text:
Health facilities are places that provide health care. They include hospitals, clinics, outpatient care centers, and specialized care centers, such as birthing centers and psychiatric care centers. When you ...
NSDL National Science Digital Library
National Center for Environmental Health
This Centers for Disease Control and Prevention (CDC) Health Studies page focuses on cyanobacteria, single-celled organisms thought to be the origin of plants. Cyanobacteria live in fresh, brackish, or marine water and are of concern to the CDC and Environmental Protection Agency (EPA) because some can form harmful blooms that deplete the oxygen and block sunlight that other organisms need to live. They can also produce powerful toxins that affect the brain and liver of animals and humans. This website links to an informational page about cyanobacterial harmful algal blooms (including impact to public health), general information, CDC activities, links to relevant websites, publications, and additional CDC topics.
Environmental Health Facilities Experimental laboratories
Stuart, Amy L.
, and a Nanopure® DiamondTM analytical ultra-pure water treatment system. Common facilities include two temperature) columns, and a automatic sampler; · a Varian 3400 gas chromatograph with a flame ionization and electronic facilities and equipment The Environmental Health group is involved in atmospheric and water sampling
Health Resources Statistics; Health Manpower and Health Facilities, 1969.
ERIC Educational Resources Information Center
National Center for Health Statistics (DHEW/PHS), Hyattsville, MD.
Intended to provide current statistics on health manpower and inpatient health facilities for the evaluation, planning, and administration of health programs, data were gathered from college and university records, state licensing records, association membership records, and agencies and establishments that provide health services. About 3.7…
Civil Liberties in Mental Health Facilities
ERIC Educational Resources Information Center
Kelley, Verne R.; Weston, Hanna B.
Mental health facilities that feed data about their patients into computers should be careful to follow civil liberties standards and those of professional ethics, so that they do not unwittingly contribute to unathorized breaches of privacy. (Authors)
Peter Meyer Lab Facilities page Tissue Culture Facility
Meyer, Peter
are regenerated from the transformed tissue using plant growth hormones. #12;2 Plant Growth Facility Transgenic-mediated gene transfer. Transgenic tissue is selected and propagated in the culture room, and transgenic plants plants are grown in the glasshouse or in controlled environment chambers. In Vivo Imaging Facility
Industrial Sanitation and Personal Facilities. Module SH-13. Safety and Health.
ERIC Educational Resources Information Center
Center for Occupational Research and Development, Inc., Waco, TX.
This student module on industrial sanitation and personal facilities is one of 50 modules concerned with job safety and health. This module deals wth many facets of industrial sanitation and the facilities industries should provide so that proper health procedures may be followed. Following the introduction, 14 objectives (each keyed to a page in…
Energy conservation in health-care facilities
Hunt, V.D. (comp.)
As energy expenditures continue their dramatic rise in the health-care industry, they absorb a larger portion of hospital budgets and prompt managers to seek ways to conserve energy and reduce consumption. Hospital managers, however, may be forced by capital constraints to choose between medical and energy conservation investments. The author examines some of the issues (including fairness, legal and financial impediments, and medical practices) involved in reducing health care costs. He makes practical suggestions for improving facility efficiency that include a strategy for energy management and a checklist of ideas. The case histories of 25 medical facilities illustrate conservation opportunities. 18 references, 34 figures, 3 tables. (DCK)
JAMA Patient Page: Health Literacy
... you get information. FINDING RELIABLE INFORMATION ON THE INTERNET The Internet can be a good source for health information ... are some tips to help you start your Internet search: • Government Web sites, like the National Institutes ...
Establishing and training health care facility decontamination teams
John L Hick; Paul Penn; Dan Hanfling; Mark A Lappe; Dan O'Laughlin; Jonathan L Burstein
Recent terrorist events, changes in Joint Commission on Accreditation of Healthcare Organizations requirements, and availability of grant funding have focused health care facility attention on emergency preparedness. Health care facilities have historically been underprepared for contaminated patients presenting to their facilities. These incidents must be properly managed to reduce the health risks to the victims, providers, and facility. A properly
Household Health Care Facility Utilization in the Philippines
Gerard Russo; Alejandro N Herrin; Melahi C Pons
This paper presents probit estimates of household utilization of health care facilities in the Philippines. Using household data from the 1987 National Health Survey and supply data from the Department of Health, separate probit equations are estimated for each of the four major types of facilities in the Philippines: Public hospitals, private hospitals, major rural health units and barangay (village)
Facilities-Site Services Environmental, Health & Safety Committee
Facilities- Site Services Environmental, Health & Safety Committee Charter (Draft) 1.0 The purpose of this EH&S Committee is: 1.1 To provide an environment, safety and health forum for Facilities Site Services Sr. Manager on safety, health and environmental protection matters that may affect the health
A health maintenance facility for space station freedom
NASA Technical Reports Server (NTRS)
Billica, R. D.; Doarn, C. R.
We describe a health care facility to be built and used on an orbiting space station in low Earth orbit. This facility, called the health maintenance facility, is based on and modeled after isolated terrestrial medical facilities. It will provide a phased approach to health care for the crews of Space Station Freedom. This paper presents the capabilities of the health maintenance facility. As Freedom is constructed over the next decade there will be an increase in activities, both construction and scientific. The health maintenance facility will evolve with this process until it is a mature, complete, stand-alone health care facility that establishes a foundation to support interplanetary travel. As our experience in space continues to grow so will the commitment to providing health care.
Page 1 of 1 Price list for the NORTEM facilities
Johansen, Tom Henning
Page 1 of 1 Price list for the NORTEM facilities 1. April 2013 Â 31. March 2014 The following prices apply to all activities from April 1st 2013, and should be used as a basis for applications for future funding. The price list is preliminary, changes should be expected when the full NORTEM running
The SAS System PHYSICAL FACILITIES SPACE FILE PAGE: 1
Fernandez, Eduardo
The SAS System PHYSICAL FACILITIES SPACE FILE PAGE: 1 PGM = SPAIC V01 - 2014 FLORIDA ATLANTIC ---- ---- ------------- ------------------------- ------------------------ 0001 SC0107. SANSON LIFE SCIENCES BUILDING 162 162 0001 SC0108. SANSON LIFE SCIENCES BUILDING 165 165 0001 SC0109. SANSON LIFE SCIENCES BUILDING 12 12 0001 SC0110. SANSON LIFE SCIENCES BUILDING 11 11 0001
Manned Mars mission health maintenance facility
NASA Technical Reports Server (NTRS)
Degioanni, Joseph C.
The Health Maintenance Facility (HMF) requirements which enable/enhance manned Mars missions (MMMs) are addressed. It does not attempt to resolve any issues that may affect the feasibility of any given element in the HMF. Reference is made to current work being conducted in the design of the space station HMF. The HMF requirements are discussed within the context of two distinctly different scenarios: HMF as part of the Mars surface infrastructure, and HMF as part of the nine months translation from low Earth orbit to Mars orbit. Requirements for an HMF are provided, and a concept of HMF is shown.
Health maintenance facility: Dental equipment requirements
NASA Technical Reports Server (NTRS)
Young, John; Gosbee, John; Billica, Roger
The objectives were to test the effectiveness of the Health Maintenance Facility (HMF) dental suction/particle containment system, which controls fluids and debris generated during simulated dental treatment, in microgravity; to test the effectiveness of fiber optic intraoral lighting systems in microgravity, while simulating dental treatment; and to evaluate the operation and function of off-the-shelf dental handheld instruments, namely a portable dental hand drill and temporary filling material, in microgravity. A description of test procedures, including test set-up, flight equipment, and the data acquisition system, is given.
HEALTH AND SAFETY POLICY June 2012 Page 1
Levi, Ran
HEALTH AND SAFETY POLICY June 2012 #12;June 2012 Page 1 UNIVERSITY OF ABERDEEN HEALTH AND SAFETY POLICY 2012 Contents Page Foreword by the Principal 2 A) Health and Safety Policy Statement 3 B) Organisation and Responsibilities for Health and Safety 4 C) Health and Safety Management in Schools
Psychiatric and Medical Health Care Policies in Juvenile Detention Facilities
ERIC Educational Resources Information Center
Pajer, Kathleen A.; Kelleher, Kelly; Gupta, Ravindra A.; Rolls, Jennifer; Gardner, William
A study aims to examine the existing health care policies in U.S. juvenile detention centres. The results conclude that juvenile detention facilities have many shortfalls in providing care for adolescents, particularly mental health care.
Health care facility preparation for weapons of mass destruction
Richard Neville Bradley
Weapons of mass destruction (WMD) are a threat that all health care facilities must be prepared for. Every health care facility is a vital part of the community response system and must be ready to respond. A terrorist attack using WMD can occur in any location, urban or rural. Private vehicles or buses may transport the majority of patients, with
Health maintenance facility system effectiveness testing
NASA Technical Reports Server (NTRS)
Lloyd, Charles W.; Gosbee, John; Bueker, Richard; Kupra, Debra; Ruta, Mary
The Medical Simulations Working Group conducted a series of medical simulations to evaluate the proposed Health Maintenance Facility (HMF) Preliminary Design Review (PDR) configuration. The goal of these simulations was to test the system effectiveness of the HMF PDR configurations. The objectives of the medical simulations are to (1) ensure fulfillment of requirements with this HMF design, (2) demonstrate the conformance of the system to human engineering design criteria, and (3) determine whether undesirable design or procedural features were introduced into the design. The simulations consisted of performing 6 different medical scenarios with the HMF mockup in the KRUG laboratory. The scenarios included representative medical procedures and used a broad spectrum of HMF equipment and supplies. Scripts were written and simulations performed by medical simulations working group members under observation from others. Data were collected by means of questionnaires, debriefings, and videotapes. Results were extracted and listed in the individual reports. Specific issues and recommendations from each simulation were compiled into the individual reports. General issues regarding the PDR design of the HMF are outlined in the summary report.
Health and Safety Policy Version 2012, Page 1 of 8 Health and Safety Policy
Low, Robert
Health and Safety Policy Version 2012, Page 1 of 8 Health and Safety Policy #12;Health and Safety Policy Version 2012, Page 2 of 8 Coventry University Health and Safety Policy 1. Introduction, Purpose and Scope The objective of our Health and Safety Policy is to enable the University to operate effectively
42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.
Code of Federal Regulations, 2010 CFR
...residents in skilled nursing facilities and home health agencies...SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS...residents in skilled nursing facilities and home health agencies...furnished by a skilled nursing facility or home health...
42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.
Code of Federal Regulations, 2014 CFR
...residents in skilled nursing facilities and home health agencies...SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS...residents in skilled nursing facilities and home health agencies...furnished by a skilled nursing facility or home health...
42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.
Code of Federal Regulations, 2011 CFR
...residents in skilled nursing facilities and home health agencies...SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS...residents in skilled nursing facilities and home health agencies...furnished by a skilled nursing facility or home health...
42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.
Code of Federal Regulations, 2013 CFR
...residents in skilled nursing facilities and home health agencies...SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS...residents in skilled nursing facilities and home health agencies...furnished by a skilled nursing facility or home health...
42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.
Code of Federal Regulations, 2012 CFR
...residents in skilled nursing facilities and home health agencies...SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS...residents in skilled nursing facilities and home health agencies...furnished by a skilled nursing facility or home health...
42 CFR 476.90 - Lack of cooperation by a health care facility or practitioner.
Code of Federal Regulations, 2011 CFR
...cooperation by a health care facility or practitioner. 476.90 Section 476.90 Public...cooperation by a health care facility or practitioner. (a) If a health care facility or practitioner refuses to allow a QIO to enter...
42 CFR 476.90 - Lack of cooperation by a health care facility or practitioner.
Code of Federal Regulations, 2010 CFR
...cooperation by a health care facility or practitioner. 476.90 Section 476.90 Public...cooperation by a health care facility or practitioner. (a) If a health care facility or practitioner refuses to allow a QIO to enter...
77 FR 21580 - Changes in Certain Multifamily Housing and Health Care Facility Mortgage Insurance Premiums for...
Federal Register 2010, 2011, 2012, 2013, 2014
...Certain Multifamily Housing and Health Care Facility Mortgage Insurance Premiums...Administration (FHA) Multifamily Housing, Health Care Facilities, and Hospital Mortgage...market-rate multifamily housing, health care facility, and hospital...
Health care facilities resilient to climate change impacts.
Paterson, Jaclyn; Berry, Peter; Ebi, Kristie; Varangu, Linda
Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator's guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned are as were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change. PMID:25590098
Health care facilities resilient to climate change impacts.
Paterson, Jaclyn; Berry, Peter; Ebi, Kristie; Varangu, Linda
Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator's guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change. PMID:25522050
Health Care Facilities Resilient to Climate Change Impacts
Paterson, Jaclyn; Berry, Peter; Ebi, Kristie; Varangu, Linda
Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator's guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change. PMID:25522050
Development of a Master Health Facility List in Nigeria
Azeez, Aderemi; Bamidele, Samson; Oyemakinde, Akin; Oyediran, Kolawole Azeez; Adebayo, Wura; Fapohunda, Bolaji; Abioye, Abimbola; Mullen, Stephanie
Abstract Introduction Routine Health Information Systems (RHIS) are increasingly transitioning to electronic platforms in several developing countries. Establishment of a Master Facility List (MFL) to standardize the allocation of unique identifiers for health facilities can overcome identification issues and support health facility management. The Nigerian Federal Ministry of Health (FMOH) recently developed a MFL, and we present the process and outcome. Methods The MFL was developed from the ground up, and includes a state code, a local government area (LGA) code, health facility ownership (public or private), the level of care, and an exclusive LGA level health facility serial number, as part of the unique identifier system in Nigeria. To develop the MFL, the LGAs sent the list of all health facilities in their jurisdiction to the state, which in turn collated for all LGAs under them before sending to the FMOH. At the FMOH, a group of RHIS experts verified the list and identifiers for each state. Results The national MFL consists of 34,423 health facilities uniquely identified. The list has been published and is available for worldwide access; it is currently used for planning and management of health services in Nigeria. Discussion Unique identifiers are a basic component of any information system. However, poor planning and execution of implementing this key standard can diminish the success of the RHIS. Conclusion Development and adherence to standards is the hallmark for a national health information infrastructure. Explicit processes and multi-level stakeholder engagement is necessary to ensuring the success of the effort. PMID:25422720
Malaria diagnostic capacity in health facilities in Ethiopia
Background Accurate early diagnosis and prompt treatment is one of the key strategies to control and prevent malaria in Ethiopia where both Plasmodium falciparum and Plasmodium vivax are sympatric and require different treatment regimens. Microscopy is the standard for malaria diagnosis at the health centres and hospitals whereas rapid diagnostic tests are used at community-level health posts. The current study was designed to assess malaria microscopy capacity of health facilities in Oromia Regional State and Dire Dawa Administrative City, Ethiopia. Methods A descriptive cross-sectional study was conducted from February to April 2011 in 122 health facilities, where health professionals were interviewed using a pre-tested, standardized assessment tool and facilities' laboratory practices were assessed by direct observation. Results Of the 122 assessed facilities, 104 (85%) were health centres and 18 (15%) were hospitals. Out of 94 health facilities reportedly performing blood films, only 34 (36%) used both thin and thick smears for malaria diagnosis. The quality of stained slides was graded in 66 health facilities as excellent, good and poor quality in 11(17%), 31 (47%) and 24 (36%) respectively. Quality assurance guidelines and malaria microscopy standard operating procedures were found in only 13 (11%) facilities and 12 (10%) had involved in external quality assessment activities, and 32 (26%) had supportive supervision within six months of the survey. Only seven (6%) facilities reported at least one staff's participation in malaria microscopy refresher training during the previous 12 months. Although most facilities, 96 (79%), had binocular microscopes, only eight (7%) had the necessary reagents and supplies to perform malaria microscopy. Treatment guidelines for malaria were available in only 38 (31%) of the surveyed facilities. Febrile patients with negative malaria laboratory test results were managed with artemether-lumefantrine or chloroquine in 51% (53/104) of assessed health facilities. Conclusions The current study indicated that most of the health facilities had basic infrastructure and equipment to perform malaria laboratory diagnosis but with significant gaps in continuous laboratory supplies and reagents, and lack of training and supportive supervision. Overcoming these gaps will be critical to ensure that malaria laboratory diagnosis is of high-quality for better patient management. PMID:25073561
Violence in Healthcare Facilities: Lessons From the Veterans Health Administration
Michael J. Hodgson; Richard Reed; Thomas Craig; Frances Murphy; Larry Lehmann; Linda Belton; Nick Warren
Goals: The authors examined assault frequency and risk factors in health care. Methods: The authors conducted a cross-sectional question naire survey in 142 hospitals. Analyses are presented at the level of the individual and aggregated by facility. Results: Thirteen percent of employees described at least 1 assault in the last year; the proportion assaulted per facility ranged from 1% to
Modelling of risk management in health care facilities
M. I. Okoroh; B. D. Ilozor; P. P. Gombera
Purpose – To evaluate the use of neural networks in healthcare facilities risk management. Design\\/methodology\\/approach – The data used to develop the input to the national health service facilities risk exposure system (NHSFRES) was solicited from 60 healthcare managers. Risk exposure system has been developed using the risk knowledge that was articulated from experienced healthcare operators through postal questionnaires and
ACSM's Health/Fitness Facility Standards and Guidelines. Second Edition.
ERIC Educational Resources Information Center
Peterson, James A., Ed; Tharrett, Stephen J., Ed.
The American College of Sports Medicine (ACSM) sets the industry standard for certifying professionals involved in health and fitness and their clinical applications. This 5-part publication provides a revised edition of six standards representing the industry's consensus on design and operation of a safe and high-quality health/fitness facility.…
Facilities Services and Environmental Health and Safety
Pawlowski, Wojtek
and recommendations about the design and operation of specific lab ventilation systems. This group includes EHS staff and facility maintenance, mechanical support and operational budget management. The Energy Management Office energy conservation opportunities in campus laboratories. It provides continuous laboratory systems
Page 1 of 2 Mental Health Services Provider Information
Lichtarge, Olivier
to patients." · Mental Health Services are defined as "assessment, diagnosis, treatment or counseling, conditions or disorders." · Positions that may qualify as Mental Health Service Providers includePage 1 of 2 Mental Health Services Provider Information Section 81.003 of the Texas Civil Practice
PagePagePage 111 Health and Safety MattersHealth and Safety MattersHealth and Safety Matters
of human health is concerned). · though existing regulations covering work with genetically modified organ Modified Organisms (Contained Use) Regulations will be rescinded. · the Specified Animal Pathogens Order of Substances Haz- ardous to Health Regulations) will be amended to exclude biological agents. · the Genetically
Updated Feb 10, 2014 Shared Facilities and Cores Guidelines & Policies Page 1 of 6 Einstein Shared Facilities and Cores
Kenny, Paraic
and guidelines for the fiscal and administrative operations of Albert Einstein College of Medicine (EinsteinUpdated Feb 10, 2014 Shared Facilities and Cores Guidelines & Policies Page 1 of 6 Einstein Shared and accounting practices within Einstein shared facilities and cores. · Ensure compliance with federal
Version: Non-Management Page 1 Revision Date: 11/13/12 UAF FACILITIES SERVICES
Hartman, Chris
Version: Non-Management Page 1 Revision Date: 11/13/12 UAF FACILITIES SERVICES Employee Performance Review EMPLOYEE INFORMATION Name Employee ID Job Title Date Department Facilities Services Supervisor Administrative Review). EMPLOYEE INFORMATION Name Employee ID Job Title Date Department Facilities Services
National Institute of Environmental Health Sciences Kids' Pages
Skip Navigation National Institute of Environmental Health Sciences Kids Pages skip navigation Home Discover & Explore What's That Word Scientific Kids Fun & Games Parents & Teachers About Contact Oil Spills No one really ...
7 CFR 1956.143 - Debt restructuring-hospitals and health care facilities.
Code of Federal Regulations, 2012 CFR
...Community Facility hospital and health care facility loans. Those...restructuring is to keep the hospital or health care facility in operation with...be determined by adding the fair market value of FmHA or...facility continuing to offer health care services which may,...
7 CFR 1956.143 - Debt restructuring-hospitals and health care facilities.
Code of Federal Regulations, 2011 CFR
...Community Facility hospital and health care facility loans. Those...restructuring is to keep the hospital or health care facility in operation with...be determined by adding the fair market value of FmHA or...facility continuing to offer health care services which may,...
7 CFR 1956.143 - Debt restructuring-hospitals and health care facilities.
Code of Federal Regulations, 2014 CFR
...Community Facility hospital and health care facility loans. Those...restructuring is to keep the hospital or health care facility in operation with...be determined by adding the fair market value of FmHA or...facility continuing to offer health care services which may,...
7 CFR 1956.143 - Debt restructuring-hospitals and health care facilities.
Code of Federal Regulations, 2013 CFR
...Community Facility hospital and health care facility loans. Those...restructuring is to keep the hospital or health care facility in operation with...be determined by adding the fair market value of FmHA or...facility continuing to offer health care services which may,...
Jump to first page Promoting Health,
Breastfeeding Poor Nutrition - Food Preferences Low physical activity Lack of sleep #12;Jump to first page establishes a "thrifty" way of handling food: Adjustments to protect brain tissue preferentially over visceral and somatic growth result in an altered metabolic profile, obesity & type 2 diabetes High blood
Facilities President's Council Section Page 5 Motion: 199704.18
Bolch, Tobias
by Facilities personnel. Support equipment (e.g. autoclave and washer, acid neutralizing pit and deionized water areas: 1. Base building 2. University supported programs 3. Research supported programs (grants) 1. Base Building The Facilities Department will be responsible for all general base building infrastructure
Academic Handbook, Admission, Health Sciences Page 1 Issued: 2009 12
Sinnamon, Gordon J.
- Health Sciences' Communication Sciences and Disorders (CSD) Academic Handbook users are advisedAcademic Handbook, Admission, Health Sciences Page 1 Issued: 2009 12 (S.09-249) Following Therapy and Communicative Sciences and Disorders, and the Academic Calendar Coordinator, all copy relating
Page 1 of 3 One Health Leadership Experience
Peak, Derek
Page 1 of 3 One Health Leadership Experience August, 2012 Learning Objectives: · To understand the definition and basic concepts of the One Health Initiative · To understand, and be able Orientation to the Framework for Leadership and the Leadership Working Groups 134 Arts 9:00 AM
OMG! Page 1 BUSINESS WEEK: EXECUTIVE HEALTH November 09, 2010
Preston, Scott
find TUESDAY, Nov. 9 (HealthDay News) -- Excessive texting and social networking may increase teens in an urban county in the U.S. Midwest. Many of the 19.8 percent of teens who reported hyper-texting wereOMG! Page 1 BUSINESS WEEK: EXECUTIVE HEALTH November 09, 2010 OMG! Excessive Texting Tied to Risky
42 CFR 476.78 - Responsibilities of health care facilities.
Code of Federal Regulations, 2010 CFR
...CONTROL REVIEW Review Responsibilities of Utilization and...Provisions § 476.78 Responsibilities of health care facilities...Medicare claims must cooperate in the assumption and...to the providers' responsibility to the QIOs to provide...provisions of the Social Security Act and...
Facility Organizational and Facility Resident Characteristics in Nursing Homes Serving Residents With a Mental Health History
Kathryn Frahm; Denise Gammonley; Ning Jackie Zhang; Seung Chun Paek
The prevalence of mental health disorders among nursing home residents has been noted. The purpose of this study was to identify characteristics among nursing homes serving residents with a mental health history. A retrospective, cross-sectional design was conducted using the 2003 national Online Survey, Certification, and Reporting facility data merged with the resident-level Minimum Data Set resulting in 2,499 nursing
Current trends in health facility planning, design, and construction.
Beale, Craig; Kittredge, Frank D
It is critical now more than ever for today's healthcare facilities to serve as more than just a backdrop to the care provided--they can, and should, be an integral part of that care. In addition to promoting efficacy, delighting the senses, and placing patients and families at ease, facilities need to be high-performing, sustainable, and healthy environments. Creating today's healthcare facilities requires breaking through barriers in unexpected ways, and it often requires looking outside the healthcare profession for guidance. In this article, we explore current trends in health facility planning, design, and construction. Our focus is on the buildings that serve as venues for the provision of healthcare services across the full continuum, from prevention to critical care. In particular, we discuss four current broad trends and conclude with thoughts on future developments. PMID:25671997
The structural quality of Tanzanian primary health facilities.
Gilson, L.; Magomi, M.; Mkangaa, E.
Structural quality is a key element in the quality of care provided at the primary level, which aims to offer health care interventions of proven efficacy. This assessment of the structural quality of Tanzanian primary health services indicated serious weaknesses in the available physical infrastructure, as well as supervision and other support, both for government and nongovernmental services and for dispensary and first referral-level services. Addressing these weaknesses is likely to require some additional funding and review of the functions of different groups of health care facilities within the primary care system. Although district health management teams have an important role to play in tackling the weaknesses, the existing division of management responsibilities indicates that they can only do so with the support of the regional and national levels of the health management structure. Study methods might be adapted to facilitate improved supervision and management. PMID:7704920
Community health facility preparedness for a cholera surge in Haiti.
Mobula, Linda Meta; Jacquet, Gabrielle A; Weinhauer, Kristin; Alcidas, Gladys; Thomas, Hans-Muller; Burnham, Gilbert
With increasing population displacement and worsening water insecurity after the 2010 earthquake, Haiti experienced a large cholera outbreak. Our goal was to evaluate the strengths and weaknesses of seven community health facilities' ability to respond to a surge in cholera cases. Since 2010, Catholic Relief Services (CRS) with a number of public and private donors has been working with seven health facilities in an effort to reduce morbidity and mortality from cholera infection. In November 2012, CRS through the Centers for Disease Control and Prevention (CDC)'s support, asked the Johns Hopkins Center for Refugee and Disaster Response to conduct a cholera surge simulation tabletop exercise at these health facilities to improve each facility's response in the event of a cholera surge. Using simulation development guidelines from the Pan American Health Organization and others, a simulation scenario script was produced that included situations of differing severity, supply chain, as well as a surge of patients. A total of 119 hospital staff from seven sites participated in the simulation exercise including community health workers, clinicians, managers, pharmacists, cleaners, and security guards. Clinics that had challenges during the simulated clinical care of patients were those that did not appropriately treat all cholera patients according to protocol, particularly those that were vulnerable, those that would need additional staff to properly treat patients during a surge of cholera, and those that required a better inventory of supplies. Simulation-based activities have the potential to identify healthcare delivery system vulnerabilities that are amenable to intervention prior to a cholera surge. PMID:24481887
A spatial national health facility database for public health sector planning in Kenya in 2008
Noor, Abdisalan M; Alegana, Victor A; Gething, Peter W; Snow, Robert W
Background Efforts to tackle the enormous burden of ill-health in low-income countries are hampered by weak health information infrastructures that do not support appropriate planning and resource allocation. For health information systems to function well, a reliable inventory of health service providers is critical. The spatial referencing of service providers to allow their representation in a geographic information system is vital if the full planning potential of such data is to be realized. Methods A disparate series of contemporary lists of health service providers were used to update a public health facility database of Kenya last compiled in 2003. These new lists were derived primarily through the national distribution of antimalarial and antiretroviral commodities since 2006. A combination of methods, including global positioning systems, was used to map service providers. These spatially-referenced data were combined with high-resolution population maps to analyze disparity in geographic access to public health care. Findings The updated 2008 database contained 5,334 public health facilities (67% ministry of health; 28% mission and nongovernmental organizations; 2% local authorities; and 3% employers and other ministries). This represented an overall increase of 1,862 facilities compared to 2003. Most of the additional facilities belonged to the ministry of health (79%) and the majority were dispensaries (91%). 93% of the health facilities were spatially referenced, 38% using global positioning systems compared to 21% in 2003. 89% of the population was within 5 km Euclidean distance to a public health facility in 2008 compared to 71% in 2003. Over 80% of the population outside 5 km of public health service providers was in the sparsely settled pastoralist areas of the country. Conclusion We have shown that, with concerted effort, a relatively complete inventory of mapped health services is possible with enormous potential for improving planning. Expansion in public health care in Kenya has resulted in significant increases in geographic access although several areas of the country need further improvements. This information is key to future planning and with this paper we have released the digital spatial database in the public domain to assist the Kenyan Government and its partners in the health sector. PMID:19267903
Corporate Real Estate and Facilities Cost Reduction IBM Corporation | December 2, 2009 Page 1 of 7
Corporate Real Estate and Facilities Cost Reduction © IBM Corporation | December 2, 2009 Page 1 of 7 - Internal distribution only Corporate Real Estate and Facilities Cost Reduction Summary By moving from typical to best practice, organisations can improve value for money and reduce their real estate
Health Resources Statistics; Health Manpower and Health Facilities, 1968. Public Health Service Publication No. 1509.
ERIC Educational Resources Information Center
National Center for Health Statistics (DHEW/PHS), Hyattsville, MD.
This report is a part of the program of the National Center for Health Statistics to provide current statistics as baseline data for the evaluation, planning, and administration of health programs. Part I presents data concerning the occupational fields: (1) administration, (2) anthropology and sociology, (3) data processing, (4) basic sciences,…
Regulation and oversight of independent health facilities in Canada.
Pries, Charlene R; Vanin, Sharon; Cartagena, Rosario G
Independent health facilities ("IHFs") are an important part of Canada's health care system existing at the interface of public and private care. They offer benefits to individual patients and the public at large, such as improved access to care, reduced wait times, improved choice in the delivery of care, and more efficient use of health care resources. They can also provide physicians greater autonomy, control of resources, and opportunity for profit compared to other practice settings, particularly because IHFs can deliver services outside of publicly-funded health care plans. IHFs also present challenges, particularly around quality of care and patient safety, and the potential to breach the principles of "Medicare" under the Canada Health Act. Various measures are in place to address these challenges, while still enabling the benefits IHFs can offer. IHFs are primarily regulated and overseen at the provincial level through legislation, regulations and provincial medical regulatory College by-laws. Health Canada is responsible for administering the overarching framework for "Medicare". Oversight and regulatory provisions vary across Canada, and are notably absent in the Maritime provinces and the territories. This article provides an overview of specific provisions related to IHFs across the country and how they can co-exist with the Canada Health Act. PMID:24696939
041 (a) 1-WH 06/2012 MEDICAL HISTORY--WOMEN'S HEALTH Page 1 of 1 MEDICAL HISTORY WOMEN'S HEALTH
Yener, Aylin
041 (a) 1-WH 06/2012 MEDICAL HISTORY--WOMEN'S HEALTH Page 1 of 1 MEDICAL HISTORY Â WOMEN'S HEALTH: _______________________ DOB: / / Mo. Day Year Please complete for your first Women's Health visit at University Health
Animal Health Diagnostic Center Page 1 of 2
Pawlowski, Wojtek
Animal Health Diagnostic Center Histology Page 1 of 2 Issue Date: 5/25/2012 Document Title: Histology Laboratory Research Prices Document Code: AP-HISTO-CHT-010-V.01 Histology Laboratory Research Prices Prepared/Reviewed by: Martin Slade, Technical Service Supervisor, Histology Laboratory Tissues
Health spending and political influence: the case of earmarks and health care facilities.
Leider, Jonathon P; Tung, Greg; Castrucci, Brian; Sprague, James B
Earmarks, otherwise known as Congressionally directed spending requests, are a historically significant means of political influence over budgets. In this brief, we report on the results of a longitudinal study of federal earmarks affecting health care facilities and public health. We analyzed 10 years of earmark for health care facilities and examined the correlates of being in the top 50% of earmark recipients for each year. Having representatives or senators serving on the respective Appropriations committees were shown to have increased odds of being a top earmark recipient, as was being in jurisdictions with greater poverty. However, health-related measures of need were not significantly associated with being a top earmark recipient. PMID:25148133
Health Spending and Political Influence: The Case of Earmarks and Health Care Facilities
Leider, Jonathon P.; Tung, Greg; Castrucci, Brian; Sprague, James B.
Earmarks, otherwise known as Congressionally directed spending requests, are a historically significant means of political influence over budgets. In this brief, we report on the results of a longitudinal study of federal earmarks affecting health care facilities and public health. We analyzed 10 years of earmark for health care facilities and examined the correlates of being in the top 50% of earmark recipients for each year. Having representatives or senators serving on the respective Appropriations committees were shown to have increased odds of being a top earmark recipient, as was being in jurisdictions with greater poverty. However, health-related measures of need were not significantly associated with being a top earmark recipient. PMID:25148133
A descriptive study of primary health care practices in Ontario's youth custody facilities
Cossy, Lisa S; Miller, Linda T
BACKGROUND: Adolescents admitted to youth custody facilities are often in need of physical and mental health care. OBJECTIVES: To describe primary health care practices in Ontario's youth custody facilities. METHOD: A questionnaire regarding facility characteristics and primary health care practices was distributed to the directors of all youth custody facilities in Ontario. RESULTS: Most (87.8%) facilities obtained medical histories after the youth arrived, and 92% used health care professionals to perform that assessment. Intake medical examinations were performed on each youth admitted to custody at 94% of all facilities; however, only 57.2% of facilities reported that these examinations were performed by a doctor within 72 h of admission. Performing suicide assessments on all youth at intake was reported by 77.6% of facilities. Continuous health education was provided by 76% of facilities. Facility type and type of management appear to be related to some areas of health services provision. CONCLUSIONS: Youth custody facilities in Ontario are providing primary health care services. Weaknesses are, however, evident, particularly in relation to untimely intake medical examinations, failure to provide continuous health education and failure to conduct suicide assessments on all youth at intake. Future research on barriers to health service provision in Canadian youth custody facilities is recommended. PMID:24497778
Health effects from hazardous waste incineration facilities: five case studies.
Pleus, R C; Kelly, K E
Environmental pollution, primarily from industrialization, has caused significant adverse effects to humans, animals, and the ecosystem. Attempts have been made to reduce and prevent these pollutants through better waste management practices. Incineration is one such practice, which seeks to prevent adverse health impacts to future generations by destroying waste today, without increasing risk to those living near incineration facilities in the process. As with any industrial process, however, proper design and operation are important requirements to ensure the facility can be operated safely. Any technology that cannot be managed safely should not be considered acceptable. This paper reviews the scientific basis of past allegations associated with the process of hazardous waste incineration. These five case studies, which have attracted considerable public attention, have not been shown to be scientifically accurate of factually based. This paper attempts to separate fact from fiction and to show some of the consistent inaccuracies that were repeated throughout all five studies. In reviewing the above cases and others in the literature, several common elements become apparent. 1. Most of the reports are based on single newspaper articles, activist newsletters, interviews with admittedly biased respondents, and other secondary or inappropriate sources of information that do not withstand scientific scrutiny. 2. Research studies are quoted incompletely or out of context. Often the original point made by the researcher is the exact opposite of the impression left by Costner and Thornton. 3. In four of five cases, no data were supplied to substantiate the claims. As an observation, where substantive research data do not exist to support allegations of adverse health effects, a tendency seems to be increasing over time to make allegations and then not provide supporting data. Because public damage is often done simply by making the allegation, this tactic appears to be effective. Thus, unsubstantiated allegations should not go unchallenged. 4. A relatively small group of people appears to be consistently generating most of the allegations. 5. The format of the allegations tends to be similar; often just the name of the facility changes. 6. Furthermore, these same few individuals tend to repeat the same allegations about the same facilities, even after the allegations have been long since proven incorrect. Despite the widespread prevalence of incineration facilities around the world and the millions of tons of waste destroyed in them each year, surprisingly few reports of adverse health effects exist in the scientific literature relative to other types of waste management practices. 7. The existing reports do not indicate that hazardous waste incineration has widespread potential for adverse health effects. However, as with all industrial processes, care must be taken to ensure that facilities are well designed and well operated to minimize or prevent adverse health effects. As with all environmental exposures, potential impacts on public health need to be addressed scientifically. Making a scientifically valid connection between operation of an incinerator and resulting disease within a population is a difficult undertaking, requiring the combined efforts of toxicologists, epidemiologists, chemists, physicians, and persons in other disciplines. Nevertheless, concerns regarding potential impacts of incineration must be addressed and communicated, both accurately and effectively, if the actual risks of incineration are to become widely understood. PMID:8794540
Health promotion and education in youth correctional facilities.
Greene, E; Lucarelli, P; Shocksnider, J
In 1997 a comprehensive perinatal/pediatric needs assessment was conducted in the two counties comprising the region. As a result, the Regional Perinatal Consortium of Monmouth and Ocean Counties, Inc. submitted both a perinatal and a pediatric plan that addressed the strengths and the needs of the region to the New Jersey Department of Health and Senior Services. One of thirteen pediatric action plans, Pediatric Health Care and Educational Services in Correctional Facilities, set the stage for the start of ongoing and wide-ranging health programs for the youth in one of the county youth detention centers. Beginning with "Alternatives to Violence," Consortium staff have met monthly with the incarcerated youth to plan and provide these much needed sessions. As expected, these sessions have produced many responses from the youth, some anticipated and many pleasantly surprising, as they have begun to recognize the helpful intent and nature of our programs. The youth are encouraged to participate in planning for upcoming programs and their input is appreciated and respected. As many of these teens are parents themselves, this program has also been able to incorporate parenting skills in some of the sessions, with a major focus on child abuse prevention. Health-education services for incarcerated youth open the door to an exciting frontier for pediatric nurses to deliver prevention in this much-needed setting. This program is a model for planning, implementing, and evaluating public health programs in the pediatric arena. PMID:12024350
Neuroscience and Mental Health Page 1 New program proposal: Neuroscience and Mental Health
public interest and scientific investigation, reflecting an increased public awareness of mental illness plus incidence of mental illness (due in part to our aging population). The proposed programsNeuroscience and Mental Health Page 1 New program proposal: Neuroscience and Mental Health · B
Community and Public Health MEASLES Canterbury District Health Board, NZ Page 1 of 1 February 2009
Hickman, Mark
Community and Public Health MEASLES Canterbury District Health Board, NZ Page 1 of 1 February 2009 Ph (03) 364 1777, Fx (03) 379 6125 Measles fact sheet What is Measles? Measles, sometimes known as English measles, is a viral infection that can lead to ear infections, pneumonia and/or diarrhoea
Does the Health Maintenance Facility Provide Speciality Capabilities?
NASA Technical Reports Server (NTRS)
Boyce, Joey; Wurgler, James; Broadwell, Kim; Martin, William; Stiernberg, Charles M.; Bove, Alfred; Fromm, Rob; O'Neill, Daniel
The Health Maintenance Facility (HMF) is capable of handling all minor illnesses, most moderate illnesses, and some major illnesses on board a space station. Its primary purpose should be to treat problems that are mission threatening, not life threatening. The HMF will have greater medical capabilities than those currently on Navy submarines. Much of the discussion in this document focuses on the possibilities of treating specific medical conditions on board a space station. The HMF will be limited to caring for critically ill patients for a few days, so a crew return vehicle will be important.
PRIVACY POLICY AND PROCEDURES Policy #: 2100.15 LSU Health Sciences Center New Orleans Page: 1
: All Louisiana State University (LSU) System health care facilities and providers including Orleans Academic Campus. Nota Bene: All LSU System health care facilities and providers including Health Information Psychotherapy Notes  means notes recorded by a health care provider who is a mental
42 CFR 476.88 - Examination of the operations and records of health care facilities and practitioners.
Code of Federal Regulations, 2011 CFR
...records of health care facilities and practitioners. 476.88 Section 476.88 Public...records of health care facilities and practitioners. (a) Authorization to examine...authorization from the facility or practitioner. (c) Conditions of...
42 CFR 476.88 - Examination of the operations and records of health care facilities and practitioners.
Code of Federal Regulations, 2013 CFR
...records of health care facilities and practitioners. 476.88 Section 476.88 Public...records of health care facilities and practitioners. (a) Authorization to examine...authorization from the facility or practitioner. (c) Conditions of...
42 CFR 476.88 - Examination of the operations and records of health care facilities and practitioners.
Code of Federal Regulations, 2014 CFR
...records of health care facilities and practitioners. 476.88 Section 476.88 Public...records of health care facilities and practitioners. (a) Authorization to examine...authorization from the facility or practitioner. (c) Conditions of...
42 CFR 476.88 - Examination of the operations and records of health care facilities and practitioners.
Code of Federal Regulations, 2012 CFR
...records of health care facilities and practitioners. 476.88 Section 476.88 Public...records of health care facilities and practitioners. (a) Authorization to examine...authorization from the facility or practitioner. (c) Conditions of...
42 CFR 476.88 - Examination of the operations and records of health care facilities and practitioners.
Code of Federal Regulations, 2010 CFR
...records of health care facilities and practitioners. 476.88 Section 476.88 Public...records of health care facilities and practitioners. (a) Authorization to examine...authorization from the facility or practitioner. (c) Conditions of...
School Health Services: A Facility Planning and Design Guide for School Systems.
ERIC Educational Resources Information Center
Maryland State Dept. of Education, Baltimore.
This guide for Maryland schools outlines the role of school health services and proper facility design for these services. Chapter 1 provides an overview, describing coordinated school health programs, school health services programs, school health services programs in Maryland, how school health services are delivered, trends, the number of…
ERIC Educational Resources Information Center
American Association for Health, Physical Education, and Recreation, Washington, DC.
UK HealthCare HIPAA Education Page 1 September 1, 2009 HIPAA Education Level One
MacAdam, Keith
UK HealthCare HIPAA Education Page 1 September 1, 2009 HIPAA Education Level of an individual's health information Ensures physical and technical security of an individual's health HealthCare HIPAA Education Page 2 September 1, 2009 ~ Who is required to comply
Health & Safety Policy (Dec 2010) Page 1 of 18 Version 4.0 KINGSTON UNIVERSITY
Jones, Graeme A.
Health & Safety Policy (Dec 2010) Page 1 of 18 Version 4.0 KINGSTON UNIVERSITY HEALTH & SAFETY POLICY Release: Final Subject: Health & Safety Policy Issued by: University Safety Office Version: 4.0 Effective From : December 2010 #12;Health & Safety Policy (Dec 2010) Page 2 of 18 Version 4.0 Foreword
28.99.99.M1 Student Health Services Page 1 of 1 UNIVERSITY RULE
28.99.99.M1 Student Health Services Page 1 of 1 UNIVERSITY RULE 28.99.99.M1 Student Health Services The Department of Student Health Services (A.P. Beutel Health Center) is an ambulatory health care provider serving the Texas A&M University student body through the provision of primary health care services
The Global Health Group Page 1 of 2 Private Sector Healthcare Initiative Postdoctoral Fellow Position Description
Mullins, Dyche
The Global Health Group Page 1 of 2 Private Sector Healthcare Initiative Postdoctoral Fellow  Position Description The Global Health Group University of California, San Francisco The Global Health Group (GHG) at the University of California, San
Implementation of tuberculosis infection control in health facilities in Mukono and Wakiso districts, Uganda
Background Tuberculosis infection control (TBIC) is rarely implemented in the health facilities in resource limited settings. Understanding the reasons for low level of implementation is critical. The study aim was to assess TBIC practices and barriers to implementation in two districts in Uganda. Methods We conducted a cross-sectional study in 51 health facilities in districts of Mukono and Wakiso. The study included: a facility survey, observations of practices and eight focus group discussions with health workers. Results Quantitative: Only 16 facilities (31%) had a TBIC plan. Five facilities (10%) were screening patients for cough. Two facilities (4%) reported providing masks to patients with cough. Ventilation in the waiting areas was inadequate for TBIC in 43% (22/51) of the facilities. No facility possessed N95 particulate respirators. Qualitative: Barriers that hamper implementation of TBIC elicited included: under-staffing, lack of space for patient separation, lack of funds to purchase masks, and health workers not appreciating the importance of TBIC. Conclusion TBIC measures were not implemented in health facilities in the two Ugandan districts where the survey was done. Health system factors like lack of staff, space and funds are barriers to implement TBIC. Effective implementation of TBIC measures occurs when the fundamental health system building blocks -governance and stewardship, financing, infrastructure, procurement and supply chain management are in place and functioning appropriately. PMID:23915376
Utilization of Occupational Therapy in Mental Health Facilities in Western Pennsylvania
Jaime Phillip Muńoz; John Sciulli Jr; Dara L. Thomas; Ryan S. Wissner
This paper explores factors that are influencing the utilization of occupational therapists in mental health facilities in Western Pennsylvania from the perspective of administrators of mental health agencies. Administrators completed a 32 item survey. Descriptive statistics were compiled and inferential statistical analysis compared group means by type of facility, employment of occupational therapy personnel, awareness of occupational therapy education, and
SDS-PAGE PROTOCOL: NCBS MS-FACILITY H2O (HPLC grade-Spectrochem)
Bhalla, Upinder S.
SDS-PAGE PROTOCOL: NCBS MS-FACILITY Chemicals: H2O (HPLC grade-Spectrochem) Methanol (HPLC grade-Spectrochem) Acetic Acid (HPLC grade-Spectrochem) 10% Ammonium per Sulphate (sigma-161-0700) 10% SDS (biorad-161) H2O (HPLC grade) 4 1.36 30% Acryl amide 3.3 0.34 Tris 2.5(1.5M) 0.25( 0.5M) 10% SDS 0.1 0.02 10% APS
Cost analysis and efficiency of sub-district health facilities in two districts in Ghana.
Aboagye, Anthony Q Q; Degboe, Arnold N K
To establish the full costs borne by sub-district health facilities in providing services, we analysed the costs and revenues of 10 sub-district health facilities located in two districts in Ghana. The full costs were obtained by considering staff costs, cost of utilities, cost of using health facility equipment, cost of non-drug consumables, equipment maintenance expenses, amounts spent on training, community information sessions and other outreach activities as well as all other costs incurred in running the facilities. We found that (i) a large proportion of sub-district health facility costs is made up of staff salaries; (ii) at all facilities, internally generated funds (IGFs) are substantially lower than costs incurred in running the facilities; (iii) average IGF is several times higher in one district than the other; (iv) wide variations exist in efficiency indicators and (v) there is some evidence that sub-district health facilities may not necessarily be financially more efficient than hospitals in using financial resources. We suggest that the study should be replicated in other districts; but in the mean time, the health authorities should take note of the conclusions and recommendations of this study. Efforts should also be made to improve record keeping at these facilities. PMID:21674614
Uses of inorganic hypochlorite (bleach) in health-care facilities.
Rutala, W A; Weber, D J
Hypochlorite has been used as a disinfectant for more than 100 years. It has many of the properties of an ideal disinfectant, including a broad antimicrobial activity, rapid bactericidal action, reasonable persistence in treated potable water, ease of use, solubility in water, relative stability, relative nontoxicity at use concentrations, no poisonous residuals, no color, no staining, and low cost. The active species is undissociated hypochlorous acid (HOCl). Hypochlorites are lethal to most microbes, although viruses and vegetative bacteria are more susceptible than endospore-forming bacteria, fungi, and protozoa. Activity is reduced by the presence of heavy metal ions, a biofilm, organic material, low temperature, low pH, or UV radiation. Clinical uses in health-care facilities include hyperchlorination of potable water to prevent Legionella colonization, chlorination of water distribution systems used in hemodialysis centers, cleaning of environmental surfaces, disinfection of laundry, local use to decontaminate blood spills, disinfection of equipment, decontamination of medical waste prior to disposal, and dental therapy. Despite the increasing availability of other disinfectants, hypochlorites continue to find wide use in hospitals. PMID:9336664
Development and use of a master health facility list: Haiti's experience during the 2010 earthquake response
Rose-Wood, Alyson; Heard, Nathan; Thermidor, Roody; Chan, Jessica; Joseph, Fanor; Lerebours, Gerald; Zugaldia, Antonio; Konkel, Kimberly; Edwards, Michael; Lang, Bill; Torres, Carmen-Rosa
ABSTRACT Master health facility lists (MHFLs) are gaining attention as a standards-based means to uniquely identify health facilities and to link facility-level data. The ability to reliably communicate information about specific health facilities can support an array of health system functions, such as routine reporting and emergency response operations. MHFLs support the alignment of donor-supported health information systems with county-owned systems. Recent World Health Organization draft guidance promotes the utility of MHFLs and outlines a process for list development and governance. Although the potential benefits of MHFLs are numerous and may seem obvious, there are few documented cases of MHFL construction and use. The international response to the 2010 Haiti earthquake provides an example of how governments, nongovernmental organizations, and others can collaborate within a framework of standards to build a more complete and accurate list of health facilities. Prior to the earthquake, the Haitian Ministry of Health (Ministčre de la Santé Publique et de la Population [MSPP]) maintained a list of public-sector health facilities but lacked information on privately managed facilities. Following the earthquake, the MSPP worked with a multinational group to expand the completeness and accuracy of the list of health facilities, including information on post-quake operational status. This list later proved useful in the response to the cholera epidemic and is now incorporated into the MSPP's routine health information system. Haiti's experience demonstrates the utility of MHFL formation and use in crisis as well as in the routine function of the health information system. PMID:25276595
Development and use of a master health facility list: Haiti's experience during the 2010 earthquake response.
Rose-Wood, Alyson; Heard, Nathan; Thermidor, Roody; Chan, Jessica; Joseph, Fanor; Lerebours, Gerald; Zugaldia, Antonio; Konkel, Kimberly; Edwards, Michael; Lang, Bill; Torres, Carmen-Rosa
Master health facility lists (MHFLs) are gaining attention as a standards-based means to uniquely identify health facilities and to link facility-level data. The ability to reliably communicate information about specific health facilities can support an array of health system functions, such as routine reporting and emergency response operations. MHFLs support the alignment of donor-supported health information systems with county-owned systems. Recent World Health Organization draft guidance promotes the utility of MHFLs and outlines a process for list development and governance. Although the potential benefits of MHFLs are numerous and may seem obvious, there are few documented cases of MHFL construction and use. The international response to the 2010 Haiti earthquake provides an example of how governments, nongovernmental organizations, and others can collaborate within a framework of standards to build a more complete and accurate list of health facilities. Prior to the earthquake, the Haitian Ministry of Health (Ministčre de la Santé Publique et de la Population [MSPP]) maintained a list of public-sector health facilities but lacked information on privately managed facilities. Following the earthquake, the MSPP worked with a multinational group to expand the completeness and accuracy of the list of health facilities, including information on post-quake operational status. This list later proved useful in the response to the cholera epidemic and is now incorporated into the MSPP's routine health information system. Haiti's experience demonstrates the utility of MHFL formation and use in crisis as well as in the routine function of the health information system. PMID:25276595
Health Insurance Portability and Accountability Act (HIPAA) legislation and its implication on speech privacy design in health care facilities
NASA Astrophysics Data System (ADS)
Tocci, Gregory C.; Storch, Christopher A.
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 (104th Congress, H.R. 3103, January 3, 1986), among many things, individual patient records and information be protected from unnecessary issue. This responsibility is assigned to the U.S. Department of Health and Human Services (HHS) which has issued a Privacy Rule most recently dated August 2002 with a revision being proposed in 2005 to strengthen penalties for inappropriate breaches of patient privacy. Despite this, speech privacy, in many instances in health care facilities need not be guaranteed by the facility. Nevertheless, the regulation implies that due regard be given to speech privacy in both facility design and operation. This presentation will explore the practical aspects of implementing speech privacy in health care facilities and make recommendations for certain specific speech privacy situations.
A Meta-Analysis of Socio-Demographic Factors Predicting Birth in Health Facility
Berhan, Yifru; Berhan, Asres
Background The low proportion of health facility delivery in developing countries is one of the main challenges in achieving the Millennium Development Goal of a global reduction of maternal deaths by 75% by 2015. There are several primary studies which identified socio-demographic and other predictors of birth in health facility. However, there are no efforts to synthesis the findings of these studies. The objective of this meta-analysis was to determine the strength of the association of birth in the health facility with selected sociodemographic factors. Methods A meta-analysis of Mantel-Haenszel odds ratios was conducted by including 24 articles which were reported between 2000 and 2013 from developing countries. A computer-based search was done from MEDLINE, African Journals Online, Google Scholar and HINARI databases. Included studies did compare the women's' health facility delivery in relation to their selected socio-demographic characteristics. Results The pooled analysis demonstrated association of health facility delivery with living in urban areas (OR = 9.8), secondary and above educational level of the parents (OR = 5.0), middle to high wealth status (OR = 2.3) and first time pregnancy (OR = 2.8). The risk of delivering outside the health facility was not significantly associated with maternal age (teenage vs 20 years and above) and marital status. The distance of pregnant women's residence from the health facility was found to have an inverse relation to the proportion of health facility delivery. Conclusion Although the present meta-analysis identified several variables which were associated with an increase in health facility delivery, the most important predictor of birth in the health facility amenable to intervention is educational status of the parents to be. Therefore, formal and informal education to women and family members on the importance of health facility delivery needs to be strengthened. Improving the wealth status of the population across the world may not be achieved soon, but should be in the long-term strategy to increase the birth rate in the health facility. PMID:25489185
Health and Safety Management for Small-scale Methane Fermentation Facilities
NASA Astrophysics Data System (ADS)
Yamaoka, Masaru; Yuyama, Yoshito; Nakamura, Masato; Oritate, Fumiko
In this study, we considered health and safety management for small-scale methane fermentation facilities that treat 2-5 ton of biomass daily based on several years operation experience with an approximate capacity of 5 t·d-1. We also took account of existing knowledge, related laws and regulations. There are no qualifications or licenses required for management and operation of small-scale methane fermentation facilities, even though rural sewerage facilities with a relative similar function are required to obtain a legitimate license. Therefore, there are wide variations in health and safety consciousness of the operators of small-scale methane fermentation facilities. The industrial safety and health laws are not applied to the operation of small-scale methane fermentation facilities. However, in order to safely operate a small-scale methane fermentation facility, the occupational safety and health management system that the law recommends should be applied. The aims of this paper are to clarify the risk factors in small-scale methane fermentation facilities and encourage planning, design and operation of facilities based on health and safety management.
Protecting new health facilities from natural hazards: guidelines for the promotion of disaster mitigation.
The health sector is particularly vulnerable to naturally occurring events. The vulnerability of the health infrastructure (hospitals and clinics) is of particular concern. Not only are such facilities vulnerable structurally, but their ability to continue to provide essential functions may be severely compromised, thus leaving the stricken population without essential services. This paper summarizes a more detailed document, Guidelines for Vulnerability Reduction in the Design of New Health Facilities published by the Pan-American Health Organization (PAHO)/ World Health Organization (WHO). The current document summarizes these Guidelines emphasizing how they may be used, by whom, and for what purpose. Potential users of the Guidelines include, but are not limited to: (1) initiators of health facility construction projects; (2) executors and supervisors of health facility construction projects; and (3) financing bodies in charge of funding health facility construction projects. The Guidelines include: (1) implications of natural phenomena upon the health infrastructure; (2) guidelines for vulnerability reduction for incorporation into development project cycles; (3) definitive phases and stages within the phases for development projects including: (I) Projects Assessment (needs assessment; assessment of options, the preliminary project); (II) Investment (project design, construction); and (III) Operational Activities (operations and maintenance). In addition, investment in damage reduction measures, policies and regulations, training and education, and the role of international organizations in the promotion and funding of mitigation strategies are addressed. PMID:15645629
Lung Health Dissertation Grant (LH) Program Description Page 1 of 6 5/25/2011
Gleeson, Joseph G.
Lung Health Dissertation Grant (LH) Program Description Page 1 of 6 5/25/2011 IMPORTANT NOTES · APPLICANTS ARE ADVISED TO READ THE INDIVIDUAL AWARD PROGRAM DESCRIPTIONS AND INSTRUCTIONS BEFORE STARTING and health policy research. > Epidemiological and biostatistical lung health research. > Public Health
Page 1 of 5 Binghamton University Health Service Student Name:__________________
Suzuki, Masatsugu
other to know about your mental health care? YES NO Names-777-2881 ________________________________________________________________________ Medical History -Do you have any health problems or complaints? (Please list any conditions) _______________________________ -Any medical or mental health problems with mom
Differences in essential newborn care at birth between private and public health facilities in eastern Uganda
Waiswa, Peter; Akuze, Joseph; Peterson, Stefan; Kerber, Kate; Tetui, Moses; Forsberg, Birger C.; Hanson, Claudia
Background In Uganda and elsewhere, the private sector provides an increasing and significant proportion of maternal and child health services. However, little is known whether private care results in better quality services and improved outcomes compared to the public sector, especially regarding care at the time of birth. Objective To describe the characteristics of care-seekers and assess newborn care practices and services received at public and private facilities in rural eastern Uganda. Design Within a community-based maternal and newborn care intervention with health systems strengthening, we collected data from mothers with infants at baseline and endline using a structured questionnaire. Descriptive, bivariate, and multivariate data analysis comparing nine newborn care practices and three composite newborn care indicators among private and public health facilities was conducted. Results The proportion of women giving birth at private facilities decreased from 25% at baseline to 17% at endline, whereas overall facility births increased. Private health facilities did not perform significantly better than public health facilities in terms of coverage of any essential newborn care interventions, and babies were more likely to receive thermal care practices in public facilities compared to private (68% compared to 60%, p=0.007). Babies born at public health facilities received an average of 7.0 essential newborn care interventions compared to 6.2 at private facilities (p<0.001). Women delivering in private facilities were more likely to have higher parity, lower socio-economic status, less education, to seek antenatal care later in pregnancy, and to have a normal delivery compared to women delivering in public facilities. Conclusions In this setting, private health facilities serve a vulnerable population and provide access to service for those who might not otherwise have it. However, provision of essential newborn care practices was slightly lower in private compared to public facilities, calling for quality improvement in both private and public sector facilities, and a greater emphasis on tracking access to and quality of care in private sector facilities. PMID:25843495
TB in Correctional Facilities Is a Public Health Concern
... Stages & Populations Travelers' Health Workplace Safety & Health Features Media Sign up for Features Get Email Updates To ... October 2013. http://www.cdc.gov/tb/ Features Media Sign up for Features Get Email Updates To ...
PRIVACY POLICY AND PROCEDURES Policy #: 2100.14 LSU Health Sciences Center New Orleans Page: 1
Health Sciences Center New Orleans Page: 2 Date Effective: April 14, 2003 Date Revised: September 23 numbers · Fax numbers · Electronic mail addresses · Social Security numbers · Medical record numbersPRIVACY POLICY AND PROCEDURES Policy #: 2100.14 LSU Health Sciences Center New Orleans Page: 1 Date
Prevalence and predictors of giving birth in health facilities in Bugesera District, Rwanda
Background The proportion of births attended by skilled health personnel is one of two indicators used to measure progress towards Millennium Development Goal 5, which aims for a 75% reduction in global maternal mortality ratios by 2015. Rwanda has one of the highest maternal mortality ratios in the world, estimated between 249–584 maternal deaths per 100,000 live births. The objectives of this study were to quantify secular trends in health facility delivery and to identify factors that affect the uptake of intrapartum healthcare services among women living in rural villages in Bugesera District, Eastern Province, Rwanda. Methods Using census data and probability proportional to size cluster sampling methodology, 30 villages were selected for community-based, cross-sectional surveys of women aged 18–50 who had given birth in the previous three years. Complete obstetric histories and detailed demographic data were elicited from respondents using iPad technology. Geospatial coordinates were used to calculate the path distances between each village and its designated health center and district hospital. Bivariate and multivariate logistic regressions were used to identify factors associated with delivery in health facilities. Results Analysis of 3106 lifetime deliveries from 859 respondents shows a sharp increase in the percentage of health facility deliveries in recent years. Delivering a penultimate baby at a health facility (OR = 4.681 [3.204 - 6.839]), possessing health insurance (OR = 3.812 [1.795 - 8.097]), managing household finances (OR = 1.897 [1.046 - 3.439]), attending more antenatal care visits (OR = 1.567 [1.163 - 2.112]), delivering more recently (OR = 1.438 [1.120 - 1.847] annually), and living closer to a health center (OR = 0.909 [0.846 - 0.976] per km) were independently associated with facility delivery. Conclusions The strongest correlates of facility-based delivery in Bugesera District include previous delivery at a health facility, possession of health insurance, greater financial autonomy, more recent interactions with the health system, and proximity to a health center. Recent structural interventions in Rwanda, including the rapid scale-up of community-financed health insurance, likely contributed to the dramatic improvement in the health facility delivery rate observed in our study. PMID:23217157
Using classification tree modelling to investigate drug prescription practices at health facilities in rural Tanzania
Background Drug prescription practices depend on several factors related to the patient, health worker and health facilities. A better understanding of the factors influencing prescription patterns is essential to develop strategies to mitigate the negative consequences associated with poor practices in both the public and private sectors. Methods A cross-sectional study was conducted in rural Tanzania among patients attending health facilities, and health workers. Patients, health workers and health facilities-related factors with the potential to influence drug prescription patterns were used to build a model of key predictors. Standard data mining methodology of classification tree analysis was used to define the importance of the different factors on prescription patterns. Results This analysis included 1,470 patients and 71 health workers practicing in 30 health facilities. Patients were mostly treated in dispensaries. Twenty two variables were used to construct two classification tree models: one for polypharmacy (prescription of ?3 drugs) on a single clinic visit and one for co-prescription of artemether-lumefantrine (AL) with antibiotics. The most important predictor of polypharmacy was the diagnosis of several illnesses. Polypharmacy was also associated with little or no supervision of the health workers, administration of AL and private facilities. Co-prescription of AL with antibiotics was more frequent in children under five years of age and the other important predictors were transmission season, mode of diagnosis and the location of the health facility. Conclusion Standard data mining methodology is an easy-to-implement analytical approach that can be useful for decision-making. Polypharmacy is mainly due to the diagnosis of multiple illnesses. PMID:22950486
United States radiological health activities: inspection results of mammography facilities
Spelic, DC; Kaczmarek, RV; Hilohi, M; Belella, S
Purpose: The Mammography Quality Standards Act (MQSA) was enacted in 1992 to set national standards for high-quality mammography, including standards for mammographic X-ray equipment, patient dose, clinical image quality, and related technical parameters. The MQSA also requires minimum qualifications for radiologic technologists, interpreting physicians and medical physicists, mandates acceptable practices for quality-control, quality-assurance, and requires processes to audit medical outcomes. This paper presents the findings of MQSA inspections of facilities, which characterize significant factors affecting mammography quality in the United States. Materials and Methods: Trained inspectors collected data regarding X-ray technical factors, made exposure measurements for the determination of mean glandular dose (MGD), evaluated image quality, and inspected the quality of the film-processing environment. The average annual facility and total U.S. screening exam workloads were computed using workload data reported by facilities. Results: Mammography facilities have made technical improvements as evidenced by a narrower distribution of doses, higher phantom-film background optical densities associated with higher phantom image-quality scores, and better film processing. It is estimated that approximately 36 million screening mammography exams were conducted in 2006, a rate that is almost triple the exam volume estimated for 1997. Digital mammography (DM) is now in use at approximately 14% (1,191 of 8,834) of MQSA-certified mammography facilities. The results indicate that DM can offer lower dose to the patient while providing comparable or better image quality. PMID:21614276
Using Facebook Page Insights Data to Determine Posting Best Practices in an Academic Health Sciences Library
ERIC Educational Resources Information Center
Houk, Kathryn M.; Thornhill, Kate
Tufts University Hirsh Health Sciences Library created a Facebook page and a corresponding managing committee in March 2010. Facebook Page Insights data collected from the library's Facebook page were statistically analyzed to investigate patterns of user engagement. The committee hoped to improve posting practices and increase user…
A checklist for planning and designing audiovisual facilities in health sciences libraries.
Holland, G J; Bischoff, F A; Foxman, D S
Developed by an MLA/HeSCA (Health Sciences Communications Association) joint committee, this checklist is intended to serve as a conceptual framework for planning a new or renovated audiovisual facility in a health sciences library. Emphasis is placed on the philosophical and organizational decisions that must be made about an audiovisual facility before the technical or spatial decisions can be wisely made. Specific standards for facilities or equipment are not included. The first section focuses on health sciences library settings. Ideas presented in the remaining sections could apply to academic learning resource center environments as well. A bibliography relating to all aspects of audiovisual facilities planning and design is included with references to specific sections of the checklist. PMID:6208957
Race Differences in Mental Health Service Access in a Secure Male Juvenile Justice Facility
ERIC Educational Resources Information Center
Dalton, Richard F.; Evans, Lisa J.; Cruise, Keith R.; Feinstein, Ronald A.; Kendrick, Rhonda F.
This study examined whether African American and Caucasian male youths had similar rates of referral to mental health services in a juvenile justice secure facility when controlling for differences obtained in the initial screening and assessment process. Data from the Massachusetts Youth Screening Instrument-2 (MAYSI-2), Initial Health Care…
Page 1 of 4 National Institutes of Health
Rau, Don C.
and Affordable Care Act (PPACA); however, it is important to understand that the entire health care system SUMMARY OF GUEST SPEAKER PRESENTATION1 Research Issues on Health Care Markets Martin Gaynor, Federal Trade Research (NBER) The health care industry comprises about one-fifth of the U.S. economy and is almost
OccupationalHealthCenter EnvironmentalSafetyFacility(ESF)
Kay, Mark A.
for work-related: · injuries · illnesses · medical surveillance · immunizations Environmental Health Occupational Health Center: (650) 725-5308 if event involves a work-related injury or illness. 3. Complete-Site Services Provided Medical Surveillance & Immunizations Medical surveillance is the process of evaluating
Health sciences libraries in Kuwait: a study of their resources, facilities, and services
Al-Ansari, Husain A.; Al-Enezi, Sana
The purpose of this study was to examine the current status of health sciences libraries in Kuwait in terms of their staff, collections, facilities, use of information technology, information services, and cooperation. Seventeen libraries participated in the study. Results show that the majority of health sciences libraries were established during the 1980s. Their collections are relatively small. The majority of their staff is nonprofessional. The majority of libraries provide only basic information services. Cooperation among libraries is limited. Survey results also indicate that a significant number of health sciences libraries are not automated. Some recommendations for the improvement of existing resources, facilities, and services are made. PMID:11465688
Version Date: 1/5/2012 Page 1 of 3 Cases in Public Health Communication & Marketing
Vertes, Akos
Health Communication & Marketing (CPHCM) is an online journal featuring peer- reviewed case studiesVersion Date: 1/5/2012 Page 1 of 3 Cases in Public Health Communication & Marketing Peer Review Guidelines & Manuscript Review Form About Cases in Public Health Communication & Marketing Cases in Public
Human Resources hs_pro08 Page 1 of 12 Human Resources: Health, Safety & Wellbeing
Hickman, Mark
Human Resources  hs_pro08 Page 1 of 12 Human Resources: Health, Safety & Wellbeing Protocol: Contractor Management Last Modified: September 2014 Review Date: March2015 Approved By: Sharon Butt, Health & Safety Manager Contact: Health & Safety Team Table of Contents Introduction
SmartConnect: Data connectivity for peripheral health facilities
Anderson, Richard
-visit · Target facilities with vaccine storage  Grid power or solar power  Associate the device with the refrigerator · Solar refrigerator power SmartConnect · Key use cases  Refrigerator temperature monitoring/15/2010 18NSDR 2010 #12;Power situation · Grid power generally good  Has improved in recent years (help from
A framework for addressing health issues in or near a manufacturing facility.
Collins, J J; Barbela, T; Huebner, W W; Divine, B J; Schnatter, A R; Carpenter, A V; Hearne, F T; Raabe, G K; Fayerweather, W
Clustering of health events in or around industrial facilities sometimes leads to worker and community concerns that plant management or local health professionals must address. We provide an eight-step process to deal with these concerns systematically. We emphasize the use of good scientific practices with managerial oversight for effective worker and community communication. This process is directed to plant management and the local health professional and emphasizes the practical aspects of the investigation. PMID:10693077
Strengthening health facilities for maternal and newborn care: experiences from rural eastern Uganda
Namazzi, Gertrude; Waiswa, Peter; Nakakeeto, Margaret; Nakibuuka, Victoria K.; Namutamba, Sarah; Najjemba, Maria; Namusaabi, Ruth; Tagoola, Abner; Nakate, Grace; Ajeani, Judith; Peterson, Stefan; Byaruhanga, Romano N.
Background In Uganda maternal and neonatal mortality remains high due to a number of factors, including poor quality of care at health facilities. Objective This paper describes the experience of building capacity for maternal and newborn care at a district hospital and lower-level health facilities in eastern Uganda within the existing system parameters and a robust community outreach programme. Design This health system strengthening study, part of the Uganda Newborn Study (UNEST), aimed to increase frontline health worker capacity through district-led training, support supervision, and mentoring at one district hospital and 19 lower-level facilities. A once-off supply of essential medicines and equipment was provided to address immediate critical gaps. Health workers were empowered to requisition subsequent supplies through use of district resources. Minimal infrastructure adjustments were provided. Quantitative data collection was done within routine process monitoring and qualitative data were collected during support supervision visits. We use the World Health Organization Health System Building Blocks to describe the process of district-led health facility strengthening. Results Seventy two per cent of eligible health workers were trained. The mean post-training knowledge score was 68% compared to 32% in the pre-training test, and 80% 1 year later. Health worker skills and competencies in care of high-risk babies improved following support supervision and mentoring. Health facility deliveries increased from 3,151 to 4,115 (a 30% increase) in 2 years. Of 547 preterm babies admitted to the newly introduced kangaroo mother care (KMC) unit, 85% were discharged alive to continue KMC at home. There was a non-significant declining trend for in-hospital neonatal deaths across the 2-year study period. While equipment levels remained high after initial improvement efforts, maintaining supply of even the most basic medications was a challenge, with less than 40% of health facilities reporting no stock-outs. Conclusion Health system strengthening for care at birth and the newborn period is possible even in low-resource settings and can be associated with improved utilisation and outcomes. Through a participatory process with wide engagement, training, and improvements to support supervision and logistics, health workers were able to change behaviours and practices for maternal and newborn care. Local solutions are needed to ensure sustainability of medical commodities. PMID:25843496
Assessment of human resources for health using cross-national comparison of facility surveys in six countries
Neeru Gupta; Mario R Dal Poz
BACKGROUND: Health facility assessments are being increasingly used to measure and monitor indicators of health workforce performance, but the global evidence base remains weak. Partly this is due to the wide variability in assessment methods and tools, hampering comparability across and within countries and over time. The World Health Organization coordinated a series of facility-based surveys using a common approach
Health physics manual of good practices for tritium facilities
Blauvelt, R.K.; Deaton, M.R.; Gill, J.T. [and others
The purpose of this document is to provide written guidance defining the generally accepted good practices in use at Department of Energy (DOE) tritium facilities. A {open_quotes}good practice{close_quotes} is an action, policy, or procedure that enhances the radiation protection program at a DOE site. The information selected for inclusion in this document should help readers achieve an understanding of the key radiation protection issues at tritium facilities and provide guidance as to what characterizes excellence from a radiation protection point of view. The ALARA (As Low as Reasonable Achievable) program at DOE sites should be based, in part, on following the good practices that apply to their operations.
Preventing Airborne Disease Transmission: Review of Methods for Ventilation Design in Health Care Facilities
Aliabadi, Amir A.; Rogak, Steven N.; Bartlett, Karen H.; Green, Sheldon I.
Health care facility ventilation design greatly affects disease transmission by aerosols. The desire to control infection in hospitals and at the same time to reduce their carbon footprint motivates the use of unconventional solutions for building design and associated control measures. This paper considers indoor sources and types of infectious aerosols, and pathogen viability and infectivity behaviors in response to environmental conditions. Aerosol dispersion, heat and mass transfer, deposition in the respiratory tract, and infection mechanisms are discussed, with an emphasis on experimental and modeling approaches. Key building design parameters are described that include types of ventilation systems (mixing, displacement, natural and hybrid), air exchange rate, temperature and relative humidity, air flow distribution structure, occupancy, engineered disinfection of air (filtration and UV radiation), and architectural programming (source and activity management) for health care facilities. The paper describes major findings and suggests future research needs in methods for ventilation design of health care facilities to prevent airborne infection risk. PMID:22162813
Public health response to a measles outbreak in a large correctional facility, Queensland, 2013.
Chatterji, Madhumati; Baldwin, Anne M; Prakash, Rajendra; Vlack, Susan A; Lambert, Stephen B
This report documents the prompt, co-ordinated and effective public health response to a measles outbreak in Queensland in 2013. There were 17 cases in a large, high-security, regional correctional facility, a setting with unique challenges. Recommendations are provided to reduce the likelihood and magnitude of measles outbreaks in correctional facilities. Commun Dis Intell 2014;38(4):E294-E297. PMID:25631590
An e-health solution for ambulatory facilities
Petar J. Rajkovic; Dragan S. Jankovic; Tatjana N. Stankovic
Ambulatory segment of the Serbian public health system has a complex organization and much operational inefficiency, so it needs significant information technology (IT) support to perform all its operational aspects better. Our main goal is to create software, suited to satisfy the needs of the Serbian public healthcare system. This system development experience paper presents the results of our project
Adoption and Utilization of Electronic Health Record Systems by Long-Term Care Facilities in Texas
Wang, Tiankai; Biedermann, Sue
Long-term care (LTC) is an important sector in the healthcare industry; however, the adoption of electronic health record (EHR) systems in LTC facilities lags behind that in other sectors of healthcare. This study examines the adoption and utilization of EHRs in LTC facilities in Texas and identifies the barriers preventing implementation of EHRs. A survey instrument was mailed to all Texas LTC facilities between October 2010 and March 2011. The survey found that in Texas, 39.5 percent of LTC facilities have fully or partially implemented EHR systems and 15 percent of LTC facilities have no plans to adopt EHRs yet. There is significant variation in the use of EHR functionalities across the LTC facilities in Texas. In the LTC facilities, the administrative functions of EHRs have been more widely adopted and are more widely utilized than the clinical functions of EHRs. Among the clinical functions adopted, the resident assessment, physician orders, care management plan, and census management are the leading functions used by the LTC facilities in Texas. Lack of capital resources is still the greatest barrier to EHR adoption and implementation. Policy makers, vendors, LTC administrators, educators, and researchers should make more effort to improve EHR adoption in LTC facilities. PMID:22737099
A One-Page Guide to the Health Insurance Marketplace
... you qualify, coverage can start immediately. Qualifying coverage, fees and exemptions You're considered covered if you ... must have qualifying health coverage or pay a fee . If you don't have coverage in 2015, ...
Changing with the times: reconfiguring a mental health facility in response to changing market conditions.
Bleakley, M; Holdwick, C; Deane, R P
A 130-bed private mental health hospital in Ann Arbor, Michigan, was a state-of-the-art, progressive facility when it was built in 1986. Since then, changing reimbursement patterns and the shift from inpatient to outpatient services have led to an organizational and physical reconfiguration of the facility to accommodate both mental health and chemical dependency programs. This paper describes the original design of the building and how it was modified in 1990 to achieve organizational objectives and enhance patient care. PMID:10128758
Antenatal Care as a Means of Increasing Birth in the Health Facility and Reducing Maternal Mortality: A Systematic Review
Berhan, Yifru; Berhan, Asres
Background Although there is a general agreement on the importance of antenatal care to improve the maternal and perinatal health, little is known about its importance to improve health facility delivery in developing countries. The objective of this study was to assess the association of antenatal care with birth in health facility. Methods A systematic review with meta-analysis of Mantel-Haenszel odds ratios was conducted by including seventeen small scale studies that compared antenatal care and health facility delivery between 2003 and 2013. Additionally, national survey data of African countries which included antenatal care, health facility delivery and maternal mortality in their report were included. Data were accessed via a computer based search from MEDLINE, African Journals Online, HINARI and Google Scholar databases. Results The regression analysis of antenatal care with health facility delivery revealed a positive correlation. The pooled analysis also demonstrated that woman attending antenatal care had more than 7 times increased chance of delivering in a health facility. The comparative descriptive analysis, however, demonstrated a big gap between the proportion of antenatal care and health facility delivery by the same individuals (27%–95% vs 4%–45%). Antenatal care and health facility delivery had negative correlation with maternal mortality. Conclusion The present regression and meta-analysis has identified the relative advantage of having antenatal care to give birth in health facilities. However, the majority of women who had antenatal care did not show up to a health facility for delivery. Therefore, future research needs to give emphasis to identifying barriers to health facility delivery despite having antenatal care follow up. PMID:25489186
A 'Mystery Client' Evaluation of Adolescent Sexual and Reproductive Health services in Health Facilities from Two Regions in Tanzania
Mchome, Zaina; Richards, Esther; Nnko, Soori; Dusabe, John; Mapella, Elizabeth; Obasi, Angela
Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people's access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region) trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning). The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers' mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people's efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed. PMID:25803689
A 'Mystery Client' Evaluation of Adolescent Sexual and Reproductive Health services in Health Facilities from Two Regions in Tanzania.
Mchome, Zaina; Richards, Esther; Nnko, Soori; Dusabe, John; Mapella, Elizabeth; Obasi, Angela
Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people's access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region) trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning). The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers' mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people's efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed. PMID:25803689
Food security practice in Kansas schools and health care facilities.
Yoon, Eunju; Shanklin, Carol W
This pilot study investigated perceived importance and frequency of specific preventive measures, and food and nutrition professionals' and foodservice directors' willingness to develop a food defense management plan. A mail questionnaire was developed based on the US Department of Agriculture document, Biosecurity Checklist for School Foodservice Programs--Developing a Biosecurity Management Plan. The survey was sent to food and nutrition professionals and foodservice operators in 151 acute care hospitals, 181 long-term-care facilities, and 450 school foodservice operations. Chemical use and storage was perceived as the most important practice to protect an operation and was the practice implemented most frequently. Results of the study indicate training programs on food security are needed to increase food and nutrition professionals' motivation to implement preventive measures. PMID:17258972
Determining health-care facility catchment areas in Uganda using data on malaria-related visits
Charland, Katia; Kigozi, Ruth; Dorsey, Grant; Kamya, Moses R; Buckeridge, David L
Abstract Objective To illustrate the use of a new method for defining the catchment areas of health-care facilities based on their utilization. Methods The catchment areas of six health-care facilities in Uganda were determined using the cumulative case ratio: the ratio of the observed to expected utilization of a facility for a particular condition by patients from small administrative areas. The cumulative case ratio for malaria-related visits to these facilities was determined using data from the Uganda Malaria Surveillance Project. Catchment areas were also derived using various straight line and road network distances from the facility. Subsequently, the 1-year cumulative malaria case rate was calculated for each catchment area, as determined using the three methods. Findings The 1-year cumulative malaria case rate varied considerably with the method used to define the catchment areas. With the cumulative case ratio approach, the catchment area could include noncontiguous areas. With the distance approaches, the denominator increased substantially with distance, whereas the numerator increased only slightly. The largest cumulative case rate per 1000 population was for the Kamwezi facility: 234.9 (95% confidence interval, CI: 226.2–243.8) for a straight-line distance of 5 km, 193.1 (95% CI: 186.8–199.6) for the cumulative case ratio approach and 156.1 (95% CI: 150.9–161.4) for a road network distance of 5 km. Conclusion Use of the cumulative case ratio for malaria-related visits to determine health-care facility catchment areas was feasible. Moreover, this approach took into account patients' actual addresses, whereas using distance from the facility did not. PMID:24700977
Telepsychiatry in Correctional Facilities: Using Technology to Improve Access and Decrease Costs of Mental Health Care in Underserved Populations
Deslich, Stacie Anne; Thistlethwaite, Timothy; Coustasse, Alberto
Objective: It is unclear if telepsychiatry, a subset of telemedicine, increases access to mental health care for inmates in correctional facilities or decreases costs for clinicians or facility administrators. The purpose of this investigation was to determine how utilization of telepsychiatry affected access to care and costs of providing mental health care in correctional facilities. Methods: A literature review complemented by a semistructured interview with a telepsychiatry practitioner. Five electronic databases, the National Bureau of Justice, and the American Psychiatric Association Web sites were searched for this research, and 49 sources were referenced. The literature review examined implementation of telepsychiatry in correctional facilities in Arizona, California, Georgia, Kansas, Ohio, Texas, and West Virginia to determine the effect of telepsychiatry on inmate access to mental health services and the costs of providing mental health care in correctional facilities. Results: Telepsychiatry provided improved access to mental health services for inmates, and this increase in access is through the continuum of mental health care, which has been instrumental in increasing quality of care for inmates. Use of telepsychiatry saved correctional facilities from $12,000 to more than $1 million. The semistructured interview with the telepsychiatry practitioner supported utilization of telepsychiatry to increase access and lower costs of providing mental health care in correctional facilities. Conclusions: Increasing access to mental health care for this underserved group through telepsychiatry may improve living conditions and safety inside correctional facilities. Providers, facilities, and state and federal governments can expect increased savings with utilization of telepsychiatry. PMID:24355894
The effect of health facility delivery on neonatal mortality: systematic review and meta-analysis
Background Though promising progress has been made towards achieving the Millennium Development Goal four through substantial reduction in under-five mortality, the decline in neonatal mortality remains stagnant, mainly in the middle and low-income countries. As an option, health facility delivery is assumed to reduce this problem significantly. However, the existing evidences show contradicting conclusions about this fact, particularly in areas where enabling environments are constraint. Thus, this review was conducted with the aim of determining the pooled effect of health facility delivery on neonatal mortality. Methods The reviewed studies were accessed through electronic web-based search strategy from PUBMED, Cochrane Library and Advanced Google Scholar by using combination key terms. The analysis was done by using STATA-11. I2 test statistic was used to assess heterogeneity. Funnel plot, Begg's test and Egger's test were used to check for publication bias. Pooled effect size was determined in the form of relative risk in the random-effects model using DerSimonian and Laird's estimator. Results A total of 2,216 studies conducted on the review topic were identified. During screening, 37 studies found to be relevant for data abstraction. From these, only 19 studies fulfilled the preset criteria and included in the analysis. In 10 of the 19 studies included in the analysis, facility delivery had significant association with neonatal mortality; while in 9 studies the association was not significant. Based on the random effects model, the final pooled effect size in the form of relative risk was 0.71 (95% CI: 0.54, 0.87) for health facility delivery as compared to home delivery. Conclusion Health facility delivery is found to reduce the risk of neonatal mortality by 29% in low and middle income countries. Expansion of health facilities, fulfilling the enabling environments and promoting their utilization during childbirth are essential in areas where home delivery is a common practice. PMID:23339515
Potential community and public health impacts of medically supervised safer smoking facilities for crack cocaine users
Kate Shannon; Tomiye Ishida; Robert Morgan; Arthur Bear; Megan Oleson; Thomas Kerr; Mark W Tyndall
There is growing evidence of the public health and community harms associated with crack cocaine smoking, particularly the risk of blood-borne transmission through non-parenteral routes. In response, community advocates and policy makers in Vancouver, Canada are calling for an exemption from Health Canada to pilot a medically supervised safer smoking facility (SSF) for non-injection drug users (NIDU). Current reluctance on
Quality of malaria case management at outpatient health facilities in Angola
Alexander K Rowe; Gabriel F Ponce de León; Jules Mihigo; Ana Santelli; Nathan P Miller; Pedro Van-Dúnem
BACKGROUND: Angola's malaria case-management policy recommends treatment with artemether-lumefantrine (AL). In 2006, AL implementation began in Huambo Province, which involved training health workers (HWs), supervision, delivering AL to health facilities, and improving malaria testing with microscopy and rapid diagnostic tests (RDTs). Implementation was complicated by a policy that was sometimes ambiguous. METHODS: Fourteen months after implementation began, a cross-sectional survey
University of Connecticut Health Center Page 1 of 3 John Dempsey Hospital
Oliver, Douglas L.
University of Connecticut Health Center Page 1 of 3 John Dempsey Hospital Infection Control Manual PATHOGENS POLICY: The University of Connecticut Health Center has implemented Bloodborne Pathogen Training of protective footwear when employees are working in areas where there is a danger of foot injuries due
Guiding Ebola patients to suitable health facilities: an SMS-based approach
Trad, Mohamad-Ali; Jurdak, Raja; Rana, Rajib
Access to appropriate health services is a fundamental problem in developing countries, where patients do not have access to information and to the nearest health service facility. We propose building a recommendation system based on simple SMS text messaging to help Ebola patients readily find the closest health service with available and appropriate resources. The system will map people's reported symptoms to likely Ebola case definitions and suitable health service locations. In addition to providing a valuable individual service to people with curable diseases, the proposed system will also predict population-level disease spread risk for infectious diseases using crowd-sourced symptoms from the population. Health workers will be able to better plan and anticipate responses to the current Ebola outbreak in West Africa. Patients will have improved access to appropriate health care. This system could also be applied in other resource poor or rich settings.
Profit versus public health: the need to improve the food environment in recreational facilities.
Olstad, Dana Lee; Raine, Kim D
Despite their wellness mandate, many publicly funded recreational facilities offer primarily unhealthy foods. Governments have developed programs and resources to assist facilities to improve their food offerings, however the challenge to incent preferential sale of healthier foods remains substantial. In the Canadian province of Alberta, uptake of government-issued voluntary nutrition guidelines for recreational facilities has been limited, and offers of free assistance to implement them as part of a research study were not embraced. Financial constraints appear to be the most important barrier to offering healthier items in Alberta's recreational facilities, as facility and food service managers perceive that selling healthier foods is unprofitable and might jeopardize sponsorship agreements. Mandatory government regulation may therefore be required to overcome the barriers to offering healthier foods in this setting. The advantages of a regulatory approach appear to outweigh any disadvantages, with benefits for population health, more effective use of public funds, and greater equity for the public and industry. Adverse effects on corporate profitability and freedom of choice are expected to be limited. Regulation may offer an efficient, effective and equitable means of ensuring that recreational facilities support child health and do not undermine it by exposing children to unhealthy food environments. PMID:23618211
A Preceptorship Model for Nurses in Rural Health Care Facilities. Rural Education Research Series No. 2.
ERIC Educational Resources Information Center
Pottinger, M. Enid
This report describes a preceptorship model that provides student nurses with clinical practice in rural health facilities. The development and implementation of a preceptorship model reflects a partnership between nursing education and nursing service--between the urban nursing school and the rural hospital. A five-stage preceptorship model is…
Robot assisted activity to elderly at a health service facility for the aged
Kazuyoshi WadgI; Takanori Shibata; Tomoko Saito; Kazuo Tanie
We have been developing mental commit robots that provide psychological, physiological, and social effects to human beings through physical interaction. The appearances of these robots look like real animals such as cat and seal. The seal robot was developed especially for therapy. We have applied seal robots to assisting activity of elderly people at a health service facility for the
10/13/09 5:32 PMQ&A: Dana-Farber's Paul Morrison on Running a Helicos Sequencer in a Core Facility Page 1 of 8http://www.genomeweb.com/print/925657?page=show
Sliz, Piotr
10/13/09 5:32 PMQ&A: Dana-Farber's Paul Morrison on Running a Helicos Sequencer in a Core Facility Page 1 of 8http://www.genomeweb.com/print/925657?page=show Q&A: Dana-Farber's Paul Morrison on Running, Molecular Biology Core Facilities (since 1992), Dana-Farber Cancer Institute Associate director, Molecular
Effects of health and safety problem recognition on small business facility investment
Objectives This study involved a survey of the facility investment experiences, which was designed to recognize the importance of health and safety problems, and industrial accident prevention. Ultimately, we hope that small scale industries will create effective industrial accident prevention programs and facility investments. Methods An individual survey of businesses' present physical conditions, recognition of the importance of the health and safety problems, and facility investment experiences for preventing industrial accidents was conducted. The survey involved 1,145 business operators or management workers in small business places with fewer than 50 workers in six industrial complexes. Results Regarding the importance of occupational health and safety problems (OHS), 54.1% said it was "very important". Received technical and financial support, and industrial accidents that occurred during the past three years were recognized as highly important for OHS. In an investigation regarding facility investment experiences for industrial accident prevention, the largest factors were business size, greater numbers of industrial accidents, greater technical and financial support received, and greater recognition of the importance of the OHS. The related variables that decided facility investment for industry accident prevention in a logistic regression analysis were the experiences of business facilities where industrial accidents occurred during the past three years, received technical and financial support, and recognition of the OHS. Those considered very important were shown to be highly significant. Conclusions Recognition of health and safety issues was higher when small businesses had experienced industrial accidents or received financial support. The investment in industrial accidents was greater when health and safety issues were recognized as important. Therefore, the goal of small business health and safety projects is to prioritize health and safety issues in terms of business management and recognition of importance. Therefore, currently various support projects are being conducted. However, there are issues regarding the limitations of the target businesses and inadequacies in maintenance and follow-up. Overall, it is necessary to provide various incentives for onsite participation that can lead to increased recognition of health and safety issues and practical investments, while perfecting maintenance and follow up measures by thoroughly revising existing operating systems. PMID:24472180
[Gerodontology consultation in geriatric facilities: general health status (I)].
Katsoulis, Joannis; Huber, Sandra; Mericske-Stern, Regina
Dental undertreatment is often seen in the older population. This is particularly true for the elderly living in nursing homes and geriatric hospitals. The progression of chronic diseases results in loss of their independence. They rely on daily support and care due to physical or mental impairment. The visit of a dentist in private praxis becomes difficult or impossible and is a logistic problem. These elderly patients are often not aware of oral and dental problems or these are not addressed. The geriatric hospital Bern, Ziegler, has integrated dental care in the concept of physical rehabilitation of geriatric patients. A total of 139 patients received dental treatment in the years 2005/2006. Their mean age was 83 years, but the segment with > 85 years of age amounted to 46%. The general health examinations reveald multiple and complex disorders. The ASA classification (American Society of Anesthesiologists, Physical Status Classification System) was applied and resulted in 15% = P2 (mild systemic disease, no functional limitation), 47% = P3 (severe systemic disease, definite functional limitations) and 38% = P4 (severe systemic disease, constant threat to life). Eighty-seven of the patients exhibited 3 or more chronic diseases with a prevalence of cardiovascular diseases, musculoskelettal disorders and dementia. Overall the differences between men and women were small, but broncho-pulmonary dieseases were significantly more frequent in women, while men were more often diagnosed with dementia and depression. Verbal communication was limited or not possible with 60% of the patients due to cognitive impairment or aphasia after a stroke. Although the objective treatment need is high, providing dentistry for frail and geriatric patients is characterized by risks due to poor general health conditions, difficulties in communication, limitations in feasibility and lack of adequate aftercare. In order to prevent the problem of undertreatment, elderly independently living people should undergo dental treatment regularly and in time. Training of nurses and doctors of geriatric hospitals in oral hygiene should improve the awareness. A multidisciplinary assessment of geriatric patients should include the oral and dental aspect if they enter the hospital. PMID:19227801
Behind bars: the compelling case for academic health centers partnering with correctional facilities.
Trestman, Robert L; Ferguson, Warren; Dickert, Jeff
Academic health centers (AHCs), particularly those that are publicly funded institutions, have as their mission the treatment of disadvantaged populations, the training of the next generation of clinicians, and the development and dissemination of new knowledge to reduce the burden of disease and improve the health of individuals and populations. Incarcerated populations have the most prevalent and acute disease burden and health disparities in the United States, even in comparison with inner-city populations. Yet, only a small proportion of AHCs have reached out to incarcerated populations to fulfill their mission. Those AHCs that have partnered with correctional facilities have overcome concerns about the value and popularity of "training behind bars"; the cost, liability, and pragmatics of caring for a medically complicated population; and the viability of correctional health research and extramural research funding. They have done so to great benefit to patients, students, and faculty. Partnering with correctional facilities to provide health care offers opportunities for AHCs to fulfill their core missions of clinical service, education, and research, while also enhancing their financial stability, to the benefit of all. In this Commentary, the authors discuss, based on their experiences, these concerns, how existing partnerships have overcome them, and the benefits of such relationships to both AHCs and correctional facilities. PMID:25054416
Health Facilities Safety in Natural Disasters: Experiences and Challenges from South East Europe
Radovic, Vesela; Vitale, Ksenija; Tchounwou, Paul B.
The United Nations named 2010 as a year of natural disasters, and launched a worldwide campaign to improve the safety of schools and hospitals from natural disasters. In the region of South East Europe, Croatia and Serbia have suffered the greatest impacts of natural disasters on their communities and health facilities. In this paper the disaster management approaches of the two countries are compared, with a special emphasis on the existing technological and legislative systems for safety and protection of health facilities and people. Strategic measures that should be taken in future to provide better safety for health facilities and populations, based on the best practices and positive experiences in other countries are recommended. Due to the expected consequences of global climate change in the region and the increased different environmental risks both countries need to refine their disaster preparedness strategies. Also, in the South East Europe, the effects of a natural disaster are amplified in the health sector due to its critical medical infrastructure. Therefore, the principles of environmental security should be implemented in public health policies in the described region, along with principles of disaster management through regional collaborations. PMID:22754465
Environmental Assessment for the Health Protection Instrument Calibration Facility at the Savannah River Site
Not Available
The purpose of this Environmental Assessment (EA) is to review the possible environmental consequences associated with the construction and operation of a Health Protection Instrument Calibration Facility on the Savannah River Site (SRS). The proposed replacement calibration facility would be located in B Area of SRS and would replace an inadequate existing facility currently located within A Area of SRS (Building 736-A). The new facility would provide laboratories, offices, test equipment and the support space necessary for the SRS Radiation Monitoring Instrument Calibration Program to comply with DOE Orders 5480.4 (Environmental Protection, Safety and Health Protection Standards) and 5480.11 (Radiation Protection for Occupational Workers). The proposed facility would serve as the central site source for the evaluation, selection, inspection, testing, calibration, and maintenance of all SRS radiation monitoring instrumentation. The proposed facility would be constructed on a currently undeveloped portion in B Area of SRS. The exact plot associated with the proposed action is a 1.2 hectare (3 acre) tract of land located on the west side of SRS Road No. 2. The proposed facility would lie approximately 4.4 km (2.75 mi) from the nearest SRS site boundary. The proposed facility would also lie within the confines of the existing B Area, and SRS safeguards and security systems. Archaeological, ecological, and land use reviews have been conducted in connection with the use of this proposed plot of land, and a detailed discussion of these reviews is contained herein. Socioeconomic, operational, and accident analyses were also examined in relation to the proposed project and the findings from these reviews are also contained in this EA.
Fairness of utilizing health care facilities and out-of-pocket payment burden: evidence from Cambodia.
Dalal, Koustuv; Aremu, Olatunde
Catastrophic spending on health care through out-of-pocket payment is a huge problem in most low- and middle-income countries all over the world. The collapse of health systems and poverty have resulted in the proliferation of the private health sector in Cambodia, but very few studies have examined the fairness in ease of utilization of these services based on mode of payment. This study examined the utilization of health services for sickness or injury and identified its relationship with people's ability to pay for treatment seeking at various instances. Based on cross-sectional data from the Cambodian 2007 Demographic and Health Survey, the economic index estimated through principal component analysis and Lorenz curve was used to quantify the degree of fairness and equality in utilization and payment burden among the respondents. A distinct level of fairness was found in health care utilization and out-of-pocket payments. Specifically, use of private health care facilities and over-the-counter remedies dominate, and out-of-pocket payments cut across all socioeconomic strata. As many countries in low- and middle-income regions, and most importantly those in transition such as Cambodia, are repositioning their health systems, efforts should be made towards maintaining equitable access through adoption of finance mechanisms that make utilization of health care services fair and equitable. PMID:22958391
Delivering enhanced cardiovascular (Hypertension) disease care through private health facilities in Pakistan
Background Cardiovascular diseases (CVDs) are one of the leading causes of death and disability in the world. Over 80% of CVD deaths take place in low-and middle-income countries. One-third of the population aged above 40 years suffers from Hypertension (HTN) and this is largely unreported as there is no registry for CVDs. No guidelines are available for use in health care facilities, especially private health facilities where practice among GPs varies considerably. We aim to conduct a Cluster Randomized Controlled trial delivering a quality HTN-CVD care package at strengthened private health facilities as compared to current practice at private health facilities. Methods/Design A pragmatic cluster randomized trial, with qualitative and economic studies, will be conducted in Sargodha district of Punjab, Pakistan, from January 2012 to December 2016. At least 912 hypertensives will be registered in the two arms, six clusters per arm. The proposed cluster randomized controlled trial will evaluate the effects of delivering quality HTN-CVD care, through enabled private health care facilities, to achieve better case registration, adherence and hypertension control also blood glucose and serum cholesterol control. The trial will be conducted through the doctors and paramedics at private health facilities. Main outcomes are mean difference in Systolic blood pressure among the two arms. Secondary outcomes are mean change in total serum cholesterol levels and mean change in glycaemic control achieved in the adult hypertensive patients. Individual and Cluster level analysis will be done according to intention-to-treat. Discussion Due to the high burden of disease where 1 in 3 individuals aged above 45 suffers from hypertension, topped with the fact that there is a dearth of a set of available, standardised guidelines for management, the disease is constantly on a hike in Pakistan. The government has made no effort to issue a set of guidelines adapted specifically for our population and this becomes more of a problem when managing CVD in urban population through private practitioners whose practices vary widely.If our set of context sensitive guidelines show an effectiveness in the proposed intervention districts it will be replicated in other such settings. Trial registration Current Controlled Trials ISRCTN34381594 PMID:24066730
Appraisal of Supervisor's Attitude and Managerial Performance in Health Care Facilities-Mashhad-2007
NASA Astrophysics Data System (ADS)
Vafaee, A.; Majdi, M.; Kabazkhoob, M.
This is an applied, cross-sectional descriptive research which includes all supervisors and Staffs in Mashhad health care facilities. It was used of 2 different questionnaires. Data was gathered and then had been coded and analyzed with SPSS software and t-test. In practice, the maximum notice of administrations was to organization and the minimum one referred to assessment. Between administration attitudes and their performance about planning and assessment was a significant direction positive but there was a significant difference about organization between these groups. The length of services of employee's was the only factor that was effective about the administration performance. The finding depicted that supervisor's performance evaluation as one of the most effective recognition and control methods and has an important role and is effective in promoting productivity of services in health care facilities.
Psychiatric components of a Health Maintenance Facility (HMF) on Space Station
NASA Technical Reports Server (NTRS)
Santy, Patricia A.
The operational psychiatric requirements for a comprehensive Health Maintenance Facility (HMF) on a permanently manned Space Station are examined. Consideration is given to the psychological health maintenance program designed for the diagnosis of mental distress in astronauts during flight and for prevention of mental breakdown. The types of mental disorders that can possibly affect the astronauts in flight are discussed, including various organic, psychotic, and affective mental disorders, as well as anxiety, adjustment, and somatoform/dissociative disorders. Special attention is given to therapeutic considerations for psychiatric operations on Space Station, such as restraints, psychopharmacology, psychotherapy, and psychosocial support.
Collaboration with behavioral health care facilities to implement systemwide tobacco control policies--California, 2012.
Gordon, Lauren; Modayil, Mary V; Pavlik, Jim; Morris, Chad D
The California Tobacco Control Program (CTCP) administered 4 regional trainings in 2012 to staffers at CTCP-funded projects, tobacco control coalitions, several county departments of mental health and alcohol and drug, and administrators and providers from behavioral health care facilities. These trainings focused on the special tobacco use cessation needs and opportunities for cessation among persons with mental illness or substance abuse disorders, and they provided information about cessation and smoke-free policies. CTCP surveyed county and private behavioral health care programs to assess their readiness for adopting tobacco control strategies at treatment facilities. Between baseline and follow-up we found a decrease in the proportion of organizations at the precontemplation or contemplation stages of change and twice as many organizations at the action and maintenance stages of change. Significant obstacles remain to implementing policy: many agencies have concerns about going tobacco-free. But significant progress has been made, as evidenced by new policies and a growing number of tobacco-free coalitions consisting of public health agencies, behavioral health care agencies, and local hospitals. PMID:25654218
Collaboration With Behavioral Health Care Facilities to Implement Systemwide Tobacco Control Policies — California, 2012
Gordon, Lauren; Modayil, Mary V.; Pavlik, Jim
The California Tobacco Control Program (CTCP) administered 4 regional trainings in 2012 to staffers at CTCP-funded projects, tobacco control coalitions, several county departments of mental health and alcohol and drug, and administrators and providers from behavioral health care facilities. These trainings focused on the special tobacco use cessation needs and opportunities for cessation among persons with mental illness or substance abuse disorders, and they provided information about cessation and smoke-free policies. CTCP surveyed county and private behavioral health care programs to assess their readiness for adopting tobacco control strategies at treatment facilities. Between baseline and follow-up we found a decrease in the proportion of organizations at the precontemplation or contemplation stages of change and twice as many organizations at the action and maintenance stages of change. Significant obstacles remain to implementing policy: many agencies have concerns about going tobacco-free. But significant progress has been made, as evidenced by new policies and a growing number of tobacco-free coalitions consisting of public health agencies, behavioral health care agencies, and local hospitals. PMID:25654218
Compliance with infection prevention and control in oral health-care facilities: a global perspective.
Oosthuysen, Jeanné; Potgieter, Elsa; Fossey, Annabel
Many publications are available on the topic of compliance with infection prevention and control in oral health-care facilities all over the world. The approaches of developing and developed countries show wide variation, but the principles of infection prevention and control are the same globally. This study is a systematic review and global perspective of the available literature on infection prevention and control in oral health-care facilities. Nine focus areas on compliance with infection-control measures were investigated: knowledge of infectious occupational hazards; personal hygiene and care of hands; correct application of personal protective equipment; use of environmental barriers and disposable items; sterilisation (recirculation) of instruments and handpieces; disinfection (surfaces) and housekeeping; management of waste disposal; quality control of dental unit waterlines, biofilms and water; and some special considerations. Various international studies from developed countries have reported highly scientific evidence-based information. In developed countries, the resources for infection prevention and control are freely available, which is not the case in developing countries. The studies in developing countries also indicate serious shortcomings with regard to infection prevention and control knowledge and education in oral health-care facilities. This review highlights the fact that availability of resources will always be a challenge, but more so in developing countries. This presents unique challenges and the opportunity for innovative thinking to promote infection prevention and control. PMID:25244364
Regional health care planning: a methodology to cluster facilities using community utilization patterns
Background Community-based health care planning and regulation necessitates grouping facilities and areal units into regions of similar health care use. Limited research has explored the methodologies used in creating these regions. We offer a new methodology that clusters facilities based on similarities in patient utilization patterns and geographic location. Our case study focused on Hospital Groups in Michigan, the allocation units used for predicting future inpatient hospital bed demand in the state's Bed Need Methodology. The scientific, practical, and political concerns that were considered throughout the formulation and development of the methodology are detailed. Methods The clustering methodology employs a 2-step K-means + Ward's clustering algorithm to group hospitals. The final number of clusters is selected using a heuristic that integrates both a statistical-based measure of cluster fit and characteristics of the resulting Hospital Groups. Results Using recent hospital utilization data, the clustering methodology identified 33 Hospital Groups in Michigan. Conclusions Despite being developed within the politically charged climate of Certificate of Need regulation, we have provided an objective, replicable, and sustainable methodology to create Hospital Groups. Because the methodology is built upon theoretically sound principles of clustering analysis and health care service utilization, it is highly transferable across applications and suitable for grouping facilities or areal units. PMID:23964905
Uchendu, O.C.; Ilesanmi, O.S.; Olumide, A.E.
Background: There is increasing interest in the choice of health care providing facility in Nigeria. Objectives: This study aimed to assess the factors influencing choice and satisfaction with health service providers among local government staff. Methods: A cross sectional survey of all 312 workers in a Local Government Secretariat in South West Nigeria was done. Chi Square and logistic regression analysis was done. Results: The mean age was 38.6 ± 7.5 years, 55% were females and 71.7% had tertiary education. The median monthly family income of the respondents was N 28, 000 (N3,000 – N500,000), with 24.4% earning a monthly income of N21, 000 to N30, 000. Many (72.3%) utilized public health facilities attributing the choice to the low cost of services. Respondents who are satisfied with their usual care providing facilities are 12.2 times more likely to have used public facilities than private facilities (95%, CI 3.431 – 43.114). Respondents who described the quality with ease of getting care/short waiting times as being good are 3.9 times more likely to have private facilities as their chosen health care providing facility (95%, CI 1.755 – 8.742). Cost/payment for service is 2.9 times more likely to predict the use of public health facility as the usual health care provider. Conclusion: Private facilities though costlier do not appear to be providing better services than public facilities. To increase access to health care the cost of services and the waiting time are important factors to address. PMID:25161426
Occupational traumatic injuries among workers in health care facilities - United States, 2012-2014.
Gomaa, Ahmed E; Tapp, Loren C; Luckhaupt, Sara E; Vanoli, Kelly; Sarmiento, Raymond Francis; Raudabaugh, William M; Nowlin, Susan; Sprigg, Susan M
In 2013, one in five reported nonfatal occupational injuries occurred among workers in the health care and social assistance industry, the highest number of such injuries reported for all private industries. In 2011, U.S. health care personnel experienced seven times the national rate of musculoskeletal disorders compared with all other private sector workers. To reduce the number of preventable injuries among health care personnel, CDC's National Institute for Occupational Safety and Health (NIOSH), with collaborating partners, created the Occupational Health Safety Network (OHSN) to collect detailed injury data to help target prevention efforts. OHSN, a free, voluntary surveillance system for health care facilities, enables prompt and secure tracking of occupational injuries by type, occupation, location, and risk factors. This report describes OHSN and reports on current findings for three types of injuries. A total of 112 U.S. facilities reported 10,680 OSHA-recordable* patient handling and movement (4,674 injuries); slips, trips, and falls (3,972 injuries); and workplace violence (2,034 injuries) injuries occurring from January 1, 2012-September 30, 2014. Incidence rates for patient handling; slips, trips, and falls; and workplace violence were 11.3, 9.6, and 4.9 incidents per 10,000 worker-months,† respectively. Nurse assistants and nurses had the highest injury rates of all occupations examined. Focused interventions could mitigate some injuries. Data analyzed through OHSN identify where resources, such as lifting equipment and training, can be directed to potentially reduce patient handling injuries. Using OHSN can guide institutional and national interventions to protect health care personnel from common, disabling, preventable injuries. PMID:25905893
Physical Exposure to Seismic Hazards of Health Facilities in Mexico City, Mexico
NASA Astrophysics Data System (ADS)
Rodriguez, S. M.; Novelo Casanova, D.
Although health facilities are essential infrastructure during disasters and emergencies, they are also usually highly vulnerable installations in the case of the occurrence of large and major earthquakes. Hospitals are one of the most complex critical facilities in modern cities and they are used as first response in emergency situations. The operability of a hospital must be maintained after the occurrence of a local strong earthquake in order to satisfy the need for medical care of the affected population. If a health facility is seriously damaged, it cannot fulfill its function when most is needed. In this case, hospitals become a casualty of the disaster. To identify the level of physical exposure of hospitals to seismic hazards in Mexico City, we analyzed their geographic location with respect to the seismic response of the different type of soils of the city from past earthquakes, mainly from the events that occurred on September 1985 (Ms= 8.0) and April 1989 (Ms= 6.9). Seismic wave amplification in this city is the result of the interaction of the incoming seismic waves with the soft and water saturated clay soils, on which a large part of Mexico City is built. The clay soils are remnants of the lake that existed in the Valley of Mexico and which has been drained gradually to accommodate the growing urban sprawl. Hospital facilities were converted from a simple database of names and locations into a map layer of resources. This resource layer was combined with other map layers showing areas of seismic microzonation in Mexico City. This overlay was then used to identify those hospitals that may be threatened by the occurrence of a large or major seismic event. We analyzed the public and private hospitals considered as main health facilities. Our results indicate that more than 50% of the hospitals are highly exposed to seismic hazards. Besides, in most of these health facilities we identified the lack of preventive measures and preparedness to reduce their vulnerability. For proper interpretation, our results are also presented in a Geographical Information System (GIS) that provides elements to support government plans to mitigate the impact of future earthquakes.
Waiving Health Insurance Last changed on: 1/11/2010 10:15:00 AM Page 1
Rollins, Andrew M.
Waiving Health Insurance Last changed on: 1/11/2010 10:15:00 AM Page 1 Waiving Health Insurance Concept This business process demonstrates how to waive the student health insurance fee. You must be enrolled in a class in order to waive the health insurance fee. This fee is charged in the Fall and Spring
2013 StudentHealthInsurance Page1 NorthwesternUniversity CAESAR/SES Updated:7/11/2013
Shahriar, Selim
©2013 StudentHealthInsurance Page1 NorthwesternUniversity CAESAR/SES Updated:7/11/2013 SES/CAESAR v ____________________________________________________________________________________________________________ Student Health Insurance: Instructions for Entering Student Health Insurance Information in CAESAR Follow the instructions below to enroll in or waive the NU-sponsored, Aetna student health insurance on CAESAR. Step 1
Revised January 2008 Page 1 of 1 University of Tennessee Health Science Center
Cui, Yan
Revised January 2008 Page 1 of 1 University of Tennessee Health Science Center Laboratory Animal: 20 X 10 X 30 white plastic bag 1.5 mil The Laboratory Animal Care Unit (LACU) has purchased chosen as they are inexpensive, durable, opaque and of appropriate size. The use of yellow PPE gowns
THE UNIVERSITY OF CONNECTICUT HEALTH CENTER Page 1 of 19 DEPARTMENT OF NURSING -STRUCTURE STANDARDS
Oliver, Douglas L.
THE UNIVERSITY OF CONNECTICUT HEALTH CENTER Page 1 of 19 DEPARTMENT OF NURSING - STRUCTURE of Nursing Services a. Clinical: The nursing staff provides for the nursing care needs of acute patients and newborns/neonates. Children receive emergency and ambulatory surgical care. The practice of nursing
Keynote Paper, Shah, Page 1/13 HEALTH MONITORING OF EARLY AGE CONCRETE
Keynote Paper, Shah, Page 1/13 HEALTH MONITORING OF EARLY AGE CONCRETE Thomas Voigt, Zhihui Sun The setting and hardening process of concrete can be considered as the most critical time period during the life of a concrete structure. To assure high quality and avoid problems in performance throughout
Current status of sharps waste management in the lower-level health facilities in Tanzania.
Manyele, Samwel V; Mujuni, Churchil M
Sharps waste is part of infectious medical waste, management of which is a critical problem in Tanzanian health facilities. This study aimed at assessing the current status of sharps waste management in lower level health facilities (LLHFs) in Ilala Municipality in Tanzania. In this study a sample of 135 LLHFs (103 dispensaries, 13 clinics, 11 laboratories, and 8 health centers) was involved. The average number of workers per facility was 10, with positively skewed probability density function (up to 80 workers). The average patient-to-workers ratio was 5.87. About 59% of the LLHFs improvised sharps waste containers (SWCs). Sharps waste was transported by hands in 77% of LLHFs leading to high risks of exposure to needle stick injuries. Boots, aprons and masks were among the personal protective equipment (PPE) missing in most LLHFs, while latex gloves that cannot protect workers from injuries caused by sharps waste were readily available. Most facilities stored sharps waste for about 72 hours (before treatment), which is beyond the recommended maximum storage time of 24 hours. About 39.3% of LLHFs utilized on-site single-chamber incinerators for sharps waste treatment, which are of poor design, have rusted mechanical parts, short and rusted chimneys, and without automatic flame ignition burners. It is concluded that sharps waste management in LLHFs is poor, which puts workers, the public and the environment at risk of exposure to blood-borne pathogens. It is, therefore, important that the municipality should establish a waste processing center which will collect and incinerate all sharps waste. PMID:24409634
Health care facilities' "war on terrorism": a deliberate process for recommending personal protective equipment.
Koenig, Kristi L; Boatright, Connie J; Hancock, John A; Denny, Frank J; Teeter, David S; Kahn, Christopher A; Schultz, Carl H
The protection of health care facility (HCF) staff from the effects of weapons of mass destruction has gained heightened attention since the 9-11 terrorist attacks. One critical component of protection is personal protective equipment (PPE). No universal standard exists for an "essential" level of PPE for HCF staff. The absence of such a standard raises the need for development of national policy for PPE levels, particularly in HCFs. We describe a process used by the Veterans Health Administration for recommending policy for "essential" PPE levels. Although the recommendations are specific for Veterans Health Administration, the process, findings, and applications may be useful to other institutions as they attempt to resolve this critical issue. This descriptive account will serve to generate practical scientific debate in the academic community and lead to definitive public policy recommendations for the Nation's HCFs in executing their roles in the event of a terrorist attack. PMID:17276809
Assessment of community mobilization and home-based HIV counselling and testing offered by health facilities in rural Uganda.
Shumba, Constance S; Atuhaire, Lydia; Memiah, Peter; Atukunda, Ruth
Home-based HIV counselling and testing (HBHCT) and community mobilization have been proven to be effective in increasing the number of people linked to HIV care and treatment. An assessment was conducted in 18 health facilities in Uganda to evaluate the availability and extent of home based testing services and community mobilization activities in underserved communities. The performance of the health facilities was assessed using a checklist with indicators of HBHCT and community mobilization. While most of the health facilities (72.2%) had active community mobilization, only 12.2% had HBHCT services and this might have affected universal access to HIV prevention, care and treatment. The health facilities did not accompany their intensive community mobilization activities with HBHCT yet this provided the ideal entry point and opportunity to improve linkage to HIV treatment and care. PMID:24689329
7 CFR 353.9 - Standards for accreditation of non-government facilities to perform laboratory seed health...
Code of Federal Regulations, 2010 CFR
...Manual B. The facility must have a quality manual documenting its quality system for laboratory seed health testing and seed crop phytosanitary inspection procedures. The quality system must follow the general...
The report describes the multi-user radiofrequency radiation exposure facilities for bio-effects research in use at the Health Effects Research Laboratory, Research Triangle Park, NC. Four facilities are described: (1) a 100 MHz CW exposure system, (2) a 2450 MHz CW exposure syst...
Work plan, health and safety plan, and site characterization for the Waste Coolant Processing Facility (T-038)
D. E. Bohrman; M. S. Uziel; D. C. Landguth; S. W. Hawthorne
As part of the Resource Conservation and Recovery Act (RCRA) Facility Investigation (RFI) of the Department of Energy's Y-12 Plant located in Oak Ridge, Tennessee, this work plan has been developed for theWaste Coolant Processing Facility (T-038). The work plan was developed by the Measurement Applications and Development Group (MAD) of the Health and Safety Research Division (HASRD) at Oak
Long-term robot therapy in a health service facility for the aged - A case study for 5 years -
Kazuyoshi Wada; Takanori Shibata; Yukitaka Kawaguchi
A long-term experiment of robot therapy for elderly people has been conducted at a health service facility for the aged since Aug. 2003. Three therapeutic seal robots, Paro, were introduced there. This paper describes the results of the experiment for five year. We regularly visited the facility twice or once a month and observed their interaction with the robots. Moreover,
Using geographical information systems for defining the accessibility to health care facilities in Jeddah City, Saudi Arabia.
Murad, Abdulkader A
Spatial data play an important role in the planning of health care facilities and their allocation. Today, geographical information systems (GIS) provide useful techniques for capturing, maintaining and analysing health care spatial data; indeed health geoinformatics is an emerging discipline that uses innovative geospatial technology to investigate health issues. The purpose of this paper is to define how GIS can be used for assessing the level of accessibility to health care. The paper identifies the advantages of using GIS in health care planning and covers GIS-based international accessibility with a focus on GIS applications for health care facilities in Jeddah city, Saudi Arabia. A geodatabase that includes location of health services, road networks, health care demand and population districts was created using ArcGIS software. The geodatabase produced is based on collected data and covers issues, such as defining the spatial distribution of health care facilities, evaluating health demand types and modelling health service areas based on analysis of driving-time and straight-line distances. PMID:25599637
Accessibility to health care facilities in Montreal Island: an application of relative accessibility indicators from the perspective of senior and non-senior residents
Antonio Paez; Ruben G Mercado; Steven Farber; Catherine Morency; Matthew Roorda
BACKGROUND: Geographical access to health care facilities is known to influence health services usage. As societies age, accessibility to health care becomes an increasingly acute public health concern. It is known that seniors tend to have lower mobility levels, and it is possible that this may negatively affect their ability to reach facilities and services. Therefore, it becomes important to
Household Decision-making about Delivery in Health Facilities: Evidence from Tanzania
Danforth, E.J.; Rockers, P.C.; Mbaruku, G; Galea, S
This study investigated how partners' perceptions of the healthcare system influence decisions about delivery-location in low-resource settings. A multistage population-representative sample was used in Kasulu district, Tanzania, to identify women who had given birth in the last five years and their partners. Of 826 couples in analysis, 506 (61.3%) of the women delivered in the home. In multivariate analysis, factors associated with delivery in a health facility were agreement of partners on the importance of delivering in a health facility and agreement that skills of doctors are better than those of traditional birth attendants. When partners disagreed, the opinion of the woman was more influential in determining delivery-location. Agreement of partners regarding perceptions about the healthcare system appeared to be an important driver of decisions about delivery-location. These findings suggest that both partners should be included in the decision-making process regarding delivery to raise rates of delivery at facility. PMID:19902806
Preparedness of Tanzanian health facilities for outpatient primary care of hypertension and diabetes: a cross-sectional survey
Peck, Robert; Mghamba, Janneth; Vanobberghen, Fiona; Kavishe, Bazil; Rugarabamu, Vivian; Smeeth, Liam; Hayes, Richard; Grosskurth, Heiner; Kapiga, Saidi
Summary Background Historically, health facilities in sub-Saharan Africa have mainly managed acute, infectious diseases. Few data exist for the preparedness of African health facilities to handle the growing epidemic of chronic, non-communicable diseases (NCDs). We assessed the burden of NCDs in health facilities in northwestern Tanzania and investigated the strengths of the health system and areas for improvement with regard to primary care management of selected NCDs. Methods Between November, 2012, and May, 2013, we undertook a cross-sectional survey of a representative sample of 24 public and not-for-profit health facilities in urban and rural Tanzania (four hospitals, eight health centres, and 12 dispensaries). We did structured interviews of facility managers, inspected resources, and administered self-completed questionnaires to 335 health-care workers. We focused on hypertension, diabetes, and HIV (for comparison). Our key study outcomes related to service provision, availability of guidelines and supplies, management and training systems, and preparedness of human resources. Findings Of adult outpatient visits to hospitals, 58% were for chronic diseases compared with 20% at health centres, and 13% at dispensaries. In many facilities, guidelines, diagnostic equipment, and first-line drug therapy for the primary care of NCDs were inadequate, and management, training, and reporting systems were weak. Services for HIV accounted for most chronic disease visits and seemed stronger than did services for NCDs. Ten (42%) facilities had guidelines for HIV whereas three (13%) facilities did for NCDs. 261 (78%) health workers showed fair knowledge of HIV, whereas 198 (59%) did for hypertension and 187 (56%) did for diabetes. Generally, health systems were weaker in lower-level facilities. Front-line health-care workers (such as non-medical-doctor clinicians and nurses) did not have knowledge and experience of NCDs. For example, only 74 (49%) of 150 nurses had at least fair knowledge of diabetes care compared with 85 (57%) of 150 for hyptertension and 119 (79%) of 150 for HIV, and only 31 (21%) of 150 had seen more than five patients with diabetes in the past 3 months compared with 50 (33%) of 150 for hypertension and 111 (74%) of 150 for HIV. Interpretation Most outpatient services for NCDs in Tanzania are provided at hospitals, despite present policies stating that health centres and dispensaries should provide such services. We identified crucial weaknesses (and strengths) in health systems that should be considered to improve primary care for NCDs in Africa and identified ways that HIV programmes could serve as a model and structural platform for these improvements. Funding UK Medical Research Council. PMID:24818084
Factors determining intention to quit tobacco: exploring patient responses visiting public health facilities in India
Introduction Intention to quit and setting a quit date are key steps in the process towards improving quit rates and are thus an integral part of tobacco cessation efforts. The present study examined various motivating factors of "intention to quit" and "setting a quit date" in patients visiting public health facilities in two states of India. Methods A total of 1569 tobacco-users visiting public health facilities in 12 districts of the states of Andhra Pradesh and Gujarat were assessed through an interviewer-administered questionnaire. Bivariate and multivariable logistic regression was performed to assess the effect of socio-demographic characteristics, nicotine dependence, previous quit attempts and motivational factors on "intention to quit within 30 days" and "setting a quit date". Results Only 12% of patients intended to quit tobacco within 30 days and about 11% of them were ready to set a quit date. Respondents aged above 25 years were 53% less likely to quit tobacco within 30 days when compared to those below 25 years (95% Confidence Intervals [CI]: 0.22 to 0.99). Smokeless tobacco users were associated with an odds ratio (OR) of 2.05 (95% CI: 1.15 to 3.65) for "setting a quit date" when compared to smokers. Those with 1 to 5 previous quit attempts (in the past twelve months) were associated with an OR of 2.2 (95% CI: 1.38 to 3.51) for "intention to quit" and 2.46 (95% CI: 1.52 to 3.96) for "setting a quit date". "Concern for personal health" and "setting an example for children" were associated with ORs of 3.42 (95% CI: 1.35 to 8.65) and 2.5 (95% CI: 1.03 to 6.03) respectively for "setting a quit date". Conclusions This study is amongst the first in India to explore factors associated with the "intention to quit" and "setting a quit date" among patients visiting public health facilities. Our findings suggest that socio-economic and individual-level factors are important factors depicting intention to quit and setting a quit date. We recommend the need for well-defined studies to understand the long term effects of factors influencing tobacco cessation for patients visiting public health facilities in India. PMID:24444137
DOE standard: Integration of environment, safety, and health into facility disposition activities. Volume 2: Appendices
This volume contains the appendices that provide additional environment, safety, and health (ES and H) information to complement Volume 1 of this Standard. Appendix A provides a set of candidate DOE ES and H directives and external regulations, organized by hazard types that may be used to identify potentially applicable directives to a specific facility disposition activity. Appendix B offers examples and lessons learned that illustrate implementation of ES and H approaches discussed in Section 3 of Volume 1. Appendix C contains ISMS performance expectations to guide a project team in developing and implementing an effective ISMS and in developing specific performance criteria for use in facility disposition. Appendix D provides guidance for identifying potential Applicable or Relevant and Appropriate Requirements (ARARs) when decommissioning facilities fall under the Comprehensive Environmental Response, Compensation, Liability Act (CERCLA) process. Appendix E discusses ES and H considerations for dispositioning facilities by privatization. Appendix F is an overview of the WSS process. Appendix G provides a copy of two DOE Office of Nuclear Safety Policy and Standards memoranda that form the bases for some of the guidance discussed within the Standard. Appendix H gives information on available hazard analysis techniques and references. Appendix I provides a supplemental discussion to Sections 3.3.4, Hazard Baseline Documentation, and 3.3.6, Environmental Permits. Appendix J presents a sample readiness evaluation checklist.
LABORATORY SAFETY CHECKLIST Department of Environment, Health and Safety v.1.9 July 2014 Page 1
Machel, Hans
CHECKLIST Department of Environment, Health and Safety v.1.9 July 2014 Page 2 g) Containers used to storeLABORATORY SAFETY CHECKLIST Department of Environment, Health and Safety v.1.9 July 2014 Page 1 located within the lab. 2 Hazard Specific Signage: a) Containers used to store radioactive material
Induced Abortion and Associated Factors in Health Facilities of Guraghe Zone, Southern Ethiopia
Hambisa, Mitiku Teshome; Semahegn, Agumasie
Unsafe abortion is one of the major medical and public health problems in developing countries including Ethiopia. However, there is a lack of up-to-date and reliable information on induced abortion distribution and its determinant factors in the country. This study was intended to assess induced abortion and associated factors in health facilities of Guraghe zone, Southern Ethiopia. Institution based cross-sectional study was conducted in eight health facilities in Guraghe zone. Client exit interview was conducted on 400 patients using a structured questionnaire. Bivariate and multivariate logistic regression analysis was performed to identify factors associated with induced abortion. Out of 400 women, 75.5% responded that the current pregnancy that ended in abortion is unwanted. However, only 12.3% of the respondents have admitted interference to the current pregnancy. Having more than four pregnancies (AOR?=?4.28, CI: (1.24–14.71)), age of 30–34 years (AOR?=?0.15, CI: (0.04–0.55)), primary education (AOR?=?0.26, CI: (0.13–0.88)), and wanted pregnancy (AOR?=?0.44, CI: (0.14–0.65)) were found to have association with induced abortion. The study revealed high level of induced abortion which is underpinned by high magnitude of unwanted pregnancy. There is requirement for widespread expansion of increased access to high quality family planning service and post-abortion care. PMID:24800079
Going digital: adoption of electronic health records in assisted living facilities.
Holup, Amanda A; Dobbs, Debra; Temple, April; Hyer, Kathryn
This pilot study examines the associations between structural characteristics and the adoption and subsequent use of electronic health records (EHR; resident demographics, clinical notes, medication lists, problem lists, discharge summaries, and advance directives) as a process characteristic in assisted living facilities (ALFs). The study is guided conceptually by Donabedian's Structure-Process-Outcome (SPO) model. Primary survey data were collected from a randomly selected sample (N = 76) in Florida during 2009-2010. Analysis included descriptive and bivariate statistics. Descriptive results indicated that ALFs most frequently used an EHR to record medication lists. Characteristics, including size, profit status, resident case mix, and staffing, were associated at the bivariate level with the use of one or more functional domains of an EHR. Thus, the use of EHRs in ALFs is correlated with facility characteristics. PMID:24781968
Chapter 12 -Facilities -Uses and Priorities Page 12-1 Code of Policies
Gering, Jon C.
. 3. Effective February 8, 2014 smoking of materials other than tobacco products is prohibited FACILITIES - USES AND PRIORITIES Sections: 12.010. General 12.020. Guest Speakers 12.030. Tobacco Compilation: Article 14 12.030. Tobacco and Substance Use Restrictions. The use of tobacco in buildings
[Addressing the Sexual Health of Severe Mentally Ill People in Residential Facilities: A Pilot Study on the Perspective of Professionals.
Carreiro da Costa Faria E Melo Höfle, Mariana; Degano Kieser, Luciana
Aim: The study explores the perspectives of Mental Health Care Professionals on the importance of Sexual Health promotion of severe mentally ill people in Mental Health Care. Methodology: A qualitative approach was used. Eight semi-structured Problem Centred Interviews were conducted in August 2012 in two residential facilities in Berlin. Results: Participants are aware of the importance of Sexual Health in the psychosocial rehabilitation process. However, they believe Sexual Health Promotion is yet to be acknowledged as a legitimate Mental Health care issue. Conclusions: Sexual Health Promotion is poorly integrated in Mental Health Care practice. However, sexuality contributes strongly to the health and quality of life of users. Adequate guidelines on Sexual Health Promotion are not available and are urgently needed. PMID:25347419
Interactions between Native American Women and Their White Male Doctor: The Stages of a Health Care Visit at a Public Health Facility
Lynda Dee Dixon
This paper analyzes the stages of health care visits between a White male doctor and Native American women at a public health facility. The seven stages provide a framework of analysis wherein conflict between the patients and physician emerges. The nonsequential organizing features of the medical visit emerged during analysis using perspectival rhetorical analysis of audio-tape recordings and verbatim transcripts
page 1Student Health and Counseling Services Resource Guide: 2013-2014 Health Contact Information
Schladow, S. Geoffrey
Services) 530.752.2300 Advice Nurse/ Appointment Desk (Medical Services) 530.752.2349 Appointment Cancellations (24 hr. message system) 530.752.8821 General Information (CAPS Mental Health Services) 530 and Quality Care that define the Patient Centered Medical Home. Accessibility: Our open access scheduling
Unfulfilled expectations to services offered at primary health care facilities: Experiences of caretakers of underfive children in rural Tanzania
Background There is growing evidence that patients frequently bypass primary health care (PHC) facilities in favour of higher level hospitals regardless of substantial additional time and costs. Among the reasons given for bypassing are poor services (including lack of drugs and diagnostic facilities) and lack of trust in health workers. The World Health Report 2008 "PHC now more than ever" pointed to the importance of organizing health services around people's needs and expectations as one of the four main issues of PHC reforms. There is limited documentation of user's expectations to services offered at PHC facilities. The current study is a community extension of a hospital-based survey that showed a high bypassing frequency of PHC facilities among caretakers seeking care for their underfive children at two district hospitals. We aimed to explore caretakers' perceptions and expectations to services offered at PHC facilities in their area with reference to their experiences seeking care at such facilities. Methods We conducted four community-based focus group discussions (FGD's) with 47 caretakers of underfive children in Muheza district of Tanga region, Tanzania in October 2009. Results Lack of clinical examinations and laboratory tests, combined with shortage of drugs and health workers, were common experiences. Across all the focus group discussions, unpleasant health workers' behaviors, lack of urgency and unnecessary delays were major complaints. In some places, unauthorized fees reduced access to services. Conclusion The study revealed significant disappointments among caretakers with regard to the quality of services offered at PHC facilities in their areas, with implications for their utilization and proper functioning of the referral system. Practices regarding partial drugs administrations, skipping of injections, unofficial payments and consultations by unskilled health care providers need urgent action. There is also a need for proper accountability mechanisms to govern appropriate allocation and monitoring of health care resources and services in Tanzania. PMID:22697458
Why give birth in health facility? Users' and providers' accounts of poor quality of birth care in Tanzania
Background In Tanzania, half of all pregnant women access a health facility for delivery. The proportion receiving skilled care at birth is even lower. In order to reduce maternal mortality and morbidity, the government has set out to increase health facility deliveries by skilled care. The aim of this study was to describe the weaknesses in the provision of acceptable and adequate quality care through the accounts of women who have suffered obstetric fistula, nurse-midwives at both BEmOC and CEmOC health facilities and local community members. Methods Semi-structured interviews involving 16 women affected by obstetric fistula and five nurse-midwives at maternity wards at both BEmOC and CEmOC health facilities, and Focus Group Discussions with husbands and community members were conducted between October 2008 and February 2010 at Comprehensive Community Based Rehabilitation in Tanzania and Temeke hospitals in Dar es Salaam, and Mpwapwa district in Dodoma region. Results Health care users and health providers experienced poor quality caring and working environments in the health facilities. Women in labour lacked support, experienced neglect, as well as physical and verbal abuse. Nurse-midwives lacked supportive supervision, supplies and also seemed to lack motivation. Conclusions There was a consensus among women who have suffered serious birth injuries and nurse midwives staffing both BEmOC and CEmOC maternity wards that the quality of care offered to women in birth was inadequate. While the birth accounts of women pointed to failure of care, the nurses described a situation of disempowerment. The bad birth care experiences of women undermine the reputation of the health care system, lower community expectations of facility birth, and sustain high rates of home deliveries. The only way to increase the rate of skilled attendance at birth in the current Tanzanian context is to make facility birth a safer alternative than home birth. The findings from this study indicate that there is a long way to go. PMID:23663299
OSU Student Health History Form Updated 3/6/13 Page 1 Student Health Services, SHS @ Dixon, 211 Dixon Recreation Center
Tullos, Desiree
Meningitis 6 Sexually Transmitted 6 Antibiotic Use 6 Heart Disease 6 Mental Illness Disease 6 Asthma 6OSU Student Health History Form · Updated 3/6/13 · Page 1 Student Health Services, SHS @ Dixon, 211 541-737-7721 | Medical Fax 541-737-9665 | studenthealth.oregonstate.edu/ Acupuncture Health History
Mapping the capacities of fixed health facilities to cover people at risk of gambiense human African trypanosomiasis
Background The emphasis placed on the activities of mobile teams in the detection of gambiense human African trypanosomiasis (HAT) can at times obscure the major role played by fixed health facilities in HAT control and surveillance. The lack of consistent and detailed data on the coverage of passive case-finding and treatment further constrains our ability to appreciate the full contribution of the health system to the control of HAT. Methods A survey was made of all fixed health facilities that are active in the control and surveillance of gambiense HAT. Information on their diagnostic and treatment capabilities was collected, reviewed and harmonized. Health facilities were geo-referenced. Time-cost distance analysis was conducted to estimate physical accessibility and the potential coverage of the population at-risk of gambiense HAT. Results Information provided by the National Sleeping Sickness Control Programmes revealed the existence of 632 fixed health facilities that are active in the control and surveillance of gambiense HAT in endemic countries having reported cases or having conducted active screening activities during the period 2000-2012. Different types of diagnosis (clinical, serological, parasitological and disease staging) are available from 622 facilities. Treatment with pentamidine for first-stage disease is provided by 495 health facilities, while for second-stage disease various types of treatment are available in 206 health facilities only. Over 80% of the population at-risk for gambiense HAT lives within 5-hour travel of a fixed health facility offering diagnosis and treatment for the disease. Conclusions Fixed health facilities have played a crucial role in the diagnosis, treatment and coverage of at-risk-population for gambiense HAT. As the number of reported cases continues to dwindle, their role will become increasingly important for the prospects of disease elimination. Future updates of the database here presented will regularly provide evidence to inform and monitor a rational deployment of control and surveillance efforts. Support to the development and, if successful, the implementation of new control tools (e.g. new diagnostics and new drugs) is crucial, both for strengthening and expanding the existing network of fixed health facilities by improving access to diagnosis and treatment and for securing a sustainable control and surveillance of gambiense HAT. PMID:24517513
An assessment of clinical chemical sensing technology for potential use in space station health maintenance facility
NASA Technical Reports Server (NTRS)
A Health Maintenance Facility is currently under development for space station application which will provide capabilities equivalent to those found on Earth. This final report addresses the study of alternate means of diagnosis and evaluation of impaired tissue perfusion in a microgravity environment. Chemical data variables related to the dysfunction and the sensors required to measure these variables are reviewed. A technology survey outlines the ability of existing systems to meet these requirements. How the candidate sensing system was subjected to rigorous testing is explored to determine its suitability. Recommendations for follow-on activities are included that would make the commercial system more appropriate for space station applications.
An Assessment of the Electric Power Quality and Electrical Installation Impacts on Medical Electrical Equipment Operations at Health Care Facilities
Mário César; Giacco Ramos
Medical Electrical Equipments at Health Care Facilities presented malfunction and wrong medical information due to poor Electric Power Quality and to inadequate Electrical Installations. The use of electronic equipment with computerized resources increases every day, especially in the health- medical area, providing support to diagnosis, treatment or surgical procedures, among others. Some equipment such as X-Ray, Computerized Axial Tomography and
Utilisation of health services and geography: deconstructing regional differences in barriers to facility-based delivery in Nepal.
Hodge, Andrew; Byrne, Abbey; Morgan, Alison; Jimenez-Soto, Eliana
While established that geographical inaccessibility is a key barrier to the utilisation of health services, it remains unknown whether disparities are driven only by limited access to these services, or are also attributable to health behaviour. Significant disparities exist in health outcomes and the coverage of many critical health services between the mountains region of Nepal and the rest of the country, yet the principal factors driving these regional disparities are not well understood. Using national representative data from the 2011 Nepal Demographic and Health Survey, we examine the extent to which observable factors explain the overall differences in the utilisation of maternal health services. We apply nonlinear Blinder-Oaxaca-type decomposition methods to quantify the effect that differences in measurable characteristics have on the regional coverage gap in facility-based delivery. The mean coverage of facility-based deliveries was 18.6 and 36.3 % in the mountains region and the rest of Nepal, respectively. Between 54.8 and 74.1 % of the regional coverage gap was explained by differences in observed characteristics. Factors influencing health behaviours (proxied by mothers' education, TV viewership and tobacco use, and household wealth) and subjective distance to the health facility were the major factors, contributing between 52.9 and 62.5 % of the disparity. Mothers' birth history was also noteworthy. Policies simultaneously addressing access and health behaviours appear necessary to achieve greater coverage and better health outcomes for women and children in isolated areas. PMID:24927787
The Effects of Barriers on Health Related Quality of Life (HRQL) and Compliance in Adult Asthmatics who are Followed in an Urban Community Health Care Facility
Rosemary L. Hoffmann; Wesley M. Rohrer; Jeannette E. South-Paul; Ray Burdett; Valerie J. M. Watzlaf
This cross sectional descriptive study sought to identify perceived barriers to follow-up care for adult asthmatics who are\\u000a followed in two community health care facilities. A second purpose of the study was to determine the effect of any barriers\\u000a to Health Related Quality of Life (HRQL) and compliance in the sample. Thirty-four adults completed a demographic and health\\u000a status survey,
Reproductive rights denied: the Hyde Amendment and access to abortion for Native American women using Indian health service facilities.
Arnold, Shaye Beverly
Restrictions on the use of federal funds to provide abortions have limited the access to abortion services for Native American women receiving care at Indian Health Service facilities. Current data suggest that the vast majority of Indian Health Service facilities are unequipped to provide abortions under any circumstances. Native American women experience disproportionately high rates of sexual assault and unintended pregnancy. Hyde Amendment restrictions systematically infringe on the reproductive rights of Native American women and present a pressing public health policy concern. PMID:25122025
Mine Safety and Health Administration: Kids Page (title enhanced or provided by cataloger)
NSDL National Science Digital Library
This kid's page offers information on mine safety and the dangers of abandoned mines, an interactive map illustrating which minerals are mined in each state, a presentation on the Mine Safety and Health Administration (MSHA) and their role in mining, a pictorial history of children working in mines, the amount of minerals, metals and fuels each American will use in a lifetime, and a story based on the practice of taking a canary bird into the mines to warn of low oxygen supply.
26.99.01.M0.01 International Student Health Insurance Page 1 of 2 STANDARD ADMINISTRATIVE PROCEDURE
26.99.01.M0.01 International Student Health Insurance Page 1 of 2 STANDARD ADMINISTRATIVE PROCEDURE 26.99.01.M0.01 International Student Health Insurance Approved September 2, 2010 Revised September 30 compliance with System Regulation 26.99.01 Student Health Insurance. Reason for SAP International students
Quality of newborn care: a health facility assessment in rural Ghana using survey, vignette and surveillance data
Vesel, Linda; Manu, Alexander; Lohela, Terhi J; Gabrysch, Sabine; Okyere, Eunice; ten Asbroek, Augustinus H A; Hill, Zelee; Agyemang, Charlotte Tawiah; Owusu-Agyei, Seth; Kirkwood, Betty R
Objective To assess the structural capacity for, and quality of, immediate and essential newborn care (ENC) in health facilities in rural Ghana, and to link this with demand for facility deliveries and admissions. Design Health facility assessment survey and population-based surveillance data. Setting Seven districts in Brong Ahafo Region, Ghana. Participants Heads of maternal/neonatal wards in all 64 facilities performing deliveries. Main outcome measures Indicators include: the availability of essential infrastructure, newborn equipment and drugs, and personnel; vignette scores and adequacy of reasons given for delayed discharge of newborn babies; and prevalence of key immediate ENC practices that facilities should promote. These are matched to the percentage of babies delivered in and admitted to each type of facility. Results 70% of babies were delivered in health facilities; 56% of these and 87% of neonatal admissions were in four referral level hospitals. These had adequate infrastructure, but all lacked staff trained in ENC and some essential equipment (including incubators and bag and masks) and/or drugs. Vignette scores for care of very low-birth-weight babies were generally moderate-to-high, but only three hospitals achieved high overall scores for quality of ENC. We estimate that only 33% of babies were born in facilities capable of providing high quality, basic resuscitation as assessed by a vignette plus the presence of a bag and mask. Promotion of immediate ENC practices in facilities was also inadequate, with coverage of early initiation of breastfeeding and delayed bathing both below 50% for babies born in facilities; this represents a lost opportunity. Conclusions Unless major gaps in ENC equipment, drugs, staff, practices and skills are addressed, strategies to increase facility utilisation will not achieve their potential to save newborn lives. Trial registration http://clinicaltrials.gov NCT00623337. PMID:23667161
Page 1 of 3 Building or Facility Demolition / Waste Hauling Contractor
Yener, Aylin
. A copy of your current insurance certificate(s). Insurance coverage must include the following: Workers' Liability insurance shall be provided with limit of not less than $500,000 per accident for each subcategory of coverage. #12;Page 2 of 3 Automobile Liability (Bodily Injury Liability and Property Damage Liability
Back pain among health care workers in a Saudi Aramco facility: prevalence and associated factors.
Behisi, Marwan Ahmed; Al-Otaibi, Sultan Thoail; Beach, Jeremy
The objective of this study was to identify risk factors for back pain among health care workers of Saudi Aramco. A validated questionnaire was used to collect information on back pain in the last 12 months as well as relevant risk factors among health care workers at a single Saudi Aramco health care facility. Completed responses were received from 964 of 3,295 workers. Three significant predictors for the presence of back pain were identified: female gender (odds ratio [OR] = 1.9, 95% confidence interval [CI] = 1.3-2.7), Saudi nationality (OR = 2.3, 95% CI = 1.4-3.9), and working as a surgeon (OR = 5.4, 95% CI = 1.4-21.5). Educational level was of borderline significance (OR = 1.6, 95% CI = 0.98-2.7). An interaction between gender and race was identified, with Saudi females being at particularly high risk of reporting back pain (OR = 3.9, 95% CI = 1.8-8.5). Gender, occupation, and nationality were identified as risk factors for back pain, and a particularly high risk was seen among female Saudis health care workers in Saudi Aramco. Nationality may be important because of cultural difference between groups, but also because of differences in benefits available. PMID:23298422
The Impact of Health Information Technology Adoption by Outpatient Facilities on Pregnancy Outcomes
Deily, Mary E; Hu, Tianyan; Terrizzi, Sabrina; Chou, Shin-Yi; Meyerhoefer, Chad D
Objective Examine whether health information technology (HIT) at nonhospital facilities (NHFs) improves health outcomes and decreases resource use at hospitals within the same heath care network, and whether the impact of HIT varies as providers gain experience using the technologies. Data Sources Administrative claims data on 491,832 births in Pennsylvania during 1998–2004 from the Pennsylvania Health Care Cost Containment Council and HIT applications data from the Dorenfest Institute. Study Design Fixed-effects regression analysis of the impact of HIT at NHFs on adverse birth outcomes and resource use. Principal Findings Greater use of clinical HIT applications by NHFs is associated with reduced incidence of obstetric trauma and preventable complications, as well as longer lengths of stay. In addition, the beneficial effects of HIT increase the longer that technologies have been in use. However, we find no consistent evidence on whether or how nonclinical HIT in NHFs affects either resource use or health outcomes. Conclusions Clinical HIT applications at NHFs may reduce the likelihood of adverse birth outcomes, particularly after physicians and staff gain experience using the technologies. PMID:22742682
Health-hazard evaluation report HETA 89-270-2080, Harrisburg Steam Generation Facility, Harrisburg, Pennsylvania
Seitz, T.A.
In response to a request from the City of Harrisburg, Pennsylvania, a health hazard evaluation was conducted at the Harrisburg Steam Generation Facility (HSGF)(SIC-4953) concerning possible exposure to fly ash, combustion products and asbestos (1332214). The facility was a waste to energy site where municipal refuse was incinerated at approximately 1400 degrees-F. The steam generated was either sold directly or converted to electricity via an on site turbine. Employees used hard hats, safety shoes and glasses, work clothes and single use disposable dust and mist respirators. There was a potential for exposure to fly ash for employees working in the boiler and basement areas. Total particulate exposures ranged from 5 to llmg/m3 for laborers. The concentration of lead (7439921) exceeded the standards set by OSHA permissible exposure level of 0.05mg/kg in three of the personal breathing zone air samples. Amosite (12172735) and chrysotile (12001295) asbestos were identified in bulk samples of insulation and asbestos taken from a settled dust sample in the boiler area. Surface wipe samples indicated the possibility of hand to mouth contact with fly ash, particularly in the break and locker rooms. The author concludes that there is a need for reducing worker exposure to fly ash particulate. The author recommends engineering and work practice controls to reduce particulate exposures, increased cleaning and maintenance activities; and further evaluation of asbestos contamination at the facility.
The impact of reducing financial barriers on utilisation of a primary health care facility in Rwanda
Dhillon, Ranu S.; Bonds, Matthew H.; Fraden, Max; Ndahiro, Donald; Ruxin, Josh
This study investigates the impact of subsidising community-based health insurance (mutuelle) enrolment, removing point-of-service co-payments, and improving service delivery on health facility utilisation rates in Mayange, a sector of rural Rwanda of approximately 25,000 people divided among five 'imidugudu' or small villages. While comprehensive service upgrades were introduced in the Mayange Health Centre between April 2006 and February 2007, utilisation rates remained similar to comparison sites. Between February 2007 and April 2007, subsidies for mutuelle enrolment established virtually 100% coverage. Immediately after co-payments were eliminated in February 2007, patient visits levelled at a rate triple the previous value. Regression analyses using data from Mayange and two comparison sites indicate that removing financial barriers resulted in about 0.6 additional annual visits for curative care per capita. Although based on a single local pilot, these findings suggest that in order to achieve improved health outcomes, key short-term objectives include improved service delivery and reduced financial barriers. Based on this pilot, higher utilisation rates may be affected if broader swaths of the population are enrolled in mutuelle and co-payments are eliminated. Health leaders in Rwanda should consider further studies to determine if the impact of eliminating co-payments and increasing subsidies for mutuelle enrolment as seen in Mayange holds at greater levels of scale. Broader studies to better elucidate the impact of enrolment subsidies and co-payment subsidies on utilisation, health outcomes, and costs would also provide policy insights. PMID:21732708
Limited electricity access in health facilities of sub-Saharan Africa: a systematic review of data on electricity access, sources, and reliability
Adair-Rohani, Heather; Zukor, Karen; Bonjour, Sophie; Wilburn, Susan; Kuesel, Annette C; Hebert, Ryan; Fletcher, Elaine R
ABSTRACT Background: Access to electricity is critical to health care delivery and to the overarching goal of universal health coverage. Data on electricity access in health care facilities are rarely collected and have never been reported systematically in a multi-country study. We conducted a systematic review of available national data on electricity access in health care facilities in sub-Saharan Africa. Methods: We identified publicly-available data from nationally representative facility surveys through a systematic review of articles in PubMed, as well as through websites of development agencies, ministries of health, and national statistics bureaus. To be included in our analysis, data sets had to be collected in or after 2000, be nationally representative of a sub-Saharan African country, cover both public and private health facilities, and include a clear definition of electricity access. Results: We identified 13 health facility surveys from 11 sub-Saharan African countries that met our inclusion criteria. On average, 26% of health facilities in the surveyed countries reported no access to electricity. Only 28% of health care facilities, on average, had reliable electricity among the 8 countries reporting data. Among 9 countries, an average of 7% of facilities relied solely on a generator. Electricity access in health care facilities increased by 1.5% annually in Kenya between 2004 and 2010, and by 4% annually in Rwanda between 2001 and 2007. Conclusions: Energy access for health care facilities in sub-Saharan African countries varies considerably. An urgent need exists to improve the geographic coverage, quality, and frequency of data collection on energy access in health care facilities. Standardized tools should be used to collect data on all sources of power and supply reliability. The United Nations Secretary-General's "Sustainable Energy for All" initiative provides an opportunity to comprehensively monitor energy access in health care facilities. Such evidence about electricity needs and gaps would optimize use of limited resources, which can help to strengthen health systems. PMID:25276537
Coverage and Quality of Antenatal Care Provided at Primary Health Care Facilities in the 'Punjab' Province of 'Pakistan'
Majrooh, Muhammad Ashraf; Hasnain, Seema; Akram, Javaid; Siddiqui, Arif; Memon, Zahid Ali
Background Antenatal care is a very important component of maternal health services. It provides the opportunity to learn about risks associated with pregnancy and guides to plan the place of deliveries thereby preventing maternal and infant morbidity and mortality. In 'Pakistan' antenatal services to rural population are being provided through a network of primary health care facilities designated as 'Basic Health Units and Rural Health Centers. Pakistan is a developing country, consisting of four provinces and federally administered areas. Each province is administratively subdivided in to 'Divisions' and 'Districts'. By population 'Punjab' is the largest province of Pakistan having 36 districts. This study was conducted to assess the coverage and quality antenatal care in the primary health care facilities in 'Punjab' province of 'Pakistan'. Methods Quantitative and Qualitative methods were used to collect data. Using multistage sampling technique nine out of thirty six districts were selected and 19 primary health care facilities of public sector (seventeen Basic Health Units and two Rural Health Centers were randomly selected from each district. Focus group discussions and in-depth interviews were conducted with clients, providers and health managers. Results The overall enrollment for antenatal checkup was 55.9% and drop out was 32.9% in subsequent visits. The quality of services regarding assessment, treatment and counseling was extremely poor. The reasons for low coverage and quality were the distant location of facilities, deficiency of facility resources, indifferent attitude and non availability of the staff. Moreover, lack of client awareness about importance of antenatal care and self empowerment for decision making to seek care were also responsible for low coverage. Conclusion The coverage and quality of the antenatal care services in 'Punjab' are extremely compromised. Only half of the expected pregnancies are enrolled and out of those 1/3 drop out in follow-up visits. PMID:25409502
Are Health Facility Management Committees in Kenya ready to implement financial management tasks: findings from a nationally representative survey
Background Community participation in peripheral public health facilities has in many countries focused on including community representatives in Health Facility Management Committees (HFMCs). In Kenya, HFMC roles are being expanded with the phased implementation of the Health Sector Services Fund (HSSF). Under HSSF, HFMCs manage facility funds which are dispersed directly from central level into facility bank accounts. We assessed how prepared HFMCs were to undertake this new role in advance of HSSF roll out, and considered the implications for Kenya and other similar settings. Methods Data were collected through a nationally representative sample of 248 public health centres and dispensaries in 24 districts in 2010. Data collection included surveys with in-charges (n?=?248), HFMC members (n?=?464) and facility users (n?=?698), and record reviews. These data were supplemented by semi-structured interviews with district health managers in each district. Results Some findings supported preparedness of HFMCs to take on their new roles. Most facilities had bank accounts and HFMCs which met regularly. HFMC members and in-charges generally reported positive relationships, and HFMC members expressed high levels of motivation and job satisfaction. Challenges included users' low awareness of HFMCs, lack of training and clarity in roles among HFMCs, and some indications of strained relations with in-charges. Such challenges are likely to be common to many similar settings, and are therefore important considerations for any health facility based initiatives involving HFMCs. Conclusion Most HFMCs have the basic requirements to operate. However to manage their own budgets effectively and meet their allocated roles in HSSF implementation, greater emphasis is needed on financial management training, targeted supportive supervision, and greater community awareness and participation. Once new budget management roles are fully established, qualitative and quantitative research on how HFMCs are adapting to their expanded roles, especially in financial management, would be valuable in informing similar financing mechanisms in Kenya and beyond. PMID:24107094
Self medication among hospitalized patients in selected secondary health facilities in South Western Nigeria
Fakeye, Titilayo O.; Adisa, Razaq; Olatunji, Eniola
Practice of self-medication has not been evaluated in hospitalized patients especially in Nigerian hospitals. Objectives To evaluate the practice of self-medication among hospitalized patients with an aim to unearth some of the reasons for, and perceptions of benefits of this type of behaviour in secondary health care facilities. Methods This study was carried out among 197 in-patients admitted in three secondary health facilities in southwestern Nigeria using structured questionnaire. Effects of variables such as age, gender and marital status on the practice of self medication were also evaluated using the Fisher's Exact test at p<0.05 as level of significance. Results Response rate of the study was 93.8% with 174 respondents (88.3%) perceived that the medications prescribed for them were efficacious. Almost 38% of the respondents were self-medicating, with herbal medicines (29.2%) and western medicines (37%) partly due to side effects of the prescribed medicines. Thirty one (15.7%) respondents obtained medicines for self medication through relatives and friends. Prescription medicines used for self medication constituted 7.5%. Major reasons given for self medication included habit, availability and necessity. Ninety respondents (35.7%) had been informed by health care personnel about possible side effects of the medications. Ninety six respondents (48.7%) experienced side effects with the prescribed medications and was a major reason for self medication. Seventy six respondents (79.2%) who had side effects or other secondary symptoms informed healthcare personnel in the hospital while 16 (16.7%) informed relatives and friends. There was statistically significant association between age and the action taken on whom was informed (p=0.001). Conclusions There is need for extra vigilance from health personnel directly responsible for care of hospitalized patients to look for incidences of self-medication and patient education on the negative aspects of administering undisclosed medicines to their health care givers especially while they are hospitalized. PMID:25126146
Primary Headache Disorders at a Tertiary Health Facility in Lagos, Nigeria: Prevalence and Consultation Patterns
Okubadejo, Njideka; Ojelabi, Olaitan; Dada, Akinola
Background. Primary headaches are underdiagnosed and undertreated, with a significant impact on social activities and work. Aim. To determine the last-year prevalence and health care utilization pattern of primary headaches at a tertiary centre. Methods. A cross-sectional study was carried out amongst staff of the Lagos State University Teaching Hospital in Lagos, Nigeria. 402 staff members were selected by simple random sampling and administered a detailed structured headache assessment questionnaire. Migraine and tension-type headache were diagnosed according to the criteria of the International Headache Society (2004). Results. The participants comprised 168 males and 234 females. The mean age was 36.9 ± 7.9 years. The overall headache prevalence was 39.3% with female predominance (P < 0.0001). Tension-type headache was the most prevalent at 72.8% and migraine at 18.9%. Unclassifiable headache constituted 8.2%. Migraine headache showed female preponderance (P = 0.000). 80.4% of participants did not seek medical consultation compared with 19.6% who did (P = 0.000). Of the latter, 83.9% consulted the general practitioner (GP), whilst 16.1% consulted the neurologist. Conclusions. Primary headache prevalence is high in our population. It is not recognised as that requiring care by most of the staff of this tertiary health facility; thus education is required to increase health care utilization. PMID:24587991
Aging, health and place in residential care facilities in Beijing, China.
Cheng, Yang; Rosenberg, Mark W; Wang, Wuyi; Yang, Linsheng; Li, Hairong
In recent years, residential care has become an alternative option for elder care in Beijing, China. Little is known, however, about the well-being of elderly residents and the relationship between their health and living in residential care facilities (RCFs). Hence this research aims to understand the well-being of elderly residents in RCFs and how the environment of RCFs affects elderly people's everyday activities and health. The concepts of therapeutic landscapes, active aging, and well-being contribute to understanding the relationships among aging, health, and environment within RCF settings. Qualitative data from 46 in-depth semi-structured interviews with RCF managers, elderly residents, and family members in Beijing were transcribed and analysed using the constant comparative method. The results show that most of the elderly residents are satisfied with their lives in RCFs, but a few of them feel isolated and depressed after their relocation. Each RCF, as a place with its unique physical and social environment, has a significant influence on the elderly residents' physical and psychological well-being. Individual factors such as characteristics of elderly residents, their attitudes on aging and residential care, and family support also play important roles in their adaptation and well-being after relocation from home to RCFs. Although this study focuses on residential care at the local level, it sheds light on future research on geographical and socio-cultural meanings of elder care at local, regional, and national levels in China. PMID:21109338
Health hazard evaluation report HETA 98-0041-2741, San Francisco Municipal Railway, Flynn Facility, San Francisco, California
Blade, L.M.; Mortimer, V.D.
The Director of Public Transportation for the City and County of San Francisco, California, requested that the National Institute of Occupational Safety and Health (NIOSHS) conduct a health hazard evaluation (HHE) at the San Francisco Municipal Railway's Flynn Facility. This facility serves as a base of operations for approximately 123 diesel-powered buses, leading to employee exposures to diesel-engine exhaust emissions in the workplace air. The requester, concerned about the potential adverse effects of these exposures on workers' health and about the apparent ineffectiveness of the facility's ventilation systems and other exposure-control measures, asked that NIOSH evaluate workplace exposures along with the ventilation system and other control measure and recommend appropriate improvements.
Assessing the population-level impact of vouchers on access to health facility delivery for women in Kenya.
Obare, Francis; Warren, Charlotte; Abuya, Timothy; Askew, Ian; Bellows, Ben
Although available evidence indicates that vouchers improve service utilization among the target populations, we do not know whether increased utilization results from improved access (new clients who would not have used services without the voucher) or from shifting clients from non-accredited to contracted service providers. This paper examines whether the safe motherhood voucher program in Kenya is associated with improved access to health facility delivery using information on births within two years preceding the survey in voucher and comparison sites. Data were collected in 2010-2011 and in 2012 among 2933 and 3094 women aged 15-49 years reporting 962 and 1494 births within two years before the respective surveys. Analysis entails cross-tabulations and estimation of multilevel random-intercept logit models. The results show that the proportion of births occurring at home declined by more than 10 percentage points while the proportion of births delivered in health facilities increased by a similar margin over time in voucher sites. The increase in facility-based births occurred in both public and private health facilities. There was also a significant increase in the likelihood of facility-based delivery (odds ratios [OR]: 2.04; 95% confidence interval [CI]: 1.40-2.98 in the 2006 voucher arm; OR: 1.72; 95% CI: 1.22-2.43 in the 2010-2011 voucher arm) in voucher sites over time. In contrast, there were no significant changes in the likelihood of facility-based delivery in the comparison arm over time. These findings suggest that the voucher program contributed to improved access to institutional delivery by shifting births from home to health facilities. However, available evidence from qualitative data shows that some women who purchased the vouchers did not use them because of high transportation costs to accredited facilities. The implication is that substantial improvements in service uptake could be achieved if the program subsidized transportation costs as well. PMID:24565156
Work plan, health and safety plan, and site characterization for the Waste Coolant Processing Facility (T-038)
D. E. Bohrman; M. S. Uziel; D. C. Landguth; S. W. Hawthorne
As part of the Resource Conservation and Recovery Act (RCRA) Facility Investigation (RFI) of the Department of Energy`s Y-12 Plant located in Oak Ridge, Tennessee, this work plan has been developed for theWaste Coolant Processing Facility (T-038). The work plan was developed by the Measurement Applications and Development Group (MAD) of the Health and Safety Research Division (HASRD) at Oak
Direct facility funding as a response to user fee reduction: implementation and perceived impact among Kenyan health centres and dispensaries.
Opwora, Antony; Kabare, Margaret; Molyneux, Sassy; Goodman, Catherine
There is increasing pressure for reduction of user fees, but this can have adverse effects by decreasing facility-level funds. To address this, direct facility funding (DFF) was piloted in Coast Province, Kenya, with health facility committees (HFCs) responsible for managing the funds. We evaluated the implementation and perceived impact 2.5 years after DFF introduction. Quantitative data collection at 30 public health centres and dispensaries included a structured interview with the in-charge, record reviews and exit interviews. In addition, in-depth interviews were conducted with the in-charge and HFC members at 12 facilities, and with district staff and other stakeholders. DFF procedures were well established: HFCs met regularly and accounting procedures were broadly followed. DFF made an important contribution to facility cash income, accounting for 47% in health centres and 62% in dispensaries. The main items of expenditure were wages for support staff (32%), travel (21%), and construction and maintenance (18%). DFF was perceived to have a highly positive impact through funding support staff such as cleaners and patient attendants, outreach activities, renovations, patient referrals and increasing HFC activity. This was perceived to have improved health worker motivation, utilization and quality of care. A number of problems were identified. HFC training was reportedly inadequate, and no DFF documentation was available at facility level, leading to confusion. Charging user fees above those specified in the national policy remained common, and understanding of DFF among the broader community was very limited. Finally, relationships between HFCs and health workers were sometimes characterized by mistrust and resentment. Relatively small increases in funding may significantly affect facility performance when the funds are managed at the periphery. Kenya plans to scale up DFF nationwide. Our findings indicate this is warranted, but should include improved training and documentation, greater emphasis on community engagement, and insistence on user fee adherence. PMID:20211967
Status of the implementation of the World Health Organization multimodal hand hygiene strategy in United States of America health care facilities
Allegranzi, Benedetta; Conway, Laurie; Larson, Elaine; Pittet, Didier
Background The World Health Organization (WHO) launched a multimodal strategy and campaign in 2009 to improve hand hygiene practices worldwide. Our objective was to evaluate the implementation of the strategy in United States health care facilities. Methods From July through December 2011, US facilities participating in the WHO global campaign were invited to complete the Hand Hygiene Self-Assessment Framework online, a validated tool based on the WHO multimodal strategy. Results Of 2,238 invited facilities, 168 participated in the survey (7.5%). A detailed analysis of 129, mainly nonteaching public facilities (80.6%), showed that most had an advanced or intermediate level of hand hygiene implementation progress (48.9% and 45.0%, respectively). The total Hand Hygiene Self-Assessment Framework score was 36 points higher for facilities with staffing levels of infection preventionists > 0.75/100 beds than for those with lower ratios (P = .01) and 41 points higher for facilities participating in hand hygiene campaigns (P = .002). Conclusion Despite the low response rate, the survey results are unique and allow interesting reflections. Whereas the level of progress of most participating facilities was encouraging, this may reflect reporting bias, ie, better hospitals more likely to report. However, even in respondents, further improvement can be achieved, in particular by embedding hand hygiene in a stronger institutional safety climate and optimizing staffing levels dedicated to infection prevention. These results should encourage the launch of a coordinated national campaign and higher participation in the WHO global campaign. PMID:24581011
Environmental Management Waste Management Facility (EMWMF) Site-Specific Health and Safety Plan, Oak Ridge, Tennessee
Flynn, N.C. Bechtel Jacobs
The Bechtel Jacobs Company LLC (BJC) policy is to provide a safe and healthy workplace for all employees and subcontractors. The implementation of this policy requires that operations of the Environmental Management Waste Management Facility (EMWMF), located one-half mile west of the U.S. Department of Energy (DOE) Y-12 National Security Complex, be guided by an overall plan and consistent proactive approach to environment, safety and health (ES&H) issues. The BJC governing document for worker safety and health, BJC/OR-1745, 'Worker Safety and Health Program', describes the key elements of the BJC Safety and Industrial Hygiene (IH) programs, which includes the requirement for development and implementation of a site-specific Health and Safety Plan (HASP) where required by regulation (refer also to BJC-EH-1012, 'Development and Approval of Safety and Health Plans'). BJC/OR-1745, 'Worker Safety and Health Program', implements the requirements for worker protection contained in Title 10 Code of Federal Regulations (CFR) Part 851. The EMWMF site-specific HASP requirements identifies safe operating procedures, work controls, personal protective equipment, roles and responsibilities, potential site hazards and control measures, site access requirements, frequency and types of monitoring, site work areas, decontamination procedures, and outlines emergency response actions. This HASP will be available on site for use by all workers, management and supervisors, oversight personnel and visitors. All EMWMF assigned personnel will be briefed on the contents of this HASP and will be required to follow the procedures and protocols as specified. The policies and procedures referenced in this HASP apply to all EMWMF operations activities. In addition the HASP establishes ES&H criteria for the day-to-day activities to prevent or minimize any adverse effect on the environment and personnel safety and health and to meet standards that define acceptable waste management practices. The HASP is written to make use of past experience and best management practices to eliminate or minimize hazards to workers or the environment from events such as fires, falls, mechanical hazards, or any unplanned release to the environment.
Observation of the extent of smoking in a mental health inpatient facility with a smoke-free policy
Background People with a mental illness experience a higher burden of smoking-related disease. Smoke-free policies in mental health facilities provide an opportunity to reduce smoking-related harms for patients and staff alike. Limited evidence regarding the effect of such policies on preventing smoking in mental health facilities has been reported. The aims of this study are to describe the extent of smoking and the provision of nicotine replacement therapy (NRT) to patients in a mental health facility with a smoke-free policy. Methods Cross-sectional studies of smoking (cigarette butt count and observed smoking) and nicotine dependence treatment (patient record audit) were undertaken over 9 consecutive weekdays in one mental health facility in Australia. A smoke-free policy incorporating a total smoking ban and guidelines for treating nicotine dependence among patients was implemented in the facility 4 years prior to the study. Results Two thousand one hundred and thirty seven cigarette butts were collected and 152 occasions of people smoking were observed. Staff members were observed to enforce the policy on 66% of occasions. Use of NRT was recorded for 53% of patients who were smokers. Conclusion Implementation of the smoke-free policy was less than optimal and as a consequence ineffective in eliminating smoking and in optimising the provision of NRT. Additional strategies to improve the provision of nicotine dependence treatment to patients and the monitoring of adherence are needed to ensure the intended benefits of smoke-free policies are realised. PMID:24679109
Expansion of health facilities in Iraq a decade after the US-led invasion, 2003–2012
Background In the last few decades, Iraq's health care capacity has been severely undermined by the effects of different wars, international sanctions, sectarian violence and political instability. In the aftermath of the 2003 US-led invasion, the Ministry of Health has set plans to expand health service delivery, by reorienting the public sector towards primary health care and attributing a larger role to the private sector for hospital care. Quantitative assessments of the post-2003 health policy outcomes have remained scant. This paper addresses this gap focusing on a key outcome indicator that is the expansion of health facilities. Methods The analysis is based on data on health facilities provided by the World Health Organisation and Iraq's Ministry of Health. For each governorate, we calculated the change in the absolute number of facilities by type from early 2003 to the end of 2012. To account for population growth, we computed the change in the number of facilities per 100,000 population. We compared trends in the autonomous northern Kurdistan region, which has been relatively stable from 2003 onwards, and in the rest of Iraq (centre/south), where fragile institutions and persistent sectarian strife have posed major challenges to health system recovery. Results The countrywide number of primary health care centres per 100,000 population rose from 5.5 in 2003 to 7.4 in 2012. The extent of improvement varied significantly within the country, with an average increase of 4.3 primary health care centres per 100,000 population in the Kurdistan region versus an average increase of only 1.4 in central/southern Iraq. The average number of public hospitals per 100,000 population rose from 1.3 to 1.5 in Kurdistan, whereas it remained at 0.6 in centre/south. The average number of private hospitals per 100,000 population rose from 0.2 to 0.6 in Kurdistan, whereas it declined from 0.3 to 0.2 in centre/south. Conclusions The expansion of both public and private health facilities in the Kurdistan region appears encouraging, but still much should be done to reach the standards of neighbouring countries. The slow pace of improvement in the rest of Iraq is largely attributable to the dire security situation and should be a cause for major concern. PMID:25221620
Correlates of change in health care worker seasonal influenza vaccination rates among dialysis facilities.
Lynch, Janet R; Armistead, Nancy; Vinson, Brandy B; Howard, Andrew D
We conducted a campaign to increase seasonal influenza vaccination of dialysis health care workers (HCWs) in the District of Columbia, Maryland, Virginia, and West Virginia. Between the 2010-2011 and 2011-2012 influenza seasons we examined the correlates of change. HCW vaccination rates improved significantly (P < .01) from a mean ± standard deviation of 64.5 ± 27.4 to 72.7 ± 23.1. Evidence-based practices were in wide use and although we did not find an association between these and improvement, we did find that lower-performing facilities tended to improve more (P < .01) and there was a positive relationship between patient influenza vaccination rates and improvement in HCW rates (P < .01), with the mean ± standard deviation patient rate of 88.3 ± 7.9 exceeding the HCW rate during the 2011-2012 season (P < .01). PMID:25681300
Piloting Laboratory Quality System Management in Six Health Facilities in Nigeria
Mbah, Henry; Ojo, Emmanuel; Ameh, James; Musuluma, Humphrey; Negedu-Momoh, Olubunmi Ruth; Jegede, Feyisayo; Ojo, Olufunmilayo; Uwakwe, Nkem; Ochei, Kingsley; Dada, Michael; Udah, Donald; Chiegil, Robert; Torpey, Kwasi
Background Achieving accreditation in laboratories is a challenge in Nigeria like in most African countries. Nigeria adopted the World Health Organization Regional Office for Africa Stepwise Laboratory (Quality) Improvement Process Towards Accreditation (WHO/AFRO– SLIPTA) in 2010. We report on FHI360 effort and progress in piloting WHO-AFRO recognition and accreditation preparedness in six health facility laboratories in five different states of Nigeria. Method Laboratory assessments were conducted at baseline, follow up and exit using the WHO/AFRO– SLIPTA checklist. From the total percentage score obtained, the quality status of laboratories were classified using a zero to five star rating, based on the WHO/AFRO quality improvement stepwise approach. Major interventions include advocacy, capacity building, mentorship and quality improvement projects. Results At baseline audit, two of the laboratories attained 1- star while the remaining four were at 0- star. At follow up audit one lab was at 1- star, two at 3-star and three at 4-star. At exit audit, four labs were at 4- star, one at 3-star and one at 2-star rating. One laboratory dropped a 'star' at exit audit, while others consistently improved. The two weakest elements at baseline; internal audit (4%) and occurrence/incidence management (15%) improved significantly, with an exit score of 76% and 81% respectively. The elements facility and safety was the major strength across board throughout the audit exercise. Conclusion This effort resulted in measurable and positive impact on the laboratories. We recommend further improvement towards a formal international accreditation status and scale up of WHO/AFRO– SLIPTA implementation in Nigeria. PMID:25542022
DOE standard: Integration of environment, safety, and health into facility disposition activities. Volume 1: Technical standard
This Department of Energy (DOE) technical standard (referred to as the Standard) provides guidance for integrating and enhancing worker, public, and environmental protection during facility disposition activities. It provides environment, safety, and health (ES and H) guidance to supplement the project management requirements and associated guidelines contained within DOE O 430.1A, Life-Cycle Asset Management (LCAM), and amplified within the corresponding implementation guides. In addition, the Standard is designed to support an Integrated Safety Management System (ISMS), consistent with the guiding principles and core functions contained in DOE P 450.4, Safety Management System Policy, and discussed in DOE G 450.4-1, Integrated Safety Management System Guide. The ISMS guiding principles represent the fundamental policies that guide the safe accomplishment of work and include: (1) line management responsibility for safety; (2) clear roles and responsibilities; (3) competence commensurate with responsibilities; (4) balanced priorities; (5) identification of safety standards and requirements; (6) hazard controls tailored to work being performed; and (7) operations authorization. This Standard specifically addresses the implementation of the above ISMS principles four through seven, as applied to facility disposition activities.
The NIH Almanac -National Institutes of Health (NIH) Page 1 of 1 Begun as a one-room Laboratory of Hygiene in 1887, the National Institutes of Health (NIH) today is one of the world's foremost medical research centers. An
Levin, Judith G.
of Hygiene in 1887, the National Institutes of Health (NIH) today is one of the world's foremost medical) Page 1 of 1 #12;Organization - The NIH Almanac - National Institutes of Health (NIH) Page 1 of 1 OrganiThe NIH Almanac - National Institutes of Health (NIH) Page 1 of 1 Begun as a one-room Laboratory
24.01.01.Q0.03 Environmental Health and Safety Programs Page 1 of 3 STANDARD ADMINISTRATIVE PROCEDURE
24.01.01.Q0.03 Environmental Health and Safety Programs Page 1 of 3 STANDARD ADMINISTRATIVE PROCEDURE 24.01.01.Q0.03 Environmental Health and Safety Programs Approved July 18, 2012 Next scheduled to all TAMUQ employees, students and non- university building occupants as well as other employees
Malaria prevalence and morbidity among children reporting at health facilities in Nouakchott, Mauritania.
Lekweiry, Khadijetou Mint; Basco, Leonardo K; Salem, Mohamed Salem O Ahmedou; Hafid, Jamal Eddine; Marin-Jauffre, Adeline; Weddih, Abdallahi O; Briolant, Sébastien; Bogreau, Hervé; Pradines, Bruno; Rogier, Christophe; Trape, Jean-François; Boukhary, Ali O Mohamed Salem O
Although malaria has become a serious public health problem in Mauritania since the late 1990s, few documented data on its epidemiology exist. The objective of this study was to assess the morbidity of clinical malaria among children in Nouakchott. Three hundred and one febrile children, consulting at three health facilities of Nouakchott, were screened for malaria in 2009 (n=216) and 2010 (n=85). Plasmodium species identification and parasite density were determined by microscopic examination of Giemsa-stained thin and thick films and confirmed by rapid diagnostic test and nested PCR. Of 301 febrile children, 105 (34.9%) were malaria-positive by nested PCR and 87 (28.9%) by microscopy. Plasmodium vivax represented 97.1% (102/105) and P. falciparum accounted for 2.9% (3/105) of positive cases. All positive children under five years old were infected with P. vivax. The highest numbers of malaria positives were found during or shortly after the rainy season and the lowest during the dry season. Fifty-four of 105 (51.4%) malaria cases, all with P. vivax, had never travelled outside Nouakchott. Individuals belonging to the Moors ethnic group represented 97.0% of P. vivax cases. Results of the present study indicate that malaria is endemic in Nouakchott and that P. vivax is the principal causative agent. Regular surveillance is required to monitor malaria prevalence and incidence, and further measures are needed to counter the possible spread of malaria in the country. PMID:22019287
Challenges, alternatives, and paths to sustainability: better public health promotion using social networking pages as key tools.
Zaidan, A A; Zaidan, B B; Kadhem, Z; Larbani, M; Lakulu, M B; Hashim, M
This paper discusses the possibility of promoting public health and implementing educational health services using Facebook. We discuss the challenges and strengths of using such a platform as a tool for public health care systems from two different perspectives, namely, the view of IT developers and that of physicians. We present a new way of evaluating user interactivity in health care systems from tools provided by Facebook that measure statistical traffic in the Internet. Findings show that Facebook is a very promising tool in promoting e-health services in Web 2.0. Results from statistical traffic show that a Facebook page is more efficient than other pages in promoting public health. PMID:25631841
Emergency and urgent care capacity in a resource-limited setting: an assessment of health facilities in western Kenya
Burke, Thomas F; Hines, Rosemary; Ahn, Roy; Walters, Michelle; Young, David; Anderson, Rachel Eleanor; Tom, Sabrina M; Clark, Rachel; Obita, Walter; Nelson, Brett D
Objective Injuries, trauma and non-communicable diseases are responsible for a rising proportion of death and disability in low-income and middle-income countries. Delivering effective emergency and urgent healthcare for these and other conditions in resource-limited settings is challenging. In this study, we sought to examine and characterise emergency and urgent care capacity in a resource-limited setting. Methods We conducted an assessment within all 30 primary and secondary hospitals and within a stratified random sampling of 30 dispensaries and health centres in western Kenya. The key informants were the most senior facility healthcare provider and manager available. Emergency physician researchers utilised a semistructured assessment tool, and data were analysed using descriptive statistics and thematic coding. Results No lower level facilities and 30% of higher level facilities reported having a defined, organised approach to trauma. 43% of higher level facilities had access to an anaesthetist. The majority of lower level facilities had suture and wound care supplies and gloves but typically lacked other basic trauma supplies. For cardiac care, 50% of higher level facilities had morphine, but a minority had functioning ECG, sublingual nitroglycerine or a defibrillator. Only 20% of lower level facilities had glucometers, and only 33% of higher level facilities could care for diabetic emergencies. No facilities had sepsis clinical guidelines. Conclusions Large gaps in essential emergency care capabilities were identified at all facility levels in western Kenya. There are great opportunities for a universally deployed basic emergency care package, an advanced emergency care package and facility designation scheme, and a reliable prehospital care transportation and communications system in resource-limited settings. PMID:25260371
Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo
Background Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC). Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH) indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH) of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC) and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC) and family planning (FP). Methods Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. Results None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive). Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Conclusions Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1) providing necessary equipment and renovations to health facilities; 2) improving supply management systems; 3) providing comprehensive competency-based training for health providers in RH and infection prevention; 4) improving referral systems to the hospitals; 5) advocating for changes in national RH policies and protocols; and 6) providing technical assistance for monitoring and evaluation of key RH indicators. Together, these initiatives will improve the quality and accessibility of RH services in the DRC - services which are urgently needed and to which Congolese women are entitled by international human rights law. PMID:20025757
Psychological, physiological and social effects to elderly people by robot assisted activity at a health service facility for the aged
Kazuyosbi Wada; Takanori Shibata; Tomoko Saito; Kazuo Tanie
We have been developing mental commit robots that provide psychological, physiological, and social effects to human beings through physical interaction. The appearances of these robots look like real animals such as cat and seal. The seal robot was developed especially for therapy. We have applied seal robots to assisting activity of elderly people at a health service facility for the
Effects of robot assisted activity to elderly people who stay at a health service facility for the aged
Kazuyoshi Wada; Takanori Shibata; Tomoko Saito; Kazuo Tanie
We have been developing mental commit robots that provide psychological, physiological, and social effects to human beings through physical interaction. The appearances of these robots look like real animals such as cat and seal. The seal robot was developed especially for therapy. We have applied seal robots to assisting activity of elderly people at a health service facility for the
Cornell University On-Campus Housing Facility Fire Log 2010 Page 1 The following table provides information about fires that have occurred at Cornell University on-campus housing facilities during
Chen, Tsuhan
bathroom, burned tennis balls and weights in basement 5/13/2010 17:45 600 University Ave 3rd Floor corridorCornell University On-Campus Housing Facility Fire Log 2010 Page 1 The following table provides porch Unintentional Open Flame  Candles left unattended on table on back porch. 8/9/2010 14:05 Carl
Factors associated with health facility childbirth in districts of Kenya, Tanzania and Zambia: a population based survey
Background Maternal mortality continues to be a heavy burden in low and middle income countries where half of all deliveries take place in homes without skilled attendance. The study aimed to investigate the underlying and proximate determinants of health facility childbirth in rural and urban areas of three districts in Kenya, Tanzania and Zambia. Methods A population-based survey was conducted in 2007 as part of the 'REsponse to ACcountable priority setting for Trust in health systems' (REACT) project. Stratified random cluster sampling was used and the data included information on place of delivery and factors that might influence health care seeking behaviour. A total of 1800 women who had childbirth in the previous five years were analysed. The distal and proximate conceptual framework for analysing determinants of maternal mortality was modified for studying factors associated with place of delivery. Socioeconomic position was measured by employing a construct of educational attainment and wealth index. All analyses were stratified by district and urban–rural residence. Results There were substantial inter-district differences in proportion of health facility childbirth. Facility childbirth was 15, 70 and 37% in the rural areas of Malindi, Mbarali and Kapiri Mposhi respectively, and 57, 75 and 77% in the urban areas of the districts respectively. However, striking socio-economic inequities were revealed regardless of district. Furthermore, there were indications that repeated exposure to ANC services and HIV related counselling and testing were positively associated with health facility deliveries. Perceived distance was negatively associated with facility childbirth in rural areas of Malindi and urban areas of Kapiri Mposhi. Conclusion Strong socio-economic inequities in the likelihood of facility childbirths were revealed in all the districts added to geographic inequities in two of the three districts. This strongly suggests an urgent need to strengthen services targeting disadvantaged and remote populations. The finding of a positive association between HIV counselling/testing and odds in favor of giving birth at a health facility suggests potential positive effects can be achieved by strengthening integrated approaches in maternal health service delivery. PMID:24996456
Modern contraceptive utilization among female ART attendees in health facilities of Gimbie town, West Ethiopia
Background In many areas of the world where HIV prevalence is high, rates of unintended pregnancy have also been shown to be high. Of all pregnancies worldwide in 2008, 41% were reported as unintended and approximately 50% of these ended in abortion. To address these problems family planning is the best solution. Therefore, the purpose of the study was to assess modern contraceptive use among females on ART in health facilities of Gimbie town, Western Ethiopia. Methods A facility based cross-sectional study was conducted in Gimbie town, western Ethiopia from December 2012 to January 2013. HIV infected women of reproductive age group (15-49 years) who came for ART care follow up during the data collection period were included in the study. Data was collected using an interviewer administered questionnaire. Binary logistic regression and multivariate analysis were employed using SPSS version 17. Results Three hundred ninety five women on ART have participated in the study. More than half, 224 (56.7%), of the respondents were using modern contraceptive, of whom 67 (30%) use dual contraceptive method. Having information on modern contraception is positively associated with modern contraceptive use with (AOR=6.3, 95% CI (1.67, 24.1)) and respondents who have family size ?4 were 50% less contraceptive users than those who have family size >4 (AOR=0.51, 95% CI (0.27, 0.96)). Conclusion In this study contraceptive use among HIV positive women is better than the general population. However, use of dual methods, long acting and permanent method of contraceptives were found to be low. Continuous and targeted information provision on modern contraceptive should be done. PMID:24731751
Monitoring System for Storm Readiness and Recovery of Test Facilities: Integrated System Health Management (ISHM) Approach
NASA Technical Reports Server (NTRS)
Figueroa, Fernando; Morris, Jon; Turowski, Mark; Franzl, Richard; Walker, Mark; Kapadia, Ravi; Venkatesh, Meera; Schmalzel, John
Severe weather events are likely occurrences on the Mississippi Gulf Coast. It is important to rapidly diagnose and mitigate the effects of storms on Stennis Space Center's rocket engine test complex to avoid delays to critical test article programs, reduce costs, and maintain safety. An Integrated Systems Health Management (ISHM) approach and technologies are employed to integrate environmental (weather) monitoring, structural modeling, and the suite of available facility instrumentation to provide information for readiness before storms, rapid initial damage assessment to guide mitigation planning, and then support on-going assurance as repairs are effected and finally support recertification. The system is denominated Katrina Storm Monitoring System (KStorMS). Integrated Systems Health Management (ISHM) describes a comprehensive set of capabilities that provide insight into the behavior the health of a system. Knowing the status of a system allows decision makers to effectively plan and execute their mission. For example, early insight into component degradation and impending failures provides more time to develop work around strategies and more effectively plan for maintenance. Failures of system elements generally occur over time. Information extracted from sensor data, combined with system-wide knowledge bases and methods for information extraction and fusion, inference, and decision making, can be used to detect incipient failures. If failures do occur, it is critical to detect and isolate them, and suggest an appropriate course of action. ISHM enables determining the condition (health) of every element in a complex system-of-systems or SoS (detect anomalies, diagnose causes, predict future anomalies), and provide data, information, and knowledge (DIaK) to control systems for safe and effective operation. ISHM capability is achieved by using a wide range of technologies that enable anomaly detection, diagnostics, prognostics, and advise for control: (1) anomaly detection algorithms and strategies, (2) fusion of DIaK for anomaly detection (model-based, numerical, statistical, empirical, expert-based, qualitative, etc.), (3) diagnostics/prognostics strategies and methods, (4) user interface, (5) advanced control strategies, (6) integration architectures/frameworks, (7) embedding of intelligence. Many of these technologies are mature, and they are being used in the KStorMS. The paper will describe the design, implementation, and operation of the KStorMS; and discuss further evolution to support other needs such as condition-based maintenance (CBM).
Hazardous medical waste generation rates of different categories of health-care facilities
Komilis, Dimitrios, E-mail: email@example.com [Laboratory of Solid and Hazardous Waste Management, Dept. of Environmental Engineering, Democritus University of Thrace, Xanthi 671 00 (Greece); Fouki, Anastassia [Hellenic Open University, Patras (Greece); Papadopoulos, Dimitrios [APOTEFROTIRAS S.A., Ano Liossia, 192 00 Elefsina (Greece)
Highlights: Black-Right-Pointing-Pointer We calculated hazardous medical waste generation rates (HMWGR) from 132 hospitals. Black-Right-Pointing-Pointer Based on a 22-month study period, HMWGR were highly skewed to the right. Black-Right-Pointing-Pointer The HMWGR varied from 0.00124 to 0.718 kg bed{sup -1} d{sup -1}. Black-Right-Pointing-Pointer A positive correlation existed between the HMWGR and the number of hospital beds. Black-Right-Pointing-Pointer We used non-parametric statistics to compare rates among hospital categories. - Abstract: Goal of this work was to calculate the hazardous medical waste unit generation rates (HMWUGR), in kg bed{sup -1} d{sup -1}, using data from 132 health-care facilities in Greece. The calculations were based on the weights of the hazardous medical wastes that were regularly transferred to the sole medical waste incinerator in Athens over a 22-month period during years 2009 and 2010. The 132 health-care facilities were grouped into public and private ones, and, also, into seven sub-categories, namely: birth, cancer treatment, general, military, pediatric, psychiatric and university hospitals. Results showed that there is a large variability in the HMWUGR, even among hospitals of the same category. Average total HMWUGR varied from 0.012 kg bed{sup -1} d{sup -1}, for the public psychiatric hospitals, to up to 0.72 kg bed{sup -1} d{sup -1}, for the public university hospitals. Within the private hospitals, average HMWUGR ranged from 0.0012 kg bed{sup -1} d{sup -1}, for the psychiatric clinics, to up to 0.49 kg bed{sup -1} d{sup -1}, for the birth clinics. Based on non-parametric statistics, HMWUGR were statistically similar for the birth and general hospitals, in both the public and private sector. The private birth and general hospitals generated statistically more wastes compared to the corresponding public hospitals. The infectious/toxic and toxic medical wastes appear to be 10% and 50% of the total hazardous medical wastes generated by the public cancer treatment and university hospitals, respectively.
Health care facility-based decontamination of victims exposed to chemical, biological, and radiological materials
Koenig, Kristi L MD
current issues and recommendations for healthcare facilityHealthcare Group Technical Advisory Committee: Expert guidance for complex issues.healthcare facilities must be prepared to manage contaminated patients. Regulatory issues
Safe motherhood voucher programme coverage of health facility deliveries among poor women in South-western Uganda.
Kanya, Lucy; Obare, Francis; Warren, Charlotte; Abuya, Timothy; Askew, Ian; Bellows, Ben
There has been increased interest in and experimentation with demand-side mechanisms such as the use of vouchers that place purchasing power in the hands of targeted consumers to improve the uptake of healthcare services in low-income settings. A key measure of the success of such interventions is the extent to which the programmes have succeeded in reaching the target populations. This article estimates the coverage of facility deliveries by a maternal health voucher programme in South-western Uganda and examines whether such coverage is correlated with district-level characteristics such as poverty density and the number of contracted facilities. Analysis entails estimating the voucher coverage of health facility deliveries among the general population and poor population (PP) using programme data for 2010, which was the most complete calendar year of implementation of the Uganda safe motherhood (SM) voucher programme. The results show that: (1) the programme paid for 38% of estimated deliveries among the PP in the targeted districts, (2) there was a significant negative correlation between the poverty density in a district and proportions of births to poor women that were covered by the programme and (3) improving coverage of health facility deliveries for poor women is dependent upon increasing the sales and redemption rates. The findings suggest that to the extent that the programme stimulated demand for SM services by new users, it has the potential of increasing facility-based births among poor women in the region. In addition, the significant negative correlation between the poverty density and the proportions of facility-based births to poor women that are covered by the voucher programme suggests that there is need to increase both voucher sales and the rate of redemption to improve coverage in districts with high levels of poverty. PMID:24173430
Safe motherhood voucher programme coverage of health facility deliveries among poor women in South-western Uganda
Kanya, Lucy; Obare, Francis; Warren, Charlotte; Abuya, Timothy; Askew, Ian; Bellows, Ben
There has been increased interest in and experimentation with demand-side mechanisms such as the use of vouchers that place purchasing power in the hands of targeted consumers to improve the uptake of healthcare services in low-income settings. A key measure of the success of such interventions is the extent to which the programmes have succeeded in reaching the target populations. This article estimates the coverage of facility deliveries by a maternal health voucher programme in South-western Uganda and examines whether such coverage is correlated with district-level characteristics such as poverty density and the number of contracted facilities. Analysis entails estimating the voucher coverage of health facility deliveries among the general population and poor population (PP) using programme data for 2010, which was the most complete calendar year of implementation of the Uganda safe motherhood (SM) voucher programme. The results show that: (1) the programme paid for 38% of estimated deliveries among the PP in the targeted districts, (2) there was a significant negative correlation between the poverty density in a district and proportions of births to poor women that were covered by the programme and (3) improving coverage of health facility deliveries for poor women is dependent upon increasing the sales and redemption rates. The findings suggest that to the extent that the programme stimulated demand for SM services by new users, it has the potential of increasing facility-based births among poor women in the region. In addition, the significant negative correlation between the poverty density and the proportions of facility-based births to poor women that are covered by the voucher programme suggests that there is need to increase both voucher sales and the rate of redemption to improve coverage in districts with high levels of poverty. PMID:24173430
Pregnancy outcomes associated with Cesarean deliveries in Peruvian public health facilities
Gonzales, Gustavo F; Tapia, Vilma L; Fort, Alfredo L; Betran, Ana Pilar
A continuous rise in the rate of cesarean deliveries has been reported in many countries over recent decades. This trend has prompted the emergence of a debate on the risks and benefits associated with cesarean section. The present study was designed to estimate cesarean section rates over time during the period between 2000 and 2010 in Peru and to present outcomes for each mode of delivery. This is a secondary analysis of a large database obtained from the Perinatal Information System, which includes 570,997 pregnant women and their babies from 43 Peruvian public health facilities in three geographical regions: coast, highlands, and jungle. Over 10 years, 558,901 women delivered 563,668 infants weighing at least 500 g. The cesarean section rate increased from 25.5% in 2000 to 29.9% in 2010 (26.9% average; P < 0.01). The rate of stillbirths was lower with cesarean than vaginal deliveries (P < 0.01). On the other hand, and as expected, the rates for preterm births, twin pregnancies, and preeclampsia were higher in women who delivered by cesarean section (P < 0.01). More importantly, the rate of maternal mortality was 5.5 times higher in the cesarean section group than in the vaginal delivery group. Data suggest that cesarean sections are associated with adverse pregnancy outcomes. PMID:24124393
Occupational-health study at the Geokinetics true in-situ oil-shale retorting facility
Hargis, K.M.; Rom, W.N.; Grier, R.S.; Tillery, M.I.; Voelz, G.L.; Ettinger, H.J.; Wheat, L.D.
An occupational health study was conducted during the burn of the first commercial-size retort employing the Geokinetics, Inc., horizontal in situ oil shale retorting process. The study consisted of field industrial hygiene surveys and sampling, and medical evaluation of workers and spouses living at the facility. Industrial hygiene surveys and sampling were conducted during early, middle, and late phases of the 9-month burn of the retort. An attempt was made to sample areas of expected maximum concentrations in order to characterize air contaminants near process units or areas, rather than to sample actual employee exposures. Samples were collected for analysis of dust and a number of selected gases and vapors in air, and limited monitoring was conducted for noise. Limited dust monitoring was also conducted during the drilling of blastholes for another retort. Medical evaluations consisted of medical history, physical examination, pulmonary ventilation function tests, chest x ray, and blood and urine tests (including chromosome evaluations and Ames testing of urine). 30 references.
Environmental Assessment for the construction and operation of the Health Physics Site Support Facility on the Savannah River Site
DOE has prepared an environmental assessment for the proposed construction and operation of the Health Physics Site Support Facility on the Savannah River Site. This (new) facility would meet requirements of the site radiological protection program and would ensure site compliance with regulations. It was determined that the proposed action is not a major Federal action significantly affecting the quality of the environment within the meaning of NEPA. Therefore, a finding of no significant impact is made, and no environmental impact statement is needed.
Evidence from facility level inputs to improve quality of care for maternal and newborn health: interventions and findings
Most of the maternal and newborn deaths occur at birth or within 24 hours of birth. Therefore, essential lifesaving interventions need to be delivered at basic or comprehensive emergency obstetric care facilities. Facilities provide complex interventions including advice on referrals, post discharge care, long-term management of chronic conditions along with staff training, managerial and administrative support to other facilities. This paper reviews the effectiveness of facility level inputs for improving maternal and newborn health outcomes. We considered all available systematic reviews published before May 2013 on the pre-defined facility level interventions and included 32 systematic reviews. Findings suggest that additional social support during pregnancy and labour significantly decreased the risk of antenatal hospital admission, intrapartum analgesia, dissatisfaction, labour duration, cesarean delivery and instrumental vaginal birth. However, it did not have any impact on pregnancy outcomes. Continued midwifery care from early pregnancy to postpartum period was associated with reduced medical procedures during labour and shorter length of stay. Facility based stress training and management interventions to maintain well performing and motivated workforce, significantly reduced job stress and improved job satisfaction while the interventions tailored to address identified barriers to change improved the desired practice. We found limited and inconclusive evidence for the impacts of physical environment, exit interviews and organizational culture modifications. At the facility level, specialized midwifery teams and social support during pregnancy and labour have demonstrated conclusive benefits in improving maternal newborn health outcomes. However, the generalizability of these findings is limited to high income countries. Future programs in resource limited settings should utilize these findings to implement relevant interventions tailored to their needs. PMID:25208539
Reproductive health and access to healthcare facilities: risk factors for depression and anxiety in women with an earthquake experience
Background The reproductive and mental health of women contributes significantly to their overall well-being. Three of the eight Millennium Development Goals are directly related to reproductive and sexual health while mental disorders make up three of the ten leading causes of disease burden in low and middle-income countries. Among mental disorders, depression and anxiety are two of the most prevalent. In the context of slower progress in achieving Millennium Development Goals in developing countries and the ever-increasing man-made and natural disasters in these areas, it is important to understand the association between reproductive health and mental health among women with post-disaster experiences. Methods This was a cross-sectional study with a sample of 387 women of reproductive age (15-49 years) randomly selected from the October 2005 earthquake affected areas of Pakistan. Data on reproductive health was collected using the Centers for Disease Control reproductive health assessment toolkit. Depression and anxiety were measured using the Hopkins Symptom Checklist-25, while earthquake experiences were captured using the Harvard Trauma Questionnaire. The association of either depression or anxiety with socio-demographic variables, earthquake experiences, reproductive health and access to health facilities was estimated using multivariate logistic regression. Results Post-earthquake reproductive health events together with economic deprivation, lower family support and poorer access to health care facilities explained a significant proportion of differences in the experiencing of clinical levels of depression and anxiety. For instance, women losing resources for subsistence, separation from family and experiencing reproductive health events such as having a stillbirth, having had an abortion, having had abnormal vaginal discharge or having had genital ulcers, were at significant risk of depression and anxiety. Conclusion The relationship between women's post-earthquake mental health and reproductive health, socio-economic status, and health care access is complex and explained largely by the socio-cultural role of women. It is suggested that interventions that consider gender differences and that are culturally appropriate are likely to reduce the incidence. PMID:21718519
Tax Exempt Financing of Health Care Facilities as a Component of the Market Approach to Health Care Cost Containment
George A. King
This Comment will discuss the current health delivery system in the context of a Market Approach to health care cost containment. Political and financial issues in health care as well as current judicial and tax policies affecting Market Approach theory will be examined. The Comment concludes that targeted tax exempt financing must play a major role in establishing competitive forces
Rotordynamic Analysis and Feasibility Study of a Disk Spin Test Facility for Rotor Health Monitoring
NASA Technical Reports Server (NTRS)
Sawicki, Jerzy T.
Recently, National Aeronautics and Space Administration (NASA) initiated a program to achieve the significant improvement in aviation safety. One of the technical challenges is the design and development of accelerated experiments that mimic critical damage cases encountered in engine components. The Nondestructive Evaluation (NDE) Group at the NASA Glenn Research Center (GRC) is currently addressing the goal concerning propulsion health management and the development of propulsion system specific technologies intended to detect potential failures prior to catastrophe. For this goal the unique disk spin simulation system was assembled at NASA GRC, which allows testing of rotors with the spinning speeds up to 10K RPM, and at the elevated temperature environment reaching 540 C (1000 F). It is anticipated that the facility can be employed for detection of Low Cycle Fatigue disk cracking and further High Cycle Fatigue blade vibration. The controlled crack growth studies at room and elevated temperatures can be conducted on the turbine wheels, and various NDE techniques can be integrated and assessed as in-situ damage monitoring tools. Critical rotating parts in advanced gas turbine engines such as turbine disks frequently operate at high temperature and stress for long periods of time. The integrity of these parts must be proven by non-destructive evaluation (NDE) during various machining steps ranging from forging blank to finished shape, and also during the systematic overhaul inspections. Conventional NDE methods, however, have unacceptable limits. Some of these techniques are time-consuming and inconvenient for service aircraft testing. Almost all of these techniques require that the vicinity of the damage is known in advance. These experimental techniques can provide only local information and no indication of the structural strength at a component and/or system level. The shortcomings of currently available NDE methods lead to the requirement of new damage detection techniques that can provide global information on the rotating components/system, and, in addition, they do not require direct human access to the operating system. During this period of research considerable effort was directed towards the further development of experimental facility and development of the vibration-based crack detection methodology for rotating disks and shafts. A collection of papers and reports were written to describe the results of this work. The attached captures that effort and represents the research output during the grant period.
77 FR 1495 - Criteria for Determining Priorities Among Correctional Facility Health Professional Shortage Areas
Federal Register 2010, 2011, 2012, 2013, 2014
...amended by the Health Care Safety Net Amendments...1)(A) of the health professional shortage...Policy and Program Development, Bureau of Clinician...Recruitment and Service, Health Resources and Services...determined in the primary care, mental...
A Multidisciplinary Paradigm and Approach to Protecting Human Health and the Environment, Society, and Stakeholders at Nuclear Facilities - 12244
Burger, Joanna [Division of Life Sciences, Rutgers University, Piscataway, NJ (United States); Environmental and Occupational Health Sciences Institute, Piscataway, NJ (United States); Gochfeld, Michael [Consortium for Risk Evaluation with Stakeholder Participation (CRESP), Rutgers University, Piscataway NY, USA and Vanderbilt University, Nashville, TN (United States); Environmental and Occupational Medicine, UMDNJ-Robert Wood Johnson Medical School, Piscataway, NJ (United States); Clarke, James; Powers, Charles W.; Kosson, David [Consortium for Risk Evaluation with Stakeholder Participation (CRESP), Rutgers University, Piscataway NY, USA and Vanderbilt University, Nashville, TN (United States); Civil and Environmental Engineering, Vanderbilt University, Nashville, TN (United States)
As the Department of Energy (DOE) continues to remediate its lands, and to consider moving toward long-term stewardship and the development of energy parks on its industrial, remediated land, it is essential to adequately characterize the environment around such facilities to protect society, human health, and the environment. While DOE sites re considering several different land-use scenarios, all of them require adequate protection of the environment. Even if DOE lands are developed for energy parks that are mainly for industrializes sections of DOE lands that will not be remediated to residential standards, there is still the need to consider the protection of human health and the environment. We present an approach to characterization and establishment of teams that will gather the information, and integrate that information for a full range of stakeholders from technical personnel, to public policy makers, and that public. Such information is needed to establish baselines, site new energy facilities in energy parks, protect existing nuclear facilities and nuclear wastes, improve the basis for emergency planning, devise suitable monitoring schemes to ensure continued protection, provide data to track local and regional response changes, and for mitigation, remediation and decommissioning planning. We suggest that there are five categories of information or data needs, including 1) geophysical, sources, fate and transport, 2) biological systems, 3) human health, 4) stakeholder and environmental justice, and 5) societal, economic, and political. These informational needs are more expansive than the traditional site characterization, but encompass a suite of physical, biological, and societal needs to protect all aspects of human health and the environment, not just physical health. We suggest a Site Committee be established that oversees technical teams for each of the major informational categories, with appropriate representation among teams and with a broad involvement of a range of governmental personnel, natural and social scientists, Native Americans, environmental justice communities, and other stakeholders. Such informational teams (and Oversight Committee) would report to a DOE-designated authority or Citizen's Advisory Board. Although designed for nuclear facilities and energy parks on DOE lands, the templates and information teams can be adapted for other hazardous facilities, such as a mercury storage facility at Oak Ridge. (authors)
Health Facility Characteristics and Their Relationship to Coverage of PMTCT of HIV Services across Four African Countries: The PEARL Study
Ekouevi, Didier K.; Stringer, Elizabeth; Coetzee, David; Tih, Pius; Creek, Tracy; Stinson, Kathryn; Westfall, Andrew O.; Welty, Thomas; Chintu, Namwinga; Chi, Benjamin H.; Wilfert, Cathy; Shaffer, Nathan; Stringer, Jeff; Dabis, Francois
Background Health facility characteristics associated with effective prevention of mother-to-child transmission of HIV (PMTCT) coverage in sub-Saharan are poorly understood. Methodology/Principal Findings We conducted surveys in health facilities with active PMTCT services in Cameroon, Cote d'Ivoire, South Africa, and Zambia. Data was compiled via direct observation and exit interviews. We constructed composite scores to describe provision of PMTCT services across seven topical areas: antenatal quality, PMTCT quality, supplies available, patient satisfaction, patient understanding of medication, and infrastructure quality. Pearson correlations and Generalized Estimating Equations (GEE) to account for clustering of facilities within countries were used to evaluate the relationship between the composite scores, total time of visit and select individual variables with PMTCT coverage among women delivering. Between July 2008 and May 2009, we collected data from 32 facilities; 78% were managed by the government health system. An opt-out approach for HIV testing was used in 100% of facilities in Zambia, 63% in Cameroon, and none in Côte d'Ivoire or South Africa. Using Pearson correlations, PMTCT coverage (median of 55%, (IQR: 33–68) was correlated with PMTCT quality score (rho?=?0.51; p?=?0.003); infrastructure quality score (rho?=?0.43; p?=?0.017); time spent at clinic (rho?=?0.47; p?=?0.013); patient understanding of medications score (rho?=?0.51; p?=?0.006); and patient satisfaction quality score (rho?=?0.38; p?=?0.031). PMTCT coverage was marginally correlated with the antenatal quality score (rho?=?0.304; p?=?0.091). Using GEE adjustment for clustering, the, antenatal quality score became more strongly associated with PMTCT coverage (p<0.001) and the PMTCT quality score and patient understanding of medications remained marginally significant. Conclusions/Results We observed a positive relationship between an antenatal quality score and PMTCT coverage but did not identify a consistent set of variables that predicted PMTCT coverage. PMID:22276130
Impact of permethrin-treated bed nets on the incidence of sick child visits to peripheral health facilities
PENELOPE A. PHILLIPS-HOWARD; BERNARD L. NAHLEN; KATHLEEN A. WANNEMUEHLER; MARGARETTE S. KOLCZAK; Kuile ter F. O; JOHN E. GIMNIG; KRIS OLSON; JANE A. ALAII; AMOS ODHACHA; JOHN M. VULULE; WILLIAM A. HAWLEY
Duringa randomized controlled trial of insecticide (permethrin)-treat ed bed nets (ITNs) in an area with intense malaria transmission in western Kenya, we monitored 20,915 sick child visits (SCVs) by children less than five years of age visiting seven peripheral health facilities. The SCVs were monitored over a four-year period both before (1995-1996) and duringthe intervention (1997-1998). Results are used to
Amino Acids In Health and Disease: New Perspectives, pages 369-382 @ 1987 Alan R. Liss, Inc. )
Wurtman, Richard
Amino Acids In Health and Disease: New Perspectives, pages 369-382 @ 1987 Alan R. Liss, Inc. ) PLASMA AMINO ACID LEVELS IN OBESITY: EFFECTS OF INSULIN RESISTANCE Benjamin Caballero, Nicholas Finer1, lsoleucine, tyrosine and phenylalanine. The plasma amino acid response t(f. food Intake is also different
Page 2 of 6 student health fee, student activity fee, and athletic fee are waived, are ineligible for the services
Hutcheon, James M.
#12;Page 2 of 6 student health fee, student activity fee, and athletic fee are waived, are ineligible for the services sponsored by these fees unless the fees are paid separately. Other student fees and charges, as defined by the "teaching institution", are not waived for TAP attendees. Such student fees
Page 1 of 4 Health and Safety Programs Office 080406 DR/Heat Wave Guidelines.doc
Ford, James
Page 1 of 4 Health and Safety Programs Office 080406 DR/Heat Wave Guidelines.doc Heat Wave a heat wave and how to prepare your area for the next wave. (Special thanks to Cathy Booth for her of 2006 the Bay Area experienced a record heat wave. This heat wave resulted in a "severe" Stage Two
Spatial Analysis of the Level of Exposure to Seismic Hazards of Health Facilities in Mexico City, Mexico
NASA Astrophysics Data System (ADS)
Moran, S.; Novelo-Casanova, D. A.
Although health facilities are essential infrastructure during disasters and emergencies, they are also usually highly vulnerable installations in the case of the occurrence of large and major earthquakes. Hospitals are one of the most complex critical facilities in modern cities and they are used as first response in emergency situations. The operability of a hospital must be maintained after the occurrence of a local strong earthquake in order to satisfy the need for medical care of the affected population. If a health facility is seriously damaged, it cannot fulfill its function when most is needed. In this case, hospitals become a casualty of the disaster. To identify the level of physical exposure of hospitals to seismic hazards in Mexico City, we analyzed their geographic location with respect to the seismic response of the different type of soils of the city from past earthquakes, mainly from the events that occurred on September 1985 (Ms= 8.0) and April 1989 (Ms= 6.9). Seismic wave amplification in this city is the result of the interaction of the incoming seismic waves with the soft and water saturated clay soils, on which a large part of Mexico City is built. The clay soils are remnants of the lake that existed in the Valley of Mexico and which has been drained gradually to accommodate the growing urban sprawl. Hospital facilities were converted from a simple database of names and locations into a map layer of resources. This resource layer was combined with other map layers showing areas of seismic microzonation in Mexico City. This overlay was then used to identify those hospitals that may be threatened by the occurrence of a large or major seismic event. We analyzed the public and private hospitals considered as main health facilities. Our results indicate that more than 50% of the hospitals are highly exposed to seismic hazards. Besides, in most of these health facilities we identified the lack of preventive measures and preparedness to reduce their vulnerability. For proper interpretation, our results are also presented in a Geographical Information System (GIS) that provides elements to support government plans to mitigate the impact of future earthquakes.
Gestational age at booking for antenatal care in a tertiary health facility in north-central, Nigeria
Ifenne, Dennis Isaac; Utoo, Bernard Terkimbi
Background: Early initiation of antenatal care is widely believed to improve maternal and fetal outcome. This study was designed to ascertain the gestational age at booking using World Health Organization recommendations for developing countries. Materials and Methods: This cross-sectional study was carried out using interviewer-administered questionnaire to 345 willing participants at a booking clinic in a tertiary health facility in North-Central, Nigeria. Results: A total of 345 women were interviewed. The average age of the clients was 27.1±5.1 years. Almost (45.8%) had at least secondary level of education. One-third of the women were not working women. The average gestational age at booking was 19.1±7.8. Late booking (?17 weeks) was significantly influenced by the client's level of education (P=0.017). Reasons for booking late were given as follows: Not being sick (26.1%), Lack of knowledge of booking time (22.8%), having booked elsewhere (14.1%), financial constraints (9.2%), fear of too many follow-up visits (4.9%), spouse's un co-operative attitude (3.9%), lack of transport to the health care facility (2.2%), and other minor reasons (16.8%). Conclusion: Most women booked for antenatal care (ANC) late. Efforts toward maternal education, public health enlightenment campaigns, poverty reduction, and use of focused antenatal care model should be sustained as measures to encourage early initiation of ANC. PMID:23661885
Health physics manual of good practices for plutonium facilities. [Contains glossary
Brackenbush, L.W.; Heid, K.R.; Herrington, W.N.; Kenoyer, J.L.; Munson, L.F.; Munson, L.H.; Selby, J.M.; Soldat, K.L.; Stoetzel, G.A.; Traub, R.J.
This manual consists of six sections: Properties of Plutonium, Siting of Plutonium Facilities, Facility Design, Radiation Protection, Emergency Preparedness, and Decontamination and Decommissioning. While not the final authority, the manual is an assemblage of information, rules of thumb, regulations, and good practices to assist those who are intimately involved in plutonium operations. An in-depth understanding of the nuclear, physical, chemical, and biological properties of plutonium is important in establishing a viable radiation protection and control program at a plutonium facility. These properties of plutonium provide the basis and perspective necessary for appreciating the quality of control needed in handling and processing the material. Guidance in selecting the location of a new plutonium facility may not be directly useful to most readers. However, it provides a perspective for the development and implementation of the environmental surveillance program and the in-plant controls required to ensure that the facility is and remains a good neighbor. The criteria, guidance, and good practices for the design of a plutonium facility are also applicable to the operation and modification of existing facilities. The design activity provides many opportunities for implementation of features to promote more effective protection and control. The application of ''as low as reasonably achievable'' (ALARA) principles and optimization analyses are generally most cost-effective during the design phase. 335 refs., 8 figs., 20 tabs.
42 CFR 431.110 - Participation by Indian Health Service facilities.
Code of Federal Regulations, 2014 CFR
...CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE...GENERAL ADMINISTRATION Administrative Requirements: Provider Relations § 431.110 Participation by Indian Health Service...
42 CFR 431.110 - Participation by Indian Health Service facilities.
Code of Federal Regulations, 2012 CFR
...CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE...GENERAL ADMINISTRATION Administrative Requirements: Provider Relations § 431.110 Participation by Indian Health Service...
42 CFR 431.110 - Participation by Indian Health Service facilities.
Code of Federal Regulations, 2013 CFR
...CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE...GENERAL ADMINISTRATION Administrative Requirements: Provider Relations § 431.110 Participation by Indian Health Service...
Concentration, distribution, and human health risk assessment of endosulfan from a manufacturing facility in Huai'an, China.
Wang, De-Gao; Alaee, Mehran; Guo, Ming-Xing; Pei, Wei; Wu, Qian
Endosulfan concentrations and its distribution in air, soil, sediment and foodstuffs in the area surrounding a production facility in Huai'an, China were investigated because of its threats to the environment and human health. Air concentrations for endosulfan ?, endosulfan II and endosulfan sulfate measured in this study were several orders of magnitude higher than those reported previously for this region. Surface soil concentration ranges of endosulfan I, endosulfan II, and endosulfan sulfate were greater than in sediment. Endosulfan II was the greatest contributor to total endosulfan concentrations in both surface sediment and soil followed by endosulfan sulfate and endosulfan ?. However, a different concentration profile was observed in fish and crop samples, with endosulfan sulfate having the highest concentration followed by endosulfan I and endosulfan II. The concentration of ?endosulfans (endosulfans ? and II) in soil decreased rapidly with increasing distance from the plant by a factor of 10 within 45 km. Trace amounts of ?endosulfans were observed in deep soil layers which implied that these compounds are transported through the leaching of pore water in soil. This demonstrated that emissions from the manufacturing facility can lead to ground water contamination in the area near the plant. A screening level human health risk assessment of ?endosulfans based on the worst-case scenario was performed for people living in the vicinity of the manufacturing facility. The hazard indices were at least 2 orders of magnitude of <1, indicating no adverse health effects are likely to occur at current exposure levels, and the risk to human health is generally acceptable. PMID:24491393
Diversion of Drugs Within Health Care Facilities, a Multiple-Victim Crime: Patterns of Diversion, Scope, Consequences, Detection, and Prevention
Berge, Keith H.; Dillon, Kevin R.; Sikkink, Karen M.; Taylor, Timothy K.; Lanier, William L.
Mayo Clinic has been involved in an ongoing effort to prevent the diversion of controlled substances from the workplace and to rapidly identify and respond when such diversion is detected. These efforts have found that diversion of controlled substances is not uncommon and can result in substantial risk not only to the individual who is diverting the drugs but also to patients, co-workers, and employers. We believe that all health care facilities should have systems in place to deter controlled substance diversion and to promptly identify diversion and intervene when it is occurring. Such systems are multifaceted and require close cooperation between multiple stakeholders including, but not limited to, departments of pharmacy, safety and security, anesthesiology, nursing, legal counsel, and human resources. Ideally, there should be a broad-based appreciation of the dangers that diversion creates not only for patients but also for all employees of health care facilities, because diversion can occur at any point along a long supply chain. All health care workers must be vigilant for signs of possible diversion and must be aware of how to engage a preexisting group with expertise in investigating possible diversions. In addition, clear policies and procedures should be in place for dealing with such investigations and for managing the many possible outcomes of a confirmed diversion. This article provides an overview of the multiple types of risk that result from drug diversion from health care facilities. Further, we describe a system developed at Mayo Clinic for evaluating episodes of potential drug diversion and for taking action once diversion is confirmed. PMID:22766087
Health impact of a proposed waste-to-energy facility in Illinois
W. H. Hallenbeck
The Illinois Environmental Protection Agency (IEPA) has given the Robbins Resource Recovery Company (RRRC) a permit to construct a Regional Pollution Control Facility in Robbins, Illinois. Site approval for this waste-to-energy (WTE) combustor has been granted by the Village of Robbins which is located about three miles south of Chicago. The facility is designed to operate continuously for 40-45 years,
CHS Graduate Student Competencies & Requirements in Health Economics Health Economics Competencies October 2012 --Page 1 of 4
Habib, Ayman
use. Additional Admission Requirements None None CHS Core Courses MDCH 600 (formerly MDSC 644 (Fall Block Week)): Introduction to Community Health Sciences MDCH 601 (formerly MDSC 642 (Winter Block Week)): Determinants of Health I MDCH 610 (formerly MDSC 643.01): Biostatistics I: Essentials of Biostatistics MDCH 640
Reasons and circumstances for the late notification of Acute Flaccid Paralysis (AFP) cases in health facilities in Luanda
Macama, Arciolanda; Okeibunor, Joseph; Grando, Silvia; Djibaoui, Karim; Yameogo, Robert Koudounoaga; Morais, Alda; Gasasira, Alex Ntale; Mbaye, Salla; Mihigo, Richard; Nshimirimana, Deo
Introduction As the polio eradication effort enters the end game stage, surveillance for Acute Flaccid Paralysis in children becomes a pivotal tool. Thus given the gaps in AFP surveillance as identified in the cases of late notification, this study was designed to explore the reasons and circumstances responsible for late notification of AFP and collection of inadequate stools (more than 14 days of onset of paralysis until collection of the 2nd stool specimen) of AFP cases in health facilities equipped to manage AFP cases. Methods Eleven AFP cases with inadequate stools were reported from January 2 to July 8, 2012 - Epidemiological Weeks 1-27. The families of these cases were interviewed with an in-depth interview guide. The staff of the seven health units, where they later reported, was also enlisted for the study which used in-depth interview guide in eliciting information from them. Results Ignorance and wrong perception of the etiology of the cases as well as dissatisfaction with the health units as the major reasons for late reporting of AFP cases. The first port of call is usually alternative health care system such as traditional healers and spiritualists because the people hold the belief that the problem is spiritually induced. The few, who make it to health units, are faced with ill equipped rural health workers who wait for the arrival of more qualified staff, who may take days to do so. Conclusion An understanding of the health seeking behavior of the population is germane to effective AFP surveillance. There is thus a need to tailor AFP surveillance to the health seeking behavior of the populations and expand it to community structures. PMID:25426197
060810 PageChecklist for New Animal Users UGA Office of Animal Care and Use
Arnold, Jonathan
animal) Charles Dove (email@example.com) 583-0796 Animal Health Research Center Tom Buckner (tfbuckne060810 PageChecklist for New Animal Users UGA Office of Animal Care and Use Animal Facility Access Contact List Animal Facility Supervisor Contact List for Facility Access For questions about this form
Community accountability at peripheral health facilities: a review of the empirical literature and development of a conceptual framework
Molyneux, Sassy; Atela, Martin; Angwenyi, Vibian; Goodman, Catherine
Public accountability has re-emerged as a top priority for health systems all over the world, and particularly in developing countries where governments have often failed to provide adequate public sector services for their citizens. One approach to strengthening public accountability is through direct involvement of clients, users or the general public in health delivery, here termed 'community accountability'. The potential benefits of community accountability, both as an end in itself and as a means of improving health services, have led to significant resources being invested by governments and non-governmental organizations. Data are now needed on the implementation and impact of these initiatives on the ground. A search of PubMed using a systematic approach, supplemented by a hand search of key websites, identified 21 papers from low- or middle-income countries describing at least one measure to enhance community accountability that was linked with peripheral facilities. Mechanisms covered included committees and groups (n?=?19), public report cards (n?=?1) and patients' rights charters (n?=?1). In this paper we summarize the data presented in these papers, including impact, and factors influencing impact, and conclude by commenting on the methods used, and the issues they raise. We highlight that the international interest in community accountability mechanisms linked to peripheral facilities has not been matched by empirical data, and present a conceptual framework and a set of ideas that might contribute to future studies. PMID:22279082
Releases of Contaminants from Oak Ridge Facilities and Risks to Public Health; Final Report of the Oak Ridge Health Agreement Steering Panel
Alexander,J; Brooks,B; Erwin,P; Hamilton,J; Holloway,J; Lipford,P; Morin,N; Peelle,R; Smith,J; Voilleque,P; Zawia,N.
In the early 1990s, concern about the Oak Ridge Reservation's past releases of contaminants to the environment prompted Tennessee?s public health officials to pursue an in-depth study of potential off-site health effects at Oak Ridge. This study, the Oak Ridge dose reconstruction, was supported by an agreement between the U.S. Department of Energy (DOE) and the State of Tennessee, and was overseen by a 12-member panel appointed by Tennessee's Commissioner of Health. The following report, "Releases of Contaminants from Oak Ridge Facilities and Risks to Public Health," was written by the Oak Ridge Health Agreement Steering Panel (ORHASP) for the following purposes: (1) to explain the components and process of the lengthy, complex study; (2) to summarize important study results in less technical language; and (3) to provide the State with the Panel's recommendations for future actions concerning the Oak Ridge communities. The dose reconstruction process involved the examination of thousands of historical records to obtain information relating to past operations at each facility. It resulted in hundreds of documents being declassified and provided an avenue for a complete public accounting of past practices and releases. Researchers used this information to identify released contaminants of concern, to estimate the quantity and timing of these releases, to evaluate the routes taken by contaminants through the environment to nearby populations, and to estimate the doses and health risks to exposed groups. The results suggest it is likely that some people's risks of developing various types of cancers or other health effects were increased because of the releases. Two groups were most likely to have been harmed: local children drinking milk, in the early 1950's, from a ?backyard? cow or goat that had grazed on pastures contaminated with iodine-131, and fetuses carried in the 1950's and early 1960's by women who routinely ate fish taken from nearby creeks and rivers contaminated with mercury and PCBs. More detailed dose and risk estimates, and associated uncertainties, are presented in seven technical reports. One way to easily locate them in OSTI's Information Bridge is by searching the "author field" for the name "Widner," since Mr. T.E. Widner was the principal investigator on this project.
Methodology for optimising location of new primary health care facilities in rural communities: a case study in KwaZulu- Natal, South Africa
Frank Tanser
Study objective: To develop a quantitative methodology to optimally site new primary health care facilities so as to achieve the maximum population level increase in accessibility to care. The study aims to test the methodology in a rural community characterised by considerable heterogeneity in population distribution and health care access. Design: A geographical information system was used to estimate travel
Trends and Disparities in Mortality in Eastern North Carolina--29 Counties Report #2.201, May 2012 PageCenter for Health Systems Research and Development, ECU
Trends and Disparities in Mortality in Eastern North Carolina--29 Counties Report #2.201, May 2012 PageCenter for Health Systems Research and Development, ECU A Resource for Healthy Communities Health Indicator Series - Report #2.201 May 2012 Center for Health Systems Research and Development East Carolina
Trends and Disparities in Mortality in Eastern North Carolina--29 Counties Report #2.201, September 2012 PageCenter for Health Systems Research and Development, ECU
Trends and Disparities in Mortality in Eastern North Carolina--29 Counties Report #2.201, September 2012 PageCenter for Health Systems Research and Development, ECU A Resource for Healthy Communities Health Indicator Series - Report #2.201 September 2012 Center for Health Systems Research and Development
Trends and Disparities in Mortality in Eastern North Carolina-29 Counties Report #2.201, August 2014 PageCenter for Health Systems Research and Development, ECU
Trends and Disparities in Mortality in Eastern North Carolina-29 Counties Report #2.201, August 2014 PageCenter for Health Systems Research and Development, ECU A Resource for Healthy Communities Health Indicator Series - Report #2.201 August 2014 Center for Health Systems Research and Development
Trends and Disparities in Mortality in Robeson County Report #2.155, November 2011 PageCenter for Health Services Research and Development, ECU
Trends and Disparities in Mortality in Robeson County Report #2.155, November 2011 PageCenter for Health Services Research and Development, ECU A Resource for Healthy Communities Health Indicator Series - Report #2.155 November 2011 Center for Health Services Research and Development East Carolina University
Trends and Disparities in Specific Cancer Mortality in Eastern North Carolina Report #2.203, September 2009 PageCenter for Health Services Research and Development, ECU
Trends and Disparities in Specific Cancer Mortality in Eastern North Carolina Report #2.203, September 2009 PageCenter for Health Services Research and Development, ECU A Resource for Healthy Communities Health Indicator Series - Report #2.203 September 2009 Center for Health Services Research
Trends and Disparities in Mortality in Eastern North Carolina-41 Counties Report #2.203, September 2012 PageCenter for Health Systems Research and Development, ECU
Trends and Disparities in Mortality in Eastern North Carolina-41 Counties Report #2.203, September 2012 PageCenter for Health Systems Research and Development, ECU A Resource for Healthy Communities Health Indicator Series - Report #2.203 September 2012 Center for Health Systems Research and Development
Trends and Disparities in Mortality in Eastern North Carolina-41 Counties Report #2.203, February 2014 PageCenter for Health Systems Research and Development, ECU
Trends and Disparities in Mortality in Eastern North Carolina-41 Counties Report #2.203, February 2014 PageCenter for Health Systems Research and Development, ECU A Resource for Healthy Communities Health Indicator Series - Report #2.203 February 2014 Center for Health Systems Research and Development
Trends and Disparities in Mortality in Eastern North Carolina-29 Counties Report #2.201, February 2014 PageCenter for Health Systems Research and Development, ECU
Trends and Disparities in Mortality in Eastern North Carolina-29 Counties Report #2.201, February 2014 PageCenter for Health Systems Research and Development, ECU A Resource for Healthy Communities Health Indicator Series - Report #2.201 February 2014 Center for Health Systems Research and Development
Trends and Disparities in Mortality in Eastern North Carolina-41 Counties Report #2.203, May 2012 PageCenter for Health Systems Research and Development, ECU
Trends and Disparities in Mortality in Eastern North Carolina-41 Counties Report #2.203, May 2012 PageCenter for Health Systems Research and Development, ECU A Resource for Healthy Communities Health Indicator Series - Report #2.203 May 2012 Center for Health Systems Research and Development East Carolina
Trends and Disparities in Mortality in Eastern North Carolina-41 Counties Report #2.203, August 2014 PageCenter for Health Systems Research and Development, ECU
Trends and Disparities in Mortality in Eastern North Carolina-41 Counties Report #2.203, August 2014 PageCenter for Health Systems Research and Development, ECU A Resource for Healthy Communities Health Indicator Series - Report #2.203 August 2014 Center for Health Systems Research and Development
Nevada Institute for Children's Research and Policy, UNLV April 2014 Results of the 2013-2014 Nevada Kindergarten Health Survey Page 6
Hemmers, Oliver
Nevada Institute for Children's Research and Policy, UNLV April 2014 Results of the 2013-2014 Nevada Kindergarten Health Survey Page 6 EXECUTIVE SUMMARY To gather additional data on the health status of children entering the school system and to better track student health status, the Nevada Institute
New York State School Facilities and Student Health, Achievement, and Attendance: A Data Analysis Report
ERIC Educational Resources Information Center
Boese, Stephen; Shaw, John
Students who attend schools with environmental hazards that impact indoor air quality are more likely to miss class, and therefore lose learning opportunities. Yet school environmental health and safety remains largely unregulated and there is no state or federal agency in charge of protecting children's environmental health in schools. This…
Critical Factors in Mental Health Programming for Juveniles in Corrections Facilities
ERIC Educational Resources Information Center
Underwood, Lee A.; Phillips, Annie; von Dresner, Kara; Knight, Pamela D.
Juveniles with mental health and other specialized needs are overrepresented in the juvenile justice system, and while juvenile corrections have not historically provided standardized and evidence-based mental health services for its incarcerated youth, the demand is evident. The reality is that juveniles with serious mental illness are committed…
Construction Grants for Educational Facilities. Fiscal Years 1965-76. Health Manpower References.
ERIC Educational Resources Information Center
Health Resources Administration (DHEW/PHS), Bethesda, MD. Bureau of Health Manpower.
This publication provides information on construction assistance awarded during fiscal years 1965 through 1976 by the Bureau of Health Manpower (BHM) and its predecessors to schools of medicine, osteopathic medicine, dentistry, optometry, pharmacy, podiatric medicine, veterinary medicine, public health, and nursing. In addition, it provides data…
Facility Use Policy for Registered Student Organizations 9/6/11 PAGE 1 The University of Oklahoma Norman Campus
Oklahoma, University of
campus with many public, private and limited access/use locations, including public sidewalks, public of the students, RSOs or others regarding the use of University property/facilities. No public forum is intended followed by programs sponsored by RSOs. 3. Classroom space is not available for use by RSOs and individual
Facility Use Policy for Registered Student Organizations REVISED 06/13 PAGE 1 The University of Oklahoma Norman Campus
Oklahoma, University of
campus with many public, private and limited access/use locations, including public sidewalks, public of the students, RSOs or others regarding the use of University property/facilities. No public forum is intended, have first priority followed by programs sponsored by RSOs. 3. Classroom space is not available for use
Accessibility to health care facilities in Montreal Island: an application of relative accessibility indicators from the perspective of senior and non-senior residents
Background Geographical access to health care facilities is known to influence health services usage. As societies age, accessibility to health care becomes an increasingly acute public health concern. It is known that seniors tend to have lower mobility levels, and it is possible that this may negatively affect their ability to reach facilities and services. Therefore, it becomes important to examine the mobility situation of seniors vis-a-vis the spatial distribution of health care facilities, to identify areas where accessibility is low and interventions may be required. Methods Accessibility is implemented using a cumulative opportunities measure. Instead of assuming a fixed bandwidth (i.e. a distance threshold) for measuring accessibility, in this paper the bandwidth is defined using model-based estimates of average trip length. Average trip length is an all-purpose indicator of individual mobility and geographical reach. Adoption of a spatial modelling approach allows us to tailor these estimates of travel behaviour to specific locations and person profiles. Replacing a fixed bandwidth with these estimates permits us to calculate customized location- and person-based accessibility measures that allow inter-personal as well as geographical comparisons. Data The case study is Montreal Island. Geo-coded travel behaviour data, specifically average trip length, and relevant traveller's attributes are obtained from the Montreal Household Travel Survey. These data are complemented with information from the Census. Health care facilities, also geo-coded, are extracted from a comprehensive business point database. Health care facilities are selected based on Standard Industrial Classification codes 8011-21 (Medical Doctors and Dentists). Results Model-based estimates of average trip length show that travel behaviour varies widely across space. With the exception of seniors in the downtown area, older residents of Montreal Island tend to be significantly less mobile than people of other age cohorts. The combination of average trip length estimates with the spatial distribution of health care facilities indicates that despite being more mobile, suburban residents tend to have lower levels of accessibility compared to central city residents. The effect is more marked for seniors. Furthermore, the results indicate that accessibility calculated using a fixed bandwidth would produce patterns of exposure to health care facilities that would be difficult to achieve for suburban seniors given actual mobility patterns. Conclusions The analysis shows large disparities in accessibility between seniors and non-seniors, between urban and suburban seniors, and between vehicle owning and non-owning seniors. This research was concerned with potential accessibility levels. Follow up research could consider the results reported here to select case studies of actual access and usage of health care facilities, and related health outcomes. PMID:20973969
Information needs for siting new, and evaluating current, nuclear facilities: ecology, fate and transport, and human health.
Burger, Joanna; Clarke, James; Gochfeld, Michael
The USA is entering an era of energy diversity, and increasing nuclear capacity and concerns focus on accidents, security, waste, and pollution. Physical buffers that separate outsiders from nuclear facilities often support important natural ecosystems but may contain contaminants. The US Nuclear Regulatory Commission (NRC) licenses nuclear reactors; the applicant provides environmental assessments that serve as the basis for Environmental Impact Statements developed by NRC. We provide a template for the types of information needed for safe siting of nuclear facilities with buffers in three categories: ecological, fate and transport, and human health information that can be used for risk evaluations. Each item on the lists is an indicator for evaluation, and individual indicators can be selected for specific region. Ecological information needs include biodiversity (species, populations, communities) and structure and functioning of ecosystems, habitats, and landscapes, in addition to common, abundant, and unique species and endangered and rare ones. The key variables of fate and transport are sources of release for radionuclides and other chemicals, nature of releases (atmospheric vapors, subsurface liquids), features, and properties of environmental media (wind speed, direction and atmospheric stability, hydraulic gradient, hydraulic conductivity, groundwater chemistry). Human health aspects include receptor populations (demography, density, dispersion, and distance), potential pathways (drinking water sources, gardening, fishing), and exposure opportunities (lifestyle activities). For each of the three types of information needs, we expect that only a few of the indicators will be applicable to a particular site and that stakeholders should agree on a site-specific suite. PMID:20140506
Evaluation of an oral health education program for nursing personnel in special housing facilities for the elderly. Part II: Clinical aspects.
Isaksson, R; Paulsson, G; Fridlund, B; Nederfors, T
In Sweden, efforts are being made to create strategies for evaluating realistic dental treatment needs among the elderly, who are retaining more natural teeth. These strategies focus on the importance of maintaining adequate oral hygiene. Elderly in long-term-care facilities often depend on nursing personnel for carrying out daily oral hygiene procedures. Therefore, the nursing personnel's knowledge about and attitudes toward oral health make oral health education for health care professionals an important concern. The purpose of this study was to evaluate the clinical oral health outcome in residents after their caregivers had undergone a one-session, four-hour oral health education program. The study consisted of an intervention with a pre- and a post-test and was carried out in three municipalities in the southwestern part of Sweden. A newly developed oral health screening protocol was carried out for 170 subjects living in long-term-care facilities both before and 3-4 months after nursing personnel had attended an oral health education program. Following the intervention, a statistically significant improvement was recorded for changes in oral mucosal color, a modified plaque index which measured oral hygiene status, and a mucosal index which recorded mucosal inflammation. This study indicated that a limited, one-session, four-hour oral health education, offered to caregivers within long-term-care facilities, had a positive impact on the oral health status of residents. PMID:11203883
Current issues in the design of academic health sciences libraries: findings from three recent facility projects.
Nelson, Patricia P
Planning a new health sciences library at the beginning of the twenty-first century is a tremendous challenge. Technology has radically changed the way libraries function in an academic environment and the services they provide. Some individuals question whether the library as place will continue to exist as information becomes increasingly available electronically. To understand how libraries resolve programming and building design issues, visits were made to three academic health sciences libraries that have had significant renovation or completed new construction. The information gathered will be valuable for planning a new library for the University of Colorado Health Sciences Center and may assist other health sciences librarians as they plan future library buildings. PMID:12883559
Evaluation of the built environment at a children's convalescent hospital: development of the Pediatric Quality of Life Inventory parent and staff satisfaction measures for pediatric health care facilities.
Varni, James W; Burwinkle, Tasha M; Dickinson, Paige; Sherman, Sandra A; Dixon, Pamela; Ervice, Judy A; Leyden, Pat A; Sadler, Blair L
In preparation for the design, construction, and postoccupancy evaluation of a new Children's Convalescent Hospital, focus groups were conducted and measurement instruments were developed to quantify and characterize parent and staff satisfaction with the built environment of the existing pediatric health care facility, a 30-year-old, 59-bed, long-term, skilled nursing facility dedicated to the care of medically fragile children with complex chronic conditions. The measurement instruments were designed in close collaboration with parents, staff, and senior management involved with the existing and planned facility. The objectives of the study were to develop pediatric measurement instruments that measured the following: (1) parent and staff satisfaction with the built environment of the existing pediatric health care facility, (2) parent satisfaction with the health care services provided to their child, and (3) staff satisfaction with their coworker relationships. The newly developed Pediatric Quality of Life Inventory scales demonstrated internal consistency reliability (average alpha = 0.92 parent report, 0.93 staff report) and initial construct validity. As anticipated, parents and staff were not satisfied with the existing facility, providing detailed qualitative and quantitative data input to the design of the planned facility and a baseline for postoccupancy evaluation of the new facility. Consistent with the a priori hypotheses, higher parent satisfaction with the built environment structure and aesthetics was associated with higher parent satisfaction with health care services (r =.54, p <.01; r =.59, p <.01, respectively). Higher staff satisfaction with the built environment structure and aesthetics was associated with higher coworker relationship satisfaction (r =.53; p <.001; r =.51; p <.01, respectively). The implications of the findings for the architectural design and evaluation of pediatric health care facilities are discussed. PMID:14767351
Quality of Antimalarial Drugs and Antibiotics in Papua New Guinea: A Survey of the Health Facility Supply Chain
Hetzel, Manuel W.; Page-Sharp, Madhu; Bala, Nancy; Pulford, Justin; Betuela, Inoni; Davis, Timothy M. E.; Lavu, Evelyn K.
Background Poor-quality life-saving medicines are a major public health threat, particularly in settings with a weak regulatory environment. Insufficient amounts of active pharmaceutical ingredients (API) endanger patient safety and may contribute to the development of drug resistance. In the case of malaria, concerns relate to implications for the efficacy of artemisinin-based combination therapies (ACT). In Papua New Guinea (PNG), Plasmodium falciparum and P. vivax are both endemic and health facilities are the main source of treatment. ACT has been introduced as first-line treatment but other drugs, such as primaquine for the treatment of P. vivax hypnozoites, are widely available. This study investigated the quality of antimalarial drugs and selected antibiotics at all levels of the health facility supply chain in PNG. Methods and Findings Medicines were obtained from randomly sampled health facilities and selected warehouses and hospitals across PNG and analysed for API content using validated high performance liquid chromatography (HPLC). Of 360 tablet/capsule samples from 60 providers, 9.7% (95% CI 6.9, 13.3) contained less, and 0.6% more, API than pharmacopoeial reference ranges, including 29/37 (78.4%) primaquine, 3/70 (4.3%) amodiaquine, and one sample each of quinine, artemether, sulphadoxine-pyrimethamine and amoxicillin. According to the package label, 86.5% of poor-quality samples originated from India. Poor-quality medicines were found in 48.3% of providers at all levels of the supply chain. Drug quality was unrelated to storage conditions. Conclusions This study documents the presence of poor-quality medicines, particularly primaquine, throughout PNG. Primaquine is the only available transmission-blocking antimalarial, likely to become important to prevent the spread of artemisinin-resistant P. falciparum and eliminating P. vivax hypnozoites. The availability of poor-quality medicines reflects the lack of adequate quality control and regulatory mechanisms. Measures to stop the availability of poor-quality medicines should include limiting procurement to WHO prequalified products and implementing routine quality testing. PMID:24828338
PRIVACY POLICY AND PROCEDURES Policy #: 2100.16 LSU Health Sciences Center New Orleans Page: 1
development, case management and care coordination, contacting patients with information about treatment to hospitals, physician practices, clinics, schools, etc. on the LSU Health Sciences Center New Orleans to hospitals, physician clinics, schools, etc. on the LSU Health Sciences Center New Orleans Academic Campus
Page 1 of 8 Institute of Biodiversity, Animal Health & Comparative Medicine
Guo, Zaoyang
of compensation : effect of early life conditions and reproduction on flight performance in zebra finches(3) 582-592 #12;Page 2 of 8 Hampson, K. ; Lembo, T. ; Bessell, P. ; Auty, H. ; Packer, C. ; Halliday, J
How can malaria rapid diagnostic tests achieve their potential? A qualitative study of a trial at health facilities in Ghana
Background Rapid diagnostic tests (RDTs) for malaria are at the early stages of introduction across malaria endemic countries. This is central to efforts to decrease malaria overdiagnosis and the consequent overuse of valuable anti-malarials and underdiagnosis of alternative causes of fever. Evidence of the effect of introducing RDTs on the overprescription of anti-malarials is mixed. A recent trial in rural health facilities in Ghana reduced overprescription of anti-malarials, but found that 45.5% patients who tested negative with RDTs were still prescribed an anti-malarial. Methods A qualitative study of this trial was conducted, using in-depth interviews with a purposive sample of health workers involved in the trial, ranging from those who continued to prescribe anti-malarials to most patients with negative RDT results to those who largely restricted anti-malarials to patients with positive RDT results. Interviews explored the experiences of using RDTs and their results amongst trial participants. Results Meanings of RDTs were constructed by health workers through participation with the tests themselves as well as through interactions with colleagues, patients and the research team. These different modes of participation with the tests and their results led to a change in practice for some health workers, and reinforced existing practice for others. Many of the characteristics of RDTs were found to be inherently conducive to change, but the limited support from purveyors, lack of system antecedents for change and limited system readiness for change were apparent in the analysis. Conclusions When introduced with a limited supporting package, RDTs were variously interpreted and used, reflecting how health workers had learnt how to use RDT results through participation. To build confidence of health workers in the face of negative RDT results, a supporting package should include local preparation for the innovation; unambiguous guidelines; training in alternative causes of disease; regular support for health workers to meet as communities of practice; interventions that address negotiation of health worker-patient relationships and encourage self-reflection of practice; feedback systems for results of quality control of RDTs; feedback systems of the results of their practice with RDTs; and RDT augmentation such as a technical and/or clinical troubleshooting resource. PMID:20398262
WWU, Environmental Health and Safety Page 1 of 5 Effective Date: 06-09-2004
Zaferatos, Nicholas C.
as Human Resources or Facilities Management) EHS personnel 1. Are encouraged to notify their supervisors. 2/09/2004, Procedure U5950.01B Indoor Air Quality.DOC.doc University personnel With concerns about Indoor air quality Students University personnel with continued concerns about indoor air quality Personnel in other
Perceived health status and environmental quality in the assessment of external costs of waste disposal facilities. An empirical investigation.
Giaccaria, Sergio; Frontuto, Vito
Taxation for urban waste management has been reformed in Italy by the introduction of an environmental law in 2006. In the planning phase of waste management, externalities generated by new facilities remain widely unaccounted, with a consequent distortion for prices, often raising local conflicts. The paper presents a survey based on the choice modelling methodology, aimed to evaluate on a monetary scale the disamenity effect perceived by incinerator and landfills in an Italian urban context: the city of Turin. In a random utility framework the behaviour of respondents, whose choices are found to be driven by the endowment of information about technological options, socio-economic characteristics as income, education, family composition, and also by their health status was modelled. Furthermore, empirical evidence that the behaviour in residential location choices is affected by different aspects of the respondent life and in particular by the health status was found. Distinct estimates of willingness to accept compensation for disamenity effects of incinerator (Euro 2670) and landfill (Euro 3816) are elicited. The effect of health status of the respondents, their level of information about the waste disposal infrastructure, the presence of a subjective strong aversion (NIMBY) and the actual endowment and concentration of infrastructures are demonstrated to be significant factors determining the choice behaviour, but differentiated and specific for incinerators and landfills. PMID:22588111
The food and beverage vending environment in health care facilities participating in the healthy eating, active communities program. — Measures of the Food Environment
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Medical team training and coaching in the veterans health administration; assessment and impact on the first 32 facilities in the programme
Julia Neily; Peter D Mills; Pamela Lee; Brian Carney; Priscilla West; Katherine Percarpio; Lisa Mazzia; Douglas E Paull; James P Bagian
BackgroundCommunication is problematic in healthcare. The Veterans Health Administration is implementing Medical Team Training. The authors describe results of the first 32 of 130 sites to undergo the programme. This report is unique; it provides aggregate results of a crew resource-management programme for numerous facilities.MethodsFacilities were taught medical team training and implemented briefings, debriefings and other projects. The authors coached
Improvements in access to malaria treatment in Tanzania following community, retail sector and health facility interventions -- a user perspective
Background The ACCESS programme aims at understanding and improving access to prompt and effective malaria treatment. Between 2004 and 2008 the programme implemented a social marketing campaign for improved treatment-seeking. To improve access to treatment in the private retail sector a new class of outlets known as accredited drug dispensing outlets (ADDO) was created in Tanzania in 2006. Tanzania changed its first-line treatment for malaria from sulphadoxine-pyrimethamine (SP) to artemether-lumefantrine (ALu) in 2007 and subsidized ALu was made available in both health facilities and ADDOs. The effect of these interventions on understanding and treatment of malaria was studied in rural Tanzania. The data also enabled an investigation of the determinants of access to treatment. Methods Three treatment-seeking surveys were conducted in 2004, 2006 and 2008 in the rural areas of the Ifakara demographic surveillance system (DSS) and in Ifakara town. Each survey included approximately 150 people who had suffered a fever case in the previous 14 days. Results Treatment-seeking and awareness of malaria was already high at baseline, but various improvements were seen between 2004 and 2008, namely: better understanding causes of malaria (from 62% to 84%); an increase in health facility attendance as first treatment option for patients older than five years (27% to 52%); higher treatment coverage with anti-malarials (86% to 96%) and more timely use of anti-malarials (80% to 93-97% treatments taken within 24 hrs). Unfortunately, the change of treatment policy led to a low availability of ALu in the private sector and, therefore, to a drop in the proportion of patients taking a recommended malaria treatment (85% to 53%). The availability of outlets (health facilities or drug shops) is the most important determinant of whether patients receive prompt and effective treatment, whereas affordability and accessibility contribute to a lesser extent. Conclusions An integrated approach aimed at improving understanding and treatment of malaria has led to tangible improvements in terms of people's actions for the treatment of malaria. However, progress was hindered by the low availability of the first-line treatment after the switch to ACT. PMID:20550653
Health care workers' perspectives about disclosure to HIV-infected children; cross-sectional survey of health facilities in Gauteng and Mpumalanga provinces, South Africa
Mokgatle, Mathildah
The perspectives and practices of health care workers (HCWs) regarding disclosure to HIV-infected children have not been adequately investigated ten years after the roll-out of pediatrics antiretroviral therapy (ART). The aim of the study was to examine the opinions of HCWs about disclosure to HIV-infected children and determine their role in disclosure to children accessing ART in health centers in South Africa. This was a cross-sectional survey using a semi-structured questionnaire among HCWs in ART centers at three hospitals and 48 primary health facilities in two provinces in South Africa. Of the 206 HCWs, 140 (68.2%) were nurses, 44 (21.5%) were lay counsellors, and 4 (2%) were doctors. The majority (n = 183, 89.3%) felt that disclosure benefits children and they should be told about their HIV status. Over half (n = 93, 51.4%) recommended 11–18 years as the appropriate age to disclose. Half (n = 99, 48.5%) said that caregivers should take the lead to disclose, 87 (42.7%) said that disclosure is a shared responsibility of caregivers and HCWs, and 18 (8.8%) said HCWs should lead disclosure. HCWs perceived their role as that of preparing the caregiver for disclosure and the child to understand the disease. However, the lack of guidelines and training on disclosure counselling for children affects their ability to fully participate in disclosure to children. There is a need to adopt the World Health Organizations' disclosure guidelines for children and adapt them to the local cultural and community contexts and train HCWs to guide, support, and assist caregivers in their disclosure to HIV-infected children.
Barriers and solutions in implementing occupational health and safety services at a large nuclear weapons facility.
Takaro, T K; Ertell, K; Salazar, M K; Beaudet, N; Stover, B; Hagopian, A; Omenn, G; Barnhart, S
The Hanford Nuclear Reservation is one of the U.S. Department of Energy's largest nuclear weapons sites. The enormous changes experienced by Hanford over the last several years, as its mission has shifted from weapons production to cleanup, has profoundly affected its occupational health and safety services. Innovative programs and new initiatives hold promise for a safer workplace for the thousands of workers at Hanford and other DOE sites. However, occupational health and safety professionals continue to face multiple organizational, economic, and cultural challenges. A major problem identified during this review was the lack of coordination of onsite services. Because each health and safety program operates independently (albeit with the guidance of the Richland field operations office), many services are duplicative and the health and safety system is fragmented. The fragmentation is compounded by the lack of centralized data repositories for demographic and exposure data. Innovative measures such as a questionnaire-driven Employee Job Task Analysis linked to medical examinations has allowed the site to move from the inefficient and potentially dangerous administrative medical monitoring assignment to defensible risk-based assignments and could serve as a framework for improving centralized data management and service delivery. PMID:11186038
Antiretroviral Therapy Program Expansion in Zambézia Province, Mozambique: Geospatial Mapping of Community-Based and Health Facility Data for Integrated Health Planning
Moon, Troy D.; Ossemane, Ezequiel B.; Green, Ann F.; Ndatimana, Elisée; José, Eurico; Buehler, Charlotte P.; Wester, C. William; Vermund, Sten H.; Olupona, Omo
Objective To generate maps reflecting the intersection of community-based Voluntary Counseling and Testing (VCT) delivery points with facility-based HIV program demographic information collected at the district level in three districts (Ile, Maganja da Costa and Chinde) of Zambézia Province, Mozambique; in order to guide planning decisions about antiretroviral therapy (ART) program expansion. Methods Program information was harvested from two separate open source databases maintained for community-based VCT and facility-based HIV care and treatment monitoring from October 2011 to September 2012. Maps were created using ArcGIS 10.1. Travel distance by foot within a 10 km radius is generally considered a tolerable distance in Mozambique for purposes of adherence and retention planning. Results Community-based VCT activities in each of three districts were clustered within geographic proximity to clinics providing ART, within communities with easier transportation access, and/or near the homes of VCT volunteers. Community HIV testing results yielded HIV seropositivity rates in some regions that were incongruent with the Ministry of Health's estimates for the entire district (2–13% vs. 2% in Ile, 2–54% vs. 11.5% in Maganja da Costa, and 23–43% vs. 14.4% in Chinde). All 3 districts revealed gaps in regional disbursement of community-based VCT activities as well as access to clinics offering ART. Conclusions Use of geospatial mapping in the context of program planning and monitoring allowed for characterizing the location and size of each district's HIV population. In extremely resource limited and logistically challenging settings, maps are valuable tools for informing evidence-based decisions in planning program expansion, including ART. PMID:25329169
The Effect of Health-Facility Admission and Skilled Birth Attendant Coverage on Maternal Survival in India: A Case-Control Analysis
Montgomery, Ann L.; Fadel, Shaza; Kumar, Rajesh; Bondy, Sue; Moineddin, Rahim; Jha, Prabhat
Background Research in areas of low skilled attendant coverage found that maternal mortality is paradoxically higher in women who seek obstetric care. We estimated the effect of health-facility admission on maternal survival, and how this effect varies with skilled attendant coverage across India. Methods/Findings Using unmatched population-based case-control analysis of national datasets, we compared the effect of health-facility admission at any time (antenatal, intrapartum, postpartum) on maternal deaths (cases) to women reporting pregnancies (controls). Probability of maternal death decreased with increasing skilled attendant coverage, among both women who were and were not admitted to a health-facility, however, the risk of death among women who were admitted was higher (at 50% coverage, OR?=?2.32, 95% confidence interval 1.85–2.92) than among those women who were not; while at higher levels of coverage, the effect of health-facility admission was attenuated. In a secondary analysis, the probability of maternal death decreased with increasing coverage among both women admitted for delivery or delivered at home but there was no effect of admission for delivery on mortality risk (50% coverage, OR?=?1.0, 0.80–1.25), suggesting that poor quality of obstetric care may have attenuated the benefits of facility-based care. Subpopulation analysis of obstetric hemorrhage cases and report of 'excessive bleeding' in controls showed that the probability of maternal death decreased with increasing skilled attendant coverage; but the effect of health-facility admission was attenuated (at 50% coverage, OR?=?1.47, 0.95–1.79), suggesting that some of the effect in the main model can be explained by women arriving at facility with complications underway. Finally, highest risk associated with health-facility admission was clustered in women with education 8 years. Conclusions The effect of health-facility admission did vary by skilled attendant coverage, and this effect appears to be driven partially by reverse causality; however, inequitable access to and possibly poor quality of healthcare for primary and emergency services appears to play a role in maternal survival as well. PMID:24887586
Availability of drugs and medical supplies for emergency obstetric care: experience of health facility managers in a rural District of Tanzania
Background Provision of quality emergency obstetric care relies upon the presence of skilled health attendants working in an environment where drugs and medical supplies are available when needed and in adequate quantity and of assured quality. This study aimed to describe the experience of rural health facility managers in ensuring the timely availability of drugs and medical supplies for emergency obstetric care (EmOC). Methods In-depth interviews were conducted with a total of 17 health facility managers: 14 from dispensaries and three from health centers. Two members of the Council Health Management Team and one member of the Council Health Service Board were also interviewed. A survey of health facilities was conducted to supplement the data. All the materials were analysed using a qualitative thematic analysis approach. Results Participants reported on the unreliability of obtaining drugs and medical supplies for EmOC; this was supported by the absence of essential items observed during the facility survey. The unreliability of obtaining drugs and medical supplies was reported to result in the provision of untimely and suboptimal EmOC services. An insufficient budget for drugs from central government, lack of accountability within the supply system and a bureaucratic process of accessing the locally mobilized drug fund were reported to contribute to the current situation. Conclusion The unreliability of obtaining drugs and medical supplies compromises the timely provision of quality EmOC. Multiple approaches should be used to address challenges within the health system that prevent access to essential drugs and supplies for maternal health. There should be a special focus on improving the governance of the drug delivery system so that it promotes the accountability of key players, transparency in the handling of information and drug funds, and the participation of key stakeholders in decision making over the allocation of locally collected drug funds. PMID:24646098
ORNL necessary and sufficient standards for environment, safety, and health. Final report of the Identification Team for other industrial, radiological, and non-radiological hazard facilities
This Necessary and Sufficient (N and S) set of standards is for Other Industrial, Radiological, and Non-Radiological Hazard Facilities at Oak Ridge National Laboratory (ORNL). These facility classifications are based on a laboratory-wide approach to classify facilities by hazard category. An analysis of the hazards associated with the facilities at ORNL was conducted in 1993. To identify standards appropriate for these Other Industrial, Radiological, and Non-Radiological Hazard Facilities, the activities conducted in these facilities were assessed, and the hazards associated with the activities were identified. A preliminary hazards list was distributed to all ORNL organizations. The hazards identified in prior hazard analyses are contained in the list, and a category of other was provided in each general hazard area. A workshop to assist organizations in properly completing the list was held. Completed hazard screening lists were compiled for each ORNL division, and a master list was compiled for all Other Industrial, Radiological Hazard, and Non-Radiological facilities and activities. The master list was compared against the results of prior hazard analyses by research and development and environment, safety, and health personnel to ensure completeness. This list, which served as a basis for identifying applicable environment, safety, and health standards, appears in Appendix A.
An overview of the space medicine program and development of the Health Maintenance Facility for Space Station
NASA Technical Reports Server (NTRS)
Pool, Sam Lee
Because the prolonged stay on board the Space Station will increase the risk of possible inflight medical problems from that on Skylab missions, the Health Maintenance Facility (HMF) planned for the Space Station is much more sophisticated than the small clinics of the Skylab missions. The development of the HMF is directed by the consideration of three primary factors: prevention, diagnosis, and treatment of injuries and illnesses that may occur in flight. The major components of the HMF include the clinical laboratory, pharmacy, imaging system, critical-care system, patient-restraint system, data-management system, exercise system, surgical system, electrophysiologic-monitoring system, introvenous-fluid system, dental system, and hyperbaric-treatment-support system.
Environmental health-risk assessment for tritium releases from the National Tritium Labeling Facility (NTLF) at Lawrence Berkeley Laboratory
McKone, T.E.; Brand, K.P.
This report is a health risk assessment that addresses continuous releases of tritium to the environment from the National Tritium Labeling Facility (NTLF) at the Lawrence Berkeley Laboratory (LBL). The NTLF contributes approximately 95% of all tritium releases from LBL. Transport and transformation models were used to determine the movement of tritium releases from the NRLF to the air, surface water, soils, and plants and to determine the subsequent doses to humans. These models were calibrated against environmental measurements of tritium levels in the vicinity of the NTLF and in the surrounding community. Risk levels were determined for human populations in each of these zones. Risk levels to both individuals and populations were calculated. In this report population risks and individual risks were calculated for three types of diseases--cancer, heritable genetic effects, and developmental and reproductive effects.
Knowledge among drug dispensers and antimalarial drug prescribing practices in public health facilities in Dar es Salaam
Kamuhabwa, Appolinary AR; Silumbe, Richard
Background Irrational prescribing and dispensing of antimalarials has been identified as a contributing factor in the emergence of malaria parasites resistant to existing antimalarial drugs. Factors that contribute to such irrational prescribing and dispensing should therefore be identified to address this problem. The aim of this study was to assess irrational antimalarial drug dispensing and prescribing practices in public health facilities. Methods A descriptive-retrospective cross-sectional study was conducted between January and June 2011 in order to assess prescribing and dispensing practices for antimalarial drugs in three public hospitals and nine health centers in Dar es Salaam, Tanzania. Thirty-two drug dispensers were interviewed using a structured questionnaire. A total of 4,320 prescriptions for the period January to December 2010 were collected and assessed for antimalarial drug prescribing patterns. Results The majority (84.6%) of drug dispensers had poor knowledge regarding the basic information required from patients before dispensing artemether-lumefantrine. Seventeen of 32 drug dispensers did not know the basic information that should be given to patients in order to increase absorption of artemether-lumefantrine after oral intake. Most drug dispensers also showed limited knowledge about the dosage and contraindications for artemether-lumefantrine. Eighty-seven percent of all prescriptions contained artemether-lumefantrine as the only antimalarial drug, 77.1% contained at least one analgesic, and 26.9% contained at least one antibiotic, indicating unnecessary use of analgesics and antibiotics with antimalarial drugs. A substantial number of prescriptions contained antimalarial drugs that have already been declared ineffective for the treatment of malaria in Tanzania, providing additional evidence of inadequate knowledge among health care workers concerning treatment policy. Conclusion Despite the government's efforts to increase public awareness regarding use of artemether-lumefantrine as first-line treatment for uncomplicated malaria, there is still irrational prescribing, dispensing, and use of this combination. Based on the results of this study, it is proposed that regular on-the-job training and continuing education be provided to drug dispensers and prescribers in public health facilities. PMID:24039454
Use of T12 lighting systems in retrofit applications within New York Office of Mental Health Facilities - A case history
Henry, C.P.; Marsh, E.J.
In 1990, the Governor of New York State issued Executive Order No. 132, directing all state agencies to reduce energy consumption by 20% from the base year of 1988/89 by the year 2000. To assist in meeting this goal, the New York State Office of Mental Health (OMH) established the Lighting Revitalization Program in 1992. State facilities are divided into five regions, each served by existing Environmental Revitalization Teams. OMH supplemented these teams with lighting technicians in this new program. The program`s goal was to rehabilitate outdated, inefficient lighting systems throughout 28 OMH facilities, totaling 28 million square feet in area. OMH requested the former Facility Development Corporation (FDC), now the Dormitory Authority of the State of New York (DASNY), to contract with Novus Engineering to evaluate the relative efficiency of T8 and T12 ballasts. Novus contracted an independent laboratory, Eastern Testing Laboratories (ETL), for performance testing. ETL tested four ballast/lamp configurations for light Output and input power, and Novus analyzed the results for relative efficiency and also calculated 25-year life cycle costs. The test results indicated that the efficiencies of the T12/34W and T8/32W ballast/lamp technologies were nearly identical. The input power and light output of these systems were similar. The lumens per Watt ratings for the two systems were nearly equal, with the T8 technology being only about two percent more efficient, generating more light with similar input power. The life cycle costs for the two systems were nearly identical, with the T12 system providing a slightly lower life cycle cost. Given the above considerations, the agency has been installing T12 electronic ballasts and 34W lamps in buildings where fluorescent fixtures warranted upgrading. This type of retrofit goes against current trends, but the use of T8 system could not be justified in buildings undergoing minor retrofitting.
Giving cell phones to pregnant women and improving services may increase primary health facility utilization: a case–control study of a Nigerian project
Background Worldwide, about 287 000 women die each year from mostly preventable complications related to pregnancy and childbirth. A disproportionately high number of these deaths occur in sub-Saharan Africa. The Abiye ('Safe Motherhood') project in the Ifedore Local Government Area (LGA) of Ondo-State of Nigeria aimed at improving facility utilization and maternal health through the use of cell phones and generally improved health care services for pregnant women, including Health Rangers, renovated Health Centres, and improved means of transportation. Methods A one-year sample of retrospective data was collected from hospital records and patients' case files from Ifedore (the project area) and Idanre (control area) and was analyzed to determine healthcare facility utilization rates in each location. Semi-structured questionnaires were used to generate supplemental data. Results The total facility utilization rate of pregnant women was significantly higher in Ifedore than in Idanre. The facility utilization rate of the primary health care centres was significantly higher in Ifedore than in Idanre. The number of recorded cases of the five major causes of maternal death in the two LGAs was not significantly different, possibly because the project was new. Conclusions Giving cell phones to pregnant women and generally improving services could increase their utilization of the primary healthcare system. PMID:24438150
In-flight demonstration of the Space Station Freedom Health Maintenance Facility fluid therapy system (E300/E05)
NASA Technical Reports Server (NTRS)
Lloyd, Charles W.
The Space Station Freedom (SSF) Health Maintenance Facility (HMF) will provide medical care for crew members for up to 10 days. An integral part of the required medical care consists of providing intravenous infusion of fluids, electrolyte solutions, and nutrients to sustain an ill or injured crew member. In terrestrial health care facilities, intravenous solutions are normally stored in large quantities. However, due to the station's weight and volume constraints, an adequate supply of the required solutions cannot be carried onboard SSF. By formulating medical fluids onboard from concentrates and station water as needed, the Fluid Therapy System (FTS) eliminates weight and volume concerns regarding intravenous fluids. The first full-system demonstration of FTS is continuous microgravity will be conducted in Spacelab-Japan (SL-J). The FTS evaluation consists of two functional objectives and an in-flight demonstration of intravenous administration of fluids. The first is to make and store sterile water and IV solutions onboard the spacecraft. If intravenous fluids are to be produced in SSF, successful sterilization of water and reconstituting of IV solutions must be achieved. The second objective is to repeat the verification of the FTS infusion pump, which had been performed in Spacelab Life Sciences - 1 (SLS-1). during SLS-1, the FTS IV pump was operated in continuous microgravity for the first time. The pump functioned successfully, and valuable knowledge on its performance in continuous microgravity was obtained. Finally, the technique of starting an IF in microgravity will be demonstrated. The IV technique requires modifications in microgravity, such as use of restraints for equipment and crew members involved.
Health impact assessment of waste management facilities in three European countries
Background Policies on waste disposal in Europe are heterogeneous and rapidly changing, with potential health implications that are largely unknown. We conducted a health impact assessment of landfilling and incineration in three European countries: Italy, Slovakia and England. Methods A total of 49 (Italy), 2 (Slovakia), and 11 (England) incinerators were operating in 2001 while for landfills the figures were 619, 121 and 232, respectively. The study population consisted of residents living within 3 km of an incinerator and 2 km of a landfill. Excess risk estimates from epidemiological studies were used, combined with air pollution dispersion modelling for particulate matter (PM10) and nitrogen dioxide (NO2). For incinerators, we estimated attributable cancer incidence and years of life lost (YoLL), while for landfills we estimated attributable cases of congenital anomalies and low birth weight infants. Results About 1,000,000, 16,000, and 1,200,000 subjects lived close to incinerators in Italy, Slovakia and England, respectively. The additional contribution to NO2 levels within a 3 km radius was 0.23, 0.15, and 0.14 ?g/m3, respectively. Lower values were found for PM10. Assuming that the incinerators continue to operate until 2020, we are moderately confident that the annual number of cancer cases due to exposure in 2001-2020 will reach 11, 0, and 7 in 2020 and then decline to 0 in the three countries in 2050. We are moderately confident that by 2050, the attributable impact on the 2001 cohort of residents will be 3,621 (Italy), 37 (Slovakia) and 3,966 (England) YoLL. The total exposed population to landfills was 1,350,000, 329,000, and 1,425,000 subjects, respectively. We are moderately confident that the annual additional cases of congenital anomalies up to 2030 will be approximately 2, 2, and 3 whereas there will be 42, 13, and 59 additional low-birth weight newborns, respectively. Conclusions The current health impacts of landfilling and incineration can be characterized as moderate when compared to other sources of environmental pollution, e.g. traffic or industrial emissions, that have an impact on public health. There are several uncertainties and critical assumptions in the assessment model, but it provides insight into the relative health impact attributable to waste management. PMID:21635784
Assessment of laboratory logistics management information system practice for HIV/AIDS and tuberculosis laboratory commodities in selected public health facilities in Addis Ababa, Ethiopia
Desale, Adino; Taye, Bineyam; Belay, Getachew; Nigatu, Alemayehu
Introduction Logistics management information system for health commodities remained poorly implemented in most of developing countries. To assess the status of laboratory logistics management information system for HIV/AIDS and tuberculosis laboratory commodities in public health facilities in Addis Ababa. Methods A cross-sectional descriptive study was conducted from September 2010-January 2011 at selected public health facilities. A stratified random sampling method was used to include a total of 43 facilities which, were investigated through quantitative methods using structured questionnaires interviews. Focus group discussion with the designated supply chain managers and key informant interviews were conducted for the qualitative method. Results There exists a well-designed logistics system for laboratory commodities with trained pharmacy personnel, distributed standard LMIS formats and established inventory control procedures. However, majority of laboratory professionals were not trained in LMIS. Majority of the facilities (60.5%) were stocked out for at least one ART monitoring and TB laboratory reagents and the highest stock out rate was for chemistry reagents. Expired ART monitoring laboratory commodities were found in 25 (73.5%) of facilities. Fifty percent (50%) of the assessed hospitals and 54% of health centers were currently using stock/bin cards for all HIV/AIDS and TB laboratory commodities in main pharmacy store, among these only 25% and 20.8% of them were updated with accurate information matching with the physical count done at the time of visit for hospitals and health centers respectively. Conclusion Even though there exists a well designed laboratory LMIS, keeping quality stock/bin cards and LMIS reports were very low. Key ART monitoring laboratory commodities were stock out at many facilities at the day of visit and during the past six months. Based on findings, training of laboratory personnel's managing laboratory commodities and keeping accurate inventory control procedures were recommended. PMID:24106574
Evaluating the level of satisfaction of patients utilizing first-level health facilities as a function of health system performance rating in the province of Elazig, Turkey
Bulut, Aliye; Oguzoncul, A Ferdane
Purpose This study was conducted to determine the level of satisfaction of patients utilizing first-level health care facilities as a function of health system performance rating in Elazig province of Turkey. Methods The study was conducted between December 2013 and March 2014 at the family health centers in the Elazig province center. For collecting the data in the cross-sectional study conducted with 1,290 patients, personal data form for patients and the Turkish version of European Patients Evaluate General/Family Practice scale was used. Results Of the patients who participated in the study, 54.3% were female. According to the general average scores received by the patients from European Patients Evaluate General/Family Practice-TR Patient Satisfaction Survey questions, average scores of male patients were found to be higher than those of female patients. Scores of the divorced and widow patients were higher compared to other groups, but this was not statistically significant. Average scores of the patients whose educational status is secondary school were higher compared to other groups. Scores of the patients with children were higher compared to those without children. Scores of the patients whose occupation was farming were higher compared to the other groups of occupation. Scores of the patients whose income was TL 1,001–2,500 were found to be higher compared to other patients. Scores of the patients who stated that they never had difficulty in access were higher compared to others, but this was not statistically significant. Average scores of the patients who had chronic diseases and patients who stated to have physical handicap were higher compared to those who did not have chronic disease and physical handicap, but these differences were not found to be statistically significant, either. Conclusion There is a statistically significant difference between the patients' demographic characteristics (sex, educational status, occupation, and income status) and their levels of satisfaction with the family medicine practice. PMID:25414572
UNIVERSITY OF DELAWARE Information on biosafety is available on the Environmental Health & Safety web page at
Firestone, Jeremy
.):______________ __________________________________________________________________ 10. List human diseases caused by the agents and/or diseases that may impact plantsUNIVERSITY OF DELAWARE Information on biosafety is available on the Environmental Health & Safety:_____________________________________________________ 5. Please attach an abstract of the work being performed. 6. Labs to be used for work
Page 1 Updated 08/22/12 National Science Foundation / National Institutes of Health
Berdichevsky, Victor
Institutes of Health (NIH) to provide training in the Responsible Conduct of Research (RCR) to relevant and NIH, WSU offers a basic RCR course that can be applied toward these training requirements. This on), which is also used for IRB and IACUC training at WSU. For the RCR requirements, additional discipline
Bloodborne pathogens. -1910.1030 Page 1 of 33 Occupational Safety & Health Administration
Baker, Chris I.
, human blood components, and products made from human blood. Bloodborne Pathogens means pathogenic, needles, scalpels, broken glass, broken capillary tubes, and exposed ends of dental wires. http://www.osha.S. Department of Health and Human Services, or designated representative. Engineering Controls means controls (e
-Page 1 -10/11 JOHNS HOPKINS UNIVERSITY SCHOOL OF NURSING PRE-ENTRANCE HEALTH FORM
Connor, Ed
on your course registration. Please provide titer documentation for MEASLES, RUBELLA, MUMPS, VARICELLA by Health Care Provider (Please print) 1. MEASLES (Rubeola) Please provide documentation of positive measles/DD/Year) __ __ / __ __ / ________. IF TITER IS NEGATIVE, please see your Healthcare Provider to receive the MMR vaccine. Repeat Measles Titer
PRIVACY POLICY AND PROCEDURES Policy #: 2100.10 LSU Health Sciences Center New Orleans Page: 1
as otherwise statutorily excluded. Such exclusions consists of psychotherapy notes, information incident. Examples of Protected Health Information include medical and billing records of a patient. Psychotherapy counseling session and that are separated from the rest of the individual's record. Psychotherapy notes do
Environmental health-risk assessment for tritium releases at the National Tritium Labeling Facility at Lawrence Berkeley National Laboratory
McKone, T.E.; Brand, K.P. [Lawrence Livermore National Lab., CA (United States). Health and Ecological Assessment Div.; Shan, C. [Lawrence Berkeley National Lab., CA (United States). Earth Sciences Div.
This risk assessment calculates the probability of experiencing health effects, including cancer incidence due to tritium exposure for three groups of people: (1) LBNL workers near the LBNL facility--Building 75--that uses tritium; (2) other workers at LBNL and nearby neighbors; and (3) people who use the UC Berkeley campus area, and some Berkeley residents. All of these groups share the same probability of health effects from the background radiation from natural sources in the Berkeley area environment, including an increased risk of developing a cancer of 11,000 chances per million. In calculating risk the authors assumed continuous operation in Building 75 for at least a human lifetime. Under this assumption, LBNL workers located near Building 75 have an additional risk of 60 chances out of one million to suffer a cancer; other workers at LBNL and people who live near LBNL have an additional risk of six chances out of one million over a lifetime of exposure; and users of the UC Berkeley campus area and other residents of Berkeley have an additional risk of less than once chance out of one million over a lifetime.
The interdependence of mental health service systems: the effects of VA mental health funding on veterans' use of state mental health inpatient facilities
Rani A. Desai; Robert A. Rosenheck
Background: There are relatively few published data on how the financial structures of different health systems affect each other. With increasing financial restrictions in both public and private healthcare systems, it is important to understand how changes in one system (e.g. VA mental healthcare) affect utilization of other systems (e.g. state hospitals). Aims of Study: This study utilizes data from
Women's Education Level, Maternal Health Facilities, Abortion Legislation and Maternal Deaths: A Natural Experiment in Chile from 1957 to 2007
Koch, Elard; Thorp, John; Bravo, Miguel; Gatica, Sebastián; Romero, Camila X.; Aguilera, Hernán; Ahlers, Ivonne
Background The aim of this study was to assess the main factors related to maternal mortality reduction in large time series available in Chile in context of the United Nations' Millennium Development Goals (MDGs). Methods Time series of maternal mortality ratio (MMR) from official data (National Institute of Statistics, 1957–2007) along with parallel time series of education years, income per capita, fertility rate (TFR), birth order, clean water, sanitary sewer, and delivery by skilled attendants were analysed using autoregressive models (ARIMA). Historical changes on the mortality trend including the effect of different educational and maternal health policies implemented in 1965, and legislation that prohibited abortion in 1989 were assessed utilizing segmented regression techniques. Results During the 50-year study period, the MMR decreased from 293.7 to 18.2/100,000 live births, a decrease of 93.8%. Women's education level modulated the effects of TFR, birth order, delivery by skilled attendants, clean water, and sanitary sewer access. In the fully adjusted model, for every additional year of maternal education there was a corresponding decrease in the MMR of 29.3/100,000 live births. A rapid phase of decline between 1965 and 1981 (?13.29/100,000 live births each year) and a slow phase between 1981 and 2007 (?1.59/100,000 live births each year) were identified. After abortion was prohibited, the MMR decreased from 41.3 to 12.7 per 100,000 live births (?69.2%). The slope of the MMR did not appear to be altered by the change in abortion law. Conclusion Increasing education level appears to favourably impact the downward trend in the MMR, modulating other key factors such as access and utilization of maternal health facilities, changes in women's reproductive behaviour and improvements of the sanitary system. Consequently, different MDGs can act synergistically to improve maternal health. The reduction in the MMR is not related to the legal status of abortion. PMID:22574194
Health risks for the population living in the vicinity of an Integrated Waste Management Facility: Screening environmental pollutants.
Domingo, José L; Rovira, Joaquim; Vilavert, Lolita; Nadal, Martí; Figueras, María J; Schuhmacher, Marta
We performed a screening investigation to assess the human health risks of the Integrated Waste Management Facility (IWMF: mechanical-biological treatment (MBT) plant plus municipal solid waste incinerator (MSWI); Ecoparc-3) of Barcelona (Spain). Air concentrations of pollutants potentially released by the MBT plant (VOCs and bioaerosols) and the MSWI (trace elements, PCDD/Fs and PCBs) were determined. Trace elements, PCDD/Fs and PCBs were also analyzed in soil samples. The concentrations of trace elements and bioaerosols were similar to those previously reported in other areas of similar characteristics, while formaldehyde was the predominant VOC. Interestingly, PCDD/F concentrations in soil and air were the highest ever reported near a MSWI in Catalonia, being maximum concentrations 10.8ngWHO-TEQ/kg and 41.3fgWHO-TEQ/m(3), respectively. In addition, there has not been any reduction in soils, even after the closure of a power plant located adjacently. Human health risks of PCDD/F exposure in the closest urban nucleus located downwind the MSWI are up to 10-times higher than those nearby other MSWIs in Catalonia. Although results must be considered as very preliminary, they are a serious warning for local authorities. We strongly recommend to conduct additional studies to confirm these findings and, if necessary, to implement measures to urgently mitigate the impact of the MSWI on the surrounding environment. We must also state the tremendous importance of an individual evaluation of MSWIs, rather than generalizing their environmental and health risks. PMID:25770949
The Impact of a Direct Care Training Program on the Self-Efficacy of Newly Hired Direct Care Employees at State Mental Health Facilities
ERIC Educational Resources Information Center
Lewis, Marcus Wayne
Self-efficacy has been shown to be an important element in the success of individuals in a variety of different settings. This research examined the impact of a two week new employee orientation training program on the general and social self-efficacy of newly hired direct care employees at state mental health facilities. The research showed that…
Adults with Intellectual Disabilities Living in Hong Kong's Residential Care Facilities: A Descriptive Analysis of Health and Disease Patterns by Sex, Age, and Presence of Down Syndrome
ERIC Educational Resources Information Center
Wong, Chi Wai
The aim of this study was to describe the health status profile and identify the healthcare needs of adults with intellectual disability (ID) residing in 18 of Hong Kong's residential care facilities. The author employed a cross-sectional study using a structured questionnaire survey to collect data on 811 persons with ID (432 males, 53.3%, and…
Psychological and social effects of robot assisted activity to elderly people who stay at a health service facility for the aged
Kazuyoshi Wada; Takanori Shibata; Tomoko Saito; Kazuo Tanie
We have been developing mental commit robots that provide psychological, physiological, and social effects to human beings through physical interaction. The appearances of these robots look like real animals such as cat and seal. The seal robot was developed especially for therapy. We have applied seal robots to assisting activity of elderly people at a health service facility for the
Savings analysis of a 1 MW cogeneration system at a Texas mental health facility
Athar, A.; Turner, W.D.; Caton, J.A. [Texas A and M Univ., College Station, TX (United States); McClean, G. [Texas Department for Mental Health and Mental Retardation, Austin, TX (United States)
Cogeneration is defined as the generation of electric power and coincident recovery of useful thermal energy from a single prime mover using a single fuel. The 1 MW gas turbine cogeneration system at Texas Department of Mental Health and Mental Retardation (TDMHMR), Austin, came on line in March, 1992 and is a unique application of federal and state funds. This system has been analyzed for its present performance and loads using hourly measured data. The Energy Systems Laboratory (ESL) at Texas A and M University has been collecting hourly data for natural gas use and the electrical energy produced by the engine since August, 1992. Waste heat recovered by the Waste Heat Recovery Boiler (WHRB) is also monitored. This paper describes the present system, analyzes the system using hourly monitored data, calculates energy and dollar savings, compares the measured results with the estimated savings, and discusses some of the problems encountered during the first year of operation.
Quality of prescribing for hypertension and bronchial asthma at a tertiary health care facility, India using Prescription Quality Index tool
Suthar, Jalpa V.; Patel, Varsha J.; Vaishnav, B.
Objective: Several tools have been introduced to evaluate the quality of prescribing. The aim of this study was to determine the quality of prescribing in hypertension and bronchial asthma in tertiary health care (THC) setting using the new Prescription Quality Index (PQI) tool and to assess the reliability of this tool. Methods: A prospective cross-sectional study was carried out for 2 months in order to assess the quality of prescribing of antihypertensive and antiasthmatic drugs using recently described PQI at THC facility. Patients with hypertension and bronchial asthma, attending out-patient departments of internal medicine and pulmonary medicine respectively for at least 3 months were included. Complete medical history and prescriptions received were noted. Total and criteria wise PQI scores were derived for each prescription. Prescriptions were categorized as poor, medium and high quality based on total PQI scores. Results: A total of 222 patients were included. Mean age was 56 ± 15.1 years (range 4-87 years) with 67 (30.2%) patients above 65 years of age. Mean total PQI score was 32.1 ± 5.1. Of 222 prescriptions, 103 (46.4%) prescriptions were of high quality with PQI score ?34. Quality of prescribing did not differ between hypertension and bronchial asthma (P > 0.05). The value of Cronbach's ? for the entire 22 criteria of PQI was 0.71. Conclusion: As evaluated by PQI tool, the quality of prescribing for hypertension and bronchial asthma is good in about 47% of prescriptions at THC facility. PQI is valid for measuring prescribing quality in these chronic diseases in Indian setting. PMID:25538464
Woodbridge research facility remedial investigation/feasibility study. Health and safety plan. Final report
Thompson, P.; McKown, G.; Waugh, J.; Houser, W.; Joy, G.
The requirements set forth in 29 CFR 1910.120(f), shall be met for all employees performing or supervising hazardous waste operations. Medical exams shall be conducted as soon as possible upon notification by an employee that he/she has developed signs or symptoms indicating possible health hazards or overexposure to hazardous substances. Subcontractor personnel shall provide documentation of current status of participation in a medical surveillance program as required by 29 CFR 1910.120(f). Subcontractors unable to provide such documentation shall have successfully completed a medical examination as described in the above referenced OSHA standard prior to beginning work in a contaminated zone. Specific protocols for medical examinations are designed by an occupational physician. Common components include: (a) medical history and physical examination; (b) dipstick urinalysis, vision screen and vital signs; (c) spirometry ;(d) audiometry; (e) blood chemistry (complete blood count, liver function, kidney function, lipid metabolism, carbohydrate metabolism); (f) resting EkG (with approval); (g) chest radiograph (P/A). No project-specific medical examinations, or biological monitoring is required for this project.
Survey of potential health and safety hazards of commercial-scale ethanol production facilities
Watson, A.P.; Smith, J.G.; Elmore, J.L.
Generic safety and health aspects of commercial-scale (60 to 600 million L/y) anhydrous ethanol production were identified. Several common feedstocks (grains, roots and fibers, and sugarcane) and fuels (coal, natural gas, wood, and bagasse) were evaluated throughout each step of generic plant operation, from initial milling and sizing through saccharification, fermentation, distillation, and stillage disposal. The fermentation, digestion, or combustion phases are not particularly hazardous, although the strong acids and bases used for hydrolysis and pH adjustment should be handled with the same precautions that every industrial solvent deserves. The most serious safety hazard is that of explosion from grain dust or ethanol fume ignition and boiler/steam line overpressurization. Inhalation of ethanol and carbon dioxide vapors may cause intoxication or asphyxiation in unventilated areas, which could be particularly hazardous near equipment controls and agitating vats. Contact with low-pressure process steam would produce scalding burns. Benzene, used in stripping water from ethanol in the final distillation column, is a suspected leukemogen. Substitution of this fluid by alternative liquids is addressed.
Health facility-based malaria surveillance: The effects of age, area of residence and diagnostics on test positivity rates
Background The malaria test positivity rate (TPR) is increasingly used as an indicator of malaria morbidity because TPR is based on laboratory-confirmed cases and is simple to incorporate into existing surveillance systems. However, temporal trends in TPR may reflect changes in factors associated with malaria rather than true changes in malaria morbidity. This study examines the effects of age, area of residence and diagnostic test on TPR at two health facilities in regions of Uganda with differing malaria endemicity. Methods The analysis included data from diagnostic blood smears performed at health facilities in Walukuba and Aduku between January 2009 and December 2010. The associations between age and time and between age and TPR were evaluated independently to determine the potential for age to confound temporal trends in TPR. Subsequently, differences between observed TPR and TPR adjusted for age were compared to determine if confounding was present. A similar analysis was performed for area of residence. Temporal trends in observed TPR were compared to trends in TPR expected using rapid diagnostic tests, which were modelled based upon sensitivity and specificity in prior studies. Results Age was independently associated with both TPR and time at both sites. At Aduku, age-adjusted TPR increased relative to observed TPR due to the association between younger age and TPR and the gradual increase in age distribution. At Walukuba, there were no clear differences between observed and age-adjusted TPR. Area of residence was independently associated with both TPR and time at both sites, though there were no clear differences in temporal trends in area of residence-adjusted TPR and observed TPR at either site. Expected TPR with pLDH- and HRP-2-based rapid diagnostic tests (RDTs) was higher than observed TPR at all time points at both sites. Conclusions Adjusting for potential confounders such as age and area of residence can ensure that temporal trends in TPR due to confounding are not mistakenly ascribed to true changes in malaria morbidity. The potentially large effect of diagnostic test on TPR can be accounted for by calculating and adjusting for the sensitivity and specificity of the test used. PMID:22770511
Cost-Effectiveness Analysis of Health Care Waste Treatment Facilities in Iran Hospitals; a Provider Perspective
RASHIDIAN, Arash; ALINIA, Cyrus; MAJDZADEH, Reza
Background: Our aim was to make right and informative decision about choosing the most cost-effectiveness heterogeneous infectious waste treatment methods and devices. Methods: In this descriptive study, decision tree analysis, with 10-yr time horizon in bottom-up approach was used to estimate the costs and effectiveness criteria of the employed devices at provider perspective in Iranian hospitals. We used the one-way and scenario sensitivity analysis to measure the effects of variables with uncertainty. The resources of data were national Environmental and Occupational Health Center Survey (EOHCS) in 2012, field observation and completing questionnaire by relevant authorities in mentioned centers. Results: Devices called Saray 2, Autoclave based, and Newster 10, Hydroclave based, with 92032.4 (±12005) and 6786322.9 (±826453) Dollars had the lowest and highest costs respectively in studied time period and given the 5–10% discount rate. Depending on effectiveness factor type, Newster 10 with Ecodas products and Saray products respectively had the highest and lowest effectiveness. In most considered scenarios, Caspian-Alborz device was the most cost-effectiveness alternative, so for the treatment of each adjusted unit of volume and weight of infectious waste in a 10 year period and in different conditions, between 39.4 (±5.1) to 915 (±111.4) dollars must be spent. Conclusion: The findings indicate the inefficiency and waste of resources, so in order to efficient resource allocation and to encourage further cost containment in infectious waste management we introduce policy recommendation that be taken in three levels.
NASA Technical Reports Server (NTRS)
The safety of NASA's in house microelectronics facility is addressed. Industrial health standards, facility emission control requirements, operation and safety checklists, and the disposal of epitaxial vent gas are considered.
Care Everywhere Facility Listing (April 2012) Facility Name City State
Squire, Larry R.
FEATHER RIVER HEALTH CENTER Paradise CA FAIR OAKS CLINIC - COMMUNITY HEALTH ALLIANCE OF PASADENA PasadenaCare Everywhere Facility Listing (April 2012) Facility Name City State PROVIDENCE HEALTH & SERVICES ALASKA Anchorage AK KODIAK COMMUNITY HEALTH CENTER Kodiak AK INFIRMARY HEALTH SYSTEMS Mobile AL SISTERS
Communicating health risks to the community from a state-of-the art waste-to-energy resource recovery facility through multimedia environmental monitoring program
Rao, R.K.
Since 1986, when Montgomery County, Maryland decided to construct a municipal solid waste Resource Recovery Facility (RRF), the County has been seeking citizen input through citizen advisory committee meetings. Due to public concern that organics, primarily dioxins, that are released from municipal waste combustion create the risk of potential health-effects including cancer, the County conducted a multiple pathway health-risk study in 1989. In this study, organics and trace metals that are known to be released from municipal waste combustors and are generally considered to be of importance from a public health perspective were addressed. The County conducted several citizen meetings for communicating the results of the health risk studies. In these meetings, some citizens living in the neighborhood of the facility still expressed concern, and asked the County to conduct an ambient monitoring program prior to and during the operation of the facility. The County agreed to conduct a multimedia environmental monitoring program. The County Council endorsed this program. The major objective of the program was to determine the existing background levels of toxics prior to the operation of the facility and incremental increases, if any, resulting from the operation of the facility. In this program organics and trace metals discussed earlier, were periodically sampled. The media sampled were: air, soil, garden vegetables, surface water, fish and sediment from the farm ponds, dairy milk and hay. This paper discusses the original design of the program, citizen input to the design of the program, results of the program, and typical issues raised by the citizens in numerous public briefing conducted by the County, and the County's responses.
'I was raped by Santa Claus': Responding to disclosures of sexual assault in mental health inpatient facilities.
Ashmore, Toni; Spangaro, Jo; McNamara, Lorna
Sexual violence is significantly higher among those with mental illness than the rest of the population. The risk of sexual violence posed to patients during inpatient admissions is now also beginning to be recognized, but remains a challenging area of practice. This paper introduces a trauma-informed care approach for responding to disclosures of sexual violence by people with serious mental illness, taking into account the complexities of caring for individuals who might be unable to provide coherent accounts of assaults and/or who might be experiencing varying degrees of psychosis. A framework for understanding and responding to disclosures of sexual violence that occur in mental health facilities is described, recognizing that such disclosures take many forms, including plausible and implausible accounts of recent sexual violence, as well as disclosures of past abuse triggered by current traumatic experiences. Illustrated by case studies, the practice implications for each type of disclosure described in the framework are explored in relation to investigation, care planning, and prevention. PMID:25582409
Factors Influencing Job Satisfaction and Anticipated Turnover among Nurses in Sidama Zone Public Health Facilities, South Ethiopia
Belachew, Tefera; Yimam, Ebrahim
Background. Workplace turnover is destructive to nursing and patient outcomes as it leads to losing competent and qualified nurses. However, developments of coping strategies demand a clear understanding of workplace variables that either motivate nurses to remain employed or lead them to leave their current jobs. Objective. This study was designed toassess factors influencing job satisfaction and intention to turnover among nurses in Sidama zone public health facilities, in Southern Ethiopia. Method. Cross-sectional study design was carried out on 278 nurses using both qualitative and quantitative data collection methods from May 12 to June 05, 2010. Result. A total of 242 nurses were interviewed giving a response rate of 87%. Nearly two-third (68.6%) of the participants were female, and the mean age was 28 (±6.27) years for both sexes. All job satisfaction subscale except benefit and salary subscale were significant predictors of overall job satisfaction. Satisfactions with work environment and group cohesion (AOR: 0.25 [95% CI: 0.12, 0.51]), single cohesion (AOR: 2.56 [95% CI: 1.27, 5.13]), and working in hospital (AOR: 2.19 [95% CI: 1.12, 4.30]) were the final significant predictors of anticipated turnover of Sidama zone nurses. Conclusions. More than any factors managers should consider the modification of working environment and group cohesions rather than trying to modify nurses to retain and maintain more experienced nurses for the organizations. PMID:24707397
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Why some women fail to give birth at health facilities: a qualitative study of women's perceptions of perinatal care from rural Southern Malawi
Background Despite Malawi government's policy to support women to deliver in health facilities with the assistance of skilled attendants, some women do not access this care. Objective The study explores the reasons why women delivered at home without skilled attendance despite receiving antenatal care at a health centre and their perceptions of perinatal care. Methods A descriptive study design with qualitative data collection and analysis methods. Data were collected through face-to-face in-depth interviews using a semi- structured interview guide that collected information on women's perception on perinatal care. A total of 12 in- depth interviews were conducted with women that had delivered at home in the period December 2010 to March 2011. The women were asked how they perceived the care they received from health workers before, during, and after delivery. Data were manually analyzed using thematic analysis. Results Onset of labor at night, rainy season, rapid labor, socio-cultural factors and health workers' attitudes were related to the women delivering at home. The participants were assisted in the delivery by traditional birth attendants, relatives or neighbors. Two women delivered alone. Most women went to the health facility the same day after delivery. Conclusions This study reveals beliefs about labor and delivery that need to be addressed through provision of appropriate perinatal information to raise community awareness. Even though, it is not easy to change cultural beliefs to convince women to use health facilities for deliveries. There is a need for further exploration of barriers that prevent women from accessing health care for better understanding and subsequently identification of optimal solutions with involvement of the communities themselves. PMID:23394229
Site specific risk assessment of an energy-from-waste thermal treatment facility in Durham Region, Ontario, Canada. Part A: Human health risk assessment.
Ollson, Christopher A; Knopper, Loren D; Whitfield Aslund, Melissa L; Jayasinghe, Ruwan
The regions of Durham and York in Ontario, Canada have partnered to construct an energy-from-waste thermal treatment facility as part of a long term strategy for the management of their municipal solid waste. This paper presents the results of a comprehensive human health risk assessment for this facility. This assessment was based on extensive sampling of baseline environmental conditions (e.g., collection and analysis of air, soil, water, and biota samples) as well as detailed site specific modeling to predict facility-related emissions of 87 identified contaminants of potential concern. Emissions were estimated for both the approved initial operating design capacity of the facility (140,000 tonnes per year) and for the maximum design capacity (400,000 tonnes per year). For the 140,000 tonnes per year scenario, this assessment indicated that facility-related emissions are unlikely to cause adverse health risks to local residents, farmers, or other receptors (e.g., recreational users). For the 400,000 tonnes per year scenarios, slightly elevated risks were noted with respect to inhalation (hydrogen chloride) and infant consumption of breast milk (dioxins and furans), but only during predicted 'upset conditions' (i.e. facility start-up, shutdown, and loss of air pollution control) that represent unusual and/or transient occurrences. However, current provincial regulations require that additional environmental screening would be mandatory prior to expansion of the facility beyond the initial approved capacity (140,000 tonnes per year). Therefore, the potential risks due to upset conditions for the 400,000 tonnes per year scenario should be more closely investigated if future expansion is pursued. PMID:23911923
Systematic review of facility-based sexual and reproductive health services for female sex workers in Africa
Background Several biological, behavioural, and structural risk factors place female sex workers (FSWs) at heightened risk of HIV, sexually transmitted infections (STIs), and other adverse sexual and reproductive health (SRH) outcomes. FSW projects in many settings have demonstrated effective ways of altering this risk, improving the health and wellbeing of these women. Yet the optimum delivery model of FSW projects in Africa is unclear. This systematic review describes intervention packages, service-delivery models, and extent of government involvement in these services in Africa. Methods On 22 November 2012, we searched Web of Science and MEDLINE, without date restrictions, for studies describing clinical and non-clinical facility-based SRH prevention and care services for FSWs in low- and middle-income countries in Africa. We also identified articles in key non-indexed journals and on websites of international organizations. A single reviewer screened titles and abstracts, and extracted data from articles using standardised tools. Results We located 149 articles, which described 54 projects. Most were localised and small-scale; focused on research activities (rather than on large-scale service delivery); operated with little coordination, either nationally or regionally; and had scanty government support (instead a range of international donors generally funded services). Almost all sites only addressed HIV prevention and STIs. Most services distributed male condoms, but only 10% provided female condoms. HIV services mainly encompassed HIV counselling and testing; few offered HIV care and treatment such as CD4 testing or antiretroviral therapy (ART). While STI services were more comprehensive, periodic presumptive treatment was only provided in 11 instances. Services often ignored broader SRH needs such as family planning, cervical cancer screening, and gender-based violence services. Conclusions Sex work programmes in Africa have limited coverage and a narrow scope of services and are poorly coordinated with broader HIV and SRH services. To improve FSWs' health and reduce onward HIV transmission, access to ART needs to be addressed urgently. Nevertheless, HIV prevention should remain the mainstay of services. Service delivery models that integrate broader SRH services and address structural risk factors are much needed. Government-led FSW services of high quality and scale would markedly reduce SRH vulnerabilities of FSWs in Africa. PMID:24916010
Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo
Sara E Casey; Kathleen T Mitchell; Immaculée Mulamba Amisi; Martin Migombano Haliza; Blandine Aveledi; Prince Kalenga; Judy Austin
BACKGROUND: Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC). Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH) indicators illustrate the effect that the prolonged crisis in DRC has had
Mixed and low-level waste treatment project: Appendix C, Health and safety criteria for the mixed and low-level waste treatment facility at the Idaho National Engineering Laboratory
Neupauer, R.M.; Thurmond, S.M.
This report contains health and safety information relating to the chemicals that have been identified in the mixed waste streams at the Waste Treatment Facility at the Idaho National Engineering Laboratory. Information is summarized in two summary sections--one for health considerations and one for safety considerations. Detailed health and safety information is presented in material safety data sheets (MSDSs) for each chemical.
Mixed and low-level waste treatment project: Appendix C, Health and safety criteria for the mixed and low-level waste treatment facility at the Idaho National Engineering Laboratory. Part 2, Chemical constituents
Neupauer, R.M.; Thurmond, S.M.
This report contains health and safety information relating to the chemicals that have been identified in the mixed waste streams at the Waste Treatment Facility at the Idaho National Engineering Laboratory. Information is summarized in two summary sections--one for health considerations and one for safety considerations. Detailed health and safety information is presented in material safety data sheets (MSDSs) for each chemical.
Individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda
Background Obstructed labour is still a major cause of maternal morbidity and mortality and of adverse outcome for newborns in low-income countries. The aim of this study was to investigate the role of individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda. Methods A review was performed on 12,463 obstetric records for the year 2006 from six hospitals located in south-western Uganda and 11,180 women records were analysed. Multivariate logistic regression analyses were applied to control for probable confounders. Results Prevalence of obstructed labour for the six hospitals was 10.5% and the main causes were cephalopelvic disproportion (63.3%), malpresentation or malposition (36.4%) and hydrocephalus (0.3%). The risk of obstructed labour was statistically significantly associated with being resident of a particular district [Isingiro] (AOR 1.39, 95% CI: 1.04-1.86), with nulliparous status (AOR 1.47, 95% CI: 1.22-1.78), having delivered once before (AOR 1.57, 95% CI: 1.30-1.91) and age group 15-19 years (AOR 1.21, 95% CI: 1.02-1.45). The risk for perinatal death as an adverse outcome was statistically significantly associated with districts other than five comprising the study area (AOR 2.85, 95% CI: 1.60-5.08) and grand multiparous status (AOR 1.89, 95% CI: 1.11-3.22). Women who lacked paid employment were at increased risk of obstructed labour. Perinatal mortality rate was 142/1000 total births in women with obstructed labour compared to 65/1000 total births in women without the condition. The odds of having maternal complications in women with obstructed labour were 8 times those without the condition. The case fatality rate for obstructed labour was 1.2%. Conclusions Individual socio-demographic and health system factors are strongly associated with obstructed labour and its adverse outcome in south-western Uganda. Our study provides baseline information which may be used by policy makers and implementers to improve implementation of safe motherhood programmes. PMID:21995340
Applying the sisterhood method for estimating maternal mortality to a health facility-based sample: a comparison with results from a household-based sample.
Danel, I; Graham, W; Stupp, P; Castillo, P
Researchers compared maternal mortality estimates using the sisterhood method in a household survey conducted in November 1991 and in an outpatient health facility survey conducted in July 1992. Both surveys were conducted in Region I, a predominantly rural, mountainous area in northern Nicaragua. They analyzed data from 9232 interviews with adults younger than 49. The estimated lifetime risk of maternal death and the corresponding maternal mortality ratio were essentially identical for both the household and health facility surveys (0.145 and 0.144 [i.e., 1 in 69 of reproductive age died due to pregnancy-related events] and 243 and 241/100,000 live births, respectively). The estimates were similar for both surveys, even when the results were standardized for age, residence, and socioeconomic characteristics. An important limitation to the sisterhood method of estimating maternal mortality is that it estimates maternal mortality for a period about 10-12 years before the study and therefore cannot be used to assess the immediate effect of interventions to reduce maternal mortality. Nevertheless, in areas with poor maternal mortality surveillance or where no alternative exists to collecting population-based data, the sisterhood method can reliably estimate maternal mortality. These findings suggest that health facilities-based studies using the sisterhood method is a feasible, low-cost, and efficient method to estimate maternal mortality in certain settings at subnational levels. PMID:8921489
Evaluating health care facilities.
Kennon, P A; Bauer, J S; Parshall, S A
Much lip service is given to the idea of post-occupancy evaluation by planners and architects, but examples are rare. The firm these authors represent has had a formal and documented post-occupancy evaluation (POE) program in place since the mid-1960s. In this article, the authors offer a model POE process involving the project team and users working together at the project site. Subjective and objective data are combined in a quantitative scoring format, and lessons learned are documented for use by both the institution (operationally) and the planner/designer team (in future projects). The POE model is demonstrated by application to a project recently completed for the University of Washington Hospitals and Clinics in Seattle. PMID:10291626
Problem 65 in Section 4.1 (Page 274) Constructing a pipeline Supertankers off-load oil at a docking facility 4 mi offshore. The nearest refinery
Schilling, Anne
facility 4 mi offshore. The nearest refinery is 9 mi east of the shore point nearest the docking facility. A pipeline must be constructed connecting the docking facility with the refinery. The pipeline costs $300.42 miles away from the refinery, or equivalently 3.58 miles away from Point A (as the back of the book has
Road map to scaling-up: translating operations research study's results into actions for expanding medical abortion services in rural health facilities in Nepal
Background Identifying unsafe abortion among the major causes of maternal deaths and respecting the rights to health of women, in 2002, the Nepali parliament liberalized abortion up to 12 weeks of pregnancy on request. However, enhancing women's awareness on and access to safe and legal abortion services, particularly in rural areas, remains a challenge in Nepal despite a decade of the initiation of safe abortion services. Methods Between January 2011 and December 2012, an operations research study was carried out using quasi-experimental design to determine the effectiveness of engaging female community health volunteers, auxiliary nurse midwives, and nurses to provide medical abortion services from outreach health facilities to increase the accessibility and acceptability of women to medical abortion. This paper describes key components of the operations research study, key research findings, and follow-up actions that contributed to create a conducive environment and evidence in scaling up medical abortion services in rural areas of Nepal. Results It was found that careful planning and implementation, continuous advocacy, and engagement of key stakeholders, including key government officials, from the planning stage of study is not only crucial for successful completion of the project but also instrumental for translating research results into action and policy change. While challenges remained at different levels, medical abortion services delivered by nurses and auxiliary nurse midwives working at rural outreach health facilities without oversight of physicians was perceived to be accessible, effective, and of good quality by the service providers and the women who received medical abortion services from these rural health facilities. Conclusions This research provided further evidence and a road-map for expanding medical abortion services to rural areas by mid-level service providers in minimum clinical settings without the oversight of physicians, thus reducing complications and deaths due to unsafe abortion. PMID:24886393
Human Health and Ecological Risk Assessment for the Operation of the Explosives Waste Treatment Facility at Site 300 of the Lawrence Livermore National Laboratory
Gallegos, G; Daniels, J; Wegrecki, A
This document contains the human health and ecological risk assessment for the Resource Recovery and Conservation Act (RCRA) permit renewal for the Explosives Waste Treatment Facility (EWTF). Volume 1 is the text of the risk assessment, and Volume 2 (provided on a compact disc) is the supporting modeling data. The EWTF is operated by the Lawrence Livermore National Laboratory (LLNL) at Site 300, which is located in the foothills between the cities of Livermore and Tracy, approximately 17 miles east of Livermore and 8 miles southwest of Tracy. Figure 1 is a map of the San Francisco Bay Area, showing the location of Site 300 and other points of reference. One of the principal activities of Site 300 is to test what are known as 'high explosives' for nuclear weapons. These are the highly energetic materials that provide the force to drive fissionable material to criticality. LLNL scientists develop and test the explosives and the integrated non-nuclear components in support of the United States nuclear stockpile stewardship program as well as in support of conventional weapons and the aircraft, mining, oil exploration, and construction industries. Many Site 300 facilities are used in support of high explosives research. Some facilities are used in the chemical formulation of explosives; others are locations where explosive charges are mechanically pressed; others are locations where the materials are inspected radiographically for such defects as cracks and voids. Finally, some facilities are locations where the machined charges are assembled before they are sent to the onsite test firing facilities, and additional facilities are locations where materials are stored. Wastes generated from high-explosives research are treated by open burning (OB) and open detonation (OD). OB and OD treatments are necessary because they are the safest methods for treating explosives wastes generated at these facilities, and they eliminate the requirement for further handling and transportation that would be required if the wastes were treated off site.
Inner Workings of Gene Tied to Breast Ovarian Cancer Revealed -Print -MSN Health & Fitness http://health.msn.com/print.aspx?cp-documentid=100262630&page=0[8/24/2010 3:20:16 PM
Kowalczykowski, Stephen C.
protein encoded by the BRCA2 gene. Dysfunction of this gene can up the risk for both breast and ovarianInner Workings of Gene Tied to Breast Ovarian Cancer Revealed - Print - MSN Health & Fitness http://health.msn.com/print.aspx?cp-documentid=100262630&page=0[8/24/2010 3:20:16 PM] Inner Workings of Gene Tied to Breast, Ovarian Cancer Revealed In 3
Where Do the Rural Poor Deliver When High Coverage of Health Facility Delivery Is Achieved? Findings from a Community and Hospital Survey in Tanzania
Straneo, Manuela; Fogliati, Piera; Azzimonti, Gaetano; Mangi, Sabina; Kisika, Firma
Introduction As part of maternal mortality reducing strategies, coverage of delivery care among sub-Saharan African rural poor will improve, with a range of facilities providing services. Whether high coverage will benefit all socio-economic groups is unknown. Iringa rural District, Southern Tanzania, with high facility delivery coverage, offers a paradigm to address this question. Delivery services are available in first-line facilities (dispensaries, health centres) and one hospital. We assessed whether all socio-economic groups access the only comprehensive emergency obstetric care facility equally, and surveyed existing delivery services. Methods District population characteristics were obtained from a household community survey (n?=?463). A Hospital survey collected data on women who delivered in this facility (n?=?1072). Principal component analysis on household assets was used to assess socio-economic status. Hospital population socio-demographic characteristics were compared to District population using multivariable logistic regression. Deliveries' distribution in District facilities and staffing were analysed using routine data. Results Women from the hospital compared to the District population were more likely to be wealthier. Adjusted odds ratio of hospital delivery increased progressively across socio-economic groups, from 1.73 for the poorer (p?=?0.0031) to 4.53 (p<0.0001) for the richest. Remarkable dispersion of deliveries and poor staffing were found. In 2012, 5505/7645 (72%) institutional deliveries took place in 68 first-line facilities, the remaining in the hospital. 56/68 (67.6%) first-line facilities reported ?100 deliveries/year, attending 33% of deliveries. Insufficient numbers of skilled birth attendants were found in 42.9% of facilities. Discussion Poorer women remain disadvantaged in high coverage, as they access lower level facilities and are under-represented where life-saving transfusions and caesarean sections are available. Tackling the challenges posed by low caseloads and staffing on first-line rural care requires confronting a dilemma between coverage and quality. Reducing number of delivery sites is recommended to improve quality and equity of care. PMID:25460007
Health and safety plan for the Isotopes Facilities Deactivation Project at Oak Ridge National Laboratory, Oak Ridge, Tennessee
This HASP describes the process for identifying the requirements, written safety documentation, and procedures for protecting personnel involved in the Isotopes Facilities Deactivation Project. Objective of this project is to place 19 former isotope production facilities at ORNL in a safe condition in anticipation of an extended period of minimum surveillance and maintenance.
Who cares for older people with mental illness? A survey of residential aged care facilities in the Australian Capital Territory: implications for mental health nursing.
Jones, Tony S; Matias, May; Powell, Jo; Jones, Eriita G; Fishburn, Joe; Looi, Jeffrey C L
Residential aged care facilities are increasingly becoming locations wherein the most frail and older people with mental illness live out the remainder of their lives, yet it has become apparent in recent years that these institutions are fraught with a variety of social and clinical problems. One issue of concern has been the exodus of registered nurses (both general and psychiatric), who have been increasingly replaced by carers with little or no expertise in psychiatric illness or disorders of cognitive decline. This 'de-professionalizing' of aged care has important implications for the well-being of clients, particularity those with complex mental health problems. In this survey we sought to discover demographic information concerning those who provide front-line care to this population of aged Australians, and we sought also to ascertain how much education in caring for residents who suffer specifically from neurodegenerative disorders (the dementias) and mental illness was provided by the facilities to those who care for such older people. The lack of training in the areas of mental health and cognitive impairment raises a variety of issues that mental health nurses need to address. These issues cover clinical, professional, and social justice dimensions. We believe that mental health nurses are strategically and professionally placed to take a leadership role in raising the profile of aged care in this country and they need to act proactively to secure the well-being of this particularly vulnerable client group. PMID:17845552
Staff Report to the Senior Department Official on Recognition Compliance Issues. Recommendation Page: Council on Education for Public Health
ERIC Educational Resources Information Center
US Department of Education, 2010
Between 1945-1973, the American Public Health Association (APHA), a membership organization for public professionals, accredited graduate programs in public health. In 1974, the APHA and the Association of Schools of Public Health (ASPH), a national association representing deans, faculty, and students of accredited schools of public health,…
Health, United States, 2000 With Adolescent Health Chartbook
NSDL National Science Digital Library
Duran, C. R.
This week, the National Center for Health Statistics (NCHS) released this major report on health in the United States. It is an electronic edition of the annual report which details a variety of health statistics, such as "birth and death rates, infant mortality, life expectancy, morbidity and health status, risk factors, use of ambulatory care and inpatient care, health personnel and facilities, financing of health care, health insurance and managed care, and other health topics." Users can download the full text of the 450-page report by topical section or in its entirety. Additionally, the report also includes a chartbook and trend tables that may be downloaded in Excel or Lotus formats. Updated tables, the official news releases, and previous editions of the report are also available at the site.
28/05/2008 18:53Malaria parasites fine-tune offspring's gender: study | Health | Reuters Page 1 of 2http://www.reuters.com/article/healthNews/idUSL2887819620080528?sp=true
Gardner, Andy
28/05/2008 18:53Malaria parasites fine-tune offspring's gender: study | Health | Reuters Page 1 EDT Malaria parasites fine-tune offspring's gender: study powered by Sphere By Michael Kahn LONDON (Reuters) - Malaria parasites fine-tune the number of male and female offspring they produce to maximize
Prevalence and determinants of caesarean section in private and public health facilities in underserved South Asian communities: cross-sectional analysis of data from Bangladesh, India and Nepal
Neuman, Melissa; Alcock, Glyn; Azad, Kishwar; Kuddus, Abdul; Osrin, David; More, Neena Shah; Nair, Nirmala; Tripathy, Prasanta; Sikorski, Catherine; Saville, Naomi; Sen, Aman; Colbourn, Tim; Houweling, Tanja A J; Seward, Nadine; Manandhar, Dharma S; Shrestha, Bhim P; Costello, Anthony; Prost, Audrey
Objectives To describe the prevalence and determinants of births by caesarean section in private and public health facilities in underserved communities in South Asia. Design Cross-sectional study. Setting 81 community-based geographical clusters in four locations in Bangladesh, India and Nepal (three rural, one urban). Participants 45?327 births occurring in the study areas between 2005 and 2012. Outcome measures Proportion of caesarean section deliveries by location and type of facility; determinants of caesarean section delivery by location. Results Institutional delivery rates varied widely between settings, from 21% in rural India to 90% in urban India. The proportion of private and charitable facility births delivered by caesarean section was 73% in Bangladesh, 30% in rural Nepal, 18% in urban India and 5% in rural India. The odds of caesarean section were greater in private and charitable health facilities than in public facilities in three of four study locations, even when adjusted for pregnancy and delivery characteristics, maternal characteristics and year of delivery (Bangladesh: adjusted OR (AOR) 5.91, 95% CI 5.15 to 6.78; Nepal: AOR 2.37, 95% CI 1.62 to 3.44; urban India: AOR 1.22, 95% CI 1.09 to 1.38). We found that highly educated women were particularly likely to deliver by caesarean in private facilities in urban India (AOR 2.10; 95% CI 1.61 to 2.75) and also in rural Bangladesh (AOR 11.09, 95% CI 6.28 to 19.57). Conclusions Our results lend support to the hypothesis that increased caesarean section rates in these South Asian countries may be driven in part by the private sector. They also suggest that preferences for caesarean delivery may be higher among highly educated women, and that individual-level and provider-level factors interact in driving caesarean rates higher. Rates of caesarean section in the private sector, and their maternal and neonatal health outcomes, require close monitoring. PMID:25550293
The Department of Energy`s Rocky Flats Plant: A guide to record series useful for health-related research. Volume III, facilities and equipment
This is the third in a series of seven volumes which constitute a guide to records of the Rocky Flats Plant useful for conducting health-related research. The primary purpose of Volume M is to describe record series pertaining to facilities and equipment at the Department of Energy`s (DOE) Rocky Flats Plant, now named the Rocky Flats Environmental Technology Site, near Denver, Colorado. History Associates Incorporated (HAI) prepared this guide as part of its work as the support services contractor for DOE`s Epidemiologic Records Inventory Project. This introduction briefly describes the Epidemiologic Records Inventory Project and HAI`s role in the project, provides a history of facilities and equipment practices at Rocky Flats, and identifies organizations contributing to facilities and equipment policies and activities. Other topics include the scope and arrangement of this volume and the organization to contact for access to these records. Comprehensive introductory and background information is available in Volume I. Other volumes in the guide pertain to administrative and general subjects, production and materials handling, workplace and environmental monitoring, employee health, and waste management. In addition, HAI has produced a subject-specific guide, titled The September 1957 Rocky Flats Fire: A Guide to Record Series of the Department of Energy and Its Contractors, which researchers should consult for further information about records related to this incident.
Parent and Health Care Professional Perspectives on Family-Centered Care for Children with Special Health Care Needs: Are We on the Same Page?
ERIC Educational Resources Information Center
Bellin, Melissa H.; Osteen, Philip; Heffernan, Caitlin; Levy, Judy M.; Snyder-Vogel, Mary E.
A family-centered approach to health care for children with special health care needs (CSHCN) is widely acknowledged as the ideal model of service delivery, but less is known about the actual practice of family-centered care (FCC), especially from the viewpoints of parents and health care professionals. This cross-sectional research compared…
An investigation of pre-activity cardiovascular screening procedures in health/fitness facilities--part II: rationale for low adherence with national standards.
Springer, Judy B; Eickhoff-Shemek, JoAnn M; Zuberbuehler, Ernest J
The purpose of this study was to explore the rationale provided by program directors and general managers of health/fitness facilities for low adherence to nationally accepted standards related to pre-activity cardiovascular screening procedures (PACSPs) for members and clients of personal trainers. Qualitative interviews were conducted with the directors/managers in a Midwest region representing 76 facilities who indicated they did not conduct PACSPs for members and clients of personal trainers. Analysis of the rationale provided revealed 6 major clusters: (1) Purpose or need for screening; (2) time and staffing; (3) barrier to participation; (4) personal responsibility for health and actions; (5) legal issues; and (6) company or franchise policy that categorized the reasons for low adherence to PACSPs. These findings highlight the need to increase awareness of the relevance of PACSPs among health/fitness managers, staff members, and current exercise science students as well as engage those in risk management for informed dialogue for consistent application of the standard of care. PMID:19751481
A brief, standardized tool for measuring HIV-related stigma among health facility staff: results of field testing in China, Dominica, Egypt, Kenya, Puerto Rico and St. Christopher & Nevis
Nyblade, Laura; Jain, Aparna; Benkirane, Manal; Li, Li; Lohiniva, Anna-Leena; McLean, Roger; Turan, Janet M; Varas-Díaz, Nelson; Cintrón-Bou, Francheska; Guan, Jihui; Kwena, Zachary; Thomas, Wendell
Introduction Within healthcare settings, HIV-related stigma is a recognized barrier to access of HIV prevention and treatment services and yet, few efforts have been made to scale-up stigma reduction programs in service delivery. This is in part due to the lack of a brief, simple, standardized tool for measuring stigma among all levels of health facility staff that works across diverse HIV prevalence, language and healthcare settings. In response, an international consortium led by the Health Policy Project, has developed and field tested a stigma measurement tool for use with health facility staff. Methods Experts participated in a content-development workshop to review an item pool of existing measures, identify gaps and prioritize questions. The resulting questionnaire was field tested in six diverse sites (China, Dominica, Egypt, Kenya, Puerto Rico and St. Christopher & Nevis). Respondents included clinical and non-clinical staff. Questionnaires were self- or interviewer-administered. Analysis of item performance across sites examined both psychometric properties and contextual issues. Results The key outcome of the process was a substantially reduced questionnaire. Eighteen core questions measure three programmatically actionable drivers of stigma within health facilities (worry about HIV transmission, attitudes towards people living with HIV (PLHIV), and health facility environment, including policies), and enacted stigma. The questionnaire also includes one short scale for attitudes towards PLHIV (5-item scale, ? = 0.78). Conclusions Stigma-reduction programmes in healthcare facilities are urgently needed to improve the quality of care provided, uphold the human right to healthcare, increase access to health services, and maximize investments in HIV prevention and treatment. This brief, standardized tool will facilitate inclusion of stigma measurement in research studies and in routine facility data collection, allowing for the monitoring of stigma within healthcare facilities and evaluation of stigma-reduction programmes. There is potential for wide use of the tool either as a stand-alone survey or integrated within other studies of health facility staff. PMID:24242266
The Uganda Newborn Study (UNEST): an effectiveness study on improving newborn health and survival in rural Uganda through a community-based intervention linked to health facilities - study protocol for a cluster randomized controlled trial
Background Reducing neonatal-related deaths is one of the major bottlenecks to achieving Millennium Development Goal 4. Studies in Asia and South America have shown that neonatal mortality can be reduced through community-based interventions, but these have not been adapted to scalable intervention packages for sub-Saharan Africa where the culture, health system and policy environment is different. In Uganda, health outcomes are poor for both mothers and newborn babies. Policy opportunities for neonatal health include the new national Health Sector Strategic Plan, which now prioritizes newborn health including use of a community model through Village Health Teams (VHT). The aim of the present study is to adapt, develop and cost an integrated maternal-newborn care package that links community and facility care, and to evaluate its effect on maternal and neonatal practices in order to inform policy and scale-up in Uganda. Methods/Design Through formative research around evidence-based practices, and dialogue with policy and technical advisers, we constructed a home-based neonatal care package implemented by the responsible VHT member, effectively a Community Health Worker (CHW). This CHW was trained to identify pregnant women and make five home visits - two before and three just after birth - so that linkages will be made to facility care and targeted messages for home-care and care-seeking delivered. The project is improving care in health units to provide standardized care for the mother and the newborn in both intervention and comparison areas. The study is taking place in a new Demographic Surveillance Site in two rural districts, Iganga and Mayuge, in Uganda. It is a two-arm cluster randomized controlled design with 31 intervention and 32 control areas (villages). The comparison parishes receive the standard care already being provided by the district, but to the intervention villages are added a system for CHWs to visit the mother five times in her home during pregnancy and the neonatal period. Both areas benefit from a standardized strengthening of facility care for mothers and neonates. Discussion UNEST is designed to directly feed into the operationalization of maternal and newborn care in the national VHT strategy, thereby helping to inform scale-up in rural Uganda. The study is registered as a randomized controlled trial, number ISRCTN50321130. PMID:23153395
Elementary Rehabilitation Nursing Care; a Manual for Nurses and Ancillary Workers in Nursing Homes, Hospitals, Convalescent Facilities, and Public Health Agencies. Public Health Service Publication No. 1436.
ERIC Educational Resources Information Center
Colorado State Dept. of Public Health, Denver. Public Health Nursing Section.
This guide for teacher and student use presents a comprehensive program of physical rehabilitation for aged and physically disabled patients. Developed by the Public Health Nursing Section, the manual was tested by state health department personnel and persons doing inservice teaching in their respective nursing homes. The program is designed to…
Early results of integrated malaria control and implications for the management of fever in under-five children at a peripheral health facility: a case study of Chongwe rural health centre in Zambia
Chanda, Pascalina; Hamainza, Busiku; Mulenga, Susan; Chalwe, Victor; Msiska, Charles; Chizema-Kawesha, Elizabeth
Background Zambia has taken lead in implementing integrated malaria control so as to attain the National Health Strategic Plan goal of "reducing malaria incidence by 75% and under-five mortality due to malaria by 20% by the year 2010". The strategic interventions include the use of long-lasting insecticide-treated nets and indoor residual spraying, the use of artemisinin-based combination therapies (ACT) for the treatment of uncomplicated malaria, improving diagnostic capacity (both microscopy and rapid diagnostic tests), use of intermittent presumptive treatment for pregnant women, research, monitoring and evaluation, and behaviour change communication. Financial barriers to access have been removed by providing free malaria prevention and treatment services. Methods Data involving all under-five children reporting at the health facility in the first quarter of 2008 was evaluated prospectively. Malaria morbidity, causes of non-malaria fever, prescription patterns treatment patterns and referral cases were evaluated Results Malaria infection was found only in 0.7% (10/1378), 1.8% (251378) received anti-malarial treatment, no severe malaria cases and deaths occurred among the under-five children with fever during the three months of the study in the high malaria transmission season. 42.5% (586/1378) of the cases were acute respiratory infections (non-pneumonia), while 5.7% (79/1378) were pneumonia. Amoxicillin was the most prescribed antibiotic followed by septrin. Conclusion Malaria related OPD visits have reduced at Chongwe rural health facility. The reduction in health facility malaria cases has led to an increase in diagnoses of respiratory infections. These findings have implications for the management of non-malaria fevers in children under the age of five years. PMID:19292919
Evaluation of prototype Advanced Life Support (ALS) pack for use by the Health Maintenance Facility (HMF) on Space Station Freedom (SSF)
NASA Technical Reports Server (NTRS)
Krupa, Debra T.; Gosbee, John; Murphy, Linda; Kizzee, Victor D.
The purpose is to evaluate the prototype Advanced Life Support (ALS) Pack which was developed for the Health Maintenance Facility (HMF). This pack will enable the Crew Medical Officer (CMO) to have ready access to advanced life support supplies and equipment for time critical responses to any situation within the Space Station Freedom. The objectives are: (1) to evaluate the design of the pack; and (2) to collect comments for revision to the design of the pack. The in-flight test procedures and other aspects of the KC-135 parabolic test flight to simulate weightlessness are presented.
HIV/AIDS among Inmates of and Releasees from US Correctional Facilities, 2006: Declining Share of Epidemic but Persistent Public Health Opportunity
Spaulding, Anne C.; Seals, Ryan M.; Page, Matthew J.; Brzozowski, Amanda K.; Rhodes, William; Hammett, Theodore M.
Because certain groups at high risk for HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) come together in correctional facilities, seroprevalence was high early in the epidemic. The share of the HIV/AIDS epidemic borne by inmates of and persons released from jails and prisons in the United States (US) in 1997 was estimated in a previous paper. While the number of inmates and releasees has risen, their HIV seroprevalence rates have fallen. We sought to determine if the share of HIV/AIDS borne by inmates and releasees in the US decreased between 1997 and 2006. We created a new model of population flow in and out of correctional facilities to estimate the number of persons released in 1997 and 2006. In 1997, approximately one in five of all HIV-infected Americans was among the 7.3 million who left a correctional facility that year. Nine years later, only one in seven (14%) of infected Americans was among the 9.1 million leaving, a 29.3% decline in the share. For black and Hispanic males, two demographic groups with heightened incarceration rates, recently released inmates comprise roughly one in five of those groups' total HIV-infected persons, a figure similar to the proportion borne by the correctional population as a whole in 1997. Decreasing HIV seroprevalence among those admitted to jails and prisons, prolonged survival and aging of the US population with HIV/AIDS beyond the crime-prone years, and success with discharge planning programs targeting HIV-infected prisoners could explain the declining concentration of the epidemic among correctional populations. Meanwhile, the number of persons with HIV/AIDS leaving correctional facilities remains virtually identical. Jails and prisons continue to be potent targets for public health interventions. The fluid nature of incarcerated populations ensures that effective interventions will be felt not only in correctional facilities but also in communities to which releasees return. PMID:19907649
OHS 11-119 *Reference Health & Safety Requirements for Minors in Laboratories at Stanford University for additional guidance: Page 1
facilities, and research projects. 2.Cutting Edge of Human Anatomy and Surgical. Program Participants Activities 1.Clinical Anatomy Research Scholars (CARS) Host: School of Medicine Contact: email@example.com Website: http://anatomy
9/18/09 2:57 PMDark energy may not actually exist Page 1 of 9http://www.thaindian.com/newsportal/health/dark-energy-may-not-actually-exist_100234185.html
Temple, Blake
9/18/09 2:57 PMDark energy may not actually exist Page 1 of 9http://www.thaindian.com/newsportal/health Business CPI Entertainment Environment Events Feature Health Health Science images India Life Style The Big Bang Ads by Google Nursing Theory Sandbox Theory Music Theory Einstein Theme #12;9/18/09 2
Communicating public health preparedness information to pregnant and postpartum women: an assessment of centers for disease control and prevention web pages.
McDonough, Brianna; Felter, Elizabeth; Downes, Amia; Trauth, Jeanette
Pregnant and postpartum women have special needs during public health emergencies but often have inadequate levels of disaster preparedness. Thus, improving maternal emergency preparedness is a public health priority. More research is needed to identify the strengths and weaknesses of various approaches to how preparedness information is communicated to these women. A sample of web pages from the Centers for Disease Control and Prevention intended to address the preparedness needs of pregnant and postpartum populations was examined for suitability for this audience. Five of the 7 web pages examined were considered adequate. One web page was considered not suitable and one the raters split between not suitable and adequate. None of the resources examined were considered superior. If these resources are considered some of the best available to pregnant and postpartum women, more work is needed to improve the suitability of educational resources, especially for audiences with low literacy and low incomes. (Disaster Med Public Health Preparedness. 2015;9:134-137). PMID:25882119
Older Adults in Nursing Homes: Assessing Relationships Between Multiple Constructs of Social Integration, Facility Characteristics, and Health
Leedahl, Skye N.
An extensive body of research has examined connections between older adults' social worlds and health and well-being, particularly for community-dwelling older adults. Yet, little is known about the social worlds of older ...
Reproductive health and access to healthcare facilities: risk factors for depression and anxiety in women with an earthquake experience
Jasim Anwar; Elias Mpofu; Lynda R Matthews; Ahmed Farah Shadoul; Kaye E Brock
Background The reproductive and mental health of women contributes significantly to their overall well-being. Three of the eight Millennium\\u000a Development Goals are directly related to reproductive and sexual health while mental disorders make up three of the ten leading\\u000a causes of disease burden in low and middle-income countries. Among mental disorders, depression and anxiety are two of the\\u000a most prevalent. In
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Energy management system optimization for on-site facility staff - a case history of the New York State Office of Mental Health
Bagdon, M.J.; Martin, P.J.
In 1994, Novus Engineering and EME Group began a project for the New York State Office of Mental Health (OMH) to maximize the use and benefit of energy management systems (EMS) installed at various large psychiatric hospitals throughout New York State. The project, which was funded and managed by the Dormitory Authority of the State of New York (DASNY), had three major objectives: (1) Maximize Energy Savings - Novus staff quickly learned that EMS systems as set up by contractors are far from optimal for generating energy savings. This part of the program revealed numerous opportunities for increased energy savings, such as: fine tuning proportional/integral/derivative (PID) loops to eliminate valve and damper hunting; adjusting temperature reset schedules to reduce energy consumption and provide more uniform temperature conditions throughout the facilities; and modifying equipment schedules. (2) Develop Monitoring Protocols - Large EMS systems are so complex that they require a systematic approach to daily, monthly and seasonal monitoring of building system conditions in order to locate system problems before they turn into trouble calls or equipment failures. In order to assist local facility staff in their monitoring efforts, Novus prepared user-friendly handbooks on each EMS. These included monitoring protocols tailored to each facility. (3) Provide Staff Training - When a new EMS is installed at a facility, it is frequently the maintenance staffs first exposure to a complex computerized system. Without proper training in what to look for, staff use of the EMS is generally very limited. With proper training, staff can be taught to take a pro-active approach to identify and solve problems before they get out of hand. The staff then realize that the EMS is a powerful preventative maintenance tool that can be used to make their work more effective and efficient. Case histories are presented.
Assessment and documentation of non-healing, chronic wounds in inpatient health care facilities in the Czech Republic: an evaluation study.
Pokorná, Andrea; Leaper, David
The foundation of health care management of patients with non-healing, chronic wounds needs accurate evaluation followed by the selection of an appropriate therapeutic strategy. Assessment of non-healing, chronic wounds in clinical practice in the Czech Republic is not standardised. The aim of this study was to analyse the methods being used to assess non-healing, chronic wounds in inpatient facilities in the Czech Republic. The research was carried out at 77 inpatient medical facilities (8 university/faculty hospitals, 63 hospitals and 6 long- term hospitals) across all regions of the Czech Republic. A mixed model was used for the research (participatory observation including creation of field notes and content analysis of documents for documentation and analysis of qualitative and quantitative data). The results of this research have corroborated the suspicion of inconsistencies in procedures used by general nurses for assessment of non-healing, chronic wounds. However, the situation was found to be more positive with regard to evaluation of basic/fundamental parameters of a wound (e.g. size, depth and location of a wound) compared with the evaluation of more specific parameters (e.g. exudate or signs of infection). This included not only the number of observed variables, but also the action taken. Both were significantly improved when a consultant for wound healing was present (P?=?0·047). The same applied to facilities possessing a certificate of quality issued by the Czech Wound Management Association (P?=?0·010). In conclusion, an effective strategy for wound management depends on the method and scope of the assessment of non-healing, chronic wounds in place in clinical practice in observed facilities; improvement may be expected following the general introduction of a 'non-healing, chronic wound assessment' algorithm. PMID:25224308
Please cite this article in press as: Y. Zhang, et al., The benefits of introducing electronic health records in residential aged care facilities: A multiple case study, Int. J. Med. Inform. (2012), http://dx.doi.org/10.1016/j.ijmedinf.2012.05.013
Yu, Ping
health records in residential aged care facilities: A multiple case study, Int. J. Med. Inform. (2012.ijmijournal.com The benefits of introducing electronic health records in residential aged care facilities: A multiple case Electronic health records (EHR) Electronic nursing documentation Interview Nursing home Residential aged care
File: How to Meet the Health Check Secure Remote Access Page 1 of 7 January 2013 Security Requirements
Jiang, Huiqiang
of an infected computer passing viruses via this connection, a Health Check checks configuration settings on your computer is infected with a virus. It does mean that your computer is vulnerable to being infected with a virus. In order to pass Health Check, your computer must meet the following criteria: Operating system
Information needs for siting new, and evaluating current, nuclear facilities: ecology, fate and transport, and human health
Joanna Burger; Michael Gochfeld
The USA is entering an era of energy diversity, and increasing nuclear capacity and concerns focus on accidents, security,\\u000a waste, and pollution. Physical buffers that separate outsiders from nuclear facilities often support important natural ecosystems\\u000a but may contain contaminants. The US Nuclear Regulatory Commission (NRC) licenses nuclear reactors; the applicant provides\\u000a environmental assessments that serve as the basis for Environmental
Latest revised date: October 26, 2011 Page 1 of 7 Prepared by: Department of Health & Safety G-008
deYoung, Brad
, radiation, vibration, #12;Latest revised date: October 26, 2011 Page 3 of 7 Prepared by: Department and guard railing lift tables, conveyors 3.7.3 Warnings and Alarms computer warnings odors #12;Latest
[Peers contribution to mental health work: considerations on the relationship between formal and informal help. A case study in a mental health facility in Buenos Aires].
Ardila Gómez, Sara; Agrest, Martín; Abadi, Daniel; Cáceres, Carmen
Including peers to the mental health workforce has been part of a larger debate regarding specificity and incumbencies of peers' work, as well as their relationship with other workers. While some members of the workforce are proposing to train peers to have them help in different settings and interventions, others see them as unfair and underprepared competitors trying to replace them. Based on this debate, and from a Collective Health perspective on the concept of "care", this paper supports the idea that, since they put "care" as central to anything done by the mental health workforce, peers could be crucial to practices in Mental Health. An experience that took place in a Day Hospital in Buenos Aires City, conversed within a group dedicated to reflect on peers' support, is analyzed in order to unveil the relationship between peers and professionals, as well as peers' specificity. It is withstand that one of the main contributions of including peers is to help professionals think more about the relational dimension of their work and about the way they treat, call and refer to patients. PMID:24511565
Occurrence of extended spectrum ?-lactamase-producing Enterobacteriaceae among pet dogs and cats: an emerging public health threat outside health care facilities.
Abdel-Moein, Khaled A; Samir, Ahmed
We aimed to investigate the potential role of pet dogs and cats in the epidemiology of extended spectrum ?-lactamase-producing Enterobacteriaceae. Twenty bacterial isolates were recovered from rectal swabs obtained from 110 dogs and cats. The occurrence of extended spectrum ?-lactamase-producing Enterobacteriaceae in pets spotlights the emergence of a significant public health threat. PMID:24792717
The Utah Beacon Experience: Integrating Quality Improvement, Health Information Technology, and Practice Facilitation to Improve Diabetes Outcomes in Small Health Care Facilities
Tennison, Janet; Rajeev, Deepthi; Woolsey, Sarah; Black, Jeff; Oostema, Steven J.; North, Christie
Purpose: The Utah Improving Care through Connectivity and Collaboration (IC3) Beacon community (2010–2013) was spearheaded by HealthInsight, a nonprofit, community-based organization. One of the main objectives of IC3 was to improve health care provided to patients with diabetes in three Utah counties, collaborating with 21 independent smaller clinics and two large health care enterprises. This paper will focus on the use of health information technology (HIT) and practice facilitation to develop and implement new care processes to improve clinic workflow and ultimately improve patients' diabetes outcomes at 21 participating smaller, independent clinics. Innovation: Early in the project, we learned that most of the 21 clinics did not have the resources needed to successfully implement quality improvement (QI) initiatives. IC3 helped clinics effectively use data generated from their electronic health records (EHRs) to design and implement interventions to improve patients' diabetes outcomes. This close coupling of HIT, expert practice facilitation, and Learning Collaboratives was found to be especially valuable in clinics with limited resources. Findings: Through this process we learned that (1) an extensive readiness assessment improved clinic retention, (2) clinic champions were important for a successful collaboration, and (3) current EHR systems have limited functionality to assist in QI initiatives. In general, smaller, independent clinics lack knowledge and experience with QI and have limited HIT experience to improve patient care using electronic clinical data. Additionally, future projects like IC3 Beacon will be instrumental in changing clinic culture so that QI is integrated into routine workflow. Conclusion and Discussion: Our efforts led to significant changes in how practice staff optimized their EHRs to manage and improve diabetes care, while establishing the framework for sustainability. Some of the IC3 Beacon practices are currently smoothly transitioning to new models of care such as Patient-Centered Medical Homes. Thus, IC3 Beacon has been instrumental in creating a strong community partnership among various organizations to meet the shared vision of better health and lower costs, and the experience over the last few years has helped the community prepare for the changing health care landscape. PMID:25848624
Health, United States, 2012 With Urban and Rural Health Chartbook
NSDL National Science Digital Library
Eberhardt, M. S.
Released Monday, this large statistical report presents data on the nation's health in 460 pages, including birth and death rates, infant mortality, life expectancy, health personnel and facilities, financing of health care, health insurance and managed care, and much more. This is the 25th annual report of its kind (see the July 28, 2000 Scout Report for a review of 2000's report), and this year is the first to give statistics on health status relative to level of urbanization, finding that suburban Americans "fare significantly better in many key health measures than those who live in the most rural and most urban areas." The report is available in its entirety or by section in .pdf format, and trendtables are available in Lotus or Excel formats.
Set home page Bookmark site Add search Latest News Browse Topics Encyclopedia Health Center Videos Amazon Store
Suslick, Kenneth S.
> Fossils & Ruins Science Topics > Agriculture > Astronomy > Biology > Chemistry > Earth Sciences > Mind & Brain > Plants & Animals > Space & Time > Earth & Climate > Matter & Energy > Computers & Math > Environment > Mathematics > Physics > Social Sciences > Technology > more topics Health Topics > Aging
P:\\Policy & Procedures\\FP\\FP#11-F&E Ordering -Major.doc Page 1 of 5 Facilities Planning
Fernandez, Eduardo
to be located within the facility such as portable machines, lab equipment, building maintenance or cleaning operational such as window treatment, e.g., drapes, blinds. Floor covering is not eligible and must into and purchased for each new room will fit and comply with ADA requirements. Generate an 8-1/2" x 11" floor plan
Study of Occupational Safety and Health Audit on Facilities at Ungku Omar College, Universiti Kebangsaan Malaysia (UKM): A Preliminary Analysis
ERIC Educational Resources Information Center
Ariffin, Kadir; Ahmad, Shaharuddin; Aiyub, Kadaruddin; Awang, Azhan; Aziz, Azmi; Mohamad, Lukman Z.; Mamat, Samsu Adabi
Occupational safety and health (OSH) in Universiti Kebangsaan Malaysia (UKM) is being considered as an important program to measure employee and student welfare and well-being. During academic session, apart from attending lectures, laboratory works, tutorial and library search, majority of students spend most of their time in residential…
Effect of health insurance and facility quality improvement on blood pressure in adults with hypertension in Nigeria: a population-based study.
Hendriks, Marleen E; Wit, Ferdinand W N M; Akande, Tanimola M; Kramer, Berber; Osagbemi, Gordon K; Tanovic, Zlata; Gustafsson-Wright, Emily; Brewster, Lizzy M; Lange, Joep M A; Schultsz, Constance
IMPORTANCE Hypertension is a major public health problem in sub-Saharan Africa, but the lack of affordable treatment and the poor quality of health care compromise antihypertensive treatment coverage and outcomes. OBJECTIVE To report the effect of a community-based health insurance (CBHI) program on blood pressure in adults with hypertension in rural Nigeria. DESIGN, SETTING, AND PARTICIPANTS We compared changes in outcomes from baseline (2009) between the CBHI program area and a control area in 2011 through consecutive household surveys. Households were selected from a stratified random sample of geographic areas. Among 3023 community-dwelling adults, all nonpregnant adults (aged ?18 years) with hypertension at baseline were eligible for this study. INTERVENTION Voluntary CBHI covering primary and secondary health care and quality improvement of health care facilities. MAIN OUTCOMES AND MEASURES The difference in change in blood pressure from baseline between the program and the control areas in 2011, which was estimated using difference-in-differences regression analysis. RESULTS Of 1500 eligible households, 1450 (96.7%) participated, including 564 adults with hypertension at baseline (313 in the program area and 251 in the control area). Longitudinal data were available for 413 adults (73.2%) (237 in the program area and 176 in the control area). Baseline blood pressure in respondents with hypertension who had incomplete data did not differ between areas. Insurance coverage in the hypertensive population increased from 0% to 40.1% in the program area (n?=?237) and remained less than 1% in the control area (n?=?176) from 2009 to 2011. Systolic blood pressure decreased by 10.41 (95% CI, -13.28 to -7.54) mm Hg in the program area, constituting a 5.24 (-9.46 to -1.02)-mm Hg greater reduction compared with the control area (P?=?.02), where systolic blood pressure decreased by 5.17 (-8.29 to -2.05) mm Hg. Diastolic blood pressure decreased by 4.27 (95% CI, -5.74 to -2.80) mm Hg in the program area, a 2.16 (-4.27 to -0.05)-mm Hg greater reduction compared with the control area, where diastolic blood pressure decreased by 2.11 (-3.80 to -0.42) mm Hg (P?=?.04). CONCLUSIONS AND RELEVANCE Increased access to and improved quality of health care through a CBHI program was associated with a significant decrease in blood pressure in a hypertensive population in rural Nigeria. Community-based health insurance programs should be included in strategies to combat cardiovascular disease in sub-Saharan Africa. PMID:24534947
Impact of an electronic clinical decision support system on workflow in antenatal care: the QUALMAT eCDSS in rural health care facilities in Ghana and Tanzania
Mensah, Nathan; Sukums, Felix; Awine, Timothy; Meid, Andreas; Williams, John; Akweongo, Patricia; Kaltschmidt, Jens; Haefeli, Walter E.; Blank, Antje
Background The implementation of new technology can interrupt established workflows in health care settings. The Quality of Maternal Care (QUALMAT) project has introduced an electronic clinical decision support system (eCDSS) for antenatal care (ANC) and delivery in rural primary health care facilities in Africa. Objective This study was carried out to investigate the influence of the QUALMAT eCDSS on the workflow of health care workers in rural primary health care facilities in Ghana and Tanzania. Design A direct observation, time-and-motion study on ANC processes was conducted using a structured data sheet with predefined major task categories. The duration and sequence of tasks performed during ANC visits were observed, and changes after the implementation of the eCDSS were analyzed. Results In 24 QUALMAT study sites, 214 observations of ANC visits (144 in Ghana, 70 in Tanzania) were carried out at baseline and 148 observations (104 in Ghana, 44 in Tanzania) after the software was implemented in 12 of those sites. The median time spent combined for all centers in both countries to provide ANC at baseline was 6.5 min [interquartile range (IQR) =4.0–10.6]. Although the time spent on ANC increased in Tanzania and Ghana after the eCDSS implementation as compared to baseline, overall there was no significant increase in time used for ANC activities (0.51 min, p=0.06 in Ghana; and 0.54 min, p=0.26 in Tanzania) as compared to the control sites without the eCDSS. The percentage of medical history taking in women who had subsequent examinations increased after eCDSS implementation from 58.2% (39/67) to 95.3% (61/64) p<0.001 in Ghana but not in Tanzania [from 65.4% (17/26) to 71.4% (15/21) p=0.70]. Conclusions The QUALMAT eCDSS does not increase the time needed for ANC but partly streamlined workflow at sites in Ghana, showing the potential of such a system to influence quality of care positively. PMID:25630707
G:\\FORMS-Info Handouts-Labels\\Reception\\History and Physical Form.doc Rev'd 1/25/13 Page 1 of 3 BYU Student Health Center
Hart, Gus
________ Mental illness ________ Arthritis ________ OtherG:\\FORMS-Info Handouts-Labels\\Reception\\History and Physical Form.doc Rev'd 1/25/13 Page 1 of 3 BYU Student Health Center PERSONAL MEDICAL HISTORY / PHYSICAL EXAMINATION COMPLETE AND SIGN THIS PAGE Name
Girlfriends' Health and Safety Tips
... message, please visit this page: About CDC.gov . Women's Health Share Compartir Girlfriends' Health and Safety Tips Having ... and Teens Chronic Disease Prevention Family History National Women's Health Information Center (HHS) Top of Page Print page ...
Reported Sexual Violence among Women and Children Seen at the Gynecological Emergency Unit of a Rural Tertiary Health Facility, Northwest Nigeria
Ashimi, AO; Amole, TG; Ugwa, EA
Background: Various forms of sexual violence including: Coerced marriage or wife inheritance, female genital mutilation, forced exposure to pornography, rape by intimate partner or strangers, unwanted sexual advances, and sexual abuse occurs, especially in vulnerable groups. However, most of these cases are not reported. Aim: The aim was to review reported cases in the facility, determine the prevalence and pattern of presentation. Subjects and Methods: This was a prospective longitudinal study undertaken at the Gynecological Emergency Unit of a Tertiary Health Facility in a rural setting Northwest Nigeria. A study of survivors of alleged sexual violence who presented to the hospital from the September 1, 2011 to August 31, 2013. Results: During the study period, there were 24 cases of sexual violence (22 were alleged rape and 2 were others) of 973 gynecological consultations at the emergency unit, giving a prevalence of 3% (24/973) for sexual violence and 2.3% (22/973) for alleged rape. Majority 91.7% (22/24) of the cases were children < 16 years; 45.8% (11/24) had no formal education while 33.3% (8/24) hawked homemade drinks and snacks. The assailants were known in 83.3% (20/24) of the cases; of which 45.8% (11/24) were neighbors, 29.2% (7/24) were buyers of snacks and drinks while 8.3% (2/24) were family members. Conclusion: The prevalence of reported sexual violence in this facility was low with the majority of the survivors being children and nonstranger assailants', mostly neighbors. PMID:25745572
Reproductive rights and options available to women infected with HIV in Ghana: perspectives of service providers from three Ghanaian health facilities
Background Owing to improved management of HIV and its associated opportunistic infections, many HIV-positive persons of reproductive age are choosing to exercise their right of parenthood. This study explored the knowledge of health workers from two Ghanaian districts on the reproductive rights and options available to HIV-positive women who wish to conceive. Methods Facility-based cross-sectional in design, the study involved the entire population of nurse counselors (32) and medical officers (3) who provide counseling and testing services to clients infected with HIV. Both structured and in-depth interviews were conducted after informed consent. Results Two main perspectives were revealed. There was an overwhelmingly high level of approbation by the providers on HIV-positive women's right to reproduction (94.3%). At the same time, the providers demonstrated a lack of knowledge regarding the various reproductive options available to women infected with HIV. Site of facility, and being younger were associated with practices that violated client's right to contraceptive counseling (p?0.05) in each case. Some of the providers openly expressed their inability to give qualified guidance to HIV-positive women on the various reproductive options. Conclusions Taken together, these findings suggest that many HIV-positive clients do not receive comprehensive information about their reproductive options. These findings highlight some of the problems that service providers face as HIV counselors. Both service providers and policy makers need to recognize these realities and incorporate reproductive health issues of HIV-persons into the existing guidelines. PMID:23496943
Treatment in Kenyan rural health facilities: projected drug costs using the WHO-UNICEF integrated management of childhood illness (IMCI) guidelines.
Boulanger, L. L.; Lee, L. A.; Odhacha, A.
Guidelines for the integrated management of childhood illness (IMCI) in peripheral health facilities have been developed by WHO and UNICEF to improve the recognition and treatment of common causes of childhood death. To evaluate the impact of the guidelines on treatment costs, we compared the cost of drugs actually prescribed to a sample of 747 sick children aged 2-59 months in rural health facilities in western Kenya with the cost of drugs had the children been managed using the IMCI guidelines. The average cost of drugs actually prescribed per child was US$ 0.44 (1996 US$). Antibiotics were the most costly component, with phenoxymethylpenicillin syrup accounting for 59% of the cost of all the drugs prescribed. Of the 295 prescriptions for phenoxymethylpenicillin syrup, 223 (76%) were for treatment of colds or cough. The cost of drugs that would have been prescribed had the same children been managed with the IMCI guidelines ranged from US$ 0.16 per patient (based on a formulary of larger-dose tablets and a home remedy for cough) to US$ 0.39 per patient (based on a formulary of syrups or paediatric-dose tablets and a commercial cough preparation). Treatment of coughs and colds with antibiotics is not recommended in the Kenyan or in the IMCI guidelines. Compliance with existing treatment guidelines for the management of acute respiratory infections would have halved the cost of the drugs prescribed. The estimated cost of the drugs needed to treat children using the IMCI guidelines was less than the cost of the drugs actually prescribed, but varied considerably depending on the dosage forms and whether a commercial cough preparation was used. PMID:10593034
Comparison of activities of daily living after osteoporotic hip fracture surgery in patients admitted from home and from geriatric health service facilities
Horikawa, Akira; Miyakoshi, Naohisa; Shimada, Yoichi; Kodama, Hiroyuki
With the population and proportion of the elderly increasing each year, difficulties with postoperative treatment outcomes after osteoporotic hip fracture are increasing. This study focused on activities of daily living (ADL) in patients who underwent surgery for hip fracture through an investigation of living arrangements, the presence of dementia, and other complications of aging. Information from 99 patients who lived either at home or in geriatric health service facilities was collected for this trial. Most patients were over 65 years of age and female, and about half of them had dementia. The postoperative ADL score (focusing on patients' walking ability) was significant for those living at home than for those living in facilities. In addition, patients with dementia were divided into the following two categories: an early-rising group, comprising patients who were able to use a wheelchair within 48 hours of their operation; and a late-rising group, who did not start using a wheelchair until more than 48 hours after surgery. The ADL scores for the two groups were compared. Although the preoperative ADL scores were not significantly different between the two groups, postoperative ADL scores were significantly higher in the early-rising group than in the late-rising group, especially in patients who had undergone hemiarthroplasty. These data suggest that ADL in dementia patients following hip fracture depends on the surgical procedure performed and whether they are late or early risers after surgery. PMID:25378917
Chapter to appear in book "Future of Health Technology", 2001, OIS Press. Page 1 Affective Medicine: Technology with
", 2001, OIS Press. Page 2 the United States to be stress rated above cancer, AIDS, high blood pressure of recent studies indicates that emotions, particularly stress, anger, and depression, are important factors emotion, especially affective states such as frustration, confusion, interest, stress, anger, and joy
Occupational exposure to hazardous chemicals in laboratories. -1910.1450 Page 1 of 14 Occupational Safety & Health Administration
Baker, Chris I.
Occupational exposure to hazardous chemicals in laboratories. - 1910.1450 Page 1 of 14 Occupational chemicals in laboratories. - 1910.1450 Regulations (Standards - 29 CFR) - Table of Contents · Part Number and Hazardous Substances · Standard Number: 1910.1450 · Title: Occupational exposure to hazardous chemicals
Facility Flood Response Standard Procedure
Pawlowski, Wojtek
Facility Flood Response Standard Procedure Last revised by: Hunter Revision date: 3/28/11 Facility Flood Response SOP.docx Page 1 of 5 This copy expires 7 days from the print date of: 6/8/2011. The most/ehs/HSE Documents/Facility Flood Response SOP.docx 1. Purpose and Requirements The purpose
Perceptions of the risk for Ebola and health facility use among health workers and pregnant and lactating women--Kenema District, Sierra Leone, September 2014.
Dynes, Michelle M; Miller, Laura; Sam, Tamba; Vandi, Mohamed Alex; Tomczyk, Barbara
With an estimated maternal mortality ratio of 1,100 per 100,000 live births and a neonatal mortality rate of 49 per 1,000 live births, Sierra Leone has the highest maternal mortality ratio and the fourth highest neonatal mortality rate in the world, accounting for 2,400 maternal and 11,200 newborn deaths annually. By straining the fragile health care infrastructure, the Ebola virus disease (Ebola) epidemic might put pregnant women and their newborns at even greater risk for adverse outcomes. PMID:25551595
7/23/12 9:32 PMHow You Move Your Arm Says Something About Who You Are : Shots -Health Blog : NPR Page 1 of 6http://www.npr.org/templates/transcript/transcript.php?storyId=157055720
Shenoy, Krishna V.
by:SEARCH home news arts & life music programs listen July 23, 2012 NPR Shop | NPR Social Media7/23/12 9:32 PMHow You Move Your Arm Says Something About Who You Are : Shots - Health Blog : NPR;7/23/12 9:32 PMHow You Move Your Arm Says Something About Who You Are : Shots - Health Blog : NPR Page 2
PLEASE COMPLETE ALL 3 PAGES OF FORM 05/14/14 Required Immunizations for Health Sciences Students
Queitsch, Christine
by Health Care Provider (HCP) Form should not be signed by student, parent, or spouse. 1. MEASLES (RUBEOLA): TWO doses of measles-containing vaccine (regardless of birthdate), or a positive IgG antibody titer: Please indicate type: Measles (single antigen vaccine) Measles Measles/Rubella Measles
Page 1 of 5 Alison Van Eenennaam, UC Davis Applications of Animal Biotechnology in Animal Health, January 2009
Delany, Mary E.
or the use of antibiotics. However, the use of antibiotic in animal agriculture is meeting increased associated with disease resistance. Through careful selection, they can develop populations of animals resistance genes from new sources, allowing for improved animal health. Disease resistance benefits not only
ISIS Facility: Facility Design Challenges
McDonald, Kirk
driven · Safety People Environment Facility Design Goals #12;Facility Design Challenges · TechnicalISIS Facility: Facility Design Challenges Matt Fletcher Head, Design Division ISIS Department development #12;Additional Liquid Metal Target Challenges Design and Operational Features of a Mercury Target
Environmental, Health and Safety Assessment: ATS 7H Program (Phase 3R) Test Activities at the GE Power Systems Gas Turbine Manufacturing Facility, Greenville, SC
International Technology Corporation (IT) was contracted by General Electric Company (GE) to assist in the preparation of an Environmental, Health and Safety (HI&3) assessment of the implementation of Phase 3R of the Advanced Turbine System (ATS) 7H program at the GE Gas Turbines facility located in Greenville, South Carolina. The assessment was prepared in accordance with GE's contractual agreement with the U.S. Department of Energy (GE/DOE Cooperative Agreement DE-FC21-95MC3 1176) and supports compliance with the requirements of the National Environmental Policy Act of 1970. This report provides a summary of the EH&S review and includes the following: General description of current site operations and EH&S status, Description of proposed ATS 7H-related activities and discussion of the resulting environmental, health, safety and other impacts to the site and surrounding area. Listing of permits and/or licenses required to comply with federal, state and local regulations for proposed 7H-related activities. Assessment of adequacy of current and required permits, licenses, programs and/or plans.
Anti-malarial prescription practices among outpatients with laboratory-confirmed malaria in the setting of a health facility-based sentinel site surveillance system in Uganda
Background Most African countries have adopted artemisinin-based combination therapy (ACT) as the first-line treatment for uncomplicated malaria. The World Health Organization now recommends limiting anti-malarial treatment to those with a positive malaria test result. Limited data exist on how these policies have affected ACT prescription practices. Methods Data were collected from all outpatients presenting to six public health facilities in Uganda as part of a sentinel site malaria surveillance programme. Training in case management, encouragement of laboratory-based diagnosis of malaria, and regular feedback were provided. Data for this report include patients with laboratory confirmed malaria who were prescribed anti-malarial therapy over a two-year period. Patient visits were analysed in two groups: those considered ACT candidates (defined as uncomplicated malaria with no referral for admission in patients???4 months of age and???5 kg in weight) and those who may not have been ACT candidates. Associations between variables of interest and failure to prescribe ACT to patients who were ACT candidates were estimated using multivariable logistic regression. Results A total of 51,355 patient visits were included in the analysis and 46,265 (90.1%) were classified as ACT candidates. In the ACT candidate group, 94.5% were correctly prescribed ACT. Artemether-lumefantrine made up 97.3% of ACT prescribed. There were significant differences across the sites in the proportion of patients for whom there was a failure to prescribe ACT, ranging from 3.0-9.3%. Young children and woman of childbearing age had higher odds of failure to receive an ACT prescription. Among patients who may not have been ACT candidates, the proportion prescribed quinine versus ACT differed based on if the patient had severe malaria or was referred for admission (93.4% vs 6.5%) or was below age or weight cutoffs for ACT (41.4% vs 57.2%). Conclusions High rates of compliance with recommended ACT use can be achieved in resource-limited settings. The unique health facility-based malaria surveillance system operating at these clinical sites may provide a framework for improving appropriate ACT use at other sites in sub-Saharan Africa. PMID:23870515
Attributes and perspectives of public providers related to provision of medical abortion at public health facilities in Vietnam: a cross-sectional study in three provinces
Ngo, Thoai D; Free, Caroline; Le, Hoan T; Edwards, Phil; Pham, Kiet HT; Nguyen, Yen BT; Nguyen, Thang H
Background The purpose of this study was to investigate attributes of public service providers associated with the provision of medical abortion in Vietnam. Methods We conducted a cross-sectional study via interviewer-administered questionnaire among abortion providers from public health facilities in Hanoi, Khanh Hoa, and Ho Chi Minh City in Vietnam between August 2011 and January 2012. We recruited abortion providers at all levels of Vietnam's public health service delivery system. Participants were questioned about their medical abortion provision practices and perspectives regarding abortion methods. Results A total of 905 providers from 62 health facilities were included, comprising 525 (58.0%) from Hanoi, 122 (13.5%) from Khanh Hoa, and 258 (28.5%) from Ho Chi Minh City. The majority of providers were female (96.7%), aged ?25 years (94%), married (84.4%), and had at least one child (89%); 68.9% of providers offered only manual vacuum aspiration and 31.1% performed both medical abortion and manual vacuum aspiration. Those performing both methods included physicians (74.5%), midwives (21.7%), and nurses (3.9%). Unadjusted analyses showed that female providers (odds ratio 0.1; 95% confidence interval 0.01–0.30) and providers in rural settings (odds ratio 0.3; 95% confidence interval 0.08–0.79) were less likely to provide medical abortion than their counterparts. Obstetricians and gynecologists were more likely to provide medical abortion than providers with nursing/midwifery training (odds ratio 22.2; 95% confidence interval 3.81–129.41). The most frequently cited advantages of medical abortion for providers were that no surgical skills are required (61.7%) and client satisfaction is better (61.0%). Conclusion Provision of medical abortion in Vietnam is lower than provision of manual vacuum aspiration. While the majority of abortion providers are female midwives in Vietnam, medical abortion provision is concentrated in urban settings among physicians. Individuals providing medical abortion found that the method yields high client satisfaction. PMID:25152635
Sediment is accumulating in New York/New Jersey Harbor, and shipping channels are rapidly becoming too shallow for large ships. The Port Authority of New York/New Jersey has determined that dredging of the ship channels is essential to keep them navigable. About five million cubic yards of sediment must be removed per year to keep the channels open. Without dredging, the channels will soon become unusable, and the shoreside shipping and warehousing businesses that depend on them will fade away. The economic loss to the area would be devastating. But the deeper layers of sediment in the Harbor contain a broad range of pollutants that are hazardous to humans and the environment-a legacy of past discharges that are no longer permitted. These include heavy metals, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), chlorinated pesticides, and dioxins. As a result, there are several million cubic yards of sediments to be dredged per year that do not meet applicable criteria for ocean disposal and must be dealt with in some other way. A possible solution to the problem is to treat the dredged material to immobilize or destroy the contaminants and make the treated sediments suitable for disposal in the ocean or on land at acceptable cost. A variety of technologies can be used to achieve this goal. The simplest approach is to make manufactured soil from untreated sediment. The most complex approaches involve high-temperature destruction of organic contaminants and immobilization of inorganic contaminants. When any of these technologies are used, there is potential for risks to human health from process wastes and from the treated materials themselves. Also, disposal or beneficial use of treated materials may generate other risks to human health or the environment. A description of some of the technologies considered is given in Table 1. Success in removing or immobilizing the contaminants, which varies significantly among technologies, is reported elsewhere. This report provides a preliminary evaluation, or ``screening assessment,'' of potential occupational, public, and environmental health risks from dredging, transporting, and treating contaminated harbor sediments with thermal treatment methods to render them suitable for disposal or beneficial use. The assessment was done in stages as the project advanced and data became available from other tasks on characteristics of sediments and treatment processes.
Advanced Bio-Imaging for Nanomaterial Environmental Health and Safety: Post-Event Summary The NNIN-Nano Research Facility at Washington University in St. Louis held a short course, Advanced
Subramanian, Venkat
Advanced Bio-Imaging for Nanomaterial Environmental Health and Safety: Post-Event Summary The NNIN-Nano Research Facility at Washington University in St. Louis held a short course, Advanced Bio the applications and technical requirements of electron microscopy for nano-bio- imaging. An introductory lecture
Mixed and low-level waste treatment project: Appendix C, Health and safety criteria for the mixed and low-level waste treatment facility at the Idaho National Engineering Laboratory
Neupauer, R.M.; Thurmond, S.M.
This report describes health and safety concerns associated with the Mixed and Low-level Waste Treatment Facility at the Idaho National Engineering Laboratory. Various hazards are described such as fire, electrical, explosions, reactivity, temperature, and radiation hazards, as well as the potential for accidental spills, exposure to toxic materials, and other general safety concerns.
Mixed and low-level waste treatment project: Appendix C, Health and safety criteria for the mixed and low-level waste treatment facility at the Idaho National Engineering Laboratory. Part 1, Waste streams and treatment technologies
Neupauer, R.M.; Thurmond, S.M.
This report describes health and safety concerns associated with the Mixed and Low-level Waste Treatment Facility at the Idaho National Engineering Laboratory. Various hazards are described such as fire, electrical, explosions, reactivity, temperature, and radiation hazards, as well as the potential for accidental spills, exposure to toxic materials, and other general safety concerns.
Overview of Dose Assessment Developments and the Health of Riverside Residents Close to the "Mayak" PA Facilities, Russia
Standring, William J.F.; Dowdall, Mark; Strand, Per
The Norwegian Radiation Protection Authority (NRPA) has been involved in studies related to the Mayak PA and the consequences of activities undertaken at the site for a number of years. This paper strives to present an overview of past and present activities at the Mayak PA and subsequent developments in the quantification of health effects on local populations caused by discharges of radioactive waste into the Techa River. Assessments of doses to affected populations have relied on the development of dose reconstruction techniques for both external and internal doses. Contamination levels are typically inhomogeneous and decrease with increasing distance from the discharge point. Citations made in this paper give a comprehensive, though not exhaustive, basis for further reading about this topic. PMID:19440276
Scaling up prevention of mother to child transmission of HIV infection to primary health facilities in Nigeria: findings from two primary health centres in Northwest Nigeria.
Okusanya, Babasola O; Ashimi, Adewale O; Aigere, Egbaname O; Salawu, Siyaka E; Hassan, Rakiya
Nigeria is scaling up prevention of mother-to-child transmission (PMTCT) of HIV interventions to primary health care centres (PHCs). This retrospective study of PMTCT was at two PHCs in Northwest Nigeria with the main outcome measure being HIV infection rate of exposed infants at 6 weeks of life. Of 10,289 women who had antenatal HIV test, 74 had positive results. This gave a prevalence of 0.7%. The uptake of antenatal (99.8%) and intrapartum (97.3%) tests was high at both centres. 30% of HIV infected mothers and 25% of exposed infants were lost to follow-up (LFU). Most women (85.7%) had highly active antiretroviral therapy (HAART) and vaginal delivery (98%). Perinatal mortality rate was 66/1000 births and 95.3% of exposed infants had negative HIV-DNA polymerase reaction test at 6 weeks of life. Despite a high LFU, a new vista has been opened to attaining a zero infection rate. PMID:24689324
A Method for the Design and Development of Medical or Health Care Information Websites to Optimize Search Engine Results Page Rankings on Google
Cummins, Niamh Maria; Hannigan, Ailish; Shannon, Bill; Dunne, Colum; Cullen, Walter
Background The Internet is a widely used source of information for patients searching for medical/health care information. While many studies have assessed existing medical/health care information on the Internet, relatively few have examined methods for design and delivery of such websites, particularly those aimed at the general public. Objective This study describes a method of evaluating material for new medical/health care websites, or for assessing those already in existence, which is correlated with higher rankings on Google's Search Engine Results Pages (SERPs). Methods A website quality assessment (WQA) tool was developed using criteria related to the quality of the information to be contained in the website in addition to an assessment of the readability of the text. This was retrospectively applied to assess existing websites that provide information about generic medicines. The reproducibility of the WQA tool and its predictive validity were assessed in this study. Results The WQA tool demonstrated very high reproducibility (intraclass correlation coefficient=0.95) between 2 independent users. A moderate to strong correlation was found between WQA scores and rankings on Google SERPs. Analogous correlations were seen between rankings and readability of websites as determined by Flesch Reading Ease and Flesch-Kincaid Grade Level scores. Conclusions The use of the WQA tool developed in this study is recommended as part of the design phase of a medical or health care information provision website, along with assessment of readability of the material to be used. This may ensure that the website performs better on Google searches. The tool can also be used retrospectively to make improvements to existing websites, thus, potentially enabling better Google search result positions without incurring the costs associated with Search Engine Optimization (SEO) professionals or paid promotion. PMID:23981848
78 FR 27129 - Proposed Priority and Requirements-Education Facilities Clearinghouse
Federal Register 2010, 2011, 2012, 2013, 2014
...outcomes and documenting inequality in the distribution or quality of facilities: Inequality in School Facilities: There are significant inequalities in capital investment and... Facilities and Health: Air quality,...
R M Hare
Many practical issues in medical ethics depend on an understanding of the concept of health. The main question is whether it is a purely descriptive or a partly evaluative or normative concept. After posing some puzzles about the concept, the views of C Boorse, who thinks it is descriptive, are discussed and difficulties are found for them. An evaluative treatment
Efficacy of hospital germicides against adenovirus 8, a common cause of epidemic keratoconjunctivitis in health care facilities.
Rutala, William A; Peacock, Jeffrey E; Gergen, Maria F; Sobsey, Mark D; Weber, David J
The inactivation of virus-contaminated nonporous inanimate surfaces was investigated using adenovirus type 8, a common cause of epidemic keratoconjunctivitis. A 10-microl inoculum of adenovirus was placed onto each stainless steel disk (1-cm diameter), and the inoculum was allowed to air dry for 40 min. Twenty-one different germicides (including disinfectants and antiseptics) were selected for this study based on their current uses in health care. After a 1- or 5-minute exposure to 50 microl of the germicide, the virus-germicide test mixture was neutralized and assayed for infectivity. Using an efficacy criterion of a 3-log10 reduction in the titer of virus infectivity and regardless of the virus suspending medium (i.e., hard water, sterile water, and hard water with 5% fetal calf serum), only five disinfectants proved to be effective against the test virus at 1 min: 0.55% ortho-phthalaldehyde, 2.4% glutaraldehyde, 2.65% glutaraldehyde, approximately 6,000 ppm chlorine, and approximately 1,900 ppm chlorine. Four other disinfectants showed effectiveness under four of the five testing conditions: 70% ethanol, 65% ethanol with 0.63% quaternary ammonium compound, 79.6% ethanol with 0.1% quaternary ammonium compound, and 0.2% peracetic acid. Of the germicides suitable for use as an antiseptic, 70% ethanol achieved a 3-log10 reduction under four of the five test conditions. These results emphasize the need for proper selection of germicides for use in disinfecting noncritical surfaces and semicritical medical devices, such as applanation tonometers, in order to prevent outbreaks of epidemic keratoconjunctivitis. PMID:16569860
Disclosure to sexual partner and condom use among HIV positive clients attending ART clinic at a tertiary health facility in South West Nigeria
Adebayo, Ayodeji Matthew; Ilesanmi, Olayinka Stephen; Omotoso, Bridget Ama; Ayodeji, Oladele Olufemi; Kareem, Adesola Olawumi; Alele, Faith Osaretin
Introduction Condom use and disclosure of HIV status increase the safety of sexual activity. Its extent will determine the need for appropriate interventions. The objective of this study was to identify determinants of condom use and disclosure to sexual partners among individuals receiving Antiretroviral Therapy at a tertiary health facility in South West Nigeria. Methods A cross-sectional study of 578 clients enrolled in the ART program of Federal Medical Centre Owo, Ondo State Nigeria, was conducted. Results The mean age of respondents was 38.6+9.6 years, more than half (66.6%) were females and 7% were currently married. Three-quarter were sexually active out of which 324(75.9%) used condom consistently and correctly and 323(75.6%) disclosed their status to their sexual partner. Use of condom was by 81% of those with tertiary education (p=0.002), and 84.5% of singles utilized condom (p<0.001). Determinant of condom use wwere, male (OR: 2; CI: 1.1- 3.3; p=0.013), secondary and tertiary education (OR: 3.69; CI: 1.48 - 9.19; p=0.005) and (OR: 4.79; CI: 1.84 - 12.44; p=0.001) respectively. Determinant of disclosure was being married (OR: 11.8; CI- 5.5-25.7; p<0.001). No significant association exist between disclosure and condom use. Conclusion Most of the people living with HIV accessing ART were sexually active. A good proportion of them used condom consistently and correctly. Disclosure did not have significant effect on condom use. More health education intervention to increase disclosure rate and safe sexual behaviour among HIV positive clients is needed. PMID:25426203
The National Health Care Survey (NHCS) encompasses a family of health care provider surveys, including information about the facilities that supply health care, the services rendered, and the characteristics of the patients served.
A macro-ergonomic work system analysis of the diagnostic testing process in an outpatient health care facility for process improvement and patient safety.
Hallock, M L; Alper, S J; Karsh, B
The diagnosis of illness is important for quality patient care and patient safety and is greatly aided by diagnostic testing. For diagnostic tests, such as pathology and radiology, to positively impact patient care, the tests must be processed and the physician and patient must be notified of the results in a timely fashion. There are many steps in the diagnostic testing process, from ordering to result dissemination, where the process can break down and therefore delay patient care and reduce patient safety. This study was carried out to examine the diagnostic testing process (i.e. from ordering to result notification) and used a macro-ergonomic work system analysis to uncover system design flaws that contributed to delayed physician and patient notification of results. The study was carried out in a large urban outpatient health-care facility made up of 30 outpatient clinics. Results indicated a number of variances that contributed to delays, the majority of which occurred across the boundaries of different systems and were related to poor or absent feedback structures. Recommendations for improvements are discussed. PMID:16723328
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... of the American Medical Association JAMA PATIENT PAGE Malaria M alaria is a potentially deadly disease caused ... the parasite. According to the World Health Organization, malaria is present in more than 100 countries—mostly ...
Environmental Public Health Performance Standards
Environmental Public Health Performance Standards Environmental Health Program Self Agency: Total Environmental Health Program Budget: #12;Environmental Public Health Performance Standards (v. 2.0); Environmental Health Program Assessment Instrument, 1/7/2010 Page 2 Proportion
CDC Health Disparities and Inequalities Report--U.S. 2013
... Health LGBT Health Disability & Health Tribal Support CDC Health Disparities & Inequalities Report (CHDIR) On this Page CDC Health Disparities & Inequalities Report 2013 Introduction The 2013 Report Disparities Analytics ...
9 CFR 3.27 - Facilities, outdoor.
Code of Federal Regulations, 2011 CFR
...Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE STANDARDS ...facilities unless such facilities are located in an appropriate climate and prior approval for such outdoor housing is obtained...
9 CFR 3.27 - Facilities, outdoor.
Code of Federal Regulations, 2012 CFR
...Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE STANDARDS ...facilities unless such facilities are located in an appropriate climate and prior approval for such outdoor housing is obtained...
9 CFR 3.27 - Facilities, outdoor.
Code of Federal Regulations, 2014 CFR
...Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE STANDARDS ...facilities unless such facilities are located in an appropriate climate and prior approval for such outdoor housing is obtained...
9 CFR 3.27 - Facilities, outdoor.
Code of Federal Regulations, 2013 CFR
...Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE STANDARDS ...facilities unless such facilities are located in an appropriate climate and prior approval for such outdoor housing is obtained...
... ??????? Espańol RSS Feed Youtube Twitter Facebook Google + iTunes Play Store Humanitarian Health Action Menu Humanitarian Health ... Twitter WHO Facebook page WHO Google+ page WHO iTunes WHO Play Store © WHO 2015 Back to top ...
35129_u67_UNCORR_PRF.3d 11/16/07 5:50pm Page 737 Responsiveness to Host Community Health Needs
Spirtes, Peter
of the World Health Organization (WHO) has noted, ``The health of the world's peoples has improved more's Health Needs The health inequalities that currently divide the developed from the developing world. As a result, the staggering health problems that plague many communities of the developing world play a major
69 FR 33923 - Integrated Research Facility Record of Decision
Federal Register 2010, 2011, 2012, 2013, 2014
...of Health Integrated Research Facility Record of Decision...making its decision. Social Resources Additional...proposed Integrated Research Facility includes up...from escaped agents. Qualitative and quantitative risk...specifically the Integrated Research Facility from a...
42 CFR 4.4 - Use of Library facilities.
Code of Federal Regulations, 2011 CFR
...SERVICES GENERAL PROVISIONS NATIONAL LIBRARY OF MEDICINE § 4.4 Use of Library facilities. (a) General. The Library facilities are available to...effective use of facilities by health-sciences professionals and to...
VA Health Care Facilities Locator
... the News Room Public Affairs News Releases Speeches Videos Publications National Observances Veterans Day Memorial Day Celebrating America's Freedoms Special Events Adaptive Sports Program Creative Arts Festival Golden Age Games Summer Sports Clinic Training – Exposure – Experience (TEE) Tournament ...
09/11/2006 09:54 AMStopovers May Ease Jet Lag -Forbes.com Page 1 of 3http://www.forbes.com/health/feeds/hscout/2006/09/10/hscout534732.html
Siegelmann , Hava T
09/11/2006 09:54 AMStopovers May Ease Jet Lag - Forbes.com Page 1 of 3http May Ease Jet Lag 09.10.06, 12:00 AM ET SUNDAY, Sept. 10 (HealthDay News) -- If you suffer from severe's clock to advance smoothly and nudges the entire system in the right time direction. "Jet lag isn
8/20/09 11:56 AMStudents learn more when peer discussions are combined with "clickers" Page 1 of 7http://www.thaindian.com/newsportal/health/students-learn-more-when-peer-discussions-are-combined-with-clickers_100138000.html
Su, Tin Tin
Tornado Hits Minneapolis: Tears Down Church Roof Hurricane Bill Weakens Slightly To Category 3, May Bengal Release date of Road To Sangam pushed ahead I'll be last person to privatise Indian Railways peer discussions are combined with "clickers" Page 3 of 7http://www.thaindian.com/newsportal/health
9/2/2014 Advice for Colleges, Universities, and Students about Ebola in West Africa | Travelers' Health | CDC http://wwwnc.cdc.gov/travel/page/advice-for-colleges-universities-and-students-about-ebola-in-west-africa 1/5
Qian, Ning
9/2/2014 Advice for Colleges, Universities, and Students about Ebola in West Africa | Travelers' Health | CDC http://wwwnc.cdc.gov/travel/page/advice-for-colleges-universities-and-students-about-ebola-in-west-africa 1/5 Advice for Colleges, Universities, and Students about Ebola in West Africa For Colleges
Human Health and Ecological Risk Assessment for the Operation of the Explosives Waste Treatment Facility at Site 300 of the Lawrence Livermore National Laboratory Volume 1: Report of Results
Gallegos, G; Daniels, J; Wegrecki, A
This document contains the human health and ecological risk assessment for the Resource Recovery and Conservation Act (RCRA) permit renewal for the Explosives Waste Treatment Facility (EWTF). Volume 1 is the text of the risk assessment, and Volume 2 (provided on a compact disc) is the supporting modeling data. The EWTF is operated by the Lawrence Livermore National Laboratory (LLNL) at Site 300, which is located in the foothills between the cities of Livermore and Tracy, approximately 17 miles east of Livermore and 8 miles southwest of Tracy. Figure 1 is a map of the San Francisco Bay Area, showing the location of Site 300 and other points of reference. One of the principal activities of Site 300 is to test what are known as ''high explosives'' for nuclear weapons. These are the highly energetic materials that provide the force to drive fissionable material to criticality. LLNL scientists develop and test the explosives and the integrated non-nuclear components in support of the United States nuclear stockpile stewardship program as well as in support of conventional weapons and the aircraft, mining, oil exploration, and construction industries. Many Site 300 facilities are used in support of high explosives research. Some facilities are used in the chemical formulation of explosives; others are locations where explosive charges are mechanically pressed; others are locations where the materials are inspected radiographically for such defects as cracks and voids. Finally, some facilities are locations where the machined charges are assembled before they are sent to the on-site test firing facilities, and additional facilities are locations where materials are stored. Wastes generated from high-explosives research are treated by open burning (OB) and open detonation (OD). OB and OD treatments are necessary because they are the safest methods for treating explosives wastes generated at these facilities, and they eliminate the requirement for further handling and transportation that would be required if the wastes were treated off site.
Health Service Areas used in SEER*Stat
Health Service AreaPage ofHealth Service Area (SEER 17)Page ofHealth Service Area (SEER 17 excl AK)Page ofHealth Service Area (SEER 13)Page ofHealth Service Area (SEER 9)Page ofHSA # (NCI Modified) Health Service Area (NCI Modified) Description State-county FIPS Butler,
Cornell University Facilities Services
Manning, Sturt
to be constructed as part of the LATC is the Teaching Dairy Barn (TDB) for the CVM. The Animal Health Diagnostic & Teaching Dairy Barn Project Director: John Keefe Project Manager: Rachel Fives Architect: Erdy Mc to as the Dairy Barn), formerly used as a teaching facility. This project will provide CVM with a new dairy barn
ERIC Educational Resources Information Center
American Inst. of Architects, Washington, DC.
This book is a compilation of nearly 100 projects and trends in school design. The projects were submitted for a 1999-2000 competition and focus on a variety of school facilities. These facilities range from early childhood to community colleges, including public, private, and alternative facilities. A jury of architects and educational…
Career Minors Page 81Sonoma State University 2011-2012 Catalog either of two significant dimensions of health care: technical and mana-
Ravikumar, B.
in minor electives 8 total units in the minor 20 Career Minor in Women's Health Women's health is a large minor in women's health is designed to provide students with interdisciplinary course work, training, and work experience in the politics, practice, and experience of women's health. Career needs of both
Roadmap: Public Health Global Health Bachelor of Science in Public Health
Sheridan, Scott
Roadmap: Public Health  Global Health Bachelor of Science in Public Health [PH Hours] PH 10002 Introduction to Global Health 3 Kent Core Requirement 3 See Kent Core Summary on page 2 General Electives 6 See note 2 on pages 2 and 3 #12;Roadmap: Public Health  Global Health Bachelor
UAF FACILITIES SERVICES Employee Performance Review
Hartman, Chris
UAF FACILITIES SERVICES Employee Performance Review Version: Management Page 1 Revision Date: 11 SERVICES Employee Performance Review Version: Management Page 2 Revision Date: 11/13/12 EMPLOYEE/13/12 EMPLOYEE INFORMATION Name Employee ID Job Title Date Department Facilities Services Supervisor Review
Facilities 2010/11 Annual Statement
Value for Money  Page 2 Leading Change Management  Page 2 Enhance Environmental Sustainability Best in Facilities is to work together to provide excellent value for money facilities and services which enhance, Reception, Portering and Cleaning Services Catering Conferencing & Event Management Management of Student
MedlinePLUS Videos and Cool Tools
... hand corner of the player. Kids and Heart Health HealthDay March 18, 2015 Related MedlinePlus Pages Child ... An ideal diet was the least prevalent heart health indicator. For example, fewer than 10% of the ...
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... hand corner of the player. Alcohol and Your Health HealthDay February 11, 2015 Related MedlinePlus Page Alcohol Transcript Does alcohol consumption offer any health benefits? Researchers out of the United Kingdom and ...
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... lower right-hand corner of the player. Eczema Health Risks HealthDay January 22, 2015 Related MedlinePlus Pages ... with eczema. But a new study finds the health risks from this disease may go way beyond ...
Physical Activity Frequency & Health
MedlinePLUS Videos and Cool Tools
... hand corner of the player. Physical Activity Frequency & Health HealthDay February 20, 2015 Related MedlinePlus Pages Exercise ... in a study on physical activity frequency and health. They reported their level of activity at the ...
Technological trends in health care: electronic health record.
Abraham, Sam
The most relevant technological trend affecting health care organizations and physician services is the electronic health record (EHR). Billions of dollars from the federal government stimulus bill are available for investment toward EHR. Based on the government directives, it is evident EHR has to be a high-priority technological intervention in health care organizations. Addressed in the following pages are the effects of the EHR trend on financial and human resources; analysis of advantages and disadvantages of EHR; action steps involved in implementing EHR, and a timeline for implementation. Medical facilities that do not meet the timetable for using EHR will likely experience reduction of Medicare payments. This article also identifies the strengths, weaknesses, opportunities, and threats of the EHR and steps to be taken by hospitals and physician medical groups to receive stimulus payment. PMID:21045583
Assessment of potential public health impacts associated with predicted emissions of polychlorinated dibenzo-dioxins and polychlorinated dibenzo-furans from a resource recovery facility
Lipsky, D.; Boldt, K.
This paper provides summary results of a risk assessment performed by Fred C. Hart Associates regarding potential dioxin-related impacts associated with a proposed resource recovery facility to be constructed in New York City by the NYC Dept. of Sanitation. The facility, know as the Brooklyn Navy Yard Resource Recovery Facility (BNYRRF), will be a 3,000 ton per day (tpd) mass burn facility that will include four 750 tpd combustion units and will incorporate the Martin stoker system. The BNYRRF will have natural gas auxiliary burners located at the point where secondary air will be injected to maintain a minimum secondary combustion temperature. Emission control systems will include a high efficiency (greater than 99.5%) fabric filter.
Hanford facility contingency plan
Sutton, L.N.
The Hanford Facility Contingency Plan, together with each TSD unit- specific contingency plan, meets the WAC 173-303 requirements for a contingency plan. Applicability of this plan to Hanford Facility activities is described in the Hanford Facility RCRA Permit, Dangerous Waste Portion, General Condition II.A. General Condition II.A applies to Part III TSD units, Part V TSD units, and to releases of hazardous substances which threaten human health or the environment. Additional information about the applicability of this document may also be found in the Hanford Facility RCRA Permit Handbook (DOE/RL-96-10). This plan includes descriptions of responses to a nonradiological hazardous substance spill or release at Hanford Facility locations not covered by TSD unit-specific contingency plans or building emergency plans. The term hazardous substances is defined in WAC 173-303-040 as: ``any liquid, solid, gas, or sludge, including any material, substance, product, commodity, or waste, regardless of quantity, that exhibits any of the physical, chemical or biological properties described in WAC 173-303-090 or 173-303-100.`` Whenever the term hazardous substances is used in this document, it will be used in the context of this definition. This plan includes descriptions of responses for spills or releases of hazardous substances occurring at areas between TSD units that may, or may not, threaten human health or the environment.
42 CFR 90.3 - Procedures for requesting health assessments.
Code of Federal Regulations, 2010 CFR
...Procedures for requesting health assessments. 90.3 Section 90.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES...
Krovi, Venkat
. Additionally, mice should be tested for Helicobacter as outlined in SOP 2.D.6, "Animal Health Monitoring health concerns: i. Additional testing of the sentinels or quarantine animals may be required2.D.9 COMPARATIVE MEDICINE LABORATORY ANIMAL FACILITIES STANDARD OPERATING PROCEDURES for ANIMAL
"It's Got to Be on This Page": Age and Cognitive Style in a Study of Online Health Information Seeking
King, Abby C; Castro, Cynthia M; Wiley, Adrienne; Borzekowski, Dina LG
Background The extensive availability of online health information offers the public opportunities to become independently informed about their care, but what affects the successful retrieval and understanding of accurate and detailed information? We have limited knowledge about the ways individuals use the Internet and the personal characteristics that affect online health literacy. Objective This study examined the extent to which age and cognitive style predicted success in searching for online health information, controlling for differences in education, daily Internet use, and general health literacy. Methods The Online Health Study (OHS) was conducted at Johns Hopkins School of Public Health and Stanford University School of Medicine from April 2009 to June 2010. The OHS was designed to explore the factors associated with success in obtaining health information across different age groups. A total of 346 men and women aged 35 years and older of diverse racial and ethnic backgrounds participated in the study. Participants were evaluated for success in searching online for answers to health-related tasks/questions on nutrition, cancer, alternative medicine, vaccinations, medical equipment, and genetic testing. Results Cognitive style, in terms of context sensitivity, was associated with less success in obtaining online health information, with tasks involving visual judgment most affected. In addition, better health literacy was positively associated with overall success in online health seeking, specifically for tasks requiring prior health knowledge. The oldest searchers were disadvantaged even after controlling for education, Internet use, general health literacy, and cognitive style, especially when spatial tasks such as mapping were involved. Conclusions The increasing availability of online health information provides opportunities to improve patient education and knowledge, but effective use of these resources depends on online health literacy. Greater support for those who are in the oldest cohorts and for design of interfaces that support users with different cognitive styles may be required in an age of shared medical decision making. PMID:25831483
H. R. 5887: A Bill to provide health insurance benefits to certain former employees at defense nuclear facilities of the Department of Energy for injuries caused by exposure to ionizing radiation. Introduced in the House of Representatives, One Hundred Second Congress, Second Session, August 12, 1992
Not Available
This Act may be cited as the [open quotes]Defense Nuclear Workers' Health Insurance Act of 1992[close quotes]. The purpose of this bill is to provide health insurance benefits to certain former employees at defense nuclear facilities of the Department of Energy for injuries caused by exposure to ionizing radiation. Definitions for terms within this bill are provided.
NSDL National Science Digital Library
Christopher Griffith
In order to produce nuclear weapons, each country must have facilities to produce and refine the nuclear materials, conduct research on weapon design, and store the completed weapons. The interactives in this collection allow you to explore the nuclear facilities of the nuclear powers (both declared and undeclared).
Points represent facilities that are regulated by the EPA under the Resource Conservation and Recovery Act (RCRA). Facilities regulated under RCRA generate, dispose of, treate or transport hazardous waste. RCRA is a law enacted by Congress in 1976 and amended in 1984 to include ...
42 CFR 4.4 - Use of Library facilities.
Code of Federal Regulations, 2010 CFR
... 2010-10-01 false Use of Library facilities. 4.4 Section 4.4 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS NATIONAL LIBRARY OF MEDICINE § 4.4 Use of...
Using business intelligence for efficient inter-facility patient transfer.
Haque, Waqar; Derksen, Beth Ann; Calado, Devin; Foster, Lee
In the context of inter-facility patient transfer, a transfer operator must be able to objectively identify a destination which meets the needs of a patient, while keeping in mind each facility's limitations. We propose a solution which uses Business Intelligence (BI) techniques to analyze data related to healthcare infrastructure and services, and provides a web based system to identify optimal destination(s). The proposed inter-facility transfer system uses a single data warehouse with an Online Analytical Processing (OLAP) cube built on top that supplies analytical data to multiple reports embedded in web pages. The data visualization tool includes map based navigation of the health authority as well as an interactive filtering mechanism which finds facilities meeting the selected criteria. The data visualization is backed by an intuitive data entry web form which safely constrains the data, ensuring consistency and a single version of truth. The overall time required to identify the destination for inter-facility transfers is reduced from hours to a few minutes with this interactive solution. PMID:25676968
Health facility-based data on women receiving sulphadoxine-pyrimethamine during pregnancy in Tanzania: lessons to learn from a cross-sectional survey in Mkuranga and Mufindi districts and other national survey reports
Background A study of health facility (HF) data on women receiving sulphadoxine-pyrimethamine (SP) for intermittent preventive treatment of malaria during pregnancy (IPTp) was carried out at antenatal care clinics in Mkuranga and Mufindi districts. Methods A review of health management information system (HMIS) registers, interviews with health-care workers (HWs) and district and national level malaria control program managers corroborated by inter-temporal assessment through observations at HF levels. Statistical data were analyzed in Excel and interpreted in triangulation with qualitative data from interviews and observations. Results Data indicated that IPTp doses administered to women were inadequate and partly inconsistent. HMIS registers lacked space for IPT records, forcing HWs to manipulate their record-keeping. The proportion/number of IPTp recipients in related to the supply of SP for free delivery, to women's attendance behaviours, showed variation by quarter and year of reporting. Conclusion It is impossible to achieve rational health service planning when the HMIS is weak. Whilst it is acknowledged that the HMIS is already overloaded, concerted measures are urgently needed to accommodate data on new interventions and other vertical programs if malaria programs are to achieve their goals. PMID:24433529
National Institutes of Health: Health Information
NSDL National Science Digital Library
The Health Information portion of the National Institutes of Health website covers a wide range of topics. This consumer-oriented site includes Quick Links, on the left side of the page, to such topics as "Child & Teen Health", "Men's Health", "Minority Health", and "Seniors' Health". To browse health categories, the visitor can browse several different ways. They can browse under "Body Location/Systems", "Conditions/Diseases", "Procedures", and "Health and Wellness". On the left side of the page the visitor can also choose to search for Health Topics alphabetically and for those more inclined toward audio learning, visitors can listen to NIH Radio by clicking on "MP3 audio reports" on the right side of the page. The Research in Action feature in the top middle of the page offers insight into how humans hear. Just click on the picture above Research in Action to be taken to the article. For visitors who just can't find what they need on the Health Information site, there are a slew of Related Links near the bottom of the page, including Health Information on the Web, Health Newsletters, Health Databases, and Federal Health Agencies.
Health Ethics Education for Health Administration Chaplains
ERIC Educational Resources Information Center
Porter, Russell; Broussard, Amelia; Duckett, Todd
It is imperative for divinity and health administration programs to improve their level of ethics education for their graduates who work as health administration chaplains. With an initial presentation of the variation of ethical dilemmas presented in health care facilities covering social, organizational, and patient levels, we indicate the need…
January 2008 LASP FACILTY Database Form 5.000 Issue Reporting Form This form is used to report data and/or program related issues regarding the FACILITY database, Supplemental, or the LASP Online Access System. Before submitting this form,
LASP Administrative Use Only Data Entry Start Date _______________ July 2007 LASP FACILTY Database Form 1.000 FACILITY DATABASE Principal Investigator – Data Entry Requirements This form is used to identify the level of data that each investigator
ERIC Educational Resources Information Center
Athletic Business, 2002
Describes the building designs of eight school athletic and recreational facilities, including the educational contexts and design goals. Includes information on architects and designers, construction cost, size, and occupancy date. Also provides photographs. (EV)
Human Resources hs_chk06 Page 1 of 2 Date issued: 15-Apr-10 Activity Leader: Health Declaration and Consent
Hickman, Mark
and Consent Personal Details Full Name Work Area Employee/ Student ID Email Phone Fitness to lead field: Information Privacy The information that you provide on this Health Declaration and Consent Form is collected correction. Declaration and Consent I have truthfully completed all sections of this Health Declaration
Science and Technology Facilities Council
NSDL National Science Digital Library
The Science and Technology Facilities Council (STFC) is a multidisciplinary research organization that supports scientists and engineers world-wide, operates large-scale research facilities, manages international research projects, and provides advice to the British government on development of research facilities. Site materials include news articles, information on STFC and its partner organizations, information on grants and funding, and information on STFC research projects. The education and public outreach page features access to publications, advice and resources for schools and colleges on astronomy, space, and particle physics; funding information; and an overview of STFC's efforts to engage public and school audiences in science and technology.
ERIC Educational Resources Information Center
Druce, Mike
Notes that the planning of an effective entertainment page in a school newspaper must begin by establishing its purpose. Examines all the elements that contribute to the makeup of a good entertainment page. (RL)
Staff Retention and Recruitment. Implications of Staff Organization and Utilization in Rural and Urban Mental Health Facilities in the South. Final Report: Distribution of Mental Health Professionals Supplemental Project.
ERIC Educational Resources Information Center
Eisenhart, Margaret A.; Ruff, Teresa C.
This project explored influences of the service delivery system on the distribution, especially the rural-urban distribution, of mental health practitioners in public settings. Research was planned as a two-phase pilot study--an ethnographic phase (open-ended interviews and day-long observations at 14 mental health agencies) and a survey phase…
Facility effluent monitoring plan for the tank farm facility
Crummel, G.M.
A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements.
Satisfaction with focused antenatal care service and associated factors among pregnant women attending focused antenatal care at health centers in Jimma town, Jimma zone, South West Ethiopia; a facility based cross-sectional study triangulated with qualitative study
Background Client satisfaction is essential for further improvement of quality of focused antenatal care and to provide uniform health care services for pregnant women. However, studies on level of client satisfaction with focused antenatal care and associated factors are lacking. So, the purpose of this study is to assess satisfaction with focused antenatal care service and associated factors among pregnant women attending focused antenatal care at health centers in Jimma town. Methods A facility based cross-sectional study involving both qualitative and quantitative methods of data collection was used from Feb 1-30/2013. Three hundred eighty nine pregnant women those come to the health centers were included in the study. A semi-structured questionnaire and focus group discussion guide was employed to obtain the necessary information for this study. Quantitative data was analysed using SPSS for windows version 16.0. Logistic regression model was used to compare level of satisfaction by predictors' variables. Qualitative data was analyzed based on thematic frameworks to support the quantitative results. Result More than half of the respondents (60.4%) were satisfied with the service that they received. As to specific components, most of the respondents (80.7%) were satisfied with interpersonal aspects, and 62.2% were satisfied with organization of health care aspect. Meanwhile, 49.9% of the respondents were not satisfied with technical quality aspect and 67.1% were not satisfied with physical environment aspect. Multivariate logistic regression analysis result showed that type of health center, educational status of mother, monthly income of the family, type of pregnancy and history of stillbirth were the predictors of the level of satisfaction. The study found out that dissatisfaction was high in mothers utilizing service at Jimma health center, in mothers with tertiary educational level, in mothers with average monthly family income >1000birr, in mothers with unplanned pregnancy and in mothers with history of stillbirth. Conclusions Even though greater percentages of women (60.4%) were satisfied with the focused antenatal care service, the level of satisfaction was lower compared to other studies. The investigator recommends that patient feedback should be recognized as a legitimate method of evaluating health services in the health center as a whole. PMID:24646407
Human Health and Ecological Risk Assessment for the Operation of the Explosives Waste Treatment Facility at Site 300 of the Lawrence Livermore National Laboratory, Volume 1: Report of Results
Gallegos, G M; Daniels, J I; Wegrecki, A M
Human health and ecological risk assessments are required as part of the Resource Recovery and Conservation Act (RCRA) permit renewal process for waste treatment units. This risk assessment is prepared in support of the RCRA permit renewal for the Explosives Waste Treatment Facility at Site 300 of the Lawrence Livermore National Laboratory. The human health risk assessment is based on U.S. Environmental Protection Agency approved emissions factors and on California Environmental Protection Agency, Air Resources Board and U.S. Environmental Protection Agency risk assessment and air dispersion models. The risk assessment identifies receptors of concern and evaluates carcinogenic risk, and acute and chronic noncarcinogenic hazard. The carcinogenic risk to a 30-year resident at the maximum offsite receptor location is 0.0000006 or 0.6 in one million. The carcinogenic risk to a 25-year worker at the maximum bystander on-site receptor location is also 0.0000006 or 0.6 in one million. Any risk of less than 1 in a million is below the level of regulatory concern. The acute noncarcinogenic hazard for the 30-year resident is 0.02 and the chronic noncarcinogenic hazard is 0.01. The acute noncarcinogenic hazard for the 25-year worker is 0.3 and the chronic noncarcinogenic hazard is 0.2. The point of comparison for acute and chronic noncarcinogenic hazard is 1.0, an estimate less than 1.0 is below the level of regulatory concern. The estimates of health effects are based on health conservative assumptions and represent an upper bound of the possible exposures to the receptors. For the ecological risk assessment, four receptor species were evaluated for potential detrimental effects; none were found to be adversely affected because for each species the predicted ecological hazard quotients are always less than one. Based on these results, emissions from the operations of the Explosive Waste Treatment Facility should not be considered to be of concern for human health or ecological reasons.
JAMA Patient Page: Medical Journals
... other health professionals. With the development of electronic publishing, many medical journals now have Web sites on ... This Patient Page is based on one previously published in the June 5, 2002, issue of JAMA . ...
JAMA Patient Page: Burn Injuries
... of the American Medical Association JAMA PATIENT PAGE Burn Injuries B urns, most commonly caused by fire, ... burn injuries in the United States. TYPES OF BURNS FOR MORE INFORMATION • World Health Organization www.who. ...
JAMA Patient Page: Basic Science Research
... of Health and Human Services VALUE OF BASIC SCIENCE RESEARCH Basic science research can help in a ... dedicated to basic science and translational research. Basic Science Research JAMA PATIENT PAGE The JAMA Patient Page ...
Pre-Health Professions Program Page 317Sonoma State University 2006-2008 Catalog Sonoma State University provides preparation for continuing study
Ravikumar, B.
assistant, and chiropractic medicine. Students interested in entering the health professions will select, and chiropractic medicine may require fewer units and courses for admission. The following outline of courses
Indiatimes l My Mail l Make TOI your home page l Home | Cities | India | World | Indians Abroad | Business | Cricket | Other Sports | Health/Sci | Infotech | Education | Earth
Lummaa, Virpi
Abroad | Business | Cricket | Other Sports | Health/Sci | Infotech | Education | Earth Less height? Blame Behavior . Ian Rickard and colleagues at the University of Glasgow in Scotland collected data from 79
Human Resources hs_pro12 Page 1 of 7 Date issued: 16-Apr-10 Human Resources Health, Safety and Wellbeing
Hickman, Mark
Date issued: 16-Apr-10 Definitions Activity Leader Person with authority to make decisions on field ............................................................................................................... 1 Definitions and objectives, and the educational, and health and safety needs of students and staff. Note: Department
Facility-Level Characteristics Associated with Serious Suicide Attempts and Deaths from Suicide in Juvenile Justice Residential Facilities
ERIC Educational Resources Information Center
Gallagher, Catherine A.; Dobrin, Adam
Little is known about how facility-level characteristics affect the risk of suicide and suicide attempts in juvenile justice residential facilities. This leaves facility administrators and mental health providers without evidence-based guidance on how the facility itself affects risks. The current study uses data from two recently developed…
Health Care Visits to Check More Than Just Health?
... News Spotlights Media Resources Selected Profiles & Interviews Multimedia Health Care Visits to Check More Than Just Health? Skip ... media links Share this: Page Content Study Shows Health Care Providers Can Help with School Readiness During Primary ...
MedlinePLUS Videos and Cool Tools
... 16, 2015 Related MedlinePlus Pages Heart Diseases--Prevention Mental Health Transcript Always look on the bright side of ... also asked to complete surveys that assessed their mental health and outlook on life. The results showed that ...
... racial or ethnic group has specific health concerns. Differences in the health of groups can result from Genetics Environmental factors Access to care Cultural factors On this page, you'll find links ...
... racial or ethnic group has specific health concerns. Differences in the health of groups can result from Genetics Environmental factors Access to care Cultural factors On this page, you'll find links ...
... racial or ethnic group has specific health concerns. Differences in the health of groups can result from Genetics Environmental factors Access to care Cultural factors On this page, you'll find links ...
... racial or ethnic group has specific health concerns. Differences in the health of groups can result from: Genetics Environmental factors Access to care Cultural factors On this page, you'll find links ...
... Information Clinical Trials Resources and Publications En Espańol Urinary Tract Health: Condition Information Skip sharing on social media links Share this: Page Content What is urinary tract health? The urinary (pronounced YOOR-uh-ner-ee ) tract? ...
December 2010 FACILITIES & PROPERTY MANAGEMENT
change with carbon management being the key issue for many organisations. The HE sector must play itsDecember 2010 FACILITIES & PROPERTY MANAGEMENT CARBON MANAGEMENT AND SUSTAINABILITY ACTIVITIES REPORT 2009/10 #12;Contents Page · Introduction 1 · Carbon and Energy Management 3 · Waste and Recycling
Workout Intensity and Your Health
MedlinePLUS Videos and Cool Tools
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... corner of the player. Whole Grains and Heart Health HealthDay January 6, 2015 Related MedlinePlus Pages Carbohydrates ... TV, your source for ideas to protect your health. Mobile version Get email updates Subscribe to RSS ...
ERIC Educational Resources Information Center
Bete, Tim, Ed.
Presents responses from Matt McGovern, "School Planning and Management's" Maintenance and Operations columnist, on the issue of school facility maintenance. McGovern does not believe schools will ever likely meet acceptable levels of maintenance, nor use infrared thermography for assessing roofs, outsource all maintenance work, nor find a pressing…
Centers for Disease Control (CDC) Search Page
NSDL National Science Digital Library
This page allows users to search the CDC and National Center for Health Statistics sites (NCHS). Collectively, these sites contain a huge amount of health and disease data from a large number of surveys. These include: National Health Interview Survey, National Immunization Survey, National Health and Nutrition Examination Survey, National Survey of Family Growth, National Health Care Survey , National Employer Health Insurance Survey, National Vital Statistics System, and Mortality Data.
David Baldwin's Trauma Information Pages
NSDL National Science Digital Library
Baldwin, David V.
The Trauma Information Pages, provided by psychologist David Baldwin, provide information about traumatic stress for clinicians and researchers in the field. The pages include information on trauma symptoms, connections to trauma resources including full text articles and an EMDR (eye movement desensitization and reprocessing) bibliography, general support information including grief, stress, and mental health pointers, disaster handouts and links, and links to other trauma and trauma related sites. The Trauma Pages are searchable.
MedlinePLUS Videos and Cool Tools
... hand corner of the player. Smog and Mental Health HealthDay March 25, 2015 Related MedlinePlus Pages Air ... air pollution globally as a cause of ill health." I'm Dr. Cindy Haines of HealthDay TV, ...
ASID (HICSIG) position statement: infection control guidelines for patients with influenza-like illnesses, including pandemic (H1N1) influenza 2009, in Australian health care facilities.
Stuart, Rhonda L; Cheng, Allen C; Marshall, Caroline L; Ferguson, John K
Standard and Droplet Precautions are considered adequate to control the transmission of influenza in most health care situations. Vaccination of health care staff, carers and vulnerable patients against seasonal and, eventually, pandemic influenza strains is an essential protective strategy. Management principles include: performance of hand hygiene before and after every patient contact or contact with the patient environment, in accord with the national 5 Moments for Hand Hygiene Standard; disinfection of the patient environment; early identification and isolation of patients with suspected or proven influenza; adoption of a greater minimum distance of patient separation (2 metres) than previously recommended; use of a surgical mask and eye protection for personal protection on entry to infectious areas or within 2 metres of an infectious patient; contact tracing for patient and health care staff and restriction of prophylactic antivirals mainly to those at high risk of severe disease; in high aerosol-risk settings, use of particulate mask, eye protection, impervious long-sleeved gown, and gloves donned in that sequence and removed in reverse sequence, avoiding self-contamination; exclusion of symptomatic staff from the workplace until criteria for non-infectious status are met; reserving negative-pressure ventilation rooms (if available) for intensive care patients, especially those receiving non-invasive ventilation; ensuring that infectious postpartum women wear surgical masks when caring for their newborn infants and practise strict hand hygiene; and implementation of special arrangements for potentially infected newborns who require nursery or intensive care. PMID:19835543
What Are the Factors That Interplay From Normal Pregnancy to Near Miss Maternal Morbidity in a Nigerian Tertiary Health Care Facility?
Adeoye, Ikeola A.; Ijarotimi, Omotade O.; Fatusi, Adesegun O.
Researchers in Nigeria examined the epidemiological characteristics and factors associated with maternal outcomes using a mixed method approach: a prospective case control study design involving 375 pregnant women who received maternal care from a tertiary facility and in-depth interviews reporting the experience of near-miss survivors. A generalized ordered logit model was used to generate the estimates of partial proportional odds ratios (and 95% confidence intervals) across categories of the outcome variable. Factors strongly associated with maternal morbidity were late referral of women, presence of complications at booking antenatal visits, low birth weight, and severe birth asphyxia. The nearmiss women were further characterized, and a low proportion (25%) had organ dysfunction or failure. The challenge of such diagnoses in resource-constrained settings raises questions about the appropriateness of using organ dysfunction criteria in developing countries. PMID:25119488
30 CFR 71.403 - Waiver of surface facilities requirements; posting of waiver.
Code of Federal Regulations, 2011 CFR
...DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES Surface Bathing Facilities, Change Rooms, and Sanitary Flush Toilet Facilities at...
30 CFR 71.403 - Waiver of surface facilities requirements; posting of waiver.
Code of Federal Regulations, 2012 CFR
...DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES Surface Bathing Facilities, Change Rooms, and Sanitary Flush Toilet Facilities at...
30 CFR 71.404 - Application for waiver of surface facilities requirements.
Code of Federal Regulations, 2014 CFR
...DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES Surface Bathing Facilities, Change Rooms, and Sanitary Flush Toilet Facilities at...
30 CFR 71.404 - Application for waiver of surface facilities requirements.
Code of Federal Regulations, 2012 CFR
...DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES Surface Bathing Facilities, Change Rooms, and Sanitary Flush Toilet Facilities at...
30 CFR 71.403 - Waiver of surface facilities requirements; posting of waiver.
Code of Federal Regulations, 2013 CFR
...DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES Surface Bathing Facilities, Change Rooms, and Sanitary Flush Toilet Facilities at...
30 CFR 71.404 - Application for waiver of surface facilities requirements.
Code of Federal Regulations, 2010 CFR
...DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES Surface Bathing Facilities, Change Rooms, and Sanitary Flush Toilet Facilities at...
30 CFR 71.403 - Waiver of surface facilities requirements; posting of waiver.
Code of Federal Regulations, 2014 CFR
...DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES Surface Bathing Facilities, Change Rooms, and Sanitary Flush Toilet Facilities at...
30 CFR 71.404 - Application for waiver of surface facilities requirements.
Code of Federal Regulations, 2013 CFR
...DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES Surface Bathing Facilities, Change Rooms, and Sanitary Flush Toilet Facilities at...
30 CFR 71.403 - Waiver of surface facilities requirements; posting of waiver.
Code of Federal Regulations, 2010 CFR
...DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES Surface Bathing Facilities, Change Rooms, and Sanitary Flush Toilet Facilities at...
30 CFR 71.404 - Application for waiver of surface facilities requirements.
Code of Federal Regulations, 2011 CFR
...DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES Surface Bathing Facilities, Change Rooms, and Sanitary Flush Toilet Facilities at...
10 CFR 26.715 - Recordkeeping requirements for collection sites, licensee testing facilities, and laboratories...
Code of Federal Regulations, 2014 CFR
...facilities, and laboratories certified by the Department of Health and Human Services. 26.715 Section 26.715 Energy...facilities, and laboratories certified by the Department of Health and Human Services. (a) Collection sites...
10 CFR 26.715 - Recordkeeping requirements for collection sites, licensee testing facilities, and laboratories...
Code of Federal Regulations, 2011 CFR
...facilities, and laboratories certified by the Department of Health and Human Services. 26.715 Section 26.715 Energy...facilities, and laboratories certified by the Department of Health and Human Services. (a) Collection sites...
10 CFR 26.715 - Recordkeeping requirements for collection sites, licensee testing facilities, and laboratories...
Code of Federal Regulations, 2012 CFR
...facilities, and laboratories certified by the Department of Health and Human Services. 26.715 Section 26.715 Energy...facilities, and laboratories certified by the Department of Health and Human Services. (a) Collection sites...
UK HealthCare University of Kentucky
MacAdam, Keith
HealthCare construction and facilities news In thIs Issue: UK HealthCare and Norton Healthcare officialsUK HealthCare University of Kentucky 800 Rose St. Lexington KY 40536 RENEWALYour resource for the latest UK HealthCare construction and facilities news WINTER 2011 RENEWALYour resource for the latest UK
MedlinePlus - Health Information from the National Library of Medicine
... Health Women's Health Checkup Allergy Asthma in Children Bullying Child Safety Childhood Immunization Children's Health Children's Page ... Women's Health Checkup Children Allergy Asthma in Children Bullying Child Safety Childhood Immunization Children's Health Children's Page ...
Video-Based Multi-Camera Automated Surveillance of High Value Assets in Nuclear Facilities C.-H. Chen, Y. Yao, D. Page, B. Abidi, A. Koschan, and M. Abidi
Abidi, Mongi A.
Video-Based Multi-Camera Automated Surveillance of High Value Assets in Nuclear Facilities C for a multi- camera surveillance system that automatically detects, tracks, and records security violations its gaze to the object of interest. In a surveillance system with multiple dual-camera sets, camera
Facility effluent monitoring plan for the plutonium uranium extraction facility
Wiegand, D.L.
A facility effluent monitoring plan is required by the US Department of Energy in DOE Order 5400.1 for any operations that involve hazardous materials and radioactive substances that could impact employee or public safety or the environment. This document is prepared using the specific guidelines identified in A Guide for Preparing Hanford Site Facility Effluent Monitoring Plans, WHC-EP-0438-01. This facility effluent monitoring plan assesses effluent monitoring systems and evaluates whether they are adequate to ensure the public health and safety as specified in applicable federal, state, and local requirements. This facility effluent monitoring plan shall ensure long-range integrity of the effluent monitoring systems by requiring an update whenever a new process or operation introduces new hazardous materials or significant radioactive materials. This document must be reviewed annually even if there are no operational changes, and it must be updated at a minimum of every three years.