designed for Federal, state, and local energy managers or people who are asked to recommend how-to conservation guides to the public. Each listing describes a publication's intended audience and provides a summary of its contents. Included are operations and maintenance manuals, life-cycle costing handbooks, home insulation manuals, films on fuel-saving driving techniques, and courses devoted exclusively to home weatherization. 166 items.

Home birth integration into the health care systems of eleven international jurisdictions.

Science.gov (United States)

Comeau, Amanda; Hutton, Eileen K; Simioni, Julia; Anvari, Ella; Bowen, Megan; Kruegar, Samantha; Darling, Elizabeth K

2018-02-13

The purpose of this study was to develop assessment criteria that could be used to examine the level of integration of home birth within larger health care systems in developed countries across 11 international jurisdictions. An expert panel developed criteria and a definition to assess home birth integration within health care systems. We selected jurisdictions based on the publications that were eligible for inclusion in our systematic review and meta-analysis on planned place of birth. We sent the authors of the included publications a questionnaire about home birth practitioners and practices in their respective health care system at the time of their studies. We searched published peer-reviewed, non-peer-reviewed, and gray literature, and the websites of professional bodies to document information about home birth integration in each jurisdiction based on our criteria. Where information was lacking, we contacted experts in the field from the relevant jurisdiction. Home birth is well integrated into the health care system in British Columbia (Canada), England, Iceland, the Netherlands, New Zealand, Ontario (Canada), and Washington State (USA). Home birth is less well integrated into the health care system in Australia, Japan, Norway, and Sweden. This paper is the first to propose criteria for the evaluation of home birth integration within larger maternity care systems. Application of these criteria across 11 international jurisdictions indicates differences in the recognition and training of home birth practitioners, in access to hospital facilities, and in the supplies and equipment available at home births, which give rise to variation in the level of integration across different settings. Standardized criteria for the evaluation of systems integration are essential for interpreting planned home birth outcomes that emerge from contextual differences. © 2018 Wiley Periodicals, Inc.

33 CFR 385.5 - Guidance memoranda.

Science.gov (United States)

2010-07-01

... ability of the Corps of Engineers, the South Florida Water Management District, and other non-Federal... § 385.5 Guidance memoranda. (a) General. (1) Technical guidance for internal management of Corps of...) General format and content of Project Implementation Reports (§ 385.26(a)); (ii) Instructions for...

Why Guidance Works Better than Punishment.

Science.gov (United States)

Gartrell, Dan

1995-01-01

Examines how guidance techniques address the full spectrum of intervention methods, from prevention to conflict resolution to long-term management strategies. Discusses how punishment affects both children and teachers. Suggests that to put guidance into practice teachers should: be realistic, tailor activities to each child, practice positive…

76 FR 14660 - Public Comment on the Development of Final Guidance for Evaluating the Vapor Intrusion to Indoor...

Science.gov (United States)

2011-03-17

... the RCRA Docket is (202) 566-0270. FOR FURTHER INFORMATION CONTACT: Stiven Foster, Policy Analysis... petroleum hydrocarbons should be addressed; How the guidance applies to Superfund Five-Year reviews; When or... intrusion can occur when there is migration of volatile chemicals from contaminated groundwater or soil into...

European Universities' Guidance on Research Integrity and Misconduct.

Science.gov (United States)

Aubert Bonn, Noémie; Godecharle, Simon; Dierickx, Kris

2017-02-01

Research integrity is imperative to good science. Nonetheless, many countries and institutions develop their own integrity guidance, thereby risking incompatibilities with guidance of collaborating institutions. We retrieved guidance for academic integrity and misconduct of 18 universities from 10 European countries and investigated accessibility, general content, principles endorsed, and definitions of misconduct. Accessibility and content differ substantially between institutions. There are general trends of common principles of integrity and definitions of misconduct, yet differences remain. Parallel with previous research, we distinguish different approaches in integrity guidance; one emphasizes broad values of integrity, and the other details negative behaviors of misconduct. We propose that a balance between both approaches is necessary to preserve trust, meaning, and realism of guidance on research integrity.

SPAR-H Step-by-Step Guidance

Energy Technology Data Exchange (ETDEWEB)

April M. Whaley; Dana L. Kelly; Ronald L. Boring; William J. Galyean

2012-06-01

Step-by-step guidance was developed recently at Idaho National Laboratory for the US Nuclear Regulatory Commission on the use of the Standardized Plant Analysis Risk-Human Reliability Analysis (SPAR-H) method for quantifying Human Failure Events (HFEs). This work was done to address SPAR-H user needs, specifically requests for additional guidance on the proper application of various aspects of the methodology. This paper overviews the steps of the SPAR-H analysis process and highlights some of the most important insights gained during the development of the step-by-step directions. This supplemental guidance for analysts is applicable when plant-specific information is available, and goes beyond the general guidance provided in existing SPAR-H documentation. The steps highlighted in this paper are: Step-1, Categorizing the HFE as Diagnosis and/or Action; Step-2, Rate the Performance Shaping Factors; Step-3, Calculate PSF-Modified HEP; Step-4, Accounting for Dependence, and; Step-5, Minimum Value Cutoff.

Health Service use of ionising radiations: Guidance

International Nuclear Information System (INIS)

1995-01-01

This booklet gives outline guidance on the use of ionising radiations in the Health Service in the United Kingdom. Extensive reference is made to documents where more detailed information may be found. The guidance covers general advice on the medical use of ionising radiations, statutory requirements, and guidance on selected Health Service issues such as patient identification procedures, information management systems, deviations from prescribed radiation dose, imaging and radiotherapy. (57 references) (U.K.)

76 FR 44594 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

Science.gov (United States)

2011-07-26

... Dockets Management (see ADDRESSES) either electronic or written comments regarding this document. It is... Stimulation Systems.'' This guidance document describes a means by which a repetitive transcranial magnetic... guidance document is being immediately implemented as the special control for rTMS systems, but it remains...

76 FR 48870 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

Science.gov (United States)

2011-08-09

... selection inclusion and exclusion criteria section. The revisions define and differentiate the required... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-D-0428] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document...

76 FR 20992 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

Science.gov (United States)

2011-04-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0189] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document: Low Level Laser System for Aesthetic Use; Availability AGENCY: Food and Drug Administration, HHS...

75 FR 68364 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

Science.gov (United States)

2010-11-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2008-D-0275] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document: Full-Field Digital Mammography System; Availability AGENCY: Food and Drug Administration, HHS. [[Page...

76 FR 16425 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

Science.gov (United States)

2011-03-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0028] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document: Ovarian Adnexal Mass Assessment Score Test System; Availability AGENCY: Food and Drug Administration, HHS...

76 FR 6622 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

Science.gov (United States)

2011-02-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-D-0645] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document: Contact Cooling System for Aesthetic Use; Availability AGENCY: Food and Drug Administration, HHS. ACTION...

76 FR 22906 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

Science.gov (United States)

2011-04-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2006-D-0094] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document: Topical Oxygen Chamber for Extremities; Availability AGENCY: Food and Drug Administration, HHS. ACTION...

76 FR 43332 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

Science.gov (United States)

2011-07-20

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0500] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document: Focused Ultrasound Stimulator System for Aesthetic Use; Availability AGENCY: Food and Drug Administration...

Guidance for implementing the long-term surveillance program for UMTRA Project Title I Disposal Sites

International Nuclear Information System (INIS)

1996-02-01

This guidance document has two purposes: it provides guidance for writing site-specific long-term surveillance plans (LTSP) and it describes site surveillance, monitoring, and long-term care techniques for Title I disposal sites of the Uranium Mill Tailings Radiation Control Act (UMTRCA) (42 USC Section 7901 et seq.). Long-term care includes monitoring, maintenance, and emergency measures needed to protect public health and safety and the environment after remedial action is completed. This document applies to the UMTRCA-designated Title I disposal sites. The requirements for long-term care of the Title I sites and the contents of the LTSPs are provided in U.S. Nuclear Regulatory Commission (NRC) regulations (10 CFR Section 40.27) provided in Attachment 1

Coral Reef Guidance

Science.gov (United States)

Guidance prepared by EPA and Army Corps of Engineers concerning coral reef protection under the Clean Water Act, Marine Protection, Research, and Sanctuaries Act, Rivers and Harbors Act, and Federal Project Authorities.

Assessing Commercially Available Personal Health Records for Home Health: Recommendations for Design.

Science.gov (United States)

Kneale, Laura; Choi, Yong; Demiris, George

2016-01-01

Home health nurses and clients experience unmet information needs when transitioning from hospital to home health. Personal health records (PHRs) support consumer-centered information management activities. Previous work has assessed PHRs associated with healthcare providers, but these systems leave home health nurses unable to access necessary information. To evaluate the ability of publically available PHRs to accept, manage, and share information from a home health case study. Two researchers accessed the publically available PHRs on myPHR.com, and attempted to enter, manage, and share the case study data. We qualitatively described the PHR features, and identified gaps between the case study information and PHR functionality. Eighteen PHRs were identified in our initial search. Seven systems met our inclusion criteria, and are included in this review. The PHRs were able to accept basic medical information. Gaps occurred when entering, managing, and/or sharing data from the acute care and home health episodes. The PHRs that were reviewed were unable to effectively manage the case study information. Therefore, increasing consumer health literacy through these systems may be difficult. The PHRs that we reviewed were also unable to electronically share their data. The gap between the existing functionality and the information needs from the case study may make these PHRs difficult to use for home health environments. Additional work is needed to increase the functionality of the PHR systems to better fit the data needs of home health clients.

RMP Guidance for Chemical Distributors - Appendix D: OSHA Guidance on PSM

Science.gov (United States)

Guidance on the Process Safety Management standard says information (including MSDS) about chemicals, including process intermediates, must enable accurate assessment of fire/explosion characteristics, reactivity hazards, and corrosing/erosion effects.

41 CFR 302-10.204 - What costs are allowed for preparing a mobile home for shipment?

Science.gov (United States)

2010-07-01

... and cost of replacement blocks broken while mobile home was being transported; (h) Packing and... for preparing a mobile home for shipment? 302-10.204 Section 302-10.204 Public Contracts and Property...-ALLOWANCES FOR TRANSPORTATION OF MOBILE HOMES AND BOATS USED AS A PRIMARY RESIDENCE Computation of Allowances...

International Thermonuclear Experimental Reactor U.S. Home Team Quality Assurance Plan

Energy Technology Data Exchange (ETDEWEB)

Sowder, W. K.

1998-10-01

The International Thermonuclear Experimental Reactor (ITER) project is unique in that the work is divided among an international Joint Central Team and four Home Teams, with the overall responsibility for the quality of activities performed during the project residing with the ITER Director. The ultimate responsibility for the adequacy of work performed on tasks assigned to the U.S. Home Team resides with the U.S. Home Team Leader and the U.S. Department of Energy Office of Fusion Energy (DOE-OFE). This document constitutes the quality assurance plan for the ITER U.S. Home Team. This plan describes the controls exercised by U.S. Home Team management and the Performing Institutions to ensure the quality of tasks performed and the data developed for the Engineering Design Activities assigned to the U.S. Home Team and, in particular, the Research and Development Large Projects (7). This plan addresses the DOE quality assurance requirements of 10 CFR 830.120, "Quality Assurance." The plan also describes U.S. Home Team quality commitments to the ITER Quality Assurance Program. The ITER Quality Assurance Program is based on the principles described in the International Atomic Energy Agency Standard No. 50-C-QA, "Quality Assurance for Safety in Nuclear Power Plants and Other Nuclear Facilities." Each commitment is supported with preferred implementation methodology that will be used in evaluating the task quality plans to be submitted by the Performing Institutions. The implementing provisions of the program are based on guidance provided in American National Standards Institute/American Society of Mechanical Engineers NQA-1 1994, "Quality Assurance." The individual Performing Institutions will implement the appropriate quality program provisions through their own established quality plans that have been reviewed and found to comply with U.S. Home Team quality assurance plan commitments to the ITER Quality Assurance Program. The extent of quality program provisions

Guidance Counsellor Strategies for Handling Bullying

Science.gov (United States)

Power-Elliott, Michleen; Harris, Gregory E.

2012-01-01

The purpose of this exploratory-descriptive study was to examine how guidance counsellors in the province of Newfoundland and Labrador would handle a specific verbal-relational bullying incident. Also of interest was guidance counsellor involvement and training in bullying programmes and Positive Behaviour Supports. Data for this study was…

Exploration of the methodological quality and clinical usefulness of a cross-sectional sample of published guidance about exercise training and physical activity for the secondary prevention of coronary heart disease.

Science.gov (United States)

Abell, Bridget; Glasziou, Paul; Hoffmann, Tammy

2017-06-13

Clinicians are encouraged to use guidelines to assist in providing evidence-based secondary prevention to patients with coronary heart disease. However, the expanding number of publications providing guidance about exercise training may confuse cardiac rehabilitation clinicians. We therefore sought to explore the number, scope, publication characteristics, methodological quality, and clinical usefulness of published exercise-based cardiac rehabilitation guidance. We included publications recommending physical activity, exercise or cardiac rehabilitation for patients with coronary heart disease. These included systematically developed clinical practice guidelines, as well as other publications intended to support clinician decision making, such as position papers or consensus statements. Publications were obtained via electronic searches of preventive cardiology societies, guideline databases and PubMed, to November 2016. Publication characteristics were extracted, and two independent assessors evaluated quality using the 23-item Appraisal of Guidelines Research and Evaluation II (AGREE) tool. Fifty-four international publications from 1994 to 2016 were identified. Most were found on preventive cardiology association websites (n = 35; 65%) and were freely accessible (n = 50; 93%). Thirty (56%) publications contained only broad recommendations for physical activity and cardiac rehabilitation referral, while 24 (44%) contained the necessary detailed exercise training recommendations. Many were labelled as "guidelines", however publications with other titles (e.g. scientific statements) were common (n = 24; 44%). This latter group of publications contained a significantly greater proportion of detailed exercise training recommendations than clinical guidelines (p = 0.017). Wide variation in quality also existed, with 'applicability' the worst scoring AGREE II domain for clinical guidelines (mean score 53%) and 'rigour of development' rated lowest for other

Robot-assisted endoscope guidance versus manual endoscope guidance in functional endonasal sinus surgery (FESS).

Science.gov (United States)

Eichhorn, Klaus Wolfgang; Westphal, Ralf; Rilk, Markus; Last, Carsten; Bootz, Friedrich; Wahl, Friedrich; Jakob, Mark; Send, Thorsten

2017-10-01

Having one hand occupied with the endoscope is the major disadvantage for the surgeon when it comes to functional endoscopic sinus surgery (FESS). Only the other hand is free to use the surgical instruments. Tiredness or frequent instrument changes can thus lead to shaky endoscopic images. We collected the pose data (position and orientation) of the rigid 0° endoscope and all the instruments used in 16 FESS procedures with manual endoscope guidance as well as robot-assisted endoscope guidance. In combination with the DICOM CT data, we tracked the endoscope poses and workspaces using self-developed tracking markers. All surgeries were performed once with the robot and once with the surgeon holding the endoscope. Looking at the durations required, we observed a decrease in the operating time because one surgeon doing all the procedures and so a learning curve occurred what we expected. The visual inspection of the specimens showed no damages to any of the structures outside the paranasal sinuses. Robot-assisted endoscope guidance in sinus surgery is possible. Further CT data, however, are desirable for the surgical analysis of a tracker-based navigation within the anatomic borders. Our marker-based tracking of the endoscope as well as the instruments makes an automated endoscope guidance feasible. On the subjective side, we see that RASS brings a relief for the surgeon.

Development, evaluation and implementation of video-EEG telemetry at home.

Science.gov (United States)

Brunnhuber, Franz; Amin, Devyani; Nguyen, Yan; Goyal, Sushma; Richardson, Mark P

2014-05-01

To describe the development and implementation of video EEG telemetry (VT) in the patient's home (home video telemetry, HVT) in a single centre. HVT met the UK Medical Research Council definition of a complex intervention, and we used its guidance to evaluate the process of piloting, evaluating, developing and implementing this new clinical service. The first phase was a feasibility study, comparing inpatient VT (IVT) with HVT in a test-retest design (n=5), to assess data quality and yield of clinically relevant events. The second phase was a pre-implementation study (n=8), to examine acceptability and satisfaction as well as the costs of IVT and HVT. Subsequently, we implemented the service, and reviewed the outcomes of the first 34 patients. The feasibility study found no difference in the quality of recording or clinical yield between IVT and HVT. The pre-implementation study showed excellent patient satisfaction. We also discuss the findings of the main stakeholder survey (consultants and technicians). Our economic modelling demonstrates a clear financial superiority of HVT over IVT. Our findings show that diagnostic HVT for seizure classification and polysomnographies can be carried out safely in the patients' home and poses no security risks for staff. HVT can be effectively integrated into an existing tertiary care service as a routine home or community-based procedure. We hope to encourage other clinical neurophysiology departments and epilepsy centres to take advantage of our experience and consider adopting and implementing HVT, with the aim of a nationwide coverage. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Home care in Europe: a systematic literature review

Science.gov (United States)

2011-01-01

Background Health and social services provided at home are becoming increasingly important. Hence, there is a need for information on home care in Europe. The objective of this literature review was to respond to this need by systematically describing what has been reported on home care in Europe in the scientific literature over the past decade. Methods A systematic literature search was performed for papers on home care published in English, using the following data bases: Cinahl, the Cochrane Library, Embase, Medline, PsycINFO, Sociological Abstracts, Social Services Abstracts, and Social Care Online. Studies were only included if they complied with the definition of home care, were published between January 1998 and October 2009, and dealt with at least one of the 31 specified countries. Clinical interventions, instrument developments, local projects and reviews were excluded. The data extracted included: the characteristics of the study and aspects of home care 'policy & regulation', 'financing', 'organisation & service delivery', and 'clients & informal carers'. Results Seventy-four out of 5,133 potentially relevant studies met the inclusion criteria, providing information on 18 countries. Many focused on the characteristics of home care recipients and on the organisation of home care. Geographical inequalities, market forces, quality and integration of services were also among the issues frequently discussed. Conclusions Home care systems appeared to differ both between and within countries. The papers included, however, provided only a limited picture of home care. Many studies only focused on one aspect of the home care system and international comparative studies were rare. Furthermore, little information emerged on home care financing and on home care in general in Eastern Europe. This review clearly shows the need for more scientific publications on home care, especially studies comparing countries. A comprehensive and more complete insight into the

75 FR 70271 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

Science.gov (United States)

2010-11-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-D-0515] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document...: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is...

Self-Assessment of Nuclear Security Culture in Facilities and Activities. Technical Guidance

International Nuclear Information System (INIS)

2017-01-01

The IAEA has developed a comprehensive methodology for evaluating nuclear security culture. When implemented by a State, this methodology will help to make nuclear security culture sustainable. It will also promote cooperation and the sharing of good practices related to nuclear security culture. This publication is the first guidance for assessing nuclear security culture and analysing its strengths and weaknesses within a facility or activity, or an organization. It reflects, within the context of assessment, the nuclear security culture model, principles and criteria set out in the Implementing Guide, IAEA Nuclear Security Series No. 7. This guidance will be useful for organizations and operating facilities in conducting the self-assessment of nuclear security culture by providing practical methods and tools. It will also help regulatory bodies and other competent authorities to understand the self-assessment methodology used by operators, encourage operators to start the self-assessment process or, if appropriate, conduct independent assessments of nuclear security culture.

Nurses' provision of parental guidance regarding school-aged children's postoperative pain management: a descriptive correlational study.

Science.gov (United States)

He, Hong-Gu; Klainin-Yobas, Piyanee; Ang, Emily Neo Kim; Sinnappan, Rajammal; Pölkki, Tarja; Wang, Wenru

2015-02-01

Involving parents in children's pain management is essential to achieve optimal outcomes. Parents need to be equipped with sufficient knowledge and information. Only a limited number of studies have explored nurses' provision of parental guidance regarding the use of nonpharmacologic methods in children's pain management. This study aimed to examine nurses' perceptions of providing preparatory information and nonpharmacologic methods to parents, and how their demographics and perceived knowledge adequacy of these methods influence this guidance. A descriptive correlational study using questionnaire surveys was conducted to collect data from a convenience sample of 134 registered nurses working in seven pediatric wards of two public hospitals in Singapore. Descriptive statistics, independent-samples t test, and multiple linear regression were used to analyze the data. Most nurses provided various types of cognitive information to parents related to their children's surgery, whereas information about children's feelings was less often provided. Most nurses provided guidance to parents on positioning, breathing technique, comforting/reassurance, helping with activities of daily living, relaxation, and creating a comfortable environment. Nurses' provision of parental guidance on preparatory information and nonpharmacologic methods was significantly different between subgroups of age, education, parent or not, and perceived knowledge adequacy of nonpharmacologic methods. Nurses' perceived knowledge adequacy was the main factor influencing their provision of parental guidance. More attention should be paid to nurses who are younger, have less working experience, and are not parents. There is a need to educate nurses about nonpharmacologic pain relief methods to optimize their provision of parental guidance. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

attitude of secondary school students towards guidance

African Journals Online (AJOL)

Elizabeth Egbochuku

gender and school location significantly influenced students' attitude towards guidance ... students respond and perceive guidance and counselling services will, to ... counsellors will be appointed in post-primary institutions and tertiary levels.

Virtual Ultrasound Guidance for Inexperienced Operators

Science.gov (United States)

Caine, Timothy; Martin, David

2012-01-01

Medical ultrasound or echocardiographic studies are highly operator-dependent and generally require lengthy training and internship to perfect. To obtain quality echocardiographic images in remote environments, such as on-orbit, remote guidance of studies has been employed. This technique involves minimal training for the user, coupled with remote guidance from an expert. When real-time communication or expert guidance is not available, a more autonomous system of guiding an inexperienced operator through an ultrasound study is needed. One example would be missions beyond low Earth orbit in which the time delay inherent with communication will make remote guidance impractical. The Virtual Ultrasound Guidance system is a combination of hardware and software. The hardware portion includes, but is not limited to, video glasses that allow hands-free, full-screen viewing. The glasses also allow the operator a substantial field of view below the glasses to view and operate the ultrasound system. The software is a comprehensive video program designed to guide an inexperienced operator through a detailed ultrasound or echocardiographic study without extensive training or guidance from the ground. The program contains a detailed description using video and audio to demonstrate equipment controls, ergonomics of scanning, study protocol, and scanning guidance, including recovery from sub-optimal images. The components used in the initial validation of the system include an Apple iPod Classic third-generation as the video source, and Myvue video glasses. Initially, the program prompts the operator to power-up the ultrasound and position the patient. The operator would put on the video glasses and attach them to the video source. After turning on both devices and the ultrasound system, the audio-video guidance would then instruct on patient positioning and scanning techniques. A detailed scanning protocol follows with descriptions and reference video of each view along with

The UK's Draft Guidance for Health in SEA in light of HIA community priorities and the UNECE SEA Protocol

International Nuclear Information System (INIS)

Posas, Paula J.

2011-01-01

The Protocol on Strategic Environmental Assessment (SEA) to the United Nations Economic Commission for Europe (UNECE) Espoo Convention came into force on 11 July 2010. This Protocol, to which the European Union is party, gives a legal basis for enhanced attention to human health in the SEA process. In this context, the United Kingdom's (UK's) 2007 Draft Guidance on Health in Strategic Environmental Assessment represents an important early government-led effort to bring health issues and public health considerations more significantly into the SEA process. Since the UK is a worldwide leader in environmental and various other types of impact assessment, and since other countries may eventually consider its example in efforts to meet UNECE SEA Protocol requirements, scrutiny of its outputs is warranted. This paper thus examines the UK's Draft Guidance from both HIA academic and practitioner perspectives. First it assesses the extent to which the Draft Guidance reflects recent issues and lessons learned in the academic literature. In order to make the assessment, a meta-analysis of 70 HIA-related peer-reviewed articles was undertaken to extract authors' priority recommendations. These recommendations were subsequently compared with the contents of the Draft Guidance. Secondly, the Draft Guidance was assessed for its accordance with recommendations of the UNECE SEA Protocol background paper written by two HIA practitioners. Overall, the Draft Guidance's accordance with both sets of recommendations was found to be high, with only a few easily-remedied gaps. This evaluation suggests that the UK's Draft Guidance can be a useful starting point in the creation of future guidance on health in SEA in both the UK and other countries.

Exploring innovative solutions for quality of life and care of bed-ridden nursing home residents through codesign sessions