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In Part 1, I discussed the importance of having a contingency plan in the event of a wide spread disaster affecting the correctional facility and surrounding area. When developing a disaster response plan the plan should consider the fact that the disaster will most likely affect the surrounding communities and may extend hundreds of miles in all directions. Now that those barriers have been crossed does the facility house special needs inmates such as; mental health inmates, geriatrics, paraplegics, inmates with specific medical needs, or have obstetrical needs. Any time an inmate is moved outside the secure confines of the institution it presents a risk. Moving inmates to another location presents other issues which are more easily dealt with when addressed in the preplanning.
Facility security is a concern of varying proportions depending on the location of the facility. Bruce Kovach is a Federal Bureau of Prisons Mission Analyst assigned to the ESF #13 National Coordination Center.
The primary purpose of UBL E-Commerce is to secure customers’ financial information, employees’ working directories and life safety. Founded in 2004, with the aim to provide buying and selling facilities to the existing consumers of UBL over the internet.
UBL Net Banking (NB) is Pakistan’s first E-Commerce Portal provided by any financial institution.
This is a strategic product that offers the consumer to use UBL Orion from all over the Pakistan without using any computer or even mobile. Emergency response plan is the immediate response, which is performed to the occurred incident.
The response procedure of ERP should include the protection of employees first, containment of the incident second and assessment of the situation third.
ERP should include the lists of roles and responsibilities, tools and equipment, resources, actions and procedures.
CMT is responsible for making high-level decisions, which might be related to the internal staff, external staff, vendors and contractors. An Incident Response Team is established to provide a quick, effective and orderly response to computer related incidents such as virus infections, hacker attempts and break-ins, improper disclosure of confidential information to others, system service interruptions, breach of personal information, and other events with serious information security implications. The Incident Response Team is authorized to take appropriate steps deemed necessary to contain, mitigate or resolve a computer security incident. The Incident Response Team will subscribe to various security industry alert services to keep abreast of relevant threats, vulnerabilities or alerts from actual incidents. The immediate actions that should be executed in any of the above emergency are given below. The Emergency Response and Disaster Recovery Team is a single team that would address the immediate first response as well as long term needs during an emergency. The Emergency Response and Disaster Recovery Team, includes a Fire Warden, Deputy Fire Wardens and Searchers, and act as a first response to an immediate emergency that affects the safety and well being of staff.
Security Focal Points are the primary contacts with UBL Security and Fire and Safety regarding emergency conditions and information.  The Security Focal Points and alternates are also designated with updating and maintaining information concerning the Emergency Plan and related activities. In the event of fire or fire alarm, ascertain the location of the fire and direct the evacuation of the floor in accordance with directions received from the Fire Command Station via the loudspeakers. The security system includes closed circuit television (CCTV) cameras, door contacts, magnetic locks, and perimeter and interior motion detectors. The UCI O&M Plan is designed to minimize the possibility of accidental disturbance of asbestos-containing materials and to protect UCI workers and building occupants who must work around these materials. The UCI O&M Plan follows a systematic approach to document UCI's intentions and to provide an inter-disciplinary approach to the protection of the building occupants and employees. Asbestos-Containing Construction Material (ACCM): Any manufactured construction material which contains more than one tenth of 1 percent asbestos by weight. Asbestos Coordinator : The person that exercises control over management and recordkeeping functions relating to UCI in which activities covered by this program take place. Certified Asbestos Consultant: An asbestos consultant certified by the Division of Occupational Safety and Health (DOSH) pursuant to 8 CCR 1529, Section (q). Encapsulation: Asbestos-containing material coated with a penetrating or bridging sealant to prevent release of asbestos fibers into the air.
Enclosure: Asbestos-containing material physically separated from the building environment by means of erecting permanent airtight barriers.
Friable: Any material that, when dry, can be crumbled, pulverized, or reduced to powder by hand pressure. Nonfriable: A material which, when dry, may not be crumbled, pulverized, or reduced to powder by hand pressure.
Removal: The asbestos-containing material is removed from UCI buildings by qualified professionals and, if applicable, state licensed and trained personnel and disposed of by burial in a site specifically approved for asbestos.
Staff Support Personnel: Personnel include employees from Facilities Management staff or contractors acting on behalf of UC Irvine.
Advance partnering with the Asbestos Coordinator on all construction and renovation activities. Advance partnering with the Asbestos Coordinator on all construction, renovation, maintenance, or equipment repair work. Informing the Asbestos Coordinator when damage to ACM is observed or when debris needs to be cleaned up. Avoiding patch or repair of any damaged ACM until the Asbestos Coordinator has assessed the ACM.
The UCI Operations and Maintenance Plan has a provision for notifying UCI building occupants of the presence of asbestos-containing materials.
EH&S notifies building occupants of the presence of asbestos in buildings on an annual basis by sending out an Asbestos Notification document to employees. UCI personnel often contact EH&S to ask if a material contains asbestos in their building. Definition: Controlled area stickers are for those areas generally accessed by custodians, maintenance workers or contractors but not by the general public or students. Purpose: The purpose of controlled area stickers is to inform workers, before they enter an area to perform any work, that their activities may disturb asbestos materials.
Placement: Controlled area stickers will be placed on all entrances to mechanical rooms, crawl spaces, attics, pipe chases, and pipe tunnels known to contain asbestos.
An inspection of all recorded ACM will be conducted every three years to monitor the condition of the materials. An air monitoring program will provide useful supplemental information to the inspection program. Inspect all friable ACMs and non-friable ACMs for damage or deterioration routinely and report findings to the Asbestos Coordinator. Inform the Asbestos Coordinator when damage to the ACM is observed or when debris needs to be cleaned up.
Collect air samples if there is a release or suspected release of asbestos fibers in an area.

The O&M procedures are designed to structure a program for handling specific types of asbestos-containing materials (ACM) and activity areas. Wear full-body disposable protective clothing and a powered air-purifying respirator or, at a minimum, a half-face, dual cartridge respirator equipped with HEPA filters and NIOSH-approved for protection from asbestos fibers.
Seal off all HVAC ducts, windows and any other sources of air circulation through the work area. Thoroughly dampen all debris with amended water from the clean up and repair work, seal the debris in two six-mil polyethylene bags (or two layers of six-mil plastic sheeting), label properly per OSHA, EPA and DOT and dispose of the bags through the EH&S Hazardous Waste Facility located on the UCI campus. When performing the repair work, workers should take precautions to minimize disturbances of the asbestos-containing material. Work area preparation and cleaning shall be in accordance with the requirements previously listed in this section.
Repair minor dents and tears in the protective jacket with duct tape or bridging encapsulant with glass cloth reinforcement. Wrap moderately water damaged or contact damaged pipe insulations with new protective jackets, or reinsulate affected areas. Monitor the condition of the asbestos-containing materials and non asbestos-containing materials. Work area preparation and cleaning shall be in accordance with the requirements listed previously.
On a temporary basis, the exposure potential of fireproofing can be reduced by constructing airtight walls and ceilings around the ACM, enclosing the exposed area.
Fireproofing may be sprayed with an encapsulant if the fireproofing is well bonded to its substrate and is less than one inch thick. If work involves hanging ducts, conduit or pipes, etc., from surfaces sprayed with fireproofing, the asbestos material around the area may have to be abated prior to the work. If the plaster is in good condition, with no delamination, deterioration or signs of water damage, it should be left alone but carefully monitored for signs of change in status. Avoid disturbing acoustical plaster by not hanging plants, drilling holes in the ceiling, and moving furniture, etc. Fiber released from cementitious (nonfriable) materials is normally extremely low unless these materials are broken, drilled, sanded, or otherwise disturbed. UCI personnel in Facilities Management and Telecommunications sometimes displace asbestos containing ceiling panels. When moving ceiling panels in occupied areas, caution should be taken not to alarm the building occupants of asbestos hazards.
If a large number of ceiling panels are damaged during the controlled displacement, notify EH&S so that a proper cleanup is conducted and air monitoring can be performed if necessary.
All work shall be performed in strict accordance with all applicable federal, state, and local regulations, standards, and codes governing asbestos abatement, and any other trade work done in conjunction with the abatement.
The most recent editions of any relevant regulation, standard, document, or code shall be in effect.
Scope of Practice The goal of the Family Medicine clerkship is for students to acquire a wide range of knowledge, skills and attitudes necessary for the recognition, understanding, and management of the common and unique health care problems in primary care. Approach to Family MedicineFamily Medicine is quite unique than other areas of medicine as it allows you to build relationships with families, and get to know their concerns overtime. Please bear in mind that with most clinics using electronic medical records, the patient’s demographics, PMHx, FHx, and allergies may already be in the system. Sample NoteFamily Medicine clinics may use paper SOAP notes or online EPR resources to document patient encounters. The basis of ERP is the risks, which is identified by the company during risk assessment phase. Various roles and responsibilities should be defined for each member of the team and each team member should receive specific training according to their concerned roles and responsibilities. It is also responsible for determining the most appropriate responses to situations as they occur. The Incident Response Team’s mission is to prevent a serious loss of profits, public confidence or information assets by providing an immediate, effective and skillful response to any unexpected event involving computer information systems, networks or databases. The Team is responsible for investigating suspected intrusion attempts or other security incidents in a timely, cost-effective manner and reporting findings to management and the appropriate authorities as necessary.
Make sure that everyone has arrived there safely; use attendance register to count the employees. The UCI Operations and Maintenance Plan will remain in effect until all asbestos-containing materials (ACM) have been completely removed from all UCI facilities. It should be noted that under this alternative the exposure potential remains and the potential liability to UCI should be considered when deferring action. This includes completion of the Job Request and Authorization Form for Maintenance Projects-FM Trades Group .
EH&S reviews existing data, may collect a sample of the material and then notifies the building occupant of the results. Usually, the entrance to these areas is kept locked to prevent unauthorized personnel from entering.
The custodial staff, knowing that the area they are going to clean contains asbestos materials, will use proper techniques such as wet mopping and HEPA vacuuming. This effort will help ensure that any ACM damage or deterioration is detected and the proper preventive or corrective action is taken.
However, air monitoring is used only as a supplemental management tool and not as a replacement for the physical and visual inspection.
This system ensures proper guidance for activities or projects that might disturb ACMs by requiring a detailed analysis of the scope of the project.
The application asks for information on the schedule and location of the project, a description of the work, and its potential to affect ACM. However, contract personnel engaged to perform O&M procedures and work practices are required to follow the elements of this section, as applicable, in addition to all applicable federal, state, and local regulations, standards, and codes governing asbestos management. The purpose of the program is to minimize the exposure potential of a specific type of ACM or activity area by addressing and organizing special procedures to: 1) clean up and properly dispose of asbestos fibers previously released, 2) repair damaged ACM, 3) prevent further disturbance or damage of the ACM, and 4) monitor conditions until removal.
Because of the high costs associated with these techniques, they shall generally be considered as temporary control techniques rather than alternatives to removal. Vacuum all the carpets throughout the building with a High Efficiency Particulate Air (HEPA)-filtered vacuum cleaner; NEVER use a conventional cleaner. The plastic should be one foot in length and width for each foot above the floor where the work is to be conducted, but never less than six feet by six feet. If an outside contractor conducts the cleanup, it is that contractor's responsibility to dispose of the debris waste according to hazardous waste disposal regulations.
Duct tape should only be used for temporary control until the bridging encapsulant is installed.
This will greatly assist in routine monitoring and detection of potential ACM deterioration.
This process will disturb the ACM through contact, vibration, etc., so the same isolation and control techniques used for removal projects must be incorporated into this type of work.

If the remaining fireproofing is well bonded to its substrate, it can then be encapsulated; however, the source of the water must be eliminated. Work area preparation and cleanup for all types of maintenance and repair work shall be in accordance with the requirements listed previously in this section.
During disturbance, the materials should be thoroughly dampened followed by a thorough HEPA equipped vacuuming to collect fibers being released. Only personnel trained in Asbestos Awareness and equipped with proper respiratory protection (issued by EH&S) and disposable coveralls should displace these panels. When moving asbestos-containing ceiling panels in small enclosed offices, ask the occupant to leave the space until the required work is complete. Where conflict among the requirements or with these specifications exists, the most stringent requirements shall apply. The asbestos section of the Hazard Communication for Trades, Building Facilities and Custodial Workers is similar in scope but targets building maintenance workers and introduces personal protective equipment, project protocol, and the work permit system. Also, an EH&S informational pamphlet is made available to attendees of the training sessions.
Editing provided by Jessica O'Neil, PA-S1, McMaster PAEP Class of 2015, was greatly appreciated.
These learning opportunities arise in the context of long‐term relationships with patients and families across a breadth of health care issues, and it is the longitudinal, comprehensive nature of Family Medicine that makes it unique. Also, it is likely that in a GP’s clinic, patients will bring forward more than one concern.
It may be useful for some patients to update their social history, or medication list during their visit. For example, if fire breaks out, the emergency response to this incident is to evacuate the building, call the fire department and in the meanwhile try to control the fire by the use of fire extinguisher.  There may be several kinds of risks that could occur and they may also require emergency response plan. The leader of the ERT is responsible for coordination and activation of the emergency response and also for notification to the concerned authorities.
EH&S periodically holds open forums to notify building occupants of the presence of asbestos prior to the initiation of building renovation projects in order to answer any questions the occupants might have. But in other cases, the entrance may be a two-foot by two-foot panel accessing the bathroom pipe chase. Air monitoring can only detect an asbestos fiber release after it has occurred and therefore, will not serve as an effective preventive measure. The system also necessitates active involvement of the UCI Asbestos Coordinator, as well as, the other divisions within EH&S by requiring feedback from the project originator. This procedure demands that the project manager research existing records and additionally request the assistance of EH&S to identify and locate ACM. All removal work shall be performed by AHERA-trained personnel wearing respirators that provide adequate protection from airborne asbestos fiber concentrations existing in the work area.
Where this work area is confined by walls, workers should extend the plastic up the wall at least one foot and seal the top edge with duct tape. If the glove bag removal is not feasible, wrap uncovered pipe insulations with protective jackets consisting of bridging encapsulant with glass cloth reinforcement.
More severely damaged pipe insulations may require removal by glove or gross containment techniques. As with enclosure, isolation and control techniques used for removal projects must be incorporated into encapsulation work. When the plaster must be disturbed, mist the affected area with amended water (soap and water solution) and use a HEPA vacuum to collect fibers being released. Asbestos ceiling panels should be carefully lifted out of the T-bar and slid gently over on top of the adjacent ceiling panels without breaking or tipping the panel.
All notifications shall be performed in strict accordance with all applicable federal, state, and local regulations, standards, and codes governing asbestos abatement, and any other trade work done in conjunction with the abatement. It is your responsibility to determine the chief complaint for the particular visit, and decide whether the subsequent concerns need to be addressed in the same visit or further appointments need to be organized.
It is better to create common checklist for all risks rather than to create separate ERP for every risk. The leader of the ERP should also be a member of the Crisis Management Team and should report the team through out the emergency response. The Asbestos Notification states that a campus-wide asbestos in buildings survey has been conducted and the results are available for review. If this work includes removal or repair of asbestos-containing materials, the worker must obtain approval from the campus Asbestos Coordinator and fill out a Job Request and Authorization Form for Maintenance Projects-FM Trades Group . The inspection will comprise of a visual and physical evaluation of the ACM to determine its current condition and physical characteristics.
Baseline airborne asbestos fiber levels should be established; a representative number of air samples should be collected throughout each building during normal operating hours. In order for the system to be effective, it needs to be activated at the point where projects are generated or initiated.
Discard vacuum bags and filters in sealed plastic bags according to EPA regulations for disposal of asbestos waste.
Enclosure of a large area often requires such effort and expense that removal is a more cost effective and practical solution. Test results have shown that, due to the impact of the spray, spraying with an encapsulant can entrain into the air more fibers than a gross wet removal project. Caution should be taken to make sure that the ceiling panel covers are not damaged by abrasion.
Subsequent air monitoring should be conducted if there is a release or suspected release of asbestos fibers. Furthermore, EH&S is involved with the authorization process and is able to impose conditions with respect to health and safety, suggest work practices, and recommend personal protective equipment.
If pieces of the ceiling panel fall to the ground, carefully wipe the area with a damp cloth and place large debris of the panel in a scaled plastic bag and notify EH&S to pick up the debris for proper disposal. Patients’ conditions could range from common cold (pharyngitis) to acute myeloid leukemia. Because Family Medicine encompasses a wide variety of clinical conditions and occurs in multiple different settings, not all conditions will be encountered in a single rotation. Discard cloths and mop heads in sealed plastic bags according to EPA regulations for disposal of asbestos waste. The purpose of the rotation is to develop basic skills in clinical assessment, diagnosis, and management, and to acquire the knowledge and attitudes that underlie Family Medicine.
As their student, you may be required to attend their clinic hours, as well as, the hospital hours.

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