Thoroughly revised, this book provides the reader with an understanding of the principles and practices of testing and balancing (TAB) heating, ventilating, and air conditioning (HVAC) air and water ...systems. For the novice and the experienced testing and balancing technician, it is a field reference book of procedures, equations, and information tables.
Divided into five parts, Part I has general and specific balancing procedures for constant air volume systems, variable air volume systems, return air systems, and fans and fan performance. Part II covers testing and balancing fume hood systems and cleanrooms, commissioning HVAC systems, centrifugal pumps and pump performance, analog and digital controls and water balancing procedures using flow meters, system components, and temperatures. Part III covers fans, pumps, air distribution, water distribution, motors, electrical, fluid flow, psychrometrics, refrigeration, and instrument usage and care. Part IV includes equations and tables. New to this edition, Part V has information and additional test and balance procedures and graphics for chapters 1-7 and 13-14. TAB Data and Test forms are in the new addendum as well.
Provides the readers with revised information about the principles and practices of testing and balancing (TAB) heating
Represents a field reference guide for both the novice and experienced testing and balancing technician
Includes a new section with information and additional test and balance procedures and graphics
Widespread shortages of personal protective equipment (PPE) during the COVID-19 pandemic have placed health care workers at risk and threatened their ability to care for patients.1 Items in shortage ...include disposable filtering facepiece respirators ("N95 masks"), filter cartridges for powered airpurifying respirators, face shields, and surgical scrubs. Many of these shortages reflect fragile international supply chains based on just-in-time manufacturing and lean inventories. Ranney et al. recently identified several promising approaches to improving national coordination of PPE supply,2 but we believe that responses to health care emergencies must also be strengthened at the community level. This is a well-recognized concept in the setting of natural disasters,3 but to our knowledge the role of fabrication of medical products such as PPE by local companies and concerned citizens (including "maker" and 3D printing communities) has not been previously considered for disease pandemics. Local fabrication during the COVID-19 crisis has largely focused on face masks, respirators, and ventilator parts but could extend in future emergencies to stretchers, custom software, and transportation. For such solutions to be useful, they must be informed by regulatory and performance standards, and hospitals must have the data needed for adoption and deployment. Shifting regulatory guidance on PPE, the introduction of products from nontraditional suppliers, and an absence ofscientific data in many guidance documents have raised concerns among health care workers that evolving PPE standards may not be based on rigorous evidence.
More than 40 percent of all reported coronavirus disease 2019 (COVID-19) deaths in the United States have occurred in nursing homes. As a result, health care workers' access to personal protective ...equipment (PPE) and infection control policies in nursing homes have received increased attention. However, it is not known whether the presence of health care worker unions in nursing homes is associated with COVID-19 mortality rates. Therefore, we used cross-sectional regression analysis to examine the association between the presence of health care worker unions and COVID-19 mortality rates in 355 nursing homes in New York State. Health care worker unions were associated with a 1.29-percentage-point reduction in mortality, which represents a 30 percent relative decrease in the COVID-19 mortality rate compared with facilities without these unions. Unions were also associated with greater access to PPE, one mechanism that may link unions to lower COVID-19 mortality rates.
The coronavirus disease 2019 (COVID-19) pandemic continues to devastate US nursing homes. Adequate personal protective equipment (PPE) and staffing levels are critical to protect nursing home ...residents and staff. Despite the importance of these basic measures, few national data are available concerning the state of nursing homes with respect to these resources. This article presents results from a new national database containing data from 98 percent of US nursing homes. We find that more than one in five nursing homes reports a severe shortage of PPE and any shortage of staff. Rates of both staff and PPE shortages did not meaningfully improve from May to July 2020. Facilities with COVID-19 cases among residents and staff, as well as those serving more Medicaid recipients and those with lower quality scores, were more likely to report shortages. Policies aimed at providing resources to obtain additional direct care staff and PPE for these vulnerable nursing homes, particularly in areas with rising community COVID-19 case rates, are needed to reduce the national COVID-19 death toll.
High profile device failures have highlighted the inadequacies of current regulation. Art Sedrakyan and colleagues call for a move to a graduated model of approval and suggest a framework to achieve ...this goal
Background coming from the Formula omittedAr decay chain is considered to be one of the most relevant for the Gerda experiment, which searches for the neutrinoless double beta decay of Formula ...omittedGe. The sensitivity strongly relies on the absence of background around the Q-value of the decay. Background coming from Formula omittedK, a progeny of Formula omittedAr, can contribute to that background via electrons from the continuous spectrum with an endpoint at 3.5 MeV. Research and development on the suppression methods targeting this source of background were performed at the low-background test facility LArGe . It was demonstrated that by reducing Formula omittedK ion collection on the surfaces of the broad energy germanium detectors in combination with pulse shape discrimination techniques and an argon scintillation veto, it is possible to suppress Formula omittedK background by three orders of magnitude. This is sufficient for Phase II of the Gerda experiment.
Policy Points
Reflecting on current response deficiencies, we offer a model for a national contingency supply chain cell (NCSCC) construct to manage the medical materials supply chain in support of ...emergencies, such as COVID‐19. We develop the following:
a framework for governance and response to enable a globally independent supply chain;
a flexible structure to accommodate the requirements of state and county health systems for receiving and distributing materials; and
a national material “control tower” to improve transparency and real‐time access to material status and location.
Context
Much of the discussion about the failure of the COVID‐19 supply chain has centered on personal protective equipment (PPE) and the degree of vulnerability of care. Prior research on supply chain risks have focused on mitigating the risk of disruptions of specific purchased materials within a bounded region or on the shifting status of cross‐border export restrictions. But COVID‐19 has impacted every purchase category, region, and border. This paper is responsive to the National Academies of Sciences, Engineering and Medicine recommendation to study and monitor disasters and to provide governments with course of action to satisfy legislative mandates.
Methods
Our analysis draws on our observations of the responses to COVID‐19 in regard to acquisition and contracting problem‐solving, our review of field discussions and interactions with experts, a critique of existing proposals for managing the strategic national stockpile in the United States a mapping of the responses to national contingency planning phases, and the identification of gaps in current national healthcare response policy frameworks and proposals.
Findings
Current proposals call for augmenting a system that has failed to deliver the needed response to COVID‐19. These proposals do not address the key attributes for pandemic plan renewal: flexibility, traceability and transparency, persistence and responsiveness, global independence, and equitable access. We offer a commons‐based framework for achieving the opportunities and risks which are responsive to a constellation of intelligence assets working in and across focal targets of global supply chain risk.
Conclusions
The United States needs a “commons‐based strategy” that is not simply a stockpile repository but instead is a network of repositories, fluid inventories, and analytic monitoring governed by the experts. We need a coordinated effort, a “commons” that will direct both conventional and new suppliers to meet demands and to eliminate hoarding and other behaviors.
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