WorldWideScience

Sample records for renewed environment care

  1. Kansas: Wichita Initiative to Renew the Environment (A Former EPA CARE Project)

    Science.gov (United States)

    Wichita Initiative to Renew the Environment is a recipient of a CARE Level II Cooperative agreement to reduce the risk of mobile air emissions, reduce the risk of storm water run-off, reduce the risk of solid waste pollution/greenhouse gas emissions

  2. Wind energy renewable energy and the environment

    CERN Document Server

    Nelson, Vaughn

    2013-01-01

    As the demand for energy increases, and fossil fuels continue to decrease, Wind Energy: Renewable Energy and the Environment, Second Edition considers the viability of wind as an alternative renewable energy source. This book examines the wind industry from its start in the 1970s until now, and introduces all aspects of wind energy. The phenomenal growth of wind power for utilities is covered along with applications such as wind-diesel, village power, telecommunications, and street lighting.. It covers the characteristics of wind, such as shear, power potential, turbulence, wind resource, wind

  3. Wind energy renewable energy and the environment

    CERN Document Server

    Nelson, Vaughn; Nelson, Vaughn

    2009-01-01

    Due to the mounting demand for energy and increasing population of the world, switching from nonrenewable fossil fuels to other energy sources is not an option-it is a necessity. Focusing on a cost-effective option for the generation of electricity, Wind Energy: Renewable Energy and the Environment covers all facets of wind energy and wind turbines. The book begins by outlining the history of wind energy, before providing reasons to shift from fossil fuels to renewable energy. After examining the characteristics of wind, such as shear, power potential, and turbulence, it discusses the measur

  4. [Renewing primary health care in the Americas].

    Science.gov (United States)

    Macinko, James; Montenegro, Hernán; Nebot Adell, Carme; Etienne, Carissa

    2007-01-01

    At the 2003 meeting of the Directing Council of the Pan American Health Organization (PAHO), the PAHO Member States issued a mandate to strengthen primary health care (Resolution CD44. R6). The mandate led in 2005 to the document "Renewing Primary Health Care in the Americas. A Position Paper of the Pan American Health Organization/WHO [World Health Organization]," and it culminated in the Declaration of Montevideo, an agreement among the governments of the Region of the Americas to renew their commitment to primary health care (PHC). Scientific data have shown that PHC, regarded as the basis of all the health systems in the Region, is a key component of effective health systems and can be adapted to the range of diverse social, cultural, and economic conditions that exist. The new, global health paradigm has given rise to changes in the population's health care needs. Health services and systems must adapt to address these changes. Building on the legacy of the International Conference on Primary Health Care, held in 1978 in Alma-Ata (Kazakhstan, Union of Soviet Socialist Republics), PAHO proposes a group of strategies critical to adopting PHC-based health care systems based on the principles of equity, solidarity, and the right to the highest possible standard of health. The main objective of the strategies is to develop and/or strengthen PHC-based health systems in the entire Region of the Americas. A substantial effort will be required on the part of health professionals, citizens, governments, associations, and agencies. This document explains the strategies that must be employed at the national, subregional, Regional, and global levels.

  5. Policy Enabling Environment for Corporate Renewable Energy Sourcing

    Energy Technology Data Exchange (ETDEWEB)

    2017-05-09

    Interest in renewable energy (RE) procurement in new markets is on the rise. Corporations are increasing their commitments to procuring RE, motivated by an interest in using clean energy sources and reducing their energy expenses. Many large companies have facilities and supply chains in multiple countries, and are interested in procuring renewable energy in the grids where they use energy. The policy environment around the world plays a key role in shaping where and how corporations will invest in renewables. This fact sheet details findings from a recent 21st Century Power Partnership report, Policies to Enable Corporate Renewable Energy Sourcing Internationally.

  6. Focus issue introduction: renewable energy and the environment.

    Science.gov (United States)

    Seassal, Christian; Koshel, John

    2013-05-06

    This focus issue highlights selected contributions from authors who presented promising concepts at OSA's Renewable Energy and the Environment Optics and Photonics Congress held 11-15 November 2012 in Eindhoven, The Netherlands.

  7. Constitutional, legal and regulatory imperatives for the renewed care ...

    African Journals Online (AJOL)

    2016-05-12

    May 12, 2016 ... renewed care and prevention of congenital disorders in. South Africa .... CDs, or at reproductive risk of having children with CDs, can ..... 2001.[3,9]. Of over 1 000 healthcare providers, mainly labour ward nurses, .... Promotion.

  8. Environment, Renewable Energy and Reduced Carbon Emissions

    Science.gov (United States)

    Sen, S.; Khazanov, G.; Kishimoto, Y.

    2011-01-01

    Increased energy security and reduced carbon emissions pose significant challenges for science and technology. However, they also create substantial opportunities for innovative research and development. In this review paper, we highlight some of the key opportunities and mention public policies that are needed to enable the efforts and to maximize the probability of their success. Climate is among the uttermost nonlinear behaviors found around us. As recent studies showed the possible effect of cosmic rays on the Earth's climate, we investigate how complex interactions between the planet and its environment can be responsible for climate anomalies.

  9. RENEWAL THEOREM FOR (L, 1)-RANDOM WALK IN RANDOM ENVIRONMENT

    Institute of Scientific and Technical Information of China (English)

    洪文明; 孙鸿雁

    2013-01-01

    We consider a random walk on Z in random environment with possible jumps{-L, · · · ,-1, 1}, in the case that the environment{ωi: i∈Z}are i.i.d.. We establish the renewal theorem for the Markov chain of “the environment viewed from the particle” in both annealed probability and quenched probability, which generalize partially the results of Kesten (1977) and Lalley (1986) for the nearest random walk in random environment on Z, respectively. Our method is based on the intrinsic branching structure within the (L, 1)-RWRE formulated in Hong and Wang (2013).

  10. 48 CFR 952.223 - Clauses related to environment, energy and water efficiency, renewable energy technologies...

    Science.gov (United States)

    2010-10-01

    ... environment, energy and water efficiency, renewable energy technologies, occupational safety, and drug-free workplace. 952.223 Section 952.223 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CLAUSES AND... related to environment, energy and water efficiency, renewable energy technologies, occupational...

  11. Renewable energy technologies and its adaptation in an urban environment

    Energy Technology Data Exchange (ETDEWEB)

    Thampi, K. Ravindranathan, E-mail: ravindranathan.thampi@ucd.ie; Byrne, Owen, E-mail: ravindranathan.thampi@ucd.ie; Surolia, Praveen K., E-mail: ravindranathan.thampi@ucd.ie [SFI Strategic Research Cluster in Solar Energy Conversion, School of Chemical and Bioprocess Engineering, University College Dublin, Belfield, Dublin 4 (Ireland)

    2014-01-28

    This general article is based on the inaugural talk delivered at the opening of OMTAT 2013 conference. It notes that the integration of renewable energy sources into living and transport sectors presents a daunting task, still. In spite of the fact that the earth and its atmosphere continually receive 1.7 × 10{sup 17} watts of radiation from the sun, in the portfolio of sustainable and environment friendly energy options, which is about 16% of the world’s energy consumption and mostly met by biomass, only a paltry 0.04% is accredited to solar. First and second generation solar cells offer mature technologies for applications. The most important difficulty with regards to integration with structures is not only the additional cost, but also the lack of sufficient knowledge in managing the available energy smartly and efficiently. The incorporation of PV as a part of building fabric greatly reduces the overall costs compared with retrofitting. BIPV (Building Integrated photovoltaic) is a critical technology for establishing aesthetically pleasing solar structures. Infusing PV and building elements is greatly simplified with some of the second generation thin film technologies now manufactured as flexible panels. The same holds true for 3{sup rd} generation technologies under development such as, and dye- and quantum dot- sensitized solar cells. Additionally, these technologies offer transparent or translucent solar cells for incorporation into windows and skylights. This review deals with the present state of solar cell technologies suitable for BIPV and the status of BIPV applications and its future prospects.

  12. Renewable energy technologies and its adaptation in an urban environment

    Science.gov (United States)

    Thampi, K. Ravindranathan; Byrne, Owen; Surolia, Praveen K.

    2014-01-01

    This general article is based on the inaugural talk delivered at the opening of OMTAT 2013 conference. It notes that the integration of renewable energy sources into living and transport sectors presents a daunting task, still. In spite of the fact that the earth and its atmosphere continually receive 1.7 × 1017 watts of radiation from the sun, in the portfolio of sustainable and environment friendly energy options, which is about 16% of the world's energy consumption and mostly met by biomass, only a paltry 0.04% is accredited to solar. First and second generation solar cells offer mature technologies for applications. The most important difficulty with regards to integration with structures is not only the additional cost, but also the lack of sufficient knowledge in managing the available energy smartly and efficiently. The incorporation of PV as a part of building fabric greatly reduces the overall costs compared with retrofitting. BIPV (Building Integrated photovoltaic) is a critical technology for establishing aesthetically pleasing solar structures. Infusing PV and building elements is greatly simplified with some of the second generation thin film technologies now manufactured as flexible panels. The same holds true for 3rd generation technologies under development such as, and dye- and quantum dot- sensitized solar cells. Additionally, these technologies offer transparent or translucent solar cells for incorporation into windows and skylights. This review deals with the present state of solar cell technologies suitable for BIPV and the status of BIPV applications and its future prospects.

  13. BUILT ENVIRONMENT: RELATING THE BENEFITS OF RENEWABLE ENERGY TECHNOLOGIES

    Directory of Open Access Journals (Sweden)

    Abdeen Mustafa Omer

    2012-06-01

    Full Text Available Recently, environmental issues have been the focus of much of the world’s attention. This has stimulated a response in many countries, which has led to a closer examination of energy conservation strategies for conventional fossil fuels. One way of reducing building energy consumption is to design buildings, which are more economical in their use of energy for: heating, lighting, cooling, ventilation and hot water supply. Passive measures, particularly natural or hybrid ventilation rather than air-conditioning, can dramatically reduce primary energy consumption. However, exploitation of renewable energy in buildings and agricultural greenhouses, can significantly contribute in reducing dependency on fossil fuels. Therefore, promoting innovative renewable applications and reinforcing the renewable energy market will contribute to preserving the ecosystem by reducing emissions at local and global levels. This will also contribute to the amelioration of environmental conditions, through a reduction in air pollution and greenhouse gases, by the replacement of conventional fuels with renewable energies.

  14. Renewable energy forecasts for solar applications : an Environment Canada perspective

    Energy Technology Data Exchange (ETDEWEB)

    Poulin, L. [Environment Canada, Montreal, PQ (Canada). Meteorological Service of Canada

    2006-07-01

    The Meteorological Service of Canada has made weather datasets available in real-time on the Internet, for use by those with an interest in solar applications. Ensemble weather models can be used to produce medium range forecasts of weather events and to predict the likely available kilowatt-hours (kWhrs) of solar energy. As such, solar sites can maximize their harvest and use of solar energy. This presentation highlighted several different types of renewable energy forecasts obtained from weather models, including forecasts of expected kWhrs from solar panels and wind turbines, daily forecasts of expected solar heated water volumes and forecasts of water collection potential from impending precipitation events. The value of renewable energy forecasts in helping the solar energy sector monitor daily energy loads as well as daily and weekly solar energy supply was emphasized. It was suggested that renewable energy forecasts could raise public awareness of the potential of solar energy applications and help promote the solar energy market. Vendors of solar technology can also use the forecasts to help customers harmonize predicted solar energy coming to their sites with daily energy use patterns. figs.

  15. The Investment Environment for Renewable Energy Development in Lithuania: The Electricity Sector

    Directory of Open Access Journals (Sweden)

    Milčiuvienė Saulė

    2014-06-01

    Full Text Available The article analyzes the investment environment in renewable electricity generation capacities, evaluating the credibility of long term renewable energy targets, the stability of promotion schemes and the impartiality of national administrative procedure. The article explores two main questions: (i are the EU and Lithuanian energy policy targets and promotion schemes credible enough to convince private investors to put their money in renewable energy development; (ii does national administrative procedure put a disproportional burden on renewable energy investors or on certain group of investors? The assessment of the investment environment includes a large number of criteria, but we analyze three of them: the stability of long term strategy; the attractiveness of promotionmeasures; and the simplicity and transparency of administrative procedure. Two further criteria are investigated: the stability of targets in renewable energy and the stability of promotional measures. The greatest uncertainty for investors occurs because of constantly changing support schemes of renewable energy sources-schemes that are not harmonized among the member States. At the national level the main driver in the development of small generators is the feed-in tariff. However, the high feed-in tariff does not always guarantee the smooth development of small scale generators of renewable energy.

  16. Uncertainty-averse TRANSCO planning for accommodating renewable energy in CO2 reduction environment

    DEFF Research Database (Denmark)

    Zhang, Chunyu; Ding, Yi; Wang, Qi

    2015-01-01

    strategic planning to handle the uncertainty challenges from the intermittent renewable energy resources. In this paper, a stochastic multi-period multi-objective transmission planning (MPMOTP) model is proposed to reduce correlated uncertainties from renewable energy generation, conventional generation......The concern of the environment and energy sustainability requests a crucial target of CO2 abatement and results in a relatively high penetration of renewable energy generation in the transmission system. For maintaining system reliability and security, the transmission company (TRANSCO) has to make...

  17. Open access in the critical care environment.

    Science.gov (United States)

    South, Tabitha; Adair, Brigette

    2014-12-01

    Open access has become an important topic in critical care over the last 3 years. In the past, critical care had restricted access and set visitation guidelines to protect patients. This article provides a review of the literature related to open access in the critical care environment, including the impact on patients, families, and health care providers. The ultimate goal is to provide care centered on patients and families and to create a healing environment to ensure safe passage of patients through their hospital stays. This outcome could lead to increased patient/family satisfaction.

  18. Renewing professionalism in dental education: overcoming the market environment.

    Science.gov (United States)

    Masella, Richard S

    2007-02-01

    The most important mission of dental education is development of student professionalism. It is only within the context of professionalism that specialized knowledge and technical expertise find meaning. Altruism, integrity, caring, community focus, and commitment to excellence are attributes of professionalism. Its backbone is the obligation of service to people before service to self--a social contract. Professionalism can and should be acquired by targeted interventions, not as an assumed by-product of dental education. Top-down, rule-based professionalism is contrasted with its experience-based, mentor-mediated, socially driven counterpart. Moral principles are inherent in professional development and the professional way of life. Unfortunately, American society, including higher education, glorifies a market mentality centered on expansion and profit. Through formal and hidden curricula, dental schools send mixed messages to students about the importance of professionalism. Institutional consensus on professionalism should be developed among faculty, administration, and students through passionate advocacy and careful analysis of dentistry's moral convictions. The consensus message should communicate to stakeholders that morality and ethics "really count." Maximum student exposure to faculty exemplars, substantial service-learning experiences, and portfolio use are likely to enhance professionalism, which should be measured for every student, every semester, along with faculty and institutional assessment. Research reveals a significant relationship between levels of student moral reasoning and measures of clinical performance and shows that moral reasoning ability can be enhanced in dental students. Valid and reliable surveys exist to assess student moral reasoning. Documented student unprofessional behavior is a predictor of future state professional board disciplinary action against practitioners, along with low admissions test scores and course failures in

  19. Understanding and Informing the Policy Environment: State-Level Renewable Fuels Standards

    Energy Technology Data Exchange (ETDEWEB)

    Brown, E.; Cory, K.; Arent, D.

    2007-01-01

    Renewable fuels standard (RFS) policies are becoming a popular public policy mechanism for developing the market for renewable fuels in the transportation sector. During the past decade, U.S. states and several countries began implementing these more market-based (less command and control) policies to support increased biofuels production and use. This paper presents an overview of current and proposed U.S. state-level policies, as well as selected electric sector policies and international fuel standard policies. Current U.S. state-level renewable fuel policies list drivers including an improved economy and environment, as well as fuel self-sufficiency. Best practices and experience from an evaluation of renewable portfolio standards (RPS) in the United States and international RFS policies can inform U.S. state-level policy by illustrating the importance of policy flexibility, binding targets, effective cost caps, and tradable permits. Understanding and building on the experiences from these previous policies can improve the policy mechanism and further develop a market for renewable fuels to meet the goals of improved economy, environment, and fuel self-sufficiency.

  20. Surviving sepsis in the critical care environment.

    Science.gov (United States)

    Benedict, Lara

    2015-01-01

    The management of sepsis and septic shock in the intensive care environment is a complex task requiring the cooperation of a multidisciplinary team. The Surviving Sepsis Campaign provides systematic guidelines for the recognition, early intervention, and supportive management of sepsis. Critical care nurses are instrumental in ensuring that these guidelines and other sources of evidence-based practice are used for patients with severe sepsis or septic shock. This article discusses the pathophysiologic processes in severe sepsis and septic shock and discusses the appropriate interventions as recommended by the Surviving Sepsis Campaign. Recommended early treatments are reviewed along with interventions related to hemodynamics, perfusion, and supportive care in the critical care environment.

  1. Fluctuating selection: the perpetual renewal of adaptation in variable environments.

    Science.gov (United States)

    Bell, Graham

    2010-01-12

    Darwin insisted that evolutionary change occurs very slowly over long periods of time, and this gradualist view was accepted by his supporters and incorporated into the infinitesimal model of quantitative genetics developed by R. A. Fisher and others. It dominated the first century of evolutionary biology, but has been challenged in more recent years both by field surveys demonstrating strong selection in natural populations and by quantitative trait loci and genomic studies, indicating that adaptation is often attributable to mutations in a few genes. The prevalence of strong selection seems inconsistent, however, with the high heritability often observed in natural populations, and with the claim that the amount of morphological change in contemporary and fossil lineages is independent of elapsed time. I argue that these discrepancies are resolved by realistic accounts of environmental and evolutionary changes. First, the physical and biotic environment varies on all time-scales, leading to an indefinite increase in environmental variance over time. Secondly, the intensity and direction of natural selection are also likely to fluctuate over time, leading to an indefinite increase in phenotypic variance in any given evolving lineage. Finally, detailed long-term studies of selection in natural populations demonstrate that selection often changes in direction. I conclude that the traditional gradualist scheme of weak selection acting on polygenic variation should be supplemented by the view that adaptation is often based on oligogenic variation exposed to commonplace, strong, fluctuating natural selection.

  2. A renewed focus on primary health care: revitalize or reframe?

    Directory of Open Access Journals (Sweden)

    Rifkin Susan

    2010-07-01

    Full Text Available Abstract The year 2008 celebrated 30 years of Primary Health Care (PHC policy emerging from the Alma Ata Declaration with publication of two key reports, the World Health Report 2008 and the Report of the Commission on the Social Determinants of Health. Both reports reaffirmed the relevance of PHC in terms of its vision and values in today's world. However, important challenges in terms of defining PHC, equity and empowerment need to be addressed. This article takes the form of a commentary reviewing developments in the last 30 years and discusses the future of this policy. Three challenges are put forward for discussion (i the challenge of moving away from a narrow technical bio-medical paradigm of health to a broader social determinants approach and the need to differentiate primary care from primary health care; (ii The challenge of tackling the equity implications of the market oriented reforms and ensuring that the role of the State in the provision of welfare services is not further weakened; and (iii the challenge of finding ways to develop local community commitments especially in terms of empowerment. These challenges need to be addressed if PHC is to remain relevant in today's context. The paper concludes that it is not sufficient to revitalize PHC of the Alma Ata Declaration but it must be reframed in light of the above discussion.

  3. FACTORS AFFECTING TEACHING THE CONCEPT of RENEWABLE ENERGY in TECHNOLOGY ASSISTED ENVIRONMENTS AND DESIGNING PROCESSES in THE DISTANCE EDUCATION MODEL

    Directory of Open Access Journals (Sweden)

    A. Seda YUCEL

    2007-01-01

    Full Text Available The energy policies of today focus mainly on sustainable energy systems and renewable energy resources. Chemistry is closely related to energy recycling, energy types, renewable energy, and nature-energy interaction; therefore, it is now an obligation to enrich chemistry classes with renewable energy concepts and related awareness. Before creating renewable energy awareness, the factors thought to affect such awareness should be determined. Knowing these factors would facilitate finding out what to take into account in creating renewable energy awareness. In this study, certain factors thought to affect the development of renewable energy awareness were investigated. The awareness was created through a technology-assisted renewable energy module and assessed using a renewable energy assessment tool. The effects of the students’ self-directed learning readiness with Guglielmino (1977, inner-individual orientation, and anxiety orientation on the awareness were examined. These three factors were found to have significant effects on renewable energy, which was developed through technology utilization. In addition, based on the finding that delivering the subject of renewable energy in technology assisted environments is more effective, the criteria that should be taken into consideration in transforming this subject into a design model that is more suitable for distance education were identified.

  4. Business models for renewable energy in the built environment (RE-BIZZ)

    Energy Technology Data Exchange (ETDEWEB)

    Wuertenberger, L.; Menkveld, M.; Vethman, P.; Van Tilburg, X. [ECN Policy Studies, Amsterdam (Netherlands); Bleyl, J.W. [Energetic Solutions, Graz (Austria)

    2011-11-15

    The project RE-BIZZ aims to provide insight to policy makers and market actors in the way new and innovative business models (and/or policy measures) can stimulate the deployment of renewable energy technologies (RET) and energy efficiency (EE) measures in the built environment. The project is initiated and funded by the IEA Implementing Agreement for Renewable Energy Technology Deployment (IEA-RETD). It analysed ten business models in three categories (amongst others different types of Energy Service Companies (ESCOs), Developing properties certified with a 'green' building label, Building owners profiting from rent increases after EE measures, Property Assessed Clean Energy (PACE) financing, On-bill financing, and Leasing of RET equipment) including their organisational and financial structure, the existing market and policy context, and an analysis of Strengths, Weaknesses, Opportunities and Threats (SWOT). The study concludes with recommendations for policy makers and other market actors.

  5. Business models for renewable energy in the built environment. Updated version

    Energy Technology Data Exchange (ETDEWEB)

    Wuertenberger, L.; Menkveld, M.; Vethman, P.; Van Tilburg, X. [ECN Policy Studies, Amsterdam (Netherlands); Bleyl, J.W. [Energetic Solutions, Graz (Austria)

    2012-04-15

    The project RE-BIZZ aims to provide insight to policy makers and market actors in the way new and innovative business models (and/or policy measures) can stimulate the deployment of renewable energy technologies (RET) and energy efficiency (EE) measures in the built environment. The project is initiated and funded by the IEA Implementing Agreement for Renewable Energy Technology Deployment (IEA-RETD). It analysed ten business models in three categories (amongst others different types of Energy Service Companies (ESCOs), Developing properties certified with a 'green' building label, Building owners profiting from rent increases after EE measures, Property Assessed Clean Energy (PACE) financing, On-bill financing, and Leasing of RET equipment) including their organisational and financial structure, the existing market and policy context, and an analysis of Strengths, Weaknesses, Opportunities and Threats (SWOT). The study concludes with recommendations for policy makers and other market actors.

  6. Creating collaborative learning environments for transforming primary care practices now.

    Science.gov (United States)

    Miller, William L; Cohen-Katz, Joanne

    2010-12-01

    The renewal of primary care waits just ahead. The patient-centered medical home (PCMH) movement and a refreshing breeze of collaboration signal its arrival with demonstration projects and pilots appearing across the country. An early message from this work suggests that the development of collaborative, cross-disciplinary teams may be essential for the success of the PCMH. Our focus in this article is on training existing health care professionals toward being thriving members of this transformed clinical care team in a relationship-centered PCMH. Our description of the optimal conditions for collaborative training begins with delineating three types of teams and how they relate to levels of collaboration. We then describe how to create a supportive, safe learning environment for this type of training, using a different model of professional socialization, and tools for building culture. Critical skills related to practice development and the cross-disciplinary collaborative processes are also included. Despite significant obstacles in readying current clinicians to be members of thriving collaborative teams, a few next steps toward implementing collaborative training programs for existing professionals are possible using competency-based and adult learning approaches. Grasping the long awaited arrival of collaborative primary health care will also require delivery system and payment reform. Until that happens, there is an abundance of work to be done envisioning new collaborative training programs and initiating a nation-wide effort to motivate and reeducate our colleagues. PsycINFO Database Record (c) 2010 APA, all rights reserved.

  7. Influence of macro and micro economical environments of energetical effectiveness for business activity of renewable power sources in the Slovakia

    Directory of Open Access Journals (Sweden)

    Mária Antošová

    2010-07-01

    Full Text Available Goal of the contribution is to explain evaluation of economical environment that firms must respect during their business activity.External environment of mining firm includes except others technological development, economical situation, legislative by the wayof regulation, but in last time also stimulations from the government, competition behavior and other. Contribution is dealing also withenergetical effectiveness in the frame of economical evaluation applied in conditions of Slovak republic.The renewable energy sources are domestic sources of energy that help to enhance the safety of energy suppliesand the diversification of energy sources. The renewable energy is proved to be commercially viable for a growing list of consumersand uses. The renewable energy technologies provide many benefits that go well beyond the energy alone. More and more,the renewable energies contribute to the three pillars of the sustainable development in the economy, environment and the society.

  8. Care assistant experiences of dementia care in long-term nursing and residential care environments.

    Science.gov (United States)

    Talbot, Rebecca; Brewer, Gayle

    2016-11-01

    Care assistants have a unique insight into the lives of service users and those factors which may impede or enhance the delivery of high quality dementia oriented care. To address the paucity of research in this area, the present study examined care assistant experiences of dementia care in British long-term residential and nursing environments. Semi-structured interviews were conducted with eight care assistants and transcripts were analysed using interpretive phenomenological analysis. Super-ordinate themes emerging from the data were psychological wellbeing of the care assistant, barriers to effective dementia care, the dementia reality and organisational issues within the care environment. The study revealed important deficiencies in understanding and varying levels of dementia training. Whilst person centred strategies were being implemented, task orientated care remained dominant. Furthermore, care assistants reported taking the perspectives of those with dementia into account, and actively using these to develop relationship centred care.

  9. 75 FR 76453 - CAlifornians for Renewable Energy, Inc., (CARE), and Barbara Durkin v. National Grid, Cape Wind...

    Science.gov (United States)

    2010-12-08

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission CAlifornians for Renewable Energy, Inc., (CARE), and Barbara Durkin v. National Grid, Cape Wind, and the Massachusetts Department of Public Utilities; Notice of...

  10. RENEWABLE ENERGY, A KEY TO INTEGRATING COMPETITIVE POLICIES WITH ADVANCED ENVIRONMENT PROTECTION STRATEGIES

    Directory of Open Access Journals (Sweden)

    Cinade Lucian Ovidiu

    2011-12-01

    Full Text Available Development of competitive policies and improvement of environment protection strategies are two basic trends of the development of the European Unique Market. Energy, also known as 'industry bread', is basic product and strategic resource, where energy industry plays an obvious role in the economic and social development of any community. Traditional energy production is marred by three major drawbacks: it generates negative externalities by polluting; it is totally in the hands of the producers; hence, prices rise at their will, of fossil fuels such as oil and gas. Present study focuses on electric energy industry, yet bearing over the whole length of the chain producer-to-end-consumer, thus revealed as particularly complex. The question is do alternative energy sources meet the prerequisite of market being competitive meanwhile environment protection being highly observed. We identify limits in point, of the energy market; effects of market liberalization; entry barriers; interchangeability level of energy sources; active forces on the energy market. Competitive rivalry has been expressed as per market micro-economic analysis, based on Michael Porter's 5-forces model. It will thus be noticed that, morphologically, competition evolution depends firstly on the market type. For the time being, the consumer on the energy market stays captive, for various reasons such as: legislation; limits of energy transfer infrastructure; scarcity of resources; resources availability imbalance; no integrative strategy available, of renewable energy resources usage. Energy availability is vital for human society to function. Comparative advantages of renewable energy resources are twofold, as manifested: in terms of economics, i.e. improving competition by substitute products entered at the same time as new producers enter market; and in terms of ecology, by reducing CO2 emissions. As to energy production technology and transfer, the complementary nature will

  11. Adjustment problems and residential care environment

    Directory of Open Access Journals (Sweden)

    Jan Sebastian Novotný

    2015-01-01

    Full Text Available Problem: Residential care environment represents a specific social space that is associated with a number of negative consequences, covering most aspects of children and youth functioning. The paper analyzes of the presence of adjustment problems among adolescents from institutional care environment and compares this results with a population of adolescents who grew up in a family. Methods: The sample consisted of two groups of adolescents. The first group included 285 adolescents currently growing up in an residential care environment, aged 13 to 21 (M = 16.23, SD = 1.643. The second group consisted of 214 adolescents growing up in a family, aged 15 to 20 (M = 17.07, SD = 1.070. We used a questionnaire Youth Self Report. Data were analyzed using descriptive statistics and MANOVA. Results: Results showed that adolescents in residential care exhibit higher average values in all adjustment problems. Also, in the context of diagnostic categories are the residential care adolescents more frequently in non-normal range (borderline and clinical, primarily in the border range. The greatest differences were reflected in the Thought problems and Rule-breaking behavior. MANOVA showed a significant multivariate effect between groups of adolescents, Hotelling's T = .803, F(8, 490 = 49.202, p <.001, d = .445 (large effect. Univariate analysis further showed a significant effect for Withdrawn/depressed (p = .044, d = .089, small effect, Somatic complaints (p = .002, d = .139, medium effect, Social problems (p = 004, d = .127, a small effect, Thought problems (p <.001, d = .633, strong effect, Attention problems (p <.001, d = .320,strong effect, Rule-breaking behavior (p <.001 , d = .383, strong effect, and Aggressive behavior (p = 015, d = .110, small effect. Results for the dimension of Anxious/depressed were not significant (p = .159. Discussion: The results didn’t confirmed the assumption that more than 30% of residential care adolescents have adjustment

  12. Evaluating learning environments for interprofessional care.

    Science.gov (United States)

    Kvan, Thomas

    2013-09-01

    Many institutions have invested considerably in the provision of student facilities--lecture halls, tutorial rooms and classrooms--spaces we call collectively learning environments. In expending resources on such facilities, we have assumed that we have needed to create this range of spaces for such activities. However, how do we know we have invested wisely in support of learning for interprofessional care? In this article I review the literature to identify evidence in a range of fields, including health care, to consider the issues and difficulties of employing established approaches from practices of evidence-based design. Central in this article is the role of evidence in the assessment of learning environments. In particular, I argue that the evidence must include qualitative dimensions of the learning experience. To address the qualitative outcomes from education, with particular attention to the concerns of interprofessional education, a model is proposed to examine different levels of outcomes. By developing an interpretation of Kirkpatrick's model, four levels are described for the effective evaluation of interprofessional learning environments.

  13. Modeling and Simulation of Renewable Hybrid Power System using Matlab Simulink Environment

    Directory of Open Access Journals (Sweden)

    Cristian Dragoş Dumitru

    2010-12-01

    Full Text Available The paper presents the modeling of a solar-wind-hydroelectric hybrid system in Matlab/Simulink environment. The application is useful for analysis and simulation of a real hybrid solar-wind-hydroelectric system connected to a public grid. Application is built on modular architecture to facilitate easy study of each component module influence. Blocks like wind model, solar model, hydroelectric model, energy conversion and load are implemented and the results of simulation are also presented. As an example, one of the most important studies is the behavior of hybrid system which allows employing renewable and variable in time energy sources while providing a continuous supply. Application represents a useful tool in research activity and also in teaching

  14. The evolution of parental care in stochastic environments.

    Science.gov (United States)

    Bonsall, M B; Klug, H

    2011-03-01

    Parental care is of fundamental importance to understanding reproductive strategies and allocation decisions. Here, we explore how parental care strategies evolve in variable environments. Using a set of life-history trait trade-offs, we explore the relative costs and benefits of parental care in stochastic environments. Specifically, we consider the cases in which environmental variability results in varying adult death rates, egg death rates, reproductive rate and carrying capacity. Using a measure of fitness appropriate for stochastic environments, we find that parental care has the potential to evolve over a wide range of life-history characteristics when the environment is variable. A variable environment that affects adult or egg death rates can either increase or decrease the fitness of care relative to that in a constant environment, depending on the specific costs of care. Variability that affects carrying capacity or adult reproductive rate has negligible effects on the fitness associated with care. Increasing parental care across different life-history stages can increase fitness gains in variable environments. Costly investment in care is expected to affect the overall fitness benefits, the fitness optimum and rate of evolution of parental care. In general, we find that environmental variability, the life-history traits affected by such variability and the specific costs of care interact to determine whether care will be favoured in a variable environment and what levels of care will be selected. © 2011 The Authors. Journal of Evolutionary Biology © 2011 European Society For Evolutionary Biology.

  15. Smart use of storage potentials of electric vehicles for renewable energy generation in the built environment: A design scenario

    NARCIS (Netherlands)

    Van Timmeren, A.; Bauer, T.C.; Silvester, S.

    2011-01-01

    In this paper, results are reported of a technology assessment of use of electrical vehicles for energy storage (of renewable sources), their integration in the built environment and attached required power and charging systems for the Netherlands. This was done as part of the DIEMIGO project on int

  16. Smart use of storage potentials of electric vehicles for renewable energy generation in the built environment: A design scenario

    NARCIS (Netherlands)

    Van Timmeren, A.; Bauer, T.C.; Silvester, S.

    2011-01-01

    In this paper, results are reported of a technology assessment of use of electrical vehicles for energy storage (of renewable sources), their integration in the built environment and attached required power and charging systems for the Netherlands. This was done as part of the DIEMIGO project on int

  17. Landing Marine-derived Renewable Energy: Optimising Power Cable Routing in the Nearshore Environment

    Science.gov (United States)

    Turner, Rosalind, ,, Dr.; Keane, Tom; Mullins, Brian; Phipps, Peter

    2010-05-01

    Numerous studies have demonstrated that a vast unexploited source of energy can be derived from the marine environment. Recent evolution of the energy market and looming EU renewable energy uptake targets for 2020 have driven a huge explosion of interest in exploiting this resource, triggering both governments and industry to move forward in undertaking feasibility assessments and demonstration projects for wave, tidal and offshore wind farms across coastlines. The locations which naturally lend themselves to high yield energy capture, are by definition, exposed and may be remote, located far from the end user of the electricity generated. A fundamental constraint to successfully exploiting these resources will be whether electricity generated in high energy, variable and constantly evolving environments can be brought safely and reliably to shore without the need for constant monitoring and maintenance of the subsea cables and landfall sites. In the case of riverine cable crossings superficial sediments would typically be used to trench and bury the cable. High energy coastal environments may be stripped of soft sediments. Any superficial sediments present at the site may be highly mobile and subject to re-suspension throughout the tidal cycle or under stormy conditions. EirGrid Plc. and Mott MacDonald Ireland Ltd. have been investigating the potential for routing a cable across the exposed Shannon estuary in Ireland. Information regarding the geological ground model, meteo-oceanographic and archaeological conditions of the proposed site was limited, necessitating a clear investigation strategy. The investigation included gathering site information on currents, bathymetry and geology through desk studies, hydrographic and geophysical surveys, an intrusive ground investigation and coastal erosion assessments at the landfall sites. The study identified a number of difficulties for trenching and protecting a cable through an exposed environment such as the Shannon

  18. Address burnout with a caring, nurturing environment.

    Science.gov (United States)

    2014-06-01

    With their hectic schedules and demanding work responsibilities, emergency physicians are particularly vulnerable to symptoms of burnout. One study showed that more than half of emergency providers reported at least one symptom of burnout when they were asked to fill out a survey tool used to measure burnout--more than any other type of provider. It's a concern because physicians experiencing burnout may be less attentive to their patients, and some ultimately choose to leave medicine because they are no longer satisfied with their work. However, there are steps health systems and administrators can take to help physicians who are struggling, and prevent isolated problems from escalating into larger issues. When a national sample of more than 7,200 physicians agreed to take the Maslach Burnout Inventory, a survey tool used to measure burnout, nearly half (45.8%) reported at least one symptom of burnout, and 65% of the emergency providers reported symptoms of burnout. Burnout is not just fatigue. It involves disappointment in a relationship or relationships, and lack of satisfaction or fulfillment with work, according to experts. Symptoms may include moodiness, irritability, sarcasm, and may result in performance issues as well. Further, there may be physical changes such as weight loss or changes in appetite. To prevent or address burnout, experts advise health systems to nurture a caring, collaborative environment, and to make sure that providers have mentors or resources to reach out to if they are experiencing any work-related problems. They also advise administrators to make sure that burnout is a safe topic of conversation.

  19. Planning of community-scale renewable energy management systems in a mixed stochastic and fuzzy environment

    Energy Technology Data Exchange (ETDEWEB)

    Cai, Y.P.; Tan, Q. [Environmental Systems Engineering Program, Faculty of Engineering, Unversity of Regina, Regina, Saskatchewan (Canada); Huang, G.H. [Environmental Systems Engineering Program, Faculty of Engineering, Unversity of Regina, Regina, Saskatchewan (Canada)]|[Chinese Research Academy of Environmental Science, Beijing Normal University, Beijing 100012-100875 (China); Yang, Z.F. [State Key Laboratory of Water Environment Simulation, School of Enviroment, Beijing Normal University, Beijing 100875 (China)

    2009-07-15

    In this study, an interval-parameter superiority-inferiority-based two-stage programming model has been developed for supporting community-scale renewable energy management (ISITSP-CREM). This method is based on an integration of the existing interval linear programming (ILP), two-stage programming (TSP) and superiority-inferiority-based fuzzy-stochastic programming (SI-FSP). It allows uncertainties presented as both probability/possibilistic distributions and interval values to be incorporated within a general optimization framework, facilitating the reflection of multiple uncertainties and complexities during the process of renewable energy management systems planning. ISITSP-CREM can also be used for effectively addressing dynamic interrelationships between renewable energy availabilities, economic penalties and electricity-generation deficiencies within a community scale. Thus, complexities in renewable energy management systems can be systematically reflected, highly enhancing applicability of the modeling process. The developed method has then been applied to a case of long-term renewable energy management planning for three communities. Useful solutions for the planning of renewable energy management systems have been generated. Interval solutions associated with different energy availabilities and economic penalties have been obtained. They can be used for generating decision alternatives and thus help decision makers identify desired policies under various economic and system-reliability constraints. The generated solutions can also provide desired energy resource/service allocation plans with a minimized system cost (or economic penalties), a maximized system reliability level and a maximized energy security. Tradeoffs between system costs and energy security can also be tackled. Higher costs will increase potential energy generation amount, while a desire for lower system costs will run into a risk of energy deficiency. They are helpful for supporting

  20. Caring for the Environment: Challenges from Notions of Caring

    Science.gov (United States)

    Martin, Peter

    2007-01-01

    In 2003 John Fien presented an argument for environmental education to encompass deep and wide caring for human and nonhuman nature (Fien, 2003). His philosophical discussion of care outlined work by Nel Noddings (1984; 1992). In this paper I continue that project by indicating how Noddings' work provides signposts for environmental educators to…

  1. Child Care Work Environments: The Relationship with Learning Environments

    Science.gov (United States)

    Lower, Joanna K.; Cassidy, Deborah J.

    2007-01-01

    The study explores the relationship between child care program administration, organizational climate, and global quality. The recently developed Program Administration Scale (PAS; Talan & Bloom, 2004) was utilized in the study. Both program administration and organizational climate were found to be positively correlated with preschool classroom…

  2. US EPA CARE Grants

    Data.gov (United States)

    U.S. Environmental Protection Agency — This is a provisional dataset that contains point locations for the subset of Community Action for a Renewed Environment (CARE) grants given out by the US EPA. CARE...

  3. The Living, Dynamic and Complex Environment Care in Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Marli Terezinha Stein Backes

    2015-06-01

    Full Text Available OBJECTIVE: to understand the meaning of the Adult Intensive Care Unit environment of care, experienced by professionals working in this unit, managers, patients, families and professional support services, as well as build a theoretical model about the Adult Intensive Care Unit environment of care.METHOD: Grounded Theory, both for the collection and for data analysis. Based on theoretical sampling, we carried out 39 in-depth interviews semi-structured from three different Adult Intensive Care Units.RESULTS: built up the so-called substantive theory "Sustaining life in the complex environment of care in the Intensive Care Unit". It was bounded by eight categories: "caring and continuously monitoring the patient" and "using appropriate and differentiated technology" (causal conditions; "Providing a suitable environment" and "having relatives with concern" (context; "Mediating facilities and difficulties" (intervenienting conditions; "Organizing the environment and managing the dynamics of the unit" (strategy and "finding it difficult to accept and deal with death" (consequences.CONCLUSION: confirmed the thesis that "the care environment in the Intensive Care Unit is a living environment, dynamic and complex that sustains the life of her hospitalized patients".

  4. Heterogeneity in Health Care Computing Environments

    OpenAIRE

    Sengupta, Soumitra

    1989-01-01

    This paper discusses issues of heterogeneity in computer systems, networks, databases, and presentation techniques, and the problems it creates in developing integrated medical information systems. The need for institutional, comprehensive goals are emphasized. Using the Columbia-Presbyterian Medical Center's computing environment as the case study, various steps to solve the heterogeneity problem are presented.

  5. Sense of Place in Child Care Environments

    Science.gov (United States)

    Read, Marilyn A.

    2007-01-01

    The exterior design of existing preschool environments is evaluated in the context of contemporary writings by architects focusing on creating designs that nurture children's emotions. Sense of place research is discussed in relation to young children's experiences. Findings reveal that the majority of sites included in the study incorporated many…

  6. Nurses' work environments, care rationing, job outcomes, and quality of care on neonatal units.

    Science.gov (United States)

    Rochefort, Christian M; Clarke, Sean P

    2010-10-01

    This paper is a report of a study of the relationship between work environment characteristics and neonatal intensive care unit nurses' perceptions of care rationing, job outcomes, and quality of care. International evidence suggests that attention to work environments might improve nurse recruitment and retention, and the quality of care. However, comparatively little attention has been given to neonatal care, a specialty where patient and nurse outcomes are potentially quite sensitive to problems with staffing and work environments. Over a 6-month period in 2007-2008, a questionnaire containing measures of work environment characteristics, nursing care rationing, job satisfaction, burnout and quality of care was distributed to 553 nurses in all neonatal intensive care units in the province of Quebec (Canada). A total of 339 nurses (61.3%) completed questionnaires. Overall, 18.6% were dissatisfied with their job, 35.7% showed high emotional exhaustion, and 19.2% rated the quality of care on their unit as fair or poor. Care activities most frequently rationed because of insufficient time were discharge planning, parental support and teaching, and comfort care. In multivariate analyses, higher work environment ratings were related to lower likelihood of reporting rationing and burnout, and better ratings of quality of care and job satisfaction. Additional research on the determinants of nurse outcomes, the quality of patient care, and the impact of rationing of nursing care on patient outcomes in neonatal intensive care units is required. The Neonatal Extent of Work Rationing Instrument appears to be a useful tool for monitoring the extent of rationing of nursing care in neonatal units. © 2010 Blackwell Publishing Ltd.

  7. [Surgical Center environment and its elements: implications for nursing care].

    Science.gov (United States)

    Silva, Denise Conceição; Alvim, Neide Aparecida Titonelli

    2010-01-01

    The purpose of this qualitative research was to characterize the elements that constitute the environment of the Surgical Center and to analyze its implications for dynamic of care and nursing care. Based on the Environmental Theory's principals. Participated twelve nurses from the Surgical Center of a College Hospital in Rio de Janeiro. Data were gathered through the creativity and sensitivity technique "Map-Speaker", semi-structered interviews and participant observation, and were analyzed by thematic categories. The results showed that care can happen directly and indirectly in favor of full client recovery, counting the environment that the integrate in purpose to maintain harmonic and balanced. The nurse interventions aim to maintain the environment in favorable conditions so that a higher standard of care can be promoted.

  8. Interaction Between Physical Environment, Social Environment, and Child Characteristics in Determining Physical Activity at Child Care

    NARCIS (Netherlands)

    Gubbels, J.S.; Kremers, S.P.J.; Kann, D.H.H. van; Stafleu, A.; Candel, M.J.J.M.; Dagnelie, P.C.; Thijs, C.; Vries, N.K.de

    2011-01-01

    Objective: To investigate the association between the child-care environment and physical activity of 2- and 3-year-olds. Based on an ecological view of environmental influences on health behavior, we hypothesized that the social and physical environment, as well as child characteristics (age and ge

  9. Implementing AORN recommended practices for a safe environment of care.

    Science.gov (United States)

    Hughes, Antonia B

    2013-08-01

    Providing a safe environment for every patient undergoing a surgical or other invasive procedure is imperative. AORN's "Recommended practices for a safe environment of care" provides guidance on a wide range of topics related to the safety of perioperative patients and health care personnel. The recommendations are intended to provide guidance for establishing best practices and implementing safety measures in all perioperative practice settings. Perioperative nurses should be aware of risks related to musculoskeletal injuries, fire, equipment, latex, and chemicals, among others, and understand strategies for reducing the risks. Evidence-based recommendations can give practitioners the tools to guide safe practice.

  10. Intelligent manufacturing through participation : a participative simulation environment for integral manufacturing enterprise renewal

    NARCIS (Netherlands)

    Eijnatten, F.M. van

    2002-01-01

    This book deals with a 'Participative Simulation environment for Intelligent Manufacturing' (PSIM). PSIM is a software environment for use in assembly operations and it is developed and pilot-demonstrated in five companies: Volvo (Sweden), Finland Post, Fiat (Italy), Yamatake (Japan), Ford (USA). PS

  11. Intelligent manufacturing through participation : a participative simulation environment for integral manufacturing enterprise renewal

    NARCIS (Netherlands)

    Eijnatten, F.M. van

    2002-01-01

    This book deals with a 'Participative Simulation environment for Intelligent Manufacturing' (PSIM). PSIM is a software environment for use in assembly operations and it is developed and pilot-demonstrated in five companies: Volvo (Sweden), Finland Post, Fiat (Italy), Yamatake (Japan), Ford (USA). PS

  12. Facility Service Environments, Staffing, and Psychosocial Care in Nursing Homes

    Science.gov (United States)

    Zhang, Ning Jackie; Gammonley, Denise; Paek, Seung Chun; Frahm, Kathryn

    2008-01-01

    Using 2003 Online Survey Certification and Reporting (OSCAR) data for Medicare and Medicaid certified facilities (N=14, 184) and multinomial logistic regression this study investigated if (1) psychosocial care quality was better in facilities where State requirements for qualified social services staffing exceeded Federal minimum regulations and (2) facility service environments are associated with psychosocial care quality. For-profit status and higher percentage of Medicaid residents are associated with lower quality. Staffing, market demand, and market competition are associated with better quality. Psychosocial care quality is more associated with payer status and market forces and less with regulatory requirements. PMID:19361113

  13. Virtual environment: assistance in nursing care for the deaf based on the protocol of primary care

    National Research Council Canada - National Science Library

    Rodrigues, Silvia Cristina Martini; Damião, Gardênia Costa

    2014-01-01

    Presenting a Virtual Environment (VE) based on the Protocol of Treatment of Hypertension and Diabetes Mellitus type 2, used in Primary Care for evaluation of dietary habits in nursing consultations...

  14. Virtual Environment: assistance in nursing care for the deaf based on the protocol of Primary Care

    National Research Council Canada - National Science Library

    Rodrigues, Silvia Cristina Martini; Damião, Gardênia Costa

    2014-01-01

    Objective: Presenting a Virtual Environment (VE) based on the Protocol of Treatment of Hypertension and Diabetes Mellitus type 2, used in Primary Care for evaluation of dietary habits in nursing consultations. Method...

  15. Professional Learning Environment and Human Caring Correlates of Teacher Efficacy.

    Science.gov (United States)

    Ellett, Chad D.; Hill, Flo H.; Liu, Xia; Loup, Karen S.; Lakshmanan, Aruna

    This paper presents the results of a study of relationships between elements of the school professional learning environment and dimensions of caring and efficacy motivation among teachers. The sample for the study consisted of 1009 elementary and secondary school teachers from 29 schools in two suburban/rural school districts in a southeastern…

  16. Factors Affecting Teaching the Concept of Renewable Energy In Technology Assisted Environments and Designing Processes In The Distance Education Model

    OpenAIRE

    YUCEL, A. Seda

    2007-01-01

    The energy policies of today focus mainly on sustainable energy systems and renewable energy resources. Chemistry is closely related to energy recycling, energy types, renewable energy, and nature-energy interaction; therefore, it is now an obligation to enrich chemistry classes with renewable energy concepts and related awareness. Before creating renewable energy awareness, the factors thought to affect such awareness should be determined. Knowing these factors would facilitate finding out w...

  17. Factors Affecting Teaching the Concept of Renewable Energy In Technology Assisted Environments and Designing Processes In The Distance Education Model

    OpenAIRE

    YUCEL, A. Seda

    2015-01-01

    The energy policies of today focus mainly on sustainable energy systems and renewable energy resources. Chemistry is closely related to energy recycling, energy types, renewable energy, and nature-energy interaction; therefore, it is now an obligation to enrich chemistry classes with renewable energy concepts and related awareness. Before creating renewable energy awareness, the factors thought to affect such awareness should be determined. Knowing these factors would facilitate finding out w...

  18. Creating healing intensive care unit environments: physical and psychological considerations in designing critical care areas.

    Science.gov (United States)

    Bazuin, Doug; Cardon, Kerrie

    2011-01-01

    A number of elements contribute to a healing ICU environment. The layout of a critical care unit helps create an environment that supports caregiving, which helps alleviate a host of work-related stresses. A quieter environment, one that includes family and friends, dotted with windows and natural light, creates a space that makes people feel balanced and reassured. A healing environment responds to the needs of all the people within a critical care unit-those who receive or give care and those who support patients and staff. Critical care units should be designed to focus on healing the body, the mind, and the senses. The design and policies of that department can be created in such a way to provide a sense of calm and balance. The physical environment has an impact on patient outcomes; the psychological environment can, too. A healing ICU environment will balance both. The authors discuss the ways in which architecture, interior design, and behavior contribute to a healing ICU environment.

  19. Factors Affecting Teaching the Concept of Renewable Energy in Technology Assisted Environments and Designing Processes in the Distance Education Model

    Science.gov (United States)

    Yucel, A. Seda

    2007-01-01

    The energy policies of today focus mainly on sustainable energy systems and renewable energy resources. Chemistry is closely related to energy recycling, energy types, renewable energy, and nature-energy interaction; therefore, it is now an obligation to enrich chemistry classes with renewable energy concepts and related awareness. Before creating…

  20. Optimizing cardiothoracic surgery information for a managed care environment.

    Science.gov (United States)

    Denton, T A; Matloff, J M

    1995-11-01

    The rapid change occurring in American healthcare is a direct response to rising costs. Managed care is the fastest growing model that attempts to control escalating costs through limitations in patient choice, the active use of guidelines, and placing providers at risk. Managed care is an information intensive system, and those providers who use information effectively will be at an advantage in the competitive healthcare marketplace. There are five classes of information that providers must collect to be competitive in a managed care environment: patient satisfaction, medical outcomes, continuous quality improvement, quality of the decision, and financial data. Each of these should be actively used in marketing, assuring the quality of patient care, and maintaining financial stability. Although changes in our healthcare system are occurring rapidly, we need to respond to the marketplace to maintain our viability, but as physicians, we have the singular obligation to maintain the supremacy of the individual patient and the physician-patient relationship.

  1. Battlefield conditions: different environment but the same duty of care.

    Science.gov (United States)

    Kelly, Janet

    2010-09-01

    Using an interpretative research approach to ethical and legal literature, it is argued that nursing in the battlefield is distinctly different to civilian nursing, even in an emergency, and that the environment is so different that a duty of care owed by military nurses to wounded soldiers should not apply. Such distinct differences in wartime can override normal peacetime professional ethics to the extent that the duty of care owed by military nurses to their patients on the battlefield should not exist. It is also argued that as military nurses have legal and professional obligations to care for wounded soldiers on the battlefield, this obligation conflicts with following military orders, causing a dual loyalty conflict. This is because soldiers are part of the 'fighting force' and must be fit to fight and win the battle. This makes them more of a commodity rather than individual persons with distinct health care needs.

  2. Use of Color in Child Care Environments: Application of Color for Wayfinding and Space Definition in Alabama Child Care Environments.

    Science.gov (United States)

    Read, Marilyn A.

    2003-01-01

    Compared the use of color in physical design features associated with the exterior and interior designs of 101 child care centers in Alabama. Found that color was evidenced on the exterior of the centers at just over half of the sample. The interior environments had warm colors and bright accents in the setting; however, the majority of centers…

  3. RENEWABLE ENERGY, A KEY TO INTEGRATING COMPETITIVE POLICIES WITH ADVANCED ENVIRONMENT PROTECTION STRATEGIES

    OpenAIRE

    Cinade Lucian Ovidiu

    2011-01-01

    Development of competitive policies and improvement of environment protection strategies are two basic trends of the development of the European Unique Market. Energy, also known as "industry bread", is basic product and strategic resource, where energy industry plays an obvious role in the economic and social development of any community. Traditional energy production is marred by three major drawbacks: it generates negative externalities by polluting; it is totally in the hands of the produ...

  4. Measuring renewed expertise for integrated care among health- and social-care professionals: Development and preliminary validation of the ICE-Q questionnaire.

    Science.gov (United States)

    van der Aa, Maartje J; van den Broeke, Jennifer R; Stronks, Karien; Busschers, Wim B; Plochg, Thomas

    2016-01-01

    Accumulations of health and social problems challenge current health systems. It is hypothesized that professionals should renew their expertise by adapting generalist, coaching, and population health orientation capacities to address these challenges. This study aimed to develop and validate an instrument for evaluating this renewal of professional expertise. The (Dutch) Integrated Care Expertise Questionnaire (ICE-Q) was developed and piloted. Psychometric analysis evaluated item, criterion, construct, and content validity. Theory and an iterative process of expert consultation constructed the ICE-Q, which was sent to 616 professionals, of whom 294 participated in the pilot (47.7%). Factor analysis (FA) identified six areas of expertise: holistic attitude towards patients (Cronbach's alpha [CA] = 0.61) and considering their social context (CA = 0.77), both related to generalism; coaching to support patient empowerment (CA = 0.66); preventive action (CA = 0.48); valuing local health knowledge (CA = 0.81); and valuing local facility knowledge (CA = 0.67) point at population health orientation. Inter-scale correlations ranged between 0.01 and 0.34. Item-response theory (IRT) indicated some items were less informative. The resulting 26-item questionnaire is a first tool for measuring integrated care expertise. The study process led to a developed understanding of the concept. Further research is warranted to improve the questionnaire.

  5. The applicability of SERVQUAL in different health care environments.

    Science.gov (United States)

    Dean, A M

    1999-01-01

    This paper reports on a study that investigates the applicability of a modified SERVQUAL instrument as a means of measuring service quality in two types of health service environments; medical care and health care (incorporating medical, social, cognitive and emotional elements). The research confirms a four factor structure that is stable for both environments, and similar to the service quality dimensions recognised in the literature. However, the relative importance of the dimensions of quality is inconsistent for the two types of health services. These results confirm the suggestion that importance values should be part of the measurement tool. Finally, the extra diagnostic advantage achieved by the use of gap scores to measure service quality, when compared to perception only scores is demonstrated.

  6. Fixing atmospheric CO2 by environment adaptive sorbent and renewable energy

    Science.gov (United States)

    Wang, T.; Liu, J.; Ge, K.; Fang, M.

    2014-12-01

    Fixing atmospheric CO2, followed by geologic storage in remote areas is considered an environmentally secure approach to climate mitigation. A moisture swing sorbent was investigated in the laboratory for CO2 capture at a remote area with humid and windy conditions. The energy requirement of moisture swing absorption could be greatly reduced compared to that of traditional high-temperature thermal swing, by assuming that the sorbent can be naturally dried and regenerated at ambient conditions. However, for currently developed moisture swing materials, the CO2 capacity would drop significantly at high relative humidity. The CO2 capture amount can be reduced by the poor thermodynamics and kinetics at high relative humidity or low temperature. Similar challenges also exist for thermal or vacuum swing sorbents. Developing sorbent materials which adapt to specific environments, such as high humidity or low temperature, can ensure sufficient capture capacity on the one hand, and realize better economics on the other hand (Figure 1) .An environment adaptive sorbent should have the abilities of tunable capacity and fast kinetics at extreme conditions, such as high humidity or low temperature. In this presentation, the possibility of tuning CO2 absorption capacity of a polymerized ionic liquid material is discussed. The energy requirement evaluation shows that tuning the CO2 binding energy of sorbent, rather than increasing the temperature or reducing the humidity of air, could be much more economic. By determining whether the absorption process is controlled by physical diffusion controlled or chemical reaction, an effective approach to fast kinetics at extreme conditions is proposed. A shrinking core model for mass transfer kinetics is modified to cope with the relatively poor kinetics of air capture. For the studied sample which has a heterogeneous structure, the kinetic analysis indicates a preference of sorbent particle size optimization, rather than support layer

  7. The changing environment for technological innovation in health care.

    Science.gov (United States)

    Goodman, C S; Gelijns, A C

    1996-01-01

    A distinguishing feature of American health care is its emphasis on advanced technology. Yet today's changing health care environment is overhauling the engine of technological innovation. The rate and direction of technological innovation are affected by a complex of supply- and demandside factors, including biomedical research, education, patent law, regulation, health care payment, tort law, and more. Some distinguishing features of technological innovation in health care are now at increased risk. Regulatory requirements and rising payment hurdles are especially challenging to small technology companies. Closer management of health care delivery and payment, particularly the standardization that may derive from practice guidelines and clamping down on payment for investigational technologies, curtails opportunities for innovation. Levels and distribution of biomedical research funding in government and industry are changing. Financial constraints are limiting the traditional roles of academic health centers in fostering innovation. Despite notable steps in recent years to lower regulatory barriers and speed approvals, especially for products for life-threatening conditions, the Food and Drug Administration is under great pressure from Congress, industry, and patients to do more. Technology gatekeeping is shifting from hundreds of thousands of physicians acting on behalf of their patients to fewer, yet more powerful, managed care organizations and health care networks. Beyond its direct effects on adoption, payment, and use of technologies, the extraordinary buying leverage of these large providers is cutting technology profit margins and heightening competition among technology companies. It is contributing to unprecedented restructuring of the pharmaceutical and medical device industries, leading to unprecedented alliances with generic product companies, health care providers, utilization review companies, and other agents. These industry changes are already

  8. Motivating teacher and student engagement with the environment through renewable energy education

    Science.gov (United States)

    Patel, Nirav Sanat

    Environmental and energy education is focused on fostering environmental behavior. This study investigates empirically if education leads to changes in environmental attitudes and subsequent environmentally significant behavior (ESB). The study contextualizes teachers' and students' motivation to engage in ESB within an environmental educational training framework. The results of structured questionnaires administered in Northeast, Mid-Atlantic, and Midwestern K-12 schools (n=214 for teachers and n=1498 for students) reveal that environmental attitudes are not a good predictor of teaching behavior but they do predict students' intent towards ESB. Teachers' energy attitudes are a better predictor in motivating them to teach while students are most responsive to their affective attitudes. The study finds that education does not play a significant role in changing environmental or energy attitudes of teachers and students. The study also advances a methodological tool for data collection that can expand the reach of evaluation instruments and measure learning across formal and informal audiences. It highlights how interactional technology can be readily utilized for future research and outreach in classrooms, nature learning centers, professional training programs, and museums. Overall, the work advances social-psychological understanding of how adults and youth respond to educational programming. It highlights the need to go beyond the cognitive shifts in affecting behavior. Curriculum based on environment might be necessary but is often not sufficient for changing environmental values. Finally, information and knowledge acquired must motivate the teachers' and students' desire and ability to conscientiously act, wherever necessary.

  9. Renewable smart materials

    Science.gov (United States)

    Kim, Hyun Chan; Mun, Seongcheol; Ko, Hyun-U.; Zhai, Lindong; Kafy, Abdullahil; Kim, Jaehwan

    2016-07-01

    The use of renewable materials is essential in future technologies to harmonize with our living environment. Renewable materials can maintain our resources from the environment so as to overcome degradation of natural environmental services and diminished productivity. This paper reviews recent advancement of renewable materials for smart material applications, including wood, cellulose, chitin, lignin, and their sensors, actuators and energy storage applications. To further improve functionality of renewable materials, hybrid composites of inorganic functional materials are introduced by incorporating carbon nanotubes, titanium dioxide and tin oxide conducting polymers and ionic liquids. Since renewable materials have many advantages of biocompatible, sustainable, biodegradable, high mechanical strength and versatile modification behaviors, more research efforts need to be focused on the development of renewable smart materials.

  10. Caring Science: Transforming the Ethic of Caring-Healing Practice, Environment, and Culture within an Integrated Care Delivery System.

    Science.gov (United States)

    Foss Durant, Anne; McDermott, Shawna; Kinney, Gwendolyn; Triner, Trudy

    2015-01-01

    In early 2010, leaders within Kaiser Permanente (KP) Northern California's Patient Care Services division embarked on a journey to embrace and embed core tenets of Caring Science into the practice, environment, and culture of the organization. Caring Science is based on the philosophy of Human Caring, a theory articulated by Jean Watson, PhD, RN, AHN-BC, FAAN, as a foundational covenant to guide nursing as a discipline and a profession. Since 2010, Caring Science has enabled KP Northern California to demonstrate its commitment to being an authentic person- and family-centric organization that promotes and advocates for total health. This commitment empowers KP caregivers to balance the art and science of clinical judgment by considering the needs of the whole person, honoring the unique perception of health and healing that each member or patient holds, and engaging with them to make decisions that nurture their well-being. The intent of this article is two-fold: 1) to provide context and background on how a professional practice framework was used to transform the ethic of caring-healing practice, environment, and culture across multiple hospitals within an integrated delivery system; and 2) to provide evidence on how integration of Caring Science across administrative, operational, and clinical areas appears to contribute to meaningful patient quality and health outcomes.

  11. Innovative Environments In Health Care: Where And How New Approaches To Care Are Succeeding.

    Science.gov (United States)

    Bates, David W; Sheikh, Aziz; Asch, David A

    2017-03-01

    Organizations seeking to create innovative environments in health care need to pay attention to a number of factors. These include making available sufficient resources, notably money and physical space, but also coordination and consultation regarding intellectual property and licensing; enabling access to engineers, software developers, and behavioral scientists; making providers and patients available to innovators; having a sufficiently long-term view; and insulating the innovation group from operational demands. If there is a single essential key to success, it is making innovation a strategic priority. Academic health systems are enormous generators of innovation in the form of generalizable research in biomedical sciences. Typically, much of that innovation is externally supported, and little is directed to improving care processes internally. In industries other than health care, organizations invest their own funds in research and development to promote innovation, and this investment is seen as a metric for a firm's commitment to its future. Increased investment in care-process innovation is long overdue.

  12. Dental Education Required for the Changing Health Care Environment.

    Science.gov (United States)

    Fontana, Margherita; González-Cabezas, Carlos; de Peralta, Tracy; Johnsen, David C

    2017-08-01

    To be able to meet the demands for care in 2040, dental graduates will need to address challenges resulting from the rapidly changing health care environment with knowledge and sets of skills to build on current standards and adapt to the future. The purposes of this article are to 1) analyze key challenges likely to evolve considerably between now and 2040 that will impact dental education and practice and 2) propose several sets of skills and educational outcomes necessary to address these challenges. The challenges discussed include changes in prevalence of oral diseases, dental practice patterns, materials and technologies, integrated medical-dental care, role of electronic health records, cultural competence, integrated curricula, interprofessional education, specialty-general balance, and web/cloud-based collaborations. To meet these challenges, the dental graduate will need skills such as core knowledge in basic and clinical dentistry, technical proficiency, critical thinking skills for lifelong learning, ethical and professional values, ability to manage a practice, social responsibility, and ability to function in a collegial intra- and interprofessional setting. Beyond the skills of the individual dentist will be the need for leadership in academia and the practice community. Academic and professional leaders will need to engage key constituencies to develop strategic directions and agendas with all parties pointed toward high standards for individual patients and the public at large. This article was written as part of the project "Advancing Dental Education in the 21(st) Century."

  13. American Organization of Nurse Executives Care Innovation and Transformation program: improving care and practice environments.

    Science.gov (United States)

    Oberlies, Amanda Stefancyk

    2014-09-01

    The American Organization of Nurse Executives conducted an evaluation of the hospitals participating in the Care Innovation and Transformation (CIT) program. A total of 24 hospitals participated in the 2-year CIT program from 2012 to 2013. Reported outcomes include increased patient satisfaction, decreased falls, and reductions in nurse turnover and overtime. Nurses reported statistically significant improvements in 4 domains of the principles and elements of a healthful practice environment developed by the Nursing Organizations Alliance.

  14. Renewable energy resources

    CERN Document Server

    Twidell, John

    2015-01-01

    Renewable Energy Resources is a numerate and quantitative text covering the full range of renewable energy technologies and their implementation worldwide. Energy supplies from renewables (such as from biofuels, solar heat, photovoltaics, wind, hydro, wave, tidal, geothermal, and ocean-thermal) are essential components of every nation's energy strategy, not least because of concerns for the local and global environment, for energy security and for sustainability. Thus in the years between the first and this third edition, most renewable energy technologies have grown from fledgling impact to s

  15. Renewable energies, development, and environment: discourses, realities, and perspectives; Energies renouvelables, developpement et environnement. Discours, realites et perspectives

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    After two contributions describing the context of renewable energies and their different objectives and roles in the North and in the South, a set of contributions discusses some controversies and generally accepted ideas about renewable energies: fossil energy appraisal and the greenhouse effect of presently used fuels, the issue of irregularity and climate hazards, photovoltaic energy as a development key for South countries, vulnerability of energy systems, renewable energies and energy market privatisation. The next set of contributions deals with different examples: renewable energies in Africa, electricity and high dams, small hydro developments in China, wind energy in Morocco, solar water-heaters in Tunisia, bio-energies and food security, second generation bio-fuels, biomass energy in Cambodia. Sheets are then proposed with a brief historical overview, a description of the state of the art, an indication of the installed power, of market shares, and a brief discussion of perspectives for the different renewable energy sources: large and small hydro, photovoltaic, thermodynamic solar, wind, geothermal, thermal solar, bio-fuels, biomass, and biogas

  16. Virtual Environment: assistance in nursing care for the deaf based on the protocol of Primary Care

    Directory of Open Access Journals (Sweden)

    Silvia Cristina Martini Rodrigues

    2014-08-01

    Full Text Available Objective: Presenting a Virtual Environment (VE based on the Protocol of Treatment of Hypertension and Diabetes Mellitus type 2, used in Primary Care for evaluation of dietary habits in nursing consultations. Method: An experimental study applied by two nurses and a nurse manager, in a sample of 30 deaf patients aged between 30 and 60 years. The environment was built in Visual Basic NET and offered eight screens about feeding containing food pictures, videos in Libras (Brazilian sign language and audio. The analysis of the VE was done through questionnaires applied to patients and professionals by the Poisson statistical test. Results: The VE shows the possible diagnostics in red, yellow, green and blue colors, depending on the degree of patients’ need. Conclusion: The environment obtained excellent acceptance by patients and nurses, allowing great interaction between them, even without an interpreter. The time in consultation was reduced to 15 minutes, with the preservation of patient privacy.

  17. [Virtual environment: assistance in nursing care for the deaf based on the protocol of primary care].

    Science.gov (United States)

    Rodrigues, Silvia Cristina Martini; Damião, Gardênia Costa

    2014-08-01

    Presenting a Virtual Environment (VE) based on the Protocol of Treatment of Hypertension and Diabetes Mellitus type 2, used in Primary Care for evaluation of dietary habits in nursing consultations. An experimental study applied by two nurses and a nurse manager, in a sample of 30 deaf patients aged between 30 and 60 years. The environment was built in Visual Basic NET and offered eight screens about feeding containing food pictures, videos in Libras (Brazilian sign language) and audio. The analysis of the VE was done through questionnaires applied to patients and professionals by the Poisson statistical test. The VE shows the possible diagnostics in red, yellow, green and blue colors, depending on the degree of patients' need. The environment obtained excellent acceptance by patients and nurses, allowing great interaction between them, even without an interpreter. The time in consultation was reduced to 15 minutes, with the preservation of patient privacy.

  18. The social responsibility commitment to the community and care environment

    Directory of Open Access Journals (Sweden)

    Martha Elena López Regalado

    2015-12-01

    Full Text Available The concept of csr has evolved in recent years, currently the main objective of the Company cannot lie only meet the monetary needs of the shareholders, but to seek the participation of all stakeholders in the company, with the different stakeholders that interact with the environment either customers, suppliers, employees and society at large, impacting the community with socially responsible actions. Because the concept has acquired new shades as social, economic and environmental responsibility among others, being on the great responsibility of the actions of companies to make social or common good acts to achieve their objectives without harming their economies community, the next job is presented focusing especially on two major indicators of social responsibility such as environmental care, and welfare of the community.

  19. Work-based learning in health care environments.

    Science.gov (United States)

    Spouse, J

    2001-03-01

    In reviewing contemporary literature and theories about work-based learning, this paper explores recent trends promoting life-long learning. In the process the paper reviews and discusses some implications of implementing recent policies and fostering le arning in health care practice settings. Recent Government policies designed to provide quality health care services and to improve staffing levels in the nursing workforce, have emphasized the importance of life-long learning whilst learning-on-the-job and the need to recognize and credit experiential learning. Such calls include negotiation of personal development plans tailored to individual educational need and context-sensitive learning activities. To be implemented effectively, this policy cann ot be seen as a cheap option but requires considerable financial resourcing for preparation of staff and the conduct of such activities. Successful work-based learning requires investment in staff at all levels as well as changes to staffing structures in organizations and trusts; changes designed to free people up to work and learn collaboratively. Creating an organizational environment where learning is prized depends upon a climate of trust; a climate where investigation and speculation are fostered and where time is protected for engaging in discussions about practice. Such a change may be radical for many health care organizations and may require a review of current policies and practices ensuring that they include education at all levels. The nature of such education also requires reconceptualizing. In the past, learning in practice settings was seen as formal lecturing or demonstration, and relied upon behaviourist principles of learning. Contemporary thinking suggests effective learning in work-settings is multi-faceted and draws on previously acquired formal knowledge, contextualizes it and moulds it according to situations at hand. Thinking about work-based learning in this way raises questions about how such

  20. Implementation by Albania of the Acquis Communautaire on Renewable Energy, and Environment with Focus to the Energy Community

    Energy Technology Data Exchange (ETDEWEB)

    Dervishi, Dael

    2010-09-15

    The Energy Community aims at establishing a common regulatory framework for energy markets in contracting parties by extending the acquis communautaire of the European Union to the territories of participating countries. The Albanian Government is drafting the Law on Renewable Energy Sources. The purpose of the law is to promote a greater contribution of renewable sources of energy to the production of electricity in the domestic energy market. In this paper, I describe the policy mechanisms and the market conditions mandated by the EU directive aimed at liberalizing the electric energy market.

  1. Comment: The Economics of Interdependent Renewable and Non-renewable Resources revisited.

    OpenAIRE

    Viktoria Kahui; Armstrong, Claire W.

    2009-01-01

    This work expands upon Swallow's theoretical analysis of interactions between renewable and non-renewable resources. In this comment the interaction is such that the renewable resource prefers the non-renewable environment, as opposed to SwallowÕs (op cit) case of the non-renewable environment being essential to the renewable resource. We find that this difference strongly affects the results, and makes the resources change from being complements to being substitutes, i.e. in the essential ca...

  2. [Elderly human being with ostomy and environments of care: reflection on the perspective of complexity].

    Science.gov (United States)

    Barros, Edaiane Joana Lima; Santos, Silvana Sidney Costa; Lunardi, Valéria Lerch; Lunardi Filho, Wilson Danilo

    2012-01-01

    This is discussion about the relationship between elderly human beings with ostomy and their environments care, under the perspective of Complexity Edgar Morin. An axis holds the reflection: environments of care for elderly humans with ostomy. In this sense, we present three types of environment that surround the context of elderly humans with ostomy: home environment, group environment and hospital environment. This brings, as a social contribution, a new look about resizing caring of elderly humans with ostomy in their environment. It is considered that the environment hosting this human being contains a diversity of feelings, emotions, experiences; it binds multiple meanings, from the Complexity perspective, about the relationship between the environment and the caring process.

  3. Renewable Energy: Policy Considerations for Deploying Renewables

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This information paper accompanies the IEA publication Deploying Renewables 2011: Best and Future Policy Practice (IEA, 2011a). It provides more detailed data and analysis on policies for Deploying Renewables, and is intended to complement the main publication. It provides an account of the strategic drivers underpinning renewable energy (RE) technology deployment (energy security, economic development and environment protection) and assesses RE technologies with respect to these drivers, including an estimate of GHG emissions reductions due to RE technologies. The paper also explores the different barriers to deploying renewables at a given stage of market maturity and discusses what tools policy makers can avail of to succeed in removing deployment barriers. An additional topical highlight explores the challenges associated with accelerating the diffusion of RE technologies in developing countries.

  4. Building a sustainable market for renewables

    Energy Technology Data Exchange (ETDEWEB)

    Rader, N.

    1996-12-31

    Opinions regarding marketing approaches for electricity generation from renewable resources are presented in the paper. The Renewables Portfolio Standard of the California Public Utilities Commission is described. This system is based on renewable energy credits. Other marketing approaches, including surcharges, auctioned renewables credit, green pricing, and green marketing are also assessed. It is concluded that the Renewables Portfolio Standard creates a stable economic environment for the renewable energy industries.

  5. Renewal processes

    CERN Document Server

    Mitov, Kosto V

    2014-01-01

    This monograph serves as an introductory text to classical renewal theory and some of its applications for graduate students and researchers in mathematics and probability theory. Renewal processes play an important part in modeling many phenomena in insurance, finance, queuing systems, inventory control and other areas. In this book, an overview of univariate renewal theory is given and renewal processes in the non-lattice and lattice case are discussed. A pre-requisite is a basic knowledge of probability theory.

  6. Promoting Students' Problem Solving Skills and Knowledge of STEM Concepts in a Data-Rich Learning Environment: Using Online Data as a Tool for Teaching about Renewable Energy Technologies

    Science.gov (United States)

    Thurmond, Brandi

    2011-01-01

    This study sought to compare a data-rich learning (DRL) environment that utilized online data as a tool for teaching about renewable energy technologies (RET) to a lecture-based learning environment to determine the impact of the learning environment on students' knowledge of Science, Technology, Engineering, and Math (STEM) concepts related…

  7. Promoting Students' Problem Solving Skills and Knowledge of STEM Concepts in a Data-Rich Learning Environment: Using Online Data as a Tool for Teaching about Renewable Energy Technologies

    Science.gov (United States)

    Thurmond, Brandi

    2011-01-01

    This study sought to compare a data-rich learning (DRL) environment that utilized online data as a tool for teaching about renewable energy technologies (RET) to a lecture-based learning environment to determine the impact of the learning environment on students' knowledge of Science, Technology, Engineering, and Math (STEM) concepts related…

  8. Feasibility of Eyetracking in Critical Care Environments - A Systematic Review.

    Science.gov (United States)

    Klausen, Andreas; Röhrig, Rainer; Lipprandt, Myriam

    2016-01-01

    Achieving a good understanding of the socio-technical system in critical or emergency situations is important for patient safety. Research in human-computer interaction in the field of anesthesia or surgery has the potential to improve usability of the user interfaces and enhance patient safety. Therefore eye-tracking is a technology for analyzing gaze patterns. It can also measure what is being perceived by the physician during medical procedures. The aim of this review is the applicability of eye-tracker in the domain of simulated or real environments of anesthesia, surgery or intensive care. We carried out a literature research in PubMed. Two independent researchers screened the titles and abstracts. The remaining 8 full-papers were analyzed based on the applicability of eye-trackers. The articles contain topics like training of surgeons, novice vs. experts or the cognitive workload. None of the publications address our goal. The applicability or limitations of the eye-tracker technology were stated incidentally.

  9. A GIS-based decision support tool for renewable energy management and planning in semi-arid rural environments of northeast of Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Tiba, C.; Fraidenraich, N.; Barbosa, E.M. de S. [Departamento de Energia Nuclear da Universidade Federal de Pernambuco, Av. Prof. Luiz Freire, 1000 - CDU, CEP 50.740-540, Recife, Pernambuco (Brazil); Candeias, A.L.B. [Departamento de Engenharia Cartografica da Universidade Federal de Pernambuco, Av. Academico Helio Ramos, s/n - CDU, Recife, Pernambuco (Brazil); de Carvalho Neto, P.B.; de Melo Filho, J.B. [Companhia Hidro Eletrica do Sao Francisco -DTG- CHESF, Recife, Pernambuco (Brazil)

    2010-12-15

    This work describes the development of a management and planning system on a GIS (Geographic Information System) platform destined to decision makers that is, administrators, planners or consultants in renewable energies. It was conceived to deal with the management and planning of solar systems, biomass and aeolics in rural regions of Brazil. The prototype of the GIS tool covers an area of 183, 500 km{sup 2} and is made up of three blocks: management of installed renewable systems, inclusion (planning) of new systems and updating of the data banks. The GISA SOL 1.0 (Geographic Information System Applied to Solar Energy) has a total of 80 layers of information that permit the realization of spatial analyses on management and planning of renewable sources of energy at macro-spatial (state) and local (municipality) levels. A description and the methodology used for its development and a description of the functionalities will be made here. The system was developed mainly for PV systems as a support tool for management and planning of the Energy Development Program for States and Municipalities (PRODEEM), a program for inclusion in large scale of solar photovoltaic energy in the rural environment, conducted by the Ministry of Mines and Energy of Brazil. (author)

  10. International scientists’ priorities for research on pharmaceutical and personal care products in the environment

    Science.gov (United States)

    Pharmaceuticals and personal care products (PPCPs) are widely discharged into the environment via diverse pathways. The effects of PPCPs in the environment have potentially important human and ecosystem health implications, so credible, salient, and legitimate scientific evidence...

  11. International scientists’ priorities for research on pharmaceutical and personal care products in the environment

    Science.gov (United States)

    Pharmaceuticals and personal care products (PPCPs) are widely discharged into the environment via diverse pathways. The effects of PPCPs in the environment have potentially important human and ecosystem health implications, so credible, salient, and legitimate scientific evidence...

  12. Essential elements of professional nursing environments in Primary Care and their influence on the quality of care.

    Science.gov (United States)

    Gea-Caballero, Vicente; Castro-Sánchez, Enrique; Júarez-Vela, Raúl; Díaz-Herrera, Miguel Ángel; de Miguel-Montoya, Isabel; Martínez-Riera, José Ramón

    2017-09-25

    Nursing work environments are key determinants of care quality. Our study aimed to evaluate the characteristics of nursing environments in primary care settings in the Canary Islands, and identify crucial components of such environments to improve quality. We conducted a cross-sectional study in primary care organisations using the Practice Environment Scale - Nursing Work Index tool. We collected sociodemographic variables, scores, and selected the essential items conducive to optimal care. Appropriate parametric and non-parametric statistical tests were used to analyse relations between variables (CI = 95%, error = 5%). One hundred and forty-four nurses participated. The mean total score was 81.6. The results for the five dimensions included in the Practice Environment Scale - Nursing Work Index ranged from 2.25 - 2.92 (Mean). Twelve key items for quality of care were selected; six were positive in the Canary Islands, two were mixed, and four negative. 7/12 items were included in Dimension 2 (fundamentals of nursing). Being a manager was statistically associated with higher scores (p<.000). Years of experience was inversely associated with scores in the 12 items (p<.021). Nursing work environments in primary care settings in the Canary Islands are comparable to others previously studied in Spain. Areas to improve were human resources and participation of nurses in management decisions. Nurse managers must be knowledgeable about their working environments so they can focus on improvements in key dimensions. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  13. The relationship between the nursing environment and delivering culturally sensitive perinatal hospice care.

    Science.gov (United States)

    Mixer, Sandra J; Lindley, Lisa; Wallace, Heather; Fornehed, Mary Lou; Wool, Charlotte

    2015-09-01

    Wide variations exist among perinatal hospices, and barriers to perinatal palliative care exist at the healthcare level. Research in the area of culturally sensitive perinatal palliative care has been scarce, a gap which this study addresses. To evaluate the relationship between the nurse work environment and the delivery of culturally sensitive perinatal hospice care. This retrospective, correlational study used data from the National Home and Hospice Care Survey, which includes a nationally representative sample of hospice care providers. A multivariate logistic regression model was used to estimate the relationship between the delivery of culturally sensitive care and the nurse work environment. Accreditation, teaching status, and baccalaureate-prepared registered nurse staff had an impact on the provision of culturally sensitive perinatal care Conclusions: The hospice and nursing unit environments, specifically in regards to education and technology, may be important contributors to the delivery of culturally sensitive care.

  14. Boards of directors under fire: an examination of nonprofit board duties in the health care environment.

    Science.gov (United States)

    Ono, N

    1998-01-01

    Attorney Ono presents a detailed discussion of fiduciary duty principles as applied to the directors of nonprofit health care corporations in the current health care environment. The article reviews general corporate responsibilities, the implication of the taxpayer's Bill of Rights 2, the care of In re Caremark International Inc. Derivative Litigation and particular issues faced by boards in nonprofit conversions.

  15. Nursing work environment and nurse caring: relationship among motivational factors.

    Science.gov (United States)

    Burtson, Paige L; Stichler, Jaynelle F

    2010-08-01

    This paper is a report of a study of the relationships among compassion satisfaction, nurse job satisfaction, stress, burnout and compassion fatigue to nurse caring. Nurse caring is the most influential dimension of patient advocation and is predictive of patient satisfaction. Qualitative studies have indicated that nurse caring is a key motivational factor impacting recruitment and retention. A correlational study of nurses (N = 126) was conducted in 2008 at a single, academic medical center. The six variables of interest were operationalized using four valid and reliable research instruments: (1) the Mueller McCloskey Satisfaction Scale, (2) the Professional Quality of Life Scale, (3) the Stress in General Scale and (4) the Caring Behaviors Inventory. Pearson Product-moment correlations showed statistically significant relationships between nurse caring and compassion satisfaction (r = 0.51, P nurse job satisfaction subscales (r = 0.16-0.28, P burnout (r = -0.22, P nurse caring subscale of knowledge and skill and compassion fatigue (r = -0.22, P nurse satisfaction with social interaction opportunities related to work (beta = 0.223, P = 0.032) explained variability in nurse caring. Fostering compassion satisfaction and social interaction opportunities among nurses may improve nurse caring, potentially sustaining long-term improvements in patient.

  16. US EPA CARE Grants/IGD: PERF_COMMUN_GRANTS_INT_MV

    Data.gov (United States)

    U.S. Environmental Protection Agency — This is a provisional dataset that contains point locations for the subset of Community Action for a Renewed Environment (CARE) grants given out by the US EPA. CARE...

  17. Definition of problems of persons in sheltered care environments

    Science.gov (United States)

    Fetzner, W. N.

    1979-01-01

    Innovations in health care using aerospace technologies are described. Voice synthesizer and voice recognition technologies were used in developing voice controlled wheel chairs and optacons. Telephone interface modules are also described.

  18. Nursing in family environment: caring for person in mental suffering

    Directory of Open Access Journals (Sweden)

    Lucas Amaral Martins

    2013-01-01

    Full Text Available The study aims to describe the experience of nursing care to person in mental suffering (PMS in the family context. Developed by nursing academic during home attendance, in the 2008.2 semester. The results showed that: is undeniable the family function of the PMS care, becoming the main partner of the heath teams, the care in the perspective of psychosocial rehabilitation influences the attitudes, patterns of response and participation in treatment, resulting in the empowerment of PMS and family. It’s concluded that home attendance contributes to the process of psychosocial rehabilitation of the PMS and assessment of mental health services, subsidizing the formulation of public policies for the sector, especially, in regard to care in perspective of the whole human life.

  19. Renewable energy education in Turkey

    Energy Technology Data Exchange (ETDEWEB)

    Acikgoz, Caglayan [Department of Chemical and Process Engineering, Faculty of Engineering, Bilecik University, P.O.11030, Bilecik (Turkey)

    2011-02-15

    Utilization of renewable energy sources and the application of environmentally sound energy technologies are essential to sustainable development and will help to secure the quality of living and the well-being of the future generations. Turkey presently has considerable renewable energy sources. The most important renewable sources are hydropower, wind, solar, geothermal, and biomass. The use of renewable energy as a topic to study energy and its forms permits a novel way to motivate students, particularly those who energy topics taking conscience with the environment. This paper presents the analysis and classification of renewable energy sources and how to find out their origin and a way to motivate students in energy topics related to renewable sources and also, the development of didactic competencies in special blended learning arrangements for educationalists, trainers and lecturers in adult education in the field of renewable energies in Turkey. (author)

  20. Combating compassion fatigue: an exemplar of an approach to nursing renewal.

    Science.gov (United States)

    Romano, Jean; Trotta, Rebecca; Rich, Victoria L

    2013-01-01

    Compassion fatigue is a phenomenon commonly experienced by nurses. The cumulative emotional burden of caring for critically ill patients and their families, coupled with the increasing complexity of the health care practice environment, significantly drives the experience of compassion fatigue. Compassion fatigue can negatively impact nurses' physical and emotional well-being. If left unaddressed, compassion fatigue can lead to burnout among nurses. Burnout has been correlated to increased patient mortality, increased infection rates, and decreased patient satisfaction. In addition, it causes nurses to leave the nursing profession. Opportunities for nursing renewal, coupled with a leadership culture that values renewal practices, could combat the negative effects of compassion fatigue. A Center for Nursing Renewal was created at the Hospital of the University of Pennsylvania in Philadelphia, Pennsylvania, to provide a variety of renewal opportunities for nurses. This center is supported by a nursing culture that recognizes the ill effects of compassion fatigue and promotes wellness and renewal practices among nurses.

  1. Continuation Of Cultural Environment In Historic Renewal%历史地段更新中人文环境的延续

    Institute of Scientific and Technical Information of China (English)

    邱李亚

    2016-01-01

    In the social background of rapid change, historic area is facing double pressure of natural fade and commercial development, the lack of understanding of the historical cultural environment, the lack of the continuation of the human environment is the major dilemma in the protection. To solve this dilemma, this paper analyzes the characteristics and evolution mechanism of the humanistic environment connotation in the historical area, through the analysis of cases at home and abroad, discusses the measures to realize the continuation of human environment in the Historical Areas Renewal.%在社会快速变革背景下,历史地段面临自然消逝与商业开发的双重压力,对历史地段人文环境认识不足,缺乏延续人文环境的方法是保护工作需要面对的困境。针对这一困境,文章浅析了历史地段中人文环境的内涵、特点与演变机制,通过借助国内外相应案例的分析,探讨了历史地段更新中实现人文环境延续的措施。

  2. Renewable Energy

    DEFF Research Database (Denmark)

    Sørensen, Bent Erik

    Bent Sorensen’s Renewable Energy: Physics, Engineering, Environmental Impacts, Economics and Planning, Fifth Edition, continues the tradition by providing a thorough and current overview of the entire renewable energy sphere. Since its first edition, this standard reference source helped put...... renewable energy on the map of scientific agendas. Several renewable energy solutions no longer form just a marginal addition to energy supply, but have become major players, with the promise to become the backbone of an energy system suitable for life in the sustainability lane. This volume is a problem...... structured around three parts in order to assist readers in focusing on the issues that impact them the most for a given project or question. PART I covers the basic scientific principles behind all major renewable energy resources, such as solar, wind, and biomass. PART II provides in-depth information...

  3. A GIS-based decision support tool for renewable energy management and planning in semi-arid rural environments of northeast of Brazil-general description and methodology

    Energy Technology Data Exchange (ETDEWEB)

    Tiba, Chigueru; Fraidenraich, Naum; Souza Barbosa, Elielza Moura de [Dept. de Energia Nuclear da Univ. Federal de Pernambuco Recife, Pernambuco (Brazil); Bezerra Candeias, Ana Lucia [Dept. de Engenharia Cartografica da Univ. Federal de Pernambuco Recife, Pernambuco (Brazil); Carvalho Neto, Pedro Bezerra de; Melo Filho, Jose Bione de [Companhia Hidro Electrica do Sao Francisco -DTG- CHESF Recife, Pernambuco (Brazil)

    2008-07-01

    This work describes the development of a system of management and planning elaborated on a GIS platform (Geographic Information System) and is directed to decision makers, be they administrators, planners or consultants in renewable energy. It was conceived to deal with the management and planning of photovoltaic solar systems, biomass and aeolic energy in rural regions of the Northeast of Brazil. The prototype of the GIS tool covers an area of 183,500 km{sup 2} (in a second phase it will be extended to 1,561,178 km{sup 2}) and it is made up of two main blocks: management of installed renewable energy systems and planning of insertion of new renewable energy systems. The system was mainly developed for PV systems as a possible tool of support for the management and planning of the Program of Energetic Development of the States and Municipalities (PRODEEM), a program of insertion of large scale photovoltaic solar energy (thousands of systems), in the rural environment, directed by the Ministry of Mines and Energy of Brazil. The tool for the management of the photovoltaic systems permits the execution of the technical analyses that are involved in the different combinations of the following layers of information: PV systems installed for the purpose of application (energetic, water pumping and others), identification of systems components, identification of component failures, maintenance and training posts, map of monthly mean solar irradiation, infrastructure access, electric transmission lines and distance from a given municipality to the nearest maintenance post. All the maps above can be combined in such a way that information at state or municipal level can be obtained. Additionally, in all the circumstances above, resulting thematic maps as well as issue reports can be printed. The tool for planning the insertion of new photovoltaic systems permits the execution of the technical analyses that are involved in the different combinations of the following layers

  4. The Renewal of Cost Behavior in The Buyer-based Market Environment%买方市场环境下的成本习性创新

    Institute of Scientific and Technical Information of China (English)

    张艳辉

    2001-01-01

    Traditional cost behavior refers to cost quantitativebehavior.The formation of buyer-based environment makes cost behavior renew.This paper intends to combine the principle of competitive strategy and evaluation choice of competitive stategy in different analysis of cost behavior.%传统的成本习性指的是成本数量习性,买方市场环境的形成,使成本习性得以创新,本文将成本习性分析与竞争战略原理相结合,对不同成本习性分析下的竞争战略选择进行评价。

  5. Increasing Military Physician Productivity in a Managed Care Environment

    Science.gov (United States)

    1992-07-13

    allows us to obtain to a common denominator, or one single rating even though the services are dissimilar and the input units are not "weighted." Serway ...Productivity 34 Riley, J. (1992, May). Quality Improvement Means Better Productivity. Health care Executive. 7, 19-22. Serway , G. (1987). Alternative

  6. Human-centered environment design in intensive care unit

    NARCIS (Netherlands)

    Li, Y.; Albayrak, A.; Goossens, R.H.M.; Xiao, D.; Jakimowicz, J.J.

    2013-01-01

    Because of high risk and instability of the patients in Intensive care unit(ICU), the design of ICU is very difficult. ICU design, auxiliary building design, lighting design, noise control and other aspects can also enhance its management. In this paper, we compare ICU design in China and Holland ba

  7. Renewable energy.

    Science.gov (United States)

    Destouni, Georgia; Frank, Harry

    2010-01-01

    The Energy Committee of the Royal Swedish Academy of Sciences has in a series of projects gathered information and knowledge on renewable energy from various sources, both within and outside the academic world. In this article, we synthesize and summarize some of the main points on renewable energy from the various Energy Committee projects and the Committee's Energy 2050 symposium, regarding energy from water and wind, bioenergy, and solar energy. We further summarize the Energy Committee's scenario estimates of future renewable energy contributions to the global energy system, and other presentations given at the Energy 2050 symposium. In general, international coordination and investment in energy research and development is crucial to enable future reliance on renewable energy sources with minimal fossil fuel use.

  8. Caring for the Environment while Teaching Organic Chemistry

    Science.gov (United States)

    Santos, Elvira Santos; Gavilan Garcia, Irma Cruz; Lejarazo Gomez, Eva Florencia

    2004-01-01

    A comprehensive program in the field of green chemistry, which concentrates on processing and managing of wastes produced during laboratory experiments, is presented. The primary aim of the program is to instill a sense of responsibility and a concern for the environment through organic chemistry education.

  9. Critical Care Performance in a Simulated Military Aircraft Cabin Environment

    Science.gov (United States)

    2007-01-01

    cognitive effects of Alzheimer’s disease. Archives of Clinical Neuropsychology , 20, 403-408. Levitzky, M. (2003). Pulmonary physiology. New York: McGraw...L., Barderet, L., Levinson, D., & Reeves, D. (2007). Neuropsychological assessment in extreme environments. Archives of Clinical Neuropsychology , 22S

  10. Demands on obstetrical care in the urban environment: postpartal survey.

    Science.gov (United States)

    Ahner, R; Stokreiter, C; Bikas, D; Kubista, E; Husslein, P

    1999-12-01

    In recent years, obstetrical management reflecting the individual needs of parturient women and newborn children has acquired an increasing significance. Today, the majority of obstetrical departments provide alternatives to traditional methods of delivery. The purpose of this study was to analyze the current obstetric situation as perceived by the women concerned. During the lying-in period spent in the care of the obstetrical department, 386 women were interviewed as to their birth experience. The questionnaire employed used a predominantly structured format. The present study examined a total of six of Vienna's municipal hospitals. The majority of women interviewed were satisfied with the standard of care provided by obstetricians and midwives. However, certain administrative and organizational aspects were subject to criticism, for example, shift changes among the medical staff as well as the presence of an excessive number of people during delivery were felt to detract from the intimate character of giving birth. In general, the standards of care provided by urban obstetrical departments as well as the experience of giving birth itself confirmed women's expectations. However, certain areas remain where improvements seem both desirable and feasible without requiring undue effort. Women who gave a positive assessment of their personal experience of delivery also tended to carry away a favorable impression of their stay in hospital as a whole.

  11. Nursing Workload and the Changing Health Care Environment: A Review of the Literature

    Science.gov (United States)

    Neill, Denise

    2011-01-01

    Changes in the health care environment have impacted nursing workload, quality of care, and patient safety. Traditional nursing workload measures do not guarantee efficiency, nor do they adequately capture the complexity of nursing workload. Review of the literature indicates nurses perceive the quality of their work has diminished. Research has…

  12. Child-care environment and dietary intake of 2- and 3-year-old children

    NARCIS (Netherlands)

    Gubbels, J.S.; Kremers, S.P.J.; Stafleu, A.; Dagnelie, P.C.; Vries, N.K.de; Thijs, C.

    2010-01-01

    Background: Previous research has shown that children in child-care do not comply with dietary intake recommendations (i.e. either exceeding or not meeting recommendations), which may be attributable to specific features of the child-care environment. The present study explored the relationship betw

  13. The Context of Child Care for Toddlers: The "Experience Expectable Environment"

    Science.gov (United States)

    La Paro, Karen M.; Gloeckler, Lissy

    2016-01-01

    An experience expectable environment in child care classrooms is one in which teachers consistently provide positive and nurturing interactions within daily routines and activities to enhance children's learning. Growing numbers of children are being enrolled in child care at earlier ages and staying for longer periods of time each day which is…

  14. Preparing Air Force Nurses to Deliver Health Care in a Unique Operational Environment: Detainee Operations

    Science.gov (United States)

    2010-03-01

    challenging. Weiskopf described the inmate nursing care experience,‘It’s not like a hospital, because the whole purpose is the offender is there...facility’s primary mission focuses on custody of the detainee, not care of the detainee. Nursing care in prison systems has already been identified as...for custody; the offender is not there incarcerated to improve their health.ʹ 1 It is difficult for nurses to transition from an environment in

  15. Relationship between psychiatric nurse work environments and nurse burnout in acute care general hospitals.

    Science.gov (United States)

    Hanrahan, Nancy P; Aiken, Linda H; McClaine, Lakeetra; Hanlon, Alexandra L

    2010-03-01

    Following deinstitutionalization, inpatient psychiatric services moved from state institutions to general hospitals. Despite the magnitude of these changes, evaluations of the quality of inpatient care environments in general hospitals are limited. This study examined the extent to which organizational factors of the inpatient psychiatric environments are associated with psychiatric nurse burnout. Organizational factors were measured by an instrument endorsed by the National Quality Forum. Robust clustered regression analysis was used to examine the relationship between organizational factors in 67 hospitals and levels of burnout for 353 psychiatric nurses. Lower levels of psychiatric nurse burnout was significantly associated with inpatient environments that had better overall quality work environments, more effective managers, strong nurse-physician relationships, and higher psychiatric nurse-to-patient staffing ratios. These results suggest that adjustments in organizational management of inpatient psychiatric environments could have a positive effect on psychiatric nurses' capacity to sustain safe and effective patient care environments.

  16. The Erosion of Rights to Abortion Care in the United States: A Call for a Renewed Anthropological Engagement with the Politics of Abortion.

    Science.gov (United States)

    Andaya, Elise; Mishtal, Joanna

    2017-03-01

    Women's rights to legal abortion in the United States are now facing their greatest social and legislative challenges since its 1973 legalization. Legislation restricting rights and access to abortion care has been passed at state and federal levels at an unprecedented rate. Given the renewed vigor of anti-abortion movements, we call on anthropologists to engage with this shifting landscape of reproductive politics. This article examines recent legislation that has severely limited abortion access and maps possible directions for future anthropological analysis. We argue that anthropology can provide unique contributions to broader abortion research. The study of abortion politics in the United States today is not only a rich opportunity for applied and policy-oriented ethnographic research. It also provides a sharply focused lens onto broader theoretical concerns in anthropology and new social formations across moral, medical, political, and scientific fields in 21st-century America. © 2016 by the American Anthropological Association.

  17. Exploring staff perceptions on the role of physical environment in dementia care setting.

    Science.gov (United States)

    Lee, Sook Y; Chaudhury, Habib; Hung, Lillian

    2016-07-01

    This study explored staff perceptions of the role of physical environment in dementia care facilities in affecting resident's behaviors and staff care practice. We conducted focus groups with staff (n = 15) in two purposely selected care facilities in Vancouver, Canada. Focus group participants included nurses, care aides, recreation staff, administrative staff, and family. Data analysis revealed two themes: (a) a supportive physical environment contributes positively to both quality of staff care interaction and residents' quality of life and (b) an unsupportive physical environment contributes negatively to residents' quality of life and thereby makes the work of staff more challenging. The staff participants collectively viewed that comfort, familiarity, and an organized space were important therapeutic resources for supporting the well-being of residents. Certain behaviors of residents were influenced by poor environmental factors, including stimulation overload, safety risks, wayfinding challenge, and rushed care This study demonstrates the complex interrelationships among the dementia care setting's physical environment, staff experiences, and residents' quality of life.

  18. Nursing work environment, patient safety and quality of care in pediatric hospital.

    Science.gov (United States)

    Alves, Daniela Fernanda Dos Santos; Guirardello, Edinêis de Brito

    2016-06-01

    Objectives To describe the characteristics of the nursing work environment, safety attitudes, quality of care, measured by the nursing staff of the pediatric units, as well as to analyze the evolution of quality of care and hospital indicators. Methods Descriptive study with 136 nursing professionals at a paediatric hospital, conducted through personal and professional characterization form, Nursing Work Index - Revised, Safety Attitudes Questionnaire - Short Form 2006 and quality indicators. Results The professionals perceive the environment as favourable to professional practice, and consider good quality care that is also observed by reducing the incidence of adverse events and decreased length of stay. The domain job satisfaction was considered favourable to patient safety. Conclusions The work environment is favourable to nursing practice, the professionals nursing approve the quality of care and the indicators tended reducing adverse events and length of stay.

  19. Content Validity for a Child Care Self-assessment Tool: Creating Healthy Eating Environments Scale (CHEERS).

    Science.gov (United States)

    Lafave, Lynne; Tyminski, Sheila; Riege, Theresa; Hoy, Diane; Dexter, Bria

    2016-06-01

    The purpose of this project was to develop and content validate both a formative and summative self-assessment scale designed to measure the nutrition and physical activity environment in community-based child care programs. The study followed a mixed-method modified Ebel procedure. An expert group with qualifications in nutrition, physical activity, and child care were recruited for content validation. The survey was subjected to expert review through digital communication followed by a face-to-face validation meeting. To establish consensus for content validity beyond the standard error of proportion (P healthy eating program planning, healthy eating environment, physical activity environment, and healthy body image environment. Content validation is an integral step in scale development that is often overlooked or poorly carried out. Initial content validity of this scale has been established and will be of value to researchers and practitioners interested in conducting healthy eating interventions in child care.

  20. Impact of nurse work environment and staffing on hospital nurse and quality of care in Thailand.

    Science.gov (United States)

    Nantsupawat, Apiradee; Srisuphan, Wichit; Kunaviktikul, Wipada; Wichaikhum, Orn-Anong; Aungsuroch, Yupin; Aiken, Linda H

    2011-12-01

    To determine the impact of nurse work environment and staffing on nurse outcomes, including job satisfaction and burnout, and on quality of nursing care. Secondary data analysis of the 2007 Thai Nurse Survey. The sample consisted of 5,247 nurses who provided direct care for patients across 39 public hospitals in Thailand. Multivariate logistic regression was used to estimate the impact of nurse work environment and staffing on nurse outcomes and quality of care. Nurses cared for an average of 10 patients each. Forty-one percent of nurses had a high burnout score as measured by the Maslach Burnout Inventory; 28% of nurses were dissatisfied with their job; and 27% rated quality of nursing care as fair or poor. At the hospital level, after controlling for nurse characteristics (age, years in unit), the addition of each patient to a nurse's workload was associated with a 2% increase in the odds on nurses reporting high emotional exhaustion (odds ratio [OR] 1.02; 95% confidence interval [CI] 1.00-1.03; p work environments were about 30% less likely to report fair to poor care quality (OR 0.69; 95% CI 0.48-0.98; p work environments. The addition of each patient to a nurse's workload was associated with a 4% increase in the odds on nurses reporting quality of nursing care as fair or poor (OR 1.04; 95% CI 1.02-1.05; p work environments and nurse staffing in Thai hospitals holds promise for reducing nurse burnout, thus improving nurse retention at the hospital bedside as well as potentially improving the quality of care. Nurses should work with management and policymakers to achieve safe staffing levels and good work environments in hospitals throughout the world. © 2011 Sigma Theta Tau International.

  1. Marketing and the medical specialist in the managed care environment.

    Science.gov (United States)

    Treister, N W

    1997-01-01

    Marketing means more than just communicating or advertising to potential patients; marketing means identifying your customers and working to meet or exceed their expectations. There are five key areas of a marketing plan: (1) Establish the foundation, beginning with your mission statement; (2) Assess your marketing environment by internal and external research; (3) Target your efforts, looking at image and perception; (4) Develop your particular mix of product, price, place of distribution, and promotion; and (5) implement and evaluate your marketing process. This article discusses the importance of a marketing plan for the medical specialist and highlights the features unique to a practice working in a system of capitated reimbursement. Applying these principles will help to demonstrate added value, protect the fundamental role of the patient-physician relationship, ensure that our efforts are aligned with professional missions and goals, and ultimately increase profitability and professional success.

  2. Planning the acoustic environment of a neonatal intensive care unit.

    Science.gov (United States)

    Philbin, M Kathleen

    2004-06-01

    This article addresses general principles of designing a quiet neonatal intensive care unit (NICU) and describes basic aspects of room acoustics as these apply to the NICU. Recommended acoustical criteria for walls, background noise, vibration, and reverberation are included as appendices. Crowding in open, multiple-bed NICUs is the major factor in designs that inevitably produce noisy nurseries with limited space for parents. Quiet infant spaces with appropriate sound sources rely on isolation of the infant from facility and operational noise sources (eg, adult work spaces, supply delivery, and travel paths) and extended contact with family members.However, crowding has been an important influence on the clinical practice and social context of neonatology. It allows clinicians to rely on wide visual and auditory access to many patients for monitoring their well-being. It also allows immediate social contact with other adults, both staff and families. Giving up this wide access and relying on other forms of communication in order to provide for increased quiet and privacy for staff, infants, and parents is a challenge for some design teams. Studies of the effects of various nursery designs on infants, parents, clinicians, and the delivery of services are proposed as a means of advancing the field of design.

  3. INFLUENCE OF SOCIOECONOMIC AND DEMOGRAPHIC ENVIRONMENT ON PRIVATE HEALTH CARE PROVIDERS

    Directory of Open Access Journals (Sweden)

    Lana Kordić

    2013-02-01

    Full Text Available Health care systems face pressure to increase the quality of health care at the same time with pressure to reduce public spending. The attempt to overcome the gap between needs and opportunities can be resolved through the introduction of public-private partnerships. Goals of this study are to investigate variation of the number, form and efficiency of private providers of general/family medicine services in primary health care and the contribution of socioeconomic and demographic environment on those variations, among counties. Socioeconomic and demographic factors are identified as independent variables that influence the health care need and utilization and consequently the decision of private entities to engage in the provision of health care services. This study extended previous studies because it has introduced socioeconomic and demographic variables. This may shed same new lights on the relationship between private providers of health service and efficiency of providing health service in primary health care.

  4. Healing environments in cancer treatment and care. Relations of space and practice in hematological cancer treatment.

    Science.gov (United States)

    Høybye, Mette Terp

    2013-02-01

    Given the growing attention to the importance of design in shaping healing hospital environments this study extends the understanding of healing environments, beyond causal links between environmental exposure and health outcome by elucidating how environments and practices interrelate. The study was conducted as an ethnographic fieldwork from March 2011 to September 2011 at the Department of Haematology at Odense University Hospital, Denmark, systematically using participant observation and interviews as research strategies. It included 20 patients, four of who were followed closely over an extended time period. Through thematic analysis five key concepts emerged about the social dynamics of hospital environments: practices of self; creating personal space; social recognition; negotiating space; and ambiguity of space and care. Through these concepts, the study demonstrates how the hospital environment is a flow of relations between space and practice that changes and challenges a structural idea of design and healing. Patients' sense of healing changes with the experience of progression in treatment and the capacity of the hospital space to incite an experience of homeliness and care. Furthermore, cancer patients continuously challenge the use and limits of space by individual objects and practices of privacy and home. Healing environments are complex relations between practices, space and care, where recognition of the individual patient's needs, values and experiences is key to developing the environment to support the patient quality of life. The present study holds implications for practice to inform design of future hospital environments for cancer treatment. The study points to the importance for being attentive to the need for flexible spaces in hospitals that recognize the dynamics of healing, by providing individualized care, relating to the particular and changing needs of patients supporting their potential and their challenged condition with the best

  5. Renewable Energy

    Science.gov (United States)

    Boyle, Godfrey

    2004-05-01

    Stimulated by recent technological developments and increasing concern over the sustainability and environmental impact of conventional fuel usage, the prospect of producing clean, sustainable power in substantial quantities from renewable energy sources arouses interest around the world. This book provides a comprehensive overview of the principal types of renewable energy--including solar, thermal, photovoltaics, bioenergy, hydro, tidal, wind, wave, and geothermal. In addition, it explains the underlying physical and technological principles of renewable energy and examines the environmental impact and prospects of different energy sources. With more than 350 detailed illustrations, more than 50 tables of data, and a wide range of case studies, Renewable Energy, 2/e is an ideal choice for undergraduate courses in energy, sustainable development, and environmental science. New to the Second Edition ·Full-color design ·Updated to reflect developments in technology, policy, attitides ·Complemented by Energy Systems and Sustainability edited by Godfrey Boyle, Bob Everett and Janet Ramage, all of the Open University, U.K.

  6. Electric car with solar and wind energy may change the environment and economy: A tool for utilizing the renewable energy resource

    Science.gov (United States)

    Liu, Quanhua

    2014-01-01

    Energy and environmental issues are among the most important problems of public concern. Wind and solar energy may be one of the alternative solutions to overcome energy shortage and to reduce greenhouse gaseous emission. Using electric cars in cities can significantly improve the air quality there. Through our analyses and modeling on the basis of the National Centers for Environment Prediction data we confirm that the amount of usable solar and wind energy far exceeds the world's total energy demand, considering the feasibility of the technology being used. Storing the surplus solar and wind energy and then releasing this surplus on demand is an important approach to maintaining uninterrupted solar- and wind-generated electricity. This approach requires us to be aware of the available solar and wind energy in advance in order to manage their storage. Solar and wind energy depends on weather conditions and we know weather forecasting. This implies that solar and wind energy is predictable. In this article, we demonstrate how solar and wind energy can be forecasted. We provide a web tool that can be used by all to arrive at solar and wind energy amount at any location in the world. The tool is available at http://www.renewableenergyst.org. The website also provides additional information on renewable energy, which is useful to a wide range of audiences, including students, educators, and the general public.

  7. Environment project: 50 measures for a development of the high environmental quality renewable energies; Grenelle Environnement: 50 mesures pour un developpement des energies renouvelables a haute qualite environnementale

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-11-15

    This document presents the 50 measures decided by the government to develop the renewable energies in France and reach the 20% of participation to the energy production in 2020. Some measures concern all the renewable energies, they deal with the regulation, the administrative procedures of the building, others are specific to each energy. (A.L.B.)

  8. Quotidian of accompanying family members in an environment of care: the emergence of hospital tribes

    Directory of Open Access Journals (Sweden)

    Silvia da Silva Santos Passos

    2016-06-01

    Full Text Available ABSTRACT OBJECTIVE Understand the quotidian relationships of accompanying family members in an environment of care, which are close to the metaphor of a tribe in hospital environment. METHODQualitative study with data gathered from semi-structured interviews and observations with 16 family members accompanying hospitalized individuals with dependence on self-care. Data were submitted to thematic analysis, and analyzed through the metaphor of "tribe" proposed by comprehensive sociology. RESULTS Family members build up social clusters around caring, where we find traits typical of tribes: emotional ambience; solidarity based on links of sympathy and mutual assistance; an affectual nebula in the process of interaction; a logic of fusion in tactile relations; and communion/religiosity in the process of connecting in a collective identity. CONCLUSION In the presence of tragedy, families build social clusters similar to tribes having care as a totem.

  9. Healing environments in cancer treatment and care. Relations of space and practice in hematological cancer treatment

    DEFF Research Database (Denmark)

    Høybye, Mette Terp

    2013-01-01

    to incite an experience of homeliness and care. Furthermore, cancer patients continuously challenge the use and limits of space by individual objects and practices of privacy and home. Discussion. Healing environments are complex relations between practices, space and care, where recognition...... to the need for fl exible spaces in hospitals that recognize the dynamics of healing, by providing individualized care, relating to the particular and changing needs of patients supporting their potential and their challenged condition with the best care possible....... these concepts, the study demonstrates how the hospital environment is a fl ow of relations between space and practice that changes and challenges a structural idea of design and healing. Patients ’ sense of healing changes with the experience of progression in treatment and the capacity of the hospital space...

  10. Effect of work environment on care managers' role ambiguity: an exploratory study in Japan.

    Science.gov (United States)

    Yoshie, Satoru; Saito, Tami; Takahashi, Miyako; Kai, Ichiro

    2008-01-01

    Previous literature pointed out that the role of care managers is ambiguous. In 2000, Japan instituted a new policy for long-term care of the elderly (the National Long-Term Care Insurance Policy), within which the work of care managers was recognized as a new profession providing care management services for the elderly needing care. We conducted a random-sampled mail survey on 530 care managers in 268 organizations to clarify the association between role ambiguity and care managers' work environments, including role clarification, organizational profit-seeking climate, and the utilization of professional and personal support. The results showed that fewer opportunities for role clarification and increased organizational profit-seeking climate were associated with greater role ambiguity for care managers. Furthermore, emotional and instrumental support from colleagues and external resources were positively associated with role ambiguity, while informational support from superiors was negatively associated with role ambiguity. Role clarification and the utilization of support within and outside of work organizations would be beneficial to reduce the role ambiguity of care managers.

  11. Health care utilization patterns in developing countries: role of the technology environment in "deriving" the demand for health care.

    Science.gov (United States)

    Wouters, A V

    1992-01-01

    Health care services, in combination with several intermediate (proximate) determinants of health such as environmental sanitation and nutrition, directly influence health status. In the economics literature, this is referred to as the health production technology. Although many studies recognize that demand for health care depends on the health production technology, otherwise known as a "derived" demand, this review indicates that few of them have so far been able to fully incorporate this technology in estimating significant determinants of health care use. Understanding the technology environment could help explain why substantial portions of the population do not gain access to care even when financial factors do not appear to be a barrier. Also, low utilization of health services may simply reflect the low productivity of these services when other complementary factors such as nutrition or clean water and sanitation are lacking. Finally, since health-producing technology is often a multistep (multivisit) process, health care demand studies generally offer an incomplete picture of health care utilization patterns because they focus on a single event such as the first visit of an illness episode. Researchers should obtain more complete information on the interaction between all health production inputs, their availability and access to them. Multidisciplinary methodologies are likely to be useful.

  12. RFID monitoring of health care routines and processes in hospital environment

    OpenAIRE

    2006-01-01

    This thesis discusses radio frequency identications (RFID) and its applications in hospital environment. RFID technology opens up possibilities to construct novel intelligent systems for monitoring and tracking purposes. Tracking systems can collect data on daily processes and care routines and this information can be used both for quality control and for improving care processes and logistics. The work consists of a literature review and an applied systems design. The literature review l...

  13. Current views of health care design and construction: practical implications for safer, cleaner environments.

    Science.gov (United States)

    Bartley, Judene M; Olmsted, Russell N; Haas, Janet

    2010-06-01

    Infection preventionists (IP) play an increasingly important role in preventing health care-associated infection in the physical environment associated with new construction or renovation of health care facilities. The Guidelines for Design and Construction of Hospital and Healthcare Facilities, 2010, formerly known as "AIA Guidelines" was the origin of the "infection control risk assessment" now required by multiple agencies. These Guidelines represent minimum US health care standards and provide guidance on best practices. They recognize that the built environment has a profound affect on health and the natural environment and require that health care facilities be designed to "first, do no harm." This review uses the Guidelines as a blueprint for IPs' role in design and construction, updating familiar concepts to the 2010 edition with special emphasis on IP input into design given its longer range impact on health care-associated infection prevention while linking to safety and sustainability. Section I provides an overview of disease transmission risks from the built environment and related costs, section II presents a broad view of design and master planning, and section III addresses the detailed design strategies for infection prevention specifically addressed in the 2010 Facility Guidelines Institute edition.

  14. The influence of environment in palliative care: supporting or hindering experiences of 'at-homeness'.

    Science.gov (United States)

    Rasmussen, Birgit H; Edvardsson, David

    2007-12-01

    Florence Nightingale stated that the art of nursing is to provide an environment in which the patient is in the best position for nature to act upon, and Martha Rogers, in turn, emphasized that one part in nursing is to pattern the environment into a place where healing conditions are optimal. This paper presents a preliminary conceptual framework that describes the influence of environment in palliative care. Based on previously published studies, a conceptual framework describing the influence of environments in palliative care was developed consisting of an atmosphere of hospitality; an atmosphere of safety; and, an atmosphere of 'everydayness'. The framework describes that the atmosphere is created in the meeting between the person's needs/expectations and the environment, an atmosphere that can influence experiential outcomes of 'at-homeness' or homelessness in the palliative care setting. In conclusion, this preliminary conceptual framework may contribute to nursing practice by providing a conceptual basis for actively reflecting on and evaluating the atmosphere in palliative care settings.

  15. Healing environments in cancer treatment and care. Relations of space and practice in hematological cancer treatment

    DEFF Research Database (Denmark)

    Høybye, Mette Terp

    2013-01-01

    of the individual patient ’ s needs, values and experiences is key to developing the environment to support the patient quality of life. The present study holds implications for practice to inform design of future hospital environments for cancer treatment. The study points to the importance for being attentive...... these concepts, the study demonstrates how the hospital environment is a fl ow of relations between space and practice that changes and challenges a structural idea of design and healing. Patients ’ sense of healing changes with the experience of progression in treatment and the capacity of the hospital space...... to incite an experience of homeliness and care. Furthermore, cancer patients continuously challenge the use and limits of space by individual objects and practices of privacy and home. Discussion. Healing environments are complex relations between practices, space and care, where recognition...

  16. Translational Cognition for Decision Support in Critical Care Environments: A Review

    Science.gov (United States)

    Patel, Vimla L.; Zhang, Jiajie; Yoskowitz, Nicole A.; Green, Robert; Sayan, Osman R.

    2008-01-01

    The dynamic and distributed work environment in critical care requires a high level of collaboration among clinical team members and a sophisticated task coordination system to deliver safe, timely and effective care. A complex cognitive system underlies the decision-making process in such cooperative workplaces. This methodological review paper addresses the issues of translating cognitive research to clinical practice with a specific focus on decision-making in critical care, and the role of information and communication technology to aid in such decisions. Examples are drawn from studies of critical care in our own research laboratories. Critical care, in this paper, includes both intensive (inpatient) and emergency (outpatient) care. We define translational cognition as the research on basic and applied cognitive issues that contribute to our understanding of how information is stored, retrieved and used for problem-solving and decision-making. The methods and findings are discussed in the context of constraints on decision-making in real world complex environments and implications for supporting the design and evaluation of decision support tools for critical care health providers. PMID:18343731

  17. [Compassionate care, emergence of a notion in the light and shade of the care environment].

    Science.gov (United States)

    Casagrande, Alice

    2016-05-01

    Compassionate care is a recent notion. It is based on a shared culture which focuses on promoting the rights of vulnerable people, integral to the quality of professionals' life at work. Tangible and part of day-to-day practice, it requires room to be set aside for discussion and ethical considerations, essential for ensuring the long-lasting creativity of caregivers, at the source of their mobilisation.

  18. Work Environment and Japanese Fathers' Involvement in Child Care

    Science.gov (United States)

    Ishii-Kuntz, Masako

    2013-01-01

    Previous studies mainly examined individual and family factors affecting Japanese fathers' involvement in child care. Along with these factors, we examine how work-related factors such as father-friendly environment at work, workplace's accommodation of parental needs, job stress, and autonomy are associated with Japanese men's…

  19. Quality of Child Care Using the Environment Rating Scales: A Meta-Analysis of International Studies

    Science.gov (United States)

    Vermeer, Harriet J.; van IJzendoorn, Marinus H.; Cárcamo, Rodrigo A.; Harrison, Linda J.

    2016-01-01

    The current study provides a systematic examination of child care quality around the globe, using the Environment Rating Scales (ERS). Additional goals of this study are to examine associations between ERS process quality and structural features (group size, caregiver-child ratio) that underpin quality and between ERS and more proximal aspects of…

  20. Learning to care for older patients : hospitals and nursing homes as learning environments

    NARCIS (Netherlands)

    Huls, Marije; de Rooij, Sophia E; Diepstraten, Annemie; Koopmans, Raymond; Helmich, Esther

    2015-01-01

    CONTEXT: A significant challenge facing health care is the ageing of the population, which calls for a major response in medical education. Most clinical learning takes place within hospitals, but nursing homes may also represent suitable learning environments in which students can gain competencies

  1. Learning to care for older patients: hospitals and nursing homes as learning environments

    NARCIS (Netherlands)

    Huls, M.; Rooij, S.E. De; Diepstraten, A.; Koopmans, R.T.C.M.; Helmich, E.

    2015-01-01

    CONTEXT: A significant challenge facing health care is the ageing of the population, which calls for a major response in medical education. Most clinical learning takes place within hospitals, but nursing homes may also represent suitable learning environments in which students can gain competencies

  2. The Language Environment of Toddlers in Center-Based Care versus Home Settings

    Science.gov (United States)

    Murray, Ann D.; Fees, Bronwyn S.; Crowe, Linda K.; Murphy, Molly E.; Henriksen, Amanda L.

    2006-01-01

    Children's language development is significantly affected by the quantity and quality of language input, particularly during infancy and toddlerhood. The purpose of this study was to compare the language environment in an accredited child care program with data collected by Hart and Risley (1995). Fourteen toddlers (mean age 24.4 months) were…

  3. Learning to care for older patients : hospitals and nursing homes as learning environments

    NARCIS (Netherlands)

    Huls, Marije; de Rooij, Sophia E; Diepstraten, Annemie; Koopmans, Raymond; Helmich, Esther

    2015-01-01

    CONTEXT: A significant challenge facing health care is the ageing of the population, which calls for a major response in medical education. Most clinical learning takes place within hospitals, but nursing homes may also represent suitable learning environments in which students can gain competencies

  4. Pharmaceuticals and Personal Care Products in the Environment: What are the Big Questions?

    Science.gov (United States)

    Over the past 10-15 years, a significant amount of work has been done by the scientific, regulatory and business communities into effects and risks of pharmaceuticals and personal care products (PPCPs) in the environment. It is now timely to review the current knowledge and to...

  5. Parental care-giving and home environment predicting offspring's temperament and character traits after 18 years.

    Science.gov (United States)

    Josefsson, Kim; Jokela, Markus; Hintsanen, Mirka; Cloninger, Claude Robert; Pulkki-Råback, Laura; Merjonen, Päivi; Hutri-Kähönen, Nina; Keltikangas-Järvinen, Liisa

    2013-10-30

    Although many personality theories emphasize the role of parental behaviors in shaping personality development, empirical data from longitudinal studies remain scarce. It is also not known, if parental behaviors affect character development more strongly than temperament or vice versa. In a prospective study, 1083 volunteer participants of the Young Finns study completed the Temperament and Character Inventory (TCI). Parents of the participants had answered questions about parenting attitudes, socioeconomic status, health behaviors, and role satisfaction 18 years before. We studied the univariate and the cumulative effects of parental care-giving and family environment on offspring's personality traits. Parental care-giving and home-environment were more strongly associated with offspring character traits reflecting personality maturity (Self-directedness and Cooperativeness) than with offspring temperament traits (Novelty seeking, Harm avoidance, Reward dependence and Persistence) reflecting emotional and behavioral tendencies. The differences were most evident in the cumulative effects model. Maternal variables were stronger predictors than paternal variables. The present findings suggest that not all personality traits are similarly predicted by parental care-giving and home-environment. In particular, character development is more strongly related to such measures than temperament. Parental care-giving and home-environment are more strongly related to psychological maturity (character) than emotional and behavioral tendencies (temperament).

  6. Implementing AORN recommended practices for a safe environment of care, part II.

    Science.gov (United States)

    Kennedy, Lynne

    2014-09-01

    Construction in and around a working perioperative suite is a challenge beyond merely managing traffic patterns and maintaining the sterile field. The AORN "Recommended practices for a safe environment of care, part II" provides guidance on building design; movement of patients, personnel, supplies, and equipment; environmental controls; safety and security; and control of noise and distractions. Whether the OR suite evolves through construction, reconstruction, or remodeling, a multidisciplinary team of construction experts and health care professionals should create a functional plan and communicate at every stage of the project to maintain a safe environment and achieve a well-designed outcome. Emergency preparedness, a facility-wide security plan, and minimization of noise and distractions in the OR also help enhance the safety of the perioperative environment.

  7. [Psychosocial stress environment and health workers in public health: Differences between primary and hospital care].

    Science.gov (United States)

    García-Rodríguez, Antonio; Gutiérrez-Bedmar, Mario; Bellón-Saameño, Juan Ángel; Muñoz-Bravo, Carlos; Fernández-Crehuet Navajas, Joaquín

    2015-01-01

    To describe the psychosocial environment of health professionals in public health in primary and hospital care, and compare it with that of the general Spanish working population, as well as to evaluate the effect of psychosocial risk factors on symptoms related to perceived stress. Cross-sectional study with stratified random sampling. Health care workers in the province of Granada, distributed in 5 hospitals and 4 health districts. A total of 738 employees (medical and nursing staff) of the Andalusian Health Service (SAS) were invited to take part. CopSoQ/Istas21 questionnaire developed for the multidimensional analysis of the psychosocial work environment. Stress symptoms were measured with the Stress Profile questionnaire. The response rate was 67.5%. Compared with the Spanish workforce, our sample showed high cognitive, emotional, and sensory psychological demands, possibilities for development and sense of direction in their work. Primary care physicians were the group with a worse psychosocial work environment. All the groups studied showed high levels of stress symptoms. Multivariate analysis showed that variables associated with high levels of stress symptom were younger and with possibilities for social relations, role conflict, and higher emotional demands, and insecurity at work. Our findings support that the psychosocial work environment of health workers differs from that of the Spanish working population, being more unfavorable in general practitioners. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  8. Influence of the helicopter environment on patient care capabilities: flight crew perceptions

    Science.gov (United States)

    Myers, K. J.; Rodenberg, H.; Woodard, D.

    1995-01-01

    INTRODUCTION: Flight crew perceptions of the effect of the rotary-wing environment on patient-care capabilities have not been subject to statistical analysis. We hypothesized that flight crew members perceived significant difficulties in performing patient-care tasks during air medical transport. METHODS: A survey was distributed to a convenience sample of flight crew members from 20 flight programs. Respondents were asked to compare the difficulty of performing patient-care tasks in rotary-wing and standard (emergency department or intensive care unit) settings. Demographic data collected on respondents included years of flight experience, flights per month, crew duty position and primary aircraft in which the respondent worked. Statistical analysis was performed as appropriate using Student's t-test, type III sum of squares, and analysis of variance. Alpha was defined as p responded. All tasks were significantly rated more difficult in the rotary-wing environment. Ratings were not significantly correlated with flight experience, duty position, flights per month or aircraft used. CONCLUSIONS: We conclude that the performance of patient-care tasks are perceived by air medical flight crew to be significantly more difficult during rotary-wing air medical transport than in hospital settings.

  9. FDAMA Section 114: Why the Renewed Interest?

    Science.gov (United States)

    Perfetto, Eleanor M; Burke, Laurie; Oehrlein, Elisabeth M; Gaballah, Mena

    2015-05-01

    The FDA regulates the use of information by biopharmaceutical companies in their promotional activities. Section 114 of the Food and Drug Administration Modernization Act of 1997 (FDAMA) was specifically designed to allow companies to more readily disseminate health care economic information (HCEI) to those who need it for formulary decision making. However, very little HCEI has been distributed promotionally under this provision over the past 17 years. There are recent discussions by stakeholders regarding the need for updates, revisions, or guidance regarding Section 114.In light of recent renewed interest in Section 114 of the FDAMA, the purpose of this commentary is to equip managed care decision makers with the information they need to understand and respond to industry communications that are governed by Section 114. This commentary reviews and synthesizes the regulatory history and language of the statute and changes to the promotion regulation generated by Section 114. It explores the reasons for the section's limited use to date, for recent renewed interest, and why changes by various stakeholders are suggested at this time. Also discussed is what managed care pharmacists need to know about Section 114, and suggestions are included regarding the active role pharmacists can play in this change process. Renewed interest in FDAMA Section 114 appears to stem largely from the increasingly visible and growing interest in comparative effectiveness research, the emergence of "big data," the expanding range of data sources available for deriving HCEI, and recent court decisions that might indicate a change in the regulatory environment. Various stakeholders are proposing recommendations regarding changes to FDAMA Section 114. Managed care pharmacists should be aware that companies are restricted when communicating HCEI promotional messages; this may mean seeing the use of FDAMA Section 114 as the "competent and reliable" effectiveness standard in promotion. If the

  10. Tribally Affiliated Child-Care Center Environment and Obesogenic Behaviors in Young Children.

    Science.gov (United States)

    Sisson, Susan B; Stoner, Julie; Li, Ji; Stephens, Lancer; Campbell, Janis E; Lora, Karina R; Arnold, Sandra H; Horm, Diane; DeGrace, Beth

    2017-03-01

    Child-care centers are an integral part of life for many families with young children. American Indian children are at elevated health risk because of higher levels of obesity and associated health behaviors. Our aim was to assess the child-care environment and children's physical activity (PA) and dietary intake in young children attending tribally affiliated child care. We conducted a cross-sectional study. Participants were from 11 tribally affiliated child-care centers across Oklahoma and included 82 children aged 3 to 5 years old. Classroom observations were conducted using the Environmental and Policy Assessment Observation to measure PA and nutrition environments. Children wore an ActiGraph GT3X accelerometer and lunchtime plate waste was observed. Descriptive statistics, including mean±standard deviation and frequencies, were calculated for the children's behaviors and environment. The total environment score was 23.9±5.2 (maximum=43). The nutrition score was 12.5±3.1 (maximum=21). The PA score was 11.7±2.2 (maximum=22). The participants were 3.8±0.1 years old, 55% were male, 67% were American Indian, and 38% were overweight or obese. Accelerometers were worn for 5.9±1.7 hours, excluding naptime. Children accumulated 4.3±2.2 min/h of moderate to vigorous PA, 4,294±1,883 steps/day, and 12.1±3.7 steps/min. At lunch, children were served 510±241 kcal, and consumed 387±239 kcal. Lunches consisted of 47% carbohydrate, 20% protein, and 33% fat. Total number of F/V served was 2.9±1.9 and consumed was 2.3±1.8, while whole grains served and consumed were 0.3±0.4 and 0.2±0.4, respectively, and lean proteins served and consumed were 0.3±0.4 and 0.2±0.4, respectively. This study describes obesogenic aspects of the child-care environment and identifies areas for improvement. Children did not accumulate adequate PA or consume calories or fat excessively. Children consumed multiple F/V; however, more whole grains and lean proteins could be provided

  11. Pharmaceuticals and personal care products (PPCPs in the freshwater aquatic environment

    Directory of Open Access Journals (Sweden)

    Anekwe Jennifer Ebele

    2017-03-01

    Full Text Available Pharmaceuticals and personal care products (PPCPs are a unique group of emerging environmental contaminants, due to their inherent ability to induce physiological effects in human at low doses. An increasing number of studies has confirmed the presence of various PPCPs in different environmental compartments, which raises concerns about the potential adverse effects to humans and wildlife. Therefore, this article reviews the current state-of-knowledge on PPCPs in the freshwater aquatic environment. The environmental risk posed by these contaminants is evaluated in light of the persistence, bioaccumulation and toxicity criteria. Available literature on the sources, transport and degradation of PPCPs in the aquatic environment are evaluated, followed by a comprehensive review of the reported concentrations of different PPCP groups in the freshwater aquatic environment (water, sediment and biota of the five continents. Finally, future perspectives for research on PPCPs in the freshwater aquatic environment are discussed in light of the identified research gaps in current knowledge.

  12. Structural characteristics of hospitals and nurse-reported care quality, work environment, burnout and leaving intentions.

    Science.gov (United States)

    Lindqvist, Rikard; Smeds Alenius, Lisa; Griffiths, Peter; Runesdotter, Sara; Tishelman, Carol

    2015-03-01

    To investigate whether hospital characteristics not readily susceptible to change (i.e. hospital size, university status, and geographic location) are associated with specific self-reported nurse outcomes. Research often focuses on factors within hospitals (e.g. work environment), which are susceptible to change, rather than on structural factors in their own right. However, numerous assumptions exist about the role of structural factors that may lead to a sense of pessimism and undermine efforts at constructive change. Data was derived from survey questions on assessments of work environment and satisfaction, intention to leave, quality of care and burnout (measured by the Maslach Burnout Inventory), from a population-based sample of 11 000 registered nurses in Sweden. Mixed model regressions were used for analysis. Registered nurses in small hospitals were slightly more likely to rank their working environment and quality of nursing care better than others. For example 23% of staff in small hospitals were very satisfied with the work environment compared with 20% in medium-sized hospitals and 21% in large hospitals. Registered nurses in urban areas, who intended to leave their job, were more likely to seek work in another hospital (38% vs. 32%). While some structural factors were related to nurse-reported outcomes in this large sample, the associations were small or of questionable importance. The influence of structural factors such as hospital size on nurse-reported outcomes is small and unlikely to negate efforts to improve work environment. © 2013 John Wiley & Sons Ltd.

  13. The health care needs of the physically disabled patient in a home-based care environment: Implications for the training of ancillary health care workers

    Directory of Open Access Journals (Sweden)

    Monica Springe

    2010-03-01

    Full Text Available According to existing literature, ancillary health care workers (AHCWs often do not meet the health care needs of patients with physical disabilities (physically disabled patients in a homebased environment, because of inadequate training programmes. The purpose of this research study was to explore the health care needs of physically disabled patients in long-term, home-based care in the northern suburbs of Johannesburg and, based on results, to offer recommendations for the training of AHCWs. Qualitative, exploratory, descriptive and contextual means were employed in data collection and analysis. The population consisted of eight physically disabled participants who employed an AHCW to assist them with their long-term home care. Purposive sampling was used with subsequent snowballing to identify further participants for the study. Individual interviews were conducted, where participants had to answer the questions (1‘What are your health care needs?’ and(2 ‘How should these be met?’ Data saturation was ensured, after which Tesch’s method of data analysis was followed. Three categories of health care needs were identified (1 physical health care needs, (2 interpersonal relationship needs and (3 social needs, and 12 themes were derived from these categories. These categories of health care needs should be addressed in the training of AHCWs.From the themes, recommendations were described for the training of AHCWs on the health care needs of the home-based physically disabled patients. The AHCW should assist in the adaptation of the environment to the patient’s individual needs, and should use knowledge and critical thinking skills to ensure a patient-centred care setting.

    Opsomming

    Volgens die literatuur kan assistentgesondheidsorgwerkers (AGWs, as gevolg van ontoereikende opleiding, nie altyd aan die behoeftes van fisies gestremde pasiënte in 'n tuisopset voldoen nie.Die doel van hierdie navorsingstudie was

  14. Evaluation and comparison of health care Work Environment Scale in military settings.

    Science.gov (United States)

    Maloney, J P; Anderson, F D; Gladd, D L; Brown, D L; Hardy, M A

    1996-05-01

    The purpose of this study was to describe health care providers' perceptions of their work environment at a large U.S. Army medical center, and to compare the findings to other military medical centers. The sample (N = 112) consisted of the professional nursing staff working on the nine inpatient units. The Work Environmental Scale (WES) was used to measure perceptions of the workplace relative to gender, position (head nurses, staff nurses, and agency nurses), specialty nursing (intensive care unit [ICU] versus non-ICU), education (MSN, BSN, and ADN), and patterns of differences between the WES subscales of four military medical centers. Results of the study indicate that there were no significant gender differences. Head nurses, non-ICU nurses, and MSN nurses perceived their environment more positively. There were significant differences in the WES subscales between the military hospitals. Implications for nursing using the WES were recommended.

  15. Influence of the day care, home and neighbourhood environment on young children's physical activity and health

    DEFF Research Database (Denmark)

    Christian, Hayley; Maitland, Clover; Enkel, Stephanie

    2016-01-01

    will be collected by geographic information systems measures, parent and day care educator surveys. ETHICS AND DISSEMINATION: Ethical approval has been granted by The University of Western Australia Human Ethics Research Committee, approval number RA/4/1/7417. Findings will be published in international peer......-sectional observational study (April 2015 to April 2018) of 2400 children aged 2-5 years attending long day care in metropolitan Perth, Western Australia. Accelerometers will measure physical activity with indoor physical activity measured using radio frequency identification. Global positioning systems will be used...... to determine outdoor location of physical activity around the home and neighbourhood for a subsample (n=310). The day care environment will be objectively measured using a validated audit tool. Other potential individual, social and physical environmental influences on preschoolers' physical activity...

  16. [Small-scale, homelike care environments for people with dementia: effects on residents, family caregivers and nursing staff].

    Science.gov (United States)

    Verbeek, H; Zwakhalen, S M G; van Rossum, E; Kempen, G I J M; Hamers, J P H

    2013-12-01

    Institutional dementia care is increasingly directed towards small-scale and homelike care environments, in The Netherlands as well as abroad. In these facilities, a small number of residents, usually six to eight, live together, and normal daily household activities and social participation are emphasized. In a quasi-experimental study, we studied the effects of small-scale, homelike care environments on residents (n = 259), family caregivers (n = 206) and nursing staff (n = 305). We compared two types of institutional nursing care during a 1 year period (baseline assessment and follow-up measurements at 6 and 12 months): (28) small-scale, homelike care environments and (21) psychogeriatric wards in traditional nursing homes. A matching procedure was applied to increase comparability of residents at baseline regarding functional status and cognition. This study was unable to demonstrate convincing overall effects of small-scale, homelike care facilities. On our primary outcome measures, such as quality of life and behaviour of residents and job satisfaction and motivation of nursing staff, no differences were found with traditional nursing homes. We conclude that small-scale, homelike care environments are not necessarily a better care environment than regular nursing homes and other types of living arrangements should be considered carefully. This provides opportunities for residents and their family caregivers to make a choice which care facility suits their wishes and beliefs best.

  17. How Nurse Work Environments Relate to the Presence of Parents in Neonatal Intensive Care.

    Science.gov (United States)

    Hallowell, Sunny G; Rogowski, Jeannette A; Lake, Eileen T

    2017-09-25

    Parental presence in the neonatal intensive care unit (NICU) is essential for families to participate in infant care and prepare them to transition from hospital to home. Nurses are the principal caregivers in the NICU. The nurse work environment may influence whether parents spend time with their hospitalized infants. To examine the relationship between the NICU work environment and parental presence in the NICU using a national data set. We conducted a cross-sectional, observational study of a national sample of 104 NICUs, where 6060 nurses reported on 15,233 infants cared for. Secondary analysis was used to examine associations between the Practice Environment Scale of the Nursing Work Index (PES-NWI) (subscale items and with a composite measure) and the proportion of parents who were present during the nurses' shift. Parents of 60% (SD = 9.7%) of infants were present during the nurses' shift. The PES-NWI composite score and 2 domains-Nurse Participation in Hospital Affairs and Manager Leadership and Support-were significant predictors of parental presence. A 1 SD higher score in the composite or either subscale was associated with 2.5% more parents being present. Parental presence in the NICU is significantly associated with better nurse work environments. NICU practices may be enhanced through enhanced leadership and professional opportunities for nurse managers and staff. Future work may benefit from qualitative work with parents to illuminate their experiences with nursing leaders and nurse-led interventions in the NICU and design and testing of interventions to improve the NICU work environment.

  18. The acoustic environment of intensive care wards based on long period nocturnal measurements

    Directory of Open Access Journals (Sweden)

    Hui Xie

    2012-01-01

    Full Text Available The patients in the Intensive Care Units are often exposed to excessive levels of noise and activities. They can suffer from sleep disturbance, especially at night, but they are often too ill to cope with the poor environment. This article investigates the acoustic environment of typical intensive care wards in the UK, based on long period nocturnal measurements, and examines the differences between singlebed and multibed wards, using statistical analysis. It has been shown that the acoustic environment differs significantly every night. There are also significant differences between the noise levels in the singlebed and multibed wards, where acoustic ceilings are present. Despite the similar background noises in both ward types, more intrusive noises tend to originate from the multibed wards, while more extreme sounds are likely to occur in the single wards. The sound levels in the measured wards for each night are in excess of the World Health Organization′s (WHO guide levels by at least 20 dBA, dominantly at the middle frequencies. Although the sound level at night varies less than that in the daytime, the nocturnal acoustic environment is not dependant on any specific time, thus neither the noisiest nor quietest period can be determined. It is expected that the statistical analysis of the collected data will provide essential information for the development of relevant guidelines and noise reduction strategies.

  19. The acoustic environment of intensive care wards based on long period nocturnal measurements.

    Science.gov (United States)

    Xie, Hui; Kang, Jian

    2012-01-01

    The patients in the Intensive Care Units are often exposed to excessive levels of noise and activities. They can suffer from sleep disturbance, especially at night, but they are often too ill to cope with the poor environment. This article investigates the acoustic environment of typical intensive care wards in the UK, based on long period nocturnal measurements, and examines the differences between singlebed and multibed wards, using statistical analysis. It has been shown that the acoustic environment differs significantly every night. There are also significant differences between the noise levels in the singlebed and multibed wards, where acoustic ceilings are present. Despite the similar background noises in both ward types, more intrusive noises tend to originate from the multibed wards, while more extreme sounds are likely to occur in the single wards. The sound levels in the measured wards for each night are in excess of the World Health Organization's (WHO) guide levels by at least 20 dBA, dominantly at the middle frequencies. Although the sound level at night varies less than that in the daytime, the nocturnal acoustic environment is not dependant on any specific time, thus neither the noisiest nor quietest period can be determined. It is expected that the statistical analysis of the collected data will provide essential information for the development of relevant guidelines and noise reduction strategies.

  20. Pharmaceuticals and personal care products in the aquatic environment as a new issue of environmental health

    Directory of Open Access Journals (Sweden)

    Aneta Koszowska

    2015-03-01

    Full Text Available Pharmaceuticals and Personal Care Products PPCPs are different chemical substances biologically active. They are part of drugs, supplements and cosmetics. An increasing interest in the field of PPCPs is observed recently. High sensitivity analysis methods allowed to detect PPCPs in natural environment in the world . Because of their complex chemical structure these compounds are not completely removed and discharged into the sewage for treatment and as such unchanged or intermediate metabolites may cause pollution of surface and deep water. It is estimated that they may accumulate in living organisms. PPCPs problem becomes a serious challenge for many scientific disciplines. The aim of the study is to present the problem of the occurrence of PPCPs in water environment as a new environmental health hazard. This study presents selected groups of PPCPs as the examples of research in the field of PPCPS and their presence in the environment. Moreover new prospects of removing these substances from water are shown.

  1. Patient care in a biological safety level-4 (BSL-4) environment.

    Science.gov (United States)

    Marklund, LeRoy A

    2003-06-01

    The greatest threats to America's public health include accidental importation of deadly diseases by international travelers and the release of biologic weapons by our adversaries. The greatest failure is unpreparedness because international travel and dispersion of biologic agents by our enemies are inevitable. An effective medical defense program is the recommended deterrent against these threats. The United States has a federal response plan in place that includes patient care and patient transport by using the highest level of biologic containment: BSL-4. The DoD has the capability to provide intensive care for victims infected with highly infectious yet unknown biologic agents in an environment that protects the caregiver while allowing scientists to study the characteristics of these new agents and assess the effectiveness of treatment. Army critical care nurses are vital in the biologic medical defense against unidentified infectious diseases, accidental occupational exposures, or intentional dispersion of weaponized biologic agents. Research that carefully advances healthcare using BSL-4 technology addresses the challenges of the human element of BSL-4 containment patient care, and BSL-4 patient transport enhances our nation's ability to address the emerging biologic threats we confront in the future.

  2. Strategic planning and radiology practice management in the new health care environment.

    Science.gov (United States)

    Sharpe, Richard E; Mehta, Tejas S; Eisenberg, Ronald L; Kruskal, Jonathan B

    2015-01-01

    Current comprehensive health care reform in the United States demands that policy makers, insurers, providers, and patients work in reshaping the health care system to deliver care that is both more affordable and of higher quality. A tectonic shift is under way that runs contrary to the traditional goal of radiology groups to perform and interpret large numbers of imaging examinations. In fact, radiology service requisitions now must be evaluated for their appropriateness, possibly resulting in a reduction in the number of imaging studies performed. To be successful, radiology groups will have to restructure their business practices and strategies to align with the emerging health care paradigm. This article outlines a four-stage strategic framework that has aided corporations in achieving their goals and that can be readily adapted and applied by radiologists. The four stages are (a) definition and articulation of a purpose, (b) clear definition of strategic goals, (c) prioritization of specific strategic enablers, and (d) implementation of processes for tracking progress and enabling continuous adaptation. The authors provide practical guidance for applying specific tools such as analyses of strengths, weaknesses, opportunities, and threats (so-called SWOT analyses), prioritization matrices, and balanced scorecards to accomplish each stage. By adopting and applying these tools within the strategic framework outlined, radiology groups can position themselves to succeed in the evolving health care environment. RSNA, 2015

  3. Utilization of renewable energy in architectural design

    Institute of Scientific and Technical Information of China (English)

    TIAN Lei; QIN Youguo

    2007-01-01

    Renewable energy does not simply equal to using a photovoltaic (PV) board.In addition to heating,ventilation and air conditioning (HVAC) engineering considerations,the design approaches of architects are crucial to the utilization condition and methods of renewable energy.Through profound comprehension of the relationship between renewable energy utilization and design approaches,we can achieve a dual-standard of building environment performance and esthetics.

  4. Primary care: A renewed strategy

    Directory of Open Access Journals (Sweden)

    Arnold Brommet

    2011-09-01

    Full Text Available Esta revisión profundiza en los cambios establecidos por diferentes estamentos mundiales con respecto al concepto y modo de implementación de la estrategia de Atención Primaria en Salud (APS originada en Alma-Ata en 1978. Baja cobertura, altos costos, inequidad, utilización inadecuada del talento humano y del recurso tecnológico hicieron imperiosa su actualización. En ella se establecen cuatro pilares fundamentales a introducir en sistemas de salud que tengan como su eje la APS, como el logro de dar cobertura universal a toda la población, brindar una atención médico-paciente centrada en el individuo, promover unas políticas de salud pública que beneficien a toda la comunidad y ejercer una gobernabilidad nacional o regional concertada con todos los estamentos que influyan en los determinantes de salud de un individuo y su entorno. La implementación de la misma en dichos sistemas de salud dependerá del contexto de cada país y de su tipo de desarrollo y crecimiento del sector salud.

  5. The Impact of the Physical Environment on Depressive Symptoms of Older Residents Living in Care Homes: A Mixed Methods Study.

    Science.gov (United States)

    Potter, Rachel; Sheehan, Bart; Cain, Rebecca; Griffin, James; Jennings, Paul A

    2017-05-23

    Forty percent of residents living in care homes in the United Kingdom have significant depressive symptoms. Care homes can appear to be depressing places, but whether the physical environment of homes directly affects depression in care home residents is unknown. This study explores the relationship between the physical environment and depressive symptoms of older people living in care homes. In a prospective cohort study the physical environment of 50 care homes were measured using the Sheffield Care Environment Assessment Matrix (SCEAM) and depressive symptoms of 510 residents measured using the Geriatric Depression Scale (GDS-15). The study was supplemented with semi-structured interviews with residents living in the care homes. Quantitative data were analyzed using multi-level modeling, and qualitative data analyzed using a thematic framework approach. The overall physical environment of care homes (overall SCEAM score) did not predict depressive symptoms. Controlling for dependency, social engagement, and home type, having access to outdoor space was the only environmental variable to significantly predict depressive symptoms. Residents interviewed reported that access to outdoor space was restricted in many ways: locked doors, uneven foot paths, steep steps, and needing permission or assistance to go outside. We provide new evidence to suggest that access to outdoor space predicts depressive symptoms in older people living in care home. Interventions aimed at increasing access to outdoor spaces could positively affect depressive symptoms in older people.

  6. The performance of primary health care organizations depends on interdependences with the local environment.

    Science.gov (United States)

    Lamarche, Paul; Maillet, Lara

    2016-09-19

    Purpose Improving the performance of health care organizations is now perceived as essential in order to better address the needs of the populations and respect their ability to pay for the services. There is no consensus on what is performance. It is increasingly considered as the optimal execution of four functions that every organization must achieve in order to survive and develop: reach goals; adapt to its environment; produce goods or services and maintain values; and a satisfying organizational climate. There is also no consensus on strategies to improve this performance. The paper aims to discuss these issues. Design/methodology/approach This paper intends to analyze the performance of primary health care organizations from the perspective of Kauffman's model. It mainly aims to understand the often contradictory, paradoxical and unexpected results that emerge from studies on this topic. Findings To do so, the first section briefly presents Kauffman's model and lays forward its principal components. The second section presents three studies on the performance of primary organizations and brings out the contradictory, paradoxical and unexpected results they obtained. The third section explains these results in the light of Kauffman's model. Originality/value Kauffman's model helps give meaning to the results of researches on performance of primary health care organizations that were qualified as paradoxical or unexpected. The performance of primary health care organizations then cannot be understood by only taking into account the characteristics of these organizations. The complexity of the environments in which they operate must simultaneously be taken into account. This paper brings original development of an integrated view of the performance of organizations, their own characteristics and those of the local environment in which they operated.

  7. Positive practice environments influence job satisfaction of primary health care clinic nursing managers in two South African provinces.

    Science.gov (United States)

    Munyewende, Pascalia Ozida; Rispel, Laetitia Charmaine; Chirwa, Tobias

    2014-05-15

    Nurses constitute the majority of the health workforce in South Africa and they play a major role in providing primary health care (PHC) services. Job satisfaction influences nurse retention and successful implementation of health system reforms. This study was conducted in light of renewed government commitment to reforms at the PHC level, and to contribute to the development of solutions to the challenges faced by the South African nursing workforce. The objective of the study was to determine overall job satisfaction of PHC clinic nursing managers and the predictors of their job satisfaction in two South African provinces. During 2012, a cross-sectional study was conducted in two South African provinces. Stratified random sampling was used to survey a total of 111 nursing managers working in PHC clinics. These managers completed a pre-tested Measure of Job Satisfaction questionnaire with subscales on personal satisfaction, workload, professional support, training, pay, career prospects and standards of care. Mean scores were used to measure overall job satisfaction and various subscales. Predictors of job satisfaction were determined through multiple logistic regression analysis. A total of 108 nursing managers completed the survey representing a 97% response rate. The mean age of respondents was 49 years (SD = 7.9) and the majority of them (92%) were female. Seventy-six percent had a PHC clinical training qualification. Overall mean job satisfaction scores were 142.80 (SD = 24.3) and 143.41 (SD = 25.6) for Gauteng and Free State provinces respectively out of a maximum possible score of 215. Predictors of job satisfaction were: working in a clinic of choice (RRR = 3.10 (95% CI: 1.11 to 8.62, P = 0.030)), being tired at work (RRR = 0.19 (95% CI: 0.08 to 0.50, P = 0.001)) and experience of verbal abuse (RRR = 0.18 (95% CI: 0.06 to 0.55, P = 0.001). Allowing nurses greater choice of clinic to work in, the prevention of violence

  8. The Application of Virtual Intensive Care Unit Principles in the Aeromedical Evacuation Environment Can Improve Patient Safety, Lead to Better Patient Outcomes and Deliver Integrated Medical Care

    Science.gov (United States)

    2016-02-01

    Medical research and innovation are critical to support the human weapon system in volatile , uncertain, complex and ambiguous (VUCA) environments. The...Information Sciences, to Lt Col Jennifer Hatzfeld, En Route Care Research Portfolio Manager, Combat Casualty Care Research Program Memorandum

  9. Impact of critical care environment on burnout, perceived quality of care and safety attitude of the nursing team.

    Science.gov (United States)

    Guirardello, Edinêis de Brito

    2017-06-05

    assess the perception of the nursing team about the environment of practice in critical care services and its relation with the safety attitude, perceived quality of care and burnout level. cross-sectional study involving 114 nursing professionals from the intensive care unit of a teaching hospital. The following instruments were used: Nursing Work Index-Revised, Maslach Burnout Inventory and the Safety Attitude Questionnaire. the professionals who perceived greater autonomy, good relationships with the medical team and better control over the work environment presented lower levels of burnout, assessed the quality of care as good and reported a positive perception on the safety attitude for the domain job satisfaction. the findings evidenced that environments favorable to these professionals' practice result in lower levels of burnout, a better perceived quality of care and attitudes favorable to patient safety. avaliar a percepção da equipe de enfermagem sobre o ambiente da prática em unidades de cuidados críticos e sua relação com atitude de segurança, percepção da qualidade do cuidado e nível de burnout. estudo transversal com a participação de 114 profissionais de enfermagem da unidade de terapia intensiva de um hospital de ensino. Foram utilizados os instrumentos: Nursing Work Index-Revised, Inventário de Burnout de Maslach e o Questionário de Atitudes de Segurança. os profissionais que perceberam maior autonomia, boas relações com a equipe médica e melhor controle sobre o ambiente de trabalho, apresentaram menores níveis de burnout, avaliaram como boa a qualidade do cuidado e relataram uma percepção positiva da atitude de segurança para o domínio satisfação no trabalho. os achados evidenciaram que ambientes favoráveis à prática desses profissionais resultam em menores níveis de burnout, melhor percepção da qualidade do cuidado e atitudes favoráveis à segurança do paciente. evaluar la percepción del equipo de enfermer

  10. Relationship between nursing care quality, nurse staffing, nurse job satisfaction, nurse practice environment, and burnout: literature review

    Directory of Open Access Journals (Sweden)

    Virya Koy

    2015-08-01

    Full Text Available The purpose of this literature review is to explore the relationship between nurse staffing, nurse job satisfaction, nurse practice environment, burnout, and nursing care quality through a consideration of what is meant by perceptions of nursing care quality. Different people define nursing care quality in many ways. It is complex, multi-faceted and multi-dimensional, and attempts to assess, monitor, evaluate and improve nursing care quality have evolved over a number of years. Of particular interest is the way in which changes in nurse staffing, nurse job satisfaction, nurse practice environment, and burnout may affect the quality of nursing care delivery. A search was conducted using the CINAHL, Medline and Embase databases, HINARI, Science Direct, Google, and PubMed. The terms searched included quality of health care; nursing care quality; nurse job satisfaction; nurse practice environment; burnout; and nurse staffing. Papers were included for their relevance to the field of enquiry. The original search was conducted in 2003 and updated in 2004. Quality of care is a complex, multi-dimensional concept, which presents researchers with a challenge when attempting to evaluate it. Many different tools have assessed nursing care quality. In addition, the review found that there were relationships between nurse staffing, nurse job satisfaction, nurse practice environment, burnout, and nursing care quality. [Int J Res Med Sci 2015; 3(8.000: 1825-1831

  11. The effect of transforming care at the bedside initiative on healthcare teams' work environments.

    Science.gov (United States)

    Lavoie-Tremblay, Mélanie; O'Conner, Patricia; Harripaul, Anastasia; Biron, Alain; Ritchie, Judith; Lavigne, Genevieve L; Baillargeon, Sophie; Ringer, Justin; Macgibbon, Brenda; Taylor-Ducharme, Sharon; Sourdif, Jacynthe

    2014-02-01

    Different initiatives have been implemented in healthcare organizations to improve efficiency, such as transforming care at the bedside (TCAB). However, there are important gaps in understanding the effect of TCAB on healthcare teams' work environments. The specific aim of the study is to describe findings regarding the TCAB initiative effects on healthcare teams' work environments. A pretest and posttest study design was used for this study. The TCAB initiative was implemented in fall 2010 in a university health center in Montreal, Canada. The sample consisted of healthcare workers from four different care units. Statistically significant improvement was observed with the communicating specific information subscale from the measure of processes of care variable, and a significant difference was found between the support from colleagues variable, which was higher at baseline than postprogram. The differences for psychological demand, decisional latitude, and effort-reward were not significant. TCAB is an intervention that allows healthcare teams to implement change to improve patients' and families' outcomes. Ongoing energy should focus on how to improve communication among all members of the team and ensure their support. © 2013 Sigma Theta Tau International.

  12. Relationships among leadership practices, work environments, staff communication and outcomes in long-term care.

    Science.gov (United States)

    Tourangeau, Ann; Cranley, Lisa; Spence Laschinger, Heather K; Pachis, Jaime

    2010-11-01

    To examine the role that work relationships have on two long-term care outcomes: job satisfaction and turnover intention. It is easy to overlook the impact that human relations have in shaping work environments that are conducive to organizational effectiveness. Employee job satisfaction and retention are important organizational outcomes. Six hundred and seventy-five nursing and other staff from 26 long-term care facilities were surveyed about their work environments, work group relationships, observed leadership practices, organizational support, job satisfaction and turnover intention. Higher job satisfaction was associated with lower emotional exhaustion burnout, higher global empowerment, higher organizational support, higher psychological empowerment, stronger work group cohesion and higher personal accomplishment. Higher turnover intention was associated with lower job satisfaction, higher emotional exhaustion burnout, more outside job opportunities, weaker work group cohesion, lower personal accomplishment and higher depersonalization. No relationship was found between leadership practices and job satisfaction or turnover intention. Stronger work group relationships, stronger sense of personal accomplishment and lower emotional exhaustion have direct effects on increasing job satisfaction and lowering turnover intention. To retain long-term care staff, attention should be paid to fostering positive work group cohesion, supporting and acknowledging staff accomplishments and minimizing staff burnout. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

  13. Focusing on patient safety in the Neonatal Intensive Care Unit environment

    Directory of Open Access Journals (Sweden)

    Ilias Chatziioannidis

    2017-02-01

    Full Text Available Patient safety in the Neonatal Intensive Care Unit (NICU environment is an under-researched area, but recently seems to get high priority on the healthcare quality agenda worldwide. NICU, as a highly sensitive and technological driven environment, signals the importance for awareness in causation of mistakes and accidents. Adverse events and near misses that comprise the majority of human errors, cause morbidity often with devastating results, even death. Likewise in other organizations, errors causes are multiple and complex. Other high reliability organizations, such as air force and nuclear industry, offer examples of how standardized/homogenized work and removal of systems weaknesses can minimize errors. It is widely accepted that medical errors can be explained based on personal and/or system approach. The impact/effect of medical errors can be reduced when thorough/causative identification approach is followed by detailed analysis of consequences and prevention measures. NICU’s medical and nursing staff should be familiar with patient safety language, implement best practices, and support safety culture, maximizing efforts for reducing errors. Furthermore, top management commitment and support in developing patient safety culture is essential in order to assure the achievement of the desirable organizational safety outcomes. The aim of the paper is to review patient safety issues in the NICU environment, focusing on development and implementation of strategies, enhancing high quality standards for health care.

  14. Local environment but not genetic differentiation influences biparental care in ten plover populations.

    Directory of Open Access Journals (Sweden)

    Orsolya Vincze

    Full Text Available Social behaviours are highly variable between species, populations and individuals. However, it is contentious whether behavioural variations are primarily moulded by the environment, caused by genetic differences, or a combination of both. Here we establish that biparental care, a complex social behaviour that involves rearing of young by both parents, differs between closely related populations, and then test two potential sources of variation in parental behaviour between populations: ambient environment and genetic differentiation. We use 2904 hours behavioural data from 10 geographically distinct Kentish (Charadrius alexandrinus and snowy plover (C. nivosus populations in America, Europe, the Middle East and North Africa to test these two sources of behavioural variation. We show that local ambient temperature has a significant influence on parental care: with extreme heat (above 40 °C total incubation (i.e. % of time the male or female incubated the nest increased, and female share (% female share of incubation decreased. By contrast, neither genetic differences between populations, nor geographic distances predicted total incubation or female's share of incubation. These results suggest that the local environment has a stronger influence on a social behaviour than genetic differentiation, at least between populations of closely related species.

  15. ïSCOPE: Safer care for older persons (in residential environments: A study protocol

    Directory of Open Access Journals (Sweden)

    Barnard Debbie

    2011-07-01

    Full Text Available Abstract Background The current profile of residents living in Canadian nursing homes includes elder persons with complex physical and social needs. High resident acuity can result in increased staff workload and decreased quality of work life. Aims Safer Care for Older Persons [in residential] Environments is a two year (2010 to 2012 proof-of-principle pilot study conducted in seven nursing homes in western Canada. The purpose of the study is to evaluate the feasibility of engaging front line staff to use quality improvement methods to integrate best practices into resident care. The goals of the study are to improve the quality of work life for staff, in particular healthcare aides, and to improve residents' quality of life. Methods/design The study has parallel research and quality improvement intervention arms. It includes an education and support intervention for direct caregivers to improve the safety and quality of their care delivery. We hypothesize that this intervention will improve not only the care provided to residents but also the quality of work life for healthcare aides. The study employs tools adapted from the Institute for Healthcare Improvement's Breakthrough Series: Collaborative Model and Canada's Safer Healthcare Now! improvement campaign. Local improvement teams in each nursing home (1 to 2 per facility are led by healthcare aides (non-regulated caregivers and focus on the management of specific areas of resident care. Critical elements of the program include local measurement, virtual and face-to-face learning sessions involving change management, quality improvement methods and clinical expertise, ongoing virtual and in person support, and networking. Discussion There are two sustainability challenges in this study: ongoing staff and leadership engagement, and organizational infrastructure. Addressing these challenges will require strategic planning with input from key stakeholders for sustaining quality improvement

  16. Development of ISO 13606 archetypes for the standardisation of data registration in the Primary Care environment.

    Science.gov (United States)

    Barros Castro, Jesús; Lamelo Alfonsín, Alejandro; Prieto Cebreiro, Javier; Rimada Mora, Dolores; Carrajo García, Lino; Vázquez González, Guillermo

    2015-01-01

    On daily procedures, companies and organizations produce a wide quantity of data. Medical information doubles every five years approximately, and most of this information has no structure and cannot be utilised. Information obtained during Primary Health Care (PC) consultations is expected to be standardized and organised following instructions made by archetype 13606 of the International Organization for Standardization (ISO) in order to guarantee the Continuity of Care as well as the potential use of these data for secondary purposes, such as investigation or statistics. This study was designed to investigate the feasibility of representing the information collected in Primary Care consultations in a structured and normalized way. A key difference to other approaches is that the intended solution is, to the best of our knowledge, the first one to register all the information collected in this area. The participation of the Primary Health Care service (PC) from Complejo Hospitalario Universitario de A Coruña (CHUAC) has been of vital importance in this project as it has provided the necessary clinical knowledge and it has allowed us to verify the effectiveness obtained in actual environments. The archetypes developed can be reused in a wide range of projects. As an example of use, we have used these archetypes to create an intelligent system that generates organised reports based on the information dictated on a medical consultation which, afterwards, can be analysed from an analytical point of view.

  17. Impact of domestic care environment on trauma and posttraumatic stress disorder among orphans in western Kenya.

    Directory of Open Access Journals (Sweden)

    Lukoye Atwoli

    Full Text Available The aim of this study was to determine the impact of the domestic care environment on the prevalence of potentially traumatic events (PTEs and posttraumatic stress disorder (PTSD among orphaned and separated children in Uasin Gishu County, western Kenya.A total of 1565 (55.5% male orphaned and separated adolescents aged 10-18 years (mean 13.8 years, sd 2.2, were assessed for PTSD and PTEs including bullying, physical abuse and sexual abuse. In this sample, 746 lived in extended family households, 746 in Charitable Children's Institutions (CCIs, and 73 on the street. Posttraumatic stress symptom (PTSS scores and PTSD were assessed using the Child PTSD Checklist.Bullying was the commonest PTE in all domestic care environments, followed by physical and sexual abuse. All PTEs were commonest among the street youth followed by CCIs. However, sexual abuse was more prevalent in households than in CCIs. Prevalence of PTSD was highest among street youth (28.8%, then households (15.0% and CCIs (11.5%. PTSS scores were also highest among street youth, followed by CCIs and households. Bullying was associated with higher PTSS scores and PTSD odds than either sexual or physical abuse.This study demonstrated differences in distribution of trauma and PTSD among orphaned and separated children in different domestic care environments, with street youth suffering more than those in CCIs or households. Interventions are needed to address bullying and sexual abuse, especially in extended family households. Street youth, a heretofore neglected population, are urgently in need of dedicated mental health services and support.

  18. Quotidian of accompanying family members in an environment of care: the emergence of hospital tribes.

    Science.gov (United States)

    Passos, Silvia da Silva Santos; Pereira, Álvaro; Nitschke, Rosane Gonçalves

    2016-01-01

    Compreender o relacionamento no quotidiano dos familiares acompanhantes nos cenários de cuidado que se aproximam da metáfora da tribo no ambiente hospitalar. Estudo qualitativo com dados coletados a partir de entrevistas semiestruturadas e observação com 16 familiares acompanhantes de pessoas hospitalizadas com dependência para o autocuidado. Os dados foram submetidos à análise temática e analisados através da metáfora da tribo proposta pela sociologia compreensiva. Os familiares formam um agrupamento social em torno do cuidado onde encontramos as características das tribos: a ambiência emocional; a solidariedade baseada nos vínculos de simpatia e ajuda mútua; a nebulosa afetual no processo interacional; a lógica da fusão nas relações tácteis e a comunhão/religiosidade no processo de ligação numa identidade coletiva. Os familiares na presença do trágico criam agrupamentos sociais que se assemelham a tribos cujo totem é o cuidado. Understand the quotidian relationships of accompanying family members in an environment of care, which are close to the metaphor of a tribe in hospital environment. METHODQualitative study with data gathered from semi-structured interviews and observations with 16 family members accompanying hospitalized individuals with dependence on self-care. Data were submitted to thematic analysis, and analyzed through the metaphor of "tribe" proposed by comprehensive sociology. Family members build up social clusters around caring, where we find traits typical of tribes: emotional ambience; solidarity based on links of sympathy and mutual assistance; an affectual nebula in the process of interaction; a logic of fusion in tactile relations; and communion/religiosity in the process of connecting in a collective identity. In the presence of tragedy, families build social clusters similar to tribes having care as a totem.

  19. Passive sampling of pharmaceuticals and personal care products in aquatic environments

    Directory of Open Access Journals (Sweden)

    Zdena Křesinová

    2016-06-01

    Full Text Available Passive sampling is a rapidly developing technology, which is widely used for the monitoring of pollutants in different environments. Passive sampling offers significant advantages over traditional grab sampling. In the present review, the authors summarize the current literature on the methods of passive sampling used in the environmental monitoring of polar or semi-polar compounds in aqueous matrices. Methods of calibrating, design and deployment of samplers are also discussed. A major focus of this review is the use of polar organic compound integrative samplers (POCIS and their use in sampling and monitoring of pharmaceuticals and personal care products (PCPs in both equilibrium and non-equilibrium conditions.

  20. Campus Retrofitting (CARE) Methodology: A Way to Co-Create Future Learning Environments

    DEFF Research Database (Denmark)

    Nenonen, Suvi; Eriksson, Robert; Niemi, Olli

    2016-01-01

    The future learning environments are not based on standardized design solutions like lecture theatres for 100 persons or classrooms for 40 persons. As new technology and new ways of studying are being developed new demands are put on university environments. At the same time utilisation of resour...... methodology and the formulation of the guiding principle of the CARE-way of sustainable retrofitting of university campuses opens up an agenda for investigating a new methodology for sustainable urban retrofitting in a Nordic context....... of resources in form of both teachers and university facilities is challenged by development of integration of learning, teaching and the spaces where it takes place. The challenges are shared among users and owners of campus, where retrofitting is needed too. This paper aims to describe Campus Retrofitting...

  1. Psychosocial Work Environment, Stress Factors and Individual Characteristics among Nursing Staff in Psychiatric In-Patient Care

    OpenAIRE

    Tuvesson Hanna; Eklund Mona

    2014-01-01

    The psychosocial work environment is an important factor in psychiatric in-patient care, and knowing more of its correlates might open up new paths for future workplace interventions. Thus, the aims of the present study were to investigate perceptions of the psychosocial work environment among nursing staff in psychiatric in-patient care and how individual characteristics—Mastery, Moral Sensitivity, Perceived Stress, and Stress of Conscience—are related to different aspects of the psychosoc...

  2. Psychosocial work environment and prediction of quality of care indicators in one Canadian health center.

    Science.gov (United States)

    Paquet, Maxime; Courcy, François; Lavoie-Tremblay, Mélanie; Gagnon, Serge; Maillet, Stéphanie

    2013-05-01

    Few studies link organizational variables and outcomes to quality indicators. This approach would expose operant mechanisms by which work environment characteristics and organizational outcomes affect clinical effectiveness, safety, and quality indicators. What are the predominant psychosocial variables in the explanation of organizational outcomes and quality indicators (in this case, medication errors and length of stay)? The primary objective of this study was to link the fields of evidence-based practice to the field of decision making, by providing an effective model of intervention to improve safety and quality. The study involved healthcare workers (n = 243) from 13 different care units of a university affiliated health center in Canada. Data regarding the psychosocial work environment (10 work climate scales, effort/reward imbalance, and social support) was linked to organizational outcomes (absenteeism, turnover, overtime), to the nurse/patient ratio and quality indicators (medication errors and length of stay) using path analyses. The models produced in this study revealed a contribution of some psychosocial factors to quality indicators, through an indirect effect of personnel- or human resources-related variables, more precisely: turnover, absenteeism, overtime, and nurse/patient ratio. Four perceptions of work environment appear to play an important part in the indirect effect on both medication errors and length of stay: apparent social support from supervisors, appreciation of the workload demands, pride in being part of one's work team, and effort/reward balance. This study reveals the importance of employee perceptions of the work environment as an indirect predictor of quality of care. Working to improve these perceptions is a good investment for loyalty and attendance. In general, better personnel conditions lead to fewer medication errors and shorter length of stay. © Sigma Theta Tau International.

  3. The Central Role of Physician Leadership for Driving Change in Value-Based Care Environments.

    Science.gov (United States)

    Lustig, Adam; Ogden, Michael; Brenner, Robert W; Penso, Jerry; Westrich, Kimberly D; Dubois, Robert W

    2016-10-01

    In 2013, it was reported that about 1 of every 3 U.S. adults has hypertension. Of these 70 million individuals, approximately 50% have their blood pressure under control. Achieving hypertension control, especially in at-risk populations, requires a multipronged approach that includes lifestyle modifications and pharmacological treatment. As provider groups, hospital systems, and integrated delivery networks optimize their care processes to promote population health activities in support of the accountable care organization (ACO) model of care, managing hypertension and other chronic diseases will be essential to their success. A critical aspect of managing populations in an ACO environment is optimization of care processes among providers to increase care efficiency and improve patient outcomes. Launched in 2013, Measure Up/Pressure Down is a 3-year campaign developed by the American Medical Group Foundation (AMGF) to reduce the burden of high blood pressure. The goal of the campaign is for participating medical groups, health systems, and other organized systems of care to achieve hypertension control for 80% of their patients with high blood pressure by 2016, according to national standards. The role of physician leadership at Cornerstone Health Care (CHC) and Summit Medical Group (SMG) in facilitating organizational change to improve hypertension management through the implementation of the Measure Up/Pressure Down national hypertension campaign is examined. Using patient stratification via its electronic health record, SMG identified 16,000 patients with hypertension. The baseline percentage of hypertension control for this patient population was 66%. Within 7 months, SMG was able to meet the 80% goal set forth by the AMGF's Measure Up/Pressure Down campaign. CHC diagnosed 25,312 patients with hypertension. The baseline percentage of hypertension control for this subgroup of patients was 51.5% when the initiative was first implemented. To date, the organization

  4. The influence of social environment on the smoking status of women employed in health care facilities

    Directory of Open Access Journals (Sweden)

    Dragana Nikšić

    2013-04-01

    Full Text Available Introduction: Bosnia and Herzegovina has a high prevalence of smoking among women, especially among health care professionals. The goal of this study is to investigate the influence of the social environment of women employed in health institutions in relation to the cigarettes smoking habits.Methods: The study included 477 women employed in hospitals, outpatient and public health institutions in Sarajevo Canton Bosnia and Herzegovina. We used a modifi ed questionnaire assessing smoking habits of medical staff in European hospitalsResults: The results showed that 50% of women are smokers, with the highest incidence among nurses (58.1% and administrative staff (55.6%. The social environment is characterized by a high incidence of colleagues (60.1% and friends who are smokers (54.0% at the workplace and in the family (p<0.005. One third of women (27.8%, mainly non-smokers, states that the work environment supports employees smoking (p=0.003.Conclusion: Workplace and social environment support smoking as an acceptable cultural habit and is contributing to increasing rates of smoking among women.

  5. The impact of the hospital work environment on social support from physicians in breast cancer care.

    Science.gov (United States)

    Ansmann, Lena; Wirtz, Markus; Kowalski, Christoph; Pfaff, Holger; Visser, Adriaan; Ernstmann, Nicole

    2014-09-01

    Research on determinants of a good patient-physician interaction mainly disregards systemic factors, such as the work environment in healthcare. This study aims to identify stressors and resources within the work environment of hospital physicians that enable or hinder the physicians' provision of social support to patients. Four data sources on 35 German breast cancer center hospitals were matched: structured hospital quality reports and surveys of 348 physicians, 108 persons in hospital leadership, and 1844 patients. Associations between hospital structures, physicians' social resources as well as job demands and control and patients' perceived support from physicians have been studied in multilevel models. Patients feel better supported by their physicians in hospitals with high social capital, a high percentage of permanently employed physicians, and less physically strained physicians. The results highlight the importance of the work environment for a good patient-physician interaction. They can be used to develop interventions for redesigning the hospital work environment, which in turn may improve physician satisfaction, well-being, and performance and consequently the quality of care. Health policy and hospital management could create conditions conducive to better patient-physician interaction by strengthening the social capital and by increasing job security for physicians. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Universality classes of foraging with resource renewal

    Science.gov (United States)

    Chupeau, M.; Bénichou, O.; Redner, S.

    2016-03-01

    We determine the impact of resource renewal on the lifetime of a forager that depletes its environment and starves if it wanders too long without eating. In the framework of a minimal starving random-walk model with resource renewal, there are three universal classes of behavior as a function of the renewal time. For sufficiently rapid renewal, foragers are immortal, while foragers have a finite lifetime otherwise. In the specific case of one dimension, there is a third regime, for sufficiently slow renewal, in which the lifetime of the forager is independent of the renewal time. We outline an enumeration method to determine the mean lifetime of the forager in the mortal regime.

  7. Nutrition Care Process Implementation: Experiences in Various Dietetics Environments in Sweden.

    Science.gov (United States)

    Lövestam, Elin; Boström, Anne-Marie; Orrevall, Ylva

    2017-05-02

    The Nutrition Care Process (NCP) and Nutrition Care Process Terminology (NCPT) are currently being implemented by nutrition and dietetics practitioners all over the world. Several advantages have been related to this implementation, such as consistency and clarity of dietetics-related health care records and the possibility to collect and research patient outcomes. However, little is known about dietitians' experiences of the implementation process. The aim of this qualitative study was to explore Swedish dietitians' experiences of the NCP implementation process in different dietetics environments. Thirty-seven Swedish dietitians from 13 different dietetics workplaces participated in seven focus group discussions that were audiotaped and carefully transcribed. A thematic secondary analysis was performed, after which all the discussions were re-read, following the implementation narrative from each workplace. In the analysis, The Promoting Action on Research Implementation in Health Services implementation model was used as a framework. Main categories identified in the thematic analysis were leadership and implementation strategy, the group and colleagues, the electronic health record, and evaluation. Three typical cases are described to illustrate the diversity of these aspects in dietetics settings: Case A represents a small hospital with an inclusive leadership style and discussion-friendly culture where dietitians had embraced the NCP/NCPT implementation. Case B represents a larger hospital with a more hierarchical structure where dietitians were more ambivalent toward NCP/NCPT implementation. Case C represents the only dietitian working at a small multiprofessional primary care center who received no dietetics-related support from management or colleagues. She had not started NCP/NCPT implementation. The diversity of dietetics settings and their different prerequisites should be considered in the development of NCP/NCPT implementation strategies. Tailored

  8. A grounded theory of humanistic nursing in acute care work environments.

    Science.gov (United States)

    Khademi, Mojgan; Mohammadi, Eesa; Vanaki, Zohreh

    2016-03-23

    Humanistic nursing practice which is dominated by technological advancement, outcome measurement, reduced resources, and staff shortages is challenging in the present work environment. To examine the main concern in humanistic nursing area and how the way it is solved and resolved by Iranian nurses in acute care setting. Data were collected from interviews and observations in 2009-2011 and analyzed using classic grounded theory. Memos were written during the analysis, and they were sorted once theoretical saturation occurred. In total, 22 nurses, 18 patients, and 12 families from two teaching hospitals in Tehran were selected by purposeful and theoretical sampling. The research was approved by the Ethics Committee of the university and hospitals. The main concern for the nurses is the violation of their rights. They overcome this concern when there is a synergy of situation-education/learning, that is, a positive interaction between education and learning of values and sensitivity of the situation or existence of care promotion elements. They turn to professional values and seeking and meeting others' needs, resulting in "success and accomplishment" of nurse/nursing manager and patient/family. This theory shows that professional values, elements of care promotion, and sensitivity of the situation have a key role in activation of humanistic approach in nursing. Violation of the nurses' professional rights often leads to a decrease in care, but these factors make the nurses practice in an unsparing response approach. It is necessary to focus on development of professional values and provide essential elements of care promotion as changeable factors for realization of humanistic nursing although there is a context in which the nurses' rights are violated. © The Author(s) 2016.

  9. A systematic review of the effectiveness of training in emergency obstetric care in low-resource environments

    NARCIS (Netherlands)

    van Lonkhuijzen, L.; Dijkman, A.; van Roosmalen, J.; Zeeman, G.; Scherpbier, A.

    2010-01-01

    Background Training of healthcare workers can play an important role in improving quality of care, and reducing maternal and perinatal mortality and morbidity. Objectives To assess the effectiveness of training programmes aimed at improving emergency obstetric care in low-resource environments. Sear

  10. Renewable energy prospects for implementation

    CERN Document Server

    Jackson, Tim

    1993-01-01

    Renewable Energy: Prospects for Implementation contains papers that were originally commissioned by the journal Energy Policy for a series on renewable energy appearing between January 1991 to September 1992. In view of the fast-changing demands on conventional energy supply to meet environmental imperatives, it seemed timely to reproduce here a selection of those papers with a new introduction and a revised concluding chapter by the Editor of the series, Dr Tim Jackson, a research fellow with the Stockholm Environment Institute. The book is organized into four parts. The papers in Part I

  11. Building Health Promotion into the Job of Home Care Aides: Transformation of the Workplace Health Environment.

    Science.gov (United States)

    Muramatsu, Naoko; Yin, Lijuan; Lin, Ting-Ti

    2017-04-05

    Home care aides (HCAs), predominantly women, constitute one of the fastest growing occupations in the United States. HCAs work in clients' homes that lack typical workplace resources and benefits. This mixed-methods study examined how HCAs' work environment was transformed by a pilot workplace health promotion program that targeted clients as well as workers. The intervention started with training HCAs to deliver a gentle physical activity program to their older clients in a Medicaid-funded home care program. Older HCAs aged 50+ reported increased time doing the types of physical activity that they delivered to their clients (stretching or strengthening exercise) (p = 0.027). Almost all (98%) HCAs were satisfied with the program. These quantitative results were corroborated by qualitative data from open-ended survey questions and focus groups. HCAs described how they exercised with clients and how the psychosocial work environment changed with the program. Building physical activity into HCAs' job is feasible and can effectively promote HCAs' health, especially among older HCAs.

  12. Building Health Promotion into the Job of Home Care Aides: Transformation of the Workplace Health Environment

    Directory of Open Access Journals (Sweden)

    Naoko Muramatsu

    2017-04-01

    Full Text Available Home care aides (HCAs, predominantly women, constitute one of the fastest growing occupations in the United States. HCAs work in clients’ homes that lack typical workplace resources and benefits. This mixed-methods study examined how HCAs’ work environment was transformed by a pilot workplace health promotion program that targeted clients as well as workers. The intervention started with training HCAs to deliver a gentle physical activity program to their older clients in a Medicaid-funded home care program. Older HCAs aged 50+ reported increased time doing the types of physical activity that they delivered to their clients (stretching or strengthening exercise (p = 0.027. Almost all (98% HCAs were satisfied with the program. These quantitative results were corroborated by qualitative data from open-ended survey questions and focus groups. HCAs described how they exercised with clients and how the psychosocial work environment changed with the program. Building physical activity into HCAs’ job is feasible and can effectively promote HCAs’ health, especially among older HCAs.

  13. [Nursing interventions on the physical environment of Neonatal Intensive Care Units].

    Science.gov (United States)

    Miquel Capó Rn, I

    2016-01-01

    The objectives of this study are to analyse nursing interventions regarding noise and lighting that influence neurodevelopment of the preterm infant in the Neonatal Intensive Care Unit. A review of the literature was performed using the databases: Cuiden Plus, PubMed, IBECS and Cochrane Library Plus. The inclusion and exclusion criteria were established in accordance with the objectives and limits used in each database. Of the 35 articles used, most were descriptive quantitative studies based on the measurement of sound pressure levels and lighting in the Neonatal Intensive Care Units. The countries included in this study are Brazil and the United States, and the variables analysed were the recording the times of light and noise. Based on the high levels of light and noise recorded in the Neonatal Intensive Care Units, nursing interventions that should be carried out to reduce them are described. The evidence indicates that after the implementation of these interventions, the high levels of both environmental stimuli are reduced significantly. Despite the extensive literature published on this problem, the levels of light and noise continue to exceed the recommended limits. Therefore, nurses need to increase and enhance their efforts in this environment, in order to positively influence neurodevelopment of premature newborn. Copyright © 2016 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

  14. Renewable energies and public policies; Energies renouvelables et politiques publiques

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    This report presents the full texts of the allocution delivered during the colloquium on the renewable energies and the public policies. It takes stock on the strategical environment and the political will of the renewable energies, the tracks of development in France and the necessity of a law on the renewable energies. (A.L.B.)

  15. 40 CFR 73.26 - Conservation and renewable energy reserve.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Conservation and renewable energy... renewable energy reserve. The Administrator will allocate 300,000 allowances to the Conservation and Renewable Energy Reserve subaccount of the Acid Rain Data System. Allowances from this Reserve will...

  16. Comparative analysis of the expected demands for nursing care services among older people from urban, rural, and institutional environments

    Science.gov (United States)

    Borowiak, Ewa; Kostka, Joanna; Kostka, Tomasz

    2015-01-01

    Background Demand for nursing and social services may vary depending on the socio-demographic variables, health status, receipt of formal and informal care provided, and place of residence. Objectives To conduct a comparative analysis of the expectations of older people from urban, rural, and institutional environments concerning nursing care with respect to the care provided and elements of a comprehensive geriatric assessment. Material and methods The study comprised 2,627 individuals above the age of 65 years living in urban (n=935) and rural (n=812) areas as well as nursing homes (n=880). Results Family care was most often expected both in urban (56.6%) and rural (54.7%) environments, followed by care provided simultaneously by a family and nurse (urban – 18.8%; rural – 26.1%) and realized only by a nurse (urban – 24.6%; rural – 19.2%). Not surprisingly, nursing home residents most commonly expected nursing care (57.5%) but 33.1% preferred care provided by family or friends and neighbors. In the whole cohort of people living in the home environment (n=1,718), those living with family demonstrated willingness to use primarily care implemented by the family (62.0%), while respondents living alone more often expected nursing services (30.3%). In the logistic regression model, among the respondents living in the city, only the form of care already received determined the expectations for nursing care. Among the respondents living in the county, the presence of musculoskeletal disorders, better nutritional status, and current care provided by family decreased expectations for nursing care. Higher cognitive functioning, symptoms of depression, and living alone increased the willingness to obtain nursing care. Conclusion Older inhabitants of urban areas, rural areas, and those residing in institutions have different expectations for individual nursing care. Nearly 45% of seniors living in the community expect to obtain nursing care, while only 1.6% do not

  17. Comparative analysis of the expected demands for nursing care services among older people from urban, rural, and institutional environments

    Directory of Open Access Journals (Sweden)

    Borowiak E

    2015-02-01

    Full Text Available Ewa Borowiak,1,2,* Joanna Kostka,3,* Tomasz Kostka1 1Department of Geriatrics, Medical University of Lodz, Poland; 2Institute of Nursing, Medical University of Lodz, Poland; 3Department of Physical Medicine, Medical University of Lodz, Poland *These authors contributed equally to this work Background: Demand for nursing and social services may vary depending on the socio-demographic variables, health status, receipt of formal and informal care provided, and place of residence. Objectives: To conduct a comparative analysis of the expectations of older people from urban, rural, and institutional environments concerning nursing care with respect to the care provided and elements of a comprehensive geriatric assessment. Material and methods: The study comprised 2,627 individuals above the age of 65 years living in urban (n=935 and rural (n=812 areas as well as nursing homes (n=880. Results: Family care was most often expected both in urban (56.6% and rural (54.7% environments, followed by care provided simultaneously by a family and nurse (urban – 18.8%; rural – 26.1% and realized only by a nurse (urban – 24.6%; rural – 19.2%. Not surprisingly, nursing home residents most commonly expected nursing care (57.5% but 33.1% preferred care provided by family or friends and neighbors. In the whole cohort of people living in the home environment (n=1,718, those living with family demonstrated willingness to use primarily care implemented by the family (62.0%, while respondents living alone more often expected nursing services (30.3%. In the logistic regression model, among the respondents living in the city, only the form of care already received determined the expectations for nursing care. Among the respondents living in the county, the presence of musculoskeletal disorders, better nutritional status, and current care provided by family decreased expectations for nursing care. Higher cognitive functioning, symptoms of depression, and living alone

  18. Creating Welcoming Spaces for Lesbian, Gay, Bisexual, and Transgender (LGBT) Patients: An Evaluation of the Health Care Environment.

    Science.gov (United States)

    McClain, Zachary; Hawkins, Linda A; Yehia, Baligh R

    2016-01-01

    Health outcomes are affected by patient, provider, and environmental factors. Previous studies have evaluated patient-level factors; few focusing on environment. Safe clinical spaces are important for lesbian, gay, bisexual, and transgender (LGBT) communities. This study evaluates current models of LGBT health care delivery, identifies strengths and weaknesses, and makes recommendations for LGBT spaces. Models are divided into LGBT-specific and LGBT-embedded care delivery. Advantages to both models exist, and they provide LGBT patients different options of healthcare. Yet certain commonalities must be met: a clean and confidential system. Once met, LGBT-competent environments and providers can advocate for appropriate care for LGBT communities, creating environments where they would want to seek care.

  19. Deploying Renewables -- principles for effective policies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-09-29

    Renewable energy can play a fundamental role in tackling climate change, environmental degradation and energy security. As these challenges have become ever more pressing, governments and markets are seeking innovative solutions. Yet, what are the key factors that will determine the success of renewable energy policies? How can current policies be improved to encourage greater deployment of renewables? What impact can more effective policies have on renewables' share in the future global energy mix and how soon? This publication addresses these questions. Responding to the Gleneagles G8 call for a clean and secure energy future, it highlights key policy tools to fast-track renewables into the mainstream. This analysis illustrates good practices by applying the combined metrics of effectiveness and efficiency to renewable energy policies in the electricity, heating and transport sectors. It highlights significant barriers to accelerating renewables penetration, and argues that the great potential of renewables can be exploited much more rapidly and to a much larger extent if good practices are adopted. Carefully designed policy frameworks, customised to support technologies at differing stages of maturity, will deliver a strong portfolio of renewable energy technologies. The document provides recommendations on key principles for policy design as a template for decision makers.

  20. Environment

    DEFF Research Database (Denmark)

    Valentini, Chiara

    2017-01-01

    The term environment refers to the internal and external context in which organizations operate. For some scholars, environment is defined as an arrangement of political, economic, social and cultural factors existing in a given context that have an impact on organizational processes and structures....... For others, environment is a generic term describing a large variety of stakeholders and how these interact and act upon organizations. Organizations and their environment are mutually interdependent and organizational communications are highly affected by the environment. This entry examines the origin...... and development of organization-environment interdependence, the nature of the concept of environment and its relevance for communication scholarships and activities....

  1. Renewable energy annual 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-03-01

    This report presents summary data on renewable energy consumption, the status of each of the primary renewable technologies, a profile of each of the associated industries, an analysis of topical issues related to renewable energy, and information on renewable energy projects worldwide. It is the second in a series of annual reports on renewable energy. The renewable energy resources included in the report are biomass (wood and ethanol); municipal solid waste, including waste-to-energy and landfill gas; geothermal; wind; and solar energy, including solar thermal and photovoltaic. The report also includes various appendices and a glossary.

  2. Measuring Nurse Leaders' and Direct Care Nurses' Perceptions of a Healthy Work Environment in an Acute Care Setting, Part 1: A Pilot Study.

    Science.gov (United States)

    Huddleston, Penny; Gray, Jennifer

    2016-01-01

    The American Association of Critical-Care Nurses Healthy Work Environment Assessment tool (AACN HWEAT) was developed as a simple screening assessment for clinical units to quickly get individual feedback on the status of the nurses' work environments based on the AACN standards of a healthy work environment (HWE). Pilot studies were conducted to determine the psychometric properties of the tool after seeking permission from AACN and the Vital Smarts Company. The purposes of these research studies were to assess the psychometric properties of the AACN HWEAT and to measure the nurse leaders' and direct care nurses' perceptions of an HWE in an acute care setting. Nonexperimental descriptive survey designs were implemented with 3 convenience samples for a total sample of 321 nurse leaders and direct care nurses. Cronbach's αs of .97 for nurse leaders and .91 for direct care nurses demonstrated strong reliability or internal consistency of the tool. Face validity demonstrated 13 of 18 items placed in the correct category. The scale content validity index score was 96.63. Concurrent validity demonstrated that items were highly correlated, ranging from 0.42, with 95% confidence interval (CI) of 0.57 to 0.69, to 0.85, with 95% CI of 0.70-0.93, P measure an HWE for nurses at all levels in acute care settings.

  3. Financing renewable energy: Obstacles and solutions

    Energy Technology Data Exchange (ETDEWEB)

    Brown, M.H.

    1994-06-01

    The majority of renewable energy technology projects now being developed use long term project financing to raise capital. The financial community scrutinizes renewables more closely than some conventionally fueled electric generation facilities because it perceives renewables as risky and expensive. Renewables pay for this perceived risk through higher interest charges and other more restrictive loan covenants. Risks that are not eliminated in the power sales agreement or through some other means generally result in higher project costs during financing. In part, this situation is a product of the private placement market and project finance process in which renewable energy facilities must function. The project finance process attracts banks and institutional lenders as well as equity investors (often pension funds) who do not want to place their capital at great risk. Energy project finance exists on the basis of a secure revenue stream and a thorough understanding of electric generation technology. Renewables, like all energy projects, operating in uncertain regulatory environments are often difficult to finance. In the uncertain regulatory environment in which renewables now operate, investors and lenders are nervous about challenges to existing contracts between independent power producers and utilities. Challenges to existing contracts could foretell challenges to contracts in the future. Investors and lenders now look to state regulatory environments as an indicator of project risk. Renewable energy technology evolves quickly. Yet, often the information about technological evolution is not available to those who invest in the energy projects. Or, those who have invested in new renewable energy technology in the past have lost money and are nervous about doing so in the future - even though technology may have improved. Inadequate or unfavorable information is a barrier to the development of renewables.

  4. AIP to Process AGU Renewals for 2005

    Science.gov (United States)

    Spilhaus, Fred

    2004-09-01

    AGU is collaborating with the American Institute of Physics (AIP) to provide improved online renewal of your membership and subscription starting with 2005 payments. The renewal process whether online or via mail will be easy for you. I would like to encourage each of you to renew early using the online form. You will be saving the Union money by cutting down on the cost of paper renewals. As a thank-you, members who renew within the first weeks will receive 2005 access without charge to the AGU Member Library of online back issues of all journals. At the same time you can help assure that your information has been correctly transferred to the new database. Great care has been taken in the transition; however, a check by you will assure your information is current.

  5. [The environment of the Intensive Care Center and the work of the nursing staff].

    Science.gov (United States)

    Chavaglia, Suzel Regina Ribeiro; Borges, Cristiana Machado; do Amaral, Eliana Maria Scarelli; Iwamoto, Helena Hemiko; Ohl, Rosali Isabel Barduchi

    2011-12-01

    This is a descriptive exploratory study with a quantitative approach. It aims to characterize the environment of the Intensive Care Center (ICC) in regard to its physical area, material resources and equipments, and to identify factors concerned to the work of nurses. It investigates environmental factors that contribute to an aesthetically harmonious, functional and humanized space and that favor the performance of nursing work. The units that make up the ICC meet the recommendations of the National Health Surveillance Agency (ANVISA) in the evaluated items. he following favorable work conditions were highlighted: thermal conditions, color of the ceiling, walls and floors, luminosity. The following unfavorable work conditions were highlighted: outdoor spaces, privacy and individuality of clients and noise. The conclusion is that the facilities of the units meet the minimum recommendations of ANVISA. Both favorable and unfavorable environmental work conditions were identified. The creation of better environmental conditions allows a better staff performance, influencing positively quality, safety, and job satisfaction.

  6. CBRNE TC3: A Hybrid Approach to Casualty Care in the CBRNE Environment.

    Science.gov (United States)

    Strain, John W

    2013-01-01

    The implementation of Tactical Combat Casualty Care (TCCC) guidelines for the Operation Enduring Freedom and Operation Iraqi Freedom contingency operations has dramatically reduced preventable combat deaths. A study of these principles and their application to medical treatment in the chemical, biological, radiological, nuclear, and high-yield explosives (CBRNE), weapons of mass destruction (WMD) environment is presented as a potential readiness and force multiplier for units engaged in this area of operations. Preparing medical operators for support of WMD sampling and mitigation missions requires extensive preventive medicine and post-exposure and downrange trauma threat preparedness. Training and equipping CBRN operators with treatment skills and appropriate interventional material requires pre-implementation planning specific to WMD threats (e.g., anthrax, radiation, organophosphates, and contaminated trauma). A scenario-based study reveals the tactics, techniques, and procedures for training, resourcing, and fielding the CBRN operator of the future.

  7. Environment surveillance of filamentous fungi in two tertiary care hospitals in China

    Institute of Scientific and Technical Information of China (English)

    HAO Zhen-feng; AO Jun-hong; HAO Fei; YANG Rong-ya; ZHU He; ZHANG Jie

    2011-01-01

    Background Invasive fungal infections have constituted an increasingly important cause of morbidity and mortality in immunocompromised patients. In this study, a surveillance project was conducted in three different intensive care units of two large tertiary hospitals in China.Methods A one-year surveillance project was conducted in two tertiary hospitals which located in northern China and southwest China respectively. Air, surfaces and tap water were sampled twice a month in a central intensive care unit, a bone marrow transplant unit, a neurosurgery intensive care unit and a live transplant department. Environmental conditions such as humidity, temperature and events taking place, for example the present of the visitors, healthcare staff and cleaning crew were also recorded at the time of sampling.Results The air fungal load was 91.94 cfu/m3 and 71.02 cfu/m3 in the southwest China hospital and the northern China hospital respectively. The five most prevalent fungi collected from air and surfaces were Penicillium spp., Cladospcrium spp., Altemaria spp., Aspergillus spp. and Saccharomyces spp. in the southwest China hospital, meanwhile Penicillium spp., Fusarium spp., Aspergillus spp., Altemaria spp. and Cladospcrium spp. in the northern China hospital. The least contaminated department was intensive care units, and the heaviest contaminated department was neurosurgery intensive care unit. Seventy-three percent of all surfaces examined in the northern China hospital and eighty-six percent in the southwest China hospital yielded fungi. Fifty-four percent of water samples from the northern China hospital and forty-nine percent from the southwest China hospital yielded fungi.Conclusions These findings suggested that the fungus exist in the environment of the hospital including air, surface and water. Air and surface fungal load fluctuated over the year. Air fungal load was lower in winter and higher In summer and autumn, but seldom exceeded acceptable level. The

  8. Influence of socio-demographic, labour and professional factors on nursing perception concerning practice environment in Primary Health Care.

    Science.gov (United States)

    Parro Moreno, Ana; Serrano Gallardo, Pilar; Ferrer Arnedo, Carmen; Serrano Molina, Lucía; de la Puerta Calatayud, M Luisa; Barberá Martín, Aurora; Morales Asencio, José Miguel; de Pedro Gómez, Joan

    2013-11-01

    To analyze the perception of nursing professionals of the Madrid Primary Health Care environment in which they practice, as well as its relationship with socio-demographic, work-related and professional factors. Cross-sectional, analytical, observational study. Questionnaire sent to a total of 475 nurses in Primary Health Care in Madrid (former Health Care Areas 6 and 9), in 2010. Perception of the practice environment using the Practice Environment Scale of the Nursing Work Index (PES-NWI) questionnaire, as well as; age; sex; years of professional experience; professional category; Health Care Area; employment status and education level. There was a response rate of 69.7% (331). The raw score for the PES-NWI was: 81.04 [95%CI: 79.18-82.91]. The factor with the highest score was "Support from Managers" (2.9 [95%CI: 2.8-3]) and the lowest "Workforce adequacy" (2.3 [95%CI: 2.2-2.4]). In the regression model (dependent variable: raw score in PES-NWI), adjusted by age, sex, employment status, professional category (coefficient B=6.586), and years worked at the centre (coefficient B=2.139, for a time of 0-2 years; coefficient B=7.482, for 3-10 years; coefficient B=7.867, for over 20 years) remained at p≤0.05. The support provided by nurse managers is the most highly valued factor in this practice environment, while workforce adequacy is perceived as the lowest. Nurses in posts of responsibility and those possessing a higher degree of training perceive their practice environment more favourably. Knowledge of the factors in the practice environment is a key element for health care organizations to optimize provision of care and to improve health care results. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  9. Marine Renewable Energy Seascape

    Directory of Open Access Journals (Sweden)

    Alistair G.L. Borthwick

    2016-03-01

    Full Text Available Energy production based on fossil fuel reserves is largely responsible for carbon emissions, and hence global warming. The planet needs concerted action to reduce fossil fuel usage and to implement carbon mitigation measures. Ocean energy has huge potential, but there are major interdisciplinary problems to be overcome regarding technology, cost reduction, investment, environmental impact, governance, and so forth. This article briefly reviews ocean energy production from offshore wind, tidal stream, ocean current, tidal range, wave, thermal, salinity gradients, and biomass sources. Future areas of research and development are outlined that could make exploitation of the marine renewable energy (MRE seascape a viable proposition; these areas include energy storage, advanced materials, robotics, and informatics. The article concludes with a sustainability perspective on the MRE seascape encompassing ethics, legislation, the regulatory environment, governance and consenting, economic, social, and environmental constraints. A new generation of engineers is needed with the ingenuity and spirit of adventure to meet the global challenge posed by MRE.

  10. Renewable Energy Certificates (RECs)

    Science.gov (United States)

    Renewable Energy Certificates (RECs), are tradable, non-tangible energy commodities in the United States that represent proof that 1 megawatt-hour (MWh) of electricity was generated from an eligible renewable energy resource.

  11. Creating trauma-informed correctional care: a balance of goals and environment

    Directory of Open Access Journals (Sweden)

    Niki A. Miller

    2012-03-01

    Full Text Available Background : Rates of posttraumatic stress disorder and exposure to violence among incarcerated males and females in the US are exponentially higher than rates among the general population; yet, abrupt detoxification from substances, the pervasive authoritative presence and sensory and environmental trauma triggers can pose a threat to individual and institutional stability during incarceration. Objective : The authors explore the unique challenges and promises of trauma informed correctional care and suggest strategies for administrative support, staff development, programming and relevant clinical approaches. Method : A review of literature includes a comparison of gendered responses and the implications for men's facilities, and the compatibility of trauma recovery goals and forensic programming goals. Results : Trauma informed care demonstrates promise in increasing offender responsivity to evidence-based cognitive behavioral programming that reduces criminal risk factors and supporting integrated programming for offenders with substance abuse and co-occurring disorders. Conclusions : Incorporating trauma recovery principles into correctional environments requires an understanding of criminal justice priorities, workforce development and specific approaches to screening, assessment and programming that unify the goals of clinical and security staff.

  12. Educating advanced level practice within complex health care workplace environments through transformational practice development.

    Science.gov (United States)

    Hardy, Sally; Jackson, Carrie; Webster, Jonathan; Manley, Kim

    2013-10-01

    Over the past 20 years health care reform has influenced the development of advanced level practitioner roles and expectations. How advanced level practitioners work to survive the highly stimulating, yet sometimes overwhelming aspects of balancing high quality provision with political reform agendas, amidst economic constraint is considered. Transformational approaches (encompassing education and practice led service development) can provide, promote and 'provoke' a harnessing of complex issues workplace environment to produce creative solutions. Transformational Practice Development provides a structured, rigorous, systematic approach that practitioners, teams and health care consumers alike can utilise to achieve skills and attributes needed for successful innovation. The authors present case study materials from action orientated locally delivered Practice Development, as a complex strategic intervention approach to influence and promote advanced level practice expertise. Initiated through facilitation of transformational leadership, and resultant team based improvements, we present how strategic collaborative processes can harness work chaos and complexity to provide sustainable and productive workplace cultures of effectiveness. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Development of a Physical Environmental Observational Tool for Dining Environments in Long-Term Care Settings.

    Science.gov (United States)

    Chaudhury, Habib; Keller, Heather; Pfisterer, Kaylen; Hung, Lillian

    2017-02-20

    This paper presents the first standardized physical environmental assessment tool titled Dining Environment Audit Protocol (DEAP) specifically designed for dining spaces in care homes and reports the results of its psychometric properties. Items rated include: adequacy of lighting, glare, personal control, clutter, staff supervision support, restraint use, and seating arrangement option for social interaction. Two scales summarize the prior items and rate the overall homelikeness and functionality of the space. Ten dining rooms in three long-term care homes were selected for assessment. Data were collected over 11 days across 5 weeks. Two trained assessors completed DEAP independently on the same day. Interrater-reliability was completed for lighting, glare, space, homelike aspects, seating arrangements and the two summary scales, homelikeness and functionality of the space. For categorical measures, measure responses were dichotomized at logical points and Cohen's Kappa and concordance on ratings were determined. The two overall rating scales on homelikeness and functionality of space were found to be reliable intraclass correlation coefficient (ICC) (~0.7). The mean rating for homelikeness for Assessor 1 was 3.5 (SD 1.35) and for functionality of the room was 5.3. (SD 0.82; median 5.5). The findings indicate that the tool's interrater-reliability scores are promising. The high concordance on the overall scores for homelikeness and functionality is indicative of the strength of the individual items in generating a reliable global assessment score on these two important aspects of the dining space.

  14. Pharmaceuticals and personal care products in the aquatic environment in China: a review.

    Science.gov (United States)

    Bu, Qingwei; Wang, Bin; Huang, Jun; Deng, Shubo; Yu, Gang

    2013-11-15

    Pharmaceuticals and personal care products (PPCPs) have been detected as contaminants of emerging concern ubiquitously in the aquatic environment in China and worldwide. A clear picture of PPCP contamination in the Chinese aquatic environment is needed to gain insight for both research and regulatory needs (e.g. monitoring, control and management). The occurrence data of 112 PPCPs in waters and sediments in China has been reviewed. In most cases, the detected concentration of these PPCPs in waters and sediments were at ng/L and ng/g levels, which were lower than or comparable to those reported worldwide. A screening level risk assessment (SLERA) identified six priority PPCPs in surface waters, namely erythromycin, roxithromycin, diclofenac, ibuprofen, salicylic acid and sulfamethoxazole. The results of SLERA also revealed that the hot spots for PPCP pollution were those river waters affected by the megacities with high density of population, such as Beijing, Tianjin, Guangzhou and Shanghai. Limitations of current researches and implications for future research in China were discussed. Some regulatory issues were also addressed. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. WORKING ENVIRONMENT AND JOB SATISFACTION AMONG HEALTH PROFESSIONAL WORKING AT A TERTIARY CARE HOSPITAL OF PAKISTAN.

    Science.gov (United States)

    Aziz, Imrana; Kumar, Ramesh; Rathore, Anita; Lal, Manohr

    2015-01-01

    Work environment is believed to be a major factor for better performance of human resource for health in any organization. This study concentrated on multiple factors involved in job satisfaction was appraised to critique their efficient significance in calculation of the health professional liking. Factors included job matched with workers' skills/experience, incentives, supervision, administrator support; convenient work load, training, appreciation, low pay and job protection were major contributors in job satisfaction. A mix method study was done in 2014; an initial descriptive cross sectional survey was done followed by qualitative approach. Eighteen in-depth interviews with health care providers were conducted after taking written consent. Nodes, sub-nodes and final themes were generated during qualitative data analysis. Main findings and themes were, generated after making the nodes and sub-nodes from the most frequent responses. These themes were; absence of work pressure, work place safety, social support, learning opportunities, and employee influence on conditions and recognition individual or team efforts. Work environment is a major contributing factor towards job satisfaction among the health workers.

  16. Renewable energy annual 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    The Renewable Energy Annual 1995 is the first in an expected series of annual reports the Energy Information Administration (EIA) intends to publish to provide a comprehensive assessment of renewable energy. This report presents the following information on the history, status, and prospects of renewable energy data: estimates of renewable resources; characterizations of renewable energy technologies; descriptions of industry infrastructures for individual technologies; evaluations of current market status; and assessments of near-term prospects for market growth. An international section is included, as well as two feature articles that discuss issues of importance for renewable energy as a whole. The report also contains a number of technical appendices and a glossary. The renewable energy sources included are biomass (wood), municipal solid waste, biomass-derived liquid fuels, geothermal, wind, and solar and photovoltaic.

  17. VT Renewable Energy Sites - Renewable Energy Professionals

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) The Renewable Energy Atlas of Vermont and this dataset were created to assist town energy committees, the Clean Energy Development Fund and other...

  18. Effect of empowerment on professional practice environments, work satisfaction, and patient care quality: further testing the Nursing Worklife Model.

    Science.gov (United States)

    Spence Laschinger, Heather K

    2008-01-01

    The purpose of this study was to test Leiter and Laschinger's Nursing Worklife Model linking structural empowerment to Lake's 5-factor professional practice work environment model and work quality outcomes. A predictive, nonexperimental design was used to test the model in a random sample of 234 staff nurses. The analysis revealed that professional practice environment characteristics mediated the relationship between structurally empowering work conditions and both job satisfaction and nurse-assessed patient care quality.

  19. Individual Health Care System Distrust and Neighborhood Social Environment: How Are They Jointly Associated with Self-rated Health?

    OpenAIRE

    Yang, Tse-Chuan; Matthews, Stephen A.; Shoff, Carla

    2011-01-01

    Americans’ distrust in the health care system has increased in the past decades; however, little research has explored the impact of distrust on self-rated health and even less is known about whether neighborhood social environment plays a role in understanding the relationship between distrust and self-rated health. This study fills these gaps by investigating both the direct and moderating associations of neighborhood social environment with self-rated health. Our analysis is based on the 2...

  20. Renewable energies in Baden-Wuerttemberg 2011; Erneuerbare Energien in Baden-Wuerttemberg 2011

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-11-15

    Within the contribution under consideration the Ministry of Environment, Climate Protection and Service Sector (Stuttgart, Federal Republic of Germany) reports on the following aspects: (1) Development of the energy consumption; (2) Contribution of the renewable energy sources to the energy supply; (3) Development of the amounts of renewable energy sources in the energy supply; (4) Structure of final energy supply from renewable energies; (5) Economic considerations on the utilization of renewable energy sources; (6) CO{sub 2} emissions and CO{sub 2} avoidance by means of renewable energy sources; (7) Utilization of renewable energy sources in Germany and Europe; (8) Remuneration for power from renewable energy sources according to the Renewable Energy Law and evaluation of the costs; (9) Utilization of renewable energy sources by Federal States; (10) Utilization of renewable energy sources by counties; (11) Potentials of renewable energy sources; (12) Employment effects in Baden-Wuertemberg; (13) Promotion of renewable energy sources.

  1. Designing health care environments: Part I. Basic concepts, principles, and issues related to evidence-based design.

    Science.gov (United States)

    Cesario, Sandra K

    2009-06-01

    A 2001 Institute of Medicine report captured the nation's attention regarding the dangers that can result from the health care environment. This report, fueled by the need for new facilities to be constructed, led to an explosion of research that now links the physical structure and design of health care facilities to the health and well-being of patients, nurses, other health care workers, and visitors. Continuing nursing education that highlights the importance of evidence-based design has been associated with measurable improvement in health care facilities' clinical outcomes, economic performance, employee productivity, customer satisfaction, and cultural congruency. Three major categories of outcomes can be impacted by evidence-based design: stress reduction, safety, and overall health care quality and ecology. In this article, Part I of a two-part series, the basic concepts, principles, and issues related to evidence-based design are introduced. Part II will describe continuing education programs available for nurses.

  2. [Health care strategies for mental health problems in the prison environment, the Spanish case in a European context].

    Science.gov (United States)

    Arroyo-Cobo, J M

    2011-01-01

    A review was carried out of scientific literature on health care strategies for mental health problems in the prison environment. Data is given about the main activities put into practice by prison administrations as a response to the worrying information that has come to light in recent epidemiological studies on mental disorders in prison, with figures that, when compared to the general population, give results of double the number of cases of Common Mental Illness (CMI) and four times the number of cases of Severe Mental Illness (SMI) amongst prison inmates. A review was made of the most important bibliographical databases containing health care policies for mental health problems in prison published by prison administrations in the last 10 years. This information was completed with other data obtained from an analysis of the indicators available in Health Care Coordination on its health care strategies for mental health in centres run by the Secretary General of Prisons, in Spain. There is little in the way of scientific literature that clearly states health care policies for mental illness in the prison environment. Those that do tend to agree with a number of affirmations that include the obligation to offer a therapeutic response of equal quality to that received by patients in the community, the need for a multi-disciplinary team responsible for caring for this type of patient, along with a coordinated effort between the medical, social, legal and prison administrations that at a given time have to care for them.

  3. Measuring Nurse Leaders' and Direct Care Nurses' Perceptions of a Healthy Work Environment in Acute Care Settings, Part 3: Healthy Work Environment Scales for Nurse Leaders and Direct Care Nurses.

    Science.gov (United States)

    Huddleston, Penny; Mancini, Mary E; Gray, Jennifer

    2017-03-01

    Survey items on the Healthy Work Environment Scales (HWES) for nurse leaders (NLs) and direct care nurses (DCNs) were developed using statements from 2 qualitative research studies conducted in a healthcare system. The purposes of 2 quantitative studies were to develop items on the HWES for NLs and DCNs, to assess the validity and reliability of these new tools, and to describe the NLs and DCNs perceptions of a healthy work environment (HWE) using nonexperimental descriptive designs. Each research study had 2 separate phases. In phase 1 of the studies, NLs and DCNs assigned each item to 1 of the 8 characteristics of an HWE to assess face validity. Content validity was determined by calculating the scale content validity and item content validity indices. Based on these results, the items were revised or deleted to obtain version 3 of both tools. In phase 2 of the studies, principal component analysis (PCA) assessed the validity of the tools, Cronbach's α served as the test for reliability, and the NLs and DCNs perceptions of an HWE were measured. Samples included 314 subjects for the HWES for NL study and 986 subjects for the HWES for DCN study. Principal component analysis for the HWES for NLs (version 3) revealed 40 items comprising 4 components, and PCA for the HWES for DCNs (version 3) revealed 39 items comprising 5 components. Internal consistencies of the tools were 0.974 and 0.957, respectively. Based on the findings of these studies, the tools demonstrated promising psychometric properties to measure a HWE in acute care settings.

  4. 40 CFR 80.1115 - How are equivalence values assigned to renewable fuel?

    Science.gov (United States)

    2010-07-01

    ... shall have an equivalence value of 1.3. (5) Non-ester renewable diesel, including that produced from... renewable source, expressed as a percent, on an energy basis. EC = Energy content of the renewable fuel, in... renewable fuel? 80.1115 Section 80.1115 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

  5. 40 CFR 80.1415 - How are equivalence values assigned to renewable fuel?

    Science.gov (United States)

    2010-07-01

    ...) Non-ester renewable diesel with a lower heating value of at least 123,500 Btu/gal shall have an... renewable fuel that came from renewable biomass, expressed as a fraction, on an energy basis. EC = Energy... renewable fuel? 80.1415 Section 80.1415 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

  6. Assessing Legal Environment Factors that Impact in the Decision to Invest in Electricity generation from Renewable Resources – Case of Albania

    Directory of Open Access Journals (Sweden)

    ABAZ ALIKO

    2016-12-01

    Full Text Available Identifying and assessing the factors impacting investments in electricity generation is important for both private and public decision-makers. Understanding the decision-making process helps to stimulate and increase investments in the energy sector. This paper examines the legal environment factors that affect the decision to invest in electricity generation. Seventeen sub-factors of this environment are identified and its relative importance in the decision-making is measured, by interviewing 68 investors having invested or having obtained the right to invest in the electricity generation. We perform the Principal Component Analysis (PCA in 17 sub-factors to find more general latent structures (factors that characterize the legal environment affecting investments. The latent factors discovered are: Legal and Favourable Framework for the Concessions, Protecting Foreign Investments, Government Conditions and Bureaucracy as well as the Cascade Investments and Information. These are the most important factors of the legal environment in the decision-making process to invest in electricity generation.

  7. Linking nurses' perceptions of patient care quality to job satisfaction: the role of authentic leadership and empowering professional practice environments.

    Science.gov (United States)

    Spence Laschinger, Heather K; Fida, Roberta

    2015-05-01

    A model linking authentic leadership, structural empowerment, and supportive professional practice environments to nurses' perceptions of patient care quality and job satisfaction was tested. Positive work environment characteristics are important for nurses' perceptions of patient care quality and job satisfaction (significant factors for retention). Few studies have examined the mechanism by which these characteristics operate to influence perceptions of patient care quality or job satisfaction. A cross-sectional provincial survey of 723 Canadian nurses was used to test the hypothesized models using structural equation modeling. The model was an acceptable fit and all paths were significant. Authentic leadership had a positive effect on structural empowerment, which had a positive effect on perceived support for professional practice and a negative effect on nurses' perceptions that inadequate unit staffing prevented them from providing high-quality patient care. These workplace conditions predicted job satisfaction. Authentic leaders play an important role in creating empowering professional practice environments that foster high-quality care and job satisfaction.

  8. Effects of Home Environment and Center-Based Child Care Quality on Children's Language, Communication, and Literacy Outcomes

    Science.gov (United States)

    Pinto, Ana Isabel; Pessanha, Manuela; Aguiar, Cecilia

    2013-01-01

    This study examined the joint effects of home environment and center-based child care quality on children's language, communication, and early literacy development, while also considering prior developmental level. Participants were 95 children (46 boys), assessed as toddlers (mean age = 26.33 months; Time 1) and preschoolers (mean age = 68.71…

  9. Effects of Home Environment and Center-Based Child Care Quality on Children's Language, Communication, and Literacy Outcomes

    Science.gov (United States)

    Pinto, Ana Isabel; Pessanha, Manuela; Aguiar, Cecilia

    2013-01-01

    This study examined the joint effects of home environment and center-based child care quality on children's language, communication, and early literacy development, while also considering prior developmental level. Participants were 95 children (46 boys), assessed as toddlers (mean age = 26.33 months; Time 1) and preschoolers (mean age = 68.71…

  10. Relationship marketing of health care plans: retaining corporate customers in a competitive environment.

    Science.gov (United States)

    Choong, P

    2000-01-01

    Corporate employers have become major purchasers of health care. They are gatekeepers who decide whether to retain or drop an insurance company from the choice set offered to employees as well as whether to include new insurers into this choice set. If marketers of health maintenance organizations are to maintain their market share in this competitive environment, they need to understand issues considered important to corporate employers. This paper identifies the key drivers of satisfaction among corporate employers and shows the impact these key drivers have on overall satisfaction. More importantly, it demonstrates both theoretically and empirically that the impact of performance attributes on satisfaction is asymmetrical. Positive performances of attributes are shown to have smaller impacts on satisfaction than negative performances. The theoretical underpinnings of these phenomena are shown to lie in prospect theory. Finally, quantitative indicators are computed to aid managerial decision-making. Marketing managers of health insurance companies will optimize returns on their investment by understanding this asymmetric effect and eliminate existing deficiencies.

  11. The renewable chemicals industry

    DEFF Research Database (Denmark)

    Christensen, Claus H.; Rass-Hansen, J.; Marsden, Charlotte Clare

    2008-01-01

    The possibilities for establishing a renewable chemicals industry featuring renewable resources as the dominant feedstock rather than fossil resources are discussed in this Concept. Such use of biomass can potentially be interesting from both an economical and ecological perspective. Simple...... per kilogram of desired product to illustrate in which processes the use of renewable resources lead to the most substantial reduction of CO2 emissions. The steps towards a renewable chemicals industry will most likely involve intimate integration of biocatalytic and conventional catalytic processes...... and educational tools are introduced to allow initial estimates of which chemical processes could be viable. Specifically, fossil and renewables value chains are used to indicate where renewable feedstocks can be optimally valorized. Additionally, C factors are introduced that specify the amount of CO2 produced...

  12. Policies for Renewable Heat

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

    This paper builds on IEA publications, Deploying Renewables, Principles for Effective Policies and Deploying Renewables, Best and Future Policy Practice, that discuss the 'integrated policy approach,' whereby renewable energy technologies require different support policies at different stages of their maturity pathways. The paper discusses how the integrated policy approach applies to renewable heat. It attempts to provide guidance for policy-makers on renewable heat throughout the different phases of the policy lifecycle, allowing for the specific challenges of renewable heat and needs of the many stakeholders involved. Stimulating a market for heat involves challenges that are different and, often, more difficult to overcome than in the electricity and transport sectors.

  13. Nurses' Practice Environment and Their Job Satisfaction: A Study on Nurses Caring for Older Adults in Shanghai.

    Directory of Open Access Journals (Sweden)

    Ying Wang

    Full Text Available To examine the job satisfaction of nurses who are caring for older adults in healthcare settings in Shanghai, and to explore the underlying factors in order to explain and predict nurses' job satisfaction.China has the largest elderly population in the world, and its population is aging rapidly. Studies on job satisfaction of nurses providing care for the elderly in China can help to identify problem areas and develop strategies for the improvement of nurses' working conditions. However, to date, this subject matter has not been thoroughly studied in the Chinese context. Previous studies in other countries show that many factors impact nurses' job satisfaction, with the practice environment being a critical factor. There is a serious nursing shortage in China, especially in the big cities such as Shanghai. Given the increasing care demand of the aging population, learning about the job satisfaction level among nurses who are caring for older adults can provide essential information to help attract and retain nurses in this specialty area.A cross-sectional survey was conducted among 444 nurses in 22 elderly care institutions in Shanghai. The Chinese version of the Index of Work Satisfaction (IWS and the Nursing Practice Environment Scale were instruments used. Inferential statistical tests used to analyze the data included Spearman correlation analysis, one-way analysis of variance, and hierarchical regression tests.The average overall IWS (part B score was 135.21 ± 19.34. Personality, job and organizational characteristics were found to be the most influential factors, and the practice environment was identified as having the strongest impact on job satisfaction (Beta = 0.494.Job satisfaction level among nurses who are caring for older adults in Shanghai is moderate, but the data suggest that this could be greatly increased if the nursing practice environment was improved.

  14. Nurses’ Practice Environment and Their Job Satisfaction: A Study on Nurses Caring for Older Adults in Shanghai

    Science.gov (United States)

    Wang, Ying; Dong, Weizhen; Mauk, Kristen; Li, Peiying; Wan, Jin; Yang, Guang; Fang, Lyuying; Huan, Wan; Chen, Chun; Hao, Mo

    2015-01-01

    Aim To examine the job satisfaction of nurses who are caring for older adults in healthcare settings in Shanghai, and to explore the underlying factors in order to explain and predict nurses’ job satisfaction. Background China has the largest elderly population in the world, and its population is aging rapidly. Studies on job satisfaction of nurses providing care for the elderly in China can help to identify problem areas and develop strategies for the improvement of nurses’ working conditions. However, to date, this subject matter has not been thoroughly studied in the Chinese context. Previous studies in other countries show that many factors impact nurses’ job satisfaction, with the practice environment being a critical factor. There is a serious nursing shortage in China, especially in the big cities such as Shanghai. Given the increasing care demand of the aging population, learning about the job satisfaction level among nurses who are caring for older adults can provide essential information to help attract and retain nurses in this specialty area. Methods A cross-sectional survey was conducted among 444 nurses in 22 elderly care institutions in Shanghai. The Chinese version of the Index of Work Satisfaction (IWS) and the Nursing Practice Environment Scale were instruments used. Inferential statistical tests used to analyze the data included Spearman correlation analysis, one-way analysis of variance, and hierarchical regression tests. Results The average overall IWS (part B) score was 135.21 ± 19.34. Personality, job and organizational characteristics were found to be the most influential factors, and the practice environment was identified as having the strongest impact on job satisfaction (Beta = 0.494). Conclusion Job satisfaction level among nurses who are caring for older adults in Shanghai is moderate, but the data suggest that this could be greatly increased if the nursing practice environment was improved. PMID:26380980

  15. Nurses' Practice Environment and Their Job Satisfaction: A Study on Nurses Caring for Older Adults in Shanghai.

    Science.gov (United States)

    Wang, Ying; Dong, Weizhen; Mauk, Kristen; Li, Peiying; Wan, Jin; Yang, Guang; Fang, Lyuying; Huan, Wan; Chen, Chun; Hao, Mo

    2015-01-01

    To examine the job satisfaction of nurses who are caring for older adults in healthcare settings in Shanghai, and to explore the underlying factors in order to explain and predict nurses' job satisfaction. China has the largest elderly population in the world, and its population is aging rapidly. Studies on job satisfaction of nurses providing care for the elderly in China can help to identify problem areas and develop strategies for the improvement of nurses' working conditions. However, to date, this subject matter has not been thoroughly studied in the Chinese context. Previous studies in other countries show that many factors impact nurses' job satisfaction, with the practice environment being a critical factor. There is a serious nursing shortage in China, especially in the big cities such as Shanghai. Given the increasing care demand of the aging population, learning about the job satisfaction level among nurses who are caring for older adults can provide essential information to help attract and retain nurses in this specialty area. A cross-sectional survey was conducted among 444 nurses in 22 elderly care institutions in Shanghai. The Chinese version of the Index of Work Satisfaction (IWS) and the Nursing Practice Environment Scale were instruments used. Inferential statistical tests used to analyze the data included Spearman correlation analysis, one-way analysis of variance, and hierarchical regression tests. The average overall IWS (part B) score was 135.21 ± 19.34. Personality, job and organizational characteristics were found to be the most influential factors, and the practice environment was identified as having the strongest impact on job satisfaction (Beta = 0.494). Job satisfaction level among nurses who are caring for older adults in Shanghai is moderate, but the data suggest that this could be greatly increased if the nursing practice environment was improved.

  16. Treatment of embolic stroke as a medical emergency. Implications in a managed care environment.

    Science.gov (United States)

    Lanzieri, C F

    1997-04-01

    Encouraging innovations should be a concern of the providers/gatekeepers of health-care if lower health-care costs are to become a reality. Controlled prices and improper incentives will dramatically slow innovation in American medicine. For the vertically integrated health-care system providing capitated coverage, the aggressive treatment of stroke is a sound financial decision.

  17. The Relationship between Prenatal Care, Personal Alcohol Abuse and Alcohol Abuse in the Home Environment

    Science.gov (United States)

    Grekin, Emily R.; Ondersma, Steven J.

    2009-01-01

    Aims: Nearly one-fourth of African-American women receive no prenatal care during the first trimester of pregnancy. The aim of the current study is to identify factors that underlie inadequate prenatal care among African-American women. Maternal alcohol abuse has been examined as one risk factor for inadequate prenatal care, but findings have been…

  18. The Relationship between Prenatal Care, Personal Alcohol Abuse and Alcohol Abuse in the Home Environment

    Science.gov (United States)

    Grekin, Emily R.; Ondersma, Steven J.

    2009-01-01

    Aims: Nearly one-fourth of African-American women receive no prenatal care during the first trimester of pregnancy. The aim of the current study is to identify factors that underlie inadequate prenatal care among African-American women. Maternal alcohol abuse has been examined as one risk factor for inadequate prenatal care, but findings have been…

  19. The effect of intensive care unit environments on nurse perceptions of family presence during resuscitation and invasive procedures.

    Science.gov (United States)

    Carroll, Diane L

    2014-01-01

    In a growing number of requests, family members are asking for proximity to their family member during resuscitation and invasive procedures. The objective of this study was to measure the impact of intensive care unit environments on nurse perception of family presence during resuscitation and invasive procedures. The study used a descriptive survey design with nurses from 9 intensive care units using the Family Presence Self-confidence Scale for resuscitation/invasive procedures that measures nurses' perception of self-confidence and Family Presence Risk-Benefit Scale for resuscitation and invasive procedures that measures nurses' perception of risks/benefits related to managing resuscitation and invasive procedures with family present. There were 207 nurses who responded: 14 male and 184 female nurses (9 missing data), with mean age of 41 ± 11 years, with a mean of 15 years in critical care practice. The environments were defined as surgical (n = 68), medical (n = 43), pediatric/neonatal (n = 34), and mixed adult medical/surgical (n = 36) intensive care units. There were significant differences in self-confidence, with medical and pediatric intensive care unit nurses rating more self-confidence for family presence during resuscitation (F = 7.73, P care unit nurses rating lower risk and higher benefit for resuscitation (F = 7.73, P care unit nurses. Further education and support may be needed in the surgical and mixed intensive care units. Evidence-based practice guidelines that are family centered can define the procedures and resources for family presence, to ultimately promote professional practice.

  20. Cluster Randomized Controlled Trial of An Aged Care Specific Leadership and Management Program to Improve Work Environment, Staff Turnover, and Care Quality.

    Science.gov (United States)

    Jeon, Yun-Hee; Simpson, Judy M; Li, Zhicheng; Cunich, Michelle M; Thomas, Tamsin H; Chenoweth, Lynn; Kendig, Hal L

    2015-07-01

    To evaluate the effectiveness of a leadership and management program in aged care. Double-blind cluster randomized controlled trial. Twelve residential and community-aged care sites in Australia. All care staff employed for 6 months or longer at the aged care sites were invited to participate in the surveys at 3 time points: baseline (time 1), 9 months from baseline (time 2), and 9 months after completion of time 2 (time 3) from 2011 to 2013. At each time point, at least 500 care staff completed a survey. At baseline (N = 503) the largest age group was 45 to 54 years (37%), and the majority of care staff were born in Australia (70%), spoke English (94%), and had at least completed secondary education (57%). A 12-month Clinical Leadership in Aged Care (CLiAC) program for middle managers, which aimed to further develop their leadership and management skills in creating positive workplace relationships and in enabling person-centered, evidence-based care. The primary outcomes were care staff ratings of the work environment, care quality and safety, and staff turnover rates. Secondary outcomes were care staff's intention to leave their employer and profession, workplace stress, job satisfaction, and cost-effectiveness of implementing the program. Absenteeism was excluded due to difficulty in obtaining reliable data. Managers' self-rated knowledge and skills in leadership and management are not included in this article, which focuses on care staff perceptions only. At 6 months after its completion, the CLiAC program was effective in improving care staff's perception of management support [mean difference 0.61, 95% confidence interval (CI) 0.04-1.18; P = .04]. Compared with the control sites, care staff at the intervention sites perceived their managers' leadership styles as more transformational (mean difference 0.30, 95% CI 0.09-0.51; P = .005), transactional (mean difference 0.22, 95% CI 0.05-0.39; P = .01), and less passive avoidant (mean difference 0.30, 95% CI 0

  1. Effects of the neonatal intensive care unit environment on preterm infant oral feeding

    Directory of Open Access Journals (Sweden)

    Pickler RH

    2013-04-01

    Full Text Available Rita H Pickler,1 Jacqueline M McGrath,2 Barbara A Reyna,3 Heather L Tubbs-Cooley,1 Al M Best4, Mary Lewis,3 Sharon Cone,3 Paul A Wetzel51Department of Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; 2School of Nursing, University of Connecticut and Connecticut Children's Medical Center, Hartford, CT, USA; 3VCU Medical Center, Children's Hospital of Richmond, Richmond, VA, USA; 4School of Dentistry, 5School of Engineering, Virginia Commonwealth University, Richmond, VA, USAObjective: To examine the effect of neonatal intensive care unit environmental characteristics (perceived levels of light and sound, and time of day in open unit wards and single-family rooms (SFRs on oral feeding outcomes in preterm infants.Design: Data were collected at each scheduled oral feeding for 87 preterm infants from the first oral feeding until discharge. Data included the prescribed volume of feeding and the volume consumed, the infant's level of wakefulness before feeding, and the nurse's perception of light and sound.Results: Data were collected on 5111 feedings in the ward unit and 5802 in the SFR unit from feedings involving 87 preterm infants. Light and sound were rated significantly lower in the SFR (χ2 = 139 and 1654.8, respectively. Feeding times of 9 am, 12 noon, and 3 pm were associated with the highest perceived levels of light and sound, regardless of unit design (P < 0.0001. Moderate light levels and feeding times of 12, 3, and 6 am were associated with improved feeding outcomes. Infants consumed a greater proportion of their prescribed feeding volume when fed in the open ward and when awake before feeding.Conclusion: Further study on the clinical effects of unit design is needed, as is study on the effects of environmental stimuli, so that interventions can be appropriately developed and tailored for infants needing the most support for optimal development.Keywords: NICU design, clinical outcomes, environment

  2. Mammography utilization among california women age 40-49 in a managed care environment.

    Science.gov (United States)

    Liu, X; Sennett, C; Legorreta, A P

    2001-05-01

    To examine the utilization of screening mammography and the relationship between risk factors and mammography use in women age 40-49 in a managed care environment. Retrospective observational study based on a mailed survey. A large HMO in California. The study population included respondents age 40-49 who completed a breast health assessment questionnaire mailed to all women age 34-49 and enrolled in a California HMO in early 1997. About 67.6% of the 20,391 women age 40-49 had at least one mammogram during 1995 and 1996. Logistic regression revealed that women age 40-44 were less likely (odds ratio: 0.83-0.90) than women age 45-49 to obtain mammography. Family history of breast cancer (odds ratio: 1.12-1.16), breast biopsy (odds ratio: 1.14-1.18), and a mammogram in the previous three years (odds ratio: 1.15-1.18) were associated with an increased likelihood of taking a mammogram. However, monthly breast self-exams (odds ratio: 0.996-1.04), having a child at or after age 30 (odds ratio: 0.97-1.02), and having menarche at age 12 or younger (odds ratio: 0.96-1.01) had no significant effect on the screening mammography rates. A relatively higher percentage of younger HMO members receive screening mammography than that of general population. However, some higher-risk groups, especially women whose first pregnancies were late in life, do not show a higher rate of using mammography.

  3. The need of a win-win regulation regarding the harmonization of advantages for the renewable energy sector and the concerns about the environment

    Directory of Open Access Journals (Sweden)

    Moraru Dan

    2015-06-01

    Full Text Available The main theme of this paper is the evolution of theories and suppositions regarding environment and growth. The sustainable green growth and the sustainable green capitalism concepts have attracted the interest and imagination of policy makers and industry, and also stimulated many exciting new ideas and practical actions such as the “triple bottom line” which refers to harmonizing and balancing out the three interests that are linked with sustainable business: economic, environmental and social ones. The policy has to create a workable association between what the government can ensure and not tax and what it cannot ensure and must tax. In this manner we get a win-win regulation meaning that both sides win. National and supranational policies are part of the macro-level governance and very relevant for the sustainable development of the EU Member States and for the stability of the EU itself.

  4. 40 CFR 270.200 - How may I renew my RAP if it is expiring?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 26 2010-07-01 2010-07-01 false How may I renew my RAP if it is expiring? 270.200 Section 270.200 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... renew my RAP if it is expiring? If you wish to renew your expiring RAP, you must follow the process...

  5. 40 CFR 62.14615 - How do I renew my lapsed operator qualification?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 8 2010-07-01 2010-07-01 false How do I renew my lapsed operator qualification? 62.14615 Section 62.14615 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... I renew my lapsed operator qualification? You must renew a lapsed operator qualification by one...

  6. 40 CFR 60.2909 - How do I renew my lapsed operator qualification?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false How do I renew my lapsed operator qualification? 60.2909 Section 60.2909 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Qualification § 60.2909 How do I renew my lapsed operator qualification? You must renew a lapsed...

  7. 40 CFR 60.2090 - How do I renew my lapsed operator qualification?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false How do I renew my lapsed operator qualification? 60.2090 Section 60.2090 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Training and Qualification § 60.2090 How do I renew my lapsed operator qualification? You must renew...

  8. Renewable Energy in Alaska

    Energy Technology Data Exchange (ETDEWEB)

    2013-03-01

    This report examines the opportunities, challenges, and costs associated with renewable energy implementation in Alaska and provides strategies that position Alaska's accumulating knowledge in renewable energy development for export to the rapidly growing energy/electric markets of the developing world.

  9. Marine Renewable Energies

    DEFF Research Database (Denmark)

    Azzellino, Arianna; Conley, Daniel; Vicinanza, Diego

    2013-01-01

    Countries with coastlines may have valuable renewable energy resources in the form of tides, currents, waves, and offshorewind.The potential to gather energy from the sea has recently gained interest in several nations, so Marine Renewable Energy Installations (hereinafter MREIs) will likely become...

  10. Region 9 Renewable Energy

    Science.gov (United States)

    Renewable energy production is expected to increase significantly in the next 25 years. The U.S. Environmental Protection Agency (EPA) Office of Solid Waste and Emergency Response (OSWER) Center for Program Analysis (OCPA) has initiated the RE-Powering America's Land Initiative to demonstrate the enormous potential that contaminated land and mining sites provide for developing renewable energy in the U.S.

  11. Renewable Energy Technology

    Science.gov (United States)

    Daugherty, Michael K.; Carter, Vinson R.

    2010-01-01

    In many ways the field of renewable energy technology is being introduced to a society that has little knowledge or background with anything beyond traditional exhaustible forms of energy and power. Dotson (2009) noted that the real challenge is to inform and educate the citizenry of the renewable energy potential through the development of…

  12. Renewable Energy Technology

    Science.gov (United States)

    Daugherty, Michael K.; Carter, Vinson R.

    2010-01-01

    In many ways the field of renewable energy technology is being introduced to a society that has little knowledge or background with anything beyond traditional exhaustible forms of energy and power. Dotson (2009) noted that the real challenge is to inform and educate the citizenry of the renewable energy potential through the development of…

  13. Renewable energy resources

    DEFF Research Database (Denmark)

    Ellabban, Omar S.; Abu-Rub, Haitham A.; Blaabjerg, Frede

    2014-01-01

    Electric energy security is essential, yet the high cost and limited sources of fossil fuels, in addition to the need to reduce greenhouse gasses emission, have made renewable resources attractive in world energy-based economies. The potential for renewable energy resources is enormous because...... they can, in principle, exponentially exceed the world's energy demand; therefore, these types of resources will have a significant share in the future global energy portfolio, much of which is now concentrating on advancing their pool of renewable energy resources. Accordingly, this paper presents how...... renewable energy resources are currently being used, scientific developments to improve their use, their future prospects, and their deployment. Additionally, the paper represents the impact of power electronics and smart grid technologies that can enable the proportionate share of renewable energy...

  14. Characteristics of effective, harm-free environments for children in out-of-home care.

    Science.gov (United States)

    Daly, D L; Dowd, T P

    1992-01-01

    The history of out-of-home care is replete with documented examples of abusive and neglectful practices. Some scholars express concern that out-of-home care is de facto abusive. Certain elements, however, can foster effective and harm-free out-of-home care, such as caregiver support, a model of care, a focus on positive behavior, a consumer orientation, training, program evaluation, and an internal program audit. These elements work together to increase program effectiveness and reduce negative outcomes such as staff burnout. Furthermore, programs that use these elements can be cost efficient.

  15. Psychosocial work environment, stress factors and individual characteristics among nursing staff in psychiatric in-patient care.

    Science.gov (United States)

    Hanna, Tuvesson; Mona, Eklund

    2014-01-20

    The psychosocial work environment is an important factor in psychiatric in-patient care, and knowing more of its correlates might open up new paths for future workplace interventions. Thus, the aims of the present study were to investigate perceptions of the psychosocial work environment among nursing staff in psychiatric in-patient care and how individual characteristics--Mastery, Moral Sensitivity, Perceived Stress, and Stress of Conscience--are related to different aspects of the psychosocial work environment. A total of 93 nursing staff members filled out five questionnaires: the QPSNordic 34+, Perceived Stress Scale, Stress of Conscience Questionnaire, Moral Sensitivity Questionnaire, and Mastery scale. Multivariate analysis showed that Perceived Stress was important for Organisational Climate perceptions. The Stress of Conscience subscale Internal Demands and Experience in current units were indicators of Role Clarity. The other Stress of Conscience subscale, External Demands and Restrictions, was related to Control at Work. Two types of stress, Perceived Stress and Stress of Conscience, were particularly important for the nursing staff's perception of the psychosocial work environment. Efforts to prevent stress may also contribute to improvements in the psychosocial work environment.

  16. Psychosocial Work Environment, Stress Factors and Individual Characteristics among Nursing Staff in Psychiatric In-Patient Care

    Directory of Open Access Journals (Sweden)

    Tuvesson Hanna

    2014-01-01

    Full Text Available The psychosocial work environment is an important factor in psychiatric in-patient care, and knowing more of its correlates might open up new paths for future workplace interventions. Thus, the aims of the present study were to investigate perceptions of the psychosocial work environment among nursing staff in psychiatric in-patient care and how individual characteristics—Mastery, Moral Sensitivity, Perceived Stress, and Stress of Conscience—are related to different aspects of the psychosocial work environment. A total of 93 nursing staff members filled out five questionnaires: the QPSNordic 34+, Perceived Stress Scale, Stress of Conscience Questionnaire, Moral Sensitivity Questionnaire, and Mastery scale. Multivariate analysis showed that Perceived Stress was important for Organisational Climate perceptions. The Stress of Conscience subscale Internal Demands and Experience in current units were indicators of Role Clarity. The other Stress of Conscience subscale, External Demands and Restrictions, was related to Control at Work. Two types of stress, Perceived Stress and Stress of Conscience, were particularly important for the nursing staff’s perception of the psychosocial work environment. Efforts to prevent stress may also contribute to improvements in the psychosocial work environment.

  17. Renewable Electricity Futures: Exploration of a U.S. Grid with 80% Renewable Electricity

    Science.gov (United States)

    Mai, Trieu

    2013-04-01

    Renewable Electricity Futures is an initial investigation of the extent to which renewable energy supply can meet the electricity demands of the contiguous United States over the next several decades. This study explores the implications and challenges of very high renewable electricity generation levels: from 30% up to 90% (focusing on 80%) of all U.S. electricity generation from renewable technologies in 2050. At such high levels of renewable electricity penetration, the unique characteristics of some renewable resources, specifically geographical distribution and variability and un-certainty in output, pose challenges to the operability of the nation's electric system. The study focuses on key technical implications of this environment from a national perspective, exploring whether the U.S. power system can supply electricity to meet customer demand on an hourly basis with high levels of renewable electricity, including variable wind and solar generation. The study also identifies some of the potential economic, environmental, and social implications of deploying and integrating high levels of renewable electricity in the U.S. The full report and associated supporting information is available at: http://www.nrel.gov/analysis/refutures/.

  18. A phase 3, randomized, double-blinded, active-controlled, unblinded standard of care study assessing the efficacy and safety of intramyocardial autologous CD34+ cell administration in patients with refractory angina: design of the RENEW study.

    Science.gov (United States)

    Povsic, Thomas J; Junge, Candice; Nada, Adel; Schatz, Richard A; Harrington, Robert A; Davidson, Charles J; Fortuin, F David; Kereiakes, Dean J; Mendelsohn, Farrell O; Sherman, Warren; Schaer, Gary L; White, Christopher J; Stewart, Duncan; Story, Kenneth; Losordo, Douglas W; Henry, Timothy D

    2013-06-01

    Preclinical trials indicate that CD34+ cells represent an effective angiogenic stem cell component. Early-phase clinical trials suggest that intramyocardial administration of autologous CD34+ cells may improve functional capacity and symptoms of angina. RENEW is a pivotal phase 3 trial designed to determine the efficacy of granulocyte colony-stimulating factor (G-CSF)-mobilized CD34+ stem cells for the treatment for patients with refractory angina and chronic myocardial ischemia. Patients (n = 444) receiving maximally tolerated antianginal therapies and lacking conventional revascularization options with Canadian Cardiovascular Society class III or IV angina and ischemia on stress testing will be randomized 2:1:1 to cell therapy (G-CSF-mediated stem cell mobilization, apheresis, and intramyocardial injection of 1 × 10(5) autologous CD34(+) cells/kg), active control (G-CSF-mediated stem cell mobilization, apheresis, and intramyocardial placebo injection), or open-label standard of care. The primary efficacy end point is change in exercise treadmill time in the treated vs active control patients, with 90% power to detect a 60-second difference in exercise time between cell-treated (n = 200) and active control (n = 100) patients. Key secondary end points include total number of anginal episodes per week and the incidence of independently adjudicated major adverse cardiac events and serious adverse events. RENEW will be the first adequately powered study aimed at definitively determining the efficacy of a cell therapy (intramyocardially delivered autologous CD34+ cells) for improvement of functional capacity in patients with refractory angina.

  19. Renewing Our Commitment to Kids: Collaborative Consultation

    Science.gov (United States)

    Strickler, Amy; Pfeifer, Doug; Cameron, Alex; Robinson, Anna; Price, Camile; David, Megan

    2014-01-01

    Children with serious emotional and behavioral problems often present challenges that far exceed what seems to be manageable. Despite the best intentions and efforts, youth move through multiple failed services because of the lack of progress, the "failure to adjust," and a presumed need for a higher level of care. Renewing Our…

  20. Natural Non-Renewable Resources in Economic Theory

    OpenAIRE

    Constantin Alexandra Mihaela

    2011-01-01

    Non-renewable resources can doubtlessly be regarded as the backbone of our modern society. However, most of economists have ignored the impact of non-renewable resources on the environment by dissociating the economy from the ecological network it is fundamentally linked to. The aim of this paper is, therefore, to highlight a literature overview of the most important opinions regarding non-renewable natural resources.

  1. Renewable energy for rural electrification

    Energy Technology Data Exchange (ETDEWEB)

    Strebkov, D. [All Russian Research Institute for Electrification of the Agriculture, Moscow (Russian Federation); Bezrukich, P. [Ministry for Fuel and Energy of Russian Federation, Moscow (Russian Federation); Kozlov, V. [Intersolarcenter Association, Moscow (Russian Federation)

    1997-12-31

    In spite of quite good centralized power supply system, rural electrification level across Russia vary widely: in some regions there are densely populated communities which lack power, while in the other the most pressing need is to electrify dispersed, isolated villages or homes. The main objective of the Russian project `Renewable energy for rural electrification` is the elaboration and application of new technologies of rural electrification in order to ensure the sustainable development of unelectrified areas of the Russia. The long-term objective of the project are: to improve the living standards of people in rural areas, who lack centralized energy supply systems, by introducing a new system for generation, transmission and distribution of electric power on the base of renewable energy systems; to provide a reliable cost-effective electric service for electrified and uncertified communities; to reduce the consumption of organic fuel in power generation systems; to support the military industry in converting their activity into the renewable energy sector; and to protect the environment

  2. Optimal Foraging of Renewable Resources

    CERN Document Server

    Enright, John J

    2011-01-01

    Consider a team of agents in the plane searching for and visiting target points that appear in a bounded environment according to a stochastic renewal process with a known absolutely continuous spatial distribution. Agents must detect targets with limited-range onboard sensors. It is desired to minimize the expected waiting time between the appearance of a target point, and the instant it is visited. When the sensing radius is small, the system time is dominated by time spent searching, and it is shown that the optimal policy requires the agents to search a region at a relative frequency proportional to the square root of its renewal rate. On the other hand, when targets appear frequently, the system time is dominated by time spent servicing known targets, and it is shown that the optimal policy requires the agents to service a region at a relative frequency proportional to the cube root of its renewal rate. Furthermore, the presented algorithms in this case recover the optimal performance achieved by agents ...

  3. Family Child Care Environment Rating Scale Revised Edition (FCCERS-R)

    Science.gov (United States)

    Harms, Thelma; Cryer, Debby; Clifford, Richard M.

    2007-01-01

    Featuring a new spiral binding, the FCCERS-R is a thorough revision of the widely used program quality assessment instrument, "The Family Day Care Rating Scale." Designed for use in family child care programs, it is suitable for programs serving children from infancy through school-age. Following extensive input from users of the…

  4. One University Making a Difference in Graduate Education: Caring in the Online Learning Environment.

    Science.gov (United States)

    Brown, Cynthia J; Wilson, Carol B

    2016-12-01

    As online education gains momentum, strategies to promote student engagement, develop social presence, and create a virtual community are essential for students' successful learning. A university with a philosophy grounded in caring developed two strategies for the graduate online education setting. These two strategies intentionally promote caring for self and others as a means to foster engagement, social presence, and a vibrant online community. One strategy was online Caring Groups, that is, small groups of four to five nursing students created each semester in one of the students' required courses in the online setting. The second strategy was the creation of two Caring Connections online sites, one for master of science in nursing students and one for doctorate in education nursing students. The sites were developed external to required courses to provide support for the online students throughout the graduate programs. Each site provides an ongoing space for students and faculty to post and discuss inspirational quotes, self-care tips, music, and photographs. The online Caring Groups and Caring Connections sites will be described, including how they were created, how they are used by students, how faculty support students, lessons learned, and how Caring Groups are integrated into the curriculum. © The Author(s) 2016.

  5. Cosmet'eau -Changes in the personal care product consumption practices: from whistle-blowers to impacts on aquatic environments

    OpenAIRE

    Bressy, Adèle; Carré, Catherine; Caupos, Émilie; Gouvello, Bernard de; Deroubaix, José-Frédéric; Deutsch, Jean-Claude; Mailler, Romain; Marconi, Anthony; Neveu, Pascale; Paulic, Laurent; Pichon, Sébastien; Rocher, Vincent; Severin, Irina; SOYER, Mathilde; Moilleron, Régis

    2016-01-01

    International audience; The Cosmet'eau project (2015-2018) investigates the " changes in the personal care product (PCP) consumption practices: from whistle-blowers to impacts on aquatic environments. " In this project, the example of PCPs will be used to understand how public health concerns related to micropollutants can be addressed by public authorities – including local authorities –, industries and consumers. The project aims to characterize the possible changes in PCP consumption pract...

  6. Biomarkers of human exposure to personal care products: Results from the Flemish Environment and Health Study (FLEHS 2007-2011)

    OpenAIRE

    Den Hond, Elly; Paulussen, Melissa; Geens, Tinne; Bruckers, Liesbeth; Baeyens, Willy; David, Frank; Dumont, Emmie; Loots, Ilse; Morrens, Bert; de Bellevaux, Benoit Nemery; Nelen, Vera; Schoeters, Greet; Van Larebeke, Nicolas; Covaci, Adrian

    2013-01-01

    Personal care products (PCPs), such as soaps, perfumes, cosmetics, lotions, etc., contain a variety of chemicals that have been described as potentially hormone disrupting chemicals. Therefore, it is important to assess the internal exposure of these chemicals in humans. Within the 2nd Flemish Environment and Health Study (FLEHS II, 2007-2011), the human exposure to three classes of pollutants that are present in a wide variety of PCPs - i.e. polycyclic musks (galaxolide, HHCB and tonalide, A...

  7. Establishing a pediatric cardiac intensive care unit - Special considerations in a limited resources environment

    Directory of Open Access Journals (Sweden)

    Nair Suresh

    2010-01-01

    Full Text Available Pediatric cardiac intensive care has evolved as a distinct discipline in well-established pediatric cardiac programs in developed nations. With increasing demand for pediatric heart surgery in emerging economies, a number of new programs are being established. The development of robust pediatric cardiac intensive care units (PCICU is critical to the success of these programs. Because of substantial resource limitations existing models of PCICU care cannot be applied in their existing forms and structure. A number of challenges need to be addressed to deliver pediatric cardiac intensive care in the developing world. Limitations in infrastructure, human, and material resources call for a number of innovations and adaptations. Additionally, a variety of strategies are required to minimize costs of care to the individual patient. This review provides a framework for the establishment of a new PCICU program in face of resource limitations typically encountered in the developing world and emerging economies.

  8. Nurses' sleep quality, work environment and quality of care in the Spanish National Health System: observational study among different shifts

    Science.gov (United States)

    Gómez-García, Teresa; Ruzafa-Martínez, María; Fuentelsaz-Gallego, Carmen; Madrid, Juan Antonio; Rol, Maria Angeles; Martínez-Madrid, María José; Moreno-Casbas, Teresa

    2016-01-01

    Objective The main objective of this study was to determine the relationship between the characteristics of nurses' work environments in hospitals in the Spanish National Health System (SNHS) with nurse reported quality of care, and how care was provided by using different shifts schemes. The study also examined the relationship between job satisfaction, burnout, sleep quality and daytime drowsiness of nurses and shift work. Methods This was a multicentre, observational, descriptive, cross-sectional study, centred on a self-administered questionnaire. The study was conducted in seven SNHS hospitals of different sizes. We recruited 635 registered nurses who worked on day, night and rotational shifts on surgical, medical and critical care units. Their average age was 41.1 years, their average work experience was 16.4 years and 90% worked full time. A descriptive and bivariate analysis was carried out to study the relationship between work environment, quality and safety care, and sleep quality of nurses working different shift patterns. Results 65.4% (410) of nurses worked on a rotating shift. The Practice Environment Scale of the Nursing Work Index classification ranked 20% (95) as favourable, showing differences in nurse manager ability, leadership and support between shifts (p=0.003). 46.6% (286) were sure that patients could manage their self-care after discharge, but there were differences between shifts (p=0.035). 33.1% (201) agreed with information being lost in the shift change, showing differences between shifts (p=0.002). The Pittsburgh Sleep Quality Index reflected an average of 6.8 (SD 3.39), with differences between shifts (p=0.017). Conclusions Nursing requires shift work, and the results showed that the rotating shift was the most common. Rotating shift nurses reported worse perception in organisational and work environmental factors. Rotating and night shift nurses were less confident about patients' competence of self-care after discharge. The

  9. Innovative approaches to educating medical students for practice in a changing health care environment: the National UME-21 Project.

    Science.gov (United States)

    Rabinowitz, H K; Babbott, D; Bastacky, S; Pascoe, J M; Patel, K K; Pye, K L; Rodak, J; Veit, K J; Wood, D L

    2001-06-01

    In today's continually changing health care environment, there is serious concern that medical students are not being adequately prepared to provide optimal health care in the system where they will eventually practice. To address this problem, the Health Resources and Services Administration (HRSA) developed a $7.6 million national demonstration project, Undergraduate Medical Education for the 21st Century (UME-21). This project funded 18 U.S. medical schools, both public and private, for a three-year period (1998-2001) to implement innovative educational strategies. To accomplish their goals, the 18 UME-21 schools worked with more than 50 organizations external to the medical school (e.g., managed care organizations, integrated health systems, Area Health Education Centers, community health centers). The authors describe the major curricular changes that have been implemented through the UME-21 project, discuss the challenges that occurred in carrying out those changes, and outline the strategies for evaluating the project. The participating schools have developed curricular changes that focus on the core primary care clinical clerkships, take place in ambulatory settings, include learning objectives and competencies identified as important to providing care in the future health care system, and have faculty development and internal evaluation components. Curricular changes implemented at the 18 schools include having students work directly with managed care organizations, as well as special demonstration projects to teach students the knowledge, skills, and attitudes necessary for successfully managing care. It is already clear that the UME-21 project has catalyzed important curricular changes within 12.5% of U.S. medical schools. The ongoing national evaluation of this project, which will be completed in 2002, will provide further information about the project's impact and effectiveness.

  10. Professional Quality of Life of Veterans Affairs Staff and Providers in a Patient-Centered Care Environment.

    Science.gov (United States)

    Locatelli, Sara M; LaVela, Sherri L

    2015-01-01

    Changes to the work environment prompted by the movement toward patient-centered care have the potential to improve occupational stress among health care workers by improving team-based work activities, collaboration, and employee-driven quality improvement. This study was conducted to examine professional quality of life among providers at patient-centered care pilot facilities. Surveys were conducted with 76 Veterans Affairs employees/providers at facilities piloting patient-centered care interventions, to assess demographics, workplace practices and views (team-based environment, employee voice, quality of communication, and turnover intention), and professional quality of life (compassion satisfaction, burnout, and secondary traumatic stress).Professional quality-of-life subscales were not related to employee position type, age, or gender. Employee voice measures were related to lower burnout and higher compassion satisfaction. In addition, employees who were considering leaving their position showed higher burnout and lower compassion satisfaction scores. None of the work practices showed relationships with secondary traumatic stress.

  11. Contribution of the psychosocial work environment to psychological distress among health care professionals before and during a major organizational change.

    Science.gov (United States)

    Lavoie-Tremblay, Melanie; Bonin, Jean-Pierre; Lesage, Alain D; Bonneville-Roussy, Arielle; Lavigne, Geneviève L; Laroche, Dominique

    2010-01-01

    The aim of this study was to investigate the relationships between 4 dimensions of the psychosocial work environment (psychological demands, decision latitude, social support, and effort-reward) among health care professionals as well as their psychological distress during a reorganization process. A correlational descriptive design was used for this quantitative study. A total of 159 health care professionals completed the questionnaire at T1, and 141 at T2. First, before the work reorganization, effort-reward imbalance was the sole variable of the psychological work environment that significantly predicted psychological distress. Second, the high overall level of psychological distress increased during the process of organizational change (from T1 to T2). Finally, effort-reward imbalance, high psychological demands, and low decision latitude were all significant predictors of psychological distress at T2, during the organizational change. In conclusion, to reduce the expected negative outcomes of restructuring on health care practitioners, managers could increase the number of opportunities for rewards, carefully explain the demands, and clarify the tasks to be performed by each of the employees to reduce their psychological burden and increase their perceptions of autonomy.

  12. Adaptation and validation of the instrument Clinical Learning Environment and Supervision for medical students in primary health care.

    Science.gov (United States)

    Öhman, Eva; Alinaghizadeh, Hassan; Kaila, Päivi; Hult, Håkan; Nilsson, Gunnar H; Salminen, Helena

    2016-12-01

    Clinical learning takes place in complex socio-cultural environments that are workplaces for the staff and learning places for the students. In the clinical context, the students learn by active participation and in interaction with the rest of the community at the workplace. Clinical learning occurs outside the university, therefore is it important for both the university and the student that the student is given opportunities to evaluate the clinical placements with an instrument that allows evaluation from many perspectives. The instrument Clinical Learning Environment and Supervision (CLES) was originally developed for evaluation of nursing students' clinical learning environment. The aim of this study was to adapt and validate the CLES instrument to measure medical students' perceptions of their learning environment in primary health care. In the adaptation process the face validity was tested by an expert panel of primary care physicians, who were also active clinical supervisors. The adapted CLES instrument with 25 items and six background questions was sent electronically to 1,256 medical students from one university. Answers from 394 students were eligible for inclusion. Exploratory factor analysis based on principal component methods followed by oblique rotation was used to confirm the adequate number of factors in the data. Construct validity was assessed by factor analysis. Confirmatory factor analysis was used to confirm the dimensions of CLES instrument. The construct validity showed a clearly indicated four-factor model. The cumulative variance explanation was 0.65, and the overall Cronbach's alpha was 0.95. All items loaded similarly with the dimensions in the non-adapted CLES except for one item that loaded to another dimension. The CLES instrument in its adapted form had high construct validity and high reliability and internal consistency. CLES, in its adapted form, appears to be a valid instrument to evaluate medical students' perceptions of

  13. Adaptation and validation of the instrument Clinical Learning Environment and Supervision for medical students in primary health care

    Directory of Open Access Journals (Sweden)

    Eva Öhman

    2016-12-01

    Full Text Available Abstract Background Clinical learning takes place in complex socio-cultural environments that are workplaces for the staff and learning places for the students. In the clinical context, the students learn by active participation and in interaction with the rest of the community at the workplace. Clinical learning occurs outside the university, therefore is it important for both the university and the student that the student is given opportunities to evaluate the clinical placements with an instrument that allows evaluation from many perspectives. The instrument Clinical Learning Environment and Supervision (CLES was originally developed for evaluation of nursing students’ clinical learning environment. The aim of this study was to adapt and validate the CLES instrument to measure medical students’ perceptions of their learning environment in primary health care. Methods In the adaptation process the face validity was tested by an expert panel of primary care physicians, who were also active clinical supervisors. The adapted CLES instrument with 25 items and six background questions was sent electronically to 1,256 medical students from one university. Answers from 394 students were eligible for inclusion. Exploratory factor analysis based on principal component methods followed by oblique rotation was used to confirm the adequate number of factors in the data. Construct validity was assessed by factor analysis. Confirmatory factor analysis was used to confirm the dimensions of CLES instrument. Results The construct validity showed a clearly indicated four-factor model. The cumulative variance explanation was 0.65, and the overall Cronbach’s alpha was 0.95. All items loaded similarly with the dimensions in the non-adapted CLES except for one item that loaded to another dimension. The CLES instrument in its adapted form had high construct validity and high reliability and internal consistency. Conclusion CLES, in its adapted form, appears

  14. FY2012 CoC Competition Grants (New and Renewal)

    Data.gov (United States)

    Department of Housing and Urban Development — This report displays the FY2012 renewal and new homeless assistance projects awarded by HUD for the FY2012 Continuum of Care (CoC) Program competition. Approximately...

  15. Job Satisfaction and Work Environment of Primary Health Care Nurses in Ekiti State, Nigeria: an Exploratory Study

    Directory of Open Access Journals (Sweden)

    Sunday Joseph Ayamolowo

    2013-01-01

    Full Text Available Background: Job satisfaction, quality of work environment and morale of health practitioners is beginning to receive attention worldwide.Objectives: This study examined the nature of the work environment of community health nurses, and determined the level of job satisfaction among these nurses. It further explored the relationship between work environment and job satisfaction of these nurses, and perceived factors in the work environment that would increase their job satisfaction. Methods: A descriptive cross-sectional design was employed. The study was conducted in public primary health care facilities in Ekiti State, Nigeria. All the 216 nurses in these facilities were recruited but only 161 nurses responded to the instrument administered. A 58- item semi-structured questionnaire was used to survey nurses currently practicing in the above health setting. Data analysis was done using descriptive and inferential statistics.Results: Findings from the study revealed the mean score of nurses’ perception of their work environment to be 64.65±19.77. Forty four percent (44% of the nurses perceived their WE as of an average quality while 31% reported high quality WE. A majority (67.1% of the nurses had low degree of job satisfaction while only few nurses (3.1% reported high degree of satisfaction with job. A significant positive strong correlation was found between overall work environment and the general job satisfaction of the nurses(r = 0.55, p = < 0.01. “Provisions of modern equipment for work” and “increment/prompt payment of salary” were the most prominent factors in work environment that the nurses perceived as capable of increasing their job satisfaction (54.7% and 49.7% respectively. The least reported factor was “recommendation when one does a good job” (1.9%.Conclusion: The study concluded that a healthy work environment for nurses in the primary health care settings is an important factor in improving work satisfaction

  16. Providing care for migrant farm worker families in their unique sociocultural context and environment.

    Science.gov (United States)

    Connor, Ann; Layne, Laura; Thomisee, Karen

    2010-04-01

    This article highlights the Farm Worker Family Health Program's (FWFHP) strategies for providing care to migrant farm workers residing within a unique social and cultural context. The care provided by health professions students from a variety of disciplines extends and augments the work of the local migrant farm worker clinic that is pushed beyond capacity during peak growing and harvest times. Nursing's social responsibility to care for underserved populations is a guiding principle of the FWFHP and shapes how the work is translated into action. The FWFHP is a community-academic partnership that began in the rural southeastern United States in 1993. Challenges facing migrant farm worker families include access to health care, language, health literacy, housing and sanitation, family and community integrity, and workplace safety. The nursing practice strategies used to address these health challenges may be adapted to strengthen health programs serving other populations who live in poverty or reside in low-resource settings.

  17. Health care logistics and space: accounting for the physical build environment

    NARCIS (Netherlands)

    Boucherie, Richardus J.; Hans, Elias W.; Hartmann, Timo; Larqoque, C.; Himmelspach, J.; Pasupathy, R.; Rose, O.; Uhrmacher, A.M.

    2012-01-01

    Planning and scheduling of health care processes has improved considerably using operations research techniques. Besides analytical and optimization tools, a substantial amount of sophisticated discrete event simulation tools supporting (re-)design of existing logistical processes in and around

  18. Unsatisfied basic needs of older patients in emergency care environments - obstacles to an active role in decision making.

    Science.gov (United States)

    Nydén, Kristoffer; Petersson, Martin; Nyström, Maria

    2003-03-01

    Little attention is paid in Emergency Care Units (ECUs) in Sweden to the special needs of older people. The aim of this study was thus to analyse older people's basic needs in the emergency care environment. The study was carried out with a life-world interpretative approach, and the theoretical framework for interpretation was Abraham Maslow's theory of motivation and personality. Seven informants aged between 65 and 88 years, with various experiences of being patients with urgent as well as non-urgent health-related problems, were interviewed about their experiences of ECU care. Their basic needs at the lower levels of Maslow's hierarchy were well-represented in the data. Higher needs, such as desire to know and understand, appeared to be totally neglected. Safety needs dominated the whole situation. Our conclusion is that standards of care must be developed in Sweden to make older patients feel safer and more secure in ECUs. Furthermore, the principles of nursing care for older patients need to be defined in order to encourage them to take an active part in their own health process.

  19. Managing the marketing function for advanced nurse practitioners in a managed care environment.

    Science.gov (United States)

    Pakis, S

    1997-09-01

    Delivering quality, cost-efficient health care is a desired service in the health care market today. Advanced nurse practitioners are positioned to deliver this product. The key in today's market is clearly defining the product, identifying the customers of the product, and crafting the message for each customer. The development of marketing strategies to address each of the above points will assist an organization in targeting resources and evaluating the effectiveness of the message being delivered.

  20. Renewable Substitutability Index: Maximizing Renewable Resource Use in Buildings

    Science.gov (United States)

    In order to achieve a material and energy balance in buildings that is sustainable in the long run, there is an urgent need to assess the renewable and non-renewable resources used in the manufacturing process and to progressively replace non-renewable resources with renewables. ...

  1. Renewable Substitutability Index: Maximizing Renewable Resource Use in Buildings

    Science.gov (United States)

    In order to achieve a material and energy balance in buildings that is sustainable in the long run, there is an urgent need to assess the renewable and non-renewable resources used in the manufacturing process and to progressively replace non-renewable resources with renewables. ...

  2. Co-Designing Ambient Assisted Living (AAL Environments: Unravelling the Situated Context of Informal Dementia Care

    Directory of Open Access Journals (Sweden)

    Amy S. Hwang

    2015-01-01

    Full Text Available Ambient assisted living (AAL aims to help older persons “age-in-place” and manage everyday activities using intelligent and pervasive computing technology. AAL research, however, has yet to explore how AAL might support or collaborate with informal care partners (ICPs, such as relatives and friends, who play important roles in the lives and care of persons with dementia (PwDs. In a multiphase codesign process with six (6 ICPs, we envisioned how AAL could be situated to complement their care. We used our codesigned “caregiver interface” artefacts as triggers to facilitate envisioning of AAL support and unpack the situated, idiosyncratic context within which AAL aims to assist. Our findings suggest that AAL should be designed to support ICPs in fashioning “do-it-yourself” solutions that complement tacitly improvised care strategies and enable them to try, observe, and adapt to solutions over time. In this way, an ICP could decide which activities to entrust to AAL support, when (i.e., scheduled or spontaneous and how a system should provide support (i.e., using personalized prompts based on care experience, and when adaptations to system support are needed (i.e., based alerting patterns and queried reports. Future longitudinal work employing participatory, design-oriented methods with care dyads is encouraged.

  3. Region 9 Renewable Energy

    Data.gov (United States)

    U.S. Environmental Protection Agency — Renewable energy production is expected to increase significantly in the next 25 years. The U.S. Environmental Protection Agency (EPA) Office of Solid Waste and...

  4. INTEGRATED RENEWAL PROCESS

    Directory of Open Access Journals (Sweden)

    Suyono .

    2012-07-01

    Full Text Available The marginal distribution of integrated renewal process is derived in this paper. Our approach is based on the theory of point processes, especially Poisson point processes. The results are presented in the form of Laplace transforms.

  5. Renewable Energy Tracking Systems

    Science.gov (United States)

    Renewable energy generation ownership can be accounted through tracking systems. Tracking systems are highly automated, contain specific information about each MWh, and are accessible over the internet to market participants.

  6. From organizational awareness to organizational competency in health care social work: the importance of formulating a "profession-in-environment" fit.

    Science.gov (United States)

    Spitzer, William; Silverman, Ed; Allen, Karen

    2015-01-01

    Today's health care environments require organizational competence as well as clinical skill. Economically driven business paradigms and the principles underlying the Patient Protection and Affordable Care Act of 2010 emphasize integrated, collaborative care delivered using transdisciplinary service models. Attention must be focused on achieving patient care goals while demonstrating an appreciation for the mission, priorities and operational constraints of the provider organization. The educational challenge is to cultivate the ability to negotiate "ideology" or ideal practice with the practical realities of health care provider environments without compromising professional ethics. Competently exercising such ability promotes a sound "profession-in-environment" fit and enhances the recognition of social work as a crucial patient care component.

  7. Battlefield Renewable Energy: A Key Joint Force Enabler

    Science.gov (United States)

    2010-06-01

    Environment, Energy Security & Sustainability Symposium Jun 2010 Battlefield Renewable Energy A Key Joint Force Enabler Roy H. Adams III, LTC, USA...COVERED 00-00-2010 to 00-00-2010 4. TITLE AND SUBTITLE Battlefield Renewable Energy : A Key Joint Force Enabler 5a. CONTRACT NUMBER 5b. GRANT

  8. Development Track of Renewable Power Technology in China

    Institute of Scientific and Technical Information of China (English)

    Hou Jianchao; Tan Zhongfu; Zhao Jianbao; Li Wei

    2009-01-01

    @@ Introduction Within the context of deeper global energy shortage and increasingly more polluted environment, countries throughout the world have been actively developing renewable energy sources to replace the fossil fuel, enhance the energy supply efficiency and relieve the environmental pollution. The renewable energy sources consist of hydropower and new energy sources, which are not defined exactly the same in different countries.

  9. Investigating Strategic Renewal of Five Large Dutch Financial Services Firms

    NARCIS (Netherlands)

    B. Flier (Bert); F.A.J. van den Bosch (Frans); H.W. Volberda (Henk); C.W.F. Baden-Fuller (Charles)

    2004-01-01

    textabstractHow do large well-established firms renew themselves in an increasing turbulent environment? Is there a generic pattern of change or is each change journey rather idiosyncratic? We posed five questions about the nature of renewal patterns. First, how do firms combine external versus inte

  10. Nurses' perception of single-occupancy versus multioccupancy rooms in acute care environments: an exploratory comparative assessment.

    Science.gov (United States)

    Chaudhury, Habib; Mahmood, Atiya; Valente, Maria

    2006-08-01

    Health care design professionals, planners, and administrators cite the advantages of private patient rooms, including reduction of hospital-acquired infections, reduction of patient stress levels, and facilitation of nurses' and health care workers' efficiency [e.g., Ulrich, R. (2003). Creating a healing environment with evidence-based design. Paper presented at the American Institute of Architects, Academy of Architecture for Health virtual seminar-Healing environments; Ulrich, R., Quan, X., Zimring, C., Joseph, A., & Choudhary, R. (2004). The role of the physical environment in the hospital of the 21st century: A once-in-a-lifetime-opportunity. ]. A review of the literature revealed that operating costs are reduced in single-patient rooms compared with multioccupancy rooms due to reduction in transfer cost, higher bed occupancy rates, and reduction in labor cost. In addition, single rooms can positively impact patients' hospital experience through increased privacy, better interaction between family and staff, and reduced noise and anxiety. This pilot study focused on nurses' perception of the advantages and disadvantages of single-occupancy versus multioccupancy patient rooms in medical-surgical units in four hospitals in the northwest. A majority of respondents in the four hospitals favored single rooms over double-occupancy rooms for the majority of the 15 categories, including the following: appropriateness for patient examination, interaction with or accommodation of family members, and lower probability of dietary mix-ups. Future studies need to carefully examine the objective measures of patient care variables (e.g., incidents of medication errors, opportunities for surveillance), patient outcomes (e.g., recovery rate, falls), and implications of room occupancy on operating costs.

  11. Promoting Renewable Energy Technologies

    DEFF Research Database (Denmark)

    Olsen, Ole Jess; Skytte, Klaus

    % of its annual electricity production. In this paper, we present and discuss the Danish experience as a case of promoting renewable energy technologies. The development path of the two technologies has been very different. Wind power is considered an outright success with fast deployment to decreasing...... technology and its particular context, it is possible to formulate some general principles that can help to create an effective and efficient policy for promoting new renewable energy technologies....

  12. Promoting Renewable Energy Technologies

    DEFF Research Database (Denmark)

    Olsen, Ole Jess; Skytte, Klaus

    % of its annual electricity production. In this paper, we present and discuss the Danish experience as a case of promoting renewable energy technologies. The development path of the two technologies has been very different. Wind power is considered an outright success with fast deployment to decreasing...... technology and its particular context, it is possible to formulate some general principles that can help to create an effective and efficient policy for promoting new renewable energy technologies....

  13. Dementia and dementia care in Asia-Taiwanese experiences: elders with dementia in two different adult day service (ADS) environments.

    Science.gov (United States)

    Liou, Chih-ling; Jarrott, Shannon E

    2013-01-01

    Researchers have demonstrated that adult day services (ADS) benefit elders with dementia and their caregivers, but they have also observed infantilization that diminishes personhood. Many ADS are socially constructed as places for incompetent elders, where clients are labeled as child-like dependents. Most ADS research has been performed in Western society; little is known about ADS in Asian countries. The Taiwanese Government seeks to expand ADS availability to meet the needs of an aging population; researchers must examine their ADS environments and practices to inform program development and expansion that supports respectful elder care. Elders' experiences of daily life were examined within the physical and social environments of one social and one medical model ADS in Taiwan. The ecological model and place rules informed our research framework. Ethnographic data were analyzed for themes reflecting our framework with attention to physical and social environment and staff-client interactions. The social model center included unique environmental features, such as a temple, indicating the purpose of different areas. Staff treated clients like family, sometimes to clients' detriment, providing limited privacy and demanding compulsory activity participation. The medical model center with nurse's station and institutional furniture reflected a hospital-like environment and fostered a patient-nurse relationship. Staff inattention actually created opportunities for autonomy among some clients. Physical features and social interactions within Taiwanese ADS reflected infantilization similar to that seen in the US and uniquely embedded within a traditional cultural background. Our findings reveal a tension between physical and social care features reflecting Eastern traditions of respect for elders and western traditions of institutional care.

  14. Deploying Renewables: Principles for Effective Policies. Executive Summary [Russian Version

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-07-01

    Renewable energy can play a fundamental role in tackling climate change, environmental degradation and energy security. As these challenges have become ever more pressing, governments and markets are seeking innovative solutions. Yet, what are the key factors that will determine the success of renewable energy policies? How can current policies be improved to encourage greater deployment of renewables? What impact can more effective policies have on renewables’ share in the future global energy mix and how soon? Deploying Renewables: Principles for Effective Policies addresses these questions. Responding to the Gleneagles G8 call for a clean and secure energy future, it highlights key policy tools to fast-track renewables into the mainstream. This analysis illustrates good practices by applying the combined metrics of effectiveness and efficiency to renewable energy policies in the electricity, heating and transport sectors. It highlights significant barriers to accelerating renewables penetration, and argues that the great potential of renewables can be exploited much more rapidly and to a much larger extent if good practices are adopted. Carefully designed policy frameworks, customised to support technologies at differing stages of maturity, will deliver a strong portfolio of renewable energy technologies. Deploying Renewables: Principles for Effective Policies provides recommendations on key principles for policy design as a template for decision makers.

  15. Community, service, and policy strategies to improve health care access in the changing urban environment.

    Science.gov (United States)

    Andrulis, D P

    2000-06-01

    Urban communities continue to face formidable historic challenges to improving public health. However, reinvestment initiatives, changing demographics, and growth in urban areas are creating changes that offer new opportunities for improving health while requiring that health systems be adapted to residents' health needs. This commentary suggests that health care improvement in metropolitan areas will require setting local, state, and national agendas around 3 priorities. First, health care must reorient around powerful population dynamics, in particular, cultural diversity, growing numbers of elderly, those in welfare-workplace transition, and those unable to negotiate an increasingly complex health system. Second, communities and governments must assess the consequences of health professional shortages, safety net provider closures and conversions, and new marketplace pressures in terms of their effects on access to care for vulnerable urban populations; they must also weigh the potential value of emerging models for improving those populations' care. Finally, governments at all levels should use their influence through accreditation, standards, tobacco settlements, and other financing streams to educate and guide urban providers in directions that respond to urban communities' health care needs.

  16. [Home care in a culturally sensitive environment: perspectives of caregivers of Haitian elderly patients and relatives].

    Science.gov (United States)

    Ducharme, Francine; Paquet, Mario; Vissandjée, Bilkis; Carpentier, Normand; Lévesque, Louise; Trudeau, Denise

    2008-01-01

    In Canada, the care provided by families occurs in an increasingly multiethnic context. Against this backdrop, the present qualitative study aims to explore the needs/expectations and solutions not only of (female) natural caregivers of an elderly relative hailing from Haiti (presented in terms of tracking cases) but also of remunerated home care providers - all with a view to developing a culturally sensitive service offering. As such, this study works from a conceptual framework centring on the negotiation of a common area of agreement between the stakeholders involved (i.e., natural caregivers and home care providers). To this end, focus groups and individual interviews were conducted among 15 caregivers and 37 home care providers. The three recurrent themes emerging from the data analysis concern, in context, the needs/expectations and solutions surrounding the experience of service use, barriers to use, and the relationships between natural caregivers and home care providers. The statements of both groups evidenced a consistency of views and have thus provided a basis for developing some recommendations acceptable to all stakeholders from the perspective of making culturally-based adjustments to the service offering.

  17. 2014 Renewable Energy Data Book

    Energy Technology Data Exchange (ETDEWEB)

    Beiter, Philipp

    2015-11-01

    The Renewable Energy Data Book for 2014 provides facts and figures on energy and electricity use, renewable electricity in the United States, global renewable energy development, wind power, solar power, geothermal power, biopower, hydropower, marine and hydrokinetic power, hydrogen, renewable fuels, and clean energy investment.

  18. 2015 Renewable Energy Data Book

    Energy Technology Data Exchange (ETDEWEB)

    Beiter, Philipp; Tian, Tian

    2016-11-01

    The 2015 Renewable Energy Data Book provides facts and figures on energy and electricity use, renewable electricity in the United States, global renewable energy development, wind power, solar power, geothermal power, biopower, hydropower, marine and hydrokinetic power, hydrogen, renewable fuels, and clean energy investment.

  19. 2015 Renewable Energy Data Book

    Energy Technology Data Exchange (ETDEWEB)

    Beiter, Philipp [National Renewable Energy Lab. (NREL), Golden, CO (United States); Tian, Tian [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-11-01

    The Renewable Energy Data Book for 2015 provides facts and figures on energy and electricity use, renewable electricity in the United States, global renewable energy development, wind power, solar power, geothermal power, biopower, hydropower, marine and hydrokinetic power, hydrogen, renewable fuels, and clean energy investment.

  20. 2008 Renewable Energy Data Book

    Energy Technology Data Exchange (ETDEWEB)

    2009-07-01

    This Renewable Energy Data Book for 2008 provides facts and figures on energy in general, renewable electricity in the United States, global renewable energy development, wind power, solar energy, geothermal power, biopower, hydropower, advanced water power, hydrogen, renewable fuels, and clean energy investments.

  1. 2010 Renewable Energy Data Book

    Energy Technology Data Exchange (ETDEWEB)

    Gelman, Rachel [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2011-10-01

    This Renewable Energy Data Book for 2010 provides facts and figures on energy in general, renewable electricity in the United States, global renewable energy development, wind power, solar energy, geothermal power, biopower, hydropower, advanced waterpower, hydrogen, renewable fuels, and clean energy investments.

  2. 2009 Renewable Energy Data Book

    Energy Technology Data Exchange (ETDEWEB)

    Gelman, R.

    2010-08-01

    This Renewable Energy Data Book for 2009 provides facts and figures on energy in general, renewable electricity in the United States, global renewable energy development, wind power, solar energy, geothermal power, biopower, hydropower, advanced waterpower, hydrogen, renewable fuels, and clean energy investments.

  3. 2011 Renewable Energy Data Book

    Energy Technology Data Exchange (ETDEWEB)

    R. Gelman

    2013-02-01

    This Renewable Energy Data Book for 2011 provides facts and figures on energy in general, renewable electricity in the United States, global renewable energy development, wind power, solar energy, geothermal power, biopower, hydropower, advanced water power, hydrogen, renewable fuels, and clean energy investments.

  4. 2014 Renewable Energy Data Book

    Energy Technology Data Exchange (ETDEWEB)

    Beiter, Philipp [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2015-11-15

    The Renewable Energy Data Book for 2014 provides facts and figures on energy and electricity use, renewable electricity in the United States, global renewable energy development, wind power, solar power, geothermal power, biopower, hydropower, marine and hydrokinetic power, hydrogen, renewable fuels, and clean energy investment.

  5. Personality assessment in today's health care environment: therapeutic alliance and patient satisfaction.

    Science.gov (United States)

    Quirk, Michael P; Erdberg, Philip; Crosier, Marlan; Steinfeld, Bradley

    2007-10-01

    This article addresses the role of personality assessment-specifically the Rorschach (Exner, 2002)-]in the context of the health care industry's increased focus on patient satisfaction. When providing psychotherapy, a challenge to providing patient-centered care turns on understanding and acting on the key aspects of the patient's personality that are crucial to forming an effective alliance. This article includes a description and examples of how personality assessment can enhance therapists' understanding of the ideational, affective, and self-control aspects of complicated patients' problem-solving styles. This enhanced understanding in turn can lead to improved therapeutic alliance between therapists and patients and to increased patient satisfaction with their care. How to provide feedback to the therapist also is addressed.

  6. Educating Medical Laboratory Technologists: Revisiting Our Assumptions in the Current Economic and Health-Care Environment

    Directory of Open Access Journals (Sweden)

    Regina Linder

    2012-08-01

    Full Text Available Health care occupies a distinct niche in an economy struggling to recover from recession. Professions related to the care of patients are thought to be relatively resistant to downturns, and thus become attractive to students typically drawn to more lucrative pursuits. Currently, a higher profile for clinical laboratory technology among college students and those considering career change results in larger and better prepared applicant pools. However, after decades of contraction marked by closing of programs, prospective students encounter an educational system without the capacity or vigor to meet their needs. Here discussed are some principles and proposals to allow universities, partnering with health-care providers, government agencies, and other stakeholders to develop new programs, or reenergize existing ones to serve our students and patients. Principles include academic rigor in biomedical and clinical science, multiple points of entry for students, flexibility in format, cost effectiveness, career ladders and robust partnerships.

  7. Shifting patterns of practice: nurse practitioners in a managed care environment.

    Science.gov (United States)

    Johnson, Rosemary

    2005-01-01

    The purpose of this qualitative study was to uncover patterns across nurse practitioner (NP) experiences that contribute to understanding their perceptions of managed care, how it affects daily practice, and how NPs respond to a changing managed care workplace. In-depth interviews were conducted with 14 NPs representing primary care, specialty, and independent practices. Over an 18-month period, data collection and analysis occurred simultaneously using standard methods of purposive sampling, constant comparison, memoing, and member checks. This study illuminates the tension NPs experience between a business and a professional ethic and the strategies they use to reconcile this difference with core nursing values. Type of setting, workplace dynamics, and length of time in practice contributed to variation in NP perspectives.

  8. Ecotoxicity and environmental risk assessment of pharmaceuticals and personal care products in aquatic environments and wastewater treatment plants.

    Science.gov (United States)

    Ortiz de García, Sheyla Andrea; Pinto Pinto, Gilberto; García-Encina, Pedro A; Irusta-Mata, Rubén

    2014-10-01

    A wide range of pharmaceuticals and personal care products (PPCPs) are present in the environment, and many of their adverse effects are unknown. The environmental risk assessment of 26 PPCPs of relevant consumption and occurrence in the aquatic environment in Spain was accomplished in this research. Based on the ecotoxicity values obtained by bioluminescence and respirometry assays and by predictions using the US EPA ecological structure-activity relationship (ECOSAR™), the compounds were classified following the Globally Harmonized System of Classification and Labelling of Chemicals. According to the criteria of the European Medicines Agency, the real risk of impact of these compounds in wastewater treatment plants (WWTPs) and in the aquatic environment was predicted. In at least two ecotoxicity tests, 65.4 % of the PPCPs under study showed high toxicity or were harmful to aquatic organisms. The global order of the species' sensitivity to the PPCPs considered was as follows: Vibrio fischeri (5 min) > Vibrio fischeri (15 min) > algae > crustaceans > fish > biomass of WWTP. Acetaminophen, ciprofloxacin, clarithromycin, clofibrate, ibuprofen, omeprazole, triclosan, parabens and 1,4-benzoquinone showed some type of risk for the aquatic environments and/or for the activated sludge of WWTPs. Development of acute and chronic ecotoxicity data, the determination of predicted and measured environmental concentrations of PPCPs, the inclusion of metabolites and transformation products and the evaluation of mixtures of these compounds will allow further improvements of the results of the ERAs and, finally, to efficiently identify the compounds that could affect the environment.

  9. The ward atmosphere important for the psychosocial work environment of nursing staff in psychiatric in-patient care

    Directory of Open Access Journals (Sweden)

    Wann-Hansson Christine

    2011-06-01

    Full Text Available Abstract Background The nursing staff working in psychiatric care have a demanding work situation, which may be reflected in how they view their psychosocial work environment and the ward atmosphere. The aims of the present study were to investigate in what way different aspects of the ward atmosphere were related to the psychosocial work environment, as perceived by nursing staff working in psychiatric in-patient care, and possible differences between nurses and nurse assistants. Methods 93 nursing staff working at 12 general psychiatric in-patient wards in Sweden completed two questionnaires, the Ward Atmosphere Scale and the QPSNordic 34+. Data analyses included descriptive statistics, the Mann-Whitney U-test, Spearman rank correlations and forward stepwise conditional logistic regression analyses. Results The data revealed that there were no differences between nurses and nurse assistants concerning perceptions of the psychosocial work environment and the ward atmosphere. The ward atmosphere subscales Personal Problem Orientation and Program Clarity were associated with a psychosocial work environment characterized by Empowering Leadership. Program Clarity was related to the staff's perceived Role Clarity, and Practical Orientation and Order and Organization were positively related to staff perceptions of the Organizational Climate. Conclusions The results from the present study indicate that several ward atmosphere subscales were related to the nursing staff's perceptions of the psychosocial work environment in terms of Empowering Leadership, Role Clarity and Organizational Climate. Improvements in the ward atmosphere could be another way to accomplish improvements in the working conditions of the staff, and such improvements would affect nurses and nurse assistants in similar ways.

  10. Networked remote area dental services: a viable, sustainable approach to oral health care in challenging environments.

    Science.gov (United States)

    Dyson, Kate; Kruger, Estie; Tennant, Marc

    2012-12-01

    This study examines the cost effectiveness of a model of remote area oral health service. Retrospective financial analysis. Rural and remote primary health services. Clinical activity data and associated cost data relating to the provision of a networked visiting oral health service by the Centre for Rural and Remote Oral Health formed the basis of the study data frameset. The cost-effectiveness of the Centre's model of service provision at five rural and remote sites in Western Australia during the calendar years 2006, 2008 and 2010 was examined in the study. Calculations of the service provision costs and value of care provided were made using data records and the Fee Schedule of Dental Services for Dentists. The ratio of service provision costs to the value of care provided was determined for each site and was benchmarked against the equivalent ratios applicable to large scale government sector models of service provision. The use of networked models have been effective in other disciplines but this study is the first to show a networked hub and spoke approach of five spokes to one hub is cost efficient in remote oral health care. By excluding special cost-saving initiatives introduced by the Centre, the study examines easily translatable direct service provision costs against direct clinical care outcomes in some of Australia's most challenging locations. This study finds that networked hub and spoke models of care can be financially efficient arrangements in remote oral health care. © 2012 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  11. Individual health care system distrust and neighborhood social environment: how are they jointly associated with self-rated health?

    Science.gov (United States)

    Yang, Tse-Chuan; Matthews, Stephen A; Shoff, Carla

    2011-10-01

    Americans' distrust in the health care system has increased in the past decades; however, little research has explored the impact of distrust on self-rated health and even less is known about whether neighborhood social environment plays a role in understanding the relationship between distrust and self-rated health. This study fills these gaps by investigating both the direct and moderating associations of neighborhood social environment with self-rated health. Our analysis is based on the 2008 Philadelphia Health Management Corporation's household survey and neighborhood-level data. Findings from multilevel logistic regression show that after controlling for individual- and neighborhood-level covariates, distrust is directly and adversely related to self-rated health, and that neighborhood social affluence and stability are directly and negatively associated with the odds of reporting poor/fair health. Neighborhood disadvantage and crime rates are not directly related to self-rated health, but increase the odds of having poor/fair health via distrust. Overall, our results suggest that macro-level actions can alter individual's perception of residential environment and lead to improved health. To improve the public health in an urban setting, rebuilding confidence in the health care system is integral, and the policies that help establish safe and cohesive neighborhoods may reduce the adverse effect of distrust on self-rated health.

  12. Talk presented to the Colloquium 'Energy diversification and environment protection: the renewable energies at 2010 horizon'; Intervention au Colloque 'Diversification energetique et protection de l'environnement: les energie renouvelables a l'horizon 2010'

    Energy Technology Data Exchange (ETDEWEB)

    Pierret, Christian [State Secretary for Industry, French Goverment, Paris (France)

    2000-02-18

    In his intervention to the Colloquium 'Energy diversification and environment protection: the renewable energies at 2010 horizon', the State Secretary for industry has presented the government's energy policy developed in the energy sector. Pillars of this policy appear to be: an energy of quality, ensured with respect to supply, of low cost for economy, environment protecting and at reach even for poor people. Indeed this policy must be serious, it should be based on all options from nuclear to renewable energies keeping open the way for any future alternative. It must be equilibrated in what concerns both the options adopted and their management and have in view the consequences particularly the ecological ones. It must be the diversified with a particular opening towards renewable energies. A special preoccupation is attached to the rational utilization of energy. Finally, it must be responsible and based upon long term plans focusing high economic payback and environmental conservation. Then in a second section the current situation of the renewable energies is outlined. They represent 22% of the primary energy production in France, what is four times the energy of oil, gas and coal combined. In spite of its success with the electro-nuclear program, since 1997 the government has decided to re-launch firmly the development of renewable energies. In this context ADEME (Agency of Environment and Energy Management), has reinforced its actions in the field of energy. Accordingly, since 1999 the means of intervention of Agency were increased by 500 million FFR. A number of programs have been launched and mentioned are the following: EOLE 2005, the plan 'Bois-combustible et developpement local' (Wood-Fuel and Local Development), the program '20.000 chauffe-eau solaires dans les DOMs' (20,000 Solar Heaters in the Overseas Departments), HELIOS 206, the program Biomasse-Biogaz. Concerning the future development the following challenges

  13. Airborne particles in indoor environment of homes, schools, offices and aged care facilities: The main routes of exposure.

    Science.gov (United States)

    Morawska, L; Ayoko, G A; Bae, G N; Buonanno, G; Chao, C Y H; Clifford, S; Fu, S C; Hänninen, O; He, C; Isaxon, C; Mazaheri, M; Salthammer, T; Waring, M S; Wierzbicka, A

    2017-11-01

    It has been shown that the exposure to airborne particulate matter is one of the most significant environmental risks people face. Since indoor environment is where people spend the majority of time, in order to protect against this risk, the origin of the particles needs to be understood: do they come from indoor, outdoor sources or both? Further, this question needs to be answered separately for each of the PM mass/number size fractions, as they originate from different sources. Numerous studies have been conducted for specific indoor environments or under specific setting. Here our aim was to go beyond the specifics of individual studies, and to explore, based on pooled data from the literature, whether there are generalizable trends in routes of exposure at homes, schools and day cares, offices and aged care facilities. To do this, we quantified the overall 24h and occupancy weighted means of PM10, PM2.5 and PN - particle number concentration. Based on this, we developed a summary of the indoor versus outdoor origin of indoor particles and compared the means to the WHO guidelines (for PM10 and PM2.5) and to the typical levels reported for urban environments (PN). We showed that the main origins of particle metrics differ from one type of indoor environment to another. For homes, outdoor air is the main origin of PM10 and PM2.5 but PN originate from indoor sources; for schools and day cares, outdoor air is the source of PN while PM10 and PM2.5 have indoor sources; and for offices, outdoor air is the source of all three particle size fractions. While each individual building is different, leading to differences in exposure and ideally necessitating its own assessment (which is very rarely done), our findings point to the existence of generalizable trends for the main types of indoor environments where people spend time, and therefore to the type of prevention measures which need to be considered in general for these environments. Copyright © 2017 The Authors

  14. Changing model of nursing care from individual patient allocation to team nursing in the acute inpatient environment.

    Science.gov (United States)

    Fairbrother, Greg; Jones, Aaron; Rivas, Ketty

    2010-06-01

    Agreement was reached with 12 acute medical and surgical wards/units at Sydney's Prince of Wales Hospital to participate in a trial of team nursing (TN). Six units employed action research principles to undertake a change to a team nursing model and six remained with the pre-existing individual patient allocation (IPA) model. Task-based teaming was widely discarded by the team nursing units in favour of allocating patients within the team and introducing more supportive and communicative processes aimed at fostering responsibility sharing. Localised team-based models of care arose in the change wards and were outlined, implemented and refined using social action research principles. A 12-month prospective experimental comparison of job satisfaction and staff retention between the TN and IPA groups indicated statistically significant job satisfaction benefits and practically important staff retention benefits associated with moving away from an IPA model of nursing care delivery towards a team-based model of care delivery. Perhaps not surprisingly, job satisfaction gains were most marked among new graduate nurses, who reported real benefits from a teaming inspired shift in model of care in the acute inpatient environment.

  15. Medical competence : The interplay between individual ability and the health care environment

    NARCIS (Netherlands)

    Ten Cate, Olle; Snell, Linda; Carraccio, Carol

    2010-01-01

    Competency-based education in the health care professions has become a prominent approach to postgraduate training in Canada, the Netherlands, the United Kingdom, the United States, and many other countries. Competency frameworks devised at national and international levels have been well received,

  16. Building a high quality medical data architecture for multiple uses in an integrated health care environment

    NARCIS (Netherlands)

    Boterenbrood, Frank; Krediet, Irene; Goossen, William

    2014-01-01

    Objective: The aim was to create a reliable information provisioning system in healthcare for both care and research processes, based on existing data standards and standardized electronic messages. The research question is: How can a Clinical Data Ware House (CDWH) be developed for standardized bas

  17. Building a high quality medical data architecture for multiple uses in an integrated health care environment

    NARCIS (Netherlands)

    William Goossen; Irene Krediet; Frank Boterenbrood

    2014-01-01

    Objective: The aim was to create a reliable information provisioning system in healthcare for both care and research processes, based on existing data standards and standardized electronic messages. The research question is: How can a Clinical Data Ware House (CDWH) be developed for standardized

  18. User Interface Considerations for Collecting Data at the Point of Care in the Tablet PC Computing Environment

    Science.gov (United States)

    Silvey, Garry M.; Lobach, David F.; Macri, Jennifer M.; Hunt, Megan; Kacmaz, Roje O.; Lee, Paul P.

    2006-01-01

    Collecting clinical data directly from clinicians is a challenge. Many standard development environments designed to expedite the creation of user interfaces for electronic healthcare applications do not provide acceptable components for satisfying the requirements for collecting and displaying clinical data at the point of care on the tablet computer. Through an iterative design and testing approach using think-aloud sessions in the eye care setting, we were able to identify and resolve several user interface issues. Issues that we discovered and subsequently resolved included checkboxes that were too small to be selectable with a stylus, radio buttons that could not be unselected, and font sizes that were too small to be read at arm’s length. PMID:17238715

  19. Renewable Energy Resources in Lebanon

    Science.gov (United States)

    Hamdy, R.

    2010-12-01

    The energy sector in Lebanon plays an important role in the overall development of the country, especially that it suffers from many serious problems. The fact that Lebanon is among the few countries that are not endowed with fossil fuels in the Middle East made this sector cause one third of the national debt in Lebanon. Despite the large government investments in the power sector, demand still exceeds supply and Lebanon frequently goes through black out in peak demand times or has to resort to importing electricity from Syria. The Energy production sector has dramatic environmental and economical impacts in the form of emitted gasses and environment sabotage, accordingly, it is imperative that renewable energy (RE) be looked at as an alternative energy source. Officials at the Ministry of Energy and Water (MEW) and Lebanese Electricity (EDL) have repeatedly expressed their support to renewable energy utilization. So far, only very few renewable energy applications can be observed over the country. Major efforts are still needed to overcome this situation and promote the use of renewable energy. These efforts are the shared responsibility of the government, EDL, NGO's and educational and research centers. Additionally, some efforts are being made by some international organizations such as UNDP, ESCWA, EC and other donor agencies operating in Lebanon. This work reviews the status of Energy in Lebanon, the installed RE projects, and the potential projects. It also reviews the stakeholders in the field of RE in Lebanon Conclusion In considering the best R.E. alternative, it is important to consider all potential R.E. sources, their costs, market availability, suitability for the selected location, significance of the energy produced and return on investment. Several RE resources in Lebanon have been investigated; Tides and waves energy is limited and not suitable two tentative sites for geothermal energy are available but not used. Biomass resources badly affect the

  20. Valorization of Renewable Carbon Resources for Chemicals.

    Science.gov (United States)

    Chen, Xi; Zhang, Bin; Wang, Yunzhu; Yan, Ning

    2015-01-01

    The overuse of fossil fuels has caused an energy crisis and associated environment issues. It is desirable to utilize renewable resources for the production of chemicals. This review mainly introduces our recent work on the transformation of renewable carbon resources including the conversion of cellulose, lignin, and chitin into sustainable chemicals. Various transformation routes have been established to form value-added chemicals, and accordingly a variety of effective catalytic systems have been developed, either based on metal catalysis and/or acid-base catalysis, to enable the desired transformation.

  1. Future improvements and implementation of animal care practices within the animal testing regulatory environment.

    Science.gov (United States)

    Guittin, Pierre; Decelle, Thierry

    2002-01-01

    Animal welfare is an increasingly important concern when considering biomedical experimentation. Many of the emerging regulations and guidelines specifically address animal welfare in laboratory animal care and use. The current revision of the appendix of the European Convention, ETS123 (Council of Europe), updates and improves on the current animal care standardization in Europe. New guidelines from the Organisation for Economic Co-operation and Development and the European Federation of Pharmaceutical Industries Association focus specifically on safety testing. These guidelines will affect the way toxicity studies are conducted and therefore the global drug development process. With the 3Rs principles taken into account, consideration regarding animal welfare will demand changes in animal care practices in regulatory safety testing. The most significant future improvements in animal care and use practices are likely to be environmental enrichment, management of animal pain and distress, and improved application of the humane endpoints. Our challenge is to implement respective guidelines based on scientific data and animal welfare, through a complex interplay of regulatory objective and public opinion. The current goal is to work toward solutions that continue to provide relevant animal models for risk assessment in drug development and that are science based. In this way, future improvements in animal care and use practices can be founded on facts, scientific results, and analysis. Some of these improvements become common practice in some countries. International harmonization can facilitate the development and practical application of "best scientific practices" by the consensus development process that harmonization requires. Since the implementation of good laboratory practices (GLP) standards in safety testing, these new regulations and recommendations represent a new way forward for animal safety studies.

  2. Integrating: A managerial practice that enables implementation in fragmented health care environments.

    Science.gov (United States)

    Kerrissey, Michaela; Satterstrom, Patricia; Leydon, Nicholas; Schiff, Gordon; Singer, Sara

    How some organizations improve while others remain stagnant is a key question in health care research. Studies identifying how organizations can implement improvement despite barriers are needed, particularly in primary care. This inductive qualitative study examines primary care clinics implementing improvement efforts in order to identify mechanisms that enable implementation despite common barriers, such as lack of time and fragmentation across stakeholder groups. Using an embedded multiple case study design, we leverage a longitudinal data set of field notes, meeting minutes, and interviews from 16 primary care clinics implementing improvement over 15 months. We segment clinics into those that implemented more versus those that implemented less, comparing similarities and differences. We identify interpersonal mechanisms promoting implementation, develop a conceptual model of our key findings, and test the relationship with performance using patient surveys conducted pre-/post-implementation. Nine clinics implemented more successfully over the study period, whereas seven implemented less. Successfully implementing clinics exhibited the managerial practice of integrating, which we define as achieving unity of effort among stakeholder groups in the pursuit of a shared and mutually developed goal. We theorize that integrating is critical in improvement implementation because of the fragmentation observed in health care settings, and we extend theory about clinic managers' role in implementation. We identify four integrating mechanisms that clinic managers enacted: engaging groups, bridging communication, sensemaking, and negotiating. The mean patient survey results for integrating clinics improved by 0.07 units over time, whereas the other clinics' survey scores declined by 0.08 units on a scale of 5 (p = .02). Our research explores an understudied element of how clinics can implement improvement despite barriers: integrating stakeholders within and outside the

  3. Development Track of Renewable Power Technology in China

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Introduction Within the context of deeper global energy shortage and increasingly more polluted environment,countries throughout the world have been actively developing renewable energy sources to replace the fossil fuel,

  4. Integrated renewable energy networks

    Science.gov (United States)

    Mansouri Kouhestani, F.; Byrne, J. M.; Hazendonk, P.; Brown, M. B.; Spencer, L.

    2015-12-01

    This multidisciplinary research is focused on studying implementation of diverse renewable energy networks. Our modern economy now depends heavily on large-scale, energy-intensive technologies. A transition to low carbon, renewable sources of energy is needed. We will develop a procedure for designing and analyzing renewable energy systems based on the magnitude, distribution, temporal characteristics, reliability and costs of the various renewable resources (including biomass waste streams) in combination with various measures to control the magnitude and timing of energy demand. The southern Canadian prairies are an ideal location for developing renewable energy networks. The region is blessed with steady, westerly winds and bright sunshine for more hours annually than Houston Texas. Extensive irrigation agriculture provides huge waste streams that can be processed biologically and chemically to create a range of biofuels. The first stage involves mapping existing energy and waste flows on a neighbourhood, municipal, and regional level. Optimal sites and combinations of sites for solar and wind electrical generation, such as ridges, rooftops and valley walls, will be identified. Geomatics based site and grid analyses will identify best locations for energy production based on efficient production and connectivity to regional grids.

  5. Organometallics and renewables

    Energy Technology Data Exchange (ETDEWEB)

    Meier, Michael A.R. [Karlsruhe Institute of Technology (KIT), Karlsruhe (Germany). Inst. of Organic Chemistry; Weckhuysen, Bert M.; Bruijnincx, Pieter C.A. (eds.) [Utrecht Univ. (Netherlands). Debye Inst. of Nanomaterials Science

    2012-11-01

    USPs - BPF Each volume of Topics in Organometallic Chemistry provides the broad scientific readership with a comprehensive summary and critical overview of a specific topic in organometallic chemistry. Research in this rapidly developing transdisciplinary field is having profound influence on other areas of scientific investigation, ranging from catalytic organic synthesis to biology, medicine and material science. With contributions by international experts. Lucas Montero de Espinosa and Michael A. R. Meier: Olefin Metathesis of Renewable Platform Chemicals.- Pieter C. A. Bruijnincx, Robin Jastrzebski, Peter J. C. Hausoul, Robertus J. M. Klein Gebbink, and Bert M. Weckhuysen: Pd-Catalysed Telomerisation of 1,3-Dienes with Multifunctional Renewable Substrates - Versatile Routes for the Valorisation of Biomass-Derived Platform Molecules.- A Behr, A. J. Vorholt: Hydroformylation and related reactions of renewable resources.- Ties J. Korstanje, Robertus J.M. Klein Gebbink: Catalytic oxidation and deoxygenation of renewables with rhenium complexes.- Antoine Buchard, Clare M. Bakewell, Jonathan Weiner and Charlotte K. Williams: Recent Developments In Catalytic Activation Of Renewable Resources For Polymer Synthesis.

  6. Trends in monitoring pharmaceuticals and personal-care products in the aquatic environment by use of passive sampling devices

    Science.gov (United States)

    Mills, G.A.; Vrana, B.; Allan, I.; Alvarez, D.A.; Huckins, J.N.; Greenwood, R.

    2007-01-01

    The use of passive sampling in monitoring pharmaceuticals and personal-care products (PPCPs) in the aquatic environment is discussed. The utility of passive sampling methods for monitoring the fraction of heavy metals and the biologically available fraction of non-polar organic priority pollutants is recognized and these technologies are being used in surveys of water quality. These devices are used to measure the dissolved fraction and they can yield information that can be used in the development of risk assessments models. These devices can also be used to locate illegal dumping and to monitor specific sources of input of PPCPs into the environment, or to monitor the effectiveness of water treatment processes in the removal of these compounds from wastewater. These devices can provide representative information at low cost which necessitate a combination of laboratory calibration and field studies for emerging pollutants.

  7. TV-Based Caring Videophone System for the Elderly in the Smart Home Environment

    Directory of Open Access Journals (Sweden)

    Jingshuang Shen

    2013-01-01

    Full Text Available A novel videophone system for the elderly-care application is proposed. Based on the detailed analysis of the elderly’s physical and psychological characteristics, a TV-based caring videophone system for the elderly is developed: an embedded multimedia device is designed to implement the interactive video and audio processing and IP-based communication, in which TV is adopted as the display terminal to achieve a low-cost but high-quality service. Considering the user’s convenience, many personalized designs, such as photo-based address book, photo-click-dialing, and touch pad based remote controller, are developed to make the proposed videophone system more intuitive and easy to use for the elderly. Based on Support Vector Machine (SVM algorithms, an evaluation model is also developed with the data collected from the embedded multimedia device. It is useful to evaluate the physical and psychological health of the elderly.

  8. Marketing environment dynamics and implications for pricing strategies: the case of home health care.

    Science.gov (United States)

    Ponsford, B J; Barlow, D

    1999-01-01

    This research reviews the factors affecting the pricing or rate schedules of home health care agencies. A large number of factors affect costs and thus rate structures. The major factors include reimbursement structures with accompanying discount structures, administrative burdens, and risks. Channel issues include bargaining power, competition, and size. Staffing issues affect pricing and product through the provider level, productivity, and quality outcomes. Physician and patient issues include quality concerns and choices. These factors are discussed in light of overall marketing strategy and the interaction of pricing with other marketing controllables such as product, place/distribution, and promotion. Economic and accounting principles are also reviewed with consideration to understanding direct and indirect costs in order to enable negotiators to effectively price health care services.

  9. Feminist health care in a hostile environment: a case study of the Womancare Health Center.

    Science.gov (United States)

    Hyde, Cheryl A

    2008-01-01

    This article presents a case study of the Womancare Health Center in order to illustrate the development of and challenges to the feminist health movement in the United States. Specific attention is placed on the legislative, fiscal, and direct actions by the New Right against this organization. Analysis focuses on the means through which Womancare survived. The repercussions of constant intimidation and harassment for women's health programs and for health care policy overall are discussed.

  10. Role of the environment in the transmission of Clostridium difficile in health care facilities.

    Science.gov (United States)

    Weber, David J; Anderson, Deverick J; Sexton, Daniel J; Rutala, William A

    2013-05-01

    Recent data demonstrate that the contaminated hospital surface environment plays a key role in the transmission of Clostridium difficile. Enhanced environmental cleaning of rooms housing Clostridium difficile-infected patients is warranted, and, if additional studies demonstrate a benefit of "no-touch" methods (eg, ultraviolet irradiation, hydrogen peroxide systems), their routine use should be considered.

  11. "I'll Take Care of the Flowers!" Researching Agency through Initiatives across Different Learning Environments

    Science.gov (United States)

    Kangas, Marjaana; Kopisto, Kaisa; Löfman, Krista; Salo, Laura; Krokfors, Leena

    2017-01-01

    This case study examined how the agency of a fifth-grade pupil appeared across different learning environments in the primary school context. In this study, agency is defined as the initiatives taken by an individual in interactive situations. The research question is: how does a pupil's agency manifest and vary through taking initiatives across…

  12. Work Environment and Workplace Bullying among Korean Intensive Care Unit Nurses

    Directory of Open Access Journals (Sweden)

    Seonyoung Yun, MSN, RN

    2014-09-01

    Conclusion: These findings indicate that the better the nursing work environment, the less workplace bullying nurses will experience. Further research needs to be done to identify factors that influence bullying in the nurses and to develop an intervention that prevents workplace bullying.

  13. Transforming the patient care environment with Lean Six Sigma and realistic evaluation.

    Science.gov (United States)

    Black, Jason

    2009-01-01

    Lean Six Sigma (LSS) is a structured methodology for transforming processes, but it does not fully consider the complex social interactions that cause processes to form in hospital organizations. By combining LSS implementations with the concept of Realistic Evaluation, a methodology that promotes change by assessing and considering the individual characteristics of an organization's social environment, successful and sustainable process improvement is more likely.

  14. Healthy Lifestyle Medicine in the Traditional Healthcare Environment-Primary Care and Cardiac Rehabilitation.

    Science.gov (United States)

    Williams, Mark A; Kaminsky, Leonard A

    There is unquestioned value of the need to incorporate Healthy Lifestyle Medicine (HLM) within the traditional models of healthcare. Primary care providers are well positioned to implement HLM as a routine aspect of their healthcare practice. Unfortunately, barriers for this to occur, including poor professional training in the components of HLM and limitations in the time they have available to spend with patients, result in inadequate delivery of HLM from primary care providers. Thus, new approaches for the delivery of HLM need to be developed that would allow primary care providers better, and more, opportunities to make patient referrals. Ideally, this would start with creating a culture change within communities that embraces the importance on living a healthy lifestyle. One opportunity which should be considered is expanding access to currently available options, such as cardiac rehabilitation programs and worksite wellness programs. Both types of programs already provide key elements of HLM within their existing structure. However, new models also need to be developed. Community-based HL centers comprising HL specialists including counselors, exercise physiologists, dietitians, and physical therapists, could be developed and become core locations for the promotion of HLM.

  15. 40 CFR 60.2655 - How do I renew my lapsed operator qualification?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false How do I renew my lapsed operator... or Before November 30, 1999 Model Rule-Operator Training and Qualification § 60.2655 How do I renew my lapsed operator qualification? You must renew a lapsed operator qualification by one of the...

  16. 40 CFR 60.3018 - How do I renew my lapsed operator qualification?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false How do I renew my lapsed operator... Model Rule-Operator Training and Qualification § 60.3018 How do I renew my lapsed operator qualification? You must renew a lapsed operator qualification by one of the two methods specified in paragraphs...

  17. 40 CFR 73.80 - Operation of allowance reserve program for conservation and renewable energy.

    Science.gov (United States)

    2010-07-01

    ... for conservation and renewable energy. 73.80 Section 73.80 Protection of Environment ENVIRONMENTAL... and Renewable Energy Reserve § 73.80 Operation of allowance reserve program for conservation and renewable energy. (a) General. The Administrator will allocate allowances from the Conservation...

  18. Patients′ perception of the quality of malaria treatment in primary health care centers of Jos and Environs

    Directory of Open Access Journals (Sweden)

    N S Jimam

    2015-01-01

    Full Text Available Background: Though the fight against malaria continued to be on the increased, the disease still remains a major public health problem in many developing countries, especially in the rural areas. The extent of drug use and its effect is affected among other things by the pattern in which these drugs are prescribed by the health workers. Patients′ assessment of the quality of care depends on their ability to judge whether health care providers are adhering to the defined standard of care, hence it is necessary to assess the views of patients regarding the quality of care they received from the primary health care (PHC centers. Aim: This study aimed at evaluating consumer′s perception of the quality of malaria treatment in PHC centers of Jos and environs. Materials and Methods: Nine PHC centers were selected by multi-stage random sampling, five from Jos North and four from Jos South Local Government Areas of Plateau State. Patients of both sexes within the age range of 18 years and above who visited the PHC centers for malaria treatment were considered eligible to participate in the survey, provided that they were able to understand and respond to the interview questions. A semi-structured interviewer questionnaire which was adapted from previous health survey studies was administered to all the 249 eligible participants. The data collected were analyzed using the Statistical Package for Social Sciences (SPSS version 20.0 software programmer. Results: The result showed that there were no consistently significant differences (P > 0.05 regarding patient satisfaction between male and female patients across selected items in the various domains, that is, irrespective of respondents′ sex, their perception of the quality of health services rendered by PHCs was similar. Conclusion: It was therefore concluded that there was similar satisfaction level between the male and the female, though some key health services were not readily available in the

  19. Renewable enery-the path to sustainability

    Institute of Scientific and Technical Information of China (English)

    Tan Xiaomei; Brett Rose

    2008-01-01

    This article seeks to address some lingering debates within sustainability studies by revealing the connections between renewable energy,consumption and sustainability.Using data from 30 OECD countries,the article amines the connections via regression and geospatial analysis Findings from the quantitative analysis indicate that about 50% of the variation in sustainability is accounted for by the degree of renewables consumption.The geospatial analysis visually illustrates the intimate connections between the two variables.Theoreticallv,renewable energy,relates to sustainability in three dimensions.The first dimension is economic.Relying on traditional fossil fuels eventually will bring our economy to a stop.Renewable energies,however,are able to secure our energy supply into an indefinite future.The second dimension links to ethics.To leave an intact planet to future generations is a moral responsibility of our generation.The current energy supply system is built on depletion of natural resources,while the sources of renewable energy are vast and constantlv replenished The last dimension is ecologic.How to allocate a porper apportionment of the global hiosphere between humankind and the other life on the earth is a critical issue related to sustainability.By using renewable energv,we can greatly reduce our impact on biodiversity and therefore strike a balance between humankind and other life.Overall the research suggests that developing renewables can and in many cases does sustain a nation's economic growth while simultaneously protecting the environment.It is a win-win situation.This finding undoubtedly points out a practical and realistic path for sudtainable development.

  20. Diversification of health care services: the effects of ownership, environment, and strategy.

    Science.gov (United States)

    Shortell, S M; Morrison, E M; Hughes, S L; Friedman, B S; Vitek, J L

    1987-01-01

    The present findings suggest that the trend toward greater diversification of hospital services is likely to be most strongly influenced by state Medicaid policies and certain hospital characteristics. Increasing Medicaid eligibility and payment levels is likely to have a positive effect on services diversification. Growth in the number of inpatient services provided and a more severe case mix are also likely to be involved with greater service diversification. Affiliation with a not-for-profit hospital system is likely to be associated with more diversified hospital services but not affiliation with an investor-owned system. There is also some indication that the overall portfolio of services which a hospital offers in regard to market share and market growth characteristics influences diversification. Specifically, a low market share portfolio is likely to be associated with less diversification. Competition is likely to be associated with more diversification; particularly for hospitals belonging to systems. The effect of competition on hospital strategy and services diversification is a particularly important area for further investigation. Increasing Medicaid payment and eligibility levels are also likely to have a positive effect on the provision of services which are usually unprofitable. Raising such levels is likely to be particularly beneficial to inner-city hospitals who are already providing a greater number of such services. However, the present data suggest that investor-owned hospitals are least likely to provide such services. Increasing Medicaid eligibility levels is also likely to be associated with fewer services for which charity care has to be provided. State regulation in the form of rate review and certificate of need is likely to be associated with more services for which hospitals provide some charity care. But such policies alone do not deal with the larger issue of how to finance care for the medically indigent. Present data suggest the

  1. Financing renewable energy for Village Power application

    Energy Technology Data Exchange (ETDEWEB)

    Santibanez-Yeneza, G.

    1997-12-01

    When one talks of rural development, no doubt, the issue of rural energy is not far behind. As a significant component of any development strategy, rural energy is seen as the engine for growth that can bring about economic upliftment in the countryside. Many approaches to rural energy development have been tried. These approaches differ from country to country. But regardless of structure and approach, the goal remain essentially the same: to provide rural communities access to reliable energy services at affordable prices. In recent years, as global concern for the environment has increased, many governments have turned to renewable energy as a more environment friendly alternative to rural electrification. Technological advances in renewable energy application has helped to encourage this use. System reliability has improved, development costs have, to some extent been brought down and varied application approaches have been tried and tested in many areas. Indeed, there is huge potential for the development of renewable energy in the rural areas of most developing countries. At the rural level, renewable energy resources are almost always abundantly available: woodwaste, agricultural residues, animal waste, small-scale hydro, wind, solar and even sometimes geothermal resources. Since smaller scale systems are usually expected in these areas, renewable energy technologies can very well serve as decentralized energy systems for rural application. And not only for rural applications, new expansion planning paradigms have likewise led to the emergence of decentralized energy systems not only as supply options but also as corrective measures for maintaining end of line voltage levels. On the other hand, where renewable energy resource can provide significant blocks of power, they can be relied upon to provide indigenous power to the grids.

  2. The state of emergency obstetric care services in Nairobi informal settlements and environs: Results from a maternity health facility survey

    Directory of Open Access Journals (Sweden)

    Saliku Teresa

    2009-03-01

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

  3. Differences in intensive care unit work environments among and within hospitals using subscales and a composite measure of the Revised Nursing Work Index.

    Science.gov (United States)

    Cho, Sung-Hyun; Mark, Barbara A; Yun, Sung-Cheol; June, Kyung Ja

    2011-12-01

    To examine variations in nurses' perceptions of their work environments among hospitals and intensive care units, and to compare analytic findings from using subscales and a composite measure of the Revised Nursing Work Index at the hospital and intensive care unit levels. A positive relationship has been found between the nurse work environment and outcomes for patients and nurses. Nurses' perceptions of their work environments have been analysed using different analytic approaches. A survey was conducted in August-October 2007 that included 817 staff nurses in 39 adult intensive care units of 15 hospitals in South Korea. Seven subscales of the Revised Nursing Work Index were identified from an exploratory factor analysis. The subscales and composite (mean of the seven subscales) for each hospital and intensive care unit were analysed using multilevel regression analyses and classified as good, moderate or poor environments. Considerable variations in the subscales were found among both hospitals and intensive care units. On the composite measure, 2 hospitals were rated as good, 10 moderate and 3 poor; 9 intensive care units were ranked as good, 24 moderate and 6 poor. Even intensive care units within hospitals exhibited variations in the subscales and composite. Most hospitals and intensive care units had mixed (i.e., good, moderate, poor) environments across the seven subscales and thus, subscales were not always congruent with the composite. Heterogeneity of the subscales and the composite measure, and the differences among intensive care units within hospitals imply that use of different analytic approaches may reveal different findings and perspectives of nurse work environments. © 2011 Blackwell Publishing Ltd.

  4. From Hospital to Home Care: Creating a Domotic Environment for Elderly and Disabled People.

    Science.gov (United States)

    Lopez, Natalia M; Ponce, Sergio; Piccinini, David; Perez, Elisa; Roberti, Martin

    2016-01-01

    Advances in medicine have led to a significant increase in human life expectancy and, therefore, to a growing number of disabled elderly people who need chronic care and assistance [1]. The World Health Organization reports that the world's population over 60 years old will double between 2000 and 2050 and quadruple for seniors older than 80 years, reaching 400 million [2]. In addition, strokes, traffic-related and other accidents, and seemingly endless wars and acts of terrorism contribute to an increasing number of disabled younger people.

  5. Renewable energy strategies in India

    Energy Technology Data Exchange (ETDEWEB)

    Uttam Kumar Reddy, N. [Solar Energy Mfrs. Association of India (India)]|[Photon Energy Systems Ltd., Hyderabad (India)

    2001-07-01

    The twenty-first century has dawned; with it the third millennium. This is indeed a significant milestone in human history and an occasion for all of us for reflection and change. The model of development followed so far has relied excessively on consumption of fossil fuels, and this has endangered the biodiversity and the ecology of the earth. On this World Environment Day, I think it's our duty to resolve that we should leave the earth, if not in a better state that what we came into, then at least at the same state as we came in. It is against the backdrop of increasing environmental degradation where, around the world, there has been an increased emphasis on renewable energy. If the current interest in renewable energy products gets concretized, the twenty-first century can be expected to be as profoundly shaped by the move away from fossil fuels as the twentieth century was by the move towards them.

  6. Nova Scotia offshore renewal plan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-10-15

    Increase in global exploration and production have caused a reduction in offshore exploration licences. This paper outlined the government of Nova Scotia's offshore renewal plan. The plan was designed to clarify the role of the government and the Canada-Nova Scotia Offshore Petroleum Board (CNSOPB) and federal government. The plan was comprised of 4 different sections, including (1) geoscience, (2) new policy, (3) regulation, and (4) investment abstraction. Requests for proposals are now being designed to develop a better understanding of the geology of offshore Nova Scotia, including the shelf slope and deep water areas in the vicinity of Sable Island. A code of practice is currently being developed to minimize the impact of resource development on the marine environment while supporting the economic development of smaller oil and gas discoveries. Resource and analysis packages are currently being developed to help investors compute the risks associated with developing offshore sites. It was concluded that early action is required to address challenges and knowledge gaps related to geological data, regulatory efficiency, policy, and marketing strategies. Success of the plan will require the continued cooperation, and support of various governmental agencies. Details of regulatory renewal initiative projects were included. 1 fig.

  7. Health facility environment as humanization strategy care in the pediatric unit: systematic review

    Directory of Open Access Journals (Sweden)

    Juliane Portella Ribeiro

    2014-06-01

    Full Text Available Objective: To identify and analyze the production of knowledge about the strategies that health care institutions have implemented to humanize care of hospitalized children. Method: This is a systematic review conducted in the Virtual Health Library - Nursing and SciELO, using the seven steps proposed by the Cochrane Handbook. Results: 15 studies were selected, and strategies that involved relationship exchanges were used between the health professional, the hospitalized child and their families, which may be mediated by leisure activities, music and by reading fairy tales. We also include the use of the architecture itself as a way of providing welfare to the child and his/her family, as well as facilitating the development of the work process of health professionals. Conclusion: Investments in research and publications about the topic are necessary, so that, the National Humanization Policy does not disappear and that the identified strategies in this study do not configure as isolated and disjointed actions of health policy.

  8. Renewable Energy for Microenterprise

    Energy Technology Data Exchange (ETDEWEB)

    Allderdice, A.; Rogers, J.H.

    2000-11-28

    This guide provides readers with a broad understanding of the potential benefits that current renewable energy technologies can offer rural microenterprises. It also introduces the institutional approaches that have been developed to make RE technologies accessible to microentrepreneurs and the challenges that these entrepreneurs have encountered.

  9. Renewable Energies, Present & Future

    Institute of Scientific and Technical Information of China (English)

    X. S. Cai

    2005-01-01

    Fossil fuels are major cause of environmental destruction in pollutions. It has created much needed momentum for renewable energies, which are environmentally benign, generated locally, and can play a significant role in developing economy. As a sustainable energy sources, it can grow at a rapid pace to meet increasing demands for electricity in a cost-effective way.

  10. Renew, refuel, and rebuild.

    Science.gov (United States)

    Chin, Allison

    2009-01-01

    We can renew, refuel, and rebuild America with millions of green jobs, but they must be good jobs. Participants at the conference understand that environmental and economic stability go hand-in-hand, that the challenges of global warming are urgent and that huge opportunities exist for building a clean energy economy.

  11. Learning about Renewable Energy.

    Science.gov (United States)

    Conservation and Renewable Energy Inquiry and Referral Service (DOE), Silver Spring, MD.

    This booklet provides an introduction to renewable energy, discussing: (1) the production of electricity from sunlight; (2) wind power; (3) hydroelectric power; (4) geothermal energy; and (5) biomass. Also provided are nine questions to answer (based on the readings), four additional questions to answer (which require additional information), and…

  12. Mid-Career Renewal

    Science.gov (United States)

    Leider, Richard J.

    1976-01-01

    Since "life/career renewal issues will be among the most discussed of society's problems in the next five years and one of the hottest problems business and industry will be faced with," the author reviews work ethic history and recommends approaches individuals may take in view of the probable future. (Author/BP)

  13. Renewable Energy Essentials: Hydropower

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    Hydropower is currently the most common form of renewable energy and plays an important part in global power generation. Worldwide hydropower produced 3 288 TWh, just over 16% of global electricity production in 2008, and the overall technical potential for hydropower is estimated to be more than 16 400 TWh/yr.

  14. Renewable Substitutability Index: Maximizing Renewable Resource Use in Buildings

    Directory of Open Access Journals (Sweden)

    Ravi S. Srinivasan

    2015-05-01

    Full Text Available In order to achieve a material and energy balance in buildings that is sustainable in the long run, there is an urgent need to assess the renewable and non-renewable resources used in the manufacturing process and to progressively replace non-renewable resources with renewables. Such progressive disinvestment in the non-renewable resources that may be substituted with renewable resources is referred to as “Renewable Substitutability” and if implemented, this process will lead to a paradigm shift in the way building materials are manufactured. This paper discusses the development of a Renewable Substitutability Index (RSI that is designed to maximize the use of renewable resources in a building and quantifies the substitution process using solar emergy (i.e., the solar equivalent joules required for any item. The RSI of a building or a building component, i.e., floor or wall systems, etc., is the ratio of the renewable resources used during construction, including replacement and maintenance, to the building’s maximum renewable emergy potential. RSI values range between 0 and 1.0. A higher RSI achieves a low-energy building strategy promoting a higher order of sustainability by optimizing the use of renewables over a building’s lifetime from formation-extraction-manufacturing to maintenance, operation, demolition, and recycle.

  15. The Renewable Energy Data Explorer: Mapping Our Renewable Energy Future

    Energy Technology Data Exchange (ETDEWEB)

    2017-04-13

    The Renewable Energy (RE) Data Explorer, developed by the National Renewable Energy Laboratory, is an innovative web-based platform that allows users to visualize and analyze renewable energy potential. The RE Data Explorer informs prospecting, integrated planning, and policymaking to enable low emission development.

  16. Sustainable Housing Renewal

    Directory of Open Access Journals (Sweden)

    M. Sitar

    2008-01-01

    Full Text Available Following the already proved models the sustainable planning culture is endangering several methods directed towards the needs of tenants in the existing post-war housing stock. The case-study of our project is the renewal of the multi stored building in the housing estate Metalna, Maribor/Tezno (1949. It is based on the sustainable renovation principle for the quality of sustainable housing in functional, technological and environmental point of view. According to it, the idea of the project was to improve the functionality of the building as well as of individual housing units. One of the main goals was to introduce the variety of space and typology of individual housing units. Beside, there was an intention to rebuild and redesign the green area, especially the problems of parking and playground for children. On the other hand, the project is introducing the low-energy renovation principle including new technologies, structural elements and materials. Two scenarios of technological renewal were suggested. The first one was a classical one using additional thermal insulation of the building envelope and fitting of new structural elements such as windows, doors, balconies, windbreaks etc. (Renewal 1. The second scenario, however, included the sunspace construction used as a new passive solar structural element, modifying the envelope (Renewal 2. The energy efficiency of the suggested scenarios were calculated according to the procedures given in EN 832 standard considering the attached sunspace as integral part of the building in first case and as a passive solar object adjacent to the thermal envelope of the building in the second case. The results show that the last case yields the most energy efficient renewal of the existing residential building.

  17. Do Companies care about the environment and do they dare communicate it?

    DEFF Research Database (Denmark)

    Madsen, Henning; Nielsen, Anne Ellerup; Thomsen, Christa

    and the natural environment and society at large. Since it makes good sense for industry to respond to concerns and stakes espoused by key holders, it is of high relevance to identify and analyze patterns in company’s perception of these behavioural drivers as well as how they try to influence stakeholders when...... communicating attitudes and actions related to their environmental and societal concern. Data for this paper comes from two studies: (i) a questionnaire based survey distributed to a random sample of industrial companies in Denmark in 1995, 1999, 2003, 2007 and 2011 focusing on their respond...... of the company....

  18. Do Companies care about the environment and do they dare communicate it?

    DEFF Research Database (Denmark)

    Madsen, Henning; Nielsen, Anne Ellerup; Thomsen, Christa

    communicating attitudes and actions related to their environmental and societal concern. Data for this paper comes from two studies: (i) a questionnaire based survey distributed to a random sample of industrial companies in Denmark in 1995, 1999, 2003, 2007 and 2011 focusing on their respond...... and the natural environment and society at large. Since it makes good sense for industry to respond to concerns and stakes espoused by key holders, it is of high relevance to identify and analyze patterns in company’s perception of these behavioural drivers as well as how they try to influence stakeholders when...... of the company....

  19. Work- influence of the renewable energy sources in the environment, their use in Cuba; Trabajo- Influencia de las fuentes energeticas renovables en el medio ambiente, su aplicacion en Cuba

    Energy Technology Data Exchange (ETDEWEB)

    Mendez Gonzalez, Mercedes; Sarmiento Sera, Antonio [Instituto Superior Politecnico Jose A. Echeverria (ISPJAE), Ciudad de la Habana (Cuba)

    2000-07-01

    Among the different renewable energy technologies, wind provides better possibilities in regions in which this resource is available. The advantages of wind, as well as solar energy technologies are less or none fuel costs and less environmental impacts. According to the current available technology development, the use of hybrid systems of photovoltaic and wind energy presents large opportunities to cover the energy needs of isolated areas, specially in facilities that don't have connection to the national transmission grid. This study presents the different environmental impacts that hybrid systems have (incorporing the landscape impacts as well as socioeconomical impacts) for the electricity generation in Cuba. We conclude that these systems allow an important power generation in Cuba, and that they have neglected impacts to the environment. The use hybrid systems in Cuba are particularly important in ecotourism facilities and other small industries. [Spanish] Dentro de las posibilidades energeticas y medioambientales de los distintos tipos de energias renovables; la eolica por su caracter limpio e inagotable, permite un gran desarrollo en aquellas areas que cuentan con el potencial necesario para su aplicacion. De forma similar la energia solar presenta ventajas importantes, ambos son recursos gratuitos, no contaminantes y disponibles en muchas localidades. Segun las tecnologias actualmente disponibles, la utilizacion de sistemas hibridos de energia solar fotovoltaica y eolica presenta mayor interes hoy en dia para cubrir consumos aislados, en instalaciones alejadas de la red nacional de electrificacion. Este trabajo plantea un estudio, de la afectacion que sobre el medio ambiente, tanto en el aspecto visual como socioeconomico, tienen las fuentes energeticas renovables, y especificamente los sistemas hibridos eolico- fotovoltaicos para la generacion de electricidad en Cuba, a partir de conocer los recursos eolico y solar disponible en el lugar del

  20. HIV treatment and care in resource-constrained environments: challenges for the next decade

    Directory of Open Access Journals (Sweden)

    Serge-Paul Eholié

    2012-08-01

    Full Text Available Many successes have been achieved in HIV care in low- and middle-income countries (LMIC: increased number of HIV-infected individuals receiving antiretroviral treatment (ART, wide decentralization, reduction in morbidity and mortality and accessibility to cheapest drugs. However, these successes should not hide existing failures and difficulties. In this paper, we underline several key challenges. First, ensure long-term financing, increase available resources, in order to meet the increasing needs, and redistribute the overall budget in a concerted way amongst donors. Second, increase ART coverage and treat the many eligible patients who have not yet started ART. Competition amongst countries is expected to become a strong driving force in encouraging the least efficient to join better performing countries. Third, decrease early mortality on ART, by improving access to prevention, case-finding and treatment of tuberculosis and invasive bacterial diseases and by getting people to start ART much earlier. Fourth, move on from WHO 2006 to WHO 2010 guidelines. Raising the cut-off point for starting ART to 350 CD4/mm3 needs changing paradigm, adopting opt-out approach, facilitating pro-active testing, facilitating task shifting and increasing staff recruitments. Phasing out stavudine needs acting for a drastic reduction in the costs of other drugs. Scaling up routine viral load needs a mobilization for lower prices of reagents and equipments, as well as efforts in relation to point-of-care automation and to maintenance. The latter is a key step to boost the utilization of second-line regimens, which are currently dramatically under prescribed. Finally, other challenges are to reduce lost-to-follow-up rates; manage lifelong treatment and care for long-term morbidity, including drug toxicity, residual AIDS and HIV-non-AIDS morbidity and aging-related morbidity; and be able to face unforeseen events such as socio-political and military crisis. An old

  1. Nurses' use of mobile devices to access information in health care environments in australia: a survey of undergraduate students.

    Science.gov (United States)

    Mather, Carey; Cummings, Elizabeth; Allen, Penny

    2014-12-10

    The growth of digital technology has created challenges for safe and appropriate use of mobile or portable devices during work-integrated learning (WIL) in health care environments. Personal and professional use of technology has outpaced the development of policy or codes of practice for guiding its use at the workplace. There is a perceived risk that portable devices may distract from provision of patient or client care if used by health professionals or students during employment or WIL. This study aimed to identify differences in behavior of undergraduate nurses in accessing information, using a portable or mobile device, when undertaking WIL compared to other non-work situations. A validated online survey was administered to students while on placement in a range of health care settings in two Australian states. There were 84 respondents, with 56% (n=47) reporting access to a mobile or portable device. Differences in use of a mobile device away from, compared with during WIL, were observed for non-work related activities such as messaging (Pshopping on the Internet (P=.01), conducting personal business online (P=.01), and checking or sending non-work related texts or emails to co-workers (P=.04). Study-related activities were conducted more regularly away from the workplace and included accessing University sites for information (P=.03) and checking or sending study-related text messages or emails to friends or co-workers (P=.01). Students continued to access nursing, medical, professional development, and study-related information away from the workplace. Undergraduate nurses limit their access to non-work or non-patient centered information while undertaking WIL. Work-related mobile learning is being undertaken, in situ, by the next generation of nurses who expect easy access to mobile or portable devices at the workplace, to ensure safe and competent care is delivered to their patients.

  2. Telemedicine in pre-hospital care: a review of telemedicine applications in the pre-hospital environment.

    Science.gov (United States)

    Amadi-Obi, Ahjoku; Gilligan, Peadar; Owens, Niall; O'Donnell, Cathal

    2014-01-01

    The right person in the right place and at the right time is not always possible; telemedicine offers the potential to give audio and visual access to the appropriate clinician for patients. Advances in information and communication technology (ICT) in the area of video-to-video communication have led to growth in telemedicine applications in recent years. For these advances to be properly integrated into healthcare delivery, a regulatory framework, supported by definitive high-quality research, should be developed. Telemedicine is well suited to extending the reach of specialist services particularly in the pre-hospital care of acute emergencies where treatment delays may affect clinical outcome. The exponential growth in research and development in telemedicine has led to improvements in clinical outcomes in emergency medical care. This review is part of the LiveCity project to examine the history and existing applications of telemedicine in the pre-hospital environment. A search of electronic databases including Medline, Excerpta Medica Database (EMBASE), Cochrane, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for relevant papers was performed. All studies addressing the use of telemedicine in emergency medical or pre-hospital care setting were included. Out of a total of 1,279 articles reviewed, 39 met the inclusion criteria and were critically analysed. A majority of the studies were on stroke management. The studies suggested that overall, telemedicine had a positive impact on emergency medical care. It improved the pre-hospital diagnosis of stroke and myocardial infarction and enhanced the supervision of delivery of tissue thromboplasminogen activator in acute ischaemic stroke. Telemedicine presents an opportunity to enhance patient management. There are as yet few definitive studies that have demonstrated whether it had an effect on clinical outcome.

  3. Resistance and Renewal in Theoretical Psychology

    DEFF Research Database (Denmark)

    . The diversity and creativity of the work undertaken within theoretical psychology is further exemplified by papers on the history of the ISTP and theoretical psychology, a new paradigm for functional disorders, experimental introspection and techniques of self, the performativity of psychological science...... care in refugee family life, resilience thinking in disaster research and practices, resisting quality management in higher education, the relationality and reflexivity of resistance and renewal, research on psychological science from its borders, rethinking possible selves research, imagination...

  4. Strategic Planning for Health Care Cost Controls in a Constantly Changing Environment.

    Science.gov (United States)

    Hembree, William E

    2015-01-01

    Health care cost increases are showing a resurgence. Despite recent years' comparatively modest increases, the projections for 2015 cost increases range from 6.6% to 7%--three to four times larger than 2015's expected underlying inflation. This resurgence is just one of many rapidly changing external and internal challenges health plan sponsors must overcome (and this resurgence advances the date when the majority of employers will trigger the "Cadillac tax"). What's needed is a planning approach that is effective in overcoming all known and yet-to-be-discovered challenges, not just affordability. This article provides detailed guidance in adopting six proven strategic planning steps. Following these steps will proactively and effectively create a flexible strategic plan for the present and future of employers' health plans that will withstand all internal and external challenges.

  5. Nanotribological effects of hair care products and environment on human hair using atomic force microscopy

    Science.gov (United States)

    Latorre, Carmen; Bhushan, Bharat

    2005-07-01

    Tribological properties are useful in the study of human hair and other biological materials. Major sources of investigation for conditioner treated hair includes localization of conditioner, mechanisms related to changes in surface roughness, friction, and adhesion on the nanoscale due to conditioner agents, and how the products change the microstructure of the cuticle. The paper presents nanotribological studies investigating surface roughness, friction, and adhesion using atomic force/friction force microscopy (AFM/FFM). Test samples include virgin and chemically damaged hair, both with and without commercial conditioner treatment, as well as chemically damaged hair with experimental conditioner treatments. Friction force mapping provides insight into the localized change in friction caused by the application of hair care materials. Adhesive force maps to study adhesion on the cuticle surface provide information about localization and distribution of conditioner as well. A discussion is presented on these properties of hair as a function of relative humidity, temperature, durability, and conditioning treatments.

  6. RFID technology in health environment opportunities and challenges for modern cancer care.

    Science.gov (United States)

    Safdari, Reza; Maserat, Elham; Maserat, Elnaz

    2012-01-01

    Cancers are significant contributors to the mortality and health care expenditures. Cancer can be reduced and monitored by new information technology. Radio frequency identification or RFID is a wireless identification technology. The use of this technology can be employed for identifying and tracking clinical staff, patients, supplies, medications and equipments. RFID can trace and manage chemotherapy drugs. There are different types of RFID. Implantable RFID allowing a chip to be embedded under the skin and that store the cancer patient's identifier. These are concerns about applications of RFID. Privacy, security and legal issues are key problems. This paper describes capabilities, benefits and confidentiality aspects in radio frequency identification systems and solutions for overcoming challenges.

  7. Renewable Systems Interconnection: Executive Summary

    Energy Technology Data Exchange (ETDEWEB)

    Kroposki, B.; Margolis, R.; Kuswa, G.; Torres, J.; Bower, W.; Key, T.; Ton, D.

    2008-02-01

    The U.S. Department of Energy launched the Renewable Systems Interconnection (RSI) study in 2007 to address the challenges to high penetrations of distributed renewable energy technologies. The RSI study consists of 14 additional reports.

  8. Renewable Energy on Tribal Lands

    Science.gov (United States)

    This page contains presentations from the Brown to Green: Make the Connection to Renewable Energy workshop held in Santa Fe, New Mexico, during December 10-11, 2008 regarding Renewable Energy on Tribal Lands.

  9. Renewable energy and wildlife conservation

    Science.gov (United States)

    Khalil, Mona

    2016-09-09

    The renewable energy sector is rapidly expanding and diversifying the power supply of the country. Yet, as our Nation works to advance renewable energy and to conserve wildlife, some conflicts arise. To address these challenges, the U.S. Geological Survey (USGS) is conducting innovative research and developing workable solutions to reduce impacts of renewable energy production on wildlife.

  10. Factors Contributing to Mental and Physical Health Care in a Disaster-Prone Environment.

    Science.gov (United States)

    Osofsky, Howard J; Hansel, Tonya Cross; Osofsky, Joy D; Speier, Anthony

    2015-01-01

    Environment as a contextual factor plays an important role in southeastern Louisiana, as this area represents a major economic hub for the United States port, petroleum, and fishing industries. The location also exposes the population to both natural and technological disasters, including Hurricane Katrina and the Gulf oil spill. This study explored associations among hurricane loss, oil spill disruption, and environmental quality of life on mental and physical health on over 1,000 residents (N = 1,225) using structural equation modeling techniques. Results showed that oil spill distress was associated with increased symptoms of mental and physical health; Hurricane Katrina loss; and decreased environmental quality of life. Findings also indicate that mental health symptoms explain the association among oil spill distress and physical health symptoms-specifically, those that overlap with somatic complaints. These findings provide important support of the need for mental health assessment and service availability for disaster recovery.

  11. Distributed-dispersed renewable energy systems and novel control strategies

    Science.gov (United States)

    Aljankawey, Abdualah S.

    Renewable green-energy systems are re-emerging as viable economic alternative sources of environmentally safe power generation in place of conventional fossil fuels. In terms of power quality and safety, this research investigates a number of renewable green-energy (wind, photovoltaic and fuel cells) interface schemes and control strategies that ensure maximum energy utilization, voltage and frequency stabilization and minimum impact on the host electric grid systems. The research key objectives are to study efficient and robust renewable energy converter schemes with associated control strategies and validate their operations for both stand-alone and electric utility grid interfacing. The research work investigates both stand-alone and grid connected renewable green-energy utilization schemes with a number of power electronic converter topologies and robust control schemes for both dispersed and hybrid renewable energy systems. Different sample study systems and control strategies are digitally simulated and fully validated using the MATLAB-Simulink-SimPower environment.

  12. Using Ground Source Heat Pumps for Renewable Energy

    OpenAIRE

    Xhevat BERISHA

    2017-01-01

    This paper provides background information on the current energy supply, energy demand, and energy sources in Kosovo. Moreover, it presents the country‟s current level of applying alternative energy sources. Additionally, this paper focuses on geothermal energy as a renewable energy resource with the potential to contribute to a sustainable use of resources to meet renewable energy and energy efficiency requirements of the European Union (EU), “EU 20 20 by 2020” policy. Hence, a careful analy...

  13. Making Sense of Varying Standards of Care: The Experiences of Staff Working in Residential Care Environments for Adults with Learning Disabilities

    Science.gov (United States)

    Hutchison, Andrew; Kroese, Biza Stenfert

    2016-01-01

    Research evidence reveals that adults with learning disabilities who live in residential care facilities are being exposed to considerable variation in the standards of care they receive. High profile cases of substandard care have also raised concerns regarding the appropriateness of existing care provisions and practices. While attempts have…

  14. Cosmet'eau-Changes in the personal care product consumption practices: from whistle-blowers to impacts on aquatic environments.

    Science.gov (United States)

    Bressy, Adèle; Carré, Catherine; Caupos, Émilie; de Gouvello, Bernard; Deroubaix, José-Frédéric; Deutsch, Jean-Claude; Mailler, Romain; Marconi, Anthony; Neveu, Pascale; Paulic, Laurent; Pichon, Sébastien; Rocher, Vincent; Severin, Irina; Soyer, Mathilde; Moilleron, Régis

    2016-07-01

    The Cosmet'eau project (2015-2018) investigates the "changes in the personal care product (PCP) consumption practices: from whistle-blowers to impacts on aquatic environments." In this project, the example of PCPs will be used to understand how public health concerns related to micropollutants can be addressed by public authorities-including local authorities, industries, and consumers. The project aims to characterize the possible changes in PCP consumption practices and to evaluate the impact of their implementation on aquatic contamination. Our goals are to study the whistle-blowers, the risk perception of consumers linked with their practices, and the contamination in parabens and their substitutes, triclosan, and triclocarban from wastewater to surface water. The project investigates the following potential solutions: modifications of industrial formulation or changes in consumption practices. The final purpose is to provide policy instruments for local authorities aiming at building effective strategies to fight against micropollutants in receiving waters.

  15. The relationship of staffing and work environment with implicit rationing of nursing care in Swiss nursing homes--A cross-sectional study.

    Science.gov (United States)

    Zúñiga, Franziska; Ausserhofer, Dietmar; Hamers, Jan P H; Engberg, Sandra; Simon, Michael; Schwendimann, René

    2015-09-01

    Implicit rationing of nursing care refers to the withdrawal of or failure to carry out necessary nursing care activities due to lack of resources, in the literature also described as missed care, omitted care, or nursing care left undone. Under time constraints, nurses give priority to activities related to vital medical needs and the safety of the patient, leaving out documentation, rehabilitation, or emotional support of patients. In nursing homes, little is known about the occurrence of implicit rationing of nursing care and possible contributing factors. The purpose of this study was (1) to describe levels and patterns of self-reported implicit rationing of nursing care in Swiss nursing homes and (2) to explore the relationship between staffing level, turnover, and work environment factors and implicit rationing of nursing care. Cross-sectional, multi-center sub-study of the Swiss Nursing Home Human Resources Project (SHURP). Nursing homes from all three language regions of Switzerland. A random selection of 156 facilities with 402 units and 4307 direct care workers from all educational levels (including 25% registered nurses). We utilized data from established scales to measure implicit rationing of nursing care (Basel Extent of Rationing of Nursing Care), perceptions of leadership ability and staffing resources (Practice Environment Scale of the Nursing Work Index), teamwork and safety climate (Safety Attitudes Questionnaire), and work stressors (Health Professions Stress Inventory). Staffing level and turnover at the unit level were measured with self-developed questions. Multilevel linear regression models were used to explore the proposed relationships. Implicit rationing of nursing care does not occur frequently in Swiss nursing homes. Care workers ration support in activities of daily living, such as eating, drinking, elimination and mobilization less often than documentation of care and the social care of nursing homes residents. Statistically

  16. Nutrition and physical activity in child care centers: the impact of a wellness policy initiative on environment and policy assessment and observation outcomes, 2011.

    Science.gov (United States)

    Lyn, Rodney; Maalouf, Joyce; Evers, Sarah; Davis, Justin; Griffin, Monica

    2013-05-23

    The child care environment has emerged as an ideal setting in which to implement policies that promote healthy body weight of children. The purpose of this study was to assess the effect of a wellness policy and training program on the physical activity and nutrition environment in 24 child care centers in Georgia. We used the Environment and Policy Assessment and Observation instrument to identify changes to foods served, staff behaviors, and physical activity opportunities. Observations were performed over 1 day, beginning with breakfast and concluding when the program ended for the day. Observations were conducted from February 2010 through April 2011 for a total of 2 observations in each center. Changes to nutrition and physical activity in centers were assessed on the basis of changes in scores related to the physical activity and nutrition environment documented in the observations. Paired t test analyses were performed to determine significance of changes. Significant improvements to total nutrition (P environments of centers by enhancing active play (P = .02), the sedentary environment (P = .005), the portable environment (P = .002), staff behavior (P = .004), and physical activity training and education (P environment (P < .001), and nutrition training and education (P < .001). Findings from this study suggest that implementing wellness policies and training caregivers in best practices for physical activity and nutrition can promote healthy weight for young children in child care settings.

  17. The association between the physical environment and the well-being of older people in residential care facilities: A multilevel analysis.

    Science.gov (United States)

    Nordin, Susanna; McKee, Kevin; Wijk, Helle; Elf, Marie

    2017-06-06

    To investigate the associations between the quality of the physical environment and the psychological and social well-being of older people living in residential care facilities. Many older people in care facilities have cognitive and physical frailties and are at risk of experiencing low levels of well-being. High-quality physical environments can support older people as frailty increases and promote their well-being. Although the importance of the physical environment for residents' well-being is recognized, more research is needed. A cross-sectional survey of 20 care facilities from each of which 10 residents were sampled. As the individual resident data were nested in the facilities, a multilevel analysis was conducted. Data were collected during 2013 and 2014. The care facilities were purposely sampled to ensure a high level of variation in their physical characteristics. Residents' demographic and health data were collected via medical records and interviews. Residents' well-being and perceived quality of care were assessed via questionnaires and interviews. Environmental quality was assessed with a structured observational instrument. Multilevel analysis indicated that cognitive support in the physical environment was associated with residents' social well-being, after controlling for independence and perceived care quality. However, no significant association was found between the physical environment and residents' psychological well-being. Our study demonstrates the role of the physical environment for enhancing the social well-being of frail older people. Professionals and practitioners involved in the design of care facilities have a responsibility to ensure that such facilities meet high-quality specifications. © 2017 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

  18. Renewable Energy Systems

    DEFF Research Database (Denmark)

    Lund, Henrik

    2014-01-01

    are to be found when the electricity sector is combined with the heating and cooling sectors and/or the transportation sector. Moreover, the combination of electricity and gas infrastructures may play an important role in the design of future renewable energy systems. The paper illustrates why electricity smart......This paper presents the learning of a series of studies that analyse the problems and perspectives of converting the present energy system into a 100 % renewable energy system using a smart energy systems approach. As opposed to, for instance, the smart grid concept, which takes a sole focus...... on the electricity sector, smart energy systems include the entire energy system in its approach to identifying suitable energy infrastructure designs and operation strategies. The typical smart grid sole focus on the electricity sector often leads to the conclusion that transmission lines, flexible electricity...

  19. RENEWABLE ENERGY IN TOURISM

    Directory of Open Access Journals (Sweden)

    MĂDĂLINA MIHĂILĂ

    2012-06-01

    Full Text Available Recent reports published by the International Energy Agency and U.S. Department of Energy, regarding the global energy outlook for the first three decades of the XXI century, warns of global trends on energy demand, increasing dependence on energy imports, coal use and volume emissions of greenhouse gases, torism industry being one of the biggest energy consumption industry. Uncertainties on different models of regional development and access of the world to traditional energy resources require a change of orientation towards long-term scenarios for assessing energy domain, increasing the share of energy from renewable resources beeing one of the solutions. Intourism the renewable energy is a solution for a positive impact on enviroment , reduced operational costs and even won an extra-profit.

  20. Bolivia renewable energy development

    Energy Technology Data Exchange (ETDEWEB)

    Smith, P.

    1997-12-01

    The author summarizes changes which have occurred in Bolivia in the past year which have had an impact on renewable energy source development. Political changes have included the privatization of power generation and power distribution, and resulted in a new role for state level government and participation by the individual. A National Rural Electrification Plan was adopted in 1996, which stresses the use of GIS analysis and emphasizes factors such as off grid, economic index, population density, maintenance risk, and local organizational structure. The USAID program has chosen to stress economic development, environmental programs, and health over village power programs. The national renewables program has adopted a new development direction, with state projects, geothermal projects, and private sector involvement stressed.

  1. Renewable Energy Systems

    DEFF Research Database (Denmark)

    Lund, Henrik; Mathiesen, Brian Vad; Connolly, David

    2014-01-01

    This paper presents the learning of a series of studies that analyse the problems and perspectives of converting the present energy system into a 100 % renewable energy system using a smart energy systems approach. As opposed to, for instance, the smart grid concept, which takes a sole focus...... on the electricity sector, smart energy systems include the entire energy system in its approach to identifying suitable energy infrastructure designs and operation strategies. The typical smart grid sole focus on the electricity sector often leads to the conclusion that transmission lines, flexible electricity...... are to be found when the electricity sector is combined with the heating and cooling sectors and/or the transportation sector. Moreover, the combination of electricity and gas infrastructures may play an important role in the design of future renewable energy systems. The paper illustrates why electricity smart...

  2. Marine Renewable Energy Seascape

    OpenAIRE

    Borthwick, Alistair G. L.

    2015-01-01

    Marine renewable energy has a major part to play in closing the world’s energy gap and lowering carbon emissions. Key global challenges relate to technology, grid infrastructure, cost and investment, environmental impact, and marine governance. Offshore wind turbines typically consist of three blades rotating about a hub. Although offshore wind technology is rapidly being implemented, there remain many fascinating engineering problems to overcome. These include: offshore foundations and float...

  3. Biotechnology for renewable chemicals

    DEFF Research Database (Denmark)

    Borodina, Irina; Kildegaard, Kanchana Rueksomtawin; Jensen, Niels Bjerg

    2014-01-01

    The majority of the industrial organic chemicals are derived from fossil sources. With the oil and gas resources becoming limiting, biotechnology offers a sustainable alternative for production ofchemicals from renewable feedstocks. Yeast is an attractive cell factory forsustainable production of...... for the production of non-native 3-hydroxypropionic acid (3HP).3HP can be chemically dehydrated into acrylic acid and thus can serve as a biosustainable building block for acrylate-based products (diapers, acrylic paints, acrylic polymers, etc.)...

  4. Sustainable Housing Renewal

    OpenAIRE

    M. Sitar; K. Krajnc

    2008-01-01

    Following the already proved models the sustainable planning culture is endangering several methods directed towards the needs of tenants in the existing post-war housing stock. The case-study of our project is the renewal of the multi stored building in the housing estate Metalna, Maribor/Tezno (1949). It is based on the sustainable renovation principle for the quality of sustainable housing in functional, technological and environmental point of view. According to it, the idea of the projec...

  5. Renewable energy project development

    Energy Technology Data Exchange (ETDEWEB)

    Ohi, J.

    1996-12-31

    The author presents this paper with three main thrusts. The first is to discuss the implementation of renewable energy options in China, the second is to identify the key project development steps necessary to implement such programs, and finally is to develop recommendations in the form of key issues which must be addressed in developing such a program, and key technical assistance needs which must be addressed to make such a program practical.

  6. Parental child-care practices of Slovenian preschoolers' mothers and fathers: The Family Environment Questionnaire

    Directory of Open Access Journals (Sweden)

    Maja Zupančič

    2004-09-01

    Full Text Available The paper reviews evidence on the construct validity and reliability of the newly developed Family Environment Questionnaire (FEQ, and presents data on the structure of socialisation practices the Slovenian parents use in daily interactions with their three-year-old children. The FEQ is a parent report measure designed to provide an assessment of individual differences in parental practices that are representative among the parents of preschool children in the given cultural community. Factor analysis of the 63 items reliably recovered a four-component solution in both, maternal and paternal self-reports indicating the following broad-band parenting practices: Authoritative Parenting, Ineffective Control, Power Assertion, and Stimulation. Variables loading high on more than one component and those that did not load on the same factor obtained from maternal and paternal data were excluded from further analyses. The 51 items that were retained and corresponded to the four factors demonstrate adequate internal consistency for both samples of respondents. In addition, parental stimulation was positively linked to authoritative parenting, while it was negatively related to ineffective control and power assertion. The mothers perceived themselves to be more authoritative and stimulative than did fathers, who described themselves as more power assertive and ineffective in control. The parent-pairs were also found to share, at least to some extent, similar parenting practices, whereas their self-perceived expression of these practices was not dependent on their child's gender.

  7. Nurse Work Engagement Impacts Job Outcome and Nurse-Assessed Quality of Care: Model Testing with Nurse Practice Environment and Nurse Work Characteristics as Predictors

    Directory of Open Access Journals (Sweden)

    Peter Mathieu Van Bogaert

    2014-11-01

    Full Text Available Key words: burnout,job satisfaction, nurse retention, nurse practice environment,quality of care, acute health care,structural equation modelling. Aim:To explore the mechanisms through which nurse practice environment dimensions are associated with job outcomes and nurse-assessed quality of care. Mediating variables tested included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption.Background: Understanding to support and guide the practice community in their daily effort to answer most accurate complex care demands along with a stable nurse workforce are challenging.Design: Cross-sectional survey.Method:Based on previous empirical findings,a structural equation model designed with valid measurement instruments was tested.The study population was registered acute care hospital nurses(N = 1201 in twoindependent hospitals and one hospital group with six hospitals in Belgium.Results: Nurse practice environment dimensions predicted job outcome variables and nurse ratings of quality of care.Analyses were consistent with features of nurses’ work characteristics including perceived workload,decision latitude,and social capital,as well as three dimension of work engagement playing mediating roles between nurse practice environment and outcomes.A revised model adjusted using various fit measures explained 60 % and 47 % of job outcomes and nurse - assessed quality of care,respectively.Conclusion: Study findings show that aspects of nurse work characteristics such as workload,decision latitude and social capital along with nurse work engagement(e.g.vigor, dedication and absorption play a role between how various stakeholders such as executives,nurse managers and physicians will organize care and how nurses perceive job outcomes and quality of care.

  8. Renewable Energy in Latvia

    Energy Technology Data Exchange (ETDEWEB)

    Shipkovs, P.; Kashkarova, G. [Latvian Energy Agency, Riga (Latvia); Shipkovs, M. [Energy-R Ltd., Riga (Latvia)

    1997-12-31

    Latvia is among those countries that do not have gas, coal and, for the time being, also oil resources of its own. The amount of power produced in Latvia does not meet the demand, consequently a part of the power has to be purchased from neighbouring countries. Firewood, peat and hydro resources are the only significant domestic energy resources. Massive decrease of energy consumption has been observed since Latvia regained independence. Domestic and renewable energy resources have been examined and estimated. There are already 13 modern boiler houses operating in Latvia with total installed capacity 45 MW that are fired with wood chips. Latvian companies are involved in the production of equipment. 7 small HPPs have been renewed with the installed capacity 1.85 MW. Wind plant in Ainazi has started its operation, where two modern wind turbines with the capacity of 0.6 MW each have been installed. Mechanism of tariff setting is aligned. Favourable power energy purchasing prices are set for renewable energy sources and small cogeneration plants

  9. Designed sound and music environment in postanaesthesia care units--a multicentre study of patients and staff.

    Science.gov (United States)

    Thorgaard, Per; Ertmann, Ellen; Hansen, Vibeke; Noerregaard, Anni; Hansen, Vibeke; Spanggaard, Lene

    2005-08-01

    A multicentre study in five postanaesthesia care units (PACUs) was performed to investigate patient and staff opinion of a specially designed music environment (DME), related to geographical location. Patients (325) and staff (91) described their opinion by means of a questionnaire-anonymously in the case of staff. Patients were not asked beforehand for permission to play music. Amongst patients 267 (83%) found the sound environment with DME pleasant or very pleasant, 26 (6%) found it unpleasant, whereas 32 (11%) answered "no opinion". The opinion of the patients did not differ significantly with geographical location. A strong correlation (P<0.05) between a positive attitude towards DME and degree of relaxation and satisfaction with stay was found. The staff had an equally positive attitude towards the DME; but theirs varied significantly with location. The opinion of the staff was more similar concerning the beneficial effect on working conditions and distress, but varied still significantly. The opinion of the staff had no demonstrable impact on that of the patients.

  10. Psychometric properties of the Persian version of the Ambulatory Care Learning Educational Environment Measure (ACLEEM) questionnaire, Shiraz, Iran

    Science.gov (United States)

    Parvizi, Mohammad Mahdi; Amini, Mitra; Dehghani, Mohammad Reza; Jafari, Peyman; Parvizi, Zahra

    2016-01-01

    Purpose Evaluation is the main component in design and implementation of educational activities and rapid growth of educational institution programs. Outpatient medical education and clinical training environment is one of the most important parts of training of medical residents. This study aimed to determine the validity and reliability of the Persian version of Ambulatory Care Learning Educational Environment Measure (ACLEEM) questionnaire, as an instrument for assessment of educational environments in residency medical clinics. Materials and methods This study was performed on 180 residents in Shiraz University of Medical Sciences, Shiraz, Iran, in 2014–2015. The questionnaire designers’ electronic permission (by email) and the residents’ verbal consent were obtained before distributing the questionnaires. The study data were gathered using ACLEEM questionnaire developed by Arnoldo Riquelme in 2013. The data were analyzed using the SPSS statistical software, version 14, and MedCalc® software. Then, the construct validity, including convergent and discriminant validities, of the Persian version of ACLEEM questionnaire was assessed. Its internal consistency was also checked by Cronbach’s alpha coefficient. Results Five team members who were experts in medical education were consulted to test the cultural adaptation, linguistic equivalency, and content validity of the Persian version of the questionnaire. Content validity indexes were >0.9 in all items. In factor analysis of the instrument, the Kaiser–Meyer–Olkin index was 0.928 and Barlett’s sphericity test yielded the following results: X2=6,717.551, df =1,225, and P≤0.001. Besides, Cronbach’s alpha coefficient of ACLEEM questionnaire was 0.964. Cronbach’s alpha coefficients were also >0.80 in all the three domains of the questionnaire. Overall, the Persian version of ACLEEM showed excellent convergent validity and acceptable discriminant validity, except for the clinical training domain

  11. Intuitive ultrasonography for autonomous medical care in limited-resource environments

    Science.gov (United States)

    Dulchavsky, Scott A.; Sargsyan, Ashot E.; Garcia, Kathleen M.; Melton, Shannon L.; Ebert, Douglas; Hamilton, Douglas R.

    2011-05-01

    Management of health problems in limited resource environments, including spaceflight, faces challenges in both available equipment and personnel. The medical support for spaceflight outside Low Earth Orbit is still being defined; ultrasound (US) imaging is a candidate since trials on the International Space Station (ISS) prove that this highly informative modality performs very well in spaceflight. Considering existing estimates, authors find that US could be useful in most potential medical problems, as a powerful factor to mitigate risks and protect mission. Using outcome-oriented approach, an intuitive and adaptive US image catalog is being developed that can couple with just-in-time training methods already in use, to allow non-expert crew to autonomously acquire and interpret US data for research or diagnosis. The first objective of this work is to summarize the experience in providing imaging expertise from a central location in real time, enabling data collection by a minimally trained operator onsite. In previous investigations, just-in-time training was combined with real-time expert guidance to allow non-physician astronauts to perform over 80 h of complex US examinations on ISS, including abdominal, cardiovascular, ocular, musculoskeletal, dental/sinus, and thoracic exams. The analysis of these events shows that non-physician crew-members, after minimal training, can perform complex, quality US examinations. These training and guidance methods were also adapted for terrestrial use in professional sporting venues, the Olympic Games, and for austere locations including Mt. Everest. The second objective is to introduce a new imaging support system under development that is based on a digital catalog of existing sample images, complete with image recognition and acquisition logic and technique, and interactive multimedia reference tools, to guide and support autonomous acquisition, and possibly interpretation, of images without real-time link with a human

  12. Renewable Microgrid STEM Education & Colonias Outreach Program

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2015-04-01

    To provide Science, Technology, Engineering, and Math (STEM) outreach and education to secondary students to encourage them to select science and engineering as a career by providing an engineering-based problem-solving experience involving renewable energy systems such as photovoltaic (PV) panels or wind turbines. All public and private schools, community colleges, and vocational training programs would be eligible for participation. The Power Microgrids High School Engineering Experience used renewable energy systems (PV and wind) to provide a design capstone experience to secondary students. The objective for each student team was to design a microgrid for the student’s school using renewable energy sources under cost, schedule, performance, and risk constraints. The students then implemented their designs in a laboratory environment to evaluate the completeness of the proposed design, which is a unique experience even for undergraduate college students. This application-based program was marketed to secondary schools in the 28th Congressional District through the Texas Education Agency’s (TEA) Regional Service Centers. Upon application, TEES identified regionally available engineers to act as mentors and supervisors for the projects. Existing curriculum was modified to include microgrid and additional renewable technologies and was made available to the schools.

  13. Influence of the day care, home and neighbourhood environment on young children's physical activity and health: protocol for the PLAYCE observational study

    Science.gov (United States)

    Christian, Hayley; Maitland, Clover; Enkel, Stephanie; Trapp, Georgina; Trost, Stewart G; Schipperijn, Jasper; Boruff, Bryan; Lester, Leanne; Rosenberg, Michael; Zubrick, Stephen R

    2016-01-01

    Introduction The early years are a critical period in a child's health and development, yet most preschool children fail to meet physical activity guidelines. Outside of the home and neighbourhood, children spend a large proportion of time within early childhood education and care (ECEC) services such as long day care. Research is required to determine how the design of day care outdoor (and indoor) spaces provides opportunities or constraints for physical activity. A significant evidence gap surrounds what objectively measured attributes of the home and neighbourhood environment influence preschoolers’ physical activity. The PLAY Spaces & Environments for Children's Physical Activity (PLAYCE) study will empirically investigate the relative and cumulative influence of the day care, home and neighbourhood environment on preschoolers’ physical activity. Methods and analysis The PLAYCE study is a cross-sectional observational study (April 2015 to April 2018) of 2400 children aged 2–5 years attending long day care in metropolitan Perth, Western Australia. Accelerometers will measure physical activity with indoor physical activity measured using radio frequency identification. Global positioning systems will be used to determine outdoor location of physical activity around the home and neighbourhood for a subsample (n=310). The day care environment will be objectively measured using a validated audit tool. Other potential individual, social and physical environmental influences on preschoolers’ physical activity will be collected by geographic information systems measures, parent and day care educator surveys. Ethics and dissemination Ethical approval has been granted by The University of Western Australia Human Ethics Research Committee, approval number RA/4/1/7417. Findings will be published in international peer-reviewed journals and presented at international conferences. Key findings will be disseminated to stakeholders, collaborators, policymakers and

  14. Provider perceptions of the social work environment and the state of pediatric care in a downsized urban public academic medical center.

    Science.gov (United States)

    Tataw, David Besong

    2011-05-01

    The author's purpose through this study was to document and analyze health provider perceptions of their social work environment and the state of pediatric care at Los Angeles County King/Drew Hospital and Medical Center in 2000, after the restructuring and downsizing of the hospital and its community clinics. The research results showed nurses and physicians reporting that both the quality of pediatric care and the provider social work environment were poor. Negative factors in the social work environment included: low employee morale, poorly staffed clinical teams, lack of professional autonomy, perceptions of low quality of care for pediatric patients, and interpersonal issues of poor communication and collaboration among providers. Providers also perceived a non-supportive work environment, sense of powerlessness, poor quality of work, lack of goal clarity from leadership, lack of fairness in leadership behavior, and an organizational leadership that is abandoning its core mission and values, thereby making it difficult for providers to carry out their professional functions. The author's findings in this study suggest a relationship between intra-role conflict, social employment environment and quality of care at King/Drew Medical Center in 2000. Lessons for practice are presented.

  15. Psychometric properties of the Persian version of the Ambulatory Care Learning Educational Environment Measure (ACLEEM questionnaire, Shiraz, Iran

    Directory of Open Access Journals (Sweden)

    Parvizi MM

    2016-09-01

    Full Text Available Mohammad Mahdi Parvizi,1,2 Mitra Amini,2 Mohammad Reza Dehghani,2 Peyman Jafari,3 Zahra Parvizi,1 1Health Policy Research Center, 2Quality Improvement in Clinical Education Research Center, 3Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Fars, Iran Purpose: Evaluation is the main component in design and implementation of educational activities and rapid growth of educational institution programs. Outpatient medical education and clinical training environment is one of the most important parts of training of medical residents. This study aimed to determine the validity and reliability of the Persian version of Ambulatory Care Learning Educational Environment Measure (ACLEEM questionnaire, as an instrument for assessment of educational environments in residency medical clinics. Materials and methods: This study was performed on 180 residents in Shiraz University of Medical Sciences, Shiraz, Iran, in 2014–2015. The questionnaire designers’ electronic permission (by email and the residents’ verbal consent were obtained before distributing the questionnaires. The study data were gathered using ACLEEM questionnaire developed by Arnoldo Riquelme in 2013. The data were analyzed using the SPSS statistical software, version 14, and MedCalc® software. Then, the construct validity, including convergent and discriminant validities, of the Persian version of ACLEEM questionnaire was assessed. Its internal consistency was also checked by Cronbach’s alpha coefficient. Results: Five team members who were experts in medical education were consulted to test the cultural adaptation, linguistic equivalency, and content validity of the Persian version of the questionnaire. Content validity indexes were >0.9 in all items. In factor analysis of the instrument, the ­Kaiser–Meyer–Olkin index was 0.928 and Barlett’s sphericity test yielded the following results: X 2=6,717.551, df =1,225, and P ≤0.001. Besides, Cronbach

  16. Regional Renewable Energy Cooperatives

    Science.gov (United States)

    Hazendonk, P.; Brown, M. B.; Byrne, J. M.; Harrison, T.; Mueller, R.; Peacock, K.; Usher, J.; Yalamova, R.; Kroebel, R.; Larsen, J.; McNaughton, R.

    2014-12-01

    We are building a multidisciplinary research program linking researchers in agriculture, business, earth science, engineering, humanities and social science. Our goal is to match renewable energy supply and reformed energy demands. The program will be focused on (i) understanding and modifying energy demand, (ii) design and implementation of diverse renewable energy networks. Geomatics technology will be used to map existing energy and waste flows on a neighbourhood, municipal, and regional level. Optimal sites and combinations of sites for solar and wind electrical generation (ridges, rooftops, valley walls) will be identified. Geomatics based site and grid analyses will identify best locations for energy production based on efficient production and connectivity to regional grids and transportation. Design of networks for utilization of waste streams of heat, water, animal and human waste for energy production will be investigated. Agriculture, cities and industry produce many waste streams that are not well utilized. Therefore, establishing a renewable energy resource mapping and planning program for electrical generation, waste heat and energy recovery, biomass collection, and biochar, biodiesel and syngas production is critical to regional energy optimization. Electrical storage and demand management are two priorities that will be investigated. Regional scale cooperatives may use electric vehicle batteries and innovations such as pump storage and concentrated solar molten salt heat storage for steam turbine electrical generation. Energy demand management is poorly explored in Canada and elsewhere - our homes and businesses operate on an unrestricted demand. Simple monitoring and energy demand-ranking software can easily reduce peaks demands and move lower ranked uses to non-peak periods, thereby reducing the grid size needed to meet peak demands. Peak demand strains the current energy grid capacity and often requires demand balancing projects and

  17. Introduction to renewable energy

    CERN Document Server

    Nelson, Vaughn C

    2011-01-01

    IntroductionEnergy and SocietyTypes of EnergyRenewable EnergyAdvantages/DisadvantagesEconomicsGlobal WarmingOrder of Magnitude EstimatesGrowth (Exponential)SolutionsEnergyIntroductionDefinition of Energy and PowerHeatThermodynamicsEnergy Dilemma in Light of the Laws of ThermodynamicsUse of Fossil FuelsNuclearFinite ResourceSummarySunSolar PowerElectromagnetic SpectrumEnergy Balance of the EarthEarth-Sun MotionInsolationSolar ResourceGreenhouse EffectHeat Transfer and StorageIntroductionConductionConvectionRadiationThermal MassSeasonal Heating or CoolingThermal ComfortSolar Heating and CoolingB

  18. Renewables | Energies renouvelables

    Directory of Open Access Journals (Sweden)

    2012-05-01

    Full Text Available World Energy Generated for Commercial Use by Type*Production mondiale d’énergie destinée à des applications commerciales, par type*­Main ProducersPrincipaux producteurs* Renewables also include biomass, yet most of it is used for energy generation for non-commercial purposes. | Les énergies renouvelables incluent la biomasse, mais celle-ci sert essentiellement à générer de l’énergie qui ne rentre pas dans les circuits commerciaux.Source: British Petroleum, BP Statistical Review of World Energ...

  19. Renewable Energy Opportunity Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Hancock, Ed [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mas, Carl [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    1998-11-13

    Presently, the US EPA is constructing a new complex at Research Triangle Park, North Carolina to consolidate its research operations in the Raleigh-Durham area. The National Computer Center (NCC) is currently in the design process and is planned for construction as part of this complex. Implementation of the new technologies can be planned as part of the normal construction process, and full credit for elimination of the conventional technologies can be taken. Several renewable technologies are specified in the current plans for the buildings. The objective of this study is to identify measures that are likely to be both technically and economically feasible.

  20. Advancing health equity for lesbian, gay, bisexual and transgender (LGBT) people through sexual health education and LGBT-affirming health care environments.

    Science.gov (United States)

    Keuroghlian, Alex S; Ard, Kevin L; Makadon, Harvey J

    2017-02-06

    Lesbian, gay, bisexual and transgender (LGBT) people face pervasive health disparities and barriers to high-quality care. Adequate LGBT sexual health education for emerging health professionals is currently lacking. Clinical training programs and healthcare organisations are well poised to start addressing these disparities and affirming LGBT patients through curricula designed to cultivate core competencies in LBGT health as well as health care environments that welcome, include and protect LGBT patients, students and staff. Health education programs can emphasise mastery of basic LGBT concepts and terminology, as well as openness towards and acceptance of LGBT people. Core concepts, language and positive attitudes can be instilled alongside clinical skill in delivering inclusive sexual health care, through novel educational strategies and paradigms for clinical implementation. Caring for the health needs of LGBT patients also involves the creation of health care settings that affirm LGBT communities in a manner that is responsive to culturally specific needs, sensitivities and challenges that vary across the globe.

  1. Using wind and solar renewable energy by enterprises and consumers in terms of the energy management

    Directory of Open Access Journals (Sweden)

    Cornelia Nistor

    2014-01-01

    Full Text Available More and more leaders realize that the wider use of renewable energy brings many benefits on long-term, both for the enterprises and for the whole society in the process of developing the smart grids. One of the continuing concerns of any leader at any level must be the energy efficiency growth for all the users, individuals or legal entities. A good corporate leader supports a wider use of the renewable energy because thereby he promotes the care for the environment through the clean energy, the green economy idea in general, which will create him a positive image in the community and he will be considered a good representative of “corporate social responsibility”, by reducing the social ethical implications of strategies adopted. The more there will be more leaders who will promote the idea of production and use of alternative and renewable energy will be required also a greater involvement of the state in the use of the economic policy instruments in order to increase the investments in the infrastructure, to encourage the innovations in this field and to establish the regulations guiding of the specific markets mechanisms and the responsibilities and roles of each economic subject.

  2. Female farmworkers' health during pregnancy: health care providers' perspectives.

    Science.gov (United States)

    Kelley, Maureen A; Flocks, Joan D; Economos, Jeannie; McCauley, Linda A

    2013-07-01

    Pregnant farmworkers and their fetuses are at increased risk of negative health outcomes due to environmental and occupational factors at their workplaces. Health care providers who serve farm communities can positively affect workers' health through the informed care they deliver. Yet, interviews with rural health care providers reveal limited knowledge about agricultural work or occupational and environmental health risks during pregnancy. Professional associations, government organizations, academic institutions, and practice settings must renew their efforts to ensure that environmental and occupational health education, especially as it relates to women and their children, is incorporated into academic and practice environments.

  3. Renewable energy development in China

    Energy Technology Data Exchange (ETDEWEB)

    Junfeng, Li

    1996-12-31

    This paper presents the resources availability, technologies development and their costs of renewable energies in China and introduces the programs of renewable energies technologies development and their adaptation for rural economic development in China. As the conclusion of this paper, renewable energies technologies are suitable for some rural areas, especially in the remote areas for both household energy and business activities energy demand. The paper looks at issues involving hydropower, wind energy, biomass combustion, geothermal energy, and solar energy.

  4. Micro-financing of renewable energy systems

    Energy Technology Data Exchange (ETDEWEB)

    Bunse, Maike; Wallbaum, Holger [triple innova (Germany); Dienst, Carmen [Wuppertal Inst. for Climate, Environment, Energy (Germany)

    2007-07-01

    While improved energy services have many quality of life benefits like lighting or television, the productive use of electricity can also help to reduce poverty, leading to increased profitability and productivity for micro, small and medium enterprises, and small industries. The remoteness of rural locations usually makes it difficult to expand electricity supply through a centralised grid system. Therefore people living in off-grid regions often rely on expensive fossil fuels like diesel and kerosene. People in remote areas often do not have the financial background to afford the initial costs for renewable energy applications. Micro-financing of renewable energy systems is a possible answer to provide financial services and support productive activities in a sustainable manner for low-income people. There are various types of microfinance institutions (MFIs), ranging from local cooperatives, NGOs, credit unions, private commercial banks and non-bank financial institutions as well as parts of state-owned banks.To underline the benefits of micro financing renewable energy systems, good practice projects of local microfinance activities are presented. These projects have been identified in the course of WISIONS, an initiative of the Wuppertal Inst. for Climate, Environment and Energy with support of ProEvolution, a Swiss-based foundation. The two different approaches of the project support on one side the realisation of new project ideas (SEPS - Sustainable Energy Project Support) and on the other spread successful examples (PREP - Promotion of Resource Efficiency Projects). Through the PREP field of action, good practices in energy and resource efficiency are spread worldwide through the Internet and brochures. In the 5th PREP-brochure of WISIONS on 'Microfinance and Renewable Energy' five good-practice examples are shown that link this promising financing system with modern and sustainable renewable energy technologies.

  5. PROSPECTS OF RENEWED POWER

    Directory of Open Access Journals (Sweden)

    Dizendorf A. V.

    2015-12-01

    Full Text Available The article considers the main types of wind and solar electric installations, and provides a comparative analysis of the renewable energy potential of the Krasnodar region. Currently, humankind cannot live without electricity. Production and consumption of electricity is constantly increasing and the cost of it is constantly becoming more expensive. The cost of oil production (to get oil out of the ground increases. The cost of electricity is going up because the cost of basic materials such as copper is at an unprecedented high. Such alternatives energy sources such as solar and wind are real solutions to these problems, moreover, the cost of "traditional" energy sources will only increase. To date, the most popular and invest renewable energy sources are the solar energy and the wind. The solar energy in the Krasnodar region is more profitable than wind, despite the fact that the production of solar installations is more expensive. But every year, the price of solar energy is being reduced and soon will be equal to the price of wind energy, and science and technology do not stand still, and considering the abundance of sunlight in the Krasnodar region, the solar installation will pay off much faster

  6. Recombinant renewable polyclonal antibodies.

    Science.gov (United States)

    Ferrara, Fortunato; D'Angelo, Sara; Gaiotto, Tiziano; Naranjo, Leslie; Tian, Hongzhao; Gräslund, Susanne; Dobrovetsky, Elena; Hraber, Peter; Lund-Johansen, Fridtjof; Saragozza, Silvia; Sblattero, Daniele; Kiss, Csaba; Bradbury, Andrew R M

    2015-01-01

    Only a small fraction of the antibodies in a traditional polyclonal antibody mixture recognize the target of interest, frequently resulting in undesirable polyreactivity. Here, we show that high-quality recombinant polyclonals, in which hundreds of different antibodies are all directed toward a target of interest, can be easily generated in vitro by combining phage and yeast display. We show that, unlike traditional polyclonals, which are limited resources, recombinant polyclonal antibodies can be amplified over one hundred million-fold without losing representation or functionality. Our protocol was tested on 9 different targets to demonstrate how the strategy allows the selective amplification of antibodies directed toward desirable target specific epitopes, such as those found in one protein but not a closely related one, and the elimination of antibodies recognizing common epitopes, without significant loss of diversity. These recombinant renewable polyclonal antibodies are usable in different assays, and can be generated in high throughput. This approach could potentially be used to develop highly specific recombinant renewable antibodies against all human gene products.

  7. Renewable Energy: Markets and Prospects by Technology

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This information paper accompanies the IEA publication Deploying Renewables 2011: Best and Future Policy Practice (IEA, 2011a). It provides more detailed data and analysis, and explores the markets, policies and prospects for a number of renewable energy technologies. This paper provides a discussion of ten technology areas: bioenergy for electricity and heat, biofuels, geothermal energy, hydro energy, ocean energy, solar energy (solar photovoltaics, concentrating solar power, and solar heating), and wind energy (onshore and offshore). Each technology discussion includes: the current technical and market status; the current costs of energy production and cost trends; the policy environment; the potential and projections for the future; and an analysis of the prospects and key hurdles to future expansion.

  8. 政治关联、制度环境差异与企业贷款续新——基于中国上市公司的实证研究%Political connections, institutional environments and loan renewals —— The evidences from the privately listed enterprises

    Institute of Scientific and Technical Information of China (English)

    黄新建; 王婷

    2012-01-01

    当前我国大部分企业的外部融资渠道以银行贷款为主,而“贷款续新”政策决定了企业是否能够继续获得银行贷款.论文选用我国非金融类民营上市公司的数据,实证分析了政治关联、制度环境差异与银行贷款续新的关系.研究发现,企业的政治关联确实为企业融资带来了便利,且政治关联对续新的作用不受地区环境差异的影响.我们还发现相同条件下,制度环境好的地区,银行处于自身规避贷款风险的角度考虑,更倾向于拒绝向民营企业提供贷款续新.%Bank loans is the mainly channels of the external financing for corporations in China, and loan renewals policy determines whether a company can continue to access bank loans. By the data of Chinese non-financial listed companies in stock exchange market, the paper investigates the relationships between political connections, institutional environments and loan renewals. The thesis finds that political connections do have impacts on access to more preferential treats of bank loans. And political connections have impacts on bank loans in different institutional environments. We also found that the higher level of regional property right protection, the less powerful of the government intervention and the higher of the financial development, the less loan renewals the enterprises will get.

  9. Ecological risks of home and personal care products in the riverine environment of a rural region in south China without domestic wastewater treatment facilities

    NARCIS (Netherlands)

    Zhang, N.; Liu, Y.; Brink, van den P.J.; Price, O.R.; Ying, G.G.

    2015-01-01

    Home and personal care products (HPCPs) including biocides, benzotriazoles (BTs) and ultraviolet (UV) filters are widely used in our daily life. After use, they are discharged with domestic wastewater into the receiving environment. This study investigated the occurrence of 29 representative HPCPs,

  10. Ecological risks of home and personal care products in the riverine environment of a rural region in south China without domestic wastewater treatment facilities

    NARCIS (Netherlands)

    Zhang, N.; Liu, Y.; Brink, van den P.J.; Price, O.R.; Ying, G.G.

    2015-01-01

    Home and personal care products (HPCPs) including biocides, benzotriazoles (BTs) and ultraviolet (UV) filters are widely used in our daily life. After use, they are discharged with domestic wastewater into the receiving environment. This study investigated the occurrence of 29 representative HPCPs,

  11. Strategic renewal for business units.

    Science.gov (United States)

    Whitney, J O

    1996-01-01

    Over the past decade, business units have increasingly taken the role of strategy formulation away from corporate headquarters. The change makes sense: business units are closer to customers, competitors, and costs. Nevertheless, business units can fail, just as headquarters once did, by losing their focus on the organization's priorities and capabilities. John Whitney--turnaround expert and professor of management at Columbia University--offers a method for refocusing companies that he calls the strategic-renewal process. The principles behind the process are straightforward, but its execution demands extensive data, rigorous analysis, and the judgment of key decision makers. However, when applied with diligence, it can produce a strategy that yields both growth and profit. To carry out the process, managers must analyze, one by one or in logical groupings, the company's customers, the products it sells, and the services it offers in light of three criteria: strategic importance, significance, and profitability. Does a given customer, product, or service mesh with the organization's goals? Is it significant in terms of current and future revenues? And is it truly profitable when all costs are care fully considered? Customers, products, and services that do not measure up, says the author, must be weeded out relentlessly. Although the process is a painstaking one, the article offers clear thinking on why-and how-to go about it. A series of exhibits takes managers through the questions they need to raise, and two matrices offer Whitney's concentrated wisdom on when to cultivate--and when to prune.

  12. Photolysis of pharmaceuticals and personal care products in the marine environment under simulated sunlight conditions: irradiation and identification.

    Science.gov (United States)

    Ali, Aasim Musa Mohamed; Kallenborn, Roland; Sydnes, Leiv Kristen; Rønning, Helene Thorsen; Alarif, Walied Mohamed; Al-Lihaibi, Sultan

    2017-06-01

    The photochemical fate of 16 pharmaceuticals and personal care products (PPCPs) found in the environment has been studied under controlled laboratory conditions applying a sunlight simulator. Aqueous samples containing PPCPs at environmentally relevant concentrations were extracted by solid-phase extraction (SPE) after irradiation. The exposed extracts were subsequently analysed by liquid chromatography combined with triple quadrupole mass spectrometry (HPLC-MS/MS) for studying the kinetics of photolytic transformations. Almost all exposed PPCPs appeared to react with a half-life time (τ 1/2) of less than 30 min. For ranitidine, sulfamethoxazole, diclofenac, warfarin, sulfamethoxazole and ciprofloxacin, τ1/2 was found to be even less than 5 min. The structures of major photolysis products were determined using quadrupole-time-of-flight mass spectrometry (QToF) and spectroscopic data reported in the literature. For diclofenac, the transformation products carbazol-1-yl-acidic acid and 8-chloro-9H-carbazol-1-yl-acetic acid were identified based on the mass/charge ratio of protonated ions and their fragmentation pattern in negative electrospray ionization (ESI(-)-QTOF). Irradiation of carbamazepine resulted in three known products: acridine, carbamazepine-10,11-epoxide, and 10,11-dihydro-10,11-dihydroxy-carbamazepine, whereas acetaminophen was photolytically transformed to 1-(2-amino-5 hydroxyphenyl) ethenone. These photochemical products were subsequently identified in seawater or fish samples collected at sites exposed to wastewater effluents on the Saudi Arabian coast of the Red Sea.

  13. APPLICATION OF U.S. EPA METHODS TO THE ANALYSIS OF PHARMACEUTICALS AND PERSONAL CARE PRODUCTS IN THE ENVIRONMENT: DETERMINATION OF CLOFIBRIC ACID IN SEWAGE EFFLUENT BY GC-MS

    Science.gov (United States)

    An emerging area of research concerns pharmaceuticals and personal care products in the environment and their possible impact on biota and ecosystems. The long term effects of constant perfusion of PPCPs into the aquatic environment are presently unknown. Some compoun...

  14. RENEWABLE ENERGY SOURCES IN POLAND - CONDITIONS AND POSSIBILITES OF DEVELOPMENT

    Energy Technology Data Exchange (ETDEWEB)

    Gawlik, L.; Mokrzycki, E.; Ney, R.

    2007-07-01

    The paper describes the state of the art in renewable energy sources development. The obligation resulting from the membership of Poland in the European Union as well as from other international agreements in the scope of renewable energy sources development are described. The production of electricity, heat and biofuels in Poland is given and the perspectives of development of particular renewable energy sources in Poland are discussed in the view of potential reserves and other constrains. The economic aspects of renewable energy technologies are shown. The environmental pros and cons of biomass energy development are described. Arguments for development of renewable energy sources use are stated: the decrease of dependence from primary energy sources, the decrease the emission of green house gases and the recovery of agricultural regions of the country. In conclusion it is stated that the significance of renewable energy sources in Polish conditions is constrained to local societies. Their development should be adjusted to conditions predominating in a given region and that wider consumption of renewable energy sources should develop in conformity with sustainable development, so it is necessary to reach agreement between local societies, institutions dealing with environment protection and representatives of power sector. (auth)

  15. EDITORIAL: Renewing energy technology Renewing energy technology

    Science.gov (United States)

    Demming, Anna

    2011-06-01

    Renewable energy is now a mainstream concern among businesses and governments across the world, and could be considered a characteristic preoccupation of our time. It is interesting to note that many of the energy technologies currently being developed date back to very different eras, and even predate the industrial revolution. The fuel cell was first invented as long ago as 1838 by the Swiss--German chemist Christian Friedrich Schönbein [1], and the idea of harnessing solar power dates back to ancient Greece [2]. The enduring fascination with new means of harnessing energy is no doubt linked to man's innate delight in expending it, whether it be to satisfy the drive of curiosity, or from a hunger for entertainment, or to power automated labour-saving devices. But this must be galvanized by the sustained ability to improve device performance, unearthing original science, and asking new questions, for example regarding the durability of photovoltaic devices [3]. As in so many fields, advances in hydrogen storage technology for fuel cells have benefited significantly from nanotechnology. The idea is that the kinetics of hydrogen uptake and release may be reduced by decreasing the particle size. An understanding of how effective this may be has been hampered by limited knowledge of the way the thermodynamics are affected by atom or molecule cluster size. Detailed calculations of individual atoms in clusters are limited by computational resources as to the number of atoms that can studied, and other innovative approaches that deal with force fields derived by extrapolating the difference between the properties of clusters and bulk matter require labour-intensive modifications when extending such studies to new materials. In [4], researchers in the US use an alternative approach, considering the nanoparticle as having the same crystal structure as the bulk but relaxing the few layers of atoms near the surface. The favourable features of nanostructures for catalysis

  16. Participatory urban renewal

    Directory of Open Access Journals (Sweden)

    Drago Kos

    2005-01-01

    Full Text Available The article consists of two parts. The first deals with the theoretical framework of urban rehabilitation. Literature provides the basis for a conclusion, which is that the key issue in rehabilitation projects is legitimate negotiation of various interests between participating individuals and institutions. In the second part this presentation and analyses of events that took place at the urban design workshop organised within the framework of the research project Renewal of housing estates in Ljubljana, provide experiential confirmation of the starting thesis. We established that the directly involved residents were willing to actively participate in rehabilitation procedures, however the process is never triggered, because of insufficient capacities in institutional frameworks. In conclusion several real proposals are shown, namely, how to surmount obstacles in urban rehabilitation and especially in larger housing estates built after World War 2.

  17. Renewable Energy Certificate Program

    Energy Technology Data Exchange (ETDEWEB)

    Gwendolyn S. Andersen

    2012-07-17

    This project was primarily to develop and implement a curriculum which will train undergraduate and graduate students at the University seeking a degree as well as training for enrollees in a special certification program to prepare individuals to be employed in a broad range of occupations in the field of renewable energy and energy conservation. Curriculum development was by teams of Saint Francis University Faculty in the Business Administration and Science Departments and industry experts. Students seeking undergraduate and graduate degrees are able to enroll in courses offered within these departments which will combine theory and hands-on training in the various elements of wind power development. For example, the business department curriculum areas include economic modeling, finance, contracting, etc. The science areas include meteorology, energy conversion and projection, species identification, habitat protection, field data collection and analysis, etc.

  18. Renewable jet fuel.

    Science.gov (United States)

    Kallio, Pauli; Pásztor, András; Akhtar, M Kalim; Jones, Patrik R

    2014-04-01

    Novel strategies for sustainable replacement of finite fossil fuels are intensely pursued in fundamental research, applied science and industry. In the case of jet fuels used in gas-turbine engine aircrafts, the production and use of synthetic bio-derived kerosenes are advancing rapidly. Microbial biotechnology could potentially also be used to complement the renewable production of jet fuel, as demonstrated by the production of bioethanol and biodiesel for piston engine vehicles. Engineered microbial biosynthesis of medium chain length alkanes, which constitute the major fraction of petroleum-based jet fuels, was recently demonstrated. Although efficiencies currently are far from that needed for commercial application, this discovery has spurred research towards future production platforms using both fermentative and direct photobiological routes. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Renewal of radiological equipment.

    Science.gov (United States)

    2014-10-01

    In this century, medical imaging is at the heart of medical practice. Besides providing fast and accurate diagnosis, advances in radiology equipment offer new and previously non-existing options for treatment guidance with quite low morbidity, resulting in the improvement of health outcomes and quality of life for the patients. Although rapid technological development created new medical imaging modalities and methods, the same progress speed resulted in accelerated technical and functional obsolescence of the same medical imaging equipment, consequently creating a need for renewal. Older equipment has a high risk of failures and breakdowns, which might cause delays in diagnosis and treatment of the patient, and safety problems both for the patient and the medical staff. The European Society of Radiology is promoting the use of up-to-date equipment, especially in the context of the EuroSafe Imaging Campaign, as the use of up-to-date equipment will improve quality and safety in medical imaging. Every healthcare institution or authority should have a plan for medical imaging equipment upgrade or renewal. This plan should look forward a minimum of 5 years, with annual updates. Teaching points • Radiological equipment has a definite life cycle span, resulting in unavoidable breakdown and decrease or loss of image quality which renders equipment useless after a certain time period.• Equipment older than 10 years is no longer state-of-the art equipment and replacement is essential. Operating costs of older equipment will be high when compared with new equipment, and sometimes maintenance will be impossible if no spare parts are available.• Older equipment has a high risk of failure and breakdown, causing delays in diagnosis and treatment of the patient and safety problems both for the patient and the medical staff.• Every healthcare institution or authority should have a plan for medical imaging equipment upgrade or replacement. This plan should look forward a

  20. Renewable Energy in European Regions

    NARCIS (Netherlands)

    Krozer, Y.

    2012-01-01

    The regional dynamics of energy innovation, in particular the shift from fossil fuels to renewable energy in the EU, is discussed within the framework of neo-Schumpeterian theory. The EU’s 4.2% average annual growth in renewable energy production in the last decade has been accompanied by diverging

  1. PYRAMID LAKE RENEWEABLE ENERGY PLAN

    Energy Technology Data Exchange (ETDEWEB)

    HIGH DESERT GEOCULTURE, LLC

    2009-06-06

    The Pyramid Lake Renewable Energy Plan covers these areas: energy potential (primarily focusing on geothermal resource potential, but also more generally addressing wind energy potential); renewable energy market potential; transmission system development; geothermal direct use potential; and business structures to accomplish the development objectives of the Pyramid Lake Paiute Tribe.

  2. Business development in renewable energy

    NARCIS (Netherlands)

    Krozer, Yoram; Visa, Ion

    2014-01-01

    This paper discusses how to foster development of renewable energy business. Factors that impede or enhance renewable energy in the EU 27 member states in the period 1998–2008 are analyzed. Nine factors are considered: population density, production output and energy sector output to indicate market

  3. Business development in renewable energy

    NARCIS (Netherlands)

    Krozer, Yoram; Visa, Ion

    2014-01-01

    This paper discusses how to foster development of renewable energy business. Factors that impede or enhance renewable energy in the EU 27 member states in the period 1998–2008 are analyzed. Nine factors are considered: population density, production output and energy sector output to indicate market

  4. Epibenthic assessment of a renewable tidal energy site.

    Science.gov (United States)

    Sheehan, Emma V; Gall, Sarah C; Cousens, Sophie L; Attrill, Martin J

    2013-01-01

    Concern over global climate change as a result of fossil fuel use has resulted in energy production from renewable sources. Marine renewable energy devices provide clean electricity but can also cause physical disturbance to the local environment. There is a considerable paucity of ecological data at potential marine renewable energy sites that is needed to assess potential future impacts and allow optimal siting of devices. Here, we provide a baseline benthic survey for the Big Russel in Guernsey, UK, a potential site for tidal energy development. To assess the suitability of proposed sites for marine renewable energy in the Big Russel and to identify potential control sites, we compared species assemblages and habitat types. This baseline survey can be used to select control habitats to compare and monitor the benthic communities after installation of the device and contribute towards the optimal siting of any future installation.

  5. Epibenthic Assessment of a Renewable Tidal Energy Site

    Directory of Open Access Journals (Sweden)

    Emma V. Sheehan

    2013-01-01

    Full Text Available Concern over global climate change as a result of fossil fuel use has resulted in energy production from renewable sources. Marine renewable energy devices provide clean electricity but can also cause physical disturbance to the local environment. There is a considerable paucity of ecological data at potential marine renewable energy sites that is needed to assess potential future impacts and allow optimal siting of devices. Here, we provide a baseline benthic survey for the Big Russel in Guernsey, UK, a potential site for tidal energy development. To assess the suitability of proposed sites for marine renewable energy in the Big Russel and to identify potential control sites, we compared species assemblages and habitat types. This baseline survey can be used to select control habitats to compare and monitor the benthic communities after installation of the device and contribute towards the optimal siting of any future installation.

  6. Renewable energy sources in Europe; Erneuerbare Energien in Europa

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Thorsten; Kahl, Hartmut (eds.)

    2015-07-01

    The book on renewable energy sources in Europe includes contributions on the following issues: Europe's energy and climate policy on the crossroad; possible promotion of renewable energy in Europe; regulation and innovations in a multi-level system - European energy and climate protection legislation - freedom of action for the member states; lessons learned - in the implementation of the European renewable energy guideline; Options for the development of the renewable energy guideline; status and development of the legal system of the energy domestic market; actual developments in the legislation of the EuGH on the compatibility of green electricity promotion systems with free movement on goods; Europe without critical power situations; prerequisites and consequences of a European electricity market coupling; selected grants of the EU commission for green energy promotion; assistance guidelines of the EU commission for energy and environment purposes.

  7. Renewables in Global Energy Supply

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    Renewable energies are essential contributors to the energy supply portfolio as they contribute to world energy supply security, reducing dependency on fossil fuel resources, and provide opportunities for mitigating greenhouse gases. Differences in definition and lack of adequate data complicated the discussion between participants on these key issues. The International Energy Agency believes that this fact sheet can be of use to all to facilitate the debate on the past, current and future place and role of renewables in total energy supply. Our goal is to present as objectively as possible the main elements of the current renewables energy situation. The definitions and coverage of national statistics vary between countries and organisations. In this fact sheet, the renewables definition includes combustible renewables and waste (CRW), hydro, geothermal, solar, wind, tide and wave energy.

  8. Somerset County Renewable Energy Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Katula, Denise [County of Somerset, Somervile, NJ (United States)

    2014-05-07

    The County of Somerset, New Jersey, through the Somerset County Improvement Authority (SCIA), applied Federal funding through the U.S. Department of Energy to will apply project funds to buy-down the capital costs of equipment associated with the installation of solar photovoltaic (PV) systems at two sites owned by the County. This Renewable Energy Initiative allows the County to take advantage of clean renewable energy, without any adverse debt impacts, and at a price that results in operating budget savings beyond what is presently available in the marketplace. This project addressed the objectives of the Office of Energy Efficiency and Renewable Energy by making the acquisition of renewable energy more affordable for the County, thereby, encouraging other counties and local units to develop similar programs and increase the deployment of solar energy technologies. The two sites that were funded by the DOE grant are part of a much larger, ambitious, and unique renewable energy project, described in the next section.

  9. Integrating Renewables in Electricity Markets

    DEFF Research Database (Denmark)

    Morales González, Juan Miguel; Conejo, Antonio J.; Madsen, Henrik

    This addition to the ISOR series addresses the analytics of the operations of electric energy systems with increasing penetration of stochastic renewable production facilities, such as wind- and solar-based generation units. As stochastic renewable production units become ubiquitous throughout...... electric energy systems, an increasing level of flexible backup provided by non-stochastic units and other system agents is needed if supply security and quality are to be maintained. Within the context above, this book provides up-to-date analytical tools to address challenging operational problems...... such as: • The modeling and forecasting of stochastic renewable power production. • The characterization of the impact of renewable production on market outcomes. • The clearing of electricity markets with high penetration of stochastic renewable units. • The development of mechanisms to counteract...

  10. Renewable energy sources; Erneuerbare Energien

    Energy Technology Data Exchange (ETDEWEB)

    Lenz, Volker [Deutsches BiomasseForschungsZentrum gGmbH (DBFZ), Leipzig (Germany); Kaltschmitt, Martin [Technische Univ. Hamburg-Harburg, Hamburg (Germany). Inst. fuer Umwelttechnik und Energiewirtschaft

    2012-07-01

    The development of the use of renewable energy sources in Germany in 2011 significantly was influenced by the disaster in Fukushima (Japan) and the change of course in the German energy policy. In addition, there is the amendment of the Renewable Energy Law (EEG) in an increasingly controversial area of tension between climate protection, energy utilization, cost minimization and considerations on sustainability. With this in mind, the authors of the contribution under consideration report on developments in Germany in the year 2011 in the field of energy supply and fuel supply from renewable energies. Beside the energy-economic framework conditions for the various possibilities for the use of renewable energies, the current status, developments and prospects are analysed. The contribution gives an outlook on the possible expansion of the supply of renewable energies in 2012.

  11. Financing investments in renewable energy: The role of policy design and restructuring

    Energy Technology Data Exchange (ETDEWEB)

    Wiser, R.; Pickle, S. [Lawrence Berkeley National Lab., CA (United States). Environmental Energy Technologies Div.

    1997-03-01

    The costs of electric power projects utilizing renewable energy technologies are highly sensitive to financing terms. Consequently, as the electricity industry is restructured and new renewables policies are created, it is important for policymakers to consider the impacts of renewables policy design on project financing. This report describes the power plant financing process and provides insights to policymakers on the important nexus between renewables policy design and finance. A cash-flow model is used to estimate the impact of various financing variables on renewable energy costs. Past and current renewable energy policies are then evaluated to demonstrate the influence of policy design on the financing process and on financing costs. The possible impacts of electricity restructuring on power plant financing are discussed and key design issues are identified for three specific renewable energy programs being considered in the restructuring process: (1) surcharge-funded policies; (2) renewables portfolio standards; and (3) green marketing programs. Finally, several policies that are intended to directly reduce financing costs and barriers are analyzed. The authors find that one of the key reasons that renewables policies are not more effective is that project development and financing processes are frequently ignored or misunderstood when designing and implementing renewable energy incentives. A policy that is carefully designed can reduce renewable energy costs dramatically by providing revenue certainty that will, in turn, reduce financing risk premiums.

  12. Eastern Renewable Generation Integration Study

    Energy Technology Data Exchange (ETDEWEB)

    Bloom, Aaron [National Renewable Energy Lab. (NREL), Golden, CO (United States); Townsend, Aaron [National Renewable Energy Lab. (NREL), Golden, CO (United States); Palchak, David [National Renewable Energy Lab. (NREL), Golden, CO (United States); Novacheck, Joshua [National Renewable Energy Lab. (NREL), Golden, CO (United States); King, Jack [RePPAE LLC, Wexford, PA (United States); Barrows, Clayton [National Renewable Energy Lab. (NREL), Golden, CO (United States); Ibanez, Eduardo [GE Energy, Denver, CO (United States); O' Connell, Matthew [National Renewable Energy Lab. (NREL), Golden, CO (United States); Jordan, Gary [GE Energy, Denver, CO (United States); Roberts, Billy [National Renewable Energy Lab. (NREL), Golden, CO (United States); Draxl, Caroline [National Renewable Energy Lab. (NREL), Golden, CO (United States); Gruchalla, Kenny [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-08-01

    The Eastern Interconnection (EI) is one of the largest power systems in the world, and its size and complexity have historically made it difficult to study in high levels of detail in a modeling environment. In order to understand how this system might be impacted by high penetrations (30% of total annual generation) of wind and solar photovoltaic (PV) during steady state operations, the National Renewable Energy Laboratory (NREL) and the U.S. Department of Energy (DOE) conducted the Eastern Renewable Generation Integration Study (ERGIS). This study investigates certain aspects of the reliability and economic efficiency problem faced by power system operators and planners. Specifically, the study models the ability to meet electricity demand at a 5-minute time interval by scheduling resources for known ramping events, while maintaining adequate reserves to meet random variation in supply and demand, and contingency events. To measure the ability to meet these requirements, a unit commitment and economic dispatch (UC&ED) model is employed to simulate power system operations. The economic costs of managing this system are presented using production costs, a traditional UC&ED metric that does not include any consideration of long-term fixed costs. ERGIS simulated one year of power system operations to understand regional and sub-hourly impacts of wind and PV by developing a comprehensive UC&ED model of the EI. In the analysis, it is shown that, under the study assumptions, generation from approximately 400 GW of combined wind and PV capacity can be balanced on the transmission system at a 5-minute level. In order to address the significant computational burdens associated with a model of this detail we apply novel computing techniques to dramatically reduce simulation solve time while simultaneously increasing the resolution and fidelity of the analysis. Our results also indicate that high penetrations of wind and PV (collectively variable generation (VG

  13. The impact of Nursing Rounds on the practice environment and nurse satisfaction in intensive care: pre-test post-test comparative study.

    Science.gov (United States)

    Aitken, Leanne M; Burmeister, Elizabeth; Clayton, Samantha; Dalais, Christine; Gardner, Glenn

    2011-08-01

    Factors previously shown to influence patient care include effective decision making, team work, evidence based practice, staffing and job satisfaction. Clinical rounds have the potential to optimise these factors and impact on patient outcomes, but use of this strategy by intensive care nurses has not been reported. To determine the effect of implementing Nursing Rounds in the intensive care environment on patient care planning and nurses' perceptions of the practice environment and work satisfaction. Pre-test post-test 2 group comparative design. Two intensive care units in tertiary teaching hospitals in Australia. A convenience sample of registered nurses (n=244) working full time or part time in the participating intensive care units. Nurses in participating intensive care units were asked to complete the Practice Environment Scale-Nursing Work Index (PES-NWI) and the Nursing Worklife Satisfaction Scale (NWSS) prior to and after a 12 month period during which regular Nursing Rounds were conducted in the intervention unit. Issues raised during Nursing Rounds were described and categorised. The characteristics of the sample and scale scores were summarised with differences between pre and post scores analysed using t-tests for continuous variables and chi-square tests for categorical variables. Independent predictors of the PES-NWI were determined using multivariate linear regression. Nursing Rounds resulted in 577 changes being initiated for 171 patients reviewed; these changes related to the physical, psychological--individual, psychological--family, or professional practice aspects of care. Total PES-NWI and NWSS scores were similar before and after the study period in both participating units. The NWSS sub-scale of interaction between nurses improved in the intervention unit during the study period (pre--4.85±0.93; post--5.36±0.89, p=0.002) with no significant increase in the control group. Factors independently related to higher PES-NWI included

  14. Biomarkers of human exposure to personal care products: results from the Flemish Environment and Health Study (FLEHS 2007-2011).

    Science.gov (United States)

    Den Hond, Elly; Paulussen, Melissa; Geens, Tinne; Bruckers, Liesbeth; Baeyens, Willy; David, Frank; Dumont, Emmie; Loots, Ilse; Morrens, Bert; de Bellevaux, Benoit Nemery; Nelen, Vera; Schoeters, Greet; Van Larebeke, Nicolas; Covaci, Adrian

    2013-10-01

    Personal care products (PCPs), such as soaps, perfumes, cosmetics, lotions, etc., contain a variety of chemicals that have been described as potentially hormone disrupting chemicals. Therefore, it is important to assess the internal exposure of these chemicals in humans. Within the 2nd Flemish Environment and Health Study (FLEHS II, 2007-2011), the human exposure to three classes of pollutants that are present in a wide variety of PCPs--i.e. polycyclic musks (galaxolide, HHCB and tonalide, AHTN in blood), parabens (urinary para-hydroxybenzoic acid, HBA) and triclosan (urinary TCS)--was assessed in 210 Flemish adolescents (14-15 years) and in 204 adults (20-40 years) randomly selected from the general population according to a stratified two stage clustered study design. The aim of this study was to define average levels of exposure in the general Flemish population and to identify determinants of exposure. Average levels (GM (95% CI)) in the Flemish adolescents were 0.717 (0.682-0.753) μg/L for blood HHCB; 0.118 (0.108-0.128) μg/L for blood AHTN; 1022 (723-1436) μg/L for urinary HBA and 2.19 (1.64-2.92) μg/L for urinary TCS. In the adults, levels of HBA were on average 634 (471-970) μg/L. Inter-individual variability was small for HHCB and AHTN, intermediate for HBA, and large for TCS. All biomarkers were positively associated with the use of PCPs. Additionally, levels of HHCB and AHTN increased with higher educational level of the adolescents. Both in adults and adolescents, urinary HBA levels were negatively correlated with BMI. We define here Flemish exposure values for biomarkers of PCPs, which can serve as baseline exposure levels to identify exposure trends in future biomonitoring campaigns.

  15. Examining the use of breast-conserving treatment for women with breast cancer in a managed care environment.

    Science.gov (United States)

    Legorreta, A P; Liu, X; Parker, R G

    2000-10-01

    At a National Institutes of Health Consensus Conference in 1991, conservation treatment was considered preferable for patients with early-stage breast cancer. In the early and mid-1990s, however, less than half of the eligible patients received this treatment and the rates varied with patient and provider characteristics. This study explores whether more eligible patients with breast cancer received conservation treatment in recent years in a managed care environment compared to reports in the literature, and if patient and hospital characteristics affected the rate of acceptance. The study population included 753 women with breast cancer in clinical stages 0, I, or II. Patients with Stage III or IV tumors or with tumors larger that 5.0 cm were excluded. A multiple logistic regression incorporated in a mixed-effect model was used to estimate the effect of patient and facility characteristics on the likelihood of using breast-conserving surgery controlling for clinical stages and demographics such as age, race, and marital status. Among the 753 eligible patients, 474 (62.9%) received conservation surgery. Only Hispanic ethnicity and clinical stage significantly affected the likelihood of receiving conservation treatment. Factors such as patient age, hospital size, and teaching status that had been found to be significant predictors in earlier studies were not statistically significant in this study, although conservation treatment was more frequent in younger women and in teaching hospitals. A larger proportion of eligible patients received conservative treatment in this study than in previous reports. This treatment became available in a broader range of institutions, moving from large, academic teaching centers to smaller community hospitals.

  16. Renewing Strategic Planning in Universities at a Time of Uncertainty

    Science.gov (United States)

    Shah, Mahsood

    2013-01-01

    The renewal of strategy development and implementation is important in the context of the changing higher education landscape. Changing government policy and the political agenda require a university to engage in careful strategy development and implementation which result in long-term sustainability. The political interest of the government will…

  17. Using the Infant/Toddler Environment Rating Scale for examining the quality of care for infants and toddlers in Norwegian day care centers

    Directory of Open Access Journals (Sweden)

    Anne-Grethe Baustad

    2012-01-01

    Full Text Available Abstract: The purpose of the presented study is to explore whether ITERS-R is an appropriate tool to use for examining the quality of care for infants and toddlers in Norwegian day care centers. The study is based on a pedagogical perspective of quality, a perspective which takes into account that it is possible both to define and assess the quality in day care centers. This study indicates that ITERS-R can be an appropriate tool to use in examining pedagogical quality in Norwegian day care centers, and especially the concept of process quality. The fit between the values and goals given in the Norwegian Framework Plan and the areas and quality indicators in the ITERS-R is also good; even if there are differences which need to be dealt with. The results are interpreted and discussed within the Norwegian day care center context and the values and goals of Norwegian day care centers. The following four interacting and interdependent dimensions of pedagogical quality made the basis for the discussion: those of the society, the child, the staff (teacher/ teachers and the learning context (Sheridan, 2007, 2009.

  18. Renewables 2013. Global Status Report

    Energy Technology Data Exchange (ETDEWEB)

    Sawin, J.L. (ed.) [and others

    2013-07-01

    Renewable energy markets, industries, and policy frameworks have evolved rapidly in recent years. The Renewables Global Status Report provides a comprehensive and timely overview of renewable energy market, industry, investment, and policy developments worldwide. It relies on the most recent data available, provided by many contributors and researchers from around the world, all of which is brought together by a multi-disciplinary authoring team. The report covers recent developments, current status, and key trends; by design, it does not provide analysis or forecasts. This latest Renewables Global Status Report saw: a shift in investment patterns that led to a global decrease in clean energy investment; continuing growth in installed capacity due to significant technology cost reductions and increased investment in developing countries; renewables progressively supplementing established electricity systems, demonstrating that the implementation of suitable policies can enable the successful integration of higher shares of variable renewables; and the emergence of integrated policy approaches that link energy efficiency measures with the implementation of renewable energy technologies.

  19. Developing Government Renewable Energy Projects

    Energy Technology Data Exchange (ETDEWEB)

    Kurt S. Myers; Thomas L. Baldwin; Jason W. Bush; Jake P. Gentle

    2012-07-01

    The US Army Corps of Engineers has retained Idaho National Laboratory (INL) to conduct a study of past INL experiences and complete a report that identifies the processes that are needed for the development of renewable energy projects on government properties. The INL has always maintained expertise in power systems and applied engineering and INL’s renewable energy experiences date back to the 1980’s when our engineers began performing US Air Force wind energy feasibility studies and development projects. Over the last 20+ years of working with Department of Defense and other government agencies to study, design, and build government renewable projects, INL has experienced the do’s and don’ts for being successful with a project. These compiled guidelines for government renewable energy projects could include wind, hydro, geothermal, solar, biomass, or a variety of hybrid systems; however, for the purpose of narrowing the focus of this report, wind projects are the main topic discussed throughout this report. It is our thought that a lot of what is discussed could be applied, possibly with some modifications, to other areas of renewable energy. It is also important to note that individual projects (regardless the type) vary to some degree depending on location, size, and need but in general these concepts and directions can be carried over to the majority of government renewable energy projects. This report focuses on the initial development that needs to occur for any project to be a successful government renewable energy project.

  20. Renew Europe - Technological developments in renewable energy. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    This event is a symposium for international stakeholders in the field of renewable energy. An accompanying fair addresses the public in the Northern German regions. Especially SMEs interested in meeting their energy demands with renewable energy sources are invited. The main focus of the symposium will be technological aspects of renewable energy production, with a special emphasis to the political and economic framework conditions for renewable energies in North Sea countries and in Central and Eastern Europe. We will introduce and showcase the latest technology trends and research. The symposium aims to stimulate further innovation in the efficient production of energy, especially polygeneration technologies (combined electricity and heat production) for small and decentralised use in companies, schools and housing estates. Best practice examples will be shown and solutions shall be worked out by manufacturers, researchers and policy makers. Only power point presentations available.

  1. Marine Renewable Energy Center

    Energy Technology Data Exchange (ETDEWEB)

    Vigeant, Paul [Univ. of Massachusetts, Dartmouth, MA (United States); Miller, John [Univ. of Massachusetts, Dartmouth, MA (United States); Howes, Brian [Univ. of Massachusetts, Dartmouth, MA (United States); McGowan, Jon G. [Univ. of Massachusetts, Amherst, MA (United States); Baldwin, Kenneth [Univ. of New Hampshire, Durham, NH (United States); Grilli, Annette [Univ. of Rhode Island, Kingston, RI (United States); Terray, Eugene [Woods Hole Oceanographic Inst., Woods Hole, MA (United States)

    2013-10-08

    Project Goals: The funding provided by this contract supported the following activities: A) Test Site Development; B) Seed Grant Funded Technology Development; C) Stakeholder Activities The first year of funding was dedicated to the formation of the NE MREC University Consortium which was comprised of University of Massachusetts Dartmouth (UMD) and Amherst (UMA), Massachusetts Institute of Technology (MIT), Woods Hole Oceanographic Institution (WHOI), University of New Hampshire (UNH), and the University of Rhode Island (URI). The consortium worked together to encourage research and promote benefits of obtaining energy from ocean wind, waves, tides and currents. In addition, NE MREC’s goal was to fund projects aimed at potential test sites with the first year funding going to studies of the potential for tidal device testing in Muskeget Channel, at the General Sullivan Bridge in New Hampshire, and for wave device testing at the proposed National Offshore Renewable Energy Innovation Zone (NOREIZ) located off the Massachusetts coast. The project spanned 4.5 years and addressed three specific tasks that are interrelated but also served as independent investigations.

  2. Renewables 2005. Global status report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    This report provides an overview of the status of renewable energy worldwide in 2005. It covers markets, investments, industries, policies, and rural (off-grid) renewable energy in developing countries. By design, the report does not provide analysis, recommendations, or conclusions. An extensive research and review process over several months involving more than 100 researchers and contributors has kept inaccuracies to a minimum. REN21 sees this report as the beginning of an active exchange of views and information. This report reveals some surprising facts about renewable energy, many reflecting strong growth trends and increasing significance relative to conventional energy. (au)

  3. Innovation strategies for renewable energy

    Energy Technology Data Exchange (ETDEWEB)

    McCarthy, S.

    1999-01-01

    Innovation is the commercial exploitation of an invention requiring marketing, management, financial and legal skills. Renewable energy is a high technology, knowledge-based business with a global market and, being decentralised, is suited to all regions of the world. Key issues for an innovation strategy for renewable energy are identified. They include: accessing the available finance for innovation; developing local expertise; networking with renewable energy experts; identifying the best available technology, expertise and technology transfer arrangements and adapting these to the region and enterprise. The ultimate success of the strategy will be judged by the new level of economic activity in the enterprise. (UK)

  4. Coordinated renewable energy support schemes

    DEFF Research Database (Denmark)

    Morthorst, P.E.; Jensen, S.G.

    2006-01-01

    This paper illustrates the effect that can be observed when support schemes for renewable energy are regionalised. Two theoretical examples are used to explain interactive effects on, e.g., the price of power, conditions for conventional power producers, and changes in import and export of power...... RES-E support schemes already has a common liberalised power market. In this case the introduction of a common support scheme for renewable technologies will lead to more efficient sitings of renewable plants, improving economic and environmental performance of the total power system...

  5. Assessing systems quality in a changing health care environment: the 2009-10 national survey of children with special health care needs.

    Science.gov (United States)

    Strickland, Bonnie B; Jones, Jessica R; Newacheck, Paul W; Bethell, Christina D; Blumberg, Stephen J; Kogan, Michael D

    2015-02-01

    To provide a national, population-based assessment of the quality of the health care system for children and youth with special health care needs using a framework of six health care system quality indicators. 49,242 interviews with parents of children with special health care needs from the 2009-10 National Survey of Children with Special Health Care Needs (NS-CSHCN) were examined to determine the extent to which CSHCN had access to six quality indicators of a well-functioning system of services. Criteria for determining access to each indicator were established and applied to the survey data to estimate the proportion of CSHCN meeting each quality indicator by socio-demographic status and functional limitations. 17.6% of CSHCN received care consistent with all six quality indicators. Results for each component of the system quality framework ranged from a high of 70.3% of parents reporting that they shared decision-making with healthcare providers to a low of 40% of parents reporting receipt of services needed for transition to adult health care. Attainment rates were lower for CSHCN of minority racial and ethnic groups, those residing in households where English was not the primary language, those in lower income households, and those most impacted by their health condition. Only a small proportion of CSHCN receive all identified attributes of a high-quality system of services. Moreover, significant disparities exist whereby those most impacted by their conditions and those in traditionally disadvantaged groups are served least well by the current system. A small proportion of CSHCN appear to remain essentially outside of the system, having met few if any of the elements studied.

  6. From “Three Olds” Reconstruction to Urban Renewal:Reflections on Establishment of Urban Renewal Bureau in Guangzhou

    Institute of Scientific and Technical Information of China (English)

    Wang; Shifu; Shen; Shuangting

    2016-01-01

    With the establishment of Guangzhou Urban Renewal Bureau,the first of its kind in China,as the background and the starting point,the paper reviews relevant experiences in the UK,Singapore,and Hong Kong,summarizes the features,responsibilities,and rights of such institutions.Through analyzing three statuses of redevelopment,which are increased,reduced,and retained construction,the paper points out that urban renewal is a process orienting at promoting the comprehensive capacity of the built-up environment.Then the paper summarizes the strength and weakness of the "three olds" reconstruction policy making and implementation in Guangzhou,holding that the strength lies in the effective land consolidation and socially collaboration experiences,while the weakness includes the unclear rights and responsibilities,unsystematic target,and imbalanced interests distribution.It concludes that the goal of urban renewal is to improve the existing built-up environment without damaging the benefits of original stakeholders,to emphasize both fairness and efficiency,and to seek for sustainable city redevelopment with optimized comprehensive capacity.Moreover,the paper clarifies that the primary responsibility of urban renewal is to well maintain the built-up environment and the extended responsibility is to properly coordinate the city redevelopment.Considering that urban renewal is a kind of public administration with distinctive social and processing features,urban renewal should be empowered the necessary implementation priority and administrative permission power via local legislation measures.In addition,an effective social collaboration platform should be established to actively support the urban renewal and to reflect the "new normal" of city redevelopment.

  7. The relationship between the quality of the built environment and the quality of life of people with dementia in residential care.

    Science.gov (United States)

    Fleming, Richard; Goodenough, Belinda; Low, Lee-Fay; Chenoweth, Lynn; Brodaty, Henry

    2016-07-01

    While there is considerable evidence on the impact of specific design features on problems associated with dementia, the link between the quality of the built environment and quality of life of people with dementia is largely unexplored. This study explored the environmental and personal characteristics that are associated with quality of life in people with dementia living in residential aged care. Data were obtained from 275 residents of 35 aged care homes and analysed using linear regression. The quality of the built environment was significantly associated with the quality of life of the resident measured by global self-report. Environmental ratings were not associated with proxy or detailed self-report ratings. Higher quality of life is associated with buildings that facilitate engagement with a variety of activities both inside and outside, are familiar, provide a variety of private and community spaces and the amenities and opportunities to take part in domestic activities.

  8. The Development of Biology Teaching Material Based on the Local Wisdom of Timorese to Improve Students Knowledge and Attitude of Environment in Caring the Preservation of Environment

    Science.gov (United States)

    Ardan, Andam S.

    2016-01-01

    The purposes of this study were (1) to describe the biology learning such as lesson plans, teaching materials, media and worksheets for the tenth grade of High School on the topic of Biodiversity and Basic Classification, Ecosystems and Environment Issues based on local wisdom of Timorese; (2) to analyze the improvement of the environmental…

  9. How nurses and their work environment affect patient experiences of the quality of care: a qualitative study.

    NARCIS (Netherlands)

    Kieft, R.A.M.M.; Brouwer, B.B.J.M. de; Francke, A.L.; Delnoij, D.M.J.

    2014-01-01

    Background: Healthcare organisations monitor patient experiences in order to evaluate and improve the quality of care. Because nurses spend a lot of time with patients, they have a major impact on patient experiences. To improve patient experiences of the quality of care, nurses need to know what

  10. Perceived Social Environment and Adolescents' Well-Being and Adjustment: Comparing a Foster Care Sample with a Matched Sample

    Science.gov (United States)

    Farruggia, Susan P.; Greenberger, Ellen; Chen, Chuansheng; Heckhausen, Jutta

    2006-01-01

    Previous research has demonstrated that former foster care youth are at risk for poor outcomes (e.g., more problem behaviors, more depression, lower self-esteem, and poor social relationships). It is not clear, however, whether these findings reflect preemancipation developmental deficits. This study used 163 preemancipation foster care youth and…

  11. How nurses and their work environment affect patient experiences of the quality of care: a qualitative study.

    NARCIS (Netherlands)

    Kieft, R.A.M.M.; Brouwer, B.B.J.M. de; Francke, A.L.; Delnoij, D.M.J.

    2014-01-01

    Background: Healthcare organisations monitor patient experiences in order to evaluate and improve the quality of care. Because nurses spend a lot of time with patients, they have a major impact on patient experiences. To improve patient experiences of the quality of care, nurses need to know what fa

  12. How nurses and their work environment affect patient experiences of the quality of care : A qualitative study

    NARCIS (Netherlands)

    Kieft, R.A.M.M.; Brouwer, B.J.M.; Francke, A.L.; Delnoij, D.

    2014-01-01

    Background Healthcare organisations monitor patient experiences in order to evaluate and improve the quality of care. Because nurses spend a lot of time with patients, they have a major impact on patient experiences. To improve patient experiences of the quality of care, nurses need to know what fac

  13. Indian Renewable Energy Status Report: Background Report for DIREC 2010

    Energy Technology Data Exchange (ETDEWEB)

    Arora, D. S.; Busche, S.; Cowlin, S.; Engelmeier, T.; Jaritz, J.; Milbrandt, A.; Wang, S.

    2010-10-01

    India has great potential to accelerate use of endowed renewable resources in powering its growing economy with a secure and affordable energy supply. The Government of India recognizes that development of local, renewable resources will be critical to ensure that India is able to meet both economic and environmental objectives and has supported the development of renewable energy through several policy actions. This paper describes the status of renewable energy in India as of DIREC 2010. It begins by describing the institutional framework guiding energy development in India, the main policy drivers impacting energy, and the major policy actions India has taken that impact renewable energy deployment. The paper presents estimates of potential for wind, solar, small hydro, and bioenergy and the deployment of each of these technologies to date in India. The potential for India to meet both large-scale generation needs and provide access to remote, unelectrified populations are covered. Finally, the enabling environment required to facilitate rapid scale of renewables is discussed, including issues of technology transfer and the status of financing in India.

  14. Barriers, Risks and Policies for Renewables in the Gulf States

    Directory of Open Access Journals (Sweden)

    Johan Lilliestam

    2015-08-01

    Full Text Available The countries of the Gulf Cooperation Council (GCC have both large fossil fuel resources and vast renewable energy potentials. Here, we investigate in a literature meta-analysis and a survey, whether there is a need for renewables in the GCC, what barriers and risks presently deter investments, and what possible policy-solutions could be. We find that there is a long-term need for renewables, to diversify the economy and prepare for a post-fossil fuel era. In the short term, two main obstacles deter investments: inefficient bureaucracy, and the combination of fossil fuel/electricity subsidies and the absence of renewable energy support. Removing fossil fuel and consumption subsidies or introducing a support scheme could make investments in renewables profitable. Eliminating energy subsidies appears particularly beneficial to the economic outlook but this seems particularly difficult to implement, due to the political economy of rentier states. Increased bureaucratic transparency and efficiency is needed, so that potentially attractive investments can rapidly and predictably obtain the necessary permissions. Hence, the administrative and economic environment for renewable energy investments in the GCC is not right today, and no breakthrough is on the horizon, but there is a range of policy solutions to enable investments in the future.

  15. Decision Making on Medical Innovations in a Changing Health Care Environment: Insights from Accountable Care Organizations and Payers on Personalized Medicine and Other Technologies.

    Science.gov (United States)

    Trosman, Julia R; Weldon, Christine B; Douglas, Michael P; Deverka, Patricia A; Watkins, John B; Phillips, Kathryn A

    2017-01-01

    New payment and care organization approaches, such as those of accountable care organizations (ACOs), are reshaping accountability and shifting risk, as well as decision making, from payers to providers, within the Triple Aim context of health reform. The Triple Aim calls for improving experience of care, improving health of populations, and reducing health care costs. To understand how the transition to the ACO model impacts decision making on adoption and use of innovative technologies in the era of accelerating scientific advancement of personalized medicine and other innovations. We interviewed representatives from 10 private payers and 6 provider institutions involved in implementing the ACO model (i.e., ACOs) to understand changes, challenges, and facilitators of decision making on medical innovations, including personalized medicine. We used the framework approach of qualitative research for study design and thematic analysis. We found that representatives from the participating payer companies and ACOs perceive similar challenges to ACOs' decision making in terms of achieving a balance between the components of the Triple Aim-improving care experience, improving population health, and reducing costs. The challenges include the prevalence of cost over care quality considerations in ACOs' decisions and ACOs' insufficient analytical and technology assessment capacity to evaluate complex innovations such as personalized medicine. Decision-making facilitators included increased competition across ACOs and patients' interest in personalized medicine. As new payment models evolve, payers, ACOs, and other stakeholders should address challenges and leverage opportunities to arm ACOs with robust, consistent, rigorous, and transparent approaches to decision making on medical innovations. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  16. VT Renewable Energy Sites - Geothermal

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) The Renewable Energy Atlas of Vermont and this dataset were created to assist town energy committees, the Clean Energy Development Fund and other...

  17. VT Renewable Energy Sites - Hydroelectric

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) The Renewable Energy Atlas of Vermont and this dataset were created to assist town energy committees, the Clean Energy Development Fund and other...

  18. VT Renewable Energy Sites - Wind

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) The Renewable Energy Atlas of Vermont and this dataset were created to assist town energy committees, the Clean Energy Development Fund and other...

  19. VT Renewable Energy Sites - Solar

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) The Renewable Energy Atlas of Vermont and this dataset were created to assist town energy committees, the Clean Energy Development Fund and other...

  20. VT Renewable Energy Sites - Landfills

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) The Renewable Energy Atlas of Vermont and this dataset were created to assist town energy committees, the Clean Energy Development Fund and other...

  1. Contributing influences of work environment on sleep quantity and quality of nursing assistants in long-term care facilities: A cross-sectional study.

    Science.gov (United States)

    Zhang, Yuan; Punnett, Laura; McEnany, Geoffry Phillips; Gore, Rebecca

    2016-01-01

    The effect of shift work on nurses' sleep is well-studied, but there are other challenging aspects of health care work that might also affect the sleep of direct caregivers. This study examined the influence of the long-term care work environment on sleep quantity and quality of nursing assistants. A cross-sectional survey collected data from 650 nursing assistants in 15 long-term care facilities; 46% reported short sleep duration and 23% reported poor sleep quality. A simple additive index of the number of beneficial work features (up to 7) was constructed for analysis with Poisson regression. With each unit increase of beneficial work features, nursing assistants were 7% less likely to report short sleep duration and 17% less likely to report poor sleep quality. These results suggest that effective workplace interventions should address a variety of work stressors, not only work schedule arrangements, in order to improve nursing assistants' sleep health.

  2. The Analytic Hierarchy Process (AHP) Approach for Assessment of Urban Renewal Proposals

    Science.gov (United States)

    Lee, Grace K. L.; Chan, Edwin H. W.

    2008-01-01

    The problem of urban decay in Hong Kong is getting worse recently; therefore, the importance of urban renewal in improving the physical environment conditions and the living standards of the citizens is widely recognized in the territory. However, it is not an easy task for the Hong Kong Government to prepare welcome urban renewal proposals…

  3. Renewable energy sources and climate change mitigation: special report of the Intergovernmental Panel on Climate Change

    National Research Council Canada - National Science Library

    Edenhofer, Ottmar

    2012-01-01

    ... and economic development, to energy access, to a secure and sustainable energy supply, and to a reduction of negative impacts of energy provision on the environment and human health. This Special Report on Renewable Energy Sources and Climate Change Mitigation (SRREN) impartially assesses the scientific literature on the potential role of renew...

  4. 40 CFR 73.81 - Qualified conservation measures and renewable energy generation.

    Science.gov (United States)

    2010-07-01

    ... renewable energy generation. 73.81 Section 73.81 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Reserve § 73.81 Qualified conservation measures and renewable energy generation. (a) Qualified energy... educational in nature; (4) Load management measures that lead to economic reduction of electric energy...

  5. Effects of Physical Environment on Health and Behaviors of Residents With Dementia in Long-Term Care Facilities: A Longitudinal Study.

    Science.gov (United States)

    Lee, Sook Young; Chaudhury, Habib; Hung, Lillian

    2016-01-01

    The challenges in investigating the effects of the physical environment on residents with dementia include having a sample of comparable study groups and a lack of long-term follow-up evaluation. The current study attempted to address these two challenges by carefully matching residents and analyzing long-term measurement data. The aim of the study was to examine whether residents with dementia (N = 12) living in a traditional large-scale setting or a small-scale, home-like setting exhibit any difference in health and behaviors over time. Physical environmental assessment of the two care facilities was conducted using the Therapeutic Environment Screening Survey for Nursing Homes. Residents' behavioral assessments were performed using three tools at three assessments over a period of 1 year: (a) Multidimensional Observation Scale for Elderly Subjects, (b) Minimum Data Set, and (c) Dementia Care Mapping. The results suggest that older adults with dementia can have increased social interaction and engagement with the support of an optimal physical environment.

  6. GRENADA. Renewables Readiness Assessment 2012

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

    Grenada, like many Caribbean islands, is dependent on costly oil imports for its energy needs, including the generation of electricity. The transition to renewable energy could potentially support price reductions and improve the overall competitiveness of key sectors of the economy, particularly tourism. This report provides facts and analysis to support the country's discussion on ways to move forward with the renewable energy agenda. IRENA is ready to provide support in the implementation of the actions identified in this report.

  7. The importance of leadership style and psychosocial work environment to staff-assessed quality of care: implications for home help services.

    Science.gov (United States)

    Westerberg, Kristina; Tafvelin, Susanne

    2014-09-01

    Work in home help services is typically conducted by an assistant nurse or nursing aide in the home of an elderly person, and working conditions have been described as solitary with a high workload, little influence and lack of peer and leader support. Relations between leadership styles, psychosocial work environment and a number of positive and negative employee outcomes have been established in research, but the outcome in terms of quality of care has been addressed to a lesser extent. In the present study, we aimed to focus on working conditions in terms of leadership and the employee psychosocial work environment, and how these conditions are related to the quality of care. The hypothesis was that the relation between a transformational leadership style and quality of care is mediated through organisational and peer support, job control and workload. A cross-sectional survey design was used and a total of 469 questionnaires were distributed (March-April 2012) to assistant nurses in nine Swedish home help organisations, including six municipalities and one private organisation, representing both rural and urban areas (302 questionnaires were returned, yielding a 65% response rate). The results showed that our hypothesis was supported and, when indirect effects were also taken into consideration, there was no direct effect of leadership style on quality of care. The mediated model explained 51% of the variance in quality of care. These results indicate that leadership style is important not only to employee outcomes in home help services but is also indirectly related to quality of care as assessed by staff members.

  8. Renewable Energy Country Profiles. Pacific

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-09-15

    The IRENA Renewable Energy Country Profiles take stock of the latest development of renewable energy in two regions where renewable energy can make a significant contribution to combat climate change and bring modern energy services to everyone: Africa and the Pacific. These two regions are presented separately in this volume and its sister publication. The country profiles combine elements of IRENA analysis with the latest information available from a vast array of sources in order to give a brief yet comprehensive and up-to-date picture of the situation of renewable energy that includes energy supply, electrical capacity, energy access, policies, targets, investment climate, projects and endowment in renewable energy resources. Because of the different timelines of these sources, data presented here refer to years between 2008 and 2012. Data availability also differs from country to country, which makes comparison with a wider regional group possible only for the year for which figures are available for all the members of the group; while this may not be the most recent year, the differences between countries, regions and the world remain striking. The current country profiles are just a starting point; they will be extended upon with new indicators to make them more informative, and maintained as a live product on the IRENA website as a key source of information on renewable energy.

  9. Renewable energy islands in Europe

    Energy Technology Data Exchange (ETDEWEB)

    Oestergaard, Iben [ed.

    1998-12-31

    This publication includes a compiled presentation of various aspects concerning the possible transformation of some European islands into renewable energy communities and these projects were presented by a selection of pioneer islands at the first European Seminar on Renewable Energy Islands, held on the Danish island of Samsoee, 29-30 June 1998. This issue has increased in importance with the presentation of the ambitious EU-White Paper: `Energy for the future: Renewable Sources of Energy` which was adopted in 1998. One of the key elements of the strategy for an accelerated implementation of renewable energy is to transform 100 localities within Europe into communities which are to be 100% self-sufficient with renewable energy before 2010. In line with this strategy, the Danish Government appointed the island of Samsoe towards the end of 1997 to be the first `official` Danish, renewable energy island. This is to serve as a demonstration project for other local communities, both in Denmark as well as in the rest Europe. Gothland, Madeira, Canary Islands, Cape Verde, Arki, Crete, Minorca and Orkney Islands were represented. Environmental advantages of wind, solar and wave power for distant island communities were indicated. Serious savings would be achieved by limitation of fossil fuel import and utilization of local resources. (EG)

  10. Renewable Energy Country Profiles. Africa

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-02-15

    The IRENA Renewable Energy Country Profiles take stock of the latest development of renewable energy in two regions where renewable energy can make a significant contribution to combat climate change and bring modern energy services to everyone: Africa and the Pacific. These two regions are presented separately in this volume and its sister publication. The country profiles combine elements of IRENA analysis with the latest information available from a vast array of sources in order to give a brief yet comprehensive and up-to-date picture of the situation of renewable energy that includes energy supply, electrical capacity, energy access, policies, targets, investment climate, projects and endowment in renewable energy resources. Because of the different timelines of these sources, data presented here refer to years between 2008 and 2012. Data availability also differs from country to country, which makes comparison with a wider regional group possible only for the year for which figures are available for all the members of the group; while this may not be the most recent year, the differences between countries, regions and the world remain striking. The current country profiles are just a starting point; they will be extended upon with new indicators to make them more informative, and maintained as a live product on the IRENA website as a key source of information on renewable energy.

  11. 40 CFR 80.1125 - Renewable Identification Numbers (RINs).

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Renewable Identification Numbers (RINs... Identification Numbers (RINs). Each RIN is a 38 character numeric code of the following form: KYYYYCCCCFFFFFBBBBBRRDSS SSSSSSEEEEEEEE (a) K is a number identifying the type of RIN as follows: (1) K has the value of...

  12. 40 CFR 80.1425 - Renewable Identification Numbers (RINs).

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Renewable Identification Numbers (RINs... Identification Numbers (RINs). Each RIN is a 38-character numeric code of the following form: KYYYYCCCCFFFFFBBBBBRRDSSSSSSSSEEEEEEEE (a) K is a number identifying the type of RIN as follows: (1) K has the value of 1 when the RIN...

  13. 2011 Renewable Energy Data Book (Book)

    Energy Technology Data Exchange (ETDEWEB)

    Gelman, R.

    2012-10-01

    This Renewable Energy Data Book for 2011 provides facts and figures on energy in general, renewable electricity in the United States, global renewable energy development, wind power, solar energy, geothermal power, biopower, hydropower, advanced water power, hydrogen, renewable fuels, and clean energy investments.

  14. 2012 Renewable Energy Data Book (Book)

    Energy Technology Data Exchange (ETDEWEB)

    Gelman, R.

    2013-10-01

    This Renewable Energy Data Book for 2012 provides facts and figures in a graphical format on energy in general, renewable electricity in the United States, global renewable energy development, wind power, solar power, geothermal power, biopower, hydropower, advanced water power, hydrogen, renewable fuels, and clean energy investment.

  15. 2013 Renewable Energy Data Book (Book)

    Energy Technology Data Exchange (ETDEWEB)

    Esterly, S.

    2014-12-01

    This Renewable Energy Data Book for 2013 provides facts and figures on energy in general, renewable electricity in the United States, global renewable energy development, wind power, solar power, geothermal power, biopower, hydropower, advanced water power, hydrogen, renewable fuels, and clean energy investment.

  16. 2010 Renewable Energy Data Book (Book)

    Energy Technology Data Exchange (ETDEWEB)

    Gelman, R.

    2011-10-01

    This Renewable Energy Data Book for 2010 provides facts and figures on energy in general, renewable electricity in the United States, global renewable energy development, wind power, solar energy, geothermal power, biopower, hydropower, advanced water power, hydrogen, renewable fuels, and clean energy investments.

  17. 2009 Renewable Energy Data Book, August 2010

    Energy Technology Data Exchange (ETDEWEB)

    2010-08-01

    This Renewable Energy Data Book for 2009 provides facts and figures on energy in general, renewable electricity in the United States, global renewable energy development, wind power, solar energy, geothermal power, biopower, hydropower, advanced water power, hydrogen, renewable fuels, and clean energy investments.

  18. Northwest National Marine Renewable Energy Center

    Energy Technology Data Exchange (ETDEWEB)

    Batten, Belinda [Oregon State Univ., Corvallis, OR (United States); Polagye, Brian [Univ. of Washington, Seattle, WA (United States); LiVecchi, Al [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-06-30

    In 2008, the US Department of Energy’s (DOE) Wind and Water Power Program issued a funding opportunity announcement to establish university-led National Marine Renewable Energy Centers. Oregon State University and the University of Washington combined their capabilities in wave and tidal energy to establish the Northwest National Marine Renewable Energy Center, or NNMREC. NNMREC’s scope included research and testing in the following topic areas: • Advanced Wave Forecasting Technologies; • Device and Array Optimization; • Integrated and Standardized Test Facility Development; • Investigate the Compatibility of Marine Energy Technologies with Environment, Fisheries and other Marine Resources; • Increased Reliability and Survivability of Marine Energy Systems; • Collaboration/Optimization with Marine Renewable and Other Renewable Energy Resources. To support the last topic, the National Renewable Energy Laboratory (NREL) was brought onto the team, particularly to assist with testing protocols, grid integration, and testing instrumentation. NNMREC’s mission is to facilitate the development of marine energy technology, to inform regulatory and policy decisions, and to close key gaps in scientific understanding with a focus on workforce development. In this, NNMREC achieves DOE’s goals and objectives and remains aligned with the research and educational mission of universities. In 2012, DOE provided NNMREC an opportunity to propose an additional effort to begin work on a utility scale, grid connected wave energy test facility. That project, initially referred to as the Pacific Marine Energy Center, is now referred to as the Pacific Marine Energy Center South Energy Test Site (PMEC-SETS) and involves work directly toward establishing the facility, which will be in Newport Oregon, as well as supporting instrumentation for wave energy converter testing. This report contains a breakdown per subtask of the funded project. Under each subtask, the following

  19. Northwest National Marine Renewable Energy Center

    Energy Technology Data Exchange (ETDEWEB)

    Batten, Belinda; Polagye, Brian

    2016-06-30

    In 2008, the US Department of Energy’s (DOE) Wind and Water Power Program issued a funding opportunity announcement to establish university-led National Marine Renewable Energy Centers. Oregon State University and the University of Washington combined their capabilities in wave and tidal energy to establish the Northwest National Marine Renewable Energy Center, or NNMREC. NNMREC’s scope included research and testing in the following topic areas: • Advanced Wave Forecasting Technologies; • Device and Array Optimization; • Integrated and Standardized Test Facility Development; • Investigate the Compatibility of Marine Energy Technologies with Environment, Fisheries and other Marine Resources; • Increased Reliability and Survivability of Marine Energy Systems; • Collaboration/Optimization with Marine Renewable and Other Renewable Energy Resources. To support the last topic, the National Renewable Energy Laboratory (NREL) was brought onto the team, particularly to assist with testing protocols, grid integration, and testing instrumentation. NNMREC’s mission is to facilitate the development of marine energy technology, to inform regulatory and policy decisions, and to close key gaps in scientific understanding with a focus on workforce development. In this, NNMREC achieves DOE’s goals and objectives and remains aligned with the research and educational mission of universities. In 2012, DOE provided NNMREC an opportunity to propose an additional effort to begin work on a utility scale, grid connected wave energy test facility. That project, initially referred to as the Pacific Marine Energy Center, is now referred to as the Pacific Marine Energy Center South Energy Test Site (PMEC-SETS) and involves work directly toward establishing the facility, which will be in Newport Oregon, as well as supporting instrumentation for wave energy converter testing. This report contains a breakdown per subtask of the funded project. Under each subtask, the following

  20. Dementia care worker stress associations with unit type, resident, and work environment characteristics: a cross-sectional secondary data analysis of the Swiss Nursing Homes Human Resources Project (SHURP).

    Science.gov (United States)

    Vogel, Barbara; De Geest, Sabina; Fierz, Katharina; Beckmann, Sonja; Zúñiga, Franziska

    2017-03-01

    Although caring for residents with dementia in nursing homes is associated with various stressors for care workers, the role of the unit type, and particularly the proportion of residents with dementia, remains unclear. This study aimed to explore associations between unit type and care worker stress, taking into account additional potential stressors. This cross-sectional study was a secondary data analysis in the Swiss Nursing Homes Human Resources Project, which included data from 3,922 care workers from 156 Swiss nursing homes. Care workers' stress was measured with a shortened version of the Health Professions Stress Inventory. Generalized estimating equation models were used to assess care worker stress and its relationships with three unit types (special care units and others with high or low proportions of residents with dementia), work environment factors, and aggressive resident behavior. After including all potential stressors in the models, no significant differences between the three unit types regarding care worker stress were found. However, increased care worker stress levels were significantly related to lower ratings of staffing and resources adequacy, the experience of verbal aggression, and the observation of verbal or physical aggression among residents. Although the unit type plays only a minor role regarding care worker stress, this study confirms that work environment and aggressive behavior of residents are important factors associated with work-related stress. To prevent increases of care worker stress, interventions to improve the work environment and strengthen care workers' ability to cope with aggressive behavior are suggested.

  1. A Transaction Cost Analysis of Dutch Hospital Care Contracting between hospitals and health insurance companies in a deregulated environment

    OpenAIRE

    Brandenburg, Claudia

    2008-01-01

    textabstractThe Dutch government has started a process of reformation in the Dutch healthcare. The goal of this reformation is cost efficient healthcare in the Netherlands. Hospitals and health insurance companies in the Netherlands experience changes in regulations and funding. They are expected to negotiate about the price and quantities of hospital care. A product-price system for hospital care, called DBC, has been introduced by the government to support these negotiations. This study sho...

  2. Early Full-Time Day Care, Mother-Child Attachment, and Quality of the Home Environment in Chile: Preliminary Findings

    Science.gov (United States)

    Cárcamo, Rodrigo A.; Vermeer, Harriet J.; van der Veer, René; van IJzendoorn, Marinus H.

    2016-01-01

    Research Findings: Two longitudinal studies are reported examining the effects of full-time day care in Mapuche and non-Mapuche families in Chile. First, the Magellan-Leiden Childcare Study (MLCS) used a sample of 95 mothers with children younger than 1 year old (n = 36 in day care). Second, we partially cross-validated our results in a large and…

  3. Early Full-Time Day Care, Mother-Child Attachment, and Quality of the Home Environment in Chile: Preliminary Findings

    Science.gov (United States)

    Cárcamo, Rodrigo A.; Vermeer, Harriet J.; van der Veer, René; van IJzendoorn, Marinus H.

    2016-01-01

    Research Findings: Two longitudinal studies are reported examining the effects of full-time day care in Mapuche and non-Mapuche families in Chile. First, the Magellan-Leiden Childcare Study (MLCS) used a sample of 95 mothers with children younger than 1 year old (n = 36 in day care). Second, we partially cross-validated our results in a large and…

  4. Policies for Enabling Corporate Sourcing of Renewable Energy Internationally: A 21st Century Power Partnership Report

    Energy Technology Data Exchange (ETDEWEB)

    Bird, Lori; Heeter, Jenny; O' Shaughnessy, Eric; Speer, Bethany; Volpi, Christina; Cook, Orrin; Jones, Todd; Taylor, Michael; Ralon, Pablo; Nilson, Emily

    2017-05-25

    This paper explores the policy and regulatory enabling environment for corporate sourcing of renewables. The paper has been developed in support of the Corporate Sourcing of Renewables Campaign, which was launched at the Clean Energy Ministerial (CEM) meeting in June 2016. Through the campaign, a subset of CEM member governments is collaborating with corporate and nongovernmental organization partners to facilitate increased corporate procurement of renewables and pursue supportive policies for corporate procurement. This paper finds that policy certainty is essential to creating vibrant markets for renewable energy. While policymakers may need to adjust policy mechanisms over time as markets go through different stages of maturity, they must also consider the economic decisions that end-users make in evaluating projects. Policy interaction is also important to consider because buyers seek assurances that their investments in renewables have impact and wish to make clear claims about their renewable energy purchases.

  5. Social sustainability in urban renewal: An assessment of community aspirations

    Directory of Open Access Journals (Sweden)

    Daniel Chi Wing Ho

    2012-01-01

    Full Text Available The lack of a proper building care culture has led to serious problems of urban decay in most developed cities, threatening community health and safety. To arrest urban decay, redevelopment is a commonly adopted approach for regenerating rundown areas. Redevelopment often results in negative outcomes such as disturbances to existing social networks and burgeoning construction and demolition waste. On the other hand, building rehabilitation is a more socially and environmentally friendly alternative to redevelopment, but its success depends much on residents’ active participation. With a view towards a sustainable strategy for urban renewal, it is necessary to balance the interests of different stakeholders regarding the choice between these two mainstream approaches to renewal. Although economic and physical issues are important decision making considerations, this study explores the aspirations and preferences of local residents in relation to the two options through a structured survey. The findings are conducive to the development of a balanced and socially sustainable strategy of urban renewal.

  6. Health care workers in danger zones: a special report on safety and security in a changing environment.

    Science.gov (United States)

    Redwood-Campbell, Lynda J; Sekhar, Sharonya N; Persaud, Christine R

    2014-10-01

    Violence against humanitarian health care workers and facilities in situations of armed conflict is a serious humanitarian problem. Targeting health care workers and destroying or looting medical facilities directly or indirectly impacts the delivery of emergency and life-saving medical assistance, often at a time when it is most needed. Attacks may be intentional or unintentional and can take a range of forms from road blockades and check points which delay or block transport, to the direct targeting of hospitals, attacks against medical personnel, suppliers, patients, and armed entry into health facilities. Lack of access to vital health care services weakens the entire health system and exacerbates existing vulnerabilities, particularly among communities of women, children, the elderly, and the disabled, or anyone else in need of urgent or chronic care. Health care workers, especially local workers, are often the target. This report reviews the work being spearheaded by the Red Cross and Red Crescent Movement on the Health Care in Danger initiative, which aims to strengthen the protections for health care workers and facilities in armed conflicts and ensure safe access for patients. This includes a review of internal reports generated from the expert workshops on a number of topics as well as a number of public sources documenting innovative coping mechanisms adopted by National Red Cross and Red Crescent Societies. The work of other organizations is also briefly examined. This is followed by a review of security mechanisms within the humanitarian sector to ensure the safety and security of health care personnel operating in armed conflicts. From the existing literature, a number of gaps have been identified with current security frameworks that need to be addressed to improve the safety of health care workers and ensure the protection and access of vulnerable populations requiring assistance. A way forward for policy, research, and practice is proposed for

  7. The nursing work environment and quality of care: A cross-sectional study using the Essentials of Magnetism II Scale in England.

    Science.gov (United States)

    Oshodi, Titilayo O; Crockett, Rachel; Bruneau, Benjamin; West, Elizabeth

    2017-09-01

    To explore the structure of the Essentials of Magnetism II (EOMII) scale using data from nurses working in England; and to describe the impact of different aspects of the nursing work environment on nurse-assessed care quality (NACQ). The EOMII Scale was developed in the United States to measure nursing work environments. It has been widely used in the United States and in a number of other countries, but has not yet been used in the UK. Cross-sectional study. Registered nurses (n = 247) providing direct patient care in two National Health Service hospitals in England completed the EOMII scale and a single-item measuring NACQ. Principal components analysis was used to assess the structure of the scale. Correlation and regression analyses were used to describe the relationships between factors and NACQ. A solution with explanatory variance of 45.25% was identified. Forty items loaded on five factors, with satisfactory consistency: (i) ward manager support; (ii) working as a team; (iii) concern for patients; (iv) organisational autonomy; and (v) constraints on nursing practice. While in univariate analyses, each of the factors was significantly associated with NACQ, in multivariate analyses, the relationship between organisational autonomy and NACQ no longer reached significance. However, a multiple mediation model indicated that the effect of organisational autonomy on NACQ was mediated by nurse manager support, working as a team and concern for patients but not constraints on nursing practice. Subscales of the EOMII identified in an English sample of nurses measured important aspects of the nursing work environment, each of which is related to NACQ. The EOMII could be a very useful tool for measuring aspects of the nursing work environment in the English Trusts particularly in relation to the quality of care. © 2017 John Wiley & Sons Ltd.

  8. U.S. Renewable Energy Policy and Industry

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Ella

    2015-10-01

    From 2005 to 2014, wind and solar power generation has seen an almost tenfold increase in the United States. Such rapid development is the result of a variety of federal and state, top-down and bottom-up drivers, as well as the macro-environment of cost-reduction globally and early adoption in Europe. This presentation, prepared for a meeting with China National Renewable Energy Center and National Energy Administration (of China), is a summary of some of the key drivers for renewable energy deployment in the United States.

  9. Renewable energy in North America: Moving toward a richer mix

    Energy Technology Data Exchange (ETDEWEB)

    Cobey, Cathy

    2010-09-15

    A follow-up to our January study with Economist Intelligence Unit, Renewable energy in North America. The update will further our call to action for a concerted group effort by energy suppliers, corporate consumers and government. 1. Introduction - State of the industry, progress made to replace carbon-based fossil fuels with alternative energy - Barriers - Pressure from public and government 2. Recent progress - Examine existing government incentive programs - International commitments - Examine the role of energy suppliers, corporate consumers and government 3. Call to Action - Creating an environment that encourages both supply and demand of renewable energy.

  10. MENA Renewables Status Report 2013

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-06-15

    The MENA Renewables Status Report is an outcome of ADIREC, the Abu Dhabi International Renewable Energy Conference. The report provides a status overview of renewable energy markets, industry, policy and investment trends in the region, drawing on the most recent data available. It is produced in cooperation with over 50 contributors and researchers in the region and reveals massive growth in the renewable energy markets of the Middle East and North Africa (MENA). Regional investment topped US$2.9 billion in 2012, up 40% from 2011 and 650% from 2004. With over 100 projects under development, the region could see a 450% increase in non-hydro renewable energy generating capacity in the next few years. For the report, the 21 MENA countries were clustered into two sub-groups: Net Oil-Exporting Countries (NOEC) -- Algeria, Bahrain, Egypt, Iran, Iraq, Kuwait, Libya, Oman, Qatar, Saudi Arabia, Syria, United Arab Emirates, and Yemen; and Net Oil-Importing Countries (NOIC) -- Djibouti, Israel, Jordan, Lebanon, Malta, Morocco, Palestine, and Tunisia.

  11. Superstatistics and renewal critical events

    Science.gov (United States)

    Paradisi, Paolo; Cesari, Rita; Grigolini, Paolo

    2009-09-01

    An approach to intermittent systems based on renewal processes is reviewed. The Waiting Times (WTs) between events are the main variables of interest in intermittent systems. A crucial role is played by the class of critical events, characterized by Non-Poisson statistics and non-exponential WT distribution. A particular important case is given by WT distributions with power tail. Critical events play a crucial role in the behavior of a property known as Renewal Aging. Focusing on the role of critical events, the relation between superstatistics and non-homogeneous Poisson processes is discussed, and the role of Renewal Aging is illustrated by comparing a Non-Poisson model with a Poisson one, both of them modulated by a periodic forcing. It is shown that the analysis of Renewal Aging is sensitive to the presence of critical events and that this property can be exploited to detect Non-Poisson statistics in a time series. As a consequence, it is claimed that, apart from the characterization of superstatistical features such as the distribution of the intensive parameter or the separation of the time scales, the Renewal Aging property can give some effort to better determine the role of Non-Poisson critical events in intermittent systems.

  12. Renewal and Change (Editorial

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis

    2011-01-01

    Full Text Available The end of yet another calendar year leads to a time of new beginnings and new challenges. For me, this is the end of my three year term as Editor-in-Chief of EBLIP, which has been a very rewarding challenge personally and professionally. I would like to thank each and every person who has contributed to the success of the journal. EBLIP relies on the talented and professional people who regularly give of their time and expertise. I particularly want to thank the Editorial Team who has worked so closely with me over the past three years: Alison Brettle, Lorie Kloda, Katrine Mallan, Jonathan Eldredge, Michelle Dunaway, and our former intern Andrea Baer. Thank you!In the past three years, EBLIP has continued to grow and thrive. We currently have more than 3400 registered readers, and an Editorial Advisory Board comprised of 70 people from 11 countries. Several of our papers have had more than 5000 pdf downloads, and the average number of downloads is 1308. I am also pleased to let you know that we have recently been accepted for inclusion in Scopus.In looking back and reflecting on the past three years, we have continued to build a strong open access journal that is relevant to LIS practitioners. We have increased the number of articles being published, and the overall number of submissions. Content is wide ranging, including multiple sectors within library and information studies. Our evidence summaries continue to be the heart of our journal, with more and more research from our field being critically appraised in this way. We have also added new sections such as Using Evidence in Practice, in which authors reflect on incorporating evidence into practice.And now it is time yet again for renewal and change. I am very pleased to welcome Alison Brettle of the University of Salford, as she begins her three year term as Editor-in-Chief. Alison has been the Associate Editor (Articles since the very early days of publication and brings extensive

  13. Change management in an environment of ongoing primary health care system reform: A case study of Australian primary health care services.

    Science.gov (United States)

    Javanparast, Sara; Maddern, Janny; Baum, Fran; Freeman, Toby; Lawless, Angela; Labonté, Ronald; Sanders, David

    2017-03-22

    Globally, health reforms continue to be high on the health policy agenda to respond to the increasing health care costs and managing the emerging complex health conditions. Many countries have emphasised PHC to prevent high cost of hospital care and improve population health and equity. The existing tension in PHC philosophies and complexity of PHC setting make the implementation and management of these changes more difficult. This paper presents an Australian case study of PHC restructuring and how these changes have been managed from the viewpoint of practitioners and middle managers. As part of a 5-year project, we interviewed PHC practitioners and managers of services in 7 Australian PHC services. Our findings revealed a policy shift away from the principles of comprehensive PHC including health promotion and action on social determinants of health to one-to-one disease management during the course of study. Analysis of the process of change shows that overall, rapid, and top-down radical reforms of policies and directions were the main characteristic of changes with minimal communication with practitioners and service managers. The study showed that services with community-controlled model of governance had more autonomy to use an emergent model of change and to maintain their comprehensive PHC services. Change is an inevitable feature of PHC systems continually trying to respond to health care demand and cost pressures. The implementation of change in complex settings such as PHC requires appropriate change management strategies to ensure that the proposed reforms are understood, accepted, and implemented successfully. Copyright © 2017 John Wiley & Sons, Ltd.

  14. Water renewal in Montevideo's bay: a two compartments model for tritium kinetics

    Energy Technology Data Exchange (ETDEWEB)

    Suarez-Antola, Roberto, E-mail: rsuarez@ucu.edu.uy [Universidad Catolica del Uruguay (UCU), Montevideo (Uruguay)

    2013-07-01

    During field work about dynamics and renewal of water in Montevideo's Bay, 100 Ci of tritiated water were evenly distributed in the north-east region of the bay, by a continuous injection of a solution, during 5 hours, from a 200 litres tank, using a peristaltic pump. The whole bay was divided in 20 concentration cells, taking into account available bathymetric charts and corrections from field data obtained in situ. Tritium concentrations (activities per unit volume) and other relevant parameters (temperature, electrical conductivity, etc.) were measured in vertical profiles during three weeks, in the mid-point of each cell, first twice a day and the on a daily basis. Remnant total tritium activity was estimated from cells volumes and midpoint cells activity concentrations. Consistency checks were done. A one compartment model was used to estimate a global renewal time of circa 29 hours. However, the details of the measured tritium kinetics, a careful consideration of bathymetric data, water movements in a tidal environment (measured with drogues, fluorescent tracers and current meters), as well as the results of computer fluid dynamics modelling (in depth averaged) suggests that the bay can be meaningfully divided in two main compartments: a North-East and a South-West compartment. The purpose of this paper is threefold: (1) to describe the construction of a two compartments model for water renewal in Montevideo's Bay, (2) to apply experimental data of tritium kinetics to estimate the parameters of the model, and (3) to discuss the validity of the model and its practical applicability. The meaning of the renewal time of each compartment and its relation with the measured tritium kinetics in each cell is discussed. The perturbations in water circulation and renewal produced by civil works already done or the perturbations that could be expected due to civil works to be done, in relation with Montevideo's harbour, is discussed. The tracer model

  15. Renovating the built environment for dementia care: lessons learned at the Lodge at Broadmead in Victoria, British Columbia.

    Science.gov (United States)

    Gnaedinger, Nancy; Robinson, Janice; Sudbury, Fiona; Dutchak, Merv

    2007-01-01

    Major renovations were carried out in occupied dementia care units at the Lodge at Broadmead, Victoria, British Columbia. A 32-bed lodge was divided into two, requiring the relocation of three sets of doors. Home-like kitchens and living and dining rooms were built and furnished in each unit. A silent resident call system was installed. Nursing stations were moved off the unit. Murals added atmosphere and camouflaged exit doors. The process, while challenging, was successful due to comprehensive planning, careful phasing, the contractor's daily presence, the education of construction workers about residents, constant communication among key people and cooperation of lodge staff. Preliminary results are positive.

  16. Introduction to Renewable Energy Systems

    DEFF Research Database (Denmark)

    Ma, Ke; Yang, Yongheng; Blaabjerg, Frede

    2014-01-01

    In this chapter, the state-of-the-arts developments of renewable energy are reviewed in respect to the installed power and market share, where wind power and photovoltaic power generation are the main focuses due to the fast growing speed and large share of installed capacity. Some basic principles...... of operation, mission profiles, as well as power electronics solutions and corresponding controls are discussed respectively in the case of wind power and photovoltaic power systems. Finally a few development trends for renewable energy conversions are also given from a power electronics point of view....... It is concluded that as the quick development of renewable energy, wind power and PV power both show great potential to be largely integrated into the power grid. Power electronics is playing essential role in both of the systems to achieve more controllable, efficient, and reliable energy production...

  17. Review of different renewable fuels for potential utilization in SOFCs

    Energy Technology Data Exchange (ETDEWEB)

    Paradis, H.; Andersson, M.; Yuan, J.; Sunden, B. [Lund Univ., Lund (Sweden). Dept. of Energy Sciences

    2010-07-01

    A literature review was carried out to enhance knowledge about alternative fuels for solid oxide fuel cells (SOFCs). This paper outlined the materials and structure of SOFCs along with the possibilities involving SOFCs fed with different renewable fuels. The alternative fuels discussed in this study were methanol, ethanol, di-methyl-ether (DME), ammonia, biogas and and natural gas (methane). Finally, the different hydrogen-based fuels were compared and analyzed. Due to their high operating temperature and suitable catalyst material, SOFCs provide a good enough environment for renewable fuels. The development of new catalyst materials could help promote the use of alternative fuels in SOFCs, so they can better tolerate impurities and effectively reform the hydrocarbon fuels. The high cost for both SOFCs and the alternative fuels remains a concern for market implementation. It was concluded that although renewable fuels in SOFCs are promising and have shown good tendency as an energy provider, further research is still needed. 25 refs., 5 tabs.

  18. Renewable energy scenario in India: Opportunities and challenges

    Science.gov (United States)

    Sen, Souvik; Ganguly, Sourav; Das, Ayanangshu; Sen, Joyjeet; Dey, Sourav

    2016-10-01

    Majority of the power generation in India is carried out by conventional energy sources, coal and fossil fuels being the primary ones, which contribute heavily to greenhouse gas emission and global warming. The Indian power sector is witnessing a revolution as excitement grips the nation about harnessing electricity from various renewable energy sources. Electricity generation from renewable sources is increasingly recognized to play an important role for the achievement of a variety of primary and secondary energy policy goals, such as improved diversity and security of energy supply, reduction of local pollutant and global greenhouse gas emissions, regional and rural development, and exploitation of opportunities for fostering social cohesion, value addition and employment generation at the local and regional level. This focuses the solution of the energy crisis on judicious utilization of abundant the renewable energy resources, such as biomass, solar, wind, geothermal and ocean tidal energy. This paper reviews the renewable energy scenario of India as well as extrapolates the future developments keeping in view the consumption, production and supply of power. Research, development, production and demonstration have been carried out enthusiastically in India to find a feasible solution to the perennial problem of power shortage for the past three decades. India has obtained application of a variety of renewable energy technologies for use in different sectors too. There are ample opportunities with favorable geology and geography with huge customer base and widening gap between demand and supply. Technological advancement, suitable regulatory policies, tax rebates, efficiency improvement in consequence to R&D efforts are the few pathways to energy and environment conservation and it will ensure that these large, clean resource bases are exploited as quickly and cost effectively as possible. This paper gives an overview of the potential renewable energy resources

  19. Renewables in Electricity Markets

    DEFF Research Database (Denmark)

    Ordoudis, Christos; Papakonstantinou, Athanasios; Pinson, Pierre

    2014-01-01

    Electricity is nowadays commonly exchanged through electricity markets, designed in a context where dispatchable generators, with non-negligible marginal costs, were dominating. By depending primarily on conventional (fossil, hydro and nuclear) power generation based on marginal pricing, determin......Electricity is nowadays commonly exchanged through electricity markets, designed in a context where dispatchable generators, with non-negligible marginal costs, were dominating. By depending primarily on conventional (fossil, hydro and nuclear) power generation based on marginal pricing......) Markets. In Energy Analytics we focus on forecasting the various quantities of energy systems, such as wind power, energy consumption and the corresponding prices, and on developing decision making tools in a market environment. This is supported by a serious commitment in data mining and analysis...... coupled day-ahead markets for the member states and co-ordination for balancing, by looking into coupling mechanisms that promote the effective cooperation between the power systems of various countries....

  20. Equilibrium Transitions from Non Renewable Energy to Renewable Energy under Capacity Constraints

    OpenAIRE

    Amigues, Jean-Pierre; Ayong Le Kama, Alain; Moreaux, Michel

    2013-01-01

    We study the transition between non renewable and renewable energy sources with adjustment costs over the production capacity of renewable energy. Assuming constant variable marginal costs for both energy sources, convex adjustment costs and a more expensive renewable energy, we show the following. With sufficiently abundant non renewable energy endowments, the dynamic equilibrium path is composed of a first time phase of only non renewable energy use followed by a transition phase substituti...