Alternative Facilities Research Articles

Rapid Deployment of National Guard Alternative Healthcare Facility With Isolation Unit Capabilities in Response to COVID-19.

ABSTRACTAt the direction of Governor Phil Scott, the Vermont National Guard rapidly erected a 400-bed alternative healthcare facility field hospital to increase the state’s medical capacity early in the COVID-19 pandemic when information was limited and cases were rapidly rising across the country. This case study reviews the preparation and management of the alternative healthcare facility’s first COVID-19-positive patient assigned to the 50-bed COVID-19 isolation ward. Despite austere conditions with rudimentary improvements to a nonstandard facility, the ad hoc team composed entirely of members of the Vermont National Guard successfully oversaw patient care from admission to discharge while maintaining a zero-percent transmission rate to staff. While the local civilian medical infrastructure was never overwhelmed and patient census at the facility remained low, this case study highlights the capability of the National Guard enterprise as a community response to pandemic crises.

О НАПРАВЛЕНИЯХ РАЗВИТИЯ СРЕДСТВ КРЕПЛЕНИЯ ГРУЗОВ В ВАГОНАХ

The paper presents an overview of the international experience on application of facilities for fastening goods in cars. In regard with the task to increase the warranty haul distance for loaded cars without commercial inspection that has been set by the JSC «RZD», the paper considers various alternative fastening facilities. The author has analysed the current regulatory and legal acts that regulate loading and strapping of goods on the railway rolling stock from the point of application of new fastening facilities. The author has revealed the main reasons that prevent using modern fastening facilities on Russian Railways and has determined approaches to solve that problem. On the example of pipe products the paper presents the comparative analysis of loading with the use of textile straps and wire fastening.

«ЗEЛEНА» EНEРГEТИКА: ОСОБЛИВОСТІ ТА ПEРСПEКТИВИ РОЗВИТКУ В УКРАЇНІ

The article is devoted to the study of the development of «green» energy in Ukraine. Extraction of non-renewable resources reduces our reserves, and using in the process of production and consumption leads to global warming. Further development of «green» energy will reduce the problems associated with environmental pollution and ensure consumer demand for clean energy at low prices. The article analyzes in details the current state of «green» energy of the country, considers promising opportunities for investment in the industry by Ukrainian and foreign entrepreneurs, which will create and implement new technologies in production, modernize obsolete enterprises. The main problems of using alternative energy sources are highlighted, the prospects for the development of «green» energy are determined, the possibilities and expediency of the transition to ecological types of energy are considered, taking into account the features of the country's economy. The article considers and analyzes the energy balance of the state, which is significantly dominated by the use of nuclear fuel, coal and gas. The use of modern and advanced technologies in the use of renewable energy sources will increase the share of clean energy in the energy balance of the country. The chronology of development of solar power plants in Ukraine is considered. It is noted that due to scientific and technological progress, reduction of prices for solar power plant equipment, «green» tariff capacity of generating alternative energy facilities will continue to grow. The volumes of energy production, which is produced with the help of renewable sources, are analyzed, the number of enterprises that receive income from the sale of electricity at the «green» tariff is considered. A comparative analysis of the size of the «green» tariff in Ukraine and European countries, the prospects for solving existing problems, proposed measures to fully disclose the potential use of alternative energy sources. The positive aspects of the use of alternative energy are analyzed; the role of the country in the process of implementing an effective energy strategy, creating an electricity market and the country's transition to a carbon-neutral economy is analyzed.

Relationship between the energy and the environment at the current stage of energy market development

The authors analyzed the current situation related to the global consumption of fossil fuels, as well as environmental problems caused by their extraction, production and consumption. The official statistical data were used, reflecting the volumes of export of fossil raw materials from the Russian Federation, the directions of raw materials flows, characterizing the demand for oil, gas, peat coal in international trade. The authors note that negative factors caused by currency fluctuations, pandemic and other factors did not lead to global changes in the fossil fuel market. The article presents the provisions of international documents adopted in order to prevent climate warming by reducing greenhouse gas emissions. In addition, attention is focused on distribution of responsibility between the developed and developing countries of the world. The authors analyzed the measures implemented in the territory of the Russian Federation, and identified positive trends to reduce emissions of pollutants into the atmosphere. Wherein, the article reflects the environmental risks associated with use of alternative energy sources and nuclear facilities, the assessment of which must be carried out during commissioning the corresponding facilities.

Utilization of Solar Energy on 10 GT Fishing Vessels as Alternative Electricity Facilities at PPI Cituis Tangerang Regency

The purpose of this study is to design or design a 10 GT fishing vessel for the territorial waters of Pakuhaji District, Tangerang Regency. This research is expected to provide benefits in getting the shape and size of fishing vessels that are suitable for the territorial waters, providing input to the Tangerang Regency Government, especially the Fisheries Service in the context of increasing the empowerment of fishing communities. The designed ship is planned to use materials / raw materials made of aluminum, fiberglass or wood. Material / raw material for the ship is still easy to find in the Greater Jakarta area. The design of the fishing vessel includes determining the basic size, making line drawings, preparing general plans, construction designs, stability diagrams, engine power, electricity, tonage and stability. The results of the maximum electricity demand is 495 Watt, 2 solar panels, and 3 batteries / batteries

Relative Tsunami Inundation Risk Assessment Considering Location of Local Government Buildings and Case Studies of Layout Plan Used for Disaster Countermeasure Alternative Facilities after the 2011 Great East Japan Earthquake

Relative Tsunami Inundation Risk Assessment Considering Location of Local Government Buildings and Case Studies of Layout Plan Used for Disaster Countermeasure Alternative Facilities after the 2011 Great East Japan Earthquake

Built Environment Airborne Infection Control Strategies in Pandemic Alternative Care Sites.

To identify design strategies utilized in airborne infection isolation and biocontainment patient rooms that improve infection control potential in an alternative care environment. As SARS-CoV-2 spreads and health care facilities near or exceed capacity, facilities may implement alternative care sites (ACSs). With COVID-19 surges predicted, developing additional capacity in alternative facilities, including hotels and convention centers, into patient care environments requires early careful consideration of the existing space constraints, infrastructure, and modifications needed for patient care and infection control. Design-based strategies utilizing engineering solutions have the greatest impact, followed by medical and operational strategies. This article evaluates infection control and environmental strategies in inpatient units and proposes system modifications to ACS surge facilities to reduce infection risk and improve care environments. Although adequate for an acute infectious disease outbreak, existing capacity in U.S. biocontainment units and airborne infection isolation rooms is not sufficient for widespread infection control and isolation during a pandemic. To improve patients' outcomes and decrease infection transmission risk in the alternative care facility, hospital planners, administrators, and clinicians can take cues from evidence-based strategies implemented in biocontainment units and standard inpatient rooms. Innovative technologies, including optimized air-handling systems with ultraviolet and particle filters, can be an essential part of an infection control strategy. For flexible surge capacity in future ACS and hospital projects, interdisciplinary design and management teams should apply strategies optimizing the treatment of both infectious patients and minimizing the risk to health care workers.

Maintaining Safety Standards While Building an Urban Alternate Care Facility in a Global Pandemic.

The Philadelphia region responded to the shortage of health care resources imposed by the 2020 COVID-19 pandemic through the creation of the COVID-19 Surge Facility at Temple University's basketball arena. The facility was designed as an acute care medical unit capable of supporting COVID-19 patients who were stable enough to be released from the intensive care unit but not ready for discharge home. Safety was optimized through the application of recommendations from the Joint Commission and Centers for Disease Control and Prevention (CDC). The safety goals include those established by the Joint Commission with regard to patient identification, security, identification of patient safety threats, communication, fire safety, laboratory services, and pharmacologic services. COVID-19-specific goals outlined by the CDC also are addressed and include recommendations for facility layout, managing staff respite and personal protective equipment, patient care areas, supply storage, airflow, and patient hygiene. Although the goal was to meet all of these recommendations, some were not possible due to the austere environment of the arena. However, these shortcomings were met with innovative solutions that provided the next best options. By sharing these experiences, the authors hope to guide future alternate care facilities in their efforts to optimize safety.

Future DNA computing device and accompanied tool stack: Towards high-throughput computation

DNA Computing is still at its infant stage since its emergence. Multiple aspects of DNA computing have been studied but most of the research results have not been applied to the reality. It has been proved to exhibit high data storage density and support efficient random data access. It also shows the potential to provide alternative facilities for general computing. Especially, its natural double-helix structure enables it to be the best fit for high-throughput parallel computing. However, the underlying rationale of DNA computing is different from the existing electronic computing devices. Therefore, the popularity of DNA computing device is limited by its accessibility. We propose our designs for high-throughput DNA computing including DNA computing circuits, system architecture, and its compiler. We also demonstrate its feasibility using a simple example through simulation experiments. The objective of this framework is to bridge the gap between the existing computer developer community and the DNA computing biotechnology.

Improving behavior characteristics and stress indices of gestating sows housed with group housing facility.

This study was conducted to investigate the effects of group-housing facility (GHF), compared to an individual confinement stall (CON), on the reproductive performance, behavior, and stress hormones of gestating sows. A total of 50 primiparous sows (Landrace × Yorkshire) were randomly allocated into either CON (n = 25) or GHF (n = 25) during the gestation period. One week before parturition, the sows were transferred into conventional farrowing crates, and cross-fostering was conducted within 1 d of delivery. Blood was collected for analyses of stress indices at 75 d of gestation and postpartum. Reproductive performance was estimated during the period of birth to weaning. Behavior patterns were identified at 90 d of gestation. Litter size was not different between the CON and GHF treatments. Weaning to estrus interval, however, tended to be lower in the GHF than in the CON (p < 0.1). Activity, treating, belly nosing, and exploring behaviors were observed only in the GHF group, whereas rubbing was shown only with the CON. Serum cortisol concentration was lower in the GHF than in the CON at 75 d of gestation (p < 0.05). Sows housed in the GHF showed lower epinephrine and norepinephrine concentrations than those housed in the CON at postpartum (p < 0.05). The GHF sows demonstrated more natural behavior characteristics associated with stress relief than the CON sows with no adverse effects on reproductive performance. Therefore, these results suggest that GHF could be applied as an alternative housing facility to improve animal welfare on swine farms.

Paediatric emergency department visits for non-urgent conditions: Can family medicine prevent this?

Background In Turkey, family physicians serve only during office hours, while emergency services have 7/24 free access. Non-urgent patients commonly use Paediatric Emergency departments (PEDs). In Turkey, there is little evidence as to why emergency services are used instead of family medicine for non-urgent paediatric healthcare. Objectives To evaluate the causes and factors affecting non-urgent PED visits. To determine the reason for non-use of family medicine for non-urgent paediatric healthcare. Methods We conducted a cross-sectional study at Gaziantep University PED between April and May 2019. We administered a questionnaire to the parents of children (from one month to 16 years) triaged to non-urgent (level-5) using a 5-level triage system. Results A total of 457 parents were surveyed. The average patient age was 6.5 ± 4.7 years and 24.5% had a chronic disease. One-third of the parents (33.7%) considered their children’s condition ‘very urgent’. The most important reason for preferring PED (42.5%) instead of family physician or alternative health facilities was the thought that the condition of children would worsen. Two hundred fifty-three (55.4%) of the patients presented outside working hours. Although 58.9% of parents were satisfied with the family physician, most (67.8%) stated that they preferred other specialists rather than family physicians when the child had health problems. Fathers who were primary school graduates were more likely to prefer other specialists than family physicians. Conclusion Parents’ perception of urgency and the thought that their child’s condition will worsen are the main reasons for non-urgent using PED.

Development and Implementation of an Alternate Care Site During the COVID-19 Pandemic.

IntroductionWith the rampant spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the subsequent pandemic of coronavirus disease 2019 (COVID-19), the need for medical resources has never been greater. In recent history, the deployment of surge medical facilities and their importance in improving the provision of crisis care became relevant. The primary objective of this study was to describe the development and implementation of an alternate care site (ACS) during the COVID-19 pandemic.MethodsThis was a retrospective, single-center study that was conducted between April 7, 2020, and May 26, 2020, of adult patients from a primary facility admitted to an ACS, labeled Staten Island University Hospital East (SIUH-E). These select patients met specific inclusion criteria for SIUH-E before transfer.ResultsDuring the operational course of SIUH-E, 813 patients were screened and 203 patients were accepted for transfer. Of the patients admitted to SIUH-E, 120 (59%) were male. The mean age was 63 years (SD = 13.91). The mean length of stay was 3.93 days (SD = 3.94). Among discharged patients, 179 (88%) were discharged to home or another long-term facility, whereas 24 (12%) patients required a transfer back to the main campus.ConclusionsIn this study, we describe the development and implementation of an alternate care surge facility during the COVID-19 pandemic. SIUH-E played a vital role in effectively caring for select COVID-19 patients, which allowed the primary facilities to treat a greater volume of higher acuity patients. The combined efforts of the state and hospital were able to create and sustain a safe, practical alternative care facility.

Marginal Impacts of Park-and-Ride Facilities in the Twin Cities Region of the US

Understanding the marginal impacts of park-and-ride (P&amp;R) transit facilities can help in planning an efficient transit system. However, these marginal impacts are not well established in a U.S. context. This study helps to fill this gap using a survey of P&amp;R users from the Twin Cities region in which the questions were specifically designed to determine how respondents would react to the removal of a P&amp;R facility. The responses allow for an estimation of the net (or marginal) impact on ridership and vehicle miles traveled (VMT) directly attributable to the presence of P&amp;R facilities. Over 80% of the surveyed P&amp;R users would only use transit if they had access to a P&amp;R facility. They would generate an average of 19 additional VMT per round trip without a P&amp;R option. If access to their current P&amp;R facility was removed but they were given the option to choose an alternative facility, the respondents who would quit using transit dropped to 32% with an average of 10 additional VMT generated, although these numbers vary to some degree when broken down by specific P&amp;R facilities.

Liquidity from two lending facilities

We examine how the threat of disclosure (stigma) changes the quality of banks that approach emergency lending facilities. We study a financial crisis where two confidential facilities were available to banks. Unexpectedly, a partial list of bank names from one facility was published, suddenly stigmatizing that facility. We find that the composition of banks that approached each facility changed, where the newly stigmatized facility attracted weaker banks that maintained smaller liquidity buffers, while the alternative confidential facility attracted both weaker and stronger banks. Our results shed light on how stigma prevents regulators from reaching many banks to inject critical liquidity into the banking sector during a crisis.

Redesigning Taman Hutan Kota PLN Medan (City Park) According to People’s Preferences

Taman Hutan Kota PLN Medan is one of important part from the city, if the park managed properly it would give a good impact to increase the quality of public space which is lead to make a positive and better contribution to people's lives who lived in the busy city like Medan. However, in reality, Taman Hutan Kota PLN cannot make a good performance as its function as public space and urban forest. To increase the level of people's happiness and develop urban quality at Medan, it is necessary to redesign Taman Hutan Kota PLN. The redesign’s purpose is to fulfill the people’s needs and hopes to this park and make better, satisfying, and responsive facilities to the user. Redesigning Taman Hutan Kota PLN will be based on people's preferences, perceptions, and perspectives. The preference, people's opinions, and documentation on the field will help us to discover what is the real reality and important resource for redesigning process so that the final result of the new Taman Hutan Kota PLN design can be a better park not only as public space and open green space but also as an alternative recreation facility for people in Medan.

Regional Flexible Surge Capacity—A Flexible Response System

Surge capacity is the ability to manage the increased influx of critically ill or injured patients during a sudden onset crisis. During such an event, all ordinary resources are activated and used in a systematic, structured, and planned way to cope with the situation. There are, however, occasions where conventional healthcare means are insufficient, and additional resources must be summoned. In such an event, the activation of existing capabilities within community resources can increase regional surge capacity in a flexible manner. These additional resources together represent the concept of Flexible Surge Capacity. This study aims to investigate the possibility of establishing a Flexible Surge Capacity response system to emergencies by examining the main components of surge capacity (Staff, Stuff, Structure, System) within facilities of interest present in the Western Region of Sweden. Through a mixed-method and use of (A) questionnaires and (B) semi-structured key-informant interviews, data was collected from potential alternative care facilities to determine capacities and capabilities and barriers and limitations as well as interest to be included in a flexible surge capacity response system. Both interest and ability were found in the investigated primary healthcare centers, veterinary and dental clinics, schools, and sports and hotel facilities to participate in such a system, either by receiving resources and/or drills and exercises. Barriers limiting the potential participation in this response system consisted of a varying lack of space, beds, healthcare materials, and competencies along with a need for clear organizational structure and medical responsibility. These results indicate that the concept of flexible surge capacity is a feasible approach to emergency management. Educational initiatives, drills and exercises, layperson empowerment, organizational and legal changes and sufficient funding are needed to realize the concept.

Mitigation of the Health and Environmental Impact of Waste Water Treatment Plant in Oman

Developing countries' experience is a huge gap in the coverage of collection-system and domestic wastewater treatment. Wherever the wastewater treatment facilities are available, they are running below the design standards. This leads to the discharge of pollutants into the natural water bodies and creating a negative impact on the environment and human health as well. Odor nuisance has become a major environmental issue worldwide with increasing public demand for better control of odor emissions from the municipal wastewater treatment facilities. Odor get affects the population directly and there is a trend that more and more peoples are becoming less tolerable with more odor emissions. Bad smell is often an indicator of the public potential health risk. Performance assessment of Haya water treatment plant in Manuma Village has been done. The main objective of this study is to assess the performance of the treatment plant with respect to produce high quality of treated water and reduce odor complaints. Influent and effluent samples were collected at critical treatment steps of the plant and analyzed for chemical, physical and microbial parameters. The study will be used to monitor the Manuma wastewater treatment plant and compare its performance to that one that uses the Sequence Batch Reactor (SBR) process. Study shows that process with wet scrubber technology will be the suitable treatment process to create an environment without any health-related issues, and selecting these alternative treatment facilities with the latest technology will lead to creating high-quality of treated water without any odor issues.

Spatial Organization of Energy Facilities: Specific Features and Development Prospects (on the Example of Belarusian Practice

The paper considers spatial organization of energy facilities with an emphasis on modern practice of the Republic of Belarus. The efficiency of enterprise operation in any industry including power industry is largely due to their architectural and planning organization. Knowledge of mechanisms and specific features of the changes taking place here makes it possible to justify a promising strategy for project activities, and therefore, it allows to manage development processes of the industry and thereby avoid many negative consequences. Energy facilities are a typological unit of industrial architecture, their formation has been started due to transition of industrial production to electric energy. Today the typology shows functional approach in architectural shaping, it includes a fairly large variety of constituent units and demonstrates a tendency towards diversification. In Belarus energy facilities in the architectural aspect of their classification are limited mostly to thermal power plants operating on different types of fuel. Currently the diversification is developing in the following areas: construction of hydropower facilities (small plants on reservoirs, medium power plants, low-pressure plants, run-of-the-river hydraulic power stations), alternative energy (wind power stations, photovoltaic power stations and biogas plants) and conventional energy (thermal power plant, mini-combined heat and power plant operating on renewable fuel). The results of Belarusian practice in construction of all types of facilities (hydropower, alternative and conventional energy), peculiarities of the architectural and planning organization of facilities at the current stage, correlation with global trends in the development of industrial architecture have been characterized in the paper. The paper has determined typological features of alternative energy facility architecture, opportunities and directions for implementation of architectural approaches, problems and prospects to develop scientific support for the project process.

Telemedicine Facilitation of Transfer Coordination From Emergency Departments

Study objectiveInterhospital transfers are costly to patients and to the health care system. The use of telemedicine may enable more efficient systems by decreasing transfers or diverting transfers from crowded referral emergency departments (EDs) to alternative appropriate facilities. Our primary objective is to describe the prevalence of telemedicine for transfer coordination among US EDs, the ways in which it is used, and characteristics of EDs that use telemedicine for transfer coordination.MethodsWe used the 2016 National Emergency Department Inventory–USA survey to identify telemedicine-using EDs. We then surveyed all EDs using telemedicine for transfer coordination and a sample of EDs using telemedicine for other clinical applications. We used a multivariable logistic regression model to identify characteristics independently associated with use of telemedicine for transfer coordination.ResultsOf the 5,375 EDs open in 2016, 4,507 responded to National Emergency Department Inventory–USA (84%). Only 146 EDs used telemedicine for transfer coordination; of these, 79 (54%) used telemedicine to assist with clinical care for local admission, 117 (80%) to assist with care before transfer, and 92 (63%) for arranging transfer to a different hospital. Among telemedicine-using EDs, lower ED annual visit volume (odds ratio 5.87, 95% CI 2.79 to 12.36) was independently associated with use of telemedicine for transfer coordination.ConclusionAlthough telemedicine has potential to improve efficiency of regional emergency care systems, it is infrequently used for coordination of transfer between EDs. When used, it is most often to assist with clinical care before transfer.

Alternative Care Sites: An Option in Disasters.

During the current COVID-19 pandemic, the limited surge capacity of the healthcare system is being quickly overwhelmed. Similar scenarios play out when an institution’s systems fail, or when local or regional disasters occur. In these situations, it becomes necessary to use one or more alternative care sites (ACS). Situated in a variety of non-healthcare structures, ACS may be used for ambulatory, acute, subacute, or chronic care. Developing alternative care facilities is the disaster-planning step that moves communities from talking to doing. This commitment pays real dividends if a disaster of any magnitude strikes. This paper discusses the basic criteria for selecting, establishing and ultimately closing an ACS, difficulties of administration, staffing, security, and providing basic supplies and equipment.